code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
CDM,0042T_1,"Computed tomography (CT) of brain blood flow, volume, and timing of flow analysis with contrast",1920.0,1248.0,78.57,1977.6,15
CDM,0055T_1,Musculoskeletal surgical navigational orthopedic operation using imaging guidance,1390.6,903.89,78.57,1432.32,15
CDM,0075T_1,"Insertion of stents into vertebral artery via catheter, open or accessed through the skin including radiologic supervision and interpretation, initial vessel",3150.0,2047.5,78.57,3244.5,15
CDM,0095T_1,Removal of upper spine artificial disc,5735.0,3727.75,78.57,5907.05,15
CDM,0184T_1,Removal of rectal tumor using an endoscope,2650.0,1722.5,78.57,2729.5,15
CDM,01953_1,"Anesthesia for treatment of second and third degree burn, each additional 9% of total body surface area or less",184.8,120.12,14.96,92.4,15
CDM,0198T_1,Measurement of eye blood flow by repeated eyeball pressure assessment,100.0,65.0,45.0,937.2,15
CDM,01996_1,Daily hospital management of continuous spinal drug administration,277.2,180.18,44.58,292.02,15
CDM,0200T_1,"Injections of one side of sacrum for enlargement, 1 or more needles, accessed through the skin",1662.3,1080.5,78.57,4551.79,15
CDM,0201T_1,"Injections of both sides of sacrum for enlargement, 2 or more needles, accessed through the skin",2555.0,1660.75,78.57,4551.79,15
CDM,0207T_1,Drainage of one eyelid glands using heat and pressure,923.07,600.0,44.89,950.76,15
CDM,0213T_1,"Injections of upper or middle spine joint or nerves using ultrasound guidance, single level",787.5,511.88,78.57,811.13,15
CDM,0214T_1,"Injections of upper or middle spine joint or nerves using ultrasound guidance, second level",404.3,262.8,78.57,416.43,15
CDM,0215T_1,Injections of upper or middle spine joint or nerves using imaging guidance,404.3,262.8,78.57,416.43,15
CDM,0216T_1,"Injections of lower or sacral spine joint or nerves using ultrasound guidance, single level",714.0,464.1,78.57,735.42,15
CDM,0217T_1,"Injections of lower or sacral spine joint or nerves using ultrasound guidance, second level",357.0,232.05,78.57,367.71,15
CDM,0218T_1,Injections of lower or sacral spine joint or nerves using imaging guidance,357.0,232.05,78.57,367.71,15
CDM,0219T_1,Insertion of upper spine facet joint implants,4585.0,2980.25,78.57,4722.55,15
CDM,0220T_1,Insertion of middle spine facet joint implants,4585.0,2980.25,78.57,4722.55,15
CDM,0222T_1,Insertion of spinal facet joint implants,1588.0,1032.2,78.57,1635.64,15
CDM,0223U_1,"Test for detection of respiratory disease-causing organisms from back of nose and throat (nasopharynx) specimen, 22 target organisms including severe acute respiratory syndrome coronavirus 2",1042.0,677.3,78.57,4342.85,19
CDM,0232T_1,Harvest and injections of platelet rich plasma using imaging guidance,1000.0,650.0,78.57,1030.0,15
CDM,0234T_1,"Catheter removal of plaque from kidney artery, accessed through the skin or open procedure including radiological supervision and interpretation",3400.0,2210.0,78.57,4993.01,15
CDM,0253T_1,"Insertion of eye fluid drainage device, internal approach",2528.4,1643.46,78.57,2604.25,15
CDM,0271T_1,Revision or removal of carotid sinus baroreflex activation device pulse generator,496.0,322.4,78.57,516.7,15
CDM,0274T_1,"Removal of bone from upper or middle spine for decompression of nerve tissue using imaging guidance, accessed through the skin",4300.0,2795.0,78.57,4429.0,15
CDM,0275T_1,"Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin",5302.65,3446.72,73.6,5461.73,15
CDM,0330T_1,Tear film imaging of one or both eyes,75.0,48.75,33.64,78.57,15
CDM,0338T_1,Destruction of nerves of arteries of both kidneys accessed through the skin with fluoroscopy and radiological supervision and interpretation,950.0,617.5,78.57,2362.13,15
CDM,0339T_1,Destruction of nerves of arteries of one kidney accessed through the skin with fluoroscopy and radiological supervision and interpretation,455.0,295.75,78.57,2848.14,15
CDM,0394T_1,"High dose rate electronic brachytherapy, external",523.0,339.95,78.57,538.69,15
CDM,0395T_1,"High dose rate electronic brachytherapy, internal",1397.0,908.05,78.57,1438.91,15
CDM,0402T_1,Collagen cross-linking treatment of disease of cornea,4674.0,3038.1,73.6,4814.22,15
CDM,0408T_1,Insertion or replacement of pulse generator and electrodes of heart contractility modulator system,2105.0,1368.25,78.57,2168.15,15
CDM,0412T_1,Removal of pulse generator for heart contractility modulator system,550.0,357.5,78.57,566.5,15
CDM,0413T_1,Removal of electrode for heart contractility modulator system,1480.0,962.0,78.57,1524.4,15
CDM,0421T_1,"TRANSURETHRAL ROBOTIC-ASSISTED WATERJET RESECTION OF PROSTATE, INCLUDING INTRAOPERATIVE PLANNING, ULTRASOUND GUIDANCE, CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE, INCLUDING VASECTOMY, MEATOTOMY, CYST",3170.0,2060.5,73.6,3265.1,16
CDM,0437T_1,Reinforcement of fascia of abdominal wall with synthetic implant,695.5,452.08,78.57,716.37,15
CDM,0441T_1,"Freezing destruction of nerve in leg, accessed through the skin, using imaging guidance",280.0,182.0,78.57,440.55,15
CDM,0446T_1,"Creation of skin pocket and insertion of glucose sensor, with patient training",250.0,162.5,46.23,7533.58,19
CDM,0447T_1,Removal of glucose sensor from skin pocket,200.0,130.0,54.01,240.66,19
CDM,0448T_1,Removal of glucose sensor from skin pocket with creation of new skin pocket and insertion of new glucose sensor,300.0,195.0,77.53,7499.61,19
CDM,0449T_1,Insertion of initial aqueous fluid drainage device into eye,4510.7,2931.96,78.57,4646.02,15
CDM,0479T_1,"Laser destruction of scar tissue, first 100 cm2, or 1% of body surface area of infants and children",475.0,308.75,78.57,532.59,15
CDM,0480T_1,"Laser destruction of scar tissue, each additional 100 cm2, or 1% of body surface area of infants and children",238.5,155.03,78.57,532.59,15
CDM,0483T_1,"Insertion of artificial valve between left heart chambers, accessed through the skin",5800.0,3770.0,78.57,5974.0,15
CDM,0509T_1,Pattern recording of retinal electrical responses to external stimuli with interpretation and report,54.0,35.1,20.24,78.57,19
CDM,0523T_1,Measurement fractional flow reserve in arteries of heart with 3D functional mapping during procedure,580.0,377.0,78.57,597.4,15
CDM,0532T_1,Removal of implantable monitor of monitoring system for deficient blood flow in heart muscle with imaging supervision and interpretation,1275.0,828.75,78.57,1313.25,15
CDM,0563T_1,Evacuation of meibomian tear glands of eyelids of both eyes,2000.0,1300.0,35.58,2060.0,15
CDM,0569T_1,"Repair of valve between upper right and lower right chambers of heart (tricuspid valve) using prosthesis delivered via catheter, accessed through skin; initial prosthesis",4700.0,3055.0,78.57,4841.0,15
CDM,0570T_1,"Repair of valve between upper right and lower right chambers of heart (tricuspid valve) using prosthesis delivered via catheter, accessed through skin; each additional prosthesis",1110.0,721.5,78.57,1143.3,15
CDM,0571T_1,Insertion or replacement of implantable cardioverter-defibrillator system with electrodes under breastbone,1300.0,845.0,78.57,1424.96,15
CDM,0573T_1,Removal of implantable defibrillator electrode from under breastbone,760.0,494.0,78.57,873.81,15
CDM,0575T_1,"In-person programming device evaluation of implantable cardioverter-defibrillator system with electrode under breastbone, with analysis, review and report",180.0,117.0,76.34,187.27,15
CDM,0578T_1,"Remote interrogation device evaluation of implantable cardioverter-defibrillator system with lead under breastbone, with analysis, review and report by healthcare professional",147.0,95.55,35.58,151.41,15
CDM,0580T_1,Removal of implantable defibrillator pulse generator from under breastbone,485.0,315.25,78.57,540.47,15
CDM,0600T_1,"Irreversible electroporation destruction of growths of internal organ, accessed through skin",442.0,287.3,78.57,2940.94,15
CDM,0601T_1,"Irreversible electroporation destruction of growths of internal organ, open procedure",3460.5,2249.33,78.57,3635.31,15
CDM,0602T_1,Measurement of kidney filtration rate using skin sensor and single dose of fluorescent agent,489.0,317.85,78.57,503.67,15
CDM,0646T_1,Implantation of artificial valve between right upper and lower chambers of heart through catheter,5800.0,3770.0,78.57,7615.52,15
CDM,0795T_1,Transcatheter insertion of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right atrial and right ventricular pacemaker components,1985.0,1290.25,73.6,2044.55,15
CDM,0796T_1,Transcatheter insertion of permanent dual-chamber pacemaker using fluoroscopy and device interrogation of right atrial pacemaker component,1135.0,737.75,73.6,1189.11,15
CDM,0797T_1,Transcatheter insertion of a permanent dual chamber leadless pacemaker using fluoroscopy and device interrogation of right ventricular pacemaker component,1135.0,737.75,73.6,1169.05,15
CDM,0798T_1,Transcatheter removal of the right atrial and right ventricular components of a permanent dual-chamber leadless pacemaker using fluoroscopy,3500.0,2275.0,73.6,3605.0,15
CDM,0799T_1,Transcatheter removal of the right atrial component of a permanent dual-chamber leadless pacemaker using fluoroscopy,2000.0,1300.0,73.6,2060.0,15
CDM,0800T_1,Transcatheter removal of the right ventricular component of a permanent dual-chamber leadless pacemaker using fluoroscopy,2000.0,1300.0,73.6,2060.0,15
CDM,0801T_1,Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right atrial and right ventricular components,1985.0,1290.25,73.6,2044.55,15
CDM,0802T_1,Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right atrial component,1985.0,1290.25,73.6,2044.55,15
CDM,0803T_1,Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right ventricular component,1985.0,1290.25,73.6,2044.55,15
CDM,0804T_1,"In-person programming device evaluation of dual-chamber leadless pacemaker with adjustment of the device to test function and to select optimal permanent values, with analysis, review and report by a ",140.0,91.0,63.0,144.2,15
CDM,0823T_1,Insertion of permanent single-chamber leadless pacemaker for pacing the right upper heart chamber using imaging guidance,1135.0,737.75,73.6,1289.07,15
CDM,0824T_1,Removal of permanent single-chamber leadless pacemaker for pacing the right upper chamber of the heart using imaging guidance,2000.0,1300.0,73.6,2060.0,15
CDM,0825T_1,Removal and replacement of single-chamber permanent leadless pacemaker for pacing the right upper chamber of the heart using imaging guidance,1135.0,737.75,73.6,1169.05,15
CDM,0826T_1,In-person device evaluation of single-chamber leadless pacemaker system,80.0,52.0,36.0,82.4,15
CDM,0894T_1,Insertion of a tube into the liver allograft in preparation for connection to the normothermic perfusion device and removal of the tube from the liver allograft following normothermic perfusion,2350.0,1527.5,73.6,2420.5,15
CDM,0895T_1,"Connection of liver allograft to normothermic machine perfusion device, blood clotting control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments",2350.0,1527.5,66.62,2420.5,15
CDM,0896T_1,"Connection of liver allograft to normothermic machine perfusion device, blood clotting control; each additional hour, including physiological and laboratory assessments",1175.0,763.75,16.69,1210.25,15
CDM,0_1,"Diphtheria, tetanus, and acellular pertussis vaccine (younger than 7 years)",30.19,19.62,7.55,77.97,19
CDM,10000IP _1,"INJECTION, ETOPOSIDE, 10 MG",32.81,21.33,1.1,98.43,17
CDM,10000OP _1,"INJECTION, ETOPOSIDE, 10 MG",25.76,16.74,1.1,77.28,17
CDM,10004_1,"Fine needle aspiration biopsy, each additional growth",103.0,66.95,33.55,131.0,19
CDM,10005_1,"Fine needle aspiration biopsy using ultrasound guidance, first growth",180.0,117.0,58.21,326.8,19
CDM,10006_1,"Fine needle aspiration biopsy using ultrasound guidance, each additional growth",120.0,78.0,40.29,156.75,19
CDM,10007_1,"Fine needle aspiration biopsy using fluoroscopic guidance, first growth",225.0,146.25,73.6,714.33,19
CDM,10008_1,"Fine needle aspiration biopsy using fluoroscopic guidance, each additional growth",147.0,95.55,43.7,343.85,19
CDM,10009IP _1,FAMOTIDINE 200 MG/20 ML VIAL,39.3,25.55,9.83,27.51,11
CDM,10009_1,"Fine needle aspiration biopsy of growth using CT guidance, first growth",275.0,178.75,78.57,1049.29,19
CDM,10010IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.45,5.49,2.11,21.82,16
CDM,10010OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.26,11.22,4.32,44.57,16
CDM,10010_1,"Fine needle aspiration biopsy of growth using CT guidance, each additional growth",200.0,130.0,61.05,574.05,19
CDM,10011IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.84,14.85,5.71,58.98,16
CDM,10011OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",95.17,61.86,23.79,245.78,16
CDM,10014IP _1,UNCLASSIFIED DRUGS,1.71,1.11,0.43,4.42,16
CDM,10021T_1,"Fine needle aspiration biopsy, first growth",150.2,97.63,42.57,243.71,19
CDM,10021_1,"Fine needle aspiration biopsy, first growth",370.0,240.5,42.57,243.71,19
CDM,10024IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",99.9,64.94,24.98,257.99,16
CDM,10025IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",112.8,73.32,28.2,291.31,16
CDM,10030_1,Drainage of fluid collection in soft tissue using imaging guidance,2504.3,1627.8,78.57,1562.95,19
CDM,100344IP _1,ROMIDEPSIN 10 MG VIAL,19723.19,12820.07,4930.8,13806.23,11
CDM,100344OP _1,ROMIDEPSIN 10 MG VIAL,14269.4,9275.11,3567.35,9988.58,11
CDM,10035_1,"Placement of soft tissue locating device using X-ray, first growth",1241.0,806.65,66.84,892.25,19
CDM,10036_1,"Placement of soft tissue locating device using X-ray, each additional growth",1076.0,699.4,34.04,740.06,19
CDM,10037IP _1,"FINASTERIDE, 5 MG",19.34,12.57,4.84,49.95,16
CDM,10037OP _1,"FINASTERIDE, 5 MG",27.91,18.14,6.98,72.08,16
CDM,100393IP _1,UNCLASSIFIED DRUGS,35.97,23.38,8.99,92.89,16
CDM,100393OP _1,UNCLASSIFIED DRUGS,11.8,7.67,2.95,30.47,16
CDM,10040_1,Acne surgery,270.0,175.5,38.08,280.2,19
CDM,100417IP _1,UNCLASSIFIED DRUGS,149.33,97.06,37.33,385.64,16
CDM,10041IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.3,6.05,2.33,24.02,16
CDM,10041OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.69,6.95,2.67,27.61,16
CDM,10043IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.8,4.42,1.7,17.56,16
CDM,10043OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.22,13.79,5.31,54.8,16
CDM,10044IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.67,6.29,2.42,24.97,16
CDM,10044OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.73,6.97,2.68,27.71,16
CDM,10045IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.49,9.42,3.62,37.42,16
CDM,10045OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",82.0,53.3,20.5,211.77,16
CDM,10046IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.28,4.08,1.57,16.22,16
CDM,10046OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.74,9.58,3.69,38.07,16
CDM,100491IP _1,UNCLASSIFIED DRUGS,912.64,593.22,228.16,2356.89,16
CDM,100491OP _1,UNCLASSIFIED DRUGS,1780.38,1157.25,445.1,4597.83,16
CDM,10049IP _1,"INJECTION FLUCONAZOLE, 200 MG",1.34,0.87,0.34,4.75,17
CDM,10052IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",126.13,81.98,31.53,325.73,16
CDM,10054IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.13,5.28,2.03,21.0,16
CDM,10054OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.69,16.05,6.17,63.76,16
CDM,10055IP _1,UNCLASSIFIED DRUGS,42.0,27.3,10.5,108.47,16
CDM,10055OP _1,UNCLASSIFIED DRUGS,6.25,4.06,1.56,16.14,16
CDM,100581OP _1,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, 1 MG",1610.12,1046.58,2.17,4158.13,19
CDM,10059OP _1,UNCLASSIFIED DRUGS,74.4,48.36,18.6,192.14,16
CDM,10060T_1,Simple or single drainage of skin abscess,169.1,109.92,52.91,314.85,19
CDM,10060_1,Simple or single drainage of skin abscess,280.0,182.0,52.91,314.85,19
CDM,100611IP _1,VOLTAREN ARTHRITIS PAIN 1% GEL,18.78,12.21,4.7,13.15,11
CDM,100611OP _1,DICLOFENAC SODIUM 1% GEL,9.44,6.14,2.36,6.61,11
CDM,10061_1,Complicated or multiple drainage of skin abscess,450.0,292.5,78.57,562.76,19
CDM,10065IP _1,FLUOROURACIL 5% CREAM,16.95,11.02,4.24,11.87,11
CDM,10069IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.72,2.42,0.93,9.61,16
CDM,10069OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.51,11.38,4.38,45.22,16
CDM,10070IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.45,4.84,1.86,19.24,16
CDM,10070OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.95,10.37,3.99,41.19,16
CDM,100796IP _1,DALFAMPRIDINE ER 10 MG TABLET,14.7,9.56,3.68,10.29,11
CDM,100796OP _1,DALFAMPRIDINE ER 10 MG TABLET,11.65,7.57,2.91,8.16,11
CDM,10080_1,Simple drainage of cyst of tailbone,390.0,253.5,36.86,604.34,19
CDM,10081_1,Complicated drainage of cyst of tailbone,790.0,513.5,65.2,821.37,19
CDM,10084IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.12,2.68,1.03,10.64,16
CDM,10084OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.75,8.94,3.44,35.51,16
CDM,10093IP _1,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",11.8,7.67,2.95,189.15,19
CDM,10094IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.35,2.83,1.09,11.23,16
CDM,10094OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.7,14.11,5.43,56.04,16
CDM,10095IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.35,3.48,1.34,13.82,16
CDM,10095OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.93,11.65,4.48,46.3,16
CDM,100995IP _1,UNCLASSIFIED DRUGS,14.54,9.45,3.64,37.55,16
CDM,100995OP _1,UNCLASSIFIED DRUGS,14.1,9.17,3.53,36.41,16
CDM,100IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.73,1.12,0.43,4.47,16
CDM,101010OP _1,"INJECTION, COLLAGENASE, CLOSTRIDIUM HISTOLYTICUM, 0.01 MG",14988.77,9742.7,83.33,38708.5,19
CDM,101034IP _1,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",281.83,183.19,70.46,727.83,19
CDM,10116OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.1,6.57,2.53,26.08,16
CDM,10117IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.7,2.41,0.93,9.56,16
CDM,10117OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.12,7.88,3.03,31.3,16
CDM,10120_1,"Removal of foreign body from tissue, accessed beneath the skin, simple",330.0,214.5,55.22,362.52,19
CDM,10121T_1,"Removal of foreign body from tissue, accessed beneath the skin, complex",2100.0,1365.0,78.57,633.17,19
CDM,10121_1,"Removal of foreign body from tissue, accessed beneath the skin, complex",690.0,448.5,78.57,633.17,19
CDM,10137OP _1,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",9397.23,6108.2,824.15,28191.69,19
CDM,10140T_1,Drainage of blood or fluid accumulation,251.0,163.15,48.68,405.92,19
CDM,10140_1,Drainage of blood or fluid accumulation,420.0,273.0,47.73,405.92,19
CDM,10149IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.46,12.65,4.87,50.26,16
CDM,10149OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.45,10.69,4.11,42.48,16
CDM,10153IP _1,"Haemophilus influenzae type b vaccine, PRP-OMP conjugate",464.0,301.6,30.97,1198.28,19
CDM,10153OP _1,"Haemophilus influenzae type b vaccine, PRP-OMP conjugate",1065.18,692.37,30.97,2750.83,19
CDM,10160_1,"Aspiration of abscess, blood, or cyst",320.0,208.0,37.93,311.61,19
CDM,10162OP _1,HALOPERIDOL DEC 100 MG/ML VIAL,36.24,23.56,9.06,25.37,11
CDM,10163IP _1,"INJECTION, HALOPERIDOL DECANOATE, PER 50 MG",106.91,69.49,4.18,276.1,17
CDM,10163OP _1,"INJECTION, HALOPERIDOL DECANOATE, PER 50 MG",33.32,21.66,4.18,86.05,17
CDM,10176IP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",50.38,32.75,0.19,130.11,17
CDM,10176OP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",104.44,67.89,0.19,269.72,17
CDM,10177IP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",112.73,73.27,0.19,291.13,17
CDM,10177OP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",59.22,38.49,0.19,152.94,17
CDM,10180T_1,Complex drainage of wound infection after surgery,2389.8,1553.37,78.57,620.9,19
CDM,10180_1,Complex drainage of wound infection after surgery,600.0,390.0,78.57,620.9,19
CDM,10181OP _1,"HEPARIN SOD 5,000 UNIT/ML VIAL",12.15,7.9,3.04,8.51,11
CDM,1019T_1,"LYMPHOVENOUS BYPASS, INCLUDING ROBOTIC ASSISTANCE, WHEN PERFORMED, PER EXTREMITY",3355.0,2180.75,73.6,3455.65,12
CDM,101IP _1,UNCLASSIFIED DRUGS,12.98,8.44,3.25,33.52,16
CDM,101OP _1,UNCLASSIFIED DRUGS,63.74,41.43,15.94,164.61,16
CDM,10209IP _1,UNCLASSIFIED DRUGS,9.71,6.31,2.43,25.08,16
CDM,10209OP _1,UNCLASSIFIED DRUGS,20.43,13.28,5.11,52.76,16
CDM,10218OP _1,UNCLASSIFIED DRUGS,2.04,1.33,0.51,5.27,16
CDM,10224IP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",29.3,19.05,0.15,75.67,17
CDM,10224OP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",5.03,3.27,0.15,12.99,17
CDM,10225IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.35,3.48,1.34,13.82,16
CDM,10225OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.6,9.49,3.65,37.7,16
CDM,10226IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.96,12.97,4.99,51.55,16
CDM,10235IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.01,14.96,5.75,59.42,16
CDM,10235OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.78,19.36,7.45,76.91,16
CDM,10236IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.46,4.2,1.62,16.68,16
CDM,10236OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.08,3.3,1.27,13.12,16
CDM,10246IP _1,UNCLASSIFIED DRUGS,1.73,1.12,0.43,4.47,16
CDM,10246OP _1,UNCLASSIFIED DRUGS,1.56,1.01,0.39,4.03,16
CDM,10248IP _1,"INJECTION, IFOSFAMIDE, 1 GRAM",206.85,134.45,26.33,620.55,17
CDM,10266IP _1,UNCLASSIFIED DRUGS,2275.91,1479.34,568.98,5877.54,16
CDM,10266OP _1,UNCLASSIFIED DRUGS,2112.18,1372.92,528.05,5454.7,16
CDM,10284IP _1,"INJECTION, INSULIN, PER 5 UNITS",154.0,100.1,0.56,397.71,17
CDM,10284OP _1,"INJECTION, INSULIN, PER 5 UNITS",853.92,555.05,0.56,2205.25,17
CDM,10286IP _1,"INJECTION, INSULIN, PER 5 UNITS",98.34,63.92,0.56,253.96,17
CDM,10286OP _1,"INJECTION, INSULIN, PER 5 UNITS",63.53,41.29,0.56,164.07,17
CDM,10289IP _1,"INJECTION, INSULIN, PER 5 UNITS",403.73,262.42,0.56,1042.63,17
CDM,10289OP _1,"INJECTION, INSULIN, PER 5 UNITS",1453.86,945.01,0.56,3754.59,17
CDM,102IP _1,UNCLASSIFIED DRUGS,19.76,12.84,4.94,51.03,16
CDM,102OP _1,UNCLASSIFIED DRUGS,77.34,50.27,19.34,199.73,16
CDM,10321IP _1,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",7.64,4.97,0.42,23.05,17
CDM,10321OP _1,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",15.27,9.93,0.42,46.07,17
CDM,10322IP _1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",166.05,107.93,0.16,500.96,17
CDM,10322OP _1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",166.05,107.93,0.16,500.96,17
CDM,10325IP _1,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",18.66,12.13,0.42,56.3,17
CDM,10325OP _1,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",56.06,36.44,0.42,169.13,17
CDM,10326IP _1,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",2.21,1.44,0.42,6.67,17
CDM,10326OP _1,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",1.98,1.29,0.42,5.97,17
CDM,10327IP _1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",66.14,42.99,0.16,199.54,17
CDM,10327OP _1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",82.67,53.74,0.16,249.41,17
CDM,10328IP _1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",6.6,4.29,0.16,19.91,17
CDM,10328OP _1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",6.03,3.92,0.16,18.19,17
CDM,10330IP _1,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",17.28,11.23,0.07,52.13,17
CDM,10330OP _1,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",17.28,11.23,0.07,52.13,17
CDM,10358IP _1,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",1329.47,864.16,10.4,3433.36,17
CDM,10358OP _1,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",1052.05,683.83,10.4,2716.92,17
CDM,10364IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.2,15.08,5.8,59.91,16
CDM,10364OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.47,5.51,2.12,21.87,16
CDM,10368IP _1,KETOCONAZOLE 2% CREAM,14.65,9.52,3.66,10.26,11
CDM,10368OP _1,KETOCONAZOLE 2% CREAM,2.19,1.42,0.55,1.53,11
CDM,10369IP _1,KETOCONAZOLE 200 MG TABLET,31.55,20.51,7.89,22.09,11
CDM,10369OP _1,KETOCONAZOLE 200 MG TABLET,31.55,20.51,7.89,22.09,11
CDM,10372IP _1,"INJECTION, LABETALOL HYDROCHLORIDE, 5 MG",115.7,75.21,0.37,298.8,17
CDM,10372OP _1,"INJECTION, LABETALOL HYDROCHLORIDE, 5 MG",55.85,36.3,0.37,144.23,17
CDM,10373IP _1,UNCLASSIFIED DRUGS,5.96,3.87,1.49,15.39,16
CDM,10373OP _1,UNCLASSIFIED DRUGS,25.13,16.33,6.28,64.9,16
CDM,10374IP _1,UNCLASSIFIED DRUGS,7.7,5.01,1.93,19.89,16
CDM,10374OP _1,UNCLASSIFIED DRUGS,19.36,12.58,4.84,50.0,16
CDM,103888IP _1,UNCLASSIFIED DRUGS,49.12,31.93,12.28,126.85,16
CDM,103888OP _1,UNCLASSIFIED DRUGS,34.25,22.26,8.56,88.45,16
CDM,103889IP _1,"INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG",21.52,13.99,5.38,55.58,16
CDM,103889OP _1,"INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG",13.95,9.07,3.49,36.03,16
CDM,103890IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.88,3.17,1.22,12.6,16
CDM,103890OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.0,16.25,6.25,64.56,16
CDM,103915OP _1,"INJECTION, VELAGLUCERASE ALFA, 100 UNITS",3347.51,2175.88,409.62,11535.65,19
CDM,103935IP _1,SOTALOL HCL 150 MG/10 ML VIAL,2505.68,1628.69,626.42,1753.98,11
CDM,103935OP _1,SOTALOL HCL 150 MG/10 ML VIAL,830.89,540.08,207.72,581.62,11
CDM,103IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.8,7.67,2.95,30.47,16
CDM,103OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.98,5.19,2.0,20.61,16
CDM,104014OP _1,LEVOTHYROXINE 150 MCG CAPSULE,19.55,12.71,4.89,13.69,11
CDM,10403IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.5,18.53,7.13,73.6,16
CDM,10403OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.09,15.01,5.77,59.63,16
CDM,10404IP _1,UNCLASSIFIED DRUGS,6.43,4.18,1.61,16.61,16
CDM,10404OP _1,UNCLASSIFIED DRUGS,22.2,14.43,5.55,57.33,16
CDM,10406IP _1,UNCLASSIFIED DRUGS,13.64,8.87,3.41,35.23,16
CDM,10406OP _1,UNCLASSIFIED DRUGS,26.55,17.26,6.64,68.57,16
CDM,104258OP _1,QUTENZA 8% KIT (2 PATCH),2200.22,1430.14,550.06,1540.15,11
CDM,10427IP _1,UNCLASSIFIED DRUGS,9.66,6.28,2.42,24.95,16
CDM,10427OP _1,UNCLASSIFIED DRUGS,18.05,11.73,4.51,46.61,16
CDM,10430IP _1,UNCLASSIFIED DRUGS,46.5,30.23,11.63,120.09,16
CDM,10430OP _1,UNCLASSIFIED DRUGS,45.63,29.66,11.41,117.84,16
CDM,10431IP _1,UNCLASSIFIED DRUGS,12.16,7.9,3.04,31.4,16
CDM,10431OP _1,UNCLASSIFIED DRUGS,11.1,7.22,2.78,28.67,16
CDM,10434IP _1,UNCLASSIFIED DRUGS,34.16,22.2,8.54,88.22,16
CDM,10434OP _1,UNCLASSIFIED DRUGS,20.91,13.59,5.23,54.0,16
CDM,1043IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.18,4.02,1.55,15.96,16
CDM,1043OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",52.67,34.24,13.17,136.02,16
CDM,10442IP _1,UNCLASSIFIED DRUGS,2579.85,1676.9,644.96,6662.46,16
CDM,10442OP _1,UNCLASSIFIED DRUGS,807.15,524.65,201.79,2084.46,16
CDM,10443IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.71,6.31,2.43,25.08,16
CDM,10443OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.23,11.85,4.56,47.08,16
CDM,10449IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.4,2.86,1.1,11.36,16
CDM,10449OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.21,11.84,4.55,47.03,16
CDM,1044IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.85,4.45,1.71,17.69,16
CDM,1044OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.13,10.48,4.03,41.66,16
CDM,10450IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.35,9.98,3.84,39.64,16
CDM,10450OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.68,14.09,5.42,55.99,16
CDM,10451IP _1,UNCLASSIFIED DRUGS,3.95,2.57,0.99,10.2,16
CDM,10451OP _1,UNCLASSIFIED DRUGS,10.7,6.96,2.68,27.63,16
CDM,10454IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.58,2.98,1.15,11.83,16
CDM,10454OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.55,7.51,2.89,29.83,16
CDM,104555IP _1,"EVEROLIMUS, ORAL, 0.25 MG",58.19,37.82,1.25,150.28,17
CDM,104556IP _1,"EVEROLIMUS, ORAL, 0.25 MG",194.5,126.43,1.25,502.3,17
CDM,10455IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.48,3.56,1.37,14.15,16
CDM,10455OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.7,12.16,4.68,48.29,16
CDM,104576IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",33.33,21.66,8.33,86.07,16
CDM,104576OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.36,7.38,2.84,29.34,16
CDM,104604IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",389.39,253.1,97.35,1005.6,16
CDM,104604OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",155.12,100.83,38.78,400.6,16
CDM,10466IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.39,3.5,1.35,13.92,16
CDM,10466OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",111.5,72.48,27.88,287.95,16
CDM,10467IP _1,"INJECTION, LORAZEPAM, 2 MG",90.37,58.74,1.49,233.38,17
CDM,10467OP _1,"INJECTION, LORAZEPAM, 2 MG",76.37,49.64,1.49,197.23,17
CDM,10468IP _1,"INJECTION, LORAZEPAM, 2 MG",107.0,69.55,1.49,276.33,17
CDM,10468OP _1,"INJECTION, LORAZEPAM, 2 MG",15.89,10.33,1.49,41.04,17
CDM,10475IP _1,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, EQUINE, PARENTERAL, 250 MG",6106.98,3969.54,1526.75,15771.28,19
CDM,104764IP _1,"SIROLIMUS, ORAL, 1 MG",36.61,23.8,1.03,94.55,17
CDM,104764OP _1,"SIROLIMUS, ORAL, 1 MG",19.85,12.9,1.03,51.26,17
CDM,10478IP _1,UNCLASSIFIED DRUGS,8.4,5.46,2.1,21.69,16
CDM,104877IP _1,"EVEROLIMUS, ORAL, 0.25 MG",151.16,98.25,1.25,390.37,17
CDM,10491IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.84,2.5,0.96,9.92,16
CDM,10491OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",59.49,38.67,14.87,153.63,16
CDM,104IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.45,4.19,1.61,16.66,16
CDM,104OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.44,17.19,6.61,68.28,16
CDM,105011OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",66.32,43.11,16.58,171.27,16
CDM,10521IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.38,2.2,0.85,8.73,16
CDM,10521OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.59,2.98,1.15,11.85,16
CDM,10522IP _1,"INJECTION, MELPHALAN HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 50 MG",1351.07,878.2,92.16,3489.14,19
CDM,10522OP _1,"INJECTION, MELPHALAN HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 50 MG",179.79,116.86,44.95,1578.71,19
CDM,10531IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.35,9.98,3.84,39.64,16
CDM,10533IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.78,13.51,5.2,53.66,16
CDM,10533OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.05,19.53,7.51,77.6,16
CDM,10535IP _1,UNCLASSIFIED DRUGS,1.81,1.18,0.45,4.67,16
CDM,10537IP _1,"INJECTION, MESNA, 200 MG",43.22,28.09,1.8,129.66,17
CDM,10537OP _1,"INJECTION, MESNA, 200 MG",12.74,8.28,1.8,38.22,17
CDM,105410IP _1,LUMIGAN 0.01% EYE DROPS,4605.0,2993.25,1151.25,3223.5,11
CDM,10543IP _1,METAXALONE 400 MG TABLET,34.03,22.12,8.51,23.82,11
CDM,10544IP _1,UNCLASSIFIED DRUGS,2.79,1.81,0.7,7.21,16
CDM,10544OP _1,UNCLASSIFIED DRUGS,15.2,9.88,3.8,39.25,16
CDM,105460IP _1,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",5.25,3.41,0.02,13.56,17
CDM,105460OP _1,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",5.79,3.76,0.02,14.95,17
CDM,10546IP _1,"INJECTION, METHADONE HCL, UP TO 10 MG",179.18,116.47,18.76,462.73,17
CDM,10546OP _1,"INJECTION, METHADONE HCL, UP TO 10 MG",112.7,73.26,18.76,291.05,17
CDM,105482IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.7,22.56,8.68,89.61,16
CDM,105482OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.59,4.28,1.65,17.02,16
CDM,10549IP _1,HIPREX 1 GM TABLET,18.4,11.96,4.6,12.88,11
CDM,10549OP _1,METHENAMINE HIPP 1 GM TABLET,50.8,33.02,12.7,35.56,11
CDM,105502IP _1,"INJECTION, DENOSUMAB, 1 MG",4534.48,2947.41,31.23,11710.29,19
CDM,105502OP _1,"INJECTION, DENOSUMAB, 1 MG",31287.49,20336.87,31.23,80799.94,19
CDM,10552IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.77,2.45,0.94,9.74,16
CDM,10552OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.52,7.49,2.88,29.75,16
CDM,10553IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.33,2.81,1.08,11.18,16
CDM,10553OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.4,4.81,1.85,19.11,16
CDM,105614IP _1,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",32.56,21.16,0.1,97.68,17
CDM,105614OP _1,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",19.3,12.55,0.1,57.9,17
CDM,105633IP _1,UNCLASSIFIED DRUGS,3.21,2.09,0.8,8.29,16
CDM,105633OP _1,UNCLASSIFIED DRUGS,2.83,1.84,0.71,7.31,16
CDM,105634IP _1,UNCLASSIFIED DRUGS,3.64,2.37,0.91,9.4,16
CDM,105634OP _1,UNCLASSIFIED DRUGS,10.75,6.99,2.69,27.76,16
CDM,105635IP _1,UNCLASSIFIED DRUGS,46.75,30.39,11.69,120.73,16
CDM,105635OP _1,UNCLASSIFIED DRUGS,1.77,1.15,0.44,4.57,16
CDM,105637OP _1,"INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML",2.14,1.39,0.54,5.53,17
CDM,105638IP _1,"INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML",30.95,20.12,3.98,79.93,17
CDM,105638OP _1,"INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML",3.94,2.56,0.99,10.18,17
CDM,105640IP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",4.86,3.16,0.01,12.55,17
CDM,105640OP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",4.18,2.72,0.01,10.79,17
CDM,105644OP _1,"INJECTION, CABAZITAXEL, 1 MG",91453.22,59444.59,244.65,272896.41,19
CDM,105699IP _1,DULERA 200 MCG-5 MCG INHALER,173.17,112.56,43.29,121.22,11
CDM,10571IP _1,"INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG",182.75,118.79,22.64,471.95,17
CDM,10571OP _1,"INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG",91.22,59.29,22.64,235.58,17
CDM,10572IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",103.2,67.08,25.8,266.51,16
CDM,10572OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",38.2,24.83,9.55,98.65,16
CDM,10575IP _1,"METHYLPREDNISOLONE ORAL, PER 4 MG",27.84,18.1,0.15,71.9,17
CDM,10575OP _1,"METHYLPREDNISOLONE ORAL, PER 4 MG",58.11,37.77,0.15,150.07,17
CDM,10577IP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",321.26,208.82,0.28,829.65,17
CDM,10577OP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",548.54,356.55,0.28,1416.6,17
CDM,10578IP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",10.2,6.63,0.28,26.34,17
CDM,10578OP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",21.45,13.94,0.28,55.39,17
CDM,10581IP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",217.98,141.69,0.28,562.93,17
CDM,10581OP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",50.2,32.63,0.28,129.64,17
CDM,10586IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.73,5.67,2.18,22.55,16
CDM,10587IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.32,4.76,1.83,18.9,16
CDM,10587OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.6,12.09,4.65,48.03,16
CDM,10588IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.48,4.86,1.87,19.32,16
CDM,10588OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.99,15.59,6.0,61.95,16
CDM,105899IP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",312.83,203.34,0.56,938.49,17
CDM,105899OP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",52.33,34.01,0.56,156.99,17
CDM,105900IP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",31.5,20.48,0.56,94.5,17
CDM,105900OP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",85.89,55.83,0.56,257.67,17
CDM,105901IP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",58.49,38.02,0.56,175.47,17
CDM,105901OP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",47.23,30.7,0.56,141.69,17
CDM,105902IP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",25.45,16.54,0.56,76.35,17
CDM,105902OP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",67.89,44.13,0.56,203.67,17
CDM,105903IP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",24.52,15.94,0.56,73.56,17
CDM,105903OP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",53.52,34.79,0.56,160.56,17
CDM,105904IP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",29.66,19.28,0.56,88.98,17
CDM,105904OP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",36.0,23.4,0.56,108.0,17
CDM,105940IP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",60.75,39.49,0.56,182.25,17
CDM,10595IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.6,7.54,2.9,29.96,16
CDM,10595OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.45,15.89,6.11,63.14,16
CDM,10596IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.94,10.36,3.99,41.17,16
CDM,10596OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.15,15.05,5.79,59.78,16
CDM,105970OP _1,"INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT",645.14,419.34,5.78,1666.07,19
CDM,105971OP _1,"INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT",2656.79,1726.91,5.78,6861.16,19
CDM,10599IP _1,UNCLASSIFIED DRUGS,1.35,0.88,0.34,3.49,16
CDM,105IP _1,UNCLASSIFIED DRUGS,5.75,3.74,1.44,14.85,16
CDM,105OP _1,UNCLASSIFIED DRUGS,17.1,11.12,4.28,44.16,16
CDM,106061IP _1,UNCLASSIFIED DRUGS,2.3,1.5,0.58,5.94,16
CDM,10606IP _1,UNCLASSIFIED DRUGS,2025.8,1316.77,506.45,5231.63,16
CDM,10606OP _1,UNCLASSIFIED DRUGS,713.86,464.01,178.47,1843.54,16
CDM,106079IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",96.45,62.69,24.11,249.08,16
CDM,106079OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",165.16,107.35,41.29,426.53,16
CDM,10607IP _1,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",47.35,30.78,0.15,122.28,17
CDM,10607OP _1,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",51.84,33.7,0.15,133.88,17
CDM,10608IP _1,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",71.57,46.52,0.15,184.83,17
CDM,10608OP _1,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",10.0,6.5,0.15,25.83,17
CDM,10609IP _1,UNCLASSIFIED DRUGS,6.17,4.01,1.54,15.93,16
CDM,10609OP _1,UNCLASSIFIED DRUGS,22.6,14.69,5.65,58.36,16
CDM,10610IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.11,3.97,1.53,15.78,16
CDM,10610OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.83,14.84,5.71,58.96,16
CDM,106176IP _1,"BUPRENORPHINE/NALOXONE, ORAL, LESS THAN OR EQUAL TO 3 MG BUPRENORPHINE",33.96,22.07,6.48,87.7,17
CDM,106177IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.37,22.99,8.84,91.34,16
CDM,106177OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.4,15.21,5.85,60.43,16
CDM,106278IP _1,"INJECTION, DIAZEPAM, UP TO 5 MG",117.55,76.41,7.09,303.57,17
CDM,106278OP _1,"INJECTION, DIAZEPAM, UP TO 5 MG",98.03,63.72,7.09,253.16,17
CDM,10628IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.06,7.84,3.02,31.15,16
CDM,10628OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.57,1.02,0.39,4.05,16
CDM,10629IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.3,8.65,3.33,34.35,16
CDM,10629OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.88,10.97,4.22,43.59,16
CDM,10630IP _1,"INJECTION, MITOMYCIN, 5 MG",1150.93,748.1,27.67,2972.28,19
CDM,10630OP _1,"INJECTION, MITOMYCIN, 5 MG",564.43,366.88,27.67,1457.64,19
CDM,10631IP _1,"INJECTION, MITOMYCIN, 5 MG",1780.51,1157.33,27.67,4598.17,19
CDM,10631OP _1,"INJECTION, MITOMYCIN, 5 MG",3110.9,2022.09,27.67,8033.9,19
CDM,10632IP _1,"INJECTION, MITOMYCIN, 5 MG",1519.0,987.35,27.67,3922.82,19
CDM,10632OP _1,"INJECTION, MITOMYCIN, 5 MG",594.31,386.3,27.67,1534.81,19
CDM,10634IP _1,"INJECTION, MITOXANTRONE HYDROCHLORIDE, PER 5 MG",62.19,40.42,15.55,202.84,19
CDM,10648IP _1,UNCLASSIFIED DRUGS,7.4,4.81,1.85,19.11,16
CDM,106490IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.53,15.94,6.13,63.35,16
CDM,106490OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.65,11.47,4.41,45.58,16
CDM,106491IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.7,22.56,8.68,89.61,16
CDM,106491OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.18,20.27,7.8,80.52,16
CDM,10655IP _1,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",22.73,14.77,3.22,58.7,17
CDM,10674IP _1,UNCLASSIFIED DRUGS,92.92,60.4,23.23,239.97,16
CDM,10674OP _1,UNCLASSIFIED DRUGS,93.15,60.55,23.29,240.56,16
CDM,106761OP _1,"INJECTION, ABOBOTULINUMTOXINA, 5 UNITS",2223.88,1445.52,9.68,5743.17,19
CDM,106773OP _1,"INJECTION, ERIBULIN MESYLATE, 0.1 MG",5069.35,3295.08,76.97,13091.6,19
CDM,106783IP _1,"INJECTION, FOSAPREPITANT, 1 MG",4503.86,2927.51,0.12,11631.22,17
CDM,106783OP _1,"INJECTION, FOSAPREPITANT, 1 MG",2822.2,1834.43,0.12,7288.33,17
CDM,106804IP _1,"INJECTION, DENOSUMAB, 1 MG",4722.56,3069.66,31.23,12196.01,19
CDM,106804OP _1,"INJECTION, DENOSUMAB, 1 MG",15701.86,10206.21,31.23,40550.05,19
CDM,10685IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",66.5,43.23,16.63,171.74,16
CDM,10685OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",62.54,40.65,15.64,161.51,16
CDM,10691IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.59,4.28,1.65,17.02,16
CDM,10708IP _1,UNCLASSIFIED DRUGS,25.04,16.28,6.26,64.67,16
CDM,10708OP _1,UNCLASSIFIED DRUGS,15.79,10.26,3.95,40.78,16
CDM,10717IP _1,SMOKING CESSATION GUM,6.0,3.9,1.5,15.5,16
CDM,10717OP _1,SMOKING CESSATION GUM,34.25,22.26,8.56,88.45,16
CDM,10722IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.78,8.96,3.45,35.59,16
CDM,10722OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.55,8.16,3.14,32.41,16
CDM,10723IP _1,NITROFURANTOIN 25 MG/5 ML SUSP,39.93,25.95,9.98,27.95,11
CDM,10724IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.6,10.79,4.15,42.87,16
CDM,10724OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",59.11,38.42,14.78,152.65,16
CDM,10734IP _1,UNCLASSIFIED DRUGS,40.54,26.35,10.14,104.69,16
CDM,10734OP _1,UNCLASSIFIED DRUGS,12.69,8.25,3.17,32.77,16
CDM,10735IP _1,NORETH-EE-FE 1-0.02(21)-75 TAB,36.2,23.53,9.05,25.34,11
CDM,10746IP _1,NORETHIN-EE 1.5-0.03 MG(21) TB,8.73,5.67,2.18,6.11,11
CDM,10747IP _1,NORETHINDRONE 5 MG TABLET,46.0,29.9,11.5,32.2,11
CDM,10750IP _1,NORGESTIMATE-ETHINYL ESTRADIOL 0.18 MG-0.215MG-0.25MG-35 MCG(28)TABLET,4.85,3.15,1.21,3.4,11
CDM,10752IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.23,3.4,1.31,13.51,16
CDM,10752OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.08,2.0,0.77,7.95,16
CDM,10757IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.93,1.9,0.73,7.57,16
CDM,107660IP _1,UNCLASSIFIED DRUGS,301.3,195.85,75.33,778.11,16
CDM,107661IP _1,UNCLASSIFIED DRUGS,565.88,367.82,141.47,1461.39,16
CDM,107661OP _1,UNCLASSIFIED DRUGS,619.95,402.97,154.99,1601.02,16
CDM,107662IP _1,UNCLASSIFIED DRUGS,839.0,545.35,209.75,2166.72,16
CDM,107662OP _1,UNCLASSIFIED DRUGS,297.8,193.57,74.45,769.07,16
CDM,107668IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",300.6,195.39,75.15,776.3,16
CDM,107668OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",117.97,76.68,29.49,304.66,16
CDM,107669IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.39,4.8,1.85,19.08,16
CDM,107669OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.13,4.63,1.78,18.41,16
CDM,107670IP _1,"INJECTION, CEFTAROLINE FOSAMIL, 10 MG",1475.93,959.35,4.49,3811.59,19
CDM,107671IP _1,"INJECTION, CEFTAROLINE FOSAMIL, 10 MG",1410.86,917.06,4.49,3643.55,19
CDM,107672IP _1,NUEDEXTA 20-10 MG CAPSULE,172.2,111.93,43.05,120.54,11
CDM,107750OP _1,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",18.64,12.12,4.66,2058.35,19
CDM,107752IP _1,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",53.3,34.65,13.33,2058.35,19
CDM,107752OP _1,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",58.37,37.94,14.59,2058.35,19
CDM,107753OP _1,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",22.71,14.76,5.68,2058.35,19
CDM,107754OP _1,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",44.39,28.85,11.1,2058.35,19
CDM,10777IP _1,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",1.56,1.01,0.1,4.68,17
CDM,10777OP _1,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",1.75,1.14,0.1,5.25,17
CDM,10778IP _1,ONDANSETRON HCL 4 MG TABLET,10.95,7.12,2.74,7.67,11
CDM,10778OP _1,ONDANSETRON HCL 4 MG TABLET,11.6,7.54,2.9,8.12,11
CDM,107798OP _1,"INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL",193.6,125.84,48.4,499.97,17
CDM,107799IP _1,"INJECTION, BACLOFEN, 10 MG",64.41,41.87,16.1,741.6,19
CDM,107800IP _1,"INJECTION, BACLOFEN, 10 MG",32.89,21.38,8.22,741.6,19
CDM,107800OP _1,"INJECTION, BACLOFEN, 10 MG",62.47,40.61,15.62,741.6,19
CDM,10780OP _1,UNCLASSIFIED DRUGS,2.44,1.59,0.61,6.3,16
CDM,10781IP _1,UNCLASSIFIED DRUGS,4.65,3.02,1.16,12.01,16
CDM,10781OP _1,UNCLASSIFIED DRUGS,3.2,2.08,0.8,8.26,16
CDM,107829IP _1,UNCLASSIFIED DRUGS,7.86,5.11,1.97,20.3,16
CDM,107829OP _1,UNCLASSIFIED DRUGS,3.44,2.24,0.86,8.88,16
CDM,1079IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.51,1.63,0.63,6.48,16
CDM,1079OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.22,10.54,4.06,41.89,16
CDM,10802IP _1,"INJECTION, OXACILLIN SODIUM, UP TO 250 MG",3.14,2.04,0.6,8.11,17
CDM,108078IP _1,UNCLASSIFIED DRUGS,584.57,379.97,146.14,1509.65,16
CDM,108078OP _1,UNCLASSIFIED DRUGS,397.65,258.47,99.41,1026.93,16
CDM,1080IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.51,3.58,1.38,14.23,16
CDM,1080OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.03,13.67,5.26,54.31,16
CDM,10810IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.1,0.72,0.28,2.84,16
CDM,10813IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.68,11.49,4.42,45.66,16
CDM,10813OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",53.23,34.6,13.31,137.47,16
CDM,108145IP _1,UNCLASSIFIED DRUGS,32.52,21.14,8.13,83.98,16
CDM,108145OP _1,UNCLASSIFIED DRUGS,4.66,3.03,1.17,12.03,16
CDM,10814IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.54,15.3,5.89,60.79,16
CDM,10814OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",48.7,31.66,12.18,125.77,16
CDM,108351IP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",2.76,1.79,0.01,7.13,17
CDM,108351OP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",5.1,3.32,0.01,13.17,17
CDM,108419IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.4,7.41,2.85,29.44,16
CDM,108419OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.7,10.86,4.18,43.13,16
CDM,108427IP _1,ESTRADIOL 0.05 MG PATCH (1/WK),137.05,89.08,34.26,95.94,11
CDM,10843IP _1,"INJECTION, PACLITAXEL, 1 MG",6.25,4.06,0.11,18.75,17
CDM,10843OP _1,"INJECTION, PACLITAXEL, 1 MG",28.24,18.36,0.11,84.72,17
CDM,108526IP _1,ERYTHROMYCIN DR 500 MG TABLET,296.25,192.56,74.06,207.38,11
CDM,10855IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.44,2.24,0.86,8.88,16
CDM,10855OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.19,17.02,6.55,67.64,16
CDM,108619IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",68.1,44.27,17.03,175.87,16
CDM,108619OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",65.72,42.72,16.43,169.72,16
CDM,108629OP _1,TUMS E-X TABLET CHEWABLE,2.05,1.33,0.51,1.44,11
CDM,108653IP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",27.63,17.96,0.01,71.35,17
CDM,108653OP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",13.06,8.49,0.01,33.73,17
CDM,108702IP _1,UNCLASSIFIED DRUGS,18.13,11.78,4.53,46.82,16
CDM,108702OP _1,UNCLASSIFIED DRUGS,14.01,9.11,3.5,36.18,16
CDM,108720IP _1,"INJECTION, DIGOXIN, UP TO 0.5 MG",53.19,34.57,10.14,137.36,17
CDM,108720OP _1,"INJECTION, DIGOXIN, UP TO 0.5 MG",13.5,8.78,3.38,34.86,17
CDM,108723IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.49,3.57,1.37,14.18,16
CDM,108728OP _1,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",1538.92,1000.3,14.62,3974.26,19
CDM,10876IP _1,PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,2.75,1.79,0.69,1.93,11
CDM,108819IP _1,UNCLASSIFIED DRUGS,5.19,3.37,1.3,13.4,16
CDM,108819OP _1,UNCLASSIFIED DRUGS,22.53,14.64,5.63,58.18,16
CDM,108834OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.97,1.28,0.49,5.09,16
CDM,108841IP _1,UNCLASSIFIED DRUGS,1602.5,1041.63,400.63,4138.46,16
CDM,108842IP _1,Rabies immune globulin for injection,1567.84,1019.1,296.75,4048.95,19
CDM,108842OP _1,Rabies immune globulin for injection,977.84,635.6,244.46,2525.27,19
CDM,108932IP _1,UNCLASSIFIED DRUGS,1311.87,852.72,327.97,3387.9,16
CDM,108932OP _1,UNCLASSIFIED DRUGS,509.7,331.31,127.43,1316.3,16
CDM,108968IP _1,UNCLASSIFIED DRUGS,8.55,5.56,2.14,22.08,16
CDM,108968OP _1,UNCLASSIFIED DRUGS,5.7,3.71,1.43,14.72,16
CDM,108970OP _1,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",63.13,41.03,15.78,189.39,17
CDM,108978OP _1,UNCLASSIFIED DRUGS,1.33,0.86,0.33,3.43,16
CDM,10897OP _1,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",452.5,294.13,33.89,1168.58,19
CDM,1090OP _1,UNCLASSIFIED DRUGS,1.13,0.73,0.28,2.92,16
CDM,10911IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.44,4.19,1.61,16.63,16
CDM,10911OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.27,10.58,4.07,42.02,16
CDM,10917IP _1,UNCLASSIFIED DRUGS,13.64,8.87,3.41,35.23,16
CDM,10918IP _1,UNCLASSIFIED DRUGS,1.94,1.26,0.49,5.01,16
CDM,109215IP _1,UNCLASSIFIED DRUGS,2.26,1.47,0.57,5.84,16
CDM,109275IP _1,UNCLASSIFIED DRUGS,12.65,8.22,3.16,32.67,16
CDM,109275OP _1,UNCLASSIFIED DRUGS,4.27,2.78,1.07,11.03,16
CDM,10947IP _1,"INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG",2884.03,1874.62,185.44,7448.01,19
CDM,10947OP _1,"INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG",1085.5,705.58,185.44,2803.3,19
CDM,109535IP _1,UNCLASSIFIED DRUGS,91.32,59.36,22.83,235.83,16
CDM,109640IP _1,"INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG",359.55,233.71,2.17,928.54,17
CDM,109663IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.5,0.98,0.38,3.87,16
CDM,109673IP _1,GLUCAGON 1 MG VIAL,1748.25,1136.36,437.06,1223.78,11
CDM,109806IP _1,"LACTAID FAST ACT 9,000 UNIT",7.08,4.6,1.77,4.96,11
CDM,109842IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.91,3.19,1.23,12.68,16
CDM,109842OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.45,6.79,2.61,26.99,16
CDM,109893IP _1,UNCLASSIFIED DRUGS,16.39,10.65,4.1,42.33,16
CDM,109893OP _1,UNCLASSIFIED DRUGS,16.29,10.59,4.07,42.07,16
CDM,11000_1,"Removal of inflamed or infected skin, up to 10% of body surface",140.0,91.0,23.11,140.57,19
CDM,11001_1,"Removal of inflamed or infected skin, each additional 10% of body surface or less",70.0,45.5,11.91,78.57,19
CDM,11004_1,"Removal of infected skin, tissue or muscle of genitals",1651.7,1073.61,78.57,1702.76,19
CDM,11005T_1,"Removal of infected skin, tissue or muscle of abdomen",2193.5,1425.78,78.57,2279.18,19
CDM,11005_1,"Removal of infected skin, tissue or muscle of abdomen",2151.5,1398.48,78.57,2279.18,19
CDM,11006_1,"Removal of infected skin, tissue or muscle of genitals, perineum, or abdomen",2016.0,1310.4,78.57,2080.45,19
CDM,11008T_1,Removal of infected artificial material or mesh from abdomen,769.7,500.31,78.57,801.57,19
CDM,11008_1,Removal of infected artificial material or mesh from abdomen,763.4,496.21,78.57,801.57,19
CDM,11010_1,Removal of foreign material from skin and tissue at open broken and/or dislocated bone,1030.0,669.5,78.57,1077.03,19
CDM,11011T_1,"Removal of foreign material from skin, tissue, and muscle at open broken and/or dislocated bone",580.7,377.46,78.57,1177.2,19
CDM,11011_1,"Removal of foreign material from skin, tissue, and muscle at open broken and/or dislocated bone",1360.0,884.0,78.57,1177.2,19
CDM,11012T_1,"Removal of foreign material from skin, tissue, muscle, and bone at open broken and/or dislocated bone",580.7,377.46,78.57,1540.81,19
CDM,11012_1,"Removal of foreign material from skin, tissue, muscle, and bone at open broken and/or dislocated bone",1860.0,1209.0,78.57,1540.81,19
CDM,11018IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.69,5.0,1.92,19.86,16
CDM,11019IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.37,7.39,2.84,29.36,16
CDM,11023IP _1,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",144.91,94.19,2.98,374.23,17
CDM,11023OP _1,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",79.2,51.48,2.98,204.53,17
CDM,11024IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",414.61,269.5,103.65,1070.73,16
CDM,11024OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.46,4.85,1.87,19.27,16
CDM,110288IP _1,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",2.92,1.9,0.73,7.54,17
CDM,110288OP _1,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",1.72,1.12,0.43,4.44,17
CDM,11042T_1,"Removal of skin and tissue, 20.0 sq cm or less",1320.9,858.59,51.64,309.39,19
CDM,11042_1,"Removal of skin and tissue, 20.0 sq cm or less",320.0,208.0,51.64,309.39,19
CDM,11043T_1,"Removal of muscle and/or tissue, 20.0 sq cm or less",359.1,233.42,78.57,551.83,19
CDM,11043_1,"Removal of muscle and/or tissue, 20.0 sq cm or less",720.0,468.0,78.57,551.83,19
CDM,11044T_1,"Removal of bone, 20.0 sq cm or less",665.8,432.77,78.57,734.61,19
CDM,11044_1,"Removal of bone, 20.0 sq cm or less",980.0,637.0,78.57,734.61,19
CDM,11045T_1,"Removal of skin and tissue, each additional 20.0 sq cm or less",115.35,74.98,20.33,94.41,19
CDM,11045_1,"Removal of skin and tissue, each additional 20.0 sq cm or less",80.0,52.0,20.33,94.41,19
CDM,11046_1,"Removal of muscle and/or tissue, each additional 20.0 sq cm or less",150.0,97.5,43.2,170.56,19
CDM,11047T_1,"Removal of bone, each additional 20.0 sq cm or less",928.2,603.33,76.77,289.17,19
CDM,11047_1,"Removal of bone, each additional 20.0 sq cm or less",890.0,578.5,76.77,289.17,19
CDM,11050IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.38,2.85,1.1,11.31,16
CDM,11055_1,"Removal of noncancer thickened skin growth, 1 growth",97.0,63.05,12.97,172.23,19
CDM,11056_1,"Removal of noncancer thickened skin growth, 2-4 growths",120.0,78.0,18.72,198.94,19
CDM,11057IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.4,0.91,0.35,3.62,16
CDM,11057_1,"Removal of noncancer thickened skin growth, more than 4 growths",150.0,97.5,24.14,217.67,19
CDM,11067IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.12,2.68,1.03,10.64,16
CDM,11067OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.22,7.94,3.06,31.56,16
CDM,110736IP _1,UNCLASSIFIED DRUGS,7.3,4.75,1.83,18.85,16
CDM,110736OP _1,UNCLASSIFIED DRUGS,1.98,1.29,0.5,5.11,16
CDM,11076IP _1,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.31,0.85,0.13,3.38,17
CDM,11079IP _1,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.49,0.97,0.13,3.85,17
CDM,11102_1,"Biopsy of related skin growth, first growth",237.5,154.38,28.3,244.82,19
CDM,11103_1,"Biopsy of related skin growth, each additional growth",137.5,89.38,16.56,121.32,19
CDM,11104_1,"Punch biopsy, first skin growth",295.0,191.75,35.59,302.75,19
CDM,11105_1,"Punch biopsy, each additional skin growth",160.0,104.0,19.59,142.3,19
CDM,11106_1,"Incision biopsy, first skin growth",357.5,232.38,43.19,374.92,19
CDM,11107_1,"Incision biopsy, each additional skin growth",192.5,125.13,23.39,171.98,19
CDM,11110IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.9,7.09,2.73,28.15,16
CDM,11110OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.2,11.18,4.3,44.42,16
CDM,11111IP _1,UNCLASSIFIED DRUGS,7.84,5.1,1.96,20.25,16
CDM,11111OP _1,UNCLASSIFIED DRUGS,30.33,19.71,7.58,78.33,16
CDM,11112IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.25,4.71,1.81,18.72,16
CDM,11112OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.27,18.38,7.07,73.01,16
CDM,11117IP _1,"PREDNISOLONE ORAL, PER 5 MG",12.24,7.96,0.98,31.61,17
CDM,11118IP _1,"PREDNISOLONE ORAL, PER 5 MG",15.67,10.19,0.98,40.47,17
CDM,11129IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.43,3.53,1.36,14.02,16
CDM,11129OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.87,23.97,9.22,95.22,16
CDM,11138OP _1,UNCLASSIFIED DRUGS,28.25,18.36,7.06,72.96,16
CDM,111439IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.12,1.38,0.53,5.47,16
CDM,111439OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.13,6.58,2.53,26.16,16
CDM,11143IP _1,UNCLASSIFIED DRUGS,101.85,66.2,25.46,263.03,16
CDM,11143OP _1,UNCLASSIFIED DRUGS,90.3,58.7,22.58,233.2,16
CDM,11144IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.13,22.83,8.78,90.72,16
CDM,11144OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.83,17.44,6.71,69.29,16
CDM,11146IP _1,UNCLASSIFIED DRUGS,7.7,5.01,1.93,19.89,16
CDM,11146OP _1,UNCLASSIFIED DRUGS,11.5,7.48,2.88,29.7,16
CDM,11147IP _1,UNCLASSIFIED DRUGS,7.46,4.85,1.87,19.27,16
CDM,11147OP _1,UNCLASSIFIED DRUGS,31.65,20.57,7.91,81.74,16
CDM,11148IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.9,4.49,1.73,17.82,16
CDM,11150IP _1,"INJECTION, PROPOFOL, 10 MG",9.72,6.32,0.1,25.1,17
CDM,11150OP _1,"INJECTION, PROPOFOL, 10 MG",2.05,1.33,0.1,5.29,17
CDM,11200T_1,"Removal of skin tag, 1-15 skin tags",107.1,69.62,47.18,232.58,19
CDM,11200_1,"Removal of skin tag, 1-15 skin tags",200.0,130.0,47.18,232.58,19
CDM,112012IP _1,UNCLASSIFIED DRUGS,3.35,2.18,0.84,8.65,16
CDM,112012OP _1,UNCLASSIFIED DRUGS,3.93,2.55,0.98,10.15,16
CDM,11201T_1,"Removal of skin tag, each additional 10 skin tags",21.0,13.65,12.2,78.57,19
CDM,11201_1,"Removal of skin tag, each additional 10 skin tags",80.0,52.0,12.2,78.57,19
CDM,112180OP _1,LORAZEPAM 2 MG/ML CARPUJECT,38.17,24.81,9.54,26.72,11
CDM,112193IP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",79.72,51.82,0.15,205.88,17
CDM,112193OP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",55.08,35.8,0.15,142.24,17
CDM,112200IP _1,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",1139.35,740.58,33.89,2942.37,19
CDM,112201IP _1,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",1310.0,851.5,33.89,3383.08,19
CDM,112201OP _1,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",553.21,359.59,33.89,1428.66,19
CDM,112224IP _1,"INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG",600.1,390.07,0.51,1549.76,17
CDM,112224OP _1,"INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG",246.02,159.91,0.51,635.35,17
CDM,112292IP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",64.25,41.76,0.19,165.93,17
CDM,112292OP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",16.9,10.99,0.19,43.64,17
CDM,11238IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.99,6.49,2.5,25.8,16
CDM,11239IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.09,9.81,3.77,38.97,16
CDM,11239OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.03,18.22,7.01,72.39,16
CDM,112480IP _1,UNCLASSIFIED DRUGS,6.35,4.13,1.59,16.4,16
CDM,112480OP _1,UNCLASSIFIED DRUGS,19.39,12.6,4.85,50.07,16
CDM,11286IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.2,6.63,2.55,26.34,16
CDM,11288IP _1,VITAMIN B-2 100 MG TABLET,4.0,2.6,1.0,2.8,11
CDM,11290IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",75.25,48.91,18.81,194.33,16
CDM,11291IP _1,UNCLASSIFIED DRUGS,1149.04,746.88,287.26,2967.4,16
CDM,112928OP _1,"INJECTION, LEVOFLOXACIN, 250 MG",1.01,0.66,0.25,2.61,17
CDM,112929IP _1,"INJECTION, LEVOFLOXACIN, 250 MG",2.68,1.74,0.67,6.92,17
CDM,11292IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.25,12.51,4.81,49.71,16
CDM,11293IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",44.45,28.89,11.11,114.79,16
CDM,11293OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.65,16.02,6.16,63.66,16
CDM,112972IP _1,GENTEAL TEARS 0.1%-0.2%-0.3%,4.03,2.62,1.01,2.82,11
CDM,112972OP _1,GENTEAL TEARS 0.1%-0.2%-0.3%,2.07,1.35,0.52,1.45,11
CDM,11300_1,"Shaving of skin growth of body, arms, or legs, 0.5 cm or less",197.0,128.05,26.01,244.38,19
CDM,11301_1,"Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm",250.0,162.5,39.34,294.51,19
CDM,11302_1,"Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm",290.0,188.5,45.69,331.84,19
CDM,11303_1,"Shaving of skin growth of body, arms, or legs, more than 2.0 cm",345.5,224.58,54.11,367.64,19
CDM,11305_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",170.0,110.5,30.94,256.29,19
CDM,11306_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",260.0,169.0,38.57,297.35,19
CDM,11307_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",300.0,195.0,48.48,337.21,19
CDM,11308_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm",300.0,195.0,56.47,356.79,19
CDM,11310_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",200.0,130.0,34.34,280.95,19
CDM,11311_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",230.0,149.5,47.61,330.86,19
CDM,11312_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",330.0,214.5,56.7,376.73,19
CDM,11313_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, more than 2.0 cm",410.6,266.89,72.34,437.61,19
CDM,113171IP _1,UNCLASSIFIED DRUGS,3.85,2.5,0.96,9.94,16
CDM,113172IP _1,UNCLASSIFIED DRUGS,5.3,3.45,1.33,13.69,16
CDM,113172OP _1,UNCLASSIFIED DRUGS,9.01,5.86,2.25,23.27,16
CDM,113188IP _1,UNCLASSIFIED DRUGS,101.65,66.07,25.41,262.51,16
CDM,113188OP _1,UNCLASSIFIED DRUGS,33.8,21.97,8.45,87.29,16
CDM,113348IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.96,5.17,1.99,20.56,16
CDM,113348OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.3,9.95,3.83,39.51,16
CDM,113352OP _1,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",1582.8,1028.82,14.62,4087.58,19
CDM,113386OP _1,"INJECTION, AMINOPHYLLIN, UP TO 250 MG",5.9,3.84,1.48,15.24,17
CDM,11338IP _1,"INJECTION, SARGRAMOSTIM (GM-CSF), 50 MCG",2212.91,1438.39,65.46,5714.84,19
CDM,11338OP _1,"INJECTION, SARGRAMOSTIM (GM-CSF), 50 MCG",768.77,499.7,65.46,1985.35,19
CDM,11340IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.73,8.27,3.18,32.88,16
CDM,11340OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.3,17.1,6.58,67.92,16
CDM,11349IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.01,1.96,0.75,7.77,16
CDM,11349OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.63,17.31,6.66,68.77,16
CDM,11350IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.67,3.04,1.17,12.06,16
CDM,11350OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.27,10.58,4.07,42.02,16
CDM,11351IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.42,3.52,1.36,14.0,16
CDM,11351OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.36,10.63,4.09,42.25,16
CDM,11359IP _1,UNCLASSIFIED DRUGS,22.55,14.66,5.64,58.24,16
CDM,11359OP _1,UNCLASSIFIED DRUGS,29.79,19.36,7.45,76.93,16
CDM,11368IP _1,"INJECTION, SINCALIDE, 5 MICROGRAMS",685.36,445.48,116.74,1769.94,19
CDM,11368OP _1,"INJECTION, SINCALIDE, 5 MICROGRAMS",276.48,179.71,69.12,714.01,19
CDM,113IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.21,2.74,1.05,10.87,16
CDM,113OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.15,7.9,3.04,31.38,16
CDM,11400T_1,"Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less",304.5,197.93,46.0,307.76,19
CDM,11400_1,"Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less",290.0,188.5,46.45,307.76,19
CDM,11401T_1,"Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm",263.6,171.34,57.39,375.21,19
CDM,11401_1,"Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm",370.0,240.5,57.39,375.21,19
CDM,11402T_1,"Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm",286.7,186.36,61.12,412.69,19
CDM,11402_1,"Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm",410.0,266.5,61.12,412.69,19
CDM,11403T_1,"Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm",308.7,200.66,77.06,473.49,19
CDM,11403_1,"Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm",480.0,312.0,77.06,473.49,19
CDM,11404IP _1,UNCLASSIFIED DRUGS,9.23,6.0,2.31,23.84,16
CDM,11404OP _1,UNCLASSIFIED DRUGS,3.48,2.26,0.87,8.99,16
CDM,11404T_1,"Removal of noncancer skin growth of body, arms, or legs, 3.1-4.0 cm",2100.0,1365.0,78.57,534.97,19
CDM,11404_1,"Removal of noncancer skin growth of body, arms, or legs, 3.1-4.0 cm",530.0,344.5,78.57,534.97,19
CDM,11406T_1,"Removal of noncancer skin growth of body, arms, or legs, more than 4.0 cm",2100.0,1365.0,78.57,753.36,19
CDM,11406_1,"Removal of noncancer skin growth of body, arms, or legs, more than 4.0 cm",771.8,501.67,78.57,753.36,19
CDM,11420T_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",595.4,387.01,51.72,307.71,19
CDM,11420_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",310.0,201.5,51.72,307.71,19
CDM,11421IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.38,2.85,1.1,11.31,16
CDM,11421OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.53,13.99,5.38,55.6,16
CDM,11421T_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",265.7,172.71,63.1,385.44,19
CDM,11421_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",390.0,253.5,63.1,385.44,19
CDM,11422T_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",291.9,189.74,78.57,431.13,19
CDM,11422_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",440.0,286.0,78.57,431.13,19
CDM,11423T_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",326.6,212.29,78.57,491.16,19
CDM,11423_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",520.0,338.0,78.57,491.16,19
CDM,11424T_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",608.0,395.2,78.57,564.15,19
CDM,11424_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",597.5,388.38,78.57,564.15,19
CDM,11425IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.5,4.88,1.88,19.37,16
CDM,11425OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.55,14.01,5.39,55.65,16
CDM,11426T_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",2753.1,1789.52,78.57,825.0,19
CDM,11426_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",857.9,557.64,78.57,825.0,19
CDM,114287IP _1,UNCLASSIFIED DRUGS,4.66,3.03,1.17,12.03,16
CDM,114287OP _1,UNCLASSIFIED DRUGS,8.94,5.81,2.24,23.09,16
CDM,11440T_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",260.4,169.26,71.87,346.23,19
CDM,11440_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",330.0,214.5,71.87,346.23,19
CDM,11441IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.87,4.47,1.72,17.74,16
CDM,11441OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.62,4.3,1.66,17.1,16
CDM,11441T_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",293.0,190.45,78.57,418.91,19
CDM,11441_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",430.0,279.5,78.57,418.91,19
CDM,11442IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.91,3.84,1.48,15.26,16
CDM,11442OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.06,15.64,6.02,62.13,16
CDM,11442T_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",321.3,208.85,78.57,464.81,19
CDM,11442_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",480.0,312.0,78.57,464.81,19
CDM,11443T_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",360.2,234.13,78.57,547.78,19
CDM,11443_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",576.5,374.73,78.57,547.78,19
CDM,11444T_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",1133.0,736.45,78.57,690.0,19
CDM,11444_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",729.8,474.37,78.57,690.0,19
CDM,11446T_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",2753.1,1789.52,78.57,976.3,19
CDM,11446_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",996.5,647.73,78.57,976.3,19
CDM,11450T_1,Removal of skin and tissue of underarms for inflamed sweat glands with simple or intermediate repair,2753.1,1789.52,78.57,1023.31,19
CDM,11450_1,Removal of skin and tissue of underarms for inflamed sweat glands with simple or intermediate repair,1357.65,882.47,78.57,1023.31,19
CDM,11451T_1,Removal of skin and tissue of underarms for inflamed sweat glands with complex repair,1238.0,804.7,78.57,1251.41,19
CDM,11451_1,Removal of skin and tissue of underarms for inflamed sweat glands with complex repair,1183.4,769.21,78.57,1251.41,19
CDM,11462T_1,Removal of skin and tissue of groin for inflamed sweat glands with simple or intermediate repair,574.4,373.36,78.57,992.34,19
CDM,11462_1,Removal of skin and tissue of groin for inflamed sweat glands with simple or intermediate repair,1340.4,871.26,78.57,992.34,19
CDM,11463T_1,Removal of skin and tissue of groin for inflamed sweat glands with complicated repair,2753.1,1789.52,78.57,1270.11,19
CDM,11463_1,Removal of skin and tissue of groin for inflamed sweat glands with complicated repair,1215.9,790.34,78.57,1270.11,19
CDM,11470T_1,Removal of skin and tissue of anus or navel for inflamed sweat glands with simple or intermediate repair,678.3,440.9,78.57,1088.24,19
CDM,11470_1,Removal of skin and tissue of anus or navel for inflamed sweat glands with simple or intermediate repair,995.4,647.01,78.57,1088.24,19
CDM,11471T_1,Removal of skin and tissue of anus or navel for inflamed sweat glands with complicated repair,1517.3,986.25,78.57,1288.56,19
CDM,11471_1,Removal of skin and tissue of anus or navel for inflamed sweat glands with complicated repair,1249.5,812.18,78.57,1288.56,19
CDM,114IP _1,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",327.38,212.8,27.13,845.46,17
CDM,114OP _1,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",204.82,133.13,27.13,528.95,17
CDM,11500IP _1,TEMAZEPAM 7.5 MG CAPSULE,22.83,14.84,5.71,15.98,11
CDM,11500OP _1,TEMAZEPAM 7.5 MG CAPSULE,21.26,13.82,5.32,14.88,11
CDM,11507IP _1,"INJECTION, TERBUTALINE SULFATE, UP TO 1 MG",190.11,123.57,2.62,490.96,17
CDM,11509IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.33,13.21,5.08,52.5,16
CDM,11509OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.7,10.21,3.93,40.55,16
CDM,115221IP _1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG",3.74,2.43,0.28,9.66,17
CDM,115221OP _1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG",2.09,1.36,0.28,5.4,17
CDM,115385OP _1,UNCLASSIFIED DRUGS,1555.77,1011.25,388.94,4017.78,16
CDM,115543IP _1,UNCLASSIFIED DRUGS,1.65,1.07,0.41,4.26,16
CDM,115589IP _1,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",434.25,282.26,0.93,1302.75,17
CDM,115590IP _1,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",432.19,280.92,0.93,1296.57,17
CDM,11561IP _1,UNCLASSIFIED DRUGS,13.9,9.04,3.48,35.9,16
CDM,11561OP _1,UNCLASSIFIED DRUGS,5.22,3.39,1.31,13.48,16
CDM,11562IP _1,UNCLASSIFIED DRUGS,16.0,10.4,4.0,41.32,16
CDM,11562OP _1,UNCLASSIFIED DRUGS,3.0,1.95,0.75,7.75,16
CDM,11565IP _1,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",332.71,216.26,2.19,859.22,17
CDM,11565OP _1,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",150.86,98.06,2.19,389.6,17
CDM,11566IP _1,UNCLASSIFIED DRUGS,174.23,113.25,43.56,449.95,16
CDM,11566OP _1,UNCLASSIFIED DRUGS,172.35,112.03,43.09,445.09,16
CDM,11567IP _1,UNCLASSIFIED DRUGS,22.85,14.85,5.71,59.01,16
CDM,11567OP _1,UNCLASSIFIED DRUGS,48.73,31.67,12.18,125.85,16
CDM,115681IP _1,UNCLASSIFIED DRUGS,1.39,0.9,0.35,3.59,16
CDM,115705OP _1,"EPOGEN 20,000 UNIT/2 ML VIAL",14.42,9.37,3.61,10.09,11
CDM,115728IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.68,1.09,0.42,4.34,16
CDM,115728OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.23,1.45,0.56,5.76,16
CDM,115753IP _1,UNCLASSIFIED DRUGS,3.83,2.49,0.96,9.89,16
CDM,11576IP _1,UNCLASSIFIED DRUGS,7.68,4.99,1.92,19.83,16
CDM,115775IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.86,2.51,0.97,9.97,16
CDM,115775OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.78,7.01,2.7,27.84,16
CDM,11584IP _1,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",31.13,20.23,0.78,80.39,17
CDM,11584OP _1,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",101.79,66.16,0.78,262.87,17
CDM,115851IP _1,UNCLASSIFIED DRUGS,76.4,49.66,19.1,197.3,16
CDM,11588IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",106.5,69.23,26.63,275.04,16
CDM,11588OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.27,24.23,9.32,96.25,16
CDM,115972IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.63,1.71,0.66,6.79,16
CDM,11600_1,"Removal of cancer skin growth of body, arms, or legs, 0.5 cm or less",467.3,303.75,47.94,474.7,19
CDM,11601_1,"Removal of cancer skin growth of body, arms, or legs, 0.6-1.0 cm",580.0,377.0,66.78,549.89,19
CDM,11602_1,"Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm",636.3,413.6,78.57,589.78,19
CDM,11603T_1,"Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm",719.3,467.55,78.57,670.65,19
CDM,11603_1,"Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm",724.5,470.93,78.57,670.65,19
CDM,11604T_1,"Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm",803.3,522.15,78.57,745.27,19
CDM,11604_1,"Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm",799.1,519.42,78.57,745.27,19
CDM,116060IP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",16.05,10.43,1.26,41.45,17
CDM,116060OP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",12.6,8.19,1.26,32.54,17
CDM,11606T_1,"Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm",2100.0,1365.0,78.57,1062.31,19
CDM,11606_1,"Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm",1127.7,733.01,78.57,1062.31,19
CDM,11608IP _1,UNCLASSIFIED DRUGS,4.38,2.85,1.1,11.31,16
CDM,116144IP _1,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",102.7,66.76,8.64,265.22,17
CDM,116144OP _1,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",68.93,44.8,8.64,178.01,17
CDM,116145OP _1,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",26.2,17.03,6.55,67.66,17
CDM,116146OP _1,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",85.7,55.71,8.64,221.32,17
CDM,116170IP _1,UNCLASSIFIED DRUGS,1.1,0.72,0.28,2.84,16
CDM,116170OP _1,UNCLASSIFIED DRUGS,1.28,0.83,0.32,3.31,16
CDM,11620_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",477.8,310.57,67.7,477.18,19
CDM,116210OP _1,"BCG LIVE INTRAVESICAL INSTILLATION, 1 MG",413.01,268.46,3.48,1066.6,19
CDM,11621_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",583.8,379.47,78.57,552.61,19
CDM,11622T_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",425.3,276.45,78.57,608.89,19
CDM,11622_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",661.5,429.98,78.57,608.89,19
CDM,116232IP _1,UNCLASSIFIED DRUGS,2589.79,1683.36,647.45,6688.13,16
CDM,11623_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",770.0,500.5,78.57,710.79,19
CDM,11624IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.54,6.2,2.39,24.64,16
CDM,11624OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.66,14.08,5.42,55.94,16
CDM,11624_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",869.4,565.11,78.57,806.77,19
CDM,11626T_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",2753.1,1789.52,78.57,967.0,19
CDM,11626_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",1056.3,686.6,78.57,967.0,19
CDM,11627IP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",1226.67,797.34,306.67,3167.88,16
CDM,11627OP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",6.71,4.36,1.68,17.33,16
CDM,116307IP _1,"ANTI-INHIBITOR, PER I.U.",20306.87,13199.47,2.59,52442.49,19
CDM,11630IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.83,7.04,2.71,27.97,16
CDM,11630OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.96,9.07,3.49,36.05,16
CDM,116319IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.7,3.71,1.43,14.72,16
CDM,116327IP _1,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",3.23,2.1,0.02,8.34,17
CDM,116327OP _1,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",15.88,10.32,0.02,41.01,17
CDM,116332IP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",221.3,143.85,0.19,571.51,17
CDM,116332OP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",7.8,5.07,0.19,20.14,17
CDM,116333IP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",174.0,113.1,0.19,449.36,17
CDM,116333OP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",20.42,13.27,0.19,52.73,17
CDM,11634IP _1,UNCLASSIFIED DRUGS,2270.0,1475.5,567.5,5862.28,16
CDM,11634OP _1,UNCLASSIFIED DRUGS,14.42,9.37,3.61,37.24,16
CDM,11635IP _1,UNCLASSIFIED DRUGS,49.98,32.49,12.5,129.07,16
CDM,116394IP _1,UNCLASSIFIED DRUGS,10.07,6.55,2.52,26.01,16
CDM,116394OP _1,UNCLASSIFIED DRUGS,2.07,1.35,0.52,5.35,16
CDM,11640IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.76,3.74,1.44,14.88,16
CDM,11640OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.5,13.98,5.38,55.52,16
CDM,11640_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",498.8,324.22,78.57,488.94,19
CDM,11641IP _1,UNCLASSIFIED DRUGS,1988.12,1292.28,497.03,5134.32,16
CDM,11641T_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",413.7,268.91,78.57,570.3,19
CDM,11641_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",635.3,412.95,78.57,570.3,19
CDM,11642T_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",462.0,300.3,78.57,644.2,19
CDM,11642_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",710.0,461.5,78.57,644.2,19
CDM,11643T_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",501.9,326.24,78.57,755.63,19
CDM,11643_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",950.0,617.5,78.57,755.63,19
CDM,11644T_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",2100.0,1365.0,78.57,929.44,19
CDM,11644_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",1102.5,716.63,78.57,929.44,19
CDM,116451IP _1,UNCLASSIFIED DRUGS,10.94,7.11,2.74,28.25,16
CDM,116451OP _1,UNCLASSIFIED DRUGS,3.05,1.98,0.76,7.88,16
CDM,11646T_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",2753.1,1789.52,78.57,1202.67,19
CDM,11646_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",1357.7,882.51,78.57,1202.67,19
CDM,116615IP _1,MAGNESIUM GLUC 500 MG TABLET,3.95,2.57,0.99,2.77,11
CDM,116630OP _1,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",36915.04,23994.78,3.2,95333.09,19
CDM,116631OP _1,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",28147.63,18295.96,3.2,72691.25,19
CDM,116632OP _1,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",3758.62,2443.1,3.2,9706.64,19
CDM,11664IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.42,2.22,0.86,8.83,16
CDM,11664OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.23,7.95,3.06,31.58,16
CDM,116659OP _1,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",5341.66,3472.08,3.2,13794.84,19
CDM,116684IP _1,UNCLASSIFIED DRUGS,4.3,2.8,1.08,11.1,16
CDM,116684OP _1,UNCLASSIFIED DRUGS,10.27,6.68,2.57,26.52,16
CDM,11671IP _1,"STERILE WATER/SALINE, 500 ML",11.14,7.24,2.79,7.8,16
CDM,11671OP _1,"STERILE WATER/SALINE, 500 ML",3.98,2.59,1.0,4.15,16
CDM,116749IP _1,UNCLASSIFIED DRUGS,2.47,1.61,0.62,6.38,16
CDM,116749OP _1,UNCLASSIFIED DRUGS,2.53,1.64,0.63,6.53,16
CDM,116787IP _1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",23.87,15.52,5.97,61.64,16
CDM,116787OP _1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",17.32,11.26,4.33,44.73,16
CDM,116809IP _1,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",96.21,62.54,0.12,288.63,17
CDM,116809OP _1,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",112.39,73.05,0.12,337.17,17
CDM,11693IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.75,3.74,1.44,14.85,16
CDM,116993IP _1,"Hepatitis B vaccine, adult dosage (3 dose schedule)",348.3,226.4,30.97,899.48,19
CDM,116993OP _1,"Hepatitis B vaccine, adult dosage (3 dose schedule)",580.4,377.26,30.97,1498.88,19
CDM,11700IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.04,9.78,3.76,38.84,16
CDM,11700OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.5,13.33,5.13,52.94,16
CDM,11701IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.95,8.42,3.24,33.44,16
CDM,11701OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.32,9.96,3.83,39.56,16
CDM,117061IP _1,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",356.19,231.52,30.97,919.86,19
CDM,117061OP _1,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",122.2,79.43,30.55,315.58,19
CDM,117065OP _1,"Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule)",245.53,159.59,61.38,634.08,19
CDM,117131IP _1,Hepatitis A vaccine adult dosage,45.0,29.25,11.25,116.21,19
CDM,117131OP _1,Hepatitis A vaccine adult dosage,344.44,223.89,30.97,889.52,19
CDM,11719_1,Trimming of fingernails or toenails,60.0,39.0,6.42,78.57,19
CDM,11720_1,"Removal of fingernails or toenails, 1-5 nails",75.0,48.75,11.97,78.57,19
CDM,11721_1,"Removal of fingernails or toenails, 6 or more nails",100.0,65.0,20.18,107.35,19
CDM,11730_1,"Simple separation of fingernail or toenail from nail bed, first nail",240.0,156.0,38.29,278.06,19
CDM,117318IP _1,Hepatitis A and hepatitis B vaccine,708.22,460.34,163.76,1828.98,19
CDM,117318OP _1,Hepatitis A and hepatitis B vaccine,946.54,615.25,163.76,2444.44,19
CDM,11732_1,"Simple separation of fingernail or toenail from nail bed, each additional nail",90.0,58.5,14.28,80.56,19
CDM,11740_1,Removal of blood accumulation under fingernail or toenail,110.0,71.5,26.37,137.21,19
CDM,11750_1,Permanent removal fingernail or toenail,540.0,351.0,78.57,386.47,19
CDM,11755_1,Biopsy of fingernail or toenail,351.8,228.67,51.39,297.17,19
CDM,11760_1,Repair of fingernail or toenail bed,430.0,279.5,78.57,450.04,19
CDM,11762_1,Repair of fingernail or toenail bed with graft,787.5,511.88,78.57,693.79,19
CDM,11765_1,Removal of skin of fingernail or toenail,350.0,227.5,29.45,399.23,19
CDM,117665IP _1,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",158.93,103.3,2.3,410.44,17
CDM,11770T_1,Simple removal of cyst of tailbone,2750.0,1787.5,78.57,843.69,19
CDM,11770_1,Simple removal of cyst of tailbone,680.0,442.0,78.57,843.69,19
CDM,11771_1,Extensive removal of cyst of tailbone,1390.2,903.63,78.57,1482.18,19
CDM,11772_1,Complicated removal of cyst of tailbone,1686.3,1096.1,78.57,1824.84,19
CDM,117740IP _1,UNCLASSIFIED DRUGS,792.89,515.38,198.22,2047.64,16
CDM,117741IP _1,UNCLASSIFIED BIOLOGICS,441.3,286.85,110.33,1139.66,16
CDM,117741OP _1,UNCLASSIFIED BIOLOGICS,286.74,186.38,71.69,740.51,16
CDM,117765IP _1,UNCLASSIFIED DRUGS,18.43,11.98,4.61,47.6,16
CDM,117765OP _1,UNCLASSIFIED DRUGS,14.37,9.34,3.59,37.11,16
CDM,117801IP _1,UNCLASSIFIED DRUGS,86.86,56.46,21.72,224.32,16
CDM,117801OP _1,UNCLASSIFIED DRUGS,64.73,42.07,16.18,167.17,16
CDM,117869IP _1,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",2.79,1.81,0.43,7.21,17
CDM,117869OP _1,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",1.56,1.01,0.39,4.03,17
CDM,117955OP _1,UNCLASSIFIED DRUGS,18.57,12.07,4.64,47.96,16
CDM,117975IP _1,"INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG",123.2,80.08,0.16,318.16,17
CDM,118173IP _1,RECOMBIVAX HB 40 MCG/ML VIAL,798.1,518.77,199.53,558.67,11
CDM,118175IP _1,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",402.4,261.56,30.97,1039.2,19
CDM,118208IP _1,"INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS",2624.65,1706.02,301.23,6778.16,19
CDM,118208OP _1,"INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS",1381.6,898.04,301.23,3567.98,19
CDM,118255IP _1,UNCLASSIFIED DRUGS,3.52,2.29,0.88,9.09,16
CDM,118255OP _1,UNCLASSIFIED DRUGS,2.62,1.7,0.66,6.77,16
CDM,118456OP _1,"INJECTION, DMSO, DIMETHYL SULFOXIDE, 50%, 50 ML",34.72,22.57,8.68,794.18,19
CDM,118460IP _1,UNCLASSIFIED DRUGS,6.67,4.34,1.67,17.23,16
CDM,118460OP _1,UNCLASSIFIED DRUGS,14.36,9.33,3.59,37.08,16
CDM,118468OP _1,UNCLASSIFIED DRUGS,1.32,0.86,0.33,3.41,16
CDM,118501IP _1,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",10.34,6.72,2.59,31.02,17
CDM,118501OP _1,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",1.13,0.73,0.28,3.39,17
CDM,118622IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.89,2.53,0.97,10.05,16
CDM,118622OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.7,21.26,8.18,84.45,16
CDM,118625IP _1,UNCLASSIFIED DRUGS,2.53,1.64,0.63,6.53,16
CDM,118625OP _1,UNCLASSIFIED DRUGS,14.65,9.52,3.66,37.83,16
CDM,118668IP _1,UNCLASSIFIED DRUGS,4.05,2.63,1.01,10.46,16
CDM,118668OP _1,UNCLASSIFIED DRUGS,26.32,17.11,6.58,67.97,16
CDM,118700IP _1,UNCLASSIFIED DRUGS,45.72,29.72,11.43,118.07,16
CDM,118700OP _1,UNCLASSIFIED DRUGS,35.33,22.96,8.83,91.24,16
CDM,118734IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.53,2.94,1.13,11.7,16
CDM,118734OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.42,1.57,0.61,6.25,16
CDM,118750OP _1,CEFAZOLIN 1 GRAM-10 ML IN STERILE WATER INTRAVENOUS SYRINGE,2.83,1.84,0.71,1.98,11
CDM,118765OP _1,"HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULAR INJECTION, 1 MG",522.52,339.64,8.01,1349.41,19
CDM,118860IP _1,MAG GLYCINATE 100 MG TABLET,5.4,3.51,1.35,3.78,11
CDM,118877OP _1,"INJECTION, CYTARABINE, 100 MG",12.64,8.22,0.89,37.92,17
CDM,11892IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.85,18.75,7.21,74.51,16
CDM,11892OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",44.75,29.09,11.19,115.57,16
CDM,118989IP _1,UNCLASSIFIED DRUGS,5.63,3.66,1.41,14.54,16
CDM,118990IP _1,UNCLASSIFIED DRUGS,15.34,9.97,3.84,39.62,16
CDM,118990OP _1,UNCLASSIFIED DRUGS,19.92,12.95,4.98,51.44,16
CDM,118996IP _1,"VITAMIN D3 5,000 UNIT TABLET",2.03,1.32,0.51,1.42,11
CDM,11900T_1,"Injection into skin growth, 1-7 growths",97.7,63.51,17.93,137.23,19
CDM,11900_1,"Injection into skin growth, 1-7 growths",150.0,97.5,17.93,137.23,19
CDM,11901_1,"Injection into skin growth, more than 7 growths",882.0,573.3,26.26,168.62,19
CDM,119104IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.7,12.81,4.93,50.88,16
CDM,119104OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.56,12.71,4.89,50.51,16
CDM,119105IP _1,UNCLASSIFIED DRUGS,10.8,7.02,2.7,27.89,16
CDM,119105OP _1,UNCLASSIFIED DRUGS,15.89,10.33,3.97,41.04,16
CDM,119133IP _1,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (INVEGA SUSTENNA), 1 MG",16382.73,10648.77,16.02,42308.4,19
CDM,119133OP _1,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (INVEGA SUSTENNA), 1 MG",3422.2,2224.43,16.02,8837.83,19
CDM,119134IP _1,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (INVEGA SUSTENNA), 1 MG",15797.05,10268.08,16.02,40795.88,19
CDM,119134OP _1,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (INVEGA SUSTENNA), 1 MG",2261.39,1469.9,16.02,5840.04,19
CDM,119135IP _1,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (INVEGA SUSTENNA), 1 MG",15356.83,9981.94,16.02,39659.01,19
CDM,119135OP _1,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (INVEGA SUSTENNA), 1 MG",5540.07,3601.05,16.02,14307.23,19
CDM,11920_1,"Tattooing of skin to correct color issue, 6.0 sq cm or less",493.5,320.78,78.57,458.71,19
CDM,11921T_1,"Tattooing of skin to correct color issue, 6.1-20.0 sq cm",284.6,184.99,78.57,531.19,19
CDM,11921_1,"Tattooing of skin to correct color issue, 6.1-20.0 sq cm",603.8,392.47,78.57,531.19,19
CDM,11922_1,"Tattooing of skin to correct color issue, each additional 20.0 sq cm",140.7,91.46,22.28,318.01,19
CDM,119323OP _1,UNCLASSIFIED DRUGS,2.51,1.63,0.63,6.48,16
CDM,119395IP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",88.81,57.73,1.26,229.35,17
CDM,119418IP _1,UNCLASSIFIED DRUGS,48.69,31.65,12.17,125.74,16
CDM,119418OP _1,UNCLASSIFIED DRUGS,45.46,29.55,11.37,117.4,16
CDM,119446IP _1,"INJECTION, TOCILIZUMAB, FOR HOSPITALIZED ADULTS AND PEDIATRIC PATIENTS (2 YEARS OF AGE AND OLDER) WITH COVID-19 WHO ARE RECEIVING SYSTEMIC CORTICOSTEROIDS AND REQUIRE SUPPLEMENTAL OXYGEN, NON-INVASIVE",431.57,280.52,8.02,1578.71,19
CDM,119450IP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",98.87,64.27,0.28,255.33,17
CDM,119450OP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",82.46,53.6,0.28,212.95,17
CDM,119451IP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",154.99,100.74,0.28,400.26,17
CDM,119451OP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",212.89,138.38,0.28,549.79,17
CDM,119452IP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",299.9,194.94,0.28,774.49,17
CDM,119452OP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",218.13,141.78,0.28,563.32,17
CDM,119453IP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",480.13,312.08,0.28,1239.94,17
CDM,119453OP _1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",636.55,413.76,0.28,1643.89,17
CDM,11950T_1,"Injection of filling material under skin, 1.0 cc or less",630.0,409.5,40.38,192.61,19
CDM,11950_1,"Injection of filling material under skin, 1.0 cc or less",315.0,204.75,40.38,192.61,19
CDM,11951T_1,"Injection of filling material under skin, 1.1-5.0 cc",150.2,97.63,56.5,255.59,19
CDM,11951_1,"Injection of filling material under skin, 1.1-5.0 cc",340.0,221.0,56.5,255.59,19
CDM,11952T_1,"Injection of filling material under skin, 5.1-10.0 cc",172.2,111.93,78.57,345.8,19
CDM,11952_1,"Injection of filling material under skin, 5.1-10.0 cc",366.5,238.23,78.57,352.72,19
CDM,11954T_1,"Injection of filling material under skin, more than 10.0 cc",525.0,341.25,78.57,376.11,19
CDM,11954_1,"Injection of filling material under skin, more than 10.0 cc",428.4,278.46,78.57,376.11,19
CDM,11960T_1,Insertion of tissue expander,2635.5,1713.08,78.57,2869.18,19
CDM,11960_1,Insertion of tissue expander,2431.8,1580.67,78.57,2869.18,19
CDM,119626IP _1,"TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",223.15,145.05,55.79,673.22,17
CDM,119626OP _1,"TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",213.18,138.57,53.3,643.14,17
CDM,119664IP _1,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",314.0,204.1,23.38,942.0,17
CDM,119665IP _1,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",403.15,262.05,23.38,1209.45,17
CDM,119665OP _1,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",533.14,346.54,23.38,1599.42,17
CDM,11970T_1,Replacement of tissue expander with permanent implant,5606.0,3643.9,78.57,1700.01,19
CDM,11970_1,Replacement of tissue expander with permanent implant,2392.5,1555.13,78.57,1700.01,19
CDM,11971T_1,Removal of tissue expander,2753.1,1789.52,78.57,1450.51,19
CDM,11971_1,Removal of tissue expander,1183.4,769.21,78.57,1450.51,19
CDM,119764IP _1,UNCLASSIFIED DRUGS,4.41,2.87,1.1,11.39,16
CDM,119764OP _1,UNCLASSIFIED DRUGS,13.27,8.63,3.32,34.27,16
CDM,11976_1,Removal of implantable contraceptive capsules,390.0,253.5,73.0,344.03,19
CDM,119785IP _1,"INJECTION, AMIKACIN SULFATE, 100 MG",82.36,53.53,0.66,212.69,17
CDM,119785OP _1,"INJECTION, AMIKACIN SULFATE, 100 MG",7.56,4.91,0.66,19.52,17
CDM,119798IP _1,UNCLASSIFIED DRUGS,9.78,6.36,2.45,25.26,16
CDM,119798OP _1,UNCLASSIFIED DRUGS,3.22,2.09,0.81,8.32,16
CDM,119800IP _1,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",12.87,8.37,0.01,33.24,17
CDM,119800OP _1,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",54.2,35.23,0.01,139.97,17
CDM,119801IP _1,UNCLASSIFIED DRUGS,26.4,17.16,6.6,68.18,16
CDM,119801OP _1,UNCLASSIFIED DRUGS,26.0,16.9,6.5,67.15,16
CDM,11980_1,Placement of hormone pellet under skin,286.7,186.36,44.72,224.15,19
CDM,11981T_1,Insertion of drug delivery implant into tissue,82.5,53.63,49.59,237.95,19
CDM,11981_1,Insertion of drug delivery implant into tissue,275.0,178.75,49.59,237.95,19
CDM,11982_1,Removal of drug delivery implant from tissue,400.0,260.0,57.45,265.43,19
CDM,11983_1,Removal with reinsertion of drug delivery implant into tissue,400.0,260.0,78.57,335.82,19
CDM,119849IP _1,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",1140.43,741.28,174.75,2945.16,19
CDM,119849OP _1,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",517.28,336.23,129.32,1335.88,19
CDM,12001_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less",320.0,208.0,39.53,222.96,19
CDM,120029OP _1,"INJECTION, DOCETAXEL, 1 MG",315.18,204.87,0.69,945.54,19
CDM,12002T_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm",172.2,111.93,51.51,269.59,19
CDM,12002_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm",360.0,234.0,51.51,269.59,19
CDM,120031IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.73,6.97,2.68,27.71,16
CDM,120031OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.95,4.52,1.74,17.95,16
CDM,120045IP _1,"TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, PER STUDY DOSE, UP TO 20 MILLICURIES",6944.44,4513.89,796.48,20950.68,17
CDM,120045OP _1,"TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, PER STUDY DOSE, UP TO 20 MILLICURIES",8378.38,5445.95,796.48,25276.73,17
CDM,12004_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 7.6-12.5 cm",430.0,279.5,64.18,313.01,19
CDM,12005_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 12.6-20.0 cm",540.0,351.0,78.57,418.5,19
CDM,12006_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 20.1-30.0 cm",670.0,435.5,78.57,485.35,19
CDM,12007_1,"Simple repair of surface wound to scalp, neck, underarms, trunk, arms, or legs, more than 30.0 cm",830.0,539.5,78.57,545.92,19
CDM,12011T_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",172.2,111.93,48.74,266.98,19
CDM,12011_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",340.0,221.0,48.74,266.98,19
CDM,12013_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",380.0,247.0,49.63,278.11,19
CDM,12014T_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",172.2,111.93,63.97,338.68,19
CDM,12014_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",430.0,279.5,63.97,338.68,19
CDM,12015_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",540.0,351.0,78.57,407.62,19
CDM,12016_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",800.0,520.0,78.57,519.11,19
CDM,12017_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm",930.0,604.5,78.57,451.69,19
CDM,12018_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, more than 30.0 cm",1150.0,747.5,78.57,511.16,19
CDM,12020_1,Simple closure of surface wound reopening,700.0,455.0,70.04,717.74,19
CDM,12021_1,Repair of separation of wound closure with insertion of packing,420.0,273.0,78.57,427.62,19
CDM,12024IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.05,2.63,1.01,10.46,16
CDM,12024OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.61,12.75,4.9,50.64,16
CDM,12025IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.19,6.62,2.55,26.32,16
CDM,12025OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.9,12.94,4.98,51.39,16
CDM,12031T_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less",284.6,184.99,75.69,634.07,19
CDM,12031_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less",590.0,383.5,75.69,634.07,19
CDM,12032T_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm",284.6,184.99,78.57,732.46,19
CDM,12032_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm",740.0,481.0,78.57,732.46,19
CDM,12034T_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm",284.6,184.99,78.57,803.21,19
CDM,12034_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm",720.0,468.0,78.57,803.21,19
CDM,12035T_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 12.6-20.0 cm",284.6,184.99,78.57,926.39,19
CDM,12035_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 12.6-20.0 cm",820.0,533.0,78.57,926.39,19
CDM,12036T_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 20.1-30.0 cm",284.6,184.99,78.57,1022.97,19
CDM,12036_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 20.1-30.0 cm",980.0,637.0,78.57,1022.97,19
CDM,12037T_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, more than 30.0 cm",3431.4,2230.41,78.57,1143.91,19
CDM,12037_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, more than 30.0 cm",1180.0,767.0,78.57,1143.91,19
CDM,12041T_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less",526.1,341.97,78.57,636.66,19
CDM,12041_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less",560.0,364.0,78.57,636.66,19
CDM,12042T_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm",608.0,395.2,78.57,747.78,19
CDM,12042_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm",680.0,442.0,78.57,747.78,19
CDM,12044T_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 7.6-12.5 cm",284.6,184.99,78.57,916.11,19
CDM,12044_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 7.6-12.5 cm",820.0,533.0,78.57,916.11,19
CDM,12045T_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 12.6-20.0 cm",657.3,427.25,78.57,988.13,19
CDM,12045_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 12.6-20.0 cm",970.0,630.5,78.57,988.13,19
CDM,12046_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 20.1-30.0 cm",1140.0,741.0,78.57,1172.99,19
CDM,12047_1,"Intermediate repair of wound of neck, hands, feet, or genitals, more than 30.0 cm",1190.0,773.5,78.57,1283.44,19
CDM,12051T_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",284.6,184.99,78.57,683.31,19
CDM,12051_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",680.0,442.0,78.57,683.31,19
CDM,12052T_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",284.6,184.99,78.57,761.31,19
CDM,12052_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",760.0,494.0,78.57,761.31,19
CDM,12053T_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",976.5,634.73,78.57,876.9,19
CDM,12053_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",870.0,565.5,78.57,876.9,19
CDM,12054T_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",284.6,184.99,78.57,922.44,19
CDM,12054_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",910.0,591.5,78.57,922.44,19
CDM,12055T_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",1695.0,1101.75,78.57,1209.95,19
CDM,12055_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",1130.0,734.5,78.57,1209.95,19
CDM,12056_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm",1310.0,851.5,78.57,1382.14,19
CDM,12057_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, more than 30.0 cm",1500.0,975.0,78.57,1451.26,19
CDM,12098IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.8,11.57,4.45,45.97,16
CDM,12098OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.9,8.39,3.23,33.31,16
CDM,12203IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.27,4.73,1.82,18.77,16
CDM,12203OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.77,2.45,0.94,9.74,16
CDM,12205OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.35,7.38,2.84,29.31,16
CDM,12206IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.59,2.98,1.15,11.85,16
CDM,12206OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.59,16.63,6.4,66.09,16
CDM,12207IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.8,4.42,1.7,17.56,16
CDM,12207OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.7,13.46,5.18,53.46,16
CDM,12211IP _1,"DORNASE ALFA, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",369.23,240.0,58.47,953.54,19
CDM,1222IP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",6.48,4.21,0.01,16.73,17
CDM,1222OP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",5.0,3.25,0.01,12.91,17
CDM,1223IP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",2.91,1.89,0.01,7.52,17
CDM,1223OP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",3.08,2.0,0.01,7.95,17
CDM,1224IP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",48.75,31.69,0.01,125.9,17
CDM,1224OP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",7.96,5.17,0.01,20.56,17
CDM,122IP _1,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",10.99,7.14,2.75,28.38,17
CDM,12370IP _1,UNCLASSIFIED DRUGS,19.75,12.84,4.94,51.0,16
CDM,12370OP _1,UNCLASSIFIED DRUGS,26.61,17.3,6.65,68.72,16
CDM,123IP _1,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",19.17,12.46,4.79,49.51,17
CDM,123OP _1,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",18.56,12.06,4.64,47.93,17
CDM,12491IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.41,3.52,1.35,13.97,16
CDM,12491OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.73,12.17,4.68,48.37,16
CDM,12519IP _1,"INJECTION, PEGASPARGASE, PER SINGLE DOSE VIAL",67279.26,43731.52,16819.82,173748.69,19
CDM,12519OP _1,"INJECTION, PEGASPARGASE, PER SINGLE DOSE VIAL",22314.52,14504.44,5578.63,57627.25,19
CDM,12556IP _1,UNCLASSIFIED DRUGS,1.75,1.14,0.44,4.52,16
CDM,12556OP _1,UNCLASSIFIED DRUGS,5.58,3.63,1.4,14.41,16
CDM,12580IP _1,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",16.01,10.41,0.42,41.35,17
CDM,12580OP _1,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",3.76,2.44,0.42,9.71,17
CDM,1259IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.48,3.56,1.37,14.15,16
CDM,1259OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.1,23.47,9.03,93.23,16
CDM,1262IP _1,UNCLASSIFIED DRUGS,105.48,68.56,26.37,272.4,16
CDM,1262OP _1,UNCLASSIFIED DRUGS,68.55,44.56,17.14,177.03,16
CDM,12724IP _1,TERBINAFINE HCL 250 MG TABLET,42.0,27.3,10.5,29.4,11
CDM,12724OP _1,TERBINAFINE HCL 250 MG TABLET,11.15,7.25,2.79,7.81,11
CDM,12729IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.82,3.13,1.21,12.45,16
CDM,12729OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.35,10.63,4.09,42.22,16
CDM,12734IP _1,UNCLASSIFIED DRUGS,1108.5,720.53,277.13,2862.7,16
CDM,12734OP _1,UNCLASSIFIED DRUGS,6.98,4.54,1.75,18.03,16
CDM,12735IP _1,UNCLASSIFIED DRUGS,4.26,2.77,1.07,11.0,16
CDM,12735OP _1,UNCLASSIFIED DRUGS,2.82,1.83,0.71,7.28,16
CDM,12803IP _1,PILOCARPINE HCL 5 MG TABLET,9.2,5.98,2.3,6.44,11
CDM,12886IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.96,7.12,2.74,28.3,16
CDM,12933IP _1,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",20.47,13.31,0.21,52.86,17
CDM,12933OP _1,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",5.53,3.59,0.21,14.28,17
CDM,12934IP _1,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",50.35,32.73,0.21,130.03,17
CDM,12934OP _1,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",7.37,4.79,0.21,19.03,17
CDM,12935IP _1,"TACROLIMUS, PARENTERAL, 5 MG",1099.15,714.45,185.44,2838.55,19
CDM,1299IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.21,7.29,2.8,28.95,16
CDM,1299OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.88,2.52,0.97,10.02,16
CDM,1306IP _1,UNCLASSIFIED DRUGS,17.17,11.16,4.29,44.34,16
CDM,1306OP _1,UNCLASSIFIED DRUGS,3.61,2.35,0.9,9.32,16
CDM,13089IP _1,UNCLASSIFIED DRUGS,6.13,3.98,1.53,15.83,16
CDM,13089OP _1,UNCLASSIFIED DRUGS,10.63,6.91,2.66,27.45,16
CDM,1308IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.94,2.56,0.99,10.18,16
CDM,1308OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.16,10.5,4.04,41.73,16
CDM,13100T_1,"Complicated repair of wound of trunk, 1.1-2.5 cm",611.1,397.22,47.99,821.91,19
CDM,13100_1,"Complicated repair of wound of trunk, 1.1-2.5 cm",830.0,539.5,47.05,821.91,19
CDM,13101T_1,"Complicated repair of wound of trunk, 2.6-7.5 cm",611.1,397.22,78.57,958.53,19
CDM,13101_1,"Complicated repair of wound of trunk, 2.6-7.5 cm",1050.0,682.5,78.57,958.53,19
CDM,13102T_1,"Complicated repair of wound of trunk, each additional 5.0 cm or less",591.2,384.28,54.66,278.45,19
CDM,13102_1,"Complicated repair of wound of trunk, each additional 5.0 cm or less",280.0,182.0,54.66,278.45,19
CDM,13120T_1,"Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm",284.6,184.99,78.57,857.14,19
CDM,13120_1,"Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm",870.0,565.5,78.57,857.14,19
CDM,13121T_1,"Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm",611.1,397.22,78.57,1026.97,19
CDM,13121_1,"Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm",1160.0,754.0,78.57,1026.97,19
CDM,13122T_1,"Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less",284.6,184.99,62.36,303.84,19
CDM,13122_1,"Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less",320.0,208.0,62.36,303.84,19
CDM,1312IP _1,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",7.08,4.6,0.03,18.28,17
CDM,1312OP _1,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",9.05,5.88,0.03,23.37,17
CDM,13131T_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm",611.1,397.22,78.57,936.21,19
CDM,13131_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm",960.0,624.0,78.57,936.21,19
CDM,13132IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.33,11.91,4.58,47.34,16
CDM,13132OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.8,14.82,5.7,58.88,16
CDM,13132T_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm",611.1,397.22,78.57,1137.01,19
CDM,13132_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm",1530.0,994.5,78.57,1137.01,19
CDM,13133IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.14,11.14,4.29,44.26,16
CDM,13133OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.93,36.35,13.98,144.44,16
CDM,13133T_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less",591.2,384.28,78.57,403.44,19
CDM,13133_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less",450.0,292.5,78.57,403.44,19
CDM,13151T_1,"Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm",611.1,397.22,78.57,1019.92,19
CDM,13151_1,"Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm",1050.0,682.5,78.57,1019.92,19
CDM,13152T_1,"Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm",611.1,397.22,78.57,1196.37,19
CDM,13152_1,"Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm",1500.0,975.0,78.57,1196.37,19
CDM,13153_1,"Complicated repair of wound of eyelids, nose, ears, or lip, each additional 5.0 cm or less",500.0,325.0,78.57,442.16,19
CDM,13160T_1,Extensive or complicated repair of surface wound reopening,2635.5,1713.08,78.57,2374.85,19
CDM,13160_1,Extensive or complicated repair of surface wound reopening,2170.0,1410.5,78.57,2374.85,19
CDM,13295OP _1,UNCLASSIFIED DRUGS,1.62,1.05,0.41,4.18,16
CDM,1355IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.85,4.45,1.71,17.69,16
CDM,1355OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.24,11.86,4.56,47.1,16
CDM,1357IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.44,5.49,2.11,21.8,16
CDM,1357OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.22,16.39,6.31,65.13,16
CDM,1359IP _1,UNCLASSIFIED DRUGS,4.62,3.0,1.16,11.93,16
CDM,1359OP _1,UNCLASSIFIED DRUGS,5.3,3.45,1.33,13.69,16
CDM,13644IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.42,2.87,1.11,11.41,16
CDM,13644OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.1,8.52,3.28,33.83,16
CDM,13651IP _1,CRITIC-AID CLEAR AF 2% OINT,1.43,0.93,0.36,1.0,11
CDM,13691IP _1,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",22712.29,14762.99,1547.76,58654.49,19
CDM,13691OP _1,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",17372.59,11292.18,1547.76,44864.71,19
CDM,13818IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.07,1.35,0.52,5.35,16
CDM,13884IP _1,COLESTID 1 GM TABLET,16.29,10.59,4.07,11.4,11
CDM,1395IP _1,SOMA 350 MG TABLET,73.75,47.94,18.44,51.63,11
CDM,13981IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.33,2.16,0.83,8.6,16
CDM,13981OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.66,16.03,6.17,63.68,16
CDM,13982IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.65,3.02,1.16,12.01,16
CDM,13982OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.65,9.52,3.66,37.83,16
CDM,13983IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.0,2.6,1.0,10.33,16
CDM,13983OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.47,6.81,2.62,27.04,16
CDM,14000T_1,"Repair of wound of trunk by transferring skin, 10.0 sq cm or less",1962.5,1275.63,78.57,1518.18,19
CDM,14000_1,"Repair of wound of trunk by transferring skin, 10.0 sq cm or less",1617.0,1051.05,78.57,1518.18,19
CDM,14001T_1,"Repair of wound of trunk by transferring skin, 10.1-30.0 sq cm",2029.7,1319.31,78.57,1966.26,19
CDM,14001_1,"Repair of wound of trunk by transferring skin, 10.1-30.0 sq cm",2105.3,1368.45,78.57,1966.26,19
CDM,14020T_1,"Repair of wound of scalp, arms, or legs by transferring skin, 10.0 sq cm or less",1962.5,1275.63,78.57,1717.39,19
CDM,14020_1,"Repair of wound of scalp, arms, or legs by transferring skin, 10.0 sq cm or less",1821.8,1184.17,78.57,1717.39,19
CDM,14021T_1,"Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm",2029.7,1319.31,78.57,2154.55,19
CDM,14021_1,"Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm",2316.3,1505.6,78.57,2154.55,19
CDM,14040T_1,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less",2029.7,1319.31,78.57,1900.73,19
CDM,14040_1,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less",2034.9,1322.69,78.57,1900.73,19
CDM,14041T_1,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm",2029.7,1319.31,78.57,2325.33,19
CDM,14041_1,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm",2597.7,1688.51,78.57,2325.33,19
CDM,14060T_1,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less",2029.7,1319.31,78.57,2029.84,19
CDM,14060_1,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less",2116.8,1375.92,78.57,2029.84,19
CDM,14061T_1,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm",2029.7,1319.31,78.57,2497.08,19
CDM,14061_1,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm",2975.7,1934.21,78.57,2497.08,19
CDM,14100IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.22,15.74,6.06,62.55,16
CDM,14100OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",44.1,28.67,11.03,113.89,16
CDM,14101IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.63,19.91,7.66,79.1,16
CDM,14101OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.05,11.08,4.26,44.03,16
CDM,14123IP _1,UNCLASSIFIED DRUGS,1.15,0.75,0.29,2.97,16
CDM,14132IP _1,KETOCONAZOLE 2% SHAMPOO,1.79,1.16,0.45,1.25,11
CDM,14190IP _1,UNCLASSIFIED DRUGS,1.54,1.0,0.39,3.98,16
CDM,14190OP _1,UNCLASSIFIED DRUGS,3.15,2.05,0.79,8.13,16
CDM,14196IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",60.75,39.49,15.19,156.89,16
CDM,14196OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.75,19.34,7.44,76.83,16
CDM,14233IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.33,4.76,1.83,18.93,16
CDM,14266IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.29,4.09,1.57,16.24,16
CDM,14266OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.8,7.02,2.7,27.89,16
CDM,14301T_1,"Repair of wound by transferring skin, 30.1-60.0 sq cm",2696.0,1752.4,78.57,2632.7,19
CDM,14301_1,"Repair of wound by transferring skin, 30.1-60.0 sq cm",2951.6,1918.54,78.57,2632.7,19
CDM,14302T_1,"Repair of wound by transferring skin, each additional 30.0 sq cm",2696.0,1752.4,78.57,648.59,19
CDM,14302_1,"Repair of wound by transferring skin, each additional 30.0 sq cm",624.8,406.12,78.57,648.59,19
CDM,14348IP _1,ULTRAVIST 300 MG/ML VIAL,12.53,8.14,3.13,8.77,11
CDM,14348OP _1,ULTRAVIST 300 MG/ML VIAL,1.49,0.97,0.37,1.04,11
CDM,14349IP _1,ULTRAVIST 370 MG/ML VIAL,7.05,4.58,1.76,4.94,11
CDM,14349OP _1,ULTRAVIST 370 MG/ML VIAL,7.05,4.58,1.76,4.94,11
CDM,14350_1,Repair of tissue loss of finger or toe,2022.3,1314.5,78.57,2085.58,19
CDM,1445IP _1,"INJECTION, CEFAZOLIN SODIUM, 500 MG",46.2,30.03,0.88,119.31,17
CDM,1445OP _1,"INJECTION, CEFAZOLIN SODIUM, 500 MG",11.34,7.37,0.88,29.29,17
CDM,1446IP _1,"INJECTION, CEFAZOLIN SODIUM, 500 MG",4062.73,2640.77,0.88,10492.0,17
CDM,1446OP _1,"INJECTION, CEFAZOLIN SODIUM, 500 MG",344.29,223.79,0.88,889.13,17
CDM,14471IP _1,UNCLASSIFIED DRUGS,9.3,6.05,2.33,24.02,16
CDM,14471OP _1,UNCLASSIFIED DRUGS,6.58,4.28,1.65,16.99,16
CDM,14472OP _1,"INJECTION, PORFIMER SODIUM, 75 MG",6465.34,4202.47,1616.34,35052.23,19
CDM,1448IP _1,"INJECTION, CEFAZOLIN SODIUM, 500 MG",248.05,161.23,0.88,640.59,17
CDM,1448OP _1,"INJECTION, CEFAZOLIN SODIUM, 500 MG",18.67,12.14,0.88,48.22,17
CDM,14550IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.95,5.17,1.99,20.53,16
CDM,14550OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.0,4.55,1.75,18.08,16
CDM,14551IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.47,2.26,0.87,8.96,16
CDM,14551OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.55,10.11,3.89,40.16,16
CDM,14552IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.04,2.63,1.01,10.43,16
CDM,14552OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.52,6.84,2.63,27.17,16
CDM,14553IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.45,6.79,2.61,26.99,16
CDM,14553OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.0,13.65,5.25,54.23,16
CDM,14632IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.88,5.77,2.22,22.93,16
CDM,14632OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.75,31.04,11.94,123.31,16
CDM,14634IP _1,"INJECTION, CYTOMEGALOVIRUS IMMUNE GLOBULIN INTRAVENOUS (HUMAN), PER VIAL",255.71,166.21,63.93,5812.21,19
CDM,14643OP _1,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",710.0,461.5,8.2,1833.58,19
CDM,1465IP _1,"INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG",179.09,116.41,2.17,462.5,17
CDM,14719IP _1,UNCLASSIFIED DRUGS,3.65,2.37,0.91,9.43,16
CDM,14719OP _1,UNCLASSIFIED DRUGS,10.45,6.79,2.61,26.99,16
CDM,14720IP _1,GRANISETRON HCL 1 MG TABLET,19.6,12.74,4.9,13.72,11
CDM,14721IP _1,UNCLASSIFIED DRUGS,6302.27,4096.48,1575.57,16275.61,16
CDM,14757IP _1,Varicella vaccine,1300.54,845.35,163.76,3358.64,19
CDM,14757OP _1,Varicella vaccine,462.95,300.92,115.74,1195.57,19
CDM,14792IP _1,TIZANIDINE HCL 2 MG TABLET,9.53,6.19,2.38,6.67,11
CDM,14793IP _1,TIZANIDINE HCL 4 MG TABLET,5.05,3.28,1.26,3.54,11
CDM,14793OP _1,TIZANIDINE HCL 4 MG TABLET,5.25,3.41,1.31,3.68,11
CDM,14823IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.02,3.91,1.51,15.55,16
CDM,14823OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.63,14.71,5.66,58.44,16
CDM,14824IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.09,10.46,4.02,41.55,16
CDM,14824OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.21,15.74,6.05,62.52,16
CDM,14825IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",451.84,293.7,112.96,1166.88,16
CDM,14825OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",240.68,156.44,60.17,621.56,16
CDM,14847IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.31,3.45,1.33,13.71,16
CDM,14847OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.51,11.38,4.38,45.22,16
CDM,14870IP _1,UNCLASSIFIED DRUGS,9.88,6.42,2.47,25.52,16
CDM,14870OP _1,UNCLASSIFIED DRUGS,10.35,6.73,2.59,26.73,16
CDM,14953IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.55,4.91,1.89,19.5,16
CDM,14953OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.93,4.5,1.73,17.9,16
CDM,14961IP _1,"INJECTION, MILRINONE LACTATE, 5 MG",2.16,1.4,0.54,5.58,17
CDM,14983IP _1,UNCLASSIFIED DRUGS,3.4,2.21,0.85,8.78,16
CDM,14983OP _1,UNCLASSIFIED DRUGS,1.11,0.72,0.28,2.87,16
CDM,14984IP _1,UNCLASSIFIED DRUGS,5.52,3.59,1.38,14.26,16
CDM,14984OP _1,UNCLASSIFIED DRUGS,1.17,0.76,0.29,3.02,16
CDM,14_1,Diphtheria and tetanus vaccine (7 years or older),40.0,26.0,10.0,103.3,19
CDM,15002T_1,"Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",611.1,397.22,78.57,818.27,19
CDM,15002_1,"Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",870.0,565.5,78.57,818.27,19
CDM,15003T_1,"Preparation of skin graft site of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",591.2,384.28,35.42,162.16,19
CDM,15003_1,"Preparation of skin graft site of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",190.0,123.5,35.42,162.16,19
CDM,15004T_1,"Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",611.1,397.22,78.57,941.81,19
CDM,15004_1,"Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",1060.0,689.0,78.57,941.81,19
CDM,15005_1,"Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for infants and children, o",320.0,208.0,69.96,272.02,19
CDM,15027IP _1,NICOTROL NS 10 MG/ML SPRAY,91.25,59.31,22.81,63.88,11
CDM,15040_1,"Relocation of skin for self skin graft, 100.0 sq cm or less",661.5,429.98,77.06,626.51,19
CDM,15050_1,"Skin graft to tip of finger or toe, 2.0 cm or less",1412.3,918.0,78.57,1411.27,19
CDM,15053IP _1,UNCLASSIFIED DRUGS,5.0,3.25,1.25,12.91,16
CDM,15053OP _1,UNCLASSIFIED DRUGS,16.37,10.64,4.09,42.28,16
CDM,150641IP _1,ABIRATERONE ACETATE 250 MG TAB,594.95,386.72,148.74,416.47,11
CDM,150653IP _1,"INJECTION, ACETAMINOPHEN, NOT OTHERWISE SPECIFIED,10 MG",2.93,1.9,0.06,7.57,17
CDM,150699IP _1,"INJECTION, AMIODARONE HYDROCHLORIDE (NEXTERONE), 30 MG",2.56,1.66,0.64,6.61,17
CDM,150700IP _1,NEXTERONE 360 MG/200 ML BAG,2.04,1.33,0.51,1.43,11
CDM,150700OP _1,NEXTERONE 360 MG/200 ML BAG,2.04,1.33,0.51,1.43,11
CDM,150723IP _1,"INJECTION, ARGATROBAN, 1 MG (FOR NON-ESRD USE)",14.58,9.48,0.65,158.28,19
CDM,150756IP _1,"INJECTION, BELATACEPT, 1 MG",809.66,526.28,4.12,2090.95,19
CDM,150756OP _1,"INJECTION, BELATACEPT, 1 MG",1245.44,809.54,4.12,3216.35,19
CDM,150757OP _1,"INJECTION, BELIMUMAB, 10 MG",6901.45,4485.94,60.59,17822.99,19
CDM,150758OP _1,"INJECTION, BELIMUMAB, 10 MG",27395.61,17807.15,60.59,70749.16,19
CDM,150782IP _1,"INJECTION, BRENTUXIMAB VEDOTIN, 1 MG",154771.4,100601.41,284.56,399697.14,19
CDM,150782OP _1,"INJECTION, BRENTUXIMAB VEDOTIN, 1 MG",66430.68,43179.94,284.56,171557.23,19
CDM,15100T_1,"Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",2635.5,1713.08,78.57,2155.18,19
CDM,15100_1,"Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",2267.0,1473.55,78.57,2155.18,19
CDM,15101T_1,"Partial thickness self skin graft of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",2635.5,1713.08,78.57,439.52,19
CDM,15101_1,"Partial thickness self skin graft of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",525.0,341.25,78.57,439.52,19
CDM,151073IP _1,DIFICID 200 MG TABLET,1655.31,1075.95,413.83,1158.72,11
CDM,151073OP _1,FIDAXOMICIN 200 MG TABLET,1406.8,914.42,351.7,984.76,11
CDM,15110_1,"Outer layer self skin graft of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",1623.3,1055.15,78.57,2131.33,19
CDM,15111_1,"Outer layer self skin graft to trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",264.25,171.76,78.57,300.92,19
CDM,151126IP _1,"INJECTION, GADOBUTROL, 0.1 ML",249.0,161.85,0.3,751.21,17
CDM,151126OP _1,"INJECTION, GADOBUTROL, 0.1 ML",622.5,404.63,0.3,1878.02,17
CDM,15113IP _1,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",4.79,3.11,0.16,12.37,17
CDM,15113OP _1,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",15.37,9.99,0.16,39.69,17
CDM,15115_1,"Outer layer self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",2472.8,1607.32,78.57,2096.03,19
CDM,15116_1,"Outer layer self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for infants and children, or l",381.25,247.81,78.57,447.95,19
CDM,15120T_1,"Partial thickness self skin graft to face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",2635.5,1713.08,78.57,2091.8,19
CDM,15120_1,"Partial thickness self skin graft to face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",2477.0,1610.05,78.57,2091.8,19
CDM,15121T_1,"Partial thickness self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for infants and children",2635.5,1713.08,78.57,493.74,19
CDM,15121_1,"Partial thickness self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for infants and children",735.0,477.75,78.57,493.74,19
CDM,151227OP _1,"IODINE 1-123 IOFLUPANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 5 MILLICURIES",4688.55,3047.56,1172.14,14144.89,17
CDM,151228OP _1,"INJECTION, IPILIMUMAB, 1 MG",7045.43,4579.53,198.12,18194.82,19
CDM,151249IP _1,"TECHNETIUM TC-99M MACROAGGREGATED ALBUMIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES",1320.08,858.05,32.21,3982.55,17
CDM,151249OP _1,"TECHNETIUM TC-99M MACROAGGREGATED ALBUMIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES",1352.65,879.22,32.21,4080.81,17
CDM,151268OP _1,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",26234.74,17052.58,181.03,78704.22,19
CDM,151275OP _1,UNCLASSIFIED DRUGS,9.61,6.25,2.4,24.82,16
CDM,151286IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",111.18,72.27,27.8,287.12,16
CDM,151286OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",100.9,65.59,25.23,260.57,16
CDM,15130_1,"Deep layer self skin graft of trunk, arms, or legs, 100.0 sq cm or 1% body area of infants and children, or less",1655.9,1076.34,78.57,1746.41,19
CDM,15131_1,"Deep layer self skin graft of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area of infants and children, or less",257.3,167.25,68.39,269.56,19
CDM,151336IP _1,METHADONE HCL 10 MG/ML SYRINGE,503.88,327.52,125.97,352.72,11
CDM,151336OP _1,METHADONE HCL 10 MG/ML SYRINGE,503.93,327.55,125.98,352.75,11
CDM,15135_1,"Deep layer self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area of infants and children, or less",2288.0,1487.2,78.57,2310.09,19
CDM,15136_1,"Deep layer self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area of infants and children, or les",245.7,159.71,68.39,269.56,19
CDM,15150_1,"Tissue skin graft from self of trunk, arms, or legs, 25.0 sq cm or less",1670.5,1085.83,78.57,1852.25,19
CDM,15151_1,"Tissue skin graft from self of trunk, arms, or legs, each additional 1.0-75.0 sq cm",278.7,181.16,78.57,320.63,19
CDM,15152_1,"Tissue skin graft from self of trunk, arms, or legs, each additional 100.0 sq cm or 1% of body area for infants and children, or less",366.6,238.29,78.57,400.04,19
CDM,15155_1,"Tissue self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less",1900.5,1235.33,78.57,2182.58,19
CDM,15156IP _1,DEXRAZOXANE 250 MG VIAL,927.91,603.14,231.98,649.54,11
CDM,15156OP _1,DEXRAZOXANE 250 MG VIAL,327.92,213.15,81.98,229.54,11
CDM,15156_1,"Tissue skin graft from self of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 75.0 sq cm",377.0,245.05,78.57,440.25,19
CDM,15157IP _1,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",931.75,605.64,61.49,2406.24,19
CDM,15157OP _1,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",563.18,366.07,61.49,1454.41,19
CDM,15157_1,"Tissue skin graft from self of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% of body area for infants and children, o",430.8,280.02,78.57,480.46,19
CDM,15168IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.1,2.67,1.03,10.59,16
CDM,15168OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.86,2.51,0.97,9.97,16
CDM,151693IP _1,UNCLASSIFIED DRUGS,4.21,2.74,1.05,10.87,16
CDM,151693OP _1,UNCLASSIFIED DRUGS,27.56,17.91,6.89,71.17,16
CDM,151695OP _1,ROFLUMILAST 500 MCG TABLET,25.65,16.67,6.41,17.96,11
CDM,151697IP _1,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",4.49,2.92,0.05,11.6,17
CDM,151697OP _1,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",16.62,10.8,0.05,42.92,17
CDM,151815IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.4,19.11,7.35,75.93,16
CDM,151815OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.2,19.63,7.55,77.99,16
CDM,151832IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",52.93,34.4,13.23,136.69,16
CDM,151832OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",65.09,42.31,16.27,168.09,16
CDM,151908IP _1,VIIBRYD 10 MG TABLET,81.05,52.68,20.26,56.74,11
CDM,151908OP _1,VILAZODONE HCL 10 MG TABLET,32.2,20.93,8.05,22.54,11
CDM,151909IP _1,VIIBRYD 20 MG TABLET,81.81,53.18,20.45,57.27,11
CDM,151909OP _1,VIIBRYD 20 MG TABLET,66.9,43.49,16.73,46.83,11
CDM,151910IP _1,VIIBRYD 40 MG TABLET,83.32,54.16,20.83,58.32,11
CDM,151910OP _1,VILAZODONE HCL 40 MG TABLET,60.5,39.33,15.13,42.35,11
CDM,151976IP _1,"TECHNETIUM TC-99M MEDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",213.44,138.74,53.36,643.93,17
CDM,151976OP _1,"TECHNETIUM TC-99M MEDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",213.8,138.97,53.45,645.01,17
CDM,15200T_1,"Full thickness skin graft to trunk, 20.0 sq cm or less",2166.2,1408.03,78.57,2027.96,19
CDM,15200_1,"Full thickness skin graft to trunk, 20.0 sq cm or less",2113.7,1373.91,78.57,2027.96,19
CDM,15201T_1,"Full thickness skin graft to trunk, each additional 20.0 sq cm",390.6,253.89,58.94,334.01,19
CDM,15201_1,"Full thickness skin graft to trunk, each additional 20.0 sq cm",420.0,273.0,58.94,334.01,19
CDM,152062IP _1,"INJECTION, CHLOROPROCAINE HYDROCHLORIDE, PER 1 MG",23.87,15.52,0.04,61.64,17
CDM,152062OP _1,"INJECTION, CHLOROPROCAINE HYDROCHLORIDE, PER 1 MG",19.68,12.79,0.04,50.82,17
CDM,152069IP _1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",128.1,83.27,32.03,330.82,16
CDM,152069OP _1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",65.94,42.86,16.49,170.29,16
CDM,152117IP _1,GABAPENTIN ER 600 MG TABLET,20.85,13.55,5.21,14.6,11
CDM,15220T_1,"Full thickness skin graft to scalp, arms, or legs, 20.0 sq cm or less",2019.2,1312.48,78.57,1854.06,19
CDM,15220_1,"Full thickness skin graft to scalp, arms, or legs, 20.0 sq cm or less",2009.7,1306.31,78.57,1854.06,19
CDM,15221T_1,"Full thickness skin graft to scalp, arms, or legs, each additional 20.0 sq cm",265.7,172.71,52.68,309.47,19
CDM,15221_1,"Full thickness skin graft to scalp, arms, or legs, each additional 20.0 sq cm",551.3,358.35,52.68,309.47,19
CDM,152308IP _1,UNCLASSIFIED DRUGS,13187.93,8572.15,3296.98,34057.83,16
CDM,152308OP _1,UNCLASSIFIED DRUGS,4174.42,2713.37,1043.61,10780.44,16
CDM,152362IP _1,"INJECTION, IRON SUCROSE, 1 MG",59.18,38.47,0.25,152.83,17
CDM,152362OP _1,"INJECTION, IRON SUCROSE, 1 MG",154.9,100.69,0.25,400.03,17
CDM,152369OP _1,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",8178.04,5315.73,181.03,24534.12,19
CDM,15240T_1,"Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 20.0 sq cm or less",2029.7,1319.31,78.57,2420.33,19
CDM,15240_1,"Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 20.0 sq cm or less",2422.4,1574.56,78.57,2420.33,19
CDM,152412OP _1,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",21.7,14.11,0.7,56.04,17
CDM,15241T_1,"Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 20.0 sq cm",525.0,341.25,78.57,412.58,19
CDM,15241_1,"Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 20.0 sq cm",630.0,409.5,78.57,412.58,19
CDM,152423IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.09,1.36,0.52,5.4,16
CDM,152423OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.19,3.37,1.3,13.4,16
CDM,152477IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.95,2.57,0.99,10.2,16
CDM,152492IP _1,UNCLASSIFIED DRUGS,4.34,2.82,1.09,11.21,16
CDM,152509IP _1,ANDROGEL 1.62% GEL PUMP,1805.0,1173.25,451.25,1263.5,11
CDM,152514IP _1,"INJECTION, TOPOTECAN, 0.1 MG",343.72,223.42,1.33,1031.16,17
CDM,152514OP _1,"INJECTION, TOPOTECAN, 0.1 MG",50.51,32.83,1.33,151.53,17
CDM,152533IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.25,2.76,1.06,10.98,16
CDM,15260T_1,"Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less",2029.7,1319.31,78.57,2584.57,19
CDM,15260_1,"Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less",2643.9,1718.54,78.57,2584.57,19
CDM,15261T_1,"Full thickness skin graft to nose, ears, eyelids, or lips, each additional 20.0 sq cm",600.0,390.0,78.57,491.78,19
CDM,15261_1,"Full thickness skin graft to nose, ears, eyelids, or lips, each additional 20.0 sq cm",945.0,614.25,78.57,491.78,19
CDM,15271_1,"Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less",280.0,182.0,69.3,366.63,19
CDM,15272_1,"Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less",50.0,32.5,13.48,78.57,19
CDM,15273_1,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",500.9,325.59,78.57,734.84,19
CDM,15274_1,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",119.7,77.81,34.98,194.14,19
CDM,15275T_1,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less",757.95,492.67,78.57,382.03,19
CDM,15275_1,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less",390.0,253.5,78.57,382.03,19
CDM,15276_1,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 25.0 sq cm of wound 100.0 sq cm or less",75.0,48.75,20.33,78.57,19
CDM,15277_1,"Skin substitute graft to wound 100.0 sq cm or more of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and childre",507.2,329.68,78.57,816.2,19
CDM,15278_1,"Skin substitute graft to wound 100.0 sq cm or more of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for inf",141.8,92.17,43.89,225.47,19
CDM,15327IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.72,3.72,1.43,14.77,16
CDM,15327OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.82,9.63,3.71,38.27,16
CDM,15328IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.51,3.58,1.38,14.23,16
CDM,15328OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.99,9.09,3.5,36.13,16
CDM,15330IP _1,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",17.1,11.12,0.56,44.16,17
CDM,15330OP _1,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",2.27,1.48,0.56,5.86,17
CDM,15341OP _1,DICLOFENAC SOD EC 75 MG TAB,15.95,10.37,3.99,11.17,11
CDM,15419OP _1,INFANT IBUPROFEN 50 MG/1.25 ML,3.07,2.0,0.77,2.15,11
CDM,154255OP _1,"INJECTION, AFLIBERCEPT, 1 MG",277832.57,180591.17,809.73,717502.61,19
CDM,15426OP _1,LEUCOVORIN CALCIUM 200 MG VIAL,56.8,36.92,14.2,39.76,11
CDM,154335IP _1,"INJECTION, BUPIVACAINE LIPOSOME, 1 MG",156.21,101.54,1.53,403.41,17
CDM,154335OP _1,"INJECTION, BUPIVACAINE LIPOSOME, 1 MG",88.97,57.83,1.53,229.77,17
CDM,154395IP _1,"INJECTION, EPOPROSTENOL, 0.5 MG",374.86,243.66,16.59,968.08,17
CDM,154395OP _1,"INJECTION, EPOPROSTENOL, 0.5 MG",338.62,220.1,16.59,874.49,17
CDM,154420IP _1,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",5.22,3.39,1.31,15.66,17
CDM,154420OP _1,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",9.74,6.33,2.44,29.22,17
CDM,154467IP _1,UNCLASSIFIED DRUGS,585.19,380.37,146.3,1511.25,16
CDM,154467OP _1,UNCLASSIFIED DRUGS,583.05,378.98,145.76,1505.73,16
CDM,154549IP _1,"INJECTION, PROCHLORPERAZINE, UP TO 10 MG",56.45,36.69,2.67,145.78,17
CDM,154549OP _1,"INJECTION, PROCHLORPERAZINE, UP TO 10 MG",42.34,27.52,2.67,109.34,17
CDM,154556IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.6,8.84,3.4,35.12,16
CDM,154556OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.05,13.03,5.01,51.78,16
CDM,154557IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.8,2.47,0.95,9.81,16
CDM,154557OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.65,12.77,4.91,50.75,16
CDM,154558IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2129.83,1384.39,532.46,5500.29,16
CDM,154559IP _1,JAKAFI 10 MG TABLET,1784.24,1159.76,446.06,1248.97,11
CDM,154559OP _1,JAKAFI 10 MG TABLET,736.0,478.4,184.0,515.2,11
CDM,154580IP _1,UNCLASSIFIED DRUGS,43.65,28.37,10.91,112.73,16
CDM,154580OP _1,UNCLASSIFIED DRUGS,34.41,22.37,8.6,88.86,16
CDM,155158IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.29,0.84,0.32,3.33,16
CDM,155158OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.66,3.68,1.42,14.62,16
CDM,155160OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.24,1.46,0.56,5.78,16
CDM,155168IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.78,5.71,2.2,22.67,16
CDM,155172IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.78,1.16,0.45,4.6,16
CDM,155174IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.78,7.01,2.7,27.84,16
CDM,155176IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.49,1.62,0.62,6.43,16
CDM,155176OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.26,4.72,1.82,18.75,16
CDM,155177IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.17,0.76,0.29,3.02,16
CDM,155178OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.29,0.84,0.32,3.33,16
CDM,155181IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.3,0.85,0.33,3.36,16
CDM,155181OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.2,2.08,0.8,8.26,16
CDM,155182IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.54,4.25,1.64,16.89,16
CDM,155186IP _1,UNCLASSIFIED DRUGS,1.15,0.75,0.29,2.97,16
CDM,155186OP _1,UNCLASSIFIED DRUGS,2.75,1.79,0.69,7.1,16
CDM,155187IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.59,1.03,0.4,4.11,16
CDM,155187OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.52,1.64,0.63,6.51,16
CDM,155189IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.83,14.84,5.71,58.96,16
CDM,155189OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.26,13.17,5.07,52.32,16
CDM,155191IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.86,1.21,0.47,4.8,16
CDM,155191OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.95,1.92,0.74,7.62,16
CDM,155194IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.24,7.31,2.81,29.03,16
CDM,155198IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.91,3.19,1.23,12.68,16
CDM,155198OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.14,0.74,0.29,2.94,16
CDM,155199IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.14,0.74,0.29,2.94,16
CDM,155218IP _1,UNCLASSIFIED DRUGS,30.56,19.86,7.64,78.92,16
CDM,155218OP _1,UNCLASSIFIED DRUGS,5.39,3.5,1.35,13.92,16
CDM,155220IP _1,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",47.68,30.99,2.19,123.13,17
CDM,155224IP _1,UNCLASSIFIED DRUGS,19.52,12.69,4.88,50.41,16
CDM,155226OP _1,"INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG",8.15,5.3,2.04,21.05,16
CDM,155598IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.94,6.46,2.49,25.67,16
CDM,155600IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",197.73,128.52,49.43,510.64,16
CDM,155600OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.33,5.41,2.08,21.51,16
CDM,155601IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.38,13.9,5.35,55.21,16
CDM,155601OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",117.8,76.57,29.45,304.22,16
CDM,155646IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.28,1.48,0.57,5.89,16
CDM,155646OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.28,0.83,0.32,3.31,16
CDM,15570_1,Creation of flap graft to trunk,2313.2,1503.58,78.57,2206.59,19
CDM,15572_1,"Creation of flap graft to scalp, arms, or legs",2252.3,1464.0,78.57,2217.11,19
CDM,15574_1,"Creation of flap graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet",2378.3,1545.9,78.57,2249.16,19
CDM,15576T_1,"Creation of flap graft to eyelids, nose, ears, lips, or mouth",2635.5,1713.08,78.57,1998.58,19
CDM,15576_1,"Creation of flap graft to eyelids, nose, ears, lips, or mouth",2121.0,1378.65,78.57,1998.58,19
CDM,155779OP _1,"IODINE I-123 IOBENGUANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",31395.35,20406.98,2456.55,81078.49,17
CDM,155799OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.03,0.67,0.26,2.66,16
CDM,155842IP _1,UNCLASSIFIED DRUGS,1.05,0.68,0.26,2.71,16
CDM,155855IP _1,OMEPRAZOLE 2 MG/ML ORAL SUSPENSION COMPOUNDING KIT [155855],10.42,6.77,2.61,7.29,11
CDM,155855OP _1,OMEPRAZOLE 2 MG/ML ORAL SUSPENSION COMPOUNDING KIT [155855],4.47,2.91,1.12,3.13,11
CDM,155875OP _1,ASCLERA 10 MG/2 ML (0.5%) AMP,27.76,18.04,6.94,19.43,11
CDM,155877OP _1,ASCLERA 20 MG/2 ML (1%) AMPULE,31.13,20.23,7.78,21.79,11
CDM,155902OP _1,"IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER 100 MICROCURIES, UP TO 999 MICROCURIES",230.8,150.02,57.7,696.3,17
CDM,15600T_1,Transfer of skin flap to trunk,2635.5,1713.08,78.57,808.56,19
CDM,15600_1,Transfer of skin flap to trunk,864.2,561.73,78.57,808.56,19
CDM,15610_1,"Transfer of skin flap to scalp, arms, or legs",853.7,554.91,78.57,880.42,19
CDM,15620T_1,"Transfer of skin flap to forehead, cheeks, chin, neck, underarms, genitals, hands, or feet",953.4,619.71,78.57,1070.73,19
CDM,15620_1,"Transfer of skin flap to forehead, cheeks, chin, neck, underarms, genitals, hands, or feet",1135.1,737.82,78.57,1070.73,19
CDM,156271IP _1,"INDIUM IN-111 OXYQUINOLINE, DIAGNOSTIC, PER 0.5 MILLICURIE",23195.88,15077.32,881.35,69979.65,17
CDM,156271OP _1,"INDIUM IN-111 OXYQUINOLINE, DIAGNOSTIC, PER 0.5 MILLICURIE",31250.0,20312.5,881.35,94278.13,17
CDM,156275OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.96,12.32,4.74,48.96,16
CDM,156278IP _1,"INJECTION, LEVETIRACETAM, 10 MG",1.64,1.07,0.04,4.24,17
CDM,156279IP _1,"INJECTION, LEVETIRACETAM, 10 MG",2.65,1.72,0.04,6.84,17
CDM,156280IP _1,"INJECTION, LEVETIRACETAM, 10 MG",1.53,0.99,0.04,3.95,17
CDM,156286IP _1,LURASIDONE HCL 20 MG TABLET,18.38,11.95,4.6,12.87,11
CDM,156286OP _1,LURASIDONE HCL 20 MG TABLET,21.25,13.81,5.31,14.88,11
CDM,156293OP _1,"INJECTION, METHYLNALTREXONE, 0.1 MG",671.0,436.15,2.23,1732.86,17
CDM,15630T_1,"Transfer of skin flap to eyelids, nose, ears, or lips",2635.5,1713.08,78.57,1108.49,19
CDM,15630_1,"Transfer of skin flap to eyelids, nose, ears, or lips",1202.3,781.5,78.57,1108.49,19
CDM,156331OP _1,INDIUM IN-111 DTPA SOLUTION,18543.96,12053.57,4635.99,12980.77,11
CDM,15636IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.86,3.16,1.22,12.55,16
CDM,15636OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.18,13.77,5.3,54.7,16
CDM,156407OP _1,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.47,0.96,0.13,3.8,17
CDM,156409IP _1,"INJECTION, CAFFEINE CITRATE, 5 MG",17.47,11.36,2.15,45.12,17
CDM,156411IP _1,UNCLASSIFIED DRUGS,1.92,1.25,0.48,4.96,16
CDM,15650_1,Transfer of skin flap,1341.9,872.24,78.57,1287.83,19
CDM,15661IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.61,3.0,1.15,11.91,16
CDM,156698IP _1,UNCLASSIFIED DRUGS,1.15,0.75,0.29,2.97,16
CDM,156704IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.57,2.32,0.89,9.22,16
CDM,156704OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.31,2.15,0.83,8.55,16
CDM,156710IP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",8.52,5.54,2.13,22.0,16
CDM,156710OP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",2.8,1.82,0.7,7.23,16
CDM,156808IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3020.93,1963.6,755.23,7801.55,16
CDM,156808OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1076.8,699.92,269.2,2780.84,16
CDM,156878IP _1,UNCLASSIFIED DRUGS,11.23,7.3,2.81,29.0,16
CDM,156878OP _1,UNCLASSIFIED DRUGS,25.0,16.25,6.25,64.56,16
CDM,15706IP _1,UNCLASSIFIED DRUGS,2.08,1.35,0.52,5.37,16
CDM,15723IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.41,2.87,1.1,11.39,16
CDM,15723OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.16,14.4,5.54,57.23,16
CDM,15730_1,Creation of flap graft to midface,3419.2,2222.48,78.57,3434.07,19
CDM,15731T_1,"Creation of flap graft to nose, forehead, temple, or scalp",3196.2,2077.53,78.57,3038.81,19
CDM,15731_1,"Creation of flap graft to nose, forehead, temple, or scalp",3015.6,1960.14,78.57,3038.81,19
CDM,15733_1,Creation of flap graft to head and/or neck,3991.1,2594.22,78.57,3136.02,19
CDM,15734T_1,Creation of muscle graft to trunk,2724.8,1771.12,78.57,4456.0,19
CDM,15734_1,Creation of muscle graft to trunk,4211.6,2737.54,78.57,4456.0,19
CDM,157359IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.95,2.57,0.99,10.2,16
CDM,157360IP _1,UNCLASSIFIED DRUGS,4.98,3.24,1.25,12.86,16
CDM,157360OP _1,"INJECTION, BUMETANIDE, 0.5 MG",2.31,1.5,0.38,5.97,17
CDM,157361IP _1,"INJECTION, FUROSEMIDE, 1 MG",4.61,3.0,0.02,11.91,17
CDM,15736T_1,Creation of muscle graft to arm,2724.8,1771.12,78.57,3643.12,19
CDM,15736_1,Creation of muscle graft to arm,3596.3,2337.6,78.57,3643.12,19
CDM,15738IP _1,UNCLASSIFIED DRUGS,183.58,119.33,45.9,474.1,16
CDM,15738T_1,Creation of muscle graft to leg,2724.8,1771.12,78.57,3842.19,19
CDM,15738_1,Creation of muscle graft to leg,3850.0,2502.5,78.57,3842.19,19
CDM,15740_1,Creation of skin and tissue graft,2706.9,1759.49,78.57,2551.27,19
CDM,157462IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.2,7.28,2.8,28.92,16
CDM,157462OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.8,11.57,4.45,45.97,16
CDM,15746IP _1,BICALUTAMIDE 50 MG TABLET,7.45,4.84,1.86,5.22,11
CDM,15747IP _1,UNCLASSIFIED DRUGS,4.28,2.78,1.07,11.05,16
CDM,15747OP _1,UNCLASSIFIED DRUGS,21.07,13.7,5.27,54.41,16
CDM,15748IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.89,2.53,0.97,10.05,16
CDM,15748OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.54,12.05,4.64,47.88,16
CDM,15749IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.18,2.72,1.05,10.79,16
CDM,15749OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.73,10.22,3.93,40.62,16
CDM,157502IP _1,UNCLASSIFIED DRUGS,40.92,26.6,10.23,105.68,16
CDM,157502OP _1,UNCLASSIFIED DRUGS,32.84,21.35,8.21,84.81,16
CDM,15750_1,Creation of nerve and blood vessel skin graft,2585.1,1680.32,78.57,2732.46,19
CDM,157512IP _1,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",5.49,3.57,1.37,14.18,17
CDM,157512OP _1,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",5.49,3.57,1.37,14.18,17
CDM,15756T_1,Muscle graft with repair of small blood vessel,1379.7,896.81,78.57,6880.41,19
CDM,15756_1,Muscle graft with repair of small blood vessel,6470.1,4205.57,78.57,6880.41,19
CDM,15757T_1,Skin graft with repair of small blood vessel,1379.7,896.81,78.57,6821.13,19
CDM,15757_1,Skin graft with repair of small blood vessel,6704.3,4357.8,78.57,6821.13,19
CDM,157585IP _1,UNCLASSIFIED DRUGS,10.8,7.02,2.7,27.89,16
CDM,15758_1,Tissue graft with repair of small blood vessel,10790.0,7013.5,78.57,6874.96,19
CDM,15760T_1,Graft with closure of wound,2635.5,1713.08,78.57,2135.53,19
CDM,15760_1,Graft with closure of wound,2234.4,1452.36,78.57,2135.53,19
CDM,15769_1,Self soft tissue graft,1126.75,732.39,78.57,1366.56,19
CDM,15770T_1,"Creation of skin, fat and muscle graft",2635.5,1713.08,78.57,1989.12,19
CDM,15770_1,"Creation of skin, fat and muscle graft",1890.0,1228.5,78.57,1989.12,19
CDM,15771_1,"Graft using patient's fat removed by liposuction and inserted into trunk, breasts, scalp, arms, or legs, 50.0 cc or less",1347.0,875.55,78.57,1434.68,19
CDM,15772_1,"Graft using patient's fat removed by liposuction and inserted into trunk, breasts, scalp, arms, or legs, each additional 50.0 cc",424.25,275.76,78.57,450.55,19
CDM,15773_1,"Graft using patient's fat removed by liposuction and inserted into face, eyelids, mouth, neck, ears, around eyes, genitals, hands, or feet, 25.0 cc or less",1360.25,884.16,78.57,1426.27,19
CDM,15774_1,"Graft using patient's fat removed by liposuction and inserted into face, eyelids, mouth, neck, ears, around eyes, genitals, hands, or feet, each additional 25.0 cc",412.0,267.8,78.57,440.27,19
CDM,15775_1,"Hair transplant, 1-15 punch grafts",702.8,456.82,78.57,894.13,19
CDM,15776T_1,"Hair transplant, more than 15 punch grafts",150.9,98.09,28.15,1207.97,19
CDM,15776_1,"Hair transplant, more than 15 punch grafts",1151.9,748.74,28.15,1207.97,19
CDM,15777T_1,Implantation of biologic implant to soft tissue,617.4,401.31,78.57,642.33,19
CDM,15777_1,Implantation of biologic implant to soft tissue,510.0,331.5,78.57,642.33,19
CDM,15778_1,Implantation of artificial material for delayed closure of defects due to soft tissue infection or trauma,831.0,540.15,78.57,1111.23,19
CDM,15780T_1,Dermabrasion of skin of total face,1412.3,918.0,78.57,2040.0,19
CDM,15780_1,Dermabrasion of skin of total face,2625.0,1706.25,78.57,2040.0,19
CDM,15781T_1,Dermabrasion of skin of part of face,1575.0,1023.75,78.57,1304.53,19
CDM,15781_1,Dermabrasion of skin of part of face,1443.8,938.47,78.57,1304.53,19
CDM,15782T_1,Dermabrasion of skin other than face,1611.8,1047.67,78.57,1170.18,19
CDM,15782_1,Dermabrasion of skin other than face,1478.4,960.96,78.57,1170.18,19
CDM,15783_1,Dermabrasion of superficial scars or tattoos from skin,1299.9,844.94,78.57,1083.65,19
CDM,15786_1,"Scraping of skin growth, first growth",630.0,409.5,18.33,554.85,19
CDM,15787_1,"Scraping of skin growth, each additional 1-4 growths",210.0,136.5,13.72,78.57,19
CDM,15788T_1,Chemical peel of outer layer of skin of face,107.1,69.62,78.57,936.83,19
CDM,15788_1,Chemical peel of outer layer of skin of face,1192.8,775.32,78.57,936.83,19
CDM,15789T_1,Chemical peel of deep layer of skin of face,1621.2,1053.78,78.57,1276.96,19
CDM,15789_1,Chemical peel of deep layer of skin of face,1413.3,918.65,78.57,1276.96,19
CDM,15792_1,Chemical peel of outer layer of nonfacial skin,1081.5,702.98,78.57,803.31,19
CDM,15793_1,Chemical peel of deep layer of nonfacial skin,1148.5,746.53,78.57,1134.14,19
CDM,15797IP _1,"AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM",4.93,3.2,1.23,13.81,17
CDM,15797OP _1,"AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM",2.1,1.37,0.53,13.81,17
CDM,15820T_1,Repair of lower eyelid defect,2635.5,1713.08,78.57,1595.07,19
CDM,15820_1,Repair of lower eyelid defect,2362.5,1535.63,78.57,1595.07,19
CDM,15821T_1,Removal of excessive skin of lower eyelid and fat around eye,1522.5,989.63,78.57,1699.29,19
CDM,15821_1,Removal of excessive skin of lower eyelid and fat around eye,2521.65,1639.07,78.57,1699.29,19
CDM,15822T_1,Removal of excessive skin of upper eyelid,2635.5,1713.08,78.57,1230.13,19
CDM,15822_1,Removal of excessive skin of upper eyelid,2008.2,1305.33,78.57,1230.13,19
CDM,15823T_1,Removal of excessive skin and fat of upper eyelid,2635.5,1713.08,78.57,1702.04,19
CDM,15823_1,Removal of excessive skin and fat of upper eyelid,2638.2,1714.83,78.57,1702.04,19
CDM,15824T_1,Removal of wrinkles and extra skin of forehead,2635.5,1713.08,78.57,3337.8,15
CDM,15824_1,Removal of wrinkles and extra skin of forehead,3294.9,2141.69,78.57,3337.8,15
CDM,15825T_1,Removal of wrinkles and extra skin of neck,1575.0,1023.75,78.57,3756.61,15
CDM,15825_1,Removal of wrinkles and extra skin of neck,5647.95,3671.17,78.57,3756.61,15
CDM,15826T_1,"Incision, stretching, and suture of skin between eyebrows",2058.0,1337.7,78.57,2711.92,15
CDM,15826_1,"Incision, stretching, and suture of skin between eyebrows",3294.9,2141.69,78.57,2711.92,15
CDM,15828T_1,"Removal of wrinkles and extra skin of cheeks, chin, and neck",2635.5,1713.08,78.57,7094.41,15
CDM,15828_1,"Removal of wrinkles and extra skin of cheeks, chin, and neck",13058.4,8487.96,78.57,7094.41,15
CDM,15829T_1,"Removal of wrinkles and extra skin with grafting of cheeks, chin, and neck",2696.0,1752.4,78.57,7928.39,15
CDM,15829_1,"Removal of wrinkles and extra skin with grafting of cheeks, chin, and neck",14471.1,9406.22,78.57,7928.39,15
CDM,15830T_1,Removal of extra skin and tissue of abdomen,2543.9,1653.54,78.57,3483.59,19
CDM,15830_1,Removal of extra skin and tissue of abdomen,3111.2,2022.28,78.57,3483.59,19
CDM,15832T_1,Removal of extra skin and tissue of thigh,2753.1,1789.52,78.57,2732.38,19
CDM,15832_1,Removal of extra skin and tissue of thigh,3921.75,2549.14,78.57,2732.38,19
CDM,15833T_1,Removal of extra skin and tissue of leg,2753.1,1789.52,78.57,2593.49,19
CDM,15833_1,Removal of extra skin and tissue of leg,2614.5,1699.43,78.57,2593.49,19
CDM,15834T_1,Removal of extra skin and tissue of hip,2491.7,1619.61,78.57,2645.14,19
CDM,15834_1,Removal of extra skin and tissue of hip,2614.5,1699.43,78.57,2645.14,19
CDM,158359IP _1,"INJECTION, C-1 ESTERASE INHIBITOR (HUMAN), BERINERT, 10 UNITS",17661.42,11479.92,80.41,45610.62,19
CDM,158359OP _1,"INJECTION, C-1 ESTERASE INHIBITOR (HUMAN), BERINERT, 10 UNITS",6750.28,4387.68,80.41,17432.6,19
CDM,15835T_1,Removal of extra skin and tissue of buttock,2538.9,1650.29,78.57,2782.42,19
CDM,15835_1,Removal of extra skin and tissue of buttock,2647.1,1720.62,78.57,2782.42,19
CDM,15836T_1,Removal of extra skin and tissue of arm,1986.6,1291.29,78.57,2350.85,19
CDM,15836_1,Removal of extra skin and tissue of arm,2972.1,1931.87,78.57,2350.85,19
CDM,15837_1,Removal of extra skin and tissue of forearm or hand,2037.0,1324.05,78.57,2165.87,19
CDM,15838T_1,Removal of extra skin and tissue of chin,1603.0,1041.95,78.57,1902.92,19
CDM,15838_1,Removal of extra skin and tissue of chin,1559.3,1013.55,78.57,1902.92,19
CDM,15839T_1,Removal of extra skin and tissue of other area,2171.4,1411.41,78.57,2235.34,19
CDM,15839_1,Removal of extra skin and tissue of other area,2256.5,1466.73,78.57,2235.34,19
CDM,15840T_1,Tissue graft to treat facial paralysis,2724.8,1771.12,78.57,3010.92,19
CDM,15840_1,Tissue graft to treat facial paralysis,3780.0,2457.0,78.57,3010.92,19
CDM,15841_1,Muscle graft to treat facial paralysis,4587.5,2981.88,78.57,5307.71,19
CDM,15842_1,Microsurgical muscle graft to treat facial paralysis,6967.8,4529.07,78.57,8085.22,19
CDM,15845_1,Muscle transfer to treat facial paralysis,3937.5,2559.38,78.57,3054.57,19
CDM,15847T_1,Extensive removal of extra skin and tissue of abdomen,2753.1,1789.52,78.57,1376.55,15
CDM,15847_1,Extensive removal of extra skin and tissue of abdomen,1050.0,682.5,78.57,1017.96,15
CDM,15851_1,Removal of sutures or staples under anesthesia,787.5,511.88,54.34,222.6,19
CDM,15852IP _1,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",11.76,7.64,2.94,30.37,17
CDM,15852OP _1,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",2.86,1.86,0.72,14.31,17
CDM,15852T_1,Dressing change under anesthesia,86.1,55.97,35.74,138.71,19
CDM,15852_1,Dressing change under anesthesia,390.0,253.5,35.74,138.71,19
CDM,15853_1,Removal of sutures or staples,25.5,16.58,12.15,78.57,19
CDM,15854_1,Removal of sutures and staples,35.5,23.08,16.16,78.57,19
CDM,15858OP _1,"INJECTION, NITROGLYCERIN, 5 MG",55.3,35.95,1.61,142.81,17
CDM,15860_1,Injection of agent into vein to assess blood flow of skin graft or flap,393.8,255.97,78.57,320.12,19
CDM,158701IP _1,UNCLASSIFIED DRUGS,259.67,168.79,64.92,670.6,16
CDM,158701OP _1,UNCLASSIFIED DRUGS,181.77,118.15,45.44,469.42,16
CDM,158702IP _1,UNCLASSIFIED DRUGS,147.01,95.56,36.75,379.65,16
CDM,158719IP _1,UNCLASSIFIED DRUGS,19.84,12.9,4.96,51.24,16
CDM,158719OP _1,UNCLASSIFIED DRUGS,3.46,2.25,0.87,8.94,16
CDM,15876T_1,Suction assisted removal of fat of head and neck,2635.5,1713.08,73.6,1317.75,15
CDM,15876_1,Suction assisted removal of fat of head and neck,708.8,460.72,73.6,354.4,15
CDM,15877T_1,Suction assisted removal of fat of body,2635.5,1713.08,76.53,1317.75,15
CDM,15877_1,Suction assisted removal of fat of body,1968.8,1279.72,76.53,984.4,15
CDM,15878T_1,Suction assisted removal of fat of arm,2635.5,1713.08,73.6,1317.75,15
CDM,15878_1,Suction assisted removal of fat of arm,2953.2,1919.58,73.6,1476.6,15
CDM,15879T_1,Suction assisted removal of fat of leg,2635.5,1713.08,73.6,1317.75,15
CDM,15879_1,Suction assisted removal of fat of leg,2953.2,1919.58,73.6,1476.6,15
CDM,15880IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.4,23.01,8.85,91.42,16
CDM,15880OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.2,11.83,4.55,47.0,16
CDM,15881IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.93,1.25,0.48,4.98,16
CDM,158922OP _1,UNCLASSIFIED DRUGS,1.7,1.11,0.43,4.39,16
CDM,15920_1,Removal of pressure sore tissue and tailbone with closure,1563.5,1016.28,78.57,1824.08,19
CDM,15922_1,Removal of pressure sore and bone at tailbone with skin graft,1966.7,1278.36,78.57,2335.55,19
CDM,159231OP _1,"INJECTION, BACLOFEN, 10 MG",42.33,27.51,10.58,741.6,19
CDM,159318OP _1,AMYVID PATIENT READY DOSE VIAL,15396.16,10007.5,3849.04,10777.31,11
CDM,15931_1,Removal of pressure sore tissue of sacrum with closure,1787.1,1161.62,78.57,2030.87,19
CDM,159334IP _1,RECOMBIVAX HB 5 MCG/0.5 ML SYR,402.4,261.56,100.6,281.68,11
CDM,15933_1,Removal of pressure sore tissue and sacrum bone with closure,2194.5,1426.43,78.57,2521.31,19
CDM,15934_1,Removal of pressure sore tissue of sacrum with skin graft,2448.6,1591.59,78.57,2784.55,19
CDM,159359OP _1,"MITOMYCIN, OPHTHALMIC, 0.2 MG",2170.0,1410.5,155.18,5604.03,18
CDM,15935_1,Removal of pressure sore and bone at sacrum with skin graft,2909.6,1891.24,78.57,3249.9,19
CDM,15936_1,Removal of pressure sore tissue of sacrum in preparation of muscle flap or skin graft,2370.9,1541.09,78.57,2636.18,19
CDM,15937_1,Removal of pressure sore and bone at sacrum in preparation of muscle flap or skin graft,2771.0,1801.15,78.57,3070.93,19
CDM,159381OP _1,"INJECTION, PERTUZUMAB, 1 MG",3881.0,2522.65,18.03,10022.68,19
CDM,15940_1,Removal of pressure sore tissue of lower pelvic bone with closure,1834.4,1192.36,78.57,2061.55,19
CDM,15941_1,Removal of pressure sore tissue and lower pelvic bone with closure,2376.2,1544.53,78.57,2688.73,19
CDM,15944_1,Removal of pressure sore tissue of lower pelvic bone with skin graft,2342.6,1522.69,78.57,2667.35,19
CDM,15945_1,Removal of pressure sore and lower pelvic bone with skin graft,2600.9,1690.59,78.57,2943.52,19
CDM,15946T_1,Removal of pressure sore and lower pelvic bone in preparation of muscle flap or skin graft closure,2724.8,1771.12,78.57,4832.2,19
CDM,15946_1,Removal of pressure sore and lower pelvic bone in preparation of muscle flap or skin graft closure,4357.5,2832.38,78.57,4832.2,19
CDM,159480IP _1,UNCLASSIFIED DRUGS,1752.32,1139.01,438.08,4525.37,16
CDM,159480OP _1,UNCLASSIFIED DRUGS,429.99,279.49,107.5,1110.45,16
CDM,15950_1,Removal of pressure sore tissue of head of thigh bone with closure,1518.3,986.9,78.57,1775.34,19
CDM,15951_1,Removal of pressure sore tissue and head of thigh bone with closure,2165.1,1407.32,78.57,2628.66,19
CDM,15952_1,Removal of pressure sore tissue of head of thigh bone with skin graft,2274.3,1478.3,78.57,2696.23,19
CDM,15953_1,Removal of pressure sore and bone at hip bone with skin graft,2532.6,1646.19,78.57,2971.35,19
CDM,15956IP _1,UNCLASSIFIED DRUGS,19.53,12.69,4.88,50.44,16
CDM,15956OP _1,UNCLASSIFIED DRUGS,16.27,10.58,4.07,42.02,16
CDM,15956_1,Removal of pressure sore tissue of head of thigh bone in preparation of muscle flap or skin graft,3052.4,1984.06,78.57,3432.92,19
CDM,15958_1,Removal of pressure sore and bone at hip bone in preparation of muscle flap or skin graft,3110.1,2021.57,78.57,3513.57,19
CDM,15960IP _1,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",1.1,0.72,0.28,2.84,17
CDM,159769IP _1,"INJECTION, DOCETAXEL, 1 MG",56.74,36.88,0.69,170.22,19
CDM,159769OP _1,"INJECTION, DOCETAXEL, 1 MG",182.02,118.31,0.69,546.06,19
CDM,15982IP _1,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",1.48,0.96,0.37,8.5,17
CDM,159840IP _1,MORPHINE 20 MG/ML ORAL SYRINGE,30.23,19.65,7.56,21.16,11
CDM,159859IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.65,2.37,0.91,9.43,16
CDM,159859OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.36,4.78,1.84,19.01,16
CDM,15985IP _1,UNCLASSIFIED DRUGS,20.95,13.62,5.24,54.1,16
CDM,15985OP _1,UNCLASSIFIED DRUGS,11.56,7.51,2.89,29.85,16
CDM,159883IP _1,UNCLASSIFIED DRUGS,520.5,338.33,130.13,1344.19,16
CDM,159883OP _1,UNCLASSIFIED DRUGS,156.6,101.79,39.15,404.42,16
CDM,159902IP _1,UNCLASSIFIED DRUGS,29.93,19.45,7.48,77.29,16
CDM,15996IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.36,0.88,0.34,3.51,16
CDM,15996OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.17,0.76,0.29,3.02,16
CDM,160005IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.66,17.98,6.92,71.43,16
CDM,160005OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.08,0.7,0.27,2.79,16
CDM,160006IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",54.2,35.23,13.55,139.97,16
CDM,16000_1,First degree burn treatment,180.0,117.0,22.23,186.7,19
CDM,160015IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",102.8,66.82,25.7,265.48,16
CDM,160015OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",420.44,273.29,105.11,1085.79,16
CDM,160016IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",100.34,65.22,25.09,259.13,16
CDM,160016OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",88.8,57.72,22.2,229.33,16
CDM,16005IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",184.46,119.9,46.12,476.37,16
CDM,160131IP _1,UNCLASSIFIED DRUGS,7.54,4.9,1.89,19.47,16
CDM,160144OP _1,"INJECTION, BEVACIZUMAB, 10 MG",693.0,450.45,173.25,2922.83,18
CDM,16020_1,"Dressing change or removal of burn tissue, less than 5% of total body surface",210.0,136.5,26.26,203.23,19
CDM,160238IP _1,XTANDI 40 MG CAPSULE,864.19,561.72,216.05,604.93,11
CDM,160240IP _1,"INJECTION, EPOPROSTENOL, 0.5 MG",185.85,120.8,16.59,479.96,17
CDM,160240OP _1,"INJECTION, EPOPROSTENOL, 0.5 MG",132.7,86.26,16.59,342.7,17
CDM,16025_1,"Dressing change or removal of burn tissue, 5-10% of total body surface",390.0,253.5,49.21,372.03,19
CDM,16030_1,"Dressing change or removal of burn tissue, more than 10% of total body surface",470.0,305.5,78.57,463.98,19
CDM,16035_1,Initial incision of dead burn tissue,787.5,511.88,78.57,583.85,19
CDM,16036IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.84,3.15,1.21,12.5,16
CDM,16036OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.8,7.02,2.7,27.89,16
CDM,16036_1,Additional incision of burn tissue,238.4,154.96,65.03,236.78,19
CDM,160375IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.52,2.29,0.88,9.09,16
CDM,160375OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.72,3.07,1.18,12.19,16
CDM,160424IP _1,TERIFLUNOMIDE 14 MG TABLET,89.25,58.01,22.31,62.48,11
CDM,160424OP _1,TERIFLUNOMIDE 14 MG TABLET,81.3,52.85,20.33,56.91,11
CDM,160512IP _1,UNCLASSIFIED DRUGS,15.4,10.01,3.85,39.77,16
CDM,160512OP _1,UNCLASSIFIED DRUGS,2.38,1.55,0.6,6.15,16
CDM,16052IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.64,7.57,2.91,30.06,16
CDM,16052OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.43,3.53,1.36,14.02,16
CDM,16053IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.6,8.84,3.4,35.12,16
CDM,16053OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.85,8.35,3.21,33.19,16
CDM,16070IP _1,UNCLASSIFIED DRUGS,10.29,6.69,2.57,26.57,16
CDM,16070OP _1,UNCLASSIFIED DRUGS,7.07,4.6,1.77,18.26,16
CDM,16071IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.67,8.24,3.17,32.72,16
CDM,16071OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.78,3.11,1.2,12.34,16
CDM,16081IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.6,3.64,1.4,14.46,16
CDM,160951IP _1,PREDNISOLONE 15MG/5ML SOLN CUP,3.57,2.32,0.89,2.5,11
CDM,160951OP _1,PREDNISOLONE 15MG/5ML SOLN CUP,2.13,1.38,0.53,1.49,11
CDM,161069IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.85,6.4,2.46,25.44,16
CDM,161070IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.85,6.4,2.46,25.44,16
CDM,16124IP _1,RILUZOLE 50 MG TABLET,68.9,44.79,17.23,48.23,11
CDM,16156IP _1,"INJECTION, IBUTILIDE FUMARATE, 1 MG",66.7,43.36,16.68,210.42,19
CDM,161591OP _1,"RADIUM RA-223 DICHLORIDE, THERAPEUTIC, PER MICROCURIE",22169.78,14410.36,182.24,57253.46,19
CDM,16162IP _1,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",1.29,0.84,0.32,3.33,17
CDM,16168IP _1,UNCLASSIFIED DRUGS,29.2,18.98,7.3,75.41,16
CDM,16168OP _1,UNCLASSIFIED DRUGS,4.81,3.13,1.2,12.42,16
CDM,16205IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.56,6.21,2.39,24.69,16
CDM,16205OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.41,14.57,5.6,57.87,16
CDM,162111IP _1,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",574.0,373.1,30.97,1482.36,19
CDM,162111OP _1,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",388.39,252.45,30.97,1003.02,19
CDM,162112IP _1,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",720.0,468.0,30.97,1859.4,19
CDM,162112OP _1,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",776.4,504.66,30.97,2005.05,19
CDM,162126IP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",170.8,111.02,0.15,441.09,17
CDM,162126OP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",45.46,29.55,0.15,117.4,17
CDM,16218IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.76,36.24,13.94,144.0,16
CDM,16254OP _1,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",16273.69,10577.9,824.15,48821.07,19
CDM,162713IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.23,1.45,0.56,5.76,16
CDM,162713OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.82,2.48,0.96,9.87,16
CDM,162715IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",118.95,77.32,29.74,307.19,16
CDM,162715OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",56.78,36.91,14.2,146.63,16
CDM,162716IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",121.5,78.98,30.38,313.77,16
CDM,162772IP _1,XELJANZ 5 MG TABLET,687.25,446.71,171.81,481.08,11
CDM,162790IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.0,10.4,4.0,41.32,16
CDM,162790OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.5,19.83,7.63,78.77,16
CDM,162824IP _1,"BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 3 MG, BUT LESS THAN OR EQUAL TO 6 MG BUPRENORPHINE",39.84,25.9,9.96,102.89,17
CDM,162824OP _1,"BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 3 MG, BUT LESS THAN OR EQUAL TO 6 MG BUPRENORPHINE",17.4,11.31,4.35,44.94,17
CDM,162838IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",68.19,44.32,17.05,176.1,16
CDM,162838OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.35,0.88,0.34,3.49,16
CDM,16299IP _1,UNCLASSIFIED DRUGS,1.6,1.04,0.4,4.13,16
CDM,163073IP _1,ICOSAPENT ETHYL 1 GRAM CAPSULE,18.45,11.99,4.61,12.92,11
CDM,163075IP _1,LOTEPREDNOL ETABONATE 0.5 % EYE GEL DROPS [163075],1077.5,700.38,269.38,754.25,11
CDM,163458IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.05,8.48,3.26,33.7,16
CDM,163458OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.9,17.49,6.73,69.47,16
CDM,163494IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.37,17.14,6.59,68.1,16
CDM,163494OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.94,14.26,5.49,56.66,16
CDM,1634OP _1,NESACAINE 2% VIAL,3.33,2.16,0.83,2.33,11
CDM,163565IP _1,UNCLASSIFIED DRUGS,1.96,1.27,0.49,5.06,16
CDM,163565OP _1,UNCLASSIFIED DRUGS,9.38,6.1,2.35,24.22,16
CDM,16356IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.34,2.82,1.09,11.21,16
CDM,16356OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.3,13.2,5.08,52.42,16
CDM,16357IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.9,2.54,0.98,10.07,16
CDM,163581OP _1,SKYLA 13.5 MG SYSTEM,2297.27,1493.23,574.32,1608.09,11
CDM,1635OP _1,"INJECTION, CHLOROPROCAINE HYDROCHLORIDE, PER 30 ML",3.33,2.16,0.83,8.6,16
CDM,163652OP _1,"GABLOFEN 20,000 MCG/20 ML SYRG",38.24,24.86,9.56,26.77,11
CDM,163653IP _1,"INJECTION, BACLOFEN, 10 MG",26.5,17.23,6.63,741.6,19
CDM,16369IP _1,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",138.57,90.07,0.92,357.86,17
CDM,16369OP _1,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",123.25,80.11,0.92,318.29,17
CDM,16371IP _1,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",253.01,164.46,0.92,653.4,17
CDM,16371OP _1,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",162.24,105.46,0.92,418.98,17
CDM,1637OP _1,CHLOROQUINE PH 250 MG TABLET,27.2,17.68,6.8,19.04,11
CDM,164114OP _1,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",36151.29,23498.34,44.72,93360.71,19
CDM,164115OP _1,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",56709.47,36861.16,44.72,146452.21,19
CDM,164328IP _1,FLUTICASONE-VILANTEROL 100-25,1198.33,778.91,299.58,838.83,11
CDM,164336IP _1,"INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG",25.42,16.52,1.49,65.65,17
CDM,164336OP _1,"INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG",9.58,6.23,1.49,24.74,17
CDM,164461OP _1,ABILIFY MAINTENA ER 400 MG VL,17454.91,11345.69,4363.73,12218.44,11
CDM,164951OP _1,GEL-ONE 30 MG/3 ML SYRINGE,965.31,627.45,241.33,675.72,11
CDM,164976IP _1,DIMETHYL FUMARATE 240 MG CAPSULEDELAYED RELEASE,470.2,305.63,117.55,329.14,11
CDM,1649IP _1,"INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG",115.95,75.37,25.2,299.44,17
CDM,1649OP _1,"INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG",17.45,11.34,4.36,45.06,17
CDM,165035IP _1,PROLENSA 0.07% EYE DROPS,792.78,515.31,198.2,554.95,11
CDM,165035OP _1,PROLENSA 0.07% EYE DROPS,282.3,183.5,70.58,197.61,11
CDM,165088IP _1,UNCLASSIFIED DRUGS,3.06,1.99,0.77,7.9,16
CDM,165088OP _1,UNCLASSIFIED DRUGS,1.51,0.98,0.38,3.9,16
CDM,165140IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",83.96,54.57,20.99,216.83,16
CDM,1653IP _1,"CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED",6.5,4.23,1.63,16.79,16
CDM,165415OP _1,UNCLASSIFIED DRUGS,12.27,7.98,3.07,31.69,16
CDM,165438IP _1,KONSYL DAILY FIBER POWDER PKT,6.15,4.0,1.54,4.31,11
CDM,165438OP _1,KONSYL DAILY FIBER POWDER PKT,18.66,12.13,4.67,13.06,11
CDM,165470OP _1,"INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE",5097.04,3313.08,12.33,13163.11,19
CDM,1654OP _1,"CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED",10.05,6.53,2.51,25.95,16
CDM,165522OP _1,"INJECTION, FERRIC CARBOXYMALTOSE, 1 MG",956.93,622.0,1.19,2471.27,19
CDM,1656IP _1,"CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED",24.63,16.01,6.16,63.61,16
CDM,1656OP _1,"CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED",13.18,8.57,3.3,34.04,16
CDM,165749IP _1,"INJECTION, ZOLEDRONIC ACID, 1 MG",3.35,2.18,0.84,10.05,17
CDM,165749OP _1,"INJECTION, ZOLEDRONIC ACID, 1 MG",2.51,1.63,0.63,7.53,17
CDM,165758IP _1,"INJECTION, FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER IU, NOT OTHERWISE SPECIFIED",7070.72,4595.97,1.94,18260.13,19
CDM,165758OP _1,"INJECTION, FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER IU, NOT OTHERWISE SPECIFIED",7070.72,4595.97,1.94,18260.13,19
CDM,165761OP _1,UNCLASSIFIED DRUGS,6.96,4.52,1.74,17.97,16
CDM,165762IP _1,INTRAUTERINE COPPER CONTRACEPTIVE,6226.5,4047.23,155.18,16079.94,19
CDM,165762OP _1,INTRAUTERINE COPPER CONTRACEPTIVE,4020.37,2613.24,155.18,10382.61,19
CDM,165780IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.38,19.1,7.35,75.87,16
CDM,165780OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.02,1.96,0.76,7.8,16
CDM,165849IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",525.23,341.4,131.31,1356.41,16
CDM,165895IP _1,TOPIRAMATE ER 50 MG CAPSULE,115.6,75.14,28.9,80.92,11
CDM,165897IP _1,TOPIRAMATE ER 200 MG CAPSULE,306.62,199.3,76.66,214.63,11
CDM,165897OP _1,TOPIRAMATE ER 200 MG CAPSULE,416.92,271.0,104.23,291.84,11
CDM,166004IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.54,3.6,1.39,14.31,16
CDM,166004OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.78,10.26,3.95,40.75,16
CDM,166029IP _1,UNCLASSIFIED DRUGS,768.15,499.3,192.04,1983.75,16
CDM,166029OP _1,UNCLASSIFIED DRUGS,193.65,125.87,48.41,500.1,16
CDM,166113IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",109.29,71.04,27.32,282.24,16
CDM,166113OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.15,16.35,6.29,64.95,16
CDM,166114IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",111.33,72.36,27.83,287.51,16
CDM,166114OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",85.38,55.5,21.35,220.49,16
CDM,166115IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",111.14,72.24,27.79,287.02,16
CDM,166115OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",59.42,38.62,14.86,153.45,16
CDM,166141IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",807.55,524.91,201.89,2085.5,16
CDM,166142IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",847.75,551.04,211.94,2189.31,16
CDM,166143IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",847.45,550.84,211.86,2188.54,16
CDM,166144IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",847.7,551.01,211.93,2189.19,16
CDM,166145IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",846.36,550.13,211.59,2185.72,16
CDM,166145OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",325.23,211.4,81.31,839.91,16
CDM,166162IP _1,PRESERVISION AREDS 2 SOFTGEL,5.2,3.38,1.3,3.64,11
CDM,166214IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1798.82,1169.23,449.71,4645.45,16
CDM,166214OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1009.1,655.92,252.28,2606.0,16
CDM,166229OP _1,"INJECTION, TOCILIZUMAB, 1 MG",3160.33,2054.21,5.95,8161.55,19
CDM,1662OP _1,CHLORTHALIDONE 50 MG TABLET,13.95,9.07,3.49,9.77,11
CDM,16632IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.65,3.67,1.41,14.59,16
CDM,16632OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.96,13.62,5.24,54.13,16
CDM,166787IP _1,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",67.43,43.83,0.15,174.14,17
CDM,166787OP _1,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",44.78,29.11,0.15,115.64,17
CDM,166788IP _1,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",52.35,34.03,0.15,135.19,17
CDM,166788OP _1,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",58.46,38.0,0.15,150.97,17
CDM,166807IP _1,"INJECTION, OBINUTUZUMAB, 10 MG",2711.61,1762.55,86.53,7236.29,19
CDM,166807OP _1,"INJECTION, OBINUTUZUMAB, 10 MG",3281.07,2132.7,86.53,8473.36,19
CDM,166917IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",442.5,287.63,110.63,1142.76,16
CDM,166917OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.19,24.17,9.3,96.04,16
CDM,167120IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",131.98,85.79,33.0,340.84,16
CDM,167120OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",46.94,30.51,11.74,121.22,16
CDM,167121IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",258.66,168.13,64.67,667.99,16
CDM,167121OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.83,18.09,6.96,71.87,16
CDM,167123IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",260.0,169.0,65.0,671.45,16
CDM,167123OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",170.87,111.07,42.72,441.27,16
CDM,167298IP _1,UNCLASSIFIED DRUGS,50.96,33.12,12.74,131.6,16
CDM,167316IP _1,FARXIGA 10 MG TABLET,130.53,84.84,32.63,91.37,11
CDM,167316OP _1,DAPAGLIFLOZIN 10 MG TABLET,45.56,29.61,11.39,31.89,11
CDM,167367IP _1,GLATIRAMER 40 MG/ML SYRINGE,1059.65,688.77,264.91,741.76,11
CDM,167445IP _1,ESLICARBAZEPINE 400 MG TABLET,61.25,39.81,15.31,42.88,11
CDM,167726IP _1,ORENITRAM ER 0.125 MG TABLET,430.21,279.64,107.55,301.15,11
CDM,167726OP _1,ORENITRAM ER 0.125 MG TABLET,170.34,110.72,42.59,119.24,11
CDM,167727IP _1,ORENITRAM ER 1 MG TABLET,328.24,213.36,82.06,229.77,11
CDM,167727OP _1,ORENITRAM ER 1 MG TABLET,151.09,98.21,37.77,105.76,11
CDM,167767OP _1,"INJECTION, TESTOSTERONE UNDECANOATE, 1 MG",1670.15,1085.6,2.19,4313.16,19
CDM,167782OP _1,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",1.05,0.68,0.26,3.22,17
CDM,167815IP _1,UNCLASSIFIED DRUGS,204.93,133.2,51.23,529.23,16
CDM,168008IP _1,UNCLASSIFIED DRUGS,1520.4,988.26,380.1,3926.43,16
CDM,168008OP _1,UNCLASSIFIED DRUGS,264.79,172.11,66.2,683.82,16
CDM,168015IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.18,4.67,1.8,18.54,16
CDM,168015OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.0,14.95,5.75,59.4,16
CDM,168174OP _1,"INJECTION, RAMUCIRUMAB, 5 MG",1288.84,837.75,80.11,7236.29,19
CDM,16830IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.29,2.79,1.07,11.08,16
CDM,16830OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.7,16.71,6.43,66.37,16
CDM,168426IP _1,UNCLASSIFIED DRUGS,8.41,5.47,2.1,21.72,16
CDM,168426OP _1,UNCLASSIFIED DRUGS,27.61,17.95,6.9,71.3,16
CDM,168438OP _1,SYLVANT 100 MG VIAL,7818.46,5082.0,1954.62,5472.92,11
CDM,168439OP _1,"INJECTION, SILTUXIMAB, 10 MG",28166.06,18307.94,178.8,72738.85,19
CDM,168505IP _1,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",180.9,117.59,2.22,2922.83,19
CDM,168505OP _1,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",103.13,67.03,2.22,2922.83,19
CDM,168531IP _1,"INJECTION, VEDOLIZUMAB, INTRAVENOUS, 1 MG",341.36,221.88,22.65,7236.29,19
CDM,168531OP _1,"INJECTION, VEDOLIZUMAB, INTRAVENOUS, 1 MG",306.38,199.15,22.65,7236.29,19
CDM,168698IP _1,"CYCLOPHOSPHAMIDE; ORAL, 25 MG",123.8,80.47,1.93,319.71,17
CDM,168716IP _1,"INJECTION, DALBAVANCIN, 5 MG",11377.8,7395.57,16.53,29383.17,19
CDM,168716OP _1,"INJECTION, DALBAVANCIN, 5 MG",9960.23,6474.15,16.53,25722.29,19
CDM,168835IP _1,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",157.85,102.6,2.22,2922.83,19
CDM,168835OP _1,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",150.16,97.6,2.22,2922.83,19
CDM,169683IP _1,DROXIDOPA 100 MG CAPSULE,11.3,7.35,2.83,7.91,11
CDM,169685IP _1,DROXIDOPA 300 MG CAPSULE,24.03,15.62,6.01,16.82,11
CDM,169692OP _1,"INJECTION, IMMUNE GLOBULIN, (OCTAGAM), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",133.27,86.63,33.32,2058.35,19
CDM,169759IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",134.9,87.69,33.73,348.38,16
CDM,169759OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",657.46,427.35,164.37,1697.89,16
CDM,169776IP _1,UNCLASSIFIED DRUGS,337.1,219.12,84.28,870.56,16
CDM,169776OP _1,UNCLASSIFIED DRUGS,466.25,303.06,116.56,1204.09,16
CDM,169788IP _1,"ANTIEMETIC DRUG, ORAL, NOT OTHERWISE SPECIFIED",161.73,105.12,40.43,417.67,16
CDM,169874IP _1,UNCLASSIFIED DRUGS,883.7,574.41,220.93,2282.16,16
CDM,169874OP _1,UNCLASSIFIED DRUGS,1216.9,790.99,304.23,3142.64,16
CDM,169978IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",52.43,34.08,13.11,135.4,16
CDM,169978OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",733.21,476.59,183.3,1893.51,16
CDM,16_1,Varicella vaccine,143.26,93.12,35.82,369.97,19
CDM,17000T_1,"Destruction of precancer skin growth, 1 growth",107.1,69.62,44.51,168.47,19
CDM,17000_1,"Destruction of precancer skin growth, 1 growth",200.0,130.0,44.51,168.47,19
CDM,17003T_1,"Destruction of precancer skin growth, 2-14 growths",20.0,13.0,1.64,78.57,19
CDM,17003_1,"Destruction of precancer skin growth, 2-14 growths",30.0,19.5,1.64,78.57,19
CDM,17004T_1,"Destruction of precancer skin growth, 15 or more growths",294.0,191.1,77.54,406.02,19
CDM,17004_1,"Destruction of precancer skin growth, 15 or more growths",480.0,312.0,77.54,406.02,19
CDM,17012IP _1,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",513.3,333.65,24.4,1539.9,17
CDM,17012OP _1,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",440.37,286.24,24.4,1321.11,17
CDM,1703IP _1,CITRIC ACID POWDER,1.67,1.09,0.42,1.17,11
CDM,170553IP _1,BORTEZOMIB 3.5 MG VIAL,311.9,202.74,77.98,218.33,11
CDM,170553OP _1,BORTEZOMIB 3.5 MG VIAL,4052.38,2634.05,1013.1,2836.67,11
CDM,170588IP _1,OFEV 100 MG CAPSULE,1580.45,1027.29,395.11,1106.32,11
CDM,170626OP _1,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",48.38,31.45,12.1,2058.35,19
CDM,170817IP _1,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,16.66,10.83,4.17,43.02,16
CDM,170817OP _1,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,27.61,17.95,6.9,71.3,16
CDM,170819IP _1,BELSOMRA 5 MG TABLET,101.07,65.7,25.27,70.75,11
CDM,170820IP _1,BELSOMRA 10 MG TABLET,113.9,74.04,28.48,79.73,11
CDM,170822IP _1,BELSOMRA 20 MG TABLET,110.4,71.76,27.6,77.28,11
CDM,170827IP _1,UNCLASSIFIED DRUGS,13.43,8.73,3.36,34.68,16
CDM,170827OP _1,UNCLASSIFIED DRUGS,13.5,8.78,3.38,34.86,16
CDM,170828IP _1,UNCLASSIFIED DRUGS,16.81,10.93,4.2,43.41,16
CDM,170828OP _1,UNCLASSIFIED DRUGS,26.55,17.26,6.64,68.57,16
CDM,170888IP _1,"INJECTION, VASOPRESSIN, 1 UNIT",470.8,306.02,0.56,1215.84,17
CDM,170888OP _1,"INJECTION, VASOPRESSIN, 1 UNIT",2268.0,1474.2,0.56,5857.11,17
CDM,170993IP _1,"INJECTION, BLINATUMOMAB, 1 MICROGRAM",70197.2,45628.18,173.5,181284.27,19
CDM,171014OP _1,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",1441.72,937.12,163.76,3723.24,19
CDM,171015IP _1,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",975.0,633.75,163.76,2517.94,19
CDM,171015OP _1,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",2163.52,1406.29,163.76,5587.29,19
CDM,171058IP _1,"INJECTION, CEFTOLOZANE 50 MG AND TAZOBACTAM 25 MG",1209.82,786.38,9.49,3124.36,19
CDM,171058OP _1,"INJECTION, CEFTOLOZANE 50 MG AND TAZOBACTAM 25 MG",362.43,235.58,9.49,935.98,19
CDM,17106T_1,"Destruction of birthmark, less than 10.0 sq cm",958.5,623.03,78.57,843.18,19
CDM,17106_1,"Destruction of birthmark, less than 10.0 sq cm",914.6,594.49,78.57,843.18,19
CDM,171079OP _1,"INJECTION, NIVOLUMAB, 1 MG",3520.37,2288.24,35.58,9091.36,19
CDM,17107T_1,"Destruction of birthmark, 10.0-50.0 sq cm",1210.0,786.5,78.57,1096.2,19
CDM,17107_1,"Destruction of birthmark, 10.0-50.0 sq cm",1575.0,1023.75,78.57,1096.2,19
CDM,17108T_1,"Destruction of birthmark, more than 50.0 sq cm",1797.25,1168.21,78.57,1598.74,19
CDM,17108_1,"Destruction of birthmark, more than 50.0 sq cm",2320.5,1508.33,78.57,1598.74,19
CDM,17110T_1,"Destruction of skin growth, 1-14 growths",107.1,69.62,31.51,273.9,19
CDM,17110_1,"Destruction of skin growth, 1-14 growths",260.0,169.0,31.51,273.9,19
CDM,17111T_1,"Destruction of skin growth, 15 or more growths",189.4,123.11,53.3,319.8,19
CDM,17111_1,"Destruction of skin growth, 15 or more growths",310.0,201.5,53.3,319.8,19
CDM,171347IP _1,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",777.69,505.5,163.76,2008.38,19
CDM,171347OP _1,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",3109.94,2021.46,163.76,8031.42,19
CDM,171349IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",39.13,25.43,9.78,101.05,16
CDM,171349OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.18,9.22,3.55,36.62,16
CDM,171351IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",64.77,42.1,16.19,167.27,16
CDM,171351OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.32,11.26,4.33,44.73,16
CDM,171353IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",113.69,73.9,28.42,293.6,16
CDM,171397IP _1,SAVAYSA 30 MG TABLET,99.1,64.42,24.78,69.37,11
CDM,171398IP _1,SAVAYSA 60 MG TABLET,99.1,64.42,24.78,69.37,11
CDM,171398OP _1,SAVAYSA 60 MG TABLET,44.15,28.7,11.04,30.91,11
CDM,171410OP _1,"INJECTION, ARIPIPRAZOLE (ABILIFY MAINTENA), 1 MG",11111.71,7222.61,7.72,28695.99,19
CDM,171430IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.41,17.82,6.85,70.79,16
CDM,171430OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.2,18.98,7.3,75.41,16
CDM,171431IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.95,18.17,6.99,72.18,16
CDM,171431OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.39,24.3,9.35,96.56,16
CDM,171432IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.26,17.72,6.82,70.4,16
CDM,171432OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.64,14.07,5.41,55.89,16
CDM,171433IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.35,22.33,8.59,88.71,16
CDM,171433OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.65,14.07,5.41,55.91,16
CDM,171445IP _1,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",33939.33,22060.56,130.21,87648.32,19
CDM,171445OP _1,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",75354.9,48980.69,130.21,194604.03,19
CDM,171476IP _1,"INJECTION, PEMBROLIZUMAB, 1 MG",6913.75,4493.94,63.31,17854.76,19
CDM,171476OP _1,"INJECTION, PEMBROLIZUMAB, 1 MG",14530.0,9444.5,63.31,37523.73,19
CDM,171634IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",556.07,361.45,139.02,1436.05,16
CDM,171634OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",208.4,135.46,52.1,538.19,16
CDM,171646IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",95.24,61.91,23.81,245.96,16
CDM,171647IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",95.93,62.35,23.98,247.74,16
CDM,171745IP _1,LENVIMA 10 MG DAILY DOSE,5784.6,3759.99,1446.15,4049.22,11
CDM,171776IP _1,"TECHNETIUM TC-99M TETROFOSMIN, DIAGNOSTIC, PER STUDY DOSE",554.27,360.28,123.91,1672.18,17
CDM,171776OP _1,"TECHNETIUM TC-99M TETROFOSMIN, DIAGNOSTIC, PER STUDY DOSE",586.47,381.21,123.91,1769.32,17
CDM,171954IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",70.36,45.73,17.59,181.7,16
CDM,171954OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",68.19,44.32,17.05,176.1,16
CDM,171955IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",71.23,46.3,17.81,183.95,16
CDM,171955OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",51.68,33.59,12.92,133.46,16
CDM,171959IP _1,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",29878.8,19421.22,211.12,77162.0,19
CDM,171959OP _1,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",39194.71,25476.56,211.12,101220.34,19
CDM,171960OP _1,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",58150.39,37797.75,211.12,150173.38,19
CDM,171961OP _1,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",7263.53,4721.29,211.12,18758.07,19
CDM,171974OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.35,3.48,1.34,13.82,16
CDM,172016IP _1,"INJECTION, CEFTAZIDIME AND AVIBACTAM, 0.5 G/0.125 G",2800.14,1820.09,110.99,7231.36,19
CDM,172048IP _1,MENVEO MENA COMPONENT,273.95,178.07,68.49,191.77,11
CDM,172048OP _1,MENVEO MENA COMPONENT,537.81,349.58,134.45,376.47,11
CDM,172061IP _1,CRESEMBA 372 MG VIAL,2528.02,1643.21,632.01,1769.61,11
CDM,172064IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",709.56,461.21,177.39,1832.44,16
CDM,172064OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",191.06,124.19,47.77,493.41,16
CDM,172152OP _1,LILETTA 52 MG SYSTEM,812.9,528.39,203.23,569.03,11
CDM,172154IP _1,PRISTIQ ER 25 MG TABLET,94.7,61.56,23.68,66.29,11
CDM,172174IP _1,JADENU 360 MG TABLET,1493.9,971.04,373.48,1045.73,11
CDM,17250_1,Application of chemical to stop tissue regrowth in wound,161.0,104.65,24.55,209.48,19
CDM,172566IP _1,"INJECTION, GLUCAGON HYDROCHLORIDE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J1610, PER 1 MG",815.3,529.95,151.85,2105.51,19
CDM,172566OP _1,"INJECTION, GLUCAGON HYDROCHLORIDE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J1610, PER 1 MG",1146.21,745.04,151.85,2960.09,19
CDM,17260_1,"Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less",252.0,163.8,55.53,241.41,19
CDM,17261_1,"Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm",374.9,243.69,69.28,357.36,19
CDM,17262_1,"Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm",457.8,297.57,78.57,430.61,19
CDM,17263_1,"Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm",506.1,328.97,78.57,466.02,19
CDM,17264_1,"Destruction of cancer skin growth of trunk, arms, or legs, 3.1-4.0 cm",540.8,351.52,78.57,499.35,19
CDM,172655OP _1,VARIZIG 125 UNIT/1.2 ML VIAL,12946.83,8415.44,3236.71,9062.78,11
CDM,172656IP _1,STIOLTO RESPIMAT INHALER (60),537.29,349.24,134.32,376.1,11
CDM,17266_1,"Destruction of cancer skin growth of trunk, arms, or legs, more than 4.0 cm",616.4,400.66,78.57,569.11,19
CDM,17270_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",362.3,235.5,75.99,360.46,19
CDM,17271_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",430.5,279.83,78.57,401.73,19
CDM,17272_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",493.5,320.78,78.57,455.46,19
CDM,17273_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",551.3,358.35,78.57,504.67,19
CDM,17274_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",655.2,425.88,78.57,591.46,19
CDM,17276_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",759.2,493.48,78.57,685.89,19
CDM,172773IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.4,0.91,0.35,3.62,16
CDM,172773OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.32,1.51,0.58,5.99,16
CDM,172798IP _1,"INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G., LIQUID), 500 MG",87.47,56.86,21.87,2922.83,19
CDM,172798OP _1,"INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G., LIQUID), 500 MG",82.44,53.59,20.61,2922.83,19
CDM,172799IP _1,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",121.92,79.25,30.48,2058.35,19
CDM,172799OP _1,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",176.18,114.52,44.05,2058.35,19
CDM,172805IP _1,UNITUXIN 17.5 MG/ 5 ML VIAL,43538.74,28300.18,10884.69,112438.8,16
CDM,17280_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",364.4,236.86,67.31,338.17,19
CDM,17281_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",468.3,304.4,78.57,434.31,19
CDM,17282_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",543.9,353.54,78.57,496.58,19
CDM,17283_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",658.4,427.96,78.57,587.04,19
CDM,17284_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",766.5,498.23,78.57,666.9,19
CDM,17285IP _1,TOPOTECAN HCL 4 MG VIAL,744.55,483.96,186.14,521.19,11
CDM,17286_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",971.3,631.35,78.57,853.68,19
CDM,17311_1,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks",1535.6,998.14,78.57,1634.44,19
CDM,17312_1,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks",901.8,586.17,78.57,991.56,19
CDM,17313_1,"Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks",1435.25,932.91,78.57,1534.43,19
CDM,17314_1,"Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks",865.2,562.38,78.57,950.98,19
CDM,17315_1,"Removal and microscopic exam of growth, each additional block after 5 tissue blocks",186.5,121.23,37.91,222.6,19
CDM,173181IP _1,"INJECTION, CANGRELOR, 1 MG",6389.92,4153.45,21.14,16501.97,19
CDM,173181OP _1,"INJECTION, CANGRELOR, 1 MG",4763.45,3096.24,21.14,12301.61,19
CDM,173251IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",77.74,50.53,19.44,200.76,16
CDM,173251OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",166.02,107.91,41.51,428.75,16
CDM,173252IP _1,UNCLASSIFIED DRUGS,84.19,54.72,21.05,217.42,16
CDM,173252OP _1,UNCLASSIFIED DRUGS,36.9,23.99,9.23,95.29,16
CDM,173253IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",77.19,50.17,19.3,199.34,16
CDM,173253OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",79.99,51.99,20.0,206.57,16
CDM,173277IP _1,REXULTI 0.5 MG TABLET,319.21,207.49,79.8,223.45,11
CDM,173278IP _1,REXULTI 1 MG TABLET,319.0,207.35,79.75,223.3,11
CDM,173278OP _1,REXULTI 1 MG TABLET,122.7,79.76,30.68,85.89,11
CDM,173279IP _1,REXULTI 2 MG TABLET,320.27,208.18,80.07,224.19,11
CDM,173279OP _1,REXULTI 2 MG TABLET,24.47,15.91,6.12,17.13,11
CDM,173280IP _1,REXULTI 3 MG TABLET,322.51,209.63,80.63,225.76,11
CDM,17340_1,Cold treatment of acne,132.3,86.0,39.5,147.79,19
CDM,17360_1,Chemical treatment of acne,299.0,194.35,24.5,298.83,19
CDM,17377IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",67.5,43.88,16.88,174.32,16
CDM,17377OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.05,1.98,0.76,7.88,16
CDM,17378IP _1,"INJECTION, CIDOFOVIR, 375 MG",1156.72,751.87,289.18,2987.23,19
CDM,17378OP _1,"INJECTION, CIDOFOVIR, 375 MG",954.85,620.65,238.71,2465.9,19
CDM,17379IP _1,"INJECTION, MEROPENEM, 100 MG",142.65,92.72,0.4,368.39,17
CDM,17379OP _1,"INJECTION, MEROPENEM, 100 MG",15.4,10.01,0.4,39.77,17
CDM,17380IP _1,"INJECTION, MEROPENEM, 100 MG",155.73,101.22,0.4,402.17,17
CDM,17380OP _1,"INJECTION, MEROPENEM, 100 MG",64.6,41.99,0.4,166.83,17
CDM,17380T_1,"Hair removal by electrolysis, each 30 minutes",104.0,67.6,46.8,224.22,15
CDM,17380_1,"Hair removal by electrolysis, each 30 minutes",177.5,115.38,76.98,224.22,15
CDM,17381OP _1,"HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULAR INJECTION, 1 MG",177.76,115.54,8.01,459.07,19
CDM,173940IP _1,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",2899.0,1884.35,0.37,7486.67,19
CDM,173940OP _1,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",2161.87,1405.22,0.37,5583.03,19
CDM,173941IP _1,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",3444.67,2239.04,0.37,8895.86,19
CDM,173941OP _1,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",2602.7,1691.76,0.37,6721.47,19
CDM,173943IP _1,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",19.45,12.64,1.98,50.23,17
CDM,173943OP _1,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",5.59,3.63,1.4,14.44,17
CDM,173944IP _1,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",19.58,12.73,1.98,50.57,17
CDM,173944OP _1,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",5.43,3.53,1.36,14.02,17
CDM,173945IP _1,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",44.18,28.72,1.98,114.09,17
CDM,173945OP _1,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",46.0,29.9,1.98,118.8,17
CDM,173958OP _1,"INJECTION, SULFUR HEXAFLUORIDE LIPID MICROSPHERES, PER ML",646.55,420.26,19.26,1669.72,17
CDM,174019IP _1,BRILINTA 60 MG TABLET,51.65,33.57,12.91,36.16,11
CDM,17405IP _1,"INJECTION, INSULIN, PER 5 UNITS",467.27,303.73,116.82,1206.72,16
CDM,17405OP _1,"INJECTION, INSULIN, PER 5 UNITS",1295.13,841.83,0.56,3344.67,17
CDM,1740IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.75,3.09,1.19,12.27,16
CDM,1740OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.4,4.81,1.85,19.11,16
CDM,174110IP _1,UNCLASSIFIED DRUGS,21.5,13.98,5.38,55.52,16
CDM,174110OP _1,UNCLASSIFIED DRUGS,16.71,10.86,4.18,43.15,16
CDM,1742IP _1,UNCLASSIFIED DRUGS,1.73,1.12,0.43,4.47,16
CDM,1742OP _1,UNCLASSIFIED DRUGS,1.39,0.9,0.35,3.59,16
CDM,174380IP _1,"INJECTION, TRABECTEDIN, 0.1 MG",22861.77,14860.15,414.53,59040.52,19
CDM,174380OP _1,"INJECTION, TRABECTEDIN, 0.1 MG",10954.81,7120.63,414.53,28290.8,19
CDM,1743IP _1,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",3.48,2.26,0.87,8.99,17
CDM,1743OP _1,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",2.77,1.8,0.69,7.15,17
CDM,174414IP _1,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",18.5,12.03,3.22,47.78,17
CDM,174414OP _1,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",12.28,7.98,3.07,31.71,17
CDM,174445OP _1,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",1722.23,1119.45,3.54,4447.66,19
CDM,174447OP _1,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",1437.27,934.23,3.54,3711.75,19
CDM,17450IP _1,"INJECTION, IRINOTECAN, 20 MG",69.95,45.47,1.9,209.85,17
CDM,17450OP _1,"INJECTION, IRINOTECAN, 20 MG",38.48,25.01,1.9,115.44,17
CDM,174512IP _1,"INJECTION, MIDAZOLAM IN 0.9% SODIUM CHLORIDE, INTRAVENOUS, NOT THERAPEUTICALLY EQUIVALENT TO J2250, 1 MG",1.6,1.04,0.19,4.13,17
CDM,174512OP _1,"INJECTION, MIDAZOLAM IN 0.9% SODIUM CHLORIDE, INTRAVENOUS, NOT THERAPEUTICALLY EQUIVALENT TO J2250, 1 MG",1.5,0.98,0.19,3.87,17
CDM,174526IP _1,UNCLASSIFIED DRUGS,241.29,156.84,60.32,623.13,16
CDM,174526OP _1,UNCLASSIFIED DRUGS,671.89,436.73,167.97,1735.16,16
CDM,174543OP _1,"INJECTION, IRINOTECAN LIPOSOME, 1 MG",2360.8,1534.52,69.92,6096.77,19
CDM,174564OP _1,"INJECTION, TALIMOGENE LAHERPAREPVEC, PER 1 MILLION PLAQUE FORMING UNITS",178.65,116.12,44.66,7236.29,19
CDM,174565OP _1,"INJECTION, TALIMOGENE LAHERPAREPVEC, PER 1 MILLION PLAQUE FORMING UNITS",15403.83,10012.49,78.38,39780.39,19
CDM,17465IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.88,3.17,1.22,12.6,16
CDM,17465OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.84,13.55,5.21,53.82,16
CDM,17466IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.14,3.34,1.29,13.27,16
CDM,17466OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",42.93,27.9,10.73,110.87,16
CDM,174787IP _1,"INJECTION, FACTOR X, (HUMAN), 1 I.U.",222.26,144.47,10.52,35052.23,19
CDM,174787OP _1,"INJECTION, FACTOR X, (HUMAN), 1 I.U.",31.59,20.53,7.9,35052.23,19
CDM,174788IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",62.2,40.43,15.55,160.63,16
CDM,174789IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",56.08,36.45,14.02,144.83,16
CDM,174789OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.53,30.89,11.88,122.75,16
CDM,174790IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",85.72,55.72,21.43,221.37,16
CDM,174790OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",62.75,40.79,15.69,162.05,16
CDM,174792IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",109.45,71.14,27.36,282.65,16
CDM,174824IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",163.03,105.97,40.76,421.03,16
CDM,174824OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",217.7,141.51,54.43,562.21,16
CDM,174825IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",153.34,99.67,38.34,396.0,16
CDM,17482OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.27,4.08,1.57,16.19,16
CDM,174835IP _1,"INJECTION, MEPOLIZUMAB, 1 MG",21709.5,14111.18,33.8,56064.78,19
CDM,174835OP _1,"INJECTION, MEPOLIZUMAB, 1 MG",27717.53,18016.39,33.8,71580.52,19
CDM,174842IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",952.85,619.35,238.21,2460.74,16
CDM,174849IP _1,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",1.61,1.05,0.4,4.16,17
CDM,174886IP _1,TAGRISSO 40 MG TABLET,4196.65,2727.82,1049.16,2937.66,11
CDM,174901IP _1,"INJECTION, DARATUMUMAB, 10 MG",2307.27,1499.73,75.04,5958.52,19
CDM,175145OP _1,"INJECTION, ELOTUZUMAB, 1 MG",5359.58,3483.73,8.52,13841.12,19
CDM,175146OP _1,"INJECTION, ELOTUZUMAB, 1 MG",6896.8,4482.92,8.52,17810.99,19
CDM,175154OP _1,UNCLASSIFIED DRUGS,113.95,74.07,28.49,294.28,16
CDM,175162IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.01,4.56,1.75,18.1,16
CDM,175162OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.16,9.2,3.54,36.57,16
CDM,175176IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.35,2.83,1.09,11.23,16
CDM,175207OP _1,ALECENSA 150 MG CAPSULE,203.68,132.39,50.92,142.58,11
CDM,175238IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1446.68,940.34,361.67,3736.05,16
CDM,175238OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1966.43,1278.18,491.61,5078.31,16
CDM,175240IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2359.15,1533.45,589.79,6092.5,16
CDM,175240OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",851.3,553.35,212.83,2198.48,16
CDM,175241IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2357.5,1532.38,589.38,6088.24,16
CDM,175463IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.15,15.05,5.79,59.78,16
CDM,175466IP _1,UNCLASSIFIED DRUGS,570.87,371.07,142.72,1474.27,16
CDM,175466OP _1,UNCLASSIFIED DRUGS,606.95,394.52,151.74,1567.45,16
CDM,1755IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.43,2.88,1.11,11.44,16
CDM,1755OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",48.3,31.4,12.08,124.73,16
CDM,1756IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.65,1.72,0.66,6.84,16
CDM,17595IP _1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",10.11,6.57,0.16,30.5,17
CDM,17595OP _1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",10.11,6.57,0.16,30.5,17
CDM,1760IP _1,CLORAZEPATE 7.5 MG TABLET,38.96,25.32,9.74,27.27,11
CDM,176112IP _1,VRAYLAR 1.5 MG CAPSULE,321.98,209.29,80.5,225.39,11
CDM,176112OP _1,VRAYLAR 1.5 MG CAPSULE,126.95,82.52,31.74,88.87,11
CDM,176113IP _1,VRAYLAR 3 MG CAPSULE,329.68,214.29,82.42,230.78,11
CDM,176113OP _1,VRAYLAR 3 MG CAPSULE,147.16,95.65,36.79,103.01,11
CDM,176114IP _1,VRAYLAR 4.5 MG CAPSULE,330.9,215.09,82.73,231.63,11
CDM,176114OP _1,VRAYLAR 4.5 MG CAPSULE,122.85,79.85,30.71,86.0,11
CDM,176115IP _1,VRAYLAR 6 MG CAPSULE,324.06,210.64,81.02,226.84,11
CDM,176115OP _1,VRAYLAR 6 MG CAPSULE,26.7,17.36,6.68,18.69,11
CDM,176121IP _1,VISTOGARD 10 GRAM PACKET,29870.56,19415.86,7467.64,20909.39,11
CDM,176597OP _1,ENTERAL PUMP ACCESSORY FOR FAT HYDROLYSIS CARTRIDGE,395.88,257.32,98.97,277.12,11
CDM,176615IP _1,UNCLASSIFIED DRUGS,12.51,8.13,3.13,32.31,16
CDM,176615OP _1,UNCLASSIFIED DRUGS,3.99,2.59,1.0,10.3,16
CDM,1767IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.92,2.55,0.98,10.12,16
CDM,1767OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.49,0.97,0.37,3.85,16
CDM,176827IP _1,UNCLASSIFIED DRUGS,2781.96,1808.27,695.49,7184.41,16
CDM,176846OP _1,"INJECTION, RESLIZUMAB, 1 MG",490.93,319.1,11.8,2058.35,19
CDM,176892IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",504.55,327.96,126.14,1303.0,16
CDM,176892OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",188.95,122.82,47.24,487.96,16
CDM,176956IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",92.38,60.05,23.1,238.57,16
CDM,176957IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",456.55,296.76,114.14,1179.04,16
CDM,176958IP _1,VENCLEXTA 100 MG TABLET,906.06,588.94,226.52,634.24,11
CDM,1769IP _1,UNCLASSIFIED DRUGS,1.45,0.94,0.36,3.74,16
CDM,177009IP _1,CABOMETYX 20 MG TABLET,5971.55,3881.51,1492.89,4180.09,11
CDM,177286IP _1,UNCLASSIFIED DRUGS,46.91,30.49,11.73,121.15,16
CDM,177287IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.82,17.43,6.71,69.26,16
CDM,177287OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.78,6.36,2.45,25.26,16
CDM,177290IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",170.65,110.92,42.66,440.7,16
CDM,177292IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",161.53,104.99,40.38,417.15,16
CDM,177292OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.84,24.6,9.46,97.72,16
CDM,177397IP _1,UNCLASSIFIED DRUGS,106.71,69.36,26.68,275.58,16
CDM,177397OP _1,UNCLASSIFIED DRUGS,97.03,63.07,24.26,250.58,16
CDM,177408OP _1,"INJECTION, ATEZOLIZUMAB, 10 MG",4915.58,3195.13,99.54,12694.49,19
CDM,17764IP _1,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",23.61,15.35,1.42,60.97,17
CDM,17764OP _1,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",7.59,4.93,1.42,19.6,17
CDM,177811IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.88,5.12,1.97,20.35,16
CDM,177811OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.06,7.84,3.02,31.15,16
CDM,177927OP _1,"INJECTION, CARFILZOMIB, 1 MG",12486.92,8116.5,58.95,32247.47,19
CDM,178123IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.15,0.75,0.29,2.97,16
CDM,178123OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.74,1.13,0.44,4.49,16
CDM,17837IP _1,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,23.31,15.15,5.83,60.2,16
CDM,17837OP _1,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,54.17,35.21,13.54,139.89,16
CDM,178419IP _1,UNCLASSIFIED DRUGS,2.64,1.72,0.66,6.82,16
CDM,178424IP _1,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",58.47,38.01,10.4,151.0,17
CDM,178424OP _1,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",22.75,14.79,5.69,58.75,17
CDM,178428IP _1,"GALLIUM GA-68, DOTATATE, DIAGNOSTIC, 0.1 MILLICURIE",20779.22,13506.49,52.61,62688.83,17
CDM,178428OP _1,"GALLIUM GA-68, DOTATATE, DIAGNOSTIC, 0.1 MILLICURIE",16785.43,10910.53,52.61,50639.96,17
CDM,178460IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.64,1.72,0.66,6.82,16
CDM,17881IP _1,UNCLASSIFIED DRUGS,11.72,7.62,2.93,30.27,16
CDM,17881OP _1,UNCLASSIFIED DRUGS,18.73,12.17,4.68,48.37,16
CDM,179018OP _1,"INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG",4570.41,2970.77,25.67,11803.08,19
CDM,179039OP _1,KYLEENA 19.5 MG SYSTEM,2834.35,1842.33,708.59,1984.05,11
CDM,179112OP _1,UNCLASSIFIED DRUGS,4.58,2.98,1.15,11.83,16
CDM,179292OP _1,"HYALURONAN OR DERIVATIVE, EUFLEXXA, FOR INTRA-ARTICULAR INJECTION, PER DOSE",429.98,279.49,107.5,1110.42,19
CDM,179336IP _1,"INJECTION, BEVACIZUMAB, 0.25 MG",871.3,566.35,1.95,2250.13,17
CDM,179336OP _1,"INJECTION, BEVACIZUMAB, 10 MG",2650.0,1722.5,78.05,6843.63,19
CDM,179337IP _1,RESTASIS MULTIDOSE 0.05% EYE,1651.25,1073.31,412.81,1155.88,11
CDM,179363IP _1,VEMLIDY 25 MG TABLET,333.77,216.95,83.44,233.64,11
CDM,17936IP _1,UNCLASSIFIED DRUGS,4.3,2.8,1.08,11.1,16
CDM,17936OP _1,UNCLASSIFIED DRUGS,103.55,67.31,25.89,267.42,16
CDM,17937IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.0,13.65,5.25,54.23,16
CDM,17937OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",51.09,33.21,12.77,131.94,16
CDM,17938OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.4,6.76,2.6,26.86,16
CDM,179514OP _1,"INJECTION, BEZLOTOXUMAB, 10 MG",641.7,417.11,42.22,2058.35,19
CDM,17960IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.75,19.99,7.69,79.41,16
CDM,17960OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.51,23.08,8.88,91.7,16
CDM,179738OP _1,"INJECTION, RANIBIZUMAB, 0.1 MG",195400.0,127010.0,69.37,504620.5,19
CDM,179740IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.13,7.88,3.03,31.33,16
CDM,179930IP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",283.26,184.12,0.15,731.52,17
CDM,179930OP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",64.68,42.04,0.15,167.04,17
CDM,179952IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",123.68,80.39,30.92,319.4,16
CDM,179952OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",58.46,38.0,14.62,150.97,16
CDM,17999AA_1,"Other procedure on skin, mucous membrane, and tissue",615.38,400.0,73.6,633.84,15
CDM,17999AB_1,"Other procedure on skin, mucous membrane, and tissue",384.62,250.0,73.6,396.16,15
CDM,17999AC_1,"Other procedure on skin, mucous membrane, and tissue",230.77,150.0,73.6,237.69,15
CDM,17999AD_1,"Other procedure on skin, mucous membrane, and tissue",461.54,300.0,73.6,475.39,15
CDM,17999AE_1,"Other procedure on skin, mucous membrane, and tissue",461.54,300.0,73.6,475.39,15
CDM,17999AF_1,"Other procedure on skin, mucous membrane, and tissue",461.54,300.0,73.6,475.39,15
CDM,17999AG_1,"Other procedure on skin, mucous membrane, and tissue",307.69,200.0,73.6,316.92,15
CDM,17999AH_1,"Other procedure on skin, mucous membrane, and tissue",700.0,455.0,73.6,721.0,15
CDM,17999AI_1,"Other procedure on skin, mucous membrane, and tissue",400.0,260.0,73.6,412.0,15
CDM,17999AJ_1,"Other procedure on skin, mucous membrane, and tissue",461.54,300.0,73.6,475.39,15
CDM,17999AK_1,"Other procedure on skin, mucous membrane, and tissue",675.0,438.75,73.6,695.25,15
CDM,17999AL_1,"Other procedure on skin, mucous membrane, and tissue",607.5,394.88,73.6,625.73,15
CDM,17999AM_1,"Other procedure on skin, mucous membrane, and tissue",50.0,32.5,22.5,80.89,15
CDM,17999AN_1,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",425.0,276.25,38.02,212.5,15
CDM,17999AY_1,"Other procedure on skin, mucous membrane, and tissue",1846.15,1200.0,73.6,1901.53,15
CDM,17999AZ_1,"Other procedure on skin, mucous membrane, and tissue",218.75,142.19,73.6,225.31,15
CDM,17999A_1,"Other procedure on skin, mucous membrane, and tissue",230.77,150.0,73.6,237.69,15
CDM,17999BA_1,"Other procedure on skin, mucous membrane, and tissue",484.38,314.85,73.6,498.91,15
CDM,17999BB_1,"Other procedure on skin, mucous membrane, and tissue",750.0,487.5,73.6,772.5,15
CDM,17999BC_1,"Other procedure on skin, mucous membrane, and tissue",400.0,260.0,73.6,412.0,15
CDM,17999BD_1,"Other procedure on skin, mucous membrane, and tissue",1312.5,853.13,73.6,1351.88,15
CDM,17999BE_1,"Other procedure on skin, mucous membrane, and tissue",1687.5,1096.88,73.6,1738.13,15
CDM,17999BF_1,"Other procedure on skin, mucous membrane, and tissue",2062.5,1340.63,73.6,2124.38,15
CDM,17999BG_1,"Other procedure on skin, mucous membrane, and tissue",200.0,130.0,73.6,206.0,15
CDM,17999BH_1,"Other procedure on skin, mucous membrane, and tissue",500.0,325.0,73.6,515.0,15
CDM,17999BJ_1,"Other procedure on skin, mucous membrane, and tissue",1000.0,650.0,73.6,1030.0,15
CDM,17999BK_1,"Other procedure on skin, mucous membrane, and tissue",1100.0,715.0,73.6,1133.0,15
CDM,17999BL_1,"Other procedure on skin, mucous membrane, and tissue",1300.0,845.0,73.6,1339.0,15
CDM,17999BM_1,"Other procedure on skin, mucous membrane, and tissue",1900.0,1235.0,73.6,1957.0,15
CDM,17999BN_1,"Other procedure on skin, mucous membrane, and tissue",2400.0,1560.0,73.6,2472.0,15
CDM,17999BP_1,"Other procedure on skin, mucous membrane, and tissue",1700.0,1105.0,73.6,1751.0,15
CDM,17999BQ_1,"Other procedure on skin, mucous membrane, and tissue",1700.0,1105.0,73.6,1751.0,15
CDM,17999BR_1,"Other procedure on skin, mucous membrane, and tissue",1300.0,845.0,73.6,1339.0,15
CDM,17999BS_1,"Other procedure on skin, mucous membrane, and tissue",600.0,390.0,73.6,618.0,15
CDM,17999BT_1,"Other procedure on skin, mucous membrane, and tissue",600.0,390.0,73.6,618.0,15
CDM,17999BU_1,"Other procedure on skin, mucous membrane, and tissue",600.0,390.0,73.6,618.0,15
CDM,17999BV_1,"Other procedure on skin, mucous membrane, and tissue",600.0,390.0,73.6,618.0,15
CDM,17999BW_1,"Other procedure on skin, mucous membrane, and tissue",600.0,390.0,73.6,618.0,15
CDM,17999BX_1,"Other procedure on skin, mucous membrane, and tissue",300.0,195.0,73.6,309.0,15
CDM,17999B_1,"Other procedure on skin, mucous membrane, and tissue",384.62,250.0,73.6,396.16,15
CDM,17999C_1,"Other procedure on skin, mucous membrane, and tissue",692.31,450.0,73.6,713.08,15
CDM,17999D_1,"Other procedure on skin, mucous membrane, and tissue",230.77,150.0,73.6,237.69,15
CDM,17999E_1,"Other procedure on skin, mucous membrane, and tissue",1538.46,1000.0,73.6,1584.61,15
CDM,17999F_1,"Other procedure on skin, mucous membrane, and tissue",3846.15,2500.0,73.6,3961.53,15
CDM,17999G_1,"Other procedure on skin, mucous membrane, and tissue",1230.77,800.0,73.6,1267.69,15
CDM,17999H_1,"Other procedure on skin, mucous membrane, and tissue",1846.15,1200.0,73.6,1901.53,15
CDM,17999J_1,"Other procedure on skin, mucous membrane, and tissue",1846.15,1200.0,73.6,1901.53,15
CDM,17999K_1,"Other procedure on skin, mucous membrane, and tissue",307.69,200.0,73.6,316.92,15
CDM,17999L_1,"Other procedure on skin, mucous membrane, and tissue",923.08,600.0,73.6,950.77,15
CDM,17999M_1,"Other procedure on skin, mucous membrane, and tissue",385.0,250.25,73.6,396.55,15
CDM,17999N_1,"Other procedure on skin, mucous membrane, and tissue",615.38,400.0,73.6,633.84,15
CDM,17999P_1,"Other procedure on skin, mucous membrane, and tissue",1000.0,650.0,73.6,1030.0,15
CDM,17999Q_1,"Other procedure on skin, mucous membrane, and tissue",230.77,150.0,73.6,237.69,15
CDM,17999R_1,"Other procedure on skin, mucous membrane, and tissue",461.54,300.0,73.6,475.39,15
CDM,17999S_1,"Other procedure on skin, mucous membrane, and tissue",461.54,300.0,73.6,475.39,15
CDM,17999U_1,"Other procedure on skin, mucous membrane, and tissue",461.54,300.0,73.6,475.39,15
CDM,17999V_1,"Other procedure on skin, mucous membrane, and tissue",307.69,200.0,73.6,316.92,15
CDM,17999W_1,"Other procedure on skin, mucous membrane, and tissue",1846.15,1200.0,73.6,1901.53,15
CDM,17999X_1,"Other procedure on skin, mucous membrane, and tissue",307.69,200.0,73.6,316.92,15
CDM,17999Y_1,"Other procedure on skin, mucous membrane, and tissue",923.08,600.0,73.6,950.77,15
CDM,17999Z_1,"Other procedure on skin, mucous membrane, and tissue",1000.0,650.0,73.6,1030.0,15
CDM,17_1,YF-VAX 1 DOSE VIAL,246.0,159.9,61.5,172.2,11
CDM,180221IP _1,UNCLASSIFIED DRUGS,3.93,2.55,0.98,10.15,16
CDM,180221OP _1,UNCLASSIFIED DRUGS,263.47,171.26,65.87,680.41,16
CDM,180284OP _1,ILARIS 150 MG/ML VIAL,81781.03,53157.67,20445.26,57246.72,11
CDM,180335OP _1,"INJECTION, AVELUMAB, 10 MG",923.8,600.47,111.29,7236.29,19
CDM,180349OP _1,"INJECTION, OCRELIZUMAB, 1 MG",20082.38,13053.55,62.88,51862.75,19
CDM,180350OP _1,UNCLASSIFIED DRUGS,11623.22,7555.09,2905.81,30016.97,16
CDM,180726IP _1,"INJECTION, THIOTEPA, 15 MG",4437.28,2884.23,1109.32,11459.28,16
CDM,180730IP _1,PIRFENIDONE 267 MG TABLET,64.45,41.89,16.11,45.12,11
CDM,180731IP _1,PIRFENIDONE 801 MG TABLET,45.15,29.35,11.29,31.61,11
CDM,180758IP _1,AUSTEDO 6 MG TABLET,542.95,352.92,135.74,380.07,11
CDM,180797IP _1,INGREZZA 40 MG CAPSULE,1812.19,1177.92,453.05,1268.53,11
CDM,180797OP _1,INGREZZA 40 MG CAPSULE,651.05,423.18,162.76,455.74,11
CDM,181207IP _1,ABIRATERONE ACETATE 500 MG TAB,684.78,445.11,171.2,479.35,11
CDM,181230IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1478.78,961.21,369.7,3818.95,16
CDM,181236IP _1,"INJECTION, DURVALUMAB, 10 MG",956.97,622.03,91.45,2922.83,19
CDM,181236OP _1,"INJECTION, DURVALUMAB, 10 MG",3701.31,2405.85,91.45,9558.63,19
CDM,181248IP _1,"INJECTION, BEVACIZUMAB, 0.25 MG",2533.0,1646.45,1.95,6541.47,17
CDM,181248OP _1,"INJECTION, BEVACIZUMAB, 0.25 MG",791.43,514.43,1.95,2043.87,17
CDM,181460OP _1,"INJECTION, RITUXIMAB 10 MG AND HYALURONIDASE",3595.1,2336.82,39.08,9284.35,19
CDM,181482IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.78,21.31,8.2,84.65,16
CDM,181482OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.52,5.54,2.13,22.0,16
CDM,181491OP _1,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",1324.87,861.17,3.54,3421.48,19
CDM,181527IP _1,MYDAYIS ER 50 MG CAPSULE,84.05,54.63,21.01,58.84,11
CDM,181536IP _1,"INJECTION, HEMIN, 1 MG",69268.7,45024.66,37.43,178886.42,19
CDM,18192OP _1,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",1.26,0.82,0.05,3.25,17
CDM,181984IP _1,"INJECTION, INFLIXIMAB-ABDA, BIOSIMILAR, (RENFLEXIS), 10 MG",3730.53,2424.84,29.42,9634.09,19
CDM,181984OP _1,"INJECTION, INFLIXIMAB-ABDA, BIOSIMILAR, (RENFLEXIS), 10 MG",3641.36,2366.88,29.42,9403.81,19
CDM,1821IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",50.5,32.83,12.63,130.42,16
CDM,1821OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.8,17.42,6.7,69.21,16
CDM,182268IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.87,10.97,4.22,43.57,16
CDM,182268OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.92,7.75,2.98,30.78,16
CDM,182333IP _1,MAVYRET 100-40 MG TABLET,1073.67,697.89,268.42,751.57,11
CDM,182364IP _1,"INJECTION, LIPOSOMAL, 1 MG DAUNORUBICIN AND 2.27 MG CYTARABINE",135295.86,87942.31,276.12,349401.56,19
CDM,182364OP _1,"INJECTION, LIPOSOMAL, 1 MG DAUNORUBICIN AND 2.27 MG CYTARABINE",24458.01,15897.71,276.12,63162.81,19
CDM,182381IP _1,"INJECTION, INOTUZUMAB OZOGAMICIN, 0.1 MG",249168.31,161959.4,2985.78,643477.16,19
CDM,182381OP _1,"INJECTION, INOTUZUMAB OZOGAMICIN, 0.1 MG",111180.05,72267.03,2985.78,287122.48,19
CDM,182424IP _1,INFUVITE ADULT VIAL 2,10.57,6.87,2.64,7.4,11
CDM,182424OP _1,INFUVITE ADULT VIAL 2,21.14,13.74,5.29,14.8,11
CDM,182427IP _1,"INJECTION, GEMTUZUMAB OZOGAMICIN, 0.1 MG",955.3,620.95,238.83,7236.29,19
CDM,182728IP _1,UNCLASSIFIED DRUGS,1403.56,912.31,350.89,3624.69,16
CDM,182768IP _1,TRELEGY ELLIPTA 100-62.5-25,73.62,47.85,18.41,51.53,11
CDM,182849OP _1,Shingles vaccine for injection into muscle,1184.38,769.85,163.76,3058.66,18
CDM,182851IP _1,Shingles vaccine for injection into muscle,1387.65,901.97,163.76,3583.61,18
CDM,182851OP _1,Shingles vaccine for injection into muscle,452.55,294.16,113.14,1168.71,18
CDM,18288IP _1,BISOPROLOL FUMARATE 5 MG TAB,9.2,5.98,2.3,6.44,11
CDM,18293IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
CDM,18293OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.53,14.64,5.63,58.18,16
CDM,18294IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.91,3.19,1.23,12.68,16
CDM,18294OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",43.2,28.08,10.8,111.56,16
CDM,18295IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.58,1.68,0.65,6.66,16
CDM,18295OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.56,4.91,1.89,19.52,16
CDM,18302IP _1,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",926.46,602.2,1.16,2392.58,17
CDM,18302OP _1,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",20.03,13.02,1.16,51.73,17
CDM,18307IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.55,1.66,0.64,6.59,16
CDM,18308IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.94,1.91,0.74,7.59,16
CDM,18308OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.9,14.89,5.73,59.14,16
CDM,183095IP _1,ARGININE 7 GRAM-GLUTAM 7 GRAM-CAHMB 1.5 GRAM-COLLA-MV-MIN ORAL PWD PKT,18.69,12.15,4.67,13.08,11
CDM,183095OP _1,ARGININE 7 GRAM-GLUTAM 7 GRAM-CAHMB 1.5 GRAM-COLLA-MV-MIN ORAL PWD PKT,17.05,11.08,4.26,11.94,11
CDM,18309IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.73,3.72,1.43,14.8,16
CDM,18309OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.98,15.59,6.0,61.93,16
CDM,18311IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.57,2.32,0.89,9.22,16
CDM,18311OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.01,7.16,2.75,28.43,16
CDM,18312IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.2,4.03,1.55,16.01,16
CDM,18312OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.61,8.85,3.4,35.15,16
CDM,18313IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.04,2.63,1.01,10.43,16
CDM,18313OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.67,8.24,3.17,32.72,16
CDM,18315IP _1,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",2.99,1.94,0.75,8.5,17
CDM,183189IP _1,PREVYMIS 240 MG TABLET,1924.25,1250.76,481.06,1346.98,11
CDM,183190IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1924.25,1250.76,481.06,4969.38,16
CDM,183190OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1392.0,904.8,348.0,3594.84,16
CDM,183192IP _1,UNCLASSIFIED DRUGS,115.25,74.91,28.81,297.63,16
CDM,183207OP _1,"INJECTION, BENRALIZUMAB, 1 MG",23154.19,15050.22,173.81,59795.7,19
CDM,183257IP _1,JULUCA 50-25 MG TABLET,826.0,536.9,206.5,578.2,11
CDM,183512IP _1,"ZENPEP DR 40,000 UNIT CAPSULE",102.59,66.68,25.65,71.81,11
CDM,183548OP _1,"INJECTION, BUPRENORPHINE EXTENDED-RELEASE (SUBLOCADE), GREATER THAN 100 MG",2753.82,1789.98,688.46,7111.74,19
CDM,183549OP _1,"INJECTION, BUPRENORPHINE EXTENDED-RELEASE (SUBLOCADE), GREATER THAN 100 MG",5532.44,3596.09,1383.11,14287.53,19
CDM,18385IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.1,3.32,1.28,13.17,16
CDM,18385OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.23,9.25,3.56,36.75,16
CDM,183869OP _1,"INJECTION, ALPHA 1 PROTEINASE INHIBITOR (HUMAN), NOT OTHERWISE SPECIFIED, 10 MG",2073.19,1347.57,5.69,5354.01,19
CDM,18386IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.8,3.77,1.45,14.98,16
CDM,18386OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.7,14.11,5.43,56.04,16
CDM,183878IP _1,UNCLASSIFIED DRUGS,12256.09,7966.46,3064.02,31651.35,16
CDM,183931IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.93,2.55,0.98,10.15,16
CDM,183939OP _1,"LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MILLICURIE",100453.3,65294.65,340.02,259420.65,19
CDM,18398IP _1,UNCLASSIFIED DRUGS,199.37,129.59,49.84,514.87,16
CDM,18398OP _1,UNCLASSIFIED DRUGS,116.23,75.55,29.06,300.16,16
CDM,18400IP _1,UNCLASSIFIED DRUGS,600.38,390.25,150.1,1550.48,16
CDM,18400OP _1,UNCLASSIFIED DRUGS,491.14,319.24,122.79,1268.37,16
CDM,184398IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",954.03,620.12,238.51,2463.78,16
CDM,184398OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",230.2,149.63,57.55,594.49,16
CDM,184667IP _1,"INJECTION, TENECTEPLASE, 1 MG",34575.47,22474.06,198.19,89291.15,19
CDM,184675IP _1,UNCLASSIFIED DRUGS,96.2,62.53,24.05,248.44,16
CDM,184676IP _1,RHOPRESSA 0.02% OPHTH SOLUTION,1535.0,997.75,383.75,1074.5,11
CDM,184712IP _1,DALIRESP 250 MCG TABLET,89.15,57.95,22.29,62.41,11
CDM,184716IP _1,UNCLASSIFIED DRUGS,311.34,202.37,77.84,804.04,16
CDM,184716OP _1,UNCLASSIFIED DRUGS,127.64,82.97,31.91,329.63,16
CDM,184717IP _1,UNCLASSIFIED DRUGS,398.01,258.71,99.5,1027.86,16
CDM,184717OP _1,UNCLASSIFIED DRUGS,180.05,117.03,45.01,464.98,16
CDM,185317OP _1,"RIBOFLAVIN 5'-PHOSPHATE, OPHTHALMIC SOLUTION (PHOTREXA VISCOUS/PHOTREXA), UP TO 3 ML",978.81,636.23,244.7,2900.16,17
CDM,185340IP _1,"INJECTION, GANCICLOVIR SODIUM, 500 MG",95.9,62.34,23.98,247.66,17
CDM,18551IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.06,2.64,1.02,10.48,16
CDM,18551OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.92,12.95,4.98,51.44,16
CDM,18621IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",44.65,29.02,11.16,115.31,16
CDM,186452OP _1,FULPHILA 6 MG/0.6 ML SYRINGE,6584.4,4279.86,1646.1,4609.08,11
CDM,186481IP _1,UNCLASSIFIED DRUGS,6.34,4.12,1.59,16.37,16
CDM,186481OP _1,UNCLASSIFIED DRUGS,1.23,0.8,0.31,3.18,16
CDM,186492IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",860.21,559.14,215.05,2221.49,16
CDM,186492OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",707.9,460.14,176.98,1828.15,16
CDM,186524OP _1,SYMTUZA 800-150-200-10 MG TAB,393.25,255.61,98.31,275.28,11
CDM,186552IP _1,ORILISSA 200 MG TABLET,146.05,94.93,36.51,102.24,11
CDM,186552OP _1,ORILISSA 200 MG TABLET,146.05,94.93,36.51,102.24,11
CDM,186573IP _1,"INJECTION, DAPTOMYCIN, 1 MG",258.81,168.23,0.03,668.38,17
CDM,186573OP _1,"INJECTION, DAPTOMYCIN, 1 MG",76.63,49.81,0.03,197.9,17
CDM,186575IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",634.61,412.5,158.65,1638.88,16
CDM,186579OP _1,"COCAINE HYDROCHLORIDE NASAL SOLUTION (NUMBRINO), 1 MG",573.26,372.62,143.32,1480.44,16
CDM,186609IP _1,HUMIRA(CF) PEN 40 MG/0.4 ML,22591.15,14684.25,5647.79,15813.81,11
CDM,186670IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.16,7.25,2.79,28.82,16
CDM,186670OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.49,22.42,8.62,89.07,16
CDM,186716IP _1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",206.43,134.18,8.02,533.11,19
CDM,186716OP _1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",89.98,58.49,8.02,307.25,19
CDM,186717IP _1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",423.89,275.53,8.02,1094.7,19
CDM,186717OP _1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",172.48,112.11,8.02,445.43,19
CDM,186718IP _1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",327.12,212.63,8.02,844.79,19
CDM,186718OP _1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",116.4,75.66,8.02,307.25,19
CDM,186719IP _1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",1357.3,882.25,8.02,3505.23,19
CDM,186719OP _1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",1503.6,977.34,8.02,3883.05,19
CDM,186720IP _1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",3514.14,2284.19,8.02,9075.27,19
CDM,186720OP _1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",8873.12,5767.53,8.02,22914.83,19
CDM,186742IP _1,DOPTELET (10 TAB PK) 20 MG TAB,2939.62,1910.75,734.91,2057.73,11
CDM,186742OP _1,DOPTELET (10 TAB PK) 20 MG TAB,3013.83,1958.99,753.46,2109.68,11
CDM,186768IP _1,OMEPRAZOLE DR 20 MG ODT,5.03,3.27,1.26,3.52,11
CDM,186768OP _1,OMEPRAZOLE DR 20 MG ODT,16.61,10.8,4.15,11.63,11
CDM,186811IP _1,XELJANZ 10 MG TABLET,691.88,449.72,172.97,484.32,11
CDM,187601IP _1,LENVIMA 4 MG CAPSULE,5772.83,3752.34,1443.21,4040.98,11
CDM,187603OP _1,"INJECTION, CARFILZOMIB, 1 MG",2508.07,1630.25,58.95,6477.09,19
CDM,187610OP _1,ILUMYA 100 MG/ML SYRINGE,110850.32,72052.71,27712.58,77595.22,11
CDM,187613IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",64.43,41.88,16.11,166.39,16
CDM,187613OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",54.53,35.44,13.63,140.82,16
CDM,187614IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",111.05,72.18,27.76,286.79,16
CDM,187614OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",79.55,51.71,19.89,205.44,16
CDM,187619IP _1,"Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use",1806.96,1174.52,30.97,4666.47,19
CDM,187619OP _1,"Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use",1830.7,1189.96,30.97,4727.78,19
CDM,187654IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",322.5,209.63,80.63,832.86,16
CDM,187671OP _1,"INJECTION, MOGAMULIZUMAB-KPKC, 1 MG",5352.17,3478.91,268.68,13821.98,19
CDM,18786IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.61,3.0,1.15,11.91,16
CDM,18786OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.41,15.22,5.85,60.46,16
CDM,18787IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.35,2.83,1.09,11.23,16
CDM,18787OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.76,16.09,6.19,63.94,16
CDM,188300IP _1,"INJECTION, PALONOSETRON HCL, 25 MCG",52.44,34.09,0.37,135.43,17
CDM,188300OP _1,"INJECTION, PALONOSETRON HCL, 25 MCG",45.8,29.77,0.37,118.28,17
CDM,188384IP _1,PIFELTRO 100 MG TABLET,209.35,136.08,52.34,146.55,11
CDM,188384OP _1,PIFELTRO 100 MG TABLET,367.35,238.78,91.84,257.15,11
CDM,188686IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.6,2.34,0.9,9.3,16
CDM,188686OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.1,13.07,5.03,51.91,16
CDM,188693IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",111.54,72.5,27.89,288.05,16
CDM,188693OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.11,2.02,0.78,8.03,16
CDM,188702OP _1,DILUENT FOR ALLERGENIC EXTRACTS NO.1 INJECTION SOLUTION [188702],7.17,4.66,1.79,5.02,11
CDM,188723OP _1,"INJECTION, CEMIPLIMAB-RWLC, 1 MG",10156.47,6601.71,30.41,26229.08,19
CDM,18877IP _1,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",17.83,11.59,0.01,46.05,17
CDM,18877OP _1,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",13.89,9.03,0.01,35.87,17
CDM,188787IP _1,UNCLASSIFIED DRUGS,3.05,1.98,0.76,7.88,16
CDM,188807IP _1,"TECHNETIUM TC-99M TILMANOCEPT, DIAGNOSTIC, UP TO 0.5 MILLICURIES",26861.7,17460.11,6715.43,81039.06,16
CDM,188807OP _1,"TECHNETIUM TC-99M TILMANOCEPT, DIAGNOSTIC, UP TO 0.5 MILLICURIES",15025.03,9766.27,3756.26,45329.01,16
CDM,18918IP _1,UNCLASSIFIED DRUGS,4.93,3.2,1.23,12.73,16
CDM,18918OP _1,UNCLASSIFIED DRUGS,10.75,6.99,2.69,27.76,16
CDM,18919IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.33,3.46,1.33,13.76,16
CDM,18919OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",53.13,34.53,13.28,137.21,16
CDM,18920IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.73,2.42,0.93,9.63,16
CDM,18920OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.74,8.93,3.44,35.48,16
CDM,18921IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.37,2.19,0.84,8.7,16
CDM,18921OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.31,6.7,2.58,26.63,16
CDM,18922IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.42,3.52,1.36,14.0,16
CDM,18922OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.02,15.61,6.01,62.03,16
CDM,18924IP _1,"INJECTION, LEVOFLOXACIN, 250 MG",1.41,0.92,0.35,3.64,17
CDM,189520OP _1,"INJECTION, OMALIZUMAB, 5 MG",5635.88,3663.32,48.23,14554.66,19
CDM,189658IP _1,XOSPATA 40 MG TABLET,2243.67,1458.39,560.92,1570.57,11
CDM,189927IP _1,UNCLASSIFIED DRUGS,1106.85,719.45,276.71,2858.44,16
CDM,189927OP _1,UNCLASSIFIED DRUGS,872.78,567.31,218.2,2253.95,16
CDM,189930IP _1,VANCOMYCIN HCL 1.25 GRAM VIAL,225.44,146.54,56.36,157.81,11
CDM,189930OP _1,VANCOMYCIN HCL 1.25 GRAM VIAL,45.33,29.46,11.33,31.73,11
CDM,189939IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1713.18,1113.57,428.3,4424.29,16
CDM,189940IP _1,"INJECTION, OMADACYCLINE, 1 MG",2081.41,1352.92,4.39,5375.24,19
CDM,189951IP _1,"INJECTION, PEGFILGRASTIM-CBQV (UDENYCA), BIOSIMILAR, 0.5 MG",32313.54,21003.8,171.71,83449.72,19
CDM,189951OP _1,"INJECTION, PEGFILGRASTIM-CBQV (UDENYCA), BIOSIMILAR, 0.5 MG",25992.62,16895.2,171.71,67125.94,19
CDM,189960IP _1,"INJECTION, CALCIUM GLUCONATE (WG CRITICAL CARE), NOT THERAPEUTICALLY EQUIVALENT TO J0612, 10 MG",3.23,2.1,0.1,8.34,17
CDM,189962IP _1,"INJECTION, EMAPALUMAB-LZSG, 1 MG",21118.51,13727.03,5279.63,54538.55,18
CDM,189962OP _1,"INJECTION, EMAPALUMAB-LZSG, 1 MG",6755.12,4390.83,1688.78,35052.23,18
CDM,19000_1,"Aspiration of cyst of breast, first cyst",290.9,189.09,31.49,244.74,19
CDM,19001_1,"Aspiration of cyst of breast, each additional cyst",111.3,72.35,15.67,78.57,19
CDM,19020T_1,Drainage of abscess of breast,1283.1,834.02,78.57,1111.39,19
CDM,19020_1,Drainage of abscess of breast,1126.7,732.36,78.57,1111.39,19
CDM,19030_1,Injection for X-ray imaging of breast duct,465.2,302.38,21.91,398.45,19
CDM,190388IP _1,PRUCALOPRIDE 1 MG TABLET,79.1,51.42,19.78,55.37,11
CDM,190391IP _1,PRUCALOPRIDE 2 MG TABLET,78.77,51.2,19.69,55.14,11
CDM,190391OP _1,PRUCALOPRIDE 2 MG TABLET,59.85,38.9,14.96,41.9,11
CDM,190408OP _1,"INJECTION, FILGRASTIM-AAFI, BIOSIMILAR, (NIVESTYM), 1 MICROGRAM",348.75,226.69,0.3,900.65,19
CDM,190462OP _1,"INJECTION, GUSELKUMAB, 1 MG",32019.76,20812.84,77.32,82691.03,19
CDM,19081_1,"Biopsy of breast and placement of locating device using X-ray with needle, first growth",3195.75,2077.24,78.57,1219.0,19
CDM,19082_1,"Biopsy of breast and placement of locating device using X-ray with needle, each additional growth",723.0,469.95,65.17,943.03,19
CDM,19083_1,"Biopsy of breast and placement of locating device using ultrasound, first growth",3180.0,2067.0,78.57,1219.25,19
CDM,19084_1,"Biopsy of breast and placement of locating device using ultrasound, each additional growth",678.0,440.7,55.57,929.23,19
CDM,19085_1,"Biopsy of breast and placement of locating device using MRI, first growth",4825.8,3136.77,78.57,1873.06,19
CDM,19086_1,"Biopsy of breast and placement of locating device using MRI, each additional growth",2593.5,1685.78,71.13,1453.14,19
CDM,19100_1,Needle biopsy of breast,368.6,239.59,34.16,355.58,19
CDM,19101T_1,Biopsy of breast through incision,2692.2,1749.93,78.57,774.75,19
CDM,19101_1,Biopsy of breast through incision,1260.0,819.0,78.57,774.75,19
CDM,191047IP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",127.94,83.16,0.19,330.41,17
CDM,19105_1,"Removal of growth of breast using ultrasound, each growth",479.0,311.35,24.2,5582.87,19
CDM,191107OP _1,"ESKETAMINE, NASAL SPRAY, 1 MG",935.55,608.11,233.89,2416.06,16
CDM,191108OP _1,"ESKETAMINE, NASAL SPRAY, 1 MG",243.7,158.41,60.93,629.36,16
CDM,191109OP _1,"ESKETAMINE, NASAL SPRAY, 1 MG",963.68,626.39,240.92,2488.7,16
CDM,19110_1,Exploration of breast nipple,1169.7,760.31,78.57,1144.97,19
CDM,19112_1,Removal of abnormal drainage of breast duct,1092.0,709.8,78.57,1085.48,19
CDM,191134OP _1,"INJECTION, ATEZOLIZUMAB, 10 MG",3127.98,2033.19,99.54,11535.65,19
CDM,191152OP _1,"HERCEPTIN HYLECTA 600MG-10,000",2087.5,1356.88,521.88,1461.25,11
CDM,191174IP _1,MAYZENT 2 MG TABLET,2333.9,1517.04,583.48,1633.73,11
CDM,19120T_1,"Removal of growth and tissue of breast, duct, or nipple",2692.2,1749.93,78.57,1244.89,19
CDM,19120_1,"Removal of growth and tissue of breast, duct, or nipple",1830.15,1189.6,78.57,1244.89,19
CDM,191214OP _1,"INJECTION, ROMOSOZUMAB-AQQG, 1 MG",13767.26,8948.72,12.84,35553.95,19
CDM,191219OP _1,"INJECTION, ROMOSOZUMAB-AQQG, 1 MG",13525.55,8791.61,12.84,34929.73,19
CDM,19125_1,"Removal of growth of breast identified by x-ray marker, first growth",1351.4,878.41,78.57,1376.72,19
CDM,19126_1,"Removal of growth of breast identified by x-ray marker, each additional growth",442.1,287.37,78.57,470.66,19
CDM,19176IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.87,2.52,0.97,9.99,16
CDM,19176OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",33.53,21.79,8.38,86.59,16
CDM,19177IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.07,5.25,2.02,20.84,16
CDM,19177OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.68,20.59,7.92,81.81,16
CDM,19178IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.72,2.42,0.93,9.61,16
CDM,19178OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.47,14.61,5.62,58.03,16
CDM,19179IP _1,AZELASTINE 0.1% (137 MCG) SPRY,4.91,3.19,1.23,3.44,11
CDM,191967IP _1,UNCLASSIFIED DRUGS,13.4,8.71,3.35,34.61,16
CDM,192087IP _1,"INJECTION, POLATUZUMAB VEDOTIN-PIIQ, 1 MG",116431.35,75680.38,144.98,300683.96,19
CDM,192087OP _1,"INJECTION, POLATUZUMAB VEDOTIN-PIIQ, 1 MG",161437.23,104934.2,144.98,416911.65,19
CDM,192107OP _1,KENALOG-80 80 MG/ML VIAL,53.25,34.61,13.31,37.28,11
CDM,19226IP _1,CABERGOLINE 0.5 MG TABLET,104.88,68.17,26.22,73.42,11
CDM,192489IP _1,"INJECTION, BEVACIZUMAB-AWWB, BIOSIMILAR, (MVASI), 10 MG",2130.06,1384.54,25.27,5500.88,19
CDM,192489OP _1,"INJECTION, BEVACIZUMAB-AWWB, BIOSIMILAR, (MVASI), 10 MG",1522.0,989.3,25.27,3930.57,19
CDM,192493IP _1,"INJECTION, CALCIUM GLUCONATE (WG CRITICAL CARE), NOT THERAPEUTICALLY EQUIVALENT TO J0612, 10 MG",3.79,2.46,0.1,9.79,17
CDM,192493OP _1,"INJECTION, CALCIUM GLUCONATE (WG CRITICAL CARE), NOT THERAPEUTICALLY EQUIVALENT TO J0612, 10 MG",1.25,0.81,0.1,3.23,17
CDM,192524OP _1,"INJECTION, TRASTUZUMAB-ANNS, BIOSIMILAR, (KANJINTI), 10 MG",27356.62,17781.8,54.53,70648.47,19
CDM,192580IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.81,18.73,7.2,74.4,16
CDM,192636IP _1,NUBEQA 300 MG TABLET,695.75,452.24,173.94,487.03,11
CDM,19281_1,"Placement of locating device in breast using imaging guidance, first growth",1168.65,759.62,78.32,585.28,19
CDM,19282_1,"Placement of locating device in breast using imaging guidance, each additional growth",545.0,354.25,39.29,414.34,19
CDM,19283_1,"Placement of locating device in breast using X-ray with needle guidance, first growth",1327.8,863.07,78.57,630.48,19
CDM,19284_1,"Placement of locating device in breast using X-ray with needle guidance, each additional growth",653.1,424.52,39.67,463.34,19
CDM,19285_1,"Placement of locating device in breast using ultrasound guidance, first growth",2242.8,1457.82,67.28,900.25,19
CDM,19286_1,"Placement of locating device in breast using ultrasound guidance, each additional growth",375.0,243.75,33.79,737.65,19
CDM,19287_1,"Placement of locating device in breast using MRI guidance, first growth",2746.8,1785.42,78.57,1554.19,19
CDM,19288_1,"Placement of locating device in breast using MRI guidance, each additional growth",2209.2,1435.98,50.36,1201.48,19
CDM,192913IP _1,UNCLASSIFIED DRUGS,1.53,0.99,0.38,3.95,16
CDM,192913OP _1,UNCLASSIFIED DRUGS,2.74,1.78,0.69,7.08,16
CDM,19294_1,Placement of radiation therapy device in breast for radiation therapy during surgery with partial removal of breast,355.0,230.75,78.57,482.37,19
CDM,19296_1,Insertion of expandable tube in breast for radiation treatment using imaging guidance,11309.6,7351.24,11.22,8947.74,19
CDM,19297_1,Placement of expandable tube in breast for radiation treatment using imaging guidance with partial removal of breast,258.3,167.9,73.62,275.9,19
CDM,19298_1,Placement of tubes in breast for radiation treatment using imaging guidance during or after partial removal of breast,4291.4,2789.41,78.57,2127.15,19
CDM,19300T_1,Removal of extra breast tissue in male,2692.2,1749.93,78.57,1373.85,19
CDM,19300_1,Removal of extra breast tissue in male,2005.05,1303.28,78.57,1373.85,19
CDM,19301T_1,Partial removal of breast,1797.65,1168.47,78.57,1908.7,19
CDM,19301_1,Partial removal of breast,2614.5,1699.43,78.57,1908.7,19
CDM,19302_1,Partial removal of breast and underarm lymph nodes,3501.3,2275.85,78.57,2625.37,19
CDM,19303T_1,Simple complete removal of breast,4136.0,2688.4,78.57,2800.17,19
CDM,19303_1,Simple complete removal of breast,3000.0,1950.0,78.57,2800.17,19
CDM,19305_1,"Extensive removal of breast, chest muscle, and underarm lymph nodes",2591.4,1684.41,78.57,3310.34,19
CDM,19306_1,"Extensive removal of breast, chest muscle, underarm lymph nodes, and breast lymph nodes",2712.35,1763.03,78.57,3507.66,19
CDM,19307_1,Removal of breast and underarm lymph nodes,4608.45,2995.49,78.57,3502.06,19
CDM,19316T_1,Repair for sagging of the breast,4136.0,2688.4,78.57,2290.18,19
CDM,19316_1,Repair for sagging of the breast,3858.75,2508.19,78.57,2290.18,19
CDM,19318T_1,Breast reduction,5193.3,3375.65,78.57,3272.34,19
CDM,19318_1,Breast reduction,5748.75,3736.69,78.57,3272.34,19
CDM,19325T_1,Insertion of breast implant,7379.4,4796.61,78.57,1861.47,19
CDM,19325_1,Insertion of breast implant,2686.95,1746.52,78.57,1861.47,19
CDM,19328T_1,Removal of intact breast implant,4136.0,2688.4,78.57,1477.3,19
CDM,19328_1,Removal of intact breast implant,1942.05,1262.33,78.57,1477.3,19
CDM,193309OP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",13.69,8.9,0.19,35.35,17
CDM,19330T_1,Removal of ruptured breast implant and implant material,4136.0,2688.4,78.57,1881.77,19
CDM,19330_1,Removal of ruptured breast implant and implant material,2494.8,1621.62,78.57,1881.77,19
CDM,193322IP _1,"INJECTION, INSULIN, PER 5 UNITS",4.17,2.71,0.56,10.77,17
CDM,193345IP _1,TECHNESCAN HDP PREP KIT,22500.0,14625.0,5625.0,15750.0,11
CDM,193345OP _1,TECHNESCAN HDP PREP KIT,20250.0,13162.5,5062.5,14175.0,11
CDM,19340T_1,Placement of implant on same day of breast reconstruction,5193.3,3375.65,78.57,2287.77,19
CDM,19340_1,Placement of implant on same day of breast reconstruction,3480.0,2262.0,78.57,2287.77,19
CDM,19342T_1,Placement of implant on separate day of breast reconstruction,7379.4,4796.61,78.57,2303.04,19
CDM,19342_1,Placement of implant on separate day of breast reconstruction,3976.95,2585.02,78.57,2303.04,19
CDM,19350T_1,Reconstruction of nipple or area around nipple,2692.2,1749.93,78.57,2036.14,19
CDM,19350_1,Reconstruction of nipple or area around nipple,3343.8,2173.47,78.57,2036.14,19
CDM,19355_1,Correction of inverted nipple,2838.15,1844.8,78.57,1867.3,19
CDM,19357T_1,Reconstruction of breast using tissue expander,7379.4,4796.61,78.57,3508.37,19
CDM,19357_1,Reconstruction of breast using tissue expander,6170.85,4011.05,78.57,3508.37,19
CDM,193585IP _1,"ASPARLAS 3,750 UNIT/5 ML VIAL",36341.19,23621.77,9085.3,25438.83,11
CDM,193585OP _1,"ASPARLAS 3,750 UNIT/5 ML VIAL",13069.39,8495.1,3267.35,9148.57,11
CDM,19361T_1,Reconstruction of breast with shoulder muscle tissue graft,1379.7,896.81,78.57,4685.58,19
CDM,19361_1,Reconstruction of breast with shoulder muscle tissue graft,4440.5,2886.33,78.57,4685.58,19
CDM,19364_1,Reconstruction of breast with tissue graft,26000.0,16900.0,78.57,8207.83,19
CDM,19367_1,Reconstruction of breast with abdominal muscle flap,8163.8,5306.47,78.57,5318.44,19
CDM,19368_1,Reconstruction of breast with abdominal muscle and skin flap graft,8583.8,5579.47,78.57,6550.21,19
CDM,19369_1,Reconstruction of breast with abdominal muscle and 2 skin flap grafts,7875.0,5118.75,78.57,6080.03,19
CDM,19370T_1,Revision of capsule around breast implant,4136.0,2688.4,78.57,2030.8,19
CDM,19370_1,Revision of capsule around breast implant,2707.5,1759.88,78.57,2030.8,19
CDM,19371T_1,Removal of capsule around breast implant,4136.0,2688.4,78.57,2153.63,19
CDM,19371_1,Removal of capsule around breast implant,3115.35,2024.98,78.57,2153.63,19
CDM,193745OP _1,KANJINTI 150 MG VIAL,10400.29,6760.19,2600.07,7280.2,11
CDM,19380T_1,Surgical change to reconstructed breast,5193.3,3375.65,78.57,2307.46,19
CDM,19380_1,Surgical change to reconstructed breast,3057.15,1987.15,78.57,2307.46,19
CDM,19396T_1,Preparation of mold for custom breast implant,848.5,551.53,55.52,654.4,19
CDM,19396_1,Preparation of mold for custom breast implant,795.9,517.34,53.9,654.4,19
CDM,194060IP _1,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",28504.13,18527.68,45.34,73611.92,19
CDM,194060OP _1,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",34407.11,22364.62,45.34,88856.36,19
CDM,194061IP _1,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",76394.9,49656.69,45.34,197289.83,19
CDM,194061OP _1,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",109330.85,71065.05,45.34,282346.92,19
CDM,194080IP _1,"INJECTION, CRIZANLIZUMAB-TMCA, 5 MG",185.8,120.77,46.45,1578.71,19
CDM,194080OP _1,"INJECTION, CRIZANLIZUMAB-TMCA, 5 MG",480.68,312.44,120.17,1578.71,19
CDM,194082IP _1,BRUKINSA 80 MG CAPSULE,910.98,592.14,227.75,637.69,11
CDM,194093IP _1,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",9693.86,6301.01,11.71,25034.39,17
CDM,194093OP _1,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",8811.96,5727.77,11.71,22756.89,17
CDM,19433IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.81,2.48,0.95,9.84,16
CDM,19433OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.34,11.27,4.34,44.78,16
CDM,194377OP _1,"INJECTION, AFLIBERCEPT, 1 MG",189579.97,123226.98,809.73,489590.27,19
CDM,194390IP _1,UNCLASSIFIED DRUGS,14.59,9.48,3.65,37.68,16
CDM,194390OP _1,UNCLASSIFIED DRUGS,18.63,12.11,4.66,48.11,16
CDM,194469IP _1,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",6952.28,4518.98,38.92,17954.26,19
CDM,194469OP _1,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",24712.9,16063.39,38.92,63821.06,19
CDM,194470IP _1,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",9389.93,6103.45,38.92,24249.49,19
CDM,194470OP _1,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",36109.48,23471.16,38.92,93252.73,19
CDM,194474OP _1,"INJECTION, FAM-TRASTUZUMAB DERUXTECAN-NXKI, 1 MG",26359.45,17133.64,33.18,68073.28,19
CDM,19451IP _1,"Diphtheria, tetanus, and acellular pertussis vaccine (younger than 7 years)",410.0,266.5,30.97,1058.83,19
CDM,19451OP _1,"Diphtheria, tetanus, and acellular pertussis vaccine (younger than 7 years)",379.32,246.56,30.97,979.59,19
CDM,194701IP _1,"INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG",568.02,369.21,14.07,2922.83,19
CDM,194701OP _1,"INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG",676.68,439.84,14.07,2922.83,19
CDM,194702IP _1,"INJECTION, IMIPENEM 4 MG, CILASTATIN 4 MG AND RELEBACTAM 2 MG",2157.33,1402.26,2.76,5571.3,19
CDM,194723IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",689.15,447.95,172.29,1779.73,16
CDM,194723OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",382.69,248.75,95.67,988.3,16
CDM,194724IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",674.96,438.72,168.74,1743.08,16
CDM,194724OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",427.82,278.08,106.96,1104.85,16
CDM,194736IP _1,CAPLYTA 42 MG CAPSULE,372.25,241.96,93.06,260.58,11
CDM,194736OP _1,CAPLYTA 42 MG CAPSULE,361.15,234.75,90.29,252.81,11
CDM,194800OP _1,"INJECTION, TEPROTUMUMAB-TRBW, 10 MG",35521.55,23089.01,391.47,91734.4,19
CDM,19495IP _1,UNCLASSIFIED DRUGS,42.63,27.71,10.66,110.09,16
CDM,19495OP _1,UNCLASSIFIED DRUGS,13.7,8.91,3.43,35.38,16
CDM,19499T_1,Other procedure on breast,2543.9,1653.54,73.6,2620.22,15
CDM,195017IP _1,"INJECTION, BIVALIRUDIN, 1 MG",8.02,5.21,0.17,158.28,19
CDM,195019OP _1,REYVOW 100 MG TABLET,210.35,136.73,52.59,147.25,11
CDM,195020IP _1,"INJECTION, CEFIDEROCOL, 10 MG",1510.32,981.71,2.57,3900.4,19
CDM,195392OP _1,"INJECTION, TRASTUZUMAB-PKRB, BIOSIMILAR, (HERZUMA), 10 MG",27045.04,17579.28,58.76,69843.82,19
CDM,195398OP _1,"AFAMELANOTIDE IMPLANT, 1 MG",125775.9,81754.34,3120.03,324816.26,19
CDM,195399IP _1,UNCLASSIFIED DRUGS,258.63,168.11,64.66,667.91,16
CDM,195399OP _1,UNCLASSIFIED DRUGS,85.53,55.59,21.38,220.88,16
CDM,195400IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",250.23,162.65,62.56,646.22,16
CDM,195400OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",155.02,100.76,38.76,400.34,16
CDM,195401IP _1,UNCLASSIFIED DRUGS,256.92,167.0,64.23,663.5,16
CDM,195401OP _1,UNCLASSIFIED DRUGS,593.93,386.05,148.48,1533.82,16
CDM,195423IP _1,"INJECTION, EPTINEZUMAB-JJMR, 1 MG",7682.68,4993.74,21.73,19840.52,19
CDM,195423OP _1,"INJECTION, EPTINEZUMAB-JJMR, 1 MG",11969.11,7779.92,21.73,30910.23,19
CDM,195428IP _1,NEXLETOL 180 MG TABLET,90.95,59.12,22.74,63.67,11
CDM,195433IP _1,NURTEC ODT 75 MG TABLET,814.94,529.71,203.74,570.46,11
CDM,195457IP _1,POTASSIUM PHOSPH 45 MMOL/15 ML,14.92,9.7,3.73,10.44,11
CDM,195468OP _1,HERZUMA 150 MG VIAL,4895.0,3181.75,1223.75,3426.5,11
CDM,196311OP _1,"INJECTION, SACITUZUMAB GOVITECAN-HZIY, 2.5 MG",9478.86,6161.26,39.2,24479.16,19
CDM,196316IP _1,JELMYTO 40 MG VIAL,55100.0,35815.0,13775.0,38570.0,11
CDM,196316OP _1,JELMYTO 40 MG VIAL,55094.81,35811.63,13773.7,38566.37,11
CDM,19636OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.87,11.62,4.47,46.15,16
CDM,196702OP _1,"INJECTION, INFLIXIMAB-AXXQ, BIOSIMILAR, (AVSOLA), 10 MG",1657.22,1077.19,25.24,4279.77,19
CDM,196705IP _1,DAYVIGO 10 MG TABLET,79.55,51.71,19.89,55.69,11
CDM,196708OP _1,DURYSTA 10 MCG IMPLANT,5072.5,3297.13,1268.13,3550.75,11
CDM,196726IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",74.25,48.26,18.56,191.75,16
CDM,196727IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",73.51,47.78,18.38,189.84,16
CDM,196736IP _1,"INJECTION, DARATUMUMAB, 10 MG AND HYALURONIDASE-FIHJ",1562.74,1015.78,58.36,5812.21,19
CDM,196736OP _1,"INJECTION, DARATUMUMAB, 10 MG AND HYALURONIDASE-FIHJ",6157.18,4002.17,58.36,15900.92,19
CDM,196765IP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",95.9,62.34,0.15,247.66,17
CDM,196765OP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",13.38,8.7,0.15,34.55,17
CDM,19691IP _1,UNCLASSIFIED DRUGS,7.5,4.88,1.88,19.37,16
CDM,19696IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.03,4.57,1.76,18.16,16
CDM,19696OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.91,3.19,1.23,12.68,16
CDM,197013IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.08,1.35,0.52,5.37,16
CDM,19703IP _1,UNCLASSIFIED DRUGS,265.92,172.85,66.48,686.74,16
CDM,197113OP _1,UPLIZNA 100 MG/10 ML VIAL,20097.65,13063.47,5024.41,14068.36,11
CDM,197117OP _1,"INJECTION, LURBINECTEDIN, 0.1 MG",70239.29,45655.54,223.43,181392.97,19
CDM,19713IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",62.61,40.7,15.65,161.69,16
CDM,19714IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.0,11.05,4.25,43.9,16
CDM,19714OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.59,6.88,2.65,27.35,16
CDM,19733IP _1,UNCLASSIFIED DRUGS,354.07,230.15,88.52,914.39,16
CDM,19733OP _1,UNCLASSIFIED DRUGS,476.44,309.69,119.11,1230.41,16
CDM,19736OP _1,"INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG",135.35,87.98,0.51,349.54,17
CDM,197435OP _1,UNCLASSIFIED DRUGS,715.0,464.75,178.75,1846.49,16
CDM,19743IP _1,NORETHINDRONE 0.35 MG TABLET,7.25,4.71,1.81,5.08,11
CDM,197442IP _1,UNCLASSIFIED DRUGS,3.5,2.28,0.88,9.04,16
CDM,19746IP _1,UNCLASSIFIED DRUGS,31.16,20.25,7.79,80.47,16
CDM,19746OP _1,UNCLASSIFIED DRUGS,19.96,12.97,4.99,51.55,16
CDM,197484IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.07,1.35,0.52,5.35,16
CDM,197497OP _1,"PHESGO 1,200-600MG-30,000 UNIT",2063.1,1341.02,515.78,1444.17,11
CDM,197498OP _1,"PHESGO 600-600 MG-20,000 UNIT",4145.54,2694.6,1036.39,2901.88,11
CDM,19749IP _1,UNCLASSIFIED DRUGS,42.36,27.53,10.59,109.39,16
CDM,19749OP _1,UNCLASSIFIED DRUGS,19.86,12.91,4.97,51.29,16
CDM,19769OP _1,UNCLASSIFIED DRUGS,317.91,206.64,79.48,821.0,16
CDM,197863OP _1,"METHACHOLINE CHLORIDE ADMINISTERED AS INHALATION SOLUTION THROUGH A NEBULIZER, PER 1 MG",20.81,13.53,2.01,53.74,17
CDM,197870IP _1,"INJECTION, TAFASITAMAB-CXIX, 2 MG",9382.98,6098.94,15.09,24231.55,19
CDM,197870OP _1,"INJECTION, TAFASITAMAB-CXIX, 2 MG",17331.3,11265.35,15.09,44758.08,19
CDM,19791OP _1,BETADINE 5% EYE SOLUTION,1.05,0.68,0.26,0.74,11
CDM,19809IP _1,GASTROCROM 100 MG/5 ML CONC,15.68,10.19,3.92,10.98,11
CDM,19809OP _1,GASTROCROM 100 MG/5 ML CONC,7.63,4.96,1.91,5.34,11
CDM,198116OP _1,ONGENTYS 50 MG CAPSULE,64.8,42.12,16.2,45.36,11
CDM,198134IP _1,UNCLASSIFIED DRUGS,189.16,122.95,47.29,488.51,16
CDM,198229IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.57,2.97,1.14,11.8,16
CDM,198229OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",78.75,51.19,19.69,203.37,16
CDM,198237IP _1,POLIVY 30 MG VIAL,26920.17,17498.11,6730.04,18844.12,11
CDM,198237OP _1,POLIVY 30 MG VIAL,26830.86,17440.06,6707.72,18781.6,11
CDM,198476IP _1,TRELEGY ELLIPTA 200-62.5-25,71.08,46.2,17.77,49.76,11
CDM,198476OP _1,TRELEGY ELLIPTA 200-62.5-25,4.31,2.8,1.08,3.02,11
CDM,198520OP _1,"INJECTION, RAVULIZUMAB-CWVZ, 10 MG",8543.64,5553.37,238.29,35052.23,19
CDM,19882IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.61,3.65,1.4,14.49,16
CDM,19882OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.4,17.81,6.85,70.76,16
CDM,198936OP _1,NYVEPRIA 6 MG/0.6 ML SYRINGE,3308.98,2150.84,827.25,2316.29,11
CDM,198937IP _1,BYFAVO 20 MG VIAL,268.2,174.33,67.05,187.74,11
CDM,198937OP _1,BYFAVO 20 MG VIAL,696.06,452.44,174.02,487.24,11
CDM,198959OP _1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",1197.5,778.38,8.02,3092.54,19
CDM,199050OP _1,RIABNI 500 MG/50 ML VIAL,17.9,11.64,4.48,12.53,11
CDM,199064IP _1,ORGOVYX 120 MG TABLET,648.1,421.27,162.03,453.67,11
CDM,19928IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.47,5.51,2.12,21.87,16
CDM,19928OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.24,2.11,0.81,8.37,16
CDM,199335IP _1,"INJECTION, ATROPINE SULFATE, 0.01 MG",267.6,173.94,0.11,691.08,17
CDM,199335OP _1,"INJECTION, ATROPINE SULFATE, 0.01 MG",242.45,157.59,0.11,626.13,17
CDM,199359IP _1,GEMTESA 75 MG TABLET,102.9,66.89,25.73,72.03,11
CDM,199359OP _1,GEMTESA 75 MG TABLET,48.6,31.59,12.15,34.02,11
CDM,199361OP _1,L.E.T.(LIDO-EPINEPH-TETRA) GEL,6.42,4.17,1.61,4.49,11
CDM,199429OP _1,"INJECTION, CABOTEGRAVIR AND RILPIVIRINE, 2MG/3MG",1195.58,777.13,25.61,5812.21,19
CDM,199602OP _1,OZEMPIC 1 MG/DOSE (4 MG/3 ML),781.67,508.09,195.42,547.17,11
CDM,199899IP _1,XTANDI 40 MG TABLET,865.7,562.71,216.43,605.99,11
CDM,199900IP _1,XTANDI 80 MG TABLET,1725.15,1121.35,431.29,1207.61,11
CDM,20038IP _1,UNCLASSIFIED DRUGS,184.53,119.94,46.13,476.55,16
CDM,200396OP _1,"INJECTION, THYROTROPIN ALPHA, 0.9 MG, PROVIDED IN 1.1 MG VIAL",7829.98,5089.49,1547.76,20220.92,19
CDM,20039IP _1,UNCLASSIFIED DRUGS,188.81,122.73,47.2,487.6,16
CDM,20039OP _1,UNCLASSIFIED DRUGS,189.5,123.18,47.38,489.38,16
CDM,200410IP _1,"INJECTION, CABOTEGRAVIR AND RILPIVIRINE, 2MG/3MG",846.33,550.11,25.61,5812.21,19
CDM,200410OP _1,"INJECTION, CABOTEGRAVIR AND RILPIVIRINE, 2MG/3MG",4554.46,2960.4,25.61,11761.89,19
CDM,200456IP _1,QELBREE ER 100 MG CAPSULE,81.93,53.25,20.48,57.35,11
CDM,200458IP _1,QELBREE ER 200 MG CAPSULE,77.62,50.45,19.41,54.33,11
CDM,200473IP _1,UNCLASSIFIED DRUGS,1.72,1.12,0.43,4.44,16
CDM,200544OP _1,"INJECTION, LONCASTUXIMAB TESIRINE-LPYL, 0.075 MG",121713.4,79113.71,234.49,314324.86,19
CDM,200552OP _1,"INJECTION, DOSTARLIMAB-GXLY, 10 MG",7910.48,5141.81,262.29,20428.81,19
CDM,2007IP _1,"INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG",54.18,35.22,0.68,139.92,17
CDM,2007OP _1,"INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG",86.38,56.15,0.68,223.08,17
CDM,200807OP _1,ENZNONUTY 20%-10%-10% OINTMENT,10.86,7.06,2.72,7.6,11
CDM,200877IP _1,ZYNRELEF 400-12 MG/14 ML VIAL,102.89,66.88,25.72,72.02,11
CDM,200877OP _1,ZYNRELEF 400-12 MG/14 ML VIAL,48.88,31.77,12.22,34.22,11
CDM,200879IP _1,ZYNRELEF 200-6 MG/7 ML VIAL,14.91,9.69,3.73,10.44,11
CDM,200879OP _1,ZYNRELEF 200-6 MG/7 ML VIAL,50.93,33.1,12.73,35.65,11
CDM,200891OP _1,"INJECTION, AMIVANTAMAB-VMJW, 2 MG",2425.8,1576.77,23.91,7236.29,19
CDM,2008IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.75,3.74,1.44,14.85,16
CDM,2008OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.3,9.3,3.58,36.93,16
CDM,20100_1,Exploration of wound of neck,2436.6,1583.79,78.57,1788.56,19
CDM,20101_1,Exploration of wound of chest,1400.0,910.0,78.57,1382.01,19
CDM,20102_1,"Exploration of wound of abdomen, back, or flank",1480.0,962.0,78.57,1443.64,19
CDM,20103_1,Exploration of wound of arm or leg,1470.0,955.5,78.57,1339.98,19
CDM,201118OP _1,"PIFLUFOLASTAT F-18, DIAGNOSTIC, 1 MILLICURIE",67330.22,43764.64,367.28,203128.54,17
CDM,201148IP _1,WEGOVY 0.25 MG/0.5 ML PEN,4646.4,3020.16,1161.6,3252.48,11
CDM,2012IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.13,7.88,3.03,31.33,16
CDM,2012OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.94,11.66,4.49,46.33,16
CDM,201415IP _1,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use",1146.39,745.15,163.76,2960.55,19
CDM,20150_1,Removal of growth plate,2179.7,1416.81,78.57,2980.18,19
CDM,20156IP _1,"INJECTION, CYTARABINE, 100 MG",569.98,370.49,0.89,1709.94,17
CDM,20156OP _1,"INJECTION, CYTARABINE, 100 MG",39.61,25.75,0.89,118.83,17
CDM,201712OP _1,"INJECTION, ANIFROLUMAB-FNIA, 1 MG",25196.72,16377.87,19.44,65070.53,19
CDM,201735OP _1,"INJECTION, AVALGLUCOSIDASE ALFA-NGPT, 4 MG",3910.6,2541.89,86.18,35052.23,19
CDM,2017IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.84,4.45,1.71,17.66,16
CDM,2017OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",236.06,153.44,59.02,609.63,16
CDM,20200_1,Biopsy of muscle,497.7,323.51,24.35,515.31,19
CDM,20205_1,Deep biopsy of muscle,738.2,479.83,60.46,713.27,19
CDM,20206_1,Needle biopsy of muscle,668.9,434.79,47.66,540.54,19
CDM,202101IP _1,QULIPTA 60 MG TABLET,242.3,157.5,60.58,169.61,11
CDM,202101OP _1,QULIPTA 60 MG TABLET,98.4,63.96,24.6,68.88,11
CDM,20220_1,Biopsy of bone using needle or trocar,534.5,347.43,28.96,569.58,19
CDM,20225_1,Deep biopsy of bone using needle or trocar,1733.6,1126.84,36.17,932.39,19
CDM,20240_1,Biopsy of surface bone,651.0,423.15,78.57,435.22,19
CDM,20245_1,Biopsy of deep bone,1687.4,1096.81,78.57,1045.21,19
CDM,202487IP _1,SCEMBLIX 40 MG TABLET,2584.44,1679.89,646.11,1809.11,11
CDM,202509IP _1,EPRONTIA 25 MG/ML SOLUTION,18.96,12.32,4.74,13.27,11
CDM,202509OP _1,EPRONTIA 25 MG/ML SOLUTION,8.09,5.26,2.02,5.66,11
CDM,20250_1,Biopsy of middle spine bone,1003.8,652.47,78.57,1221.17,19
CDM,20251_1,Biopsy of upper or lower spine bone,1680.0,1092.0,78.57,1243.04,19
CDM,2025IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.3,35.95,13.83,142.81,16
CDM,2025OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.5,12.03,4.63,47.78,16
CDM,202705OP _1,"INJECTION, INCLISIRAN, 1 MG",15251.02,9913.16,13.45,39385.76,19
CDM,202735OP _1,FYARRO 100 MG VIAL,31287.62,20336.95,7821.91,21901.33,11
CDM,202740IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1604.71,1043.06,401.18,4144.16,16
CDM,202803OP _1,"INJECTION, EFGARTIGIMOD ALFA-FCAB, 2MG",1381.88,898.22,34.15,11535.65,19
CDM,202806OP _1,"INJECTION, CABOTEGRAVIR, 1MG, FDA APPROVED PRESCRIPTION, ONLY FOR USE AS HIV PRE-EXPOSURE PROPHYLAXIS (NOT FOR USE AS TREATMENT FOR HIV)",2500.14,1625.09,7.58,6456.61,19
CDM,202808IP _1,PAXLOVID 300-100 MG DOSE PACK,314.9,204.69,78.73,220.43,11
CDM,203044OP _1,"INJECTION, TEZEPELUMAB-EKKO, 1 MG",20474.74,13308.58,18.89,52876.02,19
CDM,203087OP _1,"INJECTION, TEBENTAFUSP-TEBN, 1 MICROGRAM",185037.65,120274.47,235.54,477859.73,19
CDM,2032IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.15,0.75,0.29,2.97,16
CDM,2032OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.13,1.38,0.53,5.5,16
CDM,2033IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.17,2.71,1.04,10.77,16
CDM,2033OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.55,3.61,1.39,14.33,16
CDM,203420OP _1,"GALLIUM GA-68 GOZETOTIDE, DIAGNOSTIC, (ILLUCCIX), 1 MILLICURIE",19912.06,12942.84,507.23,60072.69,17
CDM,203442OP _1,"INJECTION, FARICIMAB-SVOA, 0.1 MG",226866.35,147463.13,34.87,585882.35,19
CDM,203456IP _1,"ENJAYMO 1,100 MG/22 ML VIAL",12600.0,8190.0,3150.0,8820.0,11
CDM,203456OP _1,"ENJAYMO 1,100 MG/22 ML VIAL",1900.07,1235.05,475.02,1330.05,11
CDM,203464IP _1,BACLOFEN 25 MG/5 ML SUSPENSION,33.68,21.89,8.42,23.58,11
CDM,203486IP _1,"INJECTION, VASOPRESSIN, 1 UNIT",1.93,1.25,0.48,4.98,17
CDM,203486OP _1,"INJECTION, VASOPRESSIN, 1 UNIT",5.19,3.37,0.56,13.4,17
CDM,203666IP _1,CEFAZOLIN 2 GM VIAL,65.5,42.58,16.38,45.85,11
CDM,203666OP _1,CEFAZOLIN 2 GM VIAL,19.94,12.96,4.99,13.96,11
CDM,203726IP _1,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",1536.05,998.43,0.36,3966.85,19
CDM,203726OP _1,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",513.0,333.45,0.36,1324.82,19
CDM,203727IP _1,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",1478.64,961.12,0.36,3818.59,19
CDM,203727OP _1,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",562.88,365.87,0.36,1453.64,19
CDM,203804IP _1,MAYZENT 1 MG TABLET,2333.9,1517.04,583.48,1633.73,11
CDM,203820OP _1,"INJECTION, NIVOLUMAB AND RELATLIMAB-RMBW, 3 MG/1 MG",6089.75,3958.34,213.75,35052.23,19
CDM,203831OP _1,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC, 1 MILLICURIE",82723.99,53770.59,274.88,213634.7,19
CDM,203841OP _1,OZEMPIC 2 MG/DOSE (8 MG/3 ML),781.67,508.09,195.42,547.17,11
CDM,204173IP _1,SODIUM CHLORIDE 23.4% ORAL SOL,6.32,4.11,1.58,4.42,11
CDM,204174IP _1,PAXLOVID 150-100 MG (MODERATE),490.5,318.83,122.63,343.35,11
CDM,20446IP _1,ANAGRELIDE HCL 0.5 MG CAPSULE,12.5,8.13,3.13,8.75,11
CDM,204503OP _1,MOUNJARO 12.5 MG/0.5 ML PEN,1322.5,859.63,330.63,925.75,11
CDM,204506OP _1,MOUNJARO 5 MG/0.5 ML PEN,1322.5,859.63,330.63,925.75,11
CDM,204701IP _1,TYVASO DPI 16 MCG CARTRIDGE,438.07,284.75,109.52,306.65,11
CDM,204703IP _1,TYVASO DPI 48 MCG CARTRIDGE,1718.3,1116.9,429.58,1202.81,11
CDM,204704IP _1,TYVASO DPI 64 MCG CARTRIDGE,1715.67,1115.19,428.92,1200.97,11
CDM,20472IP _1,UNCLASSIFIED DRUGS,9.41,6.12,2.35,24.3,16
CDM,20472OP _1,UNCLASSIFIED DRUGS,35.75,23.24,8.94,92.32,16
CDM,204764OP _1,"INJECTION, VUTRISIRAN, 1 MG",712903.04,463386.98,5310.13,1841072.1,19
CDM,204772OP _1,"INJECTION, RISANKIZUMAB-RZAA, INTRAVENOUS, 1 MG",7533.76,4896.94,15.83,19455.94,19
CDM,20500_1,Injection for repair of abnormal muscle drainage tract,632.1,410.87,25.47,297.46,19
CDM,20501_1,Injection of abnormal muscle drainage tract for X-ray study,364.4,236.86,21.15,347.88,19
CDM,205091IP _1,CAPLYTA 10.5 MG CAPSULE,359.4,233.61,89.85,251.58,11
CDM,205092IP _1,CAPLYTA 21 MG CAPSULE,359.4,233.61,89.85,251.58,11
CDM,20520_1,Removal of foreign body in muscle or tendon,500.0,325.0,78.57,519.49,19
CDM,20525_1,Complicated removal of foreign body in deep muscle or tendon,1210.0,786.5,78.57,1109.94,19
CDM,20526_1,Injection of carpal tunnel,300.0,195.0,28.89,193.6,19
CDM,20527_1,Injection of medication into palm,194.7,126.56,53.01,207.08,19
CDM,205405IP _1,UNCLASSIFIED DRUGS,2417.85,1571.6,604.46,6244.1,16
CDM,205405OP _1,UNCLASSIFIED DRUGS,1743.86,1133.51,435.97,4503.52,16
CDM,205419OP _1,XIPERE 40 MG/ML VIAL,4610.6,2996.89,1152.65,3227.42,11
CDM,20550_1,Injection into tendon or ligament,240.0,156.0,18.69,138.32,19
CDM,20551_1,Injection into tendon at attachment to bone or muscle,150.0,97.5,28.08,138.32,19
CDM,20552_1,"Injection of trigger points, 1-2 muscles",150.0,97.5,26.67,126.77,19
CDM,20553_1,"Injection of trigger points, 3 or more muscles",170.0,110.5,38.03,146.33,19
CDM,20560_1,"Insertion of needle, 1-2 muscles",65.0,42.25,12.02,78.57,19
CDM,20561_1,"Insertion of needle, 3 muscles or more",90.0,58.5,18.85,92.7,19
CDM,205769IP _1,FYLNETRA 6 MG/0.6 ML SYRINGE,42298.26,27493.87,10574.57,29608.78,11
CDM,205769OP _1,FYLNETRA 6 MG/0.6 ML SYRINGE,20472.8,13307.32,5118.2,14330.96,11
CDM,205770IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.84,11.6,4.46,46.07,16
CDM,205770OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.64,1.07,0.41,4.24,16
CDM,20600_1,Aspiration and/or injection of fluid from small joint,225.0,146.25,18.84,126.77,19
CDM,20604_1,Aspiration and/or injection of fluid from small joint using ultrasound guidance,267.75,174.04,36.92,197.73,19
CDM,20605T_1,Aspiration and/or injection of fluid from medium joint,153.3,99.65,22.23,131.4,19
CDM,20605_1,Aspiration and/or injection of fluid from medium joint,390.0,253.5,22.23,131.4,19
CDM,20606_1,Aspiration and/or injection of fluid from medium joint using ultrasound guidance,299.25,194.51,41.65,214.23,19
CDM,20610T_1,Aspiration and/or injection of fluid from large joint,151.2,98.28,24.52,153.48,19
CDM,20610_1,Aspiration and/or injection of fluid from large joint,315.0,204.75,24.52,153.48,19
CDM,20611_1,Aspiration and/or injection of fluid large joint using ultrasound guidance,330.75,214.99,46.45,237.74,19
CDM,20612_1,Aspiration and/or injection of cyst of tendon,140.0,91.0,27.6,153.12,19
CDM,206157IP _1,TERLIVAZ 0.85 MG VIAL,6846.85,4450.45,1711.71,4792.8,11
CDM,206157OP _1,TERLIVAZ 0.85 MG VIAL,2445.3,1589.45,611.33,1711.71,11
CDM,20615_1,Aspiration and injection of cyst of bone,578.6,376.09,78.57,608.19,19
CDM,206236OP _1,"INJECTION, TREMELIMUMAB-ACTL, 1 MG",19742.29,12832.49,151.6,50984.46,19
CDM,206239IP _1,"INJECTION, TECLISTAMAB-CQYV, 0.5 MG",26684.54,17344.95,36.65,68912.82,19
CDM,206239OP _1,"INJECTION, TECLISTAMAB-CQYV, 0.5 MG",19166.53,12458.24,36.65,49497.56,19
CDM,206240IP _1,"INJECTION, TECLISTAMAB-CQYV, 0.5 MG",8381.69,5448.1,36.65,21645.71,19
CDM,20634IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.77,1.8,0.69,7.15,16
CDM,20634OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.1,3.97,1.53,15.75,16
CDM,206447IP _1,"INJECTION, GADOPICLENOL, 1 ML",80.86,52.56,3.5,243.95,17
CDM,206447OP _1,"INJECTION, GADOPICLENOL, 1 ML",98.0,63.7,3.5,295.66,17
CDM,206505OP _1,"INJECTION, MIRVETUXIMAB SORAVTANSINE-GYNX, 1 MG",2122.28,1379.48,75.44,25740.26,19
CDM,20650_1,Insertion of wire or pin to bone for traction,522.9,339.89,78.57,541.06,19
CDM,20660_1,Placement of device to skull,665.7,432.71,78.57,688.61,19
CDM,20661_1,Placement of stabilizing device to skull,1238.0,804.7,78.57,1446.36,19
CDM,20662_1,Application of pelvic halo device (stabilization device for pelvis),779.4,506.61,78.57,1515.44,19
CDM,20663_1,Placement of stabilizing device to thigh,1183.4,769.21,78.57,1391.87,19
CDM,20664_1,Application of cranial halo (stabilization device for skull),2020.2,1313.13,78.57,2461.45,19
CDM,20665_1,Removal of stabilizing device from head originally applied by other provider,326.6,212.29,26.05,299.91,19
CDM,20670T_1,Removal of surface implant from bone,2100.0,1365.0,48.04,858.31,19
CDM,20670_1,Removal of surface implant from bone,1191.8,774.67,48.04,858.31,19
CDM,206737OP _1,DAXXIFY 100 UNIT VIAL,915.72,595.22,228.93,641.0,11
CDM,20680T_1,Removal of deep implant from bone,2753.1,1789.52,78.57,1431.96,19
CDM,20680_1,Removal of deep implant from bone,1565.6,1017.64,78.57,1431.96,19
CDM,206877OP _1,SUNLENCA 463.5 MG/1.5 ML VIAL,16104.2,10467.73,4026.05,11272.94,11
CDM,206879IP _1,LUNSUMIO 30 MG/30 ML VIAL,4235.73,2753.22,1058.93,2965.01,11
CDM,206879OP _1,LUNSUMIO 1 MG/ML VIAL,6448.26,4191.37,1612.07,4513.78,11
CDM,20690_1,Placement of single direction external bone stabilizing device to arm or leg,1501.5,975.98,78.57,1768.49,19
CDM,20692T_1,Placement of multiple direction external bone stabilizing device to arm or leg,3807.3,2474.75,78.57,3340.31,19
CDM,20692_1,Placement of multiple direction external bone stabilizing device to arm or leg,2847.6,1850.94,78.57,3340.31,19
CDM,20693T_1,Revision of external bone stabilizing device under anesthesia,2774.1,1803.17,78.57,1324.66,19
CDM,20693_1,Revision of external bone stabilizing device under anesthesia,1974.0,1283.1,78.57,1324.66,19
CDM,20694_1,Removal of external bone stabilizing device under anesthesia,1145.6,744.64,78.57,1033.06,19
CDM,20696_1,Placement of multiple direction external bone stabilizing device to arm or leg using imaging,2458.1,1597.77,78.57,3557.92,19
CDM,20697_1,Placement of multiple direction external bone stabilizing device to arm or leg using imaging guidance,2882.3,1873.5,6.17,5873.06,19
CDM,20700_1,Insertion of drug-delivery device in deep tissue,197.25,128.21,64.38,240.74,19
CDM,20701_1,Removal of drug-delivery devices from beneath fibrous covering of muscle,147.75,96.04,49.57,181.49,19
CDM,20702_1,Insertion of drug-delivery device in bone,327.5,212.88,78.57,402.3,19
CDM,20703_1,Removal of drug-delivery devices from marrow cavity of bone,235.75,153.24,78.57,289.48,19
CDM,20704_1,Insertion of drug-delivery device in joint,350.0,227.5,78.57,418.91,19
CDM,20705_1,Removal of drug-delivery devices into joint,281.5,182.98,78.57,346.05,19
CDM,20707IP _1,IVERMECTIN 6 MG TABLET,65.82,42.78,16.46,46.07,11
CDM,207144OP _1,"INJECTION, UBLITUXIMAB-XIIY, 1MG",10802.58,7021.68,74.39,27897.66,19
CDM,207171OP _1,TOBRAMYCIN 1.5%-VANCOMYCIN 5%,515.39,335.0,128.85,360.77,11
CDM,207201OP _1,"INJECTION, LECANEMAB-IRMB, 1 MG",968.29,629.39,1.41,2500.61,19
CDM,207218OP _1,OZEMPIC 0.25-0.5 MG/DOSE PEN,798.83,519.24,199.71,559.18,11
CDM,207499OP _1,TEZSPIRE 210 MG/1.91 ML PEN,5471.33,3556.36,1367.83,3829.93,11
CDM,207898OP _1,EMERPHED 50 MG/10 ML SYRINGE,12.6,8.19,3.15,8.82,11
CDM,207981OP _1,ZYNYZ 500 MG/20 ML VIAL,4107.25,2669.71,1026.81,2875.08,11
CDM,20802_1,Reattachment of cutoff arm,10237.5,6654.38,78.57,8153.14,19
CDM,20805_1,Reattachment of cutoff forearm,10237.5,6654.38,78.57,9704.93,19
CDM,20808_1,Reattachment of cutoff hand,11253.9,7315.04,78.57,11734.49,19
CDM,20816_1,Reattachment of cutoff finger,6568.8,4269.72,78.57,6107.45,19
CDM,20822_1,Reattachment of part of cutoff finger,5750.9,3738.09,78.57,5250.37,19
CDM,20824_1,Reattachment of cutoff thumb,6486.9,4216.49,78.57,6117.89,19
CDM,20827_1,Reattachment of part of cutoff thumb,6014.4,3909.36,78.57,5381.96,19
CDM,208368OP _1,"INJECTION, TOFERSEN, 1 MG",2175.65,1414.17,169.61,5618.62,17
CDM,20838_1,Reattachment of cutoff foot,6383.85,4149.5,78.57,8256.69,19
CDM,208585IP _1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",1.42,0.92,0.36,3.67,16
CDM,208591OP _1,ABILIFY ASIMTUFII 960 MG/3.2ML,1194.56,776.46,298.64,836.19,11
CDM,208696IP _1,LOTREXONE 4.5 MG CAPSULE,39.2,25.48,9.8,27.44,11
CDM,208735OP _1,"INJECTION, EPCORITAMAB-BYSP, 0.16 MG",45721.75,29719.14,60.22,118076.42,17
CDM,20887IP _1,UNCLASSIFIED DRUGS,18.62,12.1,4.66,48.09,16
CDM,20887OP _1,UNCLASSIFIED DRUGS,42.0,27.3,10.5,108.47,16
CDM,208983OP _1,JELCAINE STERILE 2% JELLY,40.13,26.08,10.03,28.09,11
CDM,20900_1,Harvest of graft from small bone,1567.7,1019.01,78.57,933.11,19
CDM,209014IP _1,REZZAYO 200 MG VIAL,13690.1,8898.57,3422.53,9583.07,11
CDM,209014OP _1,REZZAYO 200 MG VIAL,6041.06,3926.69,1510.27,4228.74,11
CDM,20902T_1,Harvest of graft from large bone,3807.3,2474.75,78.57,830.9,19
CDM,20902_1,Harvest of graft from large bone,1779.8,1156.87,78.57,830.9,19
CDM,2090OP _1,"DACARBAZINE, 100 MG",27.88,18.12,4.37,83.64,17
CDM,209106IP _1,"INJECTION, GLOFITAMAB-GXBM, 2.5 MG",13795.6,8967.14,3014.21,35627.14,17
CDM,209106OP _1,"INJECTION, GLOFITAMAB-GXBM, 2.5 MG",3665.18,2382.37,916.3,9465.33,17
CDM,20910T_1,Rib cartilage graft,2635.5,1713.08,78.57,1383.74,19
CDM,20910_1,Rib cartilage graft,1178.1,765.77,78.57,1383.74,19
CDM,209119OP _1,"VYVGART HYTRULO 1,008MG-11,200",19222.9,12494.89,4805.73,13456.03,11
CDM,20912T_1,Graft of nose cartilage,1415.4,920.01,78.57,1418.9,19
CDM,20912_1,Graft of nose cartilage,1310.4,851.76,78.57,1418.9,19
CDM,209137OP _1,RYSTIGGO 560 MG/4 ML VIAL,13798.58,8969.08,3449.65,9659.01,11
CDM,20919IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",40.9,26.59,10.23,105.62,16
CDM,2091OP _1,"DACARBAZINE, 100 MG",144.83,94.14,4.37,434.49,17
CDM,20920IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.55,10.76,4.14,42.74,16
CDM,20920OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.33,10.61,4.08,42.17,16
CDM,20920_1,Removal of deep thigh tissue for graft,1144.5,743.93,78.57,1188.36,19
CDM,20921IP _1,UNCLASSIFIED DRUGS,20.2,13.13,5.05,52.17,16
CDM,20921OP _1,UNCLASSIFIED DRUGS,33.15,21.55,8.29,85.61,16
CDM,20922T_1,Incision of deep thigh tissue for graft,1433.3,931.65,78.57,1469.23,19
CDM,20922_1,Incision of deep thigh tissue for graft,1624.4,1055.86,78.57,1469.23,19
CDM,20924_1,Tendon graft,1352.4,879.06,78.57,1504.49,19
CDM,20930_1,Placement of fragmented bone graft or material to spine to promote bone growth,757.1,492.12,78.57,779.81,15
CDM,209318OP _1,"INTRAVESICAL INSTILLATION, NADOFARAGENE FIRADENOVEC-VNCG, PER THERAPEUTIC DOSE",94729.75,61574.34,23682.44,244639.58,19
CDM,20931_1,Graft of donor bone to spine,420.0,273.0,78.57,314.96,19
CDM,20932_1,Graft of donor bone and joint tissue,1680.0,1092.0,78.57,2136.61,19
CDM,20933_1,Graft of donor bone to part of long bone between joints,1542.0,1002.3,78.57,1960.55,19
CDM,20934_1,Graft of donor bone to long bone between joints,1680.0,1092.0,78.57,2135.45,19
CDM,209354IP _1,AREXVY VIAL KIT,1711.65,1112.57,427.91,1198.16,11
CDM,209354OP _1,AREXVY VIAL KIT,1263.5,821.28,315.88,884.45,11
CDM,209363IP _1,"Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use",1895.11,1231.82,30.97,4894.12,19
CDM,209363OP _1,ABRYSVO VIAL WITH DILUENT SYRG,2574.54,1673.45,643.64,1802.18,11
CDM,20936_1,Harvest of bone from same spine incision for graft,1152.9,749.39,78.57,1187.49,15
CDM,20937_1,Harvest of bone fragment for spine bone graft,630.0,409.5,78.57,483.26,19
CDM,20938_1,Harvest of bone for spine surgery graft,682.5,443.63,78.57,524.87,19
CDM,20939_1,Aspiration of bone marrow for spine bone graft,150.0,97.5,53.44,200.78,19
CDM,20943IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.34,9.97,3.84,39.62,16
CDM,20943OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.85,10.95,4.21,43.52,16
CDM,209440OP _1,"CANTHARIDIN FOR TOPICAL ADMINISTRATION, 0.7%, SINGLE UNIT DOSE APPLICATOR (3.2 MG)",3385.21,2200.39,695.89,8742.3,17
CDM,20950_1,Placement of device in muscle to monitor fluid pressure,730.8,475.02,76.23,630.92,19
CDM,20954IP _1,"INJECTION, LEVOCARNITINE, PER 1 GM",45.98,29.89,11.5,118.74,17
CDM,20954OP _1,"INJECTION, LEVOCARNITINE, PER 1 GM",20.05,13.03,5.01,51.78,17
CDM,20955_1,Bone graft at lower leg with microvascular connection,7233.5,4701.78,78.57,7448.02,19
CDM,20956_1,Bone graft of pelvic bone with microvascular connection,7245.0,4709.25,78.57,7822.4,19
CDM,20957_1,Bone graft of foot bone with microvascular connection,5472.95,3557.42,78.57,8157.22,19
CDM,20962T_1,Bone graft with microvascular connection,1433.3,931.65,78.57,7890.5,19
CDM,20962_1,Bone graft with microvascular connection,7102.2,4616.43,78.57,7890.5,19
CDM,209656IP _1,BEYFORTUS 50 MG/0.5 ML SYRINGE,6201.6,4031.04,1550.4,4341.12,11
CDM,209657IP _1,BEYFORTUS 100 MG/ML SYRINGE,3078.3,2000.9,769.58,2154.81,11
CDM,20969_1,Placement of skin and bone flap with microvascular connection,8092.4,5260.06,78.57,8244.16,19
CDM,20970_1,Placement of bone and skin flap from hip bone with connection of small blood vessels,7769.0,5049.85,78.57,8457.89,19
CDM,20972_1,Placement of bone and skin flap from foot bone with connection of small blood vessels,5781.15,3757.75,78.57,8455.82,19
CDM,209734OP _1,IZERVAY 2 MG/0.1 ML VIAL,52600.0,34190.0,13150.0,36820.0,11
CDM,20973_1,Placement of bone and skin flap from big toe with connection of small blood vessels,5960.3,3874.2,78.57,8931.13,19
CDM,20974_1,Placement of electrical stimulation device for bone healing,384.3,249.8,45.49,193.34,19
CDM,209755IP _1,"INJECTION, TALQUETAMAB-TGVS, 0.25 MG",49969.15,32479.95,79.42,129045.33,17
CDM,209755OP _1,"INJECTION, TALQUETAMAB-TGVS, 0.25 MG",35663.95,23181.57,79.42,92102.15,17
CDM,209756IP _1,"INJECTION, TALQUETAMAB-TGVS, 0.25 MG",5628.97,3658.83,79.42,14536.82,17
CDM,20975_1,Placement of electrical stimulation device at broken bone for healing,482.0,313.3,78.57,510.81,19
CDM,20979_1,"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)",141.8,92.17,24.62,146.05,19
CDM,209808OP _1,EYLEA HD 8 MG/0.07 ML VIAL,174956.68,113721.84,43739.17,122469.68,11
CDM,209821IP _1,"DAPTOMYCIN 1,000 MG/100 ML-NS",4.94,3.21,1.24,3.46,11
CDM,209821OP _1,DAPTOMYCIN 500 MG/50 ML-NS BAG,1.11,0.72,0.28,0.78,11
CDM,20982_1,Destruction of growths and adjacent soft tissue,3198.0,2078.7,26.98,8471.13,19
CDM,20983_1,Freezing of growth of bone and adjacent soft tissue,993.3,645.65,78.57,12366.65,19
CDM,20985_1,Computer-assisted surgery for muscle and bone procedure,358.1,232.77,78.57,432.16,19
CDM,20_1,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",382.0,248.3,95.5,986.52,19
CDM,210104IP _1,DAPTOMYCIN 700 MG/100ML-NS BAG,3.13,2.03,0.78,2.19,11
CDM,210105IP _1,DAPTOMYCIN 500 MG/50 ML-NS BAG,3.54,2.3,0.89,2.48,11
CDM,210105OP _1,"DAPTOMYCIN 1,000 MG/100 ML-NS",2.4,1.56,0.6,1.68,11
CDM,21010_1,Incision of jaw joint,3622.5,2354.63,78.57,2286.47,19
CDM,21011T_1,"Removal of growth under skin of face or scalp, less than 2.0 cm",962.9,625.89,78.57,893.07,19
CDM,21011_1,"Removal of growth under skin of face or scalp, less than 2.0 cm",854.7,555.56,78.57,893.07,19
CDM,21012T_1,"Removal of growth under skin of face or scalp, 2.0 cm or more",977.6,635.44,78.57,1002.06,19
CDM,21012_1,"Removal of growth under skin of face or scalp, 2.0 cm or more",910.4,591.76,78.57,1002.06,19
CDM,21013T_1,"Removal of growth of muscle of face or scalp, less than 2.0 cm",1333.5,866.78,78.57,1278.59,19
CDM,21013_1,"Removal of growth of muscle of face or scalp, less than 2.0 cm",1328.3,863.4,78.57,1278.59,19
CDM,21014T_1,"Removal of growth of muscle of face or scalp, 2.0 cm or more",1664.3,1081.8,78.57,1549.62,19
CDM,21014_1,"Removal of growth of muscle of face or scalp, 2.0 cm or more",1408.1,915.27,78.57,1549.62,19
CDM,21015_1,"Extensive removal of growth of face or scalp, less than 2.0 cm",1530.9,995.09,78.57,2101.79,19
CDM,21016_1,"Extensive removal of growth of face or scalp, 2.0 cm or more",2901.2,1885.78,78.57,3010.7,19
CDM,21025_1,Removal of lower jaw bone,2488.5,1617.53,78.57,2049.11,19
CDM,21026T_1,Removal of face bone,5200.7,3380.46,78.57,1326.28,19
CDM,21026_1,Removal of face bone,1553.0,1009.45,78.57,1326.28,19
CDM,21029T_1,Removal of growth of face bone,2252.1,1463.87,78.57,1896.99,19
CDM,21029_1,Removal of growth of face bone,2121.0,1378.65,78.57,1896.99,19
CDM,21030_1,Removal of growth or cyst of jaw or upper cheek,1990.8,1294.02,78.57,1126.49,19
CDM,21031_1,Removal of bony growth of jaw bone inside mouth,1439.55,935.71,78.57,924.2,19
CDM,21032_1,Removal of bony growth of upper jaw bone inside mouth,972.3,632.0,78.57,894.13,19
CDM,21034_1,Removal of growth of upper jaw or upper cheek bone,3574.2,2323.23,78.57,3467.14,19
CDM,210374IP _1,ENFAMIL DHA-ARA SUPPLEMENT LIQ,2.86,1.86,0.72,2.0,11
CDM,21040_1,Removal of growth or cyst of lower jaw bone,1309.4,851.11,78.57,1135.87,19
CDM,210447OP _1,COSENTYX 125 MG/5 ML VIAL,4905.74,3188.73,1226.44,3434.02,11
CDM,21044IP _1,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",23111.06,15022.19,1547.76,59684.31,19
CDM,21044OP _1,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",32579.9,21176.94,1547.76,84137.59,19
CDM,21044_1,Removal of growth of lower jaw bone,2397.2,1558.18,78.57,2614.6,19
CDM,21045IP _1,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",37237.6,24204.44,181.03,111712.8,19
CDM,21045OP _1,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",24841.0,16146.65,181.03,74523.0,19
CDM,21045_1,Extensive removal of growth of lower jaw bone,3849.3,2502.05,78.57,3656.37,19
CDM,21046T_1,Removal of growth or cyst of lower jaw bone through mouth,5200.7,3380.46,78.57,3123.63,19
CDM,21046_1,Removal of growth or cyst of lower jaw bone through mouth,2920.1,1898.07,78.57,3123.63,19
CDM,21047_1,Removal of growth or cyst of part of lower jaw bone,3564.8,2317.12,78.57,3872.68,19
CDM,21048_1,Removal of growth or cyst of upper jaw bone through mouth,2967.3,1928.75,78.57,3150.78,19
CDM,21049_1,Removal of growth or cyst of part of upper jaw bone,3466.1,2252.97,78.57,3627.03,19
CDM,21050_1,Removal of rounded ends of lower jaw joint bone,4725.0,3071.25,78.57,2688.02,19
CDM,21057IP _1,UNCLASSIFIED DRUGS,3.97,2.58,0.99,10.25,16
CDM,21057OP _1,UNCLASSIFIED DRUGS,21.14,13.74,5.29,54.59,16
CDM,21058IP _1,UNCLASSIFIED DRUGS,10.02,6.51,2.51,25.88,16
CDM,21058OP _1,UNCLASSIFIED DRUGS,4.17,2.71,1.04,10.77,16
CDM,21060_1,Removal of lower jaw joint bone tissue,4725.0,3071.25,78.57,2445.1,19
CDM,21061IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.66,5.63,2.17,22.36,16
CDM,21061OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.73,8.27,3.18,32.88,16
CDM,21062IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.23,2.75,1.06,10.92,16
CDM,21062OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.85,15.5,5.96,61.59,16
CDM,21063IP _1,"INJECTION, AZITHROMYCIN, 500 MG",139.05,90.38,2.16,359.1,17
CDM,21063OP _1,"INJECTION, AZITHROMYCIN, 500 MG",70.4,45.76,2.16,181.81,17
CDM,210647IP _1,VOQUEZNA 20 MG TABLET,150.7,97.96,37.68,105.49,11
CDM,210706OP _1,"INJECTION, TORIPALIMAB-TPZI, 1 MG",1133.89,737.03,42.62,2928.27,17
CDM,21070_1,Partial removal of lower jaw bone,3307.5,2149.88,78.57,1884.25,19
CDM,21073_1,Manipulation of hinged joints of upper and lower jaw bones under anesthesia,962.9,625.89,78.57,905.26,19
CDM,210747IP _1,ZEPBOUND 2.5 MG/0.5 ML PEN,3759.3,2443.55,939.83,2631.51,11
CDM,21076_1,Preparation of temporary prosthesis to close an opening in mouth,2596.7,1687.86,78.57,2201.06,19
CDM,21077_1,Impression and preparation of eye socket prosthesis,6500.6,4225.39,78.57,5430.84,19
CDM,21079_1,Impression and custom preparation of temporary oral prosthesis,4382.7,2848.76,78.57,3651.06,19
CDM,21080_1,Preparation of permanent prosthesis to close mouth opening,4969.7,3230.31,78.57,4161.29,19
CDM,21081_1,Impression and custom preparation of lower jaw bone prosthesis,4543.4,2953.21,78.57,3797.22,19
CDM,21082_1,Impression and custom preparation of prosthesis for roof of mouth enlargement,4220.0,2743.0,78.57,3458.9,19
CDM,21083_1,Preparation of prosthesis to lift roof of mouth,4004.7,2603.06,78.57,3264.27,19
CDM,21084_1,Impression and custom preparation of speech aid prosthesis,4610.6,2996.89,78.57,3726.52,19
CDM,21085_1,Impression and custom preparation of oral surgical splint,1850.1,1202.57,78.57,1628.35,19
CDM,21086_1,Impression and custom preparation of outer ear prosthesis,4871.0,3166.15,78.57,4005.17,19
CDM,21087_1,Impression and custom preparation of nasal prosthesis,4748.1,3086.27,78.57,4005.17,19
CDM,21088_1,Impression and custom preparation of facial prosthesis,2100.0,1365.0,78.57,8571.43,15
CDM,21100_1,Placement of stabilizing device to upper jaw and face,1859.6,1208.74,78.57,1496.85,19
CDM,21108OP _1,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",1718.75,1117.19,181.03,5156.25,19
CDM,21110_1,Application and removal of dental fixation device,1953.0,1269.45,78.57,2159.9,19
CDM,21116_1,Injection for X-ray of hinged joint of upper and lower jaw bones,747.6,485.94,24.4,522.7,19
CDM,21120T_1,Implantation of graft to enlarge chin bone,1842.8,1197.82,78.57,1582.66,19
CDM,21120_1,Implantation of graft to enlarge chin bone,1624.4,1055.86,78.57,1582.66,19
CDM,21121T_1,Enlargement of chin by movement of bone,3126.9,2032.49,78.57,1656.5,19
CDM,21121_1,Enlargement of chin by movement of bone,2036.0,1323.4,78.57,1656.5,19
CDM,21122T_1,Enlargement of chin by movement of multiple bones,3148.5,2046.53,78.57,2287.71,19
CDM,21122_1,Enlargement of chin by movement of multiple bones,2100.0,1365.0,78.57,2287.71,19
CDM,21123_1,"Insertion of sliding bone graft to enlarge chin bone, additional bone graft",2306.9,1499.49,78.57,2656.31,19
CDM,211259OP _1,UDENYCA 6 MG/0.6 ML ONBODY,45421.46,29523.95,11355.37,31795.02,11
CDM,21125_1,Enlargement of lower jaw with implant,7886.6,5126.29,78.57,6334.63,19
CDM,211275OP _1,XOLAIR 150 MG/ML AUTOINJECTOR,866.83,563.44,216.71,606.78,11
CDM,21127_1,Insertion of bone grafts between portions of bone to enlarge lower jaw bone,9359.7,6083.81,78.57,9675.38,19
CDM,21135IP _1,UNCLASSIFIED DRUGS,82.68,53.74,20.67,213.52,16
CDM,21135OP _1,UNCLASSIFIED DRUGS,25.65,16.67,6.41,66.24,16
CDM,21137_1,Repair of bony defect of forehead,1950.9,1268.09,78.57,2241.68,19
CDM,21138_1,Repair of bony defect of forehead with insertion of prosthetic material,1635.1,1062.82,78.57,2737.69,19
CDM,21139_1,Repair of frontal sinus through forehead,2548.05,1656.23,78.57,3313.12,19
CDM,21141T_1,Reconstruction of upper jaw and midface bones,1379.7,896.81,78.57,4089.37,19
CDM,21141_1,Reconstruction of upper jaw and midface bones,4515.0,2934.75,78.57,4089.37,19
CDM,21142_1,"Repair of midface bones, 2 bones",4830.0,3139.5,78.57,4203.23,19
CDM,21143_1,"Repair of midface bones, 3 or more bones",5145.0,3344.25,78.57,4386.54,19
CDM,21145T_1,"Reconstruction of midface bones with bone graft, single piece (LeFort I)",1379.7,896.81,78.57,4791.79,19
CDM,21145_1,"Reconstruction of midface bones with bone graft, single piece (LeFort I)",5460.0,3549.0,78.57,4791.79,19
CDM,21146_1,"Repair of midface bones with bone graft, 2 bones",5775.0,3753.75,78.57,4990.51,19
CDM,21147_1,"Repair of midface bones with bone graft, 3 or more bones",6090.0,3958.5,78.57,5267.63,19
CDM,21150_1,Reconstruction of midface bones (LeFort II),6405.0,4163.25,78.57,4985.8,19
CDM,21151_1,Reconstruction of midface bones with bone graft (LeFort II),6720.0,4368.0,78.57,5487.98,19
CDM,21154_1,"Reconstruction of nose, cheek, and mouth bones with bone grafts",5665.8,3682.77,78.57,5903.3,19
CDM,21155_1,Reconstruction of midface bones with bone graft with LeFort I (LeFort III),4962.75,3225.79,78.57,6550.16,19
CDM,21159_1,"Reconstruction of nose, cheek, mouth, and forehead bones with bone grafts",7541.1,4901.72,78.57,7852.52,19
CDM,21160_1,"Reconstruction of nose, cheek, mouth, and forehead bones with bone grafts and repair of midface bone",6460.0,4199.0,78.57,8518.07,19
CDM,21172_1,Reconstruction of outer side of eye and lower forehead bones,5150.3,3347.7,78.57,5829.25,19
CDM,21175T_1,Repair of bony defect of lower forehead and both outer portions of eye bones,1480.5,962.33,78.57,6613.36,19
CDM,21175_1,Repair of bony defect of lower forehead and both outer portions of eye bones,5854.8,3805.62,78.57,6613.36,19
CDM,21179T_1,Reconstruction of forehead and/or upper eye bones with bone graft or implant,1379.7,896.81,78.57,4533.11,19
CDM,21179_1,Reconstruction of forehead and/or upper eye bones with bone graft or implant,4252.5,2764.13,78.57,4533.11,19
CDM,21180_1,Reconstruction of forehead and/or upper eye bones with bone graft,4523.4,2940.21,78.57,5083.07,19
CDM,21181T_1,Reconstruction of skull bones with removal of bone growth,2026.5,1317.23,78.57,2207.69,19
CDM,21181_1,Reconstruction of skull bones with removal of bone growth,2026.5,1317.23,78.57,2207.69,19
CDM,21182_1,"Reconstruction of eye, forehead, and nose bones with removal of growth with bone grafts, less than 40.0 sq cm",5643.8,3668.47,78.57,6338.07,19
CDM,21183_1,"Reconstruction of eye, forehead, and nose bones with removal of growth with bone grafts, 40.0-80.0 sq cm",5361.3,3484.85,78.57,6915.1,19
CDM,211846OP _1,"INJECTION, PEMIVIBART, FOR THE PRE-EXPOSURE PROPHYLAXIS ONLY, FOR CERTAIN ADULTS AND ADOLESCENTS (12 YEARS OF AGE AND OLDER WEIGHING AT LEAST 40 KG) WITH NO KNOWN SARS-COV-2 EXPOSURE, AND WHO EITHER H",1521.09,988.71,380.27,7673.34,17
CDM,21184_1,"Reconstruction of eye, forehead, and nose bones with removal of growth with bone grafts, more than 80.0 sq cm",5921.25,3848.81,78.57,7444.74,19
CDM,21188_1,Reconstruction of midface bones with bone graft,4505.6,2928.64,78.57,4935.95,19
CDM,21193T_1,Reconstruction of jaw bone,1379.7,896.81,78.57,3818.64,19
CDM,21193_1,Reconstruction of jaw bone,4095.0,2661.75,78.57,3818.64,19
CDM,21194T_1,Reconstruction of lower jaw bone with bone graft,1379.7,896.81,78.57,4392.92,19
CDM,21194_1,Reconstruction of lower jaw bone with bone graft,4830.0,3139.5,78.57,4392.92,19
CDM,21195_1,Reconstruction of lower jaw bones,4252.5,2764.13,78.57,4190.0,19
CDM,211966IP _1,XCOPRI 25 MG TABLET,263.27,171.13,65.82,184.29,11
CDM,21196T_1,Reconstruction of jaw bones with insertion of hardware,1663.2,1081.08,78.57,4385.26,19
CDM,21196_1,Reconstruction of jaw bones with insertion of hardware,4672.5,3037.13,78.57,4385.26,19
CDM,211970IP _1,TYENNE 80 MG/4 ML VIAL,1296.48,842.71,324.12,907.54,11
CDM,211970OP _1,TYENNE 80 MG/4 ML VIAL,661.27,429.83,165.32,462.89,11
CDM,211971IP _1,TYENNE 200 MG/10 ML VIAL,1287.75,837.04,321.94,901.43,11
CDM,211971OP _1,TYENNE 200 MG/10 ML VIAL,423.78,275.46,105.95,296.65,11
CDM,211972IP _1,TYENNE 400 MG/20 ML VIAL,1287.33,836.76,321.83,901.13,11
CDM,211972OP _1,TYENNE 400 MG/20 ML VIAL,684.43,444.88,171.11,479.1,11
CDM,21198_1,Incision or partial removal of lower jaw bone,3963.8,2576.47,78.57,3201.58,19
CDM,21199_1,Incision or partial removal of lower jaw bone and movement of tongue muscle,2391.05,1554.18,78.57,3169.16,19
CDM,21206_1,Incision or partial removal of upper jaw bone,3491.3,2269.35,78.57,3029.57,19
CDM,21208T_1,Incision and repair of bony defect of cheek bone with repositioning of bony segment,5712.6,3713.19,78.57,3971.18,19
CDM,21208_1,Incision and repair of bony defect of cheek bone with repositioning of bony segment,4507.7,2930.01,78.57,3971.18,19
CDM,21209T_1,Incision and repair of bony defect of cheek bone including bony segment reduction,2408.7,1565.66,78.57,1977.47,19
CDM,21209_1,Incision and repair of bony defect of cheek bone including bony segment reduction,2992.5,1945.13,78.57,1977.47,19
CDM,21210T_1,Repair of nasal or cheek bone with bone graft,5377.1,3495.12,78.57,4263.81,19
CDM,21210_1,Repair of nasal or cheek bone with bone graft,5375.0,3493.75,78.57,4263.81,19
CDM,21215_1,Repair of lower jaw bone with bone graft,9099.3,5914.55,78.57,9881.55,19
CDM,212242OP _1,TOFIDENCE 80 MG/4 ML VIAL,224.14,145.69,56.04,156.9,11
CDM,21230T_1,Harvest of rib cartilage for grafting,5200.7,3380.46,78.57,2226.51,19
CDM,21230_1,Harvest of rib cartilage for grafting,2992.5,1945.13,78.57,2226.51,19
CDM,21235T_1,Obtaining ear cartilage for grafting,3126.9,2032.49,78.57,1764.14,19
CDM,21235_1,Obtaining ear cartilage for grafting,2205.0,1433.25,78.57,1764.14,19
CDM,21240_1,Repair of hinged joint of upper and lower jaw bones,5236.95,3404.02,78.57,3257.25,19
CDM,212422IP _1,IMDELLTRA 10 MG VIAL,33412.5,21718.13,8353.13,23388.75,11
CDM,212422OP _1,IMDELLTRA 10 MG VIAL,31728.69,20623.65,7932.17,22210.08,11
CDM,212423IP _1,IMDELLTRA 1 MG VIAL,3712.53,2413.14,928.13,2598.77,11
CDM,212423OP _1,IMDELLTRA 1 MG VIAL,3289.05,2137.88,822.26,2302.34,11
CDM,21242_1,Repair of hinged joint of upper and lower jaw bones with donor graft,6615.0,4299.75,78.57,3107.81,19
CDM,21243_1,Repair of hinged joint of upper and lower jaw bones with prosthesis,7875.0,5118.75,78.57,4985.83,19
CDM,21244_1,Reconstruction of lower jaw bone with insertion of bone plate,4200.0,2730.0,78.57,3111.22,19
CDM,21245_1,Partial repair of lower jaw or cheek bone with implant,3176.3,2064.6,78.57,3271.59,19
CDM,21246_1,Complete reconstruction of lower or upper jaw bone with jaw bone implant (subperiosteal),5827.5,3787.88,78.57,6002.33,19
CDM,21247_1,Reconstruction of hinged joint of jaw bones with insertion of rib cartilage,5880.0,3822.0,78.57,4894.56,19
CDM,21248_1,Reconstruction of part of lower or upper jaw bone with implant,2100.0,1365.0,78.57,2461.84,19
CDM,21249_1,Complete reconstruction of lower or upper jaw bone with jaw bone implant (endosteal),4140.0,2691.0,78.57,3462.97,19
CDM,21255_1,Reconstruction of cheek bone with bone graft,3824.1,2485.67,78.57,4173.75,19
CDM,21256_1,Reconstruction of eye socket bone with bone graft,5565.0,3617.25,78.57,3710.09,19
CDM,21260_1,Repositioning of eye bone from outside skull with bone graft,6142.5,3992.63,78.57,4168.58,19
CDM,21261_1,Repositioning of eye socket bone from inside and outside skull with bone graft,10237.5,6654.38,78.57,7364.87,19
CDM,21263_1,Repositioning of cheek bone prominence with forehead advancement,10237.5,6654.38,78.57,6816.53,19
CDM,21267_1,Reconstruction of eye bone from outside skull with bone graft,9082.5,5903.63,78.57,4872.09,19
CDM,21268_1,Repositioning of eye bone from inside and outside skull with bone graft,10237.5,6654.38,78.57,6108.72,19
CDM,21270_1,Insertion of prosthetic material to enlarge cheek bone,2696.4,1752.66,78.57,2407.18,19
CDM,21275_1,"Secondary revision of reconstruction of eye, skull, and face bones",2190.3,1423.7,78.57,2506.63,19
CDM,212773IP _1,AZO BORIC ACID 600 MG VAG SUPP,10.1,6.57,2.53,7.07,11
CDM,21280T_1,Tightening of tendon of inner port of lower eyelid,1702.1,1106.37,78.57,1736.57,19
CDM,21280_1,Tightening of tendon of inner port of lower eyelid,2677.5,1740.38,78.57,1736.57,19
CDM,212819OP _1,RYTELO 47 MG VIAL,5156.22,3351.54,1289.06,3609.35,11
CDM,212821OP _1,RYTELO 188 MG VIAL,20624.84,13406.15,5156.21,14437.39,11
CDM,21282T_1,Tightening of tendon of outer edge of lower eyelid,1024.8,666.12,78.57,1158.02,19
CDM,21282_1,Tightening of tendon of outer edge of lower eyelid,2126.3,1382.1,78.57,1158.02,19
CDM,21287IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.41,1.57,0.6,6.22,16
CDM,21287OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.68,7.59,2.92,30.16,16
CDM,21288IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.6,1.69,0.65,6.71,16
CDM,21288OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.28,8.63,3.32,34.3,16
CDM,21295_1,Reduction of muscle used for chewing and lower jaw bone from outside mouth,1086.8,706.42,78.57,699.63,19
CDM,21296_1,Reduction of muscle used for chewing and lower jaw bone from inside mouth,1496.3,972.6,78.57,1224.92,19
CDM,213059IP _1,FLUZONE HIGH-DOSE TRIV 2024-25,100.0,65.0,25.0,70.0,11
CDM,213059OP _1,FLUZONE HIGH-DOSE TRIV 2024-25,100.0,65.0,25.0,70.0,11
CDM,213104OP _1,KISUNLA 350 MG/20 ML VIAL,318.53,207.04,79.63,222.97,11
CDM,21315T_1,Closed treatment of broken nose bone with manipulation,683.6,444.34,49.14,362.14,19
CDM,21315_1,Closed treatment of broken nose bone with manipulation,680.0,442.0,49.14,362.14,19
CDM,2131IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.52,6.84,2.63,27.17,16
CDM,2131OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.4,16.51,6.35,65.6,16
CDM,21320T_1,Closed treatment of broken nose bone with placement of stabilizing device,2130.5,1384.83,75.33,523.39,19
CDM,21320_1,Closed treatment of broken nose bone with placement of stabilizing device,710.0,461.5,75.33,523.39,19
CDM,21325_1,Treatment of broken nose bone,1242.2,807.43,78.57,1381.01,19
CDM,2132IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.33,2.81,1.08,11.18,16
CDM,21330_1,Treatment of broken nose bone with placement of stabilizing device,1575.0,1023.75,78.57,1656.93,19
CDM,213354OP _1,TEVIMBRA 100 MG/10 ML VIAL,6841.0,4446.65,1710.25,4788.7,11
CDM,21335T_1,Treatment of broken nose bone and tissue separating nose airways,2047.5,1330.88,78.57,2144.61,19
CDM,21335_1,Treatment of broken nose bone and tissue separating nose airways,2835.0,1842.75,78.57,2144.61,19
CDM,21336T_1,Treatment of broken bone and tissue separating nose airways,1901.6,1236.04,78.57,1917.98,19
CDM,21336_1,Treatment of broken bone and tissue separating nose airways,1706.3,1109.1,78.57,1917.98,19
CDM,21337T_1,Closed treatment of broken bone separating nose airways,872.6,567.19,77.99,1005.59,19
CDM,21337_1,Closed treatment of broken bone separating nose airways,1022.7,664.76,77.99,1005.59,19
CDM,21338_1,Treatment of broken nose and eye bones,2362.5,1535.63,78.57,1972.13,19
CDM,21339_1,Treatment of broken nose and eye bones with placement of outside stabilizing device,2709.0,1760.85,78.57,2238.06,19
CDM,21340_1,Treatment of broken nose bones with placement of stabilizing device,2677.5,1740.38,78.57,2231.47,19
CDM,21343T_1,Treatment of depressed broken front sinus bone,1541.4,1001.91,78.57,3222.58,19
CDM,21343_1,Treatment of depressed broken front sinus bone,3090.2,2008.63,78.57,3222.58,19
CDM,213449IP _1,COMIRNATY 2024-25(12Y UP) SYRG,2670.83,1736.04,667.71,1869.58,11
CDM,213449OP _1,COMIRNATY 2024-25(12Y UP) SYRG,897.54,583.4,224.39,628.28,11
CDM,21344_1,Treatment of complicated broken front sinus bone,4125.5,2681.58,78.57,4150.49,19
CDM,21345_1,Closed treatment of broken nose and upper jaw bones with placement of stabilizing device to teeth,2310.0,1501.5,78.57,1960.64,19
CDM,21346_1,Treatment of broken nose and upper jaw bones with placement of stabilizing device,2861.3,1859.85,78.57,2780.16,19
CDM,21347_1,Treatment of complex broken nose and upper jaw bones through multiple openings,3281.3,2132.85,78.57,3035.98,19
CDM,21348_1,Treatment of broken nose and upper jaw bones with bone graft,3136.4,2038.66,78.57,3247.0,19
CDM,21353OP _1,HYALGAN 20 MG/2 ML SYRINGE,67.45,43.84,16.86,47.22,11
CDM,21355_1,Treatment of broken cheek bone accessed through the skin with manipulation,1811.25,1177.31,78.57,1078.51,19
CDM,21356T_1,Treatment of depressed broken upper portion of cheek bone,3126.9,2032.49,78.57,1299.71,19
CDM,21356_1,Treatment of depressed broken upper portion of cheek bone,4961.25,3224.81,78.57,1299.71,19
CDM,21360T_1,Treatment of depressed broken cheek bone,3126.9,2032.49,78.57,1527.14,19
CDM,21360_1,Treatment of depressed broken cheek bone,3142.2,2042.43,78.57,1527.14,19
CDM,21365T_1,Treatment of complicated broken cheek bone with placement of internal stabilizing device,1541.4,1001.91,78.57,3321.58,19
CDM,21365_1,Treatment of complicated broken cheek bone with placement of internal stabilizing device,4784.85,3110.15,78.57,3321.58,19
CDM,21366_1,Treatment of complicated broken cheek bone with bone graft,2667.7,1734.01,78.57,3803.2,19
CDM,21372IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.3,2.8,1.08,11.1,16
CDM,21372OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.45,11.99,4.61,47.65,16
CDM,21374IP _1,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",10.3,6.7,0.16,26.6,17
CDM,21374OP _1,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",12.8,8.32,0.16,33.06,17
CDM,213771OP _1,TREMFYA 200 MG/20 ML VIAL,1630.38,1059.75,407.6,1141.27,11
CDM,213781OP _1,"OCREVUS ZUNOVO 920 MG-23,000",12943.05,8412.98,3235.76,9060.14,11
CDM,21385_1,Treatment of broken floor of eye bone through cheek,1976.1,1284.47,78.57,2231.11,19
CDM,21386T_1,Treatment of broken floor of eye bone through eye area,1905.8,1238.77,78.57,2072.62,19
CDM,21386_1,Treatment of broken floor of eye bone through eye area,2913.75,1893.94,78.57,2072.62,19
CDM,21387_1,Treatment of broken floor of eye bone through cheek and eye area,2008.7,1305.66,78.57,2327.63,19
CDM,21390T_1,Treatment of broken floor of eye bone through eye area with implant,2289.0,1487.85,78.57,2410.59,19
CDM,21390_1,Treatment of broken floor of eye bone through eye area with implant,4173.75,2712.94,78.57,2410.59,19
CDM,21395_1,Treatment of broken floor of eye bone through eye area with bone graft,3202.5,2081.63,78.57,3013.53,19
CDM,21400_1,Closed treatment of broken eye bone,478.8,311.22,78.57,513.81,19
CDM,21401_1,Closed treatment of broken eye bone with manipulation,1391.3,904.35,78.57,1218.32,19
CDM,21406_1,Treatment of broken eye bone,2835.0,1842.75,78.57,1716.2,19
CDM,21407T_1,Treatment of broken eye bone with implant,5200.7,3380.46,78.57,1940.85,19
CDM,21407_1,Treatment of broken eye bone with implant,3780.0,2457.0,78.57,1940.85,19
CDM,21408_1,Treatment of broken eye bone with bone graft,2556.8,1661.92,78.57,2690.16,19
CDM,214119OP _1,COBENFY 100 MG-20 MG CAPSULE,78.75,51.19,19.69,55.13,11
CDM,214205OP _1,VYLOY 100 MG VIAL,10049.18,6531.97,2512.3,7034.43,11
CDM,21421_1,Closed treatment of broken roof of mouth or upper jaw bone with placement of stabilizing device to teeth,1941.5,1261.98,78.57,1707.71,19
CDM,21422_1,Treatment of broken roof of mouth or upper jaw bone,2362.5,1535.63,78.57,1928.7,19
CDM,21423_1,Complicated treatment of broken roof of mouth or upper jaw bone,2137.8,1389.57,78.57,2311.2,19
CDM,21431_1,"Closed treatment of broken bones of cheek, nose, and face with placement of stabilizing device to teeth",1999.2,1299.48,78.57,2138.32,19
CDM,21432_1,Treatment of broken face and skull bones with placement of stabilizing device,4068.8,2644.72,78.57,2140.31,19
CDM,21433_1,Complicated repair of broken face and skull bones,4671.5,3036.48,78.57,5197.97,19
CDM,21435_1,Complicated repair of broken face and skull bones with placement of stabilizing device,4515.0,2934.75,78.57,4189.89,19
CDM,21436_1,Complicated repair of broken face and skull bones with placement of stabilizing device and bone graft,5386.5,3501.23,78.57,6096.78,19
CDM,21440_1,Closed treatment of broken upper or lower jaw bone,1399.7,909.81,78.57,1660.38,19
CDM,21445_1,Treatment of broken upper or lower jaw bone,1955.1,1270.82,78.57,1991.82,19
CDM,21450_1,Closed treatment of broken lower jaw bone,1470.0,955.5,63.5,1486.02,19
CDM,21451_1,Closed treatment of broken lower jaw bone with manipulation,1950.0,1267.5,78.57,2014.87,19
CDM,21452T_1,Treatment of broken lower jaw bone with placement of stabilizing device,2130.5,1384.83,43.81,1799.89,19
CDM,21452_1,Treatment of broken lower jaw bone with placement of stabilizing device,1493.1,970.52,42.53,1799.89,19
CDM,21453T_1,Closed treatment of broken lower jaw bone with placement of stabilizing device to teeth,2588.3,1682.4,78.57,2633.6,19
CDM,21453_1,Closed treatment of broken lower jaw bone with placement of stabilizing device to teeth,2244.9,1459.19,78.57,2633.6,19
CDM,214540IP _1,REVUFORJ 160 MG TABLET,4565.75,2967.74,1141.44,3196.03,11
CDM,21454_1,Treatment of broken lower jaw bone with placement of external stabilizing device,2257.5,1467.38,78.57,1515.74,19
CDM,214553OP _1,ZIIHERA 300 MG VIAL,44216.64,28740.82,11054.16,30951.65,11
CDM,21461T_1,Treatment of broken lower jaw bone,5377.1,3495.12,78.57,4412.44,19
CDM,21461_1,Treatment of broken lower jaw bone,4939.2,3210.48,78.57,4412.44,19
CDM,21462T_1,Treatment of broken lower jaw bone with placement of stabilizing device to teeth,5377.1,3495.12,78.57,4777.0,19
CDM,21462_1,Treatment of broken lower jaw bone with placement of stabilizing device to teeth,5580.0,3627.0,78.57,4777.0,19
CDM,21465_1,Treatment of broken hinged end of lower jaw bone,4331.25,2815.31,78.57,2480.67,19
CDM,21470_1,Complicated treatment of broken lower jaw bone with placement of stabilizing device to teeth,3937.5,2559.38,78.57,3575.33,19
CDM,21480_1,Closed treatment of dislocated jaw joint,465.0,302.25,27.21,339.92,19
CDM,21485_1,Complicated repair of dislocated jaw joint with placement of stabilizing device,1693.7,1100.91,78.57,2345.75,19
CDM,21490_1,Treatment of dislocated jaw joint,2835.0,1842.75,78.57,2443.26,19
CDM,21497_1,Wiring of jaw or oral splint to teeth,2047.5,1330.88,78.57,1820.26,19
CDM,215003IP _1,ALYFTREK 10-50-125 MG TABLET,2369.33,1540.06,592.33,1658.53,11
CDM,21501_1,Drainage of deep abscess or blood accumulation in soft tissue of neck or chest,1140.3,741.2,78.57,1161.34,19
CDM,21502_1,Drainage of deep abscess or blood accumulation in soft tissue of neck or chest with partial removal of rib,1406.0,913.9,78.57,1473.0,19
CDM,21509IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",94.1,61.17,23.53,243.01,16
CDM,21509OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.03,16.92,6.51,67.22,16
CDM,21510_1,Deep incision of chest bone,1218.0,791.7,78.57,1296.56,19
CDM,215330OP _1,NIKTIMVO 22 MG/0.44 ML VIAL,102881.19,66872.77,25720.3,72016.83,11
CDM,215336IP _1,YESINTEK 45 MG/0.5 ML SYRINGE,19544.75,12704.09,4886.19,13681.33,11
CDM,215337IP _1,YESINTEK 90 MG/ML SYRINGE,19788.65,12862.62,4947.16,13852.06,11
CDM,215454OP _1,DATROWAY 100 MG VIAL,60595.91,39387.34,15148.98,42417.14,11
CDM,21550T_1,Biopsy of soft tissue of neck or chest,1133.0,736.45,51.91,641.67,19
CDM,21550_1,Biopsy of soft tissue of neck or chest,672.0,436.8,50.89,641.67,19
CDM,21552T_1,"Removal of growth of soft tissue under skin of neck or front of chest, 3.0 cm or more",2750.0,1787.5,78.57,1310.04,19
CDM,21552_1,"Removal of growth of soft tissue under skin of neck or front of chest, 3.0 cm or more",1205.4,783.51,78.57,1310.04,19
CDM,21554T_1,"Removal of growth of muscle of neck or front of chest, 5.0 cm or more",2136.8,1388.92,78.57,2152.44,19
CDM,21554_1,"Removal of growth of muscle of neck or front of chest, 5.0 cm or more",1982.4,1288.56,78.57,2152.44,19
CDM,21555T_1,"Removal of growth under skin of neck or front of chest, less than 3.0 cm",1675.8,1089.27,78.57,1032.53,19
CDM,21555_1,"Removal of growth under skin of neck or front of chest, less than 3.0 cm",1117.2,726.18,78.57,1032.53,19
CDM,21556T_1,"Removal of growth of muscle of neck or front of chest, less than 5.0 cm",2753.1,1789.52,78.57,1565.05,19
CDM,21556_1,"Removal of growth of muscle of neck or front of chest, less than 5.0 cm",1110.9,722.09,78.57,1565.05,19
CDM,21557_1,"Extensive removal of growth of neck or front of chest, less than 5.0 cm",1576.1,1024.47,78.57,2819.8,19
CDM,21558_1,"Extensive removal of growth of neck or front of chest, 5.0 cm or more",3718.1,2416.77,78.57,3964.52,19
CDM,215787IP _1,JOURNAVX 50 MG TABLET,103.58,67.33,25.9,72.51,11
CDM,215787OP _1,JOURNAVX 50 MG TABLET,45.85,29.8,11.46,32.1,11
CDM,21600_1,Partial removal of rib,1477.4,960.31,78.57,1622.26,19
CDM,21601_1,Removal of growth of chest wall and rib,2711.75,1762.64,78.57,3376.23,19
CDM,21602_1,Removal of growth of chest wall and rib with reconstruction,3653.5,2374.78,78.57,4571.95,19
CDM,21603_1,Removal of growth of chest wall and rib with reconstruction and removal of lymph nodes from chest cavity,4033.5,2621.78,78.57,4975.31,19
CDM,21610_1,Partial removal of rib and spine bone at joint,2615.0,1699.75,78.57,3362.07,19
CDM,21615_1,Removal of first and/or extra rib at neck,2520.0,1638.0,78.57,1779.21,19
CDM,21616_1,Removal of first and/or extra rib at neck with removal of sympathetic nerves,1727.2,1122.68,78.57,2075.05,19
CDM,21620_1,Partial removal of chest bone,3150.0,2047.5,78.57,1481.08,19
CDM,21627T_1,Removal of chest bone tissue,1379.7,896.81,78.57,1582.44,19
CDM,21627_1,Removal of chest bone tissue,1475.3,958.95,78.57,1582.44,19
CDM,216293IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.92,7.75,2.98,30.78,16
CDM,216293OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.97,24.68,9.49,98.06,16
CDM,21630_1,Extensive removal of chest bone,3675.0,2388.75,78.57,3630.94,19
CDM,216726IP _1,BISOPROLOL FUMARATE 2.5 MG TAB,19.8,12.87,4.95,13.86,11
CDM,216843OP _1,VYLOY 300 MG VIAL,29707.78,19310.06,7426.95,20795.45,11
CDM,21685_1,Repositioning of bone and muscles in neck,2733.2,1776.58,78.57,2950.67,19
CDM,21688IP _1,ROPINIROLE HCL 0.25 MG TABLET,5.85,3.8,1.46,4.1,11
CDM,21688OP _1,ROPINIROLE HCL 0.25 MG TABLET,16.14,10.49,4.04,11.3,11
CDM,21689IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.4,3.51,1.35,13.95,16
CDM,21689OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.08,11.75,4.52,46.69,16
CDM,21700_1,Removal of neck muscle with release of nerves,1338.8,870.22,78.57,1038.41,19
CDM,21705_1,Removal of neck muscle and extra rib at neck with release of nerves,1890.0,1228.5,78.57,1554.93,19
CDM,21720T_1,"Release of tendons of neck muscle, open procedure",2774.1,1803.17,78.57,1466.11,19
CDM,21720_1,"Release of tendons of neck muscle, open procedure",1104.6,717.99,78.57,1466.11,19
CDM,21725_1,Release of neck muscle and placement of a cast to treat tilting head,1250.25,812.66,78.57,1598.81,19
CDM,21740_1,Repair of abnormal position of chest bone,3937.5,2559.38,78.57,3005.09,19
CDM,21742_1,Minimally invasive repair of abnormal position of chest bone,2936.9,1908.99,78.57,2882.54,15
CDM,21743_1,Repair of breast bone depression using an endoscope,4737.0,3079.05,78.57,4694.16,15
CDM,21750_1,Treatment of broken chest bone following surgery,1941.5,1261.98,78.57,1994.83,19
CDM,217612OP _1,STOBOCLO 60 MG/ML SYRINGE,10955.49,7121.07,2738.87,7668.84,11
CDM,21800IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.8,3.12,1.2,12.4,16
CDM,21800OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.13,16.98,6.53,67.48,16
CDM,218049IP _1,FLUZONE HIGH-DOSE 2025-26 SYR,200.0,130.0,50.0,140.0,11
CDM,218049OP _1,FLUZONE HIGH-DOSE 2025-26 SYR,700.0,455.0,175.0,490.0,11
CDM,218053IP _1,FLUZONE 2025-2026 SYRINGE,103.8,67.47,25.95,72.66,11
CDM,218053OP _1,FLULAVAL 2025-2026 SYRINGE,363.22,236.09,90.81,254.25,11
CDM,218055OP _1,FLUBLOK 2025-2026 SYRINGE,2230.54,1449.85,557.64,1561.38,11
CDM,218117IP _1,LYNOZYFIC 200 MG/10 ML VIAL,13248.0,8611.2,3312.0,9273.6,11
CDM,218117OP _1,LYNOZYFIC 200 MG/10 ML VIAL,11761.0,7644.65,2940.25,8232.7,11
CDM,218119IP _1,LYNOZYFIC 5 MG/2.5 ML VIAL,1360.0,884.0,340.0,952.0,11
CDM,21811_1,"Treatment of broken ribs on side with placement of stabilizing device, 1-3 ribs",1364.0,886.6,78.57,1740.32,19
CDM,21812_1,"Treatment of broken ribs on side with placement of stabilizing device, 4-6 ribs",2458.65,1598.12,78.57,2119.93,19
CDM,21813_1,"Treatment of broken ribs on side with placement of stabilizing device, 7 or more ribs",3373.65,2192.87,78.57,2871.27,19
CDM,21820_1,Closed treatment of broken chest bone,372.8,242.32,78.57,425.21,19
CDM,21823IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.69,3.05,1.17,12.11,16
CDM,21823OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.13,13.73,5.28,54.57,16
CDM,21824IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.58,2.33,0.9,9.25,16
CDM,21824OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.55,6.86,2.64,27.25,16
CDM,21825IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.18,2.07,0.8,8.21,16
CDM,21825OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.77,5.7,2.19,22.65,16
CDM,21825_1,Treatment of broken chest bone,1523.6,990.34,78.57,1586.04,19
CDM,21848IP _1,IRBESARTAN 150 MG TABLET,5.6,3.64,1.4,3.92,11
CDM,218573IP _1,COMIRNATY 2025-26(12Y UP) SYRG,3596.17,2337.51,899.04,2517.32,11
CDM,218573OP _1,COMIRNATY 2025-26(12Y UP) SYRG,17980.68,11687.44,4495.17,12586.48,11
CDM,21900IP _1,"INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG",1315.97,855.38,21.96,3398.49,19
CDM,21900OP _1,"INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG",369.06,239.89,21.96,953.1,19
CDM,219054IP _1,ULTRAVIST 370 MG/ML BOTTLE,2.61,1.7,0.65,1.83,11
CDM,219054OP _1,ULTRAVIST 370 MG/ML BOTTLE,2.61,1.7,0.65,1.83,11
CDM,21920_1,Biopsy of surface soft tissue to back or lower sides,671.0,436.15,39.45,616.1,19
CDM,21925_1,Deep biopsy of soft tissue of back or lower sides,1272.6,827.19,78.57,1169.17,19
CDM,21930T_1,"Removal of growth under skin of back or lower sides, less than 3.0 cm",2753.1,1789.52,78.57,1189.39,19
CDM,21930_1,"Removal of growth under skin of back or lower sides, less than 3.0 cm",1230.6,799.89,78.57,1189.39,19
CDM,21931T_1,"Removal of growth under skin of back or lower sides, 3.0 cm or more",2940.6,1911.39,78.57,1378.89,19
CDM,21931_1,"Removal of growth under skin of back or lower sides, 3.0 cm or more",1260.0,819.0,78.57,1378.89,19
CDM,21932T_1,"Removal of growth of muscle of back or lower sides, less than 5.0 cm",1926.8,1252.42,78.57,1940.96,19
CDM,21932_1,"Removal of growth of muscle of back or lower sides, less than 5.0 cm",1803.9,1172.54,78.57,1940.96,19
CDM,21933T_1,"Removal of growth of muscle of back or lower sides, 5.0 cm or more",2147.3,1395.75,78.57,2165.56,19
CDM,21933_1,"Removal of growth of muscle of back or lower sides, 5.0 cm or more",1987.7,1292.01,78.57,2165.56,19
CDM,21935_1,"Extensive removal of growth of back or lower side, less than 5.0 cm",3052.4,1984.06,78.57,3016.72,19
CDM,21936_1,"Extensive removal of growth of back or lower side, 5.0 cm or more",3984.8,2590.12,78.57,4161.18,19
CDM,21_1,SPIKEVAX 2025-26 (6M-11Y) SYR,225.0,146.25,56.25,157.5,11
CDM,22010_1,Drainage of abscess of deep tissue of upper or middle spine,2180.35,1417.23,78.57,2772.34,19
CDM,220149OP _1,"RYBREVANT FASPRO 1,600 MG VIAL",2759.03,1793.37,689.76,1931.32,11
CDM,22015_1,Drainage of abscess of deep tissue of lower spine or sacrum,2146.2,1395.03,78.57,2746.29,19
CDM,22100_1,Removal of rear piece of upper spine bone,2157.8,1402.57,78.57,2489.01,19
CDM,22101_1,Removal of rear piece of middle spine bone,2163.0,1405.95,78.57,2481.51,19
CDM,22102_1,Removal of rear piece of lower spine bone,2154.6,1400.49,78.57,2352.98,19
CDM,22103_1,"Partial removal of bone at back of spine, each additional segment",392.7,255.26,78.57,397.24,19
CDM,22110_1,Partial removal of upper spine bone,2680.7,1742.46,78.57,3003.3,19
CDM,22112_1,Partial removal of middle spine bone,2607.2,1694.68,78.57,3137.99,19
CDM,22114_1,Partial removal of lower spine bone,2669.1,1734.92,78.57,3152.2,19
CDM,22116_1,"Partial removal of spine bone, each additional segment",388.5,252.53,78.57,402.9,19
CDM,22120IP _1,Rabies vaccine for injection into muscle,2977.23,1935.2,163.76,7688.7,19
CDM,22120OP _1,Rabies vaccine for injection into muscle,2977.2,1935.18,163.76,7688.62,19
CDM,22142IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.74,9.58,3.69,38.07,16
CDM,22142OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.23,7.95,3.06,31.58,16
CDM,22144IP _1,"INJECTION, IDARUBICIN HYDROCHLORIDE, 5 MG",86.84,56.45,21.71,260.52,19
CDM,22148IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.5,2.93,1.13,11.62,16
CDM,22148OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.53,6.19,2.38,24.61,16
CDM,22149OP _1,"INJECTION, RITUXIMAB, 10 MG",1026.73,667.37,79.26,5812.21,19
CDM,22185IP _1,"INJECTION, FOMEPIZOLE, 15 MG",2356.79,1531.91,6.82,6086.41,19
CDM,22206_1,Incision or removal of segment of middle spine bone to correct deformity,6438.6,4185.09,78.57,7072.81,19
CDM,22207_1,Incision or removal of lower spine bone segment to correct deformity,6356.7,4131.86,78.57,6969.08,19
CDM,22208_1,"Incision or removal of spine bone segment to correct deformity, each additional segment",1601.3,1040.85,78.57,1678.64,19
CDM,22210_1,Incision or removal of upper spine bone segment,4673.6,3037.84,78.57,5155.69,19
CDM,22212_1,Incision or removal of middle spine bone segment,3892.4,2530.06,78.57,4336.64,19
CDM,22214_1,Incision or removal of lower spine bone segment,3914.4,2544.36,78.57,4348.23,19
CDM,22216_1,"Incision or removal of spine bone segment, each additional segment",1011.2,657.28,78.57,1046.1,19
CDM,22220_1,Incision or removal of upper spine bone segment and removal of disc,5486.3,3566.1,78.57,4675.65,19
CDM,22222_1,Incision or removal of middle spine bone and removal of disc,3874.5,2518.43,78.57,4875.69,19
CDM,22224_1,Incision or removal of lower spine bone segment and removal of disc,3683.4,2394.21,78.57,4643.12,19
CDM,22226_1,"Incision or removal of spine bone segment and removal of disc, each additional segment",1496.3,972.6,78.57,1043.96,19
CDM,22240IP _1,"TOBRAMYCIN, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, UNIT DOSE FORM, ADMINISTERED THROUGH DME, PER 300 MILLIGRAMS",30.38,19.75,7.6,78.46,17
CDM,22257IP _1,UNCLASSIFIED DRUGS,38.56,25.06,9.64,99.58,16
CDM,22257OP _1,UNCLASSIFIED DRUGS,13.72,8.92,3.43,35.43,16
CDM,22289IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.82,5.08,1.96,20.2,16
CDM,22289OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.34,19.07,7.34,75.77,16
CDM,22290IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.55,1.01,0.39,4.0,16
CDM,22290OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.28,0.83,0.32,3.31,16
CDM,22310_1,Closed treatment of broken spine bone with cast or brace,923.0,599.95,78.57,837.0,19
CDM,22315_1,Closed treatment of broken or dislocated spine bone with cast or brace and traction,2229.2,1448.98,78.57,2306.51,19
CDM,22318_1,Treatment of broken or dislocated uppermost spine bone with placement of stabilizing device,4185.3,2720.45,78.57,4623.71,19
CDM,22319_1,Treatment of broken or dislocated uppermost spine bone with placement of stabilizing device and bone graft,4593.8,2985.97,78.57,5105.75,19
CDM,22325_1,Treatment of broken or dislocated lower spine bone,3697.1,2403.12,78.57,4166.27,19
CDM,22326_1,Treatment of broken or dislocated upper spine bone,3838.8,2495.22,78.57,4270.96,19
CDM,22327_1,Treatment of broken or dislocated middle spine bone,3827.3,2487.75,78.57,4335.36,19
CDM,22328_1,"Treatment of broken or dislocated spine bone, each additional segment",777.0,505.05,78.57,799.39,19
CDM,22472IP _1,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",71.07,46.2,0.35,183.54,17
CDM,22472OP _1,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",22.8,14.82,0.35,58.88,17
CDM,22473IP _1,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",70.07,45.55,0.35,180.96,17
CDM,22473OP _1,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",52.73,34.27,0.35,136.18,17
CDM,22485OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.65,8.22,3.16,32.67,16
CDM,22486IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.05,11.08,4.26,44.03,16
CDM,22505_1,Manipulation of spine under anesthesia,561.8,365.17,78.57,387.98,19
CDM,22509IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.43,10.68,4.11,42.43,16
CDM,22509OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",83.16,54.05,20.79,214.76,16
CDM,22510IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.93,2.55,0.98,10.15,16
CDM,22510OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.69,1.1,0.42,4.36,16
CDM,22510_1,Stabilization of upper spine bone,1123.5,730.28,78.57,4385.75,19
CDM,22511_1,Stabilization of lower spine bone,1052.1,683.87,78.57,4364.11,19
CDM,22512_1,"Stabilization of spine bone, each additional bone",925.0,601.25,78.57,1755.64,19
CDM,22513_1,Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance,1350.0,877.5,78.57,13864.2,19
CDM,22514_1,Treatment of broken lower spine bone with placement of stabilizing device,1250.0,812.5,78.57,13798.8,19
CDM,22515_1,"Treatment of broken spine bone with stabilizing device, each additional segment",550.0,357.5,78.57,7120.79,19
CDM,22526_1,"Treatment of spine disc using fluoroscopic guidance, single level",1654.5,1075.43,78.57,4802.78,15
CDM,22527_1,"Treatment of spine disc using fluoroscopic guidance, each additional bone level",745.75,484.74,78.57,3949.2,15
CDM,22532_1,"Fusion of middle spine bone through side with partial removal of disc, 1 bone",4637.9,3014.64,78.57,5164.23,19
CDM,22533_1,"Fusion of lower spine bone through side with partial removal of disc, 1 bone",4412.1,2867.87,78.57,4860.23,19
CDM,22534_1,"Fusion of middle or lower spine bone through side with partial removal of disc, each additional bone",1002.8,651.82,78.57,1036.53,19
CDM,22548_1,"Fusion of spine bones at base of neck, oral approach",4889.9,3178.44,78.57,5493.63,19
CDM,22551_1,"Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc",3980.6,2587.39,78.57,4890.72,19
CDM,22552_1,"Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, each additional disc",930.3,604.7,78.57,1129.34,19
CDM,22554_1,Fusion of upper spine bones through front of neck with partial removal of disc,4200.0,2730.0,78.57,3610.54,19
CDM,22556_1,Fusion of middle spine bone through side of chest with partial removal of disc,4414.2,2869.23,78.57,4822.49,19
CDM,22558_1,Fusion of lower spine bone through abdomen with partial removal of disc,4100.3,2665.2,78.57,4467.42,19
CDM,22560OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.6,1.04,0.4,4.13,16
CDM,22585_1,"Fusion of spine bones through front of body with partial removal of disc, each additional disc",921.9,599.24,78.57,937.87,19
CDM,22586_1,Fusion of lower spine or sacral bone with removal of disc using image guidance,4792.2,3114.93,78.57,5686.93,19
CDM,22588IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.9,7.09,2.73,28.15,16
CDM,22588OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.54,19.85,7.64,78.87,16
CDM,22590_1,Fusion of skull and first 2 upper spine bones through back,4725.0,3071.25,78.57,4492.28,19
CDM,22595_1,Fusion of first 2 spine bones through back of neck,4725.0,3071.25,78.57,4291.97,19
CDM,22600_1,Fusion of spine in neck by posterior approach,3885.0,2525.25,78.57,3695.06,19
CDM,22610_1,Fusion of spine in upper back,3780.0,2457.0,78.57,3648.65,19
CDM,22612_1,Fusion of spine in lower back,4244.1,2758.67,78.57,4609.42,19
CDM,22614_1,Fusion of additional segment of spine,1286.3,836.1,78.57,1117.35,19
CDM,22630_1,"Fusion of lower spine bone and partial removal of spine bone or disc through back, 1 disc",4098.2,2663.83,78.57,4494.89,19
CDM,22632_1,"Fusion of lower back spine bone and partial removal of spine bone or disc through back, each additional disc",875.7,569.21,78.57,907.82,19
CDM,22633_1,Fusion of spine in lower back with partial removal of spine bone and disc,4217.25,2741.21,78.57,5346.4,19
CDM,22634_1,Fusion of additional segment of spine with partial removal of spine bone and disc,994.0,646.1,78.57,1418.19,19
CDM,22646IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.21,0.79,0.3,3.12,16
CDM,22660IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.87,9.02,3.47,35.82,16
CDM,22660OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.12,11.78,4.53,46.79,16
CDM,22661IP _1,"INJECTION, DAUNORUBICIN, 10 MG",90.6,58.89,22.65,271.8,19
CDM,22661OP _1,"INJECTION, DAUNORUBICIN, 10 MG",62.66,40.73,15.67,202.84,19
CDM,22719IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.52,1.64,0.63,6.51,16
CDM,22719OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.2,14.43,5.55,57.33,16
CDM,22783IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.53,4.89,1.88,19.45,16
CDM,22783OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.2,14.43,5.55,57.33,16
CDM,22800_1,"Fusion to repair spine deformity through back, up to 6 bones",3601.5,2340.98,78.57,3954.03,19
CDM,22802_1,"Fusion of spine bones for correction of deformity, posterior approach, 7 to 12 vertebral segments",5796.0,3767.4,78.57,6147.65,19
CDM,22804_1,"Fusion to repair spine deformity through back, 13 or more bones",6632.9,4311.39,78.57,7095.08,19
CDM,22808_1,"Fusion of spine bones for correction of deformity, anterior approach, 2 to 3 vertebral segments",5250.0,3412.5,78.57,5343.26,19
CDM,22810_1,"Fusion of spine bones for correction of deformity, anterior approach, 4 to 7 vertebral segments",5480.0,3562.0,78.57,5982.23,19
CDM,22812_1,"Fusion of spine bones for correction of deformity, anterior approach, 8 or more vertebral segments",6008.1,3905.27,78.57,6526.18,19
CDM,22818_1,Removal of 1-2 spine bones to correct outward curving spine deformity,6008.1,3905.27,78.57,6416.15,19
CDM,22819_1,Removal of parts of 3 or more spine bones to correct outward curving spine deformity,6910.1,4491.57,78.57,7364.86,19
CDM,22830_1,Exploration of spine fusion,2141.0,1391.65,78.57,2366.01,19
CDM,22840_1,Placement of stabilizing device to back of 1 spine bone in neck,2940.0,1911.0,78.57,2174.28,19
CDM,22841_1,Insertion of wire to stabilize spine bones,918.8,597.22,78.57,1143.77,15
CDM,22842_1,"Placement of stabilizing device to back, 3-6 spine bone segments",3885.0,2525.25,78.57,2181.79,19
CDM,22843_1,"Placement of stabilizing device to back, 7-12 spine bone segments",2299.5,1494.68,78.57,2334.81,19
CDM,22844_1,"Placement of stabilizing device to back, 13 or more spine bone segments",2340.5,1521.33,78.57,2848.15,19
CDM,22845_1,"Placement of stabilizing device to front, 2-3 spine bone segments",2002.4,1301.56,78.57,2073.27,19
CDM,22846_1,"Placement of stabilizing device to front, 4-7 spine bone segments",3465.0,2252.25,78.57,2154.96,19
CDM,22847_1,"Placement of stabilizing device to front, 8 or more spine bone segments",2562.0,1665.3,78.57,2381.01,19
CDM,22848_1,Insertion of instrumentation to pelvic bones,1004.9,653.19,78.57,1039.12,19
CDM,22849_1,Reinsertion of spinal fixation device,3564.8,2317.12,78.57,3767.87,19
CDM,22850_1,Removal of stabilizing device from back of spine,1989.8,1293.37,78.57,2105.68,19
CDM,22852_1,Removal of segmental stabilizing device from back of spine,2310.0,1501.5,78.57,2024.68,19
CDM,22853_1,Insertion of cage or mesh device to spine bone and disc space during spine fusion,588.5,382.53,78.57,737.59,19
CDM,22854_1,Insertion of cage or mesh device in disc space during spine fusion,761.65,495.07,78.57,954.45,19
CDM,22855_1,Removal of stabilizing device from front of spine,3005.1,1953.32,78.57,3194.8,19
CDM,22856_1,"Insertion of artificial upper spine disc, anterior approach",4289.3,2788.05,78.57,4704.93,19
CDM,22857_1,"Insertion of artificial disc between bones of lower spine, single space",4586.4,2981.16,78.57,5242.93,19
CDM,22858_1,Insertion of artificial upper spine disc anterior approach,1322.0,859.3,78.57,1456.29,19
CDM,22859_1,Placement of mesh or cage device into spine disc space,761.65,495.07,78.57,954.39,19
CDM,22861_1,Revision of total disc replacement in upper back,4510.5,2931.83,78.57,6403.47,19
CDM,22862_1,Revision of total disc replacement in lower back,5426.4,3527.16,78.57,5762.68,19
CDM,22864_1,"Revision of artificial upper spine disc, cervical",4730.3,3074.7,78.57,5789.85,19
CDM,22865_1,"Revision of artificial lower spine disc, lumbar",5727.8,3723.07,78.57,5720.62,19
CDM,22867_1,Placement of device to stabilize or reduce pressure in lower spine in 1 disc space,2220.7,1443.46,78.57,2811.11,19
CDM,22868_1,Placement of device to stabilize or reduce pressure in lower spine in second disc space,552.7,359.26,78.57,692.55,19
CDM,22869_1,Placement of stabilizing device to lower spine level,1238.0,804.7,78.57,1351.89,19
CDM,2286IP _1,DESIPRAMINE 25 MG TABLET [2286],16.3,10.6,4.08,11.41,11
CDM,22870_1,Placement of stabilizing device to second lower spine level,323.5,210.28,78.57,370.18,19
CDM,22900T_1,"Removal of growth of muscle of abdomen, less than 5.0 cm",2753.1,1789.52,78.57,1653.5,19
CDM,22900_1,"Removal of growth of muscle of abdomen, less than 5.0 cm",1105.7,718.71,78.57,1653.5,19
CDM,22901T_1,"Removal of growth of muscle of abdomen, 5.0 cm or more",1787.1,1161.62,78.57,1949.37,19
CDM,22901_1,"Removal of growth of muscle of abdomen, 5.0 cm or more",1776.6,1154.79,78.57,1949.37,19
CDM,22902T_1,"Removal of growth of soft tissue of abdominal wall, less than 3.0 cm",1243.2,808.08,78.57,1112.55,19
CDM,22902_1,"Removal of growth of soft tissue of abdominal wall, less than 3.0 cm",1138.2,739.83,78.57,1112.55,19
CDM,22903T_1,"Removal of growth of soft tissue of abdominal wall, 3.0 cm or more",1281.0,832.65,78.57,1288.2,19
CDM,22903_1,"Removal of growth of soft tissue of abdominal wall, 3.0 cm or more",1182.3,768.5,78.57,1288.2,19
CDM,22904_1,"Extensive removal of growth of soft tissue of abdominal wall, less than 5.0 cm",2777.3,1805.25,78.57,3100.02,19
CDM,22905_1,"Extensive removal of growth of soft tissue of abdominal wall, 5.0 cm or more",3597.3,2338.25,78.57,3915.15,19
CDM,22959IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.74,6.98,2.69,27.74,16
CDM,22960IP _1,"INJECTION, PARICALCITOL, 1 MCG",620.0,403.0,1.03,1601.15,17
CDM,22960OP _1,"INJECTION, PARICALCITOL, 1 MCG",6.0,3.9,1.03,15.5,17
CDM,22976IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.64,3.02,1.16,11.98,16
CDM,22976OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.43,14.58,5.61,57.93,16
CDM,22982IP _1,UNCLASSIFIED DRUGS,9.19,5.97,2.3,23.73,16
CDM,22982OP _1,UNCLASSIFIED DRUGS,2.44,1.59,0.61,6.3,16
CDM,22988IP _1,CIPRO 10% SUSPENSION,18.33,11.91,4.58,12.83,11
CDM,22993IP _1,CAPECITABINE 150 MG TABLET,32.55,21.16,8.14,22.79,11
CDM,22994IP _1,CAPECITABINE 500 MG TABLET,58.3,37.9,14.58,40.81,11
CDM,23000_1,"Removal of calcium deposits at rotator cuff tendons, open procedure",1374.5,893.43,78.57,1316.04,19
CDM,23020_1,Release of tendon of shoulder joint,1841.7,1197.11,78.57,2042.63,19
CDM,23030_1,Drainage of deep abscess or blood accumulation of shoulder,1095.2,711.88,78.57,1048.8,19
CDM,23031_1,Drainage of infected fluid-filled sac (bursa) of shoulder joint,1013.3,658.65,78.57,1035.78,19
CDM,23035_1,Incision of shoulder bone for removal of infected tissue,2740.5,1781.33,78.57,2004.71,19
CDM,23040_1,"Incision of shoulder joint for exploration, fluid drainage, or removal of foreign body",2875.95,1869.37,78.57,2123.62,19
CDM,23044_1,"Incision of collar bone joint for exploration, fluid drainage, or removal of foreign body",1980.75,1287.49,78.57,1672.27,19
CDM,23065_1,Biopsy of surface tissue of shoulder,566.0,367.9,78.57,538.58,19
CDM,23066_1,Biopsy of deep tissue of shoulder,1308.3,850.4,78.57,1346.83,19
CDM,23071T_1,"Removal of growth under skin of shoulder area, 3.0 cm or more",1208.6,785.59,78.57,1231.94,19
CDM,23071_1,"Removal of growth under skin of shoulder area, 3.0 cm or more",1118.3,726.9,78.57,1231.94,19
CDM,23073T_1,"Removal of growth of muscle of shoulder, 5.0 cm or more",1995.0,1296.75,78.57,2045.31,19
CDM,23073_1,"Removal of growth of muscle of shoulder, 5.0 cm or more",2779.95,1806.97,78.57,2045.31,19
CDM,23075T_1,"Removal of growth under skin of shoulder area, less than 3.0 cm",904.45,587.89,78.57,1225.94,19
CDM,23075_1,"Removal of growth under skin of shoulder area, less than 3.0 cm",699.3,454.55,78.57,1225.94,19
CDM,23076T_1,"Removal of growth of muscle of shoulder, less than 5.0 cm",1474.2,958.23,78.57,1594.36,19
CDM,23076_1,"Removal of growth of muscle of shoulder, less than 5.0 cm",2211.3,1437.35,78.57,1594.36,19
CDM,23077_1,"Extensive removal of growth of shoulder, less than 5.0 cm",3675.0,2388.75,78.57,3336.33,19
CDM,23078_1,"Extensive removal of growth of shoulder, 5.0 cm or more",5803.95,3772.57,78.57,4227.59,19
CDM,23082IP _1,"INJECTION, BASILIXIMAB, 20 MG",25579.21,16626.49,2865.52,66058.31,19
CDM,23082OP _1,"INJECTION, BASILIXIMAB, 20 MG",21913.68,14243.89,2865.52,56592.08,19
CDM,23100_1,Incision and biopsy of shoulder joint,1312.5,853.13,78.57,1481.83,19
CDM,23101_1,"Incision to repair joints between shoulder, chest and collar bones",1522.5,989.63,78.57,1349.58,19
CDM,23105_1,Removal of shoulder joint lining,2100.0,1365.0,78.57,1890.38,19
CDM,23106_1,Removal of lining of joint between collar and chest bones,1537.2,999.18,78.57,1471.45,19
CDM,23107_1,Incision of shoulder joint for exam,1752.5,1139.13,78.57,1955.43,19
CDM,23120_1,Partial removal of collar bone,2280.6,1482.39,78.57,1730.08,19
CDM,23122IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.4,3.51,1.35,13.95,16
CDM,23122OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.65,12.12,4.66,48.16,16
CDM,23123IP _1,"INJECTION, EPTIFIBATIDE, 5 MG",4.99,3.24,1.25,58.57,19
CDM,23123OP _1,"INJECTION, EPTIFIBATIDE, 5 MG",1.56,1.01,0.39,58.57,19
CDM,23124IP _1,"INJECTION, EPTIFIBATIDE, 5 MG",18.65,12.12,3.73,58.57,19
CDM,23124OP _1,"INJECTION, EPTIFIBATIDE, 5 MG",5.35,3.48,1.34,58.57,19
CDM,23125_1,Removal of collar bone,1873.2,1217.58,78.57,2093.18,19
CDM,23128IP _1,"INJECTION, ACYCLOVIR, 5 MG",19.4,12.61,0.13,50.1,17
CDM,23128OP _1,"INJECTION, ACYCLOVIR, 5 MG",1.22,0.79,0.13,3.15,17
CDM,23130_1,Partial removal or repair of shoulder bone near collar bone,1599.2,1039.48,78.57,1810.02,19
CDM,23140_1,Removal of cyst or growth of collar bone or shoulder blade,2053.8,1334.97,78.57,1632.82,19
CDM,23145_1,Removal of cyst or growth of collar bone or shoulder blade with self bone graft,1842.8,1197.82,78.57,2046.61,19
CDM,23146_1,Removal of cyst or growth of collar bone or shoulder blade with donor bone graft,2395.65,1557.17,78.57,1827.83,19
CDM,23150_1,Removal of cyst or growth of top part of upper arm bone,1747.2,1135.68,78.57,1952.64,19
CDM,23155_1,Removal of cyst or growth of top part of upper arm bone with self bone graft,2108.4,1370.46,78.57,2342.35,19
CDM,23156_1,Removal of cyst or growth of top of upper arm bone with donor bone graft,1791.3,1164.35,78.57,2002.81,19
CDM,23170_1,Removal of dead bone fragment from collar bone,1292.85,840.35,78.57,1659.49,19
CDM,23172_1,Removal of dead bone fragment from shoulder blade,1283.25,834.11,78.57,1673.25,19
CDM,23174_1,Removal of dead bone fragment from top of upper arm bone,1754.55,1140.46,78.57,2244.65,19
CDM,23180_1,Partial removal of infected collar bone,1822.8,1184.82,78.57,1945.1,19
CDM,23182_1,Partial removal of infected shoulder blade,2205.0,1433.25,78.57,1951.25,19
CDM,23184_1,Partial removal of infected top of upper arm bone,1985.6,1290.64,78.57,2171.73,19
CDM,23190_1,Partial removal of shoulder blade,1480.5,962.33,78.57,1691.0,19
CDM,23195_1,Removal of shoulder blade,1746.15,1135.0,78.57,2208.95,19
CDM,2319IP _1,"DEXAMETHASONE, ORAL, 0.25 MG",1.27,0.83,0.01,3.28,17
CDM,23200_1,Extensive removal of growth of collar bone,3510.0,2281.5,78.57,4476.17,19
CDM,2320IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.96,1.27,0.49,5.06,16
CDM,2320OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.89,1.23,0.47,4.88,16
CDM,23210_1,Extensive removal of growth of shoulder blade,4120.0,2678.0,78.57,5258.7,19
CDM,23220_1,Extensive removal of growth of upper end of upper arm,4525.0,2941.25,78.57,5774.83,19
CDM,2322IP _1,"DEXAMETHASONE, ORAL, 0.25 MG",5.2,3.38,0.01,13.43,17
CDM,2322OP _1,"DEXAMETHASONE, ORAL, 0.25 MG",4.75,3.09,0.01,12.27,17
CDM,23234IP _1,UNCLASSIFIED DRUGS,421.64,274.07,105.41,1088.89,16
CDM,2324IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.95,3.22,1.24,12.78,16
CDM,2324OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.88,10.97,4.22,43.59,16
CDM,2326IP _1,"DEXAMETHASONE, ORAL, 0.25 MG",7.56,4.91,0.01,19.52,17
CDM,2326OP _1,"DEXAMETHASONE, ORAL, 0.25 MG",8.52,5.54,0.01,22.0,17
CDM,2327IP _1,"DEXAMETHASONE, ORAL, 0.25 MG",21.41,13.92,0.01,55.29,17
CDM,2327OP _1,"DEXAMETHASONE, ORAL, 0.25 MG",42.68,27.74,0.01,110.22,17
CDM,2331IP _1,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",57.6,37.44,0.12,172.8,17
CDM,2331OP _1,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",63.45,41.24,0.12,190.35,17
CDM,2332IP _1,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",50.45,32.79,0.12,151.35,17
CDM,2332OP _1,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",48.31,31.4,0.12,144.93,17
CDM,23330_1,"Removal of foreign body of shoulder joint, accessed beneath the skin",686.7,446.36,78.57,720.04,19
CDM,23333_1,"Removal of foreign body of shoulder joint, accessed beneath the tissue or muscle",1440.6,936.39,78.57,1370.79,19
CDM,23334_1,Removal of ball or socket prosthesis from shoulder,3392.6,2205.19,78.57,3169.8,19
CDM,23335_1,Removal of ball and socket prosthesis from shoulder,4043.6,2628.34,78.57,3781.22,19
CDM,23350_1,Injection of contrast for imaging of shoulder joint,611.1,397.22,18.03,398.35,19
CDM,2335IP _1,UNCLASSIFIED DRUGS,71.26,46.32,17.82,184.03,16
CDM,2335OP _1,UNCLASSIFIED DRUGS,51.07,33.2,12.77,131.89,16
CDM,23377IP _1,RIZATRIPTAN 10 MG TABLET,12.85,8.35,3.21,9.0,11
CDM,23395_1,Relocation of one muscle of shoulder or upper arm,3451.4,2243.41,78.57,3804.2,19
CDM,23397_1,Relocation of multiple muscles of shoulder or upper arm,3100.7,2015.46,78.57,3361.95,19
CDM,23400_1,Reshaping and relocation of shoulder blade bone,3936.0,2558.4,78.57,2855.94,19
CDM,23405_1,Incision of shoulder tendon,1684.2,1094.73,78.57,1834.27,19
CDM,23406_1,Incision of shoulder multiple tendons through same incision,2106.3,1369.1,78.57,2275.76,19
CDM,23410_1,Repair of acute torn shoulder rotator cuff,3400.5,2210.33,78.57,2430.9,19
CDM,23412_1,Repair of chronic torn shoulder rotator cuff,3559.5,2313.68,78.57,2523.15,19
CDM,23415_1,Release of collar bone and shoulder ligament,1879.5,1221.68,78.57,2064.35,19
CDM,23420_1,Repair of complete tear of shoulder rotator cuff with release of pressure on collar bone,4014.75,2609.59,78.57,2873.69,19
CDM,23430_1,Anchoring of biceps tendon,2968.95,1929.82,78.57,2205.51,19
CDM,23440_1,Removal or relocation of biceps tendon,3724.0,2420.6,78.57,2233.13,19
CDM,23450_1,Reattachment of shoulder joint capsule without bone transfer,2565.2,1667.38,78.57,2797.33,19
CDM,23455_1,Reattachment of shoulder joint capsule and cartilage without bone transfer with repair of shoulder rim,4106.1,2668.97,78.57,2953.71,19
CDM,23458IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.37,4.79,1.84,19.03,16
CDM,23458OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.96,14.27,5.49,56.71,16
CDM,23460_1,Repair of shoulder joint capsule and shoulder blade with bone block,2964.2,1926.73,78.57,3218.13,19
CDM,23462_1,Reattachment of shoulder joint capsule with bone transfer (coracoid bone),2910.6,1891.89,78.57,3126.34,19
CDM,23465_1,Repair of shoulder joint capsule in the back of the joint,3032.4,1971.06,78.57,3304.72,19
CDM,23466_1,Repair and tightening of shoulder joint capsule,4493.55,2920.81,78.57,3304.51,19
CDM,23470_1,Partial replacement of shoulder joint,4953.45,3219.74,78.57,3556.17,19
CDM,23472_1,"Prosthetic repair of shoulder joint, total shoulder",6725.25,4371.41,78.57,4312.92,19
CDM,23473_1,Revision of total shoulder repair,7826.25,5087.06,78.57,4810.86,19
CDM,23474_1,"Revision of total shoulder repair, total shoulder",8449.95,5492.47,78.57,5195.47,19
CDM,23480_1,Incision or partial removal of collar bone,2204.0,1432.6,78.57,2429.2,19
CDM,23485_1,Incision or partial removal of collar bone with bone graft,3910.8,2542.02,78.57,2826.79,19
CDM,23490IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.15,2.7,1.04,10.72,16
CDM,23490OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",44.87,29.17,11.22,115.88,16
CDM,23490_1,Stabilization of collar bone with device,2336.3,1518.6,78.57,2542.83,19
CDM,23491_1,Stabilization of top of upper arm bone with device,2742.6,1782.69,78.57,3001.85,19
CDM,23500_1,Closed treatment of broken collar bone,825.0,536.25,78.57,661.17,19
CDM,23505_1,Closed treatment of broken collar bone with manipulation,860.0,559.0,78.57,982.86,19
CDM,23515_1,Treatment of broken collar bone,2825.55,1836.61,78.57,2130.61,19
CDM,23520_1,Closed treatment of dislocated joint between collar and chest bone,520.0,338.0,78.57,694.08,19
CDM,23525_1,Closed treatment of dislocated joint between collar and chest bone with manipulation,800.0,520.0,78.57,1055.52,19
CDM,23530_1,Treatment of dislocated joint between collar and chest bones,1435.4,933.01,78.57,1690.64,19
CDM,23532_1,Treatment of dislocated joint between collar and chest bones with tissue graft,1438.75,935.19,78.57,1839.65,19
CDM,23540_1,Closed treatment of dislocated joint between collar bone and shoulder,600.0,390.0,78.57,681.15,19
CDM,23545_1,Closed treatment of dislocated joint between collar bone and shoulder with manipulation,780.95,507.62,78.57,967.89,19
CDM,23550_1,Treatment of dislocated joint between collar bone and shoulder,1793.4,1165.71,78.57,1686.61,19
CDM,23552_1,Treatment of dislocated joint between collar bone and shoulder with tissue graft,2625.6,1706.64,78.57,1938.14,19
CDM,23570_1,Closed treatment of broken shoulder blade,855.0,555.75,78.57,707.24,19
CDM,23575_1,Closed treatment of broken shoulder blade with manipulation,916.85,595.95,78.57,1109.85,19
CDM,23585_1,Treatment of broken shoulder blade,3866.7,2513.36,78.57,2900.7,19
CDM,23600_1,Closed treatment of broken top of upper arm bone,1230.0,799.5,78.57,913.91,19
CDM,23605_1,Closed treatment of broken top of upper arm bone with manipulation,1183.4,769.21,78.57,1256.59,19
CDM,23615_1,Treatment of broken top of upper arm bone,3513.9,2284.04,78.57,2617.82,19
CDM,23616_1,Treatment of broken upper arm bone with replacement,3676.1,2389.47,78.57,3671.83,19
CDM,23617IP _1,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",558.23,362.85,4.07,1674.69,17
CDM,23617OP _1,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",211.33,137.36,4.07,633.99,17
CDM,2361IP _1,UNCLASSIFIED DRUGS,22.06,14.34,5.52,56.97,16
CDM,2361OP _1,UNCLASSIFIED DRUGS,6.68,4.34,1.67,17.25,16
CDM,23620_1,Closed treatment of upper arm bone broken at shoulder joint,1071.0,696.15,78.3,758.27,19
CDM,23625_1,Closed treatment of upper arm bone broken at shoulder joint with manipulation,989.1,642.92,78.57,1042.71,19
CDM,23630_1,"Treatment of upper arm bone, broken at shoulder joint",3024.0,1965.6,78.57,2312.0,19
CDM,2364IP _1,5% DEXTROSE/WATER (500 ML = 1 UNIT),1.97,1.28,0.49,5.09,17
CDM,23650_1,Closed treatment of dislocated shoulder with manipulation,1110.0,721.5,78.57,864.78,19
CDM,23655_1,Closed treatment of dislocated shoulder with manipulation under anesthesia,1980.0,1287.0,78.57,1193.66,19
CDM,2365IP _1,UNCLASSIFIED DRUGS,4.38,2.85,1.1,11.31,16
CDM,23660_1,Treatment of dislocated shoulder,1539.3,1000.55,78.57,1724.96,19
CDM,23665_1,Closed treatment of dislocated shoulder and broken upper arm bone at shoulder joint with manipulation,1590.0,1033.5,78.57,1173.43,19
CDM,23670_1,"Treatment of dislocated shoulder and upper arm bone, broken at shoulder joint",2273.3,1477.65,78.57,2592.25,19
CDM,23675_1,Closed treatment of dislocated shoulder and broken neck of upper arm bone with manipulation,2310.0,1501.5,78.57,1529.76,19
CDM,2367IP _1,UNCLASSIFIED DRUGS,1.29,0.84,0.32,3.33,16
CDM,23680_1,Treatment of dislocated shoulder and broken neck of upper arm bone,3672.9,2387.39,78.57,2749.19,19
CDM,23700_1,Manipulation of shoulder joint under anesthesia,534.5,347.43,78.57,579.93,19
CDM,23796OP _1,"INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG",11933.44,7756.74,34.37,30818.11,19
CDM,23800_1,Fusion of bones of shoulder joint,2766.8,1798.42,78.57,3031.56,19
CDM,23802_1,Fusion of shoulder joint bone with self bone graft,3371.6,2191.54,78.57,3787.95,19
CDM,23872IP _1,ARAVA 10 MG TABLET,314.6,204.49,78.65,220.22,11
CDM,23873IP _1,ARAVA 20 MG TABLET,345.61,224.65,86.4,241.93,11
CDM,23900_1,Amputation of entire arm with removal shoulder blade and a portion of collar bone,3600.5,2340.33,78.57,4101.48,19
CDM,23920_1,Removal of arm and shoulder blade at shoulder joint,3115.4,2025.01,78.57,3330.23,19
CDM,23921_1,Revision of scar or wound closure following removal of arm and shoulder blade at shoulder joint,1156.1,751.47,78.57,1384.02,19
CDM,23930_1,Drainage of deep abscess or blood accumulation of upper arm or elbow,1417.5,921.38,78.57,856.16,19
CDM,23931_1,Drainage of fluid filled sac in elbow joint,729.8,474.37,78.57,727.92,19
CDM,23935_1,Incision of upper arm or elbow bone,1968.75,1279.69,78.57,1505.59,19
CDM,23968IP _1,"INJECTION, MYCOPHENOLATE MOFETIL, 10 MG",1076.76,699.89,0.39,2780.73,19
CDM,24000_1,"Incision of elbow joint for exploration, fluid drainage, or removal of foreign body",1409.1,915.92,78.57,1413.41,19
CDM,24006_1,Incision of elbow with release of joint capsule,1897.4,1233.31,78.57,2118.56,19
CDM,2403IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.91,18.14,6.98,72.08,16
CDM,2404IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.53,5.54,2.13,22.03,16
CDM,2404OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.8,10.92,4.2,43.39,16
CDM,2405IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.85,9.0,3.46,35.77,16
CDM,2405OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.71,10.21,3.93,40.57,16
CDM,24065_1,Biopsy of surface tissue of upper arm or elbow,657.3,427.25,66.69,621.06,19
CDM,24066_1,Biopsy of deep tissue of upper arm or elbow,1512.0,982.8,78.57,1483.21,19
CDM,24071T_1,"Removal of growth under skin of upper arm or elbow, 3.0 cm or more",1093.1,710.52,78.57,1193.14,19
CDM,24071_1,"Removal of growth under skin of upper arm or elbow, 3.0 cm or more",1630.2,1059.63,78.57,1193.14,19
CDM,24073T_1,"Removal of growth of muscle of upper arm or elbow, 5.0 cm or more",2013.9,1309.04,78.57,2042.12,19
CDM,24073_1,"Removal of growth of muscle of upper arm or elbow, 5.0 cm or more",2795.7,1817.21,78.57,2042.12,19
CDM,24075T_1,"Removal of growth under skin of upper arm or elbow, less than 3.0 cm",2149.5,1397.18,78.57,1270.35,19
CDM,24075_1,"Removal of growth under skin of upper arm or elbow, less than 3.0 cm",1838.1,1194.77,78.57,1270.35,19
CDM,24076_1,"Removal of growth of muscle of upper arm or elbow, less than 5.0 cm",1890.0,1228.5,78.57,1606.39,19
CDM,24077_1,"Extensive removal of growth of upper arm or elbow, less than 5.0 cm",2940.0,1911.0,78.57,3053.37,19
CDM,24079_1,"Extensive removal of growth of upper arm or elbow, 5.0 cm or more",3452.4,2244.06,78.57,3899.63,19
CDM,24100_1,Incision of elbow with biopsy of joint lining,1152.9,749.39,78.57,1233.82,19
CDM,24101_1,Incision and exploration of elbow joint,2113.65,1373.87,78.57,1482.82,19
CDM,24102_1,Removal of elbow joint lining,2786.25,1811.06,78.57,1829.26,19
CDM,24105_1,Removal of fluid-filled sac of elbow,1315.2,854.88,78.57,1043.21,19
CDM,24110_1,Removal of cyst or growth of upper arm bone,1540.4,1001.26,78.57,1734.25,19
CDM,24115_1,Removal of cyst or growth of upper arm bone and self bone graft,1893.2,1230.58,78.57,2172.82,19
CDM,24116_1,Removal of cyst or growth of upper arm bone and donor bone graft,3476.1,2259.47,78.57,2546.94,19
CDM,24120_1,Removal of cyst or growth of elbow or upper forearm bone,1380.8,897.52,78.57,1573.47,19
CDM,24125_1,Removal of cyst or growth of elbow or upper forearm bone and self bone graft,1607.6,1044.94,78.57,1836.55,19
CDM,24126_1,Removal of cyst or growth of elbow or upper forearm bone with bone graft,1705.2,1108.38,78.57,1913.3,19
CDM,2412IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.01,1.31,0.5,5.19,16
CDM,24130_1,Removal of forearm bone at elbow joint,1332.5,866.13,78.57,1511.61,19
CDM,24134_1,Removal of dead upper arm bone for bone infection in the main portion and lower portion or the bone,2305.8,1498.77,78.57,2208.25,19
CDM,24136_1,Removal of dead forearm bone at elbow joint,1489.4,968.11,78.57,1866.45,19
CDM,24138_1,Removal of dead elbow bone,1752.5,1139.13,78.57,2002.97,19
CDM,24140_1,Partial removal of infected upper arm bone,1628.65,1058.62,78.57,2083.49,19
CDM,24145_1,Partial removal of infected forearm bone at elbow,1601.3,1040.85,78.57,1751.75,19
CDM,24147_1,Partial removal of infected elbow bone,1691.6,1099.54,78.57,1846.83,19
CDM,24149_1,Extensive removal of bony growth and tissue from elbow to increase elbow motion,4644.75,3019.09,78.57,3492.68,19
CDM,2414IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.0,4.55,1.75,18.08,16
CDM,2414OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.13,2.68,1.03,10.67,16
CDM,24150_1,Extensive removal of growth of upper arm bone,2613.5,1698.78,78.57,4595.76,19
CDM,24152_1,Extensive removal of growth of inner forearm bone,2384.6,1549.99,78.57,3970.5,19
CDM,24155_1,Removal of elbow joint bones,1975.65,1284.17,78.57,2518.55,19
CDM,2415OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.5,5.53,2.13,21.95,16
CDM,24160_1,Removal of elbow joint prosthesis,2956.9,1921.99,78.57,3747.9,19
CDM,24164_1,Removal of forearm bone prosthesis at elbow joint,1758.8,1143.22,78.57,2152.24,19
CDM,2417IP _1,"INJECTION, DICYCLOMINE HCL, UP TO 20 MG",43.28,28.13,10.82,111.77,17
CDM,2417OP _1,"INJECTION, DICYCLOMINE HCL, UP TO 20 MG",76.83,49.94,12.01,198.41,17
CDM,2418IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.37,4.79,1.84,19.03,16
CDM,2418OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.15,20.9,8.04,83.03,16
CDM,24200_1,"Removal of foreign body of upper arm or elbow area, accessed beneath the skin",511.4,332.41,78.57,516.55,19
CDM,24201_1,"Removal of foreign body, upper arm or elbow area",1416.5,920.73,78.57,1306.92,19
CDM,2420IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.42,4.82,1.86,19.16,16
CDM,2420OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.55,23.11,8.89,91.81,16
CDM,24216IP _1,UNCLASSIFIED DRUGS,8.73,5.67,2.18,22.55,16
CDM,24216OP _1,UNCLASSIFIED DRUGS,23.03,14.97,5.76,59.48,16
CDM,24220_1,Injection of contrast for imaging of elbow joint,1019.6,662.74,27.17,463.18,19
CDM,24268IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.29,3.44,1.32,13.66,16
CDM,24268OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.2,11.83,4.55,47.0,16
CDM,24300_1,Manipulation of elbow under anesthesia,1527.75,993.04,78.57,1249.9,19
CDM,24301_1,Relocation of muscle or tendon of upper arm or elbow,2012.9,1308.39,78.57,2222.76,19
CDM,24305_1,Lengthening of tendon of upper arm or elbow,1537.2,999.18,78.57,1718.05,19
CDM,24310_1,"Incision of tendon located from elbow to shoulder, open procedure",1305.2,848.38,78.57,1392.1,19
CDM,24320_1,Relocation of tendon from elbow to shoulder with muscle transfer,2177.7,1415.51,78.57,2301.35,19
CDM,24330_1,Relocation of forearm tendons,1912.1,1242.87,78.57,2120.93,19
CDM,24331_1,Relocation of forearm tendons with advancement of the extensor tendons,1822.15,1184.4,78.57,2309.58,19
CDM,24332_1,Release of upper arm tendon,1415.65,920.17,78.57,1812.91,19
CDM,24340_1,Anchoring of biceps tendon at elbow,1793.4,1165.71,78.57,1813.84,19
CDM,24341_1,Repair of tendon or muscle of upper arm or elbow,3150.0,2047.5,78.57,2208.35,19
CDM,24342_1,Reinsertion of torn upper arm tendon,3225.6,2096.64,78.57,2300.75,19
CDM,24343_1,Repair of ligament of thumb side of elbow,2795.7,1817.21,78.57,2105.08,19
CDM,24344_1,Repair of ligament of thumb side of elbow with tendon graft,4372.2,2841.93,78.57,3244.55,19
CDM,24345_1,Repair of ligament of small finger side of elbow,1851.2,1203.28,78.57,2089.04,19
CDM,24346_1,Repair of ligament of small finger side of elbow with tendon graft,2542.52,1652.64,78.57,3248.0,19
CDM,24357_1,Incision of elbow tendon,1745.1,1134.32,78.57,1249.47,19
CDM,24358_1,Incision of elbow tendon with removal of tissue,2063.25,1341.11,78.57,1553.68,19
CDM,24359_1,Incision and repair of elbow tendon with removal of tissue or bone,1737.8,1129.57,78.57,1960.65,19
CDM,24360_1,Repair of elbow joint with tissue graft,2818.2,1831.83,78.57,2662.21,19
CDM,24361_1,Repair of elbow joint with replacement of lower portion of upper arm bone,2818.2,1831.83,78.57,2977.89,19
CDM,24362_1,Repair of elbow joint with implant with and repair of ligament,2461.75,1600.14,78.57,3136.4,19
CDM,24363_1,Prosthetic repair of elbow joint,6092.1,3959.87,78.57,4318.77,19
CDM,24365_1,Joint repair (arthroplasty) forearm bone on the thumb side (radius) at the elbow without an implant,1704.2,1107.73,78.57,1890.27,19
CDM,24366_1,Joint repair (arthroplasty) forearm bone on the thumb side (radius) at the elbow with and implant,1827.0,1187.55,78.57,2020.64,19
CDM,24370_1,"Revision of total elbow repair (arthroplasty), upper arm or forearm components",7419.9,4822.94,78.57,4600.81,19
CDM,24371_1,"Revision of total elbow repair (arthroplasty), upper arm and forearm components",5699.4,3704.61,78.57,5288.74,19
CDM,24400_1,Incision or partial removal of upper arm bone,2202.9,1431.89,78.57,2438.63,19
CDM,24410_1,Incision or partial removal of upper arm bone with insertion of rod,2818.2,1831.83,78.57,3128.61,19
CDM,24420_1,Reconstruction of upper arm bone,2651.3,1723.35,78.57,2949.41,19
CDM,24430_1,Repair of nonhealed broken upper arm bone,4241.55,2757.01,78.57,3126.68,19
CDM,24435_1,Repair of nonhealed broken upper arm bone with self bone graft,4291.95,2789.77,78.57,3190.0,19
CDM,2444IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.43,4.18,1.61,16.61,16
CDM,2444OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.03,11.72,4.51,46.56,16
CDM,2445IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.4,3.51,1.35,13.95,16
CDM,2445OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.26,6.02,2.32,23.91,16
CDM,24470IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.08,6.55,2.52,26.03,16
CDM,24470OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.4,15.21,5.85,60.43,16
CDM,24470_1,Repair of growth plate of upper arm bone,1551.1,1008.22,78.57,1985.41,19
CDM,24471IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.25,2.11,0.81,8.39,16
CDM,24471OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.84,8.35,3.21,33.16,16
CDM,24474IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.0,4.55,1.75,18.08,16
CDM,24474OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.75,22.59,8.69,89.74,16
CDM,24495_1,Incision of tissue of forearm muscle with exploration of artery,1754.6,1140.49,78.57,2381.69,19
CDM,24498_1,Stabilization of upper arm bone with device,3513.9,2284.04,78.57,2564.13,19
CDM,24500IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.11,5.92,2.28,23.53,16
CDM,24500OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.3,14.5,5.58,57.59,16
CDM,24500_1,Closed treatment of broken middle part of upper arm bone,1305.0,848.25,72.96,968.6,19
CDM,24501IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",106.05,68.93,26.51,273.87,16
CDM,24501OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",136.56,88.76,34.14,352.67,16
CDM,24505_1,Closed treatment of broken middle part of upper arm bone with manipulation,1920.0,1248.0,78.57,1385.39,19
CDM,24513OP _1,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",1402.65,911.72,8.2,3622.34,19
CDM,24515_1,Treatment of broken middle part of upper arm bone with placement of stabilizing device (plate/screws),3521.7,2289.11,78.57,2598.87,19
CDM,24516_1,Treatment of broken middle part of upper arm bone with placement of stabilizing device (implant),3485.55,2265.61,78.57,2545.42,19
CDM,24521IP _1,UNCLASSIFIED DRUGS,5.67,3.69,1.42,14.64,16
CDM,24521OP _1,UNCLASSIFIED DRUGS,21.19,13.77,5.3,54.72,16
CDM,24530_1,Closed treatment of upper arm bone broken at elbow,1410.0,916.5,78.57,1023.08,19
CDM,24535_1,Closed treatment of upper arm bone broken at elbow with manipulation,1570.0,1020.5,78.57,1681.21,19
CDM,24538_1,Placement of stabilizing device to upper arm broken at elbow,1977.2,1285.18,78.57,2207.71,19
CDM,24545_1,Treatment of upper arm bone broken at elbow,3690.3,2398.7,78.57,2753.38,19
CDM,24546_1,Treatment of broken upper arm bone at elbow with extension,4246.2,2760.03,78.57,3078.95,19
CDM,24560_1,Closed treatment of broken outer part of upper arm bone at elbow,1125.0,731.25,78.57,908.71,19
CDM,24565_1,Closed treatment of broken outer part of upper arm bone at elbow with manipulation,1250.0,812.5,78.57,1447.13,19
CDM,24566_1,Placement of stabilizing device for broken outer part of upper arm at elbow,1858.5,1208.03,78.57,2123.01,19
CDM,24575_1,Treatment of broken outer part of upper arm bone at elbow,1952.0,1268.8,78.57,2170.37,19
CDM,24576_1,Closed treatment of broken elbow,820.0,533.0,77.8,963.27,19
CDM,24577_1,Closed treatment of broken elbow with manipulation,1995.0,1296.75,78.57,1487.16,19
CDM,24579_1,Treatment of broken elbow,3340.65,2171.42,78.57,2475.87,19
CDM,24582_1,Placement of stabilizing device for broken elbow with manipulation,2072.7,1347.26,78.57,2396.25,19
CDM,24585IP _1,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25 MG",5948.25,3866.36,1070.34,15361.36,19
CDM,24585OP _1,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25 MG",3941.34,2561.87,985.34,10178.51,19
CDM,24586_1,Treatment of broken or dislocated upper or forearm bones at elbow,2955.8,1921.27,78.57,3211.91,19
CDM,24587_1,Treatment of broken or dislocated upper or forearm bones at elbow with implant,2624.0,1705.6,78.57,3217.05,19
CDM,24600_1,Repair of dislocated elbow,1395.0,906.75,78.57,1037.49,19
CDM,24605_1,Repair of dislocated elbow under anesthesia,1920.0,1248.0,78.57,1399.76,19
CDM,24615_1,Treatment of dislocated elbow,1913.1,1243.52,78.57,2114.31,19
CDM,24620_1,Closed treatment of broken and dislocated forearm bones at elbow with manipulation,2145.0,1394.25,78.57,1642.61,19
CDM,24635_1,Treatment of broken and dislocated forearm bones at elbow,2438.1,1584.77,78.57,1997.03,19
CDM,24640_1,"Closed treatment of dislocated forearm bone on thumb side at elbow with manipulation, child",420.0,273.0,67.84,254.01,19
CDM,24650_1,Closed treatment of broken forearm bone on thumb side at elbow,960.0,624.0,78.57,715.04,19
CDM,24655_1,Closed treatment of broken forearm bone on thumb side at elbow with manipulation,1650.0,1072.5,78.57,1238.54,19
CDM,24665_1,Treatment of broken forearm bone on thumb side at elbow,2575.2,1673.88,78.57,1937.72,19
CDM,24666_1,Treatment of broken forearm bone on thumb side at elbow with prosthesis,2655.45,1726.04,78.57,2173.0,19
CDM,24670_1,Closed treatment of broken forearm bone on small finger side at elbow,1065.0,692.25,78.57,826.04,19
CDM,24675_1,Closed treatment of broken forearm bone on small finger side at elbow with manipulation,1695.0,1101.75,78.57,1290.31,19
CDM,24685_1,Treatment of broken forearm bone on small finger side at elbow,2578.35,1675.93,78.57,1937.56,19
CDM,24695IP _1,BUSULFAN 60 MG/10 ML VIAL,23.17,15.06,5.79,16.22,11
CDM,24702IP _1,MODAFINIL 100 MG TABLET,50.52,32.84,12.63,35.36,11
CDM,2475IP _1,UNCLASSIFIED DRUGS,5.0,3.25,1.25,12.91,16
CDM,2475OP _1,UNCLASSIFIED DRUGS,12.12,7.88,3.03,31.3,16
CDM,2476IP _1,UNCLASSIFIED DRUGS,5.8,3.77,1.45,14.98,16
CDM,2476OP _1,UNCLASSIFIED DRUGS,20.3,13.2,5.08,52.42,16
CDM,2477IP _1,UNCLASSIFIED DRUGS,3.96,2.57,0.99,10.23,16
CDM,24800_1,Fusion of elbow joint without bone graft from the patient,2185.1,1420.32,78.57,2450.84,19
CDM,24802_1,Fusion of elbow joint with bone graft from the patient,2691.2,1749.28,78.57,2964.52,19
CDM,2483IP _1,"INJECTION, DIMENHYDRINATE, UP TO 50 MG",147.55,95.91,0.98,381.05,17
CDM,2483OP _1,"INJECTION, DIMENHYDRINATE, UP TO 50 MG",146.35,95.13,0.98,377.95,17
CDM,24900_1,Amputation of arm through upper arm bone with closure,2887.05,1876.58,78.57,2177.96,19
CDM,24914IP _1,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",13.42,8.72,0.21,34.66,17
CDM,24914OP _1,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",11.23,7.3,0.21,29.0,17
CDM,24915IP _1,LEVALBUTEROL 0.63 MG/3 ML SOL,15.0,9.75,3.75,10.5,11
CDM,24916IP _1,LEVALBUTEROL 1.25 MG/3 ML SOL,15.32,9.96,3.83,10.72,11
CDM,24920_1,Amputation of arm through upper arm bone leaving wound,2863.35,1861.18,78.57,2168.84,19
CDM,24925_1,Secondary closure or revision of scar of previous upper arm bone amputation,1478.4,960.96,78.57,1674.67,19
CDM,24930_1,Re-amputation of remaining arm at upper arm bone,3039.75,1975.84,78.57,2286.3,19
CDM,24931_1,Amputation of arm through upper arm bone with implant,1895.4,1232.01,78.57,2759.48,19
CDM,24932IP _1,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",17.81,11.58,2.34,45.99,17
CDM,24932OP _1,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",30.8,20.02,2.34,79.54,17
CDM,24933IP _1,UNCLASSIFIED DRUGS,455.13,295.83,113.78,1175.37,16
CDM,24933OP _1,UNCLASSIFIED DRUGS,156.55,101.76,39.14,404.29,16
CDM,24935_1,Lengthening of remaining amputated arm bone,2214.95,1439.72,78.57,3446.65,19
CDM,24940_1,Insertion of lever into muscle of amputation stump of arm,2430.5,1579.83,78.57,3113.9,15
CDM,25000_1,Incision or the tendon covering on the top side of the wrist,2062.5,1340.63,78.57,1003.16,19
CDM,25001_1,Incision or the tendon covering on the palm side of the wrist,1194.9,776.69,78.57,1021.71,19
CDM,25005IP _1,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",25.15,16.35,0.16,64.95,17
CDM,25005OP _1,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",9.14,5.94,0.16,23.6,17
CDM,25020_1,"Incision of tissue of forearm and/or wrist muscle compartment on one side of the forearm to relieve pressure, without removal of tissue",1524.6,990.99,78.57,1918.5,19
CDM,25023_1,Incision to relieve pressure in top or palm side of wrist compartment with removal of damaged tissue,2925.3,1901.45,78.57,3394.05,19
CDM,25024_1,"Incision of tissue of forearm and/or wrist muscle compartment on both sides of the forearm to relieve pressure, without removal of tissue",3091.8,2009.67,78.57,2308.8,19
CDM,25025_1,Incision to relieve pressure in top and palm side of wrist compartment with removal of damaged tissue,4806.9,3124.49,78.57,3555.2,19
CDM,25028_1,Drainage of deep abscess or blood accumulation of forearm or wrist,2088.45,1357.49,78.57,1792.31,19
CDM,25031_1,Drainage of fluid filled sac in wrist joint,1140.3,741.2,78.57,1035.64,19
CDM,25035_1,Incision of forearm or wrist bone,2967.3,1928.75,78.57,1733.82,19
CDM,25040_1,"Incision of wrist joint for exploration, fluid drainage, or removal of foreign body",2283.75,1484.44,78.57,1667.85,19
CDM,2505IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.03,13.02,5.01,51.73,16
CDM,2505OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",108.82,70.73,27.21,281.03,16
CDM,25065_1,Biopsy of surface tissue of forearm or wrist,669.9,435.44,78.57,690.0,19
CDM,25066_1,Biopsy of deep tissue of forearm and/or wrist,1054.2,685.23,78.57,1062.97,19
CDM,25071T_1,"Removal of growth under skin of forearm or wrist, 3.0 cm or more",718.2,466.83,78.57,1251.27,19
CDM,25071_1,"Removal of growth under skin of forearm or wrist, 3.0 cm or more",1552.95,1009.42,78.57,1251.27,19
CDM,25073T_1,"Removal of growth of muscle of forearm or wrist, 3.0 cm or more",900.9,585.59,78.57,1578.96,19
CDM,25073_1,"Removal of growth of muscle of forearm or wrist, 3.0 cm or more",2132.55,1386.16,78.57,1578.96,19
CDM,25075T_1,"Removal of growth under skin of forearm or wrist, less than 3.0 cm",824.3,535.8,78.57,1241.11,19
CDM,25075_1,"Removal of growth under skin of forearm or wrist, less than 3.0 cm",1471.05,956.18,78.57,1241.11,19
CDM,25076T_1,"Removal of growth of muscle of forearm or wrist, less than 3.0 cm",870.5,565.83,78.57,1537.15,19
CDM,25076_1,"Removal of growth of muscle of forearm or wrist, less than 3.0 cm",1400.7,910.46,78.57,1537.15,19
CDM,25077_1,"Extensive removal of growth of forearm or wrist, less than 3.0 cm",2388.8,1552.72,78.57,2602.88,19
CDM,25078_1,"Extensive removal of growth of forearm or wrist, 3.0 cm or more",4520.25,2938.16,78.57,3443.62,19
CDM,25085_1,Incision to repair or release capsule of wrist joint,1365.0,887.25,78.57,1333.26,19
CDM,2508IP _1,"INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG",127.58,82.93,0.75,329.48,17
CDM,2508OP _1,"INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG",249.59,162.23,0.75,644.57,17
CDM,2509OP _1,"DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A ",29.14,18.94,1.51,75.25,17
CDM,250IP _1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",12.49,8.12,0.07,32.26,17
CDM,250OP _1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",6.32,4.11,0.07,16.32,17
CDM,25100_1,Incision of joint capsule of wrist,931.4,605.41,78.57,1024.59,19
CDM,25101_1,Incision and exploration of wrist joint,1155.0,750.75,78.57,1199.22,19
CDM,25105_1,Incision into wrist joint with removal of joint lining tissue,2362.5,1535.63,78.57,1437.67,19
CDM,25107_1,Incision to repair wrist joint with repair of cartilage,1627.5,1057.88,78.57,1830.51,19
CDM,25109_1,Removal of tendon of forearm and/or wrist,1264.0,821.6,78.57,1598.63,19
CDM,25110_1,Removal of growth of tendon covering of forearm or wrist,1033.2,671.58,78.57,1013.27,19
CDM,25111_1,Removal of first cyst of wrist,1288.35,837.43,78.57,951.19,19
CDM,25112_1,Removal of recurrent cyst of wrist,1516.8,985.92,78.57,1148.19,19
CDM,25115_1,Extensive removal of growth of soft tissue structures in palm side of wrist,3320.1,2158.07,78.57,2253.46,19
CDM,25116_1,Extensive removal of growth of soft tissue structures in top side of wrist,2860.2,1859.13,78.57,1786.9,19
CDM,25118IP _1,CIPROFLOXACIN HCL 250 MG TAB,10.4,6.76,2.6,7.28,11
CDM,25118_1,Removal of lining of tendon covering of wrist,1890.0,1228.5,78.57,1132.18,19
CDM,25119IP _1,CIPROFLOXACIN HCL 500 MG TAB,5.75,3.74,1.44,4.03,11
CDM,25119_1,Removal of tendon lining on top side of wrist and end of forearm bone at wrist,1575.0,1023.75,78.57,1471.64,19
CDM,2511IP _1,"DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A ",11.07,7.2,1.51,28.59,17
CDM,2511OP _1,"DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A ",12.51,8.13,1.51,32.31,17
CDM,25120IP _1,CIPROFLOXACIN HCL 750 MG TAB,5.55,3.61,1.39,3.89,11
CDM,25120_1,Removal of cyst or growth of lower forearm bone,1709.4,1111.11,78.57,1480.29,19
CDM,25125_1,Removal of cyst or growth of lower forearm bone with self bone graft,1921.5,1248.98,78.57,1748.96,19
CDM,25126_1,Removal of cyst or growth of lower forearm bone with bone graft,3052.35,1984.03,78.57,1762.65,19
CDM,25130_1,Removal of cyst or growth of wrist bone,1782.9,1158.89,78.57,1329.88,19
CDM,25135_1,Removal of cyst or growth of wrist bone with self bone graft,1575.0,1023.75,78.57,1647.88,19
CDM,25136_1,Removal of cyst or growth of wrist bone with bone graft,1141.25,741.81,78.57,1454.6,19
CDM,25145_1,Removal of fragment of dead forearm or wrist bone on small finger side,1890.0,1228.5,78.57,1528.5,19
CDM,2514OP _1,BENADRYL ALLERGY 50 MG TABLET,10.7,6.96,2.68,7.49,11
CDM,25150_1,Removal of diseased part of forearm bone on small finger side,1539.3,1000.55,78.57,1678.84,19
CDM,25151_1,Removal of diseased part of forearm bone on thumb side,1555.1,1010.82,78.57,1728.47,19
CDM,2516IP _1,UNCLASSIFIED DRUGS,21.52,13.99,5.38,55.58,16
CDM,2516OP _1,UNCLASSIFIED DRUGS,20.31,13.2,5.08,52.45,16
CDM,25170_1,Extensive removal of growth of forearm bone (radius or ulna),2585.1,1680.32,78.57,4366.24,19
CDM,25210_1,Removal of wrist bone,1305.2,848.38,78.57,1453.26,19
CDM,25215_1,Removal of multiple wrist bones,3071.25,1996.31,78.57,1837.26,19
CDM,25230_1,Partial removal of wrist bone near thumb,1155.0,750.75,78.57,1286.25,19
CDM,25238IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.77,8.3,3.19,32.98,16
CDM,25238OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.5,13.33,5.13,52.94,16
CDM,25240_1,Removal or partial removal of lower end of forearm bone on small finger side at wrist,1771.95,1151.77,78.57,1275.13,19
CDM,25246IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.67,14.09,5.42,55.96,16
CDM,25246OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.41,0.92,0.35,3.64,16
CDM,25246_1,Injection of contrast for imaging of wrist,1590.75,1033.99,38.29,477.86,19
CDM,25248T_1,Removal of deep foreign body in forearm or wrist,2774.1,1803.17,78.57,1221.46,19
CDM,25248_1,Removal of deep foreign body in forearm or wrist,1285.2,835.38,78.57,1221.46,19
CDM,25250_1,Removal of wrist prosthesis,2082.15,1353.4,78.57,1566.75,19
CDM,25251_1,"Removal of wrist prosthesis, complicated",1659.88,1078.92,78.57,2125.77,19
CDM,25259_1,Manipulation of wrist under anesthesia,963.0,625.95,78.57,1245.35,19
CDM,25260_1,Primary repair of tendon or muscle of palm side of forearm or wrist,2450.0,1592.5,78.57,1870.99,19
CDM,25263_1,Secondary repair of tendon or muscle of palm side of forearm or wrist,2002.4,1301.56,78.57,1855.85,19
CDM,25265_1,Repair of forearm and/or wrist tendon or muscle on the underside of the wrist (flexor) with graft,1729.85,1124.4,78.57,2221.88,19
CDM,25270_1,Primary repair of tendon or muscle of top side of forearm or wrist,1710.0,1111.5,78.57,1455.57,19
CDM,25272_1,"Repair of forearm and/or wrist tendon or muscle on the top of the wrist (extensor), secondary",1879.5,1221.68,78.57,1646.69,19
CDM,25274_1,Repair of tendon or muscle on top side of forearm or wrist with graft,2122.1,1379.37,78.57,1979.24,19
CDM,25275_1,Repair of forearm and/or wrist tendon covering with graft,1788.2,1162.33,78.57,1992.92,19
CDM,25280_1,Lengthening or shortening of tendon of forearm and/or wrist,1875.3,1218.95,78.57,1677.36,19
CDM,25290_1,"Incision of tendon of forearm and/or wrist, open procedure",1887.9,1227.14,78.57,1296.59,19
CDM,25295_1,Removal of scar tissue to release tendon of forearm or wrist,1769.3,1150.05,78.57,1560.56,19
CDM,25300_1,Anchoring of flexing tendon of fingers to wrist bone,2047.5,1330.88,78.57,2027.56,19
CDM,25301_1,Anchoring of extending tendon of fingers to wrist bone,1775.6,1154.14,78.57,1909.88,19
CDM,25310_1,Relocation of tendon of forearm and/or wrist,2828.0,1838.2,78.57,1886.69,19
CDM,25312_1,Relocation of tendon of forearm and/or wrist with grafts,2232.3,1451.0,78.57,2133.15,19
CDM,25315_1,Repair of tendon of forearm and/or wrist,2343.6,1523.34,78.57,2274.96,19
CDM,25316_1,Release and relocation of tendons of forearm or wrist,2730.0,1774.5,78.57,2705.06,19
CDM,25320_1,Reconstruction of wrist joint,3860.4,2509.26,78.57,2928.81,19
CDM,25332_1,Repair of wrist joint,2625.0,1706.25,78.57,2501.76,19
CDM,25335_1,Advancement of tendons of outer forearm at wrist joint,3543.8,2303.47,78.57,2790.93,19
CDM,25337_1,Repair of tendons of outer forearm at wrist joint,3545.4,2304.51,78.57,2644.56,19
CDM,25350_1,Incision or partial removal of forearm bone on thumb side near hand,2229.2,1448.98,78.57,2003.43,19
CDM,25355_1,Incision or partial removal of forearm bone on thumb side near elbow or in middle,2360.4,1534.26,78.57,2253.96,19
CDM,25360_1,Incision or partial removal of forearm bone on small finger side,2109.5,1371.18,78.57,1943.17,19
CDM,25365IP _1,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",2.13,1.38,0.53,5.5,17
CDM,25365OP _1,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",1.84,1.2,0.46,4.75,17
CDM,25365_1,Incision or partial removal of both forearm bones,2118.45,1376.99,78.57,2701.76,19
CDM,25370_1,Multiple incisions or removal of parts of forearm bone,2829.8,1839.37,78.57,2980.95,19
CDM,25375_1,Multiple incisions or removal of parts of both forearm bones with insertion of rod in bone,2204.7,1433.06,78.57,2819.74,19
CDM,25390_1,Shortening of one of the forearm bones,3565.8,2317.77,78.57,2287.71,19
CDM,25391_1,Lengthening of one of the forearm bones with patient-derived bone graft,2304.85,1498.15,78.57,2945.59,19
CDM,25392_1,Shortening of both bones of forearm,2380.2,1547.13,78.57,2970.83,19
CDM,25393_1,Lengthening of both bones of forearm with patient-derived bone graft,2646.98,1720.54,78.57,3330.78,19
CDM,25394_1,Shortening of wrist bone,2083.2,1354.08,78.57,2314.25,19
CDM,25400_1,Repair non-healed fracture of forearm bone,3816.3,2480.6,78.57,2384.39,19
CDM,25405_1,Repair non-healed fracture of forearm bone with patient-derived bone graft,4556.55,2961.76,78.57,3082.93,19
CDM,2540IP _1,DISULFIRAM 250 MG TABLET,31.8,20.67,7.95,22.26,11
CDM,2540OP _1,DISULFIRAM 250 MG TABLET [2540],17.18,11.17,4.3,12.03,11
CDM,25415_1,Treatment of both nonhealed broken forearm bones,2862.3,1860.5,78.57,2857.98,19
CDM,25420_1,Treatment of both nonhealed broken forearm bones with self bone graft,3331.7,2165.61,78.57,3449.53,19
CDM,25424IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.03,17.57,6.76,69.81,16
CDM,25424OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",142.38,92.55,35.6,367.7,16
CDM,25425OP _1,ALLEGRA ALLERGY 180 MG TABLET,12.3,8.0,3.08,8.61,11
CDM,25425_1,Repair of forearm bone,3275.0,2128.75,78.57,2843.89,19
CDM,25426_1,Repair of defect of both forearm bones with self bones graft,2613.8,1698.97,78.57,3324.67,19
CDM,25430_1,Insertion of vascular bone graft into wrist bone,1905.8,1238.77,78.57,2160.87,19
CDM,25431_1,Repair of non-healed wrist bone other than (scaphoid or navicular),1844.6,1198.99,78.57,2328.64,19
CDM,25440_1,"Repair of non-healed wrist bone, scaphoid or navicular at the base of the thumb",3189.45,2073.14,78.57,2289.21,19
CDM,25441_1,Arthroplasty or replacement of the end of the forearm bone on the thumb side at the wrist level,2222.5,1444.63,78.57,2769.22,19
CDM,25442_1,Arthroplasty or replacement of the end of the forearm bone on the small finger side at the wrist level,2164.1,1406.67,78.57,2403.01,19
CDM,25443_1,"Arthroplasty or replacement of wrist bone, one wrist bone (scaphoid or navicular bone)",2493.8,1620.97,78.57,2303.68,19
CDM,25444_1,"Arthroplasty or replacement of wrist bone, one wrist bone (lunate bone)",2730.0,1774.5,78.57,2442.02,19
CDM,25445_1,"Arthroplasty or replacement of wrist bone, one wrist bone (trapezium bone)",2520.0,1638.0,78.57,2142.93,19
CDM,25446_1,Arthroplasty or replacement of the entire wrist joint,3194.1,2076.17,78.57,3489.82,19
CDM,25447_1,Replacement of joint between wrist and fingers using tissue,3419.4,2222.61,78.57,2463.72,19
CDM,25448_1,Replacement of joint between wrist and fingers using tendon or stitches,2165.0,1407.25,78.57,2719.62,19
CDM,25449_1,Revision of wrist joint replacement with removal of existing prosthesis,2519.0,1637.35,78.57,3069.9,19
CDM,25450_1,Stapling or removal of growth plate of forearm bone,1550.9,1008.09,78.57,1821.82,19
CDM,25455_1,Stapling or removal of growth plate of both forearm bones,1676.53,1089.74,78.57,2148.36,19
CDM,25490_1,Stabilization of forearm bone on thumb side with device,1814.4,1179.36,78.57,2124.92,19
CDM,25491_1,Stabilization of forearm bone on small finger side with device,2370.9,1541.09,78.57,2186.78,19
CDM,25492_1,Stabilization of both forearm bones with device,2091.63,1359.56,78.57,2675.76,19
CDM,25500_1,Closed treatment of broken midpart of forearm bone on thumb side,900.0,585.0,78.57,744.82,19
CDM,25505_1,Closed treatment of broken midpart of forearm bone on thumb side with manipulation,1845.0,1199.25,78.57,1352.99,19
CDM,25515T_1,Treatment of broken midpart of forearm bone on thumb side,5361.3,3484.85,78.57,1983.12,19
CDM,25515_1,Treatment of broken midpart of forearm bone on thumb side,2394.0,1556.1,78.57,1983.12,19
CDM,25519IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.95,3.22,1.24,12.78,16
CDM,25519OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.8,6.37,2.45,25.31,16
CDM,2551IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.99,4.54,1.75,18.05,16
CDM,2551OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.1,15.02,5.78,59.66,16
CDM,25520IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.93,3.2,1.23,12.73,16
CDM,25520OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.89,8.38,3.22,33.29,16
CDM,25520_1,Closed treatment of broken midpart of forearm bone on thumb side and dislocated wrist joint,1500.0,975.0,78.57,1589.52,19
CDM,25525_1,Treatment of broken midpart of forearm bone on thumb side and closed treatment of dislocated wrist joint,2204.0,1432.6,78.57,2335.4,19
CDM,25526_1,Treatment of broken midpart of forearm bone on thumb side and dislocated wrist joint with repair of cartilage,3305.4,2148.51,78.57,2821.93,19
CDM,25528IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.47,2.91,1.12,11.54,16
CDM,25528OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.3,6.7,2.58,26.6,16
CDM,25529IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.81,3.13,1.2,12.42,16
CDM,25529OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.5,6.83,2.63,27.12,16
CDM,2552IP _1,UNCLASSIFIED DRUGS,4.5,2.93,1.13,11.62,16
CDM,2552OP _1,UNCLASSIFIED DRUGS,10.51,6.83,2.63,27.14,16
CDM,25530IP _1,PIOGLITAZONE HCL 45 MG TABLET,4.95,3.22,1.24,3.47,11
CDM,25530OP _1,PIOGLITAZONE HCL 45 MG TABLET,10.55,6.86,2.64,7.39,11
CDM,25530_1,Closed treatment of broken midpart of forearm bone on small finger side,945.0,614.25,78.57,704.93,19
CDM,25535_1,Closed treatment of broken midpart of forearm bone on small finger side with manipulation,1530.0,994.5,78.57,1341.77,19
CDM,2553IP _1,UNCLASSIFIED DRUGS,4.88,3.17,1.22,12.6,16
CDM,2553OP _1,UNCLASSIFIED DRUGS,11.98,7.79,3.0,30.94,16
CDM,25545_1,Treatment of broken midpart of forearm bone on small finger side,2553.15,1659.55,78.57,1846.77,19
CDM,25560_1,Closed treatment of broken midpart of both forearm bones,960.0,624.0,78.57,796.77,19
CDM,25565_1,Closed treatment of broken midpart of both forearm bones with manipulation,2010.0,1306.5,78.57,1424.15,19
CDM,25574_1,Treatment of broken midpart of both forearm bones with placement of stabilizing device to bone,1756.7,1141.86,78.57,1995.0,19
CDM,25575_1,Treatment of broken midpart of both forearm bones with placement of stabilizing device on both bones,3580.05,2327.03,78.57,2670.52,19
CDM,25600_1,Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation,1065.0,692.25,78.57,927.14,19
CDM,25605_1,Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation,2190.0,1423.5,78.57,1510.26,19
CDM,25606_1,Placement of stabilizing device for broken forearm bone on thumb side at wrist,2625.6,1706.64,78.57,1961.34,19
CDM,25607_1,"Treatment of broken forearm bone on thumb side of wrist, above wrist, with placement of stabilizing device",2846.1,1849.97,78.57,2179.22,19
CDM,25608_1,Treatment of 2 broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device,3231.9,2100.74,78.57,2444.09,19
CDM,25609_1,Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device,4129.65,2684.27,78.57,3112.08,19
CDM,25622_1,Closed treatment of broken wrist bone near base of thumb,1065.0,692.25,78.57,828.89,19
CDM,25624_1,Closed treatment of broken wrist bone near base of thumb with manipulation,1094.0,711.1,78.57,1365.49,19
CDM,25628_1,Treatment of broken wrist bone located near base of thumb,2861.85,1860.2,78.57,2140.94,19
CDM,25630_1,Closed treatment of other broken wrist bone,1140.0,741.0,78.57,834.89,19
CDM,25635_1,Closed treatment of other broken wrist bone with manipulation,1028.3,668.4,78.57,1298.27,19
CDM,25645_1,Treatment of other broken wrist bones,1497.3,973.25,78.57,1681.43,19
CDM,25650_1,Closed treatment of broken base of forearm bone on small finger side at wrist,1155.0,750.75,78.57,891.56,19
CDM,25651_1,Placement of stabilizing device for broken base of forearm bone on small finger side at wrist,1240.1,806.07,78.57,1441.49,19
CDM,25652_1,Treatment of broken base of forearm bone on small finger side at wrist,2453.85,1595.0,78.57,1845.29,19
CDM,25660_1,Closed treatment of dislocated wrist bones with manipulation,1425.0,926.25,78.57,1228.47,19
CDM,2566IP _1,UNCLASSIFIED DRUGS,4.44,2.89,1.11,11.47,16
CDM,2566OP _1,UNCLASSIFIED DRUGS,28.99,18.84,7.25,74.87,16
CDM,25670_1,Treatment of dislocated wrist bones,1618.1,1051.77,78.57,1796.47,19
CDM,25671_1,Placement of stabilizing device for dislocated forearm bones at wrist,2046.0,1329.9,78.57,1565.17,19
CDM,25675_1,Closed treatment of dislocated forearm bone at wrist with manipulation,1010.0,656.5,78.57,1245.09,19
CDM,25676_1,Treatment of dislocated forearm bones at wrist,1673.7,1087.91,78.57,1865.37,19
CDM,25680_1,Closed treatment of broken and dislocated wrist bones with manipulation,1160.0,754.0,78.57,1540.82,19
CDM,25685_1,Treatment of broken and dislocated wrist bones,1950.9,1268.09,78.57,2173.55,19
CDM,2568IP _1,UNCLASSIFIED DRUGS,5.2,3.38,1.3,13.43,16
CDM,2568OP _1,UNCLASSIFIED DRUGS,16.68,10.84,4.17,43.08,16
CDM,25690_1,Closed treatment of dislocated wrist (lunate) bone with manipulation,1450.0,942.5,78.57,1427.76,19
CDM,25695_1,Treatment of broken wrist (lunate) bone,2677.5,1740.38,78.57,1871.33,19
CDM,25800_1,Complete fusion of wrist joint,2028.6,1318.59,78.57,2173.29,19
CDM,25805_1,Fusion of wrist joint with bone graft,2296.4,1492.66,78.57,2498.89,19
CDM,25810_1,Fusion of wrist joint with graft from hip or other bone,2572.5,1672.13,78.57,2581.08,19
CDM,25820IP _1,IVERMECTIN 3 MG TABLET,29.78,19.36,7.45,20.85,11
CDM,25820_1,Fusion of part of wrist joint,1428.65,928.62,78.57,1843.41,19
CDM,25825_1,Fusion of part of wrist joint with patient-derived bone graft,2572.5,1672.13,78.57,2270.35,19
CDM,25830_1,Fusion of both forearm bones at wrist,2502.2,1626.43,78.57,2802.98,19
CDM,25896IP _1,RABEPRAZOLE 20 MG TABLETDELAYED RELEASE,12.0,7.8,3.0,8.4,11
CDM,25900_1,Amputation of arm through forearm bones,2048.6,1331.59,78.57,2107.76,19
CDM,25905_1,Amputation of arm through forearm bones leaving wound,2052.8,1334.32,78.57,2069.39,19
CDM,25907_1,Revision of scar or wound closure of previous amputation at forearm bones,2016.0,1310.4,78.57,1806.89,19
CDM,25909_1,Re-amputation of remaining arm at forearm bone,2030.7,1319.96,78.57,2022.31,19
CDM,25915_1,Conversion of wrist amputation stump to grasping function,2400.25,1560.16,78.57,3463.59,19
CDM,25920_1,"Removal of tendons, ligaments, and muscles of wrist",2740.5,1781.33,78.57,2073.68,19
CDM,25922_1,Revision of scar or wound closure following removal of hand at wrist joint,1494.2,971.23,78.57,1822.65,19
CDM,25924_1,Re-amputation following removal of hand at wrist joint,1557.6,1012.44,78.57,2013.9,19
CDM,25927_1,Amputation of fingers and part of hand at midhand bones,2072.7,1347.26,78.57,2386.99,19
CDM,25929_1,Revision of scar or wound closure of previous amputation at midhand bones,1497.3,973.25,78.57,1764.33,19
CDM,25931_1,Re-amputation of remaining hand at midhand bones,1671.68,1086.59,78.57,2195.54,19
CDM,25997IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.65,6.92,2.66,27.5,16
CDM,25997OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.16,11.8,4.54,46.9,16
CDM,26010_1,Simple drainage of abscess of finger,500.0,325.0,33.15,830.41,19
CDM,26011T_1,Complicated drainage of abscess in finger,1507.8,980.07,78.57,1159.92,19
CDM,26011_1,Complicated drainage of abscess in finger,1000.0,650.0,78.57,1159.92,19
CDM,26020_1,Drainage of tendon of finger and/or palm,1116.2,725.53,78.57,1477.26,19
CDM,26025_1,Drainage of fluid filled sac in palm,1634.85,1062.65,78.57,1250.53,19
CDM,26030_1,Drainage of multiple fluid filled sacs in palm,1575.0,1023.75,78.57,1453.45,19
CDM,26034_1,Incision of hand or finger bone,1396.5,907.73,78.57,1612.81,19
CDM,26035_1,Release of pressure on tissues of fingers and/or hand,2343.6,1523.34,78.57,2537.55,19
CDM,26037_1,Incision of tissue of hand to release pressure,2261.7,1470.11,78.57,1682.12,19
CDM,26040_1,Release of tissue of palm,1912.5,1243.13,78.57,928.47,19
CDM,26045_1,Partial release of connective tissue of palm,3079.2,2001.48,78.57,1390.96,19
CDM,26055_1,Incision of tendon covering of finger,2225.0,1446.25,78.57,1423.08,19
CDM,26060_1,Incision of finger tendon,682.5,443.63,78.57,765.5,19
CDM,26070_1,"Incision of wrist joint at finger for exploration, fluid drainage, or removal of foreign body",1176.6,764.79,78.57,953.34,19
CDM,26075_1,"Incision of lower finger joint for exploration, fluid drainage, or removal of foreign body",892.5,580.13,78.57,992.0,19
CDM,26080_1,"Incision of finger joint for exploration, fluid drainage, or removal of foreign body",1600.0,1040.0,78.57,1164.1,19
CDM,2608IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.95,4.52,1.74,17.95,16
CDM,2608OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.5,14.63,5.63,58.11,16
CDM,26100_1,Incision of wrist joint at finger with biopsy,837.9,544.64,78.57,991.9,19
CDM,26105_1,Incision of joint at base of finger with biopsy,855.8,556.27,78.57,997.86,19
CDM,26110_1,Incision of finger joint with biopsy,822.2,534.43,78.57,957.3,19
CDM,26111_1,Removal (1.5 centimeters or greater) tissue beneath the skin growth of hand or finger,1018.5,662.03,78.57,1237.12,19
CDM,26113T_1,"Removal of growth of muscle of hand or finger, 1.5 cm or more",2940.6,1911.39,78.57,1627.76,19
CDM,26113_1,"Removal of growth of muscle of hand or finger, 1.5 cm or more",1462.7,950.76,78.57,1627.76,19
CDM,26115_1,Removal (less than 1.5 centimeters) tissue beneath the skin growth of hand or finger,1550.9,1008.09,78.57,1320.4,19
CDM,26116T_1,"Removal of growth of muscle of hand or finger, less than 1.5 cm",2753.1,1789.52,78.57,1563.53,19
CDM,26116_1,"Removal of growth of muscle of hand or finger, less than 1.5 cm",1254.8,815.62,78.57,1563.53,19
CDM,26117_1,"Extensive removal of growth of hand or finger, less than 3.0 cm",2415.0,1569.75,78.57,2204.01,19
CDM,26118_1,"Extensive removal of growth of hand or finger, 3.0 cm or more",2590.4,1683.76,78.57,3118.75,19
CDM,2611IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.3,4.75,1.83,18.85,16
CDM,2611OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.27,10.58,4.07,42.02,16
CDM,26121_1,Removal of connective tissue of palm,2913.75,1893.94,78.57,1775.28,19
CDM,26123_1,"Removal of connective tissue of palm and release of finger, first digit",3252.45,2114.09,78.57,2479.49,19
CDM,26125_1,"Removal of connective tissue of palm and release of finger, each additional digit",783.3,509.15,78.57,806.94,19
CDM,2612IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.95,6.47,2.49,25.7,16
CDM,26130_1,Removal of wrist joint lining,1365.0,887.25,78.57,1364.99,19
CDM,26135_1,Repair of hand joint,1465.8,952.77,78.57,1639.19,19
CDM,26140_1,Removal of joint lining and repair of tendon on the topside of finger,1322.0,859.3,78.57,1501.24,19
CDM,26145_1,"Repair of tendon, finger, and/or palm of hand",1417.5,921.38,78.57,1523.36,19
CDM,2614IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.42,8.07,3.11,32.07,16
CDM,2614OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.36,2.18,0.84,8.68,16
CDM,26160_1,Removal of growth of tendon finger or hand,2300.0,1495.0,78.57,1482.8,19
CDM,2616IP _1,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",19.19,12.47,2.95,57.57,17
CDM,2616OP _1,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",14.28,9.28,2.95,42.84,17
CDM,26170_1,Removal of tendon of palm,1057.4,687.31,78.57,1209.71,19
CDM,26180_1,Removal of tendon of finger,1154.0,750.1,78.57,1325.21,19
CDM,26185_1,Removal of bone at base of thumb or finger,1271.2,826.28,78.57,1628.46,19
CDM,26200_1,Removal of cyst or growth from hand bone,1184.4,769.86,78.57,1336.12,19
CDM,26205_1,Removal of cyst or growth from hand bone with self bone graft,1595.0,1036.75,78.57,1781.85,19
CDM,26210_1,Removal of cyst or growth of finger bone,1147.7,746.01,78.57,1316.98,19
CDM,26215_1,Removal of cyst or growth of finger bone with self bone graft,1466.9,953.49,78.57,1667.75,19
CDM,26224IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.29,3.44,1.32,13.66,16
CDM,26224OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.3,16.45,6.33,65.34,16
CDM,26225IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.53,10.09,3.88,40.11,16
CDM,26225OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.95,14.92,5.74,59.27,16
CDM,26226IP _1,UNCLASSIFIED DRUGS,158.93,103.3,39.73,410.44,16
CDM,26226OP _1,UNCLASSIFIED DRUGS,72.53,47.14,18.13,187.31,16
CDM,2622IP _1,UNCLASSIFIED DRUGS,183.6,119.34,45.9,474.15,16
CDM,2622OP _1,UNCLASSIFIED DRUGS,1555.91,1011.34,388.98,4018.14,16
CDM,26230_1,Partial removal of hand bone,1327.2,862.68,78.57,1483.73,19
CDM,26235_1,Partial removal of finger bone nearest hand or middle of finger,1304.1,847.67,78.57,1464.57,19
CDM,26236_1,Partial removal of finger bone at end of finger,1155.0,750.75,78.57,1309.44,19
CDM,2623IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.57,10.12,3.89,40.21,16
CDM,2623OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.47,17.86,6.87,70.94,16
CDM,2624IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.88,7.72,2.97,30.68,16
CDM,2624OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.32,8.01,3.08,31.82,16
CDM,26250_1,Extensive removal of growth of hand bone,1545.6,1004.64,78.57,3161.63,19
CDM,2625OP _1,DOXYCYCLINE HYCLATE 100 MG TAB,35.5,23.08,8.88,24.85,11
CDM,26260_1,Extensive removal of growth of finger,1445.9,939.84,78.57,2368.09,19
CDM,26262_1,Extensive removal of growth at end of finger bone,1456.58,946.78,78.57,1867.24,19
CDM,26320_1,Removal of implant from finger or hand,1140.0,741.0,78.57,1032.61,19
CDM,26336IP _1,"SIROLIMUS, ORAL, 1 MG",34.12,22.18,1.03,88.11,17
CDM,26340_1,Manipulation of finger joint under anesthesia,799.1,519.42,78.57,1003.82,19
CDM,26341_1,Manipulation of finger for connective tissue release following enzyme injection,227.93,148.15,66.71,280.49,19
CDM,26350_1,Repair of finger tendon of under side of hand other than upper most part of palm and fingers,1960.0,1274.0,78.57,2077.13,19
CDM,26352_1,Repair of finger tendon on under side of hand with a graft not in zone 2,2183.0,1418.95,78.57,2374.37,19
CDM,26356_1,Primary repair of finger tendon on underside of the hand without a graft in zone 2,2780.0,1807.0,78.57,2360.1,19
CDM,26357_1,Secondary repair of finger tendon on underside of hand without a graft in zone 2,2415.0,1569.75,78.57,2624.22,19
CDM,26358_1,Secondary repair of finger tendon on underside of hand with a graft in zone 2,2730.0,1774.5,78.57,2902.9,19
CDM,26370_1,Repair of tendon deep in underside of finger,2114.7,1374.56,78.57,2207.27,19
CDM,26372_1,Secondary repair of tendon deep in underside of finger with a graft,2402.4,1561.56,78.57,2571.34,19
CDM,26373_1,Secondary repair of tendon deep in underside of finger,2268.0,1474.2,78.57,2467.68,19
CDM,26390_1,Repair of tendon on underside of finger or hand with implanted rod,2221.8,1444.17,78.57,2435.46,19
CDM,26392_1,Removal of synthetic rod and insertion of tendon graft in hand or finger,2588.3,1682.4,78.57,2831.93,19
CDM,26410_1,Repair of tendon on top of hand,1740.0,1131.0,78.57,1645.14,19
CDM,26412_1,Repair of tendon on top of hand with graft,1856.4,1206.66,78.57,1982.9,19
CDM,26415_1,Removal of tendon from top of hand or finger with rod insertion,1913.1,1243.52,78.57,2368.78,19
CDM,26416_1,Removal of rod with tendon graft at top of hand or finger,1984.1,1289.67,78.57,2578.03,19
CDM,26418T_1,Repair of tendon on top side of finger,1600.35,1040.23,78.57,1685.39,19
CDM,26418_1,Repair of tendon on top side of finger,1560.0,1014.0,78.57,1685.39,19
CDM,26420_1,Repair of tendon of top side of finger with graft,1932.0,1255.8,78.57,2063.64,19
CDM,26426_1,Secondary repair of tendon of top of finger using tissue,1827.0,1187.55,78.57,1487.85,19
CDM,26428_1,Secondary repair of tendon of upper side of finger with graft,2073.8,1347.97,78.57,2199.74,19
CDM,26431OP _1,"INJECTION, IMIGLUCERASE, 10 UNITS",3902.77,2536.8,45.82,11535.65,19
CDM,26432_1,Closed treatment of tendon of upper side of finger,1337.7,869.51,78.57,1449.95,19
CDM,26433_1,Repair of tendon on upper side of end of finger,1453.2,944.58,78.57,1542.21,19
CDM,26434_1,Repair of tendon on upper side of end of finger with graft,1692.6,1100.19,78.57,1882.81,19
CDM,26437_1,Repair of tendon on upper side of hand,1638.0,1064.7,78.57,1819.01,19
CDM,26440_1,Release of tendon of palm or finger,1743.0,1132.95,78.57,1805.97,19
CDM,26442_1,Release of tendon of palm and finger,2481.2,1612.78,78.57,2816.34,19
CDM,26445_1,Release of tendon of top of hand or finger,1647.5,1070.88,78.57,1675.41,19
CDM,26449_1,Release of tendon extending from finger to forearm,2199.8,1429.87,78.57,2065.18,19
CDM,26450_1,Incision of tendon of palm,1076.3,699.6,78.57,1220.75,19
CDM,26455_1,Incision of tendon of finger,1059.5,688.68,78.57,1211.78,19
CDM,26460_1,Incision of tendon at top of hand or finger,1024.8,666.12,78.57,1187.7,19
CDM,26471T_1,Suture of tendon to first joint of finger,1691.0,1099.15,78.57,1800.26,19
CDM,26471_1,Suture of tendon to first joint of finger,1621.2,1053.78,78.57,1800.26,19
CDM,26474_1,Suture of tendon to joint of finger near top of finger,1575.0,1023.75,78.57,1750.25,19
CDM,26476_1,Lengthening of tendon on upper side of hand or finger,1380.0,897.0,78.57,1726.92,19
CDM,26477_1,Shortening of tendon of upper side of hand or finger,1527.8,993.07,78.57,1696.1,19
CDM,26478_1,Lengthening of tendon of palm side of finger or hand,1660.1,1079.07,78.57,1809.24,19
CDM,26479_1,Shortening of tendon of palm side of hand or finger,1411.5,917.48,78.57,1820.71,19
CDM,26480_1,Transfer of tendon to back of hand,2415.0,1569.75,78.57,2196.55,19
CDM,26483_1,Transfer of tendon to back of hand with graft,2968.0,1929.2,78.57,2459.45,19
CDM,26485_1,Transfer of tendon to palm,2761.5,1794.98,78.57,2352.8,19
CDM,26489_1,Transfer of tendon to palm with graft,3451.0,2243.15,78.57,2719.75,19
CDM,26490_1,Transfer of tendon from ring finger to thumb,2078.0,1350.7,78.57,2317.88,19
CDM,26492_1,Transfer of tendon to thumb with graft,2302.7,1496.76,78.57,2574.04,19
CDM,26494_1,Transfer of tendon in palm to thumb,2152.5,1399.13,78.57,2325.69,19
CDM,26496_1,"Transfer of tendon to thumb, palm, or wrist",2310.0,1501.5,78.57,2514.14,19
CDM,26497_1,Transfer of tendon to ring and small fingers,2273.3,1477.65,78.57,2520.36,19
CDM,26498_1,"Transfer of tendons of hand, all 4 fingers",3037.7,1974.51,78.57,3335.84,19
CDM,26499_1,Correction of claw finger,2598.8,1689.22,78.57,2415.65,19
CDM,26500_1,Repair of ligament surrounding finger tendon,1660.1,1079.07,78.57,1810.33,19
CDM,26502_1,Repair of ligament surrounding finger tendon with graft,1868.0,1214.2,78.57,2066.42,19
CDM,26508_1,Release of muscles of palm near thumb,1669.5,1085.18,78.57,1846.92,19
CDM,26510_1,Transfer of finger tendon,1582.4,1028.56,78.57,1738.99,19
CDM,26516_1,"Repair of joint capsule of hand and palm, 1 finger",1861.7,1210.11,78.57,2051.18,19
CDM,26517_1,"Repair of joint capsule of hand and palm, 2 fingers",2185.1,1420.32,78.57,2398.25,19
CDM,26518_1,"Repair of joint capsule of hand and palm, 3-4 fingers",3298.05,2143.73,78.57,2432.68,19
CDM,26520_1,Incision or removal of joint capsule between hand and finger,1810.2,1176.63,78.57,1887.84,19
CDM,26525_1,Repair of joint capsule of finger,1823.9,1185.54,78.57,1897.54,19
CDM,26530_1,Repair of joint connecting hand and finger bones with implant,1410.2,916.63,78.57,1595.93,19
CDM,26531_1,Repair of joint between hand and finger bones with prosthesis,1645.4,1069.51,78.57,1860.03,19
CDM,26535_1,Replacement of finger joint,1260.0,819.0,78.57,1280.64,19
CDM,26536_1,Replacement of finger joint with prosthesis,1752.5,1139.13,78.57,2084.91,19
CDM,26540_1,Repair of ligament of finger or hand and finger joint,1738.8,1130.22,78.57,1919.61,19
CDM,26541_1,Repair of ligament of finger or hand to finger joint with graft,2144.1,1393.67,78.57,2336.51,19
CDM,26542_1,Repair of ligament of hand to finger joint with local tissue,1995.0,1296.75,78.57,1984.13,19
CDM,26545_1,Repair of ligament of finger joint with graft,1845.9,1199.84,78.57,2055.86,19
CDM,26546IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",101.8,66.17,25.45,262.9,16
CDM,26546OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",65.46,42.55,16.37,169.05,16
CDM,26546_1,Repair of nonhealed hand or finger bone,3843.0,2497.95,78.57,2913.61,19
CDM,26547IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.7,6.31,2.43,25.05,16
CDM,26547OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.55,14.66,5.64,58.24,16
CDM,26548_1,Repair of joint between finger and palm,2022.3,1314.5,78.57,2221.33,19
CDM,2654IP _1,"INJECTION, DROPERIDOL, UP TO 5 MG",47.23,30.7,7.61,121.97,17
CDM,2654OP _1,"INJECTION, DROPERIDOL, UP TO 5 MG",21.09,13.71,5.27,54.46,17
CDM,26550IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.33,3.46,1.33,13.76,16
CDM,26550OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.19,6.62,2.55,26.32,16
CDM,26550_1,Surgical creation of thumb,4012.1,2607.87,78.57,4801.48,19
CDM,26551IP _1,AROMASIN 25 MG TABLET,243.15,158.05,60.79,170.21,11
CDM,26551_1,Transfer of great toe to hand,7786.08,5060.95,78.57,9688.46,19
CDM,26553_1,Transfer of toe to hand,6662.78,4330.81,78.57,9623.28,19
CDM,26554_1,Transfer of 2 toes to hand,7801.63,5071.06,78.57,11230.35,19
CDM,26555_1,Transfer of finger,3642.5,2367.63,78.57,4000.02,19
CDM,26556_1,Transfer of toe and joint to finger,7850.53,5102.84,78.57,10002.28,19
CDM,26560_1,Repair of webbed finger with skin flaps,1575.0,1023.75,78.57,1711.11,19
CDM,26561_1,Repair of webbed finger with skin flaps and grafts,2325.8,1511.77,78.57,2752.12,19
CDM,26562_1,Complex repair of each webbed finger,3385.2,2200.38,78.57,3920.02,19
CDM,26565_1,Incision or removal of hand bone,1796.6,1167.79,78.57,1974.66,19
CDM,26567_1,Partial removal of finger bone,1807.1,1174.62,78.57,1990.14,19
CDM,26568_1,Lengthening of hand or finger bone,2369.9,1540.44,78.57,2616.86,19
CDM,26580_1,Repair of deformed hand,3746.4,2435.16,78.57,4420.84,19
CDM,26587_1,Removal of extra finger,2579.9,1676.94,78.57,3075.2,19
CDM,26590_1,Repair of enlarged finger,3466.1,2252.97,78.57,4110.45,19
CDM,26591_1,Repair of hand muscle,1235.9,803.34,78.57,1284.16,19
CDM,26593_1,Release of hand muscle,1580.3,1027.2,78.57,1754.32,19
CDM,26596_1,Removal of constricting ring of skin of finger,1934.1,1257.17,78.57,2221.91,19
CDM,26600_1,Closed treatment of broken hand bone,650.0,422.5,78.57,825.48,19
CDM,26605_1,Closed treatment of broken hand bone with manipulation,840.0,546.0,78.57,919.64,19
CDM,26607_1,Closed treatment of broken hand bone with manipulation and placement of external stabilizing device,1170.0,760.5,78.57,1384.87,19
CDM,26608_1,Treatment of broken finger bone with stabilizing device accessed through skin,1236.9,803.99,78.57,1418.51,19
CDM,26615_1,Treatment of broken midhand bone,1448.0,941.2,78.57,1706.45,19
CDM,26641_1,Closed treatment of dislocated thumb at wrist with manipulation,910.0,591.5,78.57,1076.49,19
CDM,26645_1,Closed treatment of broken thumb at wrist with manipulation,960.0,624.0,78.57,1159.47,19
CDM,26650_1,Placement of stabilizing device for broken thumb at wrist with manipulation,1850.7,1202.96,78.57,1419.22,19
CDM,26665_1,Treatment of broken thumb at wrist,2060.0,1339.0,78.57,1858.12,19
CDM,26670_1,Closed treatment of dislocated hand bone at wrist joint with manipulation,820.0,533.0,78.57,959.68,19
CDM,26675_1,Closed treatment of dislocated hand bone at wrist joint with manipulation under anesthesia,1113.0,723.45,78.57,1236.93,19
CDM,26676_1,Placement of stabilizing device for dislocated hand bone at wrist joint with manipulation,1295.7,842.21,78.57,1494.51,19
CDM,26685_1,Treatment of broken hand bone at wrist,1475.3,958.95,78.57,1704.66,19
CDM,26686_1,Complicated treatment of dislocated midhand bone at wrist,1700.0,1105.0,78.57,1840.56,19
CDM,26700_1,Closed treatment of dislocated hand joint at base of finger with manipulation,800.0,520.0,78.57,911.04,19
CDM,26703IP _1,CARBIDOPA 25 MG TABLET,27.8,18.07,6.95,19.46,11
CDM,26705_1,Closed treatment of dislocated hand joint at base of finger with manipulation under anesthesia,1021.7,664.11,78.57,1132.48,19
CDM,26706_1,Placement of stabilizing device for dislocated hand joint at base of finger with manipulation,1160.3,754.2,78.57,1309.94,19
CDM,26715_1,Treatment of dislocated hand joint at base of finger,1448.0,941.2,78.57,1700.42,19
CDM,26720_1,Closed treatment of broken finger or thumb at midportion or part near hand,500.0,325.0,78.57,548.23,19
CDM,26725_1,Closed treatment of broken finger or thumb at midportion or part near hand with manipulation,830.0,539.5,78.57,937.7,19
CDM,26727_1,Placement of stabilizing device for broken finger or thumb at midportion or part near hand with manipulation,1215.9,790.34,78.57,1396.98,19
CDM,26735_1,Treatment of broken finger at midportion or part near hand,1508.9,980.79,78.57,1767.12,19
CDM,26740_1,Closed treatment of broken finger or hand at base of finger,540.0,351.0,78.57,642.3,19
CDM,26742_1,Closed treatment of broken finger or hand at base of finger with manipulation,850.0,552.5,78.57,1034.92,19
CDM,26746_1,Treatment of broken finger or hand at base of finger,1866.9,1213.49,78.57,2204.55,19
CDM,26750_1,Closed treatment of broken end of finger or thumb,440.0,286.0,55.57,550.75,19
CDM,26755_1,Closed treatment of broken end of finger or thumb with manipulation,740.0,481.0,64.83,844.8,19
CDM,26756_1,Placement of stabilizing device for broken end of finger or thumb,1071.0,696.15,78.57,1241.32,19
CDM,26765_1,Treatment of broken end of finger or thumb,1520.0,988.0,78.57,1487.12,19
CDM,26770_1,Closed treatment of dislocated finger joint with manipulation,660.0,429.0,68.24,763.37,19
CDM,26775_1,Closed treatment of dislocated finger joint with manipulation under anesthesia,954.5,620.43,78.57,1087.23,19
CDM,26776_1,Placement of stabilizing device for dislocated finger joint with manipulation,1140.3,741.2,78.57,1314.87,19
CDM,26785_1,Treatment of dislocated finger joint,1345.1,874.32,78.57,1623.24,19
CDM,26816IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.37,2.84,1.09,11.29,16
CDM,26816OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.58,19.23,7.4,76.39,16
CDM,26817IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.38,2.85,1.1,11.31,16
CDM,26817OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.59,6.23,2.4,24.77,16
CDM,26818IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.14,3.34,1.29,13.27,16
CDM,26820_1,Fusion of thumb,2080.1,1352.07,78.57,2288.7,19
CDM,26841_1,Fusion of thumb at wrist,1922.6,1249.69,78.57,2121.89,19
CDM,26842_1,Fusion of thumb at wrist with bone graft,1794.75,1166.59,78.57,2287.86,19
CDM,26843_1,Fusion of hand joint,1945.7,1264.71,78.57,2148.17,19
CDM,26844_1,Fusion of finger at hand joint with self bone graft,2163.0,1405.95,78.57,2383.79,19
CDM,26850_1,Fusion of joint between finger and hand,1836.5,1193.73,78.57,2021.58,19
CDM,26852_1,Fusion of finger joint at hand with self bone graft,2093.7,1360.91,78.57,2324.9,19
CDM,26854IP _1,MOXIFLOXACIN HCL 400 MG TABLET,194.1,126.17,48.53,135.87,11
CDM,26860_1,"Fusion of finger joint, initial joint",1483.7,964.41,78.57,1648.74,19
CDM,26861_1,"Fusion of finger joint, each additional joint",472.5,307.13,78.34,305.66,19
CDM,26862_1,"Fusion of finger joint with self bone graft, initial joint",1928.9,1253.79,78.57,2122.62,19
CDM,26863_1,"Fusion of finger joint with self bone graft, each additional joint",651.0,423.15,78.57,677.41,19
CDM,26910_1,Amputation of finger or thumb,2090.0,1358.5,78.57,2111.72,19
CDM,26951_1,Amputation of finger or thumb with direct closure,2600.0,1690.0,78.57,1904.76,19
CDM,26952T_1,Amputation of finger or thumb with tissue flap,2147.3,1395.75,78.57,1882.26,19
CDM,26952_1,Amputation of finger or thumb with tissue flap,1930.0,1254.5,78.57,1882.26,19
CDM,26965IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.6,3.64,1.4,14.46,16
CDM,26965OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.23,3.4,1.31,13.51,16
CDM,26966IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.1,7.87,3.03,31.25,16
CDM,26966OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.0,7.15,2.75,28.41,16
CDM,26967IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.77,5.05,1.94,20.07,16
CDM,26967OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.26,14.47,5.57,57.49,16
CDM,26990_1,Drainage of deep abscess or blood accumulation of pelvis or hip near joint,2446.5,1590.23,78.57,1881.17,19
CDM,26991_1,Drainage of infected fluid-filled sac near pelvis or hip joint,1816.5,1180.73,60.6,1687.81,19
CDM,26992_1,Incision of pelvis and/or hip joint bone,2579.9,1676.94,78.57,2872.19,19
CDM,27000_1,Incision of hip tendon through skin,1188.6,772.59,78.57,1224.04,19
CDM,27001_1,Incision of hip tendon,1435.4,933.01,78.57,1592.18,19
CDM,27003_1,Incision of hip tendon with removal of nerve,1551.9,1008.74,78.57,1760.24,19
CDM,27005_1,Incision of tendon of hip,1948.8,1266.72,78.57,2144.94,19
CDM,27006_1,Incision of tendon of hip (abductor and/or extensor),1970.9,1281.09,78.57,2149.99,19
CDM,27025_1,Incision of connective tissue of hip or thigh,3603.6,2342.34,78.57,2713.35,19
CDM,27027_1,Incision of connective tissue on side of pelvis or buttock,2354.1,1530.17,78.57,2631.63,19
CDM,27030_1,Incision and drainage of hip joint,3827.25,2487.71,78.57,2774.05,19
CDM,27033_1,"Incision of hip joint for exploration, fluid drainage, or removal of foreign body",3962.7,2575.76,78.57,2878.67,19
CDM,27035_1,Removal of hip or pelvic nerve,2993.6,1945.84,78.57,3543.29,19
CDM,27036_1,Repair of hip joint capsule,2704.8,1758.12,78.57,2994.52,19
CDM,27038IP _1,UNCLASSIFIED DRUGS,208.04,135.23,52.01,537.26,16
CDM,27038OP _1,UNCLASSIFIED DRUGS,147.08,95.6,36.77,379.83,16
CDM,27040_1,Biopsy of surface tissue of pelvis and hip,891.5,579.48,60.16,813.93,19
CDM,27041_1,Biopsy of deep tissue of pelvis and hip,1860.6,1209.39,78.57,2070.73,19
CDM,27043T_1,"Removal of growth under skin of pelvis and hip, 3.0 cm or more",1121.4,728.91,78.57,1376.15,19
CDM,27043_1,"Removal of growth under skin of pelvis and hip, 3.0 cm or more",1260.0,819.0,78.57,1376.15,19
CDM,27045T_1,"Removal of growth of muscle of pelvis and hip, 5.0 cm or more",2356.2,1531.53,78.57,2187.2,19
CDM,27045_1,"Removal of growth of muscle of pelvis and hip, 5.0 cm or more",2992.5,1945.13,78.57,2187.2,19
CDM,27047IP _1,UNCLASSIFIED DRUGS,2535.39,1648.0,633.85,6547.64,16
CDM,27047_1,"Removal of growth under skin of pelvis and hip, less than 3.0 cm",1585.5,1030.58,78.57,1168.29,19
CDM,27048_1,"Removal of growth of soft tissue of pelvis and hip, less than 5.0 cm",1655.9,1076.34,78.57,1798.03,19
CDM,27049IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",41.26,26.82,10.32,106.55,16
CDM,27049OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.31,14.5,5.58,57.62,16
CDM,27049_1,"Extensive removal of growth of pelvis and hip, less than 5.0 cm",2714.3,1764.3,78.57,3947.61,19
CDM,27050_1,Biopsy of joint between lower spine and pelvis,1077.3,700.25,78.57,1190.42,19
CDM,27052_1,Biopsy of hip joint,1226.4,797.16,78.57,1708.51,19
CDM,27054_1,Removal of hip joint lining,2587.2,1681.68,78.57,2030.97,19
CDM,27057_1,Incision of tissue on side of pelvic muscle compartment with removal of muscle,2390.9,1554.09,78.57,2994.52,19
CDM,27059_1,"Extensive removal of growth of pelvis and hip, 5.0 cm or more",7347.45,4775.84,78.57,5389.05,19
CDM,27060_1,Removal of fluid-filled sac (bursa) of pelvis,1147.7,746.01,78.57,1374.14,19
CDM,27062_1,Removal of fluid-filled sac (bursa) or calcium deposit of pelvis,1189.7,773.31,78.57,1346.78,19
CDM,27065_1,"Removal of cyst or growth of hip, pubic, or head of thigh bone with self bone graft",1330.4,864.76,78.57,1537.04,19
CDM,27066_1,"Removal of deep cyst or growth of hip, pubic, or head of thigh bone with self bone graft",3246.15,2110.0,78.57,2382.57,19
CDM,27067_1,"Removal of cyst or growth of hip, pubic, or head of thigh bone with self bone graft obtained through different incision",2769.9,1800.44,78.57,3061.21,19
CDM,27070_1,"Partial removal of superficial cyst or growth of hip, pubic, or head of thigh bone with self bone graft",2498.0,1623.7,78.57,2539.75,19
CDM,27071_1,"Partial removal of deep cyst or growth of hip, pubic, or head of thigh bone with self bone graft",3975.3,2583.95,78.57,2742.9,19
CDM,27075_1,Extensive removal of growth of hip bone,6101.6,3966.04,78.57,6206.37,19
CDM,27076_1,"Extensive removal of growth of upper pelvic bone including hip socket, base of pelvic bone, or both pubic bones",5890.0,3828.5,78.57,7511.57,19
CDM,27077_1,Extensive removal of growth of side of pelvic bone,7309.1,4750.92,78.57,8388.35,19
CDM,27078_1,Extensive removal of growth of base of pelvis and upper end of thigh bone,2741.6,1782.04,78.57,6119.36,19
CDM,27080_1,Removal of tailbone,1319.9,857.94,78.57,1501.69,19
CDM,27086_1,"Removal of foreign body in tissue of pelvis or hip, accessed beneath the skin",700.0,455.0,60.86,744.39,19
CDM,27087_1,Removal of foreign body in tissue or muscle of pelvis or hip,1879.5,1221.68,78.57,1819.42,19
CDM,27090_1,Removal of hip prosthesis,2235.5,1453.08,78.57,2459.86,19
CDM,27091_1,"Removal of hip prosthesis, complicated",7686.0,4995.9,78.57,4730.16,19
CDM,27093_1,Injection of contrast for imaging of hip joint,1773.45,1152.74,31.38,565.32,19
CDM,27094IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.49,4.22,1.62,16.76,16
CDM,27094OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.67,13.44,5.17,53.38,16
CDM,27095_1,Injection of contrast for imaging of hip under anesthesia,1615.95,1050.37,64.18,753.44,19
CDM,27096IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",136.85,88.95,34.21,353.42,16
CDM,27096OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",115.57,75.12,28.89,298.46,16
CDM,27096T_1,Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance,548.1,356.27,69.29,392.56,19
CDM,27096_1,Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance,1093.5,710.78,69.29,392.56,19
CDM,27097_1,Release of upper hamstring muscle,1780.8,1157.52,78.57,2016.72,19
CDM,27098_1,Transfer of tendon to pelvic bone,1507.83,980.09,78.57,2053.49,19
CDM,27100_1,Transfer of abdominal muscle to thigh bone at hip joint,2197.7,1428.51,78.57,2435.65,19
CDM,27103IP _1,UNCLASSIFIED DRUGS,35.56,23.11,8.89,91.83,16
CDM,27103OP _1,UNCLASSIFIED DRUGS,14.01,9.11,3.5,36.18,16
CDM,27105_1,Transfer of muscle to hip,2312.1,1502.87,78.57,2561.88,19
CDM,27110_1,Transfer of muscle to thigh bone at hip joint,2576.7,1674.86,78.57,2861.72,19
CDM,27111_1,Transfer of muscle to upper thigh bone,2475.9,1609.34,78.57,2664.0,19
CDM,27120_1,Repair of hip socket,3497.6,2273.44,78.57,3839.59,19
CDM,27122_1,Repair of hip socket with removal of head of thigh bone,4803.75,3122.44,78.57,3260.18,19
CDM,27125_1,Partial replacement of thigh bone at hip joint with prosthesis,3458.7,2248.16,78.57,3356.74,19
CDM,27130_1,Replacement of thigh bone and hip joint with prosthesis,6821.4,4433.91,78.57,3851.59,19
CDM,27132_1,Total hip replacement after previous hip surgery,8454.6,5495.49,78.57,4963.29,19
CDM,27134_1,Revision of thigh bone and hip joint prosthesis,14142.0,9192.3,78.57,5675.58,19
CDM,27137_1,Revision of hip socket part of hip prosthesis,9623.25,6255.11,78.57,4361.92,19
CDM,27138_1,Revision of thigh bone prosthesis,9623.25,6255.11,78.57,4533.07,19
CDM,27140_1,Repositioning of part of head of thigh bone,2423.4,1575.21,78.57,2646.76,19
CDM,27146_1,Incision or partial removal of hip bone,5143.95,3343.57,78.57,3781.04,19
CDM,27147_1,Incision or partial removal of hip bone and repair of dislocated hip joint,3993.2,2595.58,78.57,4331.08,19
CDM,27151_1,Reshaping of part of hip bone,4172.7,2712.26,78.57,4705.83,19
CDM,27156_1,Incision and reshaping of part of hip and thigh bones and repair of dislocated hip joint,4664.1,3031.67,78.57,5050.8,19
CDM,27158_1,Incision or partial removal of both sides of pelvic bones,3756.9,2441.99,78.57,4123.31,19
CDM,27161_1,Incision or partial removal of neck of thigh bone,3310.7,2151.96,78.57,3596.85,19
CDM,27165_1,Incision or partial removal of thigh bone below neck with placement of stabilizing device or cast,5561.4,3614.91,78.57,4057.75,19
CDM,27170_1,Bone graft to upper thigh bone,4828.95,3138.82,78.57,3471.63,19
CDM,27175_1,Treatment of slipped growth plate at upper thigh bone,1534.1,997.17,78.57,1971.08,19
CDM,27176_1,Treatment of growth plate at top of thigh with pins inserted through skin',2754.2,1790.23,78.57,2714.8,19
CDM,27177_1,Treatment of slipped growth plate at upper end of thigh bone with pinning or bone graft,3003.0,1951.95,78.57,3260.28,19
CDM,27178_1,Treatment of slipped growth plate at upper thigh bone with manipulation and pinning,2921.1,1898.72,78.57,2719.88,19
CDM,27179_1,Repair of growth plate in head of thigh bone,2622.9,1704.89,78.57,2878.86,19
CDM,27181_1,Repair of growth plate in head of thigh bone with placement of stabilizing device,3107.0,2019.55,78.57,3291.15,19
CDM,27182IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.47,7.46,2.87,29.62,16
CDM,27185_1,Removal of growth plate of upper thigh bone,1801.8,1171.17,78.57,2123.86,19
CDM,27187_1,Stabilization of upper thigh bone with device,4028.85,2618.75,78.57,2940.47,19
CDM,27197_1,Closed treatment of broken and/or dislocated pelvis and/or sacrum,275.0,178.75,78.57,367.63,19
CDM,27198_1,Closed treatment of broken and/or dislocated pelvis and/or sacrum with manipulation,697.5,453.38,78.57,899.34,19
CDM,27200_1,Closed treatment of broken tailbone,469.4,305.11,78.57,558.03,19
CDM,27202_1,Treatment of broken tailbone,1259.33,818.56,78.57,1564.34,19
CDM,27215_1,Treatment of broken bones on side of pelvis,1910.0,1241.5,78.57,1889.49,15
CDM,27216_1,Placement of stabilizing device for broken and/or dislocated bone on side of pelvis,4010.0,2606.5,78.57,2799.52,15
CDM,27217_1,Treatment of broken and/or dislocated front of pelvis,3202.5,2081.63,78.57,2629.91,15
CDM,27218_1,Treatment of broken and/or dislocated back of pelvis,4586.4,2981.16,78.57,3614.41,15
CDM,27220_1,Closed treatment of broken hip socket,2075.85,1349.3,78.57,1253.69,19
CDM,27222_1,Closed treatment of broken hip socket with manipulation,3961.2,2574.78,78.57,2881.1,19
CDM,27226_1,Treatment of broken hip socket with placement of stabilizing device,5206.95,3384.52,78.57,3129.12,19
CDM,27227_1,Treatment of broken bones of front or back column of hip socket or across hip socket with placement of stabilizing device,10010.7,6506.96,78.57,4916.72,19
CDM,27228_1,Treatment of broken bones of front and back column or wall of hip socket with placement of stabilizing device,7829.4,5089.11,78.57,5576.65,19
CDM,27230_1,Closed treatment of broken upper thigh bone,1320.0,858.0,78.57,1399.79,19
CDM,27232_1,Closed treatment of broken upper thigh bone with manipulation,2100.0,1365.0,78.57,2208.32,19
CDM,27234IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.2,2.73,1.05,10.85,16
CDM,27235_1,Placement of stabilizing device for upper end of broken thigh bone,4035.15,2622.85,78.57,2689.06,19
CDM,27236_1,Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement,6123.6,3980.34,78.57,3540.82,19
CDM,27238_1,Closed treatment of broken below neck of thigh bone,1190.7,773.96,78.57,1366.85,19
CDM,27240_1,Closed treatment of broken below neck of thigh bone with manipulation,2576.7,1674.86,78.57,2834.84,19
CDM,27244_1,Treatment of broken neck of thigh bone with plate/screw implant,4981.8,3238.17,78.57,3644.23,19
CDM,27245_1,Treatment of broken neck of thigh bone with bone implant,5336.1,3468.47,78.57,3642.8,19
CDM,27246_1,Closed treatment of broken below head of thigh bone,1590.75,1033.99,78.57,1142.28,19
CDM,27248_1,Treatment of broken head of thigh bone with placement of stabilizing device,3042.9,1977.89,78.57,4515.78,19
CDM,27250_1,Closed treatment of dislocated hip,2145.0,1394.25,78.57,534.47,19
CDM,27252_1,Closed treatment of dislocated hip under anesthesia,2940.0,1911.0,78.57,2241.44,19
CDM,27253IP _1,CEVIMELINE HCL 30 MG CAPSULE,9.85,6.4,2.46,6.9,11
CDM,27253_1,Treatment of dislocated hip,3830.4,2489.76,78.57,2790.71,19
CDM,27254_1,Treatment of traumatic broken thigh and hip and dislocated hip,5181.75,3368.14,78.57,3746.35,19
CDM,27256_1,Closed Treatment of spontaneous dislocated hip,790.7,513.96,78.57,739.46,19
CDM,27257_1,Treatment of spontaneous dislocated hip under anesthesia,1921.5,1248.98,78.57,1072.79,19
CDM,27258_1,Treatment of spontaneous dislocated hip,2997.8,1948.57,78.57,3285.13,19
CDM,27259_1,Treatment of spontaneous dislocated hip with shortening of thigh bone,4210.5,2736.83,78.57,4589.96,19
CDM,27265_1,Closed treatment of dislocated hip prosthesis,1680.0,1092.0,78.57,1199.51,19
CDM,27266_1,Closed treatment of dislocated hip prosthesis under anesthesia,2340.0,1521.0,78.57,1720.79,19
CDM,27267_1,Closed treatment of broken head of thigh bone,1647.45,1070.84,78.57,1285.2,19
CDM,27268_1,Closed treatment of broken head of thigh bone with manipulation,1364.0,886.6,78.57,1593.78,19
CDM,27269_1,Treatment of broken head of thigh bone,4953.45,3219.74,78.57,3680.49,19
CDM,27275_1,Manipulation of hip joint under general anesthesia,477.8,310.57,78.57,544.2,19
CDM,27279_1,Fusion of pelvic joint using imaging guidance,2083.8,1354.47,78.57,2082.75,19
CDM,27280_1,"Fusion of sacroiliac joint between spine and pelvis with bone graft, open procedure",2765.7,1797.71,78.57,3930.4,19
CDM,27282_1,Fusion of joint between pubic bones,2351.0,1528.15,78.57,2534.71,19
CDM,27284_1,Fusion of hip joint,4242.0,2757.3,78.57,4754.38,19
CDM,27286_1,Fusion of hip joint with incision or partial removal of thigh bone below neck,3808.78,2475.71,78.57,4887.99,19
CDM,27290_1,Amputation of pelvic structures,4523.4,2940.21,78.57,4808.92,19
CDM,27295_1,Removal of hip bone and leg at hip joint,5512.5,3583.13,78.57,3720.27,19
CDM,27301_1,Drainage of deep abscess or blood accumulation of thigh or knee,2839.8,1845.87,78.57,1597.15,19
CDM,27303_1,Incision of bone of thigh or knee,3017.7,1961.51,78.57,1894.53,19
CDM,27305_1,Incision of connective tissue between thigh and knee,1240.1,806.07,78.57,1423.2,19
CDM,27306_1,Incision of tendon of thigh or hamstring muscle,997.5,648.38,78.57,1040.67,19
CDM,27307_1,Incision of multiple tendons of thigh or hamstring muscle,1232.7,801.26,78.57,1305.46,19
CDM,27310_1,"Incision of knee joint for exploration, fluid drainage, or removal of foreign body",2913.75,1893.94,78.57,2163.49,19
CDM,27323_1,Biopsy of surface tissue of thigh or knee,1050.6,682.89,67.38,657.09,19
CDM,27324_1,Biopsy of deep tissue of thigh or knee,1858.5,1208.03,78.57,1183.02,19
CDM,27325_1,Removal of nerve of hamstring muscle,1167.23,758.7,78.57,1650.17,19
CDM,27326_1,Removal of nerve of calf muscle,1145.88,744.82,78.57,1522.86,19
CDM,27327IP _1,"INJECTION, MILRINONE LACTATE, 5 MG",4.13,2.68,1.03,10.67,17
CDM,27327T_1,"Removal of growth under skin of thigh or knee, 3.0 cm or more",904.1,587.67,78.57,1194.1,19
CDM,27327_1,"Removal of growth under skin of thigh or knee, 3.0 cm or more",1759.35,1143.58,78.57,1194.1,19
CDM,27328T_1,"Removal of growth of muscle of thigh or knee, 5.0 cm or less",2753.1,1789.52,78.57,1838.02,19
CDM,27328_1,"Removal of growth of muscle of thigh or knee, 5.0 cm or less",2101.05,1365.68,78.57,1838.02,19
CDM,27329_1,"Extensive removal of growth of thigh or knee, less than 5.0 cm",4725.0,3071.25,78.57,3054.7,19
CDM,27330_1,Biopsy of membrane covering knee joint,1601.3,1040.85,78.57,1232.18,19
CDM,27331_1,"Incision of knee joint for exploration, biopsy, or removal of foreign body",1729.4,1124.11,78.57,1405.56,19
CDM,27332_1,Incision of knee joint with removal of cartilage of inner or outer side of knee,2049.6,1332.24,78.57,1900.66,19
CDM,27333IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.81,7.03,2.7,27.92,16
CDM,27333OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.55,14.66,5.64,58.24,16
CDM,27333_1,Incision of knee joint with removal of cartilage of inner and outer sides of knee,1420.5,923.33,78.57,1733.3,19
CDM,27334IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.35,8.68,3.34,34.48,16
CDM,27334OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.65,8.87,3.41,35.25,16
CDM,27334_1,Incision of knee joint with removal of cartilage of front or back of knee,2305.8,1498.77,78.57,2026.96,19
CDM,27335_1,Incision of knee joint with removal of cartilage of front and back of knee,2433.9,1582.04,78.57,2259.67,19
CDM,27337T_1,"Removal of growth under skin of thigh or knee, less than 3.0 cm",2940.6,1911.39,78.57,1228.78,19
CDM,27337_1,"Removal of growth under skin of thigh or knee, less than 3.0 cm",1685.25,1095.41,78.57,1228.78,19
CDM,27339T_1,"Removal of growth of muscle of thigh or knee, 5.0 cm or more",2940.6,1911.39,78.57,2217.54,19
CDM,27339_1,"Removal of growth of muscle of thigh or knee, 5.0 cm or more",3639.9,2365.94,78.57,2217.54,19
CDM,27340_1,Removal of fluid-filled sac from joint at front of knee,1537.2,999.18,78.57,1099.05,19
CDM,27345_1,Removal of cyst of back of knee,1265.3,822.45,78.57,1423.64,19
CDM,27347_1,Removal of growth of knee cartilage or capsule,1362.9,885.89,78.57,1563.57,19
CDM,27350_1,Removal of kneecap,1728.3,1123.4,78.57,1926.72,19
CDM,27355_1,Removal of cyst or growth of thigh bone,2477.55,1610.41,78.57,1790.14,19
CDM,27356_1,Removal of cyst or growth of thigh bone with donor bone graft,1967.7,1279.01,78.57,2184.24,19
CDM,27357_1,Removal of cyst or growth of thigh bone with self bone graft,2175.6,1414.14,78.57,2408.36,19
CDM,27358_1,Removal of cyst or growth of thigh bone with placement of stabilizing device,2049.6,1332.24,78.57,1017.64,19
CDM,27360_1,Partial removal of thigh and/or lower leg bones,3810.0,2476.5,78.57,2548.09,19
CDM,27364_1,"Extensive removal of growth of thigh or knee, 5.0 cm or more",6320.55,4108.36,78.57,4615.84,19
CDM,27365_1,Extensive removal of growth of thigh or knee bone,6676.5,4339.73,78.57,6113.06,19
CDM,27369_1,Injection of contrast for imaging of knee joint,145.5,94.58,31.92,448.56,19
CDM,27372_1,Removal of foreign body deep in tissue of thigh or knee,1420.7,923.46,78.57,1401.61,19
CDM,27380_1,Primary suture of tendon below knee,2346.75,1525.39,78.57,1769.67,19
CDM,27381_1,Secondary suture of tendon below knee,3208.35,2085.43,78.57,2369.63,19
CDM,27385_1,Primary suture of ruptured muscle of thigh,2513.7,1633.91,78.57,1712.32,19
CDM,27386_1,Secondary suture of ruptured muscle of thigh,3326.4,2162.16,78.57,2469.45,19
CDM,27390IP _1,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",116.99,76.04,3.22,302.13,17
CDM,27390OP _1,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",213.2,138.58,3.22,550.59,17
CDM,27390_1,Repair of hamstring tendon,1159.2,753.48,78.57,1325.24,19
CDM,27391_1,Repair of multiple hamstring tendons in leg,1514.1,984.17,78.57,1696.68,19
CDM,27392OP _1,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",39.54,25.7,9.89,102.11,17
CDM,27392_1,Repair of multiple hamstring tendons of both legs,1872.2,1216.93,78.57,2102.81,19
CDM,27393_1,Lengthening of hamstring tendon,1341.9,872.24,78.57,1508.96,19
CDM,27394_1,Lengthening of multiple hamstring tendons in leg,1747.2,1135.68,78.57,1920.42,19
CDM,27395_1,Lengthening of multiple hamstring tendons in both legs,2356.2,1531.53,78.57,2597.03,19
CDM,27396_1,Transfer of thigh tendon,2041.2,1326.78,78.57,1818.06,19
CDM,27397_1,Transfer of thigh tendons,2097.03,1363.07,78.57,2705.47,19
CDM,27400_1,Transfer of tendon or muscle in hamstring to femur,1900.5,1235.33,78.57,2047.72,19
CDM,27403_1,Incision and repair of knee cartilage,3079.2,2001.48,78.57,1896.8,19
CDM,27405_1,Primary repair of torn ligament or joint capsule at outside part of knee,2735.85,1778.3,78.57,2001.43,19
CDM,27407_1,Repair of torn ligament and/or joint capsule at front of knee,2174.6,1413.49,78.57,2336.9,19
CDM,27409_1,Repair of torn ligaments or joint capsule at front and sides of knee,2606.1,1693.97,78.57,2850.62,19
CDM,27412_1,Implantation of self cartilage into knee joint,6736.35,4378.63,78.57,4869.77,19
CDM,27415_1,Implantation of donor cartilage cells into knee joint,5581.8,3628.17,78.57,4013.55,19
CDM,27416_1,Implantation of self cartilage cells into knee bone,2604.0,1692.6,78.57,2889.65,19
CDM,27418_1,Repair of upper end of shin bone at knee joint,3969.0,2579.85,78.57,2452.92,19
CDM,27419IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",38.54,25.05,9.64,99.53,16
CDM,27420_1,Repair of dislocating kneecap,3028.8,1968.72,78.57,2200.3,19
CDM,27422_1,Repair of dislocating kneecap with realignment,2019.2,1312.48,78.57,2199.74,19
CDM,27424_1,Reconstruction of dislocating kneecap with removal,2079.0,1351.35,78.57,2210.56,19
CDM,27425_1,Release of ligaments of knee joint,3024.0,1965.6,78.57,1329.06,19
CDM,27427_1,Reconstruction of ligaments outside knee joint,3650.85,2373.05,78.57,2109.75,19
CDM,27428_1,Reconstruction ligaments inside knee joint,3402.0,2211.3,78.57,3297.45,19
CDM,27429_1,Reconstruction of ligaments inside and outside knee joint,3780.0,2457.0,78.57,3706.86,19
CDM,27430IP _1,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",440.65,286.42,110.16,1137.98,19
CDM,27430OP _1,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",596.64,387.82,149.16,1540.82,19
CDM,27430_1,Repair of muscle group above knee joint,2019.2,1312.48,78.57,2191.16,19
CDM,27431OP _1,"INJECTION, DOXORUBICIN HYDROCHLORIDE, LIPOSOMAL, NOT OTHERWISE SPECIFIED, 10 MG",239.38,155.6,59.85,903.53,19
CDM,27435_1,Incision of back portion of knee joint capsule,2127.3,1382.75,78.57,2393.86,19
CDM,27437_1,Repair of kneecap,1529.88,994.42,78.57,1952.34,19
CDM,27438_1,Repair of kneecap with prosthesis,3389.4,2203.11,78.57,2487.93,19
CDM,27440_1,Repair of lower part of knee joint,2690.1,1748.57,78.57,2356.81,19
CDM,27441_1,Repair of lower part of knee joint with prosthesis and removal of joint lining,2818.2,1831.83,78.57,2437.44,19
CDM,27442_1,Repair of end of thigh or lower leg bone at knee joint with prosthesis,2338.4,1519.96,78.57,2573.73,19
CDM,27443_1,Knee replacement with repair of end of thigh or lower leg bone and removal of knee joint lining,2656.5,1726.73,78.57,2408.13,19
CDM,27445_1,Knee joint replacement using hinged prosthesis,5433.75,3531.94,78.57,3710.74,15
CDM,27446_1,Replacement of knee joint on side of knee,5380.2,3497.13,78.57,3433.33,19
CDM,27447_1,"Replacement of knee joint, both sides of knee",7686.0,4995.9,78.57,3848.22,19
CDM,27448_1,Incision or partial removal of middle portion of thigh bone,3554.85,2310.65,78.57,2318.29,19
CDM,27450_1,Incision or partial removal of middle portion of thigh bone with stabilizing device,4515.6,2935.14,78.57,3009.45,19
CDM,27454_1,Multiple incisions or removals of parts of middle portion of thigh bone with placement of rod,3060.8,1989.52,78.57,3837.48,19
CDM,27455_1,"Incision or partial removal of upper portion of lower leg bone to repair deformity, before bone growth completed",2541.0,1651.65,78.57,2786.92,19
CDM,27456OP _1,"TESTOSTERONE PELLET, IMPLANT, 75 MG",188.75,122.69,47.19,487.45,16
CDM,27457_1,"Incision or partial removal of upper portion of lower leg bone to repair deformity, after bone growth completed",3929.7,2554.31,78.57,2843.76,19
CDM,27459IP _1,UNCLASSIFIED DRUGS,64.95,42.22,16.24,167.73,16
CDM,27460IP _1,UNCLASSIFIED DRUGS,57.92,37.65,14.48,149.58,16
CDM,27461IP _1,UNCLASSIFIED DRUGS,128.15,83.3,32.04,330.95,16
CDM,27461OP _1,UNCLASSIFIED DRUGS,30.3,19.7,7.58,78.25,16
CDM,27464IP _1,COMBIPATCH 0.05-0.14 MG PTCH,238.25,154.86,59.56,166.78,11
CDM,27465_1,Shortening of thigh bone,3330.6,2164.89,78.57,3705.48,19
CDM,27466_1,Lengthening of thigh bone,3394.7,2206.56,78.57,3499.3,19
CDM,27468_1,Lengthening and shortening of thigh bone,4931.9,3205.74,78.57,3974.87,15
CDM,27470_1,Repair of nonhealed broken thigh bone,4792.8,3115.32,78.57,3486.08,19
CDM,27471OP _1,"INFUSION, ALBUMIN (HUMAN), 25%, 20 ML",11.3,7.35,2.83,185.91,19
CDM,27472IP _1,UNCLASSIFIED DRUGS,9.03,5.87,2.26,23.32,16
CDM,27472OP _1,UNCLASSIFIED DRUGS,4.68,3.04,1.17,12.09,16
CDM,27472_1,Repair of nonhealed broken thigh bone with self bone graft,5183.4,3369.21,78.57,3739.93,19
CDM,27474IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.2,5.33,2.05,21.18,16
CDM,27475_1,Removal of growth plate at lower end of thigh bone,1812.3,1178.0,78.57,1958.31,19
CDM,27477_1,Removal of growth plate of both lower leg bones,2062.2,1340.43,78.57,2169.99,19
CDM,27479_1,Removal of growth plate of leg and thigh bones,2626.1,1706.97,78.57,2722.1,19
CDM,27480IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.5,5.53,2.13,21.95,16
CDM,27480OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.53,13.99,5.38,55.6,16
CDM,27485_1,Removal of growth plate of leg or thigh bones,1791.3,1164.35,78.57,1984.74,19
CDM,27486_1,Revision of component of total knee joint prosthesis,8758.65,5693.12,78.57,4167.09,19
CDM,27487_1,Revision of thigh and lower leg bone components of total knee joint prosthesis,11240.85,7306.55,78.57,5210.53,19
CDM,27488_1,Removal of total knee joint prosthesis,4873.05,3167.48,78.57,3557.69,19
CDM,27495_1,Stabilization of thigh bone with device,4606.95,2994.52,78.57,3336.91,19
CDM,27496_1,Incision of connective tissue of thigh and/or knee to relieve pressure,1339.8,870.87,78.57,1609.72,19
CDM,27497_1,Incision of tissue of thigh and/or knee with tissue removal to relieve pressure,1632.8,1061.32,78.57,1719.1,19
CDM,27498_1,Multiple incisions of connective tissue of thigh and/or knee to relieve pressure,1592.9,1035.39,78.57,1936.23,19
CDM,27499_1,Multiple incisions of connective tissue of thigh and/or knee with tissue removal to relieve pressure,2549.4,1657.11,78.57,2068.73,19
CDM,27500_1,Closed treatment of broken thigh bone,2190.0,1423.5,78.57,1419.24,19
CDM,27501_1,Closed treatment of broken thigh bone at lower end,2220.0,1443.0,78.57,1472.33,19
CDM,27502_1,Closed treatment of broken thigh bone at midportion with manipulation,3180.0,2067.0,78.57,2252.11,19
CDM,27503_1,Closed treatment of broken thigh bone at far end with manipulation,3225.0,2096.25,78.57,2367.79,19
CDM,27505IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",183.74,119.43,45.94,474.51,16
CDM,27505OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",69.1,44.92,17.28,178.45,16
CDM,27506IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",319.35,207.58,79.84,824.72,16
CDM,27506OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",96.8,62.92,24.2,249.99,16
CDM,27506_1,Treatment of broken shaft of thigh bone with implant,5419.65,3522.77,78.57,3962.54,19
CDM,27507IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",390.0,253.5,97.5,1007.18,16
CDM,27507OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",84.6,54.99,21.15,218.48,16
CDM,27507_1,Treatment of broken middle of thigh bone with placement of stabilizing device,4005.3,2603.45,78.57,2878.11,19
CDM,27508_1,Closed treatment of broken inside or outside portion of lower end of thigh bone,1995.0,1296.75,78.57,1463.3,19
CDM,27509_1,Treatment of broken thigh bone at far end with placement of stabilizing device,1705.2,1108.38,78.57,1922.21,19
CDM,27510_1,Closed treatment of broken thigh bone at knee area with manipulation,2520.0,1638.0,78.57,2024.62,19
CDM,27511_1,Treatment of broken thigh bone at far end,4158.0,2702.7,78.57,2953.25,19
CDM,27513_1,Treatment of broken thigh bone in knee area,5214.9,3389.69,78.57,3673.63,19
CDM,27514_1,Treatment of broken side of lower end of thigh bone,4742.4,3082.56,78.57,2866.51,19
CDM,27516_1,Closed treatment of thigh bone growth plate broken at end of thigh bone,1310.0,851.5,78.57,1414.22,19
CDM,27517_1,Closed treatment of growth plate broken at end of thigh bone with manipulation,3015.0,1959.75,78.57,2023.6,19
CDM,27519_1,Treatment of broken growth plate at end of thigh bone,2946.3,1915.1,78.57,2638.85,19
CDM,27520IP _1,UNCLASSIFIED DRUGS,9.55,6.21,2.39,24.66,16
CDM,27520OP _1,UNCLASSIFIED DRUGS,9.15,5.95,2.29,23.63,16
CDM,27520_1,Closed treatment of broken kneecap,1185.0,770.25,78.57,876.08,19
CDM,27521IP _1,UNCLASSIFIED DRUGS,7.85,5.1,1.96,20.27,16
CDM,27521OP _1,UNCLASSIFIED DRUGS,11.5,7.48,2.88,29.7,16
CDM,27524_1,Treatment of broken kneecap with placement of stabilizing device and/or removal of kneecap,3030.3,1969.7,78.57,2226.16,19
CDM,27530_1,Closed treatment of broken shin bone,1500.0,975.0,78.57,833.4,19
CDM,27532_1,Closed treatment of broken shin bone with traction,2400.0,1560.0,78.57,1705.78,19
CDM,27535_1,Treatment of broken side of upper end of shin bone,3715.5,2415.08,78.57,2659.59,19
CDM,27536_1,Treatment of broken shin bone on both sides of upper end,4825.8,3136.77,78.57,3519.74,19
CDM,27538_1,Closed treatment of broken top of shin bone at knee,1140.0,741.0,78.57,1315.7,19
CDM,27540_1,Treatment of broken shin bone at knee,2242.8,1457.82,78.57,2409.82,19
CDM,27550_1,Closed treatment of dislocated knee,1920.0,1248.0,78.57,1425.53,19
CDM,27552_1,Closed treatment of dislocated knee under anesthesia,1646.4,1070.16,78.57,1857.73,19
CDM,27556_1,Treatment of dislocated knee,2562.0,1665.3,78.57,2593.73,19
CDM,27557_1,Treatment of dislocated knee with ligament repair,2548.9,1656.79,78.57,3094.94,19
CDM,27558_1,Treatment of dislocated knee with ligament repair and reconstruction,3333.8,2166.97,78.57,3526.28,19
CDM,27560_1,Closed treatment of dislocated kneecap,1260.0,819.0,78.57,1002.18,19
CDM,27562_1,Closed treatment of dislocated kneecap under anesthesia,1215.9,790.34,78.57,1431.17,19
CDM,27566_1,Treatment of dislocated kneecap,2062.88,1340.87,78.57,2639.57,19
CDM,27570_1,Manipulation of knee joint under anesthesia,660.0,429.0,78.57,445.83,19
CDM,27580_1,Fusion of knee joint,5874.75,3818.59,78.57,4271.92,19
CDM,27590_1,Amputation of thigh through thigh bone,3405.15,2213.35,78.57,2322.22,19
CDM,27591_1,Amputation of thigh through thigh bone with immediate fitting for prosthesis,2494.8,1621.62,78.57,2856.0,19
CDM,27592_1,Amputation of thigh through thigh bone leaving wound,3937.5,2559.38,78.57,1984.43,19
CDM,27594_1,Secondary closure or revision of scar at previous thigh amputation,2069.55,1345.21,78.57,1490.26,19
CDM,27596_1,Re-amputation of thigh through thigh bone,3110.7,2021.96,78.57,2106.81,19
CDM,27598_1,Removal of leg at knee joint,3583.2,2329.08,78.57,2081.61,19
CDM,27600_1,Incision of connective tissue of front or side of lower leg to relieve pressure,1716.75,1115.89,78.57,1195.85,19
CDM,27601_1,Incision of connective tissue of back of lower leg to relieve pressure,1781.4,1157.91,78.57,1316.94,19
CDM,27602_1,Incision of connective tissue of front and/or side and back of lower leg to relieve pressure,2124.75,1381.09,78.57,1418.77,19
CDM,27603_1,Drainage of deep abscess or blood accumulation of leg or ankle,2178.3,1415.9,78.57,1257.4,19
CDM,27604_1,Drainage of infected fluid-filled sac (bursa) of leg or ankle,1343.0,872.95,60.04,1077.32,19
CDM,27605_1,Incision of Achilles tendon using local anesthetic,1092.0,709.8,78.57,795.0,19
CDM,27606_1,Incision of Achilles tendon under anesthesia,2244.45,1458.89,78.57,834.14,19
CDM,27607_1,Incision of leg or ankle bone,2742.15,1782.4,78.57,1815.55,19
CDM,27610_1,"Incision of ankle joint for exploration, fluid drainage, or removal of foreign body",1764.0,1146.6,78.57,1938.1,19
CDM,27612_1,Incision of ankle joint with release of joint lining,2316.9,1505.99,78.57,1706.57,19
CDM,27613_1,Biopsy of surface tissue of leg or ankle,605.9,393.84,78.57,604.16,19
CDM,27614_1,Biopsy of deep tissue of leg or ankle,2559.45,1663.64,78.57,1405.59,19
CDM,27615_1,"Extensive removal of growth of leg or ankle, less than 5.0 cm",3360.0,2184.0,78.57,3033.46,19
CDM,27616_1,"Extensive removal of growth of leg or ankle, 5.0 cm or more",5166.0,3357.9,78.57,3751.68,19
CDM,27618T_1,"Removal of growth under skin of leg or ankle, less than 3.0 cm",1247.3,810.75,78.57,1163.2,19
CDM,27618_1,"Removal of growth under skin of leg or ankle, less than 3.0 cm",2186.1,1420.97,78.57,1163.2,19
CDM,27619T_1,"Removal of growth of muscle of leg or ankle, less than 5.0 cm",1325.0,861.25,78.57,1389.83,19
CDM,27619_1,"Removal of growth of muscle of leg or ankle, less than 5.0 cm",2959.5,1923.68,78.57,1389.83,19
CDM,27620_1,Incision and exploration of ankle joint,1274.7,828.56,78.57,1354.37,19
CDM,27625_1,Removal of membrane covering of ankle joint,2422.35,1574.53,78.57,1717.43,19
CDM,27626_1,Removal of membrane covering ankle joint and tendon,2138.1,1389.77,78.57,1830.94,19
CDM,27629IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.46,6.8,2.62,27.01,16
CDM,27629OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.41,11.97,4.6,47.54,16
CDM,27630IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.63,6.26,2.41,24.87,16
CDM,27630OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.19,15.07,5.8,59.89,16
CDM,27630_1,Removal of growth of leg and/or ankle tendon lining or capsule,2093.25,1360.61,78.57,1284.09,19
CDM,27631IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.18,4.67,1.8,18.54,16
CDM,27631OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.31,2.8,1.08,11.13,16
CDM,27632_1,"Removal of growth under skin of leg or ankle, 3.0 cm or more",1668.0,1084.2,78.57,1220.96,19
CDM,27634IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.55,4.26,1.64,16.92,16
CDM,27634_1,"Removal of growth of muscle of leg or ankle, 5.0 cm or more",2724.75,1771.09,78.57,2012.88,19
CDM,27635IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.6,15.99,6.15,63.53,16
CDM,27635OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.9,14.24,5.48,56.56,16
CDM,27635_1,Removal of cyst or growth of lower leg bone,2509.05,1630.88,78.57,1730.71,19
CDM,27636IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.26,7.32,2.82,29.08,16
CDM,27636OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.85,8.35,3.21,33.19,16
CDM,27637_1,Removal of cyst or growth of lower leg bone with self bone graft,2041.2,1326.78,78.57,2218.63,19
CDM,27638_1,Removal of cyst or growth of lower leg bone with bone graft,2105.3,1368.45,78.57,2277.97,19
CDM,27640_1,Partial removal of shin bone,3939.15,2560.45,78.57,2476.8,19
CDM,27641_1,Partial removal of outer lower leg bone,2259.6,1468.74,78.57,1983.94,19
CDM,27644IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.52,10.74,4.13,42.66,16
CDM,27644OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.7,17.36,6.68,68.95,16
CDM,27645_1,Extensive removal of growth of shin bone,3500.0,2275.0,78.57,5261.6,19
CDM,27646_1,Extensive removal of growth of outer leg bone,3575.0,2323.75,78.57,4558.41,19
CDM,27647_1,Extensive removal of growth of heel bone,2238.6,1455.09,78.57,3132.01,19
CDM,27648_1,Injection for X-ray imaging of ankle,909.3,591.05,40.26,517.61,19
CDM,27650_1,Repair of ruptured Achilles tendon,2721.6,1769.04,78.57,1971.89,19
CDM,27652_1,Repair of ruptured Achilles tendon with graft,1965.6,1277.64,78.57,2041.85,19
CDM,27654_1,Secondary repair of ruptured Achilles tendon,3074.4,1998.36,78.57,2137.49,19
CDM,27656_1,Repair of connective tissue defect of leg,1399.7,909.81,78.57,1290.67,19
CDM,27658_1,Primary repair of tendon on back of leg,1362.9,885.89,78.57,1119.16,19
CDM,27659_1,Secondary repair of tendon on back of leg,1716.8,1115.92,78.57,1429.07,19
CDM,27663IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.96,18.82,7.24,74.79,16
CDM,27663OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.3,13.85,5.33,55.01,16
CDM,27664_1,Primary repair of tendon on front of leg,1926.8,1252.42,78.57,1084.92,19
CDM,27665_1,Secondary repair of tendon on front of leg,1517.3,986.25,78.57,1244.59,19
CDM,27666OP _1,HURRICAINE ONE 20% U-D SPRAY,42.6,27.69,10.65,29.82,11
CDM,27675_1,Repair of dislocating lower leg tendons without a cut through the lower leg bone on the outside of the leg (fibula),1385.0,900.25,78.57,1482.48,19
CDM,27676_1,Repair of dislocated lower leg tendons by incision or partial removal of lower leg bone,1647.5,1070.88,78.57,1800.39,19
CDM,27680_1,Release of leg and/or ankle tendon,1239.0,805.35,78.57,1270.21,19
CDM,27681_1,Release of multiple leg and/or ankle tendons,1393.4,905.71,78.57,1553.76,19
CDM,27685_1,Lengthening or shortening of tendon of leg or ankle,1667.4,1083.81,78.57,1574.55,19
CDM,27686_1,Lengthening or shortening of multiple tendons of leg or ankle,2986.2,1941.03,78.57,1631.34,19
CDM,27687_1,Lengthening of calf muscle,1986.15,1291.0,78.57,1366.37,19
CDM,27690_1,Transfer of tendon and muscle rerouting at lower leg or ankle,1731.5,1125.48,78.57,1924.72,19
CDM,27691_1,Transfer of deep tendon of foot with muscle rerouting,3038.25,1974.86,78.57,2228.94,19
CDM,27692_1,"Transfer of tendon with muscle rerouting at foot, each additional tendon",306.6,199.29,78.57,304.7,19
CDM,27694IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.65,3.02,1.16,12.01,16
CDM,27694OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.2,10.53,4.05,41.84,16
CDM,27695IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.99,3.24,1.25,12.89,16
CDM,27695OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.96,12.32,4.74,48.96,16
CDM,27695_1,Primary repair of disrupted ankle ligament,2085.3,1355.45,78.57,1426.76,19
CDM,27696IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",94.23,61.25,23.56,243.35,16
CDM,27696OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",308.81,200.73,77.2,797.5,16
CDM,27696_1,Primary repair of disruption of both ankle ligaments,2690.1,1748.57,78.57,1677.14,19
CDM,27697IP _1,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",9.55,6.21,2.39,24.66,16
CDM,27697OP _1,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",55.42,36.02,0.01,143.12,17
CDM,27698IP _1,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",16.67,10.84,0.01,43.05,17
CDM,27698OP _1,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",69.66,45.28,0.01,179.9,17
CDM,27698_1,Secondary repair of disrupted collateral ligament of ankle,2978.4,1935.96,78.57,1916.26,19
CDM,27700_1,Reconstruction of ankle joint,3843.0,2497.95,78.57,1864.52,19
CDM,27702_1,Reconstruction of ankle joint with prosthesis,4057.2,2637.18,78.57,2866.15,19
CDM,27703_1,Repair of ankle joint with revision of prosthesis,2591.0,1684.15,78.57,3308.84,19
CDM,27704_1,Removal of ankle implant,1529.9,994.44,78.57,1708.26,19
CDM,27705_1,Incision or partial removal of shin bone,3109.05,2020.88,78.57,2257.54,19
CDM,27707_1,Incision or partial removal of lower leg bone,1573.5,1022.78,78.57,1189.66,19
CDM,27709_1,Incision or partial removal of shin and outer lower leg bones,3083.9,2004.54,78.57,3453.42,19
CDM,27712_1,Insertion of rod in shin bone,2964.2,1926.73,78.57,3259.29,19
CDM,27715_1,Lengthening or shortening of lower leg bones,2892.8,1880.32,78.57,3167.78,19
CDM,27720_1,Repair of nonhealed broken shin bone,3576.9,2324.99,78.57,2593.03,19
CDM,27722_1,Repair of nonhealed broken shin bone with bone graft,2498.0,1623.7,78.57,2634.7,19
CDM,27724_1,Repair of nonhealed broken shin bone with self graft from hip or other bone,5241.6,3407.04,78.57,3746.51,19
CDM,27725_1,Fusion of nonhealed broken shin bone with outer lower leg bone,3586.8,2331.42,78.57,3602.64,19
CDM,27726_1,Repair of nonhealed broken outer lower leg bone with placement of stabilizing device,3776.85,2454.95,78.57,2850.41,19
CDM,27727_1,Repair of congenital nonhealed broken shin bone,2864.4,1861.86,78.57,3038.78,19
CDM,27730_1,Scraping or stapling of shin bone growth plate of lower leg bone at ankle,2290.1,1488.57,78.57,1735.94,19
CDM,27732_1,Fusion of lower outer leg bone growth plate,1550.9,1008.09,78.57,1327.36,19
CDM,27734_1,Fusion of lower end of growth plate of lower leg bone,1742.0,1132.3,78.57,1941.92,19
CDM,27735IP _1,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",1.12,0.73,0.07,3.38,17
CDM,27737IP _1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",12.6,8.19,0.16,38.01,17
CDM,27737OP _1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",20.16,13.1,0.16,60.82,17
CDM,27740_1,Fusion of lower and upper ends of growth plates of lower leg bones,2751.0,1788.15,78.57,2095.5,19
CDM,27742_1,Fusion of lower and upper ends of growth plates of lower leg and thigh bones,1780.73,1157.47,78.57,2301.35,19
CDM,27745_1,Placement of stabilizing device for shin bone,3050.85,1983.05,78.57,2236.43,19
CDM,27750_1,Closed treatment of broken middle part of shin bone,1290.0,838.5,78.57,943.16,19
CDM,27752_1,Closed treatment of middle part of broken shin bone with manipulation,2130.0,1384.5,78.57,1457.48,19
CDM,27756_1,Placement of stabilizing device for broken middle part of shin bone,1576.1,1024.47,78.57,1712.24,19
CDM,27758_1,Treatment broken middle part of shin bone with plate or screws,3589.5,2333.18,78.57,2644.4,19
CDM,27759_1,Treatment of broken part of shin bone with rod,4068.3,2644.4,78.57,2957.77,19
CDM,27760_1,Closed treatment of inside portion of shin bone at ankle,1245.0,809.25,78.57,906.97,19
CDM,27762_1,Closed treatment of inside portion of shin bone at ankle with manipulation,1240.0,806.0,78.57,1338.13,19
CDM,27766_1,Treatment of inside portion of broken shin bone at ankle,2428.65,1578.62,78.57,1798.96,19
CDM,27767_1,Closed treatment of back portion of shin bone at ankle,990.75,643.99,78.57,839.11,19
CDM,27768_1,Closed treatment of back portion of shin bone at ankle with manipulation,1597.05,1038.08,78.57,1304.8,19
CDM,27769_1,Treatment of broken back portion of shin bone at ankle,2803.5,1822.28,78.57,2160.44,19
CDM,27780IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.7,5.01,1.93,19.89,16
CDM,27780OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.1,3.97,1.53,15.75,16
CDM,27780_1,Closed treatment of broken middle or upper end of outside lower leg bone,1110.0,721.5,78.57,828.63,19
CDM,27781_1,Closed treatment of broken middle or upper end of outside lower leg bone with manipulation,1575.0,1023.75,78.57,1174.73,19
CDM,27784_1,Treatment of broken upper or middle part of outer lower leg bone,1862.7,1210.76,78.57,2119.94,19
CDM,27786_1,Closed treatment of broken outside lower leg bone at ankle,1170.0,760.5,78.57,849.05,19
CDM,27788_1,Closed treatment of broken outside lower leg bone at ankle with manipulation,1635.0,1062.75,78.57,1181.81,19
CDM,27792_1,Treatment of broken outer lower leg bone at ankle,2819.25,1832.51,78.57,1927.63,19
CDM,27808_1,Closed treatment of 2 broken lower leg bones at ankle,1245.0,809.25,78.57,945.84,19
CDM,27810_1,Closed treatment of 2 broken lower leg bones at ankle with manipulation,1830.0,1189.5,78.57,1302.48,19
CDM,27814_1,Treatment of both broken lower leg bones at ankle,3120.15,2028.1,78.57,2281.18,19
CDM,27816_1,Closed treatment of 3 broken lower leg bones at ankle,1200.0,780.0,78.57,906.53,19
CDM,27818_1,Closed treatment of 3 broken lower leg bones at ankle with manipulation,2025.0,1316.25,78.57,1337.1,19
CDM,27822_1,Treatment of 3 broken lower leg bones at ankle,3414.6,2219.49,78.57,2549.13,19
CDM,27823_1,Treatment of 3 broken lower leg bones at ankle with fixation of posterior lip,3895.05,2531.78,78.57,2886.84,19
CDM,27824_1,Closed treatment of broken shin bone at lower weight bearing joint,1410.0,916.5,78.57,902.88,19
CDM,27825_1,Closed treatment of broken shin bone at lower weight bearing joint with manipulation and/or traction,2145.0,1394.25,78.57,1494.75,19
CDM,27826_1,Treatment of broken outer lower leg bone at lower weight bearing joint,3306.0,2148.9,78.57,2505.4,19
CDM,27827_1,Treatment of broken shin bone at lower weight bearing joint,4378.5,2846.03,78.57,3266.41,19
CDM,27828_1,Treatment of broken lower weight bearing joint of both lower leg bones,5259.0,3418.35,78.57,3895.57,19
CDM,27829_1,Treatment of ligament tear at ankle joint,2652.3,1724.0,78.57,2066.06,19
CDM,27830_1,Closed treatment of dislocated knee joint,920.0,598.0,78.57,1048.84,19
CDM,27831_1,Closed treatment of dislocated knee joint under anesthesia,1135.5,738.08,78.57,1190.33,19
CDM,27832_1,Treatment of dislocated knee joint,1912.1,1242.87,78.57,2234.76,19
CDM,27838IP _1,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",9.85,6.4,0.62,6.9,16
CDM,27838OP _1,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",12.63,8.21,0.62,8.84,16
CDM,27840_1,Closed treatment of dislocated ankle,1470.0,955.5,78.57,1116.98,19
CDM,27842_1,Closed treatment of dislocated ankle under anesthesia,1300.0,845.0,78.57,1454.87,19
CDM,27846_1,Treatment of dislocated ankle,2984.7,1940.06,78.57,2143.49,19
CDM,27848_1,Treatment of dislocated ankle with repair or placement of stabilizing device,3379.95,2196.97,78.57,2377.37,19
CDM,27857IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.62,4.3,1.66,17.1,16
CDM,27857OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.2,14.43,5.55,57.33,16
CDM,27858IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.0,4.55,1.75,18.08,16
CDM,27858OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.02,14.96,5.76,59.45,16
CDM,27859IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.15,4.0,1.54,15.88,16
CDM,27859OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.28,14.48,5.57,57.54,16
CDM,27860IP _1,"NICOTINE PATCHES, LEGEND",17.82,11.58,4.46,46.02,16
CDM,27860OP _1,"NICOTINE PATCHES, LEGEND",16.2,10.53,4.05,41.84,16
CDM,27860_1,Manipulation of ankle under general anesthesia,479.9,311.94,78.57,508.85,19
CDM,27862IP _1,"NICOTINE PATCHES, LEGEND",25.12,16.33,6.28,64.87,16
CDM,27862OP _1,"NICOTINE PATCHES, LEGEND",34.04,22.13,8.51,87.91,16
CDM,27863IP _1,"NICOTINE PATCHES, LEGEND",19.87,12.92,4.97,51.31,16
CDM,27863OP _1,"NICOTINE PATCHES, LEGEND",19.46,12.65,4.87,50.26,16
CDM,27870_1,"Fusion of ankle joint, open procedure",4277.7,2780.51,78.57,3058.37,19
CDM,27871_1,Fusion of lower leg bone at knee or ankle joint,2795.7,1817.21,78.57,2044.7,19
CDM,27880_1,Amputation of both lower leg bones,3835.2,2492.88,78.57,2658.77,19
CDM,27881_1,Amputation of both lower leg bones with immediate fitting,2436.0,1583.4,78.57,2537.57,19
CDM,27882_1,Amputation of both lower leg bones leaving wound,2913.75,1893.94,78.57,1745.01,19
CDM,27884_1,Secondary closure or revision of scar of lower leg bone amputation,1598.1,1038.77,78.57,1671.37,19
CDM,27886_1,Re-amputation of lower leg,2992.5,1945.13,78.57,1922.21,19
CDM,27888_1,Amputation of foot at ankle with reconstruction of skin and tissue,2100.0,1365.0,78.57,1960.52,19
CDM,27889_1,Removal of foot at ankle joint,1995.0,1296.75,78.57,1893.28,19
CDM,27892_1,Incision of connective tissue of lower leg to relieve pressure with removal of muscle and/or nerve,2439.75,1585.84,78.57,1618.9,19
CDM,27893_1,Incision of connective tissue at back of lower leg to relieve pressure with removal of muscle and/or nerve,1626.5,1057.23,78.57,1804.08,19
CDM,27894_1,Incision of connective tissue at front and/or side and back of lower leg to relieve pressure with removal of muscle and/or nerve,2313.2,1503.58,78.57,2460.89,19
CDM,27905IP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",83.29,54.14,1.26,215.1,17
CDM,27905OP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",3.68,2.39,0.92,9.5,17
CDM,27906IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",131.84,85.7,32.96,340.48,16
CDM,27906OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",222.4,144.56,55.6,574.35,16
CDM,27907IP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",170.92,111.1,1.26,441.4,17
CDM,27907OP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",90.65,58.92,1.26,234.1,17
CDM,27908IP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",240.69,156.45,1.26,621.58,17
CDM,27908OP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",183.05,118.98,1.26,472.73,17
CDM,27974IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.44,6.14,2.36,24.38,16
CDM,27974OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.3,11.9,4.58,47.26,16
CDM,27992IP _1,UNCLASSIFIED DRUGS,4.22,2.74,1.06,10.9,16
CDM,27992OP _1,UNCLASSIFIED DRUGS,2.79,1.81,0.7,7.21,16
CDM,27996OP _1,PETROLATUM BASE OINTMENT,10.25,6.66,2.56,7.18,11
CDM,28000007_1,HC TUBBING CRITICAL IP,244.0,158.6,61.0,170.8,11
CDM,28000008_1,HC TUBBING NON-CRITICAL IP,100.0,65.0,25.0,70.0,11
CDM,28000045_1,HC TUBIGRIP SUPPLY PER FOOT,14.0,9.1,3.5,9.8,11
CDM,28000047_1,HC TUBENET SUPPLY,20.0,13.0,5.0,14.0,11
CDM,28000048_1,HC PRESSURE GARMENT MEASURING,147.0,95.55,36.75,102.9,11
CDM,28000122_1,HC DIGITAL PHOTO ASSESSMENT,12.0,7.8,3.0,8.4,11
CDM,28001_1,Drainage of fluid filled sac in foot,784.4,509.86,54.98,413.46,19
CDM,28002_1,Drainage of fluid filled sac below connective tissue in foot joint,1334.6,867.49,78.57,594.53,19
CDM,28003_1,Drainage of fluid filled sacs beneath connective tissue in multiple foot joints,1839.6,1195.74,78.57,913.43,19
CDM,28005_1,Incision of foot bone,1697.9,1103.64,78.57,1772.51,19
CDM,28008_1,Incision of connective tissue of foot and/or toe,1154.0,750.1,78.57,1030.77,19
CDM,28010_1,Repair of toe tendon,774.9,503.69,68.91,644.35,19
CDM,28011686_1,HC PIC SET TRAY BURN SERVICES,15.0,9.75,3.75,10.5,11
CDM,28011688_1,HC SILVADENE PAD,85.0,55.25,21.25,59.5,11
CDM,28011689_1,HC SILVADENE ROLL,38.0,24.7,9.5,26.6,11
CDM,28011691_1,HC SULFAMYLON ROLL,134.0,87.1,33.5,93.8,11
CDM,28011692_1,HC TUB LINER,18.0,11.7,4.5,12.6,11
CDM,28011IP _1,UNCLASSIFIED DRUGS,6.71,4.36,1.68,17.33,16
CDM,28011OP _1,UNCLASSIFIED DRUGS,8.84,5.75,2.21,22.83,16
CDM,28011_1,Repair of multiple toe tendons,1073.1,697.52,78.57,868.14,19
CDM,28016020_1,"Dressing change or removal of burn tissue, less than 5% of total body surface",175.0,113.75,43.75,451.94,19
CDM,28016025_1,"Dressing change or removal of burn tissue, 5-10% of total body surface",225.0,146.25,56.25,581.06,19
CDM,28016030_1,"Dressing change or removal of burn tissue, more than 10% of total body surface",325.0,211.25,81.25,839.31,19
CDM,28017IP _1,UNCLASSIFIED DRUGS,432.67,281.24,108.17,1117.37,16
CDM,28017OP _1,UNCLASSIFIED DRUGS,409.0,265.85,102.25,1056.24,16
CDM,28020_1,"Incision of foot at ankle joint for exploration, fluid drainage, or removal of foreign body",1344.0,873.6,78.57,1308.55,19
CDM,28022_1,"Incision of midfoot joint for exploration, fluid drainage, or removal of foreign body",1256.9,816.99,78.57,1164.73,19
CDM,28024_1,"Incision of toe joint for exploration, fluid drainage, or removal of foreign body",1185.5,770.58,78.57,1101.26,19
CDM,28035_1,Release of nerve between tissue and ankle bone,2016.0,1310.4,78.57,1265.05,19
CDM,28039_1,Removal (1.5 centimeters or greater) tissue growth beneath the skin of foot or toe,1797.15,1168.15,78.57,1152.22,19
CDM,28041_1,"Removal of growth of muscle of foot or toe, 1.5 cm or more",1849.05,1201.88,78.57,1384.34,19
CDM,28043_1,Removal (less than 1.5 centimeters) tissue growth beneath the skin of foot or toe,1489.95,968.47,78.57,922.73,19
CDM,28045_1,"Removal of growth of muscle of foot or toe, less than 1.5 cm",1273.7,827.91,78.57,1156.82,19
CDM,28046_1,"Extensive removal of growth of foot or toe, less than 3.0 cm",2220.8,1443.52,78.57,2201.65,19
CDM,28047_1,"Extensive removal of growth of foot or toe, 3.0 cm or more",2626.1,1706.97,78.57,3149.29,19
CDM,28050_1,Biopsy through a joint opening in the midfoot,1211.7,787.61,78.57,999.85,19
CDM,28052_1,Incision of midfoot joint with biopsy,1106.7,719.36,78.57,936.23,19
CDM,28054_1,Incision of toe joint with biopsy,1028.0,668.2,78.57,880.65,19
CDM,28055_1,Removal of nerve of foot muscle,954.7,620.56,78.57,1175.8,19
CDM,28060_1,Partial removal of connective tissue at sole of foot,2011.35,1307.38,78.57,1239.45,19
CDM,28062_1,Removal of connective tissue at sole of foot,1407.93,915.15,78.57,1386.06,19
CDM,28070_1,Removal of foot bone joint lining at ankle,1276.08,829.45,78.57,1214.84,19
CDM,28072_1,Removal of joint lining of toe joint at foot,1313.6,853.84,78.57,1171.47,19
CDM,28080_1,Removal of fibrous nerve growth from between toes,1317.8,856.57,78.57,1275.72,19
CDM,28086_1,Removal of lining of tendon on under surface of foot,1473.2,957.58,78.57,1268.28,19
CDM,28088_1,Removal of lining of tendon on upper surface of foot,1171.8,761.67,78.57,1099.22,19
CDM,28090_1,Removal of growth of tendon covering or joint capsule of foot,1210.7,786.96,78.57,1115.55,19
CDM,28092_1,Removal of growth of tendon covering or joint capsule of toes,1088.9,707.79,78.57,1010.06,19
CDM,28097597_1,"Removal of tissue from wound, 20.0 sq cm or less",410.0,266.5,102.5,1058.83,19
CDM,28097598_1,"Removal of tissue from wound, each additional 20.0 sq cm",157.0,102.05,39.25,1507.02,19
CDM,280Q4110_1,"PRIMATRIX, PER SQUARE CENTIMETER",126.0,81.9,31.5,325.4,17
CDM,28100002_1,HC SUPPLY PACK FOR ECT,528.0,343.2,132.0,369.6,11
CDM,28100_1,Removal of cyst or growth of heel or ankle bone,2290.05,1488.53,78.57,1461.33,19
CDM,28102_1,Removal of cyst or growth of heel or ankle bone with self bone graft,1416.5,920.73,78.57,1794.48,19
CDM,28103_1,Removal of cyst or growth of heel or ankle bone with donor bone graft,1811.25,1177.31,78.57,1211.17,19
CDM,28104_1,Removal of cyst or growth of foot bone,1341.9,872.24,78.57,1252.68,19
CDM,28106_1,Removal of cyst or growth of foot bone with self bone graft,1278.9,831.29,78.57,1328.45,19
CDM,28107_1,Removal of cyst or growth of foot bone with bone graft,1434.3,932.3,78.57,1216.77,19
CDM,28108_1,Removal of cyst or growth of toe bone,1138.2,739.83,78.57,1172.35,19
CDM,28110_1,Removal of bunion at fifth toe joint,1781.4,1157.91,78.57,1099.53,19
CDM,28111_1,Removal of foot bone at great toe joint,1319.9,857.94,78.57,1143.34,19
CDM,28112_1,"Removal of toe bone at second, third, or fourth joints",1263.2,821.08,78.57,1154.89,19
CDM,28113_1,Complete removal of foot bone at fifth toe joint,1535.1,997.82,78.57,1403.81,19
CDM,28114_1,Complete removal of second to fifth foot bones,2729.0,1773.85,78.57,2563.71,19
CDM,28116_1,Removal of abnormal bones at ankle joint,2007.6,1304.94,78.57,1867.95,19
CDM,28118_1,Removal of heel bone,2271.15,1476.25,78.57,1437.44,19
CDM,28119_1,Removal of heel bone spur,1373.4,892.71,78.57,1256.66,19
CDM,28120_1,Partial removal of infected foot or heel bone,2230.2,1449.63,78.57,1602.83,19
CDM,28122_1,Partial removal of foot or heel bone,2625.6,1706.64,78.57,1416.59,19
CDM,28124_1,Partial removal of toe bone,1890.0,1228.5,78.57,1142.49,19
CDM,28126_1,Removal of toe bone at foot,1021.7,664.11,78.57,933.88,19
CDM,28130_1,Removal of ankle joint bone,1761.9,1145.24,78.57,1889.28,19
CDM,28140_1,Removal of foot bone,1634.9,1062.69,78.57,1360.83,19
CDM,28150_1,Removal of toe,1157.1,752.12,78.57,1003.0,19
CDM,28153_1,Removal of end of toe at joint,1084.7,705.06,78.57,972.19,19
CDM,28159IP _1,UNCLASSIFIED DRUGS,20.85,13.55,5.21,53.85,16
CDM,28159OP _1,UNCLASSIFIED DRUGS,25.89,16.83,6.47,66.86,16
CDM,28160IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.45,15.24,5.86,60.56,16
CDM,28160OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.8,10.27,3.95,40.8,16
CDM,28160_1,Partial removal of toe at joint,1084.7,705.06,78.57,978.62,19
CDM,28171_1,Extensive removal of growth of middle portion of foot bone,1731.5,1125.48,78.57,3297.12,19
CDM,28173_1,Extensive removal of growth of foot bone,1890.0,1228.5,78.57,2274.99,19
CDM,28175_1,Extensive removal of growth of toe bone,1443.8,938.47,78.57,1465.48,19
CDM,28190870_1,Therapy using electrical currents,667.0,433.55,340.17,1722.53,16
CDM,28190_1,"Removal of foreign body of foot tissue, accessed beneath the skin",885.0,575.25,62.71,579.19,19
CDM,28192_1,"Removal of foreign body of foot tissue, deep",1605.0,1043.25,78.57,1100.85,19
CDM,28193_1,Complicated removal of foreign body in foot,1425.9,926.84,78.57,1254.07,19
CDM,28200_1,Repair of tendon on sole of foot,1244.3,808.8,78.57,1182.81,19
CDM,28202_1,Secondary repair of tendon on sole of foot with graft,1486.8,966.42,78.57,1443.12,19
CDM,28203IP _1,UNCLASSIFIED DRUGS,156.09,101.46,39.02,403.1,16
CDM,28203OP _1,UNCLASSIFIED DRUGS,102.03,66.32,25.51,263.49,16
CDM,28208_1,Repair of tendon of top side of foot,1199.1,779.42,78.57,1163.72,19
CDM,28210_1,Repair of tendon on top side of foot with graft,1393.78,905.96,78.57,1426.67,19
CDM,28220_1,Removal of scar tissue of tendon on bottom side of foot,1188.6,772.59,78.57,1080.6,19
CDM,28222_1,Removal of scar tissue of multiple foot tendons,1369.2,889.98,78.57,1265.05,19
CDM,28224IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",41.15,26.75,10.29,106.27,16
CDM,28224OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.4,21.06,8.1,83.67,16
CDM,28225_1,Removal of scar tissue of tendon on top side of foot,1044.8,679.12,78.57,989.19,19
CDM,28226_1,Removal of scar tissue of multiple tendons at top of foot,1219.1,792.42,78.57,1465.8,19
CDM,28229OP _1,"INJECTION, VERTEPORFIN, 0.1 MG",4084.09,2654.66,12.25,10547.16,19
CDM,28230_1,Incision to lengthen foot tendon,1708.95,1110.82,78.57,1040.43,19
CDM,28232T_1,Incision to lengthen toe tendon,1162.1,755.37,78.57,904.88,19
CDM,28232_1,Incision to lengthen toe tendon,981.8,638.17,78.57,904.88,19
CDM,28234T_1,Incision to release foot tendon,1227.7,798.01,74.1,979.81,19
CDM,28234_1,Incision to release foot tendon,1021.7,664.11,52.24,979.81,19
CDM,28235IP _1,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",887.61,576.95,155.18,2292.25,19
CDM,28235OP _1,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",599.76,389.84,149.94,1548.88,19
CDM,28238_1,Reconstruction of ankle tendon with removal of extra ankle joint bone,1778.7,1156.16,78.57,1615.95,19
CDM,28240_1,Release or lengthening of tendon in foot,1162.4,755.56,78.57,1063.4,19
CDM,28250_1,Incision of connective tissue and muscle of sole of foot,1471.1,956.22,78.57,1400.04,19
CDM,28260_1,Incision of ankle joint capsule to correct foot deformity,1813.4,1178.71,78.57,1714.47,19
CDM,28261_1,Incision of ankle joint capsule and lengthening of tendon,3907.65,2539.97,78.57,2831.98,19
CDM,28262_1,Extensive repair of foot defect with tendon lengthening and relief of tension in foot,3607.8,2345.07,78.57,3406.24,19
CDM,28264_1,Release of capsule of midfoot,2232.3,1451.0,78.57,2118.11,19
CDM,28270_1,Incision of joint capsule of foot and toe,1902.6,1236.69,78.57,1165.5,19
CDM,28272_1,Incision of toe joint capsule,1042.7,677.76,78.57,919.99,19
CDM,28278IP _1,RIVASTIGMINE 1.5 MG CAPSULE,23.26,15.12,5.82,16.28,11
CDM,28278OP _1,RIVASTIGMINE 1.5 MG CAPSULE,17.35,11.28,4.34,12.15,11
CDM,28280IP _1,RIVASTIGMINE 4.5 MG CAPSULE,5.6,3.64,1.4,3.92,11
CDM,28280_1,Creation of webbing between toes,1357.7,882.51,78.57,1221.91,19
CDM,28282IP _1,"INJECTION, INSULIN, PER 5 UNITS",145.71,94.71,36.43,376.3,16
CDM,28282OP _1,"INJECTION, INSULIN, PER 5 UNITS",144.71,94.06,36.18,373.71,16
CDM,28285_1,Correction of toe joint deformity,1226.4,797.16,78.57,1288.76,19
CDM,28286_1,Correction of fifth toe joint deformity,1203.3,782.15,78.57,1059.68,19
CDM,28288_1,Removal of foot bone spur,1550.9,1008.09,78.57,1444.49,19
CDM,28289_1,Correction of rigid deformity of first joint of big toe,2866.5,1863.23,78.57,1647.08,19
CDM,28291_1,Correction of rigid deformity of first joint of big toe using implant,1155.0,750.75,78.57,1675.36,19
CDM,28292_1,Correction of bunion,2068.5,1344.53,78.57,1669.52,19
CDM,28295_1,Correction of bunion with alignment correction of midfoot bone toward ankle,1290.5,838.83,78.57,2555.96,19
CDM,28296_1,Correction of bunion with alignment correction of midfoot bone toward toe area,3001.95,1951.27,78.57,2127.13,19
CDM,28297_1,Correction of bunion with forefoot and midfoot bone fusion,3246.15,2110.0,78.57,2459.97,19
CDM,28298_1,Correction of bunion with alignment correction of big toe,1886.9,1226.49,78.57,1991.78,19
CDM,28299_1,Correction of bunion with 2 areas of realignment,2153.6,1399.84,78.57,2414.72,19
CDM,28300_1,Incision or partial removal of heel bone,3194.1,2076.17,78.57,1952.37,19
CDM,28302_1,Incision or partial removal of ankle bone,3184.65,2070.02,78.57,2114.83,19
CDM,28304_1,Incision or partial removal of foot bone,3112.2,2022.93,78.57,1977.8,19
CDM,28305_1,Incision or partial removal of foot bone with bone graft,1992.9,1295.39,78.57,2010.66,19
CDM,28306_1,Incision or partial removal of big toe bone to straighten toe,1551.9,1008.74,78.57,1451.39,19
CDM,28307_1,Incision or partial removal of big toe bone with self bone graft to straighten toe,1819.7,1182.81,78.57,1861.41,19
CDM,28308_1,Incision or partial removal of foot bone (other than big toe) to straighten toe,2149.95,1397.47,78.57,1362.07,19
CDM,28309_1,Incision or partial removal of multiple foot bones to straighten toes,2483.3,1614.15,78.57,2677.27,19
CDM,28310_1,Incision or partial removal of big toe bone at first toe bone level to straighten toe,1409.1,915.92,78.57,1300.82,19
CDM,28312_1,Incision or partial removal of toe bone to straighten toe,1289.4,838.11,78.57,1274.48,19
CDM,28313_1,Reconstruction of soft tissue angular deformity of toe,1335.6,868.14,78.57,1261.49,19
CDM,28315_1,Removal of small bone underlying long bone of foot at big toe joint,1254.8,815.62,78.57,1149.72,19
CDM,28320_1,Repair of nonhealed broken midfoot bone,1733.6,1126.84,78.57,1841.29,19
CDM,28322_1,Repair of nonhealed broken forefoot bone,2007.6,1304.94,78.57,1874.82,19
CDM,28340_1,Reconstruction of abnormal toe,1422.8,924.82,78.57,1365.22,19
CDM,28341_1,Reconstruction of abnormal toe with bone removal,1642.2,1067.43,78.57,1586.19,19
CDM,28344_1,Removal of extra toes with reconstruction,1187.6,771.94,78.57,1007.14,19
CDM,28345_1,Removal of congenital web space deformity of toes,1460.6,949.39,78.57,1233.56,19
CDM,28360_1,Reconstruction of congenital foot defect,2462.3,1600.5,78.57,3222.12,19
CDM,28372OP _1,COLESEVELAM 625 MG TABLET,7.15,4.65,1.79,5.01,11
CDM,28384IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.5,11.38,4.38,45.19,16
CDM,28384OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",45.66,29.68,11.42,117.92,16
CDM,28400IP _1,"STERILE WATER/SALINE, 500 ML",2.15,1.4,0.54,4.15,16
CDM,28400OP _1,"STERILE WATER/SALINE, 500 ML",12.69,8.25,3.17,8.88,16
CDM,28400_1,Closed treatment of broken heel bone,1035.0,672.75,78.57,679.85,19
CDM,28405_1,Closed treatment of broken heel bone with manipulation,1620.0,1053.0,78.57,1089.53,19
CDM,28406_1,Placement of stabilizing device for broken heel bone with manipulation,2101.05,1365.68,78.57,1568.2,19
CDM,28415_1,Treatment of broken heel bone,4641.6,3017.04,78.57,3338.18,19
CDM,28420_1,Treatment of broken heel bone with graft,4895.1,3181.82,78.57,3773.02,19
CDM,28430_1,Closed treatment of broken ankle joint bone,960.0,624.0,78.57,651.63,19
CDM,28435_1,Closed treatment of broken ankle joint bone with manipulation,1290.0,838.5,78.57,1002.34,19
CDM,28436_1,Placement of stabilizing device for broken ankle joint with manipulation,1165.5,757.58,78.57,1337.04,19
CDM,28445_1,Treatment of broken bone between foot and ankle,4380.15,2847.1,78.57,3122.55,19
CDM,28446_1,Implantation of self cartilage cells into foot joint with graft,4832.1,3140.87,78.57,3618.22,19
CDM,28450_1,Treatment of broken foot bone at ankle,620.0,403.0,78.57,592.63,19
CDM,28455_1,Treatment of broken foot bone at ankle with manipulation,750.0,487.5,78.57,805.95,19
CDM,28456_1,Placement of stabilizing device for broken foot joint with manipulation,719.3,467.55,78.57,986.69,19
CDM,28465_1,Treatment of broken hind portion of foot,1673.7,1087.91,78.57,1899.7,19
CDM,28470_1,Closed treatment of broken bone in forefoot or midfoot,560.0,364.0,78.57,609.79,19
CDM,28475_1,Closed treatment of broken foot with manipulation,720.0,468.0,78.57,701.29,19
CDM,28476_1,Placement of stabilizing device for broken foot bone with manipulation,913.5,593.78,78.57,1053.2,19
CDM,28485_1,Treatment of broken midportion of foot,1446.9,940.49,78.57,1647.73,19
CDM,2848IP _1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",8.55,5.56,2.14,22.08,16
CDM,2848OP _1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",7.23,4.7,1.81,18.67,16
CDM,28490_1,Closed treatment of broken great toe,525.0,341.25,66.7,382.97,19
CDM,28495_1,Closed treatment of broken great toe with manipulation,440.0,286.0,78.57,460.92,19
CDM,28496_1,Placement of stabilizing device for broken big toe with manipulation,1677.45,1090.34,75.94,1087.18,19
CDM,28505_1,Treatment of broken great toe,1770.0,1150.5,78.57,1561.89,19
CDM,2850IP _1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",25.99,16.89,6.5,67.12,16
CDM,2850OP _1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",22.5,14.63,5.63,58.11,16
CDM,28510_1,Closed treatment of broken toe,320.0,208.0,49.33,360.85,19
CDM,28515_1,Closed treatment of broken toe with manipulation,400.0,260.0,75.65,441.46,19
CDM,2851IP _1,"NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME",39.44,25.64,9.86,101.85,16
CDM,2851OP _1,"NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME",11.58,7.53,2.9,29.91,16
CDM,28525_1,Treatment of broken toe,1456.4,946.66,78.57,1359.59,19
CDM,28530_1,Closed treatment of broken small bone in tendon attached to great toe,280.0,182.0,78.57,306.63,19
CDM,28531_1,Treatment of broken small bone in tendon attached to great toe,1054.2,685.23,78.57,791.22,19
CDM,28534IP _1,"INJECTION, INSULIN, PER 5 UNITS",95.89,62.33,0.56,247.64,17
CDM,28534OP _1,"INJECTION, INSULIN, PER 5 UNITS",13.93,9.05,0.56,35.97,17
CDM,28540_1,Closed treatment of dislocated ankle joint bone,510.0,331.5,78.57,547.18,19
CDM,28545_1,Closed treatment of dislocated midfoot joint bone under anesthesia,755.0,490.75,78.57,827.41,19
CDM,28546_1,Placement of stabilizing device for dislocated midfoot joint with manipulation,2099.55,1364.71,78.57,1402.62,19
CDM,28555_1,Treatment of dislocated midfoot or hindfoot bones,3369.0,2189.85,78.57,2064.57,19
CDM,28570_1,Closed treatment of dislocated ankle joint,470.0,305.5,78.57,601.03,19
CDM,28575_1,Closed treatment of dislocated ankle joint under anesthesia,852.6,554.19,78.57,1036.14,19
CDM,28576_1,Placement of stabilizing device for dislocated ankle joint with manipulation,2105.85,1368.8,78.57,1159.02,19
CDM,28585_1,Treatment of dislocated ankle joint,2454.9,1595.69,78.57,2152.83,19
CDM,28600_1,Closed treatment of dislocated midfoot joint,540.0,351.0,78.57,571.93,19
CDM,28605_1,Closed treatment of dislocated midfoot joint under anesthesia,723.5,470.28,78.57,929.78,19
CDM,28606_1,Placement of stabilizing device for dislocated midfoot with manipulation,1892.1,1229.87,78.57,1161.55,19
CDM,28615_1,Treatment of dislocated midfoot bone,2105.3,1368.45,78.57,2419.88,19
CDM,28630_1,Closed treatment of dislocated joint between toe and foot,336.6,218.79,78.57,370.27,19
CDM,28635_1,Closed treatment of dislocated joint between toe and foot under anesthesia,523.25,340.11,78.57,424.72,19
CDM,28636_1,Placement of stabilizing device for dislocated joint between toe and foot with manipulation,822.2,534.43,78.57,744.96,19
CDM,2863IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.66,3.03,1.17,12.03,16
CDM,2863OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.71,14.76,5.68,58.65,16
CDM,28645_1,Treatment of dislocated joint between toe and foot,1689.5,1098.18,78.57,1556.23,19
CDM,28660_1,Closed treatment of dislocated joint in toe,250.0,162.5,78.57,297.82,19
CDM,28665_1,Closed treatment of dislocated joint in toe under anesthesia,413.7,268.91,78.57,392.24,19
CDM,28666_1,Placement of stabilizing device for dislocated toe joint,797.0,518.05,78.57,487.52,19
CDM,28675_1,Treatment of dislocated toe joint,1479.5,961.68,78.57,1378.91,19
CDM,28705_1,Fusion of all bones of ankle and hindfoot,3617.3,2351.25,78.57,3715.63,19
CDM,28715_1,Fusion of 3 bones of ankle,4016.25,2610.56,78.57,2811.59,19
CDM,28725_1,Fusion of foot below ankle,3302.85,2146.85,78.57,2335.29,19
CDM,28730_1,Fusion of multiple foot joints,3463.5,2251.28,78.57,2207.6,19
CDM,28735_1,Fusion of multiple foot joints with bone incision to correct a foot deformity,2210.3,1436.7,78.57,2354.86,19
CDM,28737_1,Fusion of upper part of foot and lengthening of tendon,1945.7,1264.71,78.57,2111.17,19
CDM,28740_1,Fusion of foot in midfoot region,3320.1,2158.07,78.57,1974.42,19
CDM,28750_1,Fusion of big toe at joint with foot,3227.25,2097.71,78.57,1867.59,19
CDM,28755_1,Fusion of big toe between toe joints,1299.9,844.94,78.57,1207.29,19
CDM,28760_1,Fusion of big toe between toe joints with tendon transfer,2050.7,1332.96,78.57,1824.53,19
CDM,28774IP _1,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",48.03,31.22,1.11,124.04,17
CDM,28774OP _1,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",9.18,5.97,1.11,23.71,17
CDM,28775IP _1,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",50.65,32.92,1.11,130.8,17
CDM,28775OP _1,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",9.03,5.87,1.11,23.32,17
CDM,28800_1,Amputation of midfoot bone,2379.9,1546.94,78.57,1621.28,19
CDM,28805_1,Amputation of foot across instep,3172.05,2061.83,78.57,2183.28,19
CDM,28810OP _1,UNCLASSIFIED DRUGS,21.9,14.24,5.48,56.56,16
CDM,28810_1,Amputation of toe and midfoot bone,1252.7,814.26,78.57,1284.55,19
CDM,28820_1,Amputation of toe at joint between forefoot and toes,1369.2,889.98,78.57,713.5,19
CDM,28824IP _1,UNCLASSIFIED DRUGS,18.52,12.04,4.63,47.83,16
CDM,28824OP _1,UNCLASSIFIED DRUGS,6.53,4.24,1.63,16.86,16
CDM,28825_1,Amputation of toe at toe joint,1497.3,973.25,78.57,699.81,19
CDM,28842IP _1,"CYCLOSPORINE, ORAL, 25 MG",21.33,13.86,0.56,55.08,17
CDM,28842OP _1,"CYCLOSPORINE, ORAL, 25 MG",12.29,7.99,0.56,31.74,17
CDM,28843IP _1,"CYCLOSPORINE, ORAL, 100 MG",74.06,48.14,1.92,191.26,17
CDM,28843OP _1,"CYCLOSPORINE, ORAL, 100 MG",14.48,9.41,1.92,37.39,17
CDM,28844IP _1,"CYCLOSPORINE, ORAL, 100 MG",19.67,12.79,1.92,50.8,17
CDM,2888IP _1,UNCLASSIFIED DRUGS,91.89,59.73,22.97,237.31,16
CDM,2888OP _1,UNCLASSIFIED DRUGS,55.37,35.99,13.84,142.99,16
CDM,28890_1,Shock wave therapy to arch of foot using ultrasound guidance under anesthesia,774.08,503.15,78.57,797.3,19
CDM,28899IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.37,17.79,6.84,70.68,16
CDM,28899OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.69,14.75,5.67,58.6,16
CDM,2889IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",67.75,44.04,16.94,174.96,16
CDM,28900023_1,HC THERAPEUTIC HYPOTHERMIA,352.0,228.8,88.0,246.4,11
CDM,28911IP _1,"INJECTION, CARMUSTINE, 100 MG",2486.39,1616.15,246.58,6421.1,19
CDM,28911OP _1,"INJECTION, CARMUSTINE, 100 MG",433.0,281.45,108.25,2922.83,19
CDM,28912OP _1,DACTINOMYCIN 500 MCG VIAL,1099.79,714.86,274.95,769.85,11
CDM,28913IP _1,UNCLASSIFIED DRUGS,1908.98,1240.84,477.25,4929.94,16
CDM,28913OP _1,UNCLASSIFIED DRUGS,1596.24,1037.56,399.06,4122.29,16
CDM,28916OP _1,UNCLASSIFIED DRUGS,636.6,413.79,159.15,1644.02,16
CDM,28917OP _1,UNCLASSIFIED DRUGS,603.55,392.31,150.89,1558.67,16
CDM,28922IP _1,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",4306.66,2799.33,0.63,11121.95,17
CDM,28922OP _1,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",2092.95,1360.42,0.63,5405.04,17
CDM,28923IP _1,UNCLASSIFIED DRUGS,2225.81,1446.78,556.45,5748.15,16
CDM,28923OP _1,UNCLASSIFIED DRUGS,1950.8,1268.02,487.7,5037.94,16
CDM,28947IP _1,"INJECTION, ARGATROBAN, 1 MG (FOR NON-ESRD USE)",367.54,238.9,0.65,949.17,19
CDM,28958IP _1,"SIROLIMUS, ORAL, 1 MG",59.12,38.43,1.03,152.68,17
CDM,28958OP _1,"SIROLIMUS, ORAL, 1 MG",93.4,60.71,1.03,241.21,17
CDM,28964IP _1,UNCLASSIFIED DRUGS,9.73,6.32,2.43,25.13,16
CDM,28964OP _1,UNCLASSIFIED DRUGS,20.52,13.34,5.13,52.99,16
CDM,28975IP _1,"MIFEPRISTONE, ORAL, 200 MG",577.5,375.38,144.38,1491.39,18
CDM,28975OP _1,"MIFEPRISTONE, ORAL, 200 MG",334.97,217.73,83.74,865.06,18
CDM,28995IP _1,UNCLASSIFIED DRUGS,5.71,3.71,1.43,14.75,16
CDM,28995OP _1,UNCLASSIFIED DRUGS,20.73,13.47,5.18,53.54,16
CDM,29000_1,Application of halo type body cast,665.7,432.71,78.57,820.93,19
CDM,2900IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",54.75,35.59,13.69,141.39,16
CDM,29010_1,Application of jacket type body cast,668.9,434.79,78.57,652.1,19
CDM,29015_1,Application of jacket type body cast including head,623.78,405.46,78.57,699.58,19
CDM,2901IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",89.45,58.14,22.36,231.0,16
CDM,29031OP _1,UNCLASSIFIED DRUGS,681.85,443.2,170.46,1760.88,16
CDM,29035_1,Application of shoulder to hip body cast,613.2,398.58,67.02,613.33,19
CDM,2903IP _1,"INJECTION, ERYTHROMYCIN LACTOBIONATE, PER 500 MG",506.7,329.36,21.37,1308.55,17
CDM,29040_1,Application of shoulder to hip body cast including head,596.4,387.66,78.57,699.35,19
CDM,29044_1,Application of shoulder to hip body cast and thigh,665.7,432.71,78.57,686.38,19
CDM,29046_1,Application of shoulder to hip body cast and both thighs,724.5,470.93,78.57,750.72,19
CDM,29048IP _1,UNCLASSIFIED DRUGS,8.18,5.32,2.05,21.12,16
CDM,29048OP _1,UNCLASSIFIED DRUGS,11.05,7.18,2.76,28.54,16
CDM,29049_1,Application of figure-of-eight cast,171.9,111.74,60.44,236.37,19
CDM,29055_1,Application of shoulder spica cast,528.2,343.33,78.57,531.89,19
CDM,29058_1,Application of plaster Velpeau cast to upper forearm and shoulder,288.8,187.72,78.57,292.6,19
CDM,29065_1,Application of shoulder to hand cast,240.0,156.0,36.55,229.84,19
CDM,29071IP _1,"INJECTION, ARSENIC TRIOXIDE, 1 MG",45.02,29.26,7.83,202.84,19
CDM,29071OP _1,"INJECTION, ARSENIC TRIOXIDE, 1 MG",15.21,9.89,3.8,202.84,19
CDM,29072IP _1,UNCLASSIFIED DRUGS,6.14,3.99,1.54,15.86,16
CDM,29075_1,Application of elbow to finger cast,330.0,214.5,26.67,208.06,19
CDM,29085_1,Application of hand and lower forearm cast,210.0,136.5,37.05,228.8,19
CDM,29086_1,Application of finger cast,131.3,85.35,34.77,184.58,19
CDM,29105_1,Application of lower and upper arm splint,285.0,185.25,26.41,196.31,19
CDM,29125T_1,Application of nonmoveable forearm to hand splint,123.9,80.54,20.16,158.0,19
CDM,29125_1,Application of nonmoveable forearm to hand splint,195.0,126.75,20.16,158.0,19
CDM,29126_1,Application of moveable or hinged forearm to hand splint,162.5,105.63,41.99,185.74,19
CDM,29130_1,Application of nonmoveable finger splint,150.0,97.5,22.9,98.85,19
CDM,29131_1,Application of hinged finger splint,120.2,78.13,28.6,127.21,19
CDM,29132IP _1,"INJECTION, IRON SUCROSE, 1 MG",57.85,37.6,0.25,149.4,17
CDM,29132OP _1,"INJECTION, IRON SUCROSE, 1 MG",144.16,93.7,0.25,372.29,17
CDM,29169IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.87,1.22,0.47,4.83,16
CDM,29169OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.86,3.16,1.22,12.55,16
CDM,29200_1,Placement of strapping to chest,140.7,91.46,14.98,79.35,19
CDM,29240_1,Placement of strapping to shoulder,157.5,102.38,14.98,78.57,19
CDM,29260_1,Placement of strapping to elbow or wrist,135.5,88.08,13.93,78.57,19
CDM,29272IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.16,3.35,1.29,13.33,16
CDM,29272OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.5,19.83,7.63,78.77,16
CDM,29274IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.07,3.3,1.27,13.09,16
CDM,29274OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.75,14.14,5.44,56.17,16
CDM,29276IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.27,3.43,1.32,13.61,16
CDM,29276OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.8,14.82,5.7,58.88,16
CDM,29280IP _1,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (MIRENA), 52 MG",8725.73,5671.72,727.06,22534.2,19
CDM,29280OP _1,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (MIRENA), 52 MG",4734.97,3077.73,727.06,12228.06,19
CDM,29280_1,Placement of strapping to hand or finger,196.95,128.02,14.06,78.57,19
CDM,29287IP _1,ABREVA 10% CREAM,90.3,58.7,22.58,63.21,11
CDM,29299IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.27,3.43,1.32,13.61,16
CDM,29299OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.23,4.05,1.56,16.09,16
CDM,29302IP _1,"PREDNISOLONE ORAL, PER 5 MG",8.12,5.28,0.98,20.97,17
CDM,29302OP _1,"PREDNISOLONE ORAL, PER 5 MG",1.7,1.11,0.43,4.39,17
CDM,29305_1,Application of hip spica cast on leg,595.4,387.01,78.57,589.31,19
CDM,2930OP _1,"INJECTION, ESTRADIOL VALERATE, UP TO 10 MG",73.3,47.65,7.9,189.3,17
CDM,2931OP _1,ESTRADIOL VALERATE 100 MG/5 ML,107.6,69.94,26.9,75.32,11
CDM,29325_1,"Application of hip spica cast on both legs, or on leg and part of other leg",663.6,431.34,78.57,650.24,19
CDM,29335IP _1,"INJECTION, PROPRANOLOL HCL, UP TO 1 MG",43.45,28.24,10.86,112.21,17
CDM,29335OP _1,"INJECTION, PROPRANOLOL HCL, UP TO 1 MG",35.65,23.17,8.91,92.07,17
CDM,29345_1,Application of long leg cast from thigh to toe,340.0,221.0,52.7,321.51,19
CDM,29355_1,Application of walking cast covering thigh to toe,350.0,227.5,64.05,337.34,19
CDM,29358_1,Application of long leg brace-type cast from thigh to toe,400.0,260.0,43.16,381.33,19
CDM,29365_1,Application of thigh to lower leg cylinder cast,290.0,188.5,47.7,294.1,19
CDM,29396IP _1,"INJECTION, BIVALIRUDIN, 1 MG",939.94,610.96,0.17,2427.4,19
CDM,29396OP _1,"INJECTION, BIVALIRUDIN, 1 MG",246.24,160.06,0.17,635.91,19
CDM,29405_1,Application of short leg cast,345.0,224.25,36.9,191.12,19
CDM,29424IP _1,UNCLASSIFIED DRUGS,5.73,3.72,1.43,14.8,16
CDM,29424OP _1,UNCLASSIFIED DRUGS,7.46,4.85,1.87,19.27,16
CDM,29425_1,Application of walking cast covering below knee to toe,250.0,162.5,47.05,180.27,19
CDM,29434IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",44.24,28.76,11.06,114.25,16
CDM,29434OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",126.96,82.52,31.74,327.87,16
CDM,29435IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",45.57,29.62,11.39,117.68,16
CDM,29435OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",163.6,106.34,40.9,422.5,16
CDM,29435_1,Application of kneecap tendon bearing cast,302.4,196.56,71.65,274.21,19
CDM,29440_1,Addition of walker to previously applied cast,120.0,78.0,18.52,103.58,19
CDM,29443IP _1,TACROLIMUS 0.1% OINTMENT,11.42,7.42,2.86,7.99,11
CDM,29445_1,"Application of walking cast covering foot, ankle, and lower leg",470.0,305.5,78.57,308.13,19
CDM,29449OP _1,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",1518.72,987.17,14.62,3922.09,19
CDM,29450_1,Application of leg cast and manipulation of foot to treat deformity,408.5,265.53,20.59,351.07,19
CDM,29464IP _1,MORPHINE 5 MG/10 ML VIAL,906.0,588.9,226.5,634.2,11
CDM,29481IP _1,UNCLASSIFIED DRUGS,35.85,23.3,8.96,92.58,16
CDM,29481OP _1,UNCLASSIFIED DRUGS,12.15,7.9,3.04,31.38,16
CDM,29505_1,Application of long leg splint from thigh to ankle or toe,300.0,195.0,27.96,211.06,19
CDM,29515T_1,Application of short leg splint from calf to foot,113.4,73.71,26.78,171.18,19
CDM,29515_1,Application of short leg splint from calf to foot,240.0,156.0,26.78,171.18,19
CDM,29520_1,Placement of strapping to hip,74.75,48.59,14.98,84.95,19
CDM,29530_1,Placement of strapping to knee,68.23,44.35,14.98,78.57,19
CDM,29540_1,Placement of strapping to ankle or foot,174.9,113.69,14.61,78.57,19
CDM,29550_1,Placement of strapping to toes,45.05,29.28,9.19,78.57,19
CDM,29580_1,"Strapping, Unna boot",195.0,126.75,21.69,151.29,19
CDM,29581_1,"Application of vein wound compression bandages on lower leg, ankle, and foot",218.82,142.23,22.61,217.39,19
CDM,29584_1,"Application of vein wound compression bandages on upper arm, forearm, hand, and fingers",183.3,119.15,13.02,197.88,19
CDM,29588OP _1,"AMINOLEVULINIC ACID HCL FOR TOPICAL ADMINISTRATION, 20%, SINGLE UNIT DOSAGE FORM (354 MG)",949.16,616.95,237.29,2451.21,19
CDM,29700_1,"Removal or cutting of gauntlet, boot, or body cast",150.0,97.5,13.98,148.14,19
CDM,29705_1,Removal or cutting of full arm or leg cast,160.0,104.0,24.7,149.27,19
CDM,29710_1,"Removal or cutting of shoulder, hip spica, or jacket cast",307.7,200.01,26.75,288.26,19
CDM,29720_1,"Repair of spica, body cast, or jacket",147.0,95.55,10.88,203.46,19
CDM,29730_1,Exam of skin surface by creation of opening in cast,160.0,104.0,13.57,151.6,19
CDM,29740_1,Insertion of wedge in cast,220.0,143.0,18.52,232.68,19
CDM,29745IP _1,ESOMEPRAZOLE MAG DR 20 MG CAP,9.5,6.18,2.38,6.65,11
CDM,29750_1,Insertion of wedge in clubfoot cast,216.43,140.68,14.82,252.02,19
CDM,29778IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.07,2.65,1.02,10.51,16
CDM,29778OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.32,6.71,2.58,26.65,16
CDM,29781IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.66,4.33,1.67,17.2,16
CDM,29781OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.0,14.3,5.5,56.82,16
CDM,29800IP _1,FLUOXETINE DR 90 MG CAPSULE,204.86,133.16,51.22,143.4,11
CDM,29800_1,Diagnostic exam of jaw joint using an endoscope,2472.75,1607.29,78.57,1562.05,19
CDM,29804_1,Exam of jaw joint using an endoscope,3661.95,2380.27,78.57,1873.49,19
CDM,29805IP _1,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",4.03,2.62,0.22,10.41,17
CDM,29805_1,Diagnostic exam of shoulder using an endoscope,1139.3,740.55,78.57,1394.26,19
CDM,29806_1,Repair of shoulder joint capsule using an endoscope,4301.4,2795.91,78.57,3136.79,19
CDM,29807_1,Repair of shoulder socket using an endoscope,4188.0,2722.2,78.57,3065.8,19
CDM,29819_1,Removal of loose or foreign body in shoulder joint using an endoscope,1704.2,1107.73,78.57,1734.42,19
CDM,29820_1,Partial removal of shoulder joint lining using an endoscope,2556.3,1661.6,78.57,1589.96,19
CDM,29821_1,Removal of entire shoulder joint lining using an endoscope,2049.6,1332.24,78.57,1747.59,19
CDM,29822IP _1,UNCLASSIFIED DRUGS,6.91,4.49,1.73,17.85,16
CDM,29822OP _1,UNCLASSIFIED DRUGS,19.36,12.58,4.84,50.0,16
CDM,29822_1,Limited removal of abnormal shoulder joint tissue using endoscope,2880.0,1872.0,78.57,1642.69,19
CDM,29823_1,Removal of extensive shoulder joint tissue using an endoscope,3203.55,2082.31,78.57,1797.66,19
CDM,29824_1,Partial removal of collar bone at shoulder using an endoscope,2685.0,1745.25,78.57,1991.59,19
CDM,29825_1,Removal of shoulder scar tissue using an endoscope,2345.25,1524.41,78.57,1723.53,19
CDM,29826_1,Shaving of part of shoulder bone and repair of ligament using an endoscope,1840.0,1196.0,78.57,979.48,19
CDM,29827_1,Repair of shoulder rotator cuff using an endoscope,4405.35,2863.48,78.57,3154.48,19
CDM,29828_1,Release of tendon connecting biceps muscle and shoulder using an endoscope,3690.3,2398.7,78.57,2711.55,19
CDM,29830_1,Diagnostic exam of elbow joint using an endoscope,1204.4,782.86,78.57,1353.15,19
CDM,29834_1,Removal of loose or foreign body in elbow joint using an endoscope,1422.8,924.82,78.57,1450.82,19
CDM,29835_1,Partial removal of elbow joint lining using an endoscope,1537.2,999.18,78.57,1497.92,19
CDM,29836_1,Removal of entire elbow joint lining using an endoscope,1338.38,869.95,78.57,1709.91,19
CDM,29837_1,Removal of elbow joint tissue using an endoscope,2118.45,1376.99,78.57,1562.14,19
CDM,29838_1,Removal of extensive damaged tissue from elbow joint using an endoscope,2368.8,1539.72,78.57,1748.71,19
CDM,29840_1,Diagnostic exam of wrist using an endoscope,1184.4,769.86,78.57,1338.53,19
CDM,29843_1,"Diagnostic exam, washing, and drainage of infected wrist using an endoscope",1121.68,729.09,78.57,1431.22,19
CDM,29844_1,Partial removal of wrist joint lining using an endoscope,1319.9,857.94,78.57,1483.41,19
CDM,29845_1,Removal of entire wrist joint lining using an endoscope,2019.15,1312.45,78.57,1725.9,19
CDM,29846_1,Removal or repair of wrist cartilage using an endoscope,2086.95,1356.52,78.57,1551.12,19
CDM,29847_1,Placement of internal stabilizing device using an endoscope to treat broken or unstable wrist,1437.5,934.38,78.57,1599.03,19
CDM,29848_1,Release of wrist ligament using an endoscope,1978.2,1285.83,78.57,1518.17,19
CDM,29850_1,Treatment of broken knee joint using an endoscope,2304.3,1497.8,78.57,1844.09,19
CDM,29851_1,Treatment of broken knee joint with placement of stabilizing device using an endoscope,2515.8,1635.27,78.57,2753.17,19
CDM,29855_1,Treatment of broken upper portion of lower leg bone on side using an endoscope,2106.3,1369.1,78.57,2319.95,19
CDM,29856_1,Treatment of broken upper portion of lower leg bone on both sides using an endoscope,2702.7,1756.76,78.57,2940.8,19
CDM,29858IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.49,4.87,1.87,19.34,16
CDM,29858OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.28,17.73,6.82,70.45,16
CDM,29860_1,Diagnostic exam of hip using an endoscope,1531.38,995.4,78.57,1954.37,19
CDM,29861_1,Removal of loose or foreign body in hip joint using an endoscope,1931.0,1255.15,78.57,2139.06,19
CDM,29862_1,Removal or shaving of hip joint socket cartilage using an endoscope,2162.0,1405.3,78.57,2404.39,19
CDM,29863_1,Removal of hip joint lining using an endoscope,2147.3,1395.75,78.57,2405.82,19
CDM,29866_1,Repair of knee cartilage and bone with patient-derived healthy cartilage transplant using an endoscope,2810.9,1827.09,78.57,3109.32,19
CDM,29867_1,Repair of knee cartilage and bone with donor cartilage graft using an endoscope,3418.8,2222.22,78.57,3778.67,19
CDM,29868_1,Repair of knee cartilage with donor cartilage graft using an endoscope,8785.0,5710.25,78.57,4956.4,19
CDM,29870_1,Diagnostic exam of knee using an endoscope,1082.6,703.69,78.57,1310.41,19
CDM,29871_1,"Exam, washing, and drainage of infected knee joint using an endoscope",2055.45,1336.04,78.57,1523.24,19
CDM,29873_1,Release of ligaments at outer side of knee joint using an endoscope,1357.7,882.51,78.57,1558.09,19
CDM,29874_1,Removal of loose or foreign body in knee joint using an endoscope,2242.8,1457.82,78.57,1589.64,19
CDM,29875_1,Partial removal of knee joint lining using an endoscope,2690.1,1748.57,78.57,1467.12,19
CDM,29876_1,Removal of joint lining from multiple knee joint compartments using an endoscope,3074.4,1998.36,78.57,1941.59,19
CDM,29877_1,Removal or shaving of knee joint cartilage using an endoscope,2690.1,1748.57,78.57,1840.92,19
CDM,29879_1,Repair of knee joint with drilling and or scraping of joint using an endoscope,3362.7,2185.76,78.57,1961.22,19
CDM,29880_1,Removal of both knee cartilages using an endoscope,3735.9,2428.34,78.57,1664.74,19
CDM,29881_1,Removal of knee cartilage using an endoscope,2690.1,1748.57,78.57,1603.57,19
CDM,29882_1,Repair of inside or outside knee joint cartilage using an endoscope,3362.7,2185.76,78.57,2063.7,19
CDM,29883_1,Repair of inside and outside knee joint cartilage using an endoscope,4803.75,3122.44,78.57,2501.43,19
CDM,29884_1,Removal of scar tissue from knee using an endoscope,2458.65,1598.12,78.57,1827.92,19
CDM,29885_1,Repair of knee joint with bone graft using an endoscope,2983.05,1938.98,78.57,2219.84,19
CDM,29886_1,Repair of knee joint by drilling cartilage using an endoscope,1677.9,1090.64,78.57,1884.8,19
CDM,29887_1,Repair of knee joint with bone graft and internal stabilizing device using an endoscope,2112.6,1373.19,78.57,2217.17,19
CDM,29888_1,Repair of anterior cruciate ligament of knee using an endoscope,5956.65,3871.82,78.57,2914.69,19
CDM,29889_1,Repair of posterior cruciate ligament of knee using an endoscope,5956.65,3871.82,78.57,3620.39,19
CDM,29891_1,Removal of shin and/or ankle bone defect using an endoscope,2805.15,1823.35,78.57,2013.98,19
CDM,29892_1,Removal of large shin or ankle bone defect using an endoscope,1542.2,1002.43,78.57,1969.97,19
CDM,29893_1,Repair of fibrous tissue of arch of foot using an endoscope,1465.15,952.35,78.57,1601.38,19
CDM,29894_1,Removal of loose or foreign body in ankle using an endoscope,1704.2,1107.73,78.57,1486.1,19
CDM,29895_1,Partial removal of ankle joint lining using an endoscope,1495.2,971.88,78.57,1415.88,19
CDM,29897_1,Removal of limited dead or infected tissue using an endoscope,1495.2,971.88,78.57,1508.51,19
CDM,29898_1,Removal of extensive dead or infected tissue using an endoscope,2384.55,1549.96,78.57,1693.09,19
CDM,29899_1,Fusion of ankle joint using an endoscope,2420.93,1573.6,78.57,3076.63,19
CDM,29900_1,Biopsy of lining of joint of finger using an endoscope,1011.98,657.79,78.57,1471.57,19
CDM,29901_1,Removal of dead or infected finger joint tissue using an endoscope,1237.23,804.2,78.57,1579.03,19
CDM,29902_1,Treatment of displaced finger joint ligament using an endoscope,1147.98,746.19,78.57,1681.55,19
CDM,29904_1,Removal of loose or foreign body in ankle joint at heel bones using an endoscope,1661.1,1079.72,78.57,1880.18,19
CDM,29905_1,Removal of lining of ankle joint using an endoscope,1787.1,1161.62,78.57,1608.18,19
CDM,29906_1,Removal of dead or infected ankle joint tissue using an endoscope,1882.7,1223.76,78.57,1996.18,19
CDM,29907_1,Fusion of foot joint using an endoscope,2303.7,1497.41,78.57,2591.88,19
CDM,29914_1,Reshaping of thigh bone at hip joint using an endoscope,3679.2,2391.48,78.57,2938.05,19
CDM,29915_1,Reshaping of hip socket using an endoscope,2500.1,1625.07,78.57,3029.82,19
CDM,29916_1,Repair of hip joint socket cartilage using an endoscope,3750.15,2437.6,78.57,3023.16,19
CDM,30000004_1,Test to measure exhaled air for evaluation of lung function at rest,377.0,245.05,83.86,1438.0,19
CDM,30000005_1,Test to measure exhaled air for evaluation of lung function at rest,377.0,245.05,83.86,1438.0,19
CDM,30000006_1,Whole body composition tissue and fluid measurements with interpretation and report,25.0,16.25,6.25,784.0,19
CDM,30000007_1,Whole body composition tissue and fluid measurements with interpretation and report,25.0,16.25,6.25,784.0,19
CDM,30000_1,Drainage of abscess or blood accumulation of nose,593.3,385.65,55.42,647.79,19
CDM,3000442T_1,"Freezing destruction of nerve plexus, accessed through the skin, using imaging guidance",10504.0,6827.6,188.0,27126.58,19
CDM,3000575T_1,"In-person programming device evaluation of implantable cardioverter-defibrillator system with electrode under breastbone, with analysis, review and report",45.0,29.25,11.25,116.21,17
CDM,3000576T_1,"In-person interrogation device evaluation of implantable cardioverter-defibrillator system with electrode under breastbone, with analysis, review and report",45.0,29.25,11.25,116.21,17
CDM,3000577T_1,"Electrophysiological evaluation of implantable cardioverter-defibrillator system with electrode under breastbone, with analysis, review and report",2652.0,1723.8,663.0,9454.3,17
CDM,3000627T_1,"Injection of cell or tissue-based material into spinal disc of lower back accessed through skin, first level",30345.0,19724.25,2166.29,78365.96,19
CDM,3000629T_1,"Injection of cell or tissue-based material into spinal disc of lower back accessed through skin using CT imaging guidance, first level",30345.0,19724.25,2166.29,78365.96,19
CDM,3000699T_1,Injection of medication into posterior chamber of eye,5128.0,3333.2,1282.0,13243.06,19
CDM,3000708T_1,Preparation and initial injection of cancer immunotherapy into skin,175.0,113.75,43.75,3678.0,19
CDM,30008509_1,"TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, INSERTED BY A LICENSED HEALTH CARE PROVIDER, ANY TYPE",357.0,232.05,89.25,428.4,16
CDM,30009000_1,Other procedure on lymphatic system,10000.0,6500.0,2500.0,25825.0,18
CDM,30009010_1,Other procedure on lymphatic system,10000.0,6500.0,2500.0,25825.0,18
CDM,30010004_1,"Fine needle aspiration biopsy, each additional growth",150.0,97.5,76.5,2166.29,17
CDM,30010005_1,"Fine needle aspiration biopsy using ultrasound guidance, first growth",2340.0,1521.0,993.51,6043.05,17
CDM,30010006_1,"Fine needle aspiration biopsy using ultrasound guidance, each additional growth",200.0,130.0,102.0,2166.29,17
CDM,30010007_1,"Fine needle aspiration biopsy using fluoroscopic guidance, first growth",870.0,565.5,443.7,3227.0,17
CDM,30010008_1,"Fine needle aspiration biopsy using fluoroscopic guidance, each additional growth",200.0,130.0,102.0,2166.29,17
CDM,30010009_1,"Fine needle aspiration biopsy of growth using CT guidance, first growth",870.0,565.5,443.7,3227.0,17
CDM,30010010_1,"Fine needle aspiration biopsy of growth using CT guidance, each additional growth",200.0,130.0,102.0,2166.29,17
CDM,30010021_1,"Fine needle aspiration biopsy, first growth",465.0,302.25,237.15,2166.29,17
CDM,30010030_1,Drainage of fluid collection in soft tissue using imaging guidance,1674.0,1088.1,853.74,4323.11,17
CDM,30010035_1,"Placement of soft tissue locating device using X-ray, first growth",1281.0,832.65,653.31,3308.18,17
CDM,30010036_1,"Placement of soft tissue locating device using X-ray, each additional growth",600.0,390.0,306.0,2166.29,17
CDM,30010040_1,Acne surgery,163.0,105.95,83.13,8477.27,17
CDM,30010060_1,Simple or single drainage of skin abscess,120.0,78.0,30.0,2166.29,19
CDM,30010061_1,Complicated or multiple drainage of skin abscess,300.0,195.0,75.0,2166.29,19
CDM,30010080_1,Simple drainage of cyst of tailbone,580.0,377.0,145.0,3227.0,19
CDM,30010081_1,Complicated drainage of cyst of tailbone,549.0,356.85,137.25,3227.0,19
CDM,30010120_1,"Removal of foreign body from tissue, accessed beneath the skin, simple",300.0,195.0,75.0,2166.29,19
CDM,30010121_1,"Removal of foreign body from tissue, accessed beneath the skin, complex",1325.0,861.25,331.25,3726.0,19
CDM,30010140_1,Drainage of blood or fluid accumulation,1500.0,975.0,375.0,3873.75,19
CDM,30010160_1,"Aspiration of abscess, blood, or cyst",400.0,260.0,100.0,2166.29,19
CDM,30010180_1,Complex drainage of wound infection after surgery,6444.0,4188.6,1477.47,16641.63,19
CDM,30011000_1,"Removal of inflamed or infected skin, up to 10% of body surface",479.0,311.35,119.75,2166.29,19
CDM,30011001_1,"Removal of inflamed or infected skin, each additional 10% of body surface or less",50.0,32.5,12.5,2166.29,19
CDM,30011010_1,Removal of foreign material from skin and tissue at open broken and/or dislocated bone,1215.0,789.75,303.75,3227.0,19
CDM,30011012_1,"Removal of foreign material from skin, tissue, muscle, and bone at open broken and/or dislocated bone",6444.0,4188.6,1477.47,16641.63,19
CDM,30011042_1,"Removal of skin and tissue, 20.0 sq cm or less",914.0,594.1,208.0,2360.41,19
CDM,30011043_1,"Removal of muscle and/or tissue, 20.0 sq cm or less",2332.0,1515.8,208.0,6022.39,19
CDM,30011044_1,"Removal of bone, 20.0 sq cm or less",3000.0,1950.0,750.0,7747.5,19
CDM,30011045_1,"Removal of skin and tissue, each additional 20.0 sq cm or less",300.0,195.0,75.0,1507.02,19
CDM,30011046_1,"Removal of muscle and/or tissue, each additional 20.0 sq cm or less",800.0,520.0,200.0,2066.0,19
CDM,30011055_1,"Removal of noncancer thickened skin growth, 1 growth",207.0,134.55,51.75,534.58,19
CDM,30011056_1,"Removal of noncancer thickened skin growth, 2-4 growths",292.0,189.8,73.0,754.09,19
CDM,30011057_1,"Removal of noncancer thickened skin growth, more than 4 growths",386.0,250.9,96.5,996.85,19
CDM,30011102_1,"Biopsy of related skin growth, first growth",352.0,228.8,88.0,2166.29,19
CDM,30011103_1,"Biopsy of related skin growth, each additional growth",30.0,19.5,7.5,2166.29,19
CDM,30011104_1,"Punch biopsy, first skin growth",352.0,228.8,88.0,1242.0,19
CDM,30011105_1,"Punch biopsy, each additional skin growth",30.0,19.5,7.5,2166.29,19
CDM,30011106_1,"Incision biopsy, first skin growth",630.0,409.5,157.5,3227.0,19
CDM,30011107_1,"Incision biopsy, each additional skin growth",50.0,32.5,12.5,2166.29,19
CDM,30011200_1,"Removal of skin tag, 1-15 skin tags",163.0,105.95,40.75,2166.29,19
CDM,30011201_1,"Removal of skin tag, each additional 10 skin tags",21.0,13.65,5.25,8477.27,19
CDM,30011300_1,"Shaving of skin growth of body, arms, or legs, 0.5 cm or less",163.0,105.95,40.75,8477.27,19
CDM,30011301_1,"Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm",163.0,105.95,40.75,8477.27,19
CDM,30011302_1,"Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm",200.0,130.0,50.0,8477.27,19
CDM,30011303_1,"Shaving of skin growth of body, arms, or legs, more than 2.0 cm",200.0,130.0,50.0,8477.27,19
CDM,30011305_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",163.0,105.95,40.75,8477.27,19
CDM,30011306_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",163.0,105.95,40.75,8477.27,19
CDM,30011307_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",200.0,130.0,50.0,8477.27,19
CDM,30011308_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm",330.0,214.5,82.5,8477.27,19
CDM,30011310_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",163.0,105.95,40.75,8477.27,19
CDM,30011311_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",163.0,105.95,40.75,8477.27,19
CDM,30011312_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",200.0,130.0,50.0,8477.27,19
CDM,30011313_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, more than 2.0 cm",200.0,130.0,50.0,8477.27,19
CDM,30011400_1,"Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less",549.0,356.85,137.25,3227.0,19
CDM,30011401_1,"Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm",302.0,196.3,75.5,2166.29,19
CDM,30011402_1,"Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011403_1,"Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011404_1,"Removal of noncancer skin growth of body, arms, or legs, 3.1-4.0 cm",1330.0,864.5,332.5,3726.0,19
CDM,30011406_1,"Removal of noncancer skin growth of body, arms, or legs, more than 4.0 cm",1330.0,864.5,332.5,3726.0,19
CDM,30011420_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",1330.0,864.5,332.5,3434.73,19
CDM,30011421_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011422_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011423_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",2021.0,1313.65,505.25,5219.23,19
CDM,30011424_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",2158.0,1402.7,208.0,5573.04,19
CDM,30011426_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",2270.0,1475.5,567.5,6451.0,19
CDM,30011440_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",549.0,356.85,137.25,3227.0,19
CDM,30011441_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011442_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011443_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",1351.0,878.15,337.75,3488.96,19
CDM,30011444_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",1330.0,864.5,332.5,3434.73,19
CDM,30011446_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",2460.0,1599.0,615.0,6451.0,19
CDM,30011601_1,"Removal of cancer skin growth of body, arms, or legs, 0.6-1.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011602_1,"Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm",200.0,130.0,50.0,623.98,19
CDM,30011603_1,"Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011604_1,"Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011606_1,"Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm",1330.0,864.5,332.5,3726.0,19
CDM,30011620_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",1330.0,864.5,332.5,3434.73,19
CDM,30011621_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011622_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011623_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",1330.0,864.5,332.5,3434.73,19
CDM,30011624_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",1330.0,864.5,332.5,3726.0,19
CDM,30011626_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",2270.0,1475.5,567.5,6451.0,19
CDM,30011640_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",549.0,356.85,137.25,3227.0,19
CDM,30011641_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011642_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",549.0,356.85,137.25,3227.0,19
CDM,30011643_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",1581.0,1027.65,395.25,4082.93,19
CDM,30011644_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",1950.0,1267.5,487.5,5035.88,19
CDM,30011646_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",2270.0,1475.5,567.5,6451.0,19
CDM,30011719_1,Trimming of fingernails or toenails,65.0,42.25,16.25,8477.27,19
CDM,30011730_1,"Simple separation of fingernail or toenail from nail bed, first nail",400.0,260.0,96.73,2166.29,19
CDM,30011732_1,"Simple separation of fingernail or toenail from nail bed, each additional nail",50.0,32.5,12.5,2166.29,19
CDM,30011740_1,Removal of blood accumulation under fingernail or toenail,159.0,103.35,39.75,2166.29,19
CDM,30011750_1,Permanent removal fingernail or toenail,302.0,196.3,75.5,2166.29,19
CDM,30011755_1,Biopsy of fingernail or toenail,549.0,356.85,137.25,3227.0,19
CDM,30011760_1,Repair of fingernail or toenail bed,1357.0,882.05,96.73,3504.45,19
CDM,30011765_1,Removal of skin of fingernail or toenail,302.0,196.3,75.5,2166.29,19
CDM,30011771_1,Extensive removal of cyst of tailbone,5250.0,3412.5,208.0,13558.13,19
CDM,30011900_1,"Injection into skin growth, 1-7 growths",163.0,105.95,40.75,2166.29,19
CDM,30011901_1,"Injection into skin growth, more than 7 growths",170.0,110.5,42.5,2166.29,19
CDM,30011950_1,"Injection of filling material under skin, 1.0 cc or less",150.0,97.5,37.5,8477.27,19
CDM,30011951_1,"Injection of filling material under skin, 1.1-5.0 cc",225.0,146.25,56.25,8477.27,19
CDM,30011976_1,Removal of implantable contraceptive capsules,549.0,356.85,137.25,1417.79,19
CDM,30011981_1,Insertion of drug delivery implant into tissue,110.0,71.5,27.5,2166.29,19
CDM,30011982_1,Removal of drug delivery implant from tissue,494.0,321.1,123.5,2166.29,19
CDM,30012001_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less",250.0,162.5,62.5,2166.29,19
CDM,30012002_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm",260.0,169.0,65.0,8477.27,19
CDM,30012004_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 7.6-12.5 cm",275.0,178.75,68.75,2166.29,19
CDM,30012005_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 12.6-20.0 cm",325.0,211.25,81.25,2318.31,19
CDM,30012006_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 20.1-30.0 cm",375.0,243.75,93.75,2318.31,19
CDM,30012007_1,"Simple repair of surface wound to scalp, neck, underarms, trunk, arms, or legs, more than 30.0 cm",180.0,117.0,45.0,2318.31,19
CDM,30012011_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",250.0,162.5,62.5,8477.27,19
CDM,30012013_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",260.0,169.0,65.0,8477.27,19
CDM,30012014_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",275.0,178.75,68.75,2166.29,19
CDM,30012015_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",325.0,211.25,81.25,2166.29,19
CDM,30012016_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",375.0,243.75,93.75,2318.31,19
CDM,30012017_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm",425.0,276.25,106.25,2318.31,19
CDM,30012018_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, more than 30.0 cm",475.0,308.75,118.75,2318.31,19
CDM,30012020_1,Simple closure of surface wound reopening,500.0,325.0,125.0,2166.29,19
CDM,30012021_1,Repair of separation of wound closure with insertion of packing,325.0,211.25,81.25,2166.29,19
CDM,30012031_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less",325.0,211.25,81.25,2166.29,19
CDM,30012032_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm",375.0,243.75,93.75,2166.29,19
CDM,30012034_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm",425.0,276.25,106.25,2318.31,19
CDM,30012035_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 12.6-20.0 cm",475.0,308.75,118.75,2318.31,19
CDM,30012036_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 20.1-30.0 cm",525.0,341.25,131.25,2318.31,19
CDM,30012037_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, more than 30.0 cm",2000.0,1300.0,500.0,5165.0,19
CDM,30012041_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less",325.0,211.25,81.25,2166.29,19
CDM,30012042_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm",375.0,243.75,93.75,2166.29,19
CDM,30012044_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 7.6-12.5 cm",525.0,341.25,131.25,2318.31,19
CDM,30012045_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 12.6-20.0 cm",575.0,373.75,143.75,2318.31,19
CDM,30012046_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 20.1-30.0 cm",625.0,406.25,156.25,3227.0,19
CDM,30012051_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",325.0,211.25,81.25,2166.29,19
CDM,30012052_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",375.0,243.75,93.75,2166.29,19
CDM,30012053_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",425.0,276.25,106.25,2166.29,19
CDM,30012054_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",475.0,308.75,118.75,2318.31,19
CDM,30012055_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",525.0,341.25,131.25,2318.31,19
CDM,30012056_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm",575.0,373.75,143.75,2318.31,19
CDM,30013100_1,"Complicated repair of wound of trunk, 1.1-2.5 cm",525.0,341.25,131.25,2318.31,19
CDM,30013101_1,"Complicated repair of wound of trunk, 2.6-7.5 cm",575.0,373.75,143.75,6141.01,19
CDM,30013102_1,"Complicated repair of wound of trunk, each additional 5.0 cm or less",250.0,162.5,62.5,2166.29,19
CDM,30013120_1,"Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm",525.0,341.25,131.25,2318.31,19
CDM,30013121_1,"Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm",575.0,373.75,143.75,6141.01,19
CDM,30013122_1,"Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less",250.0,162.5,62.5,2166.29,19
CDM,30013131_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm",325.0,211.25,81.25,2318.31,19
CDM,30013132_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm",525.0,341.25,131.25,6141.01,19
CDM,30013133_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less",250.0,162.5,62.5,2166.29,19
CDM,30013151_1,"Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm",525.0,341.25,131.25,6141.01,19
CDM,30013152_1,"Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm",625.0,406.25,156.25,6141.01,19
CDM,30013153_1,"Complicated repair of wound of eyelids, nose, ears, or lip, each additional 5.0 cm or less",250.0,162.5,62.5,6141.01,19
CDM,30013160_1,Extensive or complicated repair of surface wound reopening,2695.0,1751.75,673.75,6959.84,19
CDM,30014000_1,"Repair of wound of trunk by transferring skin, 10.0 sq cm or less",1550.0,1007.5,387.5,4002.88,19
CDM,30014001_1,"Repair of wound of trunk by transferring skin, 10.1-30.0 sq cm",1600.0,1040.0,400.0,6141.01,19
CDM,30014020_1,"Repair of wound of scalp, arms, or legs by transferring skin, 10.0 sq cm or less",1550.0,1007.5,387.5,6141.01,19
CDM,30014021_1,"Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm",1600.0,1040.0,400.0,6141.01,19
CDM,30014040_1,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less",1550.0,1007.5,387.5,4002.88,19
CDM,30014041_1,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm",1600.0,1040.0,400.0,6141.01,19
CDM,30014060_1,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less",6550.0,4257.5,1637.5,16915.38,19
CDM,30014061_1,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm",1600.0,1040.0,400.0,6141.01,19
CDM,30014301_1,"Repair of wound by transferring skin, 30.1-60.0 sq cm",4000.0,2600.0,1000.0,10330.0,19
CDM,30014302_1,"Repair of wound by transferring skin, each additional 30.0 sq cm",1500.0,975.0,375.0,3873.75,19
CDM,30015002_1,"Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",1550.0,1007.5,208.0,4002.88,19
CDM,30015003_1,"Preparation of skin graft site of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",500.0,325.0,125.0,1291.25,19
CDM,30015004_1,"Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",525.0,341.25,131.25,1507.02,19
CDM,30015005_1,"Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for infants and children, o",200.0,130.0,50.0,566.47,19
CDM,30015100_1,"Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",1550.0,1007.5,208.0,4002.88,19
CDM,30015120_1,"Partial thickness self skin graft to face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",2750.0,1787.5,208.0,7101.88,19
CDM,30015220_1,"Full thickness skin graft to scalp, arms, or legs, 20.0 sq cm or less",1550.0,1007.5,387.5,4002.88,19
CDM,30015240_1,"Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 20.0 sq cm or less",1550.0,1007.5,387.5,6141.01,19
CDM,30015260_1,"Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less",1550.0,1007.5,387.5,4002.88,19
CDM,30015261_1,"Full thickness skin graft to nose, ears, eyelids, or lips, each additional 20.0 sq cm",500.0,325.0,125.0,2881.28,19
CDM,30015271_1,"Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less",1550.0,1007.5,208.0,4002.88,19
CDM,30015272_1,"Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less",500.0,325.0,125.0,2881.28,19
CDM,30015273_1,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",2750.0,1787.5,208.0,7101.88,19
CDM,30015274_1,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",750.0,487.5,187.5,2881.28,19
CDM,30015275_1,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less",1550.0,1007.5,387.5,4002.88,19
CDM,30015276_1,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 25.0 sq cm of wound 100.0 sq cm or less",50.0,32.5,12.5,2881.28,19
CDM,30015277_1,"Skin substitute graft to wound 100.0 sq cm or more of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and childre",1550.0,1007.5,208.0,4002.88,19
CDM,30015576_1,"Creation of flap graft to eyelids, nose, ears, lips, or mouth",1550.0,1007.5,387.5,6141.01,19
CDM,30015630_1,"Transfer of skin flap to eyelids, nose, ears, or lips",1550.0,1007.5,387.5,6141.01,19
CDM,30015788_1,Chemical peel of outer layer of skin of face,170.0,110.5,42.5,8477.27,19
CDM,30015792_1,Chemical peel of outer layer of nonfacial skin,325.0,211.25,81.25,8477.27,19
CDM,30015793_1,Chemical peel of deep layer of nonfacial skin,325.0,211.25,81.25,8477.27,19
CDM,30015823_1,Removal of excessive skin and fat of upper eyelid,3000.0,1950.0,750.0,8023.32,19
CDM,30015830_1,Removal of extra skin and tissue of abdomen,5390.0,3503.5,1347.5,13919.68,19
CDM,30015851_1,Removal of sutures or staples under anesthesia,1550.0,1007.5,387.5,4002.88,19
CDM,30015853_1,Removal of sutures or staples,20.0,13.0,5.0,208.0,17
CDM,30015854_1,Removal of sutures and staples,30.0,19.5,7.5,208.0,17
CDM,30016000_1,First degree burn treatment,450.0,292.5,112.5,1242.0,19
CDM,30016020_1,"Dressing change or removal of burn tissue, less than 5% of total body surface",175.0,113.75,43.75,451.94,19
CDM,30016025_1,"Dressing change or removal of burn tissue, 5-10% of total body surface",225.0,146.25,56.25,581.06,19
CDM,30016030_1,"Dressing change or removal of burn tissue, more than 10% of total body surface",325.0,211.25,81.25,839.31,19
CDM,30016035_1,Initial incision of dead burn tissue,825.0,536.25,206.25,2318.31,19
CDM,30017000_1,"Destruction of precancer skin growth, 1 growth",225.0,146.25,56.25,2166.29,19
CDM,30017003_1,"Destruction of precancer skin growth, 2-14 growths",18.0,11.7,4.5,2166.29,19
CDM,30017004_1,"Destruction of precancer skin growth, 15 or more growths",325.0,211.25,81.25,2166.29,19
CDM,30017106_1,"Destruction of birthmark, less than 10.0 sq cm",325.0,211.25,81.25,2166.29,19
CDM,30017107_1,"Destruction of birthmark, 10.0-50.0 sq cm",525.0,341.25,131.25,2166.29,19
CDM,30017110_1,"Destruction of skin growth, 1-14 growths",163.0,105.95,40.75,2166.29,19
CDM,30017111_1,"Destruction of skin growth, 15 or more growths",163.0,105.95,40.75,2166.29,19
CDM,30017250_1,Application of chemical to stop tissue regrowth in wound,266.0,172.9,66.5,2166.29,19
CDM,30017260_1,"Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less",175.0,113.75,43.75,2166.29,19
CDM,30017261_1,"Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm",225.0,146.25,56.25,2166.29,19
CDM,30017262_1,"Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm",275.0,178.75,68.75,2166.29,19
CDM,30017263_1,"Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm",325.0,211.25,81.25,2166.29,19
CDM,30017264_1,"Destruction of cancer skin growth of trunk, arms, or legs, 3.1-4.0 cm",375.0,243.75,93.75,2166.29,19
CDM,30017266_1,"Destruction of cancer skin growth of trunk, arms, or legs, more than 4.0 cm",425.0,276.25,106.25,2318.31,19
CDM,30017270_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",175.0,113.75,43.75,2166.29,19
CDM,30017271_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",225.0,146.25,56.25,2166.29,19
CDM,30017272_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",275.0,178.75,68.75,2166.29,19
CDM,30017273_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",325.0,211.25,81.25,2166.29,19
CDM,30017274_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",375.0,243.75,93.75,2166.29,19
CDM,30017281_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",225.0,146.25,56.25,2166.29,19
CDM,30017282_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",275.0,178.75,68.75,2166.29,19
CDM,30017283_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",325.0,211.25,81.25,2166.29,19
CDM,30017284_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",375.0,243.75,93.75,2166.29,19
CDM,30017286_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",425.0,276.25,106.25,2318.31,19
CDM,30017311_1,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks",1320.0,858.0,330.0,3408.9,19
CDM,30017312_1,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks",250.0,162.5,62.5,2166.29,19
CDM,30017313_1,"Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks",550.0,357.5,137.5,2318.31,19
CDM,30017314_1,"Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks",250.0,162.5,62.5,2166.29,19
CDM,30017315_1,"Removal and microscopic exam of growth, each additional block after 5 tissue blocks",250.0,162.5,62.5,2166.29,19
CDM,30019000_1,"Aspiration of cyst of breast, first cyst",861.0,559.65,215.25,3227.0,19
CDM,30019001_1,"Aspiration of cyst of breast, each additional cyst",430.0,279.5,107.5,2166.29,19
CDM,30019020_1,Drainage of abscess of breast,3709.0,2410.85,927.25,9578.49,19
CDM,30019081_1,"Biopsy of breast and placement of locating device using X-ray with needle, first growth",7681.5,4992.98,1920.38,19837.47,19
CDM,30019082_1,"Biopsy of breast and placement of locating device using X-ray with needle, each additional growth",5121.0,3328.65,1242.0,13224.98,19
CDM,30019083_1,"Biopsy of breast and placement of locating device using ultrasound, first growth",3618.0,2351.7,904.5,9343.49,19
CDM,30019084_1,"Biopsy of breast and placement of locating device using ultrasound, each additional growth",1206.0,783.9,301.5,3114.5,19
CDM,30019085_1,"Biopsy of breast and placement of locating device using MRI, first growth",1995.0,1296.75,498.75,6141.01,19
CDM,30019086_1,"Biopsy of breast and placement of locating device using MRI, each additional growth",144.0,93.6,36.0,2166.29,19
CDM,30019100_1,Needle biopsy of breast,3709.0,2410.85,927.25,9578.49,19
CDM,30019101_1,Biopsy of breast through incision,11415.0,7419.75,1935.39,29479.24,19
CDM,30019281_1,"Placement of locating device in breast using imaging guidance, first growth",4102.5,2666.63,1025.63,10594.71,19
CDM,30019282_1,"Placement of locating device in breast using imaging guidance, each additional growth",674.0,438.1,168.5,2166.29,19
CDM,30019283_1,"Placement of locating device in breast using X-ray with needle guidance, first growth",8581.5,5577.98,1935.39,22161.72,19
CDM,30019284_1,"Placement of locating device in breast using X-ray with needle guidance, each additional growth",154.0,100.1,38.5,2166.29,19
CDM,30019285_1,"Placement of locating device in breast using ultrasound guidance, first growth",5445.0,3539.25,1361.25,14061.71,19
CDM,30019286_1,"Placement of locating device in breast using ultrasound guidance, each additional growth",328.0,213.2,82.0,2166.29,19
CDM,30019287_1,"Placement of locating device in breast using MRI guidance, first growth",7314.0,4754.1,1828.5,18888.41,19
CDM,30019288_1,"Placement of locating device in breast using MRI guidance, each additional growth",110.0,71.5,27.5,2166.29,19
CDM,30019499_1,Other procedure on breast,3832.0,2490.8,958.0,9896.14,19
CDM,30020102_1,"Exploration of wound of abdomen, back, or flank",3700.0,2405.0,925.0,9555.25,19
CDM,30020103_1,Exploration of wound of arm or leg,1597.0,1038.05,399.25,4124.25,19
CDM,30020200_1,Biopsy of muscle,2616.0,1700.4,654.0,6755.82,19
CDM,30020205_1,Deep biopsy of muscle,2270.0,1475.5,567.5,6141.01,19
CDM,30020206_1,Needle biopsy of muscle,2023.0,1314.95,505.75,5224.4,19
CDM,30020220_1,Biopsy of bone using needle or trocar,1500.0,975.0,375.0,3873.75,19
CDM,30020225_1,Deep biopsy of bone using needle or trocar,2453.0,1594.45,613.25,6334.87,19
CDM,30020240_1,Biopsy of surface bone,2270.0,1475.5,567.5,6451.0,19
CDM,30020500_1,Injection for repair of abnormal muscle drainage tract,1936.0,1258.4,484.0,4999.72,19
CDM,30020501_1,Injection of abnormal muscle drainage tract for X-ray study,872.0,566.8,218.0,2251.94,19
CDM,30020520_1,Removal of foreign body in muscle or tendon,2590.0,1683.5,647.5,6688.68,19
CDM,30020525_1,Complicated removal of foreign body in deep muscle or tendon,6213.0,4038.45,208.0,16045.07,19
CDM,30020526_1,Injection of carpal tunnel,361.5,234.98,90.38,2166.29,19
CDM,30020527_1,Injection of medication into palm,524.0,340.6,131.0,2166.29,19
CDM,30020550_1,Injection into tendon or ligament,361.5,234.98,90.38,2166.29,19
CDM,30020551_1,Injection into tendon at attachment to bone or muscle,241.0,156.65,60.25,2166.29,19
CDM,30020552_1,"Injection of trigger points, 1-2 muscles",255.0,165.75,63.75,2166.29,19
CDM,30020553_1,"Injection of trigger points, 3 or more muscles",241.0,156.65,60.25,2166.29,19
CDM,30020560_1,"Insertion of needle, 1-2 muscles",75.0,48.75,18.75,2166.29,19
CDM,30020561_1,"Insertion of needle, 3 muscles or more",75.0,48.75,18.75,2166.29,19
CDM,30020600_1,Aspiration and/or injection of fluid from small joint,361.5,234.98,90.38,2166.29,19
CDM,30020604_1,Aspiration and/or injection of fluid from small joint using ultrasound guidance,399.0,259.35,99.75,2166.29,19
CDM,30020605_1,Aspiration and/or injection of fluid from medium joint,361.5,234.98,90.38,2166.29,19
CDM,30020606_1,Aspiration and/or injection of fluid from medium joint using ultrasound guidance,885.0,575.25,221.25,3227.0,19
CDM,30020610_1,Aspiration and/or injection of fluid from large joint,714.0,464.1,178.5,2166.29,19
CDM,30020611_1,Aspiration and/or injection of fluid large joint using ultrasound guidance,412.5,268.13,103.13,2166.29,19
CDM,30020612_1,Aspiration and/or injection of cyst of tendon,241.0,156.65,60.25,2166.29,19
CDM,30020615_1,Aspiration and injection of cyst of bone,948.0,616.2,237.0,3227.0,19
CDM,30020650_1,Insertion of wire or pin to bone for traction,3500.0,2275.0,875.0,9038.75,19
CDM,30020670_1,Removal of surface implant from bone,1330.0,864.5,332.5,3726.0,19
CDM,30020680_1,Removal of deep implant from bone,2957.58,1922.43,739.4,7637.95,19
CDM,30020982_1,Destruction of growths and adjacent soft tissue,9774.0,6353.1,2166.29,25241.36,19
CDM,30020983_1,Freezing of growth of bone and adjacent soft tissue,9324.0,6060.6,2318.31,24079.23,19
CDM,30020999_1,Other procedure on muscle or bone,4839.0,3145.35,1209.75,12496.72,19
CDM,30020_1,Drainage of abscess or blood accumulation of nasal cartilage,574.4,373.36,60.57,654.97,19
CDM,30021012_1,"Removal of growth under skin of face or scalp, 2.0 cm or more",1330.0,864.5,332.5,3434.73,19
CDM,30021013_1,"Removal of growth of muscle of face or scalp, less than 2.0 cm",1330.0,864.5,332.5,3434.73,19
CDM,30021014_1,"Removal of growth of muscle of face or scalp, 2.0 cm or more",1330.0,864.5,332.5,3434.73,19
CDM,30021040_1,Removal of growth or cyst of lower jaw bone,4164.0,2706.6,1041.0,10753.53,19
CDM,30021110_1,Application and removal of dental fixation device,1523.0,989.95,380.75,3933.15,19
CDM,30021116_1,Injection for X-ray of hinged joint of upper and lower jaw bones,707.0,459.55,176.75,2166.29,19
CDM,30021235_1,Obtaining ear cartilage for grafting,4200.0,2730.0,1050.0,10846.5,19
CDM,30021315_1,Closed treatment of broken nose bone with manipulation,1230.0,799.5,307.5,3726.0,19
CDM,30021320_1,Closed treatment of broken nose bone with placement of stabilizing device,6519.0,4237.35,669.25,16835.32,19
CDM,30021390_1,Treatment of broken floor of eye bone through eye area with implant,12237.0,7954.05,3059.25,31602.05,19
CDM,30021450_1,Closed treatment of broken lower jaw bone,475.0,308.75,118.75,6141.01,19
CDM,30021451_1,Closed treatment of broken lower jaw bone with manipulation,1921.0,1248.65,480.25,7016.18,19
CDM,30021480_1,Closed treatment of dislocated jaw joint,441.0,286.65,110.25,2166.29,19
CDM,30021497_1,Wiring of jaw or oral splint to teeth,3340.0,2171.0,835.0,8625.55,19
CDM,30021501_1,Drainage of deep abscess or blood accumulation in soft tissue of neck or chest,2340.0,1521.0,585.0,6451.0,19
CDM,30021550_1,Biopsy of soft tissue of neck or chest,3709.0,2410.85,927.25,9578.49,19
CDM,30021552_1,"Removal of growth of soft tissue under skin of neck or front of chest, 3.0 cm or more",2250.0,1462.5,562.5,6451.0,19
CDM,30021554_1,"Removal of growth of muscle of neck or front of chest, 5.0 cm or more",2300.0,1495.0,575.0,6451.0,19
CDM,30021556_1,"Removal of growth of muscle of neck or front of chest, less than 5.0 cm",2350.0,1527.5,587.5,6451.0,19
CDM,30021601_1,Removal of growth of chest wall and rib,4640.0,3016.0,1160.0,11982.8,19
CDM,30021899_1,Other procedure on neck or chest,506.0,328.9,126.5,8477.27,19
CDM,30021920_1,Biopsy of surface soft tissue to back or lower sides,3709.0,2410.85,927.25,9578.49,19
CDM,30021925_1,Deep biopsy of soft tissue of back or lower sides,3271.0,2126.15,817.75,8447.36,19
CDM,30021931_1,"Removal of growth under skin of back or lower sides, 3.0 cm or more",3271.0,2126.15,208.0,8447.36,19
CDM,30022010_1,Drainage of abscess of deep tissue of upper or middle spine,5782.0,3758.3,1445.5,17051.3,19
CDM,30022015_1,Drainage of abscess of deep tissue of lower spine or sacrum,5782.0,3758.3,1445.5,17051.3,19
CDM,30022510_1,Stabilization of upper spine bone,7312.0,4752.8,1828.0,18883.24,19
CDM,30022511_1,Stabilization of lower spine bone,7312.0,4752.8,1828.0,18883.24,19
CDM,30022512_1,"Stabilization of spine bone, each additional bone",7707.0,5009.55,1242.0,19903.33,19
CDM,30022513_1,Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance,14690.0,9548.5,3672.5,37936.93,19
CDM,30022514_1,Treatment of broken lower spine bone with placement of stabilizing device,13601.0,8840.65,3400.25,35124.58,19
CDM,30022515_1,"Treatment of broken spine bone with stabilizing device, each additional segment",6257.0,4067.05,1242.0,16158.7,19
CDM,30022899_1,Other procedure on spine,1126.0,731.9,281.5,7322.72,19
CDM,30022903_1,"Removal of growth of soft tissue of abdominal wall, 3.0 cm or more",4385.0,2850.25,1096.25,11324.26,19
CDM,30022999_1,Other procedure on abdominal muscle or bone,925.0,601.25,231.25,2388.81,19
CDM,30023030_1,Drainage of deep abscess or blood accumulation of shoulder,2270.0,1475.5,567.5,6451.0,19
CDM,30023071_1,"Removal of growth under skin of shoulder area, 3.0 cm or more",3300.0,2145.0,825.0,8522.25,19
CDM,30023076_1,"Removal of growth of muscle of shoulder, less than 5.0 cm",4020.0,2613.0,1005.0,10381.65,19
CDM,30023350_1,Injection of contrast for imaging of shoulder joint,663.0,430.95,165.75,2166.29,19
CDM,30023500_1,Closed treatment of broken collar bone,967.5,628.88,241.88,2498.57,19
CDM,30023600_1,Closed treatment of broken top of upper arm bone,967.5,628.88,241.88,2498.57,19
CDM,30023620_1,Closed treatment of upper arm bone broken at shoulder joint,1582.5,1028.63,395.63,4086.81,19
CDM,30023625_1,Closed treatment of upper arm bone broken at shoulder joint with manipulation,3422.0,2224.3,669.25,8837.32,19
CDM,30023650_1,Closed treatment of dislocated shoulder with manipulation,1720.5,1118.33,430.13,4443.19,19
CDM,30023655_1,Closed treatment of dislocated shoulder with manipulation under anesthesia,5476.5,3559.73,1369.13,14143.06,19
CDM,30023665_1,Closed treatment of dislocated shoulder and broken upper arm bone at shoulder joint with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30023675_1,Closed treatment of dislocated shoulder and broken neck of upper arm bone with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30023929_1,Other procedure on shoulder,505.0,328.25,126.25,2166.29,19
CDM,30023930_1,Drainage of deep abscess or blood accumulation of upper arm or elbow,6586.5,4281.23,1646.63,17009.64,19
CDM,30024071_1,"Removal of growth under skin of upper arm or elbow, 3.0 cm or more",7815.0,5079.75,1953.75,20182.24,19
CDM,30024075_1,"Removal of growth under skin of upper arm or elbow, less than 3.0 cm",1980.0,1287.0,495.0,5113.35,19
CDM,30024200_1,"Removal of foreign body of upper arm or elbow area, accessed beneath the skin",1370.0,890.5,342.5,8477.27,19
CDM,30024357_1,Incision of elbow tendon,7800.0,5070.0,1950.0,20143.5,19
CDM,30024500_1,Closed treatment of broken middle part of upper arm bone,907.5,589.88,226.88,2343.62,19
CDM,30024505_1,Closed treatment of broken middle part of upper arm bone with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30024530_1,Closed treatment of upper arm bone broken at elbow,1383.0,898.95,345.75,3571.6,19
CDM,30024535_1,Closed treatment of upper arm bone broken at elbow with manipulation,2428.0,1578.2,607.0,6270.31,19
CDM,30024560_1,Closed treatment of broken outer part of upper arm bone at elbow,1567.5,1018.88,391.88,4048.07,19
CDM,30024565_1,Closed treatment of broken outer part of upper arm bone at elbow with manipulation,1861.0,1209.65,465.25,4806.03,19
CDM,30024576_1,Closed treatment of broken elbow,1060.0,689.0,265.0,2737.45,19
CDM,30024577_1,Closed treatment of broken elbow with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30024600_1,Repair of dislocated elbow,967.5,628.88,241.88,2498.57,19
CDM,30024605_1,Repair of dislocated elbow under anesthesia,5476.5,3559.73,1369.13,14143.06,19
CDM,30024620_1,Closed treatment of broken and dislocated forearm bones at elbow with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30024640_1,"Closed treatment of dislocated forearm bone on thumb side at elbow with manipulation, child",967.5,628.88,241.88,8477.27,19
CDM,30024650_1,Closed treatment of broken forearm bone on thumb side at elbow,967.5,628.88,241.88,2498.57,19
CDM,30024655_1,Closed treatment of broken forearm bone on thumb side at elbow with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30024670_1,Closed treatment of broken forearm bone on small finger side at elbow,1026.0,666.9,256.5,2649.65,19
CDM,30024675_1,Closed treatment of broken forearm bone on small finger side at elbow with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30024999_1,Other procedure on upper arm or elbow,588.0,382.2,147.0,2166.29,19
CDM,30025066_1,Biopsy of deep tissue of forearm and/or wrist,6444.0,4188.6,1611.0,16641.63,19
CDM,30025075_1,"Removal of growth under skin of forearm or wrist, less than 3.0 cm",1995.0,1296.75,498.75,5152.09,19
CDM,30025246_1,Injection of contrast for imaging of wrist,423.0,274.95,105.75,2166.29,19
CDM,30025260_1,Primary repair of tendon or muscle of palm side of forearm or wrist,4321.0,2808.65,1080.25,11158.98,19
CDM,30025270_1,Primary repair of tendon or muscle of top side of forearm or wrist,3986.0,2590.9,996.5,10293.85,19
CDM,30025500_1,Closed treatment of broken midpart of forearm bone on thumb side,1510.5,981.83,377.63,3900.87,19
CDM,30025505_1,Closed treatment of broken midpart of forearm bone on thumb side with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30025530_1,Closed treatment of broken midpart of forearm bone on small finger side,1011.0,657.15,252.75,2610.91,19
CDM,30025535_1,Closed treatment of broken midpart of forearm bone on small finger side with manipulation,1804.5,1172.93,451.13,4660.12,19
CDM,30025560_1,Closed treatment of broken midpart of both forearm bones,1041.0,676.65,260.25,2688.38,19
CDM,30025565_1,Closed treatment of broken midpart of both forearm bones with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30025600_1,Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation,967.5,628.88,241.88,2498.57,19
CDM,30025605_1,Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation,3039.0,1975.35,669.25,7848.22,19
CDM,30025622_1,Closed treatment of broken wrist bone near base of thumb,1086.0,705.9,271.5,8477.27,19
CDM,30025630_1,Closed treatment of other broken wrist bone,2041.5,1326.98,510.38,5272.17,19
CDM,30025650_1,Closed treatment of broken base of forearm bone on small finger side at wrist,1806.0,1173.9,451.5,8477.27,19
CDM,30025675_1,Closed treatment of dislocated forearm bone at wrist with manipulation,1455.0,945.75,363.75,3757.54,19
CDM,30025680_1,Closed treatment of broken and dislocated wrist bones with manipulation,1579.0,1026.35,394.75,4077.77,19
CDM,30025690_1,Closed treatment of dislocated wrist (lunate) bone with manipulation,2804.0,1822.6,669.25,7241.33,19
CDM,30026010_1,Simple drainage of abscess of finger,507.0,329.55,126.75,8477.27,19
CDM,30026011_1,Complicated drainage of abscess in finger,3709.0,2410.85,927.25,9578.49,19
CDM,30026075_1,"Incision of lower finger joint for exploration, fluid drainage, or removal of foreign body",6745.0,4384.25,1686.25,17418.96,19
CDM,30026160_1,Removal of growth of tendon finger or hand,6000.0,3900.0,1500.0,15495.0,19
CDM,30026350_1,Repair of finger tendon of under side of hand other than upper most part of palm and fingers,2839.0,1845.35,709.75,7441.0,19
CDM,30026410_1,Repair of tendon on top of hand,7312.0,4752.8,1828.0,18883.24,19
CDM,30026418_1,Repair of tendon on top side of finger,7312.0,4752.8,1828.0,18883.24,19
CDM,30026600_1,Closed treatment of broken hand bone,645.0,419.25,161.25,8477.27,19
CDM,30026605_1,Closed treatment of broken hand bone with manipulation,1414.0,919.1,353.5,3651.66,19
CDM,30026641_1,Closed treatment of dislocated thumb at wrist with manipulation,1046.0,679.9,261.5,8477.27,19
CDM,30026645_1,Closed treatment of broken thumb at wrist with manipulation,1358.0,882.7,339.5,3507.04,19
CDM,30026670_1,Closed treatment of dislocated hand bone at wrist joint with manipulation,960.0,624.0,240.0,8477.27,19
CDM,30026700_1,Closed treatment of dislocated hand joint at base of finger with manipulation,944.0,613.6,236.0,8477.27,19
CDM,30026720_1,Closed treatment of broken finger or thumb at midportion or part near hand,645.0,419.25,161.25,2166.29,19
CDM,30026725_1,Closed treatment of broken finger or thumb at midportion or part near hand with manipulation,1058.0,687.7,264.5,2732.29,19
CDM,30026740_1,Closed treatment of broken finger or hand at base of finger,638.0,414.7,159.5,2166.29,19
CDM,30026742_1,Closed treatment of broken finger or hand at base of finger with manipulation,3651.0,2373.15,669.25,9428.71,19
CDM,30026750_1,Closed treatment of broken end of finger or thumb,686.0,445.9,171.5,8477.27,19
CDM,30026755_1,Closed treatment of broken end of finger or thumb with manipulation,609.0,395.85,152.25,8477.27,19
CDM,30026770_1,Closed treatment of dislocated finger joint with manipulation,1014.0,659.1,253.5,8477.27,19
CDM,30026775_1,Closed treatment of dislocated finger joint with manipulation under anesthesia,3236.0,2103.4,809.0,8477.27,19
CDM,30026910_1,Amputation of finger or thumb,7312.0,4752.8,1828.0,18883.24,19
CDM,30026951_1,Amputation of finger or thumb with direct closure,7200.0,4680.0,1800.0,18594.0,19
CDM,30026952_1,Amputation of finger or thumb with tissue flap,7312.0,4752.8,1828.0,18883.24,19
CDM,30026989_1,Other procedure on hands or fingers,580.0,377.0,145.0,2166.29,19
CDM,30026990_1,Drainage of deep abscess or blood accumulation of pelvis or hip near joint,3290.0,2138.5,822.5,8496.43,19
CDM,30027040_1,Biopsy of surface tissue of pelvis and hip,1310.0,851.5,327.5,3383.08,19
CDM,30027041_1,Biopsy of deep tissue of pelvis and hip,1816.0,1180.4,454.0,4689.82,19
CDM,30027043_1,"Removal of growth under skin of pelvis and hip, 3.0 cm or more",5526.0,3591.9,1381.5,14270.9,19
CDM,30027093_1,Injection of contrast for imaging of hip joint,2038.5,1325.03,476.5,5264.43,19
CDM,30027095_1,Injection of contrast for imaging of hip under anesthesia,2427.0,1577.55,476.5,6267.73,19
CDM,30027096_1,Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance,2455.5,1596.08,613.88,6341.33,19
CDM,30027222_1,Closed treatment of broken hip socket with manipulation,736.5,478.73,184.13,2166.29,19
CDM,30027232_1,Closed treatment of broken upper thigh bone with manipulation,3827.0,2487.55,669.25,9883.23,19
CDM,30027250_1,Closed treatment of dislocated hip,4117.5,2676.38,669.25,10633.44,19
CDM,30027252_1,Closed treatment of dislocated hip under anesthesia,5476.5,3559.73,1369.13,14143.06,19
CDM,30027265_1,Closed treatment of dislocated hip prosthesis,1885.5,1225.58,471.38,4869.3,19
CDM,30027266_1,Closed treatment of dislocated hip prosthesis under anesthesia,4714.5,3064.43,1178.63,12175.2,19
CDM,30027299_1,Other procedure on pelvis or hip joint,513.0,333.45,128.25,2166.29,19
CDM,30027301_1,Drainage of deep abscess or blood accumulation of thigh or knee,9666.0,6282.9,2416.5,24962.45,19
CDM,30027323_1,Biopsy of surface tissue of thigh or knee,5563.5,3616.28,1390.88,14367.74,19
CDM,30027327_1,"Removal of growth under skin of thigh or knee, 3.0 cm or more",1995.0,1296.75,498.75,6451.0,19
CDM,30027337_1,"Removal of growth under skin of thigh or knee, less than 3.0 cm",3405.0,2213.25,851.25,8793.41,19
CDM,30027369_1,Injection of contrast for imaging of knee joint,903.0,586.95,225.75,2332.0,19
CDM,30027372_1,Removal of foreign body deep in tissue of thigh or knee,6444.0,4188.6,1611.0,16641.63,19
CDM,30027500_1,Closed treatment of broken thigh bone,3600.0,2340.0,669.25,9297.0,19
CDM,30027501_1,Closed treatment of broken thigh bone at lower end,3369.0,2189.85,669.25,8700.44,19
CDM,30027502_1,Closed treatment of broken thigh bone at midportion with manipulation,5781.0,3757.65,669.25,14929.43,19
CDM,30027508_1,Closed treatment of broken inside or outside portion of lower end of thigh bone,2370.0,1540.5,592.5,6120.53,19
CDM,30027510_1,Closed treatment of broken thigh bone at knee area with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30027516_1,Closed treatment of thigh bone growth plate broken at end of thigh bone,2017.0,1311.05,504.25,5208.9,19
CDM,30027520_1,Closed treatment of broken kneecap,1792.5,1165.13,448.13,4629.13,19
CDM,30027530_1,Closed treatment of broken shin bone,1596.0,1037.4,399.0,4121.67,19
CDM,30027532_1,Closed treatment of broken shin bone with traction,4041.0,2626.65,669.25,10435.88,19
CDM,30027538_1,Closed treatment of broken top of shin bone at knee,1625.0,1056.25,406.25,4196.56,19
CDM,30027550_1,Closed treatment of dislocated knee,2608.5,1695.53,652.13,6736.45,19
CDM,30027560_1,Closed treatment of dislocated kneecap,1633.5,1061.78,408.38,4218.51,19
CDM,30027570_1,Manipulation of knee joint under anesthesia,5476.5,3559.73,1369.13,14143.06,19
CDM,30027599_1,Other procedure on thigh or knee,630.0,409.5,157.5,2166.29,19
CDM,30027600_1,Incision of connective tissue of front or side of lower leg to relieve pressure,7800.0,5070.0,1950.0,20143.5,19
CDM,30027602_1,Incision of connective tissue of front and/or side and back of lower leg to relieve pressure,7420.0,4823.0,1855.0,19162.15,19
CDM,30027603_1,Drainage of deep abscess or blood accumulation of leg or ankle,9666.0,6282.9,2318.31,24962.45,19
CDM,30027605_1,Incision of Achilles tendon using local anesthetic,3651.0,2373.15,912.75,9428.71,19
CDM,30027648_1,Injection for X-ray imaging of ankle,229.0,148.85,57.25,2166.29,19
CDM,30027750_1,Closed treatment of broken middle part of shin bone,2113.5,1373.78,528.38,5458.11,19
CDM,30027752_1,Closed treatment of middle part of broken shin bone with manipulation,3276.0,2129.4,669.25,8460.27,19
CDM,30027760_1,Closed treatment of inside portion of shin bone at ankle,1240.5,806.33,310.13,3203.59,19
CDM,30027762_1,Closed treatment of inside portion of shin bone at ankle with manipulation,3651.0,2373.15,669.25,9428.71,19
CDM,30027768_1,Closed treatment of back portion of shin bone at ankle with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30027780_1,Closed treatment of broken middle or upper end of outside lower leg bone,967.5,628.88,241.88,2498.57,19
CDM,30027781_1,Closed treatment of broken middle or upper end of outside lower leg bone with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30027786_1,Closed treatment of broken outside lower leg bone at ankle,967.5,628.88,241.88,2498.57,19
CDM,30027788_1,Closed treatment of broken outside lower leg bone at ankle with manipulation,2443.5,1588.28,610.88,6310.34,19
CDM,30027808_1,Closed treatment of 2 broken lower leg bones at ankle,1260.0,819.0,315.0,3253.95,19
CDM,30027810_1,Closed treatment of 2 broken lower leg bones at ankle with manipulation,3190.5,2073.83,669.25,8239.47,19
CDM,30027816_1,Closed treatment of 3 broken lower leg bones at ankle,1017.0,661.05,254.25,2626.4,19
CDM,30027818_1,Closed treatment of 3 broken lower leg bones at ankle with manipulation,3039.0,1975.35,669.25,7848.22,19
CDM,30027824_1,Closed treatment of broken shin bone at lower weight bearing joint,2646.0,1719.9,661.5,6833.3,19
CDM,30027825_1,Closed treatment of broken shin bone at lower weight bearing joint with manipulation and/or traction,5476.5,3559.73,669.25,14143.06,19
CDM,30027831_1,Closed treatment of dislocated knee joint under anesthesia,2500.0,1625.0,625.0,6456.25,19
CDM,30027840_1,Closed treatment of dislocated ankle,1407.0,914.55,351.75,3633.58,19
CDM,30028008_1,Incision of connective tissue of foot and/or toe,7312.0,4752.8,1828.0,18883.24,19
CDM,30028190_1,"Removal of foreign body of foot tissue, accessed beneath the skin",2578.5,1676.03,611.75,6658.98,19
CDM,30028192_1,"Removal of foreign body of foot tissue, deep",6060.0,3939.0,1515.0,15649.95,19
CDM,30028193_1,Complicated removal of foreign body in foot,4040.0,2626.0,1010.0,10433.3,19
CDM,30028400_1,Closed treatment of broken heel bone,1068.0,694.2,267.0,2758.11,19
CDM,30028405_1,Closed treatment of broken heel bone with manipulation,2563.5,1666.28,640.88,6620.24,19
CDM,30028430_1,Closed treatment of broken ankle joint bone,1446.0,939.9,361.5,3734.3,19
CDM,30028435_1,Closed treatment of broken ankle joint bone with manipulation,5476.5,3559.73,669.25,14143.06,19
CDM,30028450_1,Treatment of broken foot bone at ankle,745.0,484.25,186.25,2166.29,19
CDM,30028455_1,Treatment of broken foot bone at ankle with manipulation,1270.0,825.5,317.5,3279.78,19
CDM,30028470_1,Closed treatment of broken bone in forefoot or midfoot,597.0,388.05,149.25,2166.29,19
CDM,30028475_1,Closed treatment of broken foot with manipulation,210.0,136.5,52.5,2166.29,19
CDM,30028490_1,Closed treatment of broken great toe,775.5,504.08,193.88,2166.29,19
CDM,30028495_1,Closed treatment of broken great toe with manipulation,539.0,350.35,134.75,2166.29,19
CDM,30028505_1,Treatment of broken great toe,7800.0,5070.0,1950.0,20143.5,19
CDM,30028510_1,Closed treatment of broken toe,285.0,185.25,71.25,2166.29,19
CDM,30028515_1,Closed treatment of broken toe with manipulation,539.0,350.35,134.75,2166.29,19
CDM,30028540_1,Closed treatment of dislocated ankle joint bone,511.0,332.15,127.75,2166.29,19
CDM,30028600_1,Closed treatment of dislocated midfoot joint,451.0,293.15,112.75,2166.29,19
CDM,30028630_1,Closed treatment of dislocated joint between toe and foot,569.0,369.85,142.25,2166.29,19
CDM,30028660_1,Closed treatment of dislocated joint in toe,355.0,230.75,88.75,2166.29,19
CDM,30029065_1,Application of shoulder to hand cast,410.0,266.5,102.5,1242.0,19
CDM,30029075_1,Application of elbow to finger cast,535.5,348.08,133.88,1382.93,19
CDM,30029085_1,Application of hand and lower forearm cast,320.0,208.0,80.0,826.4,19
CDM,30029105_1,Application of lower and upper arm splint,462.0,300.3,110.15,1242.0,19
CDM,30029125_1,Application of nonmoveable forearm to hand splint,436.5,283.73,109.13,1242.0,19
CDM,30029126_1,Application of moveable or hinged forearm to hand splint,358.0,232.7,89.5,1242.0,19
CDM,30029130_1,Application of nonmoveable finger splint,346.5,225.23,86.63,1242.0,19
CDM,30029280_1,Placement of strapping to hand or finger,190.0,123.5,47.5,1242.0,19
CDM,30029345_1,Application of long leg cast from thigh to toe,511.0,332.15,127.75,2166.29,19
CDM,30029405_1,Application of short leg cast,1048.5,681.53,261.6,2707.75,19
CDM,30029445_1,"Application of walking cast covering foot, ankle, and lower leg",475.0,308.75,118.75,1226.69,19
CDM,30029505_1,Application of long leg splint from thigh to ankle or toe,682.5,443.63,110.15,1762.56,19
CDM,30029515_1,Application of short leg splint from calf to foot,421.5,273.98,105.38,1242.0,19
CDM,30029540_1,Placement of strapping to ankle or foot,297.0,193.05,74.25,767.0,19
CDM,30029550_1,Placement of strapping to toes,198.0,128.7,49.5,511.34,19
CDM,30029580_1,"Strapping, Unna boot",384.0,249.6,96.0,991.68,19
CDM,30029581_1,"Application of vein wound compression bandages on lower leg, ankle, and foot",484.5,314.93,121.13,1251.22,19
CDM,30029584_1,"Application of vein wound compression bandages on upper arm, forearm, hand, and fingers",286.5,186.23,71.63,739.89,19
CDM,30029700_1,"Removal or cutting of gauntlet, boot, or body cast",231.0,150.15,57.75,1242.0,19
CDM,30029705_1,Removal or cutting of full arm or leg cast,222.0,144.3,55.5,1242.0,19
CDM,30030000_1,Drainage of abscess or blood accumulation of nose,225.0,146.25,56.25,2166.29,19
CDM,30030020_1,Drainage of abscess or blood accumulation of nasal cartilage,475.0,308.75,118.75,2166.29,19
CDM,30030100_1,Biopsy of lining of nose,1230.0,799.5,307.5,3726.0,19
CDM,30030120_1,Removal or scraping of skin on nose,2183.0,1418.95,545.75,6451.0,19
CDM,30030300_1,Removal of foreign body in nose,361.0,234.65,90.25,8477.27,19
CDM,30030520_1,Reshaping of nasal cartilage,6843.0,4447.95,1710.75,17672.05,19
CDM,30030560_1,Release of nasal scar tissue,450.0,292.5,112.5,2318.31,19
CDM,30030901_1,Simple control of nose bleed,552.0,358.8,138.0,2166.29,19
CDM,30030903_1,Complex control of nose bleed,745.5,484.58,186.38,2166.29,19
CDM,30030905_1,Initial control of nose bleed and insertion of packing,786.0,510.9,196.5,2166.29,19
CDM,30030930_1,Therapeutic fracture of nasal passages,3338.0,2169.7,834.5,8620.39,19
CDM,30031000_1,Irrigation of nasal sinus,560.0,364.0,140.0,2166.29,19
CDM,30031205_1,Removal of nasal sinus from outside nasal passage,5007.0,3254.55,1251.75,12930.58,19
CDM,30031231_1,Diagnostic exam of nasal passages using an endoscope,156.0,101.4,39.0,2318.31,19
CDM,30031237_1,Biopsy or removal of nasal polyp or tissue using an endoscope,1918.5,1247.03,479.63,4954.53,19
CDM,30031238_1,Control of bleeding of nose using an endoscope,1980.0,1287.0,495.0,5113.35,19
CDM,30031299_1,Other procedure on accessory sinuses,230.0,149.5,57.5,8477.27,19
CDM,30031500_1,Emergent insertion of breathing tube into windpipe using an endoscope,738.0,479.7,184.5,2166.29,19
CDM,30031502_1,Change of breathing tube in windpipe,342.0,222.3,85.5,883.22,19
CDM,30031505_1,Diagnostic exam of voice box using an endoscope with mirror,315.0,204.75,78.75,1242.0,19
CDM,30031510_1,Biopsy of voice box using an endoscope with mirror,5600.0,3640.0,1400.0,14462.0,19
CDM,30031511_1,Removal of foreign body in voice box using an endoscope with mirror,606.0,393.9,151.5,2318.31,19
CDM,30031513_1,Injection of vocal cord using an endoscope with mirror,392.0,254.8,98.0,1052.0,19
CDM,30031515_1,Aspiration of voice box using an endoscope,883.0,573.95,220.75,2280.35,19
CDM,30031525_1,Diagnostic exam of voice box using an endoscope,1320.0,858.0,330.0,3726.0,19
CDM,30031528_1,Initial dilation of voice box using an endoscope,4496.0,2922.4,1124.0,11610.92,19
CDM,30031530_1,Removal of foreign body in voice box using an endoscope,2047.0,1330.55,511.75,5286.38,19
CDM,30031535_1,Biopsy of voice box using an endoscope,2904.0,1887.6,726.0,7499.58,19
CDM,30031570_1,Injection into vocal cords using an endoscope,7850.0,5102.5,1052.0,20272.63,19
CDM,30031571_1,Injection into vocal cords using an endoscope with operating microscope or telescope,8557.0,5562.05,2139.25,22098.45,19
CDM,30031572_1,Removal or destruction of growth of side of voice box using an endoscope,11775.0,7653.75,208.0,30408.94,19
CDM,30031573_1,Injection of drug into side of voice box using an endoscope,6006.0,3903.9,208.0,15510.5,19
CDM,30031574_1,Injection of substance to augment voice box using an endoscope,6006.0,3903.9,208.0,15510.5,19
CDM,30031575_1,Diagnostic exam of voice box using a flexible endoscope,560.0,364.0,140.0,1446.2,19
CDM,30031576_1,Biopsy of voice box using a flexible endoscope,3808.0,2475.2,952.0,9834.16,19
CDM,30031577_1,Removal of foreign body in voice box using a flexible endoscope,675.0,438.75,168.75,2318.31,19
CDM,30031578_1,Removal of growth of voice box using an endoscope,6078.0,3950.7,208.0,15696.44,19
CDM,30031579_1,Exam to assess movement of vocal cord flaps using an endoscope,372.0,241.8,93.0,2318.31,19
CDM,30031591_1,Repair of side of voice box by moving vocal cord to middle,15492.0,10069.8,208.0,40008.09,19
CDM,30031603_1,Emergent incision of windpipe through neck for insertion of breathing tube,2800.0,1820.0,700.0,7231.0,19
CDM,30031605_1,Emergent incision of windpipe for insertion of breathing tube,1589.0,1032.85,397.25,4103.59,19
CDM,30031611_1,Creation of opening of windpipe and insertion of speech prosthesis,6519.0,4237.35,1629.75,16835.32,19
CDM,30031615_1,Exam of windpipe and lung airways through permanent windpipe opening using an endoscope,452.0,293.8,113.0,2659.49,19
CDM,30031622_1,Diagnostic exam of lung airway using an endoscope,3121.0,2028.65,780.25,8059.98,19
CDM,30031624_1,Irrigation and suction of lung airways to obtain cells using an endoscope,3121.0,2028.65,208.0,8059.98,19
CDM,30031635_1,Removal of foreign body in lung airways using an endoscope,3845.0,2499.25,961.25,9929.71,19
CDM,30031645_1,Aspiration of initial secretion of lung airway using an endoscope,3409.0,2215.85,852.25,8803.74,19
CDM,30031647_1,Assessment of initial lobe of lung for air leak and airway sizing with insertion of bronchial valve in lung airway using an endoscope,4880.0,3172.0,1220.0,12602.6,19
CDM,30031648_1,"Removal of bronchial valves of lung airways of lobe of lung using an endoscope, initial lobe",4512.0,2932.8,1128.0,11652.24,19
CDM,30031649_1,"Removal of bronchial valves of lung airways of lobe of lung using an endoscope, each additional lobe",2192.0,1424.8,548.0,5660.84,19
CDM,30031651_1,"Assessment of air leak and airway sizing with insertion of bronchial valve in lung airway using an endoscope, each additional lobe",4512.0,2932.8,1128.0,11652.24,19
CDM,30031660_1,Thermal repair of airways of lobe of lung using an endoscope,4880.0,3172.0,1220.0,12602.6,19
CDM,30031661_1,Thermal repair of airways of multiple lobes of lung using an endoscope,4880.0,3172.0,1220.0,12602.6,19
CDM,30031720_1,Insertion of tube into airway for aspiration of secretions,512.0,332.8,83.86,2166.29,19
CDM,30031730_1,Insertion of needle wire dilator or indwelling tube for oxygen therapy,3808.0,2475.2,208.0,9834.16,19
CDM,30031899_1,Other procedure on windpipe or lung airway,1754.0,1140.1,208.0,4529.71,19
CDM,30032110_1,Repair of tear of lung and/or control of traumatic bleeding through chest,16000.0,10400.0,3678.0,41320.0,19
CDM,30032400_1,Needle biopsy of lining of lung,3709.0,2410.85,927.25,9578.49,19
CDM,30032408_1,"Core needle biopsy of lung or center cavity of chest (mediastinum), accessed through skin",4490.0,2918.5,1122.5,11595.43,19
CDM,30032550_1,Insertion of indwelling tube for drainage of lung fluid,4368.0,2839.2,1092.0,11280.36,19
CDM,30032551_1,Removal of fluid from between lung and chest cavity,2214.0,1439.1,553.5,5717.66,19
CDM,30032552_1,Removal of indwelling tube in lining of lung,694.0,451.1,173.5,3227.0,19
CDM,30032553_1,Insertion of device in chest cavity for radiation therapy guidance,3225.0,2096.25,806.25,8328.56,19
CDM,30032554_1,Aspiration of fluid from chest cavity,1041.0,676.65,260.25,3227.0,19
CDM,30032555_1,Aspiration of fluid from chest cavity using imaging guidance,4005.0,2603.25,1001.25,10342.91,19
CDM,30032556_1,Drainage of fluid from chest cavity with insertion of indwelling tube,2140.0,1391.0,535.0,5526.55,19
CDM,30032557_1,Drainage of fluid from chest cavity with insertion of indwelling tube using imaging guidance,3040.5,1976.33,760.13,7852.09,19
CDM,30032560_1,Instillation of agent onto lung surface using chest tube,395.0,256.75,98.75,3227.0,19
CDM,30032561_1,Initial instillation of agent onto lung lining using chest tube,1283.0,833.95,320.75,3313.35,19
CDM,30032562_1,Subsequent instillation of agent onto lung lining using chest tube,1210.0,786.5,302.5,3227.0,19
CDM,30032994_1,Destruction of growth of lung using extreme cold,10626.0,6906.9,2656.5,27441.65,19
CDM,30032998_1,Destruction of growth of lung using radiofrequency,13155.0,8550.75,3288.75,33972.79,19
CDM,30032999_1,Other procedure on lung and lung lining,1123.0,729.95,280.75,8477.27,19
CDM,30033016_1,Drainage of heart sac using imaging guidance,3265.0,2122.25,816.25,8431.86,19
CDM,30033017_1,Drainage of heart sac using tube and imaging guidance (6 years or older),4000.0,2600.0,1000.0,10330.0,19
CDM,30033019_1,Drainage of heart sac using tube and CT imaging guidance,4250.0,2762.5,1052.0,10975.63,19
CDM,30033206_1,Insertion of pacemaker and upper heart chamber electrode,24425.0,15876.25,1052.0,63077.56,19
CDM,30033207_1,Insertion of pacemaker and lower heart chamber electrode,24481.0,15912.65,1052.0,63222.18,19
CDM,30033208_1,Insertion of pacemaker and upper and lower heart chamber electrode,26162.0,17005.3,1052.0,67563.37,19
CDM,30033210_1,Insertion of temporary pacemaker lead in single heart chamber,19450.0,12642.5,1052.0,50229.63,19
CDM,30033212_1,Insertion of pacemaker pulse generator with existing single lead,17647.0,11470.55,1052.0,45573.38,19
CDM,30033213_1,Insertion of pacemaker pulse generator with existing dual leads,18151.0,11798.15,1052.0,46874.96,19
CDM,30033214_1,Insertion of 2 chamber pacemaker system,28230.0,18349.5,7057.5,72903.98,19
CDM,30033215_1,Repositioning of pacemaker or defibrillator electrode,16639.0,10815.35,1052.0,42970.22,19
CDM,30033216_1,Insertion of 1 electrode for permanent pacemaker or defibrillator,20921.0,13598.65,1052.0,54028.48,19
CDM,30033217_1,Insertion of 2 electrodes for permanent pacemaker or defibrillator,20921.0,13598.65,1052.0,54028.48,19
CDM,30033218_1,Repair of electrode for permanent pacemaker or defibrillator,14097.0,9163.05,1052.0,36405.5,19
CDM,30033220_1,Repair of 2 electrodes for permanent pacemaker or defibrillator,3451.0,2243.15,862.75,8912.21,19
CDM,30033222_1,Relocation of pacemaker skin pocket,9113.0,5923.45,1052.0,23534.32,19
CDM,30033223_1,Relocation of defibrillator skin pocket,9113.0,5923.45,1052.0,23534.32,19
CDM,30033224_1,Insertion of left lower heart electrode and attachment to pacemaker or defibrillator,28230.0,18349.5,1052.0,72903.98,19
CDM,30033225_1,Insertion of left lower heart electrode for pacemaker or defibrillator,17374.0,11293.1,1052.0,44868.36,19
CDM,30033233_1,Removal of permanent pacemaker pulse generator,11057.0,7187.05,1052.0,28554.7,19
CDM,30033234_1,Removal of single electrode from right heart,13269.0,8624.85,1052.0,34267.19,19
CDM,30033235_1,Removal of dual electrodes from right heart,16586.0,10780.9,1052.0,42833.35,19
CDM,30033240_1,Insertion of defibrillator with existing single lead,65973.0,42882.45,1052.0,170375.27,19
CDM,30033241_1,Removal of defibrillator,8895.0,5781.75,1052.0,22971.34,19
CDM,30033244_1,Removal of defibrillator electrodes through vein,8895.0,5781.75,1052.0,22971.34,19
CDM,30033249_1,Insertion of implantable defibrillator system,75400.0,49010.0,1052.0,194720.5,19
CDM,30033274_1,Insertion of permanent leadless pacemaker using imaging guidance,30709.0,19960.85,7677.25,79305.99,18
CDM,30033275_1,Removal of permanent leadless pacemaker using imaging guidance,5285.0,3435.25,1321.25,13648.51,18
CDM,30033285_1,Insertion of heart rhythm monitor under skin,19840.98,12896.64,1052.0,51239.33,19
CDM,30033286_1,Removal of heart rhythm monitor from under the skin,1160.0,754.0,290.0,2995.7,19
CDM,30033289_1,Insertion of wireless pressure sensor into lung artery through tube with review by radiologist,9483.0,6163.95,2370.75,32890.52,18
CDM,30033340_1,Repair of left upper heart chamber with implant with review by radiologist,12000.0,7800.0,3000.0,30990.0,19
CDM,30033477_1,Insertion of pulmonary valve,9700.0,6305.0,1052.0,25050.25,19
CDM,30033530_1,Coronary artery bypass or valve procedure reoperation more than 1 month after original operation,11330.0,7364.5,2832.5,29259.73,19
CDM,30033946_1,Initiation of ECMO external vein to vein blood circulation in heart and lungs using a pump,6339.0,4120.35,1584.75,16370.47,19
CDM,30033947_1,Initiation of ECMO external vein to artery blood circulation in heart and lungs using a pump,4500.0,2925.0,1125.0,11621.25,19
CDM,30033952_1,Insertion of tube through the skin for ECMO external blood circulation in heart and lungs using a pump (6 years or older),1000.0,650.0,250.0,10301.94,19
CDM,30033967_1,Insertion of blood flow assist device in aorta through skin,4475.0,2908.75,1118.75,11676.43,18
CDM,30033968_1,Removal of blood flow assist device in aorta,1500.0,975.0,375.0,17036.0,19
CDM,30033990_1,Insertion of blood flow assist device in lower heart chamber through skin with review by radiologist using artery access,6339.0,4120.35,1584.75,43784.36,19
CDM,30033992_1,Removal of blood flow assist device in left lower heart chamber through the skin,10000.0,6500.0,2500.0,25825.0,19
CDM,30033995_1,"Insertion of right lower heart chamber blood flow assist device via vein accessed through skin, including radiological supervision and interpretation",6500.0,4225.0,1625.0,43784.36,19
CDM,30033997_1,"Removal of right lower heart chamber blood flow assist device, accessed through skin",4000.0,2600.0,1000.0,10722.03,19
CDM,30033999_1,Other heart surgery procedure,1225.0,796.25,306.25,3163.56,18
CDM,30034401_1,Removal of blood clot in vena cava,9900.0,6435.0,2475.0,25566.75,19
CDM,30034841_1,"Repair of aorta in abdomen with graft, including graft in abdominal organ arteries with review by radiologist",2153.0,1399.45,538.25,24359.93,19
CDM,30035206_1,Repair of blood vessel of arm,2500.0,1625.0,625.0,7441.0,19
CDM,30035226_1,Repair of blood vessel of leg,1561.0,1014.65,390.25,7016.18,19
CDM,30035556_1,Bypass of diseased or blocked upper to lower leg artery with vein,18000.0,11700.0,3678.0,46485.0,19
CDM,30035665_1,Bypass of diseased or blocked groin to upper leg artery with other than vein,18000.0,11700.0,3678.0,46485.0,19
CDM,30036000_1,Insertion of needle or tube into vein,282.0,183.3,70.5,1242.0,19
CDM,30036002_1,Injection to cause blood clot in diseased or pseudoaneurysm of arm or leg,1843.0,1197.95,460.75,4759.55,19
CDM,30036005_1,Injection for X-ray imaging procedure into vein of arm or leg,832.5,541.13,208.13,2166.29,19
CDM,30036010_1,Insertion of tube into vena cava,947.0,615.55,236.75,2445.63,19
CDM,30036011_1,"Insertion of tube into vein, first order branch",2764.5,1796.93,691.13,7139.32,19
CDM,30036012_1,"Insertion of tube into vein, second order branch",3042.0,1977.3,760.5,7855.97,19
CDM,30036013_1,Insertion of tube into right heart or main pulmonary artery,1212.0,787.8,303.0,3129.99,19
CDM,30036014_1,Insertion of tube into left or right pulmonary artery,2244.0,1458.6,561.0,5795.13,19
CDM,30036015_1,Insertion of tube into artery of lobe of lung,2581.5,1677.98,645.38,6666.72,19
CDM,30036140_1,Insertion of needle or tube into artery of arm or leg,975.0,633.75,243.75,2517.94,19
CDM,30036160_1,Insertion of needle or tube into aorta,1234.0,802.1,308.5,3186.81,19
CDM,30036200_1,Insertion of tube into aorta,2431.5,1580.48,607.88,6279.35,19
CDM,30036215_1,"Insertion of tube into chest or arm artery, each first order branch",1500.0,975.0,375.0,3873.75,19
CDM,30036216_1,"Insertion of tube into chest or arm artery, initial second order branch",2396.0,1557.4,599.0,6187.67,19
CDM,30036217_1,"Insertion of tube into chest or arm artery, initial third order branch",2852.0,1853.8,713.0,7365.29,19
CDM,30036218_1,"Insertion of tube into chest or arm artery, additional second, third order and beyond",456.0,296.4,114.0,2318.31,19
CDM,30036221_1,Insertion of tube into chest aorta for diagnosis or treatment with review by radiologist,4163.0,2705.95,1040.75,10750.95,19
CDM,30036222_1,Insertion of tube into extracranial artery for diagnosis or treatment with review by radiologist,8763.0,5695.95,2190.75,22630.45,19
CDM,30036223_1,Insertion of tube into intracranial artery for diagnosis or treatment with review by radiologist,9748.5,6336.53,2318.31,25175.5,19
CDM,30036224_1,Insertion of tube into internal neck artery for diagnosis or treatment with review by radiologist,11064.0,7191.6,2766.0,28572.78,19
CDM,30036225_1,Insertion of tube into chest artery for diagnosis or treatment with review by radiologist,9748.5,6336.53,2318.31,25175.5,19
CDM,30036226_1,Insertion of tube into brain artery for diagnosis or treatment with review by radiologist,10953.0,7119.45,2738.25,28286.12,19
CDM,30036227_1,Insertion of tube into external neck artery for diagnosis or treatment with review by radiologist,2410.0,1566.5,602.5,6559.08,19
CDM,30036228_1,Insertion of tube into neck or brain artery for diagnosis or treatment with review by radiologist,3092.0,2009.8,773.0,7985.09,19
CDM,30036245_1,"Insertion of tube into abdominal, pelvic, or leg artery, each first order branch",6457.5,4197.38,994.94,16676.49,19
CDM,30036246_1,"Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch",4203.0,2731.95,994.94,10854.25,19
CDM,30036247_1,"Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch",4996.5,3247.73,994.94,12903.46,19
CDM,30036248_1,"Insertion of tube into abdominal, pelvic, or leg artery, additional second, third, and beyond",1959.0,1273.35,489.75,5059.12,19
CDM,30036251_1,Insertion of tube into first order main and accessory arteries of kidney for imaging with review by radiologist,7570.0,4920.5,1892.5,19549.53,19
CDM,30036252_1,Insertion of tube into first order main and accessory arteries of both kidneys for imaging with review by radiologist,3556.0,2311.4,889.0,9183.37,19
CDM,30036253_1,Insertion of tube into second or third order branches of arteries of kidney for imaging with review by radiologist,6399.0,4159.35,1599.75,16525.42,19
CDM,30036254_1,Insertion of tube into second or third order branches of arteries of both kidneys for imaging with review by radiologist,7487.0,4866.55,1871.75,19335.18,19
CDM,30036299_1,Other blood vessel injection procedure,1178.0,765.7,294.5,8477.27,19
CDM,30036400_1,Insertion of needle into upper leg or neck vein (younger than 3 years),54.0,35.1,3.89,139.46,18
CDM,30036405_1,Insertion of needle into scalp vein (younger than 3 years),70.0,45.5,3.89,180.78,18
CDM,30036406_1,Insertion of needle into vein (younger than 3 years),70.0,45.5,3.89,180.78,18
CDM,30036410_1,Insertion of needle into vein (3 years or older),84.0,54.6,21.0,216.93,18
CDM,30036415_1,Insertion of needle into vein for collection of blood sample,12.0,7.8,3.0,30.99,19
CDM,30036416_1,Puncture of skin for collection of blood sample,23.0,14.95,3.11,59.4,19
CDM,30036425_1,Incision of vein for insertion of needle or tube (1 year or older),695.0,451.75,109.28,2166.29,19
CDM,30036430_1,Transfusion of blood or blood products,1150.0,747.5,287.5,2969.88,19
CDM,30036455_1,"Exchange blood transfusion, other than newborn",689.0,447.85,172.25,1779.34,19
CDM,30036456_1,"Partial exchange transfusion, newborn",913.0,593.45,228.25,2357.82,19
CDM,30036470_1,Injection of chemical agent into single incompetent vein,525.0,341.25,131.25,2166.29,19
CDM,30036471_1,Injection of chemical agent into multiple incompetent veins of leg,525.0,341.25,131.25,2166.29,19
CDM,30036473_1,Mechanochemical destruction of first incompetent vein of arm or leg using imaging guidance,6000.0,3900.0,1500.0,15495.0,19
CDM,30036474_1,Mechanochemical destruction of subsequent incompetent veins of arm or leg using imaging guidance,2500.0,1625.0,625.0,6456.25,19
CDM,30036475_1,Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance,4000.0,2600.0,1000.0,10330.0,19
CDM,30036478_1,Laser destruction of incompetent vein of arm or leg using imaging guidance,6000.0,3900.0,1500.0,15495.0,19
CDM,30036479_1,"Laser destruction of incompetent veins of arm or leg using imaging guidance, subsequent",620.0,403.0,155.0,4036.25,19
CDM,30036481_1,Insertion of tube into portal vein of liver,5454.0,3545.1,994.94,14084.96,19
CDM,30036482_1,Chemical destruction of first incompetent vein of arm or leg using imaging guidance,4655.0,3025.75,1163.75,12021.54,19
CDM,30036500_1,Insertion of tube into vein with collection of blood sample,574.0,373.1,143.5,2166.29,19
CDM,30036510_1,"Insertion of tube into umbilical vein, newborn",740.0,481.0,109.28,8477.27,19
CDM,30036512_1,Mechanical separation of red blood cells from blood,10028.0,6518.2,2318.31,25897.31,19
CDM,30036513_1,Transfusion medicine procedures,104.0,67.6,5.24,268.58,19
CDM,30036514_1,Mechanical separation of plasma from blood,8953.0,5819.45,208.0,23121.12,19
CDM,30036516_1,Mechanical separation of plasma and abnormal antibodies from blood,7969.0,5179.85,1992.25,20579.94,19
CDM,30036522_1,Mechanical separation of white blood cells and platelets from blood,11100.0,7215.0,2318.31,28665.75,19
CDM,30036555_1,Insertion of non-tunneled central venous tube for infusion (younger than 5 years),2307.0,1499.55,576.75,5957.83,19
CDM,30036556_1,Insertion of non-tunneled central venous tube for infusion (5 years or older),2621.0,1703.65,655.25,6768.73,19
CDM,30036557_1,Insertion of tunneled central venous tube for infusion (younger than 5 years),7727.0,5022.55,1931.75,19954.98,19
CDM,30036558_1,Insertion of tunneled central venous tube for infusion (5 years or older),9639.0,6265.35,2318.31,24892.72,19
CDM,30036560_1,Insertion of central venous tube with port (younger than 5 years),9337.0,6069.05,2334.25,24112.8,19
CDM,30036561_1,Insertion of central venous tube with port (5 years or older),9060.0,5889.0,2265.0,23397.45,19
CDM,30036565_1,Insertion of 2 central venous tubes in 2 veins for infusion,8306.0,5398.9,2076.5,21450.25,19
CDM,30036568_1,Insertion of tube for infusion (younger than 5 years),2752.0,1788.8,208.0,7107.04,19
CDM,30036569_1,Insertion of tube for infusion (5 years or older),3199.0,2079.35,208.0,8261.42,19
CDM,30036570_1,Insertion of central venous tube with port for infusion (younger than 5 years),12317.0,8006.05,1596.28,31808.65,19
CDM,30036571_1,Insertion of central venous tube with port for infusion (5 years or older),11645.0,7569.25,1596.28,30073.21,19
CDM,30036572_1,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient younger than 5 years",2250.0,1462.5,562.5,5810.63,19
CDM,30036573_1,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient 5 years or older",4200.0,2730.0,1050.0,10846.5,19
CDM,30036575_1,Repair of central venous tube for infusion,1129.0,733.85,282.25,3227.0,19
CDM,30036576_1,Repair of central venous tube for infusion with port or pump,5950.0,3867.5,1072.29,15365.88,19
CDM,30036578_1,"Replacement of central venous tube, tube only",2520.0,1638.0,630.0,7441.0,19
CDM,30036580_1,Replacement of nontunneled central venous tube,4216.0,2740.4,1054.0,10887.82,19
CDM,30036581_1,Replacement of tunneled central venous tube,7305.0,4748.25,1826.25,18865.16,19
CDM,30036582_1,Replacement of tunneled central venous tube with port,5910.0,3841.5,1477.5,15262.58,19
CDM,30036584_1,Replacement of peripherally inserted central venous tube (PICC) with review by radiologist,2949.0,1916.85,208.0,7615.79,19
CDM,30036585_1,Replacement of peripherally inserted central venous tube (PICC) with port,7491.0,4869.15,1596.28,19345.51,19
CDM,30036589_1,Removal of tunneled central venous tube,3948.0,2566.2,987.0,10195.71,19
CDM,30036590_1,Removal of central venous tube with port or pump,5482.0,3563.3,1072.29,14157.27,19
CDM,30036591_1,Collection of blood sample from implanted device,235.0,152.75,58.75,606.89,19
CDM,30036592_1,Collection of blood sample from central venous tube,267.0,173.55,66.75,689.53,19
CDM,30036593_1,Declotting of central venous tube,470.0,305.5,117.5,2166.29,19
CDM,30036595_1,Mechanical removal of obstructive material from central venous tube,4985.0,3240.25,1072.29,12873.76,18
CDM,30036596_1,Mechanical removal of tissue or obstructive material from central venous tube,2413.0,1568.45,603.25,6231.57,18
CDM,30036597_1,Repositioning of central venous tube using fluoroscopic guidance,1625.0,1056.25,406.25,4196.56,19
CDM,30036598_1,Contrast injection for imaging to evaluate central venous access device,331.0,215.15,82.75,2318.31,19
CDM,30036600_1,Artery puncture collection of blood sample,159.0,103.35,39.75,1242.0,19
CDM,30036620_1,Insertion of artery tube for blood sampling or infusion through skin,589.0,382.85,147.25,2166.29,19
CDM,30036680_1,Insertion of needle for infusion into bone,990.0,643.5,247.5,2556.68,19
CDM,30036823_1,Insertion of tube into arm or leg for blood circulation and chemotherapy,4486.0,2915.9,1121.5,11585.1,19
CDM,30036901_1,Insertion of needle and/or tube into hemodialysis circuit with review by radiologist,1831.0,1190.15,457.75,4728.56,19
CDM,30036902_1,Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,15254.0,9915.1,3813.5,39393.46,19
CDM,30036903_1,Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist,31576.0,20524.4,7894.0,81545.02,19
CDM,30036904_1,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,15254.0,9915.1,3813.5,39393.46,19
CDM,30036905_1,"Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube",31576.0,20524.4,7894.0,81545.02,19
CDM,30036906_1,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment and placement of stent with review by radiologist,48051.0,31233.15,9592.09,124091.71,19
CDM,30036907_1,Balloon dilation of dialysis segment with review by radiologist,13001.0,8450.65,1242.0,33575.08,19
CDM,30036908_1,Insertion of stent in dialysis segment with review by radiologist,5874.0,3818.1,1242.0,15169.61,19
CDM,30036909_1,Permanent blockage of hemodialysis circuit with review by radiologist,5874.0,3818.1,1242.0,15873.48,19
CDM,30037182_1,Insertion of shunts to bypass blood flow to liver with review by radiologist,30728.0,19973.2,7682.0,79355.06,19
CDM,30037183_1,Revision of shunts to bypass blood flow to liver with review by radiologist,15254.0,9915.1,3813.5,39393.46,19
CDM,30037184_1,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, initial vessel",8001.0,5200.65,2000.25,20662.58,19
CDM,30037185_1,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, subsequent vessels",5644.0,3668.6,1242.0,14575.63,19
CDM,30037186_1,Secondary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance,1109.0,720.85,277.25,15873.48,19
CDM,30037187_1,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, initial treatment",6660.0,4329.0,1665.0,17199.45,19
CDM,30037188_1,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, repeat treatment on subsequent day",2795.0,1816.75,698.75,12029.7,19
CDM,30037191_1,Insertion of vena cava filter with review by radiologist,9160.0,5954.0,2290.0,23655.7,19
CDM,30037192_1,Repositioning of vena cava filter with review by radiologist,14198.0,9228.7,3549.5,36666.34,19
CDM,30037193_1,Removal of vena cava filter with review by radiologist,14290.0,9288.5,3572.5,36903.93,19
CDM,30037197_1,Retrieval of foreign body in blood vessel with review by radiologist,6832.0,4440.8,1708.0,17643.64,19
CDM,30037200_1,Biopsy of blood vessel using tube,4150.0,2697.5,1037.5,10717.38,19
CDM,30037211_1,"Insertion of tube into artery for drug infusion for blood clot with review by radiologist, initial treatment day",12855.0,8355.75,2166.29,33198.04,19
CDM,30037212_1,"Insertion of tube into vein for drug infusion for blood clot with review by radiologist, initial treatment day",7517.0,4886.05,1879.25,19412.65,19
CDM,30037213_1,Insertion of tube into artery or vein for drug infusion for blood clot with review by radiologist,5187.0,3371.55,1296.75,13395.43,19
CDM,30037214_1,Removal of tube into artery or vein with review by radiologist,2707.0,1759.55,676.75,6990.83,19
CDM,30037215_1,Insertion of stent and blood clot protection device in neck artery with review by radiologist,22455.0,14595.75,3678.0,57990.04,19
CDM,30037216_1,Insertion of stent in neck artery with review by radiologist,7935.0,5157.75,1983.75,32128.91,19
CDM,30037218_1,Insertion of stent in blood vessel of chest open or accessed through skin with review by radiologist,11274.0,7328.1,2818.5,32128.91,19
CDM,30037220_1,"Balloon dilation of groin artery, initial vessel",19156.5,12451.73,4789.13,49471.66,19
CDM,30037221_1,"Insertion of stent in groin artery, initial vessel",23695.89,15402.33,5923.97,61194.64,19
CDM,30037222_1,"Balloon dilation of groin artery, each additional vessel",5834.0,3792.1,1458.5,15873.48,18
CDM,30037223_1,"Insertion of stent in groin artery, additional vessel",6780.0,4407.0,1695.0,17509.35,19
CDM,30037224_1,Balloon dilation of artery of leg,18966.0,12327.9,4741.5,48979.7,19
CDM,30037225_1,Removal of plaque in arteries of leg,27699.0,18004.35,6924.75,71532.67,19
CDM,30037226_1,Insertion of stent in arteries of leg,24085.5,15655.58,6021.38,62200.8,19
CDM,30037227_1,Removal of plaque and insertion of stents in arteries of leg,33480.0,21762.0,8370.0,86462.1,19
CDM,30037228_1,"Balloon dilation of artery of leg, initial vessel",43867.5,28513.88,7016.18,113287.82,19
CDM,30037229_1,"Removal of plaque in artery of leg, initial vessel",14794.0,9616.1,3698.5,38205.51,19
CDM,30037230_1,"Insertion of stent in artery of leg, initial vessel",44328.0,28813.2,7016.18,114477.06,19
CDM,30037232_1,"Balloon dilation of artery of leg, each additional vessel",9846.0,6399.9,2166.29,25427.3,19
CDM,30037236_1,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, initial artery",23649.0,15371.85,5912.25,61073.54,19
CDM,30037237_1,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, each additional artery",7568.0,4919.2,1892.0,19544.36,19
CDM,30037238_1,"Insertion of stent in vein with review by radiologist, initial vein",25330.0,16464.5,6141.01,65414.73,19
CDM,30037239_1,"Insertion of stent in vein with review by radiologist, each additional vein",12665.0,8232.25,2166.29,32707.36,19
CDM,30037241_1,Occlusion of vein with review by radiologist,25209.0,16385.85,6302.25,65102.24,19
CDM,30037242_1,Occlusion of artery with review by radiologist,15766.0,10247.9,3941.5,53527.48,19
CDM,30037243_1,Occlusion of growths or obstructed vessels with review by radiologist,17269.0,11224.85,4317.25,53527.48,19
CDM,30037244_1,Occlusion of artery or vein bleeding with review by radiologist,31530.0,20494.5,6141.01,81426.23,19
CDM,30037246_1,"Balloon dilation of artery with review by radiologist, initial artery",22881.0,14872.65,5360.09,59090.18,19
CDM,30037247_1,"Balloon dilation of artery with review by radiologist, each additional artery",7475.0,4858.75,1242.0,19304.19,19
CDM,30037248_1,"Balloon dilation of vein with review by radiologist, initial vein",18637.5,12114.38,4659.38,48131.34,19
CDM,30037249_1,"Balloon dilation of vein with review by radiologist, each additional vein",3732.0,2425.8,933.0,9637.89,19
CDM,30037252_1,"Ultrasound evaluation of blood vessel with review by radiologist, initial vessel",8392.0,5454.8,1242.0,21672.34,17
CDM,30037253_1,"Ultrasound evaluation of blood vessel with review by radiologist, each additional vessel",6714.0,4364.1,1242.0,17338.91,17
CDM,30037607_1,Tying or banding of surgically created artery-vein connection,7305.0,4748.25,1826.25,18865.16,19
CDM,30037609_1,Tying or biopsy of artery on side of skull,1995.0,1296.75,498.75,5152.09,19
CDM,30037785_1,"Tying, incision, and/or removal of varicose vein clusters of leg",2520.0,1638.0,630.0,7441.0,19
CDM,30037799_1,Other procedure on blood vessel,1440.0,936.0,360.0,3718.8,19
CDM,30038200_1,Injection procedure for imaging of spleen,753.0,489.45,188.25,2166.29,19
CDM,30038220_1,Aspiration of bone marrow sample for diagnosis,2023.0,1314.95,505.75,5224.4,19
CDM,30038221_1,Biopsy of bone marrow,2160.0,1404.0,540.0,5578.2,19
CDM,30038222_1,Biopsy and aspiration of bone marrow sample for diagnosis,5280.0,3432.0,1320.0,13635.6,19
CDM,30038228_1,Administration of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy,10000.0,6500.0,2500.0,25825.0,16
CDM,30038240_1,Transplantation of donor stem cells per donor,83259.0,54118.35,6455.25,215016.37,19
CDM,30038241_1,Transplantation of patient-derived stem cells,10000.0,6500.0,2379.25,25825.0,18
CDM,30038242_1,Transplantation of donor white blood cells,10000.0,6500.0,2379.25,25825.0,19
CDM,30038243_1,Transplantation of donor stem cells,10000.0,6500.0,2166.29,25825.0,19
CDM,30038500_1,Biopsy or removal of lymph nodes,6990.0,4543.5,1747.5,18051.68,19
CDM,30038505_1,Needle biopsy or removal of surface lymph nodes,5625.0,3656.25,1406.25,14526.56,19
CDM,30038510_1,Biopsy or removal of deep lymph nodes of neck,11244.0,7308.6,2318.31,29037.63,19
CDM,30038745_1,Removal of lymph nodes of underarm,17277.0,11230.05,2600.83,44617.85,19
CDM,30038790_1,Injection procedure for imaging of lymphatic system,393.0,255.45,98.25,2166.29,19
CDM,30038792_1,Injection of radioactive material for X-ray identification of lymph node,1197.0,778.05,299.25,3091.25,18
CDM,30038794_1,Exposure of lymph duct of chest cavity,798.0,518.7,199.5,8477.27,19
CDM,30038999_1,Other procedure on lymphatic system,1064.0,691.6,266.0,4715.89,19
CDM,30039499_1,Other procedure on chest cavity below breast bone,1075.0,698.75,268.75,8477.27,19
CDM,30040490_1,Biopsy of lip,187.0,121.55,46.75,8477.27,19
CDM,30040520_1,V-shaped removal of lip tissue,2150.0,1397.5,537.5,5552.38,19
CDM,30040650_1,Repair of lip and border,1085.0,705.25,246.43,6141.01,19
CDM,30040652_1,Repair of vertical lip wound extending to half of lip,917.0,596.05,229.25,6141.01,19
CDM,30040654_1,Repair of vertical lip wound extending to over half of lip,2572.0,1671.8,643.0,6642.19,19
CDM,30040800_1,"Simple drainage of abscess, cyst, or blood accumulation of mouth",549.0,356.85,137.25,8477.27,19
CDM,30040804_1,Simple removal of embedded foreign body in mouth,1980.0,1287.0,495.0,8477.27,19
CDM,30040808_1,Biopsy of mouth,452.0,293.8,113.0,2166.29,19
CDM,30040812_1,Removal of growth of mouth with simple repair,2183.0,1418.95,545.75,5637.6,19
CDM,30040830_1,"Repair of lacerated mouth, 2.5 cm or less",504.0,327.6,126.0,8477.27,19
CDM,30040831_1,"Repair of lacerated mouth, more than 2.5 cm",921.0,598.65,230.25,2378.48,19
CDM,30041000_1,"Drainage of abscess, cyst, or blood accumulation of side of tongue from inside mouth",1061.0,689.65,265.25,2740.03,19
CDM,30041008_1,"Drainage of abscess, cyst, or blood accumulation under jaw bone from inside mouth",7378.0,4795.7,1844.5,19053.69,19
CDM,30041010_1,Incision of tissue connecting tongue and floor of mouth,1707.0,1109.55,426.75,4408.33,19
CDM,30041017_1,"Drainage of abscess, cyst, or blood accumulation under jaw bone from outside mouth",6519.0,4237.35,1629.75,16835.32,19
CDM,30041100_1,Biopsy of front 2/3 of tongue,1296.0,842.4,246.43,3346.92,19
CDM,30041105_1,Biopsy of back 1/3 of tongue,2587.0,1681.55,646.75,6680.93,19
CDM,30041108_1,Biopsy of floor of mouth,3709.0,2410.85,927.25,9578.49,19
CDM,30041112_1,Removal of growth of front 2/3 of tongue with switches,7378.0,4795.7,1844.5,19053.69,19
CDM,30041115_1,Removal of tissue connecting tongue and floor of mouth,1230.0,799.5,307.5,3726.0,19
CDM,30041250_1,"Repair of lacerated floor of mouth and/or tongue, 2.5 cm or less",620.0,403.0,155.0,2318.31,19
CDM,30041252_1,"Repair of lacerated tongue or floor of mouth, more than 2.6 cm",1150.0,747.5,246.43,2969.88,19
CDM,30041800_1,"Drainage of abscess, cyst, or blood accumulation of dental bone",444.0,288.6,111.0,2166.29,19
CDM,30042000_1,Drainage of abscess of roof of mouth,384.0,249.6,96.0,2318.31,19
CDM,30042100_1,Biopsy of roof of mouth,1230.0,799.5,307.5,3726.0,19
CDM,30042104_1,Removal of growth of roof of mouth,2183.0,1418.95,545.75,5637.6,19
CDM,30042106_1,Removal of growth of roof of mouth with simple closure,2620.0,1703.0,655.0,6766.15,19
CDM,30042180_1,"Repair of lacerated roof of mouth, 2.0 cm or less",1260.0,819.0,315.0,3253.95,19
CDM,30042300_1,Simple drainage of abscess of saliva gland,3215.0,2089.75,803.75,8302.74,19
CDM,30042330_1,Uncomplicated removal of saliva gland stone from inside mouth,6519.0,4237.35,1629.75,16835.32,19
CDM,30042340_1,Complicated removal of saliva gland stone,5900.0,3835.0,1475.0,15236.75,19
CDM,30042400_1,Needle biopsy of saliva gland,908.0,590.2,227.0,3227.0,19
CDM,30042405_1,Biopsy of saliva gland,3215.0,2089.75,803.75,8302.74,19
CDM,30042500_1,Simple repair of salivary duct,4860.0,3159.0,1215.0,12550.95,19
CDM,30042550_1,Injection of contrast for imaging of saliva glands,877.0,570.05,219.25,2264.85,19
CDM,30042700_1,Drainage of abscess near tonsil,536.0,348.4,134.0,2166.29,19
CDM,30042800_1,Biopsy of back of throat,2183.0,1418.95,545.75,5637.6,19
CDM,30042804_1,Simple biopsy of growth of throat behind nose,6600.0,4290.0,1650.0,17044.5,19
CDM,30042809_1,Removal of foreign body in throat,358.0,232.7,89.5,2166.29,19
CDM,30042960_1,Simple control of bleeding of throat,443.0,287.95,110.75,2075.68,19
CDM,30043197_1,Diagnostic exam of esophagus using a flexible endoscope through nose,1986.0,1290.9,496.5,5128.85,19
CDM,30043200_1,Diagnostic exam of esophagus using a flexible endoscope through mouth,2138.0,1389.7,534.5,5521.39,19
CDM,30043202_1,Biopsy of esophagus using a flexible endoscope through mouth,4003.0,2601.95,1000.75,10337.75,19
CDM,30043206_1,Microscopic exam of esophagus using a flexible endoscope,4003.0,2601.95,1000.75,10337.75,19
CDM,30043226_1,Dilation of esophagus with insertion of guide wire using a flexible endoscope,2084.0,1354.6,521.0,5381.93,19
CDM,30043235_1,"Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",1824.0,1185.6,456.0,4710.48,19
CDM,30043236_1,"Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2084.0,1354.6,521.0,5381.93,19
CDM,30043239_1,"Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2125.0,1381.25,531.25,5487.81,19
CDM,30043242_1,"Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2084.0,1354.6,521.0,5381.93,19
CDM,30043246_1,Insertion of stomach tube using a flexible endoscope,2293.0,1490.45,573.25,5921.67,19
CDM,30043247_1,"Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2227.0,1447.55,556.75,5751.23,19
CDM,30043248_1,Insertion of guide wire with dilation of esophagus using a flexible endoscope,2227.0,1447.55,556.75,5751.23,19
CDM,30043249_1,"Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm",4003.0,2601.95,1000.75,10337.75,19
CDM,30043251_1,"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare",2084.0,1354.6,521.0,5381.93,19
CDM,30043252_1,"Microscopic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2660.0,1729.0,665.0,6869.45,19
CDM,30043257_1,Heat delivery to muscle at esophagus and/or stomach to treat gastric reflux using a flexible endoscope,5245.0,3409.25,1311.25,13545.21,19
CDM,30043259_1,"Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",3685.0,2395.25,921.25,9516.51,19
CDM,30043460_1,Control of bleeding of esophagus,900.0,585.0,225.0,8477.27,19
CDM,30043752_1,Insertion of stomach tube through nose or mouth using fluoroscopic guidance,990.0,643.5,247.5,2556.68,19
CDM,30043753_1,Insertion of stomach tube and aspiration of stomach contents,283.0,183.95,70.75,2166.29,17
CDM,30043761_1,Repositioning of oral or nasal feeding tube in small bowel,1274.0,828.1,318.5,3290.11,19
CDM,30043762_1,Replacement of stomach stoma tube,463.0,300.95,115.75,1195.7,19
CDM,30043763_1,Replacement of stomach stoma tube with revision of stoma opening,463.0,300.95,115.75,2166.29,19
CDM,30043771_1,Adjustment of stomach reduction device using an endoscope,9950.0,6467.5,2487.5,25695.88,19
CDM,30043999_1,Other procedure on stomach,1882.0,1223.3,470.5,4860.27,19
CDM,30044360_1,Diagnostic exam of small bowel (excluding lower small intestine) using an endoscope,2303.0,1496.95,575.75,5947.5,19
CDM,30044372_1,Insertion of tube into middle small bowel using an endoscope,2802.0,1821.3,700.5,7236.17,19
CDM,30044376_1,Diagnostic exam of small bowel (including lower small intestine) using an endoscope,2303.0,1496.95,575.75,5947.5,19
CDM,30044377_1,Biopsy of small bowel using an endoscope,2303.0,1496.95,575.75,5947.5,19
CDM,30044378_1,Control of bleeding of small bowel using an endoscope,2303.0,1496.95,575.75,5947.5,19
CDM,30044500_1,Dilation of stomach and/or small bowel using long gastrointestinal tube,445.0,289.25,111.25,8477.27,19
CDM,30044640_1,Closure of abnormal drainage tract from small bowel to skin,1240.0,806.0,310.0,8477.27,19
CDM,30044799_1,Other procedure on small bowel,925.0,601.25,231.25,3726.0,19
CDM,30045100_1,Biopsy of anal and/or rectal wall through anus,5017.0,3261.05,1254.25,12956.4,19
CDM,30045300_1,Diagnostic exam of rectum and lower large bowel using an endoscope,685.0,445.25,171.25,3227.0,19
CDM,30045378_1,Diagnostic exam of large bowel using a flexible endoscope,2240.0,1456.0,560.0,5784.8,19
CDM,30045380_1,Biopsy of large bowel using a flexible endoscope,2197.0,1428.05,549.25,5673.75,19
CDM,30045910_1,Dilation of narrowing of rectum under anesthesia,4960.0,3224.0,1240.0,12809.2,19
CDM,30045915_1,Removal of impacted stool or foreign body in rectum under anesthesia,1007.0,654.55,251.75,3726.0,19
CDM,30045999_1,Other procedure on rectum,880.0,572.0,220.0,8477.27,19
CDM,30046030_1,Removal of drain (seton) from anus,950.0,617.5,237.5,3726.0,19
CDM,30046040_1,Drainage of deep abscess in rectum,950.0,617.5,237.5,6141.01,19
CDM,30046050_1,Drainage of superficial rectal abscess surrounding anus,667.0,433.55,166.75,3227.0,19
CDM,30046083_1,Incision of external hemorrhoid with blood clot,346.0,224.9,86.5,2166.29,19
CDM,30046220_1,Removal of single external noncancer growth of anus,2704.0,1757.6,208.0,6983.08,19
CDM,30046221_1,Removal of external hemorrhoids by rubber banding,677.0,440.05,169.25,3227.0,19
CDM,30046280_1,Repair of abnormal drainage tract around anal sphincter,6180.0,4017.0,1545.0,15959.85,19
CDM,30046320_1,Removal of external hemorrhoid with blood clot,950.0,617.5,237.5,3726.0,19
CDM,30046600_1,Diagnostic exam of anus using an endoscope,110.0,71.5,27.5,2166.29,19
CDM,30046606_1,Biopsy of anus using an endoscope,950.0,617.5,237.5,3726.0,19
CDM,30046706_1,Repair of abnormal anal drainage tract with tissue glue,6921.0,4498.65,1730.25,17873.48,19
CDM,30046707_1,Repair of abnormal anal drainage tract with implanted plug,5419.0,3522.35,1354.75,13994.57,19
CDM,30047000_1,Needle biopsy of liver through skin,2023.0,1314.95,505.75,5224.4,19
CDM,30047001_1,Needle biopsy of liver,1148.0,746.2,287.0,2964.71,19
CDM,30047015_1,Injection and/or aspiration of abscess or cyst of liver,960.0,624.0,240.0,8477.27,19
CDM,30047382_1,Destruction of growth of liver through skin using radiofrequency,13411.0,8717.15,3352.75,34633.91,19
CDM,30047383_1,Destruction of growth of liver through skin using freezing,13466.0,8752.9,3366.5,34775.95,19
CDM,30047399_1,Other procedure on liver,970.0,630.5,242.5,8477.27,19
CDM,30047490_1,Insertion of tube into gallbladder using imaging guidance with review by radiologist,8733.0,5676.45,2183.25,22552.97,19
CDM,30047531_1,Injection of bile duct for X-ray through already existing skin access using imaging guidance with review by radiologist,2810.0,1826.5,702.5,7441.0,19
CDM,30047532_1,Injection of bile duct for X-ray through new skin access using imaging guidance with review by radiologist,5801.0,3770.65,1450.25,14981.08,19
CDM,30047533_1,Placement of external drainage tube of biliary duct using imaging guidance with review by radiologist,5801.0,3770.65,1450.25,14981.08,19
CDM,30047534_1,Placement of internal-external drainage tube of biliary duct using imaging guidance with review by radiologist,6007.0,3904.55,1501.75,15513.08,19
CDM,30047535_1,Conversion of external biliary drainage tube to internal-external biliary drainage tube using imaging guidance and study of bile duct with review by radiologist,9478.0,6160.7,2318.31,24476.94,19
CDM,30047536_1,Replacement of liver duct drainage tube using imaging guidance with review by radiologist,6361.0,4134.65,1590.25,16427.28,19
CDM,30047537_1,Removal of biliary drainage tube using imaging guidance with review by radiologist,4644.0,3018.6,565.93,11993.13,19
CDM,30047538_1,Placement of stent of biliary duct through existing skin access using imaging guidance with review by radiologist,12593.0,8185.45,3148.25,32521.42,19
CDM,30047539_1,Placement of stent of biliary duct through new skin access using imaging with review by radiologist,10764.0,6996.6,2691.0,27798.03,19
CDM,30047540_1,Placement of stent and drainage tube of biliary duct using imaging guidance with review by radiologist,12593.0,8185.45,3148.25,32521.42,19
CDM,30047541_1,Placement of access device into biliary tract using imaging guidance with review by radiologist,5691.0,3699.15,1422.75,14697.01,19
CDM,30047542_1,Balloon dilation of bile duct using imaging guidance with review by radiologist,1287.0,836.55,321.75,8045.61,19
CDM,30047543_1,Biopsy of bile duct or liver duct using imaging guidance with review by radiologist,2957.0,1922.05,739.25,8045.61,19
CDM,30047544_1,Removal of biliary duct or gallbladder stone using imaging guidance with review by radiologist,10973.0,7132.45,1242.0,28337.77,19
CDM,30047552_1,Diagnostic exam of bile duct using an endoscope,8585.0,5580.25,2146.25,22170.76,19
CDM,30047553_1,Biopsy of bile duct using an endoscope,8585.0,5580.25,2146.25,22170.76,19
CDM,30047554_1,Removal of bile duct stones using an endoscope,12593.0,8185.45,3148.25,32521.42,19
CDM,30047555_1,Dilation of bile ducts using an endoscope,8585.0,5580.25,2146.25,22170.76,19
CDM,30047556_1,Dilation of bile ducts with stent insertion using an endoscope,12593.0,8185.45,3148.25,32521.42,19
CDM,30047999_1,Other procedure on bile duct,2602.0,1691.3,650.5,8477.27,19
CDM,30048102_1,Needle biopsy of pancreas,4044.0,2628.6,1011.0,10443.63,19
CDM,30048400_1,Injection for X-ray study of pancreas during surgery,662.0,430.3,165.5,8477.27,19
CDM,30048999_1,Other procedure on pancreas,925.0,601.25,231.25,8477.27,19
CDM,30049020_1,Drainage of abdominal abscess or infection,6086.0,3955.9,1521.5,15717.1,19
CDM,30049082_1,Drainage of fluid from abdominal cavity,865.0,562.25,216.25,3726.0,19
CDM,30049083_1,Drainage of fluid from abdominal cavity using imaging guidance,1272.0,826.8,318.0,3726.0,19
CDM,30049084_1,Irrigation of abdominal cavity,1313.0,853.45,328.25,3726.0,19
CDM,30049180_1,Needle biopsy of growth of abdominal cavity,2023.0,1314.95,505.75,5224.4,19
CDM,30049185_1,Injection of chemical agent into fluid collection using imaging guidance,1719.0,1117.35,429.75,4439.32,19
CDM,30049402_1,Removal of foreign body in abdominal cavity,8585.0,5580.25,2146.25,22170.76,19
CDM,30049405_1,Drainage of fluid collection by tube through skin using imaging guidance,9537.0,6199.05,1049.65,24629.3,19
CDM,30049406_1,Drainage of fluid collection of abdominal cavity by tube using imaging guidance,9537.0,6199.05,1049.65,24629.3,19
CDM,30049407_1,Drainage of fluid collection by tube through vagina or rectum using imaging guidance,9537.0,6199.05,1049.65,24629.3,19
CDM,30049411_1,Insertion of device in abdominal cavity through skin for radiation therapy guidance,3560.0,2314.0,890.0,9193.7,19
CDM,30049418_1,Insertion of abdominal tube using imaging guidance with review by radiologist,5716.0,3715.4,1429.0,14761.57,19
CDM,30049419_1,Insertion of abdominal cavity tube for drug delivery,4150.0,2697.5,1037.5,10717.38,19
CDM,30049421_1,Insertion of abdominal cavity tube for drainage or dialysis,6872.0,4466.8,1718.0,17746.94,19
CDM,30049422_1,Removal of abdominal cavity tube,6858.0,4457.7,1049.65,17710.79,19
CDM,30049423_1,Exchange of abdominal cavity drainage tube using imaging guidance,3390.0,2203.5,847.5,8754.68,19
CDM,30049424_1,Injection of contrast through abdominal cavity tube for X-ray study,572.0,371.8,143.0,2166.29,19
CDM,30049425_1,Insertion of shunt from jugular vein to abdominal cavity,2307.0,1499.55,576.75,5957.83,19
CDM,30049427_1,Injection for X-ray study of shunt from jugular vein to abdominal cavity,524.0,340.6,131.0,2166.29,19
CDM,30049429_1,Removal of shunt from jugular vein to abdominal cavity,4120.0,2678.0,1030.0,10639.9,19
CDM,30049440_1,Insertion of stomach tube using fluoroscopic guidance with contrast,2142.0,1392.3,535.5,5531.72,19
CDM,30049441_1,Insertion of small bowel tube using fluoroscopic guidance with contrast,2507.0,1629.55,565.93,6474.33,19
CDM,30049442_1,Insertion of large bowel tube using fluoroscopic guidance with contrast,2164.0,1406.6,541.0,5588.53,19
CDM,30049446_1,Conversion of stomach tube to stomach-to-small bowel tube using fluoroscopic guidance with contrast,1543.0,1002.95,385.75,3984.8,19
CDM,30049450_1,Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast,2320.0,1508.0,565.93,5991.4,19
CDM,30049451_1,Replacement of small bowel tube using fluoroscopic guidance with contrast,943.0,612.95,235.75,3726.0,19
CDM,30049452_1,Replacement of stomach-to-small bowel tube using fluoroscopic guidance with contrast,1436.0,933.4,359.0,3726.0,19
CDM,30049460_1,"Mechanical removal of obstructive material from stomach, large, or small bowel tube using fluoroscopic guidance",493.0,320.45,123.25,3726.0,19
CDM,30049465_1,"Contrast injection for X-ray imaging through existing tube in stomach, small bowel or large bowel",322.0,209.3,80.5,2166.29,19
CDM,30049557_1,Repair of trapped recurrent femoral groin hernia,8520.0,5538.0,208.0,22002.9,19
CDM,30049999_1,Other procedure on abdomen,5965.0,3877.25,1049.65,15404.61,19
CDM,30050080_1,Simple surgical treatment of kidney stone with imaging guidance,22349.0,14526.85,5587.25,57716.29,19
CDM,30050200_1,Needle biopsy of kidney,5580.0,3627.0,1395.0,14410.35,19
CDM,30050382_1,Removal and replacement of stent in ureter with review by radiologist,4932.0,3205.8,1233.0,12736.89,19
CDM,30050384_1,Removal of stent in ureter through skin with review by radiologist,1670.0,1085.5,417.5,6451.0,19
CDM,30050386_1,Removal of stent in ureter through ureter with review by radiologist,1670.0,1085.5,417.5,6451.0,19
CDM,30050387_1,Removal and replacement of stent in kidney and ureter using fluoroscopic guidance with review by radiologist,7630.5,4959.83,1907.63,19705.77,19
CDM,30050389_1,Removal of kidney drainage tube using fluoroscopic guidance,1625.0,1056.25,406.25,4196.56,19
CDM,30050390_1,Aspiration and/or injection of cyst of kidney,1025.0,666.25,256.25,3227.0,19
CDM,30050391_1,Instillation of drug into kidney and/or ureter,236.0,153.4,59.0,2166.29,19
CDM,30050396_1,Measurement of urine flow in kidneys and ureters,579.0,376.35,144.75,3227.0,19
CDM,30050430_1,Injection procedure for imaging of kidney and ureter through new skin access using imaging guidance with review by radiologist,5058.0,3287.7,587.05,13062.29,19
CDM,30050431_1,Injection procedure for imaging of kidney and ureter through already existing skin access using imaging guidance with review by radiologist,2170.5,1410.83,542.63,5605.32,19
CDM,30050432_1,Placement of tube of kidney using imaging guidance with review by radiologist,6235.5,4053.08,1558.88,16103.18,19
CDM,30050433_1,Placement of tube of kidney and urinary tube through new skin access using imaging guidance with review by radiologist,7398.0,4808.7,1849.5,19105.34,19
CDM,30050434_1,Conversion of kidney tube to nephroureteral tube using imaging guidance and study of kidney and ureter with review by radiologist,4887.0,3176.55,1221.75,12620.68,19
CDM,30050435_1,Replacement of kidney drainage tube using imaging guidance with review by radiologist,3817.5,2481.38,954.38,9858.69,19
CDM,30050436_1,Dilation of existing opening into urinary tract using imaging guidance,3480.0,2262.0,870.0,8987.1,19
CDM,30050437_1,Dilation of existing opening into urinary tract and creation of new access into urine collecting system of kidney using imaging guidance,8781.0,5707.65,2130.12,22676.93,19
CDM,30050592_1,Destruction of growth of kidney using radiofrequency,8546.0,5554.9,2136.5,22070.05,19
CDM,30050593_1,Destruction of growth of kidney by freezing,11394.0,7406.1,2848.5,29425.01,19
CDM,30050684_1,Injection of ureter for imaging,577.0,375.05,144.25,2166.29,19
CDM,30050686_1,Measurement of urine flow in ureter,341.0,221.65,85.25,1242.0,19
CDM,30050688_1,Change of tube or stent in ureter,2379.0,1546.35,594.75,6143.77,19
CDM,30050690_1,Injection of bladder and ureter for imaging,507.0,329.55,126.75,2166.29,19
CDM,30050693_1,Placement of stent of ureter through existing skin access using imaging guidance with review by radiologist,5344.0,3473.6,1336.0,13800.88,19
CDM,30050694_1,Placement of stent of ureter through new skin access using imaging guidance with review by radiologist,7001.0,4550.65,1750.25,18080.08,19
CDM,30050695_1,Placement of stent of ureter and separate tube in kidney through new skin access using imaging guidance with review by radiologist,8978.0,5835.7,2244.5,23185.69,19
CDM,30050706_1,Balloon dilation treatment of stricture of ureter using imaging guidance with review by radiologist,1605.0,1043.25,401.25,10111.49,19
CDM,30051040_1,Incision of bladder with drainage,3377.0,2195.05,844.25,8721.1,19
CDM,30051100_1,Needle aspiration of bladder,585.0,380.25,146.25,2166.29,19
CDM,30051102_1,Aspiration of bladder with insertion of bladder tube to skin,2543.0,1652.95,635.75,6567.3,19
CDM,30051600_1,Injection procedure for imaging of bladder during voiding,568.0,369.2,142.0,8477.27,19
CDM,30051610_1,Injection procedure through bladder and urethra for X-ray imaging,613.0,398.45,153.25,8477.27,19
CDM,30051700_1,Simple bladder irrigation and/or instillation,226.0,146.9,56.5,2166.29,19
CDM,30051701_1,Insertion of temporary bladder tube,110.0,71.5,27.5,284.08,19
CDM,30051702_1,Simple insertion of temporary bladder tube,110.0,71.5,27.5,2166.29,19
CDM,30051703_1,Complicated insertion of bladder tube,137.0,89.05,34.25,2166.29,19
CDM,30051705_1,Simple change of bladder tube,226.0,146.9,56.5,2166.29,19
CDM,30051710_1,Complicated change of bladder tube,559.0,363.35,139.75,3227.0,19
CDM,30051720_1,Instillation of anti-cancer drug into bladder,559.0,363.35,139.75,1443.62,19
CDM,30051798_1,Ultrasound measurement of bladder capacity after voiding,65.0,42.25,16.25,208.0,19
CDM,30052000_1,Diagnostic exam of bladder and urethra using an endoscope,850.0,552.5,208.0,2310.6,19
CDM,30052281_1,Dilation of urethra using an endoscope,1654.0,1075.1,413.5,4271.46,19
CDM,30052283_1,Steroid injection into urethra stricture using an endoscope,1795.0,1166.75,448.75,6451.0,19
CDM,30052310_1,"Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope",1750.0,1137.5,437.5,4519.38,19
CDM,30052356_1,Crushing of stone of ureter with insertion of stent using an endoscope,15525.0,10091.25,3881.25,40093.31,19
CDM,30053899_1,Other procedure on urinary system,970.0,630.5,242.5,2505.03,19
CDM,30054050_1,Simple destruction of growths of penis using chemical,302.0,196.3,75.5,8477.27,19
CDM,30054056_1,Simple destruction of growth of penis using freezing,163.0,105.95,40.75,8477.27,19
CDM,30054065_1,Destruction of multiple growths of penis,1490.0,968.5,372.5,3847.93,19
CDM,30054100_1,Biopsy of penis,1330.0,864.5,332.5,3726.0,19
CDM,30054150_1,Removal of foreskin using clamp or device,1654.0,1075.1,413.5,6451.0,19
CDM,30054160_1,Removal of foreskin (28 days or younger),1822.0,1184.3,455.5,6451.0,19
CDM,30054161_1,Removal of foreskin (older than 28 days),4932.0,3205.8,1233.0,12736.89,19
CDM,30054220_1,Injection of drug into erectile tissue at sides and back of penis,228.0,148.2,57.0,2166.29,19
CDM,30054235_1,Injection procedure to cause erection,226.0,146.9,56.5,8477.27,19
CDM,30054450_1,Repositioning of foreskin including scar tissue removal,650.0,422.5,162.5,2166.29,19
CDM,30054700_1,"Incision and drainage of sperm reservoir, testis, and/or scrotal area",4932.0,3205.8,1233.0,12736.89,19
CDM,30055000_1,Aspiration of fluid collection in testicle and sperm reservoir,2287.5,1486.88,125.32,8477.27,19
CDM,30055100_1,Drainage of abscess of scrotum,1330.0,864.5,332.5,3726.0,19
CDM,30055250_1,Removal of sperm duct,1654.0,1075.1,208.0,4271.46,19
CDM,30055540_1,Removal of spermatic cord venous dilation or suturing spermatic veins with hernia repair,7590.0,4933.5,1897.5,19601.18,19
CDM,30055700_1,Biopsy of prostate gland,1654.0,1075.1,208.0,4271.46,19
CDM,30055707_1,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",9005.0,5853.25,2251.25,23255.41,16
CDM,30055709_1,"BIOPSY, PROSTATE, TRANSPERINEAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",9005.0,5853.25,2251.25,23255.41,16
CDM,30055873_1,Destruction of prostate using imaging guidance,8120.0,5278.0,2030.0,20969.9,19
CDM,30056405_1,Incision and drainage of abscess of external female genitals,632.5,411.13,158.13,2318.31,19
CDM,30056420_1,Incision and drainage of abscess of female genital gland,380.0,247.0,95.0,2166.29,19
CDM,30056605_1,"Biopsy of growth of external female genitals, first growth",560.0,364.0,140.0,3227.0,19
CDM,30056606_1,"Biopsy of growth of external female genitals, each additional growth",250.0,162.5,62.5,2166.29,19
CDM,30056620_1,Simple partial removal of external female genitals,2540.0,1651.0,635.0,8023.32,19
CDM,30056820_1,Exam of external female genitals using an endoscope,357.0,232.05,89.25,2166.29,19
CDM,30056821_1,Exam and biopsy of external female genitals using an endoscope,635.0,412.75,158.75,2166.29,19
CDM,30057100_1,Simple biopsy of vaginal mucous membrane,676.0,439.4,169.0,3227.0,19
CDM,30057156_1,Insertion of device into vagina for radiation therapy,1635.0,1062.75,408.75,4222.39,19
CDM,30057180_1,Insertion of drug agent or packing to control vaginal bleeding,381.0,247.65,95.25,8477.27,19
CDM,30057200_1,Suture of nonobstetrical injury of vagina,2250.0,1462.5,562.5,6451.0,19
CDM,30057420_1,Exam of vagina and cervix using an endoscope,459.0,298.35,114.75,2166.29,19
CDM,30057421_1,Biopsy of vagina and cervix using an endoscope,676.0,439.4,169.0,3227.0,19
CDM,30057452_1,Exam of cervix and upper part of vagina using an endoscope,162.0,105.3,40.5,2318.31,19
CDM,30057454_1,Biopsy and scraping of cervix using an endoscope,286.0,185.9,71.5,2318.31,19
CDM,30057455_1,Biopsy of cervix using an endoscope,286.0,185.9,71.5,2166.29,19
CDM,30057500_1,Biopsy of cervix or removal of growth,676.0,439.4,169.0,3227.0,19
CDM,30057505_1,Scraping of tissue of cervix,676.0,439.4,169.0,3227.0,19
CDM,30057522_1,Removal or destruction of cervix using loop electrode,2250.0,1462.5,562.5,6451.0,19
CDM,30058100_1,Biopsy of lining of uterus,162.0,105.3,40.5,2166.29,19
CDM,30058300_1,Insertion of IUD for pregnancy prevention,110.0,71.5,27.5,2166.29,19
CDM,30058301_1,Removal of IUD,286.0,185.9,71.5,2166.29,19
CDM,30058340_1,Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes,718.0,466.7,179.5,2166.29,19
CDM,30058999_1,Other procedure on female genital system (nonobstetrical),567.0,368.55,141.75,2166.29,19
CDM,30059000_1,Removal of sample of amniotic fluid surrounding fetus for diagnosis,676.0,439.4,169.0,3227.0,19
CDM,30059020_1,Fetal contraction stress test,162.0,105.3,40.5,1242.0,19
CDM,30059025_1,Fetal test,260.0,169.0,65.0,1242.0,19
CDM,30059200_1,Insertion of dilator device into cervix,867.0,563.55,216.75,2239.03,19
CDM,30059320_1,Suture of cervix during pregnancy through vagina,8270.0,5375.5,2067.5,21357.28,19
CDM,30059409_1,Vaginal delivery,3408.0,2215.2,852.0,8801.16,19
CDM,30059412_1,Turning of fetus through external manipulation,6818.0,4431.7,839.36,17607.49,19
CDM,30059414_1,Delivery of placenta,6254.0,4065.1,1563.5,16150.96,19
CDM,30059812_1,Treatment of miscarriage,2250.0,1462.5,562.5,8023.32,19
CDM,30059820_1,Treatment of miscarriage during first trimester,2891.42,1879.42,722.86,8023.32,19
CDM,30059871_1,Removal of suture of cervix under anesthesia,4500.0,2925.0,1125.0,11621.25,19
CDM,30060100_1,Needle biopsy of thyroid through skin,691.0,449.15,172.75,3227.0,19
CDM,30060300_1,Aspiration and/or injection of cyst of thyroid,647.0,420.55,161.75,3227.0,19
CDM,30060699_1,Other procedure on endocrine system,12593.0,8185.45,2166.29,32521.42,19
CDM,30061020_1,Removal of cerebrospinal fluid from brain for diagnosis,1301.0,845.65,325.25,3359.83,19
CDM,30061026_1,Removal of cerebrospinal fluid from brain and injection of substance,1575.0,1023.75,393.75,4067.44,19
CDM,30061050_1,Removal of cerebrospinal fluid from upper spine,187.0,121.55,46.75,2166.29,19
CDM,30061055_1,Spinal puncture in upper spine with injection of substance,534.0,347.1,133.5,2166.29,19
CDM,30061070_1,Aspiration of cerebrospinal fluid and injection in shunt tubing or reservoir,1006.0,653.9,251.5,3227.0,19
CDM,30061107_1,Creation of opening in skull for insertion of brain tube or monitoring device,1304.0,847.6,326.0,8477.27,19
CDM,30061154_1,Burr hole with removal and/or drainage of blood accumulation outside or below brain membrane,1250.0,812.5,312.5,8477.27,19
CDM,30061210_1,Burr hole for insertion of brain tube or monitoring device,1360.0,884.0,340.0,8477.27,19
CDM,30061623_1,Balloon occlusion of head or neck artery with review by radiologist,10655.0,6925.75,2663.75,27516.54,19
CDM,30061624_1,Occlusion of central nervous system or spinal cord artery,8244.0,5358.6,2061.0,21290.13,19
CDM,30061626_1,Occlusion of head or neck artery,9130.0,5934.5,2282.5,23578.23,19
CDM,30061630_1,Balloon dilation of blood vessel in head,7186.0,4670.9,1796.5,20863.33,19
CDM,30061635_1,Insertion of stent in blood vessel of head,18913.0,12293.45,3678.0,48842.82,19
CDM,30061640_1,Balloon dilation of blood vessel spasm in head,18913.0,12293.45,3678.0,48842.82,19
CDM,30061641_1,Balloon dilation of additional blood vessel spasm in head in same vessel family,12579.0,8176.35,3144.75,32485.27,19
CDM,30061642_1,Balloon dilation of additional blood vessel spasm in head in different vessel family,15081.0,9802.65,3678.0,38946.68,19
CDM,30061645_1,Removal of blood clot and injection to dissolve blood clot from head artery using fluoroscopic guidance,12465.0,8102.25,3116.25,32190.86,19
CDM,30061650_1,"Infusion of chemical agent into artery of brain with insertion of tube and imaging, initial territory",5402.0,3511.3,1350.5,20863.33,19
CDM,30061651_1,"Infusion of chemical agent into artery of brain with insertion of tube and imaging, each additional territory",2327.0,1512.55,581.75,20863.33,19
CDM,30062230_1,Insertion or revision of cerebrospinal fluid drainage shunt valve or tube,13583.0,8828.95,2318.31,35078.1,19
CDM,30062252_1,Reprogramming of cerebrospinal fluid shunt,119.0,77.35,29.75,1242.0,19
CDM,30062267_1,Aspiration of spinal disc tissue for diagnostic purposes,1105.0,718.25,276.25,3227.0,19
CDM,30062270_1,Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test,590.0,383.5,147.5,3227.0,19
CDM,30062272_1,Removal of cerebrospinal fluid with lower back spinal tap,817.0,531.05,204.25,3227.0,19
CDM,30062273_1,Injection of blood or blood clot into spinal canal,968.0,629.2,242.0,3227.0,19
CDM,30062281_1,Injection of substance into spinal canal for removal of upper spine nerve tissue,1555.0,1010.75,388.75,4015.79,19
CDM,30062282_1,Injection of substance into spinal canal for removal of lower spine nerve tissue,1600.0,1040.0,400.0,4132.0,18
CDM,30062284_1,Injection of contrast for imaging of lower spinal canal,1197.0,778.05,299.25,3091.25,19
CDM,30062287_1,Removal of lower spine disc tissue at single or multiple levels using fluoroscopic guidance,8313.0,5403.45,2078.25,21468.32,19
CDM,30062290_1,Injection of contrast for imaging of each level of lower spine,533.0,346.45,133.25,2166.29,19
CDM,30062291_1,Injection of contrast for imaging of each level of middle or upper spine,528.0,343.2,132.0,2166.29,19
CDM,30062302_1,X-ray of upper spinal canal with review by radiologist,3183.0,2068.95,795.75,8220.1,18
CDM,30062303_1,X-ray of middle spinal canal with review by radiologist,2775.0,1803.75,693.75,7166.44,18
CDM,30062304_1,X-ray of lower spinal canal with review by radiologist,2644.0,1718.6,661.0,6828.13,18
CDM,30062305_1,X-ray of multiple regions of spinal canal with review by radiologist,3370.0,2190.5,813.47,8703.03,18
CDM,30062320_1,Injection of substance into middle or upper spine canal,1142.0,742.3,285.5,3227.0,19
CDM,30062321_1,Injection of substance into middle or upper spine canal using imaging guidance,1631.0,1060.15,407.75,4212.06,19
CDM,30062322_1,Injection of substance into lower spine canal,1142.0,742.3,285.5,3227.0,19
CDM,30062323_1,Injection of substance into lower spine canal using imaging guidance,1631.0,1060.15,407.75,4212.06,19
CDM,30062324_1,Insertion of tube and injection of substance into middle or upper spine canal,1510.0,981.5,377.5,3899.58,19
CDM,30062325_1,Insertion of tube and injection of substance into middle or upper spine canal using imaging guidance,1678.0,1090.7,419.5,4333.44,19
CDM,30062326_1,Insertion of tube and injection of substance into lower spine canal,1510.0,981.5,377.5,3899.58,19
CDM,30062327_1,Insertion of tube and injection of substance into lower spine canal using imaging guidance,1678.0,1090.7,419.5,4333.44,19
CDM,30062328_1,Removal of spinal fluid with lower back spinal tap for diagnostic test using imaging guidance,2220.0,1443.0,555.0,5733.15,19
CDM,30062329_1,Removal of cerebrospinal fluid with lower back spinal tap using imaging guidance,1250.0,812.5,312.5,3228.13,19
CDM,30062367_1,Electronic analysis of spinal canal drug infusion pump,290.0,188.5,72.5,748.93,19
CDM,30062368_1,Electronic analysis and reprogramming of spinal canal drug infusion pump,392.0,254.8,98.0,2318.31,19
CDM,30062369_1,Electronic analysis reprogramming and refill of spinal canal drug infusion pump,392.0,254.8,98.0,1242.0,19
CDM,30062370_1,Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician,522.0,339.3,130.5,2318.31,19
CDM,30063650_1,Insertion of spinal neurostimulator electrode array through skin,17229.0,11198.85,2318.31,44493.89,19
CDM,30063661_1,Insertion of spinal neurostimulator electrode array using fluoroscopic guidance,3909.0,2540.85,977.25,10094.99,19
CDM,30063685_1,Insertion or replacement of spinal neurostimulator generator or receiver,55784.0,36259.6,13946.0,144062.18,19
CDM,30064400_1,Injection of anesthetic agent and/or steroid into face nerve,873.0,567.45,218.25,2254.52,19
CDM,30064405_1,Injection of anesthetic agent and/or steroid into upper neck and back of head nerve,654.0,425.1,163.5,2166.29,19
CDM,30064415_1,Injection of anesthetic agent and/or steroid into arm nerve bundle (brachial plexus),1342.5,872.63,335.63,3467.01,19
CDM,30064416_1,Continuous infusion of anesthetic agent and/or steroid into arm nerve bundle through catheter,1125.0,731.25,281.25,3227.0,19
CDM,30064418_1,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,1260.0,819.0,315.0,3253.95,19
CDM,30064420_1,Injection of anesthetic agent and/or steroid into rib nerve,525.0,341.25,131.25,3227.0,19
CDM,30064421_1,Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block,479.0,311.35,119.75,3227.0,19
CDM,30064425_1,Injection of anesthetic agent and/or steroid into lower abdomen and groin nerve,975.0,633.75,243.75,3227.0,19
CDM,30064430_1,Injection of anesthetic agent and/or steroid into external genitals and anus nerve,973.5,632.78,243.38,3227.0,19
CDM,30064445_1,Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve),2460.0,1599.0,580.38,6352.95,19
CDM,30064446_1,Continuous infusion of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve) through catheter,3238.5,2105.03,809.63,8477.27,19
CDM,30064447_1,Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve),775.5,504.08,193.88,8477.27,19
CDM,30064448_1,Continuous infusion of anesthetic agent and/or steroid into thigh nerve (femoral nerve) through catheter,2022.0,1314.3,505.5,8477.27,19
CDM,30064450_1,Injection of anesthetic agent and/or steroid into other nerve or branch,1119.0,727.35,279.75,3227.0,19
CDM,30064451_1,Injection of anesthetic agent and/or steroid into spine and pelvis nerve using imaging guidance,1875.0,1218.75,468.75,4842.19,19
CDM,30064454_1,Injection of anesthetic agent and/or steroid into knee nerve branch using imaging guidance,1875.0,1218.75,468.75,4842.19,19
CDM,30064455_1,Injection of anesthetic and/or steroid drug into foot nerve,936.0,608.4,208.0,2417.22,19
CDM,30064466_1,Unilateral thoracic fascial plane block by injection(s),1000.0,650.0,250.0,2582.5,17
CDM,30064468_1,Bilateral thoracic fascial plane block by injection(s),1665.0,1082.25,416.25,4299.86,17
CDM,30064473_1,Unilateral lower extremity fascial plane block by injection(s),1665.0,1082.25,416.25,4299.86,17
CDM,30064479_1,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level",2749.5,1787.18,687.38,7100.58,19
CDM,30064480_1,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, each additional level",805.0,523.25,201.25,2166.29,19
CDM,30064483_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level",3168.0,2059.2,792.0,8181.36,19
CDM,30064484_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level",972.0,631.8,243.0,2510.19,19
CDM,30064486_1,Injection of local anesthetic for abdominal wall pain control on side using imaging guidance,300.0,195.0,75.0,2318.31,19
CDM,30064488_1,Injection of local anesthetic for abdominal wall pain control on both sides using imaging guidance,1545.0,1004.25,386.25,3989.96,19
CDM,30064490_1,"Injection of upper or middle spine facet joint using imaging guidance, single level",2038.5,1325.03,509.63,5264.43,19
CDM,30064491_1,"Injection of upper or middle spine facet joint using imaging guidance, second level",1495.0,971.75,373.75,3860.84,19
CDM,30064492_1,"Injection of upper or middle spine facet joint using imaging guidance, third and any additional level",1631.0,1060.15,407.75,4212.06,19
CDM,30064493_1,"Injection of lower or sacral spine facet joint using imaging guidance, single level",3168.0,2059.2,792.0,8181.36,19
CDM,30064494_1,"Injection of lower or sacral spine facet joint using imaging guidance, second level",1204.0,782.6,301.0,3109.33,19
CDM,30064495_1,"Injection of lower or sacral spine facet joint using imaging guidance, third and any additional level",1225.0,796.25,306.25,3163.56,19
CDM,30064505_1,"Injection of anesthetic agent, trigeminal nerve bundle",346.5,225.23,86.63,2166.29,19
CDM,30064510_1,Injection of anesthetic agent into sympathetic nerve bundle,3025.5,1966.58,756.38,7813.35,19
CDM,30064517_1,Injection of anesthetic agent into sacral nerve bundle,415.49,270.07,103.87,3227.0,19
CDM,30064520_1,Injection of anesthetic agent into middle or lower spine sympathetic nerve,3025.5,1966.58,756.38,7813.35,19
CDM,30064530_1,Injection of anesthetic agent into abdominal sympathetic nerve bundle,2017.0,1311.05,504.25,5208.9,19
CDM,30064600_1,Destruction of first division of face nerve branch,2191.0,1424.15,547.75,5658.26,19
CDM,30064610_1,Destruction of face nerve branch under X-ray monitoring,4425.0,2876.25,1106.25,11427.56,19
CDM,30064611_1,Injection of chemical for paralysis of salivary glands on both sides of mouth,735.0,477.75,183.75,2166.29,19
CDM,30064612_1,Injection of chemical for paralysis of nerve muscles on side of face,361.5,234.98,90.38,2166.29,19
CDM,30064615_1,Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face,735.0,477.75,183.75,2166.29,19
CDM,30064616_1,Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box,1102.5,716.63,275.63,2847.21,19
CDM,30064617_1,Injection of chemical for paralysis of nerve muscles on side of voice box,2446.5,1590.23,580.38,6318.09,19
CDM,30064620_1,Injection of agent to destroy rib nerve,3025.5,1966.58,756.38,7813.35,19
CDM,30064624_1,Destruction of nerve branches of knee using imaging guidance,5160.0,3354.0,1290.0,13325.7,19
CDM,30064625_1,Destruction of nerves supplying joint between spine and pelvis using imaging guidance,5160.0,3354.0,1290.0,13325.7,19
CDM,30064633_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint",8820.0,5733.0,1861.61,22777.65,19
CDM,30064634_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint",1226.0,796.9,306.5,3166.15,19
CDM,30064635_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint",9000.0,5850.0,1861.61,23242.5,19
CDM,30064636_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint",1066.0,692.9,266.5,2752.95,19
CDM,30064640_1,Destruction of peripheral nerve or branch,1512.0,982.8,378.0,3904.74,19
CDM,30064642_1,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, first extremity",1220.0,793.0,305.0,3227.0,19
CDM,30064643_1,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, each additional extremity",627.0,407.55,156.75,2166.29,19
CDM,30064644_1,"Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, first extremity",1590.0,1033.5,397.5,4106.18,19
CDM,30064645_1,"Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, each additional extremity",665.0,432.25,166.25,2166.29,19
CDM,30064646_1,"Injection of chemical for paralysis of nerve muscles on trunk, 1-5 muscles",949.0,616.85,237.25,3227.0,19
CDM,30064647_1,"Injection of chemical for paralysis of nerve muscles on trunk, 6 or more muscles",1130.0,734.5,282.5,3227.0,19
CDM,30064650_1,Injection of chemical for paralysis of underarm sweat glands,241.0,156.65,60.25,622.38,19
CDM,30064653_1,Injection of chemical for paralysis of sweat glands,941.0,611.65,208.0,2430.13,19
CDM,30064680_1,Injection of agent to destroy abdominal nerve bundle,853.0,554.45,213.25,3227.0,19
CDM,30064681_1,Injection of agent to destroy presacral nerve bundle,1280.0,832.0,320.0,3305.6,19
CDM,30064999_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,30065103_1,Removal of eyeball with insertion of implant,5171.0,3361.15,1292.75,13354.11,19
CDM,30065105_1,Removal of eyeball with insertion of implant attached to muscles,7756.5,5041.73,1939.13,20031.16,19
CDM,30065140_1,Insertion of eye implant attached to muscles after removal of eye,7756.5,5041.73,1939.13,20031.16,19
CDM,30065205_1,Removal of foreign body from external eye (conjunctiva),165.0,107.25,41.25,8477.27,19
CDM,30065210_1,Removal of foreign body from external eye (conjunctiva or sclera),495.0,321.75,109.6,8477.27,19
CDM,30065220_1,Removal of foreign body in cornea,495.0,321.75,109.6,8477.27,19
CDM,30065222_1,Removal of foreign body in cornea using slit lamp,165.0,107.25,41.25,8477.27,19
CDM,30065235_1,Removal of foreign body in eye or lens,8206.5,5334.23,1466.12,21193.29,19
CDM,30065285_1,Repair of perforating laceration of cornea and/or sclera with reposition or removal of uveal tissue,10444.5,6788.93,2611.13,26972.92,19
CDM,30065286_1,Repair of lacerated cornea and/or sclera using tissue glue,1834.0,1192.1,458.5,4736.31,19
CDM,30065400_1,Removal of growth of cornea,1176.0,764.4,294.0,3726.0,19
CDM,30065430_1,Scraping of cornea for diagnosis,495.0,321.75,123.75,8477.27,19
CDM,30065435_1,Removal of outer layer of cornea,1102.5,716.63,275.63,3726.0,19
CDM,30065436_1,Removal of outer layer of cornea with application of chelating agent,2565.0,1667.25,641.25,6624.11,19
CDM,30065778_1,Placement of amniotic membrane on eye surface for wound healing,1299.0,844.35,324.75,3726.0,19
CDM,30065800_1,Removal of eye fluid,2751.0,1788.15,687.75,7104.46,19
CDM,30065855_1,Laser repair to improve eye fluid flow,720.0,468.0,180.0,3227.0,19
CDM,30066030_1,Injection of medication into eye,1840.0,1196.0,460.0,4751.8,19
CDM,30066250_1,Revision or repair of operative wound of eye,2566.5,1668.23,641.63,6627.99,19
CDM,30066710_1,Destruction of lens tissue using laser,2610.0,1696.5,652.5,6740.33,19
CDM,30066761_1,"Creation of eye fluid drainage tracts in iris using a laser, per session",1096.5,712.73,274.13,3227.0,19
CDM,30066821_1,Removal of recurring cataract in lens capsule using a laser,720.0,468.0,180.0,3227.0,19
CDM,30066984_1,Removal of cataract with insertion of prosthetic lens,5407.5,3514.88,1351.88,13964.87,19
CDM,30067028_1,Injection of drug into eye,450.0,292.5,112.5,2166.29,19
CDM,30067039_1,Destruction of eye fluid (vitreous) between lens and retina using a laser,10444.5,6788.93,2611.13,26972.92,19
CDM,30067101_1,Repair of detached retina by cold treatment,5471.0,3556.15,1367.75,14128.86,19
CDM,30067108_1,Repair of detached retina with drainage and removal of eye fluid between lens and retina,6885.98,4475.89,1721.5,17783.04,19
CDM,30067110_1,Repair of detached retina by injection of air or gas,2751.0,1788.15,687.75,8477.27,19
CDM,30067145_1,Photocoagulation treatment to prevent detachment of retina,720.0,468.0,180.0,3227.0,19
CDM,30067210_1,Destruction of growth of retina using a laser,720.0,468.0,180.0,8023.32,19
CDM,30067220_1,Destruction of vascular growth between retina and sclera by photocoagulation,720.0,468.0,180.0,3227.0,19
CDM,30067221_1,Destruction of vascular growth between retina and sclera by photodynamic therapy,480.0,312.0,120.0,3227.0,19
CDM,30067228_1,Destruction of leaking blood vessels of retina using laser,720.0,468.0,180.0,3227.0,19
CDM,30067311_1,Realignment of horizontal eye muscle,7654.5,4975.43,1913.63,19767.75,19
CDM,30067312_1,Realignment of eye by repair of 2 horizontal muscles,12481.5,8112.98,3080.82,32233.47,19
CDM,30067314_1,Realignment of vertical eye muscle,7654.5,4975.43,1913.63,19767.75,19
CDM,30067316_1,Realignment of multiple vertical eye muscles,4326.0,2811.9,1081.5,11171.9,19
CDM,30067320_1,Relocation of eye muscle to restore function,309.0,200.85,77.25,7016.18,19
CDM,30067332_1,Realignment of eye muscle complicated by scarring or restrictive muscle movement,309.0,200.85,77.25,7016.18,19
CDM,30067335_1,Placement of adjustable sutures during eye muscle surgery,309.0,200.85,77.25,7016.18,19
CDM,30067340_1,Realignment and repair of detached eye muscle,309.0,200.85,77.25,7016.18,19
CDM,30067343_1,Release of extensive scar tissue of eye,4326.0,2811.9,1081.5,11171.9,19
CDM,30067400_1,Exploration of cavity behind eye,7756.5,5041.73,1939.13,20031.16,19
CDM,30067412_1,Removal of growth of cavity behind eye,4326.0,2811.9,1081.5,11171.9,19
CDM,30067414_1,Removal of bone cavity behind eye for decompression,7756.5,5041.73,1939.13,20031.16,19
CDM,30067415_1,Fine needle aspiration of orbital contents,6747.0,4385.55,1492.32,17424.13,19
CDM,30067420_1,Removal of bone and growth of cavity behind eye,7756.5,5041.73,1939.13,20031.16,19
CDM,30067450_1,Exploration of cavity behind eye with bone flap,7756.5,5041.73,1939.13,20031.16,19
CDM,30067515_1,Injection of drug or substance into membrane covering eyeball,420.0,273.0,105.0,2166.29,19
CDM,30067570_1,Release of optic nerve,7756.5,5041.73,1939.13,20031.16,19
CDM,30067700_1,Incision and drainage of abscess of eyelid,417.0,271.05,104.25,2166.29,19
CDM,30067710_1,Removal of sutures between upper and lower eyelids,1176.0,764.4,294.0,3726.0,19
CDM,30067715_1,Incision of corner of eye at eyelid,5466.0,3552.9,1366.5,14115.95,19
CDM,30067800_1,Removal of chronic growth of eyelid,850.5,552.83,212.63,2196.42,19
CDM,30067801_1,Removal of multiple chronic growths of same eyelid,721.0,468.65,180.25,3726.0,19
CDM,30067805_1,Removal of multiple chronic growths of different eyelids,279.0,181.35,69.75,2166.29,19
CDM,30067808_1,Removal of chronic eyelid growth under general anesthesia and/or requiring hospitalization,2884.0,1874.6,721.0,7447.93,19
CDM,30067810_1,Biopsy of eyelid,417.0,271.05,104.25,2166.29,19
CDM,30067820_1,Removal of eyelashes using forceps,165.0,107.25,41.25,8477.27,19
CDM,30067825_1,Removal of eyelashes,667.5,433.88,166.88,8477.27,19
CDM,30067840_1,Removal of growth of eyelid,1176.0,764.4,294.0,3726.0,19
CDM,30067875_1,Temporary closure of eyelids by suture,1081.5,702.98,270.38,3726.0,19
CDM,30067882_1,Creation of permanent eyelid margin scarring with relocation of eyelid tissue,2595.0,1686.75,648.75,6701.59,19
CDM,30067900_1,Repair of brow paralysis,2595.0,1686.75,648.75,7016.18,19
CDM,30067901_1,Repair of upper eyelid muscle to correct drooping or paralysis using external material,2595.0,1686.75,648.75,8023.32,19
CDM,30067904_1,Repair of tendon of upper eyelid,2595.0,1686.75,648.75,7016.18,19
CDM,30067908_1,"Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis",1730.0,1124.5,432.5,7016.18,19
CDM,30067911_1,Correction of widely-opened upper eyelid,2595.0,1686.75,648.75,6701.59,19
CDM,30067914_1,Suture repair of turning-outward upper or lower eyelid defect,1730.0,1124.5,432.5,6451.0,19
CDM,30067917_1,Extensive repair of turning-outward eyelid defect,2595.0,1686.75,648.75,7016.18,19
CDM,30067921_1,Suture repair of turning-inward eyelid defect,1730.0,1124.5,432.5,6451.0,19
CDM,30067924_1,Extensive repair of turning-inward eyelid defect,2595.0,1686.75,648.75,7016.18,19
CDM,30067930_1,Suture of recent wound of eyelid,1730.0,1124.5,432.5,6451.0,19
CDM,30067935_1,Repair of wound of eyelid margin,2595.0,1686.75,648.75,6701.59,19
CDM,30067938_1,Removal of embedded foreign body in eyelid,571.5,371.48,142.88,2166.29,19
CDM,30067961_1,Removal of up to 1/4 of eyelid margin and repair of eyelid,2595.0,1686.75,648.75,6701.59,19
CDM,30067966_1,Removal of over 1/4 of eyelid margin and repair of eyelid,2595.0,1686.75,648.75,6701.59,19
CDM,30067971_1,Reconstruction of up to 2/3 of eyelid with tissue from opposite eyelid,4326.0,2811.9,1081.5,11171.9,19
CDM,30067973_1,Reconstruction of lower eyelid by transfer of eyelid tissue from opposite eyelid,4326.0,2811.9,1081.5,11171.9,19
CDM,30067975_1,Reconstruction of eyelid by transfer of eyelid tissue from opposite eyelid,4326.0,2811.9,1081.5,11171.9,19
CDM,30068040_1,Removal of scars of eyelid lining due to infection,279.0,181.35,69.75,8477.27,19
CDM,30068100_1,Biopsy of eyelid lining,2595.0,1686.75,648.75,6701.59,19
CDM,30068110_1,"Removal of growth of eyelid lining, 1.0 cm or less",2595.0,1686.75,648.75,6701.59,19
CDM,30068115_1,"Removal of growth of eyelid lining, more than 1.0 cm",1740.0,1131.0,435.0,6451.0,19
CDM,30068200_1,Injection into conjunctiva,409.5,266.18,102.38,8477.27,19
CDM,30068320_1,Repair of eyelid lining with graft from external eye,2610.0,1696.5,652.5,7016.18,19
CDM,30068400_1,Incision and drainage of tear producing gland,784.0,509.6,196.0,3726.0,19
CDM,30068440_1,Snip incision of tear duct at inner corner of eye,426.0,276.9,106.5,2166.29,19
CDM,30068510_1,Biopsy of tear producing gland,2610.0,1696.5,652.5,6740.33,19
CDM,30068520_1,Removal of tear sac,5171.0,3361.15,1292.75,13354.11,19
CDM,30068530_1,Removal of foreign body or stone in tear passages,474.0,308.1,118.5,2166.29,19
CDM,30068700_1,Plastic repair of tear duct,4326.0,2811.9,1081.5,11171.9,19
CDM,30068720_1,Creation of drainage tract from tear sac to nasal cavity,7756.5,5041.73,1939.13,20031.16,19
CDM,30068750_1,Creation of tear drainage tract to nasal cavity with insertion of tube or stent,7756.5,5041.73,1939.13,20031.16,19
CDM,30068761_1,Closure of tear duct opening using plug,417.0,271.05,104.25,2166.29,19
CDM,30068810_1,Insertion of probe into nasal tear duct,418.5,272.03,104.63,2166.29,19
CDM,30068811_1,Insertion of probe into nasal tear duct under anesthesia,2884.0,1874.6,721.0,7447.93,19
CDM,30068815_1,Probing of nasal tear duct with insertion of tube or stent,7654.5,4975.43,1913.63,19767.75,19
CDM,30068816_1,Probing of nasal tear duct with balloon tube dilation,1740.0,1131.0,435.0,6451.0,19
CDM,30068840_1,Probing of nasal tear duct,601.5,390.98,150.38,2166.29,19
CDM,30069000_1,Simple drainage of abscess or blood accumulation of external ear,823.5,535.28,205.88,3227.0,19
CDM,30069100_1,Biopsy of ear,452.0,293.8,113.0,8477.27,19
CDM,30069105_1,Biopsy of ear canal,1845.0,1199.25,461.25,8477.27,19
CDM,30069200_1,Removal of foreign body in ear canal,274.5,178.43,68.63,8477.27,17
CDM,30069209_1,Removal of impacted ear wax by washing,97.5,63.38,24.38,251.79,17
CDM,30069210_1,Removal of impacted ear wax,65.0,42.25,16.25,2166.29,17
CDM,30069799_1,Other procedure on middle ear,216.0,140.4,54.0,2166.29,19
CDM,30070IP _1,UNCLASSIFIED DRUGS,13.8,8.97,3.45,35.64,16
CDM,30070OP _1,UNCLASSIFIED DRUGS,27.95,18.17,6.99,72.18,16
CDM,30071IP _1,UNCLASSIFIED DRUGS,7.6,4.94,1.9,19.63,16
CDM,30071OP _1,UNCLASSIFIED DRUGS,60.99,39.64,15.25,157.51,16
CDM,30072IP _1,UNCLASSIFIED DRUGS,8.02,5.21,2.01,20.71,16
CDM,30072OP _1,UNCLASSIFIED DRUGS,20.7,13.46,5.18,53.46,16
CDM,30076536_1,Ultrasound scan of head and neck soft tissue,461.0,299.65,115.25,1190.53,18
CDM,30076705_1,Limited ultrasound scan of abdomen,511.0,332.15,127.75,1319.66,18
CDM,30076770_1,Complete ultrasound scan behind abdominal cavity,650.0,422.5,162.5,1678.63,18
CDM,30081025_1,Urine pregnancy test,30.0,19.5,2.58,77.48,19
CDM,30083013_1,Breath test analysis for helicobacter pylori,190.0,123.5,67.36,490.68,19
CDM,30083014_1,Administration of drug for helicobacter pylori,68.0,44.2,5.34,175.61,19
CDM,30085018_1,"Blood count, hemoglobin",21.0,13.65,0.5,54.23,19
CDM,30087880_1,"Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep)",75.0,48.75,12.4,193.69,19
CDM,30090380_1,"Respiratory syncytial virus antibody, 0.5 mL dosage for injection into muscle",910.0,591.5,227.5,2350.08,19
CDM,30090381_1,"Respiratory syncytial virus antibody, 1.0 mL dosage for injection into muscle",1000.0,650.0,250.0,2582.5,19
CDM,30090471_1,Administration of vaccine,80.0,52.0,20.0,206.6,19
CDM,30090472_1,"Administration of vaccine, each additional vaccine",25.0,16.25,6.25,76.0,19
CDM,30090473_1,"Administration of nasal or oral vaccine, 1 vaccine",30.0,19.5,7.5,77.48,19
CDM,30090480_1,"Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose",80.0,52.0,20.0,206.6,19
CDM,30090589_1,Chikungunya virus vaccine,550.0,357.5,137.5,1420.38,16
CDM,30090611_1,"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use",690.75,448.99,0.01,1783.86,19
CDM,30090620_1,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",382.0,248.3,95.5,986.52,18
CDM,30090621_1,"Meningococcal recombinant lipoprotein vaccine, serogroup B",353.0,229.45,88.25,911.62,18
CDM,30090625_1,Cholera vaccine,640.0,416.0,30.97,1652.8,18
CDM,30090632_1,Hepatitis A vaccine adult dosage,120.0,78.0,30.0,309.9,19
CDM,30090634_1,Hepatitis A vaccine pediatric or adolescent dosage (3 dose schedule),89.0,57.85,22.25,229.84,18
CDM,30090636_1,Hepatitis A and hepatitis B vaccine,183.0,118.95,45.75,472.6,19
CDM,30090647_1,"Haemophilus influenzae type b vaccine, PRP-OMP conjugate",50.0,32.5,12.5,129.13,19
CDM,30090648_1,"Haemophilus influenzae type b vaccine, PRP-T conjugate",50.0,32.5,12.5,129.13,19
CDM,30090649_1,"Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent",245.0,159.25,61.25,632.71,19
CDM,30090650_1,"Human Papillomavirus vaccine, types 16, 18, bivalent",250.0,162.5,30.97,645.63,18
CDM,30090651_1,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",387.0,251.55,96.75,999.43,19
CDM,30090653_1,"Influenza vaccine, inactivated",5.0,3.25,1.25,104.05,19
CDM,30090656_1,"Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage",5.0,3.25,1.25,31.59,19
CDM,30090658_1,"Influenza vaccine, trivalent, 0.5 mL dosage",5.0,3.25,1.25,31.59,19
CDM,30090662_1,"Influenza vaccine split virus, preservative free",5.0,3.25,1.25,104.05,19
CDM,30090666_1,"Influenza vaccine, live, pandemic formulation, split virus, preservative free",5.0,3.25,1.25,31.59,18
CDM,30090670_1,"Pneumococcal vaccine, 13-valent",265.54,172.6,66.39,685.76,19
CDM,30090672_1,"Influenza vaccine, quadrivalent for nasal administration",5.0,3.25,1.25,31.59,18
CDM,30090673_1,"Influenza vaccine, trivalent derived from recombinant DNA",5.0,3.25,1.25,104.05,19
CDM,30090674_1,"Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free",30.0,19.5,7.5,77.48,18
CDM,30090677_1,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use",572.68,372.24,143.17,1478.95,19
CDM,30090678_1,"Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use",630.0,409.5,30.97,1626.98,19
CDM,30090680_1,"Rotavirus vaccine, pentavalent",132.0,85.8,33.0,340.89,19
CDM,30090682_1,"Influenza vaccine, quadrivalent derived from recombinant DNA",30.0,19.5,7.5,77.48,18
CDM,30090685_1,"Influenza vaccine, quadrivalent, preservative free, 0.25 mL dosage",5.0,3.25,1.25,31.59,18
CDM,30090686_1,"Influenza vaccine, quadrivalent, preservative free, 0.5 mL dosage",25.0,16.25,6.25,64.56,18
CDM,30090687_1,"Influenza vaccine, quadrivalent, 0.25 mL dosage",5.0,3.25,1.25,31.59,18
CDM,30090690_1,Typhoid vaccine,79.0,51.35,19.75,204.02,18
CDM,30090691_1,Typhoid vaccine for injection into muscle,115.0,74.75,28.75,296.99,18
CDM,30090694_1,"Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage",25.0,16.25,6.25,64.56,18
CDM,30090698_1,"Diphtheria, tetanus, acellular pertussis, polio, and Haemophilus influenzae type b vaccine",125.0,81.25,30.97,322.81,19
CDM,30090700_1,"Diphtheria, tetanus, and acellular pertussis vaccine (younger than 7 years)",45.0,29.25,11.25,116.21,19
CDM,30090707_1,"Measles, mumps, and rubella vaccine",102.0,66.3,25.5,263.42,19
CDM,30090710_1,"Measles, mumps, rubella, and varicella vaccine",278.0,180.7,30.97,717.94,19
CDM,30090715_1,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",65.0,42.25,16.25,167.86,19
CDM,30090717_1,Yellow fever vaccine,246.0,159.9,61.5,635.3,18
CDM,30090732_1,"Pneumococcal vaccine, 23-valent",140.76,91.49,30.97,363.51,19
CDM,30090733_1,"Meningococcal vaccine, serogroups A, C, Y, W-135",225.0,146.25,56.25,581.06,18
CDM,30090734_1,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",200.0,130.0,50.0,516.5,19
CDM,30090736_1,Shingles vaccine for injection under skin,360.0,234.0,90.0,929.7,19
CDM,30090738_1,Japanese encephalitis vaccine,385.0,250.25,96.25,994.26,18
CDM,30090739_1,"Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use",100.0,65.0,25.0,258.25,19
CDM,30090740_1,"Hepatitis B vaccine, dialysis or immunosuppressed patient dosage",281.0,182.65,70.25,725.68,18
CDM,30090743_1,"Hepatitis B vaccine, adolescent dosage",100.0,65.0,25.0,258.25,18
CDM,30090746_1,"Hepatitis B vaccine, adult dosage (3 dose schedule)",100.0,65.0,25.0,258.25,19
CDM,30090748_1,Hepatitis B and Haemophilus influenzae type b vaccine,100.0,65.0,25.0,258.25,18
CDM,30090750_1,Shingles vaccine for injection into muscle,331.0,215.15,82.75,854.81,18
CDM,30090792_1,REV - BH/TREATMENTS,358.0,232.7,89.5,476.0,12
CDM,30091318_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 3 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",350.0,227.5,30.97,903.88,19
CDM,30091319_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 10 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",150.0,97.5,30.97,387.38,19
CDM,30091320_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",225.0,146.25,30.97,581.06,19
CDM,30091321_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular use",225.0,146.25,30.97,581.06,19
CDM,30091322_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use",225.0,146.25,30.97,581.06,19
CDM,30092511_1,Exam of the nose and throat using an endoscope,380.0,247.0,95.0,2166.29,18
CDM,30092950_1,Manual attempt to restore blood circulation and breathing,1138.0,739.7,284.5,2938.89,19
CDM,30092953_1,Temporary pacemaker to regulate heart beat,530.0,344.5,132.5,3227.0,19
CDM,30092960_1,External shock to heart to regulate heart beat,2388.0,1552.2,597.0,6167.01,19
CDM,30093005_1,Routine electrocardiogram (ECG) using at least 12 leads with tracing,205.0,133.25,37.41,529.41,19
CDM,30093288_1,"Evaluation of single, dual, multiple lead or leadless pacemaker system",45.0,29.25,11.25,1052.0,19
CDM,30093289_1,"Evaluation of single, dual, or multiple lead implantable defibrillator system",45.0,29.25,11.25,1052.0,19
CDM,30093308_1,"Ultrasound of heart, follow-up",783.0,508.95,195.75,2022.1,19
CDM,30093582_1,Repair of congenital abnormality of pulmonary artery to aorta,28075.0,18248.75,7018.75,72503.69,18
CDM,30093583_1,Repair of wall between lower heart chambers including pacemaker insertion,2239.0,1455.35,559.75,21409.87,18
CDM,30093724_1,Electronic analysis of pacemaker to correct rapid heart rate,634.0,412.1,158.5,1637.31,19
CDM,30093750_1,Evaluation of lower heart chamber assist device,300.0,195.0,52.57,1052.0,19
CDM,30093770_1,Measurement of heart and circulatory system pressure,26.0,16.9,6.5,1052.0,19
CDM,30093799_1,Other cardiovascular service or procedure,19184.0,12469.6,37.41,49542.68,18
CDM,30094150_1,Test to measure the total volume of air that can be exhaled after inhaling,268.54,174.55,67.14,1438.0,19
CDM,30094618_1,Test for exercise-induced lung stress,300.0,195.0,75.0,1438.0,19
CDM,30094640_1,Inhalation treatment for airway obstruction or sputum production,480.0,312.0,83.86,1239.6,19
CDM,30094642_1,Inhalation treatment for pneumonia,430.0,279.5,83.86,1177.0,19
CDM,30094644_1,"Inhalation treatment for acute airway obstruction, first hour",488.0,317.2,83.86,1260.26,19
CDM,30094760_1,Test to measure oxygen level in blood using ear or finger device,58.0,37.7,14.5,1438.0,17
CDM,30094761_1,Test to measure oxygen level in blood using ear or finger device multiple times,290.0,188.5,72.5,1438.0,17
CDM,30094762_1,Test to measure oxygen level in blood using ear or finger device continuously overnight,420.0,273.0,83.86,1438.0,19
CDM,30095076_1,"Test for allergy using ingested items, initial 2 hours",1140.0,741.0,285.0,2944.05,19
CDM,30095079_1,"Test for allergy using ingested items, each additional hour",327.0,212.55,81.75,844.48,19
CDM,30095180_1,Injection for rapid desensitization to allergen,850.0,552.5,67.58,2195.13,19
CDM,30095972_1,Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming,328.0,213.2,82.0,847.06,19
CDM,30095990_1,Maintenance of spinal canal or brain drug infusion pump,838.0,544.7,67.35,2164.14,19
CDM,30096041_1,"Counseling for genetic testing provided by a genetic counselor, each 30 minutes of total time on the date of encounter",185.0,120.25,46.25,477.76,17
CDM,30096360_1,"Infusion into a vein for hydration, 31-60 minutes",625.0,406.25,156.25,1614.06,19
CDM,30096361_1,"Infusion into a vein for hydration, each additional hour",300.0,195.0,75.0,1019.0,19
CDM,30096365_1,"Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less",625.0,406.25,156.25,1614.06,19
CDM,30096366_1,"Infusion into a vein for therapy, prevention, or diagnosis, each additional hour",300.0,195.0,75.0,1019.0,19
CDM,30096367_1,"Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less",300.0,195.0,75.0,1019.0,19
CDM,30096368_1,"Infusion into a vein for therapy, prevention, or diagnosis concurrent with another infusion",300.0,195.0,75.0,1019.0,19
CDM,30096369_1,"Infusion into tissue for therapy or prevention, 1 hour or less",440.6,286.39,110.15,1137.85,19
CDM,30096370_1,"Infusion into tissue for therapy or prevention, each additional hour",89.15,57.95,22.29,1019.0,19
CDM,30096371_1,Establishment of new infusion site into tissue with pump set up,140.65,91.42,35.16,1019.0,19
CDM,30096372_1,Injection of drug or substance under skin or into muscle,225.0,146.25,56.25,1019.0,19
CDM,30096373_1,Injection of drug or substance into artery,500.0,325.0,67.35,1291.25,19
CDM,30096374_1,Injection of drug or substance into vein,500.0,325.0,67.35,1291.25,19
CDM,30096375_1,Injection of additional new drug or substance into vein,150.0,97.5,37.5,1019.0,19
CDM,30096376_1,Injection of additional drug or substance into vein provided in a facility,150.0,97.5,37.5,1019.0,19
CDM,30096377_1,Application of on-body injector for under skin injection,95.0,61.75,23.75,2166.29,18
CDM,30096379_1,"Injection or infusion into a vein or artery for therapy, prevention, or diagnosis",248.0,161.2,62.0,1019.0,19
CDM,30096380_1,"Administration of seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional",80.0,52.0,20.0,206.6,17
CDM,30096381_1,"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection",80.0,52.0,20.0,206.6,17
CDM,30096401_1,Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle,631.0,410.15,67.35,2054.0,19
CDM,30096402_1,Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle,631.0,410.15,67.35,2054.0,19
CDM,30096405_1,"Administration of chemotherapy into growth, 1-7",160.0,104.0,40.0,2054.0,19
CDM,30096406_1,"Administration of chemotherapy into growth, more than 7",438.0,284.7,67.35,2054.0,19
CDM,30096409_1,Administration of chemotherapy into vein using push technique,655.0,425.75,67.35,2054.0,19
CDM,30096411_1,Administration of additional new drug or substance into vein using push technique,620.0,403.0,67.35,2054.0,19
CDM,30096413_1,"Administration of chemotherapy into vein, 1 hour or less",880.0,572.0,220.0,2272.6,19
CDM,30096415_1,"Administration of chemotherapy into vein, each additional hour",625.0,406.25,156.25,2054.0,19
CDM,30096416_1,Administration of prolonged chemotherapy into vein,834.0,542.1,208.5,2153.81,19
CDM,30096417_1,"Administration of additional new drug or substance into vein, 1 hour or less",735.0,477.75,183.75,2054.0,19
CDM,30096446_1,Administration of chemotherapy into abdominal cavity,1581.0,1027.65,395.25,4082.93,19
CDM,30096450_1,Administration of chemotherapy into fluid-filled space between the tissue that cover the brain and spinal cord,800.0,520.0,200.0,2066.0,19
CDM,30096521_1,Refilling and maintenance of portable pump,852.0,553.8,67.35,2200.29,19
CDM,30096523_1,Irrigation of implanted venous access drug delivery device,613.0,398.45,67.35,1583.07,19
CDM,30096542_1,Injection of chemotherapy via reservoir under skin,893.0,580.45,67.35,2306.17,19
CDM,30096549_1,Other chemotherapy procedure,207.0,134.55,51.75,1052.0,19
CDM,30097597_1,"Removal of tissue from wound, 20.0 sq cm or less",410.0,266.5,102.5,2166.29,19
CDM,30097598_1,"Removal of tissue from wound, each additional 20.0 sq cm",157.0,102.05,39.25,1507.02,19
CDM,30097802_1,"Therapy procedure for nutrition management, each 15 minutes",80.0,52.0,20.0,295.67,19
CDM,30097803_1,"Therapy procedure reassessment for nutrition management, each 15 minutes",62.0,40.3,15.5,295.67,19
CDM,30097804_1,"Therapy procedure for nutrition management with group, each 30 minutes",33.0,21.45,8.25,295.67,19
CDM,30099091_1,"Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 ",200.0,130.0,50.0,516.5,19
CDM,30099195_1,Drawing of blood for a medical problem,312.0,202.8,78.0,805.74,19
CDM,30099445_1,"REMOTE MONITORING OF PHYSIOLOGIC PARAMETER(S) (EG, WEIGHT, BLOOD PRESSURE, PULSE OXIMETRY, RESPIRATORY FLOW RATE); DEVICE(S) SUPPLY WITH DAILY RECORDING(S) OR PROGRAMMED ALERT(S) TRANSMISSION, 2-15 DA",125.0,81.25,31.25,322.81,17
CDM,30099453_1,"Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment",300.0,195.0,75.0,774.75,19
CDM,30099454_1,"Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days",125.0,81.25,31.25,322.81,19
CDM,30099457_1,"Management using the results of remote vital sign monitoring per calendar month, first 20 minutes",125.0,81.25,31.25,322.81,19
CDM,30099458_1,"Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes",125.0,81.25,31.25,322.81,19
CDM,30099470_1,"REMOTE PHYSIOLOGIC MONITORING TREATMENT MANAGEMENT SERVICES, CLINICAL STAFF/PHYSICIAN/OTHER QUALIFIED HEALTH CARE PROFESSIONAL TIME IN A CALENDAR MONTH REQUIRING 1 REAL-TIME INTERACTIVE COMMUNICATION ",125.0,81.25,31.25,322.81,17
CDM,300A4263_1,"PERMANENT, LONG TERM, NON-DISSOLVABLE LACRIMAL DUCT IMPLANT, EACH",84.0,54.6,21.0,216.93,16
CDM,300C5271_1,"Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less",1714.0,1114.1,208.0,4426.41,19
CDM,300C5272_1,"Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less",818.0,531.7,204.5,2881.28,19
CDM,300C5273_1,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",3837.0,2494.05,208.0,9909.05,19
CDM,300C5274_1,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",1919.0,1247.35,208.0,4955.82,19
CDM,300C5275_1,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less",1635.0,1062.75,208.0,4222.39,19
CDM,300C5276_1,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 25.0 sq cm of wound 100.0 sq cm or less",818.0,531.7,204.5,2881.28,19
CDM,300C5277_1,"Skin substitute graft to wound 100.0 sq cm or more of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and childre",1146.0,744.9,208.0,2959.55,19
CDM,300C5278_1,"Skin substitute graft to wound 100.0 sq cm or more of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for inf",573.0,372.45,143.25,2881.28,19
CDM,300C8957_1,"INTRAVENOUS INFUSION FOR THERAPY/DIAGNOSIS; INITIATION OF PROLONGED INFUSION (MORE THAN 8 HOURS), REQUIRING USE OF PORTABLE OR IMPLANTABLE PUMP",570.0,370.5,142.5,1472.03,19
CDM,300C9758_1,"BLINDED PROCEDURE FOR NYHA CLASS III/IV HEART FAILURE; TRANSCATHETER IMPLANTATION OF INTERATRIAL SHUNT OR PLACEBO CONTROL, INCLUDING RIGHT HEART CATHETERIZATION, TRANS-ESOPHAGEAL ECHOCARDIOGRAPHY (TEE",25000.0,16250.0,6250.0,64562.5,19
CDM,300G0008_1,ADMINISTRATION OF INFLUENZA VIRUS VACCINE,80.0,52.0,20.0,206.6,19
CDM,300G0009_1,ADMINISTRATION OF PNEUMOCOCCAL VACCINE,45.0,29.25,11.25,116.21,19
CDM,300G0010_1,ADMINISTRATION OF HEPATITIS B VACCINE,65.0,42.25,16.25,167.86,19
CDM,300G0023_1,"PRINCIPAL ILLNESS NAVIGATION SERVICES BY CERTIFIED OR TRAINED AUXILIARY PERSONNEL UNDER THE DIRECTION OF A PHYSICIAN OR OTHER PRACTITIONER, INCLUDING A PATIENT NAVIGATOR; 60 MINUTES PER CALENDAR MONTH",260.0,169.0,65.0,671.45,17
CDM,300G0024_1,"PRINCIPAL ILLNESS NAVIGATION SERVICES, ADDITIONAL 30 MINUTES PER CALENDAR MONTH (LIST SEPARATELY IN ADDITION TO G0023)",130.0,84.5,32.5,335.73,17
CDM,300G0136_1,"ADMINISTRATION OF A STANDARDIZED, EVIDENCE-BASED ASSESSMENT OF PHYSICAL ACTIVITY AND NUTRITION, 5-15 MINUTES, NOT MORE OFTEN THAN EVERY 6 MONTHS",96.0,62.4,24.0,247.92,17
CDM,300G0260_1,"INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID AND/OR OTHER THERAPEUTIC AGENT, WITH OR WITHOUT ARTHROGRAPHY",4092.5,2660.13,667.58,10568.88,19
CDM,300G0390_1,TRAUMA RESPONSE TEAM ASSOCIATED WITH HOSPITAL CRITICAL CARE SERVICE,4457.0,2897.05,1114.25,11510.2,17
CDM,300G0447_1,"FACE-TO-FACE BEHAVIORAL COUNSELING FOR OBESITY, 15 MINUTES",90.0,58.5,22.5,232.43,19
CDM,300G0473_1,"FACE-TO-FACE BEHAVIORAL COUNSELING FOR OBESITY, GROUP (2-10), 30 MINUTES",108.0,70.2,27.0,349.54,17
CDM,300G2066_1,"INTERROGATION DEVICE EVALUATION(S), (REMOTE) UP TO 30 DAYS; IMPLANTABLE CARDIOVASCULAR PHYSIOLOGIC MONITOR SYSTEM, IMPLANTABLE LOOP RECORDER SYSTEM, OR SUBCUTANEOUS CARDIAC RHYTHM MONITOR SYSTEM, REMO",75.0,48.75,18.75,1124.0,17
CDM,300G2082_1,OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT THAT REQUIRES THE SUPERVISION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL AND PROVISION OF U,1531.2,995.28,208.0,3954.32,19
CDM,300G2083_1,OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT THAT REQUIRES THE SUPERVISION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL AND PROVISION OF  ,2237.35,1454.28,208.0,5777.96,19
CDM,300M0220_1,"INJECTION, TIXAGEVIMAB AND CILGAVIMAB, FOR THE PRE-EXPOSURE PROPHYLAXIS ONLY, FOR CERTAIN ADULTS AND PEDIATRIC INDIVIDUALS (12 YEARS OF AGE AND OLDER WEIGHING AT LEAST 40KG) WITH NO KNOWN SARS-COV-2 E",375.0,243.75,76.0,968.44,17
CDM,300M0222_1,"INTRAVENOUS INJECTION, BEBTELOVIMAB, INCLUDES INJECTION AND POST ADMINISTRATION MONITORING",670.0,435.5,76.0,1730.28,17
CDM,300M0224_1,"INTRAVENOUS INFUSION, PEMIVIBART, FOR THE PRE-EXPOSURE PROPHYLAXIS ONLY, FOR CERTAIN ADULTS AND ADOLESCENTS (12 YEARS OF AGE AND OLDER WEIGHING AT LEAST 40 KG) WITH NO KNOWN SARS-COV-2 EXPOSURE, WHO E",775.0,503.75,76.0,2001.44,17
CDM,300M0233_1,"INTRAVENOUS INFUSION, TOCILIZUMAB-AAZG, FOR HOSPITALIZED ADULT PATIENTS WITH COVID-19 WHO ARE RECEIVING SYSTEMIC CORTICOSTEROIDS AND REQUIRE SUPPLEMENTAL OXYGEN, NON-INVASIVE OR INVASIVE MECHANICAL VE",775.0,503.75,76.0,2001.44,17
CDM,300M0234_1,"INTRAVENOUS INFUSION, TOCILIZUMAB-AAZG, FOR HOSPITALIZED ADULT PATIENTS WITH COVID-19 WHO ARE RECEIVING SYSTEMIC CORTICOSTEROIDS AND REQUIRE SUPPLEMENTAL OXYGEN, NON-INVASIVE OR INVASIVE MECHANICAL VE",775.0,503.75,76.0,2001.44,17
CDM,300M0239_1,"INTRAVENOUS INFUSION, BAMLANIVIMAB-XXXX, INCLUDES INFUSION AND POST ADMINISTRATION MONITORING",775.0,503.75,193.75,2001.44,17
CDM,300M0240_1,"INTRAVENOUS INFUSION OR SUBCUTANEOUS INJECTION, CASIRIVIMAB AND IMDEVIMAB INCLUDES INFUSION OR INJECTION, AND POST ADMINISTRATION MONITORING, SUBSEQUENT REPEAT DOSES",775.0,503.75,76.0,2001.44,17
CDM,300M0243_1,"INTRAVENOUS INFUSION OR SUBCUTANEOUS INJECTION, CASIRIVIMAB AND IMDEVIMAB INCLUDES INFUSION OR INJECTION, AND POST ADMINISTRATION MONITORING",775.0,503.75,76.0,2001.44,17
CDM,300M0245_1,"INTRAVENOUS INFUSION, BAMLANIVIMAB AND ETESEVIMAB, INCLUDES INFUSION AND POST ADMINISTRATION MONITORING",775.0,503.75,193.75,2001.44,17
CDM,300M0247_1,"INTRAVENOUS INFUSION, SOTROVIMAB, INCLUDES INFUSION AND POST ADMINISTRATION MONITORING",775.0,503.75,193.75,2001.44,17
CDM,300Q3014_1,TELEHEALTH ORIGINATING SITE FACILITY FEE,60.0,39.0,15.0,154.95,18
CDM,300Q4107_1,"GRAFTJACKET, PER SQUARE CENTIMETER",278.0,180.7,69.5,717.94,17
CDM,30100_1,Biopsy of lining of nose,369.6,240.24,22.43,341.63,19
CDM,3010575T_1,"In-person programming device evaluation of implantable cardioverter-defibrillator system with electrode under breastbone, with analysis, review and report",90.0,58.5,22.5,232.43,17
CDM,3010804T_1,"In-person programming device evaluation of dual-chamber leadless pacemaker with adjustment of the device to test function and to select optimal permanent values, with analysis, review and report by a ",86.0,55.9,21.5,1052.0,19
CDM,3010826T_1,In-person device evaluation of single-chamber leadless pacemaker system,90.0,58.5,22.5,1052.0,17
CDM,30110_1,Simple removal of nasal polyp,584.9,380.19,78.57,601.58,19
CDM,30115_1,Extensive removal of nasal polyp,1140.3,741.2,78.57,1303.16,19
CDM,30117T_1,Removal or destruction of growth of nose through nose,2299.5,1494.68,65.66,2347.61,19
CDM,30117_1,Removal or destruction of growth of nose through nose,2238.6,1455.09,65.66,2347.61,19
CDM,30118_1,Removal or destruction of growth of nose,2081.1,1352.72,78.57,2312.96,19
CDM,30120T_1,Removal or scraping of skin on nose,1282.9,833.89,78.57,1289.14,19
CDM,30120_1,Removal or scraping of skin on nose,1370.3,890.7,78.57,1289.14,19
CDM,30124T_1,Simple removal of cyst and skin growth of nose,971.3,631.35,78.57,856.35,19
CDM,30124_1,Simple removal of cyst and skin growth of nose,737.1,479.12,78.57,856.35,19
CDM,30125_1,Removal of growth under nasal bone or cartilage,1061.6,690.04,78.57,1835.91,19
CDM,30130T_1,Removal of nasal air passage,2133.0,1386.45,78.57,1152.18,19
CDM,30130_1,Removal of nasal air passage,1486.8,966.42,78.57,1152.18,19
CDM,30131001_1,Other procedure on voice box,10458.0,6797.7,1242.0,27007.79,19
CDM,30131002_1,Other procedure on voice box,10458.0,6797.7,1242.0,27007.79,19
CDM,30140T_1,Removal of nasal air passage under lining tissue,3148.5,2046.53,78.57,713.84,19
CDM,30140_1,Removal of nasal air passage under lining tissue,1691.55,1099.51,78.57,713.84,19
CDM,30148IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.15,13.1,5.04,52.04,16
CDM,30150_1,Partial removal of nose,2117.9,1376.64,78.57,2301.83,19
CDM,30160_1,Removal of nose,2206.1,1433.97,78.57,2323.31,19
CDM,30193260_1,Programming of implantable defibrillator system,150.0,97.5,37.5,1052.0,19
CDM,30193261_1,Evaluation of implantable defibrillator system,45.0,29.25,11.25,1052.0,19
CDM,30193279_1,Programming of single lead pacemaker system,45.0,29.25,11.25,1052.0,19
CDM,30193280_1,Programming of dual lead pacemaker system,150.0,97.5,37.5,1052.0,19
CDM,30193281_1,Programming of multiple lead pacemaker system,150.0,97.5,37.5,1052.0,19
CDM,30193282_1,Programming of single lead implantable defibrillator system,150.0,97.5,37.5,1052.0,19
CDM,30193283_1,Programming of dual lead implantable defibrillator system,150.0,97.5,37.5,1052.0,19
CDM,30193284_1,Programming of multiple lead implantable defibrillator system,150.0,97.5,37.5,1052.0,19
CDM,30193285_1,Programming of cardiac rhythm monitor system,150.0,97.5,37.5,1052.0,19
CDM,30193286_1,"Programming of single, dual, or multiple lead or leadless pacemaker system before or after surgery",45.0,29.25,11.25,1052.0,19
CDM,30193287_1,"Programming of single, dual or multiple lead implantable defibrillator system before or after surgery",45.0,29.25,11.25,1052.0,19
CDM,30193288_1,"Evaluation of single, dual, multiple lead or leadless pacemaker system",45.0,29.25,11.25,1052.0,19
CDM,30193289_1,"Evaluation of single, dual, or multiple lead implantable defibrillator system",80.0,52.0,20.0,1052.0,19
CDM,30193290_1,Evaluation of implantable heart and blood vessel monitoring system,45.0,29.25,11.25,1052.0,19
CDM,30193291_1,Evaluation of cardiac rhythm monitor system,45.0,29.25,11.25,1052.0,19
CDM,30193293_1,"Telephonic rhythm strip evaluation of single, dual, multiple lead or leadless pacemaker system, up to 90 days",45.0,29.25,11.25,1052.0,19
CDM,30193296_1,"Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days",150.0,97.5,37.5,1052.0,19
CDM,30193298_1,"Evaluation of cardiac rhythm monitor system, remote up to 30 days",200.0,130.0,50.0,1052.0,19
CDM,30193701_1,Measurement of heart blood flow and respiration,290.0,188.5,72.5,1052.0,19
CDM,301C0001_1,"MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)",1985.0,1290.25,496.25,5126.26,16
CDM,301C0002_1,"MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)",266.0,172.9,66.5,686.95,16
CDM,301C0003_1,"MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)",4172.0,2711.8,1043.0,10774.19,16
CDM,301C0004_1,"MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)",4172.0,2711.8,1043.0,10774.19,16
CDM,301C0005_1,"MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)",935.0,607.75,233.75,2414.64,16
CDM,301Q0001_1,"INJECTION, RADIESSE, 0.1 ML",560.0,364.0,140.0,1446.2,16
CDM,30200_1,Injection of medication into nasal air passage,289.8,188.37,20.48,268.24,19
CDM,30210_1,Irrigation and drainage of sinus,381.2,247.78,59.56,363.43,19
CDM,30212IP _1,"METHOTREXATE; ORAL, 2.5 MG",298.43,193.98,0.16,770.7,17
CDM,30212OP _1,"METHOTREXATE; ORAL, 2.5 MG",440.87,286.57,0.16,1138.55,17
CDM,30220T_1,Insertion of implant to close nasal passage,1192.2,774.93,43.22,738.92,19
CDM,30220_1,Insertion of implant to close nasal passage,766.5,498.23,19.23,738.92,19
CDM,30264IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.0,2.6,1.0,10.33,16
CDM,30264OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.52,11.39,4.38,45.25,16
CDM,30300_1,Removal of foreign body in nose,460.0,299.0,78.57,507.79,19
CDM,30310T_1,Removal of foreign body in nose under anesthesia,614.3,399.3,78.57,603.32,19
CDM,30310_1,Removal of foreign body in nose under anesthesia,542.9,352.89,78.57,603.32,19
CDM,30320_1,Removal of foreign body in nose by incision,1047.6,680.94,78.57,1361.61,19
CDM,3037IP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",50.55,32.86,1.26,130.55,17
CDM,3037OP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",46.53,30.24,1.26,120.16,17
CDM,30400T_1,Reshaping of tip of nose,5200.7,3380.46,78.57,3225.99,19
CDM,30400_1,Reshaping of tip of nose,2754.2,1790.23,78.57,3225.99,19
CDM,30410T_1,"Reshaping of bone, cartilage, and/or tip of nose",5200.7,3380.46,78.57,3729.65,19
CDM,30410_1,"Reshaping of bone, cartilage, and/or tip of nose",3271.8,2126.67,78.57,3729.65,19
CDM,30420T_1,Reshaping of bony cartilage dividing nasal passages,5200.7,3380.46,78.57,4116.02,19
CDM,30420_1,Reshaping of bony cartilage dividing nasal passages,4126.5,2682.23,78.57,4116.02,19
CDM,30430T_1,Revision to reshape nose or small amount of tip of nose after previous repair,2405.6,1563.64,78.57,2837.53,19
CDM,30430_1,Revision to reshape nose or small amount of tip of nose after previous repair,2398.2,1558.83,78.57,2837.53,19
CDM,30435T_1,Revision to reshape nasal bones after previous repair,5200.7,3380.46,78.57,3522.63,19
CDM,30435_1,Revision to reshape nasal bones after previous repair,3134.3,2037.3,78.57,3522.63,19
CDM,30450T_1,Revision to reshape nasal bones and tip of nose after previous repair,5200.7,3380.46,78.57,4682.95,19
CDM,30450_1,Revision to reshape nasal bones and tip of nose after previous repair,4248.3,2761.4,78.57,4682.95,19
CDM,30460T_1,Revision of congenital nasal defect to lengthen tip of nose,2075.9,1349.34,78.57,2438.87,19
CDM,30460_1,Revision of congenital nasal defect to lengthen tip of nose,2106.3,1369.1,78.57,2438.87,19
CDM,30462T_1,Revision of congenital nasal defect with lengthening of tip of nose,5200.7,3380.46,78.57,4685.95,19
CDM,30462_1,Revision of congenital nasal defect with lengthening of tip of nose,4305.0,2798.25,78.57,4685.95,19
CDM,30465T_1,Repair of nasal passage,5200.7,3380.46,78.57,2938.21,19
CDM,30465_1,Repair of nasal passage,2714.3,1764.3,78.57,2938.21,19
CDM,30468_1,Repair of collapsed nostril using implant in side of nose,156.75,101.89,78.57,6194.63,19
CDM,30469_1,Repair of collapsed nasal valve,337.0,219.05,78.57,6035.67,19
CDM,30479IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.91,3.19,1.23,12.68,16
CDM,30500000_1,LABOR ROOM/DELIVERY - LABOR,549.0,356.85,137.25,664.0,12
CDM,30500001_1,LABOR ROOM/DELIVERY - LABOR,946.0,614.9,236.5,664.0,12
CDM,30500004_1,LABOR ROOM/DELIVERY - LABOR,1472.0,956.8,368.0,1030.4,12
CDM,30500005_1,LABOR ROOM/DELIVERY - LABOR,1104.0,717.6,276.0,772.8,12
CDM,30500006_1,LABOR ROOM/DELIVERY - LABOR,859.0,558.35,214.75,664.0,12
CDM,30500007_1,LABOR ROOM/DELIVERY - LABOR,1227.0,797.55,306.75,858.9,12
CDM,30500009_1,LABOR ROOM/DELIVERY - LABOR,359.0,233.35,89.75,664.0,12
CDM,30500010_1,HC CHILDBIRTH EDUCATION SERIES,136.0,88.4,34.0,273.0,12
CDM,30510001_1,HC SUPPLY PACK VAGINAL,150.0,97.5,37.5,105.0,11
CDM,30510005_1,Vaginal delivery with post delivery care,2007.0,1304.55,501.75,5183.08,19
CDM,30510011_1,HC SUPPLY PACK C-SECTION,178.0,115.7,44.5,124.6,11
CDM,30510015_1,Cesarean delivery with care after delivery,4336.0,2818.4,664.0,11197.72,19
CDM,30510016_1,LABOR ROOM/DELIVERY - GENERAL CLASSIFICATION,812.0,527.8,203.0,664.0,12
CDM,30510021_1,HC SUPPLY PACK OR AND RR,543.0,352.95,135.75,380.1,11
CDM,30510025_1,LABOR ROOM/DELIVERY - GENERAL CLASSIFICATION,613.0,398.45,153.25,664.0,12
CDM,30510026_1,LABOR ROOM/DELIVERY - GENERAL CLASSIFICATION,414.0,269.1,103.5,664.0,12
CDM,30510033_1,LABOR ROOM/DELIVERY - LABOR,593.0,385.45,148.25,664.0,12
CDM,30510041_1,HC SEPRAFILM MEMBRANE,562.0,365.3,140.5,393.4,11
CDM,30510101_1,HC SUPPLY PACK OP BASIC,192.0,124.8,48.0,134.4,11
CDM,30510210_1,LABOR ROOM/DELIVERY - LABOR,233.0,151.45,58.25,664.0,12
CDM,30510220_1,LABOR ROOM/DELIVERY - OTHER LABOR ROOM/DELIVERY,50.0,32.5,12.5,664.0,12
CDM,30510IP _1,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",16.34,10.62,0.21,42.2,17
CDM,30510OP _1,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",22.47,14.61,0.21,58.03,17
CDM,30520800_1,HC SUPPLY PACK LOCAL ANESTHESIA,383.0,248.95,95.75,268.1,11
CDM,30520T_1,Reshaping of nasal cartilage,3126.9,2032.49,78.57,1884.63,19
CDM,30520_1,Reshaping of nasal cartilage,1756.7,1141.86,78.57,1884.63,19
CDM,30521000_1,OPERATING ROOM SERVICES - MINOR SURGERY,397.0,258.05,99.25,277.9,11
CDM,30540_1,Repair of nasal passage through nose,2111.6,1372.54,78.57,2073.92,19
CDM,30545_1,Repair of nasal passages through palate,3004.1,1952.67,78.57,2836.87,19
CDM,30560T_1,Release of nasal scar tissue,531.3,345.35,39.19,784.04,19
CDM,30560_1,Release of nasal scar tissue,682.5,443.63,74.1,784.04,19
CDM,30576805_1,"Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus",325.0,211.25,81.25,839.31,18
CDM,30576811_1,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus",350.0,227.5,87.5,903.88,18
CDM,30576815_1,Limited ultrasound of pregnant uterus,235.0,152.75,58.75,606.89,18
CDM,30576817_1,Vaginal ultrasound of pregnant uterus,325.0,211.25,81.25,839.31,18
CDM,30576818_1,Ultrasound and monitoring of heart of fetus,310.0,201.5,77.5,800.58,18
CDM,30580_1,Repair of abnormal drainage tract between nasal sinuses,1661.1,1079.72,78.57,1474.82,19
CDM,30584112_1,Cervicovaginal secretion of placenta protein,442.0,287.3,80.37,1141.47,19
CDM,30592564_1,LABOR ROOM/DELIVERY - LABOR,361.0,234.65,90.25,664.0,12
CDM,30599211_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,100.0,65.0,25.0,258.25,17
CDM,30599212_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,150.0,97.5,37.5,387.38,17
CDM,30600_1,Repair of abnormal drainage tract between mouth and nasal cavity,1605.5,1043.58,78.57,1250.51,19
CDM,30620_1,Reconstruction of lining of nasal passage with graft,1632.8,1061.32,78.57,1902.81,19
CDM,30630T_1,Repair of openings of nasal cartilage,1683.2,1094.08,78.57,1887.93,19
CDM,30630_1,Repair of openings of nasal cartilage,1669.5,1085.18,78.57,1887.93,19
CDM,30699IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.37,2.84,1.09,11.29,16
CDM,30699OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.61,11.45,4.4,45.48,16
CDM,3071IP _1,UNCLASSIFIED DRUGS,5.82,3.78,1.46,15.03,16
CDM,3071OP _1,UNCLASSIFIED DRUGS,9.03,5.87,2.26,23.32,16
CDM,3077IP _1,UNCLASSIFIED DRUGS,6.04,3.93,1.51,15.6,16
CDM,3077OP _1,UNCLASSIFIED DRUGS,21.4,13.91,5.35,55.27,16
CDM,30801T_1,Destruction of soft tissue of nasal passages,575.4,374.01,61.75,529.75,19
CDM,30801_1,Destruction of soft tissue of nasal passages,574.4,373.36,61.75,529.75,19
CDM,30802T_1,Destruction of surface soft tissue of nasal passages,971.3,631.35,67.87,673.18,19
CDM,30802_1,Destruction of surface soft tissue of nasal passages,747.6,485.94,67.87,673.18,19
CDM,30901T_1,Simple control of nose bleed,401.4,260.91,38.53,377.27,19
CDM,30901_1,Simple control of nose bleed,375.0,243.75,38.53,377.27,19
CDM,30903_1,Complex control of nose bleed,615.0,399.75,63.19,591.64,19
CDM,30905_1,Initial control of nose bleed and insertion of packing,550.0,357.5,78.57,845.57,19
CDM,30906_1,Subsequent control of nosebleed and insertion of packing,725.6,471.64,73.42,898.68,19
CDM,30915_1,Tying of ethmoidal artery ethmoidal for control of nose bleed,1862.7,1210.76,78.57,1727.54,19
CDM,30920_1,Tying of internal nasal artery for control of nose bleed,2466.5,1603.23,78.57,2511.7,19
CDM,30930T_1,Therapeutic fracture of nasal passages,525.0,341.25,43.22,358.91,19
CDM,30930_1,Therapeutic fracture of nasal passages,323.4,210.21,43.22,358.91,19
CDM,30961IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.5,6.18,2.38,24.53,16
CDM,30961OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.33,13.21,5.08,52.5,16
CDM,31000_1,Irrigation of nasal sinus,459.9,298.94,78.57,447.32,19
CDM,31002_1,Irrigation of sphenoid nasal sinus,533.4,346.71,78.57,567.94,19
CDM,31020T_1,Incision of nasal sinus through nose,1328.3,863.4,78.57,1156.81,19
CDM,31020_1,Incision of nasal sinus through nose,1243.2,808.08,78.57,1156.81,19
CDM,31030_1,Creation of window into nasal sinus,3189.45,2073.14,78.57,1602.65,19
CDM,31032_1,Removal of nasal sinus polyp,2205.0,1433.25,78.57,1723.53,19
CDM,31040_1,Incision through sinus at cheek bone to reach nerve and blood vessel,4725.0,3071.25,78.57,2302.38,19
CDM,31050_1,Incision of sphenoid nasal sinus,1696.8,1102.92,78.57,1456.53,19
CDM,31051_1,Removal of nasal polyps,2054.9,1335.69,78.57,1946.58,19
CDM,31070_1,Simple incision of frontal nasal sinus,1653.8,1074.97,78.57,1323.61,19
CDM,31075T_1,Incision of nasal sinus of side of face,5200.7,3380.46,78.57,2348.88,19
CDM,31075_1,Incision of nasal sinus of side of face,2657.6,1727.44,78.57,2348.88,19
CDM,31080_1,Insertion of material to stop growth of nasal sinus lining through eyebrow,2721.6,1769.04,78.57,3092.87,19
CDM,31081_1,Insertion of material to stop growth of nasal sinus lining through forehead,3269.7,2125.31,78.57,3331.3,19
CDM,31084_1,Insertion of material to stop growth of nasal sinus lining with bone flap through eyebrow,3780.0,2457.0,78.57,3450.97,19
CDM,31085_1,Insertion of material to stop growth of nasal sinus lining with bone flap through forehead,5862.15,3810.4,78.57,3570.1,19
CDM,31086_1,Incision of eyebrow and placement of bone flap to drain frontal nasal sinus,3024.0,1965.6,78.57,3361.73,19
CDM,31087_1,Incision of forehead and placement of bone flap to drain frontal nasal sinus,3095.4,2012.01,78.57,3232.47,19
CDM,31090_1,Removal of tissue or growths in 3 or more nasal sinuses on side of face,4091.9,2659.74,78.57,3103.81,19
CDM,310IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.51,10.08,3.88,40.05,16
CDM,310OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.44,12.64,4.86,50.2,16
CDM,31177IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.66,1.08,0.42,4.29,16
CDM,31177OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.72,3.72,1.43,14.77,16
CDM,311IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.7,13.46,5.18,53.46,16
CDM,311OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",95.9,62.34,23.98,247.66,16
CDM,31200001_1,RECOVERY ROOM - GENERAL CLASSIFICATION,319.0,207.35,79.75,223.3,11
CDM,31200002_1,SPECIALTY SERVICES - TREATMENT ROOM,480.0,312.0,120.0,336.0,12
CDM,31200003_1,SPECIALTY SERVICES - TREATMENT ROOM,206.0,133.9,51.5,208.0,12
CDM,31200_1,Partial removal of nasal sinus,2132.55,1386.16,78.57,1766.43,19
CDM,31201_1,Removal of nasal sinus from within nasal passage,2020.2,1313.13,78.57,2243.39,19
CDM,31205_1,Removal of nasal sinus from outside nasal passage,3723.3,2420.15,78.57,2769.6,19
CDM,31209IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.19,5.97,2.3,23.73,16
CDM,31209OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.34,9.32,3.59,37.03,16
CDM,31225_1,Removal of nasal sinus,7572.6,4922.19,78.57,5513.69,19
CDM,31230_1,Removal of nasal sinus and eye bone,5654.3,3675.3,78.57,6102.95,19
CDM,31231T_1,Diagnostic exam of nasal passages using an endoscope,528.2,343.33,31.97,454.32,19
CDM,31231_1,Diagnostic exam of nasal passages using an endoscope,420.0,273.0,50.4,454.32,19
CDM,31233_1,Exam of nasal passage and sinus using an endoscope,702.5,456.63,78.57,661.4,19
CDM,31235_1,Exam of nasal passage and sphenoid sinus using an endoscope,807.5,524.88,78.57,749.74,19
CDM,31237T_1,Biopsy or removal of nasal polyp or tissue using an endoscope,757.9,492.64,78.57,615.89,19
CDM,31237_1,Biopsy or removal of nasal polyp or tissue using an endoscope,1307.25,849.71,78.57,615.89,19
CDM,31238_1,Control of bleeding of nose using an endoscope,1373.4,892.71,78.57,601.22,19
CDM,31239_1,Incision of tear duct using an endoscope,3600.45,2340.29,78.57,1862.67,19
CDM,31240T_1,Removal of nasal breathing passages using an endoscope,363.3,236.15,78.57,476.59,19
CDM,31240_1,Removal of nasal breathing passages using an endoscope,691.5,449.48,78.57,476.59,19
CDM,31241_1,Tying of sphenopalatine artery using an endoscope,1470.0,955.5,78.57,1340.47,19
CDM,31243_1,Destruction of nasal nerve by freezing using an endoscope,750.0,487.5,78.57,5822.26,19
CDM,31253_1,Complete exam of nose and sinuses using an endoscope,1650.0,1072.5,78.57,1511.52,19
CDM,31254_1,Partial removal of nasal sinus using an endoscope,1184.4,769.86,78.57,1055.75,19
CDM,31255_1,Removal of nasal sinus using an endoscope,1745.1,1134.32,78.57,977.1,19
CDM,31256T_1,Incision of nasal sinus using an endoscope,593.3,385.65,78.57,543.35,19
CDM,31256_1,Incision of nasal sinus using an endoscope,740.25,481.16,78.57,543.35,19
CDM,31257_1,Exam of nose and sinus with removal of nasal sinus using an endoscope,1470.0,955.5,78.57,1347.37,19
CDM,31259_1,Removal of tissue from sphenoid sinus using an endoscope,1560.0,1014.0,78.57,1426.81,19
CDM,31267_1,Removal of nasal sinus tissue using an endoscope,1379.7,896.81,78.57,800.4,19
CDM,31270IP _1,"INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML",2555.83,1661.29,42.62,6600.43,17
CDM,31270OP _1,"INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML",2555.7,1661.21,42.62,6600.1,17
CDM,31276_1,Exploration of nasal sinus using an endoscope,2201.85,1431.2,78.57,1142.34,19
CDM,31285566_1,HC ETT REGULAR/LMA/RAE,37.0,24.05,9.25,25.9,11
CDM,31287_1,Incision of sphenoid nasal sinus using an endoscope,1006.5,654.23,78.57,606.89,19
CDM,31288_1,Removal of sphenoid nasal sinus tissue using an endoscope,1165.5,757.58,78.57,706.02,19
CDM,31290_1,Repair of leak of brain and spinal fluid from sinus behind bridge of nose using endoscope,5454.3,3545.3,78.57,3422.79,19
CDM,31291_1,Repair of leak of brain and spinal fluid from sinus behind eyes using endoscope,5729.85,3724.4,78.57,3618.39,19
CDM,31292_1,Decompression of medial or inferior wall of eye socket using an endoscope,4219.5,2742.68,78.57,2968.83,19
CDM,31293_1,Decompression of medial and inferior wall of eye socket using an endoscope,3230.9,2100.09,78.57,3222.12,19
CDM,31294_1,Decompression of optic nerve using an endoscope,3692.9,2400.39,78.57,3688.98,19
CDM,31295_1,Dilation of nasal sinus using an endoscope,5296.4,3442.66,78.57,5455.29,19
CDM,31296_1,Dilation of frontal nasal sinus using an endoscope,11973.3,7782.65,78.57,12332.5,19
CDM,31297_1,Dilation of sphenoid nasal sinus using an endoscope,420.0,273.0,78.57,4024.18,19
CDM,31298_1,Dilation of sphenoid and frontal nasal sinus using an endoscope,8535.0,5547.75,78.57,7639.15,19
CDM,31300_1,Removal of vocal cord growth or cartilage attachment,3416.7,2220.86,78.57,3828.11,19
CDM,31310IP _1,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",2604.39,1692.85,99.46,6725.84,19
CDM,31310OP _1,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",2352.53,1529.14,99.46,6075.41,19
CDM,31360_1,Complete removal of voice box,5531.4,3595.41,78.57,6246.76,19
CDM,31365_1,Complete removal of voice box with extensive dissection of neck,6932.1,4505.87,78.57,7712.11,19
CDM,31367_1,Removal of voice box,5945.1,3864.32,78.57,6611.19,19
CDM,31368_1,Removal of voice box with extensive dissection of neck,6635.0,4312.75,78.57,7341.04,19
CDM,31370_1,Partial removal of voice box,5575.5,3624.08,78.57,6214.35,19
CDM,31375_1,Partial removal of voice box through front and side of neck,5273.1,3427.52,78.57,5892.55,19
CDM,31380_1,Partial removal of voice box and adjoining tissue,5191.2,3374.28,78.57,5813.0,19
CDM,31382_1,Partial removal of voice box and cartilage,5701.5,3705.98,78.57,6378.49,19
CDM,31390_1,"Removal of voice box, throat, muscle, lymph nodes, and glands",7714.4,5014.36,78.57,8565.57,19
CDM,31395_1,"Removal of voice box and throat, muscle, lymph nodes, and glands with reconstruction of defect",8163.8,5306.47,78.57,9042.65,19
CDM,31400_1,Removal or repair of voice box cartilage,2914.8,1894.62,78.57,2940.86,19
CDM,31420_1,Removal of cartilage attaching tongue,2503.2,1627.08,78.57,2465.09,19
CDM,31500_1,Emergent insertion of breathing tube into windpipe using an endoscope,350.0,227.5,78.57,430.84,19
CDM,31502_1,Change of breathing tube in windpipe,190.0,123.5,28.22,106.6,19
CDM,31505_1,Diagnostic exam of voice box using an endoscope with mirror,190.0,123.5,37.54,218.32,19
CDM,31510_1,Biopsy of voice box using an endoscope with mirror,693.0,450.45,40.48,519.65,19
CDM,31511_1,Removal of foreign body in voice box using an endoscope with mirror,415.0,269.75,43.4,506.19,19
CDM,31512_1,Removal of growth of voice box using an endoscope with mirror,693.0,450.45,44.15,521.28,19
CDM,31513_1,Injection of vocal cord using an endoscope with mirror,525.0,341.25,43.22,392.65,19
CDM,31515_1,Aspiration of voice box using an endoscope,400.0,260.0,30.87,517.48,19
CDM,31520_1,"Diagnostic exam of voice box using an endoscope, newborn",440.0,286.0,78.57,468.37,19
CDM,31525_1,Diagnostic exam of voice box using an endoscope,680.0,442.0,78.57,600.93,19
CDM,31526_1,Diagnostic exam of voice box using an endoscope with operating microscope or telescope,837.9,544.64,78.57,469.54,19
CDM,31527_1,Insertion of device to close opening of voice box using an endoscope,561.8,365.17,78.57,584.29,19
CDM,31528_1,Initial dilation of voice box using an endoscope,413.7,268.91,78.57,431.99,19
CDM,31529_1,Subsequent dilation of voice box using an endoscope,577.5,375.38,78.57,482.87,19
CDM,31530_1,Removal of foreign body in voice box using an endoscope,620.0,403.0,78.57,596.93,19
CDM,31531_1,Removal of foreign body in voice box using an endoscope with operating microscope or telescope,1208.6,785.59,78.57,636.23,19
CDM,31535_1,Biopsy of voice box using an endoscope,1050.0,682.5,78.57,567.16,19
CDM,31536_1,Biopsy of voice box using an endoscope with operating microscope or telescope,1319.9,857.94,78.57,631.74,19
CDM,31540_1,Removal of growth of throat and/or stripping of vocal cords using an endoscope,1254.8,815.62,78.57,722.89,19
CDM,31541_1,Removal of growth of tongue and/or stripping of vocal cord using an endoscope with operating microscope or telescope,1580.3,1027.2,78.57,789.69,19
CDM,31545_1,Removal of vocal cord growths and reconstruction with local tissue flap using an endoscope with operating microscope or telescope,1568.7,1019.66,78.57,1087.18,19
CDM,31546_1,Removal of vocal cord growths and reconstruction with graft using an endoscope with operating microscope or telescope,1586.6,1031.29,78.57,1650.91,19
CDM,31551_1,Repair of narrowed voice box with graft (younger than 12 years),3350.65,2177.92,78.57,4317.82,19
CDM,31552_1,Repair of narrowed voice box with graft (12 years or older),3386.35,2201.13,78.57,4334.99,19
CDM,31553_1,Repair of narrowed voice box with graft and placement of indwelling stent (younger than 12 years),3691.25,2399.31,78.57,4742.87,19
CDM,31554_1,Repair of narrowed voice box with graft and placement of indwelling stent (12 years or older),3885.35,2525.48,78.57,4955.04,19
CDM,31560_1,Removal of voice box cartilage using an endoscope,2010.8,1307.02,78.57,938.49,19
CDM,31561_1,Removal of voice box cartilage using an endoscope with operating microscope or telescope,2363.6,1536.34,78.57,1027.96,19
CDM,31570_1,Injection into vocal cords using an endoscope,1089.9,708.44,78.57,820.08,19
CDM,31571_1,Injection into vocal cords using an endoscope with operating microscope or telescope,1387.1,901.62,78.57,746.96,19
CDM,31572_1,Removal or destruction of growth of side of voice box using an endoscope,641.4,416.91,78.57,1270.94,19
CDM,31573_1,Injection of drug into side of voice box using an endoscope,529.05,343.88,78.57,691.65,19
CDM,31574_1,Injection of substance to augment voice box using an endoscope,529.05,343.88,78.57,2293.94,19
CDM,31575_1,Diagnostic exam of voice box using a flexible endoscope,310.0,201.5,56.42,310.94,19
CDM,31576IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.41,10.67,4.1,42.38,16
CDM,31576OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.72,10.22,3.93,40.6,16
CDM,31576_1,Biopsy of voice box using a flexible endoscope,605.9,393.84,70.88,648.64,19
CDM,31577_1,Removal of foreign body in voice box using a flexible endoscope,560.0,364.0,78.57,664.81,19
CDM,31578IP _1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",15.31,9.95,0.07,39.54,17
CDM,31578OP _1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",4.33,2.81,0.07,11.18,17
CDM,31578_1,Removal of growth of voice box using an endoscope,688.8,447.72,78.57,737.19,19
CDM,31579_1,Exam to assess movement of vocal cord flaps using an endoscope,647.9,421.14,78.57,477.31,19
CDM,31580_1,Repair of congenital vocal cord defect with insertion of indwelling stent,3000.0,1950.0,78.57,3738.55,19
CDM,31584_1,Incision of voice box to repair fracture,4153.8,2699.97,78.57,4144.66,19
CDM,31587_1,Repair of split of voice box,3349.5,2177.18,78.57,3472.72,19
CDM,31590_1,Relocation of nerve and muscle to restore voice box function,3150.0,2047.5,78.57,2618.1,19
CDM,31591_1,Repair of side of voice box by moving vocal cord to middle,3676.13,2389.48,78.57,3145.76,19
CDM,31592_1,Partial removal of windpipe and cartilage,3971.8,2581.67,78.57,5102.6,19
CDM,31600_1,Incision of windpipe for insertion of breathing tube (older than 2 years),1131.9,735.74,78.57,915.74,19
CDM,31601_1,Incision of windpipe for insertion of breathing tube (2 years or younger),1128.8,733.72,78.57,1357.79,19
CDM,31603_1,Emergent incision of windpipe through neck for insertion of breathing tube,945.0,614.25,78.57,961.98,19
CDM,31605_1,Emergent incision of windpipe for insertion of breathing tube,930.0,604.5,78.57,989.07,19
CDM,31610_1,Creation of permanent opening of windpipe for breathing,1934.1,1257.17,78.57,2838.28,19
CDM,31611_1,Creation of opening of windpipe and insertion of speech prosthesis,1441.7,937.11,78.57,1589.69,19
CDM,31612_1,Puncture of windpipe for aspiration and/or injection,219.5,142.68,11.65,222.71,19
CDM,31613_1,Simple revision of permanent opening of windpipe for breathing,1187.6,771.94,78.57,1317.33,19
CDM,31614_1,Revision of permanent opening of windpipe for breathing with flap rotation,1985.6,1290.64,78.57,2197.2,19
CDM,31615_1,Exam of windpipe and lung airways through permanent windpipe opening using an endoscope,501.9,326.24,78.57,413.87,19
CDM,31622_1,Diagnostic exam of lung airway using an endoscope,847.4,550.81,78.57,593.5,19
CDM,31623_1,Exam of lung airways using an endoscope,928.2,603.33,78.57,661.33,19
CDM,31624_1,Irrigation and suction of lung airways to obtain cells using an endoscope,870.0,565.5,78.57,613.28,19
CDM,31625_1,Biopsy of lung airway using an endoscope,933.5,606.78,78.57,839.27,19
CDM,31626_1,Placement of radiation therapy markers into lung airways using an endoscope,1121.6,729.04,78.57,1893.36,19
CDM,31627_1,Computer-assisted image-guided navigation of lung airways using an endoscope,846.0,549.9,78.57,2606.82,19
CDM,31628_1,"Biopsy of lobe of lung using an endoscope, 1 lobe",1120.4,728.26,78.57,897.18,19
CDM,31629_1,"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope",1698.9,1104.29,78.57,1090.08,19
CDM,31630_1,Dilation of windpipe cartilage or treatment of broken windpipe cartilage using an endoscope,589.1,382.92,78.57,604.1,19
CDM,31631_1,Placement of stent into windpipe using an endoscope,672.0,436.8,78.57,692.36,19
CDM,31632_1,"Biopsy of lobe of lung using an endoscope, each additional lobe",204.8,133.12,30.87,155.65,19
CDM,31633_1,"Needle biopsy of lobe of lung using an endoscope, each additional lobe",249.9,162.44,32.15,196.8,19
CDM,31634_1,Exam of lung airways with repair of air leak using an endoscope,1662.0,1080.3,78.57,3636.66,19
CDM,31635_1,Removal of foreign body in lung airways using an endoscope,959.7,623.81,78.57,701.03,19
CDM,31636_1,"Placement of stent in lung airway using an endoscope, first stent",650.0,422.5,78.57,672.58,19
CDM,31637_1,"Placement of stent in lung airway using an endoscope, each additional stent",227.9,148.14,63.2,237.57,19
CDM,31638_1,Revision of previously inserted lung airway stent using an endoscope,744.5,483.93,78.57,762.26,19
CDM,31640_1,Removal of growth of lung airways using an endoscope,1260.0,819.0,78.57,768.33,19
CDM,31641_1,Destruction of growth or narrowing of lung airway using an endoscope,759.2,493.48,78.57,786.3,19
CDM,31643_1,Placement of tube for radiation delivery in lung airway using an endoscope,477.8,310.57,78.57,546.33,19
CDM,31645_1,Aspiration of initial secretion of lung airway using an endoscope,837.9,544.64,78.57,656.42,19
CDM,31646_1,Aspiration of subsequent secretions of lung airway using an endoscope during same hospital stay,759.2,493.48,78.57,437.43,19
CDM,31647_1,Assessment of initial lobe of lung for air leak and airway sizing with insertion of bronchial valve in lung airway using an endoscope,736.1,478.47,78.57,640.81,19
CDM,31648_1,"Removal of bronchial valves of lung airways of lobe of lung using an endoscope, initial lobe",767.6,498.94,78.57,612.2,19
CDM,31649_1,"Removal of bronchial valves of lung airways of lobe of lung using an endoscope, each additional lobe",247.8,161.07,58.09,209.67,19
CDM,31651_1,"Assessment of air leak and airway sizing with insertion of bronchial valve in lung airway using an endoscope, each additional lobe",262.5,170.63,63.2,230.25,19
CDM,31652_1,"Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes",2108.0,1370.2,78.57,3024.69,19
CDM,31653_1,"Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 3 or more lymph nodes",2241.0,1456.65,78.57,3144.75,19
CDM,31654_1,Exam of lung airways with diagnostic or therapeutic procedure on growths using an endoscope and ultrasound,257.0,167.05,56.34,289.99,19
CDM,31660_1,Thermal repair of airways of lobe of lung using an endoscope,738.2,479.83,78.57,606.16,19
CDM,31661_1,Thermal repair of airways of multiple lobes of lung using an endoscope,778.1,505.77,78.57,640.4,19
CDM,31684IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.0,9.1,3.5,36.16,16
CDM,31684OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.2,7.28,2.8,28.92,16
CDM,31717_1,Insertion of tube into airway of lung for biopsy,611.85,397.7,29.49,693.28,19
CDM,31720_1,Insertion of tube into airway for aspiration of secretions,125.38,81.5,18.52,154.61,19
CDM,31725_1,Insertion of tube into windpipe and airways of lung for aspiration of secretions using an endoscope at bedside,189.3,123.05,66.8,244.86,19
CDM,31730_1,Insertion of needle wire dilator or indwelling tube for oxygen therapy,2508.5,1630.53,41.77,2563.32,19
CDM,31750_1,Repair of windpipe cartilage through neck,3630.9,2360.09,78.57,4113.25,19
CDM,31755_1,Creation of drainage tract from throat to windpipe,4159.8,2703.87,78.57,5221.91,19
CDM,31760_1,Repair of windpipe cartilage through chest,3847.2,2500.68,78.57,3997.71,19
CDM,31766_1,Reconstruction of upper breast bone through chest,4085.88,2655.82,78.57,5180.35,19
CDM,31770_1,Repair of lung airway with graft,3748.5,2436.53,78.57,3871.98,19
CDM,31775_1,Repair of narrowed area of lung airway,3103.73,2017.42,78.57,4078.59,19
CDM,3177IP _1,FLOXURIDINE 500 MG VIAL,1206.67,784.34,301.67,844.67,11
CDM,3177OP _1,FLOXURIDINE 500 MG VIAL,1380.18,897.12,345.05,966.13,11
CDM,31780_1,Removal of narrowed area of windpipe in neck with suture repair,3517.5,2286.38,78.57,3579.24,19
CDM,31781_1,Removal of narrowed area of windpipe in neck and chest with suture repair,3381.0,2197.65,78.57,4030.63,19
CDM,31784IP _1,UNCLASSIFIED DRUGS,2207.78,1435.06,551.95,5701.59,16
CDM,31784OP _1,UNCLASSIFIED DRUGS,785.74,510.73,196.44,2029.17,16
CDM,31785_1,Removal of growth of windpipe cartilage,3228.8,2098.72,78.57,3233.53,19
CDM,31786_1,Removal of growth of windpipe cartilage through chest,4092.9,2660.39,78.57,4204.96,19
CDM,31800_1,Suture of injury of windpipe in neck,1893.2,1230.58,78.57,2156.2,19
CDM,31805_1,Suture of injury of windpipe in chest,2084.3,1354.8,78.57,2373.29,19
CDM,31820_1,Closure of permanent windpipe opening or abnormal drainage tract,1150.8,748.02,78.57,1068.59,19
CDM,31825_1,Closure of permanent windpipe opening or abnormal drainage tract with plastic repair,1344.0,873.6,78.57,1488.85,19
CDM,31830_1,Revision of permanent windpipe opening scar,1156.1,751.47,78.57,1197.5,19
CDM,3187IP _1,UNCLASSIFIED DRUGS,21.91,14.24,5.48,56.58,16
CDM,3187OP _1,UNCLASSIFIED DRUGS,1.51,0.98,0.38,3.9,16
CDM,31921IP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",97.0,63.05,0.56,291.0,17
CDM,31921OP _1,"INJECTION, ENOXAPARIN SODIUM, 10 MG",16.07,10.45,0.56,48.21,17
CDM,31922IP _1,"INJECTION, ERTAPENEM SODIUM, 500 MG",279.02,181.36,9.71,720.57,17
CDM,31922OP _1,"INJECTION, ERTAPENEM SODIUM, 500 MG",201.81,131.18,9.71,521.17,17
CDM,32035_1,Removal of rib with creation of tract for drainage of infected material,2008.7,1305.66,78.57,2111.06,19
CDM,32036_1,Creation of open flap tract for drainage of infected material from lining around lung,2205.0,1433.25,78.57,2271.31,19
CDM,32096_1,Biopsy of fluid collection of lung,2529.7,1644.31,78.57,2342.06,19
CDM,32097_1,Biopsy of growth of lung,1354.5,880.43,78.57,2345.92,19
CDM,32098_1,Biopsy of lung lining,1273.7,827.91,78.57,2224.31,19
CDM,32100_1,Incision and exploration of chest cavity,2701.7,1756.11,78.57,2364.72,19
CDM,32110_1,Repair of tear of lung and/or control of traumatic bleeding through chest,4121.3,2678.85,78.57,4298.86,19
CDM,32120_1,Incision of chest cavity for complications after surgery,2454.9,1595.69,78.57,2547.43,19
CDM,32124_1,Release of lung lining through chest,2606.1,1693.97,78.57,2702.64,19
CDM,32140_1,Removal of cysts of lung through chest,2992.5,1945.13,78.57,2888.34,19
CDM,32141_1,Removal of air sac of lung through chest,4279.8,2781.87,78.57,4439.15,19
CDM,32150_1,Removal of foreign body or clot in lining of lung through chest,2811.9,1827.74,78.57,2935.8,19
CDM,32151_1,Removal of foreign body in lung,2821.4,1833.91,78.57,2925.15,19
CDM,3215OP _1,"INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG",43.0,27.95,6.57,111.05,17
CDM,32160_1,Massage of heart muscle through chest,2171.4,1411.41,78.57,2328.43,19
CDM,3218IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.14,4.64,1.79,18.44,16
CDM,3218OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.65,8.22,3.16,32.67,16
CDM,32200_1,Drainage of abscess or cyst of infected lung,3158.4,2052.96,78.57,3313.77,19
CDM,32215IP _1,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",189.25,123.01,0.93,567.75,17
CDM,32215_1,Creation of scarring on surface of lung,2625.0,1706.25,78.57,2324.85,19
CDM,3221IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.1,15.02,5.78,59.66,16
CDM,3221OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.05,13.68,5.26,54.36,16
CDM,32220_1,Removal of lining of lung for lung expansion,4499.3,2924.55,78.57,4633.78,19
CDM,32225_1,Partial removal of lining of lung for lung expansion,2811.9,1827.74,78.57,2904.48,19
CDM,32248IP _1,XULANE 150-35 MCG/DAY PATCH,289.25,188.01,72.31,202.48,11
CDM,32267IP _1,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",65972.09,42881.86,130.21,170372.92,19
CDM,32267OP _1,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",78838.92,51245.3,130.21,203601.51,19
CDM,32298IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.4,11.31,4.35,44.94,16
CDM,32310_1,Removal of lining of chest cavity,2861.3,1859.85,78.57,2664.65,19
CDM,32320_1,Removal of lining of chest cavity and lining of lung,4525.5,2941.58,78.57,4663.21,19
CDM,3232IP _1,UNCLASSIFIED DRUGS,20.07,13.05,5.02,51.83,16
CDM,3232OP _1,UNCLASSIFIED DRUGS,32.04,20.83,8.01,82.74,16
CDM,3233IP _1,UNCLASSIFIED DRUGS,14.62,9.5,3.66,37.76,16
CDM,3233OP _1,UNCLASSIFIED DRUGS,15.38,10.0,3.85,39.72,16
CDM,3234IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.01,1.96,0.75,7.77,16
CDM,32400_1,Needle biopsy of lining of lung,420.0,273.0,45.57,405.22,19
CDM,32408_1,"Core needle biopsy of lung or center cavity of chest (mediastinum), accessed through skin",358.0,232.7,78.57,2079.52,19
CDM,32440_1,Removal of lung,4456.2,2896.53,78.57,4566.81,19
CDM,32442_1,Removal of lung with portion of windpipe cartilage,7047.08,4580.6,78.57,8876.85,19
CDM,32445_1,Removal of lung and lining of chest cavity,9686.3,6296.1,78.57,10272.47,19
CDM,32469IP _1,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",1732.14,1125.89,1.41,4473.25,17
CDM,32469OP _1,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",25.0,16.25,1.41,64.56,17
CDM,32470IP _1,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",92.15,59.9,1.41,237.98,17
CDM,32470OP _1,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",12.17,7.91,1.41,31.43,17
CDM,32471IP _1,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",134.8,87.62,1.41,348.12,17
CDM,32471OP _1,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",18.85,12.25,1.41,48.68,17
CDM,32480_1,Removal of lobe of lung,4213.7,2738.91,78.57,4313.5,19
CDM,32482_1,Removal of 2 lobes of lung,4507.7,2930.01,78.57,4614.4,19
CDM,32484_1,Removal of segment of lung tissue,4089.8,2658.37,78.57,4177.42,19
CDM,32486_1,Removal of portion of lung and segment of lung airway,6675.9,4339.34,78.57,6809.75,19
CDM,32488_1,Removal of remaining lung after previous partial removal of lung,6747.3,4385.75,78.57,6964.59,19
CDM,32491_1,Removal of lung segment to reduce lung volume through chest,3383.9,2199.54,78.57,4306.38,19
CDM,324IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.7,8.91,3.43,35.38,16
CDM,324OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.76,16.09,6.19,63.94,16
CDM,32501_1,Repair of lung airway and removal of segment of lung,2572.5,1672.13,78.57,702.94,19
CDM,32503_1,Removal of growth of lung,4652.6,3024.19,78.57,5236.49,19
CDM,32504_1,Removal of growth of lung and reconstruction of chest wall,5320.4,3458.26,78.57,5959.72,19
CDM,32505_1,Initial removal of wedge of lung tissue,1893.0,1230.45,78.57,2718.71,19
CDM,32506_1,"Removal of lung tissue wedge through chest, each additional removal",319.0,207.35,78.57,453.49,19
CDM,32507_1,Removal of lung tissue wedge for diagnosis,262.5,170.63,78.57,453.49,19
CDM,32540_1,Removal of infected material between lung and chest wall,4823.7,3135.41,78.57,5022.94,19
CDM,32550_1,Insertion of indwelling tube for drainage of lung fluid,2105.3,1368.45,70.39,1898.2,19
CDM,32551_1,Removal of fluid from between lung and chest cavity,885.0,575.25,78.57,469.09,19
CDM,32552_1,Removal of indwelling tube in lining of lung,492.5,320.13,78.57,480.18,19
CDM,32553_1,Insertion of device in chest cavity for radiation therapy guidance,1222.95,794.92,70.62,1234.0,19
CDM,32554_1,Aspiration of fluid from chest cavity,1500.0,975.0,13.61,564.39,19
CDM,32555_1,Aspiration of fluid from chest cavity using imaging guidance,2336.55,1518.76,17.37,764.41,19
CDM,32556_1,Drainage of fluid from chest cavity with insertion of indwelling tube,1927.8,1253.07,26.05,1783.82,19
CDM,32557_1,Drainage of fluid from chest cavity with insertion of indwelling tube using imaging guidance,1962.0,1275.3,23.85,1610.76,19
CDM,32559OP _1,UNCLASSIFIED DRUGS,173.71,112.91,43.43,448.61,16
CDM,32560_1,Instillation of agent onto lung surface using chest tube,887.3,576.75,39.06,610.1,19
CDM,32561_1,Initial instillation of agent onto lung lining using chest tube,260.4,169.26,56.26,224.77,19
CDM,32562_1,Subsequent instillation of agent onto lung lining using chest tube,210.0,136.5,47.36,201.34,19
CDM,32589IP _1,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",14.49,9.42,3.62,37.42,17
CDM,32589OP _1,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",3.21,2.09,0.8,11.97,17
CDM,325IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.8,20.67,7.95,82.12,16
CDM,325OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",45.06,29.29,11.27,116.37,16
CDM,32601_1,"Diagnostic exam of lungs, heart sac, chest cavity, or lung lining using an endoscope",874.7,568.56,78.57,897.65,19
CDM,32604_1,Biopsy of heart sac using an endoscope,1438.5,935.03,78.57,1392.0,19
CDM,32606_1,Biopsy of tissue of chest using an endoscope,1317.8,856.57,78.57,1343.2,19
CDM,32607_1,Biopsy of fluid collection of lung using an endoscope,705.0,458.25,78.57,896.63,19
CDM,32608_1,Biopsy of growth of lung using an endoscope,865.0,562.25,78.57,1100.85,19
CDM,32609_1,Biopsy of lung lining using an endoscope,595.0,386.75,78.57,754.28,19
CDM,32650_1,Adhesion of linings of lung using an endoscope,1882.7,1223.76,78.57,1946.95,19
CDM,32651_1,Partial removal of chest cavity lining and lung lining using an endoscope,3056.6,1986.79,78.57,3194.58,19
CDM,32652_1,Removal of chest cavity lining and lung lining using an endoscope,4652.6,3024.19,78.57,4845.96,19
CDM,32653_1,Removal of foreign body in lining of chest cavity using an endoscope,2958.9,1923.29,78.57,3097.3,19
CDM,32654_1,Control of traumatic bleeding in chest using an endoscope,2670.0,1735.5,78.57,3407.02,19
CDM,32655_1,Removal of air sac of lung using an endoscope,2861.3,1859.85,78.57,2788.21,19
CDM,32656_1,Removal of lining of lung using an endoscope,2255.4,1466.01,78.57,2337.23,19
CDM,32658_1,Removal of blood clot or foreign body in heart sac using an endoscope,1640.08,1066.05,78.57,2079.13,19
CDM,32659_1,Creation of opening or partial removal of heart sac using an endoscope,2055.9,1336.34,78.57,2135.82,19
CDM,32661_1,Removal of cyst or growth of heart sac using an endoscope,1883.6,1224.34,78.57,2321.9,19
CDM,32662_1,Removal of cyst or growth of chest cavity using an endoscope,2530.5,1644.83,78.57,2604.6,19
CDM,32663_1,Exam of lung with removal of lung lobe using an endoscope,3963.8,2576.47,78.57,4082.15,19
CDM,32664_1,Removal of nerves to chest cavity using an endoscope,2377.2,1545.18,78.57,2470.55,19
CDM,32665_1,Repair of esophagus using an endoscope,1013.3,658.65,78.57,3581.22,19
CDM,32666_1,Initial removal of wedge of lung tissue using an endoscope,2653.5,1724.78,78.57,2539.58,19
CDM,32667_1,"Removal of wedge of tissue of lung using an endoscope, each additional removal",360.0,234.0,78.57,454.54,19
CDM,32668_1,Biopsy of wedge of lung tissue followed by partial removal of lung,360.0,234.0,78.57,454.8,19
CDM,32669_1,Removal of segment of lung tissue using an endoscope,3100.0,2015.0,78.57,3917.22,19
CDM,32670_1,Removal of 2 lobes of lung using an endoscope,3670.0,2385.5,78.57,4678.23,19
CDM,32671_1,Removal of lung using an endoscope,2972.6,1932.19,78.57,5162.47,19
CDM,32672_1,Partial removal of lung to reduce lung volume using an endoscope,3485.0,2265.25,78.57,4430.72,19
CDM,32673_1,Removal of thymus gland using an endoscope,2775.0,1803.75,78.57,3542.15,19
CDM,32674_1,Removal of lymph nodes of chest cavity using an endoscope,438.0,284.7,78.57,623.08,19
CDM,326IP _1,UNCLASSIFIED DRUGS,11.63,7.56,2.91,30.03,16
CDM,326OP _1,UNCLASSIFIED DRUGS,13.05,8.48,3.26,33.7,16
CDM,32700IP _1,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",4701.3,3055.85,7.16,12141.11,19
CDM,32700OP _1,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",5788.41,3762.47,7.16,14948.57,19
CDM,32701_1,Delineation of thoracic targets for radiation therapy,689.9,448.44,78.57,629.32,19
CDM,32767IP _1,"INJECTION, FULVESTRANT, 25 MG",72.43,47.08,6.06,202.84,19
CDM,32767OP _1,"INJECTION, FULVESTRANT, 25 MG",100.53,65.34,6.06,259.62,19
CDM,32800_1,Repair of lung hernia through chest wall,2251.2,1463.28,78.57,2744.17,19
CDM,32810_1,Closure of chest wall after drainage of infected lung,2522.1,1639.37,78.57,2623.59,19
CDM,32815_1,Closure of abnormal drainage tract from chest cavity to lung airway,7732.2,5025.93,78.57,8174.37,19
CDM,32820_1,Reconstruction of chest wall after injury,3753.8,2439.97,78.57,3876.84,19
CDM,32850_1,Removal of lung from cadaver,3543.8,2303.47,73.6,1771.9,15
CDM,32851_1,Transplantation of lung,20874.0,13568.1,78.57,9522.4,19
CDM,32852_1,Transplantation of lung on heart-lung machine,22925.0,14901.25,78.57,10326.82,19
CDM,32853_1,Transplantation of 2 lungs,29568.0,19219.2,78.57,13311.58,19
CDM,32854_1,Transplantation of 2 lungs on heart-lung machine,31500.0,20475.0,78.57,14088.26,19
CDM,32855IP _1,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",32.09,20.86,8.02,82.87,17
CDM,32855_1,Preparation of donor lung,681.1,442.72,78.57,2671.31,15
CDM,32856_1,Preparation of 2 donor lungs,817.3,531.25,78.57,2925.72,15
CDM,32893OP _1,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",245.0,159.25,61.25,735.0,19
CDM,32900019_1,HC AQUAPHERESIS TREATMENT PER DAY,82.0,53.3,20.5,57.4,11
CDM,32900_1,Removal of ribs,3898.7,2534.16,78.57,4146.84,19
CDM,32905_1,Removal of infected area of chest cavity,3758.0,2442.7,78.57,3882.92,19
CDM,32906_1,Removal of infected area of chest cavity and closure of abnormal drainage tract,4649.4,3022.11,78.57,4802.58,19
CDM,3291IP _1,"INJECTION, FUROSEMIDE, 1 MG",348.08,226.25,0.02,898.92,17
CDM,3291OP _1,"INJECTION, FUROSEMIDE, 1 MG",11.68,7.59,0.02,30.16,17
CDM,3292IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.71,2.41,0.93,9.58,16
CDM,32931IP _1,"INJECTION, TREPROSTINIL, 1 MG",559.32,363.56,57.75,1444.44,19
CDM,32932IP _1,"INJECTION, TREPROSTINIL, 1 MG",361.87,235.22,57.75,934.53,19
CDM,32933IP _1,"INJECTION, TREPROSTINIL, 1 MG",2623.5,1705.28,57.75,6775.19,19
CDM,32940_1,Release of lining covering lung from chest wall,3591.0,2334.15,78.57,3589.42,19
CDM,3294IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
CDM,3294OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.85,19.4,7.46,77.09,16
CDM,3295IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.41,2.87,1.1,11.39,16
CDM,3295OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.28,11.88,4.57,47.21,16
CDM,32960_1,Injection of air into chest cavity to collapse lung,395.9,257.34,53.87,305.7,19
CDM,3296IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.18,2.72,1.05,10.79,16
CDM,3296OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.3,13.2,5.08,52.42,16
CDM,32994_1,Destruction of growth of lung using extreme cold,13615.0,8849.75,78.57,11874.52,19
CDM,32997_1,Irrigation and drainage of lung,889.4,578.11,78.57,1064.67,19
CDM,32998_1,Destruction of growth of lung using radiofrequency,7510.7,4881.96,41.68,7556.82,19
CDM,32_1,Hepatitis A vaccine adult dosage,140.76,91.49,30.97,363.51,19
CDM,33005IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.3,9.95,3.83,39.51,16
CDM,33005OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.95,8.42,3.24,33.44,16
CDM,33006IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.42,9.37,3.61,37.24,16
CDM,33006OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.32,6.71,2.58,26.65,16
CDM,33008IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",52.33,34.01,13.08,135.14,16
CDM,33009IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",61.43,39.93,15.36,158.64,16
CDM,33009OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.36,6.73,2.59,26.75,16
CDM,33010IP _1,"INJECTION, VORICONAZOLE, 10 MG",211.3,137.35,0.8,545.68,17
CDM,33010OP _1,"INJECTION, VORICONAZOLE, 10 MG",37.73,24.52,0.8,97.44,17
CDM,33016_1,Drainage of heart sac using imaging guidance,545.5,354.58,78.57,690.0,19
CDM,33017_1,Drainage of heart sac using tube and imaging guidance (6 years or older),567.0,368.55,78.57,723.25,19
CDM,33018_1,Drainage of heart sac using tube and imaging guidance (5 years or younger or any age with congenital heart defect),655.5,426.08,78.57,846.15,19
CDM,33019_1,Drainage of heart sac using tube and CT imaging guidance,528.0,343.2,78.57,655.21,19
CDM,33020_1,Removal of blood clot or foreign body in heart sac,2487.5,1616.88,78.57,2425.82,19
CDM,33025_1,Surgical removal of piece of sac covering heart for drainage,2274.3,1478.3,78.57,2253.45,19
CDM,33030_1,Removal of heart sac,3663.5,2381.28,78.57,5834.28,19
CDM,33031_1,Removal of heart sac on heart-lung machine,5145.0,3344.25,78.57,7205.63,19
CDM,33050_1,Removal of growth or cyst of from heart sac,2839.2,1845.48,78.57,2931.25,19
CDM,33083IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.13,3.98,1.53,15.83,16
CDM,33083OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.5,7.48,2.88,29.7,16
CDM,33109OP _1,UNCLASSIFIED DRUGS,470.61,305.9,117.65,1215.35,16
CDM,33120_1,Removal of growth of heart on heart-lung machine,4435.2,2882.88,78.57,6091.21,19
CDM,33130_1,Removal of growth on outside of heart,3962.7,2575.76,78.57,3995.9,19
CDM,33140_1,Laser treatment of heart muscle to improve blood flow,4486.7,2916.36,78.57,4542.81,19
CDM,33141_1,Laser treatment of heart muscle to improve blood flow during procedure,648.9,421.79,78.57,763.23,19
CDM,33202_1,Insertion of electrode to outer layer of heart,2185.1,1420.32,78.57,2257.36,19
CDM,33203_1,Insertion of electrode to outer layer of heart using an endoscope,1850.15,1202.6,78.57,2362.38,19
CDM,33206_1,Insertion of pacemaker and upper heart chamber electrode,1968.8,1279.72,78.57,1333.41,19
CDM,33207_1,Insertion of pacemaker and lower heart chamber electrode,2310.0,1501.5,78.57,1414.18,19
CDM,33208_1,Insertion of pacemaker and upper and lower heart chamber electrode,2336.3,1518.6,78.57,1533.8,19
CDM,33210_1,Insertion of temporary pacemaker lead in single heart chamber,840.0,546.0,78.57,477.88,19
CDM,33211_1,Insertion of temporary pacemaker lead in upper and lower heart chambers,540.8,351.52,78.57,499.37,19
CDM,33212_1,Insertion of pacemaker pulse generator with existing single lead,779.1,506.42,78.57,944.32,19
CDM,33213_1,Insertion of pacemaker pulse generator with existing dual leads,812.7,528.26,78.57,987.2,19
CDM,33214_1,Insertion of 2 chamber pacemaker system,2310.0,1501.5,78.57,1409.46,19
CDM,33215_1,Repositioning of pacemaker or defibrillator electrode,905.1,588.32,78.57,913.84,19
CDM,33216_1,Insertion of 1 electrode for permanent pacemaker or defibrillator,1365.0,887.25,78.57,1092.3,19
CDM,33217_1,Insertion of 2 electrodes for permanent pacemaker or defibrillator,1470.0,955.5,78.57,1076.67,19
CDM,33218_1,Repair of electrode for permanent pacemaker or defibrillator,1152.9,749.39,78.57,1142.07,19
CDM,33220_1,Repair of 2 electrodes for permanent pacemaker or defibrillator,1164.5,756.93,78.57,1118.55,19
CDM,33221_1,Insertion of pacemaker pulse generator with existing multiple leads,846.3,550.1,78.57,1059.55,19
CDM,33222_1,Relocation of pacemaker skin pocket,1050.0,682.5,78.57,996.84,19
CDM,33223_1,Relocation of defibrillator skin pocket,1228.5,798.53,78.57,1204.16,19
CDM,33224_1,Insertion of left lower heart electrode and attachment to pacemaker or defibrillator,1512.0,982.8,78.57,1513.41,19
CDM,33225_1,Insertion of left lower heart electrode for pacemaker or defibrillator,1218.0,791.7,78.57,1371.39,19
CDM,33226_1,Repositioning of left lower heart electrode,1890.0,1228.5,78.57,1448.7,19
CDM,33227IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.75,5.69,2.19,22.6,16
CDM,33227OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.38,12.6,4.85,50.05,16
CDM,33227_1,Removal and replacement of single lead permanent pacemaker,780.0,507.0,78.57,995.2,19
CDM,33228IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.99,11.69,4.5,46.46,16
CDM,33228OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.97,15.58,5.99,61.9,16
CDM,33228_1,Removal and replacement of dual lead permanent pacemaker,588.0,382.2,78.57,1040.49,19
CDM,33229IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.12,2.03,0.78,8.06,16
CDM,33229_1,Removal and replacement of multiple lead permanent pacemaker,815.0,529.75,78.57,1102.12,19
CDM,33230IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.18,0.77,0.3,3.05,16
CDM,33230OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.95,1.27,0.49,5.04,16
CDM,33230_1,Insertion of defibrillator with existing dual leads,915.6,595.14,78.57,1125.25,19
CDM,33231_1,Insertion of defibrillator with existing multiple leads,950.3,617.7,78.57,1180.97,19
CDM,33233_1,Removal of permanent pacemaker pulse generator,813.8,528.97,78.57,679.31,19
CDM,33234_1,Removal of single electrode from right heart,1439.6,935.74,78.57,1429.02,19
CDM,33235_1,Removal of dual electrodes from right heart,1858.5,1208.03,78.57,1876.96,19
CDM,33236_1,"Removal of permanent pacemaker and electrodes, single lead",2940.0,1911.0,78.57,2281.24,19
CDM,33237_1,"Removal of permanent pacemaker and electrodes, dual lead",3097.5,2013.38,78.57,2453.82,19
CDM,33238_1,Removal of permanent pacemaker venous electrodes,2648.1,1721.27,78.57,2755.31,19
CDM,33240_1,Insertion of defibrillator with existing single lead,1010.1,656.57,78.57,1075.1,19
CDM,33241_1,Removal of defibrillator,671.0,436.15,78.57,705.98,19
CDM,33243_1,Removal of defibrillator electrodes through incision,3871.4,2516.41,78.57,4009.45,19
CDM,33244_1,Removal of defibrillator electrodes through vein,2529.5,1644.18,78.57,2539.85,19
CDM,33249_1,Insertion of implantable defibrillator system,3885.0,2525.25,78.57,2699.11,19
CDM,33250_1,Destruction of abnormal heart beat pathway,4175.9,2714.34,78.57,4254.46,19
CDM,33251_1,Destruction of abnormal heart beat pathway on heart-lung machine,4693.5,3050.78,78.57,4744.17,19
CDM,33254_1,Partial destruction and reconstruction of upper heart chamber,3897.6,2533.44,78.57,3964.39,19
CDM,33255_1,Extensive destruction and reconstruction of upper heart chamber,4690.4,3048.76,78.57,4750.02,19
CDM,33256_1,Extensive destruction and reconstruction of upper heart chamber on heart-lung machine,5571.3,3621.35,78.57,5625.29,19
CDM,33257_1,Partial destruction and reconstruction of right upper heart chamber,1665.3,1082.45,78.57,1704.06,19
CDM,33258_1,Extensive destruction and reconstruction of right upper heart chamber,1874.3,1218.3,78.57,1904.26,19
CDM,33259_1,Extensive destruction and reconstruction of right upper heart chamber on heart-lung machine,2417.1,1571.12,78.57,2473.74,19
CDM,33261_1,Destruction of tissue and reconstruction of right lower heart chamber on heart-lung machine,4626.3,3007.1,78.57,4706.36,19
CDM,33262_1,Removal and replacement of single lead defibrillator,860.0,559.0,78.57,1097.1,19
CDM,33263_1,Removal and replacement of dual lead defibrillator,760.0,494.0,78.57,1142.77,19
CDM,33264_1,Removal and replacement of multiple lead defibrillator,846.0,549.9,78.57,1191.88,19
CDM,33265_1,Limited reconstruction of upper heart chamber and alteration of electrical pathway using an endoscope,3156.5,2051.73,78.57,3977.68,19
CDM,33266_1,Extensive reconstruction of upper heart chamber and alteration of electrical pathway using an endoscope,4368.0,2839.2,78.57,5369.51,19
CDM,33267_1,Exclusion of appendage of left upper chamber of heart,2249.0,1461.85,78.57,3066.7,19
CDM,33268_1,Exclusion of appendage of left upper chamber of heart performed during other procedure on chest,280.0,182.0,78.57,381.79,19
CDM,33269_1,Exclusion of appendage of left upper chamber of heart using an endoscope,1780.0,1157.0,78.57,2427.06,19
CDM,33270_1,Insertion or replacement of defibrillator with electrode,1473.2,957.58,78.57,1668.58,19
CDM,33271_1,Insertion of defibrillator electrode,1188.6,772.59,78.57,1335.67,19
CDM,33272_1,Removal of defibrillator electrode,948.2,616.33,78.57,1020.68,19
CDM,33273_1,Repositioning of defibrillator electrode,958.7,623.16,78.57,1179.33,19
CDM,33274_1,Insertion of permanent leadless pacemaker using imaging guidance,1132.0,735.8,78.57,1426.53,19
CDM,33275_1,Removal of permanent leadless pacemaker using imaging guidance,2000.0,1300.0,78.57,2060.0,19
CDM,33285_1,Insertion of heart rhythm monitor under skin,205.0,133.25,67.26,10416.9,19
CDM,33286_1,Removal of heart rhythm monitor from under the skin,202.0,131.3,66.26,307.12,19
CDM,33289_1,Insertion of wireless pressure sensor into lung artery through tube with review by radiologist,760.0,494.0,78.57,966.57,19
CDM,33300_1,Repair of wound to heart,6836.6,4443.79,78.57,7110.64,19
CDM,33305_1,Repair of wound to heart on heart-lung machine,11484.9,7465.19,78.57,11876.97,19
CDM,33310_1,Incision and exploration of heart,3341.1,2171.72,78.57,3424.07,19
CDM,33315_1,Incision or exploration of heart on heart-lung machine,5407.5,3514.88,78.57,5587.16,19
CDM,33320_1,Repair of aorta or great vessels with sutures,3016.7,1960.86,78.57,3091.11,19
CDM,33321_1,Repair of aorta or great vessels with sutures using a shunt bypass,2751.45,1788.44,78.57,3466.69,19
CDM,33322_1,Repair of aorta or great vessels with sutures on heart-lung machine,4935.0,3207.75,78.57,4057.36,19
CDM,33330_1,Repair of aorta or great vessels with graft,4935.0,3207.75,78.57,4163.67,19
CDM,33335_1,Repair of aorta or great vessels with graft on heart-lung machine,6195.0,4026.75,78.57,5451.9,19
CDM,33340_1,Repair of left upper heart chamber with implant with review by radiologist,1850.85,1203.05,78.57,2304.12,19
CDM,33361_1,Replacement of aortic valve through the skin and femoral artery,4237.8,2754.57,78.57,3525.71,19
CDM,33362_1,Replacement of aortic valve by through femoral artery,4636.8,3013.92,78.57,3841.0,19
CDM,33363_1,Replacement of aortic valve through axillary artery,4800.6,3120.39,78.57,3981.54,19
CDM,33364_1,Replacement of aortic valve through iliac artery,5108.3,3320.4,78.57,3974.16,19
CDM,33365_1,Replacement of aortic valve by tube through aorta,5564.0,3616.6,78.57,4158.12,19
CDM,33366_1,Replacement of aortic valve by tube through heart,6002.9,3901.89,78.57,4580.42,19
CDM,33367_1,Insertion of tube in peripheral blood vessel accessed through skin for heart-lung machine support,1953.0,1269.45,78.57,1775.91,19
CDM,33368_1,Insertion of tube in peripheral blood vessel for heart-lung machine support,2365.7,1537.71,78.57,2152.12,19
CDM,33369_1,Insertion of tube in central blood vessel for heart-lung machine support,3123.8,2030.47,78.57,2839.99,19
CDM,33370_1,Placement and subsequent removal of device to protect brain from embolism through catheter using imaging guidance,289.0,187.85,78.57,393.41,19
CDM,33390_1,Simple repair of aortic valve on heart-lung machine,4428.4,2878.46,78.57,5617.32,19
CDM,33391_1,Complex repair of aortic valve on heart-lung machine,5247.75,3411.04,78.57,6675.04,19
CDM,33404_1,Creation of blood flow from left lower heart chamber to aorta,7140.0,4641.0,78.57,5105.55,19
CDM,33405_1,Replacement of aortic valve on heart-lung machine,6573.0,4272.45,78.57,6612.98,19
CDM,33406_1,Replacement of aortic valve using human donor valve on heart-lung machine,8275.1,5378.82,78.57,8364.63,19
CDM,33410_1,Replacement of aortic valve using tissue valve on heart-lung machine,7340.6,4771.39,78.57,7391.88,19
CDM,33411_1,Replacement of aortic valve with aorta enlargement,9409.1,6115.92,78.57,9757.27,19
CDM,33412_1,Replacement of aortic valve with enlargement at base of valve,7140.0,4641.0,78.57,9157.36,19
CDM,33413_1,Repair and enlargement of blood outflow tract to great vessels from left or right lower heart chamber,9150.8,5948.02,78.57,9385.67,19
CDM,33414_1,Repair and enlargement of blood outflow tract of left lower heart chamber,6982.5,4538.63,78.57,6241.84,19
CDM,33415_1,Incision or removal of tissue below aortic valve,5868.5,3814.53,78.57,5904.09,19
CDM,33416_1,Removal of thickened heart muscle at left lower heart chamber,6405.0,4163.25,78.57,5897.96,19
CDM,33417_1,Repair of aorta at heart,6405.0,4163.25,78.57,4866.32,19
CDM,33418_1,"Repair of mitral valve through the skin, initial prosthesis",4259.9,2768.94,78.57,5263.09,19
CDM,33419_1,"Repair of mitral valve through the skin, additional prosthesis",1172.9,762.39,78.57,1237.08,19
CDM,33420_1,Removal of mitral valve scar tissue,4567.5,2968.88,78.57,4239.8,19
CDM,33422_1,Removal of mitral valve scar tissue on heart-lung machine,6273.8,4077.97,78.57,4860.13,19
CDM,33425_1,Repair of mitral valve on heart-lung machine,7749.0,5036.85,78.57,7950.53,19
CDM,33426_1,Repair of mitral valve with artificial valve on heart-lung machine,6876.5,4469.73,78.57,6938.24,19
CDM,33427_1,Radical reconstruction of mitral valve on heart-lung machine,7044.5,4578.93,78.57,7118.94,19
CDM,33430_1,Replacement of mitral valve on heart-lung machine,8081.9,5253.24,78.57,8161.16,19
CDM,33440_1,Replacement of aortic and pulmonary valves and enlargement of outflow tract from left lower heart chamber,7811.0,5077.15,78.57,9905.61,19
CDM,33460_1,Removal of tricuspid valve on heart-lung machine,6904.8,4488.12,78.57,6987.25,19
CDM,33463_1,Repair of tricuspid valve,8751.8,5688.67,78.57,9020.04,19
CDM,33464_1,Repair of tricuspid valve with ring insertion,6992.0,4544.8,78.57,7111.07,19
CDM,33465_1,Replacement of tricuspid valve on heart-lung machine,7845.6,5099.64,78.57,8018.39,19
CDM,33468_1,Repositioning of tricuspid valve,7691.3,4999.35,78.57,7116.57,19
CDM,33474_1,Incision of pulmonary valve on heart-lung machine,6405.0,4163.25,78.57,6342.26,19
CDM,33475_1,Replacement of pulmonary valve,6683.3,4344.15,78.57,6774.43,19
CDM,33476_1,Release of restrictive right ventricular muscle bands or valve leaflets,6273.8,4077.97,78.57,4415.51,19
CDM,33477_1,Insertion of pulmonary valve,3077.0,2000.05,78.57,3950.49,19
CDM,33478_1,Enlargement of blood outflow tract in right lower heart chamber,6851.3,4453.35,78.57,4587.95,19
CDM,33496_1,Repair of artificial heart valve on heart-lung machine,4810.1,3126.57,78.57,4863.39,19
CDM,33500_1,Repair of heart abnormal artery-vein or artery-heart connection on heart-lung machine,6090.0,3958.5,78.57,4559.84,19
CDM,33501_1,Repair of heart abnormal artery-vein or artery-heart connection,3195.2,2076.88,78.57,3267.71,19
CDM,33502_1,Repair of abnormal heart artery,3087.0,2006.55,78.57,3719.2,19
CDM,33503_1,Repair of abnormal heart artery with graft,3061.1,1989.72,78.57,3877.67,19
CDM,33504_1,Repair of abnormal heart artery with graft on heart-lung machine,6273.8,4077.97,78.57,4264.19,19
CDM,33505_1,Repair of abnormal heart artery with diversion of blood flow,4758.9,3093.29,78.57,5975.53,19
CDM,33506_1,Repair of abnormal heart artery with diversion of blood flow to aorta,5825.4,3786.51,78.57,5935.65,19
CDM,33507_1,Repair of abnormal heart artery at its aortic origin,4896.2,3182.53,78.57,5005.34,19
CDM,33508_1,Harvest of vein using an endoscope,47.3,30.75,12.35,78.57,19
CDM,33509_1,Harvest of artery from arm for heart bypass graft using an endoscope,368.0,239.2,78.57,502.37,19
CDM,33510015_1,"Exam of neurobehavioral status, first hour",550.0,357.5,137.5,1420.38,19
CDM,33510020_1,"Exam of neurobehavioral status, first hour",550.0,357.5,137.5,1420.38,19
CDM,33510110_1,"Family psychotherapy without patient, 50 minutes",290.0,188.5,147.9,748.93,16
CDM,33510115_1,"Family psychotherapy without patient, 50 minutes",290.0,188.5,147.9,748.93,16
CDM,33510120_1,"Family psychotherapy without patient, 50 minutes",290.0,188.5,147.9,748.93,16
CDM,33510125_1,"Family psychotherapy with patient, 50 minutes",290.0,188.5,147.9,748.93,16
CDM,33510130_1,"Family psychotherapy with patient, 50 minutes",290.0,188.5,147.9,748.93,16
CDM,33510140_1,"Family psychotherapy with patient, 50 minutes",290.0,188.5,147.9,748.93,16
CDM,33510170_1,"Psychiatric evaluation of hospital records, reports, testing, or data for diagnosis",118.0,76.7,29.5,304.74,17
CDM,33510175_1,"Explanation of psychiatric, medical examinations, procedures, and data to responsible person",210.0,136.5,107.1,542.33,16
CDM,33510180_1,Preparation of report of patient's psychiatric status,568.0,369.2,142.0,1466.86,17
CDM,33510200_1,Developmental screening,34.26,22.27,8.57,866.51,19
CDM,33510_1,"Coronary artery bypass using vein graft, 1 graft",5600.7,3640.46,78.57,5639.47,19
CDM,33511_1,"Coronary artery bypass using vein graft, 2 grafts",6140.4,3991.26,78.57,6189.25,19
CDM,33512IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.0,3.25,1.25,12.91,16
CDM,33512OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.48,15.26,5.87,60.64,16
CDM,33512_1,"Coronary artery bypass using vein graft, 3 grafts",6982.5,4538.63,78.57,7058.61,19
CDM,33513IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.52,9.44,3.63,37.5,16
CDM,33513OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.75,19.99,7.69,79.41,16
CDM,33513_1,"Coronary artery bypass using vein graft, 4 grafts",7376.3,4794.6,78.57,7224.63,19
CDM,33514_1,"Coronary artery bypass using vein graft, 5 grafts",7848.8,5101.72,78.57,7603.66,19
CDM,33516_1,"Coronary artery bypass using vein graft, 6 or more grafts",7875.0,5118.75,78.57,7872.65,19
CDM,33517_1,"Coronary artery bypass using vein or artery graft, 1 graft",543.9,353.54,78.57,543.77,19
CDM,33518_1,"Coronary artery bypass using vein or artery graft, 2 grafts",1190.7,773.96,78.57,1192.09,19
CDM,33519_1,"Coronary artery bypass using vein or artery graft, 3 grafts",1581.3,1027.85,78.57,1577.16,19
CDM,33521_1,"Coronary artery bypass using vein or artery graft, 4 grafts",1899.5,1234.68,78.57,1891.24,19
CDM,33522_1,"Coronary artery bypass using vein or artery graft, 5 grafts",3071.3,1996.35,78.57,2123.15,19
CDM,33523_1,"Coronary artery bypass using vein or artery graft, 6 or more grafts",3570.0,2320.5,78.57,2402.95,19
CDM,33530_1,Coronary artery bypass or valve procedure reoperation more than 1 month after original operation,1516.2,985.53,78.57,1522.58,19
CDM,33533_1,"Coronary artery bypass using artery graft, 1 graft",5394.9,3506.69,78.57,5456.73,19
CDM,33534_1,"Coronary artery bypass using artery graft, 2 grafts",6351.5,4128.48,78.57,6403.53,19
CDM,33535_1,"Coronary artery bypass using artery graft, 3 grafts",7086.5,4606.23,78.57,7129.28,19
CDM,33536_1,"Coronary artery bypass using artery graft, 4 grafts",7661.9,4980.24,78.57,7681.51,19
CDM,33541IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.2,9.23,3.55,36.67,16
CDM,33541OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.81,17.43,6.7,69.24,16
CDM,33542_1,Partial removal of heart muscle,7491.8,4869.67,78.57,7626.08,19
CDM,33545_1,Repair of lower heart chamber following heart attack,8838.9,5745.29,78.57,8932.68,19
CDM,33548_1,Restoration and reshaping of left lower heart chamber,8552.3,5559.0,78.57,8650.2,19
CDM,33572_1,Removal of plaque from heart artery at time of coronary artery bypass,3045.0,1979.25,78.57,667.59,19
CDM,33590839_1,"Psychotherapy for crisis, first hour",327.0,212.55,81.75,844.48,19
CDM,33590840_1,"Psychotherapy for crisis, each additional 30 minutes",156.0,101.4,39.0,476.0,19
CDM,33591IP _1,"INJECTION, RASBURICASE, 0.5 MG",10032.76,6521.29,406.37,25909.6,19
CDM,33591OP _1,"INJECTION, RASBURICASE, 0.5 MG",2744.83,1784.14,406.37,7088.52,19
CDM,33596132_1,"Evaluation of neuropsychological test, first hour",580.0,377.0,145.0,1497.85,19
CDM,33600000_1,HC BIOCONTAINMENT UNIT ACTIVATION FEE,100000.0,65000.0,25000.0,70000.0,11
CDM,33600_1,Closure of mitral or tricuspid valve,4364.9,2837.19,78.57,5003.96,19
CDM,33602_1,Closure of aortic or pulmonary valve,2793.0,1815.45,78.57,4856.31,19
CDM,33606_1,Connection of pulmonary artery to aorta,5144.0,3343.6,78.57,5185.36,19
CDM,33608_1,Repair of congenital defect in right or left heart chamber,5145.0,3344.25,78.57,5250.5,19
CDM,33610_1,Repair of congenital defect in wall between lower heart chambers,4581.2,2977.78,78.57,5179.0,19
CDM,33611_1,Repair of double outlet defect of right lower heart chamber,5568.2,3619.33,78.57,5670.05,19
CDM,33612_1,Repair of double outlet defect and outflow tract of right lower heart chamber,3363.2,2186.08,78.57,5819.91,19
CDM,33615_1,Repair of congenital defect in wall between upper heart chambers and connection of atria to pulmonary artery (Simple Fontan procedure),4606.23,2994.05,78.57,5818.05,19
CDM,33617_1,Repair of complex congenital defect in wall between upper heart chambers and connection of atria to pulmonary artery (Modified Fontan procedure),8137.5,5289.38,78.57,6266.35,19
CDM,33619_1,Repair to improve congenital blood flow defect from lower heart chamber,7686.0,4995.9,78.57,7989.1,19
CDM,33620_1,Application of right and left pulmonary artery bands,3990.0,2593.5,78.57,4794.5,19
CDM,33621_1,Insertion of stent in defect between upper heart chambers,2148.93,1396.8,78.57,2713.75,19
CDM,33622_1,Reconstruction of complex cardiac defects,8406.08,5463.95,78.57,9951.29,19
CDM,33641_1,Repair of congenital defect between upper heart chambers on heart-lung machine,4697.7,3053.51,78.57,4768.91,19
CDM,33645_1,Repair of tissue between upper heart chambers,5407.5,3514.88,78.57,5038.33,19
CDM,33647_1,Repair of congenital defect in wall between both upper and lower heart chamber,7140.0,4641.0,78.57,5282.56,19
CDM,33660_1,Repair of partial congenital defect between both upper and lower heart chambers,6142.5,3992.63,78.57,5107.21,19
CDM,33665_1,Repair of intermediate congenital defect between both upper and lower heart chambers,6562.5,4265.63,78.57,5561.16,19
CDM,33669OP _1,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",2842.08,1847.35,181.03,8526.24,19
CDM,33670_1,Repair of complete congenital defect between both upper and lower heart chambers,7691.3,4999.35,78.57,5725.39,19
CDM,33675_1,Closure of multiple congenital defects between lower heart chambers,5669.0,3684.85,78.57,5728.46,19
CDM,33676_1,Closure of multiple congenital defects between lower heart chambers with valve tissue release,5826.5,3787.23,78.57,5879.61,19
CDM,33677_1,Closure of multiple congenital defects between lower heart chambers with removal of band,6056.4,3936.66,78.57,6105.58,19
CDM,33681_1,Closure of congenital defect between lower heart chambers,6011.3,3907.35,78.57,5366.6,19
CDM,33684_1,Closure of congenital defect between lower heart chambers with valve tissue release,5482.1,3563.37,78.57,5488.66,19
CDM,33688_1,Closure of congenital defect between lower heart chambers with removal of band,6562.5,4265.63,78.57,5470.14,19
CDM,33690_1,Banding of pulmonary artery,3376.8,2194.92,78.57,3509.18,19
CDM,33692_1,Repair and correction of 4 congenital heart defects,6273.8,4077.97,78.57,5680.69,19
CDM,33694_1,Repair and correction of 4 congenital heart defects with patch,6982.5,4538.63,78.57,5670.05,19
CDM,33697_1,Repair and correction of 4 congenital heart defects including closure between lower heart chambers,6055.4,3936.01,78.57,5971.07,19
CDM,33702_1,Repair to improve blood flow to lung or heart on heart-lung machine,5696.3,3702.6,78.57,4496.83,19
CDM,33710_1,Repair of opening in wall between lower heart chambers on heart-lung machine,4735.88,3078.32,78.57,5960.94,19
CDM,33720_1,Repair of aneurysm above heart valve to lung on heart-lung machine,4368.0,2839.2,78.57,4515.85,19
CDM,33724_1,Repair of abnormal pulmonary vein return to left upper heart chamber,4413.2,2868.58,78.57,4476.0,19
CDM,33726_1,Repair of pulmonary vein narrowing,5803.4,3772.21,78.57,5905.11,19
CDM,33730_1,Complete repair of abnormal pulmonary vein return to left upper heart chamber,6693.8,4350.97,78.57,5808.53,19
CDM,33732_1,Removal of membrane of left upper heart chamber,4272.5,2777.13,78.57,4730.61,19
CDM,33735_1,Enlargement of hole in wall between upper heart chambers using balloon,4278.8,2781.22,78.57,3789.21,19
CDM,33736_1,Enlargement of hole in wall between upper heart chambers on heart-lung machine,3992.1,2594.87,78.57,4069.24,19
CDM,33741_1,"Incision of partition between upper chambers of heart to allow blood flow for congenital heart defects, via catheter using imaging guidance",1681.0,1092.65,78.57,2194.16,19
CDM,33745_1,"Creation of shunt for blood flow within heart for congenital heart defects, via catheter using imaging guidance",2397.0,1558.05,78.57,3134.13,19
CDM,33746_1,"Creation of additional shunt for blood flow within heart for congenital heart defects, via catheter using imaging guidance",951.5,618.48,78.57,1253.42,19
CDM,33750_1,Insertion of shunt from chest to pulmonary artery,3865.1,2512.32,78.57,3688.75,19
CDM,33755_1,Insertion of shunt from ascending aorta to pulmonary artery,3990.0,2593.5,78.57,3850.14,19
CDM,33762_1,Insertion of shunt from descending aorta to pulmonary artery,3640.4,2366.26,78.57,3744.82,19
CDM,33764_1,Insertion of shunt with artificial graft from aorta to pulmonary artery,4278.8,2781.22,78.57,3850.14,19
CDM,33766_1,"Insertion of shunt from vena cava to pulmonary artery to improve blood flow, 1 lung",3896.6,2532.79,78.57,3890.98,19
CDM,33767_1,"Insertion of shunt from vena cava to pulmonary artery to improve blood flow, both lungs",4462.5,2900.63,78.57,4152.42,19
CDM,33768_1,Removal of congenital extra vena cava,1211.7,787.61,78.57,1204.58,19
CDM,33770_1,Repair of group of congenital heart defects with reversal of blood flow,5174.58,3363.48,78.57,6145.76,19
CDM,33771_1,Repair of group of congenital heart defects with reversal of blood flow and enlargement of hole in wall between lower heart chambers,5334.8,3467.62,78.57,6318.03,19
CDM,33774_1,Repair of group of congenital heart defects with reversal of blood flow on heart-lung machine,7140.0,4641.0,78.57,5250.96,19
CDM,33775_1,Repair of group of congenital heart defects with reversal of blood flow and band removal on heart-lung machine,8268.8,5374.72,78.57,5405.19,19
CDM,33776_1,Repair of group of congenital heart defects with reversal of blood flow and closure of hole in wall between lower heart chambers on heart-lung machine,8557.5,5562.38,78.57,5659.13,19
CDM,33777_1,Repair of group of congenital heart defects and obstruction with reversal of blood flow on heart-lung machine,8505.0,5528.25,78.57,5510.18,19
CDM,33778_1,Repair of group of congenital heart defects with redirection of blood flow,8557.5,5562.38,78.57,6836.68,19
CDM,33779_1,Repair of group of congenital heart defects with redirection of blood flow and band removal,8846.3,5750.1,78.57,6746.66,19
CDM,33780_1,Repair of a group of congenital heart defects with redirection of blood flow and closure of hole in wall between lower heart chambers,9870.0,6415.5,78.57,6838.51,19
CDM,33781_1,Repair of a group of congenital heart defects and obstruction with redirection of blood flow,9450.0,6142.5,78.57,6706.95,19
CDM,33782_1,Relocation of aorta and repair of wall between lower heart chambers,8589.0,5582.85,78.57,9362.1,19
CDM,33783_1,Relocation of aorta and repair of wall between lower heart chambers with reimplantation,9305.1,6048.32,78.57,10113.96,19
CDM,33786_1,Total repair of group of congenital heart defects with redirection of blood flow,7796.3,5067.6,78.57,6618.96,19
CDM,33788_1,Reimplantation of abnormal pulmonary artery to heart,4698.8,3054.22,78.57,4471.12,19
CDM,33800_1,Suture of aorta to chest bone,2513.7,1633.91,78.57,2874.44,19
CDM,33802_1,Division of extra arch of aorta,3150.0,2047.5,78.57,3172.02,19
CDM,33803_1,Division and reconnection of extra arch of aorta,2653.75,1724.94,78.57,3364.26,19
CDM,33814_1,Repair of defect of wall between aorta and pulmonary artery on heart-lung machine,6300.0,4095.0,78.57,4452.35,19
CDM,33820_1,Tying of congenital heart defect from pulmonary artery to aorta,2835.0,1842.75,78.57,2820.88,19
CDM,33822_1,"Repair of congenital heart defect from pulmonary artery to aorta, younger than 18 years",3412.5,2218.13,78.57,2981.38,19
CDM,33824_1,"Repair of congenital heart defect from pulmonary artery to aorta, 18 years or older",3990.0,2593.5,78.57,3449.4,19
CDM,33840_1,Repair of congenital narrowed aorta,3990.0,2593.5,78.57,3623.27,19
CDM,33845_1,Repair of congenital narrowed aorta with graft,5696.3,3702.6,78.57,3873.25,19
CDM,33851_1,Repair of congenital narrowed aorta using left chest artery or artificial material,6273.8,4077.97,78.57,3720.47,19
CDM,33852_1,Repair of abnormal aortic arch,5276.3,3429.6,78.57,4017.68,19
CDM,33853_1,Repair of abnormal aortic arch on heart-lung machine,5455.8,3546.27,78.57,5310.12,19
CDM,33858_1,Repair of ascending aorta with graft on heart-lung machine with valve suspension for aortic wall separation,7776.5,5054.73,78.57,9815.36,19
CDM,33859_1,Repair of ascending aorta with graft on heart-lung machine with valve suspension for aortic disease,5587.25,3631.71,78.57,7055.11,19
CDM,33863_1,Repair of ascending aorta with graft on heart-lung machine with aortic root replacement and heart reconstruction,8882.0,5773.3,78.57,9142.7,19
CDM,33864_1,Repair of ascending aorta with graft on heart-lung machine with aortic root remodeling and heart reconstruction,9126.6,5932.29,78.57,9349.56,19
CDM,33866_1,Repair of aortic arch with graft,2390.0,1553.5,78.57,2671.09,19
CDM,33871_1,Repair of aortic arch with graft on heart-lung machine,7468.75,4854.69,78.57,9463.46,19
CDM,33875_1,Repair of descending aorta with graft,5627.0,3657.55,78.57,7914.06,19
CDM,33877_1,Repair of aortic aneurysm with graft,10207.1,6634.62,78.57,10457.3,19
CDM,33880_1,Repair of descending aorta and subclavian artery with insertion of graft and extensions,4733.4,3076.71,78.57,5184.93,19
CDM,33881_1,Repair of descending aorta with insertion of graft and extensions,4065.6,2642.64,78.57,4446.5,19
CDM,33882_1,ENDOVASCULAR REPAIR OF THE THORACIC AORTA BY DEPLOYMENT OF A BRANCHED ENDOGRAFT MULTIPIECE SYSTEM INVOLVING AN AORTO-AORTIC TUBE DEVICE WITH A FENESTRATION FOR THE LEFT SUBCLAVIAN ARTERY STENT GRAFT(S,3946.0,2564.9,73.6,4064.38,16
CDM,33883_1,"Repair of descending aorta, initial extension",2986.2,1941.03,78.57,3229.86,19
CDM,33884_1,"Repair of descending aorta, initial extension",1115.1,724.82,78.57,3229.86,19
CDM,33886_1,Insertion of extension after previous repair of descending aorta,2573.6,1672.84,78.57,2788.23,19
CDM,33889_1,Relocation and/or reimplantation of chest artery to neck artery,2204.0,1432.6,78.57,2844.85,19
CDM,33891_1,"BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID-CONTRALATERAL CAROTID",2811.9,1827.74,73.6,2896.26,16
CDM,33894_1,Repair of aorta by insertion of stent across major side branches,2108.0,1370.2,78.57,2874.71,19
CDM,33895_1,Repair of aorta by insertion of stent not crossing major side branches,1677.0,1090.05,78.57,2287.16,19
CDM,33897_1,Balloon dilation of native or recurrent narrowing of heart blood vessel,1248.0,811.2,78.57,1701.15,19
CDM,33900_1,"Placement of stent in pulmonary artery with normal anatomical connections, on one side of body",1255.0,815.75,78.57,1709.74,19
CDM,33901_1,"Placement of stent in pulmonary arteries with normal anatomical connections, on both sides of body",1649.5,1072.18,78.57,2247.64,19
CDM,33902_1,"Placement of stent in pulmonary artery with abnormal anatomical connections, on one side of body",1593.0,1035.45,78.57,2170.41,19
CDM,33903_1,"Placement of stent in pulmonary arteries with abnormal anatomical connections, on both sides of body",1877.5,1220.38,78.57,2558.36,19
CDM,33904_1,Placement of additional stent in pulmonary artery,697.0,453.05,78.57,858.07,19
CDM,33910_1,Removal of blood clot in pulmonary artery on heart-lung machine,5145.0,3344.25,78.57,7654.07,19
CDM,33915_1,Removal of blood clot in pulmonary artery,4110.8,2672.02,78.57,4021.46,19
CDM,33916_1,Removal of plaque from pulmonary artery on heart-lung machine,9754.2,6340.23,78.57,12134.94,19
CDM,33917_1,Repair of pulmonary artery narrowing with graft,4204.2,2732.73,78.57,4254.46,19
CDM,33920_1,Repair of right lower heart chamber obstruction with creation of channel from lower heart chamber to pulmonary artery,5131.4,3335.41,78.57,5271.71,19
CDM,33922_1,Incision of pulmonary artery on heart-lung machine,4095.0,2661.75,78.57,4047.21,19
CDM,33924_1,Disconnection of pulmonary artery shunt,814.8,529.62,78.57,825.8,19
CDM,33925_1,Repair of defect of pulmonary artery,4570.7,2970.96,78.57,4990.46,19
CDM,33926_1,Repair of defect of pulmonary artery on heart-lung machine,6834.5,4442.43,78.57,7011.64,19
CDM,33927_1,Implantation of artificial heart,5420.0,3523.0,78.57,7377.11,19
CDM,33930_1,Harvest of donor heart and lung,4410.0,2866.5,73.6,2205.0,15
CDM,33933_1,Preparation of donor heart and lung for transplantation,645.43,419.53,78.57,3307.33,15
CDM,33935_1,Transplantation of donor heart and lung,32123.0,20879.95,78.57,14351.91,19
CDM,33937IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.65,6.92,2.66,27.5,16
CDM,33937OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.67,19.29,7.42,76.62,16
CDM,33940_1,Removal of donor heart for transplantation,2625.0,1706.25,73.6,1335.65,15
CDM,33944_1,Preparation of donor heart for transplantation,4725.0,3071.25,78.57,2362.5,15
CDM,33945_1,Transplantation of donor heart,31325.0,20361.25,78.57,14139.0,19
CDM,33946_1,Initiation of ECMO external vein to vein blood circulation in heart and lungs using a pump,766.5,498.23,78.57,911.22,19
CDM,33947_1,Initiation of ECMO external vein to artery blood circulation in heart and lungs using a pump,842.1,547.37,78.57,1005.35,19
CDM,33948_1,Daily management of ECMO external vein to vein blood circulation in heart and lungs using a pump,599.6,389.74,78.57,716.44,19
CDM,33949_1,Daily management of ECMO external vein to artery blood circulation in heart and lungs using a pump,583.8,379.47,78.57,693.2,19
CDM,33951_1,Insertion of tube through the skin for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),1015.4,660.01,78.57,1229.33,19
CDM,33952_1,Insertion of tube through the skin for ECMO external blood circulation in heart and lungs using a pump (6 years or older),990.2,643.63,78.57,1249.52,19
CDM,33953_1,Insertion of tube for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),1133.0,736.45,78.57,1373.03,19
CDM,33954_1,Insertion of tube for ECMO external blood circulation in heart and lungs using a pump (6 years or older),1105.7,718.71,78.57,1386.02,19
CDM,33955_1,Insertion of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),2158.8,1403.22,78.57,2401.61,19
CDM,33956_1,Insertion of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (6 years or older),2038.1,1324.77,78.57,2422.12,19
CDM,33957_1,Repositioning of tube for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),577.5,375.38,78.57,535.66,19
CDM,33958_1,Repositioning of tube for ECMO external blood circulation in heart and lungs using a pump (6 years or older),560.7,364.46,78.57,535.66,19
CDM,33959_1,Repositioning of tube open procedure for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),700.4,455.26,78.57,679.34,19
CDM,33962_1,Repositioning of tube open procedure for ECMO external blood circulation in heart and lungs using a pump (6 years or older),660.5,429.33,78.57,679.34,19
CDM,33963IP _1,METAXALONE 800 MG TABLET,87.75,57.04,21.94,61.43,11
CDM,33963_1,Repositioning of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),1272.6,827.19,78.57,1356.0,19
CDM,33964_1,Repositioning of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (6 years or older),1293.6,840.84,78.57,1430.77,19
CDM,33965_1,Removal of tube through skin for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),569.1,369.92,78.57,535.66,19
CDM,33966_1,Removal of tube through skin for ECMO external blood circulation in heart and lungs using a pump (6 years or older),655.2,425.88,78.57,690.79,19
CDM,33967_1,Insertion of blood flow assist device in aorta through skin,788.6,512.59,78.57,755.59,19
CDM,33968_1,Removal of blood flow assist device in aorta,100.8,65.52,26.48,190.81,19
CDM,33969_1,Removal of tube for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),757.1,492.12,78.57,790.65,19
CDM,33970_1,Insertion of blood flow assist device in aorta through upper leg artery,1706.3,1109.1,78.57,1031.86,19
CDM,33971_1,Removal of blood flow assist device in aorta with repair of upper leg artery,2126.3,1382.1,78.57,2075.36,19
CDM,33973_1,Insertion of blood flow assist device in aorta through ascending aorta,1523.6,990.34,78.57,1456.87,19
CDM,33974_1,Removal of blood flow assist device in aorta with repair of ascending aorta,2066.78,1343.41,78.57,2609.54,19
CDM,33975_1,Insertion of external blood flow assist device in lower heart chamber,3753.8,2439.97,78.57,3779.11,19
CDM,33976_1,Insertion of external blood flow assist device in both lower heart chambers,4777.5,3105.38,78.57,4596.28,19
CDM,33977_1,Removal of external blood flow assist device in lower heart chamber,3440.9,2236.59,78.57,3263.15,19
CDM,33978_1,Removal of external blood flow assist device in both lower heart chambers,3808.4,2475.46,78.57,3865.21,19
CDM,33979_1,Insertion of implanted blood flow assist device in lower heart chamber,6880.7,4472.46,78.57,5633.26,19
CDM,33980_1,Removal of implanted blood flow assist device in lower heart chamber,10150.4,6597.76,78.57,5162.24,19
CDM,33981_1,Replacement of external blood flow assist device in lower heart chamber,2441.3,1586.85,78.57,2407.73,19
CDM,33982_1,Replacement of implanted blood flow assist device in lower heart chamber,6636.0,4313.4,78.57,5658.95,19
CDM,33983_1,Replacement of implanted blood flow assist device in lower heart chamber on heart-lung machine,6636.0,4313.4,78.57,6684.01,19
CDM,33984_1,Removal of tube for ECMO external blood circulation in heart and lungs using a pump (6 years or older),741.3,481.85,78.57,822.36,19
CDM,33985_1,Removal of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),1416.5,920.73,78.57,1489.32,19
CDM,33986_1,Removal of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (6 years or older),1344.0,873.6,78.57,1519.07,19
CDM,33987_1,Incision of artery for creation of channel for ECMO external blood circulation in heart and lungs using a pump,551.3,358.35,78.57,604.81,19
CDM,33988_1,Insertion of left heart vent through chest for ECMO external blood circulation in heart and lungs using a pump,1851.2,1203.28,78.57,2252.79,19
CDM,33989_1,Removal of left heart vent through chest for ECMO external blood circulation in heart and lungs using a pump,1200.2,780.13,78.57,1430.77,19
CDM,33990_1,Insertion of blood flow assist device in lower heart chamber through skin with review by radiologist using artery access,1378.7,896.16,78.57,1054.83,19
CDM,33991_1,Insertion of blood flow assist device in lower heart chamber through skin with review by radiologist using artery and vein access,2008.7,1305.66,78.57,1382.8,19
CDM,33992_1,Removal of blood flow assist device in left lower heart chamber through the skin,655.2,425.88,78.57,549.59,19
CDM,33993_1,Repositioning of blood flow assist device in lower heart chamber using imaging guidance,575.4,374.01,78.57,488.3,19
CDM,33995_1,"Insertion of right lower heart chamber blood flow assist device via vein accessed through skin, including radiological supervision and interpretation",810.25,526.66,78.57,1063.84,19
CDM,33997_1,"Removal of right lower heart chamber blood flow assist device, accessed through skin",360.6,234.39,78.57,473.67,19
CDM,33_1,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",225.0,146.25,56.25,581.06,19
CDM,34001_1,Removal of blood clot in neck to chest artery,2841.3,1846.85,78.57,2632.16,19
CDM,34051_1,Removal of blood clot in chest artery,2824.5,1835.93,78.57,2902.49,19
CDM,34101_1,Removal of blood clot in artery of upper arm,1794.5,1166.43,78.57,1731.27,19
CDM,34111_1,Removal of blood clot in artery of lower arm,1794.5,1166.43,78.57,1741.38,19
CDM,34151_1,Removal of blood clot in artery of abdominal organs,4155.9,2701.34,78.57,4032.78,19
CDM,34153IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.55,22.46,8.64,89.23,16
CDM,34153OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.65,36.17,13.91,143.72,16
CDM,34201_1,Removal of blood clot in artery of groin and leg,4469.85,2905.4,78.57,2953.02,19
CDM,34203_1,Removal of blood clot in artery of lower leg,4290.3,2788.7,78.57,2741.39,19
CDM,3423IP _1,UNCLASSIFIED DRUGS,18.78,12.21,4.7,48.5,16
CDM,3424IP _1,UNCLASSIFIED DRUGS,8.98,5.84,2.25,23.19,16
CDM,3424OP _1,UNCLASSIFIED DRUGS,7.72,5.02,1.93,19.94,16
CDM,3426IP _1,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",397.08,258.1,2.3,1025.46,17
CDM,3426OP _1,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",25.92,16.85,2.3,66.94,17
CDM,3428OP _1,UNCLASSIFIED DRUGS,3.94,2.56,0.99,10.18,16
CDM,3430IP _1,UNCLASSIFIED DRUGS,1.27,0.83,0.32,3.28,16
CDM,34369IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.97,5.18,1.99,20.58,16
CDM,34369OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.16,5.3,2.04,21.07,16
CDM,34370IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.6,7.54,2.9,29.96,16
CDM,34370OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.3,14.5,5.58,57.59,16
CDM,34371IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.93,3.2,1.23,12.73,16
CDM,34372IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.93,3.85,1.48,15.31,16
CDM,34372OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.83,7.04,2.71,27.97,16
CDM,34401_1,Removal of blood clot in vena cava,4223.1,2745.02,78.57,4309.52,19
CDM,34418IP _1,UNCLASSIFIED DRUGS,8.01,5.21,2.0,20.69,16
CDM,34418OP _1,UNCLASSIFIED DRUGS,12.1,7.87,3.03,31.25,16
CDM,34421_1,"Removal of blood clot in vena cava, pelvic, or thigh vein",2179.8,1416.87,78.57,2003.26,19
CDM,34447OP _1,ATOMOXETINE HCL 40 MG CAPSULE,43.15,28.05,10.79,30.21,11
CDM,34448IP _1,STRATTERA 60 MG CAPSULE,92.95,60.42,23.24,65.07,11
CDM,34451_1,"Removal of blood clot in vena cava, pelvic, or thigh vein by abdominal and leg incision",4339.7,2820.81,78.57,4127.07,19
CDM,34471_1,Removal of blood clot in upper chest vein,3216.2,2090.53,78.57,3106.06,19
CDM,34490_1,Removal of blood clot in underarm or upper chest vein,1968.8,1279.72,78.57,1873.91,19
CDM,34501_1,Repair of upper leg vein valve,2697.5,1753.38,78.57,2578.18,19
CDM,34502_1,Reconstruction of vena cava,4908.8,3190.72,78.57,4517.79,19
CDM,34505IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.26,17.07,6.57,67.82,16
CDM,34505OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",49.8,32.37,12.45,128.61,16
CDM,34510_1,Transfer of vein valve to another vein,3189.9,2073.44,78.57,2940.53,19
CDM,34520_1,Removal of vein segment,2961.0,1924.65,78.57,2849.72,19
CDM,34530_1,Connection of leg veins at back of knee,2893.8,1880.97,78.57,2685.67,19
CDM,34544IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.84,18.1,6.96,71.9,16
CDM,34544OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.57,12.72,4.89,50.54,16
CDM,34550OP _1,"Diphtheria, tetanus, acellular pertussis, hepatitis B, and polio vaccine",325.1,211.32,30.97,839.57,19
CDM,34594IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",78.83,51.24,19.71,203.58,16
CDM,34595IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",42.95,27.92,10.74,110.92,16
CDM,34652IP _1,HUMIRA 40 MG/0.8 ML SYRINGE,22657.47,14727.36,5664.37,15860.23,11
CDM,34701_1,Repair of aorta with graft for other than rupture with review by radiologist,2655.0,1725.75,78.57,3594.79,19
CDM,34702_1,Repair of ruptured aorta with graft with review by radiologist,3970.0,2580.5,78.57,5337.37,19
CDM,34703_1,Repair of infrarenal aorta and groin artery with graft for other than rupture with review by radiologist,2970.0,1930.5,78.57,3975.05,19
CDM,34704_1,Repair of infrarenal aorta and groin artery with graft for rupture with review by radiologist,4950.0,3217.5,78.57,6579.38,19
CDM,34705_1,Repair of infrarenal aorta and groin artery with graft for other than rupture on both sides with review by radiologist,3290.0,2138.5,78.57,4417.48,19
CDM,34706_1,Repair of infrarenal aorta and groin artery with graft for rupture on both sides with review by radiologist,4950.0,3217.5,78.57,6576.97,19
CDM,34707_1,Repair of groin artery with graft for other than rupture with review by radiologist,2475.0,1608.75,78.57,3353.43,19
CDM,34708_1,Repair of groin artery with graft for rupture with review by radiologist,3985.0,2590.25,78.57,5353.12,19
CDM,34709_1,Repair of abdominal or groin artery with prosthesis with review by radiologist,695.0,451.75,78.57,929.77,19
CDM,34710_1,"Delayed insertion of prosthesis for repair of abdominal or groin artery with review by radiologist, initial vessel treated",1725.0,1121.25,78.57,2303.82,19
CDM,34711IP _1,"BUPRENORPHINE, ORAL, 1 MG",38.3,24.9,1.34,98.91,17
CDM,34711OP _1,"BUPRENORPHINE, ORAL, 1 MG",18.21,11.84,1.34,47.03,17
CDM,34711_1,"Delayed insertion of prosthesis for repair of abdominal or groin artery with review by radiologist, each additional vessel treated",640.0,416.0,78.57,849.5,19
CDM,34712IP _1,"BUPRENORPHINE, ORAL, 1 MG",52.1,33.87,1.34,134.55,17
CDM,34712OP _1,"BUPRENORPHINE, ORAL, 1 MG",13.2,8.58,1.34,34.09,17
CDM,34712_1,Delivery of fixation device to graft with review by radiologist,1490.0,968.5,78.57,1902.28,19
CDM,34713IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.61,18.6,7.15,73.89,16
CDM,34713_1,Exposure of groin artery for delivery of graft,280.0,182.0,78.57,355.55,19
CDM,34714IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.95,20.12,7.74,79.93,16
CDM,34714OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.0,1.3,0.5,5.17,16
CDM,34714_1,Exposure of major groin artery with creation of conduit,590.0,383.5,78.57,777.74,19
CDM,34715_1,Exposure of underarm or upper chest artery for delivery of prosthesis,660.0,429.0,78.57,860.97,19
CDM,34716_1,Exposure of underarm or upper chest artery with creation of conduit,815.0,529.75,78.57,1075.73,19
CDM,34717_1,Repair of groin artery with graft insert through artery and repair of aorta,1016.75,660.89,78.57,1281.69,19
CDM,34718_1,Repair of groin artery with graft insert through artery,2838.5,1845.03,78.57,3575.07,19
CDM,34808_1,Insertion of device to block groin artery,606.9,394.49,78.57,569.06,19
CDM,34812_1,Exposure of thigh artery for insertion of prosthesis,1023.8,665.47,78.57,593.58,19
CDM,34813_1,Insertion of graft in upper thigh artery,706.7,459.36,78.57,678.17,19
CDM,34820_1,Exposure of groin artery for insertion of prosthesis,1475.3,958.95,78.57,964.84,19
CDM,34830_1,Repair of aneurysm of aorta with prosthesis,5284.7,3435.06,78.57,5060.43,19
CDM,34831_1,Repair of aneurysm of aorta or groin artery with prosthesis,5679.5,3691.68,78.57,5540.32,19
CDM,34832_1,Repair of aneurysm of aorta or upper thigh artery with prothesis,6069.0,3944.85,78.57,5439.78,19
CDM,34833_1,Exposure of groin artery with creation of conduit,1799.7,1169.81,78.57,1124.5,19
CDM,34834_1,Exposure of arm artery for insertion of prosthesis,812.7,528.26,78.57,370.96,19
CDM,34839_1,Physician planning of a patient-specific graft for repair of aorta,1398.75,909.19,73.6,699.38,15
CDM,34841_1,"Repair of aorta in abdomen with graft, including graft in abdominal organ arteries with review by radiologist",5113.75,3323.94,78.57,4353.99,15
CDM,34842_1,"Repair of aorta in abdomen below kidneys with graft, including 2 grafts in abdominal organ arteries with review by radiologist",5574.5,3623.43,78.57,4765.79,15
CDM,34843_1,"Repair of aorta in abdomen below kidneys with graft, including 3 grafts in abdominal organ arteries with review by radiologist",5735.4,3728.01,78.57,5229.28,15
CDM,34844_1,"Repair of aorta in abdomen below kidneys with graft, including 4 or more grafts in abdominal organ arteries with review by radiologist",5735.4,3728.01,78.57,5786.72,15
CDM,34845_1,"Repair of aorta in abdomen between and below kidneys with graft, including graft in artery to abdominal organs with review by radiologist",5113.75,3323.94,78.57,5190.69,15
CDM,34846_1,"Repair of aorta in abdomen between and below kidneys with graft, including 2 grafts in abdominal organ arteries with review by radiologist",5126.16,3332.0,78.57,5709.77,15
CDM,34847_1,"Repair of aorta in abdomen between and below kidneys with graft, including 3 grafts in abdominal organ arteries with review by radiologist",5735.4,3728.01,78.57,6228.83,15
CDM,34848_1,"Repair of aorta in abdomen between and below kidneys with graft, including 4 or more grafts in abdominal organ arteries with review by radiologist",5858.2,3807.83,78.57,6747.88,15
CDM,34897IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.57,1.67,0.64,6.64,16
CDM,3492IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.87,11.62,4.47,46.15,16
CDM,3492OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.25,6.66,2.56,26.47,16
CDM,3493IP _1,UNCLASSIFIED DRUGS,1.52,0.99,0.38,3.93,16
CDM,3497IP _1,"INJECTION, GLYCOPYRROLATE, 0.1 MG",36.91,23.99,0.4,95.32,17
CDM,3497OP _1,"INJECTION, GLYCOPYRROLATE, 0.1 MG",40.08,26.05,0.4,103.51,17
CDM,34_1,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",200.0,130.0,50.0,516.5,19
CDM,35000001_1,RECOVERY ROOM - GENERAL CLASSIFICATION,336.0,218.4,84.0,235.2,11
CDM,35001_1,Repair of aneurysm or neck or upper chest artery with graft,3806.3,2474.1,78.57,3253.65,19
CDM,35002_1,Repair of ruptured aneurysm of neck or upper chest artery with graft,3806.3,2474.1,78.57,3275.69,19
CDM,35005_1,Repair of aneurysm or head artery with graft,2578.27,1675.88,78.57,2870.94,19
CDM,35011_1,Repair of aneurysm or arm artery with graft,2961.0,1924.65,78.57,2924.35,19
CDM,35013_1,Repair of ruptured aneurysm of arm artery with graft,3680.3,2392.2,78.57,3653.85,19
CDM,35021_1,Repair of aneurysm or upper chest or neck artery with graft,3575.3,2323.95,78.57,3686.26,19
CDM,35022_1,Repair of ruptured aneurysm of upper chest or neck artery with graft,4097.1,2663.12,78.57,4183.1,19
CDM,35045_1,Repair of aneurysm or forearm artery with graft,2882.3,1873.5,78.57,2829.19,19
CDM,35067028_1,Injection of drug into eye,450.0,292.5,112.5,2166.29,19
CDM,35081_1,Repair of aneurysm or abdominal aorta with graft,5194.4,3376.36,78.57,4986.94,19
CDM,35082_1,Repair of ruptured aneurysm of abdominal aorta with graft,6507.9,4230.14,78.57,6252.74,19
CDM,35091_1,Repair of aneurysm or abdominal aorta involving arteries to abdominal organs with graft,5385.5,3500.58,78.57,5149.55,19
CDM,35092_1,Repair of ruptured aneurysm of abdominal aorta involving arteries to abdominal organs with graft,7784.7,5060.06,78.57,7505.63,19
CDM,35098689_1,HC EEG MONITORING 1ST 24 HRS,2663.0,1730.95,632.0,1864.1,12
CDM,35098690_1,HC EEG MONITORING EA ADDL  24 HRS,1332.0,865.8,333.0,932.4,12
CDM,35098691_1,HC DONOR BREAST MILK,93.0,60.45,23.25,65.1,11
CDM,35099465_1,Reviving newborn at delivery,559.0,363.35,139.75,1443.62,19
CDM,35102_1,Repair of aneurysm or abdominal aorta involving groin arteries with graft,5631.2,3660.28,78.57,5404.59,19
CDM,35103_1,Repair of ruptured aneurysm of abdominal aorta involving groin arteries with graft,6706.4,4359.16,78.57,6385.71,19
CDM,35111_1,Repair of aneurysm or spleen artery with graft,4137.0,2689.05,78.57,3819.29,19
CDM,35112_1,Repair of ruptured aneurysm of spleen artery with graft,5079.9,3301.94,78.57,4692.76,19
CDM,35121_1,"Repair of aneurysm or liver, kidneys, stomach and/or intestines artery with graft",4904.6,3187.99,78.57,4539.78,19
CDM,35122_1,"Repair of ruptured aneurysm of liver, kidneys, stomach, and/or intestine artery with graft",5893.7,3830.91,78.57,5426.58,19
CDM,35131_1,Repair of aneurysm or groin artery with graft,4158.0,2702.7,78.57,3944.04,19
CDM,35132_1,Repair of ruptured aneurysm of groin artery with graft,5057.9,3287.64,78.57,4692.76,19
CDM,35134IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.22,9.24,3.56,36.72,16
CDM,35134OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.27,18.38,7.07,73.01,16
CDM,35135IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.54,6.2,2.39,24.64,16
CDM,35135OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.86,20.06,7.72,79.7,16
CDM,35136IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.46,2.9,1.12,11.52,16
CDM,35136OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.71,8.26,3.18,32.82,16
CDM,35141_1,Repair of aneurysm or upper thigh artery with graft,3299.1,2144.42,78.57,3167.56,19
CDM,35142_1,Repair of ruptured aneurysm of upper thigh artery with graft,4042.5,2627.63,78.57,3820.68,19
CDM,35151_1,Repair of aneurysm or lower leg artery with graft,4042.5,2627.63,78.57,3567.32,19
CDM,35152_1,Repair of ruptured aneurysm of lower leg artery with graft,4209.5,2736.18,78.57,4017.18,19
CDM,35180_1,Repair of congenital abnormal artery-vein connection of head and neck,2250.38,1462.75,78.57,2262.92,19
CDM,35182_1,Repair of congenital abnormal artery-vein connection in chest and abdomen,4120.75,2678.49,78.57,5226.79,19
CDM,35184IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.4,4.81,1.85,19.11,16
CDM,35184OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.57,18.57,7.14,73.78,16
CDM,35184_1,Repair of congenital abnormal artery-vein connection in arms or legs,3162.6,2055.69,78.57,2777.47,19
CDM,35188_1,Repair of abnormal artery-vein connection of head and neck,3255.0,2115.75,78.57,3588.31,19
CDM,35189_1,Repair of abnormal artery-vein connection in chest and abdomen,4717.7,3066.51,78.57,4335.95,19
CDM,35190_1,Repair of abnormal artery-vein connection in arm or leg,3150.0,2047.5,78.57,2224.98,19
CDM,35201_1,Repair of blood vessel of neck,3307.5,2149.88,78.57,2748.84,19
CDM,35206_1,Repair of blood vessel of arm,3470.0,2255.5,78.57,2292.07,19
CDM,35207_1,Repair of blood vessel of hand or finger,3307.5,2149.88,78.57,2251.27,19
CDM,35209IP _1,CYCLOSPORINE 0.05% EYE EMULS,363.94,236.56,90.99,254.76,11
CDM,35209OP _1,CYCLOSPORINE 0.05% EYE EMULS,193.33,125.66,48.33,135.33,11
CDM,35211_1,Repair of blood vessel of chest on heart-lung machine,4003.7,2602.41,78.57,4049.57,19
CDM,35216_1,Repair of blood vessel of chest,5691.0,3699.15,78.57,6044.67,19
CDM,35220IP _1,"INJECTION, BASILIXIMAB, 20 MG",21954.56,14270.46,2865.52,56697.65,19
CDM,35221_1,Repair of blood vessel of abdomen,5130.0,3334.5,78.57,4284.97,19
CDM,35226_1,Repair of blood vessel of leg,3240.0,2106.0,78.57,2417.59,19
CDM,35231_1,Repair of blood vessel of neck with vein graft,4700.0,3055.0,78.57,3680.67,19
CDM,35236_1,Repair of blood vessel of arm with vein graft,4300.0,2795.0,78.57,2922.53,19
CDM,35241_1,Repair of blood vessel of chest with vein graft on heart-lung machine,4850.0,3152.5,78.57,4199.56,19
CDM,35246_1,Repair of blood vessel in chest with vein graft,5570.0,3620.5,78.57,4566.58,19
CDM,35251_1,Repair of blood vessel of abdomen with vein graft,6060.0,3939.0,78.57,5046.64,19
CDM,35256_1,Repair of blood vessel of leg with vein graft,5505.0,3578.25,78.57,2947.93,19
CDM,35261_1,Repair of blood vessel of neck with graft,3123.8,2030.47,78.57,2821.62,19
CDM,35266_1,Repair of blood vessel of arm with graft,3040.0,1976.0,78.57,2509.32,19
CDM,35271_1,Repair of blood vessel of chest with graft on heart-lung machine,3986.9,2591.49,78.57,4039.36,19
CDM,35276_1,Repair of blood vessel of chest with graft,5150.0,3347.5,78.57,4265.45,19
CDM,35281_1,Repair of blood vessel of abdomen with graft,4705.1,3058.32,78.57,4706.36,19
CDM,35286_1,Repair of blood vessel of leg with graft,5055.0,3285.75,78.57,2705.51,19
CDM,35301_1,"Removal of blood clot and portion of chest, neck, or brain artery",4685.7,3045.71,78.57,3262.89,19
CDM,35302_1,Removal of blood clot and portion of superficial femoral artery,2746.8,1785.42,78.57,3237.56,19
CDM,35303_1,Removal of blood clot and portion of popliteal artery,3018.8,1962.22,78.57,3561.07,19
CDM,35304_1,Removal of blood clot and portion of tibioperoneal trunk artery,3184.7,2070.06,78.57,3674.82,19
CDM,35305_1,"Removal of blood clot and portion of tibial or peroneal artery, initial artery",3018.8,1962.22,78.57,3540.47,19
CDM,35306_1,"Removal of blood clot and portion of tibial or peroneal artery, each additional artery",1128.8,733.72,78.57,1274.54,19
CDM,35311_1,Removal of blood clot and portion of chest or neck artery,4445.7,2889.71,78.57,4539.34,19
CDM,35321_1,Removal of blood clot and portion of artery of upper arm,3202.5,2081.63,78.57,2582.36,19
CDM,35331_1,Removal of blood clot and portion of abdominal aorta,4350.2,2827.63,78.57,4186.52,19
CDM,35341_1,Removal of blood clot and portion of artery of abdominal organ,4076.1,2649.47,78.57,4005.34,19
CDM,35351_1,Removal of blood clot and portion of artery of groin,3845.1,2499.32,78.57,3715.46,19
CDM,35355_1,Removal of blood clot and portion of artery of upper thigh,3675.0,2388.75,78.57,2968.05,19
CDM,35361_1,Removal of blood clot and portion of abdominal aorta and groin artery,4575.9,2974.34,78.57,4372.06,19
CDM,35363_1,Removal of blood clot and portion of abdominal aorta and upper thigh artery,4093.95,2661.07,78.57,4663.63,19
CDM,35371_1,Removal of blood clot and portion of upper thigh artery,4213.2,2738.58,78.57,2356.92,19
CDM,35372_1,Removal of blood clot and portion of deep upper thigh artery,3858.8,2508.22,78.57,2811.53,19
CDM,35390_1,Removal of blood clot and portion of neck artery following previous surgery,724.5,470.93,78.57,456.82,19
CDM,35400_1,Exam of blood vessel or graft using an endoscope,444.2,288.73,78.57,424.12,19
CDM,3542IP _1,UNCLASSIFIED DRUGS,1.53,0.99,0.38,3.95,16
CDM,3542OP _1,UNCLASSIFIED DRUGS,2.05,1.33,0.51,5.29,16
CDM,35488IP _1,"APREPITANT, ORAL, 5 MG",996.04,647.43,2.94,2572.27,17
CDM,35488OP _1,"APREPITANT, ORAL, 5 MG",539.87,350.92,2.94,1394.21,17
CDM,35489IP _1,"APREPITANT, ORAL, 5 MG",1593.9,1036.04,2.94,4116.25,17
CDM,35489OP _1,"APREPITANT, ORAL, 5 MG",2305.77,1498.75,2.94,5954.65,17
CDM,35495IP _1,UNCLASSIFIED DRUGS,584.8,380.12,146.2,1510.25,16
CDM,35495OP _1,UNCLASSIFIED DRUGS,206.35,134.13,51.59,532.9,16
CDM,35500_1,Harvest of upper arm vein segment,966.0,627.9,78.57,913.58,19
CDM,35501_1,Bypass of diseased or blocked neck to brain artery with vein,4654.7,3025.56,78.57,4189.89,19
CDM,35506_1,Bypass of diseased or blocked neck to chest artery with vein,3961.7,2575.11,78.57,3659.29,19
CDM,35508_1,Bypass of diseased or blocked back of neck to brain artery with vein,3101.4,2015.91,78.57,3815.68,19
CDM,35509_1,Bypass of diseased or blocked neck to opposite neck artery with vein,4404.8,2863.12,78.57,4055.34,19
CDM,35510_1,Bypass of diseased or blocked neck to arm artery with vein,3687.6,2396.94,78.57,3531.94,19
CDM,35511_1,Bypass of diseased or blocked chest to opposite chest artery with vein,3540.6,2301.39,78.57,3219.19,19
CDM,35512_1,Bypass of diseased or blocked chest to arm artery with vein,3615.2,2349.88,78.57,3462.56,19
CDM,35515_1,Bypass of diseased or blocked chest to brain artery with vein,3490.33,2268.71,78.57,3781.95,19
CDM,35516_1,Bypass of diseased or blocked chest to upper arm artery with vein,3658.2,2377.83,78.57,3504.76,19
CDM,35518_1,Bypass of diseased or blocked under arm to opposite arm artery with vein,3990.0,2593.5,78.57,3280.99,19
CDM,35521_1,Bypass of diseased or blocked arm to upper leg artery with vein,3675.0,2388.75,78.57,3531.47,19
CDM,35522_1,Bypass of diseased or blocked under arm to arm artery with vein,3626.7,2357.36,78.57,3361.02,19
CDM,35523_1,Bypass of diseased or blocked upper arm to arm artery with vein,4573.8,2972.97,78.57,3710.47,19
CDM,35525_1,Bypass of diseased or blocked upper arm to opposite arm artery with vein,3396.8,2207.92,78.57,3270.13,19
CDM,35526_1,Bypass of diseased or blocked chest to neck artery with vein,4974.9,3233.69,78.57,5049.26,19
CDM,35531_1,Bypass of diseased or blocked abdominal to abdominal artery with vein,6051.2,3933.28,78.57,5595.73,19
CDM,35533_1,Bypass of diseased or blocked arm to upper leg and opposite leg artery with vein,4987.5,3241.88,78.57,4329.07,19
CDM,35535_1,Bypass of diseased or blocked liver to kidney artery with vein,4442.1,2887.37,78.57,5461.93,19
CDM,35536_1,Bypass of diseased or blocked artery spleen to kidney artery with vein,5065.2,3292.38,78.57,4853.71,19
CDM,35537_1,Bypass of diseased or blocked aorta to groin artery with vein,5535.88,3598.32,78.57,5979.91,19
CDM,35538_1,Bypass of diseased or blocked aorta to groin and opposite groin artery with vein,5450.78,3543.01,78.57,6699.93,19
CDM,35539_1,Bypass of diseased or blocked aorta to upper leg artery with vein,5147.73,3346.02,78.57,6287.85,19
CDM,35540_1,Bypass of diseased or blocked aorta to upper leg and opposite upper leg artery with vein,7548.5,4906.53,78.57,7006.31,19
CDM,35556_1,Bypass of diseased or blocked upper to lower leg artery with vein,4158.0,2702.7,78.57,4030.49,19
CDM,35558_1,Bypass of diseased or blocked upper leg to opposite upper leg artery with vein,3666.6,2383.29,78.57,3557.82,19
CDM,35560_1,Bypass of diseased or blocked aorta to kidney artery with vein,5289.9,3438.44,78.57,4895.45,19
CDM,35563_1,Bypass of diseased or blocked groin to opposite groin artery with vein,4084.5,2654.93,78.57,3804.83,19
CDM,35565_1,Bypass of diseased or blocked groin to upper leg artery with vein,3943.8,2563.47,78.57,3781.1,19
CDM,35566_1,Bypass of diseased or blocked major upper to lower leg artery with vein,4987.5,3241.88,78.57,4800.62,19
CDM,35570_1,Bypass of diseased or blocked lower leg to opposite lower leg artery with vein,4358.6,2833.09,78.57,4233.98,19
CDM,35571_1,Bypass of diseased or blocked lower leg to lower leg artery with vein,4278.8,2781.22,78.57,3820.68,19
CDM,35572_1,Harvest of upper leg to thigh vein segment,1021.7,664.11,78.57,990.82,19
CDM,35583_1,Bypass of diseased or blocked thigh to knee artery with vein graft,4297.7,2793.51,78.57,4148.38,19
CDM,35585_1,Bypass of diseased or blocked upper leg to lower leg artery with vein graft,5016.9,3260.99,78.57,4809.47,19
CDM,35587_1,Bypass of diseased or blocked lower leg to lower leg artery with vein graft,4102.4,2666.56,78.57,3897.35,19
CDM,35600_1,Harvest of arm artery segment for heart byplass procedure,751.8,488.67,78.57,540.43,19
CDM,35601_1,Bypass of diseased or blocked neck to brain artery with other than vein,4307.1,2799.62,78.57,4038.36,19
CDM,35602_1,"BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID-CONTRALATERAL CAROTID",2561.0,1664.65,73.6,2637.83,16
CDM,35606_1,Bypass of diseased or blocked neck to chest artery with other than vein,3511.2,2282.28,78.57,3383.4,19
CDM,35612_1,Bypass of diseased or blocked chest to opposite chest artery with other than vein,3270.8,2126.02,78.57,3008.45,19
CDM,35616_1,Bypass of diseased or blocked chest to upper arm artery with other than vein,3391.5,2204.48,78.57,3165.44,19
CDM,35621_1,Bypass of diseased or blocked arm to chest artery with other than vein,3412.5,2218.13,78.57,3166.79,19
CDM,35623_1,Bypass of diseased or blocked arm to lower leg artery with other than vein,3936.5,2558.73,78.57,3777.99,19
CDM,35625IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.5,6.18,2.38,24.53,16
CDM,35625OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.56,2.96,1.14,11.78,16
CDM,35626IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.48,8.76,3.37,34.81,16
CDM,35626OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.92,7.1,2.73,28.2,16
CDM,35626_1,Bypass of diseased or blocked arm to lower thigh or leg artery with other than vein,4593.8,2985.97,78.57,4638.3,19
CDM,35631_1,Bypass of diseased or blocked artery aorta to abdominal or kidney artery with other than vein,5502.0,3576.3,78.57,5318.87,19
CDM,35632_1,Bypass of diseased or blocked groin to stomach artery with other than vein,4185.23,2720.4,78.57,5186.37,19
CDM,35633_1,Bypass of diseased or blocked groin to abdominal artery with other than vein,5958.8,3873.22,78.57,5699.4,19
CDM,35634_1,Bypass of diseased or blocked groin to kidney artery with other than vein,5403.3,3512.15,78.57,5075.83,19
CDM,35636_1,Bypass of diseased or blocked spleen to kidney artery with other than vein,4789.1,3112.92,78.57,4580.45,19
CDM,35637_1,Bypass of diseased or blocked aorta to groin artery with other than vein,4234.7,2752.56,78.57,4762.69,19
CDM,35638_1,Bypass of diseased or blocked aorta to groin to opposite groin artery with other than vein,5226.9,3397.49,78.57,5000.69,19
CDM,35639IP _1,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",5.3,3.45,0.22,13.69,17
CDM,35639OP _1,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",9.73,6.32,0.22,25.13,17
CDM,35640IP _1,"INJECTION, ZOLEDRONIC ACID, 1 MG",94.5,61.43,5.38,283.5,17
CDM,35640OP _1,"INJECTION, ZOLEDRONIC ACID, 1 MG",47.35,30.78,5.38,142.05,17
CDM,35642_1,Bypass of diseased or blocked back of neck to brain artery with other than vein,2547.18,1655.67,78.57,2846.38,19
CDM,35645_1,Bypass of diseased or blocked chest to arm artery with other than vein,2420.78,1573.51,78.57,2727.75,19
CDM,35646_1,Bypass of diseased or blocked artery aorta to upper leg and opposite upper leg artery with other than vein,5141.9,3342.24,78.57,4920.71,19
CDM,35647_1,Bypass of diseased or blocked aorta to upper leg artery with other than vein,4125.5,2681.58,78.57,4469.47,19
CDM,35650_1,Bypass of diseased or blocked under arm to opposite arm artery with other than vein,3543.8,2303.47,78.57,2937.76,19
CDM,35654_1,Bypass of diseased or blocked arm to both lower thigh arteries with other than vein,4961.3,3224.85,78.57,3938.58,19
CDM,35656_1,Bypass of diseased or blocked upper leg to lower thigh artery with other than vein,3543.8,2303.47,78.57,3106.92,19
CDM,35661_1,Bypass of diseased or blocked upper leg to opposite upper leg artery with other than vein,3250.8,2113.02,78.57,3132.93,19
CDM,35663_1,Bypass of diseased or blocked groin to opposite groin artery with other than vein,3760.1,2444.07,78.57,3503.81,19
CDM,35665_1,Bypass of diseased or blocked groin to upper leg artery with other than vein,3543.8,2303.47,78.57,3386.82,19
CDM,35666_1,Bypass of diseased or blocked upper leg to lower leg artery with other than vein,3803.1,2472.02,78.57,3697.15,19
CDM,35671_1,Bypass of diseased or blocked knee to lower leg arteries with other than vein,4068.8,2644.72,78.57,3259.92,19
CDM,35681_1,Bypass of diseased or blocked artery with prosthetic and vein,787.5,511.88,63.01,381.62,19
CDM,35682_1,Bypass of diseased or blocked artery with 2 vein segments from 2 locations,1071.0,696.15,78.57,1013.93,19
CDM,35683_1,Bypass of diseased or blocked artery with 3 or more segments from 2 or more locations,949.38,617.1,78.57,1170.45,19
CDM,35685_1,Insertion of vein patch at lowest portion of bypass graft,598.5,389.03,78.57,567.67,19
CDM,35686IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.25,7.31,2.81,29.05,16
CDM,35686OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.54,10.75,4.14,42.71,16
CDM,35686_1,Creation of artery-vein connection during procedure on leg,372.3,242.0,78.57,460.57,19
CDM,35687IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.04,5.88,2.26,23.35,16
CDM,35687OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.07,9.8,3.77,38.92,16
CDM,35688IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",41.5,26.98,10.38,107.17,16
CDM,35691_1,Relocation and/or reimplantation of brain artery to neck artery,2853.9,1855.04,78.57,2725.47,19
CDM,35693_1,Relocation and/or reimplantation of brain artery to chest artery,2528.4,1643.46,78.57,2406.4,19
CDM,35694_1,Relocation and/or reimplantation of chest artery to neck artery,2954.7,1920.56,78.57,2844.85,19
CDM,35695_1,Relocation and/or reimplantation of neck artery to chest artery,3078.6,2001.09,78.57,2952.55,19
CDM,35697_1,Reimplantation of organ artery to aorta prothesis below kidney,444.2,288.73,78.57,421.49,19
CDM,35699IP _1,UNCLASSIFIED DRUGS,69.09,44.91,17.27,178.42,16
CDM,35699OP _1,UNCLASSIFIED DRUGS,89.39,58.1,22.35,230.85,16
CDM,35700_1,Bypass of upper or lower leg artery reoperation more than 1 month after original operation,577.5,375.38,78.57,435.63,19
CDM,35701_1,Exploration of neck artery,1585.5,1030.58,78.57,1319.16,19
CDM,35702_1,Exploration of arm artery,946.0,614.9,78.57,1193.02,19
CDM,35703_1,Exploration of leg artery,1433.25,931.61,78.57,1476.25,19
CDM,35779OP _1,ALDURAZYME 2.9 MG/5 ML VIAL,145.25,94.41,36.31,101.68,11
CDM,3578IP _1,UNCLASSIFIED DRUGS,5.49,3.57,1.37,14.18,16
CDM,3578OP _1,UNCLASSIFIED DRUGS,8.95,5.82,2.24,23.11,16
CDM,3579IP _1,UNCLASSIFIED DRUGS,7.41,4.82,1.85,19.14,16
CDM,3579OP _1,UNCLASSIFIED DRUGS,17.76,11.54,4.44,45.87,16
CDM,35800T_1,"Exploration of neck for bleeding, blood clot, or infection after surgery",1379.7,896.81,78.57,2133.04,19
CDM,35800_1,"Exploration of neck for bleeding, blood clot, or infection after surgery",1575.0,1023.75,78.57,2133.04,19
CDM,3581IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.62,3.65,1.41,14.51,16
CDM,35820_1,"Exploration of chest for bleeding, blood clot, or infection after surgery",5623.8,3655.47,78.57,5863.01,19
CDM,3583IP _1,UNCLASSIFIED DRUGS,6.95,4.52,1.74,17.95,16
CDM,3583OP _1,UNCLASSIFIED DRUGS,13.38,8.7,3.35,34.55,16
CDM,35840_1,"Exploration of abdomen for bleeding, blood clot, or infection after surgery",2800.0,1820.0,78.57,3506.76,19
CDM,3584IP _1,"INJECTION, HALOPERIDOL, UP TO 5 MG",130.62,84.9,0.77,337.33,17
CDM,3584OP _1,"INJECTION, HALOPERIDOL, UP TO 5 MG",67.78,44.06,0.77,175.04,17
CDM,3585IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
CDM,35860_1,"Exploration of arm or leg for bleeding, blood clot, or infection after surgery",1920.0,1248.0,78.57,2438.14,19
CDM,35870_1,Repair of abnormal drainage tract of blood vessel graft and bowel,3727.5,2422.88,78.57,3589.78,19
CDM,35875T_1,Removal of blood clot of artery or vein graft,5055.8,3286.27,78.57,1721.73,19
CDM,35875_1,Removal of blood clot of artery or vein graft,1811.3,1177.35,78.57,1721.73,19
CDM,35876_1,Removal of blood clot and revision of artery or vein graft,2826.6,1837.29,78.57,2733.04,19
CDM,35879_1,Revision of leg artery bypass with vein patch,2783.6,1809.34,78.57,2664.5,19
CDM,35881_1,Revision of leg artery bypass with placement of relocated vein,3053.4,1984.71,78.57,2948.54,19
CDM,35883_1,Revision of groin artery bypass with patch graft,3089.1,2007.92,78.57,3464.98,19
CDM,35884_1,Revision of groin artery bypass with vein patch graft,3719.1,2417.42,78.57,3560.2,19
CDM,35891IP _1,UNCLASSIFIED DRUGS,6.84,4.45,1.71,17.66,16
CDM,35891OP _1,UNCLASSIFIED DRUGS,3.16,2.05,0.79,8.16,16
CDM,35900027_1,HC METHADONE,293.0,190.45,73.25,205.1,11
CDM,35901_1,Removal of infected neck graft,1690.5,1098.83,78.57,1370.25,19
CDM,35903_1,Removal of infected graft of arm or leg,1932.0,1255.8,78.57,1651.63,19
CDM,35905_1,Removal of infected chest graft,5044.2,3278.73,78.57,4825.74,19
CDM,35907_1,Removal of infected abdominal graft,5715.2,3714.88,78.57,5493.93,19
CDM,35990018_1,Therapy procedure in a group setting,69.79,45.36,17.45,277.0,19
CDM,35990035_1,HC SYNCHROMED PUMP REFILL KIT,92.0,59.8,23.0,64.4,11
CDM,35990040_1,Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming,328.0,213.2,82.0,847.06,19
CDM,35990042_1,HC CATHETER ACCESS PORT KIT,109.0,70.85,27.25,76.3,11
CDM,35990058_1,HC METHADONE COCKTAIL (DOSE),15.0,9.75,3.75,10.5,11
CDM,35990060_1,HC CATAPRES TTS-1 PATCH,246.0,159.9,61.5,172.2,11
CDM,35997161_1,"Evaluation for physical therapy, typically 20 minutes",260.0,169.0,65.0,671.45,19
CDM,35997162_1,"Evaluation for physical therapy, typically 30 minutes",260.0,169.0,65.0,671.45,19
CDM,35997163_1,"Evaluation for physical therapy, typically 45 minutes",260.0,169.0,65.0,671.45,19
CDM,35997164_1,"Re-evaluation for physical therapy, typically 20 minutes",176.0,114.4,44.0,454.52,19
CDM,35997750_1,"Test or measurement for functional capacity, each 15 minutes",116.0,75.4,29.0,299.57,19
CDM,36000_1,Insertion of needle or tube into vein,78.8,51.22,23.81,81.16,15
CDM,36002_1,Injection to cause blood clot in diseased or pseudoaneurysm of arm or leg,470.4,305.76,78.57,360.04,19
CDM,36005_1,Injection for X-ray imaging procedure into vein of arm or leg,630.0,409.5,23.77,613.8,19
CDM,36010_1,Insertion of tube into vena cava,1591.8,1034.67,28.15,1297.0,19
CDM,36011_1,"Insertion of tube into vein, first order branch",2065.5,1342.58,33.9,1933.12,19
CDM,36012_1,"Insertion of tube into vein, second order branch",3558.0,2312.7,60.29,2003.19,19
CDM,36013_1,Insertion of tube into right heart or main pulmonary artery,2180.9,1417.59,31.49,1893.21,19
CDM,36014_1,Insertion of tube into left or right pulmonary artery,1984.5,1289.93,54.46,1888.1,19
CDM,36015_1,Insertion of tube into artery of lobe of lung,3759.6,2443.74,57.79,2050.72,19
CDM,36092IP _1,IMATINIB MESYLATE 400 MG TAB,403.05,261.98,100.76,282.14,11
CDM,36100_1,Insertion of needle or tube into artery of neck or brain,1459.5,948.68,78.54,1339.34,19
CDM,36140_1,Insertion of needle or tube into artery of arm or leg,783.0,508.95,42.05,1219.59,19
CDM,36151OP _1,"INJECTION, OMALIZUMAB, 5 MG",16057.59,10437.43,48.23,41468.73,19
CDM,36160_1,Insertion of needle or tube into aorta,1438.5,935.03,48.72,1351.63,19
CDM,36200_1,Insertion of tube into aorta,1822.5,1184.63,78.57,1411.92,19
CDM,36215_1,"Insertion of tube into chest or arm artery, each first order branch",1845.0,1199.25,78.57,2484.43,19
CDM,36216_1,"Insertion of tube into chest or arm artery, initial second order branch",3422.0,2224.3,78.57,2538.11,19
CDM,36217_1,"Insertion of tube into chest or arm artery, initial third order branch",5549.3,3607.05,78.57,4250.95,19
CDM,36218_1,"Insertion of tube into chest or arm artery, additional second, third order and beyond",548.1,356.27,26.95,495.65,19
CDM,36221_1,Insertion of tube into chest aorta for diagnosis or treatment with review by radiologist,3731.7,2425.61,52.22,2358.38,19
CDM,36222_1,Insertion of tube into extracranial artery for diagnosis or treatment with review by radiologist,3717.0,2416.05,78.57,2892.5,19
CDM,36223_1,Insertion of tube into intracranial artery for diagnosis or treatment with review by radiologist,4203.0,2731.95,78.57,3898.88,19
CDM,36224_1,Insertion of tube into internal neck artery for diagnosis or treatment with review by radiologist,4747.5,3085.88,78.57,4842.69,19
CDM,36225_1,Insertion of tube into chest artery for diagnosis or treatment with review by radiologist,4180.5,2717.33,78.57,3679.66,19
CDM,36226_1,Insertion of tube into brain artery for diagnosis or treatment with review by radiologist,4698.0,3053.7,78.57,4708.29,19
CDM,36227_1,Insertion of tube into external neck artery for diagnosis or treatment with review by radiologist,809.6,526.24,78.57,558.06,19
CDM,36228_1,Insertion of tube into neck or brain artery for diagnosis or treatment with review by radiologist,3855.6,2506.14,51.78,2983.42,19
CDM,36245_1,"Insertion of tube into abdominal, pelvic, or leg artery, each first order branch",3078.0,2000.7,78.57,2979.96,19
CDM,36246_1,"Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch",5085.75,3305.74,78.57,1984.88,19
CDM,36247_1,"Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch",7955.4,5171.01,78.57,3406.49,19
CDM,36248_1,"Insertion of tube into abdominal, pelvic, or leg artery, additional second, third, and beyond",426.0,276.9,38.56,281.42,19
CDM,36251_1,Insertion of tube into first order main and accessory arteries of kidney for imaging with review by radiologist,2513.7,1633.91,78.57,3086.43,19
CDM,36252_1,Insertion of tube into first order main and accessory arteries of both kidneys for imaging with review by radiologist,3134.0,2037.1,78.57,3304.46,19
CDM,36253_1,Insertion of tube into second or third order branches of arteries of kidney for imaging with review by radiologist,3078.0,2000.7,78.57,4851.6,19
CDM,36254_1,Insertion of tube into second or third order branches of arteries of both kidneys for imaging with review by radiologist,4001.6,2601.04,78.57,4728.52,19
CDM,36260_1,Insertion of implantable arterial infusion pump,1791.3,1164.35,78.57,1899.53,19
CDM,36261_1,Revision of implanted arterial infusion pump,1022.7,664.76,78.57,1180.08,19
CDM,36262_1,Removal of implanted arterial infusion pump,776.0,504.4,78.57,902.48,19
CDM,36267IP _1,ESTRADIOL 0.0375MG PATCH(1/WK),112.0,72.8,28.0,78.4,11
CDM,36310000_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,4603.0,2991.95,1150.75,3222.1,11
CDM,36310005_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,1785.0,1160.25,446.25,1249.5,11
CDM,36310015_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,4806.0,3123.9,1201.5,3364.2,11
CDM,36310020_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,4806.0,3123.9,1201.5,3364.2,11
CDM,36310025_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,4486.0,2915.9,1121.5,3140.2,11
CDM,36310030_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,7793.0,5065.45,1948.25,5455.1,11
CDM,36310035_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,5283.0,3433.95,1320.75,3698.1,11
CDM,36310040_1,Other chemotherapy procedure,1573.0,1022.45,393.25,4062.27,18
CDM,36310045_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,4577.0,2975.05,1144.25,3203.9,11
CDM,36310050_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,2087.0,1356.55,521.75,1460.9,11
CDM,36310055_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,1872.0,1216.8,468.0,1310.4,11
CDM,36310060_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,2647.0,1720.55,661.75,1852.9,11
CDM,36310065_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,4710.0,3061.5,1177.5,3297.0,11
CDM,36310070_1,HC CANCELLED PROCEDURE OR PERFUSION,3166.0,2057.9,791.5,2216.2,11
CDM,36310075_1,HC CANCELLED PROCEDURE CATH PERFUSION,3166.0,2057.9,791.5,2216.2,11
CDM,36310080_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,1024.0,665.6,256.0,716.8,11
CDM,36310085_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,2087.0,1356.55,521.75,1460.9,11
CDM,36310095_1,HC RENTAL CENTRIMAG CONSOLE/MOTOR DAILY,733.5,476.78,183.38,513.45,11
CDM,36310100_1,HC RENTAL CARDIOHELP ECMO CONSOLE DAILY,540.0,351.0,135.0,378.0,11
CDM,36310105_1,HC CARDIOHELP ECMO CONSOLE DAILY,540.0,351.0,135.0,378.0,11
CDM,36310110_1,HC TRANSMEDICS OCS SERVICE,5653.0,3674.45,2543.85,3957.1,10
CDM,36318000_1,HC HEARTMATE SYSTEM COMPLETE NMC OWNED DAILY,474.0,308.1,118.5,331.8,11
CDM,36318005_1,HC HEARTMATE SYS COMP RENTAL DAILY,488.0,317.2,122.0,341.6,11
CDM,36318010_1,HC HEARTMATE PNEUMATIC CONSOLE RENTAL-DAY 1-7,28336.0,18418.4,7084.0,19835.2,11
CDM,36318015_1,HC HEART LUNG MACHINE USAGE FEE,1370.0,890.5,342.5,959.0,11
CDM,36318020_1,HC PVAD TLC-II PORTABLE CONSOLE DAILY,479.0,311.35,119.75,335.3,11
CDM,36318025_1,HC PVAD TLC-II BATTERY CHARGER DAILY,114.0,74.1,28.5,79.8,11
CDM,36318030_1,HC CENTRIMAG DRIVE CONSOLE/MOTOR DAILY,733.5,476.78,183.38,513.45,11
CDM,36318035_1,HC THORATEC CONSOLE INITIAL SET UP,32083.0,20853.95,8020.75,22458.1,11
CDM,36318040_1,HC THORATEC CONSOLE DAY 61+,668.0,434.2,167.0,467.6,11
CDM,36318045_1,HC OCS ORGAN CARE SYSTEM GAS (LUNG),2700.0,1755.0,675.0,1890.0,11
CDM,36318046_1,HC OCS ORGAN CARE SYSTEM GAS (LIVER),2700.0,1755.0,675.0,1890.0,11
CDM,36318047_1,HC TANDEM HEART LIFESPARC CONSOLE,1024.99,666.24,256.25,717.49,11
CDM,36320010_1,"BATTERY/POWER PACK CHARGER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",34992.0,22744.8,5118.21,41990.4,17
CDM,36321015_1,HC PERFUSION SUPPLY $101-200,360.0,234.0,90.0,252.0,11
CDM,36322020_1,HC CANNULA ATRIAL PVAD LONG BEVELED,9570.0,6220.5,2392.5,6699.0,11
CDM,36322065_1,HC IABP F/O CAT 7FR 40CC SENSATION,4351.73,2828.62,1087.93,3046.21,11
CDM,36322110_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,2087.0,1356.55,521.75,1460.9,11
CDM,36322175_1,"POWER MODULE FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",38880.0,25272.0,9720.0,46656.0,17
CDM,36332997_1,Irrigation and drainage of lung,3850.0,2502.5,962.5,9942.63,19
CDM,36340000_1,HC OXYGENATOR MAQUET HLS 7.0 ADV SET ECMO,45000.0,29250.0,11250.0,31500.0,11
CDM,36361202_1,Insertion of tube into arm or leg for blood circulation and chemotherapy,4486.0,2915.9,1121.5,11585.1,19
CDM,363SU270_1,HC PERF SUPPLY REV CODE 270 NO HCPCS,4937.32,3209.26,1234.33,3456.12,11
CDM,363SU278_1,HC PERF SUPPLY REV CODE 278 NO HCPCS,184500.0,119925.0,46125.0,184500.0,12
CDM,36400020_1,HC GRASPER BIPOLAR FORCE 8MM DA VINCI XI 470405,1178.0,765.7,294.5,824.6,11
CDM,36400021_1,HC LASER DIODE YAG RENTAL,2090.0,1358.5,522.5,1463.0,11
CDM,36400040_1,HC AQUAMANTYS BIPOLAR SEALER GENERATOR,147.0,95.55,36.75,102.9,11
CDM,36400043_1,HC AQUARIUS URODYNAMICS SYSTEM,361.0,234.65,90.25,252.7,11
CDM,36400046_1,HC ARGON BEAM COAGULATOR,533.0,346.45,133.25,373.1,11
CDM,36400050_1,HC PROBE U/S LITHOCLAST LITHOTRIPSY,409.0,265.85,102.25,286.3,11
CDM,36400052_1,HC AUTOSONIX SCALPEL,404.0,262.6,101.0,282.8,11
CDM,36400053_1,HC BIPOLAR GENERATOR,519.0,337.35,129.75,363.3,11
CDM,36400055_1,HC CUSA/ELEKTA GENERATOR,622.0,404.3,155.5,435.4,11
CDM,36400056_1,HS CUSA CLARITY GENERATOR,3106.64,2019.32,776.66,2174.65,11
CDM,36400058_1,HC CYBERWAND US LITHOTRIPTOR ACMI,867.0,563.55,216.75,606.9,11
CDM,36400059_1,HC CYPRESS ULTRASOUND,176.0,114.4,44.0,123.2,11
CDM,36400061_1,HC ENDOBROCHOSCOPE US TOWER (EBUS TOWER),949.0,616.85,237.25,664.3,11
CDM,36400062_1,HC D & C SUCTION MACHINE,31.0,20.15,7.75,21.7,11
CDM,36400064_1,HC EVLT DIOMED 15 PLUS LASER,229.0,148.85,57.25,160.3,11
CDM,36400065_1,HC LASER IRRIDEX CYCLO G6 GLAUCOMA SYS,187.0,121.55,46.75,130.9,11
CDM,36400067_1,HC EVOK POT EQUIPMENT FEE,361.0,234.65,90.25,252.7,11
CDM,36400070_1,HC AQUILEX FLUID MGMT SYSTEM HOLOGIC,160.0,104.0,40.0,112.0,11
CDM,36400071_1,HC FLUID SAFE MANAGEMENT SYSTEM,257.0,167.05,64.25,179.9,11
CDM,36400073_1,HC GREENLIGHT HPS/XPS LASER RENTAL,1214.0,789.1,303.5,849.8,11
CDM,36400075_1,HC LASER CO2 OMNIGUIDE NMC,1131.0,735.15,282.75,791.7,11
CDM,36400076_1,HC GYRUS PK G400 GENERATOR,813.0,528.45,203.25,569.1,11
CDM,36400079_1,HC HARMONIC SCALPEL,603.0,391.95,150.75,422.1,11
CDM,36400081_1,HC HIP DISTRACTOR SMITH NEPHEW,178.0,115.7,44.5,124.6,11
CDM,36400082_1,HC LAMINAR FLOW,472.0,306.8,118.0,330.4,11
CDM,36400083_1,HC HOLMIUM LASER 20 WATT,113.0,73.45,28.25,79.1,11
CDM,36400084_1,HC DAVINCI SYSTEM 5 SURGICAL ROBOT PAY PER USE EQUIP,11633.0,7561.45,2908.25,8143.1,11
CDM,36400085_1,HC LAPAROSCOPIC MORCELLATOR,132.0,85.8,33.0,92.4,11
CDM,36400086_1,HC NEURO BK ULTRASOUND EQUIP,2121.0,1378.65,530.25,1484.7,11
CDM,36400088_1,HC LASER 100 W HOLMIUM RENTAL,1124.0,730.6,281.0,786.8,11
CDM,36400089_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,31500.0,20475.0,7875.0,22050.0,11
CDM,36400091_1,HC LASER CIRALIS/EVOLVE RENTAL,1225.0,796.25,306.25,857.5,11
CDM,36400094_1,"HC LASER CO2, OMNIGUIDE OR ERBIUM RENTAL",3568.5,2319.53,892.13,2497.95,11
CDM,36400097_1,HC LASER COSMETIC RENTAL,1132.0,735.8,283.0,792.4,11
CDM,36400100_1,HC LASER CYBER THULIUM RENTAL,1161.0,754.65,290.25,812.7,11
CDM,36400103_1,HC LASER HOLMIUM (COHERENT),1496.0,972.4,374.0,1047.2,11
CDM,36400106_1,HC LASER HOLMIUM 30W RENTAL,1091.0,709.15,272.75,763.7,11
CDM,36400107_1,HC STORZ MITAKA ARM BASE UNIT,1181.0,767.65,295.25,826.7,11
CDM,36400109_1,HC LASER KTP AURA RENTAL,1529.0,993.85,382.25,1070.3,11
CDM,36400110_1,HC LASER CO2 TMR HEART RENTAL,10834.0,7042.1,2708.5,7583.8,11
CDM,36400111_1,HC ULTRASOUND PROBE SVC RENTAL,11600.0,7540.0,2900.0,8120.0,11
CDM,36400112_1,HC LASER LUMENIS NOVUS SPECTRA,404.0,262.6,101.0,282.8,11
CDM,36400113_1,HC GRASPER FEN TIP UP DA VINCI XI 470347,836.0,543.4,209.0,585.2,11
CDM,36400114_1,HC CRYO UNIT FRIGITRONICS CE2000,213.0,138.45,53.25,149.1,11
CDM,36400115_1,HC LESION GENERATOR,449.0,291.85,112.25,314.3,11
CDM,36400116_1,HC SCISSORS POTTS DA VINCI XI 470001,741.0,481.65,185.25,518.7,11
CDM,36400118_1,HC LIGASURE SYSTEM,156.0,101.4,39.0,109.2,11
CDM,36400119_1,HC LIPOSUCTION MACHINE,570.0,370.5,142.5,399.0,11
CDM,36400120_1,HC HYDROTHERMAL ABLATION SYSTEM RENTAL,190.0,123.5,47.5,133.0,11
CDM,36400121_1,HC LITHOCLAST LITHOTRIPTER,757.0,492.05,189.25,529.9,11
CDM,36400122_1,HC UROLIFT INSTRUMENT SET RENTAL,1015.0,659.75,253.75,710.5,11
CDM,36400123_1,HC MINOP INST SET RENTAL,6438.0,4184.7,1609.5,4506.6,11
CDM,36400124_1,HC MEDRAD INJECTOR,190.0,123.5,47.5,133.0,11
CDM,36400125_1,HC NICO BRAIN PATH RENTAL,29000.0,18850.0,7250.0,20300.0,11
CDM,36400127_1,HC MICROSCOPE MAJOR,3150.0,2047.5,787.5,2205.0,11
CDM,36400130_1,HC MICROSCOPE MINOR,3150.0,2047.5,787.5,2205.0,11
CDM,36400133_1,HC MIDAS REX DRILL,314.0,204.1,78.5,219.8,11
CDM,36400136_1,HC MIRA CRYO UNIT,213.0,138.45,53.25,149.1,11
CDM,36400139_1,HC NEOPROBE GAMMA FINDER,150.0,97.5,37.5,105.0,11
CDM,36400142_1,HC NIM RESPONSE MONITOR XOMED,286.0,185.9,71.5,200.2,11
CDM,36400145_1,HC NOVASURE ENDOMETRIAL ABLATION SYSTEM,879.0,571.35,219.75,615.3,11
CDM,36400148_1,HC OJEMAN CORTICAL STIMULATOR,298.0,193.7,74.5,208.6,11
CDM,36400149_1,HC NATUS NICOLET CORTICAL STIMULATOR,300.0,195.0,75.0,210.0,11
CDM,36400151_1,HC OR SPECIALTY TABLE,144.0,93.6,36.0,100.8,11
CDM,36400157_1,HC PHACO UNIT,125.0,81.25,31.25,87.5,11
CDM,36400160_1,HC PUMP CONT FLOW IRRIG UROLOGY,59.0,38.35,14.75,41.3,11
CDM,36400163_1,HC RADIO FREQUENCY GENERATOR (RITA),295.0,191.75,73.75,206.5,11
CDM,36400166_1,HC RADIOLUCENT HEAD FRAME,184.0,119.6,46.0,128.8,11
CDM,36400169_1,HC RHIZOTOMY GENERATOR RENTAL,401.0,260.65,100.25,280.7,11
CDM,36400172_1,HC SENORX GAMMA FINDER PROBE,150.0,97.5,37.5,105.0,11
CDM,36400175_1,HC SONOPET ULTRA SONIC ASPIRATOR,2306.0,1498.9,576.5,1614.2,11
CDM,36400178_1,HC NEURO NAVIGATION SYSTEM BRAIN LAB,4107.0,2669.55,1026.75,2874.9,11
CDM,36400179_1,HC SUPER DIMENSION ENDO NAVIGATION SYS,1056.0,686.4,264.0,739.2,11
CDM,36400181_1,HC STEALTH STATION ENT FUSION MEDTRONIC,2093.0,1360.45,523.25,1465.1,11
CDM,36400184_1,HC STEALTH STATION NEURO MEDTRONIC,4189.0,2722.85,1047.25,2932.3,11
CDM,36400187_1,HC STEREOTACTIC UNIT,2320.0,1508.0,580.0,1624.0,11
CDM,36400190_1,HC STERILE AIR SUIT SYSTEM,68.0,44.2,17.0,47.6,11
CDM,36400193_1,HC STRYKER RF MULTIGEN PAIN GENERATOR,621.0,403.65,155.25,434.7,11
CDM,36400196_1,HC THERMACHOICE CONTROLLER,169.0,109.85,42.25,118.3,11
CDM,36400199_1,HC TRABECTOME,432.0,280.8,108.0,302.4,11
CDM,36400202_1,HC UROLOGY ULTRASOUND (MODEL 2202),472.0,306.8,118.0,330.4,11
CDM,36400205_1,HC VALLEY LAB FORCE TRIAD,156.0,101.4,39.0,109.2,11
CDM,36400208_1,HC VERSAPOINT GENERATOR,148.0,96.2,37.0,103.6,11
CDM,36400211_1,HC VIDEO SYSTEM,187.0,121.55,46.75,130.9,11
CDM,36400213_1,HC VIDEO TOWER STYRKER,187.0,121.55,46.75,130.9,11
CDM,36400214_1,HC VIDEO TOWER OLYMPUS BRONCH,187.0,121.55,46.75,130.9,11
CDM,36400217_1,HC VIDEO TOWER OLYMPUS GI,183.0,118.95,45.75,128.1,11
CDM,36400220_1,HC VIDEO TOWER OLYMPUS LAP ENDO EYE,183.0,118.95,45.75,128.1,11
CDM,36400223_1,HC VIDEO TOWER VISION SCIENCE BRONCH,187.0,121.55,46.75,130.9,11
CDM,36400224_1,HC VIDEO TOWER OLYMPUS UROLOGY DIGITAL,187.0,121.55,46.75,130.9,11
CDM,36400225_1,HC STORZ CLEARVISION IRRIGATION SYSTEM,105.0,68.25,26.25,73.5,11
CDM,36400226_1,HC VIRECTOMY UNIT,278.0,180.7,69.5,194.6,11
CDM,36400227_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,3568.5,2319.53,892.13,2497.95,11
CDM,36400229_1,HC XOMED STRAIGHT SHOT PUMP/PEDAL,171.0,111.15,42.75,119.7,11
CDM,36400231_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,120.0,78.0,30.0,84.0,11
CDM,36400237_1,HC MICROWAVE ABLATION RENTAL,1972.0,1281.8,493.0,1380.4,11
CDM,36400238_1,HC DAVINIC SHD CURVED SHEARS HARMONIC 8MM,168.0,109.2,42.0,117.6,11
CDM,36400239_1,HC SONOSCISION HARMONIC SYSTEM,141.0,91.65,35.25,98.7,11
CDM,36400241_1,HC I-DRIVE POWER STAPLER SYSTEM,1006.0,653.9,251.5,704.2,11
CDM,36400242_1,HC ERBE CRYOSURGICAL SYSTEM,405.0,263.25,101.25,283.5,11
CDM,36400243_1,HC SIALENDOSCOPIC INST SET RENTAL,2334.0,1517.1,583.5,1633.8,11
CDM,36400245_1,HC AVINGER LIGHTBOX OCELOT TOWER,2794.0,1816.1,698.5,1955.8,11
CDM,36400246_1,HC VISUALASE MRI GUIDED LASER ABLTIN SYS,7031.3,4570.35,1757.83,4921.91,11
CDM,36400247_1,HC OSTEOCOOL RF GENERATOR RENTAL,4050.0,2632.5,1012.5,2835.0,11
CDM,36400350_1,HC FORTEC ON CALL LUMENIS SCAAR SOFTWARE RENTAL,360.0,234.0,90.0,252.0,11
CDM,36400354_1,HC PEDICLE SCREW BALL TIP PROBE,341.0,221.65,85.25,238.7,11
CDM,36400356_1,Complex measurement of pressure of urine flow in bladder with voiding pressure studies,600.0,390.0,150.0,1549.5,19
CDM,36400357_1,Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies,600.0,390.0,150.0,1549.5,19
CDM,36400360_1,HC CLIP APPLIER LARGE DA VINCI XI 470230,63.0,40.95,15.75,44.1,11
CDM,36400361_1,HC CLIP APPLIER MED-LGE DA VINCI XI 470237,63.0,40.95,15.75,44.1,11
CDM,36400362_1,HC STAPLER ENDOWRIST 45 DA VINCI XI 470298,532.0,345.8,133.0,372.4,11
CDM,36400363_1,HC STAPLER ENDOWRIST 30 CVD DA VINCI XI 470530,547.2,355.68,136.8,383.04,11
CDM,36400364_1,HC CAUTERY HOOK MONOPOLAR DA VINCI XI 470183,760.0,494.0,190.0,532.0,11
CDM,36400365_1,HC FORCEPS BLACK DIA MICRO DA VINCI XI 470033,760.0,494.0,190.0,532.0,11
CDM,36400366_1,HC FORCEPS DEBAKEY DA VINCI XI 470036,760.0,494.0,190.0,532.0,11
CDM,36400367_1,HC FORCEPS CADIERE DA VINCI XI 470049,798.0,518.7,199.5,558.6,11
CDM,36400368_1,HC NEEDLE DRIVER LARGE DA VINCI XI 470006,836.0,543.4,209.0,585.2,11
CDM,36400369_1,HC FORCEPS PROGRASP DA VINCI XI 470093,836.0,543.4,209.0,585.2,11
CDM,36400370_1,HC GRASPER COBRA DA VINCI XI 470190,836.0,543.4,209.0,585.2,11
CDM,36400371_1,HC NEEDLE DRIVER MEGA DA VINCI XI 470194,836.0,543.4,209.0,585.2,11
CDM,36400372_1,HC FORCEPS TENACULUM DA VINCI XI 470207,836.0,543.4,209.0,585.2,11
CDM,36400373_1,HC NEEDLE DRIVER LGE SUTURECUT DA VINCI XI 470296,912.0,592.8,228.0,638.4,11
CDM,36400374_1,HC NEEDLE DRIVER MEGA SUTURECUT DA VINCI XI 470309,912.0,592.8,228.0,638.4,11
CDM,36400375_1,HC FORCEPS MARYLAND BIPOLAR DA VINCI XI 470172,1026.0,666.9,256.5,718.2,11
CDM,36400376_1,HC FORCEPS FENESTRAT BIPOLAR DA VINCI XI 470205,1026.0,666.9,256.5,718.2,11
CDM,36400377_1,HC FORCEPS LONG TIP DA VINCI XI 470048,1064.0,691.6,266.0,744.8,11
CDM,36400378_1,HC GRASPER LONG BIPOLAR DA VINCI XI 470400,1102.0,716.3,275.5,771.4,11
CDM,36400379_1,HC SCISSORS CVD MONO HOT SHEARS DA VINCI XI 470179,1216.0,790.4,304.0,851.2,11
CDM,36400380_1,HC DA VINCI XI SURGICAL ROBOT,8851.5,5753.48,2212.88,6196.05,11
CDM,36400381_1,HC EKOS ULTRASONIC DEVICE,1377.0,895.05,344.25,963.9,11
CDM,36400382_1,HC BREAST SIZER RESTERILIZABLE ALLERGAN,76.0,49.4,19.0,53.2,11
CDM,36400384_1,HC DAVINCI XI BIPOLAR CORD 470384,60.75,39.49,15.19,42.53,11
CDM,36400385_1,HC DAVINCI XI MONOPOLAR CORD 470383,60.75,39.49,15.19,42.53,11
CDM,36400386_1,HC LASER SCAAR ENCORE C02 RENTAL,4545.0,2954.25,1136.25,3181.5,11
CDM,36400387_1,HC LASER IPL PALOMAR MEDILUX RENTAL,2465.0,1602.25,616.25,1725.5,11
CDM,36400388_1,HC ENDO OPTIKS E2 LASER,870.0,565.5,217.5,609.0,11
CDM,36400389_1,HC LASER ENDOSCOPE 19G ENDO OPTIKS,654.0,425.1,163.5,457.8,11
CDM,36400390_1,HC LASER ENDOSCOPE 23G ENDO OPTIKS,428.0,278.2,107.0,299.6,11
CDM,36400391_1,HC LASER ENDOSCOPE 20G ENDO OPTIKS,553.0,359.45,138.25,387.1,11
CDM,36400392_1,HC SYNERCOOL CRYOGEN UNIT,130.0,84.5,32.5,91.0,11
CDM,36400393_1,HC LASER 35W HOLMIUM OLYMPUS,1200.0,780.0,300.0,840.0,11
CDM,36400394_1,HC VERAN THORACIC NAVIGATION SYSTEM,1056.0,686.4,264.0,739.2,11
CDM,36400395_1,HC CAUTERY SPATULA DA VINCI XI 470184,760.0,494.0,190.0,532.0,11
CDM,36400396_1,HC DUAL BLADE RETRACTOR  DA VINCI 470249,1330.0,864.5,332.5,931.0,11
CDM,36400397_1,HC NAVIO ORTHO SURGICAL ROBOT SYSTEM,1045.0,679.25,261.25,731.5,11
CDM,36400398_1,HC ROSA 3.0 EPILEPSY ROBOT,7859.0,5108.35,1964.75,5501.3,11
CDM,36400399_1,HC LASER LUMENIS ENCORE FX,1121.0,728.65,280.25,784.7,11
CDM,36400400_1,HC OLYMPUS ENT WORKSTATION,783.75,509.44,195.94,548.63,11
CDM,36400401_1,HC LASER AGILITI PDL V-BEAM RENTAL,2700.0,1755.0,675.0,1890.0,11
CDM,36400402_1,HC LASER AGILITI ULTRAPULSE C02 RENTAL,6952.5,4519.13,1738.13,4866.75,11
CDM,36400403_1,HC KARL STORZ ICG TOWER,1012.5,658.13,253.13,708.75,11
CDM,36400404_1,HC MITAKA PDE NEO III ICG IMAGING SYSTEM,986.44,641.19,246.61,690.51,11
CDM,36400405_1,HC ALPHA OMEGA NEURO MONITORING,13500.0,8775.0,3375.0,9450.0,11
CDM,36400407_1,HC MICROSCOPE ZEISS KINEVO 900,3150.0,2047.5,787.5,2205.0,11
CDM,36400408_1,HC MICROSCOPE ZEISS TIVATO 700,3150.0,2047.5,787.5,2205.0,11
CDM,36400409_1,HC HOLMIUM MASTERPULSE LASER RENTAL,3825.0,2486.25,956.25,2677.5,11
CDM,36400410_1,HC MORCELLATOR RESECTOSCOPE RENTAL,877.5,570.38,219.38,614.25,11
CDM,36400411_1,HC LASER ENUCLEATION SYSTEM RENTAL,3825.0,2486.25,956.25,2677.5,11
CDM,36400413_1,HC NODE SEEKER PROBE NS-1000,147.0,95.55,36.75,102.9,11
CDM,36400414_1,HC TRUCLEAR HYSTEROSCOPE TISSUE REMOVAL SYSTM,120.0,78.0,30.0,84.0,11
CDM,36400415_1,HC HYSTEROLUX FLUID MANAGEMENT SYSTEM,160.0,104.0,40.0,112.0,11
CDM,36400416_1,HC ROSA ONE BRAIN SYS CASE SUPPORT,15750.0,10237.5,3937.5,11025.0,11
CDM,36400417_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,4050.0,2632.5,1012.5,2835.0,11
CDM,36400418_1,HC CRYO UNIT ENDO CARE RENTAL,3375.0,2193.75,843.75,2362.5,11
CDM,36400420_1,HC DAVINCI XI LONG TIP FORCEPS 471048,562.5,365.63,140.63,393.75,11
CDM,36400421_1,HC DAVINCI XI CADIERE FORCEPS 471049,675.0,438.75,168.75,472.5,11
CDM,36400422_1,HC DAVINCI XI PROGRASP 471093,675.0,438.75,168.75,472.5,11
CDM,36400423_1,HC DAVINCI XI COBRA GRASPER 471190,810.0,526.5,202.5,567.0,11
CDM,36400424_1,HC DAVINCI XI LARGE NEEDLE DRIVER 471006,765.0,497.25,191.25,535.5,11
CDM,36400425_1,HC DAVINCI XI LARGE SUTURECUT NEEDLE DRIVER 471296,765.0,497.25,191.25,535.5,11
CDM,36400426_1,HC DAVINCI XI MEGA SUTURECT NEEDLE DRIVER 471309,787.5,511.88,196.88,551.25,11
CDM,36400427_1,HC DAVINCI XI MICRO BIPOLAR 471171,1305.0,848.25,326.25,913.5,11
CDM,36400428_1,HC DAVINCI XI MARYLAND BIPOLAR FORCEPS 471172,1057.5,687.38,264.38,740.25,11
CDM,36400429_1,HC DAVINCI XI FENESTRATED BIPOLAR FORCEPS 471205,900.0,585.0,225.0,630.0,11
CDM,36400430_1,HC DAVINCI XI  CURVED BIPOLAR DISSSECTOR 471344,1215.0,789.75,303.75,850.5,11
CDM,36400431_1,HC DAVINCI XI LONG BIPLOAR 471400,1305.0,848.25,326.25,913.5,11
CDM,36400432_1,HC DAVINCI XI FORCE BIPOLAR 471405,1057.5,687.38,264.38,740.25,11
CDM,36400433_1,HC OLYMPUS CONTAINED TISSUE EXTRACTION (CTE) SYS,375.0,243.75,93.75,262.5,11
CDM,36400434_1,HC OLYMPUS SHOCKPULSE LITHOTRISPY SYS,1062.4,690.56,265.6,743.68,11
CDM,36400435_1,HC MEDTRONIC IPC CLEARVISION TOWER - EQUIP,226.0,146.9,56.5,158.2,11
CDM,36400436_1,HC MICROSCOPE MITAKA MM51 - EQUIP,3150.0,2047.5,787.5,2205.0,11
CDM,36400437_1,HC MEDTRONIC MR8 NAVIGATED DRILL SYS - EQUIP,292.27,189.98,73.07,204.59,11
CDM,36400438_1,HC MAZOR X ROBOTIC GUIDANCE SYS - EQUIP,2515.62,1635.15,628.91,1760.93,11
CDM,36400439_1,HC SHOCKWAVE IV LITHOTRIPSY SYS - EQUIP,137.52,89.39,34.38,96.26,11
CDM,36400440_1,HC LASER LENSAR SYSTEM – EQUIP,1540.89,1001.58,385.22,1078.62,11
CDM,36400441_1,HC ULTRASOUND STEPPER RENTAL - EQUIP,2025.0,1316.25,506.25,1417.5,11
CDM,36400442_1,HC LENSAR LASER PROCEDURE LICENSE KEY,1012.5,658.13,253.13,708.75,11
CDM,36400444_1,HC CORI ORTHO NAVIGATION SYSTEM – EQUIP,1045.0,679.25,261.25,731.5,11
CDM,36400445_1,HC VASER LIPOSUCTION SYS - EQUIP,374.7,243.56,93.68,262.29,11
CDM,36400446_1,HC PHACO SYS CENTURION ACTIVE SENTRY – EQUIP,125.0,81.25,31.25,87.5,11
CDM,36400447_1,HC LASER 100W HOLMIUM PULSE - EQUIP,855.63,556.16,213.91,598.94,11
CDM,36400448_1,HC LASER 120W HOLMIUM MOSES 2.0 - EQUIP,855.63,556.16,213.91,598.94,11
CDM,36400449_1,HC ION ROBOT ASSISTED BRONCH SYS - EQUIP,3857.14,2507.14,964.29,2700.0,11
CDM,36400450_1,HC ION ARTICULATING CATHETER 490105,5625.0,3656.25,1406.25,3937.5,11
CDM,36400451_1,HC ION PERIF 1.5 VISION PROBE 490206,2137.5,1389.38,534.38,1496.25,11
CDM,36400452_1,HC ION CATHETER GUIDE 490107,207.69,135.0,51.92,145.38,11
CDM,36400453_1,HC ION SENSOR CONN CLEAN 490115,27.0,17.55,6.75,18.9,11
CDM,36400454_1,HC LASER IRIDEX 810 OPHTHALMOLOGY – EQUIP,187.0,121.55,46.75,130.9,11
CDM,36400455_1,HC KARL STORZ ICG TOWER RUBINA – EQUIP,1012.45,658.09,253.11,708.72,11
CDM,36400456_1,HC LASER CO2 DEKA RENTAL,4275.0,2778.75,1068.75,2992.5,11
CDM,36400457_1,HC HISCAN SCANNER FOR DEKA LASER RENTAL,1687.0,1096.55,421.75,1180.9,11
CDM,36400458_1,HC ENDOSCAN SCANNER FOR DEKA LASER RENTAL,1687.0,1096.55,421.75,1180.9,11
CDM,36400459_1,HC MICROMANIPULATOR FOR DEKA LASER RENTAL,450.0,292.5,112.5,315.0,11
CDM,36400460_1,HC IRIDEX OCULIGHT TX LASER RENTAL,5112.0,3322.8,1278.0,3578.4,11
CDM,36400461_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,15750.0,10237.5,3937.5,11025.0,11
CDM,36400462_1,HC TAEWOONG MEDICAL VIVA RF THYROID ABLATION GENERATOR,450.0,292.5,112.5,315.0,11
CDM,36400463_1,HC PROCEDURAL SUPPORT FEE FROM FHC (VENDOR),10080.0,6552.0,2520.0,7056.0,11
CDM,36400464_1,HC WAYPOINT NAVIGATION RENTAL FEE FROM FHC (VENDOR),12600.0,8190.0,3150.0,8820.0,11
CDM,36400465_1,HC DAVINCI XI SURGICAL ROBOT PAY PER USE,8851.5,5753.48,2212.88,6196.05,11
CDM,36400466_1,HC MICROSCOPE MITAKA MM90 - EQUIP,3150.0,2047.5,787.5,2205.0,11
CDM,36400467_1,HC STEALTH STATION SUPPORT FROM MEDTRONIC,18225.0,11846.25,4556.25,12757.5,11
CDM,36400468_1,HC MOLLI WAND - EQUIP,870.0,565.5,217.5,609.0,11
CDM,36400469_1,HC CAUTERY UNIT VALLEYLAB FT10 - EQUIP,156.0,101.4,39.0,109.2,11
CDM,36400470_1,HC CAUTERY UNIT FORCE FX - EQUIP,156.0,101.4,39.0,109.2,11
CDM,36400471_1,HC TITAN POWER UNIT - EQUIP,450.0,292.5,112.5,315.0,11
CDM,36400472_1,HC LEICA AVREO MICROSCOPE - EQUIP,3150.0,2047.5,787.5,2205.0,11
CDM,36400473_1,HC INTRACEPT RF GENERATOR RENTAL-EQUIP,1350.0,877.5,337.5,945.0,11
CDM,36400474_1,HC PTEYE EQUIPMENT,450.0,292.5,112.5,315.0,11
CDM,36400475_1,HC AQUABLATION HYDROS ROBOTIC SYS EQUIPMENT,2412.0,1567.8,603.0,1688.4,11
CDM,36400476_1,HC SPY-PHI EQUIPMENT,970.0,630.5,242.5,679.0,11
CDM,36400477_1,HC SUTTER CURIS GENERATOR EQUIPMENT,215.0,139.75,53.75,150.5,11
CDM,36400478_1,HC PHOENIX ICON SYSTEM EQUIPMENT,450.0,292.5,112.5,315.0,11
CDM,36400479_1,HC NICO MYRIAD EQUIPMENT,550.0,357.5,137.5,385.0,11
CDM,36400480_1,HC JOIMAX TOWER EQUIPMENT,850.0,552.5,212.5,595.0,11
CDM,36400481_1,HC CLIP APPLIER SMALL DA VINCI XI 470401,132.0,85.8,33.0,92.4,11
CDM,36400482_1,HC ALCON UNITY EQUIPMENT,1157.0,752.05,289.25,809.9,11
CDM,36400484_1,HC DAVINCI 5 FORCEPS FORCE FB BIPO FENESTRATED (476205) - EQUIP,2457.0,1597.05,614.25,1719.9,11
CDM,36400485_1,HC DAVINCI 5 FORCEPS FORCE FB CADIERE (476049) - EQUIP,1773.0,1152.45,443.25,1241.1,11
CDM,36400486_1,HC DAVINCI 5 FORCEPS FORCE FB MARYLAND BIPO (476172)- EQUIP,2889.0,1877.85,722.25,2022.3,11
CDM,36400487_1,HC DAVINCI 5 FORCEPS FORCE FB PROGRASP (476093) - EQUIP,1773.0,1152.45,443.25,1241.1,11
CDM,36400488_1,HC DAVINCI 5 NEEDDRIVER FORCE FB LARGE (476006) - EQUIP,2169.0,1409.85,542.25,1518.3,11
CDM,36400489_1,HC DAVINCI 5 NEEDDRIVER FORCE FB SUTURECUT MEGA (476309) - EQUIP,2232.0,1450.8,558.0,1562.4,11
CDM,36400490_1,HC MITAKA SURGICAL MICROSCOPE EQIP,4819.5,3132.68,1204.88,3373.65,11
CDM,36400_1,Insertion of needle into upper leg or neck vein (younger than 3 years),60.0,39.0,15.08,78.57,19
CDM,36401001_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,36401002_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,36401004_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,36401013_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,384.0,249.6,96.0,268.8,11
CDM,36405_1,Insertion of needle into scalp vein (younger than 3 years),80.0,52.0,12.12,78.57,19
CDM,36406_1,Insertion of needle into vein (younger than 3 years),80.0,52.0,7.37,78.57,19
CDM,36410080_1,HC BRAIN LAB CURVE,4189.0,2722.85,1047.25,2932.3,11
CDM,36410_1,Insertion of needle into vein (3 years or older),60.0,39.0,7.5,78.57,19
CDM,36411010_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,36415_1,Insertion of needle into vein for collection of blood sample,10.0,6.5,0.93,78.57,19
CDM,36416_1,Puncture of skin for collection of blood sample,10.0,6.5,3.0,78.57,15
CDM,36419499_1,Other procedure on breast,3832.0,2490.8,958.0,9896.14,19
CDM,36420550_1,Injection into tendon or ligament,361.5,234.98,90.38,2166.29,19
CDM,36420552_1,"Injection of trigger points, 1-2 muscles",255.0,165.75,63.75,2166.29,19
CDM,36420553_1,"Injection of trigger points, 3 or more muscles",241.0,156.65,60.25,2166.29,19
CDM,36420605_1,Aspiration and/or injection of fluid from medium joint,361.5,234.98,90.38,2166.29,19
CDM,36420606_1,Aspiration and/or injection of fluid from medium joint using ultrasound guidance,459.0,298.35,114.75,3227.0,19
CDM,36420610_1,Aspiration and/or injection of fluid from large joint,714.0,464.1,178.5,2166.29,19
CDM,36420611_1,Aspiration and/or injection of fluid large joint using ultrasound guidance,412.5,268.13,103.13,2166.29,19
CDM,36420_1,Incision of vein for insertion of needle or tube (younger than 1 year),280.0,182.0,40.7,139.01,19
CDM,36422511_1,Stabilization of lower spine bone,7312.0,4752.8,1828.0,18883.24,19
CDM,36425_1,Incision of vein for insertion of needle or tube (1 year or older),130.0,84.5,30.79,121.98,19
CDM,36427096_1,Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance,2455.5,1596.08,613.88,6341.33,19
CDM,36430_1,Transfusion of blood or blood products,150.0,97.5,24.7,110.75,19
CDM,36436430_1,Transfusion of blood or blood products,1150.0,747.5,287.5,2969.88,19
CDM,36438IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",61.86,40.21,15.47,159.75,16
CDM,36438OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",65.15,42.35,16.29,168.25,16
CDM,36440_1,Push blood transfusion (2 years or younger),152.3,99.0,40.32,158.11,19
CDM,36450542_1,Destruction of growth of kidney using an endoscope,7320.0,4758.0,1830.0,18903.9,19
CDM,36450_1,"Exchange blood transfusion, newborn",472.5,307.13,78.57,535.55,19
CDM,36455_1,"Exchange blood transfusion, other than newborn",485.1,315.32,78.57,636.03,19
CDM,36456111_1,HC ALPHA OMEGA NEURONAV SYSTEM,1994.0,1296.1,498.5,1395.8,11
CDM,36456116_1,HC LASER EXCIMER SPECTRANETICS,195.0,126.75,48.75,136.5,11
CDM,36456_1,"Partial exchange transfusion, newborn",255.08,165.8,78.57,309.27,19
CDM,36460_1,Intrauterine fetal transfusion,1050.0,682.5,78.57,1041.44,19
CDM,36462273_1,Injection of blood or blood clot into spinal canal,968.0,629.2,242.0,3227.0,19
CDM,36462320_1,Injection of substance into middle or upper spine canal,1142.0,742.3,285.5,3227.0,19
CDM,36462321_1,Injection of substance into middle or upper spine canal using imaging guidance,1631.0,1060.15,407.75,4212.06,19
CDM,36462322_1,Injection of substance into lower spine canal,1142.0,742.3,285.5,3227.0,19
CDM,36462323_1,Injection of substance into lower spine canal using imaging guidance,1631.0,1060.15,407.75,4212.06,19
CDM,36462370_1,Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician,522.0,339.3,130.5,2318.31,19
CDM,36463650_1,Insertion of spinal neurostimulator electrode array through skin,17229.0,11198.85,2318.31,44493.89,19
CDM,36464400_1,Injection of anesthetic agent and/or steroid into face nerve,873.0,567.45,218.25,2254.52,19
CDM,36464405_1,Injection of anesthetic agent and/or steroid into upper neck and back of head nerve,654.0,425.1,163.5,2166.29,19
CDM,36464416_1,Continuous infusion of anesthetic agent and/or steroid into arm nerve bundle through catheter,1125.0,731.25,281.25,3227.0,19
CDM,36464417_1,Injection of anesthetic agent and/or steroid into upper arm and shoulder nerve (axillary nerve),273.0,177.45,68.25,3227.0,19
CDM,36464418_1,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,775.5,504.08,193.88,3227.0,19
CDM,36464420_1,Injection of anesthetic agent and/or steroid into rib nerve,525.0,341.25,131.25,3227.0,19
CDM,36464421_1,Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block,479.0,311.35,119.75,3227.0,19
CDM,36464425_1,Injection of anesthetic agent and/or steroid into lower abdomen and groin nerve,975.0,633.75,243.75,3227.0,19
CDM,36464430_1,Injection of anesthetic agent and/or steroid into external genitals and anus nerve,973.5,632.78,243.38,3227.0,19
CDM,36464447_1,Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve),775.5,504.08,193.88,8477.27,19
CDM,36464450_1,Injection of anesthetic agent and/or steroid into other nerve or branch,1119.0,727.35,279.75,3227.0,19
CDM,36464451_1,Injection of anesthetic agent and/or steroid into spine and pelvis nerve using imaging guidance,1875.0,1218.75,468.75,4842.19,19
CDM,36464454_1,Injection of anesthetic agent and/or steroid into knee nerve branch using imaging guidance,1875.0,1218.75,468.75,4842.19,19
CDM,36464479_1,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level",2824.5,1835.93,706.13,7294.27,19
CDM,36464483_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level",3168.0,2059.2,792.0,8181.36,19
CDM,36464484_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level",972.0,631.8,243.0,2510.19,19
CDM,36464490_1,"Injection of upper or middle spine facet joint using imaging guidance, single level",2038.5,1325.03,509.63,5264.43,19
CDM,36464491_1,"Injection of upper or middle spine facet joint using imaging guidance, second level",1495.0,971.75,373.75,3860.84,19
CDM,36464492_1,"Injection of upper or middle spine facet joint using imaging guidance, third and any additional level",1631.0,1060.15,407.75,4212.06,19
CDM,36464493_1,"Injection of lower or sacral spine facet joint using imaging guidance, single level",3168.0,2059.2,792.0,8181.36,19
CDM,36464494_1,"Injection of lower or sacral spine facet joint using imaging guidance, second level",1204.0,782.6,301.0,3109.33,19
CDM,36464495_1,"Injection of lower or sacral spine facet joint using imaging guidance, third and any additional level",1225.0,796.25,306.25,3163.56,19
CDM,36464510_1,Injection of anesthetic agent into sympathetic nerve bundle,3025.5,1966.58,756.38,7813.35,19
CDM,36464517_1,Injection of anesthetic agent into sacral nerve bundle,416.0,270.4,104.0,3227.0,19
CDM,36464520_1,Injection of anesthetic agent into middle or lower spine sympathetic nerve,3025.5,1966.58,756.38,7813.35,19
CDM,36464530_1,Injection of anesthetic agent into abdominal sympathetic nerve bundle,2017.0,1311.05,504.25,5208.9,19
CDM,36464555_1,Insertion of peripheral nerve neurostimulator electrode through skin,8629.5,5609.18,2157.38,22285.68,19
CDM,36464600_1,Destruction of first division of face nerve branch,2191.0,1424.15,547.75,5658.26,19
CDM,36464612_1,Injection of chemical for paralysis of nerve muscles on side of face,361.5,234.98,90.38,2166.29,19
CDM,36464615_1,Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face,735.0,477.75,183.75,2166.29,19
CDM,36464620_1,Injection of agent to destroy rib nerve,3025.5,1966.58,756.38,7813.35,19
CDM,36464624_1,Destruction of nerve branches of knee using imaging guidance,5160.0,3354.0,1290.0,13325.7,19
CDM,36464625_1,Destruction of nerves supplying joint between spine and pelvis using imaging guidance,5160.0,3354.0,1290.0,13325.7,19
CDM,36464633_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint",8820.0,5733.0,1861.61,22777.65,19
CDM,36464634_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint",1226.0,796.9,306.5,3166.15,19
CDM,36464635_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint",9000.0,5850.0,1861.61,23242.5,19
CDM,36464636_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint",1066.0,692.9,266.5,2752.95,19
CDM,36464640_1,Destruction of peripheral nerve or branch,1512.0,982.8,378.0,3904.74,19
CDM,36464680_1,Injection of agent to destroy abdominal nerve bundle,853.0,554.45,213.25,3227.0,19
CDM,36464681_1,Injection of agent to destroy presacral nerve bundle,1280.0,832.0,320.0,3305.6,19
CDM,36464999_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,36465_1,Injection of chemical agent into single incompetent vein of leg using ultrasound guidance,3500.0,2275.0,78.57,3148.96,19
CDM,36466_1,Injection of chemical agent into multiple incompetent veins of same leg using ultrasound guidance,3655.0,2375.75,78.57,3396.95,19
CDM,36468T_1,"Injection of chemical agent into spider vein of arm, leg, or trunk",326.3,212.1,55.57,453.06,15
CDM,36468_1,"Injection of chemical agent into spider vein of arm, leg, or trunk",530.0,344.5,55.57,453.06,15
CDM,36470320_1,"X-ray of teeth, full mouth",150.0,97.5,37.5,387.38,18
CDM,36470T_1,Injection of chemical agent into single incompetent vein,326.3,212.1,25.44,272.64,19
CDM,36470_1,Injection of chemical agent into single incompetent vein,570.0,370.5,25.44,272.64,19
CDM,36471T_1,Injection of chemical agent into multiple incompetent veins of leg,326.3,212.1,60.13,472.97,19
CDM,36471_1,Injection of chemical agent into multiple incompetent veins of leg,705.0,458.25,43.64,472.97,19
CDM,36473_1,Mechanochemical destruction of first incompetent vein of arm or leg using imaging guidance,3459.65,2248.77,78.57,2913.93,19
CDM,36474_1,Mechanochemical destruction of subsequent incompetent veins of arm or leg using imaging guidance,633.7,411.91,69.62,610.31,19
CDM,36475T_1,Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance,4380.9,2847.59,72.7,2572.64,19
CDM,36475_1,Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance,5165.0,3357.25,74.88,2572.64,19
CDM,36476232_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,855.0,555.75,213.75,598.5,11
CDM,36476237_1,HC MONITORING ELECTRODE SINGLE,13.0,8.45,3.25,9.1,11
CDM,36476238_1,HC MONITORING ELECTRODE PAIR,21.0,13.65,5.25,14.7,11
CDM,36476261_1,Electronic assessment of bladder emptying,307.0,199.55,76.75,792.83,19
CDM,36476262_1,Complex measurement of pressure of urine flow in bladder,600.0,390.0,150.0,1549.5,19
CDM,36476263_1,Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings,137.0,89.05,34.25,1279.0,19
CDM,36476264_1,Insertion of device into abdomen with pressure and urine flow rate study,372.0,241.8,93.0,960.69,19
CDM,36476267_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,15563.0,10115.95,3890.75,10894.1,11
CDM,36476270_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,825.0,536.25,206.25,577.5,11
CDM,36476271_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,449.0,291.85,112.25,314.3,11
CDM,36476272_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,449.0,291.85,112.25,314.3,11
CDM,36476T_1,Destruction of subsequent incompetent veins of arm or leg using radiofrequency and imaging guidance,3280.5,2132.33,78.57,668.69,19
CDM,36476_1,Destruction of subsequent incompetent veins of arm or leg using radiofrequency and imaging guidance,1077.3,700.25,78.57,668.69,19
CDM,36477002_1,Fluoroscopic guidance for needle placement,395.0,256.75,98.75,1020.09,18
CDM,36477003_1,Fluoroscopic guidance for spine or back muscle injection,200.0,130.0,50.0,516.5,18
CDM,36477004_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,4402.0,2861.3,1100.5,3081.4,11
CDM,36477424_1,Delivery of single session of intraoperative radiation treatment with X-ray,7230.0,4699.5,1197.0,18671.48,19
CDM,36478165_1,HC TRAY/SETS B,53.0,34.45,13.25,37.1,11
CDM,36478166_1,HC TRAY SETS C,98.0,63.7,24.5,68.6,11
CDM,36478167_1,HC TRAY SETS D,159.0,103.35,39.75,111.3,11
CDM,36478168_1,HC TRAY SETS E,180.0,117.0,45.0,126.0,11
CDM,36478T_1,Laser destruction of incompetent vein of arm or leg using imaging guidance,3280.5,2132.33,78.57,2335.73,19
CDM,36478_1,Laser destruction of incompetent vein of arm or leg using imaging guidance,3825.0,2486.25,78.57,2335.73,19
CDM,36479T_1,"Laser destruction of incompetent veins of arm or leg using imaging guidance, subsequent",3280.5,2132.33,76.07,707.38,19
CDM,36479_1,"Laser destruction of incompetent veins of arm or leg using imaging guidance, subsequent",1099.4,714.61,77.59,707.38,19
CDM,36480000_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,1532.2,995.93,383.05,1072.54,11
CDM,36480001_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,67.0,43.55,16.75,46.9,11
CDM,36480002_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,92.95,60.42,23.24,65.07,11
CDM,36480003_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,118.2,76.83,29.55,82.74,11
CDM,36480004_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,142.45,92.59,35.61,99.72,11
CDM,36480005_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,168.7,109.66,42.18,118.09,11
CDM,36480006_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,199.0,129.35,49.75,139.3,11
CDM,36481_1,Insertion of tube into portal vein of liver,4172.0,2711.8,78.57,4205.43,19
CDM,36482_1,Chemical destruction of first incompetent vein of arm or leg using imaging guidance,1572.0,1021.8,78.57,4013.9,19
CDM,36483_1,Chemical destruction of subsequent incompetent veins of arm or leg using imaging guidance,310.0,201.5,70.49,317.73,19
CDM,36486035_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,18.2,11.83,4.55,12.74,11
CDM,36486036_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,27.3,17.75,6.83,19.11,11
CDM,36486037_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,32.35,21.03,8.09,22.65,11
CDM,36486038_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,39.0,25.35,9.75,27.3,11
CDM,36486039_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,395.0,256.75,98.75,276.5,11
CDM,36488000_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,850.0,552.5,212.5,595.0,11
CDM,36488011_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,36.0,23.4,9.0,25.2,11
CDM,36488012_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,55.0,35.75,13.75,38.5,11
CDM,36488013_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,110.0,71.5,27.5,77.0,11
CDM,36488014_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,143.0,92.95,35.75,100.1,11
CDM,36488015_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,169.0,109.85,42.25,118.3,11
CDM,36488016_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,130.3,84.7,32.58,91.21,11
CDM,36489000_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,752.0,488.8,188.0,526.4,11
CDM,36489001_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,33.0,21.45,8.25,23.1,11
CDM,36489002_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,47.0,30.55,11.75,32.9,11
CDM,36489003_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,94.0,61.1,23.5,65.8,11
CDM,36489004_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,99.0,64.35,24.75,69.3,11
CDM,36489005_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,110.0,71.5,27.5,77.0,11
CDM,36489006_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,118.0,76.7,29.5,82.6,11
CDM,36490870_1,Therapy using electrical currents,1198.0,778.7,610.98,3093.84,16
CDM,36495972_1,Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming,328.0,213.2,82.0,847.06,19
CDM,36495991_1,Maintenance of spinal canal or brain drug infusion pump by health care professional,241.0,156.65,60.25,2054.0,19
CDM,364C1713_1,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),184.58,119.98,46.15,476.69,16
CDM,364C1750_1,"CATHETER, HEMODIALYSIS/PERITONEAL, LONG-TERM",1197.0,778.05,299.25,3091.25,16
CDM,364C1760_1,"CLOSURE DEVICE, VASCULAR (IMPLANTABLE/INSERTABLE)",658.0,427.7,164.5,1699.29,16
CDM,364C1761_1,"CATHETER, TRANSLUMINAL INTRAVASCULAR LITHOTRIPSY, CORONARY",12000.0,7800.0,3000.0,30990.0,17
CDM,364C1769_1,GUIDE WIRE,222.0,144.3,55.5,573.32,16
CDM,364C1776_1,JOINT DEVICE (IMPLANTABLE),7650.0,4972.5,1912.5,19756.13,17
CDM,364C1780_1,"LENS, INTRAOCULAR (NEW TECHNOLOGY)",6052.5,3934.13,1513.13,15630.58,17
CDM,364C1876_1,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",4481.0,2912.65,1120.25,11572.18,16
CDM,364C1889_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",3594.38,2336.35,898.6,9282.49,16
CDM,364C1894_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",277.0,180.05,69.25,715.35,16
CDM,364G0260_1,"INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID AND/OR OTHER THERAPEUTIC AGENT, WITH OR WITHOUT ARTHROGRAPHY",4092.5,2660.13,667.58,10568.88,19
CDM,364IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.48,7.46,2.87,29.65,16
CDM,364L8610_1,OCULAR IMPLANT,5975.0,3883.75,716.57,7170.0,17
CDM,364OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.7,16.06,6.18,63.79,16
CDM,364SU270_1,HC OR SUPPLY REV CODE 270 NO HCPCS,59.58,38.73,14.9,41.71,11
CDM,36500000_1,RECOVERY ROOM - GENERAL CLASSIFICATION,20.0,13.0,5.0,14.0,11
CDM,36500009_1,RECOVERY ROOM - GENERAL CLASSIFICATION,1888.0,1227.2,472.0,1321.6,11
CDM,36500010_1,RECOVERY ROOM - GENERAL CLASSIFICATION,1282.0,833.3,320.5,897.4,11
CDM,36500013_1,RECOVERY ROOM - GENERAL CLASSIFICATION,336.0,218.4,84.0,235.2,11
CDM,36500101_1,SPECIALTY SERVICES - TREATMENT ROOM,778.0,505.7,194.5,544.6,12
CDM,36500102_1,SPECIALTY SERVICES - TREATMENT ROOM,778.0,505.7,194.5,544.6,12
CDM,36500103_1,SPECIALTY SERVICES - TREATMENT ROOM,778.0,505.7,194.5,544.6,12
CDM,36500104_1,SPECIALTY SERVICES - TREATMENT ROOM,1880.0,1222.0,208.0,1316.0,12
CDM,36500105_1,SPECIALTY SERVICES - TREATMENT ROOM,778.0,505.7,194.5,544.6,12
CDM,36500106_1,SPECIALTY SERVICES - TREATMENT ROOM,418.0,271.7,104.5,292.6,12
CDM,36500107_1,SPECIALTY SERVICES - TREATMENT ROOM,778.0,505.7,194.5,544.6,12
CDM,36500108_1,SPECIALTY SERVICES - TREATMENT ROOM,783.0,508.95,195.75,548.1,12
CDM,36500110_1,SPECIALTY SERVICES - TREATMENT ROOM,1564.0,1016.6,208.0,1094.8,12
CDM,36500111_1,SPECIALTY SERVICES - TREATMENT ROOM,778.0,505.7,194.5,544.6,12
CDM,36500_1,Insertion of tube into vein with collection of blood sample,534.5,347.43,78.57,539.91,19
CDM,36510_1,"Insertion of tube into umbilical vein, newborn",290.0,188.5,34.76,207.57,19
CDM,36511_1,Mechanical separation of white blood cells from blood,276.2,179.53,78.57,334.34,19
CDM,36512_1,Mechanical separation of red blood cells from blood,273.0,177.45,78.57,335.36,19
CDM,36513_1,Mechanical separation of platelet cells from blood,279.3,181.55,78.57,328.33,19
CDM,36514_1,Mechanical separation of plasma from blood,1100.0,715.0,73.75,1353.26,19
CDM,36516_1,Mechanical separation of plasma and abnormal antibodies from blood,741.0,481.65,9.57,4215.3,19
CDM,36522_1,Mechanical separation of white blood cells and platelets from blood,855.0,555.75,12.28,3257.52,19
CDM,36551798_1,Ultrasound measurement of bladder capacity after voiding,196.0,127.4,49.0,506.17,19
CDM,36555_1,Insertion of non-tunneled central venous tube for infusion (younger than 5 years),790.0,513.5,39.71,459.02,19
CDM,36556_1,Insertion of non-tunneled central venous tube for infusion (5 years or older),760.0,494.0,39.86,513.19,19
CDM,36557_1,Insertion of tunneled central venous tube for infusion (younger than 5 years),2357.3,1532.25,65.38,2767.66,19
CDM,36558_1,Insertion of tunneled central venous tube for infusion (5 years or older),3304.35,2147.83,62.76,2001.0,19
CDM,36560_1,Insertion of central venous tube with port (younger than 5 years),3233.0,2101.45,68.44,2945.39,19
CDM,36561_1,Insertion of central venous tube with port (5 years or older),4800.6,3120.39,63.16,2361.4,19
CDM,36563_1,Insertion of central venous tube with pump,3910.2,2541.63,67.43,2688.67,19
CDM,36565_1,Insertion of 2 central venous tubes in 2 veins for infusion,2774.1,1803.17,73.76,1953.94,19
CDM,36566_1,Insertion of 2 central venous tubes in 2 veins with port,9995.0,6496.75,21.11,10245.91,19
CDM,36568_1,Insertion of tube for infusion (younger than 5 years),640.0,416.0,20.68,283.75,19
CDM,36569_1,Insertion of tube for infusion (5 years or older),830.0,539.5,20.95,286.5,19
CDM,36570_1,Insertion of central venous tube with port for infusion (younger than 5 years),4011.0,2607.15,52.05,3487.02,19
CDM,36571_1,Insertion of central venous tube with port for infusion (5 years or older),3612.0,2347.8,48.16,3024.43,19
CDM,36572700_1,RECOVERY ROOM - GENERAL CLASSIFICATION,336.0,218.4,84.0,235.2,11
CDM,36572701_1,RECOVERY ROOM - GENERAL CLASSIFICATION,733.0,476.45,183.25,513.1,11
CDM,36572_1,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient younger than 5 years",224.0,145.6,68.37,904.51,19
CDM,36573_1,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient 5 years or older",205.0,133.25,67.58,928.23,19
CDM,36575_1,Repair of central venous tube for infusion,430.0,279.5,6.71,348.78,19
CDM,36576IP _1,UNCLASSIFIED DRUGS,46.2,30.03,11.55,119.31,16
CDM,36576OP _1,UNCLASSIFIED DRUGS,61.88,40.22,15.47,159.81,16
CDM,36576_1,Repair of central venous tube for infusion with port or pump,1023.8,665.47,63.0,821.29,19
CDM,36577OP _1,"INJECTION, ALPHA 1 PROTEINASE INHIBITOR (HUMAN), NOT OTHERWISE SPECIFIED, 10 MG",3199.36,2079.58,5.69,8262.35,19
CDM,36578_1,"Replacement of central venous tube, tube only",1371.3,891.35,78.57,1029.71,19
CDM,36580_1,Replacement of nontunneled central venous tube,743.4,483.21,13.57,456.96,19
CDM,36581_1,Replacement of tunneled central venous tube,2050.0,1332.5,36.04,1876.29,19
CDM,36582_1,Replacement of tunneled central venous tube with port,2891.7,1879.61,54.46,2110.8,19
CDM,36583_1,Replacement of tunneled central venous tube with pump,2969.4,1930.11,52.79,2744.41,19
CDM,36584_1,Replacement of peripherally inserted central venous tube (PICC) with review by radiologist,746.6,485.29,14.13,788.74,19
CDM,36585_1,Replacement of peripherally inserted central venous tube (PICC) with port,3543.8,2303.47,46.68,2780.26,19
CDM,36589T_1,Removal of tunneled central venous tube,739.2,480.48,73.48,417.74,19
CDM,36589_1,Removal of tunneled central venous tube,470.0,305.5,75.68,417.74,19
CDM,36590870_1,Therapy using electrical currents,1198.0,778.7,610.98,3093.84,16
CDM,36590IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.17,2.71,1.04,10.77,16
CDM,36590OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.08,1.35,0.52,5.37,16
CDM,36590T_1,Removal of central venous tube with port or pump,1422.8,924.82,78.57,573.72,19
CDM,36590_1,Removal of central venous tube with port or pump,890.0,578.5,78.57,573.72,19
CDM,36591IP _1,"INJECTION, PALONOSETRON HCL, 25 MCG",57.92,37.65,0.37,149.58,17
CDM,36591OP _1,"INJECTION, PALONOSETRON HCL, 25 MCG",31.89,20.73,0.37,82.36,17
CDM,36591_1,Collection of blood sample from implanted device,60.9,39.59,18.52,78.57,19
CDM,36592960_1,External shock to heart to regulate heart beat,2388.0,1552.2,597.0,6167.01,19
CDM,36592_1,Collection of blood sample from central venous tube,66.2,43.03,24.7,79.62,19
CDM,36593_1,Declotting of central venous tube,72.5,47.13,34.78,91.43,19
CDM,36595_1,Mechanical removal of obstructive material from central venous tube,2059.1,1338.42,39.42,1428.55,19
CDM,36596_1,Mechanical removal of tissue or obstructive material from central venous tube,453.6,294.84,10.83,273.38,19
CDM,36597_1,Repositioning of central venous tube using fluoroscopic guidance,399.0,259.35,37.05,267.34,19
CDM,36598_1,Contrast injection for imaging to evaluate central venous access device,278.3,180.9,28.63,291.78,19
CDM,365IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.88,1.87,0.72,7.44,16
CDM,365OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.73,1.12,0.43,4.47,16
CDM,36600_1,Artery puncture collection of blood sample,80.0,52.0,12.46,78.57,19
CDM,36612IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.23,6.0,2.31,23.84,16
CDM,36612OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.95,14.27,5.49,56.69,16
CDM,36620_1,Insertion of artery tube for blood sampling or infusion through skin,150.0,97.5,38.68,137.75,19
CDM,36625_1,Insertion of artery tube for blood sampling or infusion through artery incision,340.0,221.0,78.57,317.36,19
CDM,36640_1,Insertion of artery tube for prolonged infusion,350.7,227.96,78.57,355.55,19
CDM,36660_1,"Insertion of umbilical artery tube, newborn",200.0,130.0,55.28,214.78,19
CDM,36680_1,Insertion of needle for infusion into bone,310.0,201.5,52.16,176.38,19
CDM,3670238T_1,"Catheter removal of plaque from groin artery, accessed through the skin or open procedure including radiological supervision and interpretation",14490.0,9418.5,3622.5,37420.43,19
CDM,3670441T_1,"Freezing destruction of nerve in leg, accessed through the skin, using imaging guidance",4425.0,2876.25,188.0,11427.56,19
CDM,3670620T_1,Insertion of stent to shunt arterial blood to deep vein of lower leg via catheter using imaging guidance,126270.0,82075.5,7016.18,326092.28,19
CDM,3670994T_1,"ENDOVASCULAR DELIVERY OF AORTIC WALL STABILIZATION DRUG THERAPY THROUGH A SHEATH POSITIONED WITHIN AN ABDOMINAL AORTIC ANEURYSM, WITH AORTIC ROADMAPPING, BALLOON OCCLUSION, IMAGING GUIDANCE, AND RADIO",15000.0,9750.0,3750.0,38737.5,16
CDM,3670995T_1,"ENDOVASCULAR DELIVERY OF AORTIC WALL STABILIZATION DRUG THERAPY THROUGH A SHEATH POSITIONED WITHIN AN ABDOMINAL AORTIC ANEURYSM, WITH AORTIC ROADMAPPING, BALLOON OCCLUSION, IMAGING GUIDANCE, AND RADIO",25000.0,16250.0,6250.0,64562.5,16
CDM,36710140_1,Drainage of blood or fluid accumulation,1500.0,975.0,375.0,3873.75,19
CDM,36711042_1,"Removal of skin and tissue, 20.0 sq cm or less",914.0,594.1,228.5,2360.41,19
CDM,36711043_1,"Removal of muscle and/or tissue, 20.0 sq cm or less",2332.0,1515.8,555.36,6022.39,19
CDM,36711044_1,"Removal of bone, 20.0 sq cm or less",3000.0,1950.0,750.0,7747.5,19
CDM,36711045_1,"Removal of skin and tissue, each additional 20.0 sq cm or less",300.0,195.0,75.0,2166.29,19
CDM,36711046_1,"Removal of muscle and/or tissue, each additional 20.0 sq cm or less",720.0,468.0,180.0,2166.29,19
CDM,36711047_1,"Removal of bone, each additional 20.0 sq cm or less",800.0,520.0,200.0,2166.29,19
CDM,36711730_1,"Simple separation of fingernail or toenail from nail bed, first nail",460.0,299.0,96.73,2166.29,19
CDM,36711981_1,Insertion of drug delivery implant into tissue,110.0,71.5,27.5,2166.29,19
CDM,36715271_1,"Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less",1550.0,1007.5,387.5,32200.71,19
CDM,36715275_1,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less",4180.0,2717.0,1045.0,10794.85,19
CDM,36720205_1,Deep biopsy of muscle,2270.0,1475.5,567.5,6141.01,19
CDM,36720610_1,Aspiration and/or injection of fluid from large joint,476.0,309.4,119.0,2166.29,19
CDM,36720670_1,Removal of surface implant from bone,1330.0,864.5,332.5,3726.0,19
CDM,36720680_1,Removal of deep implant from bone,2957.58,1922.43,739.4,7637.95,19
CDM,36727301_1,Drainage of deep abscess or blood accumulation of thigh or knee,9666.0,6282.9,2416.5,24962.45,19
CDM,36727590_1,Amputation of thigh through thigh bone,7450.0,4842.5,1862.5,19239.63,19
CDM,36727599_1,Other procedure on thigh or knee,630.0,409.5,157.5,2166.29,19
CDM,36727602_1,Incision of connective tissue of front and/or side and back of lower leg to relieve pressure,7800.0,5070.0,1950.0,20143.5,19
CDM,36727603_1,Drainage of deep abscess or blood accumulation of leg or ankle,6444.0,4188.6,1611.0,16641.63,19
CDM,36727880_1,Amputation of both lower leg bones,7418.0,4821.7,1854.5,19156.99,19
CDM,36728110_1,Removal of bunion at fifth toe joint,7420.0,4823.0,1855.0,19162.15,19
CDM,36728111_1,Removal of foot bone at great toe joint,7420.0,4823.0,1855.0,19162.15,19
CDM,36728112_1,"Removal of toe bone at second, third, or fourth joints",7420.0,4823.0,1855.0,19162.15,19
CDM,36728113_1,Complete removal of foot bone at fifth toe joint,7420.0,4823.0,1855.0,19162.15,19
CDM,36728114_1,Complete removal of second to fifth foot bones,7420.0,4823.0,1855.0,19162.15,19
CDM,36728116_1,Removal of abnormal bones at ankle joint,7420.0,4823.0,1855.0,19162.15,19
CDM,36728118_1,Removal of heel bone,7420.0,4823.0,1855.0,19162.15,19
CDM,36728119_1,Removal of heel bone spur,7420.0,4823.0,1855.0,19162.15,19
CDM,36728120_1,Partial removal of infected foot or heel bone,7420.0,4823.0,1855.0,19162.15,19
CDM,36728122_1,Partial removal of foot or heel bone,7803.0,5071.95,1950.75,20151.25,19
CDM,36728124_1,Partial removal of toe bone,7420.0,4823.0,1855.0,19162.15,19
CDM,36728126_1,Removal of toe bone at foot,7420.0,4823.0,1855.0,19162.15,19
CDM,36728190_1,"Removal of foreign body of foot tissue, accessed beneath the skin",1719.0,1117.35,429.75,4439.32,19
CDM,36728192_1,"Removal of foreign body of foot tissue, deep",4040.0,2626.0,1010.0,10433.3,19
CDM,36728193_1,Complicated removal of foreign body in foot,4040.0,2626.0,1010.0,10433.3,19
CDM,36728800_1,Amputation of midfoot bone,7805.0,5073.25,1951.25,20156.41,19
CDM,36728805_1,Amputation of foot across instep,7417.0,4821.05,1854.25,19154.4,19
CDM,36728810_1,Amputation of toe and midfoot bone,7803.0,5071.95,1950.75,20151.25,19
CDM,36728820_1,Amputation of toe at joint between forefoot and toes,7803.0,5071.95,1950.75,20151.25,19
CDM,36728825_1,Amputation of toe at toe joint,7803.0,5071.95,1950.75,20151.25,19
CDM,36731622_1,Diagnostic exam of lung airway using an endoscope,3121.0,2028.65,780.25,8059.98,19
CDM,36733880_1,Repair of descending aorta and subclavian artery with insertion of graft and extensions,33572.0,21821.8,3678.0,86699.69,19
CDM,36733881_1,Repair of descending aorta with insertion of graft and extensions,35191.0,22874.15,3678.0,90880.76,19
CDM,36733902_1,"Placement of stent in pulmonary artery with abnormal anatomical connections, on one side of body",40182.0,26118.3,9815.0,103770.02,19
CDM,36734001_1,Removal of blood clot in neck to chest artery,12595.0,8186.75,3148.75,32526.59,19
CDM,36734051_1,Removal of blood clot in chest artery,12595.0,8186.75,3148.75,32526.59,19
CDM,36734101_1,Removal of blood clot in artery of upper arm,12593.0,8185.45,3148.25,32521.42,19
CDM,36734111_1,Removal of blood clot in artery of lower arm,12593.0,8185.45,3148.25,32521.42,19
CDM,36734151_1,Removal of blood clot in artery of abdominal organs,12595.0,8186.75,3148.75,32526.59,19
CDM,36734201_1,Removal of blood clot in artery of groin and leg,13515.0,8784.75,3378.75,34902.49,19
CDM,36734203_1,Removal of blood clot in artery of lower leg,13515.0,8784.75,3378.75,34902.49,19
CDM,36734401_1,Removal of blood clot in vena cava,9900.0,6435.0,2475.0,25566.75,19
CDM,36734421_1,"Removal of blood clot in vena cava, pelvic, or thigh vein",7305.0,4748.25,1826.25,18865.16,19
CDM,36734451_1,"Removal of blood clot in vena cava, pelvic, or thigh vein by abdominal and leg incision",9900.0,6435.0,2475.0,25566.75,19
CDM,36734471_1,Removal of blood clot in upper chest vein,1440.0,936.0,360.0,8477.27,19
CDM,36734490_1,Removal of blood clot in underarm or upper chest vein,7305.0,4748.25,1826.25,18865.16,19
CDM,36734703_1,Repair of infrarenal aorta and groin artery with graft for other than rupture with review by radiologist,25000.0,16250.0,3678.0,64562.5,19
CDM,36734705_1,Repair of infrarenal aorta and groin artery with graft for other than rupture on both sides with review by radiologist,7305.0,4748.25,1826.25,24359.93,19
CDM,36734709_1,Repair of abdominal or groin artery with prosthesis with review by radiologist,7305.0,4748.25,1826.25,24359.93,19
CDM,36734710_1,"Delayed insertion of prosthesis for repair of abdominal or groin artery with review by radiologist, initial vessel treated",25200.0,16380.0,3678.0,65079.0,19
CDM,36734711_1,"Delayed insertion of prosthesis for repair of abdominal or groin artery with review by radiologist, each additional vessel treated",25200.0,16380.0,2166.29,65079.0,19
CDM,36734712_1,Delivery of fixation device to graft with review by radiologist,25210.0,16386.5,3678.0,65104.83,19
CDM,36734713_1,Exposure of groin artery for delivery of graft,7305.0,4748.25,1242.0,24359.93,19
CDM,36734715_1,Exposure of underarm or upper chest artery for delivery of prosthesis,1690.0,1098.5,422.5,5929.67,19
CDM,36734716_1,Exposure of underarm or upper chest artery with creation of conduit,7500.0,4875.0,1242.0,19368.75,17
CDM,36734717_1,Repair of groin artery with graft insert through artery and repair of aorta,25000.0,16250.0,3678.0,64562.5,19
CDM,36734812_1,Exposure of thigh artery for insertion of prosthesis,12592.0,8184.8,3148.0,32518.84,19
CDM,36734834_1,Exposure of arm artery for insertion of prosthesis,7300.0,4745.0,1825.0,18852.25,19
CDM,36734841_1,"Repair of aorta in abdomen with graft, including graft in abdominal organ arteries with review by radiologist",2153.0,1399.45,538.25,24359.93,19
CDM,36734842_1,"Repair of aorta in abdomen below kidneys with graft, including 2 grafts in abdominal organ arteries with review by radiologist",2153.0,1399.45,538.25,24359.93,19
CDM,36734843_1,"Repair of aorta in abdomen below kidneys with graft, including 3 grafts in abdominal organ arteries with review by radiologist",2153.0,1399.45,538.25,24359.93,19
CDM,36734844_1,"Repair of aorta in abdomen below kidneys with graft, including 4 or more grafts in abdominal organ arteries with review by radiologist",2153.0,1399.45,538.25,24359.93,19
CDM,36734845_1,"Repair of aorta in abdomen between and below kidneys with graft, including graft in artery to abdominal organs with review by radiologist",3685.0,2395.25,921.25,24359.93,19
CDM,36734846_1,"Repair of aorta in abdomen between and below kidneys with graft, including 2 grafts in abdominal organ arteries with review by radiologist",3685.0,2395.25,921.25,24359.93,19
CDM,36734847_1,"Repair of aorta in abdomen between and below kidneys with graft, including 3 grafts in abdominal organ arteries with review by radiologist",3685.0,2395.25,921.25,24359.93,19
CDM,36734848_1,"Repair of aorta in abdomen between and below kidneys with graft, including 4 or more grafts in abdominal organ arteries with review by radiologist",3685.0,2395.25,921.25,24359.93,19
CDM,36735011_1,Repair of aneurysm or arm artery with graft,13001.0,8450.65,3250.25,33575.08,19
CDM,36735141_1,Repair of aneurysm or upper thigh artery with graft,1690.0,1098.5,422.5,8477.27,19
CDM,36735226_1,Repair of blood vessel of leg,1561.0,1014.65,390.25,7016.18,19
CDM,36735286_1,Repair of blood vessel of leg with graft,4955.0,3220.75,1238.75,12796.29,19
CDM,36735301_1,"Removal of blood clot and portion of chest, neck, or brain artery",18000.0,11700.0,3678.0,46485.0,19
CDM,36735302_1,Removal of blood clot and portion of superficial femoral artery,18000.0,11700.0,3678.0,46485.0,19
CDM,36735303_1,Removal of blood clot and portion of popliteal artery,18000.0,11700.0,3678.0,46485.0,19
CDM,36735304_1,Removal of blood clot and portion of tibioperoneal trunk artery,18000.0,11700.0,3678.0,46485.0,19
CDM,36735305_1,"Removal of blood clot and portion of tibial or peroneal artery, initial artery",18000.0,11700.0,3678.0,46485.0,19
CDM,36735306_1,"Removal of blood clot and portion of tibial or peroneal artery, each additional artery",18000.0,11700.0,3678.0,46485.0,19
CDM,36735311_1,Removal of blood clot and portion of chest or neck artery,18000.0,11700.0,3678.0,46485.0,19
CDM,36735321_1,Removal of blood clot and portion of artery of upper arm,13515.0,8784.75,3378.75,34902.49,19
CDM,36735331_1,Removal of blood clot and portion of abdominal aorta,18000.0,11700.0,3678.0,46485.0,19
CDM,36735341_1,Removal of blood clot and portion of artery of abdominal organ,18000.0,11700.0,3678.0,46485.0,19
CDM,36735351_1,Removal of blood clot and portion of artery of groin,18000.0,11700.0,3678.0,46485.0,19
CDM,36735355_1,Removal of blood clot and portion of artery of upper thigh,18000.0,11700.0,3678.0,46485.0,19
CDM,36735361_1,Removal of blood clot and portion of abdominal aorta and groin artery,18000.0,11700.0,3678.0,46485.0,19
CDM,36735371_1,Removal of blood clot and portion of upper thigh artery,25000.0,16250.0,3678.0,64562.5,19
CDM,36735372_1,Removal of blood clot and portion of deep upper thigh artery,18000.0,11700.0,4500.0,46485.0,19
CDM,36735500_1,Harvest of upper arm vein segment,12592.0,8184.8,1242.0,32518.84,19
CDM,36735556_1,Bypass of diseased or blocked upper to lower leg artery with vein,18000.0,11700.0,3678.0,46485.0,19
CDM,36735572_1,Harvest of upper leg to thigh vein segment,12592.0,8184.8,1242.0,32518.84,19
CDM,36735646_1,Bypass of diseased or blocked artery aorta to upper leg and opposite upper leg artery with other than vein,18000.0,11700.0,3678.0,46485.0,19
CDM,36735647_1,Bypass of diseased or blocked aorta to upper leg artery with other than vein,18000.0,11700.0,3678.0,46485.0,19
CDM,36735650_1,Bypass of diseased or blocked under arm to opposite arm artery with other than vein,18000.0,11700.0,3678.0,46485.0,19
CDM,36735654_1,Bypass of diseased or blocked arm to both lower thigh arteries with other than vein,18000.0,11700.0,3678.0,46485.0,19
CDM,36735656_1,Bypass of diseased or blocked upper leg to lower thigh artery with other than vein,18000.0,11700.0,3678.0,46485.0,19
CDM,36735661_1,Bypass of diseased or blocked upper leg to opposite upper leg artery with other than vein,18000.0,11700.0,3678.0,46485.0,19
CDM,36735663_1,Bypass of diseased or blocked groin to opposite groin artery with other than vein,18000.0,11700.0,3678.0,46485.0,19
CDM,36735665_1,Bypass of diseased or blocked groin to upper leg artery with other than vein,18000.0,11700.0,3678.0,46485.0,19
CDM,36735666_1,Bypass of diseased or blocked upper leg to lower leg artery with other than vein,18000.0,11700.0,3678.0,46485.0,19
CDM,36735671_1,Bypass of diseased or blocked knee to lower leg arteries with other than vein,18000.0,11700.0,3678.0,46485.0,19
CDM,36735685_1,Insertion of vein patch at lowest portion of bypass graft,9000.0,5850.0,1242.0,23242.5,19
CDM,36735701_1,Exploration of neck artery,2500.0,1625.0,625.0,8477.27,19
CDM,36735702_1,Exploration of arm artery,1615.0,1049.75,403.75,5929.67,19
CDM,36735703_1,Exploration of leg artery,1615.0,1049.75,403.75,5929.67,19
CDM,36735860_1,"Exploration of arm or leg for bleeding, blood clot, or infection after surgery",7305.0,4748.25,1826.25,18865.16,19
CDM,36735875_1,Removal of blood clot of artery or vein graft,13515.0,8784.75,3378.75,34902.49,19
CDM,36735903_1,Removal of infected graft of arm or leg,7305.0,4748.25,1826.25,18865.16,19
CDM,36736005_1,Injection for X-ray imaging procedure into vein of arm or leg,555.0,360.75,138.75,2166.29,19
CDM,36736010_1,Insertion of tube into vena cava,947.0,615.55,236.75,2445.63,19
CDM,36736011_1,"Insertion of tube into vein, first order branch",1843.0,1197.95,460.75,4759.55,19
CDM,36736012_1,"Insertion of tube into vein, second order branch",2028.0,1318.2,507.0,5237.31,19
CDM,36736014_1,Insertion of tube into left or right pulmonary artery,1496.0,972.4,374.0,3863.42,19
CDM,36736015_1,Insertion of tube into artery of lobe of lung,1843.0,1197.95,460.75,4759.55,19
CDM,36736140_1,Insertion of needle or tube into artery of arm or leg,975.0,633.75,243.75,2517.94,19
CDM,36736200_1,Insertion of tube into aorta,1621.0,1053.65,405.25,4186.23,19
CDM,36736215_1,"Insertion of tube into chest or arm artery, each first order branch",1500.0,975.0,375.0,3873.75,19
CDM,36736216_1,"Insertion of tube into chest or arm artery, initial second order branch",2396.0,1557.4,599.0,6187.67,19
CDM,36736217_1,"Insertion of tube into chest or arm artery, initial third order branch",2852.0,1853.8,713.0,7365.29,19
CDM,36736218_1,"Insertion of tube into chest or arm artery, additional second, third order and beyond",456.0,296.4,114.0,2318.31,19
CDM,36736224_1,Insertion of tube into internal neck artery for diagnosis or treatment with review by radiologist,12595.0,8186.75,3148.75,32526.59,19
CDM,36736245_1,"Insertion of tube into abdominal, pelvic, or leg artery, each first order branch",4305.0,2798.25,994.94,11117.66,19
CDM,36736246_1,"Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch",2802.0,1821.3,700.5,7236.17,19
CDM,36736247_1,"Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch",3331.0,2165.15,832.75,8602.31,19
CDM,36736248_1,"Insertion of tube into abdominal, pelvic, or leg artery, additional second, third, and beyond",1959.0,1273.35,489.75,5059.12,19
CDM,36736251_1,Insertion of tube into first order main and accessory arteries of kidney for imaging with review by radiologist,7570.0,4920.5,1892.5,19549.53,19
CDM,36736252_1,Insertion of tube into first order main and accessory arteries of both kidneys for imaging with review by radiologist,3556.0,2311.4,889.0,9183.37,19
CDM,36736253_1,Insertion of tube into second or third order branches of arteries of kidney for imaging with review by radiologist,6399.0,4159.35,1599.75,16525.42,19
CDM,36736254_1,Insertion of tube into second or third order branches of arteries of both kidneys for imaging with review by radiologist,7487.0,4866.55,1871.75,19335.18,19
CDM,36736430_1,Transfusion of blood or blood products,1051.0,683.15,262.75,2714.21,19
CDM,36736478_1,Laser destruction of incompetent vein of arm or leg using imaging guidance,4000.0,2600.0,1000.0,10330.0,19
CDM,36736556_1,Insertion of non-tunneled central venous tube for infusion (5 years or older),7305.0,4748.25,1596.28,18865.16,19
CDM,36736589_1,Removal of tunneled central venous tube,3948.0,2566.2,987.0,10195.71,19
CDM,36736595_1,Mechanical removal of obstructive material from central venous tube,7305.0,4748.25,1072.29,18865.16,19
CDM,36736596_1,Mechanical removal of tissue or obstructive material from central venous tube,3670.0,2385.5,917.5,9477.78,19
CDM,36736620_1,Insertion of artery tube for blood sampling or infusion through skin,589.0,382.85,147.25,2166.29,19
CDM,36736821_1,Relocation of arm vein with connection to arm artery for hemodialysis,7570.0,4920.5,1892.5,19549.53,19
CDM,36736830_1,Creation of artery-vein connection using tube graft for hemodialysis,13001.0,8450.65,3250.25,33575.08,19
CDM,36736832_1,Revision of hemodialysis graft,13001.0,8450.65,3250.25,33575.08,19
CDM,36736833_1,Revision of hemodialysis graft with removal of blood clot,13005.0,8453.25,3251.25,33585.41,19
CDM,36736901_1,Insertion of needle and/or tube into hemodialysis circuit with review by radiologist,1831.0,1190.15,457.75,4728.56,19
CDM,36736902_1,Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,15254.0,9915.1,3813.5,39393.46,19
CDM,36736903_1,Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist,31576.0,20524.4,7894.0,81545.02,19
CDM,36736904_1,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,15254.0,9915.1,3813.5,39393.46,19
CDM,36736905_1,"Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube",31576.0,20524.4,7894.0,81545.02,19
CDM,36736906_1,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment and placement of stent with review by radiologist,48051.0,31233.15,9592.09,124091.71,19
CDM,36736907_1,Balloon dilation of dialysis segment with review by radiologist,13001.0,8450.65,1242.0,33575.08,19
CDM,36736908_1,Insertion of stent in dialysis segment with review by radiologist,13001.0,8450.65,1242.0,33575.08,19
CDM,36736909_1,Permanent blockage of hemodialysis circuit with review by radiologist,5874.0,3818.1,1242.0,15873.48,19
CDM,36737184_1,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, initial vessel",5334.0,3467.1,1333.5,13775.06,19
CDM,36737185_1,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, subsequent vessels",5644.0,3668.6,1242.0,14575.63,19
CDM,36737186_1,Secondary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance,1109.0,720.85,277.25,15873.48,19
CDM,36737187_1,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, initial treatment",4440.0,2886.0,1110.0,12029.7,19
CDM,36737188_1,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, repeat treatment on subsequent day",2795.0,1816.75,698.75,12029.7,19
CDM,36737191_1,Insertion of vena cava filter with review by radiologist,9160.0,5954.0,2290.0,23655.7,19
CDM,36737193_1,Removal of vena cava filter with review by radiologist,14290.0,9288.5,3572.5,36903.93,19
CDM,36737211_1,"Insertion of tube into artery for drug infusion for blood clot with review by radiologist, initial treatment day",12593.0,8185.45,2166.29,32521.42,19
CDM,36737212_1,"Insertion of tube into vein for drug infusion for blood clot with review by radiologist, initial treatment day",7305.0,4748.25,1826.25,18865.16,19
CDM,36737213_1,Insertion of tube into artery or vein for drug infusion for blood clot with review by radiologist,7305.0,4748.25,1826.25,18865.16,19
CDM,36737214_1,Removal of tube into artery or vein with review by radiologist,7305.0,4748.25,1826.25,18865.16,19
CDM,36737215_1,Insertion of stent and blood clot protection device in neck artery with review by radiologist,10830.0,7039.5,2707.5,32128.91,19
CDM,36737216_1,Insertion of stent in neck artery with review by radiologist,10830.0,7039.5,2707.5,32128.91,19
CDM,36737220_1,"Balloon dilation of groin artery, initial vessel",12771.0,8301.15,3192.75,32981.11,19
CDM,36737221_1,"Insertion of stent in groin artery, initial vessel",15798.0,10268.7,3949.5,40798.34,19
CDM,36737222_1,"Balloon dilation of groin artery, each additional vessel",5834.0,3792.1,1458.5,15873.48,19
CDM,36737223_1,"Insertion of stent in groin artery, additional vessel",6780.0,4407.0,1695.0,17509.35,19
CDM,36737224_1,Balloon dilation of artery of leg,12644.0,8218.6,3161.0,32653.13,19
CDM,36737225_1,Removal of plaque in arteries of leg,18466.0,12002.9,4616.5,47688.45,19
CDM,36737226_1,Insertion of stent in arteries of leg,16057.0,10437.05,4014.25,41467.2,19
CDM,36737227_1,Removal of plaque and insertion of stents in arteries of leg,22320.0,14508.0,5580.0,57641.4,19
CDM,36737228_1,"Balloon dilation of artery of leg, initial vessel",29245.0,19009.25,7016.18,75525.21,19
CDM,36737229_1,"Removal of plaque in artery of leg, initial vessel",14794.0,9616.1,3698.5,38205.51,19
CDM,36737230_1,"Insertion of stent in artery of leg, initial vessel",44328.0,28813.2,7016.18,114477.06,19
CDM,36737231_1,"Removal of plaque and insertion of stents in artery of leg, initial vessel",15313.0,9953.45,3828.25,39545.82,19
CDM,36737232_1,"Balloon dilation of artery of leg, each additional vessel",9846.0,6399.9,2166.29,25427.3,19
CDM,36737233_1,"Removal of plaque in artery of leg, each additional vessel",9846.0,6399.9,2166.29,25427.3,19
CDM,36737234_1,"Insertion of stent in artery of leg, each additional vessel",12592.0,8184.8,2166.29,32518.84,19
CDM,36737236_1,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, initial artery",15766.0,10247.9,3941.5,40715.7,19
CDM,36737237_1,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, each additional artery",7568.0,4919.2,1892.0,19544.36,19
CDM,36737238_1,"Insertion of stent in vein with review by radiologist, initial vein",25330.0,16464.5,6141.01,65414.73,19
CDM,36737239_1,"Insertion of stent in vein with review by radiologist, each additional vein",12665.0,8232.25,2166.29,32707.36,19
CDM,36737241_1,Occlusion of vein with review by radiologist,25209.0,16385.85,6302.25,65102.24,19
CDM,36737242_1,Occlusion of artery with review by radiologist,15766.0,10247.9,3941.5,53527.48,19
CDM,36737246_1,"Balloon dilation of artery with review by radiologist, initial artery",15254.0,9915.1,3813.5,39393.46,19
CDM,36737247_1,"Balloon dilation of artery with review by radiologist, each additional artery",7475.0,4858.75,1242.0,19304.19,19
CDM,36737248_1,"Balloon dilation of vein with review by radiologist, initial vein",12425.0,8076.25,3106.25,32087.56,19
CDM,36737249_1,"Balloon dilation of vein with review by radiologist, each additional vein",3732.0,2425.8,933.0,9637.89,19
CDM,36737252_1,"Ultrasound evaluation of blood vessel with review by radiologist, initial vessel",8392.0,5454.8,1242.0,21672.34,17
CDM,36737253_1,"Ultrasound evaluation of blood vessel with review by radiologist, each additional vessel",6714.0,4364.1,1242.0,17338.91,17
CDM,36737254_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",14540.0,9451.0,3635.0,37549.55,16
CDM,36737255_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",7270.0,4725.5,1817.5,18774.78,16
CDM,36737256_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",14540.0,9451.0,3635.0,37549.55,16
CDM,36737257_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",7270.0,4725.5,1817.5,18774.78,16
CDM,36737258_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",29490.0,19168.5,7372.5,76157.93,16
CDM,36737259_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",14745.0,9584.25,3686.25,38078.96,16
CDM,36737260_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",29490.0,19168.5,7372.5,76157.93,16
CDM,36737261_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",14745.0,9584.25,3686.25,38078.96,16
CDM,36737263_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",14540.0,9451.0,3635.0,37549.55,16
CDM,36737264_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",7270.0,4725.5,1817.5,18774.78,16
CDM,36737265_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",14540.0,9451.0,3635.0,37549.55,16
CDM,36737266_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",7270.0,4725.5,1817.5,18774.78,16
CDM,36737267_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",29490.0,19168.5,7372.5,76157.93,16
CDM,36737268_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",14745.0,9584.25,3686.25,38078.96,16
CDM,36737269_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",29490.0,19168.5,7372.5,76157.93,16
CDM,36737270_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",14745.0,9584.25,3686.25,38078.96,16
CDM,36737271_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",46830.0,30439.5,11707.5,120938.48,16
CDM,36737272_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",23415.0,15219.75,5853.75,60469.24,16
CDM,36737273_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",46830.0,30439.5,11707.5,120938.48,16
CDM,36737274_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",23415.0,15219.75,5853.75,60469.24,16
CDM,36737275_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",46830.0,30439.5,11707.5,120938.48,16
CDM,36737276_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",23415.0,15219.75,5853.75,60469.24,16
CDM,36737277_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",46830.0,30439.5,11707.5,120938.48,16
CDM,36737278_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",23415.0,15219.75,5853.75,60469.24,16
CDM,36737279_1,"INTRAVASCULAR LITHOTRIPSY(IES), FEMORAL AND POPLITEAL VASCULAR TERRITORY, INCLUDING ALL IMAGING GUIDANCE AND RADIOLOGICAL SUPERVISION AND INTERPRETATION NECESSARY TO PERFORM THE INTRAVASCULAR LITHOTRI",11008.0,7155.2,2752.0,28428.16,16
CDM,36737280_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",29490.0,19168.5,7372.5,76157.93,16
CDM,36737281_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",14745.0,9584.25,3686.25,38078.96,16
CDM,36737282_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",29490.0,19168.5,7372.5,76157.93,16
CDM,36737283_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",14745.0,9584.25,3686.25,38078.96,16
CDM,36737284_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",46830.0,30439.5,11707.5,120938.48,16
CDM,36737285_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",23415.0,15219.75,5853.75,60469.24,16
CDM,36737286_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",46830.0,30439.5,11707.5,120938.48,16
CDM,36737287_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",23415.0,15219.75,5853.75,60469.24,16
CDM,36737288_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",46830.0,30439.5,11707.5,120938.48,16
CDM,36737289_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",23415.0,15219.75,5853.75,60469.24,16
CDM,36737290_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",46830.0,30439.5,11707.5,120938.48,16
CDM,36737291_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",23415.0,15219.75,5853.75,60469.24,16
CDM,36737292_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",46830.0,30439.5,11707.5,120938.48,16
CDM,36737293_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",23415.0,15219.75,5853.75,60469.24,16
CDM,36737294_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",46830.0,30439.5,11707.5,120938.48,16
CDM,36737295_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",23415.0,15219.75,5853.75,60469.24,16
CDM,36737296_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",29490.0,19168.5,7372.5,76157.93,16
CDM,36737297_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",14745.0,9584.25,3686.25,38078.96,16
CDM,36737298_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",29490.0,19168.5,7372.5,76157.93,16
CDM,36737299_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",14745.0,9584.25,3686.25,38078.96,16
CDM,36737607_1,Tying or banding of surgically created artery-vein connection,7305.0,4748.25,1826.25,18865.16,19
CDM,36737609_1,Tying or biopsy of artery on side of skull,1330.0,864.5,332.5,3726.0,19
CDM,36737616_1,Tying of major chest artery,7570.0,4920.5,1892.5,19549.53,19
CDM,36737617_1,Tying of major artery of the abdomen,7570.0,4920.5,1892.5,19549.53,19
CDM,36737618_1,Tying of major arm or leg artery,7570.0,4920.5,1892.5,19549.53,19
CDM,36737619_1,Tying of inferior vena cava,13005.0,8453.25,3251.25,33585.41,19
CDM,36737650_1,Tying of upper leg vein,7570.0,4920.5,1892.5,19549.53,19
CDM,36737660_1,Tying of groin vein,7570.0,4920.5,1892.5,19549.53,19
CDM,36737700_1,Tying and division of long leg vein,7570.0,4920.5,1892.5,19549.53,19
CDM,36737718_1,"Tying, incision, and stripping of short leg vein",7570.0,4920.5,1892.5,19549.53,19
CDM,36737722_1,"Tying, incision, and stripping of long leg vein",7570.0,4920.5,1892.5,19549.53,19
CDM,36737735_1,"Tying, incision, and stripping of leg veins with removal of ulcer and skin graft and/or interruption of lower leg veins",7570.0,4920.5,1892.5,19549.53,19
CDM,36737760_1,"Tying of varicose veins, radical procedure including skin graft",7570.0,4920.5,1892.5,19549.53,19
CDM,36737765_1,"Removal of varicose veins of arm or leg, 10-20 incisions",2520.0,1638.0,630.0,7441.0,19
CDM,36737799_1,Other procedure on blood vessel,1440.0,936.0,360.0,3718.8,19
CDM,36743247_1,"Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2255.0,1465.75,563.75,5823.54,19
CDM,36743249_1,"Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm",4003.0,2601.95,1000.75,10337.75,19
CDM,36743266_1,"Placement of stent in esophagus, stomach, and/or upper small bowel using a flexible endoscope",14317.0,9306.05,3579.25,36973.65,19
CDM,36749000_1,Exploration of abdominal cavity,6086.0,3955.9,1521.5,15717.1,19
CDM,36762272_1,Removal of cerebrospinal fluid with lower back spinal tap,817.0,531.05,204.25,3227.0,19
CDM,36764640_1,Destruction of peripheral nerve or branch,2089.0,1357.85,522.25,5394.84,19
CDM,36764905_1,"Transfer of nerve to injured nerve, stage 1 of 2",15265.0,9922.25,2318.31,39421.86,19
CDM,36764907_1,"Transfer of nerve to injured nerve, stage 2 of 2",15265.0,9922.25,2166.29,39421.86,19
CDM,36764999_1,Other procedure on nervous system,679.0,441.35,169.75,2166.29,19
CDM,36775625_1,Review by radiologist of abdominal aorta image,5490.0,3568.5,1372.5,14177.93,18
CDM,36775630_1,Review by radiologist of abdominal aorta and both leg arteries image,7305.0,4748.25,1826.25,18865.16,18
CDM,36775710_1,Review by radiologist of arm or leg artery image,8065.0,5242.25,2016.25,20827.86,18
CDM,36775716_1,Review by radiologist of both arms or legs arteries image,8605.0,5593.25,2151.25,22222.41,18
CDM,36775726_1,Review by radiologist of abdominal artery image,11670.0,7585.5,2917.5,30137.78,18
CDM,36775741_1,Review by radiologist of lung artery image,7305.0,4748.25,1826.25,18865.16,18
CDM,36775743_1,Review by radiologist of arteries of both lungs image,7305.0,4748.25,1826.25,18865.16,18
CDM,36775746_1,Review by radiologist of lung artery image with contrast,7305.0,4748.25,1826.25,18865.16,18
CDM,36775774_1,Review by radiologist of additional artery image,854.0,555.1,213.5,6559.08,18
CDM,36775820_1,Review by radiologist of 1 arm or leg vein of 1 arm or leg image,1728.0,1123.2,432.0,4462.56,18
CDM,36775822_1,Review by radiologist of both arms and legs veins of both arms or legs image,2265.0,1472.25,566.25,5849.36,18
CDM,36775825_1,Review by radiologist of major lower body vein image,6820.0,4433.0,1705.0,17612.65,18
CDM,36775827_1,Review by radiologist of major upper body vein image,3670.0,2385.5,917.5,9477.78,18
CDM,36775956_1,ENDOVASCULAR REPAIR OF THE THORACIC AORTA BY DEPLOYMENT OF A BRANCHED ENDOGRAFT MULTIPIECE SYSTEM INVOLVING AN AORTO-AORTIC TUBE DEVICE WITH A FENESTRATION FOR THE LEFT SUBCLAVIAN ARTERY STENT GRAFT(S,3100.0,2015.0,775.0,8005.75,16
CDM,36775IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.4,13.26,5.1,52.68,16
CDM,36775OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.06,20.84,8.02,82.8,16
CDM,36776536_1,Ultrasound scan of head and neck soft tissue,461.0,299.65,115.25,1190.53,18
CDM,36776705_1,Limited ultrasound scan of abdomen,511.0,332.15,127.75,1319.66,18
CDM,36776937_1,Ultrasonic guidance for blood vessel access,650.0,422.5,162.5,1678.63,18
CDM,36776IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.95,3.22,1.24,12.78,16
CDM,36792978_1,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel",3394.0,2206.1,294.16,8765.01,19
CDM,36792979_1,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, each additional vessel",2716.0,1765.4,294.16,8477.27,19
CDM,36797605_1,"Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less",460.0,299.0,115.0,1187.95,18
CDM,36797607_1,"Therapy procedure using a special bandage, vacuum pump and disposable medical equipment, surface area 50.0 sq cm or less",914.0,594.1,228.5,2360.41,18
CDM,36797608_1,"Therapy procedure using a special bandage, vacuum pump and disposable medical equipment, surface area more than 50.0 sq cm",914.0,594.1,228.5,2360.41,18
CDM,367C9764_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL(S), WHEN PERFORM",11811.0,7677.15,2952.75,30501.91,19
CDM,367C9765_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, AND TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WI",23931.0,15555.15,5982.75,61801.81,19
CDM,367C9772_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL/PERONEAL ARTERY(IES), WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL (S), WHEN PERFORMED",23931.0,15555.15,5982.75,61801.81,19
CDM,367G0269_1,"PLACEMENT OF OCCLUSIVE DEVICE INTO EITHER A VENOUS OR ARTERIAL ACCESS SITE, POST SURGICAL OR INTERVENTIONAL PROCEDURE (E.G., ANGIOSEAL PLUG, VASCULAR PLUG)",153.0,99.45,38.25,8477.27,17
CDM,36800_1,Insertion of tube connecting vein to vein for hemodialysis,458.9,298.29,78.57,371.39,19
CDM,36810_1,Insertion of tube connecting artery to vein for hemodialysis,1076.3,699.6,78.57,634.29,19
CDM,36815_1,Revision or removal of tube connecting artery to vein for hemodialysis,708.8,460.72,78.57,389.37,19
CDM,36818_1,Relocation of major upper arm vein with connection to arm artery for hemodialysis,1957.2,1272.18,78.57,2003.29,19
CDM,36819_1,Relocation of upper arm surface vein with connection to arm artery for hemodialysis,2322.6,1509.69,78.57,2120.4,19
CDM,36820_1,Relocation of forearm vein with connection to arm artery for hemodialysis,2331.0,1515.15,78.57,2090.18,19
CDM,36821_1,Relocation of arm vein with connection to arm artery for hemodialysis,1953.0,1269.45,78.57,1923.7,19
CDM,36823_1,Insertion of tube into arm or leg for blood circulation and chemotherapy,3716.0,2415.4,78.57,4078.06,19
CDM,36825_1,Creation of artery-vein connection using vein graft for hemodialysis,2448.6,1591.59,78.57,2304.63,19
CDM,36830_1,Creation of artery-vein connection using tube graft for hemodialysis,2441.3,1586.85,78.57,1936.28,19
CDM,36831_1,Removal of blood clot from hemodialysis graft,1522.5,989.63,78.57,1787.36,19
CDM,36832_1,Revision of hemodialysis graft,1696.8,1102.92,78.57,2196.49,19
CDM,36833_1,Revision of hemodialysis graft with removal of blood clot,1916.3,1245.6,78.57,2346.39,19
CDM,36835_1,Insertion of hemodialysis shunt in artery or vein,1135.7,738.21,78.57,1400.7,19
CDM,36836_1,Creation of opening between artery and vein in arm with single access to both blood vessels,782.0,508.3,78.57,16795.18,19
CDM,36837_1,Creation of opening between artery and vein in arm with separate access to each blood vessels,1011.5,657.48,78.57,23892.36,19
CDM,36838_1,Repair of hemodialysis access in arm,3423.0,2224.95,78.57,3300.29,19
CDM,36860_1,Injection for removal of blood clot from external dialysis tube,579.6,376.74,33.96,544.37,19
CDM,36861_1,Insertion of balloon tube for removal of blood clot from external dialysis tube,682.5,443.63,78.57,403.63,19
CDM,36900010_1,HC ORGAN ACQ - LIVER,503134.0,327037.1,226410.3,352193.8,10
CDM,36900015_1,HC ORGAN ACQ - KIDNEY SCD,224671.0,146036.15,101101.95,157269.7,10
CDM,36900016_1,HC ORGAN ACQ - KIDNEY DCD,224671.0,146036.15,101101.95,157269.7,10
CDM,36900017_1,HC ORGAN ACQ - KIDNEY ECD,224671.0,146036.15,101101.95,157269.7,10
CDM,36900020_1,HC ORGAN ACQ - PANCREAS,351542.0,228502.3,158193.9,246079.4,10
CDM,36900025_1,HC ORGAN ACQ - SMALL BOWEL,384145.0,249694.25,172865.25,268901.5,10
CDM,36900030_1,HC ORGAN ACQ - HEART,440330.0,286214.5,198148.5,308231.0,10
CDM,36900035_1,HC ORGAN ACQ-KIDNEY,224671.0,146036.15,101101.95,157269.7,10
CDM,36900040_1,HC ORGAN ACQ - SINGLE LUNG,362282.0,235483.3,163026.9,253597.4,10
CDM,36900045_1,HC ORGAN ACQ - BILATERAL LUNG,452852.0,294353.8,203783.4,316996.4,10
CDM,36900050_1,HC ORGAN ACQ LOCAL - LIVER,503134.0,327037.1,226410.3,352193.8,10
CDM,36900055_1,HC ORGAN ACQ LOCAL- KIDNEY,224671.0,146036.15,101101.95,157269.7,10
CDM,36900060_1,HC ORGAN ACQ LOCAL - PANCREAS,351542.0,228502.3,158193.9,246079.4,10
CDM,36900065_1,HC ORGAN ACQ LOCAL- SMALL BOWEL,384145.0,249694.25,172865.25,268901.5,10
CDM,36900070_1,HC ORGAN ACQ LOCAL- HEART,440330.0,286214.5,198148.5,308231.0,10
CDM,36900075_1,HC ORGAN ACQ LOCAL- BILATERAL LUNG,452852.0,294353.8,203783.4,316996.4,10
CDM,36900080_1,HC ORGAN ACQ IMPORT - LIVER,503134.0,327037.1,226410.3,352193.8,10
CDM,36900085_1,HC ORGAN ACQ IMPORT- KIDNEY,224671.0,146036.15,101101.95,157269.7,10
CDM,36900090_1,HC ORGAN ACQ IMPORT - PANCREAS,351542.0,228502.3,158193.9,246079.4,10
CDM,36900095_1,HC ORGAN ACQ IMPORT- SMALL BOWEL,384145.0,249694.25,172865.25,268901.5,10
CDM,36900100_1,HC ORGAN ACQ IMPORT- HEART,440330.0,286214.5,198148.5,308231.0,10
CDM,36900105_1,HC ORGAN ACQ IMPORT- BILATERAL LUNG,452852.0,294353.8,203783.4,316996.4,10
CDM,36900110_1,HC LIVE DONOR - LIVER,503134.0,327037.1,226410.3,352193.8,10
CDM,36900115_1,HC LIVE DONOR - KIDNEY,224671.0,146036.15,101101.95,157269.7,10
CDM,36900116_1,HC LIVE DONOR – APKD KIDNEY,224671.0,146036.15,101101.95,157269.7,10
CDM,36900120_1,HC ORGAN ACQ LOCAL - SINGLE LUNG,362282.0,235483.3,163026.9,253597.4,10
CDM,36900125_1,HC ORGAN ACQ IMPORT - SINGLE LUNG,362282.0,235483.3,163026.9,253597.4,10
CDM,36901_1,Insertion of needle and/or tube into hemodialysis circuit with review by radiologist,1318.63,857.11,78.57,1692.64,19
CDM,36902_1,Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,2805.25,1823.41,78.57,2900.42,19
CDM,36903_1,Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist,12868.45,8364.49,78.57,10302.5,19
CDM,36904_1,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,4090.0,2658.5,78.57,4351.63,19
CDM,36905_1,"Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube",5233.58,3401.83,78.57,5484.92,19
CDM,36906_1,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment and placement of stent with review by radiologist,15602.9,10141.89,78.57,13066.91,19
CDM,36907_1,Balloon dilation of dialysis segment with review by radiologist,1678.58,1091.08,78.57,1417.34,19
CDM,36908_1,Insertion of stent in dialysis segment with review by radiologist,6184.1,4019.67,78.57,3404.6,19
CDM,36909_1,Permanent blockage of hemodialysis circuit with review by radiologist,4510.55,2931.86,78.57,4603.45,19
CDM,36959IP _1,UNCLASSIFIED DRUGS,18.66,12.13,4.67,48.19,16
CDM,36959OP _1,UNCLASSIFIED DRUGS,21.83,14.19,5.46,56.38,16
CDM,36962IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.83,1.19,0.46,4.73,16
CDM,36962OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.35,1.53,0.59,6.07,16
CDM,36966IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.35,4.13,1.59,16.4,16
CDM,36966OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",40.46,26.3,10.12,104.49,16
CDM,3697IP _1,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",143.2,93.08,4.65,369.81,17
CDM,3697OP _1,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",91.41,59.42,4.65,236.07,17
CDM,36983IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.52,13.99,5.38,55.58,16
CDM,36983OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",46.6,30.29,11.65,120.34,16
CDM,36987IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",114.35,74.33,28.59,295.31,16
CDM,36987OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.2,3.38,1.3,13.43,16
CDM,36988IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.55,2.96,1.14,11.75,16
CDM,36989IP _1,"INJECTION, DAPTOMYCIN (XELLIA), UNREFRIGERATED, NOT THERAPEUTICALLY EQUIVALENT TO J0878 OR J0873, 1 MG",192.62,125.2,0.06,497.44,17
CDM,36989OP _1,"INJECTION, DAPTOMYCIN (XELLIA), UNREFRIGERATED, NOT THERAPEUTICALLY EQUIVALENT TO J0878 OR J0873, 1 MG",132.52,86.14,0.06,342.23,17
CDM,3698IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.9,3.19,1.23,12.65,16
CDM,3698OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.99,23.39,9.0,92.94,16
CDM,36_1,"ESKETAMINE, NASAL SPRAY, 1 MG",2317.5,1506.38,579.38,5984.94,16
CDM,3700IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.3,4.75,1.83,18.85,16
CDM,3700OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.86,18.76,7.22,74.53,16
CDM,3701IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.95,2.57,0.99,10.2,16
CDM,3701OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.5,9.43,3.63,37.45,16
CDM,37140_1,Connection of vena cava and portal vein of liver,4672.5,3037.13,78.57,6779.66,19
CDM,37145_1,Connection of kidney vein and portal vein of liver,4672.5,3037.13,78.57,6288.04,19
CDM,37160_1,Connection of vena cava and abdominal vein,4672.5,3037.13,78.57,6460.06,19
CDM,37170IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.68,3.69,1.42,14.67,16
CDM,37170OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.28,18.38,7.07,73.03,16
CDM,37180_1,Connection of spleen and kidney vein near aorta,4672.5,3037.13,78.57,6210.74,19
CDM,37181_1,Connection of spleen and kidney vein,4672.5,3037.13,78.57,6779.66,19
CDM,37182_1,Insertion of shunts to bypass blood flow to liver with review by radiologist,2629.2,1708.98,78.57,2512.49,19
CDM,37183_1,Revision of shunts to bypass blood flow to liver with review by radiologist,1291.5,839.48,78.57,14161.04,19
CDM,37184_1,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, initial vessel",5638.5,3665.03,78.57,4090.05,19
CDM,37185_1,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, subsequent vessels",2336.3,1518.6,46.05,1122.34,19
CDM,37186_1,Secondary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance,4814.3,3129.3,53.1,2837.14,19
CDM,37187_1,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, initial treatment",5125.5,3331.58,78.57,4091.5,19
CDM,37188_1,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, repeat treatment on subsequent day",2418.0,1571.7,62.52,3531.35,19
CDM,37191_1,Insertion of vena cava filter with review by radiologist,1935.0,1257.75,78.57,4902.3,19
CDM,37192_1,Repositioning of vena cava filter with review by radiologist,3073.4,1997.71,78.57,3029.06,19
CDM,37193_1,Removal of vena cava filter with review by radiologist,2932.7,1906.26,78.57,3606.67,19
CDM,37195_1,Infusion of drug to dissolve blood clot in brain,665.88,432.82,78.57,853.1,15
CDM,37197_1,Retrieval of foreign body in blood vessel with review by radiologist,5117.7,3326.51,78.57,5271.23,19
CDM,37200_1,Biopsy of blood vessel using tube,871.5,566.48,78.57,662.19,19
CDM,3720IP _1,UNCLASSIFIED DRUGS,4.76,3.09,1.19,12.29,16
CDM,3720OP _1,UNCLASSIFIED DRUGS,17.98,11.69,4.5,46.43,16
CDM,37211_1,"Insertion of tube into artery for drug infusion for blood clot with review by radiologist, initial treatment day",1949.85,1267.4,78.57,1143.77,19
CDM,37212_1,"Insertion of tube into vein for drug infusion for blood clot with review by radiologist, initial treatment day",1147.7,746.01,78.57,1006.44,19
CDM,37213_1,Insertion of tube into artery or vein for drug infusion for blood clot with review by radiologist,801.2,520.78,78.57,691.95,19
CDM,37214_1,Removal of tube into artery or vein with review by radiologist,470.4,305.76,78.57,362.78,19
CDM,37215_1,Insertion of stent and blood clot protection device in neck artery with review by radiologist,4852.65,3154.22,78.57,2877.22,19
CDM,37216_1,Insertion of stent in neck artery with review by radiologist,3030.0,1969.5,78.57,3049.87,15
CDM,37217_1,Insertion of stent in blood vessel of chest with review by radiologist,3544.8,2304.12,78.57,3125.39,19
CDM,37218_1,Insertion of stent in blood vessel of chest open or accessed through skin with review by radiologist,1912.1,1242.87,78.57,2388.06,19
CDM,3721IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.69,2.4,0.92,9.53,16
CDM,3721OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.08,13.05,5.02,51.86,16
CDM,37220_1,"Balloon dilation of groin artery, initial vessel",1534.05,997.13,78.57,6000.02,15
CDM,37221_1,"Insertion of stent in groin artery, initial vessel",1880.55,1222.36,78.57,7381.21,15
CDM,37222_1,"Balloon dilation of groin artery, each additional vessel",465.2,302.38,78.57,1460.14,15
CDM,37223_1,"Insertion of stent in groin artery, additional vessel",529.2,343.98,78.57,3047.58,15
CDM,37224_1,Balloon dilation of artery of leg,1650.0,1072.5,78.57,7001.58,15
CDM,37225_1,Removal of plaque in arteries of leg,2227.5,1447.88,78.57,21073.74,15
CDM,37226_1,Insertion of stent in arteries of leg,1575.0,1023.75,78.57,19609.46,15
CDM,37227_1,Removal of plaque and insertion of stents in arteries of leg,2756.25,1791.56,78.57,26994.47,15
CDM,37228_1,"Balloon dilation of artery of leg, initial vessel",7087.5,4606.88,78.57,9951.94,15
CDM,37229_1,"Removal of plaque in artery of leg, initial vessel",1772.4,1152.06,78.57,21415.6,15
CDM,37230_1,"Insertion of stent in artery of leg, initial vessel",1726.2,1122.03,78.57,21436.42,15
CDM,37231_1,"Removal of plaque and insertion of stents in artery of leg, initial vessel",1876.4,1219.66,78.57,28358.27,15
CDM,37232_1,"Balloon dilation of artery of leg, each additional vessel",497.7,323.51,78.57,1958.25,15
CDM,37233_1,"Removal of plaque in artery of leg, each additional vessel",815.9,530.34,78.57,2484.15,15
CDM,37234_1,"Insertion of stent in artery of leg, each additional vessel",683.6,444.34,78.57,8731.31,15
CDM,37235_1,"Removal of plaque and insertion of stents in artery of leg, each additional vessel",970.2,630.63,78.57,9544.75,15
CDM,37236_1,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, initial artery",1712.1,1112.87,78.57,6580.86,19
CDM,37237_1,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, each additional artery",632.1,410.87,78.57,3092.19,19
CDM,37238_1,"Insertion of stent in vein with review by radiologist, initial vein",760.0,494.0,78.57,8296.93,19
CDM,37239_1,"Insertion of stent in vein with review by radiologist, each additional vein",688.8,447.72,78.57,4119.16,19
CDM,37241_1,Occlusion of vein with review by radiologist,3765.0,2447.25,78.57,11247.29,19
CDM,37242_1,Occlusion of artery with review by radiologist,4137.0,2689.05,78.57,17172.15,19
CDM,37243_1,Occlusion of growths or obstructed vessels with review by radiologist,4842.0,3147.3,78.57,20890.89,19
CDM,37244_1,Occlusion of artery or vein bleeding with review by radiologist,5745.0,3734.25,78.57,15946.93,19
CDM,37246_1,"Balloon dilation of artery with review by radiologist, initial artery",7407.38,4814.8,78.57,4356.05,19
CDM,37247_1,"Balloon dilation of artery with review by radiologist, each additional artery",1997.73,1298.52,78.57,1342.0,19
CDM,37248_1,"Balloon dilation of vein with review by radiologist, initial vein",3874.5,2518.43,78.57,3263.93,19
CDM,37249_1,"Balloon dilation of vein with review by radiologist, each additional vein",1465.43,952.53,78.57,1053.55,19
CDM,37252_1,"Ultrasound evaluation of blood vessel with review by radiologist, initial vessel",783.0,508.95,70.86,2289.96,19
CDM,37253_1,"Ultrasound evaluation of blood vessel with review by radiologist, each additional vessel",498.0,323.7,56.15,405.48,19
CDM,37254_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",748.0,486.2,73.6,770.44,16
CDM,37255_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",303.0,196.95,73.6,312.09,16
CDM,37256_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",1096.0,712.4,73.6,1128.88,16
CDM,37257_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",392.0,254.8,73.6,403.76,16
CDM,37258_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",892.0,579.8,73.6,918.76,16
CDM,37259_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",402.0,261.3,73.6,414.06,16
CDM,37260_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",1289.0,837.85,73.6,1327.67,16
CDM,37261_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",427.0,277.55,73.6,439.81,16
CDM,37262_1,"INTRAVASCULAR LITHOTRIPSY(IES), ILIAC VASCULAR TERRITORY, INCLUDING ALL IMAGING GUIDANCE AND RADIOLOGICAL SUPERVISION AND INTERPRETATION NECESSARY TO PERFORM THE INTRAVASCULAR LITHOTRIPSY(IES) WITHIN ",308.0,200.2,73.6,317.24,16
CDM,37263_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",793.0,515.45,73.6,816.79,16
CDM,37264_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",304.0,197.6,73.6,313.12,16
CDM,37265_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",1072.0,696.8,73.6,1104.16,16
CDM,37266_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",404.0,262.6,73.6,416.12,16
CDM,37267_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",892.0,579.8,73.6,918.76,16
CDM,37268_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",377.0,245.05,73.6,388.31,16
CDM,37269_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",1499.0,974.35,73.6,1543.97,16
CDM,3726IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.28,1.48,0.57,5.89,16
CDM,37270_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",506.0,328.9,73.6,521.18,16
CDM,37271_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",921.0,598.65,73.6,948.63,16
CDM,37272_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",406.0,263.9,73.6,418.18,16
CDM,37273_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",1290.0,838.5,73.6,1328.7,16
CDM,37274_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",559.0,363.35,73.6,575.77,16
CDM,37275_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",1119.0,727.35,73.6,1152.57,16
CDM,37276_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",430.0,279.5,73.6,442.9,16
CDM,37277_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",1522.0,989.3,73.6,1567.66,16
CDM,37278_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",606.0,393.9,73.6,624.18,16
CDM,37279_1,"INTRAVASCULAR LITHOTRIPSY(IES), FEMORAL AND POPLITEAL VASCULAR TERRITORY, INCLUDING ALL IMAGING GUIDANCE AND RADIOLOGICAL SUPERVISION AND INTERPRETATION NECESSARY TO PERFORM THE INTRAVASCULAR LITHOTRI",411.0,267.15,73.6,423.33,16
CDM,3727IP _1,UNCLASSIFIED DRUGS,1.78,1.16,0.45,4.6,16
CDM,37280_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",996.0,647.4,73.6,1025.88,16
CDM,37281_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",302.0,196.3,73.6,311.06,16
CDM,37282_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",1249.0,811.85,73.6,1286.47,16
CDM,37283_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",429.0,278.85,73.6,441.87,16
CDM,37284_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",1030.0,669.5,73.6,1060.9,16
CDM,37285_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",342.0,222.3,73.6,352.26,16
CDM,37286_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",1382.0,898.3,73.6,1423.46,16
CDM,37287_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",513.0,333.45,73.6,528.39,16
CDM,37288_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",1371.0,891.15,73.6,1412.13,16
CDM,37289_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",483.0,313.95,73.6,497.49,16
CDM,3728OP _1,UNCLASSIFIED DRUGS,1.16,0.75,0.29,3.0,16
CDM,37290_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",1725.0,1121.25,73.6,1776.75,16
CDM,37291_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",660.0,429.0,73.6,679.8,16
CDM,37292_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",1533.0,996.45,73.6,1578.99,16
CDM,37293_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",674.0,438.1,73.6,694.22,16
CDM,37294_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",1837.0,1194.05,73.6,1892.11,16
CDM,37295_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",847.0,550.55,73.6,872.41,16
CDM,37296_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",1117.0,726.05,73.6,1150.51,16
CDM,37297_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",403.0,261.95,73.6,415.09,16
CDM,37298_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",1384.0,899.6,73.6,1425.52,16
CDM,37299_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",503.0,326.95,73.6,518.09,16
CDM,37300028_1,HC MOTOR AQUA  K  UNIT,184.0,119.6,46.0,128.8,11
CDM,37300029_1,HC BED CLINITRON RITE HITE,806.0,523.9,201.5,564.2,11
CDM,37300101_1,HC MONITOR VIGILANCE II,226.0,146.9,56.5,158.2,11
CDM,37300102_1,HC CUSHION ROHO  18X18,12.0,7.8,3.0,8.4,11
CDM,37300103_1,HC CUSHION ROHO  20X18,12.0,7.8,3.0,8.4,11
CDM,37300105_1,HC MONITOR HEMOSPHERE,226.0,146.9,56.5,158.2,11
CDM,37300347_1,HC CATALYST VERTICAL BED RENTAL,1170.0,760.5,292.5,819.0,11
CDM,37302409_1,HC BED ENCLOSURE,258.0,167.7,64.5,180.6,11
CDM,37302516_1,HC BLOODWARMER,56.0,36.4,14.0,39.2,11
CDM,37302970_1,HC COOLING  MOTOR,78.0,50.7,19.5,54.6,11
CDM,37303701_1,HC CART TRACTION,205.0,133.25,51.25,143.5,11
CDM,37303827_1,HC MONITOR HEART & RESP,62.0,40.3,15.5,43.4,11
CDM,37304294_1,HC BED EXTENDER,34.0,22.1,8.5,23.8,11
CDM,37305605_1,HC CADDY FRACTURE OVERHEAD ONLY,117.0,76.05,29.25,81.9,11
CDM,37306097_1,HC WARMING UNIT BAIR HUGGER,68.0,44.2,17.0,47.6,11
CDM,37308474_1,HC PUMP EPIDURAL ANALGESIA,56.0,36.4,14.0,39.2,11
CDM,37309499_1,HC BED KINETIC ROTO REST DELTA,974.0,633.1,243.5,681.8,11
CDM,37310512_1,HC MONITOR INTERFACE CONTROL ICP,603.0,391.95,150.75,422.1,11
CDM,37310525_1,HC BED TRIADYNE THERAPY,828.0,538.2,207.0,579.6,11
CDM,37310526_1,HC BED KINETIC (SPORT),806.0,523.9,201.5,564.2,11
CDM,37310988_1,HC BED BARI AIR THERAPY,1101.0,715.65,275.25,770.7,11
CDM,37310992_1,HC BED BARI MAX II W/FOAM MATTRESS,599.0,389.35,149.75,419.3,11
CDM,37310995_1,HC LOW BED PER DAY,285.38,185.5,71.35,199.77,11
CDM,37311345_1,HC BLANKET WALLABY II PHOTOTHERAPY,55.0,35.75,13.75,38.5,11
CDM,37311346_1,HC BILICOCOON PHOTOTHERAPY,55.0,35.75,13.75,38.5,11
CDM,37311631_1,HC PUMP COMPANION FEEDING,28.0,18.2,7.0,19.6,11
CDM,37311954_1,HC COMMODE BARI,68.0,44.2,17.0,47.6,11
CDM,37311956_1,HC SLING BARI,311.0,202.15,77.75,217.7,11
CDM,37312048_1,HC WHEEL CHAIR BARI,108.0,70.2,27.0,75.6,11
CDM,37313097_1,HC LIFT BARI,282.0,183.3,70.5,197.4,11
CDM,37313098_1,HC CHAIR BARTON,282.0,183.3,70.5,197.4,11
CDM,37313106_1,HC LIFT BARI PATIENT AIR,140.0,91.0,35.0,98.0,11
CDM,37313282_1,HC PUMP ALARIS SYRINGE,125.0,81.25,31.25,87.5,11
CDM,37313386_1,HC WOUND VAC -  KCI INFO,482.0,313.3,120.5,337.4,11
CDM,37313387_1,HC WOUND VAC - KCI VAC INSTILL,405.0,263.25,101.25,283.5,11
CDM,37313388_1,HC MONITOR ICP AESCULAP,228.0,148.2,57.0,159.6,11
CDM,37313395_1,HC AIR MATTRESS BARIMAX REPLACEMENT,292.0,189.8,73.0,204.4,11
CDM,37313396_1,HC BED BARIMAX II  W/AIR MATTRESS,896.0,582.4,224.0,627.2,11
CDM,37313408_1,HC CUSHION BARI TALLY,93.0,60.45,23.25,65.1,11
CDM,37313409_1,HC MATTRESS OVERLAY GAYMAR PCE,315.0,204.75,78.75,220.5,11
CDM,37313410_1,HC PUMP ALARIS 8120 PCA,139.0,90.35,34.75,97.3,11
CDM,37313412_1,HC PUMP MEDELA SUCTION,87.0,56.55,21.75,60.9,11
CDM,37313413_1,HC MONITOR LICOX (KEPT IN AICU),603.0,391.95,150.75,422.1,11
CDM,37313415_1,HC PUMP INTRATHECAL  (NSU ONLY),53.0,34.45,13.25,37.1,11
CDM,37313416_1,HC PUMP MEDFUSION SYRINGE,115.0,74.75,28.75,80.5,11
CDM,37313417_1,HC TEMP  PACEMAKER TRANSVENOUS (5388),24.0,15.6,6.0,16.8,11
CDM,37313418_1,HC PUMP ABTHERA,482.0,313.3,120.5,337.4,11
CDM,37313419_1,HC BED BARI TOTAL CARE W/AIR,1101.0,715.65,275.25,770.7,11
CDM,37313421_1,HC BED BARI TOTAL CARE W/FOAM,806.0,523.9,201.5,564.2,11
CDM,37313425_1,HC MONITOR BIS A-2000,105.0,68.25,26.25,73.5,11
CDM,37313430_1,HC COMPACT FEEDING PUMP,30.0,19.5,7.5,21.0,11
CDM,37313431_1,HC VAC ULTA,482.0,313.3,120.5,337.4,11
CDM,37313432_1,HC TOTAL CARE 500 BED (500LB WEIGHT LIMIT),655.0,425.75,163.75,458.5,11
CDM,37313433_1,HC VECTOR 1 CPM MACHINE,246.0,159.9,61.5,172.2,11
CDM,37313434_1,HC VECTOR GLOVE,258.0,167.7,64.5,180.6,11
CDM,37313435_1,HC HEAT THERAPY PUMP HTP1500,184.0,119.6,46.0,128.8,11
CDM,3731IP _1,UNCLASSIFIED DRUGS,2.18,1.42,0.55,5.63,16
CDM,3732IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.84,1.2,0.46,4.75,16
CDM,3733IP _1,UNCLASSIFIED DRUGS,12.76,8.29,3.19,32.95,16
CDM,3733OP _1,UNCLASSIFIED DRUGS,19.65,12.77,4.91,50.75,16
CDM,3734IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.64,7.57,2.91,30.06,16
CDM,3734OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",58.06,37.74,14.52,149.94,16
CDM,3738IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.95,24.02,9.24,95.42,16
CDM,3738OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",52.15,33.9,13.04,134.68,16
CDM,37400IP _1,TADALAFIL 5 MG TABLET,7.65,4.97,1.91,5.36,11
CDM,37500019_1,HC RADIAL JAW BIOPSY FORCEPS,177.99,115.69,44.5,124.59,11
CDM,37500021_1,HC ADHES SKIN DERMABOND,59.32,38.56,14.83,41.52,11
CDM,37500022_1,HC CUSTOM INTERVENTIONAL KIT,82.8,53.82,20.7,57.96,11
CDM,37500023_1,HC BLANKET THERAPY BILICOMBI DISP MEDELA,46.15,30.0,11.54,32.31,11
CDM,37500042_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",1575.0,1023.75,393.75,4067.44,16
CDM,37500043_1,HC TUBING COOL POINT SET,477.0,310.05,119.25,333.9,11
CDM,37500045_1,HC COAGRASPER HEMOSTATIC FORCEPS,1028.39,668.45,257.1,719.87,11
CDM,37500046_1,HC HEMO COAGRASPER,393.98,256.09,98.5,275.79,11
CDM,37500132_1,HC SPLINT WALKING PNEUMATIC,152.87,99.37,38.22,107.01,11
CDM,37500139_1,HC TODDLER TUB,82.78,53.81,20.7,57.95,11
CDM,37500141_1,HC PASTE TUBE MEDIHONEY HYDROCOLLOID,52.93,34.4,13.23,37.05,11
CDM,37500143_1,HC ENDOMETRIAL BIOPSY CURETTE,224.0,145.6,56.0,156.8,11
CDM,37500144_1,"CERVICAL, SEMI-RIGID, ADJUSTABLE (PLASTIC COLLAR)",139.5,90.68,34.88,167.4,16
CDM,37500258_1,HC FOLEY CATHETER COUDE 12FR 5ML,77.27,50.23,19.32,54.09,11
CDM,37500263_1,HC FOLEY CATHETER SILVER COUDE 16FR 30ML,78.66,51.13,19.67,55.06,11
CDM,37500264_1,HC CATH FOLEY COUDE SILV 18FR 30ML,78.66,51.13,19.67,55.06,11
CDM,37500265_1,"DISPOSABLE ENDOSCOPE SHEATH, EACH",175.5,114.08,43.88,453.23,16
CDM,37500273_1,HC PEAK PLASMABLADE DEVICE,1237.5,804.38,309.38,866.25,11
CDM,37500285_1,HC KIT NEWBORN,85.72,55.72,21.43,60.0,11
CDM,37500287_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTOR MAPPING, COOL-TIP",12510.0,8131.5,3127.5,32307.08,17
CDM,37500291_1,HC BILIARY PROBE,1930.5,1254.83,482.63,1351.35,11
CDM,37500322_1,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, PEEL-AWAY",164.76,107.09,41.19,425.48,16
CDM,37500392_1,HC CYTOLOGY BRUSH 2,485.19,315.37,121.3,339.63,11
CDM,37500506_1,"BATTERY, LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",12150.0,7897.5,1046.55,14580.0,17
CDM,37500507_1,"BATTERY, LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",2250.0,1462.5,562.5,2700.0,16
CDM,37500583_1,HC SURGIFOAM SPONGE SIZE 100,124.4,80.86,31.1,87.08,11
CDM,37500738_1,HC PUNCH BIOPSY KIT,108.09,70.26,27.02,75.66,11
CDM,37500_1,Tying of veins in leg muscles using an endoscope,1708.4,1110.46,78.57,1825.07,15
CDM,37501010_1,HC EVACUATED GLASS CONTAINER,55.98,36.39,14.0,39.19,11
CDM,37501062_1,HC SUPPORT KNEE LARGE,56.61,36.8,14.15,39.63,11
CDM,37501068_1,"HC SURGICEL 1/2 X 2""",353.87,230.02,88.47,247.71,11
CDM,37501079_1,HC REPOSITIONING SHEET,153.0,99.45,38.25,107.1,11
CDM,37501300_1,HC PLEURAL VAC DRAINAGE SET ADULT,279.0,181.35,69.75,195.3,11
CDM,37501353_1,HC DRAINAGE BAG W REFLUX VALVE,227.84,148.1,56.96,159.49,11
CDM,37501388_1,HC ESOPHAGEAL BALLOON CATHETER SET,288.0,187.2,72.0,201.6,11
CDM,37501672_1,"RETRIEVAL DEVICE, INSERTABLE (USED TO RETRIEVE FRACTURED MEDICAL DEVICES)",60.64,39.41,15.16,156.59,16
CDM,37501701_1,GUIDE WIRE,71.63,46.56,17.91,184.98,16
CDM,37501735_1,HC PANNICULUS RETRACTORS,211.5,137.48,52.88,148.05,11
CDM,37501756_1,HC MYELOGRAM TRAY W/SPINAL NEEDLE,47.0,30.55,11.75,32.9,11
CDM,37501757_1,HC HEART KIT,83.16,54.05,20.79,58.21,11
CDM,37501885_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, LASER",13927.5,9052.88,3481.88,35967.77,17
CDM,37502574_1,HC OB SUPPLY KIT,90.33,58.71,22.58,63.23,11
CDM,37502624_1,"IMPLANTABLE WIRELESS PULMONARY ARTERY PRESSURE SENSOR WITH DELIVERY CATHETER, INCLUDING ALL SYSTEM COMPONENTS",103050.0,66982.5,25762.5,266126.63,17
CDM,37503072_1,HC BLOOD/FLUID WARMING SET PEDI/NEONATE,85.46,55.55,21.37,59.82,11
CDM,37503089_1,"HC ARTERIAL LINE KIT 20GA 5""",180.0,117.0,45.0,126.0,11
CDM,37503117_1,HC HICKMAN CATH SINGLE LUMEN,468.0,304.2,117.0,327.6,11
CDM,37503215_1,HC CATH THERMODILUTION HEPARIN 7F,371.48,241.46,92.87,260.04,11
CDM,37503216_1,HC NASAL PACKING TAMPON,61.04,39.68,15.26,42.73,11
CDM,37503218_1,HC RAPID INFUSER LINE EXTENSION,84.0,54.6,21.0,58.8,11
CDM,37503219_1,HC RAPID INFUSER DUAL LINE,153.75,99.94,38.44,107.63,11
CDM,37503307_1,HC PORTA WARM MATTRESS,48.42,31.47,12.11,33.89,11
CDM,37503481_1,HC MICROCLIMATE BODY PAD,69.75,45.34,17.44,48.83,11
CDM,37503506_1,HC DOUBLE LUMEN CATH,106.2,69.03,26.55,74.34,11
CDM,37503601_1,HC UMBILICAL CATH II SILICONE 3.5FR,80.55,52.36,20.14,56.39,11
CDM,37503820_1,HC TRANSDUCER DISP SINGLE LINE,63.23,41.1,15.81,44.26,11
CDM,37503821_1,HC TRANSDUCER DISP TRIPLE LINE,225.0,146.25,56.25,157.5,11
CDM,37503822_1,HC TRANSDUCER DISP ARM MOUNT,64.31,41.8,16.08,45.02,11
CDM,37503909_1,HC BROVIAC CATH SINGLE LUMEN 6.6FR,477.0,310.05,119.25,333.9,11
CDM,37503914_1,HC FOLEY CATHETER SILVER COUDE 22FR 5ML,77.27,50.23,19.32,54.09,11
CDM,37504159_1,HC KENDALL SLEEVE KNEE,92.7,60.26,23.18,64.89,11
CDM,37504449_1,HC TRANSDUCER DISP NEONATAL,58.82,38.23,14.71,41.17,11
CDM,37504541_1,HC VYGON LECTRO SPIRAL TUBING,45.0,29.25,11.25,31.5,11
CDM,37504542_1,HC ELECTRODE EDGE QUIK COMBO RTS,147.11,95.62,36.78,102.98,11
CDM,37504545_1,"GENERATOR, NEUROSTIMULATOR (IMPLANTABLE), HIGH FREQUENCY, WITH RECHARGEABLE BATTERY AND CHARGING SYSTEM",74083.5,48154.28,18520.88,191320.64,17
CDM,37504724_1,HC BINDER BREAST,97.0,63.05,24.25,67.9,11
CDM,37504726_1,HC BINDER CROW ABD LARGE,88.56,57.56,22.14,61.99,11
CDM,37505027_1,HC SUCTION TOOTHBRUSH,87.0,56.55,21.75,60.9,11
CDM,37505331_1,HC INTRODUCER SET,432.0,280.8,108.0,302.4,11
CDM,37506628_1,"HC KNEE IMMOBILIZER 18"" CUTAWAY UNIV",77.54,50.4,19.39,54.28,11
CDM,37506669_1,HC WARMING BLANKET PEDI 55501,57.29,37.24,14.32,40.1,11
CDM,37507618_1,HC UMBILICAL VESSEL CATH INSERT TRAY,306.0,198.9,76.5,214.2,11
CDM,37508127_1,HC RADIAL ARTERY CATH SET 3F 20GA,175.5,114.08,43.88,122.85,11
CDM,37508565_1,HC CATH SINGLE LUMEN REPAIR KIT,2308.5,1500.53,577.13,1615.95,11
CDM,37508837_1,HC REPAIR KIT WHITE 1-LUMEN 4.2FR,2308.5,1500.53,577.13,1615.95,11
CDM,37508950_1,"CATHETER, DRAINAGE",144.77,94.1,36.19,373.87,16
CDM,37508951_1,"CATHETER, DRAINAGE",144.77,94.1,36.19,373.87,16
CDM,37509303_1,HC ANGIOGRAPHY PACK (CCL ONLY),292.5,190.13,73.13,204.75,11
CDM,37509461_1,HC COMPRESS CARTER PILLOW,67.46,43.85,16.87,47.22,11
CDM,37510143_1,HC O-RING RETRACTOR,220.5,143.33,55.13,154.35,11
CDM,37510152_1,"CATHETER, HEMODIALYSIS/PERITONEAL, LONG-TERM",1364.36,886.83,341.09,3523.46,16
CDM,37510154_1,"CATHETER, HEMODIALYSIS/PERITONEAL, LONG-TERM",1364.36,886.83,341.09,3523.46,16
CDM,37510178_1,HC NEEDLE RHIZOTOMY CRVD RFK,65.21,42.39,16.3,45.65,11
CDM,37510181_1,HC ELECTRODE GROUNDING PAD,45.0,29.25,11.25,31.5,11
CDM,37510182_1,HC ELECTRODE RHIZOTOMY RFK,319.32,207.56,79.83,223.52,11
CDM,37510183_1,"LEAD, NEUROSTIMULATOR (IMPLANTABLE)",35100.0,22815.0,8775.0,90645.75,17
CDM,37510185_1,"LEAD, NEUROSTIMULATOR TEST KIT (IMPLANTABLE)",3187.5,2071.88,796.88,8231.72,16
CDM,37510188_1,HC SUCTION VALVE BRONCHOSCOPE,55.16,35.85,13.79,38.61,11
CDM,37510451_1,HC CATHETER UMBILICAL ARTERY DBL LUMEN 3.5,141.98,92.29,35.5,99.39,11
CDM,37510460_1,HC TRACH TUBE 3,709.46,461.15,177.37,496.62,11
CDM,37510464_1,HC TRACH TUBE ADJ 6MM MID RANGE CUFF,833.49,541.77,208.37,583.44,11
CDM,37510483_1,HC PLUER-E-VAC DRY SUCTION ADULT/PEDI,184.31,119.8,46.08,129.02,11
CDM,37510599_1,"GASTROSTOMY/JEJUNOSTOMY TUBE, LOW-PROFILE, ANY MATERIAL, ANY TYPE, EACH",1051.47,683.46,262.87,2715.42,16
CDM,37510988_1,HC PEDI-WRAP MEDIUM   203,198.0,128.7,49.5,138.6,11
CDM,37511013_1,HC PASSY MUTR VALVE AQUA 15MM X 22M,331.2,215.28,82.8,231.84,11
CDM,37511076_1,HC BALLARD CLOSED SUCTION Y INLINE 8FR,60.24,39.16,15.06,42.17,11
CDM,37511077_1,HC BALLARD CLOSED SUCTION Y INLINE 6FR,60.24,39.16,15.06,42.17,11
CDM,37511177_1,HC FEMOSTOP,391.5,254.48,97.88,274.05,11
CDM,37511450_1,"HC BINDER X-LRG 12""X64""-75""",86.18,56.02,21.55,60.33,11
CDM,37511460_1,HC KNEE BRACE POST-OP SHORT 07590,296.06,192.44,74.02,207.24,11
CDM,37511739_1,HC C-SECTION PACK,536.51,348.73,134.13,375.56,11
CDM,37511762_1,HC NEEDLE MICROINTRODUCER,84.78,55.11,21.2,59.35,11
CDM,37512101_1,HC KNEE IMMOBILIZER TRI-PANEL UNI,79.29,51.54,19.82,55.5,11
CDM,37512105_1,HC LIGASURE SMALL JAW INSTRUMENT,1771.2,1151.28,442.8,1239.84,11
CDM,37512107_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",930.67,604.93,232.67,2403.45,16
CDM,37512108_1,HC LIGASURE IMPACT INSTRUMENT,2638.67,1715.14,659.67,1847.07,11
CDM,37512112_1,HC NEEDLE ACQUIRE,1830.83,1190.04,457.71,1281.58,11
CDM,37512113_1,HC SOFIA LUMEN SUPPORT CATH,10040.63,6526.41,2510.16,10040.63,12
CDM,37512118_1,HC NEEDLE BIOPSY CORE KIT,169.7,110.31,42.43,118.79,11
CDM,37512125_1,HC PNEUMOTHORAX KIT WAYNE PIGTAIN,1029.17,668.96,257.29,720.42,11
CDM,37512130_1,HC ABDUCTION PILLOW,85.97,55.88,21.49,60.18,11
CDM,37512131_1,HC CATH POWERGLIDE CATH ONLY,315.18,204.87,78.8,220.63,11
CDM,37512132_1,HC CATH POWERGLIDE FULL KIT,505.22,328.39,126.31,353.65,11
CDM,37512143_1,HC RETAINER FISH VISCERA,180.0,117.0,45.0,126.0,11
CDM,37512145_1,HC SURGICAL DRAPES,60.41,39.27,15.1,42.29,11
CDM,37512148_1,HC ENDOSCOPIC ULTRASOUND FINE NEEDLE,2410.2,1566.63,602.55,1687.14,11
CDM,37512150_1,HC NEEDLE ASPIRATION ENDO BRONCHIAL,431.72,280.62,107.93,302.2,11
CDM,37512298_1,HC TROCAR CATHETER KIT 20FR 6.7MM,135.99,88.39,34.0,95.19,11
CDM,37512320_1,HC BINDER ABD LARGE 46/50,49.59,32.23,12.4,34.71,11
CDM,37512339_1,HC SHOULDER IMMOBILIZER CHILD,70.88,46.07,17.72,49.62,11
CDM,37512418_1,HC ROOKE PERI OP POST OP BOOT ON,474.75,308.59,118.69,332.33,11
CDM,37512535_1,HC DOUBLE LINE TRANSDUCER KIT,164.79,107.11,41.2,115.35,11
CDM,37512599_1,HC INTRA AMNIAINFUSION IV PRESS CATH,126.0,81.9,31.5,88.2,11
CDM,37512610_1,HC INTRACARDIAC ELECTRODE PACING,2452.5,1594.13,613.13,1716.75,11
CDM,37512706_1,"HC CALDWELL PARACENTESIS CANNULA 17GAX3.5""",75.03,48.77,18.76,52.52,11
CDM,37512799_1,"HC TRANSDUCER TRANSPAC 24"" MON",135.36,87.98,33.84,94.75,11
CDM,37512976_1,HC GELFOAM SIZE 100 COMPRESSED,202.5,131.63,50.63,141.75,11
CDM,37513011_1,HC TRACH BIVONA,340.16,221.1,85.04,238.11,11
CDM,37513127_1,HC TRAY SI NERVE BLOCK,75.17,48.86,18.79,52.62,11
CDM,37513128_1,HC TRAY UNIVERSAL BLOCK,58.62,38.1,14.66,41.03,11
CDM,37513131_1,HC TRAY EPIDURAL 18GA SNGL SHOT,73.25,47.61,18.31,51.28,11
CDM,37513134_1,HC DRAINAGE SET NIGHT,45.36,29.48,11.34,31.75,11
CDM,37513170_1,HC TRACH SHILEY XLT PROXIMAL  CUFFED SIZE 6,284.58,184.98,71.15,199.21,11
CDM,37513171_1,HC TRACH - SHILEY,187.02,121.56,46.76,130.91,11
CDM,37513248_1,HC VAC DRESSING SMALL FOAM BLACK,139.43,90.63,34.86,97.6,11
CDM,37513250_1,HC VAC DRESSING LARGE FOAM BLACK,212.17,137.91,53.04,148.52,11
CDM,37513251_1,HC VAC DRESSING EXTRA LARGE FOAM BLACK,497.77,323.55,124.44,348.44,11
CDM,37513254_1,HC VAC CANISTER W/GEL. ATS,143.27,93.13,35.82,100.29,11
CDM,37513256_1,HC WOUND CANISTER,105.3,68.45,26.33,73.71,11
CDM,37513266_1,HC CATH QUAD LUMEN KIT,640.91,416.59,160.23,448.64,11
CDM,37513308_1,HC SLEEVE CALF SCD GARMENT LARGE VASO PRESS,57.94,37.66,14.49,40.56,11
CDM,37513366_1,HC CTC BARIATRIC SLEEVE,92.7,60.26,23.18,64.89,11
CDM,37513375_1,HC BOOT MULTI-PODUS LG ORTHOWICK,392.99,255.44,98.25,275.09,11
CDM,37513379_1,HC PNEUMOTHORAX KIT,481.5,312.98,120.38,337.05,11
CDM,37513380_1,HC TRANSPAC SAFESET RESERVOIR ONLY,87.75,57.04,21.94,61.43,11
CDM,37513407_1,HC BALLOON CRE 6FR 12-13.5MM 5.5 LEN 240CM,989.42,643.12,247.36,692.59,11
CDM,37513408_1,HC BALLOON CRE 6FR 15-16.5-18MM 5.5 MM LEN,989.42,643.12,247.36,692.59,11
CDM,37513410_1,HC BREAST PUMP KIT,105.19,68.37,26.3,73.63,11
CDM,37513412_1,HC LACTATION AID CLEANING KIT,242.6,157.69,60.65,169.82,11
CDM,37520089_1,HC GENERAL SURGERY SET UP TRAY,251.64,163.57,62.91,176.15,11
CDM,37520091_1,HC ENDOSCOPIC DISTAL ATTACHMENTS,119.48,77.66,29.87,83.64,11
CDM,37520095_1,HC DRESSING MED FOAM BLK VACM 6275052,172.29,111.99,43.07,120.6,11
CDM,37520102_1,"GASTROSTOMY/JEJUNOSTOMY TUBE, LOW-PROFILE, ANY MATERIAL, ANY TYPE, EACH",567.0,368.55,141.75,1464.28,16
CDM,37520104_1,HC CIRCUMCISION TRAY KIT W/ BELL,232.79,151.31,58.2,162.95,11
CDM,37520113_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",819.0,532.35,204.75,2115.07,16
CDM,37520114_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",4297.5,2793.38,1074.38,11098.29,16
CDM,37520116_1,HC SITE RITE NEEDLE GUIDE KIT 21 GAUGE,55.94,36.36,13.99,39.16,11
CDM,37520117_1,HC SITE RITE NEEDLE GUIDE KIT 20 GAUGE,57.33,37.26,14.33,40.13,11
CDM,37520123_1,HC BALLARD MAC CATHETER 3.5 MM,61.43,39.93,15.36,43.0,11
CDM,37520133_1,GUIDE WIRE,249.0,161.85,62.25,643.04,16
CDM,37520134_1,HC PROTRACK PIGTAIL WIRE,864.0,561.6,216.0,604.8,11
CDM,37520135_1,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",11506.5,7479.23,2876.63,29715.54,17
CDM,37520136_1,HC GEL HEAD PAD,222.75,144.79,55.69,155.93,11
CDM,37520139_1,HC DRESSING ACTICOAT 7 4X5,70.95,46.11,17.74,49.66,11
CDM,37520140_1,HC HYDROCONDUCTIVE WOUND DRESSING,67.82,44.08,16.96,47.47,11
CDM,37520143_1,HC COLLEGEN DRESSING 16 SQ IN OR> EA,47.3,30.75,11.83,33.11,11
CDM,37535017_1,HC TUBE JEJUNAL FDG 22 FR MIC TRANSGASTRIC,1051.47,683.46,262.87,736.03,11
CDM,37535021_1,HC NASOJEJUNAL TUBE,160.34,104.22,40.09,112.24,11
CDM,37535023_1,HC TUBE NASO ENTERIC DOBHOFF 752513,45.0,29.25,11.25,31.5,11
CDM,37535029_1,HC CIRCUMCISION TRAY KIT W/CLAMP,211.21,137.28,52.8,147.84,11
CDM,37535589_1,HC VAGINAL DELIVERY PACK,136.65,88.82,34.16,95.65,11
CDM,37535596_1,"HC THORACENTESIS KIT 8 FR X 4.75""",243.0,157.95,60.75,170.1,11
CDM,37535601_1,HC FORCEP BIOPSY UPPER,42.97,27.93,10.74,30.08,11
CDM,37535622_1,HC INFLATION SYSTEM BALLOON DILATOR 60 ML,140.61,91.4,35.15,98.43,11
CDM,37535636_1,HC CATHETER ASPIRATION ENDOSCOPY (LX),208.88,135.77,52.22,146.22,11
CDM,37535644_1,HC SCLEROTHERAPY NEEDLE,140.0,91.0,35.0,98.0,11
CDM,37535657_1,HC RETRIEVAL RESCUE NET,393.98,256.09,98.5,275.79,11
CDM,37535665_1,HC BIOPSY FORCEP PEDI,154.12,100.18,38.53,107.88,11
CDM,37535703_1,HC LIGATOR/TAMPONADE 122 CM TRIG CORD W/6,1017.0,661.05,254.25,711.9,11
CDM,37535708_1,HC PROBE ARGON (SIDE FIRE),1055.25,685.91,263.81,738.68,11
CDM,37535709_1,HC CRE BALLOON 6 FR 18-19-20 MM 5.5 MM,989.42,643.12,247.36,692.59,11
CDM,37535718_1,HC CRE BALLOON 6FR 10-11-12 5.5 LENGTH,989.42,643.12,247.36,692.59,11
CDM,37535720_1,HC INJECTION GOLD PROBE 7FR,973.62,632.85,243.41,681.53,11
CDM,37535721_1,HC INJECTION GOLD PROBE 10FR,973.62,632.85,243.41,681.53,11
CDM,37535723_1,HC ELEVIEW SUBMUCOSAL INJECTABLE,376.2,244.53,94.05,263.34,11
CDM,37535724_1,HC TRAPEZOID 2.5-3.2 BASKET RETRIEVAL,1222.16,794.4,305.54,855.51,11
CDM,37536000_1,HC CATH WORD BARTHOLIN 10 F (LX),45.0,29.25,11.25,31.5,11
CDM,37536003_1,"GASTROSTOMY/JEJUNOSTOMY TUBE, LOW-PROFILE, ANY MATERIAL, ANY TYPE, EACH",610.88,397.07,152.72,1577.6,16
CDM,37536010_1,HC BALLOON TIP PACING CATH 5 FR (LX),427.5,277.88,106.88,299.25,11
CDM,37536190_1,HC COONS 18 FR 20 CM DILATOR,68.55,44.56,17.14,47.99,11
CDM,37536195_1,HC CATH MAHURKAR TRIPLE LUMEN TEMP 20 CM,432.0,280.8,108.0,302.4,11
CDM,37536198_1,HC QCARE ORAL SAGE SYSTM,119.25,77.51,29.81,83.48,11
CDM,37536507_1,HC HYBRID ERBE KNIFE,2263.5,1471.28,565.88,1584.45,11
CDM,37536518_1,HC MICROCATH W ANGLED TIP,2317.5,1506.38,579.38,1622.25,11
CDM,37536531_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",1575.0,1023.75,393.75,4067.44,16
CDM,37536537_1,HC COMBO THERMODILUTION CATH,1507.5,979.88,376.88,1055.25,11
CDM,37536538_1,"HC CHEST TUBE, PIGTAIL",806.31,524.1,201.58,564.42,11
CDM,37536550_1,HC NG/NI TUBE RETENTION SYSTEM,372.91,242.39,93.23,261.04,11
CDM,37536551_1,HC HEMOSTATIC QUICKCLOT,684.86,445.16,171.22,479.4,11
CDM,37565_1,Tying of neck vein,2002.4,1301.56,78.57,2130.02,19
CDM,3757IP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",215.8,140.27,0.15,557.3,17
CDM,3757OP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",41.17,26.76,0.15,106.32,17
CDM,37580004_1,GUIDE WIRE,3581.87,2328.22,895.47,9250.18,16
CDM,37580005_1,GUIDE WIRE,2879.69,1871.8,719.92,7436.8,16
CDM,37580017_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",600.82,390.53,150.21,1551.62,16
CDM,37580065_1,HC COIL NESTER,407.57,264.92,101.89,285.3,11
CDM,37580092_1,"CATHETER, DRAINAGE",3042.0,1977.3,760.5,7855.97,16
CDM,37580093_1,HC MIC-KEY J KIT,494.27,321.28,123.57,345.99,11
CDM,37580107_1,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",22693.5,14750.78,5673.38,58605.96,17
CDM,37580116_1,GUIDE WIRE,555.89,361.33,138.97,1435.59,16
CDM,37580129_1,HC ANGIOFLUSH SYSTEM,135.0,87.75,33.75,94.5,11
CDM,37580130_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",2484.59,1614.98,621.15,6416.44,16
CDM,37580133_1,HC BRUSHES I,74.5,48.43,18.63,52.15,11
CDM,37580134_1,"STENT, NON-CORONARY, TEMPORARY, WITH DELIVERY SYSTEM",248.85,161.75,62.21,642.66,16
CDM,37580141_1,HC FULL CORE BIOPSY INSTRUMENT,298.8,194.22,74.7,209.16,11
CDM,37580142_1,"CATHETER, TRANSLUMINAL ATHERECTOMY, ROTATIONAL",8482.5,5513.63,2120.63,21906.06,17
CDM,37580148_1,GUIDE WIRE,301.5,195.98,75.38,778.62,16
CDM,37580152_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",228.22,148.34,57.06,589.38,16
CDM,37580153_1,HC HAWKINS-AIKINS BLUNT NEEDLE,145.76,94.74,36.44,102.03,11
CDM,37580159_1,HC YUEH NEEDLE,76.5,49.73,19.13,53.55,11
CDM,37580162_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",97.73,63.52,24.43,252.37,16
CDM,37580165_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",113.49,73.77,28.37,293.1,16
CDM,37580172_1,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, STEERABLE, OTHER THAN PEEL-AWAY",4536.0,2948.4,1134.0,11714.22,16
CDM,37580181_1,HC CATHETER FLUSH,139.39,90.6,34.85,97.57,11
CDM,37580182_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",218.84,142.25,54.71,565.16,16
CDM,37580187_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",939.67,610.78,234.92,2426.69,16
CDM,37580188_1,"CATHETER, OCCLUSION",951.75,618.64,237.94,2457.89,16
CDM,37580191_1,HC HYDROPHILIC DILATOR,50.34,32.72,12.59,35.24,11
CDM,37580192_1,HC COONS DILATOR,66.55,43.26,16.64,46.59,11
CDM,37580193_1,HC DILATOR,65.28,42.43,16.32,45.7,11
CDM,37580196_1,"CATHETER, DRAINAGE",315.97,205.38,78.99,816.0,16
CDM,37580197_1,"CATHETER, DRAINAGE",369.21,239.98,92.3,953.47,16
CDM,37580199_1,GUIDE WIRE,137.28,89.23,34.32,354.53,16
CDM,37580201_1,GUIDE WIRE,121.37,78.89,30.34,313.43,16
CDM,37580202_1,GUIDE WIRE,168.1,109.26,42.02,434.11,16
CDM,37580203_1,GUIDE WIRE,298.8,194.22,74.7,771.65,16
CDM,37580204_1,GUIDE WIRE,189.0,122.85,47.25,488.09,16
CDM,37580207_1,GUIDE WIRE,127.0,82.55,31.75,327.98,16
CDM,37580208_1,GUIDE WIRE,63.0,40.95,15.75,162.7,16
CDM,37580209_1,HC NEEDLE,61.84,40.19,15.46,43.28,11
CDM,37580210_1,HC TURNER BIOPSY NEEDLE DTB,67.46,43.85,16.87,47.22,11
CDM,37580212_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",3078.0,2000.7,769.5,7948.94,16
CDM,37580213_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",328.05,213.23,82.01,847.19,16
CDM,37580214_1,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, OTHER THAN PEEL-AWAY",190.83,124.04,47.71,492.82,16
CDM,37580218_1,HC BIOPSY SET UP TRAY FOR CT PACK,210.2,136.63,52.55,147.14,11
CDM,37580221_1,GUIDE WIRE,200.97,130.63,50.24,519.01,16
CDM,37580223_1,"RETRIEVAL DEVICE, INSERTABLE (USED TO RETRIEVE FRACTURED MEDICAL DEVICES)",1489.5,968.18,372.38,3846.63,16
CDM,37580228_1,HC TRPLE LUMEN CATH,599.4,389.61,149.85,419.58,11
CDM,37580237_1,HC NITROUS OXIDE CARTRIDGE,455.0,295.75,113.75,318.5,11
CDM,37580242_1,HC NEEDLE BIOPSY,69.71,45.31,17.43,48.8,11
CDM,37580248_1,HC INTRODUCER INTUBATION,113.4,73.71,28.35,79.38,11
CDM,37580250_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",369.0,239.85,92.25,952.94,16
CDM,37580252_1,GUIDE WIRE,126.65,82.33,31.66,327.08,16
CDM,37580253_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",182.92,118.9,45.73,472.39,16
CDM,37580254_1,GUIDE WIRE,483.83,314.49,120.96,1249.5,16
CDM,37580256_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",621.0,403.65,155.25,1603.73,16
CDM,37580257_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",1507.5,979.88,376.88,3893.12,16
CDM,37580258_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",2340.0,1521.0,585.0,6043.05,16
CDM,37580264_1,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",4020.0,2613.0,1005.0,10381.65,16
CDM,37580265_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",3442.5,2237.63,860.63,8890.26,16
CDM,37580270_1,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",7479.0,4861.35,1869.75,19314.52,17
CDM,37580271_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",386.82,251.43,96.7,998.95,16
CDM,37580286_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",65.15,42.35,16.29,168.24,16
CDM,37580287_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",93.42,60.72,23.36,241.26,16
CDM,37580288_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",173.25,112.61,43.31,447.42,16
CDM,37580291_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",243.07,158.0,60.77,627.74,16
CDM,37580296_1,"CLOSURE DEVICE, VASCULAR (IMPLANTABLE/INSERTABLE)",922.5,599.63,230.63,2382.36,16
CDM,37580302_1,GUIDE WIRE,1556.89,1011.98,389.22,4020.67,16
CDM,37580312_1,HC BALLOON WEDGE,360.0,234.0,90.0,252.0,11
CDM,37580313_1,HC PACEMAKER/ICD IMPLT POUCH,4477.5,2910.38,1119.38,3134.25,11
CDM,37580328_1,HC CATHETER LAB TRAY,304.74,198.08,76.19,213.32,11
CDM,37580329_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",594.0,386.1,148.5,1534.01,16
CDM,37580332_1,"CATHETER, INTRAVASCULAR ULTRASOUND",3037.5,1974.38,759.38,7844.34,16
CDM,37580348_1,"CLOSURE DEVICE, VASCULAR (IMPLANTABLE/INSERTABLE)",1092.86,710.36,273.21,2822.3,16
CDM,37580368_1,HC TRAY-CENTESIS,191.6,124.54,47.9,134.12,11
CDM,37580389_1,HC HEMOSTATIC VALVE 3 PORTS TOUGHY,126.0,81.9,31.5,88.2,11
CDM,37580393_1,HC INFLATION DEVICE,333.0,216.45,83.25,233.1,11
CDM,37580400_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",71.36,46.39,17.84,184.3,16
CDM,37580407_1,HC MANIFOLD KIT CATH LAB INCLUDES WIRE/TRAN,179.87,116.92,44.97,125.91,11
CDM,37580409_1,"RETRIEVAL DEVICE, INSERTABLE (USED TO RETRIEVE FRACTURED MEDICAL DEVICES)",7290.0,4738.5,1822.5,18826.43,17
CDM,37580419_1,HC PACER ICD TRAY SETUP,412.92,268.4,103.23,289.04,11
CDM,37580420_1,"LEAD, PACEMAKER, OTHER THAN TRANSVENOUS VDD SINGLE PASS",1799.8,1169.87,449.95,4647.97,16
CDM,37580460_1,HC TOOLS INFLATION DEVICE,207.95,135.17,51.99,145.56,11
CDM,37580481_1,GUIDE WIRE,1327.5,862.88,331.88,3428.27,16
CDM,37580488_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",1587.56,1031.91,396.89,4099.87,16
CDM,37580490_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",80.73,52.47,20.18,208.49,16
CDM,37580500_1,GUIDE WIRE,346.5,225.23,86.63,894.84,16
CDM,37580530_1,HC COIL NESTER EMBOLIZATION PLATINUM,407.57,264.92,101.89,285.3,11
CDM,37580535_1,HC 7FR BIOPSY FORCEPS,981.0,637.65,245.25,686.7,11
CDM,37580548_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",2412.0,1567.8,603.0,6228.99,16
CDM,37580560_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",310.69,201.95,77.67,802.35,16
CDM,37580566_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",644.06,418.64,161.02,1663.29,16
CDM,37580567_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",1795.5,1167.08,448.88,4636.88,16
CDM,37580569_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",1462.5,950.63,365.63,3776.91,16
CDM,37580574_1,HC LUBRICANT ROTAGLIDE,405.0,263.25,101.25,283.5,11
CDM,37580578_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",407.21,264.69,101.8,1051.62,16
CDM,37580579_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTOR MAPPING, OTHER THAN COOL-TIP",7942.5,5162.63,1985.63,20511.51,17
CDM,37580590_1,HC COIL 2,2799.0,1819.35,699.75,1959.3,11
CDM,37580594_1,HC COIL 6,2799.0,1819.35,699.75,1959.3,11
CDM,37580600_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",1476.11,959.47,369.03,3812.07,16
CDM,37580602_1,"PORT, INDWELLING (IMPLANTABLE)",1305.0,848.25,326.25,3370.16,16
CDM,37580603_1,HC FEEDING TUBE,59.67,38.79,14.92,41.77,11
CDM,37580608_1,HC COIL TORNADO,428.18,278.32,107.05,299.73,11
CDM,37580618_1,"PORT, INDWELLING (IMPLANTABLE)",2866.5,1863.23,716.63,7402.74,16
CDM,37580624_1,GUIDE WIRE,3581.87,2328.22,895.47,9250.18,16
CDM,37580625_1,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",6565.5,4267.58,1641.38,16955.4,17
CDM,37580628_1,HC VENTRICULAR DRAINAGE SYSTEM,1263.69,821.4,315.92,884.58,11
CDM,37580634_1,"STENT, NON-COATED/NON-COVERED, WITHOUT DELIVERY SYSTEM",8698.5,5654.03,2174.63,22463.88,17
CDM,37580638_1,HC RESUSCITATION BAG INFANT,88.28,57.38,22.07,61.8,11
CDM,37580646_1,HC DIALYSIS CATHETER 1 HIM,948.46,616.5,237.12,663.92,11
CDM,37580668_1,HC RAPID REFILL SYRINGE,97.34,63.27,24.34,68.14,11
CDM,37580669_1,HC PICC CATH I,1276.05,829.43,319.01,893.24,11
CDM,37580670_1,"CATHETER, INTRAVASCULAR ULTRASOUND",4275.0,2778.75,1068.75,11040.19,16
CDM,37580672_1,HC COIL 15,6100.88,3965.57,1525.22,4270.62,11
CDM,37580677_1,EMBOLIZATION PROTECTIVE SYSTEM,13275.0,8628.75,3318.75,34282.69,17
CDM,37580680_1,HC LIQUID EMBOLIC,11250.0,7312.5,2812.5,7875.0,11
CDM,37580690_1,"CATHETER, INTRACARDIAC ECHOCARDIOGRAPHY",12199.5,7929.68,3049.88,31505.21,17
CDM,37580691_1,HC OSTOMY SUPPLY 1,54.09,35.16,13.52,37.86,11
CDM,37580692_1,HC OSTOMY SUPPLY 2 BOX,55.27,35.93,13.82,38.69,11
CDM,37580699_1,HC FECAL MANAGEMENT KIT,540.0,351.0,135.0,378.0,11
CDM,37580705_1,HC NASAL PACKING,44.83,29.14,11.21,31.38,11
CDM,37580716_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",1111.5,722.48,277.88,2870.45,16
CDM,37580734_1,"LEAD, CARDIOVERTER-DEFIBRILLATOR, ENDOCARDIAL SINGLE COIL (IMPLANTABLE)",14404.95,9363.22,3601.24,37200.78,17
CDM,37580736_1,HC CARDIAC LEAD REMOVAL 2,2580.0,1677.0,645.0,1806.0,11
CDM,37580743_1,HC BARRIER DEVICE KIT 1,132.53,86.14,33.13,92.77,11
CDM,37580754_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1334.7,867.56,333.68,3446.86,16
CDM,37580757_1,HC COIL 20,9886.55,6426.26,2471.64,6920.59,11
CDM,37580759_1,HC OSTOMY SUPPLY,20.99,13.65,5.25,14.69,11
CDM,37580768_1,HC CONTROLLER DETACHMENT,976.5,634.73,244.13,683.55,11
CDM,37580910_1,HC DRESSING SELF-ADHRNT,91.86,59.71,22.96,64.3,11
CDM,37580911_1,HC INTERDRY DRESSING,208.98,135.84,52.25,146.29,11
CDM,37580912_1,"HC DRESSING, NON ADHESIVE CONTACT LAYER",65.35,42.48,16.34,45.75,11
CDM,37580917_1,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, STEERABLE, OTHER THAN PEEL-AWAY",3955.5,2571.08,988.88,10215.08,16
CDM,37580922_1,"CATHETER, DRAINAGE",112.5,73.13,28.13,290.53,16
CDM,37580953_1,HC BRUSH FUSION,513.0,333.45,128.25,359.1,11
CDM,37580964_1,"GASTROSTOMY/JEJUNOSTOMY TUBE, LOW-PROFILE, ANY MATERIAL, ANY TYPE, EACH",1579.68,1026.79,394.92,4079.52,16
CDM,37580971_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",3343.5,2173.28,835.88,8634.59,16
CDM,37580984_1,HC TRAY THYROID BIOPSY,121.41,78.92,30.35,84.99,11
CDM,37580986_1,HC WIRE GUIDE SYNCHRO,2879.69,1871.8,719.92,2015.78,11
CDM,37581001_1,HC STOCKING EDEMA WEAR,59.77,38.85,14.94,41.84,11
CDM,37581003_1,HC MITTEN PEEK A BOO,74.88,48.67,18.72,52.42,11
CDM,37581008_1,HC ELECTRODE RADIOLUCENT,203.29,132.14,50.82,142.3,11
CDM,37581012_1,HC CATH DOUBLE LUMEN,526.5,342.23,131.63,368.55,11
CDM,37581013_1,HC CATH ACCESS SPYSCOPE,11025.0,7166.25,2756.25,7717.5,11
CDM,37581020_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",6581.25,4277.81,1645.31,16996.08,17
CDM,37581026_1,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",355.14,230.84,88.79,917.15,16
CDM,37581030_1,HC TRANSBRONCHIAL ASPIRATION NEEDLE,368.95,239.82,92.24,258.27,11
CDM,37581031_1,HC EXPECT ENDO US ASPIRATION NEEDLE,946.21,615.04,236.55,662.35,11
CDM,37581036_1,HC WIRELESS CAPSULE,2275.65,1479.17,568.91,1592.96,11
CDM,37581038_1,HC DISP BRONCH ASCOPE,1222.65,794.72,305.66,855.86,11
CDM,37581057_1,HC CATH ACCESORY KIT LUMBAR,1052.6,684.19,263.15,736.82,11
CDM,37581059_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",868.22,564.34,217.06,2242.18,16
CDM,37581069_1,HC COLLAR ASPEN,144.23,93.75,36.06,100.96,11
CDM,37581075_1,HC PROBE FIAPC,1158.98,753.34,289.75,811.29,11
CDM,37581077_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",3510.0,2281.5,877.5,9064.58,16
CDM,37581082_1,HC DRAPE WARMING UNIT,172.13,111.88,43.03,120.49,11
CDM,37581083_1,HC NEEDLE INTRAOSSIOUS,665.1,432.32,166.28,465.57,11
CDM,37581092_1,HC CATH NEURON SELELCT SYSTEM,2182.5,1418.63,545.63,1527.75,11
CDM,37581093_1,HC BOOT PODUS MP,241.92,157.25,60.48,169.34,11
CDM,37581096_1,HC CATH NEURON SELELCT,562.5,365.63,140.63,393.75,11
CDM,37581101_1,HC OVERTUBE ENTEROSCOPE,1021.5,663.98,255.38,715.05,11
CDM,37581102_1,HC BALLOON ENTEROSCOPE,138.35,89.93,34.59,96.85,11
CDM,37581117_1,HC SPHINCTERTOME,1867.46,1213.85,466.87,1307.22,11
CDM,37581123_1,HC KIT PEG,403.61,262.35,100.9,282.53,11
CDM,37581129_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",427.5,277.88,106.88,1104.02,16
CDM,37581136_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",3559.46,2313.65,889.87,9192.31,16
CDM,37581138_1,HC CLOG ZAPPER -DECLOTTING FEEDING TUBE,92.89,60.38,23.22,65.02,11
CDM,37581139_1,HC POUCH,114.09,74.16,28.52,79.87,11
CDM,37581145_1,HC COVER ULTRASOUND PROBE,54.0,35.1,13.5,37.8,11
CDM,37581150_1,HC DRESSING PATCH HEMCON,90.0,58.5,22.5,63.0,11
CDM,37581151_1,HC TRAY LUMBAR PUNCT,156.65,101.82,39.16,109.66,11
CDM,37581153_1,HC SYRINGE MONARCH,256.5,166.73,64.13,179.55,11
CDM,37581156_1,HC ADAPTER Y,60.62,39.4,15.15,42.43,11
CDM,37581159_1,HC CATHETER FOLEY SILICONE,65.24,42.4,16.31,45.66,11
CDM,37581164_1,HC DRESSING VAC WHITEFOAM,139.98,90.99,34.99,97.98,11
CDM,37581165_1,HC PAD TRAC W TUBING CLAMP CONNECTOR,73.59,47.83,18.4,51.51,11
CDM,37581166_1,EMBOLIZATION PROTECTIVE SYSTEM,8077.5,5250.38,2019.38,20860.14,17
CDM,37581171_1,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",11213.82,7288.98,2803.46,28959.69,17
CDM,37581175_1,HC DILIATOR ACCUSTICK,45.45,29.54,11.36,31.82,11
CDM,37581185_1,HC NEEDLE CARR-LOCKE INJECTION,217.8,141.57,54.45,152.46,11
CDM,37581192_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, 3D OR VECTOR MAPPING",8667.0,5633.55,2166.75,22382.53,17
CDM,37581194_1,HC CUSHION BARIATRIC CHAIR,176.99,115.04,44.25,123.89,11
CDM,37581196_1,HC COOLFLOW TUBING SET,391.5,254.48,97.88,274.05,11
CDM,37581198_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, 3D OR VECTOR MAPPING",5004.0,3252.6,1251.0,12922.83,16
CDM,37581199_1,"CATHETER, INTRACARDIAC ECHOCARDIOGRAPHY",12145.5,7894.58,3036.38,31365.75,17
CDM,37581201_1,HC MATTRESS OVERLAY GAYMAR,196.02,127.41,49.01,137.21,11
CDM,37581202_1,HC CUSHION SOF-CARE CHAIR,69.12,44.93,17.28,48.38,11
CDM,37581209_1,HC MANAGEMENT SYSTEM FISTULA AND WOUND MAXI,442.76,287.79,110.69,309.93,11
CDM,37581211_1,HC VASCULAR DILATOR KIT,1111.5,722.48,277.88,778.05,11
CDM,37581215_1,HC CATHETER IMPELLA 2.5,112500.0,73125.0,28125.0,78750.0,11
CDM,37581218_1,HC INTRO ACCESS DILATOR KIT,220.5,143.33,55.13,154.35,11
CDM,37581228_1,HC BALLOON EXTRACTOR,672.08,436.85,168.02,470.46,11
CDM,37581232_1,HC CATH CENTESIS,58.64,38.11,14.66,41.05,11
CDM,37581237_1,HC CATHETER CHGB,109.98,71.49,27.5,76.99,11
CDM,37581238_1,HC BAG POST M,98.25,63.86,24.56,68.78,11
CDM,37581240_1,HC INTRODUCER INTUBATION 3,724.14,470.69,181.04,506.9,11
CDM,37581241_1,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",23151.83,15048.69,5787.96,59789.6,17
CDM,37581243_1,HC NEEDLE EZ-IO,665.1,432.32,166.28,465.57,11
CDM,37581252_1,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",10458.0,6797.7,2614.5,27007.79,17
CDM,37581258_1,HC ELECTRODE ONE STEP CPR,303.87,197.52,75.97,212.71,11
CDM,37581265_1,HC RADIAL CATHETER,104.82,68.13,26.2,73.37,11
CDM,37581268_1,HC COIL HYDROFRAME,10996.88,7147.97,2749.22,7697.82,11
CDM,37581280_1,HC CARTO 3 EXTERNAL REF PATCH,2592.0,1684.8,648.0,1814.4,11
CDM,37581282_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",1507.5,979.88,376.88,3893.12,16
CDM,37581283_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",540.0,351.0,135.0,1394.55,16
CDM,37581287_1,HC CIRCUIT BREATHING VENTILATOR,74.7,48.56,18.68,52.29,11
CDM,37581291_1,"CONTACT LAYER, STERILE, MORE THAN 48 SQ. IN., EACH DRESSING",69.75,45.34,17.44,180.13,16
CDM,37581292_1,HC SET SENSOR ADAPTOR FOR BRAIN MONITOR,126.0,81.9,31.5,88.2,11
CDM,37581307_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, 3D OR VECTOR MAPPING",15529.5,10094.18,3882.38,40104.93,17
CDM,37581309_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",292.5,190.13,73.13,755.38,16
CDM,37581325_1,HC DRESSING ACTICOAT 6X6,126.64,82.32,31.66,88.65,11
CDM,37581327_1,HC IODOSORB GEL WOUND DRESSING NON-WOVEN,63.28,41.13,15.82,44.3,11
CDM,37581329_1,HC PLUG 10MM AMPLATZER II VASCULAR,3744.0,2433.6,936.0,2620.8,11
CDM,37581340_1,HC AUTOPLEX CEMENT W/VERTAPLEX HV KIT,3487.5,2266.88,871.88,2441.25,11
CDM,37581349_1,HC WOUND CLEANSER SOLN,123.2,80.08,30.8,86.24,11
CDM,37581355_1,HC MANAGEMENT SYSTEM FISTULA AND WOUND MAXI,52.56,34.16,13.14,36.79,11
CDM,37581365_1,HC ARCTICGEL PAD,5343.75,3473.44,1335.94,3740.63,11
CDM,37581370_1,"CATHETER, THROMBECTOMY/EMBOLECTOMY",9118.13,5926.78,2279.53,23547.56,17
CDM,37581374_1,HC COVER GVL STAT,176.4,114.66,44.1,123.48,11
CDM,37581383_1,HC CATHETER-FOLEY,48.65,31.62,12.16,34.06,11
CDM,37581385_1,HC KIT WASTE BAG CUSTOM TNMC,64.98,42.24,16.25,45.49,11
CDM,37581386_1,HC SET CONTRAST DELIVERY TNMC CUSTOM,193.5,125.78,48.38,135.45,11
CDM,37581388_1,"INFUSION PUMP, PROGRAMMABLE (IMPLANTABLE)",51.08,33.2,12.77,131.91,16
CDM,37581397_1,HC SENSOR  FOR BIS MONITOR ANESTH,74.25,48.26,18.56,51.98,11
CDM,37581407_1,"CATHETER, INTRAVASCULAR ULTRASOUND",3310.41,2151.77,827.6,8549.13,16
CDM,37581412_1,HC MICROSPHERE SYRINGES,945.0,614.25,236.25,661.5,11
CDM,37581429_1,HC CUSHION GEO-MATT WHEELCHAIR 4IN,90.0,58.5,22.5,63.0,11
CDM,37581431_1,HC TRAY ON CONTOL BONE MARROW BIOPSY,738.75,480.19,184.69,517.13,11
CDM,37581437_1,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",2700.0,1755.0,675.0,6972.75,16
CDM,37581443_1,HC DRESSING AQUACEL STERILE,46.91,30.49,11.73,32.84,11
CDM,37581444_1,"CLOSURE DEVICE, VASCULAR (IMPLANTABLE/INSERTABLE)",1198.8,779.22,299.7,3095.9,16
CDM,37581450_1,HC EAKIN FISTULA AND WOUND POUCH,85.64,55.67,21.41,59.95,11
CDM,37581459_1,HC NEEDLE CELIAC PLEXUS 20 GA NEUROLYSIS,1201.5,780.98,300.38,841.05,11
CDM,37581462_1,HC KIT T-FASTENER GI ANCHOR 3 PACK,531.86,345.71,132.97,372.3,11
CDM,37581465_1,HC DEVICE SOLITAIRE  REVASCULARIZATION,29290.5,19038.83,7322.63,20503.35,11
CDM,37581468_1,HC CASSETTE VERALINK,247.5,160.88,61.88,173.25,11
CDM,37581470_1,HC SET OTSC SYSTEM,2695.5,1752.08,673.88,1886.85,11
CDM,37581471_1,HC RESERVOIR RAPID INFUSOR,799.5,519.68,199.88,559.65,11
CDM,37581472_1,HC SHOE XL SURGICAL MEDICAL,42.89,27.88,10.72,30.02,11
CDM,37581473_1,HC INSOLE XL PEG-ASSIST,54.9,35.69,13.73,38.43,11
CDM,37581474_1,HC CANNULA,90.13,58.58,22.53,63.09,11
CDM,37581481_1,HC DELIVERY SYSTEM,370.67,240.94,92.67,259.47,11
CDM,37581493_1,HC CATH IAB,4351.73,2828.62,1087.93,3046.21,11
CDM,37581495_1,HC DEVICE SAMPLING,720.0,468.0,180.0,504.0,11
CDM,37581498_1,HC DEVICE PIPELINE EMBOLIZATION,62536.5,40648.73,15634.13,43775.55,11
CDM,37581516_1,MISCELLANEOUS SUPPLY OR ACCESSORY FOR USE WITH AN IMPLANTED VENTRICULAR ASSIST DEVICE,1919.7,1247.81,479.93,4957.63,16
CDM,37581517_1,"HOLSTER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",1919.7,1247.81,479.93,2303.64,16
CDM,37581518_1,"SHOWER COVER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",1093.5,710.78,273.38,1312.2,16
CDM,37581520_1,HC INFANT RESUSCITATOR WITH MASK,102.0,66.3,25.5,71.4,11
CDM,37581523_1,FOLEY CATHETER TRAY,86.38,56.15,21.6,60.47,11
CDM,37581527_1,HC CATHETER GUIDE 6F XB3.0,209.25,136.01,52.31,146.48,11
CDM,37581529_1,HC GUIDEWIRE MOD J TIP 0.35INX260CM EXT LGTH 3/PK,277.5,180.38,69.38,194.25,11
CDM,37581530_1,HC GUIDEWIRE MOD J TIP 0.03INX145CM EXT COMP 3/PK,265.5,172.58,66.38,185.85,11
CDM,37581531_1,HC COAXIAL BIOPSY TRAY ONCONTROL 15CMX11GA,2017.5,1311.38,504.38,1412.25,11
CDM,37581537_1,HC DOUBLE BALLOON ENTEROSCOPE,2025.0,1316.25,506.25,1417.5,11
CDM,37581539_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",2017.8,1311.57,504.45,5210.97,16
CDM,37581542_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",329.09,213.91,82.27,849.87,16
CDM,37581543_1,HC HEMOSPRAY HEMOSTAT,10350.0,6727.5,2587.5,7245.0,11
CDM,37581577_1,HC ENGINE VACUUM CANISTER,1627.5,1057.88,406.88,1139.25,11
CDM,37581581_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",779.54,506.7,194.89,2013.16,16
CDM,37581588_1,"CATHETER, BALLOON DILATATION, NON-VASCULAR",1251.45,813.44,312.86,3231.87,16
CDM,37581592_1,HC DUAL J ELECTROSURGICAL KNIFE,5993.51,3895.78,1498.38,4195.46,11
CDM,37581602_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",4995.0,3246.75,1248.75,12899.59,16
CDM,37581603_1,HC STERILE PULLBACK SLED,180.0,117.0,45.0,126.0,11
CDM,37581609_1,"CATHETER, BALLOON DILATATION, NON-VASCULAR",260.43,169.28,65.11,672.55,16
CDM,37581614_1,HC ABSORBABLE SURGICAL HEMOSTATIC AGENT,731.25,475.31,182.81,511.88,11
CDM,37581624_1,GUIDE WIRE,1192.5,775.13,298.13,3079.63,16
CDM,37581643_1,HC PUMP CARTRIDGE,523.8,340.47,130.95,366.66,11
CDM,37581645_1,HC COIL SOFT 2,13528.17,8793.31,3382.04,9469.72,11
CDM,37581650_1,HC ENDO ULTRASOUND BLN,67.5,43.88,16.88,47.25,11
CDM,37581668_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, LASER",13477.5,8760.38,3369.38,34805.64,17
CDM,37581675_1,HC BRIDGE PREP KIT,1237.5,804.38,309.38,866.25,11
CDM,37581677_1,HC SPLIT CV STERILE DRAPE,133.0,86.45,33.25,93.1,11
CDM,37581678_1,HC HEAVY DUTY STERILE DRAPE SYS,161.1,104.72,40.28,112.77,11
CDM,37581679_1,HC UNDERBODY BLANKET,115.46,75.05,28.87,80.82,11
CDM,37581695_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",4882.5,3173.63,1220.63,12609.06,16
CDM,37581701_1,"CATHETER, DRAINAGE",76.5,49.73,19.13,197.56,16
CDM,37581702_1,HC AUTOMATED MANIFOLD KIT W TRANSDUCER,130.5,84.83,32.63,91.35,11
CDM,37581709_1,HC CUSTOM CONTRAST KIT,63.23,41.1,15.81,44.26,11
CDM,37581761_1,HC SUTURE HOLDING INSERTS,144.0,93.6,36.0,100.8,11
CDM,37581762_1,HC BLN IN BLN CATH,4993.43,3245.73,1248.36,3495.4,11
CDM,37581783_1,"HC FETAL PILLOW, SILICONE BLN DEVICE",4027.5,2617.88,1006.88,2819.25,11
CDM,37581784_1,HC RF TRANSSEPTAL SHEATH W WIRE CURVED,4500.0,2925.0,1125.0,3150.0,11
CDM,37581789_1,HC PRESSURE GUIDE WIRE,2812.5,1828.13,703.13,1968.75,11
CDM,37581791_1,HC SMART TIPS,3597.75,2338.54,899.44,2518.43,11
CDM,37581792_1,"HC CARTRIDGES, LIQUID NITROUS OXIDE",85.6,55.64,21.4,59.92,11
CDM,37581795_1,HC POSITIONER FREESTANDING,187.52,121.89,46.88,131.26,11
CDM,37581796_1,HC DRAPE RADIATION PAD,116.42,75.67,29.11,81.49,11
CDM,37581798_1,HC NASOENTERIC FEEDING TUBE W STYLET,278.63,181.11,69.66,195.04,11
CDM,37581800_1,HC GASTRO FEEDING TUBE W CONNECTORS,144.77,94.1,36.19,101.34,11
CDM,37581801_1,HC MIC-KEY J FEEDING TUBE W CONNECTOR,610.88,397.07,152.72,427.62,11
CDM,37581804_1,HC SELECT CATH,562.5,365.63,140.63,393.75,11
CDM,37581813_1,HC LVAD DISCHARGE KIT,753.39,489.7,188.35,527.37,11
CDM,37581815_1,HC Z/PH PROBE,517.5,336.38,129.38,362.25,11
CDM,37581818_1,"HC DRAPE, DERMATAC",86.25,56.06,21.56,60.38,11
CDM,37581819_1,"HC FORCEPS, BIOPSY",2352.51,1529.13,588.13,1646.76,11
CDM,37581827_1,"HC CRYOPROBE, FLEXIBLE",1831.5,1190.48,457.88,1282.05,11
CDM,37581828_1,"HC CRYOPROBE, FLEXIBLE 2",1368.0,889.2,342.0,957.6,11
CDM,37581834_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",4297.5,2793.38,1074.38,11098.29,16
CDM,37581846_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",8100.0,5265.0,2025.0,20918.25,17
CDM,37581847_1,HC CATH ASPIRATION SYS 2,8415.0,5469.75,2103.75,5890.5,11
CDM,37581859_1,HC PROBE STRAIGHT FIRE W FILTER,1158.75,753.19,289.69,811.13,11
CDM,37581860_1,"CATHETER, DRAINAGE",562.5,365.63,140.63,1452.66,16
CDM,37581869_1,"CATHETER, THROMBECTOMY/EMBOLECTOMY",54000.0,35100.0,13500.0,139455.0,17
CDM,37581876_1,HC MICROCATH DUAL LUMEN,1957.5,1272.38,489.38,1370.25,11
CDM,37581880_1,HC SUTURE BARBED W NEEDLE,96.57,62.77,24.14,67.6,11
CDM,37581886_1,LUNG BIOPSY PLUG WITH DELIVERY SYSTEM,1654.2,1075.23,413.55,4271.97,16
CDM,37581892_1,HC MASK KITS PRO-NOX,76.46,49.7,19.12,53.52,11
CDM,37581917_1,HC PENCIL SMOKE EVACUATOR,131.63,85.56,32.91,92.14,11
CDM,37581923_1,"LEAD, NEUROSTIMULATOR (IMPLANTABLE)",19444.17,12638.71,4861.04,50214.56,17
CDM,37581961_1,HC CATH HEMODIALYSIS PK,301.23,195.8,75.31,210.86,11
CDM,37581964_1,HC BRA SHIRRED FRONT CLOSURE,162.0,105.3,40.5,113.4,11
CDM,37581973_1,GUIDE WIRE,949.5,617.18,237.38,2452.08,16
CDM,37581974_1,GUIDE WIRE,949.5,617.18,237.38,2452.08,16
CDM,37581985_1,HC NERVE BLOCK PERIPHERAL PACK CUSTOM,50.0,32.5,12.5,35.0,11
CDM,37582008_1,HC ADAPTER UNIVERSAL CABLE PACING CATH,136.22,88.54,34.06,95.35,11
CDM,37582009_1,HC VASCULAR CLOSURE SYS,900.0,585.0,225.0,630.0,11
CDM,37582010_1,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",4316.29,2805.59,1079.07,11146.82,16
CDM,37582044_1,HC PRIMOBOOT W STAB WEDGE,159.75,103.84,39.94,111.83,11
CDM,37582070_1,HC NEEDLE BIOPSY ION,1125.0,731.25,281.25,787.5,11
CDM,37582071_1,HC SWIVEL CONNECTOR ION,585.0,380.25,146.25,409.5,11
CDM,37582072_1,HC VISION PROBE ADAPTOR AND SUCTION ADAPTOR,225.0,146.25,56.25,157.5,11
CDM,37582073_1,HC VISION PROBE BAG,99.0,64.35,24.75,69.3,11
CDM,37582087_1,GUIDE WIRE,2745.0,1784.25,686.25,7088.96,16
CDM,37582091_1,HC DRESSING LVAD CHANGE TRAY,154.56,100.47,38.64,108.19,11
CDM,37582093_1,HC HOOD SHORT ENDOSCOPY,220.5,143.33,55.13,154.35,11
CDM,37582102_1,HC UNDERPAD PREMIUM,55.58,36.13,13.9,38.91,11
CDM,37582103_1,HC WEDGE BODY WIPE DOWN,193.99,126.1,48.5,135.8,11
CDM,37582110_1,HC POUCH EXTRN MALE URINE MGMT,78.75,51.19,19.69,55.13,11
CDM,37582113_1,HC SENSOR CEREBRAL/SOMATIC OXIMETRY ADULT,315.0,204.75,78.75,220.5,11
CDM,37582122_1,HC CATH EXTERNAL MALE,96.57,62.77,24.14,67.6,11
CDM,37586763_1,HC SPOT INDIA INK MARKER,171.0,111.15,42.75,119.7,11
CDM,37590057_1,HC NEURO DIAGNOSTIC PACK,426.56,277.26,106.64,298.59,11
CDM,37590060_1,HC CABLE PACING,91.73,59.62,22.93,64.21,11
CDM,37590062_1,HC KIT SYMPHONY BREAST MILK INITIATION SYST,59.08,38.4,14.77,41.36,11
CDM,37598031_1,HC SPEC PURCH SUPPLY $26-50 CHG PER ITEM,5.29,3.44,1.32,3.7,11
CDM,37598033_1,HC SPEC PURCH SUPPLY $76-100 CHG PER ITEM,98.44,63.98,24.61,68.9,11
CDM,37598034_1,HC SPEC PURCH SUPPLY $101-200 CHG PER ITEM,161.15,104.75,40.29,112.8,11
CDM,37598035_1,HC SPEC PURCH SUPPLY $201-300 CHG PER ITEM,237.77,154.55,59.44,166.44,11
CDM,37598036_1,HC SPEC PURCH SUPPLY $301-400 CHG PER ITEM,340.66,221.43,85.17,238.46,11
CDM,37598037_1,HC SPEC PURCH SUPPLY $401-500 CHG PER ITEM,465.13,302.33,116.28,325.59,11
CDM,37598038_1,HC SPEC PURCH SUPPLY $501-1000 CHG PER ITEM,846.94,550.51,211.73,592.86,11
CDM,37598039_1,HC SPEC PURCH SUPPLY $1001-2000 CHG PER ITEM,1343.52,873.29,335.88,940.46,11
CDM,37598040_1,HC SPEC PURCH SUPPLY >$2000 CHG PER ITEM,5659.04,3678.37,1414.76,3961.33,11
CDM,37598045_1,HC TRANSSEPTAL NEEDLE,2227.5,1447.88,556.88,1559.25,11
CDM,37598047_1,HC ENDO BRONCHIAL NEEDLE,1512.0,982.8,378.0,1058.4,11
CDM,37598048_1,HC ENDO BRONCHIAL NEEDLE 2,1071.0,696.15,267.75,749.7,11
CDM,37598051_1,GUIDE WIRE,1966.5,1278.23,491.63,5078.49,16
CDM,37598053_1,GUIDE WIRE,968.0,629.2,242.0,2499.86,16
CDM,375A4270_1,"DISPOSABLE ENDOSCOPE SHEATH, EACH",175.5,114.08,43.88,453.23,16
CDM,375A4301_1,"IMPLANTABLE ACCESS TOTAL CATHETER, PORT/RESERVOIR (E.G., VENOUS, ARTERIAL, EPIDURAL, SUBARACHNOID, PERITONEAL, ETC.)",3042.0,1977.3,760.5,7855.97,16
CDM,375A4410_1,"OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), EXTENDED WEAR, WITHOUT BUILT-IN CONVEXITY, LARGER THAN 4 X 4 INCHES, EACH",12.15,7.9,3.04,13.78,16
CDM,375A4556_1,"ELECTRODES, (E.G., APNEA MONITOR), PER PAIR",6300.0,4095.0,14.71,4410.0,16
CDM,375A4615_1,"CANNULA, NASAL",91.16,59.25,1.04,63.81,16
CDM,375A5063_1,"OSTOMY POUCH, DRAINABLE; FOR USE ON BARRIER WITH FLANGE (2 PIECE SYSTEM), EACH",90.37,58.74,3.86,63.26,16
CDM,375A6154_1,"WOUND POUCH, EACH",236.84,153.94,20.47,165.78,16
CDM,375A6199_1,"ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND FILLER, STERILE, PER 6 INCHES",47.85,31.11,7.52,33.5,16
CDM,375A6208_1,"CONTACT LAYER, STERILE, MORE THAN 48 SQ. IN., EACH DRESSING",69.75,45.34,17.44,180.13,16
CDM,375A6210_1,"FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING",62.99,40.94,15.75,44.09,16
CDM,375A6211_1,"FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING",102.57,66.67,25.64,71.8,16
CDM,375A6550_1,"WOUND CARE SET, FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, INCLUDES ALL SUPPLIES AND ACCESSORIES",2173.5,1412.78,31.78,1521.45,16
CDM,375B4087_1,"GASTROSTOMY/JEJUNOSTOMY TUBE, STANDARD, ANY MATERIAL, ANY TYPE, EACH",659.63,428.76,164.91,1703.49,16
CDM,375B4088_1,"GASTROSTOMY/JEJUNOSTOMY TUBE, LOW-PROFILE, ANY MATERIAL, ANY TYPE, EACH",971.28,631.33,242.82,2508.32,16
CDM,375C1052_1,"HEMOSTATIC AGENT, GASTROINTESTINAL, TOPICAL",10350.0,6727.5,2587.5,26728.88,16
CDM,375C1714_1,"CATHETER, TRANSLUMINAL ATHERECTOMY, DIRECTIONAL",15075.0,9798.75,3768.75,38931.19,17
CDM,375C1721_1,"CARDIOVERTER-DEFIBRILLATOR, DUAL CHAMBER (IMPLANTABLE)",53605.74,34843.73,13401.43,138436.82,17
CDM,375C1722_1,"CARDIOVERTER-DEFIBRILLATOR, SINGLE CHAMBER (IMPLANTABLE)",61009.65,39656.27,15252.41,157557.43,17
CDM,375C1724_1,"CATHETER, TRANSLUMINAL ATHERECTOMY, ROTATIONAL",8482.5,5513.63,2120.63,21906.06,17
CDM,375C1725_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",807.32,524.76,201.83,2084.89,16
CDM,375C1726_1,"CATHETER, BALLOON DILATATION, NON-VASCULAR",685.28,445.43,171.32,1769.74,16
CDM,375C1729_1,"CATHETER, DRAINAGE",293.39,190.71,73.35,757.69,16
CDM,375C1730_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",1880.12,1222.08,470.03,4855.4,16
CDM,375C1732_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, 3D OR VECTOR MAPPING",10064.13,6541.69,2516.03,25990.63,17
CDM,375C1733_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTOR MAPPING, OTHER THAN COOL-TIP",25259.99,16418.99,6315.0,65233.92,17
CDM,375C1750_1,"CATHETER, HEMODIALYSIS/PERITONEAL, LONG-TERM",1370.87,891.06,342.72,3540.26,16
CDM,375C1752_1,"CATHETER, HEMODIALYSIS/PERITONEAL, SHORT-TERM",466.84,303.45,116.71,1205.62,16
CDM,375C1753_1,"CATHETER, INTRAVASCULAR ULTRASOUND",3335.93,2168.35,833.98,8615.03,16
CDM,375C1757_1,"CATHETER, THROMBECTOMY/EMBOLECTOMY",13042.35,8477.53,3260.59,33681.88,17
CDM,375C1759_1,"CATHETER, INTRACARDIAC ECHOCARDIOGRAPHY",11069.88,7195.42,2767.47,28587.97,17
CDM,375C1760_1,"CLOSURE DEVICE, VASCULAR (IMPLANTABLE/INSERTABLE)",1058.35,687.93,264.59,2733.19,16
CDM,375C1761_1,"CATHETER, TRANSLUMINAL INTRAVASCULAR LITHOTRIPSY, CORONARY",20935.31,13607.95,5233.83,54065.43,17
CDM,375C1764_1,"EVENT RECORDER, CARDIAC (IMPLANTABLE)",21256.6,13816.79,5314.15,54895.17,17
CDM,375C1766_1,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, STEERABLE, OTHER THAN PEEL-AWAY",2923.45,1900.24,730.86,7549.8,16
CDM,375C1768_1,"GRAFT, VASCULAR",68.63,44.61,17.16,177.24,16
CDM,375C1769_1,GUIDE WIRE,541.95,352.27,135.49,1399.6,16
CDM,375C1773_1,"RETRIEVAL DEVICE, INSERTABLE (USED TO RETRIEVE FRACTURED MEDICAL DEVICES)",1857.89,1207.63,464.47,4798.0,16
CDM,375C1777_1,"LEAD, CARDIOVERTER-DEFIBRILLATOR, ENDOCARDIAL SINGLE COIL (IMPLANTABLE)",14342.34,9322.52,3585.59,37039.11,17
CDM,375C1785_1,"PACEMAKER, DUAL CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)",16165.15,10507.35,4041.29,41746.51,17
CDM,375C1786_1,"PACEMAKER, SINGLE CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)",50046.78,32530.4,12511.69,129245.8,17
CDM,375C1788_1,"PORT, INDWELLING (IMPLANTABLE)",1365.48,887.56,341.37,3526.36,16
CDM,375C1817_1,"SEPTAL DEFECT IMPLANT SYSTEM, INTRACARDIAC",41960.61,27274.4,10490.15,108363.28,17
CDM,375C1822_1,"GENERATOR, NEUROSTIMULATOR (IMPLANTABLE), HIGH FREQUENCY, WITH RECHARGEABLE BATTERY AND CHARGING SYSTEM",74083.5,48154.28,18520.88,191320.64,17
CDM,375C1824_1,"GENERATOR, CARDIAC CONTRACTILITY MODULATION (IMPLANTABLE)",117000.0,76050.0,29250.0,302152.5,17
CDM,375C1874_1,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",5759.19,3743.47,1439.8,14873.1,17
CDM,375C1875_1,"STENT, COATED/COVERED, WITHOUT DELIVERY SYSTEM",11878.59,7721.09,2969.65,30676.47,17
CDM,375C1876_1,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",10647.69,6921.0,2661.92,27497.65,17
CDM,375C1877_1,"STENT, NON-COATED/NON-COVERED, WITHOUT DELIVERY SYSTEM",8698.5,5654.03,2174.63,22463.88,17
CDM,375C1880_1,VENA CAVA FILTER,5025.05,3266.28,1256.26,12977.18,16
CDM,375C1882_1,"CARDIOVERTER-DEFIBRILLATOR, OTHER THAN SINGLE OR DUAL CHAMBER (IMPLANTABLE)",79955.47,51971.06,19988.87,206485.01,17
CDM,375C1884_1,EMBOLIZATION PROTECTIVE SYSTEM,4481.67,2913.08,1120.42,11573.91,16
CDM,375C1885_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, LASER",13927.5,9052.88,3481.88,35967.77,17
CDM,375C1886_1,"CATHETER, EXTRAVASCULAR TISSUE ABLATION, ANY MODALITY (INSERTABLE)",8676.0,5639.4,2169.0,22405.77,17
CDM,375C1887_1,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",936.03,608.42,234.01,2417.31,16
CDM,375C1888_1,"CATHETER, ABLATION, NON-CARDIAC, ENDOVASCULAR (IMPLANTABLE)",2467.09,1603.61,616.77,6371.26,16
CDM,375C1889_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",5293.92,3441.05,1323.48,13671.55,16
CDM,375C1892_1,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, PEEL-AWAY",176.78,114.91,44.19,456.53,16
CDM,375C1893_1,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, OTHER THAN PEEL-AWAY",1887.36,1226.78,471.84,4874.11,16
CDM,375C1894_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",197.64,128.47,49.41,510.41,16
CDM,375C1895_1,"LEAD, CARDIOVERTER-DEFIBRILLATOR, ENDOCARDIAL DUAL COIL (IMPLANTABLE)",12682.35,8243.52,3170.59,32752.16,17
CDM,375C1896_1,"LEAD, CARDIOVERTER-DEFIBRILLATOR, OTHER THAN ENDOCARDIAL SINGLE OR DUAL COIL (IMPLANTABLE)",16905.0,10988.25,4226.25,43657.16,17
CDM,375C1898_1,"LEAD, PACEMAKER, OTHER THAN TRANSVENOUS VDD SINGLE PASS",1789.81,1163.38,447.45,4622.19,16
CDM,375C1900_1,"LEAD, LEFT VENTRICULAR CORONARY VENOUS SYSTEM",11144.91,7244.19,2786.23,28781.74,17
CDM,375C2613_1,LUNG BIOPSY PLUG WITH DELIVERY SYSTEM,1654.2,1075.23,413.55,4271.97,16
CDM,375C2617_1,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",314.49,204.42,78.62,812.16,16
CDM,375C2618_1,"PROBE/NEEDLE, CRYOABLATION",5376.34,3494.62,1344.08,13884.39,16
CDM,375C2621_1,"PACEMAKER, OTHER THAN SINGLE OR DUAL CHAMBER (IMPLANTABLE)",27859.29,18108.54,6964.82,71946.61,17
CDM,375C2623_1,"CATHETER, TRANSLUMINAL ANGIOPLASTY, DRUG-COATED, NON-LASER",7902.81,5136.83,1975.7,20409.0,17
CDM,375C2624_1,"IMPLANTABLE WIRELESS PULMONARY ARTERY PRESSURE SENSOR WITH DELIVERY CATHETER, INCLUDING ALL SYSTEM COMPONENTS",103050.0,66982.5,25762.5,266126.63,17
CDM,375C2625_1,"STENT, NON-CORONARY, TEMPORARY, WITH DELIVERY SYSTEM",327.22,212.69,81.8,845.04,16
CDM,375C2628_1,"CATHETER, OCCLUSION",3130.02,2034.51,782.51,8083.28,16
CDM,375C2629_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, LASER",13683.55,8894.31,3420.89,35337.77,17
CDM,375C2630_1,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTOR MAPPING, COOL-TIP",12766.01,8297.91,3191.5,32968.22,17
CDM,375L0140_1,"CERVICAL, SEMI-RIGID, ADJUSTABLE (PLASTIC COLLAR)",145.59,94.63,36.4,174.71,16
CDM,375Q0477_1,"POWER MODULE PATIENT CABLE FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",5625.0,3656.25,950.64,6750.0,17
CDM,375Q0481_1,"MICROPROCESSOR CONTROL UNIT FOR USE WITH ELECTRIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",26703.41,17357.22,6675.85,32044.09,17
CDM,375Q0496_1,"BATTERY, OTHER THAN LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",405.0,263.25,101.25,1965.57,16
CDM,375Q0499_1,"BELT/VEST/BAG FOR USE TO CARRY EXTERNAL PERIPHERAL COMPONENTS OF ANY TYPE VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",1579.5,1026.68,204.47,1895.4,16
CDM,375Q0501_1,"SHOWER COVER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",1093.5,710.78,273.38,1312.2,16
CDM,375Q0506_1,"BATTERY, LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",5811.18,3777.27,1046.55,6973.42,17
CDM,375Q0508_1,MISCELLANEOUS SUPPLY OR ACCESSORY FOR USE WITH AN IMPLANTED VENTRICULAR ASSIST DEVICE,9825.88,6386.82,2456.47,25375.33,17
CDM,375SU270_1,HC GENERAL SUPPLY REV CODE 270 NO HCPCS,305.55,198.61,76.39,213.89,11
CDM,37600_1,Tying of external neck artery,2046.5,1330.23,78.57,2178.32,19
CDM,37605_1,Tying of internal neck artery,2326.8,1512.42,78.57,2127.72,19
CDM,37606_1,Tying and gradual clamping of neck artery,1196.13,777.48,78.57,2009.63,19
CDM,37607_1,Tying or banding of surgically created artery-vein connection,1082.6,703.69,78.57,1097.26,19
CDM,37609T_1,Tying or biopsy of artery on side of skull,814.8,529.62,78.57,736.98,19
CDM,37609_1,Tying or biopsy of artery on side of skull,1324.65,861.02,78.57,736.98,19
CDM,3760IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.03,16.92,6.51,67.22,16
CDM,3760OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",70.64,45.92,17.66,182.43,16
CDM,37615_1,Tying of major neck artery,1496.3,972.6,78.57,1536.2,19
CDM,37616IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.07,2.65,1.02,10.51,16
CDM,37616OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.14,10.49,4.04,41.68,16
CDM,37616_1,Tying of major chest artery,3135.3,2037.95,78.57,3239.02,19
CDM,37617_1,Tying of major artery of the abdomen,3737.0,2429.05,78.57,3876.75,19
CDM,37618_1,Tying of major arm or leg artery,1077.3,700.25,78.57,1130.97,19
CDM,37619_1,Tying of inferior vena cava,3808.2,2475.33,78.57,5039.89,19
CDM,3761IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.93,12.95,4.98,51.47,16
CDM,3761OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",105.0,68.25,26.25,271.16,16
CDM,37635IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.11,2.67,1.03,10.61,16
CDM,37635OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.15,6.6,2.54,26.21,16
CDM,37637IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.83,3.14,1.21,12.47,16
CDM,37637OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.14,20.24,7.79,80.42,16
CDM,37642IP _1,UNCLASSIFIED DRUGS,1.35,0.88,0.34,3.49,16
CDM,37642OP _1,UNCLASSIFIED DRUGS,1.55,1.01,0.39,4.0,16
CDM,37648IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.3,2.8,1.08,11.1,16
CDM,37648OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.6,10.14,3.9,40.29,16
CDM,37649IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.18,2.07,0.8,8.21,16
CDM,37649OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.6,13.39,5.15,53.2,16
CDM,37650IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.37,3.49,1.34,13.87,16
CDM,37650OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.17,11.81,4.54,46.92,16
CDM,37650_1,Tying of upper leg vein,1443.8,938.47,78.57,1330.61,19
CDM,37660_1,Tying of groin vein,3511.2,2282.28,78.57,3840.14,19
CDM,37662IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.95,3.87,1.49,15.37,16
CDM,37690791_1,Psychiatric diagnostic evaluation,321.0,208.65,80.25,828.98,19
CDM,37690832_1,"Psychotherapy, 30 minutes",244.63,159.01,61.16,631.76,17
CDM,37690834_1,"Psychotherapy, 45 minutes",241.0,156.65,60.25,622.38,17
CDM,37690837_1,"Psychotherapy, 1 hour",313.0,203.45,78.25,808.32,17
CDM,37690847_1,"Family psychotherapy with patient, 50 minutes",290.0,188.5,72.5,748.93,19
CDM,37700T_1,Tying and division of long leg vein,3280.5,2132.33,78.57,717.49,19
CDM,37700_1,Tying and division of long leg vein,1575.0,1023.75,78.57,717.49,19
CDM,37718T_1,"Tying, incision, and stripping of short leg vein",3280.5,2132.33,78.57,1140.19,19
CDM,37718_1,"Tying, incision, and stripping of short leg vein",1068.9,694.79,78.57,1140.19,19
CDM,3771IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.69,1.1,0.42,4.36,16
CDM,3771OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.44,0.94,0.36,3.72,16
CDM,37722T_1,"Tying, incision, and stripping of long leg vein",4380.9,2847.59,78.57,1365.24,19
CDM,37722_1,"Tying, incision, and stripping of long leg vein",1238.0,804.7,78.57,1365.24,19
CDM,3772IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.82,8.33,3.21,33.11,16
CDM,3772OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.6,15.99,6.15,63.53,16
CDM,37735T_1,"Tying, incision, and stripping of leg veins with removal of ulcer and skin graft and/or interruption of lower leg veins",4380.9,2847.59,78.57,1684.4,19
CDM,37735_1,"Tying, incision, and stripping of leg veins with removal of ulcer and skin graft and/or interruption of lower leg veins",2625.0,1706.25,78.57,1684.4,19
CDM,3774IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.62,9.5,3.66,37.76,16
CDM,3774OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.47,23.71,9.12,94.18,16
CDM,3775IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.05,2.63,1.01,10.46,16
CDM,3775OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.4,10.01,3.85,39.77,16
CDM,37760T_1,"Tying of varicose veins, radical procedure including skin graft",3280.5,2132.33,78.57,1668.05,19
CDM,37760_1,"Tying of varicose veins, radical procedure including skin graft",2100.0,1365.0,78.57,1668.05,19
CDM,37761T_1,"Tying of varicose veins, simple procedure using ultrasound",3280.5,2132.33,78.57,1568.82,19
CDM,37761_1,"Tying of varicose veins, simple procedure using ultrasound",1622.3,1054.5,78.57,1568.82,19
CDM,37765T_1,"Removal of varicose veins of arm or leg, 10-20 incisions",2973.3,1932.65,78.57,988.54,19
CDM,37765_1,"Removal of varicose veins of arm or leg, 10-20 incisions",1970.4,1280.76,78.57,988.54,19
CDM,37766T_1,"Removal of varicose veins of arm or leg, more than 20 incisions",3370.2,2190.63,78.57,1159.72,19
CDM,37766_1,"Removal of varicose veins of arm or leg, more than 20 incisions",2406.6,1564.29,78.57,1159.72,19
CDM,37780T_1,Tying and division of short leg vein,3280.5,2132.33,78.57,682.55,19
CDM,37780_1,Tying and division of short leg vein,739.2,480.48,78.57,682.55,19
CDM,37785T_1,"Tying, incision, and/or removal of varicose vein clusters of leg",3280.5,2132.33,64.57,813.18,19
CDM,37785_1,"Tying, incision, and/or removal of varicose vein clusters of leg",994.4,646.36,64.57,813.18,19
CDM,37788_1,Restoration of blood flow in artery of penis,4173.8,2712.97,78.57,3867.15,19
CDM,37790_1,Blockage of penis vein,1444.8,939.12,78.57,1488.59,19
CDM,37800010_1,HC TRAUMA ACTIVATION WITH PRE-ED NOTIFICATION,4457.0,2897.05,1114.25,3119.9,11
CDM,37819128_1,HC SUPPLIES FOR CAST/SPLINT LEG,90.0,58.5,22.5,63.0,11
CDM,37819129_1,HC SUPPLIES FOR CAST/SPLINT ARM,65.0,42.25,16.25,45.5,11
CDM,37819132_1,T-PODS PELVIC ORTHOTIC DEVICE,453.0,294.45,113.25,317.1,11
CDM,3781IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.46,0.95,0.37,3.77,16
CDM,3781OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.3,2.15,0.83,8.52,16
CDM,37848IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.89,1.88,0.72,7.46,16
CDM,37848OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.67,1.74,0.67,6.9,16
CDM,37849083_1,Drainage of fluid from abdominal cavity using imaging guidance,1377.0,895.05,344.25,3556.1,19
CDM,37864999_1,Other procedure on nervous system,375.0,243.75,93.75,2166.29,19
CDM,37872572_1,HC OTHER MISC PROCEDURE,2739.22,1780.5,684.81,1974.0,12
CDM,37894IP _1,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",361.48,234.96,3.81,2058.35,19
CDM,37894OP _1,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",17698.43,11503.98,3.81,45706.2,19
CDM,37899211_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,100.0,65.0,25.0,1974.0,17
CDM,37899215_1,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",320.0,208.0,80.0,826.4,17
CDM,37989OP _1,"INJECTION, CETUXIMAB, 10 MG",108.26,70.37,27.07,2922.83,19
CDM,38004OP _1,IBUPROFEN JR STR 100 MG TB CHW,2.33,1.51,0.58,1.63,11
CDM,38022OP _1,"INJECTION, BEVACIZUMAB, 10 MG",1042.81,677.83,78.05,2922.83,19
CDM,38062IP _1,"MYCOPHENOLIC ACID, ORAL, 180 MG",51.79,33.66,0.34,133.75,17
CDM,38062OP _1,"MYCOPHENOLIC ACID, ORAL, 180 MG",11.07,7.2,0.34,28.59,17
CDM,38063IP _1,"MYCOPHENOLIC ACID, ORAL, 180 MG",100.74,65.48,0.34,260.16,17
CDM,38063OP _1,"MYCOPHENOLIC ACID, ORAL, 180 MG",42.67,27.74,0.34,110.2,17
CDM,38092IP _1,UNCLASSIFIED DRUGS,15.19,9.87,3.8,39.23,16
CDM,38092OP _1,UNCLASSIFIED DRUGS,4.33,2.81,1.08,11.18,16
CDM,38100IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.79,4.41,1.7,17.54,16
CDM,38100OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.38,11.3,4.35,44.88,16
CDM,38100_1,Removal of spleen,3050.3,1982.7,78.57,3381.16,19
CDM,38101_1,Partial removal of spleen,3059.7,1988.81,78.57,3395.98,19
CDM,38102_1,Removal of spleen during other surgical procedure,997.5,648.38,78.57,770.88,19
CDM,38103IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",71.22,46.29,17.81,183.93,16
CDM,38115_1,Repair of ruptured spleen,3395.7,2207.21,78.57,3757.8,19
CDM,38120_1,Exam of spleen using an endoscope,2797.2,1818.18,78.57,3086.04,19
CDM,38200_1,Injection procedure for imaging of spleen,415.8,270.27,78.57,408.16,19
CDM,38204_1,Management of stem cell donor search,294.2,191.23,78.57,314.0,15
CDM,38205_1,Collection of donor stem cells for transplantation,525.0,341.25,65.81,257.5,19
CDM,38206_1,Collection of stem cells for transplantation,525.0,341.25,64.39,257.85,19
CDM,38207_1,Preservation and storage of stem cells for transplantation,138.5,90.03,49.4,139.44,15
CDM,38208_1,Thawing of frozen stem cells for transplantation,87.5,56.88,30.87,88.38,15
CDM,38209_1,Thawing and washing of frozen stem cells for transplantation,37.85,24.6,17.03,78.57,15
CDM,38210_1,Preparation of stem cells for transplantation with removal of T cells,245.58,159.63,74.1,246.51,15
CDM,38211_1,Preparation of stem cells for transplantation with removal of growth cells,222.25,144.46,37.05,222.82,15
CDM,38212_1,Preparation of stem cells for transplantation with red blood cell removal,146.65,95.32,30.87,147.51,15
CDM,38213_1,Preparation of stem cells for transplantation with removal of platelets,37.85,24.6,17.03,78.57,15
CDM,38214_1,Preparation of stem cells for transplantation with reduction of blood fluid (plasma) volume,126.35,82.13,24.7,127.16,15
CDM,38215_1,Preparation of stem cells for transplantation with cell concentration in blood fluid (plasma),146.65,95.32,43.22,147.51,15
CDM,38220_1,Aspiration of bone marrow sample for diagnosis,420.0,273.0,25.62,374.3,19
CDM,38221_1,Biopsy of bone marrow,470.0,305.5,37.97,389.31,19
CDM,38222_1,Biopsy and aspiration of bone marrow sample for diagnosis,570.0,370.5,58.88,422.17,19
CDM,38224IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.82,10.28,3.96,40.86,16
CDM,38224OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.24,15.76,6.06,62.6,16
CDM,38225IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.83,3.14,1.21,12.47,16
CDM,38225OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.53,8.79,3.38,34.94,16
CDM,38225_1,"Harvesting of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy, per day",385.0,250.25,78.57,396.55,15
CDM,38228_1,Administration of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy,395.0,256.75,78.57,703.64,19
CDM,38230_1,Harvest of donor bone marrow for transplantation,902.0,586.3,78.57,604.65,19
CDM,38232_1,Harvest of patient bone marrow for transplantation,1225.0,796.25,78.57,594.87,19
CDM,38240_1,Transplantation of donor stem cells per donor,525.0,341.25,78.57,704.41,19
CDM,38241_1,Transplantation of patient-derived stem cells,525.0,341.25,78.57,526.84,19
CDM,38242_1,Transplantation of donor white blood cells,281.4,182.91,78.57,372.66,19
CDM,38243_1,Transplantation of donor stem cells,389.6,253.24,78.57,374.93,19
CDM,38245IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.77,1.8,0.69,7.15,16
CDM,38245OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.63,1.06,0.41,4.21,16
CDM,38263IP _1,"INJECTION, OLANZAPINE, 0.5 MG",331.97,215.78,0.86,857.31,17
CDM,38263OP _1,"INJECTION, OLANZAPINE, 0.5 MG",78.42,50.97,0.86,202.52,17
CDM,38270IP _1,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",1759.01,1143.36,0.63,4542.64,17
CDM,38270OP _1,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",1054.39,685.35,0.63,2722.96,17
CDM,38271IP _1,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",863.03,560.97,0.63,2228.78,17
CDM,38271OP _1,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",325.96,211.87,0.63,841.79,17
CDM,38300_1,Simple drainage of abscess or swelling of lymph node,715.1,464.82,54.66,800.65,19
CDM,38303IP _1,"INJECTION, ACETYLCYSTEINE, 100 MG",25.0,16.25,0.39,64.56,17
CDM,38303OP _1,"INJECTION, ACETYLCYSTEINE, 100 MG",2.36,1.53,0.39,6.09,17
CDM,38305_1,Drainage of extensive abscess or swelling of lymph node,1235.9,803.34,78.57,1419.33,19
CDM,38308_1,Incision or other operation on lymphatic channels,1189.7,773.31,78.57,1323.88,19
CDM,38380_1,Suture and/or tying of chest lymph duct through neck,1546.7,1005.36,78.57,1705.29,19
CDM,38381_1,Suture and/or tying of chest lymph duct through back,2258.6,1468.09,78.57,2346.24,19
CDM,38382_1,Suture and/or tying of chest lymph duct through abdomen,1844.9,1199.19,78.57,1971.78,19
CDM,3841IP _1,UNCLASSIFIED DRUGS,4.88,3.17,1.22,12.6,16
CDM,3841OP _1,UNCLASSIFIED DRUGS,30.12,19.58,7.53,77.78,16
CDM,3843IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.99,2.59,1.0,10.3,16
CDM,3843OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.48,10.71,4.12,42.56,16
CDM,3844IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.61,3.0,1.15,11.91,16
CDM,3844OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.93,14.25,5.48,56.63,16
CDM,3845IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.1,3.32,1.28,13.17,16
CDM,3845OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.61,17.95,6.9,71.3,16
CDM,38488IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.83,1.84,0.71,7.31,16
CDM,38488OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.36,0.88,0.34,3.51,16
CDM,38489IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.17,0.76,0.29,3.02,16
CDM,38500101_1,HBS ORO TRACHEAL NEEDLE,201.0,130.65,50.25,140.7,11
CDM,38500102_1,HBS OLYMPUS INJECTOR FORCE NEEDLE,97.0,63.05,24.25,67.9,11
CDM,38500103_1,HBS VEGA VOICE PROVOX WITH PUNCTURE KIT,1068.0,694.2,267.0,747.6,11
CDM,38500104_1,HBS ADHESIVE SKIN DERMABOND,103.0,66.95,25.75,72.1,11
CDM,38500105_1,HBS VALLEY LAB CAUTERY TIP,93.0,60.45,23.25,65.1,11
CDM,38500106_1,HBS PLAIN GUT FAST ABSORBING SUTURE,62.0,40.3,15.5,43.4,11
CDM,38500107_1,HBS PROLENE 4-0 PS-2 BL MONO SUTURE,40.0,26.0,10.0,28.0,11
CDM,38500108_1,HBS PROLENE SURGILENE SUTURE,41.0,26.65,10.25,28.7,11
CDM,38500109_1,HBS SKIN STAPLER,71.0,46.15,17.75,49.7,11
CDM,38500110_1,HBS LARYNGECTOMY TUBE,318.0,206.7,79.5,222.6,11
CDM,38500111_1,HBS RADIESSE NEEDLE,77.0,50.05,19.25,53.9,11
CDM,38500112_1,"CONTACT LENS, OTHER TYPE",73.0,47.45,18.25,188.52,16
CDM,38500113_1,HBS LASER KTP AURA RENTAL LOC,1529.0,993.85,382.25,1070.3,11
CDM,38500114_1,HBS LASER FIBER AURA KPT LOC,986.0,640.9,246.5,690.2,11
CDM,38500115_1,HBS EMG NEEDLE,189.0,122.85,47.25,132.3,11
CDM,38500116_1,HBS MISCARRIAGE MGMT KIT,276.0,179.4,69.0,193.2,11
CDM,38500117_1,HBS PEG TUBE KIT,257.0,167.05,64.25,179.9,11
CDM,38500118_1,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",112.0,72.8,28.0,78.4,16
CDM,38500119_1,"TRACHEOSTOMY/LARYNGECTOMY TUBE, CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",116.0,75.4,29.0,81.2,16
CDM,38500120_1,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",180.0,117.0,45.0,126.0,16
CDM,38500121_1,"TRACHEOSTOMY/LARYNGECTOMY TUBE, CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",180.0,117.0,45.0,126.0,16
CDM,38500122_1,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",164.0,106.6,41.0,114.8,16
CDM,38500123_1,"TRACHEOSTOMY/LARYNGECTOMY TUBE, CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",210.0,136.5,52.5,147.0,16
CDM,38500124_1,"TRACHEOSTOMY/LARYNGECTOMY TUBE, STAINLESS STEEL OR EQUAL (STERILIZABLE AND REUSABLE), EACH",292.0,189.8,64.36,204.4,16
CDM,38500125_1,HBS HEMOSTAT WRAP,456.0,296.4,114.0,319.2,11
CDM,38500126_1,HBS SINUS CONE,63.0,40.95,15.75,44.1,11
CDM,38500127_1,HBS EMG NEEDLE ELECTRODE,61.0,39.65,15.25,42.7,11
CDM,38500128_1,HBS SURGIFOAM SPONGE,114.0,74.1,28.5,79.8,11
CDM,38500129_1,HBS SILICONE SHEETING,58.5,38.03,14.63,40.95,11
CDM,38500130_1,HBS RAPID RHINO,171.0,111.15,42.75,119.7,11
CDM,38500131_1,HBS NASAL TAMPON,100.0,65.0,25.0,70.0,11
CDM,38500132_1,HBS SUCTION BRONCHOSCOPE VALVE,49.5,32.18,12.38,34.65,11
CDM,38500133_1,HBS MICRONEEDLE CAUTERY TIP,25.0,16.25,6.25,17.5,11
CDM,38500134_1,"INJECTABLE BULKING AGENT, SYNTHETIC IMPLANT, URINARY TRACT, 1 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",1389.5,903.18,268.67,1667.4,16
CDM,38500135_1,HBS COAPTITE NEEDLE,199.0,129.35,49.75,139.3,11
CDM,38500136_1,HBS SPRAY CATH,740.0,481.0,185.0,518.0,11
CDM,38500137_1,SURGICAL SUPPLY; MISCELLANEOUS,696.0,452.4,174.0,1797.42,16
CDM,38500138_1,HBS EAR TUBE,68.0,44.2,17.0,47.6,11
CDM,38500139_1,HBS PHENOL APPLICATION KIT,72.0,46.8,18.0,50.4,11
CDM,38500140_1,"STENT, NON-CORONARY, TEMPORARY, WITH DELIVERY SYSTEM",2641.0,1716.65,660.25,6820.38,16
CDM,38500141_1,HBS NASAL DRSSNG BIORESORBABLE,628.0,408.2,157.0,439.6,11
CDM,38500142_1,HBS RENU SMALL,1900.0,1235.0,475.0,1330.0,11
CDM,38500143_1,HBS RENU MEDIUM,3800.0,2470.0,950.0,2660.0,11
CDM,38500144_1,HBS RENU LARGE,5700.0,3705.0,1425.0,3990.0,11
CDM,38500145_1,HBS CELON PROBREATH APPLICATOR,636.0,413.4,159.0,445.2,11
CDM,38500146_1,HBS COLLECTION TUBING SET,31.5,20.48,7.88,22.05,11
CDM,38500147_1,HBS LOOP ELECTRODE,67.5,43.88,16.88,47.25,11
CDM,38500148_1,HBS BALL ELECTRODE,67.5,43.88,16.88,47.25,11
CDM,38500149_1,HBS MISCARRIAGE MANAGEMENT KIT,361.0,234.65,90.25,252.7,11
CDM,38500150_1,HBS FINESSE FILTER PACK,157.5,102.38,39.38,110.25,11
CDM,38500151_1,HBS UTAHLOOP ELECTRODE,67.5,43.88,16.88,47.25,11
CDM,38500152_1,HBS EXTERNAL LESION ELECTRODE,58.5,38.03,14.63,40.95,11
CDM,38500153_1,HBS ABDOMINAL PRESSURE CATH,1444.0,938.6,361.0,1010.8,11
CDM,38500154_1,HBS DUAL SENSOR CATH,2154.6,1400.49,538.65,1508.22,11
CDM,38500155_1,HBS BREAST PAD/SHIELD/SHELL,48.0,31.2,12.0,33.6,11
CDM,38500156_1,HBS CATH SYR&SCALPEL BARTHOLIN GLAND,80.0,52.0,20.0,56.0,11
CDM,38500157_1,HBS ALLIGATOR JAW BIOPSY FORCEPS,119.5,77.68,29.88,83.65,11
CDM,38500158_1,HBS PLATINUM EYELID WEIGHTS,1980.0,1287.0,495.0,1386.0,11
CDM,38500159_1,"HBS NASAL SEPTAL BUTTON, 5 CM",423.0,274.95,105.75,296.1,11
CDM,38500160_1,"HBS NASAL SEPTAL BUTTON, 3 CM",883.5,574.28,220.88,618.45,11
CDM,38500161_1,"PROBE/NEEDLE, CRYOABLATION",5377.5,3495.38,1344.38,13887.39,16
CDM,38500162_1,"HBS DERMABRADER, STRAIGHT",346.5,225.23,86.63,242.55,11
CDM,38500163_1,HBS LUMBAR PUNCTURE KIT,48.5,31.53,12.13,33.95,11
CDM,38500164_1,HBS SMART TIPS 309 IOVERA 3X8.55MM,2697.75,1753.54,674.44,1888.43,11
CDM,38500165_1,HBS SMART TIPS 90 IOVERA 17.2X3.0MM,3597.75,2338.54,899.44,2518.43,11
CDM,38500166_1,HBS CARTRIDGES IOVERA,85.5,55.58,21.38,59.85,11
CDM,38500167_1,HBS SMARTLOCK  HMMF PLATE SMALL,1553.0,1009.45,388.25,1087.1,11
CDM,38500168_1,HBS SMARTLOCK HMMF SCR 2.0 X 6 MM,633.0,411.45,158.25,443.1,11
CDM,38500169_1,HBS SMARTLOCK HMMF SCR 2.0 X 8 MM,633.0,411.45,158.25,443.1,11
CDM,38500170_1,HBS ABDOMINAL BINDER,45.0,29.25,11.25,31.5,11
CDM,38500171_1,HBS CRUTCHES,42.0,27.3,10.5,29.4,11
CDM,38500172_1,HBS ANKLE BRACE AIR STIRRUP,76.0,49.4,19.0,53.2,11
CDM,38500173_1,HBS BAND IMPLANT STABILIZER,45.0,29.25,11.25,31.5,11
CDM,38500174_1,HBS BINDER 9 INCH,112.0,72.8,28.0,78.4,11
CDM,38500175_1,HBS GIRDLE HIGH WAIST BIKINI LENGTH,215.0,139.75,53.75,150.5,11
CDM,38500176_1,HBS GIRDLE HIGH WAIST CALF LENGTH,293.0,190.45,73.25,205.1,11
CDM,38500177_1,HBS WOUND CLEANSER SOLN,73.0,47.45,18.25,51.1,11
CDM,38500178_1,HBS SLING ARM,50.0,32.5,12.5,35.0,11
CDM,38500179_1,HBS CAM WALKER BOOT,111.0,72.15,27.75,77.7,11
CDM,38500180_1,HBS DRSNG MEPILEX,67.0,43.55,16.75,46.9,11
CDM,38500181_1,HBS SURGICAL SHOE,35.0,22.75,8.75,24.5,11
CDM,38500191_1,HBS DRSING WOUND BALANCING MATRIX,112.0,72.8,28.0,78.4,11
CDM,38500192_1,HBS KENDALL SLEEVE KNEE,90.0,58.5,22.5,63.0,11
CDM,38500193_1,HBS CATH AIR CHARGED SINGLE SENSOR,228.0,148.2,57.0,159.6,11
CDM,38500194_1,HBS CATH AIR CHARGED DUAL SENSOR,340.0,221.0,85.0,238.0,11
CDM,38500195_1,HBS TUBING PRESSURE MONITORING,87.0,56.55,21.75,60.9,11
CDM,38500196_1,HBS ELECTRODE PATCH PRE-WIRED,38.0,24.7,9.5,26.6,11
CDM,38500197_1,HBS SURGICEL,405.0,263.25,101.25,283.5,11
CDM,38500198_1,HBS FACIAL BAND UNIVERSAL,80.0,52.0,20.0,56.0,11
CDM,38500199_1,"INJECTABLE BULKING AGENT, SYNTHETIC IMPLANT, URINARY TRACT, 1 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",4725.0,3071.25,268.67,5670.0,16
CDM,38500200_1,HBS CATH FOLEY TRAY W URINE METER,69.5,45.18,17.38,48.65,11
CDM,38500201_1,HBS CATH HYDROGEL COAT LATEX URINE METER FOLEY TRAY 16 FR,71.5,46.48,17.88,50.05,11
CDM,38500202_1,"DISPOSABLE ENDOSCOPE SHEATH, EACH",265.5,172.58,66.38,685.65,16
CDM,38500203_1,HBS LVAD DRESSING CHANGE TRAY,160.5,104.33,40.13,112.35,11
CDM,38500204_1,GUIDE WIRE,451.0,293.15,112.75,1164.71,16
CDM,38500205_1,HBS ASCOPE 4 CYSTO,787.5,511.88,196.88,551.25,11
CDM,38500206_1,HBS HEMOSTASIS VALVE,56.25,36.56,14.06,39.38,11
CDM,38500207_1,HBS NEEDLE 21G INFUSION SET,101.25,65.81,25.31,70.88,11
CDM,38500208_1,HBS DILATOR URETHRAL S CURVE SET,781.5,507.98,195.38,547.05,11
CDM,38500209_1,HBS PENCIL CAUTERY PUSH BUTTON W HOLSTER,563.0,365.95,140.75,394.1,11
CDM,38500210_1,HBS CYSTOSCOPY NEEDLE ADJ TIP,367.0,238.55,91.75,256.9,11
CDM,38500211_1,HBS NEEDLE ASPIR BIOPSY CHIBA 22GA,226.0,146.9,56.5,158.2,11
CDM,38500212_1,HBS CORE BIOPSY INSTRUMENT,159.5,103.68,39.88,111.65,11
CDM,38500213_1,HBS STAPLE REMOVER SKIN DISP SCISSOR STYLE,87.0,56.55,21.75,60.9,11
CDM,38500214_1,"OSTOMY POUCH, URINARY, WITH EXTENDED WEAR BARRIER ATTACHED, WITH FAUCET-TYPE TAP WITH VALVE (1 PIECE), EACH",72.0,46.8,9.29,50.4,16
CDM,38500215_1,HBS DRAPE SURGICAL NONFENESTRATED,66.0,42.9,16.5,46.2,11
CDM,38500216_1,HBS CATH IV ANGIOCATH,59.5,38.68,14.88,41.65,11
CDM,38500218_1,"INDWELLING CATHETER; FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER, OR HYDROPHILIC, ETC.), EACH",46.5,30.23,11.63,32.55,16
CDM,38500219_1,HBS WOUND CANISTER 45M,95.75,62.24,23.94,67.03,11
CDM,38500220_1,HBS WOUND CANISTER 150ML,105.3,68.45,26.33,73.71,11
CDM,38500221_1,HBS VAC DRESSING,172.5,112.13,43.13,120.75,11
CDM,38500222_1,HBS NUCELL PRF,135.0,87.75,33.75,94.5,11
CDM,38500223_1,HBS ILLUMINE PRF,135.0,87.75,33.75,94.5,11
CDM,38500224_1,HBS CLARIFY PRF,135.0,87.75,33.75,94.5,11
CDM,38500225_1,HBS RED CARPET READY PRF,135.0,87.75,33.75,94.5,11
CDM,38500226_1,"CERVICAL, SEMI-RIGID, ADJUSTABLE (PLASTIC COLLAR)",76.5,49.73,19.13,104.95,16
CDM,38500227_1,HBS SUPPORT BRA,103.5,67.28,25.88,72.45,11
CDM,38500228_1,"TRACHEOSTOMA STENT/STUD/BUTTON, EACH",615.65,400.17,110.33,430.96,16
CDM,38500_1,Biopsy or removal of lymph nodes,1263.15,821.05,78.57,789.03,19
CDM,38501270_1,HBS DISPOSABLE PIVOT PRO QUAN EA,900.0,585.0,225.0,630.0,11
CDM,38501849_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",8275.5,5379.08,2068.88,21371.48,17
CDM,38504648_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",207.0,134.55,51.75,534.58,16
CDM,38505_1,Needle biopsy or removal of surface lymph nodes,513.45,333.74,69.95,426.07,19
CDM,38506197_1,"ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH DRESSING",45.0,29.25,11.25,31.5,16
CDM,38508948_1,"HBS LASER, NORDLYS ROLLER EA - 15MINS",145.0,94.25,36.25,101.5,11
CDM,38510101_1,SURGICAL SUPPLY; MISCELLANEOUS,450.0,292.5,112.5,1162.13,16
CDM,38510102_1,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",12.0,7.8,3.0,741.6,19
CDM,38510103_1,"INJECTION, ABOBOTULINUMTOXINA, 5 UNITS",4.0,2.6,1.0,741.6,19
CDM,38510105_1,SURGICAL SUPPLY; MISCELLANEOUS,500.0,325.0,125.0,1291.25,16
CDM,38510106_1,SURGICAL SUPPLY; MISCELLANEOUS,550.0,357.5,137.5,1420.38,16
CDM,38510107_1,SURGICAL SUPPLY; MISCELLANEOUS,500.0,325.0,125.0,1291.25,16
CDM,38510109_1,SURGICAL SUPPLY; MISCELLANEOUS,550.0,357.5,137.5,1420.38,16
CDM,38510110_1,SURGICAL SUPPLY; MISCELLANEOUS,800.0,520.0,200.0,2066.0,16
CDM,38510111_1,"INJECTION, RADIESSE, 0.1 ML",502.5,326.63,125.63,1297.71,16
CDM,38510112_1,"INJECTION, SCULPTRA, 0.5 MG",603.0,391.95,150.75,1557.25,16
CDM,38510113_1,SURGICAL SUPPLY; MISCELLANEOUS,650.0,422.5,162.5,1678.63,16
CDM,38510114_1,SURGICAL SUPPLY; MISCELLANEOUS,550.0,357.5,137.5,1420.38,16
CDM,38510115_1,SURGICAL SUPPLY; MISCELLANEOUS,550.0,357.5,137.5,1420.38,16
CDM,38510116_1,HBS FX PRODUCT PACKAGE,200.0,130.0,50.0,140.0,11
CDM,38510117_1,HBS FACELIFT MINILIFT PRODUCT PACKAGE,450.0,292.5,112.5,315.0,11
CDM,38510118_1,HBS SCAR RECOVERY GEL,106.0,68.9,26.5,74.2,11
CDM,38510120_1,HBS DRESSING AQUACEL AG SILVER,49.0,31.85,12.25,34.3,11
CDM,38510121_1,HBS DRESSING ACTICOAT,50.0,32.5,12.5,35.0,11
CDM,38510122_1,HBC NO RETURN ALLERGY TEST - PATCHES CHG,562.0,365.3,140.5,393.4,11
CDM,38510123_1,SURGICAL SUPPLY; MISCELLANEOUS,12.0,7.8,3.0,30.99,16
CDM,38510124_1,HBS THORACENTESIS KIT,175.0,113.75,43.75,122.5,11
CDM,38510125_1,HBS STOCKING EDEMA WEAR,49.5,32.18,12.38,34.65,11
CDM,38510126_1,HBS TUBING PUMP INFUSION,70.0,45.5,17.5,49.0,11
CDM,38510127_1,HBS ELECTRODE DEFIB AND CPR SYSTEM,555.0,360.75,138.75,388.5,11
CDM,38510128_1,"HBS CPR ELECTRODE, SINGLE",320.0,208.0,80.0,224.0,11
CDM,38510130_1,"ZINC PASTE IMPREGNATED BANDAGE, NON-ELASTIC, KNITTED/WOVEN, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARD",47.0,30.55,1.79,32.9,16
CDM,38510131_1,HBS MULTI-FUNCTION PEDIATRIC ELECTRODE,194.0,126.1,48.5,135.8,11
CDM,38510132_1,"NASAL SEPTAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN",1305.0,848.25,326.25,1671.06,16
CDM,38510133_1,"HYALURONAN OR DERIVATIVE, GEL-ONE, FOR INTRA-ARTICULAR INJECTION, PER DOSE",2430.0,1579.5,301.23,6275.48,18
CDM,38510138_1,HBS IB STIM DEVICE,5377.5,3495.38,1344.38,3764.25,11
CDM,38510140_1,HBS SKINPEN KIT PLUS,355.5,231.08,88.88,248.85,11
CDM,38510141_1,HBS SKINPEN KIT BASIC,310.5,201.83,77.63,217.35,11
CDM,38510142_1,HBS NEEDLE ADJUSTABLE TIP CYSTOSCOPY,252.0,163.8,63.0,176.4,11
CDM,38510143_1,HBS CATHETER 7 FRENCH AIR CHARGE,319.0,207.35,79.75,223.3,11
CDM,38510144_1,HBS CATHETER 7 FRENCH ABDOMEN,207.5,134.88,51.88,145.25,11
CDM,38510145_1,HBS VAGINAL EMG / STIM SENSOR,198.0,128.7,49.5,138.6,11
CDM,38510146_1,SURGICAL SUPPLY; MISCELLANEOUS,254.29,165.29,63.57,656.7,16
CDM,38510147_1,SURGICAL SUPPLY; MISCELLANEOUS,324.0,210.6,81.0,836.73,16
CDM,38510148_1,SURGICAL SUPPLY; MISCELLANEOUS,309.96,201.47,77.49,800.47,16
CDM,38510149_1,SURGICAL SUPPLY; MISCELLANEOUS,309.96,201.47,77.49,800.47,16
CDM,38510150_1,SURGICAL SUPPLY; MISCELLANEOUS,264.56,171.96,66.14,683.23,16
CDM,38510151_1,SURGICAL SUPPLY; MISCELLANEOUS,264.56,171.96,66.14,683.23,16
CDM,38510152_1,SURGICAL SUPPLY; MISCELLANEOUS,195.0,126.75,48.75,503.59,16
CDM,38510153_1,SURGICAL SUPPLY; MISCELLANEOUS,195.0,126.75,48.75,503.59,16
CDM,38510154_1,SURGICAL SUPPLY; MISCELLANEOUS,195.0,126.75,48.75,503.59,16
CDM,38510155_1,SURGICAL SUPPLY; MISCELLANEOUS,4.82,3.13,1.21,12.45,16
CDM,38510156_1,HBS FOLLICLE ASPIRATION NEEDLE DOUBLE LUMEN,2350.0,1527.5,587.5,1645.0,11
CDM,38510157_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",21875.0,14218.75,5468.75,56492.19,17
CDM,38510167_1,"SKIN SUBSTITUTE, INTEGRA MESHED BILAYER WOUND MATRIX, PER SQUARE CENTIMETER",526.7,342.36,131.68,1360.2,17
CDM,38510169_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",6525.0,4241.25,1631.25,16850.81,17
CDM,38510170_1,HBS ITIND SHEATH 24CM,788.65,512.62,197.16,552.06,11
CDM,38510171_1,GUIDE WIRE,310.5,201.83,77.63,801.87,16
CDM,38510172_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",14175.0,9213.75,3543.75,36606.94,17
CDM,38510173_1,HBS LASER FIBER ALMA,1125.0,731.25,281.25,787.5,11
CDM,38510174_1,HBS VEIN ABLATION PACK,239.0,155.35,59.75,167.3,11
CDM,38510175_1,UNCLASSIFIED DRUGS,9.0,5.85,2.25,23.24,16
CDM,38510178_1,HBS RF MICRONEEDLING TIP,447.3,290.75,111.83,313.11,11
CDM,38510179_1,HBS FRAX ROLLERS,122.85,79.85,30.71,86.0,11
CDM,38510180_1,HBS PROFORE COMPRESSION KIT,40.0,26.0,10.0,28.0,11
CDM,38510181_1,"FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING",65.34,42.47,16.34,45.74,16
CDM,38510182_1,HBS TUBIGRIP BANDAGE,100.0,65.0,25.0,70.0,11
CDM,38510183_1,"CONTACT LAYER, STERILE, MORE THAN 48 SQ. IN., EACH DRESSING",70.0,45.5,17.5,180.78,16
CDM,38510184_1,"ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 48 SQ. IN., EACH DRESSING",70.0,45.5,17.5,180.78,16
CDM,38510185_1,"COLLAGEN DRESSING, STERILE, SIZE 16 SQ. IN. OR LESS, EACH",47.0,30.55,11.75,32.9,16
CDM,38510186_1,HBS SKIN CLOSURE ZIP STRIP,200.0,130.0,50.0,140.0,11
CDM,38510187_1,HBS URGOK2 2 LAYER COMPRESSION BANDAGE,50.0,32.5,12.5,35.0,11
CDM,38510188_1,"CATHETER, ABLATION, NON-CARDIAC, ENDOVASCULAR (IMPLANTABLE)",1680.0,1092.0,420.0,4338.6,16
CDM,38510190_1,UNCLASSIFIED DRUGS,855.0,555.75,213.75,2208.04,16
CDM,38510191_1,"CATHETER, ABLATION, NON-CARDIAC, ENDOVASCULAR (IMPLANTABLE)",3991.5,2594.48,997.88,10308.05,16
CDM,38510192_1,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",112.5,73.13,28.13,290.53,16
CDM,38510193_1,GUIDE WIRE,60.5,39.33,15.13,156.24,16
CDM,38510194_1,HBS SCITON TRL PRODUCT PACKAGE,1575.0,1023.75,393.75,1102.5,11
CDM,38510195_1,HBS BOOT ROOKE W/HEEL FLOAT SYS ONE SIZE,474.75,308.59,118.69,332.33,11
CDM,38510196_1,HBS FREEVENT DUALCARE SPEAKING VALVE,450.0,292.5,112.5,315.0,11
CDM,38510197_1,HBS HEMOSTATIC AGENT SURGICEL 1/2X2IN CELLULOSE,131.75,85.64,32.94,92.23,11
CDM,38510198_1,HBS FREEVENT HME 15 REGULAR,499.5,324.68,124.88,349.65,11
CDM,38510199_1,HBS CANNULA MONTGOMERY SZ SHORT TERM,552.0,358.8,138.0,386.4,11
CDM,38510200_1,HBS CANNULA MONTGOMERY SZ LNG TERM,603.0,391.95,150.75,422.1,11
CDM,38510201_1,HBS NEEDLE VCE INJ LARYNX INJ FILLER,540.0,351.0,135.0,378.0,11
CDM,38510202_1,HBS TRACOE COMFORT W IC,675.0,438.75,168.75,472.5,11
CDM,38510203_1,HBS TISSUE BRIDGE FORCE MODULATE,185.0,120.25,46.25,129.5,11
CDM,38510204_1,HBS IODOSORB GEL 10G TUBE ANTIMIC,63.5,41.28,15.88,44.45,11
CDM,38510205_1,HBS TRACOE COMFORT XL W IC,1080.0,702.0,270.0,756.0,11
CDM,38510206_1,GUIDE WIRE,201.0,130.65,50.25,519.08,16
CDM,38510207_1,"BREAST PROSTHESIS, MASTECTOMY BRA, WITHOUT INTEGRATED BREAST PROSTHESIS FORM, ANY SIZE, ANY TYPE",104.0,67.6,26.0,124.8,16
CDM,38510208_1,HBS CJ TRACHEA TUBE #5 SHORT SS,2365.5,1537.58,591.38,1655.85,11
CDM,38510209_1,HBS VAC DRESSING KCI FOAM BLACK,175.0,113.75,43.75,122.5,11
CDM,38510210_1,HBS CANISTER ACTI VAC WITH GEL 300 ML,148.0,96.2,37.0,103.6,11
CDM,38510211_1,HBS SYS LIFECELL REVOLVE FAT TRANSFER PK,2430.0,1579.5,607.5,1701.0,11
CDM,38510889_1,HBS INJETAK CYSTOSCOPY NEEDLE,387.0,251.55,96.75,270.9,11
CDM,38510890_1,HBS URGENT PC NEUROMODULATION SYSTEM,370.0,240.5,92.5,259.0,11
CDM,38510_1,Biopsy or removal of deep lymph nodes of neck,2058.6,1338.09,78.57,1263.28,19
CDM,38514648_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",400.0,260.0,100.0,1033.0,16
CDM,38520_1,Biopsy or removal of lymph nodes of neck with removal of fat pad,1244.3,808.8,78.57,1369.87,19
CDM,38524559_1,HBS PASTE TUBE MEDHIHONEY HYDROCOLLOID 1.5 OZ,52.0,33.8,13.0,36.4,11
CDM,38525T_1,Biopsy or removal of deep lymph nodes of underarm,3019.95,1962.97,78.57,1280.39,19
CDM,38525_1,Biopsy or removal of deep lymph nodes of underarm,1690.05,1098.53,78.57,1280.39,19
CDM,38526656_1,HBS SHOE SURGICAL MEDICAL BLK - MEN/WOMEN,42.85,27.85,10.71,30.0,11
CDM,38526657_1,HBS INSOLE DARCO PEG ASSIST SYS MEN/WOMEN,105.0,68.25,26.25,73.5,11
CDM,38526658_1,HBS INSOLE DRACO PED ASSIST SYS & SHOE SURG MED M/W,149.0,96.85,37.25,104.3,11
CDM,38530_1,Biopsy or removal of lymph nodes of breast,1445.9,939.84,78.57,1652.4,19
CDM,38531_1,Biopsy or removal of lymph nodes of groin,1530.0,994.5,78.57,1297.71,19
CDM,38542_1,Removal of deep lymph nodes of neck,2101.05,1365.68,78.57,1544.9,19
CDM,38550_1,Removal of congenital defect of lymph nodes at underarm or neck,1281.0,832.65,78.57,1497.61,19
CDM,38555_1,Removal of congenital defect of lymph nodes at underarm or neck with deep neurovascular dissection,2714.3,1764.3,78.57,2953.84,19
CDM,38562_1,Partial removal of pelvic and aortic lymph nodes,2257.5,1467.38,78.57,2100.43,19
CDM,38564_1,Removal of lymph nodes behind abdominal cavity,2572.5,1672.13,78.57,2081.21,19
CDM,38570_1,Biopsy and removal of lymph nodes of abdominal cavity using an endoscope,2100.0,1365.0,78.57,1524.94,19
CDM,38571_1,Removal of lymph nodes of both sides of pelvis using an endoscope,2394.0,1556.1,78.57,2027.08,19
CDM,38572_1,Removal of lymph nodes of both sides of pelvis and abdominal lymph node biopsy using an endoscope,2699.6,1754.74,78.57,2755.39,19
CDM,38573_1,Removal of lymph nodes of both sides of pelvis with biopsy and washing of abdomen using an endoscope,2540.0,1651.0,78.57,3489.03,19
CDM,385A4262_1,"TEMPORARY, ABSORBABLE LACRIMAL DUCT IMPLANT, EACH",84.0,54.6,21.0,216.93,16
CDM,385A4263_1,"PERMANENT, LONG TERM, NON-DISSOLVABLE LACRIMAL DUCT IMPLANT, EACH",84.0,54.6,21.0,216.93,16
CDM,385A4351_1,"INTERMITTENT URINARY CATHETER; STRAIGHT TIP, WITH OR WITHOUT COATING (TEFLON, SILICONE, OR SILICONE ELASTOMER, ETC.), EACH",25.0,16.25,2.58,17.5,16
CDM,385A4561_1,"PESSARY, REUSABLE, RUBBER, ANY TYPE",68.0,44.2,17.0,47.6,16
CDM,385A4562_1,"PESSARY, REUSABLE, NON RUBBER, ANY TYPE",90.0,58.5,22.5,77.23,16
CDM,385A4570_1,SPLINT,163.0,105.95,40.75,420.95,16
CDM,385A4648_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",564.75,367.09,141.19,1458.47,16
CDM,385A4649_1,SURGICAL SUPPLY; MISCELLANEOUS,163.0,105.95,40.75,420.95,16
CDM,385A7520_1,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",225.0,146.25,56.25,157.5,16
CDM,385A7521_1,"TRACHEOSTOMY/LARYNGECTOMY TUBE, CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",225.0,146.25,56.25,157.5,16
CDM,385A7522_1,"TRACHEOSTOMY/LARYNGECTOMY TUBE, STAINLESS STEEL OR EQUAL (STERILIZABLE AND REUSABLE), EACH",225.0,146.25,56.25,157.5,16
CDM,385J0585_1,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",12.0,7.8,3.0,741.6,19
CDM,385L1830_1,"KNEE ORTHOSIS, IMMOBILIZER, CANVAS LONGITUDINAL, PREFABRICATED, OFF-THE-SHELF",25.0,16.25,6.25,74.57,16
CDM,385L3660_1,"SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND WEBBING, PREFABRICATED, OFF-THE-SHELF",188.0,122.2,47.0,225.6,16
CDM,385L3702_1,"ELBOW ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",106.0,68.9,26.5,343.92,16
CDM,385L4387_1,"WALKING BOOT, NON-PNEUMATIC, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",80.0,52.0,20.0,207.48,16
CDM,385L8606_1,"INJECTABLE BULKING AGENT, SYNTHETIC IMPLANT, URINARY TRACT, 1 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",1050.0,682.5,262.5,1260.0,16
CDM,385Q2028_1,"INJECTION, SCULPTRA, 0.5 MG",2.35,1.53,0.59,6.07,17
CDM,385Q4008_1,"CAST SUPPLIES, LONG ARM CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS",350.0,227.5,18.59,420.0,16
CDM,385Q4009_1,"CAST SUPPLIES, SHORT ARM CAST, ADULT (11 YEARS +), PLASTER",350.0,227.5,11.03,420.0,16
CDM,385Q4010_1,"CAST SUPPLIES, SHORT ARM CAST, ADULT (11 YEARS +), FIBERGLASS",350.0,227.5,24.8,420.0,16
CDM,385Q4022_1,"CAST SUPPLIES, SHORT ARM SPLINT, ADULT (11 YEARS +), FIBERGLASS",350.0,227.5,15.5,420.0,16
CDM,385Q4110_1,"PRIMATRIX, PER SQUARE CENTIMETER",126.0,81.9,31.5,325.4,17
CDM,38700_1,Removal of lymph nodes from chin to thyroid cartilage,3287.1,2136.62,78.57,2409.28,19
CDM,38701IP _1,UNCLASSIFIED DRUGS,31.22,20.29,7.81,80.63,16
CDM,38701OP _1,UNCLASSIFIED DRUGS,21.09,13.71,5.27,54.46,16
CDM,38720_1,Removal of lymph nodes of neck,5468.4,3554.46,78.57,4003.89,19
CDM,38724_1,"Removal of lymph nodes, muscle, and tissue of neck",5934.6,3857.49,78.57,4344.59,19
CDM,38740_1,Partial removal of lymph nodes of underarm,1805.0,1173.25,78.57,2039.26,19
CDM,38745_1,Removal of lymph nodes of underarm,3446.1,2239.97,78.57,2572.23,19
CDM,38746_1,Removal of lymph nodes of chest cavity and breast bone,732.9,476.39,78.57,623.08,19
CDM,38747_1,Removal of lymph nodes of abdominal organ,866.3,563.1,78.57,781.81,19
CDM,38760_1,Removal of lymph nodes of groin,3398.85,2209.25,78.57,2480.49,19
CDM,38765_1,Partial removal of lymph nodes of groin and pelvis,5307.75,3450.04,78.57,3834.53,19
CDM,38770_1,Removal of lymph nodes of groin and pelvis,4134.45,2687.39,78.57,2442.58,19
CDM,38780_1,Removal of lymph nodes of abdominal cavity,4252.5,2764.13,78.57,3093.39,19
CDM,38790_1,Injection procedure for imaging of lymphatic system,1071.0,696.15,69.58,245.69,19
CDM,38792_1,Injection of radioactive material for X-ray identification of lymph node,436.5,283.73,25.63,197.83,19
CDM,38794_1,Exposure of lymph duct of chest cavity,749.7,487.31,78.57,912.02,19
CDM,3879IP _1,INDAPAMIDE 2.5 MG TABLET,7.65,4.97,1.91,5.36,11
CDM,38900_1,Imaging of lymph nodes during surgery,321.3,208.85,78.57,402.79,19
CDM,38977IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.74,5.68,2.19,22.57,16
CDM,38977OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.15,13.75,5.29,54.62,16
CDM,38978IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.4,2.86,1.1,11.36,16
CDM,38978OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.78,8.96,3.45,35.59,16
CDM,3897IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.63,2.36,0.91,9.37,16
CDM,3897OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.02,9.76,3.76,38.79,16
CDM,3898IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.85,2.5,0.96,9.94,16
CDM,3898OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.35,6.73,2.59,26.73,16
CDM,38999A_1,Other procedure on lymphatic system,3470.0,2255.5,73.6,3574.1,15
CDM,38999B_1,Other procedure on lymphatic system,3240.0,2106.0,73.6,3337.2,15
CDM,38999C_1,Other procedure on lymphatic system,32300.0,20995.0,73.6,33269.0,15
CDM,38_1,IXIARO 6 UNIT(6 MCG)/0.5ML SYR,385.0,250.25,96.25,269.5,11
CDM,39000_1,"Exploration, drainage, biopsy, or removal of foreign body in chest cavity through neck",1373.4,892.71,78.57,1463.3,19
CDM,39010_1,"Exploration, drainage, biopsy, or removal of foreign body in chest cavity",2677.5,1740.38,78.57,2303.04,19
CDM,39063IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",76.36,49.63,19.09,197.2,16
CDM,39063OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.1,24.12,9.28,95.81,16
CDM,39136IP _1,UNCLASSIFIED DRUGS,13.37,8.69,3.34,34.53,16
CDM,39136OP _1,UNCLASSIFIED DRUGS,14.48,9.41,3.62,37.39,16
CDM,391IP _1,AMILORIDE HCL 5 MG TABLET,3.98,2.59,1.0,2.79,11
CDM,391OP _1,AMILORIDE HCL 5 MG TABLET,11.2,7.28,2.8,7.84,11
CDM,39200_1,Removal of cyst below breast bone,3018.8,1962.22,78.57,2541.88,19
CDM,39220_1,Removal of growth below breast bone,3237.2,2104.18,78.57,3324.18,19
CDM,39236568_1,Insertion of tube for infusion (younger than 5 years),2752.0,1788.8,688.0,7107.04,19
CDM,39236569_1,Insertion of tube for infusion (5 years or older),3199.0,2079.35,799.75,8261.42,19
CDM,39236573_1,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient 5 years or older",4200.0,2730.0,1050.0,10846.5,19
CDM,39236584_1,Replacement of peripherally inserted central venous tube (PICC) with review by radiologist,2949.0,1916.85,737.25,7615.79,19
CDM,39254OP _1,NITAZOXANIDE 500 MG TABLET,346.6,225.29,86.65,242.62,11
CDM,39255IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",418.35,271.93,104.59,1080.39,16
CDM,39255OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",158.67,103.14,39.67,409.77,16
CDM,39265IP _1,"INJECTION, CARBOPLATIN, 50 MG",11.69,7.6,2.92,35.07,17
CDM,39265OP _1,"INJECTION, CARBOPLATIN, 50 MG",7.12,4.63,1.78,21.36,17
CDM,39275IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.56,6.86,2.64,27.27,16
CDM,39275OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.2,9.88,3.8,39.25,16
CDM,39276937_1,Ultrasonic guidance for blood vessel access,475.0,308.75,118.75,1226.69,18
CDM,39276IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.89,6.43,2.47,25.54,16
CDM,39276OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.95,19.47,7.49,77.35,16
CDM,39277IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.26,6.02,2.32,23.91,16
CDM,39277OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.2,17.68,6.8,70.24,16
CDM,39401_1,Exam of chest using an endoscope,721.0,468.65,78.57,899.1,19
CDM,39402_1,Exam of chest with biopsy of lymph node using an endoscope,941.0,611.65,78.57,1174.65,19
CDM,39501_1,Repair of muscle tissue separating chest and abdominal cavities,2703.8,1757.47,78.57,2500.52,19
CDM,39503_1,"Repair of congenital defect of muscle separating chest and abdominal cavities, neonate",16359.0,10633.35,78.57,16914.67,19
CDM,39540_1,Repair of acute injury to muscle separating chest and abdominal cavities,3438.8,2235.22,78.57,2550.08,19
CDM,39541_1,Repair of chronic injury to muscle separating chest and abdominal cavities,2654.4,1725.36,78.57,2755.94,19
CDM,39545_1,Suture of muscle separating chest and abdominal cavities to restore function,3307.5,2149.88,78.57,2603.9,19
CDM,39560_1,Simple repair of muscle separating chest and abdominal cavities,2173.5,1412.78,78.57,2348.62,19
CDM,39561_1,Complex repair of muscle separating chest and abdominal cavities,3376.8,2194.92,78.57,3634.76,19
CDM,39720IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.75,10.24,3.94,40.67,16
CDM,39720OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.38,6.1,2.35,24.22,16
CDM,39803IP _1,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",161.08,104.7,0.93,483.24,17
CDM,39803OP _1,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",48.58,31.58,0.93,145.74,17
CDM,39970IP _1,UNCLASSIFIED DRUGS,12.2,7.93,3.05,31.51,16
CDM,39970OP _1,UNCLASSIFIED DRUGS,7.54,4.9,1.89,19.47,16
CDM,39984IP _1,LIDOCAINE-DIPHENHYD-AL-MAG-SIM 200 MG-25 MG-400 MG-40MG-30ML MOUTHWASH,5.14,3.34,1.29,3.6,11
CDM,39984OP _1,LIDOCAINE-DIPHENHYD-AL-MAG-SIM 200 MG-25 MG-400 MG-40MG-30ML MOUTHWASH,4.94,3.21,1.24,3.46,11
CDM,39_1,"Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use",100.0,65.0,25.0,258.25,19
CDM,400291IP _1,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",4.9,3.19,0.62,3.43,16
CDM,400291OP _1,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",1.62,1.05,0.41,1.13,16
CDM,400293OP _1,5% DEXTROSE/WATER (500 ML = 1 UNIT),1.02,0.66,0.26,2.63,17
CDM,400302IP _1,UNCLASSIFIED DRUGS,1.01,0.66,0.25,2.61,16
CDM,40120OP _1,"INJECTION, NATALIZUMAB, 1 MG",3493.91,2271.04,25.98,9023.02,19
CDM,4026IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.82,8.98,3.46,35.69,16
CDM,4026OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.39,2.85,1.1,11.34,16
CDM,40322IP _1,ESZOPICLONE 3 MG TABLET,20.45,13.29,5.11,14.32,11
CDM,40369IP _1,UNCLASSIFIED DRUGS,27.77,18.05,6.94,71.72,16
CDM,40392IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",86.65,56.32,21.66,223.77,16
CDM,403IP _1,"INJECTION, AMINOCAPROIC ACID, 1 GRAM",21.05,13.68,1.69,54.36,17
CDM,40475IP _1,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG",7559.23,4913.5,8.67,19521.71,19
CDM,40475OP _1,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG",15789.21,10262.99,8.67,40775.63,19
CDM,40478451_1,Nuclear medicine study of heart muscle at rest and with stress and SPECT,2920.0,1898.0,730.0,7540.9,18
CDM,40478452_1,Nuclear medicine studies of heart muscle at rest and with stress and SPECT,3660.0,2379.0,915.0,9451.95,18
CDM,40490_1,Biopsy of lip,347.6,225.94,22.74,296.61,19
CDM,40493018_1,HC NUCLEAR WRISTBAND,123.0,79.95,30.75,86.1,11
CDM,40500060_1,Ultrasound study of one arm or leg veins with compression and maneuvers,805.0,523.25,158.99,2078.91,19
CDM,40500_1,Removal of border of lip,1335.6,868.14,78.57,1271.2,19
CDM,40510T_1,Removal of wedge of lip tissue with closure,1017.85,661.6,78.57,1177.23,19
CDM,40510_1,Removal of wedge of lip tissue with closure,1365.0,887.25,78.57,1177.23,19
CDM,40520T_1,V-shaped removal of lip tissue,888.3,577.4,78.57,1213.8,19
CDM,40520_1,V-shaped removal of lip tissue,1365.0,887.25,78.57,1213.8,19
CDM,40525T_1,Removal of lip with repair using local tissue graft,3126.9,2032.49,78.57,1650.77,19
CDM,40525_1,Removal of lip with repair using local tissue graft,2100.0,1365.0,78.57,1650.77,19
CDM,40527T_1,Removal of lip with repair using tissue graft,3126.9,2032.49,78.57,1853.03,19
CDM,40527_1,Removal of lip with repair using tissue graft,2961.0,1924.65,78.57,1853.03,19
CDM,40530027_1,Ultrasound study of arm and leg arteries,450.0,292.5,112.5,1162.13,19
CDM,40530030_1,Complete ultrasound of within the brain blood flow,1786.0,1160.9,244.92,4612.35,19
CDM,40530032_1,Ultrasound of one side of head and neck blood flow,903.0,586.95,158.99,2332.0,19
CDM,40530046_1,Ultrasound study of arm or leg veins with compression and maneuvers,819.0,532.35,204.75,2115.07,19
CDM,40530049_1,Complete ultrasound study of arm and leg arteries,1132.0,735.8,241.11,2923.39,19
CDM,40530050_1,Ultrasound study of arm and leg arteries,450.0,292.5,112.5,1162.13,19
CDM,40530053_1,Ultrasound of leg arteries or artery grafts,812.0,527.8,203.0,2096.99,19
CDM,40530054_1,Ultrasound of one leg arteries or artery grafts,783.0,508.95,158.99,2022.1,19
CDM,40530055_1,Ultrasound of arm arteries or artery grafts,978.0,635.7,158.99,2525.69,19
CDM,40530056_1,Ultrasound of one arm arteries or artery grafts,756.0,491.4,158.99,1952.37,19
CDM,40530060_1,Ultrasound study of one arm or leg veins with compression and maneuvers,805.0,523.25,158.99,2078.91,19
CDM,40530062_1,Ultrasound of within the brain blood flow,732.0,475.8,158.99,1890.39,19
CDM,40530063_1,Ultrasound of leg arteries at rest and after exercise,749.0,486.85,158.99,1934.29,19
CDM,40530066_1,Ultrasound of leg arteries at rest and after exercise,1026.0,666.9,158.99,2649.65,19
CDM,40530067_1,Ultrasound of leg arteries or artery grafts,1112.0,722.8,244.92,2871.74,19
CDM,40530068_1,Ultrasound study of arm or leg veins with compression and maneuvers,1404.0,912.6,244.92,3625.83,19
CDM,40530069_1,Ultrasound of both sides of head and neck blood flow,1979.0,1286.35,244.92,5110.77,19
CDM,40530070_1,Ultrasound study of arm and leg arteries,450.0,292.5,112.5,1162.13,19
CDM,40530071_1,Ultrasound of one leg arteries or artery grafts,1072.0,696.8,158.99,2768.44,19
CDM,40530072_1,Ultrasound study of arm or leg veins with compression and maneuvers,819.0,532.35,204.75,2115.07,19
CDM,40530_1,Partial removal of lip,1438.5,935.03,78.57,1341.64,19
CDM,40573OP _1,"INJECTION, ZICONOTIDE, 1 MICROGRAM",644.36,418.83,11.2,2058.35,19
CDM,40576998_1,Ultrasonic guidance during surgery,1000.0,650.0,163.6,2582.5,18
CDM,40593870_1,Ultrasound of both sides of head and neck blood flow,1445.0,939.25,244.92,3731.71,19
CDM,40593882_1,Ultrasound of one side of head and neck blood flow,903.0,586.95,158.99,2332.0,19
CDM,40593889_1,Ultrasound guided compression repair of blood vessel,1800.0,1170.0,294.16,4648.5,18
CDM,40593892_1,Ultrasound of within the brain blood flow for blood clots,277.0,180.05,69.25,1052.0,19
CDM,40593923_1,Complete ultrasound study of arm and leg arteries,1132.0,735.8,241.11,2923.39,19
CDM,40593971_1,Ultrasound study of one arm or leg veins with compression and maneuvers,805.0,523.25,158.99,2078.91,19
CDM,40593975_1,Complete ultrasound of abdomen and pelvis artery and vein blood flow,773.0,502.45,193.25,1996.27,19
CDM,40593976_1,Ultrasound of abdomen and pelvis artery and vein blood flow,680.0,442.0,170.0,1756.1,19
CDM,40593978_1,"Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts",800.0,520.0,200.0,2066.0,19
CDM,40593979_1,"Ultrasound of aorta, vena cava, groin vessels or bypass grafts",301.0,195.65,75.25,1052.0,19
CDM,40593985_1,Complete ultrasound of artery and vein blood flow pre-op assessment on both sides of body for hemodialysis access,565.0,367.25,141.25,1459.11,19
CDM,40593986_1,Complete ultrasound of artery and vein blood flow pre-op assessment on side of body for hemodialysis access,267.0,173.55,66.75,1052.0,19
CDM,40593990_1,Ultrasound of hemodialysis access,508.0,330.2,127.0,1311.91,19
CDM,40595906_1,Ultrasound study of arm and leg arteries,450.0,292.5,112.5,1162.13,19
CDM,40595907_1,Complete ultrasound study of arm and leg arteries,1132.0,735.8,241.11,2923.39,19
CDM,40595908_1,Complete ultrasound study of arm and leg arteries,1132.0,735.8,241.11,2923.39,19
CDM,40595913_1,HC THROMBIN INJECTION,267.0,173.55,66.75,186.9,11
CDM,40595916_1,Ultrasonic guidance for needle placement,800.0,520.0,163.6,2066.0,18
CDM,40599211_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,100.0,65.0,25.0,258.25,17
CDM,40600001_1,GASTRO - INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,1400.0,910.0,350.0,980.0,11
CDM,40600002_1,GASTRO - INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,444.0,288.6,111.0,310.8,11
CDM,40600003_1,GASTRO - INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,336.0,218.4,84.0,235.2,11
CDM,40600011_1,GASTRO - INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45.0,29.25,11.25,31.5,11
CDM,40600021_1,RECOVERY ROOM - GENERAL CLASSIFICATION,336.0,218.4,84.0,235.2,11
CDM,40600101_1,GASTRO - INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,2401.0,1560.65,600.25,1680.7,11
CDM,40600121_1,HC LASER DIODE YAG RENTAL ENDO,3510.0,2281.5,877.5,2457.0,11
CDM,40601001_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,40601002_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,40601003_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,4060232T_1,Harvest and injections of platelet rich plasma using imaging guidance,500.0,325.0,125.0,1291.25,19
CDM,40610203_1,HC SECRETIN 16MCG,2993.0,1945.45,748.25,2095.1,11
CDM,40610204_1,Other diagnostic procedure for gastrointestine,350.0,227.5,87.5,903.88,18
CDM,40610205_1,HC ERBE HYDRO WATERJET SYSTEM,1821.43,1183.93,455.36,1275.0,11
CDM,40610206_1,HC ION ROBOT ASSISTED BRONCH SYSTEM - EQUIP,3857.14,2507.14,964.29,2700.0,11
CDM,40610207_1,HC ION ARTICULATING CATH 490105,5625.0,3656.25,1406.25,3937.5,11
CDM,40610208_1,HC ION PERIPHERAL 1.5 VISION PROBE 490206,2137.5,1389.38,534.38,1496.25,11
CDM,40610209_1,HC ION CATH GUIDE 490107,207.69,135.0,51.92,145.38,11
CDM,40610210_1,HC ION SENSOR CONN CLEANER 490115,27.0,17.55,6.75,18.9,11
CDM,40610215_1,HC ERBE CRYOSURGICAL SYSTEM ENDO,405.0,263.25,101.25,283.5,11
CDM,40610220_1,GASTRO - INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,1400.0,910.0,350.0,980.0,11
CDM,40610225_1,GASTRO - INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,45.0,29.25,11.25,31.5,11
CDM,40611010_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,40620550_1,Injection into tendon or ligament,361.5,234.98,90.38,2166.29,19
CDM,40620552_1,"Injection of trigger points, 1-2 muscles",255.0,165.75,63.75,2166.29,19
CDM,40620553_1,"Injection of trigger points, 3 or more muscles",241.0,156.65,60.25,2166.29,19
CDM,40620605_1,Aspiration and/or injection of fluid from medium joint,361.5,234.98,90.38,2166.29,19
CDM,40620610_1,Aspiration and/or injection of fluid from large joint,714.0,464.1,178.5,2166.29,19
CDM,40620611_1,Aspiration and/or injection of fluid large joint using ultrasound guidance,412.5,268.13,103.13,2166.29,19
CDM,40620982_1,Destruction of growths and adjacent soft tissue,9774.0,6353.1,2166.29,25241.36,19
CDM,40636416_1,Puncture of skin for collection of blood sample,23.0,14.95,3.11,59.4,19
CDM,40643206_1,Microscopic exam of esophagus using a flexible endoscope,4003.0,2601.95,1000.75,10337.75,18
CDM,40643252_1,"Microscopic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2660.0,1729.0,665.0,6869.45,18
CDM,40647998_1,HC SPYGLASS FIBER,3760.0,2444.0,940.0,2632.0,11
CDM,40647999_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,100.0,65.0,25.0,258.25,17
CDM,4064IP _1,UNCLASSIFIED DRUGS,7.52,4.89,1.88,19.42,16
CDM,4064OP _1,UNCLASSIFIED DRUGS,6.95,4.52,1.74,17.95,16
CDM,40650T_1,Repair of lip and border,1151.9,748.74,78.57,1147.21,19
CDM,40650_1,Repair of lip and border,1079.4,701.61,78.57,1147.21,19
CDM,40652_1,Repair of vertical lip wound extending to half of lip,1110.0,721.5,78.57,1242.94,19
CDM,40654_1,Repair of vertical lip wound extending to over half of lip,1498.4,973.96,78.57,1404.43,19
CDM,4065IP _1,UNCLASSIFIED DRUGS,5.08,3.3,1.27,13.12,16
CDM,4065OP _1,UNCLASSIFIED DRUGS,13.14,8.54,3.29,33.93,16
CDM,40661070_1,Aspiration of cerebrospinal fluid and injection in shunt tubing or reservoir,1006.0,653.9,251.5,3227.0,19
CDM,40662273_1,Injection of blood or blood clot into spinal canal,968.0,629.2,242.0,3227.0,19
CDM,40662320_1,Injection of substance into middle or upper spine canal,1142.0,742.3,285.5,3227.0,19
CDM,40662321_1,Injection of substance into middle or upper spine canal using imaging guidance,1631.0,1060.15,407.75,4212.06,19
CDM,40662322_1,Injection of substance into lower spine canal,1142.0,742.3,285.5,3227.0,19
CDM,40662323_1,Injection of substance into lower spine canal using imaging guidance,1631.0,1060.15,407.75,4212.06,19
CDM,40662324_1,Insertion of tube and injection of substance into middle or upper spine canal,1510.0,981.5,377.5,3899.58,19
CDM,40662325_1,Insertion of tube and injection of substance into middle or upper spine canal using imaging guidance,1678.0,1090.7,419.5,4333.44,19
CDM,40662326_1,Insertion of tube and injection of substance into lower spine canal,1510.0,981.5,377.5,3899.58,19
CDM,40662327_1,Insertion of tube and injection of substance into lower spine canal using imaging guidance,1678.0,1090.7,419.5,4333.44,19
CDM,40662370_1,Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician,522.0,339.3,130.5,2318.31,19
CDM,40663650_1,Insertion of spinal neurostimulator electrode array through skin,17229.0,11198.85,2318.31,44493.89,19
CDM,40664400_1,Injection of anesthetic agent and/or steroid into face nerve,873.0,567.45,218.25,2254.52,19
CDM,40664405_1,Injection of anesthetic agent and/or steroid into upper neck and back of head nerve,654.0,425.1,163.5,2166.29,19
CDM,40664416_1,Continuous infusion of anesthetic agent and/or steroid into arm nerve bundle through catheter,1125.0,731.25,281.25,3227.0,19
CDM,40664417_1,Injection of anesthetic agent and/or steroid into upper arm and shoulder nerve (axillary nerve),273.0,177.45,68.25,3227.0,19
CDM,40664418_1,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,775.5,504.08,193.88,3227.0,19
CDM,40664420_1,Injection of anesthetic agent and/or steroid into rib nerve,525.0,341.25,131.25,3227.0,19
CDM,40664421_1,Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block,479.0,311.35,119.75,3227.0,19
CDM,40664425_1,Injection of anesthetic agent and/or steroid into lower abdomen and groin nerve,975.0,633.75,243.75,3227.0,19
CDM,40664430_1,Injection of anesthetic agent and/or steroid into external genitals and anus nerve,973.5,632.78,243.38,3227.0,19
CDM,40664447_1,Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve),775.5,504.08,193.88,8477.27,19
CDM,40664450_1,Injection of anesthetic agent and/or steroid into other nerve or branch,1119.0,727.35,279.75,3227.0,19
CDM,40664451_1,Injection of anesthetic agent and/or steroid into spine and pelvis nerve using imaging guidance,1875.0,1218.75,468.75,4842.19,19
CDM,40664454_1,Injection of anesthetic agent and/or steroid into knee nerve branch using imaging guidance,1875.0,1218.75,468.75,4842.19,19
CDM,40664479_1,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level",2749.5,1787.18,687.38,7100.58,19
CDM,40664480_1,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, each additional level",805.0,523.25,201.25,2166.29,19
CDM,40664483_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level",3168.0,2059.2,792.0,8181.36,19
CDM,40664484_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level",972.0,631.8,243.0,2510.19,19
CDM,40664486_1,Injection of local anesthetic for abdominal wall pain control on side using imaging guidance,450.0,292.5,112.5,2318.31,19
CDM,40664490_1,"Injection of upper or middle spine facet joint using imaging guidance, single level",2038.5,1325.03,509.63,5264.43,19
CDM,40664491_1,"Injection of upper or middle spine facet joint using imaging guidance, second level",1495.0,971.75,373.75,3860.84,19
CDM,40664492_1,"Injection of upper or middle spine facet joint using imaging guidance, third and any additional level",1631.0,1060.15,407.75,4212.06,19
CDM,40664493_1,"Injection of lower or sacral spine facet joint using imaging guidance, single level",3168.0,2059.2,792.0,8181.36,19
CDM,40664494_1,"Injection of lower or sacral spine facet joint using imaging guidance, second level",1204.0,782.6,301.0,3109.33,19
CDM,40664495_1,"Injection of lower or sacral spine facet joint using imaging guidance, third and any additional level",1225.0,796.25,306.25,3163.56,19
CDM,40664505_1,"Injection of anesthetic agent, trigeminal nerve bundle",346.5,225.23,86.63,2166.29,19
CDM,40664510_1,Injection of anesthetic agent into sympathetic nerve bundle,3025.5,1966.58,756.38,7813.35,19
CDM,40664517_1,Injection of anesthetic agent into sacral nerve bundle,416.0,270.4,104.0,3227.0,19
CDM,40664520_1,Injection of anesthetic agent into middle or lower spine sympathetic nerve,3025.5,1966.58,756.38,7813.35,19
CDM,40664530_1,Injection of anesthetic agent into abdominal sympathetic nerve bundle,2017.0,1311.05,504.25,5208.9,19
CDM,40664555_1,Insertion of peripheral nerve neurostimulator electrode through skin,8629.5,5609.18,2157.38,22285.68,19
CDM,40664600_1,Destruction of first division of face nerve branch,2191.0,1424.15,547.75,5658.26,19
CDM,40664612_1,Injection of chemical for paralysis of nerve muscles on side of face,361.5,234.98,90.38,2166.29,19
CDM,40664615_1,Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face,735.0,477.75,183.75,2166.29,19
CDM,40664620_1,Injection of agent to destroy rib nerve,3025.5,1966.58,756.38,7813.35,19
CDM,40664624_1,Destruction of nerve branches of knee using imaging guidance,5160.0,3354.0,1290.0,13325.7,19
CDM,40664625_1,Destruction of nerves supplying joint between spine and pelvis using imaging guidance,5160.0,3354.0,1290.0,13325.7,19
CDM,40664633_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint",8820.0,5733.0,1861.61,22777.65,19
CDM,40664634_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint",1226.0,796.9,306.5,3166.15,19
CDM,40664635_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint",9000.0,5850.0,1861.61,23242.5,19
CDM,40664636_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint",1066.0,692.9,266.5,2752.95,19
CDM,40664640_1,Destruction of peripheral nerve or branch,1512.0,982.8,378.0,3904.74,19
CDM,40664680_1,Injection of agent to destroy abdominal nerve bundle,853.0,554.45,213.25,3227.0,19
CDM,40664681_1,Injection of agent to destroy presacral nerve bundle,1280.0,832.0,320.0,3305.6,19
CDM,4066IP _1,UNCLASSIFIED DRUGS,10.02,6.51,2.51,25.88,16
CDM,4066OP _1,UNCLASSIFIED DRUGS,28.82,18.73,7.21,74.43,16
CDM,40675809_1,Review by radiologist of previous placed shunt image,450.0,292.5,112.5,1162.13,18
CDM,40676942_1,Ultrasonic guidance for needle placement,800.0,520.0,163.6,2066.0,18
CDM,40677002_1,Fluoroscopic guidance for needle placement,395.0,256.75,98.75,1020.09,18
CDM,40677003_1,Fluoroscopic guidance for spine or back muscle injection,298.0,193.7,74.5,769.59,18
CDM,4067IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.83,20.04,7.71,79.62,16
CDM,4067OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.7,12.81,4.93,50.88,16
CDM,40681025_1,Urine pregnancy test,30.0,19.5,2.58,77.48,19
CDM,40691035_1,Monitoring and recording of esophageal function through a capsule attached to the esophagus wall,1111.0,722.15,277.75,2869.16,18
CDM,40691040_1,HC ENDOFLIP IMPEDANCE PLANIMETRY SYSTEM,362.5,235.63,90.63,253.75,11
CDM,40691110_1,Imaging of digestive tract done from the inside of the digestive tract,1921.0,1248.65,480.25,4960.98,18
CDM,40691112_1,Measurement of complex stomach and bowel motor function,847.0,550.55,211.75,2187.38,19
CDM,40695076_1,"Test for allergy using ingested items, initial 2 hours",1140.0,741.0,285.0,2944.05,19
CDM,40695079_1,"Test for allergy using ingested items, each additional hour",327.0,212.55,81.75,844.48,19
CDM,40695972_1,Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming,328.0,213.2,82.0,847.06,19
CDM,40695991_1,Maintenance of spinal canal or brain drug infusion pump by health care professional,241.0,156.65,60.25,2054.0,19
CDM,40697124_1,"Therapy procedure using massage, each 15 minutes",23.07,15.0,5.77,277.0,19
CDM,40697IP _1,UNCLASSIFIED DRUGS,28.64,18.62,7.16,73.96,16
CDM,40697OP _1,UNCLASSIFIED DRUGS,5.82,3.78,1.46,15.03,16
CDM,40699632_1,HC AGILE PATENCY CAPSULE,483.0,313.95,120.75,338.1,11
CDM,40699634_1,HC TRUFREEZE SPRAY CRYO SYSTEM CONSOLE,126.0,81.9,31.5,88.2,11
CDM,40699636_1,RECOVERY ROOM - GENERAL CLASSIFICATION,45.0,29.25,11.25,31.5,11
CDM,40699638_1,HC CHARTIS PULMONARY ASSESS SYS,624.99,406.24,156.25,437.49,11
CDM,40699641_1,GASTRO - INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,1564.0,1016.6,391.0,1094.8,11
CDM,40699642_1,GASTRO - INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,1880.0,1222.0,470.0,1316.0,11
CDM,40699643_1,GASTRO - INTESTINAL (GI) SERVICES - GENERAL CLASSIFICATION,112.0,72.8,28.0,78.4,11
CDM,406G0260_1,"INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID AND/OR OTHER THERAPEUTIC AGENT, WITH OR WITHOUT ARTHROGRAPHY",4092.5,2660.13,667.58,10568.88,19
CDM,40700T_1,Primary plastic repair of deformity present at birth on 1 side of nose and/or lip,5200.7,3380.46,78.57,3014.55,19
CDM,40700_1,Primary plastic repair of deformity present at birth on 1 side of nose and/or lip,2606.1,1693.97,78.57,3014.55,19
CDM,40701T_1,Plastic repair of deformity present at birth on both sides of nose and/or lip,5200.7,3380.46,78.57,3571.09,19
CDM,40701_1,Plastic repair of deformity present at birth on both sides of nose and/or lip,3780.0,2457.0,78.57,3571.09,19
CDM,40702_1,"Plastic repair of deformity present at birth on both sides of nose and/or lip, first stage",2415.0,1569.75,78.57,2996.48,19
CDM,40720T_1,Secondary plastic repair of nose and lip deformity present at birth,5200.7,3380.46,78.57,3079.12,19
CDM,40720_1,Secondary plastic repair of nose and lip deformity present at birth,4030.5,2619.83,78.57,3079.12,19
CDM,40761_1,Plastic repair of nose and/or lip deformity present at birth using a tissue graft,3937.5,2559.38,78.57,3245.99,19
CDM,40781161_1,Gene analysis (dystrophin),508.0,330.2,194.33,1417.32,19
CDM,40781162_1,Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants,2800.0,1820.0,1428.0,51096.64,19
CDM,40781163_1,Gene analysis (breast cancer 1 and 2) of full sequence,1000.0,650.0,423.93,4680.0,19
CDM,40781164_1,Gene analysis (breast cancer 1 and 2) for duplication or deletion variants,1000.0,650.0,423.93,5842.3,19
CDM,40781165_1,Gene analysis (breast cancer 1) of full sequence,1000.0,650.0,194.33,2828.8,19
CDM,40781166_1,Gene analysis (breast cancer 1) for duplication or deletion variants,500.0,325.0,194.33,1506.75,19
CDM,40781167_1,Gene analysis (breast cancer 2) for duplication or deletion variants,500.0,325.0,194.33,1414.4,19
CDM,40781201_1,"Gene analysis (adenomatous polyposis coli), full gene sequence",1015.0,659.75,517.65,7917.0,19
CDM,40781202_1,"Gene analysis (adenomatous polyposis coli), known familial variants",508.0,330.2,194.33,1422.4,19
CDM,40781203_1,"Gene analysis (adenomatous polyposis coli), duplication or deletion variants",508.0,330.2,194.33,1311.91,19
CDM,40781212_1,"Gene analysis (breast cancer 1 and 2) for 185delAG, 5385insC, 6174delT variants",762.0,495.3,388.62,3352.8,19
CDM,40781215_1,Gene analysis (breast cancer 1) for known familial variant,533.0,346.45,271.83,2000.08,19
CDM,40781216_1,Gene analysis (breast cancer 2) of full sequence,1015.0,659.75,185.12,2621.24,19
CDM,40781217_1,Gene analysis (breast cancer 2) for known familial variant,533.0,346.45,271.83,2000.08,19
CDM,40781228_1,Genome-wide microarray analysis for copy number variants,1680.0,1092.0,773.6,15120.0,19
CDM,40781229_1,Genome-wide microarray analysis for copy number and single nucleotide polymorphism (SNP) variants,2797.0,1818.05,1160.0,32445.2,19
CDM,40781242_1,"Gene analysis (Fanconi anemia, complementation group C) common variant",1015.0,659.75,36.62,2621.24,19
CDM,40781292_1,"Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) full sequence analysis",1015.0,659.75,517.65,6855.31,19
CDM,40781293_1,"Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) known familial variants",508.0,330.2,194.33,1681.48,19
CDM,40781294_1,"Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) duplication or deletion variants",508.0,330.2,194.33,1311.91,19
CDM,40781295_1,"Gene analysis (mutS homolog 2, colon cancer, nonpolyposis type 1) full sequence analysis",1015.0,659.75,381.7,3874.26,19
CDM,40781296_1,"Gene analysis (mutS homolog 2, colon cancer, nonpolyposis type 1) known familial variants",508.0,330.2,194.33,1715.67,19
CDM,40781297_1,"Gene analysis (mutS homolog 2, colon cancer, nonpolyposis type 1) duplication or deletion variants",508.0,330.2,194.33,1311.91,19
CDM,40781298_1,Gene analysis (mutS homolog 6 [E coli]) full sequence analysis,1015.0,659.75,517.65,6514.78,19
CDM,40781299_1,Gene analysis (mutS homolog 6 [E coli]) known familial variants,508.0,330.2,194.33,1564.64,19
CDM,40781300_1,Gene analysis (mutS homolog 6 [E coli]) duplication or deletion variants,508.0,330.2,194.33,1311.91,19
CDM,40781302_1,Gene analysis (methyl CpG binding protein 2) full sequence analysis,1015.0,659.75,423.93,5357.88,19
CDM,40781303_1,Gene analysis (methyl CpG binding protein 2) known familial variant,508.0,330.2,54.96,1311.91,19
CDM,40781304_1,Gene analysis (methyl CpG binding protein 2) duplication or deletion variants,508.0,330.2,150.0,1311.91,19
CDM,40781311_1,Gene analysis for cancer (neuroblastoma),1015.0,659.75,194.33,3002.27,19
CDM,40781317_1,Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) full sequence analysis,1015.0,659.75,517.65,6866.48,19
CDM,40781318_1,Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) known familiar variants,508.0,330.2,194.33,1681.48,19
CDM,40781319_1,Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) duplication or deletion variants,508.0,330.2,194.33,1311.91,19
CDM,40781321_1,"Gene analysis (phosphatase and tensin homolog), full sequence analysis",1015.0,659.75,517.65,6090.0,19
CDM,40781322_1,"Gene analysis (phosphatase and tensin homolog), known familial variant",508.0,330.2,46.6,1311.91,19
CDM,40781323_1,"Gene analysis (phosphatase and tensin homolog), duplication or deletion variant",500.0,325.0,194.33,1500.0,19
CDM,40781331_1,Methylation analysis (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A),727.0,472.55,51.07,1877.48,19
CDM,40781402_1,Molecular pathology procedure level 3,694.0,451.1,150.33,1792.26,19
CDM,40781403_1,Molecular pathology procedure level 4 genetic analysis,508.0,330.2,185.2,1311.91,19
CDM,40781404_1,Molecular pathology procedure level 5 genetic analysis,1015.0,659.75,194.33,2789.52,19
CDM,40781405_1,Molecular pathology procedure level 6 genetic analysis,1680.0,1092.0,194.33,5062.68,19
CDM,40781406_1,Molecular pathology procedure level 7 genetic analysis,1800.0,1170.0,194.33,5091.84,19
CDM,40781407_1,Molecular pathology procedure level 8 genetic analysis,2729.0,1773.85,773.6,23094.71,19
CDM,40781408_1,Molecular pathology procedure level 9 genetic analysis,2558.0,1662.7,1304.58,51160.0,19
CDM,40781410_1,"Test for detecting genes associated with heart disease, genomic sequence analysis panel, at least 9 genes",3000.0,1950.0,423.93,15120.0,19
CDM,40781411_1,"Test for detecting genes associated with heart disease, duplication/deletion analysis panel",1800.0,1170.0,918.0,24303.42,19
CDM,40781416_1,"Test for detecting exome, sequence analysis, each comparator exome",1000.0,650.0,510.0,120000.0,19
CDM,40781417_1,Reevaluation test of previously obtained exome sequence,1000.0,650.0,194.33,3200.0,19
CDM,40781432_1,"Test for detecting genes associated with inherited breast cancer-related disorders, genomic sequence analysis, at least 5 genes",1523.0,989.95,679.05,19859.16,19
CDM,40781435_1,"Test for detecting genes associated with inherited colon cancer-related disorders, genomic sequence analysis, at least 5 genes",1523.0,989.95,423.93,19859.16,19
CDM,40781437_1,"Test for detecting genes associated with inherited neuroendocrine tumor-related disorders, genomic sequence analysis, at least 5 genes",1523.0,989.95,423.93,19859.16,19
CDM,40781438_1,Molecular pathology procedure,508.0,330.2,54.96,1311.91,18
CDM,40781442_1,Gene analysis (noonan syndrome) genomic sequence analysis,2500.0,1625.0,1275.0,53590.0,19
CDM,40782105_1,"Alpha-fetoprotein (AFP) level, serum",53.0,34.45,8.89,136.87,19
CDM,40782664_1,"Electrophoresis, laboratory testing technique",93.0,60.45,33.2,240.17,19
CDM,40784311_1,Chemical analysis using spectrophotometry (light),20.0,13.0,1.62,51.65,19
CDM,40787109_1,Mycoplasma culture,44.0,28.6,6.77,113.63,19
CDM,40788230_1,Tissue culture to identify white blood cell disorders,480.0,312.0,116.49,1239.6,19
CDM,40788233_1,Tissue culture to identify skin disorders,580.0,377.0,140.73,1497.85,19
CDM,40788235_1,Tissue culture for disorders of amniotic fluid or placenta cells,605.0,393.25,150.3,1562.41,19
CDM,40788237_1,Tissue culture for tumor disorders of bone marrow and blood cells,525.0,341.25,143.75,1355.81,19
CDM,40788239_1,Tissue culture for tumor disorders,610.0,396.5,147.52,1575.33,19
CDM,40788240_1,"Cryopreservation, freezing and storage of cells",246.0,159.9,5.88,635.3,19
CDM,40788241_1,Thawing and expansion of frozen cells,403.0,261.95,5.88,1040.75,19
CDM,40788245_1,"Chromosome analysis for genetic defects, baseline Sister Chromatid Exchange (SCE), 20-25 cells",432.0,280.8,173.17,1115.64,19
CDM,40788248_1,"Chromosome analysis for genetic defects, baseline breakage, score 50-100 cells, count 20 cells",445.0,289.25,173.17,1149.21,19
CDM,40788249_1,"Chromosome analysis for genetic defects, score 100 cells, clastogen stress",509.0,330.85,173.17,1314.49,19
CDM,40788261_1,"Chromosome analysis for genetic defects, count 5 cells",730.0,474.5,194.33,1929.68,19
CDM,40788262_1,"Chromosome analysis for genetic defects, count 15-20 cells",2044.0,1328.6,54.96,5278.63,19
CDM,40788263_1,"Chromosome analysis for genetic defects, count 45 cells for mosaicism",614.0,399.1,150.29,1585.66,19
CDM,40788264_1,"Chromosome analysis for genetic defects, analyze 20-25 cells",306.0,198.9,144.61,790.25,19
CDM,40788267_1,Chromosome analysis of amniotic fluid or placenta for genetic defects,745.0,484.25,188.57,1923.96,19
CDM,40788269_1,Chromosome analysis of amniotic fluid for genetic defects,489.0,317.85,173.66,1262.84,19
CDM,40788271_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,40788272_1,"Chromosome analysis for genetic defects, analyze 3-5 cells",269.0,174.85,40.7,694.69,19
CDM,40788273_1,"Chromosome analysis for genetic defects, analyze 10-30 cells",141.0,91.65,34.81,364.13,19
CDM,40788274_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",145.6,94.64,42.38,376.01,19
CDM,40788275_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,40788280_1,"Chromosome analysis for genetic defects, additional karyotypes, each study",176.0,114.4,33.47,454.52,19
CDM,40788283_1,"Chromosome analysis for genetic defects, additional specialized banding technique",191.0,124.15,54.96,493.26,19
CDM,40788285_1,"Chromosome analysis for genetic defects, additional cells counted, each study",134.0,87.1,26.91,346.06,19
CDM,40788289_1,"Chromosome analysis for genetic defects, additional high resolution study",98.0,63.7,33.74,253.09,19
CDM,40799001_1,Molecular pathology procedure level 2,500.0,325.0,137.0,1291.25,19
CDM,40799002_1,Molecular pathology procedure level 3,500.0,325.0,150.33,1291.25,19
CDM,40799003_1,Molecular pathology procedure level 4 genetic analysis,500.0,325.0,185.2,1291.25,19
CDM,40799004_1,Molecular pathology procedure level 5 genetic analysis,500.0,325.0,194.33,1374.15,19
CDM,40799005_1,Molecular pathology procedure level 6 genetic analysis,565.0,367.25,194.33,1702.63,19
CDM,40799006_1,Molecular pathology procedure level 7 genetic analysis,500.0,325.0,194.33,1414.4,19
CDM,40799007_1,Molecular pathology procedure level 8 genetic analysis,500.0,325.0,255.0,4231.35,19
CDM,40799008_1,Molecular pathology procedure level 9 genetic analysis,500.0,325.0,255.0,10000.0,19
CDM,40799009_1,Molecular pathology procedure,1064.0,691.6,54.96,2747.78,18
CDM,40799010_1,Molecular pathology procedure level 2,1000.0,650.0,137.0,2582.5,19
CDM,40799011_1,Molecular pathology procedure level 3,1000.0,650.0,150.33,2582.5,19
CDM,40799012_1,Molecular pathology procedure level 4 genetic analysis,1000.0,650.0,185.2,2582.5,19
CDM,40799013_1,Molecular pathology procedure level 5 genetic analysis,1000.0,650.0,194.33,2748.3,19
CDM,40799014_1,Molecular pathology procedure level 6 genetic analysis,1000.0,650.0,194.33,3013.5,19
CDM,40799015_1,Molecular pathology procedure level 7 genetic analysis,2160.0,1404.0,194.33,6110.21,19
CDM,40799016_1,Molecular pathology procedure level 8 genetic analysis,1000.0,650.0,510.0,8462.7,19
CDM,40799017_1,Molecular pathology procedure level 9 genetic analysis,3300.0,2145.0,1683.0,66000.0,19
CDM,40799018_1,Molecular pathology procedure,1000.0,650.0,54.96,2582.5,18
CDM,40799019_1,Molecular pathology procedure level 2,500.0,325.0,137.0,1291.25,19
CDM,40799020_1,Molecular pathology procedure level 3,500.0,325.0,150.33,1291.25,19
CDM,40799021_1,Molecular pathology procedure level 4 genetic analysis,700.0,455.0,185.2,1807.75,19
CDM,40799022_1,Molecular pathology procedure level 5 genetic analysis,500.0,325.0,194.33,1374.15,19
CDM,40799023_1,Molecular pathology procedure level 6 genetic analysis,500.0,325.0,194.33,1506.75,19
CDM,40799024_1,Molecular pathology procedure level 7 genetic analysis,500.0,325.0,194.33,1414.4,19
CDM,40799025_1,Molecular pathology procedure level 8 genetic analysis,500.0,325.0,255.0,4231.35,19
CDM,40799026_1,Molecular pathology procedure level 9 genetic analysis,500.0,325.0,255.0,10000.0,19
CDM,40799027_1,Molecular pathology procedure,500.0,325.0,54.96,1291.25,18
CDM,40799028_1,Molecular pathology procedure level 9 genetic analysis,1500.0,975.0,765.0,30000.0,19
CDM,40799029_1,Molecular pathology procedure level 8 genetic analysis,2000.0,1300.0,773.6,16925.4,19
CDM,40799030_1,Molecular pathology procedure level 8 genetic analysis,2729.0,1773.85,773.6,23094.71,19
CDM,40799031_1,Molecular pathology procedure level 8 genetic analysis,2000.0,1300.0,773.6,16925.4,19
CDM,40799032_1,Molecular pathology procedure level 8 genetic analysis,2000.0,1300.0,773.6,16925.4,19
CDM,40799033_1,"Test for detecting exome, sequence analysis",6300.0,4095.0,2748.7,301140.0,19
CDM,40799034_1,"Test for detecting exome, sequence analysis, each comparator exome",1400.0,910.0,714.0,168000.0,19
CDM,40799035_1,Molecular pathology procedure level 8 genetic analysis,2700.0,1755.0,773.6,22849.29,19
CDM,40799036_1,Molecular pathology procedure,661.0,429.65,54.96,1707.03,18
CDM,40799037_1,Molecular pathology procedure level 6 genetic analysis,2000.0,1300.0,194.33,6027.0,19
CDM,40799038_1,Molecular pathology procedure level 6 genetic analysis,2000.0,1300.0,194.33,6027.0,19
CDM,40799039_1,Molecular pathology procedure level 6 genetic analysis,2000.0,1300.0,194.33,6027.0,19
CDM,40799040_1,Molecular pathology procedure level 8 genetic analysis,1500.0,975.0,765.0,12694.05,19
CDM,40799041_1,Molecular pathology procedure level 6 genetic analysis,500.0,325.0,194.33,1506.75,19
CDM,40799042_1,Molecular pathology procedure level 6 genetic analysis,500.0,325.0,194.33,1506.75,19
CDM,40799043_1,Molecular pathology procedure level 6 genetic analysis,500.0,325.0,194.33,1506.75,19
CDM,40799044_1,Molecular pathology procedure level 6 genetic analysis,500.0,325.0,194.33,1506.75,19
CDM,40799045_1,Molecular pathology procedure level 8 genetic analysis,1500.0,975.0,765.0,12694.05,19
CDM,40799046_1,Molecular pathology procedure level 8 genetic analysis,1500.0,975.0,765.0,12694.05,19
CDM,40799047_1,Molecular pathology procedure level 8 genetic analysis,1500.0,975.0,765.0,12694.05,19
CDM,407IP _1,"INJECTION, AMINOPHYLLIN, UP TO 250 MG",15.26,9.92,3.82,39.41,17
CDM,407OP _1,"INJECTION, AMINOPHYLLIN, UP TO 250 MG",3.42,2.22,0.86,11.03,17
CDM,40800501IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.0,1.95,0.75,7.75,16
CDM,4080067IP _1,"INJECTION, RITUXIMAB, 10 MG",649.78,422.36,79.26,5812.21,19
CDM,4080067OP _1,"INJECTION, RITUXIMAB, 10 MG",1256.37,816.64,79.26,5812.21,19
CDM,4080074IP _1,"INJECTION, RITUXIMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10 MG",128.52,83.54,31.96,2922.83,19
CDM,4080074OP _1,"INJECTION, RITUXIMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10 MG",326.52,212.24,31.96,2922.83,19
CDM,4080075IP _1,"INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG",467.28,303.73,14.07,2922.83,19
CDM,4080075OP _1,"INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG",432.05,280.83,14.07,2922.83,19
CDM,40800_1,"Simple drainage of abscess, cyst, or blood accumulation of mouth",520.0,338.0,39.89,488.5,19
CDM,408010289IP _1,"INJECTION, INSULIN, PER 5 UNITS",25.19,16.37,0.56,65.05,17
CDM,408010289OP _1,"INJECTION, INSULIN, PER 5 UNITS",21.85,14.2,0.56,56.43,17
CDM,4080118IP _1,UNCLASSIFIED DRUGS,8.65,5.62,2.16,22.34,16
CDM,40801445IP _1,"INJECTION, CEFAZOLIN SODIUM, 500 MG",110.2,71.63,0.88,284.59,17
CDM,40801445OP _1,"INJECTION, CEFAZOLIN SODIUM, 500 MG",93.01,60.46,0.88,240.2,17
CDM,40801OP _1,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",2840.0,1846.0,181.03,8520.0,19
CDM,40801T_1,"Complicated drainage of abscess, cyst, or blood accumulation of mouth",971.3,631.35,78.57,700.64,19
CDM,40801_1,"Complicated drainage of abscess, cyst, or blood accumulation of mouth",798.0,518.7,78.57,700.64,19
CDM,40802063OP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",84.17,54.71,5.02,217.37,17
CDM,40802152IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.2,2.08,0.8,8.26,16
CDM,4080297IP _1,UNCLASSIFIED DRUGS,4.18,2.72,1.05,10.79,16
CDM,4080298IP _1,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",5.81,3.78,0.15,15.0,17
CDM,4080298OP _1,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",12.1,7.87,0.15,31.25,17
CDM,4080299IP _1,"INJECTION, PENTOBARBITAL SODIUM, PER 50 MG",229.98,149.49,38.44,593.92,19
CDM,4080333OP _1,"IODINE I-123 IOBENGUANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",123.29,80.14,30.82,2456.55,17
CDM,4080334OP _1,"IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER 100 MICROCURIES, UP TO 999 MICROCURIES",400.81,260.53,100.2,1209.2,17
CDM,4080335OP _1,"IODINE I-125 SODIUM IOTHALAMATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MICROCURIES",1307.96,850.17,326.99,3945.98,17
CDM,4080336IP _1,"TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, PER STUDY DOSE, UP TO 20 MILLICURIES",1730.77,1125.0,432.69,5221.56,17
CDM,4080336OP _1,"TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, PER STUDY DOSE, UP TO 20 MILLICURIES",1782.18,1158.42,445.55,5376.66,17
CDM,4080460IP _1,UNCLASSIFIED DRUGS,552.74,359.28,138.19,1427.45,16
CDM,4080460OP _1,UNCLASSIFIED DRUGS,427.07,277.6,106.77,1102.91,16
CDM,40804_1,Simple removal of embedded foreign body in mouth,529.2,343.98,61.75,450.24,19
CDM,4080560IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.83,8.34,3.21,33.13,16
CDM,4080569IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.56,1.01,0.39,4.03,16
CDM,4080572IP _1,UNCLASSIFIED DRUGS,2.8,1.82,0.7,7.23,16
CDM,4080579IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.52,14.64,5.63,58.16,16
CDM,4080585IP _1,"INJECTION, INSULIN, PER 5 UNITS",2.72,1.77,0.68,7.02,16
CDM,4080585OP _1,"INJECTION, INSULIN, PER 5 UNITS",2.12,1.38,0.53,5.47,16
CDM,4080587IP _1,UNCLASSIFIED DRUGS,1.64,1.07,0.41,4.24,16
CDM,4080591IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.96,1.92,0.74,7.64,16
CDM,4080591OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.96,1.27,0.49,5.06,16
CDM,4080597IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.5,1.63,0.63,6.46,16
CDM,40805_1,Complicated removal of embedded foreign body in mouth,839.0,545.35,78.57,687.47,19
CDM,4080635IP _1,UNCLASSIFIED DRUGS,1.65,1.07,0.41,4.26,16
CDM,4080669IP _1,"INJECTION FLUCONAZOLE, 200 MG",7.97,5.18,1.99,20.58,17
CDM,4080671IP _1,"INJECTION, BIVALIRUDIN, 1 MG",8.5,5.53,2.13,158.28,18
CDM,4080671OP _1,"INJECTION, BIVALIRUDIN, 1 MG",2.21,1.44,0.55,158.28,18
CDM,4080675IP _1,"INJECTION, BIVALIRUDIN, 1 MG",8.5,5.53,2.13,158.28,18
CDM,4080675OP _1,"INJECTION, BIVALIRUDIN, 1 MG",8.5,5.53,2.13,158.28,18
CDM,4080676IP _1,"INJECTION, BIVALIRUDIN, 1 MG",8.48,5.51,2.12,158.28,18
CDM,4080677IP _1,"INJECTION, BIVALIRUDIN, 1 MG",8.5,5.53,2.13,158.28,18
CDM,4080677OP _1,"INJECTION, BIVALIRUDIN, 1 MG",8.5,5.53,2.13,158.28,18
CDM,40806_1,Incision of tissue joining lip and gum,272.0,176.8,26.19,239.06,19
CDM,4080705IP _1,"INJECTION, INSULIN, PER 5 UNITS",307.14,199.64,0.56,793.19,17
CDM,4080705OP _1,"INJECTION, INSULIN, PER 5 UNITS",227.82,148.08,0.56,588.35,17
CDM,4080755IP _1,UNCLASSIFIED DRUGS,5.82,3.78,1.46,15.03,16
CDM,4080762IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",43.45,28.24,10.86,112.21,16
CDM,4080762OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",96.73,62.87,24.18,249.81,16
CDM,4080774OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.25,7.96,3.06,31.64,16
CDM,4080776IP _1,UNCLASSIFIED DRUGS,18.18,11.82,4.55,46.95,16
CDM,4080780IP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",50.74,32.98,12.69,131.04,16
CDM,4080780OP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",8.99,5.84,2.25,23.22,16
CDM,4080795IP _1,"INJECTION, AZACITIDINE, 1 MG",4196.42,2727.67,0.49,10837.25,19
CDM,4080795OP _1,"INJECTION, AZACITIDINE, 1 MG",3870.56,2515.86,0.49,9995.72,19
CDM,4080821IP _1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",66.25,43.06,16.56,171.09,16
CDM,4080839OP _1,"INJECTION, FLUOROURACIL, 500 MG",66.97,43.53,2.06,200.91,17
CDM,4080851IP _1,UNCLASSIFIED DRUGS,15.43,10.03,3.86,39.85,16
CDM,4080851OP _1,UNCLASSIFIED DRUGS,2.32,1.51,0.58,5.99,16
CDM,4080878IP _1,"INJECTION, METRONIDAZOLE, 10 MG",6.22,4.04,0.03,16.06,17
CDM,4080882IP _1,"INJECTION, METRONIDAZOLE, 10 MG",1.59,1.03,0.4,4.11,16
CDM,40808_1,Biopsy of mouth,465.2,302.38,33.4,408.81,19
CDM,4080919IP _1,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",3.72,2.42,0.62,2.6,16
CDM,4080953IP _1,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25 MG",6456.38,4196.65,1070.34,16673.6,19
CDM,4080967IP _1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",1.42,0.92,0.07,3.67,17
CDM,4080967OP _1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",3.61,2.35,0.07,9.32,17
CDM,4080968IP _1,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",8.15,5.3,0.42,21.05,17
CDM,4080968OP _1,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",4.56,2.96,0.42,11.78,17
CDM,4080977IP _1,"INJECTION FLUCONAZOLE, 200 MG",1.19,0.77,0.3,4.75,17
CDM,4080977OP _1,"INJECTION FLUCONAZOLE, 200 MG",1.59,1.03,0.4,4.75,17
CDM,40810_1,Removal of growth of tissue of mouth,530.0,344.5,31.76,523.65,19
CDM,4081258IP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",20.0,13.0,5.0,51.65,16
CDM,4081258OP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",19.99,12.99,5.0,51.62,16
CDM,40812_1,Removal of growth of mouth with simple repair,731.9,475.74,52.53,680.28,19
CDM,4081309IP _1,"INFUSION, ALBUMIN (HUMAN), 5%, 50 ML",3.08,2.0,0.77,185.91,19
CDM,4081481IP _1,"INJECTION, LEVOFLOXACIN, 250 MG",7.28,4.73,1.82,18.8,17
CDM,4081482IP _1,LEVOFLOXACIN 500 MG/100 ML-D5W,1.91,1.24,0.48,1.34,11
CDM,40814_1,Removal of growth of mouth with complicated repair,987.0,641.55,78.57,902.84,19
CDM,4081670IP _1,"INJECTION, INSULIN, PER 5 UNITS",990.0,643.5,0.56,2556.68,17
CDM,4081670OP _1,"INJECTION, INSULIN, PER 5 UNITS",1334.9,867.69,333.73,3447.38,16
CDM,4081671IP _1,"INJECTION, INSULIN, PER 5 UNITS",617.81,401.58,0.56,1595.49,17
CDM,4081671OP _1,"INJECTION, INSULIN, PER 5 UNITS",1015.0,659.75,253.75,2621.24,16
CDM,4081687IP _1,SULFAMETH-TRIMETH 0.2 MG-0.04 MG-ML FOR DESENSITIZATION,7.05,4.58,1.76,4.94,11
CDM,4081688IP _1,SULFAMETH-TRIMETH 20 MG-4 MG-ML FOR DESENSITIZATION,7.05,4.58,1.76,4.94,11
CDM,40816_1,Complex removal of tissue and muscle growth of mouth,1085.7,705.71,78.57,970.1,19
CDM,4081716IP _1,UNCLASSIFIED DRUGS,36.46,23.7,9.12,94.16,16
CDM,4081716OP _1,UNCLASSIFIED DRUGS,36.87,23.97,9.22,95.22,16
CDM,4081717IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.69,3.7,1.42,14.69,16
CDM,4081735OP _1,UNCLASSIFIED DRUGS,811.77,527.65,202.94,2096.4,16
CDM,4081743IP _1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG",10.9,7.09,2.73,28.15,16
CDM,4081744IP _1,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",13.66,8.88,3.42,35.28,16
CDM,4081744OP _1,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",3.72,2.42,0.93,9.61,16
CDM,4081767IP _1,UNCLASSIFIED DRUGS,3.44,2.24,0.86,8.88,16
CDM,4081772IP _1,UNCLASSIFIED DRUGS,4025.0,2616.25,1006.25,10394.56,16
CDM,4081782IP _1,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",4.47,2.91,1.12,11.54,17
CDM,4081782OP _1,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",1.44,0.94,0.36,3.72,17
CDM,4081795IP _1,UNCLASSIFIED DRUGS,22.94,14.91,5.74,59.24,16
CDM,4081795OP _1,UNCLASSIFIED DRUGS,3.85,2.5,0.96,9.94,16
CDM,4081804OP _1,LC LUMI BEADS 70-150 MICRONS,7875.0,5118.75,1968.75,5512.5,11
CDM,4081811IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.57,1.67,0.64,6.64,16
CDM,4081872IP _1,UNCLASSIFIED DRUGS,3.32,2.16,0.83,8.57,16
CDM,4081872OP _1,UNCLASSIFIED DRUGS,3.32,2.16,0.83,8.57,16
CDM,4081884IP _1,UNCLASSIFIED DRUGS,4.78,3.11,1.2,12.34,16
CDM,4081887IP _1,UNCLASSIFIED DRUGS,2897.5,1883.38,724.38,7482.79,16
CDM,4081887OP _1,UNCLASSIFIED DRUGS,1187.5,771.88,296.88,3066.72,16
CDM,4081897IP _1,UNCLASSIFIED DRUGS,3.32,2.16,0.83,8.57,16
CDM,4081897OP _1,UNCLASSIFIED DRUGS,3.32,2.16,0.83,8.57,16
CDM,4081899IP _1,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,20.81,13.53,5.2,53.74,16
CDM,4081899OP _1,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,36.55,23.76,9.14,94.39,16
CDM,40818T_1,Removal of mouth tissue for grafting,338.1,219.77,78.57,885.45,19
CDM,40818_1,Removal of mouth tissue for grafting,915.6,595.14,78.57,885.45,19
CDM,4081905IP _1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG",5.33,3.46,0.28,13.76,17
CDM,4081905OP _1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG",1.42,0.92,0.28,3.67,17
CDM,4081906IP _1,UNCLASSIFIED DRUGS,4.51,2.93,1.13,11.65,16
CDM,4081907IP _1,UNCLASSIFIED DRUGS,4.49,2.92,1.12,11.6,16
CDM,4081907OP _1,UNCLASSIFIED DRUGS,3.19,2.07,0.8,8.24,16
CDM,4081908IP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",13.86,9.01,3.47,35.79,16
CDM,4081909IP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",13.82,8.98,3.46,35.69,16
CDM,4081910IP _1,UNCLASSIFIED DRUGS,61.0,39.65,15.25,157.53,16
CDM,4081910OP _1,UNCLASSIFIED DRUGS,9.55,6.21,2.39,24.66,16
CDM,4081912IP _1,UNCLASSIFIED DRUGS,3.32,2.16,0.83,8.57,16
CDM,4081913IP _1,UNCLASSIFIED DRUGS,3.32,2.16,0.83,8.57,16
CDM,4081914IP _1,UNCLASSIFIED DRUGS,4.55,2.96,1.14,11.75,16
CDM,4081915IP _1,UNCLASSIFIED DRUGS,4.55,2.96,1.14,11.75,16
CDM,4081958IP _1,UNCLASSIFIED DRUGS,6.96,4.52,1.74,17.97,16
CDM,4081961IP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",30.37,19.74,0.15,78.43,17
CDM,4081988IP _1,"INJECTION, MITOMYCIN, 5 MG",1150.93,748.1,27.67,2972.28,19
CDM,40819T_1,Removal of tissue at dental edge and cheek,971.3,631.35,78.57,651.07,19
CDM,40819_1,Removal of tissue at dental edge and cheek,783.3,509.15,78.57,651.07,19
CDM,4082009IP _1,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",4.99,3.24,0.03,12.89,17
CDM,4082015IP _1,"INJECTION, OXACILLIN SODIUM, UP TO 250 MG",71.68,46.59,0.6,185.11,17
CDM,4082034IP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",12.57,8.17,0.19,32.46,17
CDM,4082034OP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",11.97,7.78,0.19,30.91,17
CDM,4082051OP _1,LC LUMI BEADS 40-90 MICRONS,7875.0,5118.75,1968.75,5512.5,11
CDM,4082098IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.79,3.76,1.45,14.95,16
CDM,4082098OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.25,7.31,2.81,29.05,16
CDM,40820_1,Destruction of growth or scar of mouth,674.1,438.17,28.78,624.85,19
CDM,4082103IP _1,UNCLASSIFIED DRUGS,3.69,2.4,0.92,9.53,16
CDM,4082103OP _1,UNCLASSIFIED DRUGS,22.45,14.59,5.61,57.98,16
CDM,4082107IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.8,2.47,0.95,9.81,16
CDM,4082111IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",199.1,129.42,49.78,514.18,16
CDM,4082115IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.91,2.54,0.98,10.1,16
CDM,4082115OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.1,6.57,2.53,26.08,16
CDM,4082118IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.01,3.26,1.25,12.94,16
CDM,4082118OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.32,16.46,6.33,65.39,16
CDM,4082120IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.31,2.15,0.83,8.55,16
CDM,4082120OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.49,12.02,4.62,47.75,16
CDM,4082123IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.6,3.64,1.4,14.46,16
CDM,4082123OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.95,14.92,5.74,59.27,16
CDM,4082133IP _1,UNCLASSIFIED DRUGS,79.06,51.39,19.77,204.17,16
CDM,4082135IP _1,"PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS",80.73,52.47,20.18,208.49,16
CDM,4082138IP _1,"INJECTION, CEFEPIME HYDROCHLORIDE (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO MAXIPIME, 500 MG",23.89,15.53,5.97,61.7,17
CDM,4082141IP _1,UNCLASSIFIED DRUGS,1.43,0.93,0.36,3.69,16
CDM,4082164IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.45,7.44,2.86,29.57,16
CDM,4082166IP _1,UNCLASSIFIED DRUGS,17.27,11.23,4.32,44.6,16
CDM,4082166OP _1,UNCLASSIFIED DRUGS,4.91,3.19,1.23,12.68,16
CDM,4082170IP _1,"AZATHIOPRINE, ORAL, 50 MG",7.38,4.8,0.06,19.06,17
CDM,4082173OP _1,"IODINE I-131 SODIUM IODIDE CAPSULE(S), THERAPEUTIC, PER MILLICURIE",67.5,43.88,16.88,592.72,19
CDM,4082177IP _1,"IODINE I-131 SODIUM IODIDE SOLUTION, THERAPEUTIC, PER MILLICURIE",55.53,36.09,13.88,592.72,19
CDM,4082177OP _1,"IODINE I-131 SODIUM IODIDE SOLUTION, THERAPEUTIC, PER MILLICURIE",55.53,36.09,13.88,592.72,19
CDM,4082178OP _1,SODIUM IODIDE 131 THERAPEAUTIC(RX)-CANCER SOLUTION,55.53,36.09,13.88,38.87,11
CDM,4082187IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.52,1.64,0.63,6.51,16
CDM,4082221IP _1,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",97.3,63.25,8.64,251.28,17
CDM,4082221OP _1,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",69.31,45.05,8.64,178.99,17
CDM,4082230IP _1,"INJECTION, METHOTREXATE SODIUM, 50 MG",6.24,4.06,1.56,18.72,17
CDM,4082361IP _1,UNCLASSIFIED DRUGS,4.55,2.96,1.14,11.75,16
CDM,4082361OP _1,UNCLASSIFIED DRUGS,4.55,2.96,1.14,11.75,16
CDM,4082397IP _1,"INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG",1489.11,967.92,21.96,3845.63,19
CDM,4082580IP _1,UNCLASSIFIED DRUGS,21.75,14.14,5.44,56.17,16
CDM,4082580OP _1,UNCLASSIFIED DRUGS,4.13,2.68,1.03,10.67,16
CDM,4082630IP _1,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",8.82,5.73,0.12,26.46,17
CDM,4082630OP _1,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",22.33,14.51,0.12,66.99,17
CDM,4082635IP _1,UNCLASSIFIED DRUGS,4.17,2.71,1.04,10.77,16
CDM,4082636IP _1,UNCLASSIFIED DRUGS,3.74,2.43,0.94,9.66,16
CDM,4082637IP _1,UNCLASSIFIED DRUGS,2.86,1.86,0.72,7.39,16
CDM,4082701OP _1,"INJECTION, DECITABINE, 1 MG",267.28,173.73,0.69,690.25,19
CDM,4082785IP _1,"INJECTION, LEVETIRACETAM, 10 MG",2.71,1.76,0.04,7.0,17
CDM,4082840IP _1,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",39.4,25.61,0.15,101.75,17
CDM,4082872IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.88,1.87,0.72,7.44,16
CDM,4082872OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.78,2.46,0.95,9.76,16
CDM,4082875IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.27,9.28,3.57,36.85,16
CDM,4082878IP _1,UNCLASSIFIED DRUGS,9.62,6.25,2.41,24.84,16
CDM,4082878OP _1,UNCLASSIFIED DRUGS,5.74,3.73,1.44,14.82,16
CDM,4082887IP _1,UNCLASSIFIED DRUGS,9.95,6.47,2.49,25.7,16
CDM,4082887OP _1,UNCLASSIFIED DRUGS,6.57,4.27,1.64,16.97,16
CDM,4082911OP _1,"INJECTION, FLUOROURACIL, 500 MG",16.72,10.87,2.06,50.16,17
CDM,4082913IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.26,6.02,2.32,23.91,16
CDM,4082913OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.04,2.63,1.01,10.43,16
CDM,4082915IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.83,31.09,11.96,123.52,16
CDM,4082916OP _1,"INJECTION, FLUOROURACIL, 500 MG",83.77,54.45,2.06,251.31,17
CDM,4082919OP _1,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",1.78,1.16,0.45,1.25,16
CDM,4082933IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.9,3.19,1.23,12.65,16
CDM,4082933OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.24,3.41,1.31,13.53,16
CDM,4082964IP _1,UNCLASSIFIED DRUGS,35.9,23.34,8.98,92.71,16
CDM,4082984IP _1,"INJECTION, DEFEROXAMINE MESYLATE, 500 MG",114.63,74.51,8.98,296.03,17
CDM,4083017IP _1,UNCLASSIFIED DRUGS,15.62,10.15,3.91,40.34,16
CDM,4083065IP _1,"INJECTION, BEVACIZUMAB, 10 MG",3595.0,2336.75,78.05,9284.09,19
CDM,4083065OP _1,"INJECTION, BEVACIZUMAB, 10 MG",525.5,341.58,78.05,2922.83,19
CDM,4083068IP _1,"INJECTION, ACETAMINOPHEN, NOT OTHERWISE SPECIFIED,10 MG",9.64,6.27,0.06,24.9,17
CDM,4083095IP _1,UNCLASSIFIED DRUGS,523.22,340.09,130.81,1351.22,16
CDM,4083095OP _1,UNCLASSIFIED DRUGS,57.51,37.38,14.38,148.52,16
CDM,40830_1,"Repair of lacerated mouth, 2.5 cm or less",620.0,403.0,41.18,545.68,19
CDM,40831_1,"Repair of lacerated mouth, more than 2.5 cm",740.0,481.0,69.65,716.86,19
CDM,4083210IP _1,UNCLASSIFIED DRUGS,10.66,6.93,2.67,27.53,16
CDM,4083210OP _1,UNCLASSIFIED DRUGS,2.87,1.87,0.72,7.41,16
CDM,4083245IP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",26.67,17.34,0.19,68.88,17
CDM,4083326IP _1,"INJECTION, INSULIN, PER 5 UNITS",3.44,2.24,0.56,8.88,17
CDM,4083327IP _1,"INJECTION, INSULIN, PER 5 UNITS",2.11,1.37,0.53,5.45,17
CDM,4083328IP _1,"INJECTION, INSULIN, PER 5 UNITS",3.37,2.19,0.56,8.7,17
CDM,4083329IP _1,"INJECTION, INSULIN, PER 5 UNITS",3.57,2.32,0.56,9.22,17
CDM,4083330IP _1,"INJECTION, INSULIN, PER 5 UNITS",4.19,2.72,0.56,10.82,17
CDM,4083331IP _1,"INJECTION, INSULIN, PER 5 UNITS",2.12,1.38,0.53,5.47,17
CDM,4083332IP _1,"INJECTION, INSULIN, PER 5 UNITS",2.12,1.38,0.53,5.47,17
CDM,4083373IP _1,UNCLASSIFIED DRUGS,9.18,5.97,2.3,23.71,16
CDM,4083375IP _1,"INJECTION, HEPATITIS B IMMUNE GLOBULIN (HEPAGAM B), INTRAVENOUS, 0.5 ML",466.1,302.97,73.77,1203.7,19
CDM,4083423IP _1,UNCLASSIFIED DRUGS,1.53,0.99,0.38,3.95,16
CDM,4083432OP _1,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",24.79,16.11,6.2,2058.35,19
CDM,4083437IP _1,"INJECTION, REMDESIVIR, 1 MG",4514.03,2934.12,7.31,11657.48,19
CDM,4083437OP _1,"INJECTION, REMDESIVIR, 1 MG",5111.87,3322.72,7.31,13201.4,19
CDM,4083452IP _1,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.31,0.85,0.13,3.38,17
CDM,4083452OP _1,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.3,0.85,0.13,3.36,17
CDM,4083453IP _1,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.47,0.96,0.13,3.8,17
CDM,4083453OP _1,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.24,0.81,0.13,3.2,17
CDM,4083475IP _1,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",1.51,0.98,0.38,1.06,16
CDM,4083475OP _1,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",1.8,1.17,0.45,1.26,16
CDM,4083515IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.24,2.76,1.06,10.95,16
CDM,4083531OP _1,METHOHEXITAL 10 MG/ML IN SW COMPOUND [4083531],5.05,3.28,1.26,3.54,11
CDM,4083546OP _1,CEFAZOLIN 2 GRAM-20 ML IN SW COMPOUND,1.13,0.73,0.28,0.79,11
CDM,4083607IP _1,UNCLASSIFIED DRUGS,2.3,1.5,0.58,5.94,16
CDM,4083759IP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",7.8,5.07,1.95,20.14,16
CDM,4083773IP _1,"INJECTION, DOPAMINE HCL, 40 MG",19.66,12.78,0.85,50.77,17
CDM,4083774IP _1,"INJECTION, DOPAMINE HCL, 40 MG",13.73,8.92,0.85,35.46,17
CDM,4083781OP _1,UNCLASSIFIED DRUGS,8.85,5.75,2.21,22.86,16
CDM,4083794OP _1,"BRACHYTHERAPY SOURCE, NON-STRANDED, YTTRIUM-90, PER SOURCE",304653.53,198024.79,16299.55,786767.74,19
CDM,4083801IP _1,"INJECTION, CALCIUM GLUCONATE (WG CRITICAL CARE), NOT THERAPEUTICALLY EQUIVALENT TO J0612, 10 MG",4.49,2.92,0.1,11.6,17
CDM,4083801OP _1,"INJECTION, CALCIUM GLUCONATE (WG CRITICAL CARE), NOT THERAPEUTICALLY EQUIVALENT TO J0612, 10 MG",4.93,3.2,0.1,12.73,17
CDM,4083802OP _1,UNCLASSIFIED DRUGS,167.87,109.12,41.97,433.52,16
CDM,4083803IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2001.15,1300.75,500.29,5167.97,16
CDM,4083809IP _1,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",1108.5,720.53,7.11,2862.7,19
CDM,4083809OP _1,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",101.5,65.98,7.11,262.12,19
CDM,4084001IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.42,6.12,2.36,24.33,16
CDM,4084001OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.62,1.7,0.66,6.77,16
CDM,40840026IP _1,"INJECTION, PROPOFOL, 10 MG",7.41,4.82,0.1,19.14,17
CDM,408400293IP _1,5% DEXTROSE/WATER (500 ML = 1 UNIT),2.67,1.74,0.67,6.9,17
CDM,40840062IP _1,"TECHNETIUM TC-99M LABELED RED BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",1395.35,906.98,115.42,4209.63,17
CDM,40840065IP _1,"XENON XE-133 GAS, DIAGNOSTIC, PER 10 MILLICURIES",1268.07,824.25,317.02,3825.64,17
CDM,40840065OP _1,"XENON XE-133 GAS, DIAGNOSTIC, PER 10 MILLICURIES",1354.36,880.33,324.67,4085.97,17
CDM,40840066IP _1,"TECHNETIUM TC-99M PERTECHNETATE, DIAGNOSTIC, PER MILLICURIE",81.82,53.18,12.74,246.84,17
CDM,40840066OP _1,"TECHNETIUM TC-99M PERTECHNETATE, DIAGNOSTIC, PER MILLICURIE",5.92,3.85,1.48,17.86,17
CDM,40840067IP _1,"TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",790.24,513.66,42.14,2384.08,17
CDM,40840067OP _1,"TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",811.23,527.3,42.14,2447.4,17
CDM,40840068IP _1,"TECHNETIUM TC-99M MERTIATIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",3750.0,2437.5,840.87,11313.38,17
CDM,40840068OP _1,"TECHNETIUM TC-99M MERTIATIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",3720.0,2418.0,840.87,11222.87,17
CDM,40840081IP _1,"TECHNETIUM TC-99M BICISATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",2839.12,1845.43,709.78,8565.34,17
CDM,40840081OP _1,"TECHNETIUM TC-99M BICISATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",2608.19,1695.32,652.05,7868.65,17
CDM,40840083OP _1,"IODINE I-131 SODIUM IODIDE CAPSULE(S), DIAGNOSTIC, PER MILLICURIE",62.56,40.66,15.64,188.74,17
CDM,4084028IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.4,3.51,1.35,13.95,16
CDM,4084049IP _1,BISOPROLOL FUMARATE 5 MG TAB,9.2,5.98,2.3,6.44,11
CDM,4084050IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.8,3.12,1.2,12.4,16
CDM,4084050OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.0,13.65,5.25,54.23,16
CDM,4084061IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.61,24.45,9.4,97.13,16
CDM,4084061OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",44.4,28.86,11.1,114.66,16
CDM,40840_1,Repair to increase depth of front portion of mouth,2138.9,1390.29,78.57,2074.72,19
CDM,4084142IP _1,BISOPROLOL FUMARATE 5 MG TAB,7.45,4.84,1.86,5.22,11
CDM,4084229IP _1,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",299.25,194.51,27.13,772.81,17
CDM,4084229OP _1,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",77.6,50.44,19.4,200.4,17
CDM,40842_1,Repair to increase depth on side of mouth,2107.4,1369.81,78.57,2216.7,19
CDM,40843_1,Repair to increase depth on both sides of mouth,2759.4,1793.61,78.57,2851.89,19
CDM,4084410IP _1,"INJECTION, INSULIN, PER 5 UNITS",270.74,175.98,0.56,699.19,17
CDM,4084410OP _1,"INJECTION, INSULIN, PER 5 UNITS",244.76,159.09,0.56,632.09,17
CDM,4084411IP _1,"INJECTION, INSULIN, PER 5 UNITS",224.68,146.04,0.56,580.24,17
CDM,4084411OP _1,"INJECTION, INSULIN, PER 5 UNITS",81.0,52.65,0.56,209.18,17
CDM,4084431IP _1,EPINEPHRINE HCL 16 MCG/ML IN NS PREMADE SYRINGE [4084431],4.5,2.93,1.13,3.15,11
CDM,4084433IP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",121.75,79.14,0.63,314.42,17
CDM,4084435IP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",144.86,94.16,0.63,374.1,17
CDM,4084437IP _1,"INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG",174.64,113.52,12.8,451.01,17
CDM,4084438IP _1,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",798.1,518.77,174.75,2061.09,19
CDM,4084438OP _1,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",294.43,191.38,73.61,760.37,19
CDM,4084441IP _1,"INJECTION, OLANZAPINE, 0.5 MG",295.88,192.32,0.86,764.11,17
CDM,4084441OP _1,"INJECTION, OLANZAPINE, 0.5 MG",83.6,54.34,0.86,215.9,17
CDM,40844_1,Repair to increase depth of entire arch of mouth,3651.9,2373.74,78.57,3573.32,19
CDM,4084564IP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",16.35,10.63,1.26,42.22,17
CDM,40845_1,Complex repair to increase depth of mouth,3993.2,2595.58,78.57,3718.42,19
CDM,4084642IP _1,"INJECTION, CEFEPIME HYDROCHLORIDE (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO MAXIPIME, 500 MG",13.12,8.53,3.28,33.88,17
CDM,4084681IP _1,"INJECTION, HYDROMORPHONE, 0.1 MG",29.3,19.05,0.15,75.67,17
CDM,4084737OP _1,"INJECTION, CARFILZOMIB, 1 MG",38624.09,25105.66,58.95,99746.71,19
CDM,4084741OP _1,"INJECTION, IRINOTECAN, 20 MG",65.96,42.87,1.9,197.88,17
CDM,4084744OP _1,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",59.74,38.83,4.07,179.22,17
CDM,4084745IP _1,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",401.1,260.72,4.07,1203.3,17
CDM,4084745OP _1,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",420.67,273.44,4.07,1262.01,17
CDM,4084752IP _1,CRESEMBA 372 MG VIAL,2430.83,1580.04,607.71,1701.58,11
CDM,4084763OP _1,UNCLASSIFIED DRUGS,1.42,0.92,0.36,3.67,16
CDM,4084816OP _1,TRICHLOROACETIC ACID 25 % TOPICAL SOLUTION [4084816],8.47,5.51,2.12,5.93,11
CDM,4084818IP _1,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",5.14,3.34,0.01,13.27,17
CDM,4084865IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.15,0.75,0.29,2.97,16
CDM,4084904IP _1,UNCLASSIFIED DRUGS,37.32,24.26,9.33,96.38,16
CDM,4084907IP _1,UNCLASSIFIED DRUGS,157.84,102.6,39.46,407.62,16
CDM,4084907OP _1,UNCLASSIFIED DRUGS,132.52,86.14,33.13,342.23,16
CDM,4084908IP _1,"INJECTION, COSYNTROPIN, 0.25 MG",287.15,186.65,21.89,861.45,17
CDM,4084908OP _1,"INJECTION, COSYNTROPIN, 0.25 MG",151.79,98.66,21.89,455.37,17
CDM,4084911IP _1,UNCLASSIFIED DRUGS,610.94,397.11,152.74,1577.75,16
CDM,4084911OP _1,UNCLASSIFIED DRUGS,580.77,377.5,145.19,1499.84,16
CDM,4084934IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.9,2.54,0.98,10.07,16
CDM,4084948IP _1,"INJECTION, ZIPRASIDONE MESYLATE, 10 MG",78.58,51.08,9.7,202.93,17
CDM,4085007OP _1,TRICHLOROACETIC ACID 30 % TOPICAL SOLUTION [4085007],3.11,2.02,0.78,2.18,11
CDM,4085016OP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",27.98,18.19,0.49,72.26,17
CDM,4085017IP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",455.8,296.27,0.49,1177.1,17
CDM,4085017OP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",237.5,154.38,0.49,613.34,17
CDM,4085018OP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",8.73,5.67,0.49,22.55,17
CDM,4085019IP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",114.4,74.36,0.49,295.44,17
CDM,4085019OP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",30.86,20.06,0.49,79.7,17
CDM,4085099IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.34,1.52,0.59,6.04,16
CDM,4085137IP _1,"INJECTION, INSULIN, PER 5 UNITS",3.72,2.42,0.56,9.61,17
CDM,4085150OP _1,UNCLASSIFIED DRUGS,11.25,7.31,2.81,29.05,16
CDM,4085200OP _1,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",510.49,331.82,0.36,1318.34,19
CDM,4085236IP _1,DAPTOMYCIN 500 MG/50 ML-NS BAG,3.49,2.27,0.87,2.44,11
CDM,4085237IP _1,DAPTOMYCIN 500 MG/50 ML-NS BAG,3.48,2.26,0.87,2.44,11
CDM,4085251IP _1,UNCLASSIFIED DRUGS,894.95,581.72,223.74,2311.21,16
CDM,4085251OP _1,UNCLASSIFIED DRUGS,324.0,210.6,81.0,836.73,16
CDM,4085300OP _1,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",524.56,340.96,0.36,1354.68,19
CDM,4085395IP _1,UNCLASSIFIED DRUGS,1.18,0.77,0.3,3.05,16
CDM,4085422IP _1,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",4.1,2.67,1.03,10.59,17
CDM,4085481IP _1,"INJECTION, MEROPENEM, 100 MG",124.05,80.63,0.4,320.36,17
CDM,4085488IP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",494.35,321.33,5.02,1276.66,17
CDM,4085489IP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",200.25,130.16,5.02,517.15,17
CDM,4085489OP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",197.5,128.38,5.02,510.04,17
CDM,4085492IP _1,"INJECTION, CEFTAZIDIME, PER 500 MG",129.45,84.14,1.56,334.3,17
CDM,4085493IP _1,"INJECTION, CEFTAZIDIME, PER 500 MG",37.9,24.64,1.56,97.88,17
CDM,4085499IP _1,"INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG",121.85,79.2,2.17,314.68,17
CDM,4085501OP _1,"INJECTION, LANREOTIDE, 1 MG",39054.75,25385.59,37.51,100858.89,19
CDM,4085504OP _1,UNCLASSIFIED DRUGS,1.35,0.88,0.34,3.49,16
CDM,4085505OP _1,UNCLASSIFIED DRUGS,15.63,10.16,3.91,40.36,16
CDM,4085526OP _1,"INJECTION, CEFAZOLIN SODIUM, 500 MG",11.4,7.41,0.88,29.44,17
CDM,4085566IP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",126.8,82.42,0.63,327.46,17
CDM,4085566OP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",28.45,18.49,0.63,73.47,17
CDM,4085570IP _1,"INJECTION, LEVETIRACETAM, 10 MG",4.71,3.06,0.04,12.16,17
CDM,4085694IP _1,"INJECTION, AMINOCAPROIC ACID, 1 GRAM",5.31,3.45,1.33,13.71,17
CDM,4085710IP _1,UNCLASSIFIED DRUGS,4025.0,2616.25,1006.25,10394.56,16
CDM,4085711IP _1,UNCLASSIFIED DRUGS,3325.0,2161.25,831.25,8586.81,16
CDM,4085711OP _1,UNCLASSIFIED DRUGS,3325.0,2161.25,831.25,8586.81,16
CDM,4085714IP _1,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",3.32,2.16,0.83,8.57,16
CDM,4085716IP _1,UNCLASSIFIED DRUGS,4.55,2.96,1.14,11.75,16
CDM,4085718IP _1,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",55.64,36.17,10.4,143.69,17
CDM,4085721IP _1,"INJECTION, LEVOFLOXACIN, 250 MG",1.42,0.92,0.36,3.67,17
CDM,4085752IP _1,ZOSYN 4.5 GM/100 ML GALAXY BAG,3.2,2.08,0.8,2.24,11
CDM,4085821OP _1,YEZTUGO 463.5 MG/1.5 ML VIAL,10482.6,6813.69,2620.65,7337.82,11
CDM,4085825IP _1,DIMETHYL SULFOXIDE MEDI-GEL TOPICAL [4085825],1.62,1.05,0.41,1.13,11
CDM,4085825OP _1,DIMETHYL SULFOXIDE MEDI-GEL TOPICAL [4085825],3.24,2.11,0.81,2.27,11
CDM,4085852IP _1,FLOSEAL HEMOSTATIC MATRIX 10 ML KIT [4085852],325.1,211.32,81.28,227.57,11
CDM,4085852OP _1,FLOSEAL HEMOSTATIC MATRIX 10 ML KIT [4085852],325.41,211.52,81.35,227.79,11
CDM,4085888IP _1,CLOPIDOGREL 75 MG TABLET,1.15,0.75,0.29,0.81,11
CDM,4085888OP _1,CLOPIDOGREL 75 MG TABLET,1.52,0.99,0.38,1.06,11
CDM,4085906OP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",35.37,22.99,0.49,91.34,17
CDM,4085907IP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",263.23,171.1,0.49,679.79,17
CDM,4085907OP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",50.2,32.63,0.49,129.64,17
CDM,4085961IP _1,"INJECTION, AZITHROMYCIN, 500 MG",508.26,330.37,2.16,1312.58,17
CDM,4085999IP _1,AMPHOTERICIN B LIPOSOME 50 MG,615.18,399.87,153.8,430.63,11
CDM,4086013IP _1,REZZAYO 200 MG VIAL,13932.45,9056.09,3483.11,9752.72,11
CDM,4086042OP _1,"INJECTION, VELAGLUCERASE ALFA, 100 UNITS",3353.41,2179.72,409.62,11535.65,19
CDM,4086055OP _1,DOXYCYCLINE HYCLATE 100 MG VL,254.68,165.54,63.67,178.28,11
CDM,4086077OP _1,EMRELIS 100 MG VIAL,86501.26,56225.82,21625.32,60550.88,11
CDM,4086104OP _1,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",19127.8,12433.07,99.46,49397.54,19
CDM,4086158IP _1,UNCLASSIFIED DRUGS,23.18,15.07,5.8,59.86,16
CDM,4086163OP _1,GRANIX 300 MCG/0.5 ML SAFE SYR,757.5,492.38,189.38,530.25,11
CDM,4086164OP _1,GRANIX 480 MCG/0.8 ML SAFE SYR,746.56,485.26,186.64,522.59,11
CDM,4086402OP _1,"INJECTION, DMSO, DIMETHYL SULFOXIDE, 50%, 50 ML",32.75,21.29,8.19,794.18,19
CDM,4086510IP _1,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",3.86,2.51,0.97,9.97,17
CDM,4086510OP _1,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",3.68,2.39,0.92,9.5,17
CDM,4087065IP _1,OMEPRAZOLE 2 MG/ML ORAL SUSPENSION COMPOUNDED [4087065],2.37,1.54,0.59,1.66,11
CDM,4087065OP _1,OMEPRAZOLE 2 MG/ML ORAL SUSPENSION COMPOUNDED [4087065],4.33,2.81,1.08,3.03,11
CDM,4087321IP _1,UNCLASSIFIED DRUGS,1.17,0.76,0.29,3.02,16
CDM,4087322IP _1,UNCLASSIFIED DRUGS,5.15,3.35,1.29,13.3,16
CDM,4087547IP _1,PHENYLALANINE FREE AA 9.4 % SOLUTION [4087547],7.44,4.84,1.86,5.21,11
CDM,4088442IP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",227.46,147.85,56.87,587.42,16
CDM,4088442OP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",23.1,15.02,5.78,59.66,16
CDM,40901034_1,Monitoring and recording of esophageal function through nasal tube,1137.0,739.05,284.25,2936.3,18
CDM,40917IP _1,SOD PHENYLACET-SOD BENZOATE VL,386.5,251.23,96.63,270.55,11
CDM,40989115_1,Study of esophagus to assess movement,1919.0,1247.35,479.75,4955.82,18
CDM,40989117_1,"ANORECTAL MANOMETRY, WITH RECTAL SENSATION AND RECTAL BALLOON EXPULSION TEST, WHEN PERFORMED",720.0,468.0,180.0,1859.4,16
CDM,40991037_1,Monitoring and recording of esophageal function through nasal tube with electrode,747.0,485.55,186.75,1929.13,18
CDM,40991038_1,Prolonged monitoring and recording of esophageal function through nasal tube with electrode,2085.0,1355.25,521.25,5384.51,18
CDM,40991125_1,"ANORECTAL MANOMETRY, WITH RECTAL SENSATION AND RECTAL BALLOON EXPULSION TEST, WHEN PERFORMED",954.0,620.1,238.5,2463.71,16
CDM,41000_1,"Drainage of abscess, cyst, or blood accumulation of side of tongue from inside mouth",415.8,270.27,44.02,354.96,19
CDM,41005_1,"Drainage of abscess, cyst, or blood accumulation under tongue from inside mouth",579.6,376.74,35.62,578.18,19
CDM,41006_1,"Drainage of abscess, cyst, or blood accumulation of tongue or floor of mouth from inside mouth",936.6,608.79,45.38,823.0,19
CDM,41007_1,"Drainage of abscess, cyst, or blood accumulation beneath chin from inside mouth",938.7,610.16,61.75,793.83,19
CDM,41008_1,"Drainage of abscess, cyst, or blood accumulation under jaw bone from inside mouth",963.9,626.54,61.75,944.4,19
CDM,41009_1,"Drainage of abscess, cyst, or blood accumulation under lower teeth from inside mouth",1023.8,665.47,46.68,1021.65,19
CDM,41010_1,Incision of tissue connecting tongue and floor of mouth,519.8,337.87,61.91,525.51,19
CDM,41015_1,"Drainage of abscess, cyst, or blood accumulation under tongue from outside mouth",1104.6,717.99,55.57,964.41,19
CDM,41016_1,"Drainage of abscess, cyst, or blood accumulation beneath chin from outside mouth",1130.9,735.09,78.57,1129.11,19
CDM,41017_1,"Drainage of abscess, cyst, or blood accumulation under jaw bone from outside mouth",1140.3,741.2,78.57,1129.11,19
CDM,41018_1,"Drainage of abscess, cyst, or blood accumulation under lower teeth from outside mouth",1308.3,850.4,78.57,1270.06,19
CDM,41019_1,"Insertion of needles, tubes, or devices into head and/or neck for radiation therapy",1149.9,747.44,78.57,1484.1,19
CDM,41061404_1,"Sleep study, multiple trials",2080.0,1352.0,520.0,5371.6,19
CDM,41061408_1,Sleep study in sleep lab with continuous airway pressure (6 years or older),3157.0,2052.05,784.0,8152.95,19
CDM,41088IP _1,TIZANIDINE HCL 6 MG CAPSULE,36.55,23.76,9.14,25.59,11
CDM,41095782_1,Sleep study in sleep lab (younger than 6 years),2359.0,1533.35,589.75,6092.12,19
CDM,41095783_1,Sleep study in sleep lab with continuous airway pressure (younger than 6 years),2359.0,1533.35,589.75,6092.12,19
CDM,41095800_1,"Sleep study including heart rate, breathing, and sleep time",330.0,214.5,82.5,852.23,19
CDM,41095805_1,"Sleep study, multiple trials",2080.0,1352.0,520.0,5371.6,19
CDM,41095806_1,"Sleep study including heart rate, breathing, airflow, and effort",457.0,297.05,114.25,1180.2,19
CDM,41095810_1,Sleep study in sleep lab (6 years or older),2913.0,1893.45,728.25,7522.82,19
CDM,41100066_1,HC MADONNA REAL TIME MONITORING,41.0,26.65,10.25,339.0,12
CDM,41100_1,Biopsy of front 2/3 of tongue,461.0,299.65,37.17,452.41,19
CDM,41105_1,Biopsy of back 1/3 of tongue,440.0,286.0,54.42,452.8,19
CDM,41108_1,Biopsy of floor of mouth,379.1,246.42,55.57,406.36,19
CDM,41110_1,Removal of growth of tongue without closure,541.8,352.17,36.56,555.68,19
CDM,41112T_1,Removal of growth of front 2/3 of tongue with switches,2130.5,1384.83,78.57,819.35,19
CDM,41112_1,Removal of growth of front 2/3 of tongue with switches,856.8,556.92,78.57,819.35,19
CDM,41113_1,Removal of growth of back 1/3 of tongue with suturing,939.8,610.87,78.57,879.51,19
CDM,41114_1,Removal of growth of tongue with local tissue graft,1735.7,1128.21,78.57,1887.16,19
CDM,41115_1,Removal of tissue connecting tongue and floor of mouth,630.0,409.5,19.48,632.47,19
CDM,41116_1,Removal of growth of floor of mouth,849.5,552.18,78.57,807.96,19
CDM,41120_1,Removal of less than half of tongue,2821.4,1833.91,78.57,3221.08,19
CDM,41130_1,Partial removal of tongue,3508.1,2280.27,78.57,3976.22,19
CDM,41135_1,Partial removal of tongue and surrounding lymph nodes on side of neck,5883.2,3824.08,78.57,6561.58,19
CDM,41137IP _1,"INJECTION, GADOBENATE DIMEGLUMINE (MULTIHANCE), PER ML",7.69,5.0,1.91,23.2,17
CDM,41137OP _1,"INJECTION, GADOBENATE DIMEGLUMINE (MULTIHANCE), PER ML",14.8,9.62,1.91,44.65,17
CDM,41139IP _1,GALANTAMINE ER 16 MG CAPSULE,93.1,60.52,23.28,65.17,11
CDM,41139OP _1,GALANTAMINE ER 16 MG CAPSULE,93.1,60.52,23.28,65.17,11
CDM,41140000_1,HC HOLTER RECORDER VA,64.0,41.6,16.0,1124.0,12
CDM,41140_1,Complete removal of tongue,6015.5,3910.08,78.57,6589.22,19
CDM,41144IP _1,"INJECTION, MICAFUNGIN SODIUM, 1 MG",644.5,418.93,0.27,1664.42,17
CDM,41144OP _1,"INJECTION, MICAFUNGIN SODIUM, 1 MG",45.85,29.8,0.27,118.41,17
CDM,41145_1,Complete removal of tongue and surrounding lymph nodes on side of neck,7563.2,4916.08,78.57,8343.51,19
CDM,41147IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.23,6.65,2.56,26.42,16
CDM,41147OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.03,16.92,6.51,67.22,16
CDM,41150_1,"Removal of tongue, floor of mouth, and jaw bone",5980.8,3887.52,78.57,6634.09,19
CDM,41153_1,"Removal of tongue, floor of mouth, soft tissue, and lymph nodes",6505.8,4228.77,78.57,7194.37,19
CDM,41155_1,"Removal of tongue, floor of mouth, jaw bone, tissue, and lymph nodes",8124.9,5281.19,78.57,9099.01,19
CDM,41193222_1,Electrocardiogram (ECG) 2-day continuous with report,500.0,325.0,89.9,1291.25,19
CDM,41193228_1,Electrocardiogram (ECG) up to 30 days continuous with review and report by health care professional,153.0,99.45,38.25,1124.0,19
CDM,41193229_1,Electrocardiogram (ECG) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional,600.0,390.0,60.67,1549.5,19
CDM,41193271_1,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring and transmission and analysis,550.0,357.5,60.67,1420.38,19
CDM,41200101_1,HC NON RETURNED HOLTER MONITOR,1893.0,1230.45,473.25,1325.1,11
CDM,41200102_1,HC NON RETURNED KING OF HEARTS,1052.0,683.8,263.0,736.4,11
CDM,41200103_1,HC NON RETURNED BG MINIS DEVICE,778.0,505.7,194.5,544.6,11
CDM,41200104_1,HC NON RETURNED PREVENTICE PHONE DEVICE,414.0,269.1,103.5,289.8,11
CDM,41250_1,"Repair of lacerated floor of mouth and/or tongue, 2.5 cm or less",480.0,312.0,56.36,681.34,19
CDM,41251_1,"Repair of lacerated back 1/3 of tongue, 2.5 cm or less",590.0,383.5,78.57,753.23,19
CDM,41252_1,"Repair of lacerated tongue or floor of mouth, more than 2.6 cm",750.0,487.5,78.57,788.15,19
CDM,41293040_1,Electrocardiogram (ECG) 1 to 3 leads,275.0,178.75,37.41,710.19,19
CDM,41293056_1,Routine electrocardiogram (ECG) using at least 12 leads with tracing,205.0,133.25,37.41,529.41,19
CDM,41293057_1,Routine electrocardiogram (ECG) using at least 12 leads with tracing,205.0,133.25,37.41,529.41,19
CDM,41293058_1,Routine electrocardiogram (ECG) using at least 12 leads with tracing,280.0,182.0,37.41,723.1,19
CDM,41293069_1,Exercise or drug-induced heart stress test with electrocardiogram (ECG),1491.0,969.15,241.11,3850.51,19
CDM,41293073_1,Exercise or drug-induced heart stress test with electrocardiogram (ECG),1491.0,969.15,241.11,3850.51,19
CDM,41293079_1,Routine electrocardiogram (ECG) using at least 12 leads with tracing,205.0,133.25,37.41,529.41,19
CDM,41293218_1,Recording to evaluate height and duration of heart beats through damaged heart tissue,709.0,460.85,37.41,1830.99,19
CDM,41293222_1,Electrocardiogram (ECG) 2-day continuous with report,500.0,325.0,89.9,1291.25,19
CDM,41293224_1,Electrocardiogram (ECG) 2-day continuous,500.0,325.0,89.9,1291.25,19
CDM,41293242_1,Heart rhythm recording continuous external EKG over more than 48 hours up to 7 days,100.0,65.0,25.0,1124.0,19
CDM,41293243_1,Heart rhythm analysis and report of continuous external EKG over more than 48 hours up to 7 days,150.0,97.5,37.5,1124.0,19
CDM,41293246_1,Heart rhythm recording of continuous external EKG over 8-15 days,300.0,195.0,75.0,1124.0,19
CDM,41293247_1,Heart rhythm analysis and report of continuous external EKG over 8-15 days,350.0,227.5,87.5,1124.0,19
CDM,41293270_1,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring,300.0,195.0,60.67,1124.0,19
CDM,41294763_1,HC ZIO EVENT CARD DEVICE BMC,716.0,465.4,179.0,501.2,11
CDM,41294IP _1,"INJECTION, FLUDARABINE PHOSPHATE, 50 MG",520.82,338.53,86.29,1562.46,17
CDM,41294OP _1,"INJECTION, FLUDARABINE PHOSPHATE, 50 MG",214.14,139.19,53.54,642.42,17
CDM,41300237_1,"THERAPEUTIC PROCEDURES TO INCREASE STRENGTH OR ENDURANCE OF RESPIRATORY MUSCLES, FACE TO FACE, ONE ON ONE, EACH 15 MINUTES (INCLUDES MONITORING)",135.0,87.75,33.75,1177.0,19
CDM,41300238_1,"THERAPEUTIC PROCEDURES TO IMPROVE RESPIRATORY FUNCTION, OTHER THAN DESCRIBED BY G0237, ONE ON ONE, FACE TO FACE, PER 15 MINUTES (INCLUDES MONITORING)",150.0,97.5,37.5,1177.0,19
CDM,41300239_1,"THERAPEUTIC PROCEDURES TO IMPROVE RESPIRATORY FUNCTION OR INCREASE STRENGTH OR ENDURANCE OF RESPIRATORY MUSCLES, TWO OR MORE INDIVIDUALS (INCLUDES MONITORING)",686.0,445.9,59.64,1771.6,19
CDM,41300240_1,"Outpatient heart rehabilitation, qualified health care professional services",275.0,178.75,68.75,710.19,19
CDM,41300424_1,"PULMONARY REHABILITATION, INCLUDING EXERCISE (INCLUDES MONITORING), ONE HOUR, PER SESSION, UP TO TWO SESSIONS PER DAY",350.0,227.5,87.5,903.88,17
CDM,41301239_1,"Outpatient heart rehabilitation with electrocardiogram (ECG) monitoring, quality health care professional services",350.0,227.5,87.5,903.88,19
CDM,41301241_1,HC PHASE III CARDIAC REHAB SES,6.0,3.9,1.5,489.0,12
CDM,41301242_1,"Outpatient heart rehabilitation with electrocardiogram (ECG) monitoring, quality health care professional services",350.0,227.5,87.5,903.88,19
CDM,41301248_1,HC PHASE III CARDIAC REHAB EVAL,277.0,180.05,69.25,489.0,12
CDM,41301249_1,"Peripheral arterial disease rehabilitation, each session",150.0,97.5,37.5,489.0,19
CDM,41301250_1,"Peripheral arterial disease rehabilitation, each session",150.0,97.5,37.5,489.0,19
CDM,41301253_1,HC PHASE III CARDIAC REHAB PER MONTH,23.0,14.95,5.75,489.0,12
CDM,41382IP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",148.01,96.21,1.26,382.24,17
CDM,41382OP _1,"INJECTION, FENTANYL CITRATE, 0.1 MG",12.8,8.32,1.26,33.06,17
CDM,41393041_1,Electrocardiogram (ECG) 1 to 3 leads,275.0,178.75,37.41,710.19,19
CDM,41394625_1,"Professional services for outpatient pulmonary rehabilitation, per session",350.0,227.5,59.64,903.88,19
CDM,41394626_1,"Professional services for outpatient pulmonary rehabilitation with continuous monitoring of blood oxygen, per session",350.0,227.5,59.64,903.88,19
CDM,41394664_1,Evaluation of use of breathing device,200.0,130.0,50.0,1177.0,19
CDM,41394761_1,Test to measure oxygen level in blood using ear or finger device multiple times,290.0,188.5,72.5,1438.0,17
CDM,41399406_1,"Smoking and tobacco use intermediate counseling, 3-10 minutes",45.0,29.25,11.25,273.0,19
CDM,41399407_1,"Smoking and tobacco use intensive counseling, more than 10 minutes",57.0,37.05,14.25,273.0,19
CDM,41400001_1,"Measurement of brain wave activity (EEG), awake and drowsy",1035.0,672.75,258.75,2672.89,19
CDM,41400002_1,"Measurement of brain wave activity (EEG), in coma or asleep",1035.0,672.75,258.75,2672.89,19
CDM,41401001_1,HC LUMBAR PUNCTURE TRAY,28.0,18.2,7.0,19.6,11
CDM,41401002_1,HC KIT SYCHROMED PUMP REFILL,92.0,59.8,23.0,64.4,11
CDM,41410104_1,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",22.0,14.3,0.78,56.82,17
CDM,41410105_1,UNCLASSIFIED DRUGS,2.23,1.45,0.56,5.76,16
CDM,41410108_1,"HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULAR INJECTION, 1 MG",264.0,171.6,8.01,681.78,19
CDM,41412IP _1,UNCLASSIFIED DRUGS,1.42,0.92,0.36,3.67,16
CDM,41418184_1,Measurement of nerve conduction using visual stimulation testing with report,500.0,325.0,125.0,1291.25,19
CDM,41463IP _1,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",12.14,7.89,0.62,8.5,16
CDM,41463OP _1,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",36.73,23.87,0.62,25.71,16
CDM,41464642_1,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, first extremity",1220.0,793.0,305.0,3227.0,19
CDM,41476536_1,Ultrasound scan of head and neck soft tissue,461.0,299.65,115.25,1190.53,18
CDM,41476604_1,Ultrasound scan of chest,600.0,390.0,150.0,1549.5,18
CDM,41476705_1,Limited ultrasound scan of abdomen,511.0,332.15,127.75,1319.66,18
CDM,41476881_1,Complete ultrasound scan of joint,400.0,260.0,100.0,1033.0,18
CDM,41476882_1,Limited ultrasound scan of joint or other extremity structure except blood vessels,400.0,260.0,100.0,1033.0,18
CDM,41476883_1,Comprehensive ultrasound scan of entire length of nerves in extremity,400.0,260.0,100.0,1033.0,18
CDM,41476942_1,Ultrasonic guidance for needle placement,800.0,520.0,163.6,2066.0,18
CDM,41490929_1,Measurement of brain wave activity (EEG) outside the brain during surgery,527.0,342.55,131.75,1360.98,19
CDM,41490974_1,"Needle measurement of electrical activity in arm or leg muscles, 4 extremities",483.0,313.95,120.75,1279.0,19
CDM,41490975_1,Needle measurement of electrical activity in muscles on side of body,318.0,206.7,79.5,1279.0,19
CDM,41490976_1,Needle measurement of electrical activity in muscles on both sides of body,543.0,352.95,135.75,1402.3,19
CDM,41490977_1,"Needle measurement of electrical activity in muscle, including jitter, blocking and/or fiber density",1252.0,813.8,192.82,3233.29,19
CDM,41490985_1,Measurement of brain wave activity (EEG) to evaluate brain death,1849.0,1201.85,462.25,4775.04,19
CDM,41492132_1,Imaging of front third of eye,150.0,97.5,37.5,784.0,19
CDM,41492133_1,Imaging of optic nerve,125.0,81.25,31.25,784.0,19
CDM,41492134_1,Imaging of retina,125.0,81.25,31.25,784.0,19
CDM,41492137_1,Imaging of retina with optical coherence tomography angiography,745.0,484.25,186.25,1923.96,17
CDM,41492653_1,Evaluation of brain response to sound for diagnosis of nervous system disorders with interpretation and report,630.0,409.5,116.19,1626.98,19
CDM,41495700_1,"Measurement of brain wave activity (EEG), continuous",975.0,633.75,243.75,2517.94,19
CDM,41495705_1,"Measurement of brain wave activity (EEG), 2-12 hours",510.0,331.5,127.5,1317.08,19
CDM,41495706_1,"Measurement of brain wave activity (EEG), 2-12 hours with intermittent monitoring",510.0,331.5,127.5,1317.08,19
CDM,41495707_1,"Measurement of brain wave activity (EEG), 2-12 hours with continuous monitoring",510.0,331.5,127.5,1317.08,19
CDM,41495708_1,"Measurement of brain wave activity (EEG), 12-26 hours",975.0,633.75,243.75,2517.94,19
CDM,41495709_1,"Measurement of brain wave activity (EEG), 12-26 hours with intermittent monitoring",975.0,633.75,243.75,2517.94,19
CDM,41495710_1,"Measurement of brain wave activity (EEG), 12-26 hours with continuous monitoring",975.0,633.75,243.75,2517.94,19
CDM,41495711_1,"Measurement of brain wave activity with video (VEEG), 2-12 hours",510.0,331.5,127.5,1317.08,19
CDM,41495712_1,"Measurement of brain wave activity with video (VEEG), 2-12 hours with intermittent monitoring",510.0,331.5,127.5,1317.08,19
CDM,41495713_1,"Measurement of brain wave activity with video (VEEG), 2-12 hours with continuous monitoring",975.0,633.75,243.75,2517.94,19
CDM,41495714_1,"Measurement of brain wave activity with video (VEEG), 12-26 hours",975.0,633.75,243.75,2517.94,19
CDM,41495715_1,"Measurement of brain wave activity with video (VEEG), 12-26 hours with intermittent monitoring",975.0,633.75,243.75,2517.94,19
CDM,41495716_1,"Measurement of brain wave activity with video (VEEG), 12-26 hours with continuous monitoring",1820.0,1183.0,455.0,4700.15,19
CDM,41495800_1,"Measurement of brain wave activity (EEG), 41-60 minutes",1035.0,672.75,258.75,2672.89,19
CDM,41495801_1,"Measurement of brain wave activity (EEG), 61-119 minutes",1035.0,672.75,258.75,2672.89,19
CDM,41495814_1,Measurement of brain wave activity (EEG) during surgery,1900.0,1235.0,475.0,4906.75,19
CDM,41495816_1,"Measurement of brain wave activity (EEG), awake and asleep",1035.0,672.75,258.75,2672.89,19
CDM,41495820_1,"Measurement of brain wave activity (EEG), awake and asleep",1035.0,672.75,258.75,2672.89,19
CDM,41495826_1,"Measurement of brain wave activity (EEG), awake and asleep",1035.0,672.75,258.75,2672.89,19
CDM,41495870_1,"Needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study",234.0,152.1,58.5,1279.0,19
CDM,41495874_1,"Needle measurement of electrical activity in arm or leg muscles, 1 extremity",437.0,284.05,109.25,1279.0,19
CDM,41495876_1,"Needle measurement of electrical activity in arm or leg muscles, 3 extremities",488.0,317.2,122.0,1279.0,19
CDM,41495878_1,"Needle measurement of electrical activity in arm or leg muscles, 2 extremities",648.0,421.2,162.0,1673.46,19
CDM,41495885_1,"Needle measurement of electrical activity in arm or leg muscles, limited study",352.0,228.8,88.0,1279.0,19
CDM,41495886_1,"Needle measurement of electrical activity in arm or leg muscles, complete study",746.0,484.9,186.5,1926.55,19
CDM,41495887_1,Needle measurement of electrical activity in trunk or head muscles,384.0,249.6,96.0,1279.0,19
CDM,41495901_1,Testing of autonomic (sympathetic) nervous system function,746.0,484.9,186.5,1926.55,19
CDM,41495902_1,"Testing of autonomic (sympathetic) nervous system function, heart rate response to breathing exercises, and passive tilt",243.0,157.95,60.75,1279.0,19
CDM,41495903_1,Testing of autonomic nervous system function and heart rate response to deep breathing,382.0,248.3,95.5,1279.0,19
CDM,41495907_1,"Nerve conduction, 1-2 studies",614.0,399.1,153.5,1585.66,19
CDM,41495908_1,"Nerve conduction, 3-4 studies",920.0,598.0,192.82,2375.9,19
CDM,41495909_1,"Nerve conduction, 5-6 studies",1227.0,797.55,192.82,3168.73,19
CDM,41495910_1,"Nerve conduction, 7-8 studies",1534.0,997.1,192.82,3961.56,19
CDM,41495911_1,"Nerve conduction, 9-10 studies",1840.0,1196.0,192.82,4751.8,19
CDM,41495912_1,"Nerve conduction, 11-12 studies",2147.0,1395.55,192.82,5544.63,19
CDM,41495913_1,"Nerve conduction, 13 or more studies",2453.0,1594.45,192.82,6334.87,19
CDM,41495924_1,"Testing of autonomic (sympathetic and parasympathetic) nervous system function, at least 5 minutes of tilt",746.0,484.9,186.5,1926.55,19
CDM,41495933_1,Measurement of nerve conduction patterns of eye blink reflex,437.0,284.05,109.25,1128.55,19
CDM,41495937_1,Testing of nerve-muscle junction,500.0,325.0,125.0,1291.25,19
CDM,41495938_1,Placement of skin electrodes and measurement of stimulated sites on arms and legs,864.12,561.68,192.82,2231.59,19
CDM,41495939_1,Placement of skin electrodes and measurement of central motor stimulation in arms and legs,565.0,367.25,141.25,1459.11,19
CDM,41495965_1,Measurement of brain magnetic field for spontaneous brain magnetic activity,15929.0,10353.85,3384.75,41136.64,19
CDM,41495966_1,"Measurement of brain externally evoked magnetic field, single localization",7709.0,5010.85,1927.25,19908.49,19
CDM,41495967_1,"Measurement of brain externally evoked magnetic field, each additional localization",7709.0,5010.85,1927.25,19908.49,19
CDM,41495970_1,HC MEG RESEARCH PER HOUR,2484.0,1614.6,621.0,1738.8,11
CDM,41495987_1,Measurement of brain wave activity (EEG) in specific area of brain,3756.0,2441.4,482.14,9699.87,19
CDM,41495993_1,Placement of skin electrodes and measurement of stimulated sites in legs,1034.0,672.1,192.82,2670.31,19
CDM,41495994_1,Needle measurement of electrical activity in middle spine muscles,205.0,133.25,51.25,1279.0,19
CDM,41495995_1,Placement of skin electrodes and measurement of stimulated sites in arms,986.0,640.9,192.82,2546.35,19
CDM,41496001_1,"Measurement of brain wave activity (EEG) with electrodes on brain to provoke seizures or identify brain structures, first hour",3306.0,2148.9,482.14,8537.75,19
CDM,41496003_1,Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle,746.0,484.9,186.5,1926.55,19
CDM,41496009_1,HC PUMP REFILL KIT - SYNCHROMED,92.0,59.8,23.0,64.4,11
CDM,41496010_1,Test of electrical activity of 1-12 muscles during functional activities,318.0,206.7,79.5,821.24,19
CDM,41497001_1,HC 3 ARRAY MR/CT CONDITIONAL QC 180MM 1.5M DP CUP,571.0,371.15,142.75,399.7,11
CDM,41497002_1,HC ELECTRODE 27 DEEP CUPS 1.5M,52.0,33.8,13.0,36.4,11
CDM,41509668_1,SPECIALTY SERVICES - TREATMENT ROOM,1133.0,736.45,208.0,793.1,12
CDM,41509669_1,SPECIALTY SERVICES - TREATMENT ROOM,1419.0,922.35,208.0,993.3,12
CDM,41509671_1,Test to measure expiratory airflow and volume,310.0,201.5,77.5,1438.0,19
CDM,41509673_1,Evaluation of use of breathing device,200.0,130.0,50.0,1438.0,19
CDM,41509674_1,Test to measure expiratory airflow and volume changes before and after medication administration,575.0,373.75,143.75,1484.94,19
CDM,41509700_1,Test to measure expiratory airflow and volume,310.0,201.5,77.5,1438.0,19
CDM,41509701_1,Test to measure expiratory airflow and volume changes before and after medication administration,575.0,373.75,143.75,1484.94,19
CDM,41510_1,Suture of tongue to lip to enlarge mouth,1222.2,794.43,78.57,1358.71,19
CDM,41512_1,Permanent suspension of tongue base using sutures,1578.2,1025.83,78.57,1982.72,19
CDM,41518014_1,Test to measure expiratory airflow and volume changes before and after medication administration,575.0,373.75,143.75,1484.94,19
CDM,41518048_1,Test to measure rate of airflow,600.0,390.0,150.0,1549.5,19
CDM,41520T_1,Repair of tissue connecting tongue to floor of mouth,971.3,631.35,78.57,884.47,19
CDM,41520_1,Repair of tissue connecting tongue to floor of mouth,909.3,591.05,78.57,884.47,19
CDM,41530_1,"Destruction of tongue tissue, per session",2295.63,1492.16,78.57,2221.02,19
CDM,41531655_1,Initial therapy service to facilitate lung function,240.0,156.0,60.0,1177.0,19
CDM,41531665_1,Follow-up therapy service to facilitate lung function,162.0,105.3,40.5,1177.0,19
CDM,41548IP _1,FOCALIN XR 10 MG CAPSULE,35.8,23.27,8.95,25.06,11
CDM,41594010_1,Test to measure expiratory airflow and volume,310.0,201.5,77.5,1438.0,19
CDM,41594305_1,HC PEDI SPACER INSTRUCTION,18.0,11.7,4.5,12.6,11
CDM,41594309_1,Test to measure oxygen level in blood using ear or finger device multiple times,260.0,169.0,65.0,1438.0,17
CDM,41594310_1,Test to measure oxygen level in blood using ear or finger device,58.0,37.7,14.5,1438.0,17
CDM,41594617_1,Test for exercise-induced spasm of lung airways,493.0,320.45,83.86,1438.0,19
CDM,41594618_1,Test for exercise-induced lung stress,300.0,195.0,75.0,1438.0,19
CDM,41594619_1,Exercise test for spasm of lung airways,300.0,195.0,75.0,1438.0,19
CDM,41594664_1,Evaluation of use of breathing device,200.0,130.0,50.0,1438.0,19
CDM,41594668_1,Evaluation of use of breathing device,200.0,130.0,50.0,1438.0,19
CDM,41594674_1,Inhalation treatment for airway obstruction or sputum production,480.0,312.0,83.86,1239.6,19
CDM,41595923_1,Testing of autonomic (sympathetic) nervous system function,373.0,242.45,93.25,1279.0,19
CDM,41598527_1,HC PEDS BRONCHOSCOPE SETUP & CLEANING,103.0,66.95,25.75,72.1,11
CDM,41598IP _1,"INJECTION, OXALIPLATIN, 0.5 MG",4.77,3.1,0.05,14.31,17
CDM,41598OP _1,"INJECTION, OXALIPLATIN, 0.5 MG",32.71,21.26,0.05,98.13,17
CDM,41611122_1,Test to measure expiratory airflow and volume,310.0,201.5,77.5,1438.0,19
CDM,41611140_1,HC ADHESIVE FINGER BT SENSOR,112.5,73.13,28.13,78.75,11
CDM,41618014_1,Test to measure expiratory airflow and volume changes before and after medication administration,575.0,373.75,143.75,1484.94,19
CDM,41618015_1,Test to measure expiratory airflow and volume,310.0,201.5,77.5,1438.0,19
CDM,41618016_1,Test to measure lung airway sensitivity,1211.0,787.15,150.1,3127.41,19
CDM,41618024_1,Test to measure expiratory airflow and volume,310.0,201.5,77.5,1438.0,19
CDM,41618030_1,HC ASCOPE 4 RHINOLARYNGO SLIM VP,765.0,497.25,191.25,535.5,11
CDM,41618048_1,Test to measure rate of airflow,600.0,390.0,150.0,1549.5,19
CDM,41623IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.75,1.79,0.69,7.1,16
CDM,41631634_1,Test to measure exhaled air and carbon dioxide for evaluation of lung function,747.0,485.55,150.1,1929.13,19
CDM,41631654_1,Test to measure oxygen level in blood using ear or finger device continuously overnight,320.0,208.0,80.0,1438.0,19
CDM,41631655_1,Evaluation of use of breathing device,240.0,156.0,60.0,1177.0,19
CDM,41631656_1,"PEAK EXPIRATORY FLOW RATE METER, HAND HELD",71.0,46.15,17.75,49.7,16
CDM,41631658_1,Follow-up therapy service to facilitate lung function,540.0,351.0,83.86,1394.55,19
CDM,41631664_1,Inhalation treatment for airway obstruction or sputum production,480.0,312.0,83.86,1239.6,19
CDM,41631665_1,Inhalation treatment for airway obstruction or sputum production,480.0,312.0,83.86,1239.6,19
CDM,41652IP _1,"INJECTION, TIGECYCLINE, 1 MG",242.3,157.5,0.59,625.74,17
CDM,41673OP _1,"INJECTION, VINORELBINE TARTRATE, 10 MG",32.56,21.16,5.77,97.68,17
CDM,41693015_1,Test for exercise-induced lung stress,560.0,364.0,83.86,1446.2,19
CDM,41694010_1,Test to measure expiratory airflow and volume,310.0,201.5,77.5,1438.0,19
CDM,41694305_1,HC SPACER INSTRUCTION,18.0,11.7,4.5,12.6,11
CDM,41694309_1,Test to measure oxygen level in blood using ear or finger device multiple times,290.0,188.5,72.5,1438.0,17
CDM,41694310_1,Test to measure oxygen level in blood using ear or finger device,58.0,37.7,14.5,1438.0,17
CDM,41694617_1,Test for exercise-induced spasm of lung airways,493.0,320.45,83.86,1438.0,19
CDM,41694618_1,Test for exercise-induced lung stress,300.0,195.0,75.0,1438.0,19
CDM,41694619_1,Exercise test for spasm of lung airways,300.0,195.0,75.0,1438.0,19
CDM,41694621_1,Test for exercise-induced heart and lung stress,1250.0,812.5,150.1,3228.13,19
CDM,41694799_1,Other service or procedure on lung,707.0,459.55,83.86,1825.83,19
CDM,41698527_1,HC BRONCHOSCOPE SETUP & CLEANING,103.0,66.95,25.75,72.1,11
CDM,41698540_1,Diagnostic exam of voice box using a flexible endoscope,370.0,240.5,92.5,1438.0,19
CDM,41700009_1,RECOVERY ROOM - GENERAL CLASSIFICATION,1888.0,1227.2,472.0,1321.6,11
CDM,41700010_1,RECOVERY ROOM - GENERAL CLASSIFICATION,1282.0,833.3,320.5,897.4,11
CDM,41700013_1,RECOVERY ROOM - GENERAL CLASSIFICATION,336.0,218.4,84.0,235.2,11
CDM,41700030_1,HC CATH LAB MONITOR CABLES,200.0,130.0,50.0,140.0,11
CDM,41700238_1,"Catheter removal of plaque from groin artery, accessed through the skin or open procedure including radiological supervision and interpretation",14490.0,9418.5,3622.5,37420.43,19
CDM,4170234T_1,"Catheter removal of plaque from kidney artery, accessed through the skin or open procedure including radiological supervision and interpretation",24785.0,16110.25,6141.01,64007.26,19
CDM,41702960_1,External shock to heart to regulate heart beat,2388.0,1552.2,597.0,6167.01,18
CDM,41703285_1,Insertion of heart rhythm monitor under skin,19840.98,12896.64,1052.0,51239.33,19
CDM,41703286_1,Removal of heart rhythm monitor from under the skin,1160.0,754.0,290.0,2995.7,19
CDM,4170338T_1,Destruction of nerves of arteries of both kidneys accessed through the skin with fluoroscopy and radiological supervision and interpretation,13100.0,8515.0,3275.0,33830.75,19
CDM,4170339T_1,Destruction of nerves of arteries of one kidney accessed through the skin with fluoroscopy and radiological supervision and interpretation,13100.0,8515.0,3275.0,33830.75,19
CDM,4170408T_1,Insertion or replacement of pulse generator and electrodes of heart contractility modulator system,77147.0,50145.55,7667.55,199232.13,19
CDM,4170412T_1,Removal of pulse generator for heart contractility modulator system,8753.0,5689.45,2188.25,22604.62,19
CDM,4170413T_1,Removal of electrode for heart contractility modulator system,8753.0,5689.45,2188.25,22604.62,19
CDM,4170483T_1,"Insertion of artificial valve between left heart chambers, accessed through the skin",34894.0,22681.1,3678.0,90113.76,19
CDM,4170523T_1,Measurement fractional flow reserve in arteries of heart with 3D functional mapping during procedure,4102.0,2666.3,1025.5,10593.42,16
CDM,4170569T_1,"Repair of valve between upper right and lower right chambers of heart (tricuspid valve) using prosthesis delivered via catheter, accessed through skin; initial prosthesis",10000.0,6500.0,2500.0,25825.0,18
CDM,4170570T_1,"Repair of valve between upper right and lower right chambers of heart (tricuspid valve) using prosthesis delivered via catheter, accessed through skin; each additional prosthesis",5000.0,3250.0,1250.0,21409.87,17
CDM,4170571T_1,Insertion or replacement of implantable cardioverter-defibrillator system with electrodes under breastbone,75400.0,49010.0,9592.09,194720.5,18
CDM,4170573T_1,Removal of implantable defibrillator electrode from under breastbone,8753.0,5689.45,2188.25,22604.62,17
CDM,4170580T_1,Removal of implantable defibrillator pulse generator from under breastbone,8753.0,5689.45,2188.25,22604.62,17
CDM,4170644T_1,Removal or reduction of mass within heart by suction through catheter,12545.0,8154.25,3136.25,32397.46,17
CDM,4170646T_1,Implantation of artificial valve between right upper and lower chambers of heart through catheter,30000.0,19500.0,7500.0,77475.0,17
CDM,4170795T_1,Transcatheter insertion of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right atrial and right ventricular pacemaker components,45900.0,29835.0,11447.48,118536.75,18
CDM,4170801T_1,Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right atrial and right ventricular components,45900.0,29835.0,11447.48,118536.75,18
CDM,4170823T_1,Insertion of permanent single-chamber leadless pacemaker for pacing the right upper heart chamber using imaging guidance,44650.0,29022.5,1155.0,115308.63,17
CDM,4170824T_1,Removal of permanent single-chamber leadless pacemaker for pacing the right upper chamber of the heart using imaging guidance,7310.0,4751.5,1155.0,18878.08,17
CDM,4170825T_1,Removal and replacement of single-chamber permanent leadless pacemaker for pacing the right upper chamber of the heart using imaging guidance,44650.0,29022.5,11162.5,115308.63,16
CDM,4170826T_1,In-person device evaluation of single-chamber leadless pacemaker system,90.0,58.5,22.5,232.43,16
CDM,4170861T_1,Removal of battery and transmitter of wireless cardiac stimulator for pacing of left lower chamber of heart,9000.0,5850.0,2250.0,23242.5,16
CDM,4170862T_1,Relocation of battery of wireless cardiac stimulator for pacing of left lower chamber of heart,4200.0,2730.0,1050.0,10846.5,16
CDM,4170863T_1,Relocation of transmitter of wireless cardiac stimulator for pacing of left lower chamber of heart,4200.0,2730.0,1050.0,10846.5,16
CDM,4170913T_1,"Transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon, with imaging supervision, interpretation, and report, performed on a single major coronary artery or branch",12830.0,8339.5,3207.5,33133.48,15
CDM,4170914T_1,"Transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon, performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement ",7500.0,4875.0,1875.0,19368.75,15
CDM,4170915T_1,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), pulse generator and dual transvenous electrodes/leads",72130.0,46884.5,18032.5,186275.73,15
CDM,4170916T_1,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), pulse generator only",50500.0,32825.0,12625.0,130416.25,16
CDM,4170917T_1,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), single transvenous lead only",18620.0,12103.0,476.0,48086.15,17
CDM,4170918T_1,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), dual transvenous leads only",18620.0,12103.0,4655.0,48086.15,16
CDM,4170919T_1,"Removal of a permanent cardiac contractility modulation-defibrillation system component(s), pulse generator only",8190.0,5323.5,2047.5,21150.68,16
CDM,4170920T_1,"Removal of a permanent cardiac contractility modulation-defibrillation system component(s), single transvenous pacing lead only",8190.0,5323.5,2047.5,21150.68,16
CDM,4170921T_1,"Removal of a permanent cardiac contractility modulation-defibrillation system component(s), single transvenous defibrillation lead only",8190.0,5323.5,2047.5,21150.68,16
CDM,4170922T_1,"Removal of a permanent cardiac contractility modulation-defibrillation system component(s), dual transvenous leads only",8190.0,5323.5,2047.5,21150.68,16
CDM,4170923T_1,Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only,8190.0,5323.5,2047.5,21150.68,16
CDM,4170924T_1,Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s),1550.0,1007.5,387.5,4002.88,16
CDM,4170925T_1,Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator,4125.0,2681.25,1031.25,10652.81,16
CDM,4170930T_1,"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, at time of initial implantation or replacement with testing of cardiac contractility modulation-defibrillator pul",2750.0,1787.5,687.5,7101.88,16
CDM,4170931T_1,"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, separate from initial implantation or replacement with testing of cardiac contractility modulation-defibrillator ",2750.0,1787.5,687.5,7101.88,16
CDM,4170994T_1,"ENDOVASCULAR DELIVERY OF AORTIC WALL STABILIZATION DRUG THERAPY THROUGH A SHEATH POSITIONED WITHIN AN ABDOMINAL AORTIC ANEURYSM, WITH AORTIC ROADMAPPING, BALLOON OCCLUSION, IMAGING GUIDANCE, AND RADIO",15000.0,9750.0,3750.0,38737.5,16
CDM,4170995T_1,"ENDOVASCULAR DELIVERY OF AORTIC WALL STABILIZATION DRUG THERAPY THROUGH A SHEATH POSITIONED WITHIN AN ABDOMINAL AORTIC ANEURYSM, WITH AORTIC ROADMAPPING, BALLOON OCCLUSION, IMAGING GUIDANCE, AND RADIO",25000.0,16250.0,6250.0,64562.5,16
CDM,41710100_1,Other cardiovascular service or procedure,655.0,425.75,37.41,1691.54,18
CDM,41710140_1,Drainage of blood or fluid accumulation,1500.0,975.0,375.0,3873.75,19
CDM,41711042_1,"Removal of skin and tissue, 20.0 sq cm or less",914.0,594.1,228.5,2360.41,19
CDM,41730009_1,RECOVERY ROOM - GENERAL CLASSIFICATION,333.0,216.45,83.25,233.1,11
CDM,41733016_1,Drainage of heart sac using imaging guidance,3265.0,2122.25,816.25,8431.86,18
CDM,41733017_1,Drainage of heart sac using tube and imaging guidance (6 years or older),4000.0,2600.0,1000.0,10330.0,18
CDM,41733025_1,Surgical removal of piece of sac covering heart for drainage,4385.0,2850.25,1096.25,16106.13,19
CDM,41733206_1,Insertion of pacemaker and upper heart chamber electrode,24425.0,15876.25,6106.25,63077.56,18
CDM,41733207_1,Insertion of pacemaker and lower heart chamber electrode,24481.0,15912.65,6120.25,63222.18,18
CDM,41733208_1,Insertion of pacemaker and upper and lower heart chamber electrode,26162.0,17005.3,6540.5,67563.37,18
CDM,41733210_1,Insertion of temporary pacemaker lead in single heart chamber,19450.0,12642.5,2281.97,50229.63,18
CDM,41733211_1,Insertion of temporary pacemaker lead in upper and lower heart chambers,19450.0,12642.5,2281.97,50229.63,18
CDM,41733213_1,Insertion of pacemaker pulse generator with existing dual leads,18151.0,11798.15,4537.75,46874.96,18
CDM,41733214_1,Insertion of 2 chamber pacemaker system,28230.0,18349.5,7057.5,72903.98,18
CDM,41733215_1,Repositioning of pacemaker or defibrillator electrode,16639.0,10815.35,2281.97,42970.22,18
CDM,41733216_1,Insertion of 1 electrode for permanent pacemaker or defibrillator,20921.0,13598.65,2281.97,54028.48,18
CDM,41733221_1,Insertion of pacemaker pulse generator with existing multiple leads,32259.0,20968.35,8064.75,83308.87,18
CDM,41733222_1,Relocation of pacemaker skin pocket,9113.0,5923.45,2278.25,23534.32,18
CDM,41733223_1,Relocation of defibrillator skin pocket,9113.0,5923.45,2278.25,23534.32,18
CDM,41733225_1,Insertion of left lower heart electrode for pacemaker or defibrillator,17374.0,11293.1,4343.5,44868.36,18
CDM,41733227_1,Removal and replacement of single lead permanent pacemaker,18767.0,12198.55,1052.0,48465.78,19
CDM,41733228_1,Removal and replacement of dual lead permanent pacemaker,19440.0,12636.0,1052.0,50203.8,19
CDM,41733229_1,Removal and replacement of multiple lead permanent pacemaker,29570.0,19220.5,1052.0,76364.53,19
CDM,41733230_1,Insertion of defibrillator with existing dual leads,65973.0,42882.45,1052.0,170375.27,19
CDM,41733231_1,Insertion of defibrillator with existing multiple leads,91543.0,59502.95,22885.75,236409.8,18
CDM,41733233_1,Removal of permanent pacemaker pulse generator,11057.0,7187.05,2764.25,28554.7,18
CDM,41733235_1,Removal of dual electrodes from right heart,16586.0,10780.9,2281.97,42833.35,18
CDM,41733241_1,Removal of defibrillator,8895.0,5781.75,1052.0,22971.34,19
CDM,41733244_1,Removal of defibrillator electrodes through vein,8895.0,5781.75,1052.0,22971.34,19
CDM,41733249_1,Insertion of implantable defibrillator system,75400.0,49010.0,18850.0,194720.5,18
CDM,41733254_1,Partial destruction and reconstruction of upper heart chamber,11852.0,7703.8,2963.0,30607.79,19
CDM,41733262_1,Removal and replacement of single lead defibrillator,65973.0,42882.45,1052.0,170375.27,19
CDM,41733263_1,Removal and replacement of dual lead defibrillator,65973.0,42882.45,1052.0,170375.27,19
CDM,41733264_1,Removal and replacement of multiple lead defibrillator,68450.0,44492.5,17112.5,176772.13,18
CDM,41733270_1,Insertion or replacement of defibrillator with electrode,92880.0,60372.0,18055.0,239862.6,19
CDM,41733271_1,Insertion of defibrillator electrode,18266.0,11872.9,2281.97,47171.95,19
CDM,41733272_1,Removal of defibrillator electrode,11658.0,7577.7,2281.97,30106.79,19
CDM,41733273_1,Repositioning of defibrillator electrode,12220.0,7943.0,2281.97,31558.15,19
CDM,41733274_1,Insertion of permanent leadless pacemaker using imaging guidance,30709.0,19960.85,1052.0,79305.99,19
CDM,41733275_1,Removal of permanent leadless pacemaker using imaging guidance,5285.0,3435.25,1052.0,13648.51,19
CDM,41733285_1,Insertion of heart rhythm monitor under skin,19841.0,12896.65,1052.0,51239.38,19
CDM,41733286_1,Removal of heart rhythm monitor from under the skin,1160.0,754.0,290.0,2995.7,19
CDM,41733289_1,Insertion of wireless pressure sensor into lung artery through tube with review by radiologist,58690.0,38148.5,14672.5,151566.93,18
CDM,41733305_1,Repair of wound to heart on heart-lung machine,25000.0,16250.0,3678.0,64562.5,19
CDM,41733322_1,Repair of aorta or great vessels with sutures on heart-lung machine,12000.0,7800.0,3000.0,30990.0,19
CDM,41733340_1,Repair of left upper heart chamber with implant with review by radiologist,12000.0,7800.0,3000.0,30990.0,18
CDM,41733361_1,Replacement of aortic valve through the skin and femoral artery,35652.0,23173.8,3678.0,92071.29,19
CDM,41733370_1,Placement and subsequent removal of device to protect brain from embolism through catheter using imaging guidance,18850.0,12252.5,1242.0,48680.13,19
CDM,41733418_1,"Repair of mitral valve through the skin, initial prosthesis",34894.0,22681.1,3678.0,90113.76,19
CDM,41733419_1,"Repair of mitral valve through the skin, additional prosthesis",16645.0,10819.25,1242.0,77736.68,19
CDM,41733477_1,Insertion of pulmonary valve,9700.0,6305.0,2425.0,77736.68,19
CDM,41733741_1,"Incision of partition between upper chambers of heart to allow blood flow for congenital heart defects, via catheter using imaging guidance",15000.0,9750.0,3678.0,38737.5,19
CDM,41733745_1,"Creation of shunt for blood flow within heart for congenital heart defects, via catheter using imaging guidance",15000.0,9750.0,3678.0,38737.5,19
CDM,41733880_1,Repair of descending aorta and subclavian artery with insertion of graft and extensions,33572.0,21821.8,3678.0,86699.69,19
CDM,41733881_1,Repair of descending aorta with insertion of graft and extensions,35191.0,22874.15,3678.0,90880.76,19
CDM,41733894_1,Repair of aorta by insertion of stent across major side branches,9700.0,6305.0,2425.0,25050.25,19
CDM,41733895_1,Repair of aorta by insertion of stent not crossing major side branches,9500.0,6175.0,2375.0,24533.75,19
CDM,41733897_1,Balloon dilation of native or recurrent narrowing of heart blood vessel,15000.0,9750.0,3678.0,38737.5,19
CDM,41733902_1,"Placement of stent in pulmonary artery with abnormal anatomical connections, on one side of body",40182.0,26118.3,10045.5,103770.02,18
CDM,41733903_1,"Placement of stent in pulmonary arteries with abnormal anatomical connections, on both sides of body",27275.0,17728.75,6818.75,70437.69,18
CDM,41733946_1,Initiation of ECMO external vein to vein blood circulation in heart and lungs using a pump,6339.0,4120.35,1584.75,16370.47,19
CDM,41733947_1,Initiation of ECMO external vein to artery blood circulation in heart and lungs using a pump,4500.0,2925.0,1125.0,11621.25,19
CDM,41733948_1,Daily management of ECMO external vein to vein blood circulation in heart and lungs using a pump,6339.0,4120.35,1584.75,16370.47,19
CDM,41733958_1,Repositioning of tube for ECMO external blood circulation in heart and lungs using a pump (6 years or older),6339.0,4120.35,1584.75,16370.47,19
CDM,41733967_1,Insertion of blood flow assist device in aorta through skin,4475.0,2908.75,1118.75,11676.43,18
CDM,41733968_1,Removal of blood flow assist device in aorta,1500.0,975.0,375.0,17036.0,19
CDM,41733973_1,Insertion of blood flow assist device in aorta through ascending aorta,4475.0,2908.75,1118.75,14138.43,19
CDM,41733974_1,Removal of blood flow assist device in aorta with repair of ascending aorta,1500.0,975.0,375.0,14138.43,19
CDM,41733984_1,Removal of tube for ECMO external blood circulation in heart and lungs using a pump (6 years or older),1690.0,1098.5,422.5,10301.94,19
CDM,41733990_1,Insertion of blood flow assist device in lower heart chamber through skin with review by radiologist using artery access,6339.0,4120.35,1584.75,43784.36,18
CDM,41733991_1,Insertion of blood flow assist device in lower heart chamber through skin with review by radiologist using artery and vein access,1450.0,942.5,362.5,43784.36,19
CDM,41733992_1,Removal of blood flow assist device in left lower heart chamber through the skin,10000.0,6500.0,2500.0,25825.0,18
CDM,41733993_1,Repositioning of blood flow assist device in lower heart chamber using imaging guidance,1391.5,904.48,347.88,10722.03,19
CDM,41733995_1,"Insertion of right lower heart chamber blood flow assist device via vein accessed through skin, including radiological supervision and interpretation",6500.0,4225.0,1625.0,43784.36,18
CDM,41733999_1,Other heart surgery procedure,13855.0,9005.75,3047.23,35780.54,19
CDM,41734502_1,Reconstruction of vena cava,7305.0,4748.25,1826.25,18865.16,19
CDM,41735141_1,Repair of aneurysm or upper thigh artery with graft,1690.0,1098.5,422.5,8477.27,19
CDM,41735201_1,Repair of blood vessel of neck,12593.0,8185.45,3047.23,32521.42,19
CDM,41735211_1,Repair of blood vessel of chest on heart-lung machine,1561.0,1014.65,390.25,14138.43,19
CDM,41735226_1,Repair of blood vessel of leg,1561.0,1014.65,390.25,7016.18,19
CDM,41735271_1,Repair of blood vessel of chest with graft on heart-lung machine,12593.0,8185.45,3148.25,32521.42,19
CDM,41735286_1,Repair of blood vessel of leg with graft,4955.0,3220.75,1238.75,12796.29,19
CDM,41735820_1,"Exploration of chest for bleeding, blood clot, or infection after surgery",7165.0,4657.25,1791.25,18503.61,19
CDM,41736005_1,Injection for X-ray imaging procedure into vein of arm or leg,555.0,360.75,138.75,2166.29,19
CDM,41736011_1,"Insertion of tube into vein, first order branch",2764.5,1796.93,691.13,7139.32,18
CDM,41736200_1,Insertion of tube into aorta,1621.0,1053.65,405.25,4186.23,18
CDM,41736215_1,"Insertion of tube into chest or arm artery, each first order branch",1500.0,975.0,375.0,3873.75,19
CDM,41736251_1,Insertion of tube into first order main and accessory arteries of kidney for imaging with review by radiologist,7570.0,4920.5,1892.5,19549.53,18
CDM,41736252_1,Insertion of tube into first order main and accessory arteries of both kidneys for imaging with review by radiologist,3556.0,2311.4,889.0,9183.37,18
CDM,41736556_1,Insertion of non-tunneled central venous tube for infusion (5 years or older),2621.0,1703.65,655.25,6768.73,18
CDM,41736558_1,Insertion of tunneled central venous tube for infusion (5 years or older),9639.0,6265.35,2409.75,24892.72,18
CDM,41736580_1,Replacement of nontunneled central venous tube,4216.0,2740.4,1054.0,10887.82,19
CDM,41736581_1,Replacement of tunneled central venous tube,7305.0,4748.25,1826.25,18865.16,18
CDM,41736589_1,Removal of tunneled central venous tube,3948.0,2566.2,987.0,10195.71,19
CDM,41736620_1,Insertion of artery tube for blood sampling or infusion through skin,589.0,382.85,147.25,1521.09,18
CDM,41736901_1,Insertion of needle and/or tube into hemodialysis circuit with review by radiologist,1831.0,1190.15,457.75,4728.56,19
CDM,41736902_1,Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,15254.0,9915.1,3813.5,39393.46,18
CDM,41736903_1,Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist,31576.0,20524.4,7894.0,81545.02,18
CDM,41736905_1,"Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube",31576.0,20524.4,7894.0,81545.02,18
CDM,41736906_1,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment and placement of stent with review by radiologist,48051.0,31233.15,12012.75,124091.71,18
CDM,41736907_1,Balloon dilation of dialysis segment with review by radiologist,13001.0,8450.65,1242.0,33575.08,19
CDM,41736909_1,Permanent blockage of hemodialysis circuit with review by radiologist,5874.0,3818.1,1468.5,15873.48,18
CDM,41737197_1,Retrieval of foreign body in blood vessel with review by radiologist,6832.0,4440.8,1708.0,17643.64,18
CDM,41737200_1,Biopsy of blood vessel using tube,4150.0,2697.5,1037.5,10717.38,19
CDM,41737224_1,Balloon dilation of artery of leg,18966.0,12327.9,4741.5,48979.7,18
CDM,41737225_1,Removal of plaque in arteries of leg,27669.0,17984.85,6917.25,71455.19,18
CDM,41737236_1,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, initial artery",15766.0,10247.9,3941.5,40715.7,18
CDM,41737237_1,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, each additional artery",7568.0,4919.2,1892.0,19544.36,18
CDM,41737238_1,"Insertion of stent in vein with review by radiologist, initial vein",25330.0,16464.5,6332.5,65414.73,18
CDM,41737239_1,"Insertion of stent in vein with review by radiologist, each additional vein",12665.0,8232.25,3166.25,32707.36,18
CDM,41737241_1,Occlusion of vein with review by radiologist,25209.0,16385.85,6302.25,65102.24,18
CDM,41737242_1,Occlusion of artery with review by radiologist,15766.0,10247.9,3941.5,40715.7,18
CDM,41737246_1,"Balloon dilation of artery with review by radiologist, initial artery",22881.0,14872.65,5360.09,59090.18,18
CDM,41737247_1,"Balloon dilation of artery with review by radiologist, each additional artery",7475.0,4858.75,1868.75,19304.19,18
CDM,41737248_1,"Balloon dilation of vein with review by radiologist, initial vein",18637.5,12114.38,4659.38,48131.34,18
CDM,41737249_1,"Balloon dilation of vein with review by radiologist, each additional vein",3732.0,2425.8,933.0,9637.89,18
CDM,41737254_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",14540.0,9451.0,3635.0,37549.55,16
CDM,41737255_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",7270.0,4725.5,1817.5,18774.78,16
CDM,41737256_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",14540.0,9451.0,3635.0,37549.55,16
CDM,41737257_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",7270.0,4725.5,1817.5,18774.78,16
CDM,41737258_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",29490.0,19168.5,7372.5,76157.93,16
CDM,41737259_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",14745.0,9584.25,3686.25,38078.96,16
CDM,41737260_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",29490.0,19168.5,7372.5,76157.93,16
CDM,41737261_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",14745.0,9584.25,3686.25,38078.96,16
CDM,41737263_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",14540.0,9451.0,3635.0,37549.55,16
CDM,41737264_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",7270.0,4725.5,1817.5,18774.78,16
CDM,41737265_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",14540.0,9451.0,3635.0,37549.55,16
CDM,41737266_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",7270.0,4725.5,1817.5,18774.78,16
CDM,41737267_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",29490.0,19168.5,7372.5,76157.93,16
CDM,41737268_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",14745.0,9584.25,3686.25,38078.96,16
CDM,41737269_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",29490.0,19168.5,7372.5,76157.93,16
CDM,41737270_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",14745.0,9584.25,3686.25,38078.96,16
CDM,41737271_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",46830.0,30439.5,11707.5,120938.48,16
CDM,41737272_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",23415.0,15219.75,5853.75,60469.24,16
CDM,41737273_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",46830.0,30439.5,11707.5,120938.48,16
CDM,41737274_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",23415.0,15219.75,5853.75,60469.24,16
CDM,41737275_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",46830.0,30439.5,11707.5,120938.48,16
CDM,41737276_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",23415.0,15219.75,5853.75,60469.24,16
CDM,41737277_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",46830.0,30439.5,11707.5,120938.48,16
CDM,41737278_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",23415.0,15219.75,5853.75,60469.24,16
CDM,41737279_1,"INTRAVASCULAR LITHOTRIPSY(IES), FEMORAL AND POPLITEAL VASCULAR TERRITORY, INCLUDING ALL IMAGING GUIDANCE AND RADIOLOGICAL SUPERVISION AND INTERPRETATION NECESSARY TO PERFORM THE INTRAVASCULAR LITHOTRI",11008.0,7155.2,2752.0,28428.16,16
CDM,41737280_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",29490.0,19168.5,7372.5,76157.93,16
CDM,41737281_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",14745.0,9584.25,3686.25,38078.96,16
CDM,41737282_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",29490.0,19168.5,7372.5,76157.93,16
CDM,41737283_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",14745.0,9584.25,3686.25,38078.96,16
CDM,41737284_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",46830.0,30439.5,11707.5,120938.48,16
CDM,41737285_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",23415.0,15219.75,5853.75,60469.24,16
CDM,41737286_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",46830.0,30439.5,11707.5,120938.48,16
CDM,41737287_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",23415.0,15219.75,5853.75,60469.24,16
CDM,41737288_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",46830.0,30439.5,11707.5,120938.48,16
CDM,41737289_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",23415.0,15219.75,5853.75,60469.24,16
CDM,41737290_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",46830.0,30439.5,11707.5,120938.48,16
CDM,41737291_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",23415.0,15219.75,5853.75,60469.24,16
CDM,41737292_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",46830.0,30439.5,11707.5,120938.48,16
CDM,41737293_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",23415.0,15219.75,5853.75,60469.24,16
CDM,41737294_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",46830.0,30439.5,11707.5,120938.48,16
CDM,41737295_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",23415.0,15219.75,5853.75,60469.24,16
CDM,41737296_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",29490.0,19168.5,7372.5,76157.93,16
CDM,41737297_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",14745.0,9584.25,3686.25,38078.96,16
CDM,41737298_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",29490.0,19168.5,7372.5,76157.93,16
CDM,41737299_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",14745.0,9584.25,3686.25,38078.96,16
CDM,41737618_1,Tying of major arm or leg artery,4000.0,2600.0,1000.0,10330.0,19
CDM,41737799_1,Other procedure on blood vessel,1440.0,936.0,360.0,3718.8,19
CDM,41739010_1,"Exploration, drainage, biopsy, or removal of foreign body in chest cavity",6339.0,4120.35,1584.75,16370.47,19
CDM,41749406_1,Drainage of fluid collection of abdominal cavity by tube using imaging guidance,9537.0,6199.05,1049.65,24629.3,18
CDM,41749418_1,Insertion of abdominal tube using imaging guidance with review by radiologist,5716.0,3715.4,1429.0,14761.57,19
CDM,41749450_1,Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast,2320.0,1508.0,565.93,5991.4,19
CDM,41775580_1,"Analysis of data from CT study of heart blood vessels to assess severity of heart artery disease, with interpretation and report",3740.0,2431.0,935.0,9658.55,16
CDM,41775625_1,Review by radiologist of abdominal aorta image,5490.0,3568.5,1372.5,14177.93,18
CDM,41775630_1,Review by radiologist of abdominal aorta and both leg arteries image,7305.0,4748.25,1826.25,18865.16,18
CDM,41775710_1,Review by radiologist of arm or leg artery image,8065.0,5242.25,2016.25,20827.86,18
CDM,41775716_1,Review by radiologist of both arms or legs arteries image,8605.0,5593.25,2151.25,22222.41,18
CDM,41775743_1,Review by radiologist of arteries of both lungs image,7305.0,4748.25,1826.25,18865.16,18
CDM,41775820_1,Review by radiologist of 1 arm or leg vein of 1 arm or leg image,1728.0,1123.2,432.0,4462.56,18
CDM,41775822_1,Review by radiologist of both arms and legs veins of both arms or legs image,2265.0,1472.25,566.25,5849.36,18
CDM,41775825_1,Review by radiologist of major lower body vein image,6820.0,4433.0,1705.0,17612.65,18
CDM,41775827_1,Review by radiologist of major upper body vein image,4020.0,2613.0,1005.0,10381.65,18
CDM,41775889_1,Review by radiologist of liver vein image with assessment of blood flow,6820.0,4433.0,1705.0,17612.65,18
CDM,41775956_1,ENDOVASCULAR REPAIR OF THE THORACIC AORTA BY DEPLOYMENT OF A BRANCHED ENDOGRAFT MULTIPIECE SYSTEM INVOLVING AN AORTO-AORTIC TUBE DEVICE WITH A FENESTRATION FOR THE LEFT SUBCLAVIAN ARTERY STENT GRAFT(S,3100.0,2015.0,775.0,8005.75,16
CDM,41775957_1,ENDOVASCULAR REPAIR OF THE THORACIC AORTA BY DEPLOYMENT OF A BRANCHED ENDOGRAFT MULTIPIECE SYSTEM INVOLVING AN AORTO-AORTIC TUBE DEVICE WITH A FENESTRATION FOR THE LEFT SUBCLAVIAN ARTERY STENT GRAFT(S,3000.0,1950.0,750.0,7747.5,16
CDM,41775958_1,Review by radiologist of image for insertion of extension,5000.0,3250.0,294.16,12912.5,18
CDM,41775970_1,Review by radiologist of image for biopsy of blood vessel with tube,2250.0,1462.5,294.16,5810.63,18
CDM,41776604_1,Ultrasound scan of chest,600.0,390.0,150.0,1549.5,18
CDM,41776937_1,Ultrasonic guidance for blood vessel access,650.0,422.5,162.5,1678.63,18
CDM,41777001_1,Fluoroscopic guidance for insertion or removal of central vein access device,657.0,427.05,164.25,1696.7,18
CDM,41780000_1,RECOVERY ROOM - GENERAL CLASSIFICATION,1234.16,802.2,308.54,863.91,11
CDM,41787IP _1,UNCLASSIFIED DRUGS,244.41,158.87,61.1,631.19,16
CDM,41787OP _1,UNCLASSIFIED DRUGS,189.41,123.12,47.35,489.15,16
CDM,41792920_1,Balloon dilation of single coronary artery or branch,11700.0,7605.0,2925.0,30215.25,18
CDM,41792921_1,Balloon dilation of single coronary artery or branch,3556.0,2311.4,889.0,12169.11,18
CDM,41792924_1,Removal of plaque with balloon dilation of single coronary artery or branch,20460.0,13299.0,5115.0,52837.95,18
CDM,41792925_1,Removal of plaque with balloon dilation of single coronary artery or branch,3556.0,2311.4,889.0,12169.11,18
CDM,41792928_1,"Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch",21889.0,14227.85,5472.25,56528.34,18
CDM,41792929_1,"Insertion of stents with balloon dilation of coronary artery or branch, each additional artery or branch",14717.0,9566.05,3679.25,38006.65,18
CDM,41792930_1,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED, SINGLE MAJOR CORONARY ARTERY AND/OR ITS BRANCH(ES); 2 OR MORE DISTINCT CORONARY LESIONS WITH 2",46830.0,30439.5,11707.5,120938.48,16
CDM,41792933_1,"Removal of plaque, insertion of stent and balloon dilation of single coronary artery or branch",21336.0,13868.4,5334.0,55100.22,18
CDM,41792934_1,"Removal of plaque, insertion of stent and balloon dilation of single coronary artery or branch",14717.0,9566.05,3679.25,38006.65,18
CDM,41792937_1,"Removal of plaque, insertion of stent and/or balloon dilation of single coronary vessel with distal protection",21336.0,13868.4,5334.0,55100.22,18
CDM,41792938_1,"Removal of plaque, insertion of stent and/or balloon dilation of single coronary vessel with distal protection",14717.0,9566.05,3679.25,38006.65,18
CDM,41792941_1,"Removal of plaque and blood clot, insertion of stent and/or balloon dilation of single vessel",29245.0,19009.25,7311.25,75525.21,18
CDM,41792943_1,"Removal of plaque, insertion of stent and/or balloon dilation of single coronary artery, branch or bypass graft",21336.0,13868.4,5334.0,55100.22,18
CDM,41792944_1,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, SINGLE CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, AND/OR SUBTENDED MAJOR CORONARY ARTERY BRANCHES",14717.0,9566.05,3679.25,38006.65,16
CDM,41792945_1,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, SINGLE CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, AND/OR SUBTENDED MAJOR CORONARY ARTERY BRANCHES",29490.0,19168.5,7372.5,76157.93,16
CDM,41792950_1,Manual attempt to restore blood circulation and breathing,1138.0,739.7,284.5,2938.89,19
CDM,41792960_1,External shock to heart to regulate heart beat,2388.0,1552.2,597.0,6167.01,19
CDM,41792961_1,Internal shock to heart to regulate heart beat,2388.0,1552.2,597.0,6167.01,18
CDM,41792970_1,Placement of internal device to assist circulation,5071.0,3296.15,1052.0,13095.86,19
CDM,41792972_1,Shockwave destruction of calcified plaque in coronary artery accessed through skin using catheter,5000.0,3250.0,1250.0,12912.5,16
CDM,41792973_1,Removal of blood clot in heart artery,2575.0,1673.75,643.75,12169.11,18
CDM,41792978_1,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel",3394.0,2206.1,294.16,8765.01,18
CDM,41792979_1,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, each additional vessel",2716.0,1765.4,294.16,7014.07,18
CDM,41792986_1,Balloon dilation repair of aortic valve,23713.0,15413.45,5928.25,61238.82,18
CDM,41792987_1,Balloon dilation repair of mitral valve,22622.0,14704.3,5655.5,58421.32,18
CDM,41792990_1,Balloon dilation repair of pulmonary valve,22622.0,14704.3,5655.5,58421.32,18
CDM,41792997_1,"Balloon dilation of pulmonary artery, single vessel",24382.0,15848.3,6095.5,62966.52,18
CDM,41792998_1,"Balloon dilation of pulmonary artery, each additional vessel",5000.0,3250.0,1250.0,12912.5,18
CDM,41793024_1,Infusion of drug with evaluation of coronary artery spasm response,925.0,601.25,231.25,2388.81,18
CDM,41793280_1,Programming of dual lead pacemaker system,150.0,97.5,37.5,1052.0,19
CDM,41793284_1,Programming of multiple lead implantable defibrillator system,150.0,97.5,37.5,1052.0,19
CDM,41793286_1,"Programming of single, dual, or multiple lead or leadless pacemaker system before or after surgery",45.0,29.25,11.25,1052.0,19
CDM,41793287_1,"Programming of single, dual or multiple lead implantable defibrillator system before or after surgery",45.0,29.25,11.25,1052.0,19
CDM,41793451_1,Insertion of tube in right heart chambers for measurement,8498.0,5523.7,2124.5,21946.09,18
CDM,41793452_1,Insertion of tube in left heart chambers for diagnosis with review by radiologist,12923.0,8399.95,3230.75,33373.65,18
CDM,41793453_1,Insertion of tube in right and left heart chambers for diagnosis with review by radiologist,17290.0,11238.5,3509.68,44651.43,18
CDM,41793454_1,Insertion of tube in coronary artery for diagnosis with review by radiologist,7428.0,4828.2,1857.0,19182.81,18
CDM,41793455_1,Insertion of tube in bypass graft for diagnosis with review by radiologist,15698.0,10203.7,3509.68,40540.09,18
CDM,41793456_1,Insertion of tube in right heart chambers and coronary artery for diagnosis with review by radiologist,14410.0,9366.5,3509.68,37213.83,18
CDM,41793457_1,"Insertion of tube in right heart chambers, coronary artery, and bypass graft for diagnosis with review by radiologist",13434.0,8732.1,3358.5,34693.31,18
CDM,41793458_1,Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist,17737.0,11529.05,3509.68,45805.8,18
CDM,41793459_1,"Insertion of tube in left lower heart chamber, coronary artery and bypass graft for diagnosis with review by radiologist",20341.0,13221.65,3509.68,52530.63,18
CDM,41793460_1,Insertion of tube in right and left heart chambers and coronary artery for diagnosis with review by radiologist,15045.0,9779.25,3509.68,38853.71,18
CDM,41793461_1,"Insertion of tube in right and left heart chambers, coronary artery, and bypass graft for diagnosis with review by radiologist",14748.0,9586.2,3509.68,38086.71,18
CDM,41793462_1,Insertion of tube in left heart chamber through heart septum,14224.0,9245.6,3509.68,36733.48,18
CDM,41793463_1,Drug infusion during cardiac catheterization,1321.0,858.65,67.35,3411.48,18
CDM,41793464_1,Drug infusion or exercise for heart stimulation during diagnostic study,2197.0,1428.05,241.11,5673.75,18
CDM,41793503_1,Insertion of tube in pulmonary artery for monitoring,3670.0,2385.5,917.5,9477.78,18
CDM,41793505_1,Biopsy of heart muscle,7109.0,4620.85,1777.25,18358.99,18
CDM,41793563_1,Injection for imaging of coronary blood vessel during evaluation of congenital abnormalities with review by radiologist,3556.0,2311.4,476.5,9183.37,18
CDM,41793564_1,Injection for imaging of heart vessel grafts during evaluation of congenital abnormalities with review by radiologist,6825.0,4436.25,476.5,17625.56,18
CDM,41793565_1,Injection for imaging of left heart chambers with review by radiologist,2190.0,1423.5,476.5,5655.68,18
CDM,41793566_1,Injection for imaging of right heart chambers with review by radiologist,2190.0,1423.5,476.5,5655.68,18
CDM,41793567_1,Injection for imaging of aorta above heart valve with review by radiologist,1043.0,677.95,260.75,2693.55,18
CDM,41793568_1,Injection for nonselective imaging of pulmonary artery during heart catheterization,1768.0,1149.2,442.0,4565.86,18
CDM,41793569_1,"Injection for selective imaging of pulmonary artery during heart catheterization, on one side of body",2500.0,1625.0,476.5,6456.25,18
CDM,41793571_1,"Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel",4102.0,2666.3,1025.5,10593.42,18
CDM,41793572_1,"Ultrasound evaluation of heart blood vessel during diagnosis or treatment, each additional vessel",3282.0,2133.3,820.5,8475.77,18
CDM,41793573_1,"Injection for selective imaging of pulmonary artery during heart catheterization, on both sides of body",2300.0,1495.0,476.5,5939.75,18
CDM,41793574_1,Injection for selective imaging of pulmonary vein during heart catheterization,2300.0,1495.0,476.5,5939.75,18
CDM,41793575_1,Injection for selective imaging of major aortopulmonary collateral arteries during heart catheterization,2300.0,1495.0,476.5,5939.75,18
CDM,41793580_1,Repair of congenital abnormality in wall between upper heart chambers with implant,41040.0,26676.0,10260.0,105985.8,18
CDM,41793581_1,Repair of congenital abnormality in wall between lower heart chambers with implant,36956.0,24021.4,9239.0,95438.87,18
CDM,41793584_1,Review by radiologist of vein imaging for congenital heart defect of superior vena cava,3500.0,2275.0,875.0,9038.75,16
CDM,41793585_1,Review by radiologist of vein imaging for congenital heart defect of the azygos/hemiazygos venous system,3500.0,2275.0,875.0,9038.75,16
CDM,41793586_1,Review by radiologist of vein imaging for congenital heart defect of coronary sinus,3500.0,2275.0,875.0,9038.75,16
CDM,41793587_1,Review by radiologist of vein imaging for congenital heart defect of venovenous collaterals above the heart,3500.0,2275.0,875.0,9038.75,16
CDM,41793588_1,Review by radiologist of vein imaging for congenital heart defect of venovenous collaterals below the heart,3500.0,2275.0,875.0,9038.75,16
CDM,41793590_1,"Repair of leak adjacent to mitral valve, first closure device",36956.0,24021.4,9239.0,95438.87,18
CDM,41793591_1,"Repair of leak adjacent to aortic valve, first closure device",36956.0,24021.4,9239.0,95438.87,18
CDM,41793592_1,"Repair of lead adjacent to heart valve, each additional closure device",5000.0,3250.0,1250.0,21409.87,18
CDM,41793593_1,"Insertion of catheter into right side of heart for evaluation of congenital heart defect in heart with normal native blood vessel connections, using imaging guidance",7161.0,4654.65,1790.25,18493.28,18
CDM,41793594_1,"Insertion of catheter into right side of heart for evaluation of congenital heart defect in heart with abnormal native blood vessel connections, using imaging guidance",7161.0,4654.65,1790.25,18493.28,18
CDM,41793595_1,"Insertion of catheter into left side of heart for evaluation of congenital heart defect, using maging guidance",7161.0,4654.65,1790.25,18493.28,18
CDM,41793596_1,"Insertion of catheter into right and left sides of heart for evaluation of congenital heart defect in heart with abnormal native blood vessel connections, using imaging guidance",7161.0,4654.65,1790.25,18493.28,18
CDM,41793597_1,"Insertion of catheter into right and left sides of heart for evaluation of congenital heart defect in heart with normal native blood vessel connections, using imaging guidance",7161.0,4654.65,1790.25,18493.28,18
CDM,41793598_1,"Measurement of output of blood from heart, performed during cardiac catheterization for evaluation of congenital heart defects",4000.0,2600.0,476.5,10330.0,18
CDM,41793600_1,Recording of upper heart rhythm,4805.0,3123.25,1201.25,12408.91,18
CDM,41793603_1,Recording of right lower heart chamber rhythm,2600.0,1690.0,650.0,9454.3,18
CDM,41793609_1,Insertion of tube in upper and/or lower heart chambers to record and identify origin of abnormal heart rhythm,643.0,417.95,160.75,25935.64,18
CDM,41793612_1,Insertion of temporary pacemaker electrode for diagnostic lower heart pacing,14224.0,9245.6,3556.0,36733.48,18
CDM,41793613_1,Insertion of tube for 3D mapping of electrical impulses to heart muscle,4763.0,3095.95,1190.75,12300.45,18
CDM,41793615_1,Insertion of probe in esophagus for recording electrical impulses to upper and lower heart chambers,2736.0,1778.4,684.0,9454.3,19
CDM,41793616_1,"Insertion of probe in esophagus for recording electrical impulses to upper and lower heart chambers, with pacing",2736.0,1778.4,684.0,9454.3,19
CDM,41793618_1,Induction of abnormal heart rhythm by electrical pacing,2686.0,1745.9,671.5,9454.3,19
CDM,41793619_1,Insertion of catheters for recording and pacing of right heart chambers rhythm,9483.0,6163.95,2370.75,24489.85,18
CDM,41793620_1,Insertion of catheters for recording and pacing of right heart chambers rhythm and induction of abnormal rhythm,12230.0,7949.5,3057.5,31583.98,18
CDM,41793621_1,Insertion of catheters for recording and pacing of left upper heart chamber rhythm and induction of abnormal rhythm,6488.18,4217.32,1622.05,16755.72,18
CDM,41793622_1,Insertion of catheters for recording and pacing of left lower heart chamber rhythm and induction of abnormal rhythm,8367.0,5438.55,2091.75,21607.78,18
CDM,41793623_1,Programming of heart rhythm stimulation after drug infusion,3556.0,2311.4,889.0,9454.3,18
CDM,41793624_1,"Insertion of catheters for recording, pacing, and induction of abnormal heart rhythm to test therapy",5083.0,3303.95,1052.0,13126.85,19
CDM,41793631_1,Intra-operative heart pacing and mapping of abnormal heart rhythm for surgical correction,1885.0,1225.25,471.25,9454.3,19
CDM,41793640_1,Evaluation of single or dual chamber pacing cardioverter-defibrillator at time of implantation or replacement,1958.0,1272.7,489.5,9454.3,18
CDM,41793641_1,Evaluation of single or dual chamber pacing cardioverter-defibrillator and generator at time of implantation or replacement,3263.0,2120.95,815.75,9454.3,18
CDM,41793642_1,Programming of pacing cardioverter-defibrillator,4438.0,2884.7,1109.5,11461.14,18
CDM,41793644_1,Programming of implantable defibrillator,180.0,117.0,45.0,9454.3,18
CDM,41793650_1,Destruction of heart conduction tissue to create heart block,19720.0,12818.0,4930.0,50926.9,18
CDM,41793653_1,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of upper chamber of heart causing supraventricular tachycardia (rapid heart rate),47430.0,30829.5,11857.5,122487.98,18
CDM,41793654_1,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of lower chamber of heart causing ventricular tachycardia (rapid heart rate) or ventricular ectopy (irregular heart,47430.0,30829.5,11857.5,122487.98,18
CDM,41793655_1,Insertion of catheters and destruction of tissue to treat abnormal heart rhythm,11852.0,7703.8,2963.0,30607.79,18
CDM,41793656_1,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation,47430.0,30829.5,11857.5,122487.98,18
CDM,41793657_1,Destruction of tissue of upper heart chamber through tube to treat abnormal heart rhythm,11852.0,7703.8,2963.0,30607.79,18
CDM,41793660_1,Evaluation of heart function using tilt table,4440.0,2886.0,241.11,11466.3,19
CDM,41793662_1,Ultrasound evaluation of heart blood vessel with review by radiologist,3777.0,2455.05,630.02,9754.1,18
CDM,41793IP _1,UNCLASSIFIED DRUGS,302.69,196.75,75.67,781.7,16
CDM,41793OP _1,UNCLASSIFIED DRUGS,185.67,120.69,46.42,479.49,16
CDM,41794621_1,Test for exercise-induced heart and lung stress,1250.0,812.5,150.1,3228.13,19
CDM,41794727_1,Test to determine lung volumes using gas dilution or washout,850.0,552.5,83.86,2195.13,19
CDM,41794761_1,Test to measure oxygen level in blood using ear or finger device multiple times,290.0,188.5,72.5,1438.0,17
CDM,41796365_1,"Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less",625.0,406.25,156.25,1614.06,19
CDM,41796373_1,Injection of drug or substance into artery,500.0,325.0,67.35,1291.25,18
CDM,417C0764_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL(S), WHEN PERFORM",29500.0,19175.0,5360.09,76183.75,18
CDM,417C0765_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, AND TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WI",46830.0,30439.5,8988.34,120938.48,18
CDM,417C0766_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY AND ATHERECTOMY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL(",46830.0,30439.5,8988.34,120938.48,18
CDM,417C0767_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY AND TRANSLUMINAL STENT PLACEMENT(S), AND ATHERECTOMY, INCLUDE",46830.0,30439.5,11707.5,120938.48,18
CDM,417C0773_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS,  TIBIAL/PERONEAL ARTERY(IES); WITH INTRAVASCULAR LITHOTRIPSY, AND TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY  WITHIN THE SAME VESSEL(S",46830.0,30439.5,11707.5,120938.48,18
CDM,417C0774_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL/PERONEAL ARTERY(IES); WITH INTRAVASCULAR LITHOTRIPSY AND ATHERECTOMY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL (S), WHEN PERFORMED",46830.0,30439.5,11707.5,120938.48,18
CDM,417C0775_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL/PERONEAL ARTERY(IES); WITH INTRAVASCULAR LITHOTRIPSY AND TRANSLUMINAL STENT PLACEMENT(S), AND ATHERECTOMY, INCLUDES ANGIOPLASTY WITHIN THE",46830.0,30439.5,11707.5,120938.48,18
CDM,417C1764_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL(S), WHEN PERFORM",29500.0,19175.0,5360.09,76183.75,18
CDM,417C1765_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, AND TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WI",46830.0,30439.5,8988.34,120938.48,18
CDM,417C2764_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL(S), WHEN PERFORM",29500.0,19175.0,5360.09,76183.75,18
CDM,417C9600_1,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF DRUG ELUTING INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH",17947.0,11665.55,4486.75,46348.13,18
CDM,417C9601_1,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF DRUG-ELUTING INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; EACH ADDITIONAL BRANCH OF A MAJOR CORONARY ARTERY (LIST SEPARATELY IN ADDITION TO",17947.0,11665.55,4486.75,46348.13,18
CDM,417C9602_1,"PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY, WITH DRUG ELUTING INTRACORONARY STENT, WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH",17947.0,11665.55,4486.75,46348.13,18
CDM,417C9603_1,"PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY, WITH DRUG-ELUTING INTRACORONARY STENT, WITH CORONARY ANGIOPLASTY WHEN PERFORMED; EACH ADDITIONAL BRANCH OF A MAJOR CORONARY ARTERY (LIST SEPARATELY IN A",17947.0,11665.55,4486.75,46348.13,18
CDM,417C9604_1,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF OR THROUGH CORONARY ARTERY BYPASS GRAFT (INTERNAL MAMMARY, FREE ARTERIAL, VENOUS), ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, ATHERECTOMY AND A",17947.0,11665.55,4486.75,46348.13,18
CDM,417C9605_1,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF OR THROUGH CORONARY ARTERY BYPASS GRAFT (INTERNAL MAMMARY, FREE ARTERIAL, VENOUS), ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, ATHERECTOMY AND A",17947.0,11665.55,4486.75,46348.13,18
CDM,417C9606_1,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF ACUTE TOTAL/SUBTOTAL OCCLUSION DURING ACUTE MYOCARDIAL INFARCTION, CORONARY ARTERY OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF DRUG-ELUTING INTRA",17947.0,11665.55,4486.75,46348.13,18
CDM,417C9607_1,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, A",17947.0,11665.55,1052.0,46348.13,19
CDM,417C9608_1,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, A",17947.0,11665.55,1052.0,46348.13,19
CDM,417C9764_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL(S), WHEN PERFORM",29500.0,19175.0,5360.09,76183.75,18
CDM,417C9765_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, AND TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WI",46830.0,30439.5,8988.34,120938.48,18
CDM,417C9766_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY AND ATHERECTOMY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL(",46830.0,30439.5,8988.34,120938.48,18
CDM,417C9767_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY AND TRANSLUMINAL STENT PLACEMENT(S), AND ATHERECTOMY, INCLUDE",46830.0,30439.5,11707.5,120938.48,18
CDM,417C9772_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL/PERONEAL ARTERY(IES), WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL (S), WHEN PERFORMED",23931.0,15555.15,5982.75,61801.81,18
CDM,417C9773_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS,  TIBIAL/PERONEAL ARTERY(IES); WITH INTRAVASCULAR LITHOTRIPSY, AND TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY  WITHIN THE SAME VESSEL(S",46830.0,30439.5,11707.5,120938.48,18
CDM,417C9774_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL/PERONEAL ARTERY(IES); WITH INTRAVASCULAR LITHOTRIPSY AND ATHERECTOMY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL (S), WHEN PERFORMED",46830.0,30439.5,11707.5,120938.48,18
CDM,417C9775_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL/PERONEAL ARTERY(IES); WITH INTRAVASCULAR LITHOTRIPSY AND TRANSLUMINAL STENT PLACEMENT(S), AND ATHERECTOMY, INCLUDES ANGIOPLASTY WITHIN THE",46830.0,30439.5,11707.5,120938.48,18
CDM,417G0278_1,"ILIAC AND/OR FEMORAL ARTERY ANGIOGRAPHY, NON-SELECTIVE, BILATERAL OR IPSILATERAL TO CATHETER INSERTION, PERFORMED AT THE SAME TIME AS CARDIAC CATHETERIZATION AND/OR CORONARY ANGIOGRAPHY, INCLUDES POSI",3053.0,1984.45,763.25,7884.37,18
CDM,41800_1,"Drainage of abscess, cyst, or blood accumulation of dental bone",500.0,325.0,43.91,699.73,19
CDM,41801001_1,HC BIOPSY SITE IDENTIFIER,252.0,163.8,63.0,176.4,11
CDM,41801002_1,"HC HAND PIECE - 9GA X 12CM, 20MM",1197.0,778.05,299.25,837.9,11
CDM,41801003_1,HC INTRO LOC SET / 9-12-20,654.0,425.1,163.5,457.8,11
CDM,41801004_1,HC NEEDLE GUIDE LORAD - 9 GA,34.0,22.1,8.5,23.8,11
CDM,41801005_1,HC HAND PIECE - 9GA X 12CM  12MM,777.0,505.05,194.25,543.9,11
CDM,41801007_1,GUIDE WIRE,88.0,57.2,22.0,227.26,16
CDM,41801009_1,HC INTRODUCER CELERO 12 GA,56.0,36.4,14.0,39.2,11
CDM,41801012_1,HC HANDPIECE BIOPSY EVIVA,877.0,570.05,219.25,613.9,11
CDM,41801015_1,HC GUIDE NEEDLE- PRONE EVIVA,40.0,26.0,10.0,28.0,11
CDM,41801016_1,HC MARKER BIOPSY EVIVA,272.0,176.8,68.0,190.4,11
CDM,41801017_1,"IMAGING COIL, MAGNETIC RESONANCE (INSERTABLE)",429.0,278.85,107.25,1107.89,16
CDM,41801018_1,HC HANDPIECE BIOPSY SPRG LOADED CELERO 12 GA,623.0,404.95,155.75,436.1,11
CDM,41801019_1,HC A/C MASK WITH DIRECT DOSE FILTER,47.0,30.55,11.75,32.9,11
CDM,41801020_1,HC TRAY ADULT SPINAL,16.0,10.4,4.0,11.2,11
CDM,41801021_1,HC ZENO VENT MASK,277.0,180.05,69.25,193.9,11
CDM,41801022_1,HC WIRE LUNDERQUIST,44.0,28.6,11.0,30.8,11
CDM,41801024_1,HC TRAY MYLOGRAM,52.0,33.8,13.0,36.4,11
CDM,41801025_1,HC BREVERA BREAST STD/PETITE NEEDLE,1080.0,702.0,270.0,756.0,11
CDM,41801026_1,HC TRAY LUMBAR PUNCTURE,52.0,33.8,13.0,36.4,11
CDM,41801028_1,HC SYRINGES CT STELLANT DUAL,42.0,27.3,10.5,29.4,11
CDM,41801030_1,HC NEEDLE 18 GA ASAP,221.0,143.65,55.25,154.7,11
CDM,41801032_1,HC MILLER FEEDING TUBE,52.0,33.8,13.0,36.4,11
CDM,41801034_1,HC MANAN BIOPSY NEEDLE,72.0,46.8,18.0,50.4,11
CDM,41801036_1,HC ROBINOW 16 GAUGE,85.0,55.25,21.25,59.5,11
CDM,41801037_1,HC TRAY BIOPSY SET,116.0,75.4,29.0,81.2,11
CDM,41801038_1,HC SPECIMEN GRID X-RAY (ABBI),12.0,7.8,3.0,8.4,11
CDM,41801040_1,HC ULTRA TAG KIT,396.0,257.4,99.0,277.2,11
CDM,41801042_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",475.0,308.75,118.75,1226.69,16
CDM,41801043_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",223.0,144.95,55.75,575.9,16
CDM,41801044_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",475.0,308.75,118.75,1226.69,16
CDM,41801045_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",1450.0,942.5,362.5,3744.63,16
CDM,41801046_1,HC PROBE BODY TEMPERATURE SENSOR RAD,168.0,109.2,42.0,117.6,11
CDM,41801047_1,HC SYRINGES CT BRACCO,52.5,34.13,13.13,36.75,11
CDM,41801048_1,HC SYRINGES MR BRACCO,34.0,22.1,8.5,23.8,11
CDM,41801049_1,HC ELECTRODES CT NUCLEAR MEDICINE RADIO ECG,86.0,55.9,21.5,60.2,11
CDM,41801050_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",1450.0,942.5,362.5,3744.63,16
CDM,41801052_1,HC NEEDLE BX PINK ACHIEVE 12G,178.0,115.7,44.5,124.6,11
CDM,41801053_1,HC DTPA KIT,81.0,52.65,20.25,56.7,11
CDM,41801054_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",186.0,120.9,46.5,480.35,16
CDM,41801055_1,HC ATEC MRI HANDPIECE,836.0,543.4,209.0,585.2,11
CDM,41801056_1,HC US TRANSMISSION PAD HYPOALLERGEN,42.0,27.3,10.5,29.4,11
CDM,41801057_1,HC TRACKER VERAN VPAD 2 PATIENT,1520.0,988.0,380.0,1064.0,11
CDM,41801058_1,HC BINDER BRA,99.0,64.35,24.75,69.3,11
CDM,41801060_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",1462.5,950.63,365.63,3776.91,16
CDM,41801065_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",740.0,481.0,185.0,1911.05,16
CDM,41801070_1,HC MOLLI RE MARKABLE DEVICE,2025.0,1316.25,506.25,1417.5,11
CDM,41802001_1,HC SPECIAL BOLUS NEEDLE EA,328.0,213.2,82.0,229.6,11
CDM,41802284_1,HC HOMER BX NEEDLE,114.0,74.1,28.5,79.8,11
CDM,41802290_1,HC TRAY ARTHROGRAM,41.0,26.65,10.25,28.7,11
CDM,41805_1,Removal of embedded foreign body in soft tissue of tooth bearing bone,500.0,325.0,61.75,751.91,19
CDM,41806T_1,Removal of foreign body in dental bone,584.9,380.19,61.0,994.58,19
CDM,41806_1,Removal of foreign body in dental bone,881.0,572.65,61.0,994.58,19
CDM,41809582_1,"INJECTION, GADOLINIUM-BASED MAGNETIC RESONANCE CONTRAST AGENT, NOT OTHERWISE SPECIFIED (NOS), PER ML",15.0,9.75,1.55,45.25,17
CDM,41820_1,Removal of overgrown gum tissue,624.8,406.12,78.57,718.02,15
CDM,41821_1,Removal of gum tissue around tooth,141.8,92.17,49.4,161.72,15
CDM,41822_1,Removal of tissue fiber at dental bone,739.2,480.48,51.05,849.45,19
CDM,41823_1,Removal of dental bone,1103.6,717.34,78.57,1264.79,19
CDM,41825_1,Removal of dental bone growth,530.3,344.7,49.4,532.59,19
CDM,41826_1,Removal of dental bone growth with simple repair,790.7,513.96,78.57,732.28,19
CDM,41827_1,Removal of growth of dental bone growth with complex repair,1109.9,721.44,78.57,1041.21,19
CDM,41828_1,Removal of enlarged membrane covering of teeth or tooth socket,841.1,546.72,78.57,841.05,19
CDM,41830_1,Removal of tissue overgrowth at teeth or tooth socket,1002.8,651.82,78.57,1122.6,19
CDM,41832IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",421.35,273.88,105.34,1088.14,16
CDM,41832OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.95,13.62,5.24,54.1,16
CDM,41850_1,Destruction of growth of structure supporting teeth,312.9,203.39,37.05,358.51,15
CDM,41870_1,Graft of mouth tissue lining to gum surface,782.3,508.5,78.57,898.0,15
CDM,41872_1,Reshaping of gum,937.7,609.51,78.57,1125.93,19
CDM,41874188_1,HC MRI MEDRAD SYRINGE,45.0,29.25,11.25,31.5,11
CDM,41874200_1,HC MRI SECRETIN,1135.0,737.75,283.75,794.5,11
CDM,41874201_1,"HC SECRETIN , 16MCG VIAL",3156.0,2051.4,789.0,2209.2,11
CDM,41874_1,Reshaping of tooth socket,525.0,341.25,78.57,919.37,19
CDM,41880170_1,HC MONOPTY BIOPSY INSTRUMENT,144.0,93.6,36.0,100.8,11
CDM,41890000_1,HC US US BIOPSY TRAY,91.0,59.15,22.75,63.7,11
CDM,41893882_1,Ultrasound of one side of head and neck blood flow,903.0,586.95,158.99,2332.0,19
CDM,41893985_1,HC STERILE PROBE COVER,39.0,25.35,9.75,27.3,11
CDM,41899098_1,RECOVERY ROOM - GENERAL CLASSIFICATION,784.0,509.6,196.0,548.8,11
CDM,41899099_1,RECOVERY ROOM - GENERAL CLASSIFICATION,262.0,170.3,65.5,183.4,11
CDM,41899_1,Other procedure on teeth and gums,358.31,232.9,73.6,369.06,15
CDM,41900075_1,"Insertion of stents into vertebral artery via catheter, open or accessed through the skin including radiologic supervision and interpretation, initial vessel",11274.0,7328.1,2818.5,29115.11,19
CDM,41900077_1,"PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY/SURGERY GUIDANCE (E.G., FIDUCIAL MARKERS, DOSIMETER), FOR OTHER THAN THE FOLLOWING SITES (ANY APPROACH): ABDOMEN, PELVIS, PROSTATE, RETROPERIT",3209.0,2085.85,802.25,8477.27,18
CDM,41900078_1,"Injections of both sides of sacrum for enlargement, 2 or more needles, accessed through the skin",12614.0,8199.1,3153.5,32575.66,19
CDM,41900079_1,"Injections of one side of sacrum for enlargement, 1 or more needles, accessed through the skin",8409.0,5465.85,2102.25,21716.24,19
CDM,41900259_1,INJECTION PROCEDURE FOR SACROILIAC JOINT; ARTHROGRAPHY,1637.0,1064.05,409.25,4227.55,19
CDM,41900269_1,"PLACEMENT OF OCCLUSIVE DEVICE INTO EITHER A VENOUS OR ARTERIAL ACCESS SITE, POST SURGICAL OR INTERVENTIONAL PROCEDURE (E.G., ANGIOSEAL PLUG, VASCULAR PLUG)",153.0,99.45,38.25,8477.27,17
CDM,4190441T_1,"Freezing destruction of nerve in leg, accessed through the skin, using imaging guidance",4425.0,2876.25,188.0,11427.56,19
CDM,4190600T_1,"Irreversible electroporation destruction of growths of internal organ, accessed through skin",21300.0,13845.0,5317.76,55007.25,18
CDM,4190601T_1,"Irreversible electroporation destruction of growths of internal organ, open procedure",21300.0,13845.0,5317.76,55007.25,18
CDM,4190673T_1,Laser destruction of benign growth of thyroid using imaging guidance,3475.0,2258.75,868.75,8974.19,19
CDM,4190784T_1,"Insertion or replacement of spinal integrated nerve stimulating system with electrode array, accessed through the skin",31225.0,20296.25,6141.01,80638.56,17
CDM,4190785T_1,Revision or removal of spinal integrated nerve stimulating system with electrode array,7800.0,5070.0,1950.0,20143.5,17
CDM,4190786T_1,"Insertion or replacement of sacral integrated never stimulating system with electrode array, accessed through the skin",31225.0,20296.25,6141.01,80638.56,17
CDM,4190787T_1,Revision or removal of sacral integrated nerve stimulating system with electrode array,7800.0,5070.0,1950.0,20143.5,17
CDM,41909797_1,"VASCULAR EMBOLIZATION OR OCCLUSION PROCEDURE WITH USE OF A PRESSURE-GENERATING CATHETER (E.G., ONE-WAY VALVE, INTERMITTENTLY OCCLUDING), INCLUSIVE OF ALL RADIOLOGICAL SUPERVISION AND INTERPRETATION, I",43200.0,28080.0,6141.01,111564.0,17
CDM,41909950_1,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",3.17,2.06,0.42,9.56,17
CDM,41909951_1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",3.3,2.15,0.83,9.96,16
CDM,41909953_1,"INJECTION, GADOLINIUM-BASED MAGNETIC RESONANCE CONTRAST AGENT, NOT OTHERWISE SPECIFIED (NOS), PER ML",15.0,9.75,1.55,45.25,17
CDM,41909961_1,"HIGH OSMOLAR CONTRAST MATERIAL, 250-299 MG/ML IODINE CONCENTRATION, PER ML",3.05,1.98,0.28,9.2,17
CDM,41910005_1,"Fine needle aspiration biopsy using ultrasound guidance, first growth",2340.0,1521.0,993.51,6043.05,17
CDM,41910006_1,"Fine needle aspiration biopsy using ultrasound guidance, each additional growth",200.0,130.0,102.0,2166.29,17
CDM,41910007_1,"Fine needle aspiration biopsy using fluoroscopic guidance, first growth",870.0,565.5,443.7,3227.0,17
CDM,41910008_1,"Fine needle aspiration biopsy using fluoroscopic guidance, each additional growth",200.0,130.0,102.0,2166.29,17
CDM,41910009_1,"Fine needle aspiration biopsy of growth using CT guidance, first growth",870.0,565.5,443.7,3227.0,17
CDM,41910010_1,"Fine needle aspiration biopsy of growth using CT guidance, each additional growth",200.0,130.0,102.0,2166.29,17
CDM,41911042_1,"Removal of skin and tissue, 20.0 sq cm or less",914.0,594.1,228.5,2360.41,19
CDM,41911043_1,"Removal of muscle and/or tissue, 20.0 sq cm or less",2332.0,1515.8,555.36,6022.39,19
CDM,41911981_1,Insertion of drug delivery implant into tissue,110.0,71.5,27.5,2166.29,19
CDM,41919083_1,"Biopsy of breast and placement of locating device using ultrasound, first growth",2412.0,1567.8,603.0,6228.99,19
CDM,41919084_1,"Biopsy of breast and placement of locating device using ultrasound, each additional growth",1206.0,783.9,301.5,3114.5,19
CDM,41920551_1,Injection into tendon at attachment to bone or muscle,241.0,156.65,60.25,2166.29,19
CDM,41920560_1,"Insertion of needle, 1-2 muscles",75.0,48.75,18.75,2166.29,19
CDM,41920561_1,"Insertion of needle, 3 muscles or more",75.0,48.75,18.75,2166.29,19
CDM,41920604_1,Aspiration and/or injection of fluid from small joint using ultrasound guidance,399.0,259.35,99.75,2166.29,19
CDM,41920606_1,Aspiration and/or injection of fluid from medium joint using ultrasound guidance,459.0,298.35,114.75,3227.0,19
CDM,41920611_1,Aspiration and/or injection of fluid large joint using ultrasound guidance,412.5,268.13,103.13,2166.29,19
CDM,41921899_1,Other procedure on neck or chest,506.0,328.9,126.5,8477.27,19
CDM,41924065_1,Biopsy of surface tissue of upper arm or elbow,3709.0,2410.85,927.25,9578.49,19
CDM,41927096_1,"INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID AND/OR OTHER THERAPEUTIC AGENT, WITH OR WITHOUT ARTHROGRAPHY",4092.5,2660.13,667.58,10568.88,19
CDM,41927613_1,Biopsy of surface tissue of leg or ankle,3370.0,2190.5,842.5,8703.03,19
CDM,41935286_1,Repair of blood vessel of leg with graft,4955.0,3220.75,1238.75,12796.29,19
CDM,41935860_1,"Exploration of arm or leg for bleeding, blood clot, or infection after surgery",7305.0,4748.25,1826.25,18865.16,19
CDM,41935903_1,Removal of infected graft of arm or leg,7305.0,4748.25,1826.25,18865.16,19
CDM,41936227_1,Insertion of tube into external neck artery for diagnosis or treatment with review by radiologist,2410.0,1566.5,602.5,6559.08,19
CDM,41936620_1,Insertion of artery tube for blood sampling or infusion through skin,589.0,382.85,147.25,2166.29,19
CDM,41937214_1,Removal of tube into artery or vein with review by radiologist,7305.0,4748.25,1826.25,18865.16,19
CDM,41937231_1,"Removal of plaque and insertion of stents in artery of leg, initial vessel",15313.0,9953.45,3828.25,39545.82,19
CDM,41937254_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",14540.0,9451.0,3635.0,37549.55,16
CDM,41937255_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",7270.0,4725.5,1817.5,18774.78,16
CDM,41937256_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",14540.0,9451.0,3635.0,37549.55,16
CDM,41937257_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",7270.0,4725.5,1817.5,18774.78,16
CDM,41937258_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",29490.0,19168.5,7372.5,76157.93,16
CDM,41937259_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",14745.0,9584.25,3686.25,38078.96,16
CDM,41937260_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",29490.0,19168.5,7372.5,76157.93,16
CDM,41937261_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",14745.0,9584.25,3686.25,38078.96,16
CDM,41937263_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",14745.0,9584.25,3686.25,38078.96,16
CDM,41937264_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",7270.0,4725.5,1817.5,18774.78,16
CDM,41937265_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",14540.0,9451.0,3635.0,37549.55,16
CDM,41937266_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",7270.0,4725.5,1817.5,18774.78,16
CDM,41937267_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",29490.0,19168.5,7372.5,76157.93,16
CDM,41937268_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",14745.0,9584.25,3686.25,38078.96,16
CDM,41937269_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",29490.0,19168.5,7372.5,76157.93,16
CDM,41937270_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",14745.0,9584.25,3686.25,38078.96,16
CDM,41937271_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",46830.0,30439.5,11707.5,120938.48,16
CDM,41937272_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",23415.0,15219.75,5853.75,60469.24,16
CDM,41937273_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",46830.0,30439.5,11707.5,120938.48,16
CDM,41937274_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",23415.0,15219.75,5853.75,60469.24,16
CDM,41937276_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",23415.0,15219.75,5853.75,60469.24,16
CDM,41937277_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",46830.0,30439.5,11707.5,120938.48,16
CDM,41937278_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",23415.0,15219.75,5853.75,60469.24,16
CDM,41937279_1,"INTRAVASCULAR LITHOTRIPSY(IES), FEMORAL AND POPLITEAL VASCULAR TERRITORY, INCLUDING ALL IMAGING GUIDANCE AND RADIOLOGICAL SUPERVISION AND INTERPRETATION NECESSARY TO PERFORM THE INTRAVASCULAR LITHOTRI",11008.0,7155.2,2752.0,28428.16,16
CDM,41937280_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",29490.0,19168.5,7372.5,76157.93,16
CDM,41937281_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",14745.0,9584.25,3686.25,38078.96,16
CDM,41937283_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",29490.0,19168.5,7372.5,76157.93,16
CDM,41937284_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",46830.0,30439.5,11707.5,120938.48,16
CDM,41937285_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",23415.0,15219.75,5853.75,60469.24,16
CDM,41937286_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",46830.0,30439.5,11707.5,120938.48,16
CDM,41937287_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",23415.0,15219.75,5853.75,60469.24,16
CDM,41937288_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",46830.0,30439.5,11707.5,120938.48,16
CDM,41937289_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",23415.0,15219.75,5853.75,60469.24,16
CDM,41937290_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",46830.0,30439.5,11707.5,120938.48,16
CDM,41937291_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",23415.0,15219.75,5853.75,60469.24,16
CDM,41937292_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",46830.0,30439.5,11707.5,120938.48,16
CDM,41937293_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",23415.0,15219.75,5853.75,60469.24,16
CDM,41937294_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",46830.0,30439.5,11707.5,120938.48,16
CDM,41937295_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",23415.0,15219.75,5853.75,60469.24,16
CDM,41937296_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",29490.0,19168.5,7372.5,76157.93,16
CDM,41937297_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",14745.0,9584.25,3686.25,38078.96,16
CDM,41937298_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",29490.0,19168.5,7372.5,76157.93,16
CDM,41937299_1,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",14745.0,9584.25,3686.25,38078.96,16
CDM,41937765_1,"Removal of varicose veins of arm or leg, 10-20 incisions",3780.0,2457.0,945.0,9761.85,19
CDM,41938222_1,Biopsy and aspiration of bone marrow sample for diagnosis,5280.0,3432.0,1320.0,13635.6,19
CDM,41943275_1,Removal of stent from pancreatic or bile duct using a flexible endoscope,4375.0,2843.75,1093.75,11298.44,19
CDM,41943752_1,Insertion of stomach tube through nose or mouth using fluoroscopic guidance,913.0,593.45,228.25,2357.82,19
CDM,41943771_1,Adjustment of stomach reduction device using an endoscope,9950.0,6467.5,2487.5,25695.88,19
CDM,41947384_1,"ABLATION, IRREVERSIBLE ELECTROPORATION, LIVER, 1 OR MORE TUMORS, INCLUDING IMAGING GUIDANCE, PERCUTANEOUS",27154.0,17650.1,6788.5,70125.21,16
CDM,41947550_1,Exam of bile duct during surgery using an endoscope,2500.0,1625.0,625.0,8477.27,19
CDM,41949400_1,Injection of air or X-ray contrast into abdominal cavity,1362.0,885.3,340.5,3517.37,19
CDM,41949442_1,Insertion of large bowel tube using fluoroscopic guidance with contrast,2164.0,1406.6,541.0,5588.53,19
CDM,41952287_1,Exam with injections of chemical for destruction of bladder using an endoscope,1654.0,1075.1,413.5,4271.46,19
CDM,41952443_1,CYSTOURETHROSCOPY WITH INITIAL TRANSURETHRAL ANTERIOR PROSTATE COMMISSUROTOMY WITH A NONDRUG-COATED BALLOON CATHETER FOLLOWED BY THERAPEUTIC DRUG DELIVERY INTO THE PROSTATE BY A DRUG-COATED BALLOON CA,24182.0,15718.3,6045.5,62450.02,16
CDM,41954230_1,Injection procedure for imaging of penile erection,179.0,116.35,44.75,2924.62,19
CDM,41955707_1,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",9005.0,5853.25,2251.25,23255.41,16
CDM,41955708_1,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE, FIRST TARGETED LESION",9005.0,5853.25,2251.25,23255.41,16
CDM,41955709_1,"BIOPSY, PROSTATE, TRANSPERINEAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",9005.0,5853.25,2251.25,23255.41,16
CDM,41955710_1,"BIOPSY, PROSTATE, TRANSPERINEAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE BIOPSY, FIRST TARGETED LESION",9005.0,5853.25,2251.25,23255.41,16
CDM,41955711_1,"BIOPSY, PROSTATE, TRANSRECTAL, MRI-ULTRASOUND-FUSION GUIDED, TARGETED LESION(S) ONLY, FIRST TARGETED LESION",9005.0,5853.25,2251.25,23255.41,16
CDM,41955712_1,"BIOPSY, PROSTATE, TRANSPERINEAL, MRI-ULTRASOUND-FUSION GUIDED, TARGETED LESION(S) ONLY, FIRST TARGETED LESION",9005.0,5853.25,2251.25,23255.41,16
CDM,41955713_1,"BIOPSY, PROSTATE, IN-BORE CT- OR MRI-GUIDED (IE, SEXTANT), WITH BIOPSY OF ADDITIONAL TARGETED LESION(S), FIRST TARGETED LESION",13697.0,8903.05,3424.25,35372.5,16
CDM,41955714_1,"BIOPSY, PROSTATE, IN-BORE CT- OR MRI-GUIDED TARGETED LESION(S) ONLY, FIRST TARGETED LESION",13697.0,8903.05,3424.25,35372.5,16
CDM,41955715_1,"BIOPSY, PROSTATE, EACH ADDITIONAL, MRI-ULTRASOUND FUSION OR IN-BORE CT- OR MRI-GUIDED TARGETED LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",5000.0,3250.0,1250.0,12912.5,16
CDM,41955877_1,"ABLATION, IRREVERSIBLE ELECTROPORATION, PROSTATE, 1 OR MORE TUMORS, INCLUDING IMAGING GUIDANCE, PERCUTANEOUS",27154.0,17650.1,6788.5,70125.21,16
CDM,41958822_1,Drainage of abscess of ovaries through abdomen,1541.0,1001.65,385.25,7441.0,19
CDM,41961107_1,Creation of opening in skull for insertion of brain tube or monitoring device,1304.0,847.6,326.0,8477.27,19
CDM,41961624_1,Occlusion of central nervous system or spinal cord artery,46830.0,30439.5,9592.09,120938.48,19
CDM,41961626_1,Occlusion of head or neck artery,29490.0,19168.5,7372.5,76157.93,19
CDM,41961781_1,Computer-assisted procedure inside brain,600.0,390.0,150.0,5620.39,19
CDM,41962268_1,Aspiration of fluid from cyst of spinal cord or fluid-filled cavity,2089.0,1357.85,522.25,5394.84,19
CDM,41962287_1,Removal of lower spine disc tissue at single or multiple levels using fluoroscopic guidance,4990.0,3243.5,1247.5,12886.68,19
CDM,41964600_1,Destruction of first division of face nerve branch,2191.0,1424.15,547.75,5658.26,19
CDM,41964605_1,Destruction of second and third division of face nerve branch,4323.2,2810.08,1080.8,11164.66,19
CDM,41964610_1,Destruction of face nerve branch under X-ray monitoring,4425.0,2876.25,1106.25,11427.56,19
CDM,41974190_1,Review by radiologist of abdominal cavity lining image,1000.0,650.0,172.18,2582.5,18
CDM,41974400_1,Imaging of urinary tract with injection of contrast into a vein,750.0,487.5,172.18,1936.88,18
CDM,41975733_1,Review by radiologist of both adrenal glands arteries image,3400.0,2210.0,850.0,8780.5,18
CDM,41975880_1,Review by radiologist of eye socket vein of eye socket image,1440.0,936.0,360.0,3718.8,18
CDM,41976536_1,Ultrasound scan of head and neck soft tissue,461.0,299.65,115.25,1190.53,18
CDM,41979445_1,Radioactive drug therapy through a tube inserted in an artery,1000.0,650.0,250.0,2582.5,18
CDM,41993454_1,Insertion of tube in coronary artery for diagnosis with review by radiologist,13734.0,8927.1,3433.5,35468.06,18
CDM,41993971_1,Ultrasound study of one arm or leg veins with compression and maneuvers,1000.0,650.0,158.99,2582.5,19
CDM,41995958_1,Measurement of brain wave activity (EEG) in specific area of brain,3756.0,2441.4,482.14,9699.87,19
CDM,41996379_1,"Injection or infusion into a vein or artery for therapy, prevention, or diagnosis",248.0,161.2,62.0,640.46,18
CDM,41996405_1,"Administration of chemotherapy into growth, 1-7",160.0,104.0,40.0,2054.0,19
CDM,41996420_1,Administration of chemotherapy into artery using push technique,827.0,537.55,67.35,2135.73,19
CDM,41996446_1,Administration of chemotherapy into abdominal cavity,1581.0,1027.65,395.25,4082.93,19
CDM,41996549_1,Other chemotherapy procedure,137.0,89.05,34.25,2054.0,19
CDM,41997605_1,"Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less",460.0,299.0,115.0,1187.95,19
CDM,41997606_1,"Therapy procedure using a special bandage and vacuum pump, surface area more than 50.0 sq cm",700.0,455.0,175.0,1807.75,19
CDM,42000_1,Drainage of abscess of roof of mouth,290.0,188.5,41.8,388.22,19
CDM,42049083_1,Drainage of fluid from abdominal cavity using imaging guidance,1272.0,826.8,318.0,3726.0,19
CDM,42076098_1,X-ray of surgical specimen,1375.0,893.75,172.18,3550.94,18
CDM,42076506_1,Ultrasound scan of brain,725.0,471.25,158.99,1872.31,18
CDM,42076535_1,Ultrasound scan of head and neck soft tissue,461.0,299.65,115.25,1190.53,18
CDM,42076604_1,Ultrasound scan of chest,600.0,390.0,150.0,1549.5,18
CDM,42076641_1,Complete ultrasound scan of 1 breast,1050.0,682.5,158.99,2711.63,18
CDM,42076642_1,Limited ultrasound scan of 1 breast,825.0,536.25,158.99,2130.56,18
CDM,42076700_1,Complete ultrasound scan of abdomen,511.0,332.15,127.75,1319.66,18
CDM,42076705_1,Limited ultrasound scan of abdomen,511.0,332.15,127.75,1319.66,18
CDM,42076706_1,Ultrasound scan of abdominal aorta,500.0,325.0,125.0,1291.25,18
CDM,42076770_1,Complete ultrasound scan behind abdominal cavity,650.0,422.5,162.5,1678.63,18
CDM,42076775_1,Limited ultrasound scan behind abdominal cavity,500.0,325.0,125.0,1291.25,18
CDM,42076779_1,Ultrasound scan of transplanted kidney,621.0,403.65,155.25,1603.73,18
CDM,42076800_1,Ultrasound scan of spinal canal,500.0,325.0,125.0,1291.25,18
CDM,42076802_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), each additional fetus",150.0,97.5,37.5,387.38,18
CDM,42076803_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus",325.0,211.25,81.25,839.31,18
CDM,42076805_1,"Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus",325.0,211.25,81.25,839.31,18
CDM,42076810_1,"Ultrasound scan of pregnant uterus (14 weeks or more), each additional fetus",218.0,141.7,54.5,562.99,18
CDM,42076811_1,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus",350.0,227.5,87.5,903.88,18
CDM,42076812_1,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, each additional fetus",410.0,266.5,102.5,1058.83,18
CDM,42076814_1,Limited ultrasound of pregnant uterus,325.0,211.25,81.25,839.31,18
CDM,42076816_1,Follow-up ultrasound scan of pregnant uterus,325.0,211.25,81.25,839.31,18
CDM,42076817_1,Vaginal ultrasound of pregnant uterus,325.0,211.25,81.25,839.31,18
CDM,42076818_1,Ultrasound and monitoring of heart of fetus,310.0,201.5,77.5,800.58,18
CDM,42076831_1,"Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina",445.0,289.25,111.25,1149.21,18
CDM,42076856_1,Complete ultrasound scan of pelvis,446.0,289.9,111.5,1151.8,18
CDM,42076857_1,Limited ultrasound scan of pelvis,445.0,289.25,111.25,1149.21,18
CDM,42076860_1,Complete ultrasound scan of pelvis,600.0,390.0,150.0,1549.5,18
CDM,42076870_1,Ultrasound scan of scrotum,446.0,289.9,111.5,1151.8,18
CDM,42076872_1,Ultrasound scan of pelvic region through rectum,500.0,325.0,125.0,1291.25,18
CDM,42076881_1,Complete ultrasound scan of joint,400.0,260.0,100.0,1033.0,18
CDM,42076882_1,Limited ultrasound scan of joint or other extremity structure except blood vessels,400.0,260.0,100.0,1033.0,18
CDM,42076885_1,Ultrasound scan of infant hip during movement,850.0,552.5,158.99,2195.13,18
CDM,42076937_1,Ultrasonic guidance for blood vessel access,650.0,422.5,162.5,1678.63,18
CDM,42076940_1,Ultrasound guidance for tissue removal,650.0,422.5,162.5,1678.63,18
CDM,42076942_1,Ultrasonic guidance for needle placement,800.0,520.0,163.6,2066.0,18
CDM,42076978_1,"Ultrasound scan of growth using contrast, first growth",380.0,247.0,95.0,981.35,18
CDM,42076979_1,"Ultrasound scan of growth using contrast, each additional growth",190.0,123.5,47.5,490.68,18
CDM,42076981_1,Ultrasound scan of organ tissue for measuring elasticity,225.0,146.25,56.25,581.06,18
CDM,42076982_1,"Ultrasound scan of growth for measuring elasticity, first growth",225.0,146.25,56.25,581.06,18
CDM,42076998_1,Ultrasonic guidance during surgery,1000.0,650.0,163.6,2582.5,18
CDM,42077002_1,Fluoroscopic guidance for needle placement,540.0,351.0,135.0,1394.55,18
CDM,42077012_1,Review by radiologist of CT guidance for needle placement,3000.0,1950.0,119.76,7747.5,18
CDM,42077021_1,Review by radiologist of MRI guidance for needle placement,3500.0,2275.0,317.35,9038.75,18
CDM,42091200_1,Measurement of liver stiffness,250.0,162.5,62.5,645.63,18
CDM,42093970_1,Ultrasound study of arm or leg veins with compression and maneuvers,1404.0,912.6,244.92,3625.83,19
CDM,42093971_1,Ultrasound study of one arm or leg veins with compression and maneuvers,1000.0,650.0,158.99,2582.5,19
CDM,42093975_1,Complete ultrasound of abdomen and pelvis artery and vein blood flow,773.0,502.45,193.25,1996.27,19
CDM,42093976_1,Ultrasound of abdomen and pelvis artery and vein blood flow,613.0,398.45,153.25,1583.07,19
CDM,42093978_1,"Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts",800.0,520.0,200.0,2066.0,19
CDM,42093979_1,"Ultrasound of aorta, vena cava, groin vessels or bypass grafts",301.0,195.65,75.25,1052.0,19
CDM,42093980_1,Complete ultrasound of penis artery and vein blood flow,608.0,395.2,152.0,1570.16,19
CDM,42100_1,Biopsy of roof of mouth,407.4,264.81,37.0,353.43,19
CDM,42103120_1,"X-ray of hand, 2 views",487.5,316.88,81.72,1258.97,18
CDM,42103130_1,"X-ray of hand, minimum of 3 views",570.0,370.5,81.72,1472.03,18
CDM,42103560_1,"X-ray of knee, 1-2 views",570.0,370.5,81.72,1472.03,18
CDM,42103562_1,"X-ray of knee, 3 views",525.0,341.25,81.72,1355.81,18
CDM,42103620_1,"X-ray of foot, 2 views",337.5,219.38,81.72,871.59,18
CDM,42103630_1,"X-ray of foot, minimum of 3 views",480.0,312.0,81.72,1239.6,18
CDM,42104248_1,Follow-through X-ray of small intestines,320.0,208.0,80.0,826.4,18
CDM,42104_1,Removal of growth of roof of mouth,554.4,360.36,61.75,524.71,19
CDM,42106_1,Removal of growth of roof of mouth with simple closure,698.3,453.9,76.8,614.44,19
CDM,42107_1,Removal of growth of roof of mouth with local tissue graft,1579.2,1026.48,78.57,1093.77,19
CDM,42110101_1,"X-ray of hip, 1 view",250.0,162.5,62.5,645.63,18
CDM,42110102_1,"X-ray of hip, 2-3 views",290.0,188.5,72.5,748.93,18
CDM,42110103_1,"X-ray of hip, minimum of 4 views",400.0,260.0,81.72,1033.0,18
CDM,42110104_1,"X-ray of both hips, 2 views",350.0,227.5,81.72,903.88,18
CDM,42110105_1,"X-ray of both hips, 3-4 views",400.0,260.0,81.72,1033.0,18
CDM,42110106_1,"X-ray of both hips, minimum of 5 views",352.0,228.8,81.72,909.04,18
CDM,42120_1,Partial removal of roof of mouth,2650.2,1722.63,78.57,3043.76,19
CDM,42124220_1,Injection of contrast for imaging of elbow joint,230.0,149.5,57.5,593.98,18
CDM,42140_1,Removal of soft tissue of roof of mouth,652.1,423.87,51.13,753.25,19
CDM,42145T_1,Complex removal of soft tissue of roof of mouth,3126.9,2032.49,78.57,2091.4,19
CDM,42145_1,Complex removal of soft tissue of roof of mouth,2100.0,1365.0,78.57,2091.4,19
CDM,42151600_1,Injection procedure for imaging of bladder during voiding,568.0,369.2,142.0,8477.27,19
CDM,42160_1,Destruction of growth or soft tissue of roof of mouth,625.8,406.77,48.38,560.2,19
CDM,42162282_1,Injection of substance into spinal canal for removal of lower spine nerve tissue,1600.0,1040.0,400.0,4132.0,19
CDM,42162304_1,X-ray of lower spinal canal with review by radiologist,2644.0,1718.6,661.0,6828.13,19
CDM,42162305_1,X-ray of multiple regions of spinal canal with review by radiologist,3370.0,2190.5,813.47,8703.03,18
CDM,42162IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",74.18,48.22,18.55,191.57,16
CDM,42162OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.62,17.3,6.66,68.75,16
CDM,42163IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",85.2,55.38,21.3,220.03,16
CDM,42163OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",96.0,62.4,24.0,247.92,16
CDM,42164IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",82.11,53.37,20.53,212.05,16
CDM,42164OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",103.56,67.31,25.89,267.44,16
CDM,42165IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",78.8,51.22,19.7,203.5,16
CDM,42165OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.75,23.24,8.94,92.32,16
CDM,42166IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",75.05,48.78,18.76,193.82,16
CDM,42166OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",107.05,69.58,26.76,276.46,16
CDM,42170030_1,X-ray of eye for detection of foreign body,325.0,211.25,81.25,839.31,18
CDM,42170100_1,"X-ray of part of lower jaw, 1-4 views",225.0,146.25,56.25,581.06,18
CDM,42170110_1,"X-ray of lower jaw, minimum of 4 views",310.0,201.5,77.5,800.58,18
CDM,42170130_1,"X-ray of bone behind the ear, minimum of 3 views per side",300.0,195.0,75.0,774.75,18
CDM,42170140_1,"X-ray of face bones, 1-2 views",225.0,146.25,56.25,581.06,18
CDM,42170150_1,"X-ray of face bones, minimum of 3 views",325.0,211.25,81.25,839.31,18
CDM,42170160_1,"X-ray of nose bones, minimum of 3 views",338.0,219.7,81.72,872.89,18
CDM,42170200_1,"X-ray of eye socket, minimum of 4 views",545.0,354.25,81.72,1407.46,18
CDM,42170210_1,"X-ray of paranasal sinus, 1-2 views",270.0,175.5,67.5,697.28,18
CDM,42170220_1,"X-ray of paranasal sinus, minimum of 3 views",360.0,234.0,81.72,929.7,18
CDM,42170248_1,"X-ray of skull, 1-3 views",325.0,211.25,81.25,839.31,18
CDM,42170249_1,"X-ray of skull, 1-3 views",293.0,190.45,73.25,756.67,18
CDM,42170250_1,"X-ray of skull, 1-3 views",293.0,190.45,73.25,756.67,18
CDM,42170260_1,"X-ray of skull, minimum of 4 views",325.0,211.25,81.25,839.31,18
CDM,42170328_1,X-ray of jaw joint on 1 side of mouth,180.0,117.0,45.0,464.85,18
CDM,42170330_1,X-ray of jaw joints on both sides of mouth,180.0,117.0,45.0,464.85,18
CDM,42170355_1,"X-ray of lower jaws, upper jaws and teeth",225.0,146.25,56.25,581.06,18
CDM,42170360_1,X-ray of soft tissue of neck,225.0,146.25,56.25,581.06,18
CDM,42170370_1,X-ray of voice box or throat,250.0,162.5,62.5,645.63,18
CDM,42170372_1,Imaging of voice box with speech evaluation,250.0,162.5,62.5,645.63,18
CDM,42170390_1,Review by radiologist of salivary structure image,300.0,195.0,75.0,774.75,18
CDM,42171045_1,"X-ray of chest, 1 view",230.0,149.5,57.5,593.98,18
CDM,42171046_1,"X-ray of chest, 2 views",260.0,169.0,65.0,671.45,18
CDM,42171047_1,"X-ray of chest, 3 views",350.0,227.5,81.72,903.88,18
CDM,42171048_1,"X-ray of chest, minimum of 4 views",338.0,219.7,81.72,872.89,18
CDM,42171049_1,"Imaging guidance for procedure, 60 minutes or less",655.0,425.75,163.75,1691.54,18
CDM,42171050_1,"Imaging guidance for procedure, 60 minutes or less",655.0,425.75,163.75,1691.54,18
CDM,42171100_1,"X-ray of ribs on side of body, 2 views",270.0,175.5,67.5,697.28,18
CDM,42171101_1,"X-ray of ribs on side of body, minimum of 3 views",290.0,188.5,72.5,748.93,18
CDM,42171110_1,"X-ray of ribs on both sides of body, 3 views",315.0,204.75,78.75,813.49,18
CDM,42171111_1,"X-ray of ribs on both sides of body, minimum of 4 views",360.0,234.0,81.72,929.7,18
CDM,42171120_1,"X-ray of chest bone, minimum of 2 views",225.0,146.25,56.25,581.06,18
CDM,42171130_1,"X-ray of joint between breast and collar bones, minimum of 2 views",278.0,180.7,69.5,717.94,18
CDM,42172021_1,"X-ray of spine, 1 view",270.0,175.5,67.5,697.28,18
CDM,42172022_1,"X-ray of spine, 1 view",270.0,175.5,67.5,697.28,18
CDM,42172040_1,"X-ray of upper spine, 2-3 views",220.0,143.0,55.0,568.15,18
CDM,42172050_1,"X-ray of upper spine, 4-5 views",360.0,234.0,81.72,929.7,18
CDM,42172052_1,"X-ray of upper spine, 6 or more views",450.0,292.5,81.72,1162.13,18
CDM,42172070_1,"X-ray of middle spine, 2 views",315.0,204.75,78.75,813.49,18
CDM,42172072_1,"X-ray of middle spine, 3 views",360.0,234.0,81.72,929.7,18
CDM,42172074_1,"X-ray of middle spine, minimum of 4 views",425.0,276.25,81.72,1097.56,18
CDM,42172080_1,"X-ray of middle and lower spine, 2 views",315.0,204.75,78.75,813.49,18
CDM,42172081_1,"X-ray of entire middle and lower spine, 1 view",158.0,102.7,39.5,408.04,18
CDM,42172082_1,"X-ray of entire middle and lower spine, 2-3 views",310.0,201.5,77.5,800.58,18
CDM,42172083_1,"X-ray of entire middle and lower spine, 4-5 views",330.0,214.5,81.72,852.23,18
CDM,42172084_1,"X-ray of entire middle and lower spine, minimum of 6 views",350.0,227.5,81.72,903.88,18
CDM,42172091_1,"X-ray of spine, 1 view",300.0,195.0,75.0,774.75,18
CDM,42172100_1,"X-ray of lower and sacral spine, 2-3 views",325.0,211.25,81.25,839.31,18
CDM,42172110_1,"X-ray of lower and sacral spine, minimum of 4 views",360.0,234.0,81.72,929.7,18
CDM,42172114_1,"X-ray lower and sacral spine, minimum of 6 views",405.0,263.25,81.72,1045.91,18
CDM,42172120_1,"X-ray lower and sacral spine, 2-3 views bending views",360.0,234.0,81.72,929.7,18
CDM,42172170_1,"X-ray of pelvis, 1-2 views",350.0,227.5,81.72,903.88,18
CDM,42172190_1,"X-ray of pelvis, minimum of 3 views",325.0,211.25,81.25,839.31,18
CDM,42172200_1,"X-ray of joint between lower spine and hip bone, 1-2 views",225.0,146.25,56.25,581.06,18
CDM,42172202_1,"X-ray of joint between lower spine and hip bone, 3 or more views",310.0,201.5,77.5,800.58,18
CDM,42172220_1,"X-ray of sacrum and tailbone, minimum of 2 views",225.0,146.25,56.25,581.06,18
CDM,42172240_1,Review by radiologist of upper spinal canal image,900.0,585.0,225.0,2324.25,18
CDM,42172255_1,Review by radiologist of middle spinal canal image,1000.0,650.0,250.0,2582.5,18
CDM,42172265_1,Review by radiologist of lower spinal canal image,1350.0,877.5,337.5,3486.38,18
CDM,42172270_1,Review by radiologist of multiple spinal canals image,1800.0,1170.0,450.0,4648.5,18
CDM,42173000_1,X-ray of collar bone,337.5,219.38,81.72,871.59,18
CDM,42173010_1,X-ray of shoulder blade,465.0,302.25,81.72,1200.86,18
CDM,42173020_1,"X-ray of shoulder, 1 view",337.5,219.38,81.72,871.59,18
CDM,42173030_1,"X-ray of shoulder, minimum of 2 views",525.0,341.25,81.72,1355.81,18
CDM,42173040_1,Review by radiologist of shoulder joint image,1581.29,1027.84,172.18,4083.68,18
CDM,42173050_1,X-ray of both collar bones joints,360.0,234.0,81.72,929.7,18
CDM,42173060_1,"X-ray of upper arm, minimum of 2 views",405.0,263.25,81.72,1045.91,18
CDM,42173070_1,"X-ray of elbow, 2 views",405.0,263.25,81.72,1045.91,18
CDM,42173080_1,"X-ray of elbow, minimum of 3 views",472.5,307.13,81.72,1220.23,18
CDM,42173085_1,Review by radiologist of elbow image,905.0,588.25,172.18,2337.16,18
CDM,42173090_1,"X-ray of forearm, 2 views",405.0,263.25,81.72,1045.91,18
CDM,42173092_1,"X-ray of infant arm, minimum of 2 views",270.0,175.5,67.5,697.28,18
CDM,42173100_1,"X-ray of wrist, 2 views",405.0,263.25,81.72,1045.91,18
CDM,42173110_1,"X-ray of wrist, minimum of 3 views",525.0,341.25,81.72,1355.81,18
CDM,42173115_1,Review by radiologist of wrist joint image,1350.0,877.5,172.18,3486.38,18
CDM,42173120_1,"X-ray of hand, 2 views",487.5,316.88,81.72,1258.97,18
CDM,42173121_1,"X-ray of hand, 2 views",405.0,263.25,81.72,1045.91,18
CDM,42173122_1,"X-ray of hand, 2 views",405.0,263.25,81.72,1045.91,18
CDM,42173130_1,"X-ray of hand, minimum of 3 views",570.0,370.5,81.72,1472.03,18
CDM,42173131_1,"X-ray of hand, minimum of 3 views",472.5,307.13,81.72,1220.23,18
CDM,42173132_1,"X-ray of hand, minimum of 3 views",472.5,307.13,81.72,1220.23,18
CDM,42173140_1,"X-ray of finger, minimum of 2 views",525.0,341.25,81.72,1355.81,18
CDM,42173501_1,"X-ray of hip, 1 view",225.0,146.25,56.25,581.06,18
CDM,42173502_1,"X-ray of hip, 2-3 views",230.0,149.5,57.5,593.98,18
CDM,42173503_1,"X-ray of hip, minimum of 4 views",360.0,234.0,81.72,929.7,18
CDM,42173521_1,"X-ray of both hips, 2 views",315.0,204.75,78.75,813.49,18
CDM,42173522_1,"X-ray of both hips, 3-4 views",360.0,234.0,81.72,929.7,18
CDM,42173523_1,"X-ray of both hips, minimum of 5 views",352.0,228.8,81.72,909.04,18
CDM,42173525_1,Review by radiologist of hip joint image,1912.5,1243.13,172.18,4939.03,18
CDM,42173551_1,"X-ray of thigh bone, 1 view",405.0,263.25,81.72,1045.91,18
CDM,42173552_1,"X-ray of thigh bone, minimum 2 views",570.0,370.5,81.72,1472.03,18
CDM,42173560_1,"X-ray of knee, 1-2 views",570.0,370.5,81.72,1472.03,18
CDM,42173562_1,"X-ray of knee, 3 views",525.0,341.25,81.72,1355.81,18
CDM,42173564_1,"X-ray of knee, 4 or more views",433.5,281.78,81.72,1119.51,18
CDM,42173565_1,X-ray of both knees while standing,360.0,234.0,81.72,929.7,18
CDM,42173566_1,"X-ray of knee, 1-2 views",472.5,307.13,81.72,1220.23,18
CDM,42173567_1,"X-ray of knee, 3 views",435.0,282.75,81.72,1123.39,18
CDM,42173568_1,"X-ray of knee, 1-2 views",472.5,307.13,81.72,1220.23,18
CDM,42173569_1,"X-ray of knee, 3 views",435.0,282.75,81.72,1123.39,18
CDM,42173580_1,Review by radiologist of knee joint image,1980.0,1287.0,172.18,5113.35,18
CDM,42173590_1,"X-ray of lower leg, 2 views",480.0,312.0,81.72,1239.6,18
CDM,42173592_1,"X-ray of infant leg, minimum of 2 views",405.0,263.25,81.72,1045.91,18
CDM,42173600_1,"X-ray of ankle, 2 views",405.0,263.25,81.72,1045.91,18
CDM,42173610_1,"X-ray of ankle, minimum of 3 views",525.0,341.25,81.72,1355.81,18
CDM,42173620_1,"X-ray of foot, 2 views",337.5,219.38,81.72,871.59,18
CDM,42173621_1,"X-ray of foot, 2 views",337.5,219.38,81.72,871.59,18
CDM,42173622_1,"X-ray of foot, 2 views",337.5,219.38,81.72,871.59,18
CDM,42173630_1,"X-ray of foot, minimum of 3 views",480.0,312.0,81.72,1239.6,18
CDM,42173632_1,"X-ray of foot, minimum of 3 views",405.0,263.25,81.72,1045.91,18
CDM,42173633_1,"X-ray of foot, minimum of 3 views",405.0,263.25,81.72,1045.91,18
CDM,42173650_1,"X-ray of heel, minimum of 2 views",337.5,219.38,81.72,871.59,18
CDM,42173660_1,"X-ray of toe, minimum of 2 views",405.0,263.25,81.72,1045.91,18
CDM,42174018_1,"X-ray of abdomen, 1 view",230.0,149.5,57.5,593.98,18
CDM,42174019_1,"X-ray of abdomen, 2 views",325.0,211.25,81.25,839.31,18
CDM,42174021_1,"X-ray of abdomen, minimum of 3 views",360.0,234.0,81.72,929.7,18
CDM,42174022_1,X-ray series of abdomen with single X-ray of chest,450.0,292.5,81.72,1162.13,18
CDM,42174210_1,X-ray of voice box and/or esophagus with contrast,365.0,237.25,81.72,942.61,18
CDM,42174220_1,Single contrast X-ray of esophagus,698.0,453.7,81.72,1802.59,18
CDM,42174221_1,Double contrast X-ray of esophagus,365.0,237.25,91.25,942.61,18
CDM,42174230_1,Imaging for evaluation of swallowing function,329.0,213.85,82.25,849.64,18
CDM,42174240_1,Single contrast X-ray of upper digestive tract,660.0,429.0,165.0,1704.45,18
CDM,42174246_1,Double contrast X-ray of upper digestive tract,698.0,453.7,172.18,1802.59,18
CDM,42174250_1,Single contrast X-ray of small intestine,450.0,292.5,112.5,1162.13,18
CDM,42174251_1,Double contrast X-ray of small intestine,1827.0,1187.55,172.18,4718.23,18
CDM,42174270_1,Single contrast X-ray of large intestine,900.0,585.0,172.18,2324.25,18
CDM,42174280_1,Double contrast X-ray of large intestine,900.0,585.0,172.18,2324.25,18
CDM,42174300_1,Review by radiologist of bile and/or pancreatic duct image during surgery,585.0,380.25,146.25,1510.76,18
CDM,42174328_1,Review by radiologist of image from tube placement into bile duct using an endoscope,1125.0,731.25,281.25,2905.31,18
CDM,42174329_1,Review by radiologist of image from tube placement into pancreatic duct using an endoscope,1125.0,731.25,281.25,2905.31,18
CDM,42174330_1,Review by radiologist of image from tube placement into bile and pancreatic duct using an endoscope,1477.0,960.05,294.16,3814.35,18
CDM,42174340_1,Review by radiologist of placement of long small bowel tube,630.0,409.5,157.5,1626.98,18
CDM,42174360_1,Review by radiologist of image to guide opening of digestive tract,1449.0,941.85,294.16,3742.04,18
CDM,42174400_1,Imaging of urinary tract with injection of contrast into a vein,675.0,438.75,168.75,1743.19,18
CDM,42174420_1,Imaging of urinary tract following injection of a contrast agent,1390.0,903.5,172.18,3589.68,18
CDM,42174425_1,Review by radiologist of upper urinary tract image,675.0,438.75,168.75,1743.19,18
CDM,42174430_1,Review by radiologist of urinary bladder image,715.0,464.75,172.18,1846.49,18
CDM,42174450_1,Review by radiologist of urinary bladder and urethra images with contrast,675.0,438.75,168.75,1743.19,18
CDM,42174455_1,Review by radiologist of urinary bladder and urethra images with contrast and after passing urine,675.0,438.75,168.75,1743.19,18
CDM,42174740_1,Review by radiologist of uterine tube and ovary image,675.0,438.75,168.75,1743.19,18
CDM,42175625_1,Review by radiologist of abdominal aorta image,2700.0,1755.0,675.0,6972.75,18
CDM,42175710_1,Review by radiologist of arm or leg artery image,8065.0,5242.25,2016.25,20827.86,18
CDM,42175809_1,Review by radiologist of previous placed shunt image,450.0,292.5,112.5,1162.13,18
CDM,42175984_1,Review by radiologist of image for replacement of stomach or large bowel tube,900.0,585.0,225.0,2324.25,18
CDM,42176010_1,X-ray from nose to rectum,168.0,109.2,42.0,433.86,18
CDM,42176080_1,Review by radiologist of abscess or sinus cavity study,635.0,412.75,158.75,1639.89,18
CDM,42176098_1,X-ray of surgical specimen,1375.0,893.75,172.18,3550.94,18
CDM,42176937_1,Ultrasonic guidance for blood vessel access,650.0,422.5,162.5,1678.63,18
CDM,42177001_1,Fluoroscopic guidance for insertion or removal of central vein access device,657.0,427.05,164.25,1696.7,18
CDM,42177002_1,Fluoroscopic guidance for needle placement,395.0,256.75,98.75,1020.09,18
CDM,42177003_1,Fluoroscopic guidance for spine or back muscle injection,298.0,193.7,74.5,769.59,18
CDM,42177072_1,X-ray for estimating bone age,310.0,201.5,77.5,800.58,18
CDM,42177074_1,Limited X-ray of body bones,900.0,585.0,81.72,2324.25,18
CDM,42177075_1,Complete X-ray of body bones,360.0,234.0,90.0,929.7,18
CDM,42177076_1,X-ray of infant body bones,360.0,234.0,81.72,929.7,18
CDM,42177077_1,"X-ray of joints, multiple",360.0,234.0,81.72,929.7,18
CDM,42177080_1,"DXA bone density measurement of hip, pelvis, spine",325.0,211.25,81.25,839.31,18
CDM,42177085_1,"DXA bone density measurement of hip, pelvis, spine including spine fracture assessment",271.0,176.15,67.75,699.86,18
CDM,42177086_1,Fracture assessment of spine bones using DXA,136.0,88.4,34.0,351.22,18
CDM,42178740_1,Nuclear medicine study to assess urine flow,1351.0,878.15,337.75,3488.96,18
CDM,42180_1,"Repair of lacerated roof of mouth, 2.0 cm or less",640.0,416.0,78.57,616.87,19
CDM,42182_1,"Repair of lacerated roof of mouth, more than 2.0 cm",780.0,507.0,78.57,796.03,19
CDM,42196450_1,Administration of chemotherapy into fluid-filled space between the tissue that cover the brain and spinal cord,800.0,520.0,200.0,2066.0,18
CDM,42199306_1,"X-ray of shoulder, minimum of 2 views",525.0,341.25,81.72,1355.81,18
CDM,42200106_1,Design and construction of simple radiation treatment device,721.0,468.65,174.8,1861.98,19
CDM,42200107_1,Design and construction of intermediate radiation treatment device,670.0,435.5,167.5,1730.28,19
CDM,42200108_1,Design and construction of complex radiation treatment device,1075.0,698.75,268.75,2776.19,19
CDM,42200T_1,Repair of defect of soft and/or hard tissue of roof of mouth for cleft palate,5200.7,3380.46,78.57,2815.6,19
CDM,42200_1,Repair of defect of soft and/or hard tissue of roof of mouth for cleft palate,2940.0,1911.0,78.57,2815.6,19
CDM,42201728_1,"CATHETER, BRACHYTHERAPY SEED ADMINISTRATION",1628.0,1058.2,407.0,4204.31,16
CDM,42204648_1,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",147.0,95.55,36.75,379.63,16
CDM,42205_1,Repair of defect of soft tissue of roof of mouth for cleft palate,3150.0,2047.5,78.57,2927.79,19
CDM,42207402_1,Delivery of simple radiation treatment,600.0,390.0,150.0,1549.5,19
CDM,42207407_1,Delivery of intermediate radiation treatment,900.0,585.0,225.0,2324.25,19
CDM,42207412_1,Delivery of complex radiation treatment,1800.0,1170.0,261.6,4648.5,19
CDM,42210006_1,HC BINDER TEE FEMALE UNBLEACHED MUSLIN,46.0,29.9,11.5,32.2,11
CDM,42210840_1,HC FOLEY CATHETER W/COLLECTION BAG,115.0,74.75,28.75,80.5,11
CDM,42210T_1,Repair of cleft palate with bone graft,5200.7,3380.46,78.57,3269.53,19
CDM,42210_1,Repair of cleft palate with bone graft,3543.8,2303.47,78.57,3269.53,19
CDM,42211840_1,HC RADIATION ONC VENEZIA PACK,53.37,34.69,13.34,37.36,11
CDM,42215T_1,Revision of prior cleft palate repair,5200.7,3380.46,78.57,2136.75,19
CDM,42215_1,Revision of prior cleft palate repair,2551.5,1658.48,78.57,2136.75,19
CDM,42219081_1,"Biopsy of breast and placement of locating device using X-ray with needle, first growth",7681.5,4992.98,1920.38,19837.47,19
CDM,42219IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.33,2.16,0.83,8.6,16
CDM,42219OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.9,1.89,0.73,7.49,16
CDM,42220665_1,Removal of stabilizing device from head originally applied by other provider,146.0,94.9,36.5,377.05,19
CDM,42220_1,Repair of cleft palate with palate lengthening,2693.3,1750.65,78.57,1760.96,19
CDM,42225_1,Repair of cleft palate with local tissue graft from throat,2693.3,1750.65,78.57,2951.23,19
CDM,42226T_1,Lengthening of roof of mouth with throat tissue graft,5200.7,3380.46,78.57,2655.71,19
CDM,42226_1,Lengthening of roof of mouth with throat tissue graft,2756.3,1791.6,78.57,2655.71,19
CDM,42227_1,Lengthening of roof of mouth using mucous membrane tissue graft,2015.25,1309.91,78.57,2493.05,19
CDM,42232701_1,Delineation of thoracic targets for radiation therapy,1189.0,772.85,297.25,3070.59,16
CDM,42235_1,Lengthening of roof of mouth with tissue graft from tissue separating nose airways,2005.5,1303.58,78.57,2180.73,19
CDM,42249411_1,Insertion of device in abdominal cavity through skin for radiation therapy guidance,3560.0,2314.0,890.0,9193.7,19
CDM,42255875_1,Insertion of needle or tube into prostate for radiation therapy,1850.0,1202.5,462.5,6530.41,19
CDM,42255876_1,Placement of device in prostate for radiation therapy,1150.0,747.5,287.5,2969.88,19
CDM,42255920_1,Insertion of needles or tubes into pelvic or genital organs for radiation therapy,6539.0,4250.35,1197.0,16886.97,19
CDM,42257155_1,Insertion of device into uterus for radiation therapy,12000.0,7800.0,2318.31,30990.0,19
CDM,42257156_1,Insertion of device into vagina for radiation therapy,1635.0,1062.75,408.75,4222.39,19
CDM,42260_1,Repair of abnormal connection from nasal sinus to skin,2232.3,1451.0,78.57,2070.69,19
CDM,42275339_1,"IMAGE-GUIDED ROBOTIC LINEAR ACCELERATOR-BASED STEREOTACTIC RADIOSURGERY, COMPLETE COURSE OF THERAPY IN ONE SESSION OR FIRST SESSION OF FRACTIONATED TREATMENT",40413.0,26268.45,1197.0,104366.57,19
CDM,42275340_1,"IMAGE-GUIDED ROBOTIC LINEAR ACCELERATOR-BASED STEREOTACTIC RADIOSURGERY, DELIVERY INCLUDING COLLIMATOR CHANGES AND CUSTOM PLUGGING, FRACTIONATED TREATMENT, ALL LESIONS, PER SESSION, SECOND THROUGH FIF",8613.0,5598.45,1197.0,22243.07,19
CDM,42276295_1,3D radiation therapy planning,7100.0,4615.0,1197.0,18335.75,19
CDM,42276300_1,Calculation of radiation therapy dose,650.0,422.5,162.5,1678.63,19
CDM,42276334_1,Design and construction of complex radiation treatment device,1050.0,682.5,262.5,2711.63,19
CDM,42276873_1,Ultrasound scan of prostate through rectum,470.0,305.5,117.5,1213.78,19
CDM,42277012_1,Review by radiologist of CT guidance for needle placement,3000.0,1950.0,119.76,7747.5,18
CDM,42277014_1,Imaging guidance for localization of radiation treatment,1680.0,1092.0,174.8,4338.6,19
CDM,42277015_1,Imaging guidance for localization of radiation treatment,2100.0,1365.0,174.8,5423.25,19
CDM,42277016_1,Imaging guidance for localization of radiation treatment,2100.0,1365.0,174.8,5423.25,19
CDM,42277280_1,"Obtaining data needed to develop the optimal radiation treatment, 1 treatment area",755.0,490.75,174.8,1949.79,19
CDM,42277281_1,"Obtaining data needed to develop the optimal radiation treatment, 1 treatment area",1200.0,780.0,174.8,3099.0,19
CDM,42277285_1,"Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas",1358.0,882.7,271.37,3507.04,19
CDM,42277290_1,"Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved",1564.0,1016.6,271.37,4039.03,19
CDM,42277293_1,Obtaining respiratory data needed to develop the optimal radiation treatment,920.0,598.0,174.8,2375.9,19
CDM,42277295_1,3D radiation therapy planning,3300.0,2145.0,825.0,8522.25,19
CDM,42277300_1,Calculation of radiation therapy dose,470.0,305.5,117.5,1213.78,19
CDM,42277301_1,High precision radiation therapy planning,4100.0,2665.0,1025.0,10588.25,19
CDM,42277306_1,Simple radiation therapy planning for delivery of external radiation,1711.0,1112.15,174.8,4418.66,19
CDM,42277307_1,Complex radiation therapy planning for delivery of external radiation,1000.0,650.0,250.0,2582.5,19
CDM,42277316_1,Simple radiation therapy planning for delivery of internal radiation,1400.0,910.0,174.8,3615.5,19
CDM,42277317_1,Intermediate radiation therapy planning for delivery of internal radiation,1400.0,910.0,271.37,3615.5,19
CDM,42277318_1,Complex radiation therapy planning for delivery of internal radiation,1400.0,910.0,271.37,3615.5,19
CDM,42277321_1,Special radiation therapy planning for delivery of external radiation,1924.0,1250.6,271.37,4968.73,19
CDM,42277331_1,Special radiation therapy planning,755.0,490.75,174.8,1949.79,19
CDM,42277332_1,Design and construction of simple radiation treatment device,400.0,260.0,100.0,1197.0,19
CDM,42277333_1,Design and construction of intermediate radiation treatment device,755.0,490.75,174.8,1949.79,19
CDM,42277334_1,Design and construction of complex radiation treatment device,785.0,510.25,196.25,2027.26,19
CDM,42277336_1,Continuing radiation therapy consultation per week,470.0,305.5,117.5,1213.78,19
CDM,42277338_1,Design and construction of radiation treatment device for high precision radiation therapy,1405.0,913.25,271.37,3628.41,19
CDM,42277370_1,Special medical radiation therapy consultation,640.0,416.0,160.0,1652.8,19
CDM,42277372_1,Complete single session course of cranial lesion surgery using radiation and a machine to deliver external radiation,20700.0,13455.0,5175.0,53457.75,19
CDM,42277373_1,"IMAGE-GUIDED ROBOTIC LINEAR ACCELERATOR-BASED STEREOTACTIC RADIOSURGERY, COMPLETE COURSE OF THERAPY IN ONE SESSION OR FIRST SESSION OF FRACTIONATED TREATMENT",36372.0,23641.8,1197.0,93930.69,19
CDM,42277374_1,"IMAGE-GUIDED ROBOTIC LINEAR ACCELERATOR-BASED STEREOTACTIC RADIOSURGERY, DELIVERY INCLUDING COLLIMATOR CHANGES AND CUSTOM PLUGGING, FRACTIONATED TREATMENT, ALL LESIONS, PER SESSION, SECOND THROUGH FIF",7752.0,5038.8,1197.0,20019.54,19
CDM,42277375_1,Delivery of radiation therapy per dose to 1 or more lesions not to exceed 5 doses,4600.0,2990.0,1150.0,11879.5,19
CDM,42277385_1,Delivery of simple high precision radiation treatment,1590.0,1033.5,397.5,4106.18,19
CDM,42277386_1,Delivery of complex high precision radiation treatment,2000.0,1300.0,500.0,5165.0,19
CDM,42277387_1,Imaging guidance for localization of radiation treatment,600.0,390.0,150.0,1549.5,19
CDM,42277401_1,Superficial and/or low voltage radiation treatment delivery,950.0,617.5,237.5,2453.38,19
CDM,42277402_1,Delivery of simple radiation treatment,560.0,364.0,140.0,1446.2,19
CDM,42277407_1,Delivery of intermediate radiation treatment,560.0,364.0,140.0,1446.2,19
CDM,42277412_1,Delivery of complex radiation treatment,1000.0,650.0,250.0,2582.5,19
CDM,42277417_1,X-ray during radiation therapy,300.0,195.0,75.0,1197.0,19
CDM,42277462_1,3D radiation therapy planning,6391.0,4154.15,1197.0,16504.76,19
CDM,42277463_1,Design and construction of complex radiation treatment device,946.0,614.9,236.5,2443.05,19
CDM,42277464_1,Design and construction of complex radiation treatment device,946.0,614.9,236.5,2443.05,19
CDM,42277467_1,Design and construction of complex radiation treatment device,946.0,614.9,236.5,2443.05,19
CDM,42277470_1,Special radiation treatment,1675.0,1088.75,418.75,4325.69,19
CDM,42277471_1,Special radiation treatment,2251.0,1463.15,562.75,5813.21,19
CDM,42277473_1,BRACHYTHERAPY NEEDLE,276.0,179.4,69.0,712.77,16
CDM,42277474_1,HC DISPOSABLE PROSTATE LOCKING NEEDLE,571.0,371.15,142.75,399.7,11
CDM,42277761_1,Simple body cavity radiation source application,1462.0,950.3,365.5,3775.62,19
CDM,42277762_1,Intermediate body cavity radiation source application,2328.0,1513.2,582.0,6012.06,19
CDM,42277763_1,Complex body cavity radiation source application,3295.0,2141.75,823.75,8509.34,19
CDM,42277767_1,"High dose skin surface radiation therapy, 1 channel or lesion diameter 2.0 cm or less",3442.0,2237.3,687.75,8888.97,19
CDM,42277768_1,"High dose skin surface radiation therapy, 2 channels and lesion diameter more than 2.0 cm, or multiple lesions",717.0,466.05,179.25,1851.65,19
CDM,42277770_1,"High dose radiation therapy, 1 channel",2000.0,1300.0,500.0,5165.0,19
CDM,42277771_1,"High dose radiation therapy, 2-12 channels",2100.0,1365.0,525.0,5423.25,19
CDM,42277772_1,"High dose radiation therapy, more than 12 channels",2200.0,1430.0,550.0,5681.5,19
CDM,42277778_1,Complex application of radiation source,3601.0,2340.65,900.25,9299.58,18
CDM,42277785_1,"BRACHYTHERAPY SOURCE, NON-STRANDED, HIGH DOSE RATE IRIDIUM-192, PER SOURCE",50.0,32.5,12.5,379.51,18
CDM,42277789_1,Surface application of low dose rate source,515.0,334.75,128.75,1329.99,19
CDM,42277790_1,"Supervision, handling, and loading of radiation source",383.0,248.95,95.75,1197.0,19
CDM,42277799_1,Other administration of radiation therapy,258.0,167.7,64.5,666.29,18
CDM,42280_1,Impression of cheek bone for prosthesis at roof of mouth,385.78,250.76,21.66,430.07,19
CDM,42281728_1,"CATHETER, BRACHYTHERAPY SEED ADMINISTRATION",1288.0,837.2,322.0,3326.26,16
CDM,42281_1,Insertion of roof of mouth prosthesis,535.5,348.08,6.17,545.4,19
CDM,42288211_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,42288212_1,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",145.0,94.25,36.25,374.46,17
CDM,42288213_1,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",180.0,117.0,45.0,464.85,17
CDM,42288214_1,"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more",250.0,162.5,62.5,645.63,17
CDM,42288215_1,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",320.0,208.0,80.0,826.4,17
CDM,42298211_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,42298212_1,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",145.0,94.25,36.25,374.46,17
CDM,42298213_1,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",180.0,117.0,45.0,464.85,17
CDM,42298214_1,"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more",250.0,162.5,62.5,645.63,17
CDM,42298215_1,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",320.0,208.0,80.0,826.4,17
CDM,42299268_1,"BRACHYTHERAPY SOURCE, STRANDED, IODINE-125, PER SOURCE",63.0,40.95,15.75,379.51,18
CDM,42299277_1,"BRACHYTHERAPY SOURCE, NON-STRANDED, NON-HIGH DOSE RATE IRIDIUM-192, PER SOURCE",2890.0,1878.5,372.07,7463.43,18
CDM,42300200_1,"Injections of one side of sacrum for enlargement, 1 or more needles, accessed through the skin",7569.0,4919.85,1039.0,19546.94,18
CDM,42300201_1,"Injections of both sides of sacrum for enlargement, 2 or more needles, accessed through the skin",12614.0,8199.1,1039.0,32575.66,18
CDM,4230042T_1,"Computed tomography (CT) of brain blood flow, volume, and timing of flow analysis with contrast",200.0,130.0,50.0,1181.0,18
CDM,42300_1,Simple drainage of abscess of saliva gland,547.1,355.62,78.57,520.58,19
CDM,42301001_1,Other CT scan,1875.0,1218.75,155.26,4842.19,18
CDM,42305_1,Complicated drainage of abscess of saliva gland,1190.7,773.96,78.57,1284.76,19
CDM,4230722T_1,Quantitative computed tomography (CT scan) tissue characterization with interpretation and report and concurrent CT examination of any structure contained in the concurrently acquired diagnostic imagi,1565.0,1017.25,155.26,4041.61,18
CDM,42310_1,Drainage of abscess of lower jaw from inside of mouth,426.3,277.1,78.05,416.74,19
CDM,42320_1,Drainage of abscess of lower jaw from outside of mouth,658.4,427.96,78.57,631.47,19
CDM,42322510_1,Stabilization of upper spine bone,7312.0,4752.8,1828.0,18883.24,19
CDM,42322511_1,Stabilization of lower spine bone,7312.0,4752.8,1828.0,18883.24,19
CDM,42322512_1,"Stabilization of spine bone, each additional bone",7707.0,5009.55,1242.0,19903.33,19
CDM,42322514_1,Treatment of broken lower spine bone with placement of stabilizing device,13601.0,8840.65,3400.25,35124.58,19
CDM,42322515_1,"Treatment of broken spine bone with stabilizing device, each additional segment",6257.0,4067.05,1242.0,16158.7,19
CDM,42330_1,Uncomplicated removal of saliva gland stone from inside mouth,613.2,398.58,40.56,564.51,19
CDM,42335_1,Complicated removal of saliva gland stone from inside mouth,976.5,634.73,78.57,1045.57,19
CDM,42340_1,Complicated removal of saliva gland stone,1303.1,847.02,78.57,1288.01,19
CDM,42349083_1,Drainage of fluid from abdominal cavity using imaging guidance,1272.0,826.8,318.0,3726.0,19
CDM,42350200_1,Needle biopsy of kidney,5580.0,3627.0,1395.0,14410.35,19
CDM,4236IP _1,UNCLASSIFIED DRUGS,49.01,31.86,12.25,126.57,16
CDM,4236OP _1,UNCLASSIFIED DRUGS,45.44,29.54,11.36,117.35,16
CDM,42370450_1,CT scan head or brain without contrast,1000.0,650.0,250.0,2582.5,18
CDM,42370460_1,CT scan head or brain with contrast,1125.0,731.25,281.25,2905.31,18
CDM,42370470_1,CT scan of head or brain before and after contrast,1275.0,828.75,318.75,3292.69,18
CDM,42370471_1,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY (CTA), HEAD AND NECK, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES, WHEN PERFORMED, AND IMAGE POSTPROCESSING",892.0,579.8,223.0,2303.59,16
CDM,42370472_1,"COMPUTED TOMOGRAPHIC (CT) CEREBRAL PERFUSION ANALYSIS WITH CONTRAST MATERIAL(S), INCLUDING IMAGE POSTPROCESSING PERFORMED WITH CONCURRENT CT OR CT ANGIOGRAPHY OF THE SAME ANATOMY (LIST SEPARATELY IN A",440.0,286.0,110.0,1181.0,16
CDM,42370473_1,"COMPUTED TOMOGRAPHIC (CT) CEREBRAL PERFUSION ANALYSIS WITH CONTRAST MATERIAL(S), INCLUDING IMAGE POSTPROCESSING PERFORMED WITHOUT CONCURRENT CT OR CT ANGIOGRAPHY OF THE SAME ANATOMY",450.0,292.5,112.5,1181.0,16
CDM,42370480_1,CT scan of cranial cavity without contrast,1000.0,650.0,155.26,2582.5,18
CDM,42370481_1,CT scan of cranial cavity with contrast,1125.0,731.25,281.25,2905.31,18
CDM,42370482_1,CT scan of cranial cavity before and after contrast,1275.0,828.75,318.75,3292.69,18
CDM,42370486_1,CT scan of face without contrast,1000.0,650.0,155.26,2582.5,18
CDM,42370487_1,CT scan of face with contrast,1125.0,731.25,281.25,2905.31,18
CDM,42370488_1,CT scan of face before and after contrast,1175.0,763.75,293.75,3034.44,18
CDM,42370490_1,CT scan of soft tissue of neck without contrast,1000.0,650.0,155.26,2582.5,18
CDM,42370491_1,CT scan of soft tissue of neck with contrast,1125.0,731.25,281.25,2905.31,18
CDM,42370492_1,CT scan of soft tissue of neck before and after contrast,1275.0,828.75,318.75,3292.69,18
CDM,42370496_1,CT scan of blood vessels of head with contrast,1050.0,682.5,262.5,2711.63,18
CDM,42370498_1,CT scan of blood vessels of neck with contrast,1050.0,682.5,262.5,2711.63,18
CDM,42371250_1,CT scan of chest without contrast,1000.0,650.0,155.26,2582.5,18
CDM,42371251_1,CT scan of chest without contrast,1185.0,770.25,155.26,3060.26,18
CDM,42371260_1,CT scan of chest with contrast,1125.0,731.25,281.25,2905.31,18
CDM,42371270_1,CT scan of chest before and after contrast,1275.0,828.75,318.75,3292.69,18
CDM,42371271_1,Low dose CT scan of chest for lung cancer screening,255.0,165.75,63.75,1181.0,18
CDM,42371275_1,CT scan of blood vessels of chest with contrast,1050.0,682.5,262.5,2711.63,18
CDM,42372125_1,CT scan of upper spine without contrast,1000.0,650.0,155.26,2582.5,18
CDM,42372126_1,CT scan of upper spine with contrast,1300.0,845.0,325.0,3357.25,18
CDM,42372127_1,CT scan of upper spine before and after contrast,1200.0,780.0,300.0,3099.0,18
CDM,42372128_1,CT scan of middle spine without contrast,1000.0,650.0,155.26,2582.5,18
CDM,42372129_1,CT scan of middle spine with contrast,1125.0,731.25,281.25,2905.31,18
CDM,42372130_1,CT scan of middle spine before and after contrast,1200.0,780.0,300.0,3099.0,18
CDM,42372131_1,CT scan of lower spine without contrast,1000.0,650.0,155.26,2582.5,18
CDM,42372132_1,CT scan of lower spine with contrast,1300.0,845.0,325.0,3357.25,18
CDM,42372133_1,CT scan of lower spine before and after contrast,1325.0,861.25,331.25,3421.81,18
CDM,42372191_1,CT scan of blood vessels of pelvis with contrast,1025.0,666.25,256.25,2647.06,18
CDM,42372192_1,CT scan of pelvis without contrast,1000.0,650.0,155.26,2582.5,18
CDM,42372193_1,CT scan of pelvis with contrast,1125.0,731.25,281.25,2905.31,18
CDM,42372194_1,CT scan of pelvis before and after contrast,1172.0,761.8,293.0,3026.69,18
CDM,42373200_1,CT scan of arm without contrast,1500.0,975.0,155.26,3873.75,18
CDM,42373201_1,CT scan of arm with contrast,1687.5,1096.88,421.88,4357.97,18
CDM,42373202_1,CT scan of arm before and after contrast,1800.0,1170.0,442.27,4648.5,18
CDM,42373203_1,CT scan of arm without contrast,1500.0,975.0,155.26,3873.75,18
CDM,42373204_1,CT scan of arm with contrast,1687.5,1096.88,421.88,4357.97,18
CDM,42373205_1,CT scan of arm before and after contrast,1800.0,1170.0,442.27,4648.5,18
CDM,42373206_1,CT scan of blood vessels of arm with contrast,1537.5,999.38,384.38,3970.59,18
CDM,42373700_1,CT scan of leg without contrast,1500.0,975.0,155.26,3873.75,18
CDM,42373701_1,CT scan of leg with contrast material,1687.5,1096.88,421.88,4357.97,18
CDM,42373702_1,CT scan of leg before and after contrast,1800.0,1170.0,442.27,4648.5,18
CDM,42373706_1,CT scan of blood vessels of lower leg with contrast,1575.0,1023.75,393.75,4067.44,18
CDM,42374150_1,CT scan of abdomen without contrast,1000.0,650.0,155.26,2582.5,18
CDM,42374160_1,CT scan of abdomen with contrast,1125.0,731.25,281.25,2905.31,18
CDM,42374170_1,CT scan of abdomen before and after contrast,1275.0,828.75,318.75,3292.69,18
CDM,42374174_1,CT scan of blood vessels of abdomen and pelvis with contrast,1470.0,955.5,367.5,3796.28,18
CDM,42374175_1,CT scan of blood vessels of abdomen with contrast,1050.0,682.5,262.5,2711.63,18
CDM,42374176_1,CT scan of abdomen and pelvis without contrast,1260.0,819.0,315.0,3253.95,18
CDM,42374177_1,CT scan of abdomen and pelvis with contrast,1575.0,1023.75,393.75,4067.44,18
CDM,42374178_1,CT scan of abdomen and pelvis before and after contrast,1785.0,1160.25,442.27,4609.76,18
CDM,42374261_1,Diagnostic CT scan of large intestine without contrast,2000.0,1300.0,155.26,5165.0,18
CDM,42374263_1,Screening CT scan of large intestine,2000.0,1300.0,155.26,5165.0,18
CDM,42375571_1,CT scan of heart with evaluation of blood vessel calcium,225.0,146.25,56.25,1181.0,18
CDM,42375572_1,CT scan of heart structure with contrast,1125.0,731.25,281.25,2905.31,18
CDM,42375573_1,CT scan of congenital heart disease with contrast,1125.0,731.25,281.25,2905.31,18
CDM,42375574_1,CT scan of blood vessels and grafts of heart with contrast,1125.0,731.25,281.25,2905.31,18
CDM,42375577_1,"QUANTIFICATION AND CHARACTERIZATION OF CORONARY ATHEROSCLEROTIC PLAQUE TO ASSESS SEVERITY OF CORONARY DISEASE, DERIVED FROM AUGMENTATIVE SOFTWARE ANALYSIS OF THE DATA SET FROM A CORONARY COMPUTED TOMO",2377.0,1545.05,594.25,6138.6,16
CDM,42375580_1,"Analysis of data from CT study of heart blood vessels to assess severity of heart artery disease, with interpretation and report",3740.0,2431.0,935.0,9658.55,17
CDM,42375635_1,CT scan of abdominal aorta and both leg arteries with contrast,1425.0,926.25,356.25,3680.06,18
CDM,42375989_1,Review by radiologist of image for drainage of fluid,1185.0,770.25,294.16,3060.26,18
CDM,42376376_1,3D radiographic procedure,1000.0,650.0,250.0,2582.5,16
CDM,42376377_1,3D radiographic procedure with computerized image postprocessing,1000.0,650.0,250.0,2582.5,16
CDM,42376380_1,Limited or follow-up CT scan,1000.0,650.0,155.26,2582.5,18
CDM,42376383_1,Limited or follow-up CT scan,1200.0,780.0,155.26,3099.0,18
CDM,42376942_1,Ultrasonic guidance for needle placement,800.0,520.0,163.6,2066.0,18
CDM,42377002_1,Fluoroscopic guidance for needle placement,540.0,351.0,135.0,1394.55,18
CDM,42377011_1,CT guidance for needle or tube localization,3600.0,2340.0,119.76,9297.0,18
CDM,42377012_1,Review by radiologist of CT guidance for needle placement,1000.0,650.0,119.76,2582.5,18
CDM,42377013_1,CT guidance for tissue removal,1000.0,650.0,119.76,2582.5,18
CDM,42377021_1,Review by radiologist of MRI guidance for needle placement,3151.0,2048.15,317.35,8137.46,18
CDM,42377078_1,CT scan for measuring calcium and other minerals in bone,721.0,468.65,114.76,1861.98,18
CDM,4237IP _1,UNCLASSIFIED DRUGS,46.45,30.19,11.61,119.96,16
CDM,4237OP _1,UNCLASSIFIED DRUGS,14.88,9.67,3.72,38.43,16
CDM,4238IP _1,UNCLASSIFIED DRUGS,3.95,2.57,0.99,10.2,16
CDM,4238OP _1,UNCLASSIFIED DRUGS,5.06,3.29,1.27,13.07,16
CDM,42390214_1,Limited or follow-up CT scan,1000.0,650.0,155.26,2582.5,18
CDM,42390215_1,CT scan of blood vessels of chest with contrast,1563.0,1015.95,390.75,4036.45,18
CDM,423C8001_1,"3D ANATOMICAL SEGMENTATION IMAGING FOR PREOPERATIVE PLANNING, DATA PREPARATION AND TRANSMISSION, OBTAINED FROM PREVIOUS DIAGNOSTIC COMPUTED TOMOGRAPHIC OR MAGNETIC RESONANCE EXAMINATION OF THE SAME AN",375.0,243.75,93.75,1181.0,16
CDM,423G0297_1,Low dose CT scan of chest for lung cancer screening,1185.0,770.25,155.26,3060.26,18
CDM,42400_1,Needle biopsy of saliva gland,291.9,189.74,33.96,234.79,19
CDM,42402305_1,Nuclear medicine study from skull base to mid-thigh with CT scan,6500.0,4225.0,1625.0,16786.25,18
CDM,42402306_1,Nuclear medicine study whole body with CT scan,6500.0,4225.0,1625.0,16786.25,18
CDM,42402805_1,"INJECTION, SINCALIDE, 5 MICROGRAMS",183.82,119.48,45.96,474.72,18
CDM,42405_1,Biopsy of saliva gland,810.6,526.89,78.57,733.13,19
CDM,42408459_1,Nuclear medicine study of heart muscle with metabolic evaluation,6500.0,4225.0,1625.0,16786.25,18
CDM,42408831_1,"Nuclear medicine study, SPECT imaging, at least 2 areas or separate acquisitions, single day imaging, or single area or acquisition over multiple days",3150.0,2047.5,787.5,8134.88,18
CDM,42408_1,Removal of salivary cyst under tongue,1202.3,781.5,78.57,1320.17,19
CDM,42409584_1,"IODINE 1-123 IOFLUPANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 5 MILLICURIES",14501.0,9425.65,1471.0,43748.07,17
CDM,42409588_1,"FLUCICLOVINE F-18, DIAGNOSTIC, 1 MILLICURIE",1180.0,767.0,295.0,3559.94,17
CDM,42409604_1,"SAMARIUM SM-153 LEXIDRONAM, THERAPEUTIC, PER TREATMENT DOSE, UP TO 150 MILLICURIES",15593.0,10135.45,3349.39,40268.92,19
CDM,42409852_1,"IODINE I-123 IOBENGUANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",13760.0,8944.0,2456.55,35535.2,17
CDM,42409_1,Creation of tract to drain cyst of saliva gland,869.4,565.11,78.57,957.47,19
CDM,42410_1,"Removal of growth of saliva gland or saliva gland, lateral lobe",2586.15,1681.0,78.57,1863.55,19
CDM,42415_1,Removal of growth of saliva gland with release of facial nerve,4695.15,3051.85,78.57,3166.16,19
CDM,42420_1,Removal of growth of saliva gland or saliva gland with release of facial nerve,5385.0,3500.25,78.57,3557.14,19
CDM,42422616_1,"BRACHYTHERAPY SOURCE, NON-STRANDED, YTTRIUM-90, PER SOURCE",69992.0,45494.8,16299.55,180754.34,19
CDM,42425_1,"Removal of growth of saliva gland or saliva gland, and facial nerve",2751.0,1788.15,78.57,2504.93,19
CDM,42426_1,"Removal of growth of saliva gland or saliva gland, and surrounding lymph nodes on side of neck",5294.1,3441.17,78.57,4050.74,19
CDM,42440_1,Removal of saliva gland under floor of mouth,2953.2,1919.58,78.57,1234.99,19
CDM,42450_1,Removal of saliva gland under tongue,1203.3,782.15,78.57,1136.8,19
CDM,42470491_1,CT scan of soft tissue of neck with contrast,1500.0,975.0,375.0,3873.75,18
CDM,42471260_1,CT scan of chest with contrast,1500.0,975.0,375.0,3873.75,18
CDM,42474177_1,CT scan of abdomen and pelvis with contrast,2100.0,1365.0,442.27,5423.25,18
CDM,42477300_1,Calculation of radiation therapy dose,650.0,422.5,162.5,1678.63,19
CDM,42477790_1,"Supervision, handling, and loading of radiation source",670.0,435.5,167.5,1730.28,19
CDM,42478012_1,Nuclear medicine study of thyroid function,1500.0,975.0,375.0,3873.75,18
CDM,42478013_1,Nuclear medicine study of thyroid,1500.0,975.0,375.0,3873.75,18
CDM,42478014_1,Nuclear medicine study of thyroid and thyroid function,1095.0,711.75,273.75,2827.84,18
CDM,42478018_1,Nuclear medicine study of whole body for thyroid cancer,1500.0,975.0,375.0,3873.75,18
CDM,42478020_1,Nuclear medicine study of thyroid function for thyroid cancer,500.0,325.0,125.0,1291.25,18
CDM,42478070_1,Nuclear medicine study of parathyroid,1500.0,975.0,375.0,3873.75,18
CDM,42478071_1,Nuclear medicine study of parathyroid with SPECT,1500.0,975.0,375.0,3873.75,18
CDM,42478072_1,Nuclear medicine study of parathyroid with SPECT and CT scan,2000.0,1300.0,500.0,5165.0,18
CDM,42478099_1,Nuclear medicine study of endocrine organs,1500.0,975.0,375.0,3873.75,18
CDM,42478121_1,"Nuclear medicine study of red blood cell volume, multiple samples",1800.0,1170.0,450.0,4648.5,18
CDM,42478122_1,Nuclear medicine study of whole blood volume,1800.0,1170.0,450.0,4648.5,18
CDM,42478195_1,Nuclear medicine study of lymphatic system,1250.0,812.5,312.5,3228.13,18
CDM,42478199_1,Nuclear medicine study of blood and lymphatic systems,3000.0,1950.0,534.64,7747.5,18
CDM,42478201_1,Nuclear medicine study of liver,4000.0,2600.0,1000.0,10330.0,18
CDM,42478215_1,Nuclear medicine study of liver and spleen,1500.0,975.0,375.0,3873.75,18
CDM,42478226_1,Nuclear medicine study of liver and bile duct system,1500.0,975.0,375.0,3873.75,18
CDM,42478227_1,Nuclear medicine study of liver and bile duct system with use of drugs,1460.0,949.0,365.0,3770.45,18
CDM,42478261_1,Nuclear medicine study of stomach lining,1500.0,975.0,375.0,3873.75,18
CDM,42478264_1,Nuclear medicine study of stomach to assess emptying,1095.0,711.75,273.75,2827.84,18
CDM,42478267_1,Nuclear medicine study to acquire exhaled breath samples,75.0,48.75,14.14,193.69,18
CDM,42478268_1,Nuclear medicine study to assess exhaled breath samples,250.0,162.5,62.5,645.63,18
CDM,42478278_1,Nuclear medicine study to assess blood loss,1500.0,975.0,375.0,3873.75,18
CDM,42478290_1,Nuclear medicine study of intestine,875.0,568.75,218.75,2259.69,18
CDM,42478291_1,Nuclear medicine study to assess the degree of openness of shunt from jugular vein to abdominal cavity,1500.0,975.0,375.0,3873.75,18
CDM,42478299_1,Nuclear medicine study of digestive tracts,2500.0,1625.0,534.64,6456.25,18
CDM,42478300_1,Nuclear medicine study of bone and/or joint limited area,1500.0,975.0,375.0,3873.75,18
CDM,42478306_1,Nuclear medicine study of bone and/or joint whole body,1095.0,711.75,273.75,2827.84,18
CDM,42478315_1,Nuclear medicine study of bone taken at different times,1095.0,711.75,273.75,2827.84,18
CDM,42478399_1,Other nuclear medicine study of musculoskeletal system,1500.0,975.0,375.0,3873.75,18
CDM,42478429_1,Nuclear medicine study of heart muscle with metabolic evaluation and concurrent CT scan,2890.0,1878.5,722.5,7463.43,18
CDM,42478430_1,Nuclear medicine study of blood flow in heart muscle at rest and with stress with concurrent CT scan,2890.0,1878.5,722.5,7463.43,18
CDM,42478431_1,Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent CT scan,4510.0,2931.5,1127.5,11647.08,18
CDM,42478432_1,Nuclear medicine study of heart muscle with metabolic and blood flow evaluation requiring 2 injections,5510.0,3581.5,1377.5,14229.58,18
CDM,42478433_1,Nuclear medicine study of heart muscle with metabolic and blood flow evaluation requiring 2 injections and concurrent CT scan,5510.0,3581.5,1377.5,14229.58,18
CDM,42478434_1,Nuclear medicine study of heart muscle blood flow by PET,1750.0,1137.5,437.5,4519.38,18
CDM,42478451_1,Nuclear medicine study of heart muscle at rest and with stress and SPECT,2920.0,1898.0,730.0,7540.9,18
CDM,42478452_1,Nuclear medicine studies of heart muscle at rest and with stress and SPECT,3660.0,2379.0,915.0,9451.95,18
CDM,42478453_1,Nuclear medicine study of heart muscle at rest and with stress with single 2D image,4000.0,2600.0,1000.0,10330.0,18
CDM,42478454_1,Nuclear medicine studies of heart muscle at rest and with stress with single 2D image,4000.0,2600.0,1000.0,10330.0,18
CDM,42478469_1,Nuclear medicine study of heart muscle following heart attack with SPECT,4000.0,2600.0,1000.0,10330.0,18
CDM,42478472_1,Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume ejected with every beat over multiple cycles,1500.0,975.0,375.0,3873.75,18
CDM,42478473_1,Nuclear medicine studies of heart pumping function by labeling red blood cells with measurement of internal blood volume ejected with every beat over multiple cycles,1500.0,975.0,375.0,3873.75,18
CDM,42478491_1,Nuclear medicine study of blood flow in heart muscle at rest and with stress,4000.0,2600.0,1000.0,10330.0,18
CDM,42478492_1,Nuclear medicine studies of blood flow in heart muscle at rest and with stress,4000.0,2600.0,1000.0,10330.0,18
CDM,42478499_1,Other nuclear medicine study of cardiovascular system,1500.0,975.0,375.0,3873.75,18
CDM,42478579_1,Nuclear medicine study of lung ventilation,1500.0,975.0,375.0,3873.75,18
CDM,42478580_1,Nuclear medicine study of lung circulation,1500.0,975.0,375.0,3873.75,18
CDM,42478583_1,Nuclear medicine study of lung ventilation and circulation,1278.0,830.7,319.5,3300.44,18
CDM,42478597_1,Nuclear medicine study of lung ventilation and blood flow to lung,1500.0,975.0,375.0,3873.75,18
CDM,42478598_1,Nuclear medicine study of lung ventilation and circulation and blood flow to lung,1500.0,975.0,375.0,3873.75,18
CDM,42478599_1,Other nuclear medicine study of respiratory system,1500.0,975.0,375.0,3873.75,18
CDM,42478601_1,Nuclear medicine study of brain and blood flow,1500.0,975.0,375.0,3873.75,18
CDM,42478605_1,"Nuclear medicine study of brain, 4 static views or more",1295.0,841.75,323.75,3344.34,18
CDM,42478608_1,Nuclear medicine study of brain with metabolic evaluation,6500.0,4225.0,1625.0,16786.25,18
CDM,42478610_1,Nuclear medicine study of brain with blood flow,1295.0,841.75,323.75,3344.34,18
CDM,42478630_1,Nuclear medicine study of cerebrospinal fluid flow after injection of contrast into lower spine,2000.0,1300.0,500.0,5165.0,18
CDM,42478631_1,Nuclear medicine study of cerebrospinal fluid flow after injection of contrast into lower spine,2000.0,1300.0,500.0,5165.0,18
CDM,42478645_1,Nuclear medicine study of cerebrospinal fluid flow to evaluate shunt,2000.0,1300.0,500.0,5165.0,18
CDM,42478650_1,Nuclear medicine study of cerebrospinal fluid flow to locate leakage,4000.0,2600.0,1000.0,10330.0,18
CDM,42478699_1,Other nuclear medicine study of nervous system,1500.0,975.0,375.0,3873.75,18
CDM,42478707_1,"Nuclear medicine study of kidney, blood flow, and function",1500.0,975.0,375.0,3873.75,18
CDM,42478708_1,"Nuclear medicine study of kidney, blood, flow, and function with drug administration",1500.0,975.0,375.0,3873.75,18
CDM,42478725_1,Nuclear medicine study of kidney function,1500.0,975.0,375.0,3873.75,18
CDM,42478799_1,Other nuclear medicine study of urogenital system,1500.0,975.0,375.0,3873.75,18
CDM,42478800_1,"Nuclear medicine study, 1 area",1500.0,975.0,375.0,3873.75,18
CDM,42478801_1,"Nuclear medicine study, multiple areas",1500.0,975.0,375.0,3873.75,18
CDM,42478802_1,"Nuclear medicine study, whole body",4000.0,2600.0,1000.0,10330.0,18
CDM,42478803_1,"Nuclear medicine study, SPECT imaging, 1 area or single acquisition, single day imaging",2000.0,1300.0,500.0,5165.0,18
CDM,42478804_1,"Nuclear medicine study, whole body requiring multiple imaging days",4000.0,2600.0,1000.0,10330.0,18
CDM,42478808_1,Injection of radioactive contrast into a vein for non-imaging gamma probe,1500.0,975.0,375.0,3873.75,18
CDM,42478811_1,Nuclear medicine study limited area,4000.0,2600.0,1000.0,10330.0,18
CDM,42478830_1,"Nuclear medicine study, SPECT imaging with concurrent CT scan, 1 area or single acquisition, single day imaging",3150.0,2047.5,787.5,8134.88,18
CDM,42478831_1,"Nuclear medicine study, whole body requiring multiple imaging days",4000.0,2600.0,1000.0,10330.0,18
CDM,42478832_1,"Nuclear medicine study, SPECT imaging with concurrent CT scan, at least 2 areas or separate acquisitions, single day imaging, or single area or acquisition over multiple days",3150.0,2047.5,787.5,8134.88,18
CDM,42478835_1,Quantification of radioactive materials,1445.0,939.25,361.25,3731.71,18
CDM,42478845_1,Calculation of radiation therapy dose,650.0,422.5,162.5,1678.63,19
CDM,42478999_1,Other nuclear medicine study,1500.0,975.0,375.0,3873.75,18
CDM,42479031_1,Radioactive drug therapy by mouth,1000.0,650.0,250.0,2582.5,18
CDM,42479032_1,Radioactive drug therapy through a vein,1000.0,650.0,250.0,2582.5,18
CDM,42479033_1,Radioactive drug therapy through a tube inserted in an artery,1000.0,650.0,250.0,2582.5,18
CDM,42479403_1,Radioactive drug therapy of radiolabeled monoclonal antibody through a vein,1000.0,650.0,250.0,2582.5,18
CDM,42479578_1,"STRONTIUM SR-89 CHLORIDE, THERAPEUTIC, PER MILLICURIE",4241.0,2756.65,1060.25,18303.64,19
CDM,42496379_1,"Injection or infusion into a vein or artery for therapy, prevention, or diagnosis",248.0,161.2,62.0,640.46,18
CDM,42498814_1,Nuclear medicine study limited area with CT scan,7500.0,4875.0,1875.0,19368.75,18
CDM,42498815_1,Nuclear medicine study from skull base to mid-thigh with CT scan,6500.0,4225.0,1625.0,16786.25,18
CDM,42498816_1,Nuclear medicine study whole body with CT scan,6500.0,4225.0,1625.0,16786.25,18
CDM,42499231_1,"INJECTION, THYROTROPIN ALPHA, 0.9 MG, PROVIDED IN 1.1 MG VIAL",2210.0,1436.5,552.5,5707.33,19
CDM,42499413_1,HC FLUOROTHYMIDINE  F-18 FLT RESEARCH DRUG,5857.0,3807.05,1464.25,4099.9,11
CDM,42499572_1,"INDIUM IN-111 PENTETREOTIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 6 MILLICURIES",10029.9,6519.44,2121.0,30259.21,17
CDM,42499573_1,HC THYMOGEN PER VIAL,2767.0,1798.55,691.75,1936.9,11
CDM,424A9580_1,"SODIUM FLUORIDE F-18, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",138.0,89.7,34.5,416.33,17
CDM,424A9584_1,"IODINE 1-123 IOFLUPANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 5 MILLICURIES",6958.0,4522.7,1471.0,20991.59,17
CDM,424A9587_1,"GALLIUM GA-68, DOTATATE, DIAGNOSTIC, 0.1 MILLICURIE",202.0,131.3,50.5,609.41,17
CDM,424A9606_1,"RADIUM RA-223 DICHLORIDE, THERAPEUTIC, PER MICROCURIE",313.0,203.45,78.25,18303.64,19
CDM,424A9699_1,"RADIOPHARMACEUTICAL, THERAPEUTIC, NOT OTHERWISE CLASSIFIED",33340.0,21671.0,8335.0,86100.55,17
CDM,42500_1,Simple repair of salivary duct,1167.6,758.94,78.57,1087.26,19
CDM,42505_1,Complicated plastic repair of salivary duct,1680.0,1092.0,78.57,1415.54,19
CDM,42507_1,Creation of new drainage tracts of major saliva gland ducts on both sides of mouth,1575.0,1023.75,78.57,1514.14,19
CDM,42509_1,Creation of new drainage tracts of major saliva gland ducts on both sides of mouth with removal of salivary glands below both sides of jaw,2625.0,1706.25,78.57,2505.4,19
CDM,42510_1,Creation of new drainage tracts of major saliva gland ducts on both sides of mouth with tying of saliva gland ducts below both sides of jaw,2100.0,1365.0,78.57,1858.46,19
CDM,42550_1,Injection of contrast for imaging of saliva glands,1309.4,851.11,20.57,378.13,19
CDM,42600043_1,"MRI scan of bone of eye socket, face, and/or neck before and after contrast",2350.0,1527.5,587.5,6068.88,18
CDM,42600543_1,"MRI scan of bone of eye socket, face, and/or neck before and after contrast",3500.0,2275.0,592.21,9038.75,18
CDM,42600_1,Closure of abnormal drainage tract of saliva gland,1357.7,882.51,78.57,1319.4,19
CDM,42603723_1,MRI scan of leg joint before and after contrast,3525.0,2291.25,592.21,9103.31,18
CDM,4260649T_1,Quantitative magnetic resonance analysis of tissue composition with diagnostic MRI examination,2377.0,1545.05,351.02,6138.6,18
CDM,4260865T_1,Quantitative MRI of the brain with comparison to previous MRI scan without MRI scan performed during the same visit,610.0,396.5,152.5,2024.0,16
CDM,4260866T_1,Quantitative MRI of the brain with comparison to previous MRI scan with MRI scan performed during the same visit,610.0,396.5,152.5,2024.0,16
CDM,42609579_1,"INJECTION, GADOLINIUM-BASED MAGNETIC RESONANCE CONTRAST AGENT, NOT OTHERWISE SPECIFIED (NOS), PER ML",15.08,9.8,1.55,45.49,17
CDM,42609580_1,"INJECTION, GADOLINIUM-BASED MAGNETIC RESONANCE CONTRAST AGENT, NOT OTHERWISE SPECIFIED (NOS), PER ML",15.08,9.8,1.55,45.49,17
CDM,42609581_1,"INJECTION, GADOLINIUM-BASED MAGNETIC RESONANCE CONTRAST AGENT, NOT OTHERWISE SPECIFIED (NOS), PER ML",194.0,126.1,48.5,585.28,16
CDM,42622IP _1,PROQUAD VIAL,670.9,436.09,167.73,469.63,11
CDM,42650_1,Insertion of probe to widen saliva gland duct,220.5,143.33,22.56,179.47,19
CDM,42660000_1,Other MRI scan,2200.0,1430.0,351.02,5681.5,18
CDM,42660100_1,Other MRI scan,2200.0,1430.0,351.02,5681.5,18
CDM,42660_1,Dilation of saliva gland duct and insertion of tube,284.6,184.99,28.81,272.43,19
CDM,42662367_1,Electronic analysis of spinal canal drug infusion pump,290.0,188.5,72.5,2318.31,19
CDM,42665_1,Tying of saliva gland duct,810.6,526.89,67.97,911.0,19
CDM,42670336_1,MRI scan of jaw joint,1725.0,1121.25,351.02,4454.81,18
CDM,42670540_1,"MRI scan of bone of eye socket, face, and/or neck without contrast",1725.0,1121.25,351.02,4454.81,18
CDM,42670542_1,"MRI scan of bone of eye socket, face, and/or neck with contrast",1900.0,1235.0,475.0,4906.75,18
CDM,42670543_1,"MRI scan of bone of eye socket, face, and/or neck before and after contrast",2350.0,1527.5,587.5,6068.88,18
CDM,42670544_1,MRI scan of blood vessels of head without contrast,1800.0,1170.0,450.0,4648.5,18
CDM,42670545_1,MRI scan of blood vessels of head with contrast,2730.0,1774.5,682.5,7050.23,18
CDM,42670546_1,MRI scan of blood vessels of head before and after contrast,2100.0,1365.0,525.0,5423.25,18
CDM,42670547_1,MRI scan of blood vessels of neck without contrast,1800.0,1170.0,450.0,4648.5,18
CDM,42670548_1,MRI scan of blood vessels of neck with contrast,2730.0,1774.5,682.5,7050.23,18
CDM,42670549_1,MRI scan of blood vessels of neck before and after contrast,2200.0,1430.0,550.0,5681.5,18
CDM,42670551_1,MRI scan of brain without contrast,1725.0,1121.25,351.02,4454.81,18
CDM,42670552_1,Functional MRI scan of brain,2200.0,1430.0,351.02,5681.5,18
CDM,42670554_1,MRI scan of brain with contrast,2730.0,1774.5,592.21,7050.23,18
CDM,42670555_1,MRI scan of brain before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42670556_1,Functional MRI scan of brain with neurofunctional testing,2200.0,1430.0,351.02,5681.5,18
CDM,42670560_1,MRI scan of brain without contrast,1725.0,1121.25,351.02,4454.81,18
CDM,42670561_1,MRI scan of brain with contrast,2730.0,1774.5,592.21,7050.23,18
CDM,42670562_1,MRI scan of brain before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42670563_1,MRI scan of brain without contrast,2275.0,1478.75,351.02,5875.19,18
CDM,42670564_1,MRI scan of brain with contrast,2730.0,1774.5,592.21,7050.23,18
CDM,42670565_1,MRI scan of brain before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42670567_1,MRI scan of brain without contrast,2500.0,1625.0,351.02,6456.25,18
CDM,42671142_1,MRI scan of upper spinal canal with contrast,1900.0,1235.0,475.0,4906.75,18
CDM,42671544_1,MRI scan of blood vessels of head without contrast,1800.0,1170.0,450.0,4648.5,18
CDM,42671545_1,MRI scan of blood vessels of head with contrast,2730.0,1774.5,682.5,7050.23,18
CDM,42671546_1,MRI scan of blood vessels of head before and after contrast,2100.0,1365.0,525.0,5423.25,18
CDM,42671550_1,MRI scan of chest without contrast,1725.0,1121.25,351.02,4454.81,18
CDM,42671551_1,MRI scan of chest with contrast,3000.0,1950.0,592.21,7747.5,18
CDM,42671552_1,MRI scan of chest before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42671555_1,MRI scan of blood vessels of chest,1800.0,1170.0,450.0,4648.5,18
CDM,42671556_1,MRI scan of blood vessels of chest,2100.0,1365.0,525.0,5423.25,18
CDM,42671557_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, CHEST (EXCLUDING MYOCARDIUM)",2200.0,1430.0,550.0,5681.5,18
CDM,42672142_1,MRI scan of upper spinal canal without contrast,1725.0,1121.25,351.02,4454.81,18
CDM,42672143_1,MRI scan of middle spinal canal without contrast,1725.0,1121.25,351.02,4454.81,18
CDM,42672144_1,MRI scan of lower spinal canal without contrast,1725.0,1121.25,351.02,4454.81,18
CDM,42672147_1,MRI scan of middle spinal canal with contrast,2730.0,1774.5,592.21,7050.23,18
CDM,42672150_1,MRI scan of lower spinal canal with contrast,2730.0,1774.5,592.21,7050.23,18
CDM,42672156_1,MRI scan of upper spinal canal before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42672157_1,MRI scan of middle spinal canal before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42672158_1,MRI scan of lower spinal canal before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42672159_1,MRI scan of blood vessels of spinal canal,2350.0,1527.5,587.5,6068.88,18
CDM,42672192_1,MRI scan of pelvis without contrast,1725.0,1121.25,351.02,4454.81,18
CDM,42672193_1,MRI scan of pelvis with contrast,2730.0,1774.5,592.21,7050.23,18
CDM,42672194_1,MRI scan of pelvis before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42672195_1,MRI scan of pelvis without contrast,1725.0,1121.25,351.02,4454.81,18
CDM,42672196_1,MRI scan of pelvis with contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42672197_1,MRI scan of pelvis before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42672200_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, PELVIS",1725.0,1121.25,431.25,4454.81,18
CDM,42672202_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, PELVIS",2350.0,1527.5,587.5,6068.88,18
CDM,42673218_1,MRI scan of arm without contrast,2587.5,1681.88,351.02,6682.22,18
CDM,42673219_1,MRI scan of arm with contrast,2250.0,1462.5,562.5,5810.63,18
CDM,42673220_1,MRI scan of arm before and after contrast,3525.0,2291.25,592.21,9103.31,18
CDM,42673221_1,MRI scan of arm joint without contrast,2587.5,1681.88,351.02,6682.22,18
CDM,42673222_1,MRI scan of arm joint with contrast,2850.0,1852.5,592.21,7360.13,18
CDM,42673223_1,MRI scan of arm joint before and after contrast,3525.0,2291.25,592.21,9103.31,18
CDM,42673225_1,MRI scan of blood vessels of arm,1800.0,1170.0,450.0,4648.5,18
CDM,42673718_1,MRI scan of leg without contrast,2587.5,1681.88,351.02,6682.22,18
CDM,42673719_1,MRI scan of leg with contrast,4500.0,2925.0,592.21,11621.25,18
CDM,42673720_1,MRI scan of leg before and after contrast,3525.0,2291.25,592.21,9103.31,18
CDM,42673721_1,MRI scan of leg joint without contrast,2587.5,1681.88,351.02,6682.22,18
CDM,42673722_1,MRI scan of leg joint with contrast,2850.0,1852.5,592.21,7360.13,18
CDM,42673724_1,MRI scan of leg joint before and after contrast,3525.0,2291.25,592.21,9103.31,18
CDM,42673725_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, LOWER EXTREMITY",1529.0,993.85,382.25,3948.64,18
CDM,42673726_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, LOWER EXTREMITY",3004.0,1952.6,715.39,7757.83,18
CDM,42673727_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, LOWER EXTREMITY",2200.0,1430.0,550.0,5681.5,18
CDM,42674181_1,MRI scan of abdomen without contrast,1725.0,1121.25,351.02,4454.81,18
CDM,42674182_1,MRI scan of abdomen with contrast,2730.0,1774.5,592.21,7050.23,18
CDM,42674183_1,MRI scan of abdomen before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42674184_1,MRI scan of abdomen before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42674185_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, ABDOMEN",1529.0,993.85,382.25,3948.64,18
CDM,42674186_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, ABDOMEN",1664.0,1081.6,416.0,4297.28,18
CDM,42674187_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, ABDOMEN",2200.0,1430.0,550.0,5681.5,18
CDM,42674712_1,MRI scan of fetus for single or first pregnancy,675.0,438.75,168.75,1743.19,18
CDM,42674713_1,MRI scan of fetus for each additional pregnancy,136.5,88.73,34.13,358.04,18
CDM,42675557_1,MRI scan of heart without contrast,1800.0,1170.0,351.02,4648.5,18
CDM,42675559_1,MRI scan of heart without contrast with stress imaging,2275.0,1478.75,351.02,5875.19,18
CDM,42675561_1,MRI scan of heart before and after contrast,2100.0,1365.0,525.0,5423.25,18
CDM,42675563_1,MRI scan of heart before and after contrast with stress imaging,2200.0,1430.0,550.0,5681.5,18
CDM,42675565_1,MRI scan of blood flow of heart,990.0,643.5,247.5,2556.68,18
CDM,42676014_1,"Assessment by trained clinical staff of implant and/or foreign body for MR safety, including identification and verification of implant components from appropriate sources, analyzing current MR condit",60.0,39.0,15.0,154.95,16
CDM,42676015_1,"Assessment by trained clinical staff of implant and/or foreign body for MR safety, including identification and verification of implant components from appropriate sources, analyzing current MR condit",30.0,19.5,7.5,77.48,16
CDM,42676016_1,"Determination of MR safety by a physician or other qualified health care professional responsible for the safety of the MR procedure, including review of implant MR conditions for indicated MR examina",210.0,136.5,52.5,542.33,16
CDM,42676376_1,3D radiographic procedure,1000.0,650.0,250.0,2582.5,16
CDM,42676390_1,MRI study for measuring biochemical changes in the brain,2200.0,1430.0,351.02,5681.5,18
CDM,42676391_1,MRI and low frequency vibrations for measuring tissue stiffness,419.5,272.68,104.88,2024.0,18
CDM,42677021_1,Review by radiologist of MRI guidance for needle placement,1500.0,975.0,317.35,3873.75,18
CDM,42677046_1,MRI scan of 1 breast without contrast,765.0,497.25,191.25,2024.0,18
CDM,42677047_1,MRI scan of both breasts without contrast,1650.0,1072.5,351.02,4261.13,18
CDM,42677048_1,"MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; UNILATERAL",1750.0,1137.5,437.5,4519.38,18
CDM,42677049_1,"MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; BILATERAL",2600.0,1690.0,592.21,6714.5,18
CDM,42677058_1,"MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; UNILATERAL",3004.0,1952.6,592.21,7757.83,18
CDM,42677061_1,"MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; BILATERAL",3003.0,1951.95,592.21,7755.25,18
CDM,42691200_1,Measurement of liver stiffness,1725.0,1121.25,158.99,4454.81,18
CDM,42696020_1,Test of neurological function during functional MRI,415.0,269.75,103.75,1071.74,19
CDM,42699996_1,MRI scan of brain before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,42699997_1,MRI scan of brain before and after contrast,2350.0,1527.5,587.5,6068.88,18
CDM,426C8906_1,"MAGNETIC RESONANCE IMAGING WITH CONTRAST, BREAST; BILATERAL",881.0,572.65,220.25,2275.18,18
CDM,426C8931_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, SPINAL CANAL AND CONTENTS",3500.0,2275.0,715.39,9038.75,18
CDM,426C8932_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, SPINAL CANAL AND CONTENTS",3000.0,1950.0,715.39,7747.5,18
CDM,426C8933_1,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, SPINAL CANAL AND CONTENTS",3500.0,2275.0,715.39,9038.75,18
CDM,42700_1,Drainage of abscess near tonsil,470.0,305.5,77.68,464.53,19
CDM,42720_1,Drainage of abscess of throat from inside mouth,1253.7,814.91,78.57,1185.62,19
CDM,42725_1,Drainage of abscess of throat from outside mouth,2258.6,1468.09,78.57,2442.44,19
CDM,42800_1,Biopsy of back of throat,420.0,273.0,41.37,381.69,19
CDM,42804_1,Simple biopsy of growth of throat behind nose,524.0,340.6,40.27,520.97,19
CDM,42806_1,Complex biopsy of growth of throat behind nose,593.3,385.65,45.57,581.23,19
CDM,42808_1,Removal or destruction of growth of throat,609.0,395.85,78.57,559.74,19
CDM,42809_1,Removal of foreign body in throat,430.0,279.5,78.57,489.3,19
CDM,42810T_1,Removal of congenital skin and tissue cyst of neck,3126.9,2032.49,78.57,940.65,19
CDM,42810_1,Removal of congenital skin and tissue cyst of neck,1017.5,661.38,78.57,940.65,19
CDM,42815_1,Removal of congenital cyst or abnormal drainage tract of neck and/or throat,2721.6,1769.04,78.57,1647.03,19
CDM,42820_1,Removal of tonsils and adenoid glands (younger than 12 years),861.0,559.65,78.57,868.18,19
CDM,42821_1,Removal of tonsils and adenoid glands (12 years or older),958.7,623.16,78.57,901.62,19
CDM,42825_1,Removal of tonsils (younger than 12 years),789.6,513.24,78.57,785.26,19
CDM,42826_1,Removal of tonsils (12 years or older),960.8,624.52,78.57,754.05,19
CDM,42830_1,Primary removal of adenoids (younger than 12 years),572.3,372.0,78.57,621.88,19
CDM,42831_1,Primary removal of adenoids (12 years or older),611.1,397.22,78.57,671.56,19
CDM,42835_1,Secondary removal of adenoids (younger than 12 years),510.3,331.7,78.57,577.36,19
CDM,42836_1,Secondary removal of adenoids (12 years or older),3794.2,2466.23,78.57,721.44,19
CDM,42842_1,"Extensive removal of tonsils, tissue, muscle, and bone",2678.6,1741.09,78.57,3036.55,19
CDM,42844_1,"Extensive removal of tonsils, tissue, muscle, and bone with local tissue graft",3737.0,2429.05,78.57,4176.95,19
CDM,42845_1,"Extensive removal of tonsils, tissue, muscle, and bone with other tissue graft",6149.9,3997.44,78.57,6727.06,19
CDM,42860_1,Removal of remaining tonsil tissue,600.6,390.39,78.57,563.3,19
CDM,42870_1,Removal or destruction of growth of tongue lymph node,1549.8,1007.37,78.57,1776.79,19
CDM,42890_1,Partial removal of throat,3818.9,2482.29,78.57,4310.15,19
CDM,42892_1,Partial removal of wall of throat with suture repair,5023.2,3265.08,78.57,5660.47,19
CDM,42894_1,Removal of throat tissue with tissue graft,6433.4,4181.71,78.57,7166.51,19
CDM,42900_1,Suture of wound or injury in throat,961.8,625.17,78.57,1009.12,19
CDM,42919281_1,"Placement of locating device in breast using imaging guidance, first growth",4102.5,2666.63,1025.63,10594.71,18
CDM,42919282_1,"Placement of locating device in breast using imaging guidance, each additional growth",674.0,438.1,168.5,1974.1,18
CDM,42950T_1,Plastic or reconstructive repair of throat,3126.9,2032.49,78.57,2431.04,19
CDM,42950_1,Plastic or reconstructive repair of throat,2146.2,1395.03,78.57,2431.04,19
CDM,42953_1,Repair of throat at esophagus,2632.4,1711.06,78.57,2912.76,19
CDM,42955_1,Creation of opening to throat for feeding,2019.2,1312.48,78.57,2304.6,19
CDM,42960_1,Simple control of bleeding of throat,468.3,304.4,78.57,496.77,19
CDM,42961_1,Control of bleeding of throat requiring hospitalization,1049.8,682.37,78.57,1252.92,19
CDM,42962_1,Complicated control of bleeding of throat,1440.6,936.39,78.57,1549.91,19
CDM,42970_1,Simple control of bleeding of throat with insertion of packing,1082.6,703.69,78.57,1234.33,19
CDM,42971_1,Control of bleeding of throat with insertion of packing requiring hospitalization,1085.93,705.85,78.57,1364.22,19
CDM,42972_1,Complicated control of bleeding of throat with insertion of packing,1428.0,928.2,78.57,1527.59,19
CDM,42975_1,Evaluation of sleep-disordered breathing by examination of upper airway using an endoscope,254.0,165.1,77.21,338.48,19
CDM,42976098_1,X-ray of surgical specimen,1375.0,893.75,172.18,3550.94,18
CDM,42977048_1,Screening mammography,255.0,165.75,63.75,658.54,18
CDM,42977049_1,Diagnostic mammography of both breasts,264.0,171.6,66.0,681.78,18
CDM,42977050_1,Diagnostic mammography of 1 breast,146.0,94.9,36.5,377.05,18
CDM,42977054_1,"Review by radiologist of breast duct image, multiple ducts",515.0,334.75,128.75,1329.99,18
CDM,42977061_1,3D breast mammography of 1 breast,250.0,162.5,62.5,645.63,18
CDM,42977062_1,3D breast mammography of both breasts,315.0,204.75,69.41,813.49,18
CDM,42977063_1,Screening 3D breast mammography,250.0,162.5,62.5,645.63,18
CDM,42977065_1,Diagnostic mammography of 1 breast,250.0,162.5,62.5,645.63,18
CDM,42977066_1,Diagnostic mammography of both breasts,290.0,188.5,69.41,748.93,18
CDM,42977067_1,Screening mammography,255.0,165.75,63.75,658.54,18
CDM,42977080_1,"DXA bone density measurement of hip, pelvis, spine",325.0,211.25,81.25,839.31,18
CDM,42977085_1,"DXA bone density measurement of hip, pelvis, spine including spine fracture assessment",300.0,195.0,75.0,774.75,18
CDM,42977086_1,Fracture assessment of spine bones using DXA,150.0,97.5,37.5,387.38,18
CDM,42977091_1,Technical calculation of trabecular bone score (TBS),200.0,130.0,50.0,516.5,18
CDM,429G0279_1,"DIAGNOSTIC DIGITAL BREAST TOMOSYNTHESIS, UNILATERAL OR BILATERAL (LIST SEPARATELY IN ADDITION TO 77065 OR 77066)",45.0,29.25,11.25,116.21,18
CDM,43000250_1,HC PHARMACY CHARGE - UB 250,113.23,73.6,28.31,79.26,11
CDM,43000343_1,HC PHARMACY CHARGE - UB 343,4840.96,3146.63,1210.24,3388.67,11
CDM,43000636_1,HC PHARMACY CHARGE - UB 636,307.07,199.6,76.77,214.95,11
CDM,43020_1,Removal of foreign body in esophagus through neck,1995.0,1296.75,78.57,1635.76,19
CDM,43030_1,Incision of muscle at upper esophagus,1995.0,1296.75,78.57,1553.85,19
CDM,43045_1,Removal of foreign body in esophagus through chest,2989.93,1943.45,78.57,3801.08,19
CDM,43100_1,Removal of growth of esophagus through neck,2100.0,1365.0,78.57,1882.29,19
CDM,43101_1,Removal of growth of esophagus through chest or abdomen,2823.5,1835.28,78.57,2935.51,19
CDM,43107_1,Removal of esophagus,7110.6,4621.89,78.57,8701.7,19
CDM,43108_1,Removal of esophagus and reconstruction using bowel graft,12263.0,7970.95,78.57,12933.96,19
CDM,43112_1,Removal of esophagus through chest,7594.7,4936.56,78.57,10124.68,19
CDM,43113_1,Removal of esophagus through chest and reconstruction using bowel graft,12208.4,7935.46,78.57,12646.07,19
CDM,43116_1,Partial removal of upper esophagus with reconstruction using bowel graft,12481.7,8113.11,78.57,14457.49,19
CDM,43117_1,Partial removal of lower esophagus,6954.2,4520.23,78.57,9502.17,19
CDM,43118_1,Partial removal of lower esophagus through chest and abdomen with bowel graft,10051.7,6533.61,78.57,10554.5,19
CDM,43121_1,Partial removal of lower esophagus through chest,6573.18,4272.57,78.57,8326.18,19
CDM,43122_1,Partial removal of lower esophagus through abdomen and/or chest,7024.5,4565.93,78.57,7481.66,19
CDM,43123_1,Partial removal of esophagus with repair using bowel graft,14975.1,9733.82,78.57,13108.01,19
CDM,43124_1,Removal of esophagus with creation of artificial opening into esophagus,10480.1,6812.07,78.57,11094.92,19
CDM,43130_1,Removal of defect in wall of esophagus through neck,2201.9,1431.24,78.57,2336.65,19
CDM,43135_1,Removal of defect in wall of esophagus through chest,4141.2,2691.78,78.57,4297.27,19
CDM,43180_1,Removal of defect in wall of esophagus using a rigid endoscope,1267.4,823.81,78.57,1644.33,19
CDM,43191_1,Diagnostic exam of esophagus using an endoscope,413.7,268.91,78.57,466.63,19
CDM,43192_1,Injection into esophagus using an endoscope,492.5,320.13,78.57,509.74,19
CDM,43193_1,Biopsy of esophagus using a rigid endoscope,587.0,381.55,78.57,509.74,19
CDM,43194_1,Removal of foreign bodies from esophagus using a rigid endoscope,532.4,346.06,78.57,579.3,19
CDM,43195_1,"Balloon dilation of esophagus using a rigid endoscope, less than 3.0 cm",588.0,382.2,78.57,556.48,19
CDM,43196_1,Insertion of wire and dilation of esophagus using an endoscope,639.5,415.68,78.57,592.74,19
CDM,43197_1,Diagnostic exam of esophagus using a flexible endoscope through nose,594.3,386.3,63.18,459.72,19
CDM,43198_1,Biopsy of esophagus using a flexible endoscope through nose,663.6,431.34,75.53,511.23,19
CDM,43200086_1,HC CEPHALEXIN 500MG,1.34,0.87,0.33,0.93,11
CDM,43200762_1,HC DIAZEPAM,1.81,1.18,0.45,1.27,11
CDM,43200_1,Diagnostic exam of esophagus using a flexible endoscope through mouth,578.6,376.09,73.1,634.54,19
CDM,43201_1,Injection into esophagus using a flexible endoscope,782.3,508.5,78.57,625.55,19
CDM,43202244_1,HC BISACODYL 10MG,1.06,0.69,0.26,0.74,11
CDM,43202833_1,HC NON FORMULARY MED-TAKE HOME,2.41,1.57,0.6,1.69,11
CDM,43202_1,Biopsy of esophagus using a flexible endoscope through mouth,740.0,481.0,78.57,861.61,19
CDM,43204503_1,HC DAPSONE,3.04,1.98,0.76,2.13,11
CDM,43204_1,Injection of swollen vein of esophagus using a flexible endoscope,944.0,613.6,78.57,415.06,19
CDM,43205987_1,HC ALBUTEROL 90MCGM INHA,4.1,2.67,1.03,2.87,11
CDM,43205_1,Tying of dilated veins of esophagus with bands using a flexible endoscope,787.5,511.88,78.57,432.87,19
CDM,43207507_1,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",4.27,2.78,0.21,11.03,17
CDM,43207614_1,HC BACTRIM-DS (TN-CP),1.64,1.07,0.41,1.15,11
CDM,43207975_1,HC SCOPOLAMINE HYDROBROMIDE,22.6,14.69,5.65,15.82,11
CDM,43208193_1,HC TRAZODONE 100MG TAB,1.21,0.79,0.3,0.85,11
CDM,43208207_1,HC CYCLOBENZAPRINE,1.72,1.12,0.43,1.21,11
CDM,43208417_1,HC CLOTRIMAZOLE 10MG TRO,3.11,2.02,0.78,2.18,11
CDM,43208491_1,HC ALPRAZOLAM 1MG,1.75,1.14,0.44,1.23,11
CDM,43208558_1,HC CALCITRIOL 0.25MCG CAP,1.32,0.86,0.33,0.92,11
CDM,43208646_1,HC FAMOTIDINE 40MG TAB,4.57,2.97,1.14,3.2,11
CDM,43208683_1,HC MORPHINE SULFATE ER 30MG TAB,1.59,1.04,0.4,1.11,11
CDM,43208837_1,HC CLONIDINE PATCH 0.2MG,54.23,35.25,13.56,37.96,11
CDM,43208848_1,HC AMIODARONE 200MG,3.34,2.17,0.83,2.34,11
CDM,43208871_1,HC PREDNISOLONE 15MG/5ML,1.76,1.14,0.44,1.23,11
CDM,43208945_1,HC FAMOTIDINE 20MG,2.43,1.58,0.61,1.7,11
CDM,43208998_1,HC TRAZODONE 150MG,2.65,1.72,0.66,1.86,11
CDM,43209030_1,HC BUSPIRONE 10MG,1.3,0.84,0.32,0.91,11
CDM,43209039_1,HC GUAIFENESIN LA,1.04,0.67,0.26,0.73,11
CDM,43209153_1,HC VICODIN,1.04,0.68,0.26,0.73,11
CDM,43209156_1,HC LISINOPRIL 10MG,1.1,0.72,0.28,0.77,11
CDM,43209174_1,HC FLUOXETINE 20 MG,3.1,2.01,0.77,2.17,11
CDM,43209212_1,HC URSODIOL 30MG,7.03,4.57,1.76,4.92,11
CDM,43209229_1,HC CEFUROXIME 500MG,7.91,5.14,1.98,5.54,11
CDM,43209247_1,HC VANCOMYCIN 125MG,30.0,19.5,7.5,21.0,11
CDM,43209333_1,HC OMEPRAZOLE,5.82,3.78,1.45,4.07,11
CDM,43209352_1,HC NIFEDIPINE 30MG ER TAB,1.35,0.88,0.34,0.94,11
CDM,43209353_1,HC NIFEDIPINE ORAL,2.28,1.48,0.57,1.59,11
CDM,43209370_1,HC FLUCONAZOLE 200MG TAB,13.89,9.03,3.47,9.73,11
CDM,43209633_1,HC LORAZEPAM INTENSOL 2MG/1ML,1.43,0.93,0.36,1.0,11
CDM,43209678_1,HC DOXASIN 4MG TABLET,1.51,0.98,0.38,1.06,11
CDM,43209682_1,HC AZITHROMYCIN 250MG CAPSULE,9.06,5.89,2.27,6.34,11
CDM,43209700_1,HC SERTRALINE 50MG,2.75,1.79,0.69,1.93,11
CDM,43209727_1,HC PRAVASTATIN 20MG,3.28,2.13,0.82,2.3,11
CDM,43209797_1,HC ITRACONAZOLE 100MG,22.97,14.93,5.74,16.08,11
CDM,43209819_1,HC AMLODIPINE BESYLATE 2.5M,1.76,1.14,0.44,1.23,11
CDM,43209820_1,HC AMLODIPINE BESYLATE 5.0M,1.84,1.2,0.46,1.29,11
CDM,43209821_1,HC AMLODIPINE BESYLATE 10M,2.39,1.56,0.6,1.68,11
CDM,43209841_1,HC ONDANSETRON 4MG TAB,23.43,15.23,5.86,16.4,11
CDM,43209842_1,HC ONDANSETRON 8MG TAB,38.45,24.99,9.61,26.92,11
CDM,43210003_1,HC GABAPENTIN 300MG,1.32,0.86,0.33,0.93,11
CDM,43210193_1,HC LOSARTAN 25MG,1.77,1.15,0.44,1.24,11
CDM,43210194_1,HC LOSARTAN 50MG,2.65,1.72,0.66,1.86,11
CDM,43210199_1,HC FLUTICASONE (FLONASE),5.38,3.49,1.34,3.76,11
CDM,43210202_1,HC MYCOPHENOLATE MOFETIL 250MG,3.75,2.44,0.94,2.62,11
CDM,43210204_1,HC CYCLOSPORINE - NEORAL 25MG,1.35,0.88,0.34,0.94,11
CDM,43210205_1,HC CYCLOSPORINE - NEORAL 100MG,5.36,3.49,1.34,3.75,11
CDM,43210_1,Repair of muscle at esophagus and stomach using a flexible endoscope,1026.0,666.9,78.57,1297.9,19
CDM,43211_1,Removal of tissue lining of esophagus using a flexible endoscope,791.7,514.61,78.57,3307.33,19
CDM,43212_1,Placement of stent in esophagus using a flexible endoscope,618.5,402.03,78.57,636.03,19
CDM,43213_1,Dilation of esophagus using a flexible endoscope,3950.1,2567.57,78.57,2987.73,19
CDM,43214_1,"Balloon dilation of esophagus using a flexible endoscope, 3.0 cm or more",636.3,413.6,78.57,588.06,19
CDM,43215_1,Removal of foreign bodies in esophagus using a flexible endoscope,682.5,443.63,78.57,944.73,19
CDM,43216_1,Removal of polyps or growths of esophagus using a flexible endoscope with electrical cautery,548.1,356.27,78.57,989.26,19
CDM,43217_1,Removal of polyps or growths of esophagus using a flexible endoscope with mechanical snare,992.3,645.0,78.57,1014.78,19
CDM,43218747_1,"HC PANTOPRAZOLE 40 MG ORAL TABS, NON-CHEMO",5.18,3.37,1.3,3.63,11
CDM,43218749_1,"HC LINEZOLID 600MG ORAL TAB, NON-CHEMOTHERA",174.81,113.63,43.7,122.37,11
CDM,43220697_1,"HC TACROLIMUS 0.5 MG ORAL CAP,NON-CHEMOTHER",2.29,1.49,0.57,1.61,11
CDM,43220_1,"Balloon dilation of esophagus using a flexible endoscope, less than 3.0 cm",365.4,237.51,78.57,2180.1,19
CDM,43221022_1,HC AMOXICILLIN/CLAVULANTE 875 MG (ORAL),5.51,3.58,1.38,3.86,11
CDM,43221037_1,HC ATORVASTATIN 10 MG (ORAL),4.01,2.61,1.0,2.81,11
CDM,43221039_1,HC ATORVASTATIN 40 MG (ORAL),5.65,3.67,1.41,3.95,11
CDM,43221040_1,HC ATOVAQUONE 750 MG/5 ML,7.15,4.65,1.79,5.01,11
CDM,43221071_1,HC CARVEDILOL 12.5 MG (ORAL),2.1,1.37,0.53,1.47,11
CDM,43221072_1,HC CARVEDILOL 25 MG (ORAL),2.11,1.37,0.53,1.48,11
CDM,43221073_1,HC CARVEDILOL 3.125 MG (ORAL),2.1,1.37,0.53,1.47,11
CDM,43221074_1,HC CARVEDILOL 6.25 MG (ORAL),2.1,1.37,0.53,1.47,11
CDM,43221077_1,HC CETIRIZINE 10 MG (ORAL),1.09,0.71,0.27,0.76,11
CDM,43221114_1,HC FLUCONAZOLE SUSP 40MG/ML (ORAL),3.63,2.36,0.91,2.54,11
CDM,43221143_1,HC IPRATROPIUM/ALBUTEROL (INH),3.57,2.32,0.89,2.5,11
CDM,43221157_1,HC LANSOPRAZOLE 30MG (ORAL),4.57,2.97,1.14,3.2,11
CDM,43221161_1,HC LEVOFLOXACIN 500MG (ORAL),19.92,12.95,4.98,13.94,11
CDM,43221176_1,HC METOPROLOL EXT REL 200MG,1.25,0.81,0.31,0.87,11
CDM,43221190_1,HC OLANZAPINE 10MG (ORAL),20.09,13.06,5.02,14.06,11
CDM,43221198_1,HC OXYCODONE EXT REL 20MG (ORAL),8.0,5.2,2.0,5.6,11
CDM,43221212_1,HC PRAVASTATIN 40MG (ORAL),4.5,2.92,1.12,3.15,11
CDM,43221218_1,HC RANITIDINE 75MG (ORAL),7.0,4.55,1.75,4.9,11
CDM,43221241_1,HC TAMSULOSIN 0.4MG (ORAL),4.17,2.71,1.04,2.92,11
CDM,43221262_1,HC VALACYCLOVIR 500MG (ORAL),6.9,4.48,1.72,4.83,11
CDM,43221264_1,HC VENLAFAXINE EXT REL 150MG (ORAL),4.99,3.25,1.25,3.5,11
CDM,43221292_1,HC BUTALBITAL/APAP/CAFFINE 50/325/40MG (ORL,2.02,1.31,0.51,1.41,11
CDM,43221334_1,HC DILTIAZEM EXT RELEASE 120MG (ORAL),1.2,0.78,0.3,0.84,11
CDM,43221508_1,HC VALACYCLOVIR 1GM (ORAL),12.03,7.82,3.01,8.42,11
CDM,43221544_1,"HC MIRTAZAPINE 15MG, NON-CHEMO",2.67,1.73,0.67,1.87,11
CDM,43221567_1,HC LIDOCAINE 5% TRANSDERMAL NON-CHEMOTHERAP,9.1,5.91,2.27,6.37,11
CDM,43226_1,Dilation of esophagus with insertion of guide wire using a flexible endoscope,402.2,261.43,78.57,928.36,19
CDM,43227_1,Control of bleeding in esophagus using a flexible endoscope,600.6,390.39,78.57,1434.6,19
CDM,43229_1,Destruction of polyp or growth of esophagus using a flexible endoscope,2324.7,1511.06,78.57,1716.53,19
CDM,43230004_1,HC PREDNISONE 50MG ORAL TAB IMMUNOSUPPRESS,2.05,1.33,0.51,1.44,11
CDM,43230006_1,HC TACROLIMUS ORAL 5MG IMMUNOSUPPRESSIVE,20.36,13.23,5.09,14.25,11
CDM,43231_1,Ultrasound exam of esophagus using a flexible endoscope,538.7,350.16,78.57,489.72,19
CDM,43232_1,Ultrasound guided fine needle aspiration or biopsy of esophagus using a flexible endoscope,740.3,481.2,78.57,614.11,19
CDM,43233_1,"Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, 3.0 cm or more",755.0,490.75,78.57,696.59,19
CDM,43235_1,"Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",790.0,513.5,78.57,693.33,19
CDM,43236_1,"Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope",989.1,642.92,78.57,968.37,19
CDM,43237_1,"Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope through mouth",667.8,434.07,78.57,602.45,19
CDM,43238_1,Ultrasound guided needle aspiration or biopsy of esophagus using a flexible endoscope,832.7,541.26,78.57,715.05,19
CDM,43239_1,"Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope",920.0,598.0,78.57,908.11,19
CDM,43240_1,"Drainage of fluid collection of esophagus, stomach, and/or upper small bowel using a flexible endoscope",825.0,536.25,78.57,1205.26,19
CDM,43241_1,"Insertion of tube or tube in esophagus, stomach, and/or upper small bowel using a flexible endoscope",441.0,286.65,78.57,436.03,19
CDM,43242_1,"Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope",1200.2,780.13,78.57,809.54,19
CDM,43243_1,Injection of dilated vein of stomach and/or esophagus using a flexible endoscope,758.1,492.77,78.57,727.2,19
CDM,43244_1,Tying of dilated veins of stomach and/or esophagus using a flexible endoscope,836.9,543.99,78.57,754.8,19
CDM,43245_1,Dilation of stomach outlet using a flexible endoscope,1254.0,815.1,78.57,1432.89,19
CDM,43246_1,Insertion of stomach tube using a flexible endoscope,1155.0,750.75,78.57,607.92,19
CDM,43247_1,"Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using a flexible endoscope",849.0,551.85,78.57,922.57,19
CDM,43248_1,Insertion of guide wire with dilation of esophagus using a flexible endoscope,842.0,547.3,78.57,995.77,19
CDM,43249_1,"Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm",2182.0,1418.3,78.57,2614.41,19
CDM,43250_1,"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using a flexible endoscope with electrical cautery",932.0,605.8,78.57,1084.42,19
CDM,43251_1,"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare",1027.0,667.55,78.57,1195.08,19
CDM,43253_1,"Injection of diagnostic or therapeutic substance or marker in esophagus, stomach, and/or upper small bowel using a flexible endoscope",875.7,569.21,78.57,808.49,19
CDM,43254_1,"Removal of tissue lining of esophagus, stomach, and/or upper small bowel using a flexible endoscope",907.2,589.68,78.57,831.86,19
CDM,43255_1,"Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope",1487.0,966.55,78.57,1513.61,19
CDM,43257_1,Heat delivery to muscle at esophagus and/or stomach to treat gastric reflux using a flexible endoscope,913.5,593.78,78.57,711.94,19
CDM,43259_1,"Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",861.0,559.65,78.57,695.55,19
CDM,43260_1,"Diagnostic exam of gallbladder and pancreatic, liver, and bile ducts using an endoscope",982.8,638.82,78.57,992.28,19
CDM,43261_1,"Biopsy of gallbladder, pancreatic, liver, and bile ducts using a flexible endoscope",1033.2,671.58,78.57,1041.73,19
CDM,43262_1,Incision of pancreatic outlet using a flexible endoscope,1212.8,788.32,78.57,1100.09,19
CDM,43263_1,Pressure measurement of pancreatic or bile duct sphincter using a flexible endoscope,1197.0,778.05,78.57,1100.09,19
CDM,43264_1,Removal of stone or debris from bile or pancreatic duct using a flexible endoscope,1456.4,946.66,78.57,1120.17,19
CDM,43265_1,Destruction of stone of bile or pancreatic duct using a flexible endoscope,1680.0,1092.0,78.57,1334.75,19
CDM,43266_1,"Placement of stent in esophagus, stomach, and/or upper small bowel using a flexible endoscope",750.8,488.02,78.57,666.3,19
CDM,43270_1,"Destruction of polyp or growth of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2319.5,1507.68,78.57,1764.34,19
CDM,43273_1,Exam of common bile and/or pancreatic duct using a flexible endoscope,2353.9,1530.04,78.57,367.29,19
CDM,43274_1,Insertion of stent into pancreatic or bile duct using a flexible endoscope,1556.1,1011.47,78.57,1423.28,19
CDM,43275_1,Removal of stent from pancreatic or bile duct using a flexible endoscope,1283.1,834.02,78.57,1157.74,19
CDM,43276_1,Replacement of stent in pancreatic or bile duct using a flexible endoscope,1619.1,1052.42,78.57,1482.99,19
CDM,43277_1,Balloon dilation of pancreatic or bile duct or sphincter using a flexible endoscope,1291.5,839.48,78.57,1165.42,19
CDM,43278_1,Destruction of polyp or growth of gallbladder and/or bile duct using a flexible endoscope,1467.9,954.14,78.57,1332.56,19
CDM,43279_1,Repair of muscle at lower esophagus and stomach using an endoscope,3485.0,2265.25,78.57,3776.18,19
CDM,43280_1,Strengthening of muscle between esophagus and stomach by wrapping part of stomach around esophagus using an endoscope,3031.4,1970.41,78.57,3165.53,19
CDM,43281_1,Repair of hernia of muscle at esophagus and stomach using an endoscope,4350.0,2827.5,78.57,4519.81,19
CDM,43282_1,Repair of hernia of muscle at esophagus and stomach with implantation of mesh using an endoscope,4730.0,3074.5,78.57,5079.65,19
CDM,43283_1,Lengthening of esophagus using an endoscope,4158.0,2702.7,78.57,4282.74,19
CDM,43284_1,Insertion of magnetic band around base of esophagus to tighten opening into stomach using an endoscope,1492.65,970.22,78.57,1894.01,19
CDM,43285_1,Removal of magnetic band from base of esophagus using an endoscope,1509.3,981.05,78.57,1957.34,19
CDM,43286_1,Removal of esophagus and partial removal of stomach using an endoscope,6825.0,4436.25,78.57,9307.23,19
CDM,43287_1,Removal of lower esophagus and partial removal of stomach using an endoscope,7765.0,5047.25,78.57,10369.28,19
CDM,43288_1,Removal of esophagus and partial removal of stomach using an endoscope for each procedure with connection of stomach to throat or to remaining esophagus,8140.0,5291.0,78.57,10955.61,19
CDM,43290203_1,"HC MYCOPHENOLATE 500MG ORAL TAB,NON-CHEMOT",7.57,4.92,1.89,5.3,11
CDM,43290211_1,"HC QUETIAPINE 100 MG ORAL TABS,NON-CHEMOTH",6.68,4.34,1.67,4.68,11
CDM,43290218_1,"HC CLOPIDOGREL 75MG,ORAL TAB,NON-CHEMOTHER",6.78,4.41,1.69,4.75,11
CDM,43290_1,Placement of balloon in stomach for weight loss using flexible endoscope,390.5,253.83,78.57,6443.89,19
CDM,43291_1,Removal of balloon in stomach for weight loss using flexible endoscope,356.5,231.73,78.57,1108.65,19
CDM,43292041_1,"HC ALENDRONATE 70MG TAB, NON-CHEMOTHERAPY",20.71,13.46,5.18,14.5,11
CDM,43292061_1,HC SEVELAMER 800 MG TAB NON-CHEMOTHERAPY,4.07,2.65,1.02,2.85,11
CDM,43292106_1,"HC METHADONE 5MG/5ML ORAL SOLN, NON-CHEMOTH",1.08,0.7,0.27,0.75,11
CDM,43292124_1,HC URSODIOL 250MG TAB,2.56,1.66,0.64,1.79,11
CDM,43292147_1,HC ESOMEPRAZOLE MAG TRIHYDRATE 40 MG CAPS,8.43,5.48,2.11,5.9,11
CDM,43292148_1,HC ESOMEPRAZOLE MAG TRIHYDRATE 20 MG CAPS,8.56,5.56,2.14,5.99,11
CDM,43292169_1,HC LEVETIRACETAM (KEPPRA) 500 MG TABS N/CH,3.42,2.22,0.86,2.4,11
CDM,43292223_1,HC VALGANCICLOVIR HCL 450MG TABS-VALCYTE,61.8,40.17,15.45,43.26,11
CDM,43292255_1,HC STROMECTAL (IVERMECTIN) 3MG TABS,23.0,14.95,5.75,16.1,11
CDM,43292267_1,"HC ONDANSETRON ODT 8MG TAB,NON-CHEMOTHERAPY",31.93,20.75,7.98,22.35,11
CDM,43292268_1,"HC ONDANSETRON ODT 4MG TAB,NON-CHEMOTHERAPY",21.24,13.81,5.31,14.87,11
CDM,43292323_1,HC ESCITALOPRAM OXALATE 10MG,4.28,2.78,1.07,3.0,11
CDM,43292409_1,HC ELIQUIS 2.5MG TABS,11.38,7.4,2.84,7.96,11
CDM,43293164_1,HC ESCITALOPRAM 5MG TAB,4.11,2.67,1.03,2.88,11
CDM,43298537_1,HC TRADJENTA 5MG TAB,20.12,13.08,5.03,14.08,11
CDM,43298548_1,HC NEUPOGEN 480/1.6ML INJ FLILGRASTIM,746.79,485.41,186.7,522.75,11
CDM,432IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.84,3.15,1.21,12.5,16
CDM,432OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.05,11.08,4.26,44.03,16
CDM,43300_1,Repair of defect of esophagus through neck,2205.0,1433.25,78.57,1847.52,19
CDM,43305_1,Repair of defect of esophagus with repair of abnormal drainage tract though neck,3134.3,2037.3,78.57,3275.68,19
CDM,43310_1,Repair of defect of esophagus through chest,4273.5,2777.78,78.57,4329.17,19
CDM,43312_1,Repair of defect of esophagus with repair of abnormal drainage tract through chest,4569.6,2970.24,78.57,4629.14,19
CDM,43313_1,Repair of congenital defect of esophagus through chest,7573.7,4922.91,78.57,7985.45,19
CDM,43314_1,Repair of congenital defect of esophagus and abnormal drainage tract between esophagus and throat,8647.8,5621.07,78.57,8486.25,19
CDM,43320_1,Repair of muscle at lower esophagus and stomach through abdomen or chest,3776.9,2454.99,78.57,4082.99,19
CDM,43325_1,Repair of muscle at lower esophagus and stomach with patch,3608.9,2345.79,78.57,3969.77,19
CDM,43327_1,Repair of muscle at lower esophagus and stomach,1887.53,1226.89,78.57,2401.9,19
CDM,43328_1,Repair of muscle at lower esophagus and stomach through chest,3794.7,2466.56,78.57,3288.99,19
CDM,43330_1,Repair of esophagus through abdomen,3537.5,2299.38,78.57,3904.22,19
CDM,43331_1,Repair of esophagus through chest,3768.5,2449.53,78.57,3912.21,19
CDM,43332_1,Repair of paraesophageal hernia through abdomen,2781.5,1807.98,78.57,3392.11,19
CDM,43333_1,Repair of paraesophageal hernia with mesh implant through abdomen,4058.3,2637.9,78.57,3693.96,19
CDM,43334_1,Repair of paraesophageal hernia through chest,2935.8,1908.27,78.57,3644.01,19
CDM,43335_1,Repair of paraesophageal hernia with mesh implant through chest,3129.8,2034.37,78.57,3899.19,19
CDM,43336_1,Repair of paraesophageal hernia through abdominal incision,3640.0,2366.0,78.57,4240.07,19
CDM,43337_1,Repair of paraesophageal hernia with mesh implant through abdominal incision,3739.65,2430.77,78.57,4511.53,19
CDM,43338_1,Lengthening of esophagus,267.15,173.65,78.57,333.2,19
CDM,43340_1,Partial removal of esophagus and stomach through abdomen,3682.4,2393.56,78.57,4028.32,19
CDM,43341_1,Partial removal of esophagus and stomach through chest,4036.2,2623.53,78.57,4093.51,19
CDM,43351_1,Relocation of esophagus through chest,3679.2,2391.48,78.57,3830.33,19
CDM,43352_1,Relocation of esophagus through neck,2991.5,1944.48,78.57,3116.99,19
CDM,43360_1,Reconnection of esophagus to stomach after previous surgery,6359.9,4133.94,78.57,6571.44,19
CDM,43361_1,Reconnection of esophagus to stomach with bowel graft reconstruction after previous surgery,4433.1,2881.52,78.57,7881.11,19
CDM,43399900_1,HC DISPENSE FEE 125,609.0,395.85,152.25,426.3,11
CDM,43399901_1,HC DISPENSE FEE 75,341.0,221.65,85.25,238.7,11
CDM,43399902_1,HC DISPENSE FEE 50,228.0,148.2,57.0,159.6,11
CDM,43399904_1,HC DISPENSE FEE 25,119.0,77.35,29.75,83.3,11
CDM,43399905_1,HC DISPENSE FEE 10,46.0,29.9,11.5,32.2,11
CDM,433IP _1,UNCLASSIFIED DRUGS,4.94,3.21,1.24,12.76,16
CDM,433OP _1,UNCLASSIFIED DRUGS,10.7,6.96,2.68,27.63,16
CDM,43400_1,Tying of dilated veins of esophagus,4376.4,2844.66,78.57,4454.58,19
CDM,43405_1,Tying or stapling of hole or tear at junction of esophagus and stomach,3536.65,2298.82,78.57,4247.66,19
CDM,43410_1,Suture of wound or injury to esophagus through neck,2784.6,1809.99,78.57,3081.28,19
CDM,43415_1,Suture of wound or injury to esophagus through chest or abdomen,4727.1,3072.62,78.57,7502.2,19
CDM,43420_1,Repair of abnormal drainage tract of esophagus through neck,2802.5,1821.63,78.57,3052.91,19
CDM,43425_1,Repair of abnormal drainage tract of esophagus through chest or abdomen,3359.65,2183.77,78.57,4209.59,19
CDM,43450_1,Dilation of esophagus,422.1,274.37,64.91,450.89,19
CDM,43453_1,Dilation of esophagus with a guide wire,785.4,510.51,64.87,1941.18,19
CDM,43460_1,Control of bleeding of esophagus,637.4,414.31,78.57,653.16,19
CDM,43472IP _1,LEVALBUTEROL TAR HFA 45MCG INH,31.56,20.51,7.89,22.09,11
CDM,43496_1,Relocation of upper small bowel for graft,23290.0,15138.5,78.57,11645.0,15
CDM,43497_1,Incision of muscle of lower esophagus using an endoscope,1778.0,1155.7,78.57,2212.61,19
CDM,43500_1,Exploration of stomach or removal of foreign body in stomach,2079.0,1351.35,78.57,2304.71,19
CDM,43501_1,Suture of bleeding stomach ulcer,3576.3,2324.6,78.57,3947.26,19
CDM,43502_1,Suture of lacerated stomach,3450.95,2243.12,78.57,4451.5,19
CDM,43503312_1,"Ultrasound of heart with probe in esophagus, with report",2895.0,1881.75,630.02,7476.34,19
CDM,43503320_1,"Ultrasound of heart blood flow, valves and chambers",880.0,572.0,220.0,2272.6,19
CDM,43503325_1,"Ultrasound of heart with color-depicted blood flow, rate and valve function",657.0,427.05,158.99,1696.7,19
CDM,43509644_1,Other service or procedure on lung,140.0,91.0,35.0,361.55,18
CDM,43510_1,Insertion of permanent stomach tube with dilation of esophagus,2684.9,1745.19,78.57,2770.17,19
CDM,43520000_1,"INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML",394.0,256.1,98.5,1017.51,16
CDM,43520_1,Severing of muscle at stomach outlet to upper small bowel,1877.4,1220.31,78.57,2023.46,19
CDM,43548IP _1,"LANTHANUM CARB 1,000 MG TB CHW",46.25,30.06,11.56,32.38,11
CDM,43556IP _1,UNCLASSIFIED DRUGS,18.88,12.27,4.72,48.76,16
CDM,43564415_1,Injection of anesthetic agent and/or steroid into arm nerve bundle (brachial plexus),3390.0,2203.5,847.5,8754.68,19
CDM,43564416_1,Continuous infusion of anesthetic agent and/or steroid into arm nerve bundle through catheter,1125.0,731.25,281.25,3227.0,19
CDM,43564417_1,Injection of anesthetic agent and/or steroid into upper arm and shoulder nerve (axillary nerve),273.0,177.45,68.25,3227.0,19
CDM,43564418_1,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,2706.0,1758.9,580.38,6988.25,19
CDM,43564425_1,Injection of anesthetic agent and/or steroid into lower abdomen and groin nerve,2706.0,1758.9,580.38,6988.25,19
CDM,43564445_1,Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve),2460.0,1599.0,580.38,6352.95,19
CDM,43564447_1,Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve),2706.0,1758.9,676.5,8477.27,19
CDM,43564448_1,OPERATING ROOM SERVICES - MINOR SURGERY,2022.0,1314.3,505.5,1415.4,11
CDM,43564450_1,Injection of anesthetic agent and/or steroid into other nerve or branch,1119.0,727.35,279.75,3227.0,19
CDM,43564461_1,"Injection of anesthetic agent into thoracic vertebra using imaging guidance, single site",2706.0,1758.9,676.5,6988.25,19
CDM,43564466_1,Unilateral thoracic fascial plane block by injection(s),1000.0,650.0,250.0,2582.5,17
CDM,43564467_1,Unilateral thoracic fascial plane block by continuous infusion(s),500.0,325.0,125.0,1291.25,17
CDM,43564468_1,Bilateral thoracic fascial plane block by injection(s),1665.0,1082.25,416.25,4299.86,17
CDM,43564469_1,Bilateral thoracic fascial plane block by infusion(s),750.0,487.5,187.5,1936.88,17
CDM,43564473_1,Unilateral lower extremity fascial plane block by injection(s),1625.0,1056.25,406.25,4196.56,17
CDM,43564474_1,Unilateral lower extremity fascial plane block by infusion(s),900.0,585.0,225.0,2324.25,17
CDM,43564486_1,Injection of local anesthetic for abdominal wall pain control on side using imaging guidance,300.0,195.0,75.0,2318.31,19
CDM,43564487_1,Continuous infusion of local anesthetic for abdominal wall pain control on side using imaging guidance,450.0,292.5,112.5,2318.31,19
CDM,43564488_1,Injection of local anesthetic for abdominal wall pain control on both sides using imaging guidance,500.0,325.0,125.0,2318.31,19
CDM,43564489_1,Continuous infusion of local anesthetic for abdominal wall pain control on both sides using imaging guidance,650.0,422.5,162.5,2318.31,19
CDM,43564510_1,Injection of anesthetic agent into sympathetic nerve bundle,3390.0,2203.5,847.5,8754.68,19
CDM,43575316_1,HC ATX SERVICE BY ANEST RT,1703.0,1106.95,425.75,1192.1,11
CDM,43584026_1,HC ANESTHESIA BASE RATE,200.0,130.0,50.0,140.0,11
CDM,43584127_1,HC ANESTHESIA BASE RATE ECT OFF SITE,66.0,42.9,16.5,46.2,11
CDM,43584201_1,HC ANES LEVEL 1 / MINUTE,23.0,14.95,5.75,16.1,11
CDM,43584202_1,HC ANES LEVEL 2 / MINUTE,25.0,16.25,6.25,17.5,11
CDM,43584203_1,HC ANES LEVEL 3 / MINUTE,27.0,17.55,6.75,18.9,11
CDM,43585606_1,HC ANES ORGAN DONATION LEVEL 1 / MIN,10.0,6.5,2.5,7.0,11
CDM,43590000_1,HC ETT REGULAR/RAE/ORAL/NASAL,53.0,34.45,13.25,37.1,11
CDM,43590005_1,HC ETT LARYNGEAL AIRWAY (LMA),63.0,40.95,15.75,44.1,11
CDM,43590010_1,HC ETT REINFORCED,149.0,96.85,37.25,104.3,11
CDM,43590015_1,HC ETT LASER TUBE,354.0,230.1,88.5,247.8,11
CDM,43590020_1,HC ETT LASER TUBE DBL CUFF,539.0,350.35,134.75,377.3,11
CDM,43590025_1,HC ETT BRONCHIAL BLOCKER,576.0,374.4,144.0,403.2,11
CDM,43590030_1,HC ETT TUBE UNIVENT,539.0,350.35,134.75,377.3,11
CDM,43590035_1,HC ETT DOUBLE LUMEN BRONCHOCATH,191.0,124.15,47.75,133.7,11
CDM,43590040_1,HC CATHETER EXCHANGE  C-CAE WITH JET VENT,205.0,133.25,51.25,143.5,11
CDM,43590045_1,HC CIRCUIT ONE LUNG CPAP DEVICE W/5CM H20,81.0,52.65,20.25,56.7,11
CDM,43590050_1,HC INTRODUCER ETT FROVA DIFFICULT INTUBATION,87.0,56.55,21.75,60.9,11
CDM,43590055_1,HC TUBE  LARYNGECTOMY,354.0,230.1,88.5,247.8,11
CDM,43590056_1,HC ENDOTRACH TUBE NIM EMG TRIVANTAGE,959.0,623.35,239.75,671.3,11
CDM,43590060_1,HC VALVE SUCTION -  DISP FOR FLEXIBLE ENDOSCOPE,62.0,40.3,15.5,43.4,11
CDM,43590065_1,HC TRAY COMBINED SPINAL EPIDURAL 17G X 3.5 TUOHY,150.0,97.5,37.5,105.0,11
CDM,43590300_1,HC KIT - EPIDURAL CATHETERIZATION,91.0,59.15,22.75,63.7,11
CDM,43590305_1,HC TRAY SPINAL,67.0,43.55,16.75,46.9,11
CDM,43590310_1,HC NEEDLE STIM NERVE BLOCK,44.0,28.6,11.0,30.8,11
CDM,43590400_1,HC SET BLOOD/FLUID WARMING HOTLINE,45.0,29.25,11.25,31.5,11
CDM,43590405_1,HC SET BLOOD/FLUID WARMING  BIFURCATED LEVEL 1,230.0,149.5,57.5,161.0,11
CDM,43590410_1,HC SET  RAPID INFUSION UNIV 3 BAG SPIKE BELMONT,404.0,262.6,101.0,282.8,11
CDM,43590415_1,HC RESERVOIR  3.0  LTR F/RAPID INFUSOR BELMONT,348.0,226.2,87.0,243.6,11
CDM,43590420_1,HC TRANSDUCER SINGLE LINE,33.0,21.45,8.25,23.1,11
CDM,43590425_1,HC TRANSDUCER DOUBLE LINE,67.0,43.55,16.75,46.9,11
CDM,43590430_1,HC TRANSDUCER TRIPLE LINE,100.0,65.0,25.0,70.0,11
CDM,43590435_1,HC SITE RITE NEEDLE GUIDE KIT,50.0,32.5,12.5,35.0,11
CDM,43590440_1,HC CENTRAL VENOUS ACCESS KIT 9FR MAC TWO LUMEN USE W/7.5-8FR,50.0,32.5,12.5,35.0,11
CDM,43590445_1,HC CENTRAL VENOUS KIT 7FR TWO LUMEN,275.0,178.75,68.75,192.5,11
CDM,43590450_1,HC SLIC CENTRAL VENOUS SGL 7FR 16CM (9FR MAC),187.0,121.55,46.75,130.9,11
CDM,43590455_1,HC BLOOD FILTER LEUKOCYTE W/O TUBING,35.0,22.75,8.75,24.5,11
CDM,43590460_1,HC CATHETER SWAN CCO THERMODILUTION SV02 8FR,63.0,40.95,15.75,44.1,11
CDM,43590465_1,HC CATHETER SWAN VIP THERMODILUTION HEPARIN 7FR,955.0,620.75,238.75,668.5,11
CDM,43590470_1,HC FEMORAL ARTERIAL LINE 20G X 5IN KIT,188.0,122.2,47.0,131.6,11
CDM,43590475_1,HC KIT QUAD LUMEN 8.5FR CV CATH,90.0,58.5,22.5,63.0,11
CDM,43590480_1,HC PERCUTANEOUS 8.5FR SHEATH INTRODUCER,262.0,170.3,65.5,183.4,11
CDM,43590485_1,HC SHEATH 9FR X 10CM  ARROW,117.0,76.05,29.25,81.9,11
CDM,43590490_1,HC TRAY PERIPHERAL INSERTED CATHETER ARROWFLEX (RIC),106.0,68.9,26.5,74.2,11
CDM,43590495_1,HC PORTA WARMER MATTRESS INFANT,97.0,63.05,24.25,67.9,11
CDM,43590600_1,HC PRONEVIEW CUSHION INSERT,61.0,39.65,15.25,42.7,11
CDM,43590605_1,HC SENSOR FOR BIS MONITOR ANESTH,110.0,71.5,27.5,77.0,11
CDM,43590610_1,HC TEG TEST,85.0,55.25,21.25,59.5,11
CDM,43590615_1,HC CARTRIDGE WATER SEPARATOR,97.0,63.05,24.25,67.9,11
CDM,43590620_1,HC 02 TRANSCDUCER PULSE ADULT D-25,53.0,34.45,13.25,37.1,11
CDM,43590625_1,HC GE VENUE 50 ULTRASOUND,366.0,237.9,91.5,256.2,11
CDM,43590626_1,HC PHILLIPS CX50 ULTRASOUND,366.0,237.9,91.5,256.2,11
CDM,43590628_1,HC PHILLIPS IE33/CVX 3-D ECHO ULTRASOUND,642.86,417.86,160.72,450.0,11
CDM,43590630_1,HC 02 TRANSDUCER PULSE PEDI,42.0,27.3,10.5,29.4,11
CDM,43590635_1,HC ENFLOW BLOOD/FLUID WARMING CARTRIDGE,40.0,26.0,10.0,28.0,11
CDM,43590636_1,HC SPINAL NEEDLE GERTIE MARX 22GX3.5IN W/INTRO,44.0,28.6,11.0,30.8,11
CDM,43590637_1,HC SPINAL NEEDLE GERTIE MARX 22GX6IN W/INTRO,58.0,37.7,14.5,40.6,11
CDM,43590638_1,HC PACK CUSTOM NERVE BLOCK PERIPHERAL,60.0,39.0,15.0,42.0,11
CDM,43590640_1,HC GE LOGIC E ULTRASOUND,366.0,237.9,91.5,256.2,11
CDM,43590641_1,HC SET 3M RANGER FLUID WARMING 44ML ST FLOW,46.35,30.13,11.59,32.45,11
CDM,43590642_1,HC SET 3M RANGER FLUID WARMING 20ML PEDS/NEONATE,85.46,55.55,21.37,59.82,11
CDM,43590643_1,HC MANUJET VENTILATION CATHETER,168.03,109.22,42.01,117.62,11
CDM,43590644_1,HC TWITCHVIEW NMB MONITOR,22.0,14.3,5.5,15.4,11
CDM,43590645_1,HC TWITCHVIEW SENSOR ARRAY,117.18,76.17,29.3,82.03,11
CDM,43590646_1,HC ECMO ARTERIAL BLOOD GAS,159.0,103.35,39.75,111.3,11
CDM,43590647_1,HC PERIPHERAL CATH BLOCK KIT 18G 4IN SONO,252.23,163.95,63.06,176.56,11
CDM,43590650_1,HC MONITOR ANESTHESIA BIS - EQUIP,105.0,68.25,26.25,73.5,11
CDM,43590655_1,HC GLIDESCOPE BFLEX DISP BRONCHOSCOPE,1327.5,862.88,331.88,929.25,11
CDM,43590660_1,HC GLIDESCOPE BLADE DISP,234.0,152.1,58.5,163.8,11
CDM,43590665_1,HC SENSOR CEREBRAL INVOS ADULT,315.0,204.75,78.75,220.5,11
CDM,43590670_1,HC SENSOR CEREBRAL INVOS PEDI,427.5,277.88,106.88,299.25,11
CDM,43590675_1,HC ACUMEN IQ SENSOR 84 INCH,1845.0,1199.25,461.25,1291.5,11
CDM,43590680_1,HC VENUE FIT ULTRASOUND EQUIP,540.0,351.0,135.0,378.0,11
CDM,43590681_1,HC VIDEO BRONCHOSCOPE,1372.5,892.13,343.13,960.75,11
CDM,43590682_1,HC VIDEO LARYNGOSCOPE,157.5,102.38,39.38,110.25,11
CDM,43593306_1,"Ultrasound of heart with color-depicted blood flow, rate, direction and valve function",1350.0,877.5,337.5,3486.38,19
CDM,43593312_1,"Ultrasound of heart with probe in esophagus, with report",2895.0,1881.75,630.02,7476.34,19
CDM,43593319_1,3D ultrasound imaging of heart for evaluation of heart structure performed during ultrasound imaging of congenital heart defects,725.0,471.25,181.25,1872.31,19
CDM,43593320_1,"Ultrasound of heart blood flow, valves and chambers",880.0,572.0,220.0,2272.6,19
CDM,43593325_1,"Ultrasound of heart with color-depicted blood flow, rate and valve function",657.0,427.05,158.99,1696.7,19
CDM,43593331_1,HC SENSOR CARDIAC OUTPUT NICOM CHEETAH,581.0,377.65,145.25,406.7,11
CDM,43593332_1,HC PACK ANESTHESIA TURNOVER,67.0,43.55,16.75,46.9,11
CDM,43593334_1,HC GLIDESCOPE COVER PEDI/ADULT,83.0,53.95,20.75,58.1,11
CDM,43593355_1,Ultrasound of heart with probe in esophagus during surgery on heart or great blood vessels with report,3500.0,2275.0,630.02,9038.75,19
CDM,43594002_1,Initial hospital inpatient or observation ventilation assistance and management,1650.0,1072.5,412.5,4261.13,18
CDM,43594022_1,Initial hospital inpatient or observation ventilation assistance and management,1650.0,1072.5,412.5,4261.13,18
CDM,43594660_1,Therapy procedure using a positive pressure ventilator,235.0,152.75,58.75,606.89,18
CDM,435C8927_1,"TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR MONITORING PURPOSES, INCLUDING PROBE PLACEMENT, REAL TIME 2-DIMENSIONAL IMAGE ACQUISITION AND I",3250.0,2112.5,630.02,8393.13,19
CDM,435C8929_1,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COMPLETE, WITH SPECTRAL",2750.0,1787.5,630.02,7101.88,19
CDM,435IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.3,3.45,1.33,13.69,16
CDM,435OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.35,17.13,6.59,68.05,16
CDM,43600237_1,"THERAPEUTIC PROCEDURES TO INCREASE STRENGTH OR ENDURANCE OF RESPIRATORY MUSCLES, FACE TO FACE, ONE ON ONE, EACH 15 MINUTES (INCLUDES MONITORING)",135.0,87.75,33.75,1177.0,19
CDM,43600238_1,"THERAPEUTIC PROCEDURES TO IMPROVE RESPIRATORY FUNCTION, OTHER THAN DESCRIBED BY G0237, ONE ON ONE, FACE TO FACE, PER 15 MINUTES (INCLUDES MONITORING)",150.0,97.5,37.5,1177.0,19
CDM,43600239_1,"THERAPEUTIC PROCEDURES TO IMPROVE RESPIRATORY FUNCTION OR INCREASE STRENGTH OR ENDURANCE OF RESPIRATORY MUSCLES, TWO OR MORE INDIVIDUALS (INCLUDES MONITORING)",180.0,117.0,45.0,1177.0,19
CDM,43600424_1,"PULMONARY REHABILITATION, INCLUDING EXERCISE (INCLUDES MONITORING), ONE HOUR, PER SESSION, UP TO TWO SESSIONS PER DAY",350.0,227.5,87.5,903.88,17
CDM,43602000_1,UNCLASSIFIED DRUGS,205.03,133.27,51.26,529.49,16
CDM,43602001_1,UNCLASSIFIED DRUGS,205.03,133.27,51.26,529.49,16
CDM,43605_1,Biopsy of stomach,2207.1,1434.62,78.57,2460.4,19
CDM,43609502_1,Initial therapy service to facilitate lung function,240.0,156.0,60.0,1177.0,19
CDM,43609505_1,Inhalation treatment for airway obstruction or sputum production,480.0,312.0,83.86,1239.6,19
CDM,43609593_1,"HC TRANSCUTANEOUS MONITORING,CONTINUOUS E&M",200.0,130.0,50.0,140.0,11
CDM,43609644_1,Other service or procedure on lung,707.0,459.55,83.86,1825.83,19
CDM,43609664_1,Other service or procedure on lung,715.0,464.75,83.86,1846.49,19
CDM,43609684_1,Evaluation of use of breathing device,686.0,445.9,83.86,1771.6,19
CDM,43609689_1,Inhalation treatment for airway obstruction or sputum production,480.0,312.0,83.86,1239.6,19
CDM,43609693_1,Inhalation treatment for airway obstruction or sputum production,480.0,312.0,83.86,1239.6,19
CDM,43609694_1,Inhalation treatment for airway obstruction or sputum production,480.0,312.0,83.86,1239.6,19
CDM,43609700_1,"HC OXYGEN EVALUATION AND MAINTENANCE,PER OCC",151.0,98.15,37.75,105.7,11
CDM,43609705_1,Test to measure oxygen level in blood using ear or finger device multiple times,290.0,188.5,72.5,1438.0,17
CDM,43610002_1,Therapy procedure using a positive pressure ventilator,235.0,152.75,58.75,1177.0,19
CDM,43610004_1,Therapy procedure using a positive pressure ventilator,235.0,152.75,58.75,1177.0,19
CDM,43610_1,Removal of stomach ulcer or growth,2606.1,1693.97,78.57,2881.19,19
CDM,43611002_1,Therapy procedure using a positive pressure ventilator,2076.0,1349.4,193.46,5361.27,19
CDM,43611004_1,Therapy procedure using a positive pressure ventilator,600.0,390.0,150.0,1549.5,19
CDM,43611010_1,Therapy procedure using a positive pressure ventilator,1650.0,1072.5,193.46,4261.13,19
CDM,43611015_1,Therapy procedure using a positive pressure ventilator,1200.0,780.0,193.46,3099.0,19
CDM,43611_1,Removal of malignant growth of stomach,3245.6,2109.64,78.57,3594.48,19
CDM,43617323_1,Test to measure oxygen level in blood using ear or finger device multiple times,260.0,169.0,65.0,1438.0,17
CDM,43620020_1,Therapy procedure to clear airway using an inflatable vest,465.0,302.25,83.86,1200.86,19
CDM,43620025_1,Therapy procedure to clear airway using an inflatable vest,465.0,302.25,83.86,1200.86,19
CDM,43620030_1,Therapy procedure to clear airway using an inflatable vest,700.0,455.0,83.86,1807.75,19
CDM,43620035_1,Therapy procedure to clear airway using an inflatable vest,700.0,455.0,83.86,1807.75,19
CDM,43620_1,Removal of stomach with upper small bowel attachment to esophagus,5293.1,3440.52,78.57,5758.01,19
CDM,43621_1,Removal of stomach with lower small bowel attachment to esophagus,6054.3,3935.3,78.57,6652.23,19
CDM,43622_1,Removal of stomach with creation of intestinal pouch attached to esophagus,6134.1,3987.17,78.57,6755.19,19
CDM,43631720_1,Other procedure on windpipe or lung airway,1754.0,1140.1,208.0,4529.71,19
CDM,43631_1,Removal of lower part of stomach with reattachment of remaining stomach to first part of small bowel,3873.5,2517.78,78.57,4251.04,19
CDM,43632_1,Removal of lower part of stomach with reattachment of remaining stomach to second part of small bowel,5339.3,3470.55,78.57,5958.41,19
CDM,43633_1,Removal of lower portion of stomach with reattachment of upper portion of remaining stomach to small bowel,5069.4,3295.11,78.57,5631.46,19
CDM,43634_1,Partial removal of stomach with creation of intestine pouch,5600.7,3640.46,78.57,6207.81,19
CDM,43635_1,Severing of vagus nerve with partial removal of stomach,446.3,290.1,78.57,328.56,19
CDM,43640_1,Severing of vagus nerve to stomach,3118.5,2027.03,78.57,3454.34,19
CDM,43641_1,Repair of stomach outlet muscle and severing of vagus nerve,3349.5,2177.18,78.57,3509.93,19
CDM,43644_1,Bypass of stomach using an endoscope,4630.0,3009.5,78.57,5075.24,19
CDM,43645_1,Bypass of stomach with reconstruction of small bowel using an endoscope,4946.6,3215.29,78.57,5425.23,19
CDM,43647_1,Implantation or replacement of neurostimulator electrodes in upper stomach using an endoscope,4053.0,2634.45,78.57,3083.84,15
CDM,43648_1,Revision or removal of neurostimulator electrodes in upper stomach using an endoscope,4053.0,2634.45,78.57,2026.5,15
CDM,43650285_1,Test to measure oxygen level in blood using ear or finger device multiple times,260.0,169.0,65.0,1438.0,17
CDM,43650391_1,Initial therapy service to facilitate lung function,240.0,156.0,60.0,1177.0,19
CDM,43651_1,Incision of vagus nerve in stomach using an endoscope,1736.7,1128.86,78.57,1913.49,19
CDM,43652_1,Incision of selective vagus nerves of stomach using an endoscope,2019.2,1312.48,78.57,2238.53,19
CDM,43653_1,Creation of surgical opening from stomach to skin using an endoscope,1472.1,956.87,78.57,1684.6,19
CDM,43692950_1,Manual attempt to restore blood circulation and breathing,1138.0,739.7,284.5,2938.89,19
CDM,43693224_1,Electrocardiogram (ECG) 2-day continuous with review and report by health care professional,409.0,265.85,89.9,1124.0,19
CDM,43693226_1,Electrocardiogram (ECG) 2-day continuous with report,500.0,325.0,89.9,1291.25,19
CDM,43693270_1,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring,300.0,195.0,60.67,1124.0,19
CDM,43694002_1,Initial hospital inpatient or observation ventilation assistance and management,1650.0,1072.5,412.5,4261.13,19
CDM,43694003_1,Follow-up inpatient or observation ventilation assistance and management,2400.0,1560.0,600.0,6198.0,19
CDM,43694012_1,Initial hospital inpatient or observation ventilation assistance and management,1650.0,1072.5,412.5,4261.13,19
CDM,43694013_1,Follow-up inpatient or observation ventilation assistance and management,2400.0,1560.0,600.0,6198.0,19
CDM,43694022_1,Initial hospital inpatient or observation ventilation assistance and management,1650.0,1072.5,412.5,4261.13,19
CDM,43694023_1,Follow-up inpatient or observation ventilation assistance and management,1200.0,780.0,300.0,3099.0,19
CDM,43694610_1,Administration of medication through breathing tube,192.0,124.8,48.0,1177.0,19
CDM,43694621_1,Test for exercise-induced heart and lung stress,1250.0,812.5,150.1,3228.13,19
CDM,43694644_1,"Inhalation treatment for acute airway obstruction, first hour",488.0,317.2,83.86,1260.26,19
CDM,43694645_1,"Inhalation treatment for acute airway obstruction, each additional hour",173.0,112.45,43.25,1177.0,19
CDM,43694667_1,Initial therapy service to facilitate lung function,240.0,156.0,60.0,1177.0,19
CDM,43694668_1,Follow-up therapy service to facilitate lung function,540.0,351.0,83.86,1394.55,19
CDM,43694799_1,HC INCENTIVE SPIROMETRY SETUP,64.0,41.6,16.0,44.8,11
CDM,43698538_1,Inhalation treatment for airway obstruction or sputum production,480.0,312.0,83.86,1239.6,19
CDM,43698539_1,Inhalation treatment for airway obstruction or sputum production,480.0,312.0,83.86,1239.6,19
CDM,43698542_1,Follow-up therapy service to facilitate lung function,540.0,351.0,83.86,1394.55,19
CDM,43698543_1,Follow-up therapy service to facilitate lung function,402.0,261.3,83.86,1177.0,19
CDM,43698544_1,HC TRACHEOSTOMY CARE,87.0,56.55,21.75,60.9,11
CDM,43698548_1,Test to measure oxygen level in blood using ear or finger device multiple times,290.0,188.5,72.5,1438.0,17
CDM,43698960_1,"Education and training for patient self-management, each 30 minutes",55.0,35.75,13.75,273.0,19
CDM,43699406_1,"Smoking and tobacco use intermediate counseling, 3-10 minutes",45.0,29.25,11.25,273.0,19
CDM,43699407_1,"Smoking and tobacco use intensive counseling, more than 10 minutes",57.0,37.05,14.25,273.0,19
CDM,43699464_1,Physician attendance at delivery and stabilization of newborn,263.0,170.95,65.75,679.2,17
CDM,436IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.69,4.35,1.67,17.28,16
CDM,436OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.7,13.46,5.18,53.46,16
CDM,43752_1,Insertion of stomach tube through nose or mouth using fluoroscopic guidance,136.5,88.73,32.15,124.32,19
CDM,43753_1,Insertion of stomach tube and aspiration of stomach contents,132.6,86.19,18.48,78.57,19
CDM,43754_1,Diagnostic insertion of stomach tube and aspiration of stomach contents,219.5,142.68,43.21,567.59,19
CDM,43755_1,"Diagnostic insertion of stomach tube and aspiration of stomach contents after administration of drugs to stimulate stomach secretions, with multiple samples",319.73,207.82,51.6,488.45,19
CDM,43756_1,Diagnostic insertion of tube into upper small bowel and specimen collection using imaging guidance,469.33,305.06,44.12,669.93,19
CDM,43757_1,Insertion of tube into upper small bowel for collection of multiple bile and pancreatic specimens using imaging guidance after administration of drugs to stimulate secretions,1108.8,720.72,65.36,899.06,19
CDM,43761_1,Repositioning of oral or nasal feeding tube in small bowel,344.4,223.86,78.57,314.77,19
CDM,43762_1,Replacement of stomach stoma tube,90.0,58.5,30.9,546.36,19
CDM,43763_1,Replacement of stomach stoma tube with revision of stoma opening,198.0,128.7,75.19,807.47,19
CDM,43770_1,Insertion of adjustable stomach reduction device using an endoscope,2950.5,1917.83,78.57,3290.75,19
CDM,43771_1,Adjustment of stomach reduction device using an endoscope,3365.3,2187.45,78.57,3727.86,19
CDM,43772_1,Removal of stomach reduction device using an endoscope,2545.2,1654.38,78.57,2781.99,19
CDM,43773_1,Replacement of stomach reduction device using an endoscope,3367.4,2188.81,78.57,3731.42,19
CDM,43774_1,Removal of stomach reduction device and port using an endoscope,2550.0,1657.5,78.57,2812.07,19
CDM,43775_1,Partial removal of stomach for weight loss using an endoscope,3530.0,2294.5,78.57,3256.82,19
CDM,437IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.83,7.04,2.71,27.97,16
CDM,437OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.02,7.81,3.01,31.04,16
CDM,43800_1,Repair of muscle of stomach outlet into upper small bowel,2472.8,1607.32,78.57,2727.58,19
CDM,43810_1,Removal of end portion of stomach with attachment to upper small bowel,2683.8,1744.47,78.57,2973.12,19
CDM,43820_1,Partial removal of stomach with attachment of stomach to small bowel,3501.8,2276.17,78.57,3934.52,19
CDM,43825_1,Partial removal of stomach with severing of vagus nerve,3451.4,2243.41,78.57,3826.48,19
CDM,43830_1,Insertion of stomach feeding tube,1833.3,1191.65,78.57,2058.12,19
CDM,43831_1,"Insertion of stomach feeding tube, newborn",1758.8,1143.22,78.57,1756.08,19
CDM,43832_1,Creation of stomach feeding tube,2827.7,1838.01,78.57,3043.64,19
CDM,43840_1,"Suture of perforated ulcer, wound, or injury of stomach or upper small bowel",3552.2,2308.93,78.57,3984.55,19
CDM,43842_1,Banding of upper stomach to reduce size of stomach,3911.3,2542.35,78.57,3606.37,15
CDM,43843_1,Reduction of size of upper stomach,3364.2,2186.73,78.57,3728.07,19
CDM,43845_1,"Partial removal of stomach, upper bowel, and ileum for weight loss",6300.0,4095.0,78.57,5723.36,19
CDM,43846_1,Bypass of stomach for weight loss with Roux-en-Y connection of upper bowel to upper stomach,4751.3,3088.35,78.57,4757.96,19
CDM,43847_1,Bypass of stomach for weight loss with small bowel reconstruction,5040.0,3276.0,78.57,5267.38,19
CDM,43848_1,Revision of upper stomach bypass,5144.0,3343.6,78.57,5648.02,19
CDM,43860_1,Revision of surgically created connection of stomach to small bowel,4374.3,2843.3,78.57,4799.92,19
CDM,43865_1,Revision of attachment of stomach to small bowel with severing of vagus nerve,4547.6,2955.94,78.57,4992.23,19
CDM,43870_1,Closure of surgically created opening from stomach to skin,1875.3,1218.95,78.57,2090.73,19
CDM,43880_1,Closure of abnormal drainage tract from stomach to large bowel,4271.4,2776.41,78.57,4673.12,19
CDM,43881_1,Implantation or replacement of stimulator electrodes in upper stomach,1627.7,1058.01,78.57,1844.47,15
CDM,43882_1,Removal or revision of stimulator electrodes in upper stomach,3350.8,2178.02,78.57,3651.48,15
CDM,43886_1,Revision of port for saline injection into stomach banding device,705.6,458.64,78.57,1066.56,19
CDM,43887_1,Removal of port for saline injection into stomach banding device,825.3,536.45,78.57,960.25,19
CDM,43888_1,Replacement of port for saline injection into stomach banding device,966.0,627.9,78.57,1353.41,19
CDM,43892507_1,"Treatment of speech, language, voice, communication, and/or hearing processing disorder",171.0,111.15,42.75,441.61,19
CDM,43897750_1,"Test or measurement for functional capacity, each 15 minutes",116.0,75.4,29.0,299.57,19
CDM,438G0515_1,"DEVELOPMENT OF COGNITIVE SKILLS TO IMPROVE ATTENTION, MEMORY, PROBLEM SOLVING (INCLUDES COMPENSATORY TRAINING), DIRECT (ONE-ON-ONE) PATIENT CONTACT, EACH 15 MINUTES",74.0,48.1,18.5,277.0,19
CDM,4393IP _1,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",253.73,164.92,4.07,761.19,17
CDM,4393OP _1,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",92.9,60.39,4.07,278.7,17
CDM,4397IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",57.65,37.47,14.41,148.88,16
CDM,4398IP _1,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",8.0,5.2,2.0,24.0,17
CDM,43_1,"INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML",9375.0,6093.75,42.62,24210.94,17
CDM,44005_1,Release of intestinal scar tissue,2920.1,1898.07,78.57,3212.04,19
CDM,44010_1,"Exploration, biopsy, or removal of foreign body in small bowel",2296.4,1492.66,78.57,2555.35,19
CDM,44015_1,Insertion of feeding tube or tube into upper small bowel,945.0,614.25,78.57,540.62,19
CDM,44020_1,"Incision of small bowel for exploration, biopsy, or removal of foreign body",2582.0,1678.3,78.57,2856.24,19
CDM,44021_1,Incision of small bowel for insertion of tube for relief of pressure,2612.4,1698.06,78.57,2867.79,19
CDM,44025_1,Biopsy or removal of foreign body in large bowel,2628.2,1708.33,78.57,2894.2,19
CDM,44050_1,Repair of twisted or herniated small bowel,2485.4,1615.51,78.57,2743.41,19
CDM,44055_1,Correction of abnormal rotation of small bowel,3991.1,2594.22,78.57,4386.97,19
CDM,44100_1,Biopsy of small bowel by capsule attached to tube passed through mouth,322.4,209.56,78.57,329.1,19
CDM,44110000_1,REV - PRO FEE/OTHER,274.0,178.1,109.6,205.5,11
CDM,44110_1,Removal of growth of small or large bowels,2254.4,1465.36,78.57,2507.86,19
CDM,44111_1,Removal of multiple growths of small or large bowel,2940.0,1911.0,78.57,2908.82,19
CDM,44120_1,Partial removal of small bowel with reconnection,3257.1,2117.12,78.57,3590.31,19
CDM,44121_1,"Partial removal and reconnection of small bowel, each additional removal and reconnection",945.0,614.25,78.57,708.66,19
CDM,44125_1,Partial removal of small bowel with creation of opening to skin,3156.3,2051.6,78.57,3471.75,19
CDM,44126_1,Partial removal of small bowel and reconnection to correct congenital defect,6526.8,4242.42,78.57,7203.9,19
CDM,44127_1,Partial removal of small bowel to correct congenital defect with reconnection and tapering,7588.4,4932.46,78.57,8344.97,19
CDM,44128_1,"Partial removal and reconnection of small bowel to correct congenital defect, each additional removal and reconnection",687.8,447.07,78.57,710.05,19
CDM,44130_1,Creation of connection between 2 segments of small bowel,3433.5,2231.78,78.57,3862.57,19
CDM,44132_1,Removal of donor small bowel,1575.0,1023.75,73.6,890.44,15
CDM,44135_1,Transplantation of small bowel from donor,12000.0,7800.0,73.6,6000.0,15
CDM,44137_1,Removal of transplanted donor small bowel,2100.0,1365.0,78.57,3307.12,15
CDM,44139_1,Release of large bowel from spleen and abdominal wall with partial removal of large bowel,336.0,218.4,78.57,355.71,19
CDM,44140_1,Partial removal of large bowel with connection,3584.7,2330.06,78.57,3943.48,19
CDM,44141_1,Partial removal of large bowel with creation of opening to skin,4766.0,3097.9,78.57,5366.01,19
CDM,44143_1,Partial removal of large bowel with creation of opening from large bowel to skin,4430.0,2879.5,78.57,4892.56,19
CDM,44144_1,Partial removal of large bowel with creation of 2 openings from small or large bowel to skin,4673.6,3037.84,78.57,5204.66,19
CDM,44145_1,Partial removal of large bowel and reattachment to rectum,4476.2,2909.53,78.57,4892.03,19
CDM,44146_1,Partial removal of large bowel and reattachment to rectum and creation of large bowel opening,5621.7,3654.11,78.57,6255.41,19
CDM,44147_1,Partial removal of large bowel through abdomen and anus,5107.2,3319.68,78.57,5716.47,19
CDM,44150_1,Removal of large bowel with attachment of small bowel to rectum or creation of opening from small bowel to skin through abdomen,4919.3,3197.55,78.57,5505.03,19
CDM,44151_1,Removal of large bowel with creation of small bowel opening to skin through abdomen,5628.0,3658.2,78.57,6321.91,19
CDM,44155_1,Removal of large bowel and rectum and creation of opening from end of small bowel to skin through abdomen,5522.0,3589.3,78.57,6158.17,19
CDM,44156_1,"Removal of large bowel and rectum and creation of opening from end of small bowel to skin through abdomen, with creation of small bowel pouch",6050.1,3932.57,78.57,6749.15,19
CDM,44157_1,Removal of large bowel and rectum with attachment of small bowel to anus,5911.5,3842.48,78.57,6416.44,19
CDM,44158_1,Removal of large bowel and rectum with attachment of small bowel to anus and creation of small bowel pouch,6065.9,3942.84,78.57,6580.57,19
CDM,44160_1,Partial removal of small and large bowel with attachment of small and large bowel,3339.0,2170.35,78.57,3654.44,19
CDM,44180_1,Release of small bowel scar tissue using an endoscope,2461.2,1599.78,78.57,2701.39,19
CDM,44186_1,Creation of opening from small bowel to skin with insertion of a tube for decompression or feeding using an endoscope,1730.0,1124.5,78.57,1907.87,19
CDM,44187_1,Creation of opening from small bowel to skin using an endoscope,2928.5,1903.53,78.57,3274.01,19
CDM,44188_1,Creation of large bowel opening using an endoscope,3237.2,2104.18,78.57,3616.48,19
CDM,44202_1,Partial removal and reconnection of small bowel using an endoscope,3708.6,2410.59,78.57,4070.41,19
CDM,44203_1,"Partial removal of small bowel using an endoscope, each additional removal and connection",559.95,363.97,78.57,706.08,19
CDM,44204_1,Partial removal of large bowel using an endoscope,4147.5,2695.88,78.57,4543.66,19
CDM,44205_1,Partial removal of small and large bowel with attachment of small and large bowel using an endoscope,3618.3,2351.9,78.57,3954.92,19
CDM,44206_1,Partial removal of large bowel with creation of opening from large bowel to skin using an endoscope,4706.1,3058.97,78.57,5163.45,19
CDM,44207_1,Partial removal of large bowel and reattachment to rectum using an endoscope,4948.7,3216.66,78.57,5393.59,19
CDM,44208_1,Partial removal of large bowel and reattachment to rectum and creation of opening from large bowel to skin using an endoscope,3308.6,2150.59,78.57,5886.69,19
CDM,4420IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.6,3.64,1.4,14.46,16
CDM,4420OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.9,21.39,8.23,84.96,16
CDM,44210_1,Removal of large bowel with attachment of small bowel to rectum or creation of small bowel opening using an endoscope,4806.9,3124.49,78.57,5299.84,19
CDM,44211_1,Removal of large bowel and rectum with attachment of small bowel to anus and creation of opening from small bowel to skin using an endoscope,5903.1,3837.02,78.57,6464.3,19
CDM,44212_1,Removal of large bowel and rectum with creation of opening from small bowel to skin using an endoscope,5540.9,3601.59,78.57,6112.24,19
CDM,44213_1,Partial release of large bowel and partial removal of large bowel using an endoscope,488.3,317.4,78.57,555.49,19
CDM,4421IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.94,9.06,3.49,36.0,16
CDM,4421OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.54,16.6,6.39,65.96,16
CDM,44227_1,Closure of opening from large or small bowel to skin using an endoscope,4489.8,2918.37,78.57,4907.23,19
CDM,4422IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.59,4.28,1.65,17.02,16
CDM,4422OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.56,16.61,6.39,66.01,16
CDM,4423IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.57,4.27,1.64,16.97,16
CDM,4423OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.99,12.99,5.0,51.62,16
CDM,4424IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.16,4.65,1.79,18.49,16
CDM,4424OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.88,18.12,6.97,72.0,16
CDM,4425IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.85,9.0,3.46,35.77,16
CDM,4425OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.05,14.98,5.76,59.53,16
CDM,4426IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.18,9.22,3.55,36.62,16
CDM,4426OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.55,17.91,6.89,71.15,16
CDM,44300_1,Insertion of tube into small bowel,2233.4,1451.71,78.57,2470.82,19
CDM,44310004_1,HC PACEMAKERS $1001-2000,1818.0,1181.7,454.5,1272.6,11
CDM,44310009_1,"HC PACEMAKERS $10,001-15,000",14639.63,9515.76,3659.91,14639.63,12
CDM,44310010_1,"HC PACEMAKERS $15,001-20,000",19102.5,12416.63,4775.63,19102.5,12
CDM,44310020_1,"IMPLANTABLE WIRELESS PULMONARY ARTERY PRESSURE SENSOR WITH DELIVERY CATHETER, INCLUDING ALL SYSTEM COMPONENTS",122653.0,79724.45,30663.25,316751.37,17
CDM,44310_1,Creation of opening from small bowel to skin,2797.2,1818.18,78.57,3081.91,19
CDM,44312_1,Simple revision of superficial scar tissue from surgically created opening of small bowel to skin,1593.9,1036.04,78.57,1759.76,19
CDM,44314_1,Reconstruction of opening from small bowel to skin,2712.2,1762.93,78.57,2982.09,19
CDM,44316899_1,HC UNLISTED SUPPLY $0 - 99,27.79,18.07,6.95,19.45,11
CDM,44316900_1,HC UNLISTED SUPPLY $100-250,113.39,73.7,28.35,79.37,11
CDM,44316901_1,HC UNLISTED SUPPLY $251-500,335.32,217.96,83.83,234.73,11
CDM,44316902_1,HC UNLISTED SUPPLY $501-1000,636.64,413.81,159.16,445.65,11
CDM,44316903_1,HC UNLISTED SUPPLY $1001-2000,1577.32,1025.26,394.33,1104.13,11
CDM,44316904_1,HC UNLISTED SUPPLY $2001-4000,3192.7,2075.25,798.17,2234.89,11
CDM,44316905_1,HC UNLISTED SUPPLY $4001-6000,4760.5,3094.32,1190.12,3332.35,11
CDM,44316906_1,HC UNLISTED SUPPLY $6001-8000,6498.25,4223.86,1624.56,6498.25,12
CDM,44316907_1,"HC UNLISTED SUPPLY $8001-10,000",9495.0,6171.75,2373.75,9495.0,12
CDM,44316910_1,"HC UNLISTED SUPPLY $10,001-15,000",13141.01,8541.66,3285.25,13141.01,12
CDM,44316911_1,"HC UNLISTED SUPPLY $15,001-20,000",19125.0,12431.25,4781.25,19125.0,12
CDM,44316912_1,"HC UNLISTED SUPPLY $20,001-30,000",25346.06,16474.94,6336.52,25346.06,12
CDM,44316913_1,"HC UNLISTED SUPPLY $30,001-40,000",36267.09,23573.61,9066.77,36267.09,12
CDM,44316924_1,"HC UNLISTED SUPPLY $40,001-50,000",40342.01,26222.3,10085.5,40342.01,12
CDM,44316927_1,HC CELL ADAPTER,691.0,449.15,172.75,483.7,11
CDM,44316_1,Creation of pouch of small bowel with valve,3721.2,2418.78,78.57,4138.98,19
CDM,44320_1,Creation of opening from large bowel to skin,3187.8,2072.07,78.57,3538.98,19
CDM,44322_1,Creation of opening from large bowel to skin with multiple bowel biopsies,2519.0,1637.35,78.57,2944.13,19
CDM,44340_1,Simple revision of superficial scar tissue from surgically created opening of large bowel to skin,1598.1,1038.77,78.57,1838.87,19
CDM,44345_1,Complicated reconstruction of opening from large bowel to skin,2787.8,1812.07,78.57,3104.35,19
CDM,44346_1,Revision of opening from large bowel to skin with repair of hernia,3136.4,2038.66,78.57,3491.88,19
CDM,44360_1,Diagnostic exam of small bowel (excluding lower small intestine) using an endoscope,444.2,288.73,78.57,441.19,19
CDM,44361_1,Biopsy of small bowel (except ileum) using an endoscope,577.5,375.38,78.57,487.87,19
CDM,44363_1,Removal of foreign bodies from small bowel using an endoscope,584.9,380.19,78.57,589.12,19
CDM,44364_1,Removal of small bowel polyps or growths using an endoscope with mechanical snare,703.5,457.28,78.57,628.3,19
CDM,44365_1,Removal of small bowel polyps or growths using an endoscope with electrical cautery,667.8,434.07,78.57,559.85,19
CDM,44366_1,Control of bleeding of first or second part of small bowel using an endoscope,821.1,533.72,78.57,737.59,19
CDM,44369_1,Destruction of polyp or growth of small bowel using an endoscope,753.9,490.04,78.57,755.92,19
CDM,44370_1,Insertion of small bowel stent above lower small bowel using an endoscope,645.03,419.27,78.57,817.5,19
CDM,44372_1,Insertion of tube into middle small bowel using an endoscope,727.7,473.01,78.57,731.97,19
CDM,44373_1,Conversion of stomach tube to tube in middle small bowel using an endoscope,499.8,324.87,78.57,586.8,19
CDM,44376_1,Diagnostic exam of small bowel (including lower small intestine) using an endoscope,835.8,543.27,78.57,875.35,19
CDM,44377_1,Biopsy of small bowel using an endoscope,1144.5,743.93,78.57,919.83,19
CDM,44378_1,Control of bleeding of small bowel using an endoscope,1169.7,760.31,78.57,1184.65,19
CDM,44379_1,Insertion of small bowel stent below lower small bowel using an endoscope,995.18,646.87,78.57,1258.49,19
CDM,44380_1,Diagnostic exam of small bowel using an endoscope inserted through surgically created opening from small bowel to skin,393.8,255.97,49.57,471.14,19
CDM,44381_1,Balloon dilation of small bowel using an endoscope,2165.28,1407.43,71.9,2382.87,19
CDM,44382_1,Biopsy of small bowel using an endoscope inserted through surgically created opening from lower small bowel to skin,650.0,422.5,63.15,720.17,19
CDM,44384_1,Insertion of stent into small bowel using an endoscope inserted through surgically created opening from small bowel to skin,371.8,241.67,78.57,534.26,19
CDM,44385_1,Diagnostic exam of surgically created pouch of small bowel using an endoscope,682.5,443.63,62.19,518.43,19
CDM,44386_1,Biopsy of small bowel pouch using an endoscope,910.4,591.76,75.39,750.31,19
CDM,44388_1,Diagnostic exam of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,932.4,606.06,78.57,755.99,19
CDM,44389_1,Biopsy of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,1051.1,683.22,78.57,990.84,19
CDM,44390_1,Removal of foreign bodies from large bowel using an endoscope inserted through surgically created opening from large bowel to skin,1243.2,808.08,78.57,973.84,19
CDM,44391_1,Control of bleeding of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,1362.9,885.89,78.57,1542.59,19
CDM,44392_1,Removal of growths or polyps of large bowel by electrical cautery using an endoscope inserted through surgically created opening from large bowel to skin,1171.8,761.67,78.57,925.54,19
CDM,44394_1,Removal of growths or polyps of large bowel by mechanical snare using an endoscope inserted through surgically created opening into large bowel to skin,1336.7,868.86,78.57,1052.73,19
CDM,44401_1,Destruction of growth or polyp of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,7350.75,4777.99,78.57,5744.62,19
CDM,44402_1,Insertion of stent into large bowel using an endoscope inserted through surgically created opening from large bowel to skin,630.13,409.58,78.57,805.08,19
CDM,44403_1,Removal of lining of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,735.13,477.83,78.57,935.25,19
CDM,44404_1,Injection beneath lining of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,838.05,544.73,78.57,1014.01,19
CDM,44405_1,Balloon dilation of large bowel using an endoscope,1251.73,813.62,78.57,1340.73,19
CDM,44406_1,Ultrasound exam of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,555.4,361.01,78.57,705.85,19
CDM,44407_1,Fine needle aspiration and/or biopsy of large bowel with ultrasound guidance using an endoscope inserted through surgically created opening from large bowel to skin,666.1,432.97,78.57,847.35,19
CDM,44408_1,Decompression of large bowel using an endoscope inserted through surgically created opening in large bowel to skin,570.85,371.05,78.57,711.75,19
CDM,44410025_1,"SACROILIAC ORTHOSIS, FLEXIBLE, PROVIDES PELVIC-SACRAL SUPPORT, REDUCES MOTION ABOUT THE SACROILIAC JOINT, INCLUDES STRAPS, CLOSURES, MAY INCLUDE PENDULOUS ABDOMEN DESIGN, PREFABRICATED, OFF-THE-SHELF",79.0,51.35,19.75,94.8,16
CDM,44420560_1,"Insertion of needle, 1-2 muscles",75.0,48.75,18.75,277.0,19
CDM,44420561_1,"Insertion of needle, 3 muscles or more",75.0,48.75,18.75,277.0,19
CDM,44480003_1,"ELECTRICAL STIMULATION (UNATTENDED), TO ONE OR MORE AREAS FOR INDICATION(S) OTHER THAN WOUND CARE, AS PART OF A THERAPY PLAN OF CARE",46.0,29.9,11.5,277.0,19
CDM,44480004_1,Therapy procedure using functional activities,125.0,81.25,31.25,322.81,19
CDM,4448IP _1,UNCLASSIFIED DRUGS,20.94,13.61,5.24,54.08,16
CDM,4448OP _1,UNCLASSIFIED DRUGS,33.57,21.82,8.39,86.69,16
CDM,44495851_1,"Measurement of range of motion in arm, leg or each spine section",50.0,32.5,12.5,277.0,17
CDM,44495992_1,"Repositioning exercises of head for treatment of dizziness, each day",200.0,130.0,50.0,516.5,19
CDM,44497012_1,Application of mechanical traction,200.0,130.0,50.0,516.5,19
CDM,44497016_1,Application of blood vessel compression device,49.0,31.85,12.25,277.0,19
CDM,44497022_1,Application of whirlpool therapy,49.0,31.85,12.25,277.0,19
CDM,44497032_1,"Application of electrical stimulation with therapist present, each 15 minutes",200.0,130.0,50.0,516.5,19
CDM,44497033_1,"Application of medication using electrical current, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44497035_1,"Application of ultrasound, each 15 minutes",200.0,130.0,50.0,516.5,19
CDM,44497110_1,"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",200.0,130.0,50.0,516.5,19
CDM,44497112_1,"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes",200.0,130.0,50.0,516.5,19
CDM,44497113_1,"Therapy procedure using water pool to exercises, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44497116_1,"Therapy procedure for walking training, each 15 minutes",200.0,130.0,50.0,516.5,19
CDM,44497124_1,"Therapy procedure using massage, each 15 minutes",23.0,14.95,5.75,277.0,19
CDM,44497129_1,"Therapy procedure for a range of mental processes, initial 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44497130_1,"Therapy procedure for a range of mental processes, each additional 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44497140_1,"Therapy procedure using manual technique, each 15 minutes",200.0,130.0,50.0,516.5,19
CDM,44497150_1,Therapy procedure in a group setting,57.0,37.05,14.25,277.0,19
CDM,44497161_1,"Evaluation for physical therapy, typically 20 minutes",240.0,156.0,60.0,619.8,19
CDM,44497162_1,"Evaluation for physical therapy, typically 30 minutes",240.0,156.0,60.0,619.8,19
CDM,44497163_1,"Evaluation for physical therapy, typically 45 minutes",240.0,156.0,60.0,619.8,19
CDM,44497164_1,"Re-evaluation for physical therapy, typically 20 minutes",200.0,130.0,50.0,516.5,19
CDM,44497530_1,Therapy procedure using functional activities,200.0,130.0,50.0,516.5,19
CDM,44497535_1,"Training for self-care or home management, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44497542_1,"Evaluation for wheelchair, each 15 minutes",104.0,67.6,26.0,277.0,19
CDM,44497602_1,Removal of tissue from wound gradually,225.0,146.25,56.25,581.06,19
CDM,44497750_1,"Test or measurement for functional capacity, each 15 minutes",116.0,75.4,29.0,299.57,19
CDM,44497760_1,"Training in the use of orthopedic device for arm, leg and/or trunk, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44500_1,Dilation of stomach and/or small bowel using long gastrointestinal tube,74.6,48.49,15.36,82.68,19
CDM,4450IP _1,UNCLASSIFIED DRUGS,6.59,4.28,1.65,17.02,16
CDM,4450OP _1,UNCLASSIFIED DRUGS,5.71,3.71,1.43,14.75,16
CDM,44520008_1,"WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMEN",193.0,125.45,48.25,540.96,16
CDM,4452IP _1,UNCLASSIFIED DRUGS,16.3,10.6,4.08,42.09,16
CDM,4452OP _1,UNCLASSIFIED DRUGS,31.29,20.34,7.82,80.81,16
CDM,4454IP _1,UNCLASSIFIED DRUGS,5.96,3.87,1.49,15.39,16
CDM,4454OP _1,UNCLASSIFIED DRUGS,4.51,2.93,1.13,11.65,16
CDM,4455IP _1,UNCLASSIFIED DRUGS,27.55,17.91,6.89,71.15,16
CDM,4455OP _1,UNCLASSIFIED DRUGS,102.6,66.69,25.65,264.96,16
CDM,44580003_1,Therapy procedure using functional activities,125.0,81.25,31.25,322.81,19
CDM,44580004_1,Therapy procedure using functional activities,125.0,81.25,31.25,322.81,19
CDM,44580005_1,"Removal of tissue from wound, 20.0 sq cm or less",410.0,266.5,102.5,1058.83,19
CDM,44580007_1,Removal of tissue from wound gradually,225.0,146.25,56.25,581.06,19
CDM,44590901_1,Biofeedback training,101.0,65.65,25.25,277.0,19
CDM,44597018_1,Application of hot wax bath,22.0,14.3,5.5,277.0,19
CDM,44597022_1,Application of whirlpool therapy,160.0,104.0,40.0,413.2,19
CDM,44597032_1,"Application of electrical stimulation with therapist present, each 15 minutes",49.0,31.85,12.25,277.0,19
CDM,44597033_1,"Application of medication using electrical current, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44597035_1,"Application of ultrasound, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44597110_1,"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44597112_1,"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44597124_1,"Therapy procedure using massage, each 15 minutes",23.0,14.95,5.75,277.0,19
CDM,44597129_1,"Therapy procedure for a range of mental processes, initial 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44597130_1,"Therapy procedure for a range of mental processes, each additional 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44597140_1,"Therapy procedure using manual technique, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44597165_1,"Evaluation for occupational therapy, typically 30 minutes",234.0,152.1,58.5,604.31,19
CDM,44597166_1,"Evaluation for occupational therapy, typically 45 minutes",234.0,152.1,58.5,604.31,19
CDM,44597167_1,"Evaluation for occupational therapy, typically 1 hour",234.0,152.1,58.5,604.31,19
CDM,44597168_1,"Re-evaluation for occupational therapy, typically 30 minutes",159.0,103.35,39.75,410.62,19
CDM,44597530_1,Therapy procedure using functional activities,160.0,104.0,40.0,413.2,19
CDM,44597535_1,"Training for self-care or home management, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44597537_1,"Training for community or work reintegration, each 15 minutes",89.0,57.85,22.25,277.0,19
CDM,44597542_1,"Evaluation for wheelchair, each 15 minutes",104.0,67.6,26.0,277.0,19
CDM,44597602_1,Removal of tissue from wound gradually,225.0,146.25,56.25,581.06,19
CDM,44597750_1,"Test or measurement for functional capacity, each 15 minutes",116.0,75.4,29.0,299.57,19
CDM,44597760_1,"Training in the use of orthopedic device for arm, leg and/or trunk, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,44597761_1,"Training in the use of artificial arm and/or leg, each 15 minutes",104.0,67.6,26.0,277.0,19
CDM,44597763_1,"Follow-up training in the use of orthopedic device or artificial arm, leg and/or trunk, each 15 minutes",124.0,80.6,31.0,320.23,19
CDM,4459IP _1,UNCLASSIFIED DRUGS,29.87,19.42,7.47,77.14,16
CDM,4459OP _1,UNCLASSIFIED DRUGS,5.49,3.57,1.37,14.18,16
CDM,445G0515_1,"DEVELOPMENT OF COGNITIVE SKILLS TO IMPROVE ATTENTION, MEMORY, PROBLEM SOLVING (INCLUDES COMPENSATORY TRAINING), DIRECT (ONE-ON-ONE) PATIENT CONTACT, EACH 15 MINUTES",160.0,104.0,40.0,413.2,19
CDM,44602_1,Suture of tear of hole in small bowel,3725.4,2421.51,78.57,4143.54,19
CDM,44603T_1,Suture of multiple tears or holes in small bowel,1379.7,896.81,78.57,4766.38,19
CDM,44603_1,Suture of multiple tears or holes in small bowel,4268.3,2774.4,78.57,4766.38,19
CDM,44604_1,Suture of tear or hole in large bowel,2835.0,1842.75,78.57,3113.04,19
CDM,44605_1,Suture of tear or hole in large bowel and creation of opening from large bowel to skin,3497.6,2273.44,78.57,3839.04,19
CDM,44610000_1,HC ARTIFLEX,13.0,8.45,3.25,9.1,11
CDM,44610001_1,HC COBAN,6.0,3.9,1.5,4.2,11
CDM,44610002_1,HC COMPRILAN  6 CM,22.0,14.3,5.5,15.4,11
CDM,44610003_1,HC COMPRILAN 8 CM,25.0,16.25,6.25,17.5,11
CDM,44610004_1,HC COMPRILAN 10 CM,30.0,19.5,7.5,21.0,11
CDM,44610005_1,HC COMPRILAN 12 CM,35.0,22.75,8.75,24.5,11
CDM,44610006_1,HC ELASTOMULL,16.0,10.4,4.0,11.2,11
CDM,44610007_1,HC KLING,2.35,1.53,0.59,1.65,11
CDM,44610008_1,HC BROWN SPORTS TAPE,41.0,26.65,10.25,28.7,11
CDM,44610009_1,HC DELUXE FLEXION GLOVE,69.0,44.85,17.25,48.3,11
CDM,44610010_1,HC COMPRESSION GLOVE,24.0,15.6,6.0,16.8,11
CDM,44610011_1,HC HAND EXERCISER,35.0,22.75,8.75,24.5,11
CDM,44610012_1,HC FINGER SLEEVE SILICONE,12.0,7.8,3.0,8.4,11
CDM,44610013_1,HC SILICONE GEL 2X2,44.0,28.6,11.0,30.8,11
CDM,44610014_1,CONTINUOUS PASSIVE MOTION EXERCISE DEVICE FOR USE ON KNEE ONLY,107.0,69.55,26.75,74.9,16
CDM,44610015_1,"TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) DEVICE, TWO LEAD, LOCALIZED STIMULATION",41.0,26.65,10.25,76.39,16
CDM,44610016_1,"LIFT, ELEVATION, INSIDE SHOE, TAPERED, UP TO ONE-HALF INCH",35.0,22.75,8.75,96.5,16
CDM,44610017_1,HC ELECTRODES/ TENS,32.0,20.8,8.0,22.4,11
CDM,44610018_1,"RESTRAINTS, ANY TYPE (BODY, CHEST, WRIST OR ANKLE)",32.0,20.8,8.0,82.64,16
CDM,44610019_1,HC STOCKINETTE SOCKS,2.35,1.53,0.59,1.65,11
CDM,44610020_1,HC BIOFORM GLOVE,38.0,24.7,9.5,26.6,11
CDM,44610021_1,"SACROILIAC ORTHOSIS, FLEXIBLE, PROVIDES PELVIC-SACRAL SUPPORT, REDUCES MOTION ABOUT THE SACROILIAC JOINT, INCLUDES STRAPS, CLOSURES, MAY INCLUDE PENDULOUS ABDOMEN DESIGN, PREFABRICATED, OFF-THE-SHELF",79.0,51.35,19.75,94.8,16
CDM,44610022_1,"SACROILIAC ORTHOSIS, FLEXIBLE, PROVIDES PELVIC-SACRAL SUPPORT, REDUCES MOTION ABOUT THE SACROILIAC JOINT, INCLUDES STRAPS, CLOSURES, MAY INCLUDE PENDULOUS ABDOMEN DESIGN, PREFABRICATED, OFF-THE-SHELF",132.81,86.33,33.2,159.37,16
CDM,44610023_1,HC GEOMAT  CUSHION,77.0,50.05,19.25,53.9,11
CDM,44610024_1,HC FOLEY CATHETER SPECIALTY,52.0,33.8,13.0,36.4,11
CDM,44610025_1,HC HYPAFIX TAPE,25.0,16.25,6.25,17.5,11
CDM,44610026_1,HC OTOFORM,31.0,20.15,7.75,21.7,11
CDM,44610027_1,HC ROSIDAL SOFT,32.0,20.8,8.0,22.4,11
CDM,44610028_1,HC CHANNEL FOAM,22.0,14.3,5.5,15.4,11
CDM,44610029_1,HC LYMPHEDEMA WOUND KIT,24.0,15.6,6.0,16.8,11
CDM,44615_1,Release of small bowel obstruction,2880.2,1872.13,78.57,3160.59,19
CDM,44620000_1,"SHOULDER ORTHOSIS, ABDUCTION POSITIONING (AIRPLANE DESIGN), THORACIC COMPONENT AND SUPPORT BAR, WITH OR WITHOUT NONTORSION JOINT/TURNBUCKLE, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCL",144.0,93.6,36.0,1407.69,16
CDM,44620001_1,"ELBOW ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",106.0,68.9,26.5,343.92,16
CDM,44620002_1,"ELBOW ORTHOSIS (EO), WITH ADJUSTABLE POSITION LOCKING JOINT(S), PREFABRICATED, ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC  PATIENT BY AN INDIVIDUAL ",174.0,113.1,43.5,595.56,16
CDM,44620003_1,"ELBOW ORTHOSIS, RIGID, WITHOUT JOINTS, INCLUDES SOFT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",35.0,22.75,8.75,128.07,16
CDM,44620004_1,"ELBOW ORTHOSIS, RIGID, WITHOUT JOINTS, INCLUDES SOFT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",66.0,42.9,16.5,128.07,16
CDM,44620005_1,"ELBOW ORTHOSIS, RIGID, WITHOUT JOINTS, INCLUDES SOFT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",44.0,28.6,11.0,128.07,16
CDM,44620006_1,"ELBOW ORTHOSIS, RIGID, WITHOUT JOINTS, INCLUDES SOFT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",150.0,97.5,37.5,180.0,16
CDM,44620007_1,"WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMEN",181.0,117.65,45.25,540.96,16
CDM,44620009_1,"WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMEN",105.0,68.25,26.25,540.96,16
CDM,44620010_1,"WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE",42.0,27.3,10.5,297.73,16
CDM,44620011_1,"WRIST HAND FINGER ORTHOSIS, RIGID WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE MATERIAL; STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",49.0,31.85,12.25,409.21,16
CDM,44620012_1,"WRIST HAND FINGER ORTHOSIS, RIGID WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE MATERIAL; STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",53.0,34.45,13.25,409.21,16
CDM,44620013_1,"WRIST HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",46.0,29.9,11.5,480.91,16
CDM,44620014_1,"WRIST HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",46.0,29.9,11.5,480.91,16
CDM,44620015_1,"WRIST HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",54.0,35.1,13.5,480.91,16
CDM,44620016_1,"WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK-UP, NON MOLDED, PREFABRICATED, OFF-THE-SHELF",43.0,27.95,10.75,73.24,16
CDM,44620017_1,"HAND FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",44.0,28.6,11.0,322.54,16
CDM,44620018_1,"HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",40.0,26.0,10.0,322.54,16
CDM,44620019_1,"HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",44.0,28.6,11.0,322.54,16
CDM,44620020_1,"HAND FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN IND",69.0,44.85,17.25,106.86,16
CDM,44620021_1,"HAND FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN IND",19.0,12.35,4.75,106.86,16
CDM,44620023_1,"FINGER ORTHOSIS, PROXIMAL INTERPHALANGEAL (PIP)/DISTAL INTERPHALANGEAL (DIP), NON TORSION JOINT/SPRING, EXTENSION/FLEXION, MAY INCLUDE SOFT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",30.0,19.5,7.5,76.46,16
CDM,44620024_1,"FINGER ORTHOSIS, PROXIMAL INTERPHALANGEAL (PIP)/DISTAL INTERPHALANGEAL (DIP), NON TORSION JOINT/SPRING, EXTENSION/FLEXION, MAY INCLUDE SOFT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",36.0,23.4,9.0,76.46,16
CDM,44620025_1,"WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT",69.0,44.85,17.25,269.63,16
CDM,44620026_1,"FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",26.0,16.9,6.5,254.08,16
CDM,44620027_1,"FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",43.0,27.95,10.75,254.08,16
CDM,44620028_1,"HAND FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN IND",37.0,24.05,9.25,106.86,16
CDM,44620034_1,"FINGER ORTHOSIS, PROXIMAL INTERPHALANGEAL (PIP)/DISTAL INTERPHALANGEAL (DIP), WITHOUT JOINT/SPRING, EXTENSION/FLEXION (E.G., STATIC OR RING TYPE), MAY INCLUDE SOFT INTERFACE MATERIAL, PREFABRICATED, O",131.0,85.15,32.75,157.2,16
CDM,44620035_1,SLINGS,31.0,20.15,7.75,21.7,16
CDM,44620036_1,HC TORTLE AIR HAT,45.0,29.25,11.25,31.5,11
CDM,44620037_1,"TUBULAR DRESSING WITH OR WITHOUT ELASTIC, ANY WIDTH, PER LINEAR YARD",27.0,17.55,1.62,18.9,16
CDM,44620038_1,HC SHOULDER PULLEY,37.0,24.05,9.25,25.9,11
CDM,44620039_1,Other physical medicine or rehabilitation service or procedure,150.0,97.5,37.5,387.38,19
CDM,44620040_1,Other physical medicine or rehabilitation service or procedure,75.0,48.75,18.75,277.0,19
CDM,44620041_1,Other physical medicine or rehabilitation service or procedure,150.0,97.5,37.5,387.38,19
CDM,44620042_1,Other physical medicine or rehabilitation service or procedure,75.0,48.75,18.75,277.0,19
CDM,44620_1,Closure of surgically created large or small bowel opening,2304.8,1498.12,78.57,2562.35,19
CDM,44625_1,Closure of surgically created large or small bowel opening with bowel removal and reattachment,2729.0,1773.85,78.57,3011.87,19
CDM,44626_1,Closure of surgically created large or small bowel opening with bowel removal and reattachment of large bowel and rectum,4331.3,2815.35,78.57,4715.44,19
CDM,4462IP _1,UNCLASSIFIED DRUGS,5.26,3.42,1.32,13.58,16
CDM,4462OP _1,UNCLASSIFIED DRUGS,15.39,10.0,3.85,39.74,16
CDM,44640_1,Closure of abnormal drainage tract from small bowel to skin,3780.0,2457.0,78.57,4129.58,19
CDM,44650_1,Closure of abnormal drainage tract within small bowel or small to large bowel,3929.1,2553.92,78.57,4265.61,19
CDM,44660_1,Closure of abnormal drainage tract of small bowel,3824.1,2485.67,78.57,4000.61,19
CDM,44661_1,Closure of abnormal drainage tract from small bowel to urinary bladder with resection of bladder and/or small bowel,4287.2,2786.68,78.57,4595.23,19
CDM,44680_1,Surgical folding of upper small bowel upon itself,2846.6,1850.29,78.57,3143.74,19
CDM,44697113_1,"Therapy procedure using water pool to exercises, each 15 minutes",121.0,78.65,30.25,312.48,19
CDM,446L3763_1,"ELBOW WRIST HAND ORTHOSIS, RIGID, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",106.0,68.9,26.5,845.44,16
CDM,44700_1,Suspension of small bowel using mesh or prosthesis or self tissue,2760.5,1794.33,78.57,3016.98,19
CDM,44701_1,Irrigation of large bowel during surgery,389.93,253.45,78.57,496.44,19
CDM,44705_1,Assessment and overseeing preparation of donor fecal specimen,246.8,160.42,49.4,268.94,15
CDM,44715_1,Preparation of donor small bowel and artery for transplantation,2625.0,1706.25,78.57,1399.26,15
CDM,44720_1,Reconstruction of donor small bowel and vein for transplantation,1750.0,1137.5,78.57,800.35,19
CDM,44721_1,Reconstruction of donor small bowel and artery for transplantation,2450.0,1592.5,78.57,1120.6,19
CDM,44800_1,Repair of congenital bowel defect,2017.1,1311.12,78.57,2256.12,19
CDM,44820_1,Removal of growth of abdominal cavity,2233.4,1451.71,78.57,2462.39,19
CDM,44850_1,Suture of abdominal cavity tissue,1971.9,1281.74,78.57,2202.16,19
CDM,44900_1,Drainage of abscess of appendix,2024.4,1315.86,78.57,2268.7,19
CDM,44910003_1,HC MEDICAL NUTRITION GROUP OP-60 MIN,187.0,121.55,46.75,273.0,12
CDM,44910004_1,HC MEDICAL NUTRITION GROUP OP-90 MIN,48.0,31.2,12.0,273.0,12
CDM,44916430_1,HC WT MGT GROUP PROGRAM NON-EMPLOYEE CTL,329.0,213.85,82.25,273.0,12
CDM,44916431_1,HC WT MGT GROUP PROGRAM EMPLOYEE CTL,286.0,185.9,71.5,273.0,12
CDM,44916433_1,HC SOT COUNSELING EMPLOYEE,141.0,91.65,35.25,273.0,12
CDM,44916434_1,"Therapy procedure for nutrition management, each 15 minutes",80.0,52.0,20.0,295.67,19
CDM,44916435_1,"Therapy procedure for nutrition management, each 15 minutes",80.0,52.0,20.0,295.67,19
CDM,44916436_1,"Therapy procedure for nutrition management, each 15 minutes",80.0,52.0,20.0,295.67,19
CDM,44916437_1,"Therapy procedure for nutrition management, each 15 minutes",80.0,52.0,20.0,295.67,19
CDM,44916440_1,"Therapy procedure reassessment for nutrition management, each 15 minutes",62.0,40.3,15.5,295.67,19
CDM,44916441_1,"Therapy procedure reassessment for nutrition management, each 15 minutes",62.0,40.3,15.5,295.67,19
CDM,44916442_1,"Therapy procedure reassessment for nutrition management, each 15 minutes",62.0,40.3,15.5,295.67,19
CDM,44916443_1,"Therapy procedure reassessment for nutrition management, each 15 minutes",62.0,40.3,15.5,295.67,19
CDM,44950_1,Removal of appendix,1707.3,1109.75,78.57,1883.77,19
CDM,44955_1,Removal of appendix during other major procedure,446.3,290.1,37.05,246.54,19
CDM,44960_1,Removal of ruptured infected appendix,2306.9,1499.49,78.57,2565.45,19
CDM,44970_1,Removal of appendix using an endoscope,1568.7,1019.66,78.57,1763.1,19
CDM,44_1,"RADIUM RA-223 DICHLORIDE, THERAPEUTIC, PER MICROCURIE",738.45,479.99,182.24,18303.64,19
CDM,45000_1,Drainage of abscess of pelvic region,1104.6,717.99,78.57,1266.9,19
CDM,45005_1,Drainage of superficial rectal abscess,650.0,422.5,78.57,752.22,19
CDM,45020_1,Incision and drainage of abscess above pelvic floor or behind rectum,1449.0,941.85,78.57,1694.14,19
CDM,4504IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.3,7.35,2.83,29.18,16
CDM,4504OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.76,10.89,4.19,43.28,16
CDM,450IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.03,2.62,1.01,10.41,16
CDM,450OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.48,0.96,0.37,3.82,16
CDM,45100105_1,Chemical analysis using chromatography technique,221.65,144.07,14.14,572.41,19
CDM,45100107_1,Measurement of substance using immunoassay technique,154.0,100.1,14.14,397.71,19
CDM,45100109_1,"Analysis of substance using immunoassay technique, multiple step method",28.0,18.2,3.23,72.31,19
CDM,45100111_1,"Red blood cell fragility measurement, incubated",387.0,251.55,6.99,999.43,19
CDM,45100112_1,"Pathology examination of tissue using a microscope, intermediate complexity",320.0,208.0,37.85,826.4,19
CDM,45100113_1,Electron microscopy for diagnosis,1109.0,720.85,191.4,2863.99,19
CDM,45100114_1,"Special stained specimen slides to examine tissue, initial procedure",320.0,208.0,83.76,826.4,19
CDM,45100115_1,"Special stained specimen slides to examine tissue, each additional procedure",106.37,69.14,46.86,274.7,19
CDM,45100116_1,"Antibody evaluation, initial single antibody stain procedure",360.0,234.0,116.63,929.7,19
CDM,45100117_1,"Antibody evaluation, each additional single antibody stain procedure",101.0,65.65,46.86,260.83,19
CDM,45100118_1,Special stained specimen slides to examine tissue including interpretation and report,262.0,170.3,34.57,676.62,19
CDM,45100119_1,Special stained specimen slides to identify organisms including interpretation and report,160.0,104.0,46.86,413.2,19
CDM,45100120_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100121_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100122_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100123_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100124_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100125_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100126_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100127_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100128_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100129_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100130_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100131_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100132_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100133_1,Detection test by immunoassay technique for Giardia (intestinal parasite),130.0,84.5,11.98,335.73,19
CDM,45100134_1,Stool culture,32.0,20.8,3.02,82.64,19
CDM,45100135_1,"Stool culture, additional pathogens",143.0,92.95,9.44,369.3,19
CDM,45100136_1,Detection test by immunoassay technique for Cryptosporidium (parasite),78.0,50.7,10.78,201.44,19
CDM,45100137_1,"Antipsychotics levels, 1-3",195.0,126.75,16.44,503.59,18
CDM,45100139_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45100140_1,Measurement of substance using immunoassay technique,285.0,185.25,14.14,736.01,19
CDM,45100141_1,"Antibody identification test, platelet antibodies",169.0,109.85,13.66,436.44,19
CDM,45100142_1,Chemical analysis using chromatography technique,221.65,144.07,14.14,572.41,19
CDM,45100143_1,Thyroglobulin (thyroid related hormone) level,796.0,517.4,15.65,2055.67,19
CDM,45100144_1,Measurement of antibody to noninfectious agent,196.0,127.4,12.05,506.17,19
CDM,45100145_1,Measurement of antibody to noninfectious agent,196.0,127.4,12.05,506.17,19
CDM,45100146_1,Measurement of antibody to noninfectious agent,196.0,127.4,12.05,506.17,19
CDM,45100147_1,Measurement of antibody to noninfectious agent,196.0,127.4,12.05,506.17,19
CDM,45100148_1,Measurement of antibody to noninfectious agent,196.0,127.4,12.05,506.17,19
CDM,45100149_1,Measurement of antibody to noninfectious agent,196.0,127.4,12.05,506.17,19
CDM,45100150_1,Measurement of antibody to noninfectious agent,196.0,127.4,12.05,506.17,19
CDM,45100151_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",196.0,127.4,14.14,506.17,19
CDM,45100152_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100153_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100154_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100155_1,Measurement of antibody to noninfectious agent,196.0,127.4,12.05,506.17,19
CDM,45100156_1,Islet cell (pancreas) antibody measurement,196.0,127.4,13.66,506.17,19
CDM,45100157_1,Measurement of antibody to noninfectious agent,196.0,127.4,12.05,506.17,19
CDM,45100158_1,"Protein measurement, immunological probe for band identification",984.0,639.6,29.21,2541.18,19
CDM,45100159_1,"Protein measurement, immunological probe for band identification",527.0,342.55,29.21,1360.98,19
CDM,45100160_1,"Protein measurement, immunological probe for band identification",544.0,353.6,29.21,1404.88,19
CDM,45100161_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100162_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100163_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100164_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100165_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100166_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100167_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",212.0,137.8,14.14,547.49,19
CDM,45100168_1,Islet cell (pancreas) antibody measurement,212.0,137.8,13.66,547.49,19
CDM,45100169_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100170_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100171_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100172_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100173_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100174_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100175_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100176_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100177_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100178_1,"Protein measurement, immunological probe for band identification",544.0,353.6,29.21,1404.88,19
CDM,45100179_1,"Protein measurement, immunological probe for band identification",527.0,342.55,29.21,1360.98,19
CDM,45100180_1,"Protein measurement, immunological probe for band identification",984.0,639.6,29.21,2541.18,19
CDM,45100181_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100182_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100183_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100184_1,"HC DEMENTIA-NMDA R, CSF",622.0,404.3,155.5,1606.32,16
CDM,45100186_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100187_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100188_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",251.0,163.15,14.14,648.21,19
CDM,45100189_1,Islet cell (pancreas) antibody measurement,251.0,163.15,13.66,648.21,19
CDM,45100190_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100191_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100192_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100193_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100194_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100195_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100196_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100197_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100198_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100199_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",251.0,163.15,14.14,648.21,19
CDM,45100201_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",251.0,163.15,14.14,648.21,19
CDM,45100208_1,Test for detecting genes associated with heart diseases,4000.0,2600.0,2040.0,129600.0,19
CDM,45100209_1,"Microscopic genetic analysis of tissue, manual, each additional procedure",188.0,122.2,46.86,485.51,19
CDM,45100210_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100211_1,Breath test analysis for helicobacter pylori,190.0,123.5,67.36,490.68,19
CDM,45100212_1,Breath test analysis for helicobacter pylori,190.0,123.5,67.36,490.68,19
CDM,45100213_1,"Testosterone (hormone) level, free",67.0,43.55,15.65,173.03,19
CDM,45100214_1,"Testosterone (hormone) level, total",67.0,43.55,15.65,173.03,19
CDM,45100215_1,Measurement of antibody to noninfectious agent,54.0,35.1,6.51,139.46,19
CDM,45100218_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100219_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100220_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100221_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100222_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100223_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100224_1,"Protein measurement, immunological probe for band identification",544.0,353.6,29.21,1404.88,19
CDM,45100225_1,"Protein measurement, immunological probe for band identification",527.0,342.55,29.21,1360.98,19
CDM,45100226_1,"Protein measurement, immunological probe for band identification",984.0,639.6,29.21,2541.18,19
CDM,45100227_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100228_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100229_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100230_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100232_1,Measurement of antibody to noninfectious agent,237.0,154.05,12.05,612.05,19
CDM,45100233_1,Measurement of antibody to noninfectious agent,237.0,154.05,12.05,612.05,19
CDM,45100234_1,Measurement of antibody to noninfectious agent,237.0,154.05,12.05,612.05,19
CDM,45100235_1,Measurement of antibody to noninfectious agent,237.0,154.05,12.05,612.05,19
CDM,45100236_1,Measurement of antibody to noninfectious agent,237.0,154.05,12.05,612.05,19
CDM,45100237_1,Measurement of antibody to noninfectious agent,237.0,154.05,12.05,612.05,19
CDM,45100238_1,Measurement of antibody to noninfectious agent,237.0,154.05,12.05,612.05,19
CDM,45100239_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",237.0,154.05,14.14,612.05,19
CDM,45100240_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100241_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100242_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100243_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",547.0,355.55,82.28,1412.63,19
CDM,45100244_1,Measurement of antibody to noninfectious agent,237.0,154.05,12.05,612.05,19
CDM,45100245_1,Islet cell (pancreas) antibody measurement,237.0,154.05,13.66,612.05,19
CDM,45100246_1,Measurement of antibody to noninfectious agent,237.0,154.05,12.05,612.05,19
CDM,45100247_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",237.0,154.05,14.14,612.05,19
CDM,45100248_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",237.0,154.05,14.14,612.05,19
CDM,45100249_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",237.0,154.05,14.14,612.05,19
CDM,45100250_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",237.0,154.05,14.14,612.05,19
CDM,45100251_1,"Protein measurement, immunological probe for band identification",544.0,353.6,29.21,1404.88,19
CDM,45100252_1,"Protein measurement, immunological probe for band identification",527.0,342.55,29.21,1360.98,19
CDM,45100253_1,"Protein measurement, immunological probe for band identification",984.0,639.6,29.21,2541.18,19
CDM,45100254_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100255_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100256_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100257_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100258_1,Measurement of antibody to noninfectious agent,145.0,94.25,12.05,374.46,19
CDM,45100259_1,Measurement of antibody to noninfectious agent,145.0,94.25,12.05,374.46,19
CDM,45100260_1,Measurement of antibody to noninfectious agent,145.0,94.25,12.05,374.46,19
CDM,45100261_1,Measurement of antibody to noninfectious agent,145.0,94.25,12.05,374.46,19
CDM,45100262_1,Measurement of antibody to noninfectious agent,145.0,94.25,12.05,374.46,19
CDM,45100263_1,Measurement of antibody to noninfectious agent,145.0,94.25,12.05,374.46,19
CDM,45100264_1,Measurement of antibody to noninfectious agent,145.0,94.25,12.05,374.46,19
CDM,45100265_1,Measurement of antibody to noninfectious agent,145.0,94.25,12.05,374.46,19
CDM,45100266_1,Measurement of antibody to noninfectious agent,145.0,94.25,12.05,374.46,19
CDM,45100267_1,"Protein measurement, immunological probe for band identification",544.0,353.6,29.21,1404.88,19
CDM,45100268_1,"Protein measurement, immunological probe for band identification",527.0,342.55,29.21,1360.98,19
CDM,45100269_1,Islet cell (pancreas) antibody measurement,320.0,208.0,13.66,826.4,19
CDM,45100270_1,"Protein measurement, immunological probe for band identification",984.0,639.6,29.21,2541.18,19
CDM,45100271_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100272_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100273_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100274_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100275_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100276_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100277_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100278_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",997.0,648.05,14.14,2574.75,19
CDM,45100279_1,"Microscopic genetic analysis of tumor, manual",320.0,208.0,84.12,826.4,19
CDM,45100280_1,Special stained specimen slides to examine tissue and frozen preparation of specimen including interpretation and report,269.0,174.85,46.86,694.69,19
CDM,45100281_1,Evaluation of specimen enzymes,307.0,199.55,116.27,792.83,19
CDM,45100282_1,Microscopic genetic analysis of nerve tissue,320.0,208.0,46.86,826.4,19
CDM,45100283_1,Primidone level,33.0,21.45,5.47,85.22,19
CDM,45100284_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100285_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100286_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100287_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100288_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100289_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100290_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100291_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100292_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100293_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100294_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100295_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100296_1,Chemical analysis using chromatography technique,221.65,144.07,14.14,572.41,19
CDM,45100297_1,"Drugs or substances measurement, 7 or more",215.0,139.75,16.44,555.24,18
CDM,45100298_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",251.0,163.15,14.14,648.21,19
CDM,45100299_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",251.0,163.15,14.14,648.21,19
CDM,45100300_1,"Protein measurement, immunological probe for band identification",544.0,353.6,29.21,1404.88,19
CDM,45100301_1,"Protein measurement, immunological probe for band identification",527.0,342.55,29.21,1360.98,19
CDM,45100302_1,"Protein measurement, immunological probe for band identification",984.0,639.6,29.21,2541.18,19
CDM,45100303_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100304_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100305_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100306_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100307_1,Measurement of antibody to noninfectious agent,389.0,252.85,12.05,1004.59,19
CDM,45100308_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",212.0,137.8,14.14,547.49,19
CDM,45100309_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100310_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100311_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100312_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100313_1,Islet cell (pancreas) antibody measurement,212.0,137.8,13.66,547.49,19
CDM,45100314_1,Measurement of antibody to noninfectious agent,212.0,137.8,12.05,547.49,19
CDM,45100315_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",158.0,102.7,39.5,408.04,19
CDM,45100316_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",158.0,102.7,39.5,408.04,19
CDM,45100317_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",158.0,102.7,39.5,408.04,19
CDM,45100318_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",158.0,102.7,39.5,408.04,19
CDM,45100319_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",158.0,102.7,39.5,408.04,19
CDM,45100320_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",158.0,102.7,39.5,408.04,19
CDM,45100322_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",158.0,102.7,39.5,408.04,19
CDM,45100323_1,DNA testing for genetic defects,370.0,240.5,21.42,955.53,19
CDM,45100324_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45100325_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",251.0,163.15,14.14,648.21,19
CDM,45100326_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100327_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100328_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100329_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100330_1,Islet cell (pancreas) antibody measurement,251.0,163.15,13.66,648.21,19
CDM,45100331_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100332_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100333_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100334_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100335_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100336_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100337_1,Measurement of antibody to noninfectious agent,251.0,163.15,12.05,648.21,19
CDM,45100338_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",251.0,163.15,14.14,648.21,19
CDM,45100339_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",251.0,163.15,14.14,648.21,19
CDM,45100340_1,"Protein measurement, immunological probe for band identification",544.0,353.6,29.21,1404.88,19
CDM,45100341_1,"Protein measurement, immunological probe for band identification",527.0,342.55,29.21,1360.98,19
CDM,45100342_1,"Protein measurement, immunological probe for band identification",984.0,639.6,29.21,2541.18,19
CDM,45100343_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100344_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100345_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100346_1,Measurement of antibody to noninfectious agent,622.0,404.3,12.05,1606.32,19
CDM,45100347_1,Measurement of antibody to noninfectious agent,394.0,256.1,12.05,1017.51,19
CDM,45100348_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45100349_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45100350_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",397.0,258.05,152.32,1025.25,19
CDM,45100352_1,Chemical analysis using chromatography technique,221.65,144.07,14.14,572.41,19
CDM,45100353_1,"Enzyme activity measurement, nonradioactive substrate",440.0,286.0,14.14,1136.3,19
CDM,45100354_1,Chemical analysis using chromatography technique,221.65,144.07,14.14,572.41,19
CDM,45100355_1,Chemical analysis using chromatography technique,221.65,144.07,14.14,572.41,19
CDM,45100356_1,Prostaglandin (hormone) level,342.0,222.3,41.3,883.22,19
CDM,45100357_1,"Measurement of antibody for assessment of autoimmune disorder, any method",63.0,40.95,11.3,162.7,19
CDM,45100358_1,"Analysis of substance using immunoassay technique, multiple step method",63.0,40.95,7.26,162.7,19
CDM,45100359_1,Mass spectrometry (laboratory testing method),100.0,65.0,14.14,258.25,19
CDM,45100360_1,Analysis for antibody to john cunningham virus,115.0,74.75,13.66,296.99,19
CDM,45100361_1,DNA testing for genetic defects,286.0,185.9,21.42,738.6,19
CDM,45100362_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",365.0,237.25,51.19,942.61,19
CDM,45100363_1,Detection test by immunoassay technique for Histoplasma capsulatum (parasite),220.0,143.0,12.47,568.15,19
CDM,45100364_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",275.0,178.75,68.75,710.19,19
CDM,45100365_1,"Chromosome analysis for genetic defects, count 5 cells",321.0,208.65,163.71,848.53,19
CDM,45100366_1,"Chromosome analysis for genetic defects, additional cells counted, each study",44.0,28.6,11.84,113.63,19
CDM,45100367_1,Tissue culture for tumor disorders of bone marrow and blood cells,232.0,150.8,118.32,599.14,19
CDM,45100368_1,"Chromosome analysis for genetic defects, count 15-20 cells",661.0,429.65,54.96,1707.03,19
CDM,45100369_1,DNA testing for genetic defects,70.0,45.5,14.99,180.78,19
CDM,45100370_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",129.0,83.85,51.19,333.14,19
CDM,45100371_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",251.0,163.15,128.01,648.21,19
CDM,45100372_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",1622.0,1054.3,14.14,4188.82,19
CDM,45100373_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100374_1,Measurement of antibody to noninfectious agent,300.0,195.0,12.05,774.75,19
CDM,45100375_1,"Testosterone (hormone) level, total",110.0,71.5,15.65,284.08,19
CDM,45100376_1,"Testing for presence of drug, by chemistry analyzers",58.0,37.7,29.58,149.79,19
CDM,45100377_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",323.0,209.95,80.75,834.15,19
CDM,45100378_1,"Testing for presence of drug, by chemistry analyzers",191.0,124.15,62.14,493.26,19
CDM,45100379_1,"Testing for presence of drug, by chemistry analyzers",183.0,118.95,62.14,472.6,19
CDM,45100380_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",183.0,118.95,45.75,472.6,19
CDM,45100381_1,"Testing for presence of drug, by chemistry analyzers",620.0,403.0,62.14,1601.15,19
CDM,45100382_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",195.0,126.75,14.14,503.59,19
CDM,45100383_1,Measurement of substance using immunoassay technique,195.0,126.75,14.14,503.59,19
CDM,45100384_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",195.0,126.75,14.14,503.59,19
CDM,45100385_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",383.0,248.95,14.14,989.1,19
CDM,45100386_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",921.0,598.65,14.14,2378.48,19
CDM,45100387_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",370.0,240.5,152.32,955.53,19
CDM,45100388_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",370.0,240.5,152.32,955.53,19
CDM,45100389_1,Nerve teasing preparation,450.0,292.5,130.63,1162.13,19
CDM,45100390_1,"Preparation of specimen, manual",50.0,32.5,25.5,189.99,19
CDM,45100391_1,"Test for detecting genes associated with colon cancer, promoter methylation analysis",300.0,195.0,153.0,774.75,19
CDM,45100392_1,Gene analysis (O-6-methylguanine-DNA methyltransferase) for promoter methylation,600.0,390.0,54.96,1549.5,19
CDM,45100393_1,Chemical analysis using chromatography technique,221.65,144.07,14.14,572.41,19
CDM,45100394_1,Levetiracetam level,302.0,196.3,13.25,779.92,19
CDM,45100395_1,Renin (kidney enzyme) level,88.0,57.2,15.65,227.26,19
CDM,45100396_1,Molecular pathology procedure,745.0,484.25,54.96,1923.96,18
CDM,45100397_1,"Test for detection of infectious agent antibody, qualitative or semiquantitative",100.0,65.0,13.66,258.25,19
CDM,45100398_1,Microsomal antibodies (autoantibody) measurement,108.0,70.2,13.66,278.91,19
CDM,45100399_1,"Analysis of substance using immunoassay technique, multiple step method",156.0,101.4,11.53,402.87,19
CDM,45100400_1,Analysis of cell function and analysis for genetic marker,529.0,343.85,48.13,1366.14,19
CDM,45100401_1,Analysis for antibody to Toxoplasma (parasite),81.0,52.65,11.66,209.18,19
CDM,45100402_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45100403_1,Alcohols levels,182.0,118.3,16.44,470.02,18
CDM,45100404_1,Analysis using chemiluminescent technique (light and chemical )reaction,92.0,59.8,12.99,237.59,19
CDM,45100405_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1560.0,1014.0,152.32,4028.7,19
CDM,45100406_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1080.0,702.0,152.32,2789.1,19
CDM,45100407_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",75.0,48.75,31.79,193.69,19
CDM,45100408_1,DNA testing for genetic defects,325.0,211.25,21.42,839.31,19
CDM,45100409_1,"Preparation of specimen, manual",50.0,32.5,25.5,189.99,19
CDM,45100410_1,Gene analysis (O-6-methylguanine-DNA methyltransferase) for promoter methylation,305.0,198.25,54.96,787.66,19
CDM,45100411_1,"Test for detecting genes associated with colon cancer, promoter methylation analysis",305.0,198.25,155.55,787.66,19
CDM,45100412_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1560.0,1014.0,152.32,4028.7,19
CDM,45100413_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1080.0,702.0,152.32,2789.1,19
CDM,45100414_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1080.0,702.0,152.32,2789.1,19
CDM,45100415_1,"Testing for presence of drug, by chemistry analyzers",185.0,120.25,62.14,477.76,19
CDM,45100416_1,Thyroglobulin (thyroid related hormone) level,294.0,191.1,15.65,759.26,19
CDM,45100417_1,Detection test by immunoassay technique for hepatitis B surface antigen neutralization,113.0,73.45,10.33,291.82,19
CDM,45100419_1,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",1104.0,717.6,50.59,2851.08,19
CDM,45100420_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",2100.0,1365.0,152.32,5423.25,19
CDM,45100421_1,Chemical analysis using chromatography technique,221.65,144.07,14.14,572.41,19
CDM,45100422_1,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), targeted sequence",1800.0,1170.0,194.33,5931.18,19
CDM,45100423_1,"Genetic sequencing localization, initial procedure",840.0,546.0,141.19,2169.3,19
CDM,45100424_1,"Genetic sequencing localization, initial procedure",840.0,546.0,141.19,2169.3,19
CDM,45100425_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1629.0,1058.85,152.32,4206.89,19
CDM,45100426_1,Surgical pathology consultation and report on referred material requiring preparation of slides,880.0,572.0,31.8,2272.6,19
CDM,45100427_1,Gene analysis (v-raf murine sarcoma viral oncogene homolog B1),3680.0,2392.0,175.4,9503.6,19
CDM,45100428_1,"Testosterone (hormone) level, free",320.0,208.0,15.65,826.4,19
CDM,45100429_1,"Enzyme activity measurement, nonradioactive substrate",720.0,468.0,14.14,1859.4,19
CDM,45100430_1,DNA testing for genetic defects,160.0,104.0,21.42,413.2,19
CDM,45100431_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",240.0,156.0,51.19,619.8,19
CDM,45100432_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with solid organ abnormal growth of tissue,1332.0,865.8,423.93,7964.16,19
CDM,45100433_1,Analysis of cell function and analysis for genetic marker,900.0,585.0,48.13,2324.25,19
CDM,45100434_1,"Analysis test by nucleic acid for cytomegalovirus, cytomegalovirus",2175.0,1413.75,240.71,5616.94,19
CDM,45100435_1,DNA testing for genetic defects,370.0,240.5,21.42,955.53,19
CDM,45100436_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45100437_1,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",1351.0,878.15,50.59,3488.96,19
CDM,45100438_1,"Detection test by nucleic acid for Mycobacteria species (bacteria), amplified probe technique",918.0,596.7,48.24,2370.74,19
CDM,45100439_1,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), amplified probe technique",383.5,249.28,41.68,990.39,19
CDM,45100440_1,"Flow cytometry technique for DNA or cell analysis, first marker",132.0,85.8,67.32,340.89,19
CDM,45100441_1,"Flow cytometry technique for DNA or cell analysis, each additional marker",2240.0,1456.0,22.15,5784.8,19
CDM,45100442_1,"Alpha-fetoprotein (AFP) level, serum",68.75,44.69,11.53,177.55,19
CDM,45100443_1,"Fetal congenital abnormalities, biochemical assays of four analytes (afp, ue3, hcg [any form], dia) utilizing maternal serum, algorithm reported as a risk score",180.0,117.0,91.8,464.85,19
CDM,45100444_1,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure",930.0,604.5,152.32,2401.73,19
CDM,45100445_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100446_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100447_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100448_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100449_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100450_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100451_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100452_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100453_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100454_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100455_1,"Detection of infectious agent antibody, quantitative",274.0,178.1,13.66,707.61,19
CDM,45100456_1,Islet cell (pancreas) antibody measurement,273.0,177.45,13.66,705.02,19
CDM,45100457_1,Gene analysis (thiopurine S-methyltransferase) for common variant,1125.0,731.25,174.81,2905.31,19
CDM,45100461_1,Analysis of cell function and analysis for genetic marker,1355.0,880.75,48.13,3499.29,19
CDM,45100462_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45100463_1,Analysis using chemiluminescent technique (light and chemical )reaction,529.0,343.85,14.12,1366.14,19
CDM,45100464_1,Measurement of substance using immunoassay technique,418.0,271.7,14.14,1079.49,19
CDM,45100465_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45100466_1,Measurement of substance using immunoassay technique,418.0,271.7,14.14,1079.49,19
CDM,45100467_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45100468_1,DNA testing for genetic defects,325.0,211.25,21.42,839.31,19
CDM,45100469_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",286.0,185.9,51.19,738.6,19
CDM,45100470_1,Molecular pathology procedure,4544.0,2953.6,54.96,11734.88,18
CDM,45100478_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100479_1,"Detection test by nucleic acid for organism, quantification",1192.0,774.8,42.84,3078.34,19
CDM,45100480_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100481_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100482_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100483_1,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure",930.0,604.5,152.32,2401.73,19
CDM,45100484_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100485_1,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure",816.0,530.4,81.74,2107.32,19
CDM,45100486_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100487_1,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure",1224.0,795.6,152.32,3160.98,19
CDM,45100488_1,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure",1224.0,795.6,152.32,3160.98,19
CDM,45100489_1,Clotting factor V (AcG or proaccelerin) measurement,107.0,69.55,5.24,276.33,19
CDM,45100490_1,"Clotting factor VII (proconvertin, stable factor)",115.0,74.75,5.24,296.99,19
CDM,45100491_1,Clotting factor X (Stuart-Prower) measurement,165.7,107.71,5.24,427.92,19
CDM,45100492_1,Clotting factor XI (PTA) measurement,222.0,144.3,5.24,573.32,19
CDM,45100493_1,Protein C antigen (clotting inhibitor) measurement,107.0,69.55,5.24,276.33,19
CDM,45100494_1,"Clotting factor II prothrombin, measurement",179.0,116.35,5.24,462.27,19
CDM,45100495_1,Clotting factor XII (Hageman) measurement,222.0,144.3,19.35,573.32,19
CDM,45100496_1,Translocation analysis (BCR/ABL1) minor breakpoint,870.0,565.5,144.84,2246.78,19
CDM,45100497_1,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",861.0,559.65,50.59,2223.53,19
CDM,45100498_1,Preparation of specimen using laser,2802.0,1821.3,74.75,7236.17,19
CDM,45100499_1,Molecular pathology procedure,960.0,624.0,54.96,2479.2,18
CDM,45100500_1,Tissue culture inoculation for virus isolation,57.0,37.05,12.47,147.2,19
CDM,45100501_1,Tissue culture for virus isolation,57.0,37.05,11.51,147.2,19
CDM,45100502_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100503_1,DNA testing for genetic defects,365.0,237.25,21.42,942.61,19
CDM,45100504_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",365.0,237.25,51.19,942.61,19
CDM,45100505_1,DNA testing for genetic defects,364.0,236.6,21.42,940.03,19
CDM,45100506_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",900.0,585.0,51.19,2324.25,19
CDM,45100507_1,DNA testing for genetic defects,364.0,236.6,21.42,940.03,19
CDM,45100508_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",900.0,585.0,51.19,2324.25,19
CDM,45100509_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with solid organ abnormal growth of tissue,1140.0,741.0,423.93,6816.17,19
CDM,45100510_1,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",1405.0,913.25,50.59,3628.41,19
CDM,45100511_1,"Detection test by nucleic acid for Mycobacteria species (bacteria), amplified probe technique",955.0,620.75,48.24,2466.29,19
CDM,45100512_1,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), amplified probe technique",383.5,249.28,41.68,990.39,19
CDM,45100513_1,"Detection test by nucleic acid for organism, amplified probe technique",1185.0,770.25,35.09,3060.26,19
CDM,45100514_1,"Virus isolation, centrifuge enhanced",279.0,181.35,12.47,720.52,19
CDM,45100515_1,Gene analysis (Janus kinase 2) variant,1140.0,741.0,54.96,2944.05,19
CDM,45100516_1,"Urea nitrogen level to assess kidney function, quantitative",156.0,101.4,3.95,402.87,19
CDM,45100517_1,"Liver enzyme (SGOT), level",156.0,101.4,5.18,402.87,19
CDM,45100518_1,"Liver enzyme (SGPT), level",156.0,101.4,5.3,402.87,19
CDM,45100519_1,Glutamyltransferase (liver enzyme) level,156.0,101.4,6.43,402.87,19
CDM,45100520_1,"Nephelometry, test method using light",156.0,101.4,13.6,402.87,19
CDM,45100521_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100522_1,Tissue culture inoculation for virus isolation,250.0,162.5,12.47,645.63,19
CDM,45100523_1,Tissue culture for virus isolation,174.0,113.1,12.47,449.36,19
CDM,45100524_1,Detection test by immunofluorescent technique for herpes simplex virus type 1,106.0,68.9,11.98,273.75,19
CDM,45100525_1,Detection test by immunofluorescent technique for herpes simplex virus type 2,106.0,68.9,11.98,273.75,19
CDM,45100526_1,Tissue culture inoculation for virus isolation,57.0,37.05,12.47,147.2,19
CDM,45100527_1,Tissue culture for virus isolation,57.0,37.05,11.51,147.2,19
CDM,45100528_1,Culture for chlamydia,96.0,62.4,12.47,247.92,19
CDM,45100529_1,"Identification of organisms by immunologic analysis, immunofluorescent method",96.0,62.4,5.35,247.92,19
CDM,45100530_1,Tissue culture inoculation for virus isolation,57.0,37.05,12.47,147.2,19
CDM,45100531_1,Tissue culture for virus isolation,57.0,37.05,11.51,147.2,19
CDM,45100532_1,"Identification of organisms by immunologic analysis, immunofluorescent method",186.0,120.9,5.57,480.35,19
CDM,45100533_1,Detection test by immunofluorescent technique for varicella (chicken pox) zoster virus,193.0,125.45,12.47,498.42,19
CDM,45100534_1,Tissue culture inoculation for virus isolation,131.0,85.15,12.47,338.31,19
CDM,45100535_1,"Virus isolation, centrifuge enhanced",131.0,85.15,12.47,338.31,19
CDM,45100536_1,"PSA (prostate specific antigen) measurement, total",91.0,59.15,14.14,235.01,19
CDM,45100537_1,"PSA (prostate specific antigen) measurement, free",126.0,81.9,14.14,325.4,19
CDM,45100538_1,Analysis for detection of tumor marker,126.0,81.9,13.66,325.4,19
CDM,45100539_1,Copper level,232.0,150.8,12.41,599.14,19
CDM,45100540_1,Molecular pathology procedure level 4 genetic analysis,800.0,520.0,185.2,2066.0,19
CDM,45100541_1,"Microscopic genetic analysis of tumor, using computer-assisted technology",480.0,312.0,78.78,1239.6,19
CDM,45100542_1,Analysis test by nucleic acid for HIV-1 virus,1100.0,715.0,194.33,2840.75,19
CDM,45100543_1,"Analysis test by nucleic acid for HIV-1 virus, other region",550.0,357.5,128.73,1420.38,19
CDM,45100544_1,"Enzyme activity measurement, nonradioactive substrate",27.0,17.55,5.99,69.73,19
CDM,45100545_1,Very long chain fatty acids level,54.12,35.18,10.69,139.76,19
CDM,45100546_1,Molecular pathology procedure,27.0,17.55,13.77,69.73,18
CDM,45100547_1,Mass spectrometry (laboratory testing method),80.0,52.0,14.14,206.6,19
CDM,45100548_1,"Phenylalanine, PKU (amino acid) level",27.0,17.55,1.49,69.73,19
CDM,45100549_1,Testing for presence of prion protein in cerebrospinal fluid,1623.0,1054.95,405.75,8780.27,19
CDM,45100550_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 51 or more genes associated with blood and lymphatic system disorders,5985.0,3890.25,2748.7,174738.06,19
CDM,45100551_1,"Gene analysis (ccaat/enhancer binding protein [c/ebp], alpha) full gene sequence",1185.0,770.25,194.33,3060.26,19
CDM,45100552_1,"Antiepileptics levels, 1-3",72.0,46.8,28.73,185.94,18
CDM,45100553_1,Arsenic level,374.0,243.1,14.45,965.86,19
CDM,45100554_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100555_1,Measurement of antibody to noninfectious agent,150.0,97.5,12.05,387.38,19
CDM,45100556_1,"Antibody evaluation, each additional single antibody stain procedure",876.0,569.4,46.86,2262.27,19
CDM,45100557_1,"Analysis of substance using immunoassay technique, multiple step method",584.0,379.6,11.53,1508.18,19
CDM,45100558_1,"Antibody evaluation, initial single antibody stain procedure",292.0,189.8,116.63,754.09,19
CDM,45100559_1,Chemical analysis using spectrophotometry (light),88.0,57.2,6.43,227.26,19
CDM,45100560_1,Chemical receptor analysis,154.0,100.1,33.2,397.71,19
CDM,45100561_1,Measurement of substance using immunoassay technique,4260.0,2769.0,14.14,11001.45,19
CDM,45100562_1,"Total protein level, blood",146.0,94.9,3.67,377.05,19
CDM,45100563_1,"Protein measurement, serum",146.0,94.9,6.43,377.05,19
CDM,45100564_1,Immunologic analysis technique on serum (immunofixation),205.55,133.61,13.66,530.83,19
CDM,45100565_1,"Nephelometry, test method using light",146.0,94.9,13.6,377.05,19
CDM,45100566_1,"Nephelometry, test method using light",146.0,94.9,13.6,377.05,19
CDM,45100567_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100568_1,Measurement of antibody to noninfectious agent,300.0,195.0,12.05,774.75,19
CDM,45100570_1,Analysis using chemiluminescent technique (light and chemical )reaction,418.0,271.7,14.12,1079.49,19
CDM,45100571_1,Urine sodium level,33.0,21.45,1.67,85.22,19
CDM,45100572_1,Urine sulfate (acid) level,33.0,21.45,1.81,85.22,19
CDM,45100573_1,Magnesium level,33.0,21.45,2.21,85.22,19
CDM,45100574_1,Urine phosphate level,33.0,21.45,1.91,85.22,19
CDM,45100575_1,Urine potassium level,33.0,21.45,1.56,85.22,19
CDM,45100576_1,Urine chloride level,33.0,21.45,1.9,85.22,19
CDM,45100577_1,Body fluid pH level,33.0,21.45,1.18,85.22,19
CDM,45100578_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100579_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100581_1,"Analysis of substance using immunoassay technique, multiple step method",61.0,39.65,7.03,157.53,19
CDM,45100582_1,"Gene rearrangement analysis (immunoglobulin heavy chain locus), variable region somatic mutation analysis",1485.0,965.25,194.33,4373.62,19
CDM,45100583_1,Gene analysis (Human Platelet Antigen 1) for common variant,202.0,131.3,54.96,521.67,19
CDM,45100584_1,Gene analysis (Human Platelet Antigen 2) for common variant,202.0,131.3,54.96,521.67,19
CDM,45100585_1,Gene analysis (Human Platelet Antigen 3) for common variant,202.0,131.3,54.96,521.67,19
CDM,45100586_1,Gene analysis (Human Platelet Antigen 4) for common variant,202.0,131.3,54.96,521.67,19
CDM,45100587_1,Gene analysis (Human Platelet Antigen 5) for common variant,202.0,131.3,54.96,521.67,19
CDM,45100588_1,Gene analysis (Human Platelet Antigen 6) for common variant,202.0,131.3,54.96,521.67,19
CDM,45100589_1,Gene analysis (Human Platelet Antigen 9) for common variant,202.0,131.3,54.96,521.67,19
CDM,45100590_1,Gene analysis (Human Platelet Antigen 15) for common variant,202.0,131.3,54.96,521.67,19
CDM,45100591_1,Natriuretic peptide (heart and blood vessel protein) level,240.0,156.0,33.2,619.8,19
CDM,45100592_1,DNA testing for genetic defects,364.31,236.8,21.42,940.83,19
CDM,45100593_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",364.31,236.8,51.19,940.83,19
CDM,45100594_1,DNA testing for genetic defects,364.31,236.8,21.42,940.83,19
CDM,45100595_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",364.31,236.8,51.19,940.83,19
CDM,45100596_1,Semen analysis for sperm presence,221.0,143.65,5.88,570.73,19
CDM,45100597_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100598_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",930.0,604.5,152.32,2401.73,19
CDM,45100599_1,"Measurement of complement (immune system proteins), antigen,",348.0,226.2,12.0,898.71,19
CDM,45100600_1,"Troponin (protein) analysis, quantitative",128.0,83.2,12.47,330.56,19
CDM,45100601_1,"Antibody evaluation, initial single antibody stain procedure",336.0,218.4,116.63,867.72,19
CDM,45100602_1,"Antibody evaluation, each additional single antibody stain procedure",336.0,218.4,46.86,867.72,19
CDM,45100603_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45100604_1,Heavy metal level,75.0,48.75,14.45,193.69,19
CDM,45100605_1,Zinc level,16.0,10.4,1.82,41.32,19
CDM,45100606_1,Copper level,60.0,39.0,7.45,154.95,19
CDM,45100607_1,"Analysis for antibody, Treponema pallidum",64.0,41.6,8.47,165.28,19
CDM,45100608_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100609_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100610_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100611_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100612_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100613_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100614_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100615_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1800.0,1170.0,152.32,4648.5,19
CDM,45100616_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1800.0,1170.0,152.32,4648.5,19
CDM,45100617_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100618_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1800.0,1170.0,152.32,4648.5,19
CDM,45100619_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100620_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100621_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1800.0,1170.0,152.32,4648.5,19
CDM,45100622_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1800.0,1170.0,152.32,4648.5,19
CDM,45100623_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100624_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1800.0,1170.0,152.32,4648.5,19
CDM,45100625_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1800.0,1170.0,152.32,4648.5,19
CDM,45100626_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1800.0,1170.0,152.32,4648.5,19
CDM,45100627_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100628_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100629_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",364.31,236.8,42.38,940.83,19
CDM,45100630_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",364.31,236.8,51.19,940.83,19
CDM,45100631_1,Measurement of antibody to noninfectious agent,88.0,57.2,10.6,227.26,19
CDM,45100632_1,Measurement of substance using immunoassay technique,328.0,213.2,14.14,847.06,19
CDM,45100633_1,Measurement of substance using immunoassay technique,340.0,221.0,14.14,878.05,19
CDM,45100634_1,Measurement of substance using immunoassay technique,316.0,205.4,14.14,816.07,19
CDM,45100635_1,"Protein measurement, body fluid",83.0,53.95,14.14,214.35,19
CDM,45100636_1,Total cell count for B cells (white blood cells),472.0,306.8,37.73,1218.94,19
CDM,45100637_1,"Total protein level, urine",83.0,53.95,3.05,214.35,19
CDM,45100638_1,"Antibody identification test, platelet antibodies",169.0,109.85,13.66,436.44,19
CDM,45100639_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",386.0,250.9,82.28,996.85,19
CDM,45100640_1,Measurement of dihydrotestosterone,156.0,101.4,15.65,402.87,19
CDM,45100641_1,"Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants",240.0,156.0,54.96,619.8,19
CDM,45100642_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,2371.0,1541.15,759.53,18008.46,19
CDM,45100643_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1800.0,1170.0,152.32,4648.5,19
CDM,45100644_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100645_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100646_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100647_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",167.0,108.55,41.75,431.28,19
CDM,45100648_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",133.0,86.45,33.25,343.47,19
CDM,45100649_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",242.0,157.3,60.5,624.97,19
CDM,45100650_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",148.0,96.2,37.0,382.21,19
CDM,45100651_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",164.0,106.6,41.0,423.53,19
CDM,45100652_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",237.0,154.05,59.25,612.05,19
CDM,45100653_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",167.0,108.55,41.75,431.28,19
CDM,45100654_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",237.0,154.05,59.25,612.05,19
CDM,45100655_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",155.0,100.75,38.75,400.29,19
CDM,45100656_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",736.0,478.4,82.28,1900.72,19
CDM,45100657_1,"Drugs or substances measurement, 1-3",219.0,142.35,28.73,565.57,18
CDM,45100658_1,Analysis of cell function and analysis for genetic marker,600.0,390.0,48.13,1549.5,19
CDM,45100659_1,"Detection test by nucleic acid for organism, quantification",936.0,608.4,42.84,2417.22,19
CDM,45100660_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45100661_1,DNA testing for genetic defects,364.31,236.8,21.42,940.83,19
CDM,45100662_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",364.31,236.8,51.19,940.83,19
CDM,45100663_1,Analysis for antibody to varicella-zoster virus (chicken pox),36.0,23.4,4.64,92.97,19
CDM,45100664_1,Magnesium level,96.0,62.4,6.43,247.92,19
CDM,45100665_1,Apolipoprotein level,53.0,34.45,11.18,136.87,19
CDM,45100666_1,Viral neutralization test to detect viral antibody level,260.0,169.0,13.66,671.45,19
CDM,45100667_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,191.4,2324.25,18
CDM,45100668_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1800.0,1170.0,152.32,4648.5,19
CDM,45100669_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",1800.0,1170.0,152.32,4648.5,19
CDM,45100670_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100671_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",468.0,304.2,82.28,1208.61,19
CDM,45100672_1,Gene analysis (nudix hydrolase 15) for common variants,563.0,365.95,194.33,1640.36,19
CDM,45100673_1,Analysis for antibody to aspergillus (fungus),45.76,29.74,6.89,118.18,19
CDM,45100674_1,Analysis for antibody to aspergillus (fungus),45.76,29.74,6.89,118.18,19
CDM,45100675_1,Analysis for antibody to aspergillus (fungus),45.76,29.74,6.89,118.18,19
CDM,45100676_1,Analysis for antibody to aspergillus (fungus),45.76,29.74,6.89,118.18,19
CDM,45100677_1,Analysis for antibody to aspergillus (fungus),45.76,29.74,6.89,118.18,19
CDM,45100678_1,"Measurement of antibody (IgE) to allergic substance, multiallergen screen",38.0,24.7,3.03,98.14,19
CDM,45100679_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45100680_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45100681_1,Molecular pathology procedure,2400.0,1560.0,54.96,6198.0,18
CDM,45100682_1,"Microscopic genetic analysis of tissue, manual, initial procedure",816.0,530.4,114.85,2107.32,19
CDM,45100683_1,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), targeted sequence",912.0,592.8,194.33,3005.13,19
CDM,45100684_1,Analysis for antibody to Mycoplasma (bacteria),121.85,79.2,13.24,314.68,19
CDM,45100685_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100686_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100687_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100688_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100689_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100690_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100691_1,Measurement of antibody to noninfectious agent,300.0,195.0,12.05,774.75,19
CDM,45100692_1,Measurement of antibody to noninfectious agent,300.0,195.0,12.05,774.75,19
CDM,45100693_1,Measurement of antibody to noninfectious agent,300.0,195.0,12.05,774.75,19
CDM,45100694_1,Measurement of antibody to noninfectious agent,300.0,195.0,12.05,774.75,19
CDM,45100695_1,Measurement of antibody to noninfectious agent,300.0,195.0,12.05,774.75,19
CDM,45100696_1,Measurement of antibody to noninfectious agent,300.0,195.0,12.05,774.75,19
CDM,45100697_1,Analysis using chemiluminescent technique (light and chemical )reaction,567.0,368.55,14.12,1464.28,19
CDM,45100698_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100699_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100700_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100701_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100702_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100703_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100704_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100705_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45100706_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100707_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100708_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",60.0,39.0,15.0,154.95,19
CDM,45100709_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100710_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",95.0,61.75,14.14,245.34,19
CDM,45100712_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100713_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",210.0,136.5,14.14,542.33,19
CDM,45100714_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100715_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100716_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100717_1,"Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique",64.0,41.6,22.46,165.28,19
CDM,45100718_1,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique",64.0,41.6,22.46,165.28,19
CDM,45100719_1,Molecular pathology procedure level 2,1349.67,877.29,137.0,3485.52,19
CDM,45100720_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",127.0,82.55,31.75,327.98,19
CDM,45100726_1,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure",1020.0,663.0,152.32,2634.15,19
CDM,45100727_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with solid organ abnormal growth of tissue,12500.0,8125.0,423.93,74738.75,19
CDM,45100728_1,"Microscopic genetic analysis of tumor, manual",600.0,390.0,84.12,1549.5,19
CDM,45100729_1,Oxycodone levels,140.0,91.0,16.44,361.55,18
CDM,45100730_1,Screening test for autoimmune disorder,126.0,81.9,12.09,325.4,19
CDM,45100731_1,Measurement of antibody for rheumatoid arthritis assessment,126.0,81.9,12.95,325.4,19
CDM,45100732_1,"Analysis of substance using immunoassay technique, multiple step method",113.0,73.45,11.53,291.82,19
CDM,45100733_1,"Analysis of substance using immunoassay technique, multiple step method",247.0,160.55,11.53,637.88,19
CDM,45100734_1,"Measurement of antibody for assessment of autoimmune disorder, any method",24.0,15.6,4.3,61.98,19
CDM,45100735_1,"Measurement of DNA antibody, native or double stranded",82.0,53.3,11.27,211.77,19
CDM,45100736_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100737_1,Gammaglobulin (immune system protein) measurement,40.53,26.34,3.77,104.67,19
CDM,45100738_1,"Analysis of substance using immunoassay technique, multiple step method",162.0,105.3,11.53,418.37,19
CDM,45100739_1,"Analysis of substance using immunoassay technique, multiple step method",36.0,23.4,4.15,92.97,19
CDM,45100740_1,"Analysis of substance using immunoassay technique, multiple step method",41.0,26.65,4.73,105.88,19
CDM,45100741_1,"Analysis of substance using immunoassay technique, multiple step method",24.0,15.6,2.77,61.98,19
CDM,45100742_1,"Analysis of substance using immunoassay technique, multiple step method",64.0,41.6,7.38,165.28,19
CDM,45100743_1,Measurement of antibody to noninfectious agent,92.0,59.8,11.09,237.59,19
CDM,45100744_1,"Testing for presence of drug, by chemistry analyzers",115.0,74.75,58.65,296.99,19
CDM,45100745_1,Measurement of substance using immunoassay technique,900.0,585.0,14.14,2324.25,19
CDM,45100746_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",140.0,91.0,35.09,361.55,19
CDM,45100747_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100748_1,Measurement of antibody to noninfectious agent,874.0,568.1,12.05,2257.11,19
CDM,45100749_1,"Analysis of substance using immunoassay technique, multiple step method",64.0,41.6,7.38,165.28,19
CDM,45100751_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100752_1,"Genetic sequencing localization, initial procedure",584.0,379.6,141.19,1508.18,19
CDM,45100753_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",264.0,171.6,35.09,681.78,19
CDM,45100754_1,Barbiturates levels,111.0,72.15,16.44,286.66,18
CDM,45100755_1,"Antipsychotics levels, 1-3",96.0,62.4,16.44,247.92,18
CDM,45100756_1,Gene analysis (cystic fibrosis transmembrane conductance regular) common variants,980.0,637.0,423.93,5454.68,19
CDM,45100757_1,Molecular pathology procedure level 7 genetic analysis,8269.2,5374.98,194.33,23391.91,19
CDM,45100758_1,Molecular pathology procedure,1350.0,877.5,54.96,3486.38,18
CDM,45100759_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100760_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100761_1,Tissue culture for tumor disorders,808.0,525.2,147.52,2086.66,19
CDM,45100762_1,"Chromosome analysis for genetic defects, count 15-20 cells",900.0,585.0,54.96,2324.25,19
CDM,45100763_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 51 or more genes associated with blood and lymphatic system disorders,7500.0,4875.0,2748.7,218970.0,19
CDM,45100764_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100765_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",900.0,585.0,152.32,2324.25,19
CDM,45100766_1,Analysis for detection of tumor marker,680.0,442.0,13.66,1756.1,19
CDM,45100767_1,Barbiturates levels,218.0,141.7,16.44,562.99,18
CDM,45100768_1,Molecular pathology procedure,2340.0,1521.0,54.96,6043.05,18
CDM,45100769_1,Molecular pathology procedure,900.0,585.0,54.96,2324.25,18
CDM,45100770_1,Molecular pathology procedure level 7 genetic analysis,780.0,507.0,194.33,2206.46,19
CDM,45100771_1,Measurement of lacosamide,163.0,105.95,14.3,420.95,19
CDM,45100772_1,Measurement of infliximab,738.0,479.7,14.3,1905.89,19
CDM,45100773_1,Measurement of infliximab,567.0,368.55,14.3,1464.28,19
CDM,45100774_1,Measurement of posaconazole,322.0,209.3,14.3,831.57,19
CDM,45100775_1,Measurement of vedolizumab,418.0,271.7,14.3,1079.49,19
CDM,45100776_1,"Gonadotropin, chorionic (reproductive hormone) measurement",56.0,36.4,8.56,144.62,19
CDM,45100777_1,Measurement of adalimumab,488.0,317.2,14.3,1260.26,19
CDM,45100778_1,Analysis using chemiluminescent technique (light and chemical )reaction,488.0,317.2,14.12,1260.26,19
CDM,45100779_1,"Analysis of substance using immunoassay technique, multiple step method",195.0,126.75,11.53,503.59,19
CDM,45100780_1,Measurement of blood coagulation and fibrinolysis (clot dissolving) function,422.0,274.3,29.94,1089.82,19
CDM,45100781_1,"Testing for presence of drug, by chemistry analyzers",604.0,392.6,62.14,1559.83,19
CDM,45100782_1,"Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 3-5 targets",800.0,520.0,128.29,2066.0,19
CDM,45100783_1,"Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 3-5 targets",496.0,322.4,128.29,1280.92,19
CDM,45100784_1,"Detection test by nucleic acid for organism, amplified probe technique",496.0,322.4,35.09,1280.92,19
CDM,45100785_1,"Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 6-11 targets",800.0,520.0,240.71,2103.92,19
CDM,45100786_1,"Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 6-11 targets",753.0,489.45,240.71,1980.31,19
CDM,45100787_1,"Total protein level, urine",108.0,70.2,3.67,278.91,19
CDM,45100788_1,"Immunologic analysis technique on body fluid, other fluids with concentration",108.0,70.2,29.35,278.91,19
CDM,45100789_1,Measurement of substance using immunoassay technique,108.0,70.2,14.14,278.91,19
CDM,45100790_1,Chemical analysis using chromatography technique,221.65,144.07,14.14,572.41,19
CDM,45100791_1,Translocation analysis (PML-RARA regulated adaptor molecule 1) common breakpoint,981.0,637.65,194.33,2533.43,19
CDM,45100792_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,2400.0,1560.0,759.53,18228.72,19
CDM,45100793_1,Molecular pathology procedure,2340.0,1521.0,54.96,6043.05,18
CDM,45100794_1,Analysis using chemiluminescent technique (light and chemical )reaction,428.0,278.2,14.12,1105.31,19
CDM,45100796_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with solid organ abnormal growth of tissue,3625.0,2356.25,423.93,21674.24,19
CDM,45100797_1,DNA testing for genetic defects,364.31,236.8,21.42,940.83,19
CDM,45100798_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",364.31,236.8,51.19,940.83,19
CDM,45100799_1,Flow cytometry technique for DNA or cell analysis,453.4,294.71,38.68,1170.91,19
CDM,45100800_1,Molecular pathology procedure level 6 genetic analysis,1470.0,955.5,194.33,4429.85,19
CDM,45100801_1,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure",1224.0,795.6,152.32,3160.98,19
CDM,45100802_1,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,165.0,107.25,50.59,426.11,19
CDM,45100803_1,Measure of severe acute respiratory syndrome coronavirus 2 (Covid-19) antibody,220.0,143.0,13.66,568.15,19
CDM,45100804_1,"Stool fat or lipids analysis, qualitative",67.0,43.55,3.42,173.03,19
CDM,45100805_1,Heavy metal level,316.0,205.4,14.45,816.07,19
CDM,45100806_1,Heavy metal level,244.0,158.6,14.45,630.13,19
CDM,45100807_1,"Valproic acid level, total",60.0,39.0,8.12,154.95,19
CDM,45100808_1,"Valproic acid level, free",60.0,39.0,8.12,154.95,19
CDM,45100809_1,Analysis for antibody to Rubeola (measles virus),51.0,33.15,6.57,131.71,19
CDM,45100810_1,Analysis for antibody to virus,71.0,46.15,9.14,183.36,19
CDM,45100811_1,Analysis for antibody to virus,71.0,46.15,9.14,183.36,19
CDM,45100812_1,Analysis for antibody to virus,168.0,109.2,12.88,433.86,19
CDM,45100813_1,Analysis for antibody to virus,168.0,109.2,12.88,433.86,19
CDM,45100814_1,Measurement of substance using immunoassay technique,320.0,208.0,14.14,826.4,19
CDM,45100815_1,Analysis for antibody to varicella-zoster virus (chicken pox),58.0,37.7,7.47,149.79,19
CDM,45100816_1,Chemical analysis using chromatography technique,221.65,144.07,14.14,572.41,19
CDM,45100817_1,Gene analysis (fms-related tyrosine kinase 3) internal tandem duplication variants,341.79,222.16,165.51,882.67,19
CDM,45100818_1,Test for detecting genes associated with blood cancer,341.79,222.16,54.96,882.67,19
CDM,45100819_1,Detection test by immunoassay technique for Histoplasma capsulatum (parasite),340.0,221.0,12.47,878.05,19
CDM,45100820_1,Methadone level,144.0,93.6,16.44,371.88,18
CDM,45100821_1,Analysis for detection of tumor marker,277.0,180.05,13.66,715.35,19
CDM,45100822_1,Measurement of substance using immunoassay technique,3600.0,2340.0,14.14,9297.0,19
CDM,45100823_1,"Antipsychotics levels, 1-3",273.0,177.45,16.44,705.02,18
CDM,45100824_1,Stool lactoferrin (immune system protein) analysis,106.0,68.9,14.14,273.75,19
CDM,45100825_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9",44.0,28.6,9.16,113.63,19
CDM,45100826_1,"Molecular pathology test for liver disease, including non-alcohol liver disease (NASH FibroSURE)",1509.0,980.85,377.25,7596.31,18
CDM,45100827_1,Apolipoprotein level,118.0,76.7,14.14,304.74,19
CDM,45100828_1,"Bilirubin level, total",118.0,76.7,5.02,304.74,19
CDM,45100829_1,Cholesterol level,118.0,76.7,4.35,304.74,19
CDM,45100830_1,Blood glucose (sugar) level,118.0,76.7,3.93,304.74,19
CDM,45100831_1,Glutamyltransferase (liver enzyme) level,118.0,76.7,6.43,304.74,19
CDM,45100832_1,Haptoglobin (serum protein) level,118.0,76.7,12.58,304.74,19
CDM,45100833_1,"Liver enzyme (SGOT), level",118.0,76.7,5.18,304.74,19
CDM,45100834_1,"Liver enzyme (SGPT), level",118.0,76.7,5.3,304.74,19
CDM,45100835_1,Triglycerides level,118.0,76.7,5.74,304.74,19
CDM,45100836_1,"Nephelometry, test method using light",118.0,76.7,13.6,304.74,19
CDM,45100837_1,"Analysis of substance using immunoassay technique, multiple step method",47.0,30.55,5.42,121.38,19
CDM,45100838_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",229.0,148.85,57.25,591.39,19
CDM,45100839_1,Detection test by immunoassay technique for rotavirus,53.0,34.45,6.35,136.87,19
CDM,45100840_1,Analysis for antibody to Rubella (German measles virus),36.0,23.4,5.18,92.97,19
CDM,45100841_1,Measurement of substance using immunoassay technique,683.0,443.95,14.14,1763.85,19
CDM,45100842_1,Stool calprotectin (protein) level,892.0,579.8,14.14,2303.59,19
CDM,45100843_1,Analysis for detection of tumor marker,284.0,184.6,13.66,733.43,19
CDM,45100844_1,Analysis for antibody to Francisella tularensis (bacteria transmitted by rodents),40.0,26.0,5.66,103.3,19
CDM,45100845_1,Measurement of antibody to infectious organism,148.0,96.2,6.98,382.21,19
CDM,45100846_1,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,95.0,61.75,48.45,245.34,19
CDM,45100847_1,DNA gene analysis of 324 genes in solid organ tumor tissue,3510.0,2281.5,877.5,122850.0,19
CDM,45100848_1,"Gene analysis (survival of motor neuron 1, telomeric) for dosage/deletion",22.0,14.3,11.22,198.22,19
CDM,45100849_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45100850_1,Measurement of substance using immunoassay technique,428.0,278.2,14.14,1105.31,19
CDM,45100851_1,"Drugs or substances measurement, 1-3",536.0,348.4,28.73,1384.22,18
CDM,45100852_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",19.0,12.35,0.99,49.07,19
CDM,45100853_1,"Measurement of antibody (IgE) to allergic substance, recombinant or purified component, each",71.06,46.19,12.74,183.51,19
CDM,45100854_1,"Phosphatase (enzyme) measurement, alkaline, isoenzymes",136.0,88.4,14.14,351.22,19
CDM,45100855_1,"Phosphatase (enzyme) level, alkaline",47.7,31.01,2.47,123.19,19
CDM,45100856_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",101.0,65.65,5.22,260.83,19
CDM,45100857_1,"Measurement of antibody (IgE) to allergic substance, recombinant or purified component, each",101.0,65.65,13.66,260.83,19
CDM,45100858_1,Microsomal antibodies (autoantibody) measurement,56.0,36.4,8.15,144.62,19
CDM,45100859_1,"Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), amplified probe technique",240.0,156.0,35.09,619.8,19
CDM,45100860_1,Measurement of flecainide,107.0,69.55,14.3,276.33,19
CDM,45100861_1,Measurement of alcohol level in specimen other than breath or urine,83.0,53.95,14.33,214.35,19
CDM,45100862_1,Measurement of amiodarone,68.0,44.2,12.68,175.61,19
CDM,45100863_1,Measurement of itraconazole,228.0,148.2,14.3,588.81,19
CDM,45100864_1,Measurement of leflunomide,279.0,181.35,14.3,720.52,19
CDM,45100865_1,"Testing for presence of drug, by chemistry analyzers",96.0,62.4,48.96,247.92,19
CDM,45100866_1,Analysis for antibody to Hepatitis D virus,53.0,34.45,9.09,136.87,19
CDM,45100867_1,"Analysis of substance using immunoassay technique, multiple step method",80.0,52.0,9.22,206.6,19
CDM,45100868_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100869_1,Measurement of antibody to noninfectious agent,398.0,258.7,12.05,1027.84,19
CDM,45100870_1,Measurement of antibody to noninfectious agent,398.0,258.7,12.05,1027.84,19
CDM,45100871_1,"Protein measurement, immunological probe for band identification",135.0,87.75,29.21,348.64,19
CDM,45100872_1,"Measurement of antibody (IgE) to allergic substance, recombinant or purified component, each",71.06,46.19,12.74,183.51,19
CDM,45100873_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",8.0,5.2,0.42,20.66,19
CDM,45100874_1,Measurement of felbamate,72.0,46.8,13.42,185.94,19
CDM,45100875_1,Quinidine level,150.0,97.5,14.3,387.38,19
CDM,45100876_1,Alcohols levels,83.0,53.95,16.44,214.35,18
CDM,45100877_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",284.0,184.6,14.14,733.43,19
CDM,45100878_1,Islet cell (pancreas) antibody measurement,284.0,184.6,13.66,733.43,19
CDM,45100879_1,"Protein measurement, immunological probe for band identification",284.0,184.6,29.21,733.43,19
CDM,4510087U_1,mRNA gene expression profiling of genes in heart transplant biopsy tissue to evaluate risk of rejection,8400.0,5460.0,2100.0,265391.28,19
CDM,45100880_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100881_1,Islet cell (pancreas) antibody measurement,281.0,182.65,13.66,725.68,19
CDM,45100882_1,"Protein measurement, immunological probe for band identification",281.0,182.65,29.21,725.68,19
CDM,45100883_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100884_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100885_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100886_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100887_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100888_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",183.0,118.95,14.14,472.6,19
CDM,45100889_1,Islet cell (pancreas) antibody measurement,183.0,118.95,13.66,472.6,19
CDM,45100890_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100891_1,"Protein measurement, immunological probe for band identification",183.0,118.95,29.21,472.6,19
CDM,45100892_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100893_1,Islet cell (pancreas) antibody measurement,135.0,87.75,13.66,348.64,19
CDM,45100894_1,"Protein measurement, immunological probe for band identification",135.0,87.75,29.21,348.64,19
CDM,45100895_1,Detection of Immunoglobulin paraprotein (M-protein) in blood or urine,146.0,94.9,36.5,377.05,19
CDM,45100896_1,Measurement of substance using immunoassay technique,146.0,94.9,14.14,377.05,19
CDM,45100897_1,"Hemoglobin analysis and measurement, chromatography",72.0,46.8,6.99,185.94,19
CDM,45100898_1,Red blood cell sickling measurement,98.0,63.7,5.4,253.09,19
CDM,45100899_1,"Hemoglobin analysis and measurement, electrophoresis",119.0,77.35,12.87,307.32,19
CDM,45100900_1,"Testosterone (hormone) level, total",60.0,39.0,15.49,154.95,19
CDM,45100901_1,Ethylene glycol (antifreeze) measurement,134.0,87.1,14.45,346.06,19
CDM,45100902_1,Alcohols levels,83.0,53.95,16.44,214.35,18
CDM,45100903_1,Detection of Immunoglobulin paraprotein (M-protein) in blood or urine,146.0,94.9,36.5,377.05,19
CDM,45100904_1,Measurement of substance using immunoassay technique,146.0,94.9,14.14,377.05,19
CDM,45100905_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",961.4,624.91,152.32,2482.82,19
CDM,45100906_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45100907_1,Human growth hormone level,58.0,37.7,9.67,149.79,19
CDM,45100908_1,"Protein measurement, immunological probe for band identification",253.0,164.45,29.21,653.37,19
CDM,45100909_1,"Detection test by nucleic acid for human papillomavirus (hpv), types 16 and 18 only",168.0,109.2,40.55,433.86,19
CDM,45100910_1,Molecular pathology procedure level 7 genetic analysis,1410.0,916.5,194.33,3988.61,19
CDM,45100911_1,"Detection test by nucleic acid for organism, quantification",600.0,390.0,42.84,1549.5,19
CDM,45100912_1,Quantitation of therapeutic drug,280.0,182.0,14.3,723.1,19
CDM,45100913_1,Measurement of voriconazole,180.0,117.0,14.3,464.85,19
CDM,45100914_1,Analysis for antibody to Rubeola (measles virus),36.0,23.4,4.64,92.97,19
CDM,45100915_1,Analysis for antibody to mumps virus,32.0,20.8,4.18,82.64,19
CDM,45100916_1,Infectious agent drug susceptibility analysis,354.03,230.12,130.35,914.28,19
CDM,45100917_1,Special stain for parasites,70.0,45.5,12.47,180.78,19
CDM,45100918_1,Analysis for antibody (IgM) to West Nile virus,64.57,41.97,10.88,166.75,19
CDM,45100919_1,Analysis for antibody to West Nile virus,59.34,38.57,8.54,153.25,19
CDM,45100920_1,Analysis for antibody (IgM) to West Nile virus,70.0,45.5,11.8,180.78,19
CDM,45100921_1,Analysis for antibody to West Nile virus,70.0,45.5,10.07,180.78,19
CDM,45100923_1,Smear for parasites,60.0,39.0,5.34,154.95,19
CDM,45100924_1,"Gonadotropin, chorionic (reproductive hormone) level",71.0,46.15,10.69,183.36,19
CDM,45100925_1,Molecular pathology procedure,2929.6,1904.24,54.96,7565.69,18
CDM,45100926_1,Lead level,48.44,31.49,5.87,125.1,19
CDM,45100927_1,Copper level,60.0,39.0,7.45,154.95,19
CDM,45100928_1,Zinc level,45.56,29.61,5.19,117.66,19
CDM,45100929_1,Selenium (vitamin) level,102.12,66.38,14.45,263.72,19
CDM,45100930_1,Measurement of Actin (smooth muscle) antibody,32.0,20.8,3.86,82.64,19
CDM,45100931_1,Flow cytometry detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody,757.0,492.05,12.05,1954.95,19
CDM,45100932_1,Flow cytometry detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody,300.0,195.0,12.05,774.75,19
CDM,45100933_1,Detection of gliadin (deamidated) (DGP) antibody,36.0,23.4,4.34,92.97,19
CDM,45100934_1,Detection of gliadin (deamidated) (DGP) antibody,41.0,26.65,4.94,105.88,19
CDM,45100935_1,Flow cytometry detection of myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody,1575.0,1023.75,12.05,4067.44,19
CDM,45100936_1,Flow cytometry detection of myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody,300.0,195.0,12.05,774.75,19
CDM,45100937_1,Flow cytometry detection of myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody,1131.0,735.15,12.05,2920.81,19
CDM,45100938_1,Measurement of tissue transglutaminase,64.0,41.6,7.38,165.28,19
CDM,45100939_1,Measurement of tissue transglutaminase,24.0,15.6,2.77,61.98,19
CDM,45100940_1,Measurement of immunoglobulin light chains,146.0,94.9,14.14,377.05,19
CDM,45100941_1,Measurement of voltage-gated calcium channel antibody,183.0,118.95,13.66,472.6,19
CDM,45100942_1,Measurement of voltage-gated calcium channel antibody,206.0,133.9,13.66,532.0,19
CDM,45100943_1,Special stain for inclusion bodies or parasites,50.0,32.5,3.0,129.13,19
CDM,45100944_1,Smear for parasites,50.0,32.5,4.45,129.13,19
CDM,45100945_1,Lidocaine level,396.0,257.4,14.3,1022.67,19
CDM,45100946_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",167.0,108.55,41.75,431.28,19
CDM,45100947_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",469.0,304.85,82.28,1211.19,19
CDM,45100948_1,"Detection of infectious agent antibody, quantitative",185.0,120.25,13.66,477.76,19
CDM,45100949_1,Ammonia level,61.0,39.65,8.89,157.53,19
CDM,45100950_1,"Amphetamines levels, 5 or more",36.0,23.4,16.44,92.97,18
CDM,45100951_1,"Benzodiazepines levels, 13 or more",36.0,23.4,16.44,92.97,18
CDM,45100952_1,"Opioids levels, 5 or more",36.0,23.4,16.44,92.97,18
CDM,45100953_1,Gabapentin level non-blood,36.0,23.4,16.44,92.97,18
CDM,45100954_1,"Amphetamines levels, 5 or more",60.0,39.0,16.44,154.95,18
CDM,45100955_1,"Benzodiazepines levels, 13 or more",60.0,39.0,16.44,154.95,18
CDM,45100956_1,"Opioids levels, 5 or more",60.0,39.0,16.44,154.95,18
CDM,45100957_1,Gabapentin level non-blood,60.0,39.0,16.44,154.95,18
CDM,45100958_1,Vitamin D-3 level,92.0,59.8,27.23,237.59,19
CDM,45100959_1,Cyclosporine level,88.0,57.2,14.3,227.26,19
CDM,45100960_1,Sirolimus level,132.0,85.8,13.73,340.89,19
CDM,45100963_1,Protoporphyrin (metabolism substance) level,44.0,28.6,6.31,113.63,19
CDM,45100964_1,Detection test by immunoassay technique for hepatitis B surface antigen,69.0,44.85,7.13,178.19,19
CDM,45100965_1,Hepatitis B core antibody measurement,59.0,38.35,7.11,152.37,19
CDM,45100966_1,"Detection test by nucleic acid for HIV-1 virus, amplified probe technique",140.0,91.0,35.09,361.55,19
CDM,45100967_1,"Detection test by nucleic acid for Hepatitis C virus, amplified probe technique",140.0,91.0,35.09,361.55,19
CDM,45100968_1,"Detection test by nucleic acid for Hepatitis B virus, amplified probe technique",140.0,91.0,35.09,361.55,19
CDM,45100969_1,Hepatitis C antibody measurement,90.0,58.5,12.84,232.43,19
CDM,45100970_1,Analysis for antibody to HIV-1 and HIV-2 virus,56.0,36.4,7.68,144.62,19
CDM,45100971_1,"Analysis for antibody to Human T-cell lymphotropic virus, type 1 (HTLV-1)",54.0,35.1,4.91,139.46,19
CDM,45100972_1,"Analysis for antibody to Human T-cell lymphotropic virus, type 2 (HTLV-2)",54.0,35.1,7.56,139.46,19
CDM,45100973_1,Analysis for antibody to protozoa (parasite),112.0,72.8,12.39,289.24,19
CDM,45100974_1,"Analysis for antibody, Treponema pallidum",52.0,33.8,6.88,134.29,19
CDM,45100975_1,"Detection test by nucleic acid for organism, amplified probe technique",150.0,97.5,35.09,387.38,19
CDM,45100976_1,Detection test by immunoassay technique for hepatitis B surface antigen neutralization,410.0,266.5,10.33,1058.83,19
CDM,45100977_1,Hepatitis B core antibody (IgM) measurement,320.0,208.0,11.77,826.4,19
CDM,45100978_1,Hepatitis C antibody measurement,233.0,151.45,13.66,601.72,19
CDM,45100979_1,Analysis for antibody to HIV -1 virus,216.0,140.4,8.89,557.82,19
CDM,45100980_1,Analysis for antibody to HIV-2 virus,216.0,140.4,13.52,557.82,19
CDM,45100981_1,Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV,670.0,435.5,13.66,1730.28,19
CDM,45100982_1,Analysis for antibody to protozoa (parasite),2106.0,1368.9,12.39,5438.75,19
CDM,45100983_1,"Analysis for antibody, Treponema pallidum",136.0,88.4,13.24,351.22,19
CDM,45100984_1,Virus isolation,106.0,68.9,33.86,273.75,19
CDM,45100985_1,Virus isolation,106.0,68.9,33.86,273.75,19
CDM,45100986_1,"Cortisol (hormone) measurement, total",34.0,22.1,5.54,87.81,19
CDM,45100987_1,Detection of orthopoxvirus,340.0,221.0,50.59,878.05,19
CDM,45100988_1,"Semen evaluation, volume, sperm count, motility, and analysis",600.0,390.0,5.88,1549.5,19
CDM,45100989_1,Analysis for antibody to histoplasma (fungus),32.0,20.8,4.41,82.64,19
CDM,45100990_1,Measurement of substance using immunoassay technique,2250.0,1462.5,14.14,5810.63,19
CDM,45100991_1,Measure of severe acute respiratory syndrome coronavirus 2 (Covid-19) antibody,33.5,21.78,13.66,86.51,19
CDM,45100992_1,Organic acid level,52.0,33.8,11.03,134.29,19
CDM,45100993_1,Detection test by immunoassay technique for Histoplasma capsulatum (parasite),340.0,221.0,12.47,878.05,19
CDM,45100994_1,Gammaglobulin (immune system protein) measurement,69.0,44.85,6.42,178.19,19
CDM,45100995_1,Measurement of cold agglutinin (protein) to detect infection or disease,52.0,33.8,4.19,134.29,19
CDM,45100996_1,Lactic acid level,610.0,396.5,11.57,1575.33,19
CDM,45100997_1,Measurement of Hepatitis A antibody,80.0,52.0,9.91,206.6,19
CDM,45100998_1,Analysis for detection of tumor marker,121.0,78.65,13.66,312.48,19
CDM,45100999_1,"Detection test by nucleic acid for organism, amplified probe technique",744.0,483.6,35.09,1921.38,19
CDM,45100_1,Biopsy of anal and/or rectal wall through anus,776.0,504.4,78.57,890.92,19
CDM,45101000_1,"Detection test by nucleic acid for organism, amplified probe technique",320.0,208.0,35.09,826.4,19
CDM,45101001_1,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), amplified probe technique",320.0,208.0,41.68,826.4,19
CDM,45101002_1,Infrared analysis of stone,619.0,402.35,12.9,1598.57,19
CDM,45101003_1,Tissue culture inoculation for virus isolation,240.0,156.0,12.47,619.8,19
CDM,45101004_1,Tissue culture for virus isolation,163.0,105.95,12.47,420.95,19
CDM,45101005_1,"Detection test by nucleic acid for Staphylococcus aureus, methicillin resistant (MRSA bacteria), amplified probe technique",700.0,455.0,35.09,1807.75,19
CDM,45101006_1,Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria),808.0,525.2,13.66,2086.66,19
CDM,45101007_1,Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria),569.0,369.85,13.66,1469.44,19
CDM,45101008_1,Albumin (protein) level,221.0,143.65,4.95,570.73,19
CDM,45101009_1,"Cerebrospinal fluid, or amniotic fluid albumin (protein) level",347.0,225.55,6.43,896.13,19
CDM,45101010_1,Gammaglobulin (immune system protein) measurement,415.0,269.75,6.43,1071.74,19
CDM,45101011_1,"Analysis of substance using immunoassay technique, multiple step method",140.0,91.0,11.53,361.55,19
CDM,45101012_1,"Detection test by nucleic acid for organism, amplified probe technique",727.0,472.55,35.09,1877.48,19
CDM,45101013_1,"Detection test by nucleic acid for organism, quantification",727.0,472.55,42.84,1877.48,19
CDM,45101014_1,Measurement of substance using immunoassay technique,394.0,256.1,14.14,1017.51,19
CDM,45101015_1,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), D816 variants",840.0,546.0,54.96,2169.3,19
CDM,45101016_1,Measurement of substance using immunoassay technique,185.0,120.25,14.14,477.76,19
CDM,45101017_1,Detection test by immunoassay technique for Histoplasma capsulatum (parasite),340.0,221.0,12.47,878.05,19
CDM,45101018_1,"Cannabinoids levels, natural",771.0,501.15,16.44,1991.11,18
CDM,45101019_1,Evaluation of thiopurine S-methyltransferase (TPMT),720.0,468.0,14.14,1859.4,19
CDM,45101020_1,Digital immunoassay in plasma for neurofilament light chain,2250.0,1462.5,12.47,5810.63,18
CDM,45101021_1,Screening test for antibody to noninfectious agent,2400.0,1560.0,12.05,6198.0,19
CDM,45101022_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",840.0,546.0,14.14,2169.3,19
CDM,45101023_1,Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria),70.0,45.5,10.84,180.78,19
CDM,45101024_1,"Detection test by nucleic acid for organism, amplified probe technique",521.0,338.65,35.09,1345.48,19
CDM,45101025_1,Chemical test for genetic disorder,436.0,283.4,14.14,1125.97,19
CDM,45101026_1,"Fetal congenital abnormalities, biochemical assays of two proteins (papp-a, hcg [any form]), utilizing maternal serum, algorithm reported as a risk score",172.0,111.8,54.3,444.19,19
CDM,45101027_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 51 or more genes associated with blood and lymphatic system disorders,3224.0,2095.6,1644.24,94127.9,19
CDM,45101028_1,Creatinine level to test for kidney function or muscle injury,478.0,310.7,5.18,1234.44,19
CDM,45101029_1,Molecular pathology procedure,6000.0,3900.0,54.96,15495.0,18
CDM,45101030_1,Molecular pathology procedure,8900.0,5785.0,54.96,22984.25,18
CDM,45101031_1,Islet cell (pancreas) antibody measurement,820.0,533.0,13.66,2117.65,19
CDM,45101032_1,Measurement of antibodies to Merkel cell polyoma virus oncoprotein in serum,994.0,646.1,194.33,3210.22,19
CDM,45101033_1,Molecular pathology procedure,1725.0,1121.25,54.96,4454.81,18
CDM,45101034_1,Gene analysis (tumor protein 53) targeted sequence analysis,1890.0,1228.5,194.33,6227.74,19
CDM,45101035_1,"Tuberculosis test, gamma interferon",202.0,131.3,48.13,521.67,19
CDM,45101036_1,Gene analysis (telomerase reverse transcriptase) targeted sequence analysis,630.0,409.5,185.2,1626.98,19
CDM,45101037_1,Gene analysis (breast cancer 1 and 2) of full sequence,1366.0,887.9,423.93,6392.88,19
CDM,45101038_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,6826.0,4436.9,759.53,51845.52,19
CDM,45101039_1,Blood viscosity measurement,42.0,27.3,4.9,108.47,19
CDM,45101040_1,Creatinine level to test for kidney function or muscle injury,83.0,53.95,4.3,214.35,19
CDM,45101041_1,Detection of Immunoglobulin paraprotein (M-protein) in blood or urine,500.0,325.0,43.43,1291.25,19
CDM,45101042_1,Test for presence of antibodies to Merkel cell polyoma virus oncoprotein in serum,994.0,646.1,194.33,3210.22,19
CDM,45101043_1,"Nephelometry, test method using light",400.0,260.0,13.6,1033.0,19
CDM,45101044_1,"Coagulation assessment blood test, plasma or whole blood",38.0,24.7,2.28,98.14,19
CDM,45101045_1,"Blood test, clotting time",38.0,24.7,1.63,98.14,19
CDM,45101046_1,"Clotting factor X assessment test, diluted",38.0,24.7,3.64,98.14,19
CDM,45101047_1,Beta 2 glycoprotein 1 antibody (autoantibody) measurement,38.0,24.7,9.67,98.14,19
CDM,45101048_1,Cardiolipin antibody (tissue antibody) measurement,38.0,24.7,9.67,98.14,19
CDM,45101049_1,Phospholipid test,212.0,137.8,5.24,547.49,19
CDM,45101050_1,Platelet function test,118.0,76.7,5.24,304.74,19
CDM,45101051_1,"Coagulation assessment blood test, plasma or whole blood",130.0,84.5,5.24,335.73,19
CDM,45101052_1,Heparin neutralization test,78.0,50.7,5.24,201.44,19
CDM,45101053_1,"Clotting factor X assessment test, diluted",130.0,84.5,5.24,335.73,19
CDM,45101054_1,"Thrombin time, fibrinogen screening test, plasma",55.0,35.75,3.17,142.04,19
CDM,45101055_1,Blood coagulation screening test,100.0,65.0,6.99,258.25,19
CDM,45101056_1,"Coagulation assessment blood test, substitution, plasma fractions",45.0,29.25,2.91,116.21,19
CDM,45101057_1,"Clotting factor X assessment test, diluted",45.0,29.25,4.31,116.21,19
CDM,45101060_1,Infectious agent drug susceptibility analysis,831.0,540.15,130.35,2146.06,19
CDM,45101061_1,Analysis test by nucleic acid for HIV-1 virus,831.0,540.15,194.33,2146.06,19
CDM,45101062_1,"Analysis test by nucleic acid for HIV-1 virus, other region",831.0,540.15,128.73,2146.06,19
CDM,45101063_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",180.0,117.0,45.0,464.85,19
CDM,45101064_1,Flow cytometry detection of myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody,377.0,245.05,12.05,973.6,19
CDM,45101065_1,Flow cytometry detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody,377.0,245.05,12.05,973.6,19
CDM,45101066_1,Flow cytometry detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody,249.5,162.18,12.05,644.33,19
CDM,45101067_1,"Microscopic genetic analysis of tumor, manual",652.0,423.8,84.12,1683.79,19
CDM,45101068_1,"Detection test by nucleic acid for Mycoplasma pneumoniae (bacteria), amplified probe technique",288.0,187.2,35.09,743.76,19
CDM,45101069_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",19.0,12.35,0.99,49.07,19
CDM,45101070_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",19.0,12.35,0.99,49.07,19
CDM,45101071_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",83.0,53.95,20.75,214.35,19
CDM,45101072_1,"Analysis of substance using immunoassay technique, multiple step method",210.0,136.5,11.53,542.33,19
CDM,45101073_1,Pyruvate (organic acid) level,762.0,495.3,14.14,1967.87,19
CDM,45101074_1,Molecular pathology procedure level 2,353.0,229.45,137.0,911.62,19
CDM,45101076_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",412.0,267.8,14.14,1063.99,19
CDM,45101077_1,Hydroxyindolacetic acid (product of metabolism) level,300.0,195.0,12.9,774.75,19
CDM,45101078_1,Chemical analysis using chromatography technique,300.0,195.0,14.14,774.75,19
CDM,45101079_1,Homovanillic acid (organic acid) level,300.0,195.0,15.65,774.75,19
CDM,45101080_1,"Amino acid level, 6 or more amino acids, quantitative, each specimen",2092.0,1359.8,14.14,5402.59,19
CDM,45101081_1,Pyruvate (organic acid) level,762.0,495.3,14.14,1967.87,19
CDM,45101082_1,Measurement of voltage-gated calcium channel antibody,972.0,631.8,13.66,2510.19,19
CDM,45101083_1,Measurement of rufinamide,378.0,245.7,14.3,976.19,19
CDM,45101085_1,Clotting factor XIII (fibrin stabilizing) screening test,70.0,45.5,5.24,180.78,19
CDM,45101086_1,Analysis for antibody to Coccidioides (bacteria),48.0,31.2,5.51,123.96,19
CDM,45101087_1,Analysis for antibody to Coccidioides (bacteria),140.0,91.0,11.47,361.55,19
CDM,45101088_1,Analysis for antibody to Coccidioides (bacteria),41.0,26.65,4.7,105.88,19
CDM,45101089_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",205.0,133.25,35.09,529.41,19
CDM,45101091_1,"Testosterone (hormone) level, total",18.0,11.7,4.65,46.49,19
CDM,45101092_1,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",456.0,296.4,35.09,1177.62,19
CDM,45101095_1,"Analysis for antibody to Herpes simplex virus, type 1",28.0,18.2,3.69,72.31,19
CDM,45101096_1,"Analysis for antibody to Herpes simplex virus, type 2",28.0,18.2,5.42,72.31,19
CDM,45101097_1,Analysis for antibody to Herpes simplex virus,36.0,23.4,5.18,92.97,19
CDM,45101098_1,Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria),70.0,45.5,11.92,180.78,19
CDM,45101099_1,Assessment of blood clotting function,980.0,637.0,6.99,2530.85,19
CDM,45101100_1,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",3284.0,2134.6,50.59,8480.93,19
CDM,45101101_1,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",3284.0,2134.6,50.59,8480.93,19
CDM,45101103_1,Glycine receptor alpha1 IgG live cell-binding assay in serum or cerebral spinal fluid (CSF),1500.0,975.0,188.0,3873.75,17
CDM,45101104_1,Glycine receptor alpha1 IgG live cell-binding assay in serum or cerebral spinal fluid (CSF),1500.0,975.0,188.0,3873.75,17
CDM,45101105_1,Test for acetylcholine receptor modulating antibody,336.0,218.4,12.05,867.72,17
CDM,45101106_1,Test for acetylcholine receptor binding antibody,195.0,126.75,18.4,503.59,17
CDM,45101107_1,Test for muscle-specific kinase antibody,1200.0,780.0,18.4,3099.0,17
CDM,45101108_1,"Cholinesterase (enzyme) level, to test for exposure to chemical or liver disease",51.0,33.15,4.01,131.71,19
CDM,45101109_1,Test for anti-mullerian hormone,160.0,104.0,38.62,413.2,17
CDM,45101110_1,Test for acetylcholine receptor binding antibody,119.0,77.35,18.4,307.32,17
CDM,45101111_1,Test for acetylcholine receptor blocking antibody,119.0,77.35,18.4,307.32,17
CDM,45101112_1,Test for acetylcholine receptor modulating antibody,155.0,100.75,12.05,400.29,17
CDM,45101115_1,Blood typing for red blood cell antigens,391.0,254.15,3.83,1009.76,19
CDM,45101116_1,Measurement of substance using immunoassay technique,200.0,130.0,14.14,516.5,19
CDM,45101117_1,Blood typing for red blood cell antigens,391.0,254.15,3.83,1009.76,19
CDM,45101118_1,Gammaglobulin (immune system protein) measurement,130.0,84.5,6.43,335.73,19
CDM,45101119_1,Heparin assay,180.0,117.0,5.24,464.85,19
CDM,45101120_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",19.0,12.35,0.99,49.07,19
CDM,45101121_1,Measurement of substance using immunoassay technique,1500.0,975.0,14.14,3873.75,19
CDM,45101122_1,Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor gamma),1050.0,682.5,194.33,2711.63,19
CDM,45101123_1,Molecular pathology procedure,16500.0,10725.0,54.96,42611.25,18
CDM,45101124_1,Gene analysis (telomerase reverse transcriptase) targeted sequence analysis,702.0,456.3,185.2,1812.92,19
CDM,45101125_1,Gene analysis (tumor protein 53) targeted sequence analysis,3156.0,2051.4,194.33,10399.34,19
CDM,45101126_1,Measurement of immunoglobulin light chains,380.0,247.0,14.14,981.35,19
CDM,45101127_1,Detection of Mycoplasma genitalium by DNA or RNA probe,180.0,117.0,35.09,464.85,19
CDM,45101128_1,"Detection test by nucleic acid for organism, amplified probe technique",180.0,117.0,35.09,464.85,19
CDM,45101129_1,Cholinesterase (enzyme) level,63.0,40.95,6.18,162.7,19
CDM,45101130_1,Detection of Anaplasma phagocytophilum by amplified nucleic acid probe technique,153.0,99.45,35.09,395.12,19
CDM,45101131_1,Detection of Ehrlichia chaffeensis by amplified nucleic acid probe technique,153.0,99.45,35.09,395.12,19
CDM,45101132_1,"Detection test by nucleic acid for organism, amplified probe technique",153.0,99.45,35.09,395.12,19
CDM,45101133_1,Detection of Babesia microtim by amplified nucleic acid probe technique,153.0,99.45,35.09,395.12,19
CDM,45101134_1,Islet cell (pancreas) antibody measurement,372.0,241.8,13.66,960.69,19
CDM,45101135_1,"T cell count and ratio, including ratio",66.0,42.9,31.01,170.45,19
CDM,45101136_1,"T cells count, total",66.0,42.9,24.9,170.45,19
CDM,45101137_1,Total cell count for B cells (white blood cells),344.0,223.6,37.73,888.38,19
CDM,45101138_1,White blood cell antigen measurement,344.0,223.6,26.78,888.38,19
CDM,45101139_1,Total cell count for B cells (white blood cells),80.0,52.0,30.18,206.6,19
CDM,45101140_1,Total cell count for natural killer cells (white blood cell),80.0,52.0,30.18,206.6,19
CDM,45101141_1,"T cells count, total",80.0,52.0,30.18,206.6,19
CDM,45101142_1,"T cell count and ratio, including ratio",80.0,52.0,37.58,206.6,19
CDM,45101143_1,"Testosterone (hormone) level, free",548.0,356.2,15.65,1415.21,19
CDM,45101144_1,"Testosterone (hormone) level, total",548.0,356.2,15.65,1415.21,19
CDM,45101145_1,Gene analysis (Huntingtin) for abnormal alleles,560.0,364.0,137.0,1446.2,19
CDM,45101146_1,Analysis test by nucleic acid for Hepatitis C virus,744.0,483.6,194.33,1921.38,19
CDM,45101147_1,"Detection test by nucleic acid for organism, amplified probe technique",544.0,353.6,35.09,1404.88,19
CDM,45101148_1,Oxycodone levels,5.0,3.25,2.55,28.73,18
CDM,45101149_1,Methylenedioxyamphetamines levels,5.0,3.25,2.55,28.73,18
CDM,45101150_1,"Stool culture, additional pathogens",149.0,96.85,9.44,384.79,19
CDM,45101151_1,Gabapentin level,60.0,39.0,13.0,154.95,19
CDM,45101152_1,Oxcarbazepine level,88.0,57.2,11.66,227.26,19
CDM,45101153_1,"Detection test by nucleic acid for organism, amplified probe technique",308.0,200.2,35.09,795.41,19
CDM,45101154_1,"Detection test by nucleic acid for organism, quantification",558.0,362.7,42.84,1441.04,19
CDM,45101155_1,"Detection test by nucleic acid for organism, amplified probe technique",276.0,179.4,35.09,712.77,19
CDM,45101156_1,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",200.0,130.0,35.09,516.5,19
CDM,45101157_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",520.0,338.0,35.09,1342.9,19
CDM,45101158_1,"Detection test by nucleic acid for organism, quantification",816.0,530.4,42.84,2107.32,19
CDM,45101159_1,"Detection test by nucleic acid for organism, amplified probe technique",671.0,436.15,35.09,1732.86,19
CDM,45101160_1,"Detection test by nucleic acid for organism, amplified probe technique",276.0,179.4,35.09,712.77,19
CDM,45101161_1,"Detection test by nucleic acid for herpes virus-6, quantification",632.0,410.8,41.76,1632.14,19
CDM,45101162_1,DNA testing for genetic defects,100.0,65.0,21.42,258.25,19
CDM,45101163_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",140.0,91.0,51.19,361.55,19
CDM,45101164_1,Analysis for antibody to virus,120.0,78.0,12.88,309.9,19
CDM,45101165_1,Molecular pathology procedure,7000.0,4550.0,54.96,18077.5,18
CDM,45101166_1,Screening test for antibody to noninfectious agent,177.0,115.05,12.05,457.1,19
CDM,45101167_1,Islet cell (pancreas) antibody measurement,177.0,115.05,13.66,457.1,19
CDM,45101168_1,Flow cytometry detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody,177.0,115.05,12.05,457.1,19
CDM,45101169_1,Screening test for antibody to noninfectious agent,58.0,37.7,6.99,149.79,19
CDM,45101170_1,HC BCR-ABL1 P230 BY PCR,963.0,625.95,240.75,674.1,11
CDM,45101171_1,Gammaglobulin (immune system protein) measurement,24.0,15.6,2.23,61.98,19
CDM,45101172_1,Homovanillic acid (organic acid) level,62.0,40.3,13.89,160.12,19
CDM,45101173_1,Hydroxyindolacetic acid (product of metabolism) level,68.0,44.2,8.77,175.61,19
CDM,45101174_1,Urine vanillylmandelic acid,63.0,40.95,9.77,162.7,19
CDM,45101175_1,"Blood test, lipids (cholesterol and triglycerides)",60.0,39.0,8.03,154.95,19
CDM,45101176_1,Stool calprotectin (protein) level,280.0,182.0,14.14,723.1,19
CDM,45101177_1,"Analysis for antibody, Treponema pallidum",41.0,26.65,5.43,105.88,19
CDM,45101178_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with solid organ abnormal growth of tissue,1905.0,1238.25,423.93,11390.19,19
CDM,45101179_1,"Analysis of substance using immunoassay technique, multiple step method",162.0,105.3,11.53,418.37,19
CDM,45101180_1,Molecular pathology procedure,1920.0,1248.0,54.96,4958.4,18
CDM,45101181_1,Gene analysis (T cell antigen receptor beta) amplification methodology,1962.0,1275.3,194.33,5066.87,19
CDM,45101182_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,11610.0,7546.5,759.53,88181.43,19
CDM,45101183_1,Molecular pathology procedure,14418.0,9371.7,54.96,37234.49,18
CDM,45101184_1,"Analysis of substance using immunoassay technique, multiple step method",63.0,40.95,7.26,162.7,19
CDM,45101185_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",1437.0,934.05,35.09,3711.05,19
CDM,45101186_1,Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor gamma),1878.0,1220.7,194.33,4849.94,19
CDM,45101187_1,"Analysis of substance using immunoassay technique, multiple step method",52.0,33.8,6.0,134.29,19
CDM,45101188_1,"Detection test by nucleic acid for organism, amplified probe technique",1398.0,908.7,35.09,3610.34,19
CDM,45101189_1,"Detection test by nucleic acid for organism, amplified probe technique",1398.0,908.7,35.09,3610.34,19
CDM,45101190_1,Analysis for antibody to mumps virus,32.0,20.8,4.18,82.64,19
CDM,45101191_1,Analysis for antibody to Rubeola (measles virus),36.0,23.4,4.64,92.97,19
CDM,45101192_1,Analysis for antibody to varicella-zoster virus (chicken pox),28.0,18.2,3.61,72.31,19
CDM,45101193_1,Analysis for antibody to Rubella (German measles virus),36.0,23.4,5.18,92.97,19
CDM,45101194_1,"Tuberculosis test, gamma interferon",202.0,131.3,48.13,521.67,19
CDM,45101195_1,Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 antibodies,76.0,49.4,12.47,196.27,19
CDM,45101196_1,Analysis for antibody to HIV -1 virus,183.0,118.95,8.89,472.6,19
CDM,45101197_1,Analysis for antibody to HIV-2 virus,183.0,118.95,13.52,472.6,19
CDM,45101198_1,"Detection test by nucleic acid for HIV-1 virus, amplified probe technique",249.0,161.85,35.09,643.04,19
CDM,45101199_1,"Detection test by nucleic acid for HIV-2 virus, amplified probe technique",249.0,161.85,35.09,643.04,19
CDM,45101200_1,Analysis for antibody (IgM) to Cytomegalovirus (CMV),40.0,26.0,6.74,103.3,19
CDM,45101201_1,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid",8.0,5.2,1.45,21.73,19
CDM,45101202_1,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear antigen",8.0,5.2,1.22,20.66,19
CDM,45101203_1,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen",8.0,5.2,1.05,20.66,19
CDM,45101204_1,Measurement of antibody for rheumatoid arthritis assessment,24.0,15.6,3.11,61.98,19
CDM,45101205_1,"Analysis for antibody to Herpes simplex virus, type 1",24.0,15.6,3.17,61.98,19
CDM,45101206_1,Analysis for antibody to Herpes simplex virus,36.0,23.4,5.18,92.97,19
CDM,45101207_1,Cardiolipin antibody (tissue antibody) measurement,28.0,18.2,7.13,72.31,19
CDM,45101208_1,Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria),60.0,39.0,9.29,154.95,19
CDM,45101209_1,Syphilis detection test,22.0,14.3,0.94,56.82,19
CDM,45101210_1,Syphilis test,92.0,59.8,4.05,237.59,19
CDM,45101211_1,"Analysis for antibody, Treponema pallidum",41.0,26.65,5.43,105.88,19
CDM,45101212_1,IgE (immune system protein) level,30.0,19.5,4.94,77.48,19
CDM,45101213_1,Screening test for autoimmune disorder,20.0,13.0,2.42,51.65,19
CDM,45101214_1,"Measurement of antibody for assessment of autoimmune disorder, titer",52.0,33.8,5.8,134.29,19
CDM,45101215_1,"Measurement of DNA antibody, native or double stranded",40.0,26.0,5.5,103.3,19
CDM,45101216_1,Measurement of antibody to noninfectious agent,88.0,57.2,10.6,227.26,19
CDM,45101217_1,"Measurement of antibody for assessment of autoimmune disorder, any method",52.0,33.8,9.32,134.29,19
CDM,45101218_1,"Measurement of antibody for assessment of autoimmune disorder, any method",52.0,33.8,9.32,134.29,19
CDM,45101219_1,"Measurement of antibody for assessment of autoimmune disorder, any method",26.0,16.9,4.66,67.15,19
CDM,45101220_1,"Measurement of antibody for assessment of autoimmune disorder, any method",52.0,33.8,9.32,134.29,19
CDM,45101221_1,"Measurement of antibody for assessment of autoimmune disorder, any method",52.0,33.8,9.32,134.29,19
CDM,45101222_1,"Measurement of antibody for assessment of autoimmune disorder, any method",80.0,52.0,13.66,206.6,19
CDM,45101223_1,Hepatitis B surface antibody measurement,31.0,20.15,3.33,80.06,19
CDM,45101224_1,Hepatitis C antibody measurement,40.0,26.0,5.71,103.3,19
CDM,45101225_1,"Detection test by nucleic acid for Hepatitis C virus, quantification",288.0,187.2,42.84,743.76,19
CDM,45101226_1,Hepatitis B core antibody measurement,59.0,38.35,7.11,152.37,19
CDM,45101227_1,Hepatitis B core antibody (IgM) measurement,60.0,39.0,7.06,154.95,19
CDM,45101228_1,Measurement of Hepatitis A antibody,36.0,23.4,4.46,92.97,19
CDM,45101229_1,Measurement of Hepatitis A antibody (IgM),42.0,27.3,4.73,108.47,19
CDM,45101230_1,Acute hepatitis panel,192.0,124.8,10.64,495.84,19
CDM,45101231_1,Measurement of tissue transglutaminase,25.0,16.25,2.88,64.56,19
CDM,45101232_1,Analysis for antibody to Cytomegalovirus (CMV),42.0,27.3,6.04,108.47,19
CDM,45101233_1,"Analysis for antibody, Treponema pallidum",88.0,57.2,11.65,227.26,19
CDM,45101234_1,Detection test by immunoassay technique for hepatitis B surface antigen,27.0,17.55,2.79,69.73,19
CDM,45101235_1,Molecular pathology procedure,3065.8,1992.77,54.96,7917.43,18
CDM,45101236_1,"Detection test by nucleic acid for organism, amplified probe technique",189.0,122.85,35.09,488.09,19
CDM,45101237_1,Quantitation of therapeutic drug,800.0,520.0,14.3,2066.0,19
CDM,45101238_1,"Stool culture, additional pathogens",15.0,9.75,1.42,38.74,19
CDM,45101239_1,Detection test by immunoassay technique for Shiga-like toxin (bacterial toxin),28.0,18.2,3.35,72.31,19
CDM,45101240_1,Bacterial culture for aerobic isolates,56.0,36.4,4.52,144.62,19
CDM,45101241_1,Bacterial culture for aerobic isolates,112.0,72.8,8.08,289.24,19
CDM,45101242_1,Test for neurofilament light chain,2579.0,1676.35,116.23,6660.27,17
CDM,45101243_1,Measurement of substance using immunoassay technique,960.0,624.0,14.14,2479.2,19
CDM,45101244_1,Measurement of substance using immunoassay technique,1143.0,742.95,14.14,2951.8,19
CDM,45101245_1,Measurement of substance using immunoassay technique,954.0,620.1,14.14,2463.71,19
CDM,45101246_1,"Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique",64.0,41.6,22.46,165.28,19
CDM,45101247_1,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique",64.0,41.6,22.46,165.28,19
CDM,45101248_1,Detection of orthopoxvirus,583.0,378.95,50.59,1505.6,19
CDM,45101249_1,Measurement of substance using immunoassay technique,473.0,307.45,14.14,1221.52,19
CDM,45101250_1,"Measurement of antibody for assessment of autoimmune disorder, any method",242.0,157.3,13.66,624.97,19
CDM,45101251_1,"Measurement of antibody for assessment of autoimmune disorder, any method",296.0,192.4,13.66,764.42,19
CDM,45101252_1,"Nephelometry, test method using light",400.0,260.0,13.6,1033.0,19
CDM,45101253_1,Gene analysis (Janus kinase 2) variant,400.0,260.0,54.96,1033.0,19
CDM,45101254_1,Gene analysis (Janus kinase 2) variant,400.0,260.0,54.96,1033.0,19
CDM,45101255_1,Gene analysis (Janus kinase 2) targeted sequence analysis,600.0,390.0,185.2,1549.5,19
CDM,45101256_1,Analysis using chemiluminescent technique (light and chemical )reaction,502.0,326.3,14.12,1296.42,19
CDM,45101257_1,"Analysis of substance using immunoassay technique, multiple step method",53.0,34.45,6.11,136.87,19
CDM,45101258_1,Gene analysis (dihydropyrimidine dehydrogenase) for common variant,2205.6,1433.64,174.81,5695.96,19
CDM,45101259_1,Gene analysis (dihydropyrimidine dehydrogenase) for common variant,3053.4,1984.71,174.81,7885.41,19
CDM,45103516_1,"Analysis of substance using immunoassay technique, multiple step method",87.0,56.55,10.03,224.68,19
CDM,45104393_1,Test for phosphorylated Tau protein,1500.0,975.0,128.92,3873.75,17
CDM,4510524U_1,Test to predict preeclampsia,473.0,307.45,212.85,1221.52,15
CDM,45107594_1,Detection test by nucleic acid for pneumocystis jirovecii,744.0,483.6,35.09,1921.38,17
CDM,45107626_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), separately reported high-risk types",205.0,133.25,70.2,529.41,17
CDM,45108_1,Removal of muscle in anus and rectum area,1312.5,853.13,78.57,1084.27,19
CDM,45110_1,Removal of rectum with creation of opening from large bowel to skin through abdomen and rectum,4950.8,3218.02,78.57,5475.84,19
CDM,45111_1,Partial removal of rectum through abdomen,3517.5,2286.38,78.57,3218.89,19
CDM,45112_1,Removal of rectum and suturing of large bowel to anus through incision of abdomen and region between thighs,5119.8,3327.87,78.57,5582.23,19
CDM,45113_1,Partial removal of rectum and attachment of small bowel to anus and creation of small bowel pouch,5242.7,3407.76,78.57,5712.8,19
CDM,45114_1,Partial removal of rectum through abdomen and sacrum,4785.9,3110.84,78.57,5309.53,19
CDM,45116_1,Partial removal of rectum through sacrum,3745.25,2434.41,78.57,4718.76,19
CDM,45119_1,Removal of rectum with creation of small bowel pouch through abdomen and region between thighs,5258.4,3417.96,78.57,5754.04,19
CDM,45120000_1,HC REF LAB PATIENT CHARGE $0 - $25,20.2,13.13,5.05,14.14,11
CDM,45120001_1,HC REF LAB PATIENT CHARGE $25.01 - $50,37.5,24.38,9.38,26.25,11
CDM,45120002_1,HC REF LAB PATIENT CHARGE $50.01 - $100,79.78,51.86,19.94,55.84,11
CDM,45120003_1,HC REF LAB PATIENT CHARGE $100.01 - $150,128.58,83.58,32.15,90.01,11
CDM,45120004_1,HC REF LAB PATIENT CHARGE $150.01 - $250,206.69,134.35,51.67,144.68,11
CDM,45120005_1,HC REF LAB PATIENT CHARGE $250.01 - $500,356.15,231.49,89.04,249.3,11
CDM,45120006_1,HC REF LAB PATIENT CHARGE $500.01 - $1000,757.99,492.69,189.5,530.59,11
CDM,45120007_1,HC REF LAB PATIENT CHARGE $1000.01 - $2000,1449.0,941.85,362.25,1014.3,11
CDM,45120008_1,HC REF LAB PATIENT CHARGE > $2000.01,3720.0,2418.0,930.0,2604.0,11
CDM,45120_1,Removal of rectum for congenital defect through abdomen and region between thighs,4288.2,2787.33,78.57,4653.87,19
CDM,45121_1,Removal of rectum for congenital defect and large bowel through abdomen and perineum with multiple biopsies,4583.3,2979.15,78.57,5071.58,19
CDM,45123_1,Partial removal of rectum through perineum,2979.9,1936.94,78.57,3351.28,19
CDM,45126_1,"Removal of large bowel, rectum, bladder and ureter",7793.1,5065.52,78.57,8294.33,19
CDM,45130_1,Repair of prolapsed rectum through anus,2915.9,1895.34,78.57,3256.17,19
CDM,45135_1,Repair of prolapsed rectum through abdomen and anus,3858.8,2508.22,78.57,3941.07,19
CDM,45136416_1,Insertion of needle into vein for collection of blood sample,58.0,37.7,3.0,149.79,19
CDM,45136417_1,Insertion of needle into vein for collection of blood sample,86.0,55.9,3.0,222.1,19
CDM,45136418_1,Insertion of needle into vein for collection of blood sample,115.0,74.75,3.0,296.99,19
CDM,45136423_1,HC RESEARCH SPECIMEN PROCESSING ONLY,61.0,39.65,15.25,42.7,11
CDM,45136_1,Removal of small bowel pouch with creation of opening from small bowel to skin,4948.7,3216.66,78.57,5467.79,19
CDM,45150_1,Incision of stricture of rectum,1055.3,685.95,78.57,1219.24,19
CDM,45152634_1,"Deoxycortisol, 11 (hormone) level",341.0,221.65,15.65,880.63,19
CDM,45160_1,Removal of growth of rectum through sacrum,2646.0,1719.9,78.57,2995.64,19
CDM,45171_1,Removal of growth of rectum through anus,1604.4,1042.86,78.57,1793.92,19
CDM,45172_1,Removal of growth of rectum through anus with removal of a portion of muscle,2199.8,1429.87,78.57,2429.04,19
CDM,45173520_1,Measurement of substance using immunoassay technique,543.0,352.95,14.14,1402.3,19
CDM,45180023_1,Manganese (heavy metal) level,195.0,126.75,14.45,503.59,19
CDM,45180024_1,Analysis for antibody to parvovirus,128.0,83.2,13.66,330.56,19
CDM,45180025_1,"Electrophoresis, laboratory testing technique",865.0,562.25,33.2,2233.86,19
CDM,45180026_1,Erythropoietin (protein) level,133.0,86.45,14.14,343.47,19
CDM,45180027_1,Analysis for antibody to parvovirus,128.0,83.2,13.66,330.56,19
CDM,45180070_1,Myoglobin (muscle protein) level,93.0,60.45,12.02,240.17,19
CDM,45180116_1,Zonisamide level,55.0,35.75,7.29,142.04,19
CDM,45180130_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180131_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180132_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180133_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180134_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180135_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180136_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180137_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180138_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180139_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180140_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180141_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180142_1,"Testing for presence of drug, by chemistry analyzers",30.0,19.5,15.3,83.92,19
CDM,45180152_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",84.0,54.6,21.0,216.93,19
CDM,45180154_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",248.0,161.2,62.0,640.46,19
CDM,45180155_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",186.0,120.9,46.5,480.35,19
CDM,45180158_1,"Carbamazepine level, free",83.0,53.95,11.0,214.35,19
CDM,45180159_1,"Carbamazepine level, total",126.0,81.9,14.3,325.4,19
CDM,45180160_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",83.0,53.95,20.75,214.35,19
CDM,45180161_1,Amikacin (antibiotic) level,131.0,85.15,14.3,338.31,19
CDM,45180164_1,"Valproic acid level, total",388.0,252.2,13.54,1002.01,19
CDM,45180166_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",182.0,118.3,45.5,470.02,19
CDM,45180168_1,Ethosuximide level,96.0,62.4,14.3,247.92,19
CDM,45180173_1,Haloperidol level,247.0,160.55,14.3,637.88,19
CDM,45180182_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",112.0,72.8,28.0,289.24,19
CDM,45180184_1,Phenobarbital level,108.0,70.2,14.3,278.91,19
CDM,45180185_1,"Phenytoin level, total",115.0,74.75,13.25,296.99,19
CDM,45180186_1,"Phenytoin level, free",119.0,77.35,13.76,307.32,19
CDM,45180194_1,Quinidine level,99.0,64.35,14.3,255.67,19
CDM,45180201_1,Topiramate level,166.0,107.9,11.92,428.7,19
CDM,45180288_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180289_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180290_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180291_1,Mycophenolate (mycophenolic acid) level,216.0,140.4,14.3,557.82,19
CDM,45180292_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180293_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180294_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180295_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180296_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180297_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180298_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180299_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180300_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180301_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180303_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180304_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180305_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180306_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180307_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45180320_1,Alcohols levels,182.0,118.3,16.44,470.02,18
CDM,45180323_1,Alkaloids levels,364.0,236.6,16.44,940.03,18
CDM,45180324_1,Alkaloids levels,364.0,236.6,16.44,940.03,18
CDM,45180339_1,"Antiepileptics levels, 1-3",163.0,105.95,28.73,420.95,18
CDM,45180342_1,"Antipsychotics levels, 1-3",195.0,126.75,16.44,503.59,18
CDM,45180354_1,Fentanyl level,256.0,166.4,16.44,661.12,18
CDM,45181227_1,"Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 9) common variants",614.0,399.1,174.81,1585.66,19
CDM,45181315_1,Translocation analysis (PML-RARA regulated adaptor molecule 1) common breakpoint,981.0,637.65,194.33,2533.43,19
CDM,45181355_1,Gene analysis (vitamin K epoxide reductase complex subunit 1) common variants,614.0,399.1,54.96,1585.66,19
CDM,45181401_1,Gene analysis (thiopurine S-methyltransferase) for common variant,1385.0,900.25,174.81,3576.76,19
CDM,45181478_1,Molecular pathology procedure,8586.0,5580.9,54.96,22173.35,18
CDM,45181479_1,Molecular pathology procedure,135.0,87.75,54.96,348.64,18
CDM,45182010_1,"Ketone bodies analysis, quantitative",115.0,74.75,6.43,296.99,19
CDM,45182013_1,Acetylcholinesterase (enzyme) level,465.0,302.25,12.29,1200.86,19
CDM,45182016_1,Chemical analysis for genetic disorder,49.0,31.85,8.08,126.54,19
CDM,45182024_1,Adrenocorticotropic hormone (ACTH) level,150.0,97.5,38.62,387.38,19
CDM,45182103_1,"Alpha-1-antitrypsin (protein) blood test, total",108.0,70.2,13.44,278.91,19
CDM,45182104_1,"Alpha-1-antitrypsin (protein) blood test, phenotype",108.0,70.2,14.14,278.91,19
CDM,45182105_1,"Alpha-1-antitrypsin (protein) blood test, total",360.0,234.0,13.44,929.7,19
CDM,45182106_1,"Alpha-fetoprotein (AFP) level, serum",173.0,112.45,14.14,446.77,19
CDM,45182107_1,Aluminum level,84.0,54.6,14.45,216.93,19
CDM,45182131_1,"Amino acid analysis, quantitative, each specimen",357.0,232.05,14.14,921.95,19
CDM,45182132_1,"Amino acid analysis, quantitative, each specimen",137.0,89.05,14.14,353.8,19
CDM,45182133_1,"Amino acid analysis, quantitative, each specimen",325.0,211.25,14.14,839.31,19
CDM,45182139_1,"Amino acid level, 6 or more amino acids, quantitative, each specimen",603.0,391.95,14.14,1557.25,19
CDM,45182140_1,"Amino acid level, 6 or more amino acids, quantitative, each specimen",369.0,239.85,14.14,952.94,19
CDM,45182141_1,"Amino acid level, 6 or more amino acids, quantitative, each specimen",410.0,266.5,14.14,1058.83,19
CDM,45182143_1,Amniotic fluid scan,74.0,48.1,6.43,191.11,19
CDM,45182145_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",238.0,154.7,59.5,614.64,19
CDM,45182146_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",186.0,120.9,46.5,480.35,19
CDM,45182157_1,Androstenedione (hormone) level,341.0,221.65,15.65,880.63,19
CDM,45182158_1,Androstenedione (hormone) level,227.0,147.55,15.65,586.23,19
CDM,45182164_1,Angiotensin l - converting enzyme (ACE) level,126.0,81.9,14.14,325.4,19
CDM,45182172_1,Apolipoprotein level,95.0,61.75,14.14,245.34,19
CDM,45182175_1,Arsenic level,107.0,69.55,14.45,276.33,19
CDM,45182176_1,Arsenic level,93.0,60.45,14.45,240.17,19
CDM,45182177_1,Arsenic level,101.0,65.65,14.45,260.83,19
CDM,45182180_1,"Ascorbic acid (Vitamin C) level, blood",186.0,120.9,6.43,480.35,19
CDM,45182234_1,Test for beta-amyloid 1-42,1000.0,650.0,128.92,2582.5,17
CDM,45182239_1,"Bile acids level, total",97.0,63.05,14.14,250.5,19
CDM,45182247_1,"Bilirubin level, total",30.0,19.5,1.51,77.48,19
CDM,45182261_1,Biotinidase (enzyme) level,50.0,32.5,8.44,129.13,19
CDM,45182300_1,Cadmium level,93.0,60.45,14.45,240.17,19
CDM,45182301_1,Cadmium level,101.0,65.65,14.45,260.83,19
CDM,45182340_1,Urine calcium level,66.0,42.9,3.98,170.45,19
CDM,45182374_1,Carbon dioxide (bicarbonate) level,54.0,35.1,2.64,139.46,19
CDM,45182380_1,Carotene level,97.0,63.05,6.43,250.5,19
CDM,45182384_1,Catecholamines (organic nitrogen) level,232.3,151.0,15.65,599.91,19
CDM,45182385_1,Catecholamines (organic nitrogen) level,232.3,151.0,15.65,599.91,19
CDM,45182394_1,Analysis using chemiluminescent technique (light and chemical )reaction,135.0,87.75,14.12,348.64,19
CDM,45182397_1,Analysis using chemiluminescent technique (light and chemical )reaction,436.0,283.4,14.12,1125.97,19
CDM,45182436_1,Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria),207.0,134.55,13.66,534.58,19
CDM,45182501_1,Chromium level to test for poisoning or deficiency,107.0,69.55,14.45,276.33,19
CDM,45182507_1,Citrate level,66.0,42.9,18.35,170.45,19
CDM,45182523_1,"Collagen cross links test, (urine test to evaluate bone health)",184.0,119.6,14.14,475.18,19
CDM,45182524_1,"Collagen cross links test, (urine test to evaluate bone health)",302.0,196.3,14.14,779.92,19
CDM,45182525_1,Copper level,93.0,60.45,11.54,240.17,19
CDM,45182530_1,"Cortisol (hormone) measurement, free",117.0,76.05,14.14,302.15,19
CDM,45182533_1,"Cortisol (hormone) measurement, total",341.0,221.65,15.65,880.63,19
CDM,45182534_1,"Cortisol (hormone) measurement, total",243.0,157.95,15.65,627.55,19
CDM,45182542_1,Chemical analysis using chromatography technique,221.65,144.07,14.14,572.41,19
CDM,45182550_1,"Creatine kinase (cardiac enzyme) level, total",61.0,39.65,3.97,157.53,19
CDM,45182552_1,"Creatine kinase (cardiac enzyme) level, isoenzymes",61.0,39.65,8.17,157.53,19
CDM,45182595_1,Cryoglobulin (protein) measurement,35.0,22.75,2.26,90.39,19
CDM,45182596_1,Measurement for Strep antibody (strep throat),74.0,48.1,5.4,191.11,19
CDM,45182620_1,"Enzyme activity measurement, nonradioactive substrate",2121.0,1378.65,14.14,5477.48,19
CDM,45182626_1,Dehydroepiandrosterone (DHEA) hormone level,341.0,221.65,14.14,880.63,19
CDM,45182633_1,"Desoxycorticosterone, 11 (hormone) level",341.0,221.65,30.98,880.63,19
CDM,45182638_1,Dibucaine number (enzyme) measurement,51.0,33.15,6.25,131.71,19
CDM,45182653_1,Measurement of pancreatic elastase (enzyme) in stool,200.0,130.0,14.14,516.5,19
CDM,45182656_1,"Enzyme activity measurement, nonradioactive substrate",560.0,364.0,14.14,1446.2,19
CDM,45182657_1,"Enzyme activity measurement, nonradioactive substrate",480.0,312.0,14.14,1239.6,19
CDM,45182659_1,"Enzyme activity measurement, nonradioactive substrate",667.0,433.55,14.14,1722.53,19
CDM,45182671_1,"Estrogen analysis, fractionated",187.0,121.55,32.3,482.93,19
CDM,45182677_1,Estriol (hormone) level,69.79,45.36,15.65,180.23,19
CDM,45182678_1,Estriol (hormone) level,173.0,112.45,15.65,446.77,19
CDM,45182679_1,Estrone (hormone) level,139.0,90.35,15.65,358.97,19
CDM,45182693_1,Ethylene glycol (antifreeze) measurement,120.0,78.0,14.45,309.9,19
CDM,45182726_1,Very long chain fatty acids level,577.0,375.05,14.14,1490.1,19
CDM,45182747_1,"Folic acid level, RBC",52.03,33.82,9.18,134.37,19
CDM,45182760_1,Galactose (carbohydrate) level,28.0,18.2,3.14,72.31,19
CDM,45182776_1,Galactose-1-phosphate uridyl transferase screening test,28.0,18.2,3.29,72.31,19
CDM,45182784_1,Gammaglobulin (immune system protein) measurement,71.0,46.15,6.43,183.36,19
CDM,45182785_1,Gammaglobulin (immune system protein) measurement,283.0,183.95,6.43,730.85,19
CDM,45182786_1,IgE (immune system protein) level,235.0,152.75,14.14,606.89,19
CDM,45182787_1,"Gammaglobulin (immune system protein) measurement, immunoglobulin subclasses",83.0,53.95,6.43,214.35,19
CDM,45182788_1,"Gammaglobulin (immune system protein) measurement, immunoglobulin subclasses",83.0,53.95,6.43,214.35,19
CDM,45182789_1,"Gammaglobulin (immune system protein) measurement, immunoglobulin subclasses",83.0,53.95,6.43,214.35,19
CDM,45182790_1,"Gammaglobulin (immune system protein) measurement, immunoglobulin subclasses",83.0,53.95,6.43,214.35,19
CDM,45182795_1,IgE (immune system protein) level,39.0,25.35,6.42,100.72,19
CDM,45182796_1,IgE (immune system protein) level,38.0,24.7,6.25,98.14,19
CDM,45182797_1,IgE (immune system protein) level,42.0,27.3,6.91,108.47,19
CDM,45182941_1,Gastrin (GI tract hormone) level,81.0,52.65,14.28,209.18,19
CDM,45182955_1,G6PD (enzyme) level,107.0,69.55,6.43,276.33,19
CDM,45182985_1,Glycated protein level,258.0,167.7,14.14,666.29,19
CDM,45182986_1,Glycated protein level,80.0,52.0,13.41,206.6,19
CDM,45183020_1,"Hemoglobin analysis and measurement, electrophoresis",28.0,18.2,3.6,72.31,19
CDM,45183033_1,Fetal hemoglobin analysis,465.0,302.25,6.43,1200.86,19
CDM,45183051_1,Plasma hemoglobin level,41.0,26.65,3.0,105.88,19
CDM,45183280_1,"Ketosteroids, 17 (hormone) measurement, total",140.0,91.0,12.8,361.55,19
CDM,45183320_1,Measurement of substance using immunoassay technique,280.0,182.0,14.14,723.1,19
CDM,45183321_1,Measurement of substance using immunoassay technique,280.0,182.0,14.14,723.1,19
CDM,45183416_1,"Analysis of substance using immunoassay technique, multiple step method",1380.0,897.0,11.53,3563.85,19
CDM,45183417_1,"Analysis of substance using immunoassay technique, multiple step method",745.0,484.25,11.53,1923.96,19
CDM,45183418_1,"Analysis of substance using immunoassay technique, multiple step method",747.0,485.55,11.53,1929.13,19
CDM,45183419_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",900.0,585.0,14.14,2324.25,19
CDM,45183420_1,Measurement of substance using immunoassay technique,1187.0,771.55,14.14,3065.43,19
CDM,45183491_1,"Hydroxycorticosteroids, 17 (adrenal gland hormone) level",302.0,196.3,15.65,779.92,19
CDM,45183498_1,"Hydroxyprogesterone, 17-D (synthetic hormone) level",341.0,221.65,15.65,880.63,19
CDM,45183499_1,"Hydroxyprogesterone, 17-D (synthetic hormone) level",28.0,18.2,7.61,72.31,19
CDM,45183500_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",1008.0,655.2,14.14,2603.16,19
CDM,45183502_1,"Analysis of substance using immunoassay technique, multiple step method",273.0,177.45,11.53,705.02,19
CDM,45183504_1,"Analysis of substance using immunoassay technique, multiple step method",103.0,66.95,11.53,266.0,19
CDM,45183506_1,Measurement of substance using immunoassay technique,790.0,513.5,14.14,2040.18,19
CDM,45183507_1,Measurement of substance using immunoassay technique,283.0,183.95,14.14,730.85,19
CDM,45183508_1,Measurement of substance using immunoassay technique,283.0,183.95,14.14,730.85,19
CDM,45183509_1,Measurement of substance using immunoassay technique,283.0,183.95,14.14,730.85,19
CDM,45183510_1,Measurement of substance using immunoassay technique,206.0,133.9,14.14,532.0,19
CDM,45183511_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",206.0,133.9,14.14,532.0,19
CDM,45183512_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",206.0,133.9,14.14,532.0,19
CDM,45183513_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",206.0,133.9,14.14,532.0,19
CDM,45183514_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",857.0,557.05,14.14,2213.2,19
CDM,45183515_1,"PSA (prostate specific antigen) measurement, total",75.0,48.75,13.79,193.69,19
CDM,45183516_1,"Analysis of substance using immunoassay technique, multiple step method",88.0,57.2,10.15,227.26,19
CDM,45183517_1,"Analysis of substance using immunoassay technique, multiple step method",69.0,44.85,7.96,178.19,19
CDM,45183520_1,"Analysis of substance using immunoassay technique, multiple step method",222.0,144.3,11.53,573.32,19
CDM,45183522_1,Measurement of substance using immunoassay technique,683.0,443.95,14.14,1763.85,19
CDM,45183523_1,Measurement of substance using immunoassay technique,48.0,31.2,8.29,123.96,19
CDM,45183524_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",147.0,95.55,14.14,379.63,19
CDM,45183525_1,"Insulin measurement, total",86.0,55.9,9.83,222.1,19
CDM,45183527_1,"Insulin measurement, free",74.0,48.1,9.58,191.11,19
CDM,45183529_1,Measurement of interleukin-6,296.0,192.4,14.14,764.42,19
CDM,45183532_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",380.0,247.0,14.14,981.35,19
CDM,45183533_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",899.0,584.35,14.14,2321.67,19
CDM,45183540_1,Iron level,458.0,297.7,6.43,1182.79,19
CDM,45183558_1,Measurement of substance using immunoassay technique,662.0,430.3,14.14,1709.62,19
CDM,45183559_1,Measurement of substance using immunoassay technique,662.0,430.3,14.14,1709.62,19
CDM,45183560_1,Clotting factor IX (PTC or Christmas) measurement,175.2,113.88,19.04,452.45,19
CDM,45183561_1,Measurement of substance using immunoassay technique,1170.0,760.5,14.14,3021.53,19
CDM,45183605_1,Lactic acid level,474.0,308.1,11.57,1224.11,19
CDM,45183615_1,Lactate dehydrogenase (enzyme) level,36.0,23.4,2.17,92.97,19
CDM,45183616_1,Lactate dehydrogenase (enzyme) level,25.0,16.25,1.51,64.56,19
CDM,45183625_1,Lactate dehydrogenase (enzyme) measurement,153.0,99.45,12.79,395.12,19
CDM,45183655_1,Lead level,93.0,60.45,11.26,240.17,19
CDM,45183656_1,Lead level,101.0,65.65,12.11,260.83,19
CDM,45183664_1,"Fetal lung maturity assessment, lamellar body density",155.0,100.75,14.14,400.29,19
CDM,45183695_1,Lipoprotein (A) level,215.0,139.75,14.14,555.24,19
CDM,45183700_1,"Lipoprotein level, electrophoretic separation and quantitation",200.0,130.0,11.26,516.5,19
CDM,45183706_1,"Lipoprotein level, quantitation of lipoprotein particle number(s)",503.0,326.95,33.2,1299.0,19
CDM,45183825_1,Mercury level,93.0,60.45,14.45,240.17,19
CDM,45183826_1,Mercury level,99.0,64.35,14.45,255.67,19
CDM,45183835_1,Metanephrines level,473.0,307.45,15.65,1221.52,19
CDM,45183840_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",417.0,271.05,82.28,1076.9,19
CDM,45183874_1,Myoglobin (muscle protein) level,93.0,60.45,12.02,240.17,19
CDM,45183883_1,"Nephelometry, test method using light",662.0,430.3,13.6,1709.62,19
CDM,45183886_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",381.0,247.65,82.28,983.93,19
CDM,45183887_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",398.0,258.7,82.28,1027.84,19
CDM,45183915_1,Nucleotidase 5' (enzyme) level,107.0,69.55,11.15,276.33,19
CDM,45183921_1,Organic acid level,249.0,161.85,14.14,643.04,19
CDM,45183925_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",178.0,115.7,44.5,459.69,19
CDM,45183932_1,Organic acid level,576.0,374.4,14.14,1487.52,19
CDM,45183936_1,Organic acid level,218.0,141.7,14.14,562.99,19
CDM,45183937_1,Osteocalcin (bone protein) level,301.0,195.65,29.85,777.33,19
CDM,45183945_1,Oxalate level,66.0,42.9,9.54,170.45,19
CDM,45183955_1,Organic acids level,716.0,465.4,14.45,1849.07,19
CDM,45183992_1,PCP drug level,383.0,248.95,14.45,989.1,19
CDM,45183993_1,Stool calprotectin (protein) level,892.0,579.8,14.14,2303.59,19
CDM,45183994_1,PCP drug level,186.0,120.9,14.45,480.35,19
CDM,45183995_1,Stool calprotectin (protein) level,764.0,496.6,14.14,1973.03,19
CDM,45184040_1,"Phenylalanine, PKU (amino acid) level",28.0,18.2,1.54,72.31,19
CDM,45184060_1,"Phosphatase (enzyme) measurement, acid, total",73.0,47.45,5.58,188.52,19
CDM,45184075_1,"Phosphatase (enzyme) level, alkaline",47.7,31.01,2.47,123.19,19
CDM,45184080_1,"Phosphatase (enzyme) measurement, alkaline, isoenzymes",136.0,88.4,14.14,351.22,19
CDM,45184110_1,Urine porphobilinogen (metabolism substance) level,77.65,50.47,6.43,200.53,19
CDM,45184119_1,Urine porphyrins (metabolism substance) analysis,88.0,57.2,11.76,227.26,19
CDM,45184140_1,Pregnenolone (reproductive hormone) level,195.0,126.75,15.65,503.59,19
CDM,45184142_1,17-hydroxypregnenolone (hormone) level,203.0,131.95,15.65,524.25,19
CDM,45184143_1,17-hydroxypregnenolone (hormone) level,341.0,221.65,15.65,880.63,19
CDM,45184144_1,Progesterone (reproductive hormone) level,341.0,221.65,15.65,880.63,19
CDM,45184152_1,"PSA (prostate specific antigen) measurement, complexed",462.0,300.3,14.14,1193.12,19
CDM,45184163_1,Pregnancy-associated plasma protein-A level,282.0,183.3,14.14,728.27,19
CDM,45184180_1,"Protein measurement, immunological probe for band identification",189.0,122.85,29.21,488.09,19
CDM,45184181_1,"Protein measurement, immunological probe for band identification",1206.0,783.9,29.21,3114.5,19
CDM,45184182_1,Molecular pathology procedure,1073.0,697.45,54.96,2771.02,18
CDM,45184186_1,"Protein measurement, immunological probe for band identification",725.0,471.25,29.21,1872.31,19
CDM,45184187_1,"Protein measurement, immunological probe for band identification",461.0,299.65,29.21,1190.53,19
CDM,45184202_1,Protoporphyrin (metabolism substance) level,89.0,57.85,12.77,229.84,19
CDM,45184210_1,Pyruvate (organic acid) level,301.0,195.65,14.14,777.33,19
CDM,45184265_1,Hydroxyindolacetic acid (product of metabolism) level,119.0,77.35,12.9,307.32,19
CDM,45184270_1,Sex hormone binding globulin (protein) level,69.79,45.36,14.14,180.23,19
CDM,45184305_1,Somatomedin (growth factor) level,307.0,199.55,15.65,792.83,19
CDM,45184307_1,Somatostatin (growth hormone inhibitor) level,935.0,607.75,15.65,2414.64,19
CDM,45184310_1,Chemical analysis using spectrophotometry (light),196.0,127.4,6.43,506.17,19
CDM,45184311_1,Chemical analysis using spectrophotometry (light),33.0,21.45,2.67,85.22,19
CDM,45184312_1,Chemical analysis using spectrophotometry (light),1161.0,754.65,6.43,2998.28,19
CDM,45184313_1,"Analysis of substance using immunoassay technique, multiple step method",75.0,48.75,8.65,193.69,19
CDM,45184314_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",213.0,138.45,14.14,550.07,19
CDM,45184376_1,"Carbohydrate analysis, single qualitative",66.0,42.9,3.63,170.45,19
CDM,45184378_1,"Carbohydrate analysis, single quantitative",1087.0,706.55,11.53,2807.18,19
CDM,45184393_1,Test for phosphorylated Tau protein,1000.0,650.0,128.92,2582.5,17
CDM,45184394_1,Test for total Tau protein,1000.0,650.0,128.92,2582.5,17
CDM,45184403_1,"Testosterone (hormone) level, total",341.0,221.65,15.65,880.63,19
CDM,45184430_1,Thiocyanate (organic sulfur substance) level,176.0,114.4,11.63,454.52,19
CDM,45184435_1,"Thyroxine (thyroid chemical), total",17.0,11.05,1.17,43.9,19
CDM,45184436_1,"Thyroxine (thyroid chemical), total",54.0,35.1,3.71,139.46,19
CDM,45184437_1,"Thyroxine (thyroid chemical), requiring elution",28.0,18.2,1.81,72.31,19
CDM,45184440_1,"Thyroxine (thyroid chemical), free",280.0,182.0,9.02,723.1,19
CDM,45184479_1,Thyroid hormone evaluation,52.0,33.8,3.36,134.29,19
CDM,45184480_1,Triglycerides level,33.0,21.45,1.89,85.22,19
CDM,45184510_1,Tyrosine (amino acid) level,317.0,206.05,6.43,818.65,19
CDM,45184519_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",310.0,201.5,14.14,800.58,19
CDM,45184560_1,Uric acid level,46.75,30.39,2.37,120.73,19
CDM,45184582_1,Body fluid pH level,42.0,27.3,1.5,108.47,19
CDM,45184585_1,Urine vanillylmandelic acid,127.0,82.55,15.5,327.98,19
CDM,45184586_1,Vasoactive intestinal peptide (intestinal hormone) level,397.0,258.05,35.33,1025.25,19
CDM,45184591_1,Vitamin measurement,37.4,24.31,6.38,96.59,19
CDM,45184597_1,Vitamin K level,369.0,239.85,13.72,952.94,19
CDM,45184620_1,Xylose (carbohydrate) absorption test of blood and/or urine,334.0,217.1,12.91,862.56,19
CDM,45184630_1,Zinc level,74.0,48.1,8.43,191.11,19
CDM,45184632_1,Zinc level,74.0,48.1,8.43,191.11,19
CDM,45184702_1,"Gonadotropin, chorionic (reproductive hormone) level",87.0,56.55,13.09,224.68,19
CDM,45184703_1,"Gonadotropin, chorionic (reproductive hormone) level",173.0,112.45,15.05,446.77,19
CDM,45185253_1,"Collagen cross links test, (urine test to evaluate bone health)",102.0,66.3,14.14,263.42,19
CDM,45185260_1,Clotting factor X (Stuart-Prower) measurement,165.7,107.71,5.24,427.92,19
CDM,45185292_1,Clotting factor XIII (fibrin stabilizing) screening test,58.0,37.7,5.24,149.79,19
CDM,45185302_1,"Protein C, (clotting inhibitor) activity",107.0,69.55,5.24,276.33,19
CDM,45185305_1,Protein S (clotting inhibitor) level,107.0,69.55,5.24,276.33,19
CDM,45185306_1,Protein S (clotting inhibitor) measurement,186.0,120.9,5.24,480.35,19
CDM,45185307_1,Activated protein resistance assay,183.0,118.95,6.99,472.6,19
CDM,45185361_1,Euglobulin lysis (clot dissolving) measurement,418.0,271.7,6.99,1079.49,19
CDM,45185362_1,"Coagulation function analysis, agglutination slide, semiquantitative",217.0,141.05,5.24,560.4,19
CDM,45185385_1,Fibrinogen (factor 1) antigen detection,264.0,171.6,5.24,681.78,19
CDM,45185397_1,Measurement of blood coagulation and fibrinolysis (clot dissolving) function,930.0,604.5,29.94,2401.73,19
CDM,45185410_1,Alpha-2 antiplasmin (factor inhibitor) measurement,210.0,136.5,5.24,542.33,19
CDM,45185420_1,Plasminogen (fibrinolytic factor) measurement,149.0,96.85,5.24,384.79,19
CDM,45186001_1,"Measurement of antibody (IgG) to allergic substance, each allergen",544.0,353.6,7.82,1404.88,19
CDM,45186002_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",544.0,353.6,5.22,1404.88,19
CDM,45186004_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",41.0,26.65,2.14,105.88,19
CDM,45186005_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",38.0,24.7,1.98,98.14,19
CDM,45186006_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",38.0,24.7,1.98,98.14,19
CDM,45186007_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",38.0,24.7,1.98,98.14,19
CDM,45186008_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",38.0,24.7,1.98,98.14,19
CDM,45186013_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",18.0,11.7,0.94,46.49,19
CDM,45186014_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",38.0,24.7,1.98,98.14,19
CDM,45186015_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",42.0,27.3,2.19,108.47,19
CDM,45186020_1,Antibody identification test for white blood cell antibodies,183.0,118.95,13.66,472.6,19
CDM,45186021_1,"Antibody identification test, platelet antibodies",169.0,109.85,13.66,436.44,19
CDM,45186023_1,"Antibody identification test, platelet associated immunoglobulin assay",315.0,204.75,12.46,813.49,19
CDM,45186024_1,Antibody identification test for white blood cell antibodies,523.0,339.95,13.66,1350.65,19
CDM,45186036_1,Screening test for antineutrophil cytoplasmic antibody,48.0,31.2,5.78,123.96,19
CDM,45186053_1,Flow cytometry detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody,1131.0,735.15,12.05,2920.81,19
CDM,45186141_1,Measurement C-reactive protein for detection of infection or inflammation,135.0,87.75,5.18,348.64,19
CDM,45186145_1,Beta 2 glycoprotein 1 antibody (autoantibody) measurement,174.0,113.1,13.66,449.36,19
CDM,45186147_1,Beta 2 glycoprotein 1 antibody (autoantibody) measurement,174.0,113.1,13.66,449.36,19
CDM,45186148_1,Beta 2 glycoprotein 1 antibody (autoantibody) measurement,183.0,118.95,13.66,472.6,19
CDM,45186149_1,Cardiolipin antibody (tissue antibody) measurement,88.0,57.2,13.66,227.26,19
CDM,45186150_1,Cardiolipin antibody (tissue antibody) measurement,59.0,38.35,13.66,152.37,19
CDM,45186152_1,Beta 2 glycoprotein 1 antibody (autoantibody) measurement,75.02,48.76,13.66,193.74,19
CDM,45186161_1,Measurement of complement function (immune system proteins),40.0,26.0,4.8,103.3,19
CDM,45186162_1,"Measurement of complement (immune system proteins), total hemolytic",78.0,50.7,13.66,201.44,19
CDM,45186231_1,Detection of endomysial antibody (EMA),92.0,59.8,11.12,237.59,19
CDM,45186237_1,"Measurement of antibody for assessment of autoimmune disorder, any method",68.0,44.2,12.19,175.61,19
CDM,45186242_1,"Measurement of antibody for assessment of autoimmune disorder, any method",390.0,253.5,13.66,1007.18,19
CDM,45186253_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45186254_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45186255_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45186256_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45186257_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,45186258_1,Measurement of antibody to noninfectious agent,245.0,159.25,12.05,632.71,19
CDM,45186261_1,Measurement of antibody to noninfectious agent,272.0,176.8,12.05,702.44,19
CDM,45186270_1,Measurement of antibody to noninfectious agent,206.0,133.9,12.05,532.0,19
CDM,45186271_1,Measurement of antibody to noninfectious agent,206.0,133.9,12.05,532.0,19
CDM,45186272_1,Measurement of antibody to noninfectious agent,206.0,133.9,12.05,532.0,19
CDM,45186273_1,Measurement of antibody to noninfectious agent,206.0,133.9,12.05,532.0,19
CDM,45186274_1,Measurement of antibody to noninfectious agent,206.0,133.9,12.05,532.0,19
CDM,45186275_1,Measurement of antibody to noninfectious agent,206.0,133.9,12.05,532.0,19
CDM,45186276_1,Measurement of antibody to noninfectious agent,206.0,133.9,12.05,532.0,19
CDM,45186277_1,Measurement of antibody to noninfectious agent,206.0,133.9,12.05,532.0,19
CDM,45186300_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 15-3",120.0,78.0,13.66,309.9,19
CDM,45186310_1,"Detection of infectious agent antibody, quantitative",185.0,120.25,13.66,477.76,19
CDM,45186315_1,"Detection of infectious agent antibody, quantitative",45.76,29.74,6.86,118.18,19
CDM,45186316_1,"Detection of infectious agent antibody, quantitative",185.0,120.25,13.66,477.76,19
CDM,45186317_1,"Detection of infectious agent antibody, quantitative",15.0,9.75,2.25,38.74,19
CDM,45186318_1,"Detection of infectious agent antibody, quantitative",185.0,120.25,13.66,477.76,19
CDM,45186321_1,Analysis for detection of tumor marker,284.0,184.6,13.66,733.43,19
CDM,45186327_1,"Detection of infectious agent antibody, quantitative",74.0,48.1,11.09,191.11,19
CDM,45186330_1,Immune complex measurement,1103.0,716.95,13.66,2848.5,19
CDM,45186336_1,"Immunologic analysis technique on body fluid, other fluids with concentration",748.0,486.2,29.35,1931.71,19
CDM,45186337_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186338_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186339_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186340_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186341_1,Islet cell (pancreas) antibody measurement,1139.0,740.35,13.66,2941.47,19
CDM,45186342_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186343_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186344_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186345_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186346_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186347_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186348_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186349_1,Immunologic analysis for detection of antigen or antibody,38.0,24.7,4.55,98.14,19
CDM,45186351_1,Inhibin A (reproductive organ hormone) measurement,169.0,109.85,13.66,436.44,19
CDM,45186352_1,"White blood cell function measurement, mitogen or antigen induced blastogenesis",1024.0,665.6,48.13,2644.48,19
CDM,45186355_1,Analysis of cell function and analysis for genetic marker,665.0,432.25,48.13,1717.36,19
CDM,45186356_1,Inhibin A (reproductive organ hormone) measurement,173.0,112.45,13.66,446.77,19
CDM,45186357_1,White blood cell antigen measurement,549.0,356.85,26.78,1417.79,19
CDM,45186358_1,White blood cell antigen measurement,549.0,356.85,26.78,1417.79,19
CDM,45186359_1,White blood cell antigen measurement,253.0,164.45,26.78,653.37,19
CDM,45186360_1,White blood cell antigen measurement,253.0,164.45,26.78,653.37,19
CDM,45186361_1,White blood cell antigen measurement,253.0,164.45,26.78,653.37,19
CDM,45186362_1,White blood cell antigen measurement,253.0,164.45,26.78,653.37,19
CDM,45186363_1,White blood cell antigen measurement,253.0,164.45,26.78,653.37,19
CDM,45186364_1,White blood cell antigen measurement,253.0,164.45,26.78,653.37,19
CDM,45186365_1,White blood cell antigen measurement,253.0,164.45,26.78,653.37,19
CDM,45186371_1,Thyroglobulin (thyroid protein) antibody measurement,68.0,44.2,10.82,175.61,19
CDM,45186372_1,Microsomal antibodies (autoantibody) measurement,68.0,44.2,9.89,175.61,19
CDM,45186377_1,Microsomal antibodies (autoantibody) measurement,68.0,44.2,9.89,175.61,19
CDM,45186381_1,Measurement of mitochondrial antibody,32.0,20.8,8.14,82.64,19
CDM,45186531_1,Immunologic analysis for detection of antigen or antibody,544.0,353.6,11.98,1404.88,19
CDM,45186581_1,Test for streptococcus pneumonia antibody,262.0,170.3,92.03,676.62,17
CDM,45186592_1,Syphilis detection test,28.0,18.2,1.2,72.31,19
CDM,45186593_1,Syphilis test,93.0,60.45,4.09,240.17,19
CDM,45186606_1,Analysis for antibody to aspergillus (fungus),49.0,31.85,7.37,126.54,19
CDM,45186607_1,Analysis for antibody to aspergillus (fungus),65.0,42.25,9.78,167.86,19
CDM,45186611_1,Analysis for antibody to Bartonella (bacteria),90.0,58.5,9.16,232.43,19
CDM,45186612_1,Analysis for antibody to Bartonella (bacteria),156.0,101.4,10.18,402.87,19
CDM,45186613_1,Analysis for antibody to blastomyces (fungus),65.0,42.25,8.39,167.86,19
CDM,45186616_1,Analysis for antibody bordetella (respiratory bacteria),127.0,82.55,13.19,327.98,19
CDM,45186617_1,Analysis for antibody bordetella (respiratory bacteria),172.0,111.8,13.19,444.19,19
CDM,45186618_1,Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria),74.0,48.1,12.6,191.11,19
CDM,45186619_1,Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria),74.0,48.1,12.6,191.11,19
CDM,45186628_1,Analysis for antibody to Candida (yeast),92.0,59.8,11.05,237.59,19
CDM,45186632_1,Analysis for antibody to Chlamydia (bacteria),68.0,44.2,8.04,175.61,19
CDM,45186633_1,Analysis for antibody to Chlamydia (bacteria),68.0,44.2,8.04,175.61,19
CDM,45186634_1,Analysis for antibody to Chlamydia (bacteria),68.0,44.2,8.04,175.61,19
CDM,45186635_1,Analysis for antibody (IgM) to Chlamydia (bacteria),68.0,44.2,8.62,175.61,19
CDM,45186636_1,Analysis for antibody (IgM) to Chlamydia (bacteria),68.0,44.2,8.62,175.61,19
CDM,45186637_1,Analysis for antibody (IgM) to Chlamydia (bacteria),68.0,44.2,8.62,175.61,19
CDM,45186638_1,Analysis for antibody to Coxiella burnetii (Q fever bacteria),123.0,79.95,12.12,317.65,19
CDM,45186639_1,Analysis for antibody to Coccidioides (bacteria),65.0,42.25,7.46,167.86,19
CDM,45186640_1,Analysis for antibody to Coxiella burnetii (Q fever bacteria),123.0,79.95,12.12,317.65,19
CDM,45186657_1,Analysis for antibody to Enterovirus (gastrointestinal virus),892.0,579.8,13.03,2303.59,19
CDM,45186658_1,Analysis for antibody to Enterovirus (gastrointestinal virus),163.0,105.95,13.03,420.95,19
CDM,45186667_1,Analysis for antibody to Ehrlichia (bacteria transmitted by ticks),172.0,111.8,10.18,444.19,19
CDM,45186668_1,Analysis for antibody to Francisella tularensis (bacteria transmitted by rodents),337.0,219.05,13.66,870.3,19
CDM,45186671_1,Analysis for antibody to fungus,260.0,169.0,12.25,671.45,19
CDM,45186682_1,Analysis for antibody to helminth (intestinal worm),119.7,77.81,13.01,309.13,19
CDM,45186683_1,Analysis for antibody to helminth (intestinal worm),119.7,77.81,13.01,309.13,19
CDM,45186688_1,Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV,131.0,85.15,13.66,338.31,19
CDM,45186689_1,Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV,460.0,299.0,13.66,1187.95,19
CDM,45186692_1,Analysis for antibody to Hepatitis D virus,487.0,316.55,13.66,1257.68,19
CDM,45186694_1,Analysis for antibody to Herpes simplex virus,178.0,115.7,13.66,459.69,19
CDM,45186698_1,Analysis for antibody to histoplasma (fungus),65.0,42.25,8.96,167.86,19
CDM,45186707_1,Hepatitis Be antibody measurement,99.0,64.35,11.45,255.67,19
CDM,45186713_1,Analysis for antibody to Legionella (waterborne bacteria),82.0,53.3,12.55,211.77,19
CDM,45186714_1,Analysis for antibody to Legionella (waterborne bacteria),82.0,53.3,12.55,211.77,19
CDM,45186736_1,Analysis for antibody to mumps virus,68.0,44.2,8.87,175.61,19
CDM,45186753_1,Analysis for antibody to protozoa (parasite),92.0,59.8,11.4,237.59,19
CDM,45186757_1,Analysis for antibody to Rickettsia (bacteria),207.0,134.55,13.66,534.58,19
CDM,45186778_1,Analysis for antibody (IgM) to Toxoplasma (parasite),78.0,50.7,11.24,201.44,19
CDM,45186787_1,Analysis for antibody to varicella-zoster virus (chicken pox),78.0,50.7,10.05,201.44,19
CDM,45186790_1,Analysis for antibody to virus,13.0,8.45,1.67,33.57,19
CDM,45186941_1,Red blood cell antibody measurement,89.0,57.85,5.24,229.84,19
CDM,45187081_1,Screening test for pathogenic organisms,69.0,44.85,4.57,178.19,19
CDM,45187109_1,Mycoplasma culture,264.0,171.6,12.47,681.78,19
CDM,45187186_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution",717.0,466.05,8.65,1851.65,19
CDM,45187191_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), macrobroth dilution method",123.0,79.95,6.64,317.65,19
CDM,45187192_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), macrobroth dilution method",367.0,238.55,6.64,947.78,19
CDM,45187230_1,Microbial toxin or antitoxin assay,177.0,115.05,12.47,457.1,19
CDM,45187253_1,Tissue culture for virus isolation,1634.0,1062.1,12.47,4219.81,19
CDM,45187278_1,Detection test by immunofluorescent technique for legionella pneumophila (water borne bacteria),211.0,137.15,12.47,544.91,19
CDM,45187305_1,Detection test by immunoassay technique for Aspergillus (fungus),559.0,363.35,11.98,1443.62,19
CDM,45187306_1,Detection test by immunoassay technique for Aspergillus (fungus),512.0,332.8,11.98,1322.24,19
CDM,45187350_1,Detection test by immunoassay technique for hepatitis Be surface antigen,75.0,48.75,8.65,193.69,19
CDM,45187382_1,Viral neutralization test to detect viral antibody level,3267.0,2123.55,13.66,8437.03,19
CDM,45187385_1,Detection test by immunoassay technique for Histoplasma capsulatum (parasite),486.0,315.9,12.47,1255.1,19
CDM,45187386_1,Detection test by immunoassay technique for Histoplasma capsulatum (parasite),340.0,221.0,12.47,878.05,19
CDM,45187448_1,Detection test by immunoassay technique for other organism,571.0,371.15,11.98,1474.61,19
CDM,45187494_1,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS AND NEISSERIA GONORRHOEAE, MULTIPLEX AMPLIFIED PROBE TECHNIQUE",128.0,83.2,57.6,330.56,16
CDM,45187536_1,"Detection test by nucleic acid for HIV-1 virus, quantification",908.0,590.2,50.59,2344.91,19
CDM,45187537_1,"Detection test by nucleic acid for HIV-1 virus, amplified probe technique",560.0,364.0,35.09,1446.2,19
CDM,45187556_1,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), amplified probe technique",383.5,249.28,41.68,990.39,19
CDM,45187564_1,Detection test by nucleic acid for mycobacterium tuberculosis rifampin resistance,640.0,416.0,76.77,1652.8,17
CDM,45187581_1,"Detection test by nucleic acid for Mycoplasma pneumoniae (bacteria), amplified probe technique",133.0,86.45,35.09,343.47,19
CDM,45187626_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), separately reported high-risk types",264.0,171.6,70.2,681.78,17
CDM,45187798_1,"Detection test by nucleic acid for organism, amplified probe technique",458.0,297.7,35.09,1182.79,19
CDM,45187801_1,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",244.0,158.6,50.59,630.13,19
CDM,45187900_1,Infectious agent drug susceptibility analysis,480.0,312.0,130.35,1239.6,19
CDM,45187901_1,Infectious agent drug susceptibility analysis,354.03,230.12,130.35,914.28,19
CDM,45187902_1,Analysis test by nucleic acid for HIV-1 virus,693.66,450.88,194.33,1791.38,19
CDM,45187903_1,Analysis test by nucleic acid for HIV-1 virus,478.0,310.7,194.33,1234.44,19
CDM,45187904_1,"Analysis test by nucleic acid for HIV-1 virus, first through 10 drugs tested",480.0,312.0,244.8,2345.57,19
CDM,45187905_1,"Analysis test by nucleic acid for HIV-1 virus, each additional drug tested",432.0,280.8,26.07,1115.64,19
CDM,45187906_1,Analysis test by nucleic acid for HIV-1 virus,911.0,592.15,194.33,2352.66,19
CDM,45187907_1,Infectious agent drug susceptibility analysis,911.0,592.15,130.35,2352.66,19
CDM,45187908_1,"Analysis test by nucleic acid for HIV-1 virus, other region",332.0,215.8,128.73,857.39,19
CDM,45187998_1,Unlisted microbiology procedure,1486.0,965.9,12.47,3837.6,18
CDM,45187999_1,Unlisted microbiology procedure,7941.0,5161.65,12.47,20507.63,18
CDM,45188112_1,"Cell examination of specimen, selective cellular enhancement technique",803.0,521.95,38.68,2073.75,19
CDM,45188171_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188172_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45188173_1,DNA testing for genetic defects,370.0,240.5,21.42,955.53,19
CDM,45188174_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188175_1,DNA testing for genetic defects,370.0,240.5,21.42,955.53,19
CDM,45188176_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188177_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188178_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45188179_1,DNA testing for genetic defects,370.0,240.5,21.42,955.53,19
CDM,45188180_1,"Flow cytometry technique for DNA or cell analysis, first marker",96.0,62.4,48.96,297.45,19
CDM,45188181_1,"Flow cytometry technique for DNA or cell analysis, each additional marker",96.0,62.4,22.15,247.92,19
CDM,45188182_1,Flow cytometry technique for DNA or cell analysis,96.0,62.4,38.68,247.92,19
CDM,45188183_1,"Flow cytometry technique for DNA or cell analysis, first marker",315.0,204.75,90.83,813.49,19
CDM,45188184_1,"Flow cytometry technique for DNA or cell analysis, first marker",184.0,119.6,79.93,475.18,19
CDM,45188185_1,"Flow cytometry technique for DNA or cell analysis, each additional marker",368.0,239.2,22.15,950.36,19
CDM,45188186_1,"Flow cytometry technique for DNA or cell analysis, first marker",422.0,274.3,90.83,1089.82,19
CDM,45188187_1,"Flow cytometry technique for DNA or cell analysis, each additional marker",422.0,274.3,22.15,1089.82,19
CDM,45188188_1,"Flow cytometry technique for DNA or cell analysis, 2 to 8 markers",422.0,274.3,35.99,1089.82,19
CDM,45188189_1,"Flow cytometry technique for DNA or cell analysis, each additional marker",315.0,204.75,22.15,813.49,19
CDM,45188190_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45188191_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188192_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45188193_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188194_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45188197_1,DNA testing for genetic defects,370.0,240.5,21.42,955.53,19
CDM,45188198_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188199_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188200_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45188201_1,DNA testing for genetic defects,262.0,170.3,21.42,676.62,19
CDM,45188202_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188203_1,DNA testing for genetic defects,370.0,240.5,21.42,955.53,19
CDM,45188204_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188205_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188206_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",333.0,216.45,54.96,2054.0,19
CDM,45188207_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188208_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188209_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188210_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188211_1,DNA testing for genetic defects,330.0,214.5,21.42,852.23,19
CDM,45188212_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188213_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188214_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188215_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188216_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188217_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188218_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188219_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188220_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188221_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188222_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188223_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188224_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188225_1,DNA testing for genetic defects,277.0,180.05,21.42,715.35,19
CDM,45188226_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",353.0,229.45,51.19,911.62,19
CDM,45188227_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188228_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188229_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188230_1,Tissue culture to identify white blood cell disorders,857.0,557.05,116.49,2213.2,19
CDM,45188231_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188232_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188233_1,Tissue culture to identify skin disorders,1042.0,677.3,140.73,2690.97,19
CDM,45188234_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188235_1,Tissue culture for disorders of amniotic fluid or placenta cells,365.0,237.25,150.3,942.61,19
CDM,45188236_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",353.0,229.45,51.19,911.62,19
CDM,45188237_1,Tissue culture for tumor disorders of bone marrow and blood cells,761.0,494.65,143.75,1965.28,19
CDM,45188238_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188239_1,Tissue culture for tumor disorders,1443.0,937.95,147.52,3726.55,19
CDM,45188240_1,"Cryopreservation, freezing and storage of cells",287.0,186.55,5.88,741.18,19
CDM,45188241_1,Tissue culture for tumor disorders,370.0,240.5,147.52,955.53,19
CDM,45188242_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188243_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188244_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188245_1,"Chromosome analysis for genetic defects, baseline Sister Chromatid Exchange (SCE), 20-25 cells",818.0,531.7,173.17,2112.49,19
CDM,45188246_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188248_1,"Chromosome analysis for genetic defects, baseline breakage, score 50-100 cells, count 20 cells",1321.0,858.65,173.17,3411.48,19
CDM,45188249_1,"Antibody evaluation, initial single antibody stain procedure",747.0,485.55,116.63,1929.13,19
CDM,45188250_1,"Antibody evaluation, initial single antibody stain procedure",765.0,497.25,116.63,1975.61,19
CDM,45188251_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188252_1,DNA testing for genetic defects,277.0,180.05,21.42,715.35,19
CDM,45188253_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188254_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188255_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188256_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188257_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188258_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",370.0,240.5,51.19,955.53,19
CDM,45188261_1,"Chromosome analysis for genetic defects, count 5 cells",365.0,237.25,186.15,964.84,19
CDM,45188262_1,"Chromosome analysis for genetic defects, count 15-20 cells",1042.0,677.3,54.96,2690.97,19
CDM,45188265_1,"Chromosome analysis for genetic defects, count 5 cells",370.0,240.5,188.7,978.06,19
CDM,45188269_1,Chromosome analysis of amniotic fluid for genetic defects,365.0,237.25,173.66,942.61,19
CDM,45188271_1,DNA testing for genetic defects,370.0,240.5,21.42,955.53,19
CDM,45188274_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",370.0,240.5,42.38,955.53,19
CDM,45188275_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",353.0,229.45,51.19,911.62,19
CDM,45188276_1,DNA testing for genetic defects,353.0,229.45,21.42,911.62,19
CDM,45188277_1,DNA testing for genetic defects,370.0,240.5,21.42,955.53,19
CDM,45188278_1,DNA testing for genetic defects,353.0,229.45,21.42,911.62,19
CDM,45188279_1,DNA testing for genetic defects,370.0,240.5,21.42,955.53,19
CDM,45188280_1,"Chromosome analysis for genetic defects, additional karyotypes, each study",365.0,237.25,33.47,942.61,19
CDM,45188281_1,DNA testing for genetic defects,529.0,343.85,21.42,1366.14,19
CDM,45188282_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",555.0,360.75,42.38,1433.29,19
CDM,45188284_1,"Microscopic genetic analysis of tissue, manual, initial procedure",555.0,360.75,114.85,1433.29,19
CDM,45188286_1,"Microscopic genetic analysis of tissue, manual, initial procedure",555.0,360.75,114.85,1433.29,19
CDM,45188287_1,"Chromosome analysis for genetic defects, additional karyotypes, each study",370.0,240.5,33.47,955.53,19
CDM,45188288_1,"Chromosome analysis for genetic defects, additional cells counted, each study",370.0,240.5,26.91,955.53,19
CDM,45188299_1,Genetic studies,383.0,248.95,50.75,989.1,19
CDM,45188300_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188301_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188302_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188303_1,DNA testing for genetic defects,277.0,180.05,21.42,715.35,19
CDM,45188304_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188305_1,DNA testing for genetic defects,290.0,188.5,21.42,748.93,19
CDM,45188306_1,DNA testing for genetic defects,576.0,374.4,21.42,1487.52,19
CDM,45188307_1,DNA testing for genetic defects,262.0,170.3,21.42,676.62,19
CDM,45188308_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",353.0,229.45,42.38,911.62,19
CDM,45188309_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",370.0,240.5,42.38,955.53,19
CDM,45188310_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",370.0,240.5,42.38,955.53,19
CDM,45188311_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45188312_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45188313_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45188314_1,Special stained specimen slides to examine tissue including interpretation and report,704.0,457.6,34.57,1818.08,19
CDM,45188315_1,Special stained specimen slides to examine tissue including interpretation and report,704.0,457.6,34.57,1818.08,19
CDM,45188316_1,Special stained specimen slides to examine tissue including interpretation and report,704.0,457.6,34.57,1818.08,19
CDM,45188317_1,Special stained specimen slides to examine tissue including interpretation and report,704.0,457.6,34.57,1818.08,19
CDM,45188318_1,Special stained specimen slides to examine tissue including interpretation and report,704.0,457.6,34.57,1818.08,19
CDM,45188319_1,Special stained specimen slides to examine tissue including interpretation and report,704.0,457.6,34.57,1818.08,19
CDM,45188320_1,Special stained specimen slides to examine tissue including interpretation and report,704.0,457.6,34.57,1818.08,19
CDM,45188321_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",277.0,180.05,51.19,715.35,19
CDM,45188322_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45188323_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",290.0,188.5,51.19,748.93,19
CDM,45188324_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",576.0,374.4,51.19,1487.52,19
CDM,45188325_1,"Surgical pathology consultation and report, comprehensive",704.0,457.6,121.59,1818.08,19
CDM,45188326_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",523.0,339.95,51.19,1350.65,19
CDM,45188341_1,"Special stained specimen slides to examine tissue, initial procedure",704.0,457.6,83.76,1818.08,19
CDM,45188343_1,"Special stained specimen slides to examine tissue, initial procedure",704.0,457.6,83.76,1818.08,19
CDM,45188347_1,"Antibody evaluation, initial single antibody stain procedure",283.0,183.95,116.63,730.85,19
CDM,45188356_1,Microscopic genetic analysis of nerve tissue,406.0,263.9,46.86,1048.5,19
CDM,45188362_1,Nerve teasing preparation,704.0,457.6,130.63,1818.08,19
CDM,45188369_1,"Microscopic genetic analysis of tissue, manual, initial procedure",158.0,102.7,80.58,408.04,19
CDM,45188370_1,"Microscopic genetic analysis of tissue, manual, initial procedure",158.0,102.7,80.58,408.04,19
CDM,45188371_1,"Microscopic genetic analysis of tissue, manual, initial procedure",151.0,98.15,77.01,389.96,19
CDM,45188372_1,"Microscopic genetic analysis of tissue, manual, initial procedure",151.0,98.15,77.01,389.96,19
CDM,45188373_1,"Microscopic genetic analysis of tissue, manual, initial procedure",158.0,102.7,80.58,408.04,19
CDM,45188374_1,"Microscopic genetic analysis of tissue, manual, initial procedure",158.0,102.7,80.58,408.04,19
CDM,45188375_1,"Microscopic genetic analysis of tissue, manual, initial procedure",151.0,98.15,77.01,389.96,19
CDM,45188376_1,"Microscopic genetic analysis of tissue, manual, initial procedure",158.0,102.7,80.58,408.04,19
CDM,45188377_1,"Microscopic genetic analysis of tissue, manual, initial procedure",151.0,98.15,77.01,389.96,19
CDM,45188378_1,"Microscopic genetic analysis of tissue, manual, initial procedure",151.0,98.15,77.01,389.96,19
CDM,45188379_1,"Microscopic genetic analysis of tissue, manual, initial procedure",151.0,98.15,77.01,389.96,19
CDM,45188380_1,"Microscopic genetic analysis of tissue, manual, initial procedure",158.0,102.7,80.58,408.04,19
CDM,45188381_1,"Microscopic genetic analysis of tissue, manual, initial procedure",158.0,102.7,80.58,408.04,19
CDM,45188382_1,DNA testing for genetic defects,99.0,64.35,21.21,255.67,19
CDM,45188383_1,"Chromosome analysis for genetic defects, analyze 10-30 cells",118.0,76.7,34.81,304.74,19
CDM,45188385_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",135.0,87.75,42.38,348.64,19
CDM,45188536_1,Citrate level,93.0,60.45,25.85,240.17,19
CDM,45188538_1,Analysis for antibody to Influenza virus,111.0,72.15,13.55,286.66,19
CDM,45188539_1,Analysis for antibody to Influenza virus,111.0,72.15,13.55,286.66,19
CDM,45188544_1,Analysis for antibody to Diphtheria (bacteria),111.0,72.15,13.66,286.66,19
CDM,45188558_1,Analysis for antibody to Rubella (German measles virus),65.0,42.25,9.35,167.86,19
CDM,45188605_1,Amylase (enzyme) level,119.0,77.35,6.43,307.32,19
CDM,45188606_1,"Analysis of substance using immunoassay technique, multiple step method",207.0,134.55,11.53,534.58,19
CDM,45188608_1,Arsenic level,284.0,184.6,14.45,733.43,19
CDM,45188611_1,Copper level,97.0,63.05,12.04,250.5,19
CDM,45188614_1,Analysis for antibody to Enterovirus (gastrointestinal virus),604.0,392.6,13.03,1559.83,19
CDM,45188615_1,"Deoxycortisol, 11 (hormone) level",199.0,129.35,15.65,513.92,19
CDM,45188617_1,Manganese (heavy metal) level,217.0,141.05,14.45,560.4,19
CDM,45188621_1,Detection test by immunoassay technique for hepatitis D,357.0,232.05,12.47,921.95,19
CDM,45188623_1,Homovanillic acid (organic acid) level,117.0,76.05,15.65,302.15,19
CDM,45188625_1,Lead level,188.0,122.2,12.11,485.51,19
CDM,45188628_1,Analysis for antibody to Enterovirus (gastrointestinal virus),845.0,549.25,13.03,2182.21,19
CDM,45188629_1,Oxalate level,103.0,66.95,14.14,266.0,19
CDM,45188630_1,Urine porphyrins (metabolism substance) measurement,156.0,101.4,14.14,402.87,19
CDM,45188631_1,"Thyroid hormone, T3 measurement, reverse",151.0,98.15,15.65,389.96,19
CDM,45188632_1,Selenium (vitamin) level,102.0,66.3,14.45,263.42,19
CDM,45188633_1,Selenium (vitamin) level,530.0,344.5,14.45,1368.73,19
CDM,45188634_1,Measurement of substance using immunoassay technique,273.0,177.45,14.14,705.02,19
CDM,45188635_1,"Immunologic analysis technique, unspecified",171.0,111.15,13.66,441.61,19
CDM,45188640_1,Analysis for antibody to Trichinella (worm parasite),300.0,195.0,12.56,774.75,19
CDM,45188647_1,Insulin antibody measurement,273.0,177.45,13.66,705.02,19
CDM,45188654_1,"Measurement of complement (immune system proteins), antigen,",245.0,159.25,12.0,632.71,19
CDM,45188655_1,"Measurement of complement (immune system proteins), total hemolytic",711.0,462.15,13.66,1836.16,19
CDM,45188660_1,Intrinsic factor (stomach protein) antibody measurement,117.0,76.05,13.66,302.15,19
CDM,45188676_1,Androstanediol glucuronide (hormone) level,404.0,262.6,15.65,1043.33,19
CDM,45188677_1,"Analysis of substance using immunoassay technique, multiple step method",141.0,91.65,11.53,364.13,19
CDM,45188681_1,White blood cell enzyme activity measurement,99.0,64.35,6.99,255.67,19
CDM,45188688_1,ADH (antidiuretic hormone) level,180.0,117.0,33.94,464.85,19
CDM,45188692_1,Catecholamines (organic nitrogen) level,232.3,151.0,15.65,599.91,19
CDM,45188694_1,Galactose-1-phosphate uridyl transferase (enzyme) level,778.0,505.7,14.14,2009.19,19
CDM,45188696_1,Analysis for antibody to adenovirus (respiratory virus),147.0,95.55,12.87,379.63,19
CDM,45188713_1,Serotonin (hormone) level,255.0,165.75,30.98,658.54,19
CDM,45188716_1,Fatty acids measurement,353.0,229.45,14.14,911.62,19
CDM,45188717_1,Antithrombin III antigen (clotting inhibitor) level,141.0,91.65,5.24,364.13,19
CDM,45188719_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",198.0,128.7,49.5,511.34,19
CDM,45188724_1,"Amino acid analysis, multiple amino acids, qualitative, each specimen",664.0,431.6,13.87,1714.78,19
CDM,45188725_1,"Amino acid analysis, multiple amino acids, qualitative, each specimen",636.0,413.4,13.87,1642.47,19
CDM,45188734_1,Mercury level,243.0,157.95,14.45,627.55,19
CDM,45188735_1,Mercury level,270.0,175.5,14.45,697.28,19
CDM,45188736_1,Clotting factor VIII (von Willebrand factor) measurement,864.0,561.6,22.94,2231.28,19
CDM,45188738_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,45188739_1,Plasminogen activator (fibrinolytic factor) measurement,742.0,482.3,5.24,1916.22,19
CDM,45188740_1,Plasminogen activator (fibrinolytic factor) measurement,827.0,537.55,5.24,2135.73,19
CDM,45188964_1,Volatile chemical measurement,360.0,234.0,14.14,929.7,19
CDM,45188967_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",19.0,12.35,0.99,49.07,19
CDM,45189053_1,Aldolase (enzyme) level,56.0,36.4,5.44,144.62,19
CDM,45189055_1,"Phosphatase (enzyme) measurement, alkaline, isoenzymes",136.0,88.4,14.14,351.22,19
CDM,45189056_1,Angiotensin l - converting enzyme (ACE) level,126.0,81.9,14.14,325.4,19
CDM,45189057_1,Cadmium level,221.0,143.65,14.45,570.73,19
CDM,45189059_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",190.0,123.5,47.5,490.68,19
CDM,45189061_1,Dehydroepiandrosterone (DHEA) hormone level,103.0,66.95,14.14,266.0,19
CDM,45189062_1,Glucagon (pancreatic hormone) level,279.0,181.35,14.29,720.52,19
CDM,45189063_1,Carnitine level,174.0,113.1,14.14,449.36,19
CDM,45189066_1,"Myelin basic protein (nerve protein) level, spinal fluid",141.0,91.65,14.14,364.13,19
CDM,45189077_1,"Measurement of complement (immune system proteins), antigen,",101.0,65.65,12.0,260.83,19
CDM,45189080_1,Calcitonin (hormone) level,166.0,107.9,15.65,428.7,19
CDM,45189087_1,"Stool fat or lipids analysis, quantitative",317.0,206.05,14.14,818.65,19
CDM,45189091_1,"Hydroxyprogesterone, 17-D (synthetic hormone) level",141.0,91.65,15.65,364.13,19
CDM,45189092_1,Islet cell (pancreas) antibody measurement,169.0,109.85,13.66,436.44,19
CDM,45189122_1,"Dihydroxyvitamin D, 1, 25 level",161.0,104.65,33.2,415.78,19
CDM,45189160_1,Examination of stool for meat fibers,37.0,24.05,1.79,95.55,19
CDM,45189163_1,Aldosterone hormone level,160.0,104.0,40.75,413.2,19
CDM,45189362_1,Aldosterone hormone level,141.0,91.65,40.75,364.13,19
CDM,45189369_1,"Phosphatase, prostatic (prostate enzyme) level",92.0,59.8,6.43,237.59,19
CDM,45189370_1,Proinsulin (pancreatic hormone) level,166.0,107.9,15.65,428.7,19
CDM,45189371_1,Pyruvate kinase (enzyme) level,265.0,172.25,6.43,684.36,19
CDM,45189372_1,Thyroxine binding globulin (thyroid related protein) level,104.0,67.6,14.78,268.58,19
CDM,45189373_1,Protoporphyrin (metabolism substance) level,97.0,63.05,13.92,250.5,19
CDM,45189374_1,Thyroid stimulating immune globulins (thyroid related protein) level,438.0,284.7,41.3,1131.14,19
CDM,45189379_1,Vitamin B-6 level,141.0,91.65,28.1,364.13,19
CDM,45189380_1,Vitamin B-1 (thiamine) level,161.0,104.65,14.14,415.78,19
CDM,45189381_1,Vitamin B-2 (riboflavin) level,481.0,312.65,14.14,1242.18,19
CDM,45189385_1,Infrared analysis of stone,113.0,73.45,12.9,291.82,19
CDM,45189389_1,Copper level,320.0,208.0,12.41,826.4,19
CDM,45189393_1,Metanephrines level,148.0,96.2,15.65,382.21,19
CDM,45189404_1,Analysis for antibody to Mycoplasma (bacteria),121.85,79.2,13.24,314.68,19
CDM,45189436_1,Analysis for antibody to Mycoplasma (bacteria),121.85,79.2,13.24,314.68,19
CDM,45189486_1,Xylose (carbohydrate) absorption test of blood and/or urine,334.0,217.1,12.91,862.56,19
CDM,45189936_1,Analysis for antibody to histoplasma (fungus),201.0,130.65,13.66,519.08,19
CDM,45189937_1,Analysis for antibody to blastomyces (fungus),93.0,60.45,12.0,240.17,19
CDM,45189938_1,Analysis for antibody to Coccidioides (bacteria),207.0,134.55,11.47,534.58,19
CDM,45189940_1,Analysis for antibody to aspergillus (fungus),60.0,39.0,9.03,154.95,19
CDM,45189941_1,Measurement of DNA antibody,78.0,50.7,10.34,201.44,19
CDM,45189942_1,Analysis for antibody to Brucella (bacteria),61.0,39.65,5.45,157.53,19
CDM,45190_1,Destruction of growth of rectum,1655.8,1076.27,78.57,2093.34,19
CDM,45198260_1,Measurement of substance using immunoassay technique,724.0,470.6,14.14,1869.73,19
CDM,45198261_1,"Antibody evaluation, initial single antibody stain procedure",724.0,470.6,116.63,1869.73,19
CDM,45198708_1,Measurement of substance using immunoassay technique,135.0,87.75,14.14,348.64,19
CDM,45198709_1,"Antibody evaluation, initial single antibody stain procedure",135.0,87.75,68.85,348.64,19
CDM,451G0452_1,MOLECULAR PATHOLOGY PROCEDURE; PHYSICIAN INTERPRETATION AND REPORT,552.0,358.8,3.11,1425.54,17
CDM,451IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.69,2.4,0.92,9.53,16
CDM,451OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.33,14.51,5.58,57.67,16
CDM,4526IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.37,2.84,1.09,11.29,16
CDM,4526OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",56.37,36.64,14.09,145.58,16
CDM,4528IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.26,1.47,0.57,5.84,16
CDM,4528OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.58,5.58,2.15,22.16,16
CDM,45300_1,Diagnostic exam of rectum and lower large bowel using an endoscope,285.6,185.64,20.44,308.59,19
CDM,45303_1,Dilation of rectum and/or lower large bowel using an endoscope,2174.6,1413.49,4.58,2312.84,19
CDM,45305_1,Biopsies of rectum and/or lower large bowel using a rigid endoscope,464.1,301.67,63.06,435.98,19
CDM,45307_1,Removal of foreign bodies from rectum and/or lower large bowel using a rigid endoscope,519.8,337.87,77.49,507.48,19
CDM,45308_1,Removal of polyp or growth of rectum and large bowel using an endoscope with electrical cautery,474.6,308.49,62.62,486.2,19
CDM,45309_1,Removal of polyp or growth of rectum and large bowel using an endoscope with mechanical snare,529.2,343.98,76.33,500.79,19
CDM,45315_1,Removal of multiple growths or polyps of lower large bowel by electrical cautery or mechanical snare using a rigid endoscope,595.4,387.01,78.57,539.33,19
CDM,45317_1,Control of bleeding of lower large bowel using an endoscope,564.9,367.19,78.57,531.48,19
CDM,4531IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.34,3.47,1.34,13.79,16
CDM,4531OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.74,10.88,4.19,43.23,16
CDM,45320_1,Destruction of multiple polyps or growths of lower large bowel using an endoscope,560.7,364.46,78.57,529.33,19
CDM,45321_1,Release of twisted lower large bowel using a rigid endoscope,367.5,238.88,78.57,301.64,19
CDM,45327_1,Insertion of stent into lower large bowel using an endoscope,271.38,176.4,78.57,381.62,19
CDM,45330_1,Diagnostic exam of lower portion of large bowel using a flexible endoscope,370.0,240.5,49.56,447.17,19
CDM,45331_1,Biopsy of lower large bowel using a flexible endoscope,522.0,339.3,52.09,690.46,19
CDM,45332_1,Removal of foreign bodies in lower portion of large bowel using a flexible endoscope,745.5,484.58,51.39,666.13,19
CDM,45333_1,Removal of polyps or growths of lower large bowel using a flexible endoscope with electrical cautery,758.1,492.77,78.57,792.39,19
CDM,45334_1,Control of bleeding of lower large bowel using a flexible endoscope,472.5,307.13,78.57,1190.27,19
CDM,45335_1,Injection beneath lining of lower large bowel using a flexible endoscope,648.9,421.79,42.9,703.27,19
CDM,45337_1,Decompression of twisted or abnormally dilated lower large bowel using a flexible endoscope,403.2,262.08,78.57,351.97,19
CDM,45338_1,Removal of polyps or growths of lower large bowel using a flexible endoscope with mechanical snare,876.8,569.92,77.52,720.19,19
CDM,45340_1,Balloon dilation of lower large bowel using a flexible endoscope,1167.6,758.94,34.72,1103.79,19
CDM,45341_1,Ultrasound exam of lower large bowel using a flexible endoscope,444.2,288.73,78.57,379.93,19
CDM,45342_1,Fine needle aspiration and/or biopsy of lower large bowel with ultrasound guidance using a flexible endoscope,677.3,440.25,78.57,521.83,19
CDM,45346_1,Destruction of polyp or growth of lower large bowel using a flexible endoscope,822.4,534.56,78.57,5552.6,19
CDM,45347_1,Insertion of stent into lower large bowel using a flexible endoscope,714.3,464.3,78.57,473.83,19
CDM,45349_1,Removal of lower portion of large bowel tissue using a flexible endoscope,725.5,471.58,78.57,747.27,19
CDM,45350_1,Banding of hemorrhoids using a flexible endoscope (sigmoidoscope),1214.73,789.57,78.57,1621.09,19
CDM,45378_1,Diagnostic exam of large bowel using a flexible endoscope,1050.0,682.5,78.57,815.48,19
CDM,45379_1,Removal of foreign bodies in large bowel using a flexible endoscope,1335.6,868.14,78.57,1045.62,19
CDM,45380_1,Biopsy of large bowel using a flexible endoscope,1260.0,819.0,78.57,1044.41,19
CDM,45381_1,Injection beneath lining of large bowel using a flexible endoscope,1230.0,799.5,78.57,1066.55,19
CDM,45382_1,Control of bleeding of upper large bowel using a flexible endoscope,1666.4,1083.16,78.57,1605.98,19
CDM,45384_1,Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery,1260.0,819.0,78.57,1171.7,19
CDM,45385_1,Removal of polyps or growths of large bowel using an endoscope with mechanical snare,1420.0,923.0,78.57,1091.45,19
CDM,45386_1,Balloon dilation of large bowel using a flexible endoscope,1745.1,1134.32,78.57,1471.87,19
CDM,45388_1,Destruction of polyp or growth of large bowel using a flexible endoscope,6000.0,3900.0,78.57,5934.0,19
CDM,45389_1,Insertion of stent in large bowel using a flexible endoscope,1145.9,744.84,78.57,890.9,19
CDM,45390_1,Removal of large bowel tissue using a flexible endoscope,1145.9,744.84,78.57,1022.64,19
CDM,45391_1,Ultrasound exam of large bowel using a flexible endoscope,842.1,547.37,78.57,793.77,19
CDM,45392_1,Fine needle aspiration and/or biopsy of large bowel with ultrasound guidance using a flexible endoscope,1074.2,698.23,78.57,934.49,19
CDM,45393_1,Decompression of twisted or abnormally dilated large bowel using a flexible endoscope,2073.4,1347.71,78.57,772.68,19
CDM,45395_1,Removal of rectum with creation of opening from large bowel to skin using an endoscope,4746.0,3084.9,78.57,5889.03,19
CDM,45397_1,Removal of rectum using an endoscope,5295.2,3441.88,78.57,6434.93,19
CDM,45398_1,Banding of hemorrhoids using a flexible endoscope (colonoscope),1562.13,1015.38,78.57,1989.79,19
CDM,45400_1,Repair of rectal prolapse using an endoscope,2659.7,1728.81,78.57,3409.63,19
CDM,45402_1,Repair of rectal prolapse with partial removal of lower large bowel using an endoscope,4140.2,2691.13,78.57,4524.95,19
CDM,454IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.69,1.1,0.42,4.36,16
CDM,454OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.9,1.24,0.48,4.91,16
CDM,45500_1,Repair of narrowed rectum,1548.8,1006.72,78.57,1637.7,19
CDM,45505_1,Repair of prolapsed lining of rectum through anus,1601.3,1040.85,78.57,1771.55,19
CDM,45520_1,Injection of prolapsed vein in rectum,361.4,234.91,14.91,393.42,19
CDM,45540_1,Suture of rectum to sacrum through abdomen,2857.1,1857.12,78.57,3161.9,19
CDM,45541_1,Suture of rectum to sacrum through perineum,2625.0,1706.25,78.57,2803.13,19
CDM,45550_1,Suture of rectum to sacrum with removal of large bowel,3926.0,2551.9,78.57,4366.74,19
CDM,45560_1,Repair of bulging of rectum into vagina,1940.4,1261.26,78.57,2080.78,19
CDM,45562_1,Repair of rectal wound,2973.6,1932.84,78.57,3325.14,19
CDM,45563_1,Repair of rectal wound with surgically created opening from large bowel to skin,4292.4,2790.06,78.57,4831.24,19
CDM,4560IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.58,12.73,4.9,50.57,16
CDM,4560OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.24,22.91,8.81,91.01,16
CDM,4571IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.22,35.89,13.81,142.61,16
CDM,4571OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",60.52,39.34,15.13,156.29,16
CDM,4572IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.09,9.16,3.52,36.39,16
CDM,4572OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",33.08,21.5,8.27,85.43,16
CDM,4573IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.7,12.81,4.93,50.88,16
CDM,4573OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",51.14,33.24,12.79,132.07,16
CDM,4574IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.23,6.65,2.56,26.42,16
CDM,4574OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.38,11.3,4.35,44.88,16
CDM,45800_1,Closure of abnormal opening from rectum to bladder,3349.5,2177.18,78.57,3693.73,19
CDM,45805_1,Repair of herniated rectum with creation of large bowel opening to skin,3791.6,2464.54,78.57,4293.87,19
CDM,45820_1,Repair of abnormal rectal drainage tract,3263.4,2121.21,78.57,3707.43,19
CDM,45825_1,Repair of abnormal rectal drainage tract with creation of large bowel opening to skin,3998.4,2598.96,78.57,4485.77,19
CDM,45900_1,Manual replacement of prolapsed rectum under anesthesia,960.8,624.52,78.57,600.7,19
CDM,45905_1,Dilation of sphincter of anus under anesthesia,1265.3,822.45,78.57,503.52,19
CDM,45910_1,Dilation of narrowing of rectum under anesthesia,526.1,341.97,78.57,574.07,19
CDM,45915_1,Removal of impacted stool or foreign body in rectum under anesthesia,810.0,526.5,78.57,839.5,19
CDM,45936511_1,Mechanical separation of white blood cells from blood,4629.0,3008.85,764.0,11954.39,19
CDM,45936513_1,Mechanical separation of platelet cells from blood,4629.0,3008.85,764.0,11954.39,19
CDM,45985469_1,Mechanical separation of plasma from blood,8953.0,5819.45,208.0,23121.12,19
CDM,45986850_1,Screening test for red blood cell antibodies,154.0,100.1,5.24,764.0,19
CDM,45986902_1,"Screening test for compatible blood unit, using reagent serum",97.0,63.05,5.24,764.0,19
CDM,45986924_1,REV - OTHER RX SVCS,241.0,156.65,60.25,764.0,12
CDM,45986925_1,REV - OTHER RX SVCS,427.0,277.55,106.75,764.0,12
CDM,45989587_1,REV - OTHER RX SVCS,8959.0,5823.35,764.0,6271.3,12
CDM,45989588_1,Identification of red blood cell antibodies,186.0,120.9,94.86,764.0,19
CDM,45989589_1,Blood typing Rh phenotyping,133.0,86.45,5.24,764.0,19
CDM,45989590_1,Blood typing for red blood cell antigens,339.0,220.35,5.24,875.47,19
CDM,45989591_1,"Red blood cell antibody detection test, direct",53.0,34.45,2.86,764.0,19
CDM,45989592_1,Removal of antibodies from surface of red blood cell,180.0,117.0,91.8,764.0,19
CDM,45989593_1,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with enzymes",84.0,54.6,42.84,764.0,19
CDM,45989594_1,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with chemical agents or drugs",145.0,94.25,73.95,764.0,19
CDM,45989595_1,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, incubation with drugs",675.0,438.75,123.26,1743.19,19
CDM,45989596_1,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, by differential red cell absorption",195.0,126.75,99.45,764.0,19
CDM,45989598_1,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, by dilution",150.0,97.5,76.5,764.0,19
CDM,45989599_1,Red blood cell antibody level,101.0,65.65,5.23,764.0,19
CDM,45989600_1,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, by density gradient separation",225.0,146.25,114.75,764.0,19
CDM,45989604_1,"Screening test for compatible blood unit, using patient serum",75.0,48.75,5.24,764.0,19
CDM,45989606_1,REV - OTHER RX SVCS,118.0,76.7,29.5,764.0,12
CDM,45989607_1,REV - OTHER RX SVCS,180.0,117.0,45.0,764.0,12
CDM,45989608_1,REV - OTHER RX SVCS,97.0,63.05,24.25,764.0,12
CDM,45989609_1,REV - OTHER RX SVCS,272.0,176.8,68.0,764.0,12
CDM,45989611_1,REV - OTHER RX SVCS,2925.0,1901.25,731.25,2047.5,12
CDM,45990_1,Diagnostic exam of anus and rectum under anesthesia,295.1,191.82,78.57,317.48,19
CDM,46020_1,Insertion of drain (seton) into anus,724.5,470.93,78.57,349.09,19
CDM,46030_1,Removal of drain (seton) from anus,289.8,188.37,33.98,614.93,19
CDM,46040_1,Drainage of deep abscess in rectum,1280.0,832.0,78.57,1312.58,19
CDM,46045_1,Incision and drainage of abscess within wall of rectum under anesthesia,1078.4,700.96,78.57,1289.72,19
CDM,46050_1,Drainage of superficial rectal abscess surrounding anus,510.0,331.5,32.23,566.74,19
CDM,46060_1,Incision and drainage of abscess in wall of rectum or between rectum and muscle with incision or removal of abnormal drainage tract,1365.0,887.25,78.57,1425.89,19
CDM,46070_1,"Incision of tissue blocking rectum, infant",535.95,348.37,78.57,767.38,19
CDM,46080_1,Incision of sphincter of anus,604.8,393.12,69.6,686.28,19
CDM,46083_1,Incision of external hemorrhoid with blood clot,440.0,286.0,38.28,496.89,19
CDM,46101001_1,Other procedure on front of eye,600.0,390.0,150.0,3726.0,19
CDM,46101002_1,Other procedure on front of eye,1230.0,799.5,307.5,3726.0,19
CDM,46101003_1,Other procedure on front of eye,1845.0,1199.25,461.25,4764.71,19
CDM,46101004_1,Other procedure on front of eye,2797.5,1818.38,699.38,7224.54,19
CDM,46101005_1,Other procedure on front of eye,615.0,399.75,153.75,3726.0,19
CDM,46101006_1,Other procedure on front of eye,1537.5,999.38,384.38,3970.59,19
CDM,46101007_1,Other procedure on front of eye,2152.5,1399.13,538.13,5558.83,19
CDM,46101008_1,Other procedure on front of eye,3105.75,2018.74,776.44,8020.6,19
CDM,46101009_1,PHOTOREFRACTIVE KERATECTOMY (PRK),1846.0,1199.9,461.5,8477.27,18
CDM,46101010_1,Other procedure on front of eye,1230.0,799.5,307.5,3726.0,19
CDM,46101012_1,Other procedure on front of eye,3075.0,1998.75,768.75,7941.19,19
CDM,46101014_1,LASER IN SITU KERATOMILEUSIS (LASIK),1846.0,1199.9,461.5,8477.27,18
CDM,46101015_1,Other procedure on front of eye,3300.0,2145.0,825.0,8522.25,19
CDM,46101030_1,OPERATING ROOM SERVICES - MINOR SURGERY,1350.0,877.5,337.5,945.0,11
CDM,46101031_1,OPERATING ROOM SERVICES - MINOR SURGERY,1225.0,796.25,306.25,857.5,11
CDM,46101034_1,OPERATING ROOM SERVICES - MINOR SURGERY,275.0,178.75,68.75,192.5,11
CDM,46101035_1,OPERATING ROOM SERVICES - MINOR SURGERY,410.0,266.5,102.5,287.0,11
CDM,46101036_1,OPERATING ROOM SERVICES - MINOR SURGERY,410.0,266.5,102.5,287.0,11
CDM,46101037_1,OPERATING ROOM SERVICES - MINOR SURGERY,545.0,354.25,136.25,381.5,11
CDM,46101038_1,OPERATING ROOM SERVICES - MINOR SURGERY,680.0,442.0,170.0,476.0,11
CDM,46101039_1,OPERATING ROOM SERVICES - MINOR SURGERY,820.0,533.0,205.0,574.0,11
CDM,46101040_1,OPERATING ROOM SERVICES - MINOR SURGERY,1225.0,796.25,306.25,857.5,11
CDM,46101041_1,OPERATING ROOM SERVICES - MINOR SURGERY,1350.0,877.5,337.5,945.0,11
CDM,46101042_1,OPERATING ROOM SERVICES - MINOR SURGERY,250.0,162.5,62.5,175.0,11
CDM,46101043_1,OPERATING ROOM SERVICES - MINOR SURGERY,500.0,325.0,125.0,350.0,11
CDM,46101044_1,Other procedure on front of eye,5156.25,3351.56,1289.06,13316.02,19
CDM,46101045_1,Other procedure on front of eye,5156.25,3351.56,1289.06,13316.02,19
CDM,46102000_1,HC LASIK PACK,46.0,29.9,11.5,32.2,11
CDM,4610402T_1,Collagen cross-linking treatment of disease of cornea,4674.0,3038.1,827.92,12070.61,19
CDM,46164612_1,Injection of chemical for paralysis of nerve muscles on side of face,361.5,234.98,90.38,2166.29,19
CDM,46165205_1,Removal of foreign body from external eye (conjunctiva),165.0,107.25,41.25,8477.27,19
CDM,46165210_1,Removal of foreign body from external eye (conjunctiva or sclera),495.0,321.75,109.6,8477.27,19
CDM,46165220_1,Removal of foreign body in cornea,495.0,321.75,109.6,8477.27,19
CDM,46165222_1,Removal of foreign body in cornea using slit lamp,165.0,107.25,41.25,8477.27,19
CDM,46165400_1,Removal of growth of cornea,1176.0,764.4,294.0,3726.0,19
CDM,46165430_1,Scraping of cornea for diagnosis,495.0,321.75,123.75,8477.27,19
CDM,46165436_1,Removal of outer layer of cornea with application of chelating agent,1710.0,1111.5,427.5,6451.0,19
CDM,46165710_1,Transplantation of tissue from 1 cornea to other cornea,18600.0,12090.0,4620.48,48034.5,19
CDM,46165785_1,Implantation of corneal ring segments,11175.0,7263.75,2793.75,28859.44,19
CDM,46165800_1,Removal of eye fluid,2751.0,1788.15,687.75,7104.46,19
CDM,46166020_1,Injection of air or liquid into eye,1840.0,1196.0,460.0,4751.8,19
CDM,46166030_1,Injection of medication into eye,1840.0,1196.0,460.0,4751.8,19
CDM,46166761_1,"Creation of eye fluid drainage tracts in iris using a laser, per session",1096.5,712.73,274.13,3227.0,19
CDM,46166821_1,Removal of recurring cataract in lens capsule using a laser,720.0,468.0,180.0,3227.0,19
CDM,46167820_1,Removal of eyelashes using forceps,165.0,107.25,41.25,8477.27,19
CDM,46167825_1,Removal of eyelashes,667.5,433.88,166.88,8477.27,19
CDM,46168110_1,"Removal of growth of eyelid lining, 1.0 cm or less",2595.0,1686.75,648.75,6701.59,19
CDM,46168760_1,"Repair tear duct opening by heat, tying, or laser surgery",278.0,180.7,69.5,2166.29,19
CDM,46168761_1,Closure of tear duct opening using plug,417.0,271.05,104.25,2166.29,19
CDM,46168810_1,"Removal of growth of eyelid lining, 1.0 cm or less",418.5,272.03,104.63,6451.0,19
CDM,46176510_1,1D and 2D ultrasound scan of eye tissue and structures,300.0,195.0,75.0,774.75,18
CDM,46176512_1,2D ultrasound scan of eye tissue and structures,450.0,292.5,112.5,1162.13,18
CDM,46176513_1,Ultrasound scan of eye using water bath method,225.0,146.25,56.25,581.06,18
CDM,46176514_1,Ultrasound scan of cornea to determine thickness,446.0,289.9,81.48,1151.8,18
CDM,46176519_1,Ultrasound scan to determine eye length and lens power,110.0,71.5,27.5,284.08,18
CDM,46192002_1,New patient problem focused exam of visual system,100.0,65.0,25.0,258.25,17
CDM,46192004_1,New patient complete exam of visual system,120.0,78.0,30.0,309.9,17
CDM,46192012_1,Established patient problem focused exam of visual system,200.0,130.0,50.0,516.5,17
CDM,46192014_1,Established patient complete exam of visual system,250.0,162.5,62.5,645.63,17
CDM,46192025_1,CT scan of cornea,125.0,81.25,31.25,784.0,19
CDM,46192081_1,Exam of visual field with limited testing,65.0,42.25,16.25,784.0,19
CDM,46192082_1,Exam of visual field with intermediate testing,125.0,81.25,31.25,784.0,19
CDM,46192083_1,Exam of visual field with extended testing,270.0,175.5,67.5,784.0,19
CDM,46192132_1,Imaging of front third of eye,150.0,97.5,37.5,784.0,19
CDM,46192133_1,Imaging of optic nerve,125.0,81.25,31.25,784.0,19
CDM,46192134_1,Imaging of retina,125.0,81.25,31.25,784.0,19
CDM,46192136_1,Measurement of corneal curvature and depth of eye,375.0,243.75,81.48,968.44,19
CDM,46192235_1,Exam of retinal blood vessels using a special camera after injection of a dye,600.0,390.0,150.0,1549.5,19
CDM,46192250_1,Photography of the retina,270.0,175.5,67.5,784.0,19
CDM,46192285_1,Photography of content of eyes,108.53,70.54,27.13,784.0,19
CDM,46192286_1,Imaging of front third of eye using a special microscope,270.0,175.5,67.5,784.0,19
CDM,46199202_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,46199203_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,46199204_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,46199205_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,46199211_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,46199212_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,46199213_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,46199214_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,46199215_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,461S0800_1,LASER IN SITU KERATOMILEUSIS (LASIK),1846.0,1199.9,461.5,8477.27,18
CDM,461S0810_1,PHOTOREFRACTIVE KERATECTOMY (PRK),1846.0,1199.9,461.5,8477.27,18
CDM,461S0812_1,PHOTOTHERAPEUTIC KERATECTOMY (PTK),1846.0,1199.9,461.5,8477.27,18
CDM,46200_1,Removal of chronic tear of anus,1002.8,651.82,78.57,1137.91,19
CDM,46220_1,Removal of single external noncancer growth of anus,483.0,313.95,22.67,601.68,19
CDM,46221_1,Removal of external hemorrhoids by rubber banding,634.2,412.23,77.78,680.72,19
CDM,46230_1,Removal of multiple external noncancer growths of anus,663.6,431.34,49.49,747.16,19
CDM,46250_1,Removal of multiple external hemorrhoids,1104.6,717.99,78.57,1139.41,19
CDM,46255_1,Removal of single external and internal hemorrhoid group,1232.7,801.26,78.57,1240.36,19
CDM,46257_1,Removal of single external and internal hemorrhoid group and chronic tear in anus,1167.6,758.94,78.57,1258.23,19
CDM,46258_1,Removal of single external and internal hemorrhoid group with removal of abnormal drainage tract in anus,1287.3,836.75,78.57,1374.74,19
CDM,46260_1,Removal of multiple hemorrhoid groups,1417.5,921.38,78.57,1416.93,19
CDM,46261_1,Removal of multiple hemorrhoid groups and chronic tear in anus,1496.3,972.6,78.57,1559.35,19
CDM,46262_1,Removal of multiple hemorrhoid groups with removal of abnormal drainage tract from anus,1575.0,1023.75,78.57,1656.51,19
CDM,46270_1,Repair of abnormal anal drainage tract,1199.1,779.42,78.57,1272.15,19
CDM,46275_1,Repair of abnormal drainage tract in anal sphincter,1303.1,847.02,78.57,1347.19,19
CDM,46280_1,Repair of abnormal drainage tract around anal sphincter,1443.8,938.47,78.57,1411.04,19
CDM,46285_1,second stage repair of abnormal anal drainage tract,1244.7,809.06,78.57,1342.15,19
CDM,46288_1,Repair of abnormal anal drainage tract with rectal tissue flap,1390.2,903.63,78.57,1643.21,19
CDM,46320_1,Removal of external hemorrhoid with blood clot,450.0,292.5,78.57,511.12,19
CDM,464IP _1,"INJECTION, AMPHOTERICIN B, 50 MG",254.59,165.48,45.89,657.48,17
CDM,46500_1,Injection of hemorrhoid,437.0,284.05,25.76,757.0,19
CDM,46505_1,Injection of agent to destroy nerve to internal sphincter of anus,701.4,455.91,78.57,761.09,19
CDM,46522221_1,HC ADULT HEMODIALYSIS - IP TREATMENT,1061.0,689.65,265.25,742.7,11
CDM,46540000_1,UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL OUTPATIENT DEPARTMENT THAT IS NOT CERTIFIED AS AN ESRD FACILITY,1279.0,831.35,319.75,3303.02,18
CDM,46540005_1,UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL OUTPATIENT DEPARTMENT THAT IS NOT CERTIFIED AS AN ESRD FACILITY,1658.0,1077.7,414.5,4281.79,18
CDM,46540010_1,UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL OUTPATIENT DEPARTMENT THAT IS NOT CERTIFIED AS AN ESRD FACILITY,1535.0,997.75,383.75,3964.14,18
CDM,46540015_1,UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL OUTPATIENT DEPARTMENT THAT IS NOT CERTIFIED AS AN ESRD FACILITY,1599.0,1039.35,399.75,4129.42,18
CDM,46540020_1,HC IP PERITONEAL DIALYSIS HIM CODES,1279.0,831.35,319.75,895.3,11
CDM,46540025_1,Dialysis procedure including 1 evaluation,2558.0,1662.7,639.5,6606.04,18
CDM,46540030_1,Dialysis procedure including 1 evaluation,2558.0,1662.7,639.5,6606.04,18
CDM,46540100_1,UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL OUTPATIENT DEPARTMENT THAT IS NOT CERTIFIED AS AN ESRD FACILITY,1658.0,1077.7,414.5,4281.79,19
CDM,46540105_1,UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL OUTPATIENT DEPARTMENT THAT IS NOT CERTIFIED AS AN ESRD FACILITY,1658.0,1077.7,414.5,4281.79,19
CDM,46540110_1,UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL OUTPATIENT DEPARTMENT THAT IS NOT CERTIFIED AS AN ESRD FACILITY,1535.0,997.75,383.75,3964.14,19
CDM,46540115_1,UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL OUTPATIENT DEPARTMENT THAT IS NOT CERTIFIED AS AN ESRD FACILITY,1599.0,1039.35,399.75,4129.42,19
CDM,46540120_1,HC OP PERITONEAL DIALYSIS,1279.0,831.35,319.75,1155.0,12
CDM,46550000_1,HC AFTER HRS HEMO 1:2.5 - PER HOUR,90.0,58.5,22.5,63.0,11
CDM,46550005_1,HC AFTER HRS HEMO 1:1 - PER HOUR,90.0,58.5,22.5,63.0,11
CDM,46550010_1,HC AFTER HRS HEMO POST-DECLOT RUN 1:2.5 - PER OCC,122.0,79.3,30.5,85.4,11
CDM,46550015_1,HC AFTER HRS HEMO POST-DECLOT RUN 1:1 - PER OCC,128.0,83.2,32.0,89.6,11
CDM,46600_1,Diagnostic exam of anus using an endoscope,210.0,136.5,20.83,286.25,19
CDM,46601_1,Diagnostic exam of anus with magnification and chemical agent enhancement using an endoscope,323.18,210.07,78.57,357.8,19
CDM,46604_1,Dilation of anus using an endoscope,1302.0,846.3,56.95,1580.02,19
CDM,46606_1,Biopsy of anus using an endoscope,541.8,352.17,24.58,675.56,19
CDM,46607_1,Biopsy of anus with magnification and chemical agent enhancement using an endoscope,452.95,294.42,78.57,495.32,19
CDM,46608_1,Removal of foreign body in anus using an endoscope,570.0,370.5,48.75,698.78,19
CDM,46610_1,Removal of anal polyps or growths using an endoscope with electrical cautery,551.3,358.35,43.3,666.16,19
CDM,46611_1,Removal of single anal polyp or growth using an endoscope with mechanical snare,478.8,311.22,68.68,537.83,19
CDM,46612_1,Removal of multiple anal polyps or growths using an endoscope with electrical cautery or mechanical snare,729.8,474.37,59.12,799.31,19
CDM,46614_1,Control of bleeding of anus using an endoscope,421.1,273.72,56.33,406.41,19
CDM,46615_1,Destruction of anal polyp or growth using an endoscope,497.7,323.51,77.31,428.26,19
CDM,46700_1,"Plastic repair of anal stricture, adult",1679.0,1091.35,78.57,1965.39,19
CDM,46705_1,"Plastic repair of anal stricture, infant",1372.4,892.06,78.57,1634.15,19
CDM,46706_1,Repair of abnormal anal drainage tract with tissue glue,442.1,287.37,78.57,516.86,19
CDM,46707_1,Repair of abnormal anal drainage tract with implanted plug,1239.0,805.35,78.57,1441.55,19
CDM,46710_1,Repair of abnormal drainage tract or pocket from surgically created pouch of small bowel through incision of region between thighs,2602.7,1691.76,78.57,3244.11,19
CDM,46712_1,Repair of abnormal drainage tract or pocket from surgically created pouch of small bowel through incision of abdomen and region between thighs,5019.45,3262.64,78.57,6524.72,19
CDM,46715_1,Creation of anal opening,1358.7,883.16,78.57,1597.97,19
CDM,46716_1,Reconstruction of absent anal opening,2629.9,1709.44,78.57,3554.23,19
CDM,46730_1,"Repair of absence of opening in anus, via incision of region between thighs or below sacrum",4329.4,2814.11,78.57,5759.46,19
CDM,46735_1,Repair of absence of opening in anus through incision of abdomen and region between thighs and below sacrum,5015.83,3260.29,78.57,6640.97,19
CDM,46740_1,Repair of absence of opening in anus and abnormal opening from rectum into urethra or vagina through region between thighs or below sacrum,4818.53,3132.04,78.57,6291.31,19
CDM,46742_1,Repair of absence of opening in anus and abnormal opening from rectum into urethra or vagina through abdomen or below sacrum,6398.3,4158.9,78.57,7282.65,19
CDM,46744_1,"Repair of defect for single channel outlet of rectum, vagina, and urinary tract through region between thighs or below sacrum",8082.35,5253.53,78.57,10268.8,19
CDM,46746_1,"Repair of defect for single channel outlet of rectum, vagina, and urinary tract through abdomen and region between thighs or below sacrum",8552.13,5558.88,78.57,11370.13,19
CDM,46748_1,"Repair of defect for single channel outlet of rectum, vagina, and urinary tract through incision of region between thighs or below sacrum with lengthening of vagina",11259.2,7318.48,78.57,12333.81,19
CDM,46750_1,"Repair of anal muscle for incontinence or prolapse, adult",2034.9,1322.69,78.57,2259.96,19
CDM,46751_1,"Repair of anal muscle for incontinence or prolapse, child",1413.58,918.83,78.57,1924.6,19
CDM,46753_1,"Repair of muscle of anus for incontinence and/or prolapse using wire, graft, or suture",1530.9,995.09,78.57,1796.83,19
CDM,46754_1,Removal of anal muscle wire or suture,701.38,455.9,78.57,837.9,19
CDM,46760_1,"Repair of anal muscle to correct incontinence using muscle transplant, adult",6107.5,3969.88,78.57,3310.43,19
CDM,46761_1,"Repair of anal muscle to correct incontinence with muscle tightening, adult",2030.7,1319.96,78.57,2764.73,19
CDM,46900010_1,HC SPECIMEN SHIPMENT,82409.0,53565.85,37084.05,57686.3,10
CDM,46900011_1,REV - OTHER RX SVCS,16.0,10.4,4.0,764.0,12
CDM,46900015_1,REV - OTHER RX SVCS,311.0,202.15,77.75,764.0,12
CDM,46900017_1,REV - OTHER RX SVCS,763.0,495.95,190.75,764.0,12
CDM,46900_1,Simple chemical destruction of growth of anus,581.7,378.11,26.54,574.49,19
CDM,46910_1,Simple destruction of growth of anus,611.1,397.22,34.95,630.56,19
CDM,46916_1,Electrical destruction of growth of anus,602.7,391.76,27.66,629.81,19
CDM,46917_1,Laser destruction of growth of anus,1140.3,741.2,22.52,1077.06,19
CDM,46922_1,Simple removal of growth of anus,638.4,414.96,33.4,753.2,19
CDM,46924_1,Extensive destruction of growth of anus,1298.9,844.29,78.57,1320.56,19
CDM,46930267_1,REV - PRO FEE/OTHER,2048.0,1331.2,819.2,1536.0,11
CDM,46930326_1,SPECIALTY SERVICES - TREATMENT ROOM,112.0,72.8,28.0,208.0,12
CDM,46930327_1,SPECIALTY SERVICES - TREATMENT ROOM,768.0,499.2,192.0,537.6,12
CDM,46930328_1,SPECIALTY SERVICES - TREATMENT ROOM,1564.0,1016.6,208.0,1094.8,12
CDM,46930_1,Destruction of internal hemorrhoids using heat,354.9,230.69,78.57,519.31,19
CDM,46940_1,Initial repair of anal tear with dilation of anal muscle,551.3,358.35,78.57,640.69,19
CDM,46942_1,Subsequent repair of anal tear with dilation of anal muscle,503.78,327.46,78.57,610.78,19
CDM,46945_1,Tying of single internal hemorrhoid group,731.9,475.74,78.57,899.35,19
CDM,46946_1,Tying of multiple internal hemorrhoid groups,772.8,502.32,78.57,1003.1,19
CDM,46947_1,Stapling of internal hemorrhoid,981.8,638.17,78.57,1132.98,19
CDM,46948_1,Tying of arteries to multiple internal hemorrhoid groups,1026.0,666.9,78.57,1324.88,19
CDM,469IP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",96.69,62.85,0.63,249.7,17
CDM,469OP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",18.63,12.11,0.63,48.11,17
CDM,469T1013_1,"SIGN LANGUAGE OR ORAL INTERPRETIVE SERVICES, PER 15 MINUTES",30.0,19.5,13.5,80.89,15
CDM,46_1,"Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule)",100.0,65.0,25.0,258.25,19
CDM,47000_1,Needle biopsy of liver through skin,934.5,607.43,39.02,730.21,19
CDM,47001_1,Needle biopsy of liver,286.7,186.36,78.57,303.58,19
CDM,47010_1,Drainage of abscess or cyst of liver,3191.0,2074.15,78.57,3560.97,19
CDM,47015_1,Injection and/or aspiration of abscess or cyst of liver,3149.0,2046.85,78.57,3408.5,19
CDM,470IP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",978.94,636.31,0.63,2528.11,17
CDM,470OP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",170.69,110.95,0.63,440.81,17
CDM,47100_1,Partial removal of liver tissue,2200.0,1430.0,78.57,2483.35,19
CDM,47120_1,Partial removal of liver lobe,6208.7,4035.66,78.57,6839.95,19
CDM,47122_1,Removal of right liver lobe with partial removal of left liver lobe,9246.3,6010.1,78.57,10050.62,19
CDM,47125_1,Removal of left liver lobe,8278.2,5380.83,78.57,9021.0,19
CDM,47130_1,Removal of right liver lobe,8903.0,5786.95,78.57,9691.0,19
CDM,47133_1,Removal of donor liver,4494.0,2921.1,73.6,2925.72,15
CDM,47135_1,Transplantation of donor liver,31500.0,20475.0,78.57,15737.16,19
CDM,47140_1,Partial removal of left segment of donor liver,9408.0,6115.2,78.57,10432.57,19
CDM,47141_1,Removal of left liver lobe of donor,11243.4,7308.21,78.57,12475.11,19
CDM,47142_1,Removal of right lobe of donor liver,12406.8,8064.42,78.57,13740.37,19
CDM,47143_1,Preparation of donor liver for transplantation,5250.0,3412.5,78.57,2925.72,15
CDM,47144_1,Preparation of donor liver for transplantation with split of liver graft,5250.0,3412.5,78.57,2798.51,15
CDM,47145_1,Preparation of donor liver for transplantation with lobe split of liver graft,2809.8,1826.37,78.57,2734.91,15
CDM,47146_1,Preparation of donor liver and vein grafts for transplantation,2100.0,1365.0,78.57,954.15,19
CDM,47147_1,Preparation of donor liver and artery grafts for transplantation,2450.0,1592.5,78.57,1116.9,19
CDM,4719IP _1,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",1.65,1.07,0.41,4.26,17
CDM,4720IP _1,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",15.28,9.93,0.43,39.46,17
CDM,4720OP _1,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",18.09,11.76,0.43,46.72,17
CDM,47230002_1,HC CONFIRMATION TYPING SAMPLE,3181.55,2068.0,1431.7,2227.08,10
CDM,47230003_1,HC ADDITIONAL BLOOD SAMPLES PRECOLLECT,3175.0,2063.75,1428.75,2222.5,10
CDM,47230004_1,HC DONOR LAB TESTS INFECTIOUS DZ MARKER,2589.42,1683.12,1165.24,1812.6,10
CDM,47230005_1,HC MARROW PROCUREMENT,230625.0,149906.25,103781.25,161437.5,10
CDM,47230006_1,HC DONOR INFO SESSION,4455.0,2895.75,2004.75,3118.5,10
CDM,47230007_1,HC DONOR PHYSICAL EXAM,15075.0,9798.75,6783.75,10552.5,10
CDM,47230009_1,HC WORK UP CANCELLATION,15435.0,10032.75,6945.75,10804.5,10
CDM,47230010_1,HC PBSC PRIMARY COLLECTION,199882.0,129923.3,89946.9,139917.4,10
CDM,47230017_1,HC UNSTIMULATED LEUKAPHERESIS,108295.0,70391.75,48732.75,75806.5,10
CDM,47230038_1,HC REGISTRY COORDINATION FEE,10940.0,7111.0,4923.0,7658.0,10
CDM,47240000_1,HC SEARCH ACTIVATION OTHER,3806.43,2474.18,1712.89,2664.5,10
CDM,47240002_1,HC CONFIRMATION TYPING SAMPLE OTHER,5278.11,3430.77,2375.15,3694.67,10
CDM,47240003_1,HC ADDITIONAL BLOOD SAMPLES PRECOLLCT OTHER,4914.11,3194.17,2211.35,3439.88,10
CDM,47240004_1,HC DONOR LAB TESTS INFECTIOUS DZ MARKERS OTHER,4230.83,2750.04,1903.87,2961.58,10
CDM,47240005_1,HC MARROW PROCUREMENT  OTHER,277360.0,180284.0,124812.0,194152.0,10
CDM,47240006_1,HC DONOR INFO SESSION OTHER,5240.08,3406.05,2358.03,3668.05,10
CDM,47240007_1,HC DONOR PHYSICAL EXAM OTHER,25783.33,16759.17,11602.5,18048.33,10
CDM,47240009_1,HC WORK UP CANCELLATION OTHER,28060.91,18239.59,12627.41,19642.64,10
CDM,47240010_1,HC PBSC PRIMARY COLLECTION OTHER,263419.66,171222.78,118538.84,184393.76,10
CDM,47240011_1,HC SECONDARY PBSC COLLECTION OTHER,263307.5,171149.88,118488.38,184315.25,10
CDM,47240014_1,DONOR INFORMATION SESSION OTHER,5341.67,3472.08,2403.75,3739.17,10
CDM,47240015_1,HC PBSC DONOR PHYSICAL EXAM OTHER,22660.0,14729.0,10197.0,15862.0,10
CDM,47240017_1,HC UNSTIMULATED LEUKAPHERESIS OTHER,135530.0,88094.5,60988.5,94871.0,10
CDM,47270100_1,"AXICABTAGENE CILOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3404000.0,2212600.0,65239.56,8790830.0,19
CDM,47270101_1,"AXICABTAGENE CILOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3404000.0,2212600.0,65239.56,8790830.0,19
CDM,47270200_1,"TISAGENLECLEUCEL, UP TO 600 MILLION CAR-POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3754000.0,2440100.0,65239.56,9694705.0,19
CDM,47270201_1,"TISAGENLECLEUCEL, UP TO 600 MILLION CAR-POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3754000.0,2440100.0,65239.56,9694705.0,19
CDM,47270300_1,"TISAGENLECLEUCEL, UP TO 600 MILLION CAR-POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3244000.0,2108600.0,65239.56,8377630.0,19
CDM,47270301_1,"TISAGENLECLEUCEL, UP TO 600 MILLION CAR-POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3244000.0,2108600.0,65239.56,8377630.0,19
CDM,47270400_1,"BREXUCABTAGENE AUTOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3123000.0,2029950.0,65239.56,8065147.5,19
CDM,47270401_1,"BREXUCABTAGENE AUTOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3123000.0,2029950.0,65239.56,8065147.5,19
CDM,47270500_1,"LISOCABTAGENE MARALEUCEL, UP TO 110 MILLION AUTOLOGOUS ANTI-CD19 CAR-POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3459000.0,2248350.0,65239.56,8932867.5,19
CDM,47270501_1,"LISOCABTAGENE MARALEUCEL, UP TO 110 MILLION AUTOLOGOUS ANTI-CD19 CAR-POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3459000.0,2248350.0,65239.56,8932867.5,19
CDM,47270600_1,"IDECABTAGENE VICLEUCEL, UP TO 510 MILLION AUTOLOGOUS B-CELL MATURATION ANTIGEN (BCMA) DIRECTED CAR-POSITIVE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3374000.0,2193100.0,65239.56,8713355.0,19
CDM,47270601_1,"IDECABTAGENE VICLEUCEL, UP TO 510 MILLION AUTOLOGOUS B-CELL MATURATION ANTIGEN (BCMA) DIRECTED CAR-POSITIVE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3374000.0,2193100.0,65239.56,8713355.0,19
CDM,47270700_1,"CILTACABTAGENE AUTOLEUCEL, UP TO 100 MILLION AUTOLOGOUS B-CELL MATURATION ANTIGEN (BCMA) DIRECTED CAR-POSITIVE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3547000.0,2305550.0,65239.56,9160127.5,19
CDM,47270701_1,"CILTACABTAGENE AUTOLEUCEL, UP TO 100 MILLION AUTOLOGOUS B-CELL MATURATION ANTIGEN (BCMA) DIRECTED CAR-POSITIVE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3547000.0,2305550.0,886750.0,9160127.5,16
CDM,47270800_1,UNCLASSIFIED DRUGS,3548000.0,2306200.0,887000.0,9162710.0,16
CDM,47270801_1,UNCLASSIFIED DRUGS,3548000.0,2306200.0,887000.0,9162710.0,16
CDM,47271000_1,UNCLASSIFIED DRUGS OR BIOLOGICALS,1943500.0,1263275.0,874575.0,5019088.75,14
CDM,47280101_1,"INJECTION, ETRANACOGENE DEZAPARVOVEC-DRLB, PER THERAPEUTIC DOSE",5250000.0,3412500.0,34364.93,13558125.0,19
CDM,47280201_1,"INJECTION, VALOCTOCOGENE ROXAPARVOVEC-RVOX, PER ML, CONTAINING NOMINAL 2 X 10^13 VECTOR GENOMES",18375.0,11943.75,4593.75,47453.44,17
CDM,47280300_1,"INJECTION, EXAGAMGLOGENE AUTOTEMCEL, PER TREATMENT",4620000.0,3003000.0,1155000.0,11931150.0,17
CDM,47290100_1,UNCLASSIFIED DRUGS,3789000.0,2462850.0,947250.0,9785092.5,16
CDM,472IP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",126.8,82.42,0.63,327.46,17
CDM,472OP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",14.0,9.1,0.63,36.16,17
CDM,47300_1,Creation of tract to drain abscess or cyst of liver,2967.3,1928.75,78.57,3320.58,19
CDM,47350_1,Suture of simple liver wound to control bleeding,3637.2,2364.18,78.57,4021.75,19
CDM,47360_1,Control of bleeding of wound of liver with complex suture,4963.4,3226.21,78.57,5492.21,19
CDM,47361_1,"Control of bleeding of liver with exploration, removal of tissue, suture or cautery",8161.7,5305.11,78.57,8902.72,19
CDM,47362_1,Re-exploration of liver wound with removal of packing,3783.2,2459.08,78.57,4247.56,19
CDM,47370_1,Destruction of growths of liver using an endoscope,3321.2,2158.78,78.57,3661.65,19
CDM,47371_1,Destruction of growth of liver by freezing using an endoscope,2880.55,1872.36,78.57,3639.94,19
CDM,47380_1,Destruction of growth of liver using radiofrequency,3890.3,2528.7,78.57,4243.82,19
CDM,47381_1,Destruction of growth of liver using freezing,3966.9,2578.49,78.57,4312.13,19
CDM,47382_1,Destruction of growth of liver through skin using radiofrequency,2492.7,1620.26,78.57,8899.65,19
CDM,47383_1,Destruction of growth of liver through skin using freezing,1235.9,803.34,78.57,14443.46,19
CDM,47384_1,"ABLATION, IRREVERSIBLE ELECTROPORATION, LIVER, 1 OR MORE TUMORS, INCLUDING IMAGING GUIDANCE, PERCUTANEOUS",994.0,646.1,73.6,1023.82,16
CDM,473IP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",178.05,115.73,0.63,459.81,17
CDM,47400_1,Incision or creation of opening of liver with drainage or removal of bile duct stone,5702.6,3706.69,78.57,6304.12,19
CDM,47420_1,Incision or creation of opening of gallbladder with drainage or removal of bile duct stone,3557.4,2312.31,78.57,3932.22,19
CDM,47425_1,Drainage or removal of bile duct stone with redirection of bile flow and incision or repair of gallbladder sphincter,3596.3,2337.6,78.57,4003.28,19
CDM,47460_1,Repair of bile duct,3399.9,2209.94,78.57,3711.38,19
CDM,47480_1,Drainage or removal of stone from gallbladder,2260.7,1469.46,78.57,2577.32,19
CDM,47490_1,Insertion of tube into gallbladder using imaging guidance with review by radiologist,1487.9,967.14,78.57,1017.31,19
CDM,474IP _1,"INJECTION, AMPICILLIN SODIUM, 500 MG",348.75,226.69,0.63,900.65,17
CDM,4750IP _1,"INJECTION, MANNITOL, 25% IN 50 ML",1.31,0.85,0.33,3.38,16
CDM,47531_1,Injection of bile duct for X-ray through already existing skin access using imaging guidance with review by radiologist,866.0,562.9,57.75,1030.85,19
CDM,47532_1,Injection of bile duct for X-ray through new skin access using imaging guidance with review by radiologist,1903.0,1236.95,78.57,2031.81,19
CDM,47533_1,Placement of external drainage tube of biliary duct using imaging guidance with review by radiologist,3099.0,2014.35,78.57,2828.59,19
CDM,47534_1,Placement of internal-external drainage tube of biliary duct using imaging guidance with review by radiologist,3820.0,2483.0,78.57,3102.73,19
CDM,47535_1,Conversion of external biliary drainage tube to internal-external biliary drainage tube using imaging guidance and study of bile duct with review by radiologist,2558.0,1662.7,78.57,2154.07,19
CDM,47536_1,Replacement of liver duct drainage tube using imaging guidance with review by radiologist,1892.0,1229.8,78.57,1544.4,19
CDM,47537_1,Removal of biliary drainage tube using imaging guidance with review by radiologist,934.0,607.1,78.34,1195.64,19
CDM,47538_1,Placement of stent of biliary duct through existing skin access using imaging guidance with review by radiologist,10401.0,6760.65,78.57,9141.62,19
CDM,47539_1,Placement of stent of biliary duct through new skin access using imaging with review by radiologist,11375.0,7393.75,78.57,10193.27,19
CDM,47540_1,Placement of stent and drainage tube of biliary duct using imaging guidance with review by radiologist,11834.0,7692.1,78.57,10287.42,19
CDM,47541_1,Placement of access device into biliary tract using imaging guidance with review by radiologist,2741.0,1781.65,78.57,2815.06,19
CDM,47542_1,Balloon dilation of bile duct using imaging guidance with review by radiologist,1184.0,769.6,78.57,1209.67,19
CDM,47543_1,Biopsy of bile duct or liver duct using imaging guidance with review by radiologist,1245.0,809.25,78.57,950.54,19
CDM,47544_1,Removal of biliary duct or gallbladder stone using imaging guidance with review by radiologist,1887.0,1226.55,78.57,2028.48,19
CDM,47550_1,Exam of bile duct during surgery using an endoscope,577.5,375.38,78.57,483.1,19
CDM,47552_1,Diagnostic exam of bile duct using an endoscope,967.1,628.62,78.57,846.18,19
CDM,47553_1,Biopsy of bile duct using an endoscope,976.5,634.73,78.57,851.84,19
CDM,47554_1,Removal of bile duct stones using an endoscope,1398.6,909.09,78.57,1506.61,19
CDM,47555_1,Dilation of bile ducts using an endoscope,1170.8,761.02,78.57,1013.42,19
CDM,47556_1,Dilation of bile ducts with stent insertion using an endoscope,1324.1,860.67,78.57,1147.83,19
CDM,47562_1,Removal of gallbladder using an endoscope,2210.0,1436.5,78.57,1929.36,19
CDM,47563_1,Removal of gallbladder with X-ray study of bile ducts using an endoscope,2362.5,1535.63,78.57,2096.52,19
CDM,47564_1,Removal of gallbladder with exploration of common bile duct using an endoscope,2572.5,1672.13,78.57,3261.83,19
CDM,47570_1,Connection of gallbladder to bowel using an endoscope,2205.0,1433.25,78.57,2269.17,19
CDM,47600_1,Removal of gallbladder,2820.3,1833.2,78.57,3131.8,19
CDM,47605_1,Removal of gallbladder with X-ray study of bile ducts,2596.7,1687.86,78.57,3293.03,19
CDM,47610_1,Removal of gallbladder with exploration of common bile duct,3334.8,2167.62,78.57,3674.02,19
CDM,47612_1,Removal of gallbladder and creation of bile duct drainage to bowel,3885.0,2525.25,78.57,3704.51,19
CDM,47620_1,Removal of gallbladder and incision or repair of gallbladder sphincter,3659.3,2378.55,78.57,4016.58,19
CDM,47700_1,Exploration of congenital bile duct defect,2766.8,1798.42,78.57,3090.59,19
CDM,47701_1,Connection of portion of upper small bowel to bile duct,4758.6,3093.09,78.57,5050.3,19
CDM,47711_1,Removal of growth of bile duct external to liver,4142.3,2692.5,78.57,4562.66,19
CDM,47712_1,Removal of growth of bile duct within liver,4582.13,2978.38,78.57,5841.72,19
CDM,47715_1,Removal of cyst of gallbladder,3480.8,2262.52,78.57,3890.23,19
CDM,47720_1,Creation of drainage tract from gallbladder to small bowel,3006.2,1954.03,78.57,3378.8,19
CDM,47721_1,Creation of drainage tract from gallbladder to small bowel and from stomach to small bowel,3549.0,2306.85,78.57,3967.87,19
CDM,47740_1,Creation of drainage tract from gallbladder to small bowel using Roux-en-Y connection,3430.4,2229.76,78.57,3832.24,19
CDM,47741_1,Creation of drainage tract from gallbladder to small bowel using Roux-en-Y connection and creation of drainage tract from stomach to small bowel,3885.0,2525.25,78.57,4319.53,19
CDM,47760_1,Connection of bile duct external to liver to small bowel,5904.2,3837.73,78.57,6605.88,19
CDM,47765_1,Connection of bile duct within liver to small bowel,7859.3,5108.55,78.57,8875.66,19
CDM,47780_1,Roux-en-Y connection of bile duct external to liver to small bowel,6471.2,4206.28,78.57,7247.3,19
CDM,47785_1,Connection of bile duct within liver to small bowel using Roux-en-Y connection,8465.1,5502.32,78.57,9511.09,19
CDM,47800_1,Reconstruction of bile duct,4182.2,2718.43,78.57,4612.06,19
CDM,47801_1,Insertion of stent into bile duct,2890.7,1878.96,78.57,3262.61,19
CDM,47900_1,Suture of injured bile duct,3616.2,2350.53,78.57,4016.24,19
CDM,47_1,"Haemophilus influenzae type b vaccine, PRP-OMP conjugate",50.0,32.5,12.5,129.13,19
CDM,48000_1,"Insertion of external drains from gallbladder, bile duct, and small bowel for acute pancreatitis",5031.6,3270.54,78.57,5509.84,19
CDM,48001_1,Insertion of external drains around pancreas for acute pancreatitis,5302.35,3446.53,78.57,6737.65,19
CDM,48020_1,Removal of pancreatic duct stones,3096.5,2012.73,78.57,3448.14,19
CDM,48100_1,Biopsy of pancreas,2351.0,1528.15,78.57,2612.18,19
CDM,48102_1,Needle biopsy of pancreas,1378.7,896.16,78.57,1249.35,19
CDM,48105_1,Removal of pancreatic tissue,7620.9,4953.59,78.57,8360.46,19
CDM,48120_1,Removal of growth of pancreas,2936.9,1908.99,78.57,3246.24,19
CDM,48140_1,Partial removal of pancreas,4158.0,2702.7,78.57,4586.1,19
CDM,48145_1,Partial removal of pancreas with connection of pancreas to small bowel,4317.6,2806.44,78.57,4775.9,19
CDM,48146_1,"Partial removal of pancreas with connection of pancreas to small bowel, with preservation of first part of small bowel",4924.5,3200.93,78.57,5505.66,19
CDM,48148_1,Partial removal of pancreatic and common bile ducts,3270.8,2126.02,78.57,3654.12,19
CDM,48150_1,"Partial removal of pancreas, bile duct, and small bowel with connection of pancreas to small bowel",8310.8,5402.02,78.57,9126.73,19
CDM,48152_1,"Partial removal of pancreas, bile duct, stomach, and small bowel",7685.0,4995.25,78.57,8451.41,19
CDM,48153_1,"Near total removal of pancreas, bile duct, and small bowel with connection of pancreas to small bowel",8300.3,5395.2,78.57,9093.97,19
CDM,48154_1,"Partial removal of pancreas, bile duct, and small bowel",7703.9,5007.54,78.57,8493.37,19
CDM,48155_1,Removal of pancreas,5046.3,3280.1,78.57,5322.98,19
CDM,48160_1,Removal of pancreas with pancreatic cell transplantation,10000.0,6500.0,78.57,10300.0,15
CDM,48400_1,Injection for X-ray study of pancreas during surgery,306.6,199.29,78.57,311.7,19
CDM,48500_1,Creation of drainage tract of cyst of pancreas,2992.5,1945.13,78.57,3372.51,19
CDM,48510_1,Insertion of drain from cyst of pancreas into abdominal cavity,2986.2,1941.03,78.57,3213.59,19
CDM,48520_1,Creation of direct drainage tract from cyst of pancreas to small bowel,2903.3,1887.15,78.57,3198.9,19
CDM,48540_1,Creation of drainage tract from cyst of pancreas to small bowel,3467.1,2253.62,78.57,3826.93,19
CDM,48545_1,Suture of pancreatic injury,3519.6,2287.74,78.57,3932.61,19
CDM,48547_1,Repair of pancreatic injury,3756.9,2441.99,78.57,5239.4,19
CDM,48548_1,Creation of pancreatic drainage tract from pancreas and upper small bowel,3647.7,2371.01,78.57,4870.1,19
CDM,4854IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.93,7.1,2.73,28.23,16
CDM,4854OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.52,8.79,3.38,34.92,16
CDM,48550_1,Removal of donor pancreas,3150.0,2047.5,73.6,1908.08,15
CDM,48551_1,Preparation of donor pancreas for transplantation,4200.0,2730.0,78.57,2289.69,15
CDM,48552_1,Preparation of donor pancreas and vein grafts for transplantation,644.7,419.06,78.57,688.27,19
CDM,48554_1,Transplantation of donor pancreas,13230.0,8599.5,78.57,7495.72,19
CDM,48556_1,Removal of transplanted donor pancreas,3281.3,2132.85,78.57,3733.74,19
CDM,4855IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.61,1.7,0.65,6.74,16
CDM,4855OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.72,19.32,7.43,76.75,16
CDM,4870IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
CDM,4870OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.85,7.05,2.71,28.02,16
CDM,4871IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.03,3.92,1.51,15.57,16
CDM,4871OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.52,14.64,5.63,58.16,16
CDM,48_1,ACTHIB VACCINE VIAL,21.27,13.83,5.32,14.89,11
CDM,49000T_1,Exploration of abdominal cavity,2137.8,1389.57,78.57,2263.77,19
CDM,49000_1,Exploration of abdominal cavity,2059.1,1338.42,78.57,2263.77,19
CDM,49002_1,Reopening of recent abdominal incision,2740.5,1781.33,78.57,3073.08,19
CDM,49010_1,Exploration behind abdominal cavity,2573.6,1672.84,78.57,2735.51,19
CDM,49013_1,Exploration and packing of wound in pelvic region,1029.5,669.18,78.57,1305.45,19
CDM,49014_1,Re-exploration of pelvic region wound with removal of wound packing,852.0,553.8,78.57,1080.5,19
CDM,49020_1,Drainage of abdominal abscess or infection,4244.1,2758.67,78.57,4679.61,19
CDM,49040_1,Drainage of abscess of diaphragm,2660.7,1729.46,78.57,2935.9,19
CDM,49060_1,Drainage of abscess behind abdominal cavity,2986.2,1941.03,78.57,3234.67,19
CDM,49062_1,Drainage of fluid accumulation of abdomen,2017.1,1311.12,78.57,2175.04,19
CDM,49082_1,Drainage of fluid from abdominal cavity,480.0,312.0,65.14,508.59,19
CDM,49083_1,Drainage of fluid from abdominal cavity using imaging guidance,606.0,393.9,78.57,711.77,19
CDM,49084_1,Irrigation of abdominal cavity,329.7,214.31,78.57,317.34,19
CDM,49180_1,Needle biopsy of growth of abdominal cavity,868.4,564.46,66.74,422.58,19
CDM,49185_1,Injection of chemical agent into fluid collection using imaging guidance,1032.0,670.8,78.57,3070.95,19
CDM,49186_1,"Removal or destruction of growth(s) in the abdomen, 5.0 cm or less",2810.0,1826.5,78.57,3361.77,19
CDM,49187_1,"Removal or destruction of growth(s) in the abdomen, 5.1 to 10.0 cm",3886.0,2525.9,78.57,4262.18,19
CDM,49188_1,"Removal or destruction of growth(s) in the abdomen, 10.1 to 20.0 cm",4645.0,3019.25,78.57,5093.73,19
CDM,49189_1,"Removal or destruction of growth(s) in the abdomen, 20.1 to 30.0 cm",5400.0,3510.0,78.57,5921.92,19
CDM,49190_1,"Removal or destruction of growth(s) in the abdomen, more than 30.0 cm",6664.0,4331.6,78.57,7310.66,19
CDM,49215_1,Removal of growth of pelvis or sacrum,5935.7,3858.21,78.57,6549.12,19
CDM,49250_1,Removal of navel and surrounding tissue,1536.2,998.53,78.57,1732.23,19
CDM,49255_1,Removal of lining covering abdominal organs,2089.5,1358.18,78.57,2335.06,19
CDM,49320_1,Diagnostic exam of abdomen using an endoscope,1286.3,836.1,78.57,964.29,19
CDM,49321_1,Biopsy of abdomen using an endoscope,1365.0,887.25,78.57,1017.56,19
CDM,49322_1,Aspiration of abdominal cavity or cyst using an endoscope,1417.5,921.38,78.57,1096.14,19
CDM,49323_1,Drainage of lymph fluid to abdominal cavity using an endoscope,1712.6,1113.19,78.57,1879.17,19
CDM,49324_1,Insertion of abdominal cavity tube using an endoscope,879.9,571.94,78.57,1137.93,19
CDM,49325_1,Revision of abdominal cavity tube using an endoscope,1124.6,730.99,78.57,1212.47,19
CDM,49326_1,Suture of internal abdominal lining using an endoscope,450.0,292.5,78.57,551.45,19
CDM,49327_1,Exam of abdomen with insertion of device for radiation therapy using an endoscope,300.25,195.16,78.57,380.29,19
CDM,49400_1,Injection of air or X-ray contrast into abdominal cavity,484.1,314.67,42.9,361.85,19
CDM,49402_1,Removal of foreign body in abdominal cavity,1866.9,1213.49,78.57,2513.65,19
CDM,49405_1,Drainage of fluid collection by tube through skin using imaging guidance,2808.8,1825.72,78.57,2153.16,19
CDM,49406_1,Drainage of fluid collection of abdominal cavity by tube using imaging guidance,2807.7,1825.01,78.57,2153.96,19
CDM,49407_1,Drainage of fluid collection by tube through vagina or rectum using imaging guidance,2374.1,1543.17,78.57,1819.23,19
CDM,49411_1,Insertion of device in abdominal cavity through skin for radiation therapy guidance,1417.5,921.38,73.35,1168.39,19
CDM,49412_1,Insertion of device in abdominal cavity for radiation therapy guidance,190.33,123.71,64.79,240.56,19
CDM,49418_1,Insertion of abdominal tube using imaging guidance with review by radiologist,3745.4,2434.51,78.57,2385.79,19
CDM,49419_1,Insertion of abdominal cavity tube for drug delivery,1090.0,708.5,78.57,1279.47,19
CDM,49421_1,Insertion of abdominal cavity tube for drainage or dialysis,820.0,533.0,78.57,666.96,19
CDM,49422_1,Removal of abdominal cavity tube,1043.7,678.41,78.57,653.0,19
CDM,49423_1,Exchange of abdominal cavity drainage tube using imaging guidance,615.0,399.75,31.12,1432.82,19
CDM,49424_1,Injection of contrast through abdominal cavity tube for X-ray study,413.7,268.91,30.22,442.42,19
CDM,49425_1,Insertion of shunt from jugular vein to abdominal cavity,2039.1,1325.42,78.57,2128.98,19
CDM,49426_1,Revision of shunt from jugular vein to abdominal cavity,1771.4,1151.41,78.57,1818.85,19
CDM,49427_1,Injection for X-ray study of shunt from jugular vein to abdominal cavity,138.6,90.09,32.91,165.37,19
CDM,49428_1,Closure of shunt from jugular vein to abdominal cavity,1034.3,672.3,78.57,1262.55,19
CDM,49429_1,Removal of shunt from jugular vein to abdominal cavity,1391.3,904.35,78.57,1341.6,19
CDM,49435_1,Insertion of abdominal cavity tube extension,274.33,178.31,78.57,347.63,19
CDM,49436_1,Creation of exit site for tube in abdominal cavity,428.63,278.61,78.57,1294.13,19
CDM,49440_1,Insertion of stomach tube using fluoroscopic guidance with contrast,2941.1,1911.72,55.08,2021.48,19
CDM,49441_1,Insertion of small bowel tube using fluoroscopic guidance with contrast,3462.9,2250.89,78.57,2289.93,19
CDM,49442_1,Insertion of large bowel tube using fluoroscopic guidance with contrast,2870.7,1865.96,48.9,1933.84,19
CDM,49446_1,Conversion of stomach tube to stomach-to-small bowel tube using fluoroscopic guidance with contrast,2423.4,1575.21,31.64,1938.98,19
CDM,49450_1,Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast,859.5,558.68,7.07,1449.63,19
CDM,49451_1,Replacement of small bowel tube using fluoroscopic guidance with contrast,771.0,501.15,14.12,1550.47,19
CDM,49452_1,Replacement of stomach-to-small bowel tube using fluoroscopic guidance with contrast,2610.0,1696.5,27.17,1884.25,19
CDM,49460_1,"Mechanical removal of obstructive material from stomach, large, or small bowel tube using fluoroscopic guidance",1623.3,1055.15,3.27,1701.94,19
CDM,49465_1,"Contrast injection for X-ray imaging through existing tube in stomach, small bowel or large bowel",428.4,278.46,24.19,329.8,19
CDM,49491_1,Repair of groin hernia in preterm infant younger than 37 weeks gestation performed from birth to 50 weeks postconception,2058.0,1337.7,78.57,2325.15,19
CDM,49492_1,Repair of trapped groin hernia in preterm infant younger than 37 weeks gestation performed from birth to 50 weeks postconception,2482.2,1613.43,78.57,2801.48,19
CDM,49495_1,Repair of groin hernia in full term infant younger than 6 months or preterm infant older than 50 weeks of age postconception and younger than 6 months at time of surgery,1417.5,921.38,78.57,1198.71,19
CDM,49496_1,Repair of trapped groin hernia in full term infant younger than 6 months or preterm infant older than 50 weeks postconception and younger than 6 months at time of surgery,1586.6,1031.29,78.57,1797.27,19
CDM,49500_1,Repair of groin hernia (6 months to younger than 5 years),1286.3,836.1,78.57,1199.35,19
CDM,49501_1,Repair of trapped groin hernia (6 months to younger than 5 years),1571.9,1021.74,78.57,1772.31,19
CDM,49505T_1,Repair of groin hernia (5 years or older),1438.25,934.86,78.57,1526.44,19
CDM,49505_1,Repair of groin hernia (5 years or older),2116.8,1375.92,78.57,1526.44,19
CDM,49507_1,Repair of trapped groin hernia (5 years or older),2512.2,1632.93,78.57,1717.88,19
CDM,49520_1,Repair of groin hernia that is not trapped,1662.2,1080.43,78.57,1851.94,19
CDM,49521_1,Repair of trapped or strangulated groin hernia,2029.7,1319.31,78.57,2099.38,19
CDM,49525_1,Repair of sliding groin hernia,1574.0,1023.1,78.57,1681.43,19
CDM,4952IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.46,10.05,3.87,39.93,16
CDM,4952OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.54,9.45,3.64,37.55,16
CDM,4953IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.94,4.51,1.74,17.92,16
CDM,4953OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.84,9.65,3.71,38.32,16
CDM,49540_1,Repair of abdominal muscle hernia,1778.7,1156.16,78.57,1978.39,19
CDM,4954IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.75,10.24,3.94,40.67,16
CDM,4954OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.42,10.02,3.86,39.82,16
CDM,49550_1,Repair of femoral groin hernia,1509.9,981.44,78.57,1687.97,19
CDM,49553_1,Repair of trapped femoral groin hernia,1653.8,1074.97,78.57,1851.92,19
CDM,49555_1,Repair of recurrent femoral groin hernia,1571.9,1021.74,78.57,1753.75,19
CDM,49557_1,Repair of trapped recurrent femoral groin hernia,1911.0,1242.15,78.57,2119.63,19
CDM,49591_1,"Initial repair of sliding hernia of abdomen, less than 3 cm in length",735.5,478.08,78.57,971.02,19
CDM,49592_1,"Initial repair of entrapped hernia of abdomen, less than 3 cm in length",1021.0,663.65,78.57,1348.02,19
CDM,49593_1,"Initial repair of sliding hernia of abdomen, 3-10 cm in length",1231.5,800.48,78.57,1625.94,19
CDM,49594_1,"Initial repair of entrapped hernia of abdomen, 3-10 cm in length",1601.0,1040.65,78.57,2113.57,19
CDM,49595_1,"Initial repair of sliding hernia of abdomen, more than 10 cm in length",1656.5,1076.73,78.57,2187.05,19
CDM,49596_1,"Initial repair of entrapped hernia of abdomen, more than 10 cm in length",2201.5,1430.98,78.57,2906.33,19
CDM,49600_1,Repair of small defect of abdominal wall at navel,1939.4,1260.61,78.57,2134.68,19
CDM,49605_1,Repair of large defect of abdominal wall at navel,13464.2,8751.73,78.57,14385.06,19
CDM,49606_1,Repair of defect of abdominal wall at navel with removal of prosthesis,3027.2,1967.68,78.57,3314.43,19
CDM,49610_1,"Repair of defect of abdominal wall at navel, stage 1 of 2",1812.3,1178.0,78.57,2016.23,19
CDM,49611_1,"Repair of defect of abdominal wall at navel, stage 2 or 2",1601.3,1040.85,78.57,1777.33,19
CDM,49613_1,"Repair of recurrent sliding hernia of abdomen, less than 3 cm in length",908.0,590.2,78.57,1190.84,19
CDM,49614_1,"Repair of recurrent entrapped hernia of abdomen, less than 3 cm in length",1228.5,798.53,78.57,1611.5,19
CDM,49615_1,"Repair of recurrent sliding hernia of abdomen, 3-10 cm in length",1374.0,893.1,78.57,1802.62,19
CDM,49616_1,"Repair of recurrent entrapped hernia of abdomen, 3-10 cm in length",1843.5,1198.28,78.57,2418.15,19
CDM,49617_1,"Repair of recurrent sliding hernia of abdomen, more than 10 cm in length",1905.0,1238.25,78.57,2498.91,19
CDM,49618_1,"Repair of recurrent entrapped hernia of abdomen, more than 10 cm in length",2665.5,1732.58,78.57,3496.54,19
CDM,49621_1,Repair of sliding hernia next to stoma,1611.0,1047.15,78.57,2113.56,19
CDM,49622_1,Repair of entrapped hernia next to stoma,1989.5,1293.18,78.57,2609.6,19
CDM,49623_1,Removal of mesh at same time as hernia repair,429.0,278.85,78.57,562.35,19
CDM,49650_1,Repair of groin hernia using an endoscope,2047.5,1330.88,78.57,1258.39,19
CDM,49651_1,Repair of recurrent groin hernia using an endoscope,2480.7,1612.46,78.57,1636.6,19
CDM,4971IP _1,METHOCARBAMOL 500 MG TABLET,3.02,1.96,0.76,2.11,11
CDM,4971OP _1,METHOCARBAMOL 500 MG TABLET,5.6,3.64,1.4,3.92,11
CDM,4972IP _1,METHOCARBAMOL 750 MG TABLET,3.78,2.46,0.95,2.65,11
CDM,4972OP _1,METHOCARBAMOL 750 MG TABLET,5.73,3.72,1.43,4.01,11
CDM,4973IP _1,"METHOTREXATE; ORAL, 2.5 MG",23.88,15.52,0.16,61.67,17
CDM,4973OP _1,"METHOTREXATE; ORAL, 2.5 MG",4.15,2.7,0.16,10.72,17
CDM,4974IP _1,"INJECTION, METHOTREXATE SODIUM, 50 MG",160.66,104.43,2.73,481.98,17
CDM,4974OP _1,"INJECTION, METHOTREXATE SODIUM, 50 MG",6.4,4.16,1.6,19.2,17
CDM,4985IP _1,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",101.38,65.9,10.4,261.81,17
CDM,4985OP _1,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",77.92,50.65,10.4,201.23,17
CDM,4986IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.6,10.79,4.15,42.87,16
CDM,4986OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.58,9.48,3.65,37.65,16
CDM,4988IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",50.1,32.57,12.53,129.38,16
CDM,4988OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.14,5.29,2.04,21.02,16
CDM,49900_1,Suture of postsurgical opening in abdominal wall,2145.2,1394.38,78.57,2401.4,19
CDM,49904_1,Harvest of abdominal cavity lining for grafting,4003.7,2602.41,78.57,4148.86,19
CDM,49905_1,Repair of abdomen using abdominal lining graft,1391.3,904.35,78.57,1039.31,19
CDM,49906_1,Harvesting of graft from lining of abdominal cavity and blood vessels,26500.0,17225.0,78.57,13250.0,15
CDM,4992IP _1,"METHYLPREDNISOLONE ORAL, PER 4 MG",18.47,12.01,0.15,47.7,17
CDM,4992OP _1,"METHYLPREDNISOLONE ORAL, PER 4 MG",25.25,16.41,0.15,65.21,17
CDM,4993IP _1,"METHYLPREDNISOLONE ORAL, PER 4 MG",16.2,10.53,0.15,41.84,17
CDM,4993OP _1,"METHYLPREDNISOLONE ORAL, PER 4 MG",44.26,28.77,0.15,114.3,17
CDM,4995IP _1,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",69.6,45.24,0.13,179.74,17
CDM,4995OP _1,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",64.25,41.76,0.13,165.93,17
CDM,4996IP _1,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",89.87,58.42,0.13,232.09,17
CDM,4996OP _1,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",128.3,83.4,0.13,331.33,17
CDM,50010_1,Exploration of kidney,2074.8,1348.62,78.57,2161.67,19
CDM,50020_1,Drainage of abscess of kidney,3004.1,1952.67,78.57,3105.6,19
CDM,5002IP _1,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",49.0,31.85,1.14,126.54,17
CDM,5002OP _1,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",37.88,24.62,1.14,97.83,17
CDM,50040_1,Insertion of tube for drainage of kidney,2778.3,1805.9,78.57,2834.59,19
CDM,50045_1,Incision of kidney with exploration,2797.2,1818.18,78.57,2856.37,19
CDM,5005IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.5,10.73,4.13,42.61,16
CDM,5005OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.64,19.92,7.66,79.13,16
CDM,50060_1,Removal of kidney stone,3454.5,2245.43,78.57,3486.89,19
CDM,50065_1,"Removal of kidney stone, secondary procedure",2906.25,1889.06,78.57,3696.24,19
CDM,5006IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.24,5.36,2.06,21.28,16
CDM,5006OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.32,12.56,4.83,49.89,16
CDM,50070_1,Removal of kidney stone complicated by congenital abnormality,2946.53,1915.24,78.57,3624.68,19
CDM,50075_1,Removal of kidney stones,4437.3,2884.25,78.57,4455.53,19
CDM,5007IP _1,UNCLASSIFIED DRUGS,15.94,10.36,3.99,41.17,16
CDM,5007OP _1,UNCLASSIFIED DRUGS,14.08,9.15,3.52,36.36,16
CDM,50080_1,Simple surgical treatment of kidney stone with imaging guidance,2782.5,1808.63,78.57,2660.0,19
CDM,50081_1,Complex surgical treatment of kidney stone with imaging guidance,5811.75,3777.64,78.57,3909.56,19
CDM,5008IP _1,UNCLASSIFIED DRUGS,3.89,2.53,0.97,10.05,16
CDM,5008OP _1,UNCLASSIFIED DRUGS,50.68,32.94,12.67,130.88,16
CDM,5009IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.84,2.5,0.96,9.92,16
CDM,5009OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.75,11.54,4.44,45.84,16
CDM,50100_1,Incision or repositioning of abnormal kidney blood vessel,2882.3,1873.5,78.57,3124.32,19
CDM,50120_1,Incision of renal pelvis of kidney with exploration,2855.0,1855.75,78.57,2908.1,19
CDM,50125_1,Incision of renal pelvis of kidney with drainage,3013.5,1958.78,78.57,3009.78,19
CDM,50130_1,Incision of renal pelvis of kidney with removal of kidney stone,3129.0,2033.85,78.57,3162.09,19
CDM,5015IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.45,3.54,1.36,14.07,16
CDM,5015OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.38,5.45,2.1,21.64,16
CDM,5016IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.89,4.48,1.72,17.79,16
CDM,5016OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.09,12.41,4.77,49.3,16
CDM,5018IP _1,"INJECTION, METRONIDAZOLE, 10 MG",1.18,0.77,0.03,3.05,17
CDM,50200_1,Needle biopsy of kidney,2142.0,1392.3,78.57,1248.65,19
CDM,50205_1,Biopsy of kidney,2037.0,1324.05,78.57,2220.04,19
CDM,50220_1,Removal of kidney and partial removal of ureter,4613.25,2998.61,78.57,3178.82,19
CDM,50225_1,Removal of kidney and partial removal of ureter complicated by previous surgery on same kidney,3567.9,2319.14,78.57,3654.52,19
CDM,50230_1,"Removal of kidney, lymph nodes, and/or blood clot from major vein with partial removal of ureter",4121.3,2678.85,78.57,3900.08,19
CDM,50234_1,Removal of kidney and ureter with partial removal of bladder through same incision,3930.2,2554.63,78.57,3978.53,19
CDM,50236_1,Removal of kidney and ureter with partial removal of bladder through separate incision,4445.7,2889.71,78.57,4481.04,19
CDM,50240_1,Partial removal of kidney,3994.2,2596.23,78.57,4055.48,19
CDM,50250_1,Destruction of growth of kidney,2947.4,1915.81,78.57,3724.3,19
CDM,50280_1,Removal or unroofing cysts of kidney,4263.6,2771.34,78.57,2915.96,19
CDM,50290_1,Removal of cysts of kidney,2613.5,1698.78,78.57,2753.83,19
CDM,50300_1,Removal of donor kidney,3150.0,2047.5,73.6,2217.4,15
CDM,50320_1,Removal of donor kidney from living donor,5095.7,3312.21,78.57,4397.83,19
CDM,50323_1,Preparation of donor kidney for transplantation,4200.0,2730.0,78.57,2100.0,15
CDM,50325_1,Preparation of living donor kidney for transplantation,4200.0,2730.0,78.57,2100.0,15
CDM,50327_1,Preparation of donor kidney and veins for transplantation,602.7,391.76,78.57,635.58,19
CDM,50328_1,Preparation of donor kidney and arteries for transplantation,536.6,348.79,78.57,557.41,19
CDM,50329_1,Preparation of donor kidney and ureter for transplantation,5880.0,3822.0,78.57,530.66,19
CDM,50340_1,Removal of kidney from patient receiving donor kidney,2437.1,1584.12,78.57,2776.84,19
CDM,50360_1,Transplantation of donor kidney,13958.0,9072.7,78.57,7097.48,19
CDM,50365_1,Removal of kidney and transplantation of donor kidney,16145.5,10494.58,78.57,8419.49,19
CDM,50370_1,Removal of previously transplanted donor kidney,6608.0,4295.2,78.57,3543.01,19
CDM,50380_1,Removal with relocation of kidney,5327.7,3463.01,78.57,5863.07,19
CDM,50382_1,Removal and replacement of stent in ureter with review by radiologist,3407.3,2214.75,78.57,2440.81,19
CDM,50384_1,Removal of stent in ureter through skin with review by radiologist,3387.3,2201.75,78.57,2085.23,19
CDM,50385_1,Removal and replacement of stent in ureter through urethra with review by radiologist,3469.2,2254.98,52.94,2444.42,19
CDM,50386_1,Removal of stent in ureter through ureter with review by radiologist,1921.5,1248.98,45.55,1807.43,19
CDM,50387_1,Removal and replacement of stent in kidney and ureter using fluoroscopic guidance with review by radiologist,1084.5,704.93,22.72,1348.15,19
CDM,50389_1,Removal of kidney drainage tube using fluoroscopic guidance,465.0,302.25,12.09,1008.3,19
CDM,50390_1,Aspiration and/or injection of cyst of kidney,300.3,195.2,75.7,294.11,19
CDM,50391_1,Instillation of drug into kidney and/or ureter,380.1,247.07,78.57,299.33,19
CDM,50396_1,Measurement of urine flow in kidneys and ureters,356.0,231.4,24.7,359.68,19
CDM,5039IP _1,UNCLASSIFIED DRUGS,1.98,1.29,0.5,5.11,16
CDM,50400_1,Simple reconstruction of neck of kidney,3489.2,2267.98,78.57,3536.33,19
CDM,50405_1,Complicated reconstruction of pelvis of kidney,4229.4,2749.11,78.57,4267.43,19
CDM,5040IP _1,UNCLASSIFIED DRUGS,1.73,1.12,0.43,4.47,16
CDM,50430_1,Injection procedure for imaging of kidney and ureter through new skin access using imaging guidance with review by radiologist,1822.5,1184.63,78.57,1528.36,19
CDM,50431_1,Injection procedure for imaging of kidney and ureter through already existing skin access using imaging guidance with review by radiologist,567.0,368.55,55.13,781.36,19
CDM,50432_1,Placement of tube of kidney using imaging guidance with review by radiologist,2947.5,1915.88,78.57,2200.79,19
CDM,50433_1,Placement of tube of kidney and urinary tube through new skin access using imaging guidance with review by radiologist,3964.5,2576.93,78.57,2742.01,19
CDM,50434_1,Conversion of kidney tube to nephroureteral tube using imaging guidance and study of kidney and ureter with review by radiologist,2091.0,1359.15,78.57,2201.39,19
CDM,50435_1,Replacement of kidney drainage tube using imaging guidance with review by radiologist,1287.0,836.55,78.57,1456.81,19
CDM,50436_1,Dilation of existing opening into urinary tract using imaging guidance,366.0,237.9,78.57,461.92,19
CDM,50437_1,Dilation of existing opening into urinary tract and creation of new access into urine collecting system of kidney using imaging guidance,919.5,597.68,78.57,766.78,19
CDM,50500_1,Suture of wound or injury of kidney,3472.4,2257.06,78.57,3718.21,19
CDM,50520_1,Closure of abnormal drainage tract from kidney to skin,3116.4,2025.66,78.57,3386.51,19
CDM,50525_1,Closure of abnormal drainage tract from kidney to other abdominal organ through abdomen,3585.85,2330.8,78.57,4295.62,19
CDM,50526_1,Closure of abnormal drainage tract from kidney to other abdominal organ through chest,3466.95,2253.52,78.57,4604.3,19
CDM,50540_1,Repair of abnormally shaped kidney,4016.3,2610.6,78.57,3509.56,19
CDM,50541_1,Destruction of cyst of kidney using an endoscope,2783.6,1809.34,78.57,2804.84,19
CDM,50542_1,Destruction of growth of kidney using an endoscope,2849.7,1852.31,78.57,3568.31,19
CDM,50543_1,Partial removal of kidney using an endoscope,6761.55,4395.01,78.57,4556.76,19
CDM,50544_1,Repair of kidney using an endoscope,3801.0,2470.65,78.57,3797.95,19
CDM,50545_1,Removal of kidney and lymph nodes using an endoscope,6117.3,3976.25,78.57,4080.38,19
CDM,50546_1,Removal of kidney and partial removal of ureter using an endoscope,3609.9,2346.44,78.57,3669.56,19
CDM,50547_1,Removal of kidney from living donor using an endoscope,5095.7,3312.21,78.57,4746.3,19
CDM,50548_1,Removal of kidney and ureter using an endoscope,4113.9,2674.04,78.57,4104.1,19
CDM,50551_1,Exam of kidney using an endoscope inserted through surgically created opening from kidney to skin,1104.6,717.99,78.57,895.17,19
CDM,50553_1,Insertion of tube into ureter using an endoscope inserted through surgically created opening from kidney to skin,2199.8,1429.87,78.57,954.98,19
CDM,50555_1,Biopsy of kidney using an endoscope inserted through surgically created opening from kidney to skin,947.9,616.14,78.57,1036.9,19
CDM,50557_1,Destruction and/or removal of growth of kidney using an endoscope inserted through surgically created opening from kidney to skin,2390.9,1554.09,78.57,1050.6,19
CDM,50561_1,Removal of foreign body or stone in kidney using an endoscope inserted through surgically created opening from kidney to skin,2672.3,1737.0,78.57,1199.24,19
CDM,50562_1,Removal of growth of kidney using an endoscope inserted through surgically created opening from kidney to skin,1399.23,909.5,78.57,1760.59,19
CDM,50570_1,Exam of kidney using an endoscope,1519.4,987.61,78.57,1492.99,19
CDM,50572_1,Insertion of tube into ureter using an endoscope through upper kidney area,1282.93,833.9,78.57,1615.41,19
CDM,50574_1,Biopsy of kidney using an endoscope,1363.95,886.57,78.57,1717.2,19
CDM,50575_1,Dilation and ureter stent insertion using an endoscope,2409.8,1566.37,78.57,2169.91,19
CDM,50576_1,Destruction and/or removal of growth of kidney using an endoscope,1360.43,884.28,78.57,1712.7,19
CDM,50580_1,Removal of foreign body or stone in kidney using an endoscope,1466.0,952.9,78.57,1845.23,19
CDM,50590_1,Shock wave crushing of kidney stones,4120.2,2678.13,78.57,2361.93,19
CDM,50592_1,Destruction of growth of kidney using radiofrequency,8187.9,5322.14,50.72,6854.79,19
CDM,50593_1,Destruction of growth of kidney by freezing,3969.0,2579.85,52.85,9176.57,19
CDM,50600_1,Exploration of ureter,2826.6,1837.29,78.57,2871.27,19
CDM,50605_1,Insertion of stent in ureter,4126.5,2682.23,78.57,2938.45,19
CDM,50606_1,Biopsy of ureter and/or renal pelvis using imaging guidance with review by radiologist,1229.0,798.85,78.57,1169.17,19
CDM,50610_1,Removal of stone from upper ureter,2870.7,1865.96,78.57,2891.09,19
CDM,50620_1,Removal of stone from middle ureter,2735.3,1777.95,78.57,2765.35,19
CDM,50630_1,Removal of stone from lower ureter,2666.0,1732.9,78.57,2732.62,19
CDM,50650_1,Removal of ureter and partial removal of bladder,3118.5,2027.03,78.57,3174.94,19
CDM,50660_1,Removal of an extra ureter,3450.3,2242.7,78.57,3497.29,19
CDM,50684_1,Injection of ureter for imaging,1396.5,907.73,7.21,305.44,19
CDM,50686_1,Measurement of urine flow in ureter,345.38,224.5,27.2,340.98,19
CDM,50688_1,Change of tube or stent in ureter,203.7,132.41,66.31,237.14,19
CDM,50690_1,Injection of bladder and ureter for imaging,249.9,162.44,22.26,287.36,19
CDM,50693_1,Placement of stent of ureter through existing skin access using imaging guidance with review by radiologist,2458.0,1597.7,78.57,2411.0,19
CDM,50694_1,Placement of stent of ureter through new skin access using imaging guidance with review by radiologist,2710.0,1761.5,78.57,2705.98,19
CDM,50695_1,Placement of stent of ureter and separate tube in kidney through new skin access using imaging guidance with review by radiologist,3306.0,2148.9,78.57,3247.74,19
CDM,50700_1,Reconstruction of ureter,2784.6,1809.99,78.57,2836.78,19
CDM,50705_1,Blocking of ureter using imaging guidance with review by radiologist,3944.0,2563.6,78.57,4456.76,19
CDM,50706_1,Balloon dilation treatment of stricture of ureter using imaging guidance with review by radiologist,1778.0,1155.7,78.57,2032.56,19
CDM,50715_1,Release of scar tissue at ureter,5071.5,3296.48,78.57,3626.2,19
CDM,50722_1,Release of abnormal veins blocking ureter,2942.1,1912.37,78.57,3076.95,19
CDM,50725_1,Repair and repositioning of abnormally positioned ureter,2687.18,1746.67,78.57,3371.27,19
CDM,50727_1,Revision of opening from urinary tract to skin,1564.5,1016.93,78.57,1549.87,19
CDM,50728_1,Revision of opening from urinary tract to skin with repair of hernia,2064.3,1341.8,78.57,2208.81,19
CDM,50740_1,Connection of ureter to renal pelvis,3339.0,2170.35,78.57,3576.49,19
CDM,50750_1,Connection of ureter to renal calyx,3510.2,2281.63,78.57,3527.74,19
CDM,50760_1,Removal and reconnection of diseased or injured portion of ureter,3265.5,2122.58,78.57,3410.6,19
CDM,50770_1,Partial removal of ureter with connection to opposite ureter,3432.5,2231.13,78.57,3527.74,19
CDM,50780_1,Connection of ureter to bladder,4912.5,3193.13,78.57,3367.01,19
CDM,50782_1,Connection of extra ureter to bladder,3543.8,2303.47,78.57,3290.12,19
CDM,50783_1,Repositioning of ureter to bladder,3701.3,2405.85,78.57,3448.37,19
CDM,50785_1,Repositioning of ureter with creation of bladder or muscle flap,3858.8,2508.22,78.57,3703.75,19
CDM,50800_1,Connection of ureter to bowel,3228.8,2098.72,78.57,2828.14,19
CDM,50810_1,Connection of ureter to large bowel with creation of pouch in bowel and opening from pouch to skin,3731.7,2425.61,78.57,4091.3,19
CDM,50815_1,Connection of ureter to large bowel,4935.0,3207.75,78.57,3748.66,19
CDM,50820_1,Connection of ureter to small bowel with creation of opening from ureter to skin,4935.0,3207.75,78.57,4007.75,19
CDM,50825_1,Connection of ureter to large and/or small bowel with creation of opening to skin,5381.3,3497.85,78.57,5035.34,19
CDM,50830_1,Repair to restore urine flow in ureter,5414.9,3519.69,78.57,5506.87,19
CDM,50840_1,Replacement of ureter using bowel,7048.2,4581.33,78.57,3767.96,19
CDM,50845_1,Connection of bladder to pouch at junction of small and large bowel with creation of opening to skin,3760.1,2444.07,78.57,3834.78,19
CDM,50860_1,Connection of ureter to skin,2845.5,1849.58,78.57,2896.04,19
CDM,50900_1,Suture repair of ureter,2503.2,1627.08,78.57,2582.6,19
CDM,50920_1,Closure of abnormal drainage tract from ureter to skin,2782.5,1808.63,78.57,2698.6,19
CDM,50930_1,Closure of abnormal drainage tract from ureter to an abdominal organ,3386.3,2201.1,78.57,3370.13,19
CDM,50940_1,Removal of previously placed suture or wire in ureter,2126.55,1382.26,78.57,2719.77,19
CDM,50945_1,Removal of stone from ureter using an endoscope,2957.9,1922.64,78.57,2971.58,19
CDM,50947_1,Repositioning of ureter and insertion of stent using an endoscope,4189.5,2723.18,78.57,4233.11,19
CDM,50948_1,Repositioning of ureter using an endoscope,3897.6,2533.44,78.57,3893.28,19
CDM,50951_1,Exam of kidney and ureter using an endoscope inserted through an already created ureter opening,968.1,629.27,78.57,932.57,19
CDM,50953_1,Insertion of tube into ureter using an endoscope inserted through an already created opening in ureter,2230.2,1449.63,78.57,992.21,19
CDM,50955_1,Biopsy of kidney or ureter using an endoscope inserted through an already created opening in ureter,2444.4,1588.86,78.57,1069.89,19
CDM,50957_1,Destruction and/or removal of growth of kidney or ureter using an endoscope inserted through an already created opening in ureter,1312.5,853.13,78.57,1076.59,19
CDM,50961_1,Removal of foreign body or stone in kidney or ureter using an endoscope inserted through an already created opening in ureter,2800.4,1820.26,78.57,964.21,19
CDM,50970_1,Exam of kidney and ureter using an endoscope,893.5,580.78,78.57,1126.86,19
CDM,50972_1,Insertion of tube into ureter using an endoscope,1102.5,716.63,78.57,1089.09,19
CDM,50974_1,Biopsy of kidney or ureter using an endoscope,1140.55,741.36,78.57,1437.35,19
CDM,50976_1,Destruction and/or removal of growth of kidney or ureter using an endoscope,1125.03,731.27,78.57,1416.7,19
CDM,50980_1,Removal of foreign body or stone in kidney or ureter using an endoscope,1099.4,714.61,78.57,1082.45,19
CDM,50_1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",610.0,396.5,152.5,1575.33,16
CDM,51020_1,Incision of bladder with destruction of growth and/or insertion of radioactive material,1191.8,774.67,78.57,1430.87,19
CDM,51040_1,Incision of bladder with drainage,1260.0,819.0,78.57,884.69,19
CDM,51045_1,Incision of bladder with insertion of tube or stent in ureter,1706.3,1109.1,78.57,1482.35,19
CDM,51050_1,Incision of bladder with removal of bladder stone,1863.8,1211.47,78.57,1446.67,19
CDM,51060_1,Incision of bladder with removal of stone in ureter,1390.98,904.14,78.57,1781.66,19
CDM,51065_1,Incision of bladder with basket removal and/or ultrasonic crushing of stone in ureter,1387.4,901.81,78.57,1775.41,19
CDM,51080_1,Drainage of abscess of bladder,1470.0,955.5,78.57,1251.01,19
CDM,51100_1,Needle aspiration of bladder,170.0,110.5,28.97,175.31,19
CDM,51101_1,Aspiration of bladder using tube or trocar,289.8,188.37,41.18,371.02,19
CDM,51102_1,Aspiration of bladder with insertion of bladder tube to skin,940.0,611.0,78.57,579.03,19
CDM,5110IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.37,3.49,1.34,13.87,16
CDM,5110OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.75,10.89,4.19,43.26,16
CDM,5111IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.88,3.17,1.22,12.6,16
CDM,5114IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.25,3.41,1.31,13.56,16
CDM,5114OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.88,10.32,3.97,41.01,16
CDM,5115IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.38,2.85,1.1,11.31,16
CDM,5115OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.05,9.78,3.76,38.87,16
CDM,51500_1,Repair of congenital defect of bladder,2126.3,1382.1,78.57,1950.94,19
CDM,51520_1,Simple removal of bladder neck,2310.0,1501.5,78.57,1821.91,19
CDM,51525_1,Repair of ruptured bowel into bladder,2587.2,1681.68,78.57,2630.79,19
CDM,51530_1,Removal of growth of bladder,2310.0,1501.5,78.57,2360.77,19
CDM,51535_1,"Incision, removal, or repair of abnormal drainage tract from bladder into bowel",2327.9,1513.14,78.57,2390.26,19
CDM,51550_1,Simple partial removal of bladder,2839.2,1845.48,78.57,2935.28,19
CDM,51555_1,Complicated partial removal of bladder,3780.0,2457.0,78.57,3851.2,19
CDM,51565_1,Partial removal of bladder with reimplantation of ureters,3868.2,2514.33,78.57,3945.0,19
CDM,51570_1,Complete removal of bladder,4427.9,2878.14,78.57,4494.63,19
CDM,51575_1,Complete removal of bladder and lymph nodes on both sides of pelvis,5138.7,3340.16,78.57,5559.99,19
CDM,51580_1,Complete removal of bladder with transplantation of ureters,4598.43,2988.98,78.57,5796.67,19
CDM,51585_1,Complete removal of bladder with transplantation of ureters and removal of lymph nodes on both sides of pelvis,7218.8,4692.22,78.57,6449.51,19
CDM,51590_1,Removal of bladder with transplantation of ureters to small or large bowel with creation of urinary opening,7481.3,4862.85,78.57,5894.41,19
CDM,51595_1,Removal of bladder and lymph nodes on both sides of pelvis with transplantation of ureters to small or large bowel with creation of urinary opening,8610.0,5596.5,78.57,6674.93,19
CDM,51596_1,Removal of bladder and lymph nodes on both sides of pelvis with transplantation of ureters to small and/or large bowel with creation of urinary opening,8216.3,5340.6,78.57,7187.55,19
CDM,51597_1,Removal of bladder and ureters and/or removal of rectum and partial removal of large bowel with creation of opening in large bowel through abdominal wall to skin,9161.3,5954.85,78.57,7004.37,19
CDM,51600_1,Injection procedure for imaging of bladder during voiding,592.2,384.93,4.52,513.32,19
CDM,51605_1,Injection procedure for imaging of bladder and urethra and placement of X-ray marker,1042.7,677.76,24.7,117.33,19
CDM,51610_1,Injection procedure through bladder and urethra for X-ray imaging,322.4,209.56,18.52,310.5,19
CDM,51700_1,Simple bladder irrigation and/or instillation,250.0,162.5,9.89,182.26,19
CDM,51701_1,Insertion of temporary bladder tube,190.0,123.5,8.74,106.16,19
CDM,51702_1,Simple insertion of temporary bladder tube,250.0,162.5,7.53,147.46,19
CDM,51703_1,Complicated insertion of bladder tube,380.0,247.0,22.45,359.06,19
CDM,51705_1,Simple change of bladder tube,328.7,213.66,27.38,232.42,19
CDM,5170IP _1,"INJECTION, MORPHINE SULFATE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J2270, UP TO 10 MG",66.29,43.09,7.18,171.19,17
CDM,5170OP _1,"INJECTION, MORPHINE SULFATE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J2270, UP TO 10 MG",53.6,34.84,7.18,138.42,17
CDM,51710_1,Complicated change of bladder tube,563.9,366.54,67.82,325.38,19
CDM,51715_1,Injection of implant material beneath lining of bladder and/or urethra using an endoscope,865.2,562.38,78.57,889.92,19
CDM,51720_1,Instillation of anti-cancer drug into bladder,352.8,229.32,35.33,209.79,19
CDM,51725_1,Simple measurement of pressure of urine flow in bladder,651.0,423.15,70.79,311.65,19
CDM,51726_1,Complex measurement of pressure of urine flow in bladder,915.6,595.14,78.57,413.41,19
CDM,51727_1,Complex measurement of pressure of urine flow in bladder with urethra pressure studies,935.4,608.01,78.57,572.42,19
CDM,51728_1,Complex measurement of pressure of urine flow in bladder with voiding pressure studies,938.4,609.96,78.57,604.22,19
CDM,51729_1,Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies,1019.3,662.55,78.57,744.14,19
CDM,5172IP _1,MORPHINE 4 MG/ML SYRINGE,47.46,30.85,11.87,33.22,11
CDM,5172OP _1,MORPHINE 4 MG/ML SYRINGE,15.65,10.17,3.91,10.96,11
CDM,51736_1,Simple timed assessment of bladder emptying,160.7,104.46,8.09,78.57,19
CDM,51741_1,Electronic assessment of bladder emptying,267.8,174.07,8.09,78.57,19
CDM,5176IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.67,23.84,9.17,94.7,16
CDM,5177IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.11,5.27,2.03,20.94,16
CDM,5177OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.23,5.35,2.06,21.25,16
CDM,51784_1,Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings,580.7,377.46,34.82,292.57,19
CDM,51785_1,Needle measurement and recording of electrical activity of muscles at bladder and bowel openings,630.0,409.5,78.57,311.65,19
CDM,5178IP _1,UNCLASSIFIED DRUGS,18.86,12.26,4.72,48.71,16
CDM,5178OP _1,UNCLASSIFIED DRUGS,45.32,29.46,11.33,117.04,16
CDM,51792_1,Assessment of muscle signal of pelvic nerves,653.1,424.52,51.63,445.22,19
CDM,51797_1,Insertion of device into abdomen with pressure and urine flow rate study,676.2,439.53,37.11,356.17,19
CDM,51798_1,Ultrasound measurement of bladder capacity after voiding,59.9,38.94,11.35,78.57,19
CDM,5179IP _1,UNCLASSIFIED DRUGS,10.89,7.08,2.72,28.12,16
CDM,51800_1,Repair of bladder and/or urethra,3141.6,2042.04,78.57,3179.48,19
CDM,51820_1,"Repair of bladder, urethra, and ureter",3033.5,1971.78,78.57,3323.72,19
CDM,51840_1,Simple suture of bladder neck to vaginal wall and pubic bone with urethra suspension,2362.5,1535.63,78.57,2037.8,19
CDM,51841_1,Resuture of bladder neck to vaginal wall and pubic bone with urethra suspension,2362.5,1535.63,78.57,2382.74,19
CDM,51845_1,Repair of bladder neck in female,2310.0,1501.5,78.57,1783.42,19
CDM,51860_1,"Suture of simple wound, injury, or rupture of bladder",2126.3,1382.1,78.57,2250.59,19
CDM,51865_1,"Suture of complicated wound, injury, or rupture of bladder",2730.0,1774.5,78.57,2728.76,19
CDM,51880_1,Closure of surgically created opening from bladder to skin,1372.4,892.06,78.57,1421.89,19
CDM,51900_1,Repair of abnormal drainage tract from bladder into vagina through abdomen,3150.0,2047.5,78.57,2526.48,19
CDM,51920_1,Repair of abnormal drainage tract from bladder into vagina,1852.63,1204.21,78.57,2339.98,19
CDM,51925_1,Repair of abnormal drainage tract from bladder into vagina and removal of uterus,2450.4,1592.76,78.57,3120.53,19
CDM,51940_1,Repair of congenital defect of bladder wall,3976.1,2584.47,78.57,5018.51,19
CDM,51960_1,Enlargement of bladder using a portion of bowel,4183.2,2719.08,78.57,4237.6,19
CDM,51980_1,Creation of drainage tract from bladder to skin,2703.8,1757.47,78.57,2186.55,19
CDM,51990_1,Suture suspension of urethra to control leakage using an endoscope,2200.8,1430.52,78.57,2284.74,19
CDM,51992_1,Creation of sling around urethra to control leakage using an endoscope,2446.5,1590.23,78.57,2538.28,19
CDM,51_1,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",387.0,251.55,96.75,999.43,19
CDM,52000_1,Diagnostic exam of bladder and urethra using an endoscope,616.4,400.66,65.86,577.12,19
CDM,52001_1,Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope,1145.6,744.64,78.57,1051.67,19
CDM,52005_1,Insertion of tube into ureter using an endoscope through bladder area,843.2,548.08,78.57,730.06,19
CDM,52007_1,Insertion of tube into ureter and biopsy of ureter and/or renal pelvis using an endoscope,1565.6,1017.64,78.57,1086.59,19
CDM,52010_1,Insertion of tube into sperm duct using an endoscope,861.2,559.78,78.36,918.54,19
CDM,52204_1,Biopsy of bladder using an endoscope,1455.3,945.95,45.36,909.86,19
CDM,52214_1,"Destruction of tissue of bladder, urethra, or surrounding glands using an endoscope",2310.0,1501.5,48.1,1802.68,19
CDM,52224_1,"Destruction of growth of bladder and urethra using an endoscope, less than 0.5 cm",2394.0,1556.1,29.3,1882.83,19
CDM,52234_1,"Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm",892.5,580.13,78.57,747.06,19
CDM,52235_1,"Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm",1496.3,972.6,78.57,875.64,19
CDM,52240_1,Destruction and/or removal of large growth of bladder using an endoscope,2100.0,1365.0,78.57,1191.14,19
CDM,52250_1,Insertion of radioactive substance of bladder and urethra using an endoscope,576.33,374.61,78.57,726.71,19
CDM,52260_1,Dilation of bladder using an endoscope under general or spinal anesthesia,640.5,416.33,78.57,639.16,19
CDM,52265_1,Dilation of bladder using an endoscope,1231.7,800.61,52.12,899.22,19
CDM,52270_1,Incision of urethra in female using an endoscope,1193.9,776.04,78.57,1012.38,19
CDM,52275_1,Incision of urethra in male using an endoscope,1633.8,1061.97,73.48,1297.75,19
CDM,52276_1,Incision of urethra using an endoscope,1102.5,716.63,78.57,802.99,19
CDM,52277_1,Removal of muscles at urinary opening using an endoscope,996.5,647.73,78.57,982.08,19
CDM,52281_1,Dilation of urethra using an endoscope,1471.1,956.22,78.57,784.15,19
CDM,52282_1,Insertion of a permanent urethra stent using an endoscope,1029.0,668.85,78.57,1020.68,19
CDM,52283_1,Steroid injection into urethra stricture using an endoscope,841.1,546.72,78.57,849.91,19
CDM,52285_1,Exam of bladder and urethra for treatment of female urethral syndrome using an endoscope,845.3,549.45,78.57,841.72,19
CDM,52287_1,Exam with injections of chemical for destruction of bladder using an endoscope,1007.0,654.55,78.57,933.86,19
CDM,52290_1,Incision of ureter using an endoscope,750.8,488.02,78.57,740.4,19
CDM,52300_1,Removal or destruction of abnormal pouches of ureter at bladder using an endoscope,862.1,560.37,78.57,850.49,19
CDM,52301_1,"Removal or destruction of abnormal pouches of ureter at bladder, ectopic ureterocele, using an endoscope",903.0,586.95,78.57,880.45,19
CDM,52305_1,Removal of bladder pouches using an endoscope,856.8,556.92,78.57,845.29,19
CDM,52310_1,"Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope",787.5,511.88,78.57,764.85,19
CDM,52315_1,"Complicated removal of foreign body, stone, or stent in urethra or bladder using an endoscope",1323.0,859.95,78.57,1126.34,19
CDM,52317_1,"Crushing, fragmenting, and removal of bladder stones, less than 2.5 cm",2784.6,1809.99,78.57,2129.92,19
CDM,52318_1,"Crushing, fragmenting, and removal of bladder stones, more than 2.5 cm",1653.8,1074.97,78.57,1438.58,19
CDM,52320_1,Removal of stone in ureter using an endoscope,1076.3,699.6,78.57,748.84,19
CDM,52325_1,Fragmenting of stone in ureter using an endoscope,1548.8,1006.72,78.57,972.63,19
CDM,52327_1,Injection of implant material in bladder using an endoscope,1564.5,1016.93,78.57,797.53,19
CDM,52330_1,Manipulation of stone in ureter using an endoscope,2261.7,1470.11,78.57,1450.72,19
CDM,52332_1,Insertion of stent in ureter using an endoscope,2288.55,1487.56,73.4,964.72,19
CDM,52334_1,Insertion of guide wire through kidney into ureter using an endoscope,787.5,511.88,78.57,554.86,19
CDM,52341_1,Dilation of bladder and urethra using an endoscope,1477.35,960.28,78.57,861.94,19
CDM,52342_1,Repair of stricture at junction of kidney and ureter using an endoscope,1060.5,689.33,78.57,938.49,19
CDM,52343_1,Repair of stricture in kidney using an endoscope,1163.4,756.21,78.57,1045.53,19
CDM,52344_1,Repair of stricture of ureter using an endoscope,1260.0,819.0,78.57,1122.63,19
CDM,52345_1,Repair of stricture of upper attachment of ureter to kidney using an endoscope,1336.7,868.86,78.57,1197.89,19
CDM,52346_1,Repair of stricture in kidney with exam of urinary tract using an endoscope,1491.0,969.15,78.57,1357.06,19
CDM,52351_1,"Diagnostic exam of bladder, urethra, and ureter or kidney using an endoscope",963.9,626.54,78.57,919.23,19
CDM,52352_1,Removal or manipulation of stone in ureter or kidney using an endoscope,1697.85,1103.6,78.57,1076.26,19
CDM,52353_1,Crushing of stone of ureter using an endoscope,1953.0,1269.45,78.57,1191.14,19
CDM,52354_1,Biopsy and/or destruction of growth of ureter or kidney using an endoscope,1203.3,782.15,78.57,1267.42,19
CDM,52355_1,Removal of growth of ureter or kidney using an endoscope,1435.4,933.01,78.57,1419.25,19
CDM,52356_1,Crushing of stone of ureter with insertion of stent using an endoscope,2023.95,1315.57,78.57,1263.25,19
CDM,52400_1,"Incision, destruction, or removal of congenital defects of bladder and urethra using an endoscope",1656.9,1076.99,78.57,1460.16,19
CDM,52402_1,Incision or removal of ejaculatory duct using an endoscope,826.4,537.16,78.57,809.63,19
CDM,52441_1,"Insertion of implant in urethra within prostate gland using an endoscope, 1 implant",577.5,375.38,78.57,3056.75,19
CDM,52442_1,"Insertion of implant in urethra within prostate gland using an endoscope, each additional implant",172.2,111.93,40.85,2088.33,19
CDM,52443_1,CYSTOURETHROSCOPY WITH INITIAL TRANSURETHRAL ANTERIOR PROSTATE COMMISSUROTOMY WITH A NONDRUG-COATED BALLOON CATHETER FOLLOWED BY THERAPEUTIC DRUG DELIVERY INTO THE PROSTATE BY A DRUG-COATED BALLOON CA,403.0,261.95,73.6,415.09,16
CDM,52450_1,Incision of prostate,1506.8,979.42,78.57,1439.47,19
CDM,52500_1,Removal of bladder neck through urethra,1656.9,1076.99,78.57,1496.08,19
CDM,52597_1,"TRANSURETHRAL ROBOTIC-ASSISTED WATERJET RESECTION OF PROSTATE, INCLUDING INTRAOPERATIVE PLANNING, ULTRASOUND GUIDANCE, CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE, INCLUDING VASECTOMY, MEATOTOMY, CYST",1390.0,903.5,73.6,1431.7,16
CDM,52601_1,Removal of prostate gland using an electrocautery knife through urethra with control of bleeding using an endoscope,2517.9,1636.64,78.57,2233.39,19
CDM,52630_1,Complete removal of remaining or regrown prostate tissue with control of bleeding using an endoscope,1332.5,866.13,78.57,1272.05,19
CDM,52640_1,Removal of postsurgical tightening of bladder neck,1205.4,783.51,78.57,966.39,19
CDM,52647_1,Complete laser destruction of prostate including control of bleeding using an endoscope,7639.8,4965.87,78.57,3819.9,15
CDM,52648_1,Complete laser vaporization of prostate including control of bleeding using an endoscope,6418.7,4172.16,78.57,3876.31,19
CDM,52649_1,Complete laser fragmentation of prostate including control of bleeding using an endoscope,1975.3,1283.95,78.57,2526.48,19
CDM,52700_1,Drainage of prostate abscess,1308.3,850.4,78.57,1351.31,19
CDM,53000_1,Incision or repair of urethra,840.0,546.0,78.57,452.64,19
CDM,53010_1,Incision or repair of abnormal urethra,870.5,565.83,78.57,899.91,19
CDM,53020_1,Incision of external urinary opening,533.4,346.71,78.57,294.71,19
CDM,53025_1,"Incision of external urinary opening, infant",603.8,392.47,30.87,207.56,19
CDM,53040_1,Drainage of abscess around urethra,1618.1,1051.77,78.57,1202.05,19
CDM,53060_1,Drainage of abscess or cyst of Skene's glands,518.7,337.16,78.57,503.38,19
CDM,53080_1,Uncomplicated drainage of abnormal urine collection,1296.8,842.92,78.57,1286.57,19
CDM,53085_1,Complicated drainage of abnormal urine collection,1567.95,1019.17,78.57,1989.2,19
CDM,53200_1,Biopsy of urethra,850.5,552.83,78.57,431.4,19
CDM,53210_1,Removal of bladder and urethra in female,2317.4,1506.31,78.57,2360.58,19
CDM,53215_1,Removal of bladder and urethra in male,2816.1,1830.47,78.57,2841.59,19
CDM,53220_1,Removal or destruction of cancer urethra,1092.18,709.92,78.57,1384.02,19
CDM,53230_1,Removal of pouch of urethra in female,1837.5,1194.38,78.57,1853.89,19
CDM,53235_1,Removal of pouch of urethra in male,1915.2,1244.88,78.57,1939.53,19
CDM,53240_1,Repair of pouch of urethra,1282.1,833.37,78.57,1300.41,19
CDM,53250_1,Removal of seminal fluid gland,976.8,634.92,78.57,1211.14,19
CDM,53260_1,Removal or destruction of polyps of urethra,589.1,382.92,54.95,554.4,19
CDM,53265_1,Removal or destruction of growth of urethra,840.0,546.0,78.57,576.17,19
CDM,53270_1,Removal or destruction of mucous glands of urethra,598.5,389.03,78.57,567.24,19
CDM,53275_1,Removal or destruction of prolapse of urethra,845.3,549.45,78.57,802.82,19
CDM,5330IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.85,10.3,3.96,40.93,16
CDM,5330OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.01,16.91,6.5,67.17,16
CDM,5331IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.07,2.65,1.02,10.51,16
CDM,5331OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.09,12.41,4.77,49.3,16
CDM,5339IP _1,"INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 MG",171.75,111.64,3.66,443.54,17
CDM,5339OP _1,"INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 MG",17.9,11.64,3.66,46.23,17
CDM,53400_1,"Repair of abnormal drainage tract, pouch, or stricture of urethra, first stage",2405.6,1563.64,78.57,2451.51,19
CDM,53405_1,second stage repair of urethra with creation of new urethra,2650.2,1722.63,78.57,2676.55,19
CDM,53410_1,Reconstruction of urethra in male,2963.1,1926.02,78.57,3001.28,19
CDM,53415_1,Reconstruction or repair of urethra,3419.9,2222.94,78.57,3460.09,19
CDM,53420_1,"Reconstruction or repair of urethra, stage 1 of 2",2756.3,1791.6,78.57,2578.8,19
CDM,53425_1,"Reconstruction or repair of urethra, stage 2 of 2",2249.83,1462.39,78.57,2869.95,19
CDM,53430_1,Reconstruction of urethra in female,2849.7,1852.31,78.57,2956.11,19
CDM,53431_1,Repair of urethra and/or lower bladder for incontinence,2773.1,1802.52,78.57,3528.35,19
CDM,53440_1,Creation of sling around urethra in male to control leakage,2756.3,1791.6,78.57,2308.86,19
CDM,53442_1,Removal or revision of sling in male for urinary incontinence,1876.45,1219.69,78.57,2399.16,19
CDM,53444_1,Insertion of artificial urinary sphincter,1926.8,1252.42,78.57,2432.55,19
CDM,53445_1,Insertion of inflatable urethra or bladder neck sphincter,3753.8,2439.97,78.57,2308.53,19
CDM,53446_1,Removal of inflatable urethra or bladder neck sphincter,1984.5,1289.93,78.57,1967.0,19
CDM,53447_1,Removal and replacement of inflatable urethra or bladder neck sphincter,2451.8,1593.67,78.57,2474.94,19
CDM,53448_1,Removal and replacement of inflatable urethra or bladder neck sphincter through an infected field,3884.0,2524.6,78.57,3907.34,19
CDM,53449_1,Repair of inflatable urethra or bladder neck sphincter,1701.0,1105.65,78.57,1874.59,19
CDM,53450_1,Repair of urethra and urinary opening,1223.3,795.15,78.57,1251.29,19
CDM,53453_1,Removal of adjustable balloon continence device from beside urethra,1475.0,958.75,78.57,1519.25,15
CDM,53454_1,Adjustment of fluid volume in adjustable balloon continence device beside urethra,1500.0,975.0,48.2,1545.0,15
CDM,53460_1,Repair and partial removal of urethra and urinary opening,1374.5,893.43,78.57,1402.69,19
CDM,53500_1,Release of scar tissue of urethra using an endoscope,1856.4,1206.66,78.57,2278.75,19
CDM,53502_1,Suture of wound or injury of urethra in female,1449.0,941.85,78.57,1489.35,19
CDM,53505_1,Suture of wound or injury of urethra in penis,1522.5,989.63,78.57,1488.29,19
CDM,53510_1,Suture of urethra wound or injury,1901.6,1236.04,78.57,1935.4,19
CDM,53515_1,Suture of wound or injury of urethra near prostate gland,2398.2,1558.83,78.57,2439.71,19
CDM,53520_1,Closure of abnormal drainage tract from urethra to skin in male,1668.5,1084.53,78.57,1707.2,19
CDM,53600_1,Initial dilation of urethra in male using dilator,257.3,167.25,23.58,211.42,19
CDM,53601_1,Subsequent dilation of stricture of urethra in male by passage of dilator,248.9,161.79,16.35,203.7,19
CDM,53605_1,Dilation of narrowing of urethra in male under general or spinal anesthesia,210.0,136.5,51.79,195.11,19
CDM,53620_1,Initial dilation of urethra in male using filiform dilator,367.5,238.88,40.73,408.4,19
CDM,53621_1,Subsequent dilation of urethral stricture in male by passage of filiform urethral dilator,345.5,224.58,24.61,389.88,19
CDM,53660_1,Initial dilation of urethra in female,214.2,139.23,30.87,180.37,19
CDM,53661_1,Subsequent dilation of urethra in female,213.2,138.58,14.68,177.25,19
CDM,53665_1,Dilation of urethra in female under general or spinal anesthesia,157.5,102.38,30.79,116.77,19
CDM,5373IP _1,"INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG",110.55,71.86,27.64,285.5,16
CDM,5373OP _1,"INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG",24.06,15.64,6.02,62.13,16
CDM,5374IP _1,"INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG",37.32,24.26,9.33,96.38,16
CDM,5374OP _1,"INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG",29.23,19.0,7.31,75.49,16
CDM,5384IP _1,UNCLASSIFIED DRUGS,6.06,3.94,1.52,15.65,16
CDM,5384OP _1,UNCLASSIFIED DRUGS,3.67,2.39,0.92,9.48,16
CDM,53850_1,Destruction of prostate tissue using microwave induced heat,9366.0,6087.9,78.57,3408.24,19
CDM,53852_1,Destruction of prostate tissue using radiofrequency induced heat,8995.4,5847.01,78.57,3328.25,19
CDM,53854_1,Destruction of prostate tissue using radiofrequency induced heated water vapor,904.0,587.6,78.57,4022.48,19
CDM,53855_1,Insertion of a temporary urethra stent using an endoscope,1805.8,1173.77,14.22,1577.72,19
CDM,53860_1,Reconstruction of female bladder neck for stress urinary incontinence using radiofrequency,3640.35,2366.23,78.57,5756.86,19
CDM,5391IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.58,2.33,0.9,9.25,16
CDM,5391OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.35,13.88,5.34,55.14,16
CDM,5392IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
CDM,5393IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.75,3.09,1.19,12.27,16
CDM,5393OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.8,14.82,5.7,58.88,16
CDM,54000431_1,"Testing for presence of drug, by chemistry analyzers",380.0,247.0,62.14,981.35,19
CDM,54000_1,Incision of newborn foreskin,458.9,298.29,43.41,389.77,19
CDM,54001_1,Incision of foreskin,749.7,487.31,78.57,474.94,19
CDM,54010003_1,Insertion of needle into vein for collection of blood sample,12.0,7.8,3.0,30.99,19
CDM,54015_1,Incision and drainage of penis,931.4,605.41,78.57,934.85,19
CDM,54018330_1,"Pathology examination of specimen during surgery, first tissue block",905.0,588.25,43.19,2337.16,19
CDM,54018332_1,"Pathology examination of specimen during surgery, each additional tissue block",216.0,140.4,24.57,557.82,19
CDM,54050_1,Simple destruction of growths of penis using chemical,360.0,234.0,25.5,345.48,19
CDM,54055_1,Simple destruction of growth of penis using electric current,330.8,215.02,48.1,329.18,19
CDM,54056_1,Simple destruction of growth of penis using freezing,345.5,224.58,50.56,346.38,19
CDM,54057_1,Simple destruction of growth of penis using laser,472.5,307.13,78.57,342.27,19
CDM,54060_1,Removal of growth of penis,650.0,422.5,78.57,467.21,19
CDM,54065_1,Destruction of multiple growths of penis,735.0,477.75,78.57,534.78,19
CDM,54080305_1,"Testing for presence of drug, by chemistry analyzers",280.0,182.0,62.14,723.1,19
CDM,54083540_1,Iron level,56.0,36.4,3.62,144.62,19
CDM,54084466_1,Transferrin (iron binding protein) level,111.0,72.15,12.76,286.66,19
CDM,54086140_1,Measurement C-reactive protein for detection of infection or inflammation,45.0,29.25,2.33,116.21,19
CDM,54086141_1,"Measurement C-reactive protein for detection of infection or inflammation, high sensitivity",112.0,72.8,12.95,289.24,19
CDM,54100_1,Biopsy of penis,540.8,351.52,27.62,487.49,19
CDM,54105_1,Biopsy of deep structure of penis,818.0,531.7,68.55,660.19,19
CDM,54110005_1,Insertion of needle into vein for collection of blood sample,12.0,7.8,3.0,30.99,19
CDM,54110_1,Removal of thickened tissue of penis,1942.5,1262.63,78.57,1913.8,19
CDM,54111_1,"Removal of abnormally thickened tissue in penis with graft, 5.0 cm or less",2426.6,1577.29,78.57,2450.42,19
CDM,54112_1,"Removal of abnormally thickened tissue in penis with graft, more than 5.0 cm",2239.65,1455.77,78.57,2872.63,19
CDM,54115_1,Removal of foreign body in penis,1084.5,704.93,78.57,1299.74,19
CDM,54120_1,Partial amputation of penis,1898.4,1233.96,78.57,1937.02,19
CDM,54125_1,Amputation of penis,2448.6,1591.59,78.57,2497.0,19
CDM,54130_1,Amputation of penis and removal of lymph nodes on both sides of groin,3623.6,2355.34,78.57,3653.71,19
CDM,54135_1,Amputation of penis and removal of lymph nodes on both sides of pelvis,3635.28,2362.93,78.57,4621.22,19
CDM,54150_1,Removal of foreskin using clamp or device,560.0,364.0,63.08,355.19,19
CDM,54160_1,Removal of foreskin (28 days or younger),683.6,444.34,27.7,527.4,19
CDM,54161_1,Removal of foreskin (older than 28 days),591.2,384.28,78.57,602.75,19
CDM,54162_1,Removal of scar tissue after foreskin removal,798.0,518.7,78.57,614.88,19
CDM,54163_1,Repair of incomplete removal of foreskin,648.9,421.79,78.57,666.34,19
CDM,54164_1,Incision of membrane attaching foreskin and penis,650.0,422.5,78.57,590.55,19
CDM,54180061_1,"Blood test, lipids (cholesterol and triglycerides)",116.0,75.4,10.64,299.57,19
CDM,54182150_1,Amylase (enzyme) level,56.0,36.4,3.63,144.62,19
CDM,54182465_1,Cholesterol level,38.0,24.7,1.65,98.14,19
CDM,54183615_1,Lactate dehydrogenase (enzyme) level,53.0,34.45,3.2,136.87,19
CDM,54183690_1,Lipase (fat enzyme) level,60.0,39.0,4.13,154.95,19
CDM,54183718_1,HDL cholesterol level,71.0,46.15,5.81,183.36,19
CDM,54200_1,Injection procedure to correct thickened penile tissue,404.3,262.8,33.41,277.08,19
CDM,54205_1,Injection procedure and surgery of thickened penile tissue,1275.43,829.03,78.57,1630.95,19
CDM,54220_1,Injection of drug into erectile tissue at sides and back of penis,630.0,409.5,72.69,523.42,19
CDM,54230_1,Injection procedure for imaging of penile erection,290.9,189.09,61.75,253.16,19
CDM,54231_1,Assessment of erectile dysfunction including injection of drugs into penis,443.1,288.02,78.57,352.46,19
CDM,54235_1,Injection procedure to cause erection,268.8,174.72,52.15,222.75,19
CDM,54240_1,Assessment of penile blood flow,298.2,193.83,61.37,203.2,19
CDM,54250_1,Assessment of nighttime erection,379.1,246.42,78.57,340.15,19
CDM,54300_1,Repair of curved penis,1952.0,1268.8,78.57,1975.18,19
CDM,54304_1,Repair of curved penis and urinary outlet,2289.0,1487.85,78.57,2295.02,19
CDM,54308_1,"Repair of urinary outlet at underside of penis, less than 3.0 cm",1716.23,1115.55,78.57,2193.65,19
CDM,54312_1,"Repair of urinary outlet at underside of penis, more than 3.0 cm",2035.0,1322.75,78.57,2509.86,19
CDM,54316_1,"Repair of urinary outlet of penis with skin graft, stage 2 of 2",2480.43,1612.28,78.57,3048.37,19
CDM,54318_1,Repair of urinary outlet with release of penis from scrotum,1705.93,1108.85,78.57,2179.52,19
CDM,54322_1,Simple repair and relocation of urinary outlet at underside of penis,2385.6,1550.64,78.57,2395.99,19
CDM,54324_1,Repair of urinary outlet of penis with skin flap,3013.5,1958.78,78.57,2967.89,19
CDM,54326_1,Repair of urinary outlet at underside of penis with skin flap,2790.9,1814.09,78.57,2888.64,19
CDM,54328_1,"Repair of urinary outlet at underside of head of penis with local skin flaps, skin graft patch, and/or island flap",3097.5,2013.38,78.57,2870.63,19
CDM,54332_1,Repair of urinary outlet at underside of base of penis with skin graft tube and/or island flap,3091.2,2009.28,78.57,3096.73,19
CDM,54336_1,Repair of urinary outlet between thighs in male with skin graft tube and/or island flap,3481.8,2263.17,78.57,3639.64,19
CDM,54340_1,Simple repair of urinary outlet complications at underside of penis,1696.8,1102.92,78.57,1745.77,19
CDM,54344_1,Repair of complication of urinary outlet of penis at underside of penis with mobilization of skin graft or flap,2909.6,1891.24,78.57,2895.82,19
CDM,54348_1,"Extensive repair of urinary outlet at underside of penis with flap, patch or graft",3113.3,2023.65,78.57,3096.21,19
CDM,54352_1,Extensive revision of previous repair of urinary outlet at underside of penis with skin grafts and flaps,4404.8,2863.12,78.57,4329.1,19
CDM,54360_1,Surgery to correct abnormal penis angle,2197.7,1428.51,78.57,2210.3,19
CDM,54380_1,Repair of urinary outlet of penis,2435.0,1582.75,78.57,2451.95,19
CDM,54385_1,Repair of urinary outlet of penis with incontinence,2321.3,1508.85,78.57,2849.13,19
CDM,54390_1,Repair of urinary outlet of penis with creation of bladder opening,3600.5,2340.33,78.57,3803.22,19
CDM,54400_1,Insertion of non-inflatable penile implant,2388.8,1552.72,78.57,2460.46,19
CDM,54401_1,Insertion of inflatable penile implant,2782.5,1808.63,78.57,2865.98,19
CDM,54405_1,Insertion of multicomponent inflatable penile implant,3596.3,2337.6,78.57,3704.19,19
CDM,54406_1,Removal of all components of inflatable penile implant,2336.3,1518.6,78.57,2240.3,19
CDM,54408_1,Repair of multicomponent inflatable penile implant,2375.1,1543.82,78.57,2446.35,19
CDM,54410_1,Removal and replacement of multicomponent inflatable penile implant during same surgery,2764.7,1797.06,78.57,2847.64,19
CDM,54411_1,Removal and replacement of infected components of inflatable penile implant,2463.55,1601.31,78.57,3150.11,19
CDM,54415_1,Removal of inflatable or noninflatable penile implant,1581.3,1027.85,78.57,1619.59,19
CDM,54416_1,Removal and replacement of noninflatable penile implant,2122.1,1379.37,78.57,2185.76,19
CDM,54417_1,Removal and replacement of infected noninflatable penile implant,2245.2,1459.38,78.57,2755.64,19
CDM,54420_1,Creation of blood flow tract from penis to groin,2137.8,1389.57,78.57,2157.61,19
CDM,54430_1,Creation of blood flow tract from penis to other penile anatomy,1935.2,1257.88,78.57,1961.73,19
CDM,54435_1,Redirection of blood flow from penis with partial removal of tissue at head of penis,1250.6,812.89,78.57,1272.43,19
CDM,54437_1,Repair of penis,1618.0,1051.7,78.57,2064.79,19
CDM,54440_1,Repair of injury of penis,2446.5,1590.23,78.57,1661.66,15
CDM,54450_1,Repositioning of foreskin including scar tissue removal,219.5,142.68,46.62,174.16,19
CDM,54500_1,Needle biopsy of testicle,315.0,204.75,24.7,226.39,19
CDM,54505_1,Incision of testicle for biopsy,957.6,622.44,78.57,642.48,19
CDM,54512_1,Removal of growth of testicle,1609.7,1046.31,78.57,1649.0,19
CDM,54520_1,Simple removal of testicle,1452.15,943.9,78.57,995.14,19
CDM,54522_1,Partial removal of testicle,1742.0,1132.3,78.57,1805.67,19
CDM,54530_1,Removal of growth of testicle through groin,1639.1,1065.42,78.57,1547.45,19
CDM,54535_1,Removal of growth of testicle through abdomen,2211.3,1437.35,78.57,2280.94,19
CDM,54550_1,Exploration of spermatic veins and scrotum using an endoscope,1466.9,953.49,78.57,1507.26,19
CDM,54560_1,Exploration for location of testicle in abdomen,2019.2,1312.48,78.57,2106.2,19
CDM,54600_1,Repair of twisted testicle,1356.6,881.79,78.57,1388.29,19
CDM,54620_1,Suture of testicle to other testicle,1367.1,888.62,78.57,915.83,19
CDM,54636415_1,Insertion of needle into vein for collection of blood sample,12.0,7.8,3.0,30.99,19
CDM,54640_1,Repositioning and suture of misplaced testicle,2401.95,1561.27,78.57,1323.13,19
CDM,54650_1,Repair of congenital malpositioned testicle,2124.2,1380.73,78.57,2180.83,19
CDM,54660_1,Insertion of testicular implant,1589.25,1033.01,78.57,1093.49,19
CDM,54670_1,Suture or repair of injury to testicle,1209.6,786.24,78.57,1244.12,19
CDM,54680_1,Transplantation of testicles to thigh,2354.1,1530.17,78.57,2415.38,19
CDM,54681003_1,Automated urinalysis test,20.0,13.0,0.45,51.65,19
CDM,54682962_1,Blood glucose (sugar) test performed by hand-held instrument,15.0,9.75,0.49,38.74,19
CDM,54683540_1,Iron level,56.0,36.4,3.62,144.62,19
CDM,54683550_1,Iron binding capacity,76.0,49.4,6.43,196.27,19
CDM,54687220_1,Tissue fungi or parasites,35.0,22.75,1.49,90.39,19
CDM,54687502_1,Detection test by nucleic acid for multiple types influenza virus,200.0,130.0,95.8,516.5,19
CDM,54690_1,Removal of testicles using an endoscope,1965.6,1277.64,78.57,2012.23,19
CDM,54692_1,Removal of congenital malpositioned testicle using an endoscope,2318.4,1506.96,78.57,2318.89,19
CDM,54700_1,"Incision and drainage of sperm reservoir, testis, and/or scrotal area",1052.1,683.87,78.57,648.85,19
CDM,5472IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.12,5.28,2.03,20.97,16
CDM,5472OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.95,4.52,1.74,17.95,16
CDM,54800_1,Needle biopsy of sperm reservoir,480.0,312.0,18.52,382.33,19
CDM,54830_1,Removal of growth of sperm duct,1101.5,715.98,78.57,1139.09,19
CDM,54836415_1,Insertion of needle into vein for collection of blood sample,12.0,7.8,3.0,30.99,19
CDM,54840_1,Removal of fluid accumulation in sperm reservoir,1575.0,1023.75,78.57,983.58,19
CDM,54860_1,Removal of sperm reservoir,1250.6,812.89,78.57,1283.08,19
CDM,54861_1,Removal of both sperm reservoirs,1693.7,1100.91,78.57,1736.26,19
CDM,54865_1,Search of sperm reservoir,1062.6,690.69,78.57,1097.94,19
CDM,54883540_1,Iron level,56.0,36.4,3.62,144.62,19
CDM,54883550_1,Iron binding capacity,76.0,49.4,6.43,196.27,19
CDM,54885610_1,"Blood test, clotting time",20.0,13.0,0.86,51.65,19
CDM,54886300_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 15-3",102.0,66.3,13.66,263.42,19
CDM,54900_1,Connection of sperm reservoir to sperm duct,2358.3,1532.9,78.57,2455.67,19
CDM,54901_1,Connection of both sperm reservoirs to sperm ducts,2536.23,1648.55,78.57,3243.14,19
CDM,55000_1,Aspiration of fluid collection in testicle and sperm reservoir,537.15,349.15,13.41,287.64,19
CDM,55010000_1,Insertion of needle into vein for collection of blood sample,12.0,7.8,3.0,30.99,19
CDM,55040_1,Removal of fluid collection in testicle and sperm reservoir,1102.5,716.63,78.57,1031.43,19
CDM,55041_1,Removal of fluid collection in both testicles and sperm reservoirs,1706.3,1109.1,78.57,1561.51,19
CDM,55060_1,Repair of fluid collection in testicle and sperm reservoir,1122.5,729.63,78.57,1162.51,19
CDM,55085347_1,"Coagulation time measurement, activated",109.0,70.85,4.28,281.49,19
CDM,55100_1,Drainage of abscess of scrotum,1037.4,674.31,49.4,549.53,19
CDM,55110_1,Search of scrotum,1144.5,743.93,78.57,1182.78,19
CDM,55120_1,Removal of foreign body in scrotum,864.3,561.8,78.57,1082.83,19
CDM,55150_1,Removal of diseased or injured scrotum,1450.1,942.57,78.57,1501.78,19
CDM,55175_1,Simple repair of scrotum,1102.5,716.63,78.57,1110.5,19
CDM,55180_1,Complicated repair of scrotum,2047.5,1330.88,78.57,2106.09,19
CDM,55200_1,Incision of sperm duct,1508.9,980.79,78.57,918.67,19
CDM,55202330_1,"Calcium level, ionized",50.0,32.5,6.84,129.13,19
CDM,55202803_1,Blood gases measurement,239.85,155.9,26.07,619.41,19
CDM,55202947_1,Blood glucose (sugar) level,20.0,13.0,0.79,51.65,19
CDM,55204132_1,Blood potassium level,23.0,14.95,1.09,59.4,19
CDM,55204295_1,Blood sodium level,24.0,15.6,1.15,61.98,19
CDM,55205014_1,Red blood cell concentration measurement,12.0,7.8,0.28,30.99,19
CDM,55207801_1,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",1500.0,975.0,50.59,3873.75,19
CDM,55250_1,Removal of sperm duct,1260.0,819.0,78.57,803.08,19
CDM,55280047_1,"Blood test, basic group of blood chemicals (Calcium, ionized)",97.0,63.05,10.64,250.5,19
CDM,55282330_1,"Calcium level, ionized",88.0,57.2,12.04,227.26,19
CDM,55282375_1,Carboxyhemoglobin (protein) level,91.0,59.15,11.21,235.01,19
CDM,55282435_1,Blood chloride level,34.0,22.1,1.56,87.81,19
CDM,55282565_1,Blood creatinine level,33.0,21.45,1.69,85.22,19
CDM,55282583_1,"HC CBC AND PLATELET W/AUTO DIFF, NBU",35.0,22.75,15.75,90.39,16
CDM,55282803_1,Blood gases measurement,239.85,155.9,26.07,619.41,19
CDM,55282805_1,"Blood gases measurement, with O2 saturation",489.0,317.85,78.77,1262.84,19
CDM,55282947_1,Blood glucose (sugar) level,29.0,18.85,1.14,74.89,19
CDM,55282948_1,HC GLUCOSE SUPPLIES AND EQUIPMENT,15.0,9.75,3.75,10.5,11
CDM,55282962_1,Blood glucose (sugar) test performed by hand-held instrument,15.0,9.75,0.49,38.74,19
CDM,55283605_1,Lactic acid level,74.0,48.1,8.56,191.11,19
CDM,55284132_1,Blood potassium level,34.0,22.1,1.62,87.81,19
CDM,55284295_1,Blood sodium level,36.0,23.4,1.73,92.97,19
CDM,55285014_1,Red blood cell concentration measurement,18.0,11.7,0.43,46.49,19
CDM,55285015_1,"HC CBC AND PLATELET, NBU",32.0,20.8,14.4,82.64,16
CDM,55285018_1,"Blood count, hemoglobin",18.0,11.7,0.43,46.49,19
CDM,55285347_1,"Coagulation time measurement, activated",20.0,13.0,0.86,51.65,19
CDM,55285610_1,"Blood test, clotting time",20.0,13.0,0.86,51.65,19
CDM,55285730_1,"Coagulation assessment blood test, plasma or whole blood",52.0,33.8,3.13,134.29,19
CDM,55300_1,Incision of sperm duct for X-ray procedure,564.9,367.19,78.57,567.92,19
CDM,5539IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.85,3.15,1.21,12.53,16
CDM,55400153_1,"Bilirubin level, direct",44.0,28.6,2.21,113.63,19
CDM,55400154_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,55400155_1,Buprenorphine level,140.0,91.0,16.44,361.55,18
CDM,55400156_1,Fentanyl level,140.0,91.0,16.44,361.55,18
CDM,55400157_1,"Benzodiazepines levels, 1-12",140.0,91.0,16.44,361.55,18
CDM,55400158_1,"Amphetamines levels, 1 or 2",140.0,91.0,16.44,361.55,18
CDM,55400159_1,Propoxyphene level,140.0,91.0,16.44,361.55,18
CDM,55400160_1,Methadone level,140.0,91.0,16.44,361.55,18
CDM,55400161_1,PCP drug level,140.0,91.0,14.45,361.55,19
CDM,55400162_1,Opiates levels,140.0,91.0,16.44,361.55,18
CDM,55400163_1,Alkaloids levels,140.0,91.0,16.44,361.55,18
CDM,55400164_1,"Cannabinoids levels, natural",140.0,91.0,16.44,361.55,18
CDM,55400165_1,Cocaine level,140.0,91.0,16.44,361.55,18
CDM,55400166_1,"Testing for presence of drug, by chemistry analyzers",125.0,81.25,62.14,322.81,19
CDM,55400167_1,"Testing for presence of drug, by chemistry analyzers",117.0,76.05,59.67,302.15,19
CDM,55400168_1,"Testing for presence of drug, by chemistry analyzers",280.0,182.0,62.14,723.1,19
CDM,55400169_1,Oxycodone levels,140.0,91.0,16.44,361.55,18
CDM,55400170_1,Rheumatoid factor level,28.0,18.2,1.59,72.31,19
CDM,55400171_1,Vitamin D-3 level,145.0,94.25,29.6,374.46,19
CDM,55400172_1,"Stool analysis for blood, by fecal hemoglobin determination by immunoassay",20.6,13.39,3.28,53.2,19
CDM,55400173_1,"COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS",45.0,29.25,8.12,116.21,19
CDM,55400174_1,Immunologic analysis technique on serum (immunofixation),129.94,84.46,13.66,335.57,19
CDM,55400175_1,"Protein measurement, serum",45.0,29.25,4.83,116.21,19
CDM,55400176_1,"Calcium level, ionized",50.98,33.14,6.97,131.66,19
CDM,55400177_1,Blood gases measurement,239.85,155.9,26.07,619.41,19
CDM,55400178_1,Methadone level,240.0,156.0,16.44,619.8,18
CDM,55400179_1,"Cannabinoids levels, natural",160.0,104.0,16.44,413.2,18
CDM,55400180_1,Procalcitonin (hormone) level,167.0,108.55,15.65,431.28,19
CDM,55400181_1,"Troponin (protein) analysis, quantitative",73.0,47.45,9.1,188.52,19
CDM,55400182_1,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,220.0,143.0,50.59,568.15,19
CDM,55400183_1,Measurement of acetaminophen,150.0,97.5,14.3,387.38,19
CDM,55400184_1,Measurement of methotrexate,98.0,63.7,14.3,253.09,19
CDM,55400185_1,Measurement of salicylate,280.0,182.0,14.3,723.1,19
CDM,55400186_1,Screening test for pathogenic organisms,33.0,21.45,2.19,85.22,19
CDM,55400187_1,"Coagulation assessment blood test, substitution, plasma fractions",85.5,55.58,5.24,220.8,19
CDM,55400188_1,"Coagulation assessment blood test, substitution, plasma fractions",47.47,30.86,3.07,122.59,19
CDM,55400189_1,Blood smear interpretation by physician with written report,56.0,36.4,13.45,78.57,19
CDM,55400190_1,Platelet aggregation function test,537.83,349.59,24.91,1388.95,19
CDM,55400191_1,Special stained specimen slides to examine tissue including interpretation and report,184.0,119.6,34.57,475.18,19
CDM,55400192_1,Special stained specimen slides to examine tissue including interpretation and report,184.0,119.6,34.57,475.18,19
CDM,55400253_1,"Bilirubin level, total",44.0,28.6,2.21,113.63,19
CDM,55400304_1,Blood potassium level,40.0,26.0,1.9,103.3,19
CDM,55400520_1,"Urea nitrogen level to assess kidney function, quantitative",35.0,22.75,1.38,90.39,19
CDM,55400_1,Incision or repair of sperm duct,3150.0,2047.5,78.57,3244.5,19
CDM,55403880_1,Natriuretic peptide (heart and blood vessel protein) level,60.61,39.4,23.8,156.53,19
CDM,55408227_1,Specimen analysis for blood,24.0,15.6,1.28,61.98,19
CDM,55410195_1,Sirolimus level,68.0,44.2,9.34,175.61,19
CDM,55410307_1,"Testing for presence of drug, by chemistry analyzers",326.01,211.91,62.14,841.92,19
CDM,55412105_1,"Alpha-fetoprotein (AFP) level, serum",83.0,53.95,13.92,214.35,19
CDM,55412106_1,"Alpha-fetoprotein (AFP) level, serum",145.0,94.25,14.14,374.46,19
CDM,55412192_1,Prealbumin (protein) level,72.0,46.8,10.5,185.94,19
CDM,55412232_1,Beta-2 microglobulin (protein) level,150.47,97.81,15.65,388.59,19
CDM,55412336_1,Albumin (protein) level,33.0,21.45,1.63,85.22,19
CDM,55412423_1,Immunologic analysis technique on serum (immunofixation),205.55,133.61,13.66,530.83,19
CDM,55412534_1,C-peptide (protein) level,102.0,66.3,14.14,263.42,19
CDM,55412627_1,Dehydroepiandrosterone (DHEA-S) hormone level,101.0,65.65,15.65,260.83,19
CDM,55413003_1,Human growth hormone level,82.0,53.3,13.67,211.77,19
CDM,55413010_1,Haptoglobin (serum protein) level,62.0,40.3,7.8,160.12,19
CDM,55413013_1,"Hemoglobin analysis and measurement, electrophoresis",393.96,256.07,12.87,1017.4,19
CDM,55413014_1,"Testing for presence of drug, by chemistry analyzers",280.0,182.0,62.14,723.1,19
CDM,55413015_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55413016_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55413018_1,Methylenedioxyamphetamines levels,140.0,91.0,16.44,361.55,18
CDM,55413019_1,Barbiturates levels,140.0,91.0,16.44,361.55,18
CDM,55413023_1,"Hemoglobin analysis and measurement, chromatography",295.65,192.17,6.99,763.52,19
CDM,55413030_1,Fetal hemoglobin level,66.0,42.9,6.43,170.45,19
CDM,55413090_1,Homocysteine (amino acid) level,92.0,59.8,15.65,237.59,19
CDM,55413525_1,"Insulin measurement, total",56.0,36.4,6.4,144.62,19
CDM,55413655_1,Lead level,60.0,39.0,7.27,154.95,19
CDM,55413656_1,Lead level,90.0,58.5,10.9,232.43,19
CDM,55413970_1,Parathormone (parathyroid hormone) level,202.0,131.3,41.28,521.67,19
CDM,55413971_1,Parathormone (parathyroid hormone) level,268.0,174.2,41.28,692.11,19
CDM,55414036_1,"Phenylalanine, PKU (amino acid) level",48.0,31.2,2.64,123.96,19
CDM,55414165_1,"Protein measurement, serum",53.0,34.45,5.69,136.87,19
CDM,55414166_1,"Protein measurement, body fluid",88.0,57.2,14.14,227.26,19
CDM,55414350_1,Measurement of hydrogen in breath to test for stomach and bowel symptoms,702.0,456.3,80.37,1812.92,18
CDM,55414402_1,"Testosterone (hormone) level, free",221.0,143.65,15.65,570.73,19
CDM,55414458_1,Cyclosporine level,89.0,57.85,14.3,229.84,19
CDM,55414471_1,"Alpha-fetoprotein (AFP) level, serum",145.0,94.25,14.14,374.46,19
CDM,55414472_1,"Alpha-fetoprotein (AFP) level, amniotic fluid",145.0,94.25,14.14,374.46,19
CDM,55414479_1,Estriol (hormone) level,209.0,135.85,15.65,539.74,19
CDM,55414513_1,"Amino acid level, 6 or more amino acids, quantitative, each specimen",146.0,94.9,14.14,377.05,19
CDM,55414705_1,"Gonadotropin, chorionic (reproductive hormone) level",131.0,85.15,15.05,338.31,19
CDM,55415440_1,Measurement of hemolysin (red blood cell destructive substance),77.0,50.05,5.24,198.85,19
CDM,55416067_1,"Alpha-1-antitrypsin (protein) blood test, total",66.0,42.9,8.87,170.45,19
CDM,55416157_1,Urine microalbumin (protein) level,29.0,18.85,1.68,74.89,19
CDM,55416162_1,"Measurement of complement (immune system proteins), antigen,",56.0,36.4,6.72,144.62,19
CDM,55416163_1,"Measurement of complement (immune system proteins), antigen,",56.0,36.4,6.72,144.62,19
CDM,55416300_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 15-3",204.73,133.07,13.66,528.72,19
CDM,55416301_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9",102.0,66.3,13.66,263.42,19
CDM,55416305_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 125",102.0,66.3,13.66,263.42,19
CDM,55416328_1,Transferrin (iron binding protein) level,63.0,40.95,8.04,162.7,19
CDM,55416329_1,Ceruloplasmin (protein) level,53.0,34.45,5.69,136.87,19
CDM,55416330_1,Gammaglobulin (immune system protein) measurement,46.0,29.9,4.28,118.8,19
CDM,55416336_1,Inhibin A (reproductive organ hormone) measurement,135.0,87.75,13.66,348.64,19
CDM,55416337_1,"Immunologic analysis technique on body fluid, other fluids with concentration",221.0,143.65,29.35,570.73,19
CDM,55416431_1,Rheumatoid factor level,28.0,18.2,1.59,72.31,19
CDM,55418553_1,Carcinoembryonic antigen (CEA) protein level,93.0,60.45,14.14,240.17,19
CDM,55418965_1,Tacrolimus level,245.0,159.25,13.73,632.71,19
CDM,55419075_1,Aldosterone hormone level,353.0,229.45,40.75,911.62,19
CDM,55419515_1,Gammaglobulin (immune system protein) measurement,46.0,29.9,4.28,118.8,19
CDM,55419802_1,"Thyroid hormone, T3 measurement, free",77.0,50.05,13.04,198.85,19
CDM,55419824_1,Gastrin (GI tract hormone) level,153.0,99.45,15.65,395.12,19
CDM,55419846_1,Adrenocorticotropic hormone (ACTH) level,189.0,122.85,38.62,488.09,19
CDM,55419847_1,Vitamin A level,66.88,43.47,7.76,172.72,19
CDM,55419848_1,Vitamin E level,66.88,43.47,9.48,172.72,19
CDM,5542IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.04,1.98,0.76,7.85,16
CDM,5542OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.17,9.86,3.79,39.18,16
CDM,5545IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.45,3.54,1.36,14.07,16
CDM,5545OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.3,7.35,2.83,29.18,16
CDM,55480047_1,"Blood test, basic group of blood chemicals (Calcium, ionized)",62.0,40.3,8.51,160.12,19
CDM,55480048_1,"Blood test, basic group of blood chemicals (Calcium, total)",42.0,27.3,3.55,108.47,19
CDM,55480051_1,"Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)",35.0,22.75,2.45,90.39,19
CDM,55480053_1,"Blood test, comprehensive group of blood chemicals",52.0,33.8,5.49,134.29,19
CDM,55480061_1,"Blood test, lipids (cholesterol and triglycerides)",66.0,42.9,8.84,170.45,19
CDM,55480069_1,Kidney function blood test panel,64.0,41.6,5.56,165.28,19
CDM,55480076_1,Liver function blood test panel,40.0,26.0,3.27,103.3,19
CDM,55480100_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480101_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480102_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480103_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480104_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480105_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480106_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480107_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480108_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480113_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480114_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480115_1,"Testing for presence of drug, by chemistry analyzers",503.0,326.95,62.14,1299.0,19
CDM,55480116_1,"Testing for presence of drug, by chemistry analyzers",111.0,72.15,56.61,286.66,19
CDM,55480117_1,"Testing for presence of drug, by chemistry analyzers",119.0,77.35,60.69,307.32,19
CDM,55480155_1,"Carbamazepine level, total",66.0,42.9,9.62,170.45,19
CDM,55480157_1,"Carbamazepine level, free",83.0,53.95,11.0,214.35,19
CDM,55480162_1,"Digoxin level, total",65.0,42.25,8.63,167.86,19
CDM,55480164_1,"Valproic acid level, total",388.0,252.2,13.54,1002.01,19
CDM,55480165_1,"Valproic acid level, total",67.0,43.55,9.07,173.03,19
CDM,55480169_1,Everolimus level,102.0,66.3,13.73,263.42,19
CDM,55480170_1,Gentamicin (antibiotic) level,81.0,52.65,13.27,209.18,19
CDM,55480181_1,"Phenytoin level, total",65.0,42.25,8.61,167.86,19
CDM,55480186_1,"Phenytoin level, free",119.0,77.35,13.76,307.32,19
CDM,55480197_1,Theophylline level,64.0,41.6,9.05,165.28,19
CDM,55480200_1,Tobramycin (antibiotic) level,79.0,51.35,12.74,204.02,19
CDM,55480202_1,Vancomycin (antibiotic) level,67.0,43.55,9.07,173.03,19
CDM,55480299_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,55480320_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",207.0,134.55,51.75,534.58,19
CDM,55480321_1,"Alcohols levels, 1 or 2",100.01,65.01,16.44,258.28,18
CDM,55480329_1,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",150.0,97.5,37.5,387.38,19
CDM,55480330_1,"Testing for presence of drug, by chemistry analyzers",280.0,182.0,62.14,723.1,19
CDM,55480801_1,Urinalysis using microscope,16.0,10.4,0.49,41.32,19
CDM,55481000_1,Automated urinalysis test,11.63,7.56,0.26,30.03,19
CDM,55481004_1,"Urobilinogen (metabolism substance) analysis, urine",32.0,20.8,1.43,82.64,19
CDM,55481007_1,"Ketone bodies analysis, qualitative",40.0,26.0,1.81,103.3,19
CDM,55481015_1,Crystal identification from tissue or body fluid,35.0,22.75,2.57,90.39,19
CDM,55481025_1,Urine pregnancy test,30.0,19.5,2.58,77.48,19
CDM,55482009_1,"Ketone bodies analysis, qualitative",40.0,26.0,1.81,103.3,19
CDM,55482010_1,"Ketone bodies analysis, qualitative",40.0,26.0,1.81,103.3,19
CDM,55482011_1,"Ketone bodies analysis, quantitative",51.0,33.15,4.17,131.71,19
CDM,55482040_1,Albumin (protein) level,25.0,16.25,1.24,64.56,19
CDM,55482042_1,"Cerebrospinal fluid, or amniotic fluid albumin (protein) level",36.0,23.4,2.8,92.97,19
CDM,55482112_1,Amikacin (antibiotic) level,72.0,46.8,10.86,185.94,19
CDM,55482140_1,Ammonia level,66.0,42.9,9.62,170.45,19
CDM,55482150_1,Amylase (enzyme) level,48.0,31.2,3.11,123.96,19
CDM,55482151_1,Amylase (enzyme) level,48.0,31.2,3.11,123.96,19
CDM,55482153_1,"Bilirubin level, direct",25.0,16.25,1.26,64.56,19
CDM,55482154_1,Amylase (enzyme) level,48.0,31.2,3.11,123.96,19
CDM,55482155_1,Amylase (enzyme) level,56.0,36.4,3.63,144.62,19
CDM,55482201_1,Phenobarbital level,69.0,44.85,10.56,178.19,19
CDM,55482245_1,"Analysis of urine, except immunoassays",16.0,10.4,0.35,41.32,19
CDM,55482252_1,"Bilirubin level, total",44.0,28.6,2.21,113.63,19
CDM,55482253_1,"Bilirubin level, total",25.0,16.25,1.26,64.56,19
CDM,55482269_1,Microscopic examination for white blood cells with manual cell count,35.0,22.75,1.33,90.39,19
CDM,55482270_1,Stool analysis for blood to screen for colon tumors,20.0,13.0,0.88,51.65,19
CDM,55482271_1,Specimen analysis for blood,24.0,15.6,1.28,61.98,19
CDM,55482272_1,"Stool analysis for blood, by peroxidase activity",20.0,13.0,0.85,51.65,19
CDM,55482306_1,Vitamin D-3 level,145.0,94.25,29.6,374.46,19
CDM,55482325_1,"Calcium level, total",26.0,16.9,1.34,67.15,19
CDM,55482327_1,Urine calcium level,30.0,19.5,1.81,77.48,19
CDM,55482330_1,"Calcium level, ionized",62.0,40.3,8.48,160.12,19
CDM,55482376_1,Carboxyhemoglobin (protein) level,61.0,39.65,7.52,157.53,19
CDM,55482438_1,Chloride level,43.0,27.95,2.15,111.05,19
CDM,55482440_1,Urine chloride level,26.0,16.9,1.5,67.15,19
CDM,55482441_1,Blood chloride level,23.0,14.95,1.06,59.4,19
CDM,55482465_1,Cholesterol level,22.0,14.3,0.96,56.82,19
CDM,55482525_1,Copper level,61.0,39.65,7.57,157.53,19
CDM,55482550_1,"Creatine kinase (cardiac enzyme) level, total",32.0,20.8,2.08,82.64,19
CDM,55482565_1,Blood creatinine level,26.0,16.9,1.33,67.15,19
CDM,55482570_1,Creatinine level to test for kidney function or muscle injury,26.0,16.9,1.35,67.15,19
CDM,55482572_1,Creatinine level to test for kidney function or muscle injury,26.0,16.9,1.35,67.15,19
CDM,55482575_1,Creatinine clearance measurement to test for kidney function,47.0,30.55,4.45,121.38,19
CDM,55482607_1,Cyanocobalamin (vitamin B-12) level,74.0,48.1,11.16,191.11,19
CDM,55482610_1,Cystatin C (enzyme inhibitor) level,46.3,30.1,8.57,119.57,19
CDM,55482644_1,"Electrophoresis, laboratory testing technique",277.0,180.05,33.2,715.35,19
CDM,55482669_1,"Testing for presence of drug, by chemistry analyzers",250.0,162.5,62.14,645.63,19
CDM,55482672_1,Measurement of total estradiol (hormone),130.0,84.5,15.65,335.73,19
CDM,55482705_1,"Stool fat or lipids analysis, qualitative",38.0,24.7,1.94,98.14,19
CDM,55482727_1,Ferritin (blood protein) level,67.0,43.55,9.13,173.03,19
CDM,55482731_1,Fetal fibronectin (protein) analysis,472.0,306.8,64.41,1218.94,19
CDM,55482746_1,"Folic acid level, serum",72.0,46.8,10.58,185.94,19
CDM,55482747_1,"Folic acid level, RBC",150.0,97.5,14.14,387.38,19
CDM,55482800_1,Blood pH level,50.0,32.5,5.5,129.13,19
CDM,55482804_1,Blood gases measurement,239.85,155.9,26.07,619.41,19
CDM,55482805_1,Body fluid pH level,18.0,11.7,0.64,46.49,19
CDM,55482806_1,"Blood gases measurement, with O2 saturation",355.0,230.75,78.77,916.79,19
CDM,55482810_1,"Blood gas, oxygen saturation measurement",44.0,28.6,4.3,113.63,19
CDM,55482830_1,Carbon dioxide (bicarbonate) level,24.0,15.6,1.17,61.98,19
CDM,55482892_1,Blood gases measurement,239.85,155.9,26.07,619.41,19
CDM,55482945_1,Glucose (sugar) level on body fluid,20.0,13.0,0.79,51.65,19
CDM,55482950_1,Glucose (sugar) level on body fluid,20.0,13.0,0.79,51.65,19
CDM,55482977_1,Glutamyltransferase (liver enzyme) level,53.0,34.45,3.82,136.87,19
CDM,55483001_1,"Gonadotropin, follicle stimulating (reproductive hormone) level",91.0,59.15,15.65,235.01,19
CDM,55483002_1,"Gonadotropin, luteinizing (reproductive hormone) level",91.0,59.15,15.65,235.01,19
CDM,55483022_1,Hemoglobin A1C level,18.47,12.01,1.79,47.7,19
CDM,55483032_1,Plasma hemoglobin level,64.0,41.6,4.68,165.28,19
CDM,55483050_1,"Methemoglobin (hemoglobin) analysis, quantitative",37.0,24.05,3.03,95.55,19
CDM,55483160_1,Gonadotropin (reproductive hormone) analysis,66.0,42.9,4.96,170.45,19
CDM,55483343_1,HDL cholesterol level,41.0,26.65,3.36,105.88,19
CDM,55483520_1,Measurement of substance using immunoassay technique,78.0,50.7,13.47,201.44,19
CDM,55483521_1,Measurement of substance using immunoassay technique,78.0,50.7,13.47,201.44,19
CDM,55483545_1,Iron level,32.0,20.8,2.07,82.64,19
CDM,55483549_1,Iron binding capacity,76.0,49.4,6.43,196.27,19
CDM,55483550_1,Iron binding capacity,76.0,49.4,6.43,196.27,19
CDM,55483576_1,Blood sodium level,24.0,15.6,1.15,61.98,19
CDM,55483577_1,Blood potassium level,23.0,14.95,1.09,59.4,19
CDM,55483578_1,Blood chloride level,23.0,14.95,1.06,59.4,19
CDM,55483579_1,Blood glucose (sugar) level,20.0,13.0,0.79,51.65,19
CDM,55483580_1,Blood gases measurement,239.85,155.9,26.07,619.41,19
CDM,55483581_1,"Urea nitrogen level to assess kidney function, quantitative",20.0,13.0,0.79,51.65,19
CDM,55483582_1,Red blood cell concentration measurement,12.0,7.8,0.28,30.99,19
CDM,55483605_1,Lactic acid level,74.0,48.1,8.56,191.11,19
CDM,55483615_1,Lactate dehydrogenase (enzyme) level,30.0,19.5,1.81,77.48,19
CDM,55483663_1,"Fetal lung maturity assessment, fluorescence polarization",164.0,106.6,14.14,423.53,19
CDM,55483690_1,Lipase (fat enzyme) level,34.0,22.1,2.34,87.81,19
CDM,55483725_1,Lithium level,33.0,21.45,2.18,85.22,19
CDM,55483750_1,Magnesium level,33.0,21.45,2.21,85.22,19
CDM,55483753_1,Magnesium level,33.0,21.45,2.21,85.22,19
CDM,55483874_1,Myoglobin (muscle protein) level,112.0,72.8,12.92,289.24,19
CDM,55483881_1,Natriuretic peptide (heart and blood vessel protein) level,177.0,115.05,33.2,457.1,19
CDM,55483916_1,Measurement of immune substance (oligoclonal bands),412.0,267.8,27.39,1063.99,19
CDM,55483921_1,Organic acid level,109.0,70.85,14.14,281.49,19
CDM,55483930_1,Blood osmolality (concentration) measurement,33.0,21.45,2.18,85.22,19
CDM,55483935_1,Urine osmolality (concentration) measurement,34.0,22.1,2.32,87.81,19
CDM,55483986_1,Body fluid pH level,18.0,11.7,0.64,46.49,19
CDM,55484075_1,"Phosphatase (enzyme) level, alkaline",47.7,31.01,2.47,123.19,19
CDM,55484100_1,Phosphate level,24.0,15.6,1.14,61.98,19
CDM,55484105_1,Urine phosphate level,27.0,17.55,1.56,69.73,19
CDM,55484133_1,Urine potassium level,22.0,14.3,1.04,56.82,19
CDM,55484143_1,Progesterone (reproductive hormone) level,102.0,66.3,15.65,263.42,19
CDM,55484145_1,Procalcitonin (hormone) level,91.82,59.68,15.65,237.13,19
CDM,55484148_1,Prolactin (milk producing hormone) level,95.0,61.75,15.65,245.34,19
CDM,55484154_1,"PSA (prostate specific antigen) measurement, free",90.0,58.5,14.14,232.43,19
CDM,55484155_1,"Total protein level, blood",19.0,12.35,0.7,49.07,19
CDM,55484158_1,"Total protein level, urine",19.0,12.35,0.7,49.07,19
CDM,55484159_1,"Total protein level, body fluid",19.0,12.35,0.76,49.07,19
CDM,55484160_1,"Total protein level, body fluid",19.0,12.35,0.76,49.07,19
CDM,55484255_1,Selenium (vitamin) level,115.0,74.75,14.45,296.99,19
CDM,55484270_1,Sex hormone binding globulin (protein) level,107.0,69.55,14.14,276.33,19
CDM,55484300_1,Urine sodium level,23.0,14.95,1.16,59.4,19
CDM,55484302_1,Sodium level,42.0,27.3,2.04,108.47,19
CDM,55484328_1,"Blood glucose (sugar) tolerance test, 3 specimens",63.0,40.95,8.11,162.7,19
CDM,55484329_1,"Blood glucose (sugar) tolerance test, each additional beyond 3 specimens",18.0,11.7,0.71,46.49,19
CDM,55484330_1,Blood glucose (sugar) level,20.0,13.0,0.79,51.65,19
CDM,55484348_1,Blood glucose (sugar) level after receiving dose of glucose,24.0,15.6,1.14,61.98,19
CDM,55484362_1,"Analysis of urine, except immunoassays",10.0,6.5,0.22,25.83,19
CDM,55484402_1,"Testosterone (hormone) level, total",127.0,82.55,15.65,327.98,19
CDM,55484404_1,"Blood test, thyroid stimulating hormone (TSH)",83.0,53.95,13.94,214.35,19
CDM,55484432_1,Thyroglobulin (thyroid related hormone) level,79.0,51.35,12.69,204.02,19
CDM,55484438_1,"Thyroxine (thyroid chemical), free",43.0,27.95,3.88,111.05,19
CDM,55484448_1,"Liver enzyme (SGPT), level",26.0,16.9,1.38,67.15,19
CDM,55484450_1,"Liver enzyme (SGOT), level",26.0,16.9,1.35,67.15,19
CDM,55484477_1,Triglycerides level,29.0,18.85,1.66,74.89,19
CDM,55484479_1,"Thyroid hormone, T3 measurement, total",64.0,41.6,9.08,165.28,19
CDM,55484483_1,"Troponin (protein) analysis, quantitative",57.0,37.05,7.11,147.2,19
CDM,55484484_1,"Troponin (protein) analysis, quantitative",57.0,37.05,7.11,147.2,19
CDM,55484485_1,"PSA (prostate specific antigen) measurement, total",90.0,58.5,14.14,232.43,19
CDM,55484486_1,PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA),90.0,58.5,13.66,232.43,19
CDM,55484487_1,"Troponin (protein) analysis, quantitative",57.0,37.05,7.11,147.2,19
CDM,55484500_1,"Cortisol (hormone) measurement, total",74.0,48.1,12.06,191.11,19
CDM,55484520_1,"Urea nitrogen level to assess kidney function, quantitative",20.0,13.0,0.79,51.65,19
CDM,55484540_1,"Urea nitrogen level to assess kidney function, urine",26.0,16.9,1.45,67.15,19
CDM,55484545_1,"Urea nitrogen level to assess kidney function, clearance",49.0,31.85,3.53,126.54,19
CDM,55484555_1,"Uric acid level, blood",23.0,14.95,1.04,59.4,19
CDM,55484560_1,Uric acid level,46.75,30.39,2.37,120.73,19
CDM,55484630_1,Zinc level,52.0,33.8,5.92,134.29,19
CDM,55484702_1,"Gonadotropin, chorionic (reproductive hormone) level",74.0,48.1,11.14,191.11,19
CDM,55484703_1,Gonadotropin (reproductive hormone) analysis,37.0,24.05,2.78,95.55,19
CDM,55485396_1,"Coagulation or fibrinolysis (clot dissolving) function measurement with interpretation and written report, per day",614.72,399.57,19.73,1587.51,19
CDM,55485576_1,Platelet aggregation function test,365.66,237.68,24.91,944.32,19
CDM,55486140_1,Measurement C-reactive protein for detection of infection or inflammation,26.0,16.9,1.35,67.15,19
CDM,55486141_1,"Creatine kinase (cardiac enzyme) level, MB fraction only",111.66,72.58,11.55,288.36,19
CDM,55486142_1,Quantitation of therapeutic drug,171.5,111.48,14.3,442.9,19
CDM,55486143_1,"Measurement C-reactive protein for detection of infection or inflammation, high sensitivity",64.0,41.6,8.29,165.28,19
CDM,55486800_1,Thyroglobulin (thyroid protein) antibody measurement,72.0,46.8,11.46,185.94,19
CDM,55487210_1,Smear for infectious agents,32.0,20.8,1.86,82.64,19
CDM,55487651_1,"Detection test by nucleic acid for Strep (Streptococcus, group A), amplified probe technique",90.0,58.5,31.58,232.43,19
CDM,55489304_1,Blood potassium level,23.0,14.95,1.09,59.4,19
CDM,55489306_1,Blood sodium level,24.0,15.6,1.15,61.98,19
CDM,55489478_1,Automated urinalysis test,15.0,9.75,0.34,38.74,19
CDM,55498554_1,LDL cholesterol level,48.0,31.2,5.04,123.96,19
CDM,55500_1,Removal of fluid collection in sperm cord,1120.4,728.26,78.57,1193.09,19
CDM,55501001_1,Platelet aggregation function test,161.0,104.65,24.91,415.78,19
CDM,55501002_1,Platelet aggregation function test,161.0,104.65,24.91,415.78,19
CDM,55501003_1,Platelet aggregation function test,161.0,104.65,24.91,415.78,19
CDM,55501004_1,Clotting factor VIII (AHG) measurement,218.0,141.7,5.24,562.99,19
CDM,55501005_1,Clotting factor VIII related antigen measurement,196.0,127.4,20.42,506.17,19
CDM,55501006_1,Clotting factor VIII (VW factor) measurement,196.0,127.4,22.94,506.17,19
CDM,55501007_1,Clotting factor IX (PTC or Christmas) measurement,208.53,135.54,19.04,538.53,19
CDM,55501008_1,Clotting factor IX (PTC or Christmas) measurement,218.0,141.7,19.04,562.99,19
CDM,55501009_1,Platelet aggregation function test,137.0,89.05,24.91,353.8,19
CDM,55501010_1,Platelet aggregation function test,211.0,137.15,24.91,544.91,19
CDM,55501011_1,Platelet aggregation function test,113.0,73.45,24.91,291.82,19
CDM,55501012_1,Platelet aggregation function test,113.0,73.45,24.91,291.82,19
CDM,55501013_1,Platelet aggregation function test,113.0,73.45,24.91,291.82,19
CDM,55501014_1,Platelet aggregation function test,113.0,73.45,24.91,291.82,19
CDM,55501015_1,Platelet aggregation function test,113.0,73.45,24.91,291.82,19
CDM,55501016_1,Phospholipid test,258.0,167.7,5.24,666.29,19
CDM,55501017_1,"Blood test, clotting time, substitution",115.0,74.75,3.94,296.99,19
CDM,55501018_1,"Clotting factor X assessment test, diluted",78.0,50.7,5.24,201.44,19
CDM,55501019_1,"Thrombin time, fibrinogen screening test, plasma",43.0,27.95,2.48,111.05,19
CDM,55501020_1,"Thrombin time, fibrinogen screening test, plasma",43.0,27.95,2.48,111.05,19
CDM,55501021_1,"Coagulation assessment blood test, plasma or whole blood",30.0,19.5,1.8,77.48,19
CDM,55501022_1,"Coagulation assessment blood test, substitution, plasma fractions",63.0,40.95,4.08,162.7,19
CDM,55501023_1,"Antibody identification test, platelet antibodies",964.82,627.13,13.66,2491.65,19
CDM,55501024_1,Measurement of blood coagulation and fibrinolysis (clot dissolving) function,1954.0,1270.1,29.94,5046.21,19
CDM,55501025_1,Clotting factor inhibitor test,73.0,47.45,5.24,188.52,19
CDM,55501027_1,"Red blood cell sedimentation rate, to detect inflammation, automated",15.0,9.75,0.41,38.74,19
CDM,55501028_1,Gastric acid analysis,17.0,11.05,1.14,43.9,19
CDM,55505397_1,Measurement of blood coagulation and fibrinolysis (clot dissolving) function,31.08,20.2,9.59,80.26,19
CDM,55505525_1,Platelet function test,53.94,35.06,5.24,139.3,19
CDM,55510130_1,Measurement of immunoglobulin light chains,45.0,29.25,7.77,116.21,19
CDM,55515045_1,"Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, differential lysis",117.0,76.05,6.99,302.15,19
CDM,55515240_1,Clotting factor VIII (AHG) measurement,208.53,135.54,5.24,538.53,19
CDM,55515525_1,Heparin neutralization test,54.0,35.1,5.24,139.46,19
CDM,55520_1,Removal of growth of sperm cord,1765.65,1147.67,78.57,1334.84,19
CDM,55530_1,Removal of spermatic cord venous dilation or tying of spermatic veins,1968.75,1279.69,78.57,1075.52,19
CDM,55535_1,Removal of spermatic cord venous dilation or suturing of spermatic veins,1281.0,832.65,78.57,1318.24,19
CDM,55540_1,Removal of spermatic cord venous dilation or suturing spermatic veins with hernia repair,1428.0,928.2,78.57,1617.43,19
CDM,55550_1,Tying of sperm veins using an endoscope,1312.5,853.13,78.57,1313.12,19
CDM,55581001_1,"Manual urinalysis test with examination using microscope, automated",28.16,18.3,0.89,72.72,19
CDM,55582583_1,"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count",35.0,22.75,2.72,90.39,19
CDM,55583521_1,Measurement of immunoglobulin light chains,45.0,29.25,7.77,116.21,19
CDM,55585006_1,Microscopic examination for white blood cells,27.0,17.55,0.93,69.73,19
CDM,55585015_1,"Complete blood cell count (red cells, white blood cell, platelets), automated test",32.0,20.8,2.07,82.64,19
CDM,55585030_1,Automated white blood cell count,14.0,9.1,0.36,36.16,19
CDM,55585040_1,Microscopic examination for white blood cells with manual cell count,35.0,22.75,1.33,90.39,19
CDM,55585046_1,"Red blood count automated, with additional calculations",29.0,18.85,1.62,74.89,19
CDM,55585047_1,"Red blood count automated, with additional calculations",28.0,18.2,1.56,72.31,19
CDM,55585049_1,"Platelet count, automated test",33.0,21.45,1.48,85.22,19
CDM,55585050_1,"Blood count, hemoglobin",12.0,7.8,0.28,30.99,19
CDM,55585055_1,Red blood cell concentration measurement,12.0,7.8,0.28,30.99,19
CDM,55585056_1,Reticulated (young) platelet measurement,161.0,104.65,29.94,415.78,19
CDM,55585064_1,"Blood test, clotting time, substitution",159.28,103.53,3.94,411.34,19
CDM,55585065_1,"Coagulation assessment blood test, substitution, plasma fractions",116.1,75.47,5.24,299.83,19
CDM,55585347_1,"Coagulation time measurement, activated",110.0,71.5,4.28,284.08,19
CDM,55585375_1,Fibrinogen (factor 1) activity measurement,45.4,29.51,4.41,117.25,19
CDM,55585379_1,"Coagulation function measurement, D-dimer; quantitative",85.3,55.45,5.24,220.29,19
CDM,55585384_1,Fibrinogen (factor 1) activity measurement,150.0,97.5,5.24,387.38,19
CDM,55585390_1,Coagulation function screening test with interpretation and report,150.0,97.5,5.24,387.38,19
CDM,55585520_1,Heparin assay,114.0,74.1,5.24,294.41,19
CDM,55585521_1,Heparin assay,92.52,60.14,5.24,238.93,19
CDM,55585576_1,Platelet aggregation function test,113.0,73.45,24.91,291.82,19
CDM,55585577_1,Platelet aggregation function test,113.0,73.45,24.91,291.82,19
CDM,55585578_1,Platelet aggregation function test,159.0,103.35,24.91,410.62,19
CDM,55585610_1,"Blood test, clotting time",27.38,17.8,1.17,70.71,19
CDM,55585651_1,"Red blood cell sedimentation rate, to detect inflammation, non-automated",20.0,13.0,0.85,51.65,19
CDM,55585663_1,Red blood cell sickling measurement,30.0,19.5,1.65,77.48,19
CDM,55585670_1,"Thrombin time, fibrinogen screening test, plasma",43.0,27.95,2.48,111.05,19
CDM,55585730_1,"Coagulation assessment blood test, plasma or whole blood",30.0,19.5,1.8,77.48,19
CDM,55586300_1,Screening test for mononucleosis (mono),26.0,16.9,1.35,67.15,19
CDM,55587015_1,Concentration of specimen for infectious agents,33.0,21.45,2.2,85.22,19
CDM,55587207_1,Special stain for inclusion bodies or parasites,65.0,42.25,3.89,167.86,19
CDM,55587210_1,Smear for infectious agents,32.0,20.8,1.86,82.64,19
CDM,55587211_1,Smear for infectious agents,32.0,20.8,1.86,82.64,19
CDM,55587880_1,"Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep)",75.0,48.75,12.4,193.69,19
CDM,55588283_1,"Chromosome analysis for genetic defects, additional specialized banding technique",225.0,146.25,54.96,581.06,19
CDM,55589051_1,Body fluid cell count with cell identification,64.0,41.6,3.58,165.28,19
CDM,55589052_1,Body fluid cell count with cell identification,83.0,53.95,4.65,214.35,19
CDM,55589451_1,Body fluid cell count with cell identification,71.0,46.15,3.98,183.36,19
CDM,55589725_1,Antithrombin III antigen (clotting inhibitor) activity,82.5,53.63,5.24,213.06,19
CDM,5558IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.72,5.02,1.93,19.94,16
CDM,5558OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.3,6.05,2.33,24.02,16
CDM,55600001_1,"Special stained specimen slides to examine tissue, initial procedure",62.0,40.3,31.62,195.22,19
CDM,55600002_1,Surgical pathology procedure,37.0,24.05,18.87,95.55,19
CDM,55600003_1,"Special stained specimen slides to examine tissue, initial procedure",87.0,56.55,44.37,224.68,19
CDM,55600004_1,Special stained specimen slides to identify organisms including interpretation and report,75.0,48.75,38.25,193.69,19
CDM,55600005_1,Electron microscopy for diagnosis,972.0,631.8,191.4,2510.19,19
CDM,55600007_1,HC RSCH: PROCESS & EMBED ONLY,28.0,18.2,7.0,19.6,11
CDM,55600008_1,HC RSCH: PROCESS ONLY,9.0,5.85,2.25,6.3,11
CDM,55600009_1,HC RSCH: UNSTAINED SLIDE,10.0,6.5,2.5,7.0,11
CDM,55600010_1,HC RSCH: UNSTAINED FROZEN SLIDE,9.0,5.85,2.25,6.3,11
CDM,55600011_1,HC RSCH: SPECIAL STAIN SIMPLE,79.0,51.35,19.75,55.3,11
CDM,55600012_1,HC RSCH: IMMUNOFLUORESCENT STAIN,113.0,73.45,28.25,79.1,11
CDM,55600013_1,HC RSCH: CYTOLOGY NONGYN FILTER,52.0,33.8,13.0,36.4,11
CDM,55600019_1,HC RSCH: DNA ENZYME DIGESTION,84.0,54.6,21.0,58.8,11
CDM,55600020_1,HC RSCH: NUCLEIC ACID SEPARATION AGAROSE MICRO,66.0,42.9,16.5,46.2,11
CDM,55600021_1,HC RSCH: KRAS PYROSEQUENCING,140.0,91.0,35.0,98.0,11
CDM,55600031_1,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure",112.0,72.8,57.12,289.24,19
CDM,55600032_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",163.0,105.95,83.13,420.95,19
CDM,55600033_1,Blood bank physician services for investigation of transfusion reaction with written report,125.0,81.25,53.33,322.81,19
CDM,55600036_1,Preparation of tissue for examination by removing any calcium present,109.0,70.85,8.65,281.49,19
CDM,55600037_1,Electron microscopy for diagnosis,419.4,272.61,191.4,1083.1,19
CDM,55600_1,Incision or puncture of fluid-producing gland for sperm movement,1010.48,656.81,78.57,1290.99,19
CDM,55605_1,Complicated incision of fluid-producing glands for sperm movement,1296.1,842.47,78.57,1598.88,19
CDM,5560751T_1,Digitization of glass microscope slides for level II surgical pathology,15.0,9.75,3.75,47.79,18
CDM,5560752T_1,Digitization of glass microscope slides for level III surgical pathology,15.0,9.75,3.75,47.79,18
CDM,5560753T_1,Digitization of glass microscope slides for level IV surgical pathology,15.0,9.75,3.75,47.79,18
CDM,5560754T_1,Digitization of glass microscope slides for level V surgical pathology,15.0,9.75,3.75,195.22,18
CDM,5560755T_1,Digitization of glass microscope slides for level VI surgical pathology,15.0,9.75,3.75,195.22,18
CDM,5560756T_1,Digitization of glass microscope slides for Group I special stain for microorganisms,15.0,9.75,3.75,47.79,18
CDM,5560757T_1,Digitization of glass microscope slides for Group II special stain,15.0,9.75,3.75,47.79,18
CDM,5560758T_1,Digitization of glass microscope slides for histochemical special stain on frozen tissue block,15.0,9.75,3.75,195.22,18
CDM,5560759T_1,Digitization of glass microscope slides for Group III special stain,15.0,9.75,3.75,195.22,18
CDM,5560760T_1,"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, initial single antibody stain procedure",15.0,9.75,3.75,195.22,18
CDM,5560761T_1,"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, each additional single antibody stain procedure",15.0,9.75,3.75,195.22,18
CDM,5560762T_1,"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, each multiplex antibody stain procedure",15.0,9.75,3.75,195.22,18
CDM,5560763T_1,"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry, each manual single antibody stain procedure",15.0,9.75,3.75,195.22,18
CDM,55610453_1,Electron microscopy for diagnosis,350.0,227.5,178.5,903.88,19
CDM,55610454_1,"Antibody evaluation, initial single antibody stain procedure",49.5,32.18,25.25,297.45,19
CDM,55610455_1,"Antibody evaluation, each additional single antibody stain procedure",49.5,32.18,25.25,127.83,19
CDM,55618330_1,"Pathology examination of specimen during surgery, first tissue block",500.0,325.0,43.19,1291.25,19
CDM,55618332_1,"Pathology examination of specimen during surgery, each additional tissue block",229.0,148.85,24.57,591.39,19
CDM,55650_1,Removal of fluid-producing glands for sperm movement,2145.2,1394.38,78.57,2198.48,19
CDM,55680_1,Removal of congenital remnant of fluid-producing glands for sperm movement,856.5,556.73,78.57,1462.86,19
CDM,55683256_1,"Special stained specimen slides to examine tissue, initial procedure",269.0,174.85,83.76,694.69,19
CDM,55685097_1,"Pathology examination of tissue using a microscope, intermediate complexity",223.0,144.95,37.85,575.9,19
CDM,55685100_1,"Bone marrow, smear interpretation",169.0,109.85,51.91,789.07,19
CDM,55685105_1,"Pathology examination of tissue using a microscope, intermediate complexity",384.0,249.6,37.85,991.68,19
CDM,55685106_1,"Pathology examination of tissue using a microscope, high complexity",1204.0,782.6,191.4,3109.33,19
CDM,55685107_1,Special stained specimen slides to identify organisms including interpretation and report,230.0,149.5,46.86,593.98,19
CDM,55685108_1,"Special stained specimen slides to examine tissue, initial procedure",290.0,188.5,83.76,748.93,19
CDM,55685112_1,Preparation of tissue for examination by removing any calcium present,36.0,23.4,8.65,92.97,19
CDM,55685670_1,"Thrombin time, fibrinogen screening test, plasma",71.0,46.15,4.1,183.36,19
CDM,55685671_1,"Thrombin time, fibrinogen screening test, plasma",71.0,46.15,4.1,183.36,19
CDM,55688183_1,"Special stained specimen slides to examine tissue, initial procedure",320.0,208.0,83.76,826.4,19
CDM,55688200_1,Electron microscopy for diagnosis,1109.0,720.85,191.4,2863.99,19
CDM,55688300_1,"Pathology examination of tissue using a microscope, limited examination",104.0,67.6,12.94,268.58,19
CDM,55688303_1,"Pathology examination of tissue using a microscope, limited examination",104.0,67.6,12.94,268.58,19
CDM,55688305_1,"Pathology examination of tissue using a microscope, intermediate complexity",77.0,50.05,37.85,198.85,19
CDM,55688310_1,"Pathology examination of tissue using a microscope, intermediate complexity",223.0,144.95,37.85,575.9,19
CDM,55688311_1,"Pathology examination of tissue using a microscope, moderately high complexity",725.0,471.25,191.4,1872.31,19
CDM,55688314_1,Special stained specimen slides to examine tissue and frozen preparation of specimen including interpretation and report,308.0,200.2,46.86,795.41,19
CDM,55688315_1,"Pathology examination of tissue using a microscope, moderately low complexity",204.0,132.6,33.58,526.83,19
CDM,55688316_1,Pathology examination of tissue using a microscope,104.0,67.6,25.23,268.58,19
CDM,55688319_1,Evaluation of specimen enzymes,251.05,163.18,116.27,669.29,19
CDM,55688323_1,Surgical pathology consultation and report on referred material requiring preparation of slides,223.0,144.95,31.8,575.9,19
CDM,55688330_1,"Pathology examination of specimen during surgery, first tissue block",235.0,152.75,43.19,606.89,19
CDM,55688331_1,Special stained specimen slides to examine tissue including interpretation and report,184.0,119.6,34.57,475.18,19
CDM,55688332_1,"Pathology examination of specimen during surgery, each additional tissue block",104.0,67.6,24.57,268.58,19
CDM,55688340_1,"Special stained specimen slides to examine tissue, each additional procedure",224.0,145.6,46.86,578.48,19
CDM,55688341_1,"Special stained specimen slides to examine tissue, each additional procedure",224.0,145.6,46.86,578.48,19
CDM,55688342_1,"Special stained specimen slides to examine tissue, initial procedure",290.0,188.5,83.76,748.93,19
CDM,55688344_1,"Special stained specimen slides to examine tissue, each multiplex procedure",380.0,247.0,143.92,981.35,19
CDM,55688345_1,"Special stained specimen slides to examine tissue, initial procedure",88.0,57.2,44.88,227.26,19
CDM,55688346_1,"Antibody evaluation, initial single antibody stain procedure",125.0,81.25,63.75,322.81,19
CDM,55688347_1,"Antibody evaluation, initial single antibody stain procedure",329.0,213.85,116.63,849.64,19
CDM,55688348_1,"Antibody evaluation, initial single antibody stain procedure",137.0,89.05,69.87,353.8,19
CDM,55688349_1,"Antibody evaluation, initial single antibody stain procedure",131.0,85.15,66.81,338.31,19
CDM,55688350_1,"Antibody evaluation, initial single antibody stain procedure",131.0,85.15,66.81,338.31,19
CDM,55688353_1,"Antibody evaluation, initial single antibody stain procedure",131.0,85.15,66.81,338.31,19
CDM,55688354_1,"Antibody evaluation, initial single antibody stain procedure",131.0,85.15,66.81,338.31,19
CDM,55688355_1,"Antibody evaluation, initial single antibody stain procedure",131.0,85.15,66.81,338.31,19
CDM,55688356_1,"Antibody evaluation, initial single antibody stain procedure",131.0,85.15,66.81,338.31,19
CDM,55688357_1,"Genetic sequencing localization, each multiplex procedure",219.0,142.35,111.69,565.57,19
CDM,55688358_1,"Antibody evaluation, each additional single antibody stain procedure",261.0,169.65,46.86,674.03,19
CDM,55688360_1,"Microscopic genetic analysis of tumor, manual",320.0,208.0,84.12,826.4,19
CDM,55688361_1,"Genetic sequencing localization, initial procedure",286.0,185.9,141.19,738.6,19
CDM,55688364_1,"Genetic sequencing localization, each additional procedure",426.0,276.9,46.86,1100.15,19
CDM,55688365_1,"Genetic sequencing localization, initial procedure",646.0,419.9,141.19,1668.3,19
CDM,55688367_1,"Genetic sequencing localization, initial procedure",646.0,419.9,141.19,1668.3,19
CDM,55688368_1,"Special stained specimen slides to examine tissue, initial procedure",336.0,218.4,83.76,867.72,19
CDM,55688379_1,"Pathology examination of tissue using a microscope, intermediate complexity",223.0,144.95,37.85,575.9,19
CDM,55688380_1,"Special stained specimen slides to examine tissue, initial procedure",320.0,208.0,83.76,826.4,19
CDM,55688381_1,"Pathology examination of tissue using a microscope, intermediate complexity",223.0,144.95,37.85,575.9,19
CDM,55688382_1,"Genetic sequencing localization, initial procedure",286.0,185.9,141.19,738.6,19
CDM,55688387_1,"Pathologist examination, dissection, and preparation of tissue",35.0,22.75,7.6,90.39,19
CDM,55689481_1,"Antibody evaluation, initial single antibody stain procedure",850.0,552.5,116.63,2195.13,19
CDM,55689482_1,Electron microscopy for diagnosis,1000.0,650.0,191.4,2582.5,19
CDM,556G0416_1,"SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATIONS, FOR PROSTATE NEEDLE BIOPSY, ANY METHOD",647.0,420.55,161.75,1670.88,19
CDM,55700_1,Biopsy of prostate gland,682.5,443.63,53.33,578.31,15
CDM,55705_1,Incisional biopsy of prostate gland,810.6,526.89,78.57,813.51,19
CDM,55706_1,Needle biopsy of prostate gland using image guidance,1146.6,745.29,78.57,1143.24,19
CDM,55707_1,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",317.0,206.05,73.6,326.51,16
CDM,55708142_1,"Pap test, manual screening",24.0,15.6,4.86,61.98,19
CDM,55708_1,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE, FIRST TARGETED LESION",396.0,257.4,73.6,407.88,16
CDM,55709_1,"BIOPSY, PROSTATE, TRANSPERINEAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",380.0,247.0,73.6,391.4,16
CDM,55710021_1,"Fine needle aspiration biopsy, first growth",465.0,302.25,237.15,1200.86,16
CDM,55710_1,"BIOPSY, PROSTATE, TRANSPERINEAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE BIOPSY, FIRST TARGETED LESION",440.0,286.0,73.6,453.2,16
CDM,55711_1,"BIOPSY, PROSTATE, TRANSRECTAL, MRI-ULTRASOUND-FUSION GUIDED, TARGETED LESION(S) ONLY, FIRST TARGETED LESION",316.0,205.4,73.6,325.48,16
CDM,55712_1,"BIOPSY, PROSTATE, TRANSPERINEAL, MRI-ULTRASOUND-FUSION GUIDED, TARGETED LESION(S) ONLY, FIRST TARGETED LESION",368.0,239.2,73.6,379.04,16
CDM,55713_1,"BIOPSY, PROSTATE, IN-BORE CT- OR MRI-GUIDED (IE, SEXTANT), WITH BIOPSY OF ADDITIONAL TARGETED LESION(S), FIRST TARGETED LESION",434.0,282.1,73.6,447.02,16
CDM,55714_1,"BIOPSY, PROSTATE, IN-BORE CT- OR MRI-GUIDED TARGETED LESION(S) ONLY, FIRST TARGETED LESION",395.0,256.75,73.6,406.85,16
CDM,55715_1,"BIOPSY, PROSTATE, EACH ADDITIONAL, MRI-ULTRASOUND FUSION OR IN-BORE CT- OR MRI-GUIDED TARGETED LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",110.0,71.5,43.62,113.3,16
CDM,55720_1,Simple incision and drainage of abscess of prostate,1084.05,704.63,78.57,1385.04,19
CDM,55725_1,Complicated incision and drainage of abscess of prostate,1760.9,1144.59,78.57,1819.53,19
CDM,55786381_1,Nasal smear for eosinophils (allergy related white blood cells),35.0,22.75,2.03,90.39,19
CDM,55786399_1,"SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, BY TECHNICIAN UNDER PHYSICIAN SUPERVISION",103.0,66.95,15.92,266.0,19
CDM,55786401_1,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION",63.0,40.95,12.76,162.7,19
CDM,55786402_1,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION",63.0,40.95,12.76,162.7,19
CDM,55786403_1,"Pap test, slides, manual screening (the Bethesda System)",69.0,44.85,12.79,178.19,19
CDM,55788104_1,"Cell examination of body fluid, smears",151.0,98.15,34.57,389.96,19
CDM,55788106_1,"Cell examination of body fluid, simple filter method",123.0,79.95,25.23,317.65,19
CDM,55788108_1,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION",63.0,40.95,12.76,162.7,19
CDM,55788110_1,"Screening examination of specimen cells, screening and interpretation",123.0,79.95,25.23,317.65,19
CDM,55788111_1,"Cell examination of specimen, concentration technique",161.0,104.65,34.57,415.78,19
CDM,55788112_1,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION",63.0,40.95,12.76,162.7,19
CDM,55788113_1,"Cell examination of specimen, selective cellular enhancement technique",223.0,144.95,38.68,575.9,19
CDM,55788161_1,"Screening examination of specimen cells, preparation, screening and interpretation",63.0,40.95,25.23,162.7,19
CDM,55788172_1,Evaluation of fine needle aspirate,646.0,419.9,23.26,1668.3,19
CDM,55788174_1,Evaluation of fine needle aspirate with interpretation and report,264.0,171.6,50.75,681.78,19
CDM,55788177_1,"Pap test, evaluation of fine needle aspirate, immediate, each additional evaluation episode",30.0,19.5,7.27,77.48,19
CDM,55788304_1,"Pathology examination of tissue using a microscope, intermediate complexity",223.0,144.95,37.85,575.9,19
CDM,55788312_1,Special stained specimen slides to identify organisms including interpretation and report,230.0,149.5,46.86,593.98,19
CDM,55788313_1,Special stained specimen slides to examine tissue including interpretation and report,208.0,135.2,34.57,537.16,19
CDM,55788319_1,Evaluation of specimen enzymes,248.22,161.34,116.27,669.29,19
CDM,55788333_1,"Pathology cytologic examination of specimen during surgery, initial site",725.0,471.25,33.22,1872.31,19
CDM,55788334_1,"Pathology cytologic examination of specimen during surgery, each additional site",123.0,79.95,19.38,317.65,19
CDM,55801001_1,Genome-wide microarray analysis for copy number and single nucleotide polymorphism (SNP) variants,2797.0,1818.05,1160.0,32445.2,19
CDM,55801002_1,Genome-wide microarray analysis for copy number and single nucleotide polymorphism (SNP) variants,2797.0,1818.05,1160.0,32445.2,19
CDM,55801003_1,Genome-wide microarray analysis for copy number and single nucleotide polymorphism (SNP) variants,2797.0,1818.05,1160.0,32445.2,19
CDM,55801004_1,Genome-wide microarray analysis for copy number and single nucleotide polymorphism (SNP) variants,2797.0,1818.05,1160.0,32445.2,19
CDM,55801005_1,Molecular pathology procedure level 4 genetic analysis,508.0,330.2,185.2,1311.91,19
CDM,55801006_1,Molecular pathology procedure level 4 genetic analysis,508.0,330.2,185.2,1311.91,19
CDM,55801007_1,Molecular pathology procedure level 7 genetic analysis,2160.0,1404.0,194.33,6110.21,19
CDM,55801008_1,Molecular pathology procedure level 7 genetic analysis,2160.0,1404.0,194.33,6110.21,19
CDM,55801009_1,Tissue culture for tumor disorders,610.0,396.5,147.52,1575.33,19
CDM,55801010_1,Tissue culture for tumor disorders,610.0,396.5,147.52,1575.33,19
CDM,55801011_1,"Chromosome analysis for genetic defects, count 15-20 cells",710.0,461.5,54.96,1833.58,19
CDM,55801012_1,"Chromosome analysis for genetic defects, count 15-20 cells",710.0,461.5,54.96,1833.58,19
CDM,55801013_1,"Chromosome analysis for genetic defects, count 15-20 cells",710.0,461.5,54.96,1833.58,19
CDM,55801014_1,"Chromosome analysis for genetic defects, count 15-20 cells",710.0,461.5,54.96,1833.58,19
CDM,55801015_1,"Chromosome analysis for genetic defects, count 15-20 cells",710.0,461.5,54.96,1833.58,19
CDM,55801016_1,"Chromosome analysis for genetic defects, count 15-20 cells",710.0,461.5,54.96,1833.58,19
CDM,55801017_1,"Chromosome analysis for genetic defects, count 15-20 cells",710.0,461.5,54.96,1833.58,19
CDM,55801018_1,"Chromosome analysis for genetic defects, count 15-20 cells",710.0,461.5,54.96,1833.58,19
CDM,55801019_1,"Chromosome analysis for genetic defects, count 15-20 cells",710.0,461.5,54.96,1833.58,19
CDM,55801020_1,Chromosome analysis of amniotic fluid or placenta for genetic defects,745.0,484.25,188.57,1923.96,19
CDM,55801021_1,Chromosome analysis of amniotic fluid or placenta for genetic defects,745.0,484.25,188.57,1923.96,19
CDM,55801022_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801023_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801024_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801025_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801026_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801027_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801028_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801029_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801031_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801032_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801033_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801034_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801035_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801036_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801037_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801038_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801039_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801040_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801041_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801042_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801043_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801044_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801045_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801046_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801047_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801048_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801049_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801050_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801051_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801052_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801053_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801054_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801055_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801056_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801057_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801058_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801059_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801060_1,"Chromosome analysis for genetic defects, analyze 3-5 cells",140.0,91.0,40.7,361.55,19
CDM,55801061_1,"Chromosome analysis for genetic defects, analyze 10-30 cells",140.0,91.0,34.81,361.55,19
CDM,55801062_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",150.0,97.5,42.38,387.38,19
CDM,55801063_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",150.0,97.5,42.38,387.38,19
CDM,55801064_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",150.0,97.5,42.38,387.38,19
CDM,55801065_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801066_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801067_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801068_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801069_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801070_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801071_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801072_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801073_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801074_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801075_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801076_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801077_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801078_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801079_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801080_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801081_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801082_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801083_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801084_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801085_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801086_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801087_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801088_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801089_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801090_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801091_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801092_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801093_1,DNA testing for genetic defects,154.0,100.1,21.42,397.71,19
CDM,55801094_1,"Chromosome analysis for genetic defects, analyze 25-99 cells",307.0,199.55,42.38,792.83,19
CDM,55801095_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801096_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801097_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801098_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801099_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801100_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801101_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801102_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801103_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801104_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801105_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801106_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801107_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801108_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801109_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801110_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801111_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801112_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801113_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801114_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801115_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801116_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801117_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801118_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801119_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801120_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801121_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801122_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801123_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801124_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801125_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801126_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801127_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801128_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801129_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801130_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801131_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801132_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801133_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801134_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801135_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801136_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801137_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801138_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801139_1,"Chromosome analysis for genetic defects, analyze 100-300 cells",169.0,109.85,51.19,436.44,19
CDM,55801140_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801141_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801142_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801143_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801144_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801145_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801146_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801147_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801148_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801149_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801150_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801151_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801152_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801153_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801154_1,DNA testing for genetic defects,91.0,59.15,19.49,235.01,19
CDM,55801155_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55801_1,Partial removal of prostate gland through incision between scrotum and anus,3284.4,2134.86,78.57,3355.28,19
CDM,55810_1,"Removal of prostate gland, glands for sperm movement, and sperm duct",3978.5,2586.03,78.57,4001.14,19
CDM,55812_1,Removal of prostate gland with lymph node biopsy through incision between scrotum and anus,3916.3,2545.6,78.57,4918.25,19
CDM,55815_1,Removal of prostate gland through incision between scrotum and anus and removal of surrounding lymph nodes on both sides of pelvis,4259.75,2768.84,78.57,5385.56,19
CDM,55821_1,Partial removal of prostate (suprapubic),2913.8,1893.97,78.57,2675.78,19
CDM,55831_1,Partial removal of prostate (retropubic),2913.8,1893.97,78.57,2896.23,19
CDM,55840_1,Removal of prostate,4059.3,2638.55,78.57,3578.41,19
CDM,55842_1,Removal of prostate gland and lymph node biopsy through abdominal incision,4351.2,2828.28,78.57,3579.44,19
CDM,55845_1,Removal of prostate gland and surrounding lymph nodes on both sides of pelvis through abdominal incision,4979.1,3236.42,78.57,4162.49,19
CDM,55860_1,Surgical opening of prostate for radiation therapy,2107.15,1369.65,78.57,2682.11,19
CDM,55862_1,Exposure of prostate gland for radiation therapy with biopsy of lymph nodes,2680.48,1742.31,78.57,3354.76,19
CDM,55865_1,Exposure of prostate gland for radiation therapy with removal of surrounding lymph nodes on both sides of pelvis,3206.28,2084.08,78.57,4087.06,19
CDM,55866_1,Surgical removal of prostate and surrounding lymph nodes using an endoscope,5288.9,3437.79,78.57,4406.46,19
CDM,55867_1,Simple surgical subtotal removal of prostate using laparoscope,2347.5,1525.88,78.57,3387.66,19
CDM,55869_1,"LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING, INCLUDES ROBOTIC ASSISTANCE, WHEN PERFORMED; WITH BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC, HYPOGAST",3365.0,2187.25,73.6,3465.95,16
CDM,55870_1,Insertion of device to enhance semen discharge,417.3,271.25,71.49,431.8,19
CDM,55873_1,Destruction of prostate using imaging guidance,3570.0,2320.5,78.57,13830.21,19
CDM,55874_1,Injection of biodegradable material next to prostate,725.0,471.25,78.57,6962.81,19
CDM,55875_1,Insertion of needle or tube into prostate for radiation therapy,1845.9,1199.84,78.57,2354.88,19
CDM,55876_1,Placement of device in prostate for radiation therapy,413.7,268.91,78.57,363.69,19
CDM,55877_1,"ABLATION, IRREVERSIBLE ELECTROPORATION, PROSTATE, 1 OR MORE TUMORS, INCLUDING IMAGING GUIDANCE, PERCUTANEOUS",1571.0,1021.15,73.6,1618.13,16
CDM,55880_1,"High-intensity ultrasound destruction of cancerous tissue in prostate gland, accessed through rectum using ultrasound guidance",2306.5,1499.23,78.57,2685.67,19
CDM,55881229_1,Genome-wide microarray analysis for copy number and single nucleotide polymorphism (SNP) variants,500.0,325.0,255.0,5800.0,19
CDM,55881331_1,Methylation analysis (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A),140.0,91.0,51.07,361.55,19
CDM,55881402_1,Molecular pathology procedure level 3,375.0,243.75,150.33,968.44,19
CDM,55881404_1,Molecular pathology procedure level 5 genetic analysis,825.0,536.25,194.33,2267.35,19
CDM,55881405_1,Molecular pathology procedure level 6 genetic analysis,1680.0,1092.0,194.33,5062.68,19
CDM,55881407_1,Molecular pathology procedure level 8 genetic analysis,2729.0,1773.85,773.6,23094.71,19
CDM,55881408_1,Molecular pathology procedure level 9 genetic analysis,4800.0,3120.0,2000.0,96000.0,19
CDM,55888230_1,Tissue culture to identify white blood cell disorders,480.0,312.0,116.49,1239.6,19
CDM,55888233_1,Tissue culture to identify skin disorders,580.0,377.0,140.73,1497.85,19
CDM,55888235_1,Tissue culture for disorders of amniotic fluid or placenta cells,605.0,393.25,150.3,1562.41,19
CDM,55888237_1,Tissue culture for tumor disorders of bone marrow and blood cells,525.0,341.25,143.75,1355.81,19
CDM,55888240_1,"Cryopreservation, freezing and storage of cells",246.0,159.9,5.88,635.3,19
CDM,55888241_1,Thawing and expansion of frozen cells,403.0,261.95,5.88,1040.75,19
CDM,55888248_1,"Chromosome analysis for genetic defects, baseline breakage, score 50-100 cells, count 20 cells",445.0,289.25,173.17,1149.21,19
CDM,55888249_1,"Chromosome analysis for genetic defects, score 100 cells, clastogen stress",509.0,330.85,173.17,1314.49,19
CDM,55888261_1,"Chromosome analysis for genetic defects, count 5 cells",730.0,474.5,194.33,1929.68,19
CDM,55888263_1,"Chromosome analysis for genetic defects, count 45 cells for mosaicism",614.0,399.1,150.29,1585.66,19
CDM,55888264_1,"Chromosome analysis for genetic defects, analyze 20-25 cells",306.0,198.9,144.61,790.25,19
CDM,55888269_1,Chromosome analysis of amniotic fluid for genetic defects,498.0,323.7,173.66,1286.09,19
CDM,55888280_1,"Chromosome analysis for genetic defects, additional karyotypes, each study",176.0,114.4,33.47,454.52,19
CDM,55888285_1,"Chromosome analysis for genetic defects, additional cells counted, each study",134.0,87.1,26.91,346.06,19
CDM,55888289_1,"Chromosome analysis for genetic defects, additional high resolution study",115.0,74.75,34.43,296.99,19
CDM,55888377_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",816.0,530.4,152.32,2107.32,19
CDM,55920_1,Insertion of needles or tubes into pelvic or genital organs for radiation therapy,1332.5,866.13,78.57,1395.3,19
CDM,5593IP _1,NITROFURANTOIN MCR 100 MG CAP,17.2,11.18,4.3,12.04,11
CDM,5599IP _1,"INJECTION, NITROGLYCERIN, 5 MG",81.22,52.79,1.61,209.75,17
CDM,5599OP _1,"INJECTION, NITROGLYCERIN, 5 MG",9.65,6.27,1.61,24.92,17
CDM,56000015_1,HC RSCH: RT DNA SYNTHESIS,80.0,52.0,20.0,56.0,11
CDM,56000016_1,HC RSCH: NUCLEIC ACID  AMPLIFICATION,66.0,42.9,16.5,46.2,11
CDM,56000018_1,HC RSCH: SARCOMA INTERP,33.0,21.45,8.25,23.1,11
CDM,56001374_1,"HLA class I typing, low resolution one antigen equivalent",548.0,356.2,54.96,1415.21,19
CDM,56001376_1,HLA class II typing low resolution one locus,548.0,356.2,54.96,1415.21,19
CDM,56001377_1,HLA class II typing low resolution one antigen equivalent,548.0,356.2,54.96,1415.21,19
CDM,56001379_1,HLA Class I typing high resolution,1705.0,1108.25,194.33,5718.23,19
CDM,56001380_1,HLA class I typing high resolution one locus,860.0,559.0,177.25,2220.95,19
CDM,56001381_1,HLA class I typing high resolution one allele or allele group,548.0,356.2,169.9,1415.21,19
CDM,56001382_1,HLA class II typing high resolution one locus,1554.0,1010.1,54.96,4013.21,19
CDM,56001383_1,HLA class II typing high resolution one allele or allele group,860.0,559.0,54.96,2220.95,19
CDM,56001384_1,"HLA class I and II typing high resolution HLA-A, -B, -C, and -DRB1",2750.0,1787.5,194.33,9503.18,19
CDM,56001385_1,HLA Class I typing high resolution,2500.0,1625.0,194.33,8384.5,19
CDM,56001386_1,HLA class I typing high resolution one locus,1500.0,975.0,177.25,3873.75,19
CDM,56001387_1,HLA class II typing high resolution one locus,1500.0,975.0,54.96,3873.75,19
CDM,56001388_1,"HLA class I and II typing, low resolution HLA-A, -B, and -DRB1",1750.0,1137.5,404.52,7079.1,19
CDM,56001389_1,Immunology procedures,45.0,29.25,13.66,116.21,18
CDM,56001390_1,"Chimerism analysis post transplantation, with cell selection",1500.0,975.0,194.33,3911.85,19
CDM,56001391_1,"Chimerism analysis post transplantation, with cell selection",1500.0,975.0,194.33,3911.85,19
CDM,56001392_1,Molecular pathology procedure,1200.0,780.0,54.96,3099.0,18
CDM,56001393_1,"Chimerism analysis post transplantation, without cell selection",1200.0,780.0,194.33,3099.0,19
CDM,56005147_1,"Transplant antibody measurement, standard method",157.0,102.05,73.62,405.45,19
CDM,5604IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.36,9.33,3.59,37.08,16
CDM,5604OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.68,8.24,3.17,32.75,16
CDM,5606IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",78.46,51.0,19.62,202.62,16
CDM,5606OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.33,11.91,4.58,47.34,16
CDM,56081256_1,Gene analysis (hemochromatosis) common variants,270.0,175.5,54.96,697.28,19
CDM,56081265_1,Comparative analysis using Short Tandem Repeat (STR) markers of patient and specimen,890.0,578.5,194.33,2298.43,19
CDM,56081267_1,"Chimerism analysis post transplantation, without cell selection",1360.0,884.0,194.33,3512.2,19
CDM,56081268_1,"Chimerism analysis post transplantation, with cell selection",1360.0,884.0,194.33,3546.74,19
CDM,56081269_1,"Chimerism analysis post transplantation, with cell selection",1075.0,698.75,194.33,2803.49,19
CDM,56081370_1,"HLA class I and II typing low resolution HLA-A, -B, -C, -DRB1/3/4/5 and -DQB1",1500.0,975.0,402.12,6031.8,19
CDM,56081371_1,"HLA class I and II typing, low resolution HLA-A, -B, and -DRB1",995.0,646.75,404.52,4024.97,19
CDM,56081372_1,HLA class I typing low resolution,961.0,624.65,403.59,3878.5,19
CDM,56081373_1,HLA class I typing low resolution one locus,548.0,356.2,54.96,1415.21,19
CDM,56081374_1,"HLA class I typing, low resolution one antigen equivalent",548.0,356.2,54.96,1415.21,19
CDM,56081375_1,HLA class II typing low resolution HLA-DRB1/3/4/5 and -DQB1,754.0,490.1,194.33,1947.21,19
CDM,56081376_1,HLA class II typing low resolution one locus,548.0,356.2,54.96,1415.21,19
CDM,56081377_1,HLA class II typing low resolution one antigen equivalent,548.0,356.2,54.96,1415.21,19
CDM,56081378_1,"HLA class I and II typing high resolution HLA-A, -B, -C, and -DRB1",3939.0,2560.35,194.33,13612.0,19
CDM,56081379_1,HLA Class I typing high resolution,2924.0,1900.6,194.33,9806.51,19
CDM,56081380_1,HLA class I typing high resolution one locus,1554.0,1010.1,177.25,4013.21,19
CDM,56081382_1,HLA class II typing high resolution one locus,1483.0,963.95,54.96,3829.85,19
CDM,56081383_1,HLA class II typing high resolution one allele or allele group,548.0,356.2,54.96,1415.21,19
CDM,56081384_1,"HLA class I and II typing low resolution HLA-A, -B, -C, -DRB1/3/4/5 and -DQB1",1753.0,1139.45,402.12,7049.16,19
CDM,56081385_1,"HLA class I and II typing low resolution HLA-A, -B, -C, -DRB1/3/4/5 and -DQB1",3709.0,2410.85,402.12,14914.63,19
CDM,56081386_1,Molecular pathology procedure,115.0,74.75,54.96,296.99,18
CDM,56081479_1,Molecular pathology procedure,588.0,382.2,54.96,1518.51,18
CDM,56084904_1,"Detection test by nucleic acid for HIV-1 virus, quantification",946.0,614.9,50.59,2443.05,19
CDM,56085131_1,"Immunologic analysis for autoimmune disease, with titration",275.0,178.75,140.25,710.19,19
CDM,56085132_1,"Immunologic analysis for autoimmune disease, with titration",764.0,496.6,189.51,1973.03,19
CDM,56085138_1,"Immunologic analysis for autoimmune disease, DR/DQ, multiple antigens",1273.0,827.45,73.62,3287.52,19
CDM,56085139_1,"Immunologic analysis for autoimmune disease, DR/DQ, multiple antigens",1460.0,949.0,73.62,3770.45,19
CDM,56085141_1,"Immunologic analysis for autoimmune disease, A, B, or C, multiple antigens",1087.0,706.55,58.0,2807.18,19
CDM,56085142_1,"Immunologic analysis for autoimmune disease, A, B, or C, multiple antigens",1260.0,819.0,58.0,3253.95,19
CDM,56085143_1,"Immunologic analysis for autoimmune disease, A, B, or C, single antigen",337.0,219.05,5.24,870.3,19
CDM,56085144_1,"Transplant antibody measurement, standard method",390.0,253.5,73.62,1007.18,19
CDM,56085145_1,"Transplant antibody measurement, quick method",79.0,51.35,5.24,204.02,19
CDM,56085148_1,"Transplant antibody measurement, standard method",157.0,102.05,73.62,405.45,19
CDM,56085150_1,"Transplant antibody measurement, standard method",313.0,203.45,73.62,808.32,19
CDM,56085447_1,"Immunologic analysis for autoimmune disease, with titration",485.0,315.25,189.51,1252.51,19
CDM,56086800_1,"Immunologic analysis for autoimmune disease, with titration",485.0,315.25,189.51,1252.51,19
CDM,56086805_1,"Immunologic analysis for autoimmune disease, with titration",544.0,353.6,189.51,1404.88,19
CDM,56086825_1,"Immunologic analysis for organ transplant, first serum sample or dilution",1059.0,688.35,73.62,2734.87,19
CDM,56086826_1,"Immunologic analysis for organ transplant, each additional serum sample or sample dilution",11.0,7.15,4.02,75.09,19
CDM,56086828_1,Assessment of antibodies to Class I and Class II human leukocyte antigens (HLA) antigens,275.0,178.75,64.19,710.19,19
CDM,56086830_1,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class I",164.0,106.6,73.62,423.53,19
CDM,56086831_1,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class II",164.0,106.6,73.62,423.53,19
CDM,56086832_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I",550.0,357.5,191.24,1780.63,19
CDM,56086833_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",475.0,308.75,191.24,1547.55,19
CDM,56086834_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I",550.0,357.5,191.24,1780.63,19
CDM,56086835_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",475.0,308.75,191.24,1547.55,19
CDM,56086836_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I",783.0,508.95,191.24,2534.96,19
CDM,56086837_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",693.0,450.45,191.24,2257.79,19
CDM,56086838_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I",783.0,508.95,191.24,2534.96,19
CDM,56086839_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",693.0,450.45,191.24,2257.79,19
CDM,56086842_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I",328.0,213.2,167.28,1061.9,19
CDM,56086843_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",328.0,213.2,167.28,1068.62,19
CDM,56086844_1,"Assessment of antibody to human leukocyte antigens (HLA), HLA class I",1400.0,910.0,191.24,5005.84,19
CDM,56086845_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I",328.0,213.2,167.28,1061.9,19
CDM,56086846_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",328.0,213.2,167.28,1068.62,19
CDM,56086847_1,Immunology procedures,45.0,29.25,13.66,116.21,18
CDM,56086848_1,"Assessment of antibody to human leukocyte antigens (HLA) with solid phase assays, HLA class II",1400.0,910.0,191.24,4521.44,19
CDM,56089464_1,"Immunologic analysis for autoimmune disease, with titration",764.0,496.6,189.51,1973.03,19
CDM,56100026_1,"Detection test by nucleic acid for Hepatitis B virus, quantification",343.0,222.95,42.84,885.8,19
CDM,56102001_1,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",339.0,220.35,35.09,875.47,19
CDM,56102002_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",950.0,617.5,35.09,2453.38,19
CDM,56102003_1,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,195.0,126.75,50.59,503.59,19
CDM,56102004_1,Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) and influenza virus types A and B,320.0,208.0,50.59,826.4,19
CDM,56102005_1,"Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets",320.0,208.0,142.63,826.4,19
CDM,56102006_1,"Detection test by immunoassay with direct visual observation for HIV-1 antigen, with HIV-1 and HIV-2 antibodies",174.0,113.1,32.77,449.36,19
CDM,56102007_1,Urine pregnancy test,30.0,19.5,2.58,77.48,19
CDM,56181003_1,Automated urinalysis test,15.0,9.75,0.34,38.74,19
CDM,56182040_1,Albumin (protein) level,25.0,16.25,1.24,64.56,19
CDM,56184900_1,"Detection test by nucleic acid for Hepatitis C virus, quantification",480.0,312.0,42.84,1239.6,19
CDM,56184901_1,"Detection test by nucleic acid for cytomegalovirus, quantification",851.0,553.15,42.84,2197.71,19
CDM,56184902_1,"Detection test by nucleic acid for organism, quantification",778.0,505.7,42.84,2009.19,19
CDM,56184905_1,"Detection test by nucleic acid for organism, quantification",613.0,398.45,42.84,1583.07,19
CDM,56184906_1,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",322.85,209.85,35.09,833.76,19
CDM,56184907_1,"Detection test by nucleic acid for cytomegalovirus, quantification",851.0,553.15,42.84,2197.71,19
CDM,56184908_1,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",322.85,209.85,35.09,833.76,19
CDM,56187495_1,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",344.0,223.6,35.09,888.38,19
CDM,56187496_1,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",322.85,209.85,35.09,833.76,19
CDM,56187497_1,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",322.85,209.85,35.09,833.76,19
CDM,56187499_1,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",391.0,254.15,35.09,1009.76,19
CDM,56187500_1,"Detection test by nucleic acid for organism, amplified probe technique",214.0,139.1,35.09,552.66,19
CDM,56187502_1,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",322.85,209.85,35.09,833.76,19
CDM,56187517_1,"Detection test by nucleic acid for Hepatitis B virus, quantification",596.0,387.4,42.84,1539.17,19
CDM,56187529_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",321.0,208.65,35.09,828.98,19
CDM,56187530_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",263.0,170.95,35.09,679.2,19
CDM,56187532_1,"Detection test by nucleic acid for herpes virus-6, amplified probe technique",214.0,139.1,35.09,552.66,19
CDM,56187533_1,"Detection test by nucleic acid for herpes virus-6, amplified probe technique",263.0,170.95,35.09,679.2,19
CDM,56187534_1,"Detection test by nucleic acid for herpes virus-6, amplified probe technique",537.0,349.05,35.09,1386.8,19
CDM,56187581_1,"Detection test by nucleic acid for Mycoplasma pneumoniae (bacteria), amplified probe technique",263.0,170.95,35.09,679.2,19
CDM,56187796_1,"Detection test by nucleic acid for organism, amplified probe technique",575.0,373.75,35.09,1484.94,19
CDM,56187797_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56187798_1,"Detection test by nucleic acid for organism, amplified probe technique",214.0,139.1,35.09,552.66,19
CDM,56187799_1,"Detection test by nucleic acid for organism, amplified probe technique",263.0,170.95,35.09,679.2,19
CDM,56187800_1,"Detection test by nucleic acid for organism, amplified probe technique",546.0,354.9,35.09,1410.05,19
CDM,56187801_1,"Detection test by nucleic acid for organism, quantification",517.0,336.05,42.84,1335.15,19
CDM,56187802_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56187803_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56187804_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56187805_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56187806_1,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",1500.0,975.0,50.59,3873.75,19
CDM,56187902_1,Analysis test by nucleic acid for Hepatitis C virus,649.0,421.85,194.33,1676.04,19
CDM,56187903_1,Analysis test by nucleic acid for Hepatitis C virus,1065.0,692.25,194.33,2750.36,19
CDM,56187904_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56187905_1,"Detection test by nucleic acid for organism, quantification",517.0,336.05,42.84,1335.15,19
CDM,56198265_1,"Detection test by nucleic acid for organism, amplified probe technique",619.0,402.35,35.09,1598.57,19
CDM,56198350_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",928.0,603.2,35.09,2396.56,19
CDM,56198351_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",518.0,336.7,35.09,1337.74,19
CDM,56198400_1,"Detection test by nucleic acid for organism, amplified probe technique",524.0,340.6,35.09,1353.23,19
CDM,56198403_1,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",322.85,209.85,35.09,833.76,19
CDM,56198404_1,"Detection test by nucleic acid for herpes virus-6, amplified probe technique",546.0,354.9,35.09,1410.05,19
CDM,56198405_1,"Detection test by nucleic acid for organism, amplified probe technique",572.0,371.8,35.09,1477.19,19
CDM,56198406_1,"Detection test by nucleic acid for organism, amplified probe technique",546.0,354.9,35.09,1410.05,19
CDM,56198407_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56198412_1,"Detection test by nucleic acid for organism, amplified probe technique",572.0,371.8,35.09,1477.19,19
CDM,56198500_1,"Detection test by nucleic acid for organism, amplified probe technique",546.0,354.9,35.09,1410.05,19
CDM,56198501_1,"Detection test by nucleic acid for organism, amplified probe technique",455.0,295.75,35.09,1175.04,19
CDM,56198503_1,"Detection test by nucleic acid for organism, amplified probe technique",435.0,282.75,35.09,1123.39,19
CDM,561U0005_1,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS-COV-2) (CORONAVIRUS DISEASE [COVID-19]), AMPLIFIED PROBE TECHNIQUE, CDC OR NON-CDC, MAKIN",25.0,16.25,6.25,64.56,18
CDM,56200014_1,HC RSCH: RNA/DNA EXTRACTION,121.0,78.65,30.25,84.7,11
CDM,56200017_1,HC RSCH: NUCLEIC ACID SEPARATION AGAROSE,75.0,48.75,18.75,52.5,11
CDM,56200018_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with solid organ abnormal growth of tissue,1815.0,1179.75,423.93,10852.07,19
CDM,56200019_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 51 or more genes associated with blood and lymphatic system disorders,2000.0,1300.0,1020.0,58392.0,19
CDM,56200021_1,Molecular pathology procedure,950.0,617.5,54.96,2453.38,18
CDM,56200022_1,Molecular pathology procedure level 4 genetic analysis,400.0,260.0,185.2,1033.0,19
CDM,56200023_1,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), targeted sequence",400.0,260.0,194.33,1318.04,19
CDM,56200024_1,Molecular pathology procedure level 4 genetic analysis,400.0,260.0,185.2,1033.0,19
CDM,56200025_1,"Gene analysis (calreticulin), common variants",400.0,260.0,54.96,1033.0,19
CDM,56200027_1,Reevaluation test of previously obtained genome sequence,500.0,325.0,255.0,11688.25,19
CDM,56200028_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,1900.0,1235.0,759.53,14431.07,19
CDM,56200029_1,"Gene analysis (isocitrate dehydrogenase 2 [NADP+], mitochondrial) for common variants",703.0,456.95,194.33,2079.4,19
CDM,56200030_1,"Gene analysis (isocitrate dehydrogenase 2 [NADP+], mitochondrial) for common variants",609.0,395.85,194.33,1801.36,19
CDM,56200031_1,"Gene analysis (isocitrate dehydrogenase 1 [NADP+], soluble) for common variants",703.0,456.95,193.25,1815.5,19
CDM,56200032_1,Molecular pathology procedure level 4 genetic analysis,1000.0,650.0,185.2,2582.5,19
CDM,56200034_1,Molecular pathology procedure level 6 genetic analysis,950.0,617.5,194.33,2862.83,19
CDM,56200035_1,"Gene analysis (ccaat/enhancer binding protein [c/ebp], alpha) full gene sequence",950.0,617.5,194.33,2453.38,19
CDM,56200036_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,2000.0,1300.0,759.53,15190.6,19
CDM,56200037_1,"Gene analysis (prothrombin, coagulation factor II) A variant",300.0,195.0,54.96,774.75,19
CDM,56200038_1,"Gene analysis (prothrombin, coagulation factor II) A variant",200.0,130.0,54.96,516.5,19
CDM,56200039_1,Gene analysis (coagulation factor V) Leiden variant,300.0,195.0,54.96,774.75,19
CDM,56200040_1,Gene analysis (coagulation factor V) Leiden variant,300.0,195.0,54.96,774.75,19
CDM,56200041_1,Gene analysis (myeloid differentiation primary response 88) for p.Leu265Pro variant,950.0,617.5,175.4,2453.38,19
CDM,56200042_1,"Gene analysis (isocitrate dehydrogenase 1 [NADP+], soluble) for common variants",300.0,195.0,153.0,774.75,19
CDM,56200043_1,"Gene analysis (isocitrate dehydrogenase 2 [NADP+], mitochondrial) for common variants",300.0,195.0,153.0,887.37,19
CDM,56200044_1,Molecular pathology procedure level 5 genetic analysis,950.0,617.5,194.33,2610.89,19
CDM,56200045_1,Gene analysis (partner and localizer of BRCA2) targeted sequence analysis,950.0,617.5,194.33,2610.89,19
CDM,56200046_1,Molecular pathology procedure,1500.0,975.0,54.96,3873.75,18
CDM,56200047_1,"Test for detecting genes associated with colon cancer, promoter methylation analysis",750.0,487.5,192.32,1936.88,19
CDM,56200048_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with solid organ abnormal growth of tissue,1815.0,1179.75,423.93,10852.07,19
CDM,56200049_1,Molecular pathology procedure,1500.0,975.0,54.96,3873.75,18
CDM,56200050_1,Molecular pathology procedure,1200.0,780.0,54.96,3099.0,18
CDM,56200051_1,Translocation analysis (BCR/ABL1) minor breakpoint,675.0,438.75,144.84,1743.19,19
CDM,56200052_1,Translocation analysis (BCR/ABL1) major breakpoint,675.0,438.75,163.96,1743.19,19
CDM,56200053_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 51 or more genes associated with blood and lymphatic system disorders,5000.0,3250.0,2550.0,145980.0,19
CDM,56200054_1,Gene analysis (T cell antigen receptor beta) amplification methodology,720.0,468.0,194.33,1859.4,19
CDM,56200055_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,1500.0,975.0,759.53,11392.95,19
CDM,56200056_1,Gene analysis (v-raf murine sarcoma viral oncogene homolog B1),845.0,549.25,175.4,2182.21,19
CDM,56201279_1,Gene analysis (Janus kinase 2) targeted sequence analysis,1000.0,650.0,185.2,2582.5,19
CDM,56201352_1,Gene analysis (tumor protein 53) targeted sequence analysis,950.0,617.5,194.33,3130.35,19
CDM,56251402_1,Molecular pathology procedure level 3,937.0,609.05,150.33,2419.8,19
CDM,56281205_1,Translocation analysis (BCR/ABL1) major breakpoint,675.0,438.75,163.96,1743.19,19
CDM,56281206_1,Translocation analysis (BCR/ABL1) major breakpoint,675.0,438.75,163.96,1743.19,19
CDM,56281207_1,Translocation analysis (BCR/ABL1) minor breakpoint,675.0,438.75,144.84,1743.19,19
CDM,56281210_1,Gene analysis (v-raf murine sarcoma viral oncogene homolog B1),845.0,549.25,175.4,2182.21,19
CDM,56281219_1,"Gene analysis (calreticulin), common variants",609.0,395.85,54.96,1572.74,19
CDM,56281220_1,Gene analysis (cystic fibrosis transmembrane conductance regular) common variants,980.0,637.0,423.93,5454.68,19
CDM,56281235_1,"Gene analysis (epidermal growth factor receptor), common variants",1911.0,1242.15,324.58,6202.72,19
CDM,56281236_1,"Gene analysis (epidermal growth factor receptor), common variants",1277.0,830.05,324.58,4144.89,19
CDM,56281240_1,"Gene analysis (prothrombin, coagulation factor II) A variant",525.0,341.25,54.96,1355.81,19
CDM,56281241_1,Gene analysis (coagulation factor V) Leiden variant,525.0,341.25,54.96,1355.81,19
CDM,56281242_1,"Gene analysis (prothrombin, coagulation factor II) A variant",275.0,178.75,54.96,710.19,19
CDM,56281243_1,"Gene analysis (fragile X syndrome, X-linked intellectual disability) for detection of abnormal alleles",690.0,448.5,54.96,1781.93,19
CDM,56281244_1,"Gene analysis (fragile X syndrome, X-linked intellectual disability) for characterization of alleles",1222.0,794.3,44.89,3155.82,19
CDM,56281245_1,Gene analysis (coagulation factor V) Leiden variant,275.0,178.75,54.96,710.19,19
CDM,56281255_1,Gene analysis (fms-related tyrosine kinase 3) internal tandem duplication variants,929.0,603.85,165.51,2399.14,19
CDM,56281261_1,Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect abnormal clonal population amplified methodology,2122.0,1379.3,194.33,5480.07,19
CDM,56281262_1,Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect abnormal clonal population direct probe methodology,1010.0,656.5,54.96,2608.33,19
CDM,56281264_1,Gene rearrangement analysis (immunoglobulin kappa light chain locus) to detect abnormal clonal population,1010.0,656.5,172.73,2608.33,19
CDM,56281270_1,Gene analysis (Janus kinase 2) variant,750.0,487.5,54.96,1936.88,19
CDM,56281271_1,Gene analysis (Janus kinase 2) variant,750.0,487.5,54.96,1936.88,19
CDM,56281272_1,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), targeted sequence",1000.0,650.0,194.33,3295.1,19
CDM,56281273_1,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), D816 variants",1218.0,791.7,54.96,3145.49,19
CDM,56281274_1,"Gene analysis (Kirsten rat sarcoma viral oncogene homolog), additional variants",595.0,386.75,193.25,1536.59,19
CDM,56281275_1,Gene analysis (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) variants in codons 12 and 13,959.0,623.35,193.25,2476.62,19
CDM,56281276_1,Gene analysis (v-raf murine sarcoma viral oncogene homolog B1),545.0,354.25,175.4,1407.46,19
CDM,56281277_1,Molecular pathology procedure level 3,1218.0,791.7,150.33,3145.49,19
CDM,56281278_1,Molecular pathology procedure level 3,508.0,330.2,150.33,1311.91,19
CDM,56281279_1,Molecular pathology procedure level 5 genetic analysis,508.0,330.2,194.33,1396.14,19
CDM,56281280_1,Molecular pathology procedure level 4 genetic analysis,1218.0,791.7,185.2,3145.49,19
CDM,56281281_1,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), targeted sequence",1218.0,791.7,194.33,4013.43,19
CDM,56281287_1,Gene analysis (O-6-methylguanine-DNA methyltransferase) for promoter methylation,750.0,487.5,54.96,1936.88,19
CDM,56281290_1,"Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants",139.0,90.35,54.96,358.97,19
CDM,56281291_1,"Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants",528.0,343.2,54.96,1363.56,19
CDM,56281301_1,Microsatellite instability analysis,1195.0,776.75,194.33,4165.29,19
CDM,56281310_1,Gene analysis (nucleophosmin) exon 12 variants,930.0,604.5,194.33,2401.73,19
CDM,56281311_1,Gene analysis for cancer (neuroblastoma),508.0,330.2,194.33,1502.61,19
CDM,56281314_1,"Gene analysis ((platelet-derived growth factor receptor, alpha polypeptide) targeted sequence",1000.0,650.0,194.33,3295.1,19
CDM,56281315_1,Translocation analysis (PML-RARA regulated adaptor molecule 1) common breakpoint,860.0,559.0,194.33,2220.95,19
CDM,56281332_1,"Gene analysis (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) common variants",539.0,350.35,43.65,1391.97,19
CDM,56281339_1,"Gene analysis (MPL proto-oncogene, thrombopoietin receptor) sequence analysis of exon 10",795.0,516.75,185.2,2053.09,19
CDM,56281341_1,Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor beta) direct probe methodology,1010.0,656.5,49.59,2608.33,19
CDM,56281342_1,Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor gamma),983.0,638.95,194.33,2538.6,19
CDM,56281352_1,Gene analysis (tumor protein 53) targeted sequence analysis,950.0,617.5,194.33,3130.35,19
CDM,56281401_1,Molecular pathology procedure level 2,950.0,617.5,137.0,2453.38,19
CDM,56281402_1,Molecular pathology procedure level 3,795.0,516.75,150.33,2053.09,19
CDM,56281403_1,Molecular pathology procedure level 4 genetic analysis,304.0,197.6,155.04,785.08,19
CDM,56281404_1,Molecular pathology procedure level 2,1103.0,716.95,137.0,2848.5,19
CDM,56281405_1,Molecular pathology procedure,1156.0,751.4,54.96,2985.37,18
CDM,56281406_1,Molecular pathology procedure,1103.0,716.95,54.96,2848.5,18
CDM,56281407_1,Molecular pathology procedure level 2,950.0,617.5,137.0,2453.38,19
CDM,56281408_1,Molecular pathology procedure,950.0,617.5,54.96,2453.38,18
CDM,56281409_1,Molecular pathology procedure,671.0,436.15,54.96,1732.86,18
CDM,56281410_1,Molecular pathology procedure level 4 genetic analysis,795.0,516.75,185.2,2053.09,19
CDM,56281411_1,Molecular pathology procedure level 4 genetic analysis,609.0,395.85,185.2,1572.74,19
CDM,56281412_1,Molecular pathology procedure level 4 genetic analysis,609.0,395.85,185.2,1572.74,19
CDM,56281413_1,Molecular pathology procedure level 4 genetic analysis,1200.0,780.0,185.2,3099.0,19
CDM,56281414_1,Molecular pathology procedure,1200.0,780.0,54.96,3099.0,18
CDM,56281445_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with solid organ abnormal growth of tissue,1815.0,1179.75,423.93,10852.07,19
CDM,56281446_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with solid organ abnormal growth of tissue,1815.0,1179.75,423.93,10852.07,19
CDM,56281450_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,1929.0,1253.85,759.53,14651.33,19
CDM,56281455_1,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with solid organ abnormal growth of tissue,1815.0,1179.75,423.93,10852.07,19
CDM,56288381_1,"Preparation of specimen, manual",250.0,162.5,46.86,645.63,19
CDM,56405_1,Incision and drainage of abscess of external female genitals,350.0,227.5,78.57,353.66,19
CDM,56420_1,Incision and drainage of abscess of female genital gland,320.0,208.0,59.88,446.81,19
CDM,56440T_1,Creation of drainage tract for gland cyst of female genitals,529.2,343.98,78.57,542.33,19
CDM,56440_1,Creation of drainage tract for gland cyst of female genitals,510.0,331.5,78.57,542.33,19
CDM,56441_1,Removal of scar tissue of female genitals,406.4,264.16,78.57,440.4,19
CDM,56442_1,Simple incision of hymen,112.3,73.0,39.9,141.28,19
CDM,56482411_1,Flow cytometry technique for DNA or cell analysis,128.0,83.2,38.68,330.56,19
CDM,56482412_1,Flow cytometry technique for DNA or cell analysis,245.0,159.25,38.68,632.71,19
CDM,56482596_1,Cryoglobulin (protein) measurement,69.0,44.85,4.46,178.19,19
CDM,56485007_1,Microscopic examination for white blood cells with manual cell count,35.0,22.75,1.33,90.39,19
CDM,56485211_1,"Clotting factor II prothrombin, measurement",198.0,128.7,5.24,511.34,19
CDM,56485221_1,Clotting factor V (AcG or proaccelerin) measurement,215.0,139.75,5.24,555.24,19
CDM,56485231_1,"Clotting factor VII (proconvertin, stable factor)",215.0,139.75,5.24,555.24,19
CDM,56485241_1,Clotting factor VIII (AHG) measurement,141.0,91.65,5.24,364.13,19
CDM,56485244_1,Clotting factor VIII related antigen measurement,604.0,392.6,20.42,1559.83,19
CDM,56485245_1,Clotting factor VIII (VW factor) measurement,664.0,431.6,22.94,1714.78,19
CDM,56485250_1,Clotting factor IX (PTC or Christmas) measurement,175.2,113.88,19.04,452.45,19
CDM,56485251_1,Clotting factor IX (PTC or Christmas) measurement,175.2,113.88,19.04,452.45,19
CDM,56485261_1,Clotting factor X (Stuart-Prower) measurement,164.7,107.06,5.24,425.34,19
CDM,56485271_1,Clotting factor XI (PTA) measurement,215.0,139.75,5.24,555.24,19
CDM,56485281_1,Clotting factor XII (Hageman) measurement,231.0,150.15,19.35,596.56,19
CDM,56485303_1,Protein C antigen (clotting inhibitor) measurement,248.0,161.2,5.24,640.46,19
CDM,56485306_1,Protein S (clotting inhibitor) measurement,240.0,156.0,5.24,619.8,19
CDM,56485307_1,Protein S (clotting inhibitor) measurement,408.0,265.2,5.24,1053.66,19
CDM,56485308_1,White blood cell antigen measurement,121.0,78.65,26.78,312.48,19
CDM,56485335_1,Clotting factor inhibitor test,175.0,113.75,5.24,451.94,19
CDM,56485397_1,Measurement of blood coagulation and fibrinolysis (clot dissolving) function,930.0,604.5,29.94,2401.73,19
CDM,56485540_1,White blood cell alkaline phosphatase (enzyme) measurement with cell count,588.0,382.2,6.99,1518.51,19
CDM,56485545_1,Evaluation of specimen enzymes,233.0,151.45,116.27,669.29,19
CDM,56485576_1,Platelet aggregation function test,90.0,58.5,22.42,232.43,19
CDM,56485577_1,Platelet aggregation function test,194.0,126.1,24.91,501.01,19
CDM,56485578_1,Platelet aggregation function test,87.0,56.55,21.67,224.68,19
CDM,56485579_1,Platelet aggregation function test,87.0,56.55,21.67,224.68,19
CDM,56485580_1,Platelet aggregation function test,87.0,56.55,21.67,224.68,19
CDM,56485581_1,Platelet aggregation function test,87.0,56.55,21.67,224.68,19
CDM,56485582_1,Platelet aggregation function test,87.0,56.55,21.67,224.68,19
CDM,56485597_1,Platelet function test,160.0,104.0,5.24,413.2,19
CDM,56485611_1,"Blood test, clotting time, substitution",202.0,131.3,3.94,521.67,19
CDM,56485613_1,"Clotting factor X assessment test, diluted",150.0,97.5,5.24,387.38,19
CDM,56485670_1,"Thrombin time, fibrinogen screening test, plasma",71.0,46.15,4.1,183.36,19
CDM,56485671_1,"Thrombin time, fibrinogen screening test, plasma",71.0,46.15,4.1,183.36,19
CDM,56485705_1,Thromboplastin inhibition (circulating anticoagulant) measurement,261.0,169.65,5.24,674.03,19
CDM,56485730_1,"Coagulation assessment blood test, plasma or whole blood",71.0,46.15,4.27,183.36,19
CDM,56485733_1,"Coagulation assessment blood test, substitution, plasma fractions",201.0,130.65,5.24,519.08,19
CDM,56485820_1,Blood viscosity measurement,53.0,34.45,6.19,136.87,19
CDM,56486023_1,"Antibody identification test, platelet antibodies",169.0,109.85,13.66,436.44,19
CDM,56486147_1,Cardiolipin antibody (tissue antibody) measurement,104.0,67.6,13.66,268.58,19
CDM,56486148_1,Cardiolipin antibody (tissue antibody) measurement,104.0,67.6,13.66,268.58,19
CDM,56486355_1,Total cell count for B cells (white blood cells),185.0,120.25,37.73,477.76,19
CDM,56486357_1,Total cell count for natural killer cells (white blood cell),185.0,120.25,37.73,477.76,19
CDM,56486359_1,"T cells count, total",185.0,120.25,37.73,477.76,19
CDM,56486360_1,"T cell count and ratio, including ratio",230.0,149.5,46.98,593.98,19
CDM,56486367_1,"Stem cells count, total",384.0,249.6,48.13,991.68,19
CDM,56488184_1,"Flow cytometry technique for DNA or cell analysis, first marker",300.0,195.0,90.83,774.75,19
CDM,56488185_1,"Flow cytometry technique for DNA or cell analysis, each additional marker",152.0,98.8,22.15,392.54,19
CDM,56488313_1,Special stained specimen slides to examine tissue including interpretation and report,184.0,119.6,34.57,475.18,19
CDM,56488319_1,Evaluation of specimen enzymes,980.0,637.0,116.27,2530.85,19
CDM,56489437_1,Evaluation of specimen enzymes,205.0,133.25,104.55,669.29,19
CDM,56489518_1,Evaluation of specimen enzymes,427.0,277.55,116.27,1102.73,19
CDM,56500014_1,Stool culture,82.0,53.3,7.74,211.77,19
CDM,56500015_1,"Stool culture, additional pathogens",82.0,53.3,7.74,211.77,19
CDM,56500016_1,Detection test by immunoassay technique for Shiga-like toxin (bacterial toxin),104.0,67.6,11.98,268.58,19
CDM,56500017_1,Detection test by immunoassay technique for Clostridium difficile toxins (stool pathogen),104.0,67.6,11.98,268.58,19
CDM,56500018_1,Detection test by immunoassay technique for other organism,104.0,67.6,11.98,268.58,19
CDM,56500019_1,Detection test by immunoassay technique for Giardia (intestinal parasite),104.0,67.6,11.98,268.58,19
CDM,56500020_1,Detection test by immunoassay technique for Cryptosporidium (parasite),104.0,67.6,12.47,268.58,19
CDM,56500208_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)",45.0,29.25,3.37,116.21,19
CDM,56500209_1,Stool culture,47.0,30.55,4.44,121.38,19
CDM,56500210_1,"Stool culture, additional pathogens",47.0,30.55,4.44,121.38,19
CDM,56500211_1,"Stool culture, additional pathogens",47.0,30.55,4.44,121.38,19
CDM,56500212_1,Screening test for pathogenic organisms with colony count,80.0,52.0,12.47,206.6,19
CDM,56500213_1,"Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 12-25 targets",1000.0,650.0,240.71,4167.8,19
CDM,56500214_1,Screening test for pathogenic organisms,110.0,71.5,6.63,284.08,19
CDM,56501_1,Simple destruction of growth of external female genitals,350.0,227.5,71.81,464.66,19
CDM,56515_1,Extensive destruction of growth of external female genitals,618.5,402.03,78.57,664.97,19
CDM,56550015_1,HC AFTER HRS HEMO POST-DECLOT RUN 1:1 - PER,121.0,78.65,30.25,84.7,11
CDM,56583000_1,Unlisted microbiology procedure,25.0,16.25,12.47,64.56,18
CDM,56583013_1,Breath test analysis for helicobacter pylori,190.0,123.5,67.36,490.68,19
CDM,56583630_1,Stool lactoferrin (immune system protein) analysis,96.0,62.4,14.14,247.92,19
CDM,56586403_1,Screening test for presence of antibody,62.0,40.3,7.15,160.12,19
CDM,56586677_1,Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria),126.0,81.9,13.66,325.4,19
CDM,56587000_1,Special Gram or Giemsa stain for microorganism,30.0,19.5,1.28,77.48,19
CDM,56587005_1,Special fluorescent and/or acid fast stain for microorganism,47.0,30.55,2.53,121.38,19
CDM,56587015_1,Smear for parasites,86.0,55.9,7.65,222.1,19
CDM,56587016_1,Concentration of specimen for infectious agents,33.0,21.45,2.2,85.22,19
CDM,56587046_1,"Stool culture, additional pathogens",82.0,53.3,7.74,211.77,19
CDM,56587047_1,"Stool culture, additional pathogens",82.0,53.3,7.74,211.77,19
CDM,56587048_1,"Stool culture, additional pathogens",82.0,53.3,7.74,211.77,19
CDM,56587050_1,"Stool culture, additional pathogens",82.0,53.3,7.74,211.77,19
CDM,56587065_1,Stool culture,82.0,53.3,7.74,211.77,19
CDM,56587070_1,Concentration of specimen for infectious agents,50.0,32.5,3.34,129.13,19
CDM,56587071_1,Bacterial culture and colony count,84.0,54.6,8.31,216.93,19
CDM,56587072_1,Bacterial culture and colony count,175.0,113.75,9.89,451.94,19
CDM,56587073_1,Bacterial culture and colony count for anaerobic bacteria,84.0,54.6,8.11,216.93,19
CDM,56587075_1,"Bacterial culture, any source, except blood, anaerobic",47.0,30.55,4.45,121.38,19
CDM,56587077_1,Bacterial culture for aerobic isolates,70.0,45.5,5.66,180.78,19
CDM,56587078_1,Bacterial culture for aerobic isolates,83.0,53.95,6.71,214.35,19
CDM,56587079_1,Bacterial culture for aerobic isolates,40.0,26.0,3.23,103.3,19
CDM,56587081_1,Screening test for pathogenic organisms,58.0,37.7,3.85,149.79,19
CDM,56587083_1,Screening test for pathogenic organisms,40.0,26.0,2.65,103.3,19
CDM,56587084_1,Screening test for pathogenic organisms with colony count,190.0,123.5,12.47,490.68,19
CDM,56587085_1,Screening test for pathogenic organisms,68.0,44.2,4.51,175.61,19
CDM,56587086_1,Screening test for pathogenic organisms,46.0,29.9,3.05,118.8,19
CDM,56587090_1,"Bacterial culture, any other source except urine, blood or stool, aerobic",76.0,49.4,6.55,196.27,19
CDM,56587091_1,Screening test for pathogenic organisms,33.0,21.45,2.19,85.22,19
CDM,56587094_1,Screening test for pathogenic organisms,91.0,59.15,6.03,235.01,19
CDM,56587102_1,Fungal culture (mold or yeast),71.0,46.15,5.97,183.36,19
CDM,56587104_1,Fungal blood culture (mold or yeast),93.0,60.45,12.47,240.17,19
CDM,56587105_1,"Fungal culture (mold or yeast) of skin, hair, or nail",72.0,46.8,5.55,185.94,19
CDM,56587108_1,"Fungal culture, yeast",51.0,33.15,5.26,131.71,19
CDM,56587109_1,Culture for identification of yeast,51.0,33.15,5.26,131.71,19
CDM,56587110_1,"Bacterial colony count, urine",40.0,26.0,3.23,103.3,19
CDM,56587116_1,Culture for acid-fast bacilli,133.0,86.45,10.8,343.47,19
CDM,56587117_1,Screening test for pathogenic organisms,99.0,64.35,6.56,255.67,19
CDM,56587118_1,Identification of mycobacteria (TB or TB like organism),103.0,66.95,12.47,266.0,19
CDM,56587119_1,Culture for acid-fast bacilli,94.0,61.1,10.15,242.76,19
CDM,56587124_1,"Detection test by nucleic acid for Mycobacteria species (bacteria), direct probe technique",215.0,139.75,12.47,555.24,19
CDM,56587140_1,"Identification of organisms by immunologic analysis, immunofluorescent method",49.0,31.85,2.73,126.54,19
CDM,56587148_1,"Identification of organisms by immunologic analysis, other than immunofluorescence method",30.0,19.5,1.55,77.48,19
CDM,56587149_1,"Identification of organisms by genetic analysis, direct probe technique",181.0,117.65,12.47,467.43,19
CDM,56587150_1,"Identification of organisms by genetic analysis, amplified probe technique",150.0,97.5,35.09,387.38,19
CDM,56587151_1,"Identification of organisms by genetic analysis, amplified probe technique",150.0,97.5,35.09,387.38,19
CDM,56587160_1,"Identification of organisms by immunologic analysis, other than immunofluorescence method",131.0,85.15,5.18,338.31,19
CDM,56587168_1,Macroscopic examination (visual inspection) of insect,46.0,29.9,1.96,118.8,19
CDM,56587172_1,Pinworm test,37.0,24.05,1.58,95.55,19
CDM,56587176_1,Tissue preparation for culture,45.0,29.25,2.65,116.21,19
CDM,56587180_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution",184.0,119.6,8.65,475.18,19
CDM,56587182_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method",63.0,40.95,2.99,162.7,19
CDM,56587184_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)",45.0,29.25,3.37,116.21,19
CDM,56587185_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution",43.0,27.95,3.72,111.05,19
CDM,56587186_1,"Detection of antimicrobial drug (antibiotic, antifungal, antiviral)",42.0,27.3,2.0,108.47,19
CDM,56587192_1,"Detection of antimicrobial drug (antibiotic, antifungal, antiviral)",35.0,22.75,1.66,90.39,19
CDM,56587194_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)",45.0,29.25,3.37,116.21,19
CDM,56587199_1,Microbial identification,55.0,35.75,4.26,142.04,19
CDM,56587207_1,Special stain for inclusion bodies or parasites,69.0,44.85,4.13,178.19,19
CDM,56587209_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)",45.0,29.25,3.37,116.21,19
CDM,56587210_1,Bacterial urine culture,70.0,45.5,5.66,180.78,19
CDM,56587211_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method",63.0,40.95,2.99,162.7,19
CDM,56587212_1,Screening test for pathogenic organisms,96.0,62.4,6.36,247.92,19
CDM,56587213_1,Screening test for pathogenic organisms,83.0,53.95,5.5,214.35,19
CDM,56587214_1,Special stain for parasites,88.0,57.2,12.47,227.26,19
CDM,56587324_1,Detection test by immunoassay technique for Clostridium difficile toxins (stool pathogen),59.0,38.35,7.07,152.37,19
CDM,56587330_1,Detection test by immunoassay technique for Giardia (intestinal parasite),104.0,67.6,11.98,268.58,19
CDM,56587331_1,Detection test by immunoassay technique for Cryptosporidium (parasite),104.0,67.6,12.47,268.58,19
CDM,56587338_1,Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool,182.0,118.3,12.47,470.02,19
CDM,56587427_1,Detection test by immunoassay technique for Shiga-like toxin (bacterial toxin),104.0,67.6,11.98,268.58,19
CDM,56587449_1,Detection test by immunoassay technique for other organism,59.0,38.35,7.07,152.37,19
CDM,56587450_1,Detection test by immunoassay technique for other organism,147.0,95.55,11.98,379.63,19
CDM,56587480_1,"Detection test for candida species (yeast), direct probe technique",99.0,64.35,12.47,255.67,19
CDM,56587493_1,"Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique",304.0,197.6,35.09,785.08,19
CDM,56587494_1,"Detection test by nucleic acid for clostridium difficile, amplified probe technique",188.0,122.2,37.27,485.51,19
CDM,56587495_1,"Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique",172.0,111.8,35.09,444.19,19
CDM,56587496_1,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique",172.0,111.8,35.09,444.19,19
CDM,56587507_1,"Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 12-25 targets",1800.0,1170.0,240.71,7502.04,19
CDM,56587510_1,"Detection test for gardnerella vaginalis (bacteria), direct probe technique",99.0,64.35,12.47,255.67,19
CDM,56587555_1,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), direct probe technique",227.0,147.55,12.47,586.23,19
CDM,56587556_1,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), amplified probe technique",383.5,249.28,41.68,990.39,19
CDM,56587557_1,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), amplified probe technique",383.5,249.28,41.68,990.39,19
CDM,56587560_1,"Detection test by nucleic acid for Mycobacteria avium-intracellulare (bacteria), direct probe technique",240.0,156.0,12.47,619.8,19
CDM,56587592_1,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique",95.0,61.75,33.34,245.34,19
CDM,56587660_1,"Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), direct probe technique",99.0,64.35,12.47,255.67,19
CDM,56587798_1,"Detection test by nucleic acid for organism, amplified probe technique",304.0,197.6,35.09,785.08,19
CDM,56587880_1,"Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep)",75.0,48.75,12.4,193.69,19
CDM,56588000_1,Detection test by immunoassay with direct visual observation for other organism,102.0,66.3,12.47,263.42,19
CDM,56589359_1,Bacterial blood culture,64.0,41.6,6.6,165.28,19
CDM,56589460_1,Bacterial blood culture,64.0,41.6,6.6,165.28,19
CDM,56589461_1,Tissue fungi or parasites,25.0,16.25,1.07,64.56,19
CDM,56589462_1,Screening test for pathogenic organisms,33.0,21.45,2.19,85.22,19
CDM,56589463_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method",63.0,40.95,2.99,162.7,19
CDM,56589501_1,Special fluorescent and/or acid fast stain for microorganism,44.0,28.6,2.37,113.63,19
CDM,56589523_1,Screening test for pathogenic organisms,40.0,26.0,2.65,103.3,19
CDM,56589530_1,"Bacterial culture, any other source except urine, blood or stool, aerobic",64.0,41.6,5.52,165.28,19
CDM,56589532_1,Screening test for pathogenic organisms,77.0,50.05,5.11,198.85,19
CDM,56589542_1,Detection test by immunofluorescent technique for legionella pneumophila (water borne bacteria),110.0,71.5,12.47,284.08,19
CDM,56589552_1,Detection test by immunoassay technique for rotavirus,102.0,66.3,11.98,263.42,19
CDM,56600001_1,Measurement of Hepatitis A antibody (IgM),178.0,115.7,11.26,459.69,19
CDM,56600002_1,Detection test by immunoassay technique for hepatitis B surface antigen,152.0,98.8,10.33,392.54,19
CDM,56600003_1,Hepatitis C antibody measurement,161.0,104.65,13.66,415.78,19
CDM,56600004_1,Hepatitis B core antibody (IgM) measurement,162.0,105.3,11.77,418.37,19
CDM,56600005_1,Hepatitis B surface antibody measurement,164.0,106.6,10.74,423.53,19
CDM,56600006_1,Analysis for antibody to HIV-1 and HIV-2 virus,90.0,58.5,12.34,232.43,19
CDM,56600007_1,"Analysis for antibody, Treponema pallidum",76.0,49.4,10.06,196.27,19
CDM,56600008_1,Chemistry procedures,143.0,92.95,14.14,369.3,18
CDM,56600387_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",144.0,93.6,35.09,371.88,19
CDM,56600494_1,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS AND NEISSERIA GONORRHOEAE, MULTIPLEX AMPLIFIED PROBE TECHNIQUE",344.0,223.6,154.8,888.38,16
CDM,56600626_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), separately reported high-risk types",172.0,111.8,70.2,444.19,17
CDM,56600661_1,"Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), amplified probe technique",172.0,111.8,35.09,444.19,19
CDM,56600762_1,Analysis for antibody to mumps virus,59.0,38.35,7.7,152.37,19
CDM,5660528U_1,Amplified probe technique testing for infectious agents in lower respiratory tract infections,1300.0,845.0,325.0,3357.25,17
CDM,56605_1,"Biopsy of growth of external female genitals, first growth",320.0,208.0,47.08,230.79,19
CDM,56606_1,"Biopsy of growth of external female genitals, each additional growth",231.0,150.15,23.18,91.26,19
CDM,56607183_1,"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; CARBAPENEM RESISTANCE GENES (EG, BLAKPC, BLANDM, BLAVIM, BLAOXA-48, BLAIMP), AMPLIFIED PROBE TECHNIQUE, PER ISOLATE",250.0,162.5,87.73,645.63,16
CDM,56607494_1,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS AND NEISSERIA GONORRHOEAE, MULTIPLEX AMPLIFIED PROBE TECHNIQUE",344.0,223.6,154.8,888.38,16
CDM,56607563_1,Detection of Mycoplasma genitalium by DNA or RNA probe,172.0,111.8,35.09,444.19,19
CDM,56607626_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), separately reported high-risk types",172.0,111.8,70.2,444.19,17
CDM,56607661_1,"Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), amplified probe technique",172.0,111.8,35.09,444.19,19
CDM,56610074_1,Acute hepatitis panel,215.0,139.75,10.64,555.24,19
CDM,56610075_1,"Measurement of antibody for assessment of autoimmune disorder, any method",51.0,33.15,9.14,131.71,19
CDM,56610076_1,"Measurement of antibody for assessment of autoimmune disorder, any method",51.0,33.15,9.14,131.71,19
CDM,56610077_1,Beta 2 glycoprotein 1 antibody (autoantibody) measurement,72.0,46.8,13.66,185.94,19
CDM,56610078_1,Analysis for antibody to HIV-2 virus,61.0,39.65,8.25,157.53,19
CDM,56610079_1,Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 antibodies,118.0,76.7,12.47,304.74,19
CDM,56610080_1,Analysis for antibody to HIV -1 virus,41.0,26.65,3.64,105.88,19
CDM,56612591_1,Analysis for antibody to Cytomegalovirus (CMV),107.0,69.55,13.66,276.33,19
CDM,56614634_1,Hepatitis C antibody measurement,70.0,45.5,9.99,180.78,19
CDM,56616263_1,Hepatitis B surface antibody measurement,172.0,111.8,10.74,444.19,19
CDM,56616302_1,Hepatitis B surface antibody measurement,53.0,34.45,5.69,136.87,19
CDM,56616308_1,Detection test by immunoassay technique for hepatitis B surface antigen,51.0,33.15,5.27,131.71,19
CDM,56616322_1,Hepatitis B core antibody measurement,59.0,38.35,7.11,152.37,19
CDM,56616331_1,Measurement of Hepatitis A antibody (IgM),103.0,66.95,11.26,266.0,19
CDM,56616335_1,Hepatitis B core antibody (IgM) measurement,53.0,34.45,6.24,136.87,19
CDM,56616534_1,Analysis for antibody (IgM) to Cytomegalovirus (CMV),221.0,143.65,13.66,570.73,19
CDM,56616703_1,Analysis for antibody to HIV-1 and HIV-2 virus,94.0,61.1,12.89,242.76,19
CDM,56616704_1,"Detection test by immunoassay with direct visual observation for HIV-1 antigen, with HIV-1 and HIV-2 antibodies",174.0,113.1,32.77,449.36,19
CDM,56616705_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",172.0,111.8,35.09,444.19,19
CDM,56616706_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",172.0,111.8,35.09,444.19,19
CDM,56616707_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",172.0,111.8,35.09,444.19,19
CDM,56616708_1,Screening test for autoimmune disorder,60.0,39.0,7.25,154.95,19
CDM,56616718_1,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",378.0,245.7,35.09,976.19,19
CDM,56616719_1,"Detection test by nucleic acid for organism, amplified probe technique",250.0,162.5,35.09,645.63,19
CDM,56616720_1,"Tuberculosis test, gamma interferon",303.0,196.95,48.13,782.5,19
CDM,56616721_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",172.0,111.8,35.09,444.19,19
CDM,56616722_1,"Detection test by nucleic acid for cytomegalovirus, quantification",851.0,553.15,42.84,2197.71,19
CDM,56616723_1,"Detection test by nucleic acid for Hepatitis B virus, quantification",343.0,222.95,42.84,885.8,19
CDM,56616724_1,"Detection test by nucleic acid for Hepatitis C virus, quantification",345.0,224.25,42.84,890.96,19
CDM,56616725_1,"Detection test by nucleic acid for HIV-1 virus, quantification",416.0,270.4,50.59,1074.32,19
CDM,56616726_1,Bacterial culture for anaerobic isolates,70.0,45.5,5.66,180.78,19
CDM,56616727_1,"Detection test by nucleic acid for organism, amplified probe technique",250.0,162.5,35.09,645.63,19
CDM,56616728_1,"Detection test by nucleic acid for human papillomavirus (hpv), types 16 and 18 only",165.0,107.25,40.55,426.11,19
CDM,56616729_1,"Detection test by nucleic acid for human papillomavirus (hpv), types 16 and 18 only",165.0,107.25,40.55,426.11,19
CDM,56616730_1,"Tuberculosis test, gamma interferon",160.0,104.0,48.13,413.2,19
CDM,56616731_1,"Detection test by nucleic acid for organism, amplified probe technique",250.0,162.5,35.09,645.63,19
CDM,56616733_1,"2019-NCOV CORONAVIRUS, SARS-COV-2/2019-NCOV (COVID-19), ANY TECHNIQUE, MULTIPLE TYPES OR SUBTYPES (INCLUDES ALL TARGETS), NON-CDC",130.0,84.5,12.47,335.73,19
CDM,56616734_1,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,195.0,126.75,50.59,503.59,19
CDM,56616735_1,"Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 12-25 targets",1300.0,845.0,240.71,5418.14,19
CDM,56616736_1,"Identification of organisms by genetic analysis, amplified probe technique",50.0,32.5,17.55,129.13,19
CDM,56616737_1,Measure of severe acute respiratory syndrome coronavirus 2 (Covid-19) antibody,220.0,143.0,13.66,568.15,19
CDM,56616738_1,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,130.0,84.5,50.59,335.73,19
CDM,56616739_1,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,130.0,84.5,50.59,335.73,19
CDM,56616740_1,"Test for detection of respiratory disease-causing organisms from back of nose and throat (nasopharynx) specimen, 22 target organisms including severe acute respiratory syndrome coronavirus 2",750.0,487.5,187.5,1936.88,19
CDM,56616741_1,Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) and influenza virus types A and B,200.0,130.0,50.59,516.5,19
CDM,56616742_1,"Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19), influenza virus types A and B, and respiratory syncytial virus",220.0,143.0,50.59,568.15,19
CDM,56616744_1,Stool calprotectin (protein) level,148.0,96.2,14.14,382.21,19
CDM,56616745_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56616746_1,"Detection test by nucleic acid for organism, quantification",517.0,336.05,42.84,1335.15,19
CDM,56616747_1,"Detection test by nucleic acid for organism, quantification",517.0,336.05,42.84,1335.15,19
CDM,56616748_1,"Detection test by nucleic acid for organism, quantification",517.0,336.05,42.84,1335.15,19
CDM,56616749_1,Measure of severe acute respiratory syndrome coronavirus 2 (Covid-19) antibody,140.0,91.0,13.66,361.55,19
CDM,56616750_1,"Detection test by nucleic acid for organism, amplified probe technique",466.0,302.9,35.09,1203.45,19
CDM,56616751_1,"Identification of organisms by immunologic analysis, other than immunofluorescence method",32.0,20.8,1.66,82.64,19
CDM,56616752_1,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",322.85,209.85,35.09,833.76,19
CDM,56616755_1,Unlisted microbiology procedure,1600.0,1040.0,12.47,4132.0,18
CDM,56616756_1,Test for detection of bacteria causing vaginosis and vaginitis,320.0,208.0,144.0,841.57,17
CDM,56616757_1,"Identification of organisms by genetic analysis, amplified probe technique",135.0,87.75,35.09,348.64,19
CDM,56616758_1,"Identification of organisms by genetic analysis, amplified probe technique",135.0,87.75,35.09,348.64,19
CDM,56616759_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56616760_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56616761_1,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",322.85,209.85,35.09,833.76,19
CDM,56616762_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56616763_1,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",339.0,220.35,35.09,875.47,19
CDM,56616764_1,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",339.0,220.35,35.09,875.47,19
CDM,56616765_1,"Detection test by nucleic acid for herpes virus-6, amplified probe technique",537.0,349.05,35.09,1386.8,19
CDM,56616766_1,"Detection test by nucleic acid for herpes virus-6, amplified probe technique",537.0,349.05,35.09,1386.8,19
CDM,56616767_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",518.0,336.7,35.09,1337.74,19
CDM,56616768_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",518.0,336.7,35.09,1337.74,19
CDM,56616769_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56616770_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56616771_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56616772_1,"Detection test by nucleic acid for organism, amplified probe technique",275.0,178.75,35.09,710.19,19
CDM,56617626_1,"Detection test by nucleic acid for Human Papillomavirus (HPV), separately reported high-risk types",172.0,111.8,70.2,444.19,17
CDM,56619552_1,Analysis for antibody to Rubella (German measles virus),71.0,46.15,10.22,183.36,19
CDM,56619553_1,"Detection test by nucleic acid for Mycobacteria species (bacteria), amplified probe technique",150.0,97.5,48.24,387.38,19
CDM,56619554_1,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), amplified probe technique",150.0,97.5,41.68,387.38,19
CDM,56620T_1,Simple partial removal of external female genitals,1440.8,936.52,78.57,1600.06,19
CDM,56620_1,Simple partial removal of external female genitals,1367.1,888.62,78.57,1600.06,19
CDM,56625_1,Removal of external female genitals,1667.4,1083.81,78.57,1906.05,19
CDM,56630_1,Extensive partial removal of external female genitals,2447.6,1590.94,78.57,2784.48,19
CDM,56631_1,Partial removal of external female genitals and lymph nodes on side of groin,3112.2,2022.93,78.57,3514.3,19
CDM,56632_1,Partial removal of external female genitals and lymph nodes on both sides of groin,3597.3,2338.25,78.57,4149.31,19
CDM,56633_1,Complete removal of female genitals,3194.1,2076.17,78.57,3612.92,19
CDM,56634_1,Complete removal of external female genitals and lymph nodes on side of groin,2978.35,1935.93,78.57,3842.64,19
CDM,56637_1,Complete removal of external female genitals and lymph nodes on both sides of groin,4200.0,2730.0,78.57,4472.47,19
CDM,56640_1,Complete removal of female genitals and lymph nodes,4725.0,3071.25,78.57,4476.38,19
CDM,56681515_1,Test for detection of bacteria causing vaginosis and vaginitis,320.0,208.0,144.0,841.57,17
CDM,56682598_1,Syphilis detection test,22.0,14.3,0.94,56.82,19
CDM,56682600_1,Syphilis test,72.0,46.8,3.17,185.94,19
CDM,56682785_1,IgE (immune system protein) level,75.0,48.75,12.35,193.69,19
CDM,56683519_1,"Analysis of substance using immunoassay technique, multiple step method",57.0,37.05,6.57,147.2,19
CDM,56683993_1,Stool calprotectin (protein) level,148.0,96.2,14.14,382.21,19
CDM,56684145_1,Procalcitonin (hormone) level,123.0,79.95,15.65,317.65,19
CDM,56686038_1,Screening test for autoimmune disorder,6.0,3.9,0.73,15.5,19
CDM,56686146_1,Beta 2 glycoprotein 1 antibody (autoantibody) measurement,72.0,46.8,13.66,185.94,19
CDM,56686147_1,Cardiolipin antibody (tissue antibody) measurement,125.0,81.25,13.66,322.81,19
CDM,56686148_1,Cardiolipin antibody (tissue antibody) measurement,125.0,81.25,13.66,322.81,19
CDM,56686200_1,Measurement of antibody for rheumatoid arthritis assessment,64.0,41.6,8.29,165.28,19
CDM,56686226_1,"Measurement of DNA antibody, native or double stranded",68.0,44.2,9.34,175.61,19
CDM,56686235_1,"Measurement of antibody for assessment of autoimmune disorder, any method",51.0,33.15,9.14,131.71,19
CDM,56686236_1,"Measurement of antibody for assessment of autoimmune disorder, any method",51.0,33.15,9.14,131.71,19
CDM,56686238_1,"Measurement of antibody for assessment of autoimmune disorder, any method",7.0,4.55,1.26,21.35,19
CDM,56686240_1,"Measurement of antibody for assessment of autoimmune disorder, any method",51.0,33.15,9.14,131.71,19
CDM,56686242_1,"Measurement of antibody for assessment of autoimmune disorder, any method",51.0,33.15,9.14,131.71,19
CDM,56686244_1,"Measurement of antibody for assessment of autoimmune disorder, any method",51.0,33.15,9.14,131.71,19
CDM,56686246_1,"Measurement of antibody for assessment of autoimmune disorder, any method",51.0,33.15,9.14,131.71,19
CDM,56686248_1,"Measurement of antibody for assessment of autoimmune disorder, any method",51.0,33.15,9.14,131.71,19
CDM,56686250_1,"Measurement of antibody for assessment of autoimmune disorder, any method",51.0,33.15,9.14,131.71,19
CDM,56686254_1,Screening test for antibody to noninfectious agent,65.9,42.84,7.94,170.19,19
CDM,56686255_1,Screening test for antibody to noninfectious agent,110.9,72.09,12.05,286.4,19
CDM,56686256_1,Measurement of antibody to noninfectious agent,66.0,42.9,7.95,170.45,19
CDM,56686364_1,Measurement of tissue transglutaminase,57.0,37.05,6.57,147.2,19
CDM,56686480_1,"Tuberculosis test, gamma interferon",158.0,102.7,48.13,408.04,19
CDM,56686540_1,Detection test by immunofluorescent technique for varicella (chicken pox) zoster virus,248.0,161.2,12.47,640.46,19
CDM,56686543_1,Analysis for antibody to Herpes simplex virus,132.0,85.8,13.66,340.89,19
CDM,56686592_1,Syphilis detection test,173.0,112.45,4.27,446.77,19
CDM,56686618_1,Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria),74.0,48.1,12.6,191.11,19
CDM,56686689_1,Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV,159.0,103.35,13.66,410.62,19
CDM,56686695_1,"Analysis for antibody to Herpes simplex virus, type 1",60.0,39.0,7.91,154.95,19
CDM,56686696_1,"Analysis for antibody to Herpes simplex virus, type 2",88.0,57.2,13.66,227.26,19
CDM,56686701_1,Analysis for antibody to HIV -1 virus,93.0,60.45,8.27,240.17,19
CDM,56686702_1,Analysis for antibody to HIV-2 virus,93.0,60.45,12.57,240.17,19
CDM,56686703_1,Analysis for antibody to HIV-1 and HIV-2 virus,172.0,111.8,13.66,444.19,19
CDM,56686708_1,Measurement of Hepatitis A antibody,61.0,39.65,7.56,157.53,19
CDM,56686765_1,Analysis for antibody to Rubeola (measles virus),63.0,40.95,8.11,162.7,19
CDM,56686780_1,"Analysis for antibody, Treponema pallidum",60.0,39.0,7.94,154.95,19
CDM,56686787_1,Analysis for antibody to varicella-zoster virus (chicken pox),58.0,37.7,7.47,149.79,19
CDM,56686788_1,Analysis for antibody (IgM) to West Nile virus,83.0,53.95,13.66,214.35,19
CDM,56686789_1,Analysis for antibody to West Nile virus,71.0,46.15,10.22,183.36,19
CDM,56687110_1,Culture for chlamydia,367.0,238.55,12.47,947.78,19
CDM,56687150_1,"Identification of organisms by genetic analysis, amplified probe technique",200.0,130.0,35.09,516.5,19
CDM,56687153_1,Identification of organisms by nucleic acid sequencing method,564.0,366.6,115.36,1456.53,19
CDM,56687154_1,Amplifed nucleic acid probe typing of disease agent in blood culture specimen,500.0,325.0,218.06,1291.25,19
CDM,56687183_1,"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; CARBAPENEM RESISTANCE GENES (EG, BLAKPC, BLANDM, BLAVIM, BLAOXA-48, BLAIMP), AMPLIFIED PROBE TECHNIQUE, PER ISOLATE",200.0,130.0,70.18,516.5,16
CDM,56687254_1,"Virus isolation, centrifuge enhanced",136.0,88.4,12.47,351.22,19
CDM,56687256_1,Tissue culture inoculation for virus isolation,136.0,88.4,12.47,351.22,19
CDM,56687261_1,Tissue culture inoculation for virus isolation,68.0,44.2,12.47,175.61,19
CDM,56687262_1,Tissue culture inoculation for virus isolation,282.0,183.3,12.47,728.27,19
CDM,56687263_1,Tissue culture inoculation for virus isolation,327.0,212.55,12.47,844.48,19
CDM,56687264_1,Tissue culture inoculation for virus isolation,135.0,87.75,12.47,348.64,19
CDM,56687265_1,Tissue culture inoculation for virus isolation,219.0,142.35,12.47,565.57,19
CDM,56687266_1,Tissue culture for virus isolation,60.0,39.0,12.12,154.95,19
CDM,56687267_1,Tissue culture for virus isolation,76.0,49.4,12.47,196.27,19
CDM,56687268_1,Tissue culture for virus isolation,147.0,95.55,12.47,379.63,19
CDM,56687273_1,Detection test by immunofluorescent technique for herpes simplex virus type 2,118.0,76.7,11.98,304.74,19
CDM,56687274_1,Detection test by immunofluorescent technique for herpes simplex virus type 1,118.0,76.7,11.98,304.74,19
CDM,56687338_1,Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool,25.67,16.69,3.69,66.29,19
CDM,56687390_1,Detection test by immunoassay technique for HIV-1 antigen,109.0,70.85,12.47,281.49,19
CDM,56687400_1,Detection test by immunoassay technique for influenza virus,225.0,146.25,12.47,581.06,19
CDM,56687481_1,"Detection test for candida species (yeast), amplified probe technique",200.0,130.0,35.09,516.5,19
CDM,56687483_1,Test for detecting nucleic acid of organism causing infection of central nervous system,1200.0,780.0,240.71,5001.36,19
CDM,56687486_1,"Detection test by nucleic acid for Chlamydia pneumoniae, amplified probe technique",172.0,111.8,35.09,444.19,19
CDM,56687494_1,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS AND NEISSERIA GONORRHOEAE, MULTIPLEX AMPLIFIED PROBE TECHNIQUE",344.0,223.6,154.8,888.38,16
CDM,56687502_1,Detection test by nucleic acid for multiple types influenza virus,58.0,37.7,29.58,245.53,19
CDM,56687503_1,"Detection test by nucleic acid for multiple types influenza virus, each additional influenza virus type or sub-type",58.0,37.7,16.95,149.79,19
CDM,56687563_1,Detection of Mycoplasma genitalium by DNA or RNA probe,172.0,111.8,35.09,444.19,19
CDM,56687581_1,"Detection test by nucleic acid for Mycoplasma pneumoniae (bacteria), amplified probe technique",172.0,111.8,35.09,444.19,19
CDM,56687631_1,"Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets",320.0,208.0,142.63,826.4,19
CDM,56687633_1,"Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 12-25 targets",1300.0,845.0,240.71,5418.14,19
CDM,56687651_1,"Detection test by nucleic acid for Strep (Streptococcus, group A), amplified probe technique",90.0,58.5,31.58,232.43,19
CDM,56687652_1,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,130.0,84.5,50.59,335.73,19
CDM,56687661_1,"Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), amplified probe technique",172.0,111.8,35.09,444.19,19
CDM,56687730_1,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid",101.0,65.65,13.66,260.83,19
CDM,56687731_1,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid",101.0,65.65,13.66,260.83,19
CDM,56687732_1,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen",101.0,65.65,13.12,260.83,19
CDM,56687733_1,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear antigen",101.0,65.65,13.66,260.83,19
CDM,56687798_1,"Detection test by nucleic acid for organism, amplified probe technique",250.0,162.5,35.09,645.63,19
CDM,56687800_1,"Detection test by nucleic acid for organism, amplified probe technique",64.0,41.6,22.46,165.28,19
CDM,56687801_1,"Detection test by nucleic acid for organism, amplified probe technique",64.0,41.6,22.46,165.28,19
CDM,56687802_1,"Detection test by nucleic acid for organism, amplified probe technique",64.0,41.6,22.46,165.28,19
CDM,56687803_1,Detection test by immunoassay with direct visual observation for influenza virus,80.0,52.0,12.47,206.6,19
CDM,56687805_1,"Detection test by nucleic acid for organism, amplified probe technique",64.0,41.6,22.46,165.28,19
CDM,56687806_1,"Detection test by nucleic acid for organism, amplified probe technique",64.0,41.6,22.46,165.28,19
CDM,56687807_1,Detection test by immunoassay with direct visual observation for respiratory syncytial virus,90.0,58.5,11.79,232.43,19
CDM,56687808_1,"Detection test by nucleic acid for organism, amplified probe technique",64.0,41.6,22.46,165.28,19
CDM,56687899_1,Detection test by immunoassay with direct visual observation for other organism,54.0,35.1,8.68,139.46,19
CDM,56689090_1,Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV,449.0,291.85,13.66,1159.54,19
CDM,56689551_1,Analysis for antibody to HIV -1 virus,164.0,106.6,8.89,423.53,19
CDM,566G2023_1,HC SPECIMEN COLLECTION COVID 19,50.0,32.5,12.5,129.13,16
CDM,566U0005_1,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS-COV-2) (CORONAVIRUS DISEASE [COVID-19]), AMPLIFIED PROBE TECHNIQUE, CDC OR NON-CDC, MAKIN",25.0,16.25,6.25,64.56,18
CDM,56700_1,Partial removal of hymen,520.8,338.52,78.57,567.81,19
CDM,56710010_1,Insertion of needle into vein for collection of blood sample,12.0,7.8,3.0,30.99,19
CDM,56740_1,Removal of cyst of female genital gland,847.4,550.81,78.57,905.73,19
CDM,5674IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.2,2.73,1.05,10.85,16
CDM,5674OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.98,14.29,5.5,56.76,16
CDM,5675IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.48,2.26,0.87,8.99,16
CDM,5675OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.2,6.63,2.55,26.34,16
CDM,56800T_1,Plastic repair of vaginal opening,703.5,457.28,78.57,729.45,19
CDM,56800_1,Plastic repair of vaginal opening,918.8,597.22,78.57,729.45,19
CDM,56805_1,Reconstruction or creation of the external female sexual organ for intersex state,3240.3,2106.2,78.57,3436.1,19
CDM,56810_1,Repair of skin in area between anus and genitals,761.3,494.85,78.57,789.2,19
CDM,56820_1,Exam of external female genitals using an endoscope,305.6,198.64,68.51,298.62,19
CDM,56821_1,Exam and biopsy of external female genitals using an endoscope,380.1,247.07,77.55,399.46,19
CDM,56_1,FLUARIX 2025-2026 SYRINGE,12.25,7.96,3.06,8.58,11
CDM,57000_1,Incision and exploration of vagina,537.6,349.44,78.57,574.59,19
CDM,57010_1,Incision and drainage of abscess of pelvis,1207.5,784.88,78.57,1312.91,19
CDM,57020_1,Removal of abdominal fluid,277.2,180.18,43.02,301.0,19
CDM,57022_1,Incision and drainage of vaginal blood accumulation following delivery,551.3,358.35,78.57,513.14,19
CDM,57023_1,Incision and drainage of vaginal blood accumulation,876.8,569.92,78.57,933.35,19
CDM,57061_1,Simple destruction of growth of vagina,316.1,205.47,53.04,402.66,19
CDM,57065_1,Extensive destruction of growth of vagina,603.8,392.47,78.57,592.98,19
CDM,57100_1,Simple biopsy of vaginal mucous membrane,250.0,162.5,49.4,246.96,19
CDM,57105_1,Biopsy of extensive area of vaginal mucous membrane,425.3,276.45,78.57,424.77,19
CDM,57106_1,Partial removal of vaginal wall,1332.5,866.13,78.57,1509.86,19
CDM,57107_1,Partial removal of vaginal wall and tissue,3951.2,2568.28,78.57,4322.37,19
CDM,57108724_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",212.63,138.21,53.16,653.0,19
CDM,57109011_1,"BLOOD, SPLIT UNIT",873.63,567.86,182.26,2256.15,19
CDM,57109_1,Partial removal of vaginal wall and tissue with removal of pelvic lymph nodes and biopsy of aortic lymph node,4007.95,2605.17,78.57,5148.3,19
CDM,57110_1,Removal of vaginal wall,2541.0,1651.65,78.57,2683.35,19
CDM,57111_1,Complete removal of vaginal wall and tissue,3805.2,2473.38,78.57,5151.58,19
CDM,57120503_1,HC TISSUE CP STRUT 8-16MM,2800.8,1820.52,700.2,1960.56,11
CDM,57120519_1,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",2787.6,1811.94,696.9,7198.98,16
CDM,57120520_1,"OASIS ULTRA TRI-LAYER WOUND MATRIX, PER SQUARE CENTIMETER",39.6,25.74,9.9,134.77,17
CDM,57120521_1,"OASIS ULTRA TRI-LAYER WOUND MATRIX, PER SQUARE CENTIMETER",42.0,27.3,10.5,134.77,17
CDM,57120524_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",868.8,564.72,134.77,2243.68,17
CDM,57120525_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",574.8,373.62,134.77,1484.42,17
CDM,57120526_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",351.6,228.54,87.9,908.01,17
CDM,57120533_1,"GRAFIX CORE AND GRAFIXPL CORE, PER SQUARE CENTIMETER",439.2,285.48,109.8,1134.23,17
CDM,57120536_1,HC CARDIOCEL 5X8,6033.6,3921.84,1508.4,6033.6,12
CDM,57120537_1,"SKIN SUBSTITUTE, NOT OTHERWISE SPECIFIED",381.6,248.04,95.4,985.48,16
CDM,57120543_1,HC BONE 4X8X8 MM FACET WEDGE,2240.4,1456.26,560.1,1568.28,11
CDM,57120547_1,"STRATTICE TM, PER SQUARE CENTIMETER",80.4,52.26,20.1,207.63,17
CDM,57120560_1,HC PROX TIBIA L,40534.8,26347.62,10133.7,40534.8,12
CDM,57120561_1,HC GRAFTON DBF 1,2022.0,1314.3,505.5,1415.4,11
CDM,57120562_1,HC GRAFTON DBF 3,3158.4,2052.96,789.6,2210.88,11
CDM,57120563_1,HC GRAFTON DBF 6,5439.6,3535.74,1359.9,3807.72,11
CDM,57120568_1,HC ORBITAL WRAP 20X20X2MM,3349.2,2176.98,837.3,2344.44,11
CDM,57120570_1,HC AXOGAURD NERVE CONNECTOR 3-5X15MM,5227.2,3397.68,1306.8,3659.04,11
CDM,57120574_1,HC CYLINDERS NIPPLE RECONSTRUCTION,2494.8,1621.62,623.7,1746.36,11
CDM,57120578_1,HC AXOGUARD NERVE CONNECTOR 15MM,7130.4,4634.76,1782.6,7130.4,12
CDM,57120581_1,HC PULMONARY ARTERY NON VALVES,30289.2,19687.98,7572.3,30289.2,12
CDM,57120592_1,HC THORACIC ARTERY,90039.6,58525.74,22509.9,90039.6,12
CDM,57120593_1,HC TIBIA PROX LEFT,62594.4,40686.36,15648.6,62594.4,12
CDM,57120633_1,Red blood cell sickling measurement,26.0,16.9,1.43,67.15,19
CDM,57120636_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2664.48,1731.91,666.12,6881.02,16
CDM,57120637_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3155.88,2051.32,788.97,8150.06,16
CDM,57120638_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1868.88,1214.77,467.22,4826.38,16
CDM,57120639_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3319.68,2157.79,829.92,8573.07,16
CDM,57120640_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4770.48,3100.81,1192.62,12319.76,16
CDM,57120646_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",152190.48,98923.81,38047.62,393031.91,17
CDM,57120647_1,Blood group typing (ABO),128.0,83.2,2.99,330.56,19
CDM,57120648_1,Blood typing for Rh (D) antigen,42.0,27.3,1.26,108.47,19
CDM,57120649_1,Screening test for red blood cell antibodies,188.37,122.44,5.24,486.47,19
CDM,57120650_1,Identification of red blood cell antibodies,298.35,193.93,36.49,770.49,19
CDM,57120651_1,"Red blood cell antibody detection test, direct",229.32,149.06,5.24,592.22,19
CDM,57120652_1,Removal of antibodies from surface of red blood cell,358.02,232.71,26.4,924.59,19
CDM,57120653_1,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, by differential red cell absorption",248.04,161.23,29.5,640.56,19
CDM,57120654_1,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, by density gradient separation",372.06,241.84,34.55,960.85,19
CDM,57120655_1,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with chemical agents or drugs",229.32,149.06,24.46,592.22,19
CDM,57120656_1,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with enzymes",229.32,149.06,19.8,592.22,19
CDM,57120657_1,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, incubation with inhibitors",298.35,193.93,29.5,770.49,19
CDM,57120658_1,"Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, differential lysis",483.6,314.34,6.99,1248.9,19
CDM,57120659_1,"Blood unit compatibility test, immediate spin technique",460.98,299.64,29.5,1190.48,19
CDM,57120660_1,"Blood unit compatibility test, incubation technique",75.6,49.14,26.4,195.24,19
CDM,57120662_1,Blood typing for red blood cell antigens,133.38,86.7,3.83,344.45,19
CDM,57120663_1,Blood typing Rh phenotyping,307.71,200.01,5.24,794.66,19
CDM,57120664_1,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with chemical agents or drugs",151.0,98.15,24.46,389.96,19
CDM,57120665_1,Red blood cell antibody level,500.76,325.49,5.18,1293.21,19
CDM,57120666_1,"Screening test for compatible blood unit, using patient serum",248.04,161.23,5.24,640.56,19
CDM,57120667_1,"Antibody identification test, platelet antibodies",1028.43,668.48,13.66,2655.92,19
CDM,57120668_1,"Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 ",1792.44,1165.09,60.67,4628.98,19
CDM,57120669_1,"Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 ",1792.44,1165.09,60.67,4628.98,19
CDM,57120670_1,"Antibody identification test, platelet antibodies",1622.79,1054.81,13.66,4190.86,19
CDM,57120671_1,Molecular pathology procedure level 4 genetic analysis,1296.36,842.63,185.2,3347.85,19
CDM,57120684_1,HC GRAFTON GEL 0.5,391.67,254.59,97.92,274.17,11
CDM,57120685_1,HC GRAFTON GEL 1,639.14,415.44,159.79,447.4,11
CDM,57120688_1,UNCLASSIFIED BIOLOGICS,7363.68,4786.39,1840.92,19016.7,16
CDM,57120691_1,HC GRAFTON DBM CRUNCH 5CC,2900.28,1885.18,725.07,2030.2,11
CDM,57120699_1,HC LORDOTIC UNILATERAL,18347.65,11925.97,4586.91,12843.36,11
CDM,57120705_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2991.4,1944.41,747.85,7725.29,16
CDM,57120706_1,HC AMNIOFILL 100MG,1357.9,882.64,339.48,950.53,11
CDM,57120707_1,HC AMNIOFILL 1000MG,10200.4,6630.26,2550.1,7140.28,11
CDM,57120708_1,HC AMNIOFILL 2000MG,18975.4,12334.01,4743.85,13282.78,11
CDM,57120710_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",54306.25,35299.06,13576.56,140245.89,17
CDM,57120711_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",9880.54,6422.35,2470.14,25516.49,17
CDM,57120718_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1200.4,780.26,300.1,3100.03,16
CDM,57120723_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5250.4,3412.76,1312.6,13559.16,16
CDM,57120726_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5880.4,3822.26,1470.1,15186.13,17
CDM,57120732_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",63075.4,40999.01,15768.85,162892.22,17
CDM,57120738_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3900.4,2535.26,975.1,10072.78,16
CDM,57120740_1,HC EMDOGAIN 0.3ML / SYR,709.9,461.44,177.48,496.93,11
CDM,57120743_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2434.77,1582.6,401.85,6287.79,19
CDM,57120744_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2566.98,1668.54,401.85,6629.23,19
CDM,57120745_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2701.98,1756.29,401.85,6977.86,19
CDM,57120746_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2569.77,1670.35,401.85,6636.43,19
CDM,57120747_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",3045.4,1979.51,401.85,7864.75,19
CDM,57120748_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",3180.4,2067.26,401.85,8213.38,19
CDM,57120749_1,"BLOOD (WHOLE), FOR TRANSFUSION, PER UNIT",1959.75,1273.84,182.26,5061.05,19
CDM,57120753_1,HC MTP DISC,12478.53,8111.04,3119.63,8734.97,11
CDM,57120754_1,HC AVITRAC MTP,6471.03,4206.17,1617.76,4529.72,11
CDM,57120760_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2797.9,1818.64,699.48,7225.58,16
CDM,57120761_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4777.9,3105.64,1194.48,12338.93,16
CDM,57120762_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6285.4,4085.51,1571.35,16232.05,17
CDM,57120763_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7320.4,4758.26,1830.1,18904.93,17
CDM,57120766_1,Molecular pathology procedure level 4 genetic analysis,1350.0,877.5,185.2,3486.38,19
CDM,57120771_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2784.4,1809.86,696.1,7190.71,16
CDM,57120776_1,"PLASMA, HIGH TITER COVID-19 CONVALESCENT, EACH UNIT",3375.0,2193.75,182.26,8715.94,19
CDM,57120_1,Suture closure of vagina and vaginal opening,1438.5,935.03,78.57,1541.8,19
CDM,57130_1,Removal of abnormal tissue dividing vagina,735.0,477.75,78.57,555.04,19
CDM,57135_1,Removal of cyst or growth of vaginal,656.3,426.6,78.57,595.12,19
CDM,57150_1,Irrigation of vagina and/or application of drug to treat infection,110.0,71.5,11.22,139.15,19
CDM,57155_1,Insertion of device into uterus for radiation therapy,1205.4,783.51,78.57,963.02,19
CDM,57156_1,Insertion of device into vagina for radiation therapy,413.0,268.45,78.57,556.3,19
CDM,57160_1,Fitting and insertion of vaginal support device,184.8,120.12,31.27,177.89,19
CDM,57170_1,Fitting and insertion of pregnancy prevention device,224.7,146.06,37.6,185.95,19
CDM,57180_1,Insertion of drug agent or packing to control vaginal bleeding,383.3,249.15,74.89,480.44,19
CDM,57185461_1,"Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, rosette",113.0,73.45,6.99,291.82,19
CDM,57185581_1,"HC BP PLATELET, WASHED",2696.85,1752.95,653.0,1887.8,12
CDM,57186020_1,Screening test for red blood cell antibodies,223.0,144.95,5.24,575.9,19
CDM,57186025_1,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, by differential red cell absorption",267.6,173.94,29.5,691.08,19
CDM,57186027_1,Identification of red blood cell antibodies,390.0,253.5,36.49,1007.18,19
CDM,57186035_1,"Screening test for compatible blood unit, using reagent serum",225.0,146.25,5.24,581.06,19
CDM,57186036_1,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with chemical agents or drugs",220.5,143.33,24.46,569.44,19
CDM,57186050_1,Red blood cell antibody level,54.0,35.1,2.8,139.46,19
CDM,57186051_1,Measurement of cold agglutinin (protein) to screen for infection or disease,53.0,34.45,4.28,136.87,19
CDM,57186053_1,Removal of antibodies from surface of red blood cell,253.2,164.58,26.4,653.89,19
CDM,57186055_1,Red blood cell antibody level,185.0,120.25,5.18,477.76,19
CDM,57186056_1,Special Gram or Giemsa stain for microorganism,45.0,29.25,1.92,116.21,19
CDM,57186057_1,"Bacterial culture, any other source except urine, blood or stool, aerobic",61.0,39.65,5.26,157.53,19
CDM,57186070_1,"Blood unit compatibility test, antiglobulin technique",646.0,419.9,31.44,1668.3,19
CDM,57186073_1,"Blood unit compatibility test, immediate spin technique",646.0,419.9,29.5,1668.3,19
CDM,57186074_1,Blood group typing (ABO),128.0,83.2,2.99,330.56,19
CDM,57186075_1,Red blood cell antibody level,185.0,120.25,5.18,477.76,19
CDM,57186102_1,Blood typing for Rh (D) antigen,42.0,27.3,1.26,108.47,19
CDM,57186250_1,"Red blood cell antibody detection test, direct",65.0,42.25,3.5,167.86,19
CDM,57186252_1,"Red blood cell antibody detection test, direct",65.0,42.25,3.5,167.86,19
CDM,57186850_1,Screening test for red blood cell antibodies,82.8,53.82,5.24,213.83,19
CDM,57186860_1,Removal of antibodies from surface of red blood cell,253.2,164.58,26.4,653.89,19
CDM,57186870_1,Identification of red blood cell antibodies,390.0,253.5,36.49,1007.18,19
CDM,57186880_1,"Red blood cell antibody detection test, direct",56.4,36.66,3.04,145.65,19
CDM,57186881_1,"Red blood cell antibody detection test, direct",56.4,36.66,3.04,145.65,19
CDM,57186882_1,"Red blood cell antibody detection test, direct",56.4,36.66,3.04,145.65,19
CDM,57186900_1,Blood group typing (ABO),26.0,16.9,0.78,67.15,19
CDM,57186901_1,Blood typing for Rh (D) antigen,26.0,16.9,0.78,67.15,19
CDM,57186902_1,"Screening test for compatible blood unit, using reagent serum",54.0,35.1,3.43,139.46,19
CDM,57186923_1,"Blood unit compatibility test, electronic",550.0,357.5,23.68,1420.38,19
CDM,57186978_1,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, by differential red cell absorption",267.6,173.94,29.5,691.08,19
CDM,57189421_1,Removal of antibodies from surface of red blood cell,646.0,419.9,26.4,1668.3,19
CDM,57189428_1,Splitting of blood or blood products,428.09,278.26,123.26,1105.54,19
CDM,57189504_1,HC OSTEOFIL,3700.8,2405.52,925.2,2590.56,11
CDM,57189505_1,HC PRECISION GRAFT,6733.2,4376.58,1683.3,4713.24,11
CDM,57189506_1,HC OSTEOFIL .5CC,247.2,160.68,61.8,173.04,11
CDM,57189508_1,HC VERTIGRAFT TISSUE,5660.4,3679.26,1415.1,3962.28,11
CDM,57198552_1,"CRYOPRECIPITATE, EACH UNIT",1263.6,821.34,315.9,3263.25,19
CDM,57198553_1,"CRYOPRECIPITATE, EACH UNIT",210.6,136.89,52.65,653.0,19
CDM,57198554_1,"RED BLOOD CELLS, DEGLYCEROLIZED, EACH UNIT",1149.6,747.24,182.26,2968.84,19
CDM,57198556_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",263.9,171.54,65.98,681.52,19
CDM,57198557_1,"GRANULOCYTES, PHERESIS, EACH UNIT",16614.0,10799.1,401.85,42905.66,19
CDM,57198558_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2014.8,1309.62,401.85,5203.22,19
CDM,57198559_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",850.59,552.88,182.26,2196.65,19
CDM,57198560_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",874.8,568.62,182.26,2259.17,19
CDM,57198561_1,"INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, FULL DOSE, 300 MICROGRAMS (1500 I.U.)",458.4,297.96,85.36,1183.82,19
CDM,57198562_1,"RED BLOOD CELLS, DEGLYCEROLIZED, EACH UNIT",1544.49,1003.92,182.26,3988.65,19
CDM,57198563_1,"RED BLOOD CELLS, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,57198564_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2434.77,1582.6,401.85,6287.79,19
CDM,57198566_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2709.6,1761.24,401.85,6997.54,19
CDM,57198567_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2743.2,1783.08,401.85,7084.31,19
CDM,57198568_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",2701.98,1756.29,401.85,6977.86,19
CDM,57198573_1,"RED BLOOD CELLS, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,57198574_1,"PLATELETS, EACH UNIT",2907.45,1889.84,182.26,7508.49,19
CDM,57198575_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2907.45,1889.84,401.85,7508.49,19
CDM,57198576_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",2907.45,1889.84,401.85,7508.49,19
CDM,57198580_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",3039.33,1975.56,401.85,7849.07,19
CDM,57198581_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",3039.66,1975.78,401.85,7849.92,19
CDM,57198582_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",2007.6,1304.94,182.26,5184.63,19
CDM,57198586_1,"RED BLOOD CELLS, EACH UNIT",895.2,581.88,182.26,2311.85,19
CDM,57198593_1,"PLASMA, CRYOPRECIPITATE REDUCED, EACH UNIT",263.25,171.11,65.81,679.84,19
CDM,57198594_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2113.2,1373.58,401.85,5457.34,19
CDM,57198596_1,"GRANULOCYTES, PHERESIS, EACH UNIT",16614.0,10799.1,401.85,42905.66,19
CDM,57198597_1,"GRANULOCYTES, PHERESIS, EACH UNIT",16614.0,10799.1,401.85,42905.66,19
CDM,57198598_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2499.6,1624.74,401.85,6455.22,19
CDM,57198599_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2111.0,1372.15,401.85,5451.66,19
CDM,57198600_1,"RED BLOOD CELLS, IRRADIATED, EACH UNIT",1455.48,946.06,182.26,3758.78,19
CDM,57198601_1,"RED BLOOD CELLS, IRRADIATED, EACH UNIT",1455.48,946.06,182.26,3758.78,19
CDM,57198604_1,"BLOOD, SPLIT UNIT",210.92,137.1,52.73,653.0,19
CDM,57198605_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2712.0,1762.8,401.85,7003.74,19
CDM,57198606_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2745.6,1784.64,401.85,7090.51,19
CDM,57198607_1,"BLOOD, SPLIT UNIT",541.13,351.73,135.28,1397.47,19
CDM,57198608_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1117.8,726.57,182.26,2886.72,19
CDM,57198610_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1455.48,946.06,182.26,3758.78,19
CDM,57198612_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",932.26,605.97,182.26,2407.56,19
CDM,57198614_1,"BLOOD, SPLIT UNIT",794.7,516.56,182.26,2052.31,19
CDM,57198616_1,"RED BLOOD CELLS, WASHED, EACH UNIT",1244.88,809.17,311.22,3214.9,19
CDM,57198617_1,"RED BLOOD CELLS, WASHED, EACH UNIT",1244.88,809.17,311.22,3214.9,19
CDM,57198618_1,"RED BLOOD CELLS, IRRADIATED, EACH UNIT",247.05,160.58,61.76,653.0,19
CDM,57198619_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1329.12,863.93,182.26,3432.45,19
CDM,57198621_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",2566.98,1668.54,401.85,6629.23,19
CDM,57198623_1,"BLOOD, SPLIT UNIT",1041.75,677.14,182.26,2690.32,19
CDM,57198624_1,"BLOOD, SPLIT UNIT",1041.75,677.14,182.26,2690.32,19
CDM,57198625_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",982.8,638.82,182.26,2538.08,19
CDM,57198627_1,"BLOOD, SPLIT UNIT",873.63,567.86,182.26,2256.15,19
CDM,57198628_1,"BLOOD, SPLIT UNIT",873.63,567.86,182.26,2256.15,19
CDM,57198629_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,57198630_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,57198631_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,57198632_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,57198633_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",954.72,620.57,182.26,2465.56,19
CDM,57198634_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",954.72,620.57,182.26,2465.56,19
CDM,57198635_1,"BLOOD, SPLIT UNIT",730.17,474.61,182.26,1885.66,19
CDM,57198636_1,"BLOOD, SPLIT UNIT",730.17,474.61,182.26,1885.66,19
CDM,57198637_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",1112.67,723.24,182.26,2873.47,19
CDM,57198638_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",850.59,552.88,182.26,2196.65,19
CDM,57198643_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",50.4,32.76,12.6,653.0,19
CDM,57198645_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1822.28,1184.48,401.85,4706.04,19
CDM,57198648_1,"PLATELETS, PHERESIS, IRRADIATED, EACH UNIT",879.6,571.74,219.9,2271.57,19
CDM,57198650_1,"PLATELETS, PHERESIS, IRRADIATED, EACH UNIT",220.8,143.52,55.2,653.0,19
CDM,57198652_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",1439.61,935.75,359.9,3717.79,19
CDM,57198654_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",1217.39,791.3,304.35,3143.91,19
CDM,57198656_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",783.6,509.34,195.9,2023.65,19
CDM,57198658_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1349.6,877.24,337.4,3485.34,19
CDM,57198664_1,"BLOOD, SPLIT UNIT",683.6,444.34,170.9,1765.4,19
CDM,57198665_1,"CRYOPRECIPITATE, EACH UNIT",210.6,136.89,52.65,653.0,19
CDM,57198666_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",212.63,138.21,53.16,653.0,19
CDM,57198667_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",683.28,444.13,170.82,1764.57,19
CDM,57198669_1,HC TRANSCYTE SKIN CASSETTE,3481.2,2262.78,870.3,2436.84,11
CDM,57198672_1,"HC OSTEOFIL IC, MOLDABLE STRIPS 50 MM",3108.0,2020.2,777.0,2175.6,11
CDM,57198673_1,"HC OSTEOFIL IC, MOLDABLE STRIPS 90 MM",5046.0,3279.9,1261.5,3532.2,11
CDM,57198674_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",558.0,362.7,139.5,1441.04,19
CDM,57198675_1,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",3174.66,2063.53,401.85,8198.56,19
CDM,57198676_1,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1957.28,1272.23,401.85,5054.68,19
CDM,57198677_1,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",254.4,165.36,63.6,656.99,19
CDM,57198678_1,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",3039.66,1975.78,401.85,7849.92,19
CDM,57198679_1,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",955.2,620.88,238.8,2466.8,19
CDM,57198680_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",1825.07,1186.3,401.85,4713.24,19
CDM,57198681_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",860.4,559.26,215.1,2221.98,19
CDM,57198682_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",1352.39,879.05,338.1,3492.55,19
CDM,57198683_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",2188.8,1422.72,401.85,5652.58,19
CDM,57198684_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",2907.45,1889.84,401.85,7508.49,19
CDM,57198685_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",3042.45,1977.59,401.85,7857.13,19
CDM,57198686_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",2283.6,1484.34,401.85,5897.4,19
CDM,57198687_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2569.77,1670.35,401.85,6636.43,19
CDM,57198688_1,"HC ALLOGRAFT OPTEFORM, 5 CC",1905.6,1238.64,476.4,1333.92,11
CDM,57198689_1,"HC ALLOGRAFT OPTEFORM, 10 CC",3283.2,2134.08,820.8,2298.24,11
CDM,57198690_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT",1117.8,726.57,182.26,2886.72,19
CDM,57198691_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT",794.7,516.56,182.26,2052.31,19
CDM,57198692_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT",1455.48,946.06,182.26,3758.78,19
CDM,57198693_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT",2041.2,1326.78,182.26,5271.4,19
CDM,57198694_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT",967.2,628.68,182.26,2497.79,19
CDM,57198695_1,"PLATELETS, HLA-MATCHED LEUKOCYTES REDUCED, APHERESIS/PHERESIS, EACH UNIT",2208.0,1435.2,401.85,5702.16,19
CDM,57198696_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, FROZEN, DEGLYCEROL, WASHED, EACH UNIT",1183.2,769.08,182.26,3055.61,19
CDM,57198697_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, FROZEN, DEGLYCEROL, WASHED, EACH UNIT",1329.12,863.93,182.26,3432.45,19
CDM,57198699_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1412.4,918.06,353.1,3647.52,19
CDM,57198700_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",913.2,593.58,228.3,2358.34,19
CDM,57198701_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",894.0,581.1,223.5,2308.76,19
CDM,57198702_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",145.2,94.38,36.3,653.0,19
CDM,57198703_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1352.39,879.05,338.1,3492.55,19
CDM,57198704_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1217.39,791.3,304.35,3143.91,19
CDM,57198705_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2566.98,1668.54,401.85,6629.23,19
CDM,57198706_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2222.4,1444.56,401.85,5739.35,19
CDM,57198707_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2701.98,1756.29,401.85,6977.86,19
CDM,57198708_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2569.77,1670.35,401.85,6636.43,19
CDM,57198709_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2434.77,1582.6,401.85,6287.79,19
CDM,57198710_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",3174.66,2063.53,401.85,8198.56,19
CDM,57198711_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2146.8,1395.42,401.85,5544.11,19
CDM,57198712_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2317.2,1506.18,401.85,5984.17,19
CDM,57198713_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",988.8,642.72,247.2,2553.58,19
CDM,57198714_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2241.6,1457.04,401.85,5788.93,19
CDM,57198715_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1349.6,877.24,337.4,3485.34,19
CDM,57198716_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1690.07,1098.55,401.85,4364.61,19
CDM,57198717_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1822.28,1184.48,401.85,4706.04,19
CDM,57198718_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",817.2,531.18,204.3,2110.42,19
CDM,57198719_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2204.4,1432.86,401.85,5692.86,19
CDM,57198720_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2136.0,1388.4,401.85,5516.22,19
CDM,57198721_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, CMV-NEGATIVE, IRRADIATED, EACH UNIT",2434.77,1582.6,401.85,6287.79,19
CDM,57198722_1,"RED BLOOD CELLS, FROZEN/DEGLYCEROLIZED/WASHED, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1244.4,808.86,182.26,3213.66,19
CDM,57198723_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, IRRADIATED, EACH UNIT",982.8,638.82,182.26,2538.08,19
CDM,57198725_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",425.3,276.45,106.33,1098.34,19
CDM,57198726_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",491.4,319.41,122.85,1269.04,19
CDM,57198727_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",1217.39,791.3,304.35,3143.91,19
CDM,57198728_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",1283.49,834.27,320.87,3314.61,19
CDM,57198729_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",131.95,85.77,32.99,653.0,19
CDM,57199022_1,HC AUTOLOGOUS BONE-COLLECTION KIT,40.8,26.52,10.2,28.56,11
CDM,57199027_1,"Test for detection of infectious agent antibody, qualitative or semiquantitative",152.4,99.06,13.66,393.57,19
CDM,57199028_1,HC AUTOLOGOUS BONE RECEIPT & STORAGE,944.4,613.86,236.1,661.08,11
CDM,57199029_1,"PURAPLY AM, PER SQUARE CENTIMETER",720.0,468.0,134.77,1859.4,17
CDM,57199030_1,"PURAPLY AM, PER SQUARE CENTIMETER",538.8,350.22,134.7,1391.45,17
CDM,57199031_1,"PURAPLY AM, PER SQUARE CENTIMETER",531.6,345.54,132.9,1372.86,17
CDM,57199032_1,"PURAPLY AM, PER SQUARE CENTIMETER",529.2,343.98,132.3,1366.66,17
CDM,57199033_1,"PURAPLY AM, PER SQUARE CENTIMETER",498.0,323.7,124.5,1286.09,17
CDM,57199034_1,"PURAPLY AM, PER SQUARE CENTIMETER",1105.2,718.38,134.77,2854.18,17
CDM,57199035_1,"EPIFIX, PER SQUARE CENTIMETER",840.0,546.0,134.77,2169.3,17
CDM,57200_1,Suture of nonobstetrical injury of vagina,790.0,513.5,78.57,926.28,19
CDM,57210_1,Suture of injury of vagina and/or skin,1030.1,669.57,78.57,1118.35,19
CDM,57220001_1,HC ISLET CELL PROCESSING,64330.0,41814.5,28948.5,45031.0,10
CDM,57220_1,Plastic repair of muscles at urinary opening through vagina,750.83,488.04,78.57,975.39,19
CDM,57221001_1,Preparation of stem cells for transplantation with removal of T cells,2842.0,1847.3,710.5,7339.47,18
CDM,57221002_1,Preparation of stem cells for transplantation with removal of T cells,25578.0,16625.7,2379.25,66055.19,18
CDM,57221005_1,Preparation of stem cells for transplantation with removal of growth cells,71896.5,46732.73,2379.25,185672.71,16
CDM,57221010_1,Preparation of stem cells for transplantation with removal of growth cells,74763.0,48595.95,2379.25,193075.45,16
CDM,57230_1,Plastic repair of urethra prolapse,928.23,603.35,78.57,1197.75,19
CDM,57238207_1,Preservation and storage of stem cells for transplantation,2910.0,1891.5,727.5,7515.08,18
CDM,57238208_1,Thawing of frozen stem cells for transplantation,2100.0,1365.0,525.0,5423.25,18
CDM,57238227_1,Receipt and preparation of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy,225.0,146.25,56.25,581.06,16
CDM,57240_1,Repair of bladder hernia into vaginal wall,1897.4,1233.31,78.57,1796.32,19
CDM,57250_1,Repair of herniated rectum into vaginal wall,1856.4,1206.66,78.57,1799.81,19
CDM,57260_1,"Plastic repair of vagina and tissue separating vagina, rectum, and bladder",2309.0,1500.85,78.57,2300.19,19
CDM,57265_1,Repair of bulging of rectum and bladder into vaginal wall,2568.3,1669.4,78.57,2581.02,19
CDM,57267_1,Insertion of artificial material for pelvic floor defect,750.8,488.02,78.57,763.74,19
CDM,57268_1,Repair of protrusion of intestine into rectum or vagina through vagina,1351.4,878.41,78.57,1466.33,19
CDM,57270_1,Repair of protrusion of intestine into rectum or vagina through abdomen,2254.4,1465.36,78.57,2414.56,19
CDM,57280_1,Attachment of vagina to rear pelvic bone,2744.7,1784.06,78.57,2877.21,19
CDM,57282_1,Repair of pelvic ligaments through vagina,1423.8,925.47,78.57,1808.6,19
CDM,57283_1,Repair of prolapsing vaginal vault through vagina,1950.9,1268.09,78.57,2072.89,19
CDM,57284_1,Repair of vaginal wall defect through abdomen,2348.9,1526.79,78.57,2467.27,19
CDM,57285129_1,Assessment of blood clotting function,2819.0,1832.35,6.99,7280.07,19
CDM,57285130_1,Tissue culture for tumor disorders of bone marrow and blood cells,1610.0,1046.5,143.75,4157.83,19
CDM,57285131_1,Tissue culture for tumor disorders of bone marrow and blood cells,1677.0,1090.05,143.75,4330.85,19
CDM,57285132_1,Tissue culture for tumor disorders of bone marrow and blood cells,1271.0,826.15,143.75,3282.36,19
CDM,57285133_1,Tissue culture for tumor disorders of bone marrow and blood cells,1610.0,1046.5,143.75,4157.83,19
CDM,57285391_1,HC TNMC FEE-PBSC PROC  CRYOPRESS STOR,4350.0,2827.5,1957.5,3045.0,10
CDM,57285394_1,HC TNMC FEE-CFU-GM FRESH,1473.0,957.45,368.25,1031.1,12
CDM,57285395_1,HC TNMC FEE-CFU-GM/BFU-E FROZEN,1455.0,945.75,363.75,1018.5,12
CDM,57285396_1,HC TNMC FEE-CD34 ENUMERATION,5450.0,3542.5,653.0,3815.0,12
CDM,57285397_1,HC TNMC FEE-PRODUCT INFUSION,2900.0,1885.0,653.0,2030.0,12
CDM,57285399_1,HC TNMC FEE-STORAGE FEE  ANNUAL,733.0,476.45,183.25,653.0,12
CDM,57285401_1,HC LIFETIME STORAGE FEE-STEM 017/CANISTER,525.0,341.25,131.25,653.0,12
CDM,57285406_1,Automated white blood cell count,361.0,234.65,2.54,932.28,19
CDM,57285_1,Repair of vaginal wall defect through vagina,1935.2,1257.88,78.57,2038.84,19
CDM,57287_1,Removal or revision of incontinence sling,1942.5,1262.63,78.57,2108.82,19
CDM,57288240_1,"Cryopreservation, freezing and storage of cells",4200.0,2730.0,5.88,10846.5,19
CDM,57288_1,Creation of sling around urethra in female to control leakage,2267.0,1473.55,78.57,2182.35,19
CDM,57289_1,Repair of prolapsed urinary canal and bladder into vaginal wall,2133.6,1386.84,78.57,2301.74,19
CDM,57291_1,Construction of artificial vagina,2835.0,1842.75,78.57,1749.06,19
CDM,57292_1,Construction of artificial vagina using tissue graft,4462.5,2900.63,78.57,2446.06,19
CDM,57295_1,Revision of prosthetic vaginal graft,1210.7,786.96,78.57,1454.56,19
CDM,57296_1,Revision or removal of prosthetic vaginal graft,2685.9,1745.84,78.57,2841.05,19
CDM,57299006_1,HC CORD BLOOD COLLECTION KIT,728.0,473.2,182.0,509.6,11
CDM,57299022_1,HC AUTOLOGOUS BONE COLLECTION KIT,504.0,327.6,126.0,352.8,11
CDM,57299026_1,"Cryopreservation, freezing and storage of cells",1500.0,975.0,5.88,3873.75,19
CDM,57299028_1,HC AUTOLOGOUS BONE RECEIPT/STORAGE,850.0,552.5,212.5,653.0,12
CDM,57299029_1,HC TNMC FEE- FREEZING ADDL STEM CELL/BM,1850.0,1202.5,832.5,1295.0,10
CDM,57299030_1,Preservation and storage of stem cells for transplantation,3725.0,2421.25,931.25,9619.81,18
CDM,57299033_1,Preservation and storage of stem cells for transplantation,5645.0,3669.25,1411.25,14578.21,18
CDM,57299039_1,Preparation of stem cells for transplantation with cell concentration in blood fluid (plasma),960.0,624.0,240.0,2479.2,18
CDM,57299046_1,Preparation of stem cells for transplantation with red blood cell removal,1050.0,682.5,262.5,2711.63,18
CDM,57299047_1,Preservation and storage of stem cells for transplantation,5890.0,3828.5,1472.5,15210.93,18
CDM,57299048_1,Preservation and storage of stem cells for transplantation,7250.0,4712.5,1812.5,18723.13,18
CDM,57299052_1,Preparation of stem cells for transplantation with cell concentration in blood fluid (plasma),8840.0,5746.0,2379.25,22829.3,16
CDM,57299053_1,Preparation of stem cells for transplantation with reduction of blood fluid (plasma) volume,3645.0,2369.25,1858.95,9413.21,16
CDM,57300_1,Closure of abnormal drainage tract from rectum to vagina through vagina or anus,1785.0,1160.25,78.57,1713.05,19
CDM,57305_1,Closure of abnormal drainage tract from rectum to vagina through abdomen,2606.1,1693.97,78.57,2811.38,19
CDM,57307_1,Closure of abnormal drainage tract from rectum to vagina with creation of large bowel opening through abdomen,2790.9,1814.09,78.57,3127.33,19
CDM,57308_1,Closure of abnormal drainage tract from rectum to vagina with perineal reconstruction,2231.3,1450.35,78.57,1988.38,19
CDM,57310_1,Closure of abnormal drainage tract from urethra to vagina,1356.6,881.79,78.57,1438.77,19
CDM,57311_1,Closure of abnormal drainage tract from urethra to vagina with transplant,2953.7,1919.91,78.57,1634.82,19
CDM,57320_1,Closure of abnormal drainage tract from bladder to vagina through vagina,1542.5,1002.63,78.57,1639.51,19
CDM,57330_1,Closure of abnormal drainage tract from bladder to vagina through bladder and vagina,2193.5,1425.78,78.57,2294.01,19
CDM,57335_1,Plastic repair of vagina for intersex state,3299.1,2144.42,78.57,3468.47,19
CDM,57400_1,Dilation of vagina under anesthesia,381.2,247.78,78.57,398.4,19
CDM,57410_1,Pelvic exam under anesthesia,392.7,255.26,78.57,319.09,19
CDM,57415_1,Removal of impacted foreign body in vagina under anesthesia,449.4,292.11,78.57,494.67,19
CDM,57420_1,Exam of vagina and cervix using an endoscope,330.8,215.02,73.47,316.16,19
CDM,57421_1,Biopsy of vagina and cervix using an endoscope,432.6,281.19,78.57,423.2,19
CDM,57423_1,Repair of vaginal defect using an endoscope,2149.38,1397.1,78.57,2756.83,19
CDM,57425_1,Surgical repair of vaginal defect using an endoscope,1991.9,1294.74,78.57,2923.18,19
CDM,57426_1,Revision or removal of prosthetic vaginal graft using an endoscope,2036.0,1323.4,78.57,2553.93,19
CDM,57452_1,Exam of cervix and upper part of vagina using an endoscope,300.0,195.0,75.17,302.6,19
CDM,57454_1,Biopsy and scraping of cervix using an endoscope,430.0,279.5,78.57,405.28,19
CDM,57455_1,Biopsy of cervix using an endoscope,400.0,260.0,78.57,385.28,19
CDM,57456_1,Scraping of cervix using an endoscope,370.0,240.5,78.57,363.2,19
CDM,57460_1,Biopsy of cervix using an endoscope with loop electrode,810.0,526.5,78.57,756.41,19
CDM,57461_1,Cone biopsy of cervix and vagina using an endoscope with loop electrode,897.8,583.57,78.57,842.45,19
CDM,57465_1,Computer-aided mapping of cervix during examination of vagina and cervix using endoscope,99.5,64.68,33.4,130.13,19
CDM,5749IP _1,UNCLASSIFIED DRUGS,4.78,3.11,1.2,12.34,16
CDM,5749OP _1,UNCLASSIFIED DRUGS,10.63,6.91,2.66,27.45,16
CDM,57500_1,Biopsy of cervix or removal of growth,340.0,221.0,28.6,370.04,19
CDM,57505_1,Scraping of tissue of cervix,280.0,182.0,78.57,373.17,19
CDM,5750IP _1,UNCLASSIFIED DRUGS,4.69,3.05,1.17,12.11,16
CDM,5750OP _1,UNCLASSIFIED DRUGS,1.36,0.88,0.34,3.51,16
CDM,57510_1,Electro or thermal destruction of cervix,366.5,238.23,43.42,401.14,19
CDM,57511_1,Destruction of cervix using freezing,380.0,247.0,78.57,479.28,19
CDM,57513_1,Laser destruction of cervix,398.0,258.7,78.57,495.24,19
CDM,5751IP _1,UNCLASSIFIED DRUGS,4.24,2.76,1.06,10.95,16
CDM,5751OP _1,UNCLASSIFIED DRUGS,5.13,3.33,1.28,13.25,16
CDM,57520_1,Removal or destruction of cervix with cold knife or laser,877.8,570.57,78.57,888.97,19
CDM,57522_1,Removal or destruction of cervix using loop electrode,730.0,474.5,78.57,779.18,19
CDM,57530_1,Amputation of cervix,961.8,625.17,78.57,1054.66,19
CDM,57531_1,Removal of cervix with removal of lymph nodes on both sides of pelvis and aortic lymph node biopsy,4205.63,2733.66,78.57,5061.7,19
CDM,57540_1,Removal of remaining cervix through abdomen,2193.5,1425.78,78.57,2330.99,19
CDM,57545_1,Removal of remaining cervix with repair of pelvic floor through abdomen,1945.8,1264.77,78.57,2463.42,19
CDM,5754IP _1,UNCLASSIFIED DRUGS,2.41,1.57,0.6,6.22,16
CDM,5754OP _1,UNCLASSIFIED DRUGS,1.32,0.86,0.33,3.41,16
CDM,57550_1,Removal of remaining cervix through vagina,1139.3,740.55,78.57,1233.28,19
CDM,57555_1,Removal of remaining cervix with repair of supporting vaginal tissue,1412.08,917.85,78.57,1807.7,19
CDM,57556_1,Removal of remaining cervix with repair of herniated bowel into vaginal wall,1332.13,865.88,78.57,1711.92,19
CDM,57558_1,Dilation and scraping of cervix,346.5,225.23,78.57,379.88,19
CDM,5755IP _1,UNCLASSIFIED DRUGS,8.14,5.29,2.04,21.02,16
CDM,5755OP _1,UNCLASSIFIED DRUGS,1.54,1.0,0.39,3.98,16
CDM,57600002_1,Ultrasound of heart,1428.0,928.2,357.0,3687.81,19
CDM,57600003_1,"Ultrasound of heart blood flow, valves and chambers",880.0,572.0,220.0,2272.6,19
CDM,57600005_1,"Ultrasound of heart with color-depicted blood flow, rate and valve function",657.0,427.05,158.99,1696.7,19
CDM,57600006_1,"Ultrasound of heart during rest, exercise and/or drug-induced stress with report",1708.0,1110.2,427.0,4410.91,19
CDM,57600011_1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",5.0,3.25,1.25,12.91,16
CDM,57600012_1,HC SALINE FLUSH SYRINGES 10ML,6.0,3.9,1.5,4.2,11
CDM,57600021_1,RECOVERY ROOM - GENERAL CLASSIFICATION,282.0,183.3,70.5,197.4,11
CDM,5760439T_1,Ultrasound of heart with injection of X-ray contrast material performed during rest or stress for assessment of heart muscle,25.0,16.25,6.25,642.62,19
CDM,57608921_1,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; COMPLETE",1905.0,1238.25,476.25,4919.66,19
CDM,57608922_1,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; FOLLOW-UP OR LIMITED STUDY",1905.0,1238.25,476.25,4919.66,19
CDM,57608925_1,"TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL TIME WITH IMAGE DOCUMENTATION (2D) (WITH OR WITHOUT M-MODE RECORDING); INCLUDING PROBE PLACEME",1905.0,1238.25,476.25,4919.66,19
CDM,57608926_1,"TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; INCLUDING PROBE PLACEMENT, IMAGE ACQUISITION, INTERPRETATION AND ",1905.0,1238.25,476.25,4919.66,19
CDM,57608927_1,"TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR MONITORING PURPOSES, INCLUDING PROBE PLACEMENT, REAL TIME 2-DIMENSIONAL IMAGE ACQUISITION AND I",1905.0,1238.25,476.25,4919.66,19
CDM,57608928_1,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIOV",1905.0,1238.25,476.25,4919.66,19
CDM,57620000_1,"INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML",405.0,263.25,101.25,1045.91,16
CDM,57620005_1,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",91.0,59.15,22.75,235.01,16
CDM,57620010_1,HC ATROPINE 1MG/ML,29.0,18.85,7.25,20.3,11
CDM,57620015_1,HC METROPOLOL 5MG,44.0,28.6,11.0,30.8,11
CDM,57620020_1,HC TEE PROBE COVER,56.0,36.4,14.0,39.2,11
CDM,57620025_1,HC CARDIOVERSION ELECTRODE,190.25,123.66,47.56,133.18,11
CDM,57620030_1,"SUPPLY OF INJECTABLE CONTRAST MATERIAL FOR USE IN ECHOCARDIOGRAPHY, PER STUDY",258.0,167.7,64.5,666.29,16
CDM,57620031_1,"INJECTION, SULFUR HEXAFLUORIDE LIPID MICROSPHERES, PER ML",55.0,35.75,13.75,142.04,16
CDM,57620050_1,HC NORMAL SALINE 500ML,92.0,59.8,23.0,64.4,11
CDM,57620055_1,HC ADENOSINE 90MG/30ML,1570.3,1020.7,392.58,1099.21,11
CDM,57620060_1,HC ALBUTEROL INHALER,118.59,77.08,29.65,83.01,11
CDM,57620065_1,HC BENADRYL 50 MG IV,1.85,1.2,0.46,1.3,11
CDM,57620070_1,"INJECTION, DIAZEPAM, UP TO 5 MG",44.0,28.6,11.0,113.63,16
CDM,57620075_1,"INJECTION, FENTANYL CITRATE, 0.1 MG",71.0,46.15,17.75,183.36,16
CDM,57620080_1,"INJECTION, MEPERIDINE AND PROMETHAZINE HCL, UP TO 50 MG",44.0,28.6,11.0,113.63,16
CDM,57620085_1,HC MEPERIDINE 50MG INJ,46.0,29.9,11.5,32.2,11
CDM,57620090_1,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",91.0,59.15,22.75,235.01,16
CDM,57620095_1,HC MIDAZOLAM 5MG/ML - (2ML),108.0,70.2,27.0,75.6,11
CDM,57620100_1,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",81.0,52.65,20.25,209.18,16
CDM,57620105_1,HC PERICARDIOCENTESIS TRAY ECH,932.0,605.8,233.0,652.4,11
CDM,57620110_1,HC ROMAZICON .5MG/5ML VIAL,313.0,203.45,78.25,219.1,11
CDM,57620115_1,HC RUBINOL 0.2 MG/ML,1.84,1.2,0.46,1.29,11
CDM,57625015_1,RECOVERY ROOM - GENERAL CLASSIFICATION,34.0,22.1,8.5,23.8,11
CDM,57625016_1,"Ultrasound of heart with continuous electrocardiogram (ECG) during rest, exercise and/or drug induced stress with review and report",1708.0,1110.2,427.0,4410.91,19
CDM,57625017_1,"TRANSTHORACIC ECHOCARDIOGRAPHY, WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIO",990.0,643.5,247.5,2556.68,19
CDM,57625018_1,"Ultrasound of heart with continuous electrocardiogram (ECG) during rest, exercise and/or drug induced stress with review and report",1708.0,1110.2,427.0,4410.91,19
CDM,57625019_1,"TRANSTHORACIC ECHOCARDIOGRAPHY, WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIO",1235.0,802.75,308.75,3189.39,19
CDM,57625020_1,RECOVERY ROOM - GENERAL CLASSIFICATION,319.0,207.35,79.75,223.3,11
CDM,57625021_1,"TRANSTHORACIC ECHOCARDIOGRAPHY, WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIO",1905.0,1238.25,476.25,4919.66,19
CDM,57625022_1,"TRANSTHORACIC ECHOCARDIOGRAPHY, WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIO",1905.0,1238.25,476.25,4919.66,19
CDM,57625025_1,"INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML",261.3,169.85,42.62,674.81,17
CDM,57692324_1,"Ultrasound of heart during rest, exercise and/or drug-induced stress with report",1235.0,802.75,308.75,3189.39,19
CDM,57693005_1,Routine electrocardiogram (ECG) using at least 12 leads with tracing,280.0,182.0,37.41,723.1,19
CDM,57693017_1,Exercise or drug-induced heart stress test with electrocardiogram (ECG),904.65,588.02,226.16,2490.0,19
CDM,57693207_1,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COMPLETE, WITHOUT SPECT",1428.0,928.2,357.0,3687.81,19
CDM,57693212_1,"Ultrasound of heart blood flow, valves and chambers",642.0,417.3,160.5,1657.97,19
CDM,57693213_1,"Ultrasound of heart blood flow, valves and chambers, follow-up",457.0,297.05,114.25,1180.2,19
CDM,57693214_1,"Ultrasound of heart with color-depicted blood flow, rate and valve function",480.0,312.0,120.0,1239.6,19
CDM,57693244_1,"Ultrasound of heart with probe in esophagus for congenital defect, with report",1624.0,1055.6,406.0,4193.98,19
CDM,57693303_1,Ultrasound of heart for congenital defect,1066.0,692.9,266.5,2752.95,19
CDM,57693304_1,"Ultrasound of heart for congenital defect, follow-up",1460.0,949.0,365.0,3770.45,19
CDM,57693305_1,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COMPLETE, WITH SPECTRAL",1080.0,702.0,270.0,2789.1,19
CDM,57693306_1,"Ultrasound of heart with color-depicted blood flow, rate, direction and valve function",1350.0,877.5,337.5,3486.38,19
CDM,57693307_1,Ultrasound of heart,1428.0,928.2,357.0,3687.81,19
CDM,57693308_1,"Ultrasound of heart, follow-up",783.0,508.95,195.75,2022.1,19
CDM,57693311_1,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, FOLLOW-UP OR LIMITED ST",783.0,508.95,195.75,2022.1,19
CDM,57693318_1,"Ultrasound of heart with probe in esophagus, with report",2895.0,1881.75,630.02,7476.34,19
CDM,57693319_1,3D ultrasound imaging of heart for evaluation of heart structure performed during ultrasound imaging of congenital heart defects,725.0,471.25,181.25,1872.31,19
CDM,57693350_1,"Ultrasound of heart during rest, exercise and/or drug-induced stress with report",1235.0,802.75,308.75,3189.39,19
CDM,57693351_1,"Ultrasound of heart during rest, exercise and/or drug-induced stress with report",1235.0,802.75,308.75,3189.39,19
CDM,57693353_1,"Ultrasound of heart with continuous electrocardiogram (ECG) during rest, exercise and/or drug induced stress with review and report",1708.0,1110.2,427.0,4410.91,19
CDM,57693355_1,Ultrasound of heart with probe in esophagus during surgery on heart or great blood vessels with report,1791.0,1164.15,447.75,4625.26,19
CDM,57693356_1,Heart muscle strain imaging,750.0,487.5,187.5,1936.88,19
CDM,57693406_1,"Ultrasound of heart with color-depicted blood flow, rate, direction and valve function",2471.0,1606.15,617.75,6381.36,19
CDM,57693479_1,"Ultrasound of heart with probe in esophagus, with report",2113.0,1373.45,528.25,5456.82,19
CDM,57693624_1,Ultrasound of heart with probe in esophagus to assess heart pump function,1791.0,1164.15,447.75,4625.26,19
CDM,57693662_1,Ultrasound evaluation of heart blood vessel with review by radiologist,3777.0,2455.05,630.02,9754.1,19
CDM,57699958_1,"INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML",388.0,252.2,42.62,1002.01,17
CDM,57700_1,Suture of cervix,855.8,556.27,78.57,962.85,19
CDM,57720_1,Plastic repair of cervix,856.8,556.92,78.57,938.46,19
CDM,57800022_1,"HYPERBARIC OXYGEN UNDER PRESSURE, FULL BODY CHAMBER, PER 30 MINUTE INTERVAL",2355.0,1530.75,555.36,6081.79,19
CDM,57800035_1,Complete ultrasound study of arm and leg arteries,1132.0,735.8,241.11,2923.39,19
CDM,57800257_1,HC NON CONTACT CAST SYSTEM VAC<50,361.0,234.65,90.25,252.7,11
CDM,57800258_1,HC NON CONTACT CAST SYSTEM VAC>50,99.0,64.35,24.75,69.3,11
CDM,57800259_1,HC TUBIGRIP-PER FOOT,14.0,9.1,3.5,9.8,11
CDM,57800_1,Dilation of cervical canal,165.9,107.84,30.23,186.11,19
CDM,57893922_1,Ultrasound study of arm and leg arteries,450.0,292.5,112.5,4042.0,19
CDM,57893923_1,Complete ultrasound study of arm and leg arteries,1132.0,735.8,241.11,4042.0,19
CDM,58000053_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",129.0,83.85,14.14,333.14,19
CDM,58000077_1,HC SAMPLE PROCESSING W/O SUPPLIES,10.0,6.5,2.5,7.0,11
CDM,58000078_1,HC PHLEBOTOMY W/O SUPPLIES,11.0,7.15,2.75,7.7,11
CDM,58000080_1,HC SAMPLE PROCESSING W/ SUPPLIES,15.0,9.75,3.75,10.5,11
CDM,58000081_1,HC PHLEBOTOMY W/ SUPPLIES,13.0,8.45,3.25,9.1,11
CDM,58000082_1,HC TCCR PROCESSING,16.0,10.4,4.0,11.2,11
CDM,58000083_1,HC URINE PROCESSING,9.0,5.85,2.25,6.3,11
CDM,58100014_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,58100015_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,58100016_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,58100017_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,58100018_1,HC DIABETES DAY CLASS-1ST DAY(HOURLY),14.0,9.1,3.5,273.0,12
CDM,58100021_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",30.0,19.5,7.5,273.0,19
CDM,58100023_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",53.0,34.45,13.25,273.0,19
CDM,58100024_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,58100025_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,58100032_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",30.0,19.5,7.5,273.0,19
CDM,58100040_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,58100042_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,58100049_1,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin,135.0,87.75,33.75,784.0,19
CDM,58100050_1,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment,314.0,204.1,78.5,810.91,19
CDM,58100058_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,58100064_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",30.0,19.5,7.5,273.0,19
CDM,58100066_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",30.0,19.5,7.5,273.0,19
CDM,58100067_1,"HC EAT, WALK AND TALK CLASS",85.0,55.25,21.25,273.0,12
CDM,58100110_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",30.0,19.5,7.5,273.0,19
CDM,58100111_1,HC USING INSULIN,110.0,71.5,27.5,273.0,12
CDM,58100112_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",53.0,34.45,13.25,273.0,19
CDM,58100113_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,58100114_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",30.0,19.5,7.5,273.0,19
CDM,58100_1,Biopsy of lining of uterus,320.0,208.0,50.08,243.03,19
CDM,5810446T_1,"Creation of skin pocket and insertion of glucose sensor, with patient training",250.0,162.5,62.5,2318.31,19
CDM,5810447T_1,Removal of glucose sensor from skin pocket,100.0,65.0,25.0,2166.29,19
CDM,5810448T_1,Removal of glucose sensor from skin pocket with creation of new skin pocket and insertion of new glucose sensor,200.0,130.0,50.0,2318.31,19
CDM,58110_1,Exam of cervix using an endoscope with biopsy of lining of uterus,140.0,91.0,26.55,122.62,19
CDM,58120_1,Dilation and scraping of uterus,670.0,435.5,78.57,711.72,19
CDM,58140_1,"Removal of growth of uterus through abdomen, 1-4 growths",2573.6,1672.84,78.57,2748.55,19
CDM,58145_1,"Removal of growth of uterus through vagina, 1-4 growths",1890.0,1228.5,78.57,1654.37,19
CDM,58146_1,Removal of 5 or more growths of uterus through abdomen,3277.1,2130.12,78.57,3443.34,19
CDM,58150_1,Removal of uterus and cervix through abdomen,2792.0,1814.8,78.57,3025.26,19
CDM,58152_1,Removal of uterus and cervix through abdomen with repair of vagina,3518.6,2287.09,78.57,3736.61,19
CDM,58180_1,Removal of uterus through abdomen,2305.8,1498.77,78.57,2872.22,19
CDM,58190109_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",30.0,19.5,7.5,273.0,19
CDM,58200056_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,58200_1,Removal of uterus through abdomen with partial removal of vagina,3690.8,2399.02,78.57,4066.39,19
CDM,58210_1,"Removal of uterus, cervix, and lymph nodes of pelvis with biopsy of lymph nodes of aorta",4918.2,3196.83,78.57,5453.56,19
CDM,58240_1,"Removal of malignant uterus, cervix, lymph nodes, and bladder with transplant of ureters and bowel",6318.9,4107.29,78.57,8692.07,19
CDM,58260_1,"Removal of uterus through vagina, 250.0 g or less",1948.8,1266.72,78.57,2479.32,19
CDM,58262_1,"Removal of uterus, tubes, and/or ovaries through vagina, 250.0 g or less",2648.1,1721.27,78.57,2756.68,19
CDM,58263_1,"Removal of uterus, tubes, and/or ovaries with repair of herniated bowel through vagina, 250.0 g or less",2887.5,1876.88,78.57,2962.12,19
CDM,58267_1,"Removal of uterus with repair for incontinence, 250.0 g or less",2986.2,1941.03,78.57,3157.03,19
CDM,58270_1,"Removal of uterus with repair of herniated bowel through vagina, 250.0 g or less",2492.7,1620.26,78.57,2645.79,19
CDM,58275_1,Removal of uterus and vagina,2775.2,1803.88,78.57,2946.16,19
CDM,58280_1,Removal of uterus and vagina with repair of herniated bowel into rectum or vagina through vagina,2969.4,1930.11,78.57,3144.19,19
CDM,58285_1,"Removal of uterus, vagina, and pelvic lymph nodes through vagina",2682.8,1743.82,78.57,4220.86,19
CDM,58290_1,"Removal of uterus through vagina, more than 250.0 g",4593.8,2985.97,78.57,3440.31,19
CDM,58291_1,"Removal of uterus, tubes, and/or ovaries through vagina, more than 250.0 g",5051.6,3283.54,78.57,3743.81,19
CDM,58292250_1,Photography of the retina,270.0,175.5,67.5,697.28,19
CDM,58292_1,"Removal of uterus, tubes, and/or ovaries with repair of herniated bowel through vagina, more than 250.0 g",5350.8,3478.02,78.57,3917.67,19
CDM,58294_1,Removal of uterus with repair of herniated bowel through vagina. 250.0 g or more,4927.7,3203.01,78.57,3635.77,19
CDM,582G0541_1,"CAREGIVER TRAINING IN DIRECT CARE STRATEGIES AND TECHNIQUES TO SUPPORT CARE FOR PATIENTS WITH AN ONGOING CONDITION OR ILLNESS AND TO REDUCE COMPLICATIONS (INCLUDING, BUT NOT LIMITED TO, TECHNIQUES TO ",75.0,48.75,18.75,273.0,17
CDM,582G0542_1,"CAREGIVER TRAINING IN DIRECT CARE STRATEGIES AND TECHNIQUES TO SUPPORT CARE FOR PATIENTS WITH AN ONGOING CONDITION OR ILLNESS AND TO REDUCE COMPLICATIONS (INCLUDING, BUT NOT LIMITED TO, TECHNIQUES TO ",50.0,32.5,12.5,273.0,17
CDM,582G0543_1,"GROUP CAREGIVER TRAINING IN DIRECT CARE STRATEGIES AND TECHNIQUES TO SUPPORT CARE FOR PATIENTS WITH AN ONGOING CONDITION OR ILLNESS AND TO REDUCE COMPLICATIONS (INCLUDING, BUT NOT LIMITED TO, TECHNIQU",75.0,48.75,18.75,273.0,17
CDM,58300_1,Insertion of IUD for pregnancy prevention,230.0,149.5,66.69,267.37,15
CDM,58301_1,Removal of IUD,260.0,169.0,30.87,263.72,19
CDM,58321_1,Injection of semen into cervix,179.7,116.81,37.94,195.61,19
CDM,58322_1,Injection of semen into uterus,236.3,153.6,45.23,243.39,19
CDM,58323_1,Sperm washing for artificial insemination,78.8,51.22,9.39,81.16,19
CDM,58340_1,Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes,613.2,398.58,47.76,591.79,19
CDM,58345_1,Insertion of tube into fallopian tube,879.9,571.94,78.57,839.66,19
CDM,58346_1,Insertion of capsule into uterus for radiation therapy,1086.23,706.05,78.57,1423.83,19
CDM,58350_1,Injection of X-ray contrast into fallopian tube,261.5,169.98,76.75,371.13,19
CDM,58353_1,Destruction of lining of uterus,3485.0,2265.25,56.4,2262.97,19
CDM,58356_1,Destruction of lining of uterus using ultrasound guidance,5502.0,3576.3,65.66,4063.16,19
CDM,58400_1,Repositioning of uterus,1254.8,815.62,78.57,1341.42,19
CDM,58410_1,Repositioning of uterus with removal of nerve,2261.7,1470.11,78.57,2409.18,19
CDM,58520_1,Repair of ruptured uterus,2206.1,1433.97,78.57,2358.58,19
CDM,58540_1,Repair of abnormal uterus,2558.9,1663.29,78.57,2718.4,19
CDM,58541_1,"Partial removal of uterus with retention of cervix using an endoscope, 250.0 g or less",2395.1,1556.82,78.57,2154.15,19
CDM,58542_1,"Partial removal of uterus, tubes, and/or ovaries with retention of cervix using an endoscope, 250.0 g or less",2689.1,1747.92,78.57,2458.94,19
CDM,58543_1,"Partial removal of uterus with retention of cervix using an endoscope, more than 250.0 g",2734.2,1777.23,78.57,2487.93,19
CDM,58544_1,"Partial removal of uterus, tubes, and/or ovaries with retention of cervix using an endoscope, more than 250.0 g",2955.8,1921.27,78.57,2691.03,19
CDM,58545_1,"Removal of growth of uterus using an endoscope, 250.0 g or less",3204.6,2082.99,78.57,2685.0,19
CDM,58546_1,"Removal of growth of uterus using an endoscope, more than 250.0 g",4037.3,2624.25,78.57,3346.31,19
CDM,58548_1,"Removal of uterus, cervix, and lymph nodes of pelvis with biopsy of aortic lymph node using an endoscope",4990.7,3243.96,78.57,5623.16,19
CDM,58550_1,"Removal of uterus through vagina using an endoscope, 250.0 g or less",2486.4,1616.16,78.57,2631.12,19
CDM,58552_1,"Removal of uterus, tubes, and/or ovaries through vagina using an endoscope, 250.0 g or less",3120.6,2028.39,78.57,2941.51,19
CDM,58553_1,"Removal of uterus through vagina using an endoscope, more than 250.0",4011.0,2607.15,78.57,3364.99,19
CDM,58554_1,"Removal of uterus, tubes, and/or ovaries through vagina using an endoscope, more than 250.0 g",3969.0,2579.85,78.57,3940.45,19
CDM,58555_1,Diagnostic exam of uterus using an endoscope,674.1,438.17,78.57,872.05,19
CDM,58558_1,Biopsy of lining of uterus and/or removal of polyp using an endoscope,926.1,601.97,78.57,3229.45,19
CDM,58559_1,Release of scar tissue of uterus using an endoscope,981.8,638.17,78.57,862.15,19
CDM,58560_1,Release of scar tissue of uterus and release or removal and septum using an endoscope,1108.8,720.72,78.57,946.61,19
CDM,58561_1,Removal of growth of muscle of uterus using an endoscope,1569.8,1020.37,78.57,1084.19,19
CDM,58562_1,Removal of foreign body in uterus using an endoscope,971.3,631.35,78.57,1038.55,19
CDM,58563_1,Exam of uterus with destruction of lining of uterus using an endoscope,4893.0,3180.45,78.57,5142.88,19
CDM,58565_1,Placement of implants to block fallopian tubes using an endoscope,5193.3,3375.65,78.57,4043.4,19
CDM,58570_1,"Removal of uterus through abdomen using an endoscope, 250.0 g or less",2590.4,1683.76,78.57,2352.5,19
CDM,58571_1,"Removal of uterus, tubes, and/or ovaries through abdomen using an endoscope, 250.0 g or less",2856.0,1856.4,78.57,2673.41,19
CDM,58572_1,"Removal of uterus through abdomen using an endoscope, more than 250.0 g",3223.5,2095.28,78.57,3070.11,19
CDM,58573_1,"Removal of uterus, tubes, and/or ovaries through abdomen using an endoscope, more than 250.0 g",3666.6,2383.29,78.57,3622.02,19
CDM,58575_1,Removal of uterus for removal of growth using an endoscope,8205.0,5333.25,78.57,5641.41,19
CDM,58600_1,Tying or incision of fallopian tubes,1050.0,682.5,78.57,1091.16,19
CDM,58605_1,Tying or incision of fallopian tubes during same hospitalization,920.0,598.0,78.57,987.91,19
CDM,58611_1,Tying or incision of fallopian tubes during cesarean delivery or other abdominal surgery,525.0,341.25,59.37,254.41,19
CDM,58615_1,Tying of fallopian tubes by device through vagina,1312.5,853.13,78.57,734.71,19
CDM,58660_1,Removal of scar tissue of ovaries or fallopian tubes using an endoscope,1891.1,1229.22,78.57,2011.11,19
CDM,58661_1,Removal of ovaries and/or tubes using an endoscope,3268.2,2124.33,78.57,1940.52,19
CDM,58662_1,Destruction or removal of ovary or growth of pelvis using an endoscope,2178.8,1416.22,78.57,2118.81,19
CDM,58670_1,Destruction of fallopian tubes using an endoscope,1391.3,904.35,78.57,1091.83,19
CDM,58671_1,Blockage of uterine tubes by device using an endoscope,1038.5,675.03,78.57,1092.18,19
CDM,58672_1,Repair of uterine tube tissue near ovary using an endoscope,2092.7,1360.26,78.57,2189.57,19
CDM,58673_1,Repair of uterine tube using an endoscope,2276.4,1479.66,78.57,2377.9,19
CDM,58674_1,Destruction of growth of uterus using an endoscope with ultrasound guidance and monitoring,1925.8,1251.77,78.57,2433.0,19
CDM,58700_1,Removal of uterine tubes,2142.0,1392.3,78.57,2327.48,19
CDM,58720_1,Removal of uterine tubes and ovaries,2060.1,1339.07,78.57,2207.14,19
CDM,58740_1,Removal of scar tissue of ovaries or fallopian tubes,2456.0,1596.4,78.57,2652.99,19
CDM,58750_1,Release of blocked uterine tube,2555.7,1661.21,78.57,2696.48,19
CDM,58752_1,Reconnection of fallopian tubes following tubal ligation,2543.1,1653.02,78.57,2689.19,19
CDM,58760_1,Repair of blocked ovarian end of uterine tube,2305.8,1498.77,78.57,2425.52,19
CDM,58770_1,Repair of blocked uterine tube opening,2374.1,1543.17,78.57,2552.48,19
CDM,58800_1,Drainage of cysts of ovaries through vagina,890.4,578.76,78.57,902.78,19
CDM,58805_1,Drainage of cysts of ovaries through abdomen,1135.1,737.82,78.57,1225.8,19
CDM,58820_1,Drainage of abscess of ovaries through vagina,945.0,614.25,78.57,952.27,19
CDM,58822_1,Drainage of abscess of ovaries through abdomen,1987.7,1292.01,78.57,2097.64,19
CDM,58825_1,Relocation of ovaries behind uterus,1958.3,1272.9,78.57,2082.76,19
CDM,58900_1,Biopsy of ovaries,1158.2,752.83,78.57,1251.17,19
CDM,58920_1,Partial removal of ovaries,1969.8,1280.37,78.57,2100.23,19
CDM,58925_1,Removal of cysts of ovaries,2111.6,1372.54,78.57,2235.37,19
CDM,58940_1,Removal of ovaries,1680.0,1092.0,78.57,1582.65,19
CDM,58943_1,Removal of ovaries for ovarian cancer,3144.8,2044.12,78.57,3494.61,19
CDM,58950_1,"Removal of lining of abdomen, ovaries, and fallopian tubes",2999.9,1949.94,78.57,3370.51,19
CDM,58951_1,"Removal of lining of abdomen, uterus, ovaries, fallopian tubes, and lymph nodes of pelvis and aorta",3875.6,2519.14,78.57,4306.27,19
CDM,58952_1,"Removal of lining of abdomen, ovaries, and fallopian tubes with reduction of growth",4369.1,2839.92,78.57,4879.86,19
CDM,58953_1,"Removal of lining of abdomen, uterus, ovaries, and fallopian tubes with extensive reduction of growth",5420.1,3523.07,78.57,6010.66,19
CDM,58954_1,"Removal of lining of abdomen, uterus, ovaries, fallopian tubes, and lymph nodes of pelvis and aorta for reduction of growth",5883.2,3824.08,78.57,6519.67,19
CDM,58956_1,"Removal of lining of abdomen, uterus, ovaries, and fallopian tubes",3731.7,2425.61,78.57,4088.05,19
CDM,58958_1,"Removal of uterus, ovaries, fallopian tubes, and lymph nodes for reduction of growth with lymph node dissection",4635.8,3013.27,78.57,5069.6,19
CDM,58960_1,Exam of abdominal cavity with removal or biopsy of abdominal lining or lymph nodes,2590.4,1683.76,78.57,2886.08,19
CDM,58970_1,Removal of eggs from ovaries,787.5,511.88,78.57,811.13,19
CDM,58974_1,Injection of fertilized eggs into uterus,353.9,230.04,78.57,440.46,15
CDM,58976_1,Insertion of eggs with sperm into fallopian tubes,1260.0,819.0,78.57,1297.8,19
CDM,59000_1,Removal of sample of amniotic fluid surrounding fetus for diagnosis,244.7,159.06,39.02,269.79,19
CDM,59001_1,Removal of amniotic fluid to reduce amount of fluid surrounding fetus using ultrasound guidance,495.6,322.14,78.57,510.58,19
CDM,59012_1,Removal of blood from fetal umbilical cord,559.7,363.81,78.57,575.65,19
CDM,59015_1,Removal of tissue from placenta for diagnosis,421.1,273.72,78.57,375.8,19
CDM,59020_1,Fetal contraction stress test,134.4,87.36,32.28,107.15,19
CDM,59025_1,Fetal test,118.3,76.9,26.1,85.96,19
CDM,59030_1,Removal of blood from scalp of fetus,219.5,142.68,61.75,321.29,19
CDM,59050_1,Fetal monitoring during labor by consulting physician,112.98,73.44,38.33,144.05,19
CDM,59051_1,Interpretation of fetal monitoring during labor by consulting physician,96.65,62.82,31.45,119.55,19
CDM,59070_1,Infusion of normal saline into fetal amniotic sac using ultrasound guidance,1100.4,715.26,78.57,908.54,19
CDM,59072_1,Occlusion of fetal umbilical cord using ultrasound guidance,1399.7,909.81,78.57,1490.74,19
CDM,59074_1,Drainage of fetal fluid using ultrasound guidance,1062.6,690.69,78.57,883.92,19
CDM,59076_1,Placement of shunt into fetal chest using ultrasound guidance,1370.3,890.7,78.57,1490.74,19
CDM,59100_1,Incision of uterus,2244.9,1459.19,78.57,2425.9,19
CDM,59120_1,Removal of ovarian or tubal pregnancy with removal of ovaries,1545.6,1004.64,78.57,2311.01,19
CDM,59121_1,Removal of ovarian or tubal pregnancy,2154.6,1400.49,78.57,2313.49,19
CDM,59130_1,Removal of pregnancy contents in abdominal cavity,1782.9,1158.89,78.57,2695.89,19
CDM,59136_1,Removal of tubal pregnancy and repair of uterine wall,2332.1,1515.87,78.57,2553.51,19
CDM,59140_1,Removal of impregnated ovum outside uterus,1065.8,692.77,78.57,1172.8,19
CDM,59150_1,Removal of ovarian or tubal pregnancy using an endoscope,1499.4,974.61,78.57,2240.53,19
CDM,59151_1,Removal of ovarian or tubal pregnancy with removal of ovary and/or tube using an endoscope,1464.8,952.12,78.57,2180.51,19
CDM,59160_1,Scraping of lining of uterus after delivery,441.0,286.65,78.57,638.1,19
CDM,59200_1,Insertion of dilator device into cervix,220.0,143.0,51.64,248.54,19
CDM,5926IP _1,"INJECTION, OXACILLIN SODIUM, UP TO 250 MG",139.65,90.77,0.6,360.65,17
CDM,59300_1,Episiotomy or repair of vagina,499.8,324.87,78.57,534.78,19
CDM,59320_1,Suture of cervix during pregnancy through vagina,378.0,245.7,78.57,646.49,19
CDM,59325_1,Suture of cervix during pregnancy through abdomen,646.8,420.42,78.57,986.66,19
CDM,59350_1,Repair of tear of uterus,762.3,495.5,78.57,797.23,19
CDM,5938IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.14,3.99,1.54,15.86,16
CDM,5938OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.76,18.69,7.19,74.27,16
CDM,59400_1,Vaginal delivery with care before and after delivery,4220.0,2743.0,78.57,6111.83,19
CDM,59409_1,Vaginal delivery,1780.0,1157.0,78.57,2354.13,19
CDM,5940IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.62,8.2,3.16,32.59,16
CDM,5940OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.11,13.72,5.28,54.52,16
CDM,59410_1,Vaginal delivery with post delivery care,2120.0,1378.0,78.57,3017.64,19
CDM,59412_1,Turning of fetus through external manipulation,281.4,182.91,78.57,334.04,19
CDM,59414_1,Delivery of placenta,270.0,175.5,70.88,259.68,19
CDM,59425_1,"Predelivery care, 4 to 6 visits",1200.0,780.0,65.89,1288.4,19
CDM,59426_1,"Predelivery care, 7 or more visits",1850.0,1202.5,65.22,2356.94,19
CDM,59430_1,Post delivery care,350.0,227.5,75.24,612.07,19
CDM,5943IP _1,UNCLASSIFIED DRUGS,3.56,2.31,0.89,9.19,16
CDM,5943OP _1,UNCLASSIFIED DRUGS,100.5,65.33,25.13,259.54,16
CDM,5944IP _1,"INJECTION, OXYTOCIN, UP TO 10 UNITS",51.1,33.22,2.85,131.97,17
CDM,5944OP _1,"INJECTION, OXYTOCIN, UP TO 10 UNITS",12.25,7.96,2.85,31.64,17
CDM,59510_1,Cesarean delivery with care before and after delivery,4680.0,3042.0,78.57,6735.71,19
CDM,59514_1,Cesarean delivery,2100.0,1365.0,78.57,2640.88,19
CDM,59515_1,Cesarean delivery with care after delivery,2870.0,1865.5,78.57,3646.82,19
CDM,59525_1,Cesarean delivery with removal of uterus,1125.6,731.64,78.57,1379.17,19
CDM,59610_1,Vaginal delivery and care before and after delivery after previous cesarean delivery,4350.0,2827.5,78.57,6387.26,19
CDM,59612_1,Vaginal delivery after previous cesarean delivery,2000.0,1300.0,78.57,2631.33,19
CDM,59614_1,Vaginal delivery and care after delivery after prior cesarean delivery,2233.4,1451.71,78.57,3269.46,19
CDM,59618_1,Cesarean delivery and care before and after delivery following attempted vaginal delivery after previous cesarean delivery,4540.0,2951.0,78.57,6817.23,19
CDM,59620_1,Cesarean delivery following vaginal delivery attempt after previous cesarean delivery,2280.0,1482.0,78.57,2716.35,19
CDM,59622_1,Cesarean delivery with care after delivery following vaginal delivery attempt after previous cesarean delivery,2586.2,1681.03,78.57,3751.68,19
CDM,59812_1,Treatment of miscarriage,700.0,455.0,78.57,864.74,19
CDM,59820_1,Treatment of miscarriage during first trimester,730.0,474.5,78.57,1054.95,19
CDM,59821_1,Treatment of miscarriage during second trimester,750.0,487.5,78.57,1047.58,19
CDM,59830_1,Treatment of miscarriage from infection,916.7,595.86,78.57,1283.69,19
CDM,59840_1,Induced abortion by dilation and scraping of uterine,627.9,408.14,78.57,612.72,19
CDM,59841_1,Induced abortion by dilation,992.3,645.0,78.57,1050.47,19
CDM,59850_1,Induced abortion by amniotic fluid injection,805.4,523.51,78.57,1094.75,19
CDM,59851_1,Induced abortion by injection into amniotic fluid with dilation and removal of pregnancy contents,846.3,550.1,78.57,1177.34,19
CDM,59852_1,Induced abortion by injection into amniotic fluid,1184.4,769.86,78.57,1611.86,19
CDM,59855_1,Induced abortion by insertion of vaginal suppository,877.8,570.57,78.57,1205.51,19
CDM,59856_1,Induced abortion by insertion of vaginal suppository with dilation and removal of pregnancy contents,1040.6,676.39,78.57,1414.72,19
CDM,59857_1,Induced abortion by insertion of vaginal suppository with incision of uterus,1276.8,829.92,78.57,1620.94,19
CDM,59866_1,Elimination of fetuses of a multifetal pregnancy,522.9,339.89,78.57,670.67,19
CDM,59870_1,Removal of abnormal pregnancy contents with scraping of uterine wall,916.7,595.86,78.57,1418.64,19
CDM,59871_1,Removal of suture of cervix under anesthesia,389.6,253.24,78.57,381.82,19
CDM,60000_1,Incision and drainage of cyst of thyroid duct,433.7,281.91,68.85,479.26,19
CDM,60100_1,Needle biopsy of thyroid through skin,317.1,206.12,61.24,265.45,19
CDM,60200_1,Incision of cyst or growth of thyroid,1875.3,1218.95,78.57,1958.91,19
CDM,60210_1,Partial removal of thyroid lobe on side of neck,2257.5,1467.38,78.57,2089.68,19
CDM,60212_1,Partial removal of thyroid lobes on both sides of neck and connecting tissue,2757.3,1792.25,78.57,2982.53,19
CDM,60220_1,Removal of thyroid lobe on side of neck,2204.0,1432.6,78.57,2093.56,19
CDM,60225_1,Removal of thyroid lobe on side of neck and partial removal of thyroid lobe on opposite side of neck including tissue in between,2730.0,1774.5,78.57,2756.35,19
CDM,60240_1,Removal of thyroid,2776.2,1804.53,78.57,2715.47,19
CDM,60252_1,Removal of thyroid and surrounding lymph nodes with limited neck removal,3885.0,2525.25,78.57,3904.7,19
CDM,60254_1,Removal of thyroid and surrounding lymph nodes with extensive neck removal,4856.3,3156.6,78.57,4965.55,19
CDM,60260_1,Removal of remaining thyroid tissue from prior operation,3009.3,1956.05,78.57,3239.76,19
CDM,60270_1,Removal of thyroid from under breastbone,3798.9,2469.29,78.57,4042.65,19
CDM,60271_1,Removal of thyroid through chest or back,2912.7,1893.26,78.57,3133.25,19
CDM,60280_1,Removal of cyst of thyroid or drainage of thyroid gland duct,1653.8,1074.97,78.57,1324.18,19
CDM,60281_1,Removal of recurrent cyst of thyroid or drainage of thyroid gland duct,1815.5,1180.08,78.57,1759.16,19
CDM,60300_1,Aspiration and/or injection of cyst of thyroid,273.0,177.45,23.61,259.07,19
CDM,6030IP _1,"INJECTION, PAPAVERINE HCL, UP TO 60 MG",163.93,106.55,40.98,423.35,17
CDM,6030OP _1,"INJECTION, PAPAVERINE HCL, UP TO 60 MG",109.65,71.27,27.41,283.17,17
CDM,60500_1,Removal or exploration of parathyroid glands,2849.7,1852.31,78.57,2848.19,19
CDM,60502_1,Removal or re-exploration of parathyroid glands,3461.9,2250.24,78.57,3801.41,19
CDM,60505_1,Removal or exploration of parathyroid glands and breast bone tissue,3806.3,2474.1,78.57,4127.81,19
CDM,60512_1,Removal and reimplantation of parathyroid tissue,698.3,453.9,78.57,717.69,19
CDM,60520_1,Removal of thymus gland through neck,3097.5,2013.38,78.57,3057.68,19
CDM,60521_1,Removal of thymus gland through sternum or chest,3381.0,2197.65,78.57,3278.42,19
CDM,60522_1,Removal of thymus gland surrounding lymph nodes through sternum or chest,3937.5,2559.38,78.57,3997.22,19
CDM,60540_1,Removal or exploration of adrenal gland through abdomen,4479.3,2911.55,78.57,3168.66,19
CDM,60545_1,Removal or exploration of adrenal gland through abdomen with removal of growth abdomen,3753.8,2439.97,78.57,3625.37,19
CDM,60600001_1,HC ADHES SKIN DERMABOND,103.0,66.95,25.75,72.1,11
CDM,60600002_1,HC TUBE-LARYNGECTOMY,318.0,206.7,79.5,222.6,11
CDM,60600003_1,HC CAUTERY TIP VALLEY LAB,93.0,60.45,23.25,65.1,11
CDM,60600004_1,HC DRESSING MEPILEX AG,101.0,65.65,25.25,70.7,11
CDM,60600005_1,HC PLAIN GUT FAST ABSORBING,62.0,40.3,15.5,43.4,11
CDM,60600006_1,HC PROLENE 4-0 PS-2 BL MONO,40.0,26.0,10.0,28.0,11
CDM,60600007_1,HC PROLENE/SURGILENE,41.0,26.65,10.25,28.7,11
CDM,60600008_1,HC STAPLER SKIN,71.0,46.15,17.75,49.7,11
CDM,60600009_1,HC DIL TRACHEOSTOMY BLUE RHINO,833.0,541.45,208.25,583.1,11
CDM,60600010_1,HC BLN DIL ALLIANCE II SYSTEM INFLAT,118.0,76.7,29.5,82.6,11
CDM,60600011_1,GUIDE WIRE,375.0,243.75,93.75,968.44,16
CDM,60600012_1,"CATHETER, BALLOON DILATATION, NON-VASCULAR",962.0,625.3,240.5,2484.37,16
CDM,60600013_1,HC BLN DIL CRE,671.0,436.15,167.75,469.7,11
CDM,60600014_1,"MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)",1527.0,992.55,381.75,3943.48,16
CDM,60600015_1,HC NEEDLE RADIESSE,79.0,51.35,19.75,55.3,11
CDM,60600016_1,HC DRESSING AQUACEL AG HYDROFIBER,46.0,29.9,11.5,32.2,11
CDM,60600017_1,HC CORE BIOPSY NEEDLE,150.0,97.5,37.5,105.0,11
CDM,60600018_1,HC DRESSING AQUACEL AG SILVER,38.0,24.7,9.5,26.6,11
CDM,60600019_1,HC NEEDLE ORO TRACHEAL,201.0,130.65,50.25,140.7,11
CDM,60600020_1,"MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)",1588.0,1032.2,397.0,4101.01,16
CDM,60600022_1,HC OLYMPUS INJECTORFORCE NEEDLE,100.0,65.0,25.0,70.0,11
CDM,60600023_1,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",2.25,1.46,0.12,6.75,17
CDM,60600024_1,UNCLASSIFIED DRUGS,741.0,481.65,185.25,1913.63,16
CDM,60600025_1,"MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)",1512.0,982.8,378.0,3904.74,16
CDM,60600026_1,"MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)",1512.0,982.8,378.0,3904.74,16
CDM,60600027_1,HC VEGA VOICE PROVOX W PUNCTURE KIT,1068.0,694.2,267.0,747.6,11
CDM,60600029_1,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",335.0,217.75,67.66,234.5,16
CDM,60600030_1,Other procedure on voice box,10458.0,6797.7,1242.0,27007.79,19
CDM,60600031_1,Other procedure on voice box,10458.0,6797.7,1242.0,27007.79,19
CDM,60600032_1,HC ABDOMINAL BINDER,45.0,29.25,11.25,31.5,11
CDM,60600033_1,HC VAC DRESSING,172.5,112.13,43.13,120.75,11
CDM,60600034_1,HC EDEMA WEAR MEDIUM,49.5,32.18,12.38,34.65,11
CDM,60600035_1,HC EDEMA WEAR LARGE,71.5,46.48,17.88,50.05,11
CDM,60600036_1,HC FACIAL ELASTIC SUPPORT,69.0,44.85,17.25,48.3,11
CDM,60600037_1,HC SINUS RINSE KIT,49.0,31.85,12.25,34.3,11
CDM,60600038_1,HC TRACH SHILEY CUFFED,165.25,107.41,41.31,115.68,11
CDM,60600039_1,HC TRACH SHILEY CUFFLESS,147.0,95.55,36.75,102.9,11
CDM,60600040_1,HC VAGINAL DILATOR MEDIUM,45.0,29.25,11.25,31.5,11
CDM,60600041_1,HC VAGINAL DILATOR LARGE,49.5,32.18,12.38,34.65,11
CDM,60600042_1,HC INSUFFLATION TEST SET,135.0,87.75,33.75,94.5,11
CDM,60600043_1,HC TRACH SHILEY UNCUFFED,173.5,112.78,43.38,121.45,11
CDM,60600044_1,HC PORTABLE CHEST DRAIN EXPRESS MINI,282.5,183.63,70.63,197.75,11
CDM,60600045_1,HC BRA FRONT CLOSURE,134.5,87.43,33.63,94.15,11
CDM,60600046_1,HC COMPRESSION SLEEVES 3/4 LENGTH ARM,157.5,102.38,39.38,110.25,11
CDM,60600047_1,HC GIRDLE HIGH WAIST THIGH LENGTH,247.5,160.88,61.88,173.25,11
CDM,60600048_1,HC DRESSING ACTICOAT,71.0,46.15,17.75,49.7,11
CDM,60600049_1,HC FACE WRAP UNIVERSAL,67.5,43.88,16.88,47.25,11
CDM,60600050_1,HC DRAIN JP PERFORATED WOUND,61.5,39.98,15.38,43.05,11
CDM,60600051_1,HC MICRO-NEEDLE ELECTRODE STRIAGHT,100.0,65.0,25.0,70.0,11
CDM,60600052_1,HC RHINOLARYNGO SLIM ASCOPE,765.0,497.25,191.25,535.5,11
CDM,60600053_1,TRACHEOSTOMY SPEAKING VALVE,314.0,204.1,78.5,376.8,16
CDM,60600054_1,HC SCAR RECOVERY GEL,106.0,68.9,26.5,74.2,11
CDM,60600055_1,"DISPOSABLE ENDOSCOPE SHEATH, EACH",265.5,172.58,66.38,685.65,16
CDM,60600056_1,HC ASCOPE 4 CYSTO (FOR ALL PROCEDURES),787.5,511.88,196.88,551.25,11
CDM,60600057_1,HC HEMOSTASIS VALVE (STENT REMOVAL/BOTOX ONLY),56.25,36.56,14.06,39.38,11
CDM,60600059_1,"CATHETER, DRAINAGE",177.0,115.05,44.25,457.1,16
CDM,60600060_1,"CATHETER, DRAINAGE",273.0,177.45,68.25,705.02,16
CDM,60600061_1,HC HEMOSTATIC ABSORABLE SURGICEL,254.0,165.1,63.5,177.8,11
CDM,60600062_1,"CATHETER, DRAINAGE",279.0,181.35,69.75,720.52,16
CDM,60600063_1,HC NEEDLE CARR-LOCKE,171.0,111.15,42.75,119.7,11
CDM,60600064_1,HC ELECTRODE CPR-D PADZ DEFIB,555.2,360.88,138.8,388.64,11
CDM,60600065_1,HC BONE MARROW BIOPSY TRAY,738.75,480.19,184.69,517.13,11
CDM,60600066_1,HC NEEDLE HUBER SAFETY,60.0,39.0,15.0,42.0,11
CDM,60600067_1,HC DRAW BLOOD CULTURE KIT,65.0,42.25,16.25,45.5,11
CDM,60600100_1,HC NON RETURNED TOBII DYNAVOX SC TABLET WITH TD SNAP,5295.0,3441.75,1323.75,3706.5,11
CDM,60600_1,Removal of growth of carotid artery,4000.5,2600.33,78.57,4005.31,19
CDM,60605_1,Removal of carotid artery and growth,5048.4,3281.46,78.57,4764.98,19
CDM,60621040_1,Removal of growth or cyst of lower jaw bone,4042.0,2627.3,1010.5,10438.47,19
CDM,60631570_1,Injection into vocal cords using an endoscope,7850.0,5102.5,1052.0,20272.63,19
CDM,60650_1,Removal or exploration of adrenal gland through abdomen using an endoscope,5024.25,3265.76,78.57,3535.74,19
CDM,60660_1,Destruction using heat of one or more nodules on one thyroid lobe,741.0,481.65,78.57,5893.63,19
CDM,60661_1,Destruction using heat of one or more nodules on additional thyroid lobe,515.0,334.75,78.57,949.41,19
CDM,60681443_1,HC DRESSING AQUACEL AG FOAM,44.0,28.6,11.0,30.8,11
CDM,60696041_1,"Counseling for genetic testing provided by a genetic counselor, each 30 minutes of total time on the date of encounter",185.0,120.25,46.25,477.76,17
CDM,60697602_1,Removal of tissue from wound gradually,225.0,146.25,56.25,1052.0,19
CDM,606Q2026_1,"INJECTION, RADIESSE, 0.1 ML",560.0,364.0,140.0,1446.2,16
CDM,60708957_1,"INTRAVENOUS INFUSION FOR THERAPY/DIAGNOSIS; INITIATION OF PROLONGED INFUSION (MORE THAN 8 HOURS), REQUIRING USE OF PORTABLE OR IMPLANTABLE PUMP",570.0,370.5,142.5,1472.03,19
CDM,60708958_1,"INTRAVENOUS INFUSION FOR THERAPY/DIAGNOSIS; INITIATION OF PROLONGED INFUSION (MORE THAN 8 HOURS), REQUIRING USE OF PORTABLE OR IMPLANTABLE PUMP",1624.0,1055.6,406.0,4193.98,19
CDM,60731570_1,Injection into vocal cords using an endoscope,7850.0,5102.5,1052.0,20272.63,19
CDM,60738228_1,Administration of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy,10000.0,6500.0,2500.0,25825.0,16
CDM,60738240_1,Transplantation of donor stem cells per donor,83259.0,54118.35,6455.25,215016.37,19
CDM,60738241_1,Transplantation of patient-derived stem cells,10000.0,6500.0,2379.25,25825.0,18
CDM,60738242_1,Transplantation of donor white blood cells,10000.0,6500.0,2379.25,25825.0,19
CDM,60738243_1,Transplantation of donor stem cells,10000.0,6500.0,2166.29,25825.0,19
CDM,60738999_1,Other procedure on lymphatic system,1064.0,691.6,266.0,4715.89,19
CDM,60786950_1,White blood cell transfusion,1412.0,917.8,123.26,3646.49,19
CDM,60795249_1,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin,135.0,87.75,33.75,784.0,19
CDM,60795250_1,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment,314.0,204.1,78.5,810.91,19
CDM,60796446_1,Administration of chemotherapy into abdominal cavity,1581.0,1027.65,395.25,4082.93,19
CDM,60796522_1,Refilling and maintenance of implantable pump or reservoir for drug delivery,500.0,325.0,67.35,2054.0,19
CDM,60799215_1,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",310.0,201.5,77.5,800.58,17
CDM,607G0108_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",220.0,143.0,55.0,568.15,19
CDM,60821086_1,Impression and custom preparation of outer ear prosthesis,6500.0,4225.0,1625.0,16786.25,19
CDM,60821087_1,Impression and custom preparation of nasal prosthesis,6500.0,4225.0,1625.0,16786.25,19
CDM,60821248_1,Reconstruction of part of lower or upper jaw bone with implant,5400.0,3510.0,1350.0,13945.5,19
CDM,60821249_1,Complete reconstruction of lower or upper jaw bone with jaw bone implant (endosteal),6500.0,4225.0,1625.0,16786.25,19
CDM,6085IP _1,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",1404.32,912.81,0.83,3626.66,17
CDM,6085OP _1,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",7.58,4.93,0.83,19.58,17
CDM,6086IP _1,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",545.69,354.7,0.83,1409.24,17
CDM,60877334_1,Design and construction of complex radiation treatment device,1050.0,682.5,262.5,2711.63,19
CDM,60899202_1,"New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more",220.0,143.0,55.0,1052.0,17
CDM,60899203_1,"New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more",260.0,169.0,65.0,1052.0,17
CDM,60899204_1,"New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more",320.0,208.0,80.0,1052.0,17
CDM,60899211_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,1052.0,17
CDM,60899212_1,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",145.0,94.25,36.25,1052.0,17
CDM,60899213_1,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",180.0,117.0,45.0,1052.0,17
CDM,60899214_1,"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more",250.0,162.5,62.5,1052.0,17
CDM,60899215_1,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",320.0,208.0,80.0,1052.0,17
CDM,608D0120_1,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",145.0,94.25,36.25,1052.0,17
CDM,608D0140_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,100.0,65.0,25.0,1052.0,17
CDM,608D0150_1,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",180.0,117.0,45.0,1052.0,17
CDM,608D0160_1,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",180.0,117.0,45.0,1052.0,17
CDM,608D0210_1,"X-ray of teeth, full mouth",150.0,97.5,37.5,387.38,18
CDM,608D0230_1,"X-ray of teeth, 1 view",100.0,65.0,25.0,258.25,18
CDM,608D0240_1,"X-ray of teeth, full mouth",150.0,97.5,37.5,387.38,18
CDM,608D0270_1,DENTAL BITEWING SINGLE IMAGE,100.0,65.0,25.0,258.25,18
CDM,608D0272_1,"X-ray of teeth, less than full mouth",100.0,65.0,25.0,258.25,18
CDM,608D0273_1,"X-ray of teeth, less than full mouth",100.0,65.0,25.0,258.25,18
CDM,608D0274_1,"X-ray of teeth, full mouth",150.0,97.5,37.5,387.38,18
CDM,608D0330_1,"X-ray of lower jaws, upper jaws and teeth",250.0,162.5,62.5,645.63,18
CDM,608D0367_1,CT scan of face without contrast,2000.0,1300.0,155.26,5165.0,18
CDM,608D2160_1,AMALGAM THREE SURFACES PERMA,298.0,193.7,74.5,3682.58,18
CDM,608D2330_1,RESIN ONE SURFACE-ANTERIOR,424.0,275.6,106.0,2975.33,19
CDM,608D5214_1,Other prosthetic procedure for upper jaw and face,1919.0,1247.35,479.75,4955.82,19
CDM,608D5760_1,Other prosthetic procedure for upper jaw and face,533.0,346.45,133.25,2263.29,19
CDM,608D5850_1,DENTURE TISS CONDITN MAXILL,200.0,130.0,50.0,516.5,18
CDM,608D5851_1,DENTURE TISS CONDTIN MANDBL,200.0,130.0,50.0,516.5,18
CDM,608D5875_1,Other prosthetic procedure for upper jaw and face,394.0,256.1,98.5,2263.29,19
CDM,608D5913_1,Impression and custom preparation of nasal prosthesis,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5914_1,Impression and custom preparation of outer ear prosthesis,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5915_1,Impression and preparation of eye socket prosthesis,12388.0,8052.2,3097.0,31992.01,19
CDM,608D5928_1,Impression and preparation of eye socket prosthesis,5896.0,3832.4,1474.0,15226.42,19
CDM,608D5931_1,Preparation of temporary prosthesis to close an opening in mouth,3415.0,2219.75,853.75,8819.24,19
CDM,608D5932_1,Preparation of permanent prosthesis to close mouth opening,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5935_1,Impression and custom preparation of lower jaw bone prosthesis,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5936_1,Impression and custom preparation of temporary oral prosthesis,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5952_1,Impression and custom preparation of speech aid prosthesis,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5953_1,Impression and custom preparation of speech aid prosthesis,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5954_1,Impression and custom preparation of prosthesis for roof of mouth enlargement,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5955_1,Preparation of prosthesis to lift roof of mouth,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5958_1,Preparation of prosthesis to lift roof of mouth,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5959_1,Preparation of prosthesis to lift roof of mouth,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5960_1,Impression and custom preparation of speech aid prosthesis,6500.0,4225.0,1625.0,16786.25,19
CDM,608D5982_1,Impression and custom preparation of oral surgical splint,5337.0,3469.05,1242.0,13782.8,19
CDM,608D5983_1,Design and construction of simple radiation treatment device,800.0,520.0,174.8,2066.0,19
CDM,608D5984_1,Design and construction of complex radiation treatment device,1050.0,682.5,262.5,2711.63,19
CDM,608D5985_1,Design and construction of complex radiation treatment device,1050.0,682.5,262.5,2711.63,19
CDM,608D5986_1,Other prosthetic procedure for upper jaw and face,613.0,398.45,153.25,2263.29,19
CDM,608D5988_1,Impression and custom preparation of oral surgical splint,5337.0,3469.05,1242.0,13782.8,19
CDM,608D6056_1,Reconstruction of part of lower or upper jaw bone with implant,5400.0,3510.0,1350.0,13945.5,19
CDM,608D6057_1,Other prosthetic procedure for upper jaw and face,186.0,120.9,46.5,2263.29,19
CDM,608D6059_1,Other prosthetic procedure for upper jaw and face,186.0,120.9,46.5,2263.29,19
CDM,608D6060_1,Other prosthetic procedure for upper jaw and face,371.0,241.15,92.75,2263.29,19
CDM,608D6061_1,Other prosthetic procedure for upper jaw and face,186.0,120.9,46.5,2263.29,19
CDM,608D6069_1,Other prosthetic procedure for upper jaw and face,177.0,115.05,44.25,2263.29,19
CDM,608D6080_1,Other prosthetic procedure for upper jaw and face,371.0,241.15,92.75,2263.29,19
CDM,608D6240_1,BRIDGE PORCELAIN HIGH NOBLE,177.0,115.05,44.25,1052.0,19
CDM,608D6242_1,Other prosthetic procedure for upper jaw and face,1844.0,1198.6,461.0,4762.13,19
CDM,608D7140_1,Other procedure on teeth and gums,311.0,202.15,77.75,2166.29,19
CDM,608D7880_1,Other prosthetic procedure for upper jaw and face,186.0,120.9,46.5,2263.29,19
CDM,608D7999_1,Other procedure on teeth and gums,311.0,202.15,77.75,2166.29,19
CDM,608D8210_1,Other prosthetic procedure for upper jaw and face,371.0,241.15,92.75,2263.29,19
CDM,608E0486_1,"ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY, ADJUSTABLE OR NON-ADJUSTABLE, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",1788.0,1162.2,447.0,1251.6,8
CDM,6091OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.16,0.75,0.29,3.0,16
CDM,6092IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.75,2.44,0.94,9.68,16
CDM,6092OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.2,3.38,1.3,13.43,16
CDM,6093IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.1,3.32,1.28,13.17,16
CDM,6093OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.7,10.21,3.93,40.55,16
CDM,6097IP _1,"INJECTION, PENTOBARBITAL SODIUM, PER 50 MG",230.09,149.56,38.44,594.21,19
CDM,61000024_1,"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",95.0,61.75,23.75,277.0,19
CDM,61000025_1,"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes",108.0,70.2,27.0,278.91,19
CDM,61000026_1,"Training for community or work reintegration, each 15 minutes",89.0,57.85,22.25,277.0,19
CDM,61000040_1,"Evaluation with prescription of speech-generating and alternative communication device, first hour",285.0,185.25,71.25,736.01,19
CDM,61000_1,"Initial removal of cerebrospinal fluid from skull bone soft spot, infant",309.8,201.37,78.57,314.28,19
CDM,61001_1,Subsequent aspiration of cerebrospinal fluid from infant skull bone soft spot,297.2,193.18,78.57,302.48,19
CDM,61020_1,Removal of cerebrospinal fluid from brain for diagnosis,357.0,232.05,78.57,291.04,19
CDM,61026_1,Removal of cerebrospinal fluid from brain and injection of substance,357.0,232.05,78.57,313.71,19
CDM,61050_1,Removal of cerebrospinal fluid from upper spine,294.0,191.1,65.05,251.09,19
CDM,61055_1,Spinal puncture in upper spine with injection of substance,420.0,273.0,78.57,356.27,19
CDM,61070_1,Aspiration of cerebrospinal fluid and injection in shunt tubing or reservoir,640.0,416.0,46.98,169.95,19
CDM,610G0515_1,"DEVELOPMENT OF COGNITIVE SKILLS TO IMPROVE ATTENTION, MEMORY, PROBLEM SOLVING (INCLUDES COMPENSATORY TRAINING), DIRECT (ONE-ON-ONE) PATIENT CONTACT, EACH 15 MINUTES",74.0,48.1,18.5,277.0,19
CDM,61105_1,Creation of opening in skull for removal of fluid from brain,1470.0,955.5,78.57,1311.46,19
CDM,61107_1,Creation of opening in skull for insertion of brain tube or monitoring device,1233.8,801.97,78.57,868.1,19
CDM,61108_1,Creation of opening in skull for removal and/or drainage of blood accumulation outside brain,2835.0,1842.75,78.57,2541.58,19
CDM,61120_1,Burr hole for injection into ventricle of brain,1852.2,1203.93,78.57,2106.57,19
CDM,61140_1,Burr hole with drainage or biopsy of brain or growth,3412.5,2218.13,78.57,3562.4,19
CDM,61150_1,Burr hole with drainage of abscess or cyst of brain,3553.2,2309.58,78.57,3811.32,19
CDM,61151_1,Burr hole with subsequent aspiration of abscess or cyst of brain,2488.5,1617.53,78.57,2802.29,19
CDM,61154_1,Burr hole with removal and/or drainage of blood accumulation outside or below brain membrane,5827.5,3787.88,78.57,3584.31,19
CDM,61156_1,Burr hole with aspiration of blood accumulation or cyst of brain,3412.5,2218.13,78.57,3501.22,19
CDM,61210_1,Burr hole for insertion of brain tube or monitoring device,945.0,614.25,78.57,1016.12,19
CDM,61215_1,Insertion of device for continuous infusion in brain,1268.4,824.46,78.57,1446.91,19
CDM,61250_1,Burr hole for exploration of upper brain,2157.8,1402.57,78.57,2440.08,19
CDM,61253_1,Burr hole for exploration of lower brain,2940.0,1911.0,78.57,2791.34,19
CDM,61300005_1,HC TUBIGRIP PER FOOT,18.0,11.7,4.5,12.6,11
CDM,61300257_1,HC NON CONTACT CAST SYSTEM,469.0,304.85,117.25,328.3,11
CDM,61300258_1,"HC NON CONTACT CAST SYSTEM, BOOT REG",129.0,83.85,32.25,90.3,11
CDM,61300300_1,HC PROFORE LATEX BANDAGE KIT,45.0,29.25,11.25,31.5,11
CDM,61300301_1,HC EDEMA WEAR STOCKING,59.0,38.35,14.75,41.3,11
CDM,61304_1,Removal of skull bone for exploration of upper brain,4567.5,2968.88,78.57,4628.7,19
CDM,61305_1,Removal of skull bone for exploration of lower brain,5157.6,3352.44,78.57,5633.93,19
CDM,61310051_1,"WOUND CARE SET, FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, INCLUDES ALL SUPPLIES AND ACCESSORIES",136.0,88.4,31.78,95.2,16
CDM,61310052_1,"WOUND CARE SET, FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, INCLUDES ALL SUPPLIES AND ACCESSORIES",154.0,100.1,31.78,107.8,16
CDM,61310053_1,"CANISTER, DISPOSABLE, USED WITH SUCTION PUMP, EACH",124.0,80.6,10.54,86.8,16
CDM,61311692_1,HC APPLICATOR MIST SINGLE USE,42.0,27.3,10.5,29.4,11
CDM,61311720_1,"Removal of fingernails or toenails, 1-5 nails",75.0,48.75,18.75,208.0,19
CDM,61311721_1,"Removal of fingernails or toenails, 6 or more nails",65.0,42.25,16.25,208.0,19
CDM,61312_1,Removal of skull bone for aspiration of blood accumulation in upper brain outside or below brain membrane,5471.6,3556.54,78.57,5827.33,19
CDM,61313_1,Removal of skull bone for aspiration of blood accumulation in upper brain,5617.5,3651.38,78.57,5576.52,19
CDM,61314_1,Removal of skull bone for aspiration of blood accumulation in lower brain outside or below brain membrane,4805.9,3123.84,78.57,5132.6,19
CDM,61315_1,Removal of skull bone for aspiration of blood accumulation in lower brain,5435.9,3533.34,78.57,5802.45,19
CDM,61316_1,Placement of bone graft in skull,212.1,137.87,66.99,243.44,19
CDM,61320_1,Removal of skull bone for drainage of upper brain abscess,5355.0,3480.75,78.57,5339.51,19
CDM,61321_1,Removal of skull bone for drainage of lower brain abscess,5394.9,3506.69,78.57,5951.39,19
CDM,61322_1,Removal of skull bone to reduce brain pressure,6006.0,3903.9,78.57,6681.28,19
CDM,61323_1,Removal of skull bone and brain lobe to reduce brain pressure,6101.6,3966.04,78.57,6692.75,19
CDM,61330_1,Incision of eye bone to reduce pressure,4342.8,2822.82,78.57,5031.6,19
CDM,61333_1,Exploration and removal of bone growth of eye socket,5014.8,3259.62,78.57,5673.02,19
CDM,61340_1,Incision of skull to reduce brain pressure,3659.3,2378.55,78.57,4028.65,19
CDM,61342858_1,HC PHOTO ASSESSMENT,9.0,5.85,2.25,6.3,11
CDM,61343_1,Removal of skull base bone and upper spine bone to release spinal cord,7927.5,5152.88,78.57,6158.61,19
CDM,61345_1,Removal of base of skull to reduce pressure on brain,5233.2,3401.58,78.57,5725.3,19
CDM,61397610_1,Therapy procedure using ultrasound,507.0,329.55,126.75,1309.33,19
CDM,613Q4110_1,"PRIMATRIX, PER SQUARE CENTIMETER",126.0,81.9,31.5,325.4,17
CDM,61450_1,Removal of skull bone to reduce facial nerve pressure,5052.6,3284.19,78.57,5383.45,19
CDM,61458_1,Removal of skull base bone for exploration or release of cranial nerves,6195.0,4026.75,78.57,5650.1,19
CDM,61460_1,Removal of skull base bone to sever cranial nerve,6011.3,3907.35,78.57,5910.09,19
CDM,61500T_1,Removal of growth of brain or other growth of skull bone,3128.0,2033.2,78.57,3779.34,19
CDM,61500_1,Removal of growth of brain or other growth of skull bone,4830.0,3139.5,78.57,3779.34,19
CDM,61501_1,Removal of infected skull bone,3990.0,2593.5,78.57,3299.98,19
CDM,61510_1,Removal of skull bone for removal of growth of upper brain,7008.8,4555.72,78.57,6159.56,19
CDM,61512_1,Removal of skull bone for removal of growth of upper brain membrane,7350.0,4777.5,78.57,7168.01,19
CDM,61514_1,Removal of skull bone for removal of upper brain abscess,5906.3,3839.1,78.57,5370.45,19
CDM,61516_1,Removal of skull bone for removal or drainage of cyst of upper brain,5906.3,3839.1,78.57,5243.98,19
CDM,61517_1,Implantation of chemotherapy agent into brain,230.0,149.5,66.65,241.25,19
CDM,61518_1,Removal of skull bone for removal of growth of lower brain,7008.8,4555.72,78.57,7762.46,19
CDM,61519_1,Removal of skull bone for removal of growth of lower brain membrane,7471.8,4856.67,78.57,8261.13,19
CDM,61520_1,Removal of skull bone for removal of eighth cranial nerve brain growth,9743.0,6332.95,78.57,10617.08,19
CDM,61521_1,Removal of skull bone for removal of skull base bone growth,8092.4,5260.06,78.57,8902.94,19
CDM,61522_1,Removal of skull bone for removal of brain abscess,5880.0,3822.0,78.57,6097.54,19
CDM,61524_1,Removal of skull bone for removal or drainage of cyst of brain,5880.0,3822.0,78.57,5841.3,19
CDM,61526_1,Removal of skull bone with bone flap for removal of eighth cranial nerve brain tumor,9114.0,5924.1,78.57,9710.13,19
CDM,61530_1,Removal of skull bone with bone flap for removal of eighth cranial nerve brain tumor with middle/posterior skull bone removal,7732.2,5025.93,78.57,8610.88,19
CDM,61531_1,Implantation of brain strip electrodes for seizure monitoring,3780.0,2457.0,78.57,3425.28,19
CDM,61533_1,Removal of skull bone for insertion of brain electrode for seizure monitoring,4200.0,2730.0,78.57,4272.7,19
CDM,61534_1,Removal of skull bone for removal of brain tissue to stop seizures,4191.6,2724.54,78.57,4601.43,19
CDM,61535_1,Removal of skull bone for removal of electrode from brain,2625.0,1706.25,78.57,2817.33,19
CDM,61536_1,Removal of skull bone for removal of brain tissue to stop seizures with monitoring,6672.8,4337.32,78.57,7219.14,19
CDM,61537_1,Removal of skull bone for removal of brain lobe,6229.7,4049.31,78.57,6893.16,19
CDM,61538_1,Removal of skull bone for removal of brain lobe with monitoring,6664.4,4331.86,78.57,7458.04,19
CDM,61539_1,Removal of skull bone for removal of brain lobe (other than temporal lobe) with monitoring,6510.0,4231.5,78.57,6640.17,19
CDM,61540_1,Removal of skull bone for removal of brain lobe (other than temporal lobe),5639.6,3665.74,78.57,6091.99,19
CDM,61541_1,Removal of skull bone for incision of brain tissue,6300.0,4095.0,78.57,6022.92,19
CDM,61543_1,Removal of skull bone for partial removal of brain,5775.0,3753.75,78.57,6027.32,19
CDM,61544_1,Removal of skull bone for removal or clotting of cerebrospinal fluid site,5460.0,3549.0,78.57,5347.24,19
CDM,61545_1,Removal of skull bone with bone flap for removal of growth of pituitary gland,8086.1,5255.97,78.57,8920.88,19
CDM,61546_1,Removal of skull bone for removal of growth of pituitary gland,6667.5,4333.88,78.57,6468.28,19
CDM,61548_1,Removal of growth of pituitary gland,4088.7,2657.66,78.57,4473.27,19
CDM,61550_1,Removal of skull bone for repair of single skull suture defect present at birth,2861.3,1859.85,78.57,3253.58,19
CDM,61552_1,Removal of skull bone for repair of multiple skull suture defects present at birth,4200.0,2730.0,78.57,4172.59,19
CDM,61556_1,Removal of skull bone for incision of prematurely closed skull suture,4250.4,2762.76,78.57,4798.84,19
CDM,61557_1,Removal of frontal skull bone for incision of prematurely closed skull suture,3736.58,2428.78,78.57,4736.34,19
CDM,61558_1,Extensive removal of skull bone for multiple skull suture defects,3572.1,2321.87,78.57,5287.94,19
CDM,61559_1,Extensive removal of skull bone with bone grafts for multiple skull suture defects to restore skull shape,5969.3,3880.05,78.57,6590.29,19
CDM,61563_1,Removal of growth of skull bone,6883.8,4474.47,78.57,5542.57,19
CDM,61564_1,Removal of growth of skull bone with release of optic nerve,5174.55,3363.46,78.57,6768.62,19
CDM,61566_1,Removal of skull bone for removal of brain tissue to relieve seizure activity,5783.4,3759.21,78.57,6268.44,19
CDM,61567_1,Removal of skull bone for incision of brain tissue for seizures with monitoring,6564.6,4266.99,78.57,7107.24,19
CDM,61570_1,Removal of foreign body in brain,5250.0,3412.5,78.57,5240.32,19
CDM,61571_1,Treatment of penetrating brain wound,6300.0,4095.0,78.57,5552.01,19
CDM,61575_1,"Biopsy, release of pressure, or removal of growth of brain stem of upper spinal cord",6231.8,4050.67,78.57,7033.86,19
CDM,61576_1,Biopsy of brain stem or upper spinal cord with splitting of tongue and lower jaw bone,8489.4,5518.11,78.57,11778.46,19
CDM,6157IP _1,"PERPHENAZINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",8.85,5.75,0.71,22.86,17
CDM,6157OP _1,"PERPHENAZINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",23.25,15.11,0.71,60.04,17
CDM,61580_1,Removal of nasal sinuses to approach growth of brain,6596.1,4287.47,78.57,7215.88,19
CDM,61581_1,Removal of nasal sinuses to approach growth of brain with the removal of the maxilla or eyeball,7403.6,4812.34,78.57,7962.78,19
CDM,61582_1,Removal of facial bone to approach growth of brain outside brain membrane,7403.6,4812.34,78.57,8633.92,19
CDM,61583_1,Removal of facial bone to approach growth of brain within brain membrane,7444.5,4838.93,78.57,8184.87,19
CDM,61584_1,Removal of facial bone to approach growth of brain without orbital exenteration,7284.9,4735.19,78.57,8119.69,19
CDM,61585_1,Removal of facial bone and eyeball to approach growth of brain,7820.4,5083.26,78.57,9141.93,19
CDM,61586_1,Removal of facial bone to approach growth of brain without bone graft,5622.8,3654.82,78.57,6922.33,19
CDM,6158IP _1,"PERPHENAZINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",10.9,7.09,0.71,28.15,17
CDM,61590_1,Removal of jaw bone to approach growth of brain,8392.7,5455.26,78.57,9030.99,19
CDM,61591_1,Removal of skull bone behind ear to approach growth of brain,8433.6,5481.84,78.57,9061.7,19
CDM,61592_1,Removal of cheek bone and skull to approach growth of brain,8047.2,5230.68,78.57,8985.93,19
CDM,61595_1,Removal of skull bone behind ear to approach growth of brain through the temporal lobe,6328.4,4113.46,78.57,6901.47,19
CDM,61596_1,Removal of skull bone behind ear to approach growth of brain through the ear,7025.6,4566.64,78.57,7330.65,19
CDM,61597_1,Removal of base skull bone to approach growth of brain,7443.5,4838.28,78.57,8294.39,19
CDM,61598_1,Removal of skull bone to approach growth of brain or defect at skull base with tying of sinus,6694.8,4351.62,78.57,8022.15,19
CDM,61600_1,Removal of growth or tissue of front of skull base outside membranes covering brain,5685.8,3695.77,78.57,6277.36,19
CDM,61601_1,Removal of growth or tissue of front of skull base within membranes covering brain,6087.9,3957.14,78.57,6839.57,19
CDM,61605_1,Removal of growth or tissue of lower skull base outside brain membrane,6012.3,3908.0,78.57,6458.19,19
CDM,61606_1,Removal of growth or tissue of lower skull base within brain membrane,7815.2,5079.88,78.57,8386.58,19
CDM,61607_1,Removal of growth or tissue of middle skull base outside brain membrane,7406.7,4814.36,78.57,7818.34,19
CDM,61608_1,Removal of growth or tissue of middle skull base within brain membrane,8249.9,5362.44,78.57,9227.11,19
CDM,61611_1,Incision or tying of carotid artery at skull base,1085.7,705.71,78.57,1294.67,19
CDM,61613_1,Destruction of abnormal blood vessel at skull base,8244.6,5358.99,78.57,9278.64,19
CDM,61615_1,Removal of growth or tissue of skull base outside brain membrane,6604.5,4292.93,78.57,7920.94,19
CDM,61616_1,Removal of growth or tissue of skull base within brain membrane,8574.3,5573.3,78.57,9491.77,19
CDM,61618_1,Repair of brain covering by tissue or synthetic graft,4200.0,2730.0,78.57,3687.52,19
CDM,61619_1,Repair of brain covering by vascular or combined vascular muscle graft,3910.2,2541.63,78.57,4144.39,19
CDM,61623_1,Balloon occlusion of head or neck artery with review by radiologist,1555.1,1010.82,78.57,1649.19,19
CDM,61624_1,Occlusion of central nervous system or spinal cord artery,4200.0,2730.0,78.57,3314.04,19
CDM,61626_1,Occlusion of head or neck artery,3465.0,2252.25,78.57,2631.59,19
CDM,61630_1,Balloon dilation of blood vessel in head,3387.3,2201.75,78.57,3941.79,19
CDM,61635_1,Insertion of stent in blood vessel of head,3684.5,2394.93,78.57,4246.25,19
CDM,61640_1,Balloon dilation of blood vessel spasm in head,2100.0,1365.0,78.57,1456.62,15
CDM,61641_1,Balloon dilation of additional blood vessel spasm in head in same vessel family,1312.5,853.13,78.57,656.25,15
CDM,61642_1,Balloon dilation of additional blood vessel spasm in head in different vessel family,1312.5,853.13,78.57,1023.7,15
CDM,61645_1,Removal of blood clot and injection to dissolve blood clot from head artery using fluoroscopic guidance,2716.5,1765.73,78.57,2436.29,19
CDM,61650_1,"Infusion of chemical agent into artery of brain with insertion of tube and imaging, initial territory",1232.0,800.8,78.57,1612.81,19
CDM,61651_1,"Infusion of chemical agent into artery of brain with insertion of tube and imaging, each additional territory",525.0,341.25,78.57,696.0,19
CDM,61680_1,Simple repair of abnormal artery-vein connection in upper brain,7008.8,4555.72,78.57,6347.55,19
CDM,61682_1,Complex repair of abnormal artery-vein connection in upper brain,10726.8,6972.42,78.57,11616.79,19
CDM,61684_1,Simple repair of abnormal artery-vein connection in lower brain,8190.0,5323.5,78.57,7966.6,19
CDM,61686_1,Complex repair of abnormal artery-vein connection in lower brain,11572.1,7521.87,78.57,12541.08,19
CDM,61690_1,Simple repair of abnormal artery-vein connection in membrane covering brain,6090.0,3958.5,78.57,6119.68,19
CDM,61692_1,Complex repair of abnormal artery-vein connection in membrane covering brain,9356.6,6081.79,78.57,10199.07,19
CDM,61697_1,Repair of complex aneurysm of neck artery,10820.3,7033.2,78.57,11808.59,19
CDM,61698_1,Repair of complex aneurysm of back of brain artery,11714.9,7614.69,78.57,12913.2,19
CDM,61700_1,Repair of simple aneurysm of neck artery,8719.2,5667.48,78.57,9551.95,19
CDM,61702_1,Repair of simple aneurysm of back of brain artery,10193.4,6625.71,78.57,11239.66,19
CDM,61703_1,Repair of aneurysm of neck artery with clamp,4200.0,2730.0,78.57,3793.42,19
CDM,61705_1,Repair of abnormal blood vessel in brain by clamping neck artery,7008.8,4555.72,78.57,7201.63,19
CDM,61708_1,Repair of abnormal blood vessel in brain by creating clot using electricity,6221.3,4043.85,78.57,7151.45,19
CDM,61710_1,Repair of abnormal blood vessel in brain by creating obstruction,5142.9,3342.89,78.57,6033.55,19
CDM,61711_1,Connection of arteries of head,6786.2,4411.03,78.57,7262.31,19
CDM,61720_1,Computer-assisted creation of growth of brain of globus pallidus or thalamus,4200.0,2730.0,78.57,3577.91,19
CDM,61735_1,Computer-assisted creation of growth of brain of deep brain structure,4410.0,2866.5,78.57,4479.72,19
CDM,61736_1,"Laser interstitial thermal therapy (LITT) of single, simple growth within skull",2063.0,1340.95,78.57,2931.94,19
CDM,61737_1,Laser interstitial thermal therapy (LITT) of multiple or complex growth within skull,2450.0,1592.5,78.57,3477.02,19
CDM,61750_1,"Computer-assisted biopsy, aspiration, or excision of growth of brain",3990.0,2593.5,78.57,3967.45,19
CDM,61751_1,"Computer-assisted biopsy, aspiration, or excision of growth of brain using CT and/or MRI guidance",4305.0,2798.25,78.57,3888.55,19
CDM,61760_1,Computer-assisted implantation of brain electrodes for seizure monitoring,3956.4,2571.66,78.57,4415.51,19
CDM,61770_1,Computer-assisted insertion of tube or probe for radiation placement,4725.0,3071.25,78.57,4566.83,19
CDM,61781_1,Computer-assisted procedure inside brain,545.0,354.25,78.57,652.6,19
CDM,61782_1,Computer-assisted procedure outside membrane covering brain,456.8,296.92,78.57,524.29,19
CDM,61783_1,Computer-assisted spinal procedure,545.0,354.25,78.57,653.25,19
CDM,61790_1,Computer-assisted creation of growth of face nerve,2940.0,1911.0,78.57,2485.26,19
CDM,61791_1,Computer-assisted creation of growth of brainstem,2830.8,1840.02,78.57,3169.89,19
CDM,61796_1,"Computer-assisted radiosurgery of simple growth of brain, first growth",2048.6,1331.59,78.57,2859.1,19
CDM,61797_1,"Computer-assisted radiosurgery of simple growth of brain, each additional growth",556.5,361.73,78.57,607.06,19
CDM,61798_1,"Computer-assisted radiosurgery of complex growth of brain, first growth",3050.0,1982.5,78.57,3892.89,19
CDM,61799_1,"Computer-assisted radiosurgery of complex growth of brain, each additional growth",768.6,499.59,78.57,838.37,19
CDM,61800_1,Computer-assisted radiosurgery application of headframe,385.4,250.51,78.57,422.56,19
CDM,61850_1,Creation of opening in skull for insertion of neurostimulator electrodes in brain,2500.1,1625.07,78.57,2746.65,19
CDM,61860_1,Removal of skull bone for insertion of neurostimulator electrodes in brain,4002.6,2601.69,78.57,4392.81,19
CDM,61863_1,"Removal of skull bone with computer-assisted insertion of neurostimulator electrodes in brain, first array",3847.2,2500.68,78.57,4228.49,19
CDM,61864_1,"Removal of skull bone with computer-assisted insertion of neurostimulator electrodes in brain, each additional array",889.4,578.11,78.57,782.61,19
CDM,61867_1,"Removal of skull bone with computer-assisted insertion of neurostimulator electrodes in brain with recording, first array",5808.6,3775.59,78.57,6403.98,19
CDM,61868_1,"Removal of skull bone with computer-assisted insertion of neurostimulator electrodes in brain with recording, each additional array",1379.7,896.81,78.57,1380.43,19
CDM,61880_1,Revision or removal of brain neurostimulator electrodes,1680.0,1092.0,78.57,1622.16,19
CDM,61885_1,Insertion of brain neurostimulator pulse device with connection to single electrode array,2431.8,1580.67,78.57,1469.89,19
CDM,61886_1,Insertion of brain neurostimulator pulse device with connection to 2 or more electrode arrays,2050.7,1332.96,78.57,2419.03,19
CDM,61888_1,Removal of brain neurostimulator device,1254.8,815.62,78.57,1120.51,19
CDM,61892_1,Removal of skull-mounted cranial neurostimulator pulse generator or receiver,2006.0,1303.9,78.57,2501.53,19
CDM,6193IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.93,3.2,1.23,12.73,16
CDM,6193OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.7,14.11,5.43,56.04,16
CDM,6194IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.41,4.17,1.6,16.55,16
CDM,6194OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.04,1.98,0.76,7.85,16
CDM,62000_1,Elevation of simple depressed broken skull bone,2606.1,1693.97,78.57,2906.84,19
CDM,62005_1,Elevation of complicated depressed broken skull bone,3780.0,2457.0,78.57,3553.57,19
CDM,62010_1,Elevation of depressed broken skull bone with repair of brain,3876.6,2519.79,78.57,4303.96,19
CDM,62100_1,Removal of skull bone for repair of cerebrospinal fluid leak,5460.0,3549.0,78.57,4529.62,19
CDM,62115_1,Reduction of enlarged skull bone,3113.58,2023.83,78.57,4721.18,19
CDM,62117_1,Reduction and reshaping of enlarged skull bone,4353.88,2830.02,78.57,5521.71,19
CDM,62120_1,Repair of herniated brain and reconstruction of skull bone,4831.1,3140.22,78.57,6008.17,19
CDM,62121_1,Removal of skull bone for repair of herniated brain at skull base,4317.6,2806.44,78.57,4617.33,19
CDM,6212IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.39,9.35,3.6,37.16,16
CDM,6212OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.87,1.22,0.47,4.83,16
CDM,62140_1,"Repair of skull bone defect, 5 cm or less",3675.0,2388.75,78.57,2927.37,19
CDM,62141T_1,"Repair of skull bone defect, more than 5.0 cm",1379.7,896.81,78.57,3236.1,19
CDM,62141_1,"Repair of skull bone defect, more than 5.0 cm",3139.5,2040.68,78.57,3236.1,19
CDM,62142_1,Removal of skull bone flap or skull plate,2808.8,1825.72,78.57,2508.72,19
CDM,62143_1,Replacement of skull bone flap or skull plate,3255.0,2115.75,78.57,2938.24,19
CDM,62145_1,Repair of skull bone defect and brain,3806.3,2474.1,78.57,3968.8,19
CDM,62146T_1,"Repair of skull bone with graft, 5.0 cm or less",13409.6,8716.24,78.57,3378.8,19
CDM,62146_1,"Repair of skull bone with graft, 5.0 cm or less",4200.0,2730.0,78.57,3378.8,19
CDM,62147_1,"Repair of skull bone with graft, more than 5.0 cm",3701.3,2405.85,78.57,4075.51,19
CDM,62148_1,Incision and retrieval of skull bone for graft,329.7,214.31,78.57,349.64,19
CDM,62160_1,Insertion of tube in brain using an endoscope,503.0,326.95,78.57,523.57,19
CDM,62161_1,Removal of brain scar tissue or drainage of cyst and insertion or removal tube in brain using an endoscope,3387.3,2201.75,78.57,4250.53,19
CDM,62162_1,Drainage of cyst of brain and insertion of tube in brain using an endoscope,4259.9,2768.94,78.57,5307.86,19
CDM,62164_1,Removal of growth of brain and insertion of tube in brain using an endoscope,4424.7,2876.06,78.57,5868.27,19
CDM,62165_1,Removal of growth of pituitary using an endoscope,4097.1,2663.12,78.57,4417.83,19
CDM,6217IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.76,9.59,3.69,38.12,16
CDM,62180_1,Creation of cerebrospinal fluid drainage tract in brain,4081.4,2652.91,78.57,4503.48,19
CDM,62190_1,"Creation of brain fluid drainage shunt, sub-atrial, -jugular, -auricular",3123.8,2030.47,78.57,2611.57,19
CDM,62192_1,"Creation of brain fluid drainage shunt, sub-peritoneal, -pleural, other terminus",3465.0,2252.25,78.57,2770.53,19
CDM,62194_1,Replacement or irrigation of tube in membranes covering brain,1058.4,687.96,78.57,1380.3,19
CDM,6219IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.49,13.97,5.37,55.5,16
CDM,6219OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.25,7.96,3.06,31.64,16
CDM,62200_1,Creation of spinal fluid drainage tract in third ventricle of brain,4830.0,3139.5,78.57,3868.49,19
CDM,62201_1,Computer-assisted creation of cerebrospinal fluid drainage tract in third ventricle of brain,3648.8,2371.72,78.57,3404.82,19
CDM,6220IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.31,6.05,2.33,24.04,16
CDM,6220OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.1,5.92,2.28,23.5,16
CDM,6221IP _1,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",323.47,210.26,30.82,835.36,17
CDM,62220_1,"Creation of brain fluid drainage shunt, ventriculo-atrial, -jugular, -auricular",3675.0,2388.75,78.57,2792.16,19
CDM,62223_1,"Creation of brain fluid drainage shunt, ventriculo-peritoneal, -pleural, other terminus",3570.0,2320.5,78.57,2955.48,19
CDM,62225_1,Replacement or irrigation of tube in brain,1470.0,955.5,78.57,1495.08,19
CDM,62230_1,Insertion or revision of cerebrospinal fluid drainage shunt valve or tube,2835.0,1842.75,78.57,2379.01,19
CDM,6224IP _1,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",308.48,200.51,30.82,796.65,17
CDM,62252_1,Reprogramming of cerebrospinal fluid shunt,269.9,175.44,42.56,130.09,19
CDM,62256_1,Removal of cerebrospinal fluid shunt system,1837.5,1194.38,78.57,1704.72,19
CDM,62258_1,Removal and insertion of cerebrospinal fluid shunt system,3675.0,2388.75,78.57,3152.42,19
CDM,62263_1,"Removal of spinal canal scar tissue, multiple sessions over 2 days or more",1793.4,1165.71,78.57,1538.77,19
CDM,62264_1,"Removal of spinal canal scar tissue, multiple sessions in 1 day",987.23,641.7,78.57,1062.13,19
CDM,62267_1,Aspiration of spinal disc tissue for diagnostic purposes,627.9,408.14,78.57,646.63,19
CDM,62268_1,Aspiration of fluid from cyst of spinal cord or fluid-filled cavity,1495.2,971.88,78.57,973.11,19
CDM,62269_1,Biopsy of spinal cord with needle through skin,1795.5,1167.08,78.57,1068.52,19
CDM,62270_1,Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test,410.0,266.5,52.04,314.38,19
CDM,62272_1,Removal of cerebrospinal fluid with lower back spinal tap,493.5,320.78,55.82,415.35,19
CDM,62273T_1,Injection of blood or blood clot into spinal canal,814.8,529.62,42.48,406.75,19
CDM,62273_1,Injection of blood or blood clot into spinal canal,480.0,312.0,43.33,406.75,19
CDM,62280_1,Injection of substance into spinal canal for removal of nerve tissue in space around brain,879.9,571.94,78.57,787.17,19
CDM,62281_1,Injection of substance into spinal canal for removal of upper spine nerve tissue,806.4,524.16,78.57,581.56,19
CDM,62282_1,Injection of substance into spinal canal for removal of lower spine nerve tissue,969.2,629.98,78.57,758.47,19
CDM,62284_1,Injection of contrast for imaging of lower spinal canal,591.2,384.28,67.23,459.49,19
CDM,62287_1,Removal of lower spine disc tissue at single or multiple levels using fluoroscopic guidance,1542.5,1002.63,78.57,1757.34,19
CDM,62290_1,Injection of contrast for imaging of each level of lower spine,931.4,605.41,78.57,847.53,19
CDM,62291_1,Injection of contrast for imaging of each level of middle or upper spine,845.3,549.45,78.57,781.64,19
CDM,62292_1,Injection for removal of lower spine disc,2073.8,1347.97,78.57,1762.56,19
CDM,62294_1,Injection of substance to occlude spinal cord artery and/or vein,2139.9,1390.94,78.57,2674.83,19
CDM,622IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.65,1.07,0.41,4.26,16
CDM,62302_1,X-ray of upper spinal canal with review by radiologist,450.0,292.5,78.57,623.59,19
CDM,62303_1,X-ray of middle spinal canal with review by radiologist,315.0,204.75,78.57,634.77,19
CDM,62304_1,X-ray of lower spinal canal with review by radiologist,450.0,292.5,78.57,619.27,19
CDM,62305_1,X-ray of multiple regions of spinal canal with review by radiologist,319.2,207.48,78.57,673.59,19
CDM,62321_1,Injection of substance into middle or upper spine canal using imaging guidance,689.1,447.92,78.57,631.47,19
CDM,62322_1,Injection of substance into lower spine canal,708.8,460.72,69.59,332.51,19
CDM,62323_1,Injection of substance into lower spine canal using imaging guidance,808.8,525.72,78.57,622.12,19
CDM,62324_1,Insertion of tube and injection of substance into middle or upper spine canal,761.3,494.85,78.57,334.86,19
CDM,62325_1,Insertion of tube and injection of substance into middle or upper spine canal using imaging guidance,861.3,559.85,78.57,612.84,19
CDM,62326_1,Insertion of tube and injection of substance into lower spine canal,735.0,477.75,77.58,336.41,19
CDM,62327_1,Insertion of tube and injection of substance into lower spine canal using imaging guidance,835.0,542.75,78.57,647.07,19
CDM,62328_1,Removal of spinal fluid with lower back spinal tap for diagnostic test using imaging guidance,607.5,394.88,68.89,557.88,19
CDM,62329_1,Removal of cerebrospinal fluid with lower back spinal tap using imaging guidance,746.0,484.9,78.57,680.52,19
CDM,62330_1,"DECOMPRESSION, PERCUTANEOUS, WITH PARTIAL REMOVAL OF THE LIGAMENTUM FLAVUM, INCLUDING LAMINOTOMY FOR ACCESS, EPIDUROGRAPHY, AND IMAGING GUIDANCE (IE, CT OR FLUOROSCOPY), BILATERAL; ONE INTERSPACE, LUM",1230.0,799.5,73.6,1266.9,16
CDM,62331_1,"DECOMPRESSION, PERCUTANEOUS, WITH PARTIAL REMOVAL OF THE LIGAMENTUM FLAVUM, INCLUDING LAMINOTOMY FOR ACCESS, EPIDUROGRAPHY, AND IMAGING GUIDANCE (IE, CT OR FLUOROSCOPY), BILATERAL; ADDITIONAL INTERSPA",488.0,317.2,73.6,502.64,16
CDM,62350T_1,"Insertion, revision, or repositioning of spinal canal tube for medication administration",1814.4,1179.36,78.57,1183.39,19
CDM,62350_1,"Insertion, revision, or repositioning of spinal canal tube for medication administration",1522.5,989.63,78.57,1183.39,19
CDM,62351_1,"Insertion, revision, or repositioning of spinal canal tube for medication administration with removal of spine bone",2388.8,1552.72,78.57,2487.39,19
CDM,62355T_1,Removal of implanted tube in spinal canal,763.4,496.21,78.57,791.65,19
CDM,62355_1,Removal of implanted tube in spinal canal,1233.8,801.97,78.57,791.65,19
CDM,62360_1,Insertion of spinal canal drug infusion device beneath skin,774.9,503.69,78.57,929.41,19
CDM,62361_1,Insertion of spinal canal drug infusion pump,1151.9,748.74,78.57,1212.28,19
CDM,62362_1,Insertion of programmable spinal canal drug infusion pump,1575.0,1023.75,78.57,1128.07,19
CDM,62365_1,Removal of spinal canal drug infusion pump or device,1116.2,725.53,78.57,866.43,19
CDM,62367_1,Electronic analysis of spinal canal drug infusion pump,106.1,68.97,20.03,78.57,19
CDM,62368T_1,Electronic analysis and reprogramming of spinal canal drug infusion pump,114.5,74.43,27.53,107.24,19
CDM,62368_1,Electronic analysis and reprogramming of spinal canal drug infusion pump,173.3,112.65,27.53,107.24,19
CDM,62369_1,Electronic analysis reprogramming and refill of spinal canal drug infusion pump,216.3,140.6,27.84,220.36,19
CDM,62370T_1,Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician,430.5,279.83,37.19,477.01,19
CDM,62370_1,Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician,261.0,169.65,37.19,477.01,19
CDM,6242IP _1,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",1005.0,653.25,0.01,2595.41,17
CDM,6242OP _1,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",279.64,181.77,0.01,722.17,17
CDM,6243IP _1,UNCLASSIFIED DRUGS,3.93,2.55,0.98,10.15,16
CDM,6243OP _1,UNCLASSIFIED DRUGS,1.4,0.91,0.35,3.62,16
CDM,6244IP _1,UNCLASSIFIED DRUGS,4.09,2.66,1.02,10.56,16
CDM,6246IP _1,UNCLASSIFIED DRUGS,14.7,9.56,3.68,37.96,16
CDM,6246OP _1,UNCLASSIFIED DRUGS,27.11,17.62,6.78,70.01,16
CDM,6255IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.96,1.27,0.49,5.06,16
CDM,6256IP _1,"INJECTION, PHENYTOIN SODIUM, PER 50 MG",57.0,37.05,0.64,147.2,17
CDM,6257IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.52,5.54,2.13,22.0,16
CDM,6257OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.23,6.0,2.31,23.84,16
CDM,62705003_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",1.78,1.16,0.45,4.6,16
CDM,62705004_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",1.79,1.16,0.45,4.62,16
CDM,62705006_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",1.53,0.99,0.38,3.95,16
CDM,62705007_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",1.59,1.03,0.4,4.11,16
CDM,62705008_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",2.71,1.76,0.68,7.0,16
CDM,62705012_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",2.4,1.56,0.6,6.2,16
CDM,62705203_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, CALORICALLY DENSE (EQUAL TO OR GREATER THAN 1.5 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBE",1.47,0.96,0.37,3.8,16
CDM,62705205_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",1.47,0.96,0.37,3.8,16
CDM,62705206_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",30.0,19.5,7.5,77.48,16
CDM,62705207_1,HC ORAL REHYDRATION SALTS,4.62,3.0,1.16,3.23,11
CDM,62705210_1,"ENTERAL FORMULA, NUTRITIONALLY INCOMPLETE/MODULAR NUTRIENTS, INCLUDES SPECIFIC NUTRIENTS, CARBOHYDRATES (E.G., GLUCOSE POLYMERS), PROTEINS/AMINO ACIDS (E.G., GLUTAMINE, ARGININE), FAT (E.G., MEDIUM CH",4.87,3.17,1.22,12.58,16
CDM,62705211_1,"ENTERAL FORMULA, NUTRITIONALLY INCOMPLETE/MODULAR NUTRIENTS, INCLUDES SPECIFIC NUTRIENTS, CARBOHYDRATES (E.G., GLUCOSE POLYMERS), PROTEINS/AMINO ACIDS (E.G., GLUTAMINE, ARGININE), FAT (E.G., MEDIUM CH",2.19,1.42,0.55,5.66,16
CDM,62705212_1,"ENTERAL FORMULA, NUTRITIONALLY INCOMPLETE/MODULAR NUTRIENTS, INCLUDES SPECIFIC NUTRIENTS, CARBOHYDRATES (E.G., GLUCOSE POLYMERS), PROTEINS/AMINO ACIDS (E.G., GLUTAMINE, ARGININE), FAT (E.G., MEDIUM CH",6.0,3.9,1.5,15.5,16
CDM,62705217_1,"ENTERAL FORMULA, NUTRITIONALLY INCOMPLETE/MODULAR NUTRIENTS, INCLUDES SPECIFIC NUTRIENTS, CARBOHYDRATES (E.G., GLUCOSE POLYMERS), PROTEINS/AMINO ACIDS (E.G., GLUTAMINE, ARGININE), FAT (E.G., MEDIUM CH",11.0,7.15,2.75,28.41,16
CDM,62705303_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, HYDROLYZED PROTEINS (AMINO ACIDS AND PEPTIDE CHAIN), INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FE",7.0,4.55,1.75,18.08,16
CDM,62705305_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, HYDROLYZED PROTEINS (AMINO ACIDS AND PEPTIDE CHAIN), INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FE",13.0,8.45,3.25,33.57,16
CDM,62705401_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",13.0,8.45,3.25,33.57,16
CDM,62705402_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",15.0,9.75,3.75,38.74,16
CDM,62705404_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",2.19,1.42,0.55,5.66,16
CDM,62705405_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, HYDROLYZED PROTEINS (AMINO ACIDS AND PEPTIDE CHAIN), INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FE",10.0,6.5,2.5,25.83,16
CDM,62705407_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",1.99,1.29,0.5,5.14,16
CDM,62705411_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, HYDROLYZED PROTEINS (AMINO ACIDS AND PEPTIDE CHAIN), INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FE",13.0,8.45,3.25,33.57,16
CDM,62705416_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",8.0,5.2,2.0,20.66,16
CDM,62705420_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",10.0,6.5,2.5,25.83,16
CDM,62705423_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",4.08,2.65,1.02,10.54,16
CDM,62705424_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",7.0,4.55,1.75,18.08,16
CDM,62705426_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",4.4,2.86,1.1,11.36,16
CDM,62705428_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",4.42,2.87,1.11,11.41,16
CDM,62705429_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",2.09,1.36,0.52,5.4,16
CDM,62705507_1,"HC ENTERAL FEEDING, MISCELLANEOUS",10.0,6.5,2.5,7.0,11
CDM,62705508_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",3.32,2.16,0.83,8.57,16
CDM,62705509_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, HYDROLYZED PROTEINS (AMINO ACIDS AND PEPTIDE CHAIN), INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FE",3.03,1.97,0.76,7.83,16
CDM,62705512_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",13.0,8.45,3.25,33.57,16
CDM,62705514_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, HYDROLYZED PROTEINS (AMINO ACIDS AND PEPTIDE CHAIN), INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FE",11.0,7.15,2.75,28.41,16
CDM,62705515_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",3.46,2.25,0.87,8.94,16
CDM,62705516_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, HYDROLYZED PROTEINS (AMINO ACIDS AND PEPTIDE CHAIN), INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FE",11.0,7.15,2.75,28.41,16
CDM,62705517_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",1.53,0.99,0.38,3.95,16
CDM,62705518_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",2.25,1.46,0.56,5.81,16
CDM,62705519_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",2.38,1.55,0.6,6.15,16
CDM,62705520_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, CALORICALLY DENSE (EQUAL TO OR GREATER THAN 1.5 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBE",1.31,0.85,0.33,3.38,16
CDM,62705521_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",1.99,1.29,0.5,5.14,16
CDM,62705522_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, CALORICALLY DENSE (EQUAL TO OR GREATER THAN 1.5 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBE",1.76,1.14,0.44,4.55,16
CDM,62705523_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",2.13,1.38,0.53,5.5,16
CDM,62705524_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, CALORICALLY DENSE (EQUAL TO OR GREATER THAN 1.5 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBE",1.53,0.99,0.38,3.95,16
CDM,62705525_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",4.21,2.74,1.05,10.87,16
CDM,62705526_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",1.09,0.71,0.27,2.81,16
CDM,62705527_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, HYDROLYZED PROTEINS (AMINO ACIDS AND PEPTIDE CHAIN), INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FE",4.45,2.89,1.11,11.49,16
CDM,62705528_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",1.84,1.2,0.46,4.75,16
CDM,62705529_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, HYDROLYZED PROTEINS (AMINO ACIDS AND PEPTIDE CHAIN), INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FE",15.0,9.75,3.75,38.74,16
CDM,62705530_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, HYDROLYZED PROTEINS (AMINO ACIDS AND PEPTIDE CHAIN), INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FE",11.0,7.15,2.75,28.41,16
CDM,62705531_1,"ENTERAL FORMULA, NUTRITIONALLY INCOMPLETE/MODULAR NUTRIENTS, INCLUDES SPECIFIC NUTRIENTS, CARBOHYDRATES (E.G., GLUCOSE POLYMERS), PROTEINS/AMINO ACIDS (E.G., GLUTAMINE, ARGININE), FAT (E.G., MEDIUM CH",4.62,3.0,1.16,11.93,16
CDM,62705532_1,"ENTERAL FORMULA, FOR PEDIATRICS, HYDROLYZED/AMINO ACIDS AND PEPTIDE CHAIN PROTEINS, INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE",15.0,9.75,3.75,38.74,16
CDM,62705533_1,"ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE CALORICALLY DENSE (EQUAL TO OR GREATER THAN 0.7 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, M",1.53,0.99,0.38,3.95,16
CDM,62705534_1,"ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE CALORICALLY DENSE (EQUAL TO OR GREATER THAN 0.7 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, M",1.53,0.99,0.38,3.95,16
CDM,62705535_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",2.19,1.42,0.55,5.66,16
CDM,62705536_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, CALORICALLY DENSE (EQUAL TO OR GREATER THAN 1.5 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBE",1.53,0.99,0.38,3.95,16
CDM,62705537_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",2.19,1.42,0.55,5.66,16
CDM,62705538_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, CALORICALLY DENSE (EQUAL TO OR GREATER THAN 1.5 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBE",1.53,0.99,0.38,3.95,16
CDM,62705539_1,"ENTERAL FORMULA, FOR PEDIATRICS, HYDROLYZED/AMINO ACIDS AND PEPTIDE CHAIN PROTEINS, INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE",15.0,9.75,3.75,38.74,16
CDM,62705540_1,"ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER AND/OR IRON, ADMINISTERED THROUGH AN ENT",2.77,1.8,0.69,7.15,16
CDM,62705541_1,"ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER AND/OR IRON, ADMINISTERED THROUGH AN ENT",2.71,1.76,0.68,7.0,16
CDM,62705542_1,"ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER AND/OR IRON, ADMINISTERED THROUGH AN ENT",2.77,1.8,0.69,7.15,16
CDM,62705545_1,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",11.52,7.49,2.88,29.75,16
CDM,6271IP _1,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",391.76,254.64,2.98,1011.72,17
CDM,6271OP _1,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",2.8,1.82,0.7,7.23,17
CDM,6279IP _1,UNCLASSIFIED DRUGS,24.34,15.82,6.09,62.86,16
CDM,6280IP _1,UNCLASSIFIED DRUGS,28.92,18.8,7.23,74.69,16
CDM,6280OP _1,UNCLASSIFIED DRUGS,20.85,13.55,5.21,53.85,16
CDM,62_1,FLUZONE HIGH-DOSE 2025-26 SYR,75.0,48.75,18.75,52.5,11
CDM,63001_1,"Partial removal of spine bone with exploration and/or release of upper spinal cord or nerves, 1-2 segments",4095.0,2661.75,78.57,3518.02,19
CDM,63003_1,"Partial removal of spine bone with exploration and/or release of middle spinal cord or nerves, 1-2 segments",4515.0,2934.75,78.57,3527.37,19
CDM,63005_1,"Partial removal of spine bone with exploration and/or release of lower spinal cord or nerves, 1-2 segments",3937.5,2559.38,78.57,3383.78,19
CDM,63011_1,"Partial removal of spine bone with exploration and/or release of sacral spinal cord or nerves, 1-2 segments",2527.5,1642.88,78.57,3180.74,19
CDM,63012_1,Partial removal of spine bone with release of lower spinal cord or nerves,4305.0,2798.25,78.57,3414.36,19
CDM,63015_1,"Partial removal of spine bone with exploration and/or release of upper spinal cord or nerves, more than 2 segments",5250.0,3412.5,78.57,4202.2,19
CDM,63016_1,"Partial removal of spine bone with exploration and/or release of middle spinal cord or nerves, more than 2 segments",5250.0,3412.5,78.57,4337.76,19
CDM,63017_1,"Partial removal of spine bone with exploration and/or release of lower spinal cord or nerves, more than 2 segments",4515.0,2934.75,78.57,3579.8,19
CDM,63020_1,"Partial removal of spine bone with release of upper spinal cord or nerves and/or removal of disc, 1 interspace",4200.0,2730.0,78.57,3330.26,19
CDM,63030_1,Partial removal of spine bone with release of lower spinal cord or nerves and/or removal of disc,5197.5,3378.38,78.57,2797.94,19
CDM,63035_1,"Partial removal of spine bone with release of upper or lower spinal cord or nerves and/or removal of disc, each additional interspace",945.0,614.25,78.57,570.95,19
CDM,63040_1,"Partial removal of spine bone with re-exploration, release of upper spinal cord or nerves and/or removal of disc, 1 interspace",5040.0,3276.0,78.57,4002.58,19
CDM,63042_1,"Partial removal of spine bone with re-exploration, release of lower spinal cord or nerves and/or removal of disc, 1 interspace",4935.0,3207.75,78.57,3752.54,19
CDM,63043_1,"Partial removal of spine bone with re-exploration, release of upper spinal cord or nerves and/or removal of disc, each additional interspace",1050.0,682.5,78.57,795.34,15
CDM,63044_1,"Partial removal of spine bone with re-exploration, release of upper or lower spinal cord or nerves and/or removal of disc, each additional interspace",1769.3,1150.05,78.57,884.65,15
CDM,63045_1,"Partial removal of spine bone with release of upper spinal cord and/or nerves, 1 segment",4698.8,3054.22,78.57,3666.92,19
CDM,63046_1,"Partial removal of spine bone with release of middle spinal cord and/or nerves, 1 segment",4515.0,2934.75,78.57,3520.67,19
CDM,63047_1,"Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment",2511.25,1632.31,78.57,3174.92,19
CDM,63048_1,"Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment",892.5,580.13,78.57,602.26,19
CDM,63050_1,"Reconstruction of upper spine bone with release of upper spinal cord, 2 or more segments",3964.8,2577.12,78.57,4318.0,19
CDM,63051_1,Reconstruction of upper spine bone and posterior bony elements with release of upper spinal cord,4510.8,2932.02,78.57,4931.69,19
CDM,63052_1,Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back,541.0,351.65,78.57,735.17,19
CDM,63053_1,Partial removal of bone of additional segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back,406.0,263.9,78.57,561.01,19
CDM,63055_1,"Release of middle spinal cord and/or nerves, single segment",5985.0,3890.25,78.57,4623.75,19
CDM,63056_1,"Release of lower spinal cord and/or nerves, single segment",5486.3,3566.1,78.57,4275.57,19
CDM,63057_1,"Release of middle or lower spinal cord and/or nerves, single segment",1286.3,836.1,78.57,913.05,19
CDM,63064_1,"Release of middle spinal cord or nerves through rib and spine joint, single segment",5040.0,3276.0,78.57,5074.44,19
CDM,63066_1,"Release of middle spinal cord or nerves through rib and spine joint, each additional segment",840.0,546.0,78.57,568.26,19
CDM,63075_1,"Removal of upper spine disc and release of spinal cord and/or nerves, single interspace",4620.0,3003.0,78.57,3891.18,19
CDM,63076_1,"Removal of upper spine disc and release of spinal cord and/or nerves, each additional interspace",1102.5,716.63,78.57,699.9,19
CDM,63077_1,"Removal of middle spine disc and release of spinal cord and/or nerves, single interspace",4383.8,2849.47,78.57,4365.68,19
CDM,63078_1,"Removal of middle spine disc and release of spinal cord and/or nerves, each additional interspace",1312.5,853.13,78.57,571.84,19
CDM,63081_1,"Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach, single segment",5565.0,3617.25,78.57,5051.61,19
CDM,63082_1,"Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach, each additional segment",1365.0,887.25,78.57,756.45,19
CDM,63085_1,"Removal of middle spine bone with release of spinal cord and/or nerves, transthoracic approach, single segment",5055.8,3286.27,78.57,5535.72,19
CDM,63086_1,"Removal of middle spine bone with release of spinal cord and/or nerves, transthoracic approach, each additional segment",892.5,580.13,78.57,572.42,19
CDM,63087_1,"Removal of middle or lower spine bone with release of spinal cord or nerves, combined thoracolumbar approach, single segment",6435.5,4183.08,78.57,6944.01,19
CDM,63088_1,"Removal of middle or lower spine bone with release of spinal cord or nerves, combined thoracolumbar approach, each additional segment",1155.0,750.75,78.57,737.71,19
CDM,63090_1,"Removal of middle, lower, or sacral spine bone with release of spinal cord or nerves, transperitoneal or retroperitoneal approach, single segment",5428.5,3528.53,78.57,5729.88,19
CDM,63091_1,"Removal of middle, lower, or sacral spine bone with release of spinal cord or nerves, transperitoneal or retroperitoneal approach, each additional segment",787.5,511.88,78.57,514.98,19
CDM,63101_1,"Removal of middle spine bone with release of spinal cord and/or nerves, lateral extra cavitary approach, single segment",6023.9,3915.54,78.57,6627.63,19
CDM,63102_1,"Removal of lower spine bone with release of spinal cord and/or nerves, lateral extra cavitary approach, single segment",5998.7,3899.16,78.57,6548.28,19
CDM,63103_1,"Removal of middle or lower spine bone with release of spinal cord and/or nerves, lateral extra cavitary approach, each additional segment",801.2,520.78,78.57,835.82,19
CDM,6310IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.15,9.85,3.79,39.12,16
CDM,6310OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.87,12.27,4.72,48.73,16
CDM,63170_1,Removal of spine bone with incision of spinal cord,4436.3,2883.6,78.57,4470.23,19
CDM,63172_1,Removal of spine bone with drainage of cyst of spinal cord into spinal canal,2986.2,1941.03,78.57,3933.08,19
CDM,63173_1,Removal of spine bone with drainage of cyst of spinal cord into lung or abdomen,3799.83,2469.89,78.57,4833.54,19
CDM,63185_1,"Removal of spine bone with severing of nerve roots, 1-2 segments",4121.3,2678.85,78.57,3322.27,19
CDM,63190_1,"Removal of spine bone with severing of nerve roots, more than 2 segments",4908.8,3190.72,78.57,3691.42,19
CDM,63191_1,Removal of spine bone with severing of spinal accessory nerve,3963.8,2576.47,78.57,3885.93,19
CDM,63197_1,Partial removal of spine bone with incision of both middle spinal cord tracts,4347.0,2825.55,78.57,4664.18,19
CDM,63200_1,Removal of lower spine bone with release of frayed spinal cord,3880.8,2522.52,78.57,4323.0,19
CDM,63250_1,Removal of upper spine bone and artery-vein malformation,7526.4,4892.16,78.57,8268.39,19
CDM,63251_1,Removal of middle spine bone and artery-vein malformation,7698.6,5004.09,78.57,8502.58,19
CDM,63252_1,Removal of middle and lower spine bone and artery-vein malformation,7696.5,5002.73,78.57,8500.4,19
CDM,63265_1,Removal of upper spine bone and growth outside spine membrane,4672.5,3037.13,78.57,4720.33,19
CDM,63266_1,Removal of growth of middle spine bone outside spine membrane,4672.5,3037.13,78.57,4877.08,19
CDM,63267_1,Removal of growth of lower spine bone outside spine membrane,4200.0,2730.0,78.57,3914.44,19
CDM,63268_1,Removal of growth of sacral spine bone outside spine membrane,3691.8,2399.67,78.57,4026.49,19
CDM,63270_1,Removal of upper spine bone and growth within spine membrane,5292.0,3439.8,78.57,5814.84,19
CDM,63271_1,Removal of growth of middle spine bone within spine membrane,5322.5,3459.63,78.57,5819.45,19
CDM,63272_1,Removal of growth of lower spine bone within spine membrane,5250.0,3412.5,78.57,5359.74,19
CDM,63273_1,Removal of growth of sacral spine bone within spine membrane,4645.2,3019.38,78.57,5234.03,19
CDM,63275_1,Removal or biopsy of growth of upper spine bone outside spine membrane,5381.3,3497.85,78.57,5093.18,19
CDM,63276_1,Removal or biopsy of growth of middle spine bone outside spine membrane,5381.3,3497.85,78.57,5061.41,19
CDM,63277_1,Removal or biopsy of growth of lower spine bone outside spine membrane,4908.8,3190.72,78.57,4439.22,19
CDM,63278_1,Removal or biopsy of growth of sacral spine bone outside spine membrane,4200.0,2730.0,78.57,4461.48,19
CDM,63280_1,"Removal or biopsy of growth of upper spine bone within spine membrane, extramedullary",5853.8,3804.97,78.57,5951.9,19
CDM,63281_1,"Removal or biopsy of growth of middle spine bone within spine membrane, extramedullary",5853.8,3804.97,78.57,5891.41,19
CDM,63282_1,"Removal or biopsy of growth of lower spine bone within spine membrane, extramedullary",6431.3,4180.35,78.57,5563.39,19
CDM,63283_1,Removal or biopsy of growth of sacral spine bone within spine membrane,4987.5,3241.88,78.57,5328.43,19
CDM,63285_1,"Removal or biopsy of growth of upper spine bone within spine membrane, intramedullary",6683.3,4344.15,78.57,7344.24,19
CDM,63286_1,"Removal or biopsy of growth of middle spine bone within spine membrane, intramedullary",6653.9,4325.04,78.57,7251.39,19
CDM,63287_1,"Removal or biopsy of growth of lower spine bone within spine membrane, intramedullary",7008.8,4555.72,78.57,7686.53,19
CDM,63290_1,Removal or biopsy of growth of spine bone outside and within spine membrane,7057.1,4587.12,78.57,7810.77,19
CDM,63295_1,Reconstruction of spine bone following spinal procedure,856.8,556.92,78.57,914.84,19
CDM,63300_1,Removal of growth of upper spine bone outside spine membrane,4768.1,3099.27,78.57,5219.0,19
CDM,63301_1,"Removal of growth of middle spine bone outside spine membrane, transthoracic approach",5419.1,3522.42,78.57,6175.55,19
CDM,63302_1,"Removal of growth of middle spine bone outside spine membrane, thoracolumbar approach",5375.0,3493.75,78.57,6099.19,19
CDM,63303_1,"Removal of growth of lower or sacral spine bone outside spine membrane, transperitoneal or retroperitoneal approach",5676.3,3689.6,78.57,6210.47,19
CDM,63304_1,Removal of growth of upper spine bone within spine membrane,5946.2,3865.03,78.57,6546.98,19
CDM,63305_1,"Removal of growth of middle spine bone within spine membrane, transthoracic approach",6121.5,3978.98,78.57,7034.64,19
CDM,63306_1,"Removal of growth of middle spine bone within spine membrane, thoracolumbar approach",4763.38,3096.2,78.57,6831.49,19
CDM,63307_1,"Removal of growth of lower or sacral spine bone within spine membrane, peritoneal approach",5010.58,3256.88,78.57,6769.32,19
CDM,63308_1,Removal of growth of spine bone,869.4,565.11,78.57,904.61,19
CDM,63396413_1,"Administration of chemotherapy into vein, 1 hour or less",1100.0,715.0,275.0,2840.75,19
CDM,63396415_1,"Administration of chemotherapy into vein, each additional hour",202.0,131.3,50.5,2054.0,19
CDM,63600_1,Computer-assisted creation of growth of spinal cord,2913.8,1893.97,78.57,3074.25,19
CDM,63610_1,Computer-assisted stimulation of spinal cord,6108.9,3970.79,78.57,1614.16,19
CDM,63620_1,"Computer-assisted radiosurgery of growth of spine, first growth",2488.35,1617.43,78.57,3157.25,19
CDM,63621_1,"Computer-assisted radiosurgery of growth of spine, each additional growth",558.9,363.29,78.57,697.97,19
CDM,63650T_1,Insertion of spinal neurostimulator electrode array through skin,6754.7,4390.56,78.57,5530.49,19
CDM,63650_1,Insertion of spinal neurostimulator electrode array through skin,2731.0,1775.15,78.57,5530.49,19
CDM,63655_1,Removal of spine bone for insertion of neurostimulator electrode plate in spine,2913.8,1893.97,78.57,2377.72,19
CDM,63661_1,Insertion of spinal neurostimulator electrode array using fluoroscopic guidance,1533.0,996.45,78.57,1624.68,19
CDM,63662_1,Removal of spinal neurostimulator electrode plate using fluoroscopic guidance,1921.5,1248.98,78.57,2405.03,19
CDM,63663_1,Revision of spinal neurostimulator electrode array using fluoroscopic guidance,2215.5,1440.08,78.57,2157.92,19
CDM,63664_1,Revision of spinal neurostimulator electrode plate using fluoroscopic guidance,2000.3,1300.2,78.57,2491.0,19
CDM,63685_1,Insertion or replacement of spinal neurostimulator generator or receiver,1758.8,1143.22,78.57,1065.92,19
CDM,63688_1,Removal or revision of spinal neurostimulator generator or receiver,1470.0,955.5,78.57,1094.7,19
CDM,63700_1,"Repair of spinal cord defect, 5.0 cm or less",3517.5,2286.38,78.57,3663.1,19
CDM,63702_1,"Repair of spinal cord defect, more than 5.0 cm",3806.3,2474.1,78.57,4015.36,19
CDM,63704_1,"Repair of spina bifida, 5.0 cm or less",4234.7,2752.56,78.57,4591.35,19
CDM,63706_1,"Repair of spina bifida, more than 5.0 cm",4616.9,3000.99,78.57,5094.44,19
CDM,63707_1,Repair of cerebrospinal fluid leak,3176.3,2064.6,78.57,2667.33,19
CDM,63709_1,Repair of cerebrospinal fluid leak with partial removal of vertebra,4016.3,2610.6,78.57,3182.79,19
CDM,63710_1,Placement of spinal cord graft,2850.8,1853.02,78.57,3138.03,19
CDM,63740_1,Creation of cerebrospinal fluid shunt with partial removal of vertebra,3228.8,2098.72,78.57,2747.65,19
CDM,63741_1,Creation of cerebrospinal fluid shunt,1587.6,1031.94,78.57,1937.02,19
CDM,63744_1,"Replacement, irrigation, or revision of lower spinal canal shunt",1776.6,1154.79,78.57,1906.92,19
CDM,63746_1,Removal of lower spinal canal shunt,1457.4,947.31,78.57,1697.03,19
CDM,64101001_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,64101002_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,64101003_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,64111010_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,64120550_1,Injection into tendon or ligament,361.5,234.98,90.38,2166.29,19
CDM,64120552_1,"Injection of trigger points, 1-2 muscles",255.0,165.75,63.75,2166.29,19
CDM,64120553_1,"Injection of trigger points, 3 or more muscles",241.0,156.65,60.25,2166.29,19
CDM,64120605_1,Aspiration and/or injection of fluid from medium joint,361.5,234.98,90.38,2166.29,19
CDM,64120610_1,Aspiration and/or injection of fluid from large joint,714.0,464.1,178.5,2166.29,19
CDM,64120611_1,Aspiration and/or injection of fluid large joint using ultrasound guidance,412.5,268.13,103.13,2166.29,19
CDM,64120982_1,Destruction of growths and adjacent soft tissue,9774.0,6353.1,2166.29,25241.36,19
CDM,64127096_1,Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance,2455.5,1596.08,613.88,6341.33,19
CDM,64136416_1,Puncture of skin for collection of blood sample,23.0,14.95,3.11,59.4,19
CDM,64150001_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,64161070_1,Aspiration of cerebrospinal fluid and injection in shunt tubing or reservoir,1006.0,653.9,251.5,3227.0,19
CDM,64162273_1,Injection of blood or blood clot into spinal canal,968.0,629.2,242.0,3227.0,19
CDM,64162320_1,Injection of substance into middle or upper spine canal,1142.0,742.3,285.5,3227.0,19
CDM,64162321_1,Injection of substance into middle or upper spine canal using imaging guidance,1631.0,1060.15,407.75,4212.06,19
CDM,64162322_1,Injection of substance into lower spine canal,1142.0,742.3,285.5,3227.0,19
CDM,64162323_1,Injection of substance into lower spine canal using imaging guidance,1631.0,1060.15,407.75,4212.06,19
CDM,64162324_1,Insertion of tube and injection of substance into middle or upper spine canal,1510.0,981.5,377.5,3899.58,19
CDM,64162325_1,Insertion of tube and injection of substance into middle or upper spine canal using imaging guidance,1678.0,1090.7,419.5,4333.44,19
CDM,64162326_1,Insertion of tube and injection of substance into lower spine canal,1510.0,981.5,377.5,3899.58,19
CDM,64162327_1,Insertion of tube and injection of substance into lower spine canal using imaging guidance,1678.0,1090.7,419.5,4333.44,19
CDM,64162370_1,Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician,522.0,339.3,130.5,2318.31,19
CDM,64163650_1,Insertion of spinal neurostimulator electrode array through skin,17229.0,11198.85,2318.31,44493.89,19
CDM,64164400_1,Injection of anesthetic agent and/or steroid into face nerve,873.0,567.45,218.25,2254.52,19
CDM,64164405_1,Injection of anesthetic agent and/or steroid into upper neck and back of head nerve,654.0,425.1,163.5,2166.29,19
CDM,64164416_1,Continuous infusion of anesthetic agent and/or steroid into arm nerve bundle through catheter,1125.0,731.25,281.25,3227.0,19
CDM,64164417_1,Injection of anesthetic agent and/or steroid into upper arm and shoulder nerve (axillary nerve),273.0,177.45,68.25,3227.0,19
CDM,64164418_1,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,289.5,188.18,72.38,3227.0,19
CDM,64164420_1,Injection of anesthetic agent and/or steroid into rib nerve,525.0,341.25,131.25,3227.0,19
CDM,64164421_1,Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block,479.0,311.35,119.75,3227.0,19
CDM,64164425_1,Injection of anesthetic agent and/or steroid into lower abdomen and groin nerve,975.0,633.75,243.75,3227.0,19
CDM,64164430_1,Injection of anesthetic agent and/or steroid into external genitals and anus nerve,973.5,632.78,243.38,3227.0,19
CDM,64164445_1,Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve),2460.0,1599.0,580.38,6352.95,19
CDM,64164447_1,Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve),775.5,504.08,193.88,8477.27,19
CDM,64164450_1,Injection of anesthetic agent and/or steroid into other nerve or branch,1119.0,727.35,279.75,3227.0,19
CDM,64164451_1,Injection of anesthetic agent and/or steroid into spine and pelvis nerve using imaging guidance,1875.0,1218.75,468.75,4842.19,19
CDM,64164454_1,Injection of anesthetic agent and/or steroid into knee nerve branch using imaging guidance,1875.0,1218.75,468.75,4842.19,19
CDM,64164479_1,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level",2749.5,1787.18,687.38,7100.58,19
CDM,64164480_1,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, each additional level",805.0,523.25,201.25,2166.29,19
CDM,64164483_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level",3168.0,2059.2,792.0,8181.36,19
CDM,64164484_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level",972.0,631.8,243.0,2510.19,19
CDM,64164486_1,Injection of local anesthetic for abdominal wall pain control on side using imaging guidance,450.0,292.5,112.5,2318.31,19
CDM,64164490_1,"Injection of upper or middle spine facet joint using imaging guidance, single level",2038.5,1325.03,509.63,5264.43,19
CDM,64164491_1,"Injection of upper or middle spine facet joint using imaging guidance, second level",1495.0,971.75,373.75,3860.84,19
CDM,64164492_1,"Injection of upper or middle spine facet joint using imaging guidance, third and any additional level",1631.0,1060.15,407.75,4212.06,19
CDM,64164493_1,"Injection of lower or sacral spine facet joint using imaging guidance, single level",3168.0,2059.2,792.0,8181.36,19
CDM,64164494_1,"Injection of lower or sacral spine facet joint using imaging guidance, second level",1204.0,782.6,301.0,3109.33,19
CDM,64164495_1,"Injection of lower or sacral spine facet joint using imaging guidance, third and any additional level",1225.0,796.25,306.25,3163.56,19
CDM,64164505_1,"Injection of anesthetic agent, trigeminal nerve bundle",346.5,225.23,86.63,2166.29,19
CDM,64164510_1,Injection of anesthetic agent into sympathetic nerve bundle,3025.5,1966.58,756.38,7813.35,19
CDM,64164517_1,Injection of anesthetic agent into sacral nerve bundle,416.0,270.4,104.0,3227.0,19
CDM,64164520_1,Injection of anesthetic agent into middle or lower spine sympathetic nerve,3025.5,1966.58,756.38,7813.35,19
CDM,64164530_1,Injection of anesthetic agent into abdominal sympathetic nerve bundle,2017.0,1311.05,504.25,5208.9,19
CDM,64164555_1,Insertion of peripheral nerve neurostimulator electrode through skin,8629.5,5609.18,2157.38,22285.68,19
CDM,64164600_1,Destruction of first division of face nerve branch,2191.0,1424.15,547.75,5658.26,19
CDM,64164612_1,Injection of chemical for paralysis of nerve muscles on side of face,361.5,234.98,90.38,2166.29,19
CDM,64164615_1,Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face,735.0,477.75,183.75,2166.29,19
CDM,64164620_1,Injection of agent to destroy rib nerve,3025.5,1966.58,756.38,7813.35,19
CDM,64164624_1,Destruction of nerve branches of knee using imaging guidance,5160.0,3354.0,1290.0,13325.7,19
CDM,64164625_1,Destruction of nerves supplying joint between spine and pelvis using imaging guidance,5160.0,3354.0,1290.0,13325.7,19
CDM,64164633_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint",8820.0,5733.0,1861.61,22777.65,19
CDM,64164634_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint",1226.0,796.9,306.5,3166.15,19
CDM,64164635_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint",9000.0,5850.0,1861.61,23242.5,19
CDM,64164636_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint",1066.0,692.9,266.5,2752.95,19
CDM,64164640_1,Destruction of peripheral nerve or branch,1512.0,982.8,378.0,3904.74,19
CDM,64164680_1,Injection of agent to destroy abdominal nerve bundle,853.0,554.45,213.25,3227.0,19
CDM,64164681_1,Injection of agent to destroy presacral nerve bundle,1280.0,832.0,320.0,3305.6,19
CDM,64164999_1,Other procedure on nervous system,1230.0,799.5,307.5,3176.48,19
CDM,64175809_1,Review by radiologist of previous placed shunt image,450.0,292.5,112.5,1162.13,18
CDM,64176942_1,Ultrasonic guidance for needle placement,800.0,520.0,163.6,2066.0,18
CDM,64177002_1,Fluoroscopic guidance for needle placement,395.0,256.75,98.75,1020.09,18
CDM,64177003_1,Fluoroscopic guidance for spine or back muscle injection,298.0,193.7,74.5,769.59,18
CDM,64181025_1,Urine pregnancy test,30.0,19.5,2.58,77.48,19
CDM,64182947_1,Blood glucose (sugar) level,34.0,22.1,1.34,87.81,19
CDM,64195972_1,Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming,328.0,213.2,82.0,847.06,19
CDM,64195991_1,Maintenance of spinal canal or brain drug infusion pump by health care professional,241.0,156.65,60.25,2054.0,19
CDM,641G0260_1,"INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID AND/OR OTHER THERAPEUTIC AGENT, WITH OR WITHOUT ARTHROGRAPHY",4092.5,2660.13,667.58,10568.88,19
CDM,6420IP _1,UNCLASSIFIED DRUGS,1.46,0.95,0.37,3.77,16
CDM,6423IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.07,5.25,2.02,20.84,16
CDM,6423OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.65,9.52,3.66,37.83,16
CDM,6429IP _1,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",69.74,45.33,0.13,180.1,17
CDM,6429OP _1,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",4.48,2.91,0.13,11.57,17
CDM,6432IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.78,1.81,0.7,7.18,16
CDM,6432OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.71,4.36,1.68,17.33,16
CDM,6434IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",46.78,30.41,11.7,120.81,16
CDM,6434OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.55,10.11,3.89,40.16,16
CDM,6436IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.71,5.01,1.93,19.91,16
CDM,6436OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.64,13.42,5.16,53.3,16
CDM,6437OP _1,KLOR-CON 8 MEQ TABLET,2.27,1.48,0.57,1.59,11
CDM,64400T_1,Injection of anesthetic agent and/or steroid into face nerve,1455.3,945.95,41.83,263.52,19
CDM,64400_1,Injection of anesthetic agent and/or steroid into face nerve,375.0,243.75,41.83,263.52,19
CDM,64405T_1,Injection of anesthetic agent and/or steroid into upper neck and back of head nerve,1455.3,945.95,31.07,173.76,19
CDM,64405_1,Injection of anesthetic agent and/or steroid into upper neck and back of head nerve,426.9,277.49,31.07,173.76,19
CDM,64408_1,Injection of anesthetic agent and/or steroid into vagus nerve,576.0,374.4,35.64,196.1,19
CDM,64415T_1,Injection of anesthetic agent and/or steroid into arm nerve bundle (brachial plexus),814.8,529.62,54.98,326.72,19
CDM,64415_1,Injection of anesthetic agent and/or steroid into arm nerve bundle (brachial plexus),593.85,386.0,53.9,326.72,19
CDM,64416_1,Continuous infusion of anesthetic agent and/or steroid into arm nerve bundle through catheter,345.0,224.25,68.69,205.45,19
CDM,64417T_1,Injection of anesthetic agent and/or steroid into upper arm and shoulder nerve (axillary nerve),814.8,529.62,52.88,386.0,19
CDM,64417_1,Injection of anesthetic agent and/or steroid into upper arm and shoulder nerve (axillary nerve),1222.2,794.43,52.88,386.0,19
CDM,64418T_1,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,273.0,177.45,45.14,209.4,19
CDM,64418_1,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,563.85,366.5,45.14,209.4,19
CDM,64420T_1,Injection of anesthetic agent and/or steroid into rib nerve,814.8,529.62,40.15,235.13,19
CDM,64420_1,Injection of anesthetic agent and/or steroid into rib nerve,689.85,448.4,40.54,235.13,19
CDM,64421T_1,Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block,940.8,611.52,20.39,95.4,19
CDM,64421_1,Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block,219.0,142.35,20.39,95.4,19
CDM,64425T_1,Injection of anesthetic agent and/or steroid into lower abdomen and groin nerve,1455.3,945.95,46.82,266.49,19
CDM,64425_1,Injection of anesthetic agent and/or steroid into lower abdomen and groin nerve,554.4,360.36,46.82,266.49,19
CDM,64430T_1,Injection of anesthetic agent and/or steroid into external genitals and anus nerve,814.8,529.62,45.53,236.6,19
CDM,64430_1,Injection of anesthetic agent and/or steroid into external genitals and anus nerve,617.4,401.31,45.53,236.6,19
CDM,64435_1,Injection of anesthetic agent and/or steroid into uterus nerve,380.1,247.07,35.27,193.13,19
CDM,64445T_1,Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve),264.6,171.99,56.68,386.18,19
CDM,64445_1,Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve),576.45,374.69,56.68,386.18,19
CDM,64446_1,Continuous infusion of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve) through catheter,348.15,226.3,67.02,200.68,19
CDM,64447T_1,Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve),1455.3,945.95,57.29,282.12,19
CDM,64447_1,Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve),693.0,450.45,57.29,282.12,19
CDM,64448_1,Continuous infusion of anesthetic agent and/or steroid into thigh nerve (femoral nerve) through catheter,1285.2,835.38,64.25,192.01,19
CDM,64449_1,Injection by continuous infusion of anesthetic agent into lower back nerve bundle,604.8,393.12,56.44,192.09,19
CDM,64450T_1,Injection of anesthetic agent and/or steroid into other nerve or branch,1455.3,945.95,25.93,180.22,19
CDM,64450_1,Injection of anesthetic agent and/or steroid into other nerve or branch,435.0,282.75,25.93,180.22,19
CDM,64451_1,Injection of anesthetic agent and/or steroid into spine and pelvis nerve using imaging guidance,742.88,482.87,68.16,548.71,19
CDM,64454_1,Injection of anesthetic agent and/or steroid into knee nerve branch using imaging guidance,750.38,487.75,68.96,772.89,19
CDM,64455_1,Injection of anesthetic and/or steroid drug into foot nerve,150.45,97.79,28.35,120.6,19
CDM,64461_1,"Injection of anesthetic agent into thoracic vertebra using imaging guidance, single site",529.5,344.18,67.77,326.59,19
CDM,64462_1,"Injection of anesthetic agent into thoracic vertebra using imaging guidance, additional sites",200.0,130.0,42.3,174.56,19
CDM,64463_1,Injection of anesthetic agent through tube into thoracic vertebra using imaging guidance,585.0,380.25,72.44,561.91,19
CDM,64466_1,Unilateral thoracic fascial plane block by injection(s),145.0,94.25,57.93,299.45,19
CDM,64467_1,Unilateral thoracic fascial plane block by continuous infusion(s),168.0,109.2,67.13,552.45,19
CDM,64468_1,Bilateral thoracic fascial plane block by injection(s),162.0,105.3,64.35,345.73,19
CDM,64469_1,Bilateral thoracic fascial plane block by infusion(s),177.0,115.05,70.54,841.62,19
CDM,64473_1,Unilateral lower extremity fascial plane block by injection(s),200.0,130.0,51.74,282.58,19
CDM,64474_1,Unilateral lower extremity fascial plane block by infusion(s),335.0,217.75,64.35,545.53,19
CDM,64479T_1,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level",940.8,611.52,71.16,638.78,19
CDM,64479_1,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level",1318.35,856.93,71.16,638.78,19
CDM,64480T_1,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, each additional level",248.9,161.79,43.94,323.62,19
CDM,64480_1,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, each additional level",551.3,358.35,43.94,323.62,19
CDM,64483T_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level",940.8,611.52,51.62,592.49,19
CDM,64483_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level",1323.0,859.95,51.62,592.49,19
CDM,64484T_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level",328.7,213.66,41.45,268.89,19
CDM,64484_1,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level",682.5,443.63,32.56,268.89,19
CDM,64486_1,Injection of local anesthetic for abdominal wall pain control on side using imaging guidance,455.25,295.91,46.07,271.99,19
CDM,64487_1,Continuous infusion of local anesthetic for abdominal wall pain control on side using imaging guidance,556.05,361.43,53.29,524.76,19
CDM,64488_1,Injection of local anesthetic for abdominal wall pain control on both sides using imaging guidance,373.8,242.97,53.75,337.08,19
CDM,64489_1,Continuous infusion of local anesthetic for abdominal wall pain control on both sides using imaging guidance,518.7,337.16,67.02,854.43,19
CDM,64490T_1,"Injection of upper or middle spine facet joint using imaging guidance, single level",390.6,253.89,64.0,459.23,19
CDM,64490_1,"Injection of upper or middle spine facet joint using imaging guidance, single level",765.45,497.54,64.0,459.23,19
CDM,64491T_1,"Injection of upper or middle spine facet joint using imaging guidance, second level",193.2,125.58,47.76,233.01,19
CDM,64491_1,"Injection of upper or middle spine facet joint using imaging guidance, second level",241.5,156.98,41.49,233.01,19
CDM,64492T_1,"Injection of upper or middle spine facet joint using imaging guidance, third and any additional level",291.9,189.74,41.74,234.61,19
CDM,64492_1,"Injection of upper or middle spine facet joint using imaging guidance, third and any additional level",246.8,160.42,42.57,234.61,19
CDM,64493T_1,"Injection of lower or sacral spine facet joint using imaging guidance, single level",525.0,341.25,52.05,423.15,19
CDM,64493_1,"Injection of lower or sacral spine facet joint using imaging guidance, single level",685.2,445.38,52.05,423.15,19
CDM,64494T_1,"Injection of lower or sacral spine facet joint using imaging guidance, second level",262.5,170.63,39.02,217.75,19
CDM,64494_1,"Injection of lower or sacral spine facet joint using imaging guidance, second level",236.3,153.6,39.02,217.75,19
CDM,64495T_1,"Injection of lower or sacral spine facet joint using imaging guidance, third and any additional level",267.8,174.07,39.33,217.75,19
CDM,64495_1,"Injection of lower or sacral spine facet joint using imaging guidance, third and any additional level",241.5,156.98,39.33,217.75,19
CDM,64505T_1,"Injection of anesthetic agent, trigeminal nerve bundle",1455.3,945.95,67.67,333.7,19
CDM,64505_1,"Injection of anesthetic agent, trigeminal nerve bundle",398.55,259.06,78.57,333.7,19
CDM,64510T_1,Injection of anesthetic agent into sympathetic nerve bundle,940.8,611.52,41.34,352.32,19
CDM,64510_1,Injection of anesthetic agent into sympathetic nerve bundle,637.95,414.67,65.49,352.32,19
CDM,64517T_1,Injection of anesthetic agent into sacral nerve bundle,365.4,237.51,48.36,468.76,19
CDM,64517_1,Injection of anesthetic agent into sacral nerve bundle,476.7,309.86,48.36,468.76,19
CDM,6451IP _1,UNCLASSIFIED DRUGS,34.93,22.7,8.73,90.21,16
CDM,6451OP _1,UNCLASSIFIED DRUGS,33.51,21.78,8.38,86.54,16
CDM,64520T_1,Injection of anesthetic agent into middle or lower spine sympathetic nerve,381.2,247.78,39.64,552.53,19
CDM,64520_1,Injection of anesthetic agent into middle or lower spine sympathetic nerve,878.85,571.25,40.43,552.53,19
CDM,64530T_1,Injection of anesthetic agent into abdominal sympathetic nerve bundle,386.4,251.16,78.57,555.47,19
CDM,64530_1,Injection of anesthetic agent into abdominal sympathetic nerve bundle,577.5,375.38,39.09,555.47,19
CDM,64553_1,Insertion of cranial nerve neurostimulator electrode,589.1,382.92,78.57,6071.96,19
CDM,64555_1,Insertion of peripheral nerve neurostimulator electrode through skin,850.5,552.83,78.57,5188.7,19
CDM,6455IP _1,UNCLASSIFIED DRUGS,35.85,23.3,8.96,92.58,16
CDM,64561T_1,Insertion of sacral nerve neurostimulator electrode array,4328.1,2813.27,78.57,1774.96,19
CDM,64561_1,Insertion of sacral nerve neurostimulator electrode array,4575.45,2974.04,78.57,1774.96,19
CDM,64566_1,Insertion of lower leg neurostimulator electrode,259.0,168.35,24.29,280.57,19
CDM,64568_1,Insertion of cranial nerve neurostimulator electrode and generator,1561.4,1014.91,78.57,1821.09,19
CDM,64569_1,Revision of cranial nerve neurostimulator electrodes,1438.5,935.03,78.57,2184.61,19
CDM,64570_1,Removal of cranial nerve neurostimulator electrodes,1233.8,801.97,78.57,2068.68,19
CDM,64575_1,Insertion of peripheral nerve neurostimulator electrode,1029.0,668.85,78.57,968.58,19
CDM,64580_1,Insertion of muscle neurostimulator electrodes,1029.0,668.85,78.57,899.1,19
CDM,64581_1,Insertion of sacral nerve neurostimulator electrode,2290.1,1488.57,78.57,2012.23,19
CDM,64582_1,Insertion of hypoglossal nerve neurostimulator electrode and generator and breathing sensor electrode,2854.5,1855.43,78.57,2940.14,19
CDM,64583_1,Revision or replacement of hypoglossal nerve neurostimulator electrode and breathing sensor electrode with connection to existing generator,1824.0,1185.6,78.57,2486.67,19
CDM,64584_1,Removal of hypoglossal nerve neurostimulator electrode and generator and breathing sensor electrode,1536.0,998.4,78.57,2094.81,19
CDM,64585_1,Revision of peripheral neurostimulator electrodes,1211.7,787.61,78.57,579.11,19
CDM,6458IP _1,UNCLASSIFIED DRUGS,2.96,1.92,0.74,7.64,16
CDM,64590T_1,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver",15870.8,10316.02,78.57,772.37,19
CDM,64590_1,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver",896.7,582.86,78.57,772.37,19
CDM,64595_1,"Removal or revision of a peripheral, sacral, or gastric neurostimulator pulse generator or receiver",1102.5,716.63,78.57,603.05,19
CDM,64597_1,Insertion or replacement of a peripheral integrated neurostimulator each additional electrode array,750.0,487.5,78.57,1439.51,15
CDM,64598_1,Revision or removal of a electrode array with an integrated neurostimulator,1560.0,1014.0,78.57,1606.8,15
CDM,64600_1,Destruction of first division of face nerve branch,1172.9,762.39,78.57,1102.4,19
CDM,64605_1,Destruction of second and third division of face nerve branch,1521.5,988.98,78.57,1533.68,19
CDM,64610_1,Destruction of face nerve branch under X-ray monitoring,1829.1,1188.92,78.57,1803.14,19
CDM,64611_1,Injection of chemical for paralysis of salivary glands on both sides of mouth,236.3,153.6,78.57,317.69,19
CDM,64612T_1,Injection of chemical for paralysis of nerve muscles on side of face,525.0,341.25,78.57,355.21,19
CDM,64612_1,Injection of chemical for paralysis of nerve muscles on side of face,667.8,434.07,78.57,355.21,19
CDM,64615_1,Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face,441.0,286.65,78.57,351.8,19
CDM,64616_1,Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box,563.85,366.5,78.57,313.5,19
CDM,64617_1,Injection of chemical for paralysis of nerve muscles on side of voice box,915.15,594.85,78.57,390.03,19
CDM,64620T_1,Injection of agent to destroy rib nerve,518.7,337.16,57.7,545.81,19
CDM,64620_1,Injection of agent to destroy rib nerve,1137.15,739.15,57.7,545.81,19
CDM,64624_1,Destruction of nerve branches of knee using imaging guidance,1433.63,931.86,78.57,1476.64,19
CDM,64625_1,Destruction of nerves supplying joint between spine and pelvis using imaging guidance,1753.88,1140.02,78.57,1138.12,19
CDM,64628_1,"Heat destruction of intraosseous basivertebral nerve in bones of spine in lower back, first two bones",998.0,648.7,78.57,1316.74,19
CDM,64629_1,Heat destruction of intraosseous basivertebral nerve in additional bone of spine in lower back,464.0,301.6,78.57,611.87,19
CDM,64630_1,Destruction of external genital nerve,621.6,404.04,42.73,605.84,19
CDM,64632_1,Destruction of foot nerve,204.15,132.7,58.48,217.9,19
CDM,64633T_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint",726.6,472.29,78.57,1055.26,19
CDM,64633_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint",1342.5,872.63,78.57,1055.26,19
CDM,64634T_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint",327.6,212.94,54.47,619.43,19
CDM,64634_1,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint",358.1,232.77,54.47,619.43,19
CDM,64635T_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint",713.0,463.45,78.57,1064.84,19
CDM,64635_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint",2223.75,1445.44,78.57,1064.84,19
CDM,64636T_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint",295.1,191.82,47.76,582.03,19
CDM,64636_1,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint",522.0,339.3,47.76,582.03,19
CDM,64640T_1,Destruction of peripheral nerve or branch,434.7,282.56,49.4,593.34,19
CDM,64640_1,Destruction of peripheral nerve or branch,910.35,591.73,49.4,593.34,19
CDM,64642_1,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, first extremity",438.9,285.29,78.57,351.57,19
CDM,64643_1,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, each additional extremity",288.8,187.72,30.87,216.56,19
CDM,64644_1,"Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, first extremity",501.9,326.24,78.57,412.71,19
CDM,64645_1,"Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, each additional extremity",352.8,229.32,30.87,279.12,19
CDM,64646_1,"Injection of chemical for paralysis of nerve muscles on trunk, 1-5 muscles",472.5,307.13,78.57,368.08,19
CDM,64647_1,"Injection of chemical for paralysis of nerve muscles on trunk, 6 or more muscles",547.1,355.62,30.87,419.14,19
CDM,64650_1,Injection of chemical for paralysis of underarm sweat glands,182.7,118.76,30.17,211.13,19
CDM,64653_1,Injection of chemical for paralysis of sweat glands,265.7,172.71,38.89,273.67,19
CDM,64654_1,"INITIAL OPEN IMPLANTATION OF BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM, INCLUDING LEAD PLACEMENT ONTO THE CAROTID SINUS, LEAD TUNNELLING, CONNECTION TO A PULSE GENERATOR PLACED IN A DISTAN",1350.0,877.5,73.6,1390.5,16
CDM,64655_1,"REVISION OR REPLACEMENT OF BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM, WITH INTRAOPERATIVE INTERROGATION AND PROGRAMMING; LEAD ONLY",1575.0,1023.75,73.6,1622.25,16
CDM,64657_1,"REMOVAL OF BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM; TOTAL SYSTEM, INCLUDING LEAD AND PULSE GENERATOR",1530.0,994.5,73.6,1575.9,16
CDM,64658_1,REMOVAL OF BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM; LEAD ONLY,1150.0,747.5,73.6,1184.5,16
CDM,64659_1,REMOVAL OF BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM; PULSE GENERATOR ONLY,1070.0,695.5,73.6,1102.1,16
CDM,64680T_1,Injection of agent to destroy abdominal nerve bundle,622.7,404.76,26.62,837.59,19
CDM,64680_1,Injection of agent to destroy abdominal nerve bundle,903.0,586.95,26.62,837.59,19
CDM,64681T_1,Injection of agent to destroy presacral nerve bundle,746.6,485.29,72.61,1108.6,19
CDM,64681_1,Injection of agent to destroy presacral nerve bundle,1175.0,763.75,72.61,1108.6,19
CDM,6468IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.56,5.56,2.14,22.11,16
CDM,6468OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.81,9.63,3.7,38.25,16
CDM,6469IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.67,6.94,2.67,27.56,16
CDM,6469OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.28,2.78,1.07,11.05,16
CDM,64702_1,Release of finger nerve,1241.1,806.72,78.57,1499.94,19
CDM,64704_1,Release of hand or foot nerve,1260.0,819.0,78.57,976.77,19
CDM,64708_1,Release of arm or leg nerve,2598.75,1689.19,78.57,1486.95,19
CDM,6470IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.7,20.61,7.93,81.87,16
CDM,6470OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.14,13.09,5.04,52.01,16
CDM,64712_1,Release of sciatic nerve,3071.25,1996.31,78.57,1727.27,19
CDM,64713_1,Release of major arm or leg nerve,2178.8,1416.22,78.57,2293.77,19
CDM,64714_1,Release of upper leg nerve,1776.6,1154.79,78.57,2148.92,19
CDM,64716_1,Release and/or relocation of cranial nerve,2362.5,1535.63,78.57,1555.94,19
CDM,64718_1,Release and/or relocation of elbow nerve,2598.75,1689.19,78.57,1755.8,19
CDM,64719_1,Release and/or relocation of wrist nerve,1929.45,1254.14,78.57,1192.07,19
CDM,64721_1,Release and/or relocation of hand nerve,2700.0,1755.0,78.57,1267.91,19
CDM,64722_1,Release of unspecified nerve,1575.0,1023.75,78.57,1059.36,19
CDM,64726_1,Release of sole of foot nerve,792.8,515.32,78.57,832.84,19
CDM,64727_1,Release of nerve using operating microscope,525.0,341.25,78.57,542.16,19
CDM,64732_1,"Incision or removal of forehead, scalp and upper eyelid nerve",1009.1,655.92,78.57,1256.66,19
CDM,64734_1,"Incision or removal of lower eyelid, upper lip, and mouth nerve",1100.4,715.26,78.57,1420.28,19
CDM,64736_1,"Incision or removal of chin, lower lip, and jaw nerve",1113.0,723.45,78.57,1030.01,19
CDM,64738_1,Incision or removal of teeth and jaw bone nerve,1357.7,882.51,78.57,1386.29,19
CDM,64740_1,Incision and removal of tongue nerve,1443.8,938.47,78.57,1433.72,19
CDM,64742_1,Incision or removal of face nerve,1601.3,1040.85,78.57,1508.51,19
CDM,64744_1,Incision or removal of scalp and over ear nerve,1093.1,710.52,78.57,1397.59,19
CDM,64746_1,"Incision or removal of abdomen, gallbladder, and liver nerve",1200.2,780.13,78.57,1257.43,19
CDM,64755_1,Incision or removal of stomach nerve,2001.88,1301.22,78.57,2675.81,19
CDM,64760_1,Incision or removal of abdomen nerve,1290.5,838.83,78.57,1503.24,19
CDM,64763_1,Incision or removal of outside pelvic and thigh nerve,1418.6,922.09,78.57,1492.7,19
CDM,64766_1,Incision or removal of inside pelvic and thigh nerve,1698.9,1104.29,78.57,1827.53,19
CDM,64771_1,Incision or removal of cranial nerve,1385.0,900.25,78.57,1763.4,19
CDM,64772_1,Incision or removal of spinal nerve,1507.8,980.07,78.57,1671.29,19
CDM,64774_1,Removal of growth of skin nerve,1100.4,715.26,78.57,1216.25,19
CDM,64776_1,"Removal of growth of finger or toe nerve, same digit",1056.3,686.6,78.57,1169.12,19
CDM,64778_1,"Removal of growth of finger or toe nerve, each additional digit",512.4,333.06,78.57,536.71,19
CDM,64782_1,"Removal of growth of nerve of hand or foot nerve, first nerve",1248.5,811.53,78.57,1385.31,19
CDM,64783_1,"Removal of growth of nerve of hand or foot nerve, each additional nerve",614.3,399.3,78.57,641.21,19
CDM,64784_1,Removal of growth of peripheral nerve,1942.5,1262.63,78.57,2163.13,19
CDM,64786_1,Removal or growth of sciatic nerve,2897.0,1883.05,78.57,2925.85,19
CDM,64787_1,Implantation of nerve end into bone or muscle,1023.8,665.47,78.57,717.99,19
CDM,64788_1,Removal of growth of skin nerve or nerve lining,1085.7,705.71,78.57,1185.67,19
CDM,64790_1,Removal of growth of major peripheral nerve or nerve lining,2198.7,1429.16,78.57,2447.43,19
CDM,64792_1,"Removal of growth of major peripheral nerve or nerve lining, extensive including growth",2864.4,1861.86,78.57,3160.41,19
CDM,64795_1,Biopsy of nerve,603.8,392.47,78.57,559.43,19
CDM,64802_1,Removal of upper spine sympathetic nerves,2100.0,1365.0,78.57,2353.64,19
CDM,64804_1,Removal of upper and middle spine sympathetic nerves,3150.0,2047.5,78.57,3317.01,19
CDM,64809_1,Removal of middle and lower spine sympathetic nerves,3045.0,1979.25,78.57,3030.8,19
CDM,64818_1,Removal of lower spine sympathetic nerves,3307.5,2149.88,78.57,2311.33,19
CDM,64820_1,Removal of finger or toe sympathetic nerve,2028.6,1318.59,78.57,2143.15,19
CDM,64821_1,Removal of lower arm radial artery sympathetic nerve,1829.1,1188.92,78.57,2053.57,19
CDM,64822_1,Removal of lower arm ulnar artery sympathetic nerve,1806.0,1173.9,78.57,2053.57,19
CDM,64823_1,Removal of hand sympathetic nerve,2050.7,1332.96,78.57,2333.84,19
CDM,64831_1,"Suture of hand or foot digital nerve, first digital nerve",2827.2,1837.68,78.57,2046.55,19
CDM,64832_1,"Suture of hand or foot digital nerve, each additional digital nerve",951.3,618.35,78.57,995.47,19
CDM,64834_1,Suture of hand or foot common sensory nerve,2005.5,1303.58,78.57,2212.05,19
CDM,64835_1,Suture of hand median motor nerve,2171.4,1411.41,78.57,2410.59,19
CDM,64836_1,Suture of forearm and hand nerve,2172.5,1412.13,78.57,2411.3,19
CDM,64837_1,"Suture of hand or foot nerve, each additional nerve",1055.3,685.95,78.57,1080.29,19
CDM,64840_1,Suture of foreleg nerve to sole of foot,2419.2,1572.48,78.57,2849.06,19
CDM,64856_1,Suture and relocation of arm or leg peripheral nerve,2737.4,1779.31,78.57,3011.66,19
CDM,64857T_1,Suture of arm or leg peripheral nerve,4339.7,2820.81,78.57,3139.42,19
CDM,64857_1,Suture of arm or leg peripheral nerve,2862.3,1860.5,78.57,3139.42,19
CDM,64858_1,Suture of sciatic nerve,3264.5,2121.93,78.57,3487.65,19
CDM,64859_1,Suture of peripheral nerve,945.0,614.25,78.57,973.35,19
CDM,64861_1,Suture of arm nerve bundle,3677.1,2390.12,78.57,4268.34,19
CDM,64862_1,Suture of lower spine nerve bundle,3169.7,2060.31,78.57,4060.92,19
CDM,64864T_1,Suture of face nerve outside skull,4339.7,2820.81,78.57,2592.96,19
CDM,64864_1,Suture of face nerve outside skull,2399.3,1559.55,78.57,2592.96,19
CDM,64865_1,Suture of face nerve at temple,3163.7,2056.41,78.57,3289.13,19
CDM,64866_1,Connection of face-spinal nerves to restore function to the face,3543.8,2303.47,78.57,3789.57,19
CDM,64868_1,Connection of face-hypoglossal nerves to restore function to the face,4646.3,3020.1,78.57,3016.39,19
CDM,64872_1,Delayed suture nerve repair,337.1,219.12,78.57,343.76,19
CDM,64874_1,Suture and relocation of nerve to restore function,486.2,316.03,78.57,514.81,19
CDM,64876_1,Suture of nerve with shortening of arm or leg bone,421.6,274.04,78.57,581.63,19
CDM,6487IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",173.32,112.66,43.33,447.6,16
CDM,6487OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",50.79,33.01,12.7,131.17,16
CDM,64885_1,"Graft of head or neck nerve, 4.0 cm or less",3128.0,2033.2,78.57,3349.95,19
CDM,64886T_1,"Graft of head or neck nerve, more than 4.0 cm",4339.7,2820.81,78.57,3881.09,19
CDM,64886_1,"Graft of head or neck nerve, more than 4.0 cm",3810.5,2476.83,78.57,3881.09,19
CDM,64890_1,"Graft of hand or foot nerve , 4.0 cm or less",2947.4,1915.81,78.57,3198.96,19
CDM,64891_1,"Graft of hand or foot nerve, more than 4.0 cm",3078.6,2001.09,78.57,3399.68,19
CDM,64892_1,"Graft of arm or leg nerve, 4.0 cm or less",2857.1,1857.12,78.57,3103.6,19
CDM,64893_1,"Graft of arm or leg nerve, more than 4.0 cm",3010.4,1956.76,78.57,3321.84,19
CDM,64895_1,"Graft of multiple hand or foot nerves, 4.0 cm or less",3557.4,2312.31,78.57,3928.66,19
CDM,64896_1,"Graft of multiple hand or foot nerves, more than 4.0 cm",3907.1,2539.62,78.57,4244.23,19
CDM,64897_1,"Graft of multiple arm or leg nerves, 4.0 cm or less",3438.8,2235.22,78.57,3750.62,19
CDM,64898_1,"Graft of multiple arm or leg nerves, more than 4.0 cm",3747.5,2435.88,78.57,4066.96,19
CDM,64901_1,"Graft of single strand of nerve, each additional nerve",1688.4,1097.46,78.57,1762.81,19
CDM,64902_1,Graft of multiple nerve sections,1942.5,1262.63,78.57,2041.36,19
CDM,64905_1,"Transfer of nerve to injured nerve, stage 1 of 2",2430.75,1579.99,78.57,3033.69,19
CDM,64907_1,"Transfer of nerve to injured nerve, stage 2 of 2",3116.85,2025.95,78.57,3860.47,19
CDM,64910_1,Repair of nerve with graft,2193.5,1425.78,78.57,2345.44,19
CDM,64911_1,Repair of nerve using vein graft,2383.98,1549.59,78.57,3034.28,19
CDM,64912_1,"Repair of nerve using nerve graft, first strand",1715.0,1114.75,78.57,2330.79,19
CDM,64913_1,"Repair of nerve using nerve graft, each additional strand",345.0,224.25,78.57,470.26,19
CDM,6492IP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",4.93,3.2,0.01,12.73,17
CDM,6492OP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",1.8,1.17,0.01,4.65,17
CDM,6493IP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",2.95,1.92,0.01,7.62,17
CDM,6493OP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",12.72,8.27,0.01,32.85,17
CDM,6494IP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",16.79,10.91,0.01,43.36,17
CDM,6494OP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",145.78,94.76,0.01,376.48,17
CDM,6495IP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",14.1,9.17,0.01,36.41,17
CDM,6495OP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",21.48,13.96,0.01,55.47,17
CDM,6496IP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",6.47,4.21,0.01,16.71,17
CDM,6496OP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",30.94,20.11,0.01,79.9,17
CDM,6497IP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",5.19,3.37,0.01,13.4,17
CDM,6497OP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",26.57,17.27,0.01,68.62,17
CDM,6498IP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",8.18,5.32,0.01,21.12,17
CDM,6498OP _1,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",27.2,17.68,0.01,70.24,17
CDM,65091_1,Removal of eye contents,2395.65,1557.17,78.57,1957.98,19
CDM,65093_1,Removal of eye contents with insertion of implant,2411.4,1567.41,78.57,1935.92,19
CDM,65101_1,Removal of eyeball,2761.05,1794.68,78.57,2272.92,19
CDM,65103_1,Removal of eyeball with insertion of implant,1923.6,1250.34,78.57,2366.87,19
CDM,65105_1,Removal of eyeball with insertion of implant attached to muscles,3186.3,2071.1,78.57,2606.23,19
CDM,65110_1,Removal of eye contents and eye socket bone,3101.7,2016.11,78.57,3738.9,19
CDM,65112_1,Removal of eye contents and therapeutic removal of eye socket bone,3639.3,2365.55,78.57,4331.55,19
CDM,65114_1,Removal of eye contents with muscle or flap graft,3802.1,2471.37,78.57,4540.14,19
CDM,65125_1,Placement or replacement of peg in eye implant,1145.6,744.64,78.57,1096.07,19
CDM,65130_1,Insertion of eye implant in scleral shell after evisceration,1822.8,1184.82,78.57,2252.64,19
CDM,65135_1,Insertion of eye implant after removal of eye,1856.4,1206.66,78.57,2285.1,19
CDM,65140_1,Insertion of eye implant attached to muscles after removal of eye,3035.1,1972.82,78.57,2482.79,19
CDM,65150_1,Reinsertion of eye implant,1537.2,999.18,78.57,1822.39,19
CDM,65155_1,Reinsertion of eye implant using foreign material and/or attachment to muscles for reinforcement,2133.6,1386.84,78.57,2598.6,19
CDM,65175_1,Removal of eye implant,2460.15,1599.1,78.57,2031.48,19
CDM,65205_1,Removal of foreign body from external eye (conjunctiva),187.5,121.88,23.38,90.49,19
CDM,65210_1,Removal of foreign body from external eye (conjunctiva or sclera),360.0,234.0,28.72,112.53,19
CDM,65220_1,Removal of foreign body in cornea,240.0,156.0,34.97,143.61,19
CDM,65222_1,Removal of foreign body in cornea using slit lamp,225.0,146.25,39.92,163.97,19
CDM,65235_1,Removal of foreign body in eye or lens,2520.0,1638.0,78.57,2161.12,19
CDM,65260_1,Removal of foreign body in eye with a magnet,2414.0,1569.1,78.57,2925.37,19
CDM,65265_1,Removal of foreign body in eye,4080.9,2652.59,78.57,3287.51,19
CDM,65270_1,Repair of lacerated conjunctiva,671.0,436.15,78.57,686.95,19
CDM,65272_1,Repair of lacerated conjunctiva using flap or graft,1231.7,800.61,78.57,1271.71,19
CDM,65273_1,Repair of lacerated conjunctiva using flap or graft with hospitalization,960.8,624.52,78.57,1158.67,19
CDM,65275_1,Repair of lacerated cornea,1391.3,904.35,78.57,1420.34,19
CDM,65280_1,Repair of perforating laceration of cornea and/or sclera,2529.45,1644.14,78.57,2041.1,19
CDM,65285_1,Repair of perforating laceration of cornea and/or sclera with reposition or removal of uveal tissue,3954.9,2570.69,78.57,3373.91,19
CDM,65286_1,Repair of lacerated cornea and/or sclera using tissue glue,1743.0,1132.95,78.57,1679.18,19
CDM,65290_1,Repair of wound of eye muscle or tendon,1853.85,1205.0,78.57,1490.94,19
CDM,65400_1,Removal of growth of cornea,1950.0,1267.5,78.57,1848.91,19
CDM,65410_1,Biopsy of cornea,361.2,234.78,78.57,377.91,19
CDM,6541IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.53,9.44,3.63,37.52,16
CDM,65420_1,Removal or relocation of corneal conjunctiva,1272.6,827.19,78.57,1296.69,19
CDM,65426_1,Removal or relocation of corneal conjunctiva with graft,2417.7,1571.51,78.57,1612.39,19
CDM,65430_1,Scraping of cornea for diagnosis,337.5,219.38,33.78,311.75,19
CDM,65435_1,Removal of outer layer of cornea,319.8,207.87,56.16,211.53,19
CDM,65436_1,Removal of outer layer of cornea with application of chelating agent,1200.0,780.0,78.57,1125.92,19
CDM,6544IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.66,3.68,1.42,14.62,16
CDM,6544OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.03,15.62,6.01,62.06,16
CDM,65450_1,Destruction of growth of cornea,1447.5,940.88,78.57,972.15,19
CDM,654IP _1,UNCLASSIFIED DRUGS,108.37,70.44,27.09,279.87,16
CDM,65600_1,Multiple punctures of cornea,965.0,627.25,78.57,1053.17,19
CDM,6561IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.51,10.73,4.13,42.64,16
CDM,6561OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.6,19.89,7.65,79.02,16
CDM,6562IP _1,"INJECTION, PROCAINAMIDE HCL, UP TO 1 GM",52.3,34.0,13.08,365.2,17
CDM,6563IP _1,"INJECTION, PROCAINAMIDE HCL, UP TO 1 GM",1799.79,1169.86,365.2,4647.96,17
CDM,6563OP _1,"INJECTION, PROCAINAMIDE HCL, UP TO 1 GM",640.55,416.36,160.14,1654.22,17
CDM,65710_1,Transplantation of tissue from 1 cornea to other cornea,4170.6,2710.89,78.57,3389.08,19
CDM,65730_1,Penetrating transplantation of tissue from 1 cornea to other cornea (except in aphakia or pseudophakia),4643.1,3018.02,78.57,3753.3,19
CDM,65750_1,Penetrating transplantation of tissue from 1 cornea to other cornea (in aphakia),5255.85,3416.3,78.57,3774.0,19
CDM,65755_1,Penetrating transplantation of tissue from 1 cornea to other cornea (in pseudophakia),5011.65,3257.57,78.57,3754.1,19
CDM,65756_1,Transplantation of outer layer of corneal tissue,4521.9,2939.24,78.57,3599.25,19
CDM,65757_1,Preparation of corneal tissue for transplant,156.6,101.79,70.47,200.63,15
CDM,65760_1,Removal and reshaping of corneal tissue,3692.9,2400.39,78.57,3803.69,15
CDM,65765_1,Transplantation of donor cornea,4284.0,2784.6,78.57,4942.51,15
CDM,65767_1,Transplantation of donor corneal tissue,3987.9,2592.14,78.57,4600.85,15
CDM,65770_1,Insertion of cornea prosthesis,3595.2,2336.88,78.57,4241.78,19
CDM,65771_1,Incision in cornea to correct refraction error,2171.4,1411.41,78.57,2236.54,15
CDM,65772_1,Incision of cornea to correct astigmatism,1118.3,726.9,78.57,1240.42,19
CDM,65775_1,Removal of corneal tissue to correct astigmatism,1379.7,896.81,78.57,1686.74,19
CDM,65778_1,Placement of amniotic membrane on eye surface for wound healing,3975.0,2583.75,34.37,3178.79,19
CDM,65779_1,Placement of amniotic membrane on eye surface with sutures for wound healing,3600.0,2340.0,78.57,2739.04,19
CDM,65780_1,Transplantation of fetal sac tissue to cornea,3326.4,2162.16,78.57,2018.29,19
CDM,65781_1,Transplantation of stem cells to cornea,3145.5,2044.58,78.57,4050.7,19
CDM,65782_1,Transplantation of stem cells from 1 cornea to other cornea,2729.7,1774.31,78.57,3490.37,19
CDM,65785_1,Implantation of corneal ring segments,4883.0,3173.95,78.57,5183.67,19
CDM,65800_1,Removal of eye fluid,405.0,263.25,67.31,287.8,19
CDM,6580IP _1,"INJECTION, PROCHLORPERAZINE, UP TO 10 MG",30.7,19.96,2.67,79.28,17
CDM,65810_1,Complex removal of eye fluid,1303.1,847.02,78.57,1410.88,19
CDM,65815_1,Removal of blood from eye,1628.6,1058.59,78.57,1545.67,19
CDM,65820_1,Incision to improve eye fluid flow,1877.4,1220.31,78.57,2293.56,19
CDM,6582IP _1,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",21.75,14.14,0.83,56.17,17
CDM,6582OP _1,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",72.78,47.31,0.83,187.95,17
CDM,6583IP _1,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",9.46,6.15,0.83,24.43,17
CDM,6583OP _1,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",21.98,14.29,0.83,56.76,17
CDM,65850_1,Insertion of eye fluid drainage tube,3220.95,2093.62,78.57,2551.19,19
CDM,65855_1,Laser repair to improve eye fluid flow,1063.5,691.28,78.57,636.03,19
CDM,65860_1,Laser removal of scar tissue of eye,951.3,618.35,78.57,762.71,19
CDM,65865_1,Removal of scar tissue in eye (goniosynechiae),2205.0,1433.25,78.57,1434.35,19
CDM,65870_1,Removal of scar tissue in eye (anterior synechiae),2217.6,1441.44,78.57,1789.75,19
CDM,65875_1,Removal of scar tissue in eye (posterior synechiae),2356.2,1531.53,78.57,1910.89,19
CDM,65880_1,Removal of corneal scar tissue,2485.35,1615.48,78.57,2011.86,19
CDM,65900_1,Removal of outer lining of cornea,2432.9,1581.39,78.57,2947.98,19
CDM,65920_1,Removal of implanted lens of eye,2951.55,1918.51,78.57,2390.66,19
CDM,65930_1,Removal of blood clot of eye,2431.8,1580.67,78.57,1931.87,19
CDM,66020_1,Injection of air or liquid into eye,462.0,300.3,78.57,474.83,19
CDM,66030_1,Injection of medication into eye,408.5,265.53,78.57,427.02,19
CDM,66130_1,Removal of growth of sclera,1768.2,1149.33,78.57,1735.66,19
CDM,66150_1,Partial removal of iris and creation of drainage hole for treatment of glaucoma,2158.8,1403.22,78.57,2657.29,19
CDM,66155_1,Partial removal of iris using heat for treatment of glaucoma,2152.5,1399.13,78.57,2655.09,19
CDM,66160_1,Removal of sclera and iris and creation of eye fluid drainage tract for treatment of glaucoma,2454.9,1595.69,78.57,2996.42,19
CDM,66170_1,Creation of eye fluid drainage tract for treatment of glaucoma,2972.6,1932.19,78.57,3319.81,19
CDM,66172_1,Creation of eye fluid drainage tract for treatment of glaucoma with previous scarring,5602.35,3641.53,78.57,3614.19,19
CDM,66174_1,Dilation of fluid outflow drainage within eye,2247.5,1460.88,78.57,2321.07,19
CDM,66175_1,Dilation of fluid outflow drainage within eye with insertion of device to maintain open channel,2356.03,1531.42,78.57,2443.57,19
CDM,66179_1,Creation of shunt to improve eye fluid flow,2240.7,1456.46,78.57,3272.46,19
CDM,66180_1,Creation of shunt to improve eye fluid flow using tissue graft,4454.1,2895.17,78.57,3453.54,19
CDM,66183_1,Insertion of eye fluid drainage device,3391.5,2204.48,78.57,3124.79,19
CDM,66184_1,Revision of eye fluid drainage shunt,1560.3,1014.2,78.57,2381.14,19
CDM,66185_1,Revision of eye fluid drainage shunt with graft,2800.35,1820.23,78.57,2565.03,19
CDM,6618IP _1,"INJECTION, PROMETHAZINE HCL, UP TO 50 MG",16.7,10.86,4.18,43.13,17
CDM,6619IP _1,PROMETHAZINE 50 MG/ML AMPUL,27.8,18.07,6.95,19.46,11
CDM,6620IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.3,0.85,0.33,3.36,16
CDM,6620OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.59,2.98,1.15,11.85,16
CDM,6621IP _1,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",6.0,3.9,0.31,15.5,17
CDM,6621OP _1,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",10.9,7.09,0.31,28.15,17
CDM,66225_1,Repair of protrusion of inner tissue through eyeball with graft,2659.7,1728.81,78.57,2829.32,19
CDM,6622IP _1,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",7.52,4.89,0.31,19.42,17
CDM,6622OP _1,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",32.07,20.85,0.31,82.82,17
CDM,6624IP _1,UNCLASSIFIED DRUGS,342.0,222.3,85.5,883.22,16
CDM,66250_1,Revision or repair of operative wound of eye,2781.45,1807.94,78.57,1809.18,19
CDM,6627IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.37,2.19,0.84,8.7,16
CDM,6627OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.07,2.65,1.02,10.51,16
CDM,663IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.65,2.37,0.91,9.43,16
CDM,663OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.05,9.78,3.76,38.87,16
CDM,6644IP _1,UNCLASSIFIED DRUGS,7.51,4.88,1.88,19.39,16
CDM,6644OP _1,UNCLASSIFIED DRUGS,19.0,12.35,4.75,49.07,16
CDM,664IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.63,3.01,1.16,11.96,16
CDM,664OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.96,22.72,8.74,90.28,16
CDM,66500_1,Incision of iris to improve eye fluid flow,878.9,571.29,78.57,1084.65,19
CDM,66505_1,Incision and drainage of eye fluid accumulation of iris,1260.0,819.0,78.57,1187.09,19
CDM,6654IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.83,1.19,0.46,4.73,16
CDM,6654OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.57,1.02,0.39,4.05,16
CDM,6656IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.15,3.35,1.29,13.3,16
CDM,6656OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.39,15.85,6.1,62.99,16
CDM,6657IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.83,6.39,2.46,25.39,16
CDM,6657OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.31,15.8,6.08,62.78,16
CDM,6658IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.5,4.23,1.63,16.79,16
CDM,6658OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.84,7.05,2.71,27.99,16
CDM,66600_1,Removal of iris and growth,2050.7,1332.96,78.57,2550.86,19
CDM,66605_1,Removal of iris and eyelid border to improve eye fluid flow with partial removal of ciliary muscle,2669.1,1734.92,78.57,3240.03,19
CDM,66625_1,Removal of margin of iris to improve eye fluid flow,1307.3,849.75,78.57,1300.19,19
CDM,6662IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.57,3.62,1.39,14.38,16
CDM,66630_1,Removal of section of iris to improve eye fluid flow,1419.6,922.74,78.57,1725.68,19
CDM,66635_1,Partial removal of iris and eyelid border to improve eye fluid flow,2153.1,1399.52,78.57,1742.62,19
CDM,66680_1,Repair of iris and lens,1923.15,1250.05,78.57,1569.72,19
CDM,66682_1,Suture of iris and lens,1556.1,1011.47,78.57,1957.0,19
CDM,66700_1,Destruction of lens tissue,1192.8,775.32,78.57,1201.7,19
CDM,66710_1,Destruction of lens tissue using laser,1842.75,1197.79,78.57,1201.7,19
CDM,66711_1,Destruction of tissue encircling lens using an endoscope,1586.6,1031.29,78.57,1549.45,19
CDM,66720_1,Destruction of tissue encircling lens,1179.2,766.48,78.57,1255.02,19
CDM,66740_1,Destruction of tissue of eyelid border,1260.0,819.0,78.57,1201.7,19
CDM,66761_1,"Creation of eye fluid drainage tracts in iris using a laser, per session",937.5,609.38,78.57,726.31,19
CDM,66762_1,Creation of opening of iris for eye fluid drainage using a laser,1075.0,698.75,78.57,1302.25,19
CDM,66770_1,Destruction of growth of iris using a laser,1308.3,850.4,78.57,1462.76,19
CDM,6677IP _1,"INJECTION, PROTAMINE SULFATE, PER 10 MG",45.78,29.76,1.66,118.23,17
CDM,6677OP _1,"INJECTION, PROTAMINE SULFATE, PER 10 MG",7.83,5.09,1.66,20.22,17
CDM,66820_1,Removal of recurring cataract in lens capsule by stab incision,1033.2,671.58,78.57,1217.19,19
CDM,66821_1,Removal of recurring cataract in lens capsule using a laser,1030.5,669.83,78.57,941.02,19
CDM,66825_1,Repositioning of lens prosthesis,2855.55,1856.11,78.57,2326.9,19
CDM,66830_1,Removal of recurring cataract in lens capsule with sectioning of cornea and scleral areas,1793.4,1165.71,78.57,2151.03,19
CDM,66840_1,Aspiration of lens material by aspiration,3203.55,2082.31,78.57,2113.2,19
CDM,66850_1,Aspiration of lens material by fragmenting and aspiration,3729.6,2424.24,78.57,2405.17,19
CDM,66852_1,Removal of lens material,3625.65,2356.67,78.57,2563.24,19
CDM,66920_1,Removal of lens material and capsule,2217.6,1441.44,78.57,2287.18,19
CDM,66930_1,Removal of lens material and capsule for dislocated lens,2465.4,1602.51,78.57,2600.09,19
CDM,66940_1,Removal of lens material and portion of lens capsule,2315.3,1504.95,78.57,2373.75,19
CDM,66982_1,Complex removal of cataract with insertion of prosthetic lens,4071.45,2646.44,78.57,2290.95,19
CDM,66983_1,Removal of cataract and capsule with insertion of prosthetic lens,2520.0,1638.0,78.57,2264.35,15
CDM,66984_1,Removal of cataract with insertion of prosthetic lens,3646.2,2370.03,78.57,1780.87,19
CDM,66985_1,Insertion of prosthetic lens,3252.45,2114.09,78.57,2333.86,19
CDM,66986_1,Exchange of prosthetic lens,3556.35,2311.63,78.57,2759.11,19
CDM,66989_1,Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye,1929.0,1253.85,78.57,2630.2,19
CDM,66990_1,Exam of eye using an endoscope,216.33,140.61,66.65,272.63,19
CDM,66991_1,Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye,1539.0,1000.35,78.57,2098.89,19
CDM,66999AA_1,Other procedure on front of eye,4887.5,3176.88,73.6,5034.13,15
CDM,66999AB_1,Other procedure on front of eye,5750.0,3737.5,73.6,5922.5,15
CDM,66999AC_1,Other procedure on front of eye,6267.5,4073.88,73.6,6455.53,15
CDM,66999A_1,Other procedure on front of eye,400.0,260.0,73.6,412.0,15
CDM,66999B_1,Other procedure on front of eye,820.0,533.0,73.6,844.6,15
CDM,66999C_1,Other procedure on front of eye,1230.0,799.5,73.6,1266.9,15
CDM,66999D_1,Other procedure on front of eye,1865.0,1212.25,73.6,1920.95,15
CDM,66999E_1,Other procedure on front of eye,410.0,266.5,73.6,422.3,15
CDM,66999F_1,Other procedure on front of eye,1025.0,666.25,73.6,1055.75,15
CDM,66999G_1,Other procedure on front of eye,1435.0,932.75,73.6,1478.05,15
CDM,66999H_1,Other procedure on front of eye,820.0,533.0,73.6,844.6,15
CDM,66999I_1,PHOTOREFRACTIVE KERATECTOMY (PRK),1846.0,1199.9,73.6,1901.38,15
CDM,66999J_1,Other procedure on front of eye,820.0,533.0,73.6,844.6,15
CDM,66999L_1,Other procedure on front of eye,2050.0,1332.5,73.6,2111.5,15
CDM,66999N_1,LASER IN SITU KERATOMILEUSIS (LASIK),1846.0,1199.9,73.6,1901.38,15
CDM,66999P_1,Other procedure on front of eye,2200.0,1430.0,73.6,2266.0,15
CDM,66999R_1,Other procedure on front of eye,1718.75,1117.19,73.6,1770.31,15
CDM,66999S_1,Other procedure on front of eye,1718.75,1117.19,73.6,1770.31,15
CDM,67005_1,Partial removal of eye fluid between lens and retina,2913.75,1893.94,78.57,1432.47,19
CDM,67010_1,Partial removal of eye fluid between lens and retina with mechanical removal of eye fluid,3354.75,2180.59,78.57,1645.92,19
CDM,67015_1,Aspiration or release of eye fluid between lens and retina,2184.6,1419.99,78.57,1767.01,19
CDM,67025_1,Injection of synthetic eye fluid,2959.5,1923.68,78.57,1933.62,19
CDM,67027_1,Implantation of eye drug delivery system,4625.85,3006.8,78.57,2588.7,19
CDM,67028_1,Injection of drug into eye,375.0,243.75,71.27,475.47,19
CDM,67030_1,Cutting of strands of eye fluid between lens and retina,1357.7,882.51,78.57,1618.96,19
CDM,67031_1,Release of scar tissue between lens and retina using a laser,3150.0,2047.5,78.57,1080.91,19
CDM,67036_1,Removal of eye fluid (vitreous) between lens and retina,5670.0,3685.5,78.57,2735.49,19
CDM,67039_1,Destruction of eye fluid (vitreous) between lens and retina using a laser,5512.5,3583.13,78.57,2930.87,19
CDM,67040_1,Destruction of eye fluid (vitreous) between lens and retina and all of retina using a laser,6722.1,4369.37,78.57,3168.58,19
CDM,67041_1,Removal of membrane of retina,5080.95,3302.62,78.57,3502.19,19
CDM,67042_1,Removal of membrane of retina with removal of internal limiting membrane of retina,6352.05,4128.83,78.57,3502.19,19
CDM,67043_1,Removal of membrane of retina with removal of subretinal membrane,4071.9,2646.74,78.57,3696.83,19
CDM,67101_1,Repair of detached retina by cold treatment,1300.0,845.0,78.57,1590.06,19
CDM,67105_1,Repair of detached retina using a laser,2131.5,1385.48,78.57,1431.05,19
CDM,67107_1,Repair of detached retina and drainage of eye fluid between lens and retina,5235.3,3402.95,78.57,3442.45,19
CDM,67108_1,Repair of detached retina with drainage and removal of eye fluid between lens and retina,7572.6,4922.19,78.57,3647.83,19
CDM,67110_1,Repair of detached retina by injection of air or gas,2400.0,1560.0,78.57,2466.0,19
CDM,67113_1,Complex repair of detached retina and drainage of eye fluid between lens and retina,6687.45,4346.84,78.57,4071.82,19
CDM,67115_1,Release of material used for retina repair,1231.7,800.61,78.57,1512.61,19
CDM,67120744_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",982.8,638.82,182.26,2538.08,19
CDM,67120_1,Removal of implant material from outside of eye,3019.35,1962.58,78.57,1701.94,19
CDM,67121_1,Removal of implant material from inside of eye,3435.15,2232.85,78.57,2756.92,19
CDM,67141_1,Heat or freezing treatment to prevent detachment of retina,1458.5,948.03,78.57,686.91,19
CDM,67145_1,Photocoagulation treatment to prevent detachment of retina,1500.0,975.0,78.57,915.88,19
CDM,6714IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.75,2.44,0.94,9.68,16
CDM,6714OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.7,11.51,4.43,45.71,16
CDM,6715IP _1,UNCLASSIFIED DRUGS,3.75,2.44,0.94,9.68,16
CDM,6715OP _1,UNCLASSIFIED DRUGS,10.1,6.57,2.53,26.08,16
CDM,67198625_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",982.8,638.82,182.26,2538.08,19
CDM,67208_1,Destruction of growth of retina by heat or freezing,1503.6,977.34,78.57,1753.52,19
CDM,67210_1,Destruction of growth of retina using a laser,1500.0,975.0,78.57,1515.93,19
CDM,67218_1,Destruction of growth of retina by implantation of radiation source,5378.7,3496.16,78.57,4216.01,19
CDM,67220_1,Destruction of vascular growth between retina and sclera by photocoagulation,4054.05,2635.13,78.57,1515.93,19
CDM,67221_1,Destruction of vascular growth between retina and sclera by photodynamic therapy,997.5,648.38,78.57,654.95,19
CDM,67225_1,Destruction of vascular growth between retina and sclera by photodynamic therapy for second eye at 1 session,997.5,648.38,20.8,85.05,19
CDM,67227_1,Destruction of leaking blood vessels of retina,1527.8,993.07,78.57,954.04,19
CDM,67228_1,Destruction of leaking blood vessels of retina using laser,3169.5,2060.18,78.57,932.15,19
CDM,67229_1,"Destruction of leaking blood vessels of retina, preterm infant",6300.0,4095.0,78.57,3543.22,19
CDM,67250_1,Repair of defect of sclera,2034.9,1322.69,78.57,2409.64,19
CDM,67255_1,Repair of defect of sclera with graft,2351.0,1528.15,78.57,2070.45,19
CDM,67311_1,Realignment of horizontal eye muscle,2464.95,1602.22,78.57,1482.54,19
CDM,67312_1,Realignment of eye by repair of 2 horizontal muscles,3017.7,1961.51,78.57,2044.84,19
CDM,67314_1,Realignment of vertical eye muscle,2608.2,1695.33,78.57,1692.6,19
CDM,67316_1,Realignment of multiple vertical eye muscles,3405.15,2213.35,78.57,2188.12,19
CDM,67318_1,Realignment of eye muscle at upper inner edge of eye,1975.1,1283.82,78.57,2116.12,19
CDM,67320_1,Relocation of eye muscle to restore function,1486.8,966.42,78.57,1208.45,19
CDM,67331_1,Realignment of eye muscle following injury or eye surgery,1000.0,650.0,78.57,954.04,19
CDM,67332_1,Realignment of eye muscle complicated by scarring or restrictive muscle movement,1946.7,1265.36,78.57,1272.05,19
CDM,67334_1,Realignment of eye muscle by suture,1171.8,761.67,78.57,954.04,19
CDM,67335_1,Placement of adjustable sutures during eye muscle surgery,863.1,561.02,78.57,493.16,19
CDM,67340_1,Realignment and repair of detached eye muscle,1287.3,836.75,78.57,1208.45,19
CDM,67343_1,Release of extensive scar tissue of eye,2079.0,1351.35,78.57,1976.23,19
CDM,67345_1,Destruction of eye muscle by injection of chemical,1008.0,655.2,78.57,654.02,19
CDM,67346_1,Biopsy of eye muscle,693.15,450.55,78.57,585.31,19
CDM,6738IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.77,24.55,9.44,97.54,16
CDM,67400_1,Exploration of cavity behind eye,3523.35,2290.18,78.57,2852.31,19
CDM,67405_1,Incision and drainage of cavity behind eye,2995.65,1947.17,78.57,2423.99,19
CDM,67412_1,Removal of growth of cavity behind eye,3425.7,2226.71,78.57,2625.1,19
CDM,67413_1,Removal of foreign body in cavity behind eye,3586.35,2331.13,78.57,2626.57,19
CDM,67414_1,Removal of bone cavity behind eye for decompression,5044.8,3279.12,78.57,4064.44,19
CDM,67415_1,Fine needle aspiration of orbital contents,527.7,343.01,77.71,317.15,19
CDM,67420_1,Removal of bone and growth of cavity behind eye,6498.45,4223.99,78.57,4927.25,19
CDM,67430_1,Removal of bone and foreign body in cavity behind eye,4885.65,3175.67,78.57,3829.48,19
CDM,67440_1,Removal of bone with drainage from cavity behind eye,3285.5,2135.58,78.57,3705.93,19
CDM,67445_1,Removal of bone from cavity behind eye with bone flap,3599.4,2339.61,78.57,4300.56,19
CDM,6744IP _1,"INJECTION, PYRIDOXINE HCL, 100 MG",189.83,123.39,16.49,490.24,17
CDM,67450_1,Exploration of cavity behind eye with bone flap,5024.25,3265.76,78.57,3851.96,19
CDM,6748IP _1,UNCLASSIFIED DRUGS,3.33,2.16,0.83,8.6,16
CDM,6748OP _1,UNCLASSIFIED DRUGS,21.52,13.99,5.38,55.58,16
CDM,67500_1,Injection of drug into cavity behind eye,352.8,229.32,52.37,194.78,19
CDM,67505_1,Injection of alcohol into cavity behind eye,255.2,165.88,55.14,222.85,19
CDM,67515_1,Injection of drug or substance into membrane covering eyeball,270.0,175.5,36.24,145.01,19
CDM,67516_1,Injection of drug into the space between the cornea and retina in the eye,240.0,156.0,75.33,301.95,19
CDM,67550T_1,Insertion of implant outside eye muscles,2850.5,1852.83,78.57,2957.45,19
CDM,67550_1,Insertion of implant outside eye muscles,3666.6,2383.29,78.57,2957.45,19
CDM,67560_1,Removal or revision of implant outside eye muscles,2494.8,1621.62,78.57,3033.63,19
CDM,67570_1,Release of optic nerve,4403.7,2862.41,78.57,3540.27,19
CDM,67700_1,Incision and drainage of abscess of eyelid,787.5,511.88,54.83,686.15,19
CDM,67710_1,Removal of sutures between upper and lower eyelids,826.95,537.52,36.54,585.9,19
CDM,67715_1,Incision of corner of eye at eyelid,900.0,585.0,59.46,634.85,19
CDM,6777IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",80.04,52.03,20.01,206.7,16
CDM,67800T_1,Removal of chronic growth of eyelid,525.0,341.25,78.57,314.23,19
CDM,67800_1,Removal of chronic growth of eyelid,375.0,243.75,77.15,314.23,19
CDM,67801_1,Removal of multiple chronic growths of same eyelid,858.9,558.29,78.57,404.57,19
CDM,67805_1,Removal of multiple chronic growths of different eyelids,905.1,588.32,78.57,502.22,19
CDM,67808_1,Removal of chronic eyelid growth under general anesthesia and/or requiring hospitalization,915.6,595.14,78.57,1111.86,19
CDM,67810_1,Biopsy of eyelid,861.6,560.04,35.08,446.32,19
CDM,67820_1,Removal of eyelashes using forceps,187.5,121.88,17.7,78.57,19
CDM,67825_1,Removal of eyelashes,405.0,263.25,75.69,368.72,19
CDM,67830_1,Removal of eyelashes by incision,1119.3,727.55,49.27,651.15,19
CDM,67835_1,Removal of eyelashes with graft,1140.3,741.2,78.57,1330.42,19
CDM,67840_1,Removal of growth of eyelid,900.0,585.0,78.57,677.06,19
CDM,67850_1,"Destruction of growth of eyelid margin, 1.0 cm or less",690.9,449.09,78.57,523.91,19
CDM,67875_1,Temporary closure of eyelids by suture,1246.5,810.23,64.68,439.06,19
CDM,67880_1,Creation of permanent eyelid margin scarring,1869.6,1215.24,78.57,1126.53,19
CDM,67882_1,Creation of permanent eyelid margin scarring with relocation of eyelid tissue,2253.9,1465.04,78.57,1441.66,19
CDM,67900T_1,Repair of brow paralysis,2443.4,1588.21,78.57,1562.87,19
CDM,67900_1,Repair of brow paralysis,2420.85,1573.55,78.57,1562.87,19
CDM,67901_1,Repair of upper eyelid muscle to correct drooping or paralysis using external material,2663.4,1731.21,78.57,1918.11,19
CDM,67902_1,Repair of upper eyelid muscle to correct drooping or paralysis using internal tissues,1865.9,1212.84,78.57,2189.86,19
CDM,67903T_1,Shortening or advancement of upper eyelid muscle to correct drooping or paralysis,2443.4,1588.21,78.57,1473.66,19
CDM,67903_1,Shortening or advancement of upper eyelid muscle to correct drooping or paralysis,2308.95,1500.82,78.57,1473.66,19
CDM,67904T_1,Repair of tendon of upper eyelid,2443.4,1588.21,78.57,1824.04,19
CDM,67904_1,Repair of tendon of upper eyelid,2743.65,1783.37,78.57,1824.04,19
CDM,67906_1,Suspension of upper eyelid muscle to correct drooping or paralysis,1980.3,1287.2,78.57,1543.08,19
CDM,67908_1,"Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis",1708.4,1110.46,78.57,1326.08,19
CDM,67909_1,Revision of surgery to correct drooping or paralyzed upper eyelid,1486.8,966.42,78.57,1340.97,19
CDM,67911T_1,Correction of widely-opened upper eyelid,2443.4,1588.21,78.57,1703.72,19
CDM,67911_1,Correction of widely-opened upper eyelid,2109.0,1370.85,78.57,1703.72,19
CDM,67912T_1,Restoration of eyelid blinking function with implant,2443.4,1588.21,78.57,2175.35,19
CDM,67912_1,Restoration of eyelid blinking function with implant,3480.75,2262.49,78.57,2175.35,19
CDM,67914_1,Suture repair of turning-outward upper or lower eyelid defect,1167.6,758.94,78.57,1176.25,19
CDM,67915_1,Repair of turning-outward defect of upper or lower eyelid using heat,998.6,649.09,78.57,762.68,19
CDM,67916T_1,Repair of turning-outward eyelid defect,2443.4,1588.21,78.57,1470.58,19
CDM,67916_1,Repair of turning-outward eyelid defect,1544.6,1003.99,78.57,1470.58,19
CDM,67917T_1,Extensive repair of turning-outward eyelid defect,2443.4,1588.21,78.57,1503.95,19
CDM,67917_1,Extensive repair of turning-outward eyelid defect,2590.95,1684.12,78.57,1503.95,19
CDM,67921T_1,Suture repair of turning-inward eyelid defect,2443.4,1588.21,78.57,1152.41,19
CDM,67921_1,Suture repair of turning-inward eyelid defect,1546.7,1005.36,78.57,1152.41,19
CDM,67922_1,Repair of turning-inward eyelid defect using heat,982.8,638.82,78.57,740.29,19
CDM,67923_1,Repair of turning-inward eyelid defect,1506.8,979.42,78.57,1471.38,19
CDM,67924_1,Extensive repair of turning-inward eyelid defect,2209.8,1436.37,78.57,1565.84,19
CDM,67930_1,Suture of recent wound of eyelid,1085.7,705.71,78.57,893.15,19
CDM,67935T_1,Repair of wound of eyelid margin,2443.4,1588.21,78.57,1440.15,19
CDM,67935_1,Repair of wound of eyelid margin,2874.45,1868.39,78.57,1440.15,19
CDM,67938_1,Removal of embedded foreign body in eyelid,1065.0,692.25,27.12,658.59,19
CDM,67950T_1,Reconstruction of eyelid margin,1380.8,897.52,78.57,1414.08,19
CDM,67950_1,Reconstruction of eyelid margin,1785.0,1160.25,78.57,1414.08,19
CDM,67961_1,Removal of up to 1/4 of eyelid margin and repair of eyelid,2172.0,1411.8,78.57,1415.61,19
CDM,67966_1,Removal of over 1/4 of eyelid margin and repair of eyelid,2888.55,1877.56,78.57,2004.95,19
CDM,67971_1,Reconstruction of up to 2/3 of eyelid with tissue from opposite eyelid,2893.35,1880.68,78.57,2195.98,19
CDM,67973_1,Reconstruction of lower eyelid by transfer of eyelid tissue from opposite eyelid,3649.35,2372.08,78.57,2826.68,19
CDM,67974_1,Reconstruction of upper eyelid with tissue from opposite eyelid,2594.6,1686.49,78.57,2822.81,19
CDM,67975_1,Reconstruction of eyelid by transfer of eyelid tissue from opposite eyelid,2638.2,1714.83,78.57,2076.83,19
CDM,679IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.96,9.07,3.49,36.05,16
CDM,679OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.46,23.7,9.12,94.16,16
CDM,68020_1,Incision and drainage of cyst of eye,1164.0,756.6,47.42,336.29,19
CDM,68040_1,Removal of scars of eyelid lining due to infection,532.4,346.06,36.04,150.46,19
CDM,68100_1,Biopsy of eyelid lining,1178.1,765.77,76.31,434.02,19
CDM,68110_1,"Removal of growth of eyelid lining, 1.0 cm or less",787.5,511.88,78.57,570.17,19
CDM,68115_1,"Removal of growth of eyelid lining, more than 1.0 cm",923.0,599.95,78.57,802.0,19
CDM,68130_1,Removal of growth of eyelid lining and sclera,1344.0,873.6,78.57,1328.82,19
CDM,68135_1,Destruction of growth of eyelid lining,962.4,625.56,78.57,456.24,19
CDM,681IP _1,UNCLASSIFIED DRUGS,14.15,9.2,3.54,36.54,16
CDM,681OP _1,UNCLASSIFIED DRUGS,47.89,31.13,11.97,123.68,16
CDM,68200_1,Injection into conjunctiva,436.35,283.63,27.33,105.05,19
CDM,68320_1,Repair of eyelid lining with graft from external eye,2671.2,1736.28,78.57,1788.42,19
CDM,68325_1,Repair of conjunctiva with graft from cheek tissue,1758.8,1143.22,78.57,1995.55,19
CDM,68326_1,Reconstruction of conjunctiva with graft from outer eye or rearrangement,2531.1,1645.22,78.57,1957.28,19
CDM,68328_1,Reconstruction of conjunctiva with graft from cheek,2852.4,1854.06,78.57,2144.97,19
CDM,68330_1,Release of scar tissue from conjunctiva,1497.3,973.25,78.57,1500.05,19
CDM,68335_1,Release of scar tissue from eyelids with graft,2434.95,1582.72,78.57,1964.96,19
CDM,68340_1,Release of scar tissue from eyelids,1392.3,905.0,78.57,1452.89,19
CDM,68360_1,Partial relocation of conjunctival flap,1315.7,855.21,78.57,1306.66,19
CDM,68362_1,Relocation of conjunctival flap,1646.4,1070.16,78.57,1991.92,19
CDM,68371_1,Harvest of donor conjunctiva,977.7,635.51,78.57,1251.41,19
CDM,68400_1,Incision and drainage of tear producing gland,824.3,535.8,64.44,716.6,19
CDM,68420_1,Incision and drainage of tear duct sac,911.4,592.41,68.66,800.76,19
CDM,68440_1,Snip incision of tear duct at inner corner of eye,1113.6,723.84,75.98,298.41,19
CDM,68500_1,Removal of tear producing gland,2451.8,1593.67,78.57,2975.0,19
CDM,68505_1,Partial removal of tear producing gland,2464.4,1601.86,78.57,2960.63,19
CDM,68510_1,Biopsy of tear producing gland,750.0,487.5,78.57,1090.16,19
CDM,68520_1,Removal of tear sac,1733.6,1126.84,78.57,2086.58,19
CDM,68525_1,Biopsy of tear sac,708.8,460.72,78.57,795.48,19
CDM,68530_1,Removal of foreign body or stone in tear passages,1179.2,766.48,78.57,1045.93,19
CDM,68540_1,Removal of growth of tear producing gland,2343.6,1523.34,78.57,2829.84,19
CDM,68550_1,Removal of growth of tear producing gland with osteotomy,2877.0,1870.05,78.57,3473.29,19
CDM,685IP _1,UNCLASSIFIED DRUGS,3.11,2.02,0.78,8.03,16
CDM,685OP _1,UNCLASSIFIED DRUGS,18.02,11.71,4.51,46.54,16
CDM,68700_1,Plastic repair of tear duct,2269.65,1475.27,78.57,1831.95,19
CDM,68705_1,Release of tissue at tear duct opening,675.2,438.88,65.94,632.45,19
CDM,68720_1,Creation of drainage tract from tear sac to nasal cavity,3559.5,2313.68,78.57,2302.5,19
CDM,68745_1,Creation of tear drainage tract to nasal cavity,3175.2,2063.88,78.57,2315.34,19
CDM,68750_1,Creation of tear drainage tract to nasal cavity with insertion of tube or stent,3543.75,2303.44,78.57,2395.39,19
CDM,68760_1,"Repair tear duct opening by heat, tying, or laser surgery",1085.25,705.41,67.98,531.5,19
CDM,68761_1,Closure of tear duct opening using plug,637.5,414.38,78.57,362.56,19
CDM,68770_1,Closure of abnormal tear drainage tract,2698.05,1753.73,78.57,1908.95,19
CDM,68801_1,Dilation of tear drainage opening,565.5,367.58,53.72,240.89,19
CDM,68810_1,Insertion of probe into nasal tear duct,965.55,627.61,78.57,390.49,19
CDM,68811_1,Insertion of probe into nasal tear duct under anesthesia,516.6,335.79,78.57,411.94,19
CDM,68815_1,Probing of nasal tear duct with insertion of tube or stent,1200.0,780.0,78.57,906.4,19
CDM,68816_1,Probing of nasal tear duct with balloon tube dilation,1670.6,1085.89,78.57,2065.26,19
CDM,68840_1,Probing of nasal tear duct,375.0,243.75,57.81,357.53,19
CDM,68841_1,Insertion of drug delivery implant into tear duct of eye,73.0,47.45,25.79,91.77,19
CDM,68850_1,Injection of contrast for imaging of tear sac,1483.7,964.41,39.55,160.36,19
CDM,688IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.2,2.73,1.05,10.85,16
CDM,688OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.27,17.08,6.57,67.84,16
CDM,69000_1,Simple drainage of abscess or blood accumulation of external ear,705.0,458.25,52.98,448.95,19
CDM,69005_1,Complicated drainage of external ear abscess or blood accumulation,847.35,550.78,78.57,527.78,19
CDM,69020_1,Drainage of abscess of ear canal,600.6,390.39,77.92,566.66,19
CDM,69090T_1,Piercing of ear,64.1,41.67,28.85,89.97,15
CDM,69090_1,Piercing of ear,116.6,75.79,29.76,120.1,15
CDM,69100_1,Biopsy of ear,273.0,177.45,24.1,232.29,19
CDM,69105_1,Biopsy of ear canal,549.75,357.34,35.19,350.54,19
CDM,69110T_1,Partial removal of external ear with simple repair,2100.0,1365.0,78.57,1134.53,19
CDM,69110_1,Partial removal of external ear with simple repair,1798.65,1169.12,78.57,1134.53,19
CDM,69120_1,Removal of entire ear,1612.8,1048.32,78.57,1183.02,19
CDM,69140_1,Removal of bony growths of ear canal,2332.1,1515.87,78.57,2613.2,19
CDM,69145_1,Removal of growth in soft tissue of ear canal,1524.6,990.99,78.57,995.69,19
CDM,69150_1,Removal of growth of ear canal,4310.85,2802.05,78.57,3075.62,19
CDM,69155_1,Removal of growth of ear canal with neck dissection,4630.5,3009.83,78.57,4919.63,19
CDM,69200_1,Removal of foreign body in ear canal,375.0,243.75,23.51,192.25,19
CDM,69205_1,Removal of foreign body in ear canal under anesthesia,315.0,204.75,78.57,290.87,19
CDM,69209_1,Removal of impacted ear wax by washing,43.5,28.28,15.54,78.57,19
CDM,69210_1,Removal of impacted ear wax,120.0,78.0,25.21,113.63,19
CDM,69220_1,Simple removal of skin debris and drainage of mastoid cavity,537.15,349.15,11.6,187.34,19
CDM,69222_1,Complex removal of skin debris and drainage of mastoid cavity,863.1,561.02,59.28,522.41,19
CDM,69300T_1,Repair of protruding ear,3126.9,2032.49,78.57,1564.88,19
CDM,69300_1,Repair of protruding ear,2905.95,1888.87,78.57,1564.88,19
CDM,69310T_1,Reconstruction of ear canal,5200.7,3380.46,78.57,3240.17,19
CDM,69310_1,Reconstruction of ear canal,4380.15,2847.1,78.57,3240.17,19
CDM,69320_1,Creation of ear canal,4174.8,2713.62,78.57,4550.84,19
CDM,693IP _1,UNCLASSIFIED DRUGS,12.35,8.03,3.09,31.89,16
CDM,693OP _1,UNCLASSIFIED DRUGS,25.29,16.44,6.32,65.31,16
CDM,69420_1,"Incision, aspiration, and/or inflation of eardrum",642.6,417.69,51.85,461.71,19
CDM,69421_1,"Incision, aspiration, and inflation of eardrum under anesthesia",615.9,400.34,78.57,440.68,19
CDM,69424_1,Removal of implanted eardrum tube under anesthesia,508.8,330.72,25.48,309.31,19
CDM,69433_1,Incision of eardrum with insertion of eardrum tube under local or topical anesthesia,779.7,506.81,78.57,487.83,19
CDM,69436_1,Incision of eardrum with placement of eardrum tube under general anesthesia,902.55,586.66,78.57,471.93,19
CDM,69440_1,Exploration of middle ear,2772.0,1801.8,78.57,2042.52,19
CDM,69450_1,Incision of ear canal with release of scar tissue,1273.63,827.86,78.57,1616.63,19
CDM,69501_1,Incision of mastoid bone,2003.4,1302.21,78.57,2155.3,19
CDM,69502_1,Removal of middle ear (mastoid) bone,3978.45,2585.99,78.57,2859.98,19
CDM,69505_1,Removal of middle ear bone and removal of growth of middle ear,3399.9,2209.94,78.57,3582.33,19
CDM,69511_1,Extensive removal of mastoid bone,3675.0,2388.75,78.57,3670.3,19
CDM,69530_1,Extensive removal of bones around inner ear and mastoid bone,7087.5,4606.88,78.57,4924.52,19
CDM,69535_1,Removal of skull bone surrounding ear,11110.05,7221.53,78.57,7991.63,19
CDM,69540_1,Removal of polyp of outer ear,541.8,352.17,42.31,511.87,19
CDM,69550_1,Removal of growth of outer ear through ear canal,2974.7,1933.56,78.57,3097.78,19
CDM,69552_1,Removal of growth of outer ear through mastoid bone,3689.45,2398.14,78.57,4675.94,19
CDM,69554_1,Removal of growth of outer ear,6888.0,4477.2,78.57,7512.02,19
CDM,69601_1,Revision of operation of middle ear bones and removal of remaining bones,4288.8,2787.72,78.57,3084.13,19
CDM,69602_1,Revision of previous mastoid bone surgery,3093.3,2010.65,78.57,3235.11,19
CDM,69603_1,Extensive revision of previous mastoid bone surgery,3550.1,2307.57,78.57,3753.47,19
CDM,69604_1,Revision of operation of middle ear and eardrum,3425.1,2226.32,78.57,3308.26,19
CDM,69610_1,Repair of eardrum,1589.25,1033.01,71.5,922.03,19
CDM,69620_1,Repair of defect or tear of eardrum,3176.85,2064.95,78.57,1794.75,19
CDM,69631_1,Repair of eardrum and ear canal with opening to ear bones,4629.0,3008.85,78.57,2626.02,19
CDM,69632_1,"Repair of eardrum, ear canal, and bones",3481.8,2263.17,78.57,3203.07,19
CDM,69633_1,"Repair of eardrum, ear canal, and bones with insertion of prosthesis",5473.2,3557.58,78.57,3103.08,19
CDM,69635_1,Repair of eardrum and ear canal with incision of middle ear bone,5392.8,3505.32,78.57,3684.6,19
CDM,69636_1,"Repair of eardrum, ear canal, and bones with incision of middle ear bone",3910.2,2541.63,78.57,4110.12,19
CDM,69637_1,"Repair of eardrum, ear canal, and bones with placement of implant and opening of middle ear",5863.8,3811.47,78.57,4151.1,19
CDM,69641_1,Complex repair of eardrum and ear canal with removal of mastoid bone,6177.15,4015.15,78.57,3095.61,19
CDM,69642_1,"Repair of eardrum, ear canal, and bones with removal of middle ear bone",6759.9,4393.94,78.57,3977.94,19
CDM,69643_1,Repair of eardrum and ear canal with removal of middle ear bone,4280.9,2782.59,78.57,3635.35,19
CDM,69644_1,"Repair of eardrum, ear canal, and bones with removal of mastoid bone, with intact canal wall",6552.0,4258.8,78.57,4407.15,19
CDM,69645_1,Extensive repair of eardrum and ear canal with removal of middle ear bone,6244.95,4059.22,78.57,4328.03,19
CDM,69646_1,Extensive repair and reconstruction of eardrum and ear canal with removal of middle ear bone,6315.75,4105.24,78.57,4606.2,19
CDM,69650_1,Release of ear bone,2193.5,1425.78,78.57,2387.03,19
CDM,69660_1,Incision or removal of middle ear bone,3422.0,2224.3,78.57,2754.34,19
CDM,69661_1,Incision or removal of ear bone with drilling,5370.75,3490.99,78.57,3590.84,19
CDM,69662_1,Revision of operation of ear bone,5731.5,3725.48,78.57,3441.6,19
CDM,69666_1,Repair of opening of middle to inner ear,2828.7,1838.66,78.57,2400.86,19
CDM,69667_1,Repair of opening to cochlea,2788.8,1812.72,78.57,2407.63,19
CDM,69670_1,Creation of flap to close mastoid cavity,3849.3,2502.05,78.57,2803.26,19
CDM,69676_1,Removal of eardrum nerve,2428.7,1578.66,78.57,2467.54,19
CDM,69700_1,Closure of drainage tract of middle ear,1883.7,1224.41,78.57,2017.14,19
CDM,69705_1,"Dilation of canal between middle ear and throat (eustachian tube) on one side of body, using endoscope inserted through nose",405.0,263.25,78.57,6644.38,19
CDM,69706_1,"Dilation of canal between middle ear and throat (eustachian tube) on both sides of body, using endoscope inserted through nose",564.75,367.09,78.57,6868.22,19
CDM,69710_1,Insertion or replacement of ear bone hearing device,2625.0,1706.25,73.6,1312.5,15
CDM,69711_1,Removal or repair of hearing device in skull bone surrounding ear,2359.4,1533.61,78.57,2538.88,19
CDM,69714_1,Implantation of cochlear stimulating system into skull with attachment through skin to external speech processor,4441.5,2886.98,78.57,1995.95,19
CDM,69716_1,Implantation of cochlear stimulating system into mastoid bone of skull with magnetic attachment to external speech processor,1402.0,911.3,78.57,1912.01,19
CDM,69717_1,Replacement of cochlear stimulating system in skull with attachment through skin to external speech processor,3143.7,2043.41,78.57,2014.02,19
CDM,69719_1,Replacement of cochlear stimulating system into mastoid bone of skull with magnetic attachment to external speech processor,1402.0,911.3,78.57,1912.01,19
CDM,69720_1,Release of face nerve through side,4803.75,3122.44,78.57,3549.09,19
CDM,69725_1,Release of face nerve through bone surrounding ear,5243.7,3408.41,78.57,5599.25,19
CDM,69726_1,Removal of entire cochlear stimulating system from skull with attachment through skin to external speech processor,951.0,618.15,78.57,1259.22,19
CDM,69727_1,Removal of entire cochlear stimulating system from mastoid bone of skull with magnetic attachment to external speech processor,1089.0,707.85,78.57,1441.72,19
CDM,69728_1,Removal of entire cochlear stimulating system from outside mastoid bone of skull with magnetic attachment to external speech processor,1339.0,870.35,78.57,1654.79,19
CDM,69729_1,Implantation of cochlear stimulating system outside mastoid bone of skull with magnetic attachment to external speech processor,1517.5,986.38,78.57,1874.79,19
CDM,69730_1,Replacement of cochlear stimulating system outside mastoid bone of skull with magnetic attachment to external speech processor,1551.5,1008.48,78.57,1917.16,19
CDM,69740_1,Repair of facial nerve external to geniculate ganglion,3977.4,2585.31,78.57,3472.6,19
CDM,69745_1,Repair of facial nerve internal to geniculate ganglion,2786.18,1811.02,78.57,3695.61,19
CDM,69801_1,Incision of fluid canal of inner ear with infusion of drugs,1615.5,1050.08,78.57,1335.65,19
CDM,69805_1,Operation of inner ear,3480.8,2262.52,78.57,3117.62,19
CDM,69806_1,Operation of inner ear with insertion of shunt,5722.05,3719.33,78.57,2784.92,19
CDM,69905_1,Removal of inner ear canal,3192.0,2074.8,78.57,2725.97,19
CDM,69910_1,Removal of inner ear canal and mastoid bone,5857.5,3807.38,78.57,3003.46,19
CDM,69915_1,Severing of ear canal nerve through middle ear and skull bones,4200.0,2730.0,78.57,4559.11,19
CDM,69930_1,Insertion of cochlear device,6939.45,4510.64,78.57,3645.06,19
CDM,69950_1,Severing of ear canal nerve through skull bone,5070.5,3295.83,78.57,5291.57,19
CDM,69955_1,Release of face nerve,5781.3,3757.85,78.57,5889.18,19
CDM,69960_1,Release of ear canal,8150.7,5297.96,78.57,5712.21,19
CDM,69970_1,Removal of growth from skull bone surrounding ear,7598.9,4939.29,78.57,6383.88,19
CDM,69990T_1,Use of operating microscope,1334.6,867.49,78.57,1374.64,19
CDM,69990_1,Use of operating microscope,780.0,507.0,78.57,803.4,19
CDM,70006536_1,Ultrasound scan of head and neck soft tissue,461.0,299.65,115.25,1190.53,18
CDM,70010_1,Review by radiologist of lower back portion of brain image,570.2,370.63,32.53,229.24,19
CDM,70015_1,Review by radiologist of brain and spinal cord image,421.1,273.72,52.27,135.37,19
CDM,70030_1,X-ray of eye for detection of foreign body,83.0,53.95,8.3,78.57,19
CDM,70072285_1,Review by radiologist of disc of upper or middle spine image,1570.0,1020.5,392.5,4054.53,18
CDM,70072295_1,Review by radiologist of disc of lower spine image,1570.0,1020.5,392.5,4054.53,18
CDM,70073525_1,Review by radiologist of hip joint image,1912.5,1243.13,172.18,4939.03,18
CDM,70074300_1,Review by radiologist of bile and/or pancreatic duct image during surgery,585.0,380.25,146.25,1510.76,18
CDM,70074340_1,Review by radiologist of placement of long small bowel tube,630.0,409.5,157.5,1626.98,18
CDM,70074355_1,Review by radiologist of placement of small bowel tube,2261.0,1469.65,294.16,5839.03,18
CDM,70074360_1,Review by radiologist of image to guide opening of digestive tract,1449.0,941.85,294.16,3742.04,18
CDM,70074363_1,Review by radiologist of image to guide opening of bile duct,4304.0,2797.6,294.16,11115.08,18
CDM,70074400_1,Imaging of urinary tract with injection of contrast into a vein,675.0,438.75,168.75,1743.19,18
CDM,70074420_1,Imaging of urinary tract following injection of a contrast agent,1390.0,903.5,172.18,3589.68,18
CDM,70074425_1,Review by radiologist of upper urinary tract image,675.0,438.75,168.75,1743.19,18
CDM,70074430_1,Review by radiologist of urinary bladder image,715.0,464.75,172.18,1846.49,18
CDM,70074445_1,Review by radiologist of penis image,500.0,325.0,125.0,1291.25,18
CDM,70074450_1,Review by radiologist of urinary bladder and urethra images with contrast,675.0,438.75,168.75,1743.19,18
CDM,70074470_1,Review by radiologist of kidney cyst image,750.0,487.5,172.18,1936.88,18
CDM,70074485_1,Review by radiologist of ureter or urethra image,2500.0,1625.0,294.16,6456.25,18
CDM,70075600_1,Review by radiologist of chest aorta image,3000.0,1950.0,750.0,7747.5,18
CDM,70075605_1,Review by radiologist of chest aorta serial images,11000.0,7150.0,2750.0,28407.5,18
CDM,70075625_1,Review by radiologist of abdominal aorta image,5489.03,3567.87,1372.26,14175.42,18
CDM,70075630_1,Review by radiologist of abdominal aorta and both leg arteries image,6300.0,4095.0,1575.0,16269.75,18
CDM,70075705_1,Review by radiologist of spinal artery image,11000.0,7150.0,2750.0,28407.5,18
CDM,70075710_1,Review by radiologist of arm or leg artery image,8065.0,5242.25,2016.25,20827.86,18
CDM,70075716_1,Review by radiologist of both arms or legs arteries image,8603.72,5592.42,2150.93,22219.11,18
CDM,70075726_1,Review by radiologist of abdominal artery image,11670.0,7585.5,2917.5,30137.78,18
CDM,70075731_1,Review by radiologist of adrenal gland artery image,1700.0,1105.0,425.0,4390.25,18
CDM,70075733_1,Review by radiologist of both adrenal glands arteries image,3400.0,2210.0,850.0,8780.5,18
CDM,70075736_1,Review by radiologist of pelvis artery image,11670.0,7585.5,2917.5,30137.78,18
CDM,70075741_1,Review by radiologist of lung artery image,6820.0,4433.0,1705.0,17612.65,18
CDM,70075743_1,Review by radiologist of arteries of both lungs image,6820.0,4433.0,1705.0,17612.65,18
CDM,70075746_1,Review by radiologist of lung artery image with contrast,3410.0,2216.5,852.5,8806.33,18
CDM,70075756_1,Review by radiologist of breast artery of breast image,7270.0,4725.5,1817.5,18774.78,18
CDM,70075774_1,Review by radiologist of additional artery image,854.0,555.1,213.5,6559.08,18
CDM,70075801_1,Review by radiologist of lymphatic system of arm or leg image,1460.0,949.0,365.0,3770.45,18
CDM,70075803_1,Review by radiologist of lymphatic system of both arms or legs image,1400.0,910.0,350.0,3615.5,18
CDM,70075805_1,Review by radiologist of lymphatic system of side of pelvis and abdomen image,1800.0,1170.0,450.0,4648.5,18
CDM,70075807_1,Review by radiologist of lymphatic system of both side of pelvis and abdomen image,6820.0,4433.0,1705.0,17612.65,18
CDM,70075809_1,Review by radiologist of previous placed shunt image,450.0,292.5,112.5,1162.13,18
CDM,70075810_1,Review by radiologist of spleen and liver vein image,1800.0,1170.0,450.0,4648.5,18
CDM,70075820_1,Review by radiologist of 1 arm or leg vein of 1 arm or leg image,1728.0,1123.2,432.0,4462.56,18
CDM,70075822_1,Review by radiologist of both arms and legs veins of both arms or legs image,2265.0,1472.25,566.25,5849.36,18
CDM,70075825_1,Review by radiologist of major lower body vein image,6820.0,4433.0,1705.0,17612.65,18
CDM,70075827_1,Review by radiologist of major upper body vein image,1728.0,1123.2,432.0,4462.56,18
CDM,70075831_1,Review by radiologist of kidney image,6820.0,4433.0,1705.0,17612.65,18
CDM,70075833_1,Review by radiologist of both kidneys veins image,3000.0,1950.0,750.0,7747.5,18
CDM,70075840_1,Review by radiologist of adrenal gland vein image,2700.0,1755.0,675.0,6972.75,18
CDM,70075842_1,Review by radiologist of both adrenal gland veins image,4500.0,2925.0,1125.0,11621.25,18
CDM,70075860_1,Review by radiologist of head or neck vein system image,6820.0,4433.0,1705.0,17612.65,18
CDM,70075870_1,Review by radiologist of head vein system image,1700.0,1105.0,425.0,4390.25,18
CDM,70075872_1,Review by radiologist of spinal canal vein image,567.0,368.55,141.75,1594.02,18
CDM,70075880_1,Review by radiologist of eye socket vein of eye socket image,1440.0,936.0,360.0,3718.8,18
CDM,70075885_1,Review by radiologist of the vein that transports blood to the liver image with assessment of blood flow,2700.0,1755.0,675.0,6972.75,18
CDM,70075887_1,Review by radiologist of the vein that transports blood to the liver image,2800.0,1820.0,700.0,7231.0,18
CDM,70075889_1,Review by radiologist of liver vein image with assessment of blood flow,6820.0,4433.0,1705.0,17612.65,18
CDM,70075891_1,Review by radiologist of liver vein image,6820.0,4433.0,1705.0,17612.65,18
CDM,70075893_1,Review by radiologist of imaging guidance for removal of blood sample,12000.0,7800.0,3000.0,30990.0,18
CDM,70075894_1,Review by radiologist of image for insertion of material to block blood flow,4500.0,2925.0,294.16,11621.25,18
CDM,70075898_1,Imaging of blood vessel,3100.0,2015.0,775.0,8005.75,18
CDM,70075901_1,Review by radiologist of image for removal of obstructive material,500.0,325.0,125.0,1291.25,18
CDM,70075902_1,Review by radiologist of image for removal of tissue or obstructive material from central venous tube,500.0,325.0,125.0,1291.25,18
CDM,70075970_1,Review by radiologist of image for biopsy of blood vessel with tube,2250.0,1462.5,294.16,5810.63,18
CDM,70075984_1,Review by radiologist of image for replacement of stomach or large bowel tube,900.0,585.0,225.0,2324.25,18
CDM,70075989_1,Review by radiologist of image for drainage of fluid,1800.0,1170.0,294.16,4648.5,18
CDM,70076000_1,"Imaging guidance for procedure, 60 minutes or less",655.0,425.75,163.75,1691.54,18
CDM,70076080_1,Review by radiologist of abscess or sinus cavity study,635.0,412.75,158.75,1639.89,18
CDM,70076232_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,855.0,555.75,213.75,598.5,11
CDM,70076237_1,HC MONITORING ELECTRODE SINGLE,13.0,8.45,3.25,9.1,11
CDM,70076238_1,HC MONITORING ELECTRODE PAIR,21.0,13.65,5.25,14.7,11
CDM,70076377_1,3D radiographic procedure with computerized image postprocessing,1150.0,747.5,287.5,2969.88,16
CDM,70076380_1,Limited or follow-up CT scan,1200.0,780.0,155.26,3099.0,18
CDM,70076496_1,Other fluoroscopic procedure,150.0,97.5,37.5,387.38,18
CDM,70076499_1,Other diagnostic Imaging procedure,605.0,393.25,81.72,1562.41,18
CDM,70076510_1,1D and 2D ultrasound scan of eye tissue and structures,300.0,195.0,75.0,774.75,18
CDM,70076512_1,2D ultrasound scan of eye tissue and structures,450.0,292.5,112.5,1162.13,18
CDM,70076513_1,Ultrasound scan of eye using water bath method,225.0,146.25,56.25,581.06,18
CDM,70076514_1,Ultrasound scan of cornea to determine thickness,50.0,32.5,12.5,129.13,18
CDM,70076519_1,Ultrasound scan to determine eye length and lens power,110.0,71.5,27.5,284.08,18
CDM,70076536_1,Ultrasound scan of head and neck soft tissue,461.0,299.65,115.25,1190.53,18
CDM,70076604_1,Ultrasound scan of chest,600.0,390.0,150.0,1549.5,18
CDM,70076641_1,Complete ultrasound scan of 1 breast,1050.0,682.5,158.99,2711.63,18
CDM,70076642_1,Limited ultrasound scan of 1 breast,825.0,536.25,158.99,2130.56,18
CDM,70076705_1,Limited ultrasound scan of abdomen,511.0,332.15,127.75,1319.66,18
CDM,70076775_1,Limited ultrasound scan behind abdominal cavity,500.0,325.0,125.0,1291.25,18
CDM,70076801_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus",325.0,211.25,81.25,839.31,18
CDM,70076805_1,"Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus",325.0,211.25,81.25,839.31,18
CDM,70076815_1,Limited ultrasound of pregnant uterus,325.0,211.25,81.25,839.31,18
CDM,70076816_1,Follow-up ultrasound scan of pregnant uterus,325.0,211.25,81.25,839.31,18
CDM,70076817_1,Vaginal ultrasound of pregnant uterus,325.0,211.25,81.25,1052.0,19
CDM,70076825_1,Ultrasound scan of fetal heart,1420.0,923.0,146.52,3667.15,18
CDM,70076830_1,"Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina",500.0,325.0,125.0,1291.25,18
CDM,70076856_1,Complete ultrasound scan of pelvis,600.0,390.0,150.0,1549.5,18
CDM,70076857_1,Limited ultrasound scan of pelvis,445.0,289.25,111.25,1149.21,18
CDM,70076870_1,Ultrasound scan of scrotum,500.0,325.0,125.0,1291.25,18
CDM,70076872_1,Ultrasound scan of pelvic region through rectum,500.0,325.0,125.0,1291.25,18
CDM,70076881_1,Complete ultrasound scan of joint,400.0,260.0,100.0,1033.0,18
CDM,70076882_1,Limited ultrasound scan of joint or other extremity structure except blood vessels,400.0,260.0,100.0,1033.0,18
CDM,70076932_1,Ultrasonic guidance for biopsy of heart muscle,500.0,325.0,125.0,1291.25,18
CDM,70076936_1,Ultrasound guided compression repair of blood vessel,1800.0,1170.0,294.16,4648.5,18
CDM,70076937_1,Ultrasonic guidance for blood vessel access,475.0,308.75,118.75,1226.69,18
CDM,70076940_1,Ultrasound guidance for tissue removal,650.0,422.5,162.5,1678.63,18
CDM,70076942_1,Ultrasonic guidance for needle placement,800.0,520.0,163.6,2066.0,18
CDM,70076998_1,Ultrasonic guidance during surgery,1000.0,650.0,163.6,2582.5,18
CDM,70077001_1,Fluoroscopic guidance for insertion or removal of central vein access device,657.0,427.05,164.25,1696.7,18
CDM,70077002_1,Fluoroscopic guidance for needle placement,395.0,256.75,98.75,1020.09,18
CDM,70077003_1,Fluoroscopic guidance for spine or back muscle injection,298.0,193.7,74.5,769.59,18
CDM,70077012_1,Review by radiologist of CT guidance for needle placement,1000.0,650.0,119.76,2582.5,18
CDM,70077013_1,CT guidance for tissue removal,3000.0,1950.0,119.76,7747.5,18
CDM,70077073_1,X-ray for bone length assessment,300.0,195.0,75.0,774.75,18
CDM,70077778_1,Complex application of radiation source,4000.0,2600.0,1000.0,10330.0,18
CDM,70079445_1,Radioactive drug therapy through a tube inserted in an artery,1000.0,650.0,250.0,2582.5,18
CDM,700G0269_1,"PLACEMENT OF OCCLUSIVE DEVICE INTO EITHER A VENOUS OR ARTERIAL ACCESS SITE, POST SURGICAL OR INTERVENTIONAL PROCEDURE (E.G., ANGIOSEAL PLUG, VASCULAR PLUG)",153.0,99.45,38.25,395.12,16
CDM,70100_1,"X-ray of part of lower jaw, 1-4 views",108.1,70.27,8.6,78.57,19
CDM,70110_1,"X-ray of lower jaw, minimum of 4 views",123.3,80.15,11.23,78.57,19
CDM,70120_1,"X-ray of bone behind the ear, 1-2 views per side",97.7,63.51,8.3,78.57,19
CDM,70130_1,"X-ray of bone behind the ear, minimum of 3 views per side",178.3,115.9,15.28,78.57,19
CDM,70134_1,X-ray of inside of ear canal,136.5,88.73,16.08,78.57,19
CDM,70140_1,"X-ray of face bones, 1-2 views",92.3,60.0,9.25,78.57,19
CDM,70150_1,"X-ray of face bones, minimum of 3 views",133.5,86.78,11.87,78.57,19
CDM,70160_1,"X-ray of nose bones, minimum of 3 views",104.6,67.99,7.96,78.57,19
CDM,70170_1,Review by radiologist of tear drainage structure of eye image,149.1,96.92,13.33,209.11,19
CDM,70190_1,X-ray of eye canal,99.8,64.87,9.89,78.57,19
CDM,70200_1,"X-ray of eye socket, minimum of 4 views",136.0,88.4,12.54,78.57,19
CDM,70210_1,"X-ray of paranasal sinus, 1-2 views",96.7,62.86,7.96,78.57,19
CDM,70220_1,"X-ray of paranasal sinus, minimum of 3 views",122.2,79.43,9.92,78.57,19
CDM,70240_1,X-ray of bone at base of skull,85.1,55.32,8.63,78.57,19
CDM,70250A_1,"X-ray of skull, 1-3 views",59.9,38.94,8.3,78.57,19
CDM,70250_1,"X-ray of skull, 1-3 views",114.2,74.23,8.3,78.57,19
CDM,70260_1,"X-ray of skull, minimum of 4 views",145.5,94.58,12.54,78.57,19
CDM,70267IP _1,"INJECTION, NELARABINE, 50 MG",55.74,36.23,13.94,7236.29,19
CDM,70267OP _1,"INJECTION, NELARABINE, 50 MG",19.8,12.87,4.95,7236.29,19
CDM,70287IP _1,"INJECTION, ABATACEPT, 10 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",9998.53,6499.04,47.46,25821.2,19
CDM,70287OP _1,"INJECTION, ABATACEPT, 10 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",16191.91,10524.74,47.46,41815.61,19
CDM,7028IP _1,UNCLASSIFIED DRUGS,2.58,1.68,0.65,6.66,16
CDM,7028OP _1,UNCLASSIFIED DRUGS,24.91,16.19,6.23,64.33,16
CDM,70300_1,"X-ray of teeth, 1 view",41.9,27.24,5.01,78.57,19
CDM,70306IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.64,6.27,2.41,24.9,16
CDM,70306OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.32,14.51,5.58,57.64,16
CDM,70310_1,"X-ray of teeth, less than full mouth",119.2,77.48,7.63,78.57,19
CDM,70320_1,"X-ray of teeth, full mouth",161.5,104.98,10.66,78.57,19
CDM,70328_1,X-ray of jaw joint on 1 side of mouth,96.8,62.92,8.3,78.57,19
CDM,70330_1,X-ray of jaw joints on both sides of mouth,128.1,83.27,10.89,78.57,19
CDM,70332_1,Review by radiologist of hinged joint of upper and lower jaw bones image,275.1,178.82,23.94,111.78,19
CDM,70336_1,MRI scan of jaw joint,1438.5,935.03,64.09,380.31,19
CDM,70350R_1,X-ray of both collar bones joints,63.0,40.95,8.91,78.57,19
CDM,70350_1,Imaging of jaws and skull,63.0,40.95,8.27,78.57,19
CDM,70355R_1,"X-ray of lower jaws, upper jaws and teeth",52.5,34.13,9.58,78.57,19
CDM,70355_1,"X-ray of lower jaws, upper jaws and teeth",140.0,91.0,9.58,78.57,19
CDM,70360_1,X-ray of soft tissue of neck,84.2,54.73,8.3,78.57,19
CDM,70370_1,X-ray of voice box or throat,238.9,155.29,14.61,78.57,19
CDM,70371_1,Imaging of voice box with speech evaluation,314.0,204.1,39.3,127.38,19
CDM,70380_1,X-ray of saliva gland,106.1,68.97,7.65,78.57,19
CDM,70390_1,Review by radiologist of salivary structure image,287.7,187.01,16.62,100.38,19
CDM,70405IP _1,"INJECTION, VON WILLEBRAND FACTOR COMPLEX (HUMATE-P), PER IU VWF:RCO",6067.09,3943.61,1.58,15668.26,19
CDM,70405OP _1,"INJECTION, VON WILLEBRAND FACTOR COMPLEX (HUMATE-P), PER IU VWF:RCO",5721.63,3719.06,1.58,14776.11,19
CDM,70406IP _1,"HUMATE-P 2,400 UNIT VWF:RCO",17883.5,11624.28,4470.88,12518.45,11
CDM,70434IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.55,11.41,4.39,45.32,16
CDM,70434OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.76,12.19,4.69,48.45,16
CDM,70450_1,CT scan head or brain without contrast,612.2,397.93,37.6,244.34,19
CDM,70460_1,CT scan head or brain with contrast,808.5,525.53,49.65,305.27,19
CDM,70470_1,CT scan of head or brain before and after contrast,973.4,632.71,55.87,371.56,19
CDM,70471_1,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY (CTA), HEAD AND NECK, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES, WHEN PERFORMED, AND IMAGE POSTPROCESSING",284.0,184.6,73.6,292.52,16
CDM,70472IP _1,LUBIPROSTONE 24 MCG CAPSULE,18.9,12.29,4.73,13.23,11
CDM,70472OP _1,LUBIPROSTONE 24 MCG CAPSULE,15.5,10.08,3.88,10.85,11
CDM,70472_1,"COMPUTED TOMOGRAPHIC (CT) CEREBRAL PERFUSION ANALYSIS WITH CONTRAST MATERIAL(S), INCLUDING IMAGE POSTPROCESSING PERFORMED WITH CONCURRENT CT OR CT ANGIOGRAPHY OF THE SAME ANATOMY (LIST SEPARATELY IN A",88.0,57.2,34.67,90.64,16
CDM,70473_1,"COMPUTED TOMOGRAPHIC (CT) CEREBRAL PERFUSION ANALYSIS WITH CONTRAST MATERIAL(S), INCLUDING IMAGE POSTPROCESSING PERFORMED WITHOUT CONCURRENT CT OR CT ANGIOGRAPHY OF THE SAME ANATOMY",114.0,74.1,45.26,117.42,16
CDM,70476IP _1,ROTATEQ VACCINE,121.78,79.16,30.45,85.25,11
CDM,70480_1,CT scan of cranial cavity without contrast,1025.9,666.84,56.51,274.45,19
CDM,70481_1,CT scan of cranial cavity with contrast,1191.8,774.67,49.65,344.89,19
CDM,70482_1,CT scan of cranial cavity before and after contrast,1348.2,876.33,55.56,398.05,19
CDM,70486R_1,CT scan of face without contrast,174.3,113.3,37.91,266.33,19
CDM,70486_1,CT scan of face without contrast,420.0,273.0,37.91,266.33,19
CDM,70487_1,CT scan of face with contrast,1016.4,660.66,49.65,332.74,19
CDM,70488_1,CT scan of face before and after contrast,1241.1,806.72,55.87,396.5,19
CDM,70490_1,CT scan of soft tissue of neck without contrast,822.2,534.43,56.51,274.04,19
CDM,70491_1,CT scan of soft tissue of neck with contrast,681.5,442.98,60.77,333.15,19
CDM,70492_1,CT scan of soft tissue of neck before and after contrast,1208.6,785.59,70.74,397.64,19
CDM,70496_1,CT scan of blood vessels of head with contrast,1971.9,1281.74,76.75,415.92,19
CDM,70498_1,CT scan of blood vessels of neck with contrast,1986.6,1291.29,76.75,415.92,19
CDM,70536IP _1,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,8.74,5.68,2.19,22.57,16
CDM,70536OP _1,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,5.06,3.29,1.27,13.07,16
CDM,70540_1,"MRI scan of bone of eye socket, face, and/or neck without contrast",1619.1,1052.42,59.15,449.26,19
CDM,70542_1,"MRI scan of bone of eye socket, face, and/or neck with contrast",1768.2,1149.33,71.36,494.03,19
CDM,70543_1,"MRI scan of bone of eye socket, face, and/or neck before and after contrast",2611.4,1697.41,78.57,654.77,19
CDM,70544A_1,MRI scan of blood vessels of head without contrast,891.5,579.48,52.6,438.66,19
CDM,70544OP _1,"INJECTION, IBANDRONATE SODIUM, 1 MG",155.07,100.8,13.93,400.47,19
CDM,70544_1,MRI scan of blood vessels of head without contrast,1666.7,1083.36,52.6,438.66,19
CDM,70545IP _1,UNCLASSIFIED DRUGS,894.02,581.11,223.51,2308.81,16
CDM,70545OP _1,UNCLASSIFIED DRUGS,1620.83,1053.54,405.21,4185.79,16
CDM,70545_1,MRI scan of blood vessels of head with contrast,1769.3,1150.05,52.6,467.54,19
CDM,70546A_1,MRI scan of blood vessels of head before and after contrast,1370.3,890.7,64.83,637.23,19
CDM,70546_1,MRI scan of blood vessels of head before and after contrast,2684.9,1745.19,64.83,637.23,19
CDM,70547A_1,MRI scan of blood vessels of neck without contrast,198.8,129.22,52.6,438.23,19
CDM,70547_1,MRI scan of blood vessels of neck without contrast,1774.5,1153.43,52.6,438.23,19
CDM,70548_1,MRI scan of blood vessels of neck with contrast,1861.7,1210.11,65.81,467.73,19
CDM,70549A_1,MRI scan of blood vessels of neck before and after contrast,297.4,193.31,78.57,637.23,19
CDM,70549_1,MRI scan of blood vessels of neck before and after contrast,2569.9,1670.44,78.57,637.23,19
CDM,70551_1,MRI scan of brain without contrast,1669.5,1085.18,64.83,453.93,19
CDM,70552_1,MRI scan of brain with contrast,1826.0,1186.9,78.37,500.08,19
CDM,70553_1,MRI scan of brain before and after contrast,2660.7,1729.46,78.57,660.94,19
CDM,70554_1,Functional MRI scan of brain,1453.8,944.97,78.57,1497.41,19
CDM,70555_1,Functional MRI scan of brain with neurofunctional testing,388.5,252.53,78.57,400.16,19
CDM,70557_1,MRI scan of brain without contrast during brain procedure,367.9,239.14,78.57,378.94,19
CDM,70558_1,MRI scan of brain with contrast during brain procedure,414.3,269.3,78.57,426.73,19
CDM,70559_1,MRI scan of brain before and after contrast during brain procedure,391.0,254.15,78.57,402.73,19
CDM,70597OP _1,"INJECTION, ALPHA 1 PROTEINASE INHIBITOR (HUMAN), NOT OTHERWISE SPECIFIED, 10 MG",824.62,536.0,5.69,2129.58,19
CDM,70781IP _1,EMSAM 6 MG/24 HOURS PATCH,503.8,327.47,125.95,352.66,11
CDM,70782IP _1,EMSAM 9 MG/24 HOURS PATCH,503.8,327.47,125.95,352.66,11
CDM,70784OP _1,DROSPIRENONE-EE 3-0.02 MG TAB,35.95,23.37,8.99,25.17,11
CDM,71045_1,"X-ray of chest, 1 view",70.0,45.5,7.99,78.57,19
CDM,71046_1,"X-ray of chest, 2 views",77.0,50.05,9.61,78.57,19
CDM,71047_1,"X-ray of chest, 3 views",99.0,64.35,12.2,78.57,19
CDM,71048_1,"X-ray of chest, minimum of 4 views",106.0,68.9,13.97,78.57,19
CDM,71100_1,"X-ray of ribs on side of body, 2 views",100.5,65.33,9.92,78.57,19
CDM,71101_1,"X-ray of ribs on side of body, minimum of 3 views",122.3,79.5,12.02,78.57,19
CDM,71110_1,"X-ray of ribs on both sides of body, 3 views",125.7,81.71,12.87,78.57,19
CDM,71111_1,"X-ray of ribs on both sides of body, minimum of 4 views",165.7,107.71,14.31,78.57,19
CDM,71120_1,"X-ray of chest bone, minimum of 2 views",98.0,63.7,8.96,78.57,19
CDM,71130_1,"X-ray of joint between breast and collar bones, minimum of 2 views",116.3,75.6,9.92,78.57,19
CDM,71250_1,CT scan of chest without contrast,806.4,524.16,47.24,266.8,19
CDM,71260_1,CT scan of chest with contrast,975.5,634.08,51.27,336.58,19
CDM,71270_1,CT scan of chest before and after contrast,1203.3,782.15,54.89,393.59,19
CDM,71271_1,Low dose CT scan of chest for lung cancer screening,124.4,80.86,47.24,442.68,19
CDM,71275_1,CT scan of blood vessels of chest with contrast,1440.6,936.39,78.57,427.94,19
CDM,714236501IP _1,UNCLASSIFIED DRUGS,2.81,1.83,0.7,7.26,16
CDM,71550_1,MRI scan of chest without contrast,1859.6,1208.74,63.73,454.59,19
CDM,71551_1,MRI scan of chest with contrast,2053.8,1334.97,76.08,500.19,19
CDM,71552_1,MRI scan of chest before and after contrast,2650.2,1722.63,78.57,662.73,19
CDM,71555_1,MRI scan of blood vessels of chest,1711.5,1112.48,78.57,607.08,19
CDM,716IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.8,2.47,0.95,9.81,16
CDM,716OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.87,5.77,2.22,22.91,16
CDM,7179487IP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",234.49,152.42,0.49,605.57,17
CDM,7179487OP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",34.36,22.33,0.49,88.73,17
CDM,717IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.1,3.97,1.53,15.75,16
CDM,717OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.7,17.36,6.68,68.95,16
CDM,718IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.5,2.93,1.13,11.62,16
CDM,718OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.12,19.58,7.53,77.78,16
CDM,72020_1,"X-ray of spine, 1 view",72.8,47.32,7.32,78.57,19
CDM,72040_1,"X-ray of upper spine, 2-3 views",121.9,79.24,9.92,78.57,19
CDM,72050_1,"X-ray of upper spine, 4-5 views",165.6,107.64,12.33,78.57,19
CDM,72052_1,"X-ray of upper spine, 6 or more views",213.5,138.78,13.64,78.57,19
CDM,72070_1,"X-ray of middle spine, 2 views",103.9,67.54,9.27,78.57,19
CDM,72072_1,"X-ray of middle spine, 3 views",106.1,68.97,9.94,78.57,19
CDM,72074_1,"X-ray of middle spine, minimum of 4 views",114.6,74.49,10.92,78.57,19
CDM,72080_1,"X-ray of middle and lower spine, 2 views",111.8,72.67,9.58,78.57,19
CDM,72081_1,"X-ray of entire middle and lower spine, 1 view",90.0,58.5,11.99,78.57,19
CDM,72082_1,"X-ray of entire middle and lower spine, 2-3 views",144.0,93.6,14.28,78.57,19
CDM,72083_1,"X-ray of entire middle and lower spine, 4-5 views",156.0,101.4,16.23,78.57,19
CDM,72084_1,"X-ray of entire middle and lower spine, minimum of 6 views",186.0,120.9,18.85,78.57,19
CDM,72100_1,"X-ray of lower and sacral spine, 2-3 views",112.9,73.39,10.22,78.57,19
CDM,72110_1,"X-ray of lower and sacral spine, minimum of 4 views",148.1,96.27,11.99,78.57,19
CDM,72114_1,"X-ray lower and sacral spine, minimum of 6 views",208.9,135.79,13.64,78.57,19
CDM,72120_1,"X-ray lower and sacral spine, 2-3 views bending views",139.7,90.81,10.22,78.57,19
CDM,72125_1,CT scan of upper spine without contrast,808.5,525.53,44.28,266.8,19
CDM,72126_1,CT scan of upper spine with contrast,973.4,632.71,53.58,335.22,19
CDM,72127_1,CT scan of upper spine before and after contrast,1192.8,775.32,55.56,387.65,19
CDM,72128_1,CT scan of middle spine without contrast,807.5,524.88,44.28,266.8,19
CDM,72129_1,CT scan of middle spine with contrast,973.4,632.71,53.58,335.22,19
CDM,72130_1,CT scan of middle spine before and after contrast,1185.5,770.58,55.87,387.65,19
CDM,72131_1,CT scan of lower spine without contrast,804.3,522.8,44.28,266.8,19
CDM,72132_1,CT scan of lower spine with contrast,971.3,631.35,53.58,335.22,19
CDM,72133_1,CT scan of lower spine before and after contrast,1189.7,773.31,55.87,387.65,19
CDM,72141_1,MRI scan of upper spinal canal without contrast,1481.6,963.04,65.14,460.36,19
CDM,72142_1,MRI scan of upper spinal canal with contrast,1845.9,1199.84,78.57,508.46,19
CDM,72146_1,MRI scan of middle spinal canal without contrast,1485.8,965.77,65.14,460.36,19
CDM,72147_1,MRI scan of middle spinal canal with contrast,1638.0,1064.7,78.57,507.85,19
CDM,72148_1,MRI scan of lower spinal canal without contrast,1440.6,936.39,65.45,453.94,19
CDM,72149_1,MRI scan of lower spinal canal with contrast,1818.6,1182.09,78.57,500.49,19
CDM,72156_1,MRI scan of upper spinal canal before and after contrast,2689.1,1747.92,78.57,672.98,19
CDM,72157_1,MRI scan of middle spinal canal before and after contrast,2689.1,1747.92,78.57,672.37,19
CDM,72158_1,MRI scan of lower spinal canal before and after contrast,2660.7,1729.46,78.57,660.94,19
CDM,72159_1,MRI scan of blood vessels of spinal canal,1791.3,1164.35,78.57,980.95,19
CDM,72170_1,"X-ray of pelvis, 1-2 views",79.7,51.81,7.96,78.57,19
CDM,72190_1,"X-ray of pelvis, minimum of 3 views",133.2,86.58,11.66,78.57,19
CDM,72191_1,CT scan of blood vessels of pelvis with contrast,1450.0,942.5,78.57,421.81,19
CDM,72192_1,CT scan of pelvis without contrast,756.0,491.4,47.57,263.14,19
CDM,72193_1,CT scan of pelvis with contrast,920.9,598.59,50.96,331.58,19
CDM,72194_1,CT scan of pelvis before and after contrast,1192.8,775.32,53.58,385.14,19
CDM,72195_1,MRI scan of pelvis without contrast,1661.1,1079.72,64.04,454.81,19
CDM,72196_1,MRI scan of pelvis with contrast,1809.2,1175.98,76.08,499.8,19
CDM,72197_1,MRI scan of pelvis before and after contrast,2628.2,1708.33,78.57,659.72,19
CDM,72198_1,MRI scan of blood vessels of pelvis,1773.5,1152.78,78.42,602.08,19
CDM,72200_1,"X-ray of joint between lower spine and hip bone, 1-2 views",79.8,51.87,7.96,78.57,19
CDM,72202_1,"X-ray of joint between lower spine and hip bone, 3 or more views",109.3,71.05,9.94,78.57,19
CDM,72220_1,"X-ray of sacrum and tailbone, minimum of 2 views",79.8,51.87,7.96,78.57,19
CDM,72240_1,Review by radiologist of upper spinal canal image,542.9,352.89,40.97,216.86,19
CDM,7224IP _1,UNCLASSIFIED DRUGS,1.81,1.18,0.45,4.67,16
CDM,7224OP _1,UNCLASSIFIED DRUGS,8.25,5.36,2.06,21.31,16
CDM,72255_1,Review by radiologist of middle spinal canal image,528.2,343.33,40.22,208.18,19
CDM,72265_1,Review by radiologist of lower spinal canal image,494.6,321.49,38.17,198.71,19
CDM,72270_1,Review by radiologist of multiple spinal canals image,753.9,490.04,57.56,240.52,19
CDM,7227IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.04,14.98,5.76,59.5,16
CDM,7227OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.28,20.98,8.07,83.36,16
CDM,72285_1,Review by radiologist of disc of upper or middle spine image,945.0,614.25,54.9,344.0,19
CDM,7228IP _1,UNCLASSIFIED DRUGS,58.92,38.3,14.73,152.16,16
CDM,7228OP _1,UNCLASSIFIED DRUGS,1.21,0.79,0.3,3.12,16
CDM,72295_1,Review by radiologist of disc of lower spine image,852.6,554.19,38.66,310.53,19
CDM,73000_1,X-ray of collar bone,134.7,87.56,7.63,78.57,19
CDM,73010_1,X-ray of shoulder blade,143.4,93.21,8.58,78.57,19
CDM,7301IP _1,UNCLASSIFIED DRUGS,1.7,1.11,0.43,4.39,16
CDM,73020_1,"X-ray of shoulder, 1 view",110.85,72.05,6.99,78.57,19
CDM,73030_1,"X-ray of shoulder, minimum of 2 views",140.1,91.07,8.6,78.57,19
CDM,73040_1,Review by radiologist of shoulder joint image,510.45,331.79,25.48,118.38,19
CDM,73050_1,X-ray of both collar bones joints,122.9,79.89,8.91,78.57,19
CDM,73060_1,"X-ray of upper arm, minimum of 2 views",136.5,88.73,7.63,78.57,19
CDM,7306IP _1,UNCLASSIFIED DRUGS,11.04,7.18,2.76,28.51,16
CDM,7306OP _1,UNCLASSIFIED DRUGS,4.79,3.11,1.2,12.37,16
CDM,73070_1,"X-ray of elbow, 2 views",132.9,86.39,7.63,78.57,19
CDM,73080_1,"X-ray of elbow, minimum of 3 views",160.2,104.13,7.96,78.57,19
CDM,73085_1,Review by radiologist of elbow image,274.1,178.17,23.94,114.67,19
CDM,73090_1,"X-ray of forearm, 2 views",129.6,84.24,7.32,78.57,19
CDM,73092_1,"X-ray of infant arm, minimum of 2 views",87.6,56.94,7.32,78.57,19
CDM,7309IP _1,UNCLASSIFIED DRUGS,10.62,6.9,2.66,27.43,16
CDM,7309OP _1,UNCLASSIFIED DRUGS,2.97,1.93,0.74,7.67,16
CDM,730IP _1,"INJECTION, ATROPINE SULFATE, 0.01 MG",19.66,12.78,0.11,50.77,17
CDM,730OP _1,"INJECTION, ATROPINE SULFATE, 0.01 MG",8.14,5.29,0.11,21.02,17
CDM,73100_1,"X-ray of wrist, 2 views",144.9,94.19,7.94,78.57,19
CDM,73110_1,"X-ray of wrist, minimum of 3 views",177.3,115.25,8.27,78.57,19
CDM,73115_1,Review by radiologist of wrist joint image,534.15,347.2,25.61,103.53,19
CDM,73120_1,"X-ray of hand, 2 views",129.6,84.24,7.63,78.57,19
CDM,7312IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.34,3.47,1.34,13.79,16
CDM,7312OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.41,8.72,3.35,34.63,16
CDM,73130_1,"X-ray of hand, minimum of 3 views",151.8,98.67,8.27,78.57,19
CDM,73140_1,"X-ray of finger, minimum of 2 views",156.45,101.69,6.32,78.57,19
CDM,73200_1,CT scan of arm without contrast,1186.05,770.93,44.28,263.56,19
CDM,73201_1,CT scan of arm with contrast,1433.25,931.61,50.96,327.86,19
CDM,73202_1,CT scan of arm before and after contrast,1852.2,1203.93,53.27,385.14,19
CDM,73206_1,CT scan of blood vessels of arm with contrast,1915.65,1245.17,78.57,421.19,19
CDM,73210005_1,"Fine needle aspiration biopsy using ultrasound guidance, first growth",2340.0,1521.0,993.51,6043.05,17
CDM,73210006_1,"Fine needle aspiration biopsy using ultrasound guidance, each additional growth",200.0,130.0,102.0,2166.29,17
CDM,73218_1,MRI scan of arm without contrast,2501.1,1625.72,60.08,449.46,19
CDM,73219_1,MRI scan of arm with contrast,2669.7,1735.31,71.66,494.44,19
CDM,7321IP _1,UNCLASSIFIED DRUGS,1.17,0.76,0.29,3.02,16
CDM,73220_1,MRI scan of arm before and after contrast,3917.1,2546.12,78.57,654.77,19
CDM,73221_1,MRI scan of arm joint without contrast,2334.15,1517.2,60.39,449.26,19
CDM,73222_1,MRI scan of arm joint with contrast,2501.1,1625.72,71.97,494.24,19
CDM,73223_1,MRI scan of arm joint before and after contrast,3917.1,2546.12,78.57,655.39,19
CDM,73225_1,MRI scan of blood vessels of arm,1779.8,1156.87,74.48,980.95,19
CDM,7322IP _1,UNCLASSIFIED DRUGS,5.2,3.38,1.3,13.43,16
CDM,7322OP _1,UNCLASSIFIED DRUGS,2.88,1.87,0.72,7.44,16
CDM,73236511_1,Mechanical separation of white blood cells from blood,10028.0,6518.2,1052.0,25897.31,19
CDM,73238205_1,Collection of donor stem cells for transplantation,3665.0,2382.25,916.25,9464.86,19
CDM,73238206_1,Collection of stem cells for transplantation,3665.0,2382.25,916.25,9464.86,19
CDM,73238225_1,"Harvesting of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy, per day",6830.0,4439.5,1707.5,17638.48,16
CDM,73238226_1,Preparation of blood-derived T white blood cells (T lymphocytes) for transportation for chimeric antigen receptor T-cell (CAR-T) therapy,225.0,146.25,56.25,581.06,16
CDM,73238227_1,Receipt and preparation of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy,225.0,146.25,56.25,581.06,16
CDM,73248635_1,"HC ARC SVC APHERESIS, SET-UP  APG",869.0,564.85,217.25,608.3,11
CDM,7325IP _1,UNCLASSIFIED DRUGS,13.79,8.96,3.45,35.61,16
CDM,73286880_1,"Red blood cell antibody detection test, direct",50.0,32.5,2.7,764.0,19
CDM,73286902_1,"Screening test for compatible blood unit, using reagent serum",91.0,59.15,5.24,764.0,19
CDM,73289611_1,REV - OTHER RX SVCS,2789.0,1812.85,697.25,1952.3,12
CDM,73289612_1,Collection of stem cells for transplantation,6380.0,4147.0,1595.0,16476.35,18
CDM,73289614_1,HC NM APHERESIS SET-UP,869.0,564.85,217.25,608.3,11
CDM,73289615_1,Mechanical separation of white blood cells and platelets from blood,11100.0,7215.0,2318.31,28665.75,19
CDM,73289616_1,Mechanical separation of plasma from blood,8953.0,5819.45,208.0,23121.12,19
CDM,73289617_1,Mechanical separation of red blood cells from blood,10028.0,6518.2,2318.31,25897.31,19
CDM,73289618_1,Mechanical separation of plasma and abnormal antibodies from blood,7969.0,5179.85,1992.25,20579.94,19
CDM,73289619_1,Mechanical separation of white blood cells from blood,10028.0,6518.2,2318.31,25897.31,19
CDM,73289620_1,Collection of donor stem cells for transplantation,3665.0,2382.25,916.25,9464.86,19
CDM,73289621_1,Collection of stem cells for transplantation,3665.0,2382.25,916.25,9464.86,18
CDM,73289624_1,Collection of stem cells for transplantation,6380.0,4147.0,1595.0,16476.35,18
CDM,7331IP _1,UNCLASSIFIED DRUGS,36.14,23.49,9.04,93.33,16
CDM,7331OP _1,UNCLASSIFIED DRUGS,15.53,10.09,3.88,40.11,16
CDM,7332IP _1,UNCLASSIFIED DRUGS,9.38,6.1,2.35,24.22,16
CDM,7332OP _1,UNCLASSIFIED DRUGS,2.59,1.68,0.65,6.69,16
CDM,734IP _1,"INJECTION, ATROPINE SULFATE, 0.01 MG",266.8,173.42,0.11,689.01,17
CDM,73501_1,"X-ray of hip, 1 view",69.0,44.85,8.6,78.57,19
CDM,73502_1,"X-ray of hip, 2-3 views",96.0,62.4,10.22,78.57,19
CDM,73503_1,"X-ray of hip, minimum of 4 views",119.0,77.35,12.64,78.57,19
CDM,7351IP _1,UNCLASSIFIED DRUGS,31.25,20.31,7.81,80.7,16
CDM,7351OP _1,UNCLASSIFIED DRUGS,9.66,6.28,2.42,24.95,16
CDM,73521_1,"X-ray of both hips, 2 views",92.0,59.8,10.22,78.57,19
CDM,73522_1,"X-ray of both hips, 3-4 views",113.0,73.45,13.3,78.57,19
CDM,73523_1,"X-ray of both hips, minimum of 5 views",131.0,85.15,13.97,78.57,19
CDM,73525_1,Review by radiologist of hip joint image,486.75,316.39,26.84,114.88,19
CDM,73551_1,"X-ray of thigh bone, 1 view",96.0,62.4,7.63,78.57,19
CDM,73552_1,"X-ray of thigh bone, minimum 2 views",112.5,73.13,8.3,78.57,19
CDM,73560_1,"X-ray of knee, 1-2 views",120.0,78.0,7.63,78.57,19
CDM,73562_1,"X-ray of knee, 3 views",150.0,97.5,8.91,78.57,19
CDM,73564_1,"X-ray of knee, 4 or more views",170.1,110.57,10.53,78.57,19
CDM,73565_1,X-ray of both knees while standing,108.0,70.2,7.94,78.57,19
CDM,7356IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.29,0.84,0.32,3.33,16
CDM,73580_1,Review by radiologist of knee joint image,544.8,354.12,29.51,136.74,19
CDM,73590_1,"X-ray of lower leg, 2 views",120.0,78.0,7.32,78.57,19
CDM,73592_1,"X-ray of infant leg, minimum of 2 views",151.65,98.57,7.32,78.57,19
CDM,73600_1,"X-ray of ankle, 2 views",105.0,68.25,7.63,78.57,19
CDM,73610_1,"X-ray of ankle, minimum of 3 views",135.0,87.75,7.96,78.57,19
CDM,73615_1,Review by radiologist of ankle joint image,282.5,183.63,26.53,115.7,19
CDM,73620_1,"X-ray of foot, 2 views",90.0,58.5,7.32,78.57,19
CDM,73630_1,"X-ray of foot, minimum of 3 views",120.0,78.0,7.65,78.57,19
CDM,7364IP _1,"INJECTION, SODIUM THIOSULFATE (PEDMARK), 100 MG",14.62,9.5,3.66,7236.29,19
CDM,7364OP _1,"INJECTION, SODIUM THIOSULFATE (PEDMARK), 100 MG",20.37,13.24,5.09,7236.29,19
CDM,73650_1,"X-ray of heel, minimum of 2 views",121.35,78.88,7.32,78.57,19
CDM,73660_1,"X-ray of toe, minimum of 2 views",119.7,77.81,6.01,78.57,19
CDM,736IP _1,UNCLASSIFIED DRUGS,149.18,96.97,37.3,385.26,16
CDM,736OP _1,UNCLASSIFIED DRUGS,136.17,88.51,34.04,351.66,16
CDM,73700_1,CT scan of leg without contrast,1187.55,771.91,44.28,263.56,19
CDM,73701_1,CT scan of leg with contrast material,1444.35,938.83,50.96,328.68,19
CDM,73702_1,CT scan of leg before and after contrast,1879.05,1221.38,53.27,385.14,19
CDM,73706_1,CT scan of blood vessels of lower leg with contrast,2247.6,1460.94,78.57,426.81,19
CDM,73718_1,MRI scan of leg without contrast,2444.4,1588.86,59.46,449.46,19
CDM,73719_1,MRI scan of leg with contrast,2669.7,1735.31,71.05,494.03,19
CDM,73720_1,MRI scan of leg before and after contrast,3913.95,2544.07,78.57,654.36,19
CDM,73721_1,MRI scan of leg joint without contrast,2384.55,1549.96,60.08,449.26,19
CDM,73722_1,MRI scan of leg joint with contrast,2529.45,1644.14,71.97,494.24,19
CDM,73723_1,MRI scan of leg joint before and after contrast,3917.1,2546.12,78.57,654.58,19
CDM,73725_1,MRI scan of blood vessels of leg,2669.7,1735.31,78.57,604.27,19
CDM,73_1,FLUBLOK 2025-2026 SYRINGE,5.0,3.25,1.25,3.5,11
CDM,74018_1,"X-ray of abdomen, 1 view",60.0,39.0,8.3,78.57,19
CDM,74019_1,"X-ray of abdomen, 2 views",84.3,54.8,10.25,78.57,19
CDM,74021_1,"X-ray of abdomen, minimum of 3 views",98.0,63.7,11.89,78.57,19
CDM,74022_1,X-ray series of abdomen with single X-ray of chest,149.8,97.37,14.31,78.57,19
CDM,7413IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.81,2.48,0.95,9.84,16
CDM,7413OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.31,2.8,1.08,11.13,16
CDM,74150_1,CT scan of abdomen without contrast,770.7,500.96,52.27,268.62,19
CDM,74160_1,CT scan of abdomen with contrast,1062.6,690.69,55.87,338.34,19
CDM,74170_1,CT scan of abdomen before and after contrast,1423.8,925.47,61.44,395.76,19
CDM,74174_1,CT scan of blood vessels of abdomen and pelvis with contrast,1514.9,984.69,78.57,468.29,19
CDM,74175_1,CT scan of blood vessels of abdomen with contrast,1543.4,1003.21,78.57,426.81,19
CDM,74176_1,CT scan of abdomen and pelvis without contrast,472.8,307.32,76.42,348.78,19
CDM,74177_1,CT scan of abdomen and pelvis with contrast,897.8,583.57,78.57,546.64,19
CDM,74178_1,CT scan of abdomen and pelvis before and after contrast,1187.1,771.62,78.57,692.53,19
CDM,74181_1,MRI scan of abdomen without contrast,1458.5,948.03,63.73,454.2,19
CDM,74182_1,MRI scan of abdomen with contrast,2002.4,1301.56,75.77,500.19,19
CDM,74183_1,MRI scan of abdomen before and after contrast,2628.2,1708.33,78.57,659.72,19
CDM,74185_1,MRI scan of blood vessels of abdomen,1773.5,1152.78,78.57,602.5,19
CDM,74190_1,Review by radiologist of abdominal cavity lining image,189.0,122.85,20.7,194.67,19
CDM,74210_1,X-ray of voice box and/or esophagus with contrast,225.8,146.77,25.92,78.57,19
CDM,74220_1,Single contrast X-ray of esophagus,287.7,187.01,26.56,82.01,19
CDM,74221_1,Double contrast X-ray of esophagus,85.25,55.41,30.62,108.99,19
CDM,74230_1,Imaging for evaluation of swallowing function,289.4,188.11,23.6,89.23,19
CDM,74235_1,Review by radiologist of imaging for removal of esophageal foreign body in esophagus,409.5,266.18,52.27,139.48,19
CDM,74240_1,Single contrast X-ray of upper digestive tract,319.2,207.48,36.11,105.72,19
CDM,74246_1,Double contrast X-ray of upper digestive tract,371.7,241.61,39.89,116.86,19
CDM,74248_1,Follow-through X-ray of small intestines,85.25,55.41,30.62,78.57,19
CDM,74250_1,Single contrast X-ray of small intestine,346.6,225.29,35.65,90.93,19
CDM,74251_1,Double contrast X-ray of small intestine,1279.6,831.74,51.29,176.44,19
CDM,74261_1,Diagnostic CT scan of large intestine without contrast,1689.9,1098.44,78.57,419.21,19
CDM,74262_1,Diagnostic CT scan of large intestine with contrast,1992.3,1295.0,78.57,570.13,19
CDM,74263_1,Screening CT scan of large intestine,2585.0,1680.25,78.57,2662.55,19
CDM,74270_1,Single contrast X-ray of large intestine,499.7,324.81,45.59,126.56,19
CDM,74280_1,Double contrast X-ray of large intestine,692.0,449.8,55.22,172.06,19
CDM,74283_1,Enema using air or contrast,598.5,389.03,78.57,244.36,19
CDM,74290_1,Imaging of gallbladder with contrast,200.6,130.39,14.0,78.57,19
CDM,74300_1,Review by radiologist of bile and/or pancreatic duct image during surgery,131.3,85.35,12.15,133.01,19
CDM,74301_1,Review by radiologist of additional bile and/or pancreatic duct image during surgery,76.7,49.86,8.96,124.63,19
CDM,74328_1,Review by radiologist of image from tube placement into bile duct using an endoscope,392.7,255.26,23.02,176.53,19
CDM,74329_1,Review by radiologist of image from tube placement into pancreatic duct using an endoscope,391.7,254.61,23.32,111.35,19
CDM,74330_1,Review by radiologist of image from tube placement into bile and pancreatic duct using an endoscope,419.0,272.35,26.46,184.8,19
CDM,74340_1,Review by radiologist of placement of long small bowel tube,321.3,208.85,23.94,113.65,19
CDM,74355_1,Review by radiologist of placement of small bowel tube,350.7,227.96,33.55,151.29,19
CDM,74360_1,Review by radiologist of image to guide opening of digestive tract,371.7,241.61,27.27,102.09,19
CDM,74363_1,Review by radiologist of image to guide opening of bile duct,661.5,429.98,36.39,282.76,19
CDM,7437IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.65,3.02,1.16,12.01,16
CDM,7437OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",63.87,41.52,15.97,164.94,16
CDM,7439IP _1,UNCLASSIFIED DRUGS,10.33,6.71,2.58,26.68,16
CDM,7439OP _1,UNCLASSIFIED DRUGS,11.85,7.7,2.96,30.6,16
CDM,74400_1,Imaging of urinary tract with injection of contrast into a vein,360.3,234.2,21.65,105.9,19
CDM,74410_1,Imaging of urinary tract using infusion technique,337.1,219.12,22.14,115.4,19
CDM,74415_1,Imaging of urinary tract using infusion technique with kidney section filming,395.9,257.34,21.65,126.33,19
CDM,74420_1,Imaging of urinary tract following injection of a contrast agent,282.5,183.63,23.76,178.85,19
CDM,74425_1,Review by radiologist of upper urinary tract image,164.9,107.19,22.63,178.85,19
CDM,74430_1,Review by radiologist of urinary bladder image,228.9,148.79,14.31,78.57,19
CDM,74440_1,Review by radiologist of male internal genitals image,251.0,163.15,17.42,78.7,19
CDM,74445_1,Review by radiologist of penis image,262.5,170.63,51.76,225.25,19
CDM,74450_1,Review by radiologist of urinary bladder and urethra images with contrast,183.8,119.47,14.64,176.69,19
CDM,74455_1,Review by radiologist of urinary bladder and urethra images with contrast and after passing urine,285.5,185.58,14.95,90.45,19
CDM,74470_1,Review by radiologist of kidney cyst image,192.2,124.93,23.63,141.06,19
CDM,74485_1,Review by radiologist of ureter or urethra image,369.6,240.24,37.92,152.21,19
CDM,74712_1,MRI scan of fetus for single or first pregnancy,1116.0,725.4,78.57,922.26,19
CDM,74713_1,MRI scan of fetus for each additional pregnancy,538.0,349.7,78.57,469.52,19
CDM,74740_1,Review by radiologist of uterine tube and ovary image,253.2,164.58,16.93,79.75,19
CDM,74742_1,Review by radiologist of image from placement of uterine tube,379.1,246.42,26.87,228.44,19
CDM,74775_1,Imaging of anogenital region,222.6,144.69,27.33,193.65,19
CDM,7485IP _1,"STERILE WATER/SALINE, 500 ML",1.78,1.16,0.45,4.15,16
CDM,7536IP _1,"INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG",44.5,28.93,1.64,114.92,17
CDM,7536OP _1,"INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG",25.58,16.63,1.64,66.06,17
CDM,75557_1,MRI scan of heart without contrast,1402.8,911.82,78.57,583.54,19
CDM,75559_1,MRI scan of heart without contrast with stress imaging,2051.7,1333.61,78.57,858.54,19
CDM,7555IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.47,2.91,1.12,11.54,16
CDM,7555OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.36,24.28,9.34,96.48,16
CDM,75561_1,MRI scan of heart before and after contrast,1895.3,1231.95,78.57,793.14,19
CDM,75563_1,MRI scan of heart before and after contrast with stress imaging,2338.4,1519.96,78.57,985.98,19
CDM,75565_1,MRI scan of blood flow of heart,209.2,135.98,10.92,78.57,19
CDM,7556IP _1,UNCLASSIFIED DRUGS,29.83,19.39,7.46,77.04,16
CDM,7556OP _1,UNCLASSIFIED DRUGS,2.36,1.53,0.59,6.09,16
CDM,75571_1,CT scan of heart with evaluation of blood vessel calcium,566.0,367.9,25.58,582.98,19
CDM,75572_1,CT scan of heart structure with contrast,977.1,635.12,77.11,570.13,19
CDM,75573_1,CT scan of congenital heart disease with contrast,1334.9,867.69,78.57,570.13,19
CDM,75574_1,CT scan of blood vessels and grafts of heart with contrast,1453.5,944.78,78.57,570.13,19
CDM,75577_1,"QUANTIFICATION AND CHARACTERIZATION OF CORONARY ATHEROSCLEROTIC PLAQUE TO ASSESS SEVERITY OF CORONARY DISEASE, DERIVED FROM AUGMENTATIVE SOFTWARE ANALYSIS OF THE DATA SET FROM A CORONARY COMPUTED TOMO",100.0,65.0,39.69,103.0,16
CDM,7557IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.04,3.28,1.26,13.02,16
CDM,7557OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",46.45,30.19,11.61,119.96,16
CDM,75580_1,"Analysis of data from CT study of heart blood vessels to assess severity of heart artery disease, with interpretation and report",90.0,58.5,33.09,1626.53,19
CDM,75600_1,Review by radiologist of chest aorta image,1253.7,814.91,21.85,496.64,19
CDM,75605_1,Review by radiologist of chest aorta serial images,1278.9,831.29,48.76,501.55,19
CDM,75625_1,Review by radiologist of abdominal aorta image,1276.8,829.92,60.51,498.45,19
CDM,7562IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.31,2.15,0.83,8.55,16
CDM,7562OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.68,8.89,3.42,35.33,16
CDM,75630_1,Review by radiologist of abdominal aorta and both leg arteries image,1412.3,918.0,78.57,556.11,19
CDM,75635_1,CT scan of abdominal aorta and both leg arteries with contrast,1717.8,1116.57,78.57,456.63,19
CDM,75705_1,Review by radiologist of spinal artery image,1414.4,919.36,78.57,529.87,19
CDM,75710_1,Review by radiologist of arm or leg artery image,1278.9,831.29,74.51,505.68,19
CDM,75716_1,Review by radiologist of both arms or legs arteries image,1298.9,844.29,78.57,522.63,19
CDM,75726_1,Review by radiologist of abdominal artery image,1275.8,829.27,78.57,500.72,19
CDM,75731_1,Review by radiologist of adrenal gland artery image,1340.9,871.59,49.98,502.98,19
CDM,75733_1,Review by radiologist of both adrenal glands arteries image,1365.0,887.25,57.75,482.4,19
CDM,75736_1,Review by radiologist of pelvis artery image,1276.8,829.92,47.64,502.98,19
CDM,75741_1,Review by radiologist of lung artery image,1364.0,886.6,55.6,504.28,19
CDM,75743_1,Review by radiologist of arteries of both lungs image,1410.2,916.63,70.73,525.68,19
CDM,75746_1,Review by radiologist of lung artery image with contrast,1340.9,871.59,48.75,498.66,19
CDM,75756_1,Review by radiologist of breast artery of breast image,1346.1,874.97,50.61,511.64,19
CDM,75774_1,Review by radiologist of additional artery image,1175.0,763.75,42.25,447.7,19
CDM,75801_1,Review by radiologist of lymphatic system of arm or leg image,622.7,404.76,40.23,242.07,19
CDM,75803_1,Review by radiologist of lymphatic system of both arms or legs image,667.8,434.07,51.6,260.62,19
CDM,75805_1,Review by radiologist of lymphatic system of side of pelvis and abdomen image,685.7,445.71,35.96,241.43,19
CDM,75807_1,Review by radiologist of lymphatic system of both side of pelvis and abdomen image,732.9,476.39,48.64,261.03,19
CDM,75809_1,Review by radiologist of previous placed shunt image,327.3,212.75,22.04,271.36,19
CDM,75810_1,Review by radiologist of spleen and liver vein image,1339.8,870.87,44.69,692.16,19
CDM,75820_1,Review by radiologist of 1 arm or leg vein of 1 arm or leg image,397.0,258.05,45.56,113.79,19
CDM,75822_1,Review by radiologist of both arms and legs veins of both arms or legs image,481.2,312.78,63.61,158.87,19
CDM,75825_1,Review by radiologist of major lower body vein image,1276.8,829.92,48.58,493.31,19
CDM,75827_1,Review by radiologist of major upper body vein image,1275.8,829.27,49.02,493.3,19
CDM,75831_1,Review by radiologist of kidney image,1340.9,871.59,47.46,494.33,19
CDM,75833_1,Review by radiologist of both kidneys veins image,483.0,313.95,66.37,519.86,19
CDM,75840_1,Review by radiologist of adrenal gland vein image,1341.9,872.24,49.98,497.84,19
CDM,75842_1,Review by radiologist of both adrenal gland veins image,1387.1,901.62,78.57,693.55,15
CDM,75860_1,Review by radiologist of head or neck vein system image,1276.8,829.92,50.18,472.05,19
CDM,75870_1,Review by radiologist of head vein system image,1341.9,872.24,56.5,471.01,19
CDM,75872_1,Review by radiologist of spinal canal vein image,1344.0,873.6,49.98,506.33,19
CDM,75880_1,Review by radiologist of eye socket vein of eye socket image,412.7,268.26,30.92,97.93,19
CDM,75885_1,Review by radiologist of the vein that transports blood to the liver image with assessment of blood flow,482.0,313.3,60.17,510.75,19
CDM,75887_1,Review by radiologist of the vein that transports blood to the liver image,1379.7,896.81,60.17,513.23,19
CDM,75889_1,Review by radiologist of liver vein image with assessment of blood flow,1275.8,829.27,47.82,493.71,19
CDM,75891_1,Review by radiologist of liver vein image,1275.8,829.27,48.13,493.71,19
CDM,75893_1,Review by radiologist of imaging guidance for removal of blood sample,1257.9,817.64,24.32,436.3,19
CDM,75894_1,Review by radiologist of image for insertion of material to block blood flow,2332.1,1515.87,78.57,578.01,19
CDM,75898_1,Imaging of blood vessel,309.8,201.37,78.57,237.76,19
CDM,75901_1,Review by radiologist of image for removal of obstructive material,564.8,367.12,21.16,124.36,19
CDM,75902_1,Review by radiologist of image for removal of tissue or obstructive material from central venous tube,243.1,158.02,16.9,94.97,19
CDM,75956_1,ENDOVASCULAR REPAIR OF THE THORACIC AORTA BY DEPLOYMENT OF A BRANCHED ENDOGRAFT MULTIPIECE SYSTEM INVOLVING AN AORTO-AORTIC TUBE DEVICE WITH A FENESTRATION FOR THE LEFT SUBCLAVIAN ARTERY STENT GRAFT(S,1036.4,673.66,73.6,3921.75,16
CDM,75957_1,ENDOVASCULAR REPAIR OF THE THORACIC AORTA BY DEPLOYMENT OF A BRANCHED ENDOGRAFT MULTIPIECE SYSTEM INVOLVING AN AORTO-AORTIC TUBE DEVICE WITH A FENESTRATION FOR THE LEFT SUBCLAVIAN ARTERY STENT GRAFT(S,887.3,576.75,73.6,3921.75,16
CDM,75958_1,Review by radiologist of image for insertion of extension,585.9,380.84,78.57,603.48,15
CDM,75959_1,Review by radiologist of image for insertion of extension after previous repair of descending aorta,515.6,335.14,78.57,531.07,15
CDM,75970_1,Review by radiologist of image for biopsy of blood vessel with tube,1141.4,741.91,34.9,420.37,19
CDM,75984_1,Review by radiologist of image for replacement of stomach or large bowel tube,354.2,230.23,35.21,123.44,19
CDM,75989_1,Review by radiologist of image for drainage of fluid,436.8,283.92,51.78,186.12,19
CDM,75_1,RABAVERT RABIES VACCINE VIAL,348.29,226.39,87.07,243.8,11
CDM,76000_1,"Imaging guidance for procedure, 60 minutes or less",297.2,193.18,14.41,78.57,19
CDM,76010_1,X-ray from nose to rectum,83.2,54.08,7.99,78.57,19
CDM,76080_1,Review by radiologist of abscess or sinus cavity study,183.2,119.08,22.83,78.57,19
CDM,76098_1,X-ray of surgical specimen,60.9,39.59,13.97,78.57,19
CDM,76100_1,X-ray of body plane,386.4,251.16,25.89,106.16,19
CDM,76120_1,Imaging of organ,195.9,127.34,18.03,78.57,19
CDM,76125_1,"Imaging of organ, complimenting routine exam",33.25,21.61,13.07,78.57,19
CDM,76140_1,Written consultation report on X-ray,66.2,43.03,29.79,80.89,15
CDM,76145_1,"Medical physics dose evaluation for radiation exposure, including report",1964.0,1276.6,78.57,2372.15,19
CDM,76334OP _1,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",25271.28,16426.33,3.2,65263.08,19
CDM,76338IP _1,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",303.08,197.0,0.38,782.7,17
CDM,76338OP _1,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",372.86,242.36,0.38,962.91,17
CDM,76364IP _1,"INJECTION, DECITABINE, 1 MG",760.25,494.16,0.69,1963.35,19
CDM,76364OP _1,"INJECTION, DECITABINE, 1 MG",580.06,377.04,0.69,1498.0,19
CDM,76366OP _1,"FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U., NOT OTHERWISE SPECIFIED",2784.35,1809.83,1.69,7236.29,19
CDM,76367IP _1,"FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U., NOT OTHERWISE SPECIFIED",4798.19,3118.82,1.69,12391.33,19
CDM,76367OP _1,"FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U., NOT OTHERWISE SPECIFIED",5893.8,3830.97,1.69,15220.74,19
CDM,76376_1,3D radiographic procedure,329.7,214.31,8.96,78.57,19
CDM,76377_1,3D radiographic procedure with computerized image postprocessing,417.9,271.64,35.29,143.65,19
CDM,76380A_1,Limited or follow-up CT scan,150.2,97.63,42.51,155.49,19
CDM,76380_1,Limited or follow-up CT scan,603.8,392.47,42.51,155.49,19
CDM,76390_1,MRI study for measuring biochemical changes in the brain,1550.8,1008.02,48.2,1597.32,15
CDM,76391_1,MRI and low frequency vibrations for measuring tissue stiffness,135.0,87.75,47.9,251.53,19
CDM,76445IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",57.75,37.54,14.44,149.14,16
CDM,76445OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.73,12.17,4.68,48.37,16
CDM,76472IP _1,UNCLASSIFIED DRUGS,2.57,1.67,0.64,6.64,16
CDM,76472OP _1,UNCLASSIFIED DRUGS,2.78,1.81,0.7,7.18,16
CDM,76481IP _1,RASAGILINE MESYLATE 1 MG TAB,55.31,35.95,13.83,38.72,11
CDM,76498_1,Other MRI scan,1180.0,767.0,18.44,1215.4,15
CDM,76506_1,Ultrasound scan of brain,391.9,254.74,27.97,102.55,19
CDM,76510_1,1D and 2D ultrasound scan of eye tissue and structures,448.9,291.79,37.02,180.1,19
CDM,76511_1,1D ultrasound scan of eye tissue and structures,309.8,201.37,33.78,122.41,19
CDM,76512_1,2D ultrasound scan of eye tissue and structures,441.0,286.65,29.29,139.17,19
CDM,76513_1,Ultrasound scan of eye using water bath method,241.5,156.98,31.24,139.17,19
CDM,76514_1,Ultrasound scan of cornea to determine thickness,37.8,24.57,7.27,78.57,19
CDM,76516_1,Ultrasound scan to determine eye length,221.6,144.04,21.48,114.02,19
CDM,76519_1,Ultrasound scan to determine eye length and lens power,246.8,160.42,28.93,114.02,19
CDM,76527OP _1,"INJECTION, NALTREXONE, DEPOT FORM, 1 MG",17354.06,11280.14,4.49,44816.86,19
CDM,76529_1,Ultrasound scan of eye for foreign body localization,195.3,126.95,30.67,125.76,19
CDM,76536_1,Ultrasound scan of head and neck soft tissue,385.7,250.71,25.22,101.1,19
CDM,76604_1,Ultrasound scan of chest,274.8,178.62,26.35,88.46,19
CDM,76641_1,Complete ultrasound scan of 1 breast,393.75,255.94,32.24,167.68,19
CDM,76642_1,Limited ultrasound scan of 1 breast,324.45,210.89,29.95,134.15,19
CDM,76700_1,Complete ultrasound scan of abdomen,443.0,287.95,35.83,136.06,19
CDM,76705_1,Limited ultrasound scan of abdomen,340.7,221.46,26.23,100.25,19
CDM,76706_1,Ultrasound scan of abdominal aorta,219.4,142.61,24.4,80.48,19
CDM,76717IP _1,SPRYCEL 20 MG TABLET,1147.73,746.02,286.93,803.41,11
CDM,76718IP _1,SPRYCEL 50 MG TABLET,2283.48,1484.26,570.87,1598.44,11
CDM,76718OP _1,SPRYCEL 50 MG TABLET,819.13,532.43,204.78,573.39,11
CDM,76719IP _1,SPRYCEL 70 MG TABLET,2283.05,1483.98,570.76,1598.14,11
CDM,76719OP _1,DASATINIB 70 MG TABLET,3107.2,2019.68,776.8,2175.04,11
CDM,76770_1,Complete ultrasound scan behind abdominal cavity,421.0,273.65,32.57,131.8,19
CDM,76775_1,Limited ultrasound scan behind abdominal cavity,230.0,149.5,25.89,99.78,19
CDM,76776_1,Ultrasound scan of transplanted kidney,487.9,317.14,33.24,135.98,19
CDM,76790OP _1,LUCENTIS 0.5 MG/0.05 ML VIAL,5075.0,3298.75,1268.75,3552.5,11
CDM,76800_1,Ultrasound scan of spinal canal,401.5,260.98,58.14,145.2,19
CDM,76801U_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus",147.0,95.55,44.44,145.46,19
CDM,76801_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus",395.9,257.34,44.44,145.46,19
CDM,76802U_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), each additional fetus",125.0,81.25,37.73,94.23,19
CDM,76802_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), each additional fetus",217.4,141.31,37.73,94.23,19
CDM,76805U_1,"Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus",148.1,96.27,45.05,150.82,19
CDM,76805_1,"Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus",464.8,302.12,45.05,150.82,19
CDM,76810U_1,"Ultrasound scan of pregnant uterus (14 weeks or more), each additional fetus",146.0,94.9,45.03,112.46,19
CDM,76810_1,"Ultrasound scan of pregnant uterus (14 weeks or more), each additional fetus",293.0,190.45,45.03,112.46,19
CDM,76811U_1,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus",287.7,187.01,78.57,253.48,19
CDM,76811_1,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus",611.1,397.22,78.57,253.48,19
CDM,76812U_1,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, each additional fetus",268.8,174.72,78.57,204.65,19
CDM,76812_1,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, each additional fetus",632.1,410.87,78.57,204.65,19
CDM,76813U_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, single or first fetus",177.5,115.38,53.97,138.83,19
CDM,76813_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, single or first fetus",373.6,242.84,53.97,138.83,19
CDM,76814U_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, each additional fetus",149.1,96.92,45.36,113.29,19
CDM,76814_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, each additional fetus",229.7,149.31,45.36,113.29,19
CDM,76815U_1,Limited ultrasound of pregnant uterus,100.0,65.0,29.25,98.47,19
CDM,76815_1,Limited ultrasound of pregnant uterus,283.6,184.34,29.25,98.47,19
CDM,76816U_1,Follow-up ultrasound scan of pregnant uterus,128.1,83.27,39.02,106.33,19
CDM,76816_1,Follow-up ultrasound scan of pregnant uterus,366.5,238.23,39.02,106.33,19
CDM,76817U_1,Vaginal ultrasound of pregnant uterus,112.4,73.06,33.83,107.65,19
CDM,76817_1,Vaginal ultrasound of pregnant uterus,317.1,206.12,33.83,107.65,19
CDM,76818U_1,Ultrasound and monitoring of heart of fetus,159.6,103.74,47.96,131.52,19
CDM,76818_1,Ultrasound and monitoring of heart of fetus,370.3,240.7,47.96,131.52,19
CDM,76819U_1,Ultrasound scan of fetus,115.5,75.08,35.11,109.85,19
CDM,76819_1,Ultrasound scan of fetus,274.3,178.3,35.11,109.85,19
CDM,76820U_1,Ultrasound scan of fetal umbilical artery blood flow rate,75.6,49.14,23.09,85.78,19
CDM,76820_1,Ultrasound scan of fetal umbilical artery blood flow rate,214.2,139.23,23.09,85.78,19
CDM,76821U_1,Ultrasound scan of fetal brain artery blood flow rate,106.1,68.97,32.03,109.92,19
CDM,76821_1,Ultrasound scan of fetal brain artery blood flow rate,297.5,193.38,32.03,109.92,19
CDM,76825_1,Ultrasound scan of fetal heart,645.8,419.77,75.86,198.1,19
CDM,76826_1,Follow-up ultrasound scan of fetal heart,381.2,247.78,37.92,95.94,19
CDM,76827_1,Ultrasound scan of fetal heart blood flow,233.1,151.52,26.38,97.93,19
CDM,76828_1,Follow-up ultrasound scan of fetal heart blood flow,176.4,114.66,25.71,78.57,19
CDM,76830_1,"Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina",399.1,259.42,30.9,113.15,19
CDM,76831_1,Ultrasound scan of uterus and uterine cavity,350.7,227.96,33.13,115.79,19
CDM,76835OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.35,9.98,3.84,39.64,16
CDM,76843IP _1,"APREPITANT, ORAL, 5 MG",478.55,311.06,2.94,1235.86,17
CDM,76843OP _1,"APREPITANT, ORAL, 5 MG",787.84,512.1,2.94,2034.6,17
CDM,76856_1,Complete ultrasound scan of pelvis,395.8,257.27,30.9,113.97,19
CDM,76857_1,Limited ultrasound scan of pelvis,318.7,207.16,22.6,87.17,19
CDM,76870_1,Ultrasound scan of scrotum,394.2,256.23,28.3,111.26,19
CDM,76872_1,Ultrasound scan of pelvic region through rectum,431.9,280.74,30.6,136.04,19
CDM,76873_1,Ultrasound scan of prostate through rectum,332.7,216.26,73.08,186.56,19
CDM,76881_1,Complete ultrasound scan of joint,307.8,200.07,41.0,186.12,19
CDM,76882_1,Limited ultrasound scan of joint or other extremity structure except blood vessels,75.0,48.75,30.59,78.57,19
CDM,76883_1,Comprehensive ultrasound scan of entire length of nerves in extremity,135.5,88.08,55.4,166.34,19
CDM,76885_1,Ultrasound scan of infant hip during movement,471.9,306.74,32.57,106.42,19
CDM,76886_1,Ultrasound scan of infant hip,254.7,165.56,27.33,99.6,19
CDM,76932_1,Ultrasonic guidance for biopsy of heart muscle,254.2,165.23,32.75,176.57,19
CDM,76936_1,Ultrasound guided compression repair of blood vessel,945.0,614.25,78.57,250.99,19
CDM,76937_1,Ultrasonic guidance for blood vessel access,103.4,67.21,12.84,78.57,19
CDM,76940_1,Ultrasound guidance for tissue removal,414.8,269.62,78.57,427.24,19
CDM,76941_1,Ultrasonic guidance for fetal transfusion or umbilical blood sampling,314.0,204.1,61.47,323.42,19
CDM,76942_1,Ultrasonic guidance for needle placement,656.7,426.86,30.1,116.32,19
CDM,76945_1,Ultrasonic guidance for testing placental tissue,223.7,145.41,30.72,108.04,19
CDM,76946U_1,Ultrasonic guidance for removal of amniotic fluid,57.8,37.57,17.54,78.57,19
CDM,76946_1,Ultrasonic guidance for removal of amniotic fluid,188.0,122.2,17.54,78.57,19
CDM,76948_1,Ultrasonic guidance for retrieval of egg,80.6,52.39,30.72,78.57,19
CDM,76963OP _1,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",763.64,496.37,3.2,1972.1,19
CDM,76965OP _1,ARANESP 40 MCG/0.4 ML SYRINGE,1898.09,1233.76,474.52,1328.66,11
CDM,76965_1,Ultrasonic guidance for administration of radiation therapy,673.1,437.52,65.04,213.56,19
CDM,76966OP _1,ARANESP 60 MCG/0.3 ML SYRINGE,3783.41,2459.22,945.85,2648.39,11
CDM,76975_1,Review by radiologist of ultrasound of digestive tract using an endoscope,243.6,158.34,40.95,250.91,19
CDM,76977_1,Ultrasound scan of bone for measuring loss,80.9,52.59,2.41,78.57,19
CDM,76978_1,"Ultrasound scan of growth using contrast, first growth",196.0,127.4,71.36,310.22,19
CDM,76979_1,"Ultrasound scan of growth using contrast, each additional growth",103.0,66.95,37.6,221.34,19
CDM,76981_1,Ultrasound scan of organ tissue for measuring elasticity,72.0,46.8,27.77,125.76,19
CDM,76982_1,"Ultrasound scan of growth for measuring elasticity, first growth",72.0,46.8,26.84,115.7,19
CDM,76983_1,"Ultrasound scan of growth for measuring elasticity, each additional growth",61.0,39.65,22.83,83.84,19
CDM,76988IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
CDM,76988OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.06,13.69,5.27,54.39,16
CDM,76998_1,Ultrasonic guidance during surgery,181.7,118.11,44.39,125.8,19
CDM,77001_1,Fluoroscopic guidance for insertion or removal of central vein access device,379.8,246.87,16.56,89.65,19
CDM,77002_1,Fluoroscopic guidance for needle placement,250.0,162.5,25.79,82.68,19
CDM,77003_1,Fluoroscopic guidance for spine or back muscle injection,187.1,121.62,26.99,80.3,19
CDM,77009IP _1,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",64.29,41.79,14.31,166.03,17
CDM,77009OP _1,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",24.04,15.63,6.01,62.08,17
CDM,77011_1,CT guidance for needle or tube localization,1145.8,744.77,57.25,336.37,19
CDM,77012IP _1,"ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES",7176.64,4664.82,727.06,18533.67,19
CDM,77012OP _1,"ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES",2911.12,1892.23,727.06,7517.97,19
CDM,77012_1,Review by radiologist of CT guidance for needle placement,443.5,288.28,64.08,330.37,19
CDM,77013_1,CT guidance for tissue removal,609.0,395.85,78.57,540.97,19
CDM,77014_1,Imaging guidance for localization of radiation treatment,440.0,286.0,25.55,252.24,19
CDM,77021_1,Review by radiologist of MRI guidance for needle placement,1318.7,857.16,67.4,382.69,19
CDM,77022_1,MRI guidance for tissue removal,635.3,412.95,78.57,654.36,19
CDM,77046_1,MRI scan of 1 breast without contrast,176.0,114.4,63.39,335.37,19
CDM,77047_1,MRI scan of both breasts without contrast,195.0,126.75,70.07,452.75,19
CDM,77048_1,MRI scan of 1 breast,255.0,165.75,78.57,503.05,19
CDM,77049_1,MRI scan of both breasts,279.0,181.35,78.57,586.89,19
CDM,77053_1,"Review by radiologist of breast duct image, 1 duct",154.1,100.17,15.95,109.56,19
CDM,77054_1,"Review by radiologist of breast duct image, multiple ducts",214.0,139.1,20.01,135.6,19
CDM,77061_1,3D breast mammography of 1 breast,137.3,89.25,36.88,141.42,15
CDM,77062_1,3D breast mammography of both breasts,136.9,88.99,45.29,141.01,15
CDM,77063_1,Screening 3D breast mammography,110.0,71.5,26.56,105.64,19
CDM,77065_1,Diagnostic mammography of 1 breast,411.7,267.61,35.96,154.88,19
CDM,77066_1,Diagnostic mammography of both breasts,521.5,338.98,44.28,196.48,19
CDM,77067_1,Screening mammography,332.9,216.39,33.55,158.58,19
CDM,77071_1,Application of stress by physician for joint imaging,131.3,85.35,31.34,134.14,19
CDM,77072_1,X-ray for estimating bone age,69.7,45.31,8.63,78.57,19
CDM,77073_1,X-ray for bone length assessment,114.4,74.36,12.3,78.57,19
CDM,77074_1,Limited X-ray of body bones,215.3,139.95,19.67,78.57,19
CDM,77075_1,Complete X-ray of body bones,327.9,213.14,24.58,97.74,19
CDM,77076_1,X-ray of infant body bones,333.7,216.91,30.92,80.81,19
CDM,77077_1,"X-ray of joints, multiple",122.6,79.69,15.57,78.57,19
CDM,77078_1,CT scan for measuring calcium and other minerals in bone,455.9,296.34,10.92,90.8,19
CDM,77080_1,"DXA bone density measurement of hip, pelvis, spine",209.9,136.44,8.96,88.73,19
CDM,77081_1,"DXA bone density measurement of forearm, finger, hand, or foot",119.4,77.61,8.96,78.57,19
CDM,77084_1,MRI scan of bone marrow,1565.9,1017.84,70.38,387.53,19
CDM,77085_1,"DXA bone density measurement of hip, pelvis, spine including spine fracture assessment",136.5,88.73,13.64,194.51,19
CDM,77086_1,Fracture assessment of spine bones using DXA,86.1,55.97,7.65,78.57,19
CDM,77092_1,Interpretation of trabecular bone score (TBS) and report on fracture risk,25.0,16.25,9.58,78.57,19
CDM,7711IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.15,2.7,1.04,10.72,16
CDM,7711OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.82,5.73,2.21,22.78,16
CDM,77195IP _1,"INJECTION, LEVETIRACETAM, 10 MG",10.7,6.96,0.04,27.63,17
CDM,77261_1,Simple radiation therapy planning,231.0,150.15,66.42,165.88,19
CDM,77262_1,Intermediate radiation therapy planning,331.8,215.67,78.57,254.22,19
CDM,77263_1,Complex radiation therapy planning,484.1,314.67,78.57,396.8,19
CDM,77280_1,"Obtaining data needed to develop the optimal radiation treatment, 1 treatment area",592.5,385.13,35.42,194.68,19
CDM,77285_1,"Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas",927.2,602.68,53.38,317.58,19
CDM,77290_1,"Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved",1713.6,1113.84,78.17,430.81,19
CDM,77293_1,Obtaining respiratory data needed to develop the optimal radiation treatment,1375.5,894.08,78.57,249.58,19
CDM,77295_1,3D radiation therapy planning,1461.6,950.04,78.57,1215.33,19
CDM,77300_1,Calculation of radiation therapy dose,199.5,129.68,31.21,88.25,19
CDM,77301_1,High precision radiation therapy planning,6232.5,4051.13,78.57,1914.03,19
CDM,77306_1,Simple radiation therapy planning for delivery of external radiation,354.9,230.69,70.56,176.22,19
CDM,77307_1,Complex radiation therapy planning for delivery of external radiation,693.0,450.45,78.57,363.06,19
CDM,77316_1,Simple radiation therapy planning for delivery of internal radiation,451.5,293.48,70.26,184.45,19
CDM,77317_1,Intermediate radiation therapy planning for delivery of internal radiation,591.2,384.28,78.57,268.29,19
CDM,77318_1,Complex radiation therapy planning for delivery of internal radiation,853.7,554.91,78.57,402.44,19
CDM,77321_1,Special radiation therapy planning for delivery of external radiation,285.9,185.84,47.6,195.58,19
CDM,77331_1,Special radiation therapy planning,167.7,109.01,43.69,109.12,19
CDM,77332_1,Design and construction of simple radiation treatment device,233.0,151.45,22.66,88.26,19
CDM,77333_1,Design and construction of intermediate radiation treatment device,144.9,94.19,37.4,111.09,19
CDM,77334_1,Design and construction of complex radiation treatment device,440.8,286.52,57.46,199.0,19
CDM,77336_1,Continuing radiation therapy consultation per week,179.93,116.95,78.57,209.32,19
CDM,77338_1,Design and construction of radiation treatment device for high precision radiation therapy,1448.1,941.27,78.57,537.61,19
CDM,77370_1,Special medical radiation therapy consultation,276.05,179.43,78.57,341.21,19
CDM,77371IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",64.7,42.06,16.18,167.09,16
CDM,77372_1,Complete single session course of cranial lesion surgery using radiation and a machine to deliver external radiation,2475.25,1608.91,78.57,2143.25,19
CDM,77373_1,Delivery of radiation therapy per dose to 1 or more lesions not to exceed 5 doses,3141.98,2042.29,78.57,2244.6,19
CDM,77387_1,Imaging guidance for localization of radiation treatment,88.0,57.2,25.55,252.24,19
CDM,77401_1,Superficial and/or low voltage radiation treatment delivery,56.58,36.78,25.46,85.89,15
CDM,77412IP _1,"INJECTION, CAFFEINE CITRATE, 5 MG",186.86,121.46,2.15,482.57,17
CDM,77417_1,X-ray during radiation therapy,57.8,37.57,22.03,78.57,15
CDM,77427_1,"Radiation treatment management, 5 treatment sessions",600.6,390.39,78.57,460.24,19
CDM,77431_1,"Radiation treatment management, 1-2 treatment sessions",294.0,191.1,78.57,250.55,19
CDM,77432_1,Management of complete single session course of stereotactic radiation treatment for cranial lesion(s),1225.4,796.51,78.57,999.7,19
CDM,77435_1,Management of stereotactic body radiation therapy for lesion(s) over 1-5 sessions,1487.4,966.81,78.57,1510.81,19
CDM,77469_1,Management of intraoperative radiation treatment,517.7,336.51,78.57,678.0,19
CDM,77470_1,Special radiation treatment,487.0,316.55,78.57,488.78,19
CDM,77484OP _1,"INJECTION, PANITUMUMAB, 10 MG",2913.84,1894.0,184.09,7524.99,19
CDM,77520_1,Simple proton beam radiation treatment,1662.03,1080.32,78.57,1822.45,15
CDM,77522_1,Simple proton beam radiation treatment with compensation,1706.88,1109.47,78.57,1827.41,15
CDM,77523_1,Intermediate proton beam radiation treatment,2025.78,1316.76,78.57,2122.85,15
CDM,77525_1,Complex proton beam radiation treatment,2157.08,1402.1,78.57,2348.64,15
CDM,7753IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.58,8.83,3.4,35.07,16
CDM,7753OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.45,11.99,4.61,47.65,16
CDM,77600_1,"Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less",1126.9,732.49,66.94,280.83,19
CDM,77605_1,"Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm",1968.9,1279.79,78.57,421.0,19
CDM,77610_1,"Use of interstitial probe generated heat to increase temperature of cancer cell, 1-5 probes",1947.4,1265.81,65.89,356.71,19
CDM,77615_1,"Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes",2942.4,1912.56,78.57,508.61,19
CDM,77620_1,Use of body cavity probe generated heat to increase temperature of cancer cell,1754.4,1140.36,78.13,281.72,19
CDM,77685IP _1,"INJECTION, MICAFUNGIN SODIUM, 1 MG",1183.82,769.48,0.27,3057.22,17
CDM,77685OP _1,"INJECTION, MICAFUNGIN SODIUM, 1 MG",480.3,312.2,0.27,1240.37,17
CDM,77725IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.01,1.96,0.75,7.77,16
CDM,77725OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.04,1.98,0.76,7.85,16
CDM,77750_1,Infusion or instillation of radioelement solution,1032.2,670.93,78.57,626.97,19
CDM,77761_1,Simple body cavity radiation source application,592.7,385.26,78.57,481.87,19
CDM,77762_1,Intermediate body cavity radiation source application,1437.5,934.38,78.57,722.45,19
CDM,77763_1,Complex body cavity radiation source application,1934.7,1257.56,78.57,1084.21,19
CDM,77767_1,"High dose skin surface radiation therapy, 1 channel or lesion diameter 2.0 cm or less",521.0,338.65,52.45,191.16,19
CDM,77768_1,"High dose skin surface radiation therapy, 2 channels and lesion diameter more than 2.0 cm, or multiple lesions",814.0,529.1,70.56,300.15,19
CDM,77770_1,"High dose radiation therapy, 1 channel",747.0,485.55,78.57,273.32,19
CDM,77771_1,"High dose radiation therapy, 2-12 channels",1392.0,904.8,78.57,508.08,19
CDM,77772_1,"High dose radiation therapy, more than 12 channels",2120.0,1378.0,78.57,776.37,19
CDM,77778_1,Complex application of radiation source,2490.6,1618.89,78.57,1097.93,19
CDM,77789_1,Surface application of low dose rate source,317.1,206.12,57.13,326.61,19
CDM,77790_1,"Supervision, handling, and loading of radiation source",259.4,168.61,16.9,267.18,19
CDM,7784IP _1,"INJECTION, TESTOSTERONE CYPIONATE, 1 MG",160.65,104.42,0.03,414.88,17
CDM,7784OP _1,"INJECTION, TESTOSTERONE CYPIONATE, 1 MG",46.76,30.39,0.03,120.76,17
CDM,7795OP _1,UNCLASSIFIED DRUGS,13.37,8.69,3.34,34.53,16
CDM,7797IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.72,12.82,4.93,50.93,16
CDM,7797OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.19,18.32,7.05,72.8,16
CDM,77_1,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use",572.68,372.24,143.17,1478.95,19
CDM,78003IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.55,4.26,1.64,16.92,16
CDM,78003OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.41,1.57,0.6,6.22,16
CDM,78012_1,Nuclear medicine study of thyroid function,267.8,174.07,8.32,181.09,19
CDM,78013_1,Nuclear medicine study of thyroid,675.2,438.88,15.98,335.37,19
CDM,78014_1,Nuclear medicine study of thyroid and thyroid function,780.2,507.13,21.68,419.21,19
CDM,78015_1,Nuclear medicine study of limited area for thyroid cancer,629.0,408.85,29.61,171.2,19
CDM,78016_1,"Nuclear medicine studies for thyroid cancer, additional studies",974.4,633.36,31.47,239.24,19
CDM,78018_1,Nuclear medicine study of whole body for thyroid cancer,1039.8,675.87,36.58,297.2,19
CDM,78020_1,Nuclear medicine study of thyroid function for thyroid cancer,261.7,170.11,25.2,93.1,19
CDM,78064IP _1,PALIPERIDONE ER 3 MG TABLETEXTENDED RELEASE 24 HR,174.65,113.52,43.66,122.26,11
CDM,78064OP _1,PALIPERIDONE ER 3 MG TABLETEXTENDED RELEASE 24 HR,5.76,3.74,1.44,4.03,11
CDM,78065IP _1,PALIPERIDONE ER 6 MG TABLETEXTENDED RELEASE 24 HR,17.65,11.47,4.41,12.36,11
CDM,78070_1,Nuclear medicine study of parathyroid,509.3,331.05,34.88,211.58,19
CDM,78071_1,Nuclear medicine study of parathyroid with SPECT,1168.7,759.66,51.86,586.89,19
CDM,78072_1,Nuclear medicine study of parathyroid with SPECT and CT scan,517.4,336.31,68.1,754.58,19
CDM,78075_1,Nuclear medicine study of adrenal glands,1320.5,858.33,32.57,220.27,19
CDM,78102_1,Nuclear medicine study of bone marrow limited area,495.6,322.14,23.66,135.28,19
CDM,78103_1,Nuclear medicine study of bone marrow multiple areas,650.0,422.5,28.52,194.49,19
CDM,78104_1,Nuclear medicine study of bone marrow whole body,738.2,479.83,34.26,235.02,19
CDM,78110_1,"Nuclear medicine study of plasma volume, 1 sampling",253.2,164.58,7.4,78.57,19
CDM,78111_1,"Nuclear medicine study of plasma volume, multiple samplings",274.1,178.17,9.92,115.66,19
CDM,78120_1,"Nuclear medicine study of red blood cell volume, single sample",255.5,166.08,8.71,88.69,19
CDM,78121_1,"Nuclear medicine study of red blood cell volume, multiple samples",318.2,206.83,14.18,131.84,19
CDM,78122_1,Nuclear medicine study of whole blood volume,495.6,322.14,19.88,192.94,19
CDM,78130_1,Nuclear medicine study of red blood cell survival,434.7,282.56,23.22,158.12,19
CDM,78140_1,Nuclear medicine study of radioisotope labeled red blood cells,453.6,294.84,23.22,186.4,19
CDM,78185_1,Nuclear medicine study of spleen,637.5,414.38,15.31,147.93,19
CDM,78191_1,Nuclear medicine study of platelet survival,772.8,502.32,23.22,300.69,19
CDM,78195_1,Nuclear medicine study of lymphatic system,1160.1,754.07,51.24,279.4,19
CDM,78201_1,Nuclear medicine study of liver,605.9,393.84,18.93,145.68,19
CDM,78202_1,Nuclear medicine study of liver and blood flow,616.0,400.4,22.01,171.4,19
CDM,78215_1,Nuclear medicine study of liver and spleen,633.5,411.78,21.65,166.75,19
CDM,78216_1,"Nuclear medicine study of liver, spleen, and blood flow",405.3,263.45,25.25,168.82,19
CDM,78226_1,Nuclear medicine study of liver and bile duct system,972.0,631.8,32.26,272.97,19
CDM,78227_1,Nuclear medicine study of liver and bile duct system with use of drugs,1349.9,877.44,39.27,371.47,19
CDM,78230_1,Nuclear medicine study of salivary gland,499.6,324.74,20.01,134.15,19
CDM,78231_1,Nuclear medicine study of salivary gland with serial images,370.7,240.96,19.94,156.84,19
CDM,78232_1,Nuclear medicine study of salivary gland function,396.9,257.99,17.96,165.0,19
CDM,78258_1,Nuclear medicine study of esophagus to assess movement,664.6,431.99,32.26,189.32,19
CDM,78261_1,Nuclear medicine study of stomach lining,822.6,534.69,26.2,227.42,19
CDM,78262_1,Nuclear medicine study of stomach and esophagus to assess reflux,738.1,479.77,29.95,230.67,19
CDM,78264_1,Nuclear medicine study of stomach to assess emptying,944.3,613.8,34.24,243.56,19
CDM,78265_1,Nuclear medicine study of stomach to assess emptying and small bowel movement,947.0,615.55,42.87,350.46,19
CDM,78266_1,Nuclear medicine study of stomach to assess emptying and small and large bowel movement,1123.0,729.95,45.75,415.85,19
CDM,78267_1,Nuclear medicine study to acquire exhaled breath samples,22.55,14.66,2.49,78.57,19
CDM,78278_1,Nuclear medicine study to assess blood loss,1140.3,741.2,43.2,292.1,19
CDM,78282_1,Nuclear medicine study to assess protein loss into the digestive tract,70.4,45.76,14.64,78.57,19
CDM,78290_1,Nuclear medicine study of intestine,1007.1,654.62,29.64,216.21,19
CDM,78291_1,Nuclear medicine study to assess the degree of openness of shunt from jugular vein to abdominal cavity,716.6,465.79,38.91,205.52,19
CDM,78300_1,Nuclear medicine study of bone and/or joint limited area,509.3,331.05,26.89,153.65,19
CDM,78305_1,Nuclear medicine study of bone and/or joint multiple areas,663.6,431.34,36.32,214.98,19
CDM,78306_1,Nuclear medicine study of bone and/or joint whole body,819.5,532.68,37.19,241.29,19
CDM,78310IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",67.29,43.74,16.82,173.78,16
CDM,78310OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.69,12.15,4.67,48.27,16
CDM,78315_1,Nuclear medicine study of bone taken at different times,1138.3,739.9,44.18,291.05,19
CDM,78350_1,Nuclear medicine study to measure bone loss using 1 photon beam,73.9,48.04,21.9,78.57,15
CDM,78351_1,Nuclear medicine study to measure bone loss using 2 photon beams,190.1,123.57,10.07,195.8,15
CDM,78414_1,Nuclear medicine study of cardiovascular function,53.4,34.71,20.19,85.04,19
CDM,78420OP _1,"INJECTION, AZACITIDINE, 1 MG",2958.17,1922.81,0.49,7639.47,19
CDM,78428_1,Nuclear medicine study for detecting heart shunt,633.2,411.58,33.78,169.1,19
CDM,78429_1,Nuclear medicine study of heart muscle with metabolic evaluation and concurrent CT scan,205.5,133.58,74.98,3425.78,19
CDM,78430_1,Nuclear medicine study of blood flow in heart muscle at rest and with stress with concurrent CT scan,195.0,126.75,71.54,3422.42,19
CDM,78431_1,Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent CT scan,226.0,146.9,78.57,3432.49,19
CDM,78432_1,Nuclear medicine study of heart muscle with metabolic and blood flow evaluation requiring 2 injections,241.25,156.81,78.57,3437.52,19
CDM,78433_1,Nuclear medicine study of heart muscle with metabolic and blood flow evaluation requiring 2 injections and concurrent CT scan,263.75,171.44,78.57,3445.91,19
CDM,78434_1,Nuclear medicine study of heart muscle blood flow by PET,76.25,49.56,27.72,665.7,19
CDM,78445_1,Nuclear medicine study of non-cardiac blood flow,519.8,337.87,21.65,131.06,19
CDM,78451_1,Nuclear medicine study of heart muscle at rest and with stress and SPECT,1145.7,744.71,60.83,446.03,19
CDM,78452_1,Nuclear medicine studies of heart muscle at rest and with stress and SPECT,1610.2,1046.63,71.72,709.3,19
CDM,78453_1,Nuclear medicine study of heart muscle at rest and with stress with single 2D image,872.6,567.19,43.54,446.03,19
CDM,78454_1,Nuclear medicine studies of heart muscle at rest and with stress with single 2D image,1262.9,820.89,58.51,709.3,19
CDM,78456_1,Nuclear medicine study to assess blood clot in vein using radiolabeled peptide,1113.3,723.65,44.21,216.69,19
CDM,78457_1,Nuclear medicine study to assess blood clot in vein of side,571.2,371.28,34.06,172.96,19
CDM,78458_1,Nuclear medicine study to assess blood clot in vein of both sides,574.4,373.36,39.89,209.35,19
CDM,78459_1,Nuclear medicine study of heart muscle with metabolic evaluation,315.0,204.75,68.3,856.06,19
CDM,78466_1,Nuclear medicine study of heart muscle following heart attack,553.4,359.71,30.16,165.95,19
CDM,78468_1,Nuclear medicine study of heart muscle following heart attack with measurement of internal blood volume ejected with every beat,701.4,455.91,35.37,222.02,19
CDM,78469_1,Nuclear medicine study of heart muscle following heart attack with SPECT,778.1,505.77,40.74,280.63,19
CDM,78472_1,Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume ejected with every beat over multiple cycles,782.0,508.3,43.05,290.62,19
CDM,78473_1,Nuclear medicine studies of heart pumping function by labeling red blood cells with measurement of internal blood volume ejected with every beat over multiple cycles,993.3,645.65,65.17,410.15,19
CDM,78481_1,Nuclear medicine study of heart pumping function with measurement of internal blood volume ejected with every beat over a single cycle,643.7,418.41,43.11,273.08,19
CDM,78483_1,Nuclear medicine studies of heart pumping function by first pass technique with measurement of internal blood volume ejected with every beat over a single cycle,949.2,616.98,64.73,402.52,19
CDM,78491_1,Nuclear medicine study of blood flow in heart muscle at rest and with stress,330.8,215.02,68.17,857.52,19
CDM,78492_1,Nuclear medicine studies of blood flow in heart muscle at rest and with stress,496.7,322.86,78.57,881.09,19
CDM,78494_1,Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume ejected with every beat over multiple cycles with SPECT,639.8,415.87,52.32,339.98,19
CDM,78496_1,Nuclear medicine study of heart pumping function over single cycle,129.2,83.98,22.17,127.83,19
CDM,78579_1,Nuclear medicine study of lung ventilation,455.7,296.21,21.34,145.07,19
CDM,78580_1,Nuclear medicine study of lung circulation,717.9,466.64,32.26,199.67,19
CDM,78582_1,Nuclear medicine study of lung ventilation and circulation,899.7,584.81,46.28,267.78,19
CDM,78597_1,Nuclear medicine study of lung ventilation and blood flow to lung,537.6,349.44,31.85,164.13,19
CDM,78598_1,Nuclear medicine study of lung ventilation and circulation and blood flow to lung,871.5,566.48,36.24,251.6,19
CDM,78600_1,"Nuclear medicine study of brain, less than 4 static views",541.4,351.91,19.24,186.31,19
CDM,78601_1,Nuclear medicine study of brain and blood flow,701.4,455.91,22.32,187.91,19
CDM,78605_1,"Nuclear medicine study of brain, 4 static views or more",582.1,378.37,23.6,183.49,19
CDM,78606_1,"Nuclear medicine study of brain and blood flow, 4 static views or more",1024.0,665.6,27.56,241.82,19
CDM,78608_1,Nuclear medicine study of brain with metabolic evaluation,315.0,204.75,64.14,983.79,19
CDM,78609_1,Nuclear medicine study of brain with blood flow evaluation,496.7,322.86,78.57,332.34,15
CDM,78610_1,Nuclear medicine study of brain with blood flow,549.3,357.05,13.02,110.69,19
CDM,78630_1,Nuclear medicine study of cerebrospinal fluid flow after injection of contrast into lower spine,1132.2,735.93,29.33,266.76,19
CDM,78635_1,Nuclear medicine study of cerebrospinal fluid flow after injection of contrast into ventricles,1028.5,668.53,26.87,198.33,19
CDM,78645_1,Nuclear medicine study of cerebrospinal fluid flow to evaluate shunt,996.9,647.99,24.63,222.43,19
CDM,78650_1,Nuclear medicine study of cerebrospinal fluid flow to locate leakage,1026.3,667.1,23.22,263.31,19
CDM,78660_1,Nuclear medicine study of tear drainage structure,536.9,348.99,20.27,138.52,19
CDM,78699_1,Other nuclear medicine study of nervous system,474.6,308.49,73.6,488.84,15
CDM,78700_1,Nuclear medicine study of kidney,523.4,340.21,19.26,165.71,19
CDM,78701_1,Nuclear medicine study of kidney and blood flow,644.3,418.8,21.96,192.33,19
CDM,78707_1,"Nuclear medicine study of kidney, blood flow, and function",757.0,492.05,41.59,247.39,19
CDM,78708_1,"Nuclear medicine study of kidney, blood, flow, and function with drug administration",587.0,381.55,51.89,240.69,19
CDM,78709_1,"Nuclear medicine studies of kidney, blood flow, and function",1081.5,702.98,60.52,304.63,19
CDM,78725_1,Nuclear medicine study of kidney function,337.6,219.44,16.31,101.2,19
CDM,78730_1,Nuclear medicine study of remaining urine in bladder,233.2,151.58,7.48,78.57,19
CDM,78740_1,Nuclear medicine study to assess urine flow,683.8,444.47,26.05,151.69,19
CDM,78761_1,Nuclear medicine study of testicle and blood flow,606.9,394.49,31.26,188.14,19
CDM,7876IP _1,"INJECTION, THIAMINE HCL, 100 MG",168.51,109.53,1.92,435.18,17
CDM,7876OP _1,"INJECTION, THIAMINE HCL, 100 MG",17.44,11.34,1.92,45.04,17
CDM,7877IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.57,2.97,1.14,11.8,16
CDM,7877OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.78,19.36,7.45,76.91,16
CDM,78800_1,"Nuclear medicine study, 1 area",531.3,345.35,28.68,186.21,19
CDM,78801_1,"Nuclear medicine study, multiple areas",720.3,468.2,31.62,237.44,19
CDM,78802_1,"Nuclear medicine study, whole body",1063.2,691.08,34.26,302.77,19
CDM,78803_1,"Nuclear medicine study, SPECT imaging, 1 area or single acquisition, single day imaging",1134.3,737.3,47.13,323.77,19
CDM,78804_1,"Nuclear medicine study, whole body requiring multiple imaging days",1917.1,1246.12,43.23,451.88,19
CDM,78808_1,Injection of radioactive contrast into a vein for non-imaging gamma probe,104.33,67.81,37.84,94.51,19
CDM,78811_1,Nuclear medicine study limited area,237.3,154.25,66.09,987.55,19
CDM,78812_1,Nuclear medicine study from skull base to mid-thigh,296.1,192.47,78.57,1009.39,19
CDM,78813_1,Nuclear medicine study whole body,305.6,198.64,78.57,1013.05,19
CDM,78814_1,Nuclear medicine study limited area with CT scan,333.9,217.04,78.57,1123.85,19
CDM,78815_1,Nuclear medicine study from skull base to mid-thigh with CT scan,372.8,242.32,78.57,1137.03,19
CDM,78816_1,Nuclear medicine study whole body with CT scan,381.2,247.78,78.57,1140.68,19
CDM,78830_1,"Nuclear medicine study, SPECT imaging with concurrent CT scan, 1 area or single acquisition, single day imaging",176.25,114.56,62.75,425.92,19
CDM,78831_1,"Nuclear medicine study, SPECT imaging, at least 2 areas or separate acquisitions, single day imaging, or single area or acquisition over multiple days",214.75,139.59,77.7,615.39,19
CDM,78832_1,"Nuclear medicine study, SPECT imaging with concurrent CT scan, at least 2 areas or separate acquisitions, single day imaging, or single area or acquisition over multiple days",250.25,162.66,78.57,801.53,19
CDM,78835_1,Quantification of radioactive materials,55.25,35.91,20.55,90.55,19
CDM,78999_1,Other nuclear medicine study,474.6,308.49,73.6,488.84,15
CDM,78_1,"BRACHYTHERAPY SOURCE, NON-STRANDED, YTTRIUM-90, PER SOURCE",97800.0,63570.0,16299.55,252568.5,18
CDM,79005_1,Radioactive drug therapy by mouth,387.5,251.88,78.48,198.41,19
CDM,7901IP _1,"INJECTION, THIOTEPA, 15 MG",516.03,335.42,129.01,1332.65,16
CDM,7906IP _1,THIOTHIXENE 5 MG CAPSULE,20.2,13.13,5.05,14.14,11
CDM,79101_1,Radioactive drug therapy through a vein,420.5,273.33,78.57,216.21,19
CDM,79200_1,Radioactive drug therapy into a body cavity,521.9,339.24,75.97,213.21,19
CDM,79300_1,Radioactive drug therapy into a tissue,366.5,238.23,60.99,155.09,19
CDM,79403_1,Radioactive drug therapy of radiolabeled monoclonal antibody through a vein,552.4,359.06,78.57,288.58,19
CDM,79440_1,Radioactive drug therapy into a joint,524.0,340.6,75.97,209.29,19
CDM,79445_1,Radioactive drug therapy through a tube inserted in an artery,369.6,240.24,78.57,252.6,19
CDM,7994IP _1,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",64.38,41.85,2.19,166.26,17
CDM,7994OP _1,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",21.0,13.65,2.19,54.23,17
CDM,7995IP _1,UNCLASSIFIED DRUGS,38.99,25.34,9.75,100.69,16
CDM,7995OP _1,UNCLASSIFIED DRUGS,8.56,5.56,2.14,22.11,16
CDM,79_1,AREXVY VIAL KIT,592.5,385.13,148.13,414.75,11
CDM,80047_1,"Blood test, basic group of blood chemicals (Calcium, ionized)",18.9,12.29,2.6,78.57,19
CDM,80048_1,"Blood test, basic group of blood chemicals (Calcium, total)",37.1,24.12,3.14,78.57,19
CDM,80050_1,General health panel,88.2,57.33,22.28,105.37,15
CDM,80051_1,"Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)",29.9,19.44,2.1,78.57,19
CDM,80053W_1,"Blood test, comprehensive group of blood chemicals",7.4,4.81,0.78,78.57,19
CDM,80053_1,"Blood test, comprehensive group of blood chemicals",54.8,35.62,5.79,78.57,19
CDM,80055_1,Obstetric blood test panel,83.0,53.95,28.69,119.41,19
CDM,80061A_1,"Blood test, lipids (cholesterol and triglycerides)",22.1,14.37,2.96,78.57,19
CDM,80061W_1,"Blood test, lipids (cholesterol and triglycerides)",7.4,4.81,0.99,78.57,19
CDM,80061_1,"Blood test, lipids (cholesterol and triglycerides)",40.0,26.0,5.36,78.57,19
CDM,80069_1,Kidney function blood test panel,42.5,27.63,3.69,78.57,19
CDM,80074_1,Acute hepatitis panel,131.3,85.35,28.58,118.96,19
CDM,80076_1,Liver function blood test panel,30.9,20.09,2.52,78.57,19
CDM,80080101_1,"Testing for presence of drug, by chemistry analyzers",250.0,162.5,62.14,645.63,19
CDM,80081002_1,"Urinalysis, manual test",25.0,16.25,0.87,64.56,19
CDM,80081003_1,Automated urinalysis test,20.0,13.0,0.45,51.65,19
CDM,80082247_1,"Bilirubin level, total",25.0,16.25,1.26,64.56,19
CDM,80082270_1,Stool analysis for blood to screen for colon tumors,31.0,20.15,1.36,80.06,19
CDM,80082330_1,"Calcium level, ionized",62.0,40.3,8.48,160.12,19
CDM,80082375_1,Carboxyhemoglobin (protein) level,61.0,39.65,7.52,157.53,19
CDM,80082435_1,Blood chloride level,23.0,14.95,1.06,59.4,19
CDM,80082803_1,Blood gases measurement,239.85,155.9,26.07,619.41,19
CDM,80082805_1,"Blood gases measurement, with O2 saturation",355.0,230.75,78.77,916.79,19
CDM,80082947_1,Blood glucose (sugar) level,20.0,13.0,0.79,51.65,19
CDM,80082948_1,Blood glucose (sugar) measurement using reagent strip,35.0,22.75,1.76,90.39,19
CDM,80082951_1,"Blood glucose (sugar) tolerance test, 3 specimens",112.0,72.8,12.87,289.24,19
CDM,80082962_1,Blood glucose (sugar) test performed by hand-held instrument,23.0,14.95,0.75,59.4,19
CDM,80083036_1,Hemoglobin A1C level,48.0,31.2,4.66,123.96,19
CDM,80083050_1,"Methemoglobin (hemoglobin) analysis, quantitative",37.0,24.05,3.03,95.55,19
CDM,80083605_1,Lactic acid level,74.0,48.1,8.56,191.11,19
CDM,80084132_1,Blood potassium level,23.0,14.95,1.09,59.4,19
CDM,80084295_1,Blood sodium level,24.0,15.6,1.15,61.98,19
CDM,80085014_1,Red blood cell concentration measurement,14.0,9.1,0.33,36.16,19
CDM,80085018_1,"Blood count, hemoglobin",12.0,7.8,0.28,30.99,19
CDM,80085347_1,"Coagulation time measurement, activated",37.0,24.05,1.58,95.55,19
CDM,80086580_1,Skin test for tuberculosis,55.0,35.75,11.64,142.04,19
CDM,80086701_1,Analysis for antibody to HIV -1 virus,77.0,50.05,6.85,198.85,19
CDM,80088710_1,Smear for infectious agents,32.0,20.8,1.86,82.64,19
CDM,80088720_1,Measurement of bilirubin,51.0,33.15,2.56,131.71,19
CDM,80150_1,Amikacin (antibiotic) level,36.8,23.92,5.55,78.57,19
CDM,80156A_1,"Carbamazepine level, total",14.9,9.69,2.17,78.57,19
CDM,80156_1,"Carbamazepine level, total",36.2,23.53,5.27,78.57,19
CDM,80157A_1,"Carbamazepine level, free",21.0,13.65,2.78,78.57,19
CDM,80157_1,"Carbamazepine level, free",23.9,15.54,3.17,78.57,19
CDM,80158_1,Cyclosporine level,26.4,17.16,4.77,78.57,19
CDM,80162_1,"Digoxin level, total",14.9,9.69,1.98,78.57,19
CDM,80164A_1,"Valproic acid level, total",17.3,11.25,2.34,78.57,19
CDM,80164_1,"Valproic acid level, total",14.7,9.56,1.99,78.57,19
CDM,80168_1,Ethosuximide level,29.4,19.11,4.8,78.57,19
CDM,80169_1,Everolimus level,63.0,40.95,8.24,78.57,19
CDM,80170_1,Gentamicin (antibiotic) level,64.1,41.67,9.83,78.57,19
CDM,80176_1,Lidocaine level,18.5,12.03,2.72,78.57,19
CDM,80178_1,Lithium level,17.2,11.18,1.14,78.57,19
CDM,80184A_1,Phenobarbital level,30.9,20.09,4.73,78.57,19
CDM,80184_1,Phenobarbital level,14.7,9.56,2.25,78.57,19
CDM,80185_1,"Phenytoin level, total",14.9,9.69,1.97,78.57,19
CDM,80186_1,"Phenytoin level, free",14.7,9.56,2.02,78.57,19
CDM,80188_1,Primidone level,27.3,17.75,4.53,78.57,19
CDM,80190_1,Procainamide level,30.5,19.83,18.3,149.85,19
CDM,80192_1,"Procainamide level, with metabolites",57.8,37.57,9.68,78.57,19
CDM,80194_1,Quinidine level,21.0,13.65,3.07,78.57,19
CDM,80195_1,Sirolimus level,48.8,31.72,6.7,78.57,19
CDM,80197_1,Tacrolimus level,32.6,21.19,4.48,78.57,19
CDM,80198_1,Theophylline level,17.9,11.64,2.53,78.57,19
CDM,80200_1,Tobramycin (antibiotic) level,33.6,21.84,5.42,78.57,19
CDM,80201_1,Topiramate level,54.6,35.49,6.51,78.57,19
CDM,80202_1,Vancomycin (antibiotic) level,29.3,19.05,3.97,78.57,19
CDM,80299J_1,Quantitation of therapeutic drug,24.6,15.99,4.59,78.57,19
CDM,80299_1,Quantitation of therapeutic drug,126.0,81.9,11.18,78.57,19
CDM,80307P1_1,"Testing for presence of drug, by chemistry analyzers",50.0,32.5,31.07,155.19,19
CDM,80307P2_1,"Testing for presence of drug, by chemistry analyzers",100.0,65.0,37.28,155.19,19
CDM,80307_1,"Testing for presence of drug, by chemistry analyzers",80.0,52.0,37.28,155.19,19
CDM,80323_1,Alkaloids levels,137.5,89.38,13.18,141.63,15
CDM,80324_1,"Amphetamines levels, 1 or 2",87.5,56.88,13.18,90.13,15
CDM,80349_1,"Cannabinoids levels, natural",87.5,56.88,13.18,90.13,15
CDM,80503_1,"Pathology clinical consultation for clinical problem, 5-20 minutes",64.68,42.04,17.7,78.57,19
CDM,80504_1,"Pathology clinical consultation for moderately complex clinical problem, 21-40 minutes",129.35,84.08,37.19,133.23,19
CDM,80505_1,"Pathology clinical consultation for complex clinical problem, 41-60 minutes",234.35,152.33,70.58,241.38,19
CDM,80506_1,"Pathology clinical consultation, additional 30 minutes",105.0,68.25,39.68,108.15,19
CDM,8083IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.87,2.52,0.97,9.99,16
CDM,8083OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.38,7.4,2.85,29.39,16
CDM,8084IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.6,7.54,2.9,29.96,16
CDM,8084OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.06,10.44,4.02,41.47,16
CDM,8085IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.54,2.95,1.14,11.72,16
CDM,8085OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.67,17.34,6.67,68.88,16
CDM,80_1,ROTATEQ VACCINE,910.0,591.5,227.5,637.0,11
CDM,81000_1,"Manual urinalysis test with examination using microscope, non-automated",20.0,13.0,0.8,78.57,19
CDM,81001B_1,"Manual urinalysis test with examination using microscope, automated",7.8,5.07,0.25,78.57,19
CDM,81001_1,"Manual urinalysis test with examination using microscope, automated",10.0,6.5,0.32,78.57,19
CDM,81002_1,"Urinalysis, manual test",10.0,6.5,0.35,78.57,19
CDM,81003B_1,Automated urinalysis test,8.4,5.46,0.19,78.57,19
CDM,81003_1,Automated urinalysis test,10.0,6.5,0.23,78.57,19
CDM,81005C_1,"Analysis of urine, except immunoassays",6.9,4.49,0.15,78.57,19
CDM,81005_1,"Analysis of urine, except immunoassays",10.0,6.5,0.22,78.57,19
CDM,81015A_1,Urinalysis using microscope,7.0,4.55,0.21,78.57,19
CDM,81015_1,Urinalysis using microscope,10.0,6.5,0.31,78.57,19
CDM,81025_1,Urine pregnancy test,30.0,19.5,2.58,78.57,19
CDM,81099A_1,Unlisted analysis of urine,5.5,3.58,2.48,80.89,15
CDM,8112OP _1,UNCLASSIFIED DRUGS,1.41,0.92,0.35,3.64,16
CDM,8114IP _1,UNCLASSIFIED DRUGS,5.2,3.38,1.3,13.43,16
CDM,8114OP _1,UNCLASSIFIED DRUGS,3.06,1.99,0.77,7.9,16
CDM,8116IP _1,UNCLASSIFIED DRUGS,3.51,2.28,0.88,9.06,16
CDM,8117IP _1,UNCLASSIFIED DRUGS,3.97,2.58,0.99,10.25,16
CDM,8118IP _1,UNCLASSIFIED DRUGS,4.42,2.87,1.11,11.41,16
CDM,8118OP _1,UNCLASSIFIED DRUGS,1.59,1.03,0.4,4.11,16
CDM,8119IP _1,UNCLASSIFIED DRUGS,4.24,2.76,1.06,10.95,16
CDM,8119OP _1,UNCLASSIFIED DRUGS,2.0,1.3,0.5,5.17,16
CDM,81206_1,Translocation analysis (BCR/ABL1) major breakpoint,410.0,266.5,78.57,672.24,19
CDM,81207_1,Translocation analysis (BCR/ABL1) minor breakpoint,32.6,21.19,47.22,361.74,19
CDM,8120IP _1,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",103.45,67.24,0.78,267.16,17
CDM,8120OP _1,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",155.45,101.04,0.78,401.45,17
CDM,81210_1,Gene analysis (v-raf murine sarcoma viral oncogene homolog B1),32.6,21.19,57.18,438.06,19
CDM,8121IP _1,UNCLASSIFIED DRUGS,87.52,56.89,21.88,226.02,16
CDM,81220_1,Gene analysis (cystic fibrosis transmembrane conductance regular) common variants,350.0,227.5,78.57,1948.1,19
CDM,81240_1,"Gene analysis (prothrombin, coagulation factor II) A variant",164.23,106.75,39.41,164.06,19
CDM,81241_1,Gene analysis (coagulation factor V) Leiden variant,183.43,119.23,44.02,183.24,19
CDM,81243_1,"Gene analysis (fragile X syndrome, X-linked intellectual disability) for detection of abnormal alleles",32.6,21.19,18.6,142.46,19
CDM,81244_1,"Gene analysis (fragile X syndrome, X-linked intellectual disability) for characterization of alleles",33.0,21.45,14.81,112.11,19
CDM,81245_1,Gene analysis (fms-related tyrosine kinase 3) internal tandem duplication variants,32.6,21.19,53.96,413.36,19
CDM,81256_1,Gene analysis (hemochromatosis) common variants,32.6,21.19,21.31,163.24,19
CDM,81261_1,Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect abnormal clonal population amplified methodology,32.6,21.19,64.54,494.48,19
CDM,81265_1,Comparative analysis using Short Tandem Repeat (STR) markers of patient and specimen,32.6,21.19,75.98,582.09,19
CDM,81267_1,"Chimerism analysis post transplantation, without cell selection",32.6,21.19,67.63,518.13,19
CDM,81268_1,"Chimerism analysis post transplantation, with cell selection",32.6,21.19,78.57,651.32,19
CDM,81270_1,Gene analysis (Janus kinase 2) variant,229.15,148.95,55.0,228.92,19
CDM,81291_1,"Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants",32.6,21.19,21.3,163.19,19
CDM,81310_1,Gene analysis (nucleophosmin) exon 12 variants,32.6,21.19,78.57,615.68,19
CDM,81315_1,Translocation analysis (PML-RARA regulated adaptor molecule 1) common breakpoint,370.0,240.5,78.57,767.05,19
CDM,8131IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.55,36.11,13.89,143.46,16
CDM,81332_1,"Gene analysis (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) common variants",32.6,21.19,14.23,109.02,19
CDM,81342_1,Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor gamma),32.6,21.19,65.69,503.25,19
CDM,8134IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.48,4.21,1.62,16.73,16
CDM,8134OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.93,18.15,6.98,72.13,16
CDM,81370_1,"HLA class I and II typing low resolution HLA-A, -B, -C, -DRB1/3/4/5 and -DQB1",32.6,21.19,78.57,1004.29,19
CDM,81371_1,"HLA class I and II typing, low resolution HLA-A, -B, and -DRB1",32.6,21.19,78.57,1010.29,19
CDM,81372_1,HLA class I typing low resolution,32.6,21.19,78.57,1007.97,19
CDM,81373_1,HLA class I typing low resolution one locus,32.6,21.19,41.54,318.26,19
CDM,81375_1,HLA class II typing low resolution HLA-DRB1/3/4/5 and -DQB1,32.6,21.19,71.96,551.3,19
CDM,81376_1,HLA class II typing low resolution one locus,32.6,21.19,39.84,305.24,19
CDM,81377_1,HLA class II typing low resolution one antigen equivalent,32.6,21.19,30.89,236.61,19
CDM,81379_1,HLA Class I typing high resolution,32.6,21.19,78.57,837.61,19
CDM,81380_1,HLA class I typing high resolution one locus,381.2,247.78,78.57,675.68,19
CDM,81381_1,HLA class I typing high resolution one allele or allele group,32.6,21.19,55.39,424.33,19
CDM,81382_1,HLA class II typing high resolution one locus,32.6,21.19,40.32,308.89,19
CDM,81383_1,HLA class II typing high resolution one allele or allele group,32.6,21.19,35.58,272.55,19
CDM,81426IP _1,UNCLASSIFIED DRUGS,8.04,5.23,2.01,20.76,16
CDM,81426OP _1,UNCLASSIFIED DRUGS,15.34,9.97,3.84,39.62,16
CDM,81434OP _1,"INJECTION, ZOLEDRONIC ACID, 1 MG",60.69,39.45,5.38,182.07,17
CDM,81453IP _1,"NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME",47.0,30.55,11.75,121.38,16
CDM,81453OP _1,"NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME",95.34,61.97,23.84,246.22,16
CDM,81454IP _1,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,49.76,32.34,12.44,128.51,16
CDM,81454OP _1,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,32.93,21.4,8.23,85.04,16
CDM,81461IP _1,TEMOZOLOMIDE 140 MG CAPSULE,230.55,149.86,57.64,161.39,11
CDM,81474IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",82.62,53.7,20.66,213.37,16
CDM,81474OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",64.0,41.6,16.0,165.28,16
CDM,81475IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",88.29,57.39,22.07,228.01,16
CDM,81475OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.73,31.02,11.93,123.26,16
CDM,8166IP _1,TRIHEXYPHENIDYL 2 MG TABLET,4.8,3.12,1.2,3.36,11
CDM,81696IP _1,"INJECTION, ECULIZUMAB, 2 MG",2687.86,1747.11,47.73,6941.4,17
CDM,81696OP _1,"INJECTION, ECULIZUMAB, 2 MG",1045.63,679.66,47.73,2700.34,17
CDM,8182IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.61,8.2,3.15,32.57,16
CDM,81_1,BEYFORTUS 100 MG/ML SYRINGE,1000.0,650.0,250.0,700.0,11
CDM,82009A_1,"Ketone bodies analysis, qualitative",10.6,6.89,0.48,78.57,19
CDM,82009_1,"Ketone bodies analysis, qualitative",3.5,2.28,0.16,78.57,19
CDM,82013_1,Acetylcholinesterase (enzyme) level,130.2,84.63,7.37,78.57,19
CDM,82016_1,Chemical analysis for genetic disorder,66.6,43.29,9.89,78.57,19
CDM,82017_1,Chemical test for genetic disorder,62.9,40.89,10.12,78.57,19
CDM,82024_1,Adrenocorticotropic hormone (ACTH) level,149.1,96.92,23.17,96.45,19
CDM,82040A_1,Albumin (protein) level,9.0,5.85,0.45,78.57,19
CDM,82040B_1,Albumin (protein) level,8.9,5.79,0.44,78.57,19
CDM,82040_1,Albumin (protein) level,28.4,18.46,1.41,78.57,19
CDM,82042B_1,"Cerebrospinal fluid, or amniotic fluid albumin (protein) level",9.1,5.92,0.71,78.57,19
CDM,82042_1,"Cerebrospinal fluid, or amniotic fluid albumin (protein) level",20.0,13.0,1.56,78.57,19
CDM,82043_1,Urine microalbumin (protein) level,20.1,13.07,1.16,78.57,19
CDM,82044_1,Urine microalbumin (protein) analysis,14.7,9.56,0.92,78.57,19
CDM,82085_1,Aldolase (enzyme) level,31.2,20.28,3.03,78.57,19
CDM,82088_1,Aldosterone hormone level,38.4,24.96,15.65,101.77,19
CDM,82100IP _1,NEUPRO 2 MG/24 HR PATCH,221.35,143.88,55.34,154.95,11
CDM,82101IP _1,NEUPRO 4 MG/24 HR PATCH,214.85,139.65,53.71,150.4,11
CDM,82103_1,"Alpha-1-antitrypsin (protein) blood test, total",10.1,6.57,1.36,78.57,19
CDM,82104_1,"Alpha-1-antitrypsin (protein) blood test, phenotype",68.3,44.4,8.68,78.57,19
CDM,82105A_1,"Alpha-fetoprotein (AFP) level, serum",19.2,12.48,3.22,78.57,19
CDM,82105B_1,"Alpha-fetoprotein (AFP) level, serum",33.6,21.84,5.63,78.57,19
CDM,82105C_1,"Alpha-fetoprotein (AFP) level, serum",35.8,23.27,6.0,78.57,19
CDM,82105E_1,"Alpha-fetoprotein (AFP) level, serum",16.8,10.92,2.82,78.57,19
CDM,82105_1,"Alpha-fetoprotein (AFP) level, serum",54.6,35.49,9.16,78.57,19
CDM,82106_1,"Alpha-fetoprotein (AFP) level, amniotic fluid",56.7,36.86,9.64,78.57,19
CDM,82108_1,Aluminum level,71.5,46.48,15.29,78.57,19
CDM,82120_1,Vaginal fluid chemical analysis for bacteria,9.5,6.18,0.57,78.57,19
CDM,82128_1,"Amino acid analysis, multiple amino acids, qualitative, each specimen",66.6,43.29,8.32,78.57,19
CDM,82131_1,"Amino acid analysis, quantitative, each specimen",76.7,49.86,13.79,78.57,19
CDM,82134IP _1,UNCLASSIFIED DRUGS,9.16,5.95,2.29,23.66,16
CDM,82134OP _1,UNCLASSIFIED DRUGS,8.51,5.53,2.13,21.98,16
CDM,82135_1,Aminolevulinic acid (protein) level,99.0,64.35,9.87,78.57,19
CDM,82139_1,"Amino acid level, 6 or more amino acids, quantitative, each specimen",120.8,78.52,10.12,78.57,19
CDM,82140_1,Ammonia level,33.0,21.45,4.81,78.57,19
CDM,82143_1,Amniotic fluid scan,36.8,23.92,3.44,78.57,19
CDM,82150A_1,Amylase (enzyme) level,11.1,7.22,0.72,78.57,19
CDM,82150C_1,Amylase (enzyme) level,13.6,8.84,0.88,78.57,19
CDM,82150_1,Amylase (enzyme) level,18.9,12.29,1.22,78.57,19
CDM,82157_1,Androstenedione (hormone) level,118.7,77.16,17.57,78.57,19
CDM,82164_1,Angiotensin l - converting enzyme (ACE) level,63.0,40.95,8.76,78.57,19
CDM,82172_1,Apolipoprotein level,16.8,10.92,3.54,78.57,19
CDM,82175_1,Arsenic level,60.4,39.26,11.38,78.57,19
CDM,82177IP _1,"INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML",320.67,208.44,42.62,828.13,17
CDM,82177OP _1,"INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML",320.67,208.44,42.62,828.13,17
CDM,82180_1,"Ascorbic acid (Vitamin C) level, blood",95.3,61.95,5.93,78.57,19
CDM,82200IP _1,"INJECTION, FLUOROURACIL, 500 MG",3.52,2.29,0.88,10.56,17
CDM,82200OP _1,"INJECTION, FLUOROURACIL, 500 MG",11.44,7.44,2.06,34.32,17
CDM,82232_1,Beta-2 microglobulin (protein) level,53.6,34.84,8.67,78.57,19
CDM,82247A_1,"Bilirubin level, total",24.2,15.73,1.21,78.57,19
CDM,82247_1,"Bilirubin level, total",22.1,14.37,1.11,78.57,19
CDM,82248_1,"Bilirubin level, direct",15.0,9.75,0.75,78.57,19
CDM,82261_1,Biotinidase (enzyme) level,7.4,4.81,1.25,78.57,19
CDM,82270A_1,Stool analysis for blood to screen for colon tumors,10.5,6.83,0.46,78.57,19
CDM,82270_1,Stool analysis for blood to screen for colon tumors,10.0,6.5,0.44,78.57,19
CDM,82271A_1,Specimen analysis for blood,10.5,6.83,0.56,78.57,19
CDM,82271_1,Specimen analysis for blood,10.5,6.83,0.56,78.57,19
CDM,82272_1,"Stool analysis for blood, by peroxidase activity",10.0,6.5,0.42,78.57,19
CDM,82274_1,"Stool analysis for blood, by fecal hemoglobin determination by immunoassay",77.3,50.25,12.31,78.57,19
CDM,82300_1,Cadmium level,55.8,36.27,13.19,78.57,19
CDM,82306_1,Vitamin D-3 level,17.3,11.25,5.12,78.57,19
CDM,82307IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2852.25,1853.96,713.06,7365.94,16
CDM,82308IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",126.95,82.52,31.74,327.85,16
CDM,82308OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",126.95,82.52,31.74,327.85,16
CDM,82308_1,Calcitonin (hormone) level,107.9,70.14,16.07,78.57,19
CDM,82310_1,"Calcium level, total",15.8,10.27,0.82,78.57,19
CDM,82330_1,"Calcium level, ionized",20.3,13.2,2.78,78.57,19
CDM,82340_1,Urine calcium level,12.6,8.19,0.76,78.57,19
CDM,82355_1,Analysis of stone,36.8,23.92,4.26,78.57,19
CDM,82365_1,Infrared analysis of stone,28.4,18.46,3.66,78.57,19
CDM,82374_1,Carbon dioxide (bicarbonate) level,15.6,10.14,0.76,78.57,19
CDM,82375_1,Carboxyhemoglobin (protein) level,22.4,14.56,2.76,78.57,19
CDM,82376_1,Carboxyhemoglobin (protein) analysis,16.8,10.92,2.36,78.57,19
CDM,82378C_1,Carcinoembryonic antigen (CEA) protein level,14.7,9.56,2.79,78.57,19
CDM,82378_1,Carcinoembryonic antigen (CEA) protein level,36.8,23.92,6.98,78.57,19
CDM,82379_1,Carnitine level,50.3,32.7,8.49,78.57,19
CDM,82380_1,Carotene level,27.2,17.68,2.51,78.57,19
CDM,82384_1,Catecholamines (organic nitrogen) level,54.6,35.49,13.79,78.57,19
CDM,82390_1,Ceruloplasmin (protein) level,13.2,8.58,1.42,78.57,19
CDM,82397_1,Analysis using chemiluminescent technique (light and chemical )reaction,52.5,34.13,7.41,78.57,19
CDM,82435A_1,Blood chloride level,10.7,6.96,0.49,78.57,19
CDM,82435_1,Blood chloride level,30.5,19.83,1.4,78.57,19
CDM,82436_1,Urine chloride level,11.2,7.28,0.64,78.57,19
CDM,82438_1,Chloride level,28.4,18.46,1.42,78.57,19
CDM,82465A_1,Cholesterol level,10.7,6.96,0.47,78.57,19
CDM,82465W_1,Cholesterol level,7.4,4.81,0.32,78.57,19
CDM,82465_1,Cholesterol level,15.8,10.27,0.69,78.57,19
CDM,82480_1,"Cholinesterase (enzyme) level, to test for exposure to chemical or liver disease",13.9,9.04,1.09,78.57,19
CDM,82482_1,Cholinesterase (enzyme) level,84.0,54.6,5.89,78.57,19
CDM,8249OP _1,UNCLASSIFIED DRUGS,3.85,2.5,0.96,9.94,16
CDM,82504IP _1,EXELON 4.6 MG/24HR PATCH,177.65,115.47,44.41,124.36,11
CDM,82504OP _1,EXELON 4.6 MG/24HR PATCH,125.7,81.71,31.43,87.99,11
CDM,82505OP _1,RIVASTIGMINE 9.5 MG/24HR PATCH,20.35,13.23,5.09,14.25,11
CDM,82507_1,Citrate level,59.9,38.94,16.65,78.57,19
CDM,8250IP _1,UNCLASSIFIED DRUGS,26.08,16.95,6.52,67.35,16
CDM,8250OP _1,UNCLASSIFIED DRUGS,9.22,5.99,2.31,23.81,16
CDM,82523_1,"Collagen cross links test, (urine test to evaluate bone health)",17.7,11.51,3.31,78.57,19
CDM,82525_1,Copper level,42.7,27.76,5.3,78.57,19
CDM,82530_1,"Cortisol (hormone) measurement, free",42.0,27.3,7.02,78.57,19
CDM,82533A_1,"Cortisol (hormone) measurement, total",17.1,11.12,2.79,78.57,19
CDM,82533_1,"Cortisol (hormone) measurement, total",53.6,34.84,8.74,78.57,19
CDM,82540_1,Creatine measurement,10.1,6.57,0.47,78.57,19
CDM,82550A_1,"Creatine kinase (cardiac enzyme) level, total",5.7,3.71,0.37,78.57,19
CDM,82550_1,"Creatine kinase (cardiac enzyme) level, total",20.0,13.0,1.3,78.57,19
CDM,82552_1,"Creatine kinase (cardiac enzyme) level, isoenzymes",47.3,30.75,6.33,78.57,19
CDM,82553A_1,"Creatine kinase (cardiac enzyme) level, MB fraction only",11.9,7.74,1.37,78.57,19
CDM,82553_1,"Creatine kinase (cardiac enzyme) level, MB fraction only",32.5,21.13,3.75,78.57,19
CDM,82554_1,"Creatine kinase (cardiac enzyme) level, isoforms",367.5,238.88,7.12,78.57,19
CDM,82565_1,Blood creatinine level,15.0,9.75,0.77,78.57,19
CDM,82570_1,Creatinine level to test for kidney function or muscle injury,16.0,10.4,0.83,78.57,19
CDM,82575_1,Creatinine clearance measurement to test for kidney function,11.3,7.35,1.07,78.57,19
CDM,82585_1,Cryofibrinogen (protein) level,32.6,21.19,4.61,78.57,19
CDM,82592IP _1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",15.93,10.35,0.19,41.14,17
CDM,82592OP _1,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",13.65,8.87,0.02,35.25,17
CDM,82595_1,Cryoglobulin (protein) measurement,16.4,10.66,1.06,78.57,19
CDM,8259IP _1,UNCLASSIFIED DRUGS,1172.0,761.8,293.0,3026.69,16
CDM,8259OP _1,UNCLASSIFIED DRUGS,1172.0,761.8,293.0,3026.69,16
CDM,82600_1,Cyanide measurement,83.9,54.54,11.64,78.57,19
CDM,82607A_1,Cyanocobalamin (vitamin B-12) level,19.9,12.94,3.0,78.57,19
CDM,82607_1,Cyanocobalamin (vitamin B-12) level,58.8,38.22,8.87,78.57,19
CDM,82615_1,Cystine and homocystine (amino acids) analysis,21.0,13.65,2.01,78.57,19
CDM,82626_1,Dehydroepiandrosterone (DHEA) hormone level,151.2,98.28,15.16,78.57,19
CDM,82627B_1,Dehydroepiandrosterone (DHEA-S) hormone level,26.3,17.1,5.85,78.57,19
CDM,82627_1,Dehydroepiandrosterone (DHEA-S) hormone level,60.9,39.59,13.34,78.57,19
CDM,82634_1,"Deoxycortisol, 11 (hormone) level",63.0,40.95,17.57,78.57,19
CDM,82639IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.65,2.37,0.91,9.43,16
CDM,82639OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",63.87,41.52,15.97,164.94,16
CDM,82652_1,"Dihydroxyvitamin D, 1, 25 level",182.7,118.76,23.1,96.15,19
CDM,82657_1,"Enzyme activity measurement, nonradioactive substrate",236.3,153.6,13.3,78.57,19
CDM,82664_1,"Electrophoresis, laboratory testing technique",217.4,141.31,36.9,153.6,19
CDM,82668_1,Erythropoietin (protein) level,68.5,44.53,11.27,78.57,19
CDM,82670A_1,Measurement of total estradiol (hormone),31.5,20.48,8.8,78.57,19
CDM,82670_1,Measurement of total estradiol (hormone),102.9,66.89,16.76,78.57,19
CDM,82677A_1,Estriol (hormone) level,10.5,6.83,2.54,78.57,19
CDM,82677_1,Estriol (hormone) level,49.4,32.11,11.94,78.57,19
CDM,82705_1,"Stool fat or lipids analysis, qualitative",7.0,4.55,0.36,78.57,19
CDM,82710_1,"Stool fat or lipids analysis, quantitative",85.6,55.64,10.08,78.57,19
CDM,82725_1,Fatty acids measurement,74.8,48.62,11.26,78.57,19
CDM,82726_1,Very long chain fatty acids level,63.0,40.95,11.85,78.57,19
CDM,82728A_1,Ferritin (blood protein) level,30.0,19.5,4.09,78.57,19
CDM,82728_1,Ferritin (blood protein) level,43.1,28.02,5.87,78.57,19
CDM,82731_1,Fetal fibronectin (protein) analysis,280.0,182.0,38.65,180.35,19
CDM,82746B_1,"Folic acid level, serum",20.8,13.52,3.06,78.57,19
CDM,82746_1,"Folic acid level, serum",57.8,37.57,8.5,78.57,19
CDM,82747B_1,"Folic acid level, RBC",18.4,11.96,3.25,78.57,19
CDM,82757_1,Semen fructose (carbohydrate) level,157.5,102.38,10.4,78.57,19
CDM,82775_1,Galactose-1-phosphate uridyl transferase (enzyme) level,183.1,119.02,12.64,78.57,19
CDM,82776_1,Galactose-1-phosphate uridyl transferase screening test,13.1,8.52,1.54,78.57,19
CDM,82784A_1,Gammaglobulin (immune system protein) measurement,13.2,8.58,1.23,78.57,19
CDM,82784_1,Gammaglobulin (immune system protein) measurement,8.9,5.79,0.83,78.57,19
CDM,82785A_1,IgE (immune system protein) level,35.3,22.95,5.81,78.57,19
CDM,82785_1,IgE (immune system protein) level,52.5,34.13,8.64,78.57,19
CDM,82787_1,"Gammaglobulin (immune system protein) measurement, immunoglobulin subclasses",36.8,23.92,2.95,78.57,19
CDM,82800_1,Blood pH level,7.2,4.68,0.79,78.57,19
CDM,82803A_1,Blood gases measurement,22.3,14.5,5.81,78.57,19
CDM,82803B_1,Blood gases measurement,15.8,10.27,4.12,78.57,19
CDM,82803_1,Blood gases measurement,24.8,16.12,6.47,78.57,19
CDM,82805_1,"Blood gases measurement, with O2 saturation",28.1,18.27,22.13,196.73,19
CDM,82810_1,"Blood gas, oxygen saturation measurement",8.6,5.59,0.84,78.57,19
CDM,82941_1,Gastrin (GI tract hormone) level,24.2,15.73,4.27,78.57,19
CDM,82943_1,Glucagon (pancreatic hormone) level,55.7,36.21,7.96,78.57,19
CDM,82945A_1,Glucose (sugar) level on body fluid,9.1,5.92,0.36,78.57,19
CDM,82945B_1,Glucose (sugar) level on body fluid,9.1,5.92,0.36,78.57,19
CDM,82947A_1,Blood glucose (sugar) level,9.0,5.85,0.35,78.57,19
CDM,82947W_1,Blood glucose (sugar) level,7.4,4.81,0.29,78.57,19
CDM,82947_1,Blood glucose (sugar) level,20.0,13.0,0.79,78.57,19
CDM,82948_1,Blood glucose (sugar) measurement using reagent strip,11.6,7.54,0.58,78.57,19
CDM,82950_1,Blood glucose (sugar) level after receiving dose of glucose,20.0,13.0,0.95,78.57,19
CDM,82951A_1,"Blood glucose (sugar) tolerance test, 3 specimens",10.0,6.5,1.29,78.57,19
CDM,82951_1,"Blood glucose (sugar) tolerance test, 3 specimens",60.0,39.0,7.72,78.57,19
CDM,82952_1,"Blood glucose (sugar) tolerance test, each additional beyond 3 specimens",17.9,11.64,0.7,78.57,19
CDM,82955_1,G6PD (enzyme) level,40.0,26.0,3.88,78.57,19
CDM,82962_1,Blood glucose (sugar) test performed by hand-held instrument,10.0,6.5,0.33,78.57,19
CDM,82977A_1,Glutamyltransferase (liver enzyme) level,12.5,8.13,0.9,78.57,19
CDM,82977_1,Glutamyltransferase (liver enzyme) level,29.5,19.18,2.12,78.57,19
CDM,82985_1,Glycated protein level,24.5,15.93,4.11,78.57,19
CDM,83001_1,"Gonadotropin, follicle stimulating (reproductive hormone) level",72.5,47.13,11.15,78.57,19
CDM,83002_1,"Gonadotropin, luteinizing (reproductive hormone) level",72.5,47.13,11.11,78.57,19
CDM,83003_1,Human growth hormone level,65.1,42.32,10.0,78.57,19
CDM,83010_1,Haptoglobin (serum protein) level,15.0,9.75,1.89,78.57,19
CDM,83013A_1,Breath test analysis for helicobacter pylori,217.4,141.31,40.42,168.23,19
CDM,83013_1,Breath test analysis for helicobacter pylori,250.0,162.5,40.42,168.4,19
CDM,83014_1,Administration of drug for helicobacter pylori,30.0,19.5,2.36,78.57,19
CDM,83015_1,Heavy metal screening test,35.9,23.34,7.52,78.57,19
CDM,83020_1,"Hemoglobin analysis and measurement, electrophoresis",41.9,27.24,5.39,78.57,19
CDM,83021_1,"Hemoglobin analysis and measurement, chromatography",35.7,23.21,6.45,78.57,19
CDM,83026_1,Hemoglobin level,7.2,4.68,0.29,78.57,19
CDM,83030_1,Fetal hemoglobin level,15.2,9.88,1.63,78.57,19
CDM,83033_1,Fetal hemoglobin analysis,7.4,4.81,0.59,78.57,19
CDM,83036B_1,Hemoglobin A1C level,9.8,6.37,0.95,78.57,19
CDM,83036_1,Hemoglobin A1C level,39.75,25.84,3.86,78.57,19
CDM,83037_1,"Hemoglobin A1C level, by device for home use",29.8,19.37,2.89,78.57,19
CDM,83050_1,"Methemoglobin (hemoglobin) analysis, quantitative",8.0,5.2,0.66,78.57,19
CDM,83051_1,Plasma hemoglobin level,25.2,16.38,1.84,78.57,19
CDM,83070_1,Hemosiderin (hemoglobin breakdown product) analysis,50.8,33.02,2.41,78.57,19
CDM,83088_1,Histamine (immune system substance) level,165.9,107.84,17.72,78.57,19
CDM,83090A_1,Homocysteine (amino acid) level,28.1,18.27,5.04,78.57,19
CDM,83090_1,Homocysteine (amino acid) level,47.0,30.55,8.42,78.57,19
CDM,83150_1,Homovanillic acid (organic acid) level,93.5,60.78,13.45,78.57,19
CDM,83497_1,Hydroxyindolacetic acid (product of metabolism) level,44.1,28.67,5.69,78.57,19
CDM,83498_1,"Hydroxyprogesterone, 17-D (synthetic hormone) level",59.3,38.55,16.11,78.57,19
CDM,83511000_1,HC GENERAL ANESTHESIA PER MINUTE   BMC,27.0,17.55,6.75,18.9,11
CDM,83516_1,"Analysis of substance using immunoassay technique, multiple step method",54.5,35.43,6.28,78.57,19
CDM,83518_1,"Analysis of substance using immunoassay technique, single step method",64.8,42.12,6.25,78.57,19
CDM,83519_1,"Measurement of substance using immunoassay technique, by radioimmunoassay",152.3,99.0,11.04,78.57,19
CDM,83520_1,Measurement of substance using immunoassay technique,51.5,33.48,8.89,78.57,19
CDM,83521_1,Measurement of immunoglobulin light chains,43.18,28.07,7.46,78.57,19
CDM,83525B_1,"Insulin measurement, total",25.2,16.38,2.88,78.57,19
CDM,83525_1,"Insulin measurement, total",44.1,28.67,5.04,78.57,19
CDM,83527_1,"Insulin measurement, free",53.8,34.97,6.97,78.57,19
CDM,83540A_1,Iron level,7.7,5.01,0.5,78.57,19
CDM,83540_1,Iron level,19.0,12.35,1.23,78.57,19
CDM,83550_1,Iron binding capacity,26.0,16.9,2.27,78.57,19
CDM,83586_1,"Ketosteroids, 17 (hormone) measurement, total",38.1,24.77,4.88,78.57,19
CDM,83605_1,Lactic acid level,10.1,6.57,1.17,78.57,19
CDM,83615_1,Lactate dehydrogenase (enzyme) level,18.0,11.7,1.09,78.57,19
CDM,83625_1,Lactate dehydrogenase (enzyme) measurement,25.5,16.58,3.26,78.57,19
CDM,83630_1,Stool lactoferrin (immune system protein) analysis,65.0,42.25,11.82,78.57,19
CDM,83655_1,Lead level,6.6,4.29,0.8,78.57,19
CDM,83663A_1,"Fetal lung maturity assessment, fluorescence polarization",42.0,27.3,7.94,78.57,19
CDM,83690_1,Lipase (fat enzyme) level,21.0,13.65,1.45,78.57,19
CDM,83695_1,Lipoprotein (A) level,34.1,22.17,4.88,78.57,19
CDM,83718_1,HDL cholesterol level,25.0,16.25,2.05,78.57,19
CDM,83721_1,LDL cholesterol level,29.0,18.85,3.05,78.57,19
CDM,83735A_1,Magnesium level,10.5,6.83,0.7,78.57,19
CDM,83735B_1,Magnesium level,11.2,7.28,0.75,78.57,19
CDM,83735_1,Magnesium level,40.1,26.07,2.69,78.57,19
CDM,83785_1,Manganese (heavy metal) level,68.3,44.4,15.99,78.57,19
CDM,83789_1,Mass spectrometry (laboratory testing method),63.0,40.95,14.47,78.57,19
CDM,83825_1,Mercury level,59.8,38.87,9.72,78.57,19
CDM,83835_1,Metanephrines level,51.5,33.48,8.72,78.57,19
CDM,83864_1,Mucopolysaccharides (protein) level,506.1,328.97,17.1,144.24,19
CDM,83873_1,"Myelin basic protein (nerve protein) level, spinal fluid",53.0,34.45,9.12,78.57,19
CDM,83874C_1,Myoglobin (muscle protein) level,8.4,5.46,1.09,78.57,19
CDM,83874_1,Myoglobin (muscle protein) level,8.6,5.59,1.11,78.57,19
CDM,83880_1,Natriuretic peptide (heart and blood vessel protein) level,102.0,66.3,23.56,98.05,19
CDM,83915_1,Nucleotidase 5' (enzyme) level,28.9,18.79,3.22,78.57,19
CDM,83916_1,Measurement of immune substance (oligoclonal bands),38.9,25.29,10.65,78.57,19
CDM,83918_1,Organic acids level,115.5,75.08,14.16,78.57,19
CDM,83921_1,Organic acid level,114.8,74.62,12.73,78.57,19
CDM,83930_1,Blood osmolality (concentration) measurement,20.1,13.07,1.33,78.57,19
CDM,83935_1,Urine osmolality (concentration) measurement,8.6,5.59,0.59,78.57,19
CDM,83937_1,Osteocalcin (bone protein) level,89.3,58.05,17.91,78.57,19
CDM,83945_1,Oxalate level,36.8,23.92,5.32,78.57,19
CDM,83970B_1,Parathormone (parathyroid hormone) level,37.8,24.57,15.6,103.1,19
CDM,83970_1,Parathormone (parathyroid hormone) level,124.0,80.6,24.77,103.1,19
CDM,83986B_1,Body fluid pH level,8.9,5.79,0.32,78.57,19
CDM,83986_1,Body fluid pH level,20.0,13.0,0.72,78.57,19
CDM,84030_1,"Phenylalanine, PKU (amino acid) level",15.8,10.27,0.87,78.57,19
CDM,84060_1,"Phosphatase (enzyme) measurement, acid, total",28.4,18.46,2.17,78.57,19
CDM,84066_1,"Phosphatase, prostatic (prostate enzyme) level",68.3,44.4,5.8,78.57,19
CDM,84075_1,"Phosphatase (enzyme) level, alkaline",16.0,10.4,0.83,78.57,19
CDM,84080_1,"Phosphatase (enzyme) measurement, alkaline, isoenzymes",33.0,21.45,4.88,78.57,19
CDM,84081_1,Phosphatidylglycerol (amniotic fluid organic acid) level,42.0,27.3,6.94,78.57,19
CDM,84100_1,Phosphate level,14.0,9.1,0.66,78.57,19
CDM,84105_1,Urine phosphate level,13.9,9.04,0.8,78.57,19
CDM,84106_1,Urine porphobilinogen (metabolism substance) analysis,15.8,10.27,0.92,78.57,19
CDM,84120_1,Urine porphyrins (metabolism substance) measurement,40.7,26.46,5.99,78.57,19
CDM,84132_1,Blood potassium level,15.8,10.27,0.75,78.57,19
CDM,84133_1,Urine potassium level,7.1,4.62,0.34,78.57,19
CDM,84134_1,Prealbumin (protein) level,18.1,11.77,2.64,78.57,19
CDM,84144A_1,Progesterone (reproductive hormone) level,62.0,40.3,12.52,78.57,19
CDM,84144_1,Progesterone (reproductive hormone) level,80.9,52.59,12.52,78.57,19
CDM,84145_1,Procalcitonin (hormone) level,61.4,39.91,16.33,78.57,19
CDM,84146_1,Prolactin (milk producing hormone) level,75.6,49.14,11.63,78.57,19
CDM,84152_1,"PSA (prostate specific antigen) measurement, complexed",94.5,61.43,11.03,78.57,19
CDM,84153A_1,"PSA (prostate specific antigen) measurement, total",57.8,37.57,10.63,78.57,19
CDM,84153W_1,"PSA (prostate specific antigen) measurement, total",15.8,10.27,2.91,78.57,19
CDM,84153_1,"PSA (prostate specific antigen) measurement, total",55.0,35.75,10.11,78.57,19
CDM,84154_1,"PSA (prostate specific antigen) measurement, free",22.5,14.63,4.14,78.57,19
CDM,84155B_1,"Total protein level, blood",9.8,6.37,0.36,78.57,19
CDM,84155_1,"Total protein level, blood",10.6,6.89,0.39,78.57,19
CDM,84156B_1,"Total protein level, urine",18.3,11.9,0.67,78.57,19
CDM,84156_1,"Total protein level, urine",9.25,6.01,0.34,78.57,19
CDM,84157C_1,"Total protein level, body fluid",15.6,10.14,0.62,78.57,19
CDM,84157D_1,"Total protein level, body fluid",23.1,15.02,0.92,78.57,19
CDM,84165C_1,"Protein measurement, serum",41.1,26.72,4.41,78.57,19
CDM,84165_1,"Protein measurement, serum",44.9,29.19,4.82,78.57,19
CDM,84166_1,"Protein measurement, body fluid",44.9,29.19,8.01,78.57,19
CDM,84181_1,Protein measurement,44.9,29.19,7.65,78.57,19
CDM,84182_1,"Protein measurement, immunological probe for band identification",44.9,29.19,10.18,78.57,19
CDM,84202_1,Protoporphyrin (metabolism substance) level,173.3,112.65,8.61,78.57,19
CDM,84206_1,Proinsulin (pancreatic hormone) level,148.1,96.27,16.01,78.57,19
CDM,84207_1,Vitamin B-6 level,149.1,96.92,16.86,78.57,19
CDM,84210_1,Pyruvate (organic acid) level,57.8,37.57,8.37,78.57,19
CDM,84220_1,Pyruvate kinase (enzyme) level,73.5,47.78,5.66,78.57,19
CDM,84233_1,Estrogen receptor analysis,248.9,161.79,52.73,219.48,19
CDM,84234_1,Progesterone (reproductive hormone) receptor analysis,251.0,163.15,38.93,162.85,19
CDM,84238_1,Chemical receptor analysis,166.7,108.36,21.94,91.33,19
CDM,84244_1,Renin (kidney enzyme) level,85.1,55.32,13.19,78.57,19
CDM,84252_1,Vitamin B-2 (riboflavin) level,98.7,64.16,12.14,78.57,19
CDM,84255_1,Selenium (vitamin) level,79.5,51.68,15.32,78.57,19
CDM,84260_1,Serotonin (hormone) level,128.1,83.27,18.59,78.57,19
CDM,84270_1,Sex hormone binding globulin (protein) level,29.8,19.37,6.48,78.57,19
CDM,84275_1,Sialic acid (organic acid) level,56.7,36.86,7.62,78.57,19
CDM,8428IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.99,1.94,0.75,7.72,16
CDM,84295A_1,Blood sodium level,3.3,2.15,0.16,78.57,19
CDM,84295_1,Blood sodium level,13.5,8.78,0.65,78.57,19
CDM,8429IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.47,2.26,0.87,8.96,16
CDM,8429OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.6,12.09,4.65,48.03,16
CDM,84300_1,Urine sodium level,7.1,4.62,0.36,78.57,19
CDM,84302_1,Sodium level,13.8,8.97,0.67,78.57,19
CDM,84305_1,Somatomedin (growth factor) level,87.2,56.68,12.76,78.57,19
CDM,84311_1,Chemical analysis using spectrophotometry (light),123.9,80.54,4.86,78.57,19
CDM,84376_1,"Carbohydrate analysis, single qualitative",23.1,15.02,1.27,78.57,19
CDM,84378_1,"Carbohydrate analysis, single quantitative",217.4,141.31,6.92,78.57,19
CDM,84402A_1,"Testosterone (hormone) level, free",19.8,12.87,5.04,78.57,19
CDM,84402_1,"Testosterone (hormone) level, free",73.8,47.97,15.28,78.57,19
CDM,84403D_1,"Testosterone (hormone) level, total",10.5,6.83,2.71,78.57,19
CDM,84403_1,"Testosterone (hormone) level, total",100.8,65.52,15.49,78.57,19
CDM,84425_1,Vitamin B-1 (thiamine) level,117.6,76.44,12.74,78.57,19
CDM,8442IP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",81.77,53.15,20.44,211.17,16
CDM,8442OP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",68.41,44.47,17.1,176.67,16
CDM,84430_1,Thiocyanate (organic sulfur substance) level,83.1,54.02,6.98,78.57,19
CDM,84432_1,Thyroglobulin (thyroid related hormone) level,43.1,28.02,6.92,78.57,19
CDM,84436_1,"Thyroxine (thyroid chemical), total",28.4,18.46,1.95,78.57,19
CDM,84437_1,"Thyroxine (thyroid chemical), requiring elution",23.1,15.02,1.49,78.57,19
CDM,84439_1,"Thyroxine (thyroid chemical), free",34.7,22.56,3.13,78.57,19
CDM,8443IP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",116.08,75.45,29.02,299.78,16
CDM,8443OP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",15.25,9.91,3.81,39.38,16
CDM,84442_1,Thyroxine binding globulin (thyroid related protein) level,48.6,31.59,7.18,78.57,19
CDM,84443W_1,"Blood test, thyroid stimulating hormone (TSH)",5.3,3.45,0.89,78.57,19
CDM,84443_1,"Blood test, thyroid stimulating hormone (TSH)",48.3,31.4,8.11,78.57,19
CDM,84445_1,Thyroid stimulating immune globulins (thyroid related protein) level,204.4,132.86,30.52,127.02,19
CDM,84446_1,Vitamin E level,21.9,14.24,3.11,78.57,19
CDM,8444IP _1,VANCOMYCIN HCL 5 GM VIAL,390.34,253.72,97.59,273.24,11
CDM,8444OP _1,VANCOMYCIN HCL 5 GM VIAL,17.91,11.64,4.48,12.54,11
CDM,84450_1,"Liver enzyme (SGOT), level",16.0,10.4,0.83,78.57,19
CDM,84460_1,"Liver enzyme (SGPT), level",16.0,10.4,0.85,78.57,19
CDM,84466_1,Transferrin (iron binding protein) level,14.6,9.49,1.86,78.57,19
CDM,84478_1,Triglycerides level,17.0,11.05,0.98,78.57,19
CDM,84479_1,Thyroid hormone evaluation,26.3,17.1,1.7,78.57,19
CDM,84480_1,"Thyroid hormone, T3 measurement, total",34.7,22.56,4.92,78.57,19
CDM,84481_1,"Thyroid hormone, T3 measurement, free",44.1,28.67,7.47,78.57,19
CDM,84482_1,"Thyroid hormone, T3 measurement, reverse",58.8,38.22,9.27,78.57,19
CDM,84484_1,"Troponin (protein) analysis, quantitative",28.0,18.2,3.49,78.57,19
CDM,84488_1,"Trypsin (pancreatic enzyme) analysis, stool",18.9,12.29,1.38,78.57,19
CDM,84510_1,Tyrosine (amino acid) level,14.2,9.23,1.51,78.57,19
CDM,84520A_1,"Urea nitrogen level to assess kidney function, quantitative",9.0,5.85,0.36,78.57,19
CDM,84520_1,"Urea nitrogen level to assess kidney function, quantitative",12.0,7.8,0.47,78.57,19
CDM,84540_1,"Urea nitrogen level to assess kidney function, urine",8.9,5.79,0.49,78.57,19
CDM,84545A_1,"Urea nitrogen level to assess kidney function, clearance",11.0,7.15,0.79,78.57,19
CDM,84550_1,"Uric acid level, blood",14.0,9.1,0.63,78.57,19
CDM,84560_1,Uric acid level,12.6,8.19,0.64,78.57,19
CDM,84578_1,"Urobilinogen (metabolism substance) analysis, urine",2.8,1.82,0.13,78.57,19
CDM,84580_1,"Urobilinogen (metabolism substance) level, urine",69.2,44.98,5.73,78.57,19
CDM,84585_1,Urine vanillylmandelic acid,61.4,39.91,9.3,78.57,19
CDM,84586_1,Vasoactive intestinal peptide (intestinal hormone) level,152.3,99.0,21.2,88.24,19
CDM,84588_1,ADH (antidiuretic hormone) level,160.7,104.46,20.36,84.77,19
CDM,84590A_1,Vitamin A level,20.9,13.59,2.43,78.57,19
CDM,84590_1,Vitamin A level,52.5,34.13,6.1,78.57,19
CDM,84600_1,Volatile chemical measurement,27.6,17.94,4.72,78.57,19
CDM,84620_1,Xylose (carbohydrate) absorption test of blood and/or urine,72.7,47.26,7.75,78.57,19
CDM,84630_1,Zinc level,58.5,38.03,6.66,78.57,19
CDM,84681_1,C-peptide (protein) level,80.9,52.59,12.49,78.57,19
CDM,84702_1,"Gonadotropin, chorionic (reproductive hormone) level",46.2,30.03,6.95,78.57,19
CDM,84703_1,Gonadotropin (reproductive hormone) analysis,27.3,17.75,2.05,78.57,19
CDM,85002_1,Bleeding time,10.4,6.76,0.5,78.57,19
CDM,85007A_1,Microscopic examination for white blood cells with manual cell count,6.7,4.36,0.25,78.57,19
CDM,85007_1,Microscopic examination for white blood cells with manual cell count,42.0,27.3,1.6,78.57,19
CDM,85008_1,Microscopic examination for white blood cells,4.7,3.06,0.16,78.57,19
CDM,85009_1,Manual white blood cell count and evaluation,13.3,8.65,0.67,78.57,19
CDM,85013_1,Red blood cell hemoglobin concentration,3.2,2.08,0.22,78.57,19
CDM,85014_1,Red blood cell concentration measurement,10.0,6.5,0.24,78.57,19
CDM,85018_1,"Blood count, hemoglobin",10.0,6.5,0.24,78.57,19
CDM,85025W_1,"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count",7.4,4.81,0.58,78.57,19
CDM,85025_1,"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count",30.0,19.5,2.33,78.57,19
CDM,85027A_1,"Complete blood cell count (red cells, white blood cell, platelets), automated test",7.9,5.14,0.51,78.57,19
CDM,85027W_1,"Complete blood cell count (red cells, white blood cell, platelets), automated test",5.3,3.45,0.34,78.57,19
CDM,85027_1,"Complete blood cell count (red cells, white blood cell, platelets), automated test",20.0,13.0,1.29,78.57,19
CDM,85045_1,"Red blood count, automated test",25.7,16.71,1.03,78.57,19
CDM,85046_1,"Red blood count automated, with additional calculations",17.2,11.18,0.96,78.57,19
CDM,85048A_1,Automated white blood cell count,7.25,4.71,0.18,78.57,19
CDM,85048B_1,Automated white blood cell count,36.8,23.92,0.93,78.57,19
CDM,85048_1,Automated white blood cell count,5.9,3.84,0.15,78.57,19
CDM,85049_1,"Platelet count, automated test",14.3,9.3,0.64,78.57,19
CDM,85060_1,Blood smear interpretation by physician with written report,75.6,49.14,13.45,78.57,19
CDM,85097_1,"Bone marrow, smear interpretation",186.0,120.9,37.53,126.34,19
CDM,850IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.7,1.11,0.43,4.39,16
CDM,850OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.09,5.26,2.02,20.89,16
CDM,85130_1,Assessment of blood clotting function,39.4,25.61,4.68,78.57,19
CDM,85170_1,"Blood clot evaluation, (retraction time)",4.9,3.19,0.8,78.57,19
CDM,85210_1,"Clotting factor II prothrombin, measurement",36.8,23.92,4.78,78.57,19
CDM,85220_1,Clotting factor V (AcG or proaccelerin) measurement,93.5,60.78,10.59,78.57,19
CDM,85230_1,"Clotting factor VII (proconvertin, stable factor)",99.8,64.87,10.74,78.57,19
CDM,85240_1,Clotting factor VIII (AHG) measurement,49.7,32.31,8.9,78.57,19
CDM,85244_1,Clotting factor VIII related antigen measurement,73.5,47.78,12.25,78.57,19
CDM,85245_1,Clotting factor VIII (VW factor) measurement,174.3,113.3,13.76,78.57,19
CDM,85246_1,Clotting factor VIII (VW factor) antigen,106.1,68.97,13.76,78.57,19
CDM,85247_1,Clotting factor VIII (von Willebrand factor) measurement,231.0,150.15,13.76,78.57,19
CDM,85250_1,Clotting factor IX (PTC or Christmas) measurement,55.4,36.01,10.55,78.57,19
CDM,85260_1,Clotting factor X (Stuart-Prower) measurement,16.8,10.92,3.01,78.57,19
CDM,85270_1,Clotting factor XI (PTA) measurement,105.0,68.25,10.74,78.57,19
CDM,8527IP _1,UNCLASSIFIED DRUGS,75.2,48.88,18.8,194.2,16
CDM,8527OP _1,UNCLASSIFIED DRUGS,24.42,15.87,6.11,63.06,16
CDM,85280_1,Clotting factor XII (Hageman) measurement,100.8,65.52,11.61,78.57,19
CDM,8528IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.72,4.37,1.68,17.35,16
CDM,8528OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.05,3.93,1.51,15.62,16
CDM,85291_1,Clotting factor XIII (fibrin stabilizing) screening test,52.5,34.13,4.78,78.57,19
CDM,85300A_1,Antithrombin III antigen (clotting inhibitor) activity,21.7,14.11,2.57,78.57,19
CDM,85300_1,Antithrombin III antigen (clotting inhibitor) activity,67.2,43.68,7.11,78.57,19
CDM,85301_1,Antithrombin III antigen (clotting inhibitor) level,63.0,40.95,6.49,78.57,19
CDM,85302_1,"Protein C, (clotting inhibitor) activity",52.5,34.13,6.31,78.57,19
CDM,85303_1,Protein C antigen (clotting inhibitor) measurement,136.5,88.73,8.3,78.57,19
CDM,85305_1,Protein S (clotting inhibitor) level,78.8,51.22,6.97,78.57,19
CDM,85306_1,Protein S (clotting inhibitor) measurement,89.3,58.05,9.19,78.57,19
CDM,8530IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.57,3.62,1.39,14.38,16
CDM,8530OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.1,7.87,3.03,31.25,16
CDM,8531IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.3,7.35,2.83,29.18,16
CDM,8531OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.96,12.32,4.74,48.96,16
CDM,85335_1,Clotting factor inhibitor test,135.5,88.08,7.72,78.57,19
CDM,85347A_1,"Coagulation time measurement, activated",20.1,13.07,0.86,78.57,19
CDM,85348_1,"Coagulation time measurement, other methods",7.7,5.01,0.35,78.57,19
CDM,85360_1,Euglobulin lysis (clot dissolving) measurement,36.8,23.92,3.09,78.57,19
CDM,85362_1,"Coagulation function analysis, agglutination slide, semiquantitative",22.1,14.37,1.52,78.57,19
CDM,85378_1,"Coagulation function measurement, qualitative or semiquantitative",26.3,17.1,2.56,78.57,19
CDM,85379A_1,"Coagulation function measurement, D-dimer; quantitative",13.0,8.45,1.32,78.57,19
CDM,85379_1,"Coagulation function measurement, D-dimer; quantitative",26.3,17.1,2.68,78.57,19
CDM,85384_1,Fibrinogen (factor 1) activity measurement,10.6,6.89,1.03,78.57,19
CDM,85390_1,Coagulation function screening test with interpretation and report,91.3,59.35,14.13,78.57,19
CDM,85400_1,Plasmin (fibrinolytic factor) measurement,161.7,105.11,4.63,78.57,19
CDM,85410_1,Alpha-2 antiplasmin (factor inhibitor) measurement,122.9,79.89,4.63,78.57,19
CDM,85415_1,Plasminogen activator (fibrinolytic factor) measurement,120.8,78.52,10.31,78.57,19
CDM,85420_1,Plasminogen (fibrinolytic factor) measurement,36.6,23.79,2.39,78.57,19
CDM,85421_1,Plasminogen antigenic (factor inhibitor) measurement,54.8,35.62,5.58,78.57,19
CDM,85441_1,"Evaluation of red blood cell defect (Heinz bodies), direct",36.8,23.92,1.55,78.57,19
CDM,85445_1,"Evaluation of red blood cell defect (Heinz bodies), induced",23.8,15.47,1.62,78.57,19
CDM,85460_1,"Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, differential lysis",54.6,35.49,4.22,78.57,19
CDM,85461_1,"Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, rosette",13.9,9.04,1.3,78.57,19
CDM,85475_1,Measurement of hemolysin (red blood cell destructive substance),56.7,36.86,5.03,78.57,19
CDM,854IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.81,1.18,0.45,4.67,16
CDM,854OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.81,1.83,0.7,7.26,16
CDM,85520D_1,Heparin assay,47.3,30.75,6.19,78.57,19
CDM,85520_1,Heparin assay,70.4,45.76,7.85,78.57,19
CDM,85525B_1,Heparin neutralization test,25.2,16.38,2.98,78.57,19
CDM,85525_1,Heparin neutralization test,29.6,19.24,3.5,78.57,19
CDM,85540_1,White blood cell alkaline phosphatase (enzyme) measurement with cell count,84.0,54.6,5.16,78.57,19
CDM,85549_1,White blood cell enzyme activity measurement,46.5,30.23,8.72,78.57,19
CDM,85557_1,"Red blood cell fragility measurement, incubated",81.1,52.72,8.02,78.57,19
CDM,85576B_1,Platelet aggregation function test,21.0,13.65,5.23,78.57,19
CDM,85576_1,Platelet aggregation function test,42.7,27.76,10.18,78.57,19
CDM,85597_1,Platelet function test,38.9,25.29,6.99,78.57,19
CDM,85610006_1,Insertion of needle into vein for collection of blood sample,12.0,7.8,3.0,30.99,19
CDM,85610_1,"Blood test, clotting time",20.0,13.0,0.86,78.57,19
CDM,85611B_1,"Blood test, clotting time, substitution",47.8,31.07,1.88,78.57,19
CDM,85611_1,"Blood test, clotting time, substitution",5.4,3.51,0.21,78.57,19
CDM,85613_1,"Clotting factor X assessment test, diluted",26.3,17.1,2.52,78.57,19
CDM,85651_1,"Red blood cell sedimentation rate, to detect inflammation, non-automated",11.0,7.15,0.47,78.57,19
CDM,85652_1,"Red blood cell sedimentation rate, to detect inflammation, automated",10.0,6.5,0.27,78.57,19
CDM,85660_1,Red blood cell sickling measurement,8.7,5.66,0.48,78.57,19
CDM,85670_1,"Thrombin time, fibrinogen screening test, plasma",6.8,4.42,0.39,78.57,19
CDM,85682274_1,"Stool analysis for blood, by fecal hemoglobin determination by immunoassay",73.0,47.45,11.62,188.52,19
CDM,85683986_1,Body fluid pH level,92.0,59.8,3.29,237.59,19
CDM,85685107_1,Special stained specimen slides to identify organisms including interpretation and report,230.0,149.5,46.86,593.98,19
CDM,85688329_1,"Pathology examination of specimen during surgery, first tissue block",235.0,152.75,43.19,606.89,19
CDM,85688333_1,"Pathology cytologic examination of specimen during surgery, initial site",226.0,146.9,33.22,669.29,19
CDM,85688334_1,"Pathology cytologic examination of specimen during surgery, each additional site",123.0,79.95,19.38,317.65,19
CDM,85688335_1,"Pathology examination of specimen during surgery, each additional tissue block",104.0,67.6,24.57,268.58,19
CDM,856IP _1,UNCLASSIFIED DRUGS,62.23,40.45,15.56,160.71,16
CDM,856OP _1,UNCLASSIFIED DRUGS,83.74,54.43,20.94,216.26,16
CDM,85705_1,Thromboplastin inhibition (circulating anticoagulant) measurement,62.0,40.3,5.78,78.57,19
CDM,85730_1,"Coagulation assessment blood test, plasma or whole blood",17.0,11.05,1.02,78.57,19
CDM,85732A_1,"Coagulation assessment blood test, substitution, plasma fractions",47.8,31.07,3.09,78.57,19
CDM,85732_1,"Coagulation assessment blood test, substitution, plasma fractions",7.5,4.88,0.49,78.57,19
CDM,85810_1,Blood viscosity measurement,15.3,9.95,1.79,78.57,19
CDM,8594IP _1,"INJECTION, VINBLASTINE SULFATE, 1 MG",43.29,28.14,5.49,129.87,17
CDM,8594OP _1,"INJECTION, VINBLASTINE SULFATE, 1 MG",46.75,30.39,5.49,140.25,17
CDM,8597IP _1,"VINCRISTINE SULFATE, 1 MG",83.53,54.29,8.64,250.59,17
CDM,8597OP _1,"VINCRISTINE SULFATE, 1 MG",65.32,42.46,8.64,195.96,17
CDM,86000_1,Measurement of antibody to infectious organism,108.2,70.33,4.19,78.57,19
CDM,86003_1,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",19.8,12.87,1.03,78.57,19
CDM,86021_1,Antibody identification test for white blood cell antibodies,115.5,75.08,9.03,78.57,19
CDM,86022_1,"Antibody identification test, platelet antibodies",152.6,99.19,11.02,78.57,19
CDM,86038_1,Screening test for autoimmune disorder,22.1,14.37,2.67,78.57,19
CDM,86039_1,"Measurement of antibody for assessment of autoimmune disorder, titer",16.9,10.99,1.89,78.57,19
CDM,86060_1,Measurement for Strep antibody (strep throat),22.6,14.69,1.65,78.57,19
CDM,86077_1,Blood bank physician services for cross match and/or evaluation and written report,119.0,77.35,30.28,122.57,19
CDM,86078_1,Blood bank physician services for investigation of transfusion reaction with written report,118.0,76.7,30.28,122.3,19
CDM,86079_1,Blood bank physician services with written report,146.0,94.9,30.47,122.3,19
CDM,860IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.5,4.23,1.63,16.79,16
CDM,860OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.7,14.11,5.43,56.04,16
CDM,86140_1,Measurement C-reactive protein for detection of infection or inflammation,16.0,10.4,0.83,78.57,19
CDM,86141A_1,"Measurement C-reactive protein for detection of infection or inflammation, high sensitivity",38.9,25.29,5.04,78.57,19
CDM,86141_1,"Measurement C-reactive protein for detection of infection or inflammation, high sensitivity",38.6,25.09,5.0,78.57,19
CDM,86146_1,Beta 2 glycoprotein 1 antibody (autoantibody) measurement,74.3,48.3,15.27,78.57,19
CDM,86147_1,Cardiolipin antibody (tissue antibody) measurement,29.4,19.11,7.48,78.57,19
CDM,86156_1,Measurement of cold agglutinin (protein) to screen for infection or disease,12.6,8.19,1.02,78.57,19
CDM,86160E_1,"Measurement of complement (immune system proteins), antigen,",23.6,15.34,2.83,78.57,19
CDM,86160_1,"Measurement of complement (immune system proteins), antigen,",31.0,20.15,3.72,78.57,19
CDM,86161_1,Measurement of complement function (immune system proteins),32.9,21.39,3.95,78.57,19
CDM,86162_1,"Measurement of complement (immune system proteins), total hemolytic",152.3,99.0,12.19,78.57,19
CDM,86171_1,Measurement of complement fixation tests (immune system proteins),37.8,24.57,3.78,78.57,19
CDM,861IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.44,4.84,1.86,19.21,16
CDM,861OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.59,6.23,2.4,24.77,16
CDM,86200_1,Measurement of antibody for rheumatoid arthritis assessment,42.0,27.3,5.44,78.57,19
CDM,86215_1,Measurement of DNA antibody,46.5,30.23,6.16,78.57,19
CDM,86225_1,"Measurement of DNA antibody, native or double stranded",65.4,42.51,8.24,78.57,19
CDM,86235_1,"Measurement of antibody for assessment of autoimmune disorder, any method",18.1,11.77,3.25,78.57,19
CDM,86255D_1,Screening test for antibody to noninfectious agent,41.9,27.24,5.05,78.57,19
CDM,86255_1,Screening test for antibody to noninfectious agent,76.7,49.86,9.24,78.57,19
CDM,86256_1,Measurement of antibody to noninfectious agent,54.6,35.49,6.58,78.57,19
CDM,86280_1,Measurement of immune system protein,129.2,83.98,4.91,78.57,19
CDM,86300B_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 15-3",23.0,14.95,4.79,78.57,19
CDM,86300_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 15-3",52.03,33.82,10.83,78.57,19
CDM,86301A_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9",34.7,22.56,7.22,78.57,19
CDM,86301_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9",34.7,22.56,7.22,78.57,19
CDM,86304A_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 125",60.7,39.46,12.49,78.57,19
CDM,86304_1,"Immunologic analysis for detection of tumor antigen, quantitative; CA 125",52.03,33.82,10.83,78.57,19
CDM,86308_1,Screening test for mononucleosis (mono),20.0,13.0,1.04,78.57,19
CDM,86316_1,Analysis for detection of tumor marker,80.9,52.59,12.49,78.57,19
CDM,86317_1,"Detection of infectious agent antibody, quantitative",50.4,32.76,7.56,78.57,19
CDM,86318_1,"Test for detection of infectious agent antibody, qualitative or semiquantitative",87.2,56.68,15.77,78.57,19
CDM,86320_1,Immunologic analysis technique on serum,44.9,29.19,10.18,78.57,19
CDM,86325_1,Immunologic analysis technique on body fluid,44.9,29.19,10.18,78.57,19
CDM,86329_1,"Immunologic analysis technique, unspecified",152.3,99.0,8.43,78.57,19
CDM,86331_1,Immunologic analysis for detection of antigen or antibody,43.1,28.02,5.16,78.57,19
CDM,86332_1,Immune complex measurement,42.0,27.3,10.24,78.57,19
CDM,86334_1,Immunologic analysis technique on serum (immunofixation),41.9,27.24,9.36,78.57,19
CDM,86335_1,"Immunologic analysis technique on body fluid, other fluids with concentration",41.9,27.24,10.18,78.57,19
CDM,86336_1,Inhibin A (reproductive organ hormone) measurement,18.9,12.29,2.95,78.57,19
CDM,86337_1,Insulin antibody measurement,83.0,53.95,12.85,78.57,19
CDM,86340_1,Intrinsic factor (stomach protein) antibody measurement,57.6,37.44,8.69,78.57,19
CDM,86341_1,Islet cell (pancreas) antibody measurement,76.7,49.86,14.14,78.57,19
CDM,86343_1,White blood cell histamine (immune system chemical) release test,174.3,113.3,7.48,78.57,19
CDM,86353_1,"White blood cell function measurement, mitogen or antigen induced blastogenesis",210.0,136.5,29.42,122.45,19
CDM,86355_1,Total cell count for B cells (white blood cells),94.5,61.43,22.64,94.23,19
CDM,86357_1,Total cell count for natural killer cells (white blood cell),94.5,61.43,22.64,94.23,19
CDM,86359_1,"T cells count, total",94.5,61.43,22.64,94.23,19
CDM,86367_1,"Stem cells count, total",84.0,54.6,46.67,194.26,19
CDM,86376_1,Microsomal antibodies (autoantibody) measurement,31.5,20.48,4.58,78.57,19
CDM,86382_1,Viral neutralization test to detect viral antibody level,141.3,91.85,10.15,78.57,19
CDM,86384_1,Nitroblue tetrazolium dye test to measure white blood cell function,61.0,39.65,8.17,78.57,19
CDM,8639IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.24,2.11,0.81,8.37,16
CDM,8639OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.69,6.3,2.42,25.02,16
CDM,86403D_1,Screening test for presence of antibody,28.4,18.46,3.28,78.57,19
CDM,86403_1,Screening test for presence of antibody,125.0,81.25,11.54,78.57,19
CDM,86411000_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,835.3,542.95,208.83,584.71,11
CDM,86411001_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,832.0,540.8,208.0,582.4,11
CDM,86411007_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,832.0,540.8,208.0,582.4,11
CDM,86412001_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,35.0,22.75,8.75,24.5,11
CDM,86412002_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,54.0,35.1,13.5,37.8,11
CDM,86412003_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,105.0,68.25,26.25,73.5,11
CDM,86412004_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,125.0,81.25,31.25,87.5,11
CDM,86412005_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,116.0,75.4,29.0,81.2,11
CDM,86412010_1,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,123.0,79.95,30.75,86.1,11
CDM,86413000_1,HC HEAT THERAPY PUMP HTP1500 – EQUIP,184.0,119.6,46.0,128.8,11
CDM,86430_1,Rheumatoid factor analysis,42.1,27.37,2.58,78.57,19
CDM,86431_1,Rheumatoid factor level,17.0,11.05,0.96,78.57,19
CDM,86466821_1,Removal of recurring cataract in lens capsule using a laser,720.0,468.0,180.0,3227.0,19
CDM,86480A_1,"Tuberculosis test, gamma interferon",28.4,18.46,17.6,154.8,19
CDM,86480_1,"Tuberculosis test, gamma interferon",270.0,175.5,37.19,167.35,19
CDM,86485_1,Skin test for candida (yeast),204.8,133.12,11.98,210.94,15
CDM,86510_1,Skin test histoplasmosis (parasite infection),10.0,6.5,5.0,78.57,19
CDM,86511000_1,RECOVERY ROOM - GENERAL CLASSIFICATION,336.0,218.4,84.0,235.2,11
CDM,86511001_1,RECOVERY ROOM - GENERAL CLASSIFICATION,336.0,218.4,84.0,235.2,11
CDM,86580_1,Skin test for tuberculosis,20.0,13.0,8.38,78.57,19
CDM,86592A_1,Syphilis detection test,18.2,11.83,0.78,78.57,19
CDM,86592_1,Syphilis detection test,7.4,4.81,0.32,78.57,19
CDM,86593_1,Syphilis test,7.0,4.55,0.31,78.57,19
CDM,86603_1,Analysis for antibody to adenovirus (respiratory virus),40.4,26.26,5.2,78.57,19
CDM,86606_1,Analysis for antibody to aspergillus (fungus),43.1,28.02,6.49,78.57,19
CDM,86612_1,Analysis for antibody to blastomyces (fungus),72.7,47.26,7.74,78.57,19
CDM,86617_1,Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria),71.0,46.15,9.29,78.57,19
CDM,86618_1,Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria),71.0,46.15,10.22,78.57,19
CDM,86622_1,Analysis for antibody to Brucella (bacteria),41.1,26.72,3.67,78.57,19
CDM,86628_1,Analysis for antibody to Candida (yeast),25.9,16.84,3.11,78.57,19
CDM,86631_1,Analysis for antibody to Chlamydia (bacteria),60.9,39.59,7.09,78.57,19
CDM,86635_1,Analysis for antibody to Coccidioides (bacteria),37.8,24.57,4.34,78.57,19
CDM,86644_1,Analysis for antibody to Cytomegalovirus (CMV),19.6,12.74,2.82,78.57,19
CDM,86645_1,Analysis for antibody (IgM) to Cytomegalovirus (CMV),39.5,25.68,6.66,78.57,19
CDM,86648_1,Analysis for antibody to Diphtheria (bacteria),86.1,55.97,9.13,78.57,19
CDM,86658_1,Analysis for antibody to Enterovirus (gastrointestinal virus),78.8,51.22,7.82,78.57,19
CDM,86663_1,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen",12.6,8.19,1.65,78.57,19
CDM,86664_1,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear antigen",12.6,8.19,1.93,78.57,19
CDM,86665A_1,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid",12.6,8.19,2.29,78.57,19
CDM,86665_1,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid",25.0,16.25,4.54,78.57,19
CDM,86668_1,Analysis for antibody to Francisella tularensis (bacteria transmitted by rodents),29.8,19.37,4.22,78.57,19
CDM,86671_1,Analysis for antibody to fungus,12.9,8.39,1.58,78.57,19
CDM,86677_1,Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria),16.2,10.53,2.73,78.57,19
CDM,86684_1,Analysis for antibody to Haemophilus influenza (respiratory bacteria),38.1,24.77,6.04,78.57,19
CDM,86687_1,"Analysis for antibody to Human T-cell lymphotropic virus, type 1 (HTLV-1)",29.4,19.11,2.67,78.57,19
CDM,86688_1,"Analysis for antibody to Human T-cell lymphotropic virus, type 2 (HTLV-2)",29.4,19.11,4.12,78.57,19
CDM,86689A_1,Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV,101.9,66.24,11.61,78.57,19
CDM,86689_1,Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV,103.5,67.28,11.61,78.57,19
CDM,86692_1,Analysis for antibody to Hepatitis D virus,50.3,32.7,8.63,78.57,19
CDM,86694_1,Analysis for antibody to Herpes simplex virus,13.7,8.91,1.97,78.57,19
CDM,86695_1,"Analysis for antibody to Herpes simplex virus, type 1",43.6,28.34,5.75,78.57,19
CDM,86698_1,Analysis for antibody to histoplasma (fungus),68.1,44.27,8.27,78.57,19
CDM,86701_1,Analysis for antibody to HIV -1 virus,30.0,19.5,2.67,78.57,19
CDM,86703_1,Analysis for antibody to HIV-1 and HIV-2 virus,17.5,11.38,2.4,78.57,19
CDM,86704_1,Hepatitis B core antibody measurement,14.2,9.23,1.71,78.57,19
CDM,86705_1,Hepatitis B core antibody (IgM) measurement,31.5,20.48,3.71,78.57,19
CDM,86706A_1,Hepatitis B surface antibody measurement,24.7,16.06,2.65,78.57,19
CDM,86706_1,Hepatitis B surface antibody measurement,30.9,20.09,3.32,78.57,19
CDM,86707_1,Hepatitis Be antibody measurement,54.6,35.49,6.32,78.57,19
CDM,86708A_1,Measurement of Hepatitis A antibody,55.8,36.27,6.91,78.57,19
CDM,86708_1,Measurement of Hepatitis A antibody,27.3,17.75,3.38,78.57,19
CDM,86709_1,Measurement of Hepatitis A antibody (IgM),16.4,10.66,1.85,78.57,19
CDM,86710_1,Analysis for antibody to Influenza virus,140.7,91.46,8.13,78.57,19
CDM,86713_1,Analysis for antibody to Legionella (waterborne bacteria),24.3,15.8,3.72,78.57,19
CDM,86720_1,Analysis for antibody to Leptospira,45.4,29.51,7.35,78.57,19
CDM,86735A_1,Analysis for antibody to mumps virus,18.9,12.29,2.47,78.57,19
CDM,86735_1,Analysis for antibody to mumps virus,52.5,34.13,6.85,78.57,19
CDM,86738_1,Analysis for antibody to Mycoplasma (bacteria),39.0,25.35,5.16,78.57,19
CDM,86747_1,Analysis for antibody to parvovirus,42.0,27.3,6.31,78.57,19
CDM,86762A_1,Analysis for antibody to Rubella (German measles virus),9.9,6.44,1.42,78.57,19
CDM,86762_1,Analysis for antibody to Rubella (German measles virus),62.0,40.3,8.63,78.57,19
CDM,86765_1,Analysis for antibody to Rubeola (measles virus),27.3,17.75,3.52,78.57,19
CDM,86774_1,Analysis for antibody to tetanus bacteria (Clostridium tetanus),79.8,51.87,8.88,78.57,19
CDM,86777_1,Analysis for antibody to Toxoplasma (parasite),303.5,197.28,8.63,78.57,19
CDM,86778_1,Analysis for antibody (IgM) to Toxoplasma (parasite),25.2,16.38,3.63,78.57,19
CDM,86780_1,"Analysis for antibody, Treponema pallidum",18.9,12.29,2.5,78.57,19
CDM,86784_1,Analysis for antibody to Trichinella (worm parasite),52.5,34.13,6.59,78.57,19
CDM,86787B_1,Analysis for antibody to varicella-zoster virus (chicken pox),32.7,21.26,4.21,78.57,19
CDM,86787_1,Analysis for antibody to varicella-zoster virus (chicken pox),16.8,10.92,2.16,78.57,19
CDM,86788A_1,Analysis for antibody (IgM) to West Nile virus,21.0,13.65,3.54,78.57,19
CDM,86789A_1,Analysis for antibody to West Nile virus,21.0,13.65,3.02,78.57,19
CDM,86790_1,Analysis for antibody to virus,138.6,90.09,7.73,78.57,19
CDM,86793_1,Analysis for antibody to Yersinia (bacteria),3.2,2.08,0.42,78.57,19
CDM,86800_1,Thyroglobulin (thyroid protein) antibody measurement,36.8,23.92,5.85,78.57,19
CDM,86803_1,Hepatitis C antibody measurement,31.5,20.48,4.5,78.57,19
CDM,86805A_1,"Immunologic analysis for autoimmune disease, with titration",45.9,29.84,78.57,473.3,19
CDM,86805B_1,"Immunologic analysis for autoimmune disease, with titration",157.5,102.38,78.57,473.3,19
CDM,86805C_1,"Immunologic analysis for autoimmune disease, with titration",189.0,122.85,78.57,473.3,19
CDM,86805D_1,"Immunologic analysis for autoimmune disease, with titration",189.0,122.85,78.57,473.3,19
CDM,86805_1,"Immunologic analysis for autoimmune disease, with titration",46.3,30.1,78.57,473.3,19
CDM,86806_1,"Immunologic analysis for autoimmune disease, without titration",115.5,75.08,28.55,118.86,19
CDM,86807A_1,"Transplant antibody measurement, standard method",105.0,68.25,47.19,196.43,19
CDM,86807C_1,"Transplant antibody measurement, standard method",31.5,20.48,24.77,196.43,19
CDM,86807D_1,"Transplant antibody measurement, standard method",210.0,136.5,47.19,196.43,19
CDM,86807_1,"Transplant antibody measurement, standard method",63.0,40.95,47.19,196.43,19
CDM,86808A_1,"Transplant antibody measurement, quick method",15.8,10.27,4.69,78.57,19
CDM,86812_1,"Immunologic analysis for autoimmune disease, A, B, or C, single antigen",65.1,42.32,15.49,78.57,19
CDM,86813G_1,"Immunologic analysis for autoimmune disease, A, B, or C, multiple antigens",315.0,204.75,34.8,182.7,19
CDM,86813_1,"Immunologic analysis for autoimmune disease, A, B, or C, multiple antigens",183.8,119.47,34.8,144.86,19
CDM,86817E_1,"Immunologic analysis for autoimmune disease, DR/DQ, multiple antigens",262.5,170.63,63.68,278.62,19
CDM,86817_1,"Immunologic analysis for autoimmune disease, DR/DQ, multiple antigens",430.5,279.83,63.68,456.93,19
CDM,86821_1,"Immunologic analysis for autoimmune disease, lymphocyte culture, mixed",225.8,146.77,21.94,91.31,19
CDM,86828_1,Assessment of antibodies to Class I and Class II human leukocyte antigens (HLA) antigens,51.2,33.28,32.87,160.31,19
CDM,86830_1,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class I",121.1,78.72,57.31,238.56,19
CDM,86831_1,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class II",103.8,67.47,49.13,204.5,19
CDM,86832_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I",190.4,123.76,78.57,808.57,19
CDM,86833_1,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",173.1,112.52,78.57,813.69,19
CDM,86850_1,Screening test for red blood cell antibodies,26.3,17.1,2.57,78.57,19
CDM,86860A_1,Removal of antibodies from surface of red blood cell,29.9,19.44,13.46,79.26,15
CDM,86860_1,Removal of antibodies from surface of red blood cell,20.1,13.07,9.05,79.26,15
CDM,86870_1,Identification of red blood cell antibodies,35.9,23.34,16.16,100.55,15
CDM,86880A_1,"Red blood cell antibody detection test, direct",10.3,6.7,0.56,78.57,19
CDM,86880_1,"Red blood cell antibody detection test, direct",14.7,9.56,0.79,78.57,19
CDM,86886_1,Red blood cell antibody level,11.0,7.15,0.57,78.57,19
CDM,86900_1,Blood group typing (ABO),14.7,9.56,0.44,78.57,19
CDM,86901_1,Blood typing for Rh (D) antigen,13.7,8.91,0.41,78.57,19
CDM,86902_1,"Screening test for compatible blood unit, using reagent serum",24.0,15.6,1.52,78.57,19
CDM,86920_1,"Blood unit compatibility test, immediate spin technique",28.4,18.46,12.78,81.23,15
CDM,86922_1,"Blood unit compatibility test, antiglobulin technique",17.3,11.25,7.79,86.88,15
CDM,86927_1,Thawing of fresh frozen plasma unit,14.7,9.56,6.62,78.57,15
CDM,86930_1,Freezing of blood unit,130.2,84.63,58.59,271.88,15
CDM,86932_1,Freezing and thawing of blood unit,155.4,101.01,53.09,230.86,15
CDM,86940_1,Red blood cell antibody screening test,26.3,17.1,2.31,78.57,19
CDM,86945_1,"Irradiation of blood product, each unit",38.9,25.29,15.59,78.57,15
CDM,86965_1,Pooling of platelets or other blood products,18.9,12.29,8.51,78.57,15
CDM,86978_1,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, by differential red cell absorption",33.3,21.65,14.99,114.06,15
CDM,86985_1,Splitting of blood or blood products,27.3,17.75,12.29,78.57,15
CDM,87015A_1,Concentration of specimen for infectious agents,16.0,10.4,1.07,78.57,19
CDM,87015_1,Concentration of specimen for infectious agents,19.9,12.94,1.33,78.57,19
CDM,87040_1,Bacterial blood culture,31.9,20.74,3.29,78.57,19
CDM,87045A_1,Stool culture,16.8,10.92,1.59,78.57,19
CDM,87045_1,Stool culture,47.3,30.75,4.47,78.57,19
CDM,87046B_1,"Stool culture, additional pathogens",13.8,8.97,1.3,78.57,19
CDM,87046C_1,"Stool culture, additional pathogens",13.8,8.97,1.3,78.57,19
CDM,87046_1,"Stool culture, additional pathogens",36.8,23.92,3.47,78.57,19
CDM,87070A_1,"Bacterial culture, any other source except urine, blood or stool, aerobic",9.2,5.98,0.79,78.57,19
CDM,87070C_1,"Bacterial culture, any other source except urine, blood or stool, aerobic",19.7,12.81,1.7,78.57,19
CDM,87070D_1,"Bacterial culture, any other source except urine, blood or stool, aerobic",12.0,7.8,1.03,78.57,19
CDM,87070_1,"Bacterial culture, any other source except urine, blood or stool, aerobic",40.0,26.0,3.45,78.57,19
CDM,87071A_1,Bacterial culture and colony count,31.6,20.54,3.13,78.57,19
CDM,87071B_1,Bacterial culture and colony count,75.7,49.21,5.93,78.57,19
CDM,87073A_1,Bacterial culture and colony count for anaerobic bacteria,17.7,11.51,1.71,78.57,19
CDM,87075_1,"Bacterial culture, any source, except blood, anaerobic",14.6,9.49,1.38,78.57,19
CDM,87076_1,Bacterial culture for anaerobic isolates,16.5,10.73,1.33,78.57,19
CDM,87077A_1,Bacterial culture for aerobic isolates,16.5,10.73,1.33,78.57,19
CDM,87077B_1,Bacterial culture for aerobic isolates,8.7,5.66,0.7,78.57,19
CDM,87077C_1,Bacterial culture for aerobic isolates,26.3,17.1,2.13,78.57,19
CDM,87077_1,Bacterial culture for aerobic isolates,30.0,19.5,2.42,78.57,19
CDM,87081A_1,Screening test for pathogenic organisms,15.8,10.27,1.05,78.57,19
CDM,87081B_1,Screening test for pathogenic organisms,7.5,4.88,0.5,78.57,19
CDM,87081C_1,Screening test for pathogenic organisms,31.5,20.48,2.09,78.57,19
CDM,87081E_1,Screening test for pathogenic organisms,27.7,18.01,1.84,78.57,19
CDM,87081F_1,Screening test for pathogenic organisms,55.7,36.21,3.69,78.57,19
CDM,87081G_1,Screening test for pathogenic organisms,28.4,18.46,1.88,78.57,19
CDM,87081J_1,Screening test for pathogenic organisms,10.4,6.76,0.69,78.57,19
CDM,87081K_1,Screening test for pathogenic organisms,44.1,28.67,2.92,78.57,19
CDM,87081N_1,Screening test for pathogenic organisms,16.6,10.79,1.1,78.57,19
CDM,87081P_1,Screening test for pathogenic organisms,16.6,10.79,1.1,78.57,19
CDM,87081_1,Screening test for pathogenic organisms,30.0,19.5,1.99,78.57,19
CDM,87086_1,"Bacterial colony count, urine",24.0,15.6,1.94,78.57,19
CDM,87088_1,Bacterial urine culture,7.4,4.81,0.6,78.57,19
CDM,87101A_1,"Fungal culture (mold or yeast) of skin, hair, or nail",36.8,23.92,2.84,78.57,19
CDM,87102A_1,Fungal culture (mold or yeast),26.0,16.9,2.19,78.57,19
CDM,87102_1,Fungal culture (mold or yeast),31.5,20.48,2.65,78.57,19
CDM,87103_1,Fungal blood culture (mold or yeast),33.7,21.91,6.9,78.57,19
CDM,87106B_1,"Fungal culture, yeast",7.4,4.81,0.76,78.57,19
CDM,87106_1,"Fungal culture, yeast",36.8,23.92,3.8,78.57,19
CDM,87107A_1,Culture for identification of yeast,16.5,10.73,1.7,78.57,19
CDM,87107_1,Culture for identification of yeast,36.8,23.92,3.8,78.57,19
CDM,87108724_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",212.63,138.21,53.16,653.0,19
CDM,87109011_1,"BLOOD, SPLIT UNIT",873.63,567.86,182.26,2256.15,19
CDM,87109_1,Mycoplasma culture,69.3,45.05,9.23,78.57,19
CDM,87110A_1,Culture for chlamydia,36.2,23.53,7.1,78.57,19
CDM,87110_1,Culture for chlamydia,47.3,30.75,9.27,78.57,19
CDM,87116A_1,Culture for acid-fast bacilli,39.1,25.42,4.22,78.57,19
CDM,87118A_1,Identification of mycobacteria (TB or TB like organism),16.5,10.73,2.41,78.57,19
CDM,87120743_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2434.77,1582.6,401.85,6287.79,19
CDM,87120744_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2566.98,1668.54,401.85,6629.23,19
CDM,87120745_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2701.98,1756.29,401.85,6977.86,19
CDM,87120746_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2569.77,1670.35,401.85,6636.43,19
CDM,87120747_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",3045.4,1979.51,401.85,7864.75,19
CDM,87120748_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",3180.4,2067.26,401.85,8213.38,19
CDM,87120749_1,"BLOOD (WHOLE), FOR TRANSFUSION, PER UNIT",1959.75,1273.84,182.26,5061.05,19
CDM,87140A_1,"Identification of organisms by immunologic analysis, immunofluorescent method",7.4,4.81,0.41,78.57,19
CDM,87147B_1,"Identification of organisms by immunologic analysis, other than immunofluorescence method",7.4,4.81,0.38,78.57,19
CDM,87147_1,"Identification of organisms by immunologic analysis, other than immunofluorescence method",15.0,9.75,0.78,78.57,19
CDM,87149A_1,"Identification of organisms by genetic analysis, direct probe technique",33.4,21.71,6.7,78.57,19
CDM,87164_1,"Dark field microscopic examination for organism, includes specimen collection",48.8,31.72,5.24,78.57,19
CDM,87168A_1,Macroscopic examination (visual inspection) of insect,6.8,4.42,0.29,78.57,19
CDM,87172A_1,Pinworm test,14.9,9.69,0.64,78.57,19
CDM,87172_1,Pinworm test,15.0,9.75,0.64,78.57,19
CDM,87177A_1,Smear for parasites,18.2,11.83,1.62,78.57,19
CDM,87177_1,Smear for parasites,36.8,23.92,3.28,78.57,19
CDM,87181A_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method",17.3,11.25,0.82,78.57,19
CDM,87181B_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method",7.9,5.14,0.38,78.57,19
CDM,87181_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method",19.1,12.42,0.91,78.57,19
CDM,87184B_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)",7.9,5.14,0.59,78.57,19
CDM,87184_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)",17.0,11.05,1.27,78.57,19
CDM,87185581_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",2696.25,1752.56,401.85,6963.07,19
CDM,87185A_1,"Detection of antimicrobial drug (antibiotic, antifungal, antiviral)",17.0,11.05,0.81,78.57,19
CDM,87185B_1,"Detection of antimicrobial drug (antibiotic, antifungal, antiviral)",24.5,15.93,1.16,78.57,19
CDM,87186_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution",25.6,16.64,2.21,78.57,19
CDM,87187_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution, each plate",72.5,47.13,24.1,100.32,19
CDM,87188_1,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), macrobroth dilution method",26.4,17.16,1.75,78.57,19
CDM,87189428_1,Splitting of blood or blood products,428.09,278.26,123.26,1105.54,19
CDM,87190_1,"Antimicrobial study, mycobacteria (TB organism family)",6.6,4.29,0.48,78.57,19
CDM,87197_1,Evaluation of antibiotic therapy,68.3,44.4,9.01,78.57,19
CDM,87198552_1,"CRYOPRECIPITATE, EACH UNIT",1263.6,821.34,315.9,3263.25,19
CDM,87198553_1,"CRYOPRECIPITATE, EACH UNIT",210.6,136.89,52.65,653.0,19
CDM,87198556_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",263.9,171.54,65.98,681.52,19
CDM,87198557_1,"GRANULOCYTES, PHERESIS, EACH UNIT",16614.0,10799.1,401.85,42905.66,19
CDM,87198558_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2014.8,1309.62,401.85,5203.22,19
CDM,87198559_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",850.59,552.88,182.26,2196.65,19
CDM,87198560_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",874.8,568.62,182.26,2259.17,19
CDM,87198561_1,"INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, FULL DOSE, 300 MICROGRAMS (1500 I.U.)",458.4,297.96,85.36,1183.82,19
CDM,87198562_1,"RED BLOOD CELLS, DEGLYCEROLIZED, EACH UNIT",1544.49,1003.92,182.26,3988.65,19
CDM,87198563_1,"RED BLOOD CELLS, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,87198564_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2434.77,1582.6,401.85,6287.79,19
CDM,87198566_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2709.6,1761.24,401.85,6997.54,19
CDM,87198567_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2743.2,1783.08,401.85,7084.31,19
CDM,87198568_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",2701.98,1756.29,401.85,6977.86,19
CDM,87198573_1,"RED BLOOD CELLS, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,87198574_1,"PLATELETS, EACH UNIT",2907.45,1889.84,182.26,7508.49,19
CDM,87198575_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2907.45,1889.84,401.85,7508.49,19
CDM,87198576_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",2907.45,1889.84,401.85,7508.49,19
CDM,87198580_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",3039.66,1975.78,401.85,7849.92,19
CDM,87198581_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",3039.66,1975.78,401.85,7849.92,19
CDM,87198582_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",2007.6,1304.94,182.26,5184.63,19
CDM,87198586_1,"RED BLOOD CELLS, EACH UNIT",895.2,581.88,182.26,2311.85,19
CDM,87198593_1,"PLASMA, CRYOPRECIPITATE REDUCED, EACH UNIT",263.25,171.11,65.81,679.84,19
CDM,87198594_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2113.2,1373.58,401.85,5457.34,19
CDM,87198596_1,"GRANULOCYTES, PHERESIS, EACH UNIT",16614.0,10799.1,401.85,42905.66,19
CDM,87198597_1,"GRANULOCYTES, PHERESIS, EACH UNIT",16614.0,10799.1,401.85,42905.66,19
CDM,87198598_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2499.6,1624.74,401.85,6455.22,19
CDM,87198599_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2111.0,1372.15,401.85,5451.66,19
CDM,87198600_1,"RED BLOOD CELLS, IRRADIATED, EACH UNIT",1455.48,946.06,182.26,3758.78,19
CDM,87198601_1,"RED BLOOD CELLS, IRRADIATED, EACH UNIT",1455.48,946.06,182.26,3758.78,19
CDM,87198604_1,"BLOOD, SPLIT UNIT",210.92,137.1,52.73,653.0,19
CDM,87198605_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2712.0,1762.8,401.85,7003.74,19
CDM,87198606_1,"GRANULOCYTES, PHERESIS, EACH UNIT",2745.6,1784.64,401.85,7090.51,19
CDM,87198607_1,"BLOOD, SPLIT UNIT",541.13,351.73,135.28,1397.47,19
CDM,87198608_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1117.8,726.57,182.26,2886.72,19
CDM,87198610_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1455.48,946.06,182.26,3758.78,19
CDM,87198612_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",932.27,605.98,182.26,2407.59,19
CDM,87198614_1,"BLOOD, SPLIT UNIT",794.7,516.56,182.26,2052.31,19
CDM,87198616_1,"RED BLOOD CELLS, WASHED, EACH UNIT",1244.88,809.17,311.22,3214.9,19
CDM,87198617_1,"RED BLOOD CELLS, WASHED, EACH UNIT",1244.88,809.17,311.22,3214.9,19
CDM,87198618_1,"RED BLOOD CELLS, IRRADIATED, EACH UNIT",247.05,160.58,61.76,653.0,19
CDM,87198619_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1329.12,863.93,182.26,3432.45,19
CDM,87198621_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",2566.98,1668.54,401.85,6629.23,19
CDM,87198623_1,"BLOOD, SPLIT UNIT",1041.75,677.14,182.26,2690.32,19
CDM,87198624_1,"BLOOD, SPLIT UNIT",1041.75,677.14,182.26,2690.32,19
CDM,87198625_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",982.8,638.82,182.26,2538.08,19
CDM,87198627_1,"BLOOD, SPLIT UNIT",873.63,567.86,182.26,2256.15,19
CDM,87198628_1,"BLOOD, SPLIT UNIT",873.63,567.86,182.26,2256.15,19
CDM,87198629_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,87198630_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,87198631_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,87198632_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",1323.27,860.13,182.26,3417.34,19
CDM,87198633_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",954.72,620.57,182.26,2465.56,19
CDM,87198634_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",954.72,620.57,182.26,2465.56,19
CDM,87198635_1,"BLOOD, SPLIT UNIT",730.17,474.61,182.26,1885.66,19
CDM,87198636_1,"BLOOD, SPLIT UNIT",730.17,474.61,182.26,1885.66,19
CDM,87198637_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",1112.67,723.24,182.26,2873.47,19
CDM,87198638_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",1112.67,723.24,182.26,2873.47,19
CDM,87198643_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",50.4,32.76,12.6,653.0,19
CDM,87198645_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1822.28,1184.48,401.85,4706.04,19
CDM,87198648_1,"PLATELETS, PHERESIS, IRRADIATED, EACH UNIT",879.6,571.74,219.9,2271.57,19
CDM,87198650_1,"PLATELETS, PHERESIS, IRRADIATED, EACH UNIT",220.8,143.52,55.2,653.0,19
CDM,87198652_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",1439.61,935.75,359.9,3717.79,19
CDM,87198654_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",1217.39,791.3,304.35,3143.91,19
CDM,87198656_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",783.6,509.34,195.9,2023.65,19
CDM,87198658_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1349.6,877.24,337.4,3485.34,19
CDM,87198664_1,"BLOOD, SPLIT UNIT",683.6,444.34,170.9,1765.4,19
CDM,87198665_1,"CRYOPRECIPITATE, EACH UNIT",210.6,136.89,52.65,653.0,19
CDM,87198666_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",212.63,138.21,53.16,653.0,19
CDM,87198667_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",683.28,444.13,170.82,1764.57,19
CDM,87198674_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",558.0,362.7,139.5,1441.04,19
CDM,87198675_1,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",3174.66,2063.53,401.85,8198.56,19
CDM,87198676_1,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1957.28,1272.23,401.85,5054.68,19
CDM,87198677_1,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",254.4,165.36,63.6,656.99,19
CDM,87198678_1,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",3039.66,1975.78,401.85,7849.92,19
CDM,87198679_1,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",955.2,620.88,238.8,2466.8,19
CDM,87198680_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",1825.07,1186.3,401.85,4713.24,19
CDM,87198681_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",860.4,559.26,215.1,2221.98,19
CDM,87198682_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",1352.39,879.05,338.1,3492.55,19
CDM,87198683_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",2188.8,1422.72,401.85,5652.58,19
CDM,87198684_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",2907.45,1889.84,401.85,7508.49,19
CDM,87198685_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",3042.45,1977.59,401.85,7857.13,19
CDM,87198686_1,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",2283.6,1484.34,401.85,5897.4,19
CDM,87198687_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2569.77,1670.35,401.85,6636.43,19
CDM,87198690_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT",1117.8,726.57,182.26,2886.72,19
CDM,87198691_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT",794.7,516.56,182.26,2052.31,19
CDM,87198692_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT",1455.48,946.06,182.26,3758.78,19
CDM,87198693_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT",2041.2,1326.78,182.26,5271.4,19
CDM,87198694_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT",967.2,628.68,182.26,2497.79,19
CDM,87198695_1,"PLATELETS, HLA-MATCHED LEUKOCYTES REDUCED, APHERESIS/PHERESIS, EACH UNIT",2208.0,1435.2,401.85,5702.16,19
CDM,87198697_1,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, FROZEN, DEGLYCEROL, WASHED, EACH UNIT",1329.12,863.93,182.26,3432.45,19
CDM,87198699_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1412.4,918.06,353.1,3647.52,19
CDM,87198700_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",913.2,593.58,228.3,2358.34,19
CDM,87198701_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",894.0,581.1,223.5,2308.76,19
CDM,87198702_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",145.2,94.38,36.3,653.0,19
CDM,87198703_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1352.39,879.05,338.1,3492.55,19
CDM,87198704_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1217.39,791.3,304.35,3143.91,19
CDM,87198705_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2566.98,1668.54,401.85,6629.23,19
CDM,87198706_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2222.4,1444.56,401.85,5739.35,19
CDM,87198707_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2701.98,1756.29,401.85,6977.86,19
CDM,87198708_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2569.77,1670.35,401.85,6636.43,19
CDM,87198709_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2434.77,1582.6,401.85,6287.79,19
CDM,87198710_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",3174.66,2063.53,401.85,8198.56,19
CDM,87198711_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2146.8,1395.42,401.85,5544.11,19
CDM,87198712_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2317.2,1506.18,401.85,5984.17,19
CDM,87198713_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",988.8,642.72,247.2,2553.58,19
CDM,87198714_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2241.6,1457.04,401.85,5788.93,19
CDM,87198715_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1349.6,877.24,337.4,3485.34,19
CDM,87198716_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1690.07,1098.55,401.85,4364.61,19
CDM,87198717_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1822.28,1184.48,401.85,4706.04,19
CDM,87198718_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",817.2,531.18,204.3,2110.42,19
CDM,87198719_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2204.4,1432.86,401.85,5692.86,19
CDM,87198720_1,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",2136.0,1388.4,401.85,5516.22,19
CDM,87198721_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, CMV-NEGATIVE, IRRADIATED, EACH UNIT",2434.77,1582.6,401.85,6287.79,19
CDM,87198722_1,"RED BLOOD CELLS, FROZEN/DEGLYCEROLIZED/WASHED, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1244.4,808.86,182.26,3213.66,19
CDM,87198723_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, IRRADIATED, EACH UNIT",982.8,638.82,182.26,2538.08,19
CDM,87198725_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",425.3,276.45,106.33,1098.34,19
CDM,87198726_1,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",491.4,319.41,122.85,1269.04,19
CDM,87198727_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",1217.39,791.3,304.35,3143.91,19
CDM,87198728_1,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",1283.49,834.27,320.87,3314.61,19
CDM,87198729_1,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",131.95,85.77,32.99,653.0,19
CDM,87205_1,Special Gram or Giemsa stain for microorganism,16.8,10.92,0.72,78.57,19
CDM,87206A_1,Special fluorescent and/or acid fast stain for microorganism,13.3,8.65,0.72,78.57,19
CDM,87206_1,Special fluorescent and/or acid fast stain for microorganism,21.0,13.65,1.13,78.57,19
CDM,87207_1,Special stain for inclusion bodies or parasites,17.1,11.12,1.02,78.57,19
CDM,87209_1,Special stain for parasites,34.7,22.56,6.24,78.57,19
CDM,87210B_1,Smear for infectious agents,7.9,5.14,0.46,78.57,19
CDM,87210C_1,Smear for infectious agents,7.9,5.14,0.46,78.57,19
CDM,87210_1,Smear for infectious agents,20.0,13.0,1.16,78.57,19
CDM,87220_1,Tissue fungi or parasites,20.0,13.0,0.85,78.57,19
CDM,87230_1,Microbial toxin or antitoxin assay,52.1,33.87,10.28,78.57,19
CDM,87250_1,"Inoculation of embryonated eggs, or small animal for virus isolation",63.0,40.95,11.74,78.57,19
CDM,87252J_1,Tissue culture inoculation for virus isolation,15.6,10.14,4.07,78.57,19
CDM,87252L_1,Tissue culture inoculation for virus isolation,40.3,26.2,10.51,78.57,19
CDM,87252Q_1,Tissue culture inoculation for virus isolation,47.3,30.75,12.33,78.57,19
CDM,87252R_1,Tissue culture inoculation for virus isolation,39.4,25.61,10.27,78.57,19
CDM,87252_1,Tissue culture inoculation for virus isolation,73.5,47.78,15.64,78.57,19
CDM,87253A_1,Tissue culture for virus isolation,23.5,15.28,4.75,78.57,19
CDM,87253C_1,Tissue culture for virus isolation,9.5,6.18,1.92,78.57,19
CDM,87253_1,Tissue culture for virus isolation,18.1,11.77,3.66,78.57,19
CDM,87254A_1,"Virus isolation, centrifuge enhanced",14.3,9.3,2.8,78.57,19
CDM,87255_1,Virus isolation,65.0,42.25,20.32,84.57,19
CDM,87273A_1,Detection test by immunofluorescent technique for herpes simplex virus type 2,12.4,8.06,1.49,78.57,19
CDM,87273_1,Detection test by immunofluorescent technique for herpes simplex virus type 2,8.4,5.46,1.01,78.57,19
CDM,87274A_1,Detection test by immunofluorescent technique for herpes simplex virus type 1,12.4,8.06,1.49,78.57,19
CDM,87274_1,Detection test by immunofluorescent technique for herpes simplex virus type 1,157.5,102.38,7.19,78.57,19
CDM,87278_1,Detection test by immunofluorescent technique for legionella pneumophila (water borne bacteria),52.5,34.13,8.19,78.57,19
CDM,87290_1,Detection test by immunofluorescent technique for varicella (chicken pox) zoster virus,24.9,16.19,3.34,78.57,19
CDM,87299_1,Detection test by immunofluorescent technique for organism,20.9,13.59,3.36,78.57,19
CDM,87305_1,Detection test by immunoassay technique for Aspergillus (fungus),50.4,32.76,6.04,78.57,19
CDM,87324_1,Detection test by immunoassay technique for Clostridium difficile toxins (stool pathogen),30.5,19.83,3.65,78.57,19
CDM,87328A_1,Detection test by immunoassay technique for Cryptosporidium (parasite),12.8,8.32,1.77,78.57,19
CDM,87328B_1,Detection test by immunoassay technique for Cryptosporidium (parasite),44.6,28.99,6.16,78.57,19
CDM,87328_1,Detection test by immunoassay technique for Cryptosporidium (parasite),27.3,17.75,3.77,78.57,19
CDM,87332_1,Detection test by immunoassay technique for cytomegalovirus,68.3,44.4,7.19,78.57,19
CDM,87338A_1,Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool,43.1,28.02,6.2,78.57,19
CDM,87338_1,Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool,34.2,22.23,4.92,78.57,19
CDM,87340_1,Detection test by immunoassay technique for hepatitis B surface antigen,14.1,9.17,1.46,78.57,19
CDM,87350_1,Detection test by immunoassay technique for hepatitis Be surface antigen,30.5,19.83,3.52,78.57,19
CDM,87380_1,Detection test by immunoassay technique for hepatitis D,107.1,69.62,11.02,78.57,19
CDM,87385_1,Detection test by immunoassay technique for Histoplasma capsulatum (parasite),157.5,102.38,7.95,78.57,19
CDM,87390_1,Detection test by immunoassay technique for HIV-1 antigen,107.2,69.68,14.44,78.57,19
CDM,87420_1,Detection test by immunoassay technique for respiratory syncytial virus (RSV),45.2,29.38,6.29,78.57,19
CDM,87425_1,Detection test by immunoassay technique for rotavirus,20.2,13.13,2.42,78.57,19
CDM,87427A_1,Detection test by immunoassay technique for Shiga-like toxin (bacterial toxin),26.3,17.1,3.15,78.57,19
CDM,87430_1,"Detection test by immunoassay technique for Streptococcus, group A (strep)",44.1,28.67,7.41,78.57,19
CDM,87449D_1,Detection test by immunoassay technique for other organism,47.3,30.75,5.67,78.57,19
CDM,87449_1,Detection test by immunoassay technique for other organism,47.3,30.75,5.67,78.57,19
CDM,87480A_1,"Detection test for candida species (yeast), direct probe technique",9.1,5.92,1.82,78.57,19
CDM,87480_1,"Detection test for candida species (yeast), direct probe technique",68.3,44.4,12.03,78.57,19
CDM,8748IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.55,2.31,0.89,9.17,16
CDM,8748OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.54,8.8,3.39,34.97,16
CDM,87490_1,"Detection test by nucleic acid for chlamydia, direct probe technique",20.0,13.0,4.55,78.57,19
CDM,87491B_1,"Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique",16.8,10.92,5.9,87.64,19
CDM,87491W_1,"Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique",10.5,6.83,3.68,87.64,19
CDM,87491_1,"Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique",27.1,17.62,9.51,87.64,19
CDM,87496A_1,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",31.5,20.48,11.05,87.64,19
CDM,87496_1,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",47.3,30.75,16.6,87.64,19
CDM,87497_1,"Detection test by nucleic acid for cytomegalovirus, quantification",117.6,76.44,25.7,106.99,19
CDM,87498A_1,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",126.0,81.9,21.05,87.64,19
CDM,87498_1,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",69.3,45.05,21.05,87.64,19
CDM,8749IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.08,3.3,1.27,13.12,16
CDM,8749OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.17,13.76,5.29,54.67,16
CDM,87502A_1,Detection test by nucleic acid for multiple types influenza virus,11.9,7.74,11.4,239.26,19
CDM,87502_1,Detection test by nucleic acid for multiple types influenza virus,348.3,226.4,57.48,333.67,19
CDM,87503A_1,"Detection test by nucleic acid for multiple types influenza virus, each additional influenza virus type or sub-type",11.9,7.74,3.48,78.57,19
CDM,8750IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.78,2.46,0.95,9.76,16
CDM,8750OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.98,6.49,2.5,25.77,16
CDM,87510_1,"Detection test for gardnerella vaginalis (bacteria), direct probe technique",60.0,39.0,12.03,78.57,19
CDM,87517_1,"Detection test by nucleic acid for Hepatitis B virus, quantification",118.7,77.16,25.7,106.99,19
CDM,8751IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.89,3.18,1.22,12.63,16
CDM,8751OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.09,20.21,7.77,80.29,16
CDM,87521_1,"Detection test by nucleic acid for Hepatitis C virus, amplified probe technique",157.5,102.38,21.05,87.64,19
CDM,87522A_1,"Detection test by nucleic acid for Hepatitis C virus, quantification",157.5,102.38,25.7,106.99,19
CDM,87522_1,"Detection test by nucleic acid for Hepatitis C virus, quantification",157.5,102.38,25.7,106.99,19
CDM,87529A_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",31.5,20.48,11.05,87.64,19
CDM,87529B_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",78.8,51.22,21.05,87.64,19
CDM,87529_1,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",157.5,102.38,21.05,87.64,19
CDM,8752IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.3,3.45,1.33,13.69,16
CDM,8752OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.5,13.33,5.13,52.94,16
CDM,87532A_1,"Detection test by nucleic acid for herpes virus-6, amplified probe technique",31.5,20.48,11.05,87.64,19
CDM,87532_1,"Detection test by nucleic acid for herpes virus-6, amplified probe technique",47.3,30.75,16.6,87.64,19
CDM,87535_1,"Detection test by nucleic acid for HIV-1 virus, amplified probe technique",220.5,143.33,21.05,87.64,19
CDM,87536_1,"Detection test by nucleic acid for HIV-1 virus, quantification",70.9,46.09,51.06,212.54,19
CDM,87550_1,"Detection test by nucleic acid for Mycobacteria species (bacteria), direct probe technique",37.8,24.57,7.58,78.57,19
CDM,87555_1,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), direct probe technique",33.4,21.71,8.98,78.57,19
CDM,87556_1,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), amplified probe technique",56.7,36.86,23.63,104.1,19
CDM,87560_1,"Detection test by nucleic acid for Mycobacteria avium-intracellulare (bacteria), direct probe technique",33.4,21.71,9.11,78.57,19
CDM,87590_1,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), direct probe technique",8.5,5.53,2.28,78.57,19
CDM,87591A_1,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique",16.8,10.92,5.9,87.64,19
CDM,87591B_1,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique",16.8,10.92,5.9,87.64,19
CDM,87591W_1,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique",10.5,6.83,3.68,87.64,19
CDM,87591_1,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique",100.0,65.0,21.05,87.64,19
CDM,87660A_1,"Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), direct probe technique",9.1,5.92,1.82,78.57,19
CDM,87660_1,"Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), direct probe technique",68.3,44.4,12.03,78.57,19
CDM,87798A_1,"Detection test by nucleic acid for organism, amplified probe technique",157.5,102.38,21.05,87.64,19
CDM,87798B_1,"Detection test by nucleic acid for organism, amplified probe technique",47.3,30.75,16.6,87.64,19
CDM,87798C_1,"Detection test by nucleic acid for organism, amplified probe technique",47.3,30.75,16.6,87.64,19
CDM,87798F_1,"Detection test by nucleic acid for organism, amplified probe technique",157.5,102.38,21.05,87.64,19
CDM,87798G_1,"Detection test by nucleic acid for organism, amplified probe technique",157.5,102.38,21.05,87.64,19
CDM,87798H_1,"Detection test by nucleic acid for organism, amplified probe technique",157.5,102.38,21.05,87.64,19
CDM,87798J_1,"Detection test by nucleic acid for organism, amplified probe technique",67.0,43.55,21.05,87.64,19
CDM,87798K_1,"Detection test by nucleic acid for organism, amplified probe technique",31.5,20.48,11.05,87.64,19
CDM,87798L_1,"Detection test by nucleic acid for organism, amplified probe technique",31.5,20.48,11.05,87.64,19
CDM,87798P_1,"Detection test by nucleic acid for organism, amplified probe technique",126.0,81.9,21.05,87.64,19
CDM,87798R_1,"Detection test by nucleic acid for organism, amplified probe technique",109.2,70.98,21.05,87.64,19
CDM,87798S_1,"Detection test by nucleic acid for organism, amplified probe technique",12.6,8.19,4.42,87.64,19
CDM,87798U_1,"Detection test by nucleic acid for organism, amplified probe technique",12.6,8.19,4.42,87.64,19
CDM,87798V_1,"Detection test by nucleic acid for organism, amplified probe technique",12.6,8.19,4.42,87.64,19
CDM,87798W_1,"Detection test by nucleic acid for organism, amplified probe technique",12.6,8.19,4.42,87.64,19
CDM,87798X_1,"Detection test by nucleic acid for organism, amplified probe technique",12.6,8.19,4.42,87.64,19
CDM,87798Y_1,"Detection test by nucleic acid for organism, amplified probe technique",12.6,8.19,4.42,87.64,19
CDM,87798Z_1,"Detection test by nucleic acid for organism, amplified probe technique",12.6,8.19,4.42,87.64,19
CDM,87798_1,"Detection test by nucleic acid for organism, amplified probe technique",54.6,35.49,19.16,87.64,19
CDM,87799A_1,"Detection test by nucleic acid for organism, quantification",142.1,92.37,25.7,106.99,19
CDM,87799_1,"Detection test by nucleic acid for organism, quantification",126.0,81.9,25.7,106.99,19
CDM,87800_1,"Detection test by nucleic acid for multiple organisms, direct probe(s) technique",119.5,77.68,26.2,109.07,19
CDM,87802_1,"Detection test by immunoassay with direct visual observation for Streptococcus, group B (bacteria)",36.8,23.92,4.68,78.57,19
CDM,87804B_1,Detection test by immunoassay with direct visual observation for influenza virus,42.0,27.3,6.95,78.57,19
CDM,87804_1,Detection test by immunoassay with direct visual observation for influenza virus,35.0,22.75,5.79,78.57,19
CDM,87806_1,"Detection test by immunoassay with direct visual observation for HIV-1 antigen, with HIV-1 and HIV-2 antibodies",82.0,53.3,19.66,81.84,19
CDM,87834IP _1,BRIMONIDINE-TIMOLOL 0.2%-0.5%,31.98,20.79,8.0,22.39,11
CDM,87850_1,Detection test by immunoassay with direct visual observation for Neisseria gonorrhoeae (gonorrhea),35.7,23.21,8.77,78.57,19
CDM,87861IP _1,"INJECTION, LANREOTIDE, 1 MG",42618.72,27702.17,37.51,110062.84,19
CDM,87861OP _1,"INJECTION, LANREOTIDE, 1 MG",205918.81,133847.23,37.51,531785.33,19
CDM,87880_1,"Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep)",50.0,32.5,8.27,78.57,19
CDM,87889OP _1,UNCLASSIFIED DRUGS,1019.0,662.35,254.75,2631.57,16
CDM,87899_1,Detection test by immunoassay with direct visual observation for other organism,14.9,9.69,2.39,78.57,19
CDM,87902A_1,Analysis test by nucleic acid for Hepatitis C virus,262.5,170.63,78.57,675.81,19
CDM,87922IP _1,"INJECTION, IFOSFAMIDE, 1 GRAM",11.28,7.33,2.82,33.84,17
CDM,87926IP _1,"INJECTION, IFOSFAMIDE, 1 GRAM",11.49,7.47,2.87,34.47,17
CDM,88007_1,Autopsy with examination of brain and spinal cord,243.9,158.54,78.57,416.32,15
CDM,88010IP _1,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",82.57,53.67,1.42,213.24,17
CDM,88010OP _1,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",6.76,4.39,1.42,17.46,17
CDM,88020_1,Autopsy with microscopic examination of tissue,1050.0,682.5,78.57,1081.5,15
CDM,88027_1,Autopsy with examination of brain and spinal cord and microscopic examination of tissue,949.0,616.85,78.57,977.47,15
CDM,88036_1,"Limited, gross and/or microscopic autopsy",157.5,102.38,70.88,170.31,15
CDM,88104_1,"Cell examination of body fluid, smears",201.5,130.98,25.87,100.75,19
CDM,88106_1,"Cell examination of body fluid, simple filter method",246.7,160.36,17.08,123.35,19
CDM,88108_1,"Cell examination of specimen, concentration technique",230.9,150.09,20.65,115.45,19
CDM,88112A_1,"Cell examination of specimen, selective cellular enhancement technique",113.5,73.78,25.28,121.12,19
CDM,88112_1,"Cell examination of specimen, selective cellular enhancement technique",295.6,192.14,25.28,147.8,19
CDM,88120_1,"Cell examination of urine, manual",1398.1,908.77,52.9,817.79,19
CDM,88121_1,"Cell examination of urine, computer-assisted",1201.8,781.17,44.08,1237.85,19
CDM,88125_1,Forensic (investigation) examination of specimen,34.1,22.17,12.18,121.8,19
CDM,88130_1,"Sex identification, Barr bodies",60.9,39.59,10.95,78.57,19
CDM,88141_1,Pap test,78.8,51.22,21.59,78.57,19
CDM,88142A_1,"Pap test, manual screening",12.6,8.19,2.55,78.57,19
CDM,88142B_1,"Pap test, manual screening",26.3,17.1,5.33,78.57,19
CDM,88142C_1,"Pap test, manual screening",14.2,9.23,2.88,78.57,19
CDM,88142D_1,"Pap test, manual screening",26.3,17.1,5.33,78.57,19
CDM,88142W_1,"Pap test, manual screening",26.3,17.1,5.33,78.57,19
CDM,88142_1,"Pap test, manual screening",26.3,17.1,5.33,78.57,19
CDM,88147_1,"Pap test (Pap smear), automated system",31.5,20.48,15.93,126.27,19
CDM,88150_1,"Pap test, slides, manual screening",25.2,16.38,4.67,78.57,19
CDM,88155_1,"Pap test, slides, definitive hormonal evaluation",13.0,8.45,1.9,78.57,19
CDM,88160_1,"Screening examination of specimen cells, screening and interpretation",146.0,94.9,23.28,78.57,19
CDM,88161A_1,"Screening examination of specimen cells, preparation, screening and interpretation",89.3,58.05,23.28,78.57,19
CDM,88161_1,"Screening examination of specimen cells, preparation, screening and interpretation",170.5,110.83,23.28,85.25,19
CDM,88162_1,"Screening examination of specimen cells, extended study",239.4,155.61,35.63,119.7,19
CDM,88164_1,"Pap test, slides, manual screening (the Bethesda System)",26.3,17.1,4.88,78.57,19
CDM,88172A_1,Evaluation of fine needle aspirate,193.4,125.71,32.06,96.7,19
CDM,88172_1,Evaluation of fine needle aspirate,135.1,87.82,32.06,80.07,19
CDM,88173_1,Evaluation of fine needle aspirate with interpretation and report,403.5,262.28,63.56,201.75,19
CDM,88174_1,"Pap test, automated thin layer preparation; automated system",31.5,20.48,7.99,78.57,19
CDM,88177_1,"Pap test, evaluation of fine needle aspirate, immediate, each additional evaluation episode",72.5,47.13,19.68,78.57,19
CDM,88182A_1,Flow cytometry technique for DNA or cell analysis,105.0,68.25,34.12,115.85,19
CDM,88182_1,Flow cytometry technique for DNA or cell analysis,316.9,205.99,34.12,158.45,19
CDM,88184_1,"Flow cytometry technique for DNA or cell analysis, first marker",97.5,63.38,48.75,186.19,19
CDM,88185_1,"Flow cytometry technique for DNA or cell analysis, each additional marker",35.0,22.75,17.5,78.57,19
CDM,88187_1,"Flow cytometry technique for DNA or cell analysis, 2 to 8 markers",181.1,117.72,33.49,90.55,19
CDM,88188_1,"Flow cytometry technique for DNA or cell analysis, 9 to 15 markers",225.8,146.77,55.87,139.54,19
CDM,88189_1,"Flow cytometry technique for DNA or cell analysis, 16 or more markers",296.6,192.79,76.06,189.96,19
CDM,88245_1,"Chromosome analysis for genetic defects, baseline Sister Chromatid Exchange (SCE), 20-25 cells",262.5,170.63,78.57,454.57,19
CDM,88283_1,"Chromosome analysis for genetic defects, additional specialized banding technique",157.5,102.38,68.6,171.33,19
CDM,88291_1,Interpretation and report of genetic testing,105.0,68.25,30.22,78.6,19
CDM,88300A_1,"Pathology examination of tissue using a microscope, limited examination",26.3,17.1,4.03,78.57,19
CDM,88300_1,"Pathology examination of tissue using a microscope, limited examination",88.1,57.27,4.03,78.57,19
CDM,88302B_1,Pathology examination of tissue using a microscope,83.0,53.95,6.32,78.57,19
CDM,88302C_1,Pathology examination of tissue using a microscope,83.0,53.95,6.32,78.57,19
CDM,88302_1,Pathology examination of tissue using a microscope,178.9,116.29,6.32,89.45,19
CDM,88304A_1,"Pathology examination of tissue using a microscope, moderately low complexity",137.6,89.44,9.92,78.57,19
CDM,88304B_1,"Pathology examination of tissue using a microscope, moderately low complexity",137.6,89.44,9.92,78.57,19
CDM,88304C_1,"Pathology examination of tissue using a microscope, moderately low complexity",137.6,89.44,9.92,78.57,19
CDM,88304PW_1,"Pathology examination of tissue using a microscope, moderately low complexity",96.35,62.63,9.92,78.57,19
CDM,88304_1,"Pathology examination of tissue using a microscope, moderately low complexity",195.4,127.01,9.92,97.7,19
CDM,88305A_1,"Pathology examination of tissue using a microscope, intermediate complexity",200.6,130.39,34.07,114.07,19
CDM,88305B_1,"Pathology examination of tissue using a microscope, intermediate complexity",160.4,104.26,34.07,114.07,19
CDM,88305C_1,"Pathology examination of tissue using a microscope, intermediate complexity",78.8,51.22,34.07,114.07,19
CDM,88305D_1,"Pathology examination of tissue using a microscope, intermediate complexity",78.8,51.22,34.07,114.07,19
CDM,88305E_1,"Pathology examination of tissue using a microscope, intermediate complexity",200.6,130.39,34.07,114.07,19
CDM,88305F_1,"Pathology examination of tissue using a microscope, intermediate complexity",160.4,104.26,34.07,114.07,19
CDM,88305G_1,"Pathology examination of tissue using a microscope, intermediate complexity",160.4,104.26,34.07,114.07,19
CDM,88305K_1,"Pathology examination of tissue using a microscope, intermediate complexity",200.6,130.39,34.07,114.07,19
CDM,88305M_1,"Pathology examination of tissue using a microscope, intermediate complexity",200.6,130.39,34.07,114.07,19
CDM,88305PW_1,"Pathology examination of tissue using a microscope, intermediate complexity",164.3,106.8,34.07,114.07,19
CDM,88305_1,"Pathology examination of tissue using a microscope, intermediate complexity",321.6,209.04,34.07,160.8,19
CDM,88307A_1,"Pathology examination of tissue using a microscope, moderately high complexity",281.4,182.91,74.04,225.38,19
CDM,88307B_1,"Pathology examination of tissue using a microscope, moderately high complexity",281.4,182.91,74.04,225.38,19
CDM,88307_1,"Pathology examination of tissue using a microscope, moderately high complexity",708.0,460.2,74.04,354.0,19
CDM,88309A_1,"Pathology examination of tissue using a microscope, high complexity",367.2,238.68,78.57,338.03,19
CDM,88309B_1,"Pathology examination of tissue using a microscope, high complexity",367.2,238.68,78.57,338.03,19
CDM,88309_1,"Pathology examination of tissue using a microscope, high complexity",1055.1,685.82,78.57,527.55,19
CDM,88311_1,Preparation of tissue for examination by removing any calcium present,52.0,33.8,10.89,78.57,19
CDM,88312A_1,Special stained specimen slides to identify organisms including interpretation and report,60.3,39.2,24.3,102.04,19
CDM,88312B_1,Special stained specimen slides to identify organisms including interpretation and report,60.3,39.2,24.3,102.04,19
CDM,88312C_1,Special stained specimen slides to identify organisms including interpretation and report,60.3,39.2,24.3,102.04,19
CDM,88312PW_1,Special stained specimen slides to identify organisms including interpretation and report,255.65,166.17,24.3,127.83,19
CDM,88312ZA_1,Special stained specimen slides to identify organisms including interpretation and report,235.2,152.88,24.3,117.6,19
CDM,88312_1,Special stained specimen slides to identify organisms including interpretation and report,289.5,188.18,24.3,144.75,19
CDM,88313A_1,Special stained specimen slides to examine tissue including interpretation and report,34.7,22.56,10.89,78.57,19
CDM,88313B_1,Special stained specimen slides to examine tissue including interpretation and report,34.7,22.56,10.89,78.57,19
CDM,88313C_1,Special stained specimen slides to examine tissue including interpretation and report,34.7,22.56,10.89,78.57,19
CDM,88313D_1,Special stained specimen slides to examine tissue including interpretation and report,34.7,22.56,10.89,78.57,19
CDM,88313PW_1,Special stained specimen slides to examine tissue including interpretation and report,184.8,120.12,10.89,92.4,19
CDM,88313_1,Special stained specimen slides to examine tissue including interpretation and report,208.0,135.2,10.89,104.0,19
CDM,88314_1,Special stained specimen slides to examine tissue and frozen preparation of specimen including interpretation and report,246.9,160.49,18.21,123.45,19
CDM,88317OP _1,UNCLASSIFIED DRUGS,255.0,165.75,63.75,658.54,16
CDM,88319A_1,Evaluation of specimen enzymes,50.8,33.02,24.59,160.73,19
CDM,88319B_1,Evaluation of specimen enzymes,50.8,33.02,24.59,160.73,19
CDM,88319C_1,Evaluation of specimen enzymes,50.8,33.02,24.59,160.73,19
CDM,88319D_1,Evaluation of specimen enzymes,50.8,33.02,24.59,160.73,19
CDM,88319E_1,Evaluation of specimen enzymes,50.8,33.02,24.59,160.73,19
CDM,88319F_1,Evaluation of specimen enzymes,50.8,33.02,24.59,160.73,19
CDM,88319G_1,Evaluation of specimen enzymes,61.65,40.07,24.59,160.73,19
CDM,88319_1,Evaluation of specimen enzymes,301.8,196.17,24.59,160.73,19
CDM,88321A_1,Surgical pathology consultation and report on referred slides prepared elsewhere,180.0,117.0,65.09,162.56,19
CDM,88321_1,Surgical pathology consultation and report on referred slides prepared elsewhere,215.0,139.75,65.09,162.56,19
CDM,88323_1,Surgical pathology consultation and report on referred material requiring preparation of slides,405.9,263.84,78.57,202.95,19
CDM,88325B_1,"Surgical pathology consultation and report, comprehensive",317.5,206.38,78.57,272.33,19
CDM,88325_1,"Surgical pathology consultation and report, comprehensive",317.5,206.38,78.57,272.33,19
CDM,88329_1,Pathology examination of specimen during surgery,102.9,66.89,26.84,78.57,19
CDM,88331B_1,"Pathology examination of specimen during surgery, first tissue block",200.7,130.46,55.95,139.74,19
CDM,88331C_1,"Pathology examination of specimen during surgery, first tissue block",200.7,130.46,55.95,139.74,19
CDM,88331D_1,"Pathology examination of specimen during surgery, first tissue block",200.7,130.46,55.95,139.74,19
CDM,88331E_1,"Pathology examination of specimen during surgery, first tissue block",200.7,130.46,55.95,139.74,19
CDM,88331ZA_1,"Pathology examination of specimen during surgery, first tissue block",254.1,165.17,55.95,139.74,19
CDM,88331ZB_1,"Pathology examination of specimen during surgery, first tissue block",155.4,101.01,55.95,139.74,19
CDM,88331_1,"Pathology examination of specimen during surgery, first tissue block",253.6,164.84,55.95,139.74,19
CDM,88332C_1,"Pathology examination of specimen during surgery, each additional tissue block",87.2,56.68,28.13,78.57,19
CDM,88332D_1,"Pathology examination of specimen during surgery, each additional tissue block",87.2,56.68,28.13,78.57,19
CDM,88332E_1,"Pathology examination of specimen during surgery, each additional tissue block",87.2,56.68,28.13,78.57,19
CDM,88332F_1,"Pathology examination of specimen during surgery, each additional tissue block",87.2,56.68,28.13,78.57,19
CDM,88332ZA_1,"Pathology examination of specimen during surgery, each additional tissue block",107.1,69.62,28.13,78.57,19
CDM,88332_1,"Pathology examination of specimen during surgery, each additional tissue block",107.4,69.81,28.13,78.57,19
CDM,88333ZB_1,"Pathology cytologic examination of specimen during surgery, initial site",167.3,108.75,55.67,139.04,19
CDM,88333_1,"Pathology cytologic examination of specimen during surgery, initial site",268.7,174.66,55.67,139.04,19
CDM,88334ZA_1,"Pathology cytologic examination of specimen during surgery, each additional site",93.5,60.78,34.01,84.94,19
CDM,88334_1,"Pathology cytologic examination of specimen during surgery, each additional site",93.5,60.78,34.01,84.94,19
CDM,88337IP _1,"INJECTION, ANTIHEMOPHILIC FACTOR VIII/VON WILLEBRAND FACTOR COMPLEX (HUMAN), PER FACTOR VIII I.U.",3792.35,2465.03,1.31,9793.74,19
CDM,88341PW_1,"Special stained specimen slides to examine tissue, each additional procedure",197.45,128.34,25.9,98.73,19
CDM,88341_1,"Special stained specimen slides to examine tissue, each additional procedure",141.9,92.24,25.9,78.57,19
CDM,88342A_1,"Special stained specimen slides to examine tissue, initial procedure",71.4,46.41,31.78,107.6,19
CDM,88342B_1,"Special stained specimen slides to examine tissue, initial procedure",71.4,46.41,31.78,107.6,19
CDM,88342C_1,"Special stained specimen slides to examine tissue, initial procedure",71.4,46.41,31.78,107.6,19
CDM,88342D_1,"Special stained specimen slides to examine tissue, initial procedure",71.4,46.41,31.78,107.6,19
CDM,88342E_1,"Special stained specimen slides to examine tissue, initial procedure",71.4,46.41,31.78,107.6,19
CDM,88342F_1,"Special stained specimen slides to examine tissue, initial procedure",105.0,68.25,31.78,107.6,19
CDM,88342G_1,"Special stained specimen slides to examine tissue, initial procedure",105.0,68.25,31.78,107.6,19
CDM,88342PW_1,"Special stained specimen slides to examine tissue, initial procedure",228.85,148.75,31.78,114.43,19
CDM,88342_1,"Special stained specimen slides to examine tissue, initial procedure",218.0,141.7,31.78,109.0,19
CDM,88344_1,"Special stained specimen slides to examine tissue, each multiplex procedure",401.95,261.27,35.04,200.98,19
CDM,88346A_1,"Antibody evaluation, initial single antibody stain procedure",78.8,51.22,32.5,108.9,19
CDM,88346B_1,"Antibody evaluation, initial single antibody stain procedure",78.8,51.22,32.5,108.9,19
CDM,88346C_1,"Antibody evaluation, initial single antibody stain procedure",78.8,51.22,32.5,108.9,19
CDM,88346D_1,"Antibody evaluation, initial single antibody stain procedure",78.8,51.22,32.5,108.9,19
CDM,88346E_1,"Antibody evaluation, initial single antibody stain procedure",78.8,51.22,32.5,108.9,19
CDM,88346F_1,"Antibody evaluation, initial single antibody stain procedure",78.8,51.22,32.5,108.9,19
CDM,88346G_1,"Antibody evaluation, initial single antibody stain procedure",78.8,51.22,32.5,108.9,19
CDM,88346_1,"Antibody evaluation, initial single antibody stain procedure",310.1,201.57,32.5,155.05,19
CDM,88348A_1,Electron microscopy for diagnosis,472.5,307.13,69.83,638.59,19
CDM,88348B_1,Electron microscopy for diagnosis,220.5,143.33,69.83,638.59,19
CDM,88348_1,Electron microscopy for diagnosis,2273.2,1477.58,69.83,1136.6,19
CDM,88350_1,"Antibody evaluation, each additional single antibody stain procedure",169.0,109.85,26.59,84.5,19
CDM,88355_1,Microscopic genetic analysis of muscle,371.1,241.22,76.9,192.06,19
CDM,88356_1,Microscopic genetic analysis of nerve tissue,480.8,312.52,78.57,276.55,19
CDM,88358_1,Microscopic genetic analysis of tumor,124.4,80.86,44.57,111.31,19
CDM,88360_1,"Microscopic genetic analysis of tumor, manual",362.8,235.82,38.02,181.4,19
CDM,88361_1,"Microscopic genetic analysis of tumor, using computer-assisted technology",316.9,205.99,39.51,172.67,19
CDM,88362_1,Nerve teasing preparation,644.7,419.06,78.57,502.66,19
CDM,88363_1,Examination of archival tissue for genetic analysis,48.0,31.2,14.74,78.57,19
CDM,88364_1,"Genetic sequencing localization, each additional procedure",274.0,178.1,30.85,137.0,19
CDM,88365A_1,"Genetic sequencing localization, initial procedure",126.0,81.9,39.33,164.18,19
CDM,88365B_1,"Genetic sequencing localization, initial procedure",126.0,81.9,39.33,164.18,19
CDM,88365C_1,"Genetic sequencing localization, initial procedure",126.0,81.9,39.33,164.18,19
CDM,88365_1,"Genetic sequencing localization, initial procedure",507.1,329.62,39.33,253.55,19
CDM,88366_1,"Genetic sequencing localization, each multiplex procedure",167.3,108.75,56.08,172.32,19
CDM,88367_1,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure",676.3,439.6,30.31,338.15,19
CDM,88368_1,"Microscopic genetic analysis of tissue, manual, initial procedure",530.5,344.83,39.02,265.25,19
CDM,88371_1,Protein analysis of tissue with interpretation and report,129.2,83.98,18.2,78.57,19
CDM,88372_1,"Protein analysis of tissue by western blot, with interpretation and report",323.7,210.41,16.96,84.87,19
CDM,88374_1,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure",110.0,71.5,38.54,113.3,19
CDM,88377_1,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",831.0,540.15,59.45,855.93,19
CDM,88380_1,Preparation of specimen using laser,358.7,233.16,47.37,232.0,19
CDM,88381_1,"Preparation of specimen, manual",371.7,241.61,21.5,185.85,19
CDM,88387_1,"Pathologist examination, dissection, and preparation of tissue",95.7,62.21,2.73,78.57,19
CDM,88570OP _1,"INJECTION, LANREOTIDE, 1 MG",136179.95,88516.97,37.51,351684.72,19
CDM,88608IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",238.05,154.73,59.51,614.76,16
CDM,88608OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",67.1,43.62,16.78,173.29,16
CDM,88654IP _1,"INJECTION, HEPATITIS B IMMUNE GLOBULIN (HEPAGAM B), INTRAMUSCULAR, 0.5 ML",1059.93,688.95,73.77,2737.27,19
CDM,88704IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",93.65,60.87,23.41,241.85,16
CDM,88704OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",135.45,88.04,33.86,349.8,16
CDM,88705IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",93.65,60.87,23.41,241.85,16
CDM,88720_1,Measurement of bilirubin,15.8,10.27,0.79,78.57,19
CDM,8874IP _1,UNCLASSIFIED DRUGS,1.75,1.14,0.44,4.52,16
CDM,8874OP _1,UNCLASSIFIED DRUGS,2.36,1.53,0.59,6.09,16
CDM,8880IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.6,2.99,1.15,11.88,16
CDM,8880OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.46,13.3,5.12,52.84,16
CDM,89051C_1,Body fluid cell count with cell identification,34.5,22.43,1.93,78.57,19
CDM,89051_1,Body fluid cell count with cell identification,41.0,26.65,2.3,78.57,19
CDM,89060_1,Crystal identification from tissue or body fluid,50.0,32.5,3.67,78.57,19
CDM,89125_1,"Fat stain of stool, urine, or respiratory secretions",26.3,17.1,1.55,78.57,19
CDM,89128OP _1,"INJECTION, TRIAMCINOLONE ACETONIDE, PRESERVATIVE FREE, 1 MG",1846.56,1200.26,25.96,4768.74,19
CDM,89160_1,Examination of stool for meat fibers,8.2,5.33,0.4,78.57,19
CDM,89190A_1,Nasal smear for eosinophils (allergy related white blood cells),16.2,10.53,0.94,78.57,19
CDM,89190_1,Nasal smear for eosinophils (allergy related white blood cells),22.1,14.37,1.28,78.57,19
CDM,89201IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.57,15.97,6.14,63.45,16
CDM,89201OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.2,23.53,9.05,93.49,16
CDM,89220_1,Sputum specimen collection,39.9,25.94,9.89,78.57,19
CDM,89230_1,Sweat collection,55.7,36.21,1.36,78.57,19
CDM,89250_1,"Culture of eggs or embryos, less than 4 days",1575.0,1023.75,78.57,2187.16,15
CDM,89253_1,Assisted embryo hatching (fertility procedure),525.0,341.25,73.6,540.75,15
CDM,89257_1,Sperm identification from aspiration,262.5,170.63,50.75,270.38,15
CDM,89258_1,Frozen preservation of embryos,315.0,204.75,73.6,669.29,15
CDM,89259_1,Frozen preservation of sperm,262.5,170.63,73.6,270.38,15
CDM,89261_1,Sperm isolation and semen analysis for fertilization or diagnosis,210.0,136.5,50.75,216.3,15
CDM,89286IP _1,NEBIVOLOL 10 MG TABLET,41.0,26.65,10.25,28.7,11
CDM,89300_1,Semen analysis presence and/or motility of sperm,105.0,68.25,9.84,108.15,19
CDM,89310_1,Semen analysis motility and count,31.5,20.48,2.71,78.57,19
CDM,89320_1,"Semen evaluation volume, sperm count, motility and analysis",78.8,51.22,9.7,78.57,19
CDM,89321_1,Semen analysis for sperm presence,30.5,19.83,3.68,78.57,19
CDM,89322_1,"Semen evaluation, volume, sperm count, motility, and analysis",125.0,81.25,15.5,128.75,19
CDM,89325_1,Sperm antibody measurement,157.5,102.38,6.4,162.23,19
CDM,89329_1,"Sperm evaluation, hamster penetration test",315.0,204.75,11.75,324.45,19
CDM,89330_1,"Sperm evaluation, cervical mucus penetration test",105.0,68.25,6.23,108.15,19
CDM,89350OP _1,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",102.73,66.77,3.81,2058.35,19
CDM,89385IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",43.93,28.55,10.98,113.45,16
CDM,89385OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.24,20.31,7.81,80.68,16
CDM,8943IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.61,1.7,0.65,6.74,16
CDM,8943OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.93,2.55,0.98,10.15,16
CDM,8946IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.56,6.86,2.64,27.27,16
CDM,8946OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.85,4.45,1.71,17.69,16
CDM,8958IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.4,9.36,3.6,37.19,16
CDM,8958OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.17,15.71,6.04,62.42,16
CDM,8962IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.6,17.94,6.9,71.28,16
CDM,8962OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.46,23.05,8.87,91.58,16
CDM,8968IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.41,13.27,5.1,52.71,16
CDM,8969IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.57,2.32,0.89,9.22,16
CDM,8969OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.23,9.9,3.81,39.33,16
CDM,8970IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.86,1.21,0.47,4.8,16
CDM,8970OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.98,1.94,0.75,7.7,16
CDM,8971IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.97,3.23,1.24,12.84,16
CDM,8971OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.97,11.68,4.49,46.41,16
CDM,8972IP _1,UNCLASSIFIED DRUGS,4.77,3.1,1.19,12.32,16
CDM,8972OP _1,UNCLASSIFIED DRUGS,10.5,6.83,2.63,27.12,16
CDM,8975IP _1,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",28.89,18.78,0.56,74.61,17
CDM,8975OP _1,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",8.03,5.22,0.56,20.74,17
CDM,89783IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",89.27,58.03,22.32,230.54,16
CDM,89783OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",74.13,48.18,18.53,191.44,16
CDM,8979IP _1,ALBENDAZOLE 200 MG TABLET,116.08,75.45,29.02,81.26,11
CDM,8981IP _1,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",5.93,3.85,1.48,185.91,19
CDM,8981OP _1,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",6.45,4.19,1.61,185.91,19
CDM,8982IP _1,"INFUSION, ALBUMIN (HUMAN), 5%, 50 ML",1.46,0.95,0.37,185.91,19
CDM,8982OP _1,"INFUSION, ALBUMIN (HUMAN), 5%, 50 ML",1.61,1.05,0.4,185.91,19
CDM,8993IP _1,"INJECTION, ALDESLEUKIN, PER SINGLE USE VIAL",34890.45,22678.79,1477.95,90104.59,19
CDM,9000770T_1,Virtual reality technology to assist therapy,50.0,32.5,12.5,208.0,17
CDM,9001IP _1,"INJECTION, ALPROSTADIL, 1.25 MCG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",1069.02,694.86,0.51,2760.74,17
CDM,9002IP _1,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",51458.01,33447.71,99.46,132890.31,19
CDM,9002OP _1,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",18320.0,11908.0,99.46,47311.4,19
CDM,9003IP _1,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",30273.5,19677.78,99.46,78181.31,19
CDM,9003OP _1,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",9361.98,6085.29,99.46,24177.31,19
CDM,90090460_1,Administration of first vaccine or toxoid component with counseling (18 years or younger),50.0,32.5,12.5,129.13,19
CDM,90090785_1,Psychiatric services complicated by communication factor,35.0,22.75,8.75,476.0,19
CDM,90090791_1,Psychiatric diagnostic evaluation,321.0,208.65,80.25,828.98,19
CDM,90090792_1,Psychiatric diagnostic evaluation with medical services,358.0,232.7,89.5,924.54,19
CDM,90090832_1,"Psychotherapy, 30 minutes",280.0,182.0,70.0,723.1,17
CDM,90090833_1,"Psychotherapy with evaluation and management visit, 30 minutes",162.0,105.3,40.5,418.37,17
CDM,90090834_1,"Psychotherapy, 45 minutes",320.0,208.0,80.0,826.4,17
CDM,90090836_1,"Psychotherapy with evaluation and management visit, 45 minutes",205.0,133.25,51.25,529.41,17
CDM,90090837_1,"Psychotherapy, 1 hour",313.0,203.45,78.25,808.32,17
CDM,90090838_1,"Psychotherapy with evaluation and management visit, 1 hour",270.0,175.5,67.5,697.28,17
CDM,90090839_1,"Psychotherapy for crisis, first hour",327.0,212.55,81.75,844.48,19
CDM,90090840_1,"Psychotherapy for crisis, each additional 30 minutes",156.0,101.4,39.0,476.0,19
CDM,90090846_1,"Family psychotherapy without patient, 50 minutes",290.0,188.5,147.9,748.93,16
CDM,90090847_1,"Family psychotherapy with patient, 50 minutes",290.0,188.5,147.9,748.93,16
CDM,90090853_1,Group psychotherapy,160.0,104.0,40.0,413.2,17
CDM,90090863_1,Management of prescriptions and review of medication,62.0,40.3,15.5,160.12,17
CDM,90090867_1,"Treatment using magnetic field to stimulate nerve cells in brain, initial delivery and management",637.0,414.05,159.25,1645.05,19
CDM,90090868_1,"Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management",637.0,414.05,159.25,1645.05,19
CDM,90090869_1,"Treatment using magnetic field to stimulate nerve cells in brain, subsequent motor threshold redetermination with delivery and management",637.0,414.05,159.25,1645.05,19
CDM,90090887_1,"Explanation of psychiatric, medical examinations, procedures, and data to responsible person",210.0,136.5,107.1,542.33,16
CDM,90090901_1,Biofeedback training,101.0,65.65,25.25,277.0,19
CDM,90090912_1,"Biofeedback training for bowel or bladder control, initial 15 minutes",294.0,191.1,73.5,759.26,19
CDM,90090913_1,"Biofeedback training for bowel or bladder control, each additional 15 minutes",294.0,191.1,73.5,759.26,19
CDM,90091200_1,Measurement of liver stiffness,250.0,162.5,62.5,645.63,18
CDM,90092002_1,New patient problem focused exam of visual system,100.0,65.0,25.0,258.25,17
CDM,90092004_1,New patient complete exam of visual system,120.0,78.0,30.0,309.9,17
CDM,90092012_1,Established patient problem focused exam of visual system,200.0,130.0,50.0,516.5,17
CDM,90092014_1,Established patient complete exam of visual system,250.0,162.5,62.5,645.63,17
CDM,90092018_1,Complete exam of visual system under general anesthesia,3000.0,1950.0,420.35,7747.5,19
CDM,90092019_1,Limited exam of visual system under general anesthesia,1740.0,1131.0,420.35,4493.55,19
CDM,90092020_1,Exam of the internal drainage system of eye,100.0,65.0,25.0,784.0,19
CDM,90092025_1,CT scan of cornea,125.0,81.25,31.25,784.0,19
CDM,90092060_1,Exam to measure eye deviation and range of motion,105.0,68.25,26.25,784.0,19
CDM,90092071_1,Fitting of contact lens for treatment of eye surface disease,30.0,19.5,7.5,784.0,19
CDM,90092081_1,Exam of visual field with limited testing,65.0,42.25,16.25,784.0,19
CDM,90092082_1,Exam of visual field with intermediate testing,65.0,42.25,16.25,784.0,19
CDM,90092083_1,Exam of visual field with extended testing,270.0,175.5,67.5,784.0,19
CDM,90092100_1,Multiple measurements of eye fluid pressure over an extended time period,90.0,58.5,22.5,784.0,19
CDM,90092132_1,Imaging of front third of eye,150.0,97.5,37.5,784.0,19
CDM,90092133_1,Imaging of optic nerve,125.0,81.25,31.25,784.0,19
CDM,90092134_1,Imaging of retina,125.0,81.25,31.25,784.0,19
CDM,90092136_1,Measurement of corneal curvature and depth of eye,375.0,243.75,81.48,968.44,19
CDM,90092145_1,Measurement of corneal pressure,40.0,26.0,10.0,784.0,19
CDM,90092229_1,"Imaging of retina for disease detection, with automated review and report at point of care",140.0,91.0,35.0,784.0,19
CDM,90092235_1,Exam of retinal blood vessels using a special camera after injection of a dye,600.0,390.0,150.0,1549.5,19
CDM,90092242_1,Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye,610.0,396.5,152.5,1575.33,19
CDM,90092250_1,Photography of the retina,270.0,175.5,67.5,784.0,19
CDM,90092283_1,Extended exam involving color vision testing,70.0,45.5,17.5,784.0,19
CDM,90092285_1,Photography of content of eyes,108.53,70.54,27.13,784.0,19
CDM,90092507_1,"Treatment of speech, language, voice, communication, and/or hearing processing disorder",240.0,156.0,60.0,619.8,19
CDM,90092508_1,"Treatment of speech, language, voice, communication, and/or hearing processing disorder in a group setting",50.0,32.5,12.5,277.0,19
CDM,90092517_1,VEMP testing of lower branch of inner ear nerve with interpretation and report,330.0,214.5,82.5,852.23,19
CDM,90092518_1,VEMP testing of upper branch of inner ear nerve with interpretation and report,330.0,214.5,82.5,852.23,19
CDM,90092519_1,VEMP testing of upper and lower branches of inner ear nerve with interpretation and report,630.0,409.5,157.5,1626.98,19
CDM,90092521_1,"Evaluation of speech continuity, smoothness, rate, and effort",249.0,161.85,62.25,643.04,19
CDM,90092522_1,Evaluation of speech sound production,199.0,129.35,49.75,513.92,19
CDM,90092523_1,Evaluation of speech sound production with evaluation of language comprehension and expression,431.0,280.15,107.75,1113.06,19
CDM,90092524_1,Analysis of voice and resonance production,192.0,124.8,48.0,495.84,19
CDM,90092526_1,Treatment of swallowing and feeding disorder,300.0,195.0,62.9,774.75,19
CDM,90092588_1,Placement of ear probe for computerized measurement of repeated sounds with interpretation and report,630.15,409.6,116.19,1627.36,19
CDM,90092597_1,Evaluation for use of voice artificial device to supplement oral speech,250.0,162.5,62.5,645.63,19
CDM,90092607_1,"Evaluation with prescription of speech-generating and alternative communication device, first hour",285.0,185.25,71.25,736.01,19
CDM,90092609_1,Therapy service for use of speech-generating device with programming,239.0,155.35,59.75,617.22,19
CDM,90092610_1,Evaluation of swallowing function,320.0,208.0,80.0,826.4,19
CDM,90092611_1,Evaluation of swallowing function image,440.0,286.0,110.0,1136.3,19
CDM,90092612_1,Evaluation and recording of swallowing using an endoscope,620.0,403.0,155.0,1601.15,19
CDM,90092618_1,"Evaluation and prescription of nonspeech-generating and alternative communication device, each additional 30 minutes",74.0,48.1,18.5,405.67,19
CDM,90092650_1,Screening evaluation of brain response to sound with automated analysis,275.0,178.75,44.39,710.19,19
CDM,90092651_1,Evaluation of brain response to sound for determination of hearing status with interpretation and report,400.0,260.0,100.0,1033.0,19
CDM,90092652_1,Evaluation of brain response to sound for determination of hearing threshold with interpretation and report,630.0,409.5,116.19,1626.98,19
CDM,90092653_1,Evaluation of brain response to sound for diagnosis of nervous system disorders with interpretation and report,630.0,409.5,116.19,1626.98,19
CDM,90092997_1,"Balloon dilation of pulmonary artery, single vessel",1086.0,705.9,271.5,12169.11,18
CDM,90092998_1,"Balloon dilation of pulmonary artery, each additional vessel",5000.0,3250.0,1250.0,12912.5,18
CDM,90093041_1,Electrocardiogram (ECG) 1 to 3 leads,275.0,178.75,37.41,710.19,19
CDM,90093145_1,"INTERROGATION DEVICE EVALUATION (IN PERSON), CAROTID SINUS BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM INCLUDING TELEMETRIC ITERATIVE COMMUNICATION WITH THE IMPLANTABLE DEVICE TO MONITOR DEV",329.0,213.85,82.25,1052.0,17
CDM,90093146_1,"INTERROGATION DEVICE EVALUATION (IN PERSON), CAROTID SINUS BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM INCLUDING TELEMETRIC ITERATIVE COMMUNICATION WITH THE IMPLANTABLE DEVICE TO MONITOR DEV",329.0,213.85,82.25,1052.0,17
CDM,90093229_1,Electrocardiogram (ECG) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional,600.0,390.0,60.67,1549.5,19
CDM,90093264_1,"Remote monitoring of pulmonary artery pressure sensor, up to 30 days",75.0,48.75,18.75,784.0,19
CDM,90093297_1,"Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days",45.0,29.25,11.25,1052.0,19
CDM,90093298_1,"Evaluation of cardiac rhythm monitor system, remote up to 30 days",200.0,130.0,50.0,1052.0,19
CDM,90093312_1,"Ultrasound of heart with probe in esophagus, with report",1320.0,858.0,330.0,3408.9,19
CDM,90093503_1,Insertion of tube in pulmonary artery for monitoring,5393.0,3505.45,1348.25,13927.42,18
CDM,90093590_1,"Repair of leak adjacent to mitral valve, first closure device",36956.0,24021.4,1052.0,95438.87,19
CDM,90093591_1,"Repair of leak adjacent to aortic valve, first closure device",36956.0,24021.4,1052.0,95438.87,19
CDM,90093592_1,"Repair of lead adjacent to heart valve, each additional closure device",5000.0,3250.0,1052.0,21409.87,19
CDM,90093724_1,Electronic analysis of pacemaker to correct rapid heart rate,634.0,412.1,158.5,1637.31,19
CDM,90093750_1,Evaluation of lower heart chamber assist device,300.0,195.0,52.57,1052.0,19
CDM,90093786_1,"Ambulatory blood pressure monitoring, 1 day or longer, with recording",250.0,162.5,62.5,1052.0,19
CDM,90093788_1,"Ambulatory blood pressure monitoring, 1 day or longer, with scanning analysis and report",250.0,162.5,62.5,1052.0,19
CDM,90093971_1,Ultrasound study of one arm or leg veins with compression and maneuvers,805.0,523.25,158.99,2078.91,19
CDM,90093976_1,Ultrasound of abdomen and pelvis artery and vein blood flow,260.0,169.0,65.0,1052.0,19
CDM,90094010_1,Test to measure expiratory airflow and volume,310.0,201.5,77.5,1438.0,19
CDM,90094060_1,Test to measure expiratory airflow and volume changes before and after medication administration,575.0,373.75,143.75,1484.94,19
CDM,90094690_1,Test to measure exhaled air for evaluation of lung function at rest,377.0,245.05,83.86,1438.0,19
CDM,90094726_1,Test to determine lung volumes using sensors,600.0,390.0,150.0,1549.5,19
CDM,90094727_1,Test to determine lung volumes using gas dilution or washout,850.0,552.5,83.86,2195.13,19
CDM,90094729_1,Test to examine how well the lungs exchange gases,365.0,237.25,83.86,1438.0,19
CDM,90094780_1,"Test of car seat or bed (1 year or younger), 1 hour",245.0,159.25,61.25,1438.0,19
CDM,90094781_1,"Test of car seat or bed (1 year or younger), each additional 30 minutes",104.0,67.6,26.0,1438.0,19
CDM,90095249_1,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin,135.0,87.75,33.75,784.0,19
CDM,90095816_1,"Measurement of brain wave activity (EEG), awake and drowsy",1035.0,672.75,258.75,2672.89,19
CDM,90095874_1,Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle,746.0,484.9,186.5,1926.55,19
CDM,90095930_1,Measurement of nerve conduction using visual stimulation testing with report,500.0,325.0,125.0,1291.25,19
CDM,90095976_1,Electronic analysis of neurostimulator generator with simple cranial nerve stimulator programming,75.0,48.75,18.75,784.0,19
CDM,90095977_1,Electronic analysis of implanted neurostimulator generator with complex cranial nerve stimulator programming,235.0,152.75,58.75,784.0,19
CDM,90095983_1,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, first 15 minutes with qualified health professional",75.0,48.75,18.75,784.0,19
CDM,90095984_1,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, each additional 15 minutes with qualified health professional",75.0,48.75,18.75,784.0,19
CDM,90095991_1,Maintenance of spinal canal or brain drug infusion pump by health care professional,241.0,156.65,60.25,2054.0,19
CDM,90096105_1,"Test to assess the loss of the ability to speak, write, and understand language",360.3,234.2,90.08,930.47,19
CDM,90096112_1,"Administration of developmental test, first hour",375.0,243.75,93.75,968.44,19
CDM,90096113_1,"Administration of developmental test, each additional 30 minutes",125.0,81.25,31.25,866.51,19
CDM,90096116_1,"Exam of neurobehavioral status, first hour",550.0,357.5,137.5,1420.38,19
CDM,90096121_1,"Exam of neurobehavioral status, each additional hour",350.0,227.5,87.5,903.88,17
CDM,90096125_1,Test to assess the ability to complete specific functional tasks applicable to environment,281.0,182.65,70.25,866.51,19
CDM,90096127_1,Assessment of emotional or behavioral problems,80.0,52.0,20.0,476.0,19
CDM,90096130_1,"Evaluation of psychological test, first hour",375.0,243.75,93.75,968.44,19
CDM,90096131_1,"Evaluation of psychological test, each additional hour",250.0,162.5,62.5,866.51,19
CDM,90096132_1,"Evaluation of neuropsychological test, first hour",580.0,377.0,145.0,1497.85,19
CDM,90096133_1,"Evaluation of neuropsychological test, each additional hour",350.0,227.5,87.5,903.88,19
CDM,90096136_1,"Administration of psychological or neuropsychological test, first 30 minutes",550.0,357.5,137.5,1420.38,19
CDM,90096137_1,"Administration of psychological or neuropsychological test, each additional 30 minutes",250.0,162.5,62.5,866.51,19
CDM,90096138_1,"Administration of psychological or neuropsychological test by technician, first 30 minutes",550.0,357.5,137.5,1420.38,19
CDM,90096139_1,"Administration of psychological or neuropsychological test by technician, each additional 30 minutes",277.0,180.05,69.25,866.51,19
CDM,90096146_1,Administration of psychological or neuropsychological test by single standardized instrument via electronic platform with automated result,250.0,162.5,62.5,866.51,19
CDM,90096156_1,Assessment of health behavior,160.0,104.0,40.0,476.0,19
CDM,90096158_1,"Treatment of behavior impacting health, initial 30 minutes",320.0,208.0,80.0,826.4,19
CDM,90096159_1,"Treatment of behavior impacting health, each additional 15 minutes",160.0,104.0,40.0,476.0,17
CDM,90096164_1,"Treatment of behavior impacting health in group setting, initial 30 minutes",55.0,35.75,13.75,349.54,17
CDM,90096165_1,"Treatment of behavior impacting health in group setting, each additional 15 minutes",25.0,16.25,6.25,64.56,15
CDM,90096167_1,"Treatment of behavior impacting health with family and patient, initial 30 minutes",110.0,71.5,56.1,284.08,16
CDM,90096168_1,"Treatment of behavior impacting health with family and patient, each additional 30 minutes",55.0,35.75,24.75,142.04,14
CDM,90096170_1,"Treatment of behavior impacting health with family, initial 30 minutes",110.0,71.5,56.1,284.08,16
CDM,90096171_1,"Treatment of behavior impacting health with family, each additional 30 minutes",55.0,35.75,24.75,142.04,14
CDM,90097007_1,"MECHANICAL SCALP COOLING, INCLUDING INDIVIDUAL CAP SUPPLY WITH HEAD MEASUREMENT, FITTING, AND PATIENT EDUCATION",3630.0,2359.5,208.0,9374.48,17
CDM,90097008_1,"MECHANICAL SCALP COOLING; INCLUDING HAIR PREPARATION, INDIVIDUAL CAP PLACEMENT, THERAPY INITIATION, AND PRECOOLING PERIOD",50.0,32.5,12.5,208.0,17
CDM,90097009_1,"MECHANICAL SCALP COOLING; PROVIDED AFTER DISCONTINUATION OF CHEMOTHERAPY, EACH 30 MINUTES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",25.0,16.25,6.25,208.0,17
CDM,90097110_1,"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,90097112_1,"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,90097116_1,"Therapy procedure for walking training, each 15 minutes",94.0,61.1,23.5,277.0,19
CDM,90097124_1,"Therapy procedure using massage, each 15 minutes",23.0,14.95,5.75,277.0,19
CDM,90097129_1,"Therapy procedure for a range of mental processes, initial 15 minutes",160.0,104.0,40.0,413.2,19
CDM,90097130_1,"Therapy procedure for a range of mental processes, each additional 15 minutes",160.0,104.0,40.0,413.2,19
CDM,90097140_1,"Therapy procedure using manual technique, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,90097150_1,Therapy procedure in a group setting,69.79,45.36,17.45,277.0,19
CDM,90097151_1,"Behavior identification assessment by professional, each 15 minutes",80.0,52.0,20.0,206.6,17
CDM,90097152_1,"Behavior identification assessment by technician, each 15 minutes",80.0,52.0,20.0,206.6,17
CDM,90097153_1,"Adaptive behavior treatment by technician using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
CDM,90097154_1,"Adaptive behavior treatment by technician with multiple patients using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
CDM,90097155_1,"Adaptive behavior treatment by professional using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
CDM,90097156_1,"Adaptive behavior treatment by professional with family using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
CDM,90097157_1,"Adaptive behavior treatment by professional with multiple family group members using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
CDM,90097158_1,"Adaptive behavior treatment by professional with group using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
CDM,90097161_1,"Evaluation for physical therapy, typically 20 minutes",260.0,169.0,65.0,671.45,19
CDM,90097162_1,"Evaluation for physical therapy, typically 30 minutes",260.0,169.0,65.0,671.45,19
CDM,90097163_1,"Evaluation for physical therapy, typically 45 minutes",260.0,169.0,65.0,671.45,19
CDM,90097164_1,"Re-evaluation for physical therapy, typically 20 minutes",176.0,114.4,44.0,454.52,19
CDM,90097165_1,"Evaluation for occupational therapy, typically 30 minutes",234.0,152.1,58.5,604.31,19
CDM,90097166_1,"Evaluation for occupational therapy, typically 45 minutes",234.0,152.1,58.5,604.31,19
CDM,90097167_1,"Evaluation for occupational therapy, typically 1 hour",234.0,152.1,58.5,604.31,19
CDM,90097168_1,"Re-evaluation for occupational therapy, typically 30 minutes",159.0,103.35,39.75,410.62,19
CDM,90097530_1,Therapy procedure using functional activities,125.0,81.25,31.25,322.81,19
CDM,90097535_1,"Training for self-care or home management, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,90097537_1,"Training for community or work reintegration, each 15 minutes",89.0,57.85,22.25,277.0,19
CDM,90097542_1,"Evaluation for wheelchair, each 15 minutes",104.0,67.6,26.0,277.0,19
CDM,90097602_1,Removal of tissue from wound gradually,225.0,146.25,56.25,581.06,19
CDM,90097605_1,"Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less",400.0,260.0,100.0,1033.0,19
CDM,90097606_1,"Therapy procedure using a special bandage and vacuum pump, surface area more than 50.0 sq cm",700.0,455.0,175.0,1807.75,19
CDM,90097607_1,"Therapy procedure using a special bandage, vacuum pump and disposable medical equipment, surface area 50.0 sq cm or less",898.0,583.7,208.0,2319.09,19
CDM,90097750_1,"Test or measurement for functional capacity, each 15 minutes",116.0,75.4,29.0,299.57,19
CDM,90097760_1,"Training in the use of orthopedic device for arm, leg and/or trunk, each 15 minutes",116.0,75.4,29.0,299.57,19
CDM,90097761_1,"Training in the use of artificial arm and/or leg, each 15 minutes",104.0,67.6,26.0,277.0,19
CDM,90097763_1,"Follow-up training in the use of orthopedic device or artificial arm, leg and/or trunk, each 15 minutes",124.0,80.6,31.0,320.23,19
CDM,90099151_1,"Use of a drug to induce depression of consciousness by physician performing a procedure (younger than 5 years), initial 15 minutes",978.0,635.7,33.12,2525.69,18
CDM,90099152_1,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",700.0,455.0,33.12,1807.75,18
CDM,90099153_1,"Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes",196.0,127.4,33.12,506.17,18
CDM,90099155_1,"Use of a drug to induce depression of consciousness by physician not performing a procedure (younger than 5 years), initial 15 minutes",978.0,635.7,33.12,2525.69,18
CDM,90099156_1,"Use of a drug to induce depression of consciousness by physician not performing a procedure (5 years or older), initial 15 minutes",978.0,635.7,33.12,2525.69,18
CDM,90099157_1,"Use of a drug to induce depression of consciousness by physician not performing a procedure, each additional 15 minutes",196.0,127.4,33.12,506.17,18
CDM,90099406_1,"Smoking and tobacco use intermediate counseling, 3-10 minutes",45.0,29.25,11.25,273.0,19
CDM,90099407_1,"Smoking and tobacco use intensive counseling, more than 10 minutes",57.0,37.05,14.25,273.0,19
CDM,900A9698_1,"NON-RADIOACTIVE CONTRAST IMAGING MATERIAL, NOT OTHERWISE CLASSIFIED, PER STUDY",95.0,61.75,23.75,286.61,16
CDM,900C9257_1,"INJECTION, BEVACIZUMAB, 0.25 MG",81.0,52.65,1.95,209.18,17
CDM,900H0015_1,"ALCOHOL AND/OR DRUG SERVICES; INTENSIVE OUTPATIENT (TREATMENT PROGRAM THAT OPERATES AT LEAST 3 HOURS/DAY AND AT LEAST 3 DAYS/WEEK AND IS BASED ON AN INDIVIDUALIZED TREATMENT PLAN), INCLUDING ASSESSMEN",525.0,341.25,267.75,1355.81,16
CDM,900J0178_1,"INJECTION, AFLIBERCEPT, 1 MG",2415.0,1569.75,603.75,6236.74,19
CDM,900J0475_1,"INJECTION, BACLOFEN, 10 MG",622.0,404.3,155.5,1606.32,19
CDM,900J0713_1,"INJECTION, CEFTAZIDIME, PER 500 MG",17.0,11.05,1.56,43.9,17
CDM,900J1100_1,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",2.25,1.46,0.12,6.75,17
CDM,900J1170_1,"INJECTION, HYDROMORPHONE, 0.1 MG",9.0,5.85,0.15,23.24,17
CDM,900J1455_1,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",93.0,60.45,7.11,240.17,19
CDM,900J1570_1,"INJECTION, GANCICLOVIR SODIUM, 500 MG",180.0,117.0,35.53,464.85,17
CDM,900J2270_1,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",81.0,52.65,3.22,209.18,17
CDM,900J2274_1,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",8.0,5.2,2.0,20.66,17
CDM,900J2278_1,"INJECTION, ZICONOTIDE, 1 MICROGRAM",26.0,16.9,6.5,2058.35,19
CDM,900J2778_1,"INJECTION, RANIBIZUMAB, 0.1 MG",805.0,523.25,69.37,2078.91,19
CDM,900J3010_1,"INJECTION, FENTANYL CITRATE, 0.1 MG",71.0,46.15,1.26,183.36,17
CDM,900J3301_1,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",22.11,14.37,0.78,57.1,17
CDM,900J3370_1,"INJECTION, VANCOMYCIN HCL, 500 MG",95.0,61.75,23.75,245.34,16
CDM,900J3396_1,"INJECTION, VERTEPORFIN, 0.1 MG",23.0,14.95,5.75,1578.71,19
CDM,900J3465_1,"INJECTION, VORICONAZOLE, 10 MG",10.0,6.5,0.8,25.83,17
CDM,900J7030_1,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",10.0,6.5,2.5,25.83,16
CDM,900J7312_1,"INJECTION, DEXAMETHASONE, INTRAVITREAL IMPLANT, 0.1 MG",392.0,254.8,98.0,1578.71,19
CDM,900J7313_1,"INJECTION, FLUOCINOLONE ACETONIDE, INTRAVITREAL IMPLANT (ILUVIEN), 0.01 MG",1236.0,803.4,309.0,11535.65,19
CDM,900J7676_1,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",752.0,488.8,188.0,1942.04,16
CDM,900J9035_1,"INJECTION, BEVACIZUMAB, 10 MG",412.0,267.8,78.05,2922.83,19
CDM,900J9190_1,"INJECTION, FLUOROURACIL, 500 MG",12.0,7.8,2.06,36.0,17
CDM,900J9260_1,"INJECTION, METHOTREXATE SODIUM, 50 MG",14.0,9.1,2.73,42.0,17
CDM,900Q9958_1,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",1.87,1.22,0.07,5.64,17
CDM,900Q9961_1,"HIGH OSMOLAR CONTRAST MATERIAL, 250-299 MG/ML IODINE CONCENTRATION, PER ML",3.34,2.17,0.28,10.08,17
CDM,900Q9963_1,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",3.17,2.06,0.23,9.56,17
CDM,900Q9966_1,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",3.17,2.06,0.42,9.56,17
CDM,900Q9967_1,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",3.3,2.15,0.83,9.96,16
CDM,900S0092_1,"INJECTION, HYDROMORPHONE HYDROCHLORIDE, 250 MG (LOADING DOSE FOR INFUSION PUMP)",247.0,160.55,61.75,637.88,16
CDM,900S9480_1,"INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES, PER DIEM",525.0,341.25,267.75,1355.81,16
CDM,90100001_1,"HOSPITAL OBSERVATION SERVICE, PER HOUR",132.0,85.8,33.0,9520.0,19
CDM,90100003_1,DIRECT ADMISSION OF PATIENT FOR HOSPITAL OBSERVATION CARE,1228.0,798.2,240.75,9520.0,17
CDM,90100004_1,"HOSPITAL OBSERVATION SERVICE, PER HOUR",250.0,162.5,62.5,9520.0,19
CDM,90100011_1,RECOVERY ROOM - GENERAL CLASSIFICATION,120.0,78.0,30.0,84.0,11
CDM,90100013_1,RECOVERY ROOM - GENERAL CLASSIFICATION,120.0,78.0,30.0,84.0,11
CDM,9015OP _1,UNCLASSIFIED DRUGS,3.52,2.29,0.88,9.09,16
CDM,9016IP _1,GAVISCON ES TABLET CHEW,2.4,1.56,0.6,1.68,11
CDM,901S9976_1,"LODGING, PER DIEM, NOT OTHERWISE CLASSIFIED",660.0,429.0,174.24,462.0,9
CDM,90378_1,Respiratory syncytial virus antibody for injection into tissue or muscle,2089.0,1357.85,78.57,2897.31,15
CDM,90380_1,"Respiratory syncytial virus antibody, 0.5 mL dosage for injection into muscle",910.0,591.5,78.57,937.3,15
CDM,90381_1,"Respiratory syncytial virus antibody, 1.0 mL dosage for injection into muscle",1000.0,650.0,78.57,1030.0,15
CDM,90460_1,Administration of first vaccine or toxoid component with counseling (18 years or younger),60.0,39.0,21.0,78.57,19
CDM,90461_1,"Administration of vaccine or toxoid component with counseling (18 years or younger), each additional vaccine or toxoid component",30.0,19.5,8.3,78.57,19
CDM,90471_1,Administration of vaccine,80.0,52.0,5.8,78.57,19
CDM,90472_1,"Administration of vaccine, each additional vaccine",25.0,16.25,5.8,78.57,19
CDM,90473_1,"Administration of nasal or oral vaccine, 1 vaccine",30.0,19.5,5.8,78.57,19
CDM,90474_1,"Administration of nasal or oral vaccine, each additional vaccine",30.6,19.89,5.8,78.57,19
CDM,90480_1,"Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose",80.0,52.0,36.0,92.5,15
CDM,90589_1,Chikungunya virus vaccine,550.0,357.5,78.57,437.62,15
CDM,90593_1,"Chikungunya virus vaccine, recombinant, for intramuscular use",625.85,406.8,73.6,644.63,15
CDM,90619_1,"Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier",219.8,142.87,78.57,273.7,15
CDM,90620_1,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",381.65,248.07,78.57,356.06,15
CDM,90621_1,"Meningococcal recombinant lipoprotein vaccine, serogroup B",352.7,229.26,78.57,328.71,15
CDM,90625_1,Cholera vaccine,640.0,416.0,78.57,437.62,15
CDM,90627_1,"Inactivated tick-borne encephalitis virus vaccine, 0.5 mL dosage, for intramuscular use",659.0,428.35,78.57,678.77,15
CDM,9062IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.75,31.04,11.94,123.31,16
CDM,9062OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.04,4.58,1.76,18.18,16
CDM,90632_1,Hepatitis A vaccine adult dosage,120.0,78.0,54.0,110.64,15
CDM,90633_1,Hepatitis A vaccine pediatric or adolescent dosage,55.0,35.75,24.75,78.57,15
CDM,90634_1,Hepatitis A vaccine pediatric or adolescent dosage (3 dose schedule),88.8,57.72,24.28,91.46,15
CDM,90636_1,Hepatitis A and hepatitis B vaccine,182.7,118.76,78.57,194.98,15
CDM,9063IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",141.45,91.94,35.36,365.29,16
CDM,9063OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.05,6.53,2.51,25.95,16
CDM,90647_1,"Haemophilus influenzae type b vaccine, PRP-OMP conjugate",50.0,32.5,22.5,78.57,15
CDM,90648_1,"Haemophilus influenzae type b vaccine, PRP-T conjugate",50.0,32.5,12.87,78.57,15
CDM,90649_1,"Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent",245.0,159.25,78.57,254.89,15
CDM,90650_1,"Human Papillomavirus vaccine, types 16, 18, bivalent",250.0,162.5,78.57,257.5,15
CDM,90651_1,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",387.21,251.69,78.57,489.52,15
CDM,90653_1,"Influenza vaccine, inactivated",5.0,3.25,2.25,128.99,15
CDM,90655_1,"Influenza vaccine, trivalent, split virus, preservative-free, 0.25 mL dosage",5.0,3.25,2.25,78.57,15
CDM,90656_1,"Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage",5.0,3.25,2.25,78.57,15
CDM,90657_1,"Influenza vaccine, trivalent, 0.25 mL dosage",5.0,3.25,2.25,78.57,15
CDM,90658_1,"Influenza vaccine, trivalent, 0.5 mL dosage",5.0,3.25,2.25,78.57,15
CDM,9065IP _1,"INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG",25.99,16.89,0.43,67.12,17
CDM,9065OP _1,"INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG",3.25,2.11,0.43,8.39,17
CDM,90660_1,"Influenza vaccine, trivalent for nasal administration",5.0,3.25,2.25,78.57,15
CDM,90662_1,"Influenza vaccine split virus, preservative free",30.0,19.5,13.5,128.99,15
CDM,9066IP _1,UNCLASSIFIED DRUGS,5.47,3.56,1.37,14.13,16
CDM,9066OP _1,UNCLASSIFIED DRUGS,23.72,15.42,5.93,61.26,16
CDM,90670_1,"Pneumococcal vaccine, 13-valent",242.0,157.3,78.57,398.59,15
CDM,90672_1,"Influenza vaccine, quadrivalent for nasal administration",5.0,3.25,2.25,78.57,15
CDM,90673_1,"Influenza vaccine, trivalent derived from recombinant DNA",5.0,3.25,2.25,128.99,15
CDM,90675_1,Rabies vaccine for injection into muscle,438.9,285.29,78.57,506.42,15
CDM,90677_1,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use",453.25,294.61,78.57,460.47,15
CDM,90678_1,"Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use",630.0,409.5,78.57,488.22,15
CDM,90679_1,"Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use",592.5,385.13,78.57,467.86,15
CDM,90680_1,"Rotavirus vaccine, pentavalent",132.0,85.8,59.4,157.25,15
CDM,90681_1,"Rotavirus vaccine, human, attenuated",200.0,130.0,78.57,220.78,15
CDM,90682_1,"Influenza vaccine, quadrivalent derived from recombinant DNA",30.0,19.5,13.5,119.37,15
CDM,90685_1,"Influenza vaccine, quadrivalent, preservative free, 0.25 mL dosage",5.0,3.25,2.25,78.57,15
CDM,90686_1,"Influenza vaccine, quadrivalent, preservative free, 0.5 mL dosage",5.0,3.25,2.25,78.57,15
CDM,90687_1,"Influenza vaccine, quadrivalent, 0.25 mL dosage",5.0,3.25,2.25,78.57,15
CDM,90690_1,Typhoid vaccine,78.8,51.22,8.54,164.81,15
CDM,90691_1,Typhoid vaccine for injection into muscle,115.0,74.75,51.75,226.45,15
CDM,90694_1,"Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage",25.0,16.25,11.25,125.81,15
CDM,90696_1,"Diphtheria, tetanus, acellular pertussis, and polio vaccine",85.0,55.25,38.25,101.07,15
CDM,90698_1,"Diphtheria, tetanus, acellular pertussis, polio, and Haemophilus influenzae type b vaccine",125.0,81.25,56.25,191.36,15
CDM,9069IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.72,3.72,1.43,14.77,16
CDM,9069OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.29,15.79,6.07,62.73,16
CDM,90700_1,"Diphtheria, tetanus, and acellular pertussis vaccine (younger than 7 years)",45.0,29.25,20.25,78.57,15
CDM,90702_1,Diphtheria and tetanus vaccine (younger than 7 years),93.4,60.71,40.03,102.11,15
CDM,90707_1,"Measles, mumps, and rubella vaccine",102.0,66.3,45.9,147.08,15
CDM,9070IP _1,UNCLASSIFIED DRUGS,4.19,2.72,1.05,10.82,16
CDM,9070OP _1,UNCLASSIFIED DRUGS,32.75,21.29,8.19,84.58,16
CDM,90710_1,"Measles, mumps, rubella, and varicella vaccine",277.2,180.18,78.57,442.64,15
CDM,90713_1,Poliovirus vaccine,50.0,32.5,22.5,78.57,15
CDM,90714_1,Diphtheria and tetanus vaccine (7 years or older),40.0,26.0,18.0,80.89,15
CDM,90715_1,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",65.0,42.25,29.25,80.89,15
CDM,90716_1,Varicella vaccine,175.0,113.75,78.57,282.74,15
CDM,90717_1,Yellow fever vaccine,245.8,159.77,78.57,346.02,15
CDM,9071IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.47,9.41,3.62,37.37,16
CDM,9071OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.56,14.01,5.39,55.68,16
CDM,90723_1,"Diphtheria, tetanus, acellular pertussis, hepatitis B, and polio vaccine",135.0,87.75,60.75,151.36,15
CDM,90732_1,"Pneumococcal vaccine, 23-valent",125.0,81.25,56.25,206.21,15
CDM,90733_1,"Meningococcal vaccine, serogroups A, C, Y, W-135",225.0,146.25,78.57,231.75,15
CDM,90734_1,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",200.0,130.0,78.57,250.4,15
CDM,90736_1,Shingles vaccine for injection under skin,360.0,234.0,78.57,370.8,15
CDM,90738_1,Japanese encephalitis vaccine,385.0,250.25,78.57,431.77,15
CDM,90739_1,"Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use",100.0,65.0,45.0,260.02,15
CDM,90740_1,"Hepatitis B vaccine, dialysis or immunosuppressed patient dosage",281.4,182.91,78.57,244.34,15
CDM,90743_1,"Hepatitis B vaccine, adolescent dosage",100.0,65.0,45.0,116.11,15
CDM,90744_1,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",50.0,32.5,22.5,78.57,15
CDM,90746_1,"Hepatitis B vaccine, adult dosage (3 dose schedule)",100.0,65.0,45.0,108.74,15
CDM,90748_1,Hepatitis B and Haemophilus influenzae type b vaccine,100.0,65.0,45.0,108.75,15
CDM,90750_1,Shingles vaccine for injection into muscle,330.9,215.09,78.57,314.93,15
CDM,90756_1,"Influenza vaccine, quadrivalent derived from cell cultures",5.0,3.25,2.25,78.57,15
CDM,90785_1,Psychiatric services complicated by communication factor,31.0,20.15,11.64,78.57,19
CDM,90791_1,Psychiatric diagnostic evaluation,425.0,276.25,78.57,442.88,19
CDM,90792_1,Psychiatric diagnostic evaluation with medical services,450.0,292.5,78.57,492.73,19
CDM,9080IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.68,3.69,1.42,14.67,16
CDM,9080OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.24,1.46,0.56,5.78,16
CDM,90832_1,"Psychotherapy, 30 minutes",225.0,146.25,68.93,231.75,19
CDM,90833_1,"Psychotherapy with evaluation and management visit, 30 minutes",225.0,146.25,63.86,231.75,19
CDM,90834_1,"Psychotherapy, 45 minutes",275.0,178.75,78.57,283.25,19
CDM,90836_1,"Psychotherapy with evaluation and management visit, 45 minutes",275.0,178.75,78.57,283.25,19
CDM,90837_1,"Psychotherapy, 1 hour",325.0,211.25,78.57,382.94,19
CDM,90838_1,"Psychotherapy with evaluation and management visit, 1 hour",325.0,211.25,78.57,334.75,19
CDM,90839_1,"Psychotherapy for crisis, first hour",287.0,186.55,78.57,369.0,19
CDM,90840_1,"Psychotherapy for crisis, each additional 30 minutes",94.5,61.43,61.68,182.05,19
CDM,90846_1,"Family psychotherapy without patient, 50 minutes",241.5,156.98,78.57,279.57,19
CDM,90847_1,"Family psychotherapy with patient, 50 minutes",280.0,182.0,78.57,291.65,19
CDM,90849_1,Multiple-family group psychotherapy,98.7,64.16,29.11,101.66,19
CDM,90853_1,Group psychotherapy,175.0,113.75,24.05,180.25,19
CDM,90863_1,Management of prescriptions and review of medication,200.0,130.0,27.42,100.0,15
CDM,90867_1,"Treatment using magnetic field to stimulate nerve cells in brain, initial delivery and management",285.0,185.25,78.57,590.4,15
CDM,90868_1,"Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management",225.6,146.64,78.57,380.72,15
CDM,90869_1,"Treatment using magnetic field to stimulate nerve cells in brain, subsequent motor threshold redetermination with delivery and management",390.0,253.5,78.57,538.56,15
CDM,90870_1,Therapy using electrical currents,371.0,241.15,54.1,428.47,19
CDM,90875_1,"Psychophysiological therapy incorporating biofeedback training with psychotherapy, 30 minutes",194.3,126.3,78.57,200.13,15
CDM,90876_1,"Psychophysiological therapy incorporating biofeedback training with psychotherapy, 45 minutes",283.5,184.28,78.57,292.01,15
CDM,90880_1,Guided hypnosis,230.0,149.5,78.57,263.55,19
CDM,90882_1,"Medical management interactions on the patient's behalf with agencies, employers, or institutions",260.0,169.0,78.57,267.8,15
CDM,90887_1,"Explanation of psychiatric, medical examinations, procedures, and data to responsible person",210.0,136.5,78.57,216.3,15
CDM,90889_1,Preparation of report of patient's psychiatric status,195.3,126.95,66.96,201.16,15
CDM,90901_1,Biofeedback training,147.0,95.55,15.98,151.41,19
CDM,90912_1,"Biofeedback training for bowel or bladder control, initial 15 minutes",190.75,123.99,2.28,199.5,19
CDM,90913_1,"Biofeedback training for bowel or bladder control, each additional 15 minutes",78.0,50.7,1.14,79.51,19
CDM,90935_1,Hemodialysis procedure with physician evaluation,203.7,132.41,58.97,225.66,19
CDM,90937_1,Hemodialysis procedure requiring repeated evaluation,336.0,218.4,78.57,271.48,19
CDM,90945_1,Dialysis procedure including 1 evaluation,212.1,137.87,73.49,228.34,19
CDM,90947_1,Dialysis procedure requiring repeat evaluation,342.3,222.5,78.57,323.32,19
CDM,90951_1,"Dialysis services, 4 or more visits per month (younger than 2 years)",2964.2,1926.73,78.57,3079.84,19
CDM,90952_1,"Dialysis services, 2-3 physician visits per month (younger than 2 years)",1690.5,1098.83,78.57,1980.33,15
CDM,90953_1,"Dialysis services, 1 physician visit per month (younger than 2 years of age)",1352.4,879.06,78.57,1311.08,15
CDM,90954_1,"Dialysis services, 4 or more physician visits per month (2-11 years)",2435.0,1582.75,78.57,2659.05,19
CDM,90955_1,"Dialysis services, 2-3 physician visits per month (2-11 years)",1377.6,895.44,78.57,1389.54,19
CDM,90956_1,"Dialysis services, 1 physician visit per month (2-11 years of age)",929.3,604.05,78.57,957.18,19
CDM,90957_1,"Dialysis services, 4 or more physician visits per month (12-19 years)",1954.1,1270.17,78.57,2038.98,19
CDM,90958_1,"Dialysis services, 2-3 physician visits per month (12-19 years)",1317.8,856.57,78.57,1327.33,19
CDM,90959_1,"Dialysis services, 1 physician visit per month (12-19 years)",847.4,550.81,78.57,865.99,19
CDM,90960_1,"Dialysis services, 4 or more physician visits per month (20 years or older)",865.2,562.38,78.57,943.92,19
CDM,90961_1,"Dialysis services, 2-3 physician visits per month (20 years or older)",694.1,451.17,78.57,783.35,19
CDM,90962_1,"Dialysis services, 1 physician visit per month (20 years or older)",508.2,330.33,78.57,540.75,19
CDM,90963_1,Home dialysis services per month (younger than 2 years),1620.2,1053.13,78.57,1605.13,19
CDM,90964_1,Home dialysis services per month (2-11 years),1398.6,909.09,78.57,1375.77,19
CDM,90965_1,Home dialysis services per month (12-19 years),1330.4,864.76,78.57,1324.18,19
CDM,90966_1,Home dialysis services per month (20 years or older),692.0,449.8,78.57,783.35,19
CDM,90967_1,"Dialysis services, per day, less than full month service (younger than 2 years)",57.8,37.57,13.71,78.57,19
CDM,90968_1,"Dialysis services, per day, less than full month service (2-11 years)",46.2,30.03,11.42,78.57,19
CDM,90969_1,"Dialysis services, per day, less than full month service (12-19 years)",45.2,29.38,10.51,78.57,19
CDM,90970_1,"Dialysis services, per day, less than full month service (20 years or older)",24.2,15.73,5.48,78.57,19
CDM,90989_1,Dialysis training completed,1050.0,682.5,78.57,1081.5,15
CDM,90993_1,Dialysis training not completed,42.0,27.3,18.9,220.78,15
CDM,90997_1,Removal of toxins from blood,420.0,273.0,72.89,423.64,19
CDM,90999IP _1,UNCLASSIFIED DRUGS,40.43,26.28,10.11,104.41,16
CDM,90999OP _1,UNCLASSIFIED DRUGS,44.3,28.8,11.08,114.4,16
CDM,90ROOM02_1,NURSERY - NEWBORN - LEVEL I,1750.0,1137.5,462.0,1740.0,12
CDM,90ROOM03_1,NURSERY - NEWBORN - LEVEL II,3450.0,2242.5,910.8,3323.0,12
CDM,90ROOM04_1,ROOM & BOARD - SEMI-PRIVATE (TWO BEDS) - GENERAL CLASSIFICATION,3160.0,2054.0,834.24,2212.0,9
CDM,90ROOM08_1,NURSERY - NEWBORN - LEVEL IV,7450.0,4842.5,1966.8,5921.0,12
CDM,90ROOM09_1,INTENSIVE CARE UNIT - GENERAL CLASSIFICATION,4690.0,3048.5,1238.16,3283.0,9
CDM,90ROOM10_1,ROOM & BOARD - OTHER - STERILE ENVIRONMENT,2830.0,1839.5,747.12,1981.0,9
CDM,90ROOM11_1,INTENSIVE CARE UNIT - INTERMEDIATE ICU,5700.0,3705.0,1504.8,3990.0,9
CDM,90ROOM12_1,INTENSIVE CARE UNIT - GENERAL CLASSIFICATION,4890.0,3178.5,1290.96,3423.0,9
CDM,90ROOM13_1,INTENSIVE CARE UNIT - GENERAL CLASSIFICATION,7140.0,4641.0,1884.96,4998.0,9
CDM,90ROOM14_1,INTENSIVE CARE UNIT - INTERMEDIATE ICU,4020.0,2613.0,1061.28,2814.0,9
CDM,90ROOM15_1,ROOM & BOARD - PRIVATE (ONE BED) - OBSTETRICS (OB),1640.0,1066.0,432.96,1148.0,9
CDM,90ROOM16_1,ROOM & BOARD - PRIVATE (ONE BED) - GENERAL CLASSIFICATION,2700.0,1755.0,712.8,1890.0,9
CDM,90ROOM17_1,INTENSIVE CARE UNIT - INTERMEDIATE ICU,4870.0,3165.5,1285.68,3409.0,9
CDM,90ROOM19_1,ROOM & BOARD - SEMI-PRIVATE (TWO BEDS) - GENERAL CLASSIFICATION,2700.0,1755.0,712.8,1890.0,9
CDM,90ROOM20_1,INTENSIVE CARE UNIT - MEDICAL,23910.0,15541.5,6312.24,16737.0,9
CDM,90ROOM21_1,INTENSIVE CARE UNIT - MEDICAL,18595.0,12086.75,4909.08,13016.5,9
CDM,90ROOM22_1,INTENSIVE CARE UNIT - INTERMEDIATE ICU,4210.0,2736.5,1111.44,2947.0,9
CDM,90ROOM25_1,INTENSIVE CARE UNIT - INTERMEDIATE ICU,4020.0,2613.0,1061.28,2814.0,9
CDM,90ROOM26_1,INTENSIVE CARE UNIT - PEDIATRIC,6410.0,4166.5,1692.24,4487.0,9
CDM,90ROOM27_1,INTENSIVE CARE UNIT - INTERMEDIATE ICU,3430.0,2229.5,905.52,2401.0,9
CDM,90ROOM29_1,INTENSIVE CARE UNIT - INTERMEDIATE ICU,3430.0,2229.5,905.52,2401.0,9
CDM,90ROOM31_1,ROOM & BOARD - PRIVATE (ONE BED) - GENERAL CLASSIFICATION,3160.0,2054.0,834.24,2212.0,9
CDM,90ROOM32_1,INTENSIVE CARE UNIT - BURN CARE,4862.0,3160.3,1283.57,3403.4,9
CDM,90ROOM33_1,INTENSIVE CARE UNIT - INTERMEDIATE ICU,4241.0,2756.65,1119.62,2968.7,9
CDM,90ROOM34_1,NURSERY - NEWBORN - LEVEL IV,6710.0,4361.5,1771.44,5921.0,12
CDM,90ROOM35_1,NURSERY - NEWBORN - LEVEL IV,5690.0,3698.5,1502.16,5921.0,12
CDM,90ROOM36_1,NURSERY - NEWBORN - LEVEL III,3500.0,2275.0,924.0,4984.0,12
CDM,90ROOM37_1,INTENSIVE CARE UNIT - MEDICAL,5520.0,3588.0,1457.28,3864.0,9
CDM,90ROOM38_1,ROOM & BOARD - OTHER - GENERAL CLASSIFICATION,3310.0,2151.5,873.84,2317.0,9
CDM,90ROOM39_1,INTENSIVE CARE UNIT - INTERMEDIATE ICU,3430.0,2229.5,905.52,2401.0,9
CDM,90ROOM40_1,ROOM & BOARD - PRIVATE (ONE BED) - GENERAL CLASSIFICATION,2425.5,1576.58,640.33,1697.85,9
CDM,90ROOM41_1,ROOM & BOARD - SEMI-PRIVATE (TWO BEDS) - GENERAL CLASSIFICATION,2425.5,1576.58,640.33,1697.85,9
CDM,90ROOM50_1,ROOM & BOARD - PRIVATE (ONE BED) - PSYCHIATRIC,5995.0,3896.75,1582.68,4196.5,8
CDM,90ROOM60_1,ROOM & BOARD - PRIVATE (ONE BED) - GENERAL CLASSIFICATION,3670.0,2385.5,968.88,2569.0,9
CDM,90ROOM61_1,ROOM & BOARD - PRIVATE (ONE BED) - GENERAL CLASSIFICATION,2650.0,1722.5,699.6,1855.0,9
CDM,90ROOMWQ_1,ROOM & BOARD - PRIVATE (ONE BED) - GENERAL CLASSIFICATION,4690.0,3048.5,1238.16,3283.0,9
CDM,91010_1,Study of esophagus to assess movement,544.8,354.12,64.52,172.65,19
CDM,91013_1,Study of esophagus to assess movement with stimulation or tube,47.9,31.14,9.22,78.57,19
CDM,91020_1,Study of stomach to assess movement,635.3,412.95,72.98,194.33,19
CDM,91022_1,Study of upper small bowel to assess movement,348.5,226.53,72.98,194.32,19
CDM,91030_1,Test for esophageal reflux disease,384.3,249.8,46.14,123.05,19
CDM,91034_1,Monitoring and recording of esophageal function through nasal tube,609.3,396.05,47.9,255.12,19
CDM,91035_1,Monitoring and recording of esophageal function through a capsule attached to the esophagus wall,1582.8,1028.82,78.57,504.6,19
CDM,91037_1,Monitoring and recording of esophageal function through nasal tube with electrode,405.3,263.45,49.01,161.92,19
CDM,91038_1,Prolonged monitoring and recording of esophageal function through nasal tube with electrode,1268.1,824.27,56.92,148.45,19
CDM,91039IP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",155.15,100.85,5.02,400.67,17
CDM,91039OP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",32.78,21.31,5.02,84.65,17
CDM,91040OP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",65.75,42.74,5.02,169.8,17
CDM,91040_1,Study of esophageal sensation by balloon distension,902.3,586.5,48.65,492.82,19
CDM,91065_1,Measurement of hydrogen in breath to test for stomach and bowel symptoms,284.5,184.93,9.27,89.43,19
CDM,91073IP _1,PRISTIQ ER 50 MG TABLET,94.7,61.56,23.68,66.29,11
CDM,91074IP _1,PRISTIQ ER 100 MG TABLET,97.95,63.67,24.49,68.57,11
CDM,91074OP _1,PRISTIQ ER 100 MG TABLET,42.6,27.69,10.65,29.82,11
CDM,91110_1,Imaging of digestive tract done from the inside of the digestive tract,2912.2,1892.93,78.57,593.09,19
CDM,91111_1,Imaging of esophagus done from the inside of the esophagus,1929.9,1254.44,45.62,564.85,19
CDM,91112_1,Measurement of complex stomach and bowel motor function,3827.3,2487.75,78.57,894.35,19
CDM,91113_1,"Imaging of colon using capsule endoscope, with interpretation and report",285.0,185.25,78.57,322.19,19
CDM,91120_1,"RECTAL SENSATION, TONE, AND COMPLIANCE STUDY (EG, BAROSTAT)",1188.2,772.33,73.6,1223.85,16
CDM,91122_1,"ANORECTAL MANOMETRY, WITH RECTAL SENSATION AND RECTAL BALLOON EXPULSION TEST, WHEN PERFORMED",671.0,436.15,73.6,691.13,16
CDM,91125_1,"ANORECTAL MANOMETRY, WITH RECTAL SENSATION AND RECTAL BALLOON EXPULSION TEST, WHEN PERFORMED",341.0,221.65,73.6,351.23,16
CDM,91132_1,Recording and interpretation of stomach electrical activity,436.7,283.86,15.99,78.57,19
CDM,91133_1,Recording and interpretation of stomach electrical activity with drug administration,496.6,322.79,21.47,89.24,19
CDM,9116IP _1,"ANTITHROMBIN III (HUMAN), PER I.U.",13067.29,8493.74,4.29,33746.28,19
CDM,91185OP _1,"INJECTION, SECRETIN, SYNTHETIC, HUMAN, 1 MICROGRAM",1704.05,1107.63,42.87,4400.71,19
CDM,9119IP _1,UNCLASSIFIED DRUGS,28.58,18.58,7.15,73.81,16
CDM,9119OP _1,UNCLASSIFIED DRUGS,23.76,15.44,5.94,61.36,16
CDM,91200_1,Measurement of liver stiffness,88.2,57.33,10.51,78.57,19
CDM,9123IP _1,UNCLASSIFIED DRUGS,1.48,0.96,0.37,3.82,16
CDM,91279IP _1,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",52.97,34.43,0.7,136.8,17
CDM,91279OP _1,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",14.16,9.2,0.7,36.57,17
CDM,91281IP _1,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",157.77,102.55,0.7,407.44,17
CDM,91281OP _1,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",74.25,48.26,0.7,191.75,17
CDM,91299_1,Other diagnostic procedure for gastrointestine,158.4,102.96,71.28,163.15,15
CDM,91300OP _1,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, 1 MG",9286.44,6036.19,2.17,23982.23,19
CDM,91318_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 3 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",350.0,227.5,57.5,360.5,15
CDM,91319_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 10 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",150.0,97.5,67.5,154.5,15
CDM,91320_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",225.0,146.25,78.57,240.87,15
CDM,91321_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular use",225.0,146.25,78.57,231.75,15
CDM,91322_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use",225.0,146.25,78.57,249.75,15
CDM,91349IP _1,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",47.25,30.71,0.35,122.02,17
CDM,91349OP _1,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",66.23,43.05,0.35,171.04,17
CDM,91408IP _1,"INJECTION, REGADENOSON, 0.1 MG",1013.11,658.52,2.84,2616.36,17
CDM,91408OP _1,"INJECTION, REGADENOSON, 0.1 MG",287.56,186.91,2.84,742.62,17
CDM,91495OP _1,"INJECTION, CERTOLIZUMAB PEGOL, 1 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",21088.72,13707.67,4.1,54461.62,19
CDM,91534IP _1,LUBIPROSTONE 8 MCG CAPSULE,17.2,11.18,4.3,12.04,11
CDM,91552IP _1,LEVOCETIRIZINE 2.5 MG/5 ML ORAL SOLUTION [91552],3.29,2.14,0.82,2.3,11
CDM,91651IP _1,"INJECTION, METHYLNALTREXONE, 0.1 MG",1857.19,1207.17,2.23,4796.19,17
CDM,9175IP _1,BETAMETHASONE DP AUG 0.05% CRM,39.17,25.46,9.79,27.42,11
CDM,9183IP _1,"AZATHIOPRINE, ORAL, 50 MG",5.53,3.59,0.06,14.28,17
CDM,9183OP _1,"AZATHIOPRINE, ORAL, 50 MG",12.29,7.99,0.06,31.74,17
CDM,9185IP _1,UNCLASSIFIED DRUGS,252.8,164.32,63.2,652.86,16
CDM,9186IP _1,"INJECTION, AZTREONAM, 100 MG",443.07,288.0,2.36,1144.23,17
CDM,9186OP _1,"INJECTION, AZTREONAM, 100 MG",100.55,65.36,2.36,259.67,17
CDM,91870IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",809.4,526.11,202.35,2090.28,16
CDM,91870OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1546.18,1005.02,386.55,3993.01,16
CDM,91_1,TYPHIM VI 25 MCG/0.5 ML SYRNG,115.0,74.75,28.75,80.5,11
CDM,92002_1,New patient problem focused exam of visual system,202.7,131.76,27.27,200.72,19
CDM,92004_1,New patient complete exam of visual system,384.3,249.8,47.25,352.66,19
CDM,92012_1,Established patient problem focused exam of visual system,214.2,139.23,27.77,209.94,19
CDM,92014_1,Established patient complete exam of visual system,314.0,204.1,39.1,296.65,19
CDM,92015_1,Test to determine if prescription eye wear is needed,42.0,27.3,18.28,78.57,15
CDM,92018_1,Complete exam of visual system under general anesthesia,394.8,256.62,78.57,374.62,19
CDM,92019_1,Limited exam of visual system under general anesthesia,197.4,128.31,56.46,194.72,19
CDM,92020_1,Exam of the internal drainage system of eye,72.5,47.13,15.85,78.57,19
CDM,92025_1,CT scan of cornea,99.2,64.48,18.57,78.57,19
CDM,92060_1,Exam to measure eye deviation and range of motion,166.3,108.1,34.84,99.33,19
CDM,92065_1,Eye training exercise performed by health care professional,125.0,81.25,26.87,133.41,19
CDM,92066_1,Eye training exercise under supervision of health care professional,58.0,37.7,23.86,78.57,19
CDM,92071_1,Fitting of contact lens for treatment of eye surface disease,174.9,113.69,25.2,131.8,19
CDM,92072_1,Fitting of contact lens for management of corneal condition,275.0,178.75,75.35,301.78,19
CDM,92081_1,Exam of visual field with limited testing,150.2,97.63,15.05,78.57,19
CDM,92082_1,Exam of visual field with intermediate testing,210.7,136.96,19.63,78.57,19
CDM,92083_1,Exam of visual field with extended testing,214.2,139.23,25.43,102.61,19
CDM,9208OP _1,LIORESAL IT 40 MG/20 ML KIT,105.04,68.28,26.26,73.53,11
CDM,9209OP _1,LIORESAL IT 10 MG/20 ML KIT,54.12,35.18,13.53,37.88,11
CDM,92100_1,Multiple measurements of eye fluid pressure over an extended time period,242.6,157.69,10.41,198.76,19
CDM,92132_1,Imaging of front third of eye,89.3,58.05,14.72,78.57,19
CDM,92133_1,Imaging of optic nerve,110.3,71.7,15.7,78.57,19
CDM,92134_1,Imaging of retina,110.3,71.7,16.95,78.57,19
CDM,92136_1,Measurement of corneal curvature and depth of eye,381.6,248.04,28.93,90.37,19
CDM,92137_1,Imaging of retina with optical coherence tomography angiography,86.0,55.9,33.47,104.21,19
CDM,92145_1,Measurement of corneal pressure,37.8,24.57,5.32,78.57,19
CDM,92201_1,Extended exam of the back part of the eye with retinal drawing,60.5,39.33,17.59,78.57,19
CDM,92202_1,Extended exam of the back part of the eye with optic nerve drawing,38.5,25.03,11.25,78.57,19
CDM,92228_1,Imaging of retina with remote review by physician,50.4,32.76,15.72,78.57,19
CDM,92230_1,Exam of retinal blood vessels using an endoscope after injection of a dye,203.7,132.41,25.45,259.89,19
CDM,92235_1,Exam of retinal blood vessels using a special camera after injection of a dye,693.0,450.45,40.23,113.21,19
CDM,92240_1,Exam of blood vessels between the white part of eye and retina using a special camera after injection of a dye,716.1,465.47,43.89,228.76,19
CDM,92242_1,Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye,528.2,343.33,51.48,143.83,19
CDM,92250_1,Photography of the retina,229.9,149.44,19.63,108.73,19
CDM,92260_1,Measurement of eye artery pressure,68.3,44.4,8.66,78.57,19
CDM,92265_1,Measurement of eye muscle electrical activity and their nerve cells with needle electrode,243.6,158.34,43.47,122.32,19
CDM,92270_1,Measurement of eye movement,290.9,189.09,40.69,113.43,19
CDM,92273_1,Measurement of retinal and optic nerve function,92.0,59.8,33.3,156.75,19
CDM,92274_1,Measurement of retinal and optic nerve function targeting multiple separate locations,81.0,52.65,31.55,131.8,19
CDM,92283_1,Extended exam involving color vision testing,164.5,106.93,8.27,78.57,19
CDM,92284_1,Evaluation of eye adaptation to light and dark with interpretation and report,223.7,145.41,13.18,152.34,19
CDM,92285_1,Photography of content of eyes,117.6,76.44,2.72,78.57,19
CDM,92286_1,Imaging of front third of eye using a special microscope,356.0,231.4,20.24,137.92,19
CDM,92287_1,Imaging of front third of eye using a special camera after injection of a dye,322.4,209.56,21.48,122.12,19
CDM,92310A_1,Contact lens services both eyes,110.3,71.7,49.64,233.98,15
CDM,92310B_1,Contact lens services both eyes,110.3,71.7,49.64,233.98,15
CDM,92310C_1,Contact lens services both eyes,288.8,187.72,75.12,233.98,15
CDM,92310E1_1,Contact lens services both eyes,26.3,17.1,11.84,233.98,15
CDM,92310E2_1,Contact lens services both eyes,36.8,23.92,16.56,233.98,15
CDM,92310E3_1,Contact lens services both eyes,57.8,37.57,26.01,233.98,15
CDM,92310E4_1,Contact lens services both eyes,68.3,44.4,30.74,233.98,15
CDM,92310E5_1,Contact lens services both eyes,99.8,64.87,44.91,233.98,15
CDM,92310E6_1,Contact lens services both eyes,120.8,78.52,54.36,233.98,15
CDM,92310K_1,Contact lens services both eyes,315.0,204.75,72.93,233.98,15
CDM,92310M_1,Contact lens services both eyes,57.8,37.57,26.01,233.98,15
CDM,92310N1_1,Contact lens services both eyes,47.3,30.75,21.29,233.98,15
CDM,92310N2_1,Contact lens services both eyes,68.3,44.4,30.74,233.98,15
CDM,92310N3_1,Contact lens services both eyes,68.3,44.4,30.74,233.98,15
CDM,92310P_1,Contact lens services both eyes,157.5,102.38,70.88,233.98,15
CDM,92310S_1,Contact lens services both eyes,315.0,204.75,75.12,233.98,15
CDM,92310T_1,Contact lens services both eyes,110.3,71.7,49.64,233.98,15
CDM,92310_1,Contact lens services both eyes,26.3,17.1,11.84,233.98,15
CDM,92311_1,Contact lens services 1 eye where natural lens is absent,257.3,167.25,41.36,248.1,19
CDM,92312_1,Contact lens services both eyes where natural lens is absent,420.0,273.0,48.3,287.9,19
CDM,92313_1,Contact lens services for lens covering entire cornea,246.8,160.42,35.12,234.63,19
CDM,92315_1,Contact lens services 1 eye where natural lens is absent with fitting by independent technician,176.4,114.66,17.29,191.97,19
CDM,92316_1,Contact lens services both eyes where natural lens is absent with fitting by independent technician,230.0,149.5,25.87,238.26,19
CDM,92352_1,Fitting of monofocal spectacles where natural lens is absent,1522.5,989.63,48.35,761.25,15
CDM,92499_1,Other service or procedure on eye,41.1,26.72,18.5,80.89,15
CDM,92502_1,"Exam of head, neck, including ears, nose and throat under general anesthesia",279.3,181.55,36.56,252.97,19
CDM,92504_1,Exam of ear using a microscope,109.2,70.98,7.37,78.57,19
CDM,92507_1,"Treatment of speech, language, voice, communication, and/or hearing processing disorder",183.8,119.47,17.15,208.75,19
CDM,92511_1,Exam of the nose and throat using an endoscope,360.0,234.0,22.09,289.82,19
CDM,92512_1,Study of nasal function,170.1,110.57,22.24,175.2,19
CDM,92516_1,Study of facial nerve function,189.0,122.85,12.88,173.16,19
CDM,92517_1,VEMP testing of lower branch of inner ear nerve with interpretation and report,105.0,68.25,32.78,191.42,19
CDM,92518_1,VEMP testing of upper branch of inner ear nerve with interpretation and report,105.0,68.25,33.34,197.93,19
CDM,92519_1,VEMP testing of upper and lower branches of inner ear nerve with interpretation and report,155.0,100.75,49.63,329.29,19
CDM,92520_1,Study of voice box function,262.5,170.63,31.42,209.71,19
CDM,92521_1,"Evaluation of speech continuity, smoothness, rate, and effort",372.8,242.32,78.57,363.47,19
CDM,92522_1,Evaluation of speech sound production,303.5,197.28,78.57,301.67,19
CDM,92523_1,Evaluation of speech sound production with evaluation of language comprehension and expression,627.9,408.14,78.57,620.89,19
CDM,92524_1,Analysis of voice and resonance production,311.9,202.74,78.57,297.07,19
CDM,92526_1,Treatment of swallowing and feeding disorder,220.5,143.33,30.36,229.79,19
CDM,92531_1,Test for abnormal eye movement without stimulus,38.9,25.29,15.2,78.57,15
CDM,92532_1,Test for abnormal eye movement using 3 positions,51.5,33.48,17.47,78.57,15
CDM,92533_1,Test to assess balance during irrigation,63.0,40.95,25.23,78.57,15
CDM,92537_1,Test to assess balance during warm and cool irrigation in both ears,97.0,63.05,29.39,82.67,19
CDM,92538_1,Test to assess balance during warm or cool irrigation in both ears,49.0,31.85,14.75,78.57,19
CDM,92540_1,Evaluation and testing for balance with recording,254.1,165.17,72.32,206.56,19
CDM,92541_1,Test for abnormal eye movement with recording,160.7,104.46,19.63,78.57,19
CDM,92542_1,Test for abnormal eye movement using 3 positions with recording,167.0,108.55,23.53,78.57,19
CDM,92544_1,Test for abnormal eye movement using a moving target with recording,137.6,89.44,13.43,78.57,19
CDM,92545_1,Test for abnormal eye movement using a moving target that moves back and forth with recording,132.3,86.0,12.46,78.57,19
CDM,92546_1,Test for abnormal eye movement using a rotating chair,287.5,186.88,14.1,92.72,19
CDM,92547_1,Use of electrodes during balance testing,12.6,8.19,3.46,78.57,19
CDM,92548_1,Test for balance and posture,329.7,214.31,32.01,103.56,19
CDM,92549_1,Test for balance and posture with motor control and adaption test,153.25,99.61,41.77,121.11,19
CDM,92550_1,Test for eardrum and muscle function,62.0,40.3,15.99,78.57,19
CDM,92551_1,Test for screening hearing,31.5,20.48,14.18,78.57,15
CDM,92552_1,Test for hearing various pitches using earphone,59.9,38.94,15.99,103.05,19
CDM,92553_1,Test for hearing various pitches using earphone and device placed against the bone,78.8,51.22,22.85,124.62,19
CDM,92555_1,Test for ability to detect and repeat spoken words,42.0,27.3,11.42,78.57,19
CDM,92556_1,Test for ability to detect and repeat spoken words with speech recognition,66.2,43.03,22.85,121.16,19
CDM,92557_1,Comprehensive hearing and speech recognition test,123.9,80.54,25.1,92.81,19
CDM,92563_1,Test to assess defects in adaption to sounds,56.7,36.86,25.59,91.81,19
CDM,92565_1,Test to assess hearing loss,36.8,23.92,6.85,78.57,19
CDM,92567_1,Test to assess middle ear function,50.0,32.5,8.35,78.57,19
CDM,92568_1,Test to assess middle ear muscle reflex,51.5,33.48,9.14,78.57,19
CDM,92570_1,Comprehensive hearing test,93.5,60.78,18.28,81.06,19
CDM,92577_1,Test to assess hearing loss using 2 simultaneous words at different tones in same ear,66.2,43.03,7.31,78.57,19
CDM,92579_1,Test to assess hearing sensitivity using visual aids,130.2,84.63,29.0,113.07,19
CDM,92582_1,Test to assess hearing sensitivity using activity related feedback,112.4,73.06,53.01,230.84,19
CDM,92583_1,Test to assess hearing using pictures,89.3,58.05,32.9,153.12,19
CDM,92584_1,Test to assess electrical potentials generated in the inner ear as a result of sound stimulation,288.8,187.72,61.69,285.28,19
CDM,92587_1,Placement of ear probe for computerized measurement of sound with interpretation and report,184.8,120.12,17.67,78.57,19
CDM,92588_1,Placement of ear probe for computerized measurement of repeated sounds with interpretation and report,253.1,164.52,27.75,82.37,19
CDM,92591_1,"Exam for hearing aid, both ears",204.4,132.86,70.84,174.26,15
CDM,92592_1,"Check of hearing aid, 1 ear",51.5,33.48,18.28,78.57,15
CDM,92593_1,"Check of hearing aid, both ears",77.7,50.51,27.42,89.64,15
CDM,92594_1,"Evaluation of hearing aid function, 1 ear",56.7,36.86,18.28,78.57,15
CDM,92595_1,"Evaluation of hearing aid function, both ears",85.1,55.32,27.42,111.6,15
CDM,92596_1,Measurement of adequacy of hearing protection device,94.5,61.43,27.42,206.65,19
CDM,92597_1,Evaluation for use of voice artificial device to supplement oral speech,146.0,94.9,68.47,197.51,19
CDM,9259IP _1,"INJECTION, BENZTROPINE MESYLATE, PER 1 MG",63.88,41.52,14.65,164.97,17
CDM,9259OP _1,"INJECTION, BENZTROPINE MESYLATE, PER 1 MG",27.78,18.06,6.95,71.74,17
CDM,92603_1,Analysis and programming of inner ear implant (7 years or older),415.8,270.27,53.46,379.3,19
CDM,92604_1,Analysis and reprogramming of inner ear implant (7 years or older),244.7,159.06,30.83,228.21,19
CDM,92605_1,"Evaluation and prescription of nonspeech-generating and alternative communication device, first hour",196.4,127.66,78.57,229.52,15
CDM,92610_1,Evaluation of swallowing function,302.4,196.56,49.26,213.17,19
CDM,92611_1,Evaluation of swallowing function image,242.6,157.69,78.57,245.05,19
CDM,92612_1,Evaluation and recording of swallowing using an endoscope,449.4,292.11,52.22,483.76,19
CDM,92614_1,Evaluation and recording of voice box sensory function using an endoscope,402.2,261.43,27.23,362.22,19
CDM,92616_1,Evaluation and recording of swallowing and voice box sensory function using an endoscope,542.9,352.89,38.31,552.75,19
CDM,92625_1,Evaluation of hearing ringing in ear,194.3,126.3,46.15,171.8,19
CDM,92626_1,"Evaluation of hearing function related to surgically implanted hearing device, first hour",185.0,120.25,57.27,218.82,19
CDM,92627_1,"Evaluation of hearing function related to surgically implanted hearing device, each additional 15 minutes",64.5,41.93,13.8,78.57,19
CDM,92651_1,Evaluation of brain response to sound for determination of hearing status with interpretation and report,214.8,139.62,62.15,221.2,19
CDM,92652_1,Evaluation of brain response to sound for determination of hearing threshold with interpretation and report,283.5,184.28,78.57,289.66,19
CDM,92653_1,Evaluation of brain response to sound for diagnosis of nervous system disorders with interpretation and report,208.25,135.36,60.32,215.15,19
CDM,9266IP _1,"INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG",70.97,46.13,7.32,183.28,17
CDM,9266OP _1,"INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG",29.25,19.01,7.31,75.54,17
CDM,92700F_1,"Other procedure on ear, nose, or throat",500.0,325.0,73.6,515.0,15
CDM,92700U_1,"Other procedure on ear, nose, or throat",250.0,162.5,73.6,257.5,15
CDM,92777IP _1,TETRABENAZINE 25 MG TABLET,20.69,13.45,5.17,14.48,11
CDM,92777OP _1,TETRABENAZINE 25 MG TABLET,20.53,13.34,5.13,14.37,11
CDM,92853IP _1,"FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT), (NOVOSEVEN RT), 1 MICROGRAM",8896.29,5782.59,2.78,22974.67,19
CDM,92854IP _1,"FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT), (NOVOSEVEN RT), 1 MICROGRAM",8859.89,5758.93,2.78,22880.67,19
CDM,92859IP _1,UNCLASSIFIED DRUGS,148.2,96.33,37.05,382.73,16
CDM,92859OP _1,UNCLASSIFIED DRUGS,98.76,64.19,24.69,255.05,16
CDM,92895IP _1,"INJECTION, VANCOMYCIN HCL, 500 MG",2.04,1.33,0.51,5.27,16
CDM,92897IP _1,SPRYCEL 100 MG TABLET,4154.55,2700.46,1038.64,2908.19,11
CDM,9289OP _1,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",65.61,42.65,16.4,196.83,17
CDM,92920_1,Balloon dilation of single coronary artery or branch,1709.4,1111.11,78.57,1305.1,19
CDM,92921_1,Balloon dilation of single coronary artery or branch,854.7,555.56,78.57,1305.1,19
CDM,92924_1,Removal of plaque with balloon dilation of single coronary artery or branch,2031.8,1320.67,78.57,1554.9,19
CDM,92928_1,"Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch",1897.4,1233.31,78.57,1451.61,19
CDM,92929_1,"Insertion of stents with balloon dilation of coronary artery or branch, each additional artery or branch",234.2,152.23,73.6,241.23,15
CDM,92930_1,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED, SINGLE MAJOR CORONARY ARTERY AND/OR ITS BRANCH(ES); 2 OR MORE DISTINCT CORONARY LESIONS WITH 2",1211.0,787.15,73.6,1247.33,16
CDM,92933_1,"Removal of plaque, insertion of stent and balloon dilation of single coronary artery or branch",2121.0,1378.65,78.57,1627.67,19
CDM,92934_1,"Removal of plaque, insertion of stent and balloon dilation of single coronary artery or branch",263.6,171.34,78.57,1627.67,19
CDM,92937_1,"Removal of plaque, insertion of stent and/or balloon dilation of single coronary vessel with distal protection",1895.3,1231.95,78.57,1450.11,19
CDM,92941_1,"Removal of plaque and blood clot, insertion of stent and/or balloon dilation of single vessel",2125.2,1381.38,78.57,1631.62,19
CDM,92943_1,"Removal of plaque, insertion of stent and/or balloon dilation of single coronary artery, branch or bypass graft",2125.2,1381.38,78.57,1631.29,19
CDM,92945_1,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, SINGLE CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, AND/OR SUBTENDED MAJOR CORONARY ARTERY BRANCHES",1514.0,984.1,73.6,1559.42,16
CDM,92950_1,Manual attempt to restore blood circulation and breathing,940.0,611.0,78.57,799.93,19
CDM,92953_1,Temporary pacemaker to regulate heart beat,90.0,58.5,0.77,258.89,19
CDM,92960_1,External shock to heart to regulate heart beat,790.0,513.5,78.57,380.79,19
CDM,92961_1,Internal shock to heart to regulate heart beat,766.5,498.23,78.57,610.91,19
CDM,9296IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",50.05,32.53,12.51,129.25,16
CDM,92970_1,Placement of internal device to assist circulation,539.7,350.81,78.57,464.04,19
CDM,92971_1,Placement of external device to assist circulation,306.6,199.29,63.98,246.35,19
CDM,92972_1,Shockwave destruction of calcified plaque in coronary artery accessed through skin using catheter,360.0,234.0,78.57,382.71,19
CDM,92973_1,Removal of blood clot in heart artery,542.9,352.89,72.34,433.85,19
CDM,92974_1,Insertion of radiation delivery device into heart artery,497.7,323.51,78.57,396.85,19
CDM,92975_1,Other cardiovascular service or procedure,1192.8,775.32,73.6,1228.58,15
CDM,92977_1,Other cardiovascular service or procedure,722.4,469.56,73.6,744.07,15
CDM,92978_1,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel",652.1,423.87,78.57,400.1,19
CDM,92979_1,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, each additional vessel",400.1,260.07,66.51,211.82,19
CDM,9297IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.55,12.71,4.89,50.49,16
CDM,92986_1,Balloon dilation repair of aortic valve,4050.9,2633.09,78.57,3257.5,19
CDM,92987_1,Balloon dilation repair of mitral valve,4195.8,2727.27,78.57,3359.41,19
CDM,92990_1,Balloon dilation repair of pulmonary valve,3226.7,2097.36,78.57,2689.33,19
CDM,92997_1,"Balloon dilation of pulmonary artery, single vessel",2310.0,1501.5,78.57,1603.22,19
CDM,92998_1,"Balloon dilation of pulmonary artery, each additional vessel",1155.0,750.75,78.57,793.61,19
CDM,93000_1,Routine electrocardiogram (ECG) using at least 12 leads with interpretation and report,60.0,39.0,14.25,78.57,19
CDM,93005_1,Routine electrocardiogram (ECG) using at least 12 leads with tracing,40.0,26.0,6.29,78.57,19
CDM,93010A_1,Routine electrocardiogram (ECG) using at least 12 leads with interpretation and report only,30.0,19.5,7.96,78.57,19
CDM,93010_1,Routine electrocardiogram (ECG) using at least 12 leads with interpretation and report only,30.0,19.5,7.96,78.57,19
CDM,93015_1,Exercise or drug-induced heart stress test with electrocardiogram (ECG) with supervision and review by physician,230.0,149.5,68.97,192.65,19
CDM,93016_1,Exercise or drug-induced heart stress test with electrocardiogram (ECG) with supervision by physician,110.0,71.5,20.06,78.57,19
CDM,93017_1,Exercise or drug-induced heart stress test with electrocardiogram (ECG),100.0,65.0,35.71,98.13,19
CDM,93018_1,Exercise or drug-induced heart stress test with electrocardiogram (ECG) with review by physician,110.0,71.5,13.2,78.57,19
CDM,93024_1,Infusion of drug with evaluation of coronary artery spasm response,366.5,238.23,51.84,148.76,19
CDM,93025_1,Electrocardiogram (ECG) assessment of irregular heart beats,475.1,308.82,36.04,308.31,19
CDM,93040_1,Electrocardiogram (ECG) 1 to 3 leads with review by physician,37.8,24.57,13.89,78.57,19
CDM,93041_1,Electrocardiogram (ECG) 1 to 3 leads,13.7,8.91,7.22,78.57,19
CDM,93042_1,Electrocardiogram (ECG) 1 to 3 leads with review by physician only,23.1,15.02,6.68,78.57,19
CDM,93050_1,Analysis of central arterial pressure with review by physician,42.0,27.3,7.96,78.57,19
CDM,9308IP _1,"INJECTION, BUMETANIDE, 0.5 MG",12.55,8.16,0.38,32.41,17
CDM,9308OP _1,"INJECTION, BUMETANIDE, 0.5 MG",2.96,1.92,0.38,7.64,17
CDM,9309IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.52,3.59,1.38,14.26,16
CDM,9310IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.62,3.65,1.41,14.51,16
CDM,9310OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.0,4.55,1.75,18.08,16
CDM,93145_1,"INTERROGATION DEVICE EVALUATION (IN PERSON), CAROTID SINUS BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM INCLUDING TELEMETRIC ITERATIVE COMMUNICATION WITH THE IMPLANTABLE DEVICE TO MONITOR DEV",67.0,43.55,26.35,80.0,16
CDM,93146_1,"INTERROGATION DEVICE EVALUATION (IN PERSON), CAROTID SINUS BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM INCLUDING TELEMETRIC ITERATIVE COMMUNICATION WITH THE IMPLANTABLE DEVICE TO MONITOR DEV",94.0,61.1,37.29,96.82,16
CDM,9316IP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",37.36,24.28,0.01,96.48,17
CDM,9316OP _1,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",10.45,6.79,0.01,26.99,17
CDM,9321IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.97,5.83,2.24,23.17,16
CDM,9321OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.6,7.54,2.9,29.96,16
CDM,93224_1,Electrocardiogram (ECG) 2-day continuous with review and report by health care professional,377.0,245.05,65.48,220.59,19
CDM,93225_1,Electrocardiogram (ECG) 2-day continuous,114.5,74.43,16.47,78.57,19
CDM,93227_1,Electrocardiogram (ECG) 2-day continuous with review by health care professional,84.0,54.6,17.13,80.02,19
CDM,93228_1,Electrocardiogram (ECG) up to 30 days continuous with review and report by health care professional,76.7,49.86,23.3,78.57,19
CDM,9322IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.02,3.91,1.51,15.55,16
CDM,9322OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.63,10.16,3.91,40.36,16
CDM,9323IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.44,2.24,0.86,8.88,16
CDM,9323OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.3,6.7,2.58,26.6,16
CDM,93242_1,Heart rhythm recording continuous external EKG over more than 48 hours up to 7 days,30.0,19.5,9.14,78.57,19
CDM,93244_1,"Heart rhythm review, and interpretation of continuous external EKG over more than 48 hours up to 7 days",60.0,39.0,16.9,78.57,19
CDM,93246_1,Heart rhythm recording of continuous external EKG over 8-15 days,30.0,19.5,9.14,78.57,19
CDM,93248_1,Heart rhythm review and interpretation of continuous external EKG over 8-15 days,65.5,42.58,18.28,78.57,19
CDM,9324IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.38,2.85,1.1,11.31,16
CDM,9324OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.6,9.49,3.65,37.7,16
CDM,93260_1,Programming of implantable defibrillator system,162.8,105.82,39.2,112.97,19
CDM,93261_1,Evaluation of implantable defibrillator system,148.1,96.27,33.98,96.89,19
CDM,93264_1,"Remote monitoring of pulmonary artery pressure sensor, up to 30 days",87.0,56.55,28.28,123.17,19
CDM,93268_1,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring and review and report by health care professional,726.6,472.29,78.57,498.13,19
CDM,93270_1,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring,111.3,72.35,7.53,78.57,19
CDM,93272_1,"Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring, transmission and review and report by health care professional",90.0,58.5,22.84,78.57,19
CDM,93278_1,Recording to evaluate height and duration of heart beats through damaged heart tissue,139.7,90.81,11.84,89.43,19
CDM,93279_1,Programming of single lead pacemaker system,177.5,115.38,29.62,84.51,19
CDM,93280_1,Programming of dual lead pacemaker system,215.3,139.95,35.29,99.76,19
CDM,93281_1,Programming of multiple lead pacemaker system,221.6,144.04,39.2,111.76,19
CDM,93282_1,Programming of single lead implantable defibrillator system,214.2,139.23,38.89,110.89,19
CDM,93283_1,Programming of dual lead implantable defibrillator system,264.6,171.99,52.4,150.31,19
CDM,93284_1,Programming of multiple lead implantable defibrillator system,293.0,190.45,56.98,163.66,19
CDM,93285_1,Programming of cardiac rhythm monitor system,136.5,88.73,24.07,78.57,19
CDM,93286_1,"Programming of single, dual, or multiple lead or leadless pacemaker system before or after surgery",84.0,54.6,13.82,78.57,19
CDM,93287_1,"Programming of single, dual or multiple lead implantable defibrillator system before or after surgery",110.3,71.7,20.81,78.57,19
CDM,93288_1,"Evaluation of single, dual, multiple lead or leadless pacemaker system",122.9,79.89,19.4,78.57,19
CDM,93289_1,"Evaluation of single, dual, or multiple lead implantable defibrillator system",191.1,124.22,34.01,97.0,19
CDM,93290_1,Evaluation of implantable heart and blood vessel monitoring system,92.4,60.06,19.7,78.57,19
CDM,93291_1,Evaluation of cardiac rhythm monitor system,119.7,77.81,16.77,78.57,19
CDM,93292_1,Evaluation of wearable defibrillator system,51.9,33.74,19.7,78.57,19
CDM,93293_1,"Telephonic rhythm strip evaluation of single, dual, multiple lead or leadless pacemaker system, up to 90 days",167.9,109.14,12.92,78.57,19
CDM,93294_1,"Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days",80.9,52.59,27.42,78.58,19
CDM,93295_1,"Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days",147.0,95.55,34.24,113.17,19
CDM,93296_1,"Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days",74.6,48.49,27.42,78.57,19
CDM,93297_1,"Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days",79.8,51.87,18.28,78.57,19
CDM,93298_1,"Evaluation of cardiac rhythm monitor system, remote up to 30 days",69.3,45.05,16.95,78.57,19
CDM,93303_1,Ultrasound of heart for congenital defect,633.4,411.71,58.03,258.89,19
CDM,93304_1,"Ultrasound of heart for congenital defect, follow-up",415.4,270.01,33.58,141.21,19
CDM,93306_1,"Ultrasound of heart with color-depicted blood flow, rate, direction and valve function",735.0,477.75,65.02,343.62,19
CDM,93307_1,Ultrasound of heart,486.2,316.03,41.54,277.72,19
CDM,93308_1,"Ultrasound of heart, follow-up",254.0,165.1,23.79,155.33,19
CDM,93312_1,"Ultrasound of heart with probe in esophagus, with report",974.4,633.36,78.57,334.2,19
CDM,93313_1,Insertion of probe in esophagus for heart ultrasound,126.0,81.9,9.84,80.02,19
CDM,93314_1,Interpretation and report of ultrasound of heart,899.4,584.61,78.57,268.3,19
CDM,93315_1,"Ultrasound of heart with probe in esophagus for congenital defect, with report",656.3,426.6,78.57,353.03,19
CDM,93316_1,Insertion of probe in esophagus for congenital heart ultrasound,214.2,139.23,23.11,78.57,19
CDM,93317_1,Interpretation and report of congenital heart ultrasound,274.1,178.17,78.57,282.43,19
CDM,93318_1,Ultrasound of heart with probe in esophagus to assess heart pump function,674.1,438.17,78.57,269.27,19
CDM,93319_1,3D ultrasound imaging of heart for evaluation of heart structure performed during ultrasound imaging of congenital heart defects,57.0,37.05,19.65,135.53,19
CDM,93320_1,"Ultrasound of heart blood flow, valves and chambers",213.2,138.58,16.8,131.8,19
CDM,93321_1,"Ultrasound of heart blood flow, valves and chambers, follow-up",120.0,78.0,6.99,78.57,19
CDM,93325_1,"Ultrasound of heart with color-depicted blood flow, rate and valve function",273.0,177.45,3.26,148.27,19
CDM,93350_1,"Ultrasound of heart during rest, exercise and/or drug-induced stress with report",623.3,405.15,65.02,341.26,19
CDM,93351_1,"Ultrasound of heart with continuous electrocardiogram (ECG) during rest, exercise and/or drug induced stress with review and report",769.7,500.31,78.22,222.24,19
CDM,93352_1,Injection of X-ray contrast during ultrasound of heart,107.1,69.62,27.42,91.0,19
CDM,93355_1,Ultrasound of heart with probe in esophagus during surgery on heart or great blood vessels with report,577.5,375.38,78.57,594.16,19
CDM,93356_1,Heart muscle strain imaging,93.5,60.78,7.76,90.82,19
CDM,93451_1,Insertion of tube in right heart chambers for measurement,2173.4,1412.71,78.57,718.3,19
CDM,93452_1,Insertion of tube in left heart chambers for diagnosis with review by radiologist,2075.1,1348.82,78.57,797.85,19
CDM,93453_1,Insertion of tube in right and left heart chambers for diagnosis with review by radiologist,2716.3,1765.6,78.57,1044.03,19
CDM,93454_1,Insertion of tube in coronary artery for diagnosis with review by radiologist,2159.9,1403.94,78.57,823.27,19
CDM,93455_1,Insertion of tube in bypass graft for diagnosis with review by radiologist,2532.1,1645.87,78.57,959.77,19
CDM,93456_1,Insertion of tube in right heart chambers and coronary artery for diagnosis with review by radiologist,2676.8,1739.92,78.57,1029.91,19
CDM,93457_1,"Insertion of tube in right heart chambers, coronary artery, and bypass graft for diagnosis with review by radiologist",3048.6,1981.59,78.57,1166.89,19
CDM,93458_1,Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist,2618.7,1702.16,78.57,992.72,19
CDM,93459_1,"Insertion of tube in left lower heart chamber, coronary artery and bypass graft for diagnosis with review by radiologist",2841.8,1847.17,78.57,1096.28,19
CDM,93460_1,Insertion of tube in right and left heart chambers and coronary artery for diagnosis with review by radiologist,2986.5,1941.23,78.57,1173.48,19
CDM,93461_1,"Insertion of tube in right and left heart chambers, coronary artery, and bypass graft for diagnosis with review by radiologist",3481.9,2263.24,78.57,1344.81,19
CDM,93462_1,Insertion of tube in left heart chamber through heart septum,476.7,309.86,78.57,515.56,19
CDM,93463_1,Drug infusion during cardiac catheterization,255.2,165.88,78.57,255.22,19
CDM,93464_1,Drug infusion or exercise for heart stimulation during diagnostic study,574.5,373.43,78.57,237.23,19
CDM,9347IP _1,"INJECTION, CALCITONIN SALMON, UP TO 400 UNITS",2485.42,1615.52,621.36,6418.6,19
CDM,9347OP _1,"INJECTION, CALCITONIN SALMON, UP TO 400 UNITS",737.94,479.66,184.49,2058.35,19
CDM,9348IP _1,"INJECTION, CALCITRIOL, 0.1 MCG",48.05,31.23,1.26,124.09,17
CDM,9348OP _1,"INJECTION, CALCITRIOL, 0.1 MCG",48.57,31.57,1.26,125.43,17
CDM,93503_1,Insertion of tube in pulmonary artery for monitoring,390.6,253.89,76.96,244.77,19
CDM,93505_1,Biopsy of heart muscle,2403.8,1562.47,78.57,561.94,19
CDM,9350IP _1,"CALCITROL, 0.25 MICROGRAM",4.47,2.91,1.12,11.54,16
CDM,9350OP _1,"CALCITROL, 0.25 MICROGRAM",14.08,9.15,3.52,36.36,16
CDM,9351IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.37,6.09,2.34,24.2,16
CDM,9351OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.85,9.65,3.71,38.35,16
CDM,93563_1,Injection for imaging of coronary blood vessel during evaluation of congenital abnormalities with review by radiologist,577.5,375.38,40.61,145.27,19
CDM,93565_1,Injection for imaging of left heart chambers with review by radiologist,519.8,337.87,20.66,112.89,19
CDM,93566IP _1,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",19251.39,12513.4,11.71,49716.71,17
CDM,93566OP _1,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",17904.01,11637.61,11.71,46237.11,17
CDM,93566_1,Injection for imaging of right heart chambers with review by radiologist,419.0,272.35,20.46,121.06,19
CDM,93567IP _1,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",34626.68,22507.34,11.71,89423.4,17
CDM,93567OP _1,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",38721.58,25169.03,11.71,99998.48,17
CDM,93567_1,Injection for imaging of aorta above heart valve with review by radiologist,346.5,225.23,28.74,136.88,19
CDM,93568_1,Injection for nonselective imaging of pulmonary artery during heart catheterization,379.1,246.42,36.24,124.0,19
CDM,93569_1,"Injection for selective imaging of pulmonary artery during heart catheterization, on one side of body",86.5,56.23,30.77,307.8,19
CDM,93571_1,"Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel",294.0,191.1,78.57,254.18,19
CDM,93572_1,"Ultrasound evaluation of heart blood vessel during diagnosis or treatment, each additional vessel",232.1,150.87,66.51,235.36,19
CDM,93573_1,"Injection for selective imaging of pulmonary artery during heart catheterization, on both sides of body",144.0,93.6,50.83,167.78,19
CDM,93574IP _1,"INJECTION, GADOXETATE DISODIUM, 1 ML",205.67,133.69,15.64,620.49,17
CDM,93574OP _1,"INJECTION, GADOXETATE DISODIUM, 1 ML",198.36,128.93,15.64,598.43,17
CDM,93574_1,Injection for selective imaging of pulmonary vein during heart catheterization,159.0,103.35,56.22,185.7,19
CDM,93575_1,Injection for selective imaging of major aortopulmonary collateral arteries during heart catheterization,212.5,138.13,74.89,248.06,19
CDM,93580_1,Repair of congenital abnormality in wall between upper heart chambers with implant,2972.6,1932.19,78.57,2405.17,19
CDM,93581_1,Repair of congenital abnormality in wall between lower heart chambers with implant,3096.75,2012.89,78.57,3258.1,19
CDM,93582_1,Repair of congenital abnormality of pulmonary artery to aorta,2116.8,1375.92,55.11,1630.25,19
CDM,93583_1,Repair of wall between lower heart chambers including pacemaker insertion,2356.2,1531.53,32.9,1823.33,19
CDM,93584_1,Review by radiologist of vein imaging for congenital heart defect of superior vena cava,145.0,94.25,46.75,155.29,19
CDM,93585_1,Review by radiologist of vein imaging for congenital heart defect of the azygos/hemiazygos venous system,140.0,91.0,44.1,145.98,19
CDM,93586_1,Review by radiologist of vein imaging for congenital heart defect of coronary sinus,175.0,113.75,56.99,184.85,19
CDM,93587_1,Review by radiologist of vein imaging for congenital heart defect of venovenous collaterals above the heart,260.0,169.0,78.57,272.63,19
CDM,93588_1,Review by radiologist of vein imaging for congenital heart defect of venovenous collaterals below the heart,260.0,169.0,78.57,275.43,19
CDM,93590_1,"Repair of leak adjacent to mitral valve, first closure device",2749.4,1787.11,78.57,2815.2,19
CDM,93591_1,"Repair of leak adjacent to aortic valve, first closure device",2281.65,1483.07,78.57,2319.85,19
CDM,93592_1,"Repair of lead adjacent to heart valve, each additional closure device",1004.8,653.12,78.57,1028.1,19
CDM,93593_1,"Insertion of catheter into right side of heart for evaluation of congenital heart defect in heart with normal native blood vessel connections, using imaging guidance",446.0,289.9,78.57,510.6,19
CDM,93594_1,"Insertion of catheter into right side of heart for evaluation of congenital heart defect in heart with abnormal native blood vessel connections, using imaging guidance",697.0,453.05,78.57,798.23,19
CDM,93595_1,"Insertion of catheter into left side of heart for evaluation of congenital heart defect, using maging guidance",629.0,408.85,78.57,719.95,19
CDM,93596_1,"Insertion of catheter into right and left sides of heart for evaluation of congenital heart defect in heart with abnormal native blood vessel connections, using imaging guidance",766.0,497.9,78.57,877.02,19
CDM,93597_1,"Insertion of catheter into right and left sides of heart for evaluation of congenital heart defect in heart with normal native blood vessel connections, using imaging guidance",1015.0,659.75,78.57,1162.08,19
CDM,93598_1,"Measurement of output of blood from heart, performed during cardiac catheterization for evaluation of congenital heart defects",165.0,107.25,63.55,189.25,19
CDM,93600_1,Recording of upper heart rhythm,589.1,382.92,78.57,305.96,19
CDM,93602_1,Recording of upper heart chamber rhythm,389.6,253.24,78.57,291.03,19
CDM,93603_1,Recording of right lower heart chamber rhythm,441.0,286.65,78.57,291.03,19
CDM,93609_1,Insertion of tube in upper and/or lower heart chambers to record and identify origin of abnormal heart rhythm,1050.0,682.5,78.57,692.34,19
CDM,93610_1,Insertion of temporary pacemaker electrode for diagnostic upper heart pacing,534.5,347.43,78.57,410.77,19
CDM,93612_1,Insertion of temporary pacemaker electrode for diagnostic lower heart pacing,558.6,363.09,78.57,407.91,19
CDM,93613_1,Insertion of tube for 3D mapping of electrical impulses to heart muscle,1152.9,749.39,78.57,734.31,19
CDM,93615_1,Insertion of probe in esophagus for recording electrical impulses to upper and lower heart chambers,351.8,228.67,34.29,100.87,19
CDM,93616_1,"Insertion of probe in esophagus for recording electrical impulses to upper and lower heart chambers, with pacing",630.0,409.5,56.33,158.4,19
CDM,93618_1,Induction of abnormal heart rhythm by electrical pacing,936.6,608.79,78.57,588.39,19
CDM,93619_1,Insertion of catheters for recording and pacing of right heart chambers rhythm,1718.9,1117.29,78.57,1059.1,19
CDM,93620_1,Insertion of catheters for recording and pacing of right heart chambers rhythm and induction of abnormal rhythm,2197.7,1428.51,78.57,1564.73,19
CDM,93621_1,Insertion of catheters for recording and pacing of left upper heart chamber rhythm and induction of abnormal rhythm,3431.4,2230.41,72.03,1553.34,19
CDM,93622_1,Insertion of catheters for recording and pacing of left lower heart chamber rhythm and induction of abnormal rhythm,3450.3,2242.7,78.57,1553.34,19
CDM,93623_1,Programming of heart rhythm stimulation after drug infusion,758.1,492.77,47.41,400.1,19
CDM,93624_1,"Insertion of catheters for recording, pacing, and induction of abnormal heart rhythm to test therapy",1010.1,656.57,78.57,597.62,19
CDM,93631_1,Intra-operative heart pacing and mapping of abnormal heart rhythm for surgical correction,3150.0,2047.5,78.57,986.19,19
CDM,93640_1,Evaluation of single or dual chamber pacing cardioverter-defibrillator at time of implantation or replacement,1121.4,728.91,78.57,658.99,19
CDM,93641_1,Evaluation of single or dual chamber pacing cardioverter-defibrillator and generator at time of implantation or replacement,1452.2,943.93,78.57,847.28,19
CDM,93642_1,Programming of pacing cardioverter-defibrillator,1337.7,869.51,78.57,729.6,19
CDM,93644_1,Programming of implantable defibrillator,721.4,468.91,78.57,433.05,19
CDM,93650_1,Destruction of heart conduction tissue to create heart block,1755.6,1141.14,78.57,1450.41,19
CDM,93653_1,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of upper chamber of heart causing supraventricular tachycardia (rapid heart rate),2584.1,1679.67,78.57,2052.18,19
CDM,93654_1,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of lower chamber of heart causing ventricular tachycardia (rapid heart rate) or ventricular ectopy (irregular heart,3449.3,2242.05,78.57,2747.03,19
CDM,93655_1,Insertion of catheters and destruction of tissue to treat abnormal heart rhythm,1292.6,840.19,78.57,768.17,19
CDM,93656_1,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation,3450.3,2242.7,78.57,2754.78,19
CDM,93657_1,Destruction of tissue of upper heart chamber through tube to treat abnormal heart rhythm,1292.6,840.19,78.57,767.28,19
CDM,93660_1,Evaluation of heart function using tilt table,504.0,327.6,78.57,305.96,19
CDM,93662_1,Ultrasound evaluation of heart blood vessel with review by radiologist,457.8,297.57,66.2,249.48,19
CDM,93702_1,Measurement of lymphedema extracellular fluid,273.0,177.45,78.57,310.6,19
CDM,93724_1,Electronic analysis of pacemaker to correct rapid heart rate,1015.4,660.01,78.57,636.49,19
CDM,93745_1,Programming of wearable cardioverter-defibrillator,262.5,170.63,65.02,270.38,15
CDM,93750_1,Evaluation of lower heart chamber assist device,152.3,99.0,29.02,125.45,19
CDM,93770_1,Measurement of heart and circulatory system pressure,36.8,23.92,16.56,78.57,15
CDM,93784_1,"Ambulatory blood pressure monitoring, 1 day or longer, with recording, scanning analysis, interpretation, and report",210.0,136.5,44.49,150.63,19
CDM,93786_1,"Ambulatory blood pressure monitoring, 1 day or longer, with recording",84.0,54.6,21.71,78.57,19
CDM,93788_1,"Ambulatory blood pressure monitoring, 1 day or longer, with scanning analysis and report",47.3,30.75,5.37,78.57,19
CDM,93790_1,"Ambulatory blood pressure monitoring, 1 day or longer, with review, interpretation and report",57.8,37.57,17.42,78.57,19
CDM,93792_1,Patient/caregiver training for monitoring of anticoagulant therapy,120.0,78.0,66.35,176.14,19
CDM,93793_1,Anticoagulant management of patient taking warfarin,27.0,17.55,11.07,78.57,19
CDM,93834IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.55,2.31,0.89,9.17,16
CDM,93834OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.72,7.62,2.93,30.27,16
CDM,93838IP _1,"INJECTION, CEFEPIME HYDROCHLORIDE (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO MAXIPIME, 500 MG",8.71,5.66,2.18,22.49,17
CDM,93838OP _1,"INJECTION, CEFEPIME HYDROCHLORIDE (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO MAXIPIME, 500 MG",1.59,1.03,0.4,6.33,17
CDM,9385IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.25,4.06,1.56,16.14,16
CDM,9385OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.03,20.17,7.76,80.14,16
CDM,93880_1,Ultrasound of both sides of head and neck blood flow,811.0,527.15,35.26,197.7,19
CDM,93882_1,Ultrasound of one side of head and neck blood flow,574.3,373.3,21.75,112.97,19
CDM,93886_1,Complete ultrasound of within the brain blood flow,1142.5,742.63,43.1,225.94,19
CDM,93888_1,Ultrasound of within the brain blood flow,682.6,443.69,34.39,178.87,19
CDM,93892_1,Ultrasound of within the brain blood flow for blood clots,1036.8,673.92,55.56,272.54,19
CDM,93893_1,Ultrasound of blood flow within brain for atypical blood flow detection with microbubble injection,906.8,589.42,56.48,267.36,19
CDM,93922_1,Ultrasound study of arm and leg arteries,335.8,218.27,10.86,94.14,19
CDM,93923_1,Complete ultrasound study of arm and leg arteries,515.9,335.34,19.77,131.8,19
CDM,93924_1,Ultrasound of leg arteries at rest and after exercise,651.9,423.74,22.06,136.51,19
CDM,93925_1,Ultrasound of leg arteries or artery grafts,1028.6,668.59,34.64,188.28,19
CDM,93926_1,Ultrasound of one leg arteries or artery grafts,670.3,435.7,21.01,141.21,19
CDM,93930_1,Ultrasound of arm arteries or artery grafts,821.2,533.78,34.95,207.11,19
CDM,93931_1,Ultrasound of one arm arteries or artery grafts,545.3,354.45,21.31,145.92,19
CDM,93970_1,Ultrasound study of arm or leg veins with compression and maneuvers,836.5,543.73,30.25,169.46,19
CDM,93971_1,Ultrasound study of one arm or leg veins with compression and maneuvers,495.6,322.14,19.39,122.38,19
CDM,93975_1,Complete ultrasound of abdomen and pelvis artery and vein blood flow,1186.3,771.1,50.29,244.77,19
CDM,93976_1,Ultrasound of abdomen and pelvis artery and vein blood flow,673.4,437.71,35.32,174.16,19
CDM,93978_1,"Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts",780.8,507.52,34.53,207.11,19
CDM,93979_1,"Ultrasound of aorta, vena cava, groin vessels or bypass grafts",545.2,354.38,21.44,145.92,19
CDM,93980_1,Complete ultrasound of penis artery and vein blood flow,522.2,339.43,57.41,244.77,19
CDM,93981_1,Ultrasound of penis artery and vein blood flow,477.8,310.57,19.98,174.16,19
CDM,93985_1,Complete ultrasound of artery and vein blood flow pre-op assessment on both sides of body for hemodialysis access,617.5,401.38,34.04,160.04,19
CDM,93986_1,Complete ultrasound of artery and vein blood flow pre-op assessment on side of body for hemodialysis access,311.75,202.64,21.26,131.8,19
CDM,93990_1,Ultrasound of hemodialysis access,706.5,459.23,20.64,131.8,19
CDM,94002_1,Initial hospital inpatient or observation ventilation assistance and management,272.0,176.8,68.55,241.18,19
CDM,94003_1,Follow-up inpatient or observation ventilation assistance and management,196.4,127.66,50.27,169.99,19
CDM,94004_1,Nursing facility ventilation assistance and management,142.8,92.82,36.56,125.89,19
CDM,94010_1,Test to measure expiratory airflow and volume,112.5,73.13,7.96,78.57,19
CDM,9401IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.95,3.87,1.49,15.37,16
CDM,9402OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.5,7.48,2.88,29.7,16
CDM,94060_1,Test to measure expiratory airflow and volume changes before and after medication administration,197.2,128.18,9.92,94.14,19
CDM,9406IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.93,1.9,0.73,7.57,16
CDM,9406OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.94,10.36,3.99,41.17,16
CDM,94070_1,Test to measure lung airway sensitivity,340.2,221.13,27.48,164.75,19
CDM,9407IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.6,4.29,1.65,17.04,16
CDM,9407OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.67,12.79,4.92,50.8,16
CDM,9408IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.65,3.67,1.41,14.59,16
CDM,9408OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.53,13.99,5.38,55.6,16
CDM,9409IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.95,5.17,1.99,20.53,16
CDM,9409OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.6,7.54,2.9,29.96,16
CDM,9413IP _1,UNCLASSIFIED DRUGS,434.78,282.61,108.7,1122.82,16
CDM,9413OP _1,UNCLASSIFIED DRUGS,101.9,66.24,25.48,263.16,16
CDM,94150_1,Test to measure the total volume of air that can be exhaled after inhaling,78.9,51.29,8.9,81.27,15
CDM,94158IP _1,UNCLASSIFIED DRUGS,4.39,2.85,1.1,11.34,16
CDM,94158OP _1,UNCLASSIFIED DRUGS,22.15,14.4,5.54,57.2,16
CDM,94200_1,Test to measure largest amount of air breathed in an out,78.1,50.77,2.41,78.57,19
CDM,94209IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.91,31.14,11.98,123.73,16
CDM,94219IP _1,UNCLASSIFIED DRUGS,3.05,1.98,0.76,7.88,16
CDM,94220OP _1,UNCLASSIFIED DRUGS,55.58,36.13,13.9,143.54,16
CDM,9436IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.1,4.62,1.78,18.34,16
CDM,9436OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.83,13.54,5.21,53.79,16
CDM,94375_1,Test to measure rate of airflow,140.0,91.0,13.85,78.57,19
CDM,94450_1,Test to measure lung function response to low oxygen,148.5,96.53,21.6,141.21,19
CDM,94452_1,Test to measure lung function at high altitude,145.1,94.32,14.15,78.57,19
CDM,94453_1,Test to measure lung function at high altitude with evaluation of oxygen needs at rest and during exercise,201.6,131.04,18.21,78.6,19
CDM,94486OP _1,IMITREX 6 MG/0.5 ML CARTRIDGES,1075.9,699.34,268.98,753.13,11
CDM,94579IP _1,PROMACTA 25 MG TABLET,1815.47,1180.06,453.87,1270.83,11
CDM,94580IP _1,PROMACTA 50 MG TABLET,3284.49,2134.92,821.12,2299.14,11
CDM,94610_1,Administration of medication through breathing tube,210.0,136.5,45.72,147.5,19
CDM,94617_1,Test for exercise-induced spasm of lung airways,243.0,157.95,30.55,86.98,19
CDM,94618_1,Test for exercise-induced lung stress,88.0,57.2,21.81,78.57,19
CDM,94619_1,Exercise test for spasm of lung airways,55.4,36.01,20.78,78.57,19
CDM,9461IP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",85.19,55.37,5.02,220.0,17
CDM,9461OP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",12.98,8.44,3.25,33.52,17
CDM,94621_1,Test for exercise-induced heart and lung stress,488.5,317.53,65.04,188.28,19
CDM,94625_1,"Professional services for outpatient pulmonary rehabilitation, per session",42.0,27.3,15.12,140.94,19
CDM,94626_1,"Professional services for outpatient pulmonary rehabilitation with continuous monitoring of blood oxygen, per session",62.0,40.3,22.67,188.77,19
CDM,9462IP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",747.53,485.89,5.02,1930.5,17
CDM,9462OP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",111.0,72.15,5.02,286.66,17
CDM,9463IP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",128.37,83.44,5.02,331.52,17
CDM,9463OP _1,"INJECTION, CEFOXITIN SODIUM, 1 GM",30.19,19.62,5.02,77.97,17
CDM,94640_1,Inhalation treatment for airway obstruction or sputum production,40.0,26.0,7.83,78.57,19
CDM,94642_1,Inhalation treatment for pneumonia,230.4,149.76,32.62,115.2,15
CDM,94644_1,"Inhalation treatment for acute airway obstruction, first hour",97.7,63.51,27.42,148.23,19
CDM,94660_1,Therapy procedure using a positive pressure ventilator,169.1,109.92,24.08,155.08,19
CDM,94664_1,Evaluation of use of breathing device,41.0,26.65,18.13,78.57,19
CDM,94667_1,Initial therapy service to facilitate lung function,64.1,41.67,24.92,78.57,19
CDM,94668_1,Follow-up therapy service to facilitate lung function,64.1,41.67,18.28,99.0,19
CDM,94669_1,Therapy procedure to clear airway using an inflatable vest,112.4,73.06,23.37,78.57,19
CDM,94680_1,Test to measure exhaled air for evaluation of lung function during rest and exercise,191.1,124.22,11.87,261.24,19
CDM,94681_1,Test to measure exhaled air and carbon dioxide for evaluation of lung function,251.0,163.15,9.27,261.24,19
CDM,94690_1,Test to measure exhaled air for evaluation of lung function at rest,159.8,103.87,3.39,143.56,19
CDM,94726_1,Test to determine lung volumes using sensors,155.0,100.75,11.56,78.57,19
CDM,94727_1,Test to determine lung volumes using gas dilution or washout,114.2,74.23,11.56,78.57,19
CDM,94728_1,Test to measure resistance of the airways and lungs to differing frequencies,98.7,64.16,11.87,78.57,19
CDM,94729_1,Test to examine how well the lungs exchange gases,170.0,110.5,8.94,78.57,19
CDM,9474OP _1,"INJECTION, CEFTAZIDIME, PER 500 MG",507.5,329.88,1.56,1310.62,17
CDM,94760_1,Test to measure oxygen level in blood using ear or finger device,23.1,15.02,3.52,78.57,19
CDM,94761_1,Test to measure oxygen level in blood using ear or finger device multiple times,36.8,23.92,3.83,78.57,19
CDM,94762_1,Test to measure oxygen level in blood using ear or finger device continuously overnight,85.1,55.32,22.01,78.57,19
CDM,9476IP _1,"INJECTION, CEFTAZIDIME, PER 500 MG",37.16,24.15,1.56,95.97,17
CDM,9476OP _1,"INJECTION, CEFTAZIDIME, PER 500 MG",103.4,67.21,1.56,267.03,17
CDM,94772_1,Test to record infant breathing pattern over 12-24 hours,115.5,75.08,51.98,302.66,15
CDM,94780_1,"Test of car seat or bed (1 year or younger), 1 hour",126.9,82.49,19.49,130.71,19
CDM,94781_1,"Test of car seat or bed (1 year or younger), each additional 30 minutes",50.2,32.63,6.73,78.57,19
CDM,9478OP _1,"INJECTION, CEFTAZIDIME, PER 500 MG",525.0,341.25,1.56,1355.81,17
CDM,9487IP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",106.81,69.43,0.49,275.84,17
CDM,9487OP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",27.08,17.6,0.49,69.93,17
CDM,9488IP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",141.37,91.89,0.49,365.09,17
CDM,9488OP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",48.09,31.26,0.49,124.19,17
CDM,9490OP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",23.12,15.03,0.49,59.71,17
CDM,9492IP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",7.76,5.04,0.49,20.04,17
CDM,9492OP _1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",2.09,1.36,0.49,5.4,17
CDM,9495IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.48,17.86,6.87,70.97,16
CDM,9495OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.22,17.69,6.81,70.3,16
CDM,9496IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.25,4.06,1.56,16.14,16
CDM,9496OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",42.85,27.85,10.71,110.66,16
CDM,9499IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.55,3.61,1.39,14.33,16
CDM,9499OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.9,7.09,2.73,28.15,16
CDM,95004_1,Test for allergy using allergenic extract,16.8,10.92,3.19,78.57,19
CDM,9500IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.73,3.07,1.18,12.22,16
CDM,9500OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.07,12.4,4.77,49.25,16
CDM,95012_1,Test to measure the level of nitric oxide gas,46.2,30.03,13.71,78.57,19
CDM,95017_1,Test for allergy using combination of methods with venom,28.4,18.46,1.94,78.57,19
CDM,95018_1,Test for allergy using combination of methods with drug or biological,70.4,45.76,5.73,78.57,19
CDM,9501IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.11,0.72,0.28,2.87,16
CDM,95024_1,Test for allergy using allergenic extract injected into skin,18.9,12.29,0.77,78.57,19
CDM,95027_1,Test for allergy using airborne allergenic extract injected into skin,15.8,10.27,4.16,78.57,19
CDM,95028_1,Test for allergy using allergenic extract injected into skin with delayed reaction analysis,63.0,40.95,9.14,78.57,19
CDM,9502IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.65,3.67,1.41,14.59,16
CDM,9502OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.11,2.67,1.03,10.61,16
CDM,95044_1,Test for allergy using skin patch,18.9,12.29,4.44,78.57,19
CDM,9506IP _1,GS ALL DAY ALLERGY 10 MG TAB,3.3,2.15,0.83,2.31,11
CDM,9506OP _1,GS ALL DAY ALLERGY 10 MG TAB,5.33,3.46,1.33,3.73,11
CDM,95070_1,Test for allergy using drugs,200.6,130.39,36.14,103.56,19
CDM,95076_1,"Test for allergy using ingested items, initial 2 hours",389.6,253.24,60.42,300.42,19
CDM,95079_1,"Test for allergy using ingested items, each additional hour",277.2,180.18,55.66,211.02,19
CDM,95115_1,Professional service for single injection of allergen,55.0,35.75,9.37,78.57,19
CDM,95117_1,Professional service for multiple injections of allergen,55.0,35.75,11.22,78.57,19
CDM,95130_1,Professional service for injection of 1 stinging insect venom,50.0,32.5,21.35,78.57,15
CDM,95131_1,Professional service for injection of 2 stinging insect venoms,65.0,42.25,26.85,78.57,15
CDM,95132_1,Professional service for injection of 3 stinging insect venoms,80.0,52.0,32.35,78.57,15
CDM,95133_1,Professional service for injection of 4 stinging insect venoms,95.0,61.75,39.14,92.97,15
CDM,95134_1,Professional service for injection of 5 stinging insect venoms,110.0,71.5,45.7,111.6,15
CDM,95145S_1,Professional service for preparation and provision of 1 stinging insect venom,69.37,45.09,2.44,80.27,19
CDM,95145_1,Professional service for preparation and provision of 1 stinging insect venom,42.0,27.3,2.44,80.27,19
CDM,95146S_1,Professional service for preparation and provision of 2 stinging insect venom,127.08,82.6,2.44,147.65,19
CDM,95147S_1,Professional service for preparation and provision of 3 stinging insect venom,114.6,74.49,2.44,142.77,19
CDM,95148S_1,Professional service for preparation and provision of 4 stinging insect venom,183.97,119.58,2.44,210.97,19
CDM,95149S_1,Professional service for preparation and provision of 5 stinging insect venom,241.68,157.09,2.44,279.17,19
CDM,95165S_1,Professional service for preparation and provision of 1 or more antigens,40.0,26.0,2.23,78.57,19
CDM,95165WA_1,Professional service for preparation and provision of 1 or more antigens,40.0,26.0,10.0,208.0,19
CDM,95165WE_1,Professional service for preparation and provision of 1 or more antigens,40.0,26.0,10.0,208.0,19
CDM,95165_1,Professional service for preparation and provision of 1 or more antigens,40.0,26.0,2.44,78.57,19
CDM,9516IP _1,UNCLASSIFIED DRUGS,1.18,0.77,0.3,3.05,16
CDM,9516OP _1,UNCLASSIFIED DRUGS,2.0,1.3,0.5,5.17,16
CDM,95180_1,Injection for rapid desensitization to allergen,409.5,266.18,78.57,341.38,19
CDM,95250_1,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment,370.7,240.96,78.57,369.84,19
CDM,95251_1,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report,123.9,80.54,29.25,92.1,19
CDM,9525IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.56,4.91,1.89,19.52,16
CDM,9526IP _1,"INJECTION, CHLOROTHIAZIDE SODIUM, PER 500 MG",2017.86,1311.61,61.62,5211.12,17
CDM,95691IP _1,RUFINAMIDE 200 MG TABLET,23.66,15.38,5.92,16.56,11
CDM,95693IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.73,4.37,1.68,17.38,16
CDM,95717_1,"Measurement of brain wave activity (EEG), 2-12 hours with health care professional review and report",250.75,162.99,78.57,279.25,19
CDM,95718_1,"Measurement of brain wave activity with video (VEEG), 2-12 hours with review and report by health care professional",327.75,213.04,78.57,350.22,19
CDM,95719_1,"Measurement of brain wave activity (EEG), 12-26 hours with health care professional review and report",386.0,250.9,78.57,419.74,19
CDM,95720_1,"Measurement of brain wave activity with video (VEEG), 12-26 hours with review and report by health care professional",507.0,329.55,78.57,539.55,19
CDM,95721_1,"Measurement of brain wave activity (EEG), 37-60 hours with health care professional review and report",511.25,332.31,78.57,538.42,19
CDM,95722_1,"Measurement of brain wave activity with video (VEEG), 37-60 hours with review and report by health care professional",620.0,403.0,78.57,653.75,19
CDM,95723_1,"Measurement of brain wave activity (EEG), 61-84 hours with health care professional review and report",632.25,410.96,78.57,660.19,19
CDM,95724_1,"Measurement of brain wave activity with video (VEEG), 61-84 hours with review and report by health care professional",792.0,514.8,78.57,829.96,19
CDM,95725_1,"Measurement of brain wave activity (EEG), more than 84 hours with review and report by health care professional",721.75,469.14,78.57,755.93,19
CDM,95726_1,"Measurement of brain wave activity with video (VEEG), more than 84 hours with review and report by health care professional",1000.75,650.49,78.57,1054.71,19
CDM,95782_1,Sleep study in sleep lab (younger than 6 years),3364.2,2186.73,78.57,753.14,19
CDM,95783_1,Sleep study in sleep lab with continuous airway pressure (younger than 6 years),3590.0,2333.5,78.57,753.14,19
CDM,95794OP _1,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",1005.0,653.25,7.16,2595.41,19
CDM,95800_1,"Sleep study including heart rate, breathing, and sleep time",366.5,238.23,37.17,377.5,19
CDM,95801_1,Sleep study including heart rate and breathing,127.1,82.62,39.33,130.91,19
CDM,95803_1,"Sleep study and wake patterns, 3-14 days with report",365.4,237.51,41.0,376.36,19
CDM,95805_1,"Sleep study, multiple trials",1711.5,1112.48,55.43,153.69,19
CDM,95806_1,"Sleep study including heart rate, breathing, airflow, and effort",351.0,228.15,42.92,329.5,19
CDM,95807_1,Sleep study including heart rate and breathing attended by technician,1441.6,937.04,57.0,389.74,19
CDM,95808_1,Sleep study in sleep lab,1933.3,1256.65,78.32,657.57,19
CDM,95810_1,Sleep study in sleep lab (6 years or older),2214.6,1439.49,78.57,484.83,19
CDM,95811_1,Sleep study in sleep lab with continuous airway pressure (6 years or older),2375.3,1543.95,78.57,470.71,19
CDM,95812_1,"Measurement of brain wave activity (EEG), 41-60 minutes",1167.0,758.55,55.82,164.75,19
CDM,95813_1,"Measurement of brain wave activity (EEG), 61-119 minutes",1330.8,865.02,78.57,226.01,19
CDM,95816_1,"Measurement of brain wave activity (EEG), awake and drowsy",1066.4,693.16,53.89,149.46,19
CDM,95819_1,"Measurement of brain wave activity (EEG), awake and asleep",1219.0,792.35,54.2,149.47,19
CDM,95822_1,"Measurement of brain wave activity (EEG), in coma or asleep",1107.1,719.62,54.2,150.31,19
CDM,95824_1,Measurement of brain wave activity (EEG) to evaluate brain death,143.9,93.54,36.76,117.68,19
CDM,95829_1,Measurement of brain wave activity (EEG) during surgery,4523.9,2940.54,78.57,863.59,19
CDM,95836_1,Measurement of brain wave activity (EEG) with implanted brain neurostimulator generator with report,256.0,166.4,78.57,278.23,19
CDM,95849OP _1,"INJECTION, PLERIXAFOR, 1 MG",361.65,235.07,32.5,7236.29,19
CDM,95851_1,"Measurement of range of motion in arm, leg or each spine section",35.0,22.75,6.4,78.57,19
CDM,95857_1,Injection to test for myasthenia gravis,122.9,79.89,22.07,152.82,19
CDM,95860_1,"Needle measurement of electrical activity in arm or leg muscles, 1 extremity",270.2,175.63,49.17,133.9,19
CDM,95861_1,"Needle measurement of electrical activity in arm or leg muscles, 2 extremities",387.8,252.07,77.5,213.48,19
CDM,95863_1,"Needle measurement of electrical activity in arm or leg muscles, 3 extremities",470.6,305.89,78.57,260.97,19
CDM,95864_1,"Needle measurement of electrical activity in arm or leg muscles, 4 extremities",511.1,332.22,78.57,276.87,19
CDM,95865_1,Needle measurement of electrical activity in voice box muscles,247.8,161.07,78.57,217.48,19
CDM,95866_1,Needle measurement of electrical activity in half of diaphragm muscles,192.2,124.93,63.76,175.01,19
CDM,95867_1,Needle measurement of electrical activity in muscles on side of body,266.6,173.29,39.35,110.06,19
CDM,95868_1,Needle measurement of electrical activity in muscles on both sides of body,352.1,228.87,59.08,164.24,19
CDM,95869_1,Needle measurement of electrical activity in middle spine muscles,209.0,135.85,18.75,78.57,19
CDM,95870_1,"Needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study",198.8,129.22,18.75,78.57,19
CDM,95872_1,"Needle measurement of electrical activity in muscle, including jitter, blocking and/or fiber density",500.9,325.59,78.57,397.14,19
CDM,95873_1,Electrical stimulation for guidance with injection of chemical for paralysis of nerve muscle,155.2,100.88,19.24,78.57,19
CDM,95874_1,Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle,190.9,124.09,18.93,78.57,19
CDM,95875_1,Needle measurement of electrical activity of muscles with low blood flow with specimen,318.7,207.16,57.21,154.81,19
CDM,95885_1,"Needle measurement of electrical activity in arm or leg muscles, limited study",156.9,101.99,17.65,78.57,19
CDM,95886_1,"Needle measurement of electrical activity in arm or leg muscles, complete study",300.0,195.0,43.54,120.01,19
CDM,95887_1,Needle measurement of electrical activity in trunk or head muscles,262.5,170.63,35.45,97.93,19
CDM,9588IP _1,CHOLESTYRAMINE PACKET,13.43,8.73,3.36,9.4,11
CDM,9588OP _1,CHOLESTYRAMINE PACKET,62.56,40.66,15.64,43.79,11
CDM,95905_1,Nerve conduction study of arm or leg movement and/or feeling with review and report,214.0,139.1,2.41,79.55,19
CDM,95907_1,"Nerve conduction, 1-2 studies",310.8,202.02,51.12,139.35,19
CDM,95908_1,"Nerve conduction, 3-4 studies",284.0,184.6,64.19,175.29,19
CDM,95909_1,"Nerve conduction, 5-6 studies",459.9,298.94,76.65,209.16,19
CDM,95910_1,"Nerve conduction, 7-8 studies",605.9,393.84,78.57,278.66,19
CDM,95911_1,"Nerve conduction, 9-10 studies",734.0,477.1,78.57,347.97,19
CDM,95912_1,"Nerve conduction, 11-12 studies",860.0,559.0,78.57,414.85,19
CDM,95913_1,"Nerve conduction, 13 or more studies",1000.0,650.0,78.57,492.34,19
CDM,95919_1,Measurement of pupil with healthcare professional interpretation and report,23.0,14.95,9.53,78.57,19
CDM,95921_1,Testing of autonomic nervous system function and heart rate response to deep breathing,239.2,155.48,42.41,117.72,19
CDM,95922_1,"Testing of autonomic (sympathetic) nervous system function, heart rate response to breathing exercises, and passive tilt",307.5,199.88,43.98,124.64,19
CDM,95923_1,Testing of autonomic (sympathetic) nervous system function,480.9,312.59,41.92,118.87,19
CDM,95924_1,"Testing of autonomic (sympathetic and parasympathetic) nervous system function, at least 5 minutes of tilt",487.2,316.68,78.57,501.82,19
CDM,95925_1,Placement of skin electrodes and measurement of stimulated sites in arms,528.2,343.33,26.1,160.04,19
CDM,95926_1,Placement of skin electrodes and measurement of stimulated sites in legs,510.3,331.7,25.05,160.04,19
CDM,95927_1,Placement of skin electrodes and measurement of stimulated sites in trunk or head,452.6,294.19,25.97,160.04,19
CDM,95928_1,Placement of skin electrodes and measurement of central motor stimulation in arms,592.2,384.93,75.55,207.73,19
CDM,95929_1,Placement of skin electrodes and measurement of central motor stimulation in legs,605.9,393.84,74.93,207.34,19
CDM,95930_1,Measurement of nerve conduction using visual stimulation testing with report,485.1,315.32,17.34,78.57,19
CDM,95933_1,Measurement of nerve conduction patterns of eye blink reflex,240.5,156.33,30.23,82.32,19
CDM,95937_1,Testing of nerve-muscle junction,198.5,129.03,32.52,90.56,19
CDM,95938_1,Placement of skin electrodes and measurement of stimulated sites on arms and legs,835.8,543.27,43.05,221.23,19
CDM,95939_1,Placement of skin electrodes and measurement of central motor stimulation in arms and legs,1152.9,749.39,78.57,353.03,19
CDM,95940_1,"Continuous monitoring of nervous system during operation, each 15 minutes",107.1,69.62,25.66,110.31,19
CDM,95954_1,Measurement of brain wave activity (EEG) with drug or activity stimulation,953.4,619.71,78.57,301.43,19
CDM,95955_1,Measurement of brain wave activity (EEG) outside the brain during surgery,474.6,308.49,50.81,141.21,19
CDM,95957_1,"Measurement of brain wave activity (EEG), digital analysis",1191.8,774.67,78.57,268.74,19
CDM,95958_1,Measurement of brain wave activity (EEG) in specific area of brain,1445.9,939.84,78.57,590.9,19
CDM,95961_1,"Measurement of brain wave activity (EEG) with electrodes on brain to provoke seizures or identify brain structures, first hour",756.0,491.4,78.57,415.75,19
CDM,95962_1,"Measurement of brain wave activity (EEG) with electrodes on brain to provoke seizures or identify brain structures, each additional hour",635.3,412.95,78.57,449.87,19
CDM,95965_1,Measurement of brain magnetic field for spontaneous brain magnetic activity,4365.0,2837.25,78.57,3572.69,19
CDM,95966_1,"Measurement of brain externally evoked magnetic field, single localization",2200.0,1430.0,78.57,1049.68,19
CDM,95967_1,"Measurement of brain externally evoked magnetic field, each additional localization",1090.0,708.5,78.57,715.48,19
CDM,95970_1,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator",144.9,94.19,9.77,78.57,19
CDM,95971_1,Electronic analysis of implanted neurostimulator generator with simple spinal cord or peripheral nerve stimulator programming,162.8,105.82,32.49,117.32,19
CDM,95972_1,Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming,315.0,204.75,33.15,136.84,19
CDM,95976_1,Electronic analysis of neurostimulator generator with simple cranial nerve stimulator programming,96.0,62.4,30.02,101.48,19
CDM,95977_1,Electronic analysis of implanted neurostimulator generator with complex cranial nerve stimulator programming,128.0,83.2,40.14,135.51,19
CDM,95980_1,Electronic analysis of implanted gastric neurostimulator generator during surgery with programming,108.3,70.4,36.78,112.11,19
CDM,95981_1,Electronic analysis of implanted gastric neurostimulator generator,74.65,48.52,11.62,92.23,19
CDM,95983_1,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, first 15 minutes with qualified health professional",120.0,78.0,39.73,127.71,19
CDM,95984_1,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, each additional 15 minutes with qualified health professional",106.0,68.9,35.0,112.74,19
CDM,95990_1,Maintenance of spinal canal or brain drug infusion pump,164.9,107.19,36.56,226.24,19
CDM,95991T_1,Maintenance of spinal canal or brain drug infusion pump by health care professional,224.7,146.06,10.07,268.15,19
CDM,95991_1,Maintenance of spinal canal or brain drug infusion pump by health care professional,255.2,165.88,25.13,268.15,19
CDM,95992_1,"Repositioning exercises of head for treatment of dizziness, each day",125.0,81.25,24.84,108.24,19
CDM,96000_1,"Test to evaluate gait using 3D, video, and computer technology",264.6,171.99,68.67,244.21,19
CDM,96001_1,"Test to evaluate gait using 3D, video, and computer technology with measurement of foot pressure distribution",315.0,204.75,78.57,311.71,19
CDM,96002_1,Test of electrical activity of 1-12 muscles during functional activities,89.3,58.05,17.13,78.57,19
CDM,96004_1,Physician review of gait analysis test,333.9,217.04,78.57,292.72,19
CDM,96020_1,Test of neurological function during functional MRI,526.1,341.97,78.57,541.88,19
CDM,9603IP _1,"INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG",266.38,173.15,7.53,687.93,17
CDM,9610IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.17,13.11,5.04,52.09,16
CDM,9610OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.33,8.01,3.08,31.84,16
CDM,96110_1,Developmental screening,115.5,75.08,16.45,78.57,15
CDM,96112_1,"Administration of developmental test, first hour",309.0,200.85,68.55,328.18,19
CDM,96113_1,"Administration of developmental test, each additional 30 minutes",141.0,91.65,34.27,149.57,19
CDM,96116_1,"Exam of neurobehavioral status, first hour",210.0,136.5,70.28,234.05,19
CDM,96121_1,"Exam of neurobehavioral status, each additional hour",191.0,124.15,60.94,202.47,19
CDM,96125_1,Test to assess the ability to complete specific functional tasks applicable to environment,277.45,180.34,78.57,285.77,19
CDM,96127_1,Assessment of emotional or behavioral problems,12.6,8.19,4.44,78.57,19
CDM,9612IP _1,"INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG",4.51,2.93,1.13,13.53,17
CDM,9612OP _1,"INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG",2.06,1.34,0.52,6.18,17
CDM,96130_1,"Evaluation of psychological test, first hour",270.0,175.5,78.57,302.28,19
CDM,96131_1,"Evaluation of psychological test, each additional hour",206.0,133.9,68.55,220.7,19
CDM,96132_1,"Evaluation of neuropsychological test, first hour",265.0,172.25,78.57,325.82,19
CDM,96133_1,"Evaluation of neuropsychological test, each additional hour",203.0,131.95,68.55,249.94,19
CDM,96136_1,"Administration of psychological or neuropsychological test, first 30 minutes",60.0,39.0,20.78,105.41,19
CDM,96137_1,"Administration of psychological or neuropsychological test, each additional 30 minutes",48.0,31.2,16.29,97.17,19
CDM,96138_1,"Administration of psychological or neuropsychological test by technician, first 30 minutes",88.0,57.2,34.65,93.4,19
CDM,96139_1,"Administration of psychological or neuropsychological test by technician, each additional 30 minutes",88.0,57.2,31.99,93.4,19
CDM,96146_1,Administration of psychological or neuropsychological test by single standardized instrument via electronic platform with automated result,5.0,3.25,1.98,78.57,19
CDM,96156_1,Assessment of health behavior,239.5,155.68,78.57,246.69,19
CDM,96158_1,"Treatment of behavior impacting health, initial 30 minutes",164.25,106.76,59.27,169.18,19
CDM,96159_1,"Treatment of behavior impacting health, each additional 15 minutes",57.25,37.21,20.27,78.57,19
CDM,9615IP _1,CLADRIBINE 10 MG/10 ML VIAL,66.8,43.42,16.7,46.76,11
CDM,9615OP _1,CLADRIBINE 10 MG/10 ML VIAL,42.03,27.32,10.51,29.42,11
CDM,96160_1,Administration and interpretation of patient-focused health risk assessment,10.6,6.89,2.77,78.57,15
CDM,96161_1,Administration and interpretation of caregiver-focused health risk assessment,10.6,6.89,3.08,78.57,19
CDM,96164_1,"Treatment of behavior impacting health in group setting, initial 30 minutes",24.25,15.76,9.07,78.57,19
CDM,96165_1,"Treatment of behavior impacting health in group setting, each additional 15 minutes",11.5,7.48,3.98,78.57,19
CDM,96167_1,"Treatment of behavior impacting health with family and patient, initial 30 minutes",176.0,114.4,62.64,187.87,19
CDM,96168_1,"Treatment of behavior impacting health with family and patient, each additional 30 minutes",62.5,40.63,22.4,78.57,19
CDM,96170_1,"Treatment of behavior impacting health with family, initial 30 minutes",230.0,149.5,78.57,236.9,15
CDM,96171_1,"Treatment of behavior impacting health with family, each additional 30 minutes",85.0,55.25,38.25,87.55,15
CDM,9617IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.5,4.88,1.88,19.37,16
CDM,96202_1,"Multiple-family group behavior management/modification training, face-to-face, initial 60 minutes",49.5,32.18,16.95,78.57,19
CDM,9621IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.05,5.88,2.26,23.37,16
CDM,9621OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.12,22.83,8.78,90.7,16
CDM,9624IP _1,UNCLASSIFIED DRUGS,12.32,8.01,3.08,31.82,16
CDM,9626IP _1,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",3.24,2.11,0.81,8.37,17
CDM,9627IP _1,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",4.13,2.68,1.03,10.67,17
CDM,9627OP _1,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",1.68,1.09,0.42,4.34,17
CDM,9630IP _1,UNCLASSIFIED DRUGS,4.34,2.82,1.09,11.21,16
CDM,9630OP _1,UNCLASSIFIED DRUGS,1.66,1.08,0.42,4.29,16
CDM,9631IP _1,UNCLASSIFIED DRUGS,7.63,4.96,1.91,19.7,16
CDM,9631OP _1,UNCLASSIFIED DRUGS,9.96,6.47,2.49,25.72,16
CDM,9635IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.63,2.36,0.91,9.37,16
CDM,9635OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.79,7.01,2.7,27.87,16
CDM,96360_1,"Infusion into a vein for hydration, 31-60 minutes",160.0,104.0,31.08,93.44,19
CDM,96361_1,"Infusion into a vein for hydration, each additional hour",40.0,26.0,11.42,78.57,19
CDM,96365_1,"Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less",190.1,123.57,48.44,175.29,19
CDM,96366_1,"Infusion into a vein for therapy, prevention, or diagnosis, each additional hour",60.9,39.59,15.53,78.57,19
CDM,96367_1,"Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less",95.6,62.14,25.13,78.57,19
CDM,96368_1,"Infusion into a vein for therapy, prevention, or diagnosis concurrent with another infusion",56.7,36.86,13.71,78.57,19
CDM,96369_1,"Infusion into tissue for therapy or prevention, 1 hour or less",415.8,270.27,78.57,408.73,19
CDM,9636IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.75,4.39,1.69,17.43,16
CDM,9636OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.53,2.94,1.13,11.7,16
CDM,96370_1,"Infusion into tissue for therapy or prevention, each additional hour",44.1,28.67,16.0,78.57,19
CDM,96371_1,Establishment of new infusion site into tissue with pump set up,209.0,135.85,52.1,160.06,19
CDM,96372_1,Injection of drug or substance under skin or into muscle,60.0,39.0,14.44,78.57,19
CDM,96373_1,Injection of drug or substance into artery,47.3,30.75,12.79,78.57,19
CDM,96374_1,Injection of drug or substance into vein,150.0,97.5,34.94,96.11,19
CDM,96375_1,Injection of additional new drug or substance into vein,60.0,39.0,14.56,78.57,19
CDM,96376_1,Injection of additional drug or substance into vein provided in a facility,40.0,26.0,9.06,78.57,15
CDM,96377_1,Application of on-body injector for under skin injection,47.0,30.55,12.92,78.57,19
CDM,9637IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.5,10.73,4.13,42.61,16
CDM,9637OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",49.33,32.06,12.33,127.39,16
CDM,96380_1,"Administration of seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional",80.0,52.0,14.62,78.57,19
CDM,96381_1,"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection",80.0,52.0,12.79,78.57,19
CDM,9638IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.26,11.22,4.32,44.57,16
CDM,9638OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.2,14.43,5.55,57.33,16
CDM,96401_1,Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle,173.3,112.65,38.84,193.86,19
CDM,96402_1,Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle,106.1,68.97,27.42,106.1,19
CDM,96405_1,"Administration of chemotherapy into growth, 1-7",202.7,131.76,13.01,202.7,19
CDM,96406_1,"Administration of chemotherapy into growth, more than 7",279.65,181.77,20.72,313.16,19
CDM,96409_1,Administration of chemotherapy into vein using push technique,278.3,180.9,78.57,278.3,19
CDM,96411_1,Administration of additional new drug or substance into vein using push technique,156.5,101.73,41.13,156.5,19
CDM,96413_1,"Administration of chemotherapy into vein, 1 hour or less",409.5,266.18,78.57,409.5,19
CDM,96415_1,"Administration of chemotherapy into vein, each additional hour",90.3,58.7,26.33,90.3,19
CDM,96416_1,Administration of prolonged chemotherapy into vein,330.0,214.5,78.57,344.1,19
CDM,96417_1,"Administration of additional new drug or substance into vein, 1 hour or less",165.0,107.25,61.34,166.6,19
CDM,96420_1,Administration of chemotherapy into artery using push technique,297.2,193.18,33.36,297.2,19
CDM,96422_1,"Administration of chemotherapy into artery, 1 hour or less",430.5,279.83,68.55,430.5,19
CDM,96423_1,"Administration of chemotherapy into artery, each additional hour",245.7,159.71,34.27,245.7,19
CDM,96425_1,Administration of prolonged chemotherapy into artery,563.9,366.54,78.57,563.9,19
CDM,96440_1,Administration of chemotherapy into chest cavity,1742.0,1132.3,78.57,1793.43,19
CDM,96446_1,Administration of chemotherapy into abdominal cavity,436.8,283.92,16.34,443.96,19
CDM,9644IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.69,13.45,5.17,53.43,16
CDM,96450_1,Administration of chemotherapy into fluid-filled space between the tissue that cover the brain and spinal cord,650.0,422.5,19.61,650.0,19
CDM,9647IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.12,5.28,2.03,20.97,16
CDM,9647OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.73,6.97,2.68,27.71,16
CDM,9648IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.69,2.4,0.92,9.53,16
CDM,9648OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.38,8.05,3.1,31.97,16
CDM,96521_1,Refilling and maintenance of portable pump,348.8,226.72,78.57,356.6,19
CDM,96522_1,Refilling and maintenance of implantable pump or reservoir for drug delivery,274.1,178.17,77.69,291.68,19
CDM,96523_1,Irrigation of implanted venous access drug delivery device,70.4,45.76,20.56,78.57,19
CDM,96542_1,Injection of chemotherapy via reservoir under skin,525.0,341.25,31.19,525.0,19
CDM,96547_1,"Intraoperative heated intraperitoneal chemotherapy, first 60 minutes",1200.0,780.0,78.57,1726.16,19
CDM,96548_1,"Intraoperative heated intraperitoneal chemotherapy, each additional 30 minutes",800.0,520.0,78.57,863.08,19
CDM,96567_1,Application of light to destroy precancer skin growth,364.4,236.86,68.09,341.22,19
CDM,96570_1,"Application of light to destroy precancer skin growth using an endoscope, initial 30 minutes",132.1,85.87,43.92,138.39,19
CDM,96573_1,Application of light by qualified health care professional to destroy precancer skin growth,470.0,305.5,78.57,570.76,19
CDM,9682IP _1,UNCLASSIFIED DRUGS,62.46,40.6,15.62,161.3,16
CDM,9682OP _1,UNCLASSIFIED DRUGS,4.82,3.13,1.21,12.45,16
CDM,9686IP _1,"INJECTION, COSYNTROPIN, 0.25 MG",126.14,81.99,21.89,378.42,17
CDM,9686OP _1,"INJECTION, COSYNTROPIN, 0.25 MG",253.31,164.65,21.89,759.93,17
CDM,96900_1,Application of ultraviolet light to skin,52.5,34.13,13.71,78.57,19
CDM,96902_1,Exam of hair using microscope to detect shaft abnormality,112.5,73.13,50.63,115.88,15
CDM,96904_1,Photograph of entire body,255.0,165.75,60.86,262.65,19
CDM,96910_1,Therapy procedure using ultraviolet radiation with tar or petroleum jelly application,173.3,112.65,13.71,301.93,19
CDM,96912_1,Therapy procedure using ultraviolet radiation,222.6,144.69,19.65,256.17,19
CDM,96930IP _1,UNCLASSIFIED DRUGS,1.57,1.02,0.39,4.05,16
CDM,96930OP _1,UNCLASSIFIED DRUGS,1.33,0.86,0.33,3.43,16
CDM,96948IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.1,24.12,9.28,95.81,16
CDM,96968IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",40.01,26.01,10.0,103.33,16
CDM,96968OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",40.2,26.13,10.05,103.82,16
CDM,96969IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",139.18,90.47,34.8,359.43,16
CDM,96969OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.53,5.54,2.13,22.03,16
CDM,96970IP _1,VIMPAT 150 MG TABLET,138.35,89.93,34.59,96.85,11
CDM,96972IP _1,UNCLASSIFIED DRUGS,14.86,9.66,3.72,38.38,16
CDM,96972OP _1,UNCLASSIFIED DRUGS,5.17,3.36,1.29,13.35,16
CDM,96981IP _1,"INJECTION, METHOTREXATE SODIUM, 50 MG",383.65,249.37,2.73,1150.95,17
CDM,96981OP _1,"INJECTION, METHOTREXATE SODIUM, 50 MG",42.13,27.38,2.73,126.39,17
CDM,96986OP _1,"INJECTION, DEGARELIX, 1 MG",3312.5,2153.13,4.72,9937.5,19
CDM,96987IP _1,"INJECTION, DEGARELIX, 1 MG",4803.5,3122.28,4.72,14410.5,19
CDM,96987OP _1,"INJECTION, DEGARELIX, 1 MG",5201.33,3380.86,4.72,15603.99,19
CDM,96999A_1,Other special service or procedure on skin,162.5,105.63,73.13,167.38,15
CDM,96999B_1,Other special service or procedure on skin,237.5,154.38,73.6,244.63,15
CDM,96999C_1,Other special service or procedure on skin,300.0,195.0,73.6,309.0,15
CDM,96999D_1,Other special service or procedure on skin,375.0,243.75,73.6,386.25,15
CDM,96999E_1,Other special service or procedure on skin,400.0,260.0,73.6,412.0,15
CDM,96999F_1,Other special service or procedure on skin,100.0,65.0,45.0,103.0,15
CDM,96999G_1,Other special service or procedure on skin,100.0,65.0,45.0,103.0,15
CDM,96999H_1,Other special service or procedure on skin,75.0,48.75,33.75,80.89,15
CDM,96999I_1,Other special service or procedure on skin,125.0,81.25,56.25,128.75,15
CDM,96_1,KINRIX TIP-LOK SYRINGE,42.09,27.36,10.52,29.46,11
CDM,97010_1,Application of hot or cold packs,25.0,16.25,4.96,78.57,15
CDM,97012_1,Application of mechanical traction,44.1,28.67,11.75,78.57,19
CDM,97014_1,Application of electrical stimulation,52.5,34.13,10.0,78.57,15
CDM,97016_1,Application of blood vessel compression device,40.0,26.0,9.47,78.57,19
CDM,97018_1,Application of hot wax bath,30.0,19.5,4.44,78.57,19
CDM,9701IP _1,UNCLASSIFIED DRUGS,88.32,57.41,22.08,228.09,16
CDM,9701OP _1,UNCLASSIFIED DRUGS,29.69,19.3,7.42,76.67,16
CDM,97022_1,Application of whirlpool therapy,55.5,36.08,13.65,78.57,19
CDM,97028_1,Application of ultraviolet light,18.9,12.29,6.59,78.57,19
CDM,97032_1,"Application of electrical stimulation with therapist present, each 15 minutes",49.4,32.11,11.75,78.57,19
CDM,97033_1,"Application of medication using electrical current, each 15 minutes",54.0,35.1,15.98,78.57,19
CDM,97035_1,"Application of ultrasound, each 15 minutes",42.0,27.3,11.65,78.57,19
CDM,97036_1,"Application of water therapy using a special tank, each 15 minutes",80.9,52.59,25.13,93.12,19
CDM,9705IP _1,"INJECTION, CYCLOSPORINE, 250 MG",138.29,89.89,34.57,357.13,17
CDM,97089IP _1,SAVELLA 50 MG TABLET,56.8,36.92,14.2,39.76,11
CDM,97110_1,"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",67.0,43.55,22.85,79.79,19
CDM,97112_1,"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes",109.2,70.98,22.85,88.81,19
CDM,97113_1,"Therapy procedure using water pool to exercises, each 15 minutes",105.0,68.25,20.56,100.75,19
CDM,97116_1,"Therapy procedure for walking training, each 15 minutes",138.6,90.09,18.28,79.79,19
CDM,97124_1,"Therapy procedure using massage, each 15 minutes",39.0,25.35,24.36,81.6,19
CDM,97129_1,"Therapy procedure for a range of mental processes, initial 15 minutes",59.0,38.35,18.68,78.57,19
CDM,97130_1,"Therapy procedure for a range of mental processes, each additional 15 minutes",56.25,36.56,17.85,78.57,19
CDM,97133IP _1,FEBUXOSTAT 40 MG TABLET,26.29,17.09,6.57,18.4,11
CDM,97134IP _1,FEBUXOSTAT 80 MG TABLET,5.9,3.84,1.48,4.13,11
CDM,97140_1,"Therapy procedure using manual technique, each 15 minutes",78.8,51.22,22.19,78.57,19
CDM,9714IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.92,11.0,4.23,43.7,16
CDM,97161_1,"Evaluation for physical therapy, typically 20 minutes",190.65,123.92,73.12,271.36,19
CDM,97162_1,"Evaluation for physical therapy, typically 30 minutes",215.65,140.17,73.12,271.36,19
CDM,97163_1,"Evaluation for physical therapy, typically 45 minutes",240.65,156.42,73.12,271.36,19
CDM,97164_1,"Re-evaluation for physical therapy, typically 20 minutes",129.0,83.85,45.57,186.8,19
CDM,97165_1,"Evaluation for occupational therapy, typically 30 minutes",185.0,120.25,73.12,278.26,19
CDM,97166_1,"Evaluation for occupational therapy, typically 45 minutes",210.0,136.5,73.12,278.26,19
CDM,97167_1,"Evaluation for occupational therapy, typically 1 hour",235.0,152.75,73.12,278.26,19
CDM,97168_1,"Re-evaluation for occupational therapy, typically 30 minutes",122.25,79.46,49.35,191.43,19
CDM,9717IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.93,5.15,1.98,20.48,16
CDM,9717OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.6,8.84,3.4,35.12,16
CDM,9718IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.22,8.59,3.31,34.14,16
CDM,9718OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.85,9.0,3.46,35.77,16
CDM,9719IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.5,4.88,1.88,19.37,16
CDM,9719OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.34,10.62,4.09,42.2,16
CDM,97260IP _1,"INJECTION, TEMOZOLOMIDE, 1 MG",12806.24,8324.06,11.02,33072.11,19
CDM,97342IP _1,"INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",131.9,85.74,32.98,340.63,17
CDM,97342OP _1,"INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",74.26,48.27,18.57,200.87,17
CDM,97350IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.05,2.63,1.01,10.46,16
CDM,97350OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.91,13.59,5.23,54.0,16
CDM,97371IP _1,VANCOMYCIN HCL 750 MG VIAL,150.24,97.66,37.56,105.17,11
CDM,97371OP _1,VANCOMYCIN HCL 750 MG VIAL,92.83,60.34,23.21,64.98,11
CDM,97382IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",87.18,56.67,21.8,225.14,16
CDM,97382OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.02,3.91,1.51,15.55,16
CDM,97389IP _1,EVEROLIMUS 5 MG TABLET,239.0,155.35,59.75,167.3,11
CDM,97389OP _1,EVEROLIMUS 5 MG TABLET,237.25,154.21,59.31,166.08,11
CDM,97390OP _1,EVEROLIMUS 10 MG TABLET,94.15,61.2,23.54,65.91,11
CDM,9748IP _1,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",694.42,451.37,3.61,1793.34,19
CDM,9748OP _1,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",414.76,269.59,3.61,1071.12,19
CDM,97530_1,Therapy procedure using functional activities,90.3,58.7,22.85,95.25,19
CDM,97533_1,Therapy procedure using sensory experiences,78.8,51.22,50.98,164.65,19
CDM,97535_1,"Training for self-care or home management, each 15 minutes",90.3,58.7,26.72,93.01,19
CDM,97537_1,"Training for community or work reintegration, each 15 minutes",81.9,53.24,26.0,87.8,19
CDM,97542_1,"Evaluation for wheelchair, each 15 minutes",75.6,49.14,26.0,85.2,19
CDM,97597_1,"Removal of tissue from wound, 20.0 sq cm or less",150.0,97.5,29.69,93.79,19
CDM,97598_1,"Removal of tissue from wound, each additional 20.0 sq cm",140.0,91.0,20.21,78.57,19
CDM,97602_1,Removal of tissue from wound gradually,75.0,48.75,33.75,131.08,15
CDM,97605_1,"Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less",315.0,204.75,16.77,78.57,19
CDM,97606_1,"Therapy procedure using a special bandage and vacuum pump, surface area more than 50.0 sq cm",240.0,156.0,18.85,78.57,19
CDM,97607_1,"Therapy procedure using a special bandage, vacuum pump and disposable medical equipment, surface area 50.0 sq cm or less",200.0,130.0,17.2,287.95,19
CDM,97608_1,"Therapy procedure using a special bandage, vacuum pump and disposable medical equipment, surface area more than 50.0 sq cm",365.35,237.48,19.74,376.31,19
CDM,97610_1,Therapy procedure using ultrasound,279.25,181.51,15.0,351.11,19
CDM,9774IP _1,UNCLASSIFIED DRUGS,2.79,1.81,0.7,7.21,16
CDM,9774OP _1,UNCLASSIFIED DRUGS,11.71,7.61,2.93,30.24,16
CDM,97750_1,"Test or measurement for functional capacity, each 15 minutes",88.2,57.33,27.51,91.87,19
CDM,97760_1,"Training in the use of orthopedic device for arm, leg and/or trunk, each 15 minutes",95.6,62.14,33.81,125.93,19
CDM,97761_1,"Training in the use of artificial arm and/or leg, each 15 minutes",87.2,56.68,21.93,111.26,19
CDM,97802_1,"Therapy procedure for nutrition management, each 15 minutes",87.2,56.68,25.54,92.02,19
CDM,97803IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.65,3.67,1.41,14.59,16
CDM,97803OP _1,"INJECTION, FUROSEMIDE, 1 MG",13.69,8.9,0.02,35.35,17
CDM,97803_1,"Therapy procedure reassessment for nutrition management, each 15 minutes",76.7,49.86,21.32,80.03,19
CDM,97804_1,"Therapy procedure for nutrition management with group, each 30 minutes",38.9,25.29,11.87,78.57,19
CDM,97810_1,"Acupuncture, initial 15 minutes",75.0,48.75,26.12,94.91,19
CDM,97811_1,"Acupuncture, each additional 15 minutes",60.0,39.0,19.75,78.57,19
CDM,97813_1,"Acupuncture with electrical stimulation, initial 15 minutes",85.0,55.25,31.82,112.33,19
CDM,97814_1,"Acupuncture with electrical stimulation, each additional 15 minutes",70.0,45.5,20.08,91.26,19
CDM,97853OP _1,"INJECTION, CERTOLIZUMAB PEGOL, 1 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",52299.5,33994.68,4.1,135063.46,19
CDM,97893IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3644.9,2369.19,911.23,9412.95,16
CDM,97894IP _1,UNCLASSIFIED DRUGS,3871.75,2516.64,967.94,9998.79,16
CDM,97964IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.05,4.58,1.76,18.21,16
CDM,97966IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",101.7,66.11,25.43,262.64,16
CDM,97966OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.8,8.32,3.2,33.06,16
CDM,97967IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",106.45,69.19,26.61,274.91,16
CDM,97967OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.36,4.78,1.84,19.01,16
CDM,98000_1,"New patient synchronous audio-video visit with straightforward medical decision making, if using time 15 minutes or more",200.0,130.0,43.41,129.36,15
CDM,98001_1,"New patient synchronous audio-video visit with low medical decision making, if using time 30 minutes or more",300.0,195.0,63.98,212.86,15
CDM,98002_1,"New patient synchronous audio-video visit with moderate medical decision making, if using time 45 minutes or more",450.0,292.5,78.57,339.76,15
CDM,98003_1,"New patient synchronous audio-video visit with high medical decision making, if using time 60 minutes or more",600.0,390.0,78.57,453.85,15
CDM,98004_1,"Established patient synchronous audio-video visit with straightforward medical decision making, if using time 10 minutes or more",150.0,97.5,27.42,99.74,15
CDM,98005_1,"Established patient synchronous audio-video visit with low medical decision making, if using time 20 minutes or more",250.0,162.5,41.13,174.92,15
CDM,98006_1,"Established patient synchronous audio-video visit with moderate medical decision making, if using time 30 minutes or more",350.0,227.5,61.69,256.65,15
CDM,98007_1,"Established patient synchronous audio-video visit with high medical decision making, if using time 40 minutes or more",500.0,325.0,78.57,341.38,15
CDM,98008_1,"New patient synchronous audio-only visit with straightforward medical decision making and 10 minutes or more of medical discussion, if using time 15 minutes or more",200.0,130.0,78.57,206.0,15
CDM,98009_1,"New patient synchronous audio-only visit with low medical decision making and 10 minutes or more of medical discussion, if using time 30 minutes or more",300.0,195.0,78.57,309.0,15
CDM,98010_1,"New patient synchronous audio-only visit with moderate medical decision making and 10 minutes or more of medical discussion, if using time 45 minutes or more",450.0,292.5,78.57,463.5,15
CDM,98011_1,"New patient synchronous audio-only visit with high medical decision making and 10 minutes or more of medical discussion, if using time 60 minutes or more",600.0,390.0,78.57,618.0,15
CDM,98012_1,"Established patient synchronous audio-only visit with straightforward medical decision making and 10 minutes or more of medical discussion, if using time 10 minutes or more",150.0,97.5,46.33,91.24,15
CDM,98013_1,"Established patient synchronous audio-only visit with low medical decision making and 10 minutes or more of medical discussion, if using time 20 minutes or more",250.0,162.5,71.44,160.09,15
CDM,98014_1,"Established patient synchronous audio-only visit with moderate medical decision making and 10 minutes or more of medical discussion, if using time 30 minutes or more",350.0,227.5,78.57,232.36,15
CDM,98015_1,"Established patient synchronous audio-only visit with high medical decision making and 10 minutes or more of medical discussion, if using time 40 minutes or more",500.0,325.0,78.57,338.94,15
CDM,98016_1,Established patient brief communication technology-based service with 5-10 minutes of medical discussion,45.0,29.25,12.43,78.57,19
CDM,98034IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.62,10.8,4.16,42.92,16
CDM,98034OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.14,7.89,3.04,31.35,16
CDM,98035IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.31,19.05,7.33,75.69,16
CDM,98035OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.51,14.63,5.63,58.13,16
CDM,98036IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",54.9,35.69,13.73,141.78,16
CDM,98036OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.17,20.26,7.79,80.5,16
CDM,9823IP _1,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",2.46,1.6,0.07,7.42,17
CDM,9823OP _1,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",2.46,1.6,0.07,7.42,17
CDM,98249OP _1,"INJECTION, FLUOROURACIL, 500 MG",22.74,14.78,2.06,68.22,17
CDM,98253IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",86.37,56.14,21.59,223.05,16
CDM,98253OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.68,24.49,9.42,97.31,16
CDM,9828IP _1,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",7.32,4.76,0.23,22.08,17
CDM,9828OP _1,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",10.98,7.14,0.23,33.13,17
CDM,98312IP _1,"INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG (NON-ESRD USE)",76.57,49.77,0.38,307.25,19
CDM,98312OP _1,"INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG (NON-ESRD USE)",159.85,103.9,0.38,412.81,19
CDM,98329IP _1,MULTAQ 400 MG TABLET,88.38,57.45,22.1,61.87,11
CDM,98329OP _1,MULTAQ 400 MG TABLET,131.21,85.29,32.8,91.85,11
CDM,98373IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.15,7.25,2.79,28.79,16
CDM,98373OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.99,7.14,2.75,28.38,16
CDM,9853IP _1,"INJECTION, DIGOXIN, UP TO 0.5 MG",1037.5,674.38,10.14,2679.34,17
CDM,9859IP _1,"INJECTION, DIHYDROERGOTAMINE MESYLATE, PER 1 MG",557.75,362.54,60.5,1440.39,17
CDM,9859OP _1,"INJECTION, DIHYDROERGOTAMINE MESYLATE, PER 1 MG",749.8,487.37,60.5,1936.36,17
CDM,9869IP _1,UNCLASSIFIED DRUGS,36.08,23.45,9.02,93.18,16
CDM,9869OP _1,UNCLASSIFIED DRUGS,52.97,34.43,13.24,136.8,16
CDM,988IP _1,ENZONATATE 100 MG CAPSULE,5.25,3.41,1.31,3.68,11
CDM,98925_1,"Osteopathic manipulative treatment, 1-2 body regions",74.6,48.49,18.8,78.57,19
CDM,98926_1,"Osteopathic manipulative treatment, 3-4 body regions",110.3,71.7,28.48,111.18,19
CDM,98927_1,"Osteopathic manipulative treatment, 5-6 body regions",145.0,94.25,38.32,144.77,19
CDM,98928_1,"Osteopathic manipulative treatment, 7-8 body regions",178.4,115.96,48.0,177.46,19
CDM,98929_1,"Osteopathic manipulative treatment, 9-10 body regions",200.0,130.0,57.25,208.87,19
CDM,9892IP _1,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",7.61,4.95,1.9,19.65,17
CDM,9894OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.15,11.8,4.54,46.87,16
CDM,9895IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.2,13.78,5.3,54.75,16
CDM,9895OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.96,24.67,9.49,98.03,16
CDM,98960_1,"Education and training for patient self-management, each 30 minutes",66.2,43.03,29.79,80.02,15
CDM,98961_1,"Education and training for patient self-management, 2-4 patients, each 30 minutes",48.3,31.4,19.29,78.57,15
CDM,98962_1,"Education and training for patient self-management, 5-8 patients, each 30 minutes",51.5,33.48,14.37,78.57,15
CDM,98966_1,"Telephone discussion provided to an established patient by nonphysician professional, 5-10 minutes",35.0,22.75,10.02,78.57,19
CDM,98967_1,"Telephone discussion provided to an established patient by nonphysician professional, 11-20 minutes",70.0,45.5,19.42,78.57,19
CDM,98968_1,"Telephone discussion provided to an established patient by nonphysician professional, 21-30 minutes",105.0,68.25,28.39,108.15,19
CDM,9896IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.57,4.92,1.89,19.55,16
CDM,9896OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.2,20.93,8.05,83.16,16
CDM,98970_1,"Online digital evaluation and management service provided to an established patient by nonphysician professional for up to 7 days, total time 5-10 minutes",30.0,19.5,10.02,78.57,19
CDM,98971_1,"Online digital evaluation and management service provided to an established patient by nonphysician professional for up to 7 days, total time 11-20 minutes",60.0,39.0,18.34,78.57,19
CDM,98972_1,"Online digital evaluation and management service provided to an established patient by nonphysician professional for up to 7 days, total time 21 minutes or more",90.0,58.5,28.05,92.7,19
CDM,98975_1,Set-up and patient education on use of equipment for remote therapeutic monitoring,42.0,27.3,19.67,78.57,19
CDM,98976_1,"Device supply for data access or data transmissions to support monitoring of respiratory system, each 30 days",122.0,79.3,47.91,125.66,19
CDM,98977_1,"Device supply for data access or data transmissions to support monitoring of musculoskeletal system, each 30 days",122.0,79.3,47.29,125.66,19
CDM,9897IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.37,4.14,1.59,16.45,16
CDM,9897OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.5,1.63,0.63,6.46,16
CDM,98980_1,"Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, first 20 minutes per calendar month",72.0,46.8,24.79,121.05,19
CDM,98981_1,"Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, each additional 20 minutes per calendar month",71.0,46.15,24.45,97.4,19
CDM,99000_1,Handling and/or conveyance of specimen for transfer from physician office to laboratory,20.0,13.0,2.93,78.57,15
CDM,99001_1,Handling and/or conveyance of specimen for transfer to a laboratory,63.0,40.95,3.5,78.57,15
CDM,99002_1,Handling and/or conveyance of device when created by an outside laboratory or specialty service,262.5,170.63,6.47,270.38,15
CDM,9902IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.87,1.22,0.47,4.83,16
CDM,9902OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.08,0.7,0.27,2.79,16
CDM,9903IP _1,DRONABINOL 10 MG CAPSULE [9903],35.9,23.34,8.98,25.13,11
CDM,99050_1,Service provided in the office when the office is normally closed,64.1,41.67,17.47,78.57,15
CDM,99058_1,Service provided on an emergency basis in the office,86.1,55.97,20.38,88.68,15
CDM,9905IP _1,"DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",114.13,74.18,1.43,294.74,17
CDM,99070_1,PR SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP,9.5,6.18,4.28,80.89,15
CDM,99071_1,Provision of educational material by physician,5.3,3.45,2.39,80.89,15
CDM,99075_1,Medical testimony,393.8,255.97,73.6,405.61,15
CDM,99078_1,Education provided in a group setting,10.5,6.83,4.73,80.89,15
CDM,99080_1,Preparation of special reports beyond what is found in the medical record,31.5,20.48,14.18,80.89,15
CDM,99098966_1,"Telephone discussion provided to an established patient by nonphysician professional, 5-10 minutes",40.0,26.0,10.0,208.0,17
CDM,99098967_1,"Telephone discussion provided to an established patient by nonphysician professional, 11-20 minutes",75.0,48.75,18.75,208.0,17
CDM,99098968_1,"Telephone discussion provided to an established patient by nonphysician professional, 21-30 minutes",110.0,71.5,27.5,284.08,19
CDM,99099202_1,"New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more",220.0,143.0,55.0,568.15,17
CDM,99099203_1,"New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more",260.0,169.0,65.0,671.45,17
CDM,99099204_1,"New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more",320.0,208.0,80.0,826.4,17
CDM,99099205_1,"New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more",440.0,286.0,110.0,1136.3,17
CDM,99099211_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,99099212_1,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",145.0,94.25,36.25,374.46,17
CDM,99099213_1,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",180.0,117.0,45.0,464.85,17
CDM,99099214_1,"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more",250.0,162.5,62.5,645.63,17
CDM,99099215_1,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",320.0,208.0,80.0,826.4,17
CDM,99099281_1,Emergency department visit for problem that may not require health care professional,400.0,260.0,100.0,1974.0,17
CDM,99099282_1,Emergency department visit with straightforward medical decision making,600.0,390.0,150.0,1974.0,17
CDM,99099283_1,Emergency department visit with low level of medical decision making,1000.0,650.0,250.0,2582.5,17
CDM,99099284_1,Emergency department visit with moderate level of medical decision making,1500.0,975.0,375.0,3873.75,17
CDM,99099285_1,Emergency department visit with high level of medical decision making,2300.0,1495.0,575.0,5939.75,17
CDM,99099291_1,"Critical care, first 30-74 minutes",2500.0,1625.0,625.0,6456.25,17
CDM,99099292_1,"Critical care, each additional 30 minutes",700.0,455.0,175.0,5261.0,17
CDM,99100_1,Age complicating anesthesia (younger than 1 year and older than 70 years),92.4,60.06,41.58,95.17,15
CDM,99116_1,Use of low body temperature complicating anesthesia,92.4,60.06,41.58,95.17,15
CDM,99135_1,Use of low blood pressure complicating anesthesia,92.4,60.06,41.58,95.17,15
CDM,99140_1,Emergency condition complicating anesthesia,92.4,60.06,41.58,95.17,15
CDM,99151_1,"Use of a drug to induce depression of consciousness by physician performing a procedure (younger than 5 years), initial 15 minutes",120.0,78.0,11.42,147.7,19
CDM,99152_1,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",120.0,78.0,10.27,121.41,19
CDM,99153_1,"Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes",50.0,32.5,4.57,78.57,19
CDM,99155_1,"Use of a drug to induce depression of consciousness by physician not performing a procedure (younger than 5 years), initial 15 minutes",225.0,146.25,43.41,227.14,19
CDM,99156_1,"Use of a drug to induce depression of consciousness by physician not performing a procedure (5 years or older), initial 15 minutes",225.0,146.25,34.27,200.6,19
CDM,99157_1,"Use of a drug to induce depression of consciousness by physician not performing a procedure, each additional 15 minutes",170.0,110.5,27.42,163.45,19
CDM,99172_1,Screening of visual function,58.8,38.22,3.23,78.57,15
CDM,99173_1,Screening for visual sharpness,27.3,17.75,2.28,78.57,15
CDM,99175_1,Administration of medication to induce vomiting,126.0,81.9,31.99,105.02,19
CDM,99183_1,Management of oxygen chamber therapy,480.7,312.46,38.06,281.93,19
CDM,99184_1,Treatment by lowering head or total body temperature in neonate,582.8,378.82,78.57,588.39,19
CDM,99188_1,Application of topical fluoride,47.9,31.14,21.56,78.57,15
CDM,99195_1,Drawing of blood for a medical problem,200.6,130.39,22.85,245.44,19
CDM,99199211_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,160.0,104.0,40.0,413.2,17
CDM,99199212_1,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",190.0,123.5,47.5,490.68,17
CDM,99199213_1,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",220.0,143.0,55.0,568.15,17
CDM,99199214_1,"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more",310.0,201.5,77.5,800.58,17
CDM,99199215_1,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",370.0,240.5,92.5,955.53,17
CDM,99199281_1,Emergency department visit for problem that may not require health care professional,400.0,260.0,100.0,1974.0,17
CDM,99199282_1,Emergency department visit with straightforward medical decision making,600.0,390.0,150.0,1974.0,17
CDM,99199283_1,Emergency department visit with low level of medical decision making,1000.0,650.0,250.0,2582.5,17
CDM,99199284_1,Emergency department visit with moderate level of medical decision making,1500.0,975.0,375.0,3873.75,17
CDM,99199285_1,Emergency department visit with high level of medical decision making,2300.0,1495.0,575.0,5939.75,17
CDM,99201003_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,30.0,309.9,17
CDM,99201004_1,"Smoking and tobacco use intermediate counseling, 3-10 minutes",45.0,29.25,11.25,273.0,19
CDM,99201005_1,"Smoking and tobacco use intensive counseling, more than 10 minutes",57.0,37.05,14.25,273.0,19
CDM,99201105_1,"Other procedure on skin, mucous membrane, and tissue",350.0,227.5,87.5,903.88,19
CDM,99201125_1,"Other procedure on skin, mucous membrane, and tissue",400.0,260.0,100.0,1033.0,19
CDM,99201130_1,"Other procedure on skin, mucous membrane, and tissue",150.0,97.5,37.5,387.38,19
CDM,99201135_1,"Other procedure on skin, mucous membrane, and tissue",150.0,97.5,37.5,387.38,19
CDM,99201145_1,"Other procedure on skin, mucous membrane, and tissue",900.0,585.0,208.0,2324.25,19
CDM,99201150_1,"Other procedure on skin, mucous membrane, and tissue",150.0,97.5,37.5,387.38,19
CDM,99201165_1,"Other procedure on skin, mucous membrane, and tissue",150.0,97.5,37.5,387.38,19
CDM,99201170_1,"Other procedure on skin, mucous membrane, and tissue",350.0,227.5,87.5,903.88,19
CDM,99201175_1,"Other procedure on skin, mucous membrane, and tissue",900.0,585.0,208.0,2324.25,19
CDM,99201185_1,"Other procedure on skin, mucous membrane, and tissue",600.0,390.0,150.0,1549.5,19
CDM,99201190_1,"Other procedure on skin, mucous membrane, and tissue",150.0,97.5,37.5,387.38,19
CDM,99201200_1,"Other procedure on skin, mucous membrane, and tissue",300.0,195.0,75.0,774.75,19
CDM,99201205_1,"Other procedure on skin, mucous membrane, and tissue",150.0,97.5,37.5,387.38,19
CDM,99201210_1,"Other procedure on skin, mucous membrane, and tissue",350.0,227.5,87.5,903.88,19
CDM,99201215_1,"Other procedure on skin, mucous membrane, and tissue",350.0,227.5,87.5,903.88,19
CDM,99201220_1,"Other procedure on skin, mucous membrane, and tissue",350.0,227.5,87.5,903.88,19
CDM,99201225_1,"Other procedure on skin, mucous membrane, and tissue",450.0,292.5,112.5,1162.13,19
CDM,99201230_1,"Other procedure on skin, mucous membrane, and tissue",600.0,390.0,150.0,1549.5,19
CDM,99201235_1,"Other procedure on skin, mucous membrane, and tissue",400.0,260.0,100.0,1033.0,19
CDM,99201240_1,"Other procedure on skin, mucous membrane, and tissue",400.0,260.0,100.0,1033.0,19
CDM,99201245_1,"Other procedure on skin, mucous membrane, and tissue",400.0,260.0,100.0,1033.0,19
CDM,99201250_1,"Other procedure on skin, mucous membrane, and tissue",500.0,325.0,125.0,1291.25,19
CDM,99201255_1,"Other procedure on skin, mucous membrane, and tissue",650.0,422.5,162.5,1678.63,19
CDM,99202_1,"New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more",200.0,130.0,37.73,175.8,19
CDM,99203_1,"New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more",300.0,195.0,57.85,270.89,15
CDM,99204_1,"New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more",450.0,292.5,78.57,404.87,15
CDM,99205_1,"New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more",600.0,390.0,78.57,534.55,15
CDM,99211_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,50.0,32.5,9.19,78.57,15
CDM,99212_1,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",150.0,97.5,21.6,117.85,15
CDM,99213_1,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",250.0,162.5,37.27,189.01,15
CDM,99214_1,"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more",350.0,227.5,74.79,267.89,15
CDM,99215_1,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",500.0,325.0,78.57,391.54,15
CDM,99221_1,"Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes",240.0,156.0,57.12,254.6,19
CDM,99222_1,"Initial hospital inpatient or observation care with moderate level of medical decision making. If using time, 55 minutes or more",300.0,195.0,78.57,352.89,19
CDM,99223_1,"Initial hospital inpatient or observation care with high level of medical decision making, if using time, 75 minutes or more",500.0,325.0,78.57,513.29,19
CDM,99231_1,"Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes",120.0,78.0,34.27,133.11,19
CDM,99232_1,"Subsequent hospital inpatient or observation care with moderate level of medical decision making, if using time, 35 minutes or more",170.0,110.5,54.84,214.93,19
CDM,99233_1,"Subsequent hospital inpatient or observation care with high level of medical decision making, if using time, 50 minutes or more",230.0,149.5,78.57,322.23,19
CDM,99234_1,"Hospital inpatient or observation care with admission and discharge on the same date with straightforward or low level of medical decision making, if using time, 45 minutes or more",300.0,195.0,78.57,336.97,19
CDM,99235_1,"Hospital inpatient or observation care with admission and discharge on the same date with moderate level of medical decision making, if using time, 70 minutes or more",400.0,260.0,78.57,431.53,19
CDM,99236_1,"Hospital inpatient or observation care with admission and discharge on the same date with high level of medical decision making, if using time, 85 minutes or more",500.0,325.0,78.57,563.65,19
CDM,99238_1,"Hospital inpatient or observation discharge day management, 30 minutes or less",170.0,110.5,70.73,220.14,19
CDM,99239_1,"Hospital inpatient or observation discharge day management, more than 30 minutes",250.0,162.5,78.57,311.91,19
CDM,9924IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.23,2.75,1.06,10.92,16
CDM,9924OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.2,6.63,2.55,26.34,16
CDM,99251700_1,Simple bladder irrigation and/or instillation,226.0,146.9,56.5,2166.29,19
CDM,99251701_1,Insertion of temporary bladder tube,110.0,71.5,27.5,2166.29,19
CDM,99251702_1,Simple insertion of temporary bladder tube,110.0,71.5,27.5,2166.29,19
CDM,99251703_1,Complicated insertion of bladder tube,137.0,89.05,34.25,2166.29,19
CDM,99251705_1,Simple change of bladder tube,226.0,146.9,56.5,2166.29,19
CDM,99251720_1,Instillation of anti-cancer drug into bladder,559.0,363.35,139.75,2166.29,19
CDM,9925IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.95,3.22,1.24,12.78,16
CDM,9925OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.3,6.7,2.58,26.6,16
CDM,9926IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.47,2.91,1.12,11.54,16
CDM,9926OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.11,10.47,4.03,41.6,16
CDM,9927IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.05,2.63,1.01,10.46,16
CDM,99281_1,Emergency department visit for problem that may not require health care professional,70.0,45.5,10.27,78.57,19
CDM,99282930_1,Sweat collection,125.0,81.25,38.68,322.81,19
CDM,99282_1,Emergency department visit with straightforward medical decision making,120.0,78.0,37.69,112.69,19
CDM,99283_1,Emergency department visit with low level of medical decision making,180.0,117.0,64.6,191.0,19
CDM,99284_1,Emergency department visit with moderate level of medical decision making,325.0,211.25,78.57,324.95,19
CDM,99285_1,Emergency department visit with high level of medical decision making,500.0,325.0,78.57,470.84,19
CDM,99288_1,Physician direction of emergency advanced life support paramedic services,367.5,238.88,73.6,378.53,15
CDM,99291_1,"Critical care, first 30-74 minutes",525.0,341.25,78.57,670.8,19
CDM,99292_1,"Critical care, each additional 30 minutes",275.0,178.75,78.57,293.02,19
CDM,99296160_1,Administration and interpretation of patient-focused health risk assessment,125.0,81.25,31.25,476.0,19
CDM,99297802_1,"Therapy procedure for nutrition management, each 15 minutes",80.0,52.0,20.0,295.67,19
CDM,99297803_1,"Therapy procedure reassessment for nutrition management, each 15 minutes",62.0,40.3,15.5,295.67,19
CDM,9929IP _1,UNCLASSIFIED DRUGS,75.3,48.95,18.83,194.46,16
CDM,992H0046_1,"MENTAL HEALTH SERVICES, NOT OTHERWISE SPECIFIED",50.0,32.5,12.5,191.9,17
CDM,992H1002_1,"PRENATAL CARE, AT RISK ENHANCED SERVICE; CARE COORDINATION",225.0,146.25,56.25,581.06,19
CDM,992S9443_1,"LACTATION CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION",135.0,87.75,33.75,348.64,19
CDM,99304_1,"Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes",180.0,117.0,60.94,228.32,19
CDM,99305_1,"Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes",270.05,175.53,78.57,363.66,19
CDM,99306_1,"Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more",350.0,227.5,78.57,497.07,19
CDM,99307_1,"Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes",89.74,58.33,33.24,111.57,19
CDM,99308_1,"Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more",149.94,97.46,52.63,203.11,19
CDM,99309_1,"Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes",209.64,136.27,72.02,294.07,19
CDM,99310_1,"Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes",359.68,233.79,78.57,418.82,19
CDM,99315_1,"Nursing facility discharge day management, 30 minutes or less",175.0,113.75,69.74,222.21,19
CDM,99316_1,"Nursing facility discharge management, more than 30 minutes",275.0,178.75,78.57,356.52,19
CDM,99341_1,"Residence visit for new patient with straightforward medical decision making, per day, if using time, at least 15 minutes",125.0,81.25,47.16,140.44,19
CDM,99342_1,"Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes",200.0,130.0,69.25,217.21,19
CDM,99344_1,"Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes",440.0,286.0,78.57,463.27,19
CDM,99345_1,"Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes",450.0,292.5,78.57,563.1,19
CDM,99347_1,"Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes",125.0,81.25,44.13,140.36,19
CDM,99348_1,"Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes",175.0,113.75,60.94,213.4,19
CDM,99349_1,"Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes",275.0,178.75,78.57,347.17,19
CDM,99350_1,"Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes",450.0,292.5,78.57,504.38,19
CDM,99358_1,"Extended patient service without direct patient contact, first hour",280.0,182.0,78.57,288.4,15
CDM,99359_1,"Extended patient service without direct patient contact, each additional 30 minutes",140.0,91.0,63.0,144.2,15
CDM,99360_1,"Extended physician standby service, each 30 minutes",200.0,130.0,68.55,159.94,15
CDM,99366_1,"Medical team conference with patient and/or family, and nonphysician health care professionals, 30 minutes or more",106.1,68.97,47.75,109.28,15
CDM,99367_1,"Medical team conference with physician, 30 minutes or more",161.7,105.11,72.77,166.55,15
CDM,99374_1,"Physician supervision of patient home health agency services per month, 15-29 minutes",200.0,130.0,78.57,206.0,15
CDM,99375_1,"Physician supervision of patient home health agency services per month, 30 minutes or more",270.0,175.5,78.57,278.1,15
CDM,99377_1,"Physician supervision of patient hospice services per month, 15-29 minutes",199.5,129.68,78.57,205.49,15
CDM,99378_1,"Physician supervision of patient hospice services per month, 30 minutes or more",344.4,223.86,78.57,354.73,15
CDM,99379_1,"Supervision of nursing facility patient services per month, 15-29 minutes",190.0,123.5,78.57,195.7,15
CDM,99380_1,"Supervision of nursing facility patient services per month, 30 minutes or more",220.0,143.0,78.57,250.41,15
CDM,99381_1,Initial new patient preventive medicine evaluation (younger than 1 year),270.0,175.5,78.57,280.66,15
CDM,99382_1,Initial new patient preventive medicine evaluation (1-4 years),280.0,182.0,78.57,293.38,15
CDM,99383_1,Initial new patient preventive medicine evaluation (5-11 years),300.0,195.0,78.57,309.0,15
CDM,99384_1,Initial new patient preventive medicine evaluation (12-17 years),340.0,221.0,78.57,350.2,15
CDM,99385_1,Initial new patient preventive medicine evaluation (18-39 years),300.0,195.0,78.57,333.87,15
CDM,99386_1,Initial new patient preventive medicine evaluation (40-64 years),350.0,227.5,78.57,385.29,15
CDM,99387_1,Initial new patient preventive medicine evaluation (65 years or older),380.0,247.0,78.57,418.01,15
CDM,9938OP _1,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",820.2,533.13,8.2,2118.17,19
CDM,99391_1,Established patient periodic preventive medicine examination (younger than 1 year),250.0,162.5,78.57,257.5,15
CDM,99392_1,Established patient periodic preventive medicine examination (1-4 years),260.0,169.0,78.57,269.62,15
CDM,99393_1,Established patient periodic preventive medicine examination (5-11 years),260.0,169.0,78.57,268.77,15
CDM,99394_1,Established patient periodic preventive medicine examination (12-17 years),290.0,188.5,78.57,298.7,15
CDM,99395_1,Established patient periodic preventive medicine examination (18-39 years),290.0,188.5,78.57,300.8,15
CDM,99396_1,Established patient periodic preventive medicine examination (40-64 years),310.0,201.5,78.57,319.86,15
CDM,99397_1,Established patient periodic preventive medicine examination (65 year old or older),340.0,221.0,78.57,344.72,15
CDM,99401_1,"Preventive medicine counseling, typically 15 minutes",104.9,68.19,47.21,108.05,15
CDM,99402_1,"Preventive medicine counseling, typically 30 minutes",179.62,116.75,78.57,185.01,15
CDM,99403_1,"Preventive medicine counseling, typically 45 minutes",250.0,162.5,78.57,257.5,15
CDM,99404_1,"Preventive medicine counseling, typically 1 hour",330.0,214.5,78.57,339.9,15
CDM,99405IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",56.81,36.93,14.2,146.71,16
CDM,99405OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",62.86,40.86,15.72,162.34,16
CDM,99406_1,"Smoking and tobacco use intermediate counseling, 3-10 minutes",34.56,22.46,10.12,78.57,19
CDM,99407_1,"Smoking and tobacco use intensive counseling, more than 10 minutes",58.0,37.7,20.9,78.57,19
CDM,99409_1,"Alcohol and/or substance abuse screening and intervention, more than 30 minutes",159.7,103.81,71.87,173.49,15
CDM,99411_1,"Group preventive medicine counseling, typically 30 minutes",30.5,19.83,13.73,78.57,15
CDM,99412_1,"Group preventive medicine counseling, typically 1 hour",39.9,25.94,17.96,78.57,15
CDM,99415_1,"Extended office or other outpatient service by clinical staff, first hour",20.0,13.0,11.42,78.57,19
CDM,99416_1,"Extended office or other outpatient service by clinical staff, each additional 30 minutes",2.0,1.3,4.57,78.57,19
CDM,99417_1,"Prolonged outpatient service, each 15 minutes of total time beyond required time of primary service",78.5,51.03,35.33,81.67,15
CDM,99418_1,"Prolonged inpatient or observation service, each 15 minutes of total time beyond required time of primary service",121.75,79.14,36.1,108.2,15
CDM,99421_1,"Online digital evaluation and management service for an established patient for up to 7 days, total time 5-10 minutes",35.0,22.75,10.45,78.57,19
CDM,99422_1,"Online digital evaluation and management service for an established patient for up to 7 days, total time 11-20 minutes",70.0,45.5,21.21,78.57,19
CDM,99423_1,"Online digital evaluation and management service for an established patient for up to 7 days, total time 21 or more minutes",105.0,68.25,33.52,115.59,19
CDM,99424_1,"Principal care management services for a single high-risk disease, first 30 minutes provided personally by qualified health care professional, per calendar month.",172.0,111.8,61.54,202.84,19
CDM,99425_1,"Principal care management services for a single high-risk disease, each additional 30 minutes provided personally by qualified health care professional, per calendar month",119.0,77.35,41.99,143.38,19
CDM,99426_1,"Principal care management services for a single high-risk disease, first 30 minutes of clinical staff time directed by health care professional, per calendar month",115.0,74.75,41.99,150.09,19
CDM,99427_1,"Principal care management services for a single high-risk disease, each additional 30 minutes of clinical staff time directed by health care professional, per calendar month",81.0,52.65,29.9,115.72,19
CDM,99437_1,"Chronic care management services for two or more chronic conditions, additional 30 minutes provided personally by health care professional, per calendar month",118.0,76.7,41.68,147.42,19
CDM,99439_1,"Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month",66.0,42.9,29.25,116.79,19
CDM,9943IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.75,8.29,3.19,32.93,16
CDM,99443IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.33,35.96,13.83,142.89,16
CDM,99446_1,"Telephone, internet, or electronic health record assessment and management with verbal and written report by consulting physician, 5-10 minutes",45.0,29.25,14.97,78.57,19
CDM,99447_1,"Telephone or internet assessment with verbal and written report by consulting physician, 11-20 minutes",90.0,58.5,30.12,97.23,19
CDM,99448_1,"Telephone or internet assessment with verbal and written report by consulting physician, 21-30 minutes",135.0,87.75,45.15,145.07,19
CDM,99449_1,"Telephone or internet assessment with verbal and written report by consulting physician, more than 30 minutes",180.0,117.0,59.99,195.32,19
CDM,99451_1,"Telephone, internet, or electronic health record assessment and management with written report by consulting physician, at least 5 minutes",88.0,57.2,22.85,93.96,19
CDM,99452IP _1,"INJECTION, TOCILIZUMAB, FOR HOSPITALIZED ADULTS AND PEDIATRIC PATIENTS (2 YEARS OF AGE AND OLDER) WITH COVID-19 WHO ARE RECEIVING SYSTEMIC CORTICOSTEROIDS AND REQUIRE SUPPLEMENTAL OXYGEN, NON-INVASIVE",1765.59,1147.63,8.02,4559.64,19
CDM,99452OP _1,"INJECTION, TOCILIZUMAB, FOR HOSPITALIZED ADULTS AND PEDIATRIC PATIENTS (2 YEARS OF AGE AND OLDER) WITH COVID-19 WHO ARE RECEIVING SYSTEMIC CORTICOSTEROIDS AND REQUIRE SUPPLEMENTAL OXYGEN, NON-INVASIVE",1529.32,994.06,8.02,3949.47,19
CDM,99452_1,"Telephone or internet referral service, 30 minutes",88.0,57.2,29.56,95.73,19
CDM,99453_1,"Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment",44.0,28.6,13.71,78.57,19
CDM,99454_1,"Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days",145.0,94.25,47.91,154.3,19
CDM,99455_1,Work-related or medical disability examination by the treating physician,219.75,142.84,73.6,226.34,15
CDM,99456_1,Work-related or medical disability examination by other than the treating physician,52.5,34.13,23.63,80.89,15
CDM,99457_1,"Management using the results of remote vital sign monitoring per calendar month, first 20 minutes",77.0,50.05,25.2,119.34,19
CDM,99458_1,"Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes",98.25,63.86,25.2,97.4,19
CDM,99460_1,Initial evaluation and management of newborn per day,203.0,131.95,77.36,251.38,19
CDM,99461OP _1,"INJECTION, DEXAMETHASONE, INTRAVITREAL IMPLANT, 0.1 MG",10001.95,6501.27,216.81,25830.04,19
CDM,99461_1,Initial evaluation and management of newborn not in hospital or birthing center per day,220.0,143.0,50.98,229.65,19
CDM,99462_1,Follow-up hospital care of newborn per day,95.0,61.75,33.93,109.61,19
CDM,99463_1,Initial inpatient hospital or birthing center same date care and discharge of newborn,200.0,130.0,78.57,293.08,19
CDM,99464_1,Physician attendance at delivery and stabilization of newborn,250.0,162.5,60.67,196.43,19
CDM,99465OP _1,"INJECTION, ABOBOTULINUMTOXINA, 5 UNITS",4477.85,2910.6,9.68,11564.05,19
CDM,99465_1,Reviving newborn at delivery,450.0,292.5,78.57,384.28,19
CDM,99466_1,"Critical care during transport between facilities, first 30-74 minutes (2 years or younger)",703.5,457.28,78.57,627.18,19
CDM,99467_1,"Critical care during transport between facilities, each additional 30 minutes (2 years or younger)",359.1,233.42,78.57,314.82,19
CDM,99468_1,Initial inpatient hospital critical care of newborn per day (28 days or younger),2750.0,1787.5,78.57,2418.67,19
CDM,99469_1,Follow-up inpatient hospital critical care of newborn per day (28 days or younger),1200.0,780.0,78.57,1046.84,19
CDM,99471_1,Initial inpatient hospital critical care of infant or young child per day (29 days to 2 years),2375.1,1543.82,78.57,2093.41,19
CDM,99472_1,Follow-up inpatient hospital critical care of infant or young child per day (29 days to 2 years),1199.8,779.87,78.57,1071.43,19
CDM,99473_1,Education and training to self measure blood pressure,25.0,16.25,10.05,78.57,19
CDM,99474_1,Self measured blood pressure measurements,35.5,23.08,7.68,78.57,19
CDM,99475_1,Initial inpatient hospital critical care of infant or young child per day (2-5 years),1650.0,1072.5,78.57,1511.74,19
CDM,99476_1,Follow-up inpatient hospital critical care of infant or young child per day (2-5 years),979.7,636.81,78.57,914.45,19
CDM,99477_1,Initial intensive care of newborn per day (28 days or younger),999.6,649.74,78.57,917.36,19
CDM,99478_1,Follow-up intensive care of recovering very low birth weight infant per day,421.1,273.72,78.57,360.03,19
CDM,99479_1,Follow-up intensive care of recovering low birth weight infant per day,370.7,240.96,78.57,327.2,19
CDM,99480_1,Follow-up intensive care of recovering medium birth weight infant per day,356.0,231.4,78.57,314.82,19
CDM,99483_1,"Assessment of and care planning for patient with impaired thought processing, typically 60 minutes",450.0,292.5,78.57,668.36,19
CDM,99485_1,"Supervision of interfacility transport care of critical patient, first 30 minutes (2 years or younger)",220.0,143.0,78.57,226.6,15
CDM,99486_1,"Supervision of interfacility transport care of critical patient, each additional 30 minutes (2 years or younger)",190.0,123.5,78.57,195.7,15
CDM,99487_1,"Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar m",230.0,149.5,42.31,246.05,19
CDM,99489_1,"Complex chronic care management services for two or more chronic conditions, each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per ",120.0,78.0,21.16,134.31,19
CDM,99490_1,"Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month",105.0,68.25,21.16,136.08,19
CDM,99491_1,"Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month",198.0,128.7,62.64,210.12,19
CDM,99495_1,Transitional care management services for problem of at least moderate complexity,399.77,259.85,78.57,503.18,19
CDM,99496_1,Transitional care management services for problem of high complexity,549.95,357.47,78.57,681.53,19
CDM,99497_1,"Advance care planning, first 30 minutes",188.1,122.27,62.95,205.33,19
CDM,99498_1,"Advance care planning, each additional 30 minutes",175.85,114.3,60.54,193.85,19
CDM,99500001_1,Other allergy or clinical immunology service or procedure,23.0,14.95,5.75,208.0,19
CDM,99500002_1,Harvest and injections of platelet rich plasma using imaging guidance,750.0,487.5,187.5,1936.88,19
CDM,99500003_1,HBS PRP THERADOME HAIR GROWTH HELMET,908.0,590.2,227.0,635.6,11
CDM,99500005_1,"Other procedure on skin, mucous membrane, and tissue",50.0,32.5,0.01,244.96,17
CDM,99500006_1,"Other procedure on skin, mucous membrane, and tissue",69.23,45.0,0.01,244.96,17
CDM,99500007_1,"Other procedure on skin, mucous membrane, and tissue",50.0,32.5,0.01,244.96,17
CDM,99500010_1,"Other procedure on skin, mucous membrane, and tissue",656.25,426.56,164.06,1694.77,19
CDM,99500011_1,Other procedure on nervous system,1230.0,799.5,208.0,3176.48,19
CDM,99500012_1,"Other procedure on skin, mucous membrane, and tissue",70.0,45.5,0.01,244.96,17
CDM,99500013_1,"Other procedure on skin, mucous membrane, and tissue",3937.5,2559.38,240.16,10168.59,19
CDM,99500014_1,"Other procedure on skin, mucous membrane, and tissue",5062.5,3290.63,240.16,13073.91,19
CDM,99500015_1,"Other procedure on skin, mucous membrane, and tissue",6187.5,4021.88,240.16,15979.22,19
CDM,99500020_1,"Other procedure on skin, mucous membrane, and tissue",1453.13,944.53,208.0,3752.71,19
CDM,99500021_1,"Other procedure on skin, mucous membrane, and tissue",2250.0,1462.5,208.0,5810.63,19
CDM,99500025_1,"Other procedure on skin, mucous membrane, and tissue",100.0,65.0,25.0,258.25,19
CDM,99500030_1,"Other procedure on skin, mucous membrane, and tissue",100.0,65.0,25.0,258.25,19
CDM,99500100_1,"Other procedure on skin, mucous membrane, and tissue",100.0,65.0,25.0,258.25,19
CDM,99500330_1,Tear film imaging of one or both eyes,75.0,48.75,18.75,193.69,16
CDM,99501000_1,Other special service or procedure on skin,487.5,316.88,121.88,1258.97,19
CDM,99501001_1,Other special service or procedure on skin,712.5,463.13,178.13,1840.03,19
CDM,99501002_1,Other special service or procedure on skin,900.0,585.0,225.0,2324.25,19
CDM,99501003_1,Other special service or procedure on skin,1125.0,731.25,240.16,2905.31,19
CDM,99501004_1,Other special service or procedure on skin,1200.0,780.0,240.16,3099.0,19
CDM,99501005_1,Other special service or procedure on skin,300.0,195.0,75.0,774.75,19
CDM,99501006_1,Other special service or procedure on skin,300.0,195.0,75.0,774.75,19
CDM,99501007_1,Other special service or procedure on skin,225.0,146.25,56.25,764.0,19
CDM,99501008_1,Other special service or procedure on skin,375.0,243.75,93.75,968.44,19
CDM,9950198T_1,Measurement of eye blood flow by repeated eyeball pressure assessment,210.0,136.5,0.01,542.33,17
CDM,9950207T_1,Drainage of one eyelid glands using heat and pressure,135.0,87.75,33.75,2166.29,19
CDM,9950232T_1,Harvest and injections of platelet rich plasma using imaging guidance,500.0,325.0,125.0,1291.25,19
CDM,9950479T_1,"Laser destruction of scar tissue, first 100 cm2, or 1% of body surface area of infants and children",1440.0,936.0,0.01,3718.8,17
CDM,9950509T_1,Pattern recording of retinal electrical responses to external stimuli with interpretation and report,140.0,91.0,35.0,784.0,19
CDM,9950563T_1,Evacuation of meibomian tear glands of eyelids of both eyes,135.0,87.75,33.75,348.64,17
CDM,9950575T_1,"In-person programming device evaluation of implantable cardioverter-defibrillator system with electrode under breastbone, with analysis, review and report",45.0,29.25,11.25,116.21,17
CDM,9950576T_1,"In-person interrogation device evaluation of implantable cardioverter-defibrillator system with electrode under breastbone, with analysis, review and report",45.0,29.25,11.25,116.21,17
CDM,9950577T_1,"Electrophysiological evaluation of implantable cardioverter-defibrillator system with electrode under breastbone, with analysis, review and report",2652.0,1723.8,663.0,9454.3,17
CDM,9950699T_1,Injection of medication into posterior chamber of eye,5128.0,3333.2,1282.0,13243.06,19
CDM,9950804T_1,"In-person programming device evaluation of dual-chamber leadless pacemaker with adjustment of the device to test function and to select optimal permanent values, with analysis, review and report by a ",86.0,55.9,21.5,1052.0,19
CDM,9950826T_1,In-person device evaluation of single-chamber leadless pacemaker system,86.0,55.9,21.5,1052.0,17
CDM,99510004_1,"Fine needle aspiration biopsy, each additional growth",150.0,97.5,0.01,1013.38,15
CDM,99510005_1,"Fine needle aspiration biopsy using ultrasound guidance, first growth",2340.0,1521.0,0.01,6043.05,15
CDM,99510006_1,"Fine needle aspiration biopsy using ultrasound guidance, each additional growth",200.0,130.0,0.01,1013.38,15
CDM,99510021_1,"Fine needle aspiration biopsy, first growth",465.0,302.25,0.01,1200.86,15
CDM,99510040_1,Acne surgery,163.0,105.95,0.01,420.95,15
CDM,99510060_1,Simple or single drainage of skin abscess,120.0,78.0,0.01,309.9,17
CDM,99510061_1,Complicated or multiple drainage of skin abscess,300.0,195.0,0.01,774.75,17
CDM,99510080_1,Simple drainage of cyst of tailbone,538.0,349.7,0.01,1389.39,17
CDM,99510081_1,Complicated drainage of cyst of tailbone,549.0,356.85,0.01,1591.92,17
CDM,99510120_1,"Removal of foreign body from tissue, accessed beneath the skin, simple",300.0,195.0,0.01,774.75,17
CDM,99510121_1,"Removal of foreign body from tissue, accessed beneath the skin, complex",1325.0,861.25,0.01,3421.81,17
CDM,99510140_1,Drainage of blood or fluid accumulation,1500.0,975.0,0.01,3873.75,17
CDM,99510160_1,"Aspiration of abscess, blood, or cyst",400.0,260.0,0.01,1033.0,17
CDM,99510180_1,Complex drainage of wound infection after surgery,6444.0,4188.6,0.01,16641.63,17
CDM,99511000_1,"Removal of inflamed or infected skin, up to 10% of body surface",479.0,311.35,0.01,1237.02,17
CDM,99511001_1,"Removal of inflamed or infected skin, each additional 10% of body surface or less",50.0,32.5,0.01,566.47,17
CDM,99511042_1,"Removal of skin and tissue, 20.0 sq cm or less",914.0,594.1,0.01,2360.41,17
CDM,99511043_1,"Removal of muscle and/or tissue, 20.0 sq cm or less",2332.0,1515.8,0.01,6022.39,17
CDM,99511044_1,"Removal of bone, 20.0 sq cm or less",3000.0,1950.0,0.01,7747.5,17
CDM,99511045_1,"Removal of skin and tissue, each additional 20.0 sq cm or less",300.0,195.0,0.01,1507.02,17
CDM,99511055_1,"Removal of noncancer thickened skin growth, 1 growth",207.0,134.55,0.01,534.58,17
CDM,99511056_1,"Removal of noncancer thickened skin growth, 2-4 growths",292.0,189.8,0.01,754.09,17
CDM,99511057_1,"Removal of noncancer thickened skin growth, more than 4 growths",386.0,250.9,0.01,996.85,17
CDM,99511102_1,"Biopsy of related skin growth, first growth",352.0,228.8,0.01,909.04,17
CDM,99511103_1,"Biopsy of related skin growth, each additional growth",30.0,19.5,0.01,623.98,17
CDM,99511104_1,"Punch biopsy, first skin growth",352.0,228.8,0.01,909.04,17
CDM,99511105_1,"Punch biopsy, each additional skin growth",30.0,19.5,0.01,623.98,17
CDM,99511106_1,"Incision biopsy, first skin growth",630.0,409.5,0.01,1626.98,17
CDM,99511107_1,"Incision biopsy, each additional skin growth",50.0,32.5,0.01,623.98,17
CDM,99511200_1,"Removal of skin tag, 1-15 skin tags",163.0,105.95,0.01,420.95,17
CDM,99511201_1,"Removal of skin tag, each additional 10 skin tags",21.0,13.65,0.01,244.96,17
CDM,99511300_1,"Shaving of skin growth of body, arms, or legs, 0.5 cm or less",163.0,105.95,0.01,420.95,17
CDM,99511301_1,"Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm",163.0,105.95,0.01,420.95,17
CDM,99511302_1,"Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm",163.0,105.95,0.01,420.95,17
CDM,99511303_1,"Shaving of skin growth of body, arms, or legs, more than 2.0 cm",330.0,214.5,0.01,852.23,17
CDM,99511305_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",163.0,105.95,0.01,420.95,17
CDM,99511306_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",163.0,105.95,0.01,420.95,17
CDM,99511307_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",163.0,105.95,0.01,420.95,17
CDM,99511308_1,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm",163.0,105.95,0.01,420.95,17
CDM,99511310_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",163.0,105.95,0.01,420.95,17
CDM,99511311_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",163.0,105.95,0.01,420.95,17
CDM,99511312_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",330.0,214.5,0.01,852.23,17
CDM,99511313_1,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, more than 2.0 cm",330.0,214.5,0.01,852.23,17
CDM,99511400_1,"Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less",549.0,356.85,0.01,1417.79,17
CDM,99511401_1,"Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm",302.0,196.3,0.01,779.92,17
CDM,99511402_1,"Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm",549.0,356.85,0.01,1417.79,17
CDM,99511403_1,"Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm",549.0,356.85,0.01,1417.79,17
CDM,99511404_1,"Removal of noncancer skin growth of body, arms, or legs, 3.1-4.0 cm",1330.0,864.5,0.01,3434.73,17
CDM,99511406_1,"Removal of noncancer skin growth of body, arms, or legs, more than 4.0 cm",1717.0,1116.05,0.01,4434.15,17
CDM,99511420_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",1330.0,864.5,0.01,3434.73,17
CDM,99511421_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",549.0,356.85,0.01,1417.79,17
CDM,99511422_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",549.0,356.85,0.01,1794.59,17
CDM,99511423_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",2021.0,1313.65,0.01,5219.23,17
CDM,99511424_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",2158.0,1402.7,0.01,5573.04,17
CDM,99511426_1,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",2270.0,1475.5,0.01,5862.28,17
CDM,99511440_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",549.0,356.85,0.01,1417.79,17
CDM,99511441_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",549.0,356.85,0.01,1417.79,17
CDM,99511442_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",549.0,356.85,0.01,1417.79,17
CDM,99511443_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",1351.0,878.15,0.01,3488.96,17
CDM,99511444_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",1330.0,864.5,0.01,3434.73,17
CDM,99511446_1,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",2460.0,1599.0,0.01,6352.95,17
CDM,99511450_1,Removal of skin and tissue of underarms for inflamed sweat glands with simple or intermediate repair,3510.0,2281.5,0.01,9064.58,17
CDM,99511451_1,Removal of skin and tissue of underarms for inflamed sweat glands with complex repair,2340.0,1521.0,0.01,6043.05,17
CDM,99511462_1,Removal of skin and tissue of groin for inflamed sweat glands with simple or intermediate repair,3510.0,2281.5,0.01,9064.58,17
CDM,99511463_1,Removal of skin and tissue of groin for inflamed sweat glands with complicated repair,2340.0,1521.0,0.01,6043.05,17
CDM,99511470_1,Removal of skin and tissue of anus or navel for inflamed sweat glands with simple or intermediate repair,2340.0,1521.0,0.01,6043.05,17
CDM,99511471_1,Removal of skin and tissue of anus or navel for inflamed sweat glands with complicated repair,2340.0,1521.0,0.01,6043.05,17
CDM,99511600_1,"Removal of cancer skin growth of body, arms, or legs, 0.5 cm or less",549.0,356.85,0.01,1417.79,17
CDM,99511601_1,"Removal of cancer skin growth of body, arms, or legs, 0.6-1.0 cm",549.0,356.85,0.01,1417.79,17
CDM,99511602_1,"Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm",200.0,130.0,0.01,623.98,17
CDM,99511603_1,"Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm",549.0,356.85,0.01,1417.79,17
CDM,99511604_1,"Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm",549.0,356.85,0.01,1794.59,17
CDM,99511606_1,"Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm",1330.0,864.5,0.01,3434.73,17
CDM,99511620_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",1330.0,864.5,0.01,3434.73,17
CDM,99511621_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",549.0,356.85,0.01,1417.79,17
CDM,99511622_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",549.0,356.85,0.01,1417.79,17
CDM,99511623_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",1330.0,864.5,0.01,3434.73,17
CDM,99511624_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",1330.0,864.5,0.01,3434.73,17
CDM,99511626_1,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",2270.0,1475.5,0.01,5862.28,17
CDM,99511640_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",549.0,356.85,0.01,1417.79,17
CDM,99511641_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",549.0,356.85,0.01,1417.79,17
CDM,99511642_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",549.0,356.85,0.01,1417.79,17
CDM,99511643_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",1581.0,1027.65,0.01,4082.93,17
CDM,99511644_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",1950.0,1267.5,0.01,5035.88,17
CDM,99511646_1,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",2270.0,1475.5,0.01,5862.28,17
CDM,99511719_1,Trimming of fingernails or toenails,65.0,42.25,0.01,167.86,17
CDM,99511721_1,"Removal of fingernails or toenails, 6 or more nails",65.0,42.25,0.01,167.86,17
CDM,99511730_1,"Simple separation of fingernail or toenail from nail bed, first nail",400.0,260.0,0.01,1033.0,17
CDM,99511732_1,"Simple separation of fingernail or toenail from nail bed, each additional nail",50.0,32.5,0.01,129.13,17
CDM,99511740_1,Removal of blood accumulation under fingernail or toenail,159.0,103.35,0.01,410.62,17
CDM,99511750_1,Permanent removal fingernail or toenail,302.0,196.3,0.01,779.92,17
CDM,99511755_1,Biopsy of fingernail or toenail,549.0,356.85,0.01,1417.79,17
CDM,99511760_1,Repair of fingernail or toenail bed,1357.0,882.05,0.01,3504.45,17
CDM,99511765_1,Removal of skin of fingernail or toenail,302.0,196.3,0.01,779.92,17
CDM,99511770_1,Simple removal of cyst of tailbone,2270.0,1475.5,0.01,5862.28,17
CDM,99511900_1,"Injection into skin growth, 1-7 growths",163.0,105.95,0.01,420.95,17
CDM,99511901_1,"Injection into skin growth, more than 7 growths",170.0,110.5,0.01,439.03,17
CDM,99511950_1,"Injection of filling material under skin, 1.0 cc or less",150.0,97.5,0.01,623.98,17
CDM,99511951_1,"Injection of filling material under skin, 1.1-5.0 cc",225.0,146.25,0.01,623.98,17
CDM,99511952_1,"Injection of filling material under skin, 5.1-10.0 cc",300.0,195.0,0.01,774.75,17
CDM,99511954_1,"Injection of filling material under skin, more than 10.0 cc",1151.0,748.15,0.01,2972.46,17
CDM,99511976_1,Removal of implantable contraceptive capsules,549.0,356.85,0.01,1417.79,17
CDM,99511980_1,Placement of hormone pellet under skin,273.0,177.45,0.01,705.02,17
CDM,99511981_1,Insertion of drug delivery implant into tissue,110.0,71.5,0.01,284.08,17
CDM,99511982_1,Removal of drug delivery implant from tissue,494.0,321.1,0.01,1275.76,17
CDM,99511983_1,Removal with reinsertion of drug delivery implant into tissue,273.0,177.45,0.01,705.02,17
CDM,99512001_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less",250.0,162.5,0.01,645.63,17
CDM,99512002_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm",260.0,169.0,0.01,671.45,17
CDM,99512004_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 7.6-12.5 cm",275.0,178.75,0.01,710.19,17
CDM,99512005_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 12.6-20.0 cm",325.0,211.25,0.01,839.31,17
CDM,99512006_1,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 20.1-30.0 cm",375.0,243.75,0.01,968.44,17
CDM,99512007_1,"Simple repair of surface wound to scalp, neck, underarms, trunk, arms, or legs, more than 30.0 cm",180.0,117.0,0.01,464.85,17
CDM,99512011_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",250.0,162.5,0.01,645.63,17
CDM,99512013_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",260.0,169.0,0.01,671.45,17
CDM,99512014_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",275.0,178.75,0.01,710.19,17
CDM,99512015_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",325.0,211.25,0.01,839.31,17
CDM,99512016_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",375.0,243.75,0.01,968.44,17
CDM,99512017_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm",425.0,276.25,0.01,1097.56,17
CDM,99512018_1,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, more than 30.0 cm",475.0,308.75,0.01,1226.69,17
CDM,99512020_1,Simple closure of surface wound reopening,500.0,325.0,0.01,1291.25,17
CDM,99512021_1,Repair of separation of wound closure with insertion of packing,325.0,211.25,0.01,839.31,17
CDM,99512031_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less",325.0,211.25,0.01,839.31,17
CDM,99512032_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm",375.0,243.75,0.01,968.44,17
CDM,99512034_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm",425.0,276.25,0.01,1097.56,17
CDM,99512035_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 12.6-20.0 cm",475.0,308.75,0.01,1226.69,17
CDM,99512036_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 20.1-30.0 cm",525.0,341.25,0.01,1355.81,17
CDM,99512037_1,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, more than 30.0 cm",2000.0,1300.0,0.01,5165.0,17
CDM,99512041_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less",325.0,211.25,0.01,839.31,17
CDM,99512042_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm",375.0,243.75,0.01,968.44,17
CDM,99512044_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 7.6-12.5 cm",525.0,341.25,0.01,1355.81,17
CDM,99512045_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 12.6-20.0 cm",575.0,373.75,0.01,1484.94,17
CDM,99512046_1,"Intermediate repair of wound of neck, hands, feet, or genitals, 20.1-30.0 cm",625.0,406.25,0.01,1614.06,17
CDM,99512047_1,"Intermediate repair of wound of neck, hands, feet, or genitals, more than 30.0 cm",2000.0,1300.0,0.01,5165.0,17
CDM,99512051_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",325.0,211.25,0.01,839.31,17
CDM,99512052_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",375.0,243.75,0.01,968.44,17
CDM,99512053_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",425.0,276.25,0.01,1097.56,17
CDM,99512054_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",475.0,308.75,0.01,1226.69,17
CDM,99512055_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",525.0,341.25,0.01,1355.81,17
CDM,99512056_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm",575.0,373.75,0.01,1484.94,17
CDM,99512057_1,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, more than 30.0 cm",625.0,406.25,0.01,1614.06,17
CDM,99513100_1,"Complicated repair of wound of trunk, 1.1-2.5 cm",525.0,341.25,0.01,1355.81,17
CDM,99513101_1,"Complicated repair of wound of trunk, 2.6-7.5 cm",575.0,373.75,0.01,1484.94,17
CDM,99513102_1,"Complicated repair of wound of trunk, each additional 5.0 cm or less",250.0,162.5,0.01,645.63,17
CDM,99513120_1,"Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm",525.0,341.25,0.01,1355.81,17
CDM,99513121_1,"Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm",575.0,373.75,0.01,1484.94,17
CDM,99513122_1,"Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less",250.0,162.5,0.01,645.63,17
CDM,99513131_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm",325.0,211.25,0.01,839.31,17
CDM,99513132_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm",525.0,341.25,0.01,1355.81,17
CDM,99513133_1,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less",250.0,162.5,0.01,645.63,17
CDM,99513151_1,"Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm",525.0,341.25,0.01,1355.81,17
CDM,99513152_1,"Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm",625.0,406.25,0.01,1614.06,17
CDM,99513153_1,"Complicated repair of wound of eyelids, nose, ears, or lip, each additional 5.0 cm or less",250.0,162.5,0.01,1794.59,17
CDM,99513160_1,Extensive or complicated repair of surface wound reopening,2695.0,1751.75,0.01,6959.84,17
CDM,99514000_1,"Repair of wound of trunk by transferring skin, 10.0 sq cm or less",1550.0,1007.5,0.01,4002.88,17
CDM,99514001_1,"Repair of wound of trunk by transferring skin, 10.1-30.0 sq cm",1600.0,1040.0,400.0,6141.01,19
CDM,99514020_1,"Repair of wound of scalp, arms, or legs by transferring skin, 10.0 sq cm or less",1550.0,1007.5,387.5,6141.01,19
CDM,99514021_1,"Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm",1600.0,1040.0,400.0,6141.01,19
CDM,99514040_1,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less",1550.0,1007.5,387.5,4002.88,19
CDM,99514041_1,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm",1600.0,1040.0,400.0,6141.01,19
CDM,99514060_1,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less",6550.0,4257.5,1637.5,16915.38,19
CDM,99514061_1,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm",1600.0,1040.0,400.0,6141.01,19
CDM,99514301_1,"Repair of wound by transferring skin, 30.1-60.0 sq cm",4000.0,2600.0,1000.0,10330.0,19
CDM,99514302_1,"Repair of wound by transferring skin, each additional 30.0 sq cm",1500.0,975.0,375.0,3873.75,19
CDM,99515002_1,"Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",1550.0,1007.5,0.01,4002.88,17
CDM,99515004_1,"Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",525.0,341.25,0.01,1507.02,17
CDM,99515050_1,"Skin graft to tip of finger or toe, 2.0 cm or less",1440.0,936.0,0.01,3718.8,17
CDM,99515100_1,"Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",1550.0,1007.5,0.01,4002.88,17
CDM,99515120_1,"Partial thickness self skin graft to face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",2750.0,1787.5,0.01,7101.88,17
CDM,99515200_1,"Full thickness skin graft to trunk, 20.0 sq cm or less",1550.0,1007.5,0.01,4002.88,17
CDM,99515201_1,"Full thickness skin graft to trunk, each additional 20.0 sq cm",500.0,325.0,0.01,2881.28,17
CDM,99515220_1,"Full thickness skin graft to scalp, arms, or legs, 20.0 sq cm or less",1550.0,1007.5,387.5,4002.88,19
CDM,99515221_1,"Full thickness skin graft to scalp, arms, or legs, each additional 20.0 sq cm",500.0,325.0,125.0,2881.28,19
CDM,99515240_1,"Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 20.0 sq cm or less",1550.0,1007.5,387.5,6141.01,19
CDM,99515241_1,"Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 20.0 sq cm",500.0,325.0,0.01,2881.28,17
CDM,99515260_1,"Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less",1550.0,1007.5,387.5,4002.88,19
CDM,99515261_1,"Full thickness skin graft to nose, ears, eyelids, or lips, each additional 20.0 sq cm",500.0,325.0,125.0,2881.28,19
CDM,99515271_1,"Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less",1550.0,1007.5,0.01,4002.88,17
CDM,99515272_1,"Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less",500.0,325.0,0.01,2881.28,17
CDM,99515273_1,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",2750.0,1787.5,0.01,7101.88,17
CDM,99515274_1,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",750.0,487.5,0.01,2881.28,17
CDM,99515275_1,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less",1550.0,1007.5,0.01,4002.88,17
CDM,99515276_1,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 25.0 sq cm of wound 100.0 sq cm or less",500.0,325.0,0.01,2881.28,17
CDM,99515277_1,"Skin substitute graft to wound 100.0 sq cm or more of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and childre",1550.0,1007.5,0.01,4002.88,17
CDM,99515278_1,"Skin substitute graft to wound 100.0 sq cm or more of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for inf",500.0,325.0,0.01,2881.28,17
CDM,99515572_1,"Creation of flap graft to scalp, arms, or legs",2750.0,1787.5,0.01,7101.88,17
CDM,99515574_1,"Creation of flap graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet",1550.0,1007.5,0.01,4002.88,17
CDM,99515576_1,"Creation of flap graft to eyelids, nose, ears, lips, or mouth",1550.0,1007.5,387.5,6141.01,19
CDM,99515610_1,"Transfer of skin flap to scalp, arms, or legs",1550.0,1007.5,0.01,4002.88,17
CDM,99515620_1,"Transfer of skin flap to forehead, cheeks, chin, neck, underarms, genitals, hands, or feet",1550.0,1007.5,0.01,4002.88,17
CDM,99515630_1,"Transfer of skin flap to eyelids, nose, ears, or lips",1550.0,1007.5,387.5,6141.01,19
CDM,99515731_1,"Creation of flap graft to nose, forehead, temple, or scalp",3370.0,2190.5,842.5,8703.03,19
CDM,99515760_1,Graft with closure of wound,1550.0,1007.5,0.01,4002.88,17
CDM,99515769_1,Self soft tissue graft,3410.0,2216.5,0.01,8806.33,17
CDM,99515771_1,"Graft using patient's fat removed by liposuction and inserted into trunk, breasts, scalp, arms, or legs, 50.0 cc or less",8225.0,5346.25,0.01,21241.06,17
CDM,99515772_1,"Graft using patient's fat removed by liposuction and inserted into trunk, breasts, scalp, arms, or legs, each additional 50.0 cc",4100.0,2665.0,0.01,10588.25,17
CDM,99515780_1,Dermabrasion of skin of total face,2300.0,1495.0,0.01,5939.75,17
CDM,99515781_1,Dermabrasion of skin of part of face,600.0,390.0,0.01,1591.92,17
CDM,99515782_1,Dermabrasion of skin other than face,1350.0,877.5,0.01,3486.38,17
CDM,99515783_1,Dermabrasion of superficial scars or tattoos from skin,325.0,211.25,0.01,1591.92,17
CDM,99515788_1,Chemical peel of outer layer of skin of face,170.0,110.5,0.01,439.03,17
CDM,99515789_1,Chemical peel of deep layer of skin of face,525.0,341.25,0.01,1355.81,17
CDM,99515792_1,Chemical peel of outer layer of nonfacial skin,325.0,211.25,0.01,839.31,17
CDM,99515793_1,Chemical peel of deep layer of nonfacial skin,325.0,211.25,0.01,839.31,17
CDM,99515820_1,Repair of lower eyelid defect,2325.0,1511.25,0.01,6004.31,17
CDM,99515821_1,Removal of excessive skin of lower eyelid and fat around eye,3000.0,1950.0,0.01,7747.5,17
CDM,99515822_1,Removal of excessive skin of upper eyelid,2325.0,1511.25,0.01,6004.31,17
CDM,99515823_1,Removal of excessive skin and fat of upper eyelid,3000.0,1950.0,0.01,7747.5,17
CDM,99515825_1,Removal of wrinkles and extra skin of neck,4125.0,2681.25,0.01,10652.81,17
CDM,99515826_1,"Incision, stretching, and suture of skin between eyebrows",6500.0,4225.0,0.01,16786.25,17
CDM,99515828_1,"Removal of wrinkles and extra skin of cheeks, chin, and neck",4125.0,2681.25,0.01,10652.81,17
CDM,99515829_1,"Removal of wrinkles and extra skin with grafting of cheeks, chin, and neck",8221.0,5343.65,0.01,21230.73,17
CDM,99515830_1,Removal of extra skin and tissue of abdomen,5390.0,3503.5,0.01,13919.68,17
CDM,99515836_1,Removal of extra skin and tissue of arm,6885.0,4475.25,0.01,17780.51,17
CDM,99515838_1,Removal of extra skin and tissue of chin,2270.0,1475.5,0.01,5862.28,17
CDM,99515839_1,Removal of extra skin and tissue of other area,2300.0,1495.0,0.01,5939.75,17
CDM,99515840_1,Tissue graft to treat facial paralysis,3140.0,2041.0,0.01,8109.05,17
CDM,99515853_1,Removal of sutures or staples,20.0,13.0,0.01,51.65,15
CDM,99515854_1,Removal of sutures and staples,30.0,19.5,0.01,77.48,15
CDM,99515876_1,Suction assisted removal of fat of head and neck,2750.0,1787.5,0.01,7101.88,17
CDM,99515877_1,Suction assisted removal of fat of body,2750.0,1787.5,0.01,7101.88,17
CDM,99515879_1,Suction assisted removal of fat of leg,4125.0,2681.25,0.01,10652.81,17
CDM,99516000_1,First degree burn treatment,175.0,113.75,0.01,451.94,17
CDM,99516020_1,"Dressing change or removal of burn tissue, less than 5% of total body surface",175.0,113.75,0.01,451.94,17
CDM,99517000_1,"Destruction of precancer skin growth, 1 growth",225.0,146.25,0.01,581.06,17
CDM,99517003_1,"Destruction of precancer skin growth, 2-14 growths",18.0,11.7,0.01,244.96,17
CDM,99517004_1,"Destruction of precancer skin growth, 15 or more growths",325.0,211.25,0.01,839.31,17
CDM,99517106_1,"Destruction of birthmark, less than 10.0 sq cm",325.0,211.25,0.01,1591.92,17
CDM,99517107_1,"Destruction of birthmark, 10.0-50.0 sq cm",525.0,341.25,0.01,1591.92,17
CDM,99517108_1,"Destruction of birthmark, more than 50.0 sq cm",1490.0,968.5,0.01,3847.93,17
CDM,99517110_1,"Destruction of skin growth, 1-14 growths",163.0,105.95,0.01,420.95,17
CDM,99517111_1,"Destruction of skin growth, 15 or more growths",163.0,105.95,0.01,420.95,17
CDM,99517250_1,Application of chemical to stop tissue regrowth in wound,266.0,172.9,0.01,686.95,17
CDM,99517260_1,"Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less",175.0,113.75,0.01,451.94,17
CDM,99517261_1,"Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm",225.0,146.25,0.01,581.06,17
CDM,99517262_1,"Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm",275.0,178.75,0.01,710.19,17
CDM,99517263_1,"Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm",325.0,211.25,0.01,839.31,17
CDM,99517264_1,"Destruction of cancer skin growth of trunk, arms, or legs, 3.1-4.0 cm",375.0,243.75,0.01,968.44,17
CDM,99517266_1,"Destruction of cancer skin growth of trunk, arms, or legs, more than 4.0 cm",425.0,276.25,0.01,1097.56,17
CDM,99517270_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",175.0,113.75,0.01,451.94,17
CDM,99517271_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",225.0,146.25,0.01,581.06,17
CDM,99517272_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",275.0,178.75,0.01,710.19,17
CDM,99517273_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",325.0,211.25,0.01,839.31,17
CDM,99517274_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",375.0,243.75,0.01,968.44,17
CDM,99517276_1,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",425.0,276.25,0.01,1097.56,17
CDM,99517280_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",175.0,113.75,0.01,451.94,17
CDM,99517281_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",225.0,146.25,0.01,581.06,17
CDM,99517282_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",275.0,178.75,0.01,710.19,17
CDM,99517283_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",325.0,211.25,0.01,839.31,17
CDM,99517284_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",375.0,243.75,0.01,968.44,17
CDM,99517286_1,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",425.0,276.25,0.01,1097.56,17
CDM,99517311_1,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks",1320.0,858.0,330.0,3408.9,19
CDM,99517312_1,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks",250.0,162.5,62.5,2166.29,19
CDM,99517313_1,"Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks",550.0,357.5,137.5,2318.31,19
CDM,99517314_1,"Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks",250.0,162.5,62.5,2166.29,19
CDM,99517315_1,"Removal and microscopic exam of growth, each additional block after 5 tissue blocks",250.0,162.5,62.5,2166.29,19
CDM,99517360_1,Chemical treatment of acne,170.0,110.5,0.01,439.03,17
CDM,99517999_1,"Other procedure on skin, mucous membrane, and tissue",175.0,113.75,0.01,451.94,17
CDM,99519000_1,"Aspiration of cyst of breast, first cyst",861.0,559.65,0.01,2223.53,17
CDM,99519020_1,Drainage of abscess of breast,3709.0,2410.85,0.01,9578.49,17
CDM,99519101_1,Biopsy of breast through incision,4020.0,2613.0,0.01,10381.65,17
CDM,99519120_1,"Removal of growth and tissue of breast, duct, or nipple",4020.0,2613.0,0.01,10381.65,17
CDM,99519300_1,Removal of extra breast tissue in male,4020.0,2613.0,0.01,10381.65,17
CDM,99519316_1,Repair for sagging of the breast,7507.5,4879.88,0.01,19388.12,17
CDM,99519328_1,Removal of intact breast implant,4458.0,2897.7,0.01,11512.79,17
CDM,99519330_1,Removal of ruptured breast implant and implant material,9210.0,5986.5,0.01,23784.83,17
CDM,99519350_1,Reconstruction of nipple or area around nipple,4020.0,2613.0,0.01,10381.65,17
CDM,99519355_1,Correction of inverted nipple,4020.0,2613.0,0.01,10381.65,17
CDM,99519380_1,Surgical change to reconstructed breast,7507.5,4879.88,0.01,19388.12,17
CDM,99520205_1,Deep biopsy of muscle,2270.0,1475.5,0.01,5862.28,17
CDM,99520206_1,Needle biopsy of muscle,2023.0,1314.95,0.01,5224.4,17
CDM,99520220_1,Biopsy of bone using needle or trocar,1300.0,845.0,0.01,3357.25,17
CDM,99520240_1,Biopsy of surface bone,2270.0,1475.5,0.01,5862.28,17
CDM,99520500_1,Injection for repair of abnormal muscle drainage tract,1936.0,1258.4,0.01,4999.72,17
CDM,99520526_1,Injection of carpal tunnel,361.5,234.98,0.01,933.57,17
CDM,99520550_1,Injection into tendon or ligament,361.5,234.98,0.01,933.57,17
CDM,99520551_1,Injection into tendon at attachment to bone or muscle,241.0,156.65,0.01,622.38,17
CDM,99520552_1,"Injection of trigger points, 1-2 muscles",241.0,156.65,0.01,622.38,17
CDM,99520553_1,"Injection of trigger points, 3 or more muscles",241.0,156.65,0.01,622.38,17
CDM,99520600_1,Aspiration and/or injection of fluid from small joint,361.5,234.98,0.01,933.57,17
CDM,99520604_1,Aspiration and/or injection of fluid from small joint using ultrasound guidance,399.0,259.35,0.01,1030.42,17
CDM,99520605_1,Aspiration and/or injection of fluid from medium joint,361.5,234.98,0.01,933.57,17
CDM,99520606_1,Aspiration and/or injection of fluid from medium joint using ultrasound guidance,459.0,298.35,0.01,1185.37,17
CDM,99520610_1,Aspiration and/or injection of fluid from large joint,714.0,464.1,0.01,1843.91,17
CDM,99520611_1,Aspiration and/or injection of fluid large joint using ultrasound guidance,412.5,268.13,0.01,1065.28,17
CDM,99520612_1,Aspiration and/or injection of cyst of tendon,241.0,156.65,0.01,622.38,17
CDM,99520650_1,Insertion of wire or pin to bone for traction,3500.0,2275.0,0.01,9038.75,17
CDM,99520670_1,Removal of surface implant from bone,1330.0,864.5,0.01,3435.36,17
CDM,99520680_1,Removal of deep implant from bone,2957.58,1922.43,0.01,7637.95,17
CDM,99520694_1,Removal of external bone stabilizing device under anesthesia,1270.0,825.5,0.01,3435.36,17
CDM,99520950_1,Placement of device in muscle to monitor fluid pressure,549.0,356.85,0.01,1417.79,17
CDM,99521011_1,"Removal of growth under skin of face or scalp, less than 2.0 cm",1330.0,864.5,0.01,3434.73,17
CDM,99521012_1,"Removal of growth under skin of face or scalp, 2.0 cm or more",1330.0,864.5,0.01,3434.73,17
CDM,99521013_1,"Removal of growth of muscle of face or scalp, less than 2.0 cm",1330.0,864.5,0.01,3434.73,17
CDM,99521014_1,"Removal of growth of muscle of face or scalp, 2.0 cm or more",1330.0,864.5,0.01,3434.73,17
CDM,99521025_1,Removal of lower jaw bone,4200.0,2730.0,0.01,10846.5,17
CDM,99521026_1,Removal of face bone,4200.0,2730.0,0.01,10846.5,17
CDM,99521029_1,Removal of growth of face bone,2183.0,1418.95,0.01,5637.6,17
CDM,99521030_1,Removal of growth or cyst of jaw or upper cheek,6300.0,4095.0,0.01,16269.75,17
CDM,99521031_1,Removal of bony growth of jaw bone inside mouth,3274.5,2128.43,0.01,8456.4,17
CDM,99521032_1,Removal of bony growth of upper jaw bone inside mouth,2183.0,1418.95,0.01,5637.6,17
CDM,99521040_1,Removal of growth or cyst of lower jaw bone,2183.0,1418.95,0.01,5637.6,17
CDM,99521085_1,Impression and custom preparation of oral surgical splint,452.0,293.8,0.01,2263.29,17
CDM,99521120_1,Implantation of graft to enlarge chin bone,4955.0,3220.75,0.01,12796.29,17
CDM,99521181_1,Reconstruction of skull bones with removal of bone growth,5010.0,3256.5,0.01,12938.33,17
CDM,99521210_1,Repair of nasal or cheek bone with bone graft,4200.0,2730.0,0.01,10846.5,17
CDM,99521215_1,Repair of lower jaw bone with bone graft,4200.0,2730.0,0.01,10846.5,17
CDM,99521235_1,Obtaining ear cartilage for grafting,4200.0,2730.0,0.01,10846.5,17
CDM,99521248_1,Reconstruction of part of lower or upper jaw bone with implant,5400.0,3510.0,0.01,13945.5,17
CDM,99521249_1,Complete reconstruction of lower or upper jaw bone with jaw bone implant (endosteal),6500.0,4225.0,0.01,16786.25,17
CDM,99521315_1,Closed treatment of broken nose bone with manipulation,1230.0,799.5,0.01,3176.48,17
CDM,99521320_1,Closed treatment of broken nose bone with placement of stabilizing device,2130.0,1384.5,0.01,5500.73,17
CDM,99521337_1,Closed treatment of broken bone separating nose airways,2130.0,1384.5,0.01,5500.73,17
CDM,99521440_1,Closed treatment of broken upper or lower jaw bone,2183.0,1418.95,0.01,5637.6,17
CDM,99521450_1,Closed treatment of broken lower jaw bone,452.0,293.8,0.01,1167.29,17
CDM,99521453_1,Closed treatment of broken lower jaw bone with placement of stabilizing device to teeth,4200.0,2730.0,1050.0,10846.5,19
CDM,99521485_1,Complicated repair of dislocated jaw joint with placement of stabilizing device,1313.0,853.45,0.01,3390.82,17
CDM,99521501_1,Drainage of deep abscess or blood accumulation in soft tissue of neck or chest,2340.0,1521.0,0.01,6043.05,17
CDM,99521552_1,"Removal of growth of soft tissue under skin of neck or front of chest, 3.0 cm or more",2250.0,1462.5,0.01,5810.63,17
CDM,99521554_1,"Removal of growth of muscle of neck or front of chest, 5.0 cm or more",2300.0,1495.0,0.01,5939.75,17
CDM,99521555_1,"Removal of growth under skin of neck or front of chest, less than 3.0 cm",1330.0,864.5,0.01,3435.92,17
CDM,99521556_1,"Removal of growth of muscle of neck or front of chest, less than 5.0 cm",2350.0,1527.5,0.01,6068.88,17
CDM,99521930_1,"Removal of growth under skin of back or lower sides, less than 3.0 cm",1330.0,864.5,0.01,3434.73,17
CDM,99521931_1,"Removal of growth under skin of back or lower sides, 3.0 cm or more",1330.0,864.5,0.01,3434.73,17
CDM,99521932_1,"Removal of growth of muscle of back or lower sides, less than 5.0 cm",2220.0,1443.0,0.01,5733.15,17
CDM,99521933_1,"Removal of growth of muscle of back or lower sides, 5.0 cm or more",2220.0,1443.0,0.01,5733.15,17
CDM,99523071_1,"Removal of growth under skin of shoulder area, 3.0 cm or more",3300.0,2145.0,0.01,8522.25,17
CDM,99523073_1,"Removal of growth of muscle of shoulder, 5.0 cm or more",3330.0,2164.5,0.01,8599.73,17
CDM,99523075_1,"Removal of growth under skin of shoulder area, less than 3.0 cm",1330.0,864.5,0.01,3434.73,17
CDM,99523330_1,"Removal of foreign body of shoulder joint, accessed beneath the skin",549.0,356.85,0.01,2655.52,17
CDM,99523500_1,Closed treatment of broken collar bone,967.5,628.88,0.01,2498.57,17
CDM,99523570_1,Closed treatment of broken shoulder blade,315.0,204.75,0.01,813.49,17
CDM,99523600_1,Closed treatment of broken top of upper arm bone,967.5,628.88,0.01,2498.57,17
CDM,99523620_1,Closed treatment of upper arm bone broken at shoulder joint,1582.5,1028.63,0.01,4086.81,17
CDM,99523650_1,Closed treatment of dislocated shoulder with manipulation,339.0,220.35,0.01,875.47,17
CDM,99524071_1,"Removal of growth under skin of upper arm or elbow, 3.0 cm or more",7815.0,5079.75,0.01,20182.24,17
CDM,99524075_1,"Removal of growth under skin of upper arm or elbow, less than 3.0 cm",1980.0,1287.0,0.01,5113.35,17
CDM,99524200_1,"Removal of foreign body of upper arm or elbow area, accessed beneath the skin",1370.0,890.5,0.01,3538.03,17
CDM,99524500_1,Closed treatment of broken middle part of upper arm bone,907.5,589.88,0.01,2343.62,17
CDM,99524505_1,Closed treatment of broken middle part of upper arm bone with manipulation,1920.0,1248.0,0.01,4958.4,17
CDM,99524530_1,Closed treatment of upper arm bone broken at elbow,1383.0,898.95,0.01,3571.6,17
CDM,99524640_1,"Closed treatment of dislocated forearm bone on thumb side at elbow with manipulation, child",967.5,628.88,0.01,2498.57,17
CDM,99524650_1,Closed treatment of broken forearm bone on thumb side at elbow,967.5,628.88,0.01,2498.57,17
CDM,99524655_1,Closed treatment of broken forearm bone on thumb side at elbow with manipulation,5476.5,3559.73,0.01,14143.06,17
CDM,99524670_1,Closed treatment of broken forearm bone on small finger side at elbow,810.0,526.5,0.01,2091.83,17
CDM,99525000_1,Incision or the tendon covering on the top side of the wrist,9300.0,6045.0,2325.0,24017.25,19
CDM,99525075_1,"Removal of growth under skin of forearm or wrist, less than 3.0 cm",1995.0,1296.75,0.01,5152.09,17
CDM,99525076_1,"Removal of growth of muscle of forearm or wrist, less than 3.0 cm",1400.0,910.0,0.01,3615.5,17
CDM,99525112_1,Removal of recurrent cyst of wrist,3685.0,2395.25,0.01,9516.51,17
CDM,99525116_1,Extensive removal of growth of soft tissue structures in top side of wrist,6500.0,4225.0,0.01,16786.25,17
CDM,99525505_1,Closed treatment of broken midpart of forearm bone on thumb side with manipulation,3651.0,2373.15,0.01,9428.71,17
CDM,99525530_1,Closed treatment of broken midpart of forearm bone on small finger side,1011.0,657.15,0.01,2610.91,17
CDM,99525600_1,Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation,967.5,628.88,0.01,2498.57,17
CDM,99525622_1,Closed treatment of broken wrist bone near base of thumb,1086.0,705.9,0.01,2804.6,17
CDM,99525630_1,Closed treatment of other broken wrist bone,2041.5,1326.98,0.01,5272.17,17
CDM,99525650_1,Closed treatment of broken base of forearm bone on small finger side at wrist,1806.0,1173.9,0.01,4664.0,17
CDM,99526010_1,Simple drainage of abscess of finger,507.0,329.55,0.01,1309.33,17
CDM,99526011_1,Complicated drainage of abscess in finger,3709.0,2410.85,0.01,9578.49,17
CDM,99526040_1,Release of tissue of palm,10500.0,6825.0,1897.99,27116.25,19
CDM,99526055_1,Incision of tendon covering of finger,3600.0,2340.0,900.0,9297.0,19
CDM,99526060_1,Incision of finger tendon,1340.0,871.0,0.01,3460.55,17
CDM,99526080_1,"Incision of finger joint for exploration, fluid drainage, or removal of foreign body",6800.0,4420.0,1700.0,17561.0,19
CDM,99526115_1,Removal (less than 1.5 centimeters) tissue beneath the skin growth of hand or finger,2975.0,1933.75,0.01,7682.94,17
CDM,99526160_1,Removal of growth of tendon finger or hand,6000.0,3900.0,1500.0,15495.0,19
CDM,99526600_1,Closed treatment of broken hand bone,645.0,419.25,0.01,1665.71,17
CDM,99526605_1,Closed treatment of broken hand bone with manipulation,1414.0,919.1,0.01,3651.66,17
CDM,99526720_1,Closed treatment of broken finger or thumb at midportion or part near hand,645.0,419.25,0.01,1665.71,17
CDM,99526725_1,Closed treatment of broken finger or thumb at midportion or part near hand with manipulation,1058.0,687.7,0.01,2732.29,17
CDM,99526750_1,Closed treatment of broken end of finger or thumb,686.0,445.9,0.01,1771.6,17
CDM,99526770_1,Closed treatment of dislocated finger joint with manipulation,1014.0,659.1,0.01,2618.66,17
CDM,99526951_1,Amputation of finger or thumb with direct closure,7200.0,4680.0,1800.0,18594.0,19
CDM,99527043_1,"Removal of growth under skin of pelvis and hip, 3.0 cm or more",5526.0,3591.9,0.01,14270.9,17
CDM,99527045_1,"Removal of growth of muscle of pelvis and hip, 5.0 cm or more",3450.0,2242.5,0.01,8909.63,17
CDM,99527047_1,"Removal of growth under skin of pelvis and hip, less than 3.0 cm",2270.0,1475.5,0.01,5862.28,17
CDM,99527086_1,"Removal of foreign body in tissue of pelvis or hip, accessed beneath the skin",1330.0,864.5,0.01,3434.73,17
CDM,99527220_1,Closed treatment of broken hip socket,315.0,204.75,0.01,813.49,17
CDM,99527323_1,Biopsy of surface tissue of thigh or knee,5563.5,3616.28,0.01,14367.74,17
CDM,99527327_1,"Removal of growth under skin of thigh or knee, 3.0 cm or more",1995.0,1296.75,0.01,5152.09,17
CDM,99527328_1,"Removal of growth of muscle of thigh or knee, 5.0 cm or less",3330.0,2164.5,0.01,8599.73,17
CDM,99527337_1,"Removal of growth under skin of thigh or knee, less than 3.0 cm",3405.0,2213.25,0.01,8793.41,17
CDM,99527501_1,Closed treatment of broken thigh bone at lower end,3369.0,2189.85,0.01,8700.44,17
CDM,99527508_1,Closed treatment of broken inside or outside portion of lower end of thigh bone,2370.0,1540.5,0.01,6120.53,17
CDM,99527520_1,Closed treatment of broken kneecap,1792.5,1165.13,0.01,4629.13,17
CDM,99527530_1,Closed treatment of broken shin bone,1596.0,1037.4,0.01,4121.67,17
CDM,99527619_1,"Removal of growth of muscle of leg or ankle, less than 5.0 cm",3405.0,2213.25,0.01,8793.41,17
CDM,99527750_1,Closed treatment of broken middle part of shin bone,2113.5,1373.78,0.01,5458.11,17
CDM,99527760_1,Closed treatment of inside portion of shin bone at ankle,1240.5,806.33,0.01,3203.59,17
CDM,99527786_1,Closed treatment of broken outside lower leg bone at ankle,967.5,628.88,0.01,2498.57,17
CDM,99527808_1,Closed treatment of 2 broken lower leg bones at ankle,1260.0,819.0,0.01,3253.95,17
CDM,99527816_1,Closed treatment of 3 broken lower leg bones at ankle,1017.0,661.05,0.01,2626.4,17
CDM,99527818_1,Closed treatment of 3 broken lower leg bones at ankle with manipulation,3850.0,2502.5,0.01,9942.63,17
CDM,99527840_1,Closed treatment of dislocated ankle,1407.0,914.55,0.01,3633.58,17
CDM,99528011_1,Repair of multiple toe tendons,2660.0,1729.0,0.01,6869.45,17
CDM,99528190_1,"Removal of foreign body of foot tissue, accessed beneath the skin",2578.5,1676.03,0.01,6658.98,17
CDM,99528400_1,Closed treatment of broken heel bone,1068.0,694.2,0.01,2758.11,17
CDM,99528450_1,Treatment of broken foot bone at ankle,745.0,484.25,0.01,1923.96,17
CDM,99528470_1,Closed treatment of broken bone in forefoot or midfoot,597.0,388.05,0.01,1541.75,17
CDM,99528475_1,Closed treatment of broken foot with manipulation,210.0,136.5,0.01,682.63,17
CDM,99528490_1,Closed treatment of broken great toe,775.5,504.08,0.01,2002.73,17
CDM,99528510_1,Closed treatment of broken toe,285.0,185.25,0.01,736.01,17
CDM,99528600_1,Closed treatment of dislocated midfoot joint,451.0,293.15,0.01,1164.71,17
CDM,99528825_1,Amputation of toe at toe joint,2500.0,1625.0,0.01,6456.25,17
CDM,99529065_1,Application of shoulder to hand cast,410.0,266.5,0.01,1058.83,17
CDM,99529075_1,Application of elbow to finger cast,535.5,348.08,0.01,1382.93,17
CDM,99529105_1,Application of lower and upper arm splint,462.0,300.3,0.01,1193.12,17
CDM,99529125_1,Application of nonmoveable forearm to hand splint,436.5,283.73,0.01,1127.26,17
CDM,99529126_1,Application of moveable or hinged forearm to hand splint,358.0,232.7,0.01,924.54,17
CDM,99529130_1,Application of nonmoveable finger splint,346.5,225.23,0.01,894.84,17
CDM,99529280_1,Placement of strapping to hand or finger,57.0,37.05,0.01,147.2,17
CDM,99529345_1,Application of long leg cast from thigh to toe,511.0,332.15,0.01,1319.66,17
CDM,99529355_1,Application of walking cast covering thigh to toe,231.0,150.15,0.01,596.56,17
CDM,99529365_1,Application of thigh to lower leg cylinder cast,231.0,150.15,0.01,596.56,17
CDM,99529405_1,Application of short leg cast,1048.5,681.53,0.01,2707.75,17
CDM,99529515_1,Application of short leg splint from calf to foot,421.5,273.98,0.01,1088.52,17
CDM,99529550_1,Placement of strapping to toes,198.0,128.7,0.01,511.34,17
CDM,99529580_1,"Strapping, Unna boot",384.0,249.6,0.01,991.68,17
CDM,99529581_1,"Application of vein wound compression bandages on lower leg, ankle, and foot",484.5,314.93,0.01,1251.22,17
CDM,99529700_1,"Removal or cutting of gauntlet, boot, or body cast",231.0,150.15,0.01,596.56,17
CDM,99530000_1,Drainage of abscess or blood accumulation of nose,225.0,146.25,0.01,581.06,17
CDM,99530020_1,Drainage of abscess or blood accumulation of nasal cartilage,475.0,308.75,0.01,2075.68,17
CDM,99530100_1,Biopsy of lining of nose,1230.0,799.5,0.01,3176.48,17
CDM,99530110_1,Simple removal of nasal polyp,2800.0,1820.0,0.01,7231.0,17
CDM,99530117_1,Removal or destruction of growth of nose through nose,2650.0,1722.5,0.01,6843.63,17
CDM,99530120_1,Removal or scraping of skin on nose,2183.0,1418.95,0.01,5637.6,17
CDM,99530140_1,Removal of nasal air passage under lining tissue,5900.0,3835.0,0.01,15236.75,17
CDM,99530150_1,Partial removal of nose,10735.0,6977.75,0.01,27723.14,17
CDM,99530220_1,Insertion of implant to close nasal passage,1230.0,799.5,0.01,3176.48,17
CDM,99530300_1,Removal of foreign body in nose,361.0,234.65,0.01,932.28,17
CDM,99530400_1,Reshaping of tip of nose,4860.0,3159.0,0.01,12550.95,17
CDM,99530430_1,Revision to reshape nose or small amount of tip of nose after previous repair,4860.0,3159.0,0.01,12550.95,17
CDM,99530435_1,Revision to reshape nasal bones after previous repair,5035.0,3272.75,0.01,13002.89,17
CDM,99530460_1,Revision of congenital nasal defect to lengthen tip of nose,4635.0,3012.75,0.01,11969.89,17
CDM,99530465_1,Repair of nasal passage,4635.0,3012.75,0.01,11969.89,17
CDM,99530560_1,Release of nasal scar tissue,450.0,292.5,0.01,2075.68,17
CDM,99530580_1,Repair of abnormal drainage tract between nasal sinuses,4200.0,2730.0,0.01,10846.5,17
CDM,99530801_1,Destruction of soft tissue of nasal passages,1230.0,799.5,0.01,3176.48,17
CDM,99530802_1,Destruction of surface soft tissue of nasal passages,1230.0,799.5,0.01,3879.59,17
CDM,99530901_1,Simple control of nose bleed,552.0,358.8,0.01,1425.54,17
CDM,99530903_1,Complex control of nose bleed,745.5,484.58,0.01,1925.25,17
CDM,99531231_1,Diagnostic exam of nasal passages using an endoscope,156.0,101.4,0.01,402.87,17
CDM,99531237_1,Biopsy or removal of nasal polyp or tissue using an endoscope,1918.5,1247.03,0.01,4954.53,17
CDM,99531238_1,Control of bleeding of nose using an endoscope,1980.0,1287.0,0.01,5113.35,17
CDM,99531243_1,Destruction of nasal nerve by freezing using an endoscope,15000.0,9750.0,0.01,38737.5,15
CDM,99531296_1,Dilation of frontal nasal sinus using an endoscope,7800.0,5070.0,0.01,20143.5,17
CDM,99531525_1,Diagnostic exam of voice box using an endoscope,1320.0,858.0,330.0,3726.0,19
CDM,99531570_1,Injection into vocal cords using an endoscope,7850.0,5102.5,1962.5,20272.63,19
CDM,99531572_1,Removal or destruction of growth of side of voice box using an endoscope,11775.0,7653.75,2318.31,30408.94,19
CDM,99531573_1,Injection of drug into side of voice box using an endoscope,6006.0,3903.9,1501.5,15510.5,19
CDM,99531574_1,Injection of substance to augment voice box using an endoscope,6006.0,3903.9,1501.5,15510.5,19
CDM,99531575_1,Diagnostic exam of voice box using a flexible endoscope,370.0,240.5,92.5,2318.31,19
CDM,99531576_1,Biopsy of voice box using a flexible endoscope,3890.0,2528.5,0.01,10045.93,17
CDM,99531579_1,Exam to assess movement of vocal cord flaps using an endoscope,372.0,241.8,93.0,2318.31,19
CDM,99531613_1,Simple revision of permanent opening of windpipe for breathing,5910.0,3841.5,0.01,15262.58,17
CDM,99531615_1,Exam of windpipe and lung airways through permanent windpipe opening using an endoscope,452.0,293.8,113.0,2659.49,19
CDM,99531622_1,Diagnostic exam of lung airway using an endoscope,1320.0,858.0,330.0,3726.0,19
CDM,99531820_1,Closure of permanent windpipe opening or abnormal drainage tract,5900.0,3835.0,0.01,15236.75,17
CDM,99531825_1,Closure of permanent windpipe opening or abnormal drainage tract with plastic repair,2510.0,1631.5,0.01,6482.08,17
CDM,99531830_1,Revision of permanent windpipe opening scar,2110.0,1371.5,0.01,5449.08,17
CDM,99532552_1,Removal of indwelling tube in lining of lung,694.0,451.1,0.01,1792.26,17
CDM,99532554_1,Aspiration of fluid from chest cavity,1041.0,676.65,0.01,2688.38,17
CDM,99532555_1,Aspiration of fluid from chest cavity using imaging guidance,4005.0,2603.25,0.01,10342.91,17
CDM,99536000_1,Insertion of needle or tube into vein,282.0,183.3,0.01,728.27,17
CDM,99536415_1,Insertion of needle into vein for collection of blood sample,12.0,7.8,3.0,30.99,19
CDM,99536416_1,Puncture of skin for collection of blood sample,23.0,14.95,3.11,59.4,19
CDM,99536468_1,"Injection of chemical agent into spider vein of arm, leg, or trunk",163.0,105.95,40.75,2166.29,19
CDM,99536470_1,Injection of chemical agent into single incompetent vein,525.0,341.25,131.25,2166.29,19
CDM,99536471_1,Injection of chemical agent into multiple incompetent veins of leg,453.0,294.45,113.25,2166.29,19
CDM,99536475_1,Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance,4000.0,2600.0,1000.0,10330.0,19
CDM,99536478_1,Laser destruction of incompetent vein of arm or leg using imaging guidance,6000.0,3900.0,1500.0,15495.0,19
CDM,99536479_1,"Laser destruction of incompetent veins of arm or leg using imaging guidance, subsequent",620.0,403.0,155.0,4036.25,19
CDM,99536482_1,Chemical destruction of first incompetent vein of arm or leg using imaging guidance,4655.0,3025.75,0.01,12021.54,17
CDM,99536569_1,Insertion of tube for infusion (5 years or older),3199.0,2079.35,0.01,8261.42,17
CDM,99536589_1,Removal of tunneled central venous tube,3948.0,2566.2,0.01,10195.71,17
CDM,99536590_1,Removal of central venous tube with port or pump,5482.0,3563.3,0.01,14157.27,17
CDM,99536591_1,Collection of blood sample from implanted device,238.0,154.7,59.5,614.64,19
CDM,99536592_1,Collection of blood sample from central venous tube,238.0,154.7,59.5,614.64,19
CDM,99537609_1,Tying or biopsy of artery on side of skull,1995.0,1296.75,0.01,5152.09,17
CDM,99537722_1,"Tying, incision, and stripping of long leg vein",7305.0,4748.25,0.01,18865.16,17
CDM,99537760_1,"Tying of varicose veins, radical procedure including skin graft",2520.0,1638.0,0.01,6507.9,17
CDM,99537765_1,"Removal of varicose veins of arm or leg, 10-20 incisions",3780.0,2457.0,0.01,9761.85,17
CDM,99537766_1,"Removal of varicose veins of arm or leg, more than 20 incisions",3780.0,2457.0,0.01,9761.85,17
CDM,99537785_1,"Tying, incision, and/or removal of varicose vein clusters of leg",2520.0,1638.0,0.01,6507.9,17
CDM,99537799_1,Other procedure on blood vessel,1440.0,936.0,0.01,3718.8,17
CDM,99538510_1,Biopsy or removal of deep lymph nodes of neck,11244.0,7308.6,0.01,29037.63,17
CDM,99538790_1,Injection procedure for imaging of lymphatic system,393.0,255.45,0.01,1014.92,17
CDM,99540490_1,Biopsy of lip,187.0,121.55,0.01,482.93,17
CDM,99540500_1,Removal of border of lip,2210.0,1436.5,0.01,5707.33,17
CDM,99540510_1,Removal of wedge of lip tissue with closure,2110.0,1371.5,0.01,5449.08,17
CDM,99540520_1,V-shaped removal of lip tissue,2150.0,1397.5,0.01,5552.38,17
CDM,99540654_1,Repair of vertical lip wound extending to over half of lip,2572.0,1671.8,0.01,6642.19,17
CDM,99540799_1,Other procedure on lip,204.0,132.6,0.01,2075.68,17
CDM,99540800_1,"Simple drainage of abscess, cyst, or blood accumulation of mouth",549.0,356.85,0.01,1775.48,17
CDM,99540801_1,"Complicated drainage of abscess, cyst, or blood accumulation of mouth",452.0,293.8,0.01,1775.48,17
CDM,99540804_1,Simple removal of embedded foreign body in mouth,273.0,177.45,0.01,1775.48,17
CDM,99540808_1,Biopsy of mouth,452.0,293.8,0.01,1775.48,17
CDM,99540810_1,Removal of growth of tissue of mouth,2183.0,1418.95,0.01,5637.6,17
CDM,99540812_1,Removal of growth of mouth with simple repair,2183.0,1418.95,0.01,5637.6,17
CDM,99540819_1,Removal of tissue at dental edge and cheek,1230.0,799.5,0.01,3176.48,17
CDM,99540820_1,Destruction of growth or scar of mouth,2500.0,1625.0,0.01,6456.25,17
CDM,99540840_1,Repair to increase depth of front portion of mouth,4200.0,2730.0,0.01,10846.5,17
CDM,99541009_1,"Drainage of abscess, cyst, or blood accumulation under lower teeth from inside mouth",452.0,293.8,0.01,2075.68,17
CDM,99541010_1,Incision of tissue connecting tongue and floor of mouth,1707.0,1109.55,0.01,4408.33,17
CDM,99541016_1,"Drainage of abscess, cyst, or blood accumulation beneath chin from outside mouth",4200.0,2730.0,0.01,10846.5,17
CDM,99541100_1,Biopsy of front 2/3 of tongue,1296.0,842.4,0.01,3346.92,17
CDM,99541105_1,Biopsy of back 1/3 of tongue,2587.0,1681.55,0.01,6680.93,17
CDM,99541108_1,Biopsy of floor of mouth,3709.0,2410.85,0.01,9578.49,17
CDM,99541110_1,Removal of growth of tongue without closure,2183.0,1418.95,0.01,5637.6,17
CDM,99541112_1,Removal of growth of front 2/3 of tongue with switches,2500.0,1625.0,0.01,6456.25,17
CDM,99541113_1,Removal of growth of back 1/3 of tongue with suturing,2500.0,1625.0,0.01,6456.25,17
CDM,99541115_1,Removal of tissue connecting tongue and floor of mouth,1230.0,799.5,0.01,3176.48,17
CDM,99541116_1,Removal of growth of floor of mouth,2183.0,1418.95,0.01,5637.6,17
CDM,99541800_1,"Drainage of abscess, cyst, or blood accumulation of dental bone",444.0,288.6,0.01,1146.63,17
CDM,99541805_1,Removal of embedded foreign body in soft tissue of tooth bearing bone,1230.0,799.5,0.01,3176.48,17
CDM,99541820_1,Removal of overgrown gum tissue,2183.0,1418.95,0.01,5637.6,17
CDM,99541821_1,Removal of gum tissue around tooth,1230.0,799.5,0.01,3176.48,17
CDM,99541822_1,Removal of tissue fiber at dental bone,1230.0,799.5,0.01,3176.48,17
CDM,99541823_1,Removal of dental bone,4200.0,2730.0,0.01,10846.5,17
CDM,99541825_1,Removal of dental bone growth,2183.0,1418.95,0.01,5637.6,17
CDM,99541826_1,Removal of dental bone growth with simple repair,2183.0,1418.95,0.01,5637.6,17
CDM,99541828_1,Removal of enlarged membrane covering of teeth or tooth socket,2183.0,1418.95,0.01,5637.6,17
CDM,99541830_1,Removal of tissue overgrowth at teeth or tooth socket,2183.0,1418.95,0.01,5637.6,17
CDM,99541870_1,Graft of mouth tissue lining to gum surface,2183.0,1418.95,0.01,5637.6,17
CDM,99541872_1,Reshaping of gum,2183.0,1418.95,0.01,5637.6,17
CDM,99541874_1,Reshaping of tooth socket,2183.0,1418.95,0.01,5637.6,17
CDM,99541899_1,Other procedure on teeth and gums,187.0,121.55,0.01,1775.48,17
CDM,99542000_1,Drainage of abscess of roof of mouth,384.0,249.6,0.01,991.68,17
CDM,99542100_1,Biopsy of roof of mouth,1230.0,799.5,0.01,3176.48,17
CDM,99542104_1,Removal of growth of roof of mouth,2183.0,1418.95,0.01,5637.6,17
CDM,99542106_1,Removal of growth of roof of mouth with simple closure,7780.0,5057.0,0.01,20091.85,17
CDM,99542299_1,Other procedure on roof of mouth,558.5,363.03,0.01,1775.48,17
CDM,99542405_1,Biopsy of saliva gland,2183.0,1418.95,0.01,5637.6,17
CDM,99542408_1,Removal of salivary cyst under tongue,2183.0,1418.95,0.01,5637.6,17
CDM,99542700_1,Drainage of abscess near tonsil,536.0,348.4,0.01,1384.22,17
CDM,99542800_1,Biopsy of back of throat,2183.0,1418.95,0.01,5637.6,17
CDM,99542808_1,Removal or destruction of growth of throat,2183.0,1418.95,0.01,5637.6,17
CDM,99542809_1,Removal of foreign body in throat,358.0,232.7,0.01,924.54,17
CDM,99542810_1,Removal of congenital skin and tissue cyst of neck,2650.0,1722.5,0.01,6843.63,17
CDM,99542815_1,Removal of congenital cyst or abnormal drainage tract of neck and/or throat,7365.0,4787.25,0.01,19020.11,17
CDM,99545005_1,Drainage of superficial rectal abscess,950.0,617.5,0.01,2453.38,17
CDM,99545300_1,Diagnostic exam of rectum and lower large bowel using an endoscope,685.0,445.25,0.01,1769.01,17
CDM,99545305_1,Biopsies of rectum and/or lower large bowel using a rigid endoscope,950.0,617.5,0.01,2453.38,17
CDM,99546020_1,Insertion of drain (seton) into anus,2230.0,1449.5,0.01,5758.98,17
CDM,99546030_1,Removal of drain (seton) from anus,950.0,617.5,0.01,2453.38,17
CDM,99546040_1,Drainage of deep abscess in rectum,950.0,617.5,0.01,2453.38,17
CDM,99546050_1,Drainage of superficial rectal abscess surrounding anus,677.0,440.05,0.01,2134.09,17
CDM,99546083_1,Incision of external hemorrhoid with blood clot,346.0,224.9,0.01,2134.09,17
CDM,99546221_1,Removal of external hemorrhoids by rubber banding,677.0,440.05,0.01,2134.09,17
CDM,99546230_1,Removal of multiple external noncancer growths of anus,5140.0,3341.0,0.01,13274.05,17
CDM,99546320_1,Removal of external hemorrhoid with blood clot,950.0,617.5,0.01,2453.38,17
CDM,99546600_1,Diagnostic exam of anus using an endoscope,110.0,71.5,0.01,577.24,17
CDM,99546604_1,Dilation of anus using an endoscope,950.0,617.5,0.01,2453.38,17
CDM,99546606_1,Biopsy of anus using an endoscope,950.0,617.5,0.01,2453.38,17
CDM,99546900_1,Simple chemical destruction of growth of anus,302.0,196.3,0.01,2134.09,17
CDM,99546910_1,Simple destruction of growth of anus,1580.0,1027.0,0.01,4080.35,17
CDM,99546916_1,Electrical destruction of growth of anus,170.0,110.5,0.01,2134.09,17
CDM,99546917_1,Laser destruction of growth of anus,2330.0,1514.5,0.01,6017.23,17
CDM,99546922_1,Simple removal of growth of anus,2230.0,1449.5,0.01,5758.98,17
CDM,99546924_1,Extensive destruction of growth of anus,2230.0,1449.5,0.01,5758.98,17
CDM,99549083_1,Drainage of fluid from abdominal cavity using imaging guidance,1272.0,826.8,0.01,3284.94,17
CDM,99549591_1,"Initial repair of sliding hernia of abdomen, less than 3 cm in length",8480.0,5512.0,0.01,21899.6,17
CDM,99551102_1,Aspiration of bladder with insertion of bladder tube to skin,2543.0,1652.95,0.01,6567.3,17
CDM,9955115A_1,Professional service for single injection of allergen,55.0,35.75,13.75,208.0,19
CDM,9955115E_1,Professional service for single injection of allergen,45.0,29.25,11.25,208.0,19
CDM,9955117A_1,Professional service for multiple injections of allergen,55.0,35.75,13.75,208.0,19
CDM,9955117E_1,Professional service for multiple injections of allergen,45.0,29.25,11.25,208.0,19
CDM,9955165A_1,Professional service for preparation and provision of 1 or more antigens,50.0,32.5,12.5,208.0,19
CDM,9955165E_1,Professional service for preparation and provision of 1 or more antigens,50.0,32.5,12.5,208.0,19
CDM,99551700_1,Simple bladder irrigation and/or instillation,226.0,146.9,0.01,583.65,17
CDM,99551701_1,Insertion of temporary bladder tube,110.0,71.5,0.01,284.08,17
CDM,99551702_1,Simple insertion of temporary bladder tube,110.0,71.5,0.01,284.08,17
CDM,99551703_1,Complicated insertion of bladder tube,137.0,89.05,0.01,353.8,17
CDM,99551705_1,Simple change of bladder tube,226.0,146.9,0.01,583.65,17
CDM,99551710_1,Complicated change of bladder tube,559.0,363.35,0.01,1443.62,17
CDM,99551715_1,Injection of implant material beneath lining of bladder and/or urethra using an endoscope,2790.0,1813.5,0.01,7205.18,17
CDM,99551720_1,Instillation of anti-cancer drug into bladder,559.0,363.35,0.01,1443.62,17
CDM,99551725_1,Simple measurement of pressure of urine flow in bladder,585.0,380.25,0.01,1510.76,17
CDM,99551726_1,Complex measurement of pressure of urine flow in bladder,600.0,390.0,150.0,1549.5,18
CDM,99551728_1,Complex measurement of pressure of urine flow in bladder with voiding pressure studies,600.0,390.0,150.0,1549.5,18
CDM,99551729_1,Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies,600.0,390.0,150.0,1549.5,18
CDM,99551741_1,Electronic assessment of bladder emptying,137.0,89.05,34.25,598.79,18
CDM,99551784_1,Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings,746.0,484.9,186.5,1926.55,19
CDM,99551785_1,Needle measurement and recording of electrical activity of muscles at bladder and bowel openings,240.0,156.0,0.01,619.8,17
CDM,99551797_1,Insertion of device into abdomen with pressure and urine flow rate study,372.0,241.8,93.0,960.69,19
CDM,99551798_1,Ultrasound measurement of bladder capacity after voiding,65.0,42.25,16.25,208.0,19
CDM,99552000_1,Diagnostic exam of bladder and urethra using an endoscope,850.0,552.5,0.01,2310.6,17
CDM,99552204_1,Biopsy of bladder using an endoscope,1654.0,1075.1,0.01,4271.46,17
CDM,99552224_1,"Destruction of growth of bladder and urethra using an endoscope, less than 0.5 cm",1654.0,1075.1,0.01,4271.46,17
CDM,99552234_1,"Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm",3094.0,2011.1,0.01,7990.26,17
CDM,99552281_1,Dilation of urethra using an endoscope,1654.0,1075.1,0.01,4271.46,17
CDM,99552283_1,Steroid injection into urethra stricture using an endoscope,1795.0,1166.75,0.01,4635.59,17
CDM,99552287_1,Exam with injections of chemical for destruction of bladder using an endoscope,1654.0,1075.1,0.01,4271.46,17
CDM,99552310_1,"Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope",1750.0,1137.5,0.01,4519.38,17
CDM,99552315_1,"Complicated removal of foreign body, stone, or stent in urethra or bladder using an endoscope",1750.0,1137.5,0.01,4519.38,17
CDM,99552332_1,Insertion of stent in ureter using an endoscope,4185.0,2720.25,0.01,10807.76,17
CDM,99553060_1,Drainage of abscess or cyst of Skene's glands,3730.0,2424.5,0.01,9632.73,17
CDM,99553200_1,Biopsy of urethra,2551.0,1658.15,0.01,6587.96,17
CDM,99553454_1,Adjustment of fluid volume in adjustable balloon continence device beside urethra,570.0,370.5,0.01,1472.03,17
CDM,99553600_1,Initial dilation of urethra in male using dilator,226.0,146.9,0.01,583.65,17
CDM,99553660_1,Initial dilation of urethra in female,137.0,89.05,0.01,353.8,17
CDM,99553661_1,Subsequent dilation of urethra in female,110.0,71.5,0.01,284.08,17
CDM,99553899_1,Other procedure on urinary system,4534.0,2947.1,1133.5,11709.06,19
CDM,99554001_1,Incision of foreskin,1654.0,1075.1,0.01,4271.46,17
CDM,99554050_1,Simple destruction of growths of penis using chemical,302.0,196.3,0.01,779.92,17
CDM,99554055_1,Simple destruction of growth of penis using electric current,1490.0,968.5,0.01,3847.93,17
CDM,99554056_1,Simple destruction of growth of penis using freezing,163.0,105.95,0.01,598.79,17
CDM,99554057_1,Simple destruction of growth of penis using laser,1580.0,1027.0,0.01,4080.35,17
CDM,99554060_1,Removal of growth of penis,1490.0,968.5,0.01,3847.93,17
CDM,99554065_1,Destruction of multiple growths of penis,1490.0,968.5,0.01,3847.93,17
CDM,99554100_1,Biopsy of penis,1330.0,864.5,0.01,3434.73,17
CDM,99554105_1,Biopsy of deep structure of penis,2270.0,1475.5,0.01,5862.28,17
CDM,99554150_1,Removal of foreskin using clamp or device,1654.0,1075.1,0.01,4271.46,17
CDM,99554162_1,Removal of scar tissue after foreskin removal,1660.0,1079.0,0.01,4286.95,17
CDM,99554200_1,Injection procedure to correct thickened penile tissue,226.0,146.9,0.01,583.65,17
CDM,99554235_1,Injection procedure to cause erection,226.0,146.9,0.01,583.65,17
CDM,99554500_1,Needle biopsy of testicle,2250.0,1462.5,0.01,5810.63,17
CDM,99555000_1,Aspiration of fluid collection in testicle and sperm reservoir,823.5,535.28,0.01,2126.69,17
CDM,99555100_1,Drainage of abscess of scrotum,1330.0,864.5,0.01,3511.34,17
CDM,99555250_1,Removal of sperm duct,1654.0,1075.1,0.01,4271.46,17
CDM,99555700_1,Biopsy of prostate gland,1654.0,1075.1,0.01,4271.46,17
CDM,99555705_1,Incisional biopsy of prostate gland,7990.0,5193.5,0.01,20634.18,17
CDM,99555707_1,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",9005.0,5853.25,0.01,23255.41,15
CDM,99555708_1,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE, FIRST TARGETED LESION",9005.0,5853.25,0.01,23255.41,15
CDM,99555709_1,"BIOPSY, PROSTATE, TRANSPERINEAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",9005.0,5853.25,0.01,23255.41,15
CDM,99555711_1,"BIOPSY, PROSTATE, TRANSRECTAL, MRI-ULTRASOUND-FUSION GUIDED, TARGETED LESION(S) ONLY, FIRST TARGETED LESION",9005.0,5853.25,0.01,23255.41,15
CDM,99555715_1,"BIOPSY, PROSTATE, EACH ADDITIONAL, MRI-ULTRASOUND FUSION OR IN-BORE CT- OR MRI-GUIDED TARGETED LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",5000.0,3250.0,0.01,12912.5,15
CDM,99555874_1,Injection of biodegradable material next to prostate,10520.0,6838.0,2166.29,27167.9,19
CDM,99555876_1,Placement of device in prostate for radiation therapy,1150.0,747.5,0.01,2969.88,17
CDM,99555899_1,Other procedure on male genital system,585.0,380.25,0.01,3511.34,17
CDM,99556405_1,Incision and drainage of abscess of external female genitals,632.5,411.13,0.01,1633.43,17
CDM,99556420_1,Incision and drainage of abscess of female genital gland,380.0,247.0,0.01,981.35,17
CDM,99556501_1,Simple destruction of growth of external female genitals,1490.0,968.5,0.01,3847.93,17
CDM,99556515_1,Extensive destruction of growth of external female genitals,2514.0,1634.1,0.01,6492.41,17
CDM,99556605_1,"Biopsy of growth of external female genitals, first growth",560.0,364.0,0.01,1446.2,17
CDM,99556606_1,"Biopsy of growth of external female genitals, each additional growth",50.0,32.5,0.01,789.07,17
CDM,99556620_1,Simple partial removal of external female genitals,2540.0,1651.0,0.01,6559.55,17
CDM,99556800_1,Plastic repair of vaginal opening,2391.0,1554.15,0.01,6174.76,17
CDM,99556820_1,Exam of external female genitals using an endoscope,357.0,232.05,0.01,921.95,17
CDM,99556821_1,Exam and biopsy of external female genitals using an endoscope,635.0,412.75,0.01,1639.89,17
CDM,99557061_1,Simple destruction of growth of vagina,2250.0,1462.5,0.01,5810.63,17
CDM,99557100_1,Simple biopsy of vaginal mucous membrane,676.0,439.4,0.01,1745.77,17
CDM,99557135_1,Removal of cyst or growth of vaginal,7165.0,4657.25,0.01,18503.61,17
CDM,99557160_1,Fitting and insertion of vaginal support device,162.0,105.3,0.01,418.37,17
CDM,99557250_1,Repair of herniated rectum into vaginal wall,11875.0,7718.75,0.01,30667.19,17
CDM,99557420_1,Exam of vagina and cervix using an endoscope,286.0,185.9,0.01,789.07,17
CDM,99557421_1,Biopsy of vagina and cervix using an endoscope,676.0,439.4,0.01,1745.77,17
CDM,99557452_1,Exam of cervix and upper part of vagina using an endoscope,162.0,105.3,0.01,789.07,17
CDM,99557454_1,Biopsy and scraping of cervix using an endoscope,286.0,185.9,0.01,789.07,17
CDM,99557455_1,Biopsy of cervix using an endoscope,286.0,185.9,0.01,789.07,17
CDM,99557456_1,Scraping of cervix using an endoscope,286.0,185.9,0.01,789.07,17
CDM,99557460_1,Biopsy of cervix using an endoscope with loop electrode,2250.0,1462.5,0.01,5810.63,17
CDM,99557461_1,Cone biopsy of cervix and vagina using an endoscope with loop electrode,2250.0,1462.5,0.01,5810.63,17
CDM,99557500_1,Biopsy of cervix or removal of growth,676.0,439.4,0.01,1745.77,17
CDM,99557505_1,Scraping of tissue of cervix,676.0,439.4,0.01,1745.77,17
CDM,99557511_1,Destruction of cervix using freezing,300.0,195.0,0.01,789.07,17
CDM,99557522_1,Removal or destruction of cervix using loop electrode,2250.0,1462.5,0.01,5810.63,17
CDM,99557800_1,Dilation of cervical canal,5730.0,3724.5,0.01,14797.73,17
CDM,99558100_1,Biopsy of lining of uterus,162.0,105.3,0.01,789.07,17
CDM,99558110_1,Exam of cervix using an endoscope with biopsy of lining of uterus,50.0,32.5,0.01,789.07,17
CDM,99558120_1,Dilation and scraping of uterus,7645.0,4969.25,0.01,19743.21,17
CDM,99558300_1,Insertion of IUD for pregnancy prevention,110.0,71.5,0.01,313.49,17
CDM,99558301_1,Removal of IUD,286.0,185.9,0.01,738.6,17
CDM,99558340_1,Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes,718.0,466.7,0.01,1854.24,17
CDM,99558555_1,Diagnostic exam of uterus using an endoscope,2250.0,1462.5,0.01,5810.63,17
CDM,99558558_1,Biopsy of lining of uterus and/or removal of polyp using an endoscope,7165.0,4657.25,0.01,18503.61,17
CDM,99558562_1,Removal of foreign body in uterus using an endoscope,2250.0,1462.5,0.01,5810.63,17
CDM,99559000_1,Removal of sample of amniotic fluid surrounding fetus for diagnosis,676.0,439.4,0.01,1745.77,17
CDM,99559015_1,Removal of tissue from placenta for diagnosis,130.0,84.5,0.01,856.15,17
CDM,99559020_1,Fetal contraction stress test,162.0,105.3,40.5,418.37,19
CDM,99559025_1,Fetal test,260.0,169.0,65.0,671.45,19
CDM,99559070_1,Infusion of normal saline into fetal amniotic sac using ultrasound guidance,732.0,475.8,0.01,1890.39,17
CDM,99559160_1,Scraping of lining of uterus after delivery,2250.0,1462.5,0.01,5810.63,17
CDM,99559200_1,Insertion of dilator device into cervix,867.0,563.55,0.01,2239.03,17
CDM,99559425_1,"Predelivery care, 4 to 6 visits",600.0,390.0,0.01,1549.5,17
CDM,99559426_1,"Predelivery care, 7 or more visits",800.0,520.0,0.01,2066.0,17
CDM,99559430_1,Post delivery care,110.0,71.5,0.01,362.82,17
CDM,99559812_1,Treatment of miscarriage,2250.0,1462.5,0.01,5810.63,17
CDM,99559820_1,Treatment of miscarriage during first trimester,2891.42,1879.42,0.01,7467.09,17
CDM,99559821_1,Treatment of miscarriage during second trimester,5730.0,3724.5,0.01,14797.73,17
CDM,99559840_1,Induced abortion by dilation and scraping of uterine,7650.0,4972.5,0.01,19756.13,17
CDM,99559841_1,Induced abortion by dilation,2250.0,1462.5,0.01,5810.63,17
CDM,99560100_1,Needle biopsy of thyroid through skin,691.0,449.15,0.01,1784.51,17
CDM,99560300_1,Aspiration and/or injection of cyst of thyroid,1615.0,1049.75,0.01,4170.74,17
CDM,99562252_1,Reprogramming of cerebrospinal fluid shunt,119.0,77.35,29.75,307.32,19
CDM,99562270_1,Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test,590.0,383.5,0.01,1523.68,17
CDM,99562272_1,Removal of cerebrospinal fluid with lower back spinal tap,817.0,531.05,0.01,2109.9,17
CDM,99562367_1,Electronic analysis of spinal canal drug infusion pump,290.0,188.5,0.01,748.93,17
CDM,99562368_1,Electronic analysis and reprogramming of spinal canal drug infusion pump,392.0,254.8,0.01,1012.34,17
CDM,99562370_1,Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician,522.0,339.3,0.01,1348.07,17
CDM,99564400_1,Injection of anesthetic agent and/or steroid into face nerve,873.0,567.45,0.01,2254.52,17
CDM,99564405_1,Injection of anesthetic agent and/or steroid into upper neck and back of head nerve,654.0,425.1,0.01,1688.96,17
CDM,99564408_1,Injection of anesthetic agent and/or steroid into vagus nerve,361.5,234.98,0.01,933.57,17
CDM,99564415_1,Injection of anesthetic agent and/or steroid into arm nerve bundle (brachial plexus),1342.5,872.63,0.01,3467.01,17
CDM,99564418_1,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,775.5,504.08,0.01,2002.73,17
CDM,99564425_1,Injection of anesthetic agent and/or steroid into lower abdomen and groin nerve,975.0,633.75,0.01,2517.94,17
CDM,99564430_1,Injection of anesthetic agent and/or steroid into external genitals and anus nerve,973.5,632.78,0.01,2514.06,17
CDM,99564435_1,Injection of anesthetic agent and/or steroid into uterus nerve,517.0,336.05,0.01,1335.15,17
CDM,99564445_1,Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve),775.5,504.08,0.01,2002.73,17
CDM,99564447_1,Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve),775.5,504.08,0.01,2002.73,17
CDM,99564450_1,Injection of anesthetic agent and/or steroid into other nerve or branch,1119.0,727.35,0.01,2889.82,17
CDM,99564455_1,Injection of anesthetic and/or steroid drug into foot nerve,361.5,234.98,0.01,933.57,17
CDM,99564486_1,Injection of local anesthetic for abdominal wall pain control on side using imaging guidance,450.0,292.5,0.01,1162.13,17
CDM,99564510_1,Injection of anesthetic agent into sympathetic nerve bundle,3025.5,1966.58,0.01,7813.35,17
CDM,99564555_1,Insertion of peripheral nerve neurostimulator electrode through skin,8629.5,5609.18,0.01,22285.68,17
CDM,99564566_1,Insertion of lower leg neurostimulator electrode,241.0,156.65,0.01,622.38,17
CDM,99564612_1,Injection of chemical for paralysis of nerve muscles on side of face,361.5,234.98,90.38,2166.29,19
CDM,99564615_1,Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face,735.0,477.75,183.75,2166.29,19
CDM,99564616_1,Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box,1102.5,716.63,275.63,2847.21,19
CDM,99564617_1,Injection of chemical for paralysis of nerve muscles on side of voice box,2446.5,1590.23,580.38,6318.09,19
CDM,99564640_1,Destruction of peripheral nerve or branch,1512.0,982.8,378.0,3904.74,19
CDM,99564642_1,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, first extremity",1220.0,793.0,305.0,3227.0,19
CDM,99564650_1,Injection of chemical for paralysis of underarm sweat glands,241.0,156.65,60.25,2166.29,19
CDM,99564653_1,Injection of chemical for paralysis of sweat glands,941.0,611.65,235.25,2430.13,19
CDM,99564721_1,Release and/or relocation of hand nerve,7500.0,4875.0,1875.0,19368.75,19
CDM,99564742_1,Incision or removal of face nerve,4425.0,2876.25,0.01,11427.56,17
CDM,99564771_1,Incision or removal of cranial nerve,4425.0,2876.25,0.01,11427.56,17
CDM,99564788_1,Removal of growth of skin nerve or nerve lining,4965.0,3227.25,0.01,12822.11,17
CDM,99564999_1,Other procedure on nervous system,710.0,461.5,0.01,1833.58,17
CDM,99565205_1,Removal of foreign body from external eye (conjunctiva),165.0,107.25,0.01,426.11,17
CDM,99565210_1,Removal of foreign body from external eye (conjunctiva or sclera),495.0,321.75,0.01,1278.34,17
CDM,99565220_1,Removal of foreign body in cornea,495.0,321.75,0.01,1278.34,17
CDM,99565222_1,Removal of foreign body in cornea using slit lamp,165.0,107.25,0.01,426.11,17
CDM,99565235_1,Removal of foreign body in eye or lens,8206.5,5334.23,0.01,21193.29,17
CDM,99565286_1,Repair of lacerated cornea and/or sclera using tissue glue,1834.0,1192.1,0.01,4736.31,17
CDM,99565400_1,Removal of growth of cornea,1176.0,764.4,0.01,3037.02,17
CDM,99565430_1,Scraping of cornea for diagnosis,495.0,321.75,0.01,1278.34,17
CDM,99565435_1,Removal of outer layer of cornea,1176.0,764.4,0.01,3037.02,17
CDM,99565436_1,Removal of outer layer of cornea with application of chelating agent,2565.0,1667.25,0.01,6624.11,17
CDM,99565778_1,Placement of amniotic membrane on eye surface for wound healing,1176.0,764.4,0.01,3037.02,17
CDM,99565800_1,Removal of eye fluid,2751.0,1788.15,0.01,7104.46,17
CDM,99565855_1,Laser repair to improve eye fluid flow,720.0,468.0,0.01,1859.4,17
CDM,99566020_1,Injection of air or liquid into eye,1840.0,1196.0,0.01,4751.8,17
CDM,99566030_1,Injection of medication into eye,1840.0,1196.0,0.01,4751.8,17
CDM,99566250_1,Revision or repair of operative wound of eye,2566.5,1668.23,0.01,6627.99,17
CDM,99566761_1,"Creation of eye fluid drainage tracts in iris using a laser, per session",720.0,468.0,0.01,1859.4,17
CDM,99566762_1,Creation of opening of iris for eye fluid drainage using a laser,480.0,312.0,0.01,1495.44,17
CDM,99566821_1,Removal of recurring cataract in lens capsule using a laser,720.0,468.0,0.01,1859.4,17
CDM,99567015_1,Aspiration or release of eye fluid between lens and retina,5485.0,3565.25,0.01,14165.01,17
CDM,99567028_1,Injection of drug into eye,450.0,292.5,0.01,1162.13,17
CDM,99567108_1,Repair of detached retina with drainage and removal of eye fluid between lens and retina,6885.98,4475.89,0.01,17783.04,17
CDM,99567110_1,Repair of detached retina by injection of air or gas,2751.0,1788.15,0.01,7104.46,17
CDM,99567145_1,Photocoagulation treatment to prevent detachment of retina,720.0,468.0,0.01,1859.4,17
CDM,99567210_1,Destruction of growth of retina using a laser,720.0,468.0,0.01,1859.4,17
CDM,99567220_1,Destruction of vascular growth between retina and sclera by photocoagulation,720.0,468.0,0.01,1859.4,17
CDM,99567221_1,Destruction of vascular growth between retina and sclera by photodynamic therapy,480.0,312.0,0.01,1522.17,17
CDM,99567225_1,Destruction of vascular growth between retina and sclera by photodynamic therapy for second eye at 1 session,464.0,301.6,0.01,1522.17,17
CDM,99567228_1,Destruction of leaking blood vessels of retina using laser,720.0,468.0,0.01,1859.4,17
CDM,99567345_1,Destruction of eye muscle by injection of chemical,450.0,292.5,0.01,1162.13,17
CDM,99567500_1,Injection of drug into cavity behind eye,420.0,273.0,0.01,1084.65,17
CDM,99567505_1,Injection of alcohol into cavity behind eye,280.0,182.0,0.01,723.1,17
CDM,99567515_1,Injection of drug or substance into membrane covering eyeball,420.0,273.0,0.01,1084.65,17
CDM,99567516_1,Injection of drug into the space between the cornea and retina in the eye,700.0,455.0,0.01,1807.75,15
CDM,99567700_1,Incision and drainage of abscess of eyelid,417.0,271.05,0.01,1076.9,17
CDM,99567710_1,Removal of sutures between upper and lower eyelids,1176.0,764.4,0.01,3037.02,17
CDM,99567800_1,Removal of chronic growth of eyelid,417.0,271.05,0.01,1076.9,17
CDM,99567801_1,Removal of multiple chronic growths of same eyelid,784.0,509.6,0.01,2024.68,17
CDM,99567805_1,Removal of multiple chronic growths of different eyelids,279.0,181.35,0.01,720.52,17
CDM,99567810_1,Biopsy of eyelid,417.0,271.05,0.01,1076.9,17
CDM,99567820_1,Removal of eyelashes using forceps,165.0,107.25,0.01,426.11,17
CDM,99567825_1,Removal of eyelashes,667.5,433.88,0.01,1723.82,17
CDM,99567840_1,Removal of growth of eyelid,1176.0,764.4,0.01,3037.02,17
CDM,99567875_1,Temporary closure of eyelids by suture,1865.0,1212.25,0.01,4816.36,17
CDM,99567880_1,Creation of permanent eyelid margin scarring,2595.0,1686.75,0.01,6701.59,17
CDM,99567882_1,Creation of permanent eyelid margin scarring with relocation of eyelid tissue,2595.0,1686.75,0.01,6701.59,17
CDM,99567900_1,Repair of brow paralysis,2595.0,1686.75,0.01,6701.59,17
CDM,99567903_1,Shortening or advancement of upper eyelid muscle to correct drooping or paralysis,2595.0,1686.75,0.01,6701.59,17
CDM,99567904_1,Repair of tendon of upper eyelid,2595.0,1686.75,0.01,6701.59,17
CDM,99567912_1,Restoration of eyelid blinking function with implant,2595.0,1686.75,0.01,6701.59,17
CDM,99567914_1,Suture repair of turning-outward upper or lower eyelid defect,1730.0,1124.5,0.01,4467.73,17
CDM,99567917_1,Extensive repair of turning-outward eyelid defect,2595.0,1686.75,0.01,6701.59,17
CDM,99567921_1,Suture repair of turning-inward eyelid defect,1730.0,1124.5,0.01,4467.73,17
CDM,99567924_1,Extensive repair of turning-inward eyelid defect,2595.0,1686.75,0.01,6701.59,17
CDM,99567938_1,Removal of embedded foreign body in eyelid,571.5,371.48,0.01,1475.9,17
CDM,99567950_1,Reconstruction of eyelid margin,1730.0,1124.5,0.01,4467.73,17
CDM,99567961_1,Removal of up to 1/4 of eyelid margin and repair of eyelid,2595.0,1686.75,0.01,6701.59,17
CDM,99567975_1,Reconstruction of eyelid by transfer of eyelid tissue from opposite eyelid,4326.0,2811.9,0.01,11171.9,17
CDM,99567999_1,Other procedure on eyelid,275.0,178.75,0.01,710.19,17
CDM,99568020_1,Incision and drainage of cyst of eye,1176.0,764.4,0.01,3037.02,17
CDM,99568040_1,Removal of scars of eyelid lining due to infection,279.0,181.35,0.01,720.52,17
CDM,99568100_1,Biopsy of eyelid lining,2595.0,1686.75,0.01,6701.59,17
CDM,99568110_1,"Removal of growth of eyelid lining, 1.0 cm or less",2595.0,1686.75,0.01,6701.59,17
CDM,99568115_1,"Removal of growth of eyelid lining, more than 1.0 cm",1711.0,1112.15,0.01,4418.66,17
CDM,99568135_1,Destruction of growth of eyelid lining,2985.0,1940.25,0.01,7708.76,17
CDM,99568200_1,Injection into conjunctiva,409.5,266.18,0.01,1057.53,17
CDM,99568320_1,Repair of eyelid lining with graft from external eye,2610.0,1696.5,0.01,6740.33,17
CDM,99568326_1,Reconstruction of conjunctiva with graft from outer eye or rearrangement,10360.0,6734.0,0.01,26754.7,17
CDM,99568400_1,Incision and drainage of tear producing gland,784.0,509.6,0.01,2024.68,17
CDM,99568440_1,Snip incision of tear duct at inner corner of eye,426.0,276.9,0.01,1100.15,17
CDM,99568760_1,"Repair tear duct opening by heat, tying, or laser surgery",417.0,271.05,0.01,1076.9,17
CDM,99568761_1,Closure of tear duct opening using plug,417.0,271.05,0.01,1076.9,17
CDM,99568801_1,Dilation of tear drainage opening,409.5,266.18,0.01,1057.53,17
CDM,99568810_1,Insertion of probe into nasal tear duct,418.5,272.03,0.01,1080.78,17
CDM,99568815_1,Probing of nasal tear duct with insertion of tube or stent,7654.5,4975.43,0.01,19767.75,17
CDM,99568840_1,Probing of nasal tear duct,417.0,271.05,0.01,1076.9,17
CDM,99569000_1,Simple drainage of abscess or blood accumulation of external ear,823.5,535.28,0.01,2126.69,17
CDM,99569005_1,Complicated drainage of external ear abscess or blood accumulation,2040.0,1326.0,0.01,5268.3,17
CDM,99569020_1,Drainage of abscess of ear canal,549.0,356.85,0.01,1417.79,17
CDM,99569100_1,Biopsy of ear,452.0,293.8,0.01,1167.29,17
CDM,99569105_1,Biopsy of ear canal,1845.0,1199.25,0.01,4764.71,17
CDM,99569110_1,Partial removal of external ear with simple repair,3405.0,2213.25,0.01,8793.41,17
CDM,99569145_1,Removal of growth in soft tissue of ear canal,6511.0,4232.15,0.01,16814.66,17
CDM,99569200_1,Removal of foreign body in ear canal,274.5,178.43,0.01,708.9,15
CDM,99569209_1,Removal of impacted ear wax by washing,97.5,63.38,24.38,251.79,17
CDM,99569210_1,Removal of impacted ear wax,65.0,42.25,0.01,167.86,15
CDM,99569220_1,Simple removal of skin debris and drainage of mastoid cavity,244.5,158.93,0.01,631.42,17
CDM,99569222_1,Complex removal of skin debris and drainage of mastoid cavity,1265.0,822.25,0.01,3266.86,17
CDM,99569300_1,Repair of protruding ear,3274.5,2128.43,0.01,8456.4,17
CDM,99569420_1,"Incision, aspiration, and/or inflation of eardrum",280.5,182.33,0.01,724.39,17
CDM,99569433_1,Incision of eardrum with insertion of eardrum tube under local or topical anesthesia,678.0,440.7,0.01,1750.94,17
CDM,99569610_1,Repair of eardrum,3360.0,2184.0,0.01,8677.2,17
CDM,99569620_1,Repair of defect or tear of eardrum,3165.0,2057.25,0.01,8173.61,17
CDM,99569801_1,Incision of fluid canal of inner ear with infusion of drugs,1845.0,1199.25,0.01,4764.71,17
CDM,99570100_1,"X-ray of part of lower jaw, 1-4 views",225.0,146.25,56.25,581.06,18
CDM,99570110_1,"X-ray of lower jaw, minimum of 4 views",310.0,201.5,77.5,800.58,18
CDM,99570140_1,"X-ray of face bones, 1-2 views",250.0,162.5,62.5,645.63,18
CDM,99570150_1,"X-ray of face bones, minimum of 3 views",325.0,211.25,81.25,839.31,18
CDM,99570160_1,"X-ray of nose bones, minimum of 3 views",338.0,219.7,81.72,872.89,18
CDM,99570210_1,"X-ray of paranasal sinus, 1-2 views",270.0,175.5,67.5,697.28,18
CDM,99570220_1,"X-ray of paranasal sinus, minimum of 3 views",400.0,260.0,81.72,1033.0,18
CDM,99570250_1,"X-ray of skull, 1-3 views",293.0,190.45,73.25,756.67,18
CDM,99570320_1,"X-ray of teeth, full mouth",150.0,97.5,37.5,387.38,18
CDM,99570328_1,X-ray of jaw joint on 1 side of mouth,180.0,117.0,45.0,464.85,18
CDM,99570330_1,X-ray of jaw joints on both sides of mouth,300.0,195.0,75.0,774.75,18
CDM,99570350_1,Imaging of jaws and skull,170.0,110.5,42.5,439.03,18
CDM,99570355_1,"X-ray of lower jaws, upper jaws and teeth",225.0,146.25,56.25,581.06,18
CDM,99570360_1,X-ray of soft tissue of neck,225.0,146.25,56.25,581.06,18
CDM,99570486_1,CT scan of face without contrast,500.0,325.0,125.0,1291.25,18
CDM,99571045_1,"X-ray of chest, 1 view",290.0,188.5,72.5,748.93,18
CDM,99571046_1,"X-ray of chest, 2 views",260.0,169.0,65.0,671.45,18
CDM,99571047_1,"X-ray of chest, 3 views",350.0,227.5,81.72,903.88,18
CDM,99571048_1,"X-ray of chest, minimum of 4 views",375.0,243.75,81.72,968.44,18
CDM,99571100_1,"X-ray of ribs on side of body, 2 views",270.0,175.5,67.5,697.28,18
CDM,99571101_1,"X-ray of ribs on side of body, minimum of 3 views",290.0,188.5,72.5,748.93,18
CDM,99571110_1,"X-ray of ribs on both sides of body, 3 views",315.0,204.75,78.75,813.49,18
CDM,99571111_1,"X-ray of ribs on both sides of body, minimum of 4 views",360.0,234.0,81.72,929.7,18
CDM,99571120_1,"X-ray of chest bone, minimum of 2 views",225.0,146.25,56.25,581.06,18
CDM,99571130_1,"X-ray of spine, 1 view",270.0,175.5,67.5,697.28,18
CDM,99572020_1,"X-ray of spine, 1 view",300.0,195.0,75.0,774.75,18
CDM,99572040_1,"X-ray of upper spine, 2-3 views",270.0,175.5,67.5,697.28,18
CDM,99572050_1,"X-ray of upper spine, 4-5 views",360.0,234.0,81.72,929.7,18
CDM,99572052_1,"X-ray of upper spine, 6 or more views",450.0,292.5,81.72,1162.13,18
CDM,99572070_1,"X-ray of middle spine, 2 views",315.0,204.75,78.75,813.49,18
CDM,99572072_1,"X-ray of middle spine, 3 views",360.0,234.0,81.72,929.7,18
CDM,99572074_1,"X-ray of middle spine, minimum of 4 views",425.0,276.25,81.72,1097.56,18
CDM,99572080_1,"X-ray of middle and lower spine, 2 views",315.0,204.75,78.75,813.49,18
CDM,99572082_1,"X-ray of entire middle and lower spine, 2-3 views",310.0,201.5,77.5,800.58,18
CDM,99572100_1,"X-ray of lower and sacral spine, 2-3 views",325.0,211.25,81.25,839.31,18
CDM,99572110_1,"X-ray of lower and sacral spine, minimum of 4 views",360.0,234.0,81.72,929.7,18
CDM,99572170_1,"X-ray of pelvis, 1-2 views",350.0,227.5,81.72,903.88,18
CDM,99572190_1,"X-ray of pelvis, minimum of 3 views",325.0,211.25,81.25,839.31,18
CDM,99572200_1,"X-ray of joint between lower spine and hip bone, 1-2 views",250.0,162.5,62.5,645.63,18
CDM,99572202_1,"X-ray of joint between lower spine and hip bone, 3 or more views",310.0,201.5,77.5,800.58,18
CDM,99572220_1,"X-ray of sacrum and tailbone, minimum of 2 views",225.0,146.25,56.25,581.06,18
CDM,99573000_1,X-ray of collar bone,337.5,219.38,81.72,871.59,18
CDM,99573010_1,X-ray of shoulder blade,465.0,302.25,81.72,1200.86,18
CDM,99573020_1,"X-ray of shoulder, 1 view",375.0,243.75,81.72,968.44,18
CDM,99573030_1,"X-ray of shoulder, minimum of 2 views",525.0,341.25,81.72,1355.81,18
CDM,99573060_1,"X-ray of upper arm, minimum of 2 views",405.0,263.25,81.72,1045.91,18
CDM,99573070_1,"X-ray of elbow, 2 views",405.0,263.25,81.72,1045.91,18
CDM,99573080_1,"X-ray of elbow, minimum of 3 views",472.5,307.13,81.72,1220.23,18
CDM,99573090_1,"X-ray of forearm, 2 views",405.0,263.25,81.72,1045.91,18
CDM,99573100_1,"X-ray of wrist, 2 views",405.0,263.25,81.72,1045.91,18
CDM,99573110_1,"X-ray of wrist, minimum of 3 views",525.0,341.25,81.72,1355.81,18
CDM,99573120_1,"X-ray of hand, 2 views",465.0,302.25,81.72,1200.86,18
CDM,99573130_1,"X-ray of hand, minimum of 3 views",570.0,370.5,81.72,1472.03,18
CDM,99573140_1,"X-ray of finger, minimum of 2 views",525.0,341.25,81.72,1355.81,18
CDM,99573501_1,"X-ray of hip, 1 view",225.0,146.25,56.25,581.06,18
CDM,99573502_1,"X-ray of hip, 2-3 views",290.0,188.5,72.5,748.93,18
CDM,99573521_1,"X-ray of both hips, 2 views",315.0,204.75,78.75,813.49,18
CDM,99573522_1,"X-ray of both hips, 3-4 views",360.0,234.0,81.72,929.7,18
CDM,99573523_1,"X-ray of both hips, minimum of 5 views",352.0,228.8,81.72,909.04,18
CDM,99573551_1,"X-ray of thigh bone, 1 view",405.0,263.25,81.72,1045.91,18
CDM,99573552_1,"X-ray of thigh bone, minimum 2 views",570.0,370.5,81.72,1472.03,18
CDM,99573560_1,"X-ray of knee, 1-2 views",570.0,370.5,81.72,1472.03,18
CDM,99573562_1,"X-ray of knee, 3 views",525.0,341.25,81.72,1355.81,18
CDM,99573564_1,"X-ray of knee, 4 or more views",433.5,281.78,81.72,1119.51,18
CDM,99573565_1,X-ray of both knees while standing,360.0,234.0,81.72,929.7,18
CDM,99573590_1,"X-ray of lower leg, 2 views",480.0,312.0,81.72,1239.6,18
CDM,99573600_1,"X-ray of ankle, 2 views",405.0,263.25,81.72,1045.91,18
CDM,99573610_1,"X-ray of ankle, minimum of 3 views",525.0,341.25,81.72,1355.81,18
CDM,99573620_1,"X-ray of foot, 2 views",337.5,219.38,81.72,871.59,18
CDM,99573630_1,"X-ray of foot, minimum of 3 views",480.0,312.0,81.72,1239.6,18
CDM,99573650_1,"X-ray of heel, minimum of 2 views",337.5,219.38,81.72,871.59,18
CDM,99573660_1,"X-ray of toe, minimum of 2 views",405.0,263.25,81.72,1045.91,18
CDM,99574018_1,"X-ray of abdomen, 1 view",290.0,188.5,72.5,748.93,18
CDM,99574019_1,"X-ray of abdomen, 2 views",325.0,211.25,81.25,839.31,18
CDM,99574021_1,"X-ray of abdomen, minimum of 3 views",400.0,260.0,81.72,1033.0,18
CDM,99576376_1,3D radiographic procedure,1185.0,770.25,296.25,3060.26,16
CDM,99576510_1,1D and 2D ultrasound scan of eye tissue and structures,300.0,195.0,75.0,774.75,18
CDM,99576512_1,2D ultrasound scan of eye tissue and structures,450.0,292.5,112.5,1162.13,18
CDM,99576513_1,Ultrasound scan of eye using water bath method,225.0,146.25,56.25,581.06,18
CDM,99576514_1,Ultrasound scan of cornea to determine thickness,446.0,289.9,81.48,1151.8,18
CDM,99576519_1,Ultrasound scan to determine eye length and lens power,446.0,289.9,111.5,1151.8,18
CDM,99576536_1,Ultrasound scan of head and neck soft tissue,461.0,299.65,115.25,1190.53,18
CDM,99576705_1,Limited ultrasound scan of abdomen,511.0,332.15,127.75,1319.66,18
CDM,99576706_1,Ultrasound scan of abdominal aorta,500.0,325.0,125.0,1291.25,18
CDM,99576770_1,Complete ultrasound scan behind abdominal cavity,650.0,422.5,162.5,1678.63,18
CDM,99576775_1,Limited ultrasound scan behind abdominal cavity,500.0,325.0,125.0,1291.25,18
CDM,99576801_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus",325.0,211.25,81.25,839.31,18
CDM,99576802_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), each additional fetus",150.0,97.5,37.5,387.38,18
CDM,99576805_1,"Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus",325.0,211.25,81.25,839.31,18
CDM,99576810_1,"Ultrasound scan of pregnant uterus (14 weeks or more), each additional fetus",150.0,97.5,37.5,387.38,18
CDM,99576811_1,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus",350.0,227.5,87.5,903.88,18
CDM,99576812_1,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, each additional fetus",410.0,266.5,102.5,1058.83,18
CDM,99576813_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, single or first fetus",310.0,201.5,77.5,800.58,18
CDM,99576814_1,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, each additional fetus",150.0,97.5,37.5,387.38,18
CDM,99576815_1,Limited ultrasound of pregnant uterus,325.0,211.25,81.25,839.31,18
CDM,99576816_1,Follow-up ultrasound scan of pregnant uterus,260.0,169.0,65.0,671.45,18
CDM,99576817_1,Vaginal ultrasound of pregnant uterus,325.0,211.25,81.25,839.31,18
CDM,99576818_1,Ultrasound and monitoring of heart of fetus,310.0,201.5,77.5,800.58,18
CDM,99576819_1,Ultrasound scan of fetus,300.0,195.0,75.0,774.75,18
CDM,99576820_1,Ultrasound scan of fetal umbilical artery blood flow rate,360.0,234.0,90.0,929.7,18
CDM,99576821_1,Ultrasound scan of fetal brain artery blood flow rate,300.0,195.0,75.0,774.75,18
CDM,99576825_1,Ultrasound scan of fetal heart,1420.0,923.0,146.52,3667.15,18
CDM,99576826_1,Follow-up ultrasound scan of fetal heart,560.0,364.0,140.0,1446.2,18
CDM,99576827_1,Ultrasound scan of fetal heart blood flow,300.0,195.0,75.0,774.75,18
CDM,99576828_1,Follow-up ultrasound scan of fetal heart blood flow,267.0,173.55,66.75,689.53,18
CDM,99576830_1,"Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina",445.0,289.25,111.25,1149.21,18
CDM,99576831_1,Ultrasound scan of uterus and uterine cavity,562.0,365.3,140.5,1451.37,18
CDM,99576857_1,Limited ultrasound scan of pelvis,445.0,289.25,111.25,1149.21,18
CDM,99576870_1,Ultrasound scan of scrotum,500.0,325.0,125.0,1291.25,18
CDM,99576872_1,Ultrasound scan of pelvic region through rectum,500.0,325.0,125.0,1291.25,18
CDM,99576881_1,Complete ultrasound scan of joint,400.0,260.0,100.0,1033.0,18
CDM,99576882_1,Limited ultrasound scan of joint or other extremity structure except blood vessels,400.0,260.0,100.0,1033.0,18
CDM,99576941_1,Ultrasonic guidance for fetal transfusion or umbilical blood sampling,270.0,175.5,67.5,697.28,18
CDM,99576942_1,Ultrasonic guidance for needle placement,800.0,520.0,163.6,2066.0,18
CDM,99576945_1,Ultrasonic guidance for testing placental tissue,500.0,325.0,125.0,1291.25,18
CDM,99576946_1,Ultrasonic guidance for removal of amniotic fluid,400.0,260.0,100.0,1033.0,18
CDM,99576IP _1,"ADVATE 2,401-3,600 UNIT VIAL",27543.72,17903.42,6885.93,19280.6,11
CDM,99577002_1,Fluoroscopic guidance for needle placement,395.0,256.75,98.75,1020.09,18
CDM,99577080_1,"DXA bone density measurement of hip, pelvis, spine",325.0,211.25,81.25,839.31,18
CDM,99577081_1,"DXA bone density measurement of forearm, finger, hand, or foot",86.0,55.9,21.5,222.1,18
CDM,9957IP _1,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",33.51,21.78,0.22,86.54,17
CDM,9957OP _1,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",5.89,3.83,0.22,15.21,17
CDM,99581001_1,"Manual urinalysis test with examination using microscope, automated",20.0,13.0,0.63,51.65,19
CDM,99581003_1,Automated urinalysis test,15.0,9.75,0.34,38.74,19
CDM,99581005_1,"Analysis of urine, except immunoassays",10.0,6.5,0.22,25.83,19
CDM,99581015_1,Urinalysis using microscope,16.0,10.4,0.49,41.32,19
CDM,99581025_1,Urine pregnancy test,30.0,19.5,2.58,77.48,19
CDM,99582270_1,Stool analysis for blood to screen for colon tumors,91.0,59.15,3.99,235.01,19
CDM,99582272_1,"Stool analysis for blood, by peroxidase activity",30.0,19.5,1.27,77.48,19
CDM,99582274_1,"Stool analysis for blood, by fecal hemoglobin determination by immunoassay",73.0,47.45,11.62,188.52,19
CDM,99582438_1,Chloride level,19.0,12.35,0.95,49.07,19
CDM,99582947_1,Blood glucose (sugar) level,15.0,9.75,0.59,38.74,19
CDM,99582948_1,Blood glucose (sugar) measurement using reagent strip,16.0,10.4,0.81,41.32,19
CDM,99582950_1,Blood glucose (sugar) level after receiving dose of glucose,35.0,22.75,1.66,90.39,19
CDM,99582951_1,"Blood glucose (sugar) tolerance test, 3 specimens",48.0,31.2,6.18,123.96,19
CDM,99582955_1,G6PD (enzyme) level,36.0,23.4,3.49,92.97,19
CDM,99582962_1,Blood glucose (sugar) test performed by hand-held instrument,11.0,7.15,0.36,28.41,19
CDM,99583036_1,Hemoglobin A1C level,48.0,31.2,4.66,123.96,19
CDM,99583861_1,Microfluid analysis of tears,65.0,42.25,14.14,167.86,19
CDM,99583986_1,Body fluid pH level,18.0,11.7,0.64,46.49,19
CDM,99585013_1,Red blood cell hemoglobin concentration,21.0,13.65,1.47,54.23,19
CDM,99585018_1,"Blood count, hemoglobin",12.0,7.8,0.28,30.99,19
CDM,99585025_1,"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count",35.0,22.75,2.72,90.39,19
CDM,99585027_1,"Complete blood cell count (red cells, white blood cell, platelets), automated test",32.0,20.8,2.07,82.64,19
CDM,99585610_1,"Blood test, clotting time",20.0,13.0,0.86,51.65,19
CDM,99586308_1,Screening test for mononucleosis (mono),20.0,13.0,1.04,51.65,19
CDM,99586580_1,Skin test for tuberculosis,55.0,35.75,11.64,142.04,19
CDM,99586701_1,Analysis for antibody to HIV -1 virus,41.0,26.65,3.64,105.88,19
CDM,99586850_1,Screening test for red blood cell antibodies,30.0,19.5,2.93,77.48,19
CDM,99587081_1,Screening test for pathogenic organisms,37.0,24.05,2.45,95.55,19
CDM,99587210_1,Smear for infectious agents,32.0,20.8,1.86,82.64,19
CDM,99587220_1,Tissue fungi or parasites,24.0,15.6,1.02,61.98,19
CDM,99587502_1,Detection test by nucleic acid for multiple types influenza virus,316.0,205.4,95.8,816.07,19
CDM,99587800_1,"Detection test by nucleic acid for multiple organisms, direct probe(s) technique",197.0,128.05,43.67,508.75,19
CDM,99587804_1,Detection test by immunoassay with direct visual observation for influenza virus,75.0,48.75,12.41,193.69,19
CDM,99587806_1,"Detection test by immunoassay with direct visual observation for HIV-1 antigen, with HIV-1 and HIV-2 antibodies",41.0,26.65,13.44,105.88,19
CDM,99587880_1,"Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep)",75.0,48.75,12.4,193.69,19
CDM,99588331_1,"Pathology examination of specimen during surgery, first tissue block",235.0,152.75,43.19,606.89,19
CDM,99588332_1,"Pathology examination of specimen during surgery, each additional tissue block",104.0,67.6,24.57,268.58,19
CDM,99589060_1,Crystal identification from tissue or body fluid,53.0,34.45,3.88,136.87,19
CDM,99590375_1,Rabies immune globulin for injection,316.6,205.79,79.15,2058.35,19
CDM,99590380_1,"Respiratory syncytial virus antibody, 0.5 mL dosage for injection into muscle",910.0,591.5,227.5,2350.08,19
CDM,99590381_1,"Respiratory syncytial virus antibody, 1.0 mL dosage for injection into muscle",1000.0,650.0,250.0,2582.5,19
CDM,99590460_1,Administration of first vaccine or toxoid component with counseling (18 years or younger),50.0,32.5,12.5,129.13,19
CDM,99590461_1,"Administration of vaccine or toxoid component with counseling (18 years or younger), each additional vaccine or toxoid component",30.0,19.5,7.5,77.48,19
CDM,99590471_1,Administration of vaccine,80.0,52.0,20.0,206.6,19
CDM,99590472_1,"Administration of vaccine, each additional vaccine",40.0,26.0,10.0,103.3,19
CDM,99590473_1,"Administration of nasal or oral vaccine, 1 vaccine",30.0,19.5,7.5,77.48,19
CDM,99590474_1,"Administration of nasal or oral vaccine, each additional vaccine",31.0,20.15,7.75,80.06,19
CDM,99590480_1,"Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose",80.0,52.0,20.0,206.6,19
CDM,99590589_1,Chikungunya virus vaccine,550.0,357.5,137.5,1420.38,16
CDM,99590611_1,"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use",690.75,448.99,0.01,1783.86,19
CDM,99590620_1,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",382.0,248.3,95.5,986.52,19
CDM,99590621_1,"Meningococcal recombinant lipoprotein vaccine, serogroup B",353.0,229.45,88.25,911.62,19
CDM,99590625_1,Cholera vaccine,640.0,416.0,30.97,1652.8,18
CDM,99590632_1,Hepatitis A vaccine adult dosage,120.0,78.0,30.0,309.9,19
CDM,99590633_1,Hepatitis A vaccine pediatric or adolescent dosage,55.0,35.75,13.75,142.04,19
CDM,99590634_1,Hepatitis A vaccine pediatric or adolescent dosage (3 dose schedule),89.0,57.85,22.25,229.84,19
CDM,99590636_1,Hepatitis A and hepatitis B vaccine,183.0,118.95,45.75,472.6,19
CDM,99590647_1,"Haemophilus influenzae type b vaccine, PRP-OMP conjugate",50.0,32.5,12.5,129.13,19
CDM,99590648_1,"Haemophilus influenzae type b vaccine, PRP-T conjugate",50.0,32.5,12.5,129.13,19
CDM,99590649_1,"Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent",245.0,159.25,61.25,632.71,19
CDM,99590650_1,"Human Papillomavirus vaccine, types 16, 18, bivalent",250.0,162.5,30.97,645.63,18
CDM,99590651_1,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",387.0,251.55,96.75,999.43,19
CDM,99590653_1,"Influenza vaccine, inactivated",5.0,3.25,1.25,104.05,19
CDM,99590655_1,"Influenza vaccine, trivalent, split virus, preservative-free, 0.25 mL dosage",5.0,3.25,1.25,31.59,19
CDM,99590656_1,"Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage",5.0,3.25,1.25,31.59,19
CDM,99590657_1,"Influenza vaccine, trivalent, 0.25 mL dosage",5.0,3.25,1.25,31.59,19
CDM,99590658_1,"Influenza vaccine, trivalent, 0.5 mL dosage",5.0,3.25,1.25,31.59,19
CDM,99590662_1,"Influenza vaccine split virus, preservative free",75.0,48.75,18.75,193.69,19
CDM,99590666_1,"Influenza vaccine, live, pandemic formulation, split virus, preservative free",5.0,3.25,0.01,31.59,17
CDM,99590670_1,"Pneumococcal vaccine, 13-valent",300.0,195.0,75.0,774.75,19
CDM,99590672_1,"Influenza vaccine, quadrivalent for nasal administration",25.0,16.25,6.25,64.56,18
CDM,99590673_1,"Influenza vaccine, trivalent derived from recombinant DNA",5.0,3.25,1.25,104.05,19
CDM,99590674_1,"Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free",30.0,19.5,7.5,77.48,18
CDM,99590675_1,Rabies vaccine for injection into muscle,348.29,226.39,87.07,899.46,19
CDM,99590677_1,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use",572.68,372.24,143.17,1478.95,19
CDM,99590678_1,"Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use",630.0,409.5,30.97,1626.98,19
CDM,99590679_1,"Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use",592.5,385.13,30.97,1530.13,19
CDM,99590680_1,"Rotavirus vaccine, pentavalent",132.0,85.8,33.0,340.89,19
CDM,99590681_1,"Rotavirus vaccine, human, attenuated",200.0,130.0,30.97,516.5,19
CDM,99590682_1,"Influenza vaccine, quadrivalent derived from recombinant DNA",30.0,19.5,7.5,77.48,18
CDM,99590685_1,"Influenza vaccine, quadrivalent, preservative free, 0.25 mL dosage",5.0,3.25,1.25,31.59,18
CDM,99590686_1,"Influenza vaccine, quadrivalent, preservative free, 0.5 mL dosage",25.0,16.25,6.25,64.56,18
CDM,99590687_1,"Influenza vaccine, quadrivalent, 0.25 mL dosage",5.0,3.25,1.25,31.59,18
CDM,99590688_1,"Influenza vaccine, quadrivalent, 0.5 mL dosage",5.0,3.25,1.25,31.59,18
CDM,99590690_1,Typhoid vaccine,79.0,51.35,19.75,204.02,19
CDM,99590691_1,Typhoid vaccine for injection into muscle,115.0,74.75,28.75,296.99,19
CDM,99590694_1,"Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage",25.0,16.25,6.25,64.56,18
CDM,99590696_1,"Diphtheria, tetanus, acellular pertussis, and polio vaccine",85.0,55.25,21.25,219.51,19
CDM,99590698_1,"Diphtheria, tetanus, acellular pertussis, polio, and Haemophilus influenzae type b vaccine",125.0,81.25,30.97,322.81,19
CDM,99590700_1,"Diphtheria, tetanus, and acellular pertussis vaccine (younger than 7 years)",45.0,29.25,11.25,116.21,19
CDM,99590707_1,"Measles, mumps, and rubella vaccine",102.0,66.3,25.5,263.42,19
CDM,99590710_1,"Measles, mumps, rubella, and varicella vaccine",278.0,180.7,30.97,717.94,19
CDM,99590713_1,Poliovirus vaccine,50.0,32.5,12.5,129.13,19
CDM,99590714_1,Diphtheria and tetanus vaccine (7 years or older),40.0,26.0,10.0,103.3,19
CDM,99590715_1,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",65.0,42.25,16.25,167.86,19
CDM,99590716_1,Varicella vaccine,175.0,113.75,43.75,451.94,19
CDM,99590717_1,Yellow fever vaccine,246.0,159.9,61.5,635.3,19
CDM,99590723_1,"Diphtheria, tetanus, acellular pertussis, hepatitis B, and polio vaccine",135.0,87.75,30.97,348.64,19
CDM,99590732_1,"Pneumococcal vaccine, 23-valent",140.76,91.49,30.97,363.51,19
CDM,99590733_1,"Meningococcal vaccine, serogroups A, C, Y, W-135",225.0,146.25,56.25,581.06,19
CDM,99590734_1,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",200.0,130.0,50.0,516.5,19
CDM,99590736_1,Shingles vaccine for injection under skin,360.0,234.0,90.0,929.7,19
CDM,99590738_1,Japanese encephalitis vaccine,385.0,250.25,96.25,994.26,19
CDM,99590739_1,"Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use",100.0,65.0,25.0,258.25,19
CDM,99590740_1,"Hepatitis B vaccine, dialysis or immunosuppressed patient dosage",281.0,182.65,70.25,725.68,19
CDM,99590743_1,"Hepatitis B vaccine, adolescent dosage",100.0,65.0,25.0,258.25,19
CDM,99590744_1,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",50.0,32.5,12.5,129.13,19
CDM,99590746_1,"Hepatitis B vaccine, adult dosage (3 dose schedule)",100.0,65.0,25.0,258.25,19
CDM,99590748_1,Hepatitis B and Haemophilus influenzae type b vaccine,100.0,65.0,25.0,258.25,19
CDM,99590750_1,Shingles vaccine for injection into muscle,331.0,215.15,82.75,854.81,18
CDM,99590785_1,Psychiatric services complicated by communication factor,35.0,22.75,8.75,476.0,19
CDM,99590791_1,Psychiatric diagnostic evaluation,321.0,208.65,80.25,828.98,19
CDM,99590792_1,Psychiatric diagnostic evaluation with medical services,358.0,232.7,89.5,924.54,19
CDM,99590912_1,"Biofeedback training for bowel or bladder control, initial 15 minutes",294.0,191.1,73.5,759.26,19
CDM,99591010_1,Study of esophagus to assess movement,450.0,292.5,0.01,1162.13,17
CDM,99591200_1,Measurement of liver stiffness,446.0,289.9,111.5,1151.8,18
CDM,99591318_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 3 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",350.0,227.5,30.97,903.88,19
CDM,99591319_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 10 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",150.0,97.5,30.97,387.38,19
CDM,99591320_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",225.0,146.25,30.97,581.06,19
CDM,99591321_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular use",225.0,146.25,30.97,581.06,19
CDM,99591322_1,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use",225.0,146.25,30.97,581.06,19
CDM,99592002_1,New patient problem focused exam of visual system,100.0,65.0,0.01,258.25,15
CDM,99592004_1,New patient complete exam of visual system,120.0,78.0,0.01,309.9,15
CDM,99592012_1,Established patient problem focused exam of visual system,100.0,65.0,0.01,258.25,15
CDM,99592014_1,Established patient complete exam of visual system,120.0,78.0,0.01,309.9,15
CDM,99592020_1,Exam of the internal drainage system of eye,295.0,191.75,0.01,761.84,17
CDM,99592025_1,CT scan of cornea,125.0,81.25,31.25,784.0,19
CDM,99592060_1,Exam to measure eye deviation and range of motion,141.0,91.65,0.01,364.13,17
CDM,99592081_1,Exam of visual field with limited testing,65.0,42.25,16.25,784.0,19
CDM,99592082_1,Exam of visual field with intermediate testing,125.0,81.25,31.25,784.0,19
CDM,99592083_1,Exam of visual field with extended testing,270.0,175.5,67.5,784.0,19
CDM,99592100_1,Multiple measurements of eye fluid pressure over an extended time period,90.0,58.5,22.5,784.0,19
CDM,99592132_1,Imaging of front third of eye,150.0,97.5,37.5,784.0,19
CDM,99592133_1,Imaging of optic nerve,125.0,81.25,31.25,784.0,19
CDM,99592134_1,Imaging of retina,125.0,81.25,31.25,784.0,19
CDM,99592136_1,Measurement of corneal curvature and depth of eye,375.0,243.75,81.48,968.44,19
CDM,99592137_1,Imaging of retina with optical coherence tomography angiography,745.0,484.25,186.25,1923.96,17
CDM,99592145_1,Measurement of corneal pressure,40.0,26.0,10.0,784.0,19
CDM,99592229_1,"Imaging of retina for disease detection, with automated review and report at point of care",140.0,91.0,35.0,784.0,19
CDM,99592235_1,Exam of retinal blood vessels using a special camera after injection of a dye,600.0,390.0,150.0,1549.5,19
CDM,99592240_1,Exam of blood vessels between the white part of eye and retina using a special camera after injection of a dye,500.0,325.0,125.0,1291.25,19
CDM,99592242_1,Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye,748.0,486.2,0.01,1931.71,17
CDM,99592250_1,Photography of the retina,270.0,175.5,67.5,784.0,19
CDM,99592270_1,Measurement of eye movement,200.0,130.0,50.0,784.0,19
CDM,99592273_1,Measurement of retinal and optic nerve function,505.0,328.25,109.6,1304.16,19
CDM,99592274_1,Measurement of retinal and optic nerve function targeting multiple separate locations,450.0,292.5,109.6,1162.13,19
CDM,99592283_1,Extended exam involving color vision testing,70.0,45.5,17.5,784.0,19
CDM,99592285_1,Photography of content of eyes,108.53,70.54,0.01,280.28,17
CDM,99592286_1,Imaging of front third of eye using a special microscope,270.0,175.5,67.5,784.0,19
CDM,99592499_1,Other service or procedure on eye,23.0,14.95,0.01,111.79,17
CDM,99592504_1,Exam of ear using a microscope,98.0,63.7,0.01,253.09,15
CDM,99592507_1,"Treatment of speech, language, voice, communication, and/or hearing processing disorder",240.0,156.0,60.0,619.8,19
CDM,99592511_1,Exam of the nose and throat using an endoscope,380.0,247.0,0.01,981.35,17
CDM,99592516_1,Study of facial nerve function,189.0,122.85,0.01,488.09,17
CDM,99592517_1,VEMP testing of lower branch of inner ear nerve with interpretation and report,330.0,214.5,82.5,852.23,19
CDM,99592518_1,VEMP testing of upper branch of inner ear nerve with interpretation and report,333.0,216.45,83.25,859.97,19
CDM,99592519_1,VEMP testing of upper and lower branches of inner ear nerve with interpretation and report,630.0,409.5,157.5,1626.98,19
CDM,99592522_1,Evaluation of speech sound production,199.0,129.35,49.75,513.92,19
CDM,99592524_1,Analysis of voice and resonance production,192.0,124.8,48.0,495.84,19
CDM,99592526_1,Treatment of swallowing and feeding disorder,300.0,195.0,62.9,774.75,19
CDM,99592537_1,Test to assess balance during warm and cool irrigation in both ears,325.0,211.25,81.25,839.31,19
CDM,99592538_1,Test to assess balance during warm or cool irrigation in both ears,325.0,211.25,81.25,839.31,19
CDM,99592540_1,Evaluation and testing for balance with recording,325.0,211.25,81.25,839.31,19
CDM,99592541_1,Test for abnormal eye movement with recording,250.0,162.5,44.39,645.63,19
CDM,99592542_1,Test for abnormal eye movement using 3 positions with recording,110.0,71.5,27.5,284.08,19
CDM,99592544_1,Test for abnormal eye movement using a moving target with recording,325.0,211.25,44.39,839.31,19
CDM,99592545_1,Test for abnormal eye movement using a moving target that moves back and forth with recording,325.0,211.25,44.39,839.31,19
CDM,99592547_1,Use of electrodes during balance testing,13.0,8.45,3.25,257.0,19
CDM,99592548_1,Test for balance and posture,330.0,214.5,82.5,852.23,19
CDM,99592550_1,Test for eardrum and muscle function,325.0,211.25,81.25,839.31,19
CDM,99592551_1,Test for screening hearing,32.0,20.8,8.0,257.0,19
CDM,99592552_1,Test for hearing various pitches using earphone,250.0,162.5,44.39,645.63,19
CDM,99592553_1,Test for hearing various pitches using earphone and device placed against the bone,300.0,195.0,75.0,774.75,19
CDM,99592555_1,Test for ability to detect and repeat spoken words,130.0,84.5,32.5,335.73,19
CDM,99592556_1,Test for ability to detect and repeat spoken words with speech recognition,67.0,43.55,16.75,257.0,19
CDM,99592557_1,Comprehensive hearing and speech recognition test,325.0,211.25,81.25,839.31,19
CDM,99592567_1,Test to assess middle ear function,72.0,46.8,18.0,257.0,19
CDM,99592568_1,Test to assess middle ear muscle reflex,38.5,25.03,9.63,257.0,19
CDM,99592570_1,Comprehensive hearing test,137.0,89.05,34.25,353.8,19
CDM,99592577_1,Test to assess hearing loss using 2 simultaneous words at different tones in same ear,426.0,276.9,106.5,1100.15,19
CDM,99592579_1,Test to assess hearing sensitivity using visual aids,300.0,195.0,75.0,774.75,19
CDM,99592582_1,Test to assess hearing sensitivity using activity related feedback,113.0,73.45,28.25,291.82,19
CDM,99592583_1,Test to assess hearing using pictures,38.0,24.7,9.5,257.0,19
CDM,99592584_1,Test to assess electrical potentials generated in the inner ear as a result of sound stimulation,289.0,187.85,72.25,746.34,19
CDM,99592587_1,Placement of ear probe for computerized measurement of sound with interpretation and report,550.0,357.5,116.19,1420.38,19
CDM,99592588_1,Placement of ear probe for computerized measurement of repeated sounds with interpretation and report,630.0,409.5,116.19,1626.98,19
CDM,99592597_1,Evaluation for use of voice artificial device to supplement oral speech,250.0,162.5,62.5,645.63,19
CDM,99592601_1,Analysis and programming of inner ear implant (younger than 7 years),323.0,209.95,52.57,834.15,19
CDM,99592602_1,Analysis and reprogramming of inner ear implant (younger than 7 years),323.0,209.95,52.57,834.15,19
CDM,99592603_1,Analysis and programming of inner ear implant (7 years or older),416.0,270.4,52.57,1074.32,19
CDM,99592604_1,Analysis and reprogramming of inner ear implant (7 years or older),300.0,195.0,52.57,774.75,19
CDM,99592610_1,Evaluation of swallowing function,320.0,208.0,80.0,826.4,19
CDM,99592611_1,Evaluation of swallowing function image,440.0,286.0,110.0,1136.3,19
CDM,99592612_1,Evaluation and recording of swallowing using an endoscope,620.0,403.0,155.0,1601.15,19
CDM,99592626_1,"Evaluation of hearing function related to surgically implanted hearing device, first hour",300.0,195.0,75.0,774.75,19
CDM,99592627_1,"Evaluation of hearing function related to surgically implanted hearing device, each additional 15 minutes",80.0,52.0,20.0,405.67,19
CDM,99592636_1,"HEARING AID POST-FITTING FOLLOW-UP SERVICES, UNILATERAL OR BILATERAL, INCLUDING CONFIRMATION OF PHYSICAL FIT, VALIDATION OF PATIENT BENEFIT AND PERFORMANCE, SOUND QUALITY OF DEVICE, ADJUSTMENT(S) (EG,",200.0,130.0,50.0,516.5,17
CDM,99592637_1,"HEARING AID POST-FITTING FOLLOW-UP SERVICES, UNILATERAL OR BILATERAL, INCLUDING CONFIRMATION OF PHYSICAL FIT, VALIDATION OF PATIENT BENEFIT AND PERFORMANCE, SOUND QUALITY OF DEVICE, ADJUSTMENT(S) (EG,",100.0,65.0,25.0,258.25,17
CDM,99592650_1,Screening evaluation of brain response to sound with automated analysis,275.0,178.75,44.39,710.19,19
CDM,99592651_1,Evaluation of brain response to sound for determination of hearing status with interpretation and report,400.0,260.0,100.0,1033.0,19
CDM,99592652_1,Evaluation of brain response to sound for determination of hearing threshold with interpretation and report,630.0,409.5,116.19,1626.98,19
CDM,99592653_1,Evaluation of brain response to sound for diagnosis of nervous system disorders with interpretation and report,630.0,409.5,116.19,1626.98,19
CDM,99592700_1,"Other procedure on ear, nose, or throat",23.0,14.95,5.75,257.0,19
CDM,99592971_1,"EXTERNAL COUNTERPULSATION, PER TREATMENT SESSION",250.0,162.5,62.5,1052.0,19
CDM,99593005_1,Routine electrocardiogram (ECG) using at least 12 leads with tracing,205.0,133.25,37.41,529.41,19
CDM,99593016_1,Exercise or drug-induced heart stress test with electrocardiogram (ECG) with supervision by physician,110.0,71.5,27.5,2490.0,19
CDM,99593017_1,Exercise or drug-induced heart stress test with electrocardiogram (ECG),1491.0,969.15,241.11,3850.51,19
CDM,99593041_1,Electrocardiogram (ECG) 1 to 3 leads,275.0,178.75,37.41,710.19,19
CDM,99593225_1,Electrocardiogram (ECG) 2-day continuous,500.0,325.0,89.9,1291.25,19
CDM,99593226_1,Electrocardiogram (ECG) 2-day continuous with report,500.0,325.0,89.9,1291.25,19
CDM,99593229_1,Electrocardiogram (ECG) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional,600.0,390.0,60.67,1549.5,19
CDM,99593242_1,Heart rhythm recording continuous external EKG over more than 48 hours up to 7 days,100.0,65.0,25.0,1124.0,19
CDM,99593246_1,Heart rhythm recording of continuous external EKG over 8-15 days,300.0,195.0,75.0,1124.0,19
CDM,99593247_1,Heart rhythm analysis and report of continuous external EKG over 8-15 days,350.0,227.5,87.5,1124.0,19
CDM,99593260_1,Programming of implantable defibrillator system,150.0,97.5,37.5,1052.0,19
CDM,99593261_1,Evaluation of implantable defibrillator system,45.0,29.25,11.25,1052.0,19
CDM,99593270_1,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring,300.0,195.0,60.67,1124.0,19
CDM,99593271_1,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring and transmission and analysis,550.0,357.5,60.67,1420.38,19
CDM,99593279_1,Programming of single lead pacemaker system,77.96,50.67,19.49,1052.0,19
CDM,99593280_1,Programming of dual lead pacemaker system,150.0,97.5,37.5,1052.0,19
CDM,99593281_1,Programming of multiple lead pacemaker system,150.0,97.5,37.5,1052.0,19
CDM,99593282_1,Programming of single lead implantable defibrillator system,150.0,97.5,37.5,1052.0,19
CDM,99593283_1,Programming of dual lead implantable defibrillator system,150.0,97.5,37.5,1052.0,19
CDM,99593284_1,Programming of multiple lead implantable defibrillator system,150.0,97.5,37.5,1052.0,19
CDM,99593285_1,Programming of cardiac rhythm monitor system,150.0,97.5,37.5,1052.0,19
CDM,99593286_1,"Programming of single, dual, or multiple lead or leadless pacemaker system before or after surgery",45.0,29.25,11.25,1052.0,19
CDM,99593287_1,"Programming of single, dual or multiple lead implantable defibrillator system before or after surgery",45.0,29.25,11.25,1052.0,19
CDM,99593288_1,"Evaluation of single, dual, multiple lead or leadless pacemaker system",45.0,29.25,11.25,1052.0,19
CDM,99593289_1,"Evaluation of single, dual, or multiple lead implantable defibrillator system",77.96,50.67,19.49,1052.0,19
CDM,99593290_1,Evaluation of implantable heart and blood vessel monitoring system,45.0,29.25,11.25,1052.0,19
CDM,99593291_1,Evaluation of cardiac rhythm monitor system,45.0,29.25,11.25,1052.0,19
CDM,99593293_1,"Telephonic rhythm strip evaluation of single, dual, multiple lead or leadless pacemaker system, up to 90 days",45.0,29.25,11.25,1052.0,19
CDM,99593296_1,"Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days",150.0,97.5,37.5,1052.0,19
CDM,99593297_1,"Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days",45.0,29.25,11.25,1052.0,19
CDM,99593298_1,"Evaluation of cardiac rhythm monitor system, remote up to 30 days",200.0,130.0,50.0,1052.0,19
CDM,99593308_1,"Ultrasound of heart, follow-up",1252.0,813.8,313.0,3233.29,19
CDM,99593321_1,"Ultrasound of heart blood flow, valves and chambers, follow-up",308.0,200.2,77.0,795.41,19
CDM,99593325_1,"Ultrasound of heart with color-depicted blood flow, rate and valve function",657.0,427.05,158.99,1696.7,19
CDM,99593350_1,"Ultrasound of heart during rest, exercise and/or drug-induced stress with report",1708.0,1110.2,427.0,4410.91,19
CDM,99593619_1,Insertion of catheters for recording and pacing of right heart chambers rhythm,15013.0,9758.45,1052.0,38771.07,19
CDM,99593642_1,Programming of pacing cardioverter-defibrillator,4438.0,2884.7,1052.0,11461.14,19
CDM,99593750_1,Evaluation of lower heart chamber assist device,300.0,195.0,52.57,1052.0,19
CDM,99593786_1,"Ambulatory blood pressure monitoring, 1 day or longer, with recording",250.0,162.5,62.5,1052.0,19
CDM,99593788_1,"Ambulatory blood pressure monitoring, 1 day or longer, with scanning analysis and report",250.0,162.5,62.5,1052.0,19
CDM,99593970_1,Ultrasound study of arm or leg veins with compression and maneuvers,819.0,532.35,204.75,2115.07,19
CDM,99593971_1,Ultrasound study of one arm or leg veins with compression and maneuvers,805.0,523.25,158.99,2078.91,19
CDM,99593980_1,Complete ultrasound of penis artery and vein blood flow,608.0,395.2,152.0,1570.16,19
CDM,99593981_1,Ultrasound of penis artery and vein blood flow,200.0,130.0,50.0,1052.0,19
CDM,99594010_1,Test to measure expiratory airflow and volume,310.0,201.5,77.5,1438.0,19
CDM,99594060_1,Test to measure expiratory airflow and volume changes before and after medication administration,575.0,373.75,143.75,1484.94,19
CDM,99594150_1,Test to measure the total volume of air that can be exhaled after inhaling,300.0,195.0,75.0,1438.0,19
CDM,99594375_1,Test to measure rate of airflow,600.0,390.0,150.0,1549.5,19
CDM,99594617_1,Test for exercise-induced spasm of lung airways,493.0,320.45,83.86,1438.0,19
CDM,99594618_1,Test for exercise-induced lung stress,300.0,195.0,75.0,1438.0,19
CDM,99594619_1,Exercise test for spasm of lung airways,300.0,195.0,75.0,1438.0,19
CDM,99594621_1,Test for exercise-induced heart and lung stress,1250.0,812.5,150.1,3228.13,19
CDM,99594640_1,Inhalation treatment for airway obstruction or sputum production,480.0,312.0,83.86,1239.6,19
CDM,99594642_1,Inhalation treatment for pneumonia,430.0,279.5,83.86,1438.0,19
CDM,99594644_1,"Inhalation treatment for acute airway obstruction, first hour",488.0,317.2,83.86,1260.26,19
CDM,99594664_1,Evaluation of use of breathing device,365.32,237.46,83.86,1177.0,19
CDM,99594726_1,Test to determine lung volumes using sensors,600.0,390.0,150.0,1549.5,19
CDM,99594727_1,Test to determine lung volumes using gas dilution or washout,850.0,552.5,83.86,2195.13,19
CDM,99594729_1,Test to examine how well the lungs exchange gases,365.0,237.25,83.86,1438.0,19
CDM,99594760_1,Test to measure oxygen level in blood using ear or finger device,58.0,37.7,14.5,1438.0,17
CDM,99594761_1,Test to measure oxygen level in blood using ear or finger device multiple times,110.0,71.5,27.5,1438.0,17
CDM,99595004_1,Test for allergy using allergenic extract,25.0,16.25,6.25,383.0,19
CDM,99595012_1,Test to measure the level of nitric oxide gas,38.0,24.7,9.5,1438.0,19
CDM,99595017_1,Test for allergy using combination of methods with venom,38.0,24.7,9.5,383.0,19
CDM,99595018_1,Test for allergy using combination of methods with drug or biological,80.0,52.0,20.0,383.0,19
CDM,99595024_1,Test for allergy using allergenic extract injected into skin,65.0,42.25,0.01,167.86,17
CDM,99595044_1,Test for allergy using skin patch,25.0,16.25,6.25,383.0,19
CDM,99595076_1,"Test for allergy using ingested items, initial 2 hours",1140.0,741.0,285.0,2944.05,19
CDM,99595079_1,"Test for allergy using ingested items, each additional hour",327.0,212.55,81.75,844.48,19
CDM,99595115_1,Professional service for single injection of allergen,55.0,35.75,13.75,208.0,19
CDM,99595117_1,Professional service for multiple injections of allergen,55.0,35.75,13.75,208.0,19
CDM,99595130_1,Professional service for single injection of allergen,50.0,32.5,12.5,208.0,19
CDM,99595131_1,Professional service for multiple injections of allergen,65.0,42.25,16.25,208.0,19
CDM,99595132_1,Professional service for single injection of allergen,80.0,52.0,20.0,208.0,19
CDM,99595133_1,Professional service for multiple injections of allergen,95.0,61.75,23.75,245.34,19
CDM,99595134_1,Professional service for multiple injections of allergen,110.0,71.5,27.5,284.08,19
CDM,99595145_1,Professional service for preparation and provision of 1 stinging insect venom,69.37,45.09,17.34,764.0,19
CDM,99595146_1,Professional service for preparation and provision of 2 stinging insect venom,127.08,82.6,31.77,764.0,19
CDM,99595147_1,Professional service for preparation and provision of 3 stinging insect venom,114.6,74.49,28.65,764.0,19
CDM,99595148_1,Professional service for preparation and provision of 4 stinging insect venom,183.97,119.58,36.45,764.0,19
CDM,99595149_1,Professional service for preparation and provision of 5 stinging insect venom,241.68,157.09,36.45,764.0,19
CDM,99595165_1,Professional service for preparation and provision of 1 or more antigens,50.0,32.5,12.5,208.0,19
CDM,99595180_1,Injection for rapid desensitization to allergen,850.0,552.5,67.58,2195.13,19
CDM,99595199_1,Other allergy or clinical immunology service or procedure,23.0,14.95,0.01,59.4,17
CDM,99595250_1,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment,314.0,204.1,78.5,810.91,19
CDM,99595836_1,Measurement of brain wave activity (EEG) with implanted brain neurostimulator generator with report,75.0,48.75,0.01,193.69,17
CDM,99595851_1,"Measurement of range of motion in arm, leg or each spine section",50.0,32.5,0.01,129.13,15
CDM,99595872_1,"Needle measurement of electrical activity in muscle, including jitter, blocking and/or fiber density",1252.0,813.8,192.82,3233.29,19
CDM,99595885_1,"Needle measurement of electrical activity in arm or leg muscles, limited study",352.0,228.8,88.0,1279.0,19
CDM,99595886_1,"Needle measurement of electrical activity in arm or leg muscles, complete study",746.0,484.9,186.5,1926.55,19
CDM,99595887_1,Needle measurement of electrical activity in trunk or head muscles,384.0,249.6,96.0,1279.0,19
CDM,99595907_1,"Nerve conduction, 1-2 studies",614.0,399.1,153.5,1585.66,19
CDM,99595908_1,"Nerve conduction, 3-4 studies",920.0,598.0,192.82,2375.9,19
CDM,99595909_1,"Nerve conduction, 5-6 studies",1227.0,797.55,192.82,3168.73,19
CDM,99595910_1,"Nerve conduction, 7-8 studies",1534.0,997.1,192.82,3961.56,19
CDM,99595911_1,"Nerve conduction, 9-10 studies",1840.0,1196.0,192.82,4751.8,19
CDM,99595912_1,"Nerve conduction, 11-12 studies",2147.0,1395.55,192.82,5544.63,19
CDM,99595913_1,"Nerve conduction, 13 or more studies",2453.0,1594.45,192.82,6334.87,19
CDM,99595930_1,Measurement of nerve conduction using visual stimulation testing with report,500.0,325.0,125.0,1291.25,19
CDM,99595933_1,Measurement of nerve conduction patterns of eye blink reflex,437.0,284.05,109.25,1128.55,19
CDM,99595937_1,Testing of nerve-muscle junction,500.0,325.0,125.0,1291.25,19
CDM,99595970_1,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator",199.32,129.56,0.01,514.74,17
CDM,99595971_1,Electronic analysis of implanted neurostimulator generator with simple spinal cord or peripheral nerve stimulator programming,119.0,77.35,0.01,307.32,17
CDM,99595972_1,Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming,328.0,213.2,0.01,847.06,17
CDM,99595976_1,Electronic analysis of neurostimulator generator with simple cranial nerve stimulator programming,75.0,48.75,0.01,211.34,17
CDM,99595977_1,Electronic analysis of implanted neurostimulator generator with complex cranial nerve stimulator programming,235.0,152.75,0.01,606.89,17
CDM,99595983_1,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, first 15 minutes with qualified health professional",75.0,48.75,0.01,211.34,17
CDM,99595984_1,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, each additional 15 minutes with qualified health professional",75.0,48.75,0.01,211.34,17
CDM,99595991_1,Maintenance of spinal canal or brain drug infusion pump by health care professional,457.7,297.51,0.01,1182.01,17
CDM,99595992_1,"Repositioning exercises of head for treatment of dizziness, each day",172.0,111.8,0.01,444.19,17
CDM,99596041_1,"Counseling for genetic testing provided by a genetic counselor, each 30 minutes of total time on the date of encounter",185.0,120.25,46.25,477.76,17
CDM,99596105_1,"Test to assess the loss of the ability to speak, write, and understand language",237.0,154.05,59.25,866.51,19
CDM,99596360_1,"Infusion into a vein for hydration, 31-60 minutes",645.0,419.25,111.43,1665.71,19
CDM,99596361_1,"Infusion into a vein for hydration, each additional hour",300.0,195.0,75.0,1019.0,19
CDM,99596365_1,"Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less",625.0,406.25,156.25,1614.06,19
CDM,99596366_1,"Infusion into a vein for therapy, prevention, or diagnosis, each additional hour",115.0,74.75,28.75,1019.0,19
CDM,99596367_1,"Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less",188.0,122.2,47.0,1019.0,19
CDM,99596368_1,"Infusion into a vein for therapy, prevention, or diagnosis concurrent with another infusion",105.0,68.25,26.25,1019.0,19
CDM,99596372_1,Injection of drug or substance under skin or into muscle,225.0,146.25,56.25,1019.0,19
CDM,99596373_1,Injection of drug or substance into artery,190.0,123.5,47.5,1019.0,19
CDM,99596374_1,Injection of drug or substance into vein,500.0,325.0,67.35,1291.25,19
CDM,99596375_1,Injection of additional new drug or substance into vein,107.0,69.55,26.75,1019.0,19
CDM,99596376_1,Injection of additional drug or substance into vein provided in a facility,105.0,68.25,26.25,1019.0,19
CDM,99596380_1,"Administration of seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional",80.0,52.0,20.0,206.6,17
CDM,99596381_1,"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection",80.0,52.0,20.0,206.6,17
CDM,99596401_1,Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle,437.0,284.05,0.01,1128.55,17
CDM,99596402_1,Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle,631.0,410.15,67.35,2054.0,19
CDM,99596405_1,"Administration of chemotherapy into growth, 1-7",160.0,104.0,40.0,2054.0,19
CDM,99596406_1,"Administration of chemotherapy into growth, more than 7",438.0,284.7,0.01,1131.14,17
CDM,99596411_1,Administration of additional new drug or substance into vein using push technique,430.0,279.5,67.35,2054.0,19
CDM,99596413_1,"Administration of chemotherapy into vein, 1 hour or less",1100.0,715.0,275.0,2840.75,19
CDM,99596415_1,"Administration of chemotherapy into vein, each additional hour",202.0,131.3,50.5,2054.0,19
CDM,99596416_1,Administration of prolonged chemotherapy into vein,1143.0,742.95,285.75,2951.8,19
CDM,99596417_1,"Administration of additional new drug or substance into vein, 1 hour or less",505.0,328.25,126.25,2054.0,19
CDM,99596523_1,Irrigation of implanted venous access drug delivery device,613.0,398.45,67.35,1583.07,19
CDM,99596567_1,Application of light to destroy precancer skin growth,350.0,227.5,87.5,903.88,19
CDM,99596573_1,Application of light by qualified health care professional to destroy precancer skin growth,350.0,227.5,87.5,903.88,19
CDM,99596574_1,Application of light with debridement to destroy precancer skin growth,350.0,227.5,87.5,903.88,19
CDM,99596900_1,Application of ultraviolet light to skin,63.83,41.49,0.01,164.84,17
CDM,99596902_1,Exam of hair using microscope to detect shaft abnormality,55.0,35.75,0.01,142.04,17
CDM,99596904_1,Photograph of entire body,295.0,191.75,0.01,761.84,15
CDM,99596910_1,Therapy procedure using ultraviolet radiation with tar or petroleum jelly application,70.0,45.5,0.01,180.78,17
CDM,99596912_1,Therapy procedure using ultraviolet radiation,70.0,45.5,0.01,180.78,17
CDM,99596913_1,"Therapy procedure using ultraviolet radiation, 4-8 hours",310.0,201.5,0.01,800.58,17
CDM,99596920_1,"Treatment of inflammatory skin disease using laser, less than 250.0 sq cm",180.0,117.0,0.01,623.98,17
CDM,99596921_1,"Treatment of inflammatory skin disease using laser, 250.0-500.0 sq cm",180.0,117.0,0.01,623.98,17
CDM,99596922_1,"Treatment of inflammatory skin disease using laser, more than 500.0 sq cm",320.0,208.0,0.01,826.4,17
CDM,99597032_1,"Application of electrical stimulation with therapist present, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,99597110_1,"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",95.0,61.75,23.75,277.0,19
CDM,99597124_1,"Therapy procedure using massage, each 15 minutes",23.07,15.0,5.77,277.0,19
CDM,99597140_1,"Therapy procedure using manual technique, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,99597165_1,"Evaluation for occupational therapy, typically 30 minutes",234.0,152.1,58.5,604.31,19
CDM,99597166_1,"Evaluation for occupational therapy, typically 45 minutes",234.0,152.1,58.5,604.31,19
CDM,99597167_1,"Evaluation for occupational therapy, typically 1 hour",234.0,152.1,58.5,604.31,19
CDM,99597535_1,"Training for self-care or home management, each 15 minutes",160.0,104.0,40.0,413.2,19
CDM,99597597_1,"Removal of tissue from wound, 20.0 sq cm or less",410.0,266.5,0.01,1058.83,17
CDM,99597602_1,Removal of tissue from wound gradually,225.0,146.25,0.01,581.06,17
CDM,99597605_1,"Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less",400.0,260.0,0.01,1033.0,17
CDM,99597606_1,"Therapy procedure using a special bandage and vacuum pump, surface area more than 50.0 sq cm",700.0,455.0,0.01,1807.75,17
CDM,99597760_1,"Training in the use of orthopedic device for arm, leg and/or trunk, each 15 minutes",116.0,75.4,29.0,299.57,19
CDM,99597802_1,"Therapy procedure for nutrition management, each 15 minutes",80.0,52.0,20.0,295.67,19
CDM,99597803_1,"Therapy procedure reassessment for nutrition management, each 15 minutes",62.0,40.3,15.5,295.67,19
CDM,99597804_1,"Therapy procedure for nutrition management with group, each 30 minutes",33.0,21.45,8.25,295.67,19
CDM,99597810_1,"Acupuncture, initial 15 minutes",55.0,35.75,0.01,142.04,17
CDM,99597811_1,"Acupuncture, each additional 15 minutes",30.0,19.5,0.01,77.48,17
CDM,99597813_1,"Acupuncture with electrical stimulation, initial 15 minutes",55.0,35.75,0.01,142.04,17
CDM,99597814_1,"Acupuncture with electrical stimulation, each additional 15 minutes",55.0,35.75,0.01,142.04,17
CDM,99599091_1,"Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 ",200.0,130.0,50.0,516.5,19
CDM,99599151_1,"Use of a drug to induce depression of consciousness by physician performing a procedure (younger than 5 years), initial 15 minutes",978.0,635.7,0.01,2525.69,17
CDM,99599152_1,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",700.0,455.0,0.01,1807.75,17
CDM,99599153_1,"Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes",196.0,127.4,0.01,506.17,17
CDM,99599172_1,Screening of visual function,59.0,38.35,14.75,208.0,17
CDM,99599173_1,Screening for visual sharpness,27.0,17.55,6.75,208.0,17
CDM,99599195_1,Drawing of blood for a medical problem,312.0,202.8,78.0,805.74,19
CDM,99599202_1,"New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more",120.0,78.0,0.01,309.9,15
CDM,99599203_1,"New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more",130.0,84.5,0.01,335.73,15
CDM,99599204_1,"New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more",150.0,97.5,0.01,387.38,15
CDM,99599205_1,"New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more",170.0,110.5,0.01,439.03,15
CDM,99599211_1,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,0.01,309.9,15
CDM,99599212_1,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",120.0,78.0,0.01,309.9,15
CDM,99599213_1,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",120.0,78.0,0.01,309.9,15
CDM,99599214_1,"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more",250.0,162.5,0.01,645.63,15
CDM,99599215_1,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",320.0,208.0,0.01,826.4,15
CDM,99599445_1,"REMOTE MONITORING OF PHYSIOLOGIC PARAMETER(S) (EG, WEIGHT, BLOOD PRESSURE, PULSE OXIMETRY, RESPIRATORY FLOW RATE); DEVICE(S) SUPPLY WITH DAILY RECORDING(S) OR PROGRAMMED ALERT(S) TRANSMISSION, 2-15 DA",125.0,81.25,31.25,322.81,17
CDM,99599453_1,"Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment",300.0,195.0,75.0,774.75,19
CDM,99599454_1,"Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days",125.0,81.25,31.25,322.81,19
CDM,99599457_1,"Management using the results of remote vital sign monitoring per calendar month, first 20 minutes",125.0,81.25,31.25,322.81,19
CDM,99599458_1,"Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes",125.0,81.25,31.25,322.81,19
CDM,99599470_1,"REMOTE PHYSIOLOGIC MONITORING TREATMENT MANAGEMENT SERVICES, CLINICAL STAFF/PHYSICIAN/OTHER QUALIFIED HEALTH CARE PROFESSIONAL TIME IN A CALENDAR MONTH REQUIRING 1 REAL-TIME INTERACTIVE COMMUNICATION ",125.0,81.25,31.25,322.81,17
CDM,99599497_1,"Advance care planning, first 30 minutes",120.0,78.0,0.01,309.9,17
CDM,995C9769_1,Insertion of a temporary device for pressure necrosis of bladder neck and prostate using an endoscope,10721.35,6968.88,2680.34,27687.89,17
CDM,995C9789_1,"INSTILLATION OF ANTI-NEOPLASTIC PHARMACOLOGIC/BIOLOGIC AGENT INTO RENAL PELVIS, ANY METHOD, INCLUDING ALL IMAGING GUIDANCE, INCLUDING VOLUMETRIC MEASUREMENT IF PERFORMED",585.0,380.25,146.25,6451.0,19
CDM,995D0330_1,PANORAMIC IMAGE,200.0,130.0,44.71,516.5,18
CDM,995D0340_1,Imaging of jaws and skull,170.0,110.5,42.5,439.03,18
CDM,995D0350_1,Other procedure on teeth and gums,90.0,58.5,0.01,1775.48,17
CDM,995D0364_1,CT scan of face without contrast,110.0,71.5,27.5,1181.0,18
CDM,995D0365_1,CT scan of face without contrast,120.0,78.0,30.0,1181.0,18
CDM,995D0366_1,CT scan of face without contrast,100.0,65.0,25.0,1181.0,18
CDM,995D0367_1,CT scan of face without contrast,500.0,325.0,125.0,1291.25,18
CDM,995D0470_1,Other procedure on teeth and gums,115.0,74.75,0.01,1775.48,17
CDM,995D0801_1,3D INTRAORAL SCAN DIRECT,40.0,26.0,0.01,103.3,17
CDM,995D4210_1,GINGIVECTOMY/PLASTY 4 OR MOR,10.0,6.5,0.01,1663.36,17
CDM,995D4211_1,GINGIVECTOMY/PLASTY 1 TO 3,75.0,48.75,0.01,1567.53,17
CDM,995D4245_1,APICALLY POSITIONED FLAP,250.0,162.5,0.01,1567.53,17
CDM,995D4265_1,BIO MTRLS TO AID SOFT/OS REG,300.0,195.0,0.01,774.75,17
CDM,995D4266_1,Graft of mouth tissue lining to gum surface,140.0,91.0,0.01,1663.36,17
CDM,995D4267_1,GUIDED TISS REGEN NONRESORB,140.0,91.0,0.01,1567.53,17
CDM,995D4277_1,SOFT TISSUE GRAFT FIRSTTOOTH,3145.0,2044.25,0.01,8121.96,17
CDM,995D4322_1,SPLINT INTRA-CORONAL,1652.0,1073.8,0.01,4266.29,17
CDM,995D4323_1,SPLINT EXTRA-CORONAL,1652.0,1073.8,0.01,4266.29,17
CDM,995D5282_1,"REMOVE UNIL PART DENTURE,MAX",700.0,455.0,0.01,1807.75,17
CDM,995D6010_1,Reconstruction of part of lower or upper jaw bone with implant,5400.0,3510.0,0.01,13945.5,17
CDM,995D6100_1,SURG REMOVAL OF IMPLANT BODY,40.0,26.0,0.01,1921.45,17
CDM,995D6101_1,DEBRIDEMENT OF A PERIIMPLANT,110.0,71.5,0.01,343.71,17
CDM,995D6102_1,DEBRIDEMENT & CONTOURING,110.0,71.5,0.01,343.71,17
CDM,995D6103_1,BONE GRAFT REPAIR PERIMPLANT,110.0,71.5,0.01,1663.36,17
CDM,995D6104_1,Other procedure on teeth and gums,59.0,38.35,0.01,1775.48,17
CDM,995D7111_1,Other procedure on teeth and gums,27.0,17.55,0.01,1775.48,17
CDM,995D7140_1,Other procedure on teeth and gums,75.0,48.75,0.01,1775.48,17
CDM,995D7210_1,Other procedure on teeth and gums,100.0,65.0,0.01,1775.48,17
CDM,995D7220_1,Other procedure on teeth and gums,110.0,71.5,0.01,1775.48,17
CDM,995D7230_1,Other procedure on teeth and gums,120.0,78.0,0.01,1775.48,17
CDM,995D7240_1,Other procedure on teeth and gums,130.0,84.5,0.01,1775.48,17
CDM,995D7241_1,Other procedure on teeth and gums,140.0,91.0,0.01,1775.48,17
CDM,995D7250_1,Other procedure on teeth and gums,150.0,97.5,0.01,1775.48,17
CDM,995D7251_1,Other procedure on teeth and gums,100.0,65.0,0.01,1775.48,17
CDM,995D7260_1,Other procedure on teeth and gums,110.0,71.5,0.01,1775.48,17
CDM,995D7261_1,Other procedure on teeth and gums,120.0,78.0,0.01,1775.48,17
CDM,995D7280_1,Other procedure on teeth and gums,130.0,84.5,0.01,1775.48,17
CDM,995D7282_1,Other procedure on teeth and gums,140.0,91.0,0.01,1775.48,17
CDM,995D7283_1,Other procedure on teeth and gums,110.0,71.5,0.01,1775.48,17
CDM,995D7285_1,BIOPSY OF ORAL TISSUE HARD,120.0,78.0,0.01,1775.48,17
CDM,995D7286_1,BIOPSY OF ORAL TISSUE SOFT,130.0,84.5,0.01,1775.48,17
CDM,995D7292_1,Insertion of wire or pin to bone for traction,3500.0,2275.0,0.01,9038.75,17
CDM,995D7300_1,Other procedure on teeth and gums,1330.0,864.5,0.01,3434.73,17
CDM,995D7310_1,Reshaping of tooth socket,150.0,97.5,0.01,4191.3,17
CDM,995D7311_1,Reshaping of tooth socket,350.0,227.5,0.01,4191.3,17
CDM,995D7320_1,Reshaping of tooth socket,120.0,78.0,0.01,4191.3,17
CDM,995D7321_1,Reshaping of tooth socket,110.0,71.5,0.01,4191.3,17
CDM,995D7410_1,RAD EXC LESION UP TO 1.25 CM,110.0,71.5,0.01,2697.15,17
CDM,995D7411_1,EXCISION BENIGN LESION>1.25C,110.0,71.5,0.01,1775.48,17
CDM,995D7450_1,REM ODONTOGEN CYST TO 1.25CM,110.0,71.5,0.01,1775.48,17
CDM,995D7471_1,Other prosthetic procedure for upper jaw and face,110.0,71.5,0.01,2263.29,17
CDM,995D7472_1,Removal of bony growth of upper jaw bone inside mouth,110.0,71.5,0.01,3879.59,17
CDM,995D7473_1,Removal of bony growth of jaw bone inside mouth,165.0,107.25,0.01,3879.59,17
CDM,995D7485_1,Removal of dental bone,110.0,71.5,0.01,4191.3,17
CDM,995D7510_1,I&D ABSC INTRAORAL SOFT TISS,110.0,71.5,0.01,1775.48,17
CDM,995D7511_1,INCISION/DRAIN ABSCESS INTRA,110.0,71.5,0.01,1775.48,17
CDM,995D7530_1,REMOVAL FB SKIN/AREOLAR TISS,110.0,71.5,0.01,1775.48,17
CDM,995D7550_1,REMOVAL OF SLOUGHED OFF BONE,110.0,71.5,0.01,1775.48,17
CDM,995D7950_1,MANDIBLE GRAFT,110.0,71.5,0.01,3879.59,17
CDM,995D7951_1,SINUS AUG W BONE OR BONE SUB,1715.0,1114.75,0.01,4428.99,17
CDM,995D7953_1,BONE REPLACEMENT GRAFT,110.0,71.5,0.01,3879.59,17
CDM,995D7960_1,FRENULECTOMY/FRENECTOMY,25.0,16.25,0.01,1775.48,17
CDM,995D7971_1,EXCISION PERICORONAL GINGIVA,25.0,16.25,0.01,1567.53,17
CDM,995D7995_1,Other procedure on teeth and gums,25.0,16.25,0.01,1775.48,17
CDM,995D9222_1,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",700.0,455.0,0.01,1807.75,17
CDM,995D9223_1,"Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes",196.0,127.4,0.01,506.17,17
CDM,995D9239_1,"IV MOD SEDATION, 1ST 15 MIN",90.0,58.5,0.01,232.43,17
CDM,995D9243_1,IV SEDATION EA ADDL 15M,90.0,58.5,0.01,232.43,17
CDM,995D9248_1,SEDATION (NON-IV),50.0,32.5,0.01,129.13,14
CDM,995G0008_1,ADMINISTRATION OF INFLUENZA VIRUS VACCINE,80.0,52.0,20.0,206.6,19
CDM,995G0009_1,ADMINISTRATION OF PNEUMOCOCCAL VACCINE,90.0,58.5,22.5,232.43,19
CDM,995G0010_1,ADMINISTRATION OF HEPATITIS B VACCINE,72.0,46.8,18.0,185.94,19
CDM,995G0101_1,CERVICAL OR VAGINAL CANCER SCREENING; PELVIC AND CLINICAL BREAST EXAMINATION,75.0,48.75,18.75,193.69,16
CDM,995G0127_1,"TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER",65.0,42.25,0.01,167.86,17
CDM,995G0404_1,"ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT, PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATION",65.0,42.25,16.25,339.0,19
CDM,995G0429_1,"DERMAL FILLER INJECTION(S) FOR THE TREATMENT OF FACIAL LIPODYSTROPHY SYNDROME (LDS) (E.G., AS A RESULT OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY)",3343.0,2172.95,0.01,8633.3,17
CDM,995G0444_1,"ANNUAL DEPRESSION SCREENING, 5 TO 15 MINUTES",84.0,54.6,0.01,216.93,17
CDM,995G0447_1,"FACE-TO-FACE BEHAVIORAL COUNSELING FOR OBESITY, 15 MINUTES",75.0,48.75,0.01,193.69,17
CDM,995G2066_1,"INTERROGATION DEVICE EVALUATION(S), (REMOTE) UP TO 30 DAYS; IMPLANTABLE CARDIOVASCULAR PHYSIOLOGIC MONITOR SYSTEM, IMPLANTABLE LOOP RECORDER SYSTEM, OR SUBCUTANEOUS CARDIAC RHYTHM MONITOR SYSTEM, REMO",200.0,130.0,50.0,1124.0,17
CDM,995M0220_1,"INJECTION, TIXAGEVIMAB AND CILGAVIMAB, FOR THE PRE-EXPOSURE PROPHYLAXIS ONLY, FOR CERTAIN ADULTS AND PEDIATRIC INDIVIDUALS (12 YEARS OF AGE AND OLDER WEIGHING AT LEAST 40KG) WITH NO KNOWN SARS-COV-2 E",375.0,243.75,76.0,968.44,17
CDM,995M0222_1,"INTRAVENOUS INJECTION, BEBTELOVIMAB, INCLUDES INJECTION AND POST ADMINISTRATION MONITORING",615.0,399.75,76.0,1588.24,17
CDM,995Q0091_1,"SCREENING PAPANICOLAOU SMEAR; OBTAINING, PREPARING AND CONVEYANCE OF CERVICAL OR VAGINAL SMEAR TO LABORATORY",53.0,34.45,13.25,136.87,19
CDM,995Q0111_1,"WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL OR SKIN SPECIMENS",44.0,28.6,5.88,113.63,19
CDM,995Q0112_1,ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS,16.0,10.4,0.01,41.32,17
CDM,995Q0114_1,FERN TEST,30.0,19.5,2.92,77.48,19
CDM,995Q0162_1,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",61.0,39.65,0.01,157.53,17
CDM,995S0800_1,LASER IN SITU KERATOMILEUSIS (LASIK),1846.0,1199.9,461.5,8477.27,18
CDM,995V0001_1,"BINAURAL, IN THE EAR",4800.0,3120.0,1200.0,12396.0,16
CDM,995V0002_1,"BINAURAL, BEHIND THE EAR",4800.0,3120.0,1200.0,12396.0,16
CDM,995V0003_1,"HEARING AID, MONAURAL, IN THE EAR",2400.0,1560.0,600.0,6198.0,16
CDM,995V0004_1,"DISPENSING FEE, BINAURAL",2400.0,1560.0,44.39,6198.0,18
CDM,995V0005_1,"BINAURAL, BEHIND THE EAR",5200.0,3380.0,1300.0,13429.0,16
CDM,995V0006_1,"HEARING AID, MONAURAL, BEHIND THE EAR",2600.0,1690.0,650.0,6714.5,16
CDM,995V0007_1,"BINAURAL, IN THE EAR",3600.0,2340.0,900.0,9297.0,16
CDM,995V0008_1,"BINAURAL, BEHIND THE EAR",3600.0,2340.0,900.0,9297.0,16
CDM,995V0009_1,"HEARING AID, MONAURAL, IN THE EAR",1800.0,1170.0,450.0,4648.5,16
CDM,995V0010_1,"HEARING AID, MONAURAL, BEHIND THE EAR",1800.0,1170.0,450.0,4648.5,16
CDM,995V0011_1,"BINAURAL, BEHIND THE EAR",4000.0,2600.0,1000.0,10330.0,16
CDM,995V0012_1,"HEARING AID, MONAURAL, BEHIND THE EAR",2000.0,1300.0,500.0,5165.0,16
CDM,995V0013_1,"BINAURAL, IN THE EAR",2400.0,1560.0,600.0,6198.0,16
CDM,995V0014_1,"BINAURAL, BEHIND THE EAR",2400.0,1560.0,600.0,6198.0,16
CDM,995V0015_1,"HEARING AID, MONAURAL, IN THE EAR",1200.0,780.0,300.0,3099.0,16
CDM,995V0016_1,"HEARING AID, MONAURAL, BEHIND THE EAR",1200.0,780.0,300.0,3099.0,16
CDM,995V0017_1,"BINAURAL, BEHIND THE EAR",2800.0,1820.0,700.0,7231.0,16
CDM,995V0018_1,"HEARING AID, MONAURAL, BEHIND THE EAR",1400.0,910.0,350.0,3615.5,16
CDM,995V0019_1,"BINAURAL, IN THE EAR",1600.0,1040.0,400.0,4132.0,16
CDM,995V0020_1,"BINAURAL, BEHIND THE EAR",1600.0,1040.0,400.0,4132.0,16
CDM,995V0021_1,"HEARING AID, MONAURAL, IN THE EAR",800.0,520.0,200.0,2066.0,16
CDM,995V0022_1,"HEARING AID, MONAURAL, BEHIND THE EAR",800.0,520.0,200.0,2066.0,16
CDM,995V0037_1,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR (ITE)",1000.0,650.0,250.0,2582.5,16
CDM,995V0038_1,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE CANAL (ITC)",1000.0,650.0,250.0,2582.5,16
CDM,995V0039_1,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, BEHIND THE EAR (BTE)",1000.0,650.0,250.0,2582.5,16
CDM,995V0040_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE",2200.0,1430.0,550.0,5681.5,16
CDM,995V0041_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE",2800.0,1820.0,700.0,7231.0,16
CDM,995V0042_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE",3400.0,2210.0,850.0,8780.5,16
CDM,995V0043_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC",2200.0,1430.0,550.0,5681.5,16
CDM,995V0044_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC",2800.0,1820.0,700.0,7231.0,16
CDM,995V0045_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC",3400.0,2210.0,850.0,8780.5,16
CDM,995V0046_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE",2200.0,1430.0,550.0,5681.5,16
CDM,995V0047_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE",2800.0,1820.0,700.0,7231.0,16
CDM,995V0048_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE",3400.0,2210.0,850.0,8780.5,16
CDM,995V0049_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC",2200.0,1430.0,550.0,5681.5,16
CDM,995V0050_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC",2800.0,1820.0,700.0,7231.0,16
CDM,995V0051_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC",3400.0,2210.0,850.0,8780.5,16
CDM,995V0052_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE",2200.0,1430.0,550.0,5681.5,16
CDM,995V0053_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE",2800.0,1820.0,700.0,7231.0,16
CDM,995V0054_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE",3400.0,2210.0,850.0,8780.5,16
CDM,995V0055_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE",2200.0,1430.0,550.0,5681.5,16
CDM,995V0056_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE",2800.0,1820.0,700.0,7231.0,16
CDM,995V0057_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE",3400.0,2210.0,850.0,8780.5,16
CDM,995V0058_1,"HEARING AID, DIGITAL, MONAURAL, ITE",3050.0,1982.5,762.5,7876.63,16
CDM,995V0059_1,"HEARING AID, DIGITAL, MONAURAL, BTE",3050.0,1982.5,762.5,7876.63,16
CDM,995V0060_1,"HEARING AID, DIGITAL, BINAURAL, ITE",7700.0,5005.0,1925.0,19885.25,16
CDM,995V0061_1,"HEARING AID, DIGITAL, BINAURAL, BTE",7700.0,5005.0,1925.0,19885.25,16
CDM,995V0062_1,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR (ITE)",4010.0,2606.5,1002.5,10355.83,16
CDM,995V0063_1,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE CANAL (ITC)",4010.0,2606.5,1002.5,10355.83,16
CDM,995V0064_1,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, BEHIND THE EAR (BTE)",8020.0,5213.0,2005.0,20711.65,16
CDM,995V0065_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE",8020.0,5213.0,2005.0,20711.65,16
CDM,995V0066_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC",8020.0,5213.0,2005.0,20711.65,16
CDM,995V0067_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE",8020.0,5213.0,2005.0,20711.65,16
CDM,995V0068_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC",8020.0,5213.0,2005.0,20711.65,16
CDM,995V0069_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE",8020.0,5213.0,2005.0,20711.65,16
CDM,995V0070_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE",8020.0,5213.0,2005.0,20711.65,16
CDM,995V1000_1,"DISPENSING FEE, BINAURAL",1000.0,650.0,44.39,2582.5,19
CDM,995V1001_1,"DISPENSING FEE, BINAURAL",800.0,520.0,44.39,2066.0,19
CDM,995V1002_1,"DISPENSING FEE, BINAURAL",600.0,390.0,44.39,1549.5,19
CDM,995V1003_1,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",500.0,325.0,44.39,1291.25,19
CDM,995V1004_1,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",400.0,260.0,44.39,1033.0,19
CDM,995V1005_1,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",300.0,195.0,44.39,774.75,19
CDM,995V1006_1,"DISPENSING FEE, CONTRALATERAL, MONAURAL",300.0,195.0,44.39,774.75,19
CDM,995V1007_1,"DISPENSING FEE, CONTRALATERAL, MONAURAL",400.0,260.0,44.39,1033.0,19
CDM,995V1008_1,"DISPENSING FEE, CONTRALATERAL, MONAURAL",500.0,325.0,44.39,1291.25,19
CDM,995V1009_1,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",300.0,195.0,44.39,774.75,19
CDM,995V1010_1,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",400.0,260.0,44.39,1033.0,19
CDM,995V1011_1,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",500.0,325.0,44.39,1291.25,19
CDM,995V1012_1,"DISPENSING FEE, BINAURAL",2850.0,1852.5,44.39,7360.13,19
CDM,995V1013_1,"DISPENSING FEE, CONTRALATERAL, MONAURAL",1400.0,910.0,44.39,3615.5,19
CDM,995V1014_1,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",2850.0,1852.5,44.39,7360.13,19
CDM,995V1015_1,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",1400.0,910.0,44.39,3615.5,19
CDM,995V2000_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",300.0,195.0,75.0,774.75,16
CDM,995V2001_1,"EAR MOLD/INSERT, NOT DISPOSABLE, ANY TYPE",75.0,48.75,18.75,193.69,16
CDM,995V2002_1,"EAR MOLD/INSERT, NOT DISPOSABLE, ANY TYPE",50.0,32.5,12.5,129.13,16
CDM,995V2004_1,BATTERY FOR USE IN HEARING DEVICE,1.12,0.73,0.28,2.89,16
CDM,995V2005_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",425.0,276.25,106.25,1097.56,16
CDM,995V2006_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",450.0,292.5,112.5,1162.13,16
CDM,995V2007_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",175.0,113.75,43.75,451.94,16
CDM,995V2008_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",325.0,211.25,81.25,839.31,16
CDM,995V2009_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",450.0,292.5,112.5,1162.13,16
CDM,995V2010_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",500.0,325.0,125.0,1291.25,16
CDM,995V2011_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",325.0,211.25,81.25,839.31,16
CDM,995V2012_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",350.0,227.5,87.5,903.88,16
CDM,995V2013_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",325.0,211.25,81.25,839.31,16
CDM,995V2014_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",200.0,130.0,50.0,516.5,16
CDM,995V2015_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",300.0,195.0,75.0,774.75,16
CDM,995V2016_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",450.0,292.5,112.5,1162.13,16
CDM,995V2017_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",300.0,195.0,75.0,774.75,16
CDM,995V2018_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",400.0,260.0,100.0,1033.0,16
CDM,995V2019_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",275.0,178.75,68.75,710.19,16
CDM,995V2020_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",250.0,162.5,62.5,645.63,16
CDM,995V2021_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",250.0,162.5,62.5,645.63,16
CDM,995V2022_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",150.0,97.5,37.5,387.38,16
CDM,995V2023_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",125.0,81.25,31.25,322.81,16
CDM,995V2024_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",400.0,260.0,100.0,1033.0,16
CDM,995V2025_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",400.0,260.0,100.0,1033.0,16
CDM,995V2026_1,"EAR MOLD/INSERT, NOT DISPOSABLE, ANY TYPE",240.0,156.0,60.0,619.8,16
CDM,995V2027_1,BATTERY FOR USE IN HEARING DEVICE,10.0,6.5,2.5,25.83,16
CDM,995V3006_1,"Other procedure on ear, nose, or throat",299.0,194.35,74.75,772.17,19
CDM,995V3014_1,"Other procedure on ear, nose, or throat",500.0,325.0,125.0,1291.25,19
CDM,995V3015_1,"Other procedure on ear, nose, or throat",250.0,162.5,62.5,645.63,19
CDM,995V3016_1,"Other procedure on ear, nose, or throat",600.0,390.0,0.01,1549.5,17
CDM,995V3017_1,"HEARING SERVICE, MISCELLANEOUS",750.0,487.5,187.5,1936.88,17
CDM,9967IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.56,2.96,1.14,11.78,16
CDM,9967OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.8,7.02,2.7,27.89,16
CDM,9969IP _1,UNCLASSIFIED DRUGS,12.96,8.42,3.24,33.47,16
CDM,9969OP _1,UNCLASSIFIED DRUGS,3.05,1.98,0.76,7.88,16
CDM,9973IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",49.25,32.01,12.31,127.19,16
CDM,9974IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",46.41,30.17,11.6,119.85,16
CDM,99754IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",45.95,29.87,11.49,118.67,16
CDM,99755IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",45.95,29.87,11.49,118.67,16
CDM,99755OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.2,16.38,6.3,65.08,16
CDM,9975IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.7,31.01,11.93,123.19,16
CDM,9977IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",97.09,63.11,24.27,250.73,16
CDM,9979IP _1,UNCLASSIFIED DRUGS,23888.03,15527.22,5972.01,61690.84,16
CDM,9979OP _1,UNCLASSIFIED DRUGS,700.15,455.1,175.04,1808.14,16
CDM,9980IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.46,8.75,3.37,34.76,16
CDM,9980OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.01,4.56,1.75,18.1,16
CDM,9982IP _1,ETHAMBUTOL HCL 100 MG TABLET,3.94,2.56,0.99,2.76,11
CDM,99837IP _1,GUANFACINE HCL ER 3 MG TABLET,10.75,6.99,2.69,7.53,11
CDM,9983IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.73,4.37,1.68,17.38,16
CDM,9983OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.77,6.35,2.44,25.23,16
CDM,9989IP _1,ETHOSUXIMIDE 250 MG CAPSULE,3.53,2.29,0.88,2.47,11
CDM,998IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.75,3.09,1.19,12.27,16
CDM,998OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.7,13.46,5.18,53.46,16
CDM,999IP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.98,3.24,1.25,12.86,16
CDM,999OP _1,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",33.1,21.52,8.28,85.48,16
CDM,99IP _1,UNCLASSIFIED DRUGS,1.41,0.92,0.35,3.64,16
CDM,99OP _1,UNCLASSIFIED DRUGS,3.71,2.41,0.93,9.58,16
CDM,A4220_1,REFILL KIT FOR IMPLANTABLE INFUSION PUMP,21.0,13.65,9.45,80.89,15
CDM,A4262_1,"TEMPORARY, ABSORBABLE LACRIMAL DUCT IMPLANT, EACH",89.3,58.05,0.12,91.98,15
CDM,A4263_1,"PERMANENT, LONG TERM, NON-DISSOLVABLE LACRIMAL DUCT IMPLANT, EACH",84.0,54.6,9.9,86.52,15
CDM,A4300_1,"IMPLANTABLE ACCESS CATHETER, (E.G., VENOUS, ARTERIAL, EPIDURAL SUBARACHNOID, OR PERITONEAL, ETC.) EXTERNAL ACCESS",202.7,131.76,3.22,208.78,15
CDM,A4314_1,"INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER OR HYDROPHILIC, ETC.)",10.5,6.83,5.25,89.98,19
CDM,A4315_1,"INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY, ALL SILICONE",10.5,6.83,5.25,93.88,19
CDM,A4356_1,"EXTERNAL URETHRAL CLAMP OR COMPRESSION DEVICE (NOT TO BE USED FOR CATHETER CLAMP), EACH",120.8,78.52,23.27,155.69,19
CDM,A4358_1,"URINARY DRAINAGE BAG, LEG OR ABDOMEN, VINYL, WITH OR WITHOUT TUBE, WITH STRAPS, EACH",18.9,12.29,3.53,78.57,19
CDM,A4364_1,"ADHESIVE, LIQUID OR EQUAL, ANY TYPE, PER OZ",42.65,27.72,1.56,78.57,19
CDM,A4450_1,"TAPE, NON-WATERPROOF, PER 18 SQUARE INCHES",25.0,16.25,0.06,78.57,19
CDM,A4452_1,"TAPE, WATERPROOF, PER 18 SQUARE INCHES",40.0,26.0,0.2,78.57,19
CDM,A4461_1,"SURGICAL DRESSING HOLDER, NON-REUSABLE, EACH",28.4,18.46,1.76,78.57,19
CDM,A4550_1,SURGICAL TRAYS,36.8,23.92,7.3,78.57,15
CDM,A4561_1,"PESSARY, REUSABLE, RUBBER, ANY TYPE",67.2,43.68,10.83,78.57,19
CDM,A4562_1,"PESSARY, REUSABLE, NON RUBBER, ANY TYPE",73.5,47.78,26.94,180.27,19
CDM,A4565_1,SLINGS,33.6,21.84,4.1,78.57,19
CDM,A4570_1,SPLINT,25.0,16.25,4.33,78.57,15
CDM,A4595_1,"ELECTRICAL STIMULATOR SUPPLIES, 2 LEAD, PER MONTH, (E.G., TENS, NMES)",346.5,225.23,7.14,173.25,19
CDM,A6261_1,"WOUND FILLER, GEL/PASTE, PER FLUID OUNCE, NOT OTHERWISE SPECIFIED",60.9,39.59,0.99,78.57,15
CDM,A6530_1,"GRADIENT COMPRESSION STOCKING, BELOW KNEE, 18-30 MMHG, EACH",12.6,8.19,6.3,97.58,19
CDM,A6531_1,"GRADIENT COMPRESSION STOCKING, BELOW KNEE, 30-40 MMHG, USED AS A SURGICAL DRESSING, EACH",14.7,9.56,7.35,154.0,19
CDM,A6532_1,"GRADIENT COMPRESSION STOCKING, BELOW KNEE, 40-50 MMHG, USED AS A SURGICAL DRESSING, EACH",21.0,13.65,10.5,216.98,19
CDM,A9279_1,"MONITORING FEATURE/DEVICE, STAND-ALONE OR INTEGRATED, ANY TYPE, INCLUDES ALL ACCESSORIES, COMPONENTS AND ELECTRONICS, NOT OTHERWISE CLASSIFIED",386.4,251.16,73.6,397.99,15
CDM,A9300_1,EXERCISE EQUIPMENT,32.5,21.13,14.63,80.89,15
CDM,A9500_1,"TECHNETIUM TC-99M SESTAMIBI, DIAGNOSTIC, PER STUDY DOSE",500.0,325.0,78.57,696.15,15
CDM,A9502_1,"TECHNETIUM TC-99M TETROFOSMIN, DIAGNOSTIC, PER STUDY DOSE",225.0,146.25,78.57,257.66,15
CDM,B4087_1,"GASTROSTOMY/JEJUNOSTOMY TUBE, STANDARD, ANY MATERIAL, ANY TYPE, EACH",304.5,197.93,13.27,152.25,15
CDM,B4088_1,"GASTROSTOMY/JEJUNOSTOMY TUBE, LOW-PROFILE, ANY MATERIAL, ANY TYPE, EACH",252.0,163.8,14.84,259.56,15
CDM,D0120_1,PERIODIC ORAL EVALUATION,82.0,53.3,16.5,78.57,15
CDM,D0140_1,LIMIT ORAL EVAL PROBLM FOCUS,88.64,57.62,23.61,78.57,15
CDM,D0150_1,COMPREHENSVE ORAL EVALUATION,110.0,71.5,23.61,78.57,15
CDM,D0160_1,EXTENSV ORAL EVAL PROB FOCUS,190.0,123.5,32.47,153.47,15
CDM,D0170_1,"RE-EVAL,EST PT,PROBLEM FOCUS",110.0,71.5,19.24,78.57,15
CDM,D0171_1,RE-EVAL POST-OP VISIT,110.0,71.5,16.5,78.57,15
CDM,D0180_1,COMP PERIODONTAL EVALUATION,315.0,204.75,23.61,157.5,15
CDM,D0210_1,INTRAOR COMPREHENSIVE SERIES,153.0,99.45,17.14,120.52,15
CDM,D0220_1,INTRAORAL PERIAPICAL FIRST,39.0,25.35,4.21,78.57,15
CDM,D0230_1,INTRAORAL PERIAPICAL EA ADD,27.56,17.91,1.94,78.57,15
CDM,D0240_1,INTRAORAL OCCLUSAL FILM,40.0,26.0,5.18,78.57,15
CDM,D0270_1,DENTAL BITEWING SINGLE IMAGE,118.69,77.15,4.21,78.57,15
CDM,D0272_1,DENTAL BITEWINGS TWO IMAGES,164.09,106.66,5.18,82.05,15
CDM,D0273_1,BITEWINGS - THREE IMAGES,164.09,106.66,6.79,82.05,15
CDM,D0274_1,BITEWINGS FOUR IMAGES,193.14,125.54,8.41,96.57,15
CDM,D0330_1,PANORAMIC IMAGE,140.0,91.0,11.97,95.62,15
CDM,D0340_1,2D CEPHALOMETRIC IMAGE,210.0,136.5,18.11,120.52,15
CDM,D0350_1,ORAL/FACIAL PHOTO IMAGES,79.0,51.35,23.61,81.37,15
CDM,D0364_1,CONE BEAM CT CAPT & INTERP,525.0,341.25,47.87,540.75,15
CDM,D0365_1,CONE BEAM CT INTERPRETE MAN,365.0,237.25,47.87,503.07,15
CDM,D0366_1,CONE BEAM CT INTERPRETE MAX,551.0,358.15,47.87,567.53,15
CDM,D0367_1,CONE BEAM CT INTERP BOTH JAW,578.0,375.7,47.87,595.34,15
CDM,D0368_1,CONE BEAM CT INTERPRETE TMJ,578.0,375.7,69.87,737.45,15
CDM,D0460_1,PULP VITALITY TEST,60.0,39.0,19.08,78.57,15
CDM,D0461_1,TESTING FOR CRACKED TOOTH,10.0,6.5,4.5,80.0,12
CDM,D0470_1,DIAGNOSTIC CASTS,156.0,101.4,29.76,107.93,15
CDM,D0801_1,3D INTRAORAL SCAN DIRECT,80.0,52.0,36.0,235.53,15
CDM,D1110_1,DENTAL PROPHYLAXIS ADULT,112.0,72.8,37.52,94.67,15
CDM,D1120_1,DENTAL PROPHYLAXIS CHILD,88.0,57.2,25.23,78.57,15
CDM,D1206_1,TOPICAL FLUORIDE VARNISH,68.0,44.2,15.53,78.57,15
CDM,D1208_1,TOPICAL APP FLUORID EX VRNSH,61.0,39.65,12.29,78.57,15
CDM,D1351_1,DENTAL SEALANT PER TOOTH,85.0,55.25,19.73,78.57,15
CDM,D2140_1,AMALGAM ONE SURFACE PERMANEN,170.0,110.5,44.96,110.68,15
CDM,D2150_1,AMALGAM TWO SURFACES PERMANE,200.0,130.0,50.14,133.28,15
CDM,D2160_1,AMALGAM THREE SURFACES PERMA,241.0,156.65,61.13,160.86,15
CDM,D2161_1,AMALGAM 4 OR > SURFACES PERM,281.0,182.65,74.4,197.23,15
CDM,D2330_1,RESIN ONE SURFACE-ANTERIOR,197.0,128.05,44.96,127.09,15
CDM,D2331_1,RESIN TWO SURFACES-ANTERIOR,275.63,179.16,67.6,165.97,15
CDM,D2332_1,RESIN THREE SURFACES-ANTERIO,281.0,182.65,78.57,198.98,15
CDM,D2335_1,RESIN 4/> SURF OR W INCIS AN,329.0,213.85,78.57,234.79,15
CDM,D2391_1,POST 1 SRFC RESINBASED CMPST,200.0,130.0,44.96,148.81,15
CDM,D2392_1,POST 2 SRFC RESINBASED CMPST,254.0,165.1,78.57,220.44,15
CDM,D2393_1,POST 3 SRFC RESINBASED CMPST,295.0,191.75,78.57,298.4,15
CDM,D2394_1,POST >=4SRFC RESINBASE CMPST,312.0,202.8,78.57,314.2,15
CDM,D2520_1,DENTAL INLAY METALLIC 2 SURF,976.0,634.4,78.57,1005.28,15
CDM,D2530_1,DENTAL INLAY METL 3/MORE SUR,1125.0,731.25,78.57,1158.75,15
CDM,D2543_1,DENTAL ONLAY METALLIC 3 SURF,875.0,568.75,78.57,967.08,15
CDM,D2544_1,DENTAL ONLAY METL 4/MORE SUR,910.0,591.5,78.57,1006.13,15
CDM,D2643_1,DENTAL ONLAY PORCELIN 3 SURF,905.0,588.25,78.57,999.93,15
CDM,D2710_1,CROWN RESIN-BASED INDIRECT,898.0,583.7,78.57,553.03,15
CDM,D2740_1,CROWN PORCELAIN/CERAMIC,1230.0,799.5,78.57,1105.18,15
CDM,D2750_1,CROWN PORCELAIN W/ H NOBLE M,1214.0,789.1,78.57,1216.64,15
CDM,D2751_1,CROWN PORCELAIN FUSED BASE M,1131.0,735.15,78.57,999.93,15
CDM,D2752_1,CROWN PORCELAIN W/ NOBLE MET,1158.0,752.7,78.57,1023.74,15
CDM,D2780_1,CROWN 3/4 CAST HI NOBLE MET,945.0,614.25,78.57,1029.92,15
CDM,D2790_1,CROWN FULL CAST HIGH NOBLE M,1170.0,760.5,78.57,1048.97,15
CDM,D2791_1,CROWN FULL CAST BASE METAL,1110.0,721.5,78.57,980.6,15
CDM,D2799_1,INTERIM CROWN,513.0,333.45,78.57,528.39,15
CDM,D2910_1,RECEMENT INLAY ONLAY OR PART,97.0,63.05,24.05,87.75,15
CDM,D2920_1,RE-CEMENT OR RE-BOND CROWN,101.0,65.65,24.05,88.67,15
CDM,D2930_1,PREFAB STNLSS STEEL CRWN PRI,393.0,255.45,78.57,240.1,15
CDM,D2931_1,PREFAB STNLSS STEEL CROWN PE,393.0,255.45,78.57,331.7,15
CDM,D2932_1,PREFABRICATED RESIN CROWN,349.0,226.85,78.57,291.15,15
CDM,D2940_1,PLACE DIRECT RESTORATION,109.0,70.85,33.96,92.18,15
CDM,D2950_1,CORE BUILD-UP INCL ANY PINS,261.0,169.65,78.57,230.09,15
CDM,D2951_1,TOOTH PIN RETENTION,55.0,35.75,13.23,78.57,15
CDM,D2952_1,POST AND CORE CAST + CROWN,398.0,258.7,78.57,442.35,15
CDM,D2954_1,PREFAB POST/CORE + CROWN,330.0,214.5,78.57,291.15,15
CDM,D2960_1,LABIAL VENEER RESIN DIRECT,806.0,523.9,78.57,830.18,15
CDM,D2962_1,LABIAL VENEER PORC INDIRECT,980.0,637.0,78.57,1009.4,15
CDM,D2999_1,DENTAL UNSPEC RESTORATIVE PR,37.0,24.05,16.65,80.89,15
CDM,D3110_1,PULP CAP DIRECT,85.0,55.25,33.64,87.55,15
CDM,D3120_1,PULP CAP INDIRECT,70.0,45.5,26.52,78.57,15
CDM,D3220_1,THERAPEUTIC PULPOTOMY,237.0,154.05,78.57,198.43,15
CDM,D3221_1,GROSS PULPAL DEBRIDEMENT,190.0,123.5,78.57,263.37,15
CDM,D3310_1,"END THXPY, ANTERIOR TOOTH",822.0,534.3,78.57,673.27,15
CDM,D3320_1,"END THXPY, PREMOLAR TOOTH",849.0,551.85,78.57,758.49,15
CDM,D3330_1,"END THXPY, MOLAR TOOTH",1130.0,734.5,78.57,939.5,15
CDM,D3347_1,RETREAT ROOT CANAL PREMOLAR,1158.0,752.7,78.57,968.84,15
CDM,D3348_1,RETREAT ROOT CANAL MOLAR,1433.0,931.45,78.57,1199.85,15
CDM,D3351_1,APEXIFICATION/RECALC INITIAL,419.0,272.35,78.57,351.61,15
CDM,D3352_1,APEXIFICATION/RECALC INTERIM,188.0,122.2,78.57,250.99,15
CDM,D3410_1,APICOECTOMY - ANTERIOR,660.0,429.0,78.57,696.74,15
CDM,D3421_1,ROOT SURGERY PREMOLAR,735.0,477.75,78.57,775.12,15
CDM,D3425_1,ROOT SURGERY MOLAR,1047.0,680.55,78.57,1078.41,15
CDM,D3426_1,ROOT SURGERY EA ADD ROOT,285.0,185.25,78.57,329.99,15
CDM,D3430_1,RETROGRADE FILLING,263.0,170.95,78.57,270.89,15
CDM,D3450_1,ROOT AMPUTATION,525.0,341.25,78.57,540.75,15
CDM,D3950_1,CANAL PREP/FITTING OF DOWEL,172.0,111.8,77.4,198.43,15
CDM,D4210_1,GINGIVECTOMY/PLASTY 4 OR MOR,625.0,406.25,78.57,545.05,15
CDM,D4211_1,GINGIVECTOMY/PLASTY 1 TO 3,241.0,156.65,76.66,242.13,15
CDM,D4245_1,APICALLY POSITIONED FLAP,800.0,520.0,78.57,824.0,15
CDM,D4249_1,CROWN LENGTHEN HARD TISSUE,903.0,586.95,78.57,930.09,15
CDM,D4260_1,OSSEOUS SURGERY 4 OR MORE,1040.0,676.0,78.57,1150.52,15
CDM,D4261_1,OSSEOUS SURG 1 TO 3 TEETH,560.0,364.0,78.57,662.8,15
CDM,D4263_1,BONE REPLCE GRAFT FIRST SITE,525.0,341.25,78.57,540.75,15
CDM,D4264_1,BONE REPLCE GRAFT EACH ADD,525.0,341.25,78.57,540.75,15
CDM,D4265_1,BIO MTRLS TO AID SOFT/OS REG,800.0,520.0,78.57,824.0,15
CDM,D4266_1,GUIDED TISS REGEN RESORBLE,525.0,341.25,78.57,742.72,15
CDM,D4267_1,GUIDED TISS REGEN NONRESORB,735.0,477.75,78.57,855.9,15
CDM,D4270_1,PEDICLE SOFT TISSUE GRAFT PR,740.0,481.0,78.57,818.27,15
CDM,D4273_1,AUTO TISSUE GRAFT 1ST TOOTH,900.0,585.0,78.57,999.93,15
CDM,D4274_1,MESIAL/DISTAL WEDGE PROC,515.0,334.75,78.57,567.06,15
CDM,D4276_1,CON TISSUE W PEDICLE GRAFT,1010.0,656.5,78.57,1121.19,15
CDM,D4277_1,SOFT TISSUE GRAFT FIRSTTOOTH,780.0,507.0,78.57,2104.03,15
CDM,D4278_1,SOFT TISSUE GRAFT ADDL TOOTH,390.0,253.5,78.57,701.21,15
CDM,D4322_1,SPLINT INTRA-CORONAL,550.0,357.5,78.57,581.64,15
CDM,D4323_1,SPLINT EXTRA-CORONAL,885.0,575.25,78.57,442.5,15
CDM,D4341_1,PERIODONTAL SCALING & ROOT,339.0,220.35,78.57,266.76,15
CDM,D4342_1,PERIODONTAL SCALING 1-3TEETH,176.0,114.4,58.87,144.84,15
CDM,D4346_1,SCALING GINGIV INFLAMMATION,75.0,48.75,33.75,481.06,15
CDM,D4355_1,FULL MOUTH DEBRIDEMENT,214.0,139.1,54.67,157.9,15
CDM,D4910_1,PERIODONTAL MAINT PROCEDURES,161.0,104.65,34.87,140.59,15
CDM,D5110_1,DENTURES COMPLETE MAXILLARY,2243.0,1457.95,78.57,1702.16,15
CDM,D5120_1,DENTURES COMPLETE MANDIBLE,2243.0,1457.95,78.57,1702.16,15
CDM,D5130_1,DENTURES IMMEDIAT MAXILLARY,1890.0,1228.5,78.57,1871.52,15
CDM,D5140_1,DENTURES IMMEDIAT MANDIBLE,1969.0,1279.85,78.57,1871.52,15
CDM,D5211_1,DENTURES MAXILL PART RESIN,1570.0,1020.5,78.57,1157.05,15
CDM,D5212_1,DENTURES MAND PART RESIN,1570.0,1020.5,78.57,1303.16,15
CDM,D5213_1,DENTURES MAXILL PART METAL,1890.0,1228.5,78.57,2041.79,15
CDM,D5214_1,DENTURES MANDIBL PART METAL,2142.17,1392.41,78.57,2041.79,15
CDM,D5282_1,"REMOVE UNIL PART DENTURE,MAX",1720.0,1118.0,78.57,1771.6,15
CDM,D5283_1,"REMOVE UNIL PART DENTURE,MAN",1720.0,1118.0,78.57,1771.6,15
CDM,D5284_1,REM UNILAT DENT FLEX BASE,1720.0,1118.0,78.57,1771.6,15
CDM,D5286_1,REM UNILAT DENT 1 PC RESIN,1720.0,1118.0,78.57,1771.6,15
CDM,D5410_1,DENTURES ADJUST CMPLT MAXIL,82.0,53.3,24.05,81.61,15
CDM,D5411_1,DENTURES ADJUST CMPLT MAND,82.0,53.3,24.05,81.61,15
CDM,D5421_1,DENTURES ADJUST PART MAXILL,82.0,53.3,24.05,81.61,15
CDM,D5422_1,DENTURES ADJUST PART MANDBL,82.0,53.3,24.05,81.61,15
CDM,D5511_1,REP BROKE COMP DENT BASE MAN,345.0,224.25,78.57,203.54,15
CDM,D5512_1,REP BROKE COMP DENT BASE MAX,345.0,224.25,78.57,203.54,15
CDM,D5520_1,REPLACE DENTURE TEETH COMPLT,199.0,129.35,55.64,136.08,15
CDM,D5611_1,REP RESIN PART DENT BASE MAN,318.0,206.7,78.57,203.54,15
CDM,D5612_1,REP RESIN PART DENT BASE MAX,318.0,206.7,78.57,203.54,15
CDM,D5630_1,REP PARTIAL DENTURE CLASP,400.0,260.0,78.57,250.99,15
CDM,D5640_1,REPLACE PART DENTURE TEETH,199.37,129.59,70.72,203.54,15
CDM,D5650_1,ADD TOOTH TO PARTIAL DENTURE,206.0,133.9,70.72,203.54,15
CDM,D5660_1,ADD CLASP TO PARTIAL DENTURE,349.0,226.85,78.57,339.62,15
CDM,D5710_1,DENTURES REBASE CMPLT MAXIL,657.0,427.05,78.57,680.3,15
CDM,D5720_1,DENTURES REBASE PART MAXILL,657.0,427.05,78.57,544.3,15
CDM,D5730_1,DENTURE RELN CMPLT MAX DIR,368.0,239.2,78.57,408.19,15
CDM,D5731_1,DENTURE RELN CMPLT MAND DIR,368.0,239.2,78.57,408.19,15
CDM,D5740_1,DENTURE RELN PART MAX DIR,368.0,239.2,78.57,339.62,15
CDM,D5741_1,DENTURE RELN PART MAND DIR,368.0,239.2,78.57,339.62,15
CDM,D5750_1,DENTURE RELN CMPLT MAX INDIR,636.3,413.6,78.57,544.3,15
CDM,D5751_1,DENTURE RELN CMPLT MAND IND,579.03,376.37,78.57,544.3,15
CDM,D5760_1,DENTURE RELN PART MAX INDIR,572.0,371.8,78.57,544.3,15
CDM,D5761_1,DENTURE RELN PART MAND INDIR,572.0,371.8,78.57,544.3,15
CDM,D5810_1,DENTURE INTERM CMPLT MAXILL,1181.0,767.65,78.57,816.38,15
CDM,D5811_1,DENTURE INTERM CMPLT MANDBL,1181.0,767.65,78.57,816.38,15
CDM,D5820_1,DENTURE INTERM PART MAXILL,799.0,519.35,78.57,680.3,15
CDM,D5821_1,DENTURE INTERM PART MANDBL,799.0,519.35,78.57,680.3,15
CDM,D5850_1,DENTURE TISS CONDITN MAXILL,158.0,102.7,51.7,177.3,15
CDM,D5851_1,DENTURE TISS CONDTIN MANDBL,146.0,94.9,51.7,177.3,15
CDM,D5863_1,OVERDENTURE COMPLETE MAX,3230.0,2099.5,78.57,3326.9,15
CDM,D5865_1,OVERDENTURE COMPLETE MANDIB,3230.0,2099.5,78.57,3326.9,15
CDM,D5875_1,PROSTHESIS MODIFICATION,394.0,256.1,78.57,405.82,15
CDM,D5911_1,FACIAL MOULAGE SECTIONAL,2100.0,1365.0,78.57,2163.0,15
CDM,D5913_1,NASAL PROSTHESIS,2320.54,1508.35,78.57,7093.06,15
CDM,D5915_1,ORBITAL PROSTHESIS,3146.24,2045.06,78.57,9597.8,15
CDM,D5923_1,OCULAR PROSTHESIS INTERIM,4949.0,3216.85,78.57,9549.58,15
CDM,D5927_1,AURICULAR REPLACEMENT,2570.0,1670.5,78.57,5968.82,15
CDM,D5928_1,ORBITAL REPLACEMENT,3146.24,2045.06,78.57,8056.68,15
CDM,D5931_1,SURGICAL OBTURATOR,2498.0,1623.7,78.57,3818.75,15
CDM,D5932_1,POSTSURGICAL OBTURATOR,7170.0,4660.5,78.57,7385.1,15
CDM,D5933_1,REFITTING OF OBTURATOR,2650.0,1722.5,78.57,2729.5,15
CDM,D5935_1,MANDIBULAR DENTURE PROSTH,2129.81,1384.38,78.57,5663.12,15
CDM,D5936_1,TEMP OBTURATOR PROSTHESIS,7190.0,4673.5,78.57,7405.7,15
CDM,D5952_1,PEDIATRIC SPEECH AID,2151.94,1398.76,78.57,3374.94,15
CDM,D5953_1,ADULT SPEECH AID,2151.94,1398.76,78.57,6410.93,15
CDM,D5954_1,SUPERIMPOSED PROSTHESIS,5965.0,3877.25,78.57,6143.95,15
CDM,D5955_1,PALATAL LIFT PROSTHESIS,1842.97,1197.93,78.57,5495.22,15
CDM,D5958_1,INTRAORAL CON DEF INTER PLT,1842.97,1197.93,78.57,3213.26,15
CDM,D5959_1,INTRAORAL CON DEF MOD PALAT,1842.97,1197.93,78.57,1898.26,15
CDM,D5960_1,MODIFY SPEECH AID PROSTHESIS,2151.94,1398.76,78.57,2216.5,15
CDM,D5982_1,SURGICAL STENT,644.0,418.6,78.57,663.32,15
CDM,D5984_1,RADIATION SHIELD,1808.0,1175.2,78.57,1862.24,15
CDM,D5986_1,FLUORIDE APPLICATOR,125.0,81.25,56.25,203.54,15
CDM,D5988_1,SURGICAL SPLINT,1182.55,768.66,78.57,1218.03,15
CDM,D6010_1,ODONTICS ENDOSTEAL IMPLANT,2100.0,1365.0,78.57,2218.01,15
CDM,D6011_1,ODONTICS ENDOSTEAL IMPLANT,371.0,241.15,78.57,2218.01,15
CDM,D6012_1,ENDOSTEAL IMPLANT,2105.0,1368.25,78.57,2168.15,15
CDM,D6040_1,ODONTICS EPOSTEAL IMPLANT,7660.0,4979.0,78.57,7889.8,15
CDM,D6049_1,SCALE IMPLT PERI-IMPLT INFLM,50.0,32.5,22.5,80.0,12
CDM,D6050_1,ODONTICS TRANSOSTEAL IMPLNT,2762.35,1795.53,78.57,5694.21,15
CDM,D6055_1,IMPLANT CONNECTING BAR,2925.0,1901.25,78.57,3012.75,15
CDM,D6056_1,PREFABRICATED ABUTMENT,1341.87,872.22,78.57,1382.13,15
CDM,D6057_1,CUSTOM ABUTMENT,1030.0,669.5,78.57,1060.9,15
CDM,D6058_1,ABUTMENT SUPPORTED CROWN,1444.0,938.6,78.57,1487.32,15
CDM,D6059_1,ABUTMENT SUPPORTED MTL CROWN,1424.0,925.6,78.57,1466.72,15
CDM,D6060_1,ABUTMENT SUPPORTED MTL CROWN,1347.0,875.55,78.57,1387.41,15
CDM,D6061_1,ABUTMENT SUPPORTED MTL CROWN,1575.0,1023.75,78.57,1622.25,15
CDM,D6062_1,ABUTMENT SUPPORTED MTL CROWN,1575.0,1023.75,78.57,1622.25,15
CDM,D6065_1,IMPLANT SUPPORTED CROWN,1421.0,923.65,78.57,1463.63,15
CDM,D6066_1,IMPLANT SUPPORTED MTL CROWN,1384.0,899.6,78.57,1425.52,15
CDM,D6067_1,IMPLANT SUPPORTED MTL CROWN,1343.0,872.95,78.57,1383.29,15
CDM,D6069_1,ABUTMENT SUPPORTED RETAINER,8925.0,5801.25,78.57,9192.75,15
CDM,D6071_1,ABUTMENT SUPPORTED RETAINER,1680.0,1092.0,78.57,1730.4,15
CDM,D6072_1,ABUTMENT SUPPORTED RETAINER,6825.0,4436.25,78.57,7029.75,15
CDM,D6076_1,IMPLANT SUPPORTED RETAINER,3780.0,2457.0,78.57,3893.4,15
CDM,D6077_1,IMPLANT SUPPORTED RETAINER,12600.0,8190.0,78.57,12978.0,15
CDM,D6080_1,IMPLANT MAINTENANCE,158.0,102.7,71.1,192.29,15
CDM,D6090_1,REPAIR IMPLANT,158.0,102.7,71.1,614.57,15
CDM,D6095_1,ODONTICS REPR ABUTMENT,712.0,462.8,284.8,733.36,14
CDM,D6100_1,SURG REMOVAL OF IMPLANT BODY,1136.0,738.4,78.57,1170.08,15
CDM,D6101_1,DEBRIDEMENT OF A PERIIMPLANT,728.0,473.2,78.57,749.84,15
CDM,D6102_1,DEBRIDEMENT & CONTOURING,1372.0,891.8,78.57,1413.16,15
CDM,D6103_1,BONE GRAFT REPAIR PERIMPLANT,740.0,481.0,78.57,762.2,15
CDM,D6104_1,BONE GRAFT TIME OF IMPLANT,862.0,560.3,78.57,887.86,15
CDM,D6105_1,REMOVE IMPLANT BODY,600.0,390.0,78.57,618.0,15
CDM,D6190_1,RADIO/SURGICAL IMPLANT INDEX,368.0,239.2,78.57,379.04,15
CDM,D6193_1,REPLACE IMPLNT SCREW,200.0,130.0,73.6,356.39,15
CDM,D6210_1,PROSTHODONT HIGH NOBLE METAL,920.0,598.0,78.57,1098.12,15
CDM,D6212_1,BRIDGE NOBLE METAL CAST,1062.0,690.3,78.57,1093.86,15
CDM,D6240_1,BRIDGE PORCELAIN HIGH NOBLE,1231.69,800.6,78.57,1268.64,15
CDM,D6242_1,BRIDGE PORCELAIN NOBEL METAL,1048.0,681.2,78.57,1098.12,15
CDM,D6245_1,BRIDGE PORCELAIN/CERAMIC,1028.0,668.2,78.57,1058.84,15
CDM,D6250_1,BRIDGE RESIN W/HIGH NOBLE,895.0,581.75,78.57,1098.12,15
CDM,D6545_1,DENTAL RETAINR CAST METL,368.0,239.2,78.57,521.36,15
CDM,D6740_1,CROWN PORCELAIN/CERAMIC,1067.0,693.55,78.57,1114.17,15
CDM,D6750_1,CROWN PORCELAIN HIGH NOBLE,1228.0,798.2,78.57,1317.69,15
CDM,D6752_1,CROWN PORCELAIN NOBLE METAL,1173.0,762.45,78.57,1208.19,15
CDM,D6790_1,CROWN FULL HIGH NOBLE METAL,1186.0,770.9,78.57,1221.58,15
CDM,D6920_1,DENTAL CONNECTOR BAR,1050.0,682.5,78.57,1081.5,15
CDM,D6930_1,RECEMENT/BOND PART DENTURE,147.0,95.55,44.96,127.09,15
CDM,D6950_1,PRECISION ATTACHMENT,637.0,414.05,78.57,656.11,15
CDM,D6980_1,FIXED PARTIAL REPAIR,276.0,179.4,78.57,362.95,15
CDM,D7111_1,EXTRACTION CORONAL REMNANTS,149.0,96.85,52.91,196.33,15
CDM,D7140_1,EXTRACTION ERUPTED TOOTH/EXR,224.0,145.6,65.34,196.33,15
CDM,D7210_1,REM IMP TOOTH W MUCOPER FLP,425.0,276.25,78.57,451.52,15
CDM,D7220_1,IMPACT TOOTH REMOV SOFT TISS,413.0,268.45,78.57,451.52,15
CDM,D7230_1,IMPACT TOOTH REMOV PART BONY,565.0,367.25,78.57,689.21,15
CDM,D7240_1,IMPACT TOOTH REMOV COMP BONY,684.0,444.6,78.57,689.21,15
CDM,D7241_1,IMPACT TOOTH REM BONY W/COMP,717.0,466.05,78.57,726.85,15
CDM,D7250_1,TOOTH ROOT REMOVAL,298.0,193.7,78.57,290.48,15
CDM,D7251_1,CORONECTOMY,520.0,338.0,78.57,690.74,15
CDM,D7260_1,ORAL ANTRAL FISTULA CLOSURE,1661.0,1079.65,78.57,1710.83,15
CDM,D7261_1,PRIMARY CLOSURE SINUS PERF,660.0,429.0,78.57,763.61,15
CDM,D7270_1,TOOTH REIMPLANTATION,525.0,341.25,78.57,523.96,15
CDM,D7272_1,TOOTH TRANSPLANTATION,660.0,429.0,78.57,726.85,15
CDM,D7280_1,EXPOSURE OF UNERUPTED TOOTH,474.0,308.1,78.57,437.26,15
CDM,D7282_1,MOBILIZE ERUPTED/MALPOS TOOT,386.0,250.9,78.57,531.02,15
CDM,D7283_1,PLACE DEVICE IMPACTED TOOTH,210.0,136.5,78.57,553.03,15
CDM,D7285_1,BIOPSY OF ORAL TISSUE HARD,925.0,601.25,78.57,848.25,15
CDM,D7286_1,BIOPSY OF ORAL TISSUE SOFT,466.0,302.9,78.57,363.37,15
CDM,D7290_1,REPOSITIONING OF TEETH,1250.0,812.5,78.57,1287.5,15
CDM,D7291_1,TRANSSEPTAL FIBEROTOMY,315.0,204.75,78.57,324.45,15
CDM,D7292_1,SCREW RETAINED PLATE,635.0,412.75,78.57,7634.4,15
CDM,D7296_1,"CORTICOTOMY, 1-3 TEETH",670.0,435.5,78.57,1745.06,15
CDM,D7297_1,"CORTICOTOMY, 4 OR MORE TEETH",695.0,451.75,78.57,1817.93,15
CDM,D7300_1,REM ANCHORAGE DEV W/O FLAP,588.0,382.2,73.6,605.64,15
CDM,D7310_1,ALVEOPLASTY W/ EXTRACTION,473.0,307.45,78.57,305.46,15
CDM,D7311_1,ALVEOLOPLASTY W/EXTRACT 1-3,368.0,239.2,78.57,384.47,15
CDM,D7320_1,ALVEOPLASTY W/O EXTRACTION,525.0,341.25,78.57,394.47,15
CDM,D7321_1,ALVEOLOPLASTY NOT W/EXTRACTS,368.0,239.2,78.57,560.07,15
CDM,D7340_1,VESTIBULOPLASTY RIDGE EXTENS,1750.0,1137.5,78.57,1802.5,15
CDM,D7350_1,VESTIBULOPLASTY EXTEN GRAFT,5090.0,3308.5,78.57,5242.7,15
CDM,D7410_1,RAD EXC LESION UP TO 1.25 CM,765.0,497.25,78.57,787.95,15
CDM,D7411_1,EXCISION BENIGN LESION>1.25C,1210.0,786.5,78.57,1246.3,15
CDM,D7450_1,REM ODONTOGEN CYST TO 1.25CM,1310.0,851.5,78.57,1349.3,15
CDM,D7451_1,REM ODONTOGEN CYST > 1.25 CM,2416.0,1570.4,78.57,2488.48,15
CDM,D7460_1,REM NONODONTO CYST TO 1.25CM,6300.0,4095.0,78.57,6489.0,15
CDM,D7461_1,REM NONODONTO CYST > 1.25 CM,1581.0,1027.65,78.57,1628.43,15
CDM,D7465_1,LESION DESTRUCTION,263.0,170.95,78.57,394.47,15
CDM,D7471_1,REM EXOSTOSIS ANY SITE,960.0,624.0,78.57,900.45,15
CDM,D7472_1,REMOVAL OF TORUS PALATINUS,1125.0,731.25,78.57,1158.75,15
CDM,D7473_1,REMOVE TORUS MANDIBULARIS,1060.0,689.0,78.57,1091.8,15
CDM,D7485_1,SURG REDUCT OSSEOUSTUBEROSIT,1104.0,717.6,78.57,1137.12,15
CDM,D7490_1,MAXILLA OR MANDIBLE RESECTIO,7635.0,4962.75,78.57,9015.96,15
CDM,D7510_1,I&D ABSC INTRAORAL SOFT TISS,517.0,336.05,50.5,260.34,15
CDM,D7511_1,INCISION/DRAIN ABSCESS INTRA,1050.0,682.5,78.57,1081.5,15
CDM,D7520_1,I&D ABSCESS EXTRAORAL,1305.0,848.25,78.57,1344.15,15
CDM,D7530_1,REMOVAL FB SKIN/AREOLAR TISS,470.0,305.5,78.57,484.1,15
CDM,D7550_1,REMOVAL OF SLOUGHED OFF BONE,2489.0,1617.85,78.57,2563.67,15
CDM,D7560_1,MAXILLARY SINUSOTOMY,2580.0,1677.0,78.57,2657.4,15
CDM,D7630_1,OPEN RED SIMPL MANDIBLE FX,5831.0,3790.15,78.57,6005.93,15
CDM,D7640_1,CLSD RED SIMPL MANDIBLE FX,4725.0,3071.25,78.57,4866.75,15
CDM,D7650_1,OPEN RED SIMP MALAR/ZYGOM FX,3675.0,2388.75,78.57,4580.4,15
CDM,D7730_1,OPEN REDUCT COMPD MANDBLE FX,7090.0,4608.5,78.57,7302.7,15
CDM,D7840_1,REMOVAL OF TMJ CONDYLE,6250.0,4062.5,78.57,6437.5,15
CDM,D7858_1,TMJ RECONSTRUCTION,13875.0,9018.75,78.57,14291.25,15
CDM,D7865_1,TMJ RESHAPING COMPONENTS,8860.0,5759.0,78.57,9125.8,15
CDM,D7870_1,TMJ ASPIRATION JOINT FLUID,525.0,341.25,78.57,540.75,15
CDM,D7880_1,OCCLUSAL ORTHOTIC APPLIANCE,1231.69,800.6,78.57,1268.64,15
CDM,D7910_1,DENT SUTUR RECENT WND TO 5CM,420.0,273.0,78.57,432.6,15
CDM,D7921_1,COLLECT & APPL BLOOD PRODUCT,490.0,318.5,78.57,504.7,15
CDM,D7941_1,BONE CUTTING RAMUS CLOSED,9900.0,6435.0,78.57,10197.0,15
CDM,D7943_1,CUTTING RAMUS OPEN W/GRAFT,7200.0,4680.0,78.57,10324.68,15
CDM,D7945_1,BONE CUTTING BODY MANDIBLE,8530.0,5544.5,78.57,8785.9,15
CDM,D7946_1,RECONSTRUCTION MAXILLA TOTAL,10565.0,6867.25,78.57,10881.95,15
CDM,D7947_1,RECONSTRUCT MAXILLA SEGMENT,10619.0,6902.35,78.57,10937.57,15
CDM,D7948_1,RECONSTRUCT MIDFACE NO GRAFT,11530.0,7494.5,78.57,11875.9,15
CDM,D7950_1,MANDIBLE GRAFT,1575.0,1023.75,78.57,3126.63,15
CDM,D7951_1,SINUS AUG W BONE OR BONE SUB,4253.0,2764.45,78.57,4380.59,15
CDM,D7953_1,BONE REPLACEMENT GRAFT,788.0,512.2,78.57,1380.91,15
CDM,D7955_1,REPAIR MAXILLOFACIAL DEFECTS,260.0,169.0,78.57,3429.52,15
CDM,D7960_1,FRENULECTOMY/FRENECTOMY,432.0,280.8,73.6,444.96,12
CDM,D7963_1,FRENULOPLASTY,909.0,590.85,78.57,936.27,15
CDM,D7970_1,EXCISION HYPERPLASTIC TISSUE,814.0,529.1,78.57,838.42,15
CDM,D7971_1,EXCISION PERICORONAL GINGIVA,525.0,341.25,78.57,540.75,15
CDM,D7972_1,SURG REDCT FIBROUS TUBEROSIT,739.0,480.35,78.57,761.17,15
CDM,D7983_1,CLOSURE OF SALIVARY FISTULA,2444.0,1588.6,78.57,2517.32,15
CDM,D7991_1,DENTAL CORONOIDECTOMY,3820.0,2483.0,78.57,4507.53,15
CDM,D7994_1,SURG PLACE ZYGOMATIC IMPL,1691.0,1099.15,78.57,3998.32,15
CDM,D7995_1,SYNTHETIC GRAFT FACIAL BONES,525.0,341.25,73.6,540.75,15
CDM,D7999_1,ORAL SURGERY PROCEDURE,358.31,232.9,73.6,369.06,15
CDM,D8030_1,LIMITED DENTAL TX ADOLESCENT,263.0,170.95,78.57,2373.33,15
CDM,D8080_1,COMPRE DENTAL TX ADOLESCENT,394.0,256.1,78.57,6169.89,15
CDM,D8210_1,ORTHODONTIC REM APPLIANCE TX,508.0,330.2,78.57,806.62,15
CDM,D8693_1,REBOND/RECEMENT RETAINERS,137.0,89.05,61.65,141.11,12
CDM,D9110_1,PALLIATIVE TX DENTAL PAIN,105.0,68.25,27.66,95.64,15
CDM,D9120_1,FIX PARTIAL DENTURE SECTION,237.0,154.05,63.4,244.11,15
CDM,D9210_1,DENT ANESTHESIA W/O SURGERY,63.0,40.95,16.5,78.57,15
CDM,D9211_1,REGIONAL BLOCK ANESTHESIA,79.0,51.35,21.67,81.37,15
CDM,D9212_1,TRIGEMINAL BLOCK ANESTHESIA,210.0,136.5,62.16,216.3,15
CDM,D9222_1,"DEEP ANEST, 1ST 15 MIN",298.0,193.7,46.9,149.0,15
CDM,D9223_1,GENERAL ANESTH EA ADDL 15 MI,274.0,178.1,46.9,137.0,15
CDM,D9230_1,ANALGESIA,105.0,68.25,16.5,78.57,15
CDM,D9239_1,"IV MOD SEDATION, 1ST 15 MIN",210.0,136.5,43.67,109.97,15
CDM,D9243_1,IV SEDATION EA ADDL 15M,185.0,120.25,43.67,109.97,15
CDM,D9248_1,SEDATION (NON-IV),105.0,68.25,47.25,204.65,14
CDM,D9310_1,DENTAL CONSULTATION,143.0,92.95,29.11,198.75,15
CDM,D9430_1,OFFICE VISIT DURING HOURS,59.0,38.35,21.67,78.57,15
CDM,D9610_1,DENT THERAPEUTIC DRUG INJECT,110.0,71.5,18.11,113.3,15
CDM,D9612_1,THERA PAR DRUGS 2 OR > ADMIN,203.0,131.95,45.29,209.09,15
CDM,D9630_1,DRUGS/MEDS DISP FOR HOME USE,53.0,34.45,9.06,78.57,15
CDM,D9910_1,DENT APPL DESENSITIZING MED,59.0,38.35,16.5,78.57,15
CDM,D9911_1,APPL DESENSITIZING RESIN,73.0,47.45,19.73,78.57,15
CDM,D9920_1,BEHAVIOR MANAGEMENT,75.0,48.75,29.11,87.81,15
CDM,D9930_1,TREATMENT OF COMPLICATIONS,89.0,57.85,30.73,91.77,15
CDM,D9941_1,FABRICATION ATHLETIC GUARD,210.0,136.5,52.72,216.3,15
CDM,D9944_1,"OCC GUARD, HARD, FULL ARCH",577.0,375.05,78.57,393.18,15
CDM,D9945_1,"OCC GUARD, SOFT, FULL ARCH",577.0,375.05,78.57,323.8,15
CDM,D9946_1,"OCC GUARD, HARD, PART ARCH",555.0,360.75,78.57,297.61,15
CDM,D9951_1,LIMITED OCCLUSAL ADJUSTMENT,110.0,71.5,41.73,113.3,15
CDM,D9952_1,COMPLETE OCCLUSAL ADJUSTMENT,756.0,491.4,78.57,778.68,15
CDM,D9970_1,ENAMEL MICROABRASION,85.0,55.25,38.25,123.35,15
CDM,D9971_1,ODONTOPLASTY PER TOOTH,153.0,99.45,48.84,157.59,15
CDM,D9972_1,EXTRNL BLEACHING PER ARCH,333.0,216.45,78.57,342.99,15
CDM,D9973_1,EXTRNL BLEACHING PER TOOTH,236.0,153.4,42.07,243.08,15
CDM,D9974_1,INTRNL BLEACHING PER TOOTH,284.0,184.6,74.4,292.52,15
CDM,E0114_1,"CRUTCHES UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, PAIR, WITH PADS, TIPS AND HANDGRIPS",40.5,26.33,20.25,167.98,19
CDM,E0486_1,"ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY, ADJUSTABLE OR NON-ADJUSTABLE, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",1729.82,1124.38,73.6,2200.0,11
CDM,E0720_1,"TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) DEVICE, TWO LEAD, LOCALIZED STIMULATION",50.0,32.5,11.72,178.3,19
CDM,E0856_1,"CERVICAL TRACTION DEVICE, WITH INFLATABLE AIR BLADDER(S)",875.0,568.75,21.93,901.25,19
CDM,E0942_1,CERVICAL HEAD HARNESS/HALTER,33.6,21.84,5.86,78.57,19
CDM,G0008_1,ADMINISTRATION OF INFLUENZA VIRUS VACCINE,80.0,52.0,28.96,82.4,15
CDM,G0009_1,ADMINISTRATION OF PNEUMOCOCCAL VACCINE,50.0,32.5,22.5,78.57,15
CDM,G0010_1,ADMINISTRATION OF HEPATITIS B VACCINE,31.5,20.48,14.18,78.57,15
CDM,G0027_1,SEMEN ANALYSIS; PRESENCE AND/OR MOTILITY OF SPERM EXCLUDING HUHNER,23.5,15.28,1.53,78.57,19
CDM,G0076_1,"BRIEF (20 MINUTES) CARE MANAGEMENT HOME VISIT FOR A NEW PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, ASSIST",132.0,85.8,47.5,135.96,19
CDM,G0077_1,"LIMITED (30 MINUTES) CARE MANAGEMENT HOME VISIT FOR A NEW PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, ASSI",190.0,123.5,71.38,198.68,19
CDM,G0078_1,"MODERATE (45 MINUTES) CARE MANAGEMENT HOME VISIT FOR A NEW PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, ASS",311.0,202.15,78.57,324.55,19
CDM,G0079_1,"COMPREHENSIVE (60 MINUTES) CARE MANAGEMENT HOME VISIT FOR A NEW PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME",436.0,283.4,78.57,449.08,19
CDM,G0080_1,"EXTENSIVE (75 MINUTES) CARE MANAGEMENT HOME VISIT FOR A NEW PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, AS",530.0,344.5,78.57,552.89,19
CDM,G0081_1,"BRIEF (20 MINUTES) CARE MANAGEMENT HOME VISIT FOR AN EXISTING PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, ",132.0,85.8,47.47,135.96,19
CDM,G0082_1,"LIMITED (30 MINUTES) CARE MANAGEMENT HOME VISIT FOR AN EXISTING PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME",200.0,130.0,77.34,210.49,19
CDM,G0083_1,"MODERATE (45 MINUTES) CARE MANAGEMENT HOME VISIT FOR AN EXISTING PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOM",308.0,200.2,78.57,326.73,19
CDM,G0084_1,"COMPREHENSIVE (60 MINUTES) CARE MANAGEMENT HOME VISIT FOR AN EXISTING PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, RES",428.0,278.2,78.57,459.62,19
CDM,G0085_1,"EXTENSIVE (75 MINUTES) CARE MANAGEMENT HOME VISIT FOR AN EXISTING PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HO",530.0,344.5,78.57,552.89,19
CDM,G0086_1,"LIMITED (30 MINUTES) CARE MANAGEMENT HOME CARE PLAN OVERSIGHT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, ASSISTED",184.0,119.6,69.53,195.68,19
CDM,G0087_1,"COMPREHENSIVE (60 MINUTES) CARE MANAGEMENT HOME CARE PLAN OVERSIGHT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, AS",300.0,195.0,78.57,309.0,19
CDM,G0101_1,CERVICAL OR VAGINAL CANCER SCREENING; PELVIC AND CLINICAL BREAST EXAMINATION,75.0,48.75,22.67,94.46,19
CDM,G0102_1,PROSTATE CANCER SCREENING; DIGITAL RECTAL EXAMINATION,53.6,34.84,7.37,78.57,19
CDM,G0103_1,PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA),75.3,48.95,11.59,78.57,19
CDM,G0104_1,COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY,363.3,236.15,49.43,446.91,19
CDM,G0105_1,COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK,1074.2,698.23,78.57,1106.43,19
CDM,G0106_1,"COLORECTAL CANCER SCREENING; ALTERNATIVE TO G0104, SCREENING SIGMOIDOSCOPY, BARIUM ENEMA",572.3,372.0,228.92,589.47,14
CDM,G0108_1,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",129.2,83.98,53.07,146.34,19
CDM,G0120_1,"COLORECTAL CANCER SCREENING; ALTERNATIVE TO G0105, SCREENING COLONOSCOPY, BARIUM ENEMA.",572.3,372.0,228.92,589.47,14
CDM,G0121_1,COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK,1060.0,689.0,78.57,1091.8,19
CDM,G0122_1,COLORECTAL CANCER SCREENING; BARIUM ENEMA,785.9,510.84,314.36,809.48,14
CDM,G0123_1,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION",78.8,51.22,12.16,81.16,19
CDM,G0127_1,"TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER",55.7,36.21,6.42,78.57,19
CDM,G0130_1,"SINGLE ENERGY X-RAY ABSORPTIOMETRY (SEXA) BONE DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) (E.G., RADIUS, WRIST, HEEL)",100.8,65.52,10.53,103.82,19
CDM,G0136_1,"ADMINISTRATION OF A STANDARDIZED, EVIDENCE-BASED ASSESSMENT OF PHYSICAL ACTIVITY AND NUTRITION, 5-15 MINUTES, NOT MORE OFTEN THAN EVERY 6 MONTHS",20.0,13.0,7.68,78.57,19
CDM,G0159_1,"SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST, IN THE HOME HEALTH SETTING, IN THE ESTABLISHMENT OR DELIVERY OF A SAFE AND EFFECTIVE PHYSICAL THERAPY MAINTENANCE PROGRAM, EACH 15 MINUTES",477.8,310.57,73.6,492.13,15
CDM,G0166_1,"EXTERNAL COUNTERPULSATION, PER TREATMENT SESSION",445.2,289.38,78.57,458.56,19
CDM,G0179_1,"PHYSICIAN OR ALLOWED PRACTITIONER RE-CERTIFICATION FOR MEDICARE-COVERED HOME HEALTH SERVICES UNDER A HOME HEALTH PLAN OF CARE (PATIENT NOT PRESENT), INCLUDING CONTACTS WITH HOME HEALTH AGENCY AND REVI",135.5,88.08,41.59,139.57,19
CDM,G0180_1,"PHYSICIAN OR ALLOWED PRACTITIONER CERTIFICATION FOR MEDICARE-COVERED HOME HEALTH SERVICES UNDER A HOME HEALTH PLAN OF CARE (PATIENT NOT PRESENT), INCLUDING CONTACTS WITH HOME HEALTH AGENCY AND REVIEW ",177.5,115.38,53.17,182.83,19
CDM,G0181_1,PHYSICIAN OR ALLOWED PRACTITIONER SUPERVISION OF A PATIENT RECEIVING MEDICARE-COVERED SERVICES PROVIDED BY A PARTICIPATING HOME HEALTH AGENCY (PATIENT NOT PRESENT) REQUIRING COMPLEX AND MULTIDISCIPLIN,305.6,198.64,78.57,314.77,19
CDM,G0182_1,PHYSICIAN SUPERVISION OF A PATIENT UNDER A MEDICARE-APPROVED HOSPICE (PATIENT NOT PRESENT) REQUIRING COMPLEX AND MULTIDISCIPLINARY CARE MODALITIES INVOLVING REGULAR PHYSICIAN DEVELOPMENT AND/OR REVISI,306.6,199.29,78.57,315.8,19
CDM,G0245_1,"INITIAL PHYSICIAN EVALUATION AND MANAGEMENT OF A DIABETIC PATIENT WITH DIABETIC SENSORY NEUROPATHY RESULTING IN A LOSS OF PROTECTIVE SENSATION (LOPS) WHICH MUST INCLUDE: (1) THE DIAGNOSIS OF LOPS, (2)",162.8,105.82,33.55,167.68,19
CDM,G0246_1,FOLLOW-UP PHYSICIAN EVALUATION AND MANAGEMENT OF A DIABETIC PATIENT WITH DIABETIC SENSORY NEUROPATHY RESULTING IN A LOSS OF PROTECTIVE SENSATION (LOPS) TO INCLUDE AT LEAST THE FOLLOWING: (1) A PATIENT,92.4,60.06,16.8,95.17,19
CDM,G0247_1,"ROUTINE FOOT CARE BY A PHYSICIAN OF A DIABETIC PATIENT WITH DIABETIC SENSORY NEUROPATHY RESULTING IN A LOSS OF PROTECTIVE SENSATION (LOPS) TO INCLUDE, THE LOCAL CARE OF SUPERFICIAL WOUNDS (I.E. SUPERF",123.9,80.54,18.47,202.48,19
CDM,G0250_1,"PHYSICIAN REVIEW, INTERPRETATION, AND PATIENT MANAGEMENT OF HOME INR TESTING FOR PATIENT WITH EITHER MECHANICAL HEART VALVE(S), CHRONIC ATRIAL FIBRILLATION, OR VENOUS THROMBOEMBOLISM WHO MEETS MEDICAR",12.0,7.8,6.0,78.57,19
CDM,G0252_1,"PET IMAGING, FULL AND PARTIAL-RING PET SCANNERS ONLY, FOR INITIAL DIAGNOSIS OF BREAST CANCER AND/OR SURGICAL PLANNING FOR BREAST CANCER (E.G., INITIAL STAGING OF AXILLARY LYMPH NODES)",524.0,340.6,78.57,539.72,15
CDM,G0257_1,UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL OUTPATIENT DEPARTMENT THAT IS NOT CERTIFIED AS AN ESRD FACILITY,216.3,140.6,73.6,222.79,15
CDM,G0260_1,"INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID AND/OR OTHER THERAPEUTIC AGENT, WITH OR WITHOUT ARTHROGRAPHY",926.1,601.97,73.6,953.88,15
CDM,G0268_1,REMOVAL OF IMPACTED CERUMEN (ONE OR BOTH EARS) BY PHYSICIAN ON SAME DATE OF SERVICE AS AUDIOLOGIC FUNCTION TESTING,139.7,90.81,25.34,143.89,19
CDM,G0269_1,"PLACEMENT OF OCCLUSIVE DEVICE INTO EITHER A VENOUS OR ARTERIAL ACCESS SITE, POST SURGICAL OR INTERVENTIONAL PROCEDURE (E.G., ANGIOSEAL PLUG, VASCULAR PLUG)",346.5,225.23,73.6,356.9,15
CDM,G0276_1,"BLINDED PROCEDURE FOR LUMBAR STENOSIS, PERCUTANEOUS IMAGE-GUIDED LUMBAR DECOMPRESSION (PILD) OR PLACEBO-CONTROL, PERFORMED IN AN APPROVED COVERAGE WITH EVIDENCE DEVELOPMENT (CED) CLINICAL TRIAL",973.4,632.71,78.57,1002.6,19
CDM,G0277_1,"HYPERBARIC OXYGEN UNDER PRESSURE, FULL BODY CHAMBER, PER 30 MINUTE INTERVAL",111.3,72.35,55.65,451.87,19
CDM,G0278_1,"ILIAC AND/OR FEMORAL ARTERY ANGIOGRAPHY, NON-SELECTIVE, BILATERAL OR IPSILATERAL TO CATHETER INSERTION, PERFORMED AT THE SAME TIME AS CARDIAC CATHETERIZATION AND/OR CORONARY ANGIOGRAPHY, INCLUDES POSI",57.8,37.57,10.32,78.57,19
CDM,G0279_1,"DIAGNOSTIC DIGITAL BREAST TOMOSYNTHESIS, UNILATERAL OR BILATERAL (LIST SEPARATELY IN ADDITION TO 77065 OR 77066)",137.3,89.25,26.56,141.42,19
CDM,G0283_1,"ELECTRICAL STIMULATION (UNATTENDED), TO ONE OR MORE AREAS FOR INDICATION(S) OTHER THAN WOUND CARE, AS PART OF A THERAPY PLAN OF CARE",52.5,34.13,12.0,78.57,19
CDM,G0289_1,"ARTHROSCOPY, KNEE, SURGICAL, FOR REMOVAL OF LOOSE BODY, FOREIGN BODY, DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY) AT THE TIME OF OTHER SURGICAL KNEE ARTHROSCOPY IN A DIFFERENT COMPARTME",370.2,240.63,65.63,381.31,19
CDM,G0296_1,COUNSELING VISIT TO DISCUSS NEED FOR LUNG CANCER SCREENING USING LOW DOSE CT SCAN (LDCT) (SERVICE IS FOR ELIGIBILITY DETERMINATION AND SHARED DECISION MAKING),68.0,44.2,21.45,78.57,19
CDM,G0297_1,Low dose CT scan of chest for lung cancer screening,109.0,70.85,47.24,442.68,19
CDM,G0316_1,PROLONGED HOSPITAL INPATIENT OR OBSERVATION CARE EVALUATION AND MANAGEMENT SERVICE(S) BEYOND THE TOTAL TIME FOR THE PRIMARY SERVICE (WHEN THE PRIMARY SERVICE HAS BEEN SELECTED USING TIME ON THE DATE O,70.5,45.83,26.25,81.04,19
CDM,G0317_1,PROLONGED NURSING FACILITY EVALUATION AND MANAGEMENT SERVICE(S) BEYOND THE TOTAL TIME FOR THE PRIMARY SERVICE (WHEN THE PRIMARY SERVICE HAS BEEN SELECTED USING TIME ON THE DATE OF THE PRIMARY SERVICE),70.5,45.83,25.81,80.17,19
CDM,G0318_1,PROLONGED HOME OR RESIDENCE EVALUATION AND MANAGEMENT SERVICE(S) BEYOND THE TOTAL TIME FOR THE PRIMARY SERVICE (WHEN THE PRIMARY SERVICE HAS BEEN SELECTED USING TIME ON THE DATE OF THE PRIMARY SERVICE,69.0,44.85,25.94,79.3,19
CDM,G0323_1,"CARE MANAGEMENT SERVICES FOR BEHAVIORAL HEALTH CONDITIONS, AT LEAST 20 MINUTES OF CLINICAL PSYCHOLOGIST, CLINICAL SOCIAL WORKER, MENTAL HEALTH COUNSELOR, OR MARRIAGE AND FAMILY THERAPIST TIME, PER CAL",67.5,43.88,33.75,114.61,19
CDM,G0328_1,"COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS",120.0,78.0,10.83,123.6,19
CDM,G0341_1,"PERCUTANEOUS ISLET CELL TRANSPLANT, INCLUDES PORTAL VEIN CATHETERIZATION AND INFUSION",1226.4,797.16,78.57,3908.65,19
CDM,G0365_1,"VESSEL MAPPING OF VESSELS FOR HEMODIALYSIS ACCESS (SERVICES FOR PREOPERATIVE VESSEL MAPPING PRIOR TO CREATION OF HEMODIALYSIS ACCESS USING AN AUTOGENOUS HEMODIALYSIS CONDUIT, INCLUDING ARTERIAL INFLOW",694.3,451.3,73.6,715.13,12
CDM,G0372_1,PHYSICIAN SERVICE REQUIRED TO ESTABLISH AND DOCUMENT THE NEED FOR A POWER MOBILITY DEVICE,42.0,27.3,7.35,78.57,19
CDM,G0396_1,"ALCOHOL AND/OR SUBSTANCE (OTHER THAN TOBACCO) MISUSE STRUCTURED ASSESSMENT (E.G., AUDIT, DAST), AND BRIEF INTERVENTION 15 TO 30 MINUTES",77.0,50.05,27.4,90.4,19
CDM,G0397_1,"ALCOHOL AND/OR SUBSTANCE (OTHER THAN TOBACCO) MISUSE STRUCTURED ASSESSMENT (E.G., AUDIT, DAST), AND INTERVENTION, GREATER THAN 30 MINUTES",152.0,98.8,52.94,175.01,19
CDM,G0398_1,"HOME SLEEP STUDY TEST (HST) WITH TYPE II PORTABLE MONITOR, UNATTENDED; MINIMUM OF 7 CHANNELS: EEG, EOG, EMG, ECG/HEART RATE, AIRFLOW, RESPIRATORY EFFORT AND OXYGEN SATURATION",205.1,133.32,72.46,220.02,15
CDM,G0399_1,"HOME SLEEP TEST (HST) WITH TYPE III PORTABLE MONITOR, UNATTENDED; MINIMUM OF 4 CHANNELS: 2 RESPIRATORY MOVEMENT/AIRFLOW, 1 ECG/HEART RATE AND 1 OXYGEN SATURATION",159.6,103.74,39.79,209.25,15
CDM,G0400_1,"HOME SLEEP TEST (HST) WITH TYPE IV PORTABLE MONITOR, UNATTENDED; MINIMUM OF 3 CHANNELS",205.1,133.32,52.72,211.25,15
CDM,G0402_1,"INITIAL PREVENTIVE PHYSICAL EXAMINATION; FACE-TO-FACE VISIT, SERVICES LIMITED TO NEW BENEFICIARY DURING THE FIRST 12 MONTHS OF MEDICARE ENROLLMENT",346.0,224.9,78.57,428.42,19
CDM,G0403_1,"ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATION WITH INTERPRETATION AND REPORT",63.0,40.95,14.25,78.57,19
CDM,G0404_1,"ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT, PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATION",40.0,26.0,6.29,78.57,19
CDM,G0405_1,"ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; INTERPRETATION AND REPORT ONLY, PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATION",30.0,19.5,7.96,78.57,19
CDM,G0412_1,"OPEN TREATMENT OF ILIAC SPINE(S), TUBEROSITY AVULSION, OR ILIAC WING FRACTURE(S), UNILATERAL OR BILATERAL FOR PELVIC BONE FRACTURE PATTERNS WHICH DO NOT DISRUPT THE PELVIC RING INCLUDES INTERNAL FIXAT",1910.0,1241.5,78.57,1967.3,19
CDM,G0413_1,"PERCUTANEOUS SKELETAL FIXATION OF POSTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION, FOR FRACTURE PATTERNS WHICH DISRUPT THE PELVIC RING, UNILATERAL OR BILATERAL, (INCLUDES ILIUM, SACROILIAC JOINT AND",4010.0,2606.5,78.57,4130.3,19
CDM,G0414_1,"OPEN TREATMENT OF ANTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION FOR FRACTURE PATTERNS WHICH DISRUPT THE PELVIC RING, UNILATERAL OR BILATERAL, INCLUDES INTERNAL FIXATION WHEN PERFORMED (INCLUDES PUB",3202.5,2081.63,78.57,3298.58,19
CDM,G0415_1,"OPEN TREATMENT OF POSTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION, FOR FRACTURE PATTERNS WHICH DISRUPT THE PELVIC RING, UNILATERAL OR BILATERAL, INCLUDES INTERNAL FIXATION, WHEN PERFORMED (INCLUDES ",4586.4,2981.16,78.57,4723.99,19
CDM,G0416_1,"SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATIONS, FOR PROSTATE NEEDLE BIOPSY, ANY METHOD",1489.1,967.92,78.57,1533.77,19
CDM,G0420_1,"FACE-TO-FACE EDUCATIONAL SERVICES RELATED TO THE CARE OF CHRONIC KIDNEY DISEASE; INDIVIDUAL, PER SESSION, PER ONE HOUR",278.3,180.9,78.57,288.83,19
CDM,G0429_1,"DERMAL FILLER INJECTION(S) FOR THE TREATMENT OF FACIAL LIPODYSTROPHY SYNDROME (LDS) (E.G., AS A RESULT OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY)",428.4,278.46,52.41,441.25,19
CDM,G0438_1,"ANNUAL WELLNESS VISIT; INCLUDES A PERSONALIZED PREVENTION PLAN OF SERVICE (PPS), INITIAL VISIT",395.0,256.75,78.57,439.36,19
CDM,G0439_1,"ANNUAL WELLNESS VISIT, INCLUDES A PERSONALIZED PREVENTION PLAN OF SERVICE (PPS), SUBSEQUENT VISIT",275.0,178.75,78.57,345.1,19
CDM,G0442_1,"ANNUAL ALCOHOL MISUSE SCREENING, 5 TO 15 MINUTES",20.0,13.0,7.68,78.57,19
CDM,G0443_1,"BRIEF FACE-TO-FACE BEHAVIORAL COUNSELING FOR ALCOHOL MISUSE, 15 MINUTES",67.0,43.55,25.17,80.08,19
CDM,G0444_1,"ANNUAL DEPRESSION SCREENING, 5 TO 15 MINUTES",54.0,35.1,7.68,78.57,19
CDM,G0446_1,"ANNUAL, FACE-TO-FACE INTENSIVE BEHAVIORAL THERAPY FOR CARDIOVASCULAR DISEASE, INDIVIDUAL, 15 MINUTES",64.6,41.99,25.17,80.08,19
CDM,G0447_1,"FACE-TO-FACE BEHAVIORAL COUNSELING FOR OBESITY, 15 MINUTES",58.75,38.19,25.17,80.08,19
CDM,G0452_1,MOLECULAR PATHOLOGY PROCEDURE; PHYSICIAN INTERPRETATION AND REPORT,45.0,29.25,22.5,124.13,19
CDM,G0455_1,"PREPARATION WITH INSTILLATION OF FECAL MICROBIOTA BY ANY METHOD, INCLUDING ASSESSMENT OF DONOR SPECIMEN",246.8,160.42,57.55,316.43,19
CDM,G0473_1,"FACE-TO-FACE BEHAVIORAL COUNSELING FOR OBESITY, GROUP (2-10), 30 MINUTES",28.25,18.36,9.66,78.57,19
CDM,G0500_1,"MODERATE SEDATION SERVICES PROVIDED BY THE SAME PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING A GASTROINTESTINAL ENDOSCOPIC SERVICE THAT SEDATION SUPPORTS, REQUIRING THE PRESENCE OF",75.0,48.75,4.64,135.21,19
CDM,G0545_1,"VISIT COMPLEXITY INHERENT TO HOSPITAL INPATIENT OR OBSERVATION CARE ASSOCIATED WITH A CONFIRMED OR SUSPECTED INFECTIOUS DISEASE BY AN INFECTIOUS DISEASES SPECIALIST, INCLUDING DISEASE TRANSMISSION RIS",100.0,65.0,38.32,150.08,19
CDM,G0546_1,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD ASSESSMENT AND MANAGEMENT SERVICE PROVIDED BY A PRACTITIONER IN A SPECIALTY   WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICES FO,40.0,26.0,14.97,78.57,19
CDM,G0547_1,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD ASSESSMENT AND MANAGEMENT SERVICE PROVIDED BY A PRACTITIONER IN A SPECIALTY WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICES FOR ,80.0,52.0,30.12,119.77,19
CDM,G0548_1,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD ASSESSMENT AND MANAGEMENT SERVICE PROVIDED BY A PRACTITIONER IN A SPECIALTY WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICES FOR ,120.0,78.0,45.15,180.58,19
CDM,G0549_1,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD ASSESSMENT AND MANAGEMENT SERVICE PROVIDED BY A PRACTITIONER IN A SPECIALTY WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICES FOR ,160.0,104.0,59.99,242.15,19
CDM,G0550_1,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD ASSESSMENT AND MANAGEMENT SERVICE PROVIDED BY A PRACTITIONER IN A SPECIALTY WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICES FOR ,76.0,49.4,28.64,113.44,19
CDM,G0551_1,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD REFERRAL SERVICE(S) PROVIDED BY A TREATING/REQUESTING PRACTITIONER IN A SPECIALTY WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICE,79.0,51.35,29.56,119.02,19
CDM,G2010_1,"REMOTE EVALUATION OF RECORDED VIDEO AND/OR IMAGES SUBMITTED BY AN ESTABLISHED PATIENT (E.G., STORE AND FORWARD), INCLUDING INTERPRETATION WITH FOLLOW-UP WITH THE PATIENT WITHIN 24 BUSINESS HOURS, NOT ",30.0,19.5,7.68,78.57,19
CDM,G2011_1,"ALCOHOL AND/OR SUBSTANCE (OTHER THAN TOBACCO) MISUSE STRUCTURED ASSESSMENT (E.G., AUDIT, DAST), AND BRIEF INTERVENTION, 5-14 MINUTES",40.0,26.0,13.87,78.57,19
CDM,G2012_1,Established patient brief communication technology-based service with 5-10 minutes of medical discussion,45.0,29.25,12.43,78.57,19
CDM,G2058_1,"CHRONIC CARE MANAGEMENT SERVICES, EACH ADDITIONAL 20 MINUTES OF CLINICAL STAFF TIME DIRECTED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, PER CALENDAR MONTH (LIST SEPARATELY IN ADDITION",89.0,57.85,40.05,91.67,12
CDM,G2061_1,"QUALIFIED NONPHYSICIAN HEALTHCARE PROFESSIONAL ONLINE ASSESSMENT AND MANAGEMENT SERVICE, FOR AN ESTABLISHED PATIENT, FOR UP TO SEVEN DAYS, CUMULATIVE TIME DURING THE 7 DAYS; 5-10 MINUTES",30.0,19.5,12.0,30.9,14
CDM,G2062_1,"QUALIFIED NONPHYSICIAN HEALTHCARE PROFESSIONAL ONLINE ASSESSMENT AND MANAGEMENT SERVICE, FOR AN ESTABLISHED PATIENT, FOR UP TO SEVEN DAYS, CUMULATIVE TIME DURING THE 7 DAYS; 11-20 MINUTES",60.0,39.0,24.0,61.8,14
CDM,G2063_1,"QUALIFIED NONPHYSICIAN HEALTHCARE PROFESSIONAL ONLINE ASSESSMENT AND MANAGEMENT SERVICE, FOR AN ESTABLISHED PATIENT, FOR UP TO SEVEN DAYS, CUMULATIVE TIME DURING THE 7 DAYS; 21 OR MORE MINUTES",90.0,58.5,36.0,92.7,14
CDM,G2064_1,"COMPREHENSIVE CARE MANAGEMENT SERVICES FOR A SINGLE HIGH-RISK DISEASE, E.G., PRINCIPAL CARE MANAGEMENT, AT LEAST 30 MINUTES OF PHYSICIAN  OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL  TIME PER CALENDAR",215.0,139.75,86.0,221.45,14
CDM,G2065_1,"COMPREHENSIVE CARE MANAGEMENT FOR A SINGLE HIGH-RISK DISEASE SERVICES, E.G. PRINCIPAL CARE MANAGEMENT, AT LEAST 30 MINUTES OF CLINICAL STAFF TIME DIRECTED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE",92.5,60.13,37.0,95.28,14
CDM,G2082_1,OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT THAT REQUIRES THE SUPERVISION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL AND PROVISION OF U,80.0,52.0,29.2,1993.66,19
CDM,G2083_1,OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT THAT REQUIRES THE SUPERVISION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL AND PROVISION OF  ,80.0,52.0,29.2,2830.67,19
CDM,G2086_1,"OFFICE-BASED TREATMENT FOR OPIOID USE DISORDER, INCLUDING DEVELOPMENT OF THE TREATMENT PLAN, CARE COORDINATION, INDIVIDUAL THERAPY AND GROUP THERAPY AND COUNSELING; AT LEAST 70 MINUTES IN THE FIRST CA",981.75,638.14,78.57,1085.57,19
CDM,G2087_1,"OFFICE-BASED TREATMENT FOR OPIOID USE DISORDER, INCLUDING CARE COORDINATION, INDIVIDUAL THERAPY AND GROUP THERAPY AND COUNSELING; AT LEAST 60 MINUTES IN A SUBSEQUENT CALENDAR MONTH",880.0,572.0,78.57,1024.93,19
CDM,G2088_1,"OFFICE-BASED TREATMENT FOR OPIOID USE DISORDER, INCLUDING CARE COORDINATION, INDIVIDUAL THERAPY AND GROUP THERAPY AND COUNSELING; EACH ADDITIONAL 30 MINUTES BEYOND THE FIRST 120 MINUTES (LIST SEPARATE",164.25,106.76,32.64,169.18,19
CDM,G2211_1,VISIT COMPLEXITY INHERENT TO EVALUATION AND MANAGEMENT ASSOCIATED WITH MEDICAL CARE SERVICES THAT SERVE AS THE CONTINUING FOCAL POINT FOR ALL NEEDED HEALTH CARE SERVICES AND/OR WITH MEDICAL CARE SERVI,45.0,29.25,13.74,78.57,19
CDM,G2212_1,PROLONGED OFFICE OR OTHER OUTPATIENT EVALUATION AND MANAGEMENT SERVICE(S) BEYOND THE MAXIMUM REQUIRED TIME OF THE PRIMARY PROCEDURE WHICH HAS BEEN SELECTED USING TOTAL TIME ON THE DATE OF THE PRIMARY ,78.5,51.03,25.94,81.89,19
CDM,G3002_1,"CHRONIC PAIN MANAGEMENT AND TREATMENT, MONTHLY BUNDLE INCLUDING, DIAGNOSIS; ASSESSMENT AND MONITORING; ADMINISTRATION OF A VALIDATED PAIN RATING SCALE OR TOOL; THE DEVELOPMENT, IMPLEMENTATION, REVISIO",169.0,109.85,61.04,199.53,19
CDM,G3003_1,"EACH ADDITIONAL 15 MINUTES OF CHRONIC PAIN MANAGEMENT AND TREATMENT BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, PER CALENDAR MONTH. (LIST SEPARATELY IN ADDITION TO CODE FOR G3002. WHEN",58.5,38.03,21.34,78.57,19
CDM,G6017_1,"INTRA-FRACTION LOCALIZATION AND TRACKING OF TARGET OR PATIENT MOTION DURING DELIVERY OF RADIATION THERAPY (EG,3D POSITIONAL TRACKING, GATING, 3D SURFACE TRACKING), EACH FRACTION OF TREATMENT",245.0,159.25,70.43,193.24,15
CDM,G9016_1,"SMOKING CESSATION COUNSELING, INDIVIDUAL, IN THE ABSENCE OF OR IN ADDITION TO ANY OTHER EVALUATION AND MANAGEMENT SERVICE, PER SESSION (6-10 MINUTES) [DEMO PROJECT CODE ONLY]",42.0,27.3,18.9,80.89,15
CDM,H0001_1,ALCOHOL AND/OR DRUG ASSESSMENT,236.3,153.6,76.53,243.39,15
CDM,H0002_1,BEHAVIORAL HEALTH SCREENING TO DETERMINE ELIGIBILITY FOR ADMISSION TO TREATMENT PROGRAM,350.0,227.5,76.53,360.5,15
CDM,H0004_1,"BEHAVIORAL HEALTH COUNSELING AND THERAPY, PER 15 MINUTES",21.0,13.65,1.0,80.89,15
CDM,H0005_1,ALCOHOL AND/OR DRUG SERVICES; GROUP COUNSELING BY A CLINICIAN,63.0,40.95,28.35,80.89,15
CDM,H0031_1,"MENTAL HEALTH ASSESSMENT, BY NON-PHYSICIAN",351.8,228.67,76.53,362.35,15
CDM,H0032_1,MENTAL HEALTH SERVICE PLAN DEVELOPMENT BY NON-PHYSICIAN,144.4,93.86,64.98,148.73,15
CDM,H0046_1,"MENTAL HEALTH SERVICES, NOT OTHERWISE SPECIFIED",65.9,42.84,29.66,80.89,15
CDM,H2000_1,COMPREHENSIVE MULTIDISCIPLINARY EVALUATION,840.0,546.0,76.53,865.2,15
CDM,H2012_1,"BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR",144.4,93.86,64.98,148.73,15
CDM,H2014_1,"SKILLS TRAINING AND DEVELOPMENT, PER 15 MINUTES",15.8,10.27,7.11,80.89,15
CDM,ITIND_1,Other procedure on urinary system,1750.0,1137.5,73.6,1802.5,15
CDM,J0129_1,"INJECTION, ABATACEPT, 10 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",171.75,111.64,43.38,206.1,15
CDM,J0135_1,"INJECTION, ADALIMUMAB, 1 MG",1522.0,989.3,73.6,1826.4,15
CDM,J0171_1,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",2.0,1.3,0.8,3.33,14
CDM,J0178_1,"INJECTION, AFLIBERCEPT, 1 MG",2400.0,1560.0,78.57,2880.0,15
CDM,J0248_1,"INJECTION, REMDESIVIR, 1 MG",14.0,9.1,6.3,78.57,15
CDM,J0280_1,"INJECTION, AMINOPHYLLIN, UP TO 250 MG",16.0,10.4,5.89,78.57,15
CDM,J0282_1,"INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG",1.4,0.91,0.33,78.57,15
CDM,J0475_1,"INJECTION, BACLOFEN, 10 MG",357.0,232.05,78.57,428.4,15
CDM,J0490_1,"INJECTION, BELIMUMAB, 10 MG",100.95,65.62,45.43,121.14,15
CDM,J0558_1,"INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, 100,000 UNITS",12.0,7.8,5.4,78.57,15
CDM,J0561_1,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",25.0,16.25,11.25,78.57,15
CDM,J0570_1,"BUPRENORPHINE IMPLANT, 74.2 MG",23.2,15.08,10.44,1361.3,12
CDM,J0585_1,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",12.0,7.8,5.4,78.57,15
CDM,J0587_1,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",23.1,15.02,10.4,78.57,15
CDM,J0588_1,"INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT",10.5,6.83,4.73,78.57,15
CDM,J0610_1,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",7.0,4.55,0.03,78.57,15
CDM,J0640_1,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",22.0,14.3,3.51,132.0,15
CDM,J0692_1,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",14.0,9.1,0.86,78.57,15
CDM,J0696_1,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",34.2,22.23,0.46,78.57,15
CDM,J0702_1,"INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG",26.0,16.9,6.85,78.57,15
CDM,J0713_1,"INJECTION, CEFTAZIDIME, PER 500 MG",15.0,9.75,1.46,78.57,15
CDM,J0717_1,"INJECTION, CERTOLIZUMAB PEGOL, 1 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",30.23,19.65,3.86,78.57,15
CDM,J0780_1,"INJECTION, PROCHLORPERAZINE, UP TO 10 MG",15.0,9.75,2.52,78.57,15
CDM,J0881_1,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",9.0,5.85,2.92,78.57,15
CDM,J0885_1,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",38.99,25.34,7.08,78.57,15
CDM,J0894_1,"INJECTION, DECITABINE, 1 MG",5.0,3.25,0.64,78.57,15
CDM,J0896_1,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",85.0,55.25,38.25,102.0,15
CDM,J0897_1,"INJECTION, DENOSUMAB, 1 MG",40.0,26.0,18.0,78.57,15
CDM,J1020_1,"INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG",6.1,3.97,2.44,10.15,14
CDM,J1030_1,"INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG",9.4,6.11,3.76,15.65,14
CDM,J1040_1,"INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG",23.5,15.28,9.4,39.12,14
CDM,J1190_1,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",543.0,352.95,58.01,705.9,15
CDM,J1200_1,"INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG",7.7,5.01,0.66,78.57,15
CDM,J1212_1,"INJECTION, DMSO, DIMETHYL SULFOXIDE, 50%, 50 ML",385.0,250.25,78.57,1105.28,15
CDM,J1250_1,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",11.5,7.48,5.18,78.57,15
CDM,J1335_1,"INJECTION, ERTAPENEM SODIUM, 500 MG",52.0,33.8,9.16,78.57,15
CDM,J1380_1,"INJECTION, ESTRADIOL VALERATE, UP TO 10 MG",7.32,4.76,3.29,78.57,15
CDM,J1439_1,"INJECTION, FERRIC CARBOXYMALTOSE, 1 MG",2.84,1.85,1.11,78.57,15
CDM,J1442_1,"INJECTION, FILGRASTIM (G-CSF), EXCLUDES BIOSIMILARS, 1 MICROGRAM",2.0,1.3,0.9,78.57,15
CDM,J1453_1,"INJECTION, FOSAPREPITANT, 1 MG",6.0,3.9,0.1,78.57,15
CDM,J1455_1,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",92.0,59.8,6.71,110.4,15
CDM,J1459_1,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",97.65,63.47,43.94,117.18,15
CDM,J1561_1,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",500.0,325.0,49.07,600.0,15
CDM,J1566_1,"INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G., POWDER), NOT OTHERWISE SPECIFIED, 500 MG",102.9,66.89,46.31,125.81,15
CDM,J1580_1,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",9.5,6.18,2.16,78.57,15
CDM,J1602_1,"INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE",69.45,45.14,10.77,83.34,15
CDM,J1631_1,"INJECTION, HALOPERIDOL DECANOATE, PER 50 MG",118.7,77.16,3.93,142.44,15
CDM,J1644_1,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",4.2,2.73,0.17,78.57,15
CDM,J1720_1,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",33.0,21.45,14.85,198.0,15
CDM,J1745_1,"INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG",254.63,165.51,30.52,305.56,15
CDM,J1750_1,"INJECTION, IRON DEXTRAN, 50 MG",34.2,22.23,15.39,78.57,15
CDM,J1756_1,"INJECTION, IRON SUCROSE, 1 MG",1.14,0.74,0.23,78.57,15
CDM,J1815_1,"INJECTION, INSULIN, PER 5 UNITS",4.2,2.73,0.22,78.57,15
CDM,J1885_1,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",5.7,3.71,0.33,78.57,15
CDM,J1930_1,"INJECTION, LANREOTIDE, 1 MG",100.0,65.0,35.38,130.0,15
CDM,J1940_1,"INJECTION, FUROSEMIDE, 1 MG",1.58,1.03,0.01,80.89,15
CDM,J1950_1,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",1800.0,1170.0,78.57,2575.18,15
CDM,J1956_1,"INJECTION, LEVOFLOXACIN, 250 MG",35.0,22.75,1.03,78.57,15
CDM,J2001_1,"INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG",2.1,1.37,0.02,3.5,14
CDM,J2150_1,"INJECTION, MANNITOL, 25% IN 50 ML",5.0,3.25,2.25,78.57,15
CDM,J2175_1,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",7.0,4.55,3.15,78.57,15
CDM,J2323_1,"INJECTION, NATALIZUMAB, 1 MG",62.0,40.3,24.37,78.57,15
CDM,J2353_1,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",315.0,204.75,78.57,409.5,15
CDM,J2354_1,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",20.0,13.0,0.59,78.57,15
CDM,J2357_1,"INJECTION, OMALIZUMAB, 5 MG",92.0,59.8,40.12,110.4,15
CDM,J2405_1,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",10.0,6.5,0.09,78.57,15
CDM,J2430_1,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",30.0,19.5,11.29,78.57,15
CDM,J2469_1,"INJECTION, PALONOSETRON HCL, 25 MCG",5.0,3.25,0.35,78.57,15
CDM,J2505_1,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",9000.0,5850.0,19.98,10800.0,15
CDM,J2506_1,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",750.0,487.5,19.98,900.0,15
CDM,J2507_1,"INJECTION, PEGLOTICASE, 1 MG",5000.0,3250.0,78.57,6000.0,15
CDM,J2510_1,"INJECTION, PENICILLIN G PROCAINE, AQUEOUS, UP TO 600,000 UNITS",26.3,17.1,11.84,85.19,15
CDM,J2545_1,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",167.0,108.55,75.15,200.4,15
CDM,J2550_1,"INJECTION, PROMETHAZINE HCL, UP TO 50 MG",9.5,6.18,3.31,78.57,15
CDM,J2680_1,"INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG",29.4,19.11,6.19,78.57,15
CDM,J2690_1,"INJECTION, PROCAINAMIDE HCL, UP TO 1 GM",44.1,28.67,19.85,354.87,15
CDM,J2765_1,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",2.1,1.37,0.95,78.57,15
CDM,J2778_1,"INJECTION, RANIBIZUMAB, 0.1 MG",800.1,520.07,65.44,960.12,15
CDM,J2783_1,"INJECTION, RASBURICASE, 0.5 MG",730.0,474.5,78.57,876.0,15
CDM,J2785_1,"INJECTION, REGADENOSON, 0.1 MG",27.05,17.58,2.67,78.57,15
CDM,J2794_1,"INJECTION, RISPERIDONE (RISPERDAL CONSTA), 0.5 MG",11.6,7.54,5.22,78.57,15
CDM,J2796_1,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",206.0,133.9,10.52,247.2,15
CDM,J2860_1,"INJECTION, SILTUXIMAB, 10 MG",285.0,185.25,78.57,342.0,15
CDM,J2916_1,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",5.0,3.25,1.94,78.57,15
CDM,J2919_1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.25,0.81,0.25,78.57,15
CDM,J2920_1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 40 MG",10.0,6.5,4.0,60.0,14
CDM,J2930_1,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 125 MG",37.0,24.05,14.8,222.0,14
CDM,J2997_1,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",150.0,97.5,67.5,180.0,15
CDM,J3030_1,"INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",413.7,268.91,37.0,496.44,15
CDM,J3111_1,"INJECTION, ROMOSOZUMAB-AQQG, 1 MG",17.0,11.05,7.65,78.57,15
CDM,J3262_1,"INJECTION, TOCILIZUMAB, 1 MG",14.0,9.1,5.6,78.57,15
CDM,J3301_1,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",15.0,9.75,0.74,78.57,15
CDM,J3304_1,"INJECTION, TRIAMCINOLONE ACETONIDE, PRESERVATIVE-FREE, EXTENDED-RELEASE, MICROSPHERE FORMULATION, 1 MG",45.0,29.25,18.01,78.57,15
CDM,J3315_1,"INJECTION, TRIPTORELIN PAMOATE, 3.75 MG",865.0,562.25,78.57,1038.0,15
CDM,J3357_1,"USTEKINUMAB, FOR SUBCUTANEOUS INJECTION, 1 MG",127.0,82.55,57.15,311.77,15
CDM,J3360_1,"INJECTION, DIAZEPAM, UP TO 5 MG",20.7,13.46,5.79,78.57,15
CDM,J3370_1,"INJECTION, VANCOMYCIN HCL, 500 MG",12.0,7.8,2.57,19.97,14
CDM,J3380_1,"INJECTION, VEDOLIZUMAB, INTRAVENOUS, 1 MG",45.15,29.35,20.32,78.57,15
CDM,J3396_1,"INJECTION, VERTEPORFIN, 0.1 MG",21.0,13.65,9.45,78.57,15
CDM,J3410_1,"INJECTION, HYDROXYZINE HCL, UP TO 25 MG",5.5,3.58,2.48,78.57,15
CDM,J3420_1,"INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG",7.0,4.55,0.63,78.57,15
CDM,J3430_1,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",6.3,4.1,2.45,78.57,15
CDM,J3465_1,"INJECTION, VORICONAZOLE, 10 MG",9.33,6.06,0.75,78.57,15
CDM,J3475_1,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",5.0,3.25,0.4,78.57,15
CDM,J3480_1,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",2.0,1.3,0.12,78.57,15
CDM,J3489_1,"INJECTION, ZOLEDRONIC ACID, 1 MG",30.0,19.5,5.08,180.0,15
CDM,J7030_1,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",10.0,6.5,1.98,78.57,15
CDM,J7040_1,"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML = 1 UNIT)",8.0,5.2,1.24,78.57,15
CDM,J7042_1,5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT),5.0,3.25,1.25,78.57,15
CDM,J7050_1,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",4.0,2.6,0.62,78.57,15
CDM,J7060_1,5% DEXTROSE/WATER (500 ML = 1 UNIT),13.0,8.45,1.74,78.57,15
CDM,J7070_1,"INFUSION, D5W, 1000 CC",19.0,12.35,2.93,78.57,15
CDM,J7120_1,"RINGERS LACTATE INFUSION, UP TO 1000 CC",6.0,3.9,2.3,78.57,15
CDM,J7296_1,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM, (KYLEENA), 19.5 MG",2145.85,1394.8,78.57,2575.02,15
CDM,J7297_1,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (LILETTA), 52 MG",1690.0,1098.5,78.57,2028.0,15
CDM,J7298_1,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (MIRENA), 52 MG",1896.5,1232.73,78.57,2275.8,15
CDM,J7300_1,INTRAUTERINE COPPER CONTRACEPTIVE,1200.0,780.0,78.57,1726.61,15
CDM,J7301_1,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (SKYLA), 13.5 MG",1454.4,945.36,78.57,1745.28,15
CDM,J7306_1,"LEVONORGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANTS AND SUPPLIES",1636.0,1063.4,78.57,1963.2,15
CDM,J7307_1,"ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES",1300.0,845.0,78.57,1932.9,15
CDM,J7312_1,"INJECTION, DEXAMETHASONE, INTRAVITREAL IMPLANT, 0.1 MG",388.5,252.53,78.57,466.2,15
CDM,J7313_1,"INJECTION, FLUOCINOLONE ACETONIDE, INTRAVITREAL IMPLANT (ILUVIEN), 0.01 MG",1157.9,752.64,78.57,1389.48,15
CDM,J7316_1,"INJECTION, OCRIPLASMIN, 0.125 MG",3950.0,2567.5,78.57,4740.0,15
CDM,J7324_1,"HYALURONAN OR DERIVATIVE, ORTHOVISC, FOR INTRA-ARTICULAR INJECTION, PER DOSE",798.0,518.7,78.57,957.6,15
CDM,J7325_1,"HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULAR INJECTION, 1 MG",38.0,24.7,8.87,78.57,15
CDM,J7326_1,"HYALURONAN OR DERIVATIVE, GEL-ONE, FOR INTRA-ARTICULAR INJECTION, PER DOSE",1409.65,916.27,78.57,1691.58,15
CDM,J7613_1,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",2.0,1.3,0.07,78.57,15
CDM,J7614_1,"LEVALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 0.5 MG",13.7,8.91,0.08,78.57,15
CDM,J7620_1,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",32.0,20.8,0.19,78.57,15
CDM,J7626_1,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",21.0,13.65,1.04,78.57,15
CDM,J7644_1,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",4.2,2.73,0.36,78.57,15
CDM,J7676_1,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",704.33,457.81,73.6,845.2,15
CDM,J9000_1,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",14.0,9.1,2.78,84.0,16
CDM,J9017_1,"INJECTION, ARSENIC TRIOXIDE, 1 MG",115.0,74.75,4.79,149.5,16
CDM,J9022_1,"INJECTION, ATEZOLIZUMAB, 10 MG",234.0,152.1,78.57,304.2,16
CDM,J9023_1,"INJECTION, AVELUMAB, 10 MG",256.0,166.4,78.57,332.8,16
CDM,J9025_1,"INJECTION, AZACITIDINE, 1 MG",12.0,7.8,0.32,78.57,16
CDM,J9031_1,BCG (INTRAVESICAL) PER INSTILLATION,260.4,169.26,104.16,804.64,15
CDM,J9032_1,"INJECTION, BELINOSTAT, 10 MG",130.0,84.5,50.92,156.0,16
CDM,J9033_1,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, 1 MG",50.0,32.5,1.24,78.57,16
CDM,J9034_1,"INJECTION, BENDAMUSTINE HCL (BENDEKA), 1 MG",58.0,37.7,12.83,78.57,16
CDM,J9035_1,"INJECTION, BEVACIZUMAB, 10 MG",217.0,141.05,72.73,282.1,16
CDM,J9036_1,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, (BELRAPZO/BENDAMUSTINE), 1 MG",45.0,29.25,13.64,78.57,16
CDM,J9040_1,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",300.0,195.0,21.56,1800.0,16
CDM,J9041_1,"INJECTION, BORTEZOMIB, 0.1 MG",135.0,87.75,2.5,175.5,16
CDM,J9042_1,"INJECTION, BRENTUXIMAB VEDOTIN, 1 MG",456.0,296.4,78.57,769.19,16
CDM,J9043_1,"INJECTION, CABAZITAXEL, 1 MG",480.0,312.0,78.57,692.44,16
CDM,J9045_1,"INJECTION, CARBOPLATIN, 50 MG",8.0,5.2,2.92,78.57,16
CDM,J9047_1,"INJECTION, CARFILZOMIB, 1 MG",117.0,76.05,51.85,160.59,16
CDM,J9055_1,"INJECTION, CETUXIMAB, 10 MG",185.0,120.25,77.52,240.5,16
CDM,J9057_1,"INJECTION, COPANLISIB, 1 MG",154.0,100.1,69.3,278.69,16
CDM,J9060_1,"INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG",20.0,13.0,2.11,120.0,16
CDM,J9065_1,"INJECTION, CLADRIBINE, PER 1 MG",46.0,29.9,7.41,276.0,16
CDM,J9070_1,"CYCLOPHOSPHAMIDE, 100 MG",75.0,48.75,30.0,231.75,15
CDM,J9100_1,"INJECTION, CYTARABINE, 100 MG",10.0,6.5,0.81,78.57,16
CDM,J9119_1,"INJECTION, CEMIPLIMAB-RWLC, 1 MG",82.0,53.3,28.69,106.6,16
CDM,J9120_1,"INJECTION, DACTINOMYCIN, 0.5 MG",2925.0,1901.25,78.57,3510.0,16
CDM,J9130_1,"DACARBAZINE, 100 MG",45.0,29.25,4.12,270.0,16
CDM,J9144_1,"INJECTION, DARATUMUMAB, 10 MG AND HYALURONIDASE-FIHJ",110.0,71.5,49.5,158.8,16
CDM,J9171_1,"INJECTION, DOCETAXEL, 1 MG",6.0,3.9,0.61,78.57,16
CDM,J9173_1,"INJECTION, DURVALUMAB, 10 MG",227.0,147.55,78.57,295.1,16
CDM,J9176_1,"INJECTION, ELOTUZUMAB, 1 MG",25.0,16.25,7.73,78.57,16
CDM,J9179_1,"INJECTION, ERIBULIN MESYLATE, 0.1 MG",352.0,228.8,72.6,457.6,16
CDM,J9181_1,"INJECTION, ETOPOSIDE, 10 MG",5.0,3.25,1.04,78.57,16
CDM,J9190_1,"INJECTION, FLUOROURACIL, 500 MG",10.5,6.83,1.94,78.57,16
CDM,J9201_1,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",45.0,29.25,2.98,270.0,16
CDM,J9202_1,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",1745.0,1134.25,78.57,10470.0,16
CDM,J9205_1,"INJECTION, IRINOTECAN LIPOSOME, 1 MG",145.0,94.25,65.25,198.44,16
CDM,J9206_1,"INJECTION, IRINOTECAN, 20 MG",30.0,19.5,1.64,180.0,16
CDM,J9208_1,"INJECTION, IFOSFAMIDE, 1 GRAM",60.0,39.0,24.62,360.0,16
CDM,J9209_1,"INJECTION, MESNA, 200 MG",25.0,16.25,1.36,150.0,16
CDM,J9217_1,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",1000.0,650.0,78.57,6000.0,16
CDM,J9223_1,"INJECTION, LURBINECTEDIN, 0.1 MG",440.0,286.0,78.57,633.14,16
CDM,J9228_1,"INJECTION, IPILIMUMAB, 1 MG",472.0,306.8,78.57,613.6,16
CDM,J9250_1,"METHOTREXATE SODIUM, 5 MG",5.0,3.25,2.0,30.0,15
CDM,J9260_1,"INJECTION, METHOTREXATE SODIUM, 50 MG",12.6,8.19,2.57,78.57,16
CDM,J9263_1,"INJECTION, OXALIPLATIN, 0.5 MG",2.0,1.3,0.04,78.57,16
CDM,J9264_1,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG",35.0,22.75,8.18,78.57,16
CDM,J9267_1,"INJECTION, PACLITAXEL, 1 MG",1.5,0.98,0.09,78.57,16
CDM,J9271_1,"INJECTION, PEMBROLIZUMAB, 1 MG",153.0,99.45,59.35,198.9,16
CDM,J9280_1,"INJECTION, MITOMYCIN, 5 MG",172.0,111.8,25.6,223.6,16
CDM,J9298_1,"INJECTION, NIVOLUMAB AND RELATLIMAB-RMBW, 3 MG/1 MG",445.0,289.25,78.57,599.03,16
CDM,J9299_1,"INJECTION, NIVOLUMAB, 1 MG",86.0,55.9,32.35,111.8,16
CDM,J9301_1,"INJECTION, OBINUTUZUMAB, 10 MG",108.0,70.2,48.6,231.22,16
CDM,J9303_1,"INJECTION, PANITUMUMAB, 10 MG",369.0,239.85,78.57,512.04,16
CDM,J9305_1,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",218.0,141.7,3.59,283.4,16
CDM,J9306_1,"INJECTION, PERTUZUMAB, 1 MG",35.0,22.75,15.75,78.57,16
CDM,J9311_1,"INJECTION, RITUXIMAB 10 MG AND HYALURONIDASE",140.0,91.0,36.87,182.0,16
CDM,J9312_1,"INJECTION, RITUXIMAB, 10 MG",235.0,152.75,74.76,305.5,16
CDM,J9315_1,"INJECTION, ROMIDEPSIN, 1 MG",932.0,605.8,336.66,2879.88,15
CDM,J9317_1,"INJECTION, SACITUZUMAB GOVITECAN-HZIY, 2.5 MG",92.0,59.8,35.8,119.6,16
CDM,J9325_1,"INJECTION, TALIMOGENE LAHERPAREPVEC, PER 1 MILLION PLAQUE FORMING UNITS",150.0,97.5,67.5,217.44,16
CDM,J9349_1,"INJECTION, TAFASITAMAB-CXIX, 2 MG",31.0,20.15,13.93,78.57,16
CDM,J9351_1,"INJECTION, TOPOTECAN, 0.1 MG",20.0,13.0,1.24,120.0,16
CDM,J9354_1,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",85.0,55.25,38.25,126.6,16
CDM,J9355_1,"INJECTION, TRASTUZUMAB, EXCLUDES BIOSIMILAR, 10 MG",175.0,113.75,73.48,238.08,16
CDM,J9358_1,"INJECTION, FAM-TRASTUZUMAB DERUXTECAN-NXKI, 1 MG",60.0,39.0,27.0,89.02,16
CDM,J9360_1,"INJECTION, VINBLASTINE SULFATE, 1 MG",40.0,26.0,5.14,240.0,16
CDM,J9370_1,"VINCRISTINE SULFATE, 1 MG",60.0,39.0,8.15,360.0,16
CDM,J9395_1,"INJECTION, FULVESTRANT, 25 MG",300.0,195.0,5.72,390.0,16
CDM,L0621_1,"SACROILIAC ORTHOSIS, FLEXIBLE, PROVIDES PELVIC-SACRAL SUPPORT, REDUCES MOTION ABOUT THE SACROILIAC JOINT, INCLUDES STRAPS, CLOSURES, MAY INCLUDE PENDULOUS ABDOMEN DESIGN, PREFABRICATED, OFF-THE-SHELF",62.5,40.63,34.17,284.9,19
CDM,L0625_1,"LUMBAR ORTHOSIS, FLEXIBLE, PROVIDES LUMBAR SUPPORT, POSTERIOR EXTENDS FROM L-1 TO BELOW L-5 VERTEBRA, PRODUCES INTRACAVITARY PRESSURE TO REDUCE LOAD ON THE INTERVERTEBRAL DISCS, INCLUDES STRAPS, CLOSU",39.9,25.94,18.18,138.82,19
CDM,L1830_1,"KNEE ORTHOSIS, IMMOBILIZER, CANVAS LONGITUDINAL, PREFABRICATED, OFF-THE-SHELF",25.0,16.25,25.0,215.8,19
CDM,L1832_1,"KNEE ORTHOSIS, ADJUSTABLE KNEE JOINTS (UNICENTRIC OR POLYCENTRIC), POSITIONAL ORTHOSIS, RIGID SUPPORT, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT",212.5,138.13,78.57,1439.79,19
CDM,L1902_1,"ANKLE ORTHOSIS, ANKLE GAUNTLET OR SIMILAR, WITH OR WITHOUT JOINTS, PREFABRICATED, OFF-THE-SHELF",61.75,40.14,36.14,199.52,19
CDM,L1906_1,"ANKLE FOOT ORTHOSIS, MULTILIGAMENTOUS ANKLE SUPPORT, PREFABRICATED, OFF-THE-SHELF",92.5,60.13,51.58,284.81,19
CDM,L2999_1,"LOWER EXTREMITY ORTHOSES, NOT OTHERWISE SPECIFIED",200.0,130.0,73.6,240.0,15
CDM,L3040_1,"FOOT, ARCH SUPPORT, REMOVABLE, PREMOLDED, LONGITUDINAL, EACH",55.0,35.75,21.49,118.63,19
CDM,L3332_1,"LIFT, ELEVATION, INSIDE SHOE, TAPERED, UP TO ONE-HALF INCH",25.0,16.25,25.0,185.82,19
CDM,L3450_1,"HEEL, SACH CUSHION TYPE",98.5,64.03,48.18,266.02,19
CDM,L3485_1,"HEEL, PAD, REMOVABLE FOR SPUR",37.0,24.05,4.58,78.57,15
CDM,L3540_1,"ORTHOPEDIC SHOE ADDITION, SOLE, FULL",106.0,68.9,23.22,128.2,19
CDM,L3650_1,"SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, OFF-THE-SHELF",37.5,24.38,29.55,163.14,19
CDM,L3674_1,"SHOULDER ORTHOSIS, ABDUCTION POSITIONING (AIRPLANE DESIGN), THORACIC COMPONENT AND SUPPORT BAR, WITH OR WITHOUT NONTORSION JOINT/TURNBUCKLE, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCL",148.0,96.2,78.57,2711.26,19
CDM,L3702_1,"ELBOW ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",106.1,68.97,78.57,662.38,19
CDM,L3806_1,"WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMEN",53.3,34.65,53.3,1041.91,19
CDM,L3807_1,"WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE",45.75,29.74,45.75,573.45,19
CDM,L3808_1,"WRIST HAND FINGER ORTHOSIS, RIGID WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE MATERIAL; STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",50.8,33.02,50.8,788.17,19
CDM,L3906_1,"WRIST HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",48.3,31.4,48.3,926.27,19
CDM,L3908_1,"WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK-UP, NON MOLDED, PREFABRICATED, OFF-THE-SHELF",149.8,97.37,25.55,179.76,19
CDM,L3917_1,"HAND ORTHOSIS, METACARPAL FRACTURE ORTHOSIS, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE",132.5,86.13,43.87,242.2,19
CDM,L3919_1,"HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",44.1,28.67,44.1,621.24,19
CDM,L3925_1,"FINGER ORTHOSIS, PROXIMAL INTERPHALANGEAL (PIP)/DISTAL INTERPHALANGEAL (DIP), NON TORSION JOINT/SPRING, EXTENSION/FLEXION, MAY INCLUDE SOFT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",50.0,32.5,26.68,147.27,19
CDM,L3930_1,"HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, OFF-THE-SHELF",89.3,58.05,42.29,233.51,19
CDM,L3933_1,"FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",43.1,28.02,43.1,489.36,19
CDM,L3956_1,"ADDITION OF JOINT TO UPPER EXTREMITY ORTHOSIS, ANY MATERIAL; PER JOINT",89.3,58.05,73.6,107.16,13
CDM,L4386_1,"WALKING BOOT, NON-PNEUMATIC, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PA",100.5,65.33,72.38,399.63,19
CDM,L4387_1,"WALKING BOOT, NON-PNEUMATIC, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",80.0,52.0,72.38,399.63,19
CDM,L8603_1,"INJECTABLE BULKING AGENT, COLLAGEN IMPLANT, URINARY TRACT, 2.5 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",325.5,211.58,78.57,1104.81,19
CDM,L8606_1,"INJECTABLE BULKING AGENT, SYNTHETIC IMPLANT, URINARY TRACT, 1 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",1050.0,682.5,78.57,1260.0,19
CDM,L8610_1,OCULAR IMPLANT,2625.0,1706.25,78.57,3150.0,19
CDM,L8680_1,"IMPLANTABLE NEUROSTIMULATOR ELECTRODE, EACH",2189.3,1423.05,78.57,2627.16,15
CDM,L8681_1,"PATIENT PROGRAMMER (EXTERNAL) FOR USE WITH IMPLANTABLE PROGRAMMABLE NEUROSTIMULATOR PULSE GENERATOR, REPLACEMENT ONLY",1365.0,887.25,78.57,3629.1,19
CDM,L8699_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",216.3,140.6,73.6,259.56,15
CDM,M0220_1,"INJECTION, TIXAGEVIMAB AND CILGAVIMAB, FOR THE PRE-EXPOSURE PROPHYLAXIS ONLY, FOR CERTAIN ADULTS AND PEDIATRIC INDIVIDUALS (12 YEARS OF AGE AND OLDER WEIGHING AT LEAST 40KG) WITH NO KNOWN SARS-COV-2 E",375.0,243.75,150.0,579.38,14
CDM,M0222_1,"INTRAVENOUS INJECTION, BEBTELOVIMAB, INCLUDES INJECTION AND POST ADMINISTRATION MONITORING",615.0,399.75,246.0,950.18,14
CDM,M0224_1,"INTRAVENOUS INFUSION, PEMIVIBART, FOR THE PRE-EXPOSURE PROPHYLAXIS ONLY, FOR CERTAIN ADULTS AND ADOLESCENTS (12 YEARS OF AGE AND OLDER WEIGHING AT LEAST 40 KG) WITH NO KNOWN SARS-COV-2 EXPOSURE, WHO E",775.0,503.75,78.57,1101.69,15
CDM,P9012_1,"CRYOPRECIPITATE, EACH UNIT",3.2,2.08,1.44,80.89,15
CDM,P9019_1,"PLATELETS, EACH UNIT",2.1,1.37,0.95,80.89,15
CDM,Q0035_1,CARDIOKYMOGRAPHY,33.2,21.58,7.65,78.57,19
CDM,Q0091_1,"SCREENING PAPANICOLAOU SMEAR; OBTAINING, PREPARING AND CONVEYANCE OF CERVICAL OR VAGINAL SMEAR TO LABORATORY",100.0,65.0,14.87,120.0,19
CDM,Q0111_1,"WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL OR SKIN SPECIMENS",15.8,10.27,2.93,78.57,19
CDM,Q0112_1,ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS,18.9,12.29,1.1,78.57,19
CDM,Q0114_1,FERN TEST,15.8,10.27,1.54,78.57,19
CDM,Q0144_1,"AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM",95.6,62.14,24.7,114.72,15
CDM,Q0498_1,"HOLSTER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",829.5,539.18,78.57,1297.11,19
CDM,Q0508_1,MISCELLANEOUS SUPPLY OR ACCESSORY FOR USE WITH AN IMPLANTED VENTRICULAR ASSIST DEVICE,65.1,42.32,29.3,80.89,15
CDM,Q2026T_1,"INJECTION, RADIESSE, 0.1 ML",558.6,363.09,73.6,670.32,15
CDM,Q2035_1,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (AFLURIA)",30.0,19.5,13.5,78.57,15
CDM,Q2036_1,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (FLULAVAL)",5.0,3.25,2.25,80.89,15
CDM,Q2037_1,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (FLUVIRIN)",5.3,3.45,2.39,78.57,15
CDM,Q2038_1,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (FLUZONE)",5.0,3.25,2.25,78.57,15
CDM,Q2039_1,"INFLUENZA VIRUS VACCINE, NOT OTHERWISE SPECIFIED",5.0,3.25,2.25,80.89,15
CDM,Q2049_1,"INJECTION, DOXORUBICIN HYDROCHLORIDE, LIPOSOMAL, IMPORTED LIPODOX, 10 MG",900.0,585.0,78.57,1170.0,15
CDM,Q2050_1,"INJECTION, DOXORUBICIN HYDROCHLORIDE, LIPOSOMAL, NOT OTHERWISE SPECIFIED, 10 MG",900.0,585.0,78.57,1170.0,15
CDM,Q3014_1,TELEHEALTH ORIGINATING SITE FACILITY FEE,60.0,39.0,22.29,78.57,15
CDM,Q3031_1,COLLAGEN SKIN TEST,52.5,34.13,23.63,80.89,15
CDM,Q4002_1,"CAST SUPPLIES, BODY CAST ADULT, WITH OR WITHOUT HEAD, FIBERGLASS",403.2,262.08,78.57,485.63,19
CDM,Q4004_1,"CAST SUPPLIES, SHOULDER CAST, ADULT (11 YEARS +), FIBERGLASS",265.7,172.71,57.87,319.49,19
CDM,Q4006_1,"CAST SUPPLIES, LONG ARM CAST, ADULT (11 YEARS +), FIBERGLASS",63.0,40.95,13.89,78.57,19
CDM,Q4008_1,"CAST SUPPLIES, LONG ARM CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS",31.5,20.48,6.94,78.57,19
CDM,Q4010_1,"CAST SUPPLIES, SHORT ARM CAST, ADULT (11 YEARS +), FIBERGLASS",42.0,27.3,9.26,78.57,19
CDM,Q4012_1,"CAST SUPPLIES, SHORT ARM CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS",21.0,13.65,4.64,78.57,19
CDM,Q4022_1,"CAST SUPPLIES, SHORT ARM SPLINT, ADULT (11 YEARS +), FIBERGLASS",26.3,17.1,5.78,78.57,19
CDM,Q4024_1,"CAST SUPPLIES, SHORT ARM SPLINT, PEDIATRIC (0-10 YEARS), FIBERGLASS",15.8,10.27,2.9,78.57,19
CDM,Q4025_1,"CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), ADULT (11 YEARS +), PLASTER",84.0,54.6,17.96,100.8,19
CDM,Q4026_1,"CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), ADULT (11 YEARS +), FIBERGLASS",257.3,167.25,56.11,309.78,19
CDM,Q4028_1,"CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), PEDIATRIC (0-10 YEARS), FIBERGLASS",129.2,83.98,28.07,155.04,19
CDM,Q4030_1,"CAST SUPPLIES, LONG LEG CAST, ADULT (11 YEARS +), FIBERGLASS",165.9,107.84,36.18,199.74,19
CDM,Q4031_1,"CAST SUPPLIES, LONG LEG CAST, PEDIATRIC (0-10 YEARS), PLASTER",31.5,20.48,6.86,78.57,19
CDM,Q4032_1,"CAST SUPPLIES, LONG LEG CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS",84.0,54.6,18.09,100.8,19
CDM,Q4034_1,"CAST SUPPLIES, LONG LEG CYLINDER CAST, ADULT (11 YEARS +), FIBERGLASS",147.0,95.55,31.88,176.4,19
CDM,Q4038_1,"CAST SUPPLIES, SHORT LEG CAST, ADULT (11 YEARS +), FIBERGLASS",89.3,58.05,19.59,108.12,19
CDM,Q4040_1,"CAST SUPPLIES, SHORT LEG CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS",47.3,30.75,9.79,78.57,19
CDM,Q4046_1,"CAST SUPPLIES, SHORT LEG SPLINT, ADULT (11 YEARS +), FIBERGLASS",42.0,27.3,8.88,78.57,19
CDM,Q4051_1,"SPLINT SUPPLIES, MISCELLANEOUS (INCLUDES THERMOPLASTICS, STRAPPING, FASTENERS, PADDING AND OTHER SUPPLIES)",26.3,17.1,11.84,80.89,15
CDM,Q4106_1,"DERMAGRAFT, PER SQUARE CENTIMETER",74.6,48.49,33.57,89.52,15
CDM,Q5103_1,"INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG",95.0,61.75,17.84,100.7,15
CDM,Q5104_1,"INJECTION, INFLIXIMAB-ABDA, BIOSIMILAR, (RENFLEXIS), 10 MG",165.0,107.25,27.75,198.0,15
CDM,Q5106_1,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",20.0,13.0,7.07,78.57,15
CDM,Q5107_1,"INJECTION, BEVACIZUMAB-AWWB, BIOSIMILAR, (MVASI), 10 MG",210.0,136.5,23.84,273.0,15
CDM,Q5108_1,"INJECTION, PEGFILGRASTIM-JMDB (FULPHILA), BIOSIMILAR, 0.5 MG",1075.0,698.75,78.57,1397.5,15
CDM,Q5111_1,"INJECTION, PEGFILGRASTIM-CBQV (UDENYCA), BIOSIMILAR, 0.5 MG",600.0,390.0,78.57,780.0,15
CDM,Q5115_1,"INJECTION, RITUXIMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10 MG",160.0,104.0,30.14,208.0,15
CDM,Q5116_1,"INJECTION, TRASTUZUMAB-QYYP, BIOSIMILAR, (TRAZIMERA), 10 MG",115.0,74.75,8.2,149.5,15
CDM,Q5117_1,"INJECTION, TRASTUZUMAB-ANNS, BIOSIMILAR, (KANJINTI), 10 MG",272.0,176.8,27.91,353.6,15
CDM,Q5119_1,"INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG",125.0,81.25,13.27,162.5,15
CDM,Q5120_1,"INJECTION, PEGFILGRASTIM-BMEZ (ZIEXTENZO), BIOSIMILAR, 0.5 MG",605.0,393.25,24.71,786.5,15
CDM,Q5121_1,"INJECTION, INFLIXIMAB-AXXQ, BIOSIMILAR, (AVSOLA), 10 MG",165.0,107.25,23.81,174.9,15
CDM,Q9957_1,"INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML",162.8,105.82,40.2,195.36,15
CDM,RITIND_1,Other procedure on urinary system,1480.0,962.0,73.6,1524.4,15
CDM,S00170_1,Anesthesia for other procedure on mouth,462.0,300.3,73.6,231.0,15
CDM,S0020_1,"INJECTION, BUPIVICAINE HYDROCHLORIDE, 30 ML",10.5,6.83,3.29,7.88,14
CDM,S0189_1,"TESTOSTERONE PELLET, IMPLANT, 75 MG",205.88,133.82,73.6,247.06,12
CDM,S0596_1,PHAKIC INTRAOCULAR LENS FOR CORRECTION OF REFRACTIVE ERROR,1237.5,804.38,73.6,1274.63,15
CDM,S0620_1,ROUTINE OPHTHALMOLOGICAL EXAMINATION INCLUDING REFRACTION; NEW PATIENT,78.8,51.22,35.46,81.16,15
CDM,S0621_1,ROUTINE OPHTHALMOLOGICAL EXAMINATION INCLUDING REFRACTION; ESTABLISHED PATIENT,78.8,51.22,35.46,81.16,15
CDM,S0630_1,REMOVAL OF SUTURES; BY A PHYSICIAN OTHER THAN THE PHYSICIAN WHO ORIGINALLY CLOSED THE WOUND,50.0,32.5,22.5,80.89,15
CDM,S0800_1,LASER IN SITU KERATOMILEUSIS (LASIK),1846.0,1199.9,73.6,1901.38,15
CDM,S0810_1,PHOTOREFRACTIVE KERATECTOMY (PRK),1846.0,1199.9,73.6,1901.38,15
CDM,S0812_1,PHOTOTHERAPEUTIC KERATECTOMY (PTK),1846.0,1199.9,73.6,1901.38,15
CDM,S2067_1,"BREAST RECONSTRUCTION OF A SINGLE BREAST WITH ""STACKED"" DEEP INFERIOR EPIGASTRIC PERFORATOR (DIEP) FLAP(S) AND/OR GLUTEAL ARTERY PERFORATOR (GAP) FLAP(S), INCLUDING HARVESTING OF THE FLAP(S), MICROVAS",45000.0,29250.0,73.6,46350.0,15
CDM,S2068_1,"BREAST RECONSTRUCTION WITH DEEP INFERIOR EPIGASTRIC PERFORATOR (DIEP) FLAP OR SUPERFICIAL INFERIOR EPIGASTRIC ARTERY (SIEA) FLAP, INCLUDING HARVESTING OF THE FLAP, MICROVASCULAR TRANSFER, CLOSURE OF D",67500.0,43875.0,73.6,69525.0,15
CDM,S2083_1,ADJUSTMENT OF GASTRIC BAND DIAMETER VIA SUBCUTANEOUS PORT BY INJECTION OR ASPIRATION OF SALINE,260.0,169.0,73.6,267.8,15
CDM,S2102_1,ISLET CELL TISSUE TRANSPLANT FROM PANCREAS; ALLOGENEIC,3654.0,2375.1,73.6,3763.62,15
CDM,S2115_1,"OSTEOTOMY, PERIACETABULAR, WITH INTERNAL FIXATION",7350.0,4777.5,73.6,7570.5,15
CDM,S2325_1,HIP CORE DECOMPRESSION,5869.5,3815.18,73.6,6045.59,15
CDM,S4989_1,"CONTRACEPTIVE INTRAUTERINE DEVICE (E.G., PROGESTACERT IUD), INCLUDING IMPLANTS AND SUPPLIES",2145.83,1394.79,78.57,2210.2,15
CDM,S5108_1,"HOME CARE TRAINING TO HOME CARE CLIENT, PER 15 MINUTES",32.8,21.32,14.76,80.89,15
CDM,S8037_1,MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY (MRCP),308.7,200.66,73.6,317.96,15
CDM,S8096_1,PORTABLE PEAK FLOW METER,73.5,47.78,33.08,80.89,15
CDM,S8110_1,PEAK EXPIRATORY FLOW RATE (PHYSICIAN SERVICES),47.3,30.75,21.29,80.89,15
CDM,S8450_1,"SPLINT, PREFABRICATED, DIGIT (SPECIFY DIGIT BY USE OF MODIFIER)",26.3,17.1,11.84,80.89,15
CDM,S9460_1,"DIABETIC MANAGEMENT PROGRAM, NURSE VISIT",65.0,42.25,29.25,80.89,15
CDM,S9470_1,"NUTRITIONAL COUNSELING, DIETITIAN VISIT",87.2,56.68,39.24,89.82,15
CDM,S9480_1,"INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES, PER DIEM",1260.0,819.0,73.6,1297.8,15
CDM,S9986_1,NOT MEDICALLY NECESSARY SERVICE (PATIENT IS AWARE THAT SERVICE NOT MEDICALLY NECESSARY),525.0,341.25,73.6,540.75,15
CDM,T0138356_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5456.25,3546.56,1364.06,14090.77,17
CDM,T047105_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",887.06,576.59,221.77,2290.83,16
CDM,T048093_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5543.06,3602.99,1385.77,14314.95,17
CDM,T050364_1,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",5512.5,3583.13,1378.13,14236.03,17
CDM,T052079_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",20540.25,13351.16,5135.06,53045.2,17
CDM,T056285_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",1575.95,1024.37,393.99,4069.89,16
CDM,T060794_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",17351.03,11278.17,4337.76,44809.04,17
CDM,T060795_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",24474.47,15908.41,6118.62,63205.32,17
CDM,T061346_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7762.5,5045.63,1940.63,20046.66,17
CDM,T061654_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8427.38,5477.8,2106.85,21763.71,17
CDM,T062797_1,"SKIN SUBSTITUTE, NOT OTHERWISE SPECIFIED",9.73,6.32,2.43,25.13,16
CDM,T062825_1,"OASIS WOUND MATRIX, PER SQUARE CENTIMETER",60.71,39.46,15.18,156.78,17
CDM,T063191_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",26095.5,16962.08,6523.88,67391.63,17
CDM,T1001563_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8150.63,5297.91,2037.66,21049.0,17
CDM,T1001583_1,"EZ-DERM, PER SQUARE CENTIMETER",774.63,503.51,193.66,2000.48,16
CDM,T1002236_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",24336.0,15818.4,6084.0,62847.72,17
CDM,T1002310_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",5175.0,3363.75,1293.75,13364.44,16
CDM,T1002641_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",636.21,413.54,159.05,1643.01,16
CDM,T1003319_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",10985.63,7140.66,2746.41,28370.39,17
CDM,T1003453_1,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",2902.5,1886.63,725.63,7495.71,16
CDM,T1003897_1,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",3645.0,2369.25,911.25,9413.21,16
CDM,T1005130_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6412.5,4168.13,1603.13,16560.28,17
CDM,T1005791_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",56026.35,36417.13,14006.59,144688.05,17
CDM,T1006362_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",20955.42,13621.02,5238.86,54117.37,17
CDM,T1006599_1,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",4050.0,2632.5,1012.5,10459.13,16
CDM,T1007502_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7425.0,4826.25,1856.25,19175.06,17
CDM,T1007827_1,"ALLODERM, PER SQUARE CENTIMETER",125.44,81.54,31.36,323.95,16
CDM,T1008214_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3487.5,2266.88,871.88,9006.47,16
CDM,T1010542_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",30127.5,19582.88,7531.88,77804.27,17
CDM,T1010781_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6075.0,3948.75,1518.75,15688.69,17
CDM,T1011069_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3487.5,2266.88,871.88,9006.47,16
CDM,T1011093_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3170.45,2060.79,792.61,8187.69,16
CDM,T1011292_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",3487.5,2266.88,871.88,9006.47,16
CDM,T1011539_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3487.5,2266.88,871.88,9006.47,16
CDM,T1011713_1,"ALLODERM, PER SQUARE CENTIMETER",126.84,82.45,31.71,327.56,16
CDM,T1011956_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3825.0,2486.25,956.25,9878.06,16
CDM,T1012658_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18278.87,11881.27,4569.72,47205.18,17
CDM,T1012854_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",3487.5,2266.88,871.88,9006.47,16
CDM,T1012905_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4691.25,3049.31,1172.81,12115.15,16
CDM,T1013038_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4461.75,2900.14,1115.44,11522.47,16
CDM,T1013161_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",5807.57,3774.92,1451.89,14998.05,17
CDM,T1013243_1,"ALLODERM, PER SQUARE CENTIMETER",126.84,82.45,31.71,327.56,16
CDM,T1013356_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1462.5,950.63,365.63,3776.91,16
CDM,T1013357_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1957.5,1272.38,489.38,5055.24,16
CDM,T1013_1,"SIGN LANGUAGE OR ORAL INTERPRETIVE SERVICES, PER 15 MINUTES",30.0,19.5,13.5,80.89,15
CDM,T1014679_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",35676.0,23189.4,8919.0,92133.27,17
CDM,T1014920_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3560.63,2314.41,890.16,9195.33,16
CDM,T1014_1,"TELEHEALTH TRANSMISSION, PER MINUTE, PROFESSIONAL SERVICES BILL SEPARATELY",6.6,4.29,0.09,80.89,15
CDM,T1015763_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",4356.0,2831.4,1089.0,11249.37,16
CDM,T1015898_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6804.0,4422.6,1701.0,17571.33,17
CDM,T1015964_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",5245.74,3409.73,1311.44,13547.12,16
CDM,T1015978_1,"DERMAGRAFT, PER SQUARE CENTIMETER",5625.0,3656.25,1406.25,14526.56,16
CDM,T1016073_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18272.25,11876.96,4568.06,47188.09,17
CDM,T1016293_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3353.99,2180.09,838.5,8661.68,16
CDM,T1016603_1,"POROUS PURIFIED COLLAGEN MATRIX BONE VOID FILLER (INTEGRA MOZAIK OSTEOCONDUCTIVE SCAFFOLD PUTTY, INTEGRA OS OSTEOCONDUCTIVE SCAFFOLD PUTTY), PER 0.5 CC",377.64,245.47,94.41,975.26,16
CDM,T1016912_1,"POROUS PURIFIED COLLAGEN MATRIX BONE VOID FILLER (INTEGRA MOZAIK OSTEOCONDUCTIVE SCAFFOLD PUTTY, INTEGRA OS OSTEOCONDUCTIVE SCAFFOLD PUTTY), PER 0.5 CC",606.87,394.47,151.72,1567.24,16
CDM,T1017028_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",13230.0,8599.5,3307.5,34166.48,17
CDM,T1017308_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",9571.5,6221.48,2392.88,24718.4,17
CDM,T1018211_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",2117.52,1376.39,529.38,5468.5,16
CDM,T1018793_1,"STRATTICE TM, PER SQUARE CENTIMETER",104.33,67.81,26.08,269.43,17
CDM,T1019780_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18278.87,11881.27,4569.72,47205.18,17
CDM,T1019959_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8550.0,5557.5,2137.5,22080.38,17
CDM,T1020265_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18278.87,11881.27,4569.72,47205.18,17
CDM,T1020266_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18278.87,11881.27,4569.72,47205.18,17
CDM,T1020551_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8948.25,5816.36,2237.06,23108.86,17
CDM,T1020756_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",3825.0,2486.25,956.25,9878.06,16
CDM,T1020777_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",5602.5,3641.63,1400.63,14468.46,17
CDM,T1020778_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",5602.5,3641.63,1400.63,14468.46,17
CDM,T1021047_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3674.88,2388.67,918.72,9490.38,16
CDM,T1021053_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4374.84,2843.65,1093.71,11298.02,16
CDM,T1021236_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5602.5,3641.63,1400.63,14468.46,17
CDM,T1021306_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",111577.5,72525.38,27894.38,288148.89,17
CDM,T1021685_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8793.65,5715.87,2198.41,22709.6,17
CDM,T1021922_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",11583.0,7528.95,2895.75,29913.1,17
CDM,T1023253_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18278.87,11881.27,4569.72,47205.18,17
CDM,T1023255_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",19836.0,12893.4,4959.0,51226.47,17
CDM,T1023781_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3825.0,2486.25,956.25,9878.06,16
CDM,T1023782_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3825.0,2486.25,956.25,9878.06,16
CDM,T1023824_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18272.25,11876.96,4568.06,47188.09,17
CDM,T1023825_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18272.25,11876.96,4568.06,47188.09,17
CDM,T1023826_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18272.25,11876.96,4568.06,47188.09,17
CDM,T1023827_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18272.25,11876.96,4568.06,47188.09,17
CDM,T1023828_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18272.25,11876.96,4568.06,47188.09,17
CDM,T1023829_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18272.25,11876.96,4568.06,47188.09,17
CDM,T1023973_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",50348.7,32726.66,12587.18,130025.52,17
CDM,T1024050_1,"STRATTICE TM, PER SQUARE CENTIMETER",104.32,67.81,26.08,269.41,17
CDM,T1024287_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",22950.0,14917.5,5737.5,59268.38,17
CDM,T1024844_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2963.21,1926.09,740.8,7652.49,16
CDM,T1024845_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4548.15,2956.3,1137.04,11745.6,16
CDM,T1024953_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3487.5,2266.88,871.88,9006.47,16
CDM,T1025276_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1588.14,1032.29,397.04,4101.37,16
CDM,T1025397_1,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2956.5,1921.73,739.13,7635.16,16
CDM,T1025455_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",765.0,497.25,191.25,1975.61,16
CDM,T1026077_1,"ALLOSKIN, PER SQUARE CENTIMETER",33.19,21.57,8.3,134.77,17
CDM,T1027635_1,"STRATTICE TM, PER SQUARE CENTIMETER",104.31,67.8,26.08,269.38,17
CDM,T1027636_1,"STRATTICE TM, PER SQUARE CENTIMETER",104.33,67.81,26.08,269.43,17
CDM,T1027638_1,"STRATTICE TM, PER SQUARE CENTIMETER",104.34,67.82,26.09,269.46,17
CDM,T1027716_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3487.5,2266.88,871.88,9006.47,16
CDM,T1027809_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",12777.75,8305.54,3194.44,32998.54,17
CDM,T1028204_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",26993.25,17545.61,6748.31,69710.07,17
CDM,T1028286_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4944.39,3213.85,1236.1,12768.89,16
CDM,T1028498_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6281.1,4082.72,1570.28,16220.94,17
CDM,T1028870_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2713.59,1763.83,678.4,7007.85,16
CDM,T1029312_1,"APLIGRAF, PER SQUARE CENTIMETER",1912.5,1243.13,134.77,4939.03,17
CDM,T1029540_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",54230.85,35250.05,13557.71,140051.17,17
CDM,T1029541_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",50457.06,32797.09,12614.27,130305.36,17
CDM,T1029624_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24300.0,15795.0,6075.0,62754.75,17
CDM,T1029625_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",29025.0,18866.25,7256.25,74957.06,17
CDM,T1029626_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24525.0,15941.25,6131.25,63335.81,17
CDM,T1029627_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24525.0,15941.25,6131.25,63335.81,17
CDM,T1029628_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24525.0,15941.25,6131.25,63335.81,17
CDM,T1029629_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24525.0,15941.25,6131.25,63335.81,17
CDM,T1029630_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24525.0,15941.25,6131.25,63335.81,17
CDM,T1029631_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",18225.0,11846.25,4556.25,47066.06,17
CDM,T1029632_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24300.0,15795.0,6075.0,62754.75,17
CDM,T1029634_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24300.0,15795.0,6075.0,62754.75,17
CDM,T1029635_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24300.0,15795.0,6075.0,62754.75,17
CDM,T1030309_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",34271.46,22276.45,8567.87,88506.05,17
CDM,T1030324_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",26709.75,17361.34,6677.44,68977.93,17
CDM,T1030410_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",37811.97,24577.78,9452.99,97649.41,17
CDM,T1030650_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3487.5,2266.88,871.88,9006.47,16
CDM,T1030718_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",6457.5,4197.38,1614.38,16676.49,17
CDM,T1031438_1,"STRATTICE TM, PER SQUARE CENTIMETER",104.33,67.81,26.08,269.43,17
CDM,T1031439_1,"SKIN SUBSTITUTE, NOT OTHERWISE SPECIFIED",104.33,67.81,26.08,269.43,16
CDM,T1031441_1,"STRATTICE TM, PER SQUARE CENTIMETER",104.33,67.81,26.08,269.43,17
CDM,T1032274_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3337.88,2169.62,834.47,8620.08,16
CDM,T1032752_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5421.15,3523.75,1355.29,14000.12,16
CDM,T1032850_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7987.5,5191.88,1996.88,20627.72,17
CDM,T1032981_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",660.0,429.0,165.0,1704.45,16
CDM,T1033037_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5112.9,3323.39,1278.23,13204.06,16
CDM,T1033038_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5400.0,3510.0,1350.0,13945.5,16
CDM,T1033039_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5112.9,3323.39,1278.23,13204.06,16
CDM,T1033207_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",589.5,383.18,147.38,1522.38,16
CDM,T1033426_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",56158.76,36503.19,14039.69,145030.0,17
CDM,T1033526_1,"APLIGRAF, PER SQUARE CENTIMETER",132.44,86.09,33.11,342.03,17
CDM,T1034042_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5112.9,3323.39,1278.23,13204.06,16
CDM,T1034043_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5112.9,3323.39,1278.23,13204.06,16
CDM,T1034044_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5112.9,3323.39,1278.23,13204.06,16
CDM,T1034046_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5112.9,3323.39,1278.23,13204.06,16
CDM,T1034148_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",98357.14,63932.14,24589.29,254007.31,17
CDM,T1034667_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",5611.77,3647.65,1402.94,14492.4,17
CDM,T1034668_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",1094.45,711.39,273.61,2826.42,16
CDM,T1034669_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",1839.06,1195.39,459.77,4749.37,16
CDM,T1034917_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4090.23,2658.65,1022.56,10563.02,16
CDM,T1035536_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3524.76,2291.09,881.19,9102.69,16
CDM,T1035537_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3524.76,2291.09,881.19,9102.69,16
CDM,T1035674_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5112.9,3323.39,1278.23,13204.06,16
CDM,T1035675_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5112.9,3323.39,1278.23,13204.06,16
CDM,T1035676_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5112.9,3323.39,1278.23,13204.06,16
CDM,T1036558_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5112.9,3323.39,1278.23,13204.06,16
CDM,T1036612_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",118.84,77.25,29.71,306.9,16
CDM,T1037187_1,"PRIMATRIX, PER SQUARE CENTIMETER",152.58,99.18,38.15,394.04,17
CDM,T1037276_1,HC GRAFT ARTEGRAFT 40CM BOVINE ARTERY BIO,9580.5,6227.33,2395.13,24741.64,17
CDM,T1037296_1,"PRIMATRIX, PER SQUARE CENTIMETER",205.79,133.76,51.45,531.45,17
CDM,T1037325_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3972.56,2582.16,993.14,10259.14,16
CDM,T1037341_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",8235.0,5352.75,2058.75,21266.89,17
CDM,T1037381_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",3487.5,2266.88,871.88,9006.47,16
CDM,T1037464_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6463.13,4201.03,1615.78,16691.03,17
CDM,T1037609_1,"MATRISTEM MICROMATRIX, 1 MG",10548.0,6856.2,2637.0,27240.21,17
CDM,T1037676_1,"ARTHROFLEX, PER SQUARE CENTIMETER",693.62,450.85,134.77,1791.27,17
CDM,T1037789_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7179.93,4666.95,1794.98,18542.17,17
CDM,T1038094_1,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),51750.0,33637.5,12937.5,133644.38,17
CDM,T1038300_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",2623.5,1705.28,655.88,6775.19,16
CDM,T1038322_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",8608.5,5595.53,2152.13,22231.45,17
CDM,T1038324_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",8608.5,5595.53,2152.13,22231.45,17
CDM,T1038325_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",8847.0,5750.55,2211.75,22847.38,17
CDM,T1038326_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",7263.0,4720.95,1815.75,18756.7,17
CDM,T1038327_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",7263.0,4720.95,1815.75,18756.7,17
CDM,T1038761_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2790.0,1813.5,697.5,7205.18,16
CDM,T1038794_1,"PRIMATRIX, PER SQUARE CENTIMETER",153.0,99.45,38.25,395.12,17
CDM,T1039006_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",53694.0,34901.1,13423.5,138664.76,17
CDM,T1039020_1,"PRIMATRIX, PER SQUARE CENTIMETER",201.87,131.22,50.47,521.33,17
CDM,T1039021_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",11443.5,7438.28,2860.88,29552.84,17
CDM,T1039089_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",3487.5,2266.88,871.88,9006.47,16
CDM,T1039138_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",3487.5,2266.88,871.88,9006.47,16
CDM,T1039176_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",3487.5,2266.88,871.88,9006.47,16
CDM,T1039177_1,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",4720.5,3068.33,1180.13,12190.69,16
CDM,T1039261_1,"SKIN SUBSTITUTE, NOT OTHERWISE SPECIFIED",326.5,212.23,81.63,843.19,16
CDM,T1039262_1,"SKIN SUBSTITUTE, NOT OTHERWISE SPECIFIED",294.88,191.67,73.72,761.53,16
CDM,T1039557_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",135000.0,87750.0,33750.0,348637.5,17
CDM,T1039564_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",54230.85,35250.05,13557.71,140051.17,17
CDM,T1039661_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",771.12,501.23,192.78,1991.42,16
CDM,T1040258_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4584.6,2979.99,1146.15,11839.73,16
CDM,T1040259_1,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",1305.0,848.25,587.25,3370.16,14
CDM,T1040365_1,"PRIMATRIX, PER SQUARE CENTIMETER",223.37,145.19,55.84,576.85,17
CDM,T1040446_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",12654.0,8225.1,3163.5,32678.96,17
CDM,T1040563_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4968.0,3229.2,1242.0,12829.86,16
CDM,T1040567_1,"GRAFT, VASCULAR",9445.5,6139.58,2361.38,24393.0,17
CDM,T1040686_1,"OASIS ULTRA TRI-LAYER WOUND MATRIX, PER SQUARE CENTIMETER",39.29,25.54,9.82,134.77,17
CDM,T1040688_1,"OASIS ULTRA TRI-LAYER WOUND MATRIX, PER SQUARE CENTIMETER",10.48,6.81,2.62,134.77,17
CDM,T1040915_1,"PRIMATRIX, PER SQUARE CENTIMETER",179.44,116.64,44.86,463.4,17
CDM,T1041203_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2656.0,1726.4,664.0,6859.12,16
CDM,T1041617_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",11160.0,7254.0,2790.0,28820.7,17
CDM,T1041735_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",4161.86,2705.21,1040.47,10748.0,16
CDM,T1042364_1,"THERASKIN, PER SQUARE CENTIMETER",144.92,94.2,36.23,374.26,17
CDM,T1042411_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",1188.0,772.2,134.77,3068.01,17
CDM,T1042422_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",358.41,232.97,89.6,925.59,17
CDM,T1042502_1,"GRAFT, VASCULAR",29508.3,19180.4,7377.08,76205.18,17
CDM,T1042921_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3524.76,2291.09,881.19,9102.69,16
CDM,T1043057_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2619.0,1702.35,654.75,6763.57,16
CDM,T1043260_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2837.25,1844.21,709.31,7327.2,16
CDM,T1043437_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2400.75,1560.49,600.19,6199.94,16
CDM,T1043446_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",135000.0,87750.0,33750.0,348637.5,17
CDM,T1043523_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",146250.0,95062.5,36562.5,377690.63,17
CDM,T1043524_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",146250.0,95062.5,36562.5,377690.63,17
CDM,T1043525_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",146250.0,95062.5,36562.5,377690.63,17
CDM,T1043583_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",135000.0,87750.0,33750.0,348637.5,17
CDM,T1043584_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",135000.0,87750.0,33750.0,348637.5,17
CDM,T1043616_1,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",4225.5,2746.58,1056.38,10912.35,16
CDM,T1043763_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",146250.0,95062.5,36562.5,377690.63,17
CDM,T1043904_1,"ALLODERM, PER SQUARE CENTIMETER",130.64,84.92,32.66,337.38,16
CDM,T1044033_1,"ALLODERM, PER SQUARE CENTIMETER",130.64,84.92,32.66,337.38,16
CDM,T1044034_1,"STRATTICE TM, PER SQUARE CENTIMETER",107.44,69.84,26.86,277.46,17
CDM,T1044035_1,"STRATTICE TM, PER SQUARE CENTIMETER",107.45,69.84,26.86,277.49,16
CDM,T1044036_1,"STRATTICE TM, PER SQUARE CENTIMETER",107.44,69.84,26.86,277.46,17
CDM,T1044061_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",27402.3,17811.5,6850.58,70766.44,17
CDM,T1044216_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",606.38,394.15,151.6,1565.98,16
CDM,T1044217_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1185.03,770.27,296.26,3060.34,16
CDM,T1044218_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1544.58,1003.98,386.15,3988.88,16
CDM,T1044219_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1544.58,1003.98,386.15,3988.88,16
CDM,T1044220_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1544.58,1003.98,386.15,3988.88,16
CDM,T1044360_1,"CYTAL, PER SQUARE CENTIMETER",63.45,41.24,15.86,163.86,17
CDM,T1044443_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",156.79,101.91,39.2,404.91,16
CDM,T1044850_1,"PRIMATRIX, PER SQUARE CENTIMETER",154.69,100.55,38.67,399.49,16
CDM,T1044856_1,"PRIMATRIX, PER SQUARE CENTIMETER",167.58,108.93,41.9,432.78,17
CDM,T1045081_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2677.5,1740.38,669.38,6914.64,16
CDM,T1045173_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1300.5,845.33,325.13,3358.54,16
CDM,T1045350_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",544.37,353.84,136.09,1405.84,16
CDM,T1045481_1,"ALLODERM, PER SQUARE CENTIMETER",126.84,82.45,31.71,327.56,16
CDM,T1045524_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",35460.0,23049.0,8865.0,91575.45,17
CDM,T1045870_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",26993.25,17545.61,6748.31,69710.07,17
CDM,T1046012_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",14211.0,9237.15,3552.75,36699.91,17
CDM,T1046045_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",949.5,617.18,237.38,2452.08,16
CDM,T1046046_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",168.0,109.2,42.0,433.86,16
CDM,T1046291_1,"ALLODERM, PER SQUARE CENTIMETER",126.84,82.45,31.71,327.56,16
CDM,T1047738_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1366.88,888.47,341.72,3529.97,16
CDM,T1047986_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",135000.0,87750.0,33750.0,348637.5,17
CDM,T1048409_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",9171.0,5961.15,2292.75,23684.11,17
CDM,T1048410_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",14211.0,9237.15,3552.75,36699.91,17
CDM,T1048412_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5625.0,3656.25,1406.25,14526.56,17
CDM,T1048435_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",146250.0,95062.5,36562.5,377690.63,17
CDM,T1048553_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",9171.0,5961.15,2292.75,23684.11,17
CDM,T1048608_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",135000.0,87750.0,33750.0,348637.5,17
CDM,T1048645_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",23701.5,15405.98,5925.38,61209.12,17
CDM,T1048647_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",11443.5,7438.28,2860.88,29552.84,17
CDM,T1048656_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",1002.38,651.55,134.77,2588.65,17
CDM,T1048697_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4968.0,3229.2,1242.0,12829.86,16
CDM,T1048698_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",14211.0,9237.15,3552.75,36699.91,17
CDM,T1048699_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",14211.0,9237.15,3552.75,36699.91,17
CDM,T1048761_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",54000.0,35100.0,13500.0,139455.0,17
CDM,T1048762_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",54000.0,35100.0,13500.0,139455.0,17
CDM,T1048763_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",54000.0,35100.0,13500.0,139455.0,17
CDM,T1048764_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",54000.0,35100.0,13500.0,139455.0,17
CDM,T1048765_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",54000.0,35100.0,13500.0,139455.0,17
CDM,T1048811_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",135000.0,87750.0,33750.0,348637.5,17
CDM,T1049057_1,"STRATTICE TM, PER SQUARE CENTIMETER",107.45,69.84,26.86,277.49,17
CDM,T1049058_1,"STRATTICE TM, PER SQUARE CENTIMETER",107.44,69.84,26.86,277.46,17
CDM,T1049071_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",1169.1,759.92,292.28,3019.2,16
CDM,T1049072_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",2100.75,1365.49,525.19,5425.19,16
CDM,T1049302_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",34789.5,22613.18,8697.38,89843.88,17
CDM,T1049315_1,"PURAPLY AM, PER SQUARE CENTIMETER",450.0,292.5,112.5,1162.13,17
CDM,T1049317_1,"PURAPLY AM, PER SQUARE CENTIMETER",450.0,292.5,112.5,1162.13,17
CDM,T1049318_1,"PURAPLY XT, PER SQUARE CENTIMETER",450.0,292.5,112.5,1162.13,17
CDM,T1049319_1,"PURAPLY AM, PER SQUARE CENTIMETER",504.0,327.6,126.0,1301.58,17
CDM,T1049566_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",961.88,625.22,134.77,2484.06,17
CDM,T1049597_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",93750.0,60937.5,23437.5,242109.38,17
CDM,T1049624_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",29250.0,19012.5,7312.5,75538.13,17
CDM,T1050088_1,"CYTAL, PER SQUARE CENTIMETER",169.07,109.9,42.27,436.62,17
CDM,T1050145_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",54230.85,35250.05,13557.71,140051.17,17
CDM,T1050409_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",109687.5,71296.88,27421.88,283267.97,17
CDM,T1050762_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",121662.18,79080.42,30415.55,314192.58,17
CDM,T1050794_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2801.88,1821.22,700.47,7235.86,16
CDM,T1051005_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",40160.61,26104.4,10040.15,103714.78,17
CDM,T1051127_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",11250.0,7312.5,2812.5,29053.13,17
CDM,T1051131_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4410.0,2866.5,1102.5,11388.83,16
CDM,T1051132_1,UNCLASSIFIED DRUGS OR BIOLOGICALS,25500.0,16575.0,6375.0,65853.75,16
CDM,T1051147_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",54000.0,35100.0,13500.0,139455.0,17
CDM,T1051184_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",84825.0,55136.25,21206.25,219060.56,17
CDM,T1051297_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",742.5,482.63,185.63,1917.51,16
CDM,T1051368_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",93595.5,60837.08,23398.88,241710.38,17
CDM,T1051543_1,"ARTHROFLEX, PER SQUARE CENTIMETER",640.61,416.4,134.77,1654.38,17
CDM,T1051649_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",562.5,365.63,140.63,1452.66,16
CDM,T1051755_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8100.0,5265.0,2025.0,20918.25,17
CDM,T1051824_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",34177.5,22215.38,8544.38,88263.39,17
CDM,T1051825_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",32341.5,21021.98,8085.38,83521.92,17
CDM,T1051826_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",32647.5,21220.88,8161.88,84312.17,17
CDM,T1051827_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",32112.0,20872.8,8028.0,82929.24,17
CDM,T1051828_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",31882.5,20723.63,7970.63,82336.56,17
CDM,T1051829_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",31882.5,20723.63,7970.63,82336.56,17
CDM,T1051944_1,"GRAFT, VASCULAR",7330.5,4764.83,1832.63,18931.02,17
CDM,T1052297_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",990.0,643.5,247.5,2556.68,16
CDM,T1052298_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",1147.5,745.88,286.88,2963.42,16
CDM,T1052307_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",529.2,343.98,132.3,1366.66,16
CDM,T1052404_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",54230.85,35250.05,13557.71,140051.17,17
CDM,T1052471_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",11160.0,7254.0,2790.0,28820.7,17
CDM,T1052523_1,"AUTOLOGOUS CULTURED CHONDROCYTES, IMPLANT",218727.0,142172.55,54681.75,564862.48,16
CDM,T1052705_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",24944.31,16213.8,6236.08,64418.68,17
CDM,T1052735_1,"CYTAL, PER SQUARE CENTIMETER",137.44,89.34,34.36,354.94,17
CDM,T1053014_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3170.9,2061.09,792.73,8188.85,16
CDM,T1053374_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",746.25,485.06,134.77,1927.19,17
CDM,T1053375_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",455.63,296.16,113.91,1176.66,17
CDM,T1053376_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",486.0,315.9,121.5,1255.1,17
CDM,T1053418_1,"CYTAL, PER SQUARE CENTIMETER",135.39,88.0,33.85,349.64,17
CDM,T1053436_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",5611.77,3647.65,1402.94,14492.4,17
CDM,T1053526_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",51412.5,33418.13,12853.13,132772.78,17
CDM,T1053577_1,HC FEMORAL VEIN 21CM BIO,24060.78,15639.51,6015.2,24060.78,12
CDM,T1053607_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7650.0,4972.5,1912.5,19756.13,17
CDM,T1053642_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",29250.0,19012.5,7312.5,75538.13,17
CDM,T1053668_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",11250.0,7312.5,2812.5,29053.13,17
CDM,T1053774_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3690.0,2398.5,922.5,9529.43,16
CDM,T1053847_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",48316.5,31405.73,12079.13,124777.36,17
CDM,T1053848_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",32501.25,21125.81,8125.31,83934.48,17
CDM,T1053855_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1620.0,1053.0,405.0,4183.65,16
CDM,T1053894_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",18850.0,12252.5,4712.5,48680.13,17
CDM,T1053924_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",35287.65,22936.97,8821.91,91130.36,17
CDM,T1054022_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3413.43,2218.73,853.36,8815.18,16
CDM,T1054106_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2160.0,1404.0,540.0,5578.2,16
CDM,T1054127_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",32391.9,21054.74,8097.98,83652.08,17
CDM,T1054316_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",1018.13,661.78,134.77,2629.32,17
CDM,T1054654_1,HC TENDON GRAFTLINK BIO,11088.0,7207.2,2772.0,7761.6,11
CDM,T1054832_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",146250.0,95062.5,36562.5,377690.63,17
CDM,T1055039_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",1057.5,687.38,264.38,2730.99,16
CDM,T1055040_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",3600.0,2340.0,900.0,9297.0,16
CDM,T1055041_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",5400.0,3510.0,1350.0,13945.5,16
CDM,T1055198_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",28012.5,18208.13,7003.13,72342.28,17
CDM,T1055200_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",28012.5,18208.13,7003.13,72342.28,17
CDM,T1055201_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",30690.0,19948.5,7672.5,79256.93,17
CDM,T1055202_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",30690.0,19948.5,7672.5,79256.93,17
CDM,T1055305_1,"ALLODERM, PER SQUARE CENTIMETER",126.84,82.45,31.71,327.56,16
CDM,T1055306_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",771.12,501.23,192.78,1991.42,16
CDM,T1055513_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",37255.5,24216.08,9313.88,96212.33,17
CDM,T1055557_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",37255.5,24216.08,9313.88,96212.33,17
CDM,T1055665_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",58086.68,37756.34,14521.67,150008.85,17
CDM,T1055768_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5112.9,3323.39,1278.23,13204.06,16
CDM,T1055846_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3326.4,2162.16,831.6,8590.43,16
CDM,T1055847_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3326.4,2162.16,831.6,8590.43,16
CDM,T1055848_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2910.06,1891.54,727.52,7515.23,16
CDM,T1056326_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",29250.0,19012.5,7312.5,75538.13,17
CDM,T1056846_1,"ALLODERM, PER SQUARE CENTIMETER",126.84,82.45,31.71,327.56,16
CDM,T1056964_1,"ALLODERM, PER SQUARE CENTIMETER",130.64,84.92,32.66,337.38,16
CDM,T1056965_1,"ALLODERM, PER SQUARE CENTIMETER",130.64,84.92,32.66,337.38,16
CDM,T1057320_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",57252.6,37214.19,14313.15,147854.84,17
CDM,T1057637_1,"THERASKIN, PER SQUARE CENTIMETER",131.51,85.48,32.88,339.62,17
CDM,T1057658_1,"THERASKIN, PER SQUARE CENTIMETER",691.5,449.48,134.77,1785.8,17
CDM,T1057659_1,"THERASKIN, PER SQUARE CENTIMETER",362.77,235.8,90.69,936.85,17
CDM,T1057660_1,"THERASKIN, PER SQUARE CENTIMETER",131.51,85.48,32.88,339.62,17
CDM,T1057937_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",14400.0,9360.0,3600.0,37188.0,17
CDM,T1057939_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1620.0,1053.0,405.0,4183.65,16
CDM,T1058046_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4234.5,2752.43,1058.63,10935.6,16
CDM,T1058071_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2839.5,1845.68,709.88,7333.01,16
CDM,T1058080_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8662.5,5630.63,2165.63,22370.91,17
CDM,T1058081_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8662.5,5630.63,2165.63,22370.91,17
CDM,T1058082_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",7263.0,4720.95,1815.75,18756.7,17
CDM,T1058134_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",11700.0,7605.0,2925.0,30215.25,17
CDM,T1058562_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7263.0,4720.95,1815.75,18756.7,17
CDM,T1058563_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4500.0,2925.0,1125.0,11621.25,16
CDM,T1058727_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",20388.6,13252.59,5097.15,52653.56,17
CDM,T1058905_1,HC MICRO POWDER 1000MG,9841.5,6396.98,2460.38,6889.05,11
CDM,T1058906_1,HC MICRO POWDER 500MG,5376.38,3494.65,1344.1,3763.47,11
CDM,T1059412_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1544.58,1003.98,386.15,3988.88,16
CDM,T1059413_1,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1544.58,1003.98,386.15,3988.88,16
CDM,T1059871_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",63000.0,40950.0,15750.0,162697.5,17
CDM,T1059872_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",63000.0,40950.0,15750.0,162697.5,17
CDM,T1059873_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",63000.0,40950.0,15750.0,162697.5,17
CDM,T1059874_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",63000.0,40950.0,15750.0,162697.5,17
CDM,T1059875_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",63000.0,40950.0,15750.0,162697.5,17
CDM,T1059889_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3375.0,2193.75,843.75,8715.94,16
CDM,T1059934_1,"CYTAL, PER SQUARE CENTIMETER",95.94,62.36,23.99,247.77,17
CDM,T1060056_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2925.0,1901.25,731.25,7553.81,16
CDM,T1060058_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",54627.75,35508.04,13656.94,141076.16,17
CDM,T1060253_1,"ALLODERM, PER SQUARE CENTIMETER",130.64,84.92,32.66,337.38,16
CDM,T1060254_1,"ALLODERM, PER SQUARE CENTIMETER",126.85,82.45,31.71,327.59,16
CDM,T1060256_1,"ALLODERM, PER SQUARE CENTIMETER",130.64,84.92,32.66,337.38,16
CDM,T1060516_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",56627.01,36807.56,14156.75,146239.25,17
CDM,T1060633_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",54897.0,35683.05,13724.25,141771.5,17
CDM,T1060939_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",135000.0,87750.0,33750.0,348637.5,17
CDM,T1061071_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",16052.09,10433.86,4013.02,41454.52,17
CDM,T1061249_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",148500.0,96525.0,37125.0,383501.25,17
CDM,T1061250_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",148500.0,96525.0,37125.0,383501.25,17
CDM,T1061255_1,"ALLODERM, PER SQUARE CENTIMETER",142.29,92.49,35.57,367.46,16
CDM,T1061256_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",15490.26,10068.67,3872.57,40003.6,17
CDM,T1061335_1,"ALLODERM, PER SQUARE CENTIMETER",328.5,213.53,82.13,848.35,16
CDM,T1061336_1,"ALLODERM, PER SQUARE CENTIMETER",198.8,129.22,49.7,513.4,16
CDM,T1061337_1,"ALLODERM, PER SQUARE CENTIMETER",198.8,129.22,49.7,513.4,16
CDM,T1061338_1,"ALLODERM, PER SQUARE CENTIMETER",120.94,78.61,30.24,312.33,16
CDM,T1061370_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",544.37,353.84,136.09,1405.84,16
CDM,T1061371_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1228.1,798.27,307.03,3171.57,16
CDM,T1061372_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2206.98,1434.54,551.75,5699.53,16
CDM,T1061373_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2206.98,1434.54,551.75,5699.53,16
CDM,T1061374_1,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3413.43,2218.73,853.36,8815.18,16
CDM,T1061437_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2943.0,1912.95,735.75,7600.3,16
CDM,T1061438_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5216.0,3390.4,1304.0,13470.32,16
CDM,T1061439_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6511.5,4232.48,1627.88,16815.95,17
CDM,T1061441_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4488.75,2917.69,1122.19,11592.2,16
CDM,T1061442_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5933.5,3856.78,1483.38,15323.26,17
CDM,T1061461_1,"OASIS ULTRA TRI-LAYER WOUND MATRIX, PER SQUARE CENTIMETER",52.31,34.0,13.08,135.09,17
CDM,T1061663_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",7092.0,4609.8,1773.0,18315.09,17
CDM,T1061664_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",7092.0,4609.8,1773.0,18315.09,17
CDM,T1061665_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",7092.0,4609.8,1773.0,18315.09,17
CDM,T1061749_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",259.2,168.48,64.8,669.38,16
CDM,T1061750_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",331.2,215.28,82.8,855.32,16
CDM,T1061751_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",597.6,388.44,149.4,1543.3,16
CDM,T1062027_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2709.0,1760.85,677.25,6995.99,16
CDM,T1062028_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2709.0,1760.85,677.25,6995.99,16
CDM,T1062029_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2709.0,1760.85,677.25,6995.99,16
CDM,T1062212_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",270.0,175.5,67.5,697.28,16
CDM,T1062213_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",478.8,311.22,119.7,1236.5,16
CDM,T1062289_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",16052.09,10433.86,4013.02,41454.52,17
CDM,T1062313_1,"ALLODERM, PER SQUARE CENTIMETER",120.38,78.25,30.1,310.88,16
CDM,T1062345_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",11200.5,7280.33,2800.13,28925.29,17
CDM,T1062738_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",1732.5,1126.13,433.13,4474.18,16
CDM,T1062739_1,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",4027.5,2617.88,1006.88,10401.02,16
CDM,T1062740_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5827.5,3787.88,1456.88,15049.52,17
CDM,T1062784_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",4671.99,3036.79,1168.0,12065.41,16
CDM,T1062987_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",55435.5,36033.08,13858.88,143162.18,17
CDM,T1063024_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24532.9,15946.39,6133.23,63356.21,17
CDM,T1063025_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24532.9,15946.39,6133.23,63356.21,17
CDM,T1063026_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24532.9,15946.39,6133.23,63356.21,17
CDM,T1063027_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24532.9,15946.39,6133.23,63356.21,17
CDM,T1063028_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",24532.9,15946.39,6133.23,63356.21,17
CDM,T1063029_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",23569.9,15320.44,5892.48,60869.27,17
CDM,T1063030_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",23569.9,15320.44,5892.48,60869.27,17
CDM,T1063031_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",23569.9,15320.44,5892.48,60869.27,17
CDM,T1063032_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",23569.9,15320.44,5892.48,60869.27,17
CDM,T1063033_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",23569.9,15320.44,5892.48,60869.27,17
CDM,T1063034_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",23569.9,15320.44,5892.48,60869.27,17
CDM,T1063068_1,"OASIS ULTRA TRI-LAYER WOUND MATRIX, PER SQUARE CENTIMETER",57.88,37.62,14.47,149.48,17
CDM,T1063227_1,"OASIS BURN MATRIX, PER SQUARE CENTIMETER",13.5,8.78,3.38,134.77,17
CDM,T1063228_1,"OASIS BURN MATRIX, PER SQUARE CENTIMETER",48.83,31.74,12.21,134.77,17
CDM,T1063229_1,"OASIS BURN MATRIX, PER SQUARE CENTIMETER",7.88,5.12,1.97,134.77,17
CDM,T1063230_1,"OASIS BURN MATRIX, PER SQUARE CENTIMETER",129.4,84.11,32.35,334.18,17
CDM,T1063231_1,"OASIS BURN MATRIX, PER SQUARE CENTIMETER",52.38,34.05,13.1,135.27,17
CDM,T1063619_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3611.25,2347.31,902.81,9326.05,16
CDM,T1063816_1,UNCLASSIFIED BIOLOGICS,7627.5,4957.88,1906.88,19698.02,16
CDM,T1063996_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",97569.0,63419.85,24392.25,251971.94,17
CDM,T1064092_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",153000.0,99450.0,38250.0,395122.5,17
CDM,T1064168_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7301.25,4745.81,1825.31,18855.48,17
CDM,T1064169_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7301.25,4745.81,1825.31,18855.48,17
CDM,T1064170_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7301.25,4745.81,1825.31,18855.48,17
CDM,T1064171_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7301.25,4745.81,1825.31,18855.48,17
CDM,T1064172_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7301.25,4745.81,1825.31,18855.48,17
CDM,T1064173_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7301.25,4745.81,1825.31,18855.48,17
CDM,T1064174_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7301.25,4745.81,1825.31,18855.48,17
CDM,T1064175_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7301.25,4745.81,1825.31,18855.48,17
CDM,T1064176_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7301.25,4745.81,1825.31,18855.48,17
CDM,T1064177_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6682.5,4343.63,1670.63,17257.56,17
CDM,T1064178_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6682.5,4343.63,1670.63,17257.56,17
CDM,T1064179_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6682.5,4343.63,1670.63,17257.56,17
CDM,T1064180_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6682.5,4343.63,1670.63,17257.56,17
CDM,T1064916_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",3403.62,2212.35,850.91,8789.85,16
CDM,T1065047_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8550.0,5557.5,2137.5,22080.38,17
CDM,T1065153_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",135000.0,87750.0,33750.0,348637.5,17
CDM,T1065154_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",135000.0,87750.0,33750.0,348637.5,17
CDM,T1065155_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",135000.0,87750.0,33750.0,348637.5,17
CDM,T1065156_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",135000.0,87750.0,33750.0,348637.5,17
CDM,T1065200_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",153000.0,99450.0,38250.0,395122.5,17
CDM,T1065201_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",153000.0,99450.0,38250.0,395122.5,17
CDM,T1065202_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",153000.0,99450.0,38250.0,395122.5,17
CDM,T1065203_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",153000.0,99450.0,38250.0,395122.5,17
CDM,T1065787_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",11776.5,7654.73,2944.13,30412.81,17
CDM,T1065788_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",14431.5,9380.48,3607.88,37269.35,17
CDM,T1065789_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",14431.5,9380.48,3607.88,37269.35,17
CDM,T1065790_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",14431.5,9380.48,3607.88,37269.35,17
CDM,T1065909_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3735.9,2428.34,933.98,9647.96,16
CDM,T1066038_1,"ALLODERM, PER SQUARE CENTIMETER",239.67,155.79,59.92,618.95,16
CDM,T1066084_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",10894.5,7081.43,2723.63,28135.05,17
CDM,T1066144_1,"PRIMATRIX, PER SQUARE CENTIMETER",176.49,114.72,44.12,455.79,17
CDM,T1066298_1,"CYTAL, PER SQUARE CENTIMETER",75.54,49.1,18.89,195.08,17
CDM,T1066328_1,"CYTAL, PER SQUARE CENTIMETER",3595.5,2337.08,134.77,9285.38,17
CDM,T1066338_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",2053.75,1334.94,513.44,5303.81,16
CDM,T1066376_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",6644.93,4319.2,1661.23,17160.53,17
CDM,T1066389_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",1411.52,917.49,352.88,3645.25,16
CDM,T1066390_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",1562.36,1015.53,390.59,4034.79,16
CDM,T1066391_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",2020.5,1313.33,505.13,5217.94,16
CDM,T1066392_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",3329.6,2164.24,832.4,8598.69,16
CDM,T1066393_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",34177.5,22215.38,8544.38,88263.39,17
CDM,T1066394_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",34177.5,22215.38,8544.38,88263.39,17
CDM,T1066395_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",34177.5,22215.38,8544.38,88263.39,17
CDM,T1066396_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",34177.5,22215.38,8544.38,88263.39,17
CDM,T1066397_1,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",34177.5,22215.38,8544.38,88263.39,17
CDM,T1066458_1,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",495.9,322.34,123.98,1280.66,17
CDM,T1066641_1,"ALLODERM, PER SQUARE CENTIMETER",239.49,155.67,59.87,618.48,16
CDM,T1066673_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",28408.5,18465.53,7102.13,73364.95,17
CDM,T1067158_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8509.5,5531.18,2127.38,21975.78,17
CDM,T1067160_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8509.5,5531.18,2127.38,21975.78,17
CDM,T1067161_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",8509.5,5531.18,2127.38,21975.78,17
CDM,T1067264_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",771.12,501.23,192.78,1991.42,16
CDM,T1067381_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",72072.0,46846.8,18018.0,186125.94,17
CDM,T1067382_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",72072.0,46846.8,18018.0,186125.94,17
CDM,T1067550_1,ADHESION BARRIER,12514.5,8134.43,3128.63,32318.7,17
CDM,T1067948_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",11034.0,7172.1,2758.5,28495.31,17
CDM,T1068003_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5310.0,3451.5,1327.5,13713.08,16
CDM,T1068092_1,"ARTHROFLEX, PER SQUARE CENTIMETER",707.14,459.64,134.77,1826.19,17
CDM,T1068459_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",303.12,197.03,75.78,782.81,16
CDM,T1068642_1,"AMNIOEXCEL, AMNIOEXCEL PLUS OR BIODEXCEL, PER SQUARE CENTIMETER",207.0,134.55,51.75,534.58,17
CDM,T1068651_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",57252.6,37214.19,14313.15,147854.84,17
CDM,T1068652_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",57252.6,37214.19,14313.15,147854.84,17
CDM,T1068955_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",51916.5,33745.73,12979.13,134074.36,17
CDM,T1068976_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",32136.12,20888.48,8034.03,82991.53,17
CDM,T1068977_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",68000.09,44200.06,17000.02,175610.23,17
CDM,T1069012_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",7740.0,5031.0,1935.0,19988.55,17
CDM,T1069013_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",9180.0,5967.0,2295.0,23707.35,17
CDM,T1069111_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",896.4,582.66,224.1,2314.95,16
CDM,T1069252_1,"CYTAL, PER SQUARE CENTIMETER",64.89,42.18,16.22,167.58,17
CDM,T1069672_1,"ARTHROFLEX, PER SQUARE CENTIMETER",483.33,314.16,120.83,1248.2,17
CDM,T1069742_1,"AMNIOEXCEL, AMNIOEXCEL PLUS OR BIODEXCEL, PER SQUARE CENTIMETER",179.28,116.53,44.82,462.99,17
CDM,T1069766_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",20529.0,13343.85,5132.25,53016.14,17
CDM,T1069819_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",68000.09,44200.06,17000.02,175610.23,17
CDM,T1069916_1,ORTHOPEDIC/DEVICE/DRUG MATRIX FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO BONE (IMPLANTABLE),55125.0,35831.25,13781.25,142360.31,17
CDM,T1070199_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",1030.5,669.83,257.63,2661.27,16
CDM,T1070200_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",2569.5,1670.18,642.38,6635.73,16
CDM,T1070524_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",2871.0,1866.15,717.75,7414.36,16
CDM,T1070719_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",21753.0,14139.45,5438.25,56177.12,17
CDM,T1070839_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",144000.0,93600.0,36000.0,371880.0,17
CDM,T1070840_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",144000.0,93600.0,36000.0,371880.0,17
CDM,T1070841_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",144000.0,93600.0,36000.0,371880.0,17
CDM,T1070897_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",146250.0,95062.5,36562.5,377690.63,17
CDM,T1071287_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",146250.0,95062.5,36562.5,377690.63,17
CDM,T1071288_1,"ALLODERM, PER SQUARE CENTIMETER",164.34,106.82,41.09,424.41,16
CDM,T1071578_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",9311.4,6052.41,2327.85,24046.69,17
CDM,T1071653_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",22500.0,14625.0,5625.0,58106.25,17
CDM,T1071855_1,"AMNIOEXCEL, AMNIOEXCEL PLUS OR BIODEXCEL, PER SQUARE CENTIMETER",351.0,228.15,87.75,906.46,17
CDM,T1071945_1,"MEMODERM, DERMASPAN, TRANZGRAFT OR INTEGUPLY, PER SQUARE CENTIMETER",583.2,379.08,134.77,1506.11,17
CDM,T1072070_1,HC GRAFT PUROS DERMIS 10X20MM THICK BIO,583.2,379.08,145.8,408.24,11
CDM,T1072072_1,"SKIN SUBSTITUTE, NOT OTHERWISE SPECIFIED",392.4,255.06,98.1,1013.37,16
CDM,T1072579_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",22495.5,14622.08,5623.88,58094.63,17
CDM,T1072732_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",16200.0,10530.0,4050.0,41836.5,17
CDM,T1072754_1,"PROCESSING, PRESERVING AND TRANSPORTING CORNEAL TISSUE",8775.0,5703.75,2193.75,22661.44,19
CDM,T1072862_1,"ARTHROFLEX, PER SQUARE CENTIMETER",9088.2,5907.33,134.77,23470.28,17
CDM,T1072919_1,"POROUS PURIFIED COLLAGEN MATRIX BONE VOID FILLER (INTEGRA MOZAIK OSTEOCONDUCTIVE SCAFFOLD PUTTY, INTEGRA OS OSTEOCONDUCTIVE SCAFFOLD PUTTY), PER 0.5 CC",3642.75,2367.79,910.69,9407.4,16
CDM,T1073345_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",193500.0,125775.0,48375.0,499713.75,17
CDM,T1073346_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",193500.0,125775.0,48375.0,499713.75,17
CDM,T1073347_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",193500.0,125775.0,48375.0,499713.75,17
CDM,T1073348_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",193500.0,125775.0,48375.0,499713.75,17
CDM,T1073396_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",15111.0,9822.15,3777.75,39024.16,17
CDM,T1073911_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",291.6,189.54,72.9,753.06,16
CDM,T1073912_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",374.4,243.36,93.6,966.89,16
CDM,T1073913_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",659.7,428.81,164.93,1703.68,16
CDM,T1073957_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",61168.5,39759.53,15292.13,157967.65,17
CDM,T1074111_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",3595.5,2337.08,898.88,9285.38,16
CDM,T1074741_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",243000.0,157950.0,60750.0,627547.5,17
CDM,T1074873_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",25983.0,16888.95,6495.75,67101.1,17
CDM,T1074874_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",25983.0,16888.95,6495.75,67101.1,17
CDM,T1074875_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",25983.0,16888.95,6495.75,67101.1,17
CDM,T1074876_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",25983.0,16888.95,6495.75,67101.1,17
CDM,T1075038_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",4403.7,2862.41,1100.93,11372.56,16
CDM,T1075039_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",15165.0,9857.25,3791.25,39163.61,17
CDM,T1075303_1,"PRIMATRIX, PER SQUARE CENTIMETER",198.0,128.7,49.5,511.34,16
CDM,T1075318_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",2925.0,1901.25,731.25,7553.81,16
CDM,T1075319_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5760.0,3744.0,1440.0,14875.2,17
CDM,T1075502_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",30433.5,19781.78,7608.38,78594.51,17
CDM,T1075555_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",47250.0,30712.5,11812.5,122023.13,17
CDM,T1075556_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",47250.0,30712.5,11812.5,122023.13,17
CDM,T1075557_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",47250.0,30712.5,11812.5,122023.13,17
CDM,T1075558_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",47250.0,30712.5,11812.5,122023.13,17
CDM,T1075559_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",47250.0,30712.5,11812.5,122023.13,17
CDM,T1075560_1,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",47250.0,30712.5,11812.5,122023.13,17
CDM,T135670_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",30127.5,19582.88,7531.88,77804.27,17
CDM,T135671_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",30127.5,19582.88,7531.88,77804.27,17
CDM,T135672_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",30127.5,19582.88,7531.88,77804.27,17
CDM,T135673_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",30127.5,19582.88,7531.88,77804.27,17
CDM,T135674_1,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",30127.5,19582.88,7531.88,77804.27,17
CDM,T882301_1,"PROCESSING, PRESERVING AND TRANSPORTING CORNEAL TISSUE",17264.86,11222.16,3593.54,44586.5,16
CDM,T883511_1,HC SCLERA HUMAN TISSUE BIO,2475.0,1608.75,618.75,1732.5,11
CDM,TBS1227_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",33187.5,21571.88,8296.88,85706.72,17
CDM,TBS2167_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5720.63,3718.41,1430.16,14773.53,17
CDM,TU07544_1,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3337.88,2169.62,834.47,8620.08,16
CDM,TU08856_1,OCULAR IMPLANT,1305.0,848.25,326.25,1566.0,16
CDM,UNOCL_1,PR UNO CLEARANCE - HEALTH ASSMNT,36.0,23.4,14.4,27.0,11
CDM,V2510_1,"CONTACT LENS, GAS PERMEABLE, SPHERICAL, PER LENS",459.9,298.94,56.03,473.7,19
CDM,V2520_1,"CONTACT LENS, HYDROPHILIC, SPHERICAL, PER LENS",236.3,153.6,55.98,374.55,19
CDM,V2599_1,"CONTACT LENS, OTHER TYPE",630.0,409.5,73.6,648.9,15
CDM,V2628_1,FABRICATION AND FITTING OF OCULAR CONFORMER,350.0,227.5,78.57,1240.33,19
CDM,V2787_1,ASTIGMATISM CORRECTING FUNCTION OF INTRAOCULAR LENS,367.5,238.88,73.6,378.53,15
CDM,V2788_1,PRESBYOPIA CORRECTING FUNCTION OF INTRAOCULAR LENS,525.0,341.25,73.6,540.75,15
CDM,V2790_1,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",2700.0,1755.0,73.6,2781.0,15
CDM,V5050A_1,"HEARING AID, MONAURAL, IN THE EAR",1800.0,1170.0,78.57,1854.0,15
CDM,V5050B_1,"HEARING AID, MONAURAL, IN THE EAR",1200.0,780.0,78.57,1462.93,15
CDM,V5050E_1,"HEARING AID, MONAURAL, IN THE EAR",800.0,520.0,78.57,1462.93,15
CDM,V5050P_1,"HEARING AID, MONAURAL, IN THE EAR",2400.0,1560.0,78.57,2472.0,15
CDM,V5060A_1,"HEARING AID, MONAURAL, BEHIND THE EAR",1800.0,1170.0,78.57,1854.0,15
CDM,V5060B_1,"HEARING AID, MONAURAL, BEHIND THE EAR",1200.0,780.0,78.57,1236.0,15
CDM,V5060C_1,"HEARING AID, MONAURAL, BEHIND THE EAR",2000.0,1300.0,78.57,2060.0,15
CDM,V5060D_1,"HEARING AID, MONAURAL, BEHIND THE EAR",1400.0,910.0,78.57,1442.0,15
CDM,V5060E_1,"HEARING AID, MONAURAL, BEHIND THE EAR",800.0,520.0,78.57,1222.63,15
CDM,V5060P_1,"HEARING AID, MONAURAL, BEHIND THE EAR",2600.0,1690.0,78.57,2678.0,15
CDM,V5130A_1,"BINAURAL, IN THE EAR",3600.0,2340.0,78.57,3708.0,15
CDM,V5130B_1,"BINAURAL, IN THE EAR",2400.0,1560.0,78.57,2547.56,15
CDM,V5130E_1,"BINAURAL, IN THE EAR",1600.0,1040.0,78.57,2547.56,15
CDM,V5130P_1,"BINAURAL, IN THE EAR",4800.0,3120.0,78.57,4944.0,15
CDM,V5140A_1,"BINAURAL, BEHIND THE EAR",3600.0,2340.0,78.57,3708.0,15
CDM,V5140B_1,"BINAURAL, BEHIND THE EAR",2400.0,1560.0,78.57,2649.03,15
CDM,V5140C_1,"BINAURAL, BEHIND THE EAR",4000.0,2600.0,78.57,4120.0,15
CDM,V5140D_1,"BINAURAL, BEHIND THE EAR",2800.0,1820.0,78.57,2884.0,15
CDM,V5140E_1,"BINAURAL, BEHIND THE EAR",1600.0,1040.0,78.57,2649.03,15
CDM,V5140P_1,"BINAURAL, BEHIND THE EAR",4800.0,3120.0,78.57,4944.0,15
CDM,V5140Q_1,"BINAURAL, BEHIND THE EAR",5200.0,3380.0,78.57,5356.0,15
CDM,V5160A_1,"DISPENSING FEE, BINAURAL",600.0,390.0,78.57,739.57,15
CDM,V5160B_1,"DISPENSING FEE, BINAURAL",800.0,520.0,78.57,824.0,15
CDM,V5160C_1,"DISPENSING FEE, BINAURAL",1000.0,650.0,78.57,1030.0,15
CDM,V5160M_1,"DISPENSING FEE, BINAURAL",596.27,387.58,78.57,739.57,15
CDM,V5160P_1,"HEARING AID, MONAURAL, BEHIND THE EAR",2400.0,1560.0,78.57,2472.0,15
CDM,V5171E_1,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR (ITE)",1000.0,650.0,73.6,2085.77,15
CDM,V5172C_1,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE CANAL (ITC)",1000.0,650.0,73.6,2085.77,15
CDM,V5181E_1,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, BEHIND THE EAR (BTE)",1000.0,650.0,78.57,1765.53,15
CDM,V5200A_1,"DISPENSING FEE, CONTRALATERAL, MONAURAL",300.0,195.0,78.57,612.13,15
CDM,V5200B_1,"DISPENSING FEE, CONTRALATERAL, MONAURAL",400.0,260.0,78.57,612.13,15
CDM,V5200C_1,"DISPENSING FEE, CONTRALATERAL, MONAURAL",500.0,325.0,78.57,612.13,15
CDM,V5200M_1,"DISPENSING FEE, CONTRALATERAL, MONAURAL",305.3,198.45,78.57,612.13,15
CDM,V5211A_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE",2800.0,1820.0,73.6,2884.0,15
CDM,V5211B_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE",2200.0,1430.0,73.6,2266.53,15
CDM,V5211P_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE",3400.0,2210.0,73.6,3502.0,15
CDM,V5212A_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC",2800.0,1820.0,78.57,3400.0,15
CDM,V5212B_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC",2200.0,1430.0,78.57,3400.0,15
CDM,V5212P_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC",3400.0,2210.0,78.57,3502.0,15
CDM,V5213A_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE",2800.0,1820.0,73.6,2884.0,15
CDM,V5213B_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE",2200.0,1430.0,73.6,2266.53,15
CDM,V5213P_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE",3400.0,2210.0,73.6,3502.0,15
CDM,V5214A_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC",2800.0,1820.0,73.6,2884.0,15
CDM,V5214B_1,"PR BASIC CRS HA BINAURAL ITC/ITC, V5214",2200.0,1430.0,880.0,2266.0,14
CDM,V5214P_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC",3400.0,2210.0,73.6,3502.0,15
CDM,V5215A_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE",2800.0,1820.0,73.6,2884.0,15
CDM,V5215B_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE",2200.0,1430.0,73.6,2266.53,15
CDM,V5215P_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE",3400.0,2210.0,73.6,3502.0,15
CDM,V5221A_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE",2800.0,1820.0,78.57,3400.0,15
CDM,V5221B_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE",2200.0,1430.0,78.57,3400.0,15
CDM,V5221P_1,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE",3400.0,2210.0,78.57,3502.0,15
CDM,V5240A_1,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",300.0,195.0,78.57,634.04,15
CDM,V5240B_1,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",400.0,260.0,78.57,634.04,15
CDM,V5240C_1,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",500.0,325.0,78.57,634.04,15
CDM,V5240M_1,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",596.19,387.52,78.57,634.04,15
CDM,V5241A_1,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",300.0,195.0,73.6,309.0,15
CDM,V5241B_1,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",400.0,260.0,73.6,412.0,15
CDM,V5241C_1,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",500.0,325.0,73.6,515.0,15
CDM,V5241M_1,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",298.14,193.79,73.6,307.08,15
CDM,V5264A_1,"EAR MOLD/INSERT, NOT DISPOSABLE, ANY TYPE",75.0,48.75,33.75,80.89,15
CDM,V5264C_1,"EAR MOLD/INSERT, NOT DISPOSABLE, ANY TYPE",50.0,32.5,22.5,80.89,15
CDM,V5267A_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",325.0,211.25,73.6,334.75,15
CDM,V5267B_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",200.0,130.0,73.6,206.0,15
CDM,V5267C_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",350.0,227.5,73.6,360.5,15
CDM,V5267D_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",300.0,195.0,73.6,309.0,15
CDM,V5267E_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",450.0,292.5,73.6,463.5,15
CDM,V5267F_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",425.0,276.25,73.6,437.75,15
CDM,V5267G_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",500.0,325.0,73.6,515.0,15
CDM,V5267H_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",325.0,211.25,73.6,334.75,15
CDM,V5267I_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",325.0,211.25,73.6,334.75,15
CDM,V5267J_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",175.0,113.75,73.6,180.25,15
CDM,V5267K_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",450.0,292.5,73.6,463.5,15
CDM,V5267L_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",300.0,195.0,73.6,309.0,15
CDM,V5267M_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",300.0,195.0,73.6,309.0,15
CDM,V5267N_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",400.0,260.0,73.6,412.0,15
CDM,V5267O_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",275.0,178.75,73.6,283.25,15
CDM,V5267P_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",250.0,162.5,73.6,257.5,15
CDM,V5267Q_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",450.0,292.5,73.6,463.5,15
CDM,V5267R_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",125.0,81.25,56.25,128.75,15
CDM,V5267S_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",250.0,162.5,73.6,257.5,15
CDM,V5267T_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",400.0,260.0,73.6,412.0,15
CDM,V5267U_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",150.0,97.5,67.5,154.5,15
CDM,V5267V_1,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",400.0,260.0,73.6,412.0,15
CDM,V5362_1,SPEECH SCREENING,236.3,153.6,73.6,243.39,15
CDM,ZZ62320_1,Injection of substance into middle or upper spine canal,589.1,382.92,78.57,394.63,19
HCPCS,0003M,"Molecular pathology test for liver disease, including non-alcohol liver disease (NASH FibroSURE)",1509.0,980.85,377.25,7596.31,18
HCPCS,00170,Anesthesia for other procedure on mouth,462.0,300.3,73.6,231.0,15
HCPCS,0035U,Testing for presence of prion protein in cerebrospinal fluid,1623.0,1054.95,405.75,8780.27,19
HCPCS,0037U,DNA gene analysis of 324 genes in solid organ tumor tissue,3510.0,2281.5,877.5,122850.0,19
HCPCS,0042T,"Computed tomography (CT) of brain blood flow, volume, and timing of flow analysis with contrast",1060.0,689.0,50.0,1977.6,33
HCPCS,0055T,Musculoskeletal surgical navigational orthopedic operation using imaging guidance,1390.6,903.89,78.57,1432.32,15
HCPCS,0058U,Measurement of antibodies to Merkel cell polyoma virus oncoprotein in serum,994.0,646.1,194.33,3210.22,19
HCPCS,0059U,Test for presence of antibodies to Merkel cell polyoma virus oncoprotein in serum,994.0,646.1,194.33,3210.22,19
HCPCS,0075T,"Insertion of stents into vertebral artery via catheter, open or accessed through the skin including radiologic supervision and interpretation, initial vessel",7212.0,4687.8,78.57,29115.11,34
HCPCS,0077U,Detection of Immunoglobulin paraprotein (M-protein) in blood or urine,323.0,209.95,36.5,1291.25,57
HCPCS,0087U,mRNA gene expression profiling of genes in heart transplant biopsy tissue to evaluate risk of rejection,8400.0,5460.0,2100.0,265391.28,19
HCPCS,0095T,Removal of upper spine artificial disc,5735.0,3727.75,78.57,5907.05,15
HCPCS,0184T,Removal of rectal tumor using an endoscope,2650.0,1722.5,78.57,2729.5,15
HCPCS,01953,"Anesthesia for treatment of second and third degree burn, each additional 9% of total body surface area or less",184.8,120.12,14.96,92.4,15
HCPCS,0198T,Measurement of eye blood flow by repeated eyeball pressure assessment,155.0,100.75,0.01,937.2,32
HCPCS,01996,Daily hospital management of continuous spinal drug administration,277.2,180.18,44.58,292.02,15
HCPCS,0200T,"Injections of one side of sacrum for enlargement, 1 or more needles, accessed through the skin",7569.0,4919.85,78.57,21716.24,52
HCPCS,0201T,"Injections of both sides of sacrum for enlargement, 2 or more needles, accessed through the skin",7584.5,4929.925,78.57,32575.66,52
HCPCS,0202U,"Test for detection of respiratory disease-causing organisms from back of nose and throat (nasopharynx) specimen, 22 target organisms including severe acute respiratory syndrome coronavirus 2",750.0,487.5,187.5,1936.88,19
HCPCS,0207T,Drainage of one eyelid glands using heat and pressure,529.0350000000001,343.875,33.75,2166.29,34
HCPCS,0213T,"Injections of upper or middle spine joint or nerves using ultrasound guidance, single level",787.5,511.88,78.57,811.13,15
HCPCS,0214T,"Injections of upper or middle spine joint or nerves using ultrasound guidance, second level",404.3,262.8,78.57,416.43,15
HCPCS,0215T,Injections of upper or middle spine joint or nerves using imaging guidance,404.3,262.8,78.57,416.43,15
HCPCS,0216T,"Injections of lower or sacral spine joint or nerves using ultrasound guidance, single level",714.0,464.1,78.57,735.42,15
HCPCS,0217T,"Injections of lower or sacral spine joint or nerves using ultrasound guidance, second level",357.0,232.05,78.57,367.71,15
HCPCS,0218T,Injections of lower or sacral spine joint or nerves using imaging guidance,357.0,232.05,78.57,367.71,15
HCPCS,0219T,Insertion of upper spine facet joint implants,4585.0,2980.25,78.57,4722.55,15
HCPCS,0220T,Insertion of middle spine facet joint implants,4585.0,2980.25,78.57,4722.55,15
HCPCS,0222T,Insertion of spinal facet joint implants,1588.0,1032.2,78.57,1635.64,15
HCPCS,0223U,"Test for detection of respiratory disease-causing organisms from back of nose and throat (nasopharynx) specimen, 22 target organisms including severe acute respiratory syndrome coronavirus 2",1042.0,677.3,78.57,4342.85,19
HCPCS,0232T,Harvest and injections of platelet rich plasma using imaging guidance,750.0,487.5,78.57,1936.88,72
HCPCS,0234T,"Catheter removal of plaque from kidney artery, accessed through the skin or open procedure including radiological supervision and interpretation",14092.5,9160.125,78.57,64007.26,34
HCPCS,0238T,"Catheter removal of plaque from groin artery, accessed through the skin or open procedure including radiological supervision and interpretation",14490.0,9418.5,3622.5,37420.43,38
HCPCS,0253T,"Insertion of eye fluid drainage device, internal approach",2528.4,1643.46,78.57,2604.25,15
HCPCS,0271T,Revision or removal of carotid sinus baroreflex activation device pulse generator,496.0,322.4,78.57,516.7,15
HCPCS,0274T,"Removal of bone from upper or middle spine for decompression of nerve tissue using imaging guidance, accessed through the skin",4300.0,2795.0,78.57,4429.0,15
HCPCS,0275T,"Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin",5302.65,3446.72,73.6,5461.73,15
HCPCS,0330T,Tear film imaging of one or both eyes,75.0,48.75,18.75,193.69,31
HCPCS,0338T,Destruction of nerves of arteries of both kidneys accessed through the skin with fluoroscopy and radiological supervision and interpretation,7025.0,4566.25,78.57,33830.75,34
HCPCS,0339T,Destruction of nerves of arteries of one kidney accessed through the skin with fluoroscopy and radiological supervision and interpretation,6777.5,4405.375,78.57,33830.75,34
HCPCS,0358T,Whole body composition tissue and fluid measurements with interpretation and report,25.0,16.25,6.25,784.0,38
HCPCS,0361U,Digital immunoassay in plasma for neurofilament light chain,2250.0,1462.5,12.47,5810.63,18
HCPCS,0394T,"High dose rate electronic brachytherapy, external",523.0,339.95,78.57,538.69,15
HCPCS,0395T,"High dose rate electronic brachytherapy, internal",1397.0,908.05,78.57,1438.91,15
HCPCS,0402T,Collagen cross-linking treatment of disease of cornea,4674.0,3038.1,73.6,12070.61,34
HCPCS,0408T,Insertion or replacement of pulse generator and electrodes of heart contractility modulator system,39626.0,25756.9,78.57,199232.13,34
HCPCS,0412T,Removal of pulse generator for heart contractility modulator system,4651.5,3023.475,78.57,22604.62,34
HCPCS,0413T,Removal of electrode for heart contractility modulator system,5116.5,3325.725,78.57,22604.62,34
HCPCS,0431U,Glycine receptor alpha1 IgG live cell-binding assay in serum or cerebral spinal fluid (CSF),1500.0,975.0,188.0,3873.75,34
HCPCS,0437T,Reinforcement of fascia of abdominal wall with synthetic implant,695.5,452.08,78.57,716.37,15
HCPCS,0439T,Ultrasound of heart with injection of X-ray contrast material performed during rest or stress for assessment of heart muscle,25.0,16.25,6.25,642.62,19
HCPCS,0441T,"Freezing destruction of nerve in leg, accessed through the skin, using imaging guidance",2352.5,1529.125,78.57,11427.56,53
HCPCS,0442T,"Freezing destruction of nerve plexus, accessed through the skin, using imaging guidance",10504.0,6827.6,188.0,27126.58,19
HCPCS,0446T,"Creation of skin pocket and insertion of glucose sensor, with patient training",250.0,162.5,46.23,7533.58,38
HCPCS,0447T,Removal of glucose sensor from skin pocket,150.0,97.5,25.0,2166.29,38
HCPCS,0448T,Removal of glucose sensor from skin pocket with creation of new skin pocket and insertion of new glucose sensor,250.0,162.5,50.0,7499.61,38
HCPCS,0449T,Insertion of initial aqueous fluid drainage device into eye,4510.7,2931.96,78.57,4646.02,15
HCPCS,0479T,"Laser destruction of scar tissue, first 100 cm2, or 1% of body surface area of infants and children",957.5,622.375,0.01,3718.8,32
HCPCS,0480T,"Laser destruction of scar tissue, each additional 100 cm2, or 1% of body surface area of infants and children",238.5,155.03,78.57,532.59,15
HCPCS,0483T,"Insertion of artificial valve between left heart chambers, accessed through the skin",20347.0,13225.55,78.57,90113.76,34
HCPCS,0509T,Pattern recording of retinal electrical responses to external stimuli with interpretation and report,97.0,63.05,20.24,784.0,38
HCPCS,0523T,Measurement fractional flow reserve in arteries of heart with 3D functional mapping during procedure,2341.0,1521.65,78.57,10593.42,31
HCPCS,0524U,Test to predict preeclampsia,473.0,307.45,212.85,1221.52,15
HCPCS,0528U,Amplified probe technique testing for infectious agents in lower respiratory tract infections,1300.0,845.0,325.0,3357.25,17
HCPCS,0532T,Removal of implantable monitor of monitoring system for deficient blood flow in heart muscle with imaging supervision and interpretation,1275.0,828.75,78.57,1313.25,15
HCPCS,0563T,Evacuation of meibomian tear glands of eyelids of both eyes,1067.5,693.875,33.75,2060.0,32
HCPCS,0569T,"Repair of valve between upper right and lower right chambers of heart (tricuspid valve) using prosthesis delivered via catheter, accessed through skin; initial prosthesis",7350.0,4777.5,78.57,25825.0,33
HCPCS,0570T,"Repair of valve between upper right and lower right chambers of heart (tricuspid valve) using prosthesis delivered via catheter, accessed through skin; each additional prosthesis",3055.0,1985.75,78.57,21409.87,32
HCPCS,0571T,Insertion or replacement of implantable cardioverter-defibrillator system with electrodes under breastbone,38350.0,24927.5,78.57,194720.5,33
HCPCS,0573T,Removal of implantable defibrillator electrode from under breastbone,4756.5,3091.725,78.57,22604.62,32
HCPCS,0575T,"In-person programming device evaluation of implantable cardioverter-defibrillator system with electrode under breastbone, with analysis, review and report",90.0,58.5,11.25,232.43,66
HCPCS,0576T,"In-person interrogation device evaluation of implantable cardioverter-defibrillator system with electrode under breastbone, with analysis, review and report",45.0,29.25,11.25,116.21,34
HCPCS,0577T,"Electrophysiological evaluation of implantable cardioverter-defibrillator system with electrode under breastbone, with analysis, review and report",2652.0,1723.8,663.0,9454.3,34
HCPCS,0578T,"Remote interrogation device evaluation of implantable cardioverter-defibrillator system with lead under breastbone, with analysis, review and report by healthcare professional",147.0,95.55,35.58,151.41,15
HCPCS,0580T,Removal of implantable defibrillator pulse generator from under breastbone,4619.0,3002.35,78.57,22604.62,32
HCPCS,0600T,"Irreversible electroporation destruction of growths of internal organ, accessed through skin",10871.0,7066.15,78.57,55007.25,33
HCPCS,0601T,"Irreversible electroporation destruction of growths of internal organ, open procedure",12380.25,8047.165,78.57,55007.25,33
HCPCS,0602T,Measurement of kidney filtration rate using skin sensor and single dose of fluorescent agent,489.0,317.85,78.57,503.67,15
HCPCS,0620T,Insertion of stent to shunt arterial blood to deep vein of lower leg via catheter using imaging guidance,126270.0,82075.5,7016.18,326092.28,19
HCPCS,0627T,"Injection of cell or tissue-based material into spinal disc of lower back accessed through skin, first level",30345.0,19724.25,2166.29,78365.96,19
HCPCS,0629T,"Injection of cell or tissue-based material into spinal disc of lower back accessed through skin using CT imaging guidance, first level",30345.0,19724.25,2166.29,78365.96,19
HCPCS,0644T,Removal or reduction of mass within heart by suction through catheter,12545.0,8154.25,3136.25,32397.46,17
HCPCS,0646T,Implantation of artificial valve between right upper and lower chambers of heart through catheter,17900.0,11635.0,78.57,77475.0,32
HCPCS,0649T,Quantitative magnetic resonance analysis of tissue composition with diagnostic MRI examination,2377.0,1545.05,351.02,6138.6,18
HCPCS,0673T,Laser destruction of benign growth of thyroid using imaging guidance,3475.0,2258.75,868.75,8974.19,19
HCPCS,0699T,Injection of medication into posterior chamber of eye,5128.0,3333.2,1282.0,13243.06,38
HCPCS,0708T,Preparation and initial injection of cancer immunotherapy into skin,175.0,113.75,43.75,3678.0,19
HCPCS,0722T,Quantitative computed tomography (CT scan) tissue characterization with interpretation and report and concurrent CT examination of any structure contained in the concurrently acquired diagnostic imagi,1565.0,1017.25,155.26,4041.61,18
HCPCS,0751T,Digitization of glass microscope slides for level II surgical pathology,15.0,9.75,3.75,47.79,18
HCPCS,0752T,Digitization of glass microscope slides for level III surgical pathology,15.0,9.75,3.75,47.79,18
HCPCS,0753T,Digitization of glass microscope slides for level IV surgical pathology,15.0,9.75,3.75,47.79,18
HCPCS,0754T,Digitization of glass microscope slides for level V surgical pathology,15.0,9.75,3.75,195.22,18
HCPCS,0755T,Digitization of glass microscope slides for level VI surgical pathology,15.0,9.75,3.75,195.22,18
HCPCS,0756T,Digitization of glass microscope slides for Group I special stain for microorganisms,15.0,9.75,3.75,47.79,18
HCPCS,0757T,Digitization of glass microscope slides for Group II special stain,15.0,9.75,3.75,47.79,18
HCPCS,0758T,Digitization of glass microscope slides for histochemical special stain on frozen tissue block,15.0,9.75,3.75,195.22,18
HCPCS,0759T,Digitization of glass microscope slides for Group III special stain,15.0,9.75,3.75,195.22,18
HCPCS,0760T,"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, initial single antibody stain procedure",15.0,9.75,3.75,195.22,18
HCPCS,0761T,"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, each additional single antibody stain procedure",15.0,9.75,3.75,195.22,18
HCPCS,0762T,"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, each multiplex antibody stain procedure",15.0,9.75,3.75,195.22,18
HCPCS,0763T,"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry, each manual single antibody stain procedure",15.0,9.75,3.75,195.22,18
HCPCS,0770T,Virtual reality technology to assist therapy,50.0,32.5,12.5,208.0,17
HCPCS,0784T,"Insertion or replacement of spinal integrated nerve stimulating system with electrode array, accessed through the skin",31225.0,20296.25,6141.01,80638.56,17
HCPCS,0785T,Revision or removal of spinal integrated nerve stimulating system with electrode array,7800.0,5070.0,1950.0,20143.5,17
HCPCS,0786T,"Insertion or replacement of sacral integrated never stimulating system with electrode array, accessed through the skin",31225.0,20296.25,6141.01,80638.56,17
HCPCS,0787T,Revision or removal of sacral integrated nerve stimulating system with electrode array,7800.0,5070.0,1950.0,20143.5,17
HCPCS,0795T,Transcatheter insertion of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right atrial and right ventricular pacemaker components,23942.5,15562.625,73.6,118536.75,33
HCPCS,0796T,Transcatheter insertion of permanent dual-chamber pacemaker using fluoroscopy and device interrogation of right atrial pacemaker component,1135.0,737.75,73.6,1189.11,15
HCPCS,0797T,Transcatheter insertion of a permanent dual chamber leadless pacemaker using fluoroscopy and device interrogation of right ventricular pacemaker component,1135.0,737.75,73.6,1169.05,15
HCPCS,0798T,Transcatheter removal of the right atrial and right ventricular components of a permanent dual-chamber leadless pacemaker using fluoroscopy,3500.0,2275.0,73.6,3605.0,15
HCPCS,0799T,Transcatheter removal of the right atrial component of a permanent dual-chamber leadless pacemaker using fluoroscopy,2000.0,1300.0,73.6,2060.0,15
HCPCS,0800T,Transcatheter removal of the right ventricular component of a permanent dual-chamber leadless pacemaker using fluoroscopy,2000.0,1300.0,73.6,2060.0,15
HCPCS,0801T,Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right atrial and right ventricular components,23942.5,15562.625,73.6,118536.75,33
HCPCS,0802T,Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right atrial component,1985.0,1290.25,73.6,2044.55,15
HCPCS,0803T,Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right ventricular component,1985.0,1290.25,73.6,2044.55,15
HCPCS,0804T,"In-person programming device evaluation of dual-chamber leadless pacemaker with adjustment of the device to test function and to select optimal permanent values, with analysis, review and report by a ",113.0,73.45,21.5,1052.0,53
HCPCS,0823T,Insertion of permanent single-chamber leadless pacemaker for pacing the right upper heart chamber using imaging guidance,22892.5,14880.125,73.6,115308.63,32
HCPCS,0824T,Removal of permanent single-chamber leadless pacemaker for pacing the right upper chamber of the heart using imaging guidance,4655.0,3025.75,73.6,18878.08,32
HCPCS,0825T,Removal and replacement of single-chamber permanent leadless pacemaker for pacing the right upper chamber of the heart using imaging guidance,22892.5,14880.125,73.6,115308.63,31
HCPCS,0826T,In-person device evaluation of single-chamber leadless pacemaker system,86.0,55.9,21.5,1052.0,65
HCPCS,0861T,Removal of battery and transmitter of wireless cardiac stimulator for pacing of left lower chamber of heart,9000.0,5850.0,2250.0,23242.5,16
HCPCS,0862T,Relocation of battery of wireless cardiac stimulator for pacing of left lower chamber of heart,4200.0,2730.0,1050.0,10846.5,16
HCPCS,0863T,Relocation of transmitter of wireless cardiac stimulator for pacing of left lower chamber of heart,4200.0,2730.0,1050.0,10846.5,16
HCPCS,0865T,Quantitative MRI of the brain with comparison to previous MRI scan without MRI scan performed during the same visit,610.0,396.5,152.5,2024.0,16
HCPCS,0866T,Quantitative MRI of the brain with comparison to previous MRI scan with MRI scan performed during the same visit,610.0,396.5,152.5,2024.0,16
HCPCS,0894T,Insertion of a tube into the liver allograft in preparation for connection to the normothermic perfusion device and removal of the tube from the liver allograft following normothermic perfusion,2350.0,1527.5,73.6,2420.5,15
HCPCS,0895T,"Connection of liver allograft to normothermic machine perfusion device, blood clotting control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments",2350.0,1527.5,66.62,2420.5,15
HCPCS,0896T,"Connection of liver allograft to normothermic machine perfusion device, blood clotting control; each additional hour, including physiological and laboratory assessments",1175.0,763.75,16.69,1210.25,15
HCPCS,0913T,"Transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon, with imaging supervision, interpretation, and report, performed on a single major coronary artery or branch",12830.0,8339.5,3207.5,33133.48,15
HCPCS,0914T,"Transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon, performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement ",7500.0,4875.0,1875.0,19368.75,15
HCPCS,0915T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), pulse generator and dual transvenous electrodes/leads",72130.0,46884.5,18032.5,186275.73,15
HCPCS,0916T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), pulse generator only",50500.0,32825.0,12625.0,130416.25,16
HCPCS,0917T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), single transvenous lead only",18620.0,12103.0,476.0,48086.15,17
HCPCS,0918T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), dual transvenous leads only",18620.0,12103.0,4655.0,48086.15,16
HCPCS,0919T,"Removal of a permanent cardiac contractility modulation-defibrillation system component(s), pulse generator only",8190.0,5323.5,2047.5,21150.68,16
HCPCS,0920T,"Removal of a permanent cardiac contractility modulation-defibrillation system component(s), single transvenous pacing lead only",8190.0,5323.5,2047.5,21150.68,16
HCPCS,0921T,"Removal of a permanent cardiac contractility modulation-defibrillation system component(s), single transvenous defibrillation lead only",8190.0,5323.5,2047.5,21150.68,16
HCPCS,0922T,"Removal of a permanent cardiac contractility modulation-defibrillation system component(s), dual transvenous leads only",8190.0,5323.5,2047.5,21150.68,16
HCPCS,0923T,Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only,8190.0,5323.5,2047.5,21150.68,16
HCPCS,0924T,Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s),1550.0,1007.5,387.5,4002.88,16
HCPCS,0925T,Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator,4125.0,2681.25,1031.25,10652.81,16
HCPCS,0930T,"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, at time of initial implantation or replacement with testing of cardiac contractility modulation-defibrillator pul",2750.0,1787.5,687.5,7101.88,16
HCPCS,0931T,"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, separate from initial implantation or replacement with testing of cardiac contractility modulation-defibrillator ",2750.0,1787.5,687.5,7101.88,16
HCPCS,0994T,"ENDOVASCULAR DELIVERY OF AORTIC WALL STABILIZATION DRUG THERAPY THROUGH A SHEATH POSITIONED WITHIN AN ABDOMINAL AORTIC ANEURYSM, WITH AORTIC ROADMAPPING, BALLOON OCCLUSION, IMAGING GUIDANCE, AND RADIO",15000.0,9750.0,3750.0,38737.5,32
HCPCS,0995T,"ENDOVASCULAR DELIVERY OF AORTIC WALL STABILIZATION DRUG THERAPY THROUGH A SHEATH POSITIONED WITHIN AN ABDOMINAL AORTIC ANEURYSM, WITH AORTIC ROADMAPPING, BALLOON OCCLUSION, IMAGING GUIDANCE, AND RADIO",25000.0,16250.0,6250.0,64562.5,32
HCPCS,10004,"Fine needle aspiration biopsy, each additional growth",126.5,82.225,0.01,2166.29,51
HCPCS,10005,"Fine needle aspiration biopsy using ultrasound guidance, first growth",1260.0,819.0,0.01,6043.05,85
HCPCS,10006,"Fine needle aspiration biopsy using ultrasound guidance, each additional growth",160.0,104.0,0.01,2166.29,85
HCPCS,10007,"Fine needle aspiration biopsy using fluoroscopic guidance, first growth",547.5,355.875,73.6,3227.0,53
HCPCS,10008,"Fine needle aspiration biopsy using fluoroscopic guidance, each additional growth",173.5,112.775,43.7,2166.29,53
HCPCS,10009,"Fine needle aspiration biopsy of growth using CT guidance, first growth",572.5,372.125,78.57,3227.0,53
HCPCS,10010,"Fine needle aspiration biopsy of growth using CT guidance, each additional growth",200.0,130.0,61.05,2166.29,53
HCPCS,10021,"Fine needle aspiration biopsy, first growth",370.0,240.5,0.01,2166.29,86
HCPCS,10030,Drainage of fluid collection in soft tissue using imaging guidance,2089.15,1357.9499999999998,78.57,4323.11,36
HCPCS,10035,"Placement of soft tissue locating device using X-ray, first growth",1261.0,819.65,66.84,3308.18,36
HCPCS,10036,"Placement of soft tissue locating device using X-ray, each additional growth",838.0,544.7,34.04,2166.29,36
HCPCS,10040,Acne surgery,216.5,140.725,0.01,8477.27,51
HCPCS,10060,Simple or single drainage of skin abscess,169.1,109.92,0.01,2166.29,74
HCPCS,10061,Complicated or multiple drainage of skin abscess,375.0,243.75,0.01,2166.29,55
HCPCS,10080,Simple drainage of cyst of tailbone,538.0,349.7,0.01,3227.0,55
HCPCS,10081,Complicated drainage of cyst of tailbone,669.5,435.175,0.01,3227.0,55
HCPCS,10120,"Removal of foreign body from tissue, accessed beneath the skin, simple",315.0,204.75,0.01,2166.29,55
HCPCS,10121,"Removal of foreign body from tissue, accessed beneath the skin, complex",1325.0,861.25,0.01,3726.0,74
HCPCS,10140,Drainage of blood or fluid accumulation,420.0,273.0,0.01,3873.75,112
HCPCS,10160,"Aspiration of abscess, blood, or cyst",360.0,234.0,0.01,2166.29,55
HCPCS,10180,Complex drainage of wound infection after surgery,2389.8,1553.37,0.01,16641.63,74
HCPCS,1019T,"LYMPHOVENOUS BYPASS, INCLUDING ROBOTIC ASSISTANCE, WHEN PERFORMED, PER EXTREMITY",3355.0,2180.75,73.6,3455.65,12
HCPCS,11000,"Removal of inflamed or infected skin, up to 10% of body surface",309.5,201.175,0.01,2166.29,55
HCPCS,11001,"Removal of inflamed or infected skin, each additional 10% of body surface or less",60.0,39.0,0.01,2166.29,55
HCPCS,11004,"Removal of infected skin, tissue or muscle of genitals",1651.7,1073.61,78.57,1702.76,19
HCPCS,11005,"Removal of infected skin, tissue or muscle of abdomen",2172.5,1412.13,78.57,2279.18,38
HCPCS,11006,"Removal of infected skin, tissue or muscle of genitals, perineum, or abdomen",2016.0,1310.4,78.57,2080.45,19
HCPCS,11008,Removal of infected artificial material or mesh from abdomen,766.55,498.26,78.57,801.57,38
HCPCS,11010,Removal of foreign material from skin and tissue at open broken and/or dislocated bone,1122.5,729.625,78.57,3227.0,38
HCPCS,11011,"Removal of foreign material from skin, tissue, and muscle at open broken and/or dislocated bone",970.35,630.73,78.57,1177.2,38
HCPCS,11012,"Removal of foreign material from skin, tissue, muscle, and bone at open broken and/or dislocated bone",1860.0,1209.0,78.57,16641.63,57
HCPCS,11042,"Removal of skin and tissue, 20.0 sq cm or less",914.0,594.1,0.01,2360.41,131
HCPCS,11043,"Removal of muscle and/or tissue, 20.0 sq cm or less",720.0,468.0,0.01,6022.39,112
HCPCS,11044,"Removal of bone, 20.0 sq cm or less",980.0,637.0,0.01,7747.5,93
HCPCS,11045,"Removal of skin and tissue, each additional 20.0 sq cm or less",115.35,74.98,0.01,2166.29,93
HCPCS,11046,"Removal of muscle and/or tissue, each additional 20.0 sq cm or less",720.0,468.0,43.2,2166.29,57
HCPCS,11047,"Removal of bone, each additional 20.0 sq cm or less",890.0,578.5,76.77,2166.29,57
HCPCS,11055,"Removal of noncancer thickened skin growth, 1 growth",152.0,98.80000000000001,0.01,534.58,55
HCPCS,11056,"Removal of noncancer thickened skin growth, 2-4 growths",206.0,133.9,0.01,754.09,55
HCPCS,11057,"Removal of noncancer thickened skin growth, more than 4 growths",268.0,174.2,0.01,996.85,55
HCPCS,11102,"Biopsy of related skin growth, first growth",294.75,191.59,0.01,2166.29,55
HCPCS,11103,"Biopsy of related skin growth, each additional growth",83.75,54.44,0.01,2166.29,55
HCPCS,11104,"Punch biopsy, first skin growth",323.5,210.275,0.01,1242.0,55
HCPCS,11105,"Punch biopsy, each additional skin growth",95.0,61.75,0.01,2166.29,55
HCPCS,11106,"Incision biopsy, first skin growth",493.75,320.94,0.01,3227.0,55
HCPCS,11107,"Incision biopsy, each additional skin growth",121.25,78.815,0.01,2166.29,55
HCPCS,11200,"Removal of skin tag, 1-15 skin tags",163.0,105.95,0.01,2166.29,74
HCPCS,11201,"Removal of skin tag, each additional 10 skin tags",50.5,32.825,0.01,8477.27,74
HCPCS,11300,"Shaving of skin growth of body, arms, or legs, 0.5 cm or less",180.0,117.0,0.01,8477.27,55
HCPCS,11301,"Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm",206.5,134.225,0.01,8477.27,55
HCPCS,11302,"Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm",200.0,130.0,0.01,8477.27,55
HCPCS,11303,"Shaving of skin growth of body, arms, or legs, more than 2.0 cm",330.0,214.5,0.01,8477.27,55
HCPCS,11305,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",166.5,108.225,0.01,8477.27,55
HCPCS,11306,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",211.5,137.475,0.01,8477.27,55
HCPCS,11307,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",200.0,130.0,0.01,8477.27,55
HCPCS,11308,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm",300.0,195.0,0.01,8477.27,55
HCPCS,11310,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",181.5,117.975,0.01,8477.27,55
HCPCS,11311,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",196.5,127.725,0.01,8477.27,55
HCPCS,11312,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",265.0,172.25,0.01,8477.27,55
HCPCS,11313,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, more than 2.0 cm",330.0,214.5,0.01,8477.27,55
HCPCS,11400,"Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less",304.5,197.93,0.01,3227.0,74
HCPCS,11401,"Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm",302.0,196.3,0.01,2166.29,74
HCPCS,11402,"Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm",410.0,266.5,0.01,3227.0,74
HCPCS,11403,"Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm",480.0,312.0,0.01,3227.0,74
HCPCS,11404,"Removal of noncancer skin growth of body, arms, or legs, 3.1-4.0 cm",1330.0,864.5,0.01,3726.0,74
HCPCS,11406,"Removal of noncancer skin growth of body, arms, or legs, more than 4.0 cm",1523.5,990.275,0.01,4434.15,74
HCPCS,11420,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",595.4,387.01,0.01,3434.73,74
HCPCS,11421,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",390.0,253.5,0.01,3227.0,74
HCPCS,11422,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",440.0,286.0,0.01,3227.0,74
HCPCS,11423,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",520.0,338.0,0.01,5219.23,74
HCPCS,11424,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",608.0,395.2,0.01,5573.04,74
HCPCS,11426,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",2270.0,1475.5,0.01,6451.0,74
HCPCS,11440,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",330.0,214.5,0.01,3227.0,74
HCPCS,11441,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",430.0,279.5,0.01,3227.0,74
HCPCS,11442,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",480.0,312.0,0.01,3227.0,74
HCPCS,11443,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",576.5,374.73,0.01,3488.96,74
HCPCS,11444,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",1133.0,736.45,0.01,3434.73,74
HCPCS,11446,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",2460.0,1599.0,0.01,6451.0,74
HCPCS,11450,Removal of skin and tissue of underarms for inflamed sweat glands with simple or intermediate repair,2753.1,1789.52,0.01,9064.58,55
HCPCS,11451,Removal of skin and tissue of underarms for inflamed sweat glands with complex repair,1238.0,804.7,0.01,6043.05,55
HCPCS,11462,Removal of skin and tissue of groin for inflamed sweat glands with simple or intermediate repair,1340.4,871.26,0.01,9064.58,55
HCPCS,11463,Removal of skin and tissue of groin for inflamed sweat glands with complicated repair,2340.0,1521.0,0.01,6043.05,55
HCPCS,11470,Removal of skin and tissue of anus or navel for inflamed sweat glands with simple or intermediate repair,995.4,647.01,0.01,6043.05,55
HCPCS,11471,Removal of skin and tissue of anus or navel for inflamed sweat glands with complicated repair,1517.3,986.25,0.01,6043.05,55
HCPCS,11600,"Removal of cancer skin growth of body, arms, or legs, 0.5 cm or less",508.15,330.3,0.01,1417.79,36
HCPCS,11601,"Removal of cancer skin growth of body, arms, or legs, 0.6-1.0 cm",564.5,366.925,0.01,3227.0,55
HCPCS,11602,"Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm",418.15,271.8,0.01,623.98,55
HCPCS,11603,"Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm",719.3,467.55,0.01,3227.0,74
HCPCS,11604,"Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm",799.1,519.42,0.01,3227.0,74
HCPCS,11606,"Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm",1330.0,864.5,0.01,3726.0,74
HCPCS,11620,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",903.9,587.535,0.01,3434.73,55
HCPCS,11621,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",566.4,368.16,0.01,3227.0,55
HCPCS,11622,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",549.0,356.85,0.01,3227.0,74
HCPCS,11623,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",1050.0,682.5,0.01,3434.73,55
HCPCS,11624,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",1099.7,714.8050000000001,0.01,3726.0,55
HCPCS,11626,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",2270.0,1475.5,0.01,6451.0,74
HCPCS,11640,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",523.9,340.535,0.01,3227.0,55
HCPCS,11641,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",549.0,356.85,0.01,3227.0,74
HCPCS,11642,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",549.0,356.85,0.01,3227.0,74
HCPCS,11643,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",950.0,617.5,0.01,4082.93,74
HCPCS,11644,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",1950.0,1267.5,0.01,5035.88,74
HCPCS,11646,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",2270.0,1475.5,0.01,6451.0,74
HCPCS,11719,Trimming of fingernails or toenails,62.5,40.625,0.01,8477.27,55
HCPCS,11720,"Removal of fingernails or toenails, 1-5 nails",75.0,48.75,11.97,208.0,38
HCPCS,11721,"Removal of fingernails or toenails, 6 or more nails",82.5,53.625,0.01,208.0,55
HCPCS,11730,"Simple separation of fingernail or toenail from nail bed, first nail",400.0,260.0,0.01,2166.29,74
HCPCS,11732,"Simple separation of fingernail or toenail from nail bed, each additional nail",70.0,45.5,0.01,2166.29,55
HCPCS,11740,Removal of blood accumulation under fingernail or toenail,134.5,87.425,0.01,2166.29,55
HCPCS,11750,Permanent removal fingernail or toenail,421.0,273.65,0.01,2166.29,55
HCPCS,11755,Biopsy of fingernail or toenail,450.4,292.76,0.01,3227.0,55
HCPCS,11760,Repair of fingernail or toenail bed,893.5,580.775,0.01,3504.45,55
HCPCS,11762,Repair of fingernail or toenail bed with graft,787.5,511.88,78.57,693.79,19
HCPCS,11765,Removal of skin of fingernail or toenail,326.0,211.9,0.01,2166.29,55
HCPCS,11770,Simple removal of cyst of tailbone,2270.0,1475.5,0.01,5862.28,55
HCPCS,11771,Extensive removal of cyst of tailbone,3320.1,2158.065,78.57,13558.13,38
HCPCS,11772,Complicated removal of cyst of tailbone,1686.3,1096.1,78.57,1824.84,19
HCPCS,11900,"Injection into skin growth, 1-7 growths",150.0,97.5,0.01,2166.29,74
HCPCS,11901,"Injection into skin growth, more than 7 growths",526.0,341.9,0.01,2166.29,55
HCPCS,11920,"Tattooing of skin to correct color issue, 6.0 sq cm or less",493.5,320.78,78.57,458.71,19
HCPCS,11921,"Tattooing of skin to correct color issue, 6.1-20.0 sq cm",444.2,288.73,78.57,531.19,38
HCPCS,11922,"Tattooing of skin to correct color issue, each additional 20.0 sq cm",140.7,91.46,22.28,318.01,19
HCPCS,11950,"Injection of filling material under skin, 1.0 cc or less",315.0,204.75,0.01,8477.27,74
HCPCS,11951,"Injection of filling material under skin, 1.1-5.0 cc",225.0,146.25,0.01,8477.27,74
HCPCS,11952,"Injection of filling material under skin, 5.1-10.0 cc",300.0,195.0,0.01,774.75,55
HCPCS,11954,"Injection of filling material under skin, more than 10.0 cc",525.0,341.25,0.01,2972.46,55
HCPCS,11960,Insertion of tissue expander,2533.65,1646.875,78.57,2869.18,38
HCPCS,11970,Replacement of tissue expander with permanent implant,3999.25,2599.5150000000003,78.57,1700.01,38
HCPCS,11971,Removal of tissue expander,1968.25,1279.365,78.57,1450.51,38
HCPCS,11976,Removal of implantable contraceptive capsules,469.5,305.175,0.01,1417.79,55
HCPCS,11980,Placement of hormone pellet under skin,279.85,181.905,0.01,705.02,36
HCPCS,11981,Insertion of drug delivery implant into tissue,110.0,71.5,0.01,2166.29,112
HCPCS,11982,Removal of drug delivery implant from tissue,447.0,290.55,0.01,2166.29,55
HCPCS,11983,Removal with reinsertion of drug delivery implant into tissue,336.5,218.725,0.01,705.02,36
HCPCS,12001,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less",285.0,185.25,0.01,2166.29,55
HCPCS,12002,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm",260.0,169.0,0.01,8477.27,74
HCPCS,12004,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 7.6-12.5 cm",352.5,229.125,0.01,2166.29,55
HCPCS,12005,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 12.6-20.0 cm",432.5,281.125,0.01,2318.31,55
HCPCS,12006,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 20.1-30.0 cm",522.5,339.625,0.01,2318.31,55
HCPCS,12007,"Simple repair of surface wound to scalp, neck, underarms, trunk, arms, or legs, more than 30.0 cm",505.0,328.25,0.01,2318.31,55
HCPCS,12011,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",250.0,162.5,0.01,8477.27,74
HCPCS,12013,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",320.0,208.0,0.01,8477.27,55
HCPCS,12014,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",275.0,178.75,0.01,2166.29,74
HCPCS,12015,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",432.5,281.125,0.01,2166.29,55
HCPCS,12016,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",587.5,381.875,0.01,2318.31,55
HCPCS,12017,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm",677.5,440.375,0.01,2318.31,55
HCPCS,12018,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, more than 30.0 cm",812.5,528.125,0.01,2318.31,55
HCPCS,12020,Simple closure of surface wound reopening,600.0,390.0,0.01,2166.29,55
HCPCS,12021,Repair of separation of wound closure with insertion of packing,372.5,242.125,0.01,2166.29,55
HCPCS,12031,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less",325.0,211.25,0.01,2166.29,74
HCPCS,12032,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm",375.0,243.75,0.01,2166.29,74
HCPCS,12034,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm",425.0,276.25,0.01,2318.31,74
HCPCS,12035,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 12.6-20.0 cm",475.0,308.75,0.01,2318.31,74
HCPCS,12036,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 20.1-30.0 cm",525.0,341.25,0.01,2318.31,74
HCPCS,12037,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, more than 30.0 cm",2000.0,1300.0,0.01,5165.0,74
HCPCS,12041,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less",526.1,341.97,0.01,2166.29,74
HCPCS,12042,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm",608.0,395.2,0.01,2166.29,74
HCPCS,12044,"Intermediate repair of wound of neck, hands, feet, or genitals, 7.6-12.5 cm",525.0,341.25,0.01,2318.31,74
HCPCS,12045,"Intermediate repair of wound of neck, hands, feet, or genitals, 12.6-20.0 cm",657.3,427.25,0.01,2318.31,74
HCPCS,12046,"Intermediate repair of wound of neck, hands, feet, or genitals, 20.1-30.0 cm",882.5,573.625,0.01,3227.0,55
HCPCS,12047,"Intermediate repair of wound of neck, hands, feet, or genitals, more than 30.0 cm",1595.0,1036.75,0.01,5165.0,36
HCPCS,12051,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",325.0,211.25,0.01,2166.29,74
HCPCS,12052,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",375.0,243.75,0.01,2166.29,74
HCPCS,12053,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",870.0,565.5,0.01,2166.29,74
HCPCS,12054,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",475.0,308.75,0.01,2318.31,74
HCPCS,12055,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",1130.0,734.5,0.01,2318.31,74
HCPCS,12056,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm",942.5,612.625,0.01,2318.31,55
HCPCS,12057,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, more than 30.0 cm",1062.5,690.625,0.01,1614.06,36
HCPCS,13100,"Complicated repair of wound of trunk, 1.1-2.5 cm",611.1,397.22,0.01,2318.31,74
HCPCS,13101,"Complicated repair of wound of trunk, 2.6-7.5 cm",611.1,397.22,0.01,6141.01,74
HCPCS,13102,"Complicated repair of wound of trunk, each additional 5.0 cm or less",280.0,182.0,0.01,2166.29,74
HCPCS,13120,"Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm",525.0,341.25,0.01,2318.31,74
HCPCS,13121,"Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm",611.1,397.22,0.01,6141.01,74
HCPCS,13122,"Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less",284.6,184.99,0.01,2166.29,74
HCPCS,13131,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm",611.1,397.22,0.01,2318.31,74
HCPCS,13132,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm",611.1,397.22,0.01,6141.01,74
HCPCS,13133,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less",450.0,292.5,0.01,2166.29,74
HCPCS,13151,"Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm",611.1,397.22,0.01,6141.01,74
HCPCS,13152,"Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm",625.0,406.25,0.01,6141.01,74
HCPCS,13153,"Complicated repair of wound of eyelids, nose, ears, or lip, each additional 5.0 cm or less",375.0,243.75,0.01,6141.01,55
HCPCS,13160,Extensive or complicated repair of surface wound reopening,2635.5,1713.08,0.01,6959.84,74
HCPCS,14000,"Repair of wound of trunk by transferring skin, 10.0 sq cm or less",1617.0,1051.05,0.01,4002.88,74
HCPCS,14001,"Repair of wound of trunk by transferring skin, 10.1-30.0 sq cm",2029.7,1319.31,78.57,6141.01,76
HCPCS,14020,"Repair of wound of scalp, arms, or legs by transferring skin, 10.0 sq cm or less",1821.8,1184.17,78.57,6141.01,76
HCPCS,14021,"Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm",2029.7,1319.31,78.57,6141.01,76
HCPCS,14040,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less",2029.7,1319.31,78.57,4002.88,76
HCPCS,14041,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm",2029.7,1319.31,78.57,6141.01,76
HCPCS,14060,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less",2116.8,1375.92,78.57,16915.38,76
HCPCS,14061,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm",2029.7,1319.31,78.57,6141.01,76
HCPCS,14301,"Repair of wound by transferring skin, 30.1-60.0 sq cm",2951.6,1918.54,78.57,10330.0,76
HCPCS,14302,"Repair of wound by transferring skin, each additional 30.0 sq cm",1500.0,975.0,78.57,3873.75,76
HCPCS,14350,Repair of tissue loss of finger or toe,2022.3,1314.5,78.57,2085.58,19
HCPCS,15002,"Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",870.0,565.5,0.01,4002.88,74
HCPCS,15003,"Preparation of skin graft site of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",500.0,325.0,35.42,1291.25,57
HCPCS,15004,"Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",611.1,397.22,0.01,1507.02,74
HCPCS,15005,"Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for infants and children, o",260.0,169.0,50.0,566.47,38
HCPCS,15040,"Relocation of skin for self skin graft, 100.0 sq cm or less",661.5,429.98,77.06,626.51,19
HCPCS,15050,"Skin graft to tip of finger or toe, 2.0 cm or less",1426.15,927.0,0.01,3718.8,36
HCPCS,15100,"Partial thickness self skin graft to trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",2267.0,1473.55,0.01,4002.88,74
HCPCS,15101,"Partial thickness self skin graft of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",1580.25,1027.165,78.57,439.52,38
HCPCS,15110,"Outer layer self skin graft of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",1623.3,1055.15,78.57,2131.33,19
HCPCS,15111,"Outer layer self skin graft to trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",264.25,171.76,78.57,300.92,19
HCPCS,15115,"Outer layer self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",2472.8,1607.32,78.57,2096.03,19
HCPCS,15116,"Outer layer self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for infants and children, or l",381.25,247.81,78.57,447.95,19
HCPCS,15120,"Partial thickness self skin graft to face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",2635.5,1713.08,0.01,7101.88,74
HCPCS,15121,"Partial thickness self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for infants and children",1685.25,1095.415,78.57,493.74,38
HCPCS,15130,"Deep layer self skin graft of trunk, arms, or legs, 100.0 sq cm or 1% body area of infants and children, or less",1655.9,1076.34,78.57,1746.41,19
HCPCS,15131,"Deep layer self skin graft of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area of infants and children, or less",257.3,167.25,68.39,269.56,19
HCPCS,15135,"Deep layer self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area of infants and children, or less",2288.0,1487.2,78.57,2310.09,19
HCPCS,15136,"Deep layer self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area of infants and children, or les",245.7,159.71,68.39,269.56,19
HCPCS,15150,"Tissue skin graft from self of trunk, arms, or legs, 25.0 sq cm or less",1670.5,1085.83,78.57,1852.25,19
HCPCS,15151,"Tissue skin graft from self of trunk, arms, or legs, each additional 1.0-75.0 sq cm",278.7,181.16,78.57,320.63,19
HCPCS,15152,"Tissue skin graft from self of trunk, arms, or legs, each additional 100.0 sq cm or 1% of body area for infants and children, or less",366.6,238.29,78.57,400.04,19
HCPCS,15155,"Tissue self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less",1900.5,1235.33,78.57,2182.58,19
HCPCS,15156,"Tissue skin graft from self of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 75.0 sq cm",377.0,245.05,78.57,440.25,19
HCPCS,15157,"Tissue skin graft from self of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% of body area for infants and children, o",430.8,280.02,78.57,480.46,19
HCPCS,15200,"Full thickness skin graft to trunk, 20.0 sq cm or less",2113.7,1373.91,0.01,4002.88,55
HCPCS,15201,"Full thickness skin graft to trunk, each additional 20.0 sq cm",420.0,273.0,0.01,2881.28,55
HCPCS,15220,"Full thickness skin graft to scalp, arms, or legs, 20.0 sq cm or less",2009.7,1306.31,78.57,4002.88,76
HCPCS,15221,"Full thickness skin graft to scalp, arms, or legs, each additional 20.0 sq cm",500.0,325.0,52.68,2881.28,57
HCPCS,15240,"Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 20.0 sq cm or less",2029.7,1319.31,78.57,6141.01,76
HCPCS,15241,"Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 20.0 sq cm",525.0,341.25,0.01,2881.28,55
HCPCS,15260,"Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less",2029.7,1319.31,78.57,4002.88,76
HCPCS,15261,"Full thickness skin graft to nose, ears, eyelids, or lips, each additional 20.0 sq cm",600.0,390.0,78.57,2881.28,76
HCPCS,15271,"Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less",1550.0,1007.5,0.01,32200.71,93
HCPCS,15272,"Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less",500.0,325.0,0.01,2881.28,74
HCPCS,15273,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",2750.0,1787.5,0.01,9909.05,74
HCPCS,15274,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",750.0,487.5,0.01,4955.82,74
HCPCS,15275,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less",1550.0,1007.5,0.01,10794.85,112
HCPCS,15276,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 25.0 sq cm of wound 100.0 sq cm or less",287.5,186.875,0.01,2881.28,74
HCPCS,15277,"Skin substitute graft to wound 100.0 sq cm or more of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and childre",1146.0,744.9,0.01,4002.88,74
HCPCS,15278,"Skin substitute graft to wound 100.0 sq cm or more of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for inf",500.0,325.0,0.01,2881.28,55
HCPCS,15570,Creation of flap graft to trunk,2313.2,1503.58,78.57,2206.59,19
HCPCS,15572,"Creation of flap graft to scalp, arms, or legs",2501.15,1625.75,0.01,7101.88,36
HCPCS,15574,"Creation of flap graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet",1964.15,1276.7,0.01,4002.88,36
HCPCS,15576,"Creation of flap graft to eyelids, nose, ears, lips, or mouth",2121.0,1378.65,78.57,6141.01,76
HCPCS,15600,Transfer of skin flap to trunk,1749.85,1137.405,78.57,808.56,38
HCPCS,15610,"Transfer of skin flap to scalp, arms, or legs",1201.85,781.2049999999999,0.01,4002.88,36
HCPCS,15620,"Transfer of skin flap to forehead, cheeks, chin, neck, underarms, genitals, hands, or feet",1135.1,737.82,0.01,4002.88,55
HCPCS,15630,"Transfer of skin flap to eyelids, nose, ears, or lips",1550.0,1007.5,78.57,6141.01,76
HCPCS,15650,Transfer of skin flap,1341.9,872.24,78.57,1287.83,19
HCPCS,15730,Creation of flap graft to midface,3419.2,2222.48,78.57,3434.07,19
HCPCS,15731,"Creation of flap graft to nose, forehead, temple, or scalp",3196.2,2077.53,78.57,8703.03,57
HCPCS,15733,Creation of flap graft to head and/or neck,3991.1,2594.22,78.57,3136.02,19
HCPCS,15734,Creation of muscle graft to trunk,3468.2000000000003,2254.33,78.57,4456.0,38
HCPCS,15736,Creation of muscle graft to arm,3160.55,2054.3599999999997,78.57,3643.12,38
HCPCS,15738,Creation of muscle graft to leg,3287.4,2136.81,78.57,3842.19,38
HCPCS,15740,Creation of skin and tissue graft,2706.9,1759.49,78.57,2551.27,19
HCPCS,15750,Creation of nerve and blood vessel skin graft,2585.1,1680.32,78.57,2732.46,19
HCPCS,15756,Muscle graft with repair of small blood vessel,3924.9,2551.1899999999996,78.57,6880.41,38
HCPCS,15757,Skin graft with repair of small blood vessel,4042.0,2627.3050000000003,78.57,6821.13,38
HCPCS,15758,Tissue graft with repair of small blood vessel,10790.0,7013.5,78.57,6874.96,19
HCPCS,15760,Graft with closure of wound,2234.4,1452.36,0.01,4002.88,55
HCPCS,15769,Self soft tissue graft,2268.375,1474.445,0.01,8806.33,36
HCPCS,15770,"Creation of skin, fat and muscle graft",2262.75,1470.79,78.57,1989.12,38
HCPCS,15771,"Graft using patient's fat removed by liposuction and inserted into trunk, breasts, scalp, arms, or legs, 50.0 cc or less",4786.0,3110.9,0.01,21241.06,36
HCPCS,15772,"Graft using patient's fat removed by liposuction and inserted into trunk, breasts, scalp, arms, or legs, each additional 50.0 cc",2262.125,1470.38,0.01,10588.25,36
HCPCS,15773,"Graft using patient's fat removed by liposuction and inserted into face, eyelids, mouth, neck, ears, around eyes, genitals, hands, or feet, 25.0 cc or less",1360.25,884.16,78.57,1426.27,19
HCPCS,15774,"Graft using patient's fat removed by liposuction and inserted into face, eyelids, mouth, neck, ears, around eyes, genitals, hands, or feet, each additional 25.0 cc",412.0,267.8,78.57,440.27,19
HCPCS,15775,"Hair transplant, 1-15 punch grafts",702.8,456.82,78.57,894.13,19
HCPCS,15776,"Hair transplant, more than 15 punch grafts",651.4000000000001,423.415,28.15,1207.97,38
HCPCS,15777,Implantation of biologic implant to soft tissue,563.7,366.405,78.57,642.33,38
HCPCS,15778,Implantation of artificial material for delayed closure of defects due to soft tissue infection or trauma,831.0,540.15,78.57,1111.23,19
HCPCS,15780,Dermabrasion of skin of total face,2300.0,1495.0,0.01,5939.75,55
HCPCS,15781,Dermabrasion of skin of part of face,1443.8,938.47,0.01,1591.92,55
HCPCS,15782,Dermabrasion of skin other than face,1478.4,960.96,0.01,3486.38,55
HCPCS,15783,Dermabrasion of superficial scars or tattoos from skin,812.45,528.095,0.01,1591.92,36
HCPCS,15786,"Scraping of skin growth, first growth",630.0,409.5,18.33,554.85,19
HCPCS,15787,"Scraping of skin growth, each additional 1-4 growths",210.0,136.5,13.72,78.57,19
HCPCS,15788,Chemical peel of outer layer of skin of face,170.0,110.5,0.01,8477.27,74
HCPCS,15789,Chemical peel of deep layer of skin of face,1413.3,918.65,0.01,1355.81,55
HCPCS,15792,Chemical peel of outer layer of nonfacial skin,703.25,457.115,0.01,8477.27,55
HCPCS,15793,Chemical peel of deep layer of nonfacial skin,736.75,478.89,0.01,8477.27,55
HCPCS,15820,Repair of lower eyelid defect,2362.5,1535.63,0.01,6004.31,55
HCPCS,15821,Removal of excessive skin of lower eyelid and fat around eye,2521.65,1639.07,0.01,7747.5,55
HCPCS,15822,Removal of excessive skin of upper eyelid,2325.0,1511.25,0.01,6004.31,55
HCPCS,15823,Removal of excessive skin and fat of upper eyelid,2638.2,1714.83,0.01,8023.32,74
HCPCS,15824,Removal of wrinkles and extra skin of forehead,2965.2,1927.385,78.57,3337.8,30
HCPCS,15825,Removal of wrinkles and extra skin of neck,4125.0,2681.25,0.01,10652.81,47
HCPCS,15826,"Incision, stretching, and suture of skin between eyebrows",3294.9,2141.69,0.01,16786.25,47
HCPCS,15828,"Removal of wrinkles and extra skin of cheeks, chin, and neck",4125.0,2681.25,0.01,10652.81,47
HCPCS,15829,"Removal of wrinkles and extra skin with grafting of cheeks, chin, and neck",8221.0,5343.65,0.01,21230.73,47
HCPCS,15830,Removal of extra skin and tissue of abdomen,3111.2,2022.28,0.01,13919.68,74
HCPCS,15832,Removal of extra skin and tissue of thigh,3337.425,2169.33,78.57,2732.38,38
HCPCS,15833,Removal of extra skin and tissue of leg,2683.8,1744.475,78.57,2593.49,38
HCPCS,15834,Removal of extra skin and tissue of hip,2553.1,1659.52,78.57,2645.14,38
HCPCS,15835,Removal of extra skin and tissue of buttock,2593.0,1685.455,78.57,2782.42,38
HCPCS,15836,Removal of extra skin and tissue of arm,2972.1,1931.87,0.01,17780.51,55
HCPCS,15837,Removal of extra skin and tissue of forearm or hand,2037.0,1324.05,78.57,2165.87,19
HCPCS,15838,Removal of extra skin and tissue of chin,1603.0,1041.95,0.01,5862.28,55
HCPCS,15839,Removal of extra skin and tissue of other area,2256.5,1466.73,0.01,5939.75,55
HCPCS,15840,Tissue graft to treat facial paralysis,3140.0,2041.0,0.01,8109.05,55
HCPCS,15841,Muscle graft to treat facial paralysis,4587.5,2981.88,78.57,5307.71,19
HCPCS,15842,Microsurgical muscle graft to treat facial paralysis,6967.8,4529.07,78.57,8085.22,19
HCPCS,15845,Muscle transfer to treat facial paralysis,3937.5,2559.38,78.57,3054.57,19
HCPCS,15847,Extensive removal of extra skin and tissue of abdomen,1901.55,1236.01,78.57,1376.55,30
HCPCS,15851,Removal of sutures or staples under anesthesia,1168.75,759.69,54.34,4002.88,38
HCPCS,15852,Dressing change under anesthesia,238.05,154.735,35.74,138.71,38
HCPCS,15853,Removal of sutures or staples,22.75,14.79,0.01,208.0,51
HCPCS,15854,Removal of sutures and staples,32.75,21.29,0.01,208.0,51
HCPCS,15860,Injection of agent into vein to assess blood flow of skin graft or flap,393.8,255.97,78.57,320.12,19
HCPCS,15876,Suction assisted removal of fat of head and neck,2635.5,1713.08,0.01,7101.88,47
HCPCS,15877,Suction assisted removal of fat of body,2635.5,1713.08,0.01,7101.88,47
HCPCS,15878,Suction assisted removal of fat of arm,2794.35,1816.33,73.6,1476.6,30
HCPCS,15879,Suction assisted removal of fat of leg,2953.2,1919.58,0.01,10652.81,47
HCPCS,15920,Removal of pressure sore tissue and tailbone with closure,1563.5,1016.28,78.57,1824.08,19
HCPCS,15922,Removal of pressure sore and bone at tailbone with skin graft,1966.7,1278.36,78.57,2335.55,19
HCPCS,15931,Removal of pressure sore tissue of sacrum with closure,1787.1,1161.62,78.57,2030.87,19
HCPCS,15933,Removal of pressure sore tissue and sacrum bone with closure,2194.5,1426.43,78.57,2521.31,19
HCPCS,15934,Removal of pressure sore tissue of sacrum with skin graft,2448.6,1591.59,78.57,2784.55,19
HCPCS,15935,Removal of pressure sore and bone at sacrum with skin graft,2909.6,1891.24,78.57,3249.9,19
HCPCS,15936,Removal of pressure sore tissue of sacrum in preparation of muscle flap or skin graft,2370.9,1541.09,78.57,2636.18,19
HCPCS,15937,Removal of pressure sore and bone at sacrum in preparation of muscle flap or skin graft,2771.0,1801.15,78.57,3070.93,19
HCPCS,15940,Removal of pressure sore tissue of lower pelvic bone with closure,1834.4,1192.36,78.57,2061.55,19
HCPCS,15941,Removal of pressure sore tissue and lower pelvic bone with closure,2376.2,1544.53,78.57,2688.73,19
HCPCS,15944,Removal of pressure sore tissue of lower pelvic bone with skin graft,2342.6,1522.69,78.57,2667.35,19
HCPCS,15945,Removal of pressure sore and lower pelvic bone with skin graft,2600.9,1690.59,78.57,2943.52,19
HCPCS,15946,Removal of pressure sore and lower pelvic bone in preparation of muscle flap or skin graft closure,3541.15,2301.75,78.57,4832.2,38
HCPCS,15950,Removal of pressure sore tissue of head of thigh bone with closure,1518.3,986.9,78.57,1775.34,19
HCPCS,15951,Removal of pressure sore tissue and head of thigh bone with closure,2165.1,1407.32,78.57,2628.66,19
HCPCS,15952,Removal of pressure sore tissue of head of thigh bone with skin graft,2274.3,1478.3,78.57,2696.23,19
HCPCS,15953,Removal of pressure sore and bone at hip bone with skin graft,2532.6,1646.19,78.57,2971.35,19
HCPCS,15956,Removal of pressure sore tissue of head of thigh bone in preparation of muscle flap or skin graft,3052.4,1984.06,78.57,3432.92,19
HCPCS,15958,Removal of pressure sore and bone at hip bone in preparation of muscle flap or skin graft,3110.1,2021.57,78.57,3513.57,19
HCPCS,16000,First degree burn treatment,180.0,117.0,0.01,1242.0,55
HCPCS,16020,"Dressing change or removal of burn tissue, less than 5% of total body surface",192.5,125.125,0.01,451.94,74
HCPCS,16025,"Dressing change or removal of burn tissue, 5-10% of total body surface",307.5,199.875,49.21,581.06,57
HCPCS,16030,"Dressing change or removal of burn tissue, more than 10% of total body surface",397.5,258.375,78.57,839.31,57
HCPCS,16035,Initial incision of dead burn tissue,806.25,524.065,78.57,2318.31,38
HCPCS,16036,Additional incision of burn tissue,238.4,154.96,65.03,236.78,19
HCPCS,17000,"Destruction of precancer skin growth, 1 growth",200.0,130.0,0.01,2166.29,74
HCPCS,17003,"Destruction of precancer skin growth, 2-14 growths",20.0,13.0,0.01,2166.29,74
HCPCS,17004,"Destruction of precancer skin growth, 15 or more growths",325.0,211.25,0.01,2166.29,74
HCPCS,17106,"Destruction of birthmark, less than 10.0 sq cm",914.6,594.49,0.01,2166.29,74
HCPCS,17107,"Destruction of birthmark, 10.0-50.0 sq cm",1210.0,786.5,0.01,2166.29,74
HCPCS,17108,"Destruction of birthmark, more than 50.0 sq cm",1797.25,1168.21,0.01,3847.93,55
HCPCS,17110,"Destruction of skin growth, 1-14 growths",163.0,105.95,0.01,2166.29,74
HCPCS,17111,"Destruction of skin growth, 15 or more growths",189.4,123.11,0.01,2166.29,74
HCPCS,17250,Application of chemical to stop tissue regrowth in wound,213.5,138.775,0.01,2166.29,55
HCPCS,17260,"Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less",213.5,138.775,0.01,2166.29,55
HCPCS,17261,"Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm",299.95,194.97,0.01,2166.29,55
HCPCS,17262,"Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm",366.4,238.16,0.01,2166.29,55
HCPCS,17263,"Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm",415.55,270.11,0.01,2166.29,55
HCPCS,17264,"Destruction of cancer skin growth of trunk, arms, or legs, 3.1-4.0 cm",457.9,297.635,0.01,2166.29,55
HCPCS,17266,"Destruction of cancer skin growth of trunk, arms, or legs, more than 4.0 cm",520.7,338.45500000000004,0.01,2318.31,55
HCPCS,17270,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",268.65,174.625,0.01,2166.29,55
HCPCS,17271,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",327.75,213.04,0.01,2166.29,55
HCPCS,17272,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",384.25,249.765,0.01,2166.29,55
HCPCS,17273,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",438.15,284.8,0.01,2166.29,55
HCPCS,17274,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",515.1,334.815,0.01,2166.29,55
HCPCS,17276,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",592.1,384.865,0.01,1097.56,36
HCPCS,17280,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",269.7,175.305,0.01,451.94,36
HCPCS,17281,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",346.65,225.325,0.01,2166.29,55
HCPCS,17282,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",409.45,266.145,0.01,2166.29,55
HCPCS,17283,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",491.7,319.605,0.01,2166.29,55
HCPCS,17284,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",570.75,370.99,0.01,2166.29,55
HCPCS,17286,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",698.15,453.8,0.01,2318.31,55
HCPCS,17311,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks",1427.8,928.0699999999999,78.57,3408.9,57
HCPCS,17312,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks",575.9,374.335,62.5,2166.29,57
HCPCS,17313,"Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks",992.625,645.2049999999999,78.57,2318.31,57
HCPCS,17314,"Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks",557.6,362.44,62.5,2166.29,57
HCPCS,17315,"Removal and microscopic exam of growth, each additional block after 5 tissue blocks",218.25,141.865,37.91,2166.29,57
HCPCS,17340,Cold treatment of acne,132.3,86.0,39.5,147.79,19
HCPCS,17360,Chemical treatment of acne,234.5,152.425,0.01,439.03,36
HCPCS,17380,"Hair removal by electrolysis, each 30 minutes",140.75,91.49,46.8,224.22,30
HCPCS,17999,"Other procedure on skin, mucous membrane, and tissue",665.625,432.655,0.01,15979.22,1593
HCPCS,19000,"Aspiration of cyst of breast, first cyst",575.95,374.37,0.01,3227.0,55
HCPCS,19001,"Aspiration of cyst of breast, each additional cyst",270.65,175.925,15.67,2166.29,38
HCPCS,19020,Drainage of abscess of breast,1283.1,834.02,0.01,9578.49,74
HCPCS,19030,Injection for X-ray imaging of breast duct,465.2,302.38,21.91,398.45,19
HCPCS,19081,"Biopsy of breast and placement of locating device using X-ray with needle, first growth",5438.625,3535.1099999999997,78.57,19837.47,57
HCPCS,19082,"Biopsy of breast and placement of locating device using X-ray with needle, each additional growth",2922.0,1899.3,65.17,13224.98,38
HCPCS,19083,"Biopsy of breast and placement of locating device using ultrasound, first growth",3180.0,2067.0,78.57,9343.49,57
HCPCS,19084,"Biopsy of breast and placement of locating device using ultrasound, each additional growth",942.0,612.3,55.57,3114.5,57
HCPCS,19085,"Biopsy of breast and placement of locating device using MRI, first growth",3410.4,2216.76,78.57,6141.01,38
HCPCS,19086,"Biopsy of breast and placement of locating device using MRI, each additional growth",1368.75,889.6899999999999,36.0,2166.29,38
HCPCS,19100,Needle biopsy of breast,2038.8,1325.22,34.16,9578.49,38
HCPCS,19101,Biopsy of breast through incision,3356.1,2181.465,0.01,29479.24,74
HCPCS,19105,"Removal of growth of breast using ultrasound, each growth",479.0,311.35,24.2,5582.87,19
HCPCS,19110,Exploration of breast nipple,1169.7,760.31,78.57,1144.97,19
HCPCS,19112,Removal of abnormal drainage of breast duct,1092.0,709.8,78.57,1085.48,19
HCPCS,19120,"Removal of growth and tissue of breast, duct, or nipple",2692.2,1749.93,0.01,10381.65,55
HCPCS,19125,"Removal of growth of breast identified by x-ray marker, first growth",1351.4,878.41,78.57,1376.72,19
HCPCS,19126,"Removal of growth of breast identified by x-ray marker, each additional growth",442.1,287.37,78.57,470.66,19
HCPCS,19281,"Placement of locating device in breast using imaging guidance, first growth",2635.575,1713.125,78.32,10594.71,56
HCPCS,19282,"Placement of locating device in breast using imaging guidance, each additional growth",609.5,396.175,39.29,2166.29,56
HCPCS,19283,"Placement of locating device in breast using X-ray with needle guidance, first growth",4954.65,3220.5249999999996,78.57,22161.72,38
HCPCS,19284,"Placement of locating device in breast using X-ray with needle guidance, each additional growth",403.55,262.31,38.5,2166.29,38
HCPCS,19285,"Placement of locating device in breast using ultrasound guidance, first growth",3843.9,2498.535,67.28,14061.71,38
HCPCS,19286,"Placement of locating device in breast using ultrasound guidance, each additional growth",351.5,228.475,33.79,2166.29,38
HCPCS,19287,"Placement of locating device in breast using MRI guidance, first growth",5030.4,3269.76,78.57,18888.41,38
HCPCS,19288,"Placement of locating device in breast using MRI guidance, each additional growth",1159.6,753.74,27.5,2166.29,38
HCPCS,19294,Placement of radiation therapy device in breast for radiation therapy during surgery with partial removal of breast,355.0,230.75,78.57,482.37,19
HCPCS,19296,Insertion of expandable tube in breast for radiation treatment using imaging guidance,11309.6,7351.24,11.22,8947.74,19
HCPCS,19297,Placement of expandable tube in breast for radiation treatment using imaging guidance with partial removal of breast,258.3,167.9,73.62,275.9,19
HCPCS,19298,Placement of tubes in breast for radiation treatment using imaging guidance during or after partial removal of breast,4291.4,2789.41,78.57,2127.15,19
HCPCS,19300,Removal of extra breast tissue in male,2692.2,1749.93,0.01,10381.65,55
HCPCS,19301,Partial removal of breast,2206.075,1433.95,78.57,1908.7,38
HCPCS,19302,Partial removal of breast and underarm lymph nodes,3501.3,2275.85,78.57,2625.37,19
HCPCS,19303,Simple complete removal of breast,3568.0,2319.2,78.57,2800.17,38
HCPCS,19305,"Extensive removal of breast, chest muscle, and underarm lymph nodes",2591.4,1684.41,78.57,3310.34,19
HCPCS,19306,"Extensive removal of breast, chest muscle, underarm lymph nodes, and breast lymph nodes",2712.35,1763.03,78.57,3507.66,19
HCPCS,19307,Removal of breast and underarm lymph nodes,4608.45,2995.49,78.57,3502.06,19
HCPCS,19316,Repair for sagging of the breast,4136.0,2688.4,0.01,19388.12,55
HCPCS,19318,Breast reduction,5471.025,3556.17,78.57,3272.34,38
HCPCS,19325,Insertion of breast implant,5033.174999999999,3271.5649999999996,78.57,1861.47,38
HCPCS,19328,Removal of intact breast implant,4136.0,2688.4,0.01,11512.79,55
HCPCS,19330,Removal of ruptured breast implant and implant material,4136.0,2688.4,0.01,23784.83,55
HCPCS,19340,Placement of implant on same day of breast reconstruction,4336.65,2818.825,78.57,2287.77,38
HCPCS,19342,Placement of implant on separate day of breast reconstruction,5678.174999999999,3690.8149999999996,78.57,2303.04,38
HCPCS,19350,Reconstruction of nipple or area around nipple,3343.8,2173.47,0.01,10381.65,55
HCPCS,19355,Correction of inverted nipple,3429.075,2228.9,0.01,10381.65,36
HCPCS,19357,Reconstruction of breast using tissue expander,6775.125,4403.83,78.57,3508.37,38
HCPCS,19361,Reconstruction of breast with shoulder muscle tissue graft,2910.1,1891.57,78.57,4685.58,38
HCPCS,19364,Reconstruction of breast with tissue graft,26000.0,16900.0,78.57,8207.83,19
HCPCS,19367,Reconstruction of breast with abdominal muscle flap,8163.8,5306.47,78.57,5318.44,19
HCPCS,19368,Reconstruction of breast with abdominal muscle and skin flap graft,8583.8,5579.47,78.57,6550.21,19
HCPCS,19369,Reconstruction of breast with abdominal muscle and 2 skin flap grafts,7875.0,5118.75,78.57,6080.03,19
HCPCS,19370,Revision of capsule around breast implant,3421.75,2224.1400000000003,78.57,2030.8,38
HCPCS,19371,Removal of capsule around breast implant,3625.675,2356.69,78.57,2153.63,38
HCPCS,19380,Surgical change to reconstructed breast,5193.3,3375.65,0.01,19388.12,55
HCPCS,19396,Preparation of mold for custom breast implant,822.2,534.435,53.9,654.4,38
HCPCS,19499,Other procedure on breast,3187.95,2072.17,73.6,9896.14,53
HCPCS,20100,Exploration of wound of neck,2436.6,1583.79,78.57,1788.56,19
HCPCS,20101,Exploration of wound of chest,1400.0,910.0,78.57,1382.01,19
HCPCS,20102,"Exploration of wound of abdomen, back, or flank",2590.0,1683.5,78.57,9555.25,38
HCPCS,20103,Exploration of wound of arm or leg,1533.5,996.775,78.57,4124.25,38
HCPCS,20150,Removal of growth plate,2179.7,1416.81,78.57,2980.18,19
HCPCS,20200,Biopsy of muscle,1556.85,1011.955,24.35,6755.82,38
HCPCS,20205,Deep biopsy of muscle,1504.1,977.665,0.01,6141.01,74
HCPCS,20206,Needle biopsy of muscle,1345.95,874.87,0.01,5224.4,55
HCPCS,20220,Biopsy of bone using needle or trocar,1300.0,845.0,0.01,3873.75,55
HCPCS,20225,Deep biopsy of bone using needle or trocar,2093.3,1360.645,36.17,6334.87,38
HCPCS,20240,Biopsy of surface bone,1460.5,949.325,0.01,6451.0,55
HCPCS,20245,Biopsy of deep bone,1687.4,1096.81,78.57,1045.21,19
HCPCS,20250,Biopsy of middle spine bone,1003.8,652.47,78.57,1221.17,19
HCPCS,20251,Biopsy of upper or lower spine bone,1680.0,1092.0,78.57,1243.04,19
HCPCS,20500,Injection for repair of abnormal muscle drainage tract,1284.05,834.635,0.01,4999.72,55
HCPCS,20501,Injection of abnormal muscle drainage tract for X-ray study,618.2,401.83,21.15,2251.94,38
HCPCS,20520,Removal of foreign body in muscle or tendon,1545.0,1004.25,78.57,6688.68,38
HCPCS,20525,Complicated removal of foreign body in deep muscle or tendon,3711.5,2412.475,78.57,16045.07,38
HCPCS,20526,Injection of carpal tunnel,330.75,214.99,0.01,2166.29,55
HCPCS,20527,Injection of medication into palm,359.35,233.58,53.01,2166.29,38
HCPCS,20550,Injection into tendon or ligament,300.75,195.49,0.01,2166.29,112
HCPCS,20551,Injection into tendon at attachment to bone or muscle,195.5,127.075,0.01,2166.29,74
HCPCS,20552,"Injection of trigger points, 1-2 muscles",241.0,156.65,0.01,2166.29,112
HCPCS,20553,"Injection of trigger points, 3 or more muscles",205.5,133.575,0.01,2166.29,112
HCPCS,20560,"Insertion of needle, 1-2 muscles",70.0,45.5,12.02,2166.29,76
HCPCS,20561,"Insertion of needle, 3 muscles or more",82.5,53.625,18.75,2166.29,76
HCPCS,20600,Aspiration and/or injection of fluid from small joint,293.25,190.615,0.01,2166.29,55
HCPCS,20604,Aspiration and/or injection of fluid from small joint using ultrasound guidance,333.375,216.695,0.01,2166.29,74
HCPCS,20605,Aspiration and/or injection of fluid from medium joint,361.5,234.98,0.01,2166.29,131
HCPCS,20606,Aspiration and/or injection of fluid from medium joint using ultrasound guidance,459.0,298.35,0.01,3227.0,93
HCPCS,20610,Aspiration and/or injection of fluid from large joint,395.5,257.075,0.01,2166.29,150
HCPCS,20611,Aspiration and/or injection of fluid large joint using ultrasound guidance,371.625,241.56,0.01,2166.29,131
HCPCS,20612,Aspiration and/or injection of cyst of tendon,190.5,123.825,0.01,2166.29,55
HCPCS,20615,Aspiration and injection of cyst of bone,763.3,496.145,78.57,3227.0,38
HCPCS,20650,Insertion of wire or pin to bone for traction,2011.45,1307.445,0.01,9038.75,72
HCPCS,20660,Placement of device to skull,665.7,432.71,78.57,688.61,19
HCPCS,20661,Placement of stabilizing device to skull,1238.0,804.7,78.57,1446.36,19
HCPCS,20662,Application of pelvic halo device (stabilization device for pelvis),779.4,506.61,78.57,1515.44,19
HCPCS,20663,Placement of stabilizing device to thigh,1183.4,769.21,78.57,1391.87,19
HCPCS,20664,Application of cranial halo (stabilization device for skull),2020.2,1313.13,78.57,2461.45,19
HCPCS,20665,Removal of stabilizing device from head originally applied by other provider,236.3,153.595,26.05,377.05,38
HCPCS,20670,Removal of surface implant from bone,1330.0,864.5,0.01,3726.0,93
HCPCS,20680,Removal of deep implant from bone,2753.1,1789.52,0.01,7637.95,93
HCPCS,20690,Placement of single direction external bone stabilizing device to arm or leg,1501.5,975.98,78.57,1768.49,19
HCPCS,20692,Placement of multiple direction external bone stabilizing device to arm or leg,3327.45,2162.8450000000003,78.57,3340.31,38
HCPCS,20693,Revision of external bone stabilizing device under anesthesia,2374.05,1543.135,78.57,1324.66,38
HCPCS,20694,Removal of external bone stabilizing device under anesthesia,1207.8,785.0699999999999,0.01,3435.36,36
HCPCS,20696,Placement of multiple direction external bone stabilizing device to arm or leg using imaging,2458.1,1597.77,78.57,3557.92,19
HCPCS,20697,Placement of multiple direction external bone stabilizing device to arm or leg using imaging guidance,2882.3,1873.5,6.17,5873.06,19
HCPCS,20700,Insertion of drug-delivery device in deep tissue,197.25,128.21,64.38,240.74,19
HCPCS,20701,Removal of drug-delivery devices from beneath fibrous covering of muscle,147.75,96.04,49.57,181.49,19
HCPCS,20702,Insertion of drug-delivery device in bone,327.5,212.88,78.57,402.3,19
HCPCS,20703,Removal of drug-delivery devices from marrow cavity of bone,235.75,153.24,78.57,289.48,19
HCPCS,20704,Insertion of drug-delivery device in joint,350.0,227.5,78.57,418.91,19
HCPCS,20705,Removal of drug-delivery devices into joint,281.5,182.98,78.57,346.05,19
HCPCS,20802,Reattachment of cutoff arm,10237.5,6654.38,78.57,8153.14,19
HCPCS,20805,Reattachment of cutoff forearm,10237.5,6654.38,78.57,9704.93,19
HCPCS,20808,Reattachment of cutoff hand,11253.9,7315.04,78.57,11734.49,19
HCPCS,20816,Reattachment of cutoff finger,6568.8,4269.72,78.57,6107.45,19
HCPCS,20822,Reattachment of part of cutoff finger,5750.9,3738.09,78.57,5250.37,19
HCPCS,20824,Reattachment of cutoff thumb,6486.9,4216.49,78.57,6117.89,19
HCPCS,20827,Reattachment of part of cutoff thumb,6014.4,3909.36,78.57,5381.96,19
HCPCS,20838,Reattachment of cutoff foot,6383.85,4149.5,78.57,8256.69,19
HCPCS,20900,Harvest of graft from small bone,1567.7,1019.01,78.57,933.11,19
HCPCS,20902,Harvest of graft from large bone,2793.55,1815.81,78.57,830.9,38
HCPCS,20910,Rib cartilage graft,1906.8,1239.425,78.57,1383.74,38
HCPCS,20912,Graft of nose cartilage,1362.9,885.885,78.57,1418.9,38
HCPCS,20920,Removal of deep thigh tissue for graft,1144.5,743.93,78.57,1188.36,19
HCPCS,20922,Incision of deep thigh tissue for graft,1528.85,993.7549999999999,78.57,1469.23,38
HCPCS,20924,Tendon graft,1352.4,879.06,78.57,1504.49,19
HCPCS,20930,Placement of fragmented bone graft or material to spine to promote bone growth,757.1,492.12,78.57,779.81,15
HCPCS,20931,Graft of donor bone to spine,420.0,273.0,78.57,314.96,19
HCPCS,20932,Graft of donor bone and joint tissue,1680.0,1092.0,78.57,2136.61,19
HCPCS,20933,Graft of donor bone to part of long bone between joints,1542.0,1002.3,78.57,1960.55,19
HCPCS,20934,Graft of donor bone to long bone between joints,1680.0,1092.0,78.57,2135.45,19
HCPCS,20936,Harvest of bone from same spine incision for graft,1152.9,749.39,78.57,1187.49,15
HCPCS,20937,Harvest of bone fragment for spine bone graft,630.0,409.5,78.57,483.26,19
HCPCS,20938,Harvest of bone for spine surgery graft,682.5,443.63,78.57,524.87,19
HCPCS,20939,Aspiration of bone marrow for spine bone graft,150.0,97.5,53.44,200.78,19
HCPCS,20950,Placement of device in muscle to monitor fluid pressure,639.9,415.935,0.01,1417.79,36
HCPCS,20955,Bone graft at lower leg with microvascular connection,7233.5,4701.78,78.57,7448.02,19
HCPCS,20956,Bone graft of pelvic bone with microvascular connection,7245.0,4709.25,78.57,7822.4,19
HCPCS,20957,Bone graft of foot bone with microvascular connection,5472.95,3557.42,78.57,8157.22,19
HCPCS,20962,Bone graft with microvascular connection,4267.75,2774.04,78.57,7890.5,38
HCPCS,20969,Placement of skin and bone flap with microvascular connection,8092.4,5260.06,78.57,8244.16,19
HCPCS,20970,Placement of bone and skin flap from hip bone with connection of small blood vessels,7769.0,5049.85,78.57,8457.89,19
HCPCS,20972,Placement of bone and skin flap from foot bone with connection of small blood vessels,5781.15,3757.75,78.57,8455.82,19
HCPCS,20973,Placement of bone and skin flap from big toe with connection of small blood vessels,5960.3,3874.2,78.57,8931.13,19
HCPCS,20974,Placement of electrical stimulation device for bone healing,384.3,249.8,45.49,193.34,19
HCPCS,20975,Placement of electrical stimulation device at broken bone for healing,482.0,313.3,78.57,510.81,19
HCPCS,20979,"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)",141.8,92.17,24.62,146.05,19
HCPCS,20982,Destruction of growths and adjacent soft tissue,6486.0,4215.9,26.98,25241.36,76
HCPCS,20983,Freezing of growth of bone and adjacent soft tissue,5158.65,3353.125,78.57,24079.23,38
HCPCS,20985,Computer-assisted surgery for muscle and bone procedure,358.1,232.77,78.57,432.16,19
HCPCS,20999,Other procedure on muscle or bone,4839.0,3145.35,1209.75,12496.72,19
HCPCS,21010,Incision of jaw joint,3622.5,2354.63,78.57,2286.47,19
HCPCS,21011,"Removal of growth under skin of face or scalp, less than 2.0 cm",962.9,625.89,0.01,3434.73,55
HCPCS,21012,"Removal of growth under skin of face or scalp, 2.0 cm or more",977.6,635.44,0.01,3434.73,74
HCPCS,21013,"Removal of growth of muscle of face or scalp, less than 2.0 cm",1330.0,864.5,0.01,3434.73,74
HCPCS,21014,"Removal of growth of muscle of face or scalp, 2.0 cm or more",1408.1,915.27,0.01,3434.73,74
HCPCS,21015,"Extensive removal of growth of face or scalp, less than 2.0 cm",1530.9,995.09,78.57,2101.79,19
HCPCS,21016,"Extensive removal of growth of face or scalp, 2.0 cm or more",2901.2,1885.78,78.57,3010.7,19
HCPCS,21025,Removal of lower jaw bone,3344.25,2173.765,0.01,10846.5,36
HCPCS,21026,Removal of face bone,4200.0,2730.0,0.01,10846.5,55
HCPCS,21029,Removal of growth of face bone,2183.0,1418.95,0.01,5637.6,55
HCPCS,21030,Removal of growth or cyst of jaw or upper cheek,4145.4,2694.51,0.01,16269.75,36
HCPCS,21031,Removal of bony growth of jaw bone inside mouth,1439.55,935.71,0.01,8456.4,53
HCPCS,21032,Removal of bony growth of upper jaw bone inside mouth,972.3,632.0,0.01,5637.6,53
HCPCS,21034,Removal of growth of upper jaw or upper cheek bone,3574.2,2323.23,78.57,3467.14,19
HCPCS,21040,Removal of growth or cyst of lower jaw bone,3112.5,2023.125,0.01,10753.53,74
HCPCS,21044,Removal of growth of lower jaw bone,2397.2,1558.18,78.57,2614.6,19
HCPCS,21045,Extensive removal of growth of lower jaw bone,3849.3,2502.05,78.57,3656.37,19
HCPCS,21046,Removal of growth or cyst of lower jaw bone through mouth,4060.3999999999996,2639.265,78.57,3123.63,38
HCPCS,21047,Removal of growth or cyst of part of lower jaw bone,3564.8,2317.12,78.57,3872.68,19
HCPCS,21048,Removal of growth or cyst of upper jaw bone through mouth,2967.3,1928.75,78.57,3150.78,19
HCPCS,21049,Removal of growth or cyst of part of upper jaw bone,3466.1,2252.97,78.57,3627.03,19
HCPCS,21050,Removal of rounded ends of lower jaw joint bone,4725.0,3071.25,78.57,2688.02,19
HCPCS,21060,Removal of lower jaw joint bone tissue,4725.0,3071.25,78.57,2445.1,19
HCPCS,21070,Partial removal of lower jaw bone,3307.5,2149.88,78.57,1884.25,19
HCPCS,21073,Manipulation of hinged joints of upper and lower jaw bones under anesthesia,962.9,625.89,78.57,905.26,19
HCPCS,21076,Preparation of temporary prosthesis to close an opening in mouth,3005.85,1953.8049999999998,78.57,8819.24,38
HCPCS,21077,Impression and preparation of eye socket prosthesis,6500.6,4225.39,78.57,31992.01,57
HCPCS,21079,Impression and custom preparation of temporary oral prosthesis,5441.35,3536.88,78.57,16786.25,38
HCPCS,21080,Preparation of permanent prosthesis to close mouth opening,5734.85,3727.6549999999997,78.57,16786.25,38
HCPCS,21081,Impression and custom preparation of lower jaw bone prosthesis,5521.7,3589.105,78.57,16786.25,38
HCPCS,21082,Impression and custom preparation of prosthesis for roof of mouth enlargement,5360.0,3484.0,78.57,16786.25,38
HCPCS,21083,Preparation of prosthesis to lift roof of mouth,5252.35,3414.0299999999997,78.57,16786.25,76
HCPCS,21084,Impression and custom preparation of speech aid prosthesis,5555.3,3610.9449999999997,78.57,16786.25,76
HCPCS,21085,Impression and custom preparation of oral surgical splint,1850.1,1202.57,0.01,13782.8,74
HCPCS,21086,Impression and custom preparation of outer ear prosthesis,5685.5,3695.575,78.57,16786.25,57
HCPCS,21087,Impression and custom preparation of nasal prosthesis,5624.05,3655.635,78.57,16786.25,57
HCPCS,21088,Impression and custom preparation of facial prosthesis,2100.0,1365.0,78.57,8571.43,15
HCPCS,21089,Other prosthetic procedure for upper jaw and face,394.0,256.1,0.01,4955.82,264
HCPCS,21100,Placement of stabilizing device to upper jaw and face,1859.6,1208.74,78.57,1496.85,19
HCPCS,21110,Application and removal of dental fixation device,1738.0,1129.7,78.57,3933.15,38
HCPCS,21116,Injection for X-ray of hinged joint of upper and lower jaw bones,727.3,472.745,24.4,2166.29,38
HCPCS,21120,Implantation of graft to enlarge chin bone,1842.8,1197.82,0.01,12796.29,55
HCPCS,21121,Enlargement of chin by movement of bone,2581.45,1677.9450000000002,78.57,1656.5,38
HCPCS,21122,Enlargement of chin by movement of multiple bones,2624.25,1705.7649999999999,78.57,2287.71,38
HCPCS,21123,"Insertion of sliding bone graft to enlarge chin bone, additional bone graft",2306.9,1499.49,78.57,2656.31,19
HCPCS,21125,Enlargement of lower jaw with implant,7886.6,5126.29,78.57,6334.63,19
HCPCS,21127,Insertion of bone grafts between portions of bone to enlarge lower jaw bone,9359.7,6083.81,78.57,9675.38,19
HCPCS,21137,Repair of bony defect of forehead,1950.9,1268.09,78.57,2241.68,19
HCPCS,21138,Repair of bony defect of forehead with insertion of prosthetic material,1635.1,1062.82,78.57,2737.69,19
HCPCS,21139,Repair of frontal sinus through forehead,2548.05,1656.23,78.57,3313.12,19
HCPCS,21141,Reconstruction of upper jaw and midface bones,2947.35,1915.78,78.57,4089.37,38
HCPCS,21142,"Repair of midface bones, 2 bones",4830.0,3139.5,78.57,4203.23,19
HCPCS,21143,"Repair of midface bones, 3 or more bones",5145.0,3344.25,78.57,4386.54,19
HCPCS,21145,"Reconstruction of midface bones with bone graft, single piece (LeFort I)",3419.85,2222.9049999999997,78.57,4791.79,38
HCPCS,21146,"Repair of midface bones with bone graft, 2 bones",5775.0,3753.75,78.57,4990.51,19
HCPCS,21147,"Repair of midface bones with bone graft, 3 or more bones",6090.0,3958.5,78.57,5267.63,19
HCPCS,21150,Reconstruction of midface bones (LeFort II),6405.0,4163.25,78.57,4985.8,19
HCPCS,21151,Reconstruction of midface bones with bone graft (LeFort II),6720.0,4368.0,78.57,5487.98,19
HCPCS,21154,"Reconstruction of nose, cheek, and mouth bones with bone grafts",5665.8,3682.77,78.57,5903.3,19
HCPCS,21155,Reconstruction of midface bones with bone graft with LeFort I (LeFort III),4962.75,3225.79,78.57,6550.16,19
HCPCS,21159,"Reconstruction of nose, cheek, mouth, and forehead bones with bone grafts",7541.1,4901.72,78.57,7852.52,19
HCPCS,21160,"Reconstruction of nose, cheek, mouth, and forehead bones with bone grafts and repair of midface bone",6460.0,4199.0,78.57,8518.07,19
HCPCS,21172,Reconstruction of outer side of eye and lower forehead bones,5150.3,3347.7,78.57,5829.25,19
HCPCS,21175,Repair of bony defect of lower forehead and both outer portions of eye bones,3667.65,2383.975,78.57,6613.36,38
HCPCS,21179,Reconstruction of forehead and/or upper eye bones with bone graft or implant,2816.1,1830.47,78.57,4533.11,38
HCPCS,21180,Reconstruction of forehead and/or upper eye bones with bone graft,4523.4,2940.21,78.57,5083.07,19
HCPCS,21181,Reconstruction of skull bones with removal of bone growth,3518.25,2286.865,0.01,12938.33,55
HCPCS,21182,"Reconstruction of eye, forehead, and nose bones with removal of growth with bone grafts, less than 40.0 sq cm",5643.8,3668.47,78.57,6338.07,19
HCPCS,21183,"Reconstruction of eye, forehead, and nose bones with removal of growth with bone grafts, 40.0-80.0 sq cm",5361.3,3484.85,78.57,6915.1,19
HCPCS,21184,"Reconstruction of eye, forehead, and nose bones with removal of growth with bone grafts, more than 80.0 sq cm",5921.25,3848.81,78.57,7444.74,19
HCPCS,21188,Reconstruction of midface bones with bone graft,4505.6,2928.64,78.57,4935.95,19
HCPCS,21193,Reconstruction of jaw bone,2737.35,1779.28,78.57,3818.64,38
HCPCS,21194,Reconstruction of lower jaw bone with bone graft,3104.85,2018.155,78.57,4392.92,38
HCPCS,21195,Reconstruction of lower jaw bones,4252.5,2764.13,78.57,4190.0,19
HCPCS,21196,Reconstruction of jaw bones with insertion of hardware,3167.85,2059.105,78.57,4385.26,38
HCPCS,21198,Incision or partial removal of lower jaw bone,3963.8,2576.47,78.57,3201.58,19
HCPCS,21199,Incision or partial removal of lower jaw bone and movement of tongue muscle,2391.05,1554.18,78.57,3169.16,19
HCPCS,21206,Incision or partial removal of upper jaw bone,3491.3,2269.35,78.57,3029.57,19
HCPCS,21208,Incision and repair of bony defect of cheek bone with repositioning of bony segment,5110.15,3321.6000000000004,78.57,3971.18,38
HCPCS,21209,Incision and repair of bony defect of cheek bone including bony segment reduction,2700.6,1755.395,78.57,1977.47,38
HCPCS,21210,Repair of nasal or cheek bone with bone graft,5375.0,3493.75,0.01,10846.5,55
HCPCS,21215,Repair of lower jaw bone with bone graft,6649.65,4322.275,0.01,10846.5,36
HCPCS,21230,Harvest of rib cartilage for grafting,4096.6,2662.795,78.57,2226.51,38
HCPCS,21235,Obtaining ear cartilage for grafting,3126.9,2032.49,0.01,10846.5,74
HCPCS,21240,Repair of hinged joint of upper and lower jaw bones,5236.95,3404.02,78.57,3257.25,19
HCPCS,21242,Repair of hinged joint of upper and lower jaw bones with donor graft,6615.0,4299.75,78.57,3107.81,19
HCPCS,21243,Repair of hinged joint of upper and lower jaw bones with prosthesis,7875.0,5118.75,78.57,4985.83,19
HCPCS,21244,Reconstruction of lower jaw bone with insertion of bone plate,4200.0,2730.0,78.57,3111.22,19
HCPCS,21245,Partial repair of lower jaw or cheek bone with implant,3176.3,2064.6,78.57,3271.59,19
HCPCS,21246,Complete reconstruction of lower or upper jaw bone with jaw bone implant (subperiosteal),5827.5,3787.88,78.57,6002.33,19
HCPCS,21247,Reconstruction of hinged joint of jaw bones with insertion of rib cartilage,5880.0,3822.0,78.57,4894.56,19
HCPCS,21248,Reconstruction of part of lower or upper jaw bone with implant,3750.0,2437.5,0.01,13945.5,91
HCPCS,21249,Complete reconstruction of lower or upper jaw bone with jaw bone implant (endosteal),5320.0,3458.0,0.01,16786.25,55
HCPCS,21255,Reconstruction of cheek bone with bone graft,3824.1,2485.67,78.57,4173.75,19
HCPCS,21256,Reconstruction of eye socket bone with bone graft,5565.0,3617.25,78.57,3710.09,19
HCPCS,21260,Repositioning of eye bone from outside skull with bone graft,6142.5,3992.63,78.57,4168.58,19
HCPCS,21261,Repositioning of eye socket bone from inside and outside skull with bone graft,10237.5,6654.38,78.57,7364.87,19
HCPCS,21263,Repositioning of cheek bone prominence with forehead advancement,10237.5,6654.38,78.57,6816.53,19
HCPCS,21267,Reconstruction of eye bone from outside skull with bone graft,9082.5,5903.63,78.57,4872.09,19
HCPCS,21268,Repositioning of eye bone from inside and outside skull with bone graft,10237.5,6654.38,78.57,6108.72,19
HCPCS,21270,Insertion of prosthetic material to enlarge cheek bone,2696.4,1752.66,78.57,2407.18,19
HCPCS,21275,"Secondary revision of reconstruction of eye, skull, and face bones",2190.3,1423.7,78.57,2506.63,19
HCPCS,21280,Tightening of tendon of inner port of lower eyelid,2189.8,1423.375,78.57,1736.57,38
HCPCS,21282,Tightening of tendon of outer edge of lower eyelid,1575.5500000000002,1024.11,78.57,1158.02,38
HCPCS,21295,Reduction of muscle used for chewing and lower jaw bone from outside mouth,1086.8,706.42,78.57,699.63,19
HCPCS,21296,Reduction of muscle used for chewing and lower jaw bone from inside mouth,1496.3,972.6,78.57,1224.92,19
HCPCS,21315,Closed treatment of broken nose bone with manipulation,683.6,444.34,0.01,3726.0,74
HCPCS,21320,Closed treatment of broken nose bone with placement of stabilizing device,2130.25,1384.665,0.01,16835.32,74
HCPCS,21325,Treatment of broken nose bone,1242.2,807.43,78.57,1381.01,19
HCPCS,21330,Treatment of broken nose bone with placement of stabilizing device,1575.0,1023.75,78.57,1656.93,19
HCPCS,21335,Treatment of broken nose bone and tissue separating nose airways,2441.25,1586.815,78.57,2144.61,38
HCPCS,21336,Treatment of broken bone and tissue separating nose airways,1803.9499999999998,1172.57,78.57,1917.98,38
HCPCS,21337,Closed treatment of broken bone separating nose airways,1022.7,664.76,0.01,5500.73,55
HCPCS,21338,Treatment of broken nose and eye bones,2362.5,1535.63,78.57,1972.13,19
HCPCS,21339,Treatment of broken nose and eye bones with placement of outside stabilizing device,2709.0,1760.85,78.57,2238.06,19
HCPCS,21340,Treatment of broken nose bones with placement of stabilizing device,2677.5,1740.38,78.57,2231.47,19
HCPCS,21343,Treatment of depressed broken front sinus bone,2315.8,1505.27,78.57,3222.58,38
HCPCS,21344,Treatment of complicated broken front sinus bone,4125.5,2681.58,78.57,4150.49,19
HCPCS,21345,Closed treatment of broken nose and upper jaw bones with placement of stabilizing device to teeth,2310.0,1501.5,78.57,1960.64,19
HCPCS,21346,Treatment of broken nose and upper jaw bones with placement of stabilizing device,2861.3,1859.85,78.57,2780.16,19
HCPCS,21347,Treatment of complex broken nose and upper jaw bones through multiple openings,3281.3,2132.85,78.57,3035.98,19
HCPCS,21348,Treatment of broken nose and upper jaw bones with bone graft,3136.4,2038.66,78.57,3247.0,19
HCPCS,21355,Treatment of broken cheek bone accessed through the skin with manipulation,1811.25,1177.31,78.57,1078.51,19
HCPCS,21356,Treatment of depressed broken upper portion of cheek bone,4044.075,2628.65,78.57,1299.71,38
HCPCS,21360,Treatment of depressed broken cheek bone,3134.55,2037.46,78.57,1527.14,38
HCPCS,21365,Treatment of complicated broken cheek bone with placement of internal stabilizing device,3163.125,2056.03,78.57,3321.58,38
HCPCS,21366,Treatment of complicated broken cheek bone with bone graft,2667.7,1734.01,78.57,3803.2,19
HCPCS,21385,Treatment of broken floor of eye bone through cheek,1976.1,1284.47,78.57,2231.11,19
HCPCS,21386,Treatment of broken floor of eye bone through eye area,2409.775,1566.355,78.57,2072.62,38
HCPCS,21387,Treatment of broken floor of eye bone through cheek and eye area,2008.7,1305.66,78.57,2327.63,19
HCPCS,21390,Treatment of broken floor of eye bone through eye area with implant,4173.75,2712.94,78.57,31602.05,57
HCPCS,21395,Treatment of broken floor of eye bone through eye area with bone graft,3202.5,2081.63,78.57,3013.53,19
HCPCS,21400,Closed treatment of broken eye bone,478.8,311.22,78.57,513.81,19
HCPCS,21401,Closed treatment of broken eye bone with manipulation,1391.3,904.35,78.57,1218.32,19
HCPCS,21406,Treatment of broken eye bone,2835.0,1842.75,78.57,1716.2,19
HCPCS,21407,Treatment of broken eye bone with implant,4490.35,2918.73,78.57,1940.85,38
HCPCS,21408,Treatment of broken eye bone with bone graft,2556.8,1661.92,78.57,2690.16,19
HCPCS,21421,Closed treatment of broken roof of mouth or upper jaw bone with placement of stabilizing device to teeth,1941.5,1261.98,78.57,1707.71,19
HCPCS,21422,Treatment of broken roof of mouth or upper jaw bone,2362.5,1535.63,78.57,1928.7,19
HCPCS,21423,Complicated treatment of broken roof of mouth or upper jaw bone,2137.8,1389.57,78.57,2311.2,19
HCPCS,21431,"Closed treatment of broken bones of cheek, nose, and face with placement of stabilizing device to teeth",1999.2,1299.48,78.57,2138.32,19
HCPCS,21432,Treatment of broken face and skull bones with placement of stabilizing device,4068.8,2644.72,78.57,2140.31,19
HCPCS,21433,Complicated repair of broken face and skull bones,4671.5,3036.48,78.57,5197.97,19
HCPCS,21435,Complicated repair of broken face and skull bones with placement of stabilizing device,4515.0,2934.75,78.57,4189.89,19
HCPCS,21436,Complicated repair of broken face and skull bones with placement of stabilizing device and bone graft,5386.5,3501.23,78.57,6096.78,19
HCPCS,21440,Closed treatment of broken upper or lower jaw bone,1791.35,1164.38,0.01,5637.6,36
HCPCS,21445,Treatment of broken upper or lower jaw bone,1955.1,1270.82,78.57,1991.82,19
HCPCS,21450,Closed treatment of broken lower jaw bone,475.0,308.75,0.01,6141.01,55
HCPCS,21451,Closed treatment of broken lower jaw bone with manipulation,1935.5,1258.075,78.57,7016.18,38
HCPCS,21452,Treatment of broken lower jaw bone with placement of stabilizing device,1811.8,1177.675,42.53,1799.89,38
HCPCS,21453,Closed treatment of broken lower jaw bone with placement of stabilizing device to teeth,2588.3,1682.4,78.57,10846.5,57
HCPCS,21454,Treatment of broken lower jaw bone with placement of external stabilizing device,2257.5,1467.38,78.57,1515.74,19
HCPCS,21461,Treatment of broken lower jaw bone,5158.15,3352.8,78.57,4412.44,38
HCPCS,21462,Treatment of broken lower jaw bone with placement of stabilizing device to teeth,5478.55,3561.06,78.57,4777.0,38
HCPCS,21465,Treatment of broken hinged end of lower jaw bone,4331.25,2815.31,78.57,2480.67,19
HCPCS,21470,Complicated treatment of broken lower jaw bone with placement of stabilizing device to teeth,3937.5,2559.38,78.57,3575.33,19
HCPCS,21480,Closed treatment of dislocated jaw joint,453.0,294.45,27.21,2166.29,38
HCPCS,21485,Complicated repair of dislocated jaw joint with placement of stabilizing device,1503.35,977.1800000000001,0.01,3390.82,36
HCPCS,21490,Treatment of dislocated jaw joint,2835.0,1842.75,78.57,2443.26,19
HCPCS,21497,Wiring of jaw or oral splint to teeth,2693.75,1750.94,78.57,8625.55,38
HCPCS,21501,Drainage of deep abscess or blood accumulation in soft tissue of neck or chest,1740.15,1131.1,0.01,6451.0,55
HCPCS,21502,Drainage of deep abscess or blood accumulation in soft tissue of neck or chest with partial removal of rib,1406.0,913.9,78.57,1473.0,19
HCPCS,21510,Deep incision of chest bone,1218.0,791.7,78.57,1296.56,19
HCPCS,21550,Biopsy of soft tissue of neck or chest,1133.0,736.45,50.89,9578.49,57
HCPCS,21552,"Removal of growth of soft tissue under skin of neck or front of chest, 3.0 cm or more",2250.0,1462.5,0.01,6451.0,74
HCPCS,21554,"Removal of growth of muscle of neck or front of chest, 5.0 cm or more",2136.8,1388.92,0.01,6451.0,74
HCPCS,21555,"Removal of growth under skin of neck or front of chest, less than 3.0 cm",1330.0,864.5,0.01,3435.92,55
HCPCS,21556,"Removal of growth of muscle of neck or front of chest, less than 5.0 cm",2350.0,1527.5,0.01,6451.0,74
HCPCS,21557,"Extensive removal of growth of neck or front of chest, less than 5.0 cm",1576.1,1024.47,78.57,2819.8,19
HCPCS,21558,"Extensive removal of growth of neck or front of chest, 5.0 cm or more",3718.1,2416.77,78.57,3964.52,19
HCPCS,21600,Partial removal of rib,1477.4,960.31,78.57,1622.26,19
HCPCS,21601,Removal of growth of chest wall and rib,3675.875,2389.32,78.57,11982.8,38
HCPCS,21602,Removal of growth of chest wall and rib with reconstruction,3653.5,2374.78,78.57,4571.95,19
HCPCS,21603,Removal of growth of chest wall and rib with reconstruction and removal of lymph nodes from chest cavity,4033.5,2621.78,78.57,4975.31,19
HCPCS,21610,Partial removal of rib and spine bone at joint,2615.0,1699.75,78.57,3362.07,19
HCPCS,21615,Removal of first and/or extra rib at neck,2520.0,1638.0,78.57,1779.21,19
HCPCS,21616,Removal of first and/or extra rib at neck with removal of sympathetic nerves,1727.2,1122.68,78.57,2075.05,19
HCPCS,21620,Partial removal of chest bone,3150.0,2047.5,78.57,1481.08,19
HCPCS,21627,Removal of chest bone tissue,1427.5,927.88,78.57,1582.44,38
HCPCS,21630,Extensive removal of chest bone,3675.0,2388.75,78.57,3630.94,19
HCPCS,21685,Repositioning of bone and muscles in neck,2733.2,1776.58,78.57,2950.67,19
HCPCS,21700,Removal of neck muscle with release of nerves,1338.8,870.22,78.57,1038.41,19
HCPCS,21705,Removal of neck muscle and extra rib at neck with release of nerves,1890.0,1228.5,78.57,1554.93,19
HCPCS,21720,"Release of tendons of neck muscle, open procedure",1939.35,1260.58,78.57,1466.11,38
HCPCS,21725,Release of neck muscle and placement of a cast to treat tilting head,1250.25,812.66,78.57,1598.81,19
HCPCS,21740,Repair of abnormal position of chest bone,3937.5,2559.38,78.57,3005.09,19
HCPCS,21742,Minimally invasive repair of abnormal position of chest bone,2936.9,1908.99,78.57,2882.54,15
HCPCS,21743,Repair of breast bone depression using an endoscope,4737.0,3079.05,78.57,4694.16,15
HCPCS,21750,Treatment of broken chest bone following surgery,1941.5,1261.98,78.57,1994.83,19
HCPCS,21811,"Treatment of broken ribs on side with placement of stabilizing device, 1-3 ribs",1364.0,886.6,78.57,1740.32,19
HCPCS,21812,"Treatment of broken ribs on side with placement of stabilizing device, 4-6 ribs",2458.65,1598.12,78.57,2119.93,19
HCPCS,21813,"Treatment of broken ribs on side with placement of stabilizing device, 7 or more ribs",3373.65,2192.87,78.57,2871.27,19
HCPCS,21820,Closed treatment of broken chest bone,372.8,242.32,78.57,425.21,19
HCPCS,21825,Treatment of broken chest bone,1523.6,990.34,78.57,1586.04,19
HCPCS,21899,Other procedure on neck or chest,506.0,328.9,126.5,8477.27,38
HCPCS,21920,Biopsy of surface soft tissue to back or lower sides,2190.0,1423.5,39.45,9578.49,38
HCPCS,21925,Deep biopsy of soft tissue of back or lower sides,2271.8,1476.67,78.57,8447.36,38
HCPCS,21930,"Removal of growth under skin of back or lower sides, less than 3.0 cm",1330.0,864.5,0.01,3434.73,55
HCPCS,21931,"Removal of growth under skin of back or lower sides, 3.0 cm or more",2135.3,1387.9450000000002,0.01,8447.36,74
HCPCS,21932,"Removal of growth of muscle of back or lower sides, less than 5.0 cm",1926.8,1252.42,0.01,5733.15,55
HCPCS,21933,"Removal of growth of muscle of back or lower sides, 5.0 cm or more",2147.3,1395.75,0.01,5733.15,55
HCPCS,21935,"Extensive removal of growth of back or lower side, less than 5.0 cm",3052.4,1984.06,78.57,3016.72,19
HCPCS,21936,"Extensive removal of growth of back or lower side, 5.0 cm or more",3984.8,2590.12,78.57,4161.18,19
HCPCS,22010,Drainage of abscess of deep tissue of upper or middle spine,3981.175,2587.7650000000003,78.57,17051.3,38
HCPCS,22015,Drainage of abscess of deep tissue of lower spine or sacrum,3964.1,2576.665,78.57,17051.3,38
HCPCS,22100,Removal of rear piece of upper spine bone,2157.8,1402.57,78.57,2489.01,19
HCPCS,22101,Removal of rear piece of middle spine bone,2163.0,1405.95,78.57,2481.51,19
HCPCS,22102,Removal of rear piece of lower spine bone,2154.6,1400.49,78.57,2352.98,19
HCPCS,22103,"Partial removal of bone at back of spine, each additional segment",392.7,255.26,78.57,397.24,19
HCPCS,22110,Partial removal of upper spine bone,2680.7,1742.46,78.57,3003.3,19
HCPCS,22112,Partial removal of middle spine bone,2607.2,1694.68,78.57,3137.99,19
HCPCS,22114,Partial removal of lower spine bone,2669.1,1734.92,78.57,3152.2,19
HCPCS,22116,"Partial removal of spine bone, each additional segment",388.5,252.53,78.57,402.9,19
HCPCS,22206,Incision or removal of segment of middle spine bone to correct deformity,6438.6,4185.09,78.57,7072.81,19
HCPCS,22207,Incision or removal of lower spine bone segment to correct deformity,6356.7,4131.86,78.57,6969.08,19
HCPCS,22208,"Incision or removal of spine bone segment to correct deformity, each additional segment",1601.3,1040.85,78.57,1678.64,19
HCPCS,22210,Incision or removal of upper spine bone segment,4673.6,3037.84,78.57,5155.69,19
HCPCS,22212,Incision or removal of middle spine bone segment,3892.4,2530.06,78.57,4336.64,19
HCPCS,22214,Incision or removal of lower spine bone segment,3914.4,2544.36,78.57,4348.23,19
HCPCS,22216,"Incision or removal of spine bone segment, each additional segment",1011.2,657.28,78.57,1046.1,19
HCPCS,22220,Incision or removal of upper spine bone segment and removal of disc,5486.3,3566.1,78.57,4675.65,19
HCPCS,22222,Incision or removal of middle spine bone and removal of disc,3874.5,2518.43,78.57,4875.69,19
HCPCS,22224,Incision or removal of lower spine bone segment and removal of disc,3683.4,2394.21,78.57,4643.12,19
HCPCS,22226,"Incision or removal of spine bone segment and removal of disc, each additional segment",1496.3,972.6,78.57,1043.96,19
HCPCS,22310,Closed treatment of broken spine bone with cast or brace,923.0,599.95,78.57,837.0,19
HCPCS,22315,Closed treatment of broken or dislocated spine bone with cast or brace and traction,2229.2,1448.98,78.57,2306.51,19
HCPCS,22318,Treatment of broken or dislocated uppermost spine bone with placement of stabilizing device,4185.3,2720.45,78.57,4623.71,19
HCPCS,22319,Treatment of broken or dislocated uppermost spine bone with placement of stabilizing device and bone graft,4593.8,2985.97,78.57,5105.75,19
HCPCS,22325,Treatment of broken or dislocated lower spine bone,3697.1,2403.12,78.57,4166.27,19
HCPCS,22326,Treatment of broken or dislocated upper spine bone,3838.8,2495.22,78.57,4270.96,19
HCPCS,22327,Treatment of broken or dislocated middle spine bone,3827.3,2487.75,78.57,4335.36,19
HCPCS,22328,"Treatment of broken or dislocated spine bone, each additional segment",777.0,505.05,78.57,799.39,19
HCPCS,22505,Manipulation of spine under anesthesia,561.8,365.17,78.57,387.98,19
HCPCS,22510,Stabilization of upper spine bone,4217.75,2741.54,78.57,18883.24,57
HCPCS,22511,Stabilization of lower spine bone,4182.05,2718.335,78.57,18883.24,76
HCPCS,22512,"Stabilization of spine bone, each additional bone",4316.0,2805.4,78.57,19903.33,57
HCPCS,22513,Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance,8020.0,5213.0,78.57,37936.93,38
HCPCS,22514,Treatment of broken lower spine bone with placement of stabilizing device,7425.5,4826.575,78.57,35124.58,57
HCPCS,22515,"Treatment of broken spine bone with stabilizing device, each additional segment",3403.5,2212.275,78.57,16158.7,57
HCPCS,22526,"Treatment of spine disc using fluoroscopic guidance, single level",1654.5,1075.43,78.57,4802.78,15
HCPCS,22527,"Treatment of spine disc using fluoroscopic guidance, each additional bone level",745.75,484.74,78.57,3949.2,15
HCPCS,22532,"Fusion of middle spine bone through side with partial removal of disc, 1 bone",4637.9,3014.64,78.57,5164.23,19
HCPCS,22533,"Fusion of lower spine bone through side with partial removal of disc, 1 bone",4412.1,2867.87,78.57,4860.23,19
HCPCS,22534,"Fusion of middle or lower spine bone through side with partial removal of disc, each additional bone",1002.8,651.82,78.57,1036.53,19
HCPCS,22548,"Fusion of spine bones at base of neck, oral approach",4889.9,3178.44,78.57,5493.63,19
HCPCS,22551,"Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc",3980.6,2587.39,78.57,4890.72,19
HCPCS,22552,"Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, each additional disc",930.3,604.7,78.57,1129.34,19
HCPCS,22554,Fusion of upper spine bones through front of neck with partial removal of disc,4200.0,2730.0,78.57,3610.54,19
HCPCS,22556,Fusion of middle spine bone through side of chest with partial removal of disc,4414.2,2869.23,78.57,4822.49,19
HCPCS,22558,Fusion of lower spine bone through abdomen with partial removal of disc,4100.3,2665.2,78.57,4467.42,19
HCPCS,22585,"Fusion of spine bones through front of body with partial removal of disc, each additional disc",921.9,599.24,78.57,937.87,19
HCPCS,22586,Fusion of lower spine or sacral bone with removal of disc using image guidance,4792.2,3114.93,78.57,5686.93,19
HCPCS,22590,Fusion of skull and first 2 upper spine bones through back,4725.0,3071.25,78.57,4492.28,19
HCPCS,22595,Fusion of first 2 spine bones through back of neck,4725.0,3071.25,78.57,4291.97,19
HCPCS,22600,Fusion of spine in neck by posterior approach,3885.0,2525.25,78.57,3695.06,19
HCPCS,22610,Fusion of spine in upper back,3780.0,2457.0,78.57,3648.65,19
HCPCS,22612,Fusion of spine in lower back,4244.1,2758.67,78.57,4609.42,19
HCPCS,22614,Fusion of additional segment of spine,1286.3,836.1,78.57,1117.35,19
HCPCS,22630,"Fusion of lower spine bone and partial removal of spine bone or disc through back, 1 disc",4098.2,2663.83,78.57,4494.89,19
HCPCS,22632,"Fusion of lower back spine bone and partial removal of spine bone or disc through back, each additional disc",875.7,569.21,78.57,907.82,19
HCPCS,22633,Fusion of spine in lower back with partial removal of spine bone and disc,4217.25,2741.21,78.57,5346.4,19
HCPCS,22634,Fusion of additional segment of spine with partial removal of spine bone and disc,994.0,646.1,78.57,1418.19,19
HCPCS,22800,"Fusion to repair spine deformity through back, up to 6 bones",3601.5,2340.98,78.57,3954.03,19
HCPCS,22802,"Fusion of spine bones for correction of deformity, posterior approach, 7 to 12 vertebral segments",5796.0,3767.4,78.57,6147.65,19
HCPCS,22804,"Fusion to repair spine deformity through back, 13 or more bones",6632.9,4311.39,78.57,7095.08,19
HCPCS,22808,"Fusion of spine bones for correction of deformity, anterior approach, 2 to 3 vertebral segments",5250.0,3412.5,78.57,5343.26,19
HCPCS,22810,"Fusion of spine bones for correction of deformity, anterior approach, 4 to 7 vertebral segments",5480.0,3562.0,78.57,5982.23,19
HCPCS,22812,"Fusion of spine bones for correction of deformity, anterior approach, 8 or more vertebral segments",6008.1,3905.27,78.57,6526.18,19
HCPCS,22818,Removal of 1-2 spine bones to correct outward curving spine deformity,6008.1,3905.27,78.57,6416.15,19
HCPCS,22819,Removal of parts of 3 or more spine bones to correct outward curving spine deformity,6910.1,4491.57,78.57,7364.86,19
HCPCS,22830,Exploration of spine fusion,2141.0,1391.65,78.57,2366.01,19
HCPCS,22840,Placement of stabilizing device to back of 1 spine bone in neck,2940.0,1911.0,78.57,2174.28,19
HCPCS,22841,Insertion of wire to stabilize spine bones,918.8,597.22,78.57,1143.77,15
HCPCS,22842,"Placement of stabilizing device to back, 3-6 spine bone segments",3885.0,2525.25,78.57,2181.79,19
HCPCS,22843,"Placement of stabilizing device to back, 7-12 spine bone segments",2299.5,1494.68,78.57,2334.81,19
HCPCS,22844,"Placement of stabilizing device to back, 13 or more spine bone segments",2340.5,1521.33,78.57,2848.15,19
HCPCS,22845,"Placement of stabilizing device to front, 2-3 spine bone segments",2002.4,1301.56,78.57,2073.27,19
HCPCS,22846,"Placement of stabilizing device to front, 4-7 spine bone segments",3465.0,2252.25,78.57,2154.96,19
HCPCS,22847,"Placement of stabilizing device to front, 8 or more spine bone segments",2562.0,1665.3,78.57,2381.01,19
HCPCS,22848,Insertion of instrumentation to pelvic bones,1004.9,653.19,78.57,1039.12,19
HCPCS,22849,Reinsertion of spinal fixation device,3564.8,2317.12,78.57,3767.87,19
HCPCS,22850,Removal of stabilizing device from back of spine,1989.8,1293.37,78.57,2105.68,19
HCPCS,22852,Removal of segmental stabilizing device from back of spine,2310.0,1501.5,78.57,2024.68,19
HCPCS,22853,Insertion of cage or mesh device to spine bone and disc space during spine fusion,588.5,382.53,78.57,737.59,19
HCPCS,22854,Insertion of cage or mesh device in disc space during spine fusion,761.65,495.07,78.57,954.45,19
HCPCS,22855,Removal of stabilizing device from front of spine,3005.1,1953.32,78.57,3194.8,19
HCPCS,22856,"Insertion of artificial upper spine disc, anterior approach",4289.3,2788.05,78.57,4704.93,19
HCPCS,22857,"Insertion of artificial disc between bones of lower spine, single space",4586.4,2981.16,78.57,5242.93,19
HCPCS,22858,Insertion of artificial upper spine disc anterior approach,1322.0,859.3,78.57,1456.29,19
HCPCS,22859,Placement of mesh or cage device into spine disc space,761.65,495.07,78.57,954.39,19
HCPCS,22861,Revision of total disc replacement in upper back,4510.5,2931.83,78.57,6403.47,19
HCPCS,22862,Revision of total disc replacement in lower back,5426.4,3527.16,78.57,5762.68,19
HCPCS,22864,"Revision of artificial upper spine disc, cervical",4730.3,3074.7,78.57,5789.85,19
HCPCS,22865,"Revision of artificial lower spine disc, lumbar",5727.8,3723.07,78.57,5720.62,19
HCPCS,22867,Placement of device to stabilize or reduce pressure in lower spine in 1 disc space,2220.7,1443.46,78.57,2811.11,19
HCPCS,22868,Placement of device to stabilize or reduce pressure in lower spine in second disc space,552.7,359.26,78.57,692.55,19
HCPCS,22869,Placement of stabilizing device to lower spine level,1238.0,804.7,78.57,1351.89,19
HCPCS,22870,Placement of stabilizing device to second lower spine level,323.5,210.28,78.57,370.18,19
HCPCS,22899,Other procedure on spine,1126.0,731.9,281.5,7322.72,19
HCPCS,22900,"Removal of growth of muscle of abdomen, less than 5.0 cm",1929.4,1254.115,78.57,1653.5,38
HCPCS,22901,"Removal of growth of muscle of abdomen, 5.0 cm or more",1781.85,1158.205,78.57,1949.37,38
HCPCS,22902,"Removal of growth of soft tissue of abdominal wall, less than 3.0 cm",1190.7,773.955,78.57,1112.55,38
HCPCS,22903,"Removal of growth of soft tissue of abdominal wall, 3.0 cm or more",1281.0,832.65,78.57,11324.26,57
HCPCS,22904,"Extensive removal of growth of soft tissue of abdominal wall, less than 5.0 cm",2777.3,1805.25,78.57,3100.02,19
HCPCS,22905,"Extensive removal of growth of soft tissue of abdominal wall, 5.0 cm or more",3597.3,2338.25,78.57,3915.15,19
HCPCS,22999,Other procedure on abdominal muscle or bone,925.0,601.25,231.25,2388.81,19
HCPCS,23000,"Removal of calcium deposits at rotator cuff tendons, open procedure",1374.5,893.43,78.57,1316.04,19
HCPCS,23020,Release of tendon of shoulder joint,1841.7,1197.11,78.57,2042.63,19
HCPCS,23030,Drainage of deep abscess or blood accumulation of shoulder,1682.6,1093.69,78.57,6451.0,38
HCPCS,23031,Drainage of infected fluid-filled sac (bursa) of shoulder joint,1013.3,658.65,78.57,1035.78,19
HCPCS,23035,Incision of shoulder bone for removal of infected tissue,2740.5,1781.33,78.57,2004.71,19
HCPCS,23040,"Incision of shoulder joint for exploration, fluid drainage, or removal of foreign body",2875.95,1869.37,78.57,2123.62,19
HCPCS,23044,"Incision of collar bone joint for exploration, fluid drainage, or removal of foreign body",1980.75,1287.49,78.57,1672.27,19
HCPCS,23065,Biopsy of surface tissue of shoulder,566.0,367.9,78.57,538.58,19
HCPCS,23066,Biopsy of deep tissue of shoulder,1308.3,850.4,78.57,1346.83,19
HCPCS,23071,"Removal of growth under skin of shoulder area, 3.0 cm or more",1208.6,785.59,0.01,8522.25,74
HCPCS,23073,"Removal of growth of muscle of shoulder, 5.0 cm or more",2779.95,1806.97,0.01,8599.73,55
HCPCS,23075,"Removal of growth under skin of shoulder area, less than 3.0 cm",904.45,587.89,0.01,3434.73,55
HCPCS,23076,"Removal of growth of muscle of shoulder, less than 5.0 cm",2211.3,1437.35,78.57,10381.65,57
HCPCS,23077,"Extensive removal of growth of shoulder, less than 5.0 cm",3675.0,2388.75,78.57,3336.33,19
HCPCS,23078,"Extensive removal of growth of shoulder, 5.0 cm or more",5803.95,3772.57,78.57,4227.59,19
HCPCS,23100,Incision and biopsy of shoulder joint,1312.5,853.13,78.57,1481.83,19
HCPCS,23101,"Incision to repair joints between shoulder, chest and collar bones",1522.5,989.63,78.57,1349.58,19
HCPCS,23105,Removal of shoulder joint lining,2100.0,1365.0,78.57,1890.38,19
HCPCS,23106,Removal of lining of joint between collar and chest bones,1537.2,999.18,78.57,1471.45,19
HCPCS,23107,Incision of shoulder joint for exam,1752.5,1139.13,78.57,1955.43,19
HCPCS,23120,Partial removal of collar bone,2280.6,1482.39,78.57,1730.08,19
HCPCS,23125,Removal of collar bone,1873.2,1217.58,78.57,2093.18,19
HCPCS,23130,Partial removal or repair of shoulder bone near collar bone,1599.2,1039.48,78.57,1810.02,19
HCPCS,23140,Removal of cyst or growth of collar bone or shoulder blade,2053.8,1334.97,78.57,1632.82,19
HCPCS,23145,Removal of cyst or growth of collar bone or shoulder blade with self bone graft,1842.8,1197.82,78.57,2046.61,19
HCPCS,23146,Removal of cyst or growth of collar bone or shoulder blade with donor bone graft,2395.65,1557.17,78.57,1827.83,19
HCPCS,23150,Removal of cyst or growth of top part of upper arm bone,1747.2,1135.68,78.57,1952.64,19
HCPCS,23155,Removal of cyst or growth of top part of upper arm bone with self bone graft,2108.4,1370.46,78.57,2342.35,19
HCPCS,23156,Removal of cyst or growth of top of upper arm bone with donor bone graft,1791.3,1164.35,78.57,2002.81,19
HCPCS,23170,Removal of dead bone fragment from collar bone,1292.85,840.35,78.57,1659.49,19
HCPCS,23172,Removal of dead bone fragment from shoulder blade,1283.25,834.11,78.57,1673.25,19
HCPCS,23174,Removal of dead bone fragment from top of upper arm bone,1754.55,1140.46,78.57,2244.65,19
HCPCS,23180,Partial removal of infected collar bone,1822.8,1184.82,78.57,1945.1,19
HCPCS,23182,Partial removal of infected shoulder blade,2205.0,1433.25,78.57,1951.25,19
HCPCS,23184,Partial removal of infected top of upper arm bone,1985.6,1290.64,78.57,2171.73,19
HCPCS,23190,Partial removal of shoulder blade,1480.5,962.33,78.57,1691.0,19
HCPCS,23195,Removal of shoulder blade,1746.15,1135.0,78.57,2208.95,19
HCPCS,23200,Extensive removal of growth of collar bone,3510.0,2281.5,78.57,4476.17,19
HCPCS,23210,Extensive removal of growth of shoulder blade,4120.0,2678.0,78.57,5258.7,19
HCPCS,23220,Extensive removal of growth of upper end of upper arm,4525.0,2941.25,78.57,5774.83,19
HCPCS,23330,"Removal of foreign body of shoulder joint, accessed beneath the skin",617.85,401.605,0.01,2655.52,36
HCPCS,23333,"Removal of foreign body of shoulder joint, accessed beneath the tissue or muscle",1440.6,936.39,78.57,1370.79,19
HCPCS,23334,Removal of ball or socket prosthesis from shoulder,3392.6,2205.19,78.57,3169.8,19
HCPCS,23335,Removal of ball and socket prosthesis from shoulder,4043.6,2628.34,78.57,3781.22,19
HCPCS,23350,Injection of contrast for imaging of shoulder joint,637.05,414.08500000000004,18.03,2166.29,38
HCPCS,23395,Relocation of one muscle of shoulder or upper arm,3451.4,2243.41,78.57,3804.2,19
HCPCS,23397,Relocation of multiple muscles of shoulder or upper arm,3100.7,2015.46,78.57,3361.95,19
HCPCS,23400,Reshaping and relocation of shoulder blade bone,3936.0,2558.4,78.57,2855.94,19
HCPCS,23405,Incision of shoulder tendon,1684.2,1094.73,78.57,1834.27,19
HCPCS,23406,Incision of shoulder multiple tendons through same incision,2106.3,1369.1,78.57,2275.76,19
HCPCS,23410,Repair of acute torn shoulder rotator cuff,3400.5,2210.33,78.57,2430.9,19
HCPCS,23412,Repair of chronic torn shoulder rotator cuff,3559.5,2313.68,78.57,2523.15,19
HCPCS,23415,Release of collar bone and shoulder ligament,1879.5,1221.68,78.57,2064.35,19
HCPCS,23420,Repair of complete tear of shoulder rotator cuff with release of pressure on collar bone,4014.75,2609.59,78.57,2873.69,19
HCPCS,23430,Anchoring of biceps tendon,2968.95,1929.82,78.57,2205.51,19
HCPCS,23440,Removal or relocation of biceps tendon,3724.0,2420.6,78.57,2233.13,19
HCPCS,23450,Reattachment of shoulder joint capsule without bone transfer,2565.2,1667.38,78.57,2797.33,19
HCPCS,23455,Reattachment of shoulder joint capsule and cartilage without bone transfer with repair of shoulder rim,4106.1,2668.97,78.57,2953.71,19
HCPCS,23460,Repair of shoulder joint capsule and shoulder blade with bone block,2964.2,1926.73,78.57,3218.13,19
HCPCS,23462,Reattachment of shoulder joint capsule with bone transfer (coracoid bone),2910.6,1891.89,78.57,3126.34,19
HCPCS,23465,Repair of shoulder joint capsule in the back of the joint,3032.4,1971.06,78.57,3304.72,19
HCPCS,23466,Repair and tightening of shoulder joint capsule,4493.55,2920.81,78.57,3304.51,19
HCPCS,23470,Partial replacement of shoulder joint,4953.45,3219.74,78.57,3556.17,19
HCPCS,23472,"Prosthetic repair of shoulder joint, total shoulder",6725.25,4371.41,78.57,4312.92,19
HCPCS,23473,Revision of total shoulder repair,7826.25,5087.06,78.57,4810.86,19
HCPCS,23474,"Revision of total shoulder repair, total shoulder",8449.95,5492.47,78.57,5195.47,19
HCPCS,23480,Incision or partial removal of collar bone,2204.0,1432.6,78.57,2429.2,19
HCPCS,23485,Incision or partial removal of collar bone with bone graft,3910.8,2542.02,78.57,2826.79,19
HCPCS,23490,Stabilization of collar bone with device,2336.3,1518.6,78.57,2542.83,19
HCPCS,23491,Stabilization of top of upper arm bone with device,2742.6,1782.69,78.57,3001.85,19
HCPCS,23500,Closed treatment of broken collar bone,896.25,582.565,0.01,2498.57,55
HCPCS,23505,Closed treatment of broken collar bone with manipulation,860.0,559.0,78.57,982.86,19
HCPCS,23515,Treatment of broken collar bone,2825.55,1836.61,78.57,2130.61,19
HCPCS,23520,Closed treatment of dislocated joint between collar and chest bone,520.0,338.0,78.57,694.08,19
HCPCS,23525,Closed treatment of dislocated joint between collar and chest bone with manipulation,800.0,520.0,78.57,1055.52,19
HCPCS,23530,Treatment of dislocated joint between collar and chest bones,1435.4,933.01,78.57,1690.64,19
HCPCS,23532,Treatment of dislocated joint between collar and chest bones with tissue graft,1438.75,935.19,78.57,1839.65,19
HCPCS,23540,Closed treatment of dislocated joint between collar bone and shoulder,600.0,390.0,78.57,681.15,19
HCPCS,23545,Closed treatment of dislocated joint between collar bone and shoulder with manipulation,780.95,507.62,78.57,967.89,19
HCPCS,23550,Treatment of dislocated joint between collar bone and shoulder,1793.4,1165.71,78.57,1686.61,19
HCPCS,23552,Treatment of dislocated joint between collar bone and shoulder with tissue graft,2625.6,1706.64,78.57,1938.14,19
HCPCS,23570,Closed treatment of broken shoulder blade,585.0,380.25,0.01,813.49,36
HCPCS,23575,Closed treatment of broken shoulder blade with manipulation,916.85,595.95,78.57,1109.85,19
HCPCS,23585,Treatment of broken shoulder blade,3866.7,2513.36,78.57,2900.7,19
HCPCS,23600,Closed treatment of broken top of upper arm bone,1098.75,714.19,0.01,2498.57,55
HCPCS,23605,Closed treatment of broken top of upper arm bone with manipulation,1183.4,769.21,78.57,1256.59,19
HCPCS,23615,Treatment of broken top of upper arm bone,3513.9,2284.04,78.57,2617.82,19
HCPCS,23616,Treatment of broken upper arm bone with replacement,3676.1,2389.47,78.57,3671.83,19
HCPCS,23620,Closed treatment of upper arm bone broken at shoulder joint,1326.75,862.3900000000001,0.01,4086.81,55
HCPCS,23625,Closed treatment of upper arm bone broken at shoulder joint with manipulation,2205.55,1433.6100000000001,78.57,8837.32,38
HCPCS,23630,"Treatment of upper arm bone, broken at shoulder joint",3024.0,1965.6,78.57,2312.0,19
HCPCS,23650,Closed treatment of dislocated shoulder with manipulation,1110.0,721.5,0.01,4443.19,55
HCPCS,23655,Closed treatment of dislocated shoulder with manipulation under anesthesia,3728.25,2423.365,78.57,14143.06,38
HCPCS,23660,Treatment of dislocated shoulder,1539.3,1000.55,78.57,1724.96,19
HCPCS,23665,Closed treatment of dislocated shoulder and broken upper arm bone at shoulder joint with manipulation,3533.25,2296.615,78.57,14143.06,38
HCPCS,23670,"Treatment of dislocated shoulder and upper arm bone, broken at shoulder joint",2273.3,1477.65,78.57,2592.25,19
HCPCS,23675,Closed treatment of dislocated shoulder and broken neck of upper arm bone with manipulation,3893.25,2530.615,78.57,14143.06,38
HCPCS,23680,Treatment of dislocated shoulder and broken neck of upper arm bone,3672.9,2387.39,78.57,2749.19,19
HCPCS,23700,Manipulation of shoulder joint under anesthesia,534.5,347.43,78.57,579.93,19
HCPCS,23800,Fusion of bones of shoulder joint,2766.8,1798.42,78.57,3031.56,19
HCPCS,23802,Fusion of shoulder joint bone with self bone graft,3371.6,2191.54,78.57,3787.95,19
HCPCS,23900,Amputation of entire arm with removal shoulder blade and a portion of collar bone,3600.5,2340.33,78.57,4101.48,19
HCPCS,23920,Removal of arm and shoulder blade at shoulder joint,3115.4,2025.01,78.57,3330.23,19
HCPCS,23921,Revision of scar or wound closure following removal of arm and shoulder blade at shoulder joint,1156.1,751.47,78.57,1384.02,19
HCPCS,23929,Other procedure on shoulder,505.0,328.25,126.25,2166.29,19
HCPCS,23930,Drainage of deep abscess or blood accumulation of upper arm or elbow,4002.0,2601.305,78.57,17009.64,38
HCPCS,23931,Drainage of fluid filled sac in elbow joint,729.8,474.37,78.57,727.92,19
HCPCS,23935,Incision of upper arm or elbow bone,1968.75,1279.69,78.57,1505.59,19
HCPCS,24000,"Incision of elbow joint for exploration, fluid drainage, or removal of foreign body",1409.1,915.92,78.57,1413.41,19
HCPCS,24006,Incision of elbow with release of joint capsule,1897.4,1233.31,78.57,2118.56,19
HCPCS,24065,Biopsy of surface tissue of upper arm or elbow,2183.15,1419.05,66.69,9578.49,38
HCPCS,24066,Biopsy of deep tissue of upper arm or elbow,1512.0,982.8,78.57,1483.21,19
HCPCS,24071,"Removal of growth under skin of upper arm or elbow, 3.0 cm or more",1630.2,1059.63,0.01,20182.24,74
HCPCS,24073,"Removal of growth of muscle of upper arm or elbow, 5.0 cm or more",2404.8,1563.125,78.57,2042.12,38
HCPCS,24075,"Removal of growth under skin of upper arm or elbow, less than 3.0 cm",1980.0,1287.0,0.01,5113.35,74
HCPCS,24076,"Removal of growth of muscle of upper arm or elbow, less than 5.0 cm",1890.0,1228.5,78.57,1606.39,19
HCPCS,24077,"Extensive removal of growth of upper arm or elbow, less than 5.0 cm",2940.0,1911.0,78.57,3053.37,19
HCPCS,24079,"Extensive removal of growth of upper arm or elbow, 5.0 cm or more",3452.4,2244.06,78.57,3899.63,19
HCPCS,24100,Incision of elbow with biopsy of joint lining,1152.9,749.39,78.57,1233.82,19
HCPCS,24101,Incision and exploration of elbow joint,2113.65,1373.87,78.57,1482.82,19
HCPCS,24102,Removal of elbow joint lining,2786.25,1811.06,78.57,1829.26,19
HCPCS,24105,Removal of fluid-filled sac of elbow,1315.2,854.88,78.57,1043.21,19
HCPCS,24110,Removal of cyst or growth of upper arm bone,1540.4,1001.26,78.57,1734.25,19
HCPCS,24115,Removal of cyst or growth of upper arm bone and self bone graft,1893.2,1230.58,78.57,2172.82,19
HCPCS,24116,Removal of cyst or growth of upper arm bone and donor bone graft,3476.1,2259.47,78.57,2546.94,19
HCPCS,24120,Removal of cyst or growth of elbow or upper forearm bone,1380.8,897.52,78.57,1573.47,19
HCPCS,24125,Removal of cyst or growth of elbow or upper forearm bone and self bone graft,1607.6,1044.94,78.57,1836.55,19
HCPCS,24126,Removal of cyst or growth of elbow or upper forearm bone with bone graft,1705.2,1108.38,78.57,1913.3,19
HCPCS,24130,Removal of forearm bone at elbow joint,1332.5,866.13,78.57,1511.61,19
HCPCS,24134,Removal of dead upper arm bone for bone infection in the main portion and lower portion or the bone,2305.8,1498.77,78.57,2208.25,19
HCPCS,24136,Removal of dead forearm bone at elbow joint,1489.4,968.11,78.57,1866.45,19
HCPCS,24138,Removal of dead elbow bone,1752.5,1139.13,78.57,2002.97,19
HCPCS,24140,Partial removal of infected upper arm bone,1628.65,1058.62,78.57,2083.49,19
HCPCS,24145,Partial removal of infected forearm bone at elbow,1601.3,1040.85,78.57,1751.75,19
HCPCS,24147,Partial removal of infected elbow bone,1691.6,1099.54,78.57,1846.83,19
HCPCS,24149,Extensive removal of bony growth and tissue from elbow to increase elbow motion,4644.75,3019.09,78.57,3492.68,19
HCPCS,24150,Extensive removal of growth of upper arm bone,2613.5,1698.78,78.57,4595.76,19
HCPCS,24152,Extensive removal of growth of inner forearm bone,2384.6,1549.99,78.57,3970.5,19
HCPCS,24155,Removal of elbow joint bones,1975.65,1284.17,78.57,2518.55,19
HCPCS,24160,Removal of elbow joint prosthesis,2956.9,1921.99,78.57,3747.9,19
HCPCS,24164,Removal of forearm bone prosthesis at elbow joint,1758.8,1143.22,78.57,2152.24,19
HCPCS,24200,"Removal of foreign body of upper arm or elbow area, accessed beneath the skin",940.7,611.455,0.01,8477.27,55
HCPCS,24201,"Removal of foreign body, upper arm or elbow area",1416.5,920.73,78.57,1306.92,19
HCPCS,24220,Injection of contrast for imaging of elbow joint,624.8,406.12,27.17,593.98,37
HCPCS,24300,Manipulation of elbow under anesthesia,1527.75,993.04,78.57,1249.9,19
HCPCS,24301,Relocation of muscle or tendon of upper arm or elbow,2012.9,1308.39,78.57,2222.76,19
HCPCS,24305,Lengthening of tendon of upper arm or elbow,1537.2,999.18,78.57,1718.05,19
HCPCS,24310,"Incision of tendon located from elbow to shoulder, open procedure",1305.2,848.38,78.57,1392.1,19
HCPCS,24320,Relocation of tendon from elbow to shoulder with muscle transfer,2177.7,1415.51,78.57,2301.35,19
HCPCS,24330,Relocation of forearm tendons,1912.1,1242.87,78.57,2120.93,19
HCPCS,24331,Relocation of forearm tendons with advancement of the extensor tendons,1822.15,1184.4,78.57,2309.58,19
HCPCS,24332,Release of upper arm tendon,1415.65,920.17,78.57,1812.91,19
HCPCS,24340,Anchoring of biceps tendon at elbow,1793.4,1165.71,78.57,1813.84,19
HCPCS,24341,Repair of tendon or muscle of upper arm or elbow,3150.0,2047.5,78.57,2208.35,19
HCPCS,24342,Reinsertion of torn upper arm tendon,3225.6,2096.64,78.57,2300.75,19
HCPCS,24343,Repair of ligament of thumb side of elbow,2795.7,1817.21,78.57,2105.08,19
HCPCS,24344,Repair of ligament of thumb side of elbow with tendon graft,4372.2,2841.93,78.57,3244.55,19
HCPCS,24345,Repair of ligament of small finger side of elbow,1851.2,1203.28,78.57,2089.04,19
HCPCS,24346,Repair of ligament of small finger side of elbow with tendon graft,2542.52,1652.64,78.57,3248.0,19
HCPCS,24357,Incision of elbow tendon,4772.55,3102.16,78.57,20143.5,38
HCPCS,24358,Incision of elbow tendon with removal of tissue,2063.25,1341.11,78.57,1553.68,19
HCPCS,24359,Incision and repair of elbow tendon with removal of tissue or bone,1737.8,1129.57,78.57,1960.65,19
HCPCS,24360,Repair of elbow joint with tissue graft,2818.2,1831.83,78.57,2662.21,19
HCPCS,24361,Repair of elbow joint with replacement of lower portion of upper arm bone,2818.2,1831.83,78.57,2977.89,19
HCPCS,24362,Repair of elbow joint with implant with and repair of ligament,2461.75,1600.14,78.57,3136.4,19
HCPCS,24363,Prosthetic repair of elbow joint,6092.1,3959.87,78.57,4318.77,19
HCPCS,24365,Joint repair (arthroplasty) forearm bone on the thumb side (radius) at the elbow without an implant,1704.2,1107.73,78.57,1890.27,19
HCPCS,24366,Joint repair (arthroplasty) forearm bone on the thumb side (radius) at the elbow with and implant,1827.0,1187.55,78.57,2020.64,19
HCPCS,24370,"Revision of total elbow repair (arthroplasty), upper arm or forearm components",7419.9,4822.94,78.57,4600.81,19
HCPCS,24371,"Revision of total elbow repair (arthroplasty), upper arm and forearm components",5699.4,3704.61,78.57,5288.74,19
HCPCS,24400,Incision or partial removal of upper arm bone,2202.9,1431.89,78.57,2438.63,19
HCPCS,24410,Incision or partial removal of upper arm bone with insertion of rod,2818.2,1831.83,78.57,3128.61,19
HCPCS,24420,Reconstruction of upper arm bone,2651.3,1723.35,78.57,2949.41,19
HCPCS,24430,Repair of nonhealed broken upper arm bone,4241.55,2757.01,78.57,3126.68,19
HCPCS,24435,Repair of nonhealed broken upper arm bone with self bone graft,4291.95,2789.77,78.57,3190.0,19
HCPCS,24470,Repair of growth plate of upper arm bone,1551.1,1008.22,78.57,1985.41,19
HCPCS,24495,Incision of tissue of forearm muscle with exploration of artery,1754.6,1140.49,78.57,2381.69,19
HCPCS,24498,Stabilization of upper arm bone with device,3513.9,2284.04,78.57,2564.13,19
HCPCS,24500,Closed treatment of broken middle part of upper arm bone,1106.25,719.065,0.01,2343.62,55
HCPCS,24505,Closed treatment of broken middle part of upper arm bone with manipulation,3698.25,2403.865,0.01,14143.06,55
HCPCS,24515,Treatment of broken middle part of upper arm bone with placement of stabilizing device (plate/screws),3521.7,2289.11,78.57,2598.87,19
HCPCS,24516,Treatment of broken middle part of upper arm bone with placement of stabilizing device (implant),3485.55,2265.61,78.57,2545.42,19
HCPCS,24530,Closed treatment of upper arm bone broken at elbow,1396.5,907.725,0.01,3571.6,55
HCPCS,24535,Closed treatment of upper arm bone broken at elbow with manipulation,1999.0,1299.35,78.57,6270.31,38
HCPCS,24538,Placement of stabilizing device to upper arm broken at elbow,1977.2,1285.18,78.57,2207.71,19
HCPCS,24545,Treatment of upper arm bone broken at elbow,3690.3,2398.7,78.57,2753.38,19
HCPCS,24546,Treatment of broken upper arm bone at elbow with extension,4246.2,2760.03,78.57,3078.95,19
HCPCS,24560,Closed treatment of broken outer part of upper arm bone at elbow,1346.25,875.065,78.57,4048.07,38
HCPCS,24565,Closed treatment of broken outer part of upper arm bone at elbow with manipulation,1555.5,1011.075,78.57,4806.03,38
HCPCS,24566,Placement of stabilizing device for broken outer part of upper arm at elbow,1858.5,1208.03,78.57,2123.01,19
HCPCS,24575,Treatment of broken outer part of upper arm bone at elbow,1952.0,1268.8,78.57,2170.37,19
HCPCS,24576,Closed treatment of broken elbow,940.0,611.0,77.8,2737.45,38
HCPCS,24577,Closed treatment of broken elbow with manipulation,3735.75,2428.24,78.57,14143.06,38
HCPCS,24579,Treatment of broken elbow,3340.65,2171.42,78.57,2475.87,19
HCPCS,24582,Placement of stabilizing device for broken elbow with manipulation,2072.7,1347.26,78.57,2396.25,19
HCPCS,24586,Treatment of broken or dislocated upper or forearm bones at elbow,2955.8,1921.27,78.57,3211.91,19
HCPCS,24587,Treatment of broken or dislocated upper or forearm bones at elbow with implant,2624.0,1705.6,78.57,3217.05,19
HCPCS,24600,Repair of dislocated elbow,1181.25,767.815,78.57,2498.57,38
HCPCS,24605,Repair of dislocated elbow under anesthesia,3698.25,2403.865,78.57,14143.06,38
HCPCS,24615,Treatment of dislocated elbow,1913.1,1243.52,78.57,2114.31,19
HCPCS,24620,Closed treatment of broken and dislocated forearm bones at elbow with manipulation,3810.75,2476.99,78.57,14143.06,38
HCPCS,24635,Treatment of broken and dislocated forearm bones at elbow,2438.1,1584.77,78.57,1997.03,19
HCPCS,24640,"Closed treatment of dislocated forearm bone on thumb side at elbow with manipulation, child",693.75,450.94,0.01,8477.27,55
HCPCS,24650,Closed treatment of broken forearm bone on thumb side at elbow,963.75,626.44,0.01,2498.57,55
HCPCS,24655,Closed treatment of broken forearm bone on thumb side at elbow with manipulation,3563.25,2316.115,0.01,14143.06,55
HCPCS,24665,Treatment of broken forearm bone on thumb side at elbow,2575.2,1673.88,78.57,1937.72,19
HCPCS,24666,Treatment of broken forearm bone on thumb side at elbow with prosthesis,2655.45,1726.04,78.57,2173.0,19
HCPCS,24670,Closed treatment of broken forearm bone on small finger side at elbow,1026.0,666.9,0.01,2649.65,55
HCPCS,24675,Closed treatment of broken forearm bone on small finger side at elbow with manipulation,3585.75,2330.74,78.57,14143.06,38
HCPCS,24685,Treatment of broken forearm bone on small finger side at elbow,2578.35,1675.93,78.57,1937.56,19
HCPCS,24800,Fusion of elbow joint without bone graft from the patient,2185.1,1420.32,78.57,2450.84,19
HCPCS,24802,Fusion of elbow joint with bone graft from the patient,2691.2,1749.28,78.57,2964.52,19
HCPCS,24900,Amputation of arm through upper arm bone with closure,2887.05,1876.58,78.57,2177.96,19
HCPCS,24920,Amputation of arm through upper arm bone leaving wound,2863.35,1861.18,78.57,2168.84,19
HCPCS,24925,Secondary closure or revision of scar of previous upper arm bone amputation,1478.4,960.96,78.57,1674.67,19
HCPCS,24930,Re-amputation of remaining arm at upper arm bone,3039.75,1975.84,78.57,2286.3,19
HCPCS,24931,Amputation of arm through upper arm bone with implant,1895.4,1232.01,78.57,2759.48,19
HCPCS,24935,Lengthening of remaining amputated arm bone,2214.95,1439.72,78.57,3446.65,19
HCPCS,24940,Insertion of lever into muscle of amputation stump of arm,2430.5,1579.83,78.57,3113.9,15
HCPCS,24999,Other procedure on upper arm or elbow,588.0,382.2,147.0,2166.29,19
HCPCS,25000,Incision or the tendon covering on the top side of the wrist,5681.25,3692.815,78.57,24017.25,38
HCPCS,25001,Incision or the tendon covering on the palm side of the wrist,1194.9,776.69,78.57,1021.71,19
HCPCS,25020,"Incision of tissue of forearm and/or wrist muscle compartment on one side of the forearm to relieve pressure, without removal of tissue",1524.6,990.99,78.57,1918.5,19
HCPCS,25023,Incision to relieve pressure in top or palm side of wrist compartment with removal of damaged tissue,2925.3,1901.45,78.57,3394.05,19
HCPCS,25024,"Incision of tissue of forearm and/or wrist muscle compartment on both sides of the forearm to relieve pressure, without removal of tissue",3091.8,2009.67,78.57,2308.8,19
HCPCS,25025,Incision to relieve pressure in top and palm side of wrist compartment with removal of damaged tissue,4806.9,3124.49,78.57,3555.2,19
HCPCS,25028,Drainage of deep abscess or blood accumulation of forearm or wrist,2088.45,1357.49,78.57,1792.31,19
HCPCS,25031,Drainage of fluid filled sac in wrist joint,1140.3,741.2,78.57,1035.64,19
HCPCS,25035,Incision of forearm or wrist bone,2967.3,1928.75,78.57,1733.82,19
HCPCS,25040,"Incision of wrist joint for exploration, fluid drainage, or removal of foreign body",2283.75,1484.44,78.57,1667.85,19
HCPCS,25065,Biopsy of surface tissue of forearm or wrist,669.9,435.44,78.57,690.0,19
HCPCS,25066,Biopsy of deep tissue of forearm and/or wrist,3749.1,2436.915,78.57,16641.63,38
HCPCS,25071,"Removal of growth under skin of forearm or wrist, 3.0 cm or more",1135.575,738.125,78.57,1251.27,38
HCPCS,25073,"Removal of growth of muscle of forearm or wrist, 3.0 cm or more",1516.7250000000001,985.875,78.57,1578.96,38
HCPCS,25075,"Removal of growth under skin of forearm or wrist, less than 3.0 cm",1471.05,956.18,0.01,5152.09,74
HCPCS,25076,"Removal of growth of muscle of forearm or wrist, less than 3.0 cm",1400.0,910.0,0.01,3615.5,55
HCPCS,25077,"Extensive removal of growth of forearm or wrist, less than 3.0 cm",2388.8,1552.72,78.57,2602.88,19
HCPCS,25078,"Extensive removal of growth of forearm or wrist, 3.0 cm or more",4520.25,2938.16,78.57,3443.62,19
HCPCS,25085,Incision to repair or release capsule of wrist joint,1365.0,887.25,78.57,1333.26,19
HCPCS,25100,Incision of joint capsule of wrist,931.4,605.41,78.57,1024.59,19
HCPCS,25101,Incision and exploration of wrist joint,1155.0,750.75,78.57,1199.22,19
HCPCS,25105,Incision into wrist joint with removal of joint lining tissue,2362.5,1535.63,78.57,1437.67,19
HCPCS,25107,Incision to repair wrist joint with repair of cartilage,1627.5,1057.88,78.57,1830.51,19
HCPCS,25109,Removal of tendon of forearm and/or wrist,1264.0,821.6,78.57,1598.63,19
HCPCS,25110,Removal of growth of tendon covering of forearm or wrist,1033.2,671.58,78.57,1013.27,19
HCPCS,25111,Removal of first cyst of wrist,1288.35,837.43,78.57,951.19,19
HCPCS,25112,Removal of recurrent cyst of wrist,2600.9,1690.585,0.01,9516.51,36
HCPCS,25115,Extensive removal of growth of soft tissue structures in palm side of wrist,3320.1,2158.07,78.57,2253.46,19
HCPCS,25116,Extensive removal of growth of soft tissue structures in top side of wrist,4680.1,3042.065,0.01,16786.25,36
HCPCS,25118,Removal of lining of tendon covering of wrist,1890.0,1228.5,78.57,1132.18,19
HCPCS,25119,Removal of tendon lining on top side of wrist and end of forearm bone at wrist,1575.0,1023.75,78.57,1471.64,19
HCPCS,25120,Removal of cyst or growth of lower forearm bone,1709.4,1111.11,78.57,1480.29,19
HCPCS,25125,Removal of cyst or growth of lower forearm bone with self bone graft,1921.5,1248.98,78.57,1748.96,19
HCPCS,25126,Removal of cyst or growth of lower forearm bone with bone graft,3052.35,1984.03,78.57,1762.65,19
HCPCS,25130,Removal of cyst or growth of wrist bone,1782.9,1158.89,78.57,1329.88,19
HCPCS,25135,Removal of cyst or growth of wrist bone with self bone graft,1575.0,1023.75,78.57,1647.88,19
HCPCS,25136,Removal of cyst or growth of wrist bone with bone graft,1141.25,741.81,78.57,1454.6,19
HCPCS,25145,Removal of fragment of dead forearm or wrist bone on small finger side,1890.0,1228.5,78.57,1528.5,19
HCPCS,25150,Removal of diseased part of forearm bone on small finger side,1539.3,1000.55,78.57,1678.84,19
HCPCS,25151,Removal of diseased part of forearm bone on thumb side,1555.1,1010.82,78.57,1728.47,19
HCPCS,25170,Extensive removal of growth of forearm bone (radius or ulna),2585.1,1680.32,78.57,4366.24,19
HCPCS,25210,Removal of wrist bone,1305.2,848.38,78.57,1453.26,19
HCPCS,25215,Removal of multiple wrist bones,3071.25,1996.31,78.57,1837.26,19
HCPCS,25230,Partial removal of wrist bone near thumb,1155.0,750.75,78.57,1286.25,19
HCPCS,25240,Removal or partial removal of lower end of forearm bone on small finger side at wrist,1771.95,1151.77,78.57,1275.13,19
HCPCS,25246,Injection of contrast for imaging of wrist,1006.875,654.47,38.29,2166.29,38
HCPCS,25248,Removal of deep foreign body in forearm or wrist,2029.65,1319.275,78.57,1221.46,38
HCPCS,25250,Removal of wrist prosthesis,2082.15,1353.4,78.57,1566.75,19
HCPCS,25251,"Removal of wrist prosthesis, complicated",1659.88,1078.92,78.57,2125.77,19
HCPCS,25259,Manipulation of wrist under anesthesia,963.0,625.95,78.57,1245.35,19
HCPCS,25260,Primary repair of tendon or muscle of palm side of forearm or wrist,3385.5,2200.575,78.57,11158.98,38
HCPCS,25263,Secondary repair of tendon or muscle of palm side of forearm or wrist,2002.4,1301.56,78.57,1855.85,19
HCPCS,25265,Repair of forearm and/or wrist tendon or muscle on the underside of the wrist (flexor) with graft,1729.85,1124.4,78.57,2221.88,19
HCPCS,25270,Primary repair of tendon or muscle of top side of forearm or wrist,2848.0,1851.2,78.57,10293.85,38
HCPCS,25272,"Repair of forearm and/or wrist tendon or muscle on the top of the wrist (extensor), secondary",1879.5,1221.68,78.57,1646.69,19
HCPCS,25274,Repair of tendon or muscle on top side of forearm or wrist with graft,2122.1,1379.37,78.57,1979.24,19
HCPCS,25275,Repair of forearm and/or wrist tendon covering with graft,1788.2,1162.33,78.57,1992.92,19
HCPCS,25280,Lengthening or shortening of tendon of forearm and/or wrist,1875.3,1218.95,78.57,1677.36,19
HCPCS,25290,"Incision of tendon of forearm and/or wrist, open procedure",1887.9,1227.14,78.57,1296.59,19
HCPCS,25295,Removal of scar tissue to release tendon of forearm or wrist,1769.3,1150.05,78.57,1560.56,19
HCPCS,25300,Anchoring of flexing tendon of fingers to wrist bone,2047.5,1330.88,78.57,2027.56,19
HCPCS,25301,Anchoring of extending tendon of fingers to wrist bone,1775.6,1154.14,78.57,1909.88,19
HCPCS,25310,Relocation of tendon of forearm and/or wrist,2828.0,1838.2,78.57,1886.69,19
HCPCS,25312,Relocation of tendon of forearm and/or wrist with grafts,2232.3,1451.0,78.57,2133.15,19
HCPCS,25315,Repair of tendon of forearm and/or wrist,2343.6,1523.34,78.57,2274.96,19
HCPCS,25316,Release and relocation of tendons of forearm or wrist,2730.0,1774.5,78.57,2705.06,19
HCPCS,25320,Reconstruction of wrist joint,3860.4,2509.26,78.57,2928.81,19
HCPCS,25332,Repair of wrist joint,2625.0,1706.25,78.57,2501.76,19
HCPCS,25335,Advancement of tendons of outer forearm at wrist joint,3543.8,2303.47,78.57,2790.93,19
HCPCS,25337,Repair of tendons of outer forearm at wrist joint,3545.4,2304.51,78.57,2644.56,19
HCPCS,25350,Incision or partial removal of forearm bone on thumb side near hand,2229.2,1448.98,78.57,2003.43,19
HCPCS,25355,Incision or partial removal of forearm bone on thumb side near elbow or in middle,2360.4,1534.26,78.57,2253.96,19
HCPCS,25360,Incision or partial removal of forearm bone on small finger side,2109.5,1371.18,78.57,1943.17,19
HCPCS,25365,Incision or partial removal of both forearm bones,2118.45,1376.99,78.57,2701.76,19
HCPCS,25370,Multiple incisions or removal of parts of forearm bone,2829.8,1839.37,78.57,2980.95,19
HCPCS,25375,Multiple incisions or removal of parts of both forearm bones with insertion of rod in bone,2204.7,1433.06,78.57,2819.74,19
HCPCS,25390,Shortening of one of the forearm bones,3565.8,2317.77,78.57,2287.71,19
HCPCS,25391,Lengthening of one of the forearm bones with patient-derived bone graft,2304.85,1498.15,78.57,2945.59,19
HCPCS,25392,Shortening of both bones of forearm,2380.2,1547.13,78.57,2970.83,19
HCPCS,25393,Lengthening of both bones of forearm with patient-derived bone graft,2646.98,1720.54,78.57,3330.78,19
HCPCS,25394,Shortening of wrist bone,2083.2,1354.08,78.57,2314.25,19
HCPCS,25400,Repair non-healed fracture of forearm bone,3816.3,2480.6,78.57,2384.39,19
HCPCS,25405,Repair non-healed fracture of forearm bone with patient-derived bone graft,4556.55,2961.76,78.57,3082.93,19
HCPCS,25415,Treatment of both nonhealed broken forearm bones,2862.3,1860.5,78.57,2857.98,19
HCPCS,25420,Treatment of both nonhealed broken forearm bones with self bone graft,3331.7,2165.61,78.57,3449.53,19
HCPCS,25425,Repair of forearm bone,3275.0,2128.75,78.57,2843.89,19
HCPCS,25426,Repair of defect of both forearm bones with self bones graft,2613.8,1698.97,78.57,3324.67,19
HCPCS,25430,Insertion of vascular bone graft into wrist bone,1905.8,1238.77,78.57,2160.87,19
HCPCS,25431,Repair of non-healed wrist bone other than (scaphoid or navicular),1844.6,1198.99,78.57,2328.64,19
HCPCS,25440,"Repair of non-healed wrist bone, scaphoid or navicular at the base of the thumb",3189.45,2073.14,78.57,2289.21,19
HCPCS,25441,Arthroplasty or replacement of the end of the forearm bone on the thumb side at the wrist level,2222.5,1444.63,78.57,2769.22,19
HCPCS,25442,Arthroplasty or replacement of the end of the forearm bone on the small finger side at the wrist level,2164.1,1406.67,78.57,2403.01,19
HCPCS,25443,"Arthroplasty or replacement of wrist bone, one wrist bone (scaphoid or navicular bone)",2493.8,1620.97,78.57,2303.68,19
HCPCS,25444,"Arthroplasty or replacement of wrist bone, one wrist bone (lunate bone)",2730.0,1774.5,78.57,2442.02,19
HCPCS,25445,"Arthroplasty or replacement of wrist bone, one wrist bone (trapezium bone)",2520.0,1638.0,78.57,2142.93,19
HCPCS,25446,Arthroplasty or replacement of the entire wrist joint,3194.1,2076.17,78.57,3489.82,19
HCPCS,25447,Replacement of joint between wrist and fingers using tissue,3419.4,2222.61,78.57,2463.72,19
HCPCS,25448,Replacement of joint between wrist and fingers using tendon or stitches,2165.0,1407.25,78.57,2719.62,19
HCPCS,25449,Revision of wrist joint replacement with removal of existing prosthesis,2519.0,1637.35,78.57,3069.9,19
HCPCS,25450,Stapling or removal of growth plate of forearm bone,1550.9,1008.09,78.57,1821.82,19
HCPCS,25455,Stapling or removal of growth plate of both forearm bones,1676.53,1089.74,78.57,2148.36,19
HCPCS,25490,Stabilization of forearm bone on thumb side with device,1814.4,1179.36,78.57,2124.92,19
HCPCS,25491,Stabilization of forearm bone on small finger side with device,2370.9,1541.09,78.57,2186.78,19
HCPCS,25492,Stabilization of both forearm bones with device,2091.63,1359.56,78.57,2675.76,19
HCPCS,25500,Closed treatment of broken midpart of forearm bone on thumb side,1205.25,783.415,78.57,3900.87,38
HCPCS,25505,Closed treatment of broken midpart of forearm bone on thumb side with manipulation,3651.0,2373.15,0.01,14143.06,55
HCPCS,25515,Treatment of broken midpart of forearm bone on thumb side,3877.65,2520.475,78.57,1983.12,38
HCPCS,25520,Closed treatment of broken midpart of forearm bone on thumb side and dislocated wrist joint,1500.0,975.0,78.57,1589.52,19
HCPCS,25525,Treatment of broken midpart of forearm bone on thumb side and closed treatment of dislocated wrist joint,2204.0,1432.6,78.57,2335.4,19
HCPCS,25526,Treatment of broken midpart of forearm bone on thumb side and dislocated wrist joint with repair of cartilage,3305.4,2148.51,78.57,2821.93,19
HCPCS,25530,Closed treatment of broken midpart of forearm bone on small finger side,978.0,635.7,0.01,2610.91,55
HCPCS,25535,Closed treatment of broken midpart of forearm bone on small finger side with manipulation,1667.25,1083.7150000000001,78.57,4660.12,38
HCPCS,25545,Treatment of broken midpart of forearm bone on small finger side,2553.15,1659.55,78.57,1846.77,19
HCPCS,25560,Closed treatment of broken midpart of both forearm bones,1000.5,650.325,78.57,2688.38,38
HCPCS,25565,Closed treatment of broken midpart of both forearm bones with manipulation,3743.25,2433.115,78.57,14143.06,38
HCPCS,25574,Treatment of broken midpart of both forearm bones with placement of stabilizing device to bone,1756.7,1141.86,78.57,1995.0,19
HCPCS,25575,Treatment of broken midpart of both forearm bones with placement of stabilizing device on both bones,3580.05,2327.03,78.57,2670.52,19
HCPCS,25600,Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation,1016.25,660.565,0.01,2498.57,55
HCPCS,25605,Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation,2614.5,1699.425,78.57,7848.22,38
HCPCS,25606,Placement of stabilizing device for broken forearm bone on thumb side at wrist,2625.6,1706.64,78.57,1961.34,19
HCPCS,25607,"Treatment of broken forearm bone on thumb side of wrist, above wrist, with placement of stabilizing device",2846.1,1849.97,78.57,2179.22,19
HCPCS,25608,Treatment of 2 broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device,3231.9,2100.74,78.57,2444.09,19
HCPCS,25609,Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device,4129.65,2684.27,78.57,3112.08,19
HCPCS,25622,Closed treatment of broken wrist bone near base of thumb,1075.5,699.075,0.01,8477.27,55
HCPCS,25624,Closed treatment of broken wrist bone near base of thumb with manipulation,1094.0,711.1,78.57,1365.49,19
HCPCS,25628,Treatment of broken wrist bone located near base of thumb,2861.85,1860.2,78.57,2140.94,19
HCPCS,25630,Closed treatment of other broken wrist bone,1590.75,1033.99,0.01,5272.17,55
HCPCS,25635,Closed treatment of other broken wrist bone with manipulation,1028.3,668.4,78.57,1298.27,19
HCPCS,25645,Treatment of other broken wrist bones,1497.3,973.25,78.57,1681.43,19
HCPCS,25650,Closed treatment of broken base of forearm bone on small finger side at wrist,1480.5,962.325,0.01,8477.27,55
HCPCS,25651,Placement of stabilizing device for broken base of forearm bone on small finger side at wrist,1240.1,806.07,78.57,1441.49,19
HCPCS,25652,Treatment of broken base of forearm bone on small finger side at wrist,2453.85,1595.0,78.57,1845.29,19
HCPCS,25660,Closed treatment of dislocated wrist bones with manipulation,1425.0,926.25,78.57,1228.47,19
HCPCS,25670,Treatment of dislocated wrist bones,1618.1,1051.77,78.57,1796.47,19
HCPCS,25671,Placement of stabilizing device for dislocated forearm bones at wrist,2046.0,1329.9,78.57,1565.17,19
HCPCS,25675,Closed treatment of dislocated forearm bone at wrist with manipulation,1232.5,801.125,78.57,3757.54,38
HCPCS,25676,Treatment of dislocated forearm bones at wrist,1673.7,1087.91,78.57,1865.37,19
HCPCS,25680,Closed treatment of broken and dislocated wrist bones with manipulation,1369.5,890.175,78.57,4077.77,38
HCPCS,25685,Treatment of broken and dislocated wrist bones,1950.9,1268.09,78.57,2173.55,19
HCPCS,25690,Closed treatment of dislocated wrist (lunate) bone with manipulation,2127.0,1382.55,78.57,7241.33,38
HCPCS,25695,Treatment of broken wrist (lunate) bone,2677.5,1740.38,78.57,1871.33,19
HCPCS,25800,Complete fusion of wrist joint,2028.6,1318.59,78.57,2173.29,19
HCPCS,25805,Fusion of wrist joint with bone graft,2296.4,1492.66,78.57,2498.89,19
HCPCS,25810,Fusion of wrist joint with graft from hip or other bone,2572.5,1672.13,78.57,2581.08,19
HCPCS,25820,Fusion of part of wrist joint,1428.65,928.62,78.57,1843.41,19
HCPCS,25825,Fusion of part of wrist joint with patient-derived bone graft,2572.5,1672.13,78.57,2270.35,19
HCPCS,25830,Fusion of both forearm bones at wrist,2502.2,1626.43,78.57,2802.98,19
HCPCS,25900,Amputation of arm through forearm bones,2048.6,1331.59,78.57,2107.76,19
HCPCS,25905,Amputation of arm through forearm bones leaving wound,2052.8,1334.32,78.57,2069.39,19
HCPCS,25907,Revision of scar or wound closure of previous amputation at forearm bones,2016.0,1310.4,78.57,1806.89,19
HCPCS,25909,Re-amputation of remaining arm at forearm bone,2030.7,1319.96,78.57,2022.31,19
HCPCS,25915,Conversion of wrist amputation stump to grasping function,2400.25,1560.16,78.57,3463.59,19
HCPCS,25920,"Removal of tendons, ligaments, and muscles of wrist",2740.5,1781.33,78.57,2073.68,19
HCPCS,25922,Revision of scar or wound closure following removal of hand at wrist joint,1494.2,971.23,78.57,1822.65,19
HCPCS,25924,Re-amputation following removal of hand at wrist joint,1557.6,1012.44,78.57,2013.9,19
HCPCS,25927,Amputation of fingers and part of hand at midhand bones,2072.7,1347.26,78.57,2386.99,19
HCPCS,25929,Revision of scar or wound closure of previous amputation at midhand bones,1497.3,973.25,78.57,1764.33,19
HCPCS,25931,Re-amputation of remaining hand at midhand bones,1671.68,1086.59,78.57,2195.54,19
HCPCS,26010,Simple drainage of abscess of finger,503.5,327.275,0.01,8477.27,55
HCPCS,26011,Complicated drainage of abscess in finger,1507.8,980.07,0.01,9578.49,74
HCPCS,26020,Drainage of tendon of finger and/or palm,1116.2,725.53,78.57,1477.26,19
HCPCS,26025,Drainage of fluid filled sac in palm,1634.85,1062.65,78.57,1250.53,19
HCPCS,26030,Drainage of multiple fluid filled sacs in palm,1575.0,1023.75,78.57,1453.45,19
HCPCS,26034,Incision of hand or finger bone,1396.5,907.73,78.57,1612.81,19
HCPCS,26035,Release of pressure on tissues of fingers and/or hand,2343.6,1523.34,78.57,2537.55,19
HCPCS,26037,Incision of tissue of hand to release pressure,2261.7,1470.11,78.57,1682.12,19
HCPCS,26040,Release of tissue of palm,6206.25,4034.065,78.57,27116.25,38
HCPCS,26045,Partial release of connective tissue of palm,3079.2,2001.48,78.57,1390.96,19
HCPCS,26055,Incision of tendon covering of finger,2912.5,1893.125,78.57,9297.0,38
HCPCS,26060,Incision of finger tendon,1011.25,657.315,0.01,3460.55,36
HCPCS,26070,"Incision of wrist joint at finger for exploration, fluid drainage, or removal of foreign body",1176.6,764.79,78.57,953.34,19
HCPCS,26075,"Incision of lower finger joint for exploration, fluid drainage, or removal of foreign body",3818.75,2482.19,78.57,17418.96,38
HCPCS,26080,"Incision of finger joint for exploration, fluid drainage, or removal of foreign body",4200.0,2730.0,78.57,17561.0,38
HCPCS,26100,Incision of wrist joint at finger with biopsy,837.9,544.64,78.57,991.9,19
HCPCS,26105,Incision of joint at base of finger with biopsy,855.8,556.27,78.57,997.86,19
HCPCS,26110,Incision of finger joint with biopsy,822.2,534.43,78.57,957.3,19
HCPCS,26111,Removal (1.5 centimeters or greater) tissue beneath the skin growth of hand or finger,1018.5,662.03,78.57,1237.12,19
HCPCS,26113,"Removal of growth of muscle of hand or finger, 1.5 cm or more",2201.65,1431.075,78.57,1627.76,38
HCPCS,26115,Removal (less than 1.5 centimeters) tissue beneath the skin growth of hand or finger,2262.95,1470.92,0.01,7682.94,36
HCPCS,26116,"Removal of growth of muscle of hand or finger, less than 1.5 cm",2003.9499999999998,1302.57,78.57,1563.53,38
HCPCS,26117,"Extensive removal of growth of hand or finger, less than 3.0 cm",2415.0,1569.75,78.57,2204.01,19
HCPCS,26118,"Extensive removal of growth of hand or finger, 3.0 cm or more",2590.4,1683.76,78.57,3118.75,19
HCPCS,26121,Removal of connective tissue of palm,2913.75,1893.94,78.57,1775.28,19
HCPCS,26123,"Removal of connective tissue of palm and release of finger, first digit",3252.45,2114.09,78.57,2479.49,19
HCPCS,26125,"Removal of connective tissue of palm and release of finger, each additional digit",783.3,509.15,78.57,806.94,19
HCPCS,26130,Removal of wrist joint lining,1365.0,887.25,78.57,1364.99,19
HCPCS,26135,Repair of hand joint,1465.8,952.77,78.57,1639.19,19
HCPCS,26140,Removal of joint lining and repair of tendon on the topside of finger,1322.0,859.3,78.57,1501.24,19
HCPCS,26145,"Repair of tendon, finger, and/or palm of hand",1417.5,921.38,78.57,1523.36,19
HCPCS,26160,Removal of growth of tendon finger or hand,4150.0,2697.5,78.57,15495.0,57
HCPCS,26170,Removal of tendon of palm,1057.4,687.31,78.57,1209.71,19
HCPCS,26180,Removal of tendon of finger,1154.0,750.1,78.57,1325.21,19
HCPCS,26185,Removal of bone at base of thumb or finger,1271.2,826.28,78.57,1628.46,19
HCPCS,26200,Removal of cyst or growth from hand bone,1184.4,769.86,78.57,1336.12,19
HCPCS,26205,Removal of cyst or growth from hand bone with self bone graft,1595.0,1036.75,78.57,1781.85,19
HCPCS,26210,Removal of cyst or growth of finger bone,1147.7,746.01,78.57,1316.98,19
HCPCS,26215,Removal of cyst or growth of finger bone with self bone graft,1466.9,953.49,78.57,1667.75,19
HCPCS,26230,Partial removal of hand bone,1327.2,862.68,78.57,1483.73,19
HCPCS,26235,Partial removal of finger bone nearest hand or middle of finger,1304.1,847.67,78.57,1464.57,19
HCPCS,26236,Partial removal of finger bone at end of finger,1155.0,750.75,78.57,1309.44,19
HCPCS,26250,Extensive removal of growth of hand bone,1545.6,1004.64,78.57,3161.63,19
HCPCS,26260,Extensive removal of growth of finger,1445.9,939.84,78.57,2368.09,19
HCPCS,26262,Extensive removal of growth at end of finger bone,1456.58,946.78,78.57,1867.24,19
HCPCS,26320,Removal of implant from finger or hand,1140.0,741.0,78.57,1032.61,19
HCPCS,26340,Manipulation of finger joint under anesthesia,799.1,519.42,78.57,1003.82,19
HCPCS,26341,Manipulation of finger for connective tissue release following enzyme injection,227.93,148.15,66.71,280.49,19
HCPCS,26350,Repair of finger tendon of under side of hand other than upper most part of palm and fingers,2399.5,1559.675,78.57,7441.0,38
HCPCS,26352,Repair of finger tendon on under side of hand with a graft not in zone 2,2183.0,1418.95,78.57,2374.37,19
HCPCS,26356,Primary repair of finger tendon on underside of the hand without a graft in zone 2,2780.0,1807.0,78.57,2360.1,19
HCPCS,26357,Secondary repair of finger tendon on underside of hand without a graft in zone 2,2415.0,1569.75,78.57,2624.22,19
HCPCS,26358,Secondary repair of finger tendon on underside of hand with a graft in zone 2,2730.0,1774.5,78.57,2902.9,19
HCPCS,26370,Repair of tendon deep in underside of finger,2114.7,1374.56,78.57,2207.27,19
HCPCS,26372,Secondary repair of tendon deep in underside of finger with a graft,2402.4,1561.56,78.57,2571.34,19
HCPCS,26373,Secondary repair of tendon deep in underside of finger,2268.0,1474.2,78.57,2467.68,19
HCPCS,26390,Repair of tendon on underside of finger or hand with implanted rod,2221.8,1444.17,78.57,2435.46,19
HCPCS,26392,Removal of synthetic rod and insertion of tendon graft in hand or finger,2588.3,1682.4,78.57,2831.93,19
HCPCS,26410,Repair of tendon on top of hand,4526.0,2941.9,78.57,18883.24,38
HCPCS,26412,Repair of tendon on top of hand with graft,1856.4,1206.66,78.57,1982.9,19
HCPCS,26415,Removal of tendon from top of hand or finger with rod insertion,1913.1,1243.52,78.57,2368.78,19
HCPCS,26416,Removal of rod with tendon graft at top of hand or finger,1984.1,1289.67,78.57,2578.03,19
HCPCS,26418,Repair of tendon on top side of finger,1600.35,1040.23,78.57,18883.24,57
HCPCS,26420,Repair of tendon of top side of finger with graft,1932.0,1255.8,78.57,2063.64,19
HCPCS,26426,Secondary repair of tendon of top of finger using tissue,1827.0,1187.55,78.57,1487.85,19
HCPCS,26428,Secondary repair of tendon of upper side of finger with graft,2073.8,1347.97,78.57,2199.74,19
HCPCS,26432,Closed treatment of tendon of upper side of finger,1337.7,869.51,78.57,1449.95,19
HCPCS,26433,Repair of tendon on upper side of end of finger,1453.2,944.58,78.57,1542.21,19
HCPCS,26434,Repair of tendon on upper side of end of finger with graft,1692.6,1100.19,78.57,1882.81,19
HCPCS,26437,Repair of tendon on upper side of hand,1638.0,1064.7,78.57,1819.01,19
HCPCS,26440,Release of tendon of palm or finger,1743.0,1132.95,78.57,1805.97,19
HCPCS,26442,Release of tendon of palm and finger,2481.2,1612.78,78.57,2816.34,19
HCPCS,26445,Release of tendon of top of hand or finger,1647.5,1070.88,78.57,1675.41,19
HCPCS,26449,Release of tendon extending from finger to forearm,2199.8,1429.87,78.57,2065.18,19
HCPCS,26450,Incision of tendon of palm,1076.3,699.6,78.57,1220.75,19
HCPCS,26455,Incision of tendon of finger,1059.5,688.68,78.57,1211.78,19
HCPCS,26460,Incision of tendon at top of hand or finger,1024.8,666.12,78.57,1187.7,19
HCPCS,26471,Suture of tendon to first joint of finger,1656.1,1076.4650000000001,78.57,1800.26,38
HCPCS,26474,Suture of tendon to joint of finger near top of finger,1575.0,1023.75,78.57,1750.25,19
HCPCS,26476,Lengthening of tendon on upper side of hand or finger,1380.0,897.0,78.57,1726.92,19
HCPCS,26477,Shortening of tendon of upper side of hand or finger,1527.8,993.07,78.57,1696.1,19
HCPCS,26478,Lengthening of tendon of palm side of finger or hand,1660.1,1079.07,78.57,1809.24,19
HCPCS,26479,Shortening of tendon of palm side of hand or finger,1411.5,917.48,78.57,1820.71,19
HCPCS,26480,Transfer of tendon to back of hand,2415.0,1569.75,78.57,2196.55,19
HCPCS,26483,Transfer of tendon to back of hand with graft,2968.0,1929.2,78.57,2459.45,19
HCPCS,26485,Transfer of tendon to palm,2761.5,1794.98,78.57,2352.8,19
HCPCS,26489,Transfer of tendon to palm with graft,3451.0,2243.15,78.57,2719.75,19
HCPCS,26490,Transfer of tendon from ring finger to thumb,2078.0,1350.7,78.57,2317.88,19
HCPCS,26492,Transfer of tendon to thumb with graft,2302.7,1496.76,78.57,2574.04,19
HCPCS,26494,Transfer of tendon in palm to thumb,2152.5,1399.13,78.57,2325.69,19
HCPCS,26496,"Transfer of tendon to thumb, palm, or wrist",2310.0,1501.5,78.57,2514.14,19
HCPCS,26497,Transfer of tendon to ring and small fingers,2273.3,1477.65,78.57,2520.36,19
HCPCS,26498,"Transfer of tendons of hand, all 4 fingers",3037.7,1974.51,78.57,3335.84,19
HCPCS,26499,Correction of claw finger,2598.8,1689.22,78.57,2415.65,19
HCPCS,26500,Repair of ligament surrounding finger tendon,1660.1,1079.07,78.57,1810.33,19
HCPCS,26502,Repair of ligament surrounding finger tendon with graft,1868.0,1214.2,78.57,2066.42,19
HCPCS,26508,Release of muscles of palm near thumb,1669.5,1085.18,78.57,1846.92,19
HCPCS,26510,Transfer of finger tendon,1582.4,1028.56,78.57,1738.99,19
HCPCS,26516,"Repair of joint capsule of hand and palm, 1 finger",1861.7,1210.11,78.57,2051.18,19
HCPCS,26517,"Repair of joint capsule of hand and palm, 2 fingers",2185.1,1420.32,78.57,2398.25,19
HCPCS,26518,"Repair of joint capsule of hand and palm, 3-4 fingers",3298.05,2143.73,78.57,2432.68,19
HCPCS,26520,Incision or removal of joint capsule between hand and finger,1810.2,1176.63,78.57,1887.84,19
HCPCS,26525,Repair of joint capsule of finger,1823.9,1185.54,78.57,1897.54,19
HCPCS,26530,Repair of joint connecting hand and finger bones with implant,1410.2,916.63,78.57,1595.93,19
HCPCS,26531,Repair of joint between hand and finger bones with prosthesis,1645.4,1069.51,78.57,1860.03,19
HCPCS,26535,Replacement of finger joint,1260.0,819.0,78.57,1280.64,19
HCPCS,26536,Replacement of finger joint with prosthesis,1752.5,1139.13,78.57,2084.91,19
HCPCS,26540,Repair of ligament of finger or hand and finger joint,1738.8,1130.22,78.57,1919.61,19
HCPCS,26541,Repair of ligament of finger or hand to finger joint with graft,2144.1,1393.67,78.57,2336.51,19
HCPCS,26542,Repair of ligament of hand to finger joint with local tissue,1995.0,1296.75,78.57,1984.13,19
HCPCS,26545,Repair of ligament of finger joint with graft,1845.9,1199.84,78.57,2055.86,19
HCPCS,26546,Repair of nonhealed hand or finger bone,3843.0,2497.95,78.57,2913.61,19
HCPCS,26548,Repair of joint between finger and palm,2022.3,1314.5,78.57,2221.33,19
HCPCS,26550,Surgical creation of thumb,4012.1,2607.87,78.57,4801.48,19
HCPCS,26551,Transfer of great toe to hand,7786.08,5060.95,78.57,9688.46,19
HCPCS,26553,Transfer of toe to hand,6662.78,4330.81,78.57,9623.28,19
HCPCS,26554,Transfer of 2 toes to hand,7801.63,5071.06,78.57,11230.35,19
HCPCS,26555,Transfer of finger,3642.5,2367.63,78.57,4000.02,19
HCPCS,26556,Transfer of toe and joint to finger,7850.53,5102.84,78.57,10002.28,19
HCPCS,26560,Repair of webbed finger with skin flaps,1575.0,1023.75,78.57,1711.11,19
HCPCS,26561,Repair of webbed finger with skin flaps and grafts,2325.8,1511.77,78.57,2752.12,19
HCPCS,26562,Complex repair of each webbed finger,3385.2,2200.38,78.57,3920.02,19
HCPCS,26565,Incision or removal of hand bone,1796.6,1167.79,78.57,1974.66,19
HCPCS,26567,Partial removal of finger bone,1807.1,1174.62,78.57,1990.14,19
HCPCS,26568,Lengthening of hand or finger bone,2369.9,1540.44,78.57,2616.86,19
HCPCS,26580,Repair of deformed hand,3746.4,2435.16,78.57,4420.84,19
HCPCS,26587,Removal of extra finger,2579.9,1676.94,78.57,3075.2,19
HCPCS,26590,Repair of enlarged finger,3466.1,2252.97,78.57,4110.45,19
HCPCS,26591,Repair of hand muscle,1235.9,803.34,78.57,1284.16,19
HCPCS,26593,Release of hand muscle,1580.3,1027.2,78.57,1754.32,19
HCPCS,26596,Removal of constricting ring of skin of finger,1934.1,1257.17,78.57,2221.91,19
HCPCS,26600,Closed treatment of broken hand bone,647.5,420.875,0.01,8477.27,55
HCPCS,26605,Closed treatment of broken hand bone with manipulation,1127.0,732.55,0.01,3651.66,55
HCPCS,26607,Closed treatment of broken hand bone with manipulation and placement of external stabilizing device,1170.0,760.5,78.57,1384.87,19
HCPCS,26608,Treatment of broken finger bone with stabilizing device accessed through skin,1236.9,803.99,78.57,1418.51,19
HCPCS,26615,Treatment of broken midhand bone,1448.0,941.2,78.57,1706.45,19
HCPCS,26641,Closed treatment of dislocated thumb at wrist with manipulation,978.0,635.7,78.57,8477.27,38
HCPCS,26645,Closed treatment of broken thumb at wrist with manipulation,1159.0,753.35,78.57,3507.04,38
HCPCS,26650,Placement of stabilizing device for broken thumb at wrist with manipulation,1850.7,1202.96,78.57,1419.22,19
HCPCS,26665,Treatment of broken thumb at wrist,2060.0,1339.0,78.57,1858.12,19
HCPCS,26670,Closed treatment of dislocated hand bone at wrist joint with manipulation,890.0,578.5,78.57,8477.27,38
HCPCS,26675,Closed treatment of dislocated hand bone at wrist joint with manipulation under anesthesia,1113.0,723.45,78.57,1236.93,19
HCPCS,26676,Placement of stabilizing device for dislocated hand bone at wrist joint with manipulation,1295.7,842.21,78.57,1494.51,19
HCPCS,26685,Treatment of broken hand bone at wrist,1475.3,958.95,78.57,1704.66,19
HCPCS,26686,Complicated treatment of dislocated midhand bone at wrist,1700.0,1105.0,78.57,1840.56,19
HCPCS,26700,Closed treatment of dislocated hand joint at base of finger with manipulation,872.0,566.8,78.57,8477.27,38
HCPCS,26705,Closed treatment of dislocated hand joint at base of finger with manipulation under anesthesia,1021.7,664.11,78.57,1132.48,19
HCPCS,26706,Placement of stabilizing device for dislocated hand joint at base of finger with manipulation,1160.3,754.2,78.57,1309.94,19
HCPCS,26715,Treatment of dislocated hand joint at base of finger,1448.0,941.2,78.57,1700.42,19
HCPCS,26720,Closed treatment of broken finger or thumb at midportion or part near hand,572.5,372.125,0.01,2166.29,55
HCPCS,26725,Closed treatment of broken finger or thumb at midportion or part near hand with manipulation,944.0,613.6,0.01,2732.29,55
HCPCS,26727,Placement of stabilizing device for broken finger or thumb at midportion or part near hand with manipulation,1215.9,790.34,78.57,1396.98,19
HCPCS,26735,Treatment of broken finger at midportion or part near hand,1508.9,980.79,78.57,1767.12,19
HCPCS,26740,Closed treatment of broken finger or hand at base of finger,589.0,382.85,78.57,2166.29,38
HCPCS,26742,Closed treatment of broken finger or hand at base of finger with manipulation,2250.5,1462.825,78.57,9428.71,38
HCPCS,26746,Treatment of broken finger or hand at base of finger,1866.9,1213.49,78.57,2204.55,19
HCPCS,26750,Closed treatment of broken end of finger or thumb,563.0,365.95,0.01,8477.27,55
HCPCS,26755,Closed treatment of broken end of finger or thumb with manipulation,674.5,438.425,64.83,8477.27,38
HCPCS,26756,Placement of stabilizing device for broken end of finger or thumb,1071.0,696.15,78.57,1241.32,19
HCPCS,26765,Treatment of broken end of finger or thumb,1520.0,988.0,78.57,1487.12,19
HCPCS,26770,Closed treatment of dislocated finger joint with manipulation,837.0,544.05,0.01,8477.27,55
HCPCS,26775,Closed treatment of dislocated finger joint with manipulation under anesthesia,2095.25,1361.915,78.57,8477.27,38
HCPCS,26776,Placement of stabilizing device for dislocated finger joint with manipulation,1140.3,741.2,78.57,1314.87,19
HCPCS,26785,Treatment of dislocated finger joint,1345.1,874.32,78.57,1623.24,19
HCPCS,26820,Fusion of thumb,2080.1,1352.07,78.57,2288.7,19
HCPCS,26841,Fusion of thumb at wrist,1922.6,1249.69,78.57,2121.89,19
HCPCS,26842,Fusion of thumb at wrist with bone graft,1794.75,1166.59,78.57,2287.86,19
HCPCS,26843,Fusion of hand joint,1945.7,1264.71,78.57,2148.17,19
HCPCS,26844,Fusion of finger at hand joint with self bone graft,2163.0,1405.95,78.57,2383.79,19
HCPCS,26850,Fusion of joint between finger and hand,1836.5,1193.73,78.57,2021.58,19
HCPCS,26852,Fusion of finger joint at hand with self bone graft,2093.7,1360.91,78.57,2324.9,19
HCPCS,26860,"Fusion of finger joint, initial joint",1483.7,964.41,78.57,1648.74,19
HCPCS,26861,"Fusion of finger joint, each additional joint",472.5,307.13,78.34,305.66,19
HCPCS,26862,"Fusion of finger joint with self bone graft, initial joint",1928.9,1253.79,78.57,2122.62,19
HCPCS,26863,"Fusion of finger joint with self bone graft, each additional joint",651.0,423.15,78.57,677.41,19
HCPCS,26910,Amputation of finger or thumb,4701.0,3055.65,78.57,18883.24,38
HCPCS,26951,Amputation of finger or thumb with direct closure,4900.0,3185.0,78.57,18594.0,57
HCPCS,26952,Amputation of finger or thumb with tissue flap,2147.3,1395.75,78.57,18883.24,57
HCPCS,26989,Other procedure on hands or fingers,580.0,377.0,145.0,2166.29,19
HCPCS,26990,Drainage of deep abscess or blood accumulation of pelvis or hip near joint,2868.25,1864.365,78.57,8496.43,38
HCPCS,26991,Drainage of infected fluid-filled sac near pelvis or hip joint,1816.5,1180.73,60.6,1687.81,19
HCPCS,26992,Incision of pelvis and/or hip joint bone,2579.9,1676.94,78.57,2872.19,19
HCPCS,27000,Incision of hip tendon through skin,1188.6,772.59,78.57,1224.04,19
HCPCS,27001,Incision of hip tendon,1435.4,933.01,78.57,1592.18,19
HCPCS,27003,Incision of hip tendon with removal of nerve,1551.9,1008.74,78.57,1760.24,19
HCPCS,27005,Incision of tendon of hip,1948.8,1266.72,78.57,2144.94,19
HCPCS,27006,Incision of tendon of hip (abductor and/or extensor),1970.9,1281.09,78.57,2149.99,19
HCPCS,27025,Incision of connective tissue of hip or thigh,3603.6,2342.34,78.57,2713.35,19
HCPCS,27027,Incision of connective tissue on side of pelvis or buttock,2354.1,1530.17,78.57,2631.63,19
HCPCS,27030,Incision and drainage of hip joint,3827.25,2487.71,78.57,2774.05,19
HCPCS,27033,"Incision of hip joint for exploration, fluid drainage, or removal of foreign body",3962.7,2575.76,78.57,2878.67,19
HCPCS,27035,Removal of hip or pelvic nerve,2993.6,1945.84,78.57,3543.29,19
HCPCS,27036,Repair of hip joint capsule,2704.8,1758.12,78.57,2994.52,19
HCPCS,27040,Biopsy of surface tissue of pelvis and hip,1100.75,715.49,60.16,3383.08,38
HCPCS,27041,Biopsy of deep tissue of pelvis and hip,1838.3,1194.895,78.57,4689.82,38
HCPCS,27043,"Removal of growth under skin of pelvis and hip, 3.0 cm or more",1260.0,819.0,0.01,14270.9,74
HCPCS,27045,"Removal of growth of muscle of pelvis and hip, 5.0 cm or more",2992.5,1945.13,0.01,8909.63,55
HCPCS,27047,"Removal of growth under skin of pelvis and hip, less than 3.0 cm",1927.75,1253.04,0.01,5862.28,36
HCPCS,27048,"Removal of growth of soft tissue of pelvis and hip, less than 5.0 cm",1655.9,1076.34,78.57,1798.03,19
HCPCS,27049,"Extensive removal of growth of pelvis and hip, less than 5.0 cm",2714.3,1764.3,78.57,3947.61,19
HCPCS,27050,Biopsy of joint between lower spine and pelvis,1077.3,700.25,78.57,1190.42,19
HCPCS,27052,Biopsy of hip joint,1226.4,797.16,78.57,1708.51,19
HCPCS,27054,Removal of hip joint lining,2587.2,1681.68,78.57,2030.97,19
HCPCS,27057,Incision of tissue on side of pelvic muscle compartment with removal of muscle,2390.9,1554.09,78.57,2994.52,19
HCPCS,27059,"Extensive removal of growth of pelvis and hip, 5.0 cm or more",7347.45,4775.84,78.57,5389.05,19
HCPCS,27060,Removal of fluid-filled sac (bursa) of pelvis,1147.7,746.01,78.57,1374.14,19
HCPCS,27062,Removal of fluid-filled sac (bursa) or calcium deposit of pelvis,1189.7,773.31,78.57,1346.78,19
HCPCS,27065,"Removal of cyst or growth of hip, pubic, or head of thigh bone with self bone graft",1330.4,864.76,78.57,1537.04,19
HCPCS,27066,"Removal of deep cyst or growth of hip, pubic, or head of thigh bone with self bone graft",3246.15,2110.0,78.57,2382.57,19
HCPCS,27067,"Removal of cyst or growth of hip, pubic, or head of thigh bone with self bone graft obtained through different incision",2769.9,1800.44,78.57,3061.21,19
HCPCS,27070,"Partial removal of superficial cyst or growth of hip, pubic, or head of thigh bone with self bone graft",2498.0,1623.7,78.57,2539.75,19
HCPCS,27071,"Partial removal of deep cyst or growth of hip, pubic, or head of thigh bone with self bone graft",3975.3,2583.95,78.57,2742.9,19
HCPCS,27075,Extensive removal of growth of hip bone,6101.6,3966.04,78.57,6206.37,19
HCPCS,27076,"Extensive removal of growth of upper pelvic bone including hip socket, base of pelvic bone, or both pubic bones",5890.0,3828.5,78.57,7511.57,19
HCPCS,27077,Extensive removal of growth of side of pelvic bone,7309.1,4750.92,78.57,8388.35,19
HCPCS,27078,Extensive removal of growth of base of pelvis and upper end of thigh bone,2741.6,1782.04,78.57,6119.36,19
HCPCS,27080,Removal of tailbone,1319.9,857.94,78.57,1501.69,19
HCPCS,27086,"Removal of foreign body in tissue of pelvis or hip, accessed beneath the skin",1015.0,659.75,0.01,3434.73,36
HCPCS,27087,Removal of foreign body in tissue or muscle of pelvis or hip,1879.5,1221.68,78.57,1819.42,19
HCPCS,27090,Removal of hip prosthesis,2235.5,1453.08,78.57,2459.86,19
HCPCS,27091,"Removal of hip prosthesis, complicated",7686.0,4995.9,78.57,4730.16,19
HCPCS,27093,Injection of contrast for imaging of hip joint,1905.975,1238.885,31.38,5264.43,38
HCPCS,27095,Injection of contrast for imaging of hip under anesthesia,2021.475,1313.96,64.18,6267.73,38
HCPCS,27096,Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance,1093.5,710.78,69.29,6341.33,95
HCPCS,27097,Release of upper hamstring muscle,1780.8,1157.52,78.57,2016.72,19
HCPCS,27098,Transfer of tendon to pelvic bone,1507.83,980.09,78.57,2053.49,19
HCPCS,27100,Transfer of abdominal muscle to thigh bone at hip joint,2197.7,1428.51,78.57,2435.65,19
HCPCS,27105,Transfer of muscle to hip,2312.1,1502.87,78.57,2561.88,19
HCPCS,27110,Transfer of muscle to thigh bone at hip joint,2576.7,1674.86,78.57,2861.72,19
HCPCS,27111,Transfer of muscle to upper thigh bone,2475.9,1609.34,78.57,2664.0,19
HCPCS,27120,Repair of hip socket,3497.6,2273.44,78.57,3839.59,19
HCPCS,27122,Repair of hip socket with removal of head of thigh bone,4803.75,3122.44,78.57,3260.18,19
HCPCS,27125,Partial replacement of thigh bone at hip joint with prosthesis,3458.7,2248.16,78.57,3356.74,19
HCPCS,27130,Replacement of thigh bone and hip joint with prosthesis,6821.4,4433.91,78.57,3851.59,19
HCPCS,27132,Total hip replacement after previous hip surgery,8454.6,5495.49,78.57,4963.29,19
HCPCS,27134,Revision of thigh bone and hip joint prosthesis,14142.0,9192.3,78.57,5675.58,19
HCPCS,27137,Revision of hip socket part of hip prosthesis,9623.25,6255.11,78.57,4361.92,19
HCPCS,27138,Revision of thigh bone prosthesis,9623.25,6255.11,78.57,4533.07,19
HCPCS,27140,Repositioning of part of head of thigh bone,2423.4,1575.21,78.57,2646.76,19
HCPCS,27146,Incision or partial removal of hip bone,5143.95,3343.57,78.57,3781.04,19
HCPCS,27147,Incision or partial removal of hip bone and repair of dislocated hip joint,3993.2,2595.58,78.57,4331.08,19
HCPCS,27151,Reshaping of part of hip bone,4172.7,2712.26,78.57,4705.83,19
HCPCS,27156,Incision and reshaping of part of hip and thigh bones and repair of dislocated hip joint,4664.1,3031.67,78.57,5050.8,19
HCPCS,27158,Incision or partial removal of both sides of pelvic bones,3756.9,2441.99,78.57,4123.31,19
HCPCS,27161,Incision or partial removal of neck of thigh bone,3310.7,2151.96,78.57,3596.85,19
HCPCS,27165,Incision or partial removal of thigh bone below neck with placement of stabilizing device or cast,5561.4,3614.91,78.57,4057.75,19
HCPCS,27170,Bone graft to upper thigh bone,4828.95,3138.82,78.57,3471.63,19
HCPCS,27175,Treatment of slipped growth plate at upper thigh bone,1534.1,997.17,78.57,1971.08,19
HCPCS,27176,Treatment of growth plate at top of thigh with pins inserted through skin',2754.2,1790.23,78.57,2714.8,19
HCPCS,27177,Treatment of slipped growth plate at upper end of thigh bone with pinning or bone graft,3003.0,1951.95,78.57,3260.28,19
HCPCS,27178,Treatment of slipped growth plate at upper thigh bone with manipulation and pinning,2921.1,1898.72,78.57,2719.88,19
HCPCS,27179,Repair of growth plate in head of thigh bone,2622.9,1704.89,78.57,2878.86,19
HCPCS,27181,Repair of growth plate in head of thigh bone with placement of stabilizing device,3107.0,2019.55,78.57,3291.15,19
HCPCS,27185,Removal of growth plate of upper thigh bone,1801.8,1171.17,78.57,2123.86,19
HCPCS,27187,Stabilization of upper thigh bone with device,4028.85,2618.75,78.57,2940.47,19
HCPCS,27197,Closed treatment of broken and/or dislocated pelvis and/or sacrum,275.0,178.75,78.57,367.63,19
HCPCS,27198,Closed treatment of broken and/or dislocated pelvis and/or sacrum with manipulation,697.5,453.38,78.57,899.34,19
HCPCS,27200,Closed treatment of broken tailbone,469.4,305.11,78.57,558.03,19
HCPCS,27202,Treatment of broken tailbone,1259.33,818.56,78.57,1564.34,19
HCPCS,27215,Treatment of broken bones on side of pelvis,1910.0,1241.5,78.57,1889.49,15
HCPCS,27216,Placement of stabilizing device for broken and/or dislocated bone on side of pelvis,4010.0,2606.5,78.57,2799.52,15
HCPCS,27217,Treatment of broken and/or dislocated front of pelvis,3202.5,2081.63,78.57,2629.91,15
HCPCS,27218,Treatment of broken and/or dislocated back of pelvis,4586.4,2981.16,78.57,3614.41,15
HCPCS,27220,Closed treatment of broken hip socket,1195.425,777.025,0.01,1253.69,36
HCPCS,27222,Closed treatment of broken hip socket with manipulation,2348.85,1526.755,78.57,2881.1,38
HCPCS,27226,Treatment of broken hip socket with placement of stabilizing device,5206.95,3384.52,78.57,3129.12,19
HCPCS,27227,Treatment of broken bones of front or back column of hip socket or across hip socket with placement of stabilizing device,10010.7,6506.96,78.57,4916.72,19
HCPCS,27228,Treatment of broken bones of front and back column or wall of hip socket with placement of stabilizing device,7829.4,5089.11,78.57,5576.65,19
HCPCS,27230,Closed treatment of broken upper thigh bone,1320.0,858.0,78.57,1399.79,19
HCPCS,27232,Closed treatment of broken upper thigh bone with manipulation,2963.5,1926.275,78.57,9883.23,38
HCPCS,27235,Placement of stabilizing device for upper end of broken thigh bone,4035.15,2622.85,78.57,2689.06,19
HCPCS,27236,Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement,6123.6,3980.34,78.57,3540.82,19
HCPCS,27238,Closed treatment of broken below neck of thigh bone,1190.7,773.96,78.57,1366.85,19
HCPCS,27240,Closed treatment of broken below neck of thigh bone with manipulation,2576.7,1674.86,78.57,2834.84,19
HCPCS,27244,Treatment of broken neck of thigh bone with plate/screw implant,4981.8,3238.17,78.57,3644.23,19
HCPCS,27245,Treatment of broken neck of thigh bone with bone implant,5336.1,3468.47,78.57,3642.8,19
HCPCS,27246,Closed treatment of broken below head of thigh bone,1590.75,1033.99,78.57,1142.28,19
HCPCS,27248,Treatment of broken head of thigh bone with placement of stabilizing device,3042.9,1977.89,78.57,4515.78,19
HCPCS,27250,Closed treatment of dislocated hip,3131.25,2035.315,78.57,10633.44,38
HCPCS,27252,Closed treatment of dislocated hip under anesthesia,4208.25,2735.365,78.57,14143.06,38
HCPCS,27253,Treatment of dislocated hip,3830.4,2489.76,78.57,2790.71,19
HCPCS,27254,Treatment of traumatic broken thigh and hip and dislocated hip,5181.75,3368.14,78.57,3746.35,19
HCPCS,27256,Closed Treatment of spontaneous dislocated hip,790.7,513.96,78.57,739.46,19
HCPCS,27257,Treatment of spontaneous dislocated hip under anesthesia,1921.5,1248.98,78.57,1072.79,19
HCPCS,27258,Treatment of spontaneous dislocated hip,2997.8,1948.57,78.57,3285.13,19
HCPCS,27259,Treatment of spontaneous dislocated hip with shortening of thigh bone,4210.5,2736.83,78.57,4589.96,19
HCPCS,27265,Closed treatment of dislocated hip prosthesis,1782.75,1158.79,78.57,4869.3,38
HCPCS,27266,Closed treatment of dislocated hip prosthesis under anesthesia,3527.25,2292.715,78.57,12175.2,38
HCPCS,27267,Closed treatment of broken head of thigh bone,1647.45,1070.84,78.57,1285.2,19
HCPCS,27268,Closed treatment of broken head of thigh bone with manipulation,1364.0,886.6,78.57,1593.78,19
HCPCS,27269,Treatment of broken head of thigh bone,4953.45,3219.74,78.57,3680.49,19
HCPCS,27275,Manipulation of hip joint under general anesthesia,477.8,310.57,78.57,544.2,19
HCPCS,27279,Fusion of pelvic joint using imaging guidance,2083.8,1354.47,78.57,2082.75,19
HCPCS,27280,"Fusion of sacroiliac joint between spine and pelvis with bone graft, open procedure",2765.7,1797.71,78.57,3930.4,19
HCPCS,27282,Fusion of joint between pubic bones,2351.0,1528.15,78.57,2534.71,19
HCPCS,27284,Fusion of hip joint,4242.0,2757.3,78.57,4754.38,19
HCPCS,27286,Fusion of hip joint with incision or partial removal of thigh bone below neck,3808.78,2475.71,78.57,4887.99,19
HCPCS,27290,Amputation of pelvic structures,4523.4,2940.21,78.57,4808.92,19
HCPCS,27295,Removal of hip bone and leg at hip joint,5512.5,3583.13,78.57,3720.27,19
HCPCS,27299,Other procedure on pelvis or hip joint,513.0,333.45,128.25,2166.29,19
HCPCS,27301,Drainage of deep abscess or blood accumulation of thigh or knee,6252.9,4064.3849999999998,78.57,24962.45,57
HCPCS,27303,Incision of bone of thigh or knee,3017.7,1961.51,78.57,1894.53,19
HCPCS,27305,Incision of connective tissue between thigh and knee,1240.1,806.07,78.57,1423.2,19
HCPCS,27306,Incision of tendon of thigh or hamstring muscle,997.5,648.38,78.57,1040.67,19
HCPCS,27307,Incision of multiple tendons of thigh or hamstring muscle,1232.7,801.26,78.57,1305.46,19
HCPCS,27310,"Incision of knee joint for exploration, fluid drainage, or removal of foreign body",2913.75,1893.94,78.57,2163.49,19
HCPCS,27323,Biopsy of surface tissue of thigh or knee,3307.05,2149.585,0.01,14367.74,55
HCPCS,27324,Biopsy of deep tissue of thigh or knee,1858.5,1208.03,78.57,1183.02,19
HCPCS,27325,Removal of nerve of hamstring muscle,1167.23,758.7,78.57,1650.17,19
HCPCS,27326,Removal of nerve of calf muscle,1145.88,744.82,78.57,1522.86,19
HCPCS,27327,"Removal of growth under skin of thigh or knee, 3.0 cm or more",1759.35,1143.58,0.01,6451.0,74
HCPCS,27328,"Removal of growth of muscle of thigh or knee, 5.0 cm or less",2753.1,1789.52,0.01,8599.73,55
HCPCS,27329,"Extensive removal of growth of thigh or knee, less than 5.0 cm",4725.0,3071.25,78.57,3054.7,19
HCPCS,27330,Biopsy of membrane covering knee joint,1601.3,1040.85,78.57,1232.18,19
HCPCS,27331,"Incision of knee joint for exploration, biopsy, or removal of foreign body",1729.4,1124.11,78.57,1405.56,19
HCPCS,27332,Incision of knee joint with removal of cartilage of inner or outer side of knee,2049.6,1332.24,78.57,1900.66,19
HCPCS,27333,Incision of knee joint with removal of cartilage of inner and outer sides of knee,1420.5,923.33,78.57,1733.3,19
HCPCS,27334,Incision of knee joint with removal of cartilage of front or back of knee,2305.8,1498.77,78.57,2026.96,19
HCPCS,27335,Incision of knee joint with removal of cartilage of front and back of knee,2433.9,1582.04,78.57,2259.67,19
HCPCS,27337,"Removal of growth under skin of thigh or knee, less than 3.0 cm",2940.6,1911.39,0.01,8793.41,74
HCPCS,27339,"Removal of growth of muscle of thigh or knee, 5.0 cm or more",3290.25,2138.665,78.57,2217.54,38
HCPCS,27340,Removal of fluid-filled sac from joint at front of knee,1537.2,999.18,78.57,1099.05,19
HCPCS,27345,Removal of cyst of back of knee,1265.3,822.45,78.57,1423.64,19
HCPCS,27347,Removal of growth of knee cartilage or capsule,1362.9,885.89,78.57,1563.57,19
HCPCS,27350,Removal of kneecap,1728.3,1123.4,78.57,1926.72,19
HCPCS,27355,Removal of cyst or growth of thigh bone,2477.55,1610.41,78.57,1790.14,19
HCPCS,27356,Removal of cyst or growth of thigh bone with donor bone graft,1967.7,1279.01,78.57,2184.24,19
HCPCS,27357,Removal of cyst or growth of thigh bone with self bone graft,2175.6,1414.14,78.57,2408.36,19
HCPCS,27358,Removal of cyst or growth of thigh bone with placement of stabilizing device,2049.6,1332.24,78.57,1017.64,19
HCPCS,27360,Partial removal of thigh and/or lower leg bones,3810.0,2476.5,78.57,2548.09,19
HCPCS,27364,"Extensive removal of growth of thigh or knee, 5.0 cm or more",6320.55,4108.36,78.57,4615.84,19
HCPCS,27365,Extensive removal of growth of thigh or knee bone,6676.5,4339.73,78.57,6113.06,19
HCPCS,27369,Injection of contrast for imaging of knee joint,524.25,340.76500000000004,31.92,2332.0,38
HCPCS,27372,Removal of foreign body deep in tissue of thigh or knee,3932.35,2556.03,78.57,16641.63,38
HCPCS,27380,Primary suture of tendon below knee,2346.75,1525.39,78.57,1769.67,19
HCPCS,27381,Secondary suture of tendon below knee,3208.35,2085.43,78.57,2369.63,19
HCPCS,27385,Primary suture of ruptured muscle of thigh,2513.7,1633.91,78.57,1712.32,19
HCPCS,27386,Secondary suture of ruptured muscle of thigh,3326.4,2162.16,78.57,2469.45,19
HCPCS,27390,Repair of hamstring tendon,1159.2,753.48,78.57,1325.24,19
HCPCS,27391,Repair of multiple hamstring tendons in leg,1514.1,984.17,78.57,1696.68,19
HCPCS,27392,Repair of multiple hamstring tendons of both legs,1872.2,1216.93,78.57,2102.81,19
HCPCS,27393,Lengthening of hamstring tendon,1341.9,872.24,78.57,1508.96,19
HCPCS,27394,Lengthening of multiple hamstring tendons in leg,1747.2,1135.68,78.57,1920.42,19
HCPCS,27395,Lengthening of multiple hamstring tendons in both legs,2356.2,1531.53,78.57,2597.03,19
HCPCS,27396,Transfer of thigh tendon,2041.2,1326.78,78.57,1818.06,19
HCPCS,27397,Transfer of thigh tendons,2097.03,1363.07,78.57,2705.47,19
HCPCS,27400,Transfer of tendon or muscle in hamstring to femur,1900.5,1235.33,78.57,2047.72,19
HCPCS,27403,Incision and repair of knee cartilage,3079.2,2001.48,78.57,1896.8,19
HCPCS,27405,Primary repair of torn ligament or joint capsule at outside part of knee,2735.85,1778.3,78.57,2001.43,19
HCPCS,27407,Repair of torn ligament and/or joint capsule at front of knee,2174.6,1413.49,78.57,2336.9,19
HCPCS,27409,Repair of torn ligaments or joint capsule at front and sides of knee,2606.1,1693.97,78.57,2850.62,19
HCPCS,27412,Implantation of self cartilage into knee joint,6736.35,4378.63,78.57,4869.77,19
HCPCS,27415,Implantation of donor cartilage cells into knee joint,5581.8,3628.17,78.57,4013.55,19
HCPCS,27416,Implantation of self cartilage cells into knee bone,2604.0,1692.6,78.57,2889.65,19
HCPCS,27418,Repair of upper end of shin bone at knee joint,3969.0,2579.85,78.57,2452.92,19
HCPCS,27420,Repair of dislocating kneecap,3028.8,1968.72,78.57,2200.3,19
HCPCS,27422,Repair of dislocating kneecap with realignment,2019.2,1312.48,78.57,2199.74,19
HCPCS,27424,Reconstruction of dislocating kneecap with removal,2079.0,1351.35,78.57,2210.56,19
HCPCS,27425,Release of ligaments of knee joint,3024.0,1965.6,78.57,1329.06,19
HCPCS,27427,Reconstruction of ligaments outside knee joint,3650.85,2373.05,78.57,2109.75,19
HCPCS,27428,Reconstruction ligaments inside knee joint,3402.0,2211.3,78.57,3297.45,19
HCPCS,27429,Reconstruction of ligaments inside and outside knee joint,3780.0,2457.0,78.57,3706.86,19
HCPCS,27430,Repair of muscle group above knee joint,2019.2,1312.48,78.57,2191.16,19
HCPCS,27435,Incision of back portion of knee joint capsule,2127.3,1382.75,78.57,2393.86,19
HCPCS,27437,Repair of kneecap,1529.88,994.42,78.57,1952.34,19
HCPCS,27438,Repair of kneecap with prosthesis,3389.4,2203.11,78.57,2487.93,19
HCPCS,27440,Repair of lower part of knee joint,2690.1,1748.57,78.57,2356.81,19
HCPCS,27441,Repair of lower part of knee joint with prosthesis and removal of joint lining,2818.2,1831.83,78.57,2437.44,19
HCPCS,27442,Repair of end of thigh or lower leg bone at knee joint with prosthesis,2338.4,1519.96,78.57,2573.73,19
HCPCS,27443,Knee replacement with repair of end of thigh or lower leg bone and removal of knee joint lining,2656.5,1726.73,78.57,2408.13,19
HCPCS,27445,Knee joint replacement using hinged prosthesis,5433.75,3531.94,78.57,3710.74,15
HCPCS,27446,Replacement of knee joint on side of knee,5380.2,3497.13,78.57,3433.33,19
HCPCS,27447,"Replacement of knee joint, both sides of knee",7686.0,4995.9,78.57,3848.22,19
HCPCS,27448,Incision or partial removal of middle portion of thigh bone,3554.85,2310.65,78.57,2318.29,19
HCPCS,27450,Incision or partial removal of middle portion of thigh bone with stabilizing device,4515.6,2935.14,78.57,3009.45,19
HCPCS,27454,Multiple incisions or removals of parts of middle portion of thigh bone with placement of rod,3060.8,1989.52,78.57,3837.48,19
HCPCS,27455,"Incision or partial removal of upper portion of lower leg bone to repair deformity, before bone growth completed",2541.0,1651.65,78.57,2786.92,19
HCPCS,27457,"Incision or partial removal of upper portion of lower leg bone to repair deformity, after bone growth completed",3929.7,2554.31,78.57,2843.76,19
HCPCS,27465,Shortening of thigh bone,3330.6,2164.89,78.57,3705.48,19
HCPCS,27466,Lengthening of thigh bone,3394.7,2206.56,78.57,3499.3,19
HCPCS,27468,Lengthening and shortening of thigh bone,4931.9,3205.74,78.57,3974.87,15
HCPCS,27470,Repair of nonhealed broken thigh bone,4792.8,3115.32,78.57,3486.08,19
HCPCS,27472,Repair of nonhealed broken thigh bone with self bone graft,5183.4,3369.21,78.57,3739.93,19
HCPCS,27475,Removal of growth plate at lower end of thigh bone,1812.3,1178.0,78.57,1958.31,19
HCPCS,27477,Removal of growth plate of both lower leg bones,2062.2,1340.43,78.57,2169.99,19
HCPCS,27479,Removal of growth plate of leg and thigh bones,2626.1,1706.97,78.57,2722.1,19
HCPCS,27485,Removal of growth plate of leg or thigh bones,1791.3,1164.35,78.57,1984.74,19
HCPCS,27486,Revision of component of total knee joint prosthesis,8758.65,5693.12,78.57,4167.09,19
HCPCS,27487,Revision of thigh and lower leg bone components of total knee joint prosthesis,11240.85,7306.55,78.57,5210.53,19
HCPCS,27488,Removal of total knee joint prosthesis,4873.05,3167.48,78.57,3557.69,19
HCPCS,27495,Stabilization of thigh bone with device,4606.95,2994.52,78.57,3336.91,19
HCPCS,27496,Incision of connective tissue of thigh and/or knee to relieve pressure,1339.8,870.87,78.57,1609.72,19
HCPCS,27497,Incision of tissue of thigh and/or knee with tissue removal to relieve pressure,1632.8,1061.32,78.57,1719.1,19
HCPCS,27498,Multiple incisions of connective tissue of thigh and/or knee to relieve pressure,1592.9,1035.39,78.57,1936.23,19
HCPCS,27499,Multiple incisions of connective tissue of thigh and/or knee with tissue removal to relieve pressure,2549.4,1657.11,78.57,2068.73,19
HCPCS,27500,Closed treatment of broken thigh bone,2895.0,1881.75,78.57,9297.0,38
HCPCS,27501,Closed treatment of broken thigh bone at lower end,2794.5,1816.425,0.01,8700.44,55
HCPCS,27502,Closed treatment of broken thigh bone at midportion with manipulation,4480.5,2912.325,78.57,14929.43,38
HCPCS,27503,Closed treatment of broken thigh bone at far end with manipulation,3225.0,2096.25,78.57,2367.79,19
HCPCS,27506,Treatment of broken shaft of thigh bone with implant,5419.65,3522.77,78.57,3962.54,19
HCPCS,27507,Treatment of broken middle of thigh bone with placement of stabilizing device,4005.3,2603.45,78.57,2878.11,19
HCPCS,27508,Closed treatment of broken inside or outside portion of lower end of thigh bone,2182.5,1418.625,0.01,6120.53,55
HCPCS,27509,Treatment of broken thigh bone at far end with placement of stabilizing device,1705.2,1108.38,78.57,1922.21,19
HCPCS,27510,Closed treatment of broken thigh bone at knee area with manipulation,3998.25,2598.865,78.57,14143.06,38
HCPCS,27511,Treatment of broken thigh bone at far end,4158.0,2702.7,78.57,2953.25,19
HCPCS,27513,Treatment of broken thigh bone in knee area,5214.9,3389.69,78.57,3673.63,19
HCPCS,27514,Treatment of broken side of lower end of thigh bone,4742.4,3082.56,78.57,2866.51,19
HCPCS,27516,Closed treatment of thigh bone growth plate broken at end of thigh bone,1663.5,1081.275,78.57,5208.9,38
HCPCS,27517,Closed treatment of growth plate broken at end of thigh bone with manipulation,3015.0,1959.75,78.57,2023.6,19
HCPCS,27519,Treatment of broken growth plate at end of thigh bone,2946.3,1915.1,78.57,2638.85,19
HCPCS,27520,Closed treatment of broken kneecap,1488.75,967.69,0.01,4629.13,55
HCPCS,27524,Treatment of broken kneecap with placement of stabilizing device and/or removal of kneecap,3030.3,1969.7,78.57,2226.16,19
HCPCS,27530,Closed treatment of broken shin bone,1548.0,1006.2,0.01,4121.67,55
HCPCS,27532,Closed treatment of broken shin bone with traction,3220.5,2093.325,78.57,10435.88,38
HCPCS,27535,Treatment of broken side of upper end of shin bone,3715.5,2415.08,78.57,2659.59,19
HCPCS,27536,Treatment of broken shin bone on both sides of upper end,4825.8,3136.77,78.57,3519.74,19
HCPCS,27538,Closed treatment of broken top of shin bone at knee,1382.5,898.625,78.57,4196.56,38
HCPCS,27540,Treatment of broken shin bone at knee,2242.8,1457.82,78.57,2409.82,19
HCPCS,27550,Closed treatment of dislocated knee,2264.25,1471.7649999999999,78.57,6736.45,38
HCPCS,27552,Closed treatment of dislocated knee under anesthesia,1646.4,1070.16,78.57,1857.73,19
HCPCS,27556,Treatment of dislocated knee,2562.0,1665.3,78.57,2593.73,19
HCPCS,27557,Treatment of dislocated knee with ligament repair,2548.9,1656.79,78.57,3094.94,19
HCPCS,27558,Treatment of dislocated knee with ligament repair and reconstruction,3333.8,2166.97,78.57,3526.28,19
HCPCS,27560,Closed treatment of dislocated kneecap,1446.75,940.39,78.57,4218.51,38
HCPCS,27562,Closed treatment of dislocated kneecap under anesthesia,1215.9,790.34,78.57,1431.17,19
HCPCS,27566,Treatment of dislocated kneecap,2062.88,1340.87,78.57,2639.57,19
HCPCS,27570,Manipulation of knee joint under anesthesia,3068.25,1994.365,78.57,14143.06,38
HCPCS,27580,Fusion of knee joint,5874.75,3818.59,78.57,4271.92,19
HCPCS,27590,Amputation of thigh through thigh bone,5427.575,3527.925,78.57,19239.63,38
HCPCS,27591,Amputation of thigh through thigh bone with immediate fitting for prosthesis,2494.8,1621.62,78.57,2856.0,19
HCPCS,27592,Amputation of thigh through thigh bone leaving wound,3937.5,2559.38,78.57,1984.43,19
HCPCS,27594,Secondary closure or revision of scar at previous thigh amputation,2069.55,1345.21,78.57,1490.26,19
HCPCS,27596,Re-amputation of thigh through thigh bone,3110.7,2021.96,78.57,2106.81,19
HCPCS,27598,Removal of leg at knee joint,3583.2,2329.08,78.57,2081.61,19
HCPCS,27599,Other procedure on thigh or knee,630.0,409.5,157.5,2166.29,38
HCPCS,27600,Incision of connective tissue of front or side of lower leg to relieve pressure,4758.375,3092.945,78.57,20143.5,38
HCPCS,27601,Incision of connective tissue of back of lower leg to relieve pressure,1781.4,1157.91,78.57,1316.94,19
HCPCS,27602,Incision of connective tissue of front and/or side and back of lower leg to relieve pressure,7420.0,4823.0,78.57,20143.5,57
HCPCS,27603,Drainage of deep abscess or blood accumulation of leg or ankle,6444.0,4188.6,78.57,24962.45,57
HCPCS,27604,Drainage of infected fluid-filled sac (bursa) of leg or ankle,1343.0,872.95,60.04,1077.32,19
HCPCS,27605,Incision of Achilles tendon using local anesthetic,2371.5,1541.475,78.57,9428.71,38
HCPCS,27606,Incision of Achilles tendon under anesthesia,2244.45,1458.89,78.57,834.14,19
HCPCS,27607,Incision of leg or ankle bone,2742.15,1782.4,78.57,1815.55,19
HCPCS,27610,"Incision of ankle joint for exploration, fluid drainage, or removal of foreign body",1764.0,1146.6,78.57,1938.1,19
HCPCS,27612,Incision of ankle joint with release of joint lining,2316.9,1505.99,78.57,1706.57,19
HCPCS,27613,Biopsy of surface tissue of leg or ankle,1987.95,1292.17,78.57,8703.03,38
HCPCS,27614,Biopsy of deep tissue of leg or ankle,2559.45,1663.64,78.57,1405.59,19
HCPCS,27615,"Extensive removal of growth of leg or ankle, less than 5.0 cm",3360.0,2184.0,78.57,3033.46,19
HCPCS,27616,"Extensive removal of growth of leg or ankle, 5.0 cm or more",5166.0,3357.9,78.57,3751.68,19
HCPCS,27618,"Removal of growth under skin of leg or ankle, less than 3.0 cm",1716.6999999999998,1115.8600000000001,78.57,1163.2,38
HCPCS,27619,"Removal of growth of muscle of leg or ankle, less than 5.0 cm",2959.5,1923.68,0.01,8793.41,55
HCPCS,27620,Incision and exploration of ankle joint,1274.7,828.56,78.57,1354.37,19
HCPCS,27625,Removal of membrane covering of ankle joint,2422.35,1574.53,78.57,1717.43,19
HCPCS,27626,Removal of membrane covering ankle joint and tendon,2138.1,1389.77,78.57,1830.94,19
HCPCS,27630,Removal of growth of leg and/or ankle tendon lining or capsule,2093.25,1360.61,78.57,1284.09,19
HCPCS,27632,"Removal of growth under skin of leg or ankle, 3.0 cm or more",1668.0,1084.2,78.57,1220.96,19
HCPCS,27634,"Removal of growth of muscle of leg or ankle, 5.0 cm or more",2724.75,1771.09,78.57,2012.88,19
HCPCS,27635,Removal of cyst or growth of lower leg bone,2509.05,1630.88,78.57,1730.71,19
HCPCS,27637,Removal of cyst or growth of lower leg bone with self bone graft,2041.2,1326.78,78.57,2218.63,19
HCPCS,27638,Removal of cyst or growth of lower leg bone with bone graft,2105.3,1368.45,78.57,2277.97,19
HCPCS,27640,Partial removal of shin bone,3939.15,2560.45,78.57,2476.8,19
HCPCS,27641,Partial removal of outer lower leg bone,2259.6,1468.74,78.57,1983.94,19
HCPCS,27645,Extensive removal of growth of shin bone,3500.0,2275.0,78.57,5261.6,19
HCPCS,27646,Extensive removal of growth of outer leg bone,3575.0,2323.75,78.57,4558.41,19
HCPCS,27647,Extensive removal of growth of heel bone,2238.6,1455.09,78.57,3132.01,19
HCPCS,27648,Injection for X-ray imaging of ankle,569.15,369.95,40.26,2166.29,38
HCPCS,27650,Repair of ruptured Achilles tendon,2721.6,1769.04,78.57,1971.89,19
HCPCS,27652,Repair of ruptured Achilles tendon with graft,1965.6,1277.64,78.57,2041.85,19
HCPCS,27654,Secondary repair of ruptured Achilles tendon,3074.4,1998.36,78.57,2137.49,19
HCPCS,27656,Repair of connective tissue defect of leg,1399.7,909.81,78.57,1290.67,19
HCPCS,27658,Primary repair of tendon on back of leg,1362.9,885.89,78.57,1119.16,19
HCPCS,27659,Secondary repair of tendon on back of leg,1716.8,1115.92,78.57,1429.07,19
HCPCS,27664,Primary repair of tendon on front of leg,1926.8,1252.42,78.57,1084.92,19
HCPCS,27665,Secondary repair of tendon on front of leg,1517.3,986.25,78.57,1244.59,19
HCPCS,27675,Repair of dislocating lower leg tendons without a cut through the lower leg bone on the outside of the leg (fibula),1385.0,900.25,78.57,1482.48,19
HCPCS,27676,Repair of dislocated lower leg tendons by incision or partial removal of lower leg bone,1647.5,1070.88,78.57,1800.39,19
HCPCS,27680,Release of leg and/or ankle tendon,1239.0,805.35,78.57,1270.21,19
HCPCS,27681,Release of multiple leg and/or ankle tendons,1393.4,905.71,78.57,1553.76,19
HCPCS,27685,Lengthening or shortening of tendon of leg or ankle,1667.4,1083.81,78.57,1574.55,19
HCPCS,27686,Lengthening or shortening of multiple tendons of leg or ankle,2986.2,1941.03,78.57,1631.34,19
HCPCS,27687,Lengthening of calf muscle,1986.15,1291.0,78.57,1366.37,19
HCPCS,27690,Transfer of tendon and muscle rerouting at lower leg or ankle,1731.5,1125.48,78.57,1924.72,19
HCPCS,27691,Transfer of deep tendon of foot with muscle rerouting,3038.25,1974.86,78.57,2228.94,19
HCPCS,27692,"Transfer of tendon with muscle rerouting at foot, each additional tendon",306.6,199.29,78.57,304.7,19
HCPCS,27695,Primary repair of disrupted ankle ligament,2085.3,1355.45,78.57,1426.76,19
HCPCS,27696,Primary repair of disruption of both ankle ligaments,2690.1,1748.57,78.57,1677.14,19
HCPCS,27698,Secondary repair of disrupted collateral ligament of ankle,2978.4,1935.96,78.57,1916.26,19
HCPCS,27700,Reconstruction of ankle joint,3843.0,2497.95,78.57,1864.52,19
HCPCS,27702,Reconstruction of ankle joint with prosthesis,4057.2,2637.18,78.57,2866.15,19
HCPCS,27703,Repair of ankle joint with revision of prosthesis,2591.0,1684.15,78.57,3308.84,19
HCPCS,27704,Removal of ankle implant,1529.9,994.44,78.57,1708.26,19
HCPCS,27705,Incision or partial removal of shin bone,3109.05,2020.88,78.57,2257.54,19
HCPCS,27707,Incision or partial removal of lower leg bone,1573.5,1022.78,78.57,1189.66,19
HCPCS,27709,Incision or partial removal of shin and outer lower leg bones,3083.9,2004.54,78.57,3453.42,19
HCPCS,27712,Insertion of rod in shin bone,2964.2,1926.73,78.57,3259.29,19
HCPCS,27715,Lengthening or shortening of lower leg bones,2892.8,1880.32,78.57,3167.78,19
HCPCS,27720,Repair of nonhealed broken shin bone,3576.9,2324.99,78.57,2593.03,19
HCPCS,27722,Repair of nonhealed broken shin bone with bone graft,2498.0,1623.7,78.57,2634.7,19
HCPCS,27724,Repair of nonhealed broken shin bone with self graft from hip or other bone,5241.6,3407.04,78.57,3746.51,19
HCPCS,27725,Fusion of nonhealed broken shin bone with outer lower leg bone,3586.8,2331.42,78.57,3602.64,19
HCPCS,27726,Repair of nonhealed broken outer lower leg bone with placement of stabilizing device,3776.85,2454.95,78.57,2850.41,19
HCPCS,27727,Repair of congenital nonhealed broken shin bone,2864.4,1861.86,78.57,3038.78,19
HCPCS,27730,Scraping or stapling of shin bone growth plate of lower leg bone at ankle,2290.1,1488.57,78.57,1735.94,19
HCPCS,27732,Fusion of lower outer leg bone growth plate,1550.9,1008.09,78.57,1327.36,19
HCPCS,27734,Fusion of lower end of growth plate of lower leg bone,1742.0,1132.3,78.57,1941.92,19
HCPCS,27740,Fusion of lower and upper ends of growth plates of lower leg bones,2751.0,1788.15,78.57,2095.5,19
HCPCS,27742,Fusion of lower and upper ends of growth plates of lower leg and thigh bones,1780.73,1157.47,78.57,2301.35,19
HCPCS,27745,Placement of stabilizing device for shin bone,3050.85,1983.05,78.57,2236.43,19
HCPCS,27750,Closed treatment of broken middle part of shin bone,1701.75,1106.1399999999999,0.01,5458.11,55
HCPCS,27752,Closed treatment of middle part of broken shin bone with manipulation,2703.0,1756.95,78.57,8460.27,38
HCPCS,27756,Placement of stabilizing device for broken middle part of shin bone,1576.1,1024.47,78.57,1712.24,19
HCPCS,27758,Treatment broken middle part of shin bone with plate or screws,3589.5,2333.18,78.57,2644.4,19
HCPCS,27759,Treatment of broken part of shin bone with rod,4068.3,2644.4,78.57,2957.77,19
HCPCS,27760,Closed treatment of inside portion of shin bone at ankle,1242.75,807.79,0.01,3203.59,55
HCPCS,27762,Closed treatment of inside portion of shin bone at ankle with manipulation,2445.5,1589.575,78.57,9428.71,38
HCPCS,27766,Treatment of inside portion of broken shin bone at ankle,2428.65,1578.62,78.57,1798.96,19
HCPCS,27767,Closed treatment of back portion of shin bone at ankle,990.75,643.99,78.57,839.11,19
HCPCS,27768,Closed treatment of back portion of shin bone at ankle with manipulation,3536.775,2298.9049999999997,78.57,14143.06,38
HCPCS,27769,Treatment of broken back portion of shin bone at ankle,2803.5,1822.28,78.57,2160.44,19
HCPCS,27780,Closed treatment of broken middle or upper end of outside lower leg bone,1038.75,675.19,78.57,2498.57,38
HCPCS,27781,Closed treatment of broken middle or upper end of outside lower leg bone with manipulation,3525.75,2291.74,78.57,14143.06,38
HCPCS,27784,Treatment of broken upper or middle part of outer lower leg bone,1862.7,1210.76,78.57,2119.94,19
HCPCS,27786,Closed treatment of broken outside lower leg bone at ankle,1068.75,694.69,0.01,2498.57,55
HCPCS,27788,Closed treatment of broken outside lower leg bone at ankle with manipulation,2039.25,1325.5149999999999,78.57,6310.34,38
HCPCS,27792,Treatment of broken outer lower leg bone at ankle,2819.25,1832.51,78.57,1927.63,19
HCPCS,27808,Closed treatment of 2 broken lower leg bones at ankle,1252.5,814.125,0.01,3253.95,55
HCPCS,27810,Closed treatment of 2 broken lower leg bones at ankle with manipulation,2510.25,1631.665,78.57,8239.47,38
HCPCS,27814,Treatment of both broken lower leg bones at ankle,3120.15,2028.1,78.57,2281.18,19
HCPCS,27816,Closed treatment of 3 broken lower leg bones at ankle,1108.5,720.525,0.01,2626.4,55
HCPCS,27818,Closed treatment of 3 broken lower leg bones at ankle with manipulation,3039.0,1975.35,0.01,9942.63,55
HCPCS,27822,Treatment of 3 broken lower leg bones at ankle,3414.6,2219.49,78.57,2549.13,19
HCPCS,27823,Treatment of 3 broken lower leg bones at ankle with fixation of posterior lip,3895.05,2531.78,78.57,2886.84,19
HCPCS,27824,Closed treatment of broken shin bone at lower weight bearing joint,2028.0,1318.2,78.57,6833.3,38
HCPCS,27825,Closed treatment of broken shin bone at lower weight bearing joint with manipulation and/or traction,3810.75,2476.99,78.57,14143.06,38
HCPCS,27826,Treatment of broken outer lower leg bone at lower weight bearing joint,3306.0,2148.9,78.57,2505.4,19
HCPCS,27827,Treatment of broken shin bone at lower weight bearing joint,4378.5,2846.03,78.57,3266.41,19
HCPCS,27828,Treatment of broken lower weight bearing joint of both lower leg bones,5259.0,3418.35,78.57,3895.57,19
HCPCS,27829,Treatment of ligament tear at ankle joint,2652.3,1724.0,78.57,2066.06,19
HCPCS,27830,Closed treatment of dislocated knee joint,920.0,598.0,78.57,1048.84,19
HCPCS,27831,Closed treatment of dislocated knee joint under anesthesia,1817.75,1181.54,78.57,6456.25,38
HCPCS,27832,Treatment of dislocated knee joint,1912.1,1242.87,78.57,2234.76,19
HCPCS,27840,Closed treatment of dislocated ankle,1438.5,935.025,0.01,3633.58,55
HCPCS,27842,Closed treatment of dislocated ankle under anesthesia,1300.0,845.0,78.57,1454.87,19
HCPCS,27846,Treatment of dislocated ankle,2984.7,1940.06,78.57,2143.49,19
HCPCS,27848,Treatment of dislocated ankle with repair or placement of stabilizing device,3379.95,2196.97,78.57,2377.37,19
HCPCS,27860,Manipulation of ankle under general anesthesia,479.9,311.94,78.57,508.85,19
HCPCS,27870,"Fusion of ankle joint, open procedure",4277.7,2780.51,78.57,3058.37,19
HCPCS,27871,Fusion of lower leg bone at knee or ankle joint,2795.7,1817.21,78.57,2044.7,19
HCPCS,27880,Amputation of both lower leg bones,5626.6,3657.29,78.57,19156.99,38
HCPCS,27881,Amputation of both lower leg bones with immediate fitting,2436.0,1583.4,78.57,2537.57,19
HCPCS,27882,Amputation of both lower leg bones leaving wound,2913.75,1893.94,78.57,1745.01,19
HCPCS,27884,Secondary closure or revision of scar of lower leg bone amputation,1598.1,1038.77,78.57,1671.37,19
HCPCS,27886,Re-amputation of lower leg,2992.5,1945.13,78.57,1922.21,19
HCPCS,27888,Amputation of foot at ankle with reconstruction of skin and tissue,2100.0,1365.0,78.57,1960.52,19
HCPCS,27889,Removal of foot at ankle joint,1995.0,1296.75,78.57,1893.28,19
HCPCS,27892,Incision of connective tissue of lower leg to relieve pressure with removal of muscle and/or nerve,2439.75,1585.84,78.57,1618.9,19
HCPCS,27893,Incision of connective tissue at back of lower leg to relieve pressure with removal of muscle and/or nerve,1626.5,1057.23,78.57,1804.08,19
HCPCS,27894,Incision of connective tissue at front and/or side and back of lower leg to relieve pressure with removal of muscle and/or nerve,2313.2,1503.58,78.57,2460.89,19
HCPCS,28001,Drainage of fluid filled sac in foot,784.4,509.86,54.98,413.46,19
HCPCS,28002,Drainage of fluid filled sac below connective tissue in foot joint,1334.6,867.49,78.57,594.53,19
HCPCS,28003,Drainage of fluid filled sacs beneath connective tissue in multiple foot joints,1839.6,1195.74,78.57,913.43,19
HCPCS,28005,Incision of foot bone,1697.9,1103.64,78.57,1772.51,19
HCPCS,28008,Incision of connective tissue of foot and/or toe,4233.0,2751.4500000000003,78.57,18883.24,38
HCPCS,28010,Repair of toe tendon,774.9,503.69,68.91,644.35,19
HCPCS,28011,Repair of multiple toe tendons,1866.55,1213.26,0.01,6869.45,36
HCPCS,28020,"Incision of foot at ankle joint for exploration, fluid drainage, or removal of foreign body",1344.0,873.6,78.57,1308.55,19
HCPCS,28022,"Incision of midfoot joint for exploration, fluid drainage, or removal of foreign body",1256.9,816.99,78.57,1164.73,19
HCPCS,28024,"Incision of toe joint for exploration, fluid drainage, or removal of foreign body",1185.5,770.58,78.57,1101.26,19
HCPCS,28035,Release of nerve between tissue and ankle bone,2016.0,1310.4,78.57,1265.05,19
HCPCS,28039,Removal (1.5 centimeters or greater) tissue growth beneath the skin of foot or toe,1797.15,1168.15,78.57,1152.22,19
HCPCS,28041,"Removal of growth of muscle of foot or toe, 1.5 cm or more",1849.05,1201.88,78.57,1384.34,19
HCPCS,28043,Removal (less than 1.5 centimeters) tissue growth beneath the skin of foot or toe,1489.95,968.47,78.57,922.73,19
HCPCS,28045,"Removal of growth of muscle of foot or toe, less than 1.5 cm",1273.7,827.91,78.57,1156.82,19
HCPCS,28046,"Extensive removal of growth of foot or toe, less than 3.0 cm",2220.8,1443.52,78.57,2201.65,19
HCPCS,28047,"Extensive removal of growth of foot or toe, 3.0 cm or more",2626.1,1706.97,78.57,3149.29,19
HCPCS,28050,Biopsy through a joint opening in the midfoot,1211.7,787.61,78.57,999.85,19
HCPCS,28052,Incision of midfoot joint with biopsy,1106.7,719.36,78.57,936.23,19
HCPCS,28054,Incision of toe joint with biopsy,1028.0,668.2,78.57,880.65,19
HCPCS,28055,Removal of nerve of foot muscle,954.7,620.56,78.57,1175.8,19
HCPCS,28060,Partial removal of connective tissue at sole of foot,2011.35,1307.38,78.57,1239.45,19
HCPCS,28062,Removal of connective tissue at sole of foot,1407.93,915.15,78.57,1386.06,19
HCPCS,28070,Removal of foot bone joint lining at ankle,1276.08,829.45,78.57,1214.84,19
HCPCS,28072,Removal of joint lining of toe joint at foot,1313.6,853.84,78.57,1171.47,19
HCPCS,28080,Removal of fibrous nerve growth from between toes,1317.8,856.57,78.57,1275.72,19
HCPCS,28086,Removal of lining of tendon on under surface of foot,1473.2,957.58,78.57,1268.28,19
HCPCS,28088,Removal of lining of tendon on upper surface of foot,1171.8,761.67,78.57,1099.22,19
HCPCS,28090,Removal of growth of tendon covering or joint capsule of foot,1210.7,786.96,78.57,1115.55,19
HCPCS,28092,Removal of growth of tendon covering or joint capsule of toes,1088.9,707.79,78.57,1010.06,19
HCPCS,28100,Removal of cyst or growth of heel or ankle bone,2290.05,1488.53,78.57,1461.33,19
HCPCS,28102,Removal of cyst or growth of heel or ankle bone with self bone graft,1416.5,920.73,78.57,1794.48,19
HCPCS,28103,Removal of cyst or growth of heel or ankle bone with donor bone graft,1811.25,1177.31,78.57,1211.17,19
HCPCS,28104,Removal of cyst or growth of foot bone,1341.9,872.24,78.57,1252.68,19
HCPCS,28106,Removal of cyst or growth of foot bone with self bone graft,1278.9,831.29,78.57,1328.45,19
HCPCS,28107,Removal of cyst or growth of foot bone with bone graft,1434.3,932.3,78.57,1216.77,19
HCPCS,28108,Removal of cyst or growth of toe bone,1138.2,739.83,78.57,1172.35,19
HCPCS,28110,Removal of bunion at fifth toe joint,4600.7,2990.455,78.57,19162.15,38
HCPCS,28111,Removal of foot bone at great toe joint,4369.95,2840.4700000000003,78.57,19162.15,38
HCPCS,28112,"Removal of toe bone at second, third, or fourth joints",4341.6,2822.04,78.57,19162.15,38
HCPCS,28113,Complete removal of foot bone at fifth toe joint,4477.55,2910.41,78.57,19162.15,38
HCPCS,28114,Complete removal of second to fifth foot bones,5074.5,3298.425,78.57,19162.15,38
HCPCS,28116,Removal of abnormal bones at ankle joint,4713.8,3063.9700000000003,78.57,19162.15,38
HCPCS,28118,Removal of heel bone,4845.575,3149.625,78.57,19162.15,38
HCPCS,28119,Removal of heel bone spur,4396.7,2857.855,78.57,19162.15,38
HCPCS,28120,Partial removal of infected foot or heel bone,4825.1,3136.315,78.57,19162.15,38
HCPCS,28122,Partial removal of foot or heel bone,5214.3,3389.295,78.57,20151.25,38
HCPCS,28124,Partial removal of toe bone,4655.0,3025.75,78.57,19162.15,38
HCPCS,28126,Removal of toe bone at foot,4220.85,2743.555,78.57,19162.15,38
HCPCS,28130,Removal of ankle joint bone,1761.9,1145.24,78.57,1889.28,19
HCPCS,28140,Removal of foot bone,1634.9,1062.69,78.57,1360.83,19
HCPCS,28150,Removal of toe,1157.1,752.12,78.57,1003.0,19
HCPCS,28153,Removal of end of toe at joint,1084.7,705.06,78.57,972.19,19
HCPCS,28160,Partial removal of toe at joint,1084.7,705.06,78.57,978.62,19
HCPCS,28171,Extensive removal of growth of middle portion of foot bone,1731.5,1125.48,78.57,3297.12,19
HCPCS,28173,Extensive removal of growth of foot bone,1890.0,1228.5,78.57,2274.99,19
HCPCS,28175,Extensive removal of growth of toe bone,1443.8,938.47,78.57,1465.48,19
HCPCS,28190,"Removal of foreign body of foot tissue, accessed beneath the skin",1719.0,1117.35,0.01,6658.98,74
HCPCS,28192,"Removal of foreign body of foot tissue, deep",4040.0,2626.0,78.57,15649.95,57
HCPCS,28193,Complicated removal of foreign body in foot,2732.95,1776.42,78.57,10433.3,57
HCPCS,28200,Repair of tendon on sole of foot,1244.3,808.8,78.57,1182.81,19
HCPCS,28202,Secondary repair of tendon on sole of foot with graft,1486.8,966.42,78.57,1443.12,19
HCPCS,28208,Repair of tendon of top side of foot,1199.1,779.42,78.57,1163.72,19
HCPCS,28210,Repair of tendon on top side of foot with graft,1393.78,905.96,78.57,1426.67,19
HCPCS,28220,Removal of scar tissue of tendon on bottom side of foot,1188.6,772.59,78.57,1080.6,19
HCPCS,28222,Removal of scar tissue of multiple foot tendons,1369.2,889.98,78.57,1265.05,19
HCPCS,28225,Removal of scar tissue of tendon on top side of foot,1044.8,679.12,78.57,989.19,19
HCPCS,28226,Removal of scar tissue of multiple tendons at top of foot,1219.1,792.42,78.57,1465.8,19
HCPCS,28230,Incision to lengthen foot tendon,1708.95,1110.82,78.57,1040.43,19
HCPCS,28232,Incision to lengthen toe tendon,1071.9499999999998,696.77,78.57,904.88,38
HCPCS,28234,Incision to release foot tendon,1124.7,731.06,52.24,979.81,38
HCPCS,28238,Reconstruction of ankle tendon with removal of extra ankle joint bone,1778.7,1156.16,78.57,1615.95,19
HCPCS,28240,Release or lengthening of tendon in foot,1162.4,755.56,78.57,1063.4,19
HCPCS,28250,Incision of connective tissue and muscle of sole of foot,1471.1,956.22,78.57,1400.04,19
HCPCS,28260,Incision of ankle joint capsule to correct foot deformity,1813.4,1178.71,78.57,1714.47,19
HCPCS,28261,Incision of ankle joint capsule and lengthening of tendon,3907.65,2539.97,78.57,2831.98,19
HCPCS,28262,Extensive repair of foot defect with tendon lengthening and relief of tension in foot,3607.8,2345.07,78.57,3406.24,19
HCPCS,28264,Release of capsule of midfoot,2232.3,1451.0,78.57,2118.11,19
HCPCS,28270,Incision of joint capsule of foot and toe,1902.6,1236.69,78.57,1165.5,19
HCPCS,28272,Incision of toe joint capsule,1042.7,677.76,78.57,919.99,19
HCPCS,28280,Creation of webbing between toes,1357.7,882.51,78.57,1221.91,19
HCPCS,28285,Correction of toe joint deformity,1226.4,797.16,78.57,1288.76,19
HCPCS,28286,Correction of fifth toe joint deformity,1203.3,782.15,78.57,1059.68,19
HCPCS,28288,Removal of foot bone spur,1550.9,1008.09,78.57,1444.49,19
HCPCS,28289,Correction of rigid deformity of first joint of big toe,2866.5,1863.23,78.57,1647.08,19
HCPCS,28291,Correction of rigid deformity of first joint of big toe using implant,1155.0,750.75,78.57,1675.36,19
HCPCS,28292,Correction of bunion,2068.5,1344.53,78.57,1669.52,19
HCPCS,28295,Correction of bunion with alignment correction of midfoot bone toward ankle,1290.5,838.83,78.57,2555.96,19
HCPCS,28296,Correction of bunion with alignment correction of midfoot bone toward toe area,3001.95,1951.27,78.57,2127.13,19
HCPCS,28297,Correction of bunion with forefoot and midfoot bone fusion,3246.15,2110.0,78.57,2459.97,19
HCPCS,28298,Correction of bunion with alignment correction of big toe,1886.9,1226.49,78.57,1991.78,19
HCPCS,28299,Correction of bunion with 2 areas of realignment,2153.6,1399.84,78.57,2414.72,19
HCPCS,28300,Incision or partial removal of heel bone,3194.1,2076.17,78.57,1952.37,19
HCPCS,28302,Incision or partial removal of ankle bone,3184.65,2070.02,78.57,2114.83,19
HCPCS,28304,Incision or partial removal of foot bone,3112.2,2022.93,78.57,1977.8,19
HCPCS,28305,Incision or partial removal of foot bone with bone graft,1992.9,1295.39,78.57,2010.66,19
HCPCS,28306,Incision or partial removal of big toe bone to straighten toe,1551.9,1008.74,78.57,1451.39,19
HCPCS,28307,Incision or partial removal of big toe bone with self bone graft to straighten toe,1819.7,1182.81,78.57,1861.41,19
HCPCS,28308,Incision or partial removal of foot bone (other than big toe) to straighten toe,2149.95,1397.47,78.57,1362.07,19
HCPCS,28309,Incision or partial removal of multiple foot bones to straighten toes,2483.3,1614.15,78.57,2677.27,19
HCPCS,28310,Incision or partial removal of big toe bone at first toe bone level to straighten toe,1409.1,915.92,78.57,1300.82,19
HCPCS,28312,Incision or partial removal of toe bone to straighten toe,1289.4,838.11,78.57,1274.48,19
HCPCS,28313,Reconstruction of soft tissue angular deformity of toe,1335.6,868.14,78.57,1261.49,19
HCPCS,28315,Removal of small bone underlying long bone of foot at big toe joint,1254.8,815.62,78.57,1149.72,19
HCPCS,28320,Repair of nonhealed broken midfoot bone,1733.6,1126.84,78.57,1841.29,19
HCPCS,28322,Repair of nonhealed broken forefoot bone,2007.6,1304.94,78.57,1874.82,19
HCPCS,28340,Reconstruction of abnormal toe,1422.8,924.82,78.57,1365.22,19
HCPCS,28341,Reconstruction of abnormal toe with bone removal,1642.2,1067.43,78.57,1586.19,19
HCPCS,28344,Removal of extra toes with reconstruction,1187.6,771.94,78.57,1007.14,19
HCPCS,28345,Removal of congenital web space deformity of toes,1460.6,949.39,78.57,1233.56,19
HCPCS,28360,Reconstruction of congenital foot defect,2462.3,1600.5,78.57,3222.12,19
HCPCS,28400,Closed treatment of broken heel bone,1051.5,683.475,0.01,2758.11,55
HCPCS,28405,Closed treatment of broken heel bone with manipulation,2091.75,1359.6399999999999,78.57,6620.24,38
HCPCS,28406,Placement of stabilizing device for broken heel bone with manipulation,2101.05,1365.68,78.57,1568.2,19
HCPCS,28415,Treatment of broken heel bone,4641.6,3017.04,78.57,3338.18,19
HCPCS,28420,Treatment of broken heel bone with graft,4895.1,3181.82,78.57,3773.02,19
HCPCS,28430,Closed treatment of broken ankle joint bone,1203.0,781.95,78.57,3734.3,38
HCPCS,28435,Closed treatment of broken ankle joint bone with manipulation,3383.25,2199.115,78.57,14143.06,38
HCPCS,28436,Placement of stabilizing device for broken ankle joint with manipulation,1165.5,757.58,78.57,1337.04,19
HCPCS,28445,Treatment of broken bone between foot and ankle,4380.15,2847.1,78.57,3122.55,19
HCPCS,28446,Implantation of self cartilage cells into foot joint with graft,4832.1,3140.87,78.57,3618.22,19
HCPCS,28450,Treatment of broken foot bone at ankle,682.5,443.625,0.01,2166.29,55
HCPCS,28455,Treatment of broken foot bone at ankle with manipulation,1010.0,656.5,78.57,3279.78,38
HCPCS,28456,Placement of stabilizing device for broken foot joint with manipulation,719.3,467.55,78.57,986.69,19
HCPCS,28465,Treatment of broken hind portion of foot,1673.7,1087.91,78.57,1899.7,19
HCPCS,28470,Closed treatment of broken bone in forefoot or midfoot,578.5,376.025,0.01,2166.29,55
HCPCS,28475,Closed treatment of broken foot with manipulation,465.0,302.25,0.01,2166.29,55
HCPCS,28476,Placement of stabilizing device for broken foot bone with manipulation,913.5,593.78,78.57,1053.2,19
HCPCS,28485,Treatment of broken midportion of foot,1446.9,940.49,78.57,1647.73,19
HCPCS,28490,Closed treatment of broken great toe,650.25,422.66499999999996,0.01,2166.29,55
HCPCS,28495,Closed treatment of broken great toe with manipulation,489.5,318.175,78.57,2166.29,38
HCPCS,28496,Placement of stabilizing device for broken big toe with manipulation,1677.45,1090.34,75.94,1087.18,19
HCPCS,28505,Treatment of broken great toe,4785.0,3110.25,78.57,20143.5,38
HCPCS,28510,Closed treatment of broken toe,302.5,196.625,0.01,2166.29,55
HCPCS,28515,Closed treatment of broken toe with manipulation,469.5,305.175,75.65,2166.29,38
HCPCS,28525,Treatment of broken toe,1456.4,946.66,78.57,1359.59,19
HCPCS,28530,Closed treatment of broken small bone in tendon attached to great toe,280.0,182.0,78.57,306.63,19
HCPCS,28531,Treatment of broken small bone in tendon attached to great toe,1054.2,685.23,78.57,791.22,19
HCPCS,28540,Closed treatment of dislocated ankle joint bone,510.5,331.825,78.57,2166.29,38
HCPCS,28545,Closed treatment of dislocated midfoot joint bone under anesthesia,755.0,490.75,78.57,827.41,19
HCPCS,28546,Placement of stabilizing device for dislocated midfoot joint with manipulation,2099.55,1364.71,78.57,1402.62,19
HCPCS,28555,Treatment of dislocated midfoot or hindfoot bones,3369.0,2189.85,78.57,2064.57,19
HCPCS,28570,Closed treatment of dislocated ankle joint,470.0,305.5,78.57,601.03,19
HCPCS,28575,Closed treatment of dislocated ankle joint under anesthesia,852.6,554.19,78.57,1036.14,19
HCPCS,28576,Placement of stabilizing device for dislocated ankle joint with manipulation,2105.85,1368.8,78.57,1159.02,19
HCPCS,28585,Treatment of dislocated ankle joint,2454.9,1595.69,78.57,2152.83,19
HCPCS,28600,Closed treatment of dislocated midfoot joint,495.5,322.075,0.01,2166.29,55
HCPCS,28605,Closed treatment of dislocated midfoot joint under anesthesia,723.5,470.28,78.57,929.78,19
HCPCS,28606,Placement of stabilizing device for dislocated midfoot with manipulation,1892.1,1229.87,78.57,1161.55,19
HCPCS,28615,Treatment of dislocated midfoot bone,2105.3,1368.45,78.57,2419.88,19
HCPCS,28630,Closed treatment of dislocated joint between toe and foot,452.8,294.32,78.57,2166.29,38
HCPCS,28635,Closed treatment of dislocated joint between toe and foot under anesthesia,523.25,340.11,78.57,424.72,19
HCPCS,28636,Placement of stabilizing device for dislocated joint between toe and foot with manipulation,822.2,534.43,78.57,744.96,19
HCPCS,28645,Treatment of dislocated joint between toe and foot,1689.5,1098.18,78.57,1556.23,19
HCPCS,28660,Closed treatment of dislocated joint in toe,302.5,196.625,78.57,2166.29,38
HCPCS,28665,Closed treatment of dislocated joint in toe under anesthesia,413.7,268.91,78.57,392.24,19
HCPCS,28666,Placement of stabilizing device for dislocated toe joint,797.0,518.05,78.57,487.52,19
HCPCS,28675,Treatment of dislocated toe joint,1479.5,961.68,78.57,1378.91,19
HCPCS,28705,Fusion of all bones of ankle and hindfoot,3617.3,2351.25,78.57,3715.63,19
HCPCS,28715,Fusion of 3 bones of ankle,4016.25,2610.56,78.57,2811.59,19
HCPCS,28725,Fusion of foot below ankle,3302.85,2146.85,78.57,2335.29,19
HCPCS,28730,Fusion of multiple foot joints,3463.5,2251.28,78.57,2207.6,19
HCPCS,28735,Fusion of multiple foot joints with bone incision to correct a foot deformity,2210.3,1436.7,78.57,2354.86,19
HCPCS,28737,Fusion of upper part of foot and lengthening of tendon,1945.7,1264.71,78.57,2111.17,19
HCPCS,28740,Fusion of foot in midfoot region,3320.1,2158.07,78.57,1974.42,19
HCPCS,28750,Fusion of big toe at joint with foot,3227.25,2097.71,78.57,1867.59,19
HCPCS,28755,Fusion of big toe between toe joints,1299.9,844.94,78.57,1207.29,19
HCPCS,28760,Fusion of big toe between toe joints with tendon transfer,2050.7,1332.96,78.57,1824.53,19
HCPCS,28800,Amputation of midfoot bone,5092.45,3310.0950000000003,78.57,20156.41,38
HCPCS,28805,Amputation of foot across instep,5294.525,3441.44,78.57,19154.4,38
HCPCS,28810,Amputation of toe and midfoot bone,4527.85,2943.105,78.57,20151.25,38
HCPCS,28820,Amputation of toe at joint between forefoot and toes,4586.1,2980.965,78.57,20151.25,38
HCPCS,28825,Amputation of toe at toe joint,2500.0,1625.0,0.01,20151.25,55
HCPCS,28890,Shock wave therapy to arch of foot using ultrasound guidance under anesthesia,774.08,503.15,78.57,797.3,19
HCPCS,29000,Application of halo type body cast,665.7,432.71,78.57,820.93,19
HCPCS,29010,Application of jacket type body cast,668.9,434.79,78.57,652.1,19
HCPCS,29015,Application of jacket type body cast including head,623.78,405.46,78.57,699.58,19
HCPCS,29035,Application of shoulder to hip body cast,613.2,398.58,67.02,613.33,19
HCPCS,29040,Application of shoulder to hip body cast including head,596.4,387.66,78.57,699.35,19
HCPCS,29044,Application of shoulder to hip body cast and thigh,665.7,432.71,78.57,686.38,19
HCPCS,29046,Application of shoulder to hip body cast and both thighs,724.5,470.93,78.57,750.72,19
HCPCS,29049,Application of figure-of-eight cast,171.9,111.74,60.44,236.37,19
HCPCS,29055,Application of shoulder spica cast,528.2,343.33,78.57,531.89,19
HCPCS,29058,Application of plaster Velpeau cast to upper forearm and shoulder,288.8,187.72,78.57,292.6,19
HCPCS,29065,Application of shoulder to hand cast,325.0,211.25,0.01,1242.0,55
HCPCS,29075,Application of elbow to finger cast,432.75,281.28999999999996,0.01,1382.93,55
HCPCS,29085,Application of hand and lower forearm cast,265.0,172.25,37.05,826.4,38
HCPCS,29086,Application of finger cast,131.3,85.35,34.77,184.58,19
HCPCS,29105,Application of lower and upper arm splint,373.5,242.775,0.01,1242.0,55
HCPCS,29125,Application of nonmoveable forearm to hand splint,195.0,126.75,0.01,1242.0,74
HCPCS,29126,Application of moveable or hinged forearm to hand splint,260.25,169.165,0.01,1242.0,55
HCPCS,29130,Application of nonmoveable finger splint,248.25,161.365,0.01,1242.0,55
HCPCS,29131,Application of hinged finger splint,120.2,78.13,28.6,127.21,19
HCPCS,29200,Placement of strapping to chest,140.7,91.46,14.98,79.35,19
HCPCS,29240,Placement of strapping to shoulder,157.5,102.38,14.98,78.57,19
HCPCS,29260,Placement of strapping to elbow or wrist,135.5,88.08,13.93,78.57,19
HCPCS,29280,Placement of strapping to hand or finger,190.0,123.5,0.01,1242.0,55
HCPCS,29305,Application of hip spica cast on leg,595.4,387.01,78.57,589.31,19
HCPCS,29325,"Application of hip spica cast on both legs, or on leg and part of other leg",663.6,431.34,78.57,650.24,19
HCPCS,29345,Application of long leg cast from thigh to toe,425.5,276.575,0.01,2166.29,55
HCPCS,29355,Application of walking cast covering thigh to toe,290.5,188.825,0.01,596.56,36
HCPCS,29358,Application of long leg brace-type cast from thigh to toe,400.0,260.0,43.16,381.33,19
HCPCS,29365,Application of thigh to lower leg cylinder cast,260.5,169.325,0.01,596.56,36
HCPCS,29405,Application of short leg cast,696.75,452.89,0.01,2707.75,55
HCPCS,29425,Application of walking cast covering below knee to toe,250.0,162.5,47.05,180.27,19
HCPCS,29435,Application of kneecap tendon bearing cast,302.4,196.56,71.65,274.21,19
HCPCS,29440,Addition of walker to previously applied cast,120.0,78.0,18.52,103.58,19
HCPCS,29445,"Application of walking cast covering foot, ankle, and lower leg",472.5,307.125,78.57,1226.69,38
HCPCS,29450,Application of leg cast and manipulation of foot to treat deformity,408.5,265.53,20.59,351.07,19
HCPCS,29505,Application of long leg splint from thigh to ankle or toe,491.25,319.315,27.96,1762.56,38
HCPCS,29515,Application of short leg splint from calf to foot,240.0,156.0,0.01,1242.0,74
HCPCS,29520,Placement of strapping to hip,74.75,48.59,14.98,84.95,19
HCPCS,29530,Placement of strapping to knee,68.23,44.35,14.98,78.57,19
HCPCS,29540,Placement of strapping to ankle or foot,235.95,153.37,14.61,767.0,38
HCPCS,29550,Placement of strapping to toes,121.525,78.99,0.01,511.34,55
HCPCS,29580,"Strapping, Unna boot",289.5,188.175,0.01,991.68,55
HCPCS,29581,"Application of vein wound compression bandages on lower leg, ankle, and foot",351.65999999999997,228.57999999999998,0.01,1251.22,55
HCPCS,29584,"Application of vein wound compression bandages on upper arm, forearm, hand, and fingers",234.9,152.69,13.02,739.89,38
HCPCS,29700,"Removal or cutting of gauntlet, boot, or body cast",190.5,123.825,0.01,1242.0,55
HCPCS,29705,Removal or cutting of full arm or leg cast,191.0,124.15,24.7,1242.0,38
HCPCS,29710,"Removal or cutting of shoulder, hip spica, or jacket cast",307.7,200.01,26.75,288.26,19
HCPCS,29720,"Repair of spica, body cast, or jacket",147.0,95.55,10.88,203.46,19
HCPCS,29730,Exam of skin surface by creation of opening in cast,160.0,104.0,13.57,151.6,19
HCPCS,29740,Insertion of wedge in cast,220.0,143.0,18.52,232.68,19
HCPCS,29750,Insertion of wedge in clubfoot cast,216.43,140.68,14.82,252.02,19
HCPCS,29800,Diagnostic exam of jaw joint using an endoscope,2472.75,1607.29,78.57,1562.05,19
HCPCS,29804,Exam of jaw joint using an endoscope,3661.95,2380.27,78.57,1873.49,19
HCPCS,29805,Diagnostic exam of shoulder using an endoscope,1139.3,740.55,78.57,1394.26,19
HCPCS,29806,Repair of shoulder joint capsule using an endoscope,4301.4,2795.91,78.57,3136.79,19
HCPCS,29807,Repair of shoulder socket using an endoscope,4188.0,2722.2,78.57,3065.8,19
HCPCS,29819,Removal of loose or foreign body in shoulder joint using an endoscope,1704.2,1107.73,78.57,1734.42,19
HCPCS,29820,Partial removal of shoulder joint lining using an endoscope,2556.3,1661.6,78.57,1589.96,19
HCPCS,29821,Removal of entire shoulder joint lining using an endoscope,2049.6,1332.24,78.57,1747.59,19
HCPCS,29822,Limited removal of abnormal shoulder joint tissue using endoscope,2880.0,1872.0,78.57,1642.69,19
HCPCS,29823,Removal of extensive shoulder joint tissue using an endoscope,3203.55,2082.31,78.57,1797.66,19
HCPCS,29824,Partial removal of collar bone at shoulder using an endoscope,2685.0,1745.25,78.57,1991.59,19
HCPCS,29825,Removal of shoulder scar tissue using an endoscope,2345.25,1524.41,78.57,1723.53,19
HCPCS,29826,Shaving of part of shoulder bone and repair of ligament using an endoscope,1840.0,1196.0,78.57,979.48,19
HCPCS,29827,Repair of shoulder rotator cuff using an endoscope,4405.35,2863.48,78.57,3154.48,19
HCPCS,29828,Release of tendon connecting biceps muscle and shoulder using an endoscope,3690.3,2398.7,78.57,2711.55,19
HCPCS,29830,Diagnostic exam of elbow joint using an endoscope,1204.4,782.86,78.57,1353.15,19
HCPCS,29834,Removal of loose or foreign body in elbow joint using an endoscope,1422.8,924.82,78.57,1450.82,19
HCPCS,29835,Partial removal of elbow joint lining using an endoscope,1537.2,999.18,78.57,1497.92,19
HCPCS,29836,Removal of entire elbow joint lining using an endoscope,1338.38,869.95,78.57,1709.91,19
HCPCS,29837,Removal of elbow joint tissue using an endoscope,2118.45,1376.99,78.57,1562.14,19
HCPCS,29838,Removal of extensive damaged tissue from elbow joint using an endoscope,2368.8,1539.72,78.57,1748.71,19
HCPCS,29840,Diagnostic exam of wrist using an endoscope,1184.4,769.86,78.57,1338.53,19
HCPCS,29843,"Diagnostic exam, washing, and drainage of infected wrist using an endoscope",1121.68,729.09,78.57,1431.22,19
HCPCS,29844,Partial removal of wrist joint lining using an endoscope,1319.9,857.94,78.57,1483.41,19
HCPCS,29845,Removal of entire wrist joint lining using an endoscope,2019.15,1312.45,78.57,1725.9,19
HCPCS,29846,Removal or repair of wrist cartilage using an endoscope,2086.95,1356.52,78.57,1551.12,19
HCPCS,29847,Placement of internal stabilizing device using an endoscope to treat broken or unstable wrist,1437.5,934.38,78.57,1599.03,19
HCPCS,29848,Release of wrist ligament using an endoscope,1978.2,1285.83,78.57,1518.17,19
HCPCS,29850,Treatment of broken knee joint using an endoscope,2304.3,1497.8,78.57,1844.09,19
HCPCS,29851,Treatment of broken knee joint with placement of stabilizing device using an endoscope,2515.8,1635.27,78.57,2753.17,19
HCPCS,29855,Treatment of broken upper portion of lower leg bone on side using an endoscope,2106.3,1369.1,78.57,2319.95,19
HCPCS,29856,Treatment of broken upper portion of lower leg bone on both sides using an endoscope,2702.7,1756.76,78.57,2940.8,19
HCPCS,29860,Diagnostic exam of hip using an endoscope,1531.38,995.4,78.57,1954.37,19
HCPCS,29861,Removal of loose or foreign body in hip joint using an endoscope,1931.0,1255.15,78.57,2139.06,19
HCPCS,29862,Removal or shaving of hip joint socket cartilage using an endoscope,2162.0,1405.3,78.57,2404.39,19
HCPCS,29863,Removal of hip joint lining using an endoscope,2147.3,1395.75,78.57,2405.82,19
HCPCS,29866,Repair of knee cartilage and bone with patient-derived healthy cartilage transplant using an endoscope,2810.9,1827.09,78.57,3109.32,19
HCPCS,29867,Repair of knee cartilage and bone with donor cartilage graft using an endoscope,3418.8,2222.22,78.57,3778.67,19
HCPCS,29868,Repair of knee cartilage with donor cartilage graft using an endoscope,8785.0,5710.25,78.57,4956.4,19
HCPCS,29870,Diagnostic exam of knee using an endoscope,1082.6,703.69,78.57,1310.41,19
HCPCS,29871,"Exam, washing, and drainage of infected knee joint using an endoscope",2055.45,1336.04,78.57,1523.24,19
HCPCS,29873,Release of ligaments at outer side of knee joint using an endoscope,1357.7,882.51,78.57,1558.09,19
HCPCS,29874,Removal of loose or foreign body in knee joint using an endoscope,2242.8,1457.82,78.57,1589.64,19
HCPCS,29875,Partial removal of knee joint lining using an endoscope,2690.1,1748.57,78.57,1467.12,19
HCPCS,29876,Removal of joint lining from multiple knee joint compartments using an endoscope,3074.4,1998.36,78.57,1941.59,19
HCPCS,29877,Removal or shaving of knee joint cartilage using an endoscope,2690.1,1748.57,78.57,1840.92,19
HCPCS,29879,Repair of knee joint with drilling and or scraping of joint using an endoscope,3362.7,2185.76,78.57,1961.22,19
HCPCS,29880,Removal of both knee cartilages using an endoscope,3735.9,2428.34,78.57,1664.74,19
HCPCS,29881,Removal of knee cartilage using an endoscope,2690.1,1748.57,78.57,1603.57,19
HCPCS,29882,Repair of inside or outside knee joint cartilage using an endoscope,3362.7,2185.76,78.57,2063.7,19
HCPCS,29883,Repair of inside and outside knee joint cartilage using an endoscope,4803.75,3122.44,78.57,2501.43,19
HCPCS,29884,Removal of scar tissue from knee using an endoscope,2458.65,1598.12,78.57,1827.92,19
HCPCS,29885,Repair of knee joint with bone graft using an endoscope,2983.05,1938.98,78.57,2219.84,19
HCPCS,29886,Repair of knee joint by drilling cartilage using an endoscope,1677.9,1090.64,78.57,1884.8,19
HCPCS,29887,Repair of knee joint with bone graft and internal stabilizing device using an endoscope,2112.6,1373.19,78.57,2217.17,19
HCPCS,29888,Repair of anterior cruciate ligament of knee using an endoscope,5956.65,3871.82,78.57,2914.69,19
HCPCS,29889,Repair of posterior cruciate ligament of knee using an endoscope,5956.65,3871.82,78.57,3620.39,19
HCPCS,29891,Removal of shin and/or ankle bone defect using an endoscope,2805.15,1823.35,78.57,2013.98,19
HCPCS,29892,Removal of large shin or ankle bone defect using an endoscope,1542.2,1002.43,78.57,1969.97,19
HCPCS,29893,Repair of fibrous tissue of arch of foot using an endoscope,1465.15,952.35,78.57,1601.38,19
HCPCS,29894,Removal of loose or foreign body in ankle using an endoscope,1704.2,1107.73,78.57,1486.1,19
HCPCS,29895,Partial removal of ankle joint lining using an endoscope,1495.2,971.88,78.57,1415.88,19
HCPCS,29897,Removal of limited dead or infected tissue using an endoscope,1495.2,971.88,78.57,1508.51,19
HCPCS,29898,Removal of extensive dead or infected tissue using an endoscope,2384.55,1549.96,78.57,1693.09,19
HCPCS,29899,Fusion of ankle joint using an endoscope,2420.93,1573.6,78.57,3076.63,19
HCPCS,29900,Biopsy of lining of joint of finger using an endoscope,1011.98,657.79,78.57,1471.57,19
HCPCS,29901,Removal of dead or infected finger joint tissue using an endoscope,1237.23,804.2,78.57,1579.03,19
HCPCS,29902,Treatment of displaced finger joint ligament using an endoscope,1147.98,746.19,78.57,1681.55,19
HCPCS,29904,Removal of loose or foreign body in ankle joint at heel bones using an endoscope,1661.1,1079.72,78.57,1880.18,19
HCPCS,29905,Removal of lining of ankle joint using an endoscope,1787.1,1161.62,78.57,1608.18,19
HCPCS,29906,Removal of dead or infected ankle joint tissue using an endoscope,1882.7,1223.76,78.57,1996.18,19
HCPCS,29907,Fusion of foot joint using an endoscope,2303.7,1497.41,78.57,2591.88,19
HCPCS,29914,Reshaping of thigh bone at hip joint using an endoscope,3679.2,2391.48,78.57,2938.05,19
HCPCS,29915,Reshaping of hip socket using an endoscope,2500.1,1625.07,78.57,3029.82,19
HCPCS,29916,Repair of hip joint socket cartilage using an endoscope,3750.15,2437.6,78.57,3023.16,19
HCPCS,30000,Drainage of abscess or blood accumulation of nose,409.15,265.95,0.01,2166.29,55
HCPCS,30020,Drainage of abscess or blood accumulation of nasal cartilage,524.7,341.055,0.01,2166.29,55
HCPCS,30100,Biopsy of lining of nose,799.8,519.87,0.01,3726.0,55
HCPCS,30110,Simple removal of nasal polyp,1692.45,1100.095,0.01,7231.0,36
HCPCS,30115,Extensive removal of nasal polyp,1140.3,741.2,78.57,1303.16,19
HCPCS,30117,Removal or destruction of growth of nose through nose,2299.5,1494.68,0.01,6843.63,55
HCPCS,30118,Removal or destruction of growth of nose,2081.1,1352.72,78.57,2312.96,19
HCPCS,30120,Removal or scraping of skin on nose,1370.3,890.7,0.01,6451.0,74
HCPCS,30124,Simple removal of cyst and skin growth of nose,854.2,555.235,78.57,856.35,38
HCPCS,30125,Removal of growth under nasal bone or cartilage,1061.6,690.04,78.57,1835.91,19
HCPCS,30130,Removal of nasal air passage,1809.9,1176.435,78.57,1152.18,38
HCPCS,30140,Removal of nasal air passage under lining tissue,3148.5,2046.53,0.01,15236.75,55
HCPCS,30150,Partial removal of nose,6426.45,4177.195,0.01,27723.14,36
HCPCS,30160,Removal of nose,2206.1,1433.97,78.57,2323.31,19
HCPCS,30200,Injection of medication into nasal air passage,289.8,188.37,20.48,268.24,19
HCPCS,30210,Irrigation and drainage of sinus,381.2,247.78,59.56,363.43,19
HCPCS,30220,Insertion of implant to close nasal passage,1192.2,774.93,0.01,3176.48,55
HCPCS,30300,Removal of foreign body in nose,410.5,266.825,0.01,8477.27,55
HCPCS,30310,Removal of foreign body in nose under anesthesia,578.5999999999999,376.095,78.57,603.32,38
HCPCS,30320,Removal of foreign body in nose by incision,1047.6,680.94,78.57,1361.61,19
HCPCS,30400,Reshaping of tip of nose,4860.0,3159.0,0.01,12550.95,55
HCPCS,30410,"Reshaping of bone, cartilage, and/or tip of nose",4236.25,2753.565,78.57,3729.65,38
HCPCS,30420,Reshaping of bony cartilage dividing nasal passages,4663.6,3031.3450000000003,78.57,4116.02,38
HCPCS,30430,Revision to reshape nose or small amount of tip of nose after previous repair,2405.6,1563.64,0.01,12550.95,55
HCPCS,30435,Revision to reshape nasal bones after previous repair,5035.0,3272.75,0.01,13002.89,55
HCPCS,30450,Revision to reshape nasal bones and tip of nose after previous repair,4724.5,3070.9300000000003,78.57,4682.95,38
HCPCS,30460,Revision of congenital nasal defect to lengthen tip of nose,2106.3,1369.1,0.01,11969.89,55
HCPCS,30462,Revision of congenital nasal defect with lengthening of tip of nose,4752.85,3089.355,78.57,4685.95,38
HCPCS,30465,Repair of nasal passage,4635.0,3012.75,0.01,11969.89,55
HCPCS,30468,Repair of collapsed nostril using implant in side of nose,156.75,101.89,78.57,6194.63,19
HCPCS,30469,Repair of collapsed nasal valve,337.0,219.05,78.57,6035.67,19
HCPCS,30520,Reshaping of nasal cartilage,3126.9,2032.49,78.57,17672.05,57
HCPCS,30540,Repair of nasal passage through nose,2111.6,1372.54,78.57,2073.92,19
HCPCS,30545,Repair of nasal passages through palate,3004.1,1952.67,78.57,2836.87,19
HCPCS,30560,Release of nasal scar tissue,531.3,345.35,0.01,2318.31,74
HCPCS,30580,Repair of abnormal drainage tract between nasal sinuses,2930.55,1904.8600000000001,0.01,10846.5,36
HCPCS,30600,Repair of abnormal drainage tract between mouth and nasal cavity,1605.5,1043.58,78.57,1250.51,19
HCPCS,30620,Reconstruction of lining of nasal passage with graft,1632.8,1061.32,78.57,1902.81,19
HCPCS,30630,Repair of openings of nasal cartilage,1676.35,1089.63,78.57,1887.93,38
HCPCS,30801,Destruction of soft tissue of nasal passages,575.4,374.01,0.01,3176.48,55
HCPCS,30802,Destruction of surface soft tissue of nasal passages,971.3,631.35,0.01,3879.59,55
HCPCS,30901,Simple control of nose bleed,401.4,260.91,0.01,2166.29,74
HCPCS,30903,Complex control of nose bleed,680.25,442.16499999999996,0.01,2166.29,55
HCPCS,30905,Initial control of nose bleed and insertion of packing,668.0,434.2,78.57,2166.29,38
HCPCS,30906,Subsequent control of nosebleed and insertion of packing,725.6,471.64,73.42,898.68,19
HCPCS,30915,Tying of ethmoidal artery ethmoidal for control of nose bleed,1862.7,1210.76,78.57,1727.54,19
HCPCS,30920,Tying of internal nasal artery for control of nose bleed,2466.5,1603.23,78.57,2511.7,19
HCPCS,30930,Therapeutic fracture of nasal passages,525.0,341.25,43.22,8620.39,57
HCPCS,31000,Irrigation of nasal sinus,509.95,331.47,78.57,2166.29,38
HCPCS,31002,Irrigation of sphenoid nasal sinus,533.4,346.71,78.57,567.94,19
HCPCS,31020,Incision of nasal sinus through nose,1285.75,835.74,78.57,1156.81,38
HCPCS,31030,Creation of window into nasal sinus,3189.45,2073.14,78.57,1602.65,19
HCPCS,31032,Removal of nasal sinus polyp,2205.0,1433.25,78.57,1723.53,19
HCPCS,31040,Incision through sinus at cheek bone to reach nerve and blood vessel,4725.0,3071.25,78.57,2302.38,19
HCPCS,31050,Incision of sphenoid nasal sinus,1696.8,1102.92,78.57,1456.53,19
HCPCS,31051,Removal of nasal polyps,2054.9,1335.69,78.57,1946.58,19
HCPCS,31070,Simple incision of frontal nasal sinus,1653.8,1074.97,78.57,1323.61,19
HCPCS,31075,Incision of nasal sinus of side of face,3929.1499999999996,2553.95,78.57,2348.88,38
HCPCS,31080,Insertion of material to stop growth of nasal sinus lining through eyebrow,2721.6,1769.04,78.57,3092.87,19
HCPCS,31081,Insertion of material to stop growth of nasal sinus lining through forehead,3269.7,2125.31,78.57,3331.3,19
HCPCS,31084,Insertion of material to stop growth of nasal sinus lining with bone flap through eyebrow,3780.0,2457.0,78.57,3450.97,19
HCPCS,31085,Insertion of material to stop growth of nasal sinus lining with bone flap through forehead,5862.15,3810.4,78.57,3570.1,19
HCPCS,31086,Incision of eyebrow and placement of bone flap to drain frontal nasal sinus,3024.0,1965.6,78.57,3361.73,19
HCPCS,31087,Incision of forehead and placement of bone flap to drain frontal nasal sinus,3095.4,2012.01,78.57,3232.47,19
HCPCS,31090,Removal of tissue or growths in 3 or more nasal sinuses on side of face,4091.9,2659.74,78.57,3103.81,19
HCPCS,31200,Partial removal of nasal sinus,2132.55,1386.16,78.57,1766.43,19
HCPCS,31201,Removal of nasal sinus from within nasal passage,2020.2,1313.13,78.57,2243.39,19
HCPCS,31205,Removal of nasal sinus from outside nasal passage,4365.15,2837.3500000000004,78.57,12930.58,38
HCPCS,31225,Removal of nasal sinus,7572.6,4922.19,78.57,5513.69,19
HCPCS,31230,Removal of nasal sinus and eye bone,5654.3,3675.3,78.57,6102.95,19
HCPCS,31231,Diagnostic exam of nasal passages using an endoscope,420.0,273.0,0.01,2318.31,74
HCPCS,31233,Exam of nasal passage and sinus using an endoscope,702.5,456.63,78.57,661.4,19
HCPCS,31235,Exam of nasal passage and sphenoid sinus using an endoscope,807.5,524.88,78.57,749.74,19
HCPCS,31237,Biopsy or removal of nasal polyp or tissue using an endoscope,1307.25,849.71,0.01,4954.53,74
HCPCS,31238,Control of bleeding of nose using an endoscope,1676.7,1089.855,0.01,5113.35,55
HCPCS,31239,Incision of tear duct using an endoscope,3600.45,2340.29,78.57,1862.67,19
HCPCS,31240,Removal of nasal breathing passages using an endoscope,527.4,342.815,78.57,476.59,38
HCPCS,31241,Tying of sphenopalatine artery using an endoscope,1470.0,955.5,78.57,1340.47,19
HCPCS,31243,Destruction of nasal nerve by freezing using an endoscope,7875.0,5118.75,0.01,38737.5,34
HCPCS,31253,Complete exam of nose and sinuses using an endoscope,1650.0,1072.5,78.57,1511.52,19
HCPCS,31254,Partial removal of nasal sinus using an endoscope,1184.4,769.86,78.57,1055.75,19
HCPCS,31255,Removal of nasal sinus using an endoscope,1745.1,1134.32,78.57,977.1,19
HCPCS,31256,Incision of nasal sinus using an endoscope,666.775,433.405,78.57,543.35,38
HCPCS,31257,Exam of nose and sinus with removal of nasal sinus using an endoscope,1470.0,955.5,78.57,1347.37,19
HCPCS,31259,Removal of tissue from sphenoid sinus using an endoscope,1560.0,1014.0,78.57,1426.81,19
HCPCS,31267,Removal of nasal sinus tissue using an endoscope,1379.7,896.81,78.57,800.4,19
HCPCS,31276,Exploration of nasal sinus using an endoscope,2201.85,1431.2,78.57,1142.34,19
HCPCS,31287,Incision of sphenoid nasal sinus using an endoscope,1006.5,654.23,78.57,606.89,19
HCPCS,31288,Removal of sphenoid nasal sinus tissue using an endoscope,1165.5,757.58,78.57,706.02,19
HCPCS,31290,Repair of leak of brain and spinal fluid from sinus behind bridge of nose using endoscope,5454.3,3545.3,78.57,3422.79,19
HCPCS,31291,Repair of leak of brain and spinal fluid from sinus behind eyes using endoscope,5729.85,3724.4,78.57,3618.39,19
HCPCS,31292,Decompression of medial or inferior wall of eye socket using an endoscope,4219.5,2742.68,78.57,2968.83,19
HCPCS,31293,Decompression of medial and inferior wall of eye socket using an endoscope,3230.9,2100.09,78.57,3222.12,19
HCPCS,31294,Decompression of optic nerve using an endoscope,3692.9,2400.39,78.57,3688.98,19
HCPCS,31295,Dilation of nasal sinus using an endoscope,5296.4,3442.66,78.57,5455.29,19
HCPCS,31296,Dilation of frontal nasal sinus using an endoscope,9886.65,6426.325,0.01,20143.5,36
HCPCS,31297,Dilation of sphenoid nasal sinus using an endoscope,420.0,273.0,78.57,4024.18,19
HCPCS,31298,Dilation of sphenoid and frontal nasal sinus using an endoscope,8535.0,5547.75,78.57,7639.15,19
HCPCS,31299,Other procedure on accessory sinuses,230.0,149.5,57.5,8477.27,19
HCPCS,31300,Removal of vocal cord growth or cartilage attachment,3416.7,2220.86,78.57,3828.11,19
HCPCS,31360,Complete removal of voice box,5531.4,3595.41,78.57,6246.76,19
HCPCS,31365,Complete removal of voice box with extensive dissection of neck,6932.1,4505.87,78.57,7712.11,19
HCPCS,31367,Removal of voice box,5945.1,3864.32,78.57,6611.19,19
HCPCS,31368,Removal of voice box with extensive dissection of neck,6635.0,4312.75,78.57,7341.04,19
HCPCS,31370,Partial removal of voice box,5575.5,3624.08,78.57,6214.35,19
HCPCS,31375,Partial removal of voice box through front and side of neck,5273.1,3427.52,78.57,5892.55,19
HCPCS,31380,Partial removal of voice box and adjoining tissue,5191.2,3374.28,78.57,5813.0,19
HCPCS,31382,Partial removal of voice box and cartilage,5701.5,3705.98,78.57,6378.49,19
HCPCS,31390,"Removal of voice box, throat, muscle, lymph nodes, and glands",7714.4,5014.36,78.57,8565.57,19
HCPCS,31395,"Removal of voice box and throat, muscle, lymph nodes, and glands with reconstruction of defect",8163.8,5306.47,78.57,9042.65,19
HCPCS,31400,Removal or repair of voice box cartilage,2914.8,1894.62,78.57,2940.86,19
HCPCS,31420,Removal of cartilage attaching tongue,2503.2,1627.08,78.57,2465.09,19
HCPCS,31500,Emergent insertion of breathing tube into windpipe using an endoscope,544.0,353.6,78.57,2166.29,38
HCPCS,31502,Change of breathing tube in windpipe,266.0,172.9,28.22,883.22,38
HCPCS,31505,Diagnostic exam of voice box using an endoscope with mirror,252.5,164.125,37.54,1242.0,38
HCPCS,31510,Biopsy of voice box using an endoscope with mirror,3146.5,2045.225,40.48,14462.0,38
HCPCS,31511,Removal of foreign body in voice box using an endoscope with mirror,510.5,331.825,43.4,2318.31,38
HCPCS,31512,Removal of growth of voice box using an endoscope with mirror,693.0,450.45,44.15,521.28,19
HCPCS,31513,Injection of vocal cord using an endoscope with mirror,458.5,298.025,43.22,1052.0,38
HCPCS,31515,Aspiration of voice box using an endoscope,641.5,416.975,30.87,2280.35,38
HCPCS,31520,"Diagnostic exam of voice box using an endoscope, newborn",440.0,286.0,78.57,468.37,19
HCPCS,31525,Diagnostic exam of voice box using an endoscope,1000.0,650.0,78.57,3726.0,57
HCPCS,31526,Diagnostic exam of voice box using an endoscope with operating microscope or telescope,837.9,544.64,78.57,469.54,19
HCPCS,31527,Insertion of device to close opening of voice box using an endoscope,561.8,365.17,78.57,584.29,19
HCPCS,31528,Initial dilation of voice box using an endoscope,2454.85,1595.655,78.57,11610.92,38
HCPCS,31529,Subsequent dilation of voice box using an endoscope,577.5,375.38,78.57,482.87,19
HCPCS,31530,Removal of foreign body in voice box using an endoscope,1333.5,866.775,78.57,5286.38,38
HCPCS,31531,Removal of foreign body in voice box using an endoscope with operating microscope or telescope,1208.6,785.59,78.57,636.23,19
HCPCS,31535,Biopsy of voice box using an endoscope,1977.0,1285.05,78.57,7499.58,38
HCPCS,31536,Biopsy of voice box using an endoscope with operating microscope or telescope,1319.9,857.94,78.57,631.74,19
HCPCS,31540,Removal of growth of throat and/or stripping of vocal cords using an endoscope,1254.8,815.62,78.57,722.89,19
HCPCS,31541,Removal of growth of tongue and/or stripping of vocal cord using an endoscope with operating microscope or telescope,1580.3,1027.2,78.57,789.69,19
HCPCS,31545,Removal of vocal cord growths and reconstruction with local tissue flap using an endoscope with operating microscope or telescope,1568.7,1019.66,78.57,1087.18,19
HCPCS,31546,Removal of vocal cord growths and reconstruction with graft using an endoscope with operating microscope or telescope,1586.6,1031.29,78.57,1650.91,19
HCPCS,31551,Repair of narrowed voice box with graft (younger than 12 years),3350.65,2177.92,78.57,4317.82,19
HCPCS,31552,Repair of narrowed voice box with graft (12 years or older),3386.35,2201.13,78.57,4334.99,19
HCPCS,31553,Repair of narrowed voice box with graft and placement of indwelling stent (younger than 12 years),3691.25,2399.31,78.57,4742.87,19
HCPCS,31554,Repair of narrowed voice box with graft and placement of indwelling stent (12 years or older),3885.35,2525.48,78.57,4955.04,19
HCPCS,31560,Removal of voice box cartilage using an endoscope,2010.8,1307.02,78.57,938.49,19
HCPCS,31561,Removal of voice box cartilage using an endoscope with operating microscope or telescope,2363.6,1536.34,78.57,1027.96,19
HCPCS,31570,Injection into vocal cords using an endoscope,4469.95,2905.4700000000003,78.57,20272.63,95
HCPCS,31571,Injection into vocal cords using an endoscope with operating microscope or telescope,4972.05,3231.835,78.57,22098.45,38
HCPCS,31572,Removal or destruction of growth of side of voice box using an endoscope,6208.2,4035.33,78.57,30408.94,57
HCPCS,31573,Injection of drug into side of voice box using an endoscope,3267.525,2123.89,78.57,15510.5,57
HCPCS,31574,Injection of substance to augment voice box using an endoscope,3267.525,2123.89,78.57,15510.5,57
HCPCS,31575,Diagnostic exam of voice box using a flexible endoscope,370.0,240.5,56.42,2318.31,76
HCPCS,31576,Biopsy of voice box using a flexible endoscope,3808.0,2475.2,0.01,10045.93,55
HCPCS,31577,Removal of foreign body in voice box using a flexible endoscope,617.5,401.375,78.57,2318.31,38
HCPCS,31578,Removal of growth of voice box using an endoscope,3383.4,2199.21,78.57,15696.44,38
HCPCS,31579,Exam to assess movement of vocal cord flaps using an endoscope,509.95,331.47,78.57,2318.31,57
HCPCS,31580,Repair of congenital vocal cord defect with insertion of indwelling stent,3000.0,1950.0,78.57,3738.55,19
HCPCS,31584,Incision of voice box to repair fracture,4153.8,2699.97,78.57,4144.66,19
HCPCS,31587,Repair of split of voice box,3349.5,2177.18,78.57,3472.72,19
HCPCS,31590,Relocation of nerve and muscle to restore voice box function,3150.0,2047.5,78.57,2618.1,19
HCPCS,31591,Repair of side of voice box by moving vocal cord to middle,9584.065,6229.639999999999,78.57,40008.09,38
HCPCS,31592,Partial removal of windpipe and cartilage,3971.8,2581.67,78.57,5102.6,19
HCPCS,31599,Other procedure on voice box,10458.0,6797.7,1242.0,27007.79,76
HCPCS,31600,Incision of windpipe for insertion of breathing tube (older than 2 years),1131.9,735.74,78.57,915.74,19
HCPCS,31601,Incision of windpipe for insertion of breathing tube (2 years or younger),1128.8,733.72,78.57,1357.79,19
HCPCS,31603,Emergent incision of windpipe through neck for insertion of breathing tube,1872.5,1217.125,78.57,7231.0,38
HCPCS,31605,Emergent incision of windpipe for insertion of breathing tube,1259.5,818.675,78.57,4103.59,38
HCPCS,31610,Creation of permanent opening of windpipe for breathing,1934.1,1257.17,78.57,2838.28,19
HCPCS,31611,Creation of opening of windpipe and insertion of speech prosthesis,3980.35,2587.23,78.57,16835.32,38
HCPCS,31612,Puncture of windpipe for aspiration and/or injection,219.5,142.68,11.65,222.71,19
HCPCS,31613,Simple revision of permanent opening of windpipe for breathing,3548.8,2306.7200000000003,0.01,15262.58,36
HCPCS,31614,Revision of permanent opening of windpipe for breathing with flap rotation,1985.6,1290.64,78.57,2197.2,19
HCPCS,31615,Exam of windpipe and lung airways through permanent windpipe opening using an endoscope,476.95,310.02,78.57,2659.49,57
HCPCS,31622,Diagnostic exam of lung airway using an endoscope,1320.0,858.0,78.57,8059.98,76
HCPCS,31623,Exam of lung airways using an endoscope,928.2,603.33,78.57,661.33,19
HCPCS,31624,Irrigation and suction of lung airways to obtain cells using an endoscope,1995.5,1297.075,78.57,8059.98,38
HCPCS,31625,Biopsy of lung airway using an endoscope,933.5,606.78,78.57,839.27,19
HCPCS,31626,Placement of radiation therapy markers into lung airways using an endoscope,1121.6,729.04,78.57,1893.36,19
HCPCS,31627,Computer-assisted image-guided navigation of lung airways using an endoscope,846.0,549.9,78.57,2606.82,19
HCPCS,31628,"Biopsy of lobe of lung using an endoscope, 1 lobe",1120.4,728.26,78.57,897.18,19
HCPCS,31629,"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope",1698.9,1104.29,78.57,1090.08,19
HCPCS,31630,Dilation of windpipe cartilage or treatment of broken windpipe cartilage using an endoscope,589.1,382.92,78.57,604.1,19
HCPCS,31631,Placement of stent into windpipe using an endoscope,672.0,436.8,78.57,692.36,19
HCPCS,31632,"Biopsy of lobe of lung using an endoscope, each additional lobe",204.8,133.12,30.87,155.65,19
HCPCS,31633,"Needle biopsy of lobe of lung using an endoscope, each additional lobe",249.9,162.44,32.15,196.8,19
HCPCS,31634,Exam of lung airways with repair of air leak using an endoscope,1662.0,1080.3,78.57,3636.66,19
HCPCS,31635,Removal of foreign body in lung airways using an endoscope,2402.35,1561.53,78.57,9929.71,38
HCPCS,31636,"Placement of stent in lung airway using an endoscope, first stent",650.0,422.5,78.57,672.58,19
HCPCS,31637,"Placement of stent in lung airway using an endoscope, each additional stent",227.9,148.14,63.2,237.57,19
HCPCS,31638,Revision of previously inserted lung airway stent using an endoscope,744.5,483.93,78.57,762.26,19
HCPCS,31640,Removal of growth of lung airways using an endoscope,1260.0,819.0,78.57,768.33,19
HCPCS,31641,Destruction of growth or narrowing of lung airway using an endoscope,759.2,493.48,78.57,786.3,19
HCPCS,31643,Placement of tube for radiation delivery in lung airway using an endoscope,477.8,310.57,78.57,546.33,19
HCPCS,31645,Aspiration of initial secretion of lung airway using an endoscope,2123.45,1380.245,78.57,8803.74,38
HCPCS,31646,Aspiration of subsequent secretions of lung airway using an endoscope during same hospital stay,759.2,493.48,78.57,437.43,19
HCPCS,31647,Assessment of initial lobe of lung for air leak and airway sizing with insertion of bronchial valve in lung airway using an endoscope,2808.05,1825.2350000000001,78.57,12602.6,38
HCPCS,31648,"Removal of bronchial valves of lung airways of lobe of lung using an endoscope, initial lobe",2639.8,1715.8700000000001,78.57,11652.24,38
HCPCS,31649,"Removal of bronchial valves of lung airways of lobe of lung using an endoscope, each additional lobe",1219.9,792.935,58.09,5660.84,38
HCPCS,31651,"Assessment of air leak and airway sizing with insertion of bronchial valve in lung airway using an endoscope, each additional lobe",2387.25,1551.7150000000001,63.2,11652.24,38
HCPCS,31652,"Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes",2108.0,1370.2,78.57,3024.69,19
HCPCS,31653,"Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 3 or more lymph nodes",2241.0,1456.65,78.57,3144.75,19
HCPCS,31654,Exam of lung airways with diagnostic or therapeutic procedure on growths using an endoscope and ultrasound,257.0,167.05,56.34,289.99,19
HCPCS,31660,Thermal repair of airways of lobe of lung using an endoscope,2809.1,1825.915,78.57,12602.6,38
HCPCS,31661,Thermal repair of airways of multiple lobes of lung using an endoscope,2829.05,1838.885,78.57,12602.6,38
HCPCS,31717,Insertion of tube into airway of lung for biopsy,611.85,397.7,29.49,693.28,19
HCPCS,31720,Insertion of tube into airway for aspiration of secretions,318.69,207.15,18.52,2166.29,38
HCPCS,31725,Insertion of tube into windpipe and airways of lung for aspiration of secretions using an endoscope at bedside,189.3,123.05,66.8,244.86,19
HCPCS,31730,Insertion of needle wire dilator or indwelling tube for oxygen therapy,3158.25,2052.865,41.77,9834.16,38
HCPCS,31750,Repair of windpipe cartilage through neck,3630.9,2360.09,78.57,4113.25,19
HCPCS,31755,Creation of drainage tract from throat to windpipe,4159.8,2703.87,78.57,5221.91,19
HCPCS,31760,Repair of windpipe cartilage through chest,3847.2,2500.68,78.57,3997.71,19
HCPCS,31766,Reconstruction of upper breast bone through chest,4085.88,2655.82,78.57,5180.35,19
HCPCS,31770,Repair of lung airway with graft,3748.5,2436.53,78.57,3871.98,19
HCPCS,31775,Repair of narrowed area of lung airway,3103.73,2017.42,78.57,4078.59,19
HCPCS,31780,Removal of narrowed area of windpipe in neck with suture repair,3517.5,2286.38,78.57,3579.24,19
HCPCS,31781,Removal of narrowed area of windpipe in neck and chest with suture repair,3381.0,2197.65,78.57,4030.63,19
HCPCS,31785,Removal of growth of windpipe cartilage,3228.8,2098.72,78.57,3233.53,19
HCPCS,31786,Removal of growth of windpipe cartilage through chest,4092.9,2660.39,78.57,4204.96,19
HCPCS,31800,Suture of injury of windpipe in neck,1893.2,1230.58,78.57,2156.2,19
HCPCS,31805,Suture of injury of windpipe in chest,2084.3,1354.8,78.57,2373.29,19
HCPCS,31820,Closure of permanent windpipe opening or abnormal drainage tract,3525.4,2291.51,0.01,15236.75,36
HCPCS,31825,Closure of permanent windpipe opening or abnormal drainage tract with plastic repair,1927.0,1252.55,0.01,6482.08,36
HCPCS,31830,Revision of permanent windpipe opening scar,1633.05,1061.4850000000001,0.01,5449.08,36
HCPCS,31899,Other procedure on windpipe or lung airway,1754.0,1140.1,208.0,4529.71,38
HCPCS,32035,Removal of rib with creation of tract for drainage of infected material,2008.7,1305.66,78.57,2111.06,19
HCPCS,32036,Creation of open flap tract for drainage of infected material from lining around lung,2205.0,1433.25,78.57,2271.31,19
HCPCS,32096,Biopsy of fluid collection of lung,2529.7,1644.31,78.57,2342.06,19
HCPCS,32097,Biopsy of growth of lung,1354.5,880.43,78.57,2345.92,19
HCPCS,32098,Biopsy of lung lining,1273.7,827.91,78.57,2224.31,19
HCPCS,32100,Incision and exploration of chest cavity,2701.7,1756.11,78.57,2364.72,19
HCPCS,32110,Repair of tear of lung and/or control of traumatic bleeding through chest,10060.65,6539.425,78.57,41320.0,38
HCPCS,32120,Incision of chest cavity for complications after surgery,2454.9,1595.69,78.57,2547.43,19
HCPCS,32124,Release of lung lining through chest,2606.1,1693.97,78.57,2702.64,19
HCPCS,32140,Removal of cysts of lung through chest,2992.5,1945.13,78.57,2888.34,19
HCPCS,32141,Removal of air sac of lung through chest,4279.8,2781.87,78.57,4439.15,19
HCPCS,32150,Removal of foreign body or clot in lining of lung through chest,2811.9,1827.74,78.57,2935.8,19
HCPCS,32151,Removal of foreign body in lung,2821.4,1833.91,78.57,2925.15,19
HCPCS,32160,Massage of heart muscle through chest,2171.4,1411.41,78.57,2328.43,19
HCPCS,32200,Drainage of abscess or cyst of infected lung,3158.4,2052.96,78.57,3313.77,19
HCPCS,32215,Creation of scarring on surface of lung,2625.0,1706.25,78.57,2324.85,19
HCPCS,32220,Removal of lining of lung for lung expansion,4499.3,2924.55,78.57,4633.78,19
HCPCS,32225,Partial removal of lining of lung for lung expansion,2811.9,1827.74,78.57,2904.48,19
HCPCS,32310,Removal of lining of chest cavity,2861.3,1859.85,78.57,2664.65,19
HCPCS,32320,Removal of lining of chest cavity and lining of lung,4525.5,2941.58,78.57,4663.21,19
HCPCS,32400,Needle biopsy of lining of lung,2064.5,1341.925,45.57,9578.49,38
HCPCS,32408,"Core needle biopsy of lung or center cavity of chest (mediastinum), accessed through skin",2424.0,1575.6,78.57,11595.43,38
HCPCS,32440,Removal of lung,4456.2,2896.53,78.57,4566.81,19
HCPCS,32442,Removal of lung with portion of windpipe cartilage,7047.08,4580.6,78.57,8876.85,19
HCPCS,32445,Removal of lung and lining of chest cavity,9686.3,6296.1,78.57,10272.47,19
HCPCS,32480,Removal of lobe of lung,4213.7,2738.91,78.57,4313.5,19
HCPCS,32482,Removal of 2 lobes of lung,4507.7,2930.01,78.57,4614.4,19
HCPCS,32484,Removal of segment of lung tissue,4089.8,2658.37,78.57,4177.42,19
HCPCS,32486,Removal of portion of lung and segment of lung airway,6675.9,4339.34,78.57,6809.75,19
HCPCS,32488,Removal of remaining lung after previous partial removal of lung,6747.3,4385.75,78.57,6964.59,19
HCPCS,32491,Removal of lung segment to reduce lung volume through chest,3383.9,2199.54,78.57,4306.38,19
HCPCS,32501,Repair of lung airway and removal of segment of lung,2572.5,1672.13,78.57,702.94,19
HCPCS,32503,Removal of growth of lung,4652.6,3024.19,78.57,5236.49,19
HCPCS,32504,Removal of growth of lung and reconstruction of chest wall,5320.4,3458.26,78.57,5959.72,19
HCPCS,32505,Initial removal of wedge of lung tissue,1893.0,1230.45,78.57,2718.71,19
HCPCS,32506,"Removal of lung tissue wedge through chest, each additional removal",319.0,207.35,78.57,453.49,19
HCPCS,32507,Removal of lung tissue wedge for diagnosis,262.5,170.63,78.57,453.49,19
HCPCS,32540,Removal of infected material between lung and chest wall,4823.7,3135.41,78.57,5022.94,19
HCPCS,32550,Insertion of indwelling tube for drainage of lung fluid,3236.65,2103.825,70.39,11280.36,38
HCPCS,32551,Removal of fluid from between lung and chest cavity,1549.5,1007.175,78.57,5717.66,38
HCPCS,32552,Removal of indwelling tube in lining of lung,593.25,385.615,0.01,3227.0,55
HCPCS,32553,Insertion of device in chest cavity for radiation therapy guidance,2223.975,1445.585,70.62,8328.56,38
HCPCS,32554,Aspiration of fluid from chest cavity,1270.5,825.825,0.01,3227.0,55
HCPCS,32555,Aspiration of fluid from chest cavity using imaging guidance,3170.775,2061.005,0.01,10342.91,55
HCPCS,32556,Drainage of fluid from chest cavity with insertion of indwelling tube,2033.9,1322.0349999999999,26.05,5526.55,38
HCPCS,32557,Drainage of fluid from chest cavity with insertion of indwelling tube using imaging guidance,2501.25,1625.815,23.85,7852.09,38
HCPCS,32560,Instillation of agent onto lung surface using chest tube,641.15,416.75,39.06,3227.0,38
HCPCS,32561,Initial instillation of agent onto lung lining using chest tube,771.7,501.605,56.26,3313.35,38
HCPCS,32562,Subsequent instillation of agent onto lung lining using chest tube,710.0,461.5,47.36,3227.0,38
HCPCS,32601,"Diagnostic exam of lungs, heart sac, chest cavity, or lung lining using an endoscope",874.7,568.56,78.57,897.65,19
HCPCS,32604,Biopsy of heart sac using an endoscope,1438.5,935.03,78.57,1392.0,19
HCPCS,32606,Biopsy of tissue of chest using an endoscope,1317.8,856.57,78.57,1343.2,19
HCPCS,32607,Biopsy of fluid collection of lung using an endoscope,705.0,458.25,78.57,896.63,19
HCPCS,32608,Biopsy of growth of lung using an endoscope,865.0,562.25,78.57,1100.85,19
HCPCS,32609,Biopsy of lung lining using an endoscope,595.0,386.75,78.57,754.28,19
HCPCS,32650,Adhesion of linings of lung using an endoscope,1882.7,1223.76,78.57,1946.95,19
HCPCS,32651,Partial removal of chest cavity lining and lung lining using an endoscope,3056.6,1986.79,78.57,3194.58,19
HCPCS,32652,Removal of chest cavity lining and lung lining using an endoscope,4652.6,3024.19,78.57,4845.96,19
HCPCS,32653,Removal of foreign body in lining of chest cavity using an endoscope,2958.9,1923.29,78.57,3097.3,19
HCPCS,32654,Control of traumatic bleeding in chest using an endoscope,2670.0,1735.5,78.57,3407.02,19
HCPCS,32655,Removal of air sac of lung using an endoscope,2861.3,1859.85,78.57,2788.21,19
HCPCS,32656,Removal of lining of lung using an endoscope,2255.4,1466.01,78.57,2337.23,19
HCPCS,32658,Removal of blood clot or foreign body in heart sac using an endoscope,1640.08,1066.05,78.57,2079.13,19
HCPCS,32659,Creation of opening or partial removal of heart sac using an endoscope,2055.9,1336.34,78.57,2135.82,19
HCPCS,32661,Removal of cyst or growth of heart sac using an endoscope,1883.6,1224.34,78.57,2321.9,19
HCPCS,32662,Removal of cyst or growth of chest cavity using an endoscope,2530.5,1644.83,78.57,2604.6,19
HCPCS,32663,Exam of lung with removal of lung lobe using an endoscope,3963.8,2576.47,78.57,4082.15,19
HCPCS,32664,Removal of nerves to chest cavity using an endoscope,2377.2,1545.18,78.57,2470.55,19
HCPCS,32665,Repair of esophagus using an endoscope,1013.3,658.65,78.57,3581.22,19
HCPCS,32666,Initial removal of wedge of lung tissue using an endoscope,2653.5,1724.78,78.57,2539.58,19
HCPCS,32667,"Removal of wedge of tissue of lung using an endoscope, each additional removal",360.0,234.0,78.57,454.54,19
HCPCS,32668,Biopsy of wedge of lung tissue followed by partial removal of lung,360.0,234.0,78.57,454.8,19
HCPCS,32669,Removal of segment of lung tissue using an endoscope,3100.0,2015.0,78.57,3917.22,19
HCPCS,32670,Removal of 2 lobes of lung using an endoscope,3670.0,2385.5,78.57,4678.23,19
HCPCS,32671,Removal of lung using an endoscope,2972.6,1932.19,78.57,5162.47,19
HCPCS,32672,Partial removal of lung to reduce lung volume using an endoscope,3485.0,2265.25,78.57,4430.72,19
HCPCS,32673,Removal of thymus gland using an endoscope,2775.0,1803.75,78.57,3542.15,19
HCPCS,32674,Removal of lymph nodes of chest cavity using an endoscope,438.0,284.7,78.57,623.08,19
HCPCS,32701,Delineation of thoracic targets for radiation therapy,939.45,610.645,78.57,3070.59,35
HCPCS,32800,Repair of lung hernia through chest wall,2251.2,1463.28,78.57,2744.17,19
HCPCS,32810,Closure of chest wall after drainage of infected lung,2522.1,1639.37,78.57,2623.59,19
HCPCS,32815,Closure of abnormal drainage tract from chest cavity to lung airway,7732.2,5025.93,78.57,8174.37,19
HCPCS,32820,Reconstruction of chest wall after injury,3753.8,2439.97,78.57,3876.84,19
HCPCS,32850,Removal of lung from cadaver,3543.8,2303.47,73.6,1771.9,15
HCPCS,32851,Transplantation of lung,20874.0,13568.1,78.57,9522.4,19
HCPCS,32852,Transplantation of lung on heart-lung machine,22925.0,14901.25,78.57,10326.82,19
HCPCS,32853,Transplantation of 2 lungs,29568.0,19219.2,78.57,13311.58,19
HCPCS,32854,Transplantation of 2 lungs on heart-lung machine,31500.0,20475.0,78.57,14088.26,19
HCPCS,32855,Preparation of donor lung,681.1,442.72,78.57,2671.31,15
HCPCS,32856,Preparation of 2 donor lungs,817.3,531.25,78.57,2925.72,15
HCPCS,32900,Removal of ribs,3898.7,2534.16,78.57,4146.84,19
HCPCS,32905,Removal of infected area of chest cavity,3758.0,2442.7,78.57,3882.92,19
HCPCS,32906,Removal of infected area of chest cavity and closure of abnormal drainage tract,4649.4,3022.11,78.57,4802.58,19
HCPCS,32940,Release of lining covering lung from chest wall,3591.0,2334.15,78.57,3589.42,19
HCPCS,32960,Injection of air into chest cavity to collapse lung,395.9,257.34,53.87,305.7,19
HCPCS,32994,Destruction of growth of lung using extreme cold,12120.5,7878.325,78.57,27441.65,38
HCPCS,32997,Irrigation and drainage of lung,2369.7,1540.305,78.57,9942.63,38
HCPCS,32998,Destruction of growth of lung using radiofrequency,10332.85,6716.355,41.68,33972.79,38
HCPCS,32999,Other procedure on lung and lung lining,1123.0,729.95,280.75,8477.27,19
HCPCS,33016,Drainage of heart sac using imaging guidance,1905.25,1238.415,78.57,8431.86,56
HCPCS,33017,Drainage of heart sac using tube and imaging guidance (6 years or older),2283.5,1484.275,78.57,10330.0,56
HCPCS,33018,Drainage of heart sac using tube and imaging guidance (5 years or younger or any age with congenital heart defect),655.5,426.08,78.57,846.15,19
HCPCS,33019,Drainage of heart sac using tube and CT imaging guidance,2389.0,1552.85,78.57,10975.63,38
HCPCS,33020,Removal of blood clot or foreign body in heart sac,2487.5,1616.88,78.57,2425.82,19
HCPCS,33025,Surgical removal of piece of sac covering heart for drainage,3329.65,2164.275,78.57,16106.13,38
HCPCS,33030,Removal of heart sac,3663.5,2381.28,78.57,5834.28,19
HCPCS,33031,Removal of heart sac on heart-lung machine,5145.0,3344.25,78.57,7205.63,19
HCPCS,33050,Removal of growth or cyst of from heart sac,2839.2,1845.48,78.57,2931.25,19
HCPCS,33120,Removal of growth of heart on heart-lung machine,4435.2,2882.88,78.57,6091.21,19
HCPCS,33130,Removal of growth on outside of heart,3962.7,2575.76,78.57,3995.9,19
HCPCS,33140,Laser treatment of heart muscle to improve blood flow,4486.7,2916.36,78.57,4542.81,19
HCPCS,33141,Laser treatment of heart muscle to improve blood flow during procedure,648.9,421.79,78.57,763.23,19
HCPCS,33202,Insertion of electrode to outer layer of heart,2185.1,1420.32,78.57,2257.36,19
HCPCS,33203,Insertion of electrode to outer layer of heart using an endoscope,1850.15,1202.6,78.57,2362.38,19
HCPCS,33206,Insertion of pacemaker and upper heart chamber electrode,13196.9,8577.985,78.57,63077.56,56
HCPCS,33207,Insertion of pacemaker and lower heart chamber electrode,13395.5,8707.075,78.57,63222.18,56
HCPCS,33208,Insertion of pacemaker and upper and lower heart chamber electrode,14249.15,9261.949999999999,78.57,67563.37,56
HCPCS,33210,Insertion of temporary pacemaker lead in single heart chamber,10145.0,6594.25,78.57,50229.63,56
HCPCS,33211,Insertion of temporary pacemaker lead in upper and lower heart chambers,9995.4,6497.01,78.57,50229.63,37
HCPCS,33212,Insertion of pacemaker pulse generator with existing single lead,9213.05,5988.485,78.57,45573.38,38
HCPCS,33213,Insertion of pacemaker pulse generator with existing dual leads,9481.85,6163.205,78.57,46874.96,56
HCPCS,33214,Insertion of 2 chamber pacemaker system,15270.0,9925.5,78.57,72903.98,56
HCPCS,33215,Repositioning of pacemaker or defibrillator electrode,8772.05,5701.835,78.57,42970.22,56
HCPCS,33216,Insertion of 1 electrode for permanent pacemaker or defibrillator,11143.0,7242.95,78.57,54028.48,56
HCPCS,33217,Insertion of 2 electrodes for permanent pacemaker or defibrillator,11195.5,7277.075,78.57,54028.48,38
HCPCS,33218,Repair of electrode for permanent pacemaker or defibrillator,7624.95,4956.219999999999,78.57,36405.5,38
HCPCS,33220,Repair of 2 electrodes for permanent pacemaker or defibrillator,2307.75,1500.04,78.57,8912.21,38
HCPCS,33221,Insertion of pacemaker pulse generator with existing multiple leads,16552.65,10759.224999999999,78.57,83308.87,37
HCPCS,33222,Relocation of pacemaker skin pocket,5081.5,3302.975,78.57,23534.32,56
HCPCS,33223,Relocation of defibrillator skin pocket,5170.75,3360.99,78.57,23534.32,56
HCPCS,33224,Insertion of left lower heart electrode and attachment to pacemaker or defibrillator,14871.0,9666.15,78.57,72903.98,38
HCPCS,33225,Insertion of left lower heart electrode for pacemaker or defibrillator,9296.0,6042.400000000001,78.57,44868.36,56
HCPCS,33226,Repositioning of left lower heart electrode,1890.0,1228.5,78.57,1448.7,19
HCPCS,33227,Removal and replacement of single lead permanent pacemaker,9773.5,6352.775,78.57,48465.78,38
HCPCS,33228,Removal and replacement of dual lead permanent pacemaker,10014.0,6509.1,78.57,50203.8,38
HCPCS,33229,Removal and replacement of multiple lead permanent pacemaker,15192.5,9875.125,78.57,76364.53,38
HCPCS,33230,Insertion of defibrillator with existing dual leads,33444.3,21738.795,78.57,170375.27,38
HCPCS,33231,Insertion of defibrillator with existing multiple leads,46246.65,30060.324999999997,78.57,236409.8,37
HCPCS,33233,Removal of permanent pacemaker pulse generator,5935.4,3858.01,78.57,28554.7,56
HCPCS,33234,Removal of single electrode from right heart,7354.3,4780.295,78.57,34267.19,38
HCPCS,33235,Removal of dual electrodes from right heart,9222.25,5994.465,78.57,42833.35,56
HCPCS,33236,"Removal of permanent pacemaker and electrodes, single lead",2940.0,1911.0,78.57,2281.24,19
HCPCS,33237,"Removal of permanent pacemaker and electrodes, dual lead",3097.5,2013.38,78.57,2453.82,19
HCPCS,33238,Removal of permanent pacemaker venous electrodes,2648.1,1721.27,78.57,2755.31,19
HCPCS,33240,Insertion of defibrillator with existing single lead,33491.55,21769.51,78.57,170375.27,38
HCPCS,33241,Removal of defibrillator,4783.0,3108.95,78.57,22971.34,57
HCPCS,33243,Removal of defibrillator electrodes through incision,3871.4,2516.41,78.57,4009.45,19
HCPCS,33244,Removal of defibrillator electrodes through vein,5712.25,3712.965,78.57,22971.34,57
HCPCS,33249,Insertion of implantable defibrillator system,39642.5,25767.625,78.57,194720.5,56
HCPCS,33250,Destruction of abnormal heart beat pathway,4175.9,2714.34,78.57,4254.46,19
HCPCS,33251,Destruction of abnormal heart beat pathway on heart-lung machine,4693.5,3050.78,78.57,4744.17,19
HCPCS,33254,Partial destruction and reconstruction of upper heart chamber,7874.8,5118.62,78.57,30607.79,38
HCPCS,33255,Extensive destruction and reconstruction of upper heart chamber,4690.4,3048.76,78.57,4750.02,19
HCPCS,33256,Extensive destruction and reconstruction of upper heart chamber on heart-lung machine,5571.3,3621.35,78.57,5625.29,19
HCPCS,33257,Partial destruction and reconstruction of right upper heart chamber,1665.3,1082.45,78.57,1704.06,19
HCPCS,33258,Extensive destruction and reconstruction of right upper heart chamber,1874.3,1218.3,78.57,1904.26,19
HCPCS,33259,Extensive destruction and reconstruction of right upper heart chamber on heart-lung machine,2417.1,1571.12,78.57,2473.74,19
HCPCS,33261,Destruction of tissue and reconstruction of right lower heart chamber on heart-lung machine,4626.3,3007.1,78.57,4706.36,19
HCPCS,33262,Removal and replacement of single lead defibrillator,33416.5,21720.725,78.57,170375.27,38
HCPCS,33263,Removal and replacement of dual lead defibrillator,33366.5,21688.225,78.57,170375.27,38
HCPCS,33264,Removal and replacement of multiple lead defibrillator,34648.0,22521.2,78.57,176772.13,37
HCPCS,33265,Limited reconstruction of upper heart chamber and alteration of electrical pathway using an endoscope,3156.5,2051.73,78.57,3977.68,19
HCPCS,33266,Extensive reconstruction of upper heart chamber and alteration of electrical pathway using an endoscope,4368.0,2839.2,78.57,5369.51,19
HCPCS,33267,Exclusion of appendage of left upper chamber of heart,2249.0,1461.85,78.57,3066.7,19
HCPCS,33268,Exclusion of appendage of left upper chamber of heart performed during other procedure on chest,280.0,182.0,78.57,381.79,19
HCPCS,33269,Exclusion of appendage of left upper chamber of heart using an endoscope,1780.0,1157.0,78.57,2427.06,19
HCPCS,33270,Insertion or replacement of defibrillator with electrode,47176.6,30664.79,78.57,239862.6,38
HCPCS,33271,Insertion of defibrillator electrode,9727.3,6322.745,78.57,47171.95,38
HCPCS,33272,Removal of defibrillator electrode,6303.1,4097.015,78.57,30106.79,38
HCPCS,33273,Repositioning of defibrillator electrode,6589.35,4283.08,78.57,31558.15,38
HCPCS,33274,Insertion of permanent leadless pacemaker using imaging guidance,15920.5,10348.324999999999,78.57,79305.99,56
HCPCS,33275,Removal of permanent leadless pacemaker using imaging guidance,3642.5,2367.625,78.57,13648.51,56
HCPCS,33285,Insertion of heart rhythm monitor under skin,19840.98,12896.64,67.26,51239.38,76
HCPCS,33286,Removal of heart rhythm monitor from under the skin,681.0,442.65,66.26,2995.7,76
HCPCS,33289,Insertion of wireless pressure sensor into lung artery through tube with review by radiologist,9483.0,6163.95,78.57,151566.93,55
HCPCS,33300,Repair of wound to heart,6836.6,4443.79,78.57,7110.64,19
HCPCS,33305,Repair of wound to heart on heart-lung machine,18242.45,11857.595,78.57,64562.5,38
HCPCS,33310,Incision and exploration of heart,3341.1,2171.72,78.57,3424.07,19
HCPCS,33315,Incision or exploration of heart on heart-lung machine,5407.5,3514.88,78.57,5587.16,19
HCPCS,33320,Repair of aorta or great vessels with sutures,3016.7,1960.86,78.57,3091.11,19
HCPCS,33321,Repair of aorta or great vessels with sutures using a shunt bypass,2751.45,1788.44,78.57,3466.69,19
HCPCS,33322,Repair of aorta or great vessels with sutures on heart-lung machine,8467.5,5503.875,78.57,30990.0,38
HCPCS,33330,Repair of aorta or great vessels with graft,4935.0,3207.75,78.57,4163.67,19
HCPCS,33335,Repair of aorta or great vessels with graft on heart-lung machine,6195.0,4026.75,78.57,5451.9,19
HCPCS,33340,Repair of left upper heart chamber with implant with review by radiologist,6925.425,4501.525,78.57,30990.0,56
HCPCS,33361,Replacement of aortic valve through the skin and femoral artery,19944.9,12964.185,78.57,92071.29,38
HCPCS,33362,Replacement of aortic valve by through femoral artery,4636.8,3013.92,78.57,3841.0,19
HCPCS,33363,Replacement of aortic valve through axillary artery,4800.6,3120.39,78.57,3981.54,19
HCPCS,33364,Replacement of aortic valve through iliac artery,5108.3,3320.4,78.57,3974.16,19
HCPCS,33365,Replacement of aortic valve by tube through aorta,5564.0,3616.6,78.57,4158.12,19
HCPCS,33366,Replacement of aortic valve by tube through heart,6002.9,3901.89,78.57,4580.42,19
HCPCS,33367,Insertion of tube in peripheral blood vessel accessed through skin for heart-lung machine support,1953.0,1269.45,78.57,1775.91,19
HCPCS,33368,Insertion of tube in peripheral blood vessel for heart-lung machine support,2365.7,1537.71,78.57,2152.12,19
HCPCS,33369,Insertion of tube in central blood vessel for heart-lung machine support,3123.8,2030.47,78.57,2839.99,19
HCPCS,33370,Placement and subsequent removal of device to protect brain from embolism through catheter using imaging guidance,9569.5,6220.175,78.57,48680.13,38
HCPCS,33390,Simple repair of aortic valve on heart-lung machine,4428.4,2878.46,78.57,5617.32,19
HCPCS,33391,Complex repair of aortic valve on heart-lung machine,5247.75,3411.04,78.57,6675.04,19
HCPCS,33404,Creation of blood flow from left lower heart chamber to aorta,7140.0,4641.0,78.57,5105.55,19
HCPCS,33405,Replacement of aortic valve on heart-lung machine,6573.0,4272.45,78.57,6612.98,19
HCPCS,33406,Replacement of aortic valve using human donor valve on heart-lung machine,8275.1,5378.82,78.57,8364.63,19
HCPCS,33410,Replacement of aortic valve using tissue valve on heart-lung machine,7340.6,4771.39,78.57,7391.88,19
HCPCS,33411,Replacement of aortic valve with aorta enlargement,9409.1,6115.92,78.57,9757.27,19
HCPCS,33412,Replacement of aortic valve with enlargement at base of valve,7140.0,4641.0,78.57,9157.36,19
HCPCS,33413,Repair and enlargement of blood outflow tract to great vessels from left or right lower heart chamber,9150.8,5948.02,78.57,9385.67,19
HCPCS,33414,Repair and enlargement of blood outflow tract of left lower heart chamber,6982.5,4538.63,78.57,6241.84,19
HCPCS,33415,Incision or removal of tissue below aortic valve,5868.5,3814.53,78.57,5904.09,19
HCPCS,33416,Removal of thickened heart muscle at left lower heart chamber,6405.0,4163.25,78.57,5897.96,19
HCPCS,33417,Repair of aorta at heart,6405.0,4163.25,78.57,4866.32,19
HCPCS,33418,"Repair of mitral valve through the skin, initial prosthesis",19576.95,12725.019999999999,78.57,90113.76,38
HCPCS,33419,"Repair of mitral valve through the skin, additional prosthesis",8908.95,5790.82,78.57,77736.68,38
HCPCS,33420,Removal of mitral valve scar tissue,4567.5,2968.88,78.57,4239.8,19
HCPCS,33422,Removal of mitral valve scar tissue on heart-lung machine,6273.8,4077.97,78.57,4860.13,19
HCPCS,33425,Repair of mitral valve on heart-lung machine,7749.0,5036.85,78.57,7950.53,19
HCPCS,33426,Repair of mitral valve with artificial valve on heart-lung machine,6876.5,4469.73,78.57,6938.24,19
HCPCS,33427,Radical reconstruction of mitral valve on heart-lung machine,7044.5,4578.93,78.57,7118.94,19
HCPCS,33430,Replacement of mitral valve on heart-lung machine,8081.9,5253.24,78.57,8161.16,19
HCPCS,33440,Replacement of aortic and pulmonary valves and enlargement of outflow tract from left lower heart chamber,7811.0,5077.15,78.57,9905.61,19
HCPCS,33460,Removal of tricuspid valve on heart-lung machine,6904.8,4488.12,78.57,6987.25,19
HCPCS,33463,Repair of tricuspid valve,8751.8,5688.67,78.57,9020.04,19
HCPCS,33464,Repair of tricuspid valve with ring insertion,6992.0,4544.8,78.57,7111.07,19
HCPCS,33465,Replacement of tricuspid valve on heart-lung machine,7845.6,5099.64,78.57,8018.39,19
HCPCS,33468,Repositioning of tricuspid valve,7691.3,4999.35,78.57,7116.57,19
HCPCS,33474,Incision of pulmonary valve on heart-lung machine,6405.0,4163.25,78.57,6342.26,19
HCPCS,33475,Replacement of pulmonary valve,6683.3,4344.15,78.57,6774.43,19
HCPCS,33476,Release of restrictive right ventricular muscle bands or valve leaflets,6273.8,4077.97,78.57,4415.51,19
HCPCS,33477,Insertion of pulmonary valve,6388.5,4152.525,78.57,77736.68,57
HCPCS,33478,Enlargement of blood outflow tract in right lower heart chamber,6851.3,4453.35,78.57,4587.95,19
HCPCS,33496,Repair of artificial heart valve on heart-lung machine,4810.1,3126.57,78.57,4863.39,19
HCPCS,33500,Repair of heart abnormal artery-vein or artery-heart connection on heart-lung machine,6090.0,3958.5,78.57,4559.84,19
HCPCS,33501,Repair of heart abnormal artery-vein or artery-heart connection,3195.2,2076.88,78.57,3267.71,19
HCPCS,33502,Repair of abnormal heart artery,3087.0,2006.55,78.57,3719.2,19
HCPCS,33503,Repair of abnormal heart artery with graft,3061.1,1989.72,78.57,3877.67,19
HCPCS,33504,Repair of abnormal heart artery with graft on heart-lung machine,6273.8,4077.97,78.57,4264.19,19
HCPCS,33505,Repair of abnormal heart artery with diversion of blood flow,4758.9,3093.29,78.57,5975.53,19
HCPCS,33506,Repair of abnormal heart artery with diversion of blood flow to aorta,5825.4,3786.51,78.57,5935.65,19
HCPCS,33507,Repair of abnormal heart artery at its aortic origin,4896.2,3182.53,78.57,5005.34,19
HCPCS,33508,Harvest of vein using an endoscope,47.3,30.75,12.35,78.57,19
HCPCS,33509,Harvest of artery from arm for heart bypass graft using an endoscope,368.0,239.2,78.57,502.37,19
HCPCS,33510,"Coronary artery bypass using vein graft, 1 graft",5600.7,3640.46,78.57,5639.47,19
HCPCS,33511,"Coronary artery bypass using vein graft, 2 grafts",6140.4,3991.26,78.57,6189.25,19
HCPCS,33512,"Coronary artery bypass using vein graft, 3 grafts",6982.5,4538.63,78.57,7058.61,19
HCPCS,33513,"Coronary artery bypass using vein graft, 4 grafts",7376.3,4794.6,78.57,7224.63,19
HCPCS,33514,"Coronary artery bypass using vein graft, 5 grafts",7848.8,5101.72,78.57,7603.66,19
HCPCS,33516,"Coronary artery bypass using vein graft, 6 or more grafts",7875.0,5118.75,78.57,7872.65,19
HCPCS,33517,"Coronary artery bypass using vein or artery graft, 1 graft",543.9,353.54,78.57,543.77,19
HCPCS,33518,"Coronary artery bypass using vein or artery graft, 2 grafts",1190.7,773.96,78.57,1192.09,19
HCPCS,33519,"Coronary artery bypass using vein or artery graft, 3 grafts",1581.3,1027.85,78.57,1577.16,19
HCPCS,33521,"Coronary artery bypass using vein or artery graft, 4 grafts",1899.5,1234.68,78.57,1891.24,19
HCPCS,33522,"Coronary artery bypass using vein or artery graft, 5 grafts",3071.3,1996.35,78.57,2123.15,19
HCPCS,33523,"Coronary artery bypass using vein or artery graft, 6 or more grafts",3570.0,2320.5,78.57,2402.95,19
HCPCS,33530,Coronary artery bypass or valve procedure reoperation more than 1 month after original operation,6423.1,4175.015,78.57,29259.73,38
HCPCS,33533,"Coronary artery bypass using artery graft, 1 graft",5394.9,3506.69,78.57,5456.73,19
HCPCS,33534,"Coronary artery bypass using artery graft, 2 grafts",6351.5,4128.48,78.57,6403.53,19
HCPCS,33535,"Coronary artery bypass using artery graft, 3 grafts",7086.5,4606.23,78.57,7129.28,19
HCPCS,33536,"Coronary artery bypass using artery graft, 4 grafts",7661.9,4980.24,78.57,7681.51,19
HCPCS,33542,Partial removal of heart muscle,7491.8,4869.67,78.57,7626.08,19
HCPCS,33545,Repair of lower heart chamber following heart attack,8838.9,5745.29,78.57,8932.68,19
HCPCS,33548,Restoration and reshaping of left lower heart chamber,8552.3,5559.0,78.57,8650.2,19
HCPCS,33572,Removal of plaque from heart artery at time of coronary artery bypass,3045.0,1979.25,78.57,667.59,19
HCPCS,33600,Closure of mitral or tricuspid valve,4364.9,2837.19,78.57,5003.96,19
HCPCS,33602,Closure of aortic or pulmonary valve,2793.0,1815.45,78.57,4856.31,19
HCPCS,33606,Connection of pulmonary artery to aorta,5144.0,3343.6,78.57,5185.36,19
HCPCS,33608,Repair of congenital defect in right or left heart chamber,5145.0,3344.25,78.57,5250.5,19
HCPCS,33610,Repair of congenital defect in wall between lower heart chambers,4581.2,2977.78,78.57,5179.0,19
HCPCS,33611,Repair of double outlet defect of right lower heart chamber,5568.2,3619.33,78.57,5670.05,19
HCPCS,33612,Repair of double outlet defect and outflow tract of right lower heart chamber,3363.2,2186.08,78.57,5819.91,19
HCPCS,33615,Repair of congenital defect in wall between upper heart chambers and connection of atria to pulmonary artery (Simple Fontan procedure),4606.23,2994.05,78.57,5818.05,19
HCPCS,33617,Repair of complex congenital defect in wall between upper heart chambers and connection of atria to pulmonary artery (Modified Fontan procedure),8137.5,5289.38,78.57,6266.35,19
HCPCS,33619,Repair to improve congenital blood flow defect from lower heart chamber,7686.0,4995.9,78.57,7989.1,19
HCPCS,33620,Application of right and left pulmonary artery bands,3990.0,2593.5,78.57,4794.5,19
HCPCS,33621,Insertion of stent in defect between upper heart chambers,2148.93,1396.8,78.57,2713.75,19
HCPCS,33622,Reconstruction of complex cardiac defects,8406.08,5463.95,78.57,9951.29,19
HCPCS,33641,Repair of congenital defect between upper heart chambers on heart-lung machine,4697.7,3053.51,78.57,4768.91,19
HCPCS,33645,Repair of tissue between upper heart chambers,5407.5,3514.88,78.57,5038.33,19
HCPCS,33647,Repair of congenital defect in wall between both upper and lower heart chamber,7140.0,4641.0,78.57,5282.56,19
HCPCS,33660,Repair of partial congenital defect between both upper and lower heart chambers,6142.5,3992.63,78.57,5107.21,19
HCPCS,33665,Repair of intermediate congenital defect between both upper and lower heart chambers,6562.5,4265.63,78.57,5561.16,19
HCPCS,33670,Repair of complete congenital defect between both upper and lower heart chambers,7691.3,4999.35,78.57,5725.39,19
HCPCS,33675,Closure of multiple congenital defects between lower heart chambers,5669.0,3684.85,78.57,5728.46,19
HCPCS,33676,Closure of multiple congenital defects between lower heart chambers with valve tissue release,5826.5,3787.23,78.57,5879.61,19
HCPCS,33677,Closure of multiple congenital defects between lower heart chambers with removal of band,6056.4,3936.66,78.57,6105.58,19
HCPCS,33681,Closure of congenital defect between lower heart chambers,6011.3,3907.35,78.57,5366.6,19
HCPCS,33684,Closure of congenital defect between lower heart chambers with valve tissue release,5482.1,3563.37,78.57,5488.66,19
HCPCS,33688,Closure of congenital defect between lower heart chambers with removal of band,6562.5,4265.63,78.57,5470.14,19
HCPCS,33690,Banding of pulmonary artery,3376.8,2194.92,78.57,3509.18,19
HCPCS,33692,Repair and correction of 4 congenital heart defects,6273.8,4077.97,78.57,5680.69,19
HCPCS,33694,Repair and correction of 4 congenital heart defects with patch,6982.5,4538.63,78.57,5670.05,19
HCPCS,33697,Repair and correction of 4 congenital heart defects including closure between lower heart chambers,6055.4,3936.01,78.57,5971.07,19
HCPCS,33702,Repair to improve blood flow to lung or heart on heart-lung machine,5696.3,3702.6,78.57,4496.83,19
HCPCS,33710,Repair of opening in wall between lower heart chambers on heart-lung machine,4735.88,3078.32,78.57,5960.94,19
HCPCS,33720,Repair of aneurysm above heart valve to lung on heart-lung machine,4368.0,2839.2,78.57,4515.85,19
HCPCS,33724,Repair of abnormal pulmonary vein return to left upper heart chamber,4413.2,2868.58,78.57,4476.0,19
HCPCS,33726,Repair of pulmonary vein narrowing,5803.4,3772.21,78.57,5905.11,19
HCPCS,33730,Complete repair of abnormal pulmonary vein return to left upper heart chamber,6693.8,4350.97,78.57,5808.53,19
HCPCS,33732,Removal of membrane of left upper heart chamber,4272.5,2777.13,78.57,4730.61,19
HCPCS,33735,Enlargement of hole in wall between upper heart chambers using balloon,4278.8,2781.22,78.57,3789.21,19
HCPCS,33736,Enlargement of hole in wall between upper heart chambers on heart-lung machine,3992.1,2594.87,78.57,4069.24,19
HCPCS,33741,"Incision of partition between upper chambers of heart to allow blood flow for congenital heart defects, via catheter using imaging guidance",8340.5,5421.325,78.57,38737.5,38
HCPCS,33745,"Creation of shunt for blood flow within heart for congenital heart defects, via catheter using imaging guidance",8698.5,5654.025,78.57,38737.5,38
HCPCS,33746,"Creation of additional shunt for blood flow within heart for congenital heart defects, via catheter using imaging guidance",951.5,618.48,78.57,1253.42,19
HCPCS,33750,Insertion of shunt from chest to pulmonary artery,3865.1,2512.32,78.57,3688.75,19
HCPCS,33755,Insertion of shunt from ascending aorta to pulmonary artery,3990.0,2593.5,78.57,3850.14,19
HCPCS,33762,Insertion of shunt from descending aorta to pulmonary artery,3640.4,2366.26,78.57,3744.82,19
HCPCS,33764,Insertion of shunt with artificial graft from aorta to pulmonary artery,4278.8,2781.22,78.57,3850.14,19
HCPCS,33766,"Insertion of shunt from vena cava to pulmonary artery to improve blood flow, 1 lung",3896.6,2532.79,78.57,3890.98,19
HCPCS,33767,"Insertion of shunt from vena cava to pulmonary artery to improve blood flow, both lungs",4462.5,2900.63,78.57,4152.42,19
HCPCS,33768,Removal of congenital extra vena cava,1211.7,787.61,78.57,1204.58,19
HCPCS,33770,Repair of group of congenital heart defects with reversal of blood flow,5174.58,3363.48,78.57,6145.76,19
HCPCS,33771,Repair of group of congenital heart defects with reversal of blood flow and enlargement of hole in wall between lower heart chambers,5334.8,3467.62,78.57,6318.03,19
HCPCS,33774,Repair of group of congenital heart defects with reversal of blood flow on heart-lung machine,7140.0,4641.0,78.57,5250.96,19
HCPCS,33775,Repair of group of congenital heart defects with reversal of blood flow and band removal on heart-lung machine,8268.8,5374.72,78.57,5405.19,19
HCPCS,33776,Repair of group of congenital heart defects with reversal of blood flow and closure of hole in wall between lower heart chambers on heart-lung machine,8557.5,5562.38,78.57,5659.13,19
HCPCS,33777,Repair of group of congenital heart defects and obstruction with reversal of blood flow on heart-lung machine,8505.0,5528.25,78.57,5510.18,19
HCPCS,33778,Repair of group of congenital heart defects with redirection of blood flow,8557.5,5562.38,78.57,6836.68,19
HCPCS,33779,Repair of group of congenital heart defects with redirection of blood flow and band removal,8846.3,5750.1,78.57,6746.66,19
HCPCS,33780,Repair of a group of congenital heart defects with redirection of blood flow and closure of hole in wall between lower heart chambers,9870.0,6415.5,78.57,6838.51,19
HCPCS,33781,Repair of a group of congenital heart defects and obstruction with redirection of blood flow,9450.0,6142.5,78.57,6706.95,19
HCPCS,33782,Relocation of aorta and repair of wall between lower heart chambers,8589.0,5582.85,78.57,9362.1,19
HCPCS,33783,Relocation of aorta and repair of wall between lower heart chambers with reimplantation,9305.1,6048.32,78.57,10113.96,19
HCPCS,33786,Total repair of group of congenital heart defects with redirection of blood flow,7796.3,5067.6,78.57,6618.96,19
HCPCS,33788,Reimplantation of abnormal pulmonary artery to heart,4698.8,3054.22,78.57,4471.12,19
HCPCS,33800,Suture of aorta to chest bone,2513.7,1633.91,78.57,2874.44,19
HCPCS,33802,Division of extra arch of aorta,3150.0,2047.5,78.57,3172.02,19
HCPCS,33803,Division and reconnection of extra arch of aorta,2653.75,1724.94,78.57,3364.26,19
HCPCS,33814,Repair of defect of wall between aorta and pulmonary artery on heart-lung machine,6300.0,4095.0,78.57,4452.35,19
HCPCS,33820,Tying of congenital heart defect from pulmonary artery to aorta,2835.0,1842.75,78.57,2820.88,19
HCPCS,33822,"Repair of congenital heart defect from pulmonary artery to aorta, younger than 18 years",3412.5,2218.13,78.57,2981.38,19
HCPCS,33824,"Repair of congenital heart defect from pulmonary artery to aorta, 18 years or older",3990.0,2593.5,78.57,3449.4,19
HCPCS,33840,Repair of congenital narrowed aorta,3990.0,2593.5,78.57,3623.27,19
HCPCS,33845,Repair of congenital narrowed aorta with graft,5696.3,3702.6,78.57,3873.25,19
HCPCS,33851,Repair of congenital narrowed aorta using left chest artery or artificial material,6273.8,4077.97,78.57,3720.47,19
HCPCS,33852,Repair of abnormal aortic arch,5276.3,3429.6,78.57,4017.68,19
HCPCS,33853,Repair of abnormal aortic arch on heart-lung machine,5455.8,3546.27,78.57,5310.12,19
HCPCS,33858,Repair of ascending aorta with graft on heart-lung machine with valve suspension for aortic wall separation,7776.5,5054.73,78.57,9815.36,19
HCPCS,33859,Repair of ascending aorta with graft on heart-lung machine with valve suspension for aortic disease,5587.25,3631.71,78.57,7055.11,19
HCPCS,33863,Repair of ascending aorta with graft on heart-lung machine with aortic root replacement and heart reconstruction,8882.0,5773.3,78.57,9142.7,19
HCPCS,33864,Repair of ascending aorta with graft on heart-lung machine with aortic root remodeling and heart reconstruction,9126.6,5932.29,78.57,9349.56,19
HCPCS,33866,Repair of aortic arch with graft,2390.0,1553.5,78.57,2671.09,19
HCPCS,33871,Repair of aortic arch with graft on heart-lung machine,7468.75,4854.69,78.57,9463.46,19
HCPCS,33875,Repair of descending aorta with graft,5627.0,3657.55,78.57,7914.06,19
HCPCS,33877,Repair of aortic aneurysm with graft,10207.1,6634.62,78.57,10457.3,19
HCPCS,33880,Repair of descending aorta and subclavian artery with insertion of graft and extensions,19152.7,12449.255,78.57,86699.69,57
HCPCS,33881,Repair of descending aorta with insertion of graft and extensions,19628.3,12758.395,78.57,90880.76,57
HCPCS,33882,ENDOVASCULAR REPAIR OF THE THORACIC AORTA BY DEPLOYMENT OF A BRANCHED ENDOGRAFT MULTIPIECE SYSTEM INVOLVING AN AORTO-AORTIC TUBE DEVICE WITH A FENESTRATION FOR THE LEFT SUBCLAVIAN ARTERY STENT GRAFT(S,3000.0,1950.0,73.6,8005.75,96
HCPCS,33883,"Repair of descending aorta, initial extension",2050.6499999999996,1332.925,78.57,3229.86,38
HCPCS,33886,Insertion of extension after previous repair of descending aorta,2573.6,1672.84,78.57,2788.23,19
HCPCS,33894,Repair of aorta by insertion of stent across major side branches,5904.0,3837.6,78.57,25050.25,38
HCPCS,33895,Repair of aorta by insertion of stent not crossing major side branches,5588.5,3632.525,78.57,24533.75,38
HCPCS,33897,Balloon dilation of native or recurrent narrowing of heart blood vessel,8124.0,5280.6,78.57,38737.5,38
HCPCS,33900,"Placement of stent in pulmonary artery with normal anatomical connections, on one side of body",1255.0,815.75,78.57,1709.74,19
HCPCS,33901,"Placement of stent in pulmonary arteries with normal anatomical connections, on both sides of body",1649.5,1072.18,78.57,2247.64,19
HCPCS,33902,"Placement of stent in pulmonary artery with abnormal anatomical connections, on one side of body",20887.5,13576.875,78.57,103770.02,56
HCPCS,33903,"Placement of stent in pulmonary arteries with abnormal anatomical connections, on both sides of body",14576.25,9474.565,78.57,70437.69,37
HCPCS,33904,Placement of additional stent in pulmonary artery,697.0,453.05,78.57,858.07,19
HCPCS,33910,Removal of blood clot in pulmonary artery on heart-lung machine,5145.0,3344.25,78.57,7654.07,19
HCPCS,33915,Removal of blood clot in pulmonary artery,4110.8,2672.02,78.57,4021.46,19
HCPCS,33916,Removal of plaque from pulmonary artery on heart-lung machine,9754.2,6340.23,78.57,12134.94,19
HCPCS,33917,Repair of pulmonary artery narrowing with graft,4204.2,2732.73,78.57,4254.46,19
HCPCS,33920,Repair of right lower heart chamber obstruction with creation of channel from lower heart chamber to pulmonary artery,5131.4,3335.41,78.57,5271.71,19
HCPCS,33922,Incision of pulmonary artery on heart-lung machine,4095.0,2661.75,78.57,4047.21,19
HCPCS,33924,Disconnection of pulmonary artery shunt,814.8,529.62,78.57,825.8,19
HCPCS,33925,Repair of defect of pulmonary artery,4570.7,2970.96,78.57,4990.46,19
HCPCS,33926,Repair of defect of pulmonary artery on heart-lung machine,6834.5,4442.43,78.57,7011.64,19
HCPCS,33927,Implantation of artificial heart,5420.0,3523.0,78.57,7377.11,19
HCPCS,33930,Harvest of donor heart and lung,4410.0,2866.5,73.6,2205.0,15
HCPCS,33933,Preparation of donor heart and lung for transplantation,645.43,419.53,78.57,3307.33,15
HCPCS,33935,Transplantation of donor heart and lung,32123.0,20879.95,78.57,14351.91,19
HCPCS,33940,Removal of donor heart for transplantation,2625.0,1706.25,73.6,1335.65,15
HCPCS,33944,Preparation of donor heart for transplantation,4725.0,3071.25,78.57,2362.5,15
HCPCS,33945,Transplantation of donor heart,31325.0,20361.25,78.57,14139.0,19
HCPCS,33946,Initiation of ECMO external vein to vein blood circulation in heart and lungs using a pump,3552.75,2309.29,78.57,16370.47,57
HCPCS,33947,Initiation of ECMO external vein to artery blood circulation in heart and lungs using a pump,2671.05,1736.185,78.57,11621.25,57
HCPCS,33948,Daily management of ECMO external vein to vein blood circulation in heart and lungs using a pump,3469.3,2255.045,78.57,16370.47,38
HCPCS,33949,Daily management of ECMO external vein to artery blood circulation in heart and lungs using a pump,583.8,379.47,78.57,693.2,19
HCPCS,33951,Insertion of tube through the skin for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),1015.4,660.01,78.57,1229.33,19
HCPCS,33952,Insertion of tube through the skin for ECMO external blood circulation in heart and lungs using a pump (6 years or older),995.1,646.815,78.57,10301.94,38
HCPCS,33953,Insertion of tube for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),1133.0,736.45,78.57,1373.03,19
HCPCS,33954,Insertion of tube for ECMO external blood circulation in heart and lungs using a pump (6 years or older),1105.7,718.71,78.57,1386.02,19
HCPCS,33955,Insertion of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),2158.8,1403.22,78.57,2401.61,19
HCPCS,33956,Insertion of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (6 years or older),2038.1,1324.77,78.57,2422.12,19
HCPCS,33957,Repositioning of tube for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),577.5,375.38,78.57,535.66,19
HCPCS,33958,Repositioning of tube for ECMO external blood circulation in heart and lungs using a pump (6 years or older),3449.85,2242.405,78.57,16370.47,38
HCPCS,33959,Repositioning of tube open procedure for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),700.4,455.26,78.57,679.34,19
HCPCS,33962,Repositioning of tube open procedure for ECMO external blood circulation in heart and lungs using a pump (6 years or older),660.5,429.33,78.57,679.34,19
HCPCS,33963,Repositioning of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),1272.6,827.19,78.57,1356.0,19
HCPCS,33964,Repositioning of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (6 years or older),1293.6,840.84,78.57,1430.77,19
HCPCS,33965,Removal of tube through skin for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),569.1,369.92,78.57,535.66,19
HCPCS,33966,Removal of tube through skin for ECMO external blood circulation in heart and lungs using a pump (6 years or older),655.2,425.88,78.57,690.79,19
HCPCS,33967,Insertion of blood flow assist device in aorta through skin,2631.8,1710.67,78.57,11676.43,55
HCPCS,33968,Removal of blood flow assist device in aorta,800.4,520.26,26.48,17036.0,57
HCPCS,33969,Removal of tube for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),757.1,492.12,78.57,790.65,19
HCPCS,33970,Insertion of blood flow assist device in aorta through upper leg artery,1706.3,1109.1,78.57,1031.86,19
HCPCS,33971,Removal of blood flow assist device in aorta with repair of upper leg artery,2126.3,1382.1,78.57,2075.36,19
HCPCS,33973,Insertion of blood flow assist device in aorta through ascending aorta,2999.3,1949.545,78.57,14138.43,38
HCPCS,33974,Removal of blood flow assist device in aorta with repair of ascending aorta,1783.39,1159.205,78.57,14138.43,38
HCPCS,33975,Insertion of external blood flow assist device in lower heart chamber,3753.8,2439.97,78.57,3779.11,19
HCPCS,33976,Insertion of external blood flow assist device in both lower heart chambers,4777.5,3105.38,78.57,4596.28,19
HCPCS,33977,Removal of external blood flow assist device in lower heart chamber,3440.9,2236.59,78.57,3263.15,19
HCPCS,33978,Removal of external blood flow assist device in both lower heart chambers,3808.4,2475.46,78.57,3865.21,19
HCPCS,33979,Insertion of implanted blood flow assist device in lower heart chamber,6880.7,4472.46,78.57,5633.26,19
HCPCS,33980,Removal of implanted blood flow assist device in lower heart chamber,10150.4,6597.76,78.57,5162.24,19
HCPCS,33981,Replacement of external blood flow assist device in lower heart chamber,2441.3,1586.85,78.57,2407.73,19
HCPCS,33982,Replacement of implanted blood flow assist device in lower heart chamber,6636.0,4313.4,78.57,5658.95,19
HCPCS,33983,Replacement of implanted blood flow assist device in lower heart chamber on heart-lung machine,6636.0,4313.4,78.57,6684.01,19
HCPCS,33984,Removal of tube for ECMO external blood circulation in heart and lungs using a pump (6 years or older),1215.65,790.175,78.57,10301.94,38
HCPCS,33985,Removal of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (5 years or younger),1416.5,920.73,78.57,1489.32,19
HCPCS,33986,Removal of tube through the chest for ECMO external blood circulation in heart and lungs using a pump (6 years or older),1344.0,873.6,78.57,1519.07,19
HCPCS,33987,Incision of artery for creation of channel for ECMO external blood circulation in heart and lungs using a pump,551.3,358.35,78.57,604.81,19
HCPCS,33988,Insertion of left heart vent through chest for ECMO external blood circulation in heart and lungs using a pump,1851.2,1203.28,78.57,2252.79,19
HCPCS,33989,Removal of left heart vent through chest for ECMO external blood circulation in heart and lungs using a pump,1200.2,780.13,78.57,1430.77,19
HCPCS,33990,Insertion of blood flow assist device in lower heart chamber through skin with review by radiologist using artery access,3858.85,2508.255,78.57,43784.36,56
HCPCS,33991,Insertion of blood flow assist device in lower heart chamber through skin with review by radiologist using artery and vein access,1729.35,1124.08,78.57,43784.36,38
HCPCS,33992,Removal of blood flow assist device in left lower heart chamber through the skin,5327.6,3462.94,78.57,25825.0,56
HCPCS,33993,Repositioning of blood flow assist device in lower heart chamber using imaging guidance,983.45,639.245,78.57,10722.03,38
HCPCS,33995,"Insertion of right lower heart chamber blood flow assist device via vein accessed through skin, including radiological supervision and interpretation",3655.125,2375.83,78.57,43784.36,56
HCPCS,33997,"Removal of right lower heart chamber blood flow assist device, accessed through skin",2180.3,1417.195,78.57,10722.03,38
HCPCS,33999,Other heart surgery procedure,7540.0,4901.0,306.25,35780.54,37
HCPCS,34001,Removal of blood clot in neck to chest artery,7718.15,5016.8,78.57,32526.59,38
HCPCS,34051,Removal of blood clot in chest artery,7709.75,5011.34,78.57,32526.59,38
HCPCS,34101,Removal of blood clot in artery of upper arm,7193.75,4675.94,78.57,32521.42,38
HCPCS,34111,Removal of blood clot in artery of lower arm,7193.75,4675.94,78.57,32521.42,38
HCPCS,34151,Removal of blood clot in artery of abdominal organs,8375.45,5444.045,78.57,32526.59,38
HCPCS,34201,Removal of blood clot in artery of groin and leg,8992.425,5845.075,78.57,34902.49,38
HCPCS,34203,Removal of blood clot in artery of lower leg,8902.65,5786.725,78.57,34902.49,38
HCPCS,34401,Removal of blood clot in vena cava,7061.55,4590.01,78.57,25566.75,57
HCPCS,34421,"Removal of blood clot in vena cava, pelvic, or thigh vein",4742.4,3082.56,78.57,18865.16,38
HCPCS,34451,"Removal of blood clot in vena cava, pelvic, or thigh vein by abdominal and leg incision",7119.85,4627.905,78.57,25566.75,38
HCPCS,34471,Removal of blood clot in upper chest vein,2328.1,1513.265,78.57,8477.27,38
HCPCS,34490,Removal of blood clot in underarm or upper chest vein,4636.9,3013.985,78.57,18865.16,38
HCPCS,34501,Repair of upper leg vein valve,2697.5,1753.38,78.57,2578.18,19
HCPCS,34502,Reconstruction of vena cava,6106.9,3969.4849999999997,78.57,18865.16,38
HCPCS,34510,Transfer of vein valve to another vein,3189.9,2073.44,78.57,2940.53,19
HCPCS,34520,Removal of vein segment,2961.0,1924.65,78.57,2849.72,19
HCPCS,34530,Connection of leg veins at back of knee,2893.8,1880.97,78.57,2685.67,19
HCPCS,34701,Repair of aorta with graft for other than rupture with review by radiologist,2655.0,1725.75,78.57,3594.79,19
HCPCS,34702,Repair of ruptured aorta with graft with review by radiologist,3970.0,2580.5,78.57,5337.37,19
HCPCS,34703,Repair of infrarenal aorta and groin artery with graft for other than rupture with review by radiologist,13985.0,9090.25,78.57,64562.5,38
HCPCS,34704,Repair of infrarenal aorta and groin artery with graft for rupture with review by radiologist,4950.0,3217.5,78.57,6579.38,19
HCPCS,34705,Repair of infrarenal aorta and groin artery with graft for other than rupture on both sides with review by radiologist,5297.5,3443.375,78.57,24359.93,38
HCPCS,34706,Repair of infrarenal aorta and groin artery with graft for rupture on both sides with review by radiologist,4950.0,3217.5,78.57,6576.97,19
HCPCS,34707,Repair of groin artery with graft for other than rupture with review by radiologist,2475.0,1608.75,78.57,3353.43,19
HCPCS,34708,Repair of groin artery with graft for rupture with review by radiologist,3985.0,2590.25,78.57,5353.12,19
HCPCS,34709,Repair of abdominal or groin artery with prosthesis with review by radiologist,4000.0,2600.0,78.57,24359.93,38
HCPCS,34710,"Delayed insertion of prosthesis for repair of abdominal or groin artery with review by radiologist, initial vessel treated",13462.5,8750.625,78.57,65079.0,38
HCPCS,34711,"Delayed insertion of prosthesis for repair of abdominal or groin artery with review by radiologist, each additional vessel treated",12920.0,8398.0,78.57,65079.0,38
HCPCS,34712,Delivery of fixation device to graft with review by radiologist,13350.0,8677.5,78.57,65104.83,38
HCPCS,34713,Exposure of groin artery for delivery of graft,3792.5,2465.125,78.57,24359.93,38
HCPCS,34714,Exposure of major groin artery with creation of conduit,590.0,383.5,78.57,777.74,19
HCPCS,34715,Exposure of underarm or upper chest artery for delivery of prosthesis,1175.0,763.75,78.57,5929.67,38
HCPCS,34716,Exposure of underarm or upper chest artery with creation of conduit,4157.5,2702.375,78.57,19368.75,36
HCPCS,34717,Repair of groin artery with graft insert through artery and repair of aorta,13008.375,8455.445,78.57,64562.5,38
HCPCS,34718,Repair of groin artery with graft insert through artery,2838.5,1845.03,78.57,3575.07,19
HCPCS,34808,Insertion of device to block groin artery,606.9,394.49,78.57,569.06,19
HCPCS,34812,Exposure of thigh artery for insertion of prosthesis,6807.9,4425.135,78.57,32518.84,38
HCPCS,34813,Insertion of graft in upper thigh artery,706.7,459.36,78.57,678.17,19
HCPCS,34820,Exposure of groin artery for insertion of prosthesis,1475.3,958.95,78.57,964.84,19
HCPCS,34830,Repair of aneurysm of aorta with prosthesis,5284.7,3435.06,78.57,5060.43,19
HCPCS,34831,Repair of aneurysm of aorta or groin artery with prosthesis,5679.5,3691.68,78.57,5540.32,19
HCPCS,34832,Repair of aneurysm of aorta or upper thigh artery with prothesis,6069.0,3944.85,78.57,5439.78,19
HCPCS,34833,Exposure of groin artery with creation of conduit,1799.7,1169.81,78.57,1124.5,19
HCPCS,34834,Exposure of arm artery for insertion of prosthesis,4056.35,2636.63,78.57,18852.25,38
HCPCS,34839,Physician planning of a patient-specific graft for repair of aorta,1398.75,909.19,73.6,699.38,15
HCPCS,34841,"Repair of aorta in abdomen with graft, including graft in abdominal organ arteries with review by radiologist",3633.375,2361.695,78.57,24359.93,53
HCPCS,34842,"Repair of aorta in abdomen below kidneys with graft, including 2 grafts in abdominal organ arteries with review by radiologist",3863.75,2511.44,78.57,24359.93,34
HCPCS,34843,"Repair of aorta in abdomen below kidneys with graft, including 3 grafts in abdominal organ arteries with review by radiologist",3944.2,2563.73,78.57,24359.93,34
HCPCS,34844,"Repair of aorta in abdomen below kidneys with graft, including 4 or more grafts in abdominal organ arteries with review by radiologist",3944.2,2563.73,78.57,24359.93,34
HCPCS,34845,"Repair of aorta in abdomen between and below kidneys with graft, including graft in artery to abdominal organs with review by radiologist",4399.375,2859.5950000000003,78.57,24359.93,34
HCPCS,34846,"Repair of aorta in abdomen between and below kidneys with graft, including 2 grafts in abdominal organ arteries with review by radiologist",4405.58,2863.625,78.57,24359.93,34
HCPCS,34847,"Repair of aorta in abdomen between and below kidneys with graft, including 3 grafts in abdominal organ arteries with review by radiologist",4710.2,3061.63,78.57,24359.93,34
HCPCS,34848,"Repair of aorta in abdomen between and below kidneys with graft, including 4 or more grafts in abdominal organ arteries with review by radiologist",4771.6,3101.54,78.57,24359.93,34
HCPCS,35001,Repair of aneurysm or neck or upper chest artery with graft,3806.3,2474.1,78.57,3253.65,19
HCPCS,35002,Repair of ruptured aneurysm of neck or upper chest artery with graft,3806.3,2474.1,78.57,3275.69,19
HCPCS,35005,Repair of aneurysm or head artery with graft,2578.27,1675.88,78.57,2870.94,19
HCPCS,35011,Repair of aneurysm or arm artery with graft,7981.0,5187.65,78.57,33575.08,38
HCPCS,35013,Repair of ruptured aneurysm of arm artery with graft,3680.3,2392.2,78.57,3653.85,19
HCPCS,35021,Repair of aneurysm or upper chest or neck artery with graft,3575.3,2323.95,78.57,3686.26,19
HCPCS,35022,Repair of ruptured aneurysm of upper chest or neck artery with graft,4097.1,2663.12,78.57,4183.1,19
HCPCS,35045,Repair of aneurysm or forearm artery with graft,2882.3,1873.5,78.57,2829.19,19
HCPCS,35081,Repair of aneurysm or abdominal aorta with graft,5194.4,3376.36,78.57,4986.94,19
HCPCS,35082,Repair of ruptured aneurysm of abdominal aorta with graft,6507.9,4230.14,78.57,6252.74,19
HCPCS,35091,Repair of aneurysm or abdominal aorta involving arteries to abdominal organs with graft,5385.5,3500.58,78.57,5149.55,19
HCPCS,35092,Repair of ruptured aneurysm of abdominal aorta involving arteries to abdominal organs with graft,7784.7,5060.06,78.57,7505.63,19
HCPCS,35102,Repair of aneurysm or abdominal aorta involving groin arteries with graft,5631.2,3660.28,78.57,5404.59,19
HCPCS,35103,Repair of ruptured aneurysm of abdominal aorta involving groin arteries with graft,6706.4,4359.16,78.57,6385.71,19
HCPCS,35111,Repair of aneurysm or spleen artery with graft,4137.0,2689.05,78.57,3819.29,19
HCPCS,35112,Repair of ruptured aneurysm of spleen artery with graft,5079.9,3301.94,78.57,4692.76,19
HCPCS,35121,"Repair of aneurysm or liver, kidneys, stomach and/or intestines artery with graft",4904.6,3187.99,78.57,4539.78,19
HCPCS,35122,"Repair of ruptured aneurysm of liver, kidneys, stomach, and/or intestine artery with graft",5893.7,3830.91,78.57,5426.58,19
HCPCS,35131,Repair of aneurysm or groin artery with graft,4158.0,2702.7,78.57,3944.04,19
HCPCS,35132,Repair of ruptured aneurysm of groin artery with graft,5057.9,3287.64,78.57,4692.76,19
HCPCS,35141,Repair of aneurysm or upper thigh artery with graft,2494.55,1621.46,78.57,8477.27,57
HCPCS,35142,Repair of ruptured aneurysm of upper thigh artery with graft,4042.5,2627.63,78.57,3820.68,19
HCPCS,35151,Repair of aneurysm or lower leg artery with graft,4042.5,2627.63,78.57,3567.32,19
HCPCS,35152,Repair of ruptured aneurysm of lower leg artery with graft,4209.5,2736.18,78.57,4017.18,19
HCPCS,35180,Repair of congenital abnormal artery-vein connection of head and neck,2250.38,1462.75,78.57,2262.92,19
HCPCS,35182,Repair of congenital abnormal artery-vein connection in chest and abdomen,4120.75,2678.49,78.57,5226.79,19
HCPCS,35184,Repair of congenital abnormal artery-vein connection in arms or legs,3162.6,2055.69,78.57,2777.47,19
HCPCS,35188,Repair of abnormal artery-vein connection of head and neck,3255.0,2115.75,78.57,3588.31,19
HCPCS,35189,Repair of abnormal artery-vein connection in chest and abdomen,4717.7,3066.51,78.57,4335.95,19
HCPCS,35190,Repair of abnormal artery-vein connection in arm or leg,3150.0,2047.5,78.57,2224.98,19
HCPCS,35201,Repair of blood vessel of neck,7950.25,5167.665,78.57,32521.42,38
HCPCS,35206,Repair of blood vessel of arm,2985.0,1940.25,78.57,7441.0,38
HCPCS,35207,Repair of blood vessel of hand or finger,3307.5,2149.88,78.57,2251.27,19
HCPCS,35211,Repair of blood vessel of chest on heart-lung machine,2782.35,1808.53,78.57,14138.43,38
HCPCS,35216,Repair of blood vessel of chest,5691.0,3699.15,78.57,6044.67,19
HCPCS,35221,Repair of blood vessel of abdomen,5130.0,3334.5,78.57,4284.97,19
HCPCS,35226,Repair of blood vessel of leg,2400.5,1560.325,78.57,7016.18,76
HCPCS,35231,Repair of blood vessel of neck with vein graft,4700.0,3055.0,78.57,3680.67,19
HCPCS,35236,Repair of blood vessel of arm with vein graft,4300.0,2795.0,78.57,2922.53,19
HCPCS,35241,Repair of blood vessel of chest with vein graft on heart-lung machine,4850.0,3152.5,78.57,4199.56,19
HCPCS,35246,Repair of blood vessel in chest with vein graft,5570.0,3620.5,78.57,4566.58,19
HCPCS,35251,Repair of blood vessel of abdomen with vein graft,6060.0,3939.0,78.57,5046.64,19
HCPCS,35256,Repair of blood vessel of leg with vein graft,5505.0,3578.25,78.57,2947.93,19
HCPCS,35261,Repair of blood vessel of neck with graft,3123.8,2030.47,78.57,2821.62,19
HCPCS,35266,Repair of blood vessel of arm with graft,3040.0,1976.0,78.57,2509.32,19
HCPCS,35271,Repair of blood vessel of chest with graft on heart-lung machine,8289.95,5388.469999999999,78.57,32521.42,38
HCPCS,35276,Repair of blood vessel of chest with graft,5150.0,3347.5,78.57,4265.45,19
HCPCS,35281,Repair of blood vessel of abdomen with graft,4705.1,3058.32,78.57,4706.36,19
HCPCS,35286,Repair of blood vessel of leg with graft,5005.0,3253.25,78.57,12796.29,76
HCPCS,35301,"Removal of blood clot and portion of chest, neck, or brain artery",11342.85,7372.855,78.57,46485.0,38
HCPCS,35302,Removal of blood clot and portion of superficial femoral artery,10373.4,6742.71,78.57,46485.0,38
HCPCS,35303,Removal of blood clot and portion of popliteal artery,10509.4,6831.11,78.57,46485.0,38
HCPCS,35304,Removal of blood clot and portion of tibioperoneal trunk artery,10592.35,6885.03,78.57,46485.0,38
HCPCS,35305,"Removal of blood clot and portion of tibial or peroneal artery, initial artery",10509.4,6831.11,78.57,46485.0,38
HCPCS,35306,"Removal of blood clot and portion of tibial or peroneal artery, each additional artery",9564.4,6216.86,78.57,46485.0,38
HCPCS,35311,Removal of blood clot and portion of chest or neck artery,11222.85,7294.855,78.57,46485.0,38
HCPCS,35321,Removal of blood clot and portion of artery of upper arm,8358.75,5433.1900000000005,78.57,34902.49,38
HCPCS,35331,Removal of blood clot and portion of abdominal aorta,11175.1,7263.8150000000005,78.57,46485.0,38
HCPCS,35341,Removal of blood clot and portion of artery of abdominal organ,11038.05,7174.735,78.57,46485.0,38
HCPCS,35351,Removal of blood clot and portion of artery of groin,10922.55,7099.66,78.57,46485.0,38
HCPCS,35355,Removal of blood clot and portion of artery of upper thigh,10837.5,7044.375,78.57,46485.0,38
HCPCS,35361,Removal of blood clot and portion of abdominal aorta and groin artery,11287.95,7337.17,78.57,46485.0,38
HCPCS,35363,Removal of blood clot and portion of abdominal aorta and upper thigh artery,4093.95,2661.07,78.57,4663.63,19
HCPCS,35371,Removal of blood clot and portion of upper thigh artery,14606.6,9494.29,78.57,64562.5,38
HCPCS,35372,Removal of blood clot and portion of deep upper thigh artery,10929.4,7104.11,78.57,46485.0,38
HCPCS,35390,Removal of blood clot and portion of neck artery following previous surgery,724.5,470.93,78.57,456.82,19
HCPCS,35400,Exam of blood vessel or graft using an endoscope,444.2,288.73,78.57,424.12,19
HCPCS,35500,Harvest of upper arm vein segment,6779.0,4406.35,78.57,32518.84,38
HCPCS,35501,Bypass of diseased or blocked neck to brain artery with vein,4654.7,3025.56,78.57,4189.89,19
HCPCS,35506,Bypass of diseased or blocked neck to chest artery with vein,3961.7,2575.11,78.57,3659.29,19
HCPCS,35508,Bypass of diseased or blocked back of neck to brain artery with vein,3101.4,2015.91,78.57,3815.68,19
HCPCS,35509,Bypass of diseased or blocked neck to opposite neck artery with vein,4404.8,2863.12,78.57,4055.34,19
HCPCS,35510,Bypass of diseased or blocked neck to arm artery with vein,3687.6,2396.94,78.57,3531.94,19
HCPCS,35511,Bypass of diseased or blocked chest to opposite chest artery with vein,3540.6,2301.39,78.57,3219.19,19
HCPCS,35512,Bypass of diseased or blocked chest to arm artery with vein,3615.2,2349.88,78.57,3462.56,19
HCPCS,35515,Bypass of diseased or blocked chest to brain artery with vein,3490.33,2268.71,78.57,3781.95,19
HCPCS,35516,Bypass of diseased or blocked chest to upper arm artery with vein,3658.2,2377.83,78.57,3504.76,19
HCPCS,35518,Bypass of diseased or blocked under arm to opposite arm artery with vein,3990.0,2593.5,78.57,3280.99,19
HCPCS,35521,Bypass of diseased or blocked arm to upper leg artery with vein,3675.0,2388.75,78.57,3531.47,19
HCPCS,35522,Bypass of diseased or blocked under arm to arm artery with vein,3626.7,2357.36,78.57,3361.02,19
HCPCS,35523,Bypass of diseased or blocked upper arm to arm artery with vein,4573.8,2972.97,78.57,3710.47,19
HCPCS,35525,Bypass of diseased or blocked upper arm to opposite arm artery with vein,3396.8,2207.92,78.57,3270.13,19
HCPCS,35526,Bypass of diseased or blocked chest to neck artery with vein,4974.9,3233.69,78.57,5049.26,19
HCPCS,35531,Bypass of diseased or blocked abdominal to abdominal artery with vein,6051.2,3933.28,78.57,5595.73,19
HCPCS,35533,Bypass of diseased or blocked arm to upper leg and opposite leg artery with vein,4987.5,3241.88,78.57,4329.07,19
HCPCS,35535,Bypass of diseased or blocked liver to kidney artery with vein,4442.1,2887.37,78.57,5461.93,19
HCPCS,35536,Bypass of diseased or blocked artery spleen to kidney artery with vein,5065.2,3292.38,78.57,4853.71,19
HCPCS,35537,Bypass of diseased or blocked aorta to groin artery with vein,5535.88,3598.32,78.57,5979.91,19
HCPCS,35538,Bypass of diseased or blocked aorta to groin and opposite groin artery with vein,5450.78,3543.01,78.57,6699.93,19
HCPCS,35539,Bypass of diseased or blocked aorta to upper leg artery with vein,5147.73,3346.02,78.57,6287.85,19
HCPCS,35540,Bypass of diseased or blocked aorta to upper leg and opposite upper leg artery with vein,7548.5,4906.53,78.57,7006.31,19
HCPCS,35556,Bypass of diseased or blocked upper to lower leg artery with vein,11079.0,7201.35,78.57,46485.0,57
HCPCS,35558,Bypass of diseased or blocked upper leg to opposite upper leg artery with vein,3666.6,2383.29,78.57,3557.82,19
HCPCS,35560,Bypass of diseased or blocked aorta to kidney artery with vein,5289.9,3438.44,78.57,4895.45,19
HCPCS,35563,Bypass of diseased or blocked groin to opposite groin artery with vein,4084.5,2654.93,78.57,3804.83,19
HCPCS,35565,Bypass of diseased or blocked groin to upper leg artery with vein,3943.8,2563.47,78.57,3781.1,19
HCPCS,35566,Bypass of diseased or blocked major upper to lower leg artery with vein,4987.5,3241.88,78.57,4800.62,19
HCPCS,35570,Bypass of diseased or blocked lower leg to opposite lower leg artery with vein,4358.6,2833.09,78.57,4233.98,19
HCPCS,35571,Bypass of diseased or blocked lower leg to lower leg artery with vein,4278.8,2781.22,78.57,3820.68,19
HCPCS,35572,Harvest of upper leg to thigh vein segment,6806.85,4424.455,78.57,32518.84,38
HCPCS,35583,Bypass of diseased or blocked thigh to knee artery with vein graft,4297.7,2793.51,78.57,4148.38,19
HCPCS,35585,Bypass of diseased or blocked upper leg to lower leg artery with vein graft,5016.9,3260.99,78.57,4809.47,19
HCPCS,35587,Bypass of diseased or blocked lower leg to lower leg artery with vein graft,4102.4,2666.56,78.57,3897.35,19
HCPCS,35600,Harvest of arm artery segment for heart byplass procedure,751.8,488.67,78.57,540.43,19
HCPCS,35601,Bypass of diseased or blocked neck to brain artery with other than vein,4307.1,2799.62,78.57,4038.36,19
HCPCS,35602,"BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID-CONTRALATERAL CAROTID",2686.45,1746.1950000000002,73.6,2896.26,32
HCPCS,35606,Bypass of diseased or blocked neck to chest artery with other than vein,3511.2,2282.28,78.57,3383.4,19
HCPCS,35612,Bypass of diseased or blocked chest to opposite chest artery with other than vein,3270.8,2126.02,78.57,3008.45,19
HCPCS,35616,Bypass of diseased or blocked chest to upper arm artery with other than vein,3391.5,2204.48,78.57,3165.44,19
HCPCS,35621,Bypass of diseased or blocked arm to chest artery with other than vein,3412.5,2218.13,78.57,3166.79,19
HCPCS,35623,Bypass of diseased or blocked arm to lower leg artery with other than vein,3936.5,2558.73,78.57,3777.99,19
HCPCS,35626,Bypass of diseased or blocked arm to lower thigh or leg artery with other than vein,4593.8,2985.97,78.57,4638.3,19
HCPCS,35631,Bypass of diseased or blocked artery aorta to abdominal or kidney artery with other than vein,5502.0,3576.3,78.57,5318.87,19
HCPCS,35632,Bypass of diseased or blocked groin to stomach artery with other than vein,4185.23,2720.4,78.57,5186.37,19
HCPCS,35633,Bypass of diseased or blocked groin to abdominal artery with other than vein,5958.8,3873.22,78.57,5699.4,19
HCPCS,35634,Bypass of diseased or blocked groin to kidney artery with other than vein,5403.3,3512.15,78.57,5075.83,19
HCPCS,35636,Bypass of diseased or blocked spleen to kidney artery with other than vein,4789.1,3112.92,78.57,4580.45,19
HCPCS,35637,Bypass of diseased or blocked aorta to groin artery with other than vein,4234.7,2752.56,78.57,4762.69,19
HCPCS,35638,Bypass of diseased or blocked aorta to groin to opposite groin artery with other than vein,5226.9,3397.49,78.57,5000.69,19
HCPCS,35642,Bypass of diseased or blocked back of neck to brain artery with other than vein,2547.18,1655.67,78.57,2846.38,19
HCPCS,35645,Bypass of diseased or blocked chest to arm artery with other than vein,2420.78,1573.51,78.57,2727.75,19
HCPCS,35646,Bypass of diseased or blocked artery aorta to upper leg and opposite upper leg artery with other than vein,11570.95,7521.12,78.57,46485.0,38
HCPCS,35647,Bypass of diseased or blocked aorta to upper leg artery with other than vein,11062.75,7190.79,78.57,46485.0,38
HCPCS,35650,Bypass of diseased or blocked under arm to opposite arm artery with other than vein,10771.9,7001.735,78.57,46485.0,38
HCPCS,35654,Bypass of diseased or blocked arm to both lower thigh arteries with other than vein,11480.65,7462.425,78.57,46485.0,38
HCPCS,35656,Bypass of diseased or blocked upper leg to lower thigh artery with other than vein,10771.9,7001.735,78.57,46485.0,38
HCPCS,35661,Bypass of diseased or blocked upper leg to opposite upper leg artery with other than vein,10625.4,6906.51,78.57,46485.0,38
HCPCS,35663,Bypass of diseased or blocked groin to opposite groin artery with other than vein,10880.05,7072.035,78.57,46485.0,38
HCPCS,35665,Bypass of diseased or blocked groin to upper leg artery with other than vein,10771.9,7001.735,78.57,46485.0,57
HCPCS,35666,Bypass of diseased or blocked upper leg to lower leg artery with other than vein,10901.55,7086.01,78.57,46485.0,38
HCPCS,35671,Bypass of diseased or blocked knee to lower leg arteries with other than vein,11034.4,7172.36,78.57,46485.0,38
HCPCS,35681,Bypass of diseased or blocked artery with prosthetic and vein,787.5,511.88,63.01,381.62,19
HCPCS,35682,Bypass of diseased or blocked artery with 2 vein segments from 2 locations,1071.0,696.15,78.57,1013.93,19
HCPCS,35683,Bypass of diseased or blocked artery with 3 or more segments from 2 or more locations,949.38,617.1,78.57,1170.45,19
HCPCS,35685,Insertion of vein patch at lowest portion of bypass graft,4799.25,3119.515,78.57,23242.5,38
HCPCS,35686,Creation of artery-vein connection during procedure on leg,372.3,242.0,78.57,460.57,19
HCPCS,35691,Relocation and/or reimplantation of brain artery to neck artery,2853.9,1855.04,78.57,2725.47,19
HCPCS,35693,Relocation and/or reimplantation of brain artery to chest artery,2528.4,1643.46,78.57,2406.4,19
HCPCS,35694,Relocation and/or reimplantation of chest artery to neck artery,2579.35,1676.58,78.57,2844.85,38
HCPCS,35695,Relocation and/or reimplantation of neck artery to chest artery,3078.6,2001.09,78.57,2952.55,19
HCPCS,35697,Reimplantation of organ artery to aorta prothesis below kidney,444.2,288.73,78.57,421.49,19
HCPCS,35700,Bypass of upper or lower leg artery reoperation more than 1 month after original operation,577.5,375.38,78.57,435.63,19
HCPCS,35701,Exploration of neck artery,2042.75,1327.79,78.57,8477.27,38
HCPCS,35702,Exploration of arm artery,1280.5,832.325,78.57,5929.67,38
HCPCS,35703,Exploration of leg artery,1524.125,990.6800000000001,78.57,5929.67,38
HCPCS,35800,"Exploration of neck for bleeding, blood clot, or infection after surgery",1477.35,960.28,78.57,2133.04,38
HCPCS,35820,"Exploration of chest for bleeding, blood clot, or infection after surgery",6394.4,4156.36,78.57,18503.61,38
HCPCS,35840,"Exploration of abdomen for bleeding, blood clot, or infection after surgery",2800.0,1820.0,78.57,3506.76,19
HCPCS,35860,"Exploration of arm or leg for bleeding, blood clot, or infection after surgery",4612.5,2998.125,78.57,18865.16,57
HCPCS,35870,Repair of abnormal drainage tract of blood vessel graft and bowel,3727.5,2422.88,78.57,3589.78,19
HCPCS,35875,Removal of blood clot of artery or vein graft,5055.8,3286.27,78.57,34902.49,57
HCPCS,35876,Removal of blood clot and revision of artery or vein graft,2826.6,1837.29,78.57,2733.04,19
HCPCS,35879,Revision of leg artery bypass with vein patch,2783.6,1809.34,78.57,2664.5,19
HCPCS,35881,Revision of leg artery bypass with placement of relocated vein,3053.4,1984.71,78.57,2948.54,19
HCPCS,35883,Revision of groin artery bypass with patch graft,3089.1,2007.92,78.57,3464.98,19
HCPCS,35884,Revision of groin artery bypass with vein patch graft,3719.1,2417.42,78.57,3560.2,19
HCPCS,35901,Removal of infected neck graft,1690.5,1098.83,78.57,1370.25,19
HCPCS,35903,Removal of infected graft of arm or leg,4618.5,3002.025,78.57,18865.16,57
HCPCS,35905,Removal of infected chest graft,5044.2,3278.73,78.57,4825.74,19
HCPCS,35907,Removal of infected abdominal graft,5715.2,3714.88,78.57,5493.93,19
HCPCS,36000,Insertion of needle or tube into vein,180.4,117.26,0.01,1242.0,51
HCPCS,36002,Injection to cause blood clot in diseased or pseudoaneurysm of arm or leg,1156.7,751.855,78.57,4759.55,38
HCPCS,36005,Injection for X-ray imaging procedure into vein of arm or leg,630.0,409.5,23.77,2166.29,76
HCPCS,36010,Insertion of tube into vena cava,1269.4,825.11,28.15,2445.63,57
HCPCS,36011,"Insertion of tube into vein, first order branch",2065.5,1342.58,33.9,7139.32,75
HCPCS,36012,"Insertion of tube into vein, second order branch",3042.0,1977.3,60.29,7855.97,57
HCPCS,36013,Insertion of tube into right heart or main pulmonary artery,1696.45,1102.695,31.49,3129.99,38
HCPCS,36014,Insertion of tube into left or right pulmonary artery,1984.5,1289.93,54.46,5795.13,57
HCPCS,36015,Insertion of tube into artery of lobe of lung,2581.5,1677.98,57.79,6666.72,57
HCPCS,36100,Insertion of needle or tube into artery of neck or brain,1459.5,948.68,78.54,1339.34,19
HCPCS,36140,Insertion of needle or tube into artery of arm or leg,879.0,571.35,42.05,2517.94,57
HCPCS,36160,Insertion of needle or tube into aorta,1336.25,868.565,48.72,3186.81,38
HCPCS,36200,Insertion of tube into aorta,1822.5,1184.63,78.57,6279.35,75
HCPCS,36215,"Insertion of tube into chest or arm artery, each first order branch",1672.5,1087.125,78.57,3873.75,76
HCPCS,36216,"Insertion of tube into chest or arm artery, initial second order branch",2909.0,1890.8500000000001,78.57,6187.67,57
HCPCS,36217,"Insertion of tube into chest or arm artery, initial third order branch",4200.65,2730.425,78.57,7365.29,57
HCPCS,36218,"Insertion of tube into chest or arm artery, additional second, third order and beyond",502.05,326.335,26.95,2318.31,57
HCPCS,36221,Insertion of tube into chest aorta for diagnosis or treatment with review by radiologist,3947.35,2565.7799999999997,52.22,10750.95,38
HCPCS,36222,Insertion of tube into extracranial artery for diagnosis or treatment with review by radiologist,6240.0,4056.0,78.57,22630.45,38
HCPCS,36223,Insertion of tube into intracranial artery for diagnosis or treatment with review by radiologist,6975.75,4534.24,78.57,25175.5,38
HCPCS,36224,Insertion of tube into internal neck artery for diagnosis or treatment with review by radiologist,11064.0,7191.6,78.57,32526.59,57
HCPCS,36225,Insertion of tube into chest artery for diagnosis or treatment with review by radiologist,6964.5,4526.93,78.57,25175.5,38
HCPCS,36226,Insertion of tube into brain artery for diagnosis or treatment with review by radiologist,7825.5,5086.575,78.57,28286.12,38
HCPCS,36227,Insertion of tube into external neck artery for diagnosis or treatment with review by radiologist,1609.8,1046.37,78.57,6559.08,57
HCPCS,36228,Insertion of tube into neck or brain artery for diagnosis or treatment with review by radiologist,3473.8,2257.97,51.78,7985.09,38
HCPCS,36245,"Insertion of tube into abdominal, pelvic, or leg artery, each first order branch",4305.0,2798.25,78.57,16676.49,57
HCPCS,36246,"Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch",4203.0,2731.95,78.57,10854.25,57
HCPCS,36247,"Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch",4996.5,3247.73,78.57,12903.46,57
HCPCS,36248,"Insertion of tube into abdominal, pelvic, or leg artery, additional second, third, and beyond",1192.5,775.125,38.56,5059.12,57
HCPCS,36251,Insertion of tube into first order main and accessory arteries of kidney for imaging with review by radiologist,5041.85,3277.205,78.57,19549.53,75
HCPCS,36252,Insertion of tube into first order main and accessory arteries of both kidneys for imaging with review by radiologist,3345.0,2174.25,78.57,9183.37,75
HCPCS,36253,Insertion of tube into second or third order branches of arteries of kidney for imaging with review by radiologist,4738.5,3080.025,78.57,16525.42,57
HCPCS,36254,Insertion of tube into second or third order branches of arteries of both kidneys for imaging with review by radiologist,5744.3,3733.795,78.57,19335.18,57
HCPCS,36260,Insertion of implantable arterial infusion pump,1791.3,1164.35,78.57,1899.53,19
HCPCS,36261,Revision of implanted arterial infusion pump,1022.7,664.76,78.57,1180.08,19
HCPCS,36262,Removal of implanted arterial infusion pump,776.0,504.4,78.57,902.48,19
HCPCS,36299,Other blood vessel injection procedure,1178.0,765.7,294.5,8477.27,19
HCPCS,36400,Insertion of needle into upper leg or neck vein (younger than 3 years),57.0,37.05,3.89,139.46,37
HCPCS,36405,Insertion of needle into scalp vein (younger than 3 years),75.0,48.75,3.89,180.78,37
HCPCS,36406,Insertion of needle into vein (younger than 3 years),75.0,48.75,3.89,180.78,37
HCPCS,36410,Insertion of needle into vein (3 years or older),72.0,46.8,7.5,216.93,37
HCPCS,36415,Insertion of needle into vein for collection of blood sample,58.0,37.7,0.93,296.99,247
HCPCS,36416,Puncture of skin for collection of blood sample,16.5,10.725,3.0,78.57,91
HCPCS,36420,Incision of vein for insertion of needle or tube (younger than 1 year),280.0,182.0,40.7,139.01,19
HCPCS,36425,Incision of vein for insertion of needle or tube (1 year or older),412.5,268.125,30.79,2166.29,38
HCPCS,36430,Transfusion of blood or blood products,1051.0,683.15,24.7,2969.88,76
HCPCS,36440,Push blood transfusion (2 years or younger),152.3,99.0,40.32,158.11,19
HCPCS,36450,"Exchange blood transfusion, newborn",472.5,307.13,78.57,535.55,19
HCPCS,36455,"Exchange blood transfusion, other than newborn",587.05,381.58500000000004,78.57,1779.34,38
HCPCS,36456,"Partial exchange transfusion, newborn",584.04,379.625,78.57,2357.82,38
HCPCS,36460,Intrauterine fetal transfusion,1050.0,682.5,78.57,1041.44,19
HCPCS,36465,Injection of chemical agent into single incompetent vein of leg using ultrasound guidance,3500.0,2275.0,78.57,3148.96,19
HCPCS,36466,Injection of chemical agent into multiple incompetent veins of same leg using ultrasound guidance,3655.0,2375.75,78.57,3396.95,19
HCPCS,36468,"Injection of chemical agent into spider vein of arm, leg, or trunk",326.3,212.1,40.75,2166.29,49
HCPCS,36470,Injection of chemical agent into single incompetent vein,525.0,341.25,25.44,2166.29,76
HCPCS,36471,Injection of chemical agent into multiple incompetent veins of leg,489.0,317.85,43.64,2166.29,76
HCPCS,36473,Mechanochemical destruction of first incompetent vein of arm or leg using imaging guidance,4729.825,3074.385,78.57,15495.0,38
HCPCS,36474,Mechanochemical destruction of subsequent incompetent veins of arm or leg using imaging guidance,1566.85,1018.455,69.62,6456.25,38
HCPCS,36475,Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance,4380.9,2847.59,72.7,10330.0,76
HCPCS,36476,Destruction of subsequent incompetent veins of arm or leg using radiofrequency and imaging guidance,2178.9,1416.29,78.57,668.69,38
HCPCS,36478,Laser destruction of incompetent vein of arm or leg using imaging guidance,3912.5,2543.125,78.57,15495.0,95
HCPCS,36479,"Laser destruction of incompetent veins of arm or leg using imaging guidance, subsequent",1099.4,714.61,76.07,4036.25,76
HCPCS,36481,Insertion of tube into portal vein of liver,4813.0,3128.45,78.57,14084.96,38
HCPCS,36482,Chemical destruction of first incompetent vein of arm or leg using imaging guidance,3113.5,2023.775,0.01,12021.54,55
HCPCS,36483,Chemical destruction of subsequent incompetent veins of arm or leg using imaging guidance,310.0,201.5,70.49,317.73,19
HCPCS,36500,Insertion of tube into vein with collection of blood sample,554.25,360.265,78.57,2166.29,38
HCPCS,36510,"Insertion of tube into umbilical vein, newborn",515.0,334.75,34.76,8477.27,38
HCPCS,36511,Mechanical separation of white blood cells from blood,4629.0,3008.85,78.57,25897.31,76
HCPCS,36512,Mechanical separation of red blood cells from blood,5150.5,3347.825,78.57,25897.31,57
HCPCS,36513,Mechanical separation of platelet cells from blood,2454.15,1595.2,78.57,11954.39,38
HCPCS,36514,Mechanical separation of plasma from blood,5026.5,3267.225,73.75,23121.12,76
HCPCS,36516,Mechanical separation of plasma and abnormal antibodies from blood,4355.0,2830.75,9.57,20579.94,57
HCPCS,36522,Mechanical separation of white blood cells and platelets from blood,5977.5,3885.375,12.28,28665.75,57
HCPCS,36555,Insertion of non-tunneled central venous tube for infusion (younger than 5 years),1548.5,1006.525,39.71,5957.83,38
HCPCS,36556,Insertion of non-tunneled central venous tube for infusion (5 years or older),2621.0,1703.65,39.86,18865.16,75
HCPCS,36557,Insertion of tunneled central venous tube for infusion (younger than 5 years),5042.15,3277.4,65.38,19954.98,38
HCPCS,36558,Insertion of tunneled central venous tube for infusion (5 years or older),6471.675,4206.59,62.76,24892.72,56
HCPCS,36560,Insertion of central venous tube with port (younger than 5 years),6285.0,4085.25,68.44,24112.8,38
HCPCS,36561,Insertion of central venous tube with port (5 years or older),6930.3,4504.695,63.16,23397.45,38
HCPCS,36563,Insertion of central venous tube with pump,3910.2,2541.63,67.43,2688.67,19
HCPCS,36565,Insertion of 2 central venous tubes in 2 veins for infusion,5540.05,3601.035,73.76,21450.25,38
HCPCS,36566,Insertion of 2 central venous tubes in 2 veins with port,9995.0,6496.75,21.11,10245.91,19
HCPCS,36568,Insertion of tube for infusion (younger than 5 years),1696.0,1102.4,20.68,7107.04,57
HCPCS,36569,Insertion of tube for infusion (5 years or older),2014.5,1309.425,0.01,8261.42,74
HCPCS,36570,Insertion of central venous tube with port for infusion (younger than 5 years),8164.0,5306.6,52.05,31808.65,38
HCPCS,36571,Insertion of central venous tube with port for infusion (5 years or older),7628.5,4958.525,48.16,30073.21,38
HCPCS,36572,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient younger than 5 years",1237.0,804.05,68.37,5810.63,38
HCPCS,36573,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient 5 years or older",2202.5,1431.625,67.58,10846.5,57
HCPCS,36575,Repair of central venous tube for infusion,779.5,506.675,6.71,3227.0,38
HCPCS,36576,Repair of central venous tube for infusion with port or pump,3486.9,2266.485,63.0,15365.88,38
HCPCS,36578,"Replacement of central venous tube, tube only",1945.65,1264.675,78.57,7441.0,38
HCPCS,36580,Replacement of nontunneled central venous tube,2479.7,1611.805,13.57,10887.82,57
HCPCS,36581,Replacement of tunneled central venous tube,4677.5,3040.375,36.04,18865.16,56
HCPCS,36582,Replacement of tunneled central venous tube with port,4400.85,2860.555,54.46,15262.58,38
HCPCS,36583,Replacement of tunneled central venous tube with pump,2969.4,1930.11,52.79,2744.41,19
HCPCS,36584,Replacement of peripherally inserted central venous tube (PICC) with review by radiologist,1847.8,1201.07,14.13,7615.79,57
HCPCS,36585,Replacement of peripherally inserted central venous tube (PICC) with port,5517.4,3586.3099999999995,46.68,19345.51,38
HCPCS,36589,Removal of tunneled central venous tube,739.2,480.48,0.01,10195.71,112
HCPCS,36590,Removal of central venous tube with port or pump,1422.8,924.82,0.01,14157.27,74
HCPCS,36591,Collection of blood sample from implanted device,235.0,152.75,18.52,614.64,57
HCPCS,36592,Collection of blood sample from central venous tube,238.0,154.7,24.7,689.53,57
HCPCS,36593,Declotting of central venous tube,271.25,176.315,34.78,2166.29,38
HCPCS,36595,Mechanical removal of obstructive material from central venous tube,4985.0,3240.25,39.42,18865.16,56
HCPCS,36596,Mechanical removal of tissue or obstructive material from central venous tube,2413.0,1568.45,10.83,9477.78,56
HCPCS,36597,Repositioning of central venous tube using fluoroscopic guidance,1012.0,657.8,37.05,4196.56,38
HCPCS,36598,Contrast injection for imaging to evaluate central venous access device,304.65,198.025,28.63,2318.31,38
HCPCS,36600,Artery puncture collection of blood sample,119.5,77.675,12.46,1242.0,38
HCPCS,36620,Insertion of artery tube for blood sampling or infusion through skin,369.5,240.175,38.68,2166.29,94
HCPCS,36625,Insertion of artery tube for blood sampling or infusion through artery incision,340.0,221.0,78.57,317.36,19
HCPCS,36640,Insertion of artery tube for prolonged infusion,350.7,227.96,78.57,355.55,19
HCPCS,36660,"Insertion of umbilical artery tube, newborn",200.0,130.0,55.28,214.78,19
HCPCS,36680,Insertion of needle for infusion into bone,650.0,422.5,52.16,2556.68,38
HCPCS,36800,Insertion of tube connecting vein to vein for hemodialysis,458.9,298.29,78.57,371.39,19
HCPCS,36810,Insertion of tube connecting artery to vein for hemodialysis,1076.3,699.6,78.57,634.29,19
HCPCS,36815,Revision or removal of tube connecting artery to vein for hemodialysis,708.8,460.72,78.57,389.37,19
HCPCS,36818,Relocation of major upper arm vein with connection to arm artery for hemodialysis,1957.2,1272.18,78.57,2003.29,19
HCPCS,36819,Relocation of upper arm surface vein with connection to arm artery for hemodialysis,2322.6,1509.69,78.57,2120.4,19
HCPCS,36820,Relocation of forearm vein with connection to arm artery for hemodialysis,2331.0,1515.15,78.57,2090.18,19
HCPCS,36821,Relocation of arm vein with connection to arm artery for hemodialysis,4761.5,3094.975,78.57,19549.53,38
HCPCS,36823,Insertion of tube into arm or leg for blood circulation and chemotherapy,4101.0,2665.65,78.57,11585.1,57
HCPCS,36825,Creation of artery-vein connection using vein graft for hemodialysis,2448.6,1591.59,78.57,2304.63,19
HCPCS,36830,Creation of artery-vein connection using tube graft for hemodialysis,7721.15,5018.75,78.57,33575.08,38
HCPCS,36831,Removal of blood clot from hemodialysis graft,1522.5,989.63,78.57,1787.36,19
HCPCS,36832,Revision of hemodialysis graft,7348.9,4776.785,78.57,33575.08,38
HCPCS,36833,Revision of hemodialysis graft with removal of blood clot,7460.65,4849.425,78.57,33585.41,38
HCPCS,36835,Insertion of hemodialysis shunt in artery or vein,1135.7,738.21,78.57,1400.7,19
HCPCS,36836,Creation of opening between artery and vein in arm with single access to both blood vessels,782.0,508.3,78.57,16795.18,19
HCPCS,36837,Creation of opening between artery and vein in arm with separate access to each blood vessels,1011.5,657.48,78.57,23892.36,19
HCPCS,36838,Repair of hemodialysis access in arm,3423.0,2224.95,78.57,3300.29,19
HCPCS,36860,Injection for removal of blood clot from external dialysis tube,579.6,376.74,33.96,544.37,19
HCPCS,36861,Insertion of balloon tube for removal of blood clot from external dialysis tube,682.5,443.63,78.57,403.63,19
HCPCS,36901,Insertion of needle and/or tube into hemodialysis circuit with review by radiologist,1574.815,1023.6300000000001,78.57,4728.56,76
HCPCS,36902,Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,9029.625,5869.255,78.57,39393.46,75
HCPCS,36903,Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist,22222.225,14444.445,78.57,81545.02,75
HCPCS,36904,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,9672.0,6286.8,78.57,39393.46,57
HCPCS,36905,"Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube",18404.79,11963.115000000002,78.57,81545.02,75
HCPCS,36906,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment and placement of stent with review by radiologist,31826.95,20687.52,78.57,124091.71,75
HCPCS,36907,Balloon dilation of dialysis segment with review by radiologist,7339.79,4770.865,78.57,33575.08,76
HCPCS,36908,Insertion of stent in dialysis segment with review by radiologist,6184.1,4019.67,78.57,33575.08,57
HCPCS,36909,Permanent blockage of hemodialysis circuit with review by radiologist,5192.275,3374.98,78.57,15873.48,75
HCPCS,37140,Connection of vena cava and portal vein of liver,4672.5,3037.13,78.57,6779.66,19
HCPCS,37145,Connection of kidney vein and portal vein of liver,4672.5,3037.13,78.57,6288.04,19
HCPCS,37160,Connection of vena cava and abdominal vein,4672.5,3037.13,78.57,6460.06,19
HCPCS,37180,Connection of spleen and kidney vein near aorta,4672.5,3037.13,78.57,6210.74,19
HCPCS,37181,Connection of spleen and kidney vein,4672.5,3037.13,78.57,6779.66,19
HCPCS,37182,Insertion of shunts to bypass blood flow to liver with review by radiologist,16678.6,10841.09,78.57,79355.06,38
HCPCS,37183,Revision of shunts to bypass blood flow to liver with review by radiologist,8272.75,5377.29,78.57,39393.46,38
HCPCS,37184,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, initial vessel",5638.5,3665.03,78.57,20662.58,57
HCPCS,37185,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, subsequent vessels",3990.15,2593.6,46.05,14575.63,57
HCPCS,37186,Secondary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance,2961.65,1925.075,53.1,15873.48,57
HCPCS,37187,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, initial treatment",5125.5,3331.58,78.57,17199.45,57
HCPCS,37188,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, repeat treatment on subsequent day",2606.5,1694.225,62.52,12029.7,57
HCPCS,37191,Insertion of vena cava filter with review by radiologist,5547.5,3605.875,78.57,23655.7,57
HCPCS,37192,Repositioning of vena cava filter with review by radiologist,8635.7,5613.205,78.57,36666.34,38
HCPCS,37193,Removal of vena cava filter with review by radiologist,8611.35,5597.38,78.57,36903.93,57
HCPCS,37195,Infusion of drug to dissolve blood clot in brain,665.88,432.82,78.57,853.1,15
HCPCS,37197,Retrieval of foreign body in blood vessel with review by radiologist,5974.85,3883.655,78.57,17643.64,56
HCPCS,37200,Biopsy of blood vessel using tube,2510.75,1631.99,78.57,10717.38,57
HCPCS,37211,"Insertion of tube into artery for drug infusion for blood clot with review by radiologist, initial treatment day",12593.0,8185.45,78.57,33198.04,57
HCPCS,37212,"Insertion of tube into vein for drug infusion for blood clot with review by radiologist, initial treatment day",7305.0,4748.25,78.57,19412.65,57
HCPCS,37213,Insertion of tube into artery or vein for drug infusion for blood clot with review by radiologist,5187.0,3371.55,78.57,18865.16,57
HCPCS,37214,Removal of tube into artery or vein with review by radiologist,2707.0,1759.55,78.57,18865.16,76
HCPCS,37215,Insertion of stent and blood clot protection device in neck artery with review by radiologist,10830.0,7039.5,78.57,57990.04,57
HCPCS,37216,Insertion of stent in neck artery with review by radiologist,7935.0,5157.75,78.57,32128.91,53
HCPCS,37217,Insertion of stent in blood vessel of chest with review by radiologist,3544.8,2304.12,78.57,3125.39,19
HCPCS,37218,Insertion of stent in blood vessel of chest open or accessed through skin with review by radiologist,6593.05,4285.485000000001,78.57,32128.91,38
HCPCS,37220,"Balloon dilation of groin artery, initial vessel",12771.0,8301.15,78.57,49471.66,53
HCPCS,37221,"Insertion of stent in groin artery, initial vessel",15798.0,10268.7,78.57,61194.64,53
HCPCS,37222,"Balloon dilation of groin artery, each additional vessel",3149.6,2047.24,78.57,15873.48,52
HCPCS,37223,"Insertion of stent in groin artery, additional vessel",3654.6,2375.49,78.57,17509.35,53
HCPCS,37224,Balloon dilation of artery of leg,12644.0,8218.6,78.57,48979.7,71
HCPCS,37225,Removal of plaque in arteries of leg,23067.5,14993.875,78.57,71532.67,71
HCPCS,37226,Insertion of stent in arteries of leg,16057.0,10437.05,78.57,62200.8,53
HCPCS,37227,Removal of plaque and insertion of stents in arteries of leg,22320.0,14508.0,78.57,86462.1,53
HCPCS,37228,"Balloon dilation of artery of leg, initial vessel",29245.0,19009.25,78.57,113287.82,53
HCPCS,37229,"Removal of plaque in artery of leg, initial vessel",8283.2,5384.08,78.57,38205.51,53
HCPCS,37230,"Insertion of stent in artery of leg, initial vessel",23027.1,14967.615,78.57,114477.06,53
HCPCS,37231,"Removal of plaque and insertion of stents in artery of leg, initial vessel",8594.7,5586.555,78.57,39545.82,53
HCPCS,37232,"Balloon dilation of artery of leg, each additional vessel",5171.85,3361.705,78.57,25427.3,53
HCPCS,37233,"Removal of plaque in artery of leg, each additional vessel",5330.95,3465.12,78.57,25427.3,34
HCPCS,37234,"Insertion of stent in artery of leg, each additional vessel",6637.8,4314.57,78.57,32518.84,34
HCPCS,37235,"Removal of plaque and insertion of stents in artery of leg, each additional vessel",970.2,630.63,78.57,9544.75,15
HCPCS,37236,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, initial artery",15766.0,10247.9,78.57,61073.54,75
HCPCS,37237,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, each additional artery",4100.05,2665.035,78.57,19544.36,75
HCPCS,37238,"Insertion of stent in vein with review by radiologist, initial vein",13045.0,8479.25,78.57,65414.73,75
HCPCS,37239,"Insertion of stent in vein with review by radiologist, each additional vein",6676.9,4339.985,78.57,32707.36,75
HCPCS,37241,Occlusion of vein with review by radiologist,14487.0,9416.55,78.57,65102.24,75
HCPCS,37242,Occlusion of artery with review by radiologist,9951.5,6468.475,78.57,53527.48,75
HCPCS,37243,Occlusion of growths or obstructed vessels with review by radiologist,11055.5,7186.075000000001,78.57,53527.48,38
HCPCS,37244,Occlusion of artery or vein bleeding with review by radiologist,18637.5,12114.375,78.57,81426.23,38
HCPCS,37246,"Balloon dilation of artery with review by radiologist, initial artery",15254.0,9915.1,78.57,59090.18,75
HCPCS,37247,"Balloon dilation of artery with review by radiologist, each additional artery",4736.365,3078.635,78.57,19304.19,75
HCPCS,37248,"Balloon dilation of vein with review by radiologist, initial vein",12425.0,8076.25,78.57,48131.34,75
HCPCS,37249,"Balloon dilation of vein with review by radiologist, each additional vein",2598.715,1689.165,78.57,9637.89,75
HCPCS,37252,"Ultrasound evaluation of blood vessel with review by radiologist, initial vessel",4587.5,2981.875,70.86,21672.34,53
HCPCS,37253,"Ultrasound evaluation of blood vessel with review by radiologist, each additional vessel",3606.0,2343.9,56.15,17338.91,53
HCPCS,37254,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",7644.0,4968.6,73.6,37549.55,64
HCPCS,37255,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",3786.5,2461.225,73.6,18774.78,64
HCPCS,37256,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",7818.0,5081.7,73.6,37549.55,64
HCPCS,37257,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING THE ARTERY",3831.0,2490.15,73.6,18774.78,64
HCPCS,37258,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",15191.0,9874.15,73.6,76157.93,64
HCPCS,37259,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",7573.5,4922.775,73.6,38078.96,64
HCPCS,37260,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",15389.5,10003.175,73.6,76157.93,64
HCPCS,37261,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS NECESSARY",7586.0,4930.9,73.6,38078.96,64
HCPCS,37262,"INTRAVASCULAR LITHOTRIPSY(IES), ILIAC VASCULAR TERRITORY, INCLUDING ALL IMAGING GUIDANCE AND RADIOLOGICAL SUPERVISION AND INTERPRETATION NECESSARY TO PERFORM THE INTRAVASCULAR LITHOTRIPSY(IES) WITHIN ",308.0,200.2,73.6,317.24,16
HCPCS,37263,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",14540.0,9451.0,73.6,38078.96,64
HCPCS,37264,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",3787.0,2461.55,73.6,18774.78,64
HCPCS,37265,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",7806.0,5073.9,73.6,37549.55,64
HCPCS,37266,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",3837.0,2494.05,73.6,18774.78,64
HCPCS,37267,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",15191.0,9874.15,73.6,76157.93,64
HCPCS,37268,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",7561.0,4914.65,73.6,38078.96,64
HCPCS,37269,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",15494.5,10071.425,73.6,76157.93,64
HCPCS,37270,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MAN",7625.5,4956.575,73.6,38078.96,64
HCPCS,37271,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",23875.5,15519.075,73.6,120938.48,64
HCPCS,37272,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",11910.5,7741.825,73.6,60469.24,64
HCPCS,37273,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",24060.0,15639.0,73.6,120938.48,64
HCPCS,37274,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",11987.0,7791.55,73.6,60469.24,64
HCPCS,37275,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",23974.5,15583.425,73.6,120938.48,48
HCPCS,37276,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",11922.5,7749.625,73.6,60469.24,64
HCPCS,37277,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",24176.0,15714.4,73.6,120938.48,64
HCPCS,37278,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WH",12010.5,7806.825,73.6,60469.24,64
HCPCS,37279,"INTRAVASCULAR LITHOTRIPSY(IES), FEMORAL AND POPLITEAL VASCULAR TERRITORY, INCLUDING ALL IMAGING GUIDANCE AND RADIOLOGICAL SUPERVISION AND INTERPRETATION NECESSARY TO PERFORM THE INTRAVASCULAR LITHOTRI",5709.5,3711.1749999999997,73.6,28428.16,64
HCPCS,37280,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",15243.0,9907.95,73.6,76157.93,64
HCPCS,37281,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",7523.5,4890.275,73.6,38078.96,64
HCPCS,37282,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",15369.5,9990.175,73.6,76157.93,48
HCPCS,37283,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZ",14745.0,9584.25,73.6,76157.93,64
HCPCS,37284,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",23930.0,15554.5,73.6,120938.48,64
HCPCS,37285,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",11878.5,7721.025,73.6,60469.24,64
HCPCS,37286,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",24106.0,15668.9,73.6,120938.48,64
HCPCS,37287,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEU",11964.0,7776.6,73.6,60469.24,64
HCPCS,37288,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",24100.5,15665.325,73.6,120938.48,64
HCPCS,37289,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",11949.0,7766.85,73.6,60469.24,64
HCPCS,37290,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",24277.5,15780.375,73.6,120938.48,64
HCPCS,37291,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVERS",12037.5,7824.375,73.6,60469.24,64
HCPCS,37292,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",24181.5,15717.975,73.6,120938.48,64
HCPCS,37293,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",12044.5,7828.925,73.6,60469.24,64
HCPCS,37294,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",24333.5,15816.775,73.6,120938.48,64
HCPCS,37295,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL AND PERONEAL VASCULAR TERRITORY, WITH TRANSLUMINAL STENT PLACEMENT, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN",12131.0,7885.15,73.6,60469.24,64
HCPCS,37296,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",15303.5,9947.275,73.6,76157.93,64
HCPCS,37297,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",7574.0,4923.1,73.6,38078.96,64
HCPCS,37298,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",15437.0,10034.05,73.6,76157.93,64
HCPCS,37299,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, INFRAMALLEOLAR VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETERIZING T",7624.0,4955.6,73.6,38078.96,64
HCPCS,37500,Tying of veins in leg muscles using an endoscope,1708.4,1110.46,78.57,1825.07,15
HCPCS,37565,Tying of neck vein,2002.4,1301.56,78.57,2130.02,19
HCPCS,37600,Tying of external neck artery,2046.5,1330.23,78.57,2178.32,19
HCPCS,37605,Tying of internal neck artery,2326.8,1512.42,78.57,2127.72,19
HCPCS,37606,Tying and gradual clamping of neck artery,1196.13,777.48,78.57,2009.63,19
HCPCS,37607,Tying or banding of surgically created artery-vein connection,4193.8,2725.9700000000003,78.57,18865.16,57
HCPCS,37609,Tying or biopsy of artery on side of skull,1327.325,862.76,0.01,5152.09,93
HCPCS,37615,Tying of major neck artery,1496.3,972.6,78.57,1536.2,19
HCPCS,37616,Tying of major chest artery,5352.65,3479.225,78.57,19549.53,38
HCPCS,37617,Tying of major artery of the abdomen,5653.5,3674.775,78.57,19549.53,38
HCPCS,37618,Tying of major arm or leg artery,4000.0,2600.0,78.57,19549.53,57
HCPCS,37619,Tying of inferior vena cava,8406.6,5464.29,78.57,33585.41,38
HCPCS,37650,Tying of upper leg vein,4506.9,2929.485,78.57,19549.53,38
HCPCS,37660,Tying of groin vein,5540.6,3601.3900000000003,78.57,19549.53,38
HCPCS,37700,Tying and division of long leg vein,3280.5,2132.33,78.57,19549.53,57
HCPCS,37718,"Tying, incision, and stripping of short leg vein",3280.5,2132.33,78.57,19549.53,57
HCPCS,37722,"Tying, incision, and stripping of long leg vein",5842.95,3797.92,0.01,19549.53,74
HCPCS,37735,"Tying, incision, and stripping of leg veins with removal of ulcer and skin graft and/or interruption of lower leg veins",4380.9,2847.59,78.57,19549.53,57
HCPCS,37760,"Tying of varicose veins, radical procedure including skin graft",2900.25,1885.165,0.01,19549.53,74
HCPCS,37761,"Tying of varicose veins, simple procedure using ultrasound",2451.4,1593.415,78.57,1568.82,38
HCPCS,37765,"Removal of varicose veins of arm or leg, 10-20 incisions",2746.65,1785.325,0.01,9761.85,93
HCPCS,37766,"Removal of varicose veins of arm or leg, more than 20 incisions",3370.2,2190.63,0.01,9761.85,55
HCPCS,37780,Tying and division of short leg vein,2009.85,1306.405,78.57,682.55,38
HCPCS,37785,"Tying, incision, and/or removal of varicose vein clusters of leg",2520.0,1638.0,0.01,7441.0,74
HCPCS,37788,Restoration of blood flow in artery of penis,4173.8,2712.97,78.57,3867.15,19
HCPCS,37790,Blockage of penis vein,1444.8,939.12,78.57,1488.59,19
HCPCS,37799,Other procedure on blood vessel,1440.0,936.0,0.01,3718.8,74
HCPCS,38100,Removal of spleen,3050.3,1982.7,78.57,3381.16,19
HCPCS,38101,Partial removal of spleen,3059.7,1988.81,78.57,3395.98,19
HCPCS,38102,Removal of spleen during other surgical procedure,997.5,648.38,78.57,770.88,19
HCPCS,38115,Repair of ruptured spleen,3395.7,2207.21,78.57,3757.8,19
HCPCS,38120,Exam of spleen using an endoscope,2797.2,1818.18,78.57,3086.04,19
HCPCS,38200,Injection procedure for imaging of spleen,584.4,379.86,78.57,2166.29,38
HCPCS,38204,Management of stem cell donor search,294.2,191.23,78.57,314.0,15
HCPCS,38205,Collection of donor stem cells for transplantation,2095.0,1361.75,65.81,9464.86,57
HCPCS,38206,Collection of stem cells for transplantation,3665.0,2382.25,64.39,16476.35,92
HCPCS,38207,Preservation and storage of stem cells for transplantation,4685.0,3045.25,49.4,18723.13,105
HCPCS,38208,Thawing of frozen stem cells for transplantation,1093.75,710.94,30.87,5423.25,33
HCPCS,38209,Thawing and washing of frozen stem cells for transplantation,37.85,24.6,17.03,78.57,15
HCPCS,38210,Preparation of stem cells for transplantation with removal of T cells,2842.0,1847.3,74.1,66055.19,51
HCPCS,38211,Preparation of stem cells for transplantation with removal of growth cells,71896.5,46732.73,37.05,193075.45,47
HCPCS,38212,Preparation of stem cells for transplantation with red blood cell removal,598.325,388.90999999999997,30.87,2711.63,33
HCPCS,38213,Preparation of stem cells for transplantation with removal of platelets,37.85,24.6,17.03,78.57,15
HCPCS,38214,Preparation of stem cells for transplantation with reduction of blood fluid (plasma) volume,1885.675,1225.69,24.7,9413.21,31
HCPCS,38215,Preparation of stem cells for transplantation with cell concentration in blood fluid (plasma),960.0,624.0,43.22,22829.3,49
HCPCS,38220,Aspiration of bone marrow sample for diagnosis,1221.5,793.975,25.62,5224.4,38
HCPCS,38221,Biopsy of bone marrow,1315.0,854.75,37.97,5578.2,38
HCPCS,38222,Biopsy and aspiration of bone marrow sample for diagnosis,2925.0,1901.25,58.88,13635.6,57
HCPCS,38225,"Harvesting of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy, per day",3607.5,2344.875,78.57,17638.48,31
HCPCS,38226,Preparation of blood-derived T white blood cells (T lymphocytes) for transportation for chimeric antigen receptor T-cell (CAR-T) therapy,225.0,146.25,56.25,581.06,16
HCPCS,38227,Receipt and preparation of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy,225.0,146.25,56.25,581.06,32
HCPCS,38228,Administration of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy,5197.5,3378.375,78.57,25825.0,51
HCPCS,38230,Harvest of donor bone marrow for transplantation,902.0,586.3,78.57,604.65,19
HCPCS,38232,Harvest of patient bone marrow for transplantation,1225.0,796.25,78.57,594.87,19
HCPCS,38240,Transplantation of donor stem cells per donor,41892.0,27229.8,78.57,215016.37,57
HCPCS,38241,Transplantation of patient-derived stem cells,5262.5,3420.625,78.57,25825.0,55
HCPCS,38242,Transplantation of donor white blood cells,5140.7,3341.455,78.57,25825.0,57
HCPCS,38243,Transplantation of donor stem cells,5194.8,3376.62,78.57,25825.0,57
HCPCS,38300,Simple drainage of abscess or swelling of lymph node,715.1,464.82,54.66,800.65,19
HCPCS,38305,Drainage of extensive abscess or swelling of lymph node,1235.9,803.34,78.57,1419.33,19
HCPCS,38308,Incision or other operation on lymphatic channels,1189.7,773.31,78.57,1323.88,19
HCPCS,38380,Suture and/or tying of chest lymph duct through neck,1546.7,1005.36,78.57,1705.29,19
HCPCS,38381,Suture and/or tying of chest lymph duct through back,2258.6,1468.09,78.57,2346.24,19
HCPCS,38382,Suture and/or tying of chest lymph duct through abdomen,1844.9,1199.19,78.57,1971.78,19
HCPCS,38500,Biopsy or removal of lymph nodes,4126.575,2682.275,78.57,18051.68,38
HCPCS,38505,Needle biopsy or removal of surface lymph nodes,3069.225,1994.995,69.95,14526.56,38
HCPCS,38510,Biopsy or removal of deep lymph nodes of neck,6651.3,4323.345,0.01,29037.63,55
HCPCS,38520,Biopsy or removal of lymph nodes of neck with removal of fat pad,1244.3,808.8,78.57,1369.87,19
HCPCS,38525,Biopsy or removal of deep lymph nodes of underarm,2355.0,1530.75,78.57,1280.39,38
HCPCS,38530,Biopsy or removal of lymph nodes of breast,1445.9,939.84,78.57,1652.4,19
HCPCS,38531,Biopsy or removal of lymph nodes of groin,1530.0,994.5,78.57,1297.71,19
HCPCS,38542,Removal of deep lymph nodes of neck,2101.05,1365.68,78.57,1544.9,19
HCPCS,38550,Removal of congenital defect of lymph nodes at underarm or neck,1281.0,832.65,78.57,1497.61,19
HCPCS,38555,Removal of congenital defect of lymph nodes at underarm or neck with deep neurovascular dissection,2714.3,1764.3,78.57,2953.84,19
HCPCS,38562,Partial removal of pelvic and aortic lymph nodes,2257.5,1467.38,78.57,2100.43,19
HCPCS,38564,Removal of lymph nodes behind abdominal cavity,2572.5,1672.13,78.57,2081.21,19
HCPCS,38570,Biopsy and removal of lymph nodes of abdominal cavity using an endoscope,2100.0,1365.0,78.57,1524.94,19
HCPCS,38571,Removal of lymph nodes of both sides of pelvis using an endoscope,2394.0,1556.1,78.57,2027.08,19
HCPCS,38572,Removal of lymph nodes of both sides of pelvis and abdominal lymph node biopsy using an endoscope,2699.6,1754.74,78.57,2755.39,19
HCPCS,38573,Removal of lymph nodes of both sides of pelvis with biopsy and washing of abdomen using an endoscope,2540.0,1651.0,78.57,3489.03,19
HCPCS,38700,Removal of lymph nodes from chin to thyroid cartilage,3287.1,2136.62,78.57,2409.28,19
HCPCS,38720,Removal of lymph nodes of neck,5468.4,3554.46,78.57,4003.89,19
HCPCS,38724,"Removal of lymph nodes, muscle, and tissue of neck",5934.6,3857.49,78.57,4344.59,19
HCPCS,38740,Partial removal of lymph nodes of underarm,1805.0,1173.25,78.57,2039.26,19
HCPCS,38745,Removal of lymph nodes of underarm,10361.55,6735.009999999999,78.57,44617.85,38
HCPCS,38746,Removal of lymph nodes of chest cavity and breast bone,732.9,476.39,78.57,623.08,19
HCPCS,38747,Removal of lymph nodes of abdominal organ,866.3,563.1,78.57,781.81,19
HCPCS,38760,Removal of lymph nodes of groin,3398.85,2209.25,78.57,2480.49,19
HCPCS,38765,Partial removal of lymph nodes of groin and pelvis,5307.75,3450.04,78.57,3834.53,19
HCPCS,38770,Removal of lymph nodes of groin and pelvis,4134.45,2687.39,78.57,2442.58,19
HCPCS,38780,Removal of lymph nodes of abdominal cavity,4252.5,2764.13,78.57,3093.39,19
HCPCS,38790,Injection procedure for imaging of lymphatic system,732.0,475.79999999999995,0.01,2166.29,55
HCPCS,38792,Injection of radioactive material for X-ray identification of lymph node,816.75,530.89,25.63,3091.25,37
HCPCS,38794,Exposure of lymph duct of chest cavity,773.85,503.005,78.57,8477.27,38
HCPCS,38900,Imaging of lymph nodes during surgery,321.3,208.85,78.57,402.79,19
HCPCS,38999,Other procedure on lymphatic system,3470.0,2255.5,73.6,33269.0,119
HCPCS,39000,"Exploration, drainage, biopsy, or removal of foreign body in chest cavity through neck",1373.4,892.71,78.57,1463.3,19
HCPCS,39010,"Exploration, drainage, biopsy, or removal of foreign body in chest cavity",4508.25,2930.3650000000002,78.57,16370.47,38
HCPCS,39200,Removal of cyst below breast bone,3018.8,1962.22,78.57,2541.88,19
HCPCS,39220,Removal of growth below breast bone,3237.2,2104.18,78.57,3324.18,19
HCPCS,39401,Exam of chest using an endoscope,721.0,468.65,78.57,899.1,19
HCPCS,39402,Exam of chest with biopsy of lymph node using an endoscope,941.0,611.65,78.57,1174.65,19
HCPCS,39499,Other procedure on chest cavity below breast bone,1075.0,698.75,268.75,8477.27,19
HCPCS,39501,Repair of muscle tissue separating chest and abdominal cavities,2703.8,1757.47,78.57,2500.52,19
HCPCS,39503,"Repair of congenital defect of muscle separating chest and abdominal cavities, neonate",16359.0,10633.35,78.57,16914.67,19
HCPCS,39540,Repair of acute injury to muscle separating chest and abdominal cavities,3438.8,2235.22,78.57,2550.08,19
HCPCS,39541,Repair of chronic injury to muscle separating chest and abdominal cavities,2654.4,1725.36,78.57,2755.94,19
HCPCS,39545,Suture of muscle separating chest and abdominal cavities to restore function,3307.5,2149.88,78.57,2603.9,19
HCPCS,39560,Simple repair of muscle separating chest and abdominal cavities,2173.5,1412.78,78.57,2348.62,19
HCPCS,39561,Complex repair of muscle separating chest and abdominal cavities,3376.8,2194.92,78.57,3634.76,19
HCPCS,40490,Biopsy of lip,267.3,173.745,0.01,8477.27,55
HCPCS,40500,Removal of border of lip,1772.8,1152.32,0.01,5707.33,36
HCPCS,40510,Removal of wedge of lip tissue with closure,1365.0,887.25,0.01,5449.08,55
HCPCS,40520,V-shaped removal of lip tissue,1365.0,887.25,0.01,5552.38,74
HCPCS,40525,Removal of lip with repair using local tissue graft,2613.45,1698.745,78.57,1650.77,38
HCPCS,40527,Removal of lip with repair using tissue graft,3043.95,1978.5700000000002,78.57,1853.03,38
HCPCS,40530,Partial removal of lip,1438.5,935.03,78.57,1341.64,19
HCPCS,40650,Repair of lip and border,1085.0,705.25,78.57,6141.01,57
HCPCS,40652,Repair of vertical lip wound extending to half of lip,1013.5,658.775,78.57,6141.01,38
HCPCS,40654,Repair of vertical lip wound extending to over half of lip,2035.2,1322.88,0.01,6642.19,55
HCPCS,40700,Primary plastic repair of deformity present at birth on 1 side of nose and/or lip,3903.3999999999996,2537.215,78.57,3014.55,38
HCPCS,40701,Plastic repair of deformity present at birth on both sides of nose and/or lip,4490.35,2918.73,78.57,3571.09,38
HCPCS,40702,"Plastic repair of deformity present at birth on both sides of nose and/or lip, first stage",2415.0,1569.75,78.57,2996.48,19
HCPCS,40720,Secondary plastic repair of nose and lip deformity present at birth,4615.6,3000.145,78.57,3079.12,38
HCPCS,40761,Plastic repair of nose and/or lip deformity present at birth using a tissue graft,3937.5,2559.38,78.57,3245.99,19
HCPCS,40799,Other procedure on lip,204.0,132.6,0.01,2075.68,17
HCPCS,40800,"Simple drainage of abscess, cyst, or blood accumulation of mouth",534.5,347.425,0.01,8477.27,55
HCPCS,40801,"Complicated drainage of abscess, cyst, or blood accumulation of mouth",798.0,518.7,0.01,1775.48,55
HCPCS,40804,Simple removal of embedded foreign body in mouth,529.2,343.98,0.01,8477.27,55
HCPCS,40805,Complicated removal of embedded foreign body in mouth,839.0,545.35,78.57,687.47,19
HCPCS,40806,Incision of tissue joining lip and gum,272.0,176.8,26.19,239.06,19
HCPCS,40808,Biopsy of mouth,458.6,298.09000000000003,0.01,2166.29,55
HCPCS,40810,Removal of growth of tissue of mouth,1356.5,881.725,0.01,5637.6,36
HCPCS,40812,Removal of growth of mouth with simple repair,1457.45,947.345,0.01,5637.6,55
HCPCS,40814,Removal of growth of mouth with complicated repair,987.0,641.55,78.57,902.84,19
HCPCS,40816,Complex removal of tissue and muscle growth of mouth,1085.7,705.71,78.57,970.1,19
HCPCS,40818,Removal of mouth tissue for grafting,626.85,407.455,78.57,885.45,38
HCPCS,40819,Removal of tissue at dental edge and cheek,971.3,631.35,0.01,3176.48,55
HCPCS,40820,Destruction of growth or scar of mouth,1587.05,1031.585,0.01,6456.25,36
HCPCS,40830,"Repair of lacerated mouth, 2.5 cm or less",562.0,365.3,41.18,8477.27,38
HCPCS,40831,"Repair of lacerated mouth, more than 2.5 cm",830.5,539.825,69.65,2378.48,38
HCPCS,40840,Repair to increase depth of front portion of mouth,3169.45,2060.145,0.01,10846.5,36
HCPCS,40842,Repair to increase depth on side of mouth,2107.4,1369.81,78.57,2216.7,19
HCPCS,40843,Repair to increase depth on both sides of mouth,2759.4,1793.61,78.57,2851.89,19
HCPCS,40844,Repair to increase depth of entire arch of mouth,3651.9,2373.74,78.57,3573.32,19
HCPCS,40845,Complex repair to increase depth of mouth,3993.2,2595.58,78.57,3718.42,19
HCPCS,41000,"Drainage of abscess, cyst, or blood accumulation of side of tongue from inside mouth",738.4,479.96,44.02,2740.03,38
HCPCS,41005,"Drainage of abscess, cyst, or blood accumulation under tongue from inside mouth",579.6,376.74,35.62,578.18,19
HCPCS,41006,"Drainage of abscess, cyst, or blood accumulation of tongue or floor of mouth from inside mouth",936.6,608.79,45.38,823.0,19
HCPCS,41007,"Drainage of abscess, cyst, or blood accumulation beneath chin from inside mouth",938.7,610.16,61.75,793.83,19
HCPCS,41008,"Drainage of abscess, cyst, or blood accumulation under jaw bone from inside mouth",4170.95,2711.12,61.75,19053.69,38
HCPCS,41009,"Drainage of abscess, cyst, or blood accumulation under lower teeth from inside mouth",737.9,479.635,0.01,2075.68,36
HCPCS,41010,Incision of tissue connecting tongue and floor of mouth,1113.4,723.71,0.01,4408.33,55
HCPCS,41015,"Drainage of abscess, cyst, or blood accumulation under tongue from outside mouth",1104.6,717.99,55.57,964.41,19
HCPCS,41016,"Drainage of abscess, cyst, or blood accumulation beneath chin from outside mouth",2665.45,1732.545,0.01,10846.5,36
HCPCS,41017,"Drainage of abscess, cyst, or blood accumulation under jaw bone from outside mouth",3829.65,2489.275,78.57,16835.32,38
HCPCS,41018,"Drainage of abscess, cyst, or blood accumulation under lower teeth from outside mouth",1308.3,850.4,78.57,1270.06,19
HCPCS,41019,"Insertion of needles, tubes, or devices into head and/or neck for radiation therapy",1149.9,747.44,78.57,1484.1,19
HCPCS,41100,Biopsy of front 2/3 of tongue,878.5,571.025,0.01,3346.92,55
HCPCS,41105,Biopsy of back 1/3 of tongue,1513.5,983.775,0.01,6680.93,55
HCPCS,41108,Biopsy of floor of mouth,2044.05,1328.635,0.01,9578.49,55
HCPCS,41110,Removal of growth of tongue without closure,1362.4,885.5600000000001,0.01,5637.6,36
HCPCS,41112,Removal of growth of front 2/3 of tongue with switches,2315.25,1504.915,0.01,19053.69,74
HCPCS,41113,Removal of growth of back 1/3 of tongue with suturing,1719.9,1117.935,0.01,6456.25,36
HCPCS,41114,Removal of growth of tongue with local tissue graft,1735.7,1128.21,78.57,1887.16,19
HCPCS,41115,Removal of tissue connecting tongue and floor of mouth,930.0,604.5,0.01,3726.0,55
HCPCS,41116,Removal of growth of floor of mouth,1516.25,985.565,0.01,5637.6,36
HCPCS,41120,Removal of less than half of tongue,2821.4,1833.91,78.57,3221.08,19
HCPCS,41130,Partial removal of tongue,3508.1,2280.27,78.57,3976.22,19
HCPCS,41135,Partial removal of tongue and surrounding lymph nodes on side of neck,5883.2,3824.08,78.57,6561.58,19
HCPCS,41140,Complete removal of tongue,6015.5,3910.08,78.57,6589.22,19
HCPCS,41145,Complete removal of tongue and surrounding lymph nodes on side of neck,7563.2,4916.08,78.57,8343.51,19
HCPCS,41150,"Removal of tongue, floor of mouth, and jaw bone",5980.8,3887.52,78.57,6634.09,19
HCPCS,41153,"Removal of tongue, floor of mouth, soft tissue, and lymph nodes",6505.8,4228.77,78.57,7194.37,19
HCPCS,41155,"Removal of tongue, floor of mouth, jaw bone, tissue, and lymph nodes",8124.9,5281.19,78.57,9099.01,19
HCPCS,41250,"Repair of lacerated floor of mouth and/or tongue, 2.5 cm or less",550.0,357.5,56.36,2318.31,38
HCPCS,41251,"Repair of lacerated back 1/3 of tongue, 2.5 cm or less",590.0,383.5,78.57,753.23,19
HCPCS,41252,"Repair of lacerated tongue or floor of mouth, more than 2.6 cm",950.0,617.5,78.57,2969.88,38
HCPCS,41510,Suture of tongue to lip to enlarge mouth,1222.2,794.43,78.57,1358.71,19
HCPCS,41512,Permanent suspension of tongue base using sutures,1578.2,1025.83,78.57,1982.72,19
HCPCS,41520,Repair of tissue connecting tongue to floor of mouth,940.3,611.2,78.57,884.47,38
HCPCS,41530,"Destruction of tongue tissue, per session",2295.63,1492.16,78.57,2221.02,19
HCPCS,41800,"Drainage of abscess, cyst, or blood accumulation of dental bone",472.0,306.8,0.01,2166.29,55
HCPCS,41805,Removal of embedded foreign body in soft tissue of tooth bearing bone,865.0,562.25,0.01,3176.48,36
HCPCS,41806,Removal of foreign body in dental bone,732.95,476.41999999999996,61.0,994.58,38
HCPCS,41820,Removal of overgrown gum tissue,1403.9,912.5350000000001,0.01,5637.6,32
HCPCS,41821,Removal of gum tissue around tooth,685.9,445.835,0.01,3176.48,32
HCPCS,41822,Removal of tissue fiber at dental bone,984.6,639.99,0.01,3176.48,36
HCPCS,41823,Removal of dental bone,1103.6,717.34,0.01,10846.5,53
HCPCS,41825,Removal of dental bone growth,1356.65,881.825,0.01,5637.6,36
HCPCS,41826,Removal of dental bone growth with simple repair,1486.85,966.455,0.01,5637.6,36
HCPCS,41827,Removal of growth of dental bone growth with complex repair,1109.9,721.44,78.57,1041.21,19
HCPCS,41828,Removal of enlarged membrane covering of teeth or tooth socket,1512.05,982.835,0.01,5637.6,36
HCPCS,41830,Removal of tissue overgrowth at teeth or tooth socket,1592.9,1035.385,0.01,5637.6,36
HCPCS,41850,Destruction of growth of structure supporting teeth,312.9,203.39,37.05,358.51,15
HCPCS,41870,Graft of mouth tissue lining to gum surface,782.3,508.5,0.01,5637.6,49
HCPCS,41872,Reshaping of gum,1560.35,1014.23,0.01,5637.6,36
HCPCS,41874,Reshaping of tooth socket,250.0,162.5,0.01,5637.6,104
HCPCS,41899,Other procedure on teeth and gums,117.5,76.375,0.01,3434.73,393
HCPCS,42000,Drainage of abscess of roof of mouth,337.0,219.05,0.01,2318.31,55
HCPCS,42100,Biopsy of roof of mouth,818.7,532.155,0.01,3726.0,55
HCPCS,42104,Removal of growth of roof of mouth,1368.7,889.655,0.01,5637.6,55
HCPCS,42106,Removal of growth of roof of mouth with simple closure,2620.0,1703.0,0.01,20091.85,55
HCPCS,42107,Removal of growth of roof of mouth with local tissue graft,1579.2,1026.48,78.57,1093.77,19
HCPCS,42120,Partial removal of roof of mouth,2650.2,1722.63,78.57,3043.76,19
HCPCS,42140,Removal of soft tissue of roof of mouth,652.1,423.87,51.13,753.25,19
HCPCS,42145,Complex removal of soft tissue of roof of mouth,2613.45,1698.745,78.57,2091.4,38
HCPCS,42160,Destruction of growth or soft tissue of roof of mouth,625.8,406.77,48.38,560.2,19
HCPCS,42180,"Repair of lacerated roof of mouth, 2.0 cm or less",950.0,617.5,78.57,3253.95,38
HCPCS,42182,"Repair of lacerated roof of mouth, more than 2.0 cm",780.0,507.0,78.57,796.03,19
HCPCS,42200,Repair of defect of soft and/or hard tissue of roof of mouth for cleft palate,4070.35,2645.73,78.57,2815.6,38
HCPCS,42205,Repair of defect of soft tissue of roof of mouth for cleft palate,3150.0,2047.5,78.57,2927.79,19
HCPCS,42210,Repair of cleft palate with bone graft,4372.25,2841.965,78.57,3269.53,38
HCPCS,42215,Revision of prior cleft palate repair,3876.1,2519.4700000000003,78.57,2136.75,38
HCPCS,42220,Repair of cleft palate with palate lengthening,2693.3,1750.65,78.57,1760.96,19
HCPCS,42225,Repair of cleft palate with local tissue graft from throat,2693.3,1750.65,78.57,2951.23,19
HCPCS,42226,Lengthening of roof of mouth with throat tissue graft,3978.5,2586.0299999999997,78.57,2655.71,38
HCPCS,42227,Lengthening of roof of mouth using mucous membrane tissue graft,2015.25,1309.91,78.57,2493.05,19
HCPCS,42235,Lengthening of roof of mouth with tissue graft from tissue separating nose airways,2005.5,1303.58,78.57,2180.73,19
HCPCS,42260,Repair of abnormal connection from nasal sinus to skin,2232.3,1451.0,78.57,2070.69,19
HCPCS,42280,Impression of cheek bone for prosthesis at roof of mouth,385.78,250.76,21.66,430.07,19
HCPCS,42281,Insertion of roof of mouth prosthesis,535.5,348.08,6.17,545.4,19
HCPCS,42299,Other procedure on roof of mouth,558.5,363.03,0.01,1775.48,17
HCPCS,42300,Simple drainage of abscess of saliva gland,1881.05,1222.685,78.57,8302.74,38
HCPCS,42305,Complicated drainage of abscess of saliva gland,1190.7,773.96,78.57,1284.76,19
HCPCS,42310,Drainage of abscess of lower jaw from inside of mouth,426.3,277.1,78.05,416.74,19
HCPCS,42320,Drainage of abscess of lower jaw from outside of mouth,658.4,427.96,78.57,631.47,19
HCPCS,42330,Uncomplicated removal of saliva gland stone from inside mouth,3566.1,2317.965,40.56,16835.32,38
HCPCS,42335,Complicated removal of saliva gland stone from inside mouth,976.5,634.73,78.57,1045.57,19
HCPCS,42340,Complicated removal of saliva gland stone,3601.55,2341.01,78.57,15236.75,38
HCPCS,42400,Needle biopsy of saliva gland,599.95,389.97,33.96,3227.0,38
HCPCS,42405,Biopsy of saliva gland,2183.0,1418.95,0.01,8302.74,55
HCPCS,42408,Removal of salivary cyst under tongue,1692.65,1100.225,0.01,5637.6,36
HCPCS,42409,Creation of tract to drain cyst of saliva gland,869.4,565.11,78.57,957.47,19
HCPCS,42410,"Removal of growth of saliva gland or saliva gland, lateral lobe",2586.15,1681.0,78.57,1863.55,19
HCPCS,42415,Removal of growth of saliva gland with release of facial nerve,4695.15,3051.85,78.57,3166.16,19
HCPCS,42420,Removal of growth of saliva gland or saliva gland with release of facial nerve,5385.0,3500.25,78.57,3557.14,19
HCPCS,42425,"Removal of growth of saliva gland or saliva gland, and facial nerve",2751.0,1788.15,78.57,2504.93,19
HCPCS,42426,"Removal of growth of saliva gland or saliva gland, and surrounding lymph nodes on side of neck",5294.1,3441.17,78.57,4050.74,19
HCPCS,42440,Removal of saliva gland under floor of mouth,2953.2,1919.58,78.57,1234.99,19
HCPCS,42450,Removal of saliva gland under tongue,1203.3,782.15,78.57,1136.8,19
HCPCS,42500,Simple repair of salivary duct,3013.8,1958.97,78.57,12550.95,38
HCPCS,42505,Complicated plastic repair of salivary duct,1680.0,1092.0,78.57,1415.54,19
HCPCS,42507,Creation of new drainage tracts of major saliva gland ducts on both sides of mouth,1575.0,1023.75,78.57,1514.14,19
HCPCS,42509,Creation of new drainage tracts of major saliva gland ducts on both sides of mouth with removal of salivary glands below both sides of jaw,2625.0,1706.25,78.57,2505.4,19
HCPCS,42510,Creation of new drainage tracts of major saliva gland ducts on both sides of mouth with tying of saliva gland ducts below both sides of jaw,2100.0,1365.0,78.57,1858.46,19
HCPCS,42550,Injection of contrast for imaging of saliva glands,1093.2,710.5799999999999,20.57,2264.85,38
HCPCS,42600,Closure of abnormal drainage tract of saliva gland,1357.7,882.51,78.57,1319.4,19
HCPCS,42650,Insertion of probe to widen saliva gland duct,220.5,143.33,22.56,179.47,19
HCPCS,42660,Dilation of saliva gland duct and insertion of tube,284.6,184.99,28.81,272.43,19
HCPCS,42665,Tying of saliva gland duct,810.6,526.89,67.97,911.0,19
HCPCS,42700,Drainage of abscess near tonsil,503.0,326.95,0.01,2166.29,55
HCPCS,42720,Drainage of abscess of throat from inside mouth,1253.7,814.91,78.57,1185.62,19
HCPCS,42725,Drainage of abscess of throat from outside mouth,2258.6,1468.09,78.57,2442.44,19
HCPCS,42800,Biopsy of back of throat,1301.5,845.975,0.01,5637.6,55
HCPCS,42804,Simple biopsy of growth of throat behind nose,3562.0,2315.3,40.27,17044.5,38
HCPCS,42806,Complex biopsy of growth of throat behind nose,593.3,385.65,45.57,581.23,19
HCPCS,42808,Removal or destruction of growth of throat,1396.0,907.4000000000001,0.01,5637.6,36
HCPCS,42809,Removal of foreign body in throat,394.0,256.1,0.01,2166.29,55
HCPCS,42810,Removal of congenital skin and tissue cyst of neck,2650.0,1722.5,0.01,6843.63,55
HCPCS,42815,Removal of congenital cyst or abnormal drainage tract of neck and/or throat,5043.3,3278.145,0.01,19020.11,36
HCPCS,42820,Removal of tonsils and adenoid glands (younger than 12 years),861.0,559.65,78.57,868.18,19
HCPCS,42821,Removal of tonsils and adenoid glands (12 years or older),958.7,623.16,78.57,901.62,19
HCPCS,42825,Removal of tonsils (younger than 12 years),789.6,513.24,78.57,785.26,19
HCPCS,42826,Removal of tonsils (12 years or older),960.8,624.52,78.57,754.05,19
HCPCS,42830,Primary removal of adenoids (younger than 12 years),572.3,372.0,78.57,621.88,19
HCPCS,42831,Primary removal of adenoids (12 years or older),611.1,397.22,78.57,671.56,19
HCPCS,42835,Secondary removal of adenoids (younger than 12 years),510.3,331.7,78.57,577.36,19
HCPCS,42836,Secondary removal of adenoids (12 years or older),3794.2,2466.23,78.57,721.44,19
HCPCS,42842,"Extensive removal of tonsils, tissue, muscle, and bone",2678.6,1741.09,78.57,3036.55,19
HCPCS,42844,"Extensive removal of tonsils, tissue, muscle, and bone with local tissue graft",3737.0,2429.05,78.57,4176.95,19
HCPCS,42845,"Extensive removal of tonsils, tissue, muscle, and bone with other tissue graft",6149.9,3997.44,78.57,6727.06,19
HCPCS,42860,Removal of remaining tonsil tissue,600.6,390.39,78.57,563.3,19
HCPCS,42870,Removal or destruction of growth of tongue lymph node,1549.8,1007.37,78.57,1776.79,19
HCPCS,42890,Partial removal of throat,3818.9,2482.29,78.57,4310.15,19
HCPCS,42892,Partial removal of wall of throat with suture repair,5023.2,3265.08,78.57,5660.47,19
HCPCS,42894,Removal of throat tissue with tissue graft,6433.4,4181.71,78.57,7166.51,19
HCPCS,42900,Suture of wound or injury in throat,961.8,625.17,78.57,1009.12,19
HCPCS,42950,Plastic or reconstructive repair of throat,2636.55,1713.76,78.57,2431.04,38
HCPCS,42953,Repair of throat at esophagus,2632.4,1711.06,78.57,2912.76,19
HCPCS,42955,Creation of opening to throat for feeding,2019.2,1312.48,78.57,2304.6,19
HCPCS,42960,Simple control of bleeding of throat,455.65,296.17499999999995,78.57,2075.68,38
HCPCS,42961,Control of bleeding of throat requiring hospitalization,1049.8,682.37,78.57,1252.92,19
HCPCS,42962,Complicated control of bleeding of throat,1440.6,936.39,78.57,1549.91,19
HCPCS,42970,Simple control of bleeding of throat with insertion of packing,1082.6,703.69,78.57,1234.33,19
HCPCS,42971,Control of bleeding of throat with insertion of packing requiring hospitalization,1085.93,705.85,78.57,1364.22,19
HCPCS,42972,Complicated control of bleeding of throat with insertion of packing,1428.0,928.2,78.57,1527.59,19
HCPCS,42975,Evaluation of sleep-disordered breathing by examination of upper airway using an endoscope,254.0,165.1,77.21,338.48,19
HCPCS,43020,Removal of foreign body in esophagus through neck,1995.0,1296.75,78.57,1635.76,19
HCPCS,43030,Incision of muscle at upper esophagus,1995.0,1296.75,78.57,1553.85,19
HCPCS,43045,Removal of foreign body in esophagus through chest,2989.93,1943.45,78.57,3801.08,19
HCPCS,43100,Removal of growth of esophagus through neck,2100.0,1365.0,78.57,1882.29,19
HCPCS,43101,Removal of growth of esophagus through chest or abdomen,2823.5,1835.28,78.57,2935.51,19
HCPCS,43107,Removal of esophagus,7110.6,4621.89,78.57,8701.7,19
HCPCS,43108,Removal of esophagus and reconstruction using bowel graft,12263.0,7970.95,78.57,12933.96,19
HCPCS,43112,Removal of esophagus through chest,7594.7,4936.56,78.57,10124.68,19
HCPCS,43113,Removal of esophagus through chest and reconstruction using bowel graft,12208.4,7935.46,78.57,12646.07,19
HCPCS,43116,Partial removal of upper esophagus with reconstruction using bowel graft,12481.7,8113.11,78.57,14457.49,19
HCPCS,43117,Partial removal of lower esophagus,6954.2,4520.23,78.57,9502.17,19
HCPCS,43118,Partial removal of lower esophagus through chest and abdomen with bowel graft,10051.7,6533.61,78.57,10554.5,19
HCPCS,43121,Partial removal of lower esophagus through chest,6573.18,4272.57,78.57,8326.18,19
HCPCS,43122,Partial removal of lower esophagus through abdomen and/or chest,7024.5,4565.93,78.57,7481.66,19
HCPCS,43123,Partial removal of esophagus with repair using bowel graft,14975.1,9733.82,78.57,13108.01,19
HCPCS,43124,Removal of esophagus with creation of artificial opening into esophagus,10480.1,6812.07,78.57,11094.92,19
HCPCS,43130,Removal of defect in wall of esophagus through neck,2201.9,1431.24,78.57,2336.65,19
HCPCS,43135,Removal of defect in wall of esophagus through chest,4141.2,2691.78,78.57,4297.27,19
HCPCS,43180,Removal of defect in wall of esophagus using a rigid endoscope,1267.4,823.81,78.57,1644.33,19
HCPCS,43191,Diagnostic exam of esophagus using an endoscope,413.7,268.91,78.57,466.63,19
HCPCS,43192,Injection into esophagus using an endoscope,492.5,320.13,78.57,509.74,19
HCPCS,43193,Biopsy of esophagus using a rigid endoscope,587.0,381.55,78.57,509.74,19
HCPCS,43194,Removal of foreign bodies from esophagus using a rigid endoscope,532.4,346.06,78.57,579.3,19
HCPCS,43195,"Balloon dilation of esophagus using a rigid endoscope, less than 3.0 cm",588.0,382.2,78.57,556.48,19
HCPCS,43196,Insertion of wire and dilation of esophagus using an endoscope,639.5,415.68,78.57,592.74,19
HCPCS,43197,Diagnostic exam of esophagus using a flexible endoscope through nose,1290.15,838.6,63.18,5128.85,38
HCPCS,43198,Biopsy of esophagus using a flexible endoscope through nose,663.6,431.34,75.53,511.23,19
HCPCS,43200,Diagnostic exam of esophagus using a flexible endoscope through mouth,1358.3,882.895,73.1,5521.39,38
HCPCS,43201,Injection into esophagus using a flexible endoscope,782.3,508.5,78.57,625.55,19
HCPCS,43202,Biopsy of esophagus using a flexible endoscope through mouth,2371.5,1541.475,78.57,10337.75,38
HCPCS,43204,Injection of swollen vein of esophagus using a flexible endoscope,944.0,613.6,78.57,415.06,19
HCPCS,43205,Tying of dilated veins of esophagus with bands using a flexible endoscope,787.5,511.88,78.57,432.87,19
HCPCS,43206,Microscopic exam of esophagus using a flexible endoscope,4003.0,2601.95,1000.75,10337.75,37
HCPCS,43210,Repair of muscle at esophagus and stomach using a flexible endoscope,1026.0,666.9,78.57,1297.9,19
HCPCS,43211,Removal of tissue lining of esophagus using a flexible endoscope,791.7,514.61,78.57,3307.33,19
HCPCS,43212,Placement of stent in esophagus using a flexible endoscope,618.5,402.03,78.57,636.03,19
HCPCS,43213,Dilation of esophagus using a flexible endoscope,3950.1,2567.57,78.57,2987.73,19
HCPCS,43214,"Balloon dilation of esophagus using a flexible endoscope, 3.0 cm or more",636.3,413.6,78.57,588.06,19
HCPCS,43215,Removal of foreign bodies in esophagus using a flexible endoscope,682.5,443.63,78.57,944.73,19
HCPCS,43216,Removal of polyps or growths of esophagus using a flexible endoscope with electrical cautery,548.1,356.27,78.57,989.26,19
HCPCS,43217,Removal of polyps or growths of esophagus using a flexible endoscope with mechanical snare,992.3,645.0,78.57,1014.78,19
HCPCS,43220,"Balloon dilation of esophagus using a flexible endoscope, less than 3.0 cm",365.4,237.51,78.57,2180.1,19
HCPCS,43226,Dilation of esophagus with insertion of guide wire using a flexible endoscope,1243.1,808.015,78.57,5381.93,38
HCPCS,43227,Control of bleeding in esophagus using a flexible endoscope,600.6,390.39,78.57,1434.6,19
HCPCS,43229,Destruction of polyp or growth of esophagus using a flexible endoscope,2324.7,1511.06,78.57,1716.53,19
HCPCS,43231,Ultrasound exam of esophagus using a flexible endoscope,538.7,350.16,78.57,489.72,19
HCPCS,43232,Ultrasound guided fine needle aspiration or biopsy of esophagus using a flexible endoscope,740.3,481.2,78.57,614.11,19
HCPCS,43233,"Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, 3.0 cm or more",755.0,490.75,78.57,696.59,19
HCPCS,43235,"Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",1307.0,849.55,78.57,4710.48,38
HCPCS,43236,"Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope",1536.55,998.76,78.57,5381.93,38
HCPCS,43237,"Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope through mouth",667.8,434.07,78.57,602.45,19
HCPCS,43238,Ultrasound guided needle aspiration or biopsy of esophagus using a flexible endoscope,832.7,541.26,78.57,715.05,19
HCPCS,43239,"Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope",1522.5,989.625,78.57,5487.81,38
HCPCS,43240,"Drainage of fluid collection of esophagus, stomach, and/or upper small bowel using a flexible endoscope",825.0,536.25,78.57,1205.26,19
HCPCS,43241,"Insertion of tube or tube in esophagus, stomach, and/or upper small bowel using a flexible endoscope",441.0,286.65,78.57,436.03,19
HCPCS,43242,"Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope",1642.1,1067.365,78.57,5381.93,38
HCPCS,43243,Injection of dilated vein of stomach and/or esophagus using a flexible endoscope,758.1,492.77,78.57,727.2,19
HCPCS,43244,Tying of dilated veins of stomach and/or esophagus using a flexible endoscope,836.9,543.99,78.57,754.8,19
HCPCS,43245,Dilation of stomach outlet using a flexible endoscope,1254.0,815.1,78.57,1432.89,19
HCPCS,43246,Insertion of stomach tube using a flexible endoscope,1724.0,1120.6,78.57,5921.67,38
HCPCS,43247,"Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2227.0,1447.55,78.57,5823.54,57
HCPCS,43248,Insertion of guide wire with dilation of esophagus using a flexible endoscope,1534.5,997.425,78.57,5751.23,38
HCPCS,43249,"Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm",3092.5,2010.125,78.57,10337.75,57
HCPCS,43250,"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using a flexible endoscope with electrical cautery",932.0,605.8,78.57,1084.42,19
HCPCS,43251,"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare",1555.5,1011.0749999999999,78.57,5381.93,38
HCPCS,43252,"Microscopic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2660.0,1729.0,665.0,6869.45,37
HCPCS,43253,"Injection of diagnostic or therapeutic substance or marker in esophagus, stomach, and/or upper small bowel using a flexible endoscope",875.7,569.21,78.57,808.49,19
HCPCS,43254,"Removal of tissue lining of esophagus, stomach, and/or upper small bowel using a flexible endoscope",907.2,589.68,78.57,831.86,19
HCPCS,43255,"Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope",1487.0,966.55,78.57,1513.61,19
HCPCS,43257,Heat delivery to muscle at esophagus and/or stomach to treat gastric reflux using a flexible endoscope,3079.25,2001.5149999999999,78.57,13545.21,38
HCPCS,43259,"Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2273.0,1477.45,78.57,9516.51,38
HCPCS,43260,"Diagnostic exam of gallbladder and pancreatic, liver, and bile ducts using an endoscope",982.8,638.82,78.57,992.28,19
HCPCS,43261,"Biopsy of gallbladder, pancreatic, liver, and bile ducts using a flexible endoscope",1033.2,671.58,78.57,1041.73,19
HCPCS,43262,Incision of pancreatic outlet using a flexible endoscope,1212.8,788.32,78.57,1100.09,19
HCPCS,43263,Pressure measurement of pancreatic or bile duct sphincter using a flexible endoscope,1197.0,778.05,78.57,1100.09,19
HCPCS,43264,Removal of stone or debris from bile or pancreatic duct using a flexible endoscope,1456.4,946.66,78.57,1120.17,19
HCPCS,43265,Destruction of stone of bile or pancreatic duct using a flexible endoscope,1680.0,1092.0,78.57,1334.75,19
HCPCS,43266,"Placement of stent in esophagus, stomach, and/or upper small bowel using a flexible endoscope",7533.9,4897.035,78.57,36973.65,38
HCPCS,43270,"Destruction of polyp or growth of esophagus, stomach, and/or upper small bowel using a flexible endoscope",2319.5,1507.68,78.57,1764.34,19
HCPCS,43273,Exam of common bile and/or pancreatic duct using a flexible endoscope,2353.9,1530.04,78.57,367.29,19
HCPCS,43274,Insertion of stent into pancreatic or bile duct using a flexible endoscope,1556.1,1011.47,78.57,1423.28,19
HCPCS,43275,Removal of stent from pancreatic or bile duct using a flexible endoscope,2829.05,1838.885,78.57,11298.44,38
HCPCS,43276,Replacement of stent in pancreatic or bile duct using a flexible endoscope,1619.1,1052.42,78.57,1482.99,19
HCPCS,43277,Balloon dilation of pancreatic or bile duct or sphincter using a flexible endoscope,1291.5,839.48,78.57,1165.42,19
HCPCS,43278,Destruction of polyp or growth of gallbladder and/or bile duct using a flexible endoscope,1467.9,954.14,78.57,1332.56,19
HCPCS,43279,Repair of muscle at lower esophagus and stomach using an endoscope,3485.0,2265.25,78.57,3776.18,19
HCPCS,43280,Strengthening of muscle between esophagus and stomach by wrapping part of stomach around esophagus using an endoscope,3031.4,1970.41,78.57,3165.53,19
HCPCS,43281,Repair of hernia of muscle at esophagus and stomach using an endoscope,4350.0,2827.5,78.57,4519.81,19
HCPCS,43282,Repair of hernia of muscle at esophagus and stomach with implantation of mesh using an endoscope,4730.0,3074.5,78.57,5079.65,19
HCPCS,43283,Lengthening of esophagus using an endoscope,4158.0,2702.7,78.57,4282.74,19
HCPCS,43284,Insertion of magnetic band around base of esophagus to tighten opening into stomach using an endoscope,1492.65,970.22,78.57,1894.01,19
HCPCS,43285,Removal of magnetic band from base of esophagus using an endoscope,1509.3,981.05,78.57,1957.34,19
HCPCS,43286,Removal of esophagus and partial removal of stomach using an endoscope,6825.0,4436.25,78.57,9307.23,19
HCPCS,43287,Removal of lower esophagus and partial removal of stomach using an endoscope,7765.0,5047.25,78.57,10369.28,19
HCPCS,43288,Removal of esophagus and partial removal of stomach using an endoscope for each procedure with connection of stomach to throat or to remaining esophagus,8140.0,5291.0,78.57,10955.61,19
HCPCS,43290,Placement of balloon in stomach for weight loss using flexible endoscope,390.5,253.83,78.57,6443.89,19
HCPCS,43291,Removal of balloon in stomach for weight loss using flexible endoscope,356.5,231.73,78.57,1108.65,19
HCPCS,43300,Repair of defect of esophagus through neck,2205.0,1433.25,78.57,1847.52,19
HCPCS,43305,Repair of defect of esophagus with repair of abnormal drainage tract though neck,3134.3,2037.3,78.57,3275.68,19
HCPCS,43310,Repair of defect of esophagus through chest,4273.5,2777.78,78.57,4329.17,19
HCPCS,43312,Repair of defect of esophagus with repair of abnormal drainage tract through chest,4569.6,2970.24,78.57,4629.14,19
HCPCS,43313,Repair of congenital defect of esophagus through chest,7573.7,4922.91,78.57,7985.45,19
HCPCS,43314,Repair of congenital defect of esophagus and abnormal drainage tract between esophagus and throat,8647.8,5621.07,78.57,8486.25,19
HCPCS,43320,Repair of muscle at lower esophagus and stomach through abdomen or chest,3776.9,2454.99,78.57,4082.99,19
HCPCS,43325,Repair of muscle at lower esophagus and stomach with patch,3608.9,2345.79,78.57,3969.77,19
HCPCS,43327,Repair of muscle at lower esophagus and stomach,1887.53,1226.89,78.57,2401.9,19
HCPCS,43328,Repair of muscle at lower esophagus and stomach through chest,3794.7,2466.56,78.57,3288.99,19
HCPCS,43330,Repair of esophagus through abdomen,3537.5,2299.38,78.57,3904.22,19
HCPCS,43331,Repair of esophagus through chest,3768.5,2449.53,78.57,3912.21,19
HCPCS,43332,Repair of paraesophageal hernia through abdomen,2781.5,1807.98,78.57,3392.11,19
HCPCS,43333,Repair of paraesophageal hernia with mesh implant through abdomen,4058.3,2637.9,78.57,3693.96,19
HCPCS,43334,Repair of paraesophageal hernia through chest,2935.8,1908.27,78.57,3644.01,19
HCPCS,43335,Repair of paraesophageal hernia with mesh implant through chest,3129.8,2034.37,78.57,3899.19,19
HCPCS,43336,Repair of paraesophageal hernia through abdominal incision,3640.0,2366.0,78.57,4240.07,19
HCPCS,43337,Repair of paraesophageal hernia with mesh implant through abdominal incision,3739.65,2430.77,78.57,4511.53,19
HCPCS,43338,Lengthening of esophagus,267.15,173.65,78.57,333.2,19
HCPCS,43340,Partial removal of esophagus and stomach through abdomen,3682.4,2393.56,78.57,4028.32,19
HCPCS,43341,Partial removal of esophagus and stomach through chest,4036.2,2623.53,78.57,4093.51,19
HCPCS,43351,Relocation of esophagus through chest,3679.2,2391.48,78.57,3830.33,19
HCPCS,43352,Relocation of esophagus through neck,2991.5,1944.48,78.57,3116.99,19
HCPCS,43360,Reconnection of esophagus to stomach after previous surgery,6359.9,4133.94,78.57,6571.44,19
HCPCS,43361,Reconnection of esophagus to stomach with bowel graft reconstruction after previous surgery,4433.1,2881.52,78.57,7881.11,19
HCPCS,43400,Tying of dilated veins of esophagus,4376.4,2844.66,78.57,4454.58,19
HCPCS,43405,Tying or stapling of hole or tear at junction of esophagus and stomach,3536.65,2298.82,78.57,4247.66,19
HCPCS,43410,Suture of wound or injury to esophagus through neck,2784.6,1809.99,78.57,3081.28,19
HCPCS,43415,Suture of wound or injury to esophagus through chest or abdomen,4727.1,3072.62,78.57,7502.2,19
HCPCS,43420,Repair of abnormal drainage tract of esophagus through neck,2802.5,1821.63,78.57,3052.91,19
HCPCS,43425,Repair of abnormal drainage tract of esophagus through chest or abdomen,3359.65,2183.77,78.57,4209.59,19
HCPCS,43450,Dilation of esophagus,422.1,274.37,64.91,450.89,19
HCPCS,43453,Dilation of esophagus with a guide wire,785.4,510.51,64.87,1941.18,19
HCPCS,43460,Control of bleeding of esophagus,768.7,499.655,78.57,8477.27,38
HCPCS,43496,Relocation of upper small bowel for graft,23290.0,15138.5,78.57,11645.0,15
HCPCS,43497,Incision of muscle of lower esophagus using an endoscope,1778.0,1155.7,78.57,2212.61,19
HCPCS,43500,Exploration of stomach or removal of foreign body in stomach,2079.0,1351.35,78.57,2304.71,19
HCPCS,43501,Suture of bleeding stomach ulcer,3576.3,2324.6,78.57,3947.26,19
HCPCS,43502,Suture of lacerated stomach,3450.95,2243.12,78.57,4451.5,19
HCPCS,43510,Insertion of permanent stomach tube with dilation of esophagus,2684.9,1745.19,78.57,2770.17,19
HCPCS,43520,Severing of muscle at stomach outlet to upper small bowel,1877.4,1220.31,78.57,2023.46,19
HCPCS,43605,Biopsy of stomach,2207.1,1434.62,78.57,2460.4,19
HCPCS,43610,Removal of stomach ulcer or growth,2606.1,1693.97,78.57,2881.19,19
HCPCS,43611,Removal of malignant growth of stomach,3245.6,2109.64,78.57,3594.48,19
HCPCS,43620,Removal of stomach with upper small bowel attachment to esophagus,5293.1,3440.52,78.57,5758.01,19
HCPCS,43621,Removal of stomach with lower small bowel attachment to esophagus,6054.3,3935.3,78.57,6652.23,19
HCPCS,43622,Removal of stomach with creation of intestinal pouch attached to esophagus,6134.1,3987.17,78.57,6755.19,19
HCPCS,43631,Removal of lower part of stomach with reattachment of remaining stomach to first part of small bowel,3873.5,2517.78,78.57,4251.04,19
HCPCS,43632,Removal of lower part of stomach with reattachment of remaining stomach to second part of small bowel,5339.3,3470.55,78.57,5958.41,19
HCPCS,43633,Removal of lower portion of stomach with reattachment of upper portion of remaining stomach to small bowel,5069.4,3295.11,78.57,5631.46,19
HCPCS,43634,Partial removal of stomach with creation of intestine pouch,5600.7,3640.46,78.57,6207.81,19
HCPCS,43635,Severing of vagus nerve with partial removal of stomach,446.3,290.1,78.57,328.56,19
HCPCS,43640,Severing of vagus nerve to stomach,3118.5,2027.03,78.57,3454.34,19
HCPCS,43641,Repair of stomach outlet muscle and severing of vagus nerve,3349.5,2177.18,78.57,3509.93,19
HCPCS,43644,Bypass of stomach using an endoscope,4630.0,3009.5,78.57,5075.24,19
HCPCS,43645,Bypass of stomach with reconstruction of small bowel using an endoscope,4946.6,3215.29,78.57,5425.23,19
HCPCS,43647,Implantation or replacement of neurostimulator electrodes in upper stomach using an endoscope,4053.0,2634.45,78.57,3083.84,15
HCPCS,43648,Revision or removal of neurostimulator electrodes in upper stomach using an endoscope,4053.0,2634.45,78.57,2026.5,15
HCPCS,43651,Incision of vagus nerve in stomach using an endoscope,1736.7,1128.86,78.57,1913.49,19
HCPCS,43652,Incision of selective vagus nerves of stomach using an endoscope,2019.2,1312.48,78.57,2238.53,19
HCPCS,43653,Creation of surgical opening from stomach to skin using an endoscope,1472.1,956.87,78.57,1684.6,19
HCPCS,43752,Insertion of stomach tube through nose or mouth using fluoroscopic guidance,913.0,593.45,32.15,2556.68,57
HCPCS,43753,Insertion of stomach tube and aspiration of stomach contents,207.8,135.07,18.48,2166.29,36
HCPCS,43754,Diagnostic insertion of stomach tube and aspiration of stomach contents,219.5,142.68,43.21,567.59,19
HCPCS,43755,"Diagnostic insertion of stomach tube and aspiration of stomach contents after administration of drugs to stimulate stomach secretions, with multiple samples",319.73,207.82,51.6,488.45,19
HCPCS,43756,Diagnostic insertion of tube into upper small bowel and specimen collection using imaging guidance,469.33,305.06,44.12,669.93,19
HCPCS,43757,Insertion of tube into upper small bowel for collection of multiple bile and pancreatic specimens using imaging guidance after administration of drugs to stimulate secretions,1108.8,720.72,65.36,899.06,19
HCPCS,43761,Repositioning of oral or nasal feeding tube in small bowel,809.2,525.98,78.57,3290.11,38
HCPCS,43762,Replacement of stomach stoma tube,276.5,179.725,30.9,1195.7,38
HCPCS,43763,Replacement of stomach stoma tube with revision of stoma opening,330.5,214.825,75.19,2166.29,38
HCPCS,43770,Insertion of adjustable stomach reduction device using an endoscope,2950.5,1917.83,78.57,3290.75,19
HCPCS,43771,Adjustment of stomach reduction device using an endoscope,6657.65,4327.475,78.57,25695.88,57
HCPCS,43772,Removal of stomach reduction device using an endoscope,2545.2,1654.38,78.57,2781.99,19
HCPCS,43773,Replacement of stomach reduction device using an endoscope,3367.4,2188.81,78.57,3731.42,19
HCPCS,43774,Removal of stomach reduction device and port using an endoscope,2550.0,1657.5,78.57,2812.07,19
HCPCS,43775,Partial removal of stomach for weight loss using an endoscope,3530.0,2294.5,78.57,3256.82,19
HCPCS,43800,Repair of muscle of stomach outlet into upper small bowel,2472.8,1607.32,78.57,2727.58,19
HCPCS,43810,Removal of end portion of stomach with attachment to upper small bowel,2683.8,1744.47,78.57,2973.12,19
HCPCS,43820,Partial removal of stomach with attachment of stomach to small bowel,3501.8,2276.17,78.57,3934.52,19
HCPCS,43825,Partial removal of stomach with severing of vagus nerve,3451.4,2243.41,78.57,3826.48,19
HCPCS,43830,Insertion of stomach feeding tube,1833.3,1191.65,78.57,2058.12,19
HCPCS,43831,"Insertion of stomach feeding tube, newborn",1758.8,1143.22,78.57,1756.08,19
HCPCS,43832,Creation of stomach feeding tube,2827.7,1838.01,78.57,3043.64,19
HCPCS,43840,"Suture of perforated ulcer, wound, or injury of stomach or upper small bowel",3552.2,2308.93,78.57,3984.55,19
HCPCS,43842,Banding of upper stomach to reduce size of stomach,3911.3,2542.35,78.57,3606.37,15
HCPCS,43843,Reduction of size of upper stomach,3364.2,2186.73,78.57,3728.07,19
HCPCS,43845,"Partial removal of stomach, upper bowel, and ileum for weight loss",6300.0,4095.0,78.57,5723.36,19
HCPCS,43846,Bypass of stomach for weight loss with Roux-en-Y connection of upper bowel to upper stomach,4751.3,3088.35,78.57,4757.96,19
HCPCS,43847,Bypass of stomach for weight loss with small bowel reconstruction,5040.0,3276.0,78.57,5267.38,19
HCPCS,43848,Revision of upper stomach bypass,5144.0,3343.6,78.57,5648.02,19
HCPCS,43860,Revision of surgically created connection of stomach to small bowel,4374.3,2843.3,78.57,4799.92,19
HCPCS,43865,Revision of attachment of stomach to small bowel with severing of vagus nerve,4547.6,2955.94,78.57,4992.23,19
HCPCS,43870,Closure of surgically created opening from stomach to skin,1875.3,1218.95,78.57,2090.73,19
HCPCS,43880,Closure of abnormal drainage tract from stomach to large bowel,4271.4,2776.41,78.57,4673.12,19
HCPCS,43881,Implantation or replacement of stimulator electrodes in upper stomach,1627.7,1058.01,78.57,1844.47,15
HCPCS,43882,Removal or revision of stimulator electrodes in upper stomach,3350.8,2178.02,78.57,3651.48,15
HCPCS,43886,Revision of port for saline injection into stomach banding device,705.6,458.64,78.57,1066.56,19
HCPCS,43887,Removal of port for saline injection into stomach banding device,825.3,536.45,78.57,960.25,19
HCPCS,43888,Replacement of port for saline injection into stomach banding device,966.0,627.9,78.57,1353.41,19
HCPCS,43999,Other procedure on stomach,1882.0,1223.3,470.5,4860.27,19
HCPCS,44005,Release of intestinal scar tissue,2920.1,1898.07,78.57,3212.04,19
HCPCS,44010,"Exploration, biopsy, or removal of foreign body in small bowel",2296.4,1492.66,78.57,2555.35,19
HCPCS,44015,Insertion of feeding tube or tube into upper small bowel,945.0,614.25,78.57,540.62,19
HCPCS,44020,"Incision of small bowel for exploration, biopsy, or removal of foreign body",2582.0,1678.3,78.57,2856.24,19
HCPCS,44021,Incision of small bowel for insertion of tube for relief of pressure,2612.4,1698.06,78.57,2867.79,19
HCPCS,44025,Biopsy or removal of foreign body in large bowel,2628.2,1708.33,78.57,2894.2,19
HCPCS,44050,Repair of twisted or herniated small bowel,2485.4,1615.51,78.57,2743.41,19
HCPCS,44055,Correction of abnormal rotation of small bowel,3991.1,2594.22,78.57,4386.97,19
HCPCS,44100,Biopsy of small bowel by capsule attached to tube passed through mouth,322.4,209.56,78.57,329.1,19
HCPCS,44110,Removal of growth of small or large bowels,2254.4,1465.36,78.57,2507.86,19
HCPCS,44111,Removal of multiple growths of small or large bowel,2940.0,1911.0,78.57,2908.82,19
HCPCS,44120,Partial removal of small bowel with reconnection,3257.1,2117.12,78.57,3590.31,19
HCPCS,44121,"Partial removal and reconnection of small bowel, each additional removal and reconnection",945.0,614.25,78.57,708.66,19
HCPCS,44125,Partial removal of small bowel with creation of opening to skin,3156.3,2051.6,78.57,3471.75,19
HCPCS,44126,Partial removal of small bowel and reconnection to correct congenital defect,6526.8,4242.42,78.57,7203.9,19
HCPCS,44127,Partial removal of small bowel to correct congenital defect with reconnection and tapering,7588.4,4932.46,78.57,8344.97,19
HCPCS,44128,"Partial removal and reconnection of small bowel to correct congenital defect, each additional removal and reconnection",687.8,447.07,78.57,710.05,19
HCPCS,44130,Creation of connection between 2 segments of small bowel,3433.5,2231.78,78.57,3862.57,19
HCPCS,44132,Removal of donor small bowel,1575.0,1023.75,73.6,890.44,15
HCPCS,44135,Transplantation of small bowel from donor,12000.0,7800.0,73.6,6000.0,15
HCPCS,44137,Removal of transplanted donor small bowel,2100.0,1365.0,78.57,3307.12,15
HCPCS,44139,Release of large bowel from spleen and abdominal wall with partial removal of large bowel,336.0,218.4,78.57,355.71,19
HCPCS,44140,Partial removal of large bowel with connection,3584.7,2330.06,78.57,3943.48,19
HCPCS,44141,Partial removal of large bowel with creation of opening to skin,4766.0,3097.9,78.57,5366.01,19
HCPCS,44143,Partial removal of large bowel with creation of opening from large bowel to skin,4430.0,2879.5,78.57,4892.56,19
HCPCS,44144,Partial removal of large bowel with creation of 2 openings from small or large bowel to skin,4673.6,3037.84,78.57,5204.66,19
HCPCS,44145,Partial removal of large bowel and reattachment to rectum,4476.2,2909.53,78.57,4892.03,19
HCPCS,44146,Partial removal of large bowel and reattachment to rectum and creation of large bowel opening,5621.7,3654.11,78.57,6255.41,19
HCPCS,44147,Partial removal of large bowel through abdomen and anus,5107.2,3319.68,78.57,5716.47,19
HCPCS,44150,Removal of large bowel with attachment of small bowel to rectum or creation of opening from small bowel to skin through abdomen,4919.3,3197.55,78.57,5505.03,19
HCPCS,44151,Removal of large bowel with creation of small bowel opening to skin through abdomen,5628.0,3658.2,78.57,6321.91,19
HCPCS,44155,Removal of large bowel and rectum and creation of opening from end of small bowel to skin through abdomen,5522.0,3589.3,78.57,6158.17,19
HCPCS,44156,"Removal of large bowel and rectum and creation of opening from end of small bowel to skin through abdomen, with creation of small bowel pouch",6050.1,3932.57,78.57,6749.15,19
HCPCS,44157,Removal of large bowel and rectum with attachment of small bowel to anus,5911.5,3842.48,78.57,6416.44,19
HCPCS,44158,Removal of large bowel and rectum with attachment of small bowel to anus and creation of small bowel pouch,6065.9,3942.84,78.57,6580.57,19
HCPCS,44160,Partial removal of small and large bowel with attachment of small and large bowel,3339.0,2170.35,78.57,3654.44,19
HCPCS,44180,Release of small bowel scar tissue using an endoscope,2461.2,1599.78,78.57,2701.39,19
HCPCS,44186,Creation of opening from small bowel to skin with insertion of a tube for decompression or feeding using an endoscope,1730.0,1124.5,78.57,1907.87,19
HCPCS,44187,Creation of opening from small bowel to skin using an endoscope,2928.5,1903.53,78.57,3274.01,19
HCPCS,44188,Creation of large bowel opening using an endoscope,3237.2,2104.18,78.57,3616.48,19
HCPCS,44202,Partial removal and reconnection of small bowel using an endoscope,3708.6,2410.59,78.57,4070.41,19
HCPCS,44203,"Partial removal of small bowel using an endoscope, each additional removal and connection",559.95,363.97,78.57,706.08,19
HCPCS,44204,Partial removal of large bowel using an endoscope,4147.5,2695.88,78.57,4543.66,19
HCPCS,44205,Partial removal of small and large bowel with attachment of small and large bowel using an endoscope,3618.3,2351.9,78.57,3954.92,19
HCPCS,44206,Partial removal of large bowel with creation of opening from large bowel to skin using an endoscope,4706.1,3058.97,78.57,5163.45,19
HCPCS,44207,Partial removal of large bowel and reattachment to rectum using an endoscope,4948.7,3216.66,78.57,5393.59,19
HCPCS,44208,Partial removal of large bowel and reattachment to rectum and creation of opening from large bowel to skin using an endoscope,3308.6,2150.59,78.57,5886.69,19
HCPCS,44210,Removal of large bowel with attachment of small bowel to rectum or creation of small bowel opening using an endoscope,4806.9,3124.49,78.57,5299.84,19
HCPCS,44211,Removal of large bowel and rectum with attachment of small bowel to anus and creation of opening from small bowel to skin using an endoscope,5903.1,3837.02,78.57,6464.3,19
HCPCS,44212,Removal of large bowel and rectum with creation of opening from small bowel to skin using an endoscope,5540.9,3601.59,78.57,6112.24,19
HCPCS,44213,Partial release of large bowel and partial removal of large bowel using an endoscope,488.3,317.4,78.57,555.49,19
HCPCS,44227,Closure of opening from large or small bowel to skin using an endoscope,4489.8,2918.37,78.57,4907.23,19
HCPCS,44300,Insertion of tube into small bowel,2233.4,1451.71,78.57,2470.82,19
HCPCS,44310,Creation of opening from small bowel to skin,2797.2,1818.18,78.57,3081.91,19
HCPCS,44312,Simple revision of superficial scar tissue from surgically created opening of small bowel to skin,1593.9,1036.04,78.57,1759.76,19
HCPCS,44314,Reconstruction of opening from small bowel to skin,2712.2,1762.93,78.57,2982.09,19
HCPCS,44316,Creation of pouch of small bowel with valve,3721.2,2418.78,78.57,4138.98,19
HCPCS,44320,Creation of opening from large bowel to skin,3187.8,2072.07,78.57,3538.98,19
HCPCS,44322,Creation of opening from large bowel to skin with multiple bowel biopsies,2519.0,1637.35,78.57,2944.13,19
HCPCS,44340,Simple revision of superficial scar tissue from surgically created opening of large bowel to skin,1598.1,1038.77,78.57,1838.87,19
HCPCS,44345,Complicated reconstruction of opening from large bowel to skin,2787.8,1812.07,78.57,3104.35,19
HCPCS,44346,Revision of opening from large bowel to skin with repair of hernia,3136.4,2038.66,78.57,3491.88,19
HCPCS,44360,Diagnostic exam of small bowel (excluding lower small intestine) using an endoscope,1373.6,892.84,78.57,5947.5,38
HCPCS,44361,Biopsy of small bowel (except ileum) using an endoscope,577.5,375.38,78.57,487.87,19
HCPCS,44363,Removal of foreign bodies from small bowel using an endoscope,584.9,380.19,78.57,589.12,19
HCPCS,44364,Removal of small bowel polyps or growths using an endoscope with mechanical snare,703.5,457.28,78.57,628.3,19
HCPCS,44365,Removal of small bowel polyps or growths using an endoscope with electrical cautery,667.8,434.07,78.57,559.85,19
HCPCS,44366,Control of bleeding of first or second part of small bowel using an endoscope,821.1,533.72,78.57,737.59,19
HCPCS,44369,Destruction of polyp or growth of small bowel using an endoscope,753.9,490.04,78.57,755.92,19
HCPCS,44370,Insertion of small bowel stent above lower small bowel using an endoscope,645.03,419.27,78.57,817.5,19
HCPCS,44372,Insertion of tube into middle small bowel using an endoscope,1764.85,1147.155,78.57,7236.17,38
HCPCS,44373,Conversion of stomach tube to tube in middle small bowel using an endoscope,499.8,324.87,78.57,586.8,19
HCPCS,44376,Diagnostic exam of small bowel (including lower small intestine) using an endoscope,1569.4,1020.11,78.57,5947.5,38
HCPCS,44377,Biopsy of small bowel using an endoscope,1723.75,1120.44,78.57,5947.5,38
HCPCS,44378,Control of bleeding of small bowel using an endoscope,1736.35,1128.63,78.57,5947.5,38
HCPCS,44379,Insertion of small bowel stent below lower small bowel using an endoscope,995.18,646.87,78.57,1258.49,19
HCPCS,44380,Diagnostic exam of small bowel using an endoscope inserted through surgically created opening from small bowel to skin,393.8,255.97,49.57,471.14,19
HCPCS,44381,Balloon dilation of small bowel using an endoscope,2165.28,1407.43,71.9,2382.87,19
HCPCS,44382,Biopsy of small bowel using an endoscope inserted through surgically created opening from lower small bowel to skin,650.0,422.5,63.15,720.17,19
HCPCS,44384,Insertion of stent into small bowel using an endoscope inserted through surgically created opening from small bowel to skin,371.8,241.67,78.57,534.26,19
HCPCS,44385,Diagnostic exam of surgically created pouch of small bowel using an endoscope,682.5,443.63,62.19,518.43,19
HCPCS,44386,Biopsy of small bowel pouch using an endoscope,910.4,591.76,75.39,750.31,19
HCPCS,44388,Diagnostic exam of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,932.4,606.06,78.57,755.99,19
HCPCS,44389,Biopsy of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,1051.1,683.22,78.57,990.84,19
HCPCS,44390,Removal of foreign bodies from large bowel using an endoscope inserted through surgically created opening from large bowel to skin,1243.2,808.08,78.57,973.84,19
HCPCS,44391,Control of bleeding of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,1362.9,885.89,78.57,1542.59,19
HCPCS,44392,Removal of growths or polyps of large bowel by electrical cautery using an endoscope inserted through surgically created opening from large bowel to skin,1171.8,761.67,78.57,925.54,19
HCPCS,44394,Removal of growths or polyps of large bowel by mechanical snare using an endoscope inserted through surgically created opening into large bowel to skin,1336.7,868.86,78.57,1052.73,19
HCPCS,44401,Destruction of growth or polyp of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,7350.75,4777.99,78.57,5744.62,19
HCPCS,44402,Insertion of stent into large bowel using an endoscope inserted through surgically created opening from large bowel to skin,630.13,409.58,78.57,805.08,19
HCPCS,44403,Removal of lining of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,735.13,477.83,78.57,935.25,19
HCPCS,44404,Injection beneath lining of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,838.05,544.73,78.57,1014.01,19
HCPCS,44405,Balloon dilation of large bowel using an endoscope,1251.73,813.62,78.57,1340.73,19
HCPCS,44406,Ultrasound exam of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,555.4,361.01,78.57,705.85,19
HCPCS,44407,Fine needle aspiration and/or biopsy of large bowel with ultrasound guidance using an endoscope inserted through surgically created opening from large bowel to skin,666.1,432.97,78.57,847.35,19
HCPCS,44408,Decompression of large bowel using an endoscope inserted through surgically created opening in large bowel to skin,570.85,371.05,78.57,711.75,19
HCPCS,44500,Dilation of stomach and/or small bowel using long gastrointestinal tube,259.8,168.87,15.36,8477.27,38
HCPCS,44602,Suture of tear of hole in small bowel,3725.4,2421.51,78.57,4143.54,19
HCPCS,44603,Suture of multiple tears or holes in small bowel,2824.0,1835.605,78.57,4766.38,38
HCPCS,44604,Suture of tear or hole in large bowel,2835.0,1842.75,78.57,3113.04,19
HCPCS,44605,Suture of tear or hole in large bowel and creation of opening from large bowel to skin,3497.6,2273.44,78.57,3839.04,19
HCPCS,44615,Release of small bowel obstruction,2880.2,1872.13,78.57,3160.59,19
HCPCS,44620,Closure of surgically created large or small bowel opening,2304.8,1498.12,78.57,2562.35,19
HCPCS,44625,Closure of surgically created large or small bowel opening with bowel removal and reattachment,2729.0,1773.85,78.57,3011.87,19
HCPCS,44626,Closure of surgically created large or small bowel opening with bowel removal and reattachment of large bowel and rectum,4331.3,2815.35,78.57,4715.44,19
HCPCS,44640,Closure of abnormal drainage tract from small bowel to skin,2510.0,1631.5,78.57,8477.27,38
HCPCS,44650,Closure of abnormal drainage tract within small bowel or small to large bowel,3929.1,2553.92,78.57,4265.61,19
HCPCS,44660,Closure of abnormal drainage tract of small bowel,3824.1,2485.67,78.57,4000.61,19
HCPCS,44661,Closure of abnormal drainage tract from small bowel to urinary bladder with resection of bladder and/or small bowel,4287.2,2786.68,78.57,4595.23,19
HCPCS,44680,Surgical folding of upper small bowel upon itself,2846.6,1850.29,78.57,3143.74,19
HCPCS,44700,Suspension of small bowel using mesh or prosthesis or self tissue,2760.5,1794.33,78.57,3016.98,19
HCPCS,44701,Irrigation of large bowel during surgery,389.93,253.45,78.57,496.44,19
HCPCS,44705,Assessment and overseeing preparation of donor fecal specimen,246.8,160.42,49.4,268.94,15
HCPCS,44715,Preparation of donor small bowel and artery for transplantation,2625.0,1706.25,78.57,1399.26,15
HCPCS,44720,Reconstruction of donor small bowel and vein for transplantation,1750.0,1137.5,78.57,800.35,19
HCPCS,44721,Reconstruction of donor small bowel and artery for transplantation,2450.0,1592.5,78.57,1120.6,19
HCPCS,44799,Other procedure on small bowel,925.0,601.25,231.25,3726.0,19
HCPCS,44800,Repair of congenital bowel defect,2017.1,1311.12,78.57,2256.12,19
HCPCS,44820,Removal of growth of abdominal cavity,2233.4,1451.71,78.57,2462.39,19
HCPCS,44850,Suture of abdominal cavity tissue,1971.9,1281.74,78.57,2202.16,19
HCPCS,44900,Drainage of abscess of appendix,2024.4,1315.86,78.57,2268.7,19
HCPCS,44950,Removal of appendix,1707.3,1109.75,78.57,1883.77,19
HCPCS,44955,Removal of appendix during other major procedure,446.3,290.1,37.05,246.54,19
HCPCS,44960,Removal of ruptured infected appendix,2306.9,1499.49,78.57,2565.45,19
HCPCS,44970,Removal of appendix using an endoscope,1568.7,1019.66,78.57,1763.1,19
HCPCS,45000,Drainage of abscess of pelvic region,1104.6,717.99,78.57,1266.9,19
HCPCS,45005,Drainage of superficial rectal abscess,800.0,520.0,0.01,2453.38,36
HCPCS,45020,Incision and drainage of abscess above pelvic floor or behind rectum,1449.0,941.85,78.57,1694.14,19
HCPCS,45100,Biopsy of anal and/or rectal wall through anus,2896.5,1882.7250000000001,78.57,12956.4,38
HCPCS,45108,Removal of muscle in anus and rectum area,1312.5,853.13,78.57,1084.27,19
HCPCS,45110,Removal of rectum with creation of opening from large bowel to skin through abdomen and rectum,4950.8,3218.02,78.57,5475.84,19
HCPCS,45111,Partial removal of rectum through abdomen,3517.5,2286.38,78.57,3218.89,19
HCPCS,45112,Removal of rectum and suturing of large bowel to anus through incision of abdomen and region between thighs,5119.8,3327.87,78.57,5582.23,19
HCPCS,45113,Partial removal of rectum and attachment of small bowel to anus and creation of small bowel pouch,5242.7,3407.76,78.57,5712.8,19
HCPCS,45114,Partial removal of rectum through abdomen and sacrum,4785.9,3110.84,78.57,5309.53,19
HCPCS,45116,Partial removal of rectum through sacrum,3745.25,2434.41,78.57,4718.76,19
HCPCS,45119,Removal of rectum with creation of small bowel pouch through abdomen and region between thighs,5258.4,3417.96,78.57,5754.04,19
HCPCS,45120,Removal of rectum for congenital defect through abdomen and region between thighs,4288.2,2787.33,78.57,4653.87,19
HCPCS,45121,Removal of rectum for congenital defect and large bowel through abdomen and perineum with multiple biopsies,4583.3,2979.15,78.57,5071.58,19
HCPCS,45123,Partial removal of rectum through perineum,2979.9,1936.94,78.57,3351.28,19
HCPCS,45126,"Removal of large bowel, rectum, bladder and ureter",7793.1,5065.52,78.57,8294.33,19
HCPCS,45130,Repair of prolapsed rectum through anus,2915.9,1895.34,78.57,3256.17,19
HCPCS,45135,Repair of prolapsed rectum through abdomen and anus,3858.8,2508.22,78.57,3941.07,19
HCPCS,45136,Removal of small bowel pouch with creation of opening from small bowel to skin,4948.7,3216.66,78.57,5467.79,19
HCPCS,45150,Incision of stricture of rectum,1055.3,685.95,78.57,1219.24,19
HCPCS,45160,Removal of growth of rectum through sacrum,2646.0,1719.9,78.57,2995.64,19
HCPCS,45171,Removal of growth of rectum through anus,1604.4,1042.86,78.57,1793.92,19
HCPCS,45172,Removal of growth of rectum through anus with removal of a portion of muscle,2199.8,1429.87,78.57,2429.04,19
HCPCS,45190,Destruction of growth of rectum,1655.8,1076.27,78.57,2093.34,19
HCPCS,45300,Diagnostic exam of rectum and lower large bowel using an endoscope,485.3,315.445,0.01,3227.0,55
HCPCS,45303,Dilation of rectum and/or lower large bowel using an endoscope,2174.6,1413.49,4.58,2312.84,19
HCPCS,45305,Biopsies of rectum and/or lower large bowel using a rigid endoscope,707.05,459.58500000000004,0.01,2453.38,36
HCPCS,45307,Removal of foreign bodies from rectum and/or lower large bowel using a rigid endoscope,519.8,337.87,77.49,507.48,19
HCPCS,45308,Removal of polyp or growth of rectum and large bowel using an endoscope with electrical cautery,474.6,308.49,62.62,486.2,19
HCPCS,45309,Removal of polyp or growth of rectum and large bowel using an endoscope with mechanical snare,529.2,343.98,76.33,500.79,19
HCPCS,45315,Removal of multiple growths or polyps of lower large bowel by electrical cautery or mechanical snare using a rigid endoscope,595.4,387.01,78.57,539.33,19
HCPCS,45317,Control of bleeding of lower large bowel using an endoscope,564.9,367.19,78.57,531.48,19
HCPCS,45320,Destruction of multiple polyps or growths of lower large bowel using an endoscope,560.7,364.46,78.57,529.33,19
HCPCS,45321,Release of twisted lower large bowel using a rigid endoscope,367.5,238.88,78.57,301.64,19
HCPCS,45327,Insertion of stent into lower large bowel using an endoscope,271.38,176.4,78.57,381.62,19
HCPCS,45330,Diagnostic exam of lower portion of large bowel using a flexible endoscope,370.0,240.5,49.56,447.17,19
HCPCS,45331,Biopsy of lower large bowel using a flexible endoscope,522.0,339.3,52.09,690.46,19
HCPCS,45332,Removal of foreign bodies in lower portion of large bowel using a flexible endoscope,745.5,484.58,51.39,666.13,19
HCPCS,45333,Removal of polyps or growths of lower large bowel using a flexible endoscope with electrical cautery,758.1,492.77,78.57,792.39,19
HCPCS,45334,Control of bleeding of lower large bowel using a flexible endoscope,472.5,307.13,78.57,1190.27,19
HCPCS,45335,Injection beneath lining of lower large bowel using a flexible endoscope,648.9,421.79,42.9,703.27,19
HCPCS,45337,Decompression of twisted or abnormally dilated lower large bowel using a flexible endoscope,403.2,262.08,78.57,351.97,19
HCPCS,45338,Removal of polyps or growths of lower large bowel using a flexible endoscope with mechanical snare,876.8,569.92,77.52,720.19,19
HCPCS,45340,Balloon dilation of lower large bowel using a flexible endoscope,1167.6,758.94,34.72,1103.79,19
HCPCS,45341,Ultrasound exam of lower large bowel using a flexible endoscope,444.2,288.73,78.57,379.93,19
HCPCS,45342,Fine needle aspiration and/or biopsy of lower large bowel with ultrasound guidance using a flexible endoscope,677.3,440.25,78.57,521.83,19
HCPCS,45346,Destruction of polyp or growth of lower large bowel using a flexible endoscope,822.4,534.56,78.57,5552.6,19
HCPCS,45347,Insertion of stent into lower large bowel using a flexible endoscope,714.3,464.3,78.57,473.83,19
HCPCS,45349,Removal of lower portion of large bowel tissue using a flexible endoscope,725.5,471.58,78.57,747.27,19
HCPCS,45350,Banding of hemorrhoids using a flexible endoscope (sigmoidoscope),1214.73,789.57,78.57,1621.09,19
HCPCS,45378,Diagnostic exam of large bowel using a flexible endoscope,1645.0,1069.25,78.57,5784.8,38
HCPCS,45379,Removal of foreign bodies in large bowel using a flexible endoscope,1335.6,868.14,78.57,1045.62,19
HCPCS,45380,Biopsy of large bowel using a flexible endoscope,1728.5,1123.525,78.57,5673.75,38
HCPCS,45381,Injection beneath lining of large bowel using a flexible endoscope,1230.0,799.5,78.57,1066.55,19
HCPCS,45382,Control of bleeding of upper large bowel using a flexible endoscope,1666.4,1083.16,78.57,1605.98,19
HCPCS,45384,Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery,1260.0,819.0,78.57,1171.7,19
HCPCS,45385,Removal of polyps or growths of large bowel using an endoscope with mechanical snare,1420.0,923.0,78.57,1091.45,19
HCPCS,45386,Balloon dilation of large bowel using a flexible endoscope,1745.1,1134.32,78.57,1471.87,19
HCPCS,45388,Destruction of polyp or growth of large bowel using a flexible endoscope,6000.0,3900.0,78.57,5934.0,19
HCPCS,45389,Insertion of stent in large bowel using a flexible endoscope,1145.9,744.84,78.57,890.9,19
HCPCS,45390,Removal of large bowel tissue using a flexible endoscope,1145.9,744.84,78.57,1022.64,19
HCPCS,45391,Ultrasound exam of large bowel using a flexible endoscope,842.1,547.37,78.57,793.77,19
HCPCS,45392,Fine needle aspiration and/or biopsy of large bowel with ultrasound guidance using a flexible endoscope,1074.2,698.23,78.57,934.49,19
HCPCS,45393,Decompression of twisted or abnormally dilated large bowel using a flexible endoscope,2073.4,1347.71,78.57,772.68,19
HCPCS,45395,Removal of rectum with creation of opening from large bowel to skin using an endoscope,4746.0,3084.9,78.57,5889.03,19
HCPCS,45397,Removal of rectum using an endoscope,5295.2,3441.88,78.57,6434.93,19
HCPCS,45398,Banding of hemorrhoids using a flexible endoscope (colonoscope),1562.13,1015.38,78.57,1989.79,19
HCPCS,45400,Repair of rectal prolapse using an endoscope,2659.7,1728.81,78.57,3409.63,19
HCPCS,45402,Repair of rectal prolapse with partial removal of lower large bowel using an endoscope,4140.2,2691.13,78.57,4524.95,19
HCPCS,45500,Repair of narrowed rectum,1548.8,1006.72,78.57,1637.7,19
HCPCS,45505,Repair of prolapsed lining of rectum through anus,1601.3,1040.85,78.57,1771.55,19
HCPCS,45520,Injection of prolapsed vein in rectum,361.4,234.91,14.91,393.42,19
HCPCS,45540,Suture of rectum to sacrum through abdomen,2857.1,1857.12,78.57,3161.9,19
HCPCS,45541,Suture of rectum to sacrum through perineum,2625.0,1706.25,78.57,2803.13,19
HCPCS,45550,Suture of rectum to sacrum with removal of large bowel,3926.0,2551.9,78.57,4366.74,19
HCPCS,45560,Repair of bulging of rectum into vagina,1940.4,1261.26,78.57,2080.78,19
HCPCS,45562,Repair of rectal wound,2973.6,1932.84,78.57,3325.14,19
HCPCS,45563,Repair of rectal wound with surgically created opening from large bowel to skin,4292.4,2790.06,78.57,4831.24,19
HCPCS,45800,Closure of abnormal opening from rectum to bladder,3349.5,2177.18,78.57,3693.73,19
HCPCS,45805,Repair of herniated rectum with creation of large bowel opening to skin,3791.6,2464.54,78.57,4293.87,19
HCPCS,45820,Repair of abnormal rectal drainage tract,3263.4,2121.21,78.57,3707.43,19
HCPCS,45825,Repair of abnormal rectal drainage tract with creation of large bowel opening to skin,3998.4,2598.96,78.57,4485.77,19
HCPCS,45900,Manual replacement of prolapsed rectum under anesthesia,960.8,624.52,78.57,600.7,19
HCPCS,45905,Dilation of sphincter of anus under anesthesia,1265.3,822.45,78.57,503.52,19
HCPCS,45910,Dilation of narrowing of rectum under anesthesia,2743.05,1782.9850000000001,78.57,12809.2,38
HCPCS,45915,Removal of impacted stool or foreign body in rectum under anesthesia,908.5,590.525,78.57,3726.0,38
HCPCS,45990,Diagnostic exam of anus and rectum under anesthesia,295.1,191.82,78.57,317.48,19
HCPCS,45999,Other procedure on rectum,880.0,572.0,220.0,8477.27,19
HCPCS,46020,Insertion of drain (seton) into anus,1477.25,960.215,0.01,5758.98,36
HCPCS,46030,Removal of drain (seton) from anus,619.9,402.935,0.01,3726.0,55
HCPCS,46040,Drainage of deep abscess in rectum,1115.0,724.75,0.01,6141.01,55
HCPCS,46045,Incision and drainage of abscess within wall of rectum under anesthesia,1078.4,700.96,78.57,1289.72,19
HCPCS,46050,Drainage of superficial rectal abscess surrounding anus,667.0,433.55,0.01,3227.0,55
HCPCS,46060,Incision and drainage of abscess in wall of rectum or between rectum and muscle with incision or removal of abnormal drainage tract,1365.0,887.25,78.57,1425.89,19
HCPCS,46070,"Incision of tissue blocking rectum, infant",535.95,348.37,78.57,767.38,19
HCPCS,46080,Incision of sphincter of anus,604.8,393.12,69.6,686.28,19
HCPCS,46083,Incision of external hemorrhoid with blood clot,393.0,255.45,0.01,2166.29,55
HCPCS,46200,Removal of chronic tear of anus,1002.8,651.82,78.57,1137.91,19
HCPCS,46220,Removal of single external noncancer growth of anus,1593.5,1035.7749999999999,22.67,6983.08,38
HCPCS,46221,Removal of external hemorrhoids by rubber banding,655.6,426.14,0.01,3227.0,55
HCPCS,46230,Removal of multiple external noncancer growths of anus,2901.8,1886.17,0.01,13274.05,36
HCPCS,46250,Removal of multiple external hemorrhoids,1104.6,717.99,78.57,1139.41,19
HCPCS,46255,Removal of single external and internal hemorrhoid group,1232.7,801.26,78.57,1240.36,19
HCPCS,46257,Removal of single external and internal hemorrhoid group and chronic tear in anus,1167.6,758.94,78.57,1258.23,19
HCPCS,46258,Removal of single external and internal hemorrhoid group with removal of abnormal drainage tract in anus,1287.3,836.75,78.57,1374.74,19
HCPCS,46260,Removal of multiple hemorrhoid groups,1417.5,921.38,78.57,1416.93,19
HCPCS,46261,Removal of multiple hemorrhoid groups and chronic tear in anus,1496.3,972.6,78.57,1559.35,19
HCPCS,46262,Removal of multiple hemorrhoid groups with removal of abnormal drainage tract from anus,1575.0,1023.75,78.57,1656.51,19
HCPCS,46270,Repair of abnormal anal drainage tract,1199.1,779.42,78.57,1272.15,19
HCPCS,46275,Repair of abnormal drainage tract in anal sphincter,1303.1,847.02,78.57,1347.19,19
HCPCS,46280,Repair of abnormal drainage tract around anal sphincter,3811.9,2477.735,78.57,15959.85,38
HCPCS,46285,second stage repair of abnormal anal drainage tract,1244.7,809.06,78.57,1342.15,19
HCPCS,46288,Repair of abnormal anal drainage tract with rectal tissue flap,1390.2,903.63,78.57,1643.21,19
HCPCS,46320,Removal of external hemorrhoid with blood clot,700.0,455.0,0.01,3726.0,55
HCPCS,46500,Injection of hemorrhoid,437.0,284.05,25.76,757.0,19
HCPCS,46505,Injection of agent to destroy nerve to internal sphincter of anus,701.4,455.91,78.57,761.09,19
HCPCS,46600,Diagnostic exam of anus using an endoscope,160.0,104.0,0.01,2166.29,55
HCPCS,46601,Diagnostic exam of anus with magnification and chemical agent enhancement using an endoscope,323.18,210.07,78.57,357.8,19
HCPCS,46604,Dilation of anus using an endoscope,1126.0,731.9,0.01,2453.38,36
HCPCS,46606,Biopsy of anus using an endoscope,745.9,484.83500000000004,0.01,3726.0,55
HCPCS,46607,Biopsy of anus with magnification and chemical agent enhancement using an endoscope,452.95,294.42,78.57,495.32,19
HCPCS,46608,Removal of foreign body in anus using an endoscope,570.0,370.5,48.75,698.78,19
HCPCS,46610,Removal of anal polyps or growths using an endoscope with electrical cautery,551.3,358.35,43.3,666.16,19
HCPCS,46611,Removal of single anal polyp or growth using an endoscope with mechanical snare,478.8,311.22,68.68,537.83,19
HCPCS,46612,Removal of multiple anal polyps or growths using an endoscope with electrical cautery or mechanical snare,729.8,474.37,59.12,799.31,19
HCPCS,46614,Control of bleeding of anus using an endoscope,421.1,273.72,56.33,406.41,19
HCPCS,46615,Destruction of anal polyp or growth using an endoscope,497.7,323.51,77.31,428.26,19
HCPCS,46700,"Plastic repair of anal stricture, adult",1679.0,1091.35,78.57,1965.39,19
HCPCS,46705,"Plastic repair of anal stricture, infant",1372.4,892.06,78.57,1634.15,19
HCPCS,46706,Repair of abnormal anal drainage tract with tissue glue,3681.55,2393.0099999999998,78.57,17873.48,38
HCPCS,46707,Repair of abnormal anal drainage tract with implanted plug,3329.0,2163.85,78.57,13994.57,38
HCPCS,46710,Repair of abnormal drainage tract or pocket from surgically created pouch of small bowel through incision of region between thighs,2602.7,1691.76,78.57,3244.11,19
HCPCS,46712,Repair of abnormal drainage tract or pocket from surgically created pouch of small bowel through incision of abdomen and region between thighs,5019.45,3262.64,78.57,6524.72,19
HCPCS,46715,Creation of anal opening,1358.7,883.16,78.57,1597.97,19
HCPCS,46716,Reconstruction of absent anal opening,2629.9,1709.44,78.57,3554.23,19
HCPCS,46730,"Repair of absence of opening in anus, via incision of region between thighs or below sacrum",4329.4,2814.11,78.57,5759.46,19
HCPCS,46735,Repair of absence of opening in anus through incision of abdomen and region between thighs and below sacrum,5015.83,3260.29,78.57,6640.97,19
HCPCS,46740,Repair of absence of opening in anus and abnormal opening from rectum into urethra or vagina through region between thighs or below sacrum,4818.53,3132.04,78.57,6291.31,19
HCPCS,46742,Repair of absence of opening in anus and abnormal opening from rectum into urethra or vagina through abdomen or below sacrum,6398.3,4158.9,78.57,7282.65,19
HCPCS,46744,"Repair of defect for single channel outlet of rectum, vagina, and urinary tract through region between thighs or below sacrum",8082.35,5253.53,78.57,10268.8,19
HCPCS,46746,"Repair of defect for single channel outlet of rectum, vagina, and urinary tract through abdomen and region between thighs or below sacrum",8552.13,5558.88,78.57,11370.13,19
HCPCS,46748,"Repair of defect for single channel outlet of rectum, vagina, and urinary tract through incision of region between thighs or below sacrum with lengthening of vagina",11259.2,7318.48,78.57,12333.81,19
HCPCS,46750,"Repair of anal muscle for incontinence or prolapse, adult",2034.9,1322.69,78.57,2259.96,19
HCPCS,46751,"Repair of anal muscle for incontinence or prolapse, child",1413.58,918.83,78.57,1924.6,19
HCPCS,46753,"Repair of muscle of anus for incontinence and/or prolapse using wire, graft, or suture",1530.9,995.09,78.57,1796.83,19
HCPCS,46754,Removal of anal muscle wire or suture,701.38,455.9,78.57,837.9,19
HCPCS,46760,"Repair of anal muscle to correct incontinence using muscle transplant, adult",6107.5,3969.88,78.57,3310.43,19
HCPCS,46761,"Repair of anal muscle to correct incontinence with muscle tightening, adult",2030.7,1319.96,78.57,2764.73,19
HCPCS,46900,Simple chemical destruction of growth of anus,441.85,287.20500000000004,0.01,2134.09,36
HCPCS,46910,Simple destruction of growth of anus,1095.55,712.11,0.01,4080.35,36
HCPCS,46916,Electrical destruction of growth of anus,386.35,251.13,0.01,2134.09,36
HCPCS,46917,Laser destruction of growth of anus,1735.15,1127.85,0.01,6017.23,36
HCPCS,46922,Simple removal of growth of anus,1434.2,932.23,0.01,5758.98,36
HCPCS,46924,Extensive destruction of growth of anus,1764.45,1146.895,0.01,5758.98,36
HCPCS,46930,Destruction of internal hemorrhoids using heat,354.9,230.69,78.57,519.31,19
HCPCS,46940,Initial repair of anal tear with dilation of anal muscle,551.3,358.35,78.57,640.69,19
HCPCS,46942,Subsequent repair of anal tear with dilation of anal muscle,503.78,327.46,78.57,610.78,19
HCPCS,46945,Tying of single internal hemorrhoid group,731.9,475.74,78.57,899.35,19
HCPCS,46946,Tying of multiple internal hemorrhoid groups,772.8,502.32,78.57,1003.1,19
HCPCS,46947,Stapling of internal hemorrhoid,981.8,638.17,78.57,1132.98,19
HCPCS,46948,Tying of arteries to multiple internal hemorrhoid groups,1026.0,666.9,78.57,1324.88,19
HCPCS,47000,Needle biopsy of liver through skin,1478.75,961.19,39.02,5224.4,38
HCPCS,47001,Needle biopsy of liver,717.35,466.28000000000003,78.57,2964.71,38
HCPCS,47010,Drainage of abscess or cyst of liver,3191.0,2074.15,78.57,3560.97,19
HCPCS,47015,Injection and/or aspiration of abscess or cyst of liver,2054.5,1335.425,78.57,8477.27,38
HCPCS,47100,Partial removal of liver tissue,2200.0,1430.0,78.57,2483.35,19
HCPCS,47120,Partial removal of liver lobe,6208.7,4035.66,78.57,6839.95,19
HCPCS,47122,Removal of right liver lobe with partial removal of left liver lobe,9246.3,6010.1,78.57,10050.62,19
HCPCS,47125,Removal of left liver lobe,8278.2,5380.83,78.57,9021.0,19
HCPCS,47130,Removal of right liver lobe,8903.0,5786.95,78.57,9691.0,19
HCPCS,47133,Removal of donor liver,4494.0,2921.1,73.6,2925.72,15
HCPCS,47135,Transplantation of donor liver,31500.0,20475.0,78.57,15737.16,19
HCPCS,47140,Partial removal of left segment of donor liver,9408.0,6115.2,78.57,10432.57,19
HCPCS,47141,Removal of left liver lobe of donor,11243.4,7308.21,78.57,12475.11,19
HCPCS,47142,Removal of right lobe of donor liver,12406.8,8064.42,78.57,13740.37,19
HCPCS,47143,Preparation of donor liver for transplantation,5250.0,3412.5,78.57,2925.72,15
HCPCS,47144,Preparation of donor liver for transplantation with split of liver graft,5250.0,3412.5,78.57,2798.51,15
HCPCS,47145,Preparation of donor liver for transplantation with lobe split of liver graft,2809.8,1826.37,78.57,2734.91,15
HCPCS,47146,Preparation of donor liver and vein grafts for transplantation,2100.0,1365.0,78.57,954.15,19
HCPCS,47147,Preparation of donor liver and artery grafts for transplantation,2450.0,1592.5,78.57,1116.9,19
HCPCS,47300,Creation of tract to drain abscess or cyst of liver,2967.3,1928.75,78.57,3320.58,19
HCPCS,47350,Suture of simple liver wound to control bleeding,3637.2,2364.18,78.57,4021.75,19
HCPCS,47360,Control of bleeding of wound of liver with complex suture,4963.4,3226.21,78.57,5492.21,19
HCPCS,47361,"Control of bleeding of liver with exploration, removal of tissue, suture or cautery",8161.7,5305.11,78.57,8902.72,19
HCPCS,47362,Re-exploration of liver wound with removal of packing,3783.2,2459.08,78.57,4247.56,19
HCPCS,47370,Destruction of growths of liver using an endoscope,3321.2,2158.78,78.57,3661.65,19
HCPCS,47371,Destruction of growth of liver by freezing using an endoscope,2880.55,1872.36,78.57,3639.94,19
HCPCS,47380,Destruction of growth of liver using radiofrequency,3890.3,2528.7,78.57,4243.82,19
HCPCS,47381,Destruction of growth of liver using freezing,3966.9,2578.49,78.57,4312.13,19
HCPCS,47382,Destruction of growth of liver through skin using radiofrequency,7951.85,5168.705,78.57,34633.91,38
HCPCS,47383,Destruction of growth of liver through skin using freezing,7350.95,4778.12,78.57,34775.95,38
HCPCS,47384,"ABLATION, IRREVERSIBLE ELECTROPORATION, LIVER, 1 OR MORE TUMORS, INCLUDING IMAGING GUIDANCE, PERCUTANEOUS",14074.0,9148.099999999999,73.6,70125.21,32
HCPCS,47399,Other procedure on liver,970.0,630.5,242.5,8477.27,19
HCPCS,47400,Incision or creation of opening of liver with drainage or removal of bile duct stone,5702.6,3706.69,78.57,6304.12,19
HCPCS,47420,Incision or creation of opening of gallbladder with drainage or removal of bile duct stone,3557.4,2312.31,78.57,3932.22,19
HCPCS,47425,Drainage or removal of bile duct stone with redirection of bile flow and incision or repair of gallbladder sphincter,3596.3,2337.6,78.57,4003.28,19
HCPCS,47460,Repair of bile duct,3399.9,2209.94,78.57,3711.38,19
HCPCS,47480,Drainage or removal of stone from gallbladder,2260.7,1469.46,78.57,2577.32,19
HCPCS,47490,Insertion of tube into gallbladder using imaging guidance with review by radiologist,5110.45,3321.795,78.57,22552.97,38
HCPCS,47531,Injection of bile duct for X-ray through already existing skin access using imaging guidance with review by radiologist,1838.0,1194.7,57.75,7441.0,38
HCPCS,47532,Injection of bile duct for X-ray through new skin access using imaging guidance with review by radiologist,3852.0,2503.8,78.57,14981.08,38
HCPCS,47533,Placement of external drainage tube of biliary duct using imaging guidance with review by radiologist,4450.0,2892.5,78.57,14981.08,38
HCPCS,47534,Placement of internal-external drainage tube of biliary duct using imaging guidance with review by radiologist,4913.5,3193.775,78.57,15513.08,38
HCPCS,47535,Conversion of external biliary drainage tube to internal-external biliary drainage tube using imaging guidance and study of bile duct with review by radiologist,6018.0,3911.7,78.57,24476.94,38
HCPCS,47536,Replacement of liver duct drainage tube using imaging guidance with review by radiologist,4126.5,2682.225,78.57,16427.28,38
HCPCS,47537,Removal of biliary drainage tube using imaging guidance with review by radiologist,2789.0,1812.85,78.34,11993.13,38
HCPCS,47538,Placement of stent of biliary duct through existing skin access using imaging guidance with review by radiologist,11497.0,7473.049999999999,78.57,32521.42,38
HCPCS,47539,Placement of stent of biliary duct through new skin access using imaging with review by radiologist,11069.5,7195.175,78.57,27798.03,38
HCPCS,47540,Placement of stent and drainage tube of biliary duct using imaging guidance with review by radiologist,12213.5,7938.775,78.57,32521.42,38
HCPCS,47541,Placement of access device into biliary tract using imaging guidance with review by radiologist,4216.0,2740.4,78.57,14697.01,38
HCPCS,47542,Balloon dilation of bile duct using imaging guidance with review by radiologist,1235.5,803.075,78.57,8045.61,38
HCPCS,47543,Biopsy of bile duct or liver duct using imaging guidance with review by radiologist,2101.0,1365.65,78.57,8045.61,38
HCPCS,47544,Removal of biliary duct or gallbladder stone using imaging guidance with review by radiologist,6430.0,4179.5,78.57,28337.77,38
HCPCS,47550,Exam of bile duct during surgery using an endoscope,1538.75,1000.19,78.57,8477.27,38
HCPCS,47552,Diagnostic exam of bile duct using an endoscope,4776.05,3104.435,78.57,22170.76,38
HCPCS,47553,Biopsy of bile duct using an endoscope,4780.75,3107.49,78.57,22170.76,38
HCPCS,47554,Removal of bile duct stones using an endoscope,6995.8,4547.2699999999995,78.57,32521.42,38
HCPCS,47555,Dilation of bile ducts using an endoscope,4877.9,3170.635,78.57,22170.76,38
HCPCS,47556,Dilation of bile ducts with stent insertion using an endoscope,6958.55,4523.0599999999995,78.57,32521.42,38
HCPCS,47562,Removal of gallbladder using an endoscope,2210.0,1436.5,78.57,1929.36,19
HCPCS,47563,Removal of gallbladder with X-ray study of bile ducts using an endoscope,2362.5,1535.63,78.57,2096.52,19
HCPCS,47564,Removal of gallbladder with exploration of common bile duct using an endoscope,2572.5,1672.13,78.57,3261.83,19
HCPCS,47570,Connection of gallbladder to bowel using an endoscope,2205.0,1433.25,78.57,2269.17,19
HCPCS,47600,Removal of gallbladder,2820.3,1833.2,78.57,3131.8,19
HCPCS,47605,Removal of gallbladder with X-ray study of bile ducts,2596.7,1687.86,78.57,3293.03,19
HCPCS,47610,Removal of gallbladder with exploration of common bile duct,3334.8,2167.62,78.57,3674.02,19
HCPCS,47612,Removal of gallbladder and creation of bile duct drainage to bowel,3885.0,2525.25,78.57,3704.51,19
HCPCS,47620,Removal of gallbladder and incision or repair of gallbladder sphincter,3659.3,2378.55,78.57,4016.58,19
HCPCS,47700,Exploration of congenital bile duct defect,2766.8,1798.42,78.57,3090.59,19
HCPCS,47701,Connection of portion of upper small bowel to bile duct,4758.6,3093.09,78.57,5050.3,19
HCPCS,47711,Removal of growth of bile duct external to liver,4142.3,2692.5,78.57,4562.66,19
HCPCS,47712,Removal of growth of bile duct within liver,4582.13,2978.38,78.57,5841.72,19
HCPCS,47715,Removal of cyst of gallbladder,3480.8,2262.52,78.57,3890.23,19
HCPCS,47720,Creation of drainage tract from gallbladder to small bowel,3006.2,1954.03,78.57,3378.8,19
HCPCS,47721,Creation of drainage tract from gallbladder to small bowel and from stomach to small bowel,3549.0,2306.85,78.57,3967.87,19
HCPCS,47740,Creation of drainage tract from gallbladder to small bowel using Roux-en-Y connection,3430.4,2229.76,78.57,3832.24,19
HCPCS,47741,Creation of drainage tract from gallbladder to small bowel using Roux-en-Y connection and creation of drainage tract from stomach to small bowel,3885.0,2525.25,78.57,4319.53,19
HCPCS,47760,Connection of bile duct external to liver to small bowel,5904.2,3837.73,78.57,6605.88,19
HCPCS,47765,Connection of bile duct within liver to small bowel,7859.3,5108.55,78.57,8875.66,19
HCPCS,47780,Roux-en-Y connection of bile duct external to liver to small bowel,6471.2,4206.28,78.57,7247.3,19
HCPCS,47785,Connection of bile duct within liver to small bowel using Roux-en-Y connection,8465.1,5502.32,78.57,9511.09,19
HCPCS,47800,Reconstruction of bile duct,4182.2,2718.43,78.57,4612.06,19
HCPCS,47801,Insertion of stent into bile duct,2890.7,1878.96,78.57,3262.61,19
HCPCS,47900,Suture of injured bile duct,3616.2,2350.53,78.57,4016.24,19
HCPCS,47999,Other procedure on bile duct,2602.0,1691.3,650.5,8477.27,19
HCPCS,48000,"Insertion of external drains from gallbladder, bile duct, and small bowel for acute pancreatitis",5031.6,3270.54,78.57,5509.84,19
HCPCS,48001,Insertion of external drains around pancreas for acute pancreatitis,5302.35,3446.53,78.57,6737.65,19
HCPCS,48020,Removal of pancreatic duct stones,3096.5,2012.73,78.57,3448.14,19
HCPCS,48100,Biopsy of pancreas,2351.0,1528.15,78.57,2612.18,19
HCPCS,48102,Needle biopsy of pancreas,2711.35,1762.3799999999999,78.57,10443.63,38
HCPCS,48105,Removal of pancreatic tissue,7620.9,4953.59,78.57,8360.46,19
HCPCS,48120,Removal of growth of pancreas,2936.9,1908.99,78.57,3246.24,19
HCPCS,48140,Partial removal of pancreas,4158.0,2702.7,78.57,4586.1,19
HCPCS,48145,Partial removal of pancreas with connection of pancreas to small bowel,4317.6,2806.44,78.57,4775.9,19
HCPCS,48146,"Partial removal of pancreas with connection of pancreas to small bowel, with preservation of first part of small bowel",4924.5,3200.93,78.57,5505.66,19
HCPCS,48148,Partial removal of pancreatic and common bile ducts,3270.8,2126.02,78.57,3654.12,19
HCPCS,48150,"Partial removal of pancreas, bile duct, and small bowel with connection of pancreas to small bowel",8310.8,5402.02,78.57,9126.73,19
HCPCS,48152,"Partial removal of pancreas, bile duct, stomach, and small bowel",7685.0,4995.25,78.57,8451.41,19
HCPCS,48153,"Near total removal of pancreas, bile duct, and small bowel with connection of pancreas to small bowel",8300.3,5395.2,78.57,9093.97,19
HCPCS,48154,"Partial removal of pancreas, bile duct, and small bowel",7703.9,5007.54,78.57,8493.37,19
HCPCS,48155,Removal of pancreas,5046.3,3280.1,78.57,5322.98,19
HCPCS,48160,Removal of pancreas with pancreatic cell transplantation,10000.0,6500.0,78.57,10300.0,15
HCPCS,48400,Injection for X-ray study of pancreas during surgery,484.3,314.795,78.57,8477.27,38
HCPCS,48500,Creation of drainage tract of cyst of pancreas,2992.5,1945.13,78.57,3372.51,19
HCPCS,48510,Insertion of drain from cyst of pancreas into abdominal cavity,2986.2,1941.03,78.57,3213.59,19
HCPCS,48520,Creation of direct drainage tract from cyst of pancreas to small bowel,2903.3,1887.15,78.57,3198.9,19
HCPCS,48540,Creation of drainage tract from cyst of pancreas to small bowel,3467.1,2253.62,78.57,3826.93,19
HCPCS,48545,Suture of pancreatic injury,3519.6,2287.74,78.57,3932.61,19
HCPCS,48547,Repair of pancreatic injury,3756.9,2441.99,78.57,5239.4,19
HCPCS,48548,Creation of pancreatic drainage tract from pancreas and upper small bowel,3647.7,2371.01,78.57,4870.1,19
HCPCS,48550,Removal of donor pancreas,3150.0,2047.5,73.6,1908.08,15
HCPCS,48551,Preparation of donor pancreas for transplantation,4200.0,2730.0,78.57,2289.69,15
HCPCS,48552,Preparation of donor pancreas and vein grafts for transplantation,644.7,419.06,78.57,688.27,19
HCPCS,48554,Transplantation of donor pancreas,13230.0,8599.5,78.57,7495.72,19
HCPCS,48556,Removal of transplanted donor pancreas,3281.3,2132.85,78.57,3733.74,19
HCPCS,48999,Other procedure on pancreas,925.0,601.25,231.25,8477.27,19
HCPCS,49000,Exploration of abdominal cavity,2137.8,1389.57,78.57,15717.1,57
HCPCS,49002,Reopening of recent abdominal incision,2740.5,1781.33,78.57,3073.08,19
HCPCS,49010,Exploration behind abdominal cavity,2573.6,1672.84,78.57,2735.51,19
HCPCS,49013,Exploration and packing of wound in pelvic region,1029.5,669.18,78.57,1305.45,19
HCPCS,49014,Re-exploration of pelvic region wound with removal of wound packing,852.0,553.8,78.57,1080.5,19
HCPCS,49020,Drainage of abdominal abscess or infection,5165.05,3357.285,78.57,15717.1,38
HCPCS,49040,Drainage of abscess of diaphragm,2660.7,1729.46,78.57,2935.9,19
HCPCS,49060,Drainage of abscess behind abdominal cavity,2986.2,1941.03,78.57,3234.67,19
HCPCS,49062,Drainage of fluid accumulation of abdomen,2017.1,1311.12,78.57,2175.04,19
HCPCS,49082,Drainage of fluid from abdominal cavity,672.5,437.125,65.14,3726.0,38
HCPCS,49083,Drainage of fluid from abdominal cavity using imaging guidance,1272.0,826.8,0.01,3726.0,112
HCPCS,49084,Irrigation of abdominal cavity,821.35,533.88,78.57,3726.0,38
HCPCS,49180,Needle biopsy of growth of abdominal cavity,1445.7,939.705,66.74,5224.4,38
HCPCS,49185,Injection of chemical agent into fluid collection using imaging guidance,1375.5,894.0749999999999,78.57,4439.32,38
HCPCS,49186,"Removal or destruction of growth(s) in the abdomen, 5.0 cm or less",2810.0,1826.5,78.57,3361.77,19
HCPCS,49187,"Removal or destruction of growth(s) in the abdomen, 5.1 to 10.0 cm",3886.0,2525.9,78.57,4262.18,19
HCPCS,49188,"Removal or destruction of growth(s) in the abdomen, 10.1 to 20.0 cm",4645.0,3019.25,78.57,5093.73,19
HCPCS,49189,"Removal or destruction of growth(s) in the abdomen, 20.1 to 30.0 cm",5400.0,3510.0,78.57,5921.92,19
HCPCS,49190,"Removal or destruction of growth(s) in the abdomen, more than 30.0 cm",6664.0,4331.6,78.57,7310.66,19
HCPCS,49215,Removal of growth of pelvis or sacrum,5935.7,3858.21,78.57,6549.12,19
HCPCS,49250,Removal of navel and surrounding tissue,1536.2,998.53,78.57,1732.23,19
HCPCS,49255,Removal of lining covering abdominal organs,2089.5,1358.18,78.57,2335.06,19
HCPCS,49320,Diagnostic exam of abdomen using an endoscope,1286.3,836.1,78.57,964.29,19
HCPCS,49321,Biopsy of abdomen using an endoscope,1365.0,887.25,78.57,1017.56,19
HCPCS,49322,Aspiration of abdominal cavity or cyst using an endoscope,1417.5,921.38,78.57,1096.14,19
HCPCS,49323,Drainage of lymph fluid to abdominal cavity using an endoscope,1712.6,1113.19,78.57,1879.17,19
HCPCS,49324,Insertion of abdominal cavity tube using an endoscope,879.9,571.94,78.57,1137.93,19
HCPCS,49325,Revision of abdominal cavity tube using an endoscope,1124.6,730.99,78.57,1212.47,19
HCPCS,49326,Suture of internal abdominal lining using an endoscope,450.0,292.5,78.57,551.45,19
HCPCS,49327,Exam of abdomen with insertion of device for radiation therapy using an endoscope,300.25,195.16,78.57,380.29,19
HCPCS,49400,Injection of air or X-ray contrast into abdominal cavity,923.05,599.985,42.9,3517.37,38
HCPCS,49402,Removal of foreign body in abdominal cavity,5225.95,3396.87,78.57,22170.76,38
HCPCS,49405,Drainage of fluid collection by tube through skin using imaging guidance,6172.9,4012.385,78.57,24629.3,38
HCPCS,49406,Drainage of fluid collection of abdominal cavity by tube using imaging guidance,6172.35,4012.03,78.57,24629.3,56
HCPCS,49407,Drainage of fluid collection by tube through vagina or rectum using imaging guidance,5955.55,3871.11,78.57,24629.3,38
HCPCS,49411,Insertion of device in abdominal cavity through skin for radiation therapy guidance,2488.75,1617.69,73.35,9193.7,57
HCPCS,49412,Insertion of device in abdominal cavity for radiation therapy guidance,190.33,123.71,64.79,240.56,19
HCPCS,49418,Insertion of abdominal tube using imaging guidance with review by radiologist,4730.7,3074.955,78.57,14761.57,57
HCPCS,49419,Insertion of abdominal cavity tube for drug delivery,2620.0,1703.0,78.57,10717.38,38
HCPCS,49421,Insertion of abdominal cavity tube for drainage or dialysis,3846.0,2499.9,78.57,17746.94,38
HCPCS,49422,Removal of abdominal cavity tube,3950.85,2568.055,78.57,17710.79,38
HCPCS,49423,Exchange of abdominal cavity drainage tube using imaging guidance,2002.5,1301.625,31.12,8754.68,38
HCPCS,49424,Injection of contrast through abdominal cavity tube for X-ray study,492.85,320.355,30.22,2166.29,38
HCPCS,49425,Insertion of shunt from jugular vein to abdominal cavity,2173.05,1412.4850000000001,78.57,5957.83,38
HCPCS,49426,Revision of shunt from jugular vein to abdominal cavity,1771.4,1151.41,78.57,1818.85,19
HCPCS,49427,Injection for X-ray study of shunt from jugular vein to abdominal cavity,331.3,215.34500000000003,32.91,2166.29,38
HCPCS,49428,Closure of shunt from jugular vein to abdominal cavity,1034.3,672.3,78.57,1262.55,19
HCPCS,49429,Removal of shunt from jugular vein to abdominal cavity,2755.65,1791.175,78.57,10639.9,38
HCPCS,49435,Insertion of abdominal cavity tube extension,274.33,178.31,78.57,347.63,19
HCPCS,49436,Creation of exit site for tube in abdominal cavity,428.63,278.61,78.57,1294.13,19
HCPCS,49440,Insertion of stomach tube using fluoroscopic guidance with contrast,2541.55,1652.01,55.08,5531.72,38
HCPCS,49441,Insertion of small bowel tube using fluoroscopic guidance with contrast,2984.95,1940.2199999999998,78.57,6474.33,38
HCPCS,49442,Insertion of large bowel tube using fluoroscopic guidance with contrast,2517.35,1636.28,48.9,5588.53,57
HCPCS,49446,Conversion of stomach tube to stomach-to-small bowel tube using fluoroscopic guidance with contrast,1983.2,1289.08,31.64,3984.8,38
HCPCS,49450,Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast,1589.75,1033.34,7.07,5991.4,57
HCPCS,49451,Replacement of small bowel tube using fluoroscopic guidance with contrast,857.0,557.05,14.12,3726.0,38
HCPCS,49452,Replacement of stomach-to-small bowel tube using fluoroscopic guidance with contrast,2023.0,1314.95,27.17,3726.0,38
HCPCS,49460,"Mechanical removal of obstructive material from stomach, large, or small bowel tube using fluoroscopic guidance",1058.15,687.8000000000001,3.27,3726.0,38
HCPCS,49465,"Contrast injection for X-ray imaging through existing tube in stomach, small bowel or large bowel",375.2,243.88,24.19,2166.29,38
HCPCS,49491,Repair of groin hernia in preterm infant younger than 37 weeks gestation performed from birth to 50 weeks postconception,2058.0,1337.7,78.57,2325.15,19
HCPCS,49492,Repair of trapped groin hernia in preterm infant younger than 37 weeks gestation performed from birth to 50 weeks postconception,2482.2,1613.43,78.57,2801.48,19
HCPCS,49495,Repair of groin hernia in full term infant younger than 6 months or preterm infant older than 50 weeks of age postconception and younger than 6 months at time of surgery,1417.5,921.38,78.57,1198.71,19
HCPCS,49496,Repair of trapped groin hernia in full term infant younger than 6 months or preterm infant older than 50 weeks postconception and younger than 6 months at time of surgery,1586.6,1031.29,78.57,1797.27,19
HCPCS,49500,Repair of groin hernia (6 months to younger than 5 years),1286.3,836.1,78.57,1199.35,19
HCPCS,49501,Repair of trapped groin hernia (6 months to younger than 5 years),1571.9,1021.74,78.57,1772.31,19
HCPCS,49505,Repair of groin hernia (5 years or older),1777.525,1155.39,78.57,1526.44,38
HCPCS,49507,Repair of trapped groin hernia (5 years or older),2512.2,1632.93,78.57,1717.88,19
HCPCS,49520,Repair of groin hernia that is not trapped,1662.2,1080.43,78.57,1851.94,19
HCPCS,49521,Repair of trapped or strangulated groin hernia,2029.7,1319.31,78.57,2099.38,19
HCPCS,49525,Repair of sliding groin hernia,1574.0,1023.1,78.57,1681.43,19
HCPCS,49540,Repair of abdominal muscle hernia,1778.7,1156.16,78.57,1978.39,19
HCPCS,49550,Repair of femoral groin hernia,1509.9,981.44,78.57,1687.97,19
HCPCS,49553,Repair of trapped femoral groin hernia,1653.8,1074.97,78.57,1851.92,19
HCPCS,49555,Repair of recurrent femoral groin hernia,1571.9,1021.74,78.57,1753.75,19
HCPCS,49557,Repair of trapped recurrent femoral groin hernia,5215.5,3390.075,78.57,22002.9,38
HCPCS,49591,"Initial repair of sliding hernia of abdomen, less than 3 cm in length",4607.75,2995.04,0.01,21899.6,36
HCPCS,49592,"Initial repair of entrapped hernia of abdomen, less than 3 cm in length",1021.0,663.65,78.57,1348.02,19
HCPCS,49593,"Initial repair of sliding hernia of abdomen, 3-10 cm in length",1231.5,800.48,78.57,1625.94,19
HCPCS,49594,"Initial repair of entrapped hernia of abdomen, 3-10 cm in length",1601.0,1040.65,78.57,2113.57,19
HCPCS,49595,"Initial repair of sliding hernia of abdomen, more than 10 cm in length",1656.5,1076.73,78.57,2187.05,19
HCPCS,49596,"Initial repair of entrapped hernia of abdomen, more than 10 cm in length",2201.5,1430.98,78.57,2906.33,19
HCPCS,49600,Repair of small defect of abdominal wall at navel,1939.4,1260.61,78.57,2134.68,19
HCPCS,49605,Repair of large defect of abdominal wall at navel,13464.2,8751.73,78.57,14385.06,19
HCPCS,49606,Repair of defect of abdominal wall at navel with removal of prosthesis,3027.2,1967.68,78.57,3314.43,19
HCPCS,49610,"Repair of defect of abdominal wall at navel, stage 1 of 2",1812.3,1178.0,78.57,2016.23,19
HCPCS,49611,"Repair of defect of abdominal wall at navel, stage 2 or 2",1601.3,1040.85,78.57,1777.33,19
HCPCS,49613,"Repair of recurrent sliding hernia of abdomen, less than 3 cm in length",908.0,590.2,78.57,1190.84,19
HCPCS,49614,"Repair of recurrent entrapped hernia of abdomen, less than 3 cm in length",1228.5,798.53,78.57,1611.5,19
HCPCS,49615,"Repair of recurrent sliding hernia of abdomen, 3-10 cm in length",1374.0,893.1,78.57,1802.62,19
HCPCS,49616,"Repair of recurrent entrapped hernia of abdomen, 3-10 cm in length",1843.5,1198.28,78.57,2418.15,19
HCPCS,49617,"Repair of recurrent sliding hernia of abdomen, more than 10 cm in length",1905.0,1238.25,78.57,2498.91,19
HCPCS,49618,"Repair of recurrent entrapped hernia of abdomen, more than 10 cm in length",2665.5,1732.58,78.57,3496.54,19
HCPCS,49621,Repair of sliding hernia next to stoma,1611.0,1047.15,78.57,2113.56,19
HCPCS,49622,Repair of entrapped hernia next to stoma,1989.5,1293.18,78.57,2609.6,19
HCPCS,49623,Removal of mesh at same time as hernia repair,429.0,278.85,78.57,562.35,19
HCPCS,49650,Repair of groin hernia using an endoscope,2047.5,1330.88,78.57,1258.39,19
HCPCS,49651,Repair of recurrent groin hernia using an endoscope,2480.7,1612.46,78.57,1636.6,19
HCPCS,49900,Suture of postsurgical opening in abdominal wall,2145.2,1394.38,78.57,2401.4,19
HCPCS,49904,Harvest of abdominal cavity lining for grafting,4003.7,2602.41,78.57,4148.86,19
HCPCS,49905,Repair of abdomen using abdominal lining graft,1391.3,904.35,78.57,1039.31,19
HCPCS,49906,Harvesting of graft from lining of abdominal cavity and blood vessels,26500.0,17225.0,78.57,13250.0,15
HCPCS,49999,Other procedure on abdomen,5965.0,3877.25,1049.65,15404.61,19
HCPCS,50010,Exploration of kidney,2074.8,1348.62,78.57,2161.67,19
HCPCS,50020,Drainage of abscess of kidney,3004.1,1952.67,78.57,3105.6,19
HCPCS,50040,Insertion of tube for drainage of kidney,2778.3,1805.9,78.57,2834.59,19
HCPCS,50045,Incision of kidney with exploration,2797.2,1818.18,78.57,2856.37,19
HCPCS,50060,Removal of kidney stone,3454.5,2245.43,78.57,3486.89,19
HCPCS,50065,"Removal of kidney stone, secondary procedure",2906.25,1889.06,78.57,3696.24,19
HCPCS,50070,Removal of kidney stone complicated by congenital abnormality,2946.53,1915.24,78.57,3624.68,19
HCPCS,50075,Removal of kidney stones,4437.3,2884.25,78.57,4455.53,19
HCPCS,50080,Simple surgical treatment of kidney stone with imaging guidance,12565.75,8167.74,78.57,57716.29,38
HCPCS,50081,Complex surgical treatment of kidney stone with imaging guidance,5811.75,3777.64,78.57,3909.56,19
HCPCS,50100,Incision or repositioning of abnormal kidney blood vessel,2882.3,1873.5,78.57,3124.32,19
HCPCS,50120,Incision of renal pelvis of kidney with exploration,2855.0,1855.75,78.57,2908.1,19
HCPCS,50125,Incision of renal pelvis of kidney with drainage,3013.5,1958.78,78.57,3009.78,19
HCPCS,50130,Incision of renal pelvis of kidney with removal of kidney stone,3129.0,2033.85,78.57,3162.09,19
HCPCS,50200,Needle biopsy of kidney,3861.0,2509.65,78.57,14410.35,57
HCPCS,50205,Biopsy of kidney,2037.0,1324.05,78.57,2220.04,19
HCPCS,50220,Removal of kidney and partial removal of ureter,4613.25,2998.61,78.57,3178.82,19
HCPCS,50225,Removal of kidney and partial removal of ureter complicated by previous surgery on same kidney,3567.9,2319.14,78.57,3654.52,19
HCPCS,50230,"Removal of kidney, lymph nodes, and/or blood clot from major vein with partial removal of ureter",4121.3,2678.85,78.57,3900.08,19
HCPCS,50234,Removal of kidney and ureter with partial removal of bladder through same incision,3930.2,2554.63,78.57,3978.53,19
HCPCS,50236,Removal of kidney and ureter with partial removal of bladder through separate incision,4445.7,2889.71,78.57,4481.04,19
HCPCS,50240,Partial removal of kidney,3994.2,2596.23,78.57,4055.48,19
HCPCS,50250,Destruction of growth of kidney,2947.4,1915.81,78.57,3724.3,19
HCPCS,50280,Removal or unroofing cysts of kidney,4263.6,2771.34,78.57,2915.96,19
HCPCS,50290,Removal of cysts of kidney,2613.5,1698.78,78.57,2753.83,19
HCPCS,50300,Removal of donor kidney,3150.0,2047.5,73.6,2217.4,15
HCPCS,50320,Removal of donor kidney from living donor,5095.7,3312.21,78.57,4397.83,19
HCPCS,50323,Preparation of donor kidney for transplantation,4200.0,2730.0,78.57,2100.0,15
HCPCS,50325,Preparation of living donor kidney for transplantation,4200.0,2730.0,78.57,2100.0,15
HCPCS,50327,Preparation of donor kidney and veins for transplantation,602.7,391.76,78.57,635.58,19
HCPCS,50328,Preparation of donor kidney and arteries for transplantation,536.6,348.79,78.57,557.41,19
HCPCS,50329,Preparation of donor kidney and ureter for transplantation,5880.0,3822.0,78.57,530.66,19
HCPCS,50340,Removal of kidney from patient receiving donor kidney,2437.1,1584.12,78.57,2776.84,19
HCPCS,50360,Transplantation of donor kidney,13958.0,9072.7,78.57,7097.48,19
HCPCS,50365,Removal of kidney and transplantation of donor kidney,16145.5,10494.58,78.57,8419.49,19
HCPCS,50370,Removal of previously transplanted donor kidney,6608.0,4295.2,78.57,3543.01,19
HCPCS,50380,Removal with relocation of kidney,5327.7,3463.01,78.57,5863.07,19
HCPCS,50382,Removal and replacement of stent in ureter with review by radiologist,4169.65,2710.275,78.57,12736.89,38
HCPCS,50384,Removal of stent in ureter through skin with review by radiologist,2528.65,1643.625,78.57,6451.0,38
HCPCS,50385,Removal and replacement of stent in ureter through urethra with review by radiologist,3469.2,2254.98,52.94,2444.42,19
HCPCS,50386,Removal of stent in ureter through ureter with review by radiologist,1795.75,1167.24,45.55,6451.0,38
HCPCS,50387,Removal and replacement of stent in kidney and ureter using fluoroscopic guidance with review by radiologist,4357.5,2832.38,22.72,19705.77,38
HCPCS,50389,Removal of kidney drainage tube using fluoroscopic guidance,1045.0,679.25,12.09,4196.56,38
HCPCS,50390,Aspiration and/or injection of cyst of kidney,662.65,430.725,75.7,3227.0,38
HCPCS,50391,Instillation of drug into kidney and/or ureter,308.05,200.235,59.0,2166.29,38
HCPCS,50396,Measurement of urine flow in kidneys and ureters,467.5,303.875,24.7,3227.0,38
HCPCS,50400,Simple reconstruction of neck of kidney,3489.2,2267.98,78.57,3536.33,19
HCPCS,50405,Complicated reconstruction of pelvis of kidney,4229.4,2749.11,78.57,4267.43,19
HCPCS,50430,Injection procedure for imaging of kidney and ureter through new skin access using imaging guidance with review by radiologist,3440.25,2236.165,78.57,13062.29,38
HCPCS,50431,Injection procedure for imaging of kidney and ureter through already existing skin access using imaging guidance with review by radiologist,1368.75,889.6899999999999,55.13,5605.32,38
HCPCS,50432,Placement of tube of kidney using imaging guidance with review by radiologist,4591.5,2984.48,78.57,16103.18,38
HCPCS,50433,Placement of tube of kidney and urinary tube through new skin access using imaging guidance with review by radiologist,5681.25,3692.8149999999996,78.57,19105.34,38
HCPCS,50434,Conversion of kidney tube to nephroureteral tube using imaging guidance and study of kidney and ureter with review by radiologist,3489.0,2267.8500000000004,78.57,12620.68,38
HCPCS,50435,Replacement of kidney drainage tube using imaging guidance with review by radiologist,2552.25,1658.9650000000001,78.57,9858.69,38
HCPCS,50436,Dilation of existing opening into urinary tract using imaging guidance,1923.0,1249.95,78.57,8987.1,38
HCPCS,50437,Dilation of existing opening into urinary tract and creation of new access into urine collecting system of kidney using imaging guidance,4850.25,3152.665,78.57,22676.93,38
HCPCS,50500,Suture of wound or injury of kidney,3472.4,2257.06,78.57,3718.21,19
HCPCS,50520,Closure of abnormal drainage tract from kidney to skin,3116.4,2025.66,78.57,3386.51,19
HCPCS,50525,Closure of abnormal drainage tract from kidney to other abdominal organ through abdomen,3585.85,2330.8,78.57,4295.62,19
HCPCS,50526,Closure of abnormal drainage tract from kidney to other abdominal organ through chest,3466.95,2253.52,78.57,4604.3,19
HCPCS,50540,Repair of abnormally shaped kidney,4016.3,2610.6,78.57,3509.56,19
HCPCS,50541,Destruction of cyst of kidney using an endoscope,2783.6,1809.34,78.57,2804.84,19
HCPCS,50542,Destruction of growth of kidney using an endoscope,5084.85,3305.1549999999997,78.57,18903.9,38
HCPCS,50543,Partial removal of kidney using an endoscope,6761.55,4395.01,78.57,4556.76,19
HCPCS,50544,Repair of kidney using an endoscope,3801.0,2470.65,78.57,3797.95,19
HCPCS,50545,Removal of kidney and lymph nodes using an endoscope,6117.3,3976.25,78.57,4080.38,19
HCPCS,50546,Removal of kidney and partial removal of ureter using an endoscope,3609.9,2346.44,78.57,3669.56,19
HCPCS,50547,Removal of kidney from living donor using an endoscope,5095.7,3312.21,78.57,4746.3,19
HCPCS,50548,Removal of kidney and ureter using an endoscope,4113.9,2674.04,78.57,4104.1,19
HCPCS,50551,Exam of kidney using an endoscope inserted through surgically created opening from kidney to skin,1104.6,717.99,78.57,895.17,19
HCPCS,50553,Insertion of tube into ureter using an endoscope inserted through surgically created opening from kidney to skin,2199.8,1429.87,78.57,954.98,19
HCPCS,50555,Biopsy of kidney using an endoscope inserted through surgically created opening from kidney to skin,947.9,616.14,78.57,1036.9,19
HCPCS,50557,Destruction and/or removal of growth of kidney using an endoscope inserted through surgically created opening from kidney to skin,2390.9,1554.09,78.57,1050.6,19
HCPCS,50561,Removal of foreign body or stone in kidney using an endoscope inserted through surgically created opening from kidney to skin,2672.3,1737.0,78.57,1199.24,19
HCPCS,50562,Removal of growth of kidney using an endoscope inserted through surgically created opening from kidney to skin,1399.23,909.5,78.57,1760.59,19
HCPCS,50570,Exam of kidney using an endoscope,1519.4,987.61,78.57,1492.99,19
HCPCS,50572,Insertion of tube into ureter using an endoscope through upper kidney area,1282.93,833.9,78.57,1615.41,19
HCPCS,50574,Biopsy of kidney using an endoscope,1363.95,886.57,78.57,1717.2,19
HCPCS,50575,Dilation and ureter stent insertion using an endoscope,2409.8,1566.37,78.57,2169.91,19
HCPCS,50576,Destruction and/or removal of growth of kidney using an endoscope,1360.43,884.28,78.57,1712.7,19
HCPCS,50580,Removal of foreign body or stone in kidney using an endoscope,1466.0,952.9,78.57,1845.23,19
HCPCS,50590,Shock wave crushing of kidney stones,4120.2,2678.13,78.57,2361.93,19
HCPCS,50592,Destruction of growth of kidney using radiofrequency,8366.95,5438.52,50.72,22070.05,38
HCPCS,50593,Destruction of growth of kidney by freezing,7681.5,4992.975,52.85,29425.01,38
HCPCS,50600,Exploration of ureter,2826.6,1837.29,78.57,2871.27,19
HCPCS,50605,Insertion of stent in ureter,4126.5,2682.23,78.57,2938.45,19
HCPCS,50606,Biopsy of ureter and/or renal pelvis using imaging guidance with review by radiologist,1229.0,798.85,78.57,1169.17,19
HCPCS,50610,Removal of stone from upper ureter,2870.7,1865.96,78.57,2891.09,19
HCPCS,50620,Removal of stone from middle ureter,2735.3,1777.95,78.57,2765.35,19
HCPCS,50630,Removal of stone from lower ureter,2666.0,1732.9,78.57,2732.62,19
HCPCS,50650,Removal of ureter and partial removal of bladder,3118.5,2027.03,78.57,3174.94,19
HCPCS,50660,Removal of an extra ureter,3450.3,2242.7,78.57,3497.29,19
HCPCS,50684,Injection of ureter for imaging,986.75,641.39,7.21,2166.29,38
HCPCS,50686,Measurement of urine flow in ureter,343.19,223.075,27.2,1242.0,38
HCPCS,50688,Change of tube or stent in ureter,1291.35,839.38,66.31,6143.77,38
HCPCS,50690,Injection of bladder and ureter for imaging,378.45,245.995,22.26,2166.29,38
HCPCS,50693,Placement of stent of ureter through existing skin access using imaging guidance with review by radiologist,3901.0,2535.65,78.57,13800.88,38
HCPCS,50694,Placement of stent of ureter through new skin access using imaging guidance with review by radiologist,4855.5,3156.075,78.57,18080.08,38
HCPCS,50695,Placement of stent of ureter and separate tube in kidney through new skin access using imaging guidance with review by radiologist,6142.0,3992.3,78.57,23185.69,38
HCPCS,50700,Reconstruction of ureter,2784.6,1809.99,78.57,2836.78,19
HCPCS,50705,Blocking of ureter using imaging guidance with review by radiologist,3944.0,2563.6,78.57,4456.76,19
HCPCS,50706,Balloon dilation treatment of stricture of ureter using imaging guidance with review by radiologist,1691.5,1099.475,78.57,10111.49,38
HCPCS,50715,Release of scar tissue at ureter,5071.5,3296.48,78.57,3626.2,19
HCPCS,50722,Release of abnormal veins blocking ureter,2942.1,1912.37,78.57,3076.95,19
HCPCS,50725,Repair and repositioning of abnormally positioned ureter,2687.18,1746.67,78.57,3371.27,19
HCPCS,50727,Revision of opening from urinary tract to skin,1564.5,1016.93,78.57,1549.87,19
HCPCS,50728,Revision of opening from urinary tract to skin with repair of hernia,2064.3,1341.8,78.57,2208.81,19
HCPCS,50740,Connection of ureter to renal pelvis,3339.0,2170.35,78.57,3576.49,19
HCPCS,50750,Connection of ureter to renal calyx,3510.2,2281.63,78.57,3527.74,19
HCPCS,50760,Removal and reconnection of diseased or injured portion of ureter,3265.5,2122.58,78.57,3410.6,19
HCPCS,50770,Partial removal of ureter with connection to opposite ureter,3432.5,2231.13,78.57,3527.74,19
HCPCS,50780,Connection of ureter to bladder,4912.5,3193.13,78.57,3367.01,19
HCPCS,50782,Connection of extra ureter to bladder,3543.8,2303.47,78.57,3290.12,19
HCPCS,50783,Repositioning of ureter to bladder,3701.3,2405.85,78.57,3448.37,19
HCPCS,50785,Repositioning of ureter with creation of bladder or muscle flap,3858.8,2508.22,78.57,3703.75,19
HCPCS,50800,Connection of ureter to bowel,3228.8,2098.72,78.57,2828.14,19
HCPCS,50810,Connection of ureter to large bowel with creation of pouch in bowel and opening from pouch to skin,3731.7,2425.61,78.57,4091.3,19
HCPCS,50815,Connection of ureter to large bowel,4935.0,3207.75,78.57,3748.66,19
HCPCS,50820,Connection of ureter to small bowel with creation of opening from ureter to skin,4935.0,3207.75,78.57,4007.75,19
HCPCS,50825,Connection of ureter to large and/or small bowel with creation of opening to skin,5381.3,3497.85,78.57,5035.34,19
HCPCS,50830,Repair to restore urine flow in ureter,5414.9,3519.69,78.57,5506.87,19
HCPCS,50840,Replacement of ureter using bowel,7048.2,4581.33,78.57,3767.96,19
HCPCS,50845,Connection of bladder to pouch at junction of small and large bowel with creation of opening to skin,3760.1,2444.07,78.57,3834.78,19
HCPCS,50860,Connection of ureter to skin,2845.5,1849.58,78.57,2896.04,19
HCPCS,50900,Suture repair of ureter,2503.2,1627.08,78.57,2582.6,19
HCPCS,50920,Closure of abnormal drainage tract from ureter to skin,2782.5,1808.63,78.57,2698.6,19
HCPCS,50930,Closure of abnormal drainage tract from ureter to an abdominal organ,3386.3,2201.1,78.57,3370.13,19
HCPCS,50940,Removal of previously placed suture or wire in ureter,2126.55,1382.26,78.57,2719.77,19
HCPCS,50945,Removal of stone from ureter using an endoscope,2957.9,1922.64,78.57,2971.58,19
HCPCS,50947,Repositioning of ureter and insertion of stent using an endoscope,4189.5,2723.18,78.57,4233.11,19
HCPCS,50948,Repositioning of ureter using an endoscope,3897.6,2533.44,78.57,3893.28,19
HCPCS,50951,Exam of kidney and ureter using an endoscope inserted through an already created ureter opening,968.1,629.27,78.57,932.57,19
HCPCS,50953,Insertion of tube into ureter using an endoscope inserted through an already created opening in ureter,2230.2,1449.63,78.57,992.21,19
HCPCS,50955,Biopsy of kidney or ureter using an endoscope inserted through an already created opening in ureter,2444.4,1588.86,78.57,1069.89,19
HCPCS,50957,Destruction and/or removal of growth of kidney or ureter using an endoscope inserted through an already created opening in ureter,1312.5,853.13,78.57,1076.59,19
HCPCS,50961,Removal of foreign body or stone in kidney or ureter using an endoscope inserted through an already created opening in ureter,2800.4,1820.26,78.57,964.21,19
HCPCS,50970,Exam of kidney and ureter using an endoscope,893.5,580.78,78.57,1126.86,19
HCPCS,50972,Insertion of tube into ureter using an endoscope,1102.5,716.63,78.57,1089.09,19
HCPCS,50974,Biopsy of kidney or ureter using an endoscope,1140.55,741.36,78.57,1437.35,19
HCPCS,50976,Destruction and/or removal of growth of kidney or ureter using an endoscope,1125.03,731.27,78.57,1416.7,19
HCPCS,50980,Removal of foreign body or stone in kidney or ureter using an endoscope,1099.4,714.61,78.57,1082.45,19
HCPCS,51020,Incision of bladder with destruction of growth and/or insertion of radioactive material,1191.8,774.67,78.57,1430.87,19
HCPCS,51040,Incision of bladder with drainage,2318.5,1507.025,78.57,8721.1,38
HCPCS,51045,Incision of bladder with insertion of tube or stent in ureter,1706.3,1109.1,78.57,1482.35,19
HCPCS,51050,Incision of bladder with removal of bladder stone,1863.8,1211.47,78.57,1446.67,19
HCPCS,51060,Incision of bladder with removal of stone in ureter,1390.98,904.14,78.57,1781.66,19
HCPCS,51065,Incision of bladder with basket removal and/or ultrasonic crushing of stone in ureter,1387.4,901.81,78.57,1775.41,19
HCPCS,51080,Drainage of abscess of bladder,1470.0,955.5,78.57,1251.01,19
HCPCS,51100,Needle aspiration of bladder,377.5,245.375,28.97,2166.29,38
HCPCS,51101,Aspiration of bladder using tube or trocar,289.8,188.37,41.18,371.02,19
HCPCS,51102,Aspiration of bladder with insertion of bladder tube to skin,1741.5,1131.975,0.01,6567.3,55
HCPCS,51500,Repair of congenital defect of bladder,2126.3,1382.1,78.57,1950.94,19
HCPCS,51520,Simple removal of bladder neck,2310.0,1501.5,78.57,1821.91,19
HCPCS,51525,Repair of ruptured bowel into bladder,2587.2,1681.68,78.57,2630.79,19
HCPCS,51530,Removal of growth of bladder,2310.0,1501.5,78.57,2360.77,19
HCPCS,51535,"Incision, removal, or repair of abnormal drainage tract from bladder into bowel",2327.9,1513.14,78.57,2390.26,19
HCPCS,51550,Simple partial removal of bladder,2839.2,1845.48,78.57,2935.28,19
HCPCS,51555,Complicated partial removal of bladder,3780.0,2457.0,78.57,3851.2,19
HCPCS,51565,Partial removal of bladder with reimplantation of ureters,3868.2,2514.33,78.57,3945.0,19
HCPCS,51570,Complete removal of bladder,4427.9,2878.14,78.57,4494.63,19
HCPCS,51575,Complete removal of bladder and lymph nodes on both sides of pelvis,5138.7,3340.16,78.57,5559.99,19
HCPCS,51580,Complete removal of bladder with transplantation of ureters,4598.43,2988.98,78.57,5796.67,19
HCPCS,51585,Complete removal of bladder with transplantation of ureters and removal of lymph nodes on both sides of pelvis,7218.8,4692.22,78.57,6449.51,19
HCPCS,51590,Removal of bladder with transplantation of ureters to small or large bowel with creation of urinary opening,7481.3,4862.85,78.57,5894.41,19
HCPCS,51595,Removal of bladder and lymph nodes on both sides of pelvis with transplantation of ureters to small or large bowel with creation of urinary opening,8610.0,5596.5,78.57,6674.93,19
HCPCS,51596,Removal of bladder and lymph nodes on both sides of pelvis with transplantation of ureters to small and/or large bowel with creation of urinary opening,8216.3,5340.6,78.57,7187.55,19
HCPCS,51597,Removal of bladder and ureters and/or removal of rectum and partial removal of large bowel with creation of opening in large bowel through abdominal wall to skin,9161.3,5954.85,78.57,7004.37,19
HCPCS,51600,Injection procedure for imaging of bladder during voiding,580.1,377.065,4.52,8477.27,57
HCPCS,51605,Injection procedure for imaging of bladder and urethra and placement of X-ray marker,1042.7,677.76,24.7,117.33,19
HCPCS,51610,Injection procedure through bladder and urethra for X-ray imaging,467.7,304.005,18.52,8477.27,38
HCPCS,51700,Simple bladder irrigation and/or instillation,238.0,154.7,0.01,2166.29,74
HCPCS,51701,Insertion of temporary bladder tube,150.0,97.5,0.01,2166.29,74
HCPCS,51702,Simple insertion of temporary bladder tube,180.0,117.0,0.01,2166.29,74
HCPCS,51703,Complicated insertion of bladder tube,258.5,168.025,0.01,2166.29,74
HCPCS,51705,Simple change of bladder tube,277.35,180.28,0.01,2166.29,74
HCPCS,51710,Complicated change of bladder tube,561.45,364.94500000000005,0.01,3227.0,55
HCPCS,51715,Injection of implant material beneath lining of bladder and/or urethra using an endoscope,1827.6,1187.94,0.01,7205.18,36
HCPCS,51720,Instillation of anti-cancer drug into bladder,455.9,296.33500000000004,0.01,2166.29,74
HCPCS,51725,Simple measurement of pressure of urine flow in bladder,618.0,401.7,0.01,1510.76,36
HCPCS,51726,Complex measurement of pressure of urine flow in bladder,757.8,492.57,78.57,1549.5,56
HCPCS,51727,Complex measurement of pressure of urine flow in bladder with urethra pressure studies,935.4,608.01,78.57,572.42,19
HCPCS,51728,Complex measurement of pressure of urine flow in bladder with voiding pressure studies,769.2,499.98,78.57,1549.5,56
HCPCS,51729,Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies,809.65,526.275,78.57,1549.5,56
HCPCS,51736,Simple timed assessment of bladder emptying,160.7,104.46,8.09,78.57,19
HCPCS,51741,Electronic assessment of bladder emptying,267.8,174.07,8.09,792.83,56
HCPCS,51784,Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings,580.7,377.46,34.25,1926.55,57
HCPCS,51785,Needle measurement and recording of electrical activity of muscles at bladder and bowel openings,435.0,282.75,0.01,619.8,36
HCPCS,51792,Assessment of muscle signal of pelvic nerves,653.1,424.52,51.63,445.22,19
HCPCS,51797,Insertion of device into abdomen with pressure and urine flow rate study,524.1,340.66499999999996,37.11,960.69,57
HCPCS,51798,Ultrasound measurement of bladder capacity after voiding,65.0,42.25,11.35,506.17,76
HCPCS,51800,Repair of bladder and/or urethra,3141.6,2042.04,78.57,3179.48,19
HCPCS,51820,"Repair of bladder, urethra, and ureter",3033.5,1971.78,78.57,3323.72,19
HCPCS,51840,Simple suture of bladder neck to vaginal wall and pubic bone with urethra suspension,2362.5,1535.63,78.57,2037.8,19
HCPCS,51841,Resuture of bladder neck to vaginal wall and pubic bone with urethra suspension,2362.5,1535.63,78.57,2382.74,19
HCPCS,51845,Repair of bladder neck in female,2310.0,1501.5,78.57,1783.42,19
HCPCS,51860,"Suture of simple wound, injury, or rupture of bladder",2126.3,1382.1,78.57,2250.59,19
HCPCS,51865,"Suture of complicated wound, injury, or rupture of bladder",2730.0,1774.5,78.57,2728.76,19
HCPCS,51880,Closure of surgically created opening from bladder to skin,1372.4,892.06,78.57,1421.89,19
HCPCS,51900,Repair of abnormal drainage tract from bladder into vagina through abdomen,3150.0,2047.5,78.57,2526.48,19
HCPCS,51920,Repair of abnormal drainage tract from bladder into vagina,1852.63,1204.21,78.57,2339.98,19
HCPCS,51925,Repair of abnormal drainage tract from bladder into vagina and removal of uterus,2450.4,1592.76,78.57,3120.53,19
HCPCS,51940,Repair of congenital defect of bladder wall,3976.1,2584.47,78.57,5018.51,19
HCPCS,51960,Enlargement of bladder using a portion of bowel,4183.2,2719.08,78.57,4237.6,19
HCPCS,51980,Creation of drainage tract from bladder to skin,2703.8,1757.47,78.57,2186.55,19
HCPCS,51990,Suture suspension of urethra to control leakage using an endoscope,2200.8,1430.52,78.57,2284.74,19
HCPCS,51992,Creation of sling around urethra to control leakage using an endoscope,2446.5,1590.23,78.57,2538.28,19
HCPCS,52000,Diagnostic exam of bladder and urethra using an endoscope,733.2,476.58000000000004,0.01,2310.6,55
HCPCS,52001,Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope,1145.6,744.64,78.57,1051.67,19
HCPCS,52005,Insertion of tube into ureter using an endoscope through bladder area,843.2,548.08,78.57,730.06,19
HCPCS,52007,Insertion of tube into ureter and biopsy of ureter and/or renal pelvis using an endoscope,1565.6,1017.64,78.57,1086.59,19
HCPCS,52010,Insertion of tube into sperm duct using an endoscope,861.2,559.78,78.36,918.54,19
HCPCS,52204,Biopsy of bladder using an endoscope,1554.65,1010.525,0.01,4271.46,36
HCPCS,52214,"Destruction of tissue of bladder, urethra, or surrounding glands using an endoscope",2310.0,1501.5,48.1,1802.68,19
HCPCS,52224,"Destruction of growth of bladder and urethra using an endoscope, less than 0.5 cm",2024.0,1315.6,0.01,4271.46,36
HCPCS,52234,"Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm",1993.25,1295.615,0.01,7990.26,36
HCPCS,52235,"Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm",1496.3,972.6,78.57,875.64,19
HCPCS,52240,Destruction and/or removal of large growth of bladder using an endoscope,2100.0,1365.0,78.57,1191.14,19
HCPCS,52250,Insertion of radioactive substance of bladder and urethra using an endoscope,576.33,374.61,78.57,726.71,19
HCPCS,52260,Dilation of bladder using an endoscope under general or spinal anesthesia,640.5,416.33,78.57,639.16,19
HCPCS,52265,Dilation of bladder using an endoscope,1231.7,800.61,52.12,899.22,19
HCPCS,52270,Incision of urethra in female using an endoscope,1193.9,776.04,78.57,1012.38,19
HCPCS,52275,Incision of urethra in male using an endoscope,1633.8,1061.97,73.48,1297.75,19
HCPCS,52276,Incision of urethra using an endoscope,1102.5,716.63,78.57,802.99,19
HCPCS,52277,Removal of muscles at urinary opening using an endoscope,996.5,647.73,78.57,982.08,19
HCPCS,52281,Dilation of urethra using an endoscope,1562.55,1015.66,0.01,4271.46,55
HCPCS,52282,Insertion of a permanent urethra stent using an endoscope,1029.0,668.85,78.57,1020.68,19
HCPCS,52283,Steroid injection into urethra stricture using an endoscope,1318.05,856.735,0.01,6451.0,55
HCPCS,52285,Exam of bladder and urethra for treatment of female urethral syndrome using an endoscope,845.3,549.45,78.57,841.72,19
HCPCS,52287,Exam with injections of chemical for destruction of bladder using an endoscope,1330.5,864.8249999999999,0.01,4271.46,55
HCPCS,52290,Incision of ureter using an endoscope,750.8,488.02,78.57,740.4,19
HCPCS,52300,Removal or destruction of abnormal pouches of ureter at bladder using an endoscope,862.1,560.37,78.57,850.49,19
HCPCS,52301,"Removal or destruction of abnormal pouches of ureter at bladder, ectopic ureterocele, using an endoscope",903.0,586.95,78.57,880.45,19
HCPCS,52305,Removal of bladder pouches using an endoscope,856.8,556.92,78.57,845.29,19
HCPCS,52310,"Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope",1268.75,824.69,0.01,4519.38,55
HCPCS,52315,"Complicated removal of foreign body, stone, or stent in urethra or bladder using an endoscope",1536.5,998.725,0.01,4519.38,36
HCPCS,52317,"Crushing, fragmenting, and removal of bladder stones, less than 2.5 cm",2784.6,1809.99,78.57,2129.92,19
HCPCS,52318,"Crushing, fragmenting, and removal of bladder stones, more than 2.5 cm",1653.8,1074.97,78.57,1438.58,19
HCPCS,52320,Removal of stone in ureter using an endoscope,1076.3,699.6,78.57,748.84,19
HCPCS,52325,Fragmenting of stone in ureter using an endoscope,1548.8,1006.72,78.57,972.63,19
HCPCS,52327,Injection of implant material in bladder using an endoscope,1564.5,1016.93,78.57,797.53,19
HCPCS,52330,Manipulation of stone in ureter using an endoscope,2261.7,1470.11,78.57,1450.72,19
HCPCS,52332,Insertion of stent in ureter using an endoscope,3236.775,2103.9049999999997,0.01,10807.76,36
HCPCS,52334,Insertion of guide wire through kidney into ureter using an endoscope,787.5,511.88,78.57,554.86,19
HCPCS,52341,Dilation of bladder and urethra using an endoscope,1477.35,960.28,78.57,861.94,19
HCPCS,52342,Repair of stricture at junction of kidney and ureter using an endoscope,1060.5,689.33,78.57,938.49,19
HCPCS,52343,Repair of stricture in kidney using an endoscope,1163.4,756.21,78.57,1045.53,19
HCPCS,52344,Repair of stricture of ureter using an endoscope,1260.0,819.0,78.57,1122.63,19
HCPCS,52345,Repair of stricture of upper attachment of ureter to kidney using an endoscope,1336.7,868.86,78.57,1197.89,19
HCPCS,52346,Repair of stricture in kidney with exam of urinary tract using an endoscope,1491.0,969.15,78.57,1357.06,19
HCPCS,52351,"Diagnostic exam of bladder, urethra, and ureter or kidney using an endoscope",963.9,626.54,78.57,919.23,19
HCPCS,52352,Removal or manipulation of stone in ureter or kidney using an endoscope,1697.85,1103.6,78.57,1076.26,19
HCPCS,52353,Crushing of stone of ureter using an endoscope,1953.0,1269.45,78.57,1191.14,19
HCPCS,52354,Biopsy and/or destruction of growth of ureter or kidney using an endoscope,1203.3,782.15,78.57,1267.42,19
HCPCS,52355,Removal of growth of ureter or kidney using an endoscope,1435.4,933.01,78.57,1419.25,19
HCPCS,52356,Crushing of stone of ureter with insertion of stent using an endoscope,8774.475,5703.41,78.57,40093.31,38
HCPCS,52400,"Incision, destruction, or removal of congenital defects of bladder and urethra using an endoscope",1656.9,1076.99,78.57,1460.16,19
HCPCS,52402,Incision or removal of ejaculatory duct using an endoscope,826.4,537.16,78.57,809.63,19
HCPCS,52441,"Insertion of implant in urethra within prostate gland using an endoscope, 1 implant",577.5,375.38,78.57,3056.75,19
HCPCS,52442,"Insertion of implant in urethra within prostate gland using an endoscope, each additional implant",172.2,111.93,40.85,2088.33,19
HCPCS,52443,CYSTOURETHROSCOPY WITH INITIAL TRANSURETHRAL ANTERIOR PROSTATE COMMISSUROTOMY WITH A NONDRUG-COATED BALLOON CATHETER FOLLOWED BY THERAPEUTIC DRUG DELIVERY INTO THE PROSTATE BY A DRUG-COATED BALLOON CA,12292.5,7990.125,73.6,62450.02,32
HCPCS,52450,Incision of prostate,1506.8,979.42,78.57,1439.47,19
HCPCS,52500,Removal of bladder neck through urethra,1656.9,1076.99,78.57,1496.08,19
HCPCS,52597,"TRANSURETHRAL ROBOTIC-ASSISTED WATERJET RESECTION OF PROSTATE, INCLUDING INTRAOPERATIVE PLANNING, ULTRASOUND GUIDANCE, CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE, INCLUDING VASECTOMY, MEATOTOMY, CYST",2280.0,1482.0,73.6,3265.1,32
HCPCS,52601,Removal of prostate gland using an electrocautery knife through urethra with control of bleeding using an endoscope,2517.9,1636.64,78.57,2233.39,19
HCPCS,52630,Complete removal of remaining or regrown prostate tissue with control of bleeding using an endoscope,1332.5,866.13,78.57,1272.05,19
HCPCS,52640,Removal of postsurgical tightening of bladder neck,1205.4,783.51,78.57,966.39,19
HCPCS,52647,Complete laser destruction of prostate including control of bleeding using an endoscope,7639.8,4965.87,78.57,3819.9,15
HCPCS,52648,Complete laser vaporization of prostate including control of bleeding using an endoscope,6418.7,4172.16,78.57,3876.31,19
HCPCS,52649,Complete laser fragmentation of prostate including control of bleeding using an endoscope,1975.3,1283.95,78.57,2526.48,19
HCPCS,52700,Drainage of prostate abscess,1308.3,850.4,78.57,1351.31,19
HCPCS,53000,Incision or repair of urethra,840.0,546.0,78.57,452.64,19
HCPCS,53010,Incision or repair of abnormal urethra,870.5,565.83,78.57,899.91,19
HCPCS,53020,Incision of external urinary opening,533.4,346.71,78.57,294.71,19
HCPCS,53025,"Incision of external urinary opening, infant",603.8,392.47,30.87,207.56,19
HCPCS,53040,Drainage of abscess around urethra,1618.1,1051.77,78.57,1202.05,19
HCPCS,53060,Drainage of abscess or cyst of Skene's glands,2124.35,1380.83,0.01,9632.73,36
HCPCS,53080,Uncomplicated drainage of abnormal urine collection,1296.8,842.92,78.57,1286.57,19
HCPCS,53085,Complicated drainage of abnormal urine collection,1567.95,1019.17,78.57,1989.2,19
HCPCS,53200,Biopsy of urethra,1700.75,1105.49,0.01,6587.96,36
HCPCS,53210,Removal of bladder and urethra in female,2317.4,1506.31,78.57,2360.58,19
HCPCS,53215,Removal of bladder and urethra in male,2816.1,1830.47,78.57,2841.59,19
HCPCS,53220,Removal or destruction of cancer urethra,1092.18,709.92,78.57,1384.02,19
HCPCS,53230,Removal of pouch of urethra in female,1837.5,1194.38,78.57,1853.89,19
HCPCS,53235,Removal of pouch of urethra in male,1915.2,1244.88,78.57,1939.53,19
HCPCS,53240,Repair of pouch of urethra,1282.1,833.37,78.57,1300.41,19
HCPCS,53250,Removal of seminal fluid gland,976.8,634.92,78.57,1211.14,19
HCPCS,53260,Removal or destruction of polyps of urethra,589.1,382.92,54.95,554.4,19
HCPCS,53265,Removal or destruction of growth of urethra,840.0,546.0,78.57,576.17,19
HCPCS,53270,Removal or destruction of mucous glands of urethra,598.5,389.03,78.57,567.24,19
HCPCS,53275,Removal or destruction of prolapse of urethra,845.3,549.45,78.57,802.82,19
HCPCS,53400,"Repair of abnormal drainage tract, pouch, or stricture of urethra, first stage",2405.6,1563.64,78.57,2451.51,19
HCPCS,53405,second stage repair of urethra with creation of new urethra,2650.2,1722.63,78.57,2676.55,19
HCPCS,53410,Reconstruction of urethra in male,2963.1,1926.02,78.57,3001.28,19
HCPCS,53415,Reconstruction or repair of urethra,3419.9,2222.94,78.57,3460.09,19
HCPCS,53420,"Reconstruction or repair of urethra, stage 1 of 2",2756.3,1791.6,78.57,2578.8,19
HCPCS,53425,"Reconstruction or repair of urethra, stage 2 of 2",2249.83,1462.39,78.57,2869.95,19
HCPCS,53430,Reconstruction of urethra in female,2849.7,1852.31,78.57,2956.11,19
HCPCS,53431,Repair of urethra and/or lower bladder for incontinence,2773.1,1802.52,78.57,3528.35,19
HCPCS,53440,Creation of sling around urethra in male to control leakage,2756.3,1791.6,78.57,2308.86,19
HCPCS,53442,Removal or revision of sling in male for urinary incontinence,1876.45,1219.69,78.57,2399.16,19
HCPCS,53444,Insertion of artificial urinary sphincter,1926.8,1252.42,78.57,2432.55,19
HCPCS,53445,Insertion of inflatable urethra or bladder neck sphincter,3753.8,2439.97,78.57,2308.53,19
HCPCS,53446,Removal of inflatable urethra or bladder neck sphincter,1984.5,1289.93,78.57,1967.0,19
HCPCS,53447,Removal and replacement of inflatable urethra or bladder neck sphincter,2451.8,1593.67,78.57,2474.94,19
HCPCS,53448,Removal and replacement of inflatable urethra or bladder neck sphincter through an infected field,3884.0,2524.6,78.57,3907.34,19
HCPCS,53449,Repair of inflatable urethra or bladder neck sphincter,1701.0,1105.65,78.57,1874.59,19
HCPCS,53450,Repair of urethra and urinary opening,1223.3,795.15,78.57,1251.29,19
HCPCS,53453,Removal of adjustable balloon continence device from beside urethra,1475.0,958.75,78.57,1519.25,15
HCPCS,53454,Adjustment of fluid volume in adjustable balloon continence device beside urethra,1035.0,672.75,0.01,1545.0,32
HCPCS,53460,Repair and partial removal of urethra and urinary opening,1374.5,893.43,78.57,1402.69,19
HCPCS,53500,Release of scar tissue of urethra using an endoscope,1856.4,1206.66,78.57,2278.75,19
HCPCS,53502,Suture of wound or injury of urethra in female,1449.0,941.85,78.57,1489.35,19
HCPCS,53505,Suture of wound or injury of urethra in penis,1522.5,989.63,78.57,1488.29,19
HCPCS,53510,Suture of urethra wound or injury,1901.6,1236.04,78.57,1935.4,19
HCPCS,53515,Suture of wound or injury of urethra near prostate gland,2398.2,1558.83,78.57,2439.71,19
HCPCS,53520,Closure of abnormal drainage tract from urethra to skin in male,1668.5,1084.53,78.57,1707.2,19
HCPCS,53600,Initial dilation of urethra in male using dilator,241.65,157.075,0.01,583.65,36
HCPCS,53601,Subsequent dilation of stricture of urethra in male by passage of dilator,248.9,161.79,16.35,203.7,19
HCPCS,53605,Dilation of narrowing of urethra in male under general or spinal anesthesia,210.0,136.5,51.79,195.11,19
HCPCS,53620,Initial dilation of urethra in male using filiform dilator,367.5,238.88,40.73,408.4,19
HCPCS,53621,Subsequent dilation of urethral stricture in male by passage of filiform urethral dilator,345.5,224.58,24.61,389.88,19
HCPCS,53660,Initial dilation of urethra in female,175.6,114.13999999999999,0.01,353.8,36
HCPCS,53661,Subsequent dilation of urethra in female,161.6,105.04,0.01,284.08,36
HCPCS,53665,Dilation of urethra in female under general or spinal anesthesia,157.5,102.38,30.79,116.77,19
HCPCS,53850,Destruction of prostate tissue using microwave induced heat,9366.0,6087.9,78.57,3408.24,19
HCPCS,53852,Destruction of prostate tissue using radiofrequency induced heat,8995.4,5847.01,78.57,3328.25,19
HCPCS,53854,Destruction of prostate tissue using radiofrequency induced heated water vapor,904.0,587.6,78.57,4022.48,19
HCPCS,53855,Insertion of a temporary urethra stent using an endoscope,1805.8,1173.77,14.22,1577.72,19
HCPCS,53860,Reconstruction of female bladder neck for stress urinary incontinence using radiofrequency,3640.35,2366.23,78.57,5756.86,19
HCPCS,53865,Insertion of a temporary device for pressure necrosis of bladder neck and prostate using an endoscope,10721.35,6968.88,2680.34,27687.89,17
HCPCS,53899,Other procedure on urinary system,1615.0,1049.75,73.6,11709.06,68
HCPCS,54000,Incision of newborn foreskin,458.9,298.29,43.41,389.77,19
HCPCS,54001,Incision of foreskin,1201.85,781.2049999999999,0.01,4271.46,36
HCPCS,54015,Incision and drainage of penis,931.4,605.41,78.57,934.85,19
HCPCS,54050,Simple destruction of growths of penis using chemical,331.0,215.15,0.01,8477.27,55
HCPCS,54055,Simple destruction of growth of penis using electric current,910.4,591.76,0.01,3847.93,36
HCPCS,54056,Simple destruction of growth of penis using freezing,254.25,165.26500000000001,0.01,8477.27,55
HCPCS,54057,Simple destruction of growth of penis using laser,1026.25,667.065,0.01,4080.35,36
HCPCS,54060,Removal of growth of penis,1070.0,695.5,0.01,3847.93,36
HCPCS,54065,Destruction of multiple growths of penis,1112.5,723.125,0.01,3847.93,55
HCPCS,54100,Biopsy of penis,935.4,608.01,0.01,3726.0,55
HCPCS,54105,Biopsy of deep structure of penis,1544.0,1003.6,0.01,5862.28,36
HCPCS,54110,Removal of thickened tissue of penis,1942.5,1262.63,78.57,1913.8,19
HCPCS,54111,"Removal of abnormally thickened tissue in penis with graft, 5.0 cm or less",2426.6,1577.29,78.57,2450.42,19
HCPCS,54112,"Removal of abnormally thickened tissue in penis with graft, more than 5.0 cm",2239.65,1455.77,78.57,2872.63,19
HCPCS,54115,Removal of foreign body in penis,1084.5,704.93,78.57,1299.74,19
HCPCS,54120,Partial amputation of penis,1898.4,1233.96,78.57,1937.02,19
HCPCS,54125,Amputation of penis,2448.6,1591.59,78.57,2497.0,19
HCPCS,54130,Amputation of penis and removal of lymph nodes on both sides of groin,3623.6,2355.34,78.57,3653.71,19
HCPCS,54135,Amputation of penis and removal of lymph nodes on both sides of pelvis,3635.28,2362.93,78.57,4621.22,19
HCPCS,54150,Removal of foreskin using clamp or device,1107.0,719.55,0.01,6451.0,55
HCPCS,54160,Removal of foreskin (28 days or younger),1252.8,814.3199999999999,27.7,6451.0,38
HCPCS,54161,Removal of foreskin (older than 28 days),2761.6,1795.04,78.57,12736.89,38
HCPCS,54162,Removal of scar tissue after foreskin removal,1229.0,798.85,0.01,4286.95,36
HCPCS,54163,Repair of incomplete removal of foreskin,648.9,421.79,78.57,666.34,19
HCPCS,54164,Incision of membrane attaching foreskin and penis,650.0,422.5,78.57,590.55,19
HCPCS,54200,Injection procedure to correct thickened penile tissue,315.15,204.85000000000002,0.01,583.65,36
HCPCS,54205,Injection procedure and surgery of thickened penile tissue,1275.43,829.03,78.57,1630.95,19
HCPCS,54220,Injection of drug into erectile tissue at sides and back of penis,429.0,278.85,57.0,2166.29,38
HCPCS,54230,Injection procedure for imaging of penile erection,234.95,152.72,44.75,2924.62,38
HCPCS,54231,Assessment of erectile dysfunction including injection of drugs into penis,443.1,288.02,78.57,352.46,19
HCPCS,54235,Injection procedure to cause erection,247.4,160.81,0.01,8477.27,55
HCPCS,54240,Assessment of penile blood flow,298.2,193.83,61.37,203.2,19
HCPCS,54250,Assessment of nighttime erection,379.1,246.42,78.57,340.15,19
HCPCS,54300,Repair of curved penis,1952.0,1268.8,78.57,1975.18,19
HCPCS,54304,Repair of curved penis and urinary outlet,2289.0,1487.85,78.57,2295.02,19
HCPCS,54308,"Repair of urinary outlet at underside of penis, less than 3.0 cm",1716.23,1115.55,78.57,2193.65,19
HCPCS,54312,"Repair of urinary outlet at underside of penis, more than 3.0 cm",2035.0,1322.75,78.57,2509.86,19
HCPCS,54316,"Repair of urinary outlet of penis with skin graft, stage 2 of 2",2480.43,1612.28,78.57,3048.37,19
HCPCS,54318,Repair of urinary outlet with release of penis from scrotum,1705.93,1108.85,78.57,2179.52,19
HCPCS,54322,Simple repair and relocation of urinary outlet at underside of penis,2385.6,1550.64,78.57,2395.99,19
HCPCS,54324,Repair of urinary outlet of penis with skin flap,3013.5,1958.78,78.57,2967.89,19
HCPCS,54326,Repair of urinary outlet at underside of penis with skin flap,2790.9,1814.09,78.57,2888.64,19
HCPCS,54328,"Repair of urinary outlet at underside of head of penis with local skin flaps, skin graft patch, and/or island flap",3097.5,2013.38,78.57,2870.63,19
HCPCS,54332,Repair of urinary outlet at underside of base of penis with skin graft tube and/or island flap,3091.2,2009.28,78.57,3096.73,19
HCPCS,54336,Repair of urinary outlet between thighs in male with skin graft tube and/or island flap,3481.8,2263.17,78.57,3639.64,19
HCPCS,54340,Simple repair of urinary outlet complications at underside of penis,1696.8,1102.92,78.57,1745.77,19
HCPCS,54344,Repair of complication of urinary outlet of penis at underside of penis with mobilization of skin graft or flap,2909.6,1891.24,78.57,2895.82,19
HCPCS,54348,"Extensive repair of urinary outlet at underside of penis with flap, patch or graft",3113.3,2023.65,78.57,3096.21,19
HCPCS,54352,Extensive revision of previous repair of urinary outlet at underside of penis with skin grafts and flaps,4404.8,2863.12,78.57,4329.1,19
HCPCS,54360,Surgery to correct abnormal penis angle,2197.7,1428.51,78.57,2210.3,19
HCPCS,54380,Repair of urinary outlet of penis,2435.0,1582.75,78.57,2451.95,19
HCPCS,54385,Repair of urinary outlet of penis with incontinence,2321.3,1508.85,78.57,2849.13,19
HCPCS,54390,Repair of urinary outlet of penis with creation of bladder opening,3600.5,2340.33,78.57,3803.22,19
HCPCS,54400,Insertion of non-inflatable penile implant,2388.8,1552.72,78.57,2460.46,19
HCPCS,54401,Insertion of inflatable penile implant,2782.5,1808.63,78.57,2865.98,19
HCPCS,54405,Insertion of multicomponent inflatable penile implant,3596.3,2337.6,78.57,3704.19,19
HCPCS,54406,Removal of all components of inflatable penile implant,2336.3,1518.6,78.57,2240.3,19
HCPCS,54408,Repair of multicomponent inflatable penile implant,2375.1,1543.82,78.57,2446.35,19
HCPCS,54410,Removal and replacement of multicomponent inflatable penile implant during same surgery,2764.7,1797.06,78.57,2847.64,19
HCPCS,54411,Removal and replacement of infected components of inflatable penile implant,2463.55,1601.31,78.57,3150.11,19
HCPCS,54415,Removal of inflatable or noninflatable penile implant,1581.3,1027.85,78.57,1619.59,19
HCPCS,54416,Removal and replacement of noninflatable penile implant,2122.1,1379.37,78.57,2185.76,19
HCPCS,54417,Removal and replacement of infected noninflatable penile implant,2245.2,1459.38,78.57,2755.64,19
HCPCS,54420,Creation of blood flow tract from penis to groin,2137.8,1389.57,78.57,2157.61,19
HCPCS,54430,Creation of blood flow tract from penis to other penile anatomy,1935.2,1257.88,78.57,1961.73,19
HCPCS,54435,Redirection of blood flow from penis with partial removal of tissue at head of penis,1250.6,812.89,78.57,1272.43,19
HCPCS,54437,Repair of penis,1618.0,1051.7,78.57,2064.79,19
HCPCS,54440,Repair of injury of penis,2446.5,1590.23,78.57,1661.66,15
HCPCS,54450,Repositioning of foreskin including scar tissue removal,434.75,282.59000000000003,46.62,2166.29,38
HCPCS,54500,Needle biopsy of testicle,1282.5,833.625,0.01,5810.63,36
HCPCS,54505,Incision of testicle for biopsy,957.6,622.44,78.57,642.48,19
HCPCS,54512,Removal of growth of testicle,1609.7,1046.31,78.57,1649.0,19
HCPCS,54520,Simple removal of testicle,1452.15,943.9,78.57,995.14,19
HCPCS,54522,Partial removal of testicle,1742.0,1132.3,78.57,1805.67,19
HCPCS,54530,Removal of growth of testicle through groin,1639.1,1065.42,78.57,1547.45,19
HCPCS,54535,Removal of growth of testicle through abdomen,2211.3,1437.35,78.57,2280.94,19
HCPCS,54550,Exploration of spermatic veins and scrotum using an endoscope,1466.9,953.49,78.57,1507.26,19
HCPCS,54560,Exploration for location of testicle in abdomen,2019.2,1312.48,78.57,2106.2,19
HCPCS,54600,Repair of twisted testicle,1356.6,881.79,78.57,1388.29,19
HCPCS,54620,Suture of testicle to other testicle,1367.1,888.62,78.57,915.83,19
HCPCS,54640,Repositioning and suture of misplaced testicle,2401.95,1561.27,78.57,1323.13,19
HCPCS,54650,Repair of congenital malpositioned testicle,2124.2,1380.73,78.57,2180.83,19
HCPCS,54660,Insertion of testicular implant,1589.25,1033.01,78.57,1093.49,19
HCPCS,54670,Suture or repair of injury to testicle,1209.6,786.24,78.57,1244.12,19
HCPCS,54680,Transplantation of testicles to thigh,2354.1,1530.17,78.57,2415.38,19
HCPCS,54690,Removal of testicles using an endoscope,1965.6,1277.64,78.57,2012.23,19
HCPCS,54692,Removal of congenital malpositioned testicle using an endoscope,2318.4,1506.96,78.57,2318.89,19
HCPCS,54700,"Incision and drainage of sperm reservoir, testis, and/or scrotal area",2992.05,1944.835,78.57,12736.89,38
HCPCS,54800,Needle biopsy of sperm reservoir,480.0,312.0,18.52,382.33,19
HCPCS,54830,Removal of growth of sperm duct,1101.5,715.98,78.57,1139.09,19
HCPCS,54840,Removal of fluid accumulation in sperm reservoir,1575.0,1023.75,78.57,983.58,19
HCPCS,54860,Removal of sperm reservoir,1250.6,812.89,78.57,1283.08,19
HCPCS,54861,Removal of both sperm reservoirs,1693.7,1100.91,78.57,1736.26,19
HCPCS,54865,Search of sperm reservoir,1062.6,690.69,78.57,1097.94,19
HCPCS,54900,Connection of sperm reservoir to sperm duct,2358.3,1532.9,78.57,2455.67,19
HCPCS,54901,Connection of both sperm reservoirs to sperm ducts,2536.23,1648.55,78.57,3243.14,19
HCPCS,55000,Aspiration of fluid collection in testicle and sperm reservoir,823.5,535.28,0.01,8477.27,55
HCPCS,55040,Removal of fluid collection in testicle and sperm reservoir,1102.5,716.63,78.57,1031.43,19
HCPCS,55041,Removal of fluid collection in both testicles and sperm reservoirs,1706.3,1109.1,78.57,1561.51,19
HCPCS,55060,Repair of fluid collection in testicle and sperm reservoir,1122.5,729.63,78.57,1162.51,19
HCPCS,55100,Drainage of abscess of scrotum,1183.7,769.405,0.01,3726.0,55
HCPCS,55110,Search of scrotum,1144.5,743.93,78.57,1182.78,19
HCPCS,55120,Removal of foreign body in scrotum,864.3,561.8,78.57,1082.83,19
HCPCS,55150,Removal of diseased or injured scrotum,1450.1,942.57,78.57,1501.78,19
HCPCS,55175,Simple repair of scrotum,1102.5,716.63,78.57,1110.5,19
HCPCS,55180,Complicated repair of scrotum,2047.5,1330.88,78.57,2106.09,19
HCPCS,55200,Incision of sperm duct,1508.9,980.79,78.57,918.67,19
HCPCS,55250,Removal of sperm duct,1457.0,947.05,0.01,4271.46,55
HCPCS,55300,Incision of sperm duct for X-ray procedure,564.9,367.19,78.57,567.92,19
HCPCS,55400,Incision or repair of sperm duct,3150.0,2047.5,78.57,3244.5,19
HCPCS,55500,Removal of fluid collection in sperm cord,1120.4,728.26,78.57,1193.09,19
HCPCS,55520,Removal of growth of sperm cord,1765.65,1147.67,78.57,1334.84,19
HCPCS,55530,Removal of spermatic cord venous dilation or tying of spermatic veins,1968.75,1279.69,78.57,1075.52,19
HCPCS,55535,Removal of spermatic cord venous dilation or suturing of spermatic veins,1281.0,832.65,78.57,1318.24,19
HCPCS,55540,Removal of spermatic cord venous dilation or suturing spermatic veins with hernia repair,4509.0,2930.85,78.57,19601.18,38
HCPCS,55550,Tying of sperm veins using an endoscope,1312.5,853.13,78.57,1313.12,19
HCPCS,55600,Incision or puncture of fluid-producing gland for sperm movement,1010.48,656.81,78.57,1290.99,19
HCPCS,55605,Complicated incision of fluid-producing glands for sperm movement,1296.1,842.47,78.57,1598.88,19
HCPCS,55650,Removal of fluid-producing glands for sperm movement,2145.2,1394.38,78.57,2198.48,19
HCPCS,55680,Removal of congenital remnant of fluid-producing glands for sperm movement,856.5,556.73,78.57,1462.86,19
HCPCS,55700,Biopsy of prostate gland,1168.25,759.365,0.01,4271.46,51
HCPCS,55705,Incisional biopsy of prostate gland,4400.3,2860.195,0.01,20634.18,36
HCPCS,55706,Needle biopsy of prostate gland using image guidance,1146.6,745.29,78.57,1143.24,19
HCPCS,55707,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",4661.0,3029.65,0.01,23255.41,63
HCPCS,55708,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE, FIRST TARGETED LESION",4700.5,3055.325,0.01,23255.41,47
HCPCS,55709,"BIOPSY, PROSTATE, TRANSPERINEAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",4692.5,3050.125,0.01,23255.41,63
HCPCS,55710,"BIOPSY, PROSTATE, TRANSPERINEAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE BIOPSY, FIRST TARGETED LESION",4722.5,3069.625,73.6,23255.41,32
HCPCS,55711,"BIOPSY, PROSTATE, TRANSRECTAL, MRI-ULTRASOUND-FUSION GUIDED, TARGETED LESION(S) ONLY, FIRST TARGETED LESION",4660.5,3029.325,0.01,23255.41,47
HCPCS,55712,"BIOPSY, PROSTATE, TRANSPERINEAL, MRI-ULTRASOUND-FUSION GUIDED, TARGETED LESION(S) ONLY, FIRST TARGETED LESION",4686.5,3046.225,73.6,23255.41,32
HCPCS,55713,"BIOPSY, PROSTATE, IN-BORE CT- OR MRI-GUIDED (IE, SEXTANT), WITH BIOPSY OF ADDITIONAL TARGETED LESION(S), FIRST TARGETED LESION",7065.5,4592.575,73.6,35372.5,32
HCPCS,55714,"BIOPSY, PROSTATE, IN-BORE CT- OR MRI-GUIDED TARGETED LESION(S) ONLY, FIRST TARGETED LESION",7046.0,4579.9,73.6,35372.5,32
HCPCS,55715,"BIOPSY, PROSTATE, EACH ADDITIONAL, MRI-ULTRASOUND FUSION OR IN-BORE CT- OR MRI-GUIDED TARGETED LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",2555.0,1660.75,0.01,12912.5,47
HCPCS,55720,Simple incision and drainage of abscess of prostate,1084.05,704.63,78.57,1385.04,19
HCPCS,55725,Complicated incision and drainage of abscess of prostate,1760.9,1144.59,78.57,1819.53,19
HCPCS,55801,Partial removal of prostate gland through incision between scrotum and anus,3284.4,2134.86,78.57,3355.28,19
HCPCS,55810,"Removal of prostate gland, glands for sperm movement, and sperm duct",3978.5,2586.03,78.57,4001.14,19
HCPCS,55812,Removal of prostate gland with lymph node biopsy through incision between scrotum and anus,3916.3,2545.6,78.57,4918.25,19
HCPCS,55815,Removal of prostate gland through incision between scrotum and anus and removal of surrounding lymph nodes on both sides of pelvis,4259.75,2768.84,78.57,5385.56,19
HCPCS,55821,Partial removal of prostate (suprapubic),2913.8,1893.97,78.57,2675.78,19
HCPCS,55831,Partial removal of prostate (retropubic),2913.8,1893.97,78.57,2896.23,19
HCPCS,55840,Removal of prostate,4059.3,2638.55,78.57,3578.41,19
HCPCS,55842,Removal of prostate gland and lymph node biopsy through abdominal incision,4351.2,2828.28,78.57,3579.44,19
HCPCS,55845,Removal of prostate gland and surrounding lymph nodes on both sides of pelvis through abdominal incision,4979.1,3236.42,78.57,4162.49,19
HCPCS,55860,Surgical opening of prostate for radiation therapy,2107.15,1369.65,78.57,2682.11,19
HCPCS,55862,Exposure of prostate gland for radiation therapy with biopsy of lymph nodes,2680.48,1742.31,78.57,3354.76,19
HCPCS,55865,Exposure of prostate gland for radiation therapy with removal of surrounding lymph nodes on both sides of pelvis,3206.28,2084.08,78.57,4087.06,19
HCPCS,55866,Surgical removal of prostate and surrounding lymph nodes using an endoscope,5288.9,3437.79,78.57,4406.46,19
HCPCS,55867,Simple surgical subtotal removal of prostate using laparoscope,2347.5,1525.88,78.57,3387.66,19
HCPCS,55869,"LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING, INCLUDES ROBOTIC ASSISTANCE, WHEN PERFORMED; WITH BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC, HYPOGAST",3365.0,2187.25,73.6,3465.95,16
HCPCS,55870,Insertion of device to enhance semen discharge,417.3,271.25,71.49,431.8,19
HCPCS,55873,Destruction of prostate using imaging guidance,5845.0,3799.25,78.57,20969.9,38
HCPCS,55874,Injection of biodegradable material next to prostate,5622.5,3654.625,78.57,27167.9,38
HCPCS,55875,Insertion of needle or tube into prostate for radiation therapy,1847.95,1201.17,78.57,6530.41,38
HCPCS,55876,Placement of device in prostate for radiation therapy,781.85,508.20500000000004,0.01,2969.88,55
HCPCS,55877,"ABLATION, IRREVERSIBLE ELECTROPORATION, PROSTATE, 1 OR MORE TUMORS, INCLUDING IMAGING GUIDANCE, PERCUTANEOUS",14362.5,9335.625,73.6,70125.21,32
HCPCS,55880,"High-intensity ultrasound destruction of cancerous tissue in prostate gland, accessed through rectum using ultrasound guidance",2306.5,1499.23,78.57,2685.67,19
HCPCS,55899,Other procedure on male genital system,585.0,380.25,0.01,3511.34,17
HCPCS,55920,Insertion of needles or tubes into pelvic or genital organs for radiation therapy,3935.75,2558.2400000000002,78.57,16886.97,38
HCPCS,56256,"HC DEMENTIA-NMDA R, CSF",622.0,404.3,155.5,1606.32,16
HCPCS,56405,Incision and drainage of abscess of external female genitals,491.25,319.315,0.01,2318.31,55
HCPCS,56420,Incision and drainage of abscess of female genital gland,350.0,227.5,0.01,2166.29,55
HCPCS,56440,Creation of drainage tract for gland cyst of female genitals,519.6,337.74,78.57,542.33,38
HCPCS,56441,Removal of scar tissue of female genitals,406.4,264.16,78.57,440.4,19
HCPCS,56442,Simple incision of hymen,112.3,73.0,39.9,141.28,19
HCPCS,56501,Simple destruction of growth of external female genitals,920.0,598.0,0.01,3847.93,36
HCPCS,56515,Extensive destruction of growth of external female genitals,1566.25,1018.0649999999999,0.01,6492.41,36
HCPCS,56605,"Biopsy of growth of external female genitals, first growth",440.0,286.0,0.01,3227.0,55
HCPCS,56606,"Biopsy of growth of external female genitals, each additional growth",231.0,150.15,0.01,2166.29,55
HCPCS,56620,Simple partial removal of external female genitals,1440.8,936.52,0.01,8023.32,74
HCPCS,56625,Removal of external female genitals,1667.4,1083.81,78.57,1906.05,19
HCPCS,56630,Extensive partial removal of external female genitals,2447.6,1590.94,78.57,2784.48,19
HCPCS,56631,Partial removal of external female genitals and lymph nodes on side of groin,3112.2,2022.93,78.57,3514.3,19
HCPCS,56632,Partial removal of external female genitals and lymph nodes on both sides of groin,3597.3,2338.25,78.57,4149.31,19
HCPCS,56633,Complete removal of female genitals,3194.1,2076.17,78.57,3612.92,19
HCPCS,56634,Complete removal of external female genitals and lymph nodes on side of groin,2978.35,1935.93,78.57,3842.64,19
HCPCS,56637,Complete removal of external female genitals and lymph nodes on both sides of groin,4200.0,2730.0,78.57,4472.47,19
HCPCS,56640,Complete removal of female genitals and lymph nodes,4725.0,3071.25,78.57,4476.38,19
HCPCS,56700,Partial removal of hymen,520.8,338.52,78.57,567.81,19
HCPCS,56740,Removal of cyst of female genital gland,847.4,550.81,78.57,905.73,19
HCPCS,56800,Plastic repair of vaginal opening,918.8,597.22,0.01,6174.76,55
HCPCS,56805,Reconstruction or creation of the external female sexual organ for intersex state,3240.3,2106.2,78.57,3436.1,19
HCPCS,56810,Repair of skin in area between anus and genitals,761.3,494.85,78.57,789.2,19
HCPCS,56820,Exam of external female genitals using an endoscope,331.3,215.345,0.01,2166.29,55
HCPCS,56821,Exam and biopsy of external female genitals using an endoscope,507.55,329.90999999999997,0.01,2166.29,55
HCPCS,57000,Incision and exploration of vagina,537.6,349.44,78.57,574.59,19
HCPCS,57010,Incision and drainage of abscess of pelvis,1207.5,784.88,78.57,1312.91,19
HCPCS,57020,Removal of abdominal fluid,277.2,180.18,43.02,301.0,19
HCPCS,57022,Incision and drainage of vaginal blood accumulation following delivery,551.3,358.35,78.57,513.14,19
HCPCS,57023,Incision and drainage of vaginal blood accumulation,876.8,569.92,78.57,933.35,19
HCPCS,57061,Simple destruction of growth of vagina,1283.05,833.985,0.01,5810.63,36
HCPCS,57065,Extensive destruction of growth of vagina,603.8,392.47,78.57,592.98,19
HCPCS,57100,Simple biopsy of vaginal mucous membrane,463.0,300.95,0.01,3227.0,55
HCPCS,57105,Biopsy of extensive area of vaginal mucous membrane,425.3,276.45,78.57,424.77,19
HCPCS,57106,Partial removal of vaginal wall,1332.5,866.13,78.57,1509.86,19
HCPCS,57107,Partial removal of vaginal wall and tissue,3951.2,2568.28,78.57,4322.37,19
HCPCS,57109,Partial removal of vaginal wall and tissue with removal of pelvic lymph nodes and biopsy of aortic lymph node,4007.95,2605.17,78.57,5148.3,19
HCPCS,57110,Removal of vaginal wall,2541.0,1651.65,78.57,2683.35,19
HCPCS,57111,Complete removal of vaginal wall and tissue,3805.2,2473.38,78.57,5151.58,19
HCPCS,57120,Suture closure of vagina and vaginal opening,1438.5,935.03,78.57,1541.8,19
HCPCS,57130,Removal of abnormal tissue dividing vagina,735.0,477.75,78.57,555.04,19
HCPCS,57135,Removal of cyst or growth of vaginal,3910.65,2541.925,0.01,18503.61,36
HCPCS,57150,Irrigation of vagina and/or application of drug to treat infection,110.0,71.5,11.22,139.15,19
HCPCS,57155,Insertion of device into uterus for radiation therapy,6602.7,4291.755,78.57,30990.0,38
HCPCS,57156,Insertion of device into vagina for radiation therapy,1024.0,665.6,78.57,4222.39,57
HCPCS,57160,Fitting and insertion of vaginal support device,173.4,112.71000000000001,0.01,418.37,36
HCPCS,57170,Fitting and insertion of pregnancy prevention device,224.7,146.06,37.6,185.95,19
HCPCS,57180,Insertion of drug agent or packing to control vaginal bleeding,382.15,248.4,74.89,8477.27,38
HCPCS,57200,Suture of nonobstetrical injury of vagina,1520.0,988.0,78.57,6451.0,38
HCPCS,57210,Suture of injury of vagina and/or skin,1030.1,669.57,78.57,1118.35,19
HCPCS,57220,Plastic repair of muscles at urinary opening through vagina,750.83,488.04,78.57,975.39,19
HCPCS,57230,Plastic repair of urethra prolapse,928.23,603.35,78.57,1197.75,19
HCPCS,57240,Repair of bladder hernia into vaginal wall,1897.4,1233.31,78.57,1796.32,19
HCPCS,57250,Repair of herniated rectum into vaginal wall,6865.7,4462.705,0.01,30667.19,36
HCPCS,57260,"Plastic repair of vagina and tissue separating vagina, rectum, and bladder",2309.0,1500.85,78.57,2300.19,19
HCPCS,57265,Repair of bulging of rectum and bladder into vaginal wall,2568.3,1669.4,78.57,2581.02,19
HCPCS,57267,Insertion of artificial material for pelvic floor defect,750.8,488.02,78.57,763.74,19
HCPCS,57268,Repair of protrusion of intestine into rectum or vagina through vagina,1351.4,878.41,78.57,1466.33,19
HCPCS,57270,Repair of protrusion of intestine into rectum or vagina through abdomen,2254.4,1465.36,78.57,2414.56,19
HCPCS,57280,Attachment of vagina to rear pelvic bone,2744.7,1784.06,78.57,2877.21,19
HCPCS,57282,Repair of pelvic ligaments through vagina,1423.8,925.47,78.57,1808.6,19
HCPCS,57283,Repair of prolapsing vaginal vault through vagina,1950.9,1268.09,78.57,2072.89,19
HCPCS,57284,Repair of vaginal wall defect through abdomen,2348.9,1526.79,78.57,2467.27,19
HCPCS,57285,Repair of vaginal wall defect through vagina,1935.2,1257.88,78.57,2038.84,19
HCPCS,57287,Removal or revision of incontinence sling,1942.5,1262.63,78.57,2108.82,19
HCPCS,57288,Creation of sling around urethra in female to control leakage,2267.0,1473.55,78.57,2182.35,19
HCPCS,57289,Repair of prolapsed urinary canal and bladder into vaginal wall,2133.6,1386.84,78.57,2301.74,19
HCPCS,57291,Construction of artificial vagina,2835.0,1842.75,78.57,1749.06,19
HCPCS,57292,Construction of artificial vagina using tissue graft,4462.5,2900.63,78.57,2446.06,19
HCPCS,57295,Revision of prosthetic vaginal graft,1210.7,786.96,78.57,1454.56,19
HCPCS,57296,Revision or removal of prosthetic vaginal graft,2685.9,1745.84,78.57,2841.05,19
HCPCS,57300,Closure of abnormal drainage tract from rectum to vagina through vagina or anus,1785.0,1160.25,78.57,1713.05,19
HCPCS,57305,Closure of abnormal drainage tract from rectum to vagina through abdomen,2606.1,1693.97,78.57,2811.38,19
HCPCS,57307,Closure of abnormal drainage tract from rectum to vagina with creation of large bowel opening through abdomen,2790.9,1814.09,78.57,3127.33,19
HCPCS,57308,Closure of abnormal drainage tract from rectum to vagina with perineal reconstruction,2231.3,1450.35,78.57,1988.38,19
HCPCS,57310,Closure of abnormal drainage tract from urethra to vagina,1356.6,881.79,78.57,1438.77,19
HCPCS,57311,Closure of abnormal drainage tract from urethra to vagina with transplant,2953.7,1919.91,78.57,1634.82,19
HCPCS,57320,Closure of abnormal drainage tract from bladder to vagina through vagina,1542.5,1002.63,78.57,1639.51,19
HCPCS,57330,Closure of abnormal drainage tract from bladder to vagina through bladder and vagina,2193.5,1425.78,78.57,2294.01,19
HCPCS,57335,Plastic repair of vagina for intersex state,3299.1,2144.42,78.57,3468.47,19
HCPCS,57400,Dilation of vagina under anesthesia,381.2,247.78,78.57,398.4,19
HCPCS,57410,Pelvic exam under anesthesia,392.7,255.26,78.57,319.09,19
HCPCS,57415,Removal of impacted foreign body in vagina under anesthesia,449.4,292.11,78.57,494.67,19
HCPCS,57420,Exam of vagina and cervix using an endoscope,330.8,215.02,0.01,2166.29,55
HCPCS,57421,Biopsy of vagina and cervix using an endoscope,554.3,360.29499999999996,0.01,3227.0,55
HCPCS,57423,Repair of vaginal defect using an endoscope,2149.38,1397.1,78.57,2756.83,19
HCPCS,57425,Surgical repair of vaginal defect using an endoscope,1991.9,1294.74,78.57,2923.18,19
HCPCS,57426,Revision or removal of prosthetic vaginal graft using an endoscope,2036.0,1323.4,78.57,2553.93,19
HCPCS,57452,Exam of cervix and upper part of vagina using an endoscope,231.0,150.15,0.01,2318.31,55
HCPCS,57454,Biopsy and scraping of cervix using an endoscope,358.0,232.7,0.01,2318.31,55
HCPCS,57455,Biopsy of cervix using an endoscope,343.0,222.95,0.01,2166.29,55
HCPCS,57456,Scraping of cervix using an endoscope,328.0,213.2,0.01,789.07,36
HCPCS,57460,Biopsy of cervix using an endoscope with loop electrode,1530.0,994.5,0.01,5810.63,36
HCPCS,57461,Cone biopsy of cervix and vagina using an endoscope with loop electrode,1573.9,1023.0350000000001,0.01,5810.63,36
HCPCS,57465,Computer-aided mapping of cervix during examination of vagina and cervix using endoscope,99.5,64.68,33.4,130.13,19
HCPCS,57500,Biopsy of cervix or removal of growth,508.0,330.2,0.01,3227.0,55
HCPCS,57505,Scraping of tissue of cervix,478.0,310.7,0.01,3227.0,55
HCPCS,57510,Electro or thermal destruction of cervix,366.5,238.23,43.42,401.14,19
HCPCS,57511,Destruction of cervix using freezing,340.0,221.0,0.01,789.07,36
HCPCS,57513,Laser destruction of cervix,398.0,258.7,78.57,495.24,19
HCPCS,57520,Removal or destruction of cervix with cold knife or laser,877.8,570.57,78.57,888.97,19
HCPCS,57522,Removal or destruction of cervix using loop electrode,1490.0,968.5,0.01,6451.0,55
HCPCS,57530,Amputation of cervix,961.8,625.17,78.57,1054.66,19
HCPCS,57531,Removal of cervix with removal of lymph nodes on both sides of pelvis and aortic lymph node biopsy,4205.63,2733.66,78.57,5061.7,19
HCPCS,57540,Removal of remaining cervix through abdomen,2193.5,1425.78,78.57,2330.99,19
HCPCS,57545,Removal of remaining cervix with repair of pelvic floor through abdomen,1945.8,1264.77,78.57,2463.42,19
HCPCS,57550,Removal of remaining cervix through vagina,1139.3,740.55,78.57,1233.28,19
HCPCS,57555,Removal of remaining cervix with repair of supporting vaginal tissue,1412.08,917.85,78.57,1807.7,19
HCPCS,57556,Removal of remaining cervix with repair of herniated bowel into vaginal wall,1332.13,865.88,78.57,1711.92,19
HCPCS,57558,Dilation and scraping of cervix,346.5,225.23,78.57,379.88,19
HCPCS,57700,Suture of cervix,855.8,556.27,78.57,962.85,19
HCPCS,57720,Plastic repair of cervix,856.8,556.92,78.57,938.46,19
HCPCS,57800,Dilation of cervical canal,2947.95,1916.17,0.01,14797.73,36
HCPCS,58100,Biopsy of lining of uterus,241.0,156.65,0.01,2166.29,55
HCPCS,58110,Exam of cervix using an endoscope with biopsy of lining of uterus,95.0,61.75,0.01,789.07,36
HCPCS,58120,Dilation and scraping of uterus,4157.5,2702.375,0.01,19743.21,36
HCPCS,58140,"Removal of growth of uterus through abdomen, 1-4 growths",2573.6,1672.84,78.57,2748.55,19
HCPCS,58145,"Removal of growth of uterus through vagina, 1-4 growths",1890.0,1228.5,78.57,1654.37,19
HCPCS,58146,Removal of 5 or more growths of uterus through abdomen,3277.1,2130.12,78.57,3443.34,19
HCPCS,58150,Removal of uterus and cervix through abdomen,2792.0,1814.8,78.57,3025.26,19
HCPCS,58152,Removal of uterus and cervix through abdomen with repair of vagina,3518.6,2287.09,78.57,3736.61,19
HCPCS,58180,Removal of uterus through abdomen,2305.8,1498.77,78.57,2872.22,19
HCPCS,58200,Removal of uterus through abdomen with partial removal of vagina,3690.8,2399.02,78.57,4066.39,19
HCPCS,58210,"Removal of uterus, cervix, and lymph nodes of pelvis with biopsy of lymph nodes of aorta",4918.2,3196.83,78.57,5453.56,19
HCPCS,58240,"Removal of malignant uterus, cervix, lymph nodes, and bladder with transplant of ureters and bowel",6318.9,4107.29,78.57,8692.07,19
HCPCS,58260,"Removal of uterus through vagina, 250.0 g or less",1948.8,1266.72,78.57,2479.32,19
HCPCS,58262,"Removal of uterus, tubes, and/or ovaries through vagina, 250.0 g or less",2648.1,1721.27,78.57,2756.68,19
HCPCS,58263,"Removal of uterus, tubes, and/or ovaries with repair of herniated bowel through vagina, 250.0 g or less",2887.5,1876.88,78.57,2962.12,19
HCPCS,58267,"Removal of uterus with repair for incontinence, 250.0 g or less",2986.2,1941.03,78.57,3157.03,19
HCPCS,58270,"Removal of uterus with repair of herniated bowel through vagina, 250.0 g or less",2492.7,1620.26,78.57,2645.79,19
HCPCS,58275,Removal of uterus and vagina,2775.2,1803.88,78.57,2946.16,19
HCPCS,58280,Removal of uterus and vagina with repair of herniated bowel into rectum or vagina through vagina,2969.4,1930.11,78.57,3144.19,19
HCPCS,58285,"Removal of uterus, vagina, and pelvic lymph nodes through vagina",2682.8,1743.82,78.57,4220.86,19
HCPCS,58290,"Removal of uterus through vagina, more than 250.0 g",4593.8,2985.97,78.57,3440.31,19
HCPCS,58291,"Removal of uterus, tubes, and/or ovaries through vagina, more than 250.0 g",5051.6,3283.54,78.57,3743.81,19
HCPCS,58292,"Removal of uterus, tubes, and/or ovaries with repair of herniated bowel through vagina, more than 250.0 g",5350.8,3478.02,78.57,3917.67,19
HCPCS,58294,Removal of uterus with repair of herniated bowel through vagina. 250.0 g or more,4927.7,3203.01,78.57,3635.77,19
HCPCS,58300,Insertion of IUD for pregnancy prevention,170.0,110.5,0.01,2166.29,51
HCPCS,58301,Removal of IUD,273.0,177.45,0.01,2166.29,55
HCPCS,58321,Injection of semen into cervix,179.7,116.81,37.94,195.61,19
HCPCS,58322,Injection of semen into uterus,236.3,153.6,45.23,243.39,19
HCPCS,58323,Sperm washing for artificial insemination,78.8,51.22,9.39,81.16,19
HCPCS,58340,Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes,665.6,432.64,0.01,2166.29,55
HCPCS,58345,Insertion of tube into fallopian tube,879.9,571.94,78.57,839.66,19
HCPCS,58346,Insertion of capsule into uterus for radiation therapy,1086.23,706.05,78.57,1423.83,19
HCPCS,58350,Injection of X-ray contrast into fallopian tube,261.5,169.98,76.75,371.13,19
HCPCS,58353,Destruction of lining of uterus,3485.0,2265.25,56.4,2262.97,19
HCPCS,58356,Destruction of lining of uterus using ultrasound guidance,5502.0,3576.3,65.66,4063.16,19
HCPCS,58400,Repositioning of uterus,1254.8,815.62,78.57,1341.42,19
HCPCS,58410,Repositioning of uterus with removal of nerve,2261.7,1470.11,78.57,2409.18,19
HCPCS,58520,Repair of ruptured uterus,2206.1,1433.97,78.57,2358.58,19
HCPCS,58540,Repair of abnormal uterus,2558.9,1663.29,78.57,2718.4,19
HCPCS,58541,"Partial removal of uterus with retention of cervix using an endoscope, 250.0 g or less",2395.1,1556.82,78.57,2154.15,19
HCPCS,58542,"Partial removal of uterus, tubes, and/or ovaries with retention of cervix using an endoscope, 250.0 g or less",2689.1,1747.92,78.57,2458.94,19
HCPCS,58543,"Partial removal of uterus with retention of cervix using an endoscope, more than 250.0 g",2734.2,1777.23,78.57,2487.93,19
HCPCS,58544,"Partial removal of uterus, tubes, and/or ovaries with retention of cervix using an endoscope, more than 250.0 g",2955.8,1921.27,78.57,2691.03,19
HCPCS,58545,"Removal of growth of uterus using an endoscope, 250.0 g or less",3204.6,2082.99,78.57,2685.0,19
HCPCS,58546,"Removal of growth of uterus using an endoscope, more than 250.0 g",4037.3,2624.25,78.57,3346.31,19
HCPCS,58548,"Removal of uterus, cervix, and lymph nodes of pelvis with biopsy of aortic lymph node using an endoscope",4990.7,3243.96,78.57,5623.16,19
HCPCS,58550,"Removal of uterus through vagina using an endoscope, 250.0 g or less",2486.4,1616.16,78.57,2631.12,19
HCPCS,58552,"Removal of uterus, tubes, and/or ovaries through vagina using an endoscope, 250.0 g or less",3120.6,2028.39,78.57,2941.51,19
HCPCS,58553,"Removal of uterus through vagina using an endoscope, more than 250.0",4011.0,2607.15,78.57,3364.99,19
HCPCS,58554,"Removal of uterus, tubes, and/or ovaries through vagina using an endoscope, more than 250.0 g",3969.0,2579.85,78.57,3940.45,19
HCPCS,58555,Diagnostic exam of uterus using an endoscope,1462.05,950.335,0.01,5810.63,36
HCPCS,58558,Biopsy of lining of uterus and/or removal of polyp using an endoscope,4045.55,2629.61,0.01,18503.61,36
HCPCS,58559,Release of scar tissue of uterus using an endoscope,981.8,638.17,78.57,862.15,19
HCPCS,58560,Release of scar tissue of uterus and release or removal and septum using an endoscope,1108.8,720.72,78.57,946.61,19
HCPCS,58561,Removal of growth of muscle of uterus using an endoscope,1569.8,1020.37,78.57,1084.19,19
HCPCS,58562,Removal of foreign body in uterus using an endoscope,1610.65,1046.925,0.01,5810.63,36
HCPCS,58563,Exam of uterus with destruction of lining of uterus using an endoscope,4893.0,3180.45,78.57,5142.88,19
HCPCS,58565,Placement of implants to block fallopian tubes using an endoscope,5193.3,3375.65,78.57,4043.4,19
HCPCS,58570,"Removal of uterus through abdomen using an endoscope, 250.0 g or less",2590.4,1683.76,78.57,2352.5,19
HCPCS,58571,"Removal of uterus, tubes, and/or ovaries through abdomen using an endoscope, 250.0 g or less",2856.0,1856.4,78.57,2673.41,19
HCPCS,58572,"Removal of uterus through abdomen using an endoscope, more than 250.0 g",3223.5,2095.28,78.57,3070.11,19
HCPCS,58573,"Removal of uterus, tubes, and/or ovaries through abdomen using an endoscope, more than 250.0 g",3666.6,2383.29,78.57,3622.02,19
HCPCS,58575,Removal of uterus for removal of growth using an endoscope,8205.0,5333.25,78.57,5641.41,19
HCPCS,58600,Tying or incision of fallopian tubes,1050.0,682.5,78.57,1091.16,19
HCPCS,58605,Tying or incision of fallopian tubes during same hospitalization,920.0,598.0,78.57,987.91,19
HCPCS,58611,Tying or incision of fallopian tubes during cesarean delivery or other abdominal surgery,525.0,341.25,59.37,254.41,19
HCPCS,58615,Tying of fallopian tubes by device through vagina,1312.5,853.13,78.57,734.71,19
HCPCS,58660,Removal of scar tissue of ovaries or fallopian tubes using an endoscope,1891.1,1229.22,78.57,2011.11,19
HCPCS,58661,Removal of ovaries and/or tubes using an endoscope,3268.2,2124.33,78.57,1940.52,19
HCPCS,58662,Destruction or removal of ovary or growth of pelvis using an endoscope,2178.8,1416.22,78.57,2118.81,19
HCPCS,58670,Destruction of fallopian tubes using an endoscope,1391.3,904.35,78.57,1091.83,19
HCPCS,58671,Blockage of uterine tubes by device using an endoscope,1038.5,675.03,78.57,1092.18,19
HCPCS,58672,Repair of uterine tube tissue near ovary using an endoscope,2092.7,1360.26,78.57,2189.57,19
HCPCS,58673,Repair of uterine tube using an endoscope,2276.4,1479.66,78.57,2377.9,19
HCPCS,58674,Destruction of growth of uterus using an endoscope with ultrasound guidance and monitoring,1925.8,1251.77,78.57,2433.0,19
HCPCS,58700,Removal of uterine tubes,2142.0,1392.3,78.57,2327.48,19
HCPCS,58720,Removal of uterine tubes and ovaries,2060.1,1339.07,78.57,2207.14,19
HCPCS,58740,Removal of scar tissue of ovaries or fallopian tubes,2456.0,1596.4,78.57,2652.99,19
HCPCS,58750,Release of blocked uterine tube,2555.7,1661.21,78.57,2696.48,19
HCPCS,58752,Reconnection of fallopian tubes following tubal ligation,2543.1,1653.02,78.57,2689.19,19
HCPCS,58760,Repair of blocked ovarian end of uterine tube,2305.8,1498.77,78.57,2425.52,19
HCPCS,58770,Repair of blocked uterine tube opening,2374.1,1543.17,78.57,2552.48,19
HCPCS,58800,Drainage of cysts of ovaries through vagina,890.4,578.76,78.57,902.78,19
HCPCS,58805,Drainage of cysts of ovaries through abdomen,1135.1,737.82,78.57,1225.8,19
HCPCS,58820,Drainage of abscess of ovaries through vagina,945.0,614.25,78.57,952.27,19
HCPCS,58822,Drainage of abscess of ovaries through abdomen,1764.35,1146.83,78.57,7441.0,38
HCPCS,58825,Relocation of ovaries behind uterus,1958.3,1272.9,78.57,2082.76,19
HCPCS,58900,Biopsy of ovaries,1158.2,752.83,78.57,1251.17,19
HCPCS,58920,Partial removal of ovaries,1969.8,1280.37,78.57,2100.23,19
HCPCS,58925,Removal of cysts of ovaries,2111.6,1372.54,78.57,2235.37,19
HCPCS,58940,Removal of ovaries,1680.0,1092.0,78.57,1582.65,19
HCPCS,58943,Removal of ovaries for ovarian cancer,3144.8,2044.12,78.57,3494.61,19
HCPCS,58950,"Removal of lining of abdomen, ovaries, and fallopian tubes",2999.9,1949.94,78.57,3370.51,19
HCPCS,58951,"Removal of lining of abdomen, uterus, ovaries, fallopian tubes, and lymph nodes of pelvis and aorta",3875.6,2519.14,78.57,4306.27,19
HCPCS,58952,"Removal of lining of abdomen, ovaries, and fallopian tubes with reduction of growth",4369.1,2839.92,78.57,4879.86,19
HCPCS,58953,"Removal of lining of abdomen, uterus, ovaries, and fallopian tubes with extensive reduction of growth",5420.1,3523.07,78.57,6010.66,19
HCPCS,58954,"Removal of lining of abdomen, uterus, ovaries, fallopian tubes, and lymph nodes of pelvis and aorta for reduction of growth",5883.2,3824.08,78.57,6519.67,19
HCPCS,58956,"Removal of lining of abdomen, uterus, ovaries, and fallopian tubes",3731.7,2425.61,78.57,4088.05,19
HCPCS,58958,"Removal of uterus, ovaries, fallopian tubes, and lymph nodes for reduction of growth with lymph node dissection",4635.8,3013.27,78.57,5069.6,19
HCPCS,58960,Exam of abdominal cavity with removal or biopsy of abdominal lining or lymph nodes,2590.4,1683.76,78.57,2886.08,19
HCPCS,58970,Removal of eggs from ovaries,787.5,511.88,78.57,811.13,19
HCPCS,58974,Injection of fertilized eggs into uterus,353.9,230.04,78.57,440.46,15
HCPCS,58976,Insertion of eggs with sperm into fallopian tubes,1260.0,819.0,78.57,1297.8,19
HCPCS,58999,Other procedure on female genital system (nonobstetrical),567.0,368.55,141.75,2166.29,19
HCPCS,59000,Removal of sample of amniotic fluid surrounding fetus for diagnosis,460.35,299.23,0.01,3227.0,55
HCPCS,59001,Removal of amniotic fluid to reduce amount of fluid surrounding fetus using ultrasound guidance,495.6,322.14,78.57,510.58,19
HCPCS,59012,Removal of blood from fetal umbilical cord,559.7,363.81,78.57,575.65,19
HCPCS,59015,Removal of tissue from placenta for diagnosis,275.55,179.11,0.01,856.15,36
HCPCS,59020,Fetal contraction stress test,148.2,96.33,32.28,1242.0,57
HCPCS,59025,Fetal test,189.15,122.95,26.1,1242.0,57
HCPCS,59030,Removal of blood from scalp of fetus,219.5,142.68,61.75,321.29,19
HCPCS,59050,Fetal monitoring during labor by consulting physician,112.98,73.44,38.33,144.05,19
HCPCS,59051,Interpretation of fetal monitoring during labor by consulting physician,96.65,62.82,31.45,119.55,19
HCPCS,59070,Infusion of normal saline into fetal amniotic sac using ultrasound guidance,916.2,595.53,0.01,1890.39,36
HCPCS,59072,Occlusion of fetal umbilical cord using ultrasound guidance,1399.7,909.81,78.57,1490.74,19
HCPCS,59074,Drainage of fetal fluid using ultrasound guidance,1062.6,690.69,78.57,883.92,19
HCPCS,59076,Placement of shunt into fetal chest using ultrasound guidance,1370.3,890.7,78.57,1490.74,19
HCPCS,59100,Incision of uterus,2244.9,1459.19,78.57,2425.9,19
HCPCS,59120,Removal of ovarian or tubal pregnancy with removal of ovaries,1545.6,1004.64,78.57,2311.01,19
HCPCS,59121,Removal of ovarian or tubal pregnancy,2154.6,1400.49,78.57,2313.49,19
HCPCS,59130,Removal of pregnancy contents in abdominal cavity,1782.9,1158.89,78.57,2695.89,19
HCPCS,59136,Removal of tubal pregnancy and repair of uterine wall,2332.1,1515.87,78.57,2553.51,19
HCPCS,59140,Removal of impregnated ovum outside uterus,1065.8,692.77,78.57,1172.8,19
HCPCS,59150,Removal of ovarian or tubal pregnancy using an endoscope,1499.4,974.61,78.57,2240.53,19
HCPCS,59151,Removal of ovarian or tubal pregnancy with removal of ovary and/or tube using an endoscope,1464.8,952.12,78.57,2180.51,19
HCPCS,59160,Scraping of lining of uterus after delivery,1345.5,874.575,0.01,5810.63,36
HCPCS,59200,Insertion of dilator device into cervix,543.5,353.275,0.01,2239.03,55
HCPCS,59300,Episiotomy or repair of vagina,499.8,324.87,78.57,534.78,19
HCPCS,59320,Suture of cervix during pregnancy through vagina,4324.0,2810.6,78.57,21357.28,38
HCPCS,59325,Suture of cervix during pregnancy through abdomen,646.8,420.42,78.57,986.66,19
HCPCS,59350,Repair of tear of uterus,762.3,495.5,78.57,797.23,19
HCPCS,59400,Vaginal delivery with care before and after delivery,4220.0,2743.0,78.57,6111.83,19
HCPCS,59409,Vaginal delivery,2594.0,1686.1,78.57,8801.16,38
HCPCS,59410,Vaginal delivery with post delivery care,2063.5,1341.275,78.57,5183.08,38
HCPCS,59412,Turning of fetus through external manipulation,3549.7,2307.305,78.57,17607.49,38
HCPCS,59414,Delivery of placenta,3262.0,2120.3,70.88,16150.96,38
HCPCS,59425,"Predelivery care, 4 to 6 visits",900.0,585.0,0.01,1549.5,36
HCPCS,59426,"Predelivery care, 7 or more visits",1325.0,861.25,0.01,2356.94,36
HCPCS,59430,Post delivery care,230.0,149.5,0.01,612.07,36
HCPCS,59510,Cesarean delivery with care before and after delivery,4680.0,3042.0,78.57,6735.71,19
HCPCS,59514,Cesarean delivery,2100.0,1365.0,78.57,2640.88,19
HCPCS,59515,Cesarean delivery with care after delivery,3603.0,2341.95,78.57,11197.72,38
HCPCS,59525,Cesarean delivery with removal of uterus,1125.6,731.64,78.57,1379.17,19
HCPCS,59610,Vaginal delivery and care before and after delivery after previous cesarean delivery,4350.0,2827.5,78.57,6387.26,19
HCPCS,59612,Vaginal delivery after previous cesarean delivery,2000.0,1300.0,78.57,2631.33,19
HCPCS,59614,Vaginal delivery and care after delivery after prior cesarean delivery,2233.4,1451.71,78.57,3269.46,19
HCPCS,59618,Cesarean delivery and care before and after delivery following attempted vaginal delivery after previous cesarean delivery,4540.0,2951.0,78.57,6817.23,19
HCPCS,59620,Cesarean delivery following vaginal delivery attempt after previous cesarean delivery,2280.0,1482.0,78.57,2716.35,19
HCPCS,59622,Cesarean delivery with care after delivery following vaginal delivery attempt after previous cesarean delivery,2586.2,1681.03,78.57,3751.68,19
HCPCS,59812,Treatment of miscarriage,1475.0,958.75,0.01,8023.32,55
HCPCS,59820,Treatment of miscarriage during first trimester,1810.71,1176.96,0.01,8023.32,55
HCPCS,59821,Treatment of miscarriage during second trimester,3240.0,2106.0,0.01,14797.73,36
HCPCS,59830,Treatment of miscarriage from infection,916.7,595.86,78.57,1283.69,19
HCPCS,59840,Induced abortion by dilation and scraping of uterine,4138.95,2690.32,0.01,19756.13,36
HCPCS,59841,Induced abortion by dilation,1621.15,1053.75,0.01,5810.63,36
HCPCS,59850,Induced abortion by amniotic fluid injection,805.4,523.51,78.57,1094.75,19
HCPCS,59851,Induced abortion by injection into amniotic fluid with dilation and removal of pregnancy contents,846.3,550.1,78.57,1177.34,19
HCPCS,59852,Induced abortion by injection into amniotic fluid,1184.4,769.86,78.57,1611.86,19
HCPCS,59855,Induced abortion by insertion of vaginal suppository,877.8,570.57,78.57,1205.51,19
HCPCS,59856,Induced abortion by insertion of vaginal suppository with dilation and removal of pregnancy contents,1040.6,676.39,78.57,1414.72,19
HCPCS,59857,Induced abortion by insertion of vaginal suppository with incision of uterus,1276.8,829.92,78.57,1620.94,19
HCPCS,59866,Elimination of fetuses of a multifetal pregnancy,522.9,339.89,78.57,670.67,19
HCPCS,59870,Removal of abnormal pregnancy contents with scraping of uterine wall,916.7,595.86,78.57,1418.64,19
HCPCS,59871,Removal of suture of cervix under anesthesia,2444.8,1589.12,78.57,11621.25,38
HCPCS,60000,Incision and drainage of cyst of thyroid duct,433.7,281.91,68.85,479.26,19
HCPCS,60100,Needle biopsy of thyroid through skin,504.05,327.635,0.01,3227.0,55
HCPCS,60200,Incision of cyst or growth of thyroid,1875.3,1218.95,78.57,1958.91,19
HCPCS,60210,Partial removal of thyroid lobe on side of neck,2257.5,1467.38,78.57,2089.68,19
HCPCS,60212,Partial removal of thyroid lobes on both sides of neck and connecting tissue,2757.3,1792.25,78.57,2982.53,19
HCPCS,60220,Removal of thyroid lobe on side of neck,2204.0,1432.6,78.57,2093.56,19
HCPCS,60225,Removal of thyroid lobe on side of neck and partial removal of thyroid lobe on opposite side of neck including tissue in between,2730.0,1774.5,78.57,2756.35,19
HCPCS,60240,Removal of thyroid,2776.2,1804.53,78.57,2715.47,19
HCPCS,60252,Removal of thyroid and surrounding lymph nodes with limited neck removal,3885.0,2525.25,78.57,3904.7,19
HCPCS,60254,Removal of thyroid and surrounding lymph nodes with extensive neck removal,4856.3,3156.6,78.57,4965.55,19
HCPCS,60260,Removal of remaining thyroid tissue from prior operation,3009.3,1956.05,78.57,3239.76,19
HCPCS,60270,Removal of thyroid from under breastbone,3798.9,2469.29,78.57,4042.65,19
HCPCS,60271,Removal of thyroid through chest or back,2912.7,1893.26,78.57,3133.25,19
HCPCS,60280,Removal of cyst of thyroid or drainage of thyroid gland duct,1653.8,1074.97,78.57,1324.18,19
HCPCS,60281,Removal of recurrent cyst of thyroid or drainage of thyroid gland duct,1815.5,1180.08,78.57,1759.16,19
HCPCS,60300,Aspiration and/or injection of cyst of thyroid,647.0,420.55,0.01,4170.74,55
HCPCS,60500,Removal or exploration of parathyroid glands,2849.7,1852.31,78.57,2848.19,19
HCPCS,60502,Removal or re-exploration of parathyroid glands,3461.9,2250.24,78.57,3801.41,19
HCPCS,60505,Removal or exploration of parathyroid glands and breast bone tissue,3806.3,2474.1,78.57,4127.81,19
HCPCS,60512,Removal and reimplantation of parathyroid tissue,698.3,453.9,78.57,717.69,19
HCPCS,60520,Removal of thymus gland through neck,3097.5,2013.38,78.57,3057.68,19
HCPCS,60521,Removal of thymus gland through sternum or chest,3381.0,2197.65,78.57,3278.42,19
HCPCS,60522,Removal of thymus gland surrounding lymph nodes through sternum or chest,3937.5,2559.38,78.57,3997.22,19
HCPCS,60540,Removal or exploration of adrenal gland through abdomen,4479.3,2911.55,78.57,3168.66,19
HCPCS,60545,Removal or exploration of adrenal gland through abdomen with removal of growth abdomen,3753.8,2439.97,78.57,3625.37,19
HCPCS,60600,Removal of growth of carotid artery,4000.5,2600.33,78.57,4005.31,19
HCPCS,60605,Removal of carotid artery and growth,5048.4,3281.46,78.57,4764.98,19
HCPCS,60650,Removal or exploration of adrenal gland through abdomen using an endoscope,5024.25,3265.76,78.57,3535.74,19
HCPCS,60660,Destruction using heat of one or more nodules on one thyroid lobe,741.0,481.65,78.57,5893.63,19
HCPCS,60661,Destruction using heat of one or more nodules on additional thyroid lobe,515.0,334.75,78.57,949.41,19
HCPCS,60699,Other procedure on endocrine system,12593.0,8185.45,2166.29,32521.42,19
HCPCS,61000,"Initial removal of cerebrospinal fluid from skull bone soft spot, infant",309.8,201.37,78.57,314.28,19
HCPCS,61001,Subsequent aspiration of cerebrospinal fluid from infant skull bone soft spot,297.2,193.18,78.57,302.48,19
HCPCS,61020,Removal of cerebrospinal fluid from brain for diagnosis,829.0,538.85,78.57,3359.83,38
HCPCS,61026,Removal of cerebrospinal fluid from brain and injection of substance,966.0,627.9,78.57,4067.44,38
HCPCS,61050,Removal of cerebrospinal fluid from upper spine,240.5,156.325,46.75,2166.29,38
HCPCS,61055,Spinal puncture in upper spine with injection of substance,477.0,310.05,78.57,2166.29,38
HCPCS,61070,Aspiration of cerebrospinal fluid and injection in shunt tubing or reservoir,823.0,534.95,46.98,3227.0,76
HCPCS,61105,Creation of opening in skull for removal of fluid from brain,1470.0,955.5,78.57,1311.46,19
HCPCS,61107,Creation of opening in skull for insertion of brain tube or monitoring device,1268.9,824.7850000000001,78.57,8477.27,57
HCPCS,61108,Creation of opening in skull for removal and/or drainage of blood accumulation outside brain,2835.0,1842.75,78.57,2541.58,19
HCPCS,61120,Burr hole for injection into ventricle of brain,1852.2,1203.93,78.57,2106.57,19
HCPCS,61140,Burr hole with drainage or biopsy of brain or growth,3412.5,2218.13,78.57,3562.4,19
HCPCS,61150,Burr hole with drainage of abscess or cyst of brain,3553.2,2309.58,78.57,3811.32,19
HCPCS,61151,Burr hole with subsequent aspiration of abscess or cyst of brain,2488.5,1617.53,78.57,2802.29,19
HCPCS,61154,Burr hole with removal and/or drainage of blood accumulation outside or below brain membrane,3538.75,2300.19,78.57,8477.27,38
HCPCS,61156,Burr hole with aspiration of blood accumulation or cyst of brain,3412.5,2218.13,78.57,3501.22,19
HCPCS,61210,Burr hole for insertion of brain tube or monitoring device,1152.5,749.125,78.57,8477.27,38
HCPCS,61215,Insertion of device for continuous infusion in brain,1268.4,824.46,78.57,1446.91,19
HCPCS,61250,Burr hole for exploration of upper brain,2157.8,1402.57,78.57,2440.08,19
HCPCS,61253,Burr hole for exploration of lower brain,2940.0,1911.0,78.57,2791.34,19
HCPCS,61304,Removal of skull bone for exploration of upper brain,4567.5,2968.88,78.57,4628.7,19
HCPCS,61305,Removal of skull bone for exploration of lower brain,5157.6,3352.44,78.57,5633.93,19
HCPCS,61312,Removal of skull bone for aspiration of blood accumulation in upper brain outside or below brain membrane,5471.6,3556.54,78.57,5827.33,19
HCPCS,61313,Removal of skull bone for aspiration of blood accumulation in upper brain,5617.5,3651.38,78.57,5576.52,19
HCPCS,61314,Removal of skull bone for aspiration of blood accumulation in lower brain outside or below brain membrane,4805.9,3123.84,78.57,5132.6,19
HCPCS,61315,Removal of skull bone for aspiration of blood accumulation in lower brain,5435.9,3533.34,78.57,5802.45,19
HCPCS,61316,Placement of bone graft in skull,212.1,137.87,66.99,243.44,19
HCPCS,61320,Removal of skull bone for drainage of upper brain abscess,5355.0,3480.75,78.57,5339.51,19
HCPCS,61321,Removal of skull bone for drainage of lower brain abscess,5394.9,3506.69,78.57,5951.39,19
HCPCS,61322,Removal of skull bone to reduce brain pressure,6006.0,3903.9,78.57,6681.28,19
HCPCS,61323,Removal of skull bone and brain lobe to reduce brain pressure,6101.6,3966.04,78.57,6692.75,19
HCPCS,61330,Incision of eye bone to reduce pressure,4342.8,2822.82,78.57,5031.6,19
HCPCS,61333,Exploration and removal of bone growth of eye socket,5014.8,3259.62,78.57,5673.02,19
HCPCS,61340,Incision of skull to reduce brain pressure,3659.3,2378.55,78.57,4028.65,19
HCPCS,61343,Removal of skull base bone and upper spine bone to release spinal cord,7927.5,5152.88,78.57,6158.61,19
HCPCS,61345,Removal of base of skull to reduce pressure on brain,5233.2,3401.58,78.57,5725.3,19
HCPCS,61450,Removal of skull bone to reduce facial nerve pressure,5052.6,3284.19,78.57,5383.45,19
HCPCS,61458,Removal of skull base bone for exploration or release of cranial nerves,6195.0,4026.75,78.57,5650.1,19
HCPCS,61460,Removal of skull base bone to sever cranial nerve,6011.3,3907.35,78.57,5910.09,19
HCPCS,61500,Removal of growth of brain or other growth of skull bone,3979.0,2586.35,78.57,3779.34,38
HCPCS,61501,Removal of infected skull bone,3990.0,2593.5,78.57,3299.98,19
HCPCS,61510,Removal of skull bone for removal of growth of upper brain,7008.8,4555.72,78.57,6159.56,19
HCPCS,61512,Removal of skull bone for removal of growth of upper brain membrane,7350.0,4777.5,78.57,7168.01,19
HCPCS,61514,Removal of skull bone for removal of upper brain abscess,5906.3,3839.1,78.57,5370.45,19
HCPCS,61516,Removal of skull bone for removal or drainage of cyst of upper brain,5906.3,3839.1,78.57,5243.98,19
HCPCS,61517,Implantation of chemotherapy agent into brain,230.0,149.5,66.65,241.25,19
HCPCS,61518,Removal of skull bone for removal of growth of lower brain,7008.8,4555.72,78.57,7762.46,19
HCPCS,61519,Removal of skull bone for removal of growth of lower brain membrane,7471.8,4856.67,78.57,8261.13,19
HCPCS,61520,Removal of skull bone for removal of eighth cranial nerve brain growth,9743.0,6332.95,78.57,10617.08,19
HCPCS,61521,Removal of skull bone for removal of skull base bone growth,8092.4,5260.06,78.57,8902.94,19
HCPCS,61522,Removal of skull bone for removal of brain abscess,5880.0,3822.0,78.57,6097.54,19
HCPCS,61524,Removal of skull bone for removal or drainage of cyst of brain,5880.0,3822.0,78.57,5841.3,19
HCPCS,61526,Removal of skull bone with bone flap for removal of eighth cranial nerve brain tumor,9114.0,5924.1,78.57,9710.13,19
HCPCS,61530,Removal of skull bone with bone flap for removal of eighth cranial nerve brain tumor with middle/posterior skull bone removal,7732.2,5025.93,78.57,8610.88,19
HCPCS,61531,Implantation of brain strip electrodes for seizure monitoring,3780.0,2457.0,78.57,3425.28,19
HCPCS,61533,Removal of skull bone for insertion of brain electrode for seizure monitoring,4200.0,2730.0,78.57,4272.7,19
HCPCS,61534,Removal of skull bone for removal of brain tissue to stop seizures,4191.6,2724.54,78.57,4601.43,19
HCPCS,61535,Removal of skull bone for removal of electrode from brain,2625.0,1706.25,78.57,2817.33,19
HCPCS,61536,Removal of skull bone for removal of brain tissue to stop seizures with monitoring,6672.8,4337.32,78.57,7219.14,19
HCPCS,61537,Removal of skull bone for removal of brain lobe,6229.7,4049.31,78.57,6893.16,19
HCPCS,61538,Removal of skull bone for removal of brain lobe with monitoring,6664.4,4331.86,78.57,7458.04,19
HCPCS,61539,Removal of skull bone for removal of brain lobe (other than temporal lobe) with monitoring,6510.0,4231.5,78.57,6640.17,19
HCPCS,61540,Removal of skull bone for removal of brain lobe (other than temporal lobe),5639.6,3665.74,78.57,6091.99,19
HCPCS,61541,Removal of skull bone for incision of brain tissue,6300.0,4095.0,78.57,6022.92,19
HCPCS,61543,Removal of skull bone for partial removal of brain,5775.0,3753.75,78.57,6027.32,19
HCPCS,61544,Removal of skull bone for removal or clotting of cerebrospinal fluid site,5460.0,3549.0,78.57,5347.24,19
HCPCS,61545,Removal of skull bone with bone flap for removal of growth of pituitary gland,8086.1,5255.97,78.57,8920.88,19
HCPCS,61546,Removal of skull bone for removal of growth of pituitary gland,6667.5,4333.88,78.57,6468.28,19
HCPCS,61548,Removal of growth of pituitary gland,4088.7,2657.66,78.57,4473.27,19
HCPCS,61550,Removal of skull bone for repair of single skull suture defect present at birth,2861.3,1859.85,78.57,3253.58,19
HCPCS,61552,Removal of skull bone for repair of multiple skull suture defects present at birth,4200.0,2730.0,78.57,4172.59,19
HCPCS,61556,Removal of skull bone for incision of prematurely closed skull suture,4250.4,2762.76,78.57,4798.84,19
HCPCS,61557,Removal of frontal skull bone for incision of prematurely closed skull suture,3736.58,2428.78,78.57,4736.34,19
HCPCS,61558,Extensive removal of skull bone for multiple skull suture defects,3572.1,2321.87,78.57,5287.94,19
HCPCS,61559,Extensive removal of skull bone with bone grafts for multiple skull suture defects to restore skull shape,5969.3,3880.05,78.57,6590.29,19
HCPCS,61563,Removal of growth of skull bone,6883.8,4474.47,78.57,5542.57,19
HCPCS,61564,Removal of growth of skull bone with release of optic nerve,5174.55,3363.46,78.57,6768.62,19
HCPCS,61566,Removal of skull bone for removal of brain tissue to relieve seizure activity,5783.4,3759.21,78.57,6268.44,19
HCPCS,61567,Removal of skull bone for incision of brain tissue for seizures with monitoring,6564.6,4266.99,78.57,7107.24,19
HCPCS,61570,Removal of foreign body in brain,5250.0,3412.5,78.57,5240.32,19
HCPCS,61571,Treatment of penetrating brain wound,6300.0,4095.0,78.57,5552.01,19
HCPCS,61575,"Biopsy, release of pressure, or removal of growth of brain stem of upper spinal cord",6231.8,4050.67,78.57,7033.86,19
HCPCS,61576,Biopsy of brain stem or upper spinal cord with splitting of tongue and lower jaw bone,8489.4,5518.11,78.57,11778.46,19
HCPCS,61580,Removal of nasal sinuses to approach growth of brain,6596.1,4287.47,78.57,7215.88,19
HCPCS,61581,Removal of nasal sinuses to approach growth of brain with the removal of the maxilla or eyeball,7403.6,4812.34,78.57,7962.78,19
HCPCS,61582,Removal of facial bone to approach growth of brain outside brain membrane,7403.6,4812.34,78.57,8633.92,19
HCPCS,61583,Removal of facial bone to approach growth of brain within brain membrane,7444.5,4838.93,78.57,8184.87,19
HCPCS,61584,Removal of facial bone to approach growth of brain without orbital exenteration,7284.9,4735.19,78.57,8119.69,19
HCPCS,61585,Removal of facial bone and eyeball to approach growth of brain,7820.4,5083.26,78.57,9141.93,19
HCPCS,61586,Removal of facial bone to approach growth of brain without bone graft,5622.8,3654.82,78.57,6922.33,19
HCPCS,61590,Removal of jaw bone to approach growth of brain,8392.7,5455.26,78.57,9030.99,19
HCPCS,61591,Removal of skull bone behind ear to approach growth of brain,8433.6,5481.84,78.57,9061.7,19
HCPCS,61592,Removal of cheek bone and skull to approach growth of brain,8047.2,5230.68,78.57,8985.93,19
HCPCS,61595,Removal of skull bone behind ear to approach growth of brain through the temporal lobe,6328.4,4113.46,78.57,6901.47,19
HCPCS,61596,Removal of skull bone behind ear to approach growth of brain through the ear,7025.6,4566.64,78.57,7330.65,19
HCPCS,61597,Removal of base skull bone to approach growth of brain,7443.5,4838.28,78.57,8294.39,19
HCPCS,61598,Removal of skull bone to approach growth of brain or defect at skull base with tying of sinus,6694.8,4351.62,78.57,8022.15,19
HCPCS,61600,Removal of growth or tissue of front of skull base outside membranes covering brain,5685.8,3695.77,78.57,6277.36,19
HCPCS,61601,Removal of growth or tissue of front of skull base within membranes covering brain,6087.9,3957.14,78.57,6839.57,19
HCPCS,61605,Removal of growth or tissue of lower skull base outside brain membrane,6012.3,3908.0,78.57,6458.19,19
HCPCS,61606,Removal of growth or tissue of lower skull base within brain membrane,7815.2,5079.88,78.57,8386.58,19
HCPCS,61607,Removal of growth or tissue of middle skull base outside brain membrane,7406.7,4814.36,78.57,7818.34,19
HCPCS,61608,Removal of growth or tissue of middle skull base within brain membrane,8249.9,5362.44,78.57,9227.11,19
HCPCS,61611,Incision or tying of carotid artery at skull base,1085.7,705.71,78.57,1294.67,19
HCPCS,61613,Destruction of abnormal blood vessel at skull base,8244.6,5358.99,78.57,9278.64,19
HCPCS,61615,Removal of growth or tissue of skull base outside brain membrane,6604.5,4292.93,78.57,7920.94,19
HCPCS,61616,Removal of growth or tissue of skull base within brain membrane,8574.3,5573.3,78.57,9491.77,19
HCPCS,61618,Repair of brain covering by tissue or synthetic graft,4200.0,2730.0,78.57,3687.52,19
HCPCS,61619,Repair of brain covering by vascular or combined vascular muscle graft,3910.2,2541.63,78.57,4144.39,19
HCPCS,61623,Balloon occlusion of head or neck artery with review by radiologist,6105.05,3968.285,78.57,27516.54,38
HCPCS,61624,Occlusion of central nervous system or spinal cord artery,8244.0,5358.6,78.57,120938.48,57
HCPCS,61626,Occlusion of head or neck artery,9130.0,5934.5,78.57,76157.93,57
HCPCS,61630,Balloon dilation of blood vessel in head,5286.65,3436.325,78.57,20863.33,38
HCPCS,61635,Insertion of stent in blood vessel of head,11298.75,7344.1900000000005,78.57,48842.82,38
HCPCS,61640,Balloon dilation of blood vessel spasm in head,10506.5,6829.225,78.57,48842.82,34
HCPCS,61641,Balloon dilation of additional blood vessel spasm in head in same vessel family,6945.75,4514.74,78.57,32485.27,34
HCPCS,61642,Balloon dilation of additional blood vessel spasm in head in different vessel family,8196.75,5327.889999999999,78.57,38946.68,34
HCPCS,61645,Removal of blood clot and injection to dissolve blood clot from head artery using fluoroscopic guidance,7590.75,4933.99,78.57,32190.86,38
HCPCS,61650,"Infusion of chemical agent into artery of brain with insertion of tube and imaging, initial territory",3317.0,2156.05,78.57,20863.33,38
HCPCS,61651,"Infusion of chemical agent into artery of brain with insertion of tube and imaging, each additional territory",1426.0,926.9,78.57,20863.33,38
HCPCS,61680,Simple repair of abnormal artery-vein connection in upper brain,7008.8,4555.72,78.57,6347.55,19
HCPCS,61682,Complex repair of abnormal artery-vein connection in upper brain,10726.8,6972.42,78.57,11616.79,19
HCPCS,61684,Simple repair of abnormal artery-vein connection in lower brain,8190.0,5323.5,78.57,7966.6,19
HCPCS,61686,Complex repair of abnormal artery-vein connection in lower brain,11572.1,7521.87,78.57,12541.08,19
HCPCS,61690,Simple repair of abnormal artery-vein connection in membrane covering brain,6090.0,3958.5,78.57,6119.68,19
HCPCS,61692,Complex repair of abnormal artery-vein connection in membrane covering brain,9356.6,6081.79,78.57,10199.07,19
HCPCS,61697,Repair of complex aneurysm of neck artery,10820.3,7033.2,78.57,11808.59,19
HCPCS,61698,Repair of complex aneurysm of back of brain artery,11714.9,7614.69,78.57,12913.2,19
HCPCS,61700,Repair of simple aneurysm of neck artery,8719.2,5667.48,78.57,9551.95,19
HCPCS,61702,Repair of simple aneurysm of back of brain artery,10193.4,6625.71,78.57,11239.66,19
HCPCS,61703,Repair of aneurysm of neck artery with clamp,4200.0,2730.0,78.57,3793.42,19
HCPCS,61705,Repair of abnormal blood vessel in brain by clamping neck artery,7008.8,4555.72,78.57,7201.63,19
HCPCS,61708,Repair of abnormal blood vessel in brain by creating clot using electricity,6221.3,4043.85,78.57,7151.45,19
HCPCS,61710,Repair of abnormal blood vessel in brain by creating obstruction,5142.9,3342.89,78.57,6033.55,19
HCPCS,61711,Connection of arteries of head,6786.2,4411.03,78.57,7262.31,19
HCPCS,61720,Computer-assisted creation of growth of brain of globus pallidus or thalamus,4200.0,2730.0,78.57,3577.91,19
HCPCS,61735,Computer-assisted creation of growth of brain of deep brain structure,4410.0,2866.5,78.57,4479.72,19
HCPCS,61736,"Laser interstitial thermal therapy (LITT) of single, simple growth within skull",2063.0,1340.95,78.57,2931.94,19
HCPCS,61737,Laser interstitial thermal therapy (LITT) of multiple or complex growth within skull,2450.0,1592.5,78.57,3477.02,19
HCPCS,61750,"Computer-assisted biopsy, aspiration, or excision of growth of brain",3990.0,2593.5,78.57,3967.45,19
HCPCS,61751,"Computer-assisted biopsy, aspiration, or excision of growth of brain using CT and/or MRI guidance",4305.0,2798.25,78.57,3888.55,19
HCPCS,61760,Computer-assisted implantation of brain electrodes for seizure monitoring,3956.4,2571.66,78.57,4415.51,19
HCPCS,61770,Computer-assisted insertion of tube or probe for radiation placement,4725.0,3071.25,78.57,4566.83,19
HCPCS,61781,Computer-assisted procedure inside brain,572.5,372.125,78.57,5620.39,38
HCPCS,61782,Computer-assisted procedure outside membrane covering brain,456.8,296.92,78.57,524.29,19
HCPCS,61783,Computer-assisted spinal procedure,545.0,354.25,78.57,653.25,19
HCPCS,61790,Computer-assisted creation of growth of face nerve,2940.0,1911.0,78.57,2485.26,19
HCPCS,61791,Computer-assisted creation of growth of brainstem,2830.8,1840.02,78.57,3169.89,19
HCPCS,61796,"Computer-assisted radiosurgery of simple growth of brain, first growth",2048.6,1331.59,78.57,2859.1,19
HCPCS,61797,"Computer-assisted radiosurgery of simple growth of brain, each additional growth",556.5,361.73,78.57,607.06,19
HCPCS,61798,"Computer-assisted radiosurgery of complex growth of brain, first growth",3050.0,1982.5,78.57,3892.89,19
HCPCS,61799,"Computer-assisted radiosurgery of complex growth of brain, each additional growth",768.6,499.59,78.57,838.37,19
HCPCS,61800,Computer-assisted radiosurgery application of headframe,385.4,250.51,78.57,422.56,19
HCPCS,61850,Creation of opening in skull for insertion of neurostimulator electrodes in brain,2500.1,1625.07,78.57,2746.65,19
HCPCS,61860,Removal of skull bone for insertion of neurostimulator electrodes in brain,4002.6,2601.69,78.57,4392.81,19
HCPCS,61863,"Removal of skull bone with computer-assisted insertion of neurostimulator electrodes in brain, first array",3847.2,2500.68,78.57,4228.49,19
HCPCS,61864,"Removal of skull bone with computer-assisted insertion of neurostimulator electrodes in brain, each additional array",889.4,578.11,78.57,782.61,19
HCPCS,61867,"Removal of skull bone with computer-assisted insertion of neurostimulator electrodes in brain with recording, first array",5808.6,3775.59,78.57,6403.98,19
HCPCS,61868,"Removal of skull bone with computer-assisted insertion of neurostimulator electrodes in brain with recording, each additional array",1379.7,896.81,78.57,1380.43,19
HCPCS,61880,Revision or removal of brain neurostimulator electrodes,1680.0,1092.0,78.57,1622.16,19
HCPCS,61885,Insertion of brain neurostimulator pulse device with connection to single electrode array,2431.8,1580.67,78.57,1469.89,19
HCPCS,61886,Insertion of brain neurostimulator pulse device with connection to 2 or more electrode arrays,2050.7,1332.96,78.57,2419.03,19
HCPCS,61888,Removal of brain neurostimulator device,1254.8,815.62,78.57,1120.51,19
HCPCS,61892,Removal of skull-mounted cranial neurostimulator pulse generator or receiver,2006.0,1303.9,78.57,2501.53,19
HCPCS,62000,Elevation of simple depressed broken skull bone,2606.1,1693.97,78.57,2906.84,19
HCPCS,62005,Elevation of complicated depressed broken skull bone,3780.0,2457.0,78.57,3553.57,19
HCPCS,62010,Elevation of depressed broken skull bone with repair of brain,3876.6,2519.79,78.57,4303.96,19
HCPCS,62100,Removal of skull bone for repair of cerebrospinal fluid leak,5460.0,3549.0,78.57,4529.62,19
HCPCS,62115,Reduction of enlarged skull bone,3113.58,2023.83,78.57,4721.18,19
HCPCS,62117,Reduction and reshaping of enlarged skull bone,4353.88,2830.02,78.57,5521.71,19
HCPCS,62120,Repair of herniated brain and reconstruction of skull bone,4831.1,3140.22,78.57,6008.17,19
HCPCS,62121,Removal of skull bone for repair of herniated brain at skull base,4317.6,2806.44,78.57,4617.33,19
HCPCS,62140,"Repair of skull bone defect, 5 cm or less",3675.0,2388.75,78.57,2927.37,19
HCPCS,62141,"Repair of skull bone defect, more than 5.0 cm",2259.6,1468.745,78.57,3236.1,38
HCPCS,62142,Removal of skull bone flap or skull plate,2808.8,1825.72,78.57,2508.72,19
HCPCS,62143,Replacement of skull bone flap or skull plate,3255.0,2115.75,78.57,2938.24,19
HCPCS,62145,Repair of skull bone defect and brain,3806.3,2474.1,78.57,3968.8,19
HCPCS,62146,"Repair of skull bone with graft, 5.0 cm or less",8804.8,5723.12,78.57,3378.8,38
HCPCS,62147,"Repair of skull bone with graft, more than 5.0 cm",3701.3,2405.85,78.57,4075.51,19
HCPCS,62148,Incision and retrieval of skull bone for graft,329.7,214.31,78.57,349.64,19
HCPCS,62160,Insertion of tube in brain using an endoscope,503.0,326.95,78.57,523.57,19
HCPCS,62161,Removal of brain scar tissue or drainage of cyst and insertion or removal tube in brain using an endoscope,3387.3,2201.75,78.57,4250.53,19
HCPCS,62162,Drainage of cyst of brain and insertion of tube in brain using an endoscope,4259.9,2768.94,78.57,5307.86,19
HCPCS,62164,Removal of growth of brain and insertion of tube in brain using an endoscope,4424.7,2876.06,78.57,5868.27,19
HCPCS,62165,Removal of growth of pituitary using an endoscope,4097.1,2663.12,78.57,4417.83,19
HCPCS,62180,Creation of cerebrospinal fluid drainage tract in brain,4081.4,2652.91,78.57,4503.48,19
HCPCS,62190,"Creation of brain fluid drainage shunt, sub-atrial, -jugular, -auricular",3123.8,2030.47,78.57,2611.57,19
HCPCS,62192,"Creation of brain fluid drainage shunt, sub-peritoneal, -pleural, other terminus",3465.0,2252.25,78.57,2770.53,19
HCPCS,62194,Replacement or irrigation of tube in membranes covering brain,1058.4,687.96,78.57,1380.3,19
HCPCS,62200,Creation of spinal fluid drainage tract in third ventricle of brain,4830.0,3139.5,78.57,3868.49,19
HCPCS,62201,Computer-assisted creation of cerebrospinal fluid drainage tract in third ventricle of brain,3648.8,2371.72,78.57,3404.82,19
HCPCS,62220,"Creation of brain fluid drainage shunt, ventriculo-atrial, -jugular, -auricular",3675.0,2388.75,78.57,2792.16,19
HCPCS,62223,"Creation of brain fluid drainage shunt, ventriculo-peritoneal, -pleural, other terminus",3570.0,2320.5,78.57,2955.48,19
HCPCS,62225,Replacement or irrigation of tube in brain,1470.0,955.5,78.57,1495.08,19
HCPCS,62230,Insertion or revision of cerebrospinal fluid drainage shunt valve or tube,8209.0,5335.85,78.57,35078.1,38
HCPCS,62252,Reprogramming of cerebrospinal fluid shunt,194.45,126.395,29.75,1242.0,57
HCPCS,62256,Removal of cerebrospinal fluid shunt system,1837.5,1194.38,78.57,1704.72,19
HCPCS,62258,Removal and insertion of cerebrospinal fluid shunt system,3675.0,2388.75,78.57,3152.42,19
HCPCS,62263,"Removal of spinal canal scar tissue, multiple sessions over 2 days or more",1793.4,1165.71,78.57,1538.77,19
HCPCS,62264,"Removal of spinal canal scar tissue, multiple sessions in 1 day",987.23,641.7,78.57,1062.13,19
HCPCS,62267,Aspiration of spinal disc tissue for diagnostic purposes,866.45,563.1949999999999,78.57,3227.0,38
HCPCS,62268,Aspiration of fluid from cyst of spinal cord or fluid-filled cavity,1792.1,1164.865,78.57,5394.84,38
HCPCS,62269,Biopsy of spinal cord with needle through skin,1795.5,1167.08,78.57,1068.52,19
HCPCS,62270,Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test,500.0,325.0,0.01,3227.0,55
HCPCS,62272,Removal of cerebrospinal fluid with lower back spinal tap,655.25,425.91499999999996,0.01,3227.0,74
HCPCS,62273,Injection of blood or blood clot into spinal canal,814.8,529.62,42.48,3227.0,114
HCPCS,62280,Injection of substance into spinal canal for removal of nerve tissue in space around brain,879.9,571.94,78.57,787.17,19
HCPCS,62281,Injection of substance into spinal canal for removal of upper spine nerve tissue,1180.7,767.4549999999999,78.57,4015.79,38
HCPCS,62282,Injection of substance into spinal canal for removal of lower spine nerve tissue,1284.6,834.99,78.57,4132.0,56
HCPCS,62284,Injection of contrast for imaging of lower spinal canal,894.1,581.165,67.23,3091.25,38
HCPCS,62287,Removal of lower spine disc tissue at single or multiple levels using fluoroscopic guidance,4990.0,3243.5,78.57,21468.32,57
HCPCS,62290,Injection of contrast for imaging of each level of lower spine,732.2,475.92999999999995,78.57,2166.29,38
HCPCS,62291,Injection of contrast for imaging of each level of middle or upper spine,686.65,446.32500000000005,78.57,2166.29,38
HCPCS,62292,Injection for removal of lower spine disc,2073.8,1347.97,78.57,1762.56,19
HCPCS,62294,Injection of substance to occlude spinal cord artery and/or vein,2139.9,1390.94,78.57,2674.83,19
HCPCS,62302,X-ray of upper spinal canal with review by radiologist,1816.5,1180.725,78.57,8220.1,37
HCPCS,62303,X-ray of middle spinal canal with review by radiologist,1545.0,1004.25,78.57,7166.44,37
HCPCS,62304,X-ray of lower spinal canal with review by radiologist,1547.0,1005.55,78.57,6828.13,56
HCPCS,62305,X-ray of multiple regions of spinal canal with review by radiologist,1844.6,1198.99,78.57,8703.03,55
HCPCS,62320,Injection of substance into middle or upper spine canal,865.55,562.61,78.57,3227.0,95
HCPCS,62321,Injection of substance into middle or upper spine canal using imaging guidance,1160.05,754.0350000000001,78.57,4212.06,95
HCPCS,62322,Injection of substance into lower spine canal,925.4,601.51,69.59,3227.0,95
HCPCS,62323,Injection of substance into lower spine canal using imaging guidance,1219.9,792.9350000000001,78.57,4212.06,95
HCPCS,62324,Insertion of tube and injection of substance into middle or upper spine canal,1135.65,738.175,78.57,3899.58,76
HCPCS,62325,Insertion of tube and injection of substance into middle or upper spine canal using imaging guidance,1269.65,825.2750000000001,78.57,4333.44,76
HCPCS,62326,Insertion of tube and injection of substance into lower spine canal,1122.5,729.625,77.58,3899.58,76
HCPCS,62327,Insertion of tube and injection of substance into lower spine canal using imaging guidance,1256.5,816.725,78.57,4333.44,76
HCPCS,62328,Removal of spinal fluid with lower back spinal tap for diagnostic test using imaging guidance,1413.75,918.94,68.89,5733.15,38
HCPCS,62329,Removal of cerebrospinal fluid with lower back spinal tap using imaging guidance,998.0,648.7,78.57,3228.13,38
HCPCS,62330,"DECOMPRESSION, PERCUTANEOUS, WITH PARTIAL REMOVAL OF THE LIGAMENTUM FLAVUM, INCLUDING LAMINOTOMY FOR ACCESS, EPIDUROGRAPHY, AND IMAGING GUIDANCE (IE, CT OR FLUOROSCOPY), BILATERAL; ONE INTERSPACE, LUM",1230.0,799.5,73.6,1266.9,16
HCPCS,62331,"DECOMPRESSION, PERCUTANEOUS, WITH PARTIAL REMOVAL OF THE LIGAMENTUM FLAVUM, INCLUDING LAMINOTOMY FOR ACCESS, EPIDUROGRAPHY, AND IMAGING GUIDANCE (IE, CT OR FLUOROSCOPY), BILATERAL; ADDITIONAL INTERSPA",488.0,317.2,73.6,502.64,16
HCPCS,62350,"Insertion, revision, or repositioning of spinal canal tube for medication administration",1668.45,1084.495,78.57,1183.39,38
HCPCS,62351,"Insertion, revision, or repositioning of spinal canal tube for medication administration with removal of spine bone",2388.8,1552.72,78.57,2487.39,19
HCPCS,62355,Removal of implanted tube in spinal canal,998.5999999999999,649.09,78.57,791.65,38
HCPCS,62360,Insertion of spinal canal drug infusion device beneath skin,774.9,503.69,78.57,929.41,19
HCPCS,62361,Insertion of spinal canal drug infusion pump,1151.9,748.74,78.57,1212.28,19
HCPCS,62362,Insertion of programmable spinal canal drug infusion pump,1575.0,1023.75,78.57,1128.07,19
HCPCS,62365,Removal of spinal canal drug infusion pump or device,1116.2,725.53,78.57,866.43,19
HCPCS,62367,Electronic analysis of spinal canal drug infusion pump,198.05,128.735,0.01,2318.31,74
HCPCS,62368,Electronic analysis and reprogramming of spinal canal drug infusion pump,173.3,112.65,0.01,2318.31,74
HCPCS,62369,Electronic analysis reprogramming and refill of spinal canal drug infusion pump,304.15,197.7,27.84,1242.0,38
HCPCS,62370,Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician,430.5,279.83,0.01,2318.31,131
HCPCS,63001,"Partial removal of spine bone with exploration and/or release of upper spinal cord or nerves, 1-2 segments",4095.0,2661.75,78.57,3518.02,19
HCPCS,63003,"Partial removal of spine bone with exploration and/or release of middle spinal cord or nerves, 1-2 segments",4515.0,2934.75,78.57,3527.37,19
HCPCS,63005,"Partial removal of spine bone with exploration and/or release of lower spinal cord or nerves, 1-2 segments",3937.5,2559.38,78.57,3383.78,19
HCPCS,63011,"Partial removal of spine bone with exploration and/or release of sacral spinal cord or nerves, 1-2 segments",2527.5,1642.88,78.57,3180.74,19
HCPCS,63012,Partial removal of spine bone with release of lower spinal cord or nerves,4305.0,2798.25,78.57,3414.36,19
HCPCS,63015,"Partial removal of spine bone with exploration and/or release of upper spinal cord or nerves, more than 2 segments",5250.0,3412.5,78.57,4202.2,19
HCPCS,63016,"Partial removal of spine bone with exploration and/or release of middle spinal cord or nerves, more than 2 segments",5250.0,3412.5,78.57,4337.76,19
HCPCS,63017,"Partial removal of spine bone with exploration and/or release of lower spinal cord or nerves, more than 2 segments",4515.0,2934.75,78.57,3579.8,19
HCPCS,63020,"Partial removal of spine bone with release of upper spinal cord or nerves and/or removal of disc, 1 interspace",4200.0,2730.0,78.57,3330.26,19
HCPCS,63030,Partial removal of spine bone with release of lower spinal cord or nerves and/or removal of disc,5197.5,3378.38,78.57,2797.94,19
HCPCS,63035,"Partial removal of spine bone with release of upper or lower spinal cord or nerves and/or removal of disc, each additional interspace",945.0,614.25,78.57,570.95,19
HCPCS,63040,"Partial removal of spine bone with re-exploration, release of upper spinal cord or nerves and/or removal of disc, 1 interspace",5040.0,3276.0,78.57,4002.58,19
HCPCS,63042,"Partial removal of spine bone with re-exploration, release of lower spinal cord or nerves and/or removal of disc, 1 interspace",4935.0,3207.75,78.57,3752.54,19
HCPCS,63043,"Partial removal of spine bone with re-exploration, release of upper spinal cord or nerves and/or removal of disc, each additional interspace",1050.0,682.5,78.57,795.34,15
HCPCS,63044,"Partial removal of spine bone with re-exploration, release of upper or lower spinal cord or nerves and/or removal of disc, each additional interspace",1769.3,1150.05,78.57,884.65,15
HCPCS,63045,"Partial removal of spine bone with release of upper spinal cord and/or nerves, 1 segment",4698.8,3054.22,78.57,3666.92,19
HCPCS,63046,"Partial removal of spine bone with release of middle spinal cord and/or nerves, 1 segment",4515.0,2934.75,78.57,3520.67,19
HCPCS,63047,"Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment",2511.25,1632.31,78.57,3174.92,19
HCPCS,63048,"Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment",892.5,580.13,78.57,602.26,19
HCPCS,63050,"Reconstruction of upper spine bone with release of upper spinal cord, 2 or more segments",3964.8,2577.12,78.57,4318.0,19
HCPCS,63051,Reconstruction of upper spine bone and posterior bony elements with release of upper spinal cord,4510.8,2932.02,78.57,4931.69,19
HCPCS,63052,Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back,541.0,351.65,78.57,735.17,19
HCPCS,63053,Partial removal of bone of additional segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back,406.0,263.9,78.57,561.01,19
HCPCS,63055,"Release of middle spinal cord and/or nerves, single segment",5985.0,3890.25,78.57,4623.75,19
HCPCS,63056,"Release of lower spinal cord and/or nerves, single segment",5486.3,3566.1,78.57,4275.57,19
HCPCS,63057,"Release of middle or lower spinal cord and/or nerves, single segment",1286.3,836.1,78.57,913.05,19
HCPCS,63064,"Release of middle spinal cord or nerves through rib and spine joint, single segment",5040.0,3276.0,78.57,5074.44,19
HCPCS,63066,"Release of middle spinal cord or nerves through rib and spine joint, each additional segment",840.0,546.0,78.57,568.26,19
HCPCS,63075,"Removal of upper spine disc and release of spinal cord and/or nerves, single interspace",4620.0,3003.0,78.57,3891.18,19
HCPCS,63076,"Removal of upper spine disc and release of spinal cord and/or nerves, each additional interspace",1102.5,716.63,78.57,699.9,19
HCPCS,63077,"Removal of middle spine disc and release of spinal cord and/or nerves, single interspace",4383.8,2849.47,78.57,4365.68,19
HCPCS,63078,"Removal of middle spine disc and release of spinal cord and/or nerves, each additional interspace",1312.5,853.13,78.57,571.84,19
HCPCS,63081,"Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach, single segment",5565.0,3617.25,78.57,5051.61,19
HCPCS,63082,"Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach, each additional segment",1365.0,887.25,78.57,756.45,19
HCPCS,63085,"Removal of middle spine bone with release of spinal cord and/or nerves, transthoracic approach, single segment",5055.8,3286.27,78.57,5535.72,19
HCPCS,63086,"Removal of middle spine bone with release of spinal cord and/or nerves, transthoracic approach, each additional segment",892.5,580.13,78.57,572.42,19
HCPCS,63087,"Removal of middle or lower spine bone with release of spinal cord or nerves, combined thoracolumbar approach, single segment",6435.5,4183.08,78.57,6944.01,19
HCPCS,63088,"Removal of middle or lower spine bone with release of spinal cord or nerves, combined thoracolumbar approach, each additional segment",1155.0,750.75,78.57,737.71,19
HCPCS,63090,"Removal of middle, lower, or sacral spine bone with release of spinal cord or nerves, transperitoneal or retroperitoneal approach, single segment",5428.5,3528.53,78.57,5729.88,19
HCPCS,63091,"Removal of middle, lower, or sacral spine bone with release of spinal cord or nerves, transperitoneal or retroperitoneal approach, each additional segment",787.5,511.88,78.57,514.98,19
HCPCS,63101,"Removal of middle spine bone with release of spinal cord and/or nerves, lateral extra cavitary approach, single segment",6023.9,3915.54,78.57,6627.63,19
HCPCS,63102,"Removal of lower spine bone with release of spinal cord and/or nerves, lateral extra cavitary approach, single segment",5998.7,3899.16,78.57,6548.28,19
HCPCS,63103,"Removal of middle or lower spine bone with release of spinal cord and/or nerves, lateral extra cavitary approach, each additional segment",801.2,520.78,78.57,835.82,19
HCPCS,63170,Removal of spine bone with incision of spinal cord,4436.3,2883.6,78.57,4470.23,19
HCPCS,63172,Removal of spine bone with drainage of cyst of spinal cord into spinal canal,2986.2,1941.03,78.57,3933.08,19
HCPCS,63173,Removal of spine bone with drainage of cyst of spinal cord into lung or abdomen,3799.83,2469.89,78.57,4833.54,19
HCPCS,63185,"Removal of spine bone with severing of nerve roots, 1-2 segments",4121.3,2678.85,78.57,3322.27,19
HCPCS,63190,"Removal of spine bone with severing of nerve roots, more than 2 segments",4908.8,3190.72,78.57,3691.42,19
HCPCS,63191,Removal of spine bone with severing of spinal accessory nerve,3963.8,2576.47,78.57,3885.93,19
HCPCS,63197,Partial removal of spine bone with incision of both middle spinal cord tracts,4347.0,2825.55,78.57,4664.18,19
HCPCS,63200,Removal of lower spine bone with release of frayed spinal cord,3880.8,2522.52,78.57,4323.0,19
HCPCS,63250,Removal of upper spine bone and artery-vein malformation,7526.4,4892.16,78.57,8268.39,19
HCPCS,63251,Removal of middle spine bone and artery-vein malformation,7698.6,5004.09,78.57,8502.58,19
HCPCS,63252,Removal of middle and lower spine bone and artery-vein malformation,7696.5,5002.73,78.57,8500.4,19
HCPCS,63265,Removal of upper spine bone and growth outside spine membrane,4672.5,3037.13,78.57,4720.33,19
HCPCS,63266,Removal of growth of middle spine bone outside spine membrane,4672.5,3037.13,78.57,4877.08,19
HCPCS,63267,Removal of growth of lower spine bone outside spine membrane,4200.0,2730.0,78.57,3914.44,19
HCPCS,63268,Removal of growth of sacral spine bone outside spine membrane,3691.8,2399.67,78.57,4026.49,19
HCPCS,63270,Removal of upper spine bone and growth within spine membrane,5292.0,3439.8,78.57,5814.84,19
HCPCS,63271,Removal of growth of middle spine bone within spine membrane,5322.5,3459.63,78.57,5819.45,19
HCPCS,63272,Removal of growth of lower spine bone within spine membrane,5250.0,3412.5,78.57,5359.74,19
HCPCS,63273,Removal of growth of sacral spine bone within spine membrane,4645.2,3019.38,78.57,5234.03,19
HCPCS,63275,Removal or biopsy of growth of upper spine bone outside spine membrane,5381.3,3497.85,78.57,5093.18,19
HCPCS,63276,Removal or biopsy of growth of middle spine bone outside spine membrane,5381.3,3497.85,78.57,5061.41,19
HCPCS,63277,Removal or biopsy of growth of lower spine bone outside spine membrane,4908.8,3190.72,78.57,4439.22,19
HCPCS,63278,Removal or biopsy of growth of sacral spine bone outside spine membrane,4200.0,2730.0,78.57,4461.48,19
HCPCS,63280,"Removal or biopsy of growth of upper spine bone within spine membrane, extramedullary",5853.8,3804.97,78.57,5951.9,19
HCPCS,63281,"Removal or biopsy of growth of middle spine bone within spine membrane, extramedullary",5853.8,3804.97,78.57,5891.41,19
HCPCS,63282,"Removal or biopsy of growth of lower spine bone within spine membrane, extramedullary",6431.3,4180.35,78.57,5563.39,19
HCPCS,63283,Removal or biopsy of growth of sacral spine bone within spine membrane,4987.5,3241.88,78.57,5328.43,19
HCPCS,63285,"Removal or biopsy of growth of upper spine bone within spine membrane, intramedullary",6683.3,4344.15,78.57,7344.24,19
HCPCS,63286,"Removal or biopsy of growth of middle spine bone within spine membrane, intramedullary",6653.9,4325.04,78.57,7251.39,19
HCPCS,63287,"Removal or biopsy of growth of lower spine bone within spine membrane, intramedullary",7008.8,4555.72,78.57,7686.53,19
HCPCS,63290,Removal or biopsy of growth of spine bone outside and within spine membrane,7057.1,4587.12,78.57,7810.77,19
HCPCS,63295,Reconstruction of spine bone following spinal procedure,856.8,556.92,78.57,914.84,19
HCPCS,63300,Removal of growth of upper spine bone outside spine membrane,4768.1,3099.27,78.57,5219.0,19
HCPCS,63301,"Removal of growth of middle spine bone outside spine membrane, transthoracic approach",5419.1,3522.42,78.57,6175.55,19
HCPCS,63302,"Removal of growth of middle spine bone outside spine membrane, thoracolumbar approach",5375.0,3493.75,78.57,6099.19,19
HCPCS,63303,"Removal of growth of lower or sacral spine bone outside spine membrane, transperitoneal or retroperitoneal approach",5676.3,3689.6,78.57,6210.47,19
HCPCS,63304,Removal of growth of upper spine bone within spine membrane,5946.2,3865.03,78.57,6546.98,19
HCPCS,63305,"Removal of growth of middle spine bone within spine membrane, transthoracic approach",6121.5,3978.98,78.57,7034.64,19
HCPCS,63306,"Removal of growth of middle spine bone within spine membrane, thoracolumbar approach",4763.38,3096.2,78.57,6831.49,19
HCPCS,63307,"Removal of growth of lower or sacral spine bone within spine membrane, peritoneal approach",5010.58,3256.88,78.57,6769.32,19
HCPCS,63308,Removal of growth of spine bone,869.4,565.11,78.57,904.61,19
HCPCS,63600,Computer-assisted creation of growth of spinal cord,2913.8,1893.97,78.57,3074.25,19
HCPCS,63610,Computer-assisted stimulation of spinal cord,6108.9,3970.79,78.57,1614.16,19
HCPCS,63620,"Computer-assisted radiosurgery of growth of spine, first growth",2488.35,1617.43,78.57,3157.25,19
HCPCS,63621,"Computer-assisted radiosurgery of growth of spine, each additional growth",558.9,363.29,78.57,697.97,19
HCPCS,63650,Insertion of spinal neurostimulator electrode array through skin,6754.7,4390.56,78.57,44493.89,114
HCPCS,63655,Removal of spine bone for insertion of neurostimulator electrode plate in spine,2913.8,1893.97,78.57,2377.72,19
HCPCS,63661,Insertion of spinal neurostimulator electrode array using fluoroscopic guidance,2721.0,1768.65,78.57,10094.99,38
HCPCS,63662,Removal of spinal neurostimulator electrode plate using fluoroscopic guidance,1921.5,1248.98,78.57,2405.03,19
HCPCS,63663,Revision of spinal neurostimulator electrode array using fluoroscopic guidance,2215.5,1440.08,78.57,2157.92,19
HCPCS,63664,Revision of spinal neurostimulator electrode plate using fluoroscopic guidance,2000.3,1300.2,78.57,2491.0,19
HCPCS,63685,Insertion or replacement of spinal neurostimulator generator or receiver,28771.4,18701.41,78.57,144062.18,38
HCPCS,63688,Removal or revision of spinal neurostimulator generator or receiver,1470.0,955.5,78.57,1094.7,19
HCPCS,63700,"Repair of spinal cord defect, 5.0 cm or less",3517.5,2286.38,78.57,3663.1,19
HCPCS,63702,"Repair of spinal cord defect, more than 5.0 cm",3806.3,2474.1,78.57,4015.36,19
HCPCS,63704,"Repair of spina bifida, 5.0 cm or less",4234.7,2752.56,78.57,4591.35,19
HCPCS,63706,"Repair of spina bifida, more than 5.0 cm",4616.9,3000.99,78.57,5094.44,19
HCPCS,63707,Repair of cerebrospinal fluid leak,3176.3,2064.6,78.57,2667.33,19
HCPCS,63709,Repair of cerebrospinal fluid leak with partial removal of vertebra,4016.3,2610.6,78.57,3182.79,19
HCPCS,63710,Placement of spinal cord graft,2850.8,1853.02,78.57,3138.03,19
HCPCS,63740,Creation of cerebrospinal fluid shunt with partial removal of vertebra,3228.8,2098.72,78.57,2747.65,19
HCPCS,63741,Creation of cerebrospinal fluid shunt,1587.6,1031.94,78.57,1937.02,19
HCPCS,63744,"Replacement, irrigation, or revision of lower spinal canal shunt",1776.6,1154.79,78.57,1906.92,19
HCPCS,63746,Removal of lower spinal canal shunt,1457.4,947.31,78.57,1697.03,19
HCPCS,64400,Injection of anesthetic agent and/or steroid into face nerve,873.0,567.45,0.01,2254.52,131
HCPCS,64405,Injection of anesthetic agent and/or steroid into upper neck and back of head nerve,654.0,425.1,0.01,2166.29,131
HCPCS,64408,Injection of anesthetic agent and/or steroid into vagus nerve,468.75,304.69,0.01,933.57,36
HCPCS,64415,Injection of anesthetic agent and/or steroid into arm nerve bundle (brachial plexus),1078.65,701.125,0.01,8754.68,93
HCPCS,64416,Continuous infusion of anesthetic agent and/or steroid into arm nerve bundle through catheter,735.0,477.75,68.69,3227.0,114
HCPCS,64417,Injection of anesthetic agent and/or steroid into upper arm and shoulder nerve (axillary nerve),814.8,529.62,52.88,3227.0,114
HCPCS,64418,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,669.675,435.28999999999996,0.01,6988.25,150
HCPCS,64420,Injection of anesthetic agent and/or steroid into rib nerve,689.85,448.4,40.15,3227.0,114
HCPCS,64421,Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block,479.0,311.35,20.39,3227.0,114
HCPCS,64425,Injection of anesthetic agent and/or steroid into lower abdomen and groin nerve,1215.15,789.85,0.01,6988.25,150
HCPCS,64430,Injection of anesthetic agent and/or steroid into external genitals and anus nerve,814.8,529.62,0.01,3227.0,131
HCPCS,64435,Injection of anesthetic agent and/or steroid into uterus nerve,448.55,291.56,0.01,1335.15,36
HCPCS,64445,Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve),675.975,439.385,0.01,6352.95,112
HCPCS,64446,Continuous infusion of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve) through catheter,1793.325,1165.6650000000002,67.02,8477.27,38
HCPCS,64447,Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve),1115.4,725.015,0.01,8477.27,150
HCPCS,64448,Continuous infusion of anesthetic agent and/or steroid into thigh nerve (femoral nerve) through catheter,1653.6,1074.84,64.25,8477.27,38
HCPCS,64449,Injection by continuous infusion of anesthetic agent into lower back nerve bundle,604.8,393.12,56.44,192.09,19
HCPCS,64450,Injection of anesthetic agent and/or steroid into other nerve or branch,1119.0,727.35,0.01,3227.0,150
HCPCS,64451,Injection of anesthetic agent and/or steroid into spine and pelvis nerve using imaging guidance,1308.94,850.81,68.16,4842.19,95
HCPCS,64454,Injection of anesthetic agent and/or steroid into knee nerve branch using imaging guidance,1312.69,853.25,68.96,4842.19,95
HCPCS,64455,Injection of anesthetic and/or steroid drug into foot nerve,361.5,234.98,0.01,2417.22,55
HCPCS,64461,"Injection of anesthetic agent into thoracic vertebra using imaging guidance, single site",1617.75,1051.54,67.77,6988.25,38
HCPCS,64462,"Injection of anesthetic agent into thoracic vertebra using imaging guidance, additional sites",200.0,130.0,42.3,174.56,19
HCPCS,64463,Injection of anesthetic agent through tube into thoracic vertebra using imaging guidance,585.0,380.25,72.44,561.91,19
HCPCS,64466,Unilateral thoracic fascial plane block by injection(s),572.5,372.125,57.93,2582.5,53
HCPCS,64467,Unilateral thoracic fascial plane block by continuous infusion(s),334.0,217.1,67.13,1291.25,36
HCPCS,64468,Bilateral thoracic fascial plane block by injection(s),913.5,593.775,64.35,4299.86,53
HCPCS,64469,Bilateral thoracic fascial plane block by infusion(s),463.5,301.275,70.54,1936.88,36
HCPCS,64473,Unilateral lower extremity fascial plane block by injection(s),1625.0,1056.25,51.74,4299.86,53
HCPCS,64474,Unilateral lower extremity fascial plane block by infusion(s),617.5,401.375,64.35,2324.25,36
HCPCS,64479,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level",2033.925,1322.055,71.16,7294.27,114
HCPCS,64480,"Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, each additional level",551.3,358.35,43.94,2166.29,95
HCPCS,64483,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level",1323.0,859.95,51.62,8181.36,114
HCPCS,64484,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level",682.5,443.63,32.56,2510.19,114
HCPCS,64486,Injection of local anesthetic for abdominal wall pain control on side using imaging guidance,450.0,292.5,0.01,2318.31,112
HCPCS,64487,Continuous infusion of local anesthetic for abdominal wall pain control on side using imaging guidance,503.025,326.96500000000003,53.29,2318.31,38
HCPCS,64488,Injection of local anesthetic for abdominal wall pain control on both sides using imaging guidance,500.0,325.0,53.75,3989.96,57
HCPCS,64489,Continuous infusion of local anesthetic for abdominal wall pain control on both sides using imaging guidance,584.35,379.83000000000004,67.02,2318.31,38
HCPCS,64490,"Injection of upper or middle spine facet joint using imaging guidance, single level",765.45,497.54,64.0,5264.43,114
HCPCS,64491,"Injection of upper or middle spine facet joint using imaging guidance, second level",241.5,156.98,41.49,3860.84,114
HCPCS,64492,"Injection of upper or middle spine facet joint using imaging guidance, third and any additional level",291.9,189.74,41.74,4212.06,114
HCPCS,64493,"Injection of lower or sacral spine facet joint using imaging guidance, single level",685.2,445.38,52.05,8181.36,114
HCPCS,64494,"Injection of lower or sacral spine facet joint using imaging guidance, second level",262.5,170.63,39.02,3109.33,114
HCPCS,64495,"Injection of lower or sacral spine facet joint using imaging guidance, third and any additional level",267.8,174.07,39.33,3163.56,114
HCPCS,64505,"Injection of anesthetic agent, trigeminal nerve bundle",398.55,259.06,67.67,2166.29,95
HCPCS,64510,Injection of anesthetic agent into sympathetic nerve bundle,1983.15,1289.05,0.01,8754.68,150
HCPCS,64517,Injection of anesthetic agent into sacral nerve bundle,415.745,270.235,48.36,3227.0,114
HCPCS,64520,Injection of anesthetic agent into middle or lower spine sympathetic nerve,878.85,571.25,39.64,7813.35,114
HCPCS,64530,Injection of anesthetic agent into abdominal sympathetic nerve bundle,577.5,375.38,39.09,5208.9,114
HCPCS,64553,Insertion of cranial nerve neurostimulator electrode,589.1,382.92,78.57,6071.96,19
HCPCS,64555,Insertion of peripheral nerve neurostimulator electrode through skin,4740.0,3081.005,0.01,22285.68,93
HCPCS,64561,Insertion of sacral nerve neurostimulator electrode array,4451.775,2893.6549999999997,78.57,1774.96,38
HCPCS,64566,Insertion of lower leg neurostimulator electrode,250.0,162.5,0.01,622.38,36
HCPCS,64568,Insertion of cranial nerve neurostimulator electrode and generator,1561.4,1014.91,78.57,1821.09,19
HCPCS,64569,Revision of cranial nerve neurostimulator electrodes,1438.5,935.03,78.57,2184.61,19
HCPCS,64570,Removal of cranial nerve neurostimulator electrodes,1233.8,801.97,78.57,2068.68,19
HCPCS,64575,Insertion of peripheral nerve neurostimulator electrode,1029.0,668.85,78.57,968.58,19
HCPCS,64580,Insertion of muscle neurostimulator electrodes,1029.0,668.85,78.57,899.1,19
HCPCS,64581,Insertion of sacral nerve neurostimulator electrode,2290.1,1488.57,78.57,2012.23,19
HCPCS,64582,Insertion of hypoglossal nerve neurostimulator electrode and generator and breathing sensor electrode,2854.5,1855.43,78.57,2940.14,19
HCPCS,64583,Revision or replacement of hypoglossal nerve neurostimulator electrode and breathing sensor electrode with connection to existing generator,1824.0,1185.6,78.57,2486.67,19
HCPCS,64584,Removal of hypoglossal nerve neurostimulator electrode and generator and breathing sensor electrode,1536.0,998.4,78.57,2094.81,19
HCPCS,64585,Revision of peripheral neurostimulator electrodes,1211.7,787.61,78.57,579.11,19
HCPCS,64590,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver",8383.75,5449.4400000000005,78.57,772.37,38
HCPCS,64595,"Removal or revision of a peripheral, sacral, or gastric neurostimulator pulse generator or receiver",1102.5,716.63,78.57,603.05,19
HCPCS,64597,Insertion or replacement of a peripheral integrated neurostimulator each additional electrode array,750.0,487.5,78.57,1439.51,15
HCPCS,64598,Revision or removal of a electrode array with an integrated neurostimulator,1560.0,1014.0,78.57,1606.8,15
HCPCS,64600,Destruction of first division of face nerve branch,1681.95,1093.27,78.57,5658.26,114
HCPCS,64605,Destruction of second and third division of face nerve branch,2922.35,1899.53,78.57,11164.66,38
HCPCS,64610,Destruction of face nerve branch under X-ray monitoring,3127.05,2032.585,78.57,11427.56,57
HCPCS,64611,Injection of chemical for paralysis of salivary glands on both sides of mouth,485.65,315.675,78.57,2166.29,38
HCPCS,64612,Injection of chemical for paralysis of nerve muscles on side of face,525.0,341.25,78.57,2166.29,152
HCPCS,64615,Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face,588.0,382.2,78.57,2166.29,114
HCPCS,64616,Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box,833.175,541.565,78.57,2847.21,57
HCPCS,64617,Injection of chemical for paralysis of nerve muscles on side of voice box,1680.825,1092.54,78.57,6318.09,57
HCPCS,64620,Injection of agent to destroy rib nerve,1137.15,739.15,57.7,7813.35,114
HCPCS,64624,Destruction of nerve branches of knee using imaging guidance,3296.815,2142.93,78.57,13325.7,95
HCPCS,64625,Destruction of nerves supplying joint between spine and pelvis using imaging guidance,3456.94,2247.01,78.57,13325.7,95
HCPCS,64628,"Heat destruction of intraosseous basivertebral nerve in bones of spine in lower back, first two bones",998.0,648.7,78.57,1316.74,19
HCPCS,64629,Heat destruction of intraosseous basivertebral nerve in additional bone of spine in lower back,464.0,301.6,78.57,611.87,19
HCPCS,64630,Destruction of external genital nerve,621.6,404.04,42.73,605.84,19
HCPCS,64632,Destruction of foot nerve,204.15,132.7,58.48,217.9,19
HCPCS,64633,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint",1342.5,872.63,78.57,22777.65,114
HCPCS,64634,"Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint",358.1,232.77,54.47,3166.15,114
HCPCS,64635,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint",2223.75,1445.44,78.57,23242.5,114
HCPCS,64636,"Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint",522.0,339.3,47.76,2752.95,114
HCPCS,64640,Destruction of peripheral nerve or branch,1211.175,787.265,49.4,5394.84,152
HCPCS,64642,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, first extremity",829.45,539.145,78.57,3227.0,76
HCPCS,64643,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, each additional extremity",457.9,297.635,30.87,2166.29,38
HCPCS,64644,"Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, first extremity",1045.95,679.87,78.57,4106.18,38
HCPCS,64645,"Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, each additional extremity",508.9,330.78499999999997,30.87,2166.29,38
HCPCS,64646,"Injection of chemical for paralysis of nerve muscles on trunk, 1-5 muscles",710.75,461.99,78.57,3227.0,38
HCPCS,64647,"Injection of chemical for paralysis of nerve muscles on trunk, 6 or more muscles",838.55,545.06,30.87,3227.0,38
HCPCS,64650,Injection of chemical for paralysis of underarm sweat glands,211.85,137.705,30.17,2166.29,57
HCPCS,64653,Injection of chemical for paralysis of sweat glands,603.35,392.18,38.89,2430.13,57
HCPCS,64654,"INITIAL OPEN IMPLANTATION OF BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM, INCLUDING LEAD PLACEMENT ONTO THE CAROTID SINUS, LEAD TUNNELLING, CONNECTION TO A PULSE GENERATOR PLACED IN A DISTAN",1350.0,877.5,73.6,1390.5,16
HCPCS,64655,"REVISION OR REPLACEMENT OF BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM, WITH INTRAOPERATIVE INTERROGATION AND PROGRAMMING; LEAD ONLY",1575.0,1023.75,73.6,1622.25,16
HCPCS,64657,"REMOVAL OF BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM; TOTAL SYSTEM, INCLUDING LEAD AND PULSE GENERATOR",1530.0,994.5,73.6,1575.9,16
HCPCS,64658,REMOVAL OF BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM; LEAD ONLY,1150.0,747.5,73.6,1184.5,16
HCPCS,64659,REMOVAL OF BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM; PULSE GENERATOR ONLY,1070.0,695.5,73.6,1102.1,16
HCPCS,64680,Injection of agent to destroy abdominal nerve bundle,853.0,554.45,26.62,3227.0,114
HCPCS,64681,Injection of agent to destroy presacral nerve bundle,1175.0,763.75,72.61,3305.6,114
HCPCS,64702,Release of finger nerve,1241.1,806.72,78.57,1499.94,19
HCPCS,64704,Release of hand or foot nerve,1260.0,819.0,78.57,976.77,19
HCPCS,64708,Release of arm or leg nerve,2598.75,1689.19,78.57,1486.95,19
HCPCS,64712,Release of sciatic nerve,3071.25,1996.31,78.57,1727.27,19
HCPCS,64713,Release of major arm or leg nerve,2178.8,1416.22,78.57,2293.77,19
HCPCS,64714,Release of upper leg nerve,1776.6,1154.79,78.57,2148.92,19
HCPCS,64716,Release and/or relocation of cranial nerve,2362.5,1535.63,78.57,1555.94,19
HCPCS,64718,Release and/or relocation of elbow nerve,2598.75,1689.19,78.57,1755.8,19
HCPCS,64719,Release and/or relocation of wrist nerve,1929.45,1254.14,78.57,1192.07,19
HCPCS,64721,Release and/or relocation of hand nerve,5100.0,3315.0,78.57,19368.75,38
HCPCS,64722,Release of unspecified nerve,1575.0,1023.75,78.57,1059.36,19
HCPCS,64726,Release of sole of foot nerve,792.8,515.32,78.57,832.84,19
HCPCS,64727,Release of nerve using operating microscope,525.0,341.25,78.57,542.16,19
HCPCS,64732,"Incision or removal of forehead, scalp and upper eyelid nerve",1009.1,655.92,78.57,1256.66,19
HCPCS,64734,"Incision or removal of lower eyelid, upper lip, and mouth nerve",1100.4,715.26,78.57,1420.28,19
HCPCS,64736,"Incision or removal of chin, lower lip, and jaw nerve",1113.0,723.45,78.57,1030.01,19
HCPCS,64738,Incision or removal of teeth and jaw bone nerve,1357.7,882.51,78.57,1386.29,19
HCPCS,64740,Incision and removal of tongue nerve,1443.8,938.47,78.57,1433.72,19
HCPCS,64742,Incision or removal of face nerve,3013.15,1958.55,0.01,11427.56,36
HCPCS,64744,Incision or removal of scalp and over ear nerve,1093.1,710.52,78.57,1397.59,19
HCPCS,64746,"Incision or removal of abdomen, gallbladder, and liver nerve",1200.2,780.13,78.57,1257.43,19
HCPCS,64755,Incision or removal of stomach nerve,2001.88,1301.22,78.57,2675.81,19
HCPCS,64760,Incision or removal of abdomen nerve,1290.5,838.83,78.57,1503.24,19
HCPCS,64763,Incision or removal of outside pelvic and thigh nerve,1418.6,922.09,78.57,1492.7,19
HCPCS,64766,Incision or removal of inside pelvic and thigh nerve,1698.9,1104.29,78.57,1827.53,19
HCPCS,64771,Incision or removal of cranial nerve,2905.0,1888.25,0.01,11427.56,36
HCPCS,64772,Incision or removal of spinal nerve,1507.8,980.07,78.57,1671.29,19
HCPCS,64774,Removal of growth of skin nerve,1100.4,715.26,78.57,1216.25,19
HCPCS,64776,"Removal of growth of finger or toe nerve, same digit",1056.3,686.6,78.57,1169.12,19
HCPCS,64778,"Removal of growth of finger or toe nerve, each additional digit",512.4,333.06,78.57,536.71,19
HCPCS,64782,"Removal of growth of nerve of hand or foot nerve, first nerve",1248.5,811.53,78.57,1385.31,19
HCPCS,64783,"Removal of growth of nerve of hand or foot nerve, each additional nerve",614.3,399.3,78.57,641.21,19
HCPCS,64784,Removal of growth of peripheral nerve,1942.5,1262.63,78.57,2163.13,19
HCPCS,64786,Removal or growth of sciatic nerve,2897.0,1883.05,78.57,2925.85,19
HCPCS,64787,Implantation of nerve end into bone or muscle,1023.8,665.47,78.57,717.99,19
HCPCS,64788,Removal of growth of skin nerve or nerve lining,3025.35,1966.48,0.01,12822.11,36
HCPCS,64790,Removal of growth of major peripheral nerve or nerve lining,2198.7,1429.16,78.57,2447.43,19
HCPCS,64792,"Removal of growth of major peripheral nerve or nerve lining, extensive including growth",2864.4,1861.86,78.57,3160.41,19
HCPCS,64795,Biopsy of nerve,603.8,392.47,78.57,559.43,19
HCPCS,64802,Removal of upper spine sympathetic nerves,2100.0,1365.0,78.57,2353.64,19
HCPCS,64804,Removal of upper and middle spine sympathetic nerves,3150.0,2047.5,78.57,3317.01,19
HCPCS,64809,Removal of middle and lower spine sympathetic nerves,3045.0,1979.25,78.57,3030.8,19
HCPCS,64818,Removal of lower spine sympathetic nerves,3307.5,2149.88,78.57,2311.33,19
HCPCS,64820,Removal of finger or toe sympathetic nerve,2028.6,1318.59,78.57,2143.15,19
HCPCS,64821,Removal of lower arm radial artery sympathetic nerve,1829.1,1188.92,78.57,2053.57,19
HCPCS,64822,Removal of lower arm ulnar artery sympathetic nerve,1806.0,1173.9,78.57,2053.57,19
HCPCS,64823,Removal of hand sympathetic nerve,2050.7,1332.96,78.57,2333.84,19
HCPCS,64831,"Suture of hand or foot digital nerve, first digital nerve",2827.2,1837.68,78.57,2046.55,19
HCPCS,64832,"Suture of hand or foot digital nerve, each additional digital nerve",951.3,618.35,78.57,995.47,19
HCPCS,64834,Suture of hand or foot common sensory nerve,2005.5,1303.58,78.57,2212.05,19
HCPCS,64835,Suture of hand median motor nerve,2171.4,1411.41,78.57,2410.59,19
HCPCS,64836,Suture of forearm and hand nerve,2172.5,1412.13,78.57,2411.3,19
HCPCS,64837,"Suture of hand or foot nerve, each additional nerve",1055.3,685.95,78.57,1080.29,19
HCPCS,64840,Suture of foreleg nerve to sole of foot,2419.2,1572.48,78.57,2849.06,19
HCPCS,64856,Suture and relocation of arm or leg peripheral nerve,2737.4,1779.31,78.57,3011.66,19
HCPCS,64857,Suture of arm or leg peripheral nerve,3601.0,2340.6549999999997,78.57,3139.42,38
HCPCS,64858,Suture of sciatic nerve,3264.5,2121.93,78.57,3487.65,19
HCPCS,64859,Suture of peripheral nerve,945.0,614.25,78.57,973.35,19
HCPCS,64861,Suture of arm nerve bundle,3677.1,2390.12,78.57,4268.34,19
HCPCS,64862,Suture of lower spine nerve bundle,3169.7,2060.31,78.57,4060.92,19
HCPCS,64864,Suture of face nerve outside skull,3369.5,2190.18,78.57,2592.96,38
HCPCS,64865,Suture of face nerve at temple,3163.7,2056.41,78.57,3289.13,19
HCPCS,64866,Connection of face-spinal nerves to restore function to the face,3543.8,2303.47,78.57,3789.57,19
HCPCS,64868,Connection of face-hypoglossal nerves to restore function to the face,4646.3,3020.1,78.57,3016.39,19
HCPCS,64872,Delayed suture nerve repair,337.1,219.12,78.57,343.76,19
HCPCS,64874,Suture and relocation of nerve to restore function,486.2,316.03,78.57,514.81,19
HCPCS,64876,Suture of nerve with shortening of arm or leg bone,421.6,274.04,78.57,581.63,19
HCPCS,64885,"Graft of head or neck nerve, 4.0 cm or less",3128.0,2033.2,78.57,3349.95,19
HCPCS,64886,"Graft of head or neck nerve, more than 4.0 cm",4075.1,2648.8199999999997,78.57,3881.09,38
HCPCS,64890,"Graft of hand or foot nerve , 4.0 cm or less",2947.4,1915.81,78.57,3198.96,19
HCPCS,64891,"Graft of hand or foot nerve, more than 4.0 cm",3078.6,2001.09,78.57,3399.68,19
HCPCS,64892,"Graft of arm or leg nerve, 4.0 cm or less",2857.1,1857.12,78.57,3103.6,19
HCPCS,64893,"Graft of arm or leg nerve, more than 4.0 cm",3010.4,1956.76,78.57,3321.84,19
HCPCS,64895,"Graft of multiple hand or foot nerves, 4.0 cm or less",3557.4,2312.31,78.57,3928.66,19
HCPCS,64896,"Graft of multiple hand or foot nerves, more than 4.0 cm",3907.1,2539.62,78.57,4244.23,19
HCPCS,64897,"Graft of multiple arm or leg nerves, 4.0 cm or less",3438.8,2235.22,78.57,3750.62,19
HCPCS,64898,"Graft of multiple arm or leg nerves, more than 4.0 cm",3747.5,2435.88,78.57,4066.96,19
HCPCS,64901,"Graft of single strand of nerve, each additional nerve",1688.4,1097.46,78.57,1762.81,19
HCPCS,64902,Graft of multiple nerve sections,1942.5,1262.63,78.57,2041.36,19
HCPCS,64905,"Transfer of nerve to injured nerve, stage 1 of 2",8847.875,5751.12,78.57,39421.86,38
HCPCS,64907,"Transfer of nerve to injured nerve, stage 2 of 2",9190.925,5974.1,78.57,39421.86,38
HCPCS,64910,Repair of nerve with graft,2193.5,1425.78,78.57,2345.44,19
HCPCS,64911,Repair of nerve using vein graft,2383.98,1549.59,78.57,3034.28,19
HCPCS,64912,"Repair of nerve using nerve graft, first strand",1715.0,1114.75,78.57,2330.79,19
HCPCS,64913,"Repair of nerve using nerve graft, each additional strand",345.0,224.25,78.57,470.26,19
HCPCS,64999,Other procedure on nervous system,694.5,451.425,0.01,3176.48,378
HCPCS,65091,Removal of eye contents,2395.65,1557.17,78.57,1957.98,19
HCPCS,65093,Removal of eye contents with insertion of implant,2411.4,1567.41,78.57,1935.92,19
HCPCS,65101,Removal of eyeball,2761.05,1794.68,78.57,2272.92,19
HCPCS,65103,Removal of eyeball with insertion of implant,3547.3,2305.745,78.57,13354.11,38
HCPCS,65105,Removal of eyeball with insertion of implant attached to muscles,5471.4,3556.415,78.57,20031.16,38
HCPCS,65110,Removal of eye contents and eye socket bone,3101.7,2016.11,78.57,3738.9,19
HCPCS,65112,Removal of eye contents and therapeutic removal of eye socket bone,3639.3,2365.55,78.57,4331.55,19
HCPCS,65114,Removal of eye contents with muscle or flap graft,3802.1,2471.37,78.57,4540.14,19
HCPCS,65125,Placement or replacement of peg in eye implant,1145.6,744.64,78.57,1096.07,19
HCPCS,65130,Insertion of eye implant in scleral shell after evisceration,1822.8,1184.82,78.57,2252.64,19
HCPCS,65135,Insertion of eye implant after removal of eye,1856.4,1206.66,78.57,2285.1,19
HCPCS,65140,Insertion of eye implant attached to muscles after removal of eye,5395.8,3507.2749999999996,78.57,20031.16,38
HCPCS,65150,Reinsertion of eye implant,1537.2,999.18,78.57,1822.39,19
HCPCS,65155,Reinsertion of eye implant using foreign material and/or attachment to muscles for reinforcement,2133.6,1386.84,78.57,2598.6,19
HCPCS,65175,Removal of eye implant,2460.15,1599.1,78.57,2031.48,19
HCPCS,65205,Removal of foreign body from external eye (conjunctiva),176.25,114.565,0.01,8477.27,74
HCPCS,65210,Removal of foreign body from external eye (conjunctiva or sclera),427.5,277.875,0.01,8477.27,74
HCPCS,65220,Removal of foreign body in cornea,367.5,238.875,0.01,8477.27,74
HCPCS,65222,Removal of foreign body in cornea using slit lamp,195.0,126.75,0.01,8477.27,74
HCPCS,65235,Removal of foreign body in eye or lens,5363.25,3486.115,0.01,21193.29,55
HCPCS,65260,Removal of foreign body in eye with a magnet,2414.0,1569.1,78.57,2925.37,19
HCPCS,65265,Removal of foreign body in eye,4080.9,2652.59,78.57,3287.51,19
HCPCS,65270,Repair of lacerated conjunctiva,671.0,436.15,78.57,686.95,19
HCPCS,65272,Repair of lacerated conjunctiva using flap or graft,1231.7,800.61,78.57,1271.71,19
HCPCS,65273,Repair of lacerated conjunctiva using flap or graft with hospitalization,960.8,624.52,78.57,1158.67,19
HCPCS,65275,Repair of lacerated cornea,1391.3,904.35,78.57,1420.34,19
HCPCS,65280,Repair of perforating laceration of cornea and/or sclera,2529.45,1644.14,78.57,2041.1,19
HCPCS,65285,Repair of perforating laceration of cornea and/or sclera with reposition or removal of uveal tissue,7199.7,4679.81,78.57,26972.92,38
HCPCS,65286,Repair of lacerated cornea and/or sclera using tissue glue,1788.5,1162.525,0.01,4736.31,55
HCPCS,65290,Repair of wound of eye muscle or tendon,1853.85,1205.0,78.57,1490.94,19
HCPCS,65400,Removal of growth of cornea,1563.0,1015.95,0.01,3726.0,74
HCPCS,65410,Biopsy of cornea,361.2,234.78,78.57,377.91,19
HCPCS,65420,Removal or relocation of corneal conjunctiva,1272.6,827.19,78.57,1296.69,19
HCPCS,65426,Removal or relocation of corneal conjunctiva with graft,2417.7,1571.51,78.57,1612.39,19
HCPCS,65430,Scraping of cornea for diagnosis,416.25,270.565,0.01,8477.27,74
HCPCS,65435,Removal of outer layer of cornea,1102.5,716.63,0.01,3726.0,55
HCPCS,65436,Removal of outer layer of cornea with application of chelating agent,1710.0,1111.5,0.01,6624.11,74
HCPCS,65450,Destruction of growth of cornea,1447.5,940.88,78.57,972.15,19
HCPCS,65600,Multiple punctures of cornea,965.0,627.25,78.57,1053.17,19
HCPCS,65710,Transplantation of tissue from 1 cornea to other cornea,11385.3,7400.445,78.57,48034.5,38
HCPCS,65730,Penetrating transplantation of tissue from 1 cornea to other cornea (except in aphakia or pseudophakia),4643.1,3018.02,78.57,3753.3,19
HCPCS,65750,Penetrating transplantation of tissue from 1 cornea to other cornea (in aphakia),5255.85,3416.3,78.57,3774.0,19
HCPCS,65755,Penetrating transplantation of tissue from 1 cornea to other cornea (in pseudophakia),5011.65,3257.57,78.57,3754.1,19
HCPCS,65756,Transplantation of outer layer of corneal tissue,4521.9,2939.24,78.57,3599.25,19
HCPCS,65757,Preparation of corneal tissue for transplant,156.6,101.79,70.47,200.63,15
HCPCS,65760,Removal and reshaping of corneal tissue,3692.9,2400.39,78.57,3803.69,15
HCPCS,65765,Transplantation of donor cornea,4284.0,2784.6,78.57,4942.51,15
HCPCS,65767,Transplantation of donor corneal tissue,3987.9,2592.14,78.57,4600.85,15
HCPCS,65770,Insertion of cornea prosthesis,3595.2,2336.88,78.57,4241.78,19
HCPCS,65771,Incision in cornea to correct refraction error,2171.4,1411.41,78.57,2236.54,15
HCPCS,65772,Incision of cornea to correct astigmatism,1118.3,726.9,78.57,1240.42,19
HCPCS,65775,Removal of corneal tissue to correct astigmatism,1379.7,896.81,78.57,1686.74,19
HCPCS,65778,Placement of amniotic membrane on eye surface for wound healing,1299.0,844.35,0.01,3726.0,55
HCPCS,65779,Placement of amniotic membrane on eye surface with sutures for wound healing,3600.0,2340.0,78.57,2739.04,19
HCPCS,65780,Transplantation of fetal sac tissue to cornea,3326.4,2162.16,78.57,2018.29,19
HCPCS,65781,Transplantation of stem cells to cornea,3145.5,2044.58,78.57,4050.7,19
HCPCS,65782,Transplantation of stem cells from 1 cornea to other cornea,2729.7,1774.31,78.57,3490.37,19
HCPCS,65785,Implantation of corneal ring segments,8029.0,5218.85,78.57,28859.44,38
HCPCS,65800,Removal of eye fluid,1578.0,1025.7,0.01,7104.46,74
HCPCS,65810,Complex removal of eye fluid,1303.1,847.02,78.57,1410.88,19
HCPCS,65815,Removal of blood from eye,1628.6,1058.59,78.57,1545.67,19
HCPCS,65820,Incision to improve eye fluid flow,1877.4,1220.31,78.57,2293.56,19
HCPCS,65850,Insertion of eye fluid drainage tube,3220.95,2093.62,78.57,2551.19,19
HCPCS,65855,Laser repair to improve eye fluid flow,891.75,579.64,0.01,3227.0,55
HCPCS,65860,Laser removal of scar tissue of eye,951.3,618.35,78.57,762.71,19
HCPCS,65865,Removal of scar tissue in eye (goniosynechiae),2205.0,1433.25,78.57,1434.35,19
HCPCS,65870,Removal of scar tissue in eye (anterior synechiae),2217.6,1441.44,78.57,1789.75,19
HCPCS,65875,Removal of scar tissue in eye (posterior synechiae),2356.2,1531.53,78.57,1910.89,19
HCPCS,65880,Removal of corneal scar tissue,2485.35,1615.48,78.57,2011.86,19
HCPCS,65900,Removal of outer lining of cornea,2432.9,1581.39,78.57,2947.98,19
HCPCS,65920,Removal of implanted lens of eye,2951.55,1918.51,78.57,2390.66,19
HCPCS,65930,Removal of blood clot of eye,2431.8,1580.67,78.57,1931.87,19
HCPCS,66020,Injection of air or liquid into eye,1151.0,748.15,0.01,4751.8,55
HCPCS,66030,Injection of medication into eye,1124.25,730.765,0.01,4751.8,74
HCPCS,66130,Removal of growth of sclera,1768.2,1149.33,78.57,1735.66,19
HCPCS,66150,Partial removal of iris and creation of drainage hole for treatment of glaucoma,2158.8,1403.22,78.57,2657.29,19
HCPCS,66155,Partial removal of iris using heat for treatment of glaucoma,2152.5,1399.13,78.57,2655.09,19
HCPCS,66160,Removal of sclera and iris and creation of eye fluid drainage tract for treatment of glaucoma,2454.9,1595.69,78.57,2996.42,19
HCPCS,66170,Creation of eye fluid drainage tract for treatment of glaucoma,2972.6,1932.19,78.57,3319.81,19
HCPCS,66172,Creation of eye fluid drainage tract for treatment of glaucoma with previous scarring,5602.35,3641.53,78.57,3614.19,19
HCPCS,66174,Dilation of fluid outflow drainage within eye,2247.5,1460.88,78.57,2321.07,19
HCPCS,66175,Dilation of fluid outflow drainage within eye with insertion of device to maintain open channel,2356.03,1531.42,78.57,2443.57,19
HCPCS,66179,Creation of shunt to improve eye fluid flow,2240.7,1456.46,78.57,3272.46,19
HCPCS,66180,Creation of shunt to improve eye fluid flow using tissue graft,4454.1,2895.17,78.57,3453.54,19
HCPCS,66183,Insertion of eye fluid drainage device,3391.5,2204.48,78.57,3124.79,19
HCPCS,66184,Revision of eye fluid drainage shunt,1560.3,1014.2,78.57,2381.14,19
HCPCS,66185,Revision of eye fluid drainage shunt with graft,2800.35,1820.23,78.57,2565.03,19
HCPCS,66225,Repair of protrusion of inner tissue through eyeball with graft,2659.7,1728.81,78.57,2829.32,19
HCPCS,66250,Revision or repair of operative wound of eye,2673.975,1738.085,0.01,6627.99,55
HCPCS,66500,Incision of iris to improve eye fluid flow,878.9,571.29,78.57,1084.65,19
HCPCS,66505,Incision and drainage of eye fluid accumulation of iris,1260.0,819.0,78.57,1187.09,19
HCPCS,66600,Removal of iris and growth,2050.7,1332.96,78.57,2550.86,19
HCPCS,66605,Removal of iris and eyelid border to improve eye fluid flow with partial removal of ciliary muscle,2669.1,1734.92,78.57,3240.03,19
HCPCS,66625,Removal of margin of iris to improve eye fluid flow,1307.3,849.75,78.57,1300.19,19
HCPCS,66630,Removal of section of iris to improve eye fluid flow,1419.6,922.74,78.57,1725.68,19
HCPCS,66635,Partial removal of iris and eyelid border to improve eye fluid flow,2153.1,1399.52,78.57,1742.62,19
HCPCS,66680,Repair of iris and lens,1923.15,1250.05,78.57,1569.72,19
HCPCS,66682,Suture of iris and lens,1556.1,1011.47,78.57,1957.0,19
HCPCS,66700,Destruction of lens tissue,1192.8,775.32,78.57,1201.7,19
HCPCS,66710,Destruction of lens tissue using laser,2226.375,1447.145,78.57,6740.33,38
HCPCS,66711,Destruction of tissue encircling lens using an endoscope,1586.6,1031.29,78.57,1549.45,19
HCPCS,66720,Destruction of tissue encircling lens,1179.2,766.48,78.57,1255.02,19
HCPCS,66740,Destruction of tissue of eyelid border,1260.0,819.0,78.57,1201.7,19
HCPCS,66761,"Creation of eye fluid drainage tracts in iris using a laser, per session",937.5,609.38,0.01,3227.0,74
HCPCS,66762,Creation of opening of iris for eye fluid drainage using a laser,777.5,505.375,0.01,1495.44,36
HCPCS,66770,Destruction of growth of iris using a laser,1308.3,850.4,78.57,1462.76,19
HCPCS,66820,Removal of recurring cataract in lens capsule by stab incision,1033.2,671.58,78.57,1217.19,19
HCPCS,66821,Removal of recurring cataract in lens capsule using a laser,875.25,568.915,0.01,3227.0,93
HCPCS,66825,Repositioning of lens prosthesis,2855.55,1856.11,78.57,2326.9,19
HCPCS,66830,Removal of recurring cataract in lens capsule with sectioning of cornea and scleral areas,1793.4,1165.71,78.57,2151.03,19
HCPCS,66840,Aspiration of lens material by aspiration,3203.55,2082.31,78.57,2113.2,19
HCPCS,66850,Aspiration of lens material by fragmenting and aspiration,3729.6,2424.24,78.57,2405.17,19
HCPCS,66852,Removal of lens material,3625.65,2356.67,78.57,2563.24,19
HCPCS,66920,Removal of lens material and capsule,2217.6,1441.44,78.57,2287.18,19
HCPCS,66930,Removal of lens material and capsule for dislocated lens,2465.4,1602.51,78.57,2600.09,19
HCPCS,66940,Removal of lens material and portion of lens capsule,2315.3,1504.95,78.57,2373.75,19
HCPCS,66982,Complex removal of cataract with insertion of prosthetic lens,4071.45,2646.44,78.57,2290.95,19
HCPCS,66983,Removal of cataract and capsule with insertion of prosthetic lens,2520.0,1638.0,78.57,2264.35,15
HCPCS,66984,Removal of cataract with insertion of prosthetic lens,4526.85,2942.455,78.57,13964.87,38
HCPCS,66985,Insertion of prosthetic lens,3252.45,2114.09,78.57,2333.86,19
HCPCS,66986,Exchange of prosthetic lens,3556.35,2311.63,78.57,2759.11,19
HCPCS,66989,Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye,1929.0,1253.85,78.57,2630.2,19
HCPCS,66990,Exam of eye using an endoscope,216.33,140.61,66.65,272.63,19
HCPCS,66991,Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye,1539.0,1000.35,78.57,2098.89,19
HCPCS,66999,Other procedure on front of eye,1865.0,1212.25,73.6,13316.02,487
HCPCS,67005,Partial removal of eye fluid between lens and retina,2913.75,1893.94,78.57,1432.47,19
HCPCS,67010,Partial removal of eye fluid between lens and retina with mechanical removal of eye fluid,3354.75,2180.59,78.57,1645.92,19
HCPCS,67015,Aspiration or release of eye fluid between lens and retina,3834.8,2492.62,0.01,14165.01,36
HCPCS,67025,Injection of synthetic eye fluid,2959.5,1923.68,78.57,1933.62,19
HCPCS,67027,Implantation of eye drug delivery system,4625.85,3006.8,78.57,2588.7,19
HCPCS,67028,Injection of drug into eye,412.5,268.125,0.01,2166.29,74
HCPCS,67030,Cutting of strands of eye fluid between lens and retina,1357.7,882.51,78.57,1618.96,19
HCPCS,67031,Release of scar tissue between lens and retina using a laser,3150.0,2047.5,78.57,1080.91,19
HCPCS,67036,Removal of eye fluid (vitreous) between lens and retina,5670.0,3685.5,78.57,2735.49,19
HCPCS,67039,Destruction of eye fluid (vitreous) between lens and retina using a laser,7978.5,5186.030000000001,78.57,26972.92,38
HCPCS,67040,Destruction of eye fluid (vitreous) between lens and retina and all of retina using a laser,6722.1,4369.37,78.57,3168.58,19
HCPCS,67041,Removal of membrane of retina,5080.95,3302.62,78.57,3502.19,19
HCPCS,67042,Removal of membrane of retina with removal of internal limiting membrane of retina,6352.05,4128.83,78.57,3502.19,19
HCPCS,67043,Removal of membrane of retina with removal of subretinal membrane,4071.9,2646.74,78.57,3696.83,19
HCPCS,67101,Repair of detached retina by cold treatment,3385.5,2200.575,78.57,14128.86,38
HCPCS,67105,Repair of detached retina using a laser,2131.5,1385.48,78.57,1431.05,19
HCPCS,67107,Repair of detached retina and drainage of eye fluid between lens and retina,5235.3,3402.95,78.57,3442.45,19
HCPCS,67108,Repair of detached retina with drainage and removal of eye fluid between lens and retina,7229.29,4699.04,0.01,17783.04,55
HCPCS,67110,Repair of detached retina by injection of air or gas,2575.5,1674.075,0.01,8477.27,55
HCPCS,67113,Complex repair of detached retina and drainage of eye fluid between lens and retina,6687.45,4346.84,78.57,4071.82,19
HCPCS,67115,Release of material used for retina repair,1231.7,800.61,78.57,1512.61,19
HCPCS,67120,Removal of implant material from outside of eye,3019.35,1962.58,78.57,1701.94,19
HCPCS,67121,Removal of implant material from inside of eye,3435.15,2232.85,78.57,2756.92,19
HCPCS,67141,Heat or freezing treatment to prevent detachment of retina,1458.5,948.03,78.57,686.91,19
HCPCS,67145,Photocoagulation treatment to prevent detachment of retina,1110.0,721.5,0.01,3227.0,55
HCPCS,67208,Destruction of growth of retina by heat or freezing,1503.6,977.34,78.57,1753.52,19
HCPCS,67210,Destruction of growth of retina using a laser,1110.0,721.5,0.01,8023.32,55
HCPCS,67218,Destruction of growth of retina by implantation of radiation source,5378.7,3496.16,78.57,4216.01,19
HCPCS,67220,Destruction of vascular growth between retina and sclera by photocoagulation,2387.025,1551.565,0.01,3227.0,55
HCPCS,67221,Destruction of vascular growth between retina and sclera by photodynamic therapy,738.75,480.19,0.01,3227.0,55
HCPCS,67225,Destruction of vascular growth between retina and sclera by photodynamic therapy for second eye at 1 session,730.75,474.99,0.01,1522.17,36
HCPCS,67227,Destruction of leaking blood vessels of retina,1527.8,993.07,78.57,954.04,19
HCPCS,67228,Destruction of leaking blood vessels of retina using laser,1944.75,1264.09,0.01,3227.0,55
HCPCS,67229,"Destruction of leaking blood vessels of retina, preterm infant",6300.0,4095.0,78.57,3543.22,19
HCPCS,67250,Repair of defect of sclera,2034.9,1322.69,78.57,2409.64,19
HCPCS,67255,Repair of defect of sclera with graft,2351.0,1528.15,78.57,2070.45,19
HCPCS,67311,Realignment of horizontal eye muscle,5059.725,3288.8250000000003,78.57,19767.75,38
HCPCS,67312,Realignment of eye by repair of 2 horizontal muscles,7749.6,5037.245,78.57,32233.47,38
HCPCS,67314,Realignment of vertical eye muscle,5131.35,3335.38,78.57,19767.75,38
HCPCS,67316,Realignment of multiple vertical eye muscles,3865.575,2512.625,78.57,11171.9,38
HCPCS,67318,Realignment of eye muscle at upper inner edge of eye,1975.1,1283.82,78.57,2116.12,19
HCPCS,67320,Relocation of eye muscle to restore function,897.9,583.635,77.25,7016.18,38
HCPCS,67331,Realignment of eye muscle following injury or eye surgery,1000.0,650.0,78.57,954.04,19
HCPCS,67332,Realignment of eye muscle complicated by scarring or restrictive muscle movement,1127.85,733.1049999999999,77.25,7016.18,38
HCPCS,67334,Realignment of eye muscle by suture,1171.8,761.67,78.57,954.04,19
HCPCS,67335,Placement of adjustable sutures during eye muscle surgery,586.05,380.935,77.25,7016.18,38
HCPCS,67340,Realignment and repair of detached eye muscle,798.15,518.8,77.25,7016.18,38
HCPCS,67343,Release of extensive scar tissue of eye,3202.5,2081.625,78.57,11171.9,38
HCPCS,67345,Destruction of eye muscle by injection of chemical,729.0,473.85,0.01,1162.13,36
HCPCS,67346,Biopsy of eye muscle,693.15,450.55,78.57,585.31,19
HCPCS,67400,Exploration of cavity behind eye,5639.925,3665.955,78.57,20031.16,38
HCPCS,67405,Incision and drainage of cavity behind eye,2995.65,1947.17,78.57,2423.99,19
HCPCS,67412,Removal of growth of cavity behind eye,3875.85,2519.3050000000003,78.57,11171.9,38
HCPCS,67413,Removal of foreign body in cavity behind eye,3586.35,2331.13,78.57,2626.57,19
HCPCS,67414,Removal of bone cavity behind eye for decompression,6400.65,4160.424999999999,78.57,20031.16,38
HCPCS,67415,Fine needle aspiration of orbital contents,3637.35,2364.28,77.71,17424.13,38
HCPCS,67420,Removal of bone and growth of cavity behind eye,7127.475,4632.86,78.57,20031.16,38
HCPCS,67430,Removal of bone and foreign body in cavity behind eye,4885.65,3175.67,78.57,3829.48,19
HCPCS,67440,Removal of bone with drainage from cavity behind eye,3285.5,2135.58,78.57,3705.93,19
HCPCS,67445,Removal of bone from cavity behind eye with bone flap,3599.4,2339.61,78.57,4300.56,19
HCPCS,67450,Exploration of cavity behind eye with bone flap,6390.375,4153.745,78.57,20031.16,38
HCPCS,67500,Injection of drug into cavity behind eye,386.4,251.16,0.01,1084.65,36
HCPCS,67505,Injection of alcohol into cavity behind eye,267.6,173.94,0.01,723.1,36
HCPCS,67515,Injection of drug or substance into membrane covering eyeball,345.0,224.25,0.01,2166.29,55
HCPCS,67516,Injection of drug into the space between the cornea and retina in the eye,470.0,305.5,0.01,1807.75,34
HCPCS,67550,Insertion of implant outside eye muscles,3258.55,2118.06,78.57,2957.45,38
HCPCS,67560,Removal or revision of implant outside eye muscles,2494.8,1621.62,78.57,3033.63,19
HCPCS,67570,Release of optic nerve,6080.1,3952.0699999999997,78.57,20031.16,38
HCPCS,67700,Incision and drainage of abscess of eyelid,602.25,391.46500000000003,0.01,2166.29,55
HCPCS,67710,Removal of sutures between upper and lower eyelids,1001.475,650.96,0.01,3726.0,55
HCPCS,67715,Incision of corner of eye at eyelid,3183.0,2068.95,59.46,14115.95,38
HCPCS,67800,Removal of chronic growth of eyelid,471.0,306.15,0.01,2196.42,74
HCPCS,67801,Removal of multiple chronic growths of same eyelid,784.0,509.6,0.01,3726.0,55
HCPCS,67805,Removal of multiple chronic growths of different eyelids,592.05,384.83500000000004,0.01,2166.29,55
HCPCS,67808,Removal of chronic eyelid growth under general anesthesia and/or requiring hospitalization,1899.8,1234.87,78.57,7447.93,38
HCPCS,67810,Biopsy of eyelid,639.3,415.54499999999996,0.01,2166.29,55
HCPCS,67820,Removal of eyelashes using forceps,176.25,114.565,0.01,8477.27,74
HCPCS,67825,Removal of eyelashes,536.25,348.565,0.01,8477.27,74
HCPCS,67830,Removal of eyelashes by incision,1119.3,727.55,49.27,651.15,19
HCPCS,67835,Removal of eyelashes with graft,1140.3,741.2,78.57,1330.42,19
HCPCS,67840,Removal of growth of eyelid,1038.0,674.7,0.01,3726.0,55
HCPCS,67850,"Destruction of growth of eyelid margin, 1.0 cm or less",690.9,449.09,78.57,523.91,19
HCPCS,67875,Temporary closure of eyelids by suture,1246.5,810.23,0.01,4816.36,55
HCPCS,67880,Creation of permanent eyelid margin scarring,2232.3,1450.995,0.01,6701.59,36
HCPCS,67882,Creation of permanent eyelid margin scarring with relocation of eyelid tissue,2424.45,1575.895,0.01,6701.59,55
HCPCS,67900,Repair of brow paralysis,2443.4,1588.21,0.01,7016.18,74
HCPCS,67901,Repair of upper eyelid muscle to correct drooping or paralysis using external material,2629.2,1708.98,78.57,8023.32,38
HCPCS,67902,Repair of upper eyelid muscle to correct drooping or paralysis using internal tissues,1865.9,1212.84,78.57,2189.86,19
HCPCS,67903,Shortening or advancement of upper eyelid muscle to correct drooping or paralysis,2443.4,1588.21,0.01,6701.59,55
HCPCS,67904,Repair of tendon of upper eyelid,2595.0,1686.75,0.01,7016.18,74
HCPCS,67906,Suspension of upper eyelid muscle to correct drooping or paralysis,1980.3,1287.2,78.57,1543.08,19
HCPCS,67908,"Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis",1719.2,1117.48,78.57,7016.18,38
HCPCS,67909,Revision of surgery to correct drooping or paralyzed upper eyelid,1486.8,966.42,78.57,1340.97,19
HCPCS,67911,Correction of widely-opened upper eyelid,2443.4,1588.21,78.57,6701.59,57
HCPCS,67912,Restoration of eyelid blinking function with implant,2595.0,1686.75,0.01,6701.59,55
HCPCS,67914,Suture repair of turning-outward upper or lower eyelid defect,1448.8,941.72,0.01,6451.0,55
HCPCS,67915,Repair of turning-outward defect of upper or lower eyelid using heat,998.6,649.09,78.57,762.68,19
HCPCS,67916,Repair of turning-outward eyelid defect,1994.0,1296.1,78.57,1470.58,38
HCPCS,67917,Extensive repair of turning-outward eyelid defect,2590.95,1684.12,0.01,7016.18,74
HCPCS,67921,Suture repair of turning-inward eyelid defect,1730.0,1124.5,0.01,6451.0,74
HCPCS,67922,Repair of turning-inward eyelid defect using heat,982.8,638.82,78.57,740.29,19
HCPCS,67923,Repair of turning-inward eyelid defect,1506.8,979.42,78.57,1471.38,19
HCPCS,67924,Extensive repair of turning-inward eyelid defect,2402.4,1561.56,0.01,7016.18,55
HCPCS,67930,Suture of recent wound of eyelid,1407.85,915.105,78.57,6451.0,38
HCPCS,67935,Repair of wound of eyelid margin,2595.0,1686.75,78.57,6701.59,57
HCPCS,67938,Removal of embedded foreign body in eyelid,818.25,531.865,0.01,2166.29,55
HCPCS,67950,Reconstruction of eyelid margin,1730.0,1124.5,0.01,4467.73,55
HCPCS,67961,Removal of up to 1/4 of eyelid margin and repair of eyelid,2383.5,1549.275,0.01,6701.59,55
HCPCS,67966,Removal of over 1/4 of eyelid margin and repair of eyelid,2741.775,1782.155,78.57,6701.59,38
HCPCS,67971,Reconstruction of up to 2/3 of eyelid with tissue from opposite eyelid,3609.675,2346.29,78.57,11171.9,38
HCPCS,67973,Reconstruction of lower eyelid by transfer of eyelid tissue from opposite eyelid,3987.675,2591.99,78.57,11171.9,38
HCPCS,67974,Reconstruction of upper eyelid with tissue from opposite eyelid,2594.6,1686.49,78.57,2822.81,19
HCPCS,67975,Reconstruction of eyelid by transfer of eyelid tissue from opposite eyelid,3482.1,2263.365,0.01,11171.9,55
HCPCS,67999,Other procedure on eyelid,275.0,178.75,0.01,710.19,17
HCPCS,68020,Incision and drainage of cyst of eye,1170.0,760.5,0.01,3037.02,36
HCPCS,68040,Removal of scars of eyelid lining due to infection,405.7,263.705,0.01,8477.27,55
HCPCS,68100,Biopsy of eyelid lining,1886.55,1226.26,0.01,6701.59,55
HCPCS,68110,"Removal of growth of eyelid lining, 1.0 cm or less",787.5,511.88,0.01,6701.59,93
HCPCS,68115,"Removal of growth of eyelid lining, more than 1.0 cm",1711.0,1112.15,0.01,6451.0,55
HCPCS,68130,Removal of growth of eyelid lining and sclera,1344.0,873.6,78.57,1328.82,19
HCPCS,68135,Destruction of growth of eyelid lining,1973.7,1282.905,0.01,7708.76,36
HCPCS,68200,Injection into conjunctiva,422.925,274.905,0.01,8477.27,55
HCPCS,68320,Repair of eyelid lining with graft from external eye,2640.6,1716.3899999999999,0.01,7016.18,55
HCPCS,68325,Repair of conjunctiva with graft from cheek tissue,1758.8,1143.22,78.57,1995.55,19
HCPCS,68326,Reconstruction of conjunctiva with graft from outer eye or rearrangement,6445.55,4189.61,0.01,26754.7,36
HCPCS,68328,Reconstruction of conjunctiva with graft from cheek,2852.4,1854.06,78.57,2144.97,19
HCPCS,68330,Release of scar tissue from conjunctiva,1497.3,973.25,78.57,1500.05,19
HCPCS,68335,Release of scar tissue from eyelids with graft,2434.95,1582.72,78.57,1964.96,19
HCPCS,68340,Release of scar tissue from eyelids,1392.3,905.0,78.57,1452.89,19
HCPCS,68360,Partial relocation of conjunctival flap,1315.7,855.21,78.57,1306.66,19
HCPCS,68362,Relocation of conjunctival flap,1646.4,1070.16,78.57,1991.92,19
HCPCS,68371,Harvest of donor conjunctiva,977.7,635.51,78.57,1251.41,19
HCPCS,68400,Incision and drainage of tear producing gland,804.15,522.7,0.01,3726.0,55
HCPCS,68420,Incision and drainage of tear duct sac,911.4,592.41,68.66,800.76,19
HCPCS,68440,Snip incision of tear duct at inner corner of eye,769.8,500.37,0.01,2166.29,55
HCPCS,68500,Removal of tear producing gland,2451.8,1593.67,78.57,2975.0,19
HCPCS,68505,Partial removal of tear producing gland,2464.4,1601.86,78.57,2960.63,19
HCPCS,68510,Biopsy of tear producing gland,1680.0,1092.0,78.57,6740.33,38
HCPCS,68520,Removal of tear sac,3452.3,2243.995,78.57,13354.11,38
HCPCS,68525,Biopsy of tear sac,708.8,460.72,78.57,795.48,19
HCPCS,68530,Removal of foreign body or stone in tear passages,826.6,537.29,78.57,2166.29,38
HCPCS,68540,Removal of growth of tear producing gland,2343.6,1523.34,78.57,2829.84,19
HCPCS,68550,Removal of growth of tear producing gland with osteotomy,2877.0,1870.05,78.57,3473.29,19
HCPCS,68700,Plastic repair of tear duct,3297.825,2143.585,78.57,11171.9,38
HCPCS,68705,Release of tissue at tear duct opening,675.2,438.88,65.94,632.45,19
HCPCS,68720,Creation of drainage tract from tear sac to nasal cavity,5658.0,3677.705,78.57,20031.16,38
HCPCS,68745,Creation of tear drainage tract to nasal cavity,3175.2,2063.88,78.57,2315.34,19
HCPCS,68750,Creation of tear drainage tract to nasal cavity with insertion of tube or stent,5650.125,3672.585,78.57,20031.16,38
HCPCS,68760,"Repair tear duct opening by heat, tying, or laser surgery",417.0,271.05,0.01,2166.29,55
HCPCS,68761,Closure of tear duct opening using plug,527.25,342.71500000000003,0.01,2166.29,74
HCPCS,68770,Closure of abnormal tear drainage tract,2698.05,1753.73,78.57,1908.95,19
HCPCS,68801,Dilation of tear drainage opening,487.5,316.88,0.01,1057.53,36
HCPCS,68810,Insertion of probe into nasal tear duct,692.025,449.82,0.01,2166.29,55
HCPCS,68811,Insertion of probe into nasal tear duct under anesthesia,1700.3,1105.195,78.57,7447.93,38
HCPCS,68815,Probing of nasal tear duct with insertion of tube or stent,4427.25,2877.715,0.01,19767.75,55
HCPCS,68816,Probing of nasal tear duct with balloon tube dilation,1705.3,1108.4450000000002,78.57,6451.0,38
HCPCS,68840,Probing of nasal tear duct,417.0,271.05,0.01,2166.29,55
HCPCS,68841,Insertion of drug delivery implant into tear duct of eye,73.0,47.45,25.79,91.77,19
HCPCS,68850,Injection of contrast for imaging of tear sac,1483.7,964.41,39.55,160.36,19
HCPCS,69000,Simple drainage of abscess or blood accumulation of external ear,764.25,496.765,0.01,3227.0,55
HCPCS,69005,Complicated drainage of external ear abscess or blood accumulation,1443.675,938.39,0.01,5268.3,36
HCPCS,69020,Drainage of abscess of ear canal,574.8,373.62,0.01,1417.79,36
HCPCS,69090,Piercing of ear,90.35,58.730000000000004,28.85,120.1,30
HCPCS,69100,Biopsy of ear,362.5,235.625,0.01,8477.27,55
HCPCS,69105,Biopsy of ear canal,1197.375,778.295,0.01,8477.27,55
HCPCS,69110,Partial removal of external ear with simple repair,2100.0,1365.0,0.01,8793.41,55
HCPCS,69120,Removal of entire ear,1612.8,1048.32,78.57,1183.02,19
HCPCS,69140,Removal of bony growths of ear canal,2332.1,1515.87,78.57,2613.2,19
HCPCS,69145,Removal of growth in soft tissue of ear canal,4017.8,2611.5699999999997,0.01,16814.66,36
HCPCS,69150,Removal of growth of ear canal,4310.85,2802.05,78.57,3075.62,19
HCPCS,69155,Removal of growth of ear canal with neck dissection,4630.5,3009.83,78.57,4919.63,19
HCPCS,69200,Removal of foreign body in ear canal,324.75,211.09,0.01,8477.27,51
HCPCS,69205,Removal of foreign body in ear canal under anesthesia,315.0,204.75,78.57,290.87,19
HCPCS,69209,Removal of impacted ear wax by washing,70.5,45.83,15.54,251.79,53
HCPCS,69210,Removal of impacted ear wax,92.5,60.125,0.01,2166.29,51
HCPCS,69220,Simple removal of skin debris and drainage of mastoid cavity,390.825,254.04,0.01,631.42,36
HCPCS,69222,Complex removal of skin debris and drainage of mastoid cavity,1064.05,691.635,0.01,3266.86,36
HCPCS,69300,Repair of protruding ear,3126.9,2032.49,0.01,8456.4,55
HCPCS,69310,Reconstruction of ear canal,4790.424999999999,3113.7799999999997,78.57,3240.17,38
HCPCS,69320,Creation of ear canal,4174.8,2713.62,78.57,4550.84,19
HCPCS,69420,"Incision, aspiration, and/or inflation of eardrum",461.55,300.01,0.01,724.39,36
HCPCS,69421,"Incision, aspiration, and inflation of eardrum under anesthesia",615.9,400.34,78.57,440.68,19
HCPCS,69424,Removal of implanted eardrum tube under anesthesia,508.8,330.72,25.48,309.31,19
HCPCS,69433,Incision of eardrum with insertion of eardrum tube under local or topical anesthesia,728.85,473.755,0.01,1750.94,36
HCPCS,69436,Incision of eardrum with placement of eardrum tube under general anesthesia,902.55,586.66,78.57,471.93,19
HCPCS,69440,Exploration of middle ear,2772.0,1801.8,78.57,2042.52,19
HCPCS,69450,Incision of ear canal with release of scar tissue,1273.63,827.86,78.57,1616.63,19
HCPCS,69501,Incision of mastoid bone,2003.4,1302.21,78.57,2155.3,19
HCPCS,69502,Removal of middle ear (mastoid) bone,3978.45,2585.99,78.57,2859.98,19
HCPCS,69505,Removal of middle ear bone and removal of growth of middle ear,3399.9,2209.94,78.57,3582.33,19
HCPCS,69511,Extensive removal of mastoid bone,3675.0,2388.75,78.57,3670.3,19
HCPCS,69530,Extensive removal of bones around inner ear and mastoid bone,7087.5,4606.88,78.57,4924.52,19
HCPCS,69535,Removal of skull bone surrounding ear,11110.05,7221.53,78.57,7991.63,19
HCPCS,69540,Removal of polyp of outer ear,541.8,352.17,42.31,511.87,19
HCPCS,69550,Removal of growth of outer ear through ear canal,2974.7,1933.56,78.57,3097.78,19
HCPCS,69552,Removal of growth of outer ear through mastoid bone,3689.45,2398.14,78.57,4675.94,19
HCPCS,69554,Removal of growth of outer ear,6888.0,4477.2,78.57,7512.02,19
HCPCS,69601,Revision of operation of middle ear bones and removal of remaining bones,4288.8,2787.72,78.57,3084.13,19
HCPCS,69602,Revision of previous mastoid bone surgery,3093.3,2010.65,78.57,3235.11,19
HCPCS,69603,Extensive revision of previous mastoid bone surgery,3550.1,2307.57,78.57,3753.47,19
HCPCS,69604,Revision of operation of middle ear and eardrum,3425.1,2226.32,78.57,3308.26,19
HCPCS,69610,Repair of eardrum,2474.625,1608.505,0.01,8677.2,36
HCPCS,69620,Repair of defect or tear of eardrum,3170.925,2061.1,0.01,8173.61,36
HCPCS,69631,Repair of eardrum and ear canal with opening to ear bones,4629.0,3008.85,78.57,2626.02,19
HCPCS,69632,"Repair of eardrum, ear canal, and bones",3481.8,2263.17,78.57,3203.07,19
HCPCS,69633,"Repair of eardrum, ear canal, and bones with insertion of prosthesis",5473.2,3557.58,78.57,3103.08,19
HCPCS,69635,Repair of eardrum and ear canal with incision of middle ear bone,5392.8,3505.32,78.57,3684.6,19
HCPCS,69636,"Repair of eardrum, ear canal, and bones with incision of middle ear bone",3910.2,2541.63,78.57,4110.12,19
HCPCS,69637,"Repair of eardrum, ear canal, and bones with placement of implant and opening of middle ear",5863.8,3811.47,78.57,4151.1,19
HCPCS,69641,Complex repair of eardrum and ear canal with removal of mastoid bone,6177.15,4015.15,78.57,3095.61,19
HCPCS,69642,"Repair of eardrum, ear canal, and bones with removal of middle ear bone",6759.9,4393.94,78.57,3977.94,19
HCPCS,69643,Repair of eardrum and ear canal with removal of middle ear bone,4280.9,2782.59,78.57,3635.35,19
HCPCS,69644,"Repair of eardrum, ear canal, and bones with removal of mastoid bone, with intact canal wall",6552.0,4258.8,78.57,4407.15,19
HCPCS,69645,Extensive repair of eardrum and ear canal with removal of middle ear bone,6244.95,4059.22,78.57,4328.03,19
HCPCS,69646,Extensive repair and reconstruction of eardrum and ear canal with removal of middle ear bone,6315.75,4105.24,78.57,4606.2,19
HCPCS,69650,Release of ear bone,2193.5,1425.78,78.57,2387.03,19
HCPCS,69660,Incision or removal of middle ear bone,3422.0,2224.3,78.57,2754.34,19
HCPCS,69661,Incision or removal of ear bone with drilling,5370.75,3490.99,78.57,3590.84,19
HCPCS,69662,Revision of operation of ear bone,5731.5,3725.48,78.57,3441.6,19
HCPCS,69666,Repair of opening of middle to inner ear,2828.7,1838.66,78.57,2400.86,19
HCPCS,69667,Repair of opening to cochlea,2788.8,1812.72,78.57,2407.63,19
HCPCS,69670,Creation of flap to close mastoid cavity,3849.3,2502.05,78.57,2803.26,19
HCPCS,69676,Removal of eardrum nerve,2428.7,1578.66,78.57,2467.54,19
HCPCS,69700,Closure of drainage tract of middle ear,1883.7,1224.41,78.57,2017.14,19
HCPCS,69705,"Dilation of canal between middle ear and throat (eustachian tube) on one side of body, using endoscope inserted through nose",405.0,263.25,78.57,6644.38,19
HCPCS,69706,"Dilation of canal between middle ear and throat (eustachian tube) on both sides of body, using endoscope inserted through nose",564.75,367.09,78.57,6868.22,19
HCPCS,69710,Insertion or replacement of ear bone hearing device,2625.0,1706.25,73.6,1312.5,15
HCPCS,69711,Removal or repair of hearing device in skull bone surrounding ear,2359.4,1533.61,78.57,2538.88,19
HCPCS,69714,Implantation of cochlear stimulating system into skull with attachment through skin to external speech processor,4441.5,2886.98,78.57,1995.95,19
HCPCS,69716,Implantation of cochlear stimulating system into mastoid bone of skull with magnetic attachment to external speech processor,1402.0,911.3,78.57,1912.01,19
HCPCS,69717,Replacement of cochlear stimulating system in skull with attachment through skin to external speech processor,3143.7,2043.41,78.57,2014.02,19
HCPCS,69719,Replacement of cochlear stimulating system into mastoid bone of skull with magnetic attachment to external speech processor,1402.0,911.3,78.57,1912.01,19
HCPCS,69720,Release of face nerve through side,4803.75,3122.44,78.57,3549.09,19
HCPCS,69725,Release of face nerve through bone surrounding ear,5243.7,3408.41,78.57,5599.25,19
HCPCS,69726,Removal of entire cochlear stimulating system from skull with attachment through skin to external speech processor,951.0,618.15,78.57,1259.22,19
HCPCS,69727,Removal of entire cochlear stimulating system from mastoid bone of skull with magnetic attachment to external speech processor,1089.0,707.85,78.57,1441.72,19
HCPCS,69728,Removal of entire cochlear stimulating system from outside mastoid bone of skull with magnetic attachment to external speech processor,1339.0,870.35,78.57,1654.79,19
HCPCS,69729,Implantation of cochlear stimulating system outside mastoid bone of skull with magnetic attachment to external speech processor,1517.5,986.38,78.57,1874.79,19
HCPCS,69730,Replacement of cochlear stimulating system outside mastoid bone of skull with magnetic attachment to external speech processor,1551.5,1008.48,78.57,1917.16,19
HCPCS,69740,Repair of facial nerve external to geniculate ganglion,3977.4,2585.31,78.57,3472.6,19
HCPCS,69745,Repair of facial nerve internal to geniculate ganglion,2786.18,1811.02,78.57,3695.61,19
HCPCS,69799,Other procedure on middle ear,216.0,140.4,54.0,2166.29,19
HCPCS,69801,Incision of fluid canal of inner ear with infusion of drugs,1730.25,1124.665,0.01,4764.71,36
HCPCS,69805,Operation of inner ear,3480.8,2262.52,78.57,3117.62,19
HCPCS,69806,Operation of inner ear with insertion of shunt,5722.05,3719.33,78.57,2784.92,19
HCPCS,69905,Removal of inner ear canal,3192.0,2074.8,78.57,2725.97,19
HCPCS,69910,Removal of inner ear canal and mastoid bone,5857.5,3807.38,78.57,3003.46,19
HCPCS,69915,Severing of ear canal nerve through middle ear and skull bones,4200.0,2730.0,78.57,4559.11,19
HCPCS,69930,Insertion of cochlear device,6939.45,4510.64,78.57,3645.06,19
HCPCS,69950,Severing of ear canal nerve through skull bone,5070.5,3295.83,78.57,5291.57,19
HCPCS,69955,Release of face nerve,5781.3,3757.85,78.57,5889.18,19
HCPCS,69960,Release of ear canal,8150.7,5297.96,78.57,5712.21,19
HCPCS,69970,Removal of growth from skull bone surrounding ear,7598.9,4939.29,78.57,6383.88,19
HCPCS,69990,Use of operating microscope,1057.3,687.245,78.57,1374.64,38
HCPCS,70010,Review by radiologist of lower back portion of brain image,570.2,370.63,32.53,229.24,19
HCPCS,70015,Review by radiologist of brain and spinal cord image,421.1,273.72,52.27,135.37,19
HCPCS,70030,X-ray of eye for detection of foreign body,204.0,132.6,8.3,839.31,37
HCPCS,70100,"X-ray of part of lower jaw, 1-4 views",166.55,108.25999999999999,8.6,581.06,55
HCPCS,70110,"X-ray of lower jaw, minimum of 4 views",216.65,140.825,11.23,800.58,55
HCPCS,70120,"X-ray of bone behind the ear, 1-2 views per side",97.7,63.51,8.3,78.57,19
HCPCS,70130,"X-ray of bone behind the ear, minimum of 3 views per side",239.15,155.45,15.28,774.75,37
HCPCS,70134,X-ray of inside of ear canal,136.5,88.73,16.08,78.57,19
HCPCS,70140,"X-ray of face bones, 1-2 views",225.0,146.25,9.25,645.63,55
HCPCS,70150,"X-ray of face bones, minimum of 3 views",229.25,149.015,11.87,839.31,55
HCPCS,70160,"X-ray of nose bones, minimum of 3 views",221.3,143.845,7.96,872.89,55
HCPCS,70170,Review by radiologist of tear drainage structure of eye image,149.1,96.92,13.33,209.11,19
HCPCS,70190,X-ray of eye canal,99.8,64.87,9.89,78.57,19
HCPCS,70200,"X-ray of eye socket, minimum of 4 views",340.5,221.325,12.54,1407.46,37
HCPCS,70210,"X-ray of paranasal sinus, 1-2 views",183.35,119.18,7.96,697.28,55
HCPCS,70220,"X-ray of paranasal sinus, minimum of 3 views",360.0,234.0,9.92,1033.0,55
HCPCS,70240,X-ray of bone at base of skull,85.1,55.32,8.63,78.57,19
HCPCS,70250,"X-ray of skull, 1-3 views",203.6,132.34,8.3,839.31,110
HCPCS,70260,"X-ray of skull, minimum of 4 views",235.25,152.915,12.54,839.31,37
HCPCS,70300,"X-ray of teeth, 1 view",70.95,46.12,5.01,258.25,37
HCPCS,70310,"X-ray of teeth, less than full mouth",109.6,71.24000000000001,7.63,258.25,55
HCPCS,70320,"X-ray of teeth, full mouth",155.75,101.24000000000001,10.66,387.38,109
HCPCS,70328,X-ray of jaw joint on 1 side of mouth,138.4,89.96000000000001,8.3,464.85,55
HCPCS,70330,X-ray of jaw joints on both sides of mouth,180.0,117.0,10.89,774.75,55
HCPCS,70332,Review by radiologist of hinged joint of upper and lower jaw bones image,275.1,178.82,23.94,111.78,19
HCPCS,70336,MRI scan of jaw joint,1581.75,1028.1399999999999,64.09,4454.81,37
HCPCS,70350,Imaging of jaws and skull,116.5,75.725,8.27,439.03,55
HCPCS,70355,"X-ray of lower jaws, upper jaws and teeth",182.5,118.625,9.58,645.63,92
HCPCS,70360,X-ray of soft tissue of neck,154.6,100.49,8.3,581.06,55
HCPCS,70370,X-ray of voice box or throat,244.45,158.89499999999998,14.61,645.63,37
HCPCS,70371,Imaging of voice box with speech evaluation,282.0,183.3,39.3,645.63,37
HCPCS,70380,X-ray of saliva gland,106.1,68.97,7.65,78.57,19
HCPCS,70390,Review by radiologist of salivary structure image,293.85,191.005,16.62,774.75,37
HCPCS,70450,CT scan head or brain without contrast,806.1,523.965,37.6,2582.5,37
HCPCS,70460,CT scan head or brain with contrast,966.75,628.39,49.65,2905.31,37
HCPCS,70470,CT scan of head or brain before and after contrast,1124.2,730.73,55.87,3292.69,37
HCPCS,70471,"COMPUTED TOMOGRAPHIC ANGIOGRAPHY (CTA), HEAD AND NECK, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES, WHEN PERFORMED, AND IMAGE POSTPROCESSING",588.0,382.2,73.6,2303.59,32
HCPCS,70472,"COMPUTED TOMOGRAPHIC (CT) CEREBRAL PERFUSION ANALYSIS WITH CONTRAST MATERIAL(S), INCLUDING IMAGE POSTPROCESSING PERFORMED WITH CONCURRENT CT OR CT ANGIOGRAPHY OF THE SAME ANATOMY (LIST SEPARATELY IN A",264.0,171.6,34.67,1181.0,32
HCPCS,70473,"COMPUTED TOMOGRAPHIC (CT) CEREBRAL PERFUSION ANALYSIS WITH CONTRAST MATERIAL(S), INCLUDING IMAGE POSTPROCESSING PERFORMED WITHOUT CONCURRENT CT OR CT ANGIOGRAPHY OF THE SAME ANATOMY",282.0,183.3,45.26,1181.0,32
HCPCS,70480,CT scan of cranial cavity without contrast,1012.95,658.4200000000001,56.51,2582.5,37
HCPCS,70481,CT scan of cranial cavity with contrast,1158.4,752.96,49.65,2905.31,37
HCPCS,70482,CT scan of cranial cavity before and after contrast,1311.6,852.54,55.56,3292.69,37
HCPCS,70486,CT scan of face without contrast,297.15,193.15,25.0,5165.0,164
HCPCS,70487,CT scan of face with contrast,1070.7,695.9549999999999,49.65,2905.31,37
HCPCS,70488,CT scan of face before and after contrast,1208.05,785.235,55.87,3034.44,37
HCPCS,70490,CT scan of soft tissue of neck without contrast,911.1,592.2149999999999,56.51,2582.5,37
HCPCS,70491,CT scan of soft tissue of neck with contrast,1125.0,731.25,60.77,3873.75,55
HCPCS,70492,CT scan of soft tissue of neck before and after contrast,1241.8,807.1700000000001,70.74,3292.69,37
HCPCS,70496,CT scan of blood vessels of head with contrast,1510.95,982.12,76.75,2711.63,37
HCPCS,70498,CT scan of blood vessels of neck with contrast,1518.3,986.895,76.75,2711.63,37
HCPCS,70540,"MRI scan of bone of eye socket, face, and/or neck without contrast",1672.05,1086.835,59.15,4454.81,37
HCPCS,70542,"MRI scan of bone of eye socket, face, and/or neck with contrast",1834.1,1192.165,71.36,4906.75,37
HCPCS,70543,"MRI scan of bone of eye socket, face, and/or neck before and after contrast",2611.4,1697.41,78.57,9038.75,73
HCPCS,70544,MRI scan of blood vessels of head without contrast,1666.7,1083.36,52.6,4648.5,74
HCPCS,70545,MRI scan of blood vessels of head with contrast,2249.65,1462.275,52.6,7050.23,55
HCPCS,70546,MRI scan of blood vessels of head before and after contrast,2100.0,1365.0,64.83,5423.25,74
HCPCS,70547,MRI scan of blood vessels of neck without contrast,1774.5,1153.43,52.6,4648.5,56
HCPCS,70548,MRI scan of blood vessels of neck with contrast,2295.85,1492.3049999999998,65.81,7050.23,37
HCPCS,70549,MRI scan of blood vessels of neck before and after contrast,2200.0,1430.0,78.57,5681.5,56
HCPCS,70551,MRI scan of brain without contrast,2000.0,1300.0,64.83,6456.25,91
HCPCS,70552,MRI scan of brain with contrast,2278.0,1480.7,78.37,7050.23,73
HCPCS,70553,MRI scan of brain before and after contrast,2505.35,1628.48,78.57,6068.88,109
HCPCS,70554,Functional MRI scan of brain,1826.9,1187.4850000000001,78.57,5681.5,37
HCPCS,70555,Functional MRI scan of brain with neurofunctional testing,1294.25,841.265,78.57,5681.5,37
HCPCS,70557,MRI scan of brain without contrast during brain procedure,367.9,239.14,78.57,378.94,19
HCPCS,70558,MRI scan of brain with contrast during brain procedure,414.3,269.3,78.57,426.73,19
HCPCS,70559,MRI scan of brain before and after contrast during brain procedure,391.0,254.15,78.57,402.73,19
HCPCS,71045,"X-ray of chest, 1 view",230.0,149.5,7.99,748.93,55
HCPCS,71046,"X-ray of chest, 2 views",168.5,109.525,9.61,671.45,55
HCPCS,71047,"X-ray of chest, 3 views",224.5,145.925,12.2,903.88,55
HCPCS,71048,"X-ray of chest, minimum of 4 views",338.0,219.7,13.97,968.44,55
HCPCS,71100,"X-ray of ribs on side of body, 2 views",185.25,120.41499999999999,9.92,697.28,55
HCPCS,71101,"X-ray of ribs on side of body, minimum of 3 views",206.15,134.0,12.02,748.93,55
HCPCS,71110,"X-ray of ribs on both sides of body, 3 views",220.35,143.23,12.87,813.49,55
HCPCS,71111,"X-ray of ribs on both sides of body, minimum of 4 views",262.85,170.855,14.31,929.7,55
HCPCS,71120,"X-ray of chest bone, minimum of 2 views",161.5,104.975,8.96,581.06,55
HCPCS,71130,"X-ray of joint between breast and collar bones, minimum of 2 views",197.15,128.14999999999998,9.92,717.94,37
HCPCS,71250,CT scan of chest without contrast,1000.0,650.0,47.24,3060.26,55
HCPCS,71260,CT scan of chest with contrast,1125.0,731.25,51.27,3873.75,55
HCPCS,71270,CT scan of chest before and after contrast,1239.15,805.45,54.89,3292.69,37
HCPCS,71271,Low dose CT scan of chest for lung cancer screening,189.7,123.305,47.24,3060.26,74
HCPCS,71275,CT scan of blood vessels of chest with contrast,1440.6,936.39,78.57,4036.45,55
HCPCS,71550,MRI scan of chest without contrast,1792.3,1164.995,63.73,4454.81,37
HCPCS,71551,MRI scan of chest with contrast,2526.9,1642.4850000000001,76.08,7747.5,37
HCPCS,71552,MRI scan of chest before and after contrast,2500.1,1625.065,78.57,6068.88,37
HCPCS,71555,MRI scan of blood vessels of chest,1800.0,1170.0,78.57,5423.25,55
HCPCS,72020,"X-ray of spine, 1 view",270.0,175.5,7.32,774.75,109
HCPCS,72040,"X-ray of upper spine, 2-3 views",220.0,143.0,9.92,697.28,55
HCPCS,72050,"X-ray of upper spine, 4-5 views",262.8,170.82,12.33,929.7,55
HCPCS,72052,"X-ray of upper spine, 6 or more views",331.75,215.64,13.64,1162.13,55
HCPCS,72070,"X-ray of middle spine, 2 views",209.45,136.145,9.27,813.49,55
HCPCS,72072,"X-ray of middle spine, 3 views",233.05,151.485,9.94,929.7,55
HCPCS,72074,"X-ray of middle spine, minimum of 4 views",269.8,175.37,10.92,1097.56,55
HCPCS,72080,"X-ray of middle and lower spine, 2 views",213.4,138.71,9.58,813.49,55
HCPCS,72081,"X-ray of entire middle and lower spine, 1 view",124.0,80.6,11.99,408.04,37
HCPCS,72082,"X-ray of entire middle and lower spine, 2-3 views",227.0,147.55,14.28,800.58,55
HCPCS,72083,"X-ray of entire middle and lower spine, 4-5 views",243.0,157.95,16.23,852.23,37
HCPCS,72084,"X-ray of entire middle and lower spine, minimum of 6 views",268.0,174.2,18.85,903.88,37
HCPCS,72100,"X-ray of lower and sacral spine, 2-3 views",218.95,142.32,10.22,839.31,55
HCPCS,72110,"X-ray of lower and sacral spine, minimum of 4 views",254.05,165.135,11.99,929.7,55
HCPCS,72114,"X-ray lower and sacral spine, minimum of 6 views",306.95,199.51999999999998,13.64,1045.91,37
HCPCS,72120,"X-ray lower and sacral spine, 2-3 views bending views",249.85,162.405,10.22,929.7,37
HCPCS,72125,CT scan of upper spine without contrast,904.25,587.765,44.28,2582.5,37
HCPCS,72126,CT scan of upper spine with contrast,1136.7,738.855,53.58,3357.25,37
HCPCS,72127,CT scan of upper spine before and after contrast,1196.4,777.6600000000001,55.56,3099.0,37
HCPCS,72128,CT scan of middle spine without contrast,903.75,587.44,44.28,2582.5,37
HCPCS,72129,CT scan of middle spine with contrast,1049.2,681.98,53.58,2905.31,37
HCPCS,72130,CT scan of middle spine before and after contrast,1192.75,775.29,55.87,3099.0,37
HCPCS,72131,CT scan of lower spine without contrast,902.15,586.4,44.28,2582.5,37
HCPCS,72132,CT scan of lower spine with contrast,1135.65,738.175,53.58,3357.25,37
HCPCS,72133,CT scan of lower spine before and after contrast,1257.35,817.28,55.87,3421.81,37
HCPCS,72141,MRI scan of upper spinal canal without contrast,1603.3,1042.145,65.14,4454.81,37
HCPCS,72142,MRI scan of upper spinal canal with contrast,1872.95,1217.42,78.57,4906.75,37
HCPCS,72146,MRI scan of middle spinal canal without contrast,1605.4,1043.51,65.14,4454.81,37
HCPCS,72147,MRI scan of middle spinal canal with contrast,2184.0,1419.6,78.57,7050.23,37
HCPCS,72148,MRI scan of lower spinal canal without contrast,1582.8,1028.82,65.45,4454.81,37
HCPCS,72149,MRI scan of lower spinal canal with contrast,2274.3,1478.295,78.57,7050.23,37
HCPCS,72156,MRI scan of upper spinal canal before and after contrast,2519.55,1637.71,78.57,6068.88,37
HCPCS,72157,MRI scan of middle spinal canal before and after contrast,2519.55,1637.71,78.57,6068.88,37
HCPCS,72158,MRI scan of lower spinal canal before and after contrast,2505.35,1628.48,78.57,6068.88,37
HCPCS,72159,MRI scan of blood vessels of spinal canal,2070.65,1345.925,78.57,6068.88,37
HCPCS,72170,"X-ray of pelvis, 1-2 views",214.85,139.655,7.96,903.88,55
HCPCS,72190,"X-ray of pelvis, minimum of 3 views",229.1,148.915,11.66,839.31,55
HCPCS,72191,CT scan of blood vessels of pelvis with contrast,1237.5,804.375,78.57,2647.06,37
HCPCS,72192,CT scan of pelvis without contrast,878.0,570.7,47.57,2582.5,37
HCPCS,72193,CT scan of pelvis with contrast,1022.95,664.9200000000001,50.96,2905.31,37
HCPCS,72194,CT scan of pelvis before and after contrast,1182.4,768.56,53.58,3026.69,37
HCPCS,72195,MRI scan of pelvis without contrast,1693.05,1100.4850000000001,64.04,4454.81,55
HCPCS,72196,MRI scan of pelvis with contrast,2350.0,1527.5,76.08,7050.23,55
HCPCS,72197,MRI scan of pelvis before and after contrast,2489.1,1617.915,78.57,6068.88,55
HCPCS,72198,MRI scan of blood vessels of pelvis,1773.5,1152.78,78.42,602.08,19
HCPCS,72200,"X-ray of joint between lower spine and hip bone, 1-2 views",225.0,146.25,7.96,645.63,55
HCPCS,72202,"X-ray of joint between lower spine and hip bone, 3 or more views",209.65,136.275,9.94,800.58,55
HCPCS,72220,"X-ray of sacrum and tailbone, minimum of 2 views",152.4,99.06,7.96,581.06,55
HCPCS,72240,Review by radiologist of upper spinal canal image,721.45,468.945,40.97,2324.25,37
HCPCS,72255,Review by radiologist of middle spinal canal image,764.1,496.66499999999996,40.22,2582.5,37
HCPCS,72265,Review by radiologist of lower spinal canal image,922.3,599.495,38.17,3486.38,37
HCPCS,72270,Review by radiologist of multiple spinal canals image,1276.95,830.02,57.56,4648.5,37
HCPCS,72285,Review by radiologist of disc of upper or middle spine image,1257.5,817.375,54.9,4054.53,37
HCPCS,72295,Review by radiologist of disc of lower spine image,1211.3,787.345,38.66,4054.53,37
HCPCS,73000,X-ray of collar bone,236.1,153.47,7.63,871.59,55
HCPCS,73010,X-ray of shoulder blade,304.2,197.73,8.58,1200.86,55
HCPCS,73020,"X-ray of shoulder, 1 view",337.5,219.38,6.99,968.44,55
HCPCS,73030,"X-ray of shoulder, minimum of 2 views",332.55,216.16,8.6,1355.81,73
HCPCS,73040,Review by radiologist of shoulder joint image,1045.87,679.8149999999999,25.48,4083.68,37
HCPCS,73050,X-ray of both collar bones joints,122.9,79.89,8.91,929.7,56
HCPCS,73060,"X-ray of upper arm, minimum of 2 views",270.75,175.99,7.63,1045.91,55
HCPCS,73070,"X-ray of elbow, 2 views",268.95,174.82,7.63,1045.91,55
HCPCS,73080,"X-ray of elbow, minimum of 3 views",316.35,205.63,7.96,1220.23,55
HCPCS,73085,Review by radiologist of elbow image,589.55,383.21,23.94,2337.16,37
HCPCS,73090,"X-ray of forearm, 2 views",267.3,173.745,7.32,1045.91,55
HCPCS,73092,"X-ray of infant arm, minimum of 2 views",178.8,116.22,7.32,697.28,37
HCPCS,73100,"X-ray of wrist, 2 views",274.95,178.72,7.94,1045.91,55
HCPCS,73110,"X-ray of wrist, minimum of 3 views",351.15,228.25,8.27,1355.81,55
HCPCS,73115,Review by radiologist of wrist joint image,942.075,612.35,25.61,3486.38,37
HCPCS,73120,"X-ray of hand, 2 views",435.0,282.75,7.63,1258.97,109
HCPCS,73130,"X-ray of hand, minimum of 3 views",472.5,307.13,8.27,1472.03,109
HCPCS,73140,"X-ray of finger, minimum of 2 views",340.725,221.47,6.32,1355.81,55
HCPCS,73200,CT scan of arm without contrast,1343.025,872.9649999999999,44.28,3873.75,55
HCPCS,73201,CT scan of arm with contrast,1560.375,1014.2450000000001,50.96,4357.97,55
HCPCS,73202,CT scan of arm before and after contrast,1826.1,1186.9650000000001,53.27,4648.5,55
HCPCS,73206,CT scan of blood vessels of arm with contrast,1726.575,1122.275,78.57,3970.59,37
HCPCS,73218,MRI scan of arm without contrast,2544.3,1653.8000000000002,60.08,6682.22,37
HCPCS,73219,MRI scan of arm with contrast,2459.85,1598.905,71.66,5810.63,37
HCPCS,73220,MRI scan of arm before and after contrast,3721.05,2418.685,78.57,9103.31,37
HCPCS,73221,MRI scan of arm joint without contrast,2460.825,1599.54,60.39,6682.22,37
HCPCS,73222,MRI scan of arm joint with contrast,2675.55,1739.1100000000001,71.97,7360.13,37
HCPCS,73223,MRI scan of arm joint before and after contrast,3721.05,2418.685,78.57,9103.31,37
HCPCS,73225,MRI scan of blood vessels of arm,1789.9,1163.435,74.48,4648.5,37
HCPCS,73501,"X-ray of hip, 1 view",225.0,146.25,8.6,645.63,73
HCPCS,73502,"X-ray of hip, 2-3 views",230.0,149.5,10.22,748.93,73
HCPCS,73503,"X-ray of hip, minimum of 4 views",360.0,234.0,12.64,1033.0,55
HCPCS,73521,"X-ray of both hips, 2 views",315.0,204.75,10.22,903.88,73
HCPCS,73522,"X-ray of both hips, 3-4 views",360.0,234.0,13.3,1033.0,73
HCPCS,73523,"X-ray of both hips, minimum of 5 views",241.5,156.97500000000002,13.97,909.04,73
HCPCS,73525,Review by radiologist of hip joint image,1199.625,779.76,26.84,4939.03,55
HCPCS,73551,"X-ray of thigh bone, 1 view",250.5,162.825,7.63,1045.91,55
HCPCS,73552,"X-ray of thigh bone, minimum 2 views",341.25,221.815,8.3,1472.03,55
HCPCS,73560,"X-ray of knee, 1-2 views",472.5,307.13,7.63,1472.03,109
HCPCS,73562,"X-ray of knee, 3 views",435.0,282.75,8.91,1355.81,109
HCPCS,73564,"X-ray of knee, 4 or more views",301.8,196.17499999999998,10.53,1119.51,55
HCPCS,73565,X-ray of both knees while standing,234.0,152.1,7.94,929.7,55
HCPCS,73580,Review by radiologist of knee joint image,1262.4,820.56,29.51,5113.35,37
HCPCS,73590,"X-ray of lower leg, 2 views",300.0,195.0,7.32,1239.6,55
HCPCS,73592,"X-ray of infant leg, minimum of 2 views",278.325,180.91,7.32,1045.91,37
HCPCS,73600,"X-ray of ankle, 2 views",255.0,165.75,7.63,1045.91,55
HCPCS,73610,"X-ray of ankle, minimum of 3 views",330.0,214.5,7.96,1355.81,55
HCPCS,73615,Review by radiologist of ankle joint image,282.5,183.63,26.53,115.7,19
HCPCS,73620,"X-ray of foot, 2 views",213.75,138.94,7.32,871.59,109
HCPCS,73630,"X-ray of foot, minimum of 3 views",405.0,263.25,7.65,1239.6,109
HCPCS,73650,"X-ray of heel, minimum of 2 views",229.425,149.13,7.32,871.59,55
HCPCS,73660,"X-ray of toe, minimum of 2 views",262.35,170.53,6.01,1045.91,55
HCPCS,73700,CT scan of leg without contrast,1343.775,873.4549999999999,44.28,3873.75,37
HCPCS,73701,CT scan of leg with contrast material,1565.925,1017.855,50.96,4357.97,37
HCPCS,73702,CT scan of leg before and after contrast,1839.525,1195.69,53.27,4648.5,37
HCPCS,73706,CT scan of blood vessels of lower leg with contrast,1911.3,1242.345,78.57,4067.44,37
HCPCS,73718,MRI scan of leg without contrast,2515.95,1635.37,59.46,6682.22,37
HCPCS,73719,MRI scan of leg with contrast,3584.85,2330.1549999999997,71.05,11621.25,37
HCPCS,73720,MRI scan of leg before and after contrast,3719.475,2417.66,78.57,9103.31,37
HCPCS,73721,MRI scan of leg joint without contrast,2486.025,1615.92,60.08,6682.22,37
HCPCS,73722,MRI scan of leg joint with contrast,2689.725,1748.3200000000002,71.97,7360.13,37
HCPCS,73723,MRI scan of leg joint before and after contrast,3721.05,2418.685,78.57,9103.31,55
HCPCS,73725,MRI scan of blood vessels of leg,2669.7,1735.31,78.57,604.27,19
HCPCS,74018,"X-ray of abdomen, 1 view",230.0,149.5,8.3,748.93,55
HCPCS,74019,"X-ray of abdomen, 2 views",204.65,133.025,10.25,839.31,55
HCPCS,74021,"X-ray of abdomen, minimum of 3 views",360.0,234.0,11.89,1033.0,55
HCPCS,74022,X-ray series of abdomen with single X-ray of chest,299.9,194.935,14.31,1162.13,37
HCPCS,74150,CT scan of abdomen without contrast,885.35,575.48,52.27,2582.5,37
HCPCS,74160,CT scan of abdomen with contrast,1093.8,710.97,55.87,2905.31,37
HCPCS,74170,CT scan of abdomen before and after contrast,1349.4,877.11,61.44,3292.69,37
HCPCS,74174,CT scan of blood vessels of abdomen and pelvis with contrast,1492.45,970.095,78.57,3796.28,37
HCPCS,74175,CT scan of blood vessels of abdomen with contrast,1296.7,842.855,78.57,2711.63,37
HCPCS,74176,CT scan of abdomen and pelvis without contrast,866.4,563.16,76.42,3253.95,37
HCPCS,74177,CT scan of abdomen and pelvis with contrast,1575.0,1023.75,78.57,5423.25,55
HCPCS,74178,CT scan of abdomen and pelvis before and after contrast,1486.05,965.935,78.57,4609.76,37
HCPCS,74181,MRI scan of abdomen without contrast,1591.75,1034.6399999999999,63.73,4454.81,37
HCPCS,74182,MRI scan of abdomen with contrast,2366.2,1538.03,75.77,7050.23,37
HCPCS,74183,MRI scan of abdomen before and after contrast,2489.1,1617.915,78.57,6068.88,55
HCPCS,74185,MRI scan of blood vessels of abdomen,1773.5,1152.78,78.57,602.5,19
HCPCS,74190,Review by radiologist of abdominal cavity lining image,594.5,386.425,20.7,2582.5,37
HCPCS,74210,X-ray of voice box and/or esophagus with contrast,295.4,192.01,25.92,942.61,37
HCPCS,74220,Single contrast X-ray of esophagus,492.85,320.355,26.56,1802.59,37
HCPCS,74221,Double contrast X-ray of esophagus,225.125,146.32999999999998,30.62,942.61,37
HCPCS,74230,Imaging for evaluation of swallowing function,309.2,200.98000000000002,23.6,849.64,37
HCPCS,74235,Review by radiologist of imaging for removal of esophageal foreign body in esophagus,409.5,266.18,52.27,139.48,19
HCPCS,74240,Single contrast X-ray of upper digestive tract,489.6,318.24,36.11,1704.45,37
HCPCS,74246,Double contrast X-ray of upper digestive tract,534.85,347.655,39.89,1802.59,37
HCPCS,74248,Follow-through X-ray of small intestines,202.625,131.70499999999998,30.62,826.4,37
HCPCS,74250,Single contrast X-ray of small intestine,398.3,258.895,35.65,1162.13,37
HCPCS,74251,Double contrast X-ray of small intestine,1553.3,1009.645,51.29,4718.23,37
HCPCS,74261,Diagnostic CT scan of large intestine without contrast,1844.95,1199.22,78.57,5165.0,37
HCPCS,74262,Diagnostic CT scan of large intestine with contrast,1992.3,1295.0,78.57,570.13,19
HCPCS,74263,Screening CT scan of large intestine,2292.5,1490.125,78.57,5165.0,37
HCPCS,74270,Single contrast X-ray of large intestine,699.85,454.905,45.59,2324.25,37
HCPCS,74280,Double contrast X-ray of large intestine,796.0,517.4,55.22,2324.25,37
HCPCS,74283,Enema using air or contrast,598.5,389.03,78.57,244.36,19
HCPCS,74290,Imaging of gallbladder with contrast,200.6,130.39,14.0,78.57,19
HCPCS,74300,Review by radiologist of bile and/or pancreatic duct image during surgery,358.15,232.8,12.15,1510.76,55
HCPCS,74301,Review by radiologist of additional bile and/or pancreatic duct image during surgery,76.7,49.86,8.96,124.63,19
HCPCS,74328,Review by radiologist of image from tube placement into bile duct using an endoscope,758.85,493.255,23.02,2905.31,37
HCPCS,74329,Review by radiologist of image from tube placement into pancreatic duct using an endoscope,758.35,492.93,23.32,2905.31,37
HCPCS,74330,Review by radiologist of image from tube placement into bile and pancreatic duct using an endoscope,948.0,616.2,26.46,3814.35,37
HCPCS,74340,Review by radiologist of placement of long small bowel tube,475.65,309.175,23.94,1626.98,55
HCPCS,74355,Review by radiologist of placement of small bowel tube,1305.85,848.8050000000001,33.55,5839.03,37
HCPCS,74360,Review by radiologist of image to guide opening of digestive tract,910.35,591.73,27.27,3742.04,55
HCPCS,74363,Review by radiologist of image to guide opening of bile duct,2482.75,1613.79,36.39,11115.08,37
HCPCS,74400,Imaging of urinary tract with injection of contrast into a vein,675.0,438.75,21.65,1936.88,73
HCPCS,74410,Imaging of urinary tract using infusion technique,337.1,219.12,22.14,115.4,19
HCPCS,74415,Imaging of urinary tract using infusion technique with kidney section filming,395.9,257.34,21.65,126.33,19
HCPCS,74420,Imaging of urinary tract following injection of a contrast agent,836.25,543.565,23.76,3589.68,55
HCPCS,74425,Review by radiologist of upper urinary tract image,419.95,272.97,22.63,1743.19,55
HCPCS,74430,Review by radiologist of urinary bladder image,471.95,306.77,14.31,1846.49,55
HCPCS,74440,Review by radiologist of male internal genitals image,251.0,163.15,17.42,78.7,19
HCPCS,74445,Review by radiologist of penis image,381.25,247.815,51.76,1291.25,37
HCPCS,74450,Review by radiologist of urinary bladder and urethra images with contrast,429.4,279.11,14.64,1743.19,55
HCPCS,74455,Review by radiologist of urinary bladder and urethra images with contrast and after passing urine,480.25,312.165,14.95,1743.19,37
HCPCS,74470,Review by radiologist of kidney cyst image,471.1,306.21500000000003,23.63,1936.88,37
HCPCS,74485,Review by radiologist of ureter or urethra image,1434.8,932.62,37.92,6456.25,37
HCPCS,74712,MRI scan of fetus for single or first pregnancy,895.5,582.075,78.57,1743.19,37
HCPCS,74713,MRI scan of fetus for each additional pregnancy,337.25,219.215,34.13,469.52,37
HCPCS,74740,Review by radiologist of uterine tube and ovary image,464.1,301.665,16.93,1743.19,37
HCPCS,74742,Review by radiologist of image from placement of uterine tube,379.1,246.42,26.87,228.44,19
HCPCS,74775,Imaging of anogenital region,222.6,144.69,27.33,193.65,19
HCPCS,75557,MRI scan of heart without contrast,1601.4,1040.91,78.57,4648.5,37
HCPCS,75559,MRI scan of heart without contrast with stress imaging,2163.35,1406.1799999999998,78.57,5875.19,37
HCPCS,75561,MRI scan of heart before and after contrast,1997.65,1298.475,78.57,5423.25,37
HCPCS,75563,MRI scan of heart before and after contrast with stress imaging,2269.2,1474.98,78.57,5681.5,37
HCPCS,75565,MRI scan of blood flow of heart,599.6,389.74,10.92,2556.68,37
HCPCS,75571,CT scan of heart with evaluation of blood vessel calcium,395.5,257.075,25.58,1181.0,37
HCPCS,75572,CT scan of heart structure with contrast,1051.05,683.185,77.11,2905.31,37
HCPCS,75573,CT scan of congenital heart disease with contrast,1229.95,799.47,78.57,2905.31,37
HCPCS,75574,CT scan of blood vessels and grafts of heart with contrast,1289.25,838.015,78.57,2905.31,37
HCPCS,75577,"QUANTIFICATION AND CHARACTERIZATION OF CORONARY ATHEROSCLEROTIC PLAQUE TO ASSESS SEVERITY OF CORONARY DISEASE, DERIVED FROM AUGMENTATIVE SOFTWARE ANALYSIS OF THE DATA SET FROM A CORONARY COMPUTED TOMO",1238.5,805.025,39.69,6138.6,32
HCPCS,75580,"Analysis of data from CT study of heart blood vessels to assess severity of heart artery disease, with interpretation and report",1915.0,1244.75,33.09,9658.55,52
HCPCS,75600,Review by radiologist of chest aorta image,2126.85,1382.455,21.85,7747.5,37
HCPCS,75605,Review by radiologist of chest aorta serial images,6139.45,3990.645,48.76,28407.5,37
HCPCS,75625,Review by radiologist of abdominal aorta image,4094.515,2661.435,60.51,14177.93,91
HCPCS,75630,Review by radiologist of abdominal aorta and both leg arteries image,6300.0,4095.0,78.57,18865.16,73
HCPCS,75635,CT scan of abdominal aorta and both leg arteries with contrast,1571.4,1021.41,78.57,3680.06,37
HCPCS,75705,Review by radiologist of spinal artery image,6207.2,4034.68,78.57,28407.5,37
HCPCS,75710,Review by radiologist of arm or leg artery image,4671.95,3036.77,74.51,20827.86,91
HCPCS,75716,Review by radiologist of both arms or legs arteries image,8603.72,5592.42,78.57,22222.41,73
HCPCS,75726,Review by radiologist of abdominal artery image,6472.9,4207.385,78.57,30137.78,55
HCPCS,75731,Review by radiologist of adrenal gland artery image,1520.45,988.2950000000001,49.98,4390.25,37
HCPCS,75733,Review by radiologist of both adrenal glands arteries image,2382.5,1548.625,57.75,8780.5,55
HCPCS,75736,Review by radiologist of pelvis artery image,6473.4,4207.71,47.64,30137.78,37
HCPCS,75741,Review by radiologist of lung artery image,6820.0,4433.0,55.6,18865.16,55
HCPCS,75743,Review by radiologist of arteries of both lungs image,6820.0,4433.0,70.73,18865.16,73
HCPCS,75746,Review by radiologist of lung artery image with contrast,3410.0,2216.5,48.75,18865.16,55
HCPCS,75756,Review by radiologist of breast artery of breast image,4308.05,2800.235,50.61,18774.78,37
HCPCS,75774,Review by radiologist of additional artery image,1014.5,659.425,42.25,6559.08,55
HCPCS,75801,Review by radiologist of lymphatic system of arm or leg image,1041.35,676.88,40.23,3770.45,37
HCPCS,75803,Review by radiologist of lymphatic system of both arms or legs image,1033.9,672.035,51.6,3615.5,37
HCPCS,75805,Review by radiologist of lymphatic system of side of pelvis and abdomen image,1242.85,807.855,35.96,4648.5,37
HCPCS,75807,Review by radiologist of lymphatic system of both side of pelvis and abdomen image,3776.45,2454.695,48.64,17612.65,37
HCPCS,75809,Review by radiologist of previous placed shunt image,388.65,252.625,22.04,1162.13,91
HCPCS,75810,Review by radiologist of spleen and liver vein image,1569.9,1020.435,44.69,4648.5,37
HCPCS,75820,Review by radiologist of 1 arm or leg vein of 1 arm or leg image,1062.5,690.625,45.56,4462.56,73
HCPCS,75822,Review by radiologist of both arms and legs veins of both arms or legs image,1373.1,892.515,63.61,5849.36,73
HCPCS,75825,Review by radiologist of major lower body vein image,4048.4,2631.46,48.58,17612.65,73
HCPCS,75827,Review by radiologist of major upper body vein image,2699.0,1754.35,49.02,10381.65,73
HCPCS,75831,Review by radiologist of kidney image,4080.45,2652.295,47.46,17612.65,37
HCPCS,75833,Review by radiologist of both kidneys veins image,1741.5,1131.975,66.37,7747.5,37
HCPCS,75840,Review by radiologist of adrenal gland vein image,2020.95,1313.62,49.98,6972.75,37
HCPCS,75842,Review by radiologist of both adrenal gland veins image,2943.55,1913.31,78.57,11621.25,33
HCPCS,75860,Review by radiologist of head or neck vein system image,4048.4,2631.46,50.18,17612.65,37
HCPCS,75870,Review by radiologist of head vein system image,1520.95,988.62,56.5,4390.25,37
HCPCS,75872,Review by radiologist of spinal canal vein image,955.5,621.075,49.98,1594.02,37
HCPCS,75880,Review by radiologist of eye socket vein of eye socket image,926.35,602.13,30.92,3718.8,55
HCPCS,75885,Review by radiologist of the vein that transports blood to the liver image with assessment of blood flow,1591.0,1034.15,60.17,6972.75,37
HCPCS,75887,Review by radiologist of the vein that transports blood to the liver image,2089.85,1358.405,60.17,7231.0,37
HCPCS,75889,Review by radiologist of liver vein image with assessment of blood flow,4047.9,2631.135,47.82,17612.65,55
HCPCS,75891,Review by radiologist of liver vein image,4047.9,2631.135,48.13,17612.65,37
HCPCS,75893,Review by radiologist of imaging guidance for removal of blood sample,6628.95,4308.82,24.32,30990.0,37
HCPCS,75894,Review by radiologist of image for insertion of material to block blood flow,3416.05,2220.435,78.57,11621.25,37
HCPCS,75898,Imaging of blood vessel,1704.9,1108.185,78.57,8005.75,37
HCPCS,75901,Review by radiologist of image for removal of obstructive material,532.4,346.06,21.16,1291.25,37
HCPCS,75902,Review by radiologist of image for removal of tissue or obstructive material from central venous tube,371.55,241.51,16.9,1291.25,37
HCPCS,75958,Review by radiologist of image for insertion of extension,2792.95,1815.42,78.57,12912.5,33
HCPCS,75959,Review by radiologist of image for insertion of extension after previous repair of descending aorta,515.6,335.14,78.57,531.07,15
HCPCS,75970,Review by radiologist of image for biopsy of blood vessel with tube,1695.7,1102.205,34.9,5810.63,55
HCPCS,75984,Review by radiologist of image for replacement of stomach or large bowel tube,627.1,407.615,35.21,2324.25,55
HCPCS,75989,Review by radiologist of image for drainage of fluid,1185.0,770.25,51.78,4648.5,55
HCPCS,76000,"Imaging guidance for procedure, 60 minutes or less",476.1,309.46500000000003,14.41,1691.54,73
HCPCS,76010,X-ray from nose to rectum,125.6,81.64,7.99,433.86,37
HCPCS,76014,"Assessment by trained clinical staff of implant and/or foreign body for MR safety, including identification and verification of implant components from appropriate sources, analyzing current MR condit",60.0,39.0,15.0,154.95,16
HCPCS,76015,"Assessment by trained clinical staff of implant and/or foreign body for MR safety, including identification and verification of implant components from appropriate sources, analyzing current MR condit",30.0,19.5,7.5,77.48,16
HCPCS,76016,"Determination of MR safety by a physician or other qualified health care professional responsible for the safety of the MR procedure, including review of implant MR conditions for indicated MR examina",210.0,136.5,52.5,542.33,16
HCPCS,76080,Review by radiologist of abscess or sinus cavity study,409.1,265.915,22.83,1639.89,55
HCPCS,76098,X-ray of surgical specimen,717.95,466.67,13.97,3550.94,73
HCPCS,76100,X-ray of body plane,386.4,251.16,25.89,106.16,19
HCPCS,76120,Imaging of organ,195.9,127.34,18.03,78.57,19
HCPCS,76125,"Imaging of organ, complimenting routine exam",33.25,21.61,13.07,78.57,19
HCPCS,76140,Written consultation report on X-ray,66.2,43.03,29.79,80.89,15
HCPCS,76145,"Medical physics dose evaluation for radiation exposure, including report",1964.0,1276.6,78.57,2372.15,19
HCPCS,76376,3D radiographic procedure,1000.0,650.0,8.96,3060.26,67
HCPCS,76377,3D radiographic procedure with computerized image postprocessing,1000.0,650.0,35.29,2969.88,51
HCPCS,76380,Limited or follow-up CT scan,801.9,521.235,42.51,3099.0,110
HCPCS,76390,MRI study for measuring biochemical changes in the brain,1875.4,1219.01,48.2,5681.5,33
HCPCS,76391,MRI and low frequency vibrations for measuring tissue stiffness,277.25,180.215,47.9,2024.0,37
HCPCS,76496,Other fluoroscopic procedure,150.0,97.5,37.5,387.38,18
HCPCS,76497,Other CT scan,1875.0,1218.75,155.26,4842.19,18
HCPCS,76498,Other MRI scan,1690.0,1098.5,18.44,5681.5,51
HCPCS,76499,Other diagnostic Imaging procedure,605.0,393.25,81.72,1562.41,18
HCPCS,76506,Ultrasound scan of brain,558.45,362.995,27.97,1872.31,37
HCPCS,76510,1D and 2D ultrasound scan of eye tissue and structures,374.45,243.395,37.02,774.75,73
HCPCS,76511,1D ultrasound scan of eye tissue and structures,309.8,201.37,33.78,122.41,19
HCPCS,76512,2D ultrasound scan of eye tissue and structures,445.5,289.575,29.29,1162.13,73
HCPCS,76513,Ultrasound scan of eye using water bath method,233.25,151.615,31.24,581.06,73
HCPCS,76514,Ultrasound scan of cornea to determine thickness,50.0,32.5,7.27,1151.8,73
HCPCS,76516,Ultrasound scan to determine eye length,221.6,144.04,21.48,114.02,19
HCPCS,76519,Ultrasound scan to determine eye length and lens power,246.8,160.42,27.5,1151.8,73
HCPCS,76529,Ultrasound scan of eye for foreign body localization,195.3,126.95,30.67,125.76,19
HCPCS,76536,Ultrasound scan of head and neck soft tissue,423.35,275.18,25.22,1190.53,163
HCPCS,76604,Ultrasound scan of chest,437.4,284.31,26.35,1549.5,91
HCPCS,76641,Complete ultrasound scan of 1 breast,721.875,469.22,32.24,2711.63,55
HCPCS,76642,Limited ultrasound scan of 1 breast,574.725,373.57,29.95,2130.56,55
HCPCS,76700,Complete ultrasound scan of abdomen,477.0,310.04999999999995,35.83,1319.66,37
HCPCS,76705,Limited ultrasound scan of abdomen,425.85,276.805,26.23,1319.66,127
HCPCS,76706,Ultrasound scan of abdominal aorta,359.7,233.805,24.4,1291.25,55
HCPCS,76770,Complete ultrasound scan behind abdominal cavity,535.5,348.075,32.57,1678.63,73
HCPCS,76775,Limited ultrasound scan behind abdominal cavity,365.0,237.25,25.89,1291.25,73
HCPCS,76776,Ultrasound scan of transplanted kidney,554.45,360.395,33.24,1603.73,37
HCPCS,76800,Ultrasound scan of spinal canal,450.75,292.99,58.14,1291.25,37
HCPCS,76801,"Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus",325.0,211.25,44.44,839.31,92
HCPCS,76802,"Ultrasound scan of pregnant uterus (less than 14 weeks), each additional fetus",150.0,97.5,37.5,387.38,74
HCPCS,76805,"Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus",325.0,211.25,45.05,839.31,110
HCPCS,76810,"Ultrasound scan of pregnant uterus (14 weeks or more), each additional fetus",184.0,119.6,37.5,562.99,74
HCPCS,76811,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus",350.0,227.5,78.57,903.88,92
HCPCS,76812,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, each additional fetus",410.0,266.5,78.57,1058.83,74
HCPCS,76813,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, single or first fetus",310.0,201.5,53.97,800.58,56
HCPCS,76814,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, each additional fetus",150.0,97.5,37.5,387.38,56
HCPCS,76815,Limited ultrasound of pregnant uterus,259.3,168.54500000000002,29.25,839.31,110
HCPCS,76816,Follow-up ultrasound scan of pregnant uterus,292.5,190.125,39.02,839.31,92
HCPCS,76817,Vaginal ultrasound of pregnant uterus,317.1,206.12,33.83,1052.0,111
HCPCS,76818,Ultrasound and monitoring of heart of fetus,310.0,201.5,47.96,800.58,92
HCPCS,76819,Ultrasound scan of fetus,274.3,178.3,35.11,774.75,56
HCPCS,76820,Ultrasound scan of fetal umbilical artery blood flow rate,214.2,139.23,23.09,929.7,56
HCPCS,76821,Ultrasound scan of fetal brain artery blood flow rate,297.5,193.38,32.03,774.75,56
HCPCS,76825,Ultrasound scan of fetal heart,1032.9,671.385,75.86,3667.15,55
HCPCS,76826,Follow-up ultrasound scan of fetal heart,470.6,305.89,37.92,1446.2,37
HCPCS,76827,Ultrasound scan of fetal heart blood flow,266.55,173.26,26.38,774.75,37
HCPCS,76828,Follow-up ultrasound scan of fetal heart blood flow,221.7,144.10500000000002,25.71,689.53,37
HCPCS,76830,"Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina",445.0,289.25,30.9,1291.25,73
HCPCS,76831,Ultrasound scan of uterus and uterine cavity,456.35,296.63,33.13,1451.37,37
HCPCS,76856,Complete ultrasound scan of pelvis,446.0,289.9,30.9,1549.5,73
HCPCS,76857,Limited ultrasound scan of pelvis,381.85,248.20499999999998,22.6,1149.21,73
HCPCS,76870,Ultrasound scan of scrotum,446.0,289.9,28.3,1291.25,73
HCPCS,76872,Ultrasound scan of pelvic region through rectum,465.95,302.87,30.6,1291.25,73
HCPCS,76873,Ultrasound scan of prostate through rectum,401.35,260.88,73.08,1213.78,38
HCPCS,76881,Complete ultrasound scan of joint,353.9,230.035,41.0,1033.0,91
HCPCS,76882,Limited ultrasound scan of joint or other extremity structure except blood vessels,237.5,154.375,30.59,1033.0,91
HCPCS,76883,Comprehensive ultrasound scan of entire length of nerves in extremity,267.75,174.04,55.4,1033.0,37
HCPCS,76885,Ultrasound scan of infant hip during movement,660.95,429.62,32.57,2195.13,37
HCPCS,76886,Ultrasound scan of infant hip,254.7,165.56,27.33,99.6,19
HCPCS,76932,Ultrasonic guidance for biopsy of heart muscle,377.1,245.115,32.75,1291.25,37
HCPCS,76936,Ultrasound guided compression repair of blood vessel,1372.5,892.125,78.57,4648.5,55
HCPCS,76937,Ultrasonic guidance for blood vessel access,475.0,308.75,12.84,1678.63,127
HCPCS,76940,Ultrasound guidance for tissue removal,532.4,346.06,78.57,1678.63,55
HCPCS,76941,Ultrasonic guidance for fetal transfusion or umbilical blood sampling,292.0,189.8,61.47,697.28,37
HCPCS,76942,Ultrasonic guidance for needle placement,728.35,473.43,30.1,2066.0,163
HCPCS,76945,Ultrasonic guidance for testing placental tissue,361.85,235.20499999999998,30.72,1291.25,37
HCPCS,76946,Ultrasonic guidance for removal of amniotic fluid,188.0,122.2,17.54,1033.0,56
HCPCS,76948,Ultrasonic guidance for retrieval of egg,80.6,52.39,30.72,78.57,19
HCPCS,76965,Ultrasonic guidance for administration of radiation therapy,673.1,437.52,65.04,213.56,19
HCPCS,76975,Review by radiologist of ultrasound of digestive tract using an endoscope,243.6,158.34,40.95,250.91,19
HCPCS,76977,Ultrasound scan of bone for measuring loss,80.9,52.59,2.41,78.57,19
HCPCS,76978,"Ultrasound scan of growth using contrast, first growth",288.0,187.2,71.36,981.35,37
HCPCS,76979,"Ultrasound scan of growth using contrast, each additional growth",146.5,95.225,37.6,490.68,37
HCPCS,76981,Ultrasound scan of organ tissue for measuring elasticity,148.5,96.525,27.77,581.06,37
HCPCS,76982,"Ultrasound scan of growth for measuring elasticity, first growth",148.5,96.525,26.84,581.06,37
HCPCS,76983,"Ultrasound scan of growth for measuring elasticity, each additional growth",61.0,39.65,22.83,83.84,19
HCPCS,76998,Ultrasonic guidance during surgery,590.85,384.055,44.39,2582.5,73
HCPCS,77001,Fluoroscopic guidance for insertion or removal of central vein access device,518.4,336.96000000000004,16.56,1696.7,73
HCPCS,77002,Fluoroscopic guidance for needle placement,395.0,256.75,25.79,1394.55,163
HCPCS,77003,Fluoroscopic guidance for spine or back muscle injection,200.0,130.0,26.99,769.59,109
HCPCS,77011,CT guidance for needle or tube localization,2372.9,1542.385,57.25,9297.0,37
HCPCS,77012,Review by radiologist of CT guidance for needle placement,1000.0,650.0,64.08,7747.5,91
HCPCS,77013,CT guidance for tissue removal,1000.0,650.0,78.57,7747.5,55
HCPCS,77021,Review by radiologist of MRI guidance for needle placement,2325.5,1511.575,67.4,9038.75,73
HCPCS,77022,MRI guidance for tissue removal,635.3,412.95,78.57,654.36,19
HCPCS,77046,MRI scan of 1 breast without contrast,470.5,305.825,63.39,2024.0,37
HCPCS,77047,MRI scan of both breasts without contrast,922.5,599.625,70.07,4261.13,37
HCPCS,77048,MRI scan of 1 breast,255.0,165.75,78.57,503.05,19
HCPCS,77049,MRI scan of both breasts,279.0,181.35,78.57,586.89,19
HCPCS,77053,"Review by radiologist of breast duct image, 1 duct",154.1,100.17,15.95,109.56,19
HCPCS,77054,"Review by radiologist of breast duct image, multiple ducts",364.5,236.925,20.01,1329.99,37
HCPCS,77061,3D breast mammography of 1 breast,193.65,125.875,36.88,645.63,33
HCPCS,77062,3D breast mammography of both breasts,225.95,146.87,45.29,813.49,33
HCPCS,77063,Screening 3D breast mammography,180.0,117.0,26.56,645.63,37
HCPCS,77065,Diagnostic mammography of 1 breast,250.0,162.5,35.96,645.63,55
HCPCS,77066,Diagnostic mammography of both breasts,290.0,188.5,44.28,748.93,55
HCPCS,77067,Screening mammography,293.95,191.07,33.55,658.54,55
HCPCS,77071,Application of stress by physician for joint imaging,131.3,85.35,31.34,134.14,19
HCPCS,77072,X-ray for estimating bone age,189.85,123.405,8.63,800.58,37
HCPCS,77073,X-ray for bone length assessment,207.2,134.68,12.3,774.75,37
HCPCS,77074,Limited X-ray of body bones,557.65,362.475,19.67,2324.25,37
HCPCS,77075,Complete X-ray of body bones,343.95,223.57,24.58,929.7,37
HCPCS,77076,X-ray of infant body bones,346.85,225.45499999999998,30.92,929.7,37
HCPCS,77077,"X-ray of joints, multiple",241.3,156.845,15.57,929.7,37
HCPCS,77078,CT scan for measuring calcium and other minerals in bone,588.45,382.495,10.92,1861.98,37
HCPCS,77080,"DXA bone density measurement of hip, pelvis, spine",267.45,173.845,8.96,839.31,73
HCPCS,77081,"DXA bone density measurement of forearm, finger, hand, or foot",102.7,66.755,8.96,222.1,37
HCPCS,77084,MRI scan of bone marrow,1565.9,1017.84,70.38,387.53,19
HCPCS,77085,"DXA bone density measurement of hip, pelvis, spine including spine fracture assessment",271.0,176.15,13.64,774.75,55
HCPCS,77086,Fracture assessment of spine bones using DXA,136.0,88.4,7.65,387.38,55
HCPCS,77091,Technical calculation of trabecular bone score (TBS),200.0,130.0,50.0,516.5,18
HCPCS,77092,Interpretation of trabecular bone score (TBS) and report on fracture risk,25.0,16.25,9.58,78.57,19
HCPCS,77261,Simple radiation therapy planning,231.0,150.15,66.42,165.88,19
HCPCS,77262,Intermediate radiation therapy planning,331.8,215.67,78.57,254.22,19
HCPCS,77263,Complex radiation therapy planning,484.1,314.67,78.57,396.8,19
HCPCS,77280,"Obtaining data needed to develop the optimal radiation treatment, 1 treatment area",755.0,490.75,35.42,3099.0,57
HCPCS,77285,"Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas",1142.6,742.69,53.38,3507.04,38
HCPCS,77290,"Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved",1638.8,1065.22,78.17,4039.03,38
HCPCS,77293,Obtaining respiratory data needed to develop the optimal radiation treatment,1147.75,746.04,78.57,2375.9,38
HCPCS,77295,3D radiation therapy planning,4845.5,3149.575,78.57,18335.75,76
HCPCS,77300,Calculation of radiation therapy dose,470.0,305.5,31.21,1678.63,95
HCPCS,77301,High precision radiation therapy planning,5166.25,3358.065,78.57,10588.25,38
HCPCS,77306,Simple radiation therapy planning for delivery of external radiation,1032.95,671.4200000000001,70.56,4418.66,38
HCPCS,77307,Complex radiation therapy planning for delivery of external radiation,846.5,550.225,78.57,2582.5,38
HCPCS,77316,Simple radiation therapy planning for delivery of internal radiation,925.75,601.74,70.26,3615.5,38
HCPCS,77317,Intermediate radiation therapy planning for delivery of internal radiation,995.6,647.14,78.57,3615.5,38
HCPCS,77318,Complex radiation therapy planning for delivery of internal radiation,1126.85,732.4549999999999,78.57,3615.5,38
HCPCS,77321,Special radiation therapy planning for delivery of external radiation,1104.95,718.2199999999999,47.6,4968.73,38
HCPCS,77331,Special radiation therapy planning,461.35,299.88,43.69,1949.79,38
HCPCS,77332,Design and construction of simple radiation treatment device,560.5,364.325,22.66,2066.0,76
HCPCS,77333,Design and construction of intermediate radiation treatment device,670.0,435.5,37.4,1949.79,57
HCPCS,77334,Design and construction of complex radiation treatment device,946.0,614.9,57.46,2776.19,190
HCPCS,77336,Continuing radiation therapy consultation per week,324.96500000000003,211.225,78.57,1213.78,38
HCPCS,77338,Design and construction of radiation treatment device for high precision radiation therapy,1426.55,927.26,78.57,3628.41,38
HCPCS,77370,Special medical radiation therapy consultation,458.025,297.71500000000003,78.57,1652.8,38
HCPCS,77372,Complete single session course of cranial lesion surgery using radiation and a machine to deliver external radiation,11587.625,7531.955,78.57,53457.75,38
HCPCS,77373,Delivery of radiation therapy per dose to 1 or more lesions not to exceed 5 doses,3870.99,2516.145,78.57,11879.5,38
HCPCS,77385,Delivery of simple high precision radiation treatment,1590.0,1033.5,397.5,4106.18,19
HCPCS,77386,Delivery of complex high precision radiation treatment,2000.0,1300.0,500.0,5165.0,19
HCPCS,77387,Imaging guidance for localization of radiation treatment,600.0,390.0,25.55,5423.25,114
HCPCS,77401,Superficial and/or low voltage radiation treatment delivery,503.29,327.14,25.46,2453.38,34
HCPCS,77402,Delivery of simple radiation treatment,580.0,377.0,140.0,1549.5,38
HCPCS,77407,Delivery of intermediate radiation treatment,730.0,474.5,140.0,2324.25,38
HCPCS,77412,Delivery of complex radiation treatment,1400.0,910.0,250.0,4648.5,38
HCPCS,77417,X-ray during radiation therapy,178.9,116.285,22.03,1197.0,34
HCPCS,77424,Delivery of single session of intraoperative radiation treatment with X-ray,7230.0,4699.5,1197.0,18671.48,19
HCPCS,77427,"Radiation treatment management, 5 treatment sessions",600.6,390.39,78.57,460.24,19
HCPCS,77431,"Radiation treatment management, 1-2 treatment sessions",294.0,191.1,78.57,250.55,19
HCPCS,77432,Management of complete single session course of stereotactic radiation treatment for cranial lesion(s),1225.4,796.51,78.57,999.7,19
HCPCS,77435,Management of stereotactic body radiation therapy for lesion(s) over 1-5 sessions,1487.4,966.81,78.57,1510.81,19
HCPCS,77469,Management of intraoperative radiation treatment,517.7,336.51,78.57,678.0,19
HCPCS,77470,Special radiation treatment,1675.0,1088.75,78.57,5813.21,57
HCPCS,77520,Simple proton beam radiation treatment,1662.03,1080.32,78.57,1822.45,15
HCPCS,77522,Simple proton beam radiation treatment with compensation,1706.88,1109.47,78.57,1827.41,15
HCPCS,77523,Intermediate proton beam radiation treatment,2025.78,1316.76,78.57,2122.85,15
HCPCS,77525,Complex proton beam radiation treatment,2157.08,1402.1,78.57,2348.64,15
HCPCS,77600,"Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less",1126.9,732.49,66.94,280.83,19
HCPCS,77605,"Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm",1968.9,1279.79,78.57,421.0,19
HCPCS,77610,"Use of interstitial probe generated heat to increase temperature of cancer cell, 1-5 probes",1947.4,1265.81,65.89,356.71,19
HCPCS,77615,"Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes",2942.4,1912.56,78.57,508.61,19
HCPCS,77620,Use of body cavity probe generated heat to increase temperature of cancer cell,1754.4,1140.36,78.13,281.72,19
HCPCS,77750,Infusion or instillation of radioelement solution,1032.2,670.93,78.57,626.97,19
HCPCS,77761,Simple body cavity radiation source application,1027.35,667.78,78.57,3775.62,38
HCPCS,77762,Intermediate body cavity radiation source application,1882.75,1223.79,78.57,6012.06,38
HCPCS,77763,Complex body cavity radiation source application,2614.85,1699.655,78.57,8509.34,38
HCPCS,77767,"High dose skin surface radiation therapy, 1 channel or lesion diameter 2.0 cm or less",1981.5,1287.9750000000001,52.45,8888.97,38
HCPCS,77768,"High dose skin surface radiation therapy, 2 channels and lesion diameter more than 2.0 cm, or multiple lesions",765.5,497.57500000000005,70.56,1851.65,38
HCPCS,77770,"High dose radiation therapy, 1 channel",1373.5,892.775,78.57,5165.0,38
HCPCS,77771,"High dose radiation therapy, 2-12 channels",1746.0,1134.9,78.57,5423.25,38
HCPCS,77772,"High dose radiation therapy, more than 12 channels",2160.0,1404.0,78.57,5681.5,38
HCPCS,77778,Complex application of radiation source,3601.0,2340.65,78.57,10330.0,55
HCPCS,77789,Surface application of low dose rate source,416.05,270.435,57.13,1329.99,38
HCPCS,77790,"Supervision, handling, and loading of radiation source",383.0,248.95,16.9,1730.28,57
HCPCS,77799,Other administration of radiation therapy,258.0,167.7,64.5,666.29,18
HCPCS,78012,Nuclear medicine study of thyroid function,883.9,574.535,8.32,3873.75,37
HCPCS,78013,Nuclear medicine study of thyroid,1087.6,706.94,15.98,3873.75,37
HCPCS,78014,Nuclear medicine study of thyroid and thyroid function,937.6,609.44,21.68,2827.84,37
HCPCS,78015,Nuclear medicine study of limited area for thyroid cancer,629.0,408.85,29.61,171.2,19
HCPCS,78016,"Nuclear medicine studies for thyroid cancer, additional studies",974.4,633.36,31.47,239.24,19
HCPCS,78018,Nuclear medicine study of whole body for thyroid cancer,1269.9,825.435,36.58,3873.75,37
HCPCS,78020,Nuclear medicine study of thyroid function for thyroid cancer,380.85,247.555,25.2,1291.25,37
HCPCS,78070,Nuclear medicine study of parathyroid,1004.65,653.025,34.88,3873.75,37
HCPCS,78071,Nuclear medicine study of parathyroid with SPECT,1334.35,867.3299999999999,51.86,3873.75,37
HCPCS,78072,Nuclear medicine study of parathyroid with SPECT and CT scan,1258.7,818.155,68.1,5165.0,37
HCPCS,78075,Nuclear medicine study of adrenal glands,1320.5,858.33,32.57,220.27,19
HCPCS,78099,Nuclear medicine study of endocrine organs,1500.0,975.0,375.0,3873.75,18
HCPCS,78102,Nuclear medicine study of bone marrow limited area,495.6,322.14,23.66,135.28,19
HCPCS,78103,Nuclear medicine study of bone marrow multiple areas,650.0,422.5,28.52,194.49,19
HCPCS,78104,Nuclear medicine study of bone marrow whole body,738.2,479.83,34.26,235.02,19
HCPCS,78110,"Nuclear medicine study of plasma volume, 1 sampling",253.2,164.58,7.4,78.57,19
HCPCS,78111,"Nuclear medicine study of plasma volume, multiple samplings",274.1,178.17,9.92,115.66,19
HCPCS,78120,"Nuclear medicine study of red blood cell volume, single sample",255.5,166.08,8.71,88.69,19
HCPCS,78121,"Nuclear medicine study of red blood cell volume, multiple samples",1059.1,688.415,14.18,4648.5,37
HCPCS,78122,Nuclear medicine study of whole blood volume,1147.8,746.0699999999999,19.88,4648.5,37
HCPCS,78130,Nuclear medicine study of red blood cell survival,434.7,282.56,23.22,158.12,19
HCPCS,78140,Nuclear medicine study of radioisotope labeled red blood cells,453.6,294.84,23.22,186.4,19
HCPCS,78185,Nuclear medicine study of spleen,637.5,414.38,15.31,147.93,19
HCPCS,78191,Nuclear medicine study of platelet survival,772.8,502.32,23.22,300.69,19
HCPCS,78195,Nuclear medicine study of lymphatic system,1205.05,783.2850000000001,51.24,3228.13,37
HCPCS,78199,Nuclear medicine study of blood and lymphatic systems,3000.0,1950.0,534.64,7747.5,18
HCPCS,78201,Nuclear medicine study of liver,2302.95,1496.92,18.93,10330.0,37
HCPCS,78202,Nuclear medicine study of liver and blood flow,616.0,400.4,22.01,171.4,19
HCPCS,78215,Nuclear medicine study of liver and spleen,1066.75,693.39,21.65,3873.75,37
HCPCS,78216,"Nuclear medicine study of liver, spleen, and blood flow",405.3,263.45,25.25,168.82,19
HCPCS,78226,Nuclear medicine study of liver and bile duct system,1236.0,803.4,32.26,3873.75,37
HCPCS,78227,Nuclear medicine study of liver and bile duct system with use of drugs,1404.95,913.22,39.27,3770.45,37
HCPCS,78230,Nuclear medicine study of salivary gland,499.6,324.74,20.01,134.15,19
HCPCS,78231,Nuclear medicine study of salivary gland with serial images,370.7,240.96,19.94,156.84,19
HCPCS,78232,Nuclear medicine study of salivary gland function,396.9,257.99,17.96,165.0,19
HCPCS,78258,Nuclear medicine study of esophagus to assess movement,664.6,431.99,32.26,189.32,19
HCPCS,78261,Nuclear medicine study of stomach lining,1161.3,754.845,26.2,3873.75,37
HCPCS,78262,Nuclear medicine study of stomach and esophagus to assess reflux,738.1,479.77,29.95,230.67,19
HCPCS,78264,Nuclear medicine study of stomach to assess emptying,1019.65,662.775,34.24,2827.84,37
HCPCS,78265,Nuclear medicine study of stomach to assess emptying and small bowel movement,947.0,615.55,42.87,350.46,19
HCPCS,78266,Nuclear medicine study of stomach to assess emptying and small and large bowel movement,1123.0,729.95,45.75,415.85,19
HCPCS,78267,Nuclear medicine study to acquire exhaled breath samples,48.775,31.705,2.49,193.69,37
HCPCS,78268,Nuclear medicine study to assess exhaled breath samples,250.0,162.5,62.5,645.63,18
HCPCS,78278,Nuclear medicine study to assess blood loss,1320.15,858.1,43.2,3873.75,37
HCPCS,78282,Nuclear medicine study to assess protein loss into the digestive tract,70.4,45.76,14.64,78.57,19
HCPCS,78290,Nuclear medicine study of intestine,941.05,611.685,29.64,2259.69,37
HCPCS,78291,Nuclear medicine study to assess the degree of openness of shunt from jugular vein to abdominal cavity,1108.3,720.395,38.91,3873.75,37
HCPCS,78299,Nuclear medicine study of digestive tracts,2500.0,1625.0,534.64,6456.25,18
HCPCS,78300,Nuclear medicine study of bone and/or joint limited area,1004.65,653.025,26.89,3873.75,37
HCPCS,78305,Nuclear medicine study of bone and/or joint multiple areas,663.6,431.34,36.32,214.98,19
HCPCS,78306,Nuclear medicine study of bone and/or joint whole body,957.25,622.2149999999999,37.19,2827.84,37
HCPCS,78315,Nuclear medicine study of bone taken at different times,1116.65,725.825,44.18,2827.84,37
HCPCS,78350,Nuclear medicine study to measure bone loss using 1 photon beam,73.9,48.04,21.9,78.57,15
HCPCS,78351,Nuclear medicine study to measure bone loss using 2 photon beams,190.1,123.57,10.07,195.8,15
HCPCS,78399,Other nuclear medicine study of musculoskeletal system,1500.0,975.0,375.0,3873.75,18
HCPCS,78414,Nuclear medicine study of cardiovascular function,53.4,34.71,20.19,85.04,19
HCPCS,78428,Nuclear medicine study for detecting heart shunt,633.2,411.58,33.78,169.1,19
HCPCS,78429,Nuclear medicine study of heart muscle with metabolic evaluation and concurrent CT scan,1547.75,1006.04,74.98,7463.43,37
HCPCS,78430,Nuclear medicine study of blood flow in heart muscle at rest and with stress with concurrent CT scan,1542.5,1002.625,71.54,7463.43,37
HCPCS,78431,Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent CT scan,2368.0,1539.2,78.57,11647.08,37
HCPCS,78432,Nuclear medicine study of heart muscle with metabolic and blood flow evaluation requiring 2 injections,2875.625,1869.155,78.57,14229.58,37
HCPCS,78433,Nuclear medicine study of heart muscle with metabolic and blood flow evaluation requiring 2 injections and concurrent CT scan,2886.875,1876.47,78.57,14229.58,37
HCPCS,78434,Nuclear medicine study of heart muscle blood flow by PET,913.125,593.53,27.72,4519.38,37
HCPCS,78445,Nuclear medicine study of non-cardiac blood flow,519.8,337.87,21.65,131.06,19
HCPCS,78451,Nuclear medicine study of heart muscle at rest and with stress and SPECT,2032.85,1321.355,60.83,7540.9,55
HCPCS,78452,Nuclear medicine studies of heart muscle at rest and with stress and SPECT,2635.1,1712.815,71.72,9451.95,55
HCPCS,78453,Nuclear medicine study of heart muscle at rest and with stress with single 2D image,2436.3,1583.595,43.54,10330.0,37
HCPCS,78454,Nuclear medicine studies of heart muscle at rest and with stress with single 2D image,2631.45,1710.445,58.51,10330.0,37
HCPCS,78456,Nuclear medicine study to assess blood clot in vein using radiolabeled peptide,1113.3,723.65,44.21,216.69,19
HCPCS,78457,Nuclear medicine study to assess blood clot in vein of side,571.2,371.28,34.06,172.96,19
HCPCS,78458,Nuclear medicine study to assess blood clot in vein of both sides,574.4,373.36,39.89,209.35,19
HCPCS,78459,Nuclear medicine study of heart muscle with metabolic evaluation,3407.5,2214.875,68.3,16786.25,37
HCPCS,78466,Nuclear medicine study of heart muscle following heart attack,553.4,359.71,30.16,165.95,19
HCPCS,78468,Nuclear medicine study of heart muscle following heart attack with measurement of internal blood volume ejected with every beat,701.4,455.91,35.37,222.02,19
HCPCS,78469,Nuclear medicine study of heart muscle following heart attack with SPECT,2389.05,1552.885,40.74,10330.0,37
HCPCS,78472,Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume ejected with every beat over multiple cycles,1141.0,741.65,43.05,3873.75,37
HCPCS,78473,Nuclear medicine studies of heart pumping function by labeling red blood cells with measurement of internal blood volume ejected with every beat over multiple cycles,1246.65,810.325,65.17,3873.75,37
HCPCS,78481,Nuclear medicine study of heart pumping function with measurement of internal blood volume ejected with every beat over a single cycle,643.7,418.41,43.11,273.08,19
HCPCS,78483,Nuclear medicine studies of heart pumping function by first pass technique with measurement of internal blood volume ejected with every beat over a single cycle,949.2,616.98,64.73,402.52,19
HCPCS,78491,Nuclear medicine study of blood flow in heart muscle at rest and with stress,2165.4,1407.51,68.17,10330.0,37
HCPCS,78492,Nuclear medicine studies of blood flow in heart muscle at rest and with stress,2248.35,1461.43,78.57,10330.0,37
HCPCS,78494,Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume ejected with every beat over multiple cycles with SPECT,639.8,415.87,52.32,339.98,19
HCPCS,78496,Nuclear medicine study of heart pumping function over single cycle,129.2,83.98,22.17,127.83,19
HCPCS,78499,Other nuclear medicine study of cardiovascular system,1500.0,975.0,375.0,3873.75,18
HCPCS,78579,Nuclear medicine study of lung ventilation,977.85,635.605,21.34,3873.75,37
HCPCS,78580,Nuclear medicine study of lung circulation,1108.95,720.8199999999999,32.26,3873.75,37
HCPCS,78582,Nuclear medicine study of lung ventilation and circulation,1088.85,707.755,46.28,3300.44,37
HCPCS,78597,Nuclear medicine study of lung ventilation and blood flow to lung,1018.8,662.22,31.85,3873.75,37
HCPCS,78598,Nuclear medicine study of lung ventilation and circulation and blood flow to lung,1185.75,770.74,36.24,3873.75,37
HCPCS,78599,Other nuclear medicine study of respiratory system,1500.0,975.0,375.0,3873.75,18
HCPCS,78600,"Nuclear medicine study of brain, less than 4 static views",541.4,351.91,19.24,186.31,19
HCPCS,78601,Nuclear medicine study of brain and blood flow,1100.7,715.455,22.32,3873.75,37
HCPCS,78605,"Nuclear medicine study of brain, 4 static views or more",938.55,610.06,23.6,3344.34,37
HCPCS,78606,"Nuclear medicine study of brain and blood flow, 4 static views or more",1024.0,665.6,27.56,241.82,19
HCPCS,78608,Nuclear medicine study of brain with metabolic evaluation,3407.5,2214.875,64.14,16786.25,37
HCPCS,78609,Nuclear medicine study of brain with blood flow evaluation,496.7,322.86,78.57,332.34,15
HCPCS,78610,Nuclear medicine study of brain with blood flow,922.15,599.4,13.02,3344.34,37
HCPCS,78630,Nuclear medicine study of cerebrospinal fluid flow after injection of contrast into lower spine,1566.1,1017.9649999999999,29.33,5165.0,55
HCPCS,78635,Nuclear medicine study of cerebrospinal fluid flow after injection of contrast into ventricles,1028.5,668.53,26.87,198.33,19
HCPCS,78645,Nuclear medicine study of cerebrospinal fluid flow to evaluate shunt,1498.45,973.995,24.63,5165.0,37
HCPCS,78650,Nuclear medicine study of cerebrospinal fluid flow to locate leakage,2513.15,1633.55,23.22,10330.0,37
HCPCS,78660,Nuclear medicine study of tear drainage structure,536.9,348.99,20.27,138.52,19
HCPCS,78699,Other nuclear medicine study of nervous system,987.3,641.745,73.6,3873.75,33
HCPCS,78700,Nuclear medicine study of kidney,523.4,340.21,19.26,165.71,19
HCPCS,78701,Nuclear medicine study of kidney and blood flow,644.3,418.8,21.96,192.33,19
HCPCS,78707,"Nuclear medicine study of kidney, blood flow, and function",1128.5,733.525,41.59,3873.75,37
HCPCS,78708,"Nuclear medicine study of kidney, blood, flow, and function with drug administration",1043.5,678.275,51.89,3873.75,37
HCPCS,78709,"Nuclear medicine studies of kidney, blood flow, and function",1081.5,702.98,60.52,304.63,19
HCPCS,78725,Nuclear medicine study of kidney function,918.8,597.22,16.31,3873.75,37
HCPCS,78730,Nuclear medicine study of remaining urine in bladder,233.2,151.58,7.48,78.57,19
HCPCS,78740,Nuclear medicine study to assess urine flow,1017.4,661.31,26.05,3488.96,37
HCPCS,78761,Nuclear medicine study of testicle and blood flow,606.9,394.49,31.26,188.14,19
HCPCS,78799,Other nuclear medicine study of urogenital system,1500.0,975.0,375.0,3873.75,18
HCPCS,78800,"Nuclear medicine study, 1 area",1015.65,660.175,28.68,3873.75,37
HCPCS,78801,"Nuclear medicine study, multiple areas",1110.15,721.6,31.62,3873.75,37
HCPCS,78802,"Nuclear medicine study, whole body",2531.6,1645.54,34.26,10330.0,37
HCPCS,78803,"Nuclear medicine study, SPECT imaging, 1 area or single acquisition, single day imaging",1567.15,1018.65,47.13,5165.0,37
HCPCS,78804,"Nuclear medicine study, whole body requiring multiple imaging days",2958.55,1923.06,43.23,10330.0,55
HCPCS,78808,Injection of radioactive contrast into a vein for non-imaging gamma probe,802.165,521.405,37.84,3873.75,37
HCPCS,78811,Nuclear medicine study limited area,2118.65,1377.125,66.09,10330.0,37
HCPCS,78812,Nuclear medicine study from skull base to mid-thigh,296.1,192.47,78.57,1009.39,19
HCPCS,78813,Nuclear medicine study whole body,305.6,198.64,78.57,1013.05,19
HCPCS,78814,Nuclear medicine study limited area with CT scan,3916.95,2546.02,78.57,19368.75,37
HCPCS,78815,Nuclear medicine study from skull base to mid-thigh with CT scan,3436.4,2233.66,78.57,16786.25,55
HCPCS,78816,Nuclear medicine study whole body with CT scan,3440.6,2236.39,78.57,16786.25,55
HCPCS,78830,"Nuclear medicine study, SPECT imaging with concurrent CT scan, 1 area or single acquisition, single day imaging",1663.125,1081.03,62.75,8134.88,37
HCPCS,78831,"Nuclear medicine study, SPECT imaging, at least 2 areas or separate acquisitions, single day imaging, or single area or acquisition over multiple days",1682.375,1093.545,77.7,8134.88,37
HCPCS,78832,"Nuclear medicine study, SPECT imaging with concurrent CT scan, at least 2 areas or separate acquisitions, single day imaging, or single area or acquisition over multiple days",1700.125,1105.08,78.57,8134.88,37
HCPCS,78835,Quantification of radioactive materials,750.125,487.58,20.55,3731.71,37
HCPCS,78999,Other nuclear medicine study,987.3,641.745,73.6,3873.75,33
HCPCS,79005,Radioactive drug therapy by mouth,693.75,450.94,78.48,2582.5,37
HCPCS,79101,Radioactive drug therapy through a vein,710.25,461.66499999999996,78.57,2582.5,37
HCPCS,79200,Radioactive drug therapy into a body cavity,521.9,339.24,75.97,213.21,19
HCPCS,79300,Radioactive drug therapy into a tissue,366.5,238.23,60.99,155.09,19
HCPCS,79403,Radioactive drug therapy of radiolabeled monoclonal antibody through a vein,776.2,504.53,78.57,2582.5,37
HCPCS,79440,Radioactive drug therapy into a joint,524.0,340.6,75.97,209.29,19
HCPCS,79445,Radioactive drug therapy through a tube inserted in an artery,684.8,445.12,78.57,2582.5,73
HCPCS,80047,"Blood test, basic group of blood chemicals (Calcium, ionized)",62.0,40.3,2.6,250.5,57
HCPCS,80048,"Blood test, basic group of blood chemicals (Calcium, total)",39.55,25.71,3.14,108.47,38
HCPCS,80050,General health panel,88.2,57.33,22.28,105.37,15
HCPCS,80051,"Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)",32.45,21.095,2.1,90.39,38
HCPCS,80053,"Blood test, comprehensive group of blood chemicals",52.0,33.8,0.78,134.29,57
HCPCS,80055,Obstetric blood test panel,83.0,53.95,28.69,119.41,19
HCPCS,80061,"Blood test, lipids (cholesterol and triglycerides)",50.0,32.5,0.99,299.57,114
HCPCS,80069,Kidney function blood test panel,53.25,34.615,3.69,165.28,38
HCPCS,80074,Acute hepatitis panel,192.0,124.8,10.64,555.24,57
HCPCS,80076,Liver function blood test panel,35.45,23.045,2.52,103.3,38
HCPCS,80143,Measurement of acetaminophen,150.0,97.5,14.3,387.38,19
HCPCS,80145,Measurement of adalimumab,488.0,317.2,14.3,1260.26,19
HCPCS,80150,Amikacin (antibiotic) level,72.0,46.8,5.55,338.31,57
HCPCS,80151,Measurement of amiodarone,68.0,44.2,12.68,175.61,19
HCPCS,80156,"Carbamazepine level, total",51.1,33.215,2.17,325.4,76
HCPCS,80157,"Carbamazepine level, free",23.9,15.54,2.78,214.35,76
HCPCS,80158,Cyclosporine level,88.0,57.2,4.77,229.84,57
HCPCS,80162,"Digoxin level, total",39.95,25.97,1.98,167.86,38
HCPCS,80164,"Valproic acid level, total",60.0,39.0,1.99,1002.01,114
HCPCS,80165,"Valproic acid level, free",60.0,39.0,8.12,154.95,19
HCPCS,80167,Measurement of felbamate,72.0,46.8,13.42,185.94,19
HCPCS,80168,Ethosuximide level,62.7,40.754999999999995,4.8,247.92,38
HCPCS,80169,Everolimus level,82.5,53.625,8.24,263.42,38
HCPCS,80170,Gentamicin (antibiotic) level,72.55,47.16,9.83,209.18,38
HCPCS,80171,Gabapentin level,60.0,39.0,13.0,154.95,19
HCPCS,80173,Haloperidol level,247.0,160.55,14.3,637.88,19
HCPCS,80176,Lidocaine level,207.25,134.71499999999997,2.72,1022.67,38
HCPCS,80177,Levetiracetam level,302.0,196.3,13.25,779.92,19
HCPCS,80178,Lithium level,25.1,16.314999999999998,1.14,85.22,38
HCPCS,80179,Measurement of salicylate,280.0,182.0,14.3,723.1,19
HCPCS,80180,Mycophenolate (mycophenolic acid) level,216.0,140.4,14.3,557.82,19
HCPCS,80181,Measurement of flecainide,107.0,69.55,14.3,276.33,19
HCPCS,80183,Oxcarbazepine level,88.0,57.2,11.66,227.26,19
HCPCS,80184,Phenobarbital level,49.95,32.47,2.25,278.91,76
HCPCS,80185,"Phenytoin level, total",65.0,42.25,1.97,296.99,57
HCPCS,80186,"Phenytoin level, free",66.85,43.455,2.02,307.32,57
HCPCS,80187,Measurement of posaconazole,322.0,209.3,14.3,831.57,19
HCPCS,80188,Primidone level,30.15,19.6,4.53,85.22,38
HCPCS,80189,Measurement of itraconazole,228.0,148.2,14.3,588.81,19
HCPCS,80190,Procainamide level,30.5,19.83,18.3,149.85,19
HCPCS,80192,"Procainamide level, with metabolites",57.8,37.57,9.68,78.57,19
HCPCS,80193,Measurement of leflunomide,279.0,181.35,14.3,720.52,19
HCPCS,80194,Quinidine level,99.0,64.35,3.07,387.38,57
HCPCS,80195,Sirolimus level,68.0,44.2,6.7,340.89,57
HCPCS,80197,Tacrolimus level,138.8,90.22,4.48,632.71,38
HCPCS,80198,Theophylline level,40.95,26.62,2.53,165.28,38
HCPCS,80200,Tobramycin (antibiotic) level,56.3,36.595,5.42,204.02,38
HCPCS,80201,Topiramate level,110.3,71.69500000000001,6.51,428.7,38
HCPCS,80202,Vancomycin (antibiotic) level,48.15,31.299999999999997,3.97,173.03,38
HCPCS,80203,Zonisamide level,55.0,35.75,7.29,142.04,19
HCPCS,80204,Measurement of methotrexate,98.0,63.7,14.3,253.09,19
HCPCS,80210,Measurement of rufinamide,378.0,245.7,14.3,976.19,19
HCPCS,80230,Measurement of infliximab,652.5,424.125,14.3,1905.89,38
HCPCS,80235,Measurement of lacosamide,163.0,105.95,14.3,420.95,19
HCPCS,80280,Measurement of vedolizumab,418.0,271.7,14.3,1079.49,19
HCPCS,80285,Measurement of voriconazole,180.0,117.0,14.3,464.85,19
HCPCS,80299,Quantitation of therapeutic drug,171.5,111.48,4.59,2066.0,684
HCPCS,80307,"Testing for presence of drug, by chemistry analyzers",125.0,81.25,15.3,1601.15,950
HCPCS,80320,Alcohols levels,132.5,86.125,16.44,470.02,72
HCPCS,80321,"Alcohols levels, 1 or 2",100.01,65.01,16.44,258.28,18
HCPCS,80323,Alkaloids levels,140.0,91.0,13.18,940.03,69
HCPCS,80324,"Amphetamines levels, 1 or 2",113.75,73.94,13.18,361.55,33
HCPCS,80326,"Amphetamines levels, 5 or more",48.0,31.2,16.44,154.95,36
HCPCS,80339,"Antiepileptics levels, 1-3",117.5,76.375,28.73,420.95,36
HCPCS,80342,"Antipsychotics levels, 1-3",195.0,126.75,16.44,705.02,72
HCPCS,80345,Barbiturates levels,140.0,91.0,16.44,562.99,54
HCPCS,80346,"Benzodiazepines levels, 1-12",140.0,91.0,16.44,361.55,18
HCPCS,80347,"Benzodiazepines levels, 13 or more",48.0,31.2,16.44,154.95,36
HCPCS,80348,Buprenorphine level,140.0,91.0,16.44,361.55,18
HCPCS,80349,"Cannabinoids levels, natural",150.0,97.5,13.18,1991.11,69
HCPCS,80353,Cocaine level,140.0,91.0,16.44,361.55,18
HCPCS,80354,Fentanyl level,198.0,128.7,16.44,661.12,36
HCPCS,80355,Gabapentin level non-blood,48.0,31.2,16.44,154.95,36
HCPCS,80358,Methadone level,144.0,93.6,16.44,619.8,54
HCPCS,80359,Methylenedioxyamphetamines levels,72.5,47.125,2.55,361.55,36
HCPCS,80361,Opiates levels,140.0,91.0,16.44,361.55,18
HCPCS,80364,"Opioids levels, 5 or more",48.0,31.2,16.44,154.95,36
HCPCS,80365,Oxycodone levels,72.5,47.125,2.55,361.55,54
HCPCS,80367,Propoxyphene level,140.0,91.0,16.44,361.55,18
HCPCS,80375,"Drugs or substances measurement, 1-3",377.5,245.375,28.73,1384.22,36
HCPCS,80377,"Drugs or substances measurement, 7 or more",215.0,139.75,16.44,555.24,18
HCPCS,80503,"Pathology clinical consultation for clinical problem, 5-20 minutes",64.68,42.04,17.7,78.57,19
HCPCS,80504,"Pathology clinical consultation for moderately complex clinical problem, 21-40 minutes",129.35,84.08,37.19,133.23,19
HCPCS,80505,"Pathology clinical consultation for complex clinical problem, 41-60 minutes",234.35,152.33,70.58,241.38,19
HCPCS,80506,"Pathology clinical consultation, additional 30 minutes",105.0,68.25,39.68,108.15,19
HCPCS,81000,"Manual urinalysis test with examination using microscope, non-automated",20.0,13.0,0.8,78.57,19
HCPCS,81001,"Manual urinalysis test with examination using microscope, automated",15.0,9.75,0.25,78.57,76
HCPCS,81002,"Urinalysis, manual test",17.5,11.375,0.35,78.57,38
HCPCS,81003,Automated urinalysis test,11.63,7.56,0.19,78.57,152
HCPCS,81005,"Analysis of urine, except immunoassays",10.0,6.5,0.15,78.57,95
HCPCS,81015,Urinalysis using microscope,10.0,6.5,0.21,78.57,76
HCPCS,81025,Urine pregnancy test,30.0,19.5,2.58,78.57,133
HCPCS,81099,Unlisted analysis of urine,5.5,3.58,2.48,80.89,15
HCPCS,81105,Gene analysis (Human Platelet Antigen 1) for common variant,202.0,131.3,54.96,521.67,19
HCPCS,81106,Gene analysis (Human Platelet Antigen 2) for common variant,202.0,131.3,54.96,521.67,19
HCPCS,81107,Gene analysis (Human Platelet Antigen 3) for common variant,202.0,131.3,54.96,521.67,19
HCPCS,81108,Gene analysis (Human Platelet Antigen 4) for common variant,202.0,131.3,54.96,521.67,19
HCPCS,81109,Gene analysis (Human Platelet Antigen 5) for common variant,202.0,131.3,54.96,521.67,19
HCPCS,81110,Gene analysis (Human Platelet Antigen 6) for common variant,202.0,131.3,54.96,521.67,19
HCPCS,81111,Gene analysis (Human Platelet Antigen 9) for common variant,202.0,131.3,54.96,521.67,19
HCPCS,81112,Gene analysis (Human Platelet Antigen 15) for common variant,202.0,131.3,54.96,521.67,19
HCPCS,81120,"Gene analysis (isocitrate dehydrogenase 1 [NADP+], soluble) for common variants",501.5,325.975,153.0,1815.5,38
HCPCS,81121,"Gene analysis (isocitrate dehydrogenase 2 [NADP+], mitochondrial) for common variants",609.0,395.85,153.0,2079.4,57
HCPCS,81161,Gene analysis (dystrophin),508.0,330.2,194.33,1417.32,19
HCPCS,81162,Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants,2800.0,1820.0,1428.0,51096.64,19
HCPCS,81163,Gene analysis (breast cancer 1 and 2) of full sequence,1183.0,768.95,423.93,6392.88,38
HCPCS,81164,Gene analysis (breast cancer 1 and 2) for duplication or deletion variants,1000.0,650.0,423.93,5842.3,19
HCPCS,81165,Gene analysis (breast cancer 1) of full sequence,1000.0,650.0,194.33,2828.8,19
HCPCS,81166,Gene analysis (breast cancer 1) for duplication or deletion variants,500.0,325.0,194.33,1506.75,19
HCPCS,81167,Gene analysis (breast cancer 2) for duplication or deletion variants,500.0,325.0,194.33,1414.4,19
HCPCS,81201,"Gene analysis (adenomatous polyposis coli), full gene sequence",1015.0,659.75,517.65,7917.0,19
HCPCS,81202,"Gene analysis (adenomatous polyposis coli), known familial variants",508.0,330.2,194.33,1422.4,19
HCPCS,81203,"Gene analysis (adenomatous polyposis coli), duplication or deletion variants",508.0,330.2,194.33,1311.91,19
HCPCS,81206,Translocation analysis (BCR/ABL1) major breakpoint,542.5,352.625,78.57,1743.19,76
HCPCS,81207,Translocation analysis (BCR/ABL1) minor breakpoint,675.0,438.75,47.22,2246.78,76
HCPCS,81210,Gene analysis (v-raf murine sarcoma viral oncogene homolog B1),695.0,451.75,57.18,9503.6,95
HCPCS,81212,"Gene analysis (breast cancer 1 and 2) for 185delAG, 5385insC, 6174delT variants",762.0,495.3,388.62,3352.8,19
HCPCS,81215,Gene analysis (breast cancer 1) for known familial variant,533.0,346.45,271.83,2000.08,19
HCPCS,81216,Gene analysis (breast cancer 2) of full sequence,1015.0,659.75,185.12,2621.24,19
HCPCS,81217,Gene analysis (breast cancer 2) for known familial variant,533.0,346.45,271.83,2000.08,19
HCPCS,81218,"Gene analysis (ccaat/enhancer binding protein [c/ebp], alpha) full gene sequence",1067.5,693.875,194.33,3060.26,38
HCPCS,81219,"Gene analysis (calreticulin), common variants",504.5,327.925,54.96,1572.74,38
HCPCS,81220,Gene analysis (cystic fibrosis transmembrane conductance regular) common variants,665.0,432.25,78.57,5454.68,57
HCPCS,81227,"Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 9) common variants",614.0,399.1,174.81,1585.66,19
HCPCS,81228,Genome-wide microarray analysis for copy number variants,1680.0,1092.0,773.6,15120.0,19
HCPCS,81229,Genome-wide microarray analysis for copy number and single nucleotide polymorphism (SNP) variants,1648.5,1071.525,255.0,32445.2,114
HCPCS,81232,Gene analysis (dihydropyrimidine dehydrogenase) for common variant,2629.5,1709.1750000000002,174.81,7885.41,38
HCPCS,81235,"Gene analysis (epidermal growth factor receptor), common variants",1594.0,1036.1,324.58,6202.72,38
HCPCS,81240,"Gene analysis (prothrombin, coagulation factor II) A variant",275.0,178.75,39.41,1355.81,95
HCPCS,81241,Gene analysis (coagulation factor V) Leiden variant,287.5,186.875,44.02,1355.81,95
HCPCS,81242,"Gene analysis (Fanconi anemia, complementation group C) common variant",1015.0,659.75,36.62,2621.24,19
HCPCS,81243,"Gene analysis (fragile X syndrome, X-linked intellectual disability) for detection of abnormal alleles",361.3,234.845,18.6,1781.93,38
HCPCS,81244,"Gene analysis (fragile X syndrome, X-linked intellectual disability) for characterization of alleles",627.5,407.875,14.81,3155.82,38
HCPCS,81245,Gene analysis (fms-related tyrosine kinase 3) internal tandem duplication variants,341.79,222.16,53.96,2399.14,57
HCPCS,81246,Test for detecting genes associated with blood cancer,341.79,222.16,54.96,882.67,19
HCPCS,81256,Gene analysis (hemochromatosis) common variants,151.3,98.345,21.31,697.28,38
HCPCS,81261,Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect abnormal clonal population amplified methodology,1077.3,700.245,64.54,5480.07,38
HCPCS,81262,Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect abnormal clonal population direct probe methodology,1010.0,656.5,54.96,2608.33,19
HCPCS,81263,"Gene rearrangement analysis (immunoglobulin heavy chain locus), variable region somatic mutation analysis",1485.0,965.25,194.33,4373.62,19
HCPCS,81264,Gene rearrangement analysis (immunoglobulin kappa light chain locus) to detect abnormal clonal population,1010.0,656.5,172.73,2608.33,19
HCPCS,81265,Comparative analysis using Short Tandem Repeat (STR) markers of patient and specimen,461.3,299.845,75.98,2298.43,38
HCPCS,81267,"Chimerism analysis post transplantation, without cell selection",1200.0,780.0,67.63,3512.2,57
HCPCS,81268,"Chimerism analysis post transplantation, with cell selection",1217.5,791.375,78.57,3911.85,95
HCPCS,81270,Gene analysis (Janus kinase 2) variant,575.0,373.75,54.96,2944.05,114
HCPCS,81271,Gene analysis (Huntingtin) for abnormal alleles,560.0,364.0,137.0,1446.2,19
HCPCS,81272,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), targeted sequence",1000.0,650.0,194.33,5931.18,95
HCPCS,81273,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), D816 variants",1029.0,668.85,54.96,3145.49,38
HCPCS,81275,Gene analysis (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) variants in codons 12 and 13,959.0,623.35,193.25,2476.62,19
HCPCS,81276,"Gene analysis (Kirsten rat sarcoma viral oncogene homolog), additional variants",595.0,386.75,193.25,1536.59,19
HCPCS,81279,Gene analysis (Janus kinase 2) targeted sequence analysis,800.0,520.0,185.2,2582.5,38
HCPCS,81287,Gene analysis (O-6-methylguanine-DNA methyltransferase) for promoter methylation,600.0,390.0,54.96,1936.88,57
HCPCS,81288,"Test for detecting genes associated with colon cancer, promoter methylation analysis",305.0,198.25,153.0,1936.88,57
HCPCS,81291,"Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants",189.5,123.175,21.3,1363.56,76
HCPCS,81292,"Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) full sequence analysis",1015.0,659.75,517.65,6855.31,19
HCPCS,81293,"Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) known familial variants",508.0,330.2,194.33,1681.48,19
HCPCS,81294,"Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) duplication or deletion variants",508.0,330.2,194.33,1311.91,19
HCPCS,81295,"Gene analysis (mutS homolog 2, colon cancer, nonpolyposis type 1) full sequence analysis",1015.0,659.75,381.7,3874.26,19
HCPCS,81296,"Gene analysis (mutS homolog 2, colon cancer, nonpolyposis type 1) known familial variants",508.0,330.2,194.33,1715.67,19
HCPCS,81297,"Gene analysis (mutS homolog 2, colon cancer, nonpolyposis type 1) duplication or deletion variants",508.0,330.2,194.33,1311.91,19
HCPCS,81298,Gene analysis (mutS homolog 6 [E coli]) full sequence analysis,1015.0,659.75,517.65,6514.78,19
HCPCS,81299,Gene analysis (mutS homolog 6 [E coli]) known familial variants,508.0,330.2,194.33,1564.64,19
HCPCS,81300,Gene analysis (mutS homolog 6 [E coli]) duplication or deletion variants,508.0,330.2,194.33,1311.91,19
HCPCS,81301,Microsatellite instability analysis,1195.0,776.75,194.33,4165.29,19
HCPCS,81302,Gene analysis (methyl CpG binding protein 2) full sequence analysis,1015.0,659.75,423.93,5357.88,19
HCPCS,81303,Gene analysis (methyl CpG binding protein 2) known familial variant,508.0,330.2,54.96,1311.91,19
HCPCS,81304,Gene analysis (methyl CpG binding protein 2) duplication or deletion variants,508.0,330.2,150.0,1311.91,19
HCPCS,81305,Gene analysis (myeloid differentiation primary response 88) for p.Leu265Pro variant,950.0,617.5,175.4,2453.38,19
HCPCS,81306,Gene analysis (nudix hydrolase 15) for common variants,563.0,365.95,194.33,1640.36,19
HCPCS,81309,Gene analysis (partner and localizer of BRCA2) targeted sequence analysis,950.0,617.5,194.33,2610.89,19
HCPCS,81310,Gene analysis (nucleophosmin) exon 12 variants,481.3,312.845,78.57,2401.73,38
HCPCS,81311,Gene analysis for cancer (neuroblastoma),761.5,494.975,194.33,3002.27,38
HCPCS,81314,"Gene analysis ((platelet-derived growth factor receptor, alpha polypeptide) targeted sequence",1000.0,650.0,194.33,3295.1,19
HCPCS,81315,Translocation analysis (PML-RARA regulated adaptor molecule 1) common breakpoint,860.0,559.0,78.57,2533.43,76
HCPCS,81317,Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) full sequence analysis,1015.0,659.75,517.65,6866.48,19
HCPCS,81318,Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) known familiar variants,508.0,330.2,194.33,1681.48,19
HCPCS,81319,Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) duplication or deletion variants,508.0,330.2,194.33,1311.91,19
HCPCS,81321,"Gene analysis (phosphatase and tensin homolog), full sequence analysis",1015.0,659.75,517.65,6090.0,19
HCPCS,81322,"Gene analysis (phosphatase and tensin homolog), known familial variant",508.0,330.2,46.6,1311.91,19
HCPCS,81323,"Gene analysis (phosphatase and tensin homolog), duplication or deletion variant",500.0,325.0,194.33,1500.0,19
HCPCS,81329,"Gene analysis (survival of motor neuron 1, telomeric) for dosage/deletion",22.0,14.3,11.22,198.22,19
HCPCS,81331,Methylation analysis (small nuclear ribonucleoprotein polypeptide N and ubiquitin protein ligase E3A),433.5,281.775,51.07,1877.48,38
HCPCS,81332,"Gene analysis (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) common variants",285.8,185.77,14.23,1391.97,38
HCPCS,81335,Gene analysis (thiopurine S-methyltransferase) for common variant,1255.0,815.75,174.81,3576.76,38
HCPCS,81339,"Gene analysis (MPL proto-oncogene, thrombopoietin receptor) sequence analysis of exon 10",795.0,516.75,185.2,2053.09,19
HCPCS,81340,Gene analysis (T cell antigen receptor beta) amplification methodology,1341.0,871.65,194.33,5066.87,38
HCPCS,81341,Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor beta) direct probe methodology,1010.0,656.5,49.59,2608.33,19
HCPCS,81342,Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor gamma),1016.5,660.725,65.69,4849.94,76
HCPCS,81345,Gene analysis (telomerase reverse transcriptase) targeted sequence analysis,666.0,432.9,185.2,1812.92,38
HCPCS,81352,Gene analysis (tumor protein 53) targeted sequence analysis,1890.0,1228.5,194.33,10399.34,76
HCPCS,81355,Gene analysis (vitamin K epoxide reductase complex subunit 1) common variants,614.0,399.1,54.96,1585.66,19
HCPCS,81370,"HLA class I and II typing low resolution HLA-A, -B, -C, -DRB1/3/4/5 and -DQB1",1626.5,1057.225,78.57,14914.63,76
HCPCS,81371,"HLA class I and II typing, low resolution HLA-A, -B, and -DRB1",995.0,646.75,78.57,7079.1,57
HCPCS,81372,HLA class I typing low resolution,496.8,322.92,78.57,3878.5,38
HCPCS,81373,HLA class I typing low resolution one locus,290.3,188.695,41.54,1415.21,38
HCPCS,81374,"HLA class I typing, low resolution one antigen equivalent",548.0,356.2,54.96,1415.21,38
HCPCS,81375,HLA class II typing low resolution HLA-DRB1/3/4/5 and -DQB1,393.3,255.645,71.96,1947.21,38
HCPCS,81376,HLA class II typing low resolution one locus,290.3,188.695,39.84,1415.21,57
HCPCS,81377,HLA class II typing low resolution one antigen equivalent,290.3,188.695,30.89,1415.21,57
HCPCS,81378,"HLA class I and II typing high resolution HLA-A, -B, -C, and -DRB1",3344.5,2173.925,194.33,13612.0,38
HCPCS,81379,HLA Class I typing high resolution,2102.5,1366.625,78.57,9806.51,76
HCPCS,81380,HLA class I typing high resolution one locus,1180.0,767.0,78.57,4013.21,76
HCPCS,81381,HLA class I typing high resolution one allele or allele group,290.3,188.695,55.39,1415.21,38
HCPCS,81382,HLA class II typing high resolution one locus,1491.5,969.475,40.32,4013.21,76
HCPCS,81383,HLA class II typing high resolution one allele or allele group,548.0,356.2,35.58,2220.95,57
HCPCS,81401,Molecular pathology procedure level 2,975.0,633.75,137.0,3485.52,152
HCPCS,81402,Molecular pathology procedure level 3,744.5,483.925,150.33,3145.49,171
HCPCS,81403,Molecular pathology procedure level 4 genetic analysis,795.0,516.75,155.04,3486.38,342
HCPCS,81404,Molecular pathology procedure level 5 genetic analysis,887.5,576.875,194.33,2789.52,133
HCPCS,81405,Molecular pathology procedure level 6 genetic analysis,1000.0,650.0,194.33,6027.0,266
HCPCS,81406,Molecular pathology procedure level 7 genetic analysis,1605.0,1043.25,194.33,23391.91,171
HCPCS,81407,Molecular pathology procedure level 8 genetic analysis,1750.0,1137.5,255.0,23094.71,266
HCPCS,81408,Molecular pathology procedure level 9 genetic analysis,2558.0,1662.7,255.0,96000.0,114
HCPCS,81410,"Test for detecting genes associated with heart disease, genomic sequence analysis panel, at least 9 genes",3000.0,1950.0,423.93,15120.0,19
HCPCS,81411,"Test for detecting genes associated with heart disease, duplication/deletion analysis panel",1800.0,1170.0,918.0,24303.42,19
HCPCS,81415,"Test for detecting exome, sequence analysis",6300.0,4095.0,2748.7,301140.0,19
HCPCS,81416,"Test for detecting exome, sequence analysis, each comparator exome",1200.0,780.0,510.0,168000.0,38
HCPCS,81417,Reevaluation test of previously obtained exome sequence,1000.0,650.0,194.33,3200.0,19
HCPCS,81427,Reevaluation test of previously obtained genome sequence,500.0,325.0,255.0,11688.25,19
HCPCS,81432,"Test for detecting genes associated with inherited breast cancer-related disorders, genomic sequence analysis, at least 5 genes",1523.0,989.95,679.05,19859.16,19
HCPCS,81435,"Test for detecting genes associated with inherited colon cancer-related disorders, genomic sequence analysis, at least 5 genes",1523.0,989.95,423.93,19859.16,19
HCPCS,81437,"Test for detecting genes associated with inherited neuroendocrine tumor-related disorders, genomic sequence analysis, at least 5 genes",1523.0,989.95,423.93,19859.16,19
HCPCS,81442,Gene analysis (noonan syndrome) genomic sequence analysis,2500.0,1625.0,1275.0,53590.0,19
HCPCS,81445,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with solid organ abnormal growth of tissue,1860.0,1209.0,423.93,74738.75,190
HCPCS,81450,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,2185.5,1420.575,759.53,88181.43,152
HCPCS,81455,Genomic sequence analysis panel of DNA or combined DNA and RNA of 51 or more genes associated with blood and lymphatic system disorders,5000.0,3250.0,1020.0,218970.0,95
HCPCS,81479,Molecular pathology procedure,1156.0,751.4,13.77,42611.25,684
HCPCS,81508,"Fetal congenital abnormalities, biochemical assays of two proteins (papp-a, hcg [any form]), utilizing maternal serum, algorithm reported as a risk score",172.0,111.8,54.3,444.19,19
HCPCS,81511,"Fetal congenital abnormalities, biochemical assays of four analytes (afp, ue3, hcg [any form], dia) utilizing maternal serum, algorithm reported as a risk score",180.0,117.0,91.8,464.85,19
HCPCS,81515,Test for detection of bacteria causing vaginosis and vaginitis,320.0,208.0,144.0,841.57,34
HCPCS,81595,Test for detecting genes associated with heart diseases,4000.0,2600.0,2040.0,129600.0,19
HCPCS,82009,"Ketone bodies analysis, qualitative",10.6,6.89,0.16,103.3,95
HCPCS,82010,"Ketone bodies analysis, quantitative",83.0,53.95,4.17,296.99,38
HCPCS,82013,Acetylcholinesterase (enzyme) level,297.6,193.44,7.37,1200.86,38
HCPCS,82016,Chemical analysis for genetic disorder,57.8,37.57,8.08,126.54,38
HCPCS,82017,Chemical test for genetic disorder,249.45,162.14499999999998,10.12,1125.97,38
HCPCS,82024,Adrenocorticotropic hormone (ACTH) level,150.0,97.5,23.17,488.09,57
HCPCS,82040,Albumin (protein) level,26.7,17.355,0.44,570.73,133
HCPCS,82042,"Cerebrospinal fluid, or amniotic fluid albumin (protein) level",28.0,18.2,0.71,896.13,76
HCPCS,82043,Urine microalbumin (protein) level,24.55,15.96,1.16,78.57,38
HCPCS,82044,Urine microalbumin (protein) analysis,14.7,9.56,0.92,78.57,19
HCPCS,82077,Measurement of alcohol level in specimen other than breath or urine,83.0,53.95,14.33,214.35,19
HCPCS,82085,Aldolase (enzyme) level,43.6,28.34,3.03,144.62,38
HCPCS,82088,Aldosterone hormone level,150.5,97.825,15.65,911.62,76
HCPCS,82103,"Alpha-1-antitrypsin (protein) blood test, total",87.0,56.55,1.36,929.7,76
HCPCS,82104,"Alpha-1-antitrypsin (protein) blood test, phenotype",88.15,57.3,8.68,278.91,38
HCPCS,82105,"Alpha-fetoprotein (AFP) level, serum",53.8,34.97,2.82,446.77,209
HCPCS,82106,"Alpha-fetoprotein (AFP) level, amniotic fluid",100.85,65.555,9.64,374.46,38
HCPCS,82108,Aluminum level,77.75,50.54,14.45,216.93,38
HCPCS,82120,Vaginal fluid chemical analysis for bacteria,9.5,6.18,0.57,78.57,19
HCPCS,82128,"Amino acid analysis, multiple amino acids, qualitative, each specimen",636.0,413.4,8.32,1714.78,57
HCPCS,82131,"Amino acid analysis, quantitative, each specimen",231.0,150.15,13.79,921.95,76
HCPCS,82135,Aminolevulinic acid (protein) level,99.0,64.35,9.87,78.57,19
HCPCS,82139,"Amino acid level, 6 or more amino acids, quantitative, each specimen",389.5,253.175,10.12,5402.59,114
HCPCS,82140,Ammonia level,61.0,39.65,4.81,170.45,57
HCPCS,82143,Amniotic fluid scan,55.4,36.010000000000005,3.44,191.11,38
HCPCS,82150,Amylase (enzyme) level,33.45,21.744999999999997,0.72,307.32,171
HCPCS,82154,Androstanediol glucuronide (hormone) level,404.0,262.6,15.65,1043.33,19
HCPCS,82157,Androstenedione (hormone) level,227.0,147.55,15.65,880.63,57
HCPCS,82164,Angiotensin l - converting enzyme (ACE) level,94.5,61.425000000000004,8.76,325.4,57
HCPCS,82166,Test for anti-mullerian hormone,160.0,104.0,38.62,413.2,17
HCPCS,82172,Apolipoprotein level,74.0,48.1,3.54,304.74,76
HCPCS,82175,Arsenic level,104.0,67.6,11.38,965.86,114
HCPCS,82180,"Ascorbic acid (Vitamin C) level, blood",140.65,91.42500000000001,5.93,480.35,38
HCPCS,82232,Beta-2 microglobulin (protein) level,102.035,66.325,8.67,388.59,38
HCPCS,82234,Test for beta-amyloid 1-42,1000.0,650.0,128.92,2582.5,17
HCPCS,82239,"Bile acids level, total",97.0,63.05,14.14,250.5,19
HCPCS,82247,"Bilirubin level, total",27.5,17.875,1.11,304.74,152
HCPCS,82248,"Bilirubin level, direct",25.0,16.25,0.75,113.63,57
HCPCS,82261,Biotinidase (enzyme) level,28.7,18.655,1.25,129.13,38
HCPCS,82270,Stool analysis for blood to screen for colon tumors,20.0,13.0,0.44,235.01,95
HCPCS,82271,Specimen analysis for blood,17.25,11.215,0.56,78.57,76
HCPCS,82272,"Stool analysis for blood, by peroxidase activity",20.0,13.0,0.42,78.57,57
HCPCS,82274,"Stool analysis for blood, by fecal hemoglobin determination by immunoassay",73.0,47.45,3.28,188.52,76
HCPCS,82300,Cadmium level,97.0,63.050000000000004,13.19,570.73,76
HCPCS,82306,Vitamin D-3 level,92.0,59.8,5.12,374.46,76
HCPCS,82308,Calcitonin (hormone) level,136.95,89.02000000000001,15.65,428.7,38
HCPCS,82310,"Calcium level, total",20.9,13.584999999999999,0.82,78.57,38
HCPCS,82330,"Calcium level, ionized",50.98,33.14,2.78,227.26,114
HCPCS,82340,Urine calcium level,30.0,19.5,0.76,170.45,57
HCPCS,82355,Analysis of stone,36.8,23.92,4.26,78.57,19
HCPCS,82365,Infrared analysis of stone,113.0,73.45,3.66,1598.57,57
HCPCS,82374,Carbon dioxide (bicarbonate) level,24.0,15.6,0.76,139.46,57
HCPCS,82375,Carboxyhemoglobin (protein) level,61.0,39.65,2.76,235.01,76
HCPCS,82376,Carboxyhemoglobin (protein) analysis,16.8,10.92,2.36,78.57,19
HCPCS,82378,Carcinoembryonic antigen (CEA) protein level,36.8,23.92,2.79,240.17,57
HCPCS,82379,Carnitine level,112.15,72.9,8.49,449.36,38
HCPCS,82380,Carotene level,62.1,40.364999999999995,2.51,250.5,38
HCPCS,82384,Catecholamines (organic nitrogen) level,143.45000000000002,93.245,13.79,599.91,76
HCPCS,82390,Ceruloplasmin (protein) level,33.1,21.515,1.42,136.87,38
HCPCS,82397,Analysis using chemiluminescent technique (light and chemical )reaction,432.0,280.79999999999995,7.41,1464.28,190
HCPCS,82435,Blood chloride level,26.75,17.39,0.49,87.81,114
HCPCS,82436,Urine chloride level,26.0,16.9,0.64,85.22,57
HCPCS,82438,Chloride level,28.4,18.46,0.95,111.05,57
HCPCS,82465,Cholesterol level,18.9,12.285,0.32,304.74,114
HCPCS,82480,"Cholinesterase (enzyme) level, to test for exposure to chemical or liver disease",32.45,21.095,1.09,131.71,38
HCPCS,82482,Cholinesterase (enzyme) level,73.5,47.775000000000006,5.89,162.7,38
HCPCS,82495,Chromium level to test for poisoning or deficiency,107.0,69.55,14.45,276.33,19
HCPCS,82507,Citrate level,66.0,42.9,16.65,240.17,57
HCPCS,82523,"Collagen cross links test, (urine test to evaluate bone health)",143.0,92.94999999999999,3.31,779.92,76
HCPCS,82525,Copper level,93.0,60.45,5.3,826.4,152
HCPCS,82530,"Cortisol (hormone) measurement, free",79.5,51.675,7.02,302.15,38
HCPCS,82533,"Cortisol (hormone) measurement, total",63.8,41.47,2.79,880.63,114
HCPCS,82540,Creatine measurement,10.1,6.57,0.47,78.57,19
HCPCS,82542,Chemical analysis using chromatography technique,260.825,169.535,14.14,774.75,228
HCPCS,82550,"Creatine kinase (cardiac enzyme) level, total",26.0,16.9,0.37,157.53,76
HCPCS,82552,"Creatine kinase (cardiac enzyme) level, isoenzymes",54.15,35.2,6.33,157.53,38
HCPCS,82553,"Creatine kinase (cardiac enzyme) level, MB fraction only",32.5,21.13,1.37,288.36,57
HCPCS,82554,"Creatine kinase (cardiac enzyme) level, isoforms",367.5,238.88,7.12,78.57,19
HCPCS,82565,Blood creatinine level,26.0,16.9,0.77,85.22,57
HCPCS,82570,Creatinine level to test for kidney function or muscle injury,54.5,35.425,0.83,1234.44,95
HCPCS,82575,Creatinine clearance measurement to test for kidney function,29.15,18.95,1.07,121.38,38
HCPCS,82583,"HC CBC AND PLATELET W/AUTO DIFF, NBU",35.0,22.75,15.75,90.39,16
HCPCS,82585,Cryofibrinogen (protein) level,32.6,21.19,4.61,78.57,19
HCPCS,82595,Cryoglobulin (protein) measurement,35.0,22.75,1.06,178.19,57
HCPCS,82600,Cyanide measurement,83.9,54.54,11.64,78.57,19
HCPCS,82607,Cyanocobalamin (vitamin B-12) level,58.8,38.22,3.0,191.11,57
HCPCS,82610,Cystatin C (enzyme inhibitor) level,46.3,30.1,8.57,119.57,19
HCPCS,82615,Cystine and homocystine (amino acids) analysis,21.0,13.65,2.01,78.57,19
HCPCS,82626,Dehydroepiandrosterone (DHEA) hormone level,151.2,98.28,14.14,880.63,57
HCPCS,82627,Dehydroepiandrosterone (DHEA-S) hormone level,60.9,39.59,5.85,260.83,57
HCPCS,82633,"Desoxycorticosterone, 11 (hormone) level",341.0,221.65,30.98,880.63,19
HCPCS,82634,"Deoxycortisol, 11 (hormone) level",199.0,129.35,15.65,880.63,57
HCPCS,82638,Dibucaine number (enzyme) measurement,51.0,33.15,6.25,131.71,19
HCPCS,82642,Measurement of dihydrotestosterone,156.0,101.4,15.65,402.87,19
HCPCS,82652,"Dihydroxyvitamin D, 1, 25 level",171.85,111.70500000000001,23.1,415.78,38
HCPCS,82653,Measurement of pancreatic elastase (enzyme) in stool,200.0,130.0,14.14,516.5,19
HCPCS,82657,"Enzyme activity measurement, nonradioactive substrate",520.0,338.0,5.99,5477.48,152
HCPCS,82664,"Electrophoresis, laboratory testing technique",247.2,160.68,33.2,2233.86,76
HCPCS,82668,Erythropoietin (protein) level,100.75,65.49000000000001,11.27,343.47,38
HCPCS,82670,Measurement of total estradiol (hormone),102.9,66.89,8.8,335.73,57
HCPCS,82671,"Estrogen analysis, fractionated",187.0,121.55,32.3,482.93,19
HCPCS,82677,Estriol (hormone) level,69.79,45.36,2.54,539.74,95
HCPCS,82679,Estrone (hormone) level,139.0,90.35,15.65,358.97,19
HCPCS,82693,Ethylene glycol (antifreeze) measurement,127.0,82.55,14.45,346.06,38
HCPCS,82705,"Stool fat or lipids analysis, qualitative",38.0,24.7,0.36,173.03,57
HCPCS,82710,"Stool fat or lipids analysis, quantitative",201.3,130.845,10.08,818.65,38
HCPCS,82725,Fatty acids measurement,213.9,139.035,11.26,911.62,38
HCPCS,82726,Very long chain fatty acids level,63.0,40.95,10.69,1490.1,57
HCPCS,82728,Ferritin (blood protein) level,43.1,28.02,4.09,173.03,57
HCPCS,82731,Fetal fibronectin (protein) analysis,376.0,244.4,38.65,1218.94,38
HCPCS,82746,"Folic acid level, serum",57.8,37.57,3.06,185.94,57
HCPCS,82747,"Folic acid level, RBC",52.03,33.82,3.25,387.38,57
HCPCS,82757,Semen fructose (carbohydrate) level,157.5,102.38,10.4,78.57,19
HCPCS,82760,Galactose (carbohydrate) level,28.0,18.2,3.14,72.31,19
HCPCS,82775,Galactose-1-phosphate uridyl transferase (enzyme) level,480.55,312.36,12.64,2009.19,38
HCPCS,82776,Galactose-1-phosphate uridyl transferase screening test,20.55,13.36,1.54,78.57,38
HCPCS,82784,Gammaglobulin (immune system protein) measurement,57.5,37.375,0.83,1071.74,209
HCPCS,82785,IgE (immune system protein) level,40.5,26.325000000000003,4.94,606.89,152
HCPCS,82787,"Gammaglobulin (immune system protein) measurement, immunoglobulin subclasses",59.9,38.935,2.95,214.35,95
HCPCS,82800,Blood pH level,28.6,18.59,0.79,129.13,38
HCPCS,82803,Blood gases measurement,23.55,15.31,4.12,619.41,190
HCPCS,82805,"Blood gases measurement, with O2 saturation",355.0,230.75,22.13,1262.84,76
HCPCS,82810,"Blood gas, oxygen saturation measurement",26.3,17.095,0.84,113.63,38
HCPCS,82930,Gastric acid analysis,17.0,11.05,1.14,43.9,19
HCPCS,82941,Gastrin (GI tract hormone) level,81.0,52.65,4.27,395.12,57
HCPCS,82943,Glucagon (pancreatic hormone) level,167.35,108.78,7.96,720.52,38
HCPCS,82945,Glucose (sugar) level on body fluid,14.55,9.46,0.36,78.57,76
HCPCS,82947,Blood glucose (sugar) level,20.0,13.0,0.29,304.74,209
HCPCS,82948,Blood glucose (sugar) measurement using reagent strip,16.0,10.4,0.58,90.39,57
HCPCS,82950,Blood glucose (sugar) level after receiving dose of glucose,24.0,15.6,0.95,90.39,57
HCPCS,82951,"Blood glucose (sugar) tolerance test, 3 specimens",60.0,39.0,1.29,289.24,95
HCPCS,82952,"Blood glucose (sugar) tolerance test, each additional beyond 3 specimens",17.95,11.67,0.7,78.57,38
HCPCS,82955,G6PD (enzyme) level,40.0,26.0,3.49,276.33,57
HCPCS,82962,Blood glucose (sugar) test performed by hand-held instrument,13.0,8.45,0.33,78.57,95
HCPCS,82977,Glutamyltransferase (liver enzyme) level,53.0,34.45,0.9,402.87,95
HCPCS,82985,Glycated protein level,80.0,52.0,4.11,666.29,57
HCPCS,83001,"Gonadotropin, follicle stimulating (reproductive hormone) level",81.75,53.14,11.15,235.01,38
HCPCS,83002,"Gonadotropin, luteinizing (reproductive hormone) level",81.75,53.14,11.11,235.01,38
HCPCS,83003,Human growth hormone level,65.1,42.32,9.67,211.77,57
HCPCS,83010,Haptoglobin (serum protein) level,62.0,40.3,1.89,304.74,57
HCPCS,83013,Breath test analysis for helicobacter pylori,217.4,141.31,40.42,490.68,114
HCPCS,83014,Administration of drug for helicobacter pylori,49.0,31.85,2.36,175.61,38
HCPCS,83015,Heavy metal screening test,35.9,23.34,7.52,78.57,19
HCPCS,83018,Heavy metal level,244.0,158.6,14.45,816.07,57
HCPCS,83020,"Hemoglobin analysis and measurement, electrophoresis",80.45,52.294999999999995,3.6,1017.4,76
HCPCS,83021,"Hemoglobin analysis and measurement, chromatography",72.0,46.8,6.45,763.52,57
HCPCS,83026,Hemoglobin level,7.2,4.68,0.29,78.57,19
HCPCS,83030,Fetal hemoglobin level,40.6,26.39,1.63,170.45,38
HCPCS,83033,Fetal hemoglobin analysis,236.2,153.53,0.59,1200.86,38
HCPCS,83036,Hemoglobin A1C level,29.11,18.925,0.95,123.96,95
HCPCS,83037,"Hemoglobin A1C level, by device for home use",29.8,19.37,2.89,78.57,19
HCPCS,83050,"Methemoglobin (hemoglobin) analysis, quantitative",22.5,14.625,0.66,95.55,57
HCPCS,83051,Plasma hemoglobin level,41.0,26.65,1.84,165.28,57
HCPCS,83070,Hemosiderin (hemoglobin breakdown product) analysis,50.8,33.02,2.41,78.57,19
HCPCS,83088,Histamine (immune system substance) level,165.9,107.84,17.72,78.57,19
HCPCS,83090,Homocysteine (amino acid) level,47.0,30.55,5.04,237.59,57
HCPCS,83150,Homovanillic acid (organic acid) level,105.25,68.41499999999999,13.45,774.75,76
HCPCS,83491,"Hydroxycorticosteroids, 17 (adrenal gland hormone) level",302.0,196.3,15.65,779.92,19
HCPCS,83497,Hydroxyindolacetic acid (product of metabolism) level,93.5,60.775,5.69,774.75,76
HCPCS,83498,"Hydroxyprogesterone, 17-D (synthetic hormone) level",100.15,65.1,7.61,880.63,76
HCPCS,83516,"Analysis of substance using immunoassay technique, multiple step method",88.0,57.2,2.77,3563.85,684
HCPCS,83518,"Analysis of substance using immunoassay technique, single step method",64.8,42.12,6.25,78.57,19
HCPCS,83519,"Measurement of substance using immunoassay technique, by radioimmunoassay",267.5,173.875,11.04,4188.82,779
HCPCS,83520,Measurement of substance using immunoassay technique,367.0,238.55,8.29,11001.45,874
HCPCS,83521,Measurement of immunoglobulin light chains,95.5,62.075,7.46,981.35,95
HCPCS,83525,"Insulin measurement, total",50.05,32.535,2.88,222.1,76
HCPCS,83527,"Insulin measurement, free",63.9,41.535,6.97,191.11,38
HCPCS,83529,Measurement of interleukin-6,296.0,192.4,14.14,764.42,19
HCPCS,83540,Iron level,32.0,20.8,0.5,1182.79,133
HCPCS,83550,Iron binding capacity,51.0,33.15,2.27,196.27,95
HCPCS,83586,"Ketosteroids, 17 (hormone) measurement, total",89.05,57.885,4.88,361.55,38
HCPCS,83605,Lactic acid level,274.0,178.10000000000002,1.17,1575.33,114
HCPCS,83615,Lactate dehydrogenase (enzyme) level,30.0,19.5,1.09,136.87,95
HCPCS,83625,Lactate dehydrogenase (enzyme) measurement,89.25,58.015,3.26,395.12,38
HCPCS,83630,Stool lactoferrin (immune system protein) analysis,96.0,62.4,11.82,273.75,57
HCPCS,83655,Lead level,90.0,58.5,0.8,485.51,133
HCPCS,83663,"Fetal lung maturity assessment, fluorescence polarization",103.0,66.95,7.94,423.53,38
HCPCS,83664,"Fetal lung maturity assessment, lamellar body density",155.0,100.75,14.14,400.29,19
HCPCS,83690,Lipase (fat enzyme) level,34.0,22.1,1.45,154.95,57
HCPCS,83695,Lipoprotein (A) level,124.55,80.96000000000001,4.88,555.24,38
HCPCS,83700,"Lipoprotein level, electrophoretic separation and quantitation",200.0,130.0,11.26,516.5,19
HCPCS,83704,"Lipoprotein level, quantitation of lipoprotein particle number(s)",503.0,326.95,33.2,1299.0,19
HCPCS,83718,HDL cholesterol level,41.0,26.65,2.05,183.36,57
HCPCS,83721,LDL cholesterol level,38.5,25.025,3.05,123.96,38
HCPCS,83735,Magnesium level,33.0,21.45,0.7,247.92,133
HCPCS,83785,Manganese (heavy metal) level,195.0,126.75,14.45,560.4,57
HCPCS,83789,Mass spectrometry (laboratory testing method),80.0,52.0,14.14,258.25,57
HCPCS,83825,Mercury level,99.0,64.35,9.72,697.28,95
HCPCS,83835,Metanephrines level,148.0,96.2,8.72,1221.52,57
HCPCS,83861,Microfluid analysis of tears,65.0,42.25,14.14,167.86,19
HCPCS,83864,Mucopolysaccharides (protein) level,506.1,328.97,17.1,144.24,19
HCPCS,83873,"Myelin basic protein (nerve protein) level, spinal fluid",97.0,63.050000000000004,9.12,364.13,38
HCPCS,83874,Myoglobin (muscle protein) level,50.8,33.02,1.09,289.24,95
HCPCS,83880,Natriuretic peptide (heart and blood vessel protein) level,139.5,90.675,23.56,619.8,76
HCPCS,83883,"Nephelometry, test method using light",156.0,101.4,13.6,1709.62,133
HCPCS,83884,Test for neurofilament light chain,2579.0,1676.35,116.23,6660.27,17
HCPCS,83915,Nucleotidase 5' (enzyme) level,67.95,44.17,3.22,276.33,38
HCPCS,83916,Measurement of immune substance (oligoclonal bands),225.45,146.54500000000002,10.65,1063.99,38
HCPCS,83918,Organic acids level,415.75,270.24,14.16,1849.07,38
HCPCS,83921,Organic acid level,166.4,108.16,11.03,1487.52,114
HCPCS,83930,Blood osmolality (concentration) measurement,26.55,17.259999999999998,1.33,85.22,38
HCPCS,83935,Urine osmolality (concentration) measurement,21.3,13.845,0.59,87.81,38
HCPCS,83937,Osteocalcin (bone protein) level,195.15,126.85,17.91,777.33,38
HCPCS,83945,Oxalate level,66.0,42.9,5.32,266.0,57
HCPCS,83970,Parathormone (parathyroid hormone) level,163.0,105.95,15.6,692.11,76
HCPCS,83986,Body fluid pH level,26.5,17.225,0.32,237.59,152
HCPCS,83992,PCP drug level,186.0,120.9,14.45,989.1,57
HCPCS,83993,Stool calprotectin (protein) level,522.0,339.3,14.14,2303.59,114
HCPCS,84030,"Phenylalanine, PKU (amino acid) level",27.5,17.875,0.87,123.96,76
HCPCS,84060,"Phosphatase (enzyme) measurement, acid, total",50.7,32.955,2.17,188.52,38
HCPCS,84066,"Phosphatase, prostatic (prostate enzyme) level",80.15,52.099999999999994,5.8,237.59,38
HCPCS,84075,"Phosphatase (enzyme) level, alkaline",31.85,20.705000000000002,0.83,123.19,76
HCPCS,84080,"Phosphatase (enzyme) measurement, alkaline, isoenzymes",84.5,54.925000000000004,4.88,351.22,76
HCPCS,84081,Phosphatidylglycerol (amniotic fluid organic acid) level,42.0,27.3,6.94,78.57,19
HCPCS,84100,Phosphate level,19.0,12.35,0.66,78.57,38
HCPCS,84105,Urine phosphate level,27.0,17.55,0.8,85.22,57
HCPCS,84106,Urine porphobilinogen (metabolism substance) analysis,15.8,10.27,0.92,78.57,19
HCPCS,84110,Urine porphobilinogen (metabolism substance) level,77.65,50.47,6.43,200.53,19
HCPCS,84112,Cervicovaginal secretion of placenta protein,442.0,287.3,80.37,1141.47,19
HCPCS,84119,Urine porphyrins (metabolism substance) analysis,88.0,57.2,11.76,227.26,19
HCPCS,84120,Urine porphyrins (metabolism substance) measurement,98.35,63.93000000000001,5.99,402.87,38
HCPCS,84132,Blood potassium level,28.5,18.525,0.75,103.3,133
HCPCS,84133,Urine potassium level,22.0,14.3,0.34,85.22,57
HCPCS,84134,Prealbumin (protein) level,45.05,29.284999999999997,2.64,185.94,38
HCPCS,84140,Pregnenolone (reproductive hormone) level,195.0,126.75,15.65,503.59,19
HCPCS,84143,17-hydroxypregnenolone (hormone) level,272.0,176.8,15.65,880.63,38
HCPCS,84144,Progesterone (reproductive hormone) level,91.45,59.445,12.52,880.63,76
HCPCS,84145,Procalcitonin (hormone) level,107.41,69.815,15.65,431.28,76
HCPCS,84146,Prolactin (milk producing hormone) level,85.3,55.445,11.63,245.34,38
HCPCS,84150,Prostaglandin (hormone) level,342.0,222.3,41.3,883.22,19
HCPCS,84152,"PSA (prostate specific antigen) measurement, complexed",278.25,180.865,11.03,1193.12,38
HCPCS,84153,"PSA (prostate specific antigen) measurement, total",66.4,43.16,2.91,235.01,114
HCPCS,84154,"PSA (prostate specific antigen) measurement, free",90.0,58.5,4.14,325.4,57
HCPCS,84155,"Total protein level, blood",14.8,9.62,0.36,377.05,76
HCPCS,84156,"Total protein level, urine",19.0,12.35,0.34,278.91,95
HCPCS,84157,"Total protein level, body fluid",19.0,12.35,0.62,78.57,76
HCPCS,84163,Pregnancy-associated plasma protein-A level,282.0,183.3,14.14,728.27,19
HCPCS,84165,"Protein measurement, serum",45.0,29.25,4.41,377.05,95
HCPCS,84166,"Protein measurement, body fluid",83.0,53.95,8.01,227.26,57
HCPCS,84181,Protein measurement,44.9,29.19,7.65,78.57,19
HCPCS,84182,"Protein measurement, immunological probe for band identification",284.0,184.6,10.18,3114.5,608
HCPCS,84202,Protoporphyrin (metabolism substance) level,93.0,60.45,6.31,250.5,76
HCPCS,84206,Proinsulin (pancreatic hormone) level,157.05,102.08500000000001,15.65,428.7,38
HCPCS,84207,Vitamin B-6 level,145.05,94.285,16.86,364.13,38
HCPCS,84210,Pyruvate (organic acid) level,301.0,195.65,8.37,1967.87,76
HCPCS,84220,Pyruvate kinase (enzyme) level,169.25,110.015,5.66,684.36,38
HCPCS,84233,Estrogen receptor analysis,248.9,161.79,52.73,219.48,19
HCPCS,84234,Progesterone (reproductive hormone) receptor analysis,251.0,163.15,38.93,162.85,19
HCPCS,84238,Chemical receptor analysis,160.35,104.22999999999999,21.94,397.71,38
HCPCS,84244,Renin (kidney enzyme) level,86.55,56.260000000000005,13.19,227.26,38
HCPCS,84252,Vitamin B-2 (riboflavin) level,289.85,188.40499999999997,12.14,1242.18,38
HCPCS,84255,Selenium (vitamin) level,102.12,66.38,14.45,1368.73,95
HCPCS,84260,Serotonin (hormone) level,191.55,124.50999999999999,18.59,658.54,38
HCPCS,84270,Sex hormone binding globulin (protein) level,69.79,45.36,6.48,276.33,57
HCPCS,84275,Sialic acid (organic acid) level,56.7,36.86,7.62,78.57,19
HCPCS,84295,Blood sodium level,18.75,12.19,0.16,92.97,133
HCPCS,84300,Urine sodium level,23.0,14.95,0.36,85.22,57
HCPCS,84302,Sodium level,27.9,18.135,0.67,108.47,38
HCPCS,84305,Somatomedin (growth factor) level,197.1,128.115,12.76,792.83,38
HCPCS,84307,Somatostatin (growth hormone inhibitor) level,935.0,607.75,15.65,2414.64,19
HCPCS,84311,Chemical analysis using spectrophotometry (light),105.95,68.87,1.62,2998.28,114
HCPCS,84376,"Carbohydrate analysis, single qualitative",44.55,28.96,1.27,170.45,38
HCPCS,84378,"Carbohydrate analysis, single quantitative",652.2,423.92999999999995,6.92,2807.18,38
HCPCS,84392,Urine sulfate (acid) level,33.0,21.45,1.81,85.22,19
HCPCS,84393,Test for phosphorylated Tau protein,1250.0,812.5,128.92,3873.75,34
HCPCS,84394,Test for total Tau protein,1000.0,650.0,128.92,2582.5,17
HCPCS,84402,"Testosterone (hormone) level, free",147.4,95.81,5.04,1415.21,114
HCPCS,84403,"Testosterone (hormone) level, total",100.8,65.52,2.71,1415.21,171
HCPCS,84425,Vitamin B-1 (thiamine) level,139.3,90.545,12.74,415.78,38
HCPCS,84430,Thiocyanate (organic sulfur substance) level,129.55,84.21000000000001,6.98,454.52,38
HCPCS,84432,Thyroglobulin (thyroid related hormone) level,186.5,121.225,6.92,2055.67,76
HCPCS,84433,Evaluation of thiopurine S-methyltransferase (TPMT),720.0,468.0,14.14,1859.4,19
HCPCS,84436,"Thyroxine (thyroid chemical), total",28.4,18.46,1.17,139.46,57
HCPCS,84437,"Thyroxine (thyroid chemical), requiring elution",25.55,16.61,1.49,78.57,38
HCPCS,84439,"Thyroxine (thyroid chemical), free",43.0,27.95,3.13,723.1,57
HCPCS,84442,Thyroxine binding globulin (thyroid related protein) level,76.3,49.595,7.18,268.58,38
HCPCS,84443,"Blood test, thyroid stimulating hormone (TSH)",48.3,31.4,0.89,214.35,57
HCPCS,84445,Thyroid stimulating immune globulins (thyroid related protein) level,321.2,208.78,30.52,1131.14,38
HCPCS,84446,Vitamin E level,44.39,28.855,3.11,172.72,38
HCPCS,84450,"Liver enzyme (SGOT), level",72.0,46.8,0.83,402.87,76
HCPCS,84460,"Liver enzyme (SGPT), level",72.0,46.8,0.85,402.87,76
HCPCS,84466,Transferrin (iron binding protein) level,63.0,40.95,1.86,286.66,57
HCPCS,84478,Triglycerides level,31.0,20.15,0.98,304.74,76
HCPCS,84479,Thyroid hormone evaluation,39.15,25.45,1.7,134.29,38
HCPCS,84480,"Thyroid hormone, T3 measurement, total",49.35,32.08,4.92,165.28,38
HCPCS,84481,"Thyroid hormone, T3 measurement, free",60.55,39.36,7.47,198.85,38
HCPCS,84482,"Thyroid hormone, T3 measurement, reverse",104.9,68.185,9.27,389.96,38
HCPCS,84484,"Troponin (protein) analysis, quantitative",65.0,42.25,3.49,330.56,114
HCPCS,84488,"Trypsin (pancreatic enzyme) analysis, stool",18.9,12.29,1.38,78.57,19
HCPCS,84510,Tyrosine (amino acid) level,165.6,107.64,1.51,818.65,38
HCPCS,84520,"Urea nitrogen level to assess kidney function, quantitative",20.0,13.0,0.36,402.87,114
HCPCS,84540,"Urea nitrogen level to assess kidney function, urine",17.45,11.344999999999999,0.49,78.57,38
HCPCS,84545,"Urea nitrogen level to assess kidney function, clearance",30.0,19.5,0.79,126.54,38
HCPCS,84550,"Uric acid level, blood",18.5,12.024999999999999,0.63,78.57,38
HCPCS,84560,Uric acid level,29.675,19.29,0.64,120.73,57
HCPCS,84578,"Urobilinogen (metabolism substance) analysis, urine",17.4,11.31,0.13,82.64,38
HCPCS,84580,"Urobilinogen (metabolism substance) level, urine",69.2,44.98,5.73,78.57,19
HCPCS,84585,Urine vanillylmandelic acid,63.0,40.95,9.3,327.98,57
HCPCS,84586,Vasoactive intestinal peptide (intestinal hormone) level,274.65,178.525,21.2,1025.25,38
HCPCS,84588,ADH (antidiuretic hormone) level,170.35,110.72999999999999,20.36,464.85,38
HCPCS,84590,Vitamin A level,52.5,34.13,2.43,172.72,57
HCPCS,84591,Vitamin measurement,37.4,24.31,6.38,96.59,19
HCPCS,84597,Vitamin K level,369.0,239.85,13.72,952.94,19
HCPCS,84600,Volatile chemical measurement,193.8,125.97,4.72,929.7,38
HCPCS,84620,Xylose (carbohydrate) absorption test of blood and/or urine,203.35,132.18,7.75,862.56,57
HCPCS,84630,Zinc level,52.0,33.8,1.82,191.11,114
HCPCS,84681,C-peptide (protein) level,91.45,59.445,12.49,263.42,38
HCPCS,84702,"Gonadotropin, chorionic (reproductive hormone) level",80.5,52.325,6.95,446.77,114
HCPCS,84703,Gonadotropin (reproductive hormone) analysis,37.0,24.05,2.05,170.45,57
HCPCS,84704,"Gonadotropin, chorionic (reproductive hormone) measurement",56.0,36.4,8.56,144.62,19
HCPCS,84999,Chemistry procedures,143.0,92.95,14.14,369.3,18
HCPCS,85002,Bleeding time,10.4,6.76,0.5,78.57,19
HCPCS,85007,Microscopic examination for white blood cells with manual cell count,35.0,22.75,0.25,90.39,95
HCPCS,85008,Microscopic examination for white blood cells,15.85,10.305,0.16,78.57,38
HCPCS,85009,Manual white blood cell count and evaluation,13.3,8.65,0.67,78.57,19
HCPCS,85013,Red blood cell hemoglobin concentration,12.1,7.865,0.22,78.57,38
HCPCS,85014,Red blood cell concentration measurement,13.0,8.45,0.24,78.57,114
HCPCS,85015,"HC CBC AND PLATELET, NBU",32.0,20.8,14.4,82.64,16
HCPCS,85018,"Blood count, hemoglobin",15.0,9.75,0.24,78.57,114
HCPCS,85025,"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count",30.0,19.5,0.58,90.39,76
HCPCS,85027,"Complete blood cell count (red cells, white blood cell, platelets), automated test",13.95,9.07,0.34,82.64,95
HCPCS,85045,"Red blood count, automated test",25.7,16.71,1.03,78.57,19
HCPCS,85046,"Red blood count automated, with additional calculations",28.0,18.2,0.96,78.57,57
HCPCS,85048,Automated white blood cell count,14.0,9.1,0.15,932.28,95
HCPCS,85049,"Platelet count, automated test",23.65,15.375,0.64,85.22,38
HCPCS,85055,Reticulated (young) platelet measurement,161.0,104.65,29.94,415.78,19
HCPCS,85060,Blood smear interpretation by physician with written report,65.8,42.769999999999996,13.45,78.57,38
HCPCS,85097,"Bone marrow, smear interpretation",177.5,115.375,37.53,789.07,38
HCPCS,85130,Assessment of blood clotting function,980.0,637.0,4.68,7280.07,57
HCPCS,85170,"Blood clot evaluation, (retraction time)",4.9,3.19,0.8,78.57,19
HCPCS,85210,"Clotting factor II prothrombin, measurement",179.0,116.35,4.78,511.34,57
HCPCS,85220,Clotting factor V (AcG or proaccelerin) measurement,107.0,69.55,5.24,555.24,57
HCPCS,85230,"Clotting factor VII (proconvertin, stable factor)",115.0,74.75,5.24,555.24,57
HCPCS,85240,Clotting factor VIII (AHG) measurement,174.765,113.595,5.24,562.99,76
HCPCS,85244,Clotting factor VIII related antigen measurement,196.0,127.4,12.25,1559.83,57
HCPCS,85245,Clotting factor VIII (VW factor) measurement,196.0,127.4,13.76,1714.78,57
HCPCS,85246,Clotting factor VIII (VW factor) antigen,106.1,68.97,13.76,78.57,19
HCPCS,85247,Clotting factor VIII (von Willebrand factor) measurement,547.5,355.875,13.76,2231.28,38
HCPCS,85250,Clotting factor IX (PTC or Christmas) measurement,191.865,124.71,10.55,562.99,114
HCPCS,85260,Clotting factor X (Stuart-Prower) measurement,164.7,107.06,3.01,427.92,76
HCPCS,85270,Clotting factor XI (PTA) measurement,215.0,139.75,5.24,573.32,57
HCPCS,85280,Clotting factor XII (Hageman) measurement,222.0,144.3,11.61,596.56,57
HCPCS,85291,Clotting factor XIII (fibrin stabilizing) screening test,58.0,37.7,4.78,180.78,57
HCPCS,85300,Antithrombin III antigen (clotting inhibitor) activity,67.2,43.68,2.57,213.06,57
HCPCS,85301,Antithrombin III antigen (clotting inhibitor) level,102.0,66.30000000000001,5.24,364.13,38
HCPCS,85302,"Protein C, (clotting inhibitor) activity",79.75,51.84,5.24,276.33,38
HCPCS,85303,Protein C antigen (clotting inhibitor) measurement,136.5,88.73,5.24,640.46,57
HCPCS,85305,Protein S (clotting inhibitor) level,92.9,60.385,5.24,276.33,38
HCPCS,85306,Protein S (clotting inhibitor) measurement,213.0,138.45,5.24,1053.66,76
HCPCS,85307,Activated protein resistance assay,183.0,118.95,6.99,472.6,19
HCPCS,85335,Clotting factor inhibitor test,135.5,88.08,5.24,451.94,57
HCPCS,85347,"Coagulation time measurement, activated",37.0,24.05,0.86,284.08,95
HCPCS,85348,"Coagulation time measurement, other methods",7.7,5.01,0.35,78.57,19
HCPCS,85360,Euglobulin lysis (clot dissolving) measurement,227.4,147.81,3.09,1079.49,38
HCPCS,85362,"Coagulation function analysis, agglutination slide, semiquantitative",119.55,77.71000000000001,1.52,560.4,38
HCPCS,85378,"Coagulation function measurement, qualitative or semiquantitative",26.3,17.1,2.56,78.57,19
HCPCS,85379,"Coagulation function measurement, D-dimer; quantitative",26.3,17.1,1.32,220.29,57
HCPCS,85384,Fibrinogen (factor 1) activity measurement,45.4,29.51,1.03,387.38,57
HCPCS,85385,Fibrinogen (factor 1) antigen detection,264.0,171.6,5.24,681.78,19
HCPCS,85390,Coagulation function screening test with interpretation and report,120.65,78.425,5.24,387.38,38
HCPCS,85396,"Coagulation or fibrinolysis (clot dissolving) function measurement with interpretation and written report, per day",614.72,399.57,19.73,1587.51,19
HCPCS,85397,Measurement of blood coagulation and fibrinolysis (clot dissolving) function,676.0,439.4,9.59,5046.21,95
HCPCS,85400,Plasmin (fibrinolytic factor) measurement,161.7,105.11,4.63,78.57,19
HCPCS,85410,Alpha-2 antiplasmin (factor inhibitor) measurement,166.45,108.195,4.63,542.33,38
HCPCS,85415,Plasminogen activator (fibrinolytic factor) measurement,742.0,482.3,5.24,2135.73,57
HCPCS,85420,Plasminogen (fibrinolytic factor) measurement,92.8,60.31999999999999,2.39,384.79,38
HCPCS,85421,Plasminogen antigenic (factor inhibitor) measurement,54.8,35.62,5.58,78.57,19
HCPCS,85441,"Evaluation of red blood cell defect (Heinz bodies), direct",36.8,23.92,1.55,78.57,19
HCPCS,85445,"Evaluation of red blood cell defect (Heinz bodies), induced",23.8,15.47,1.62,78.57,19
HCPCS,85460,"Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, differential lysis",117.0,76.05,4.22,1248.9,57
HCPCS,85461,"Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, rosette",63.45,41.245000000000005,1.3,291.82,38
HCPCS,85475,Measurement of hemolysin (red blood cell destructive substance),66.85,43.455,5.03,198.85,38
HCPCS,85520,Heparin assay,92.52,60.14,5.24,464.85,95
HCPCS,85525,Heparin neutralization test,41.8,27.17,2.98,201.44,76
HCPCS,85540,White blood cell alkaline phosphatase (enzyme) measurement with cell count,336.0,218.4,5.16,1518.51,38
HCPCS,85549,White blood cell enzyme activity measurement,72.75,47.29,6.99,255.67,38
HCPCS,85557,"Red blood cell fragility measurement, incubated",234.05,152.135,6.99,999.43,38
HCPCS,85576,Platelet aggregation function test,148.0,96.19999999999999,5.23,1388.95,456
HCPCS,85597,Platelet function test,85.97,55.88,5.24,413.2,76
HCPCS,85598,Phospholipid test,235.0,152.75,5.24,666.29,38
HCPCS,85610,"Blood test, clotting time",27.38,17.8,0.86,98.14,114
HCPCS,85611,"Blood test, clotting time, substitution",115.0,74.75,0.21,521.67,95
HCPCS,85613,"Clotting factor X assessment test, diluted",61.5,39.975,2.52,387.38,114
HCPCS,85635,Blood coagulation screening test,100.0,65.0,6.99,258.25,19
HCPCS,85651,"Red blood cell sedimentation rate, to detect inflammation, non-automated",15.5,10.075,0.47,78.57,38
HCPCS,85652,"Red blood cell sedimentation rate, to detect inflammation, automated",12.5,8.125,0.27,78.57,38
HCPCS,85660,Red blood cell sickling measurement,28.0,18.2,0.48,253.09,76
HCPCS,85670,"Thrombin time, fibrinogen screening test, plasma",49.0,31.85,0.39,183.36,171
HCPCS,85705,Thromboplastin inhibition (circulating anticoagulant) measurement,161.5,104.975,5.24,674.03,38
HCPCS,85730,"Coagulation assessment blood test, plasma or whole blood",45.0,29.25,1.02,335.73,133
HCPCS,85732,"Coagulation assessment blood test, substitution, plasma fractions",55.4,36.010000000000005,0.49,519.08,152
HCPCS,85810,Blood viscosity measurement,42.0,27.3,1.79,136.87,57
HCPCS,86000,Measurement of antibody to infectious organism,128.1,83.265,4.19,382.21,38
HCPCS,86001,"Measurement of antibody (IgG) to allergic substance, each allergen",544.0,353.6,7.82,1404.88,19
HCPCS,86003,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",38.0,24.7,0.42,1404.88,323
HCPCS,86005,"Measurement of antibody (IgE) to allergic substance, multiallergen screen",38.0,24.7,3.03,98.14,19
HCPCS,86008,"Measurement of antibody (IgE) to allergic substance, recombinant or purified component, each",86.03,55.92,12.74,260.83,57
HCPCS,86015,Measurement of Actin (smooth muscle) antibody,32.0,20.8,3.86,82.64,19
HCPCS,86021,Antibody identification test for white blood cell antibodies,183.0,118.95,9.03,1350.65,57
HCPCS,86022,"Antibody identification test, platelet antibodies",964.82,627.13,11.02,4190.86,152
HCPCS,86023,"Antibody identification test, platelet associated immunoglobulin assay",315.0,204.75,12.46,813.49,19
HCPCS,86036,Screening test for antineutrophil cytoplasmic antibody,48.0,31.2,5.78,123.96,19
HCPCS,86038,Screening test for autoimmune disorder,22.1,14.37,0.73,325.4,95
HCPCS,86039,"Measurement of antibody for assessment of autoimmune disorder, titer",34.45,22.395,1.89,134.29,38
HCPCS,86041,Test for acetylcholine receptor binding antibody,157.0,102.05,18.4,503.59,34
HCPCS,86042,Test for acetylcholine receptor blocking antibody,119.0,77.35,18.4,307.32,17
HCPCS,86043,Test for acetylcholine receptor modulating antibody,245.5,159.575,12.05,867.72,34
HCPCS,86053,Flow cytometry detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody,338.5,220.025,12.05,2920.81,114
HCPCS,86060,Measurement for Strep antibody (strep throat),48.3,31.395,1.65,191.11,38
HCPCS,86077,Blood bank physician services for cross match and/or evaluation and written report,119.0,77.35,30.28,122.57,19
HCPCS,86078,Blood bank physician services for investigation of transfusion reaction with written report,121.5,78.975,30.28,322.81,38
HCPCS,86079,Blood bank physician services with written report,146.0,94.9,30.47,122.3,19
HCPCS,86140,Measurement C-reactive protein for detection of infection or inflammation,35.5,23.075,0.83,348.64,76
HCPCS,86141,"Measurement C-reactive protein for detection of infection or inflammation, high sensitivity",51.45,33.445,5.0,289.24,76
HCPCS,86146,Beta 2 glycoprotein 1 antibody (autoantibody) measurement,74.66,48.53,9.67,472.6,152
HCPCS,86147,Cardiolipin antibody (tissue antibody) measurement,59.0,38.35,7.13,322.81,171
HCPCS,86156,Measurement of cold agglutinin (protein) to screen for infection or disease,32.8,21.32,1.02,136.87,38
HCPCS,86157,Measurement of cold agglutinin (protein) to detect infection or disease,52.0,33.8,4.19,134.29,19
HCPCS,86160,"Measurement of complement (immune system proteins), antigen,",78.5,51.025000000000006,2.83,898.71,133
HCPCS,86161,Measurement of complement function (immune system proteins),36.45,23.695,3.95,103.3,38
HCPCS,86162,"Measurement of complement (immune system proteins), total hemolytic",152.3,99.0,12.19,1836.16,57
HCPCS,86171,Measurement of complement fixation tests (immune system proteins),37.8,24.57,3.78,78.57,19
HCPCS,86200,Measurement of antibody for rheumatoid arthritis assessment,53.0,34.45,3.11,325.4,76
HCPCS,86215,Measurement of DNA antibody,62.25,40.465,6.16,201.44,38
HCPCS,86225,"Measurement of DNA antibody, native or double stranded",66.7,43.355000000000004,5.5,211.77,76
HCPCS,86231,Detection of endomysial antibody (EMA),92.0,59.8,11.12,237.59,19
HCPCS,86235,"Measurement of antibody for assessment of autoimmune disorder, any method",57.5,37.375,1.26,1007.18,456
HCPCS,86255,Screening test for antibody to noninfectious agent,76.7,49.86,5.05,6198.0,1292
HCPCS,86256,Measurement of antibody to noninfectious agent,224.5,145.925,6.51,2257.11,2071
HCPCS,86258,Detection of gliadin (deamidated) (DGP) antibody,38.5,25.025,4.34,105.88,38
HCPCS,86280,Measurement of immune system protein,129.2,83.98,4.91,78.57,19
HCPCS,86300,"Immunologic analysis for detection of tumor antigen, quantitative; CA 15-3",102.0,66.3,4.79,528.72,95
HCPCS,86301,"Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9",44.0,28.6,7.22,263.42,76
HCPCS,86304,"Immunologic analysis for detection of tumor antigen, quantitative; CA 125",60.7,39.46,10.83,263.42,57
HCPCS,86308,Screening test for mononucleosis (mono),23.0,14.95,1.04,78.57,57
HCPCS,86316,Analysis for detection of tumor marker,201.5,130.97500000000002,12.49,1756.1,133
HCPCS,86317,"Detection of infectious agent antibody, quantitative",62.2,40.43,2.25,707.61,171
HCPCS,86318,"Test for detection of infectious agent antibody, qualitative or semiquantitative",100.0,65.0,13.66,393.57,57
HCPCS,86320,Immunologic analysis technique on serum,44.9,29.19,10.18,78.57,19
HCPCS,86325,Immunologic analysis technique on body fluid,44.9,29.19,10.18,78.57,19
HCPCS,86329,"Immunologic analysis technique, unspecified",161.65,105.075,8.43,441.61,38
HCPCS,86331,Immunologic analysis for detection of antigen or antibody,43.1,28.02,4.55,1404.88,285
HCPCS,86332,Immune complex measurement,572.5,372.125,10.24,2848.5,38
HCPCS,86334,Immunologic analysis technique on serum (immunofixation),129.94,84.46,9.36,530.83,76
HCPCS,86335,"Immunologic analysis technique on body fluid, other fluids with concentration",164.5,106.92500000000001,10.18,1931.71,76
HCPCS,86336,Inhibin A (reproductive organ hormone) measurement,152.0,98.8,2.95,446.77,76
HCPCS,86337,Insulin antibody measurement,178.0,115.69999999999999,12.85,705.02,38
HCPCS,86340,Intrinsic factor (stomach protein) antibody measurement,87.3,56.745,8.69,302.15,38
HCPCS,86341,Islet cell (pancreas) antibody measurement,244.0,158.60000000000002,13.66,2941.47,342
HCPCS,86343,White blood cell histamine (immune system chemical) release test,174.3,113.3,7.48,78.57,19
HCPCS,86352,Analysis of cell function and analysis for genetic marker,665.0,432.25,48.13,3499.29,95
HCPCS,86353,"White blood cell function measurement, mitogen or antigen induced blastogenesis",617.0,401.05,29.42,2644.48,38
HCPCS,86355,Total cell count for B cells (white blood cells),185.0,120.25,22.64,1218.94,95
HCPCS,86356,White blood cell antigen measurement,298.5,194.02499999999998,26.78,1417.79,209
HCPCS,86357,Total cell count for natural killer cells (white blood cell),94.5,61.43,22.64,477.76,57
HCPCS,86359,"T cells count, total",87.25,56.715,22.64,477.76,76
HCPCS,86360,"T cell count and ratio, including ratio",80.0,52.0,31.01,593.98,57
HCPCS,86363,Flow cytometry detection of myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody,754.0,490.1,12.05,4067.44,76
HCPCS,86364,Measurement of tissue transglutaminase,41.0,26.65,2.77,165.28,76
HCPCS,86366,Test for muscle-specific kinase antibody,1200.0,780.0,18.4,3099.0,17
HCPCS,86367,"Stem cells count, total",234.0,152.1,46.67,991.68,38
HCPCS,86376,Microsomal antibodies (autoantibody) measurement,62.0,40.3,4.58,278.91,95
HCPCS,86381,Measurement of mitochondrial antibody,32.0,20.8,8.14,82.64,19
HCPCS,86382,Viral neutralization test to detect viral antibody level,260.0,169.0,10.15,8437.03,57
HCPCS,86384,Nitroblue tetrazolium dye test to measure white blood cell function,61.0,39.65,8.17,78.57,19
HCPCS,86403,Screening test for presence of antibody,62.0,40.3,3.28,160.12,57
HCPCS,86430,Rheumatoid factor analysis,42.1,27.37,2.58,78.57,19
HCPCS,86431,Rheumatoid factor level,22.5,14.625,0.96,78.57,57
HCPCS,86480,"Tuberculosis test, gamma interferon",181.0,117.65,17.6,782.5,133
HCPCS,86485,Skin test for candida (yeast),204.8,133.12,11.98,210.94,15
HCPCS,86510,Skin test histoplasmosis (parasite infection),10.0,6.5,5.0,78.57,19
HCPCS,86580,Skin test for tuberculosis,37.5,24.375,8.38,142.04,57
HCPCS,86581,Test for streptococcus pneumonia antibody,262.0,170.3,92.03,676.62,17
HCPCS,86592,Syphilis detection test,22.0,14.3,0.32,446.77,114
HCPCS,86593,Syphilis test,82.0,53.3,0.31,240.17,76
HCPCS,86596,Measurement of voltage-gated calcium channel antibody,206.0,133.9,13.66,2510.19,57
HCPCS,86603,Analysis for antibody to adenovirus (respiratory virus),93.7,60.905,5.2,379.63,38
HCPCS,86606,Analysis for antibody to aspergillus (fungus),49.0,31.85,6.49,167.86,171
HCPCS,86611,Analysis for antibody to Bartonella (bacteria),123.0,79.95,9.16,402.87,38
HCPCS,86612,Analysis for antibody to blastomyces (fungus),72.7,47.26,7.74,240.17,57
HCPCS,86615,Analysis for antibody bordetella (respiratory bacteria),149.5,97.175,13.19,444.19,38
HCPCS,86617,Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria),70.5,45.825,9.29,534.58,76
HCPCS,86618,Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria),74.0,48.1,10.22,2086.66,133
HCPCS,86622,Analysis for antibody to Brucella (bacteria),51.05,33.185,3.67,157.53,38
HCPCS,86628,Analysis for antibody to Candida (yeast),58.95,38.32,3.11,237.59,38
HCPCS,86631,Analysis for antibody to Chlamydia (bacteria),64.45,41.895,7.09,175.61,76
HCPCS,86632,Analysis for antibody (IgM) to Chlamydia (bacteria),68.0,44.2,8.62,175.61,57
HCPCS,86635,Analysis for antibody to Coccidioides (bacteria),56.5,36.725,4.34,534.58,114
HCPCS,86638,Analysis for antibody to Coxiella burnetii (Q fever bacteria),123.0,79.95,12.12,317.65,38
HCPCS,86644,Analysis for antibody to Cytomegalovirus (CMV),42.0,27.3,2.82,276.33,57
HCPCS,86645,Analysis for antibody (IgM) to Cytomegalovirus (CMV),40.0,26.0,6.66,570.73,57
HCPCS,86648,Analysis for antibody to Diphtheria (bacteria),98.55,64.06,9.13,286.66,38
HCPCS,86658,Analysis for antibody to Enterovirus (gastrointestinal virus),604.0,392.6,7.82,2303.59,95
HCPCS,86663,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen",12.6,8.19,1.05,260.83,57
HCPCS,86664,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear antigen",12.6,8.19,1.22,260.83,57
HCPCS,86665,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid",18.8,12.219999999999999,1.45,260.83,95
HCPCS,86666,Analysis for antibody to Ehrlichia (bacteria transmitted by ticks),172.0,111.8,10.18,444.19,19
HCPCS,86668,Analysis for antibody to Francisella tularensis (bacteria transmitted by rodents),40.0,26.0,4.22,870.3,57
HCPCS,86671,Analysis for antibody to fungus,136.45,88.695,1.58,671.45,38
HCPCS,86677,Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria),71.1,46.215,2.73,325.4,38
HCPCS,86682,Analysis for antibody to helminth (intestinal worm),119.7,77.81,13.01,309.13,38
HCPCS,86684,Analysis for antibody to Haemophilus influenza (respiratory bacteria),38.1,24.77,6.04,78.57,19
HCPCS,86687,"Analysis for antibody to Human T-cell lymphotropic virus, type 1 (HTLV-1)",41.7,27.105,2.67,139.46,38
HCPCS,86688,"Analysis for antibody to Human T-cell lymphotropic virus, type 2 (HTLV-2)",41.7,27.105,4.12,139.46,38
HCPCS,86689,Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV,159.0,103.35,11.61,1730.28,133
HCPCS,86692,Analysis for antibody to Hepatitis D virus,53.0,34.45,8.63,1257.68,57
HCPCS,86694,Analysis for antibody to Herpes simplex virus,84.0,54.599999999999994,1.97,459.69,95
HCPCS,86695,"Analysis for antibody to Herpes simplex virus, type 1",35.8,23.27,3.17,154.95,76
HCPCS,86696,"Analysis for antibody to Herpes simplex virus, type 2",58.0,37.7,5.42,227.26,38
HCPCS,86698,Analysis for antibody to histoplasma (fungus),66.55,43.260000000000005,4.41,519.08,76
HCPCS,86701,Analysis for antibody to HIV -1 virus,93.0,60.45,2.67,557.82,152
HCPCS,86702,Analysis for antibody to HIV-2 virus,138.0,89.7,8.25,557.82,76
HCPCS,86703,Analysis for antibody to HIV-1 and HIV-2 virus,90.0,58.5,2.4,444.19,95
HCPCS,86704,Hepatitis B core antibody measurement,36.6,23.79,1.71,152.37,76
HCPCS,86705,Hepatitis B core antibody (IgM) measurement,60.0,39.0,3.71,826.4,95
HCPCS,86706,Hepatitis B surface antibody measurement,42.0,27.3,2.65,444.19,114
HCPCS,86707,Hepatitis Be antibody measurement,76.8,49.92,6.32,255.67,38
HCPCS,86708,Measurement of Hepatitis A antibody,55.8,36.27,3.38,206.6,95
HCPCS,86709,Measurement of Hepatitis A antibody (IgM),72.5,47.125,1.85,459.69,76
HCPCS,86710,Analysis for antibody to Influenza virus,125.85,81.805,8.13,286.66,57
HCPCS,86711,Analysis for antibody to john cunningham virus,115.0,74.75,13.66,296.99,19
HCPCS,86713,Analysis for antibody to Legionella (waterborne bacteria),53.15,34.55,3.72,211.77,57
HCPCS,86720,Analysis for antibody to Leptospira,45.4,29.51,7.35,78.57,19
HCPCS,86735,Analysis for antibody to mumps virus,52.5,34.13,2.47,175.61,114
HCPCS,86738,Analysis for antibody to Mycoplasma (bacteria),80.425,52.275000000000006,5.16,314.68,76
HCPCS,86747,Analysis for antibody to parvovirus,85.0,55.25,6.31,330.56,57
HCPCS,86753,Analysis for antibody to protozoa (parasite),112.0,72.8,11.4,5438.75,57
HCPCS,86757,Analysis for antibody to Rickettsia (bacteria),207.0,134.55,13.66,534.58,19
HCPCS,86762,Analysis for antibody to Rubella (German measles virus),62.0,40.3,1.42,183.36,114
HCPCS,86765,Analysis for antibody to Rubeola (measles virus),43.5,28.275,3.52,162.7,95
HCPCS,86769,Measure of severe acute respiratory syndrome coronavirus 2 (Covid-19) antibody,140.0,91.0,13.66,568.15,76
HCPCS,86774,Analysis for antibody to tetanus bacteria (Clostridium tetanus),79.8,51.87,8.88,78.57,19
HCPCS,86777,Analysis for antibody to Toxoplasma (parasite),192.25,124.965,8.63,209.18,38
HCPCS,86778,Analysis for antibody (IgM) to Toxoplasma (parasite),51.6,33.54,3.63,201.44,38
HCPCS,86780,"Analysis for antibody, Treponema pallidum",62.0,40.3,2.5,351.22,171
HCPCS,86784,Analysis for antibody to Trichinella (worm parasite),176.25,114.565,6.59,774.75,38
HCPCS,86787,Analysis for antibody to varicella-zoster virus (chicken pox),34.35,22.33,2.16,201.44,133
HCPCS,86788,Analysis for antibody (IgM) to West Nile virus,67.285,43.735,3.54,214.35,76
HCPCS,86789,Analysis for antibody to West Nile virus,64.67,42.035,3.02,183.36,76
HCPCS,86790,Analysis for antibody to virus,120.0,78.0,1.67,433.86,133
HCPCS,86793,Analysis for antibody to Yersinia (bacteria),3.2,2.08,0.42,78.57,19
HCPCS,86800,Thyroglobulin (thyroid protein) antibody measurement,68.0,44.2,5.85,185.94,57
HCPCS,86803,Hepatitis C antibody measurement,80.0,52.0,4.5,601.72,114
HCPCS,86805,"Immunologic analysis for autoimmune disease, with titration",232.0,150.8,78.57,1973.03,209
HCPCS,86806,"Immunologic analysis for autoimmune disease, without titration",115.5,75.08,28.55,118.86,19
HCPCS,86807,"Transplant antibody measurement, standard method",157.0,102.05,24.77,1007.18,152
HCPCS,86808,"Transplant antibody measurement, quick method",47.4,30.810000000000002,4.69,204.02,38
HCPCS,86812,"Immunologic analysis for autoimmune disease, A, B, or C, single antigen",201.05,130.685,5.24,870.3,38
HCPCS,86813,"Immunologic analysis for autoimmune disease, A, B, or C, multiple antigens",701.0,455.65,34.8,3253.95,76
HCPCS,86817,"Immunologic analysis for autoimmune disease, DR/DQ, multiple antigens",851.75,553.64,63.68,3770.45,76
HCPCS,86821,"Immunologic analysis for autoimmune disease, lymphocyte culture, mixed",225.8,146.77,21.94,91.31,19
HCPCS,86825,"Immunologic analysis for organ transplant, first serum sample or dilution",1059.0,688.35,73.62,2734.87,19
HCPCS,86826,"Immunologic analysis for organ transplant, each additional serum sample or sample dilution",11.0,7.15,4.02,75.09,19
HCPCS,86828,Assessment of antibodies to Class I and Class II human leukocyte antigens (HLA) antigens,163.1,106.015,32.87,710.19,38
HCPCS,86830,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class I",142.55,92.66,57.31,423.53,38
HCPCS,86831,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class II",133.9,87.035,49.13,423.53,38
HCPCS,86832,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I",439.0,285.35,78.57,2534.96,133
HCPCS,86833,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",401.5,260.975,78.57,2257.79,133
HCPCS,86834,"Assessment of antibody to human leukocyte antigens (HLA), HLA class I",1400.0,910.0,191.24,5005.84,19
HCPCS,86835,"Assessment of antibody to human leukocyte antigens (HLA) with solid phase assays, HLA class II",1400.0,910.0,191.24,4521.44,19
HCPCS,86849,Immunology procedures,45.0,29.25,13.66,116.21,36
HCPCS,86850,Screening test for red blood cell antibodies,118.4,76.96,2.57,764.0,114
HCPCS,86860,Removal of antibodies from surface of red blood cell,216.6,140.79000000000002,9.05,1668.3,125
HCPCS,86870,Identification of red blood cell antibodies,242.175,157.41500000000002,16.16,1007.18,91
HCPCS,86880,"Red blood cell antibody detection test, direct",53.0,34.45,0.56,764.0,190
HCPCS,86886,Red blood cell antibody level,101.0,65.65,0.57,1293.21,114
HCPCS,86900,Blood group typing (ABO),26.0,16.9,0.44,330.56,76
HCPCS,86901,Blood typing for Rh (D) antigen,26.0,16.9,0.41,108.47,76
HCPCS,86902,"Screening test for compatible blood unit, using reagent serum",91.0,59.15,1.52,764.0,95
HCPCS,86904,"Screening test for compatible blood unit, using patient serum",161.51999999999998,104.99,5.24,764.0,38
HCPCS,86905,Blood typing for red blood cell antigens,339.0,220.35,3.83,1009.76,76
HCPCS,86906,Blood typing Rh phenotyping,220.355,143.23,5.24,794.66,38
HCPCS,86920,"Blood unit compatibility test, immediate spin technique",460.98,299.64,12.78,1668.3,53
HCPCS,86921,"Blood unit compatibility test, incubation technique",75.6,49.14,26.4,195.24,19
HCPCS,86922,"Blood unit compatibility test, antiglobulin technique",331.65,215.575,7.79,1668.3,34
HCPCS,86923,"Blood unit compatibility test, electronic",550.0,357.5,23.68,1420.38,19
HCPCS,86927,Thawing of fresh frozen plasma unit,14.7,9.56,6.62,78.57,15
HCPCS,86930,Freezing of blood unit,130.2,84.63,58.59,271.88,15
HCPCS,86932,Freezing and thawing of blood unit,155.4,101.01,53.09,230.86,15
HCPCS,86940,Red blood cell antibody screening test,26.3,17.1,2.31,78.57,19
HCPCS,86941,Red blood cell antibody measurement,89.0,57.85,5.24,229.84,19
HCPCS,86945,"Irradiation of blood product, each unit",38.9,25.29,15.59,78.57,15
HCPCS,86950,White blood cell transfusion,1412.0,917.8,123.26,3646.49,19
HCPCS,86965,Pooling of platelets or other blood products,18.9,12.29,8.51,78.57,15
HCPCS,86970,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with chemical agents or drugs",185.75,120.74000000000001,24.46,764.0,76
HCPCS,86971,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with enzymes",156.66,101.83,19.8,764.0,38
HCPCS,86972,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, by density gradient separation",298.53,194.04500000000002,34.55,960.85,38
HCPCS,86975,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, incubation with drugs",675.0,438.75,123.26,1743.19,19
HCPCS,86976,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, by dilution",150.0,97.5,76.5,764.0,19
HCPCS,86977,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, incubation with inhibitors",298.35,193.93,29.5,770.49,19
HCPCS,86978,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, by differential red cell absorption",221.51999999999998,143.99,14.99,764.0,91
HCPCS,86985,Splitting of blood or blood products,227.695,148.005,12.29,1105.54,53
HCPCS,86999,Transfusion medicine procedures,104.0,67.6,5.24,268.58,19
HCPCS,87015,Concentration of specimen for infectious agents,26.45,17.195,1.07,129.13,95
HCPCS,87040,Bacterial blood culture,47.95,31.17,3.29,165.28,57
HCPCS,87045,Stool culture,47.0,30.55,1.59,211.77,114
HCPCS,87046,"Stool culture, additional pathogens",47.0,30.55,1.3,384.79,247
HCPCS,87070,"Bacterial culture, any other source except urine, blood or stool, aerobic",40.0,26.0,0.79,196.27,133
HCPCS,87071,Bacterial culture and colony count,79.85,51.905,3.13,451.94,76
HCPCS,87073,Bacterial culture and colony count for anaerobic bacteria,50.85,33.055,1.71,216.93,38
HCPCS,87075,"Bacterial culture, any source, except blood, anaerobic",30.8,20.02,1.38,121.38,38
HCPCS,87076,Bacterial culture for anaerobic isolates,43.25,28.115000000000002,1.33,180.78,38
HCPCS,87077,Bacterial culture for aerobic isolates,40.0,26.0,0.7,289.24,171
HCPCS,87081,Screening test for pathogenic organisms,44.1,28.67,0.5,284.08,513
HCPCS,87084,Screening test for pathogenic organisms with colony count,135.0,87.75,12.47,490.68,38
HCPCS,87086,"Bacterial colony count, urine",32.0,20.8,1.94,103.3,38
HCPCS,87088,Bacterial urine culture,38.7,25.155,0.6,180.78,38
HCPCS,87101,"Fungal culture (mold or yeast) of skin, hair, or nail",54.4,35.36,2.84,185.94,38
HCPCS,87102,Fungal culture (mold or yeast),31.5,20.48,2.19,183.36,57
HCPCS,87103,Fungal blood culture (mold or yeast),63.35,41.18,6.9,240.17,38
HCPCS,87106,"Fungal culture, yeast",36.8,23.92,0.76,131.71,57
HCPCS,87107,Culture for identification of yeast,36.8,23.92,1.7,131.71,57
HCPCS,87109,Mycoplasma culture,69.3,45.05,6.77,681.78,57
HCPCS,87110,Culture for chlamydia,71.65,46.575,7.1,947.78,76
HCPCS,87116,Culture for acid-fast bacilli,94.0,61.1,4.22,343.47,57
HCPCS,87118,Identification of mycobacteria (TB or TB like organism),59.75,38.84,2.41,266.0,38
HCPCS,87140,"Identification of organisms by immunologic analysis, immunofluorescent method",72.5,47.125,0.41,480.35,76
HCPCS,87147,"Identification of organisms by immunologic analysis, other than immunofluorescence method",30.0,19.5,0.38,338.31,95
HCPCS,87149,"Identification of organisms by genetic analysis, direct probe technique",107.2,69.68,6.7,467.43,38
HCPCS,87150,"Identification of organisms by genetic analysis, amplified probe technique",142.5,92.625,17.55,516.5,114
HCPCS,87153,Identification of organisms by nucleic acid sequencing method,564.0,366.6,115.36,1456.53,19
HCPCS,87154,Amplifed nucleic acid probe typing of disease agent in blood culture specimen,500.0,325.0,218.06,1291.25,19
HCPCS,87158,Microbial identification,55.0,35.75,4.26,142.04,19
HCPCS,87164,"Dark field microscopic examination for organism, includes specimen collection",48.8,31.72,5.24,78.57,19
HCPCS,87168,Macroscopic examination (visual inspection) of insect,26.4,17.16,0.29,118.8,38
HCPCS,87172,Pinworm test,15.0,9.75,0.64,95.55,57
HCPCS,87176,Tissue preparation for culture,45.0,29.25,2.65,116.21,19
HCPCS,87177,Smear for parasites,50.0,32.5,1.62,222.1,95
HCPCS,87181,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method",18.200000000000003,11.835,0.38,162.7,114
HCPCS,87183,"SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; CARBAPENEM RESISTANCE GENES (EG, BLAKPC, BLANDM, BLAVIM, BLAOXA-48, BLAIMP), AMPLIFIED PROBE TECHNIQUE, PER ISOLATE",225.0,146.25,70.18,645.63,32
HCPCS,87184,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)",17.0,11.05,0.59,116.21,114
HCPCS,87185,"Detection of antimicrobial drug (antibiotic, antifungal, antiviral)",29.75,19.34,0.81,108.47,76
HCPCS,87186,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution",113.5,73.77499999999999,2.21,1851.65,76
HCPCS,87187,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution, each plate",72.5,47.13,24.1,100.32,19
HCPCS,87188,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), macrobroth dilution method",123.0,79.95,1.75,947.78,57
HCPCS,87190,"Antimicrobial study, mycobacteria (TB organism family)",6.6,4.29,0.48,78.57,19
HCPCS,87197,Evaluation of antibiotic therapy,68.3,44.4,9.01,78.57,19
HCPCS,87205,Special Gram or Giemsa stain for microorganism,30.0,19.5,0.72,116.21,57
HCPCS,87206,Special fluorescent and/or acid fast stain for microorganism,32.5,21.125,0.72,121.38,76
HCPCS,87207,Special stain for inclusion bodies or parasites,57.5,37.375,1.02,178.19,76
HCPCS,87209,Special stain for parasites,70.0,45.5,6.24,227.26,57
HCPCS,87210,Smear for infectious agents,20.0,13.0,0.46,82.64,152
HCPCS,87220,Tissue fungi or parasites,24.5,15.925,0.85,90.39,76
HCPCS,87230,Microbial toxin or antitoxin assay,114.55,74.46,10.28,457.1,38
HCPCS,87250,"Inoculation of embryonated eggs, or small animal for virus isolation",63.0,40.95,11.74,78.57,19
HCPCS,87252,Tissue culture inoculation for virus isolation,131.0,85.15,4.07,844.48,323
HCPCS,87253,Tissue culture for virus isolation,68.0,44.2,1.92,4219.81,228
HCPCS,87254,"Virus isolation, centrifuge enhanced",133.5,86.775,2.8,720.52,76
HCPCS,87255,Virus isolation,85.5,55.575,20.32,273.75,57
HCPCS,87273,Detection test by immunofluorescent technique for herpes simplex virus type 2,59.2,38.480000000000004,1.01,304.74,76
HCPCS,87274,Detection test by immunofluorescent technique for herpes simplex virus type 1,112.0,72.80000000000001,1.49,304.74,76
HCPCS,87278,Detection test by immunofluorescent technique for legionella pneumophila (water borne bacteria),110.0,71.5,8.19,544.91,57
HCPCS,87290,Detection test by immunofluorescent technique for varicella (chicken pox) zoster virus,193.0,125.45,3.34,640.46,57
HCPCS,87299,Detection test by immunofluorescent technique for organism,20.9,13.59,3.36,78.57,19
HCPCS,87305,Detection test by immunoassay technique for Aspergillus (fungus),512.0,332.8,6.04,1443.62,57
HCPCS,87324,Detection test by immunoassay technique for Clostridium difficile toxins (stool pathogen),59.0,38.35,3.65,268.58,57
HCPCS,87328,Detection test by immunoassay technique for Cryptosporidium (parasite),44.6,28.99,1.77,268.58,114
HCPCS,87329,Detection test by immunoassay technique for Giardia (intestinal parasite),117.0,76.05,11.98,335.73,57
HCPCS,87332,Detection test by immunoassay technique for cytomegalovirus,68.3,44.4,7.19,78.57,19
HCPCS,87338,Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool,38.650000000000006,25.125,3.69,470.02,76
HCPCS,87340,Detection test by immunoassay technique for hepatitis B surface antigen,51.0,33.15,1.46,392.54,95
HCPCS,87341,Detection test by immunoassay technique for hepatitis B surface antigen neutralization,261.5,169.975,10.33,1058.83,38
HCPCS,87350,Detection test by immunoassay technique for hepatitis Be surface antigen,52.75,34.29,3.52,193.69,38
HCPCS,87380,Detection test by immunoassay technique for hepatitis D,232.05,150.835,11.02,921.95,38
HCPCS,87385,Detection test by immunoassay technique for Histoplasma capsulatum (parasite),280.0,182.0,7.95,1255.1,133
HCPCS,87389,Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 antibodies,97.0,63.05,12.47,304.74,38
HCPCS,87390,Detection test by immunoassay technique for HIV-1 antigen,108.1,70.265,12.47,281.49,38
HCPCS,87400,Detection test by immunoassay technique for influenza virus,225.0,146.25,12.47,581.06,19
HCPCS,87420,Detection test by immunoassay technique for respiratory syncytial virus (RSV),45.2,29.38,6.29,78.57,19
HCPCS,87425,Detection test by immunoassay technique for rotavirus,53.0,34.45,2.42,263.42,57
HCPCS,87427,Detection test by immunoassay technique for Shiga-like toxin (bacterial toxin),28.0,18.2,3.15,268.58,76
HCPCS,87430,"Detection test by immunoassay technique for Streptococcus, group A (strep)",44.1,28.67,7.41,78.57,19
HCPCS,87449,Detection test by immunoassay technique for other organism,104.0,67.6,5.67,1474.61,114
HCPCS,87468,Detection of Anaplasma phagocytophilum by amplified nucleic acid probe technique,153.0,99.45,35.09,395.12,19
HCPCS,87469,Detection of Babesia microtim by amplified nucleic acid probe technique,153.0,99.45,35.09,395.12,19
HCPCS,87480,"Detection test for candida species (yeast), direct probe technique",68.3,44.4,1.82,255.67,57
HCPCS,87481,"Detection test for candida species (yeast), amplified probe technique",200.0,130.0,35.09,516.5,19
HCPCS,87483,Test for detecting nucleic acid of organism causing infection of central nervous system,1200.0,780.0,240.71,5001.36,19
HCPCS,87484,Detection of Ehrlichia chaffeensis by amplified nucleic acid probe technique,153.0,99.45,35.09,395.12,19
HCPCS,87486,"Detection test by nucleic acid for Chlamydia pneumoniae, amplified probe technique",172.0,111.8,35.09,444.19,19
HCPCS,87490,"Detection test by nucleic acid for chlamydia, direct probe technique",20.0,13.0,4.55,78.57,19
HCPCS,87491,"Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique",45.55,29.61,3.68,785.08,133
HCPCS,87493,"Detection test by nucleic acid for clostridium difficile, amplified probe technique",188.0,122.2,37.27,485.51,19
HCPCS,87494,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS AND NEISSERIA GONORRHOEAE, MULTIPLEX AMPLIFIED PROBE TECHNIQUE",236.0,153.4,57.6,888.38,64
HCPCS,87496,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",123.65,80.375,11.05,833.76,209
HCPCS,87497,"Detection test by nucleic acid for cytomegalovirus, quantification",484.3,314.79499999999996,25.7,2197.71,76
HCPCS,87498,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",344.0,223.6,21.05,1177.62,171
HCPCS,87502,Detection test by nucleic acid for multiple types influenza virus,200.0,130.0,11.4,816.07,95
HCPCS,87503,"Detection test by nucleic acid for multiple types influenza virus, each additional influenza virus type or sub-type",34.95,22.720000000000002,3.48,149.79,38
HCPCS,87505,"Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 3-5 targets",648.0,421.2,128.29,2066.0,38
HCPCS,87506,"Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 6-11 targets",776.5,504.725,240.71,2103.92,38
HCPCS,87507,"Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 12-25 targets",1400.0,910.0,240.71,7502.04,38
HCPCS,87510,"Detection test for gardnerella vaginalis (bacteria), direct probe technique",79.5,51.675,12.03,255.67,38
HCPCS,87516,"Detection test by nucleic acid for Hepatitis B virus, amplified probe technique",140.0,91.0,35.09,361.55,19
HCPCS,87517,"Detection test by nucleic acid for Hepatitis B virus, quantification",343.0,222.95,25.7,1539.17,76
HCPCS,87521,"Detection test by nucleic acid for Hepatitis C virus, amplified probe technique",148.75,96.69,21.05,361.55,38
HCPCS,87522,"Detection test by nucleic acid for Hepatitis C virus, quantification",316.5,205.725,25.7,1239.6,95
HCPCS,87529,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",292.0,189.8,11.05,2453.38,228
HCPCS,87532,"Detection test by nucleic acid for herpes virus-6, amplified probe technique",238.5,155.02499999999998,11.05,1410.05,152
HCPCS,87533,"Detection test by nucleic acid for herpes virus-6, quantification",632.0,410.8,41.76,1632.14,19
HCPCS,87535,"Detection test by nucleic acid for HIV-1 virus, amplified probe technique",234.75,152.59,21.05,1446.2,76
HCPCS,87536,"Detection test by nucleic acid for HIV-1 virus, quantification",662.0,430.3,50.59,2443.05,76
HCPCS,87538,"Detection test by nucleic acid for HIV-2 virus, amplified probe technique",249.0,161.85,35.09,643.04,19
HCPCS,87550,"Detection test by nucleic acid for Mycobacteria species (bacteria), direct probe technique",126.4,82.16,7.58,555.24,38
HCPCS,87551,"Detection test by nucleic acid for Mycobacteria species (bacteria), amplified probe technique",918.0,596.7,48.24,2466.29,57
HCPCS,87555,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), direct probe technique",130.2,84.63000000000001,8.98,586.23,38
HCPCS,87556,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), amplified probe technique",235.0,152.75,23.63,990.39,152
HCPCS,87560,"Detection test by nucleic acid for Mycobacteria avium-intracellulare (bacteria), direct probe technique",136.7,88.855,9.11,619.8,38
HCPCS,87563,Detection of Mycoplasma genitalium by DNA or RNA probe,176.0,114.4,35.09,464.85,57
HCPCS,87564,Detection test by nucleic acid for mycobacterium tuberculosis rifampin resistance,640.0,416.0,76.77,1652.8,17
HCPCS,87581,"Detection test by nucleic acid for Mycoplasma pneumoniae (bacteria), amplified probe technique",217.5,141.375,35.09,743.76,76
HCPCS,87590,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), direct probe technique",8.5,5.53,2.28,78.57,19
HCPCS,87591,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique",79.5,51.675,3.68,444.19,152
HCPCS,87593,Detection of orthopoxvirus,461.5,299.975,50.59,1505.6,38
HCPCS,87594,Detection test by nucleic acid for pneumocystis jirovecii,744.0,483.6,35.09,1921.38,17
HCPCS,87624,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",188.5,122.525,35.09,3711.05,152
HCPCS,87625,"Detection test by nucleic acid for human papillomavirus (hpv), types 16 and 18 only",166.5,108.225,40.55,433.86,57
HCPCS,87626,"Detection test by nucleic acid for Human Papillomavirus (HPV), separately reported high-risk types",205.0,133.25,70.2,681.78,85
HCPCS,87631,"Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets",320.0,208.0,142.63,826.4,38
HCPCS,87633,"Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 12-25 targets",1300.0,845.0,240.71,5418.14,38
HCPCS,87635,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,165.0,107.25,48.45,568.15,152
HCPCS,87636,Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) and influenza virus types A and B,260.0,169.0,50.59,826.4,38
HCPCS,87637,"Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19), influenza virus types A and B, and respiratory syncytial virus",220.0,143.0,50.59,568.15,19
HCPCS,87641,"Detection test by nucleic acid for Staphylococcus aureus, methicillin resistant (MRSA bacteria), amplified probe technique",700.0,455.0,35.09,1807.75,19
HCPCS,87651,"Detection test by nucleic acid for Strep (Streptococcus, group A), amplified probe technique",90.0,58.5,31.58,232.43,38
HCPCS,87660,"Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), direct probe technique",68.3,44.4,1.82,255.67,57
HCPCS,87661,"Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), amplified probe technique",206.0,133.9,35.09,619.8,76
HCPCS,87798,"Detection test by nucleic acid for organism, amplified probe technique",306.0,198.89999999999998,4.42,3610.34,1463
HCPCS,87799,"Detection test by nucleic acid for organism, quantification",613.0,398.45,25.7,3078.34,285
HCPCS,87800,"Detection test by nucleic acid for multiple organisms, direct probe(s) technique",158.25,102.86500000000001,26.2,508.75,38
HCPCS,87801,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",1351.0,878.15,50.59,8480.93,171
HCPCS,87802,"Detection test by immunoassay with direct visual observation for Streptococcus, group B (bacteria)",36.8,23.92,4.68,78.57,19
HCPCS,87804,Detection test by immunoassay with direct visual observation for influenza virus,58.5,38.025,5.79,206.6,76
HCPCS,87806,"Detection test by immunoassay with direct visual observation for HIV-1 antigen, with HIV-1 and HIV-2 antibodies",82.0,53.3,13.44,449.36,76
HCPCS,87807,Detection test by immunoassay with direct visual observation for respiratory syncytial virus,90.0,58.5,11.79,232.43,19
HCPCS,87850,Detection test by immunoassay with direct visual observation for Neisseria gonorrhoeae (gonorrhea),35.7,23.21,8.77,78.57,19
HCPCS,87880,"Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep)",62.5,40.625,8.27,193.69,95
HCPCS,87899,Detection test by immunoassay with direct visual observation for other organism,54.0,35.1,2.39,263.42,57
HCPCS,87900,Infectious agent drug susceptibility analysis,655.5,426.075,130.35,2352.66,95
HCPCS,87901,Analysis test by nucleic acid for HIV-1 virus,831.0,540.15,194.33,2840.75,95
HCPCS,87902,Analysis test by nucleic acid for Hepatitis C virus,696.5,452.725,78.57,2750.36,76
HCPCS,87903,"Analysis test by nucleic acid for HIV-1 virus, first through 10 drugs tested",480.0,312.0,244.8,2345.57,19
HCPCS,87904,"Analysis test by nucleic acid for HIV-1 virus, each additional drug tested",432.0,280.8,26.07,1115.64,19
HCPCS,87906,"Analysis test by nucleic acid for HIV-1 virus, other region",550.0,357.5,128.73,2146.06,57
HCPCS,87910,"Analysis test by nucleic acid for cytomegalovirus, cytomegalovirus",2175.0,1413.75,240.71,5616.94,19
HCPCS,87999,Unlisted microbiology procedure,1543.0,1002.95,12.47,20507.63,72
HCPCS,88007,Autopsy with examination of brain and spinal cord,243.9,158.54,78.57,416.32,15
HCPCS,88020,Autopsy with microscopic examination of tissue,1050.0,682.5,78.57,1081.5,15
HCPCS,88027,Autopsy with examination of brain and spinal cord and microscopic examination of tissue,949.0,616.85,78.57,977.47,15
HCPCS,88036,"Limited, gross and/or microscopic autopsy",157.5,102.38,70.88,170.31,15
HCPCS,88104,"Cell examination of body fluid, smears",176.25,114.565,25.87,389.96,38
HCPCS,88106,"Cell examination of body fluid, simple filter method",184.85,120.155,17.08,317.65,38
HCPCS,88108,"Cell examination of specimen, concentration technique",195.95,127.37,20.65,415.78,38
HCPCS,88112,"Cell examination of specimen, selective cellular enhancement technique",259.3,168.545,25.28,2073.75,76
HCPCS,88120,"Cell examination of urine, manual",1398.1,908.77,52.9,817.79,19
HCPCS,88121,"Cell examination of urine, computer-assisted",1201.8,781.17,44.08,1237.85,19
HCPCS,88125,Forensic (investigation) examination of specimen,34.1,22.17,12.18,121.8,19
HCPCS,88130,"Sex identification, Barr bodies",60.9,39.59,10.95,78.57,19
HCPCS,88141,Pap test,78.8,51.22,21.59,78.57,19
HCPCS,88142,"Pap test, manual screening",19.1,12.415,2.55,78.57,133
HCPCS,88147,"Pap test (Pap smear), automated system",31.5,20.48,15.93,126.27,19
HCPCS,88150,"Pap test, slides, manual screening",25.2,16.38,4.67,78.57,19
HCPCS,88155,"Pap test, slides, definitive hormonal evaluation",13.0,8.45,1.9,78.57,19
HCPCS,88160,"Screening examination of specimen cells, screening and interpretation",134.5,87.42500000000001,23.28,317.65,38
HCPCS,88161,"Screening examination of specimen cells, preparation, screening and interpretation",89.3,58.05,23.28,162.7,57
HCPCS,88162,"Screening examination of specimen cells, extended study",239.4,155.61,35.63,119.7,19
HCPCS,88164,"Pap test, slides, manual screening (the Bethesda System)",47.65,30.975,4.88,178.19,38
HCPCS,88172,Evaluation of fine needle aspirate,193.4,125.71,23.26,1668.3,57
HCPCS,88173,Evaluation of fine needle aspirate with interpretation and report,333.75,216.94,50.75,681.78,38
HCPCS,88174,"Pap test, automated thin layer preparation; automated system",31.5,20.48,7.99,78.57,19
HCPCS,88177,"Pap test, evaluation of fine needle aspirate, immediate, each additional evaluation episode",51.25,33.315,7.27,78.57,38
HCPCS,88182,Flow cytometry technique for DNA or cell analysis,186.5,121.225,34.12,1170.91,114
HCPCS,88184,"Flow cytometry technique for DNA or cell analysis, first marker",184.0,119.6,48.75,1089.82,133
HCPCS,88185,"Flow cytometry technique for DNA or cell analysis, each additional marker",315.0,204.75,17.5,5784.8,133
HCPCS,88187,"Flow cytometry technique for DNA or cell analysis, 2 to 8 markers",301.55,196.01,33.49,1089.82,38
HCPCS,88188,"Flow cytometry technique for DNA or cell analysis, 9 to 15 markers",225.8,146.77,55.87,139.54,19
HCPCS,88189,"Flow cytometry technique for DNA or cell analysis, 16 or more markers",296.6,192.79,76.06,189.96,19
HCPCS,88230,Tissue culture to identify white blood cell disorders,668.5,434.525,116.49,2213.2,57
HCPCS,88233,Tissue culture to identify skin disorders,811.0,527.15,140.73,2690.97,57
HCPCS,88235,Tissue culture for disorders of amniotic fluid or placenta cells,485.0,315.25,150.3,1562.41,57
HCPCS,88237,Tissue culture for tumor disorders of bone marrow and blood cells,1016.0,660.4,118.32,4330.85,152
HCPCS,88239,Tissue culture for tumor disorders,709.0,460.85,147.52,3726.55,114
HCPCS,88240,"Cryopreservation, freezing and storage of cells",893.5,580.775,5.88,10846.5,95
HCPCS,88241,Thawing and expansion of frozen cells,403.0,261.95,5.88,1040.75,38
HCPCS,88245,"Chromosome analysis for genetic defects, baseline Sister Chromatid Exchange (SCE), 20-25 cells",432.0,280.8,78.57,2112.49,57
HCPCS,88248,"Chromosome analysis for genetic defects, baseline breakage, score 50-100 cells, count 20 cells",883.0,573.95,173.17,3411.48,57
HCPCS,88249,"Chromosome analysis for genetic defects, score 100 cells, clastogen stress",509.0,330.85,173.17,1314.49,38
HCPCS,88261,"Chromosome analysis for genetic defects, count 5 cells",367.5,238.875,163.71,1929.68,95
HCPCS,88262,"Chromosome analysis for genetic defects, count 15-20 cells",900.0,585.0,54.96,5278.63,247
HCPCS,88263,"Chromosome analysis for genetic defects, count 45 cells for mosaicism",614.0,399.1,150.29,1585.66,38
HCPCS,88264,"Chromosome analysis for genetic defects, analyze 20-25 cells",306.0,198.9,144.61,790.25,38
HCPCS,88267,Chromosome analysis of amniotic fluid or placenta for genetic defects,745.0,484.25,188.57,1923.96,57
HCPCS,88269,Chromosome analysis of amniotic fluid for genetic defects,489.0,317.85,173.66,1286.09,57
HCPCS,88271,DNA testing for genetic defects,290.0,188.5,14.99,1487.52,2242
HCPCS,88272,"Chromosome analysis for genetic defects, analyze 3-5 cells",204.5,132.925,40.7,694.69,38
HCPCS,88273,"Chromosome analysis for genetic defects, analyze 10-30 cells",140.0,91.0,34.81,364.13,57
HCPCS,88274,"Chromosome analysis for genetic defects, analyze 25-99 cells",307.0,199.55,31.79,1433.29,247
HCPCS,88275,"Chromosome analysis for genetic defects, analyze 100-300 cells",333.0,216.45,51.19,2324.25,1691
HCPCS,88280,"Chromosome analysis for genetic defects, additional karyotypes, each study",365.0,237.25,33.47,955.53,76
HCPCS,88283,"Chromosome analysis for genetic defects, additional specialized banding technique",191.0,124.15,54.96,581.06,57
HCPCS,88285,"Chromosome analysis for genetic defects, additional cells counted, each study",134.0,87.1,11.84,955.53,76
HCPCS,88289,"Chromosome analysis for genetic defects, additional high resolution study",106.5,69.225,33.74,296.99,38
HCPCS,88291,Interpretation and report of genetic testing,105.0,68.25,30.22,78.6,19
HCPCS,88299,Genetic studies,383.0,248.95,50.75,989.1,19
HCPCS,88300,"Pathology examination of tissue using a microscope, limited examination",88.1,57.27,4.03,268.58,76
HCPCS,88302,Pathology examination of tissue using a microscope,104.0,67.6,6.32,268.58,76
HCPCS,88304,"Pathology examination of tissue using a microscope, moderately low complexity",166.5,108.225,9.92,526.83,114
HCPCS,88305,"Pathology examination of tissue using a microscope, intermediate complexity",200.6,130.39,34.07,991.68,361
HCPCS,88307,"Pathology examination of tissue using a microscope, moderately high complexity",708.0,460.2,74.04,1872.31,76
HCPCS,88309,"Pathology examination of tissue using a microscope, high complexity",1055.1,685.82,78.57,3109.33,76
HCPCS,88311,Preparation of tissue for examination by removing any calcium present,52.0,33.8,8.65,281.49,57
HCPCS,88312,Special stained specimen slides to identify organisms including interpretation and report,230.0,149.5,24.3,593.98,209
HCPCS,88313,Special stained specimen slides to examine tissue including interpretation and report,196.4,127.66,10.89,1818.08,361
HCPCS,88314,Special stained specimen slides to examine tissue and frozen preparation of specimen including interpretation and report,269.0,174.85,18.21,795.41,57
HCPCS,88319,Evaluation of specimen enzymes,249.635,162.26,24.59,2530.85,285
HCPCS,88321,Surgical pathology consultation and report on referred slides prepared elsewhere,197.5,128.375,65.09,162.56,38
HCPCS,88323,Surgical pathology consultation and report on referred material requiring preparation of slides,405.9,263.84,31.8,2272.6,57
HCPCS,88325,"Surgical pathology consultation and report, comprehensive",510.75,331.99,78.57,1818.08,57
HCPCS,88329,Pathology examination of specimen during surgery,102.9,66.89,26.84,78.57,19
HCPCS,88331,"Pathology examination of specimen during surgery, first tissue block",253.6,164.84,43.19,2337.16,228
HCPCS,88332,"Pathology examination of specimen during surgery, each additional tissue block",107.25,69.715,24.57,591.39,209
HCPCS,88333,"Pathology cytologic examination of specimen during surgery, initial site",247.35,160.78,33.22,1872.31,76
HCPCS,88334,"Pathology cytologic examination of specimen during surgery, each additional site",108.25,70.36500000000001,19.38,317.65,76
HCPCS,88341,"Special stained specimen slides to examine tissue, each additional procedure",169.675,110.28999999999999,25.9,578.48,95
HCPCS,88342,"Special stained specimen slides to examine tissue, initial procedure",223.425,145.225,31.62,1818.08,399
HCPCS,88344,"Special stained specimen slides to examine tissue, each multiplex procedure",390.975,254.135,35.04,981.35,38
HCPCS,88346,"Antibody evaluation, initial single antibody stain procedure",301.05,195.685,25.25,2195.13,513
HCPCS,88348,Electron microscopy for diagnosis,722.25,469.465,69.83,2863.99,171
HCPCS,88350,"Antibody evaluation, each additional single antibody stain procedure",215.0,139.75,25.25,2262.27,114
HCPCS,88355,Microscopic genetic analysis of muscle,371.1,241.22,76.9,192.06,19
HCPCS,88356,Microscopic genetic analysis of nerve tissue,406.0,263.9,46.86,1048.5,57
HCPCS,88358,Microscopic genetic analysis of tumor,124.4,80.86,44.57,111.31,19
HCPCS,88360,"Microscopic genetic analysis of tumor, manual",481.4,312.90999999999997,38.02,1683.79,95
HCPCS,88361,"Microscopic genetic analysis of tumor, using computer-assisted technology",398.45,258.995,39.51,1239.6,38
HCPCS,88362,Nerve teasing preparation,644.7,419.06,78.57,1818.08,57
HCPCS,88363,Examination of archival tissue for genetic analysis,48.0,31.2,14.74,78.57,19
HCPCS,88364,"Genetic sequencing localization, each additional procedure",350.0,227.5,30.85,1100.15,38
HCPCS,88365,"Genetic sequencing localization, initial procedure",545.55,354.61,39.33,2169.3,209
HCPCS,88366,"Genetic sequencing localization, each multiplex procedure",193.15,125.55,56.08,565.57,38
HCPCS,88367,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure",746.15,485.0,30.31,2107.32,38
HCPCS,88368,"Microscopic genetic analysis of tissue, manual, initial procedure",530.5,344.83,39.02,2107.32,323
HCPCS,88369,"Microscopic genetic analysis of tissue, manual, each additional procedure",188.0,122.2,46.86,485.51,19
HCPCS,88371,Protein analysis of tissue with interpretation and report,129.2,83.98,18.2,78.57,19
HCPCS,88372,"Protein analysis of tissue by western blot, with interpretation and report",323.7,210.41,16.96,84.87,19
HCPCS,88374,"Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure",930.0,604.5,38.54,3160.98,152
HCPCS,88377,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",915.0,594.75,59.45,5423.25,2773
HCPCS,88380,Preparation of specimen using laser,1580.35,1027.23,47.37,7236.17,38
HCPCS,88381,"Preparation of specimen, manual",250.0,162.5,21.5,645.63,76
HCPCS,88387,"Pathologist examination, dissection, and preparation of tissue",65.35,42.480000000000004,2.73,90.39,38
HCPCS,88399,Surgical pathology procedure,37.0,24.05,18.87,95.55,19
HCPCS,88720,Measurement of bilirubin,33.4,21.71,0.79,131.71,38
HCPCS,89051,Body fluid cell count with cell identification,64.0,41.6,1.93,214.35,95
HCPCS,89060,Crystal identification from tissue or body fluid,50.0,32.5,2.57,136.87,57
HCPCS,89125,"Fat stain of stool, urine, or respiratory secretions",26.3,17.1,1.55,78.57,19
HCPCS,89160,Examination of stool for meat fibers,22.6,14.690000000000001,0.4,95.55,38
HCPCS,89190,Nasal smear for eosinophils (allergy related white blood cells),22.1,14.37,0.94,90.39,57
HCPCS,89220,Sputum specimen collection,39.9,25.94,9.89,78.57,19
HCPCS,89230,Sweat collection,90.35,58.730000000000004,1.36,322.81,38
HCPCS,89250,"Culture of eggs or embryos, less than 4 days",1575.0,1023.75,78.57,2187.16,15
HCPCS,89253,Assisted embryo hatching (fertility procedure),525.0,341.25,73.6,540.75,15
HCPCS,89257,Sperm identification from aspiration,262.5,170.63,50.75,270.38,15
HCPCS,89258,Frozen preservation of embryos,315.0,204.75,73.6,669.29,15
HCPCS,89259,Frozen preservation of sperm,262.5,170.63,73.6,270.38,15
HCPCS,89261,Sperm isolation and semen analysis for fertilization or diagnosis,210.0,136.5,50.75,216.3,15
HCPCS,89300,Semen analysis presence and/or motility of sperm,105.0,68.25,9.84,108.15,19
HCPCS,89310,Semen analysis motility and count,31.5,20.48,2.71,78.57,19
HCPCS,89320,"Semen evaluation volume, sperm count, motility and analysis",78.8,51.22,9.7,78.57,19
HCPCS,89321,Semen analysis for sperm presence,125.75,81.74000000000001,3.68,570.73,38
HCPCS,89322,"Semen evaluation, volume, sperm count, motility, and analysis",362.5,235.625,5.88,1549.5,38
HCPCS,89325,Sperm antibody measurement,157.5,102.38,6.4,162.23,19
HCPCS,89329,"Sperm evaluation, hamster penetration test",315.0,204.75,11.75,324.45,19
HCPCS,89330,"Sperm evaluation, cervical mucus penetration test",105.0,68.25,6.23,108.15,19
HCPCS,90375,Rabies immune globulin for injection,977.84,635.6,79.15,4048.95,57
HCPCS,90378,Respiratory syncytial virus antibody for injection into tissue or muscle,2089.0,1357.85,78.57,2897.31,15
HCPCS,90380,"Respiratory syncytial virus antibody, 0.5 mL dosage for injection into muscle",910.0,591.5,78.57,2350.08,53
HCPCS,90381,"Respiratory syncytial virus antibody, 1.0 mL dosage for injection into muscle",1000.0,650.0,78.57,2582.5,53
HCPCS,90460,Administration of first vaccine or toxoid component with counseling (18 years or younger),55.0,35.75,12.5,129.13,57
HCPCS,90461,"Administration of vaccine or toxoid component with counseling (18 years or younger), each additional vaccine or toxoid component",30.0,19.5,7.5,78.57,38
HCPCS,90471,Administration of vaccine,80.0,52.0,5.8,206.6,57
HCPCS,90472,"Administration of vaccine, each additional vaccine",32.5,21.125,5.8,103.3,57
HCPCS,90473,"Administration of nasal or oral vaccine, 1 vaccine",30.0,19.5,5.8,78.57,57
HCPCS,90474,"Administration of nasal or oral vaccine, each additional vaccine",30.8,20.02,5.8,80.06,38
HCPCS,90480,"Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose",80.0,52.0,20.0,206.6,53
HCPCS,90589,Chikungunya virus vaccine,550.0,357.5,78.57,1420.38,47
HCPCS,90593,"Chikungunya virus vaccine, recombinant, for intramuscular use",625.85,406.8,73.6,644.63,15
HCPCS,90611,"Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use",690.75,448.99,0.01,1783.86,38
HCPCS,90619,"Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier",219.8,142.87,78.57,273.7,15
HCPCS,90620,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",579.845,376.9,78.57,8031.42,109
HCPCS,90621,"Meningococcal recombinant lipoprotein vaccine, serogroup B",352.85,229.355,78.57,911.62,52
HCPCS,90625,Cholera vaccine,640.0,416.0,30.97,1652.8,51
HCPCS,90627,"Inactivated tick-borne encephalitis virus vaccine, 0.5 mL dosage, for intramuscular use",659.0,428.35,78.57,678.77,15
HCPCS,90632,Hepatitis A vaccine adult dosage,130.38,84.745,11.25,889.52,110
HCPCS,90633,Hepatitis A vaccine pediatric or adolescent dosage,55.0,35.75,13.75,142.04,34
HCPCS,90634,Hepatitis A vaccine pediatric or adolescent dosage (3 dose schedule),88.9,57.785,22.25,229.84,52
HCPCS,90636,Hepatitis A and hepatitis B vaccine,445.61,289.645,45.75,2444.44,91
HCPCS,90647,"Haemophilus influenzae type b vaccine, PRP-OMP conjugate",464.0,301.6,12.5,2750.83,110
HCPCS,90648,"Haemophilus influenzae type b vaccine, PRP-T conjugate",50.0,32.5,12.5,129.13,53
HCPCS,90649,"Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent",245.0,159.25,61.25,632.71,53
HCPCS,90650,"Human Papillomavirus vaccine, types 16, 18, bivalent",250.0,162.5,30.97,645.63,51
HCPCS,90651,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",975.0,633.75,78.57,5587.29,129
HCPCS,90653,"Influenza vaccine, inactivated",5.0,3.25,1.25,128.99,53
HCPCS,90655,"Influenza vaccine, trivalent, split virus, preservative-free, 0.25 mL dosage",5.0,3.25,1.25,78.57,34
HCPCS,90656,"Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage",5.0,3.25,1.25,78.57,53
HCPCS,90657,"Influenza vaccine, trivalent, 0.25 mL dosage",5.0,3.25,1.25,78.57,34
HCPCS,90658,"Influenza vaccine, trivalent, 0.5 mL dosage",5.0,3.25,1.25,78.57,53
HCPCS,90660,"Influenza vaccine, trivalent for nasal administration",5.0,3.25,2.25,78.57,15
HCPCS,90662,"Influenza vaccine split virus, preservative free",30.0,19.5,1.25,193.69,53
HCPCS,90666,"Influenza vaccine, live, pandemic formulation, split virus, preservative free",5.0,3.25,0.01,31.59,35
HCPCS,90670,"Pneumococcal vaccine, 13-valent",265.54,172.6,66.39,774.75,53
HCPCS,90672,"Influenza vaccine, quadrivalent for nasal administration",15.0,9.75,1.25,78.57,51
HCPCS,90673,"Influenza vaccine, trivalent derived from recombinant DNA",5.0,3.25,1.25,128.99,53
HCPCS,90674,"Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free",30.0,19.5,7.5,77.48,36
HCPCS,90675,Rabies vaccine for injection into muscle,1708.05,1110.2350000000001,78.57,7688.7,72
HCPCS,90677,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use",572.68,372.24,78.57,2960.55,91
HCPCS,90678,"Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use",1262.5549999999998,820.66,30.97,4894.12,72
HCPCS,90679,"Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use",592.5,385.13,30.97,1530.13,34
HCPCS,90680,"Rotavirus vaccine, pentavalent",132.0,85.8,33.0,340.89,53
HCPCS,90681,"Rotavirus vaccine, human, attenuated",200.0,130.0,30.97,516.5,34
HCPCS,90682,"Influenza vaccine, quadrivalent derived from recombinant DNA",30.0,19.5,7.5,119.37,51
HCPCS,90685,"Influenza vaccine, quadrivalent, preservative free, 0.25 mL dosage",5.0,3.25,1.25,78.57,51
HCPCS,90686,"Influenza vaccine, quadrivalent, preservative free, 0.5 mL dosage",15.0,9.75,2.25,78.57,51
HCPCS,90687,"Influenza vaccine, quadrivalent, 0.25 mL dosage",5.0,3.25,1.25,78.57,51
HCPCS,90688,"Influenza vaccine, quadrivalent, 0.5 mL dosage",5.0,3.25,1.25,31.59,18
HCPCS,90690,Typhoid vaccine,78.9,51.285,8.54,204.02,52
HCPCS,90691,Typhoid vaccine for injection into muscle,115.0,74.75,28.75,296.99,52
HCPCS,90694,"Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage",25.0,16.25,6.25,125.81,51
HCPCS,90696,"Diphtheria, tetanus, acellular pertussis, and polio vaccine",85.0,55.25,21.25,219.51,34
HCPCS,90698,"Diphtheria, tetanus, acellular pertussis, polio, and Haemophilus influenzae type b vaccine",125.0,81.25,30.97,322.81,53
HCPCS,90700,"Diphtheria, tetanus, and acellular pertussis vaccine (younger than 7 years)",212.16,137.905,7.55,1058.83,110
HCPCS,90702,Diphtheria and tetanus vaccine (younger than 7 years),93.4,60.71,40.03,102.11,15
HCPCS,90707,"Measles, mumps, and rubella vaccine",102.0,66.3,25.5,263.42,53
HCPCS,90710,"Measles, mumps, rubella, and varicella vaccine",277.6,180.44,30.97,717.94,53
HCPCS,90713,Poliovirus vaccine,50.0,32.5,12.5,129.13,34
HCPCS,90714,Diphtheria and tetanus vaccine (7 years or older),40.0,26.0,10.0,103.3,53
HCPCS,90715,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",574.0,373.1,16.25,2005.05,129
HCPCS,90716,Varicella vaccine,318.975,207.335,35.82,3358.64,91
HCPCS,90717,Yellow fever vaccine,245.9,159.835,61.5,635.3,52
HCPCS,90723,"Diphtheria, tetanus, acellular pertussis, hepatitis B, and polio vaccine",230.05,149.535,30.97,839.57,53
HCPCS,90732,"Pneumococcal vaccine, 23-valent",132.88,86.37,30.97,363.51,53
HCPCS,90733,"Meningococcal vaccine, serogroups A, C, Y, W-135",225.0,146.25,56.25,581.06,52
HCPCS,90734,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",225.0,146.25,50.0,727.83,110
HCPCS,90736,Shingles vaccine for injection under skin,360.0,234.0,78.57,929.7,53
HCPCS,90738,Japanese encephalitis vaccine,385.0,250.25,78.57,994.26,52
HCPCS,90739,"Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use",1806.96,1174.52,25.0,4727.78,110
HCPCS,90740,"Hepatitis B vaccine, dialysis or immunosuppressed patient dosage",281.2,182.78,70.25,725.68,52
HCPCS,90743,"Hepatitis B vaccine, adolescent dosage",100.0,65.0,25.0,258.25,52
HCPCS,90744,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",239.195,155.47500000000002,12.5,1039.2,91
HCPCS,90746,"Hepatitis B vaccine, adult dosage (3 dose schedule)",348.3,226.4,25.0,1498.88,91
HCPCS,90747,"Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule)",172.765,112.295,25.0,634.08,38
HCPCS,90748,Hepatitis B and Haemophilus influenzae type b vaccine,100.0,65.0,25.0,258.25,52
HCPCS,90750,Shingles vaccine for injection into muscle,452.55,294.16,78.57,3583.61,105
HCPCS,90756,"Influenza vaccine, quadrivalent derived from cell cultures",5.0,3.25,2.25,78.57,15
HCPCS,90785,Psychiatric services complicated by communication factor,33.0,21.45,8.75,476.0,57
HCPCS,90791,Psychiatric diagnostic evaluation,373.0,242.45,78.57,828.98,76
HCPCS,90792,Psychiatric diagnostic evaluation with medical services,404.0,262.6,78.57,924.54,57
HCPCS,90832,"Psychotherapy, 30 minutes",244.63,159.01,61.16,723.1,53
HCPCS,90833,"Psychotherapy with evaluation and management visit, 30 minutes",193.5,125.775,40.5,418.37,36
HCPCS,90834,"Psychotherapy, 45 minutes",275.0,178.75,60.25,826.4,53
HCPCS,90836,"Psychotherapy with evaluation and management visit, 45 minutes",240.0,156.0,51.25,529.41,36
HCPCS,90837,"Psychotherapy, 1 hour",319.0,207.35,78.25,808.32,53
HCPCS,90838,"Psychotherapy with evaluation and management visit, 1 hour",297.5,193.375,67.5,697.28,36
HCPCS,90839,"Psychotherapy for crisis, first hour",307.0,199.55,78.57,844.48,57
HCPCS,90840,"Psychotherapy for crisis, each additional 30 minutes",125.25,81.415,39.0,476.0,57
HCPCS,90846,"Family psychotherapy without patient, 50 minutes",265.75,172.74,78.57,748.93,83
HCPCS,90847,"Family psychotherapy with patient, 50 minutes",285.0,185.25,72.5,748.93,102
HCPCS,90849,Multiple-family group psychotherapy,98.7,64.16,29.11,101.66,19
HCPCS,90853,Group psychotherapy,167.5,108.875,24.05,413.2,36
HCPCS,90863,Management of prescriptions and review of medication,131.0,85.15,15.5,160.12,32
HCPCS,90867,"Treatment using magnetic field to stimulate nerve cells in brain, initial delivery and management",461.0,299.65,78.57,1645.05,34
HCPCS,90868,"Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management",431.3,280.345,78.57,1645.05,34
HCPCS,90869,"Treatment using magnetic field to stimulate nerve cells in brain, subsequent motor threshold redetermination with delivery and management",513.5,333.775,78.57,1645.05,34
HCPCS,90870,Therapy using electrical currents,667.0,433.55,54.1,3093.84,67
HCPCS,90875,"Psychophysiological therapy incorporating biofeedback training with psychotherapy, 30 minutes",194.3,126.3,78.57,200.13,15
HCPCS,90876,"Psychophysiological therapy incorporating biofeedback training with psychotherapy, 45 minutes",283.5,184.28,78.57,292.01,15
HCPCS,90880,Guided hypnosis,230.0,149.5,78.57,263.55,19
HCPCS,90882,"Medical management interactions on the patient's behalf with agencies, employers, or institutions",260.0,169.0,78.57,267.8,15
HCPCS,90885,"Psychiatric evaluation of hospital records, reports, testing, or data for diagnosis",118.0,76.7,29.5,304.74,17
HCPCS,90887,"Explanation of psychiatric, medical examinations, procedures, and data to responsible person",210.0,136.5,78.57,542.33,47
HCPCS,90889,Preparation of report of patient's psychiatric status,381.65,248.075,66.96,1466.86,32
HCPCS,90901,Biofeedback training,124.0,80.6,15.98,277.0,57
HCPCS,90912,"Biofeedback training for bowel or bladder control, initial 15 minutes",242.375,157.545,2.28,759.26,57
HCPCS,90913,"Biofeedback training for bowel or bladder control, each additional 15 minutes",186.0,120.9,1.14,759.26,38
HCPCS,90935,Hemodialysis procedure with physician evaluation,203.7,132.41,58.97,225.66,19
HCPCS,90937,Hemodialysis procedure requiring repeated evaluation,336.0,218.4,78.57,271.48,19
HCPCS,90945,Dialysis procedure including 1 evaluation,1385.05,900.2850000000001,73.49,6606.04,55
HCPCS,90947,Dialysis procedure requiring repeat evaluation,342.3,222.5,78.57,323.32,19
HCPCS,90951,"Dialysis services, 4 or more visits per month (younger than 2 years)",2964.2,1926.73,78.57,3079.84,19
HCPCS,90952,"Dialysis services, 2-3 physician visits per month (younger than 2 years)",1690.5,1098.83,78.57,1980.33,15
HCPCS,90953,"Dialysis services, 1 physician visit per month (younger than 2 years of age)",1352.4,879.06,78.57,1311.08,15
HCPCS,90954,"Dialysis services, 4 or more physician visits per month (2-11 years)",2435.0,1582.75,78.57,2659.05,19
HCPCS,90955,"Dialysis services, 2-3 physician visits per month (2-11 years)",1377.6,895.44,78.57,1389.54,19
HCPCS,90956,"Dialysis services, 1 physician visit per month (2-11 years of age)",929.3,604.05,78.57,957.18,19
HCPCS,90957,"Dialysis services, 4 or more physician visits per month (12-19 years)",1954.1,1270.17,78.57,2038.98,19
HCPCS,90958,"Dialysis services, 2-3 physician visits per month (12-19 years)",1317.8,856.57,78.57,1327.33,19
HCPCS,90959,"Dialysis services, 1 physician visit per month (12-19 years)",847.4,550.81,78.57,865.99,19
HCPCS,90960,"Dialysis services, 4 or more physician visits per month (20 years or older)",865.2,562.38,78.57,943.92,19
HCPCS,90961,"Dialysis services, 2-3 physician visits per month (20 years or older)",694.1,451.17,78.57,783.35,19
HCPCS,90962,"Dialysis services, 1 physician visit per month (20 years or older)",508.2,330.33,78.57,540.75,19
HCPCS,90963,Home dialysis services per month (younger than 2 years),1620.2,1053.13,78.57,1605.13,19
HCPCS,90964,Home dialysis services per month (2-11 years),1398.6,909.09,78.57,1375.77,19
HCPCS,90965,Home dialysis services per month (12-19 years),1330.4,864.76,78.57,1324.18,19
HCPCS,90966,Home dialysis services per month (20 years or older),692.0,449.8,78.57,783.35,19
HCPCS,90967,"Dialysis services, per day, less than full month service (younger than 2 years)",57.8,37.57,13.71,78.57,19
HCPCS,90968,"Dialysis services, per day, less than full month service (2-11 years)",46.2,30.03,11.42,78.57,19
HCPCS,90969,"Dialysis services, per day, less than full month service (12-19 years)",45.2,29.38,10.51,78.57,19
HCPCS,90970,"Dialysis services, per day, less than full month service (20 years or older)",24.2,15.73,5.48,78.57,19
HCPCS,90989,Dialysis training completed,1050.0,682.5,78.57,1081.5,15
HCPCS,90993,Dialysis training not completed,42.0,27.3,18.9,220.78,15
HCPCS,90997,Removal of toxins from blood,420.0,273.0,72.89,423.64,19
HCPCS,91010,Study of esophagus to assess movement,544.8,354.12,0.01,4955.82,54
HCPCS,91013,Study of esophagus to assess movement with stimulation or tube,47.9,31.14,9.22,78.57,19
HCPCS,91020,Study of stomach to assess movement,635.3,412.95,72.98,194.33,19
HCPCS,91022,Study of upper small bowel to assess movement,348.5,226.53,72.98,194.32,19
HCPCS,91030,Test for esophageal reflux disease,384.3,249.8,46.14,123.05,19
HCPCS,91034,Monitoring and recording of esophageal function through nasal tube,873.15,567.55,47.9,2936.3,37
HCPCS,91035,Monitoring and recording of esophageal function through a capsule attached to the esophagus wall,1346.9,875.4849999999999,78.57,2869.16,37
HCPCS,91037,Monitoring and recording of esophageal function through nasal tube with electrode,576.15,374.5,49.01,1929.13,37
HCPCS,91038,Prolonged monitoring and recording of esophageal function through nasal tube with electrode,1676.55,1089.76,56.92,5384.51,37
HCPCS,91040,Study of esophageal sensation by balloon distension,902.3,586.5,48.65,492.82,19
HCPCS,91065,Measurement of hydrogen in breath to test for stomach and bowel symptoms,493.25,320.615,9.27,1812.92,37
HCPCS,91110,Imaging of digestive tract done from the inside of the digestive tract,2416.6,1570.79,78.57,4960.98,37
HCPCS,91111,Imaging of esophagus done from the inside of the esophagus,1929.9,1254.44,45.62,564.85,19
HCPCS,91112,Measurement of complex stomach and bowel motor function,2337.15,1519.15,78.57,2187.38,38
HCPCS,91113,"Imaging of colon using capsule endoscope, with interpretation and report",285.0,185.25,78.57,322.19,19
HCPCS,91124,"RECTAL SENSATION, TONE, AND COMPLIANCE STUDY (EG, BAROSTAT)",1188.2,772.33,73.6,1223.85,16
HCPCS,91125,"ANORECTAL MANOMETRY, WITH RECTAL SENSATION AND RECTAL BALLOON EXPULSION TEST, WHEN PERFORMED",695.5,452.075,73.6,2463.71,64
HCPCS,91132,Recording and interpretation of stomach electrical activity,436.7,283.86,15.99,78.57,19
HCPCS,91133,Recording and interpretation of stomach electrical activity with drug administration,496.6,322.79,21.47,89.24,19
HCPCS,91200,Measurement of liver stiffness,348.0,226.2,10.51,4454.81,91
HCPCS,91299,Other diagnostic procedure for gastrointestine,254.2,165.23,71.28,903.88,33
HCPCS,91318,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 3 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",350.0,227.5,30.97,903.88,53
HCPCS,91319,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 10 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",150.0,97.5,30.97,387.38,53
HCPCS,91320,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",225.0,146.25,30.97,581.06,53
HCPCS,91321,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular use",225.0,146.25,30.97,581.06,53
HCPCS,91322,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use",225.0,146.25,30.97,581.06,53
HCPCS,92002,New patient problem focused exam of visual system,151.35,98.38,0.01,258.25,68
HCPCS,92004,New patient complete exam of visual system,252.15,163.9,0.01,352.66,68
HCPCS,92012,Established patient problem focused exam of visual system,200.0,130.0,0.01,516.5,68
HCPCS,92014,Established patient complete exam of visual system,250.0,162.5,0.01,645.63,68
HCPCS,92015,Test to determine if prescription eye wear is needed,42.0,27.3,18.28,78.57,15
HCPCS,92018,Complete exam of visual system under general anesthesia,1697.4,1103.31,78.57,7747.5,38
HCPCS,92019,Limited exam of visual system under general anesthesia,968.7,629.655,56.46,4493.55,38
HCPCS,92020,Exam of the internal drainage system of eye,100.0,65.0,0.01,784.0,55
HCPCS,92025,CT scan of cornea,112.1,72.86500000000001,18.57,784.0,76
HCPCS,92060,Exam to measure eye deviation and range of motion,141.0,91.65,0.01,784.0,55
HCPCS,92065,Eye training exercise performed by health care professional,125.0,81.25,26.87,133.41,19
HCPCS,92066,Eye training exercise under supervision of health care professional,58.0,37.7,23.86,78.57,19
HCPCS,92071,Fitting of contact lens for treatment of eye surface disease,102.45,66.595,7.5,784.0,38
HCPCS,92072,Fitting of contact lens for management of corneal condition,275.0,178.75,75.35,301.78,19
HCPCS,92081,Exam of visual field with limited testing,107.6,69.94,15.05,784.0,76
HCPCS,92082,Exam of visual field with intermediate testing,125.0,81.25,16.25,784.0,76
HCPCS,92083,Exam of visual field with extended testing,242.1,157.365,25.43,784.0,76
HCPCS,92100,Multiple measurements of eye fluid pressure over an extended time period,166.3,108.095,10.41,784.0,57
HCPCS,92132,Imaging of front third of eye,119.65,77.775,14.72,784.0,95
HCPCS,92133,Imaging of optic nerve,117.65,76.475,15.7,784.0,95
HCPCS,92134,Imaging of retina,117.65,76.475,16.95,784.0,95
HCPCS,92136,Measurement of corneal curvature and depth of eye,378.3,245.89499999999998,28.93,968.44,76
HCPCS,92137,Imaging of retina with optical coherence tomography angiography,415.5,270.075,33.47,1923.96,53
HCPCS,92145,Measurement of corneal pressure,38.9,25.285,5.32,784.0,57
HCPCS,92201,Extended exam of the back part of the eye with retinal drawing,60.5,39.33,17.59,78.57,19
HCPCS,92202,Extended exam of the back part of the eye with optic nerve drawing,38.5,25.03,11.25,78.57,19
HCPCS,92228,Imaging of retina with remote review by physician,50.4,32.76,15.72,78.57,19
HCPCS,92229,"Imaging of retina for disease detection, with automated review and report at point of care",140.0,91.0,35.0,784.0,38
HCPCS,92230,Exam of retinal blood vessels using an endoscope after injection of a dye,203.7,132.41,25.45,259.89,19
HCPCS,92235,Exam of retinal blood vessels using a special camera after injection of a dye,646.5,420.225,40.23,1549.5,76
HCPCS,92240,Exam of blood vessels between the white part of eye and retina using a special camera after injection of a dye,608.05,395.235,43.89,1291.25,38
HCPCS,92242,Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye,610.0,396.5,0.01,1931.71,55
HCPCS,92250,Photography of the retina,249.95,162.47,19.63,784.0,95
HCPCS,92260,Measurement of eye artery pressure,68.3,44.4,8.66,78.57,19
HCPCS,92265,Measurement of eye muscle electrical activity and their nerve cells with needle electrode,243.6,158.34,43.47,122.32,19
HCPCS,92270,Measurement of eye movement,245.45,159.54500000000002,40.69,784.0,38
HCPCS,92273,Measurement of retinal and optic nerve function,298.5,194.025,33.3,1304.16,38
HCPCS,92274,Measurement of retinal and optic nerve function targeting multiple separate locations,265.5,172.575,31.55,1162.13,38
HCPCS,92283,Extended exam involving color vision testing,117.25,76.215,8.27,784.0,57
HCPCS,92284,Evaluation of eye adaptation to light and dark with interpretation and report,223.7,145.41,13.18,152.34,19
HCPCS,92285,Photography of content of eyes,113.065,73.49000000000001,0.01,784.0,74
HCPCS,92286,Imaging of front third of eye using a special microscope,313.0,203.45,20.24,784.0,57
HCPCS,92287,Imaging of front third of eye using a special camera after injection of a dye,322.4,209.56,21.48,122.12,19
HCPCS,92310,Contact lens services both eyes,99.8,64.87,11.84,233.98,270
HCPCS,92311,Contact lens services 1 eye where natural lens is absent,257.3,167.25,41.36,248.1,19
HCPCS,92312,Contact lens services both eyes where natural lens is absent,420.0,273.0,48.3,287.9,19
HCPCS,92313,Contact lens services for lens covering entire cornea,246.8,160.42,35.12,234.63,19
HCPCS,92315,Contact lens services 1 eye where natural lens is absent with fitting by independent technician,176.4,114.66,17.29,191.97,19
HCPCS,92316,Contact lens services both eyes where natural lens is absent with fitting by independent technician,230.0,149.5,25.87,238.26,19
HCPCS,92352,Fitting of monofocal spectacles where natural lens is absent,1522.5,989.63,48.35,761.25,15
HCPCS,92499,Other service or procedure on eye,32.05,20.835,0.01,111.79,32
HCPCS,92502,"Exam of head, neck, including ears, nose and throat under general anesthesia",279.3,181.55,36.56,252.97,19
HCPCS,92504,Exam of ear using a microscope,103.6,67.34,0.01,253.09,34
HCPCS,92507,"Treatment of speech, language, voice, communication, and/or hearing processing disorder",183.8,119.47,17.15,619.8,76
HCPCS,92508,"Treatment of speech, language, voice, communication, and/or hearing processing disorder in a group setting",50.0,32.5,12.5,277.0,19
HCPCS,92511,Exam of the nose and throat using an endoscope,370.0,240.5,0.01,2166.29,54
HCPCS,92512,Study of nasal function,170.1,110.57,22.24,175.2,19
HCPCS,92516,Study of facial nerve function,189.0,122.85,0.01,488.09,36
HCPCS,92517,VEMP testing of lower branch of inner ear nerve with interpretation and report,217.5,141.375,32.78,852.23,57
HCPCS,92518,VEMP testing of upper branch of inner ear nerve with interpretation and report,330.0,214.5,33.34,859.97,57
HCPCS,92519,VEMP testing of upper and lower branches of inner ear nerve with interpretation and report,392.5,255.125,49.63,1626.98,57
HCPCS,92520,Study of voice box function,262.5,170.63,31.42,209.71,19
HCPCS,92521,"Evaluation of speech continuity, smoothness, rate, and effort",310.9,202.08499999999998,62.25,643.04,38
HCPCS,92522,Evaluation of speech sound production,251.25,163.315,49.75,513.92,57
HCPCS,92523,Evaluation of speech sound production with evaluation of language comprehension and expression,529.45,344.145,78.57,1113.06,38
HCPCS,92524,Analysis of voice and resonance production,251.95,163.77,48.0,495.84,57
HCPCS,92526,Treatment of swallowing and feeding disorder,260.25,169.16500000000002,30.36,774.75,57
HCPCS,92531,Test for abnormal eye movement without stimulus,38.9,25.29,15.2,78.57,15
HCPCS,92532,Test for abnormal eye movement using 3 positions,51.5,33.48,17.47,78.57,15
HCPCS,92533,Test to assess balance during irrigation,63.0,40.95,25.23,78.57,15
HCPCS,92537,Test to assess balance during warm and cool irrigation in both ears,211.0,137.15,29.39,839.31,38
HCPCS,92538,Test to assess balance during warm or cool irrigation in both ears,187.0,121.55,14.75,839.31,38
HCPCS,92540,Evaluation and testing for balance with recording,289.55,188.20999999999998,72.32,839.31,38
HCPCS,92541,Test for abnormal eye movement with recording,205.35,133.48,19.63,645.63,38
HCPCS,92542,Test for abnormal eye movement using 3 positions with recording,138.5,90.025,23.53,284.08,38
HCPCS,92544,Test for abnormal eye movement using a moving target with recording,231.3,150.345,13.43,839.31,38
HCPCS,92545,Test for abnormal eye movement using a moving target that moves back and forth with recording,228.65,148.625,12.46,839.31,38
HCPCS,92546,Test for abnormal eye movement using a rotating chair,287.5,186.88,14.1,92.72,19
HCPCS,92547,Use of electrodes during balance testing,12.8,8.32,3.25,257.0,38
HCPCS,92548,Test for balance and posture,329.85,214.405,32.01,852.23,38
HCPCS,92549,Test for balance and posture with motor control and adaption test,153.25,99.61,41.77,121.11,19
HCPCS,92550,Test for eardrum and muscle function,193.5,125.775,15.99,839.31,38
HCPCS,92551,Test for screening hearing,31.75,20.64,8.0,257.0,34
HCPCS,92552,Test for hearing various pitches using earphone,154.95,100.72,15.99,645.63,38
HCPCS,92553,Test for hearing various pitches using earphone and device placed against the bone,189.4,123.11,22.85,774.75,38
HCPCS,92555,Test for ability to detect and repeat spoken words,86.0,55.9,11.42,335.73,38
HCPCS,92556,Test for ability to detect and repeat spoken words with speech recognition,66.6,43.29,16.75,257.0,38
HCPCS,92557,Comprehensive hearing and speech recognition test,224.45,145.895,25.1,839.31,38
HCPCS,92563,Test to assess defects in adaption to sounds,56.7,36.86,25.59,91.81,19
HCPCS,92565,Test to assess hearing loss,36.8,23.92,6.85,78.57,19
HCPCS,92567,Test to assess middle ear function,61.0,39.65,8.35,257.0,38
HCPCS,92568,Test to assess middle ear muscle reflex,45.0,29.255,9.14,257.0,38
HCPCS,92570,Comprehensive hearing test,115.25,74.91499999999999,18.28,353.8,38
HCPCS,92577,Test to assess hearing loss using 2 simultaneous words at different tones in same ear,246.1,159.96499999999997,7.31,1100.15,38
HCPCS,92579,Test to assess hearing sensitivity using visual aids,215.1,139.815,29.0,774.75,38
HCPCS,92582,Test to assess hearing sensitivity using activity related feedback,112.7,73.255,28.25,291.82,38
HCPCS,92583,Test to assess hearing using pictures,63.65,41.375,9.5,257.0,38
HCPCS,92584,Test to assess electrical potentials generated in the inner ear as a result of sound stimulation,288.9,187.785,61.69,746.34,38
HCPCS,92587,Placement of ear probe for computerized measurement of sound with interpretation and report,367.4,238.81,17.67,1420.38,38
HCPCS,92588,Placement of ear probe for computerized measurement of repeated sounds with interpretation and report,630.0,409.5,27.75,1627.36,57
HCPCS,92591,"Exam for hearing aid, both ears",204.4,132.86,70.84,174.26,15
HCPCS,92592,"Check of hearing aid, 1 ear",51.5,33.48,18.28,78.57,15
HCPCS,92593,"Check of hearing aid, both ears",77.7,50.51,27.42,89.64,15
HCPCS,92594,"Evaluation of hearing aid function, 1 ear",56.7,36.86,18.28,78.57,15
HCPCS,92595,"Evaluation of hearing aid function, both ears",85.1,55.32,27.42,111.6,15
HCPCS,92596,Measurement of adequacy of hearing protection device,94.5,61.43,27.42,206.65,19
HCPCS,92597,Evaluation for use of voice artificial device to supplement oral speech,198.0,128.7,62.5,645.63,57
HCPCS,92601,Analysis and programming of inner ear implant (younger than 7 years),323.0,209.95,52.57,834.15,19
HCPCS,92602,Analysis and reprogramming of inner ear implant (younger than 7 years),323.0,209.95,52.57,834.15,19
HCPCS,92603,Analysis and programming of inner ear implant (7 years or older),415.9,270.335,52.57,1074.32,38
HCPCS,92604,Analysis and reprogramming of inner ear implant (7 years or older),272.35,177.03,30.83,774.75,38
HCPCS,92605,"Evaluation and prescription of nonspeech-generating and alternative communication device, first hour",196.4,127.66,78.57,229.52,15
HCPCS,92607,"Evaluation with prescription of speech-generating and alternative communication device, first hour",285.0,185.25,71.25,736.01,38
HCPCS,92609,Therapy service for use of speech-generating device with programming,239.0,155.35,59.75,617.22,19
HCPCS,92610,Evaluation of swallowing function,311.2,202.28,49.26,826.4,57
HCPCS,92611,Evaluation of swallowing function image,341.3,221.845,78.57,1136.3,57
HCPCS,92612,Evaluation and recording of swallowing using an endoscope,534.7,347.555,52.22,1601.15,57
HCPCS,92614,Evaluation and recording of voice box sensory function using an endoscope,402.2,261.43,27.23,362.22,19
HCPCS,92616,Evaluation and recording of swallowing and voice box sensory function using an endoscope,542.9,352.89,38.31,552.75,19
HCPCS,92618,"Evaluation and prescription of nonspeech-generating and alternative communication device, each additional 30 minutes",74.0,48.1,18.5,405.67,19
HCPCS,92625,Evaluation of hearing ringing in ear,194.3,126.3,46.15,171.8,19
HCPCS,92626,"Evaluation of hearing function related to surgically implanted hearing device, first hour",242.5,157.625,57.27,774.75,38
HCPCS,92627,"Evaluation of hearing function related to surgically implanted hearing device, each additional 15 minutes",72.25,46.965,13.8,405.67,38
HCPCS,92636,"HEARING AID POST-FITTING FOLLOW-UP SERVICES, UNILATERAL OR BILATERAL, INCLUDING CONFIRMATION OF PHYSICAL FIT, VALIDATION OF PATIENT BENEFIT AND PERFORMANCE, SOUND QUALITY OF DEVICE, ADJUSTMENT(S) (EG,",200.0,130.0,50.0,516.5,17
HCPCS,92637,"HEARING AID POST-FITTING FOLLOW-UP SERVICES, UNILATERAL OR BILATERAL, INCLUDING CONFIRMATION OF PHYSICAL FIT, VALIDATION OF PATIENT BENEFIT AND PERFORMANCE, SOUND QUALITY OF DEVICE, ADJUSTMENT(S) (EG,",100.0,65.0,25.0,258.25,17
HCPCS,92650,Screening evaluation of brain response to sound with automated analysis,275.0,178.75,44.39,710.19,38
HCPCS,92651,Evaluation of brain response to sound for determination of hearing status with interpretation and report,307.4,199.81,62.15,1033.0,57
HCPCS,92652,Evaluation of brain response to sound for determination of hearing threshold with interpretation and report,456.75,296.89,78.57,1626.98,57
HCPCS,92653,Evaluation of brain response to sound for diagnosis of nervous system disorders with interpretation and report,419.125,272.43,60.32,1626.98,76
HCPCS,92700,"Other procedure on ear, nose, or throat",299.0,194.35,0.01,1549.5,123
HCPCS,92920,Balloon dilation of single coronary artery or branch,2632.7,1711.255,78.57,30215.25,74
HCPCS,92924,Removal of plaque with balloon dilation of single coronary artery or branch,3556.0,2311.4,78.57,52837.95,55
HCPCS,92928,"Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch",11893.2,7730.58,78.57,56528.34,37
HCPCS,92929,"Insertion of stents with balloon dilation of coronary artery or branch, each additional artery or branch",7475.6,4859.139999999999,73.6,38006.65,33
HCPCS,92930,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED, SINGLE MAJOR CORONARY ARTERY AND/OR ITS BRANCH(ES); 2 OR MORE DISTINCT CORONARY LESIONS WITH 2",24020.5,15613.325,73.6,120938.48,32
HCPCS,92933,"Removal of plaque, insertion of stent and balloon dilation of single coronary artery or branch",8419.0,5472.349999999999,78.57,55100.22,74
HCPCS,92937,"Removal of plaque, insertion of stent and/or balloon dilation of single coronary vessel with distal protection",14717.0,9566.05,78.57,55100.22,55
HCPCS,92941,"Removal of plaque and blood clot, insertion of stent and/or balloon dilation of single vessel",15685.1,10195.315,78.57,75525.21,37
HCPCS,92943,"Removal of plaque, insertion of stent and/or balloon dilation of single coronary artery, branch or bypass graft",11730.6,7624.889999999999,78.57,55100.22,37
HCPCS,92945,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, SINGLE CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, AND/OR SUBTENDED MAJOR CORONARY ARTERY BRANCHES",14717.0,9566.05,73.6,76157.93,48
HCPCS,92950,Manual attempt to restore blood circulation and breathing,1039.0,675.35,78.57,2938.89,76
HCPCS,92953,Temporary pacemaker to regulate heart beat,310.0,201.5,0.77,3227.0,38
HCPCS,92960,External shock to heart to regulate heart beat,1589.0,1032.85,78.57,6167.01,94
HCPCS,92961,Internal shock to heart to regulate heart beat,1577.25,1025.2150000000001,78.57,6167.01,37
HCPCS,92970,Placement of internal device to assist circulation,2805.35,1823.48,78.57,13095.86,38
HCPCS,92971,Placement of external device to assist circulation,306.6,199.29,63.98,246.35,19
HCPCS,92972,Shockwave destruction of calcified plaque in coronary artery accessed through skin using catheter,2680.0,1742.0,78.57,12912.5,35
HCPCS,92973,Removal of blood clot in heart artery,1558.95,1013.3199999999999,72.34,12169.11,37
HCPCS,92974,Insertion of radiation delivery device into heart artery,497.7,323.51,78.57,396.85,19
HCPCS,92978,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel",2023.05,1314.985,78.57,8765.01,56
HCPCS,92979,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, each additional vessel",1558.05,1012.735,66.51,8477.27,56
HCPCS,92986,Balloon dilation repair of aortic valve,13881.95,9023.27,78.57,61238.82,37
HCPCS,92987,Balloon dilation repair of mitral valve,13408.9,8715.785,78.57,58421.32,37
HCPCS,92990,Balloon dilation repair of pulmonary valve,12924.35,8400.83,78.57,58421.32,37
HCPCS,92997,"Balloon dilation of pulmonary artery, single vessel",2310.0,1501.5,78.57,62966.52,55
HCPCS,92998,"Balloon dilation of pulmonary artery, each additional vessel",3077.5,2000.375,78.57,12912.5,55
HCPCS,93000,Routine electrocardiogram (ECG) using at least 12 leads with interpretation and report,60.0,39.0,14.25,78.57,19
HCPCS,93005,Routine electrocardiogram (ECG) using at least 12 leads with tracing,205.0,133.25,6.29,723.1,152
HCPCS,93010,Routine electrocardiogram (ECG) using at least 12 leads with interpretation and report only,30.0,19.5,7.96,78.57,38
HCPCS,93015,Exercise or drug-induced heart stress test with electrocardiogram (ECG) with supervision and review by physician,230.0,149.5,68.97,192.65,19
HCPCS,93016,Exercise or drug-induced heart stress test with electrocardiogram (ECG) with supervision by physician,110.0,71.5,20.06,2490.0,38
HCPCS,93017,Exercise or drug-induced heart stress test with electrocardiogram (ECG),904.65,588.02,35.71,3850.51,95
HCPCS,93018,Exercise or drug-induced heart stress test with electrocardiogram (ECG) with review by physician,110.0,71.5,13.2,78.57,19
HCPCS,93024,Infusion of drug with evaluation of coronary artery spasm response,645.75,419.74,51.84,2388.81,37
HCPCS,93025,Electrocardiogram (ECG) assessment of irregular heart beats,475.1,308.82,36.04,308.31,19
HCPCS,93040,Electrocardiogram (ECG) 1 to 3 leads with review by physician,37.8,24.57,13.89,78.57,19
HCPCS,93041,Electrocardiogram (ECG) 1 to 3 leads,144.35,93.83,7.22,710.19,95
HCPCS,93042,Electrocardiogram (ECG) 1 to 3 leads with review by physician only,23.1,15.02,6.68,78.57,19
HCPCS,93050,Analysis of central arterial pressure with review by physician,42.0,27.3,7.96,78.57,19
HCPCS,93145,"INTERROGATION DEVICE EVALUATION (IN PERSON), CAROTID SINUS BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM INCLUDING TELEMETRIC ITERATIVE COMMUNICATION WITH THE IMPLANTABLE DEVICE TO MONITOR DEV",198.0,128.7,26.35,1052.0,33
HCPCS,93146,"INTERROGATION DEVICE EVALUATION (IN PERSON), CAROTID SINUS BAROREFLEX ACTIVATION THERAPY (BAT) MODULATION SYSTEM INCLUDING TELEMETRIC ITERATIVE COMMUNICATION WITH THE IMPLANTABLE DEVICE TO MONITOR DEV",211.5,137.475,37.29,1052.0,33
HCPCS,93224,Electrocardiogram (ECG) 2-day continuous with review and report by health care professional,393.0,255.45000000000002,65.48,1124.0,38
HCPCS,93225,Electrocardiogram (ECG) 2-day continuous,307.25,199.715,16.47,1291.25,57
HCPCS,93226,Electrocardiogram (ECG) 2-day continuous with report,500.0,325.0,89.9,1291.25,76
HCPCS,93227,Electrocardiogram (ECG) 2-day continuous with review by health care professional,84.0,54.6,17.13,80.02,19
HCPCS,93228,Electrocardiogram (ECG) up to 30 days continuous with review and report by health care professional,114.85,74.655,23.3,1124.0,38
HCPCS,93229,Electrocardiogram (ECG) up to 30 days continuous with transmission of patient triggered events with review and report by health care professional,600.0,390.0,60.67,1549.5,57
HCPCS,93242,Heart rhythm recording continuous external EKG over more than 48 hours up to 7 days,65.0,42.25,9.14,1124.0,57
HCPCS,93243,Heart rhythm analysis and report of continuous external EKG over more than 48 hours up to 7 days,150.0,97.5,37.5,1124.0,19
HCPCS,93244,"Heart rhythm review, and interpretation of continuous external EKG over more than 48 hours up to 7 days",60.0,39.0,16.9,78.57,19
HCPCS,93246,Heart rhythm recording of continuous external EKG over 8-15 days,165.0,107.25,9.14,1124.0,57
HCPCS,93247,Heart rhythm analysis and report of continuous external EKG over 8-15 days,350.0,227.5,87.5,1124.0,38
HCPCS,93248,Heart rhythm review and interpretation of continuous external EKG over 8-15 days,65.5,42.58,18.28,78.57,19
HCPCS,93260,Programming of implantable defibrillator system,156.4,101.66,37.5,1052.0,57
HCPCS,93261,Evaluation of implantable defibrillator system,96.55,62.76,11.25,1052.0,57
HCPCS,93264,"Remote monitoring of pulmonary artery pressure sensor, up to 30 days",81.0,52.65,18.75,784.0,38
HCPCS,93268,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring and review and report by health care professional,726.6,472.29,78.57,498.13,19
HCPCS,93270,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring,205.65,133.675,7.53,1124.0,76
HCPCS,93271,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring and transmission and analysis,550.0,357.5,60.67,1420.38,38
HCPCS,93272,"Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring, transmission and review and report by health care professional",90.0,58.5,22.84,78.57,19
HCPCS,93278,Recording to evaluate height and duration of heart beats through damaged heart tissue,424.35,275.83000000000004,11.84,1830.99,38
HCPCS,93279,Programming of single lead pacemaker system,77.96,50.67,11.25,1052.0,57
HCPCS,93280,Programming of dual lead pacemaker system,182.65,118.725,35.29,1052.0,76
HCPCS,93281,Programming of multiple lead pacemaker system,185.8,120.77,37.5,1052.0,57
HCPCS,93282,Programming of single lead implantable defibrillator system,182.1,118.365,37.5,1052.0,57
HCPCS,93283,Programming of dual lead implantable defibrillator system,207.3,134.745,37.5,1052.0,57
HCPCS,93284,Programming of multiple lead implantable defibrillator system,221.5,143.975,37.5,1052.0,76
HCPCS,93285,Programming of cardiac rhythm monitor system,143.25,93.11500000000001,24.07,1052.0,57
HCPCS,93286,"Programming of single, dual, or multiple lead or leadless pacemaker system before or after surgery",64.5,41.925,11.25,1052.0,76
HCPCS,93287,"Programming of single, dual or multiple lead implantable defibrillator system before or after surgery",77.65,50.475,11.25,1052.0,76
HCPCS,93288,"Evaluation of single, dual, multiple lead or leadless pacemaker system",83.95,54.57,11.25,1052.0,76
HCPCS,93289,"Evaluation of single, dual, or multiple lead implantable defibrillator system",78.97999999999999,51.335,11.25,1052.0,76
HCPCS,93290,Evaluation of implantable heart and blood vessel monitoring system,68.7,44.655,11.25,1052.0,57
HCPCS,93291,Evaluation of cardiac rhythm monitor system,82.35,53.53,11.25,1052.0,57
HCPCS,93292,Evaluation of wearable defibrillator system,51.9,33.74,19.7,78.57,19
HCPCS,93293,"Telephonic rhythm strip evaluation of single, dual, multiple lead or leadless pacemaker system, up to 90 days",106.45,69.195,11.25,1052.0,57
HCPCS,93294,"Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days",80.9,52.59,27.42,78.58,19
HCPCS,93295,"Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days",147.0,95.55,34.24,113.17,19
HCPCS,93296,"Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days",112.3,72.995,27.42,1052.0,57
HCPCS,93297,"Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days",62.4,40.56,11.25,1052.0,57
HCPCS,93298,"Evaluation of cardiac rhythm monitor system, remote up to 30 days",134.65,87.525,16.95,1052.0,76
HCPCS,93303,Ultrasound of heart for congenital defect,849.7,552.305,58.03,2752.95,38
HCPCS,93304,"Ultrasound of heart for congenital defect, follow-up",937.7,609.505,33.58,3770.45,38
HCPCS,93306,"Ultrasound of heart with color-depicted blood flow, rate, direction and valve function",1350.0,877.5,65.02,6381.36,76
HCPCS,93307,Ultrasound of heart,957.1,622.115,41.54,3687.81,57
HCPCS,93308,"Ultrasound of heart, follow-up",783.0,508.95,23.79,3233.29,76
HCPCS,93312,"Ultrasound of heart with probe in esophagus, with report",1716.5,1115.725,78.57,7476.34,114
HCPCS,93313,Insertion of probe in esophagus for heart ultrasound,126.0,81.9,9.84,80.02,19
HCPCS,93314,Interpretation and report of ultrasound of heart,899.4,584.61,78.57,268.3,19
HCPCS,93315,"Ultrasound of heart with probe in esophagus for congenital defect, with report",1140.15,741.0999999999999,78.57,4193.98,38
HCPCS,93316,Insertion of probe in esophagus for congenital heart ultrasound,214.2,139.23,23.11,78.57,19
HCPCS,93317,Interpretation and report of congenital heart ultrasound,274.1,178.17,78.57,282.43,19
HCPCS,93318,Ultrasound of heart with probe in esophagus to assess heart pump function,1232.55,801.1600000000001,78.57,4625.26,38
HCPCS,93319,3D ultrasound imaging of heart for evaluation of heart structure performed during ultrasound imaging of congenital heart defects,391.0,254.15,19.65,1872.31,57
HCPCS,93320,"Ultrasound of heart blood flow, valves and chambers",642.0,417.3,16.8,2272.6,95
HCPCS,93321,"Ultrasound of heart blood flow, valves and chambers, follow-up",308.0,200.2,6.99,1180.2,57
HCPCS,93325,"Ultrasound of heart with color-depicted blood flow, rate and valve function",480.0,312.0,3.26,1696.7,114
HCPCS,93350,"Ultrasound of heart during rest, exercise and/or drug-induced stress with report",1235.0,802.75,65.02,4410.91,114
HCPCS,93351,"Ultrasound of heart with continuous electrocardiogram (ECG) during rest, exercise and/or drug induced stress with review and report",1238.85,805.255,78.22,4410.91,76
HCPCS,93352,Injection of X-ray contrast during ultrasound of heart,107.1,69.62,27.42,91.0,19
HCPCS,93355,Ultrasound of heart with probe in esophagus during surgery on heart or great blood vessels with report,1791.0,1164.15,78.57,9038.75,57
HCPCS,93356,Heart muscle strain imaging,421.75,274.14,7.76,1936.88,38
HCPCS,93451,Insertion of tube in right heart chambers for measurement,5335.7,3468.205,78.57,21946.09,37
HCPCS,93452,Insertion of tube in left heart chambers for diagnosis with review by radiologist,7499.05,4874.385,78.57,33373.65,37
HCPCS,93453,Insertion of tube in right and left heart chambers for diagnosis with review by radiologist,10003.15,6502.05,78.57,44651.43,37
HCPCS,93454,Insertion of tube in coronary artery for diagnosis with review by radiologist,7428.0,4828.2,78.57,35468.06,55
HCPCS,93455,Insertion of tube in bypass graft for diagnosis with review by radiologist,9115.05,5924.785,78.57,40540.09,37
HCPCS,93456,Insertion of tube in right heart chambers and coronary artery for diagnosis with review by radiologist,8543.4,5553.21,78.57,37213.83,37
HCPCS,93457,"Insertion of tube in right heart chambers, coronary artery, and bypass graft for diagnosis with review by radiologist",8241.3,5356.845,78.57,34693.31,37
HCPCS,93458,Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist,10177.85,6615.605,78.57,45805.8,37
HCPCS,93459,"Insertion of tube in left lower heart chamber, coronary artery and bypass graft for diagnosis with review by radiologist",11591.4,7534.41,78.57,52530.63,37
HCPCS,93460,Insertion of tube in right and left heart chambers and coronary artery for diagnosis with review by radiologist,9015.75,5860.24,78.57,38853.71,37
HCPCS,93461,"Insertion of tube in right and left heart chambers, coronary artery, and bypass graft for diagnosis with review by radiologist",9114.95,5924.72,78.57,38086.71,37
HCPCS,93462,Insertion of tube in left heart chamber through heart septum,7350.35,4777.7300000000005,78.57,36733.48,37
HCPCS,93463,Drug infusion during cardiac catheterization,788.1,512.265,67.35,3411.48,37
HCPCS,93464,Drug infusion or exercise for heart stimulation during diagnostic study,1385.75,900.74,78.57,5673.75,37
HCPCS,93503,Insertion of tube in pulmonary artery for monitoring,3670.0,2385.5,76.96,13927.42,55
HCPCS,93505,Biopsy of heart muscle,4756.4,3091.6600000000003,78.57,18358.99,37
HCPCS,93563,Injection for imaging of coronary blood vessel during evaluation of congenital abnormalities with review by radiologist,2066.75,1343.39,40.61,9183.37,37
HCPCS,93564,Injection for imaging of heart vessel grafts during evaluation of congenital abnormalities with review by radiologist,6825.0,4436.25,476.5,17625.56,18
HCPCS,93565,Injection for imaging of left heart chambers with review by radiologist,1354.9,880.685,20.66,5655.68,37
HCPCS,93566,Injection for imaging of right heart chambers with review by radiologist,1304.5,847.925,20.46,5655.68,37
HCPCS,93567,Injection for imaging of aorta above heart valve with review by radiologist,694.75,451.59000000000003,28.74,2693.55,37
HCPCS,93568,Injection for nonselective imaging of pulmonary artery during heart catheterization,1073.55,697.8100000000001,36.24,4565.86,37
HCPCS,93569,"Injection for selective imaging of pulmonary artery during heart catheterization, on one side of body",1293.25,840.615,30.77,6456.25,37
HCPCS,93571,"Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel",2198.0,1428.7,78.57,10593.42,37
HCPCS,93572,"Ultrasound evaluation of heart blood vessel during diagnosis or treatment, each additional vessel",1757.05,1142.085,66.51,8475.77,37
HCPCS,93573,"Injection for selective imaging of pulmonary artery during heart catheterization, on both sides of body",1222.0,794.3,50.83,5939.75,37
HCPCS,93574,Injection for selective imaging of pulmonary vein during heart catheterization,1229.5,799.175,56.22,5939.75,37
HCPCS,93575,Injection for selective imaging of major aortopulmonary collateral arteries during heart catheterization,1256.25,816.565,74.89,5939.75,37
HCPCS,93580,Repair of congenital abnormality in wall between upper heart chambers with implant,22006.3,14304.095,78.57,105985.8,37
HCPCS,93581,Repair of congenital abnormality in wall between lower heart chambers with implant,20026.375,13017.145,78.57,95438.87,37
HCPCS,93582,Repair of congenital abnormality of pulmonary artery to aorta,15095.9,9812.335,55.11,72503.69,37
HCPCS,93583,Repair of wall between lower heart chambers including pacemaker insertion,2297.6,1493.44,32.9,21409.87,37
HCPCS,93584,Review by radiologist of vein imaging for congenital heart defect of superior vena cava,1822.5,1184.625,46.75,9038.75,35
HCPCS,93585,Review by radiologist of vein imaging for congenital heart defect of the azygos/hemiazygos venous system,1820.0,1183.0,44.1,9038.75,35
HCPCS,93586,Review by radiologist of vein imaging for congenital heart defect of coronary sinus,1837.5,1194.375,56.99,9038.75,35
HCPCS,93587,Review by radiologist of vein imaging for congenital heart defect of venovenous collaterals above the heart,1880.0,1222.0,78.57,9038.75,35
HCPCS,93588,Review by radiologist of vein imaging for congenital heart defect of venovenous collaterals below the heart,1880.0,1222.0,78.57,9038.75,35
HCPCS,93590,"Repair of leak adjacent to mitral valve, first closure device",19852.7,12904.255000000001,78.57,95438.87,56
HCPCS,93591,"Repair of leak adjacent to aortic valve, first closure device",19618.825,12752.235,78.57,95438.87,56
HCPCS,93592,"Repair of lead adjacent to heart valve, each additional closure device",3002.4,1951.56,78.57,21409.87,56
HCPCS,93593,"Insertion of catheter into right side of heart for evaluation of congenital heart defect in heart with normal native blood vessel connections, using imaging guidance",3803.5,2472.2749999999996,78.57,18493.28,37
HCPCS,93594,"Insertion of catheter into right side of heart for evaluation of congenital heart defect in heart with abnormal native blood vessel connections, using imaging guidance",3929.0,2553.85,78.57,18493.28,37
HCPCS,93595,"Insertion of catheter into left side of heart for evaluation of congenital heart defect, using maging guidance",3895.0,2531.75,78.57,18493.28,37
HCPCS,93596,"Insertion of catheter into right and left sides of heart for evaluation of congenital heart defect in heart with abnormal native blood vessel connections, using imaging guidance",3963.5,2576.2749999999996,78.57,18493.28,37
HCPCS,93597,"Insertion of catheter into right and left sides of heart for evaluation of congenital heart defect in heart with normal native blood vessel connections, using imaging guidance",4088.0,2657.2,78.57,18493.28,37
HCPCS,93598,"Measurement of output of blood from heart, performed during cardiac catheterization for evaluation of congenital heart defects",2082.5,1353.625,63.55,10330.0,37
HCPCS,93600,Recording of upper heart rhythm,2697.05,1753.085,78.57,12408.91,37
HCPCS,93602,Recording of upper heart chamber rhythm,389.6,253.24,78.57,291.03,19
HCPCS,93603,Recording of right lower heart chamber rhythm,1520.5,988.325,78.57,9454.3,37
HCPCS,93609,Insertion of tube in upper and/or lower heart chambers to record and identify origin of abnormal heart rhythm,846.5,550.225,78.57,25935.64,37
HCPCS,93610,Insertion of temporary pacemaker electrode for diagnostic upper heart pacing,534.5,347.43,78.57,410.77,19
HCPCS,93612,Insertion of temporary pacemaker electrode for diagnostic lower heart pacing,7391.3,4804.345,78.57,36733.48,37
HCPCS,93613,Insertion of tube for 3D mapping of electrical impulses to heart muscle,2957.95,1922.6699999999998,78.57,12300.45,37
HCPCS,93615,Insertion of probe in esophagus for recording electrical impulses to upper and lower heart chambers,1543.9,1003.5350000000001,34.29,9454.3,38
HCPCS,93616,"Insertion of probe in esophagus for recording electrical impulses to upper and lower heart chambers, with pacing",1683.0,1093.95,56.33,9454.3,38
HCPCS,93618,Induction of abnormal heart rhythm by electrical pacing,1811.3,1177.345,78.57,9454.3,38
HCPCS,93619,Insertion of catheters for recording and pacing of right heart chambers rhythm,9483.0,6163.95,78.57,38771.07,56
HCPCS,93620,Insertion of catheters for recording and pacing of right heart chambers rhythm and induction of abnormal rhythm,7213.85,4689.005,78.57,31583.98,37
HCPCS,93621,Insertion of catheters for recording and pacing of left upper heart chamber rhythm and induction of abnormal rhythm,4959.79,3223.865,72.03,16755.72,37
HCPCS,93622,Insertion of catheters for recording and pacing of left lower heart chamber rhythm and induction of abnormal rhythm,5908.65,3840.625,78.57,21607.78,37
HCPCS,93623,Programming of heart rhythm stimulation after drug infusion,2157.05,1402.085,47.41,9454.3,37
HCPCS,93624,"Insertion of catheters for recording, pacing, and induction of abnormal heart rhythm to test therapy",3046.55,1980.26,78.57,13126.85,38
HCPCS,93631,Intra-operative heart pacing and mapping of abnormal heart rhythm for surgical correction,2517.5,1636.375,78.57,9454.3,38
HCPCS,93640,Evaluation of single or dual chamber pacing cardioverter-defibrillator at time of implantation or replacement,1539.7,1000.8050000000001,78.57,9454.3,37
HCPCS,93641,Evaluation of single or dual chamber pacing cardioverter-defibrillator and generator at time of implantation or replacement,2357.6,1532.4399999999998,78.57,9454.3,37
HCPCS,93642,Programming of pacing cardioverter-defibrillator,2887.85,1877.105,78.57,11461.14,56
HCPCS,93644,Programming of implantable defibrillator,450.7,292.95500000000004,45.0,9454.3,37
HCPCS,93650,Destruction of heart conduction tissue to create heart block,10737.8,6979.57,78.57,50926.9,37
HCPCS,93653,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of upper chamber of heart causing supraventricular tachycardia (rapid heart rate),25007.05,16254.585,78.57,122487.98,37
HCPCS,93654,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of lower chamber of heart causing ventricular tachycardia (rapid heart rate) or ventricular ectopy (irregular heart,25439.65,16535.775,78.57,122487.98,37
HCPCS,93655,Insertion of catheters and destruction of tissue to treat abnormal heart rhythm,6572.3,4271.995,78.57,30607.79,37
HCPCS,93656,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation,25440.15,16536.1,78.57,122487.98,37
HCPCS,93657,Destruction of tissue of upper heart chamber through tube to treat abnormal heart rhythm,6572.3,4271.995,78.57,30607.79,37
HCPCS,93660,Evaluation of heart function using tilt table,2472.0,1606.8,78.57,11466.3,38
HCPCS,93662,Ultrasound evaluation of heart blood vessel with review by radiologist,2117.4,1376.3100000000002,66.2,9754.1,56
HCPCS,93668,"Peripheral arterial disease rehabilitation, each session",150.0,97.5,37.5,489.0,38
HCPCS,93701,Measurement of heart blood flow and respiration,290.0,188.5,72.5,1052.0,19
HCPCS,93702,Measurement of lymphedema extracellular fluid,273.0,177.45,78.57,310.6,19
HCPCS,93724,Electronic analysis of pacemaker to correct rapid heart rate,824.7,536.0550000000001,78.57,1637.31,57
HCPCS,93745,Programming of wearable cardioverter-defibrillator,262.5,170.63,65.02,270.38,15
HCPCS,93750,Evaluation of lower heart chamber assist device,226.15,147.0,29.02,1052.0,76
HCPCS,93770,Measurement of heart and circulatory system pressure,31.4,20.41,6.5,1052.0,34
HCPCS,93784,"Ambulatory blood pressure monitoring, 1 day or longer, with recording, scanning analysis, interpretation, and report",210.0,136.5,44.49,150.63,19
HCPCS,93786,"Ambulatory blood pressure monitoring, 1 day or longer, with recording",167.0,108.55,21.71,1052.0,57
HCPCS,93788,"Ambulatory blood pressure monitoring, 1 day or longer, with scanning analysis and report",148.65,96.625,5.37,1052.0,57
HCPCS,93790,"Ambulatory blood pressure monitoring, 1 day or longer, with review, interpretation and report",57.8,37.57,17.42,78.57,19
HCPCS,93792,Patient/caregiver training for monitoring of anticoagulant therapy,120.0,78.0,66.35,176.14,19
HCPCS,93793,Anticoagulant management of patient taking warfarin,27.0,17.55,11.07,78.57,19
HCPCS,93797,"Outpatient heart rehabilitation, qualified health care professional services",275.0,178.75,68.75,710.19,19
HCPCS,93798,"Outpatient heart rehabilitation with electrocardiogram (ECG) monitoring, quality health care professional services",350.0,227.5,87.5,903.88,38
HCPCS,93799,Other cardiovascular service or procedure,957.5999999999999,622.44,37.41,49542.68,66
HCPCS,93880,Ultrasound of both sides of head and neck blood flow,1445.0,939.25,35.26,5110.77,57
HCPCS,93882,Ultrasound of one side of head and neck blood flow,738.65,480.125,21.75,2332.0,76
HCPCS,93886,Complete ultrasound of within the brain blood flow,1464.25,951.7650000000001,43.1,4612.35,38
HCPCS,93888,Ultrasound of within the brain blood flow,707.3,459.745,34.39,1890.39,38
HCPCS,93892,Ultrasound of within the brain blood flow for blood clots,656.9,426.985,55.56,1052.0,38
HCPCS,93893,Ultrasound of blood flow within brain for atypical blood flow detection with microbubble injection,906.8,589.42,56.48,267.36,19
HCPCS,93922,Ultrasound study of arm and leg arteries,392.9,255.385,10.86,4042.0,114
HCPCS,93923,Complete ultrasound study of arm and leg arteries,823.95,535.5699999999999,19.77,4042.0,133
HCPCS,93924,Ultrasound of leg arteries at rest and after exercise,749.0,486.85,22.06,2649.65,57
HCPCS,93925,Ultrasound of leg arteries or artery grafts,1028.6,668.59,34.64,2871.74,57
HCPCS,93926,Ultrasound of one leg arteries or artery grafts,783.0,508.95,21.01,2768.44,57
HCPCS,93930,Ultrasound of arm arteries or artery grafts,899.6,584.74,34.95,2525.69,38
HCPCS,93931,Ultrasound of one arm arteries or artery grafts,650.65,422.92499999999995,21.31,1952.37,38
HCPCS,93970,Ultrasound study of arm or leg veins with compression and maneuvers,836.5,543.73,30.25,3625.83,114
HCPCS,93971,Ultrasound study of one arm or leg veins with compression and maneuvers,805.0,523.25,19.39,2582.5,152
HCPCS,93975,Complete ultrasound of abdomen and pelvis artery and vein blood flow,979.65,636.775,50.29,1996.27,57
HCPCS,93976,Ultrasound of abdomen and pelvis artery and vein blood flow,643.2,418.08,35.32,1756.1,76
HCPCS,93978,"Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts",790.4,513.76,34.53,2066.0,57
HCPCS,93979,"Ultrasound of aorta, vena cava, groin vessels or bypass grafts",423.1,275.015,21.44,1052.0,57
HCPCS,93980,Complete ultrasound of penis artery and vein blood flow,565.1,367.315,57.41,1570.16,57
HCPCS,93981,Ultrasound of penis artery and vein blood flow,338.9,220.285,19.98,1052.0,38
HCPCS,93985,Complete ultrasound of artery and vein blood flow pre-op assessment on both sides of body for hemodialysis access,591.25,384.315,34.04,1459.11,38
HCPCS,93986,Complete ultrasound of artery and vein blood flow pre-op assessment on side of body for hemodialysis access,289.375,188.095,21.26,1052.0,38
HCPCS,93990,Ultrasound of hemodialysis access,607.25,394.71500000000003,20.64,1311.91,38
HCPCS,94002,Initial hospital inpatient or observation ventilation assistance and management,961.0,624.65,68.55,4261.13,112
HCPCS,94003,Follow-up inpatient or observation ventilation assistance and management,1200.0,780.0,50.27,6198.0,76
HCPCS,94004,Nursing facility ventilation assistance and management,142.8,92.82,36.56,125.89,19
HCPCS,94010,Test to measure expiratory airflow and volume,211.25,137.315,7.96,1438.0,190
HCPCS,94060,Test to measure expiratory airflow and volume changes before and after medication administration,386.1,250.965,9.92,1484.94,133
HCPCS,94070,Test to measure lung airway sensitivity,775.6,504.14,27.48,3127.41,38
HCPCS,94150,Test to measure the total volume of air that can be exhaled after inhaling,268.54,174.55,8.9,1438.0,53
HCPCS,94200,Test to measure largest amount of air breathed in an out,78.1,50.77,2.41,78.57,19
HCPCS,94375,Test to measure rate of airflow,370.0,240.5,13.85,1549.5,76
HCPCS,94450,Test to measure lung function response to low oxygen,148.5,96.53,21.6,141.21,19
HCPCS,94452,Test to measure lung function at high altitude,145.1,94.32,14.15,78.57,19
HCPCS,94453,Test to measure lung function at high altitude with evaluation of oxygen needs at rest and during exercise,201.6,131.04,18.21,78.6,19
HCPCS,94610,Administration of medication through breathing tube,201.0,130.65,45.72,1177.0,38
HCPCS,94617,Test for exercise-induced spasm of lung airways,368.0,239.2,30.55,1438.0,76
HCPCS,94618,Test for exercise-induced lung stress,300.0,195.0,21.81,1446.2,114
HCPCS,94619,Exercise test for spasm of lung airways,177.7,115.505,20.78,1438.0,76
HCPCS,94621,Test for exercise-induced heart and lung stress,869.25,565.015,65.04,3228.13,95
HCPCS,94625,"Professional services for outpatient pulmonary rehabilitation, per session",196.0,127.4,15.12,903.88,38
HCPCS,94626,"Professional services for outpatient pulmonary rehabilitation with continuous monitoring of blood oxygen, per session",206.0,133.9,22.67,903.88,38
HCPCS,94640,Inhalation treatment for airway obstruction or sputum production,260.0,169.0,7.83,1239.6,228
HCPCS,94642,Inhalation treatment for pneumonia,330.2,214.63,32.62,1438.0,53
HCPCS,94644,"Inhalation treatment for acute airway obstruction, first hour",292.85,190.355,27.42,1260.26,76
HCPCS,94645,"Inhalation treatment for acute airway obstruction, each additional hour",173.0,112.45,43.25,1177.0,19
HCPCS,94660,Therapy procedure using a positive pressure ventilator,900.0,585.0,24.08,5361.27,151
HCPCS,94664,Evaluation of use of breathing device,240.0,156.0,18.13,1771.6,152
HCPCS,94667,Initial therapy service to facilitate lung function,152.05,98.83500000000001,24.92,1177.0,95
HCPCS,94668,Follow-up therapy service to facilitate lung function,282.0,183.3,18.28,1394.55,114
HCPCS,94669,Therapy procedure to clear airway using an inflatable vest,465.0,302.25,23.37,1807.75,95
HCPCS,94680,Test to measure exhaled air for evaluation of lung function during rest and exercise,191.1,124.22,11.87,261.24,19
HCPCS,94681,Test to measure exhaled air and carbon dioxide for evaluation of lung function,499.0,324.35,9.27,1929.13,38
HCPCS,94690,Test to measure exhaled air for evaluation of lung function at rest,268.4,174.46,3.39,1438.0,76
HCPCS,94726,Test to determine lung volumes using sensors,377.5,245.375,11.56,1549.5,57
HCPCS,94727,Test to determine lung volumes using gas dilution or washout,482.1,313.365,11.56,2195.13,76
HCPCS,94728,Test to measure resistance of the airways and lungs to differing frequencies,98.7,64.16,11.87,78.57,19
HCPCS,94729,Test to examine how well the lungs exchange gases,267.5,173.875,8.94,1438.0,57
HCPCS,94760,Test to measure oxygen level in blood using ear or finger device,40.55,26.36,3.52,1438.0,87
HCPCS,94761,Test to measure oxygen level in blood using ear or finger device multiple times,185.0,120.25,3.83,1438.0,189
HCPCS,94762,Test to measure oxygen level in blood using ear or finger device continuously overnight,320.0,208.0,22.01,1438.0,57
HCPCS,94772,Test to record infant breathing pattern over 12-24 hours,115.5,75.08,51.98,302.66,15
HCPCS,94780,"Test of car seat or bed (1 year or younger), 1 hour",185.95,120.87,19.49,1438.0,38
HCPCS,94781,"Test of car seat or bed (1 year or younger), each additional 30 minutes",77.1,50.114999999999995,6.73,1438.0,38
HCPCS,94799,Other service or procedure on lung,707.0,459.55,35.0,1846.49,75
HCPCS,95004,Test for allergy using allergenic extract,20.9,13.585,3.19,383.0,38
HCPCS,95012,Test to measure the level of nitric oxide gas,42.1,27.365000000000002,9.5,1438.0,38
HCPCS,95017,Test for allergy using combination of methods with venom,33.2,21.58,1.94,383.0,38
HCPCS,95018,Test for allergy using combination of methods with drug or biological,75.2,48.879999999999995,5.73,383.0,38
HCPCS,95024,Test for allergy using allergenic extract injected into skin,41.95,27.27,0.01,167.86,36
HCPCS,95027,Test for allergy using airborne allergenic extract injected into skin,15.8,10.27,4.16,78.57,19
HCPCS,95028,Test for allergy using allergenic extract injected into skin with delayed reaction analysis,63.0,40.95,9.14,78.57,19
HCPCS,95044,Test for allergy using skin patch,21.95,14.27,4.44,383.0,38
HCPCS,95070,Test for allergy using drugs,200.6,130.39,36.14,103.56,19
HCPCS,95076,"Test for allergy using ingested items, initial 2 hours",764.8,497.12,60.42,2944.05,76
HCPCS,95079,"Test for allergy using ingested items, each additional hour",302.1,196.365,55.66,844.48,76
HCPCS,95115,Professional service for single injection of allergen,52.5,34.125,9.37,208.0,114
HCPCS,95117,Professional service for multiple injections of allergen,65.0,42.25,11.22,284.08,133
HCPCS,95130,Professional service for injection of 1 stinging insect venom,50.0,32.5,21.35,78.57,15
HCPCS,95131,Professional service for injection of 2 stinging insect venoms,65.0,42.25,26.85,78.57,15
HCPCS,95132,Professional service for injection of 3 stinging insect venoms,80.0,52.0,32.35,78.57,15
HCPCS,95133,Professional service for injection of 4 stinging insect venoms,95.0,61.75,39.14,92.97,15
HCPCS,95134,Professional service for injection of 5 stinging insect venoms,110.0,71.5,45.7,111.6,15
HCPCS,95145,Professional service for preparation and provision of 1 stinging insect venom,55.685,36.195,2.44,764.0,57
HCPCS,95146,Professional service for preparation and provision of 2 stinging insect venom,127.08,82.6,2.44,764.0,38
HCPCS,95147,Professional service for preparation and provision of 3 stinging insect venom,114.6,74.49,2.44,764.0,38
HCPCS,95148,Professional service for preparation and provision of 4 stinging insect venom,183.97,119.58,2.44,764.0,38
HCPCS,95149,Professional service for preparation and provision of 5 stinging insect venom,241.68,157.09,2.44,764.0,38
HCPCS,95165,Professional service for preparation and provision of 1 or more antigens,45.0,29.25,2.23,208.0,133
HCPCS,95180,Injection for rapid desensitization to allergen,629.75,409.34000000000003,67.58,2195.13,57
HCPCS,95199,Other allergy or clinical immunology service or procedure,23.0,14.95,0.01,208.0,36
HCPCS,95249,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin,135.0,87.75,33.75,784.0,57
HCPCS,95250,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment,342.35,222.53,78.5,810.91,76
HCPCS,95251,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report,123.9,80.54,29.25,92.1,19
HCPCS,95700,"Measurement of brain wave activity (EEG), continuous",975.0,633.75,243.75,2517.94,19
HCPCS,95705,"Measurement of brain wave activity (EEG), 2-12 hours",510.0,331.5,127.5,1317.08,19
HCPCS,95706,"Measurement of brain wave activity (EEG), 2-12 hours with intermittent monitoring",510.0,331.5,127.5,1317.08,19
HCPCS,95707,"Measurement of brain wave activity (EEG), 2-12 hours with continuous monitoring",510.0,331.5,127.5,1317.08,19
HCPCS,95708,"Measurement of brain wave activity (EEG), 12-26 hours",975.0,633.75,243.75,2517.94,19
HCPCS,95709,"Measurement of brain wave activity (EEG), 12-26 hours with intermittent monitoring",975.0,633.75,243.75,2517.94,19
HCPCS,95710,"Measurement of brain wave activity (EEG), 12-26 hours with continuous monitoring",975.0,633.75,243.75,2517.94,19
HCPCS,95711,"Measurement of brain wave activity with video (VEEG), 2-12 hours",510.0,331.5,127.5,1317.08,19
HCPCS,95712,"Measurement of brain wave activity with video (VEEG), 2-12 hours with intermittent monitoring",510.0,331.5,127.5,1317.08,19
HCPCS,95713,"Measurement of brain wave activity with video (VEEG), 2-12 hours with continuous monitoring",975.0,633.75,243.75,2517.94,19
HCPCS,95714,"Measurement of brain wave activity with video (VEEG), 12-26 hours",975.0,633.75,243.75,2517.94,19
HCPCS,95715,"Measurement of brain wave activity with video (VEEG), 12-26 hours with intermittent monitoring",975.0,633.75,243.75,2517.94,19
HCPCS,95716,"Measurement of brain wave activity with video (VEEG), 12-26 hours with continuous monitoring",1820.0,1183.0,455.0,4700.15,19
HCPCS,95717,"Measurement of brain wave activity (EEG), 2-12 hours with health care professional review and report",250.75,162.99,78.57,279.25,19
HCPCS,95718,"Measurement of brain wave activity with video (VEEG), 2-12 hours with review and report by health care professional",327.75,213.04,78.57,350.22,19
HCPCS,95719,"Measurement of brain wave activity (EEG), 12-26 hours with health care professional review and report",386.0,250.9,78.57,419.74,19
HCPCS,95720,"Measurement of brain wave activity with video (VEEG), 12-26 hours with review and report by health care professional",507.0,329.55,78.57,539.55,19
HCPCS,95721,"Measurement of brain wave activity (EEG), 37-60 hours with health care professional review and report",511.25,332.31,78.57,538.42,19
HCPCS,95722,"Measurement of brain wave activity with video (VEEG), 37-60 hours with review and report by health care professional",620.0,403.0,78.57,653.75,19
HCPCS,95723,"Measurement of brain wave activity (EEG), 61-84 hours with health care professional review and report",632.25,410.96,78.57,660.19,19
HCPCS,95724,"Measurement of brain wave activity with video (VEEG), 61-84 hours with review and report by health care professional",792.0,514.8,78.57,829.96,19
HCPCS,95725,"Measurement of brain wave activity (EEG), more than 84 hours with review and report by health care professional",721.75,469.14,78.57,755.93,19
HCPCS,95726,"Measurement of brain wave activity with video (VEEG), more than 84 hours with review and report by health care professional",1000.75,650.49,78.57,1054.71,19
HCPCS,95782,Sleep study in sleep lab (younger than 6 years),2861.6,1860.04,78.57,6092.12,38
HCPCS,95783,Sleep study in sleep lab with continuous airway pressure (younger than 6 years),2974.5,1933.425,78.57,6092.12,38
HCPCS,95800,"Sleep study including heart rate, breathing, and sleep time",348.25,226.365,37.17,852.23,38
HCPCS,95801,Sleep study including heart rate and breathing,127.1,82.62,39.33,130.91,19
HCPCS,95803,"Sleep study and wake patterns, 3-14 days with report",365.4,237.51,41.0,376.36,19
HCPCS,95805,"Sleep study, multiple trials",1895.75,1232.24,55.43,5371.6,57
HCPCS,95806,"Sleep study including heart rate, breathing, airflow, and effort",404.0,262.6,42.92,1180.2,38
HCPCS,95807,Sleep study including heart rate and breathing attended by technician,1441.6,937.04,57.0,389.74,19
HCPCS,95808,Sleep study in sleep lab,1933.3,1256.65,78.32,657.57,19
HCPCS,95810,Sleep study in sleep lab (6 years or older),2563.8,1666.47,78.57,7522.82,38
HCPCS,95811,Sleep study in sleep lab with continuous airway pressure (6 years or older),2766.15,1798.0,78.57,8152.95,38
HCPCS,95812,"Measurement of brain wave activity (EEG), 41-60 minutes",1101.0,715.65,55.82,2672.89,38
HCPCS,95813,"Measurement of brain wave activity (EEG), 61-119 minutes",1182.9,768.885,78.57,2672.89,38
HCPCS,95816,"Measurement of brain wave activity (EEG), awake and drowsy",1050.7,682.9549999999999,53.89,2672.89,57
HCPCS,95819,"Measurement of brain wave activity (EEG), awake and asleep",1127.0,732.55,54.2,2672.89,76
HCPCS,95822,"Measurement of brain wave activity (EEG), in coma or asleep",1071.05,696.185,54.2,2672.89,38
HCPCS,95824,Measurement of brain wave activity (EEG) to evaluate brain death,996.45,647.6949999999999,36.76,4775.04,38
HCPCS,95829,Measurement of brain wave activity (EEG) during surgery,3211.95,2087.77,78.57,4906.75,38
HCPCS,95836,Measurement of brain wave activity (EEG) with implanted brain neurostimulator generator with report,165.5,107.575,0.01,278.23,36
HCPCS,95851,"Measurement of range of motion in arm, leg or each spine section",42.5,27.625,0.01,277.0,51
HCPCS,95857,Injection to test for myasthenia gravis,122.9,79.89,22.07,152.82,19
HCPCS,95860,"Needle measurement of electrical activity in arm or leg muscles, 1 extremity",353.6,229.84,49.17,1279.0,38
HCPCS,95861,"Needle measurement of electrical activity in arm or leg muscles, 2 extremities",517.9,336.635,77.5,1673.46,38
HCPCS,95863,"Needle measurement of electrical activity in arm or leg muscles, 3 extremities",479.3,311.54499999999996,78.57,1279.0,38
HCPCS,95864,"Needle measurement of electrical activity in arm or leg muscles, 4 extremities",497.05,323.08500000000004,78.57,1279.0,38
HCPCS,95865,Needle measurement of electrical activity in voice box muscles,247.8,161.07,78.57,217.48,19
HCPCS,95866,Needle measurement of electrical activity in half of diaphragm muscles,192.2,124.93,63.76,175.01,19
HCPCS,95867,Needle measurement of electrical activity in muscles on side of body,292.3,189.995,39.35,1279.0,38
HCPCS,95868,Needle measurement of electrical activity in muscles on both sides of body,447.55,290.90999999999997,59.08,1402.3,38
HCPCS,95869,Needle measurement of electrical activity in middle spine muscles,207.0,134.55,18.75,1279.0,38
HCPCS,95870,"Needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study",216.4,140.66,18.75,1279.0,38
HCPCS,95872,"Needle measurement of electrical activity in muscle, including jitter, blocking and/or fiber density",876.45,569.6949999999999,78.57,3233.29,57
HCPCS,95873,Electrical stimulation for guidance with injection of chemical for paralysis of nerve muscle,155.2,100.88,19.24,78.57,19
HCPCS,95874,Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle,468.45,304.495,18.93,1926.55,57
HCPCS,95875,Needle measurement of electrical activity of muscles with low blood flow with specimen,318.7,207.16,57.21,154.81,19
HCPCS,95885,"Needle measurement of electrical activity in arm or leg muscles, limited study",254.45,165.395,17.65,1279.0,57
HCPCS,95886,"Needle measurement of electrical activity in arm or leg muscles, complete study",523.0,339.95,43.54,1926.55,57
HCPCS,95887,Needle measurement of electrical activity in trunk or head muscles,323.25,210.115,35.45,1279.0,57
HCPCS,95905,Nerve conduction study of arm or leg movement and/or feeling with review and report,214.0,139.1,2.41,79.55,19
HCPCS,95907,"Nerve conduction, 1-2 studies",462.4,300.56,51.12,1585.66,57
HCPCS,95908,"Nerve conduction, 3-4 studies",602.0,391.3,64.19,2375.9,57
HCPCS,95909,"Nerve conduction, 5-6 studies",843.45,548.245,76.65,3168.73,57
HCPCS,95910,"Nerve conduction, 7-8 studies",1069.95,695.47,78.57,3961.56,57
HCPCS,95911,"Nerve conduction, 9-10 studies",1287.0,836.55,78.57,4751.8,57
HCPCS,95912,"Nerve conduction, 11-12 studies",1503.5,977.275,78.57,5544.63,57
HCPCS,95913,"Nerve conduction, 13 or more studies",1726.5,1122.225,78.57,6334.87,57
HCPCS,95919,Measurement of pupil with healthcare professional interpretation and report,23.0,14.95,9.53,78.57,19
HCPCS,95921,Testing of autonomic nervous system function and heart rate response to deep breathing,310.6,201.89,42.41,1279.0,38
HCPCS,95922,"Testing of autonomic (sympathetic) nervous system function, heart rate response to breathing exercises, and passive tilt",275.25,178.915,43.98,1279.0,38
HCPCS,95923,Testing of autonomic (sympathetic) nervous system function,480.9,312.59,41.92,1926.55,57
HCPCS,95924,"Testing of autonomic (sympathetic and parasympathetic) nervous system function, at least 5 minutes of tilt",616.6,400.78999999999996,78.57,1926.55,38
HCPCS,95925,Placement of skin electrodes and measurement of stimulated sites in arms,757.1,492.115,26.1,2546.35,38
HCPCS,95926,Placement of skin electrodes and measurement of stimulated sites in legs,772.15,501.9,25.05,2670.31,38
HCPCS,95927,Placement of skin electrodes and measurement of stimulated sites in trunk or head,452.6,294.19,25.97,160.04,19
HCPCS,95928,Placement of skin electrodes and measurement of central motor stimulation in arms,592.2,384.93,75.55,207.73,19
HCPCS,95929,Placement of skin electrodes and measurement of central motor stimulation in legs,605.9,393.84,74.93,207.34,19
HCPCS,95930,Measurement of nerve conduction using visual stimulation testing with report,492.55,320.15999999999997,17.34,1291.25,76
HCPCS,95933,Measurement of nerve conduction patterns of eye blink reflex,338.75,220.19,30.23,1128.55,57
HCPCS,95937,Testing of nerve-muscle junction,349.25,227.015,32.52,1291.25,57
HCPCS,95938,Placement of skin electrodes and measurement of stimulated sites on arms and legs,849.96,552.4749999999999,43.05,2231.59,38
HCPCS,95939,Placement of skin electrodes and measurement of central motor stimulation in arms and legs,858.95,558.3199999999999,78.57,1459.11,38
HCPCS,95940,"Continuous monitoring of nervous system during operation, each 15 minutes",107.1,69.62,25.66,110.31,19
HCPCS,95954,Measurement of brain wave activity (EEG) with drug or activity stimulation,953.4,619.71,78.57,301.43,19
HCPCS,95955,Measurement of brain wave activity (EEG) outside the brain during surgery,500.8,325.52,50.81,1360.98,38
HCPCS,95957,"Measurement of brain wave activity (EEG), digital analysis",1191.8,774.67,78.57,268.74,19
HCPCS,95958,Measurement of brain wave activity (EEG) in specific area of brain,2600.95,1690.6200000000001,78.57,9699.87,57
HCPCS,95961,"Measurement of brain wave activity (EEG) with electrodes on brain to provoke seizures or identify brain structures, first hour",2031.0,1320.15,78.57,8537.75,38
HCPCS,95962,"Measurement of brain wave activity (EEG) with electrodes on brain to provoke seizures or identify brain structures, each additional hour",635.3,412.95,78.57,449.87,19
HCPCS,95965,Measurement of brain magnetic field for spontaneous brain magnetic activity,10147.0,6595.55,78.57,41136.64,38
HCPCS,95966,"Measurement of brain externally evoked magnetic field, single localization",4954.5,3220.425,78.57,19908.49,38
HCPCS,95967,"Measurement of brain externally evoked magnetic field, each additional localization",4399.5,2859.675,78.57,19908.49,38
HCPCS,95970,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator",172.11,111.875,0.01,514.74,36
HCPCS,95971,Electronic analysis of implanted neurostimulator generator with simple spinal cord or peripheral nerve stimulator programming,140.9,91.585,0.01,307.32,36
HCPCS,95972,Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming,321.5,208.975,0.01,847.06,131
HCPCS,95976,Electronic analysis of neurostimulator generator with simple cranial nerve stimulator programming,85.5,55.575,0.01,784.0,55
HCPCS,95977,Electronic analysis of implanted neurostimulator generator with complex cranial nerve stimulator programming,181.5,117.975,0.01,784.0,55
HCPCS,95980,Electronic analysis of implanted gastric neurostimulator generator during surgery with programming,108.3,70.4,36.78,112.11,19
HCPCS,95981,Electronic analysis of implanted gastric neurostimulator generator,74.65,48.52,11.62,92.23,19
HCPCS,95983,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, first 15 minutes with qualified health professional",97.5,63.375,0.01,784.0,55
HCPCS,95984,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, each additional 15 minutes with qualified health professional",90.5,58.825,0.01,784.0,55
HCPCS,95990,Maintenance of spinal canal or brain drug infusion pump,501.45,325.94500000000005,36.56,2164.14,38
HCPCS,95991,Maintenance of spinal canal or brain drug infusion pump by health care professional,248.1,161.265,0.01,2054.0,131
HCPCS,95992,"Repositioning exercises of head for treatment of dizziness, each day",172.0,111.8,0.01,516.5,55
HCPCS,96000,"Test to evaluate gait using 3D, video, and computer technology",264.6,171.99,68.67,244.21,19
HCPCS,96001,"Test to evaluate gait using 3D, video, and computer technology with measurement of foot pressure distribution",315.0,204.75,78.57,311.71,19
HCPCS,96002,Test of electrical activity of 1-12 muscles during functional activities,203.65,132.375,17.13,821.24,38
HCPCS,96004,Physician review of gait analysis test,333.9,217.04,78.57,292.72,19
HCPCS,96020,Test of neurological function during functional MRI,470.55,305.86,78.57,1071.74,38
HCPCS,96041,"Counseling for genetic testing provided by a genetic counselor, each 30 minutes of total time on the date of encounter",185.0,120.25,46.25,477.76,51
HCPCS,96105,"Test to assess the loss of the ability to speak, write, and understand language",298.65,194.125,59.25,930.47,38
HCPCS,96110,Developmental screening,74.88,48.675,8.57,866.51,34
HCPCS,96112,"Administration of developmental test, first hour",342.0,222.3,68.55,968.44,38
HCPCS,96113,"Administration of developmental test, each additional 30 minutes",133.0,86.45,31.25,866.51,38
HCPCS,96116,"Exam of neurobehavioral status, first hour",380.0,247.0,70.28,1420.38,76
HCPCS,96121,"Exam of neurobehavioral status, each additional hour",270.5,175.825,60.94,903.88,36
HCPCS,96125,Test to assess the ability to complete specific functional tasks applicable to environment,279.225,181.495,70.25,866.51,38
HCPCS,96127,Assessment of emotional or behavioral problems,46.3,30.095,4.44,476.0,38
HCPCS,96130,"Evaluation of psychological test, first hour",322.5,209.625,78.57,968.44,38
HCPCS,96131,"Evaluation of psychological test, each additional hour",228.0,148.2,62.5,866.51,38
HCPCS,96132,"Evaluation of neuropsychological test, first hour",422.5,274.625,78.57,1497.85,57
HCPCS,96133,"Evaluation of neuropsychological test, each additional hour",276.5,179.725,68.55,903.88,38
HCPCS,96136,"Administration of psychological or neuropsychological test, first 30 minutes",305.0,198.25,20.78,1420.38,38
HCPCS,96137,"Administration of psychological or neuropsychological test, each additional 30 minutes",149.0,96.85,16.29,866.51,38
HCPCS,96138,"Administration of psychological or neuropsychological test by technician, first 30 minutes",319.0,207.35,34.65,1420.38,38
HCPCS,96139,"Administration of psychological or neuropsychological test by technician, each additional 30 minutes",182.5,118.625,31.99,866.51,38
HCPCS,96146,Administration of psychological or neuropsychological test by single standardized instrument via electronic platform with automated result,127.5,82.875,1.98,866.51,38
HCPCS,96156,Assessment of health behavior,199.75,129.84,40.0,476.0,38
HCPCS,96158,"Treatment of behavior impacting health, initial 30 minutes",242.125,157.38,59.27,826.4,38
HCPCS,96159,"Treatment of behavior impacting health, each additional 15 minutes",108.625,70.605,20.27,476.0,36
HCPCS,96160,Administration and interpretation of patient-focused health risk assessment,67.8,44.07,2.77,476.0,34
HCPCS,96161,Administration and interpretation of caregiver-focused health risk assessment,10.6,6.89,3.08,78.57,19
HCPCS,96164,"Treatment of behavior impacting health in group setting, initial 30 minutes",39.625,25.755,9.07,349.54,36
HCPCS,96165,"Treatment of behavior impacting health in group setting, each additional 15 minutes",18.25,11.865,3.98,78.57,34
HCPCS,96167,"Treatment of behavior impacting health with family and patient, initial 30 minutes",143.0,92.95,56.1,284.08,35
HCPCS,96168,"Treatment of behavior impacting health with family and patient, each additional 30 minutes",58.75,38.19,22.4,142.04,33
HCPCS,96170,"Treatment of behavior impacting health with family, initial 30 minutes",170.0,110.5,56.1,284.08,31
HCPCS,96171,"Treatment of behavior impacting health with family, each additional 30 minutes",70.0,45.5,24.75,142.04,29
HCPCS,96202,"Multiple-family group behavior management/modification training, face-to-face, initial 60 minutes",49.5,32.18,16.95,78.57,19
HCPCS,96360,"Infusion into a vein for hydration, 31-60 minutes",625.0,406.25,31.08,1665.71,57
HCPCS,96361,"Infusion into a vein for hydration, each additional hour",170.0,110.5,11.42,1019.0,57
HCPCS,96365,"Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less",407.55,264.90999999999997,48.44,1614.06,76
HCPCS,96366,"Infusion into a vein for therapy, prevention, or diagnosis, each additional hour",115.0,74.75,15.53,1019.0,57
HCPCS,96367,"Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less",188.0,122.2,25.13,1019.0,57
HCPCS,96368,"Infusion into a vein for therapy, prevention, or diagnosis concurrent with another infusion",105.0,68.25,13.71,1019.0,57
HCPCS,96369,"Infusion into tissue for therapy or prevention, 1 hour or less",428.20000000000005,278.33,78.57,1137.85,38
HCPCS,96370,"Infusion into tissue for therapy or prevention, each additional hour",66.625,43.31,16.0,1019.0,38
HCPCS,96371,Establishment of new infusion site into tissue with pump set up,174.825,113.63499999999999,35.16,1019.0,38
HCPCS,96372,Injection of drug or substance under skin or into muscle,142.5,92.625,14.44,1019.0,57
HCPCS,96373,Injection of drug or substance into artery,190.0,123.5,12.79,1291.25,75
HCPCS,96374,Injection of drug or substance into vein,325.0,211.25,34.94,1291.25,57
HCPCS,96375,Injection of additional new drug or substance into vein,107.0,69.55,14.56,1019.0,57
HCPCS,96376,Injection of additional drug or substance into vein provided in a facility,105.0,68.25,9.06,1019.0,53
HCPCS,96377,Application of on-body injector for under skin injection,71.0,46.15,12.92,2166.29,37
HCPCS,96379,"Injection or infusion into a vein or artery for therapy, prevention, or diagnosis",248.0,161.2,62.0,1019.0,55
HCPCS,96380,"Administration of seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional",80.0,52.0,14.62,206.6,53
HCPCS,96381,"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection",80.0,52.0,12.79,206.6,53
HCPCS,96401,Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle,437.0,284.05,0.01,2054.0,55
HCPCS,96402,Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle,368.55,239.56,27.42,2054.0,57
HCPCS,96405,"Administration of chemotherapy into growth, 1-7",181.35,117.88,13.01,2054.0,76
HCPCS,96406,"Administration of chemotherapy into growth, more than 7",358.825,233.235,0.01,2054.0,55
HCPCS,96409,Administration of chemotherapy into vein using push technique,466.65,303.325,67.35,2054.0,38
HCPCS,96411,Administration of additional new drug or substance into vein using push technique,430.0,279.5,41.13,2054.0,57
HCPCS,96413,"Administration of chemotherapy into vein, 1 hour or less",880.0,572.0,78.57,2840.75,76
HCPCS,96415,"Administration of chemotherapy into vein, each additional hour",202.0,131.3,26.33,2054.0,76
HCPCS,96416,Administration of prolonged chemotherapy into vein,834.0,542.1,78.57,2951.8,57
HCPCS,96417,"Administration of additional new drug or substance into vein, 1 hour or less",505.0,328.25,61.34,2054.0,57
HCPCS,96420,Administration of chemotherapy into artery using push technique,562.1,365.365,33.36,2135.73,38
HCPCS,96422,"Administration of chemotherapy into artery, 1 hour or less",430.5,279.83,68.55,430.5,19
HCPCS,96423,"Administration of chemotherapy into artery, each additional hour",245.7,159.71,34.27,245.7,19
HCPCS,96425,Administration of prolonged chemotherapy into artery,563.9,366.54,78.57,563.9,19
HCPCS,96440,Administration of chemotherapy into chest cavity,1742.0,1132.3,78.57,1793.43,19
HCPCS,96446,Administration of chemotherapy into abdominal cavity,1008.9,655.7850000000001,16.34,4082.93,76
HCPCS,96450,Administration of chemotherapy into fluid-filled space between the tissue that cover the brain and spinal cord,725.0,471.25,19.61,2066.0,56
HCPCS,96521,Refilling and maintenance of portable pump,600.4,390.26,67.35,2200.29,38
HCPCS,96522,Refilling and maintenance of implantable pump or reservoir for drug delivery,387.05,251.58499999999998,67.35,2054.0,38
HCPCS,96523,Irrigation of implanted venous access drug delivery device,341.7,222.105,20.56,1583.07,57
HCPCS,96542,Injection of chemotherapy via reservoir under skin,709.0,460.85,31.19,2306.17,38
HCPCS,96547,"Intraoperative heated intraperitoneal chemotherapy, first 60 minutes",1200.0,780.0,78.57,1726.16,19
HCPCS,96548,"Intraoperative heated intraperitoneal chemotherapy, each additional 30 minutes",800.0,520.0,78.57,863.08,19
HCPCS,96549,Other chemotherapy procedure,207.0,134.55,34.25,4062.27,56
HCPCS,96567,Application of light to destroy precancer skin growth,357.2,232.18,68.09,903.88,38
HCPCS,96570,"Application of light to destroy precancer skin growth using an endoscope, initial 30 minutes",132.1,85.87,43.92,138.39,19
HCPCS,96573,Application of light by qualified health care professional to destroy precancer skin growth,410.0,266.5,78.57,903.88,38
HCPCS,96574,Application of light with debridement to destroy precancer skin growth,350.0,227.5,87.5,903.88,19
HCPCS,96900,Application of ultraviolet light to skin,58.165,37.81,0.01,164.84,36
HCPCS,96902,Exam of hair using microscope to detect shaft abnormality,83.75,54.44,0.01,142.04,32
HCPCS,96904,Photograph of entire body,275.0,178.75,0.01,761.84,34
HCPCS,96910,Therapy procedure using ultraviolet radiation with tar or petroleum jelly application,121.65,79.075,0.01,301.93,36
HCPCS,96912,Therapy procedure using ultraviolet radiation,146.3,95.095,0.01,256.17,36
HCPCS,96913,"Therapy procedure using ultraviolet radiation, 4-8 hours",310.0,201.5,0.01,800.58,17
HCPCS,96920,"Treatment of inflammatory skin disease using laser, less than 250.0 sq cm",180.0,117.0,0.01,623.98,17
HCPCS,96921,"Treatment of inflammatory skin disease using laser, 250.0-500.0 sq cm",180.0,117.0,0.01,623.98,17
HCPCS,96922,"Treatment of inflammatory skin disease using laser, more than 500.0 sq cm",320.0,208.0,0.01,826.4,17
HCPCS,96999,Other special service or procedure on skin,337.5,219.375,33.75,3099.0,306
HCPCS,97007,"MECHANICAL SCALP COOLING, INCLUDING INDIVIDUAL CAP SUPPLY WITH HEAD MEASUREMENT, FITTING, AND PATIENT EDUCATION",3630.0,2359.5,208.0,9374.48,17
HCPCS,97008,"MECHANICAL SCALP COOLING; INCLUDING HAIR PREPARATION, INDIVIDUAL CAP PLACEMENT, THERAPY INITIATION, AND PRECOOLING PERIOD",50.0,32.5,12.5,208.0,17
HCPCS,97009,"MECHANICAL SCALP COOLING; PROVIDED AFTER DISCONTINUATION OF CHEMOTHERAPY, EACH 30 MINUTES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",25.0,16.25,6.25,208.0,17
HCPCS,97010,Application of hot or cold packs,25.0,16.25,4.96,78.57,15
HCPCS,97012,Application of mechanical traction,122.05,79.33500000000001,11.75,516.5,38
HCPCS,97014,Application of electrical stimulation,52.5,34.13,10.0,78.57,15
HCPCS,97016,Application of blood vessel compression device,44.5,28.925,9.47,277.0,38
HCPCS,97018,Application of hot wax bath,26.0,16.9,4.44,277.0,38
HCPCS,97022,Application of whirlpool therapy,55.5,36.08,12.25,413.2,57
HCPCS,97028,Application of ultraviolet light,18.9,12.29,6.59,78.57,19
HCPCS,97032,"Application of electrical stimulation with therapist present, each 15 minutes",104.7,68.055,11.75,516.5,76
HCPCS,97033,"Application of medication using electrical current, each 15 minutes",107.0,69.55,15.98,413.2,57
HCPCS,97035,"Application of ultrasound, each 15 minutes",160.0,104.0,11.65,516.5,57
HCPCS,97036,"Application of water therapy using a special tank, each 15 minutes",80.9,52.59,25.13,93.12,19
HCPCS,97110,"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",127.5,82.875,22.85,516.5,114
HCPCS,97112,"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes",134.6,87.49000000000001,22.85,516.5,95
HCPCS,97113,"Therapy procedure using water pool to exercises, each 15 minutes",121.0,78.65,20.56,413.2,57
HCPCS,97116,"Therapy procedure for walking training, each 15 minutes",138.6,90.09,18.28,516.5,57
HCPCS,97124,"Therapy procedure using massage, each 15 minutes",23.07,15.0,5.75,277.0,114
HCPCS,97129,"Therapy procedure for a range of mental processes, initial 15 minutes",109.5,71.175,18.68,413.2,76
HCPCS,97130,"Therapy procedure for a range of mental processes, each additional 15 minutes",108.125,70.28,17.85,413.2,76
HCPCS,97140,"Therapy procedure using manual technique, each 15 minutes",160.0,104.0,22.19,516.5,95
HCPCS,97150,Therapy procedure in a group setting,63.395,41.205,14.25,277.0,57
HCPCS,97151,"Behavior identification assessment by professional, each 15 minutes",80.0,52.0,20.0,206.6,17
HCPCS,97152,"Behavior identification assessment by technician, each 15 minutes",80.0,52.0,20.0,206.6,17
HCPCS,97153,"Adaptive behavior treatment by technician using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
HCPCS,97154,"Adaptive behavior treatment by technician with multiple patients using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
HCPCS,97155,"Adaptive behavior treatment by professional using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
HCPCS,97156,"Adaptive behavior treatment by professional with family using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
HCPCS,97157,"Adaptive behavior treatment by professional with multiple family group members using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
HCPCS,97158,"Adaptive behavior treatment by professional with group using an established plan, each 15 minutes",80.0,52.0,20.0,206.6,17
HCPCS,97161,"Evaluation for physical therapy, typically 20 minutes",240.0,156.0,60.0,671.45,76
HCPCS,97162,"Evaluation for physical therapy, typically 30 minutes",240.0,156.0,60.0,671.45,76
HCPCS,97163,"Evaluation for physical therapy, typically 45 minutes",240.65,156.42,60.0,671.45,76
HCPCS,97164,"Re-evaluation for physical therapy, typically 20 minutes",176.0,114.4,44.0,516.5,76
HCPCS,97165,"Evaluation for occupational therapy, typically 30 minutes",209.5,136.175,58.5,604.31,76
HCPCS,97166,"Evaluation for occupational therapy, typically 45 minutes",222.0,144.3,58.5,604.31,76
HCPCS,97167,"Evaluation for occupational therapy, typically 1 hour",234.5,152.425,58.5,604.31,76
HCPCS,97168,"Re-evaluation for occupational therapy, typically 30 minutes",140.625,91.405,39.75,410.62,57
HCPCS,97530,Therapy procedure using functional activities,142.5,92.625,22.85,516.5,133
HCPCS,97533,Therapy procedure using sensory experiences,78.8,51.22,50.98,164.65,19
HCPCS,97535,"Training for self-care or home management, each 15 minutes",125.15,81.35,26.72,413.2,95
HCPCS,97537,"Training for community or work reintegration, each 15 minutes",85.45,55.545,22.25,277.0,76
HCPCS,97542,"Evaluation for wheelchair, each 15 minutes",89.8,58.37,26.0,277.0,76
HCPCS,97597,"Removal of tissue from wound, 20.0 sq cm or less",280.0,182.0,0.01,2166.29,93
HCPCS,97598,"Removal of tissue from wound, each additional 20.0 sq cm",148.5,96.525,20.21,1507.02,57
HCPCS,97602,Removal of tissue from wound gradually,150.0,97.5,0.01,1052.0,127
HCPCS,97605,"Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less",400.0,260.0,0.01,1187.95,92
HCPCS,97606,"Therapy procedure using a special bandage and vacuum pump, surface area more than 50.0 sq cm",470.0,305.5,0.01,1807.75,74
HCPCS,97607,"Therapy procedure using a special bandage, vacuum pump and disposable medical equipment, surface area 50.0 sq cm or less",898.0,583.7,17.2,2360.41,56
HCPCS,97608,"Therapy procedure using a special bandage, vacuum pump and disposable medical equipment, surface area more than 50.0 sq cm",639.675,415.79,19.74,2360.41,37
HCPCS,97610,Therapy procedure using ultrasound,393.125,255.53,15.0,1309.33,38
HCPCS,97750,"Test or measurement for functional capacity, each 15 minutes",102.1,66.36500000000001,27.51,299.57,114
HCPCS,97760,"Training in the use of orthopedic device for arm, leg and/or trunk, each 15 minutes",116.0,75.4,29.0,413.2,95
HCPCS,97761,"Training in the use of artificial arm and/or leg, each 15 minutes",95.6,62.14,21.93,277.0,57
HCPCS,97763,"Follow-up training in the use of orthopedic device or artificial arm, leg and/or trunk, each 15 minutes",124.0,80.6,31.0,320.23,38
HCPCS,97799,Other physical medicine or rehabilitation service or procedure,112.5,73.125,18.75,387.38,76
HCPCS,97802,"Therapy procedure for nutrition management, each 15 minutes",83.6,54.34,20.0,295.67,152
HCPCS,97803,"Therapy procedure reassessment for nutrition management, each 15 minutes",69.35,45.08,15.5,295.67,152
HCPCS,97804,"Therapy procedure for nutrition management with group, each 30 minutes",35.95,23.369999999999997,8.25,295.67,57
HCPCS,97810,"Acupuncture, initial 15 minutes",65.0,42.25,0.01,142.04,36
HCPCS,97811,"Acupuncture, each additional 15 minutes",45.0,29.25,0.01,78.57,36
HCPCS,97813,"Acupuncture with electrical stimulation, initial 15 minutes",70.0,45.5,0.01,142.04,36
HCPCS,97814,"Acupuncture with electrical stimulation, each additional 15 minutes",62.5,40.625,0.01,142.04,36
HCPCS,98000,"New patient synchronous audio-video visit with straightforward medical decision making, if using time 15 minutes or more",200.0,130.0,43.41,129.36,15
HCPCS,98001,"New patient synchronous audio-video visit with low medical decision making, if using time 30 minutes or more",300.0,195.0,63.98,212.86,15
HCPCS,98002,"New patient synchronous audio-video visit with moderate medical decision making, if using time 45 minutes or more",450.0,292.5,78.57,339.76,15
HCPCS,98003,"New patient synchronous audio-video visit with high medical decision making, if using time 60 minutes or more",600.0,390.0,78.57,453.85,15
HCPCS,98004,"Established patient synchronous audio-video visit with straightforward medical decision making, if using time 10 minutes or more",150.0,97.5,27.42,99.74,15
HCPCS,98005,"Established patient synchronous audio-video visit with low medical decision making, if using time 20 minutes or more",250.0,162.5,41.13,174.92,15
HCPCS,98006,"Established patient synchronous audio-video visit with moderate medical decision making, if using time 30 minutes or more",350.0,227.5,61.69,256.65,15
HCPCS,98007,"Established patient synchronous audio-video visit with high medical decision making, if using time 40 minutes or more",500.0,325.0,78.57,341.38,15
HCPCS,98008,"New patient synchronous audio-only visit with straightforward medical decision making and 10 minutes or more of medical discussion, if using time 15 minutes or more",200.0,130.0,78.57,206.0,15
HCPCS,98009,"New patient synchronous audio-only visit with low medical decision making and 10 minutes or more of medical discussion, if using time 30 minutes or more",300.0,195.0,78.57,309.0,15
HCPCS,98010,"New patient synchronous audio-only visit with moderate medical decision making and 10 minutes or more of medical discussion, if using time 45 minutes or more",450.0,292.5,78.57,463.5,15
HCPCS,98011,"New patient synchronous audio-only visit with high medical decision making and 10 minutes or more of medical discussion, if using time 60 minutes or more",600.0,390.0,78.57,618.0,15
HCPCS,98012,"Established patient synchronous audio-only visit with straightforward medical decision making and 10 minutes or more of medical discussion, if using time 10 minutes or more",150.0,97.5,46.33,91.24,15
HCPCS,98013,"Established patient synchronous audio-only visit with low medical decision making and 10 minutes or more of medical discussion, if using time 20 minutes or more",250.0,162.5,71.44,160.09,15
HCPCS,98014,"Established patient synchronous audio-only visit with moderate medical decision making and 10 minutes or more of medical discussion, if using time 30 minutes or more",350.0,227.5,78.57,232.36,15
HCPCS,98015,"Established patient synchronous audio-only visit with high medical decision making and 10 minutes or more of medical discussion, if using time 40 minutes or more",500.0,325.0,78.57,338.94,15
HCPCS,98016,Established patient brief communication technology-based service with 5-10 minutes of medical discussion,45.0,29.25,12.43,78.57,38
HCPCS,98925,"Osteopathic manipulative treatment, 1-2 body regions",74.6,48.49,18.8,78.57,19
HCPCS,98926,"Osteopathic manipulative treatment, 3-4 body regions",110.3,71.7,28.48,111.18,19
HCPCS,98927,"Osteopathic manipulative treatment, 5-6 body regions",145.0,94.25,38.32,144.77,19
HCPCS,98928,"Osteopathic manipulative treatment, 7-8 body regions",178.4,115.96,48.0,177.46,19
HCPCS,98929,"Osteopathic manipulative treatment, 9-10 body regions",200.0,130.0,57.25,208.87,19
HCPCS,98960,"Education and training for patient self-management, each 30 minutes",60.6,39.39,13.75,273.0,34
HCPCS,98961,"Education and training for patient self-management, 2-4 patients, each 30 minutes",48.3,31.4,19.29,78.57,15
HCPCS,98962,"Education and training for patient self-management, 5-8 patients, each 30 minutes",51.5,33.48,14.37,78.57,15
HCPCS,98966,"Telephone discussion provided to an established patient by nonphysician professional, 5-10 minutes",37.5,24.375,10.0,208.0,36
HCPCS,98967,"Telephone discussion provided to an established patient by nonphysician professional, 11-20 minutes",72.5,47.125,18.75,208.0,36
HCPCS,98968,"Telephone discussion provided to an established patient by nonphysician professional, 21-30 minutes",107.5,69.875,27.5,284.08,38
HCPCS,98970,"Online digital evaluation and management service provided to an established patient by nonphysician professional for up to 7 days, total time 5-10 minutes",30.0,19.5,10.02,78.57,19
HCPCS,98971,"Online digital evaluation and management service provided to an established patient by nonphysician professional for up to 7 days, total time 11-20 minutes",60.0,39.0,18.34,78.57,19
HCPCS,98972,"Online digital evaluation and management service provided to an established patient by nonphysician professional for up to 7 days, total time 21 minutes or more",90.0,58.5,28.05,92.7,19
HCPCS,98975,Set-up and patient education on use of equipment for remote therapeutic monitoring,42.0,27.3,19.67,78.57,19
HCPCS,98976,"Device supply for data access or data transmissions to support monitoring of respiratory system, each 30 days",122.0,79.3,47.91,125.66,19
HCPCS,98977,"Device supply for data access or data transmissions to support monitoring of musculoskeletal system, each 30 days",122.0,79.3,47.29,125.66,19
HCPCS,98980,"Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, first 20 minutes per calendar month",72.0,46.8,24.79,121.05,19
HCPCS,98981,"Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, each additional 20 minutes per calendar month",71.0,46.15,24.45,97.4,19
HCPCS,99000,Handling and/or conveyance of specimen for transfer from physician office to laboratory,20.0,13.0,2.93,78.57,15
HCPCS,99001,Handling and/or conveyance of specimen for transfer to a laboratory,63.0,40.95,3.5,78.57,15
HCPCS,99002,Handling and/or conveyance of device when created by an outside laboratory or specialty service,262.5,170.63,6.47,270.38,15
HCPCS,99050,Service provided in the office when the office is normally closed,64.1,41.67,17.47,78.57,15
HCPCS,99058,Service provided on an emergency basis in the office,86.1,55.97,20.38,88.68,15
HCPCS,99070,PR SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP,9.5,6.18,4.28,80.89,15
HCPCS,99071,Provision of educational material by physician,5.3,3.45,2.39,80.89,15
HCPCS,99075,Medical testimony,393.8,255.97,73.6,405.61,15
HCPCS,99078,Education provided in a group setting,10.5,6.83,4.73,80.89,15
HCPCS,99080,Preparation of special reports beyond what is found in the medical record,31.5,20.48,14.18,80.89,15
HCPCS,99091,"Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 ",996.22,647.545,50.0,4628.98,76
HCPCS,99100,Age complicating anesthesia (younger than 1 year and older than 70 years),92.4,60.06,41.58,95.17,15
HCPCS,99116,Use of low body temperature complicating anesthesia,92.4,60.06,41.58,95.17,15
HCPCS,99135,Use of low blood pressure complicating anesthesia,92.4,60.06,41.58,95.17,15
HCPCS,99140,Emergency condition complicating anesthesia,92.4,60.06,41.58,95.17,15
HCPCS,99151,"Use of a drug to induce depression of consciousness by physician performing a procedure (younger than 5 years), initial 15 minutes",549.0,356.85,0.01,2525.69,54
HCPCS,99152,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",410.0,266.5,0.01,1807.75,71
HCPCS,99153,"Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes",123.0,79.95,0.01,506.17,71
HCPCS,99155,"Use of a drug to induce depression of consciousness by physician not performing a procedure (younger than 5 years), initial 15 minutes",601.5,390.975,33.12,2525.69,37
HCPCS,99156,"Use of a drug to induce depression of consciousness by physician not performing a procedure (5 years or older), initial 15 minutes",601.5,390.975,33.12,2525.69,37
HCPCS,99157,"Use of a drug to induce depression of consciousness by physician not performing a procedure, each additional 15 minutes",183.0,118.95,27.42,506.17,37
HCPCS,99172,Screening of visual function,58.9,38.285,3.23,208.0,32
HCPCS,99173,Screening for visual sharpness,27.15,17.65,2.28,208.0,32
HCPCS,99175,Administration of medication to induce vomiting,126.0,81.9,31.99,105.02,19
HCPCS,99183,Management of oxygen chamber therapy,480.7,312.46,38.06,281.93,19
HCPCS,99184,Treatment by lowering head or total body temperature in neonate,582.8,378.82,78.57,588.39,19
HCPCS,99188,Application of topical fluoride,47.9,31.14,21.56,78.57,15
HCPCS,99195,Drawing of blood for a medical problem,256.3,166.595,22.85,805.74,57
HCPCS,99202,"New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more",200.0,130.0,0.01,1052.0,68
HCPCS,99203,"New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more",260.0,169.0,0.01,1052.0,64
HCPCS,99204,"New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more",320.0,208.0,0.01,1052.0,64
HCPCS,99205,"New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more",440.0,286.0,0.01,1136.3,47
HCPCS,99211,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,120.0,78.0,0.01,1974.0,387
HCPCS,99212,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",147.5,95.875,0.01,1052.0,132
HCPCS,99213,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",220.0,143.0,0.01,1052.0,164
HCPCS,99214,"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more",310.0,201.5,0.01,1052.0,115
HCPCS,99215,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",345.0,224.25,0.01,1052.0,149
HCPCS,99221,"Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes",240.0,156.0,57.12,254.6,19
HCPCS,99222,"Initial hospital inpatient or observation care with moderate level of medical decision making. If using time, 55 minutes or more",300.0,195.0,78.57,352.89,19
HCPCS,99223,"Initial hospital inpatient or observation care with high level of medical decision making, if using time, 75 minutes or more",500.0,325.0,78.57,513.29,19
HCPCS,99231,"Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes",120.0,78.0,34.27,133.11,19
HCPCS,99232,"Subsequent hospital inpatient or observation care with moderate level of medical decision making, if using time, 35 minutes or more",170.0,110.5,54.84,214.93,19
HCPCS,99233,"Subsequent hospital inpatient or observation care with high level of medical decision making, if using time, 50 minutes or more",230.0,149.5,78.57,322.23,19
HCPCS,99234,"Hospital inpatient or observation care with admission and discharge on the same date with straightforward or low level of medical decision making, if using time, 45 minutes or more",300.0,195.0,78.57,336.97,19
HCPCS,99235,"Hospital inpatient or observation care with admission and discharge on the same date with moderate level of medical decision making, if using time, 70 minutes or more",400.0,260.0,78.57,431.53,19
HCPCS,99236,"Hospital inpatient or observation care with admission and discharge on the same date with high level of medical decision making, if using time, 85 minutes or more",500.0,325.0,78.57,563.65,19
HCPCS,99238,"Hospital inpatient or observation discharge day management, 30 minutes or less",170.0,110.5,70.73,220.14,19
HCPCS,99239,"Hospital inpatient or observation discharge day management, more than 30 minutes",250.0,162.5,78.57,311.91,19
HCPCS,99281,Emergency department visit for problem that may not require health care professional,235.0,152.75,10.27,1974.0,53
HCPCS,99282,Emergency department visit with straightforward medical decision making,360.0,234.0,37.69,1974.0,53
HCPCS,99283,Emergency department visit with low level of medical decision making,590.0,383.5,64.6,2582.5,53
HCPCS,99284,Emergency department visit with moderate level of medical decision making,912.5,593.125,78.57,3873.75,53
HCPCS,99285,Emergency department visit with high level of medical decision making,1400.0,910.0,78.57,5939.75,53
HCPCS,99288,Physician direction of emergency advanced life support paramedic services,367.5,238.88,73.6,378.53,15
HCPCS,99291,"Critical care, first 30-74 minutes",1512.5,983.125,78.57,6456.25,36
HCPCS,99292,"Critical care, each additional 30 minutes",487.5,316.875,78.57,5261.0,36
HCPCS,99304,"Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes",180.0,117.0,60.94,228.32,19
HCPCS,99305,"Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes",270.05,175.53,78.57,363.66,19
HCPCS,99306,"Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more",350.0,227.5,78.57,497.07,19
HCPCS,99307,"Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes",89.74,58.33,33.24,111.57,19
HCPCS,99308,"Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more",149.94,97.46,52.63,203.11,19
HCPCS,99309,"Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes",209.64,136.27,72.02,294.07,19
HCPCS,99310,"Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes",359.68,233.79,78.57,418.82,19
HCPCS,99315,"Nursing facility discharge day management, 30 minutes or less",175.0,113.75,69.74,222.21,19
HCPCS,99316,"Nursing facility discharge management, more than 30 minutes",275.0,178.75,78.57,356.52,19
HCPCS,99341,"Residence visit for new patient with straightforward medical decision making, per day, if using time, at least 15 minutes",125.0,81.25,47.16,140.44,19
HCPCS,99342,"Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes",200.0,130.0,69.25,217.21,19
HCPCS,99344,"Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes",440.0,286.0,78.57,463.27,19
HCPCS,99345,"Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes",450.0,292.5,78.57,563.1,19
HCPCS,99347,"Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes",125.0,81.25,44.13,140.36,19
HCPCS,99348,"Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes",175.0,113.75,60.94,213.4,19
HCPCS,99349,"Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes",275.0,178.75,78.57,347.17,19
HCPCS,99350,"Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes",450.0,292.5,78.57,504.38,19
HCPCS,99358,"Extended patient service without direct patient contact, first hour",280.0,182.0,78.57,288.4,15
HCPCS,99359,"Extended patient service without direct patient contact, each additional 30 minutes",140.0,91.0,63.0,144.2,15
HCPCS,99360,"Extended physician standby service, each 30 minutes",200.0,130.0,68.55,159.94,15
HCPCS,99366,"Medical team conference with patient and/or family, and nonphysician health care professionals, 30 minutes or more",106.1,68.97,47.75,109.28,15
HCPCS,99367,"Medical team conference with physician, 30 minutes or more",161.7,105.11,72.77,166.55,15
HCPCS,99374,"Physician supervision of patient home health agency services per month, 15-29 minutes",200.0,130.0,78.57,206.0,15
HCPCS,99375,"Physician supervision of patient home health agency services per month, 30 minutes or more",270.0,175.5,78.57,278.1,15
HCPCS,99377,"Physician supervision of patient hospice services per month, 15-29 minutes",199.5,129.68,78.57,205.49,15
HCPCS,99378,"Physician supervision of patient hospice services per month, 30 minutes or more",344.4,223.86,78.57,354.73,15
HCPCS,99379,"Supervision of nursing facility patient services per month, 15-29 minutes",190.0,123.5,78.57,195.7,15
HCPCS,99380,"Supervision of nursing facility patient services per month, 30 minutes or more",220.0,143.0,78.57,250.41,15
HCPCS,99381,Initial new patient preventive medicine evaluation (younger than 1 year),270.0,175.5,78.57,280.66,15
HCPCS,99382,Initial new patient preventive medicine evaluation (1-4 years),280.0,182.0,78.57,293.38,15
HCPCS,99383,Initial new patient preventive medicine evaluation (5-11 years),300.0,195.0,78.57,309.0,15
HCPCS,99384,Initial new patient preventive medicine evaluation (12-17 years),340.0,221.0,78.57,350.2,15
HCPCS,99385,Initial new patient preventive medicine evaluation (18-39 years),300.0,195.0,78.57,333.87,15
HCPCS,99386,Initial new patient preventive medicine evaluation (40-64 years),350.0,227.5,78.57,385.29,15
HCPCS,99387,Initial new patient preventive medicine evaluation (65 years or older),380.0,247.0,78.57,418.01,15
HCPCS,99391,Established patient periodic preventive medicine examination (younger than 1 year),250.0,162.5,78.57,257.5,15
HCPCS,99392,Established patient periodic preventive medicine examination (1-4 years),260.0,169.0,78.57,269.62,15
HCPCS,99393,Established patient periodic preventive medicine examination (5-11 years),260.0,169.0,78.57,268.77,15
HCPCS,99394,Established patient periodic preventive medicine examination (12-17 years),290.0,188.5,78.57,298.7,15
HCPCS,99395,Established patient periodic preventive medicine examination (18-39 years),290.0,188.5,78.57,300.8,15
HCPCS,99396,Established patient periodic preventive medicine examination (40-64 years),310.0,201.5,78.57,319.86,15
HCPCS,99397,Established patient periodic preventive medicine examination (65 year old or older),340.0,221.0,78.57,344.72,15
HCPCS,99401,"Preventive medicine counseling, typically 15 minutes",104.9,68.19,47.21,108.05,15
HCPCS,99402,"Preventive medicine counseling, typically 30 minutes",179.62,116.75,78.57,185.01,15
HCPCS,99403,"Preventive medicine counseling, typically 45 minutes",250.0,162.5,78.57,257.5,15
HCPCS,99404,"Preventive medicine counseling, typically 1 hour",330.0,214.5,78.57,339.9,15
HCPCS,99406,"Smoking and tobacco use intermediate counseling, 3-10 minutes",39.78,25.855,10.12,273.0,95
HCPCS,99407,"Smoking and tobacco use intensive counseling, more than 10 minutes",57.5,37.375,14.25,273.0,95
HCPCS,99409,"Alcohol and/or substance abuse screening and intervention, more than 30 minutes",159.7,103.81,71.87,173.49,15
HCPCS,99411,"Group preventive medicine counseling, typically 30 minutes",30.5,19.83,13.73,78.57,15
HCPCS,99412,"Group preventive medicine counseling, typically 1 hour",39.9,25.94,17.96,78.57,15
HCPCS,99415,"Extended office or other outpatient service by clinical staff, first hour",20.0,13.0,11.42,78.57,19
HCPCS,99416,"Extended office or other outpatient service by clinical staff, each additional 30 minutes",2.0,1.3,4.57,78.57,19
HCPCS,99417,"Prolonged outpatient service, each 15 minutes of total time beyond required time of primary service",78.5,51.03,35.33,81.67,15
HCPCS,99418,"Prolonged inpatient or observation service, each 15 minutes of total time beyond required time of primary service",121.75,79.14,36.1,108.2,15
HCPCS,99421,"Online digital evaluation and management service for an established patient for up to 7 days, total time 5-10 minutes",35.0,22.75,10.45,78.57,19
HCPCS,99422,"Online digital evaluation and management service for an established patient for up to 7 days, total time 11-20 minutes",70.0,45.5,21.21,78.57,19
HCPCS,99423,"Online digital evaluation and management service for an established patient for up to 7 days, total time 21 or more minutes",105.0,68.25,33.52,115.59,19
HCPCS,99424,"Principal care management services for a single high-risk disease, first 30 minutes provided personally by qualified health care professional, per calendar month.",172.0,111.8,61.54,202.84,19
HCPCS,99425,"Principal care management services for a single high-risk disease, each additional 30 minutes provided personally by qualified health care professional, per calendar month",119.0,77.35,41.99,143.38,19
HCPCS,99426,"Principal care management services for a single high-risk disease, first 30 minutes of clinical staff time directed by health care professional, per calendar month",115.0,74.75,41.99,150.09,19
HCPCS,99427,"Principal care management services for a single high-risk disease, each additional 30 minutes of clinical staff time directed by health care professional, per calendar month",81.0,52.65,29.9,115.72,19
HCPCS,99437,"Chronic care management services for two or more chronic conditions, additional 30 minutes provided personally by health care professional, per calendar month",118.0,76.7,41.68,147.42,19
HCPCS,99439,"Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month",66.0,42.9,29.25,116.79,19
HCPCS,99445,"REMOTE MONITORING OF PHYSIOLOGIC PARAMETER(S) (EG, WEIGHT, BLOOD PRESSURE, PULSE OXIMETRY, RESPIRATORY FLOW RATE); DEVICE(S) SUPPLY WITH DAILY RECORDING(S) OR PROGRAMMED ALERT(S) TRANSMISSION, 2-15 DA",125.0,81.25,31.25,322.81,34
HCPCS,99446,"Telephone, internet, or electronic health record assessment and management with verbal and written report by consulting physician, 5-10 minutes",45.0,29.25,14.97,78.57,19
HCPCS,99447,"Telephone or internet assessment with verbal and written report by consulting physician, 11-20 minutes",90.0,58.5,30.12,97.23,19
HCPCS,99448,"Telephone or internet assessment with verbal and written report by consulting physician, 21-30 minutes",135.0,87.75,45.15,145.07,19
HCPCS,99449,"Telephone or internet assessment with verbal and written report by consulting physician, more than 30 minutes",180.0,117.0,59.99,195.32,19
HCPCS,99451,"Telephone, internet, or electronic health record assessment and management with written report by consulting physician, at least 5 minutes",88.0,57.2,22.85,93.96,19
HCPCS,99452,"Telephone or internet referral service, 30 minutes",88.0,57.2,29.56,95.73,19
HCPCS,99453,"Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment",172.0,111.8,13.71,774.75,57
HCPCS,99454,"Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days",135.0,87.75,31.25,322.81,57
HCPCS,99455,Work-related or medical disability examination by the treating physician,219.75,142.84,73.6,226.34,15
HCPCS,99456,Work-related or medical disability examination by other than the treating physician,52.5,34.13,23.63,80.89,15
HCPCS,99457,"Management using the results of remote vital sign monitoring per calendar month, first 20 minutes",101.0,65.65,25.2,322.81,57
HCPCS,99458,"Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes",111.625,72.555,25.2,322.81,57
HCPCS,99460,Initial evaluation and management of newborn per day,203.0,131.95,77.36,251.38,19
HCPCS,99461,Initial evaluation and management of newborn not in hospital or birthing center per day,220.0,143.0,50.98,229.65,19
HCPCS,99462,Follow-up hospital care of newborn per day,95.0,61.75,33.93,109.61,19
HCPCS,99463,Initial inpatient hospital or birthing center same date care and discharge of newborn,200.0,130.0,78.57,293.08,19
HCPCS,99464,Physician attendance at delivery and stabilization of newborn,256.5,166.725,60.67,679.2,36
HCPCS,99465,Reviving newborn at delivery,504.5,327.925,78.57,1443.62,38
HCPCS,99466,"Critical care during transport between facilities, first 30-74 minutes (2 years or younger)",703.5,457.28,78.57,627.18,19
HCPCS,99467,"Critical care during transport between facilities, each additional 30 minutes (2 years or younger)",359.1,233.42,78.57,314.82,19
HCPCS,99468,Initial inpatient hospital critical care of newborn per day (28 days or younger),2750.0,1787.5,78.57,2418.67,19
HCPCS,99469,Follow-up inpatient hospital critical care of newborn per day (28 days or younger),1200.0,780.0,78.57,1046.84,19
HCPCS,99470,"REMOTE PHYSIOLOGIC MONITORING TREATMENT MANAGEMENT SERVICES, CLINICAL STAFF/PHYSICIAN/OTHER QUALIFIED HEALTH CARE PROFESSIONAL TIME IN A CALENDAR MONTH REQUIRING 1 REAL-TIME INTERACTIVE COMMUNICATION ",125.0,81.25,31.25,322.81,34
HCPCS,99471,Initial inpatient hospital critical care of infant or young child per day (29 days to 2 years),2375.1,1543.82,78.57,2093.41,19
HCPCS,99472,Follow-up inpatient hospital critical care of infant or young child per day (29 days to 2 years),1199.8,779.87,78.57,1071.43,19
HCPCS,99473,Education and training to self measure blood pressure,25.0,16.25,10.05,78.57,19
HCPCS,99474,Self measured blood pressure measurements,35.5,23.08,7.68,78.57,19
HCPCS,99475,Initial inpatient hospital critical care of infant or young child per day (2-5 years),1650.0,1072.5,78.57,1511.74,19
HCPCS,99476,Follow-up inpatient hospital critical care of infant or young child per day (2-5 years),979.7,636.81,78.57,914.45,19
HCPCS,99477,Initial intensive care of newborn per day (28 days or younger),999.6,649.74,78.57,917.36,19
HCPCS,99478,Follow-up intensive care of recovering very low birth weight infant per day,421.1,273.72,78.57,360.03,19
HCPCS,99479,Follow-up intensive care of recovering low birth weight infant per day,370.7,240.96,78.57,327.2,19
HCPCS,99480,Follow-up intensive care of recovering medium birth weight infant per day,356.0,231.4,78.57,314.82,19
HCPCS,99483,"Assessment of and care planning for patient with impaired thought processing, typically 60 minutes",450.0,292.5,78.57,668.36,19
HCPCS,99485,"Supervision of interfacility transport care of critical patient, first 30 minutes (2 years or younger)",220.0,143.0,78.57,226.6,15
HCPCS,99486,"Supervision of interfacility transport care of critical patient, each additional 30 minutes (2 years or younger)",190.0,123.5,78.57,195.7,15
HCPCS,99487,"Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar m",230.0,149.5,42.31,246.05,19
HCPCS,99489,"Complex chronic care management services for two or more chronic conditions, each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per ",120.0,78.0,21.16,134.31,19
HCPCS,99490,"Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month",105.0,68.25,21.16,136.08,19
HCPCS,99491,"Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month",198.0,128.7,62.64,210.12,19
HCPCS,99495,Transitional care management services for problem of at least moderate complexity,399.77,259.85,78.57,503.18,19
HCPCS,99496,Transitional care management services for problem of high complexity,549.95,357.47,78.57,681.53,19
HCPCS,99497,"Advance care planning, first 30 minutes",154.05,100.13499999999999,0.01,309.9,36
HCPCS,99498,"Advance care planning, each additional 30 minutes",175.85,114.3,60.54,193.85,19
HCPCS,A4216,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",4.3100000000000005,2.8049999999999997,0.38,25.71,160
HCPCS,A4217,"STERILE WATER/SALINE, 500 ML",3.98,2.59,0.45,8.88,80
HCPCS,A4220,REFILL KIT FOR IMPLANTABLE INFUSION PUMP,21.0,13.65,9.45,80.89,15
HCPCS,A4262,"TEMPORARY, ABSORBABLE LACRIMAL DUCT IMPLANT, EACH",86.65,56.325,0.12,216.93,31
HCPCS,A4263,"PERMANENT, LONG TERM, NON-DISSOLVABLE LACRIMAL DUCT IMPLANT, EACH",84.0,54.6,9.9,216.93,47
HCPCS,A4270,"DISPOSABLE ENDOSCOPE SHEATH, EACH",220.5,143.33,43.88,685.65,64
HCPCS,A4300,"IMPLANTABLE ACCESS CATHETER, (E.G., VENOUS, ARTERIAL, EPIDURAL SUBARACHNOID, OR PERITONEAL, ETC.) EXTERNAL ACCESS",202.7,131.76,3.22,208.78,15
HCPCS,A4301,"IMPLANTABLE ACCESS TOTAL CATHETER, PORT/RESERVOIR (E.G., VENOUS, ARTERIAL, EPIDURAL, SUBARACHNOID, PERITONEAL, ETC.)",3042.0,1977.3,760.5,7855.97,16
HCPCS,A4314,"INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER OR HYDROPHILIC, ETC.)",10.5,6.83,5.25,89.98,19
HCPCS,A4315,"INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY, ALL SILICONE",10.5,6.83,5.25,93.88,19
HCPCS,A4338,"INDWELLING CATHETER; FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER, OR HYDROPHILIC, ETC.), EACH",46.5,30.23,11.63,32.55,16
HCPCS,A4351,"INTERMITTENT URINARY CATHETER; STRAIGHT TIP, WITH OR WITHOUT COATING (TEFLON, SILICONE, OR SILICONE ELASTOMER, ETC.), EACH",25.0,16.25,2.58,17.5,16
HCPCS,A4356,"EXTERNAL URETHRAL CLAMP OR COMPRESSION DEVICE (NOT TO BE USED FOR CATHETER CLAMP), EACH",120.8,78.52,23.27,155.69,19
HCPCS,A4358,"URINARY DRAINAGE BAG, LEG OR ABDOMEN, VINYL, WITH OR WITHOUT TUBE, WITH STRAPS, EACH",18.9,12.29,3.53,78.57,19
HCPCS,A4364,"ADHESIVE, LIQUID OR EQUAL, ANY TYPE, PER OZ",42.65,27.72,1.56,78.57,19
HCPCS,A4410,"OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION), EXTENDED WEAR, WITHOUT BUILT-IN CONVEXITY, LARGER THAN 4 X 4 INCHES, EACH",12.15,7.9,3.04,13.78,16
HCPCS,A4428,"OSTOMY POUCH, URINARY, WITH EXTENDED WEAR BARRIER ATTACHED, WITH FAUCET-TYPE TAP WITH VALVE (1 PIECE), EACH",72.0,46.8,9.29,50.4,16
HCPCS,A4450,"TAPE, NON-WATERPROOF, PER 18 SQUARE INCHES",25.0,16.25,0.06,78.57,19
HCPCS,A4452,"TAPE, WATERPROOF, PER 18 SQUARE INCHES",40.0,26.0,0.2,78.57,19
HCPCS,A4461,"SURGICAL DRESSING HOLDER, NON-REUSABLE, EACH",28.4,18.46,1.76,78.57,19
HCPCS,A4550,SURGICAL TRAYS,36.8,23.92,7.3,78.57,15
HCPCS,A4556,"ELECTRODES, (E.G., APNEA MONITOR), PER PAIR",6300.0,4095.0,14.71,4410.0,16
HCPCS,A4561,"PESSARY, REUSABLE, RUBBER, ANY TYPE",67.6,43.94,10.83,78.57,35
HCPCS,A4562,"PESSARY, REUSABLE, NON RUBBER, ANY TYPE",81.75,53.14,22.5,180.27,35
HCPCS,A4565,SLINGS,32.3,20.994999999999997,4.1,78.57,35
HCPCS,A4570,SPLINT,94.0,61.1,4.33,420.95,31
HCPCS,A4595,"ELECTRICAL STIMULATOR SUPPLIES, 2 LEAD, PER MONTH, (E.G., TENS, NMES)",346.5,225.23,7.14,173.25,19
HCPCS,A4614,"PEAK EXPIRATORY FLOW RATE METER, HAND HELD",71.0,46.15,17.75,49.7,16
HCPCS,A4615,"CANNULA, NASAL",91.16,59.25,1.04,63.81,16
HCPCS,A4648,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",437.5,284.375,36.75,3776.91,192
HCPCS,A4649,SURGICAL SUPPLY; MISCELLANEOUS,316.98,206.035,1.21,2066.0,352
HCPCS,A5063,"OSTOMY POUCH, DRAINABLE; FOR USE ON BARRIER WITH FLANGE (2 PIECE SYSTEM), EACH",90.37,58.74,3.86,63.26,16
HCPCS,A6021,"COLLAGEN DRESSING, STERILE, SIZE 16 SQ. IN. OR LESS, EACH",47.0,30.55,11.75,32.9,16
HCPCS,A6154,"WOUND POUCH, EACH",236.84,153.94,20.47,165.78,16
HCPCS,A6197,"ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH DRESSING",45.0,29.25,11.25,31.5,16
HCPCS,A6198,"ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 48 SQ. IN., EACH DRESSING",70.0,45.5,17.5,180.78,16
HCPCS,A6199,"ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND FILLER, STERILE, PER 6 INCHES",47.85,31.11,7.52,33.5,16
HCPCS,A6208,"CONTACT LAYER, STERILE, MORE THAN 48 SQ. IN., EACH DRESSING",69.875,45.42,17.44,180.78,48
HCPCS,A6210,"FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING",64.165,41.705,15.75,45.74,32
HCPCS,A6211,"FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING",102.57,66.67,25.64,71.8,16
HCPCS,A6261,"WOUND FILLER, GEL/PASTE, PER FLUID OUNCE, NOT OTHERWISE SPECIFIED",60.9,39.59,0.99,78.57,15
HCPCS,A6456,"ZINC PASTE IMPREGNATED BANDAGE, NON-ELASTIC, KNITTED/WOVEN, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARD",47.0,30.55,1.79,32.9,16
HCPCS,A6457,"TUBULAR DRESSING WITH OR WITHOUT ELASTIC, ANY WIDTH, PER LINEAR YARD",27.0,17.55,1.62,18.9,16
HCPCS,A6530,"GRADIENT COMPRESSION STOCKING, BELOW KNEE, 18-30 MMHG, EACH",12.6,8.19,6.3,97.58,19
HCPCS,A6531,"GRADIENT COMPRESSION STOCKING, BELOW KNEE, 30-40 MMHG, USED AS A SURGICAL DRESSING, EACH",14.7,9.56,7.35,154.0,19
HCPCS,A6532,"GRADIENT COMPRESSION STOCKING, BELOW KNEE, 40-50 MMHG, USED AS A SURGICAL DRESSING, EACH",21.0,13.65,10.5,216.98,19
HCPCS,A6550,"WOUND CARE SET, FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, INCLUDES ALL SUPPLIES AND ACCESSORIES",154.0,100.1,31.78,1521.45,48
HCPCS,A7000,"CANISTER, DISPOSABLE, USED WITH SUCTION PUMP, EACH",124.0,80.6,10.54,86.8,16
HCPCS,A7520,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",180.0,117.0,28.0,234.5,80
HCPCS,A7521,"TRACHEOSTOMY/LARYNGECTOMY TUBE, CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",195.0,126.75,29.0,157.5,64
HCPCS,A7522,"TRACHEOSTOMY/LARYNGECTOMY TUBE, STAINLESS STEEL OR EQUAL (STERILIZABLE AND REUSABLE), EACH",258.5,168.025,56.25,204.4,32
HCPCS,A7524,"TRACHEOSTOMA STENT/STUD/BUTTON, EACH",615.65,400.17,110.33,430.96,16
HCPCS,A9279,"MONITORING FEATURE/DEVICE, STAND-ALONE OR INTEGRATED, ANY TYPE, INCLUDES ALL ACCESSORIES, COMPONENTS AND ELECTRONICS, NOT OTHERWISE CLASSIFIED",386.4,251.16,73.6,397.99,15
HCPCS,A9300,EXERCISE EQUIPMENT,32.5,21.13,14.63,80.89,15
HCPCS,A9500,"TECHNETIUM TC-99M SESTAMIBI, DIAGNOSTIC, PER STUDY DOSE",500.0,325.0,78.57,696.15,15
HCPCS,A9502,"TECHNETIUM TC-99M TETROFOSMIN, DIAGNOSTIC, PER STUDY DOSE",554.27,360.28,78.57,1769.32,49
HCPCS,A9503,"TECHNETIUM TC-99M MEDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",213.62,138.85500000000002,53.36,645.01,34
HCPCS,A9512,"TECHNETIUM TC-99M PERTECHNETATE, DIAGNOSTIC, PER MILLICURIE",43.87,28.515,1.48,246.84,34
HCPCS,A9513,"LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MILLICURIE",100453.3,65294.65,340.02,259420.65,19
HCPCS,A9516,"IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER 100 MICROCURIES, UP TO 999 MICROCURIES",315.805,205.27499999999998,57.7,1209.2,34
HCPCS,A9517,"IODINE I-131 SODIUM IODIDE CAPSULE(S), THERAPEUTIC, PER MILLICURIE",67.5,43.88,16.88,592.72,19
HCPCS,A9520,"TECHNETIUM TC-99M TILMANOCEPT, DIAGNOSTIC, UP TO 0.5 MILLICURIES",20943.365,13613.19,3756.26,81039.06,32
HCPCS,A9528,"IODINE I-131 SODIUM IODIDE CAPSULE(S), DIAGNOSTIC, PER MILLICURIE",62.56,40.66,15.64,188.74,17
HCPCS,A9530,"IODINE I-131 SODIUM IODIDE SOLUTION, THERAPEUTIC, PER MILLICURIE",55.53,36.09,13.88,592.72,38
HCPCS,A9537,"TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",218.16500000000002,141.81,53.3,673.22,34
HCPCS,A9538,"TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",800.735,520.48,42.14,2447.4,34
HCPCS,A9540,"TECHNETIUM TC-99M MACROAGGREGATED ALBUMIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES",1336.365,868.635,32.21,4080.81,34
HCPCS,A9541,"TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, PER STUDY DOSE, UP TO 20 MILLICURIES",4363.3099999999995,2836.155,432.69,25276.73,68
HCPCS,A9547,"INDIUM IN-111 OXYQUINOLINE, DIAGNOSTIC, PER 0.5 MILLICURIE",27222.940000000002,17694.91,881.35,94278.13,34
HCPCS,A9554,"IODINE I-125 SODIUM IOTHALAMATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MICROCURIES",1307.96,850.17,326.99,3945.98,17
HCPCS,A9557,"TECHNETIUM TC-99M BICISATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",2723.6549999999997,1770.375,652.05,8565.34,34
HCPCS,A9558,"XENON XE-133 GAS, DIAGNOSTIC, PER 10 MILLICURIES",1311.215,852.29,317.02,4085.97,34
HCPCS,A9560,"TECHNETIUM TC-99M LABELED RED BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",1395.35,906.98,115.42,4209.63,17
HCPCS,A9562,"TECHNETIUM TC-99M MERTIATIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",3735.0,2427.75,840.87,11313.38,34
HCPCS,A9572,"INDIUM IN-111 PENTETREOTIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 6 MILLICURIES",10029.9,6519.44,2121.0,30259.21,17
HCPCS,A9573,"INJECTION, GADOPICLENOL, 1 ML",89.43,58.13,3.5,295.66,34
HCPCS,A9577,"INJECTION, GADOBENATE DIMEGLUMINE (MULTIHANCE), PER ML",11.245000000000001,7.31,1.91,44.65,34
HCPCS,A9579,"INJECTION, GADOLINIUM-BASED MAGNETIC RESONANCE CONTRAST AGENT, NOT OTHERWISE SPECIFIED (NOS), PER ML",15.08,9.8,1.55,585.28,84
HCPCS,A9580,"SODIUM FLUORIDE F-18, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",138.0,89.7,34.5,416.33,17
HCPCS,A9581,"INJECTION, GADOXETATE DISODIUM, 1 ML",202.015,131.31,15.64,620.49,34
HCPCS,A9582,"IODINE I-123 IOBENGUANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",13760.0,8944.0,30.82,81078.49,51
HCPCS,A9584,"IODINE 1-123 IOFLUPANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 5 MILLICURIES",6958.0,4522.7,1172.14,43748.07,51
HCPCS,A9585,"INJECTION, GADOBUTROL, 0.1 ML",435.75,283.24,0.3,1878.02,34
HCPCS,A9587,"GALLIUM GA-68, DOTATATE, DIAGNOSTIC, 0.1 MILLICURIE",16785.43,10910.53,50.5,62688.83,51
HCPCS,A9588,"FLUCICLOVINE F-18, DIAGNOSTIC, 1 MILLICURIE",1180.0,767.0,295.0,3559.94,17
HCPCS,A9595,"PIFLUFOLASTAT F-18, DIAGNOSTIC, 1 MILLICURIE",67330.22,43764.64,367.28,203128.54,17
HCPCS,A9596,"GALLIUM GA-68 GOZETOTIDE, DIAGNOSTIC, (ILLUCCIX), 1 MILLICURIE",19912.06,12942.84,507.23,60072.69,17
HCPCS,A9600,"STRONTIUM SR-89 CHLORIDE, THERAPEUTIC, PER MILLICURIE",4241.0,2756.65,1060.25,18303.64,19
HCPCS,A9604,"SAMARIUM SM-153 LEXIDRONAM, THERAPEUTIC, PER TREATMENT DOSE, UP TO 150 MILLICURIES",15593.0,10135.45,3349.39,40268.92,19
HCPCS,A9606,"RADIUM RA-223 DICHLORIDE, THERAPEUTIC, PER MICROCURIE",738.45,479.99,78.25,57253.46,57
HCPCS,A9607,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC, 1 MILLICURIE",82723.99,53770.59,274.88,213634.7,19
HCPCS,A9698,"NON-RADIOACTIVE CONTRAST IMAGING MATERIAL, NOT OTHERWISE CLASSIFIED, PER STUDY",95.0,61.75,23.75,286.61,16
HCPCS,A9699,"RADIOPHARMACEUTICAL, THERAPEUTIC, NOT OTHERWISE CLASSIFIED",33340.0,21671.0,8335.0,86100.55,17
HCPCS,A9700,"SUPPLY OF INJECTABLE CONTRAST MATERIAL FOR USE IN ECHOCARDIOGRAPHY, PER STUDY",258.0,167.7,64.5,666.29,16
HCPCS,B4087,"GASTROSTOMY/JEJUNOSTOMY TUBE, STANDARD, ANY MATERIAL, ANY TYPE, EACH",482.065,313.345,13.27,1703.49,31
HCPCS,B4088,"GASTROSTOMY/JEJUNOSTOMY TUBE, LOW-PROFILE, ANY MATERIAL, ANY TYPE, EACH",791.0799999999999,514.2,14.84,4079.52,95
HCPCS,B4150,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALOR",2.13,1.4,0.38,7.0,192
HCPCS,B4152,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, CALORICALLY DENSE (EQUAL TO OR GREATER THAN 1.5 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBE",1.5,0.975,0.33,4.55,96
HCPCS,B4153,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, HYDROLYZED PROTEINS (AMINO ACIDS AND PEPTIDE CHAIN), INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FE",10.0,6.5,0.76,38.74,160
HCPCS,B4154,"ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, EXCLUDES INHERITED DISEASE OF METABOLISM, INCLUDES ALTERED COMPOSITION OF PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND/OR MINERALS,",4.145,2.6950000000000003,0.27,77.48,336
HCPCS,B4155,"ENTERAL FORMULA, NUTRITIONALLY INCOMPLETE/MODULAR NUTRIENTS, INCLUDES SPECIFIC NUTRIENTS, CARBOHYDRATES (E.G., GLUCOSE POLYMERS), PROTEINS/AMINO ACIDS (E.G., GLUTAMINE, ARGININE), FAT (E.G., MEDIUM CH",4.87,3.17,0.55,28.41,80
HCPCS,B4158,"ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER AND/OR IRON, ADMINISTERED THROUGH AN ENT",2.74,1.78,0.68,7.15,48
HCPCS,B4160,"ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE CALORICALLY DENSE (EQUAL TO OR GREATER THAN 0.7 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, M",1.53,0.99,0.38,3.95,32
HCPCS,B4161,"ENTERAL FORMULA, FOR PEDIATRICS, HYDROLYZED/AMINO ACIDS AND PEPTIDE CHAIN PROTEINS, INCLUDES FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE",15.0,9.75,3.75,38.74,32
HCPCS,C1052,"HEMOSTATIC AGENT, GASTROINTESTINAL, TOPICAL",10350.0,6727.5,2587.5,26728.88,16
HCPCS,C1713,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2956.5,1921.73,46.15,133644.38,81
HCPCS,C1714,"CATHETER, TRANSLUMINAL ATHERECTOMY, DIRECTIONAL",15075.0,9798.75,3768.75,38931.19,17
HCPCS,C1715,BRACHYTHERAPY NEEDLE,276.0,179.4,69.0,712.77,16
HCPCS,C1717,"BRACHYTHERAPY SOURCE, NON-STRANDED, HIGH DOSE RATE IRIDIUM-192, PER SOURCE",50.0,32.5,12.5,379.51,18
HCPCS,C1719,"BRACHYTHERAPY SOURCE, NON-STRANDED, NON-HIGH DOSE RATE IRIDIUM-192, PER SOURCE",2890.0,1878.5,372.07,7463.43,18
HCPCS,C1721,"CARDIOVERTER-DEFIBRILLATOR, DUAL CHAMBER (IMPLANTABLE)",53605.74,34843.73,13401.43,138436.82,17
HCPCS,C1722,"CARDIOVERTER-DEFIBRILLATOR, SINGLE CHAMBER (IMPLANTABLE)",61009.65,39656.27,15252.41,157557.43,17
HCPCS,C1724,"CATHETER, TRANSLUMINAL ATHERECTOMY, ROTATIONAL",8482.5,5513.63,2120.63,21906.06,34
HCPCS,C1725,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",939.67,610.78,96.7,16996.08,209
HCPCS,C1726,"CATHETER, BALLOON DILATATION, NON-VASCULAR",823.64,535.365,65.11,3231.87,64
HCPCS,C1728,"CATHETER, BRACHYTHERAPY SEED ADMINISTRATION",1458.0,947.7,322.0,4204.31,32
HCPCS,C1729,"CATHETER, DRAINAGE",279.0,181.35,19.13,7855.97,192
HCPCS,C1730,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",1541.25,1001.815,135.0,6228.99,144
HCPCS,C1732,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, 3D OR VECTOR MAPPING",9365.564999999999,6087.62,1251.0,40104.93,67
HCPCS,C1733,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTOR MAPPING, OTHER THAN COOL-TIP",16601.245000000003,10790.810000000001,1985.63,65233.92,34
HCPCS,C1734,ORTHOPEDIC/DEVICE/DRUG MATRIX FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO BONE (IMPLANTABLE),55125.0,35831.25,13781.25,142360.31,17
HCPCS,C1750,"CATHETER, HEMODIALYSIS/PERITONEAL, LONG-TERM",1364.36,886.83,299.25,3540.26,64
HCPCS,C1752,"CATHETER, HEMODIALYSIS/PERITONEAL, SHORT-TERM",466.84,303.45,116.71,1205.62,16
HCPCS,C1753,"CATHETER, INTRAVASCULAR ULTRASOUND",3323.17,2160.06,759.38,11040.19,64
HCPCS,C1757,"CATHETER, THROMBECTOMY/EMBOLECTOMY",13042.35,8477.53,2279.53,139455.0,51
HCPCS,C1759,"CATHETER, INTRACARDIAC ECHOCARDIOGRAPHY",12145.5,7894.58,2767.47,31505.21,51
HCPCS,C1760,"CLOSURE DEVICE, VASCULAR (IMPLANTABLE/INSERTABLE)",1058.35,687.93,164.5,3095.9,80
HCPCS,C1761,"CATHETER, TRANSLUMINAL INTRAVASCULAR LITHOTRIPSY, CORONARY",16467.655,10703.975,3000.0,54065.43,34
HCPCS,C1762,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",6437.8150000000005,4184.58,39.2,383501.25,4592
HCPCS,C1763,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",5501.25,3575.815,29.71,348637.5,1983
HCPCS,C1764,"EVENT RECORDER, CARDIAC (IMPLANTABLE)",21256.6,13816.79,5314.15,54895.17,17
HCPCS,C1765,ADHESION BARRIER,12514.5,8134.43,3128.63,32318.7,17
HCPCS,C1766,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, STEERABLE, OTHER THAN PEEL-AWAY",3955.5,2571.08,730.86,11714.22,48
HCPCS,C1768,"GRAFT, VASCULAR",8388.0,5452.205,17.16,76205.18,67
HCPCS,C1769,GUIDE WIRE,306.0,198.905,15.13,9250.18,544
HCPCS,C1770,"IMAGING COIL, MAGNETIC RESONANCE (INSERTABLE)",429.0,278.85,107.25,1107.89,16
HCPCS,C1772,"INFUSION PUMP, PROGRAMMABLE (IMPLANTABLE)",51.08,33.2,12.77,131.91,16
HCPCS,C1773,"RETRIEVAL DEVICE, INSERTABLE (USED TO RETRIEVE FRACTURED MEDICAL DEVICES)",1673.6950000000002,1087.905,15.16,18826.43,65
HCPCS,C1776,JOINT DEVICE (IMPLANTABLE),7650.0,4972.5,1912.5,19756.13,17
HCPCS,C1777,"LEAD, CARDIOVERTER-DEFIBRILLATOR, ENDOCARDIAL SINGLE COIL (IMPLANTABLE)",14373.645,9342.869999999999,3585.59,37200.78,34
HCPCS,C1778,"LEAD, NEUROSTIMULATOR (IMPLANTABLE)",27272.085,17726.855,4861.04,90645.75,34
HCPCS,C1780,"LENS, INTRAOCULAR (NEW TECHNOLOGY)",6052.5,3934.13,1513.13,15630.58,17
HCPCS,C1785,"PACEMAKER, DUAL CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)",16165.15,10507.35,4041.29,41746.51,17
HCPCS,C1786,"PACEMAKER, SINGLE CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)",50046.78,32530.4,12511.69,129245.8,17
HCPCS,C1788,"PORT, INDWELLING (IMPLANTABLE)",1365.48,887.56,326.25,7402.74,48
HCPCS,C1817,"SEPTAL DEFECT IMPLANT SYSTEM, INTRACARDIAC",41960.61,27274.4,10490.15,108363.28,17
HCPCS,C1822,"GENERATOR, NEUROSTIMULATOR (IMPLANTABLE), HIGH FREQUENCY, WITH RECHARGEABLE BATTERY AND CHARGING SYSTEM",74083.5,48154.28,18520.88,191320.64,34
HCPCS,C1824,"GENERATOR, CARDIAC CONTRACTILITY MODULATION (IMPLANTABLE)",117000.0,76050.0,29250.0,302152.5,17
HCPCS,C1874,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",10982.25,7138.465,1005.0,59789.6,101
HCPCS,C1875,"STENT, COATED/COVERED, WITHOUT DELIVERY SYSTEM",11878.59,7721.09,2969.65,30676.47,17
HCPCS,C1876,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",6565.5,4267.58,675.0,28959.69,116
HCPCS,C1877,"STENT, NON-COATED/NON-COVERED, WITHOUT DELIVERY SYSTEM",8698.5,5654.03,2174.63,22463.88,34
HCPCS,C1878,"MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)",1527.0,992.55,66.5,10774.19,144
HCPCS,C1880,VENA CAVA FILTER,5025.05,3266.28,1256.26,12977.18,16
HCPCS,C1882,"CARDIOVERTER-DEFIBRILLATOR, OTHER THAN SINGLE OR DUAL CHAMBER (IMPLANTABLE)",79955.47,51971.06,19988.87,206485.01,17
HCPCS,C1884,EMBOLIZATION PROTECTIVE SYSTEM,8077.5,5250.38,1120.42,34282.69,50
HCPCS,C1885,"CATHETER, TRANSLUMINAL ANGIOPLASTY, LASER",13927.5,9052.88,3481.88,35967.77,34
HCPCS,C1886,"CATHETER, EXTRAVASCULAR TISSUE ABLATION, ANY MODALITY (INSERTABLE)",8676.0,5639.4,2169.0,22405.77,17
HCPCS,C1887,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",877.515,570.385,16.29,20918.25,305
HCPCS,C1888,"CATHETER, ABLATION, NON-CARDIAC, ENDOVASCULAR (IMPLANTABLE)",2467.09,1603.61,420.0,10308.05,48
HCPCS,C1889,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",21875.0,14218.75,232.67,627547.5,555
HCPCS,C1892,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, PEEL-AWAY",170.76999999999998,111.0,41.19,456.53,32
HCPCS,C1893,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, OTHER THAN PEEL-AWAY",1039.095,675.41,47.71,4874.11,32
HCPCS,C1894,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",310.69,201.95,24.43,21371.48,273
HCPCS,C1895,"LEAD, CARDIOVERTER-DEFIBRILLATOR, ENDOCARDIAL DUAL COIL (IMPLANTABLE)",12682.35,8243.52,3170.59,32752.16,17
HCPCS,C1896,"LEAD, CARDIOVERTER-DEFIBRILLATOR, OTHER THAN ENDOCARDIAL SINGLE OR DUAL COIL (IMPLANTABLE)",16905.0,10988.25,4226.25,43657.16,17
HCPCS,C1897,"LEAD, NEUROSTIMULATOR TEST KIT (IMPLANTABLE)",3187.5,2071.88,796.88,8231.72,16
HCPCS,C1898,"LEAD, PACEMAKER, OTHER THAN TRANSVENOUS VDD SINGLE PASS",1794.8049999999998,1166.625,447.45,4647.97,32
HCPCS,C1900,"LEAD, LEFT VENTRICULAR CORONARY VENOUS SYSTEM",11144.91,7244.19,2786.23,28781.74,17
HCPCS,C2613,LUNG BIOPSY PLUG WITH DELIVERY SYSTEM,1654.2,1075.23,413.55,4271.97,32
HCPCS,C2616,"BRACHYTHERAPY SOURCE, NON-STRANDED, YTTRIUM-90, PER SOURCE",97800.0,63570.0,16299.55,786767.74,56
HCPCS,C2617,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",334.815,217.63,78.62,917.15,32
HCPCS,C2618,"PROBE/NEEDLE, CRYOABLATION",5376.92,3495.0,1344.08,13887.39,32
HCPCS,C2621,"PACEMAKER, OTHER THAN SINGLE OR DUAL CHAMBER (IMPLANTABLE)",27859.29,18108.54,6964.82,71946.61,17
HCPCS,C2623,"CATHETER, TRANSLUMINAL ANGIOPLASTY, DRUG-COATED, NON-LASER",7902.81,5136.83,1975.7,20409.0,17
HCPCS,C2624,"IMPLANTABLE WIRELESS PULMONARY ARTERY PRESSURE SENSOR WITH DELIVERY CATHETER, INCLUDING ALL SYSTEM COMPONENTS",112851.5,73353.475,25762.5,316751.37,51
HCPCS,C2625,"STENT, NON-CORONARY, TEMPORARY, WITH DELIVERY SYSTEM",327.22,212.69,62.21,6820.38,48
HCPCS,C2628,"CATHETER, OCCLUSION",2040.885,1326.575,237.94,8083.28,32
HCPCS,C2629,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, LASER",13580.525,8827.345,3369.38,35337.77,34
HCPCS,C2630,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTOR MAPPING, COOL-TIP",12638.005000000001,8214.705,3127.5,32968.22,34
HCPCS,C2638,"BRACHYTHERAPY SOURCE, STRANDED, IODINE-125, PER SOURCE",63.0,40.95,15.75,379.51,18
HCPCS,C8001,"3D ANATOMICAL SEGMENTATION IMAGING FOR PREOPERATIVE PLANNING, DATA PREPARATION AND TRANSMISSION, OBTAINED FROM PREVIOUS DIAGNOSTIC COMPUTED TOMOGRAPHIC OR MAGNETIC RESONANCE EXAMINATION OF THE SAME AN",375.0,243.75,93.75,1181.0,16
HCPCS,C8900,"MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, ABDOMEN",1664.0,1081.6,416.0,4297.28,18
HCPCS,C8901,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, ABDOMEN",1529.0,993.85,382.25,3948.64,18
HCPCS,C8902,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, ABDOMEN",2200.0,1430.0,550.0,5681.5,18
HCPCS,C8905,"MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; UNILATERAL",2377.0,1545.05,437.5,7757.83,36
HCPCS,C8906,"MAGNETIC RESONANCE IMAGING WITH CONTRAST, BREAST; BILATERAL",881.0,572.65,220.25,2275.18,18
HCPCS,C8908,"MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; BILATERAL",2801.5,1820.975,592.21,7755.25,36
HCPCS,C8911,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, CHEST (EXCLUDING MYOCARDIUM)",2200.0,1430.0,550.0,5681.5,18
HCPCS,C8912,"MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, LOWER EXTREMITY",3004.0,1952.6,715.39,7757.83,18
HCPCS,C8913,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, LOWER EXTREMITY",1529.0,993.85,382.25,3948.64,18
HCPCS,C8914,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, LOWER EXTREMITY",2200.0,1430.0,550.0,5681.5,18
HCPCS,C8919,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, PELVIS",1725.0,1121.25,431.25,4454.81,18
HCPCS,C8920,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, PELVIS",2350.0,1527.5,587.5,6068.88,18
HCPCS,C8921,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; COMPLETE",1905.0,1238.25,476.25,4919.66,19
HCPCS,C8922,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; FOLLOW-UP OR LIMITED STUDY",1905.0,1238.25,476.25,4919.66,19
HCPCS,C8923,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COMPLETE, WITHOUT SPECT",1428.0,928.2,357.0,3687.81,19
HCPCS,C8924,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, FOLLOW-UP OR LIMITED ST",783.0,508.95,195.75,2022.1,19
HCPCS,C8925,"TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL TIME WITH IMAGE DOCUMENTATION (2D) (WITH OR WITHOUT M-MODE RECORDING); INCLUDING PROBE PLACEME",1905.0,1238.25,476.25,4919.66,19
HCPCS,C8926,"TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; INCLUDING PROBE PLACEMENT, IMAGE ACQUISITION, INTERPRETATION AND ",1905.0,1238.25,476.25,4919.66,19
HCPCS,C8927,"TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR MONITORING PURPOSES, INCLUDING PROBE PLACEMENT, REAL TIME 2-DIMENSIONAL IMAGE ACQUISITION AND I",2577.5,1675.375,476.25,8393.13,38
HCPCS,C8928,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIOV",1905.0,1238.25,476.25,4919.66,19
HCPCS,C8929,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COMPLETE, WITH SPECTRAL",1915.0,1244.75,270.0,7101.88,38
HCPCS,C8930,"TRANSTHORACIC ECHOCARDIOGRAPHY, WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIO",1235.0,802.75,247.5,4919.66,76
HCPCS,C8931,"MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, SPINAL CANAL AND CONTENTS",3500.0,2275.0,715.39,9038.75,18
HCPCS,C8932,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, SPINAL CANAL AND CONTENTS",3000.0,1950.0,715.39,7747.5,18
HCPCS,C8933,"MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, SPINAL CANAL AND CONTENTS",3500.0,2275.0,715.39,9038.75,18
HCPCS,C8957,"INTRAVENOUS INFUSION FOR THERAPY/DIAGNOSIS; INITIATION OF PROLONGED INFUSION (MORE THAN 8 HOURS), REQUIRING USE OF PORTABLE OR IMPLANTABLE PUMP",1097.0,713.05,142.5,4193.98,57
HCPCS,C9098,"CILTACABTAGENE AUTOLEUCEL, UP TO 100 MILLION AUTOLOGOUS B-CELL MATURATION ANTIGEN (BCMA) DIRECTED CAR-POSITIVE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3547000.0,2305550.0,886750.0,9160127.5,16
HCPCS,C9143,"COCAINE HYDROCHLORIDE NASAL SOLUTION (NUMBRINO), 1 MG",573.26,372.62,143.32,1480.44,16
HCPCS,C9257,"INJECTION, BEVACIZUMAB, 0.25 MG",831.365,540.39,1.95,6541.47,68
HCPCS,C9359,"POROUS PURIFIED COLLAGEN MATRIX BONE VOID FILLER (INTEGRA MOZAIK OSTEOCONDUCTIVE SCAFFOLD PUTTY, INTEGRA OS OSTEOCONDUCTIVE SCAFFOLD PUTTY), PER 0.5 CC",606.87,394.47,94.41,9407.4,48
HCPCS,C9363,"SKIN SUBSTITUTE, INTEGRA MESHED BILAYER WOUND MATRIX, PER SQUARE CENTIMETER",526.7,342.36,131.68,1360.2,17
HCPCS,C9399,UNCLASSIFIED DRUGS OR BIOLOGICALS,984500.0,639925.0,6375.0,5019088.75,30
HCPCS,C9460,"INJECTION, CANGRELOR, 1 MG",5576.6849999999995,3624.845,21.14,16501.97,38
HCPCS,C9507,"PLASMA, HIGH TITER COVID-19 CONVALESCENT, EACH UNIT",3375.0,2193.75,182.26,8715.94,19
HCPCS,C9600,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF DRUG ELUTING INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH",17947.0,11665.55,4486.75,46348.13,18
HCPCS,C9601,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF DRUG-ELUTING INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; EACH ADDITIONAL BRANCH OF A MAJOR CORONARY ARTERY (LIST SEPARATELY IN ADDITION TO",17947.0,11665.55,4486.75,46348.13,18
HCPCS,C9602,"PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY, WITH DRUG ELUTING INTRACORONARY STENT, WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH",17947.0,11665.55,4486.75,46348.13,18
HCPCS,C9603,"PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY, WITH DRUG-ELUTING INTRACORONARY STENT, WITH CORONARY ANGIOPLASTY WHEN PERFORMED; EACH ADDITIONAL BRANCH OF A MAJOR CORONARY ARTERY (LIST SEPARATELY IN A",17947.0,11665.55,4486.75,46348.13,18
HCPCS,C9604,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF OR THROUGH CORONARY ARTERY BYPASS GRAFT (INTERNAL MAMMARY, FREE ARTERIAL, VENOUS), ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, ATHERECTOMY AND A",17947.0,11665.55,4486.75,46348.13,18
HCPCS,C9605,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF OR THROUGH CORONARY ARTERY BYPASS GRAFT (INTERNAL MAMMARY, FREE ARTERIAL, VENOUS), ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, ATHERECTOMY AND A",17947.0,11665.55,4486.75,46348.13,18
HCPCS,C9606,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF ACUTE TOTAL/SUBTOTAL OCCLUSION DURING ACUTE MYOCARDIAL INFARCTION, CORONARY ARTERY OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF DRUG-ELUTING INTRA",17947.0,11665.55,4486.75,46348.13,18
HCPCS,C9607,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, A",17947.0,11665.55,1052.0,46348.13,19
HCPCS,C9608,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, A",17947.0,11665.55,1052.0,46348.13,19
HCPCS,C9728,"PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY/SURGERY GUIDANCE (E.G., FIDUCIAL MARKERS, DOSIMETER), FOR OTHER THAN THE FOLLOWING SITES (ANY APPROACH): ABDOMEN, PELVIS, PROSTATE, RETROPERIT",3209.0,2085.85,802.25,8477.27,18
HCPCS,C9758,"BLINDED PROCEDURE FOR NYHA CLASS III/IV HEART FAILURE; TRANSCATHETER IMPLANTATION OF INTERATRIAL SHUNT OR PLACEBO CONTROL, INCLUDING RIGHT HEART CATHETERIZATION, TRANS-ESOPHAGEAL ECHOCARDIOGRAPHY (TEE",25000.0,16250.0,6250.0,64562.5,19
HCPCS,C9764,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL(S), WHEN PERFORM",20655.5,13426.075,2952.75,76183.75,91
HCPCS,C9765,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, AND TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WI",35380.5,22997.325,5982.75,120938.48,73
HCPCS,C9766,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY AND ATHERECTOMY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL(",46830.0,30439.5,8988.34,120938.48,36
HCPCS,C9767,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY AND TRANSLUMINAL STENT PLACEMENT(S), AND ATHERECTOMY, INCLUDE",46830.0,30439.5,11707.5,120938.48,36
HCPCS,C9772,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL/PERONEAL ARTERY(IES), WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL (S), WHEN PERFORMED",23931.0,15555.15,5982.75,61801.81,37
HCPCS,C9773,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS,  TIBIAL/PERONEAL ARTERY(IES); WITH INTRAVASCULAR LITHOTRIPSY, AND TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY  WITHIN THE SAME VESSEL(S",46830.0,30439.5,11707.5,120938.48,36
HCPCS,C9774,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL/PERONEAL ARTERY(IES); WITH INTRAVASCULAR LITHOTRIPSY AND ATHERECTOMY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL (S), WHEN PERFORMED",46830.0,30439.5,11707.5,120938.48,36
HCPCS,C9775,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL/PERONEAL ARTERY(IES); WITH INTRAVASCULAR LITHOTRIPSY AND TRANSLUMINAL STENT PLACEMENT(S), AND ATHERECTOMY, INCLUDES ANGIOPLASTY WITHIN THE",46830.0,30439.5,11707.5,120938.48,36
HCPCS,C9789,"INSTILLATION OF ANTI-NEOPLASTIC PHARMACOLOGIC/BIOLOGIC AGENT INTO RENAL PELVIS, ANY METHOD, INCLUDING ALL IMAGING GUIDANCE, INCLUDING VOLUMETRIC MEASUREMENT IF PERFORMED",585.0,380.25,146.25,6451.0,19
HCPCS,C9797,"VASCULAR EMBOLIZATION OR OCCLUSION PROCEDURE WITH USE OF A PRESSURE-GENERATING CATHETER (E.G., ONE-WAY VALVE, INTERMITTENTLY OCCLUDING), INCLUSIVE OF ALL RADIOLOGICAL SUPERVISION AND INTERPRETATION, I",43200.0,28080.0,6141.01,111564.0,17
HCPCS,CI768,HC GRAFT ARTEGRAFT 40CM BOVINE ARTERY BIO,9580.5,6227.33,2395.13,24741.64,17
HCPCS,D0120,PERIODIC ORAL EVALUATION,82.0,53.3,16.5,78.57,15
HCPCS,D0140,LIMIT ORAL EVAL PROBLM FOCUS,88.64,57.62,23.61,78.57,15
HCPCS,D0150,COMPREHENSVE ORAL EVALUATION,110.0,71.5,23.61,78.57,15
HCPCS,D0160,EXTENSV ORAL EVAL PROB FOCUS,190.0,123.5,32.47,153.47,15
HCPCS,D0170,"RE-EVAL,EST PT,PROBLEM FOCUS",110.0,71.5,19.24,78.57,15
HCPCS,D0171,RE-EVAL POST-OP VISIT,110.0,71.5,16.5,78.57,15
HCPCS,D0180,COMP PERIODONTAL EVALUATION,315.0,204.75,23.61,157.5,15
HCPCS,D0210,INTRAOR COMPREHENSIVE SERIES,153.0,99.45,17.14,120.52,15
HCPCS,D0220,INTRAORAL PERIAPICAL FIRST,39.0,25.35,4.21,78.57,15
HCPCS,D0230,INTRAORAL PERIAPICAL EA ADD,27.56,17.91,1.94,78.57,15
HCPCS,D0240,INTRAORAL OCCLUSAL FILM,40.0,26.0,5.18,78.57,15
HCPCS,D0270,DENTAL BITEWING SINGLE IMAGE,109.345,71.075,4.21,258.25,33
HCPCS,D0272,DENTAL BITEWINGS TWO IMAGES,164.09,106.66,5.18,82.05,15
HCPCS,D0273,BITEWINGS - THREE IMAGES,164.09,106.66,6.79,82.05,15
HCPCS,D0274,BITEWINGS FOUR IMAGES,193.14,125.54,8.41,96.57,15
HCPCS,D0330,PANORAMIC IMAGE,170.0,110.5,11.97,516.5,33
HCPCS,D0340,2D CEPHALOMETRIC IMAGE,210.0,136.5,18.11,120.52,15
HCPCS,D0350,ORAL/FACIAL PHOTO IMAGES,79.0,51.35,23.61,81.37,15
HCPCS,D0364,CONE BEAM CT CAPT & INTERP,525.0,341.25,47.87,540.75,15
HCPCS,D0365,CONE BEAM CT INTERPRETE MAN,365.0,237.25,47.87,503.07,15
HCPCS,D0366,CONE BEAM CT INTERPRETE MAX,551.0,358.15,47.87,567.53,15
HCPCS,D0367,CONE BEAM CT INTERP BOTH JAW,578.0,375.7,47.87,595.34,15
HCPCS,D0368,CONE BEAM CT INTERPRETE TMJ,578.0,375.7,69.87,737.45,15
HCPCS,D0460,PULP VITALITY TEST,60.0,39.0,19.08,78.57,15
HCPCS,D0461,TESTING FOR CRACKED TOOTH,10.0,6.5,4.5,80.0,12
HCPCS,D0470,DIAGNOSTIC CASTS,156.0,101.4,29.76,107.93,15
HCPCS,D0801,3D INTRAORAL SCAN DIRECT,60.0,39.0,0.01,235.53,32
HCPCS,D1110,DENTAL PROPHYLAXIS ADULT,112.0,72.8,37.52,94.67,15
HCPCS,D1120,DENTAL PROPHYLAXIS CHILD,88.0,57.2,25.23,78.57,15
HCPCS,D1206,TOPICAL FLUORIDE VARNISH,68.0,44.2,15.53,78.57,15
HCPCS,D1208,TOPICAL APP FLUORID EX VRNSH,61.0,39.65,12.29,78.57,15
HCPCS,D1351,DENTAL SEALANT PER TOOTH,85.0,55.25,19.73,78.57,15
HCPCS,D2140,AMALGAM ONE SURFACE PERMANEN,170.0,110.5,44.96,110.68,15
HCPCS,D2150,AMALGAM TWO SURFACES PERMANE,200.0,130.0,50.14,133.28,15
HCPCS,D2160,AMALGAM THREE SURFACES PERMA,269.5,175.175,61.13,3682.58,33
HCPCS,D2161,AMALGAM 4 OR > SURFACES PERM,281.0,182.65,74.4,197.23,15
HCPCS,D2330,RESIN ONE SURFACE-ANTERIOR,310.5,201.82500000000002,44.96,2975.33,34
HCPCS,D2331,RESIN TWO SURFACES-ANTERIOR,275.63,179.16,67.6,165.97,15
HCPCS,D2332,RESIN THREE SURFACES-ANTERIO,281.0,182.65,78.57,198.98,15
HCPCS,D2335,RESIN 4/> SURF OR W INCIS AN,329.0,213.85,78.57,234.79,15
HCPCS,D2391,POST 1 SRFC RESINBASED CMPST,200.0,130.0,44.96,148.81,15
HCPCS,D2392,POST 2 SRFC RESINBASED CMPST,254.0,165.1,78.57,220.44,15
HCPCS,D2393,POST 3 SRFC RESINBASED CMPST,295.0,191.75,78.57,298.4,15
HCPCS,D2394,POST >=4SRFC RESINBASE CMPST,312.0,202.8,78.57,314.2,15
HCPCS,D2520,DENTAL INLAY METALLIC 2 SURF,976.0,634.4,78.57,1005.28,15
HCPCS,D2530,DENTAL INLAY METL 3/MORE SUR,1125.0,731.25,78.57,1158.75,15
HCPCS,D2543,DENTAL ONLAY METALLIC 3 SURF,875.0,568.75,78.57,967.08,15
HCPCS,D2544,DENTAL ONLAY METL 4/MORE SUR,910.0,591.5,78.57,1006.13,15
HCPCS,D2643,DENTAL ONLAY PORCELIN 3 SURF,905.0,588.25,78.57,999.93,15
HCPCS,D2710,CROWN RESIN-BASED INDIRECT,898.0,583.7,78.57,553.03,15
HCPCS,D2740,CROWN PORCELAIN/CERAMIC,1230.0,799.5,78.57,1105.18,15
HCPCS,D2750,CROWN PORCELAIN W/ H NOBLE M,1214.0,789.1,78.57,1216.64,15
HCPCS,D2751,CROWN PORCELAIN FUSED BASE M,1131.0,735.15,78.57,999.93,15
HCPCS,D2752,CROWN PORCELAIN W/ NOBLE MET,1158.0,752.7,78.57,1023.74,15
HCPCS,D2780,CROWN 3/4 CAST HI NOBLE MET,945.0,614.25,78.57,1029.92,15
HCPCS,D2790,CROWN FULL CAST HIGH NOBLE M,1170.0,760.5,78.57,1048.97,15
HCPCS,D2791,CROWN FULL CAST BASE METAL,1110.0,721.5,78.57,980.6,15
HCPCS,D2799,INTERIM CROWN,513.0,333.45,78.57,528.39,15
HCPCS,D2910,RECEMENT INLAY ONLAY OR PART,97.0,63.05,24.05,87.75,15
HCPCS,D2920,RE-CEMENT OR RE-BOND CROWN,101.0,65.65,24.05,88.67,15
HCPCS,D2930,PREFAB STNLSS STEEL CRWN PRI,393.0,255.45,78.57,240.1,15
HCPCS,D2931,PREFAB STNLSS STEEL CROWN PE,393.0,255.45,78.57,331.7,15
HCPCS,D2932,PREFABRICATED RESIN CROWN,349.0,226.85,78.57,291.15,15
HCPCS,D2940,PLACE DIRECT RESTORATION,109.0,70.85,33.96,92.18,15
HCPCS,D2950,CORE BUILD-UP INCL ANY PINS,261.0,169.65,78.57,230.09,15
HCPCS,D2951,TOOTH PIN RETENTION,55.0,35.75,13.23,78.57,15
HCPCS,D2952,POST AND CORE CAST + CROWN,398.0,258.7,78.57,442.35,15
HCPCS,D2954,PREFAB POST/CORE + CROWN,330.0,214.5,78.57,291.15,15
HCPCS,D2960,LABIAL VENEER RESIN DIRECT,806.0,523.9,78.57,830.18,15
HCPCS,D2962,LABIAL VENEER PORC INDIRECT,980.0,637.0,78.57,1009.4,15
HCPCS,D2999,DENTAL UNSPEC RESTORATIVE PR,37.0,24.05,16.65,80.89,15
HCPCS,D3110,PULP CAP DIRECT,85.0,55.25,33.64,87.55,15
HCPCS,D3120,PULP CAP INDIRECT,70.0,45.5,26.52,78.57,15
HCPCS,D3220,THERAPEUTIC PULPOTOMY,237.0,154.05,78.57,198.43,15
HCPCS,D3221,GROSS PULPAL DEBRIDEMENT,190.0,123.5,78.57,263.37,15
HCPCS,D3310,"END THXPY, ANTERIOR TOOTH",822.0,534.3,78.57,673.27,15
HCPCS,D3320,"END THXPY, PREMOLAR TOOTH",849.0,551.85,78.57,758.49,15
HCPCS,D3330,"END THXPY, MOLAR TOOTH",1130.0,734.5,78.57,939.5,15
HCPCS,D3347,RETREAT ROOT CANAL PREMOLAR,1158.0,752.7,78.57,968.84,15
HCPCS,D3348,RETREAT ROOT CANAL MOLAR,1433.0,931.45,78.57,1199.85,15
HCPCS,D3351,APEXIFICATION/RECALC INITIAL,419.0,272.35,78.57,351.61,15
HCPCS,D3352,APEXIFICATION/RECALC INTERIM,188.0,122.2,78.57,250.99,15
HCPCS,D3410,APICOECTOMY - ANTERIOR,660.0,429.0,78.57,696.74,15
HCPCS,D3421,ROOT SURGERY PREMOLAR,735.0,477.75,78.57,775.12,15
HCPCS,D3425,ROOT SURGERY MOLAR,1047.0,680.55,78.57,1078.41,15
HCPCS,D3426,ROOT SURGERY EA ADD ROOT,285.0,185.25,78.57,329.99,15
HCPCS,D3430,RETROGRADE FILLING,263.0,170.95,78.57,270.89,15
HCPCS,D3450,ROOT AMPUTATION,525.0,341.25,78.57,540.75,15
HCPCS,D3950,CANAL PREP/FITTING OF DOWEL,172.0,111.8,77.4,198.43,15
HCPCS,D4210,GINGIVECTOMY/PLASTY 4 OR MOR,317.5,206.375,0.01,1663.36,32
HCPCS,D4211,GINGIVECTOMY/PLASTY 1 TO 3,158.0,102.7,0.01,1567.53,32
HCPCS,D4245,APICALLY POSITIONED FLAP,525.0,341.25,0.01,1567.53,32
HCPCS,D4249,CROWN LENGTHEN HARD TISSUE,903.0,586.95,78.57,930.09,15
HCPCS,D4260,OSSEOUS SURGERY 4 OR MORE,1040.0,676.0,78.57,1150.52,15
HCPCS,D4261,OSSEOUS SURG 1 TO 3 TEETH,560.0,364.0,78.57,662.8,15
HCPCS,D4263,BONE REPLCE GRAFT FIRST SITE,525.0,341.25,78.57,540.75,15
HCPCS,D4264,BONE REPLCE GRAFT EACH ADD,525.0,341.25,78.57,540.75,15
HCPCS,D4265,BIO MTRLS TO AID SOFT/OS REG,550.0,357.5,0.01,824.0,32
HCPCS,D4266,GUIDED TISS REGEN RESORBLE,525.0,341.25,78.57,742.72,15
HCPCS,D4267,GUIDED TISS REGEN NONRESORB,437.5,284.375,0.01,1567.53,32
HCPCS,D4270,PEDICLE SOFT TISSUE GRAFT PR,740.0,481.0,78.57,818.27,15
HCPCS,D4273,AUTO TISSUE GRAFT 1ST TOOTH,900.0,585.0,78.57,999.93,15
HCPCS,D4274,MESIAL/DISTAL WEDGE PROC,515.0,334.75,78.57,567.06,15
HCPCS,D4276,CON TISSUE W PEDICLE GRAFT,1010.0,656.5,78.57,1121.19,15
HCPCS,D4277,SOFT TISSUE GRAFT FIRSTTOOTH,1962.5,1275.625,0.01,8121.96,32
HCPCS,D4278,SOFT TISSUE GRAFT ADDL TOOTH,390.0,253.5,78.57,701.21,15
HCPCS,D4322,SPLINT INTRA-CORONAL,1101.0,715.65,0.01,4266.29,32
HCPCS,D4323,SPLINT EXTRA-CORONAL,1268.5,824.525,0.01,4266.29,32
HCPCS,D4341,PERIODONTAL SCALING & ROOT,339.0,220.35,78.57,266.76,15
HCPCS,D4342,PERIODONTAL SCALING 1-3TEETH,176.0,114.4,58.87,144.84,15
HCPCS,D4346,SCALING GINGIV INFLAMMATION,75.0,48.75,33.75,481.06,15
HCPCS,D4355,FULL MOUTH DEBRIDEMENT,214.0,139.1,54.67,157.9,15
HCPCS,D4910,PERIODONTAL MAINT PROCEDURES,161.0,104.65,34.87,140.59,15
HCPCS,D5110,DENTURES COMPLETE MAXILLARY,2243.0,1457.95,78.57,1702.16,15
HCPCS,D5120,DENTURES COMPLETE MANDIBLE,2243.0,1457.95,78.57,1702.16,15
HCPCS,D5130,DENTURES IMMEDIAT MAXILLARY,1890.0,1228.5,78.57,1871.52,15
HCPCS,D5140,DENTURES IMMEDIAT MANDIBLE,1969.0,1279.85,78.57,1871.52,15
HCPCS,D5211,DENTURES MAXILL PART RESIN,1570.0,1020.5,78.57,1157.05,15
HCPCS,D5212,DENTURES MAND PART RESIN,1570.0,1020.5,78.57,1303.16,15
HCPCS,D5213,DENTURES MAXILL PART METAL,1890.0,1228.5,78.57,2041.79,15
HCPCS,D5214,DENTURES MANDIBL PART METAL,2142.17,1392.41,78.57,2041.79,15
HCPCS,D5282,"REMOVE UNIL PART DENTURE,MAX",1210.0,786.5,0.01,1807.75,32
HCPCS,D5283,"REMOVE UNIL PART DENTURE,MAN",1720.0,1118.0,78.57,1771.6,15
HCPCS,D5284,REM UNILAT DENT FLEX BASE,1720.0,1118.0,78.57,1771.6,15
HCPCS,D5286,REM UNILAT DENT 1 PC RESIN,1720.0,1118.0,78.57,1771.6,15
HCPCS,D5410,DENTURES ADJUST CMPLT MAXIL,82.0,53.3,24.05,81.61,15
HCPCS,D5411,DENTURES ADJUST CMPLT MAND,82.0,53.3,24.05,81.61,15
HCPCS,D5421,DENTURES ADJUST PART MAXILL,82.0,53.3,24.05,81.61,15
HCPCS,D5422,DENTURES ADJUST PART MANDBL,82.0,53.3,24.05,81.61,15
HCPCS,D5511,REP BROKE COMP DENT BASE MAN,345.0,224.25,78.57,203.54,15
HCPCS,D5512,REP BROKE COMP DENT BASE MAX,345.0,224.25,78.57,203.54,15
HCPCS,D5520,REPLACE DENTURE TEETH COMPLT,199.0,129.35,55.64,136.08,15
HCPCS,D5611,REP RESIN PART DENT BASE MAN,318.0,206.7,78.57,203.54,15
HCPCS,D5612,REP RESIN PART DENT BASE MAX,318.0,206.7,78.57,203.54,15
HCPCS,D5630,REP PARTIAL DENTURE CLASP,400.0,260.0,78.57,250.99,15
HCPCS,D5640,REPLACE PART DENTURE TEETH,199.37,129.59,70.72,203.54,15
HCPCS,D5650,ADD TOOTH TO PARTIAL DENTURE,206.0,133.9,70.72,203.54,15
HCPCS,D5660,ADD CLASP TO PARTIAL DENTURE,349.0,226.85,78.57,339.62,15
HCPCS,D5710,DENTURES REBASE CMPLT MAXIL,657.0,427.05,78.57,680.3,15
HCPCS,D5720,DENTURES REBASE PART MAXILL,657.0,427.05,78.57,544.3,15
HCPCS,D5730,DENTURE RELN CMPLT MAX DIR,368.0,239.2,78.57,408.19,15
HCPCS,D5731,DENTURE RELN CMPLT MAND DIR,368.0,239.2,78.57,408.19,15
HCPCS,D5740,DENTURE RELN PART MAX DIR,368.0,239.2,78.57,339.62,15
HCPCS,D5741,DENTURE RELN PART MAND DIR,368.0,239.2,78.57,339.62,15
HCPCS,D5750,DENTURE RELN CMPLT MAX INDIR,636.3,413.6,78.57,544.3,15
HCPCS,D5751,DENTURE RELN CMPLT MAND IND,579.03,376.37,78.57,544.3,15
HCPCS,D5760,DENTURE RELN PART MAX INDIR,572.0,371.8,78.57,544.3,15
HCPCS,D5761,DENTURE RELN PART MAND INDIR,572.0,371.8,78.57,544.3,15
HCPCS,D5810,DENTURE INTERM CMPLT MAXILL,1181.0,767.65,78.57,816.38,15
HCPCS,D5811,DENTURE INTERM CMPLT MANDBL,1181.0,767.65,78.57,816.38,15
HCPCS,D5820,DENTURE INTERM PART MAXILL,799.0,519.35,78.57,680.3,15
HCPCS,D5821,DENTURE INTERM PART MANDBL,799.0,519.35,78.57,680.3,15
HCPCS,D5850,DENTURE TISS CONDITN MAXILL,179.0,116.35,50.0,516.5,33
HCPCS,D5851,DENTURE TISS CONDTIN MANDBL,173.0,112.45,50.0,516.5,33
HCPCS,D5863,OVERDENTURE COMPLETE MAX,3230.0,2099.5,78.57,3326.9,15
HCPCS,D5865,OVERDENTURE COMPLETE MANDIB,3230.0,2099.5,78.57,3326.9,15
HCPCS,D5875,PROSTHESIS MODIFICATION,394.0,256.1,78.57,405.82,15
HCPCS,D5911,FACIAL MOULAGE SECTIONAL,2100.0,1365.0,78.57,2163.0,15
HCPCS,D5913,NASAL PROSTHESIS,2320.54,1508.35,78.57,7093.06,15
HCPCS,D5915,ORBITAL PROSTHESIS,3146.24,2045.06,78.57,9597.8,15
HCPCS,D5923,OCULAR PROSTHESIS INTERIM,4949.0,3216.85,78.57,9549.58,15
HCPCS,D5927,AURICULAR REPLACEMENT,2570.0,1670.5,78.57,5968.82,15
HCPCS,D5928,ORBITAL REPLACEMENT,3146.24,2045.06,78.57,8056.68,15
HCPCS,D5931,SURGICAL OBTURATOR,2498.0,1623.7,78.57,3818.75,15
HCPCS,D5932,POSTSURGICAL OBTURATOR,7170.0,4660.5,78.57,7385.1,15
HCPCS,D5933,REFITTING OF OBTURATOR,2650.0,1722.5,78.57,2729.5,15
HCPCS,D5935,MANDIBULAR DENTURE PROSTH,2129.81,1384.38,78.57,5663.12,15
HCPCS,D5936,TEMP OBTURATOR PROSTHESIS,7190.0,4673.5,78.57,7405.7,15
HCPCS,D5952,PEDIATRIC SPEECH AID,2151.94,1398.76,78.57,3374.94,15
HCPCS,D5953,ADULT SPEECH AID,2151.94,1398.76,78.57,6410.93,15
HCPCS,D5954,SUPERIMPOSED PROSTHESIS,5965.0,3877.25,78.57,6143.95,15
HCPCS,D5955,PALATAL LIFT PROSTHESIS,1842.97,1197.93,78.57,5495.22,15
HCPCS,D5958,INTRAORAL CON DEF INTER PLT,1842.97,1197.93,78.57,3213.26,15
HCPCS,D5959,INTRAORAL CON DEF MOD PALAT,1842.97,1197.93,78.57,1898.26,15
HCPCS,D5960,MODIFY SPEECH AID PROSTHESIS,2151.94,1398.76,78.57,2216.5,15
HCPCS,D5982,SURGICAL STENT,644.0,418.6,78.57,663.32,15
HCPCS,D5984,RADIATION SHIELD,1808.0,1175.2,78.57,1862.24,15
HCPCS,D5986,FLUORIDE APPLICATOR,125.0,81.25,56.25,203.54,15
HCPCS,D5988,SURGICAL SPLINT,1182.55,768.66,78.57,1218.03,15
HCPCS,D6010,ODONTICS ENDOSTEAL IMPLANT,1235.5,803.075,78.57,2218.01,30
HCPCS,D6012,ENDOSTEAL IMPLANT,2105.0,1368.25,78.57,2168.15,15
HCPCS,D6040,ODONTICS EPOSTEAL IMPLANT,7660.0,4979.0,78.57,7889.8,15
HCPCS,D6049,SCALE IMPLT PERI-IMPLT INFLM,50.0,32.5,22.5,80.0,12
HCPCS,D6050,ODONTICS TRANSOSTEAL IMPLNT,2762.35,1795.53,78.57,5694.21,15
HCPCS,D6055,IMPLANT CONNECTING BAR,2925.0,1901.25,78.57,3012.75,15
HCPCS,D6056,PREFABRICATED ABUTMENT,1341.87,872.22,78.57,1382.13,15
HCPCS,D6057,CUSTOM ABUTMENT,1030.0,669.5,78.57,1060.9,15
HCPCS,D6058,ABUTMENT SUPPORTED CROWN,1444.0,938.6,78.57,1487.32,15
HCPCS,D6059,ABUTMENT SUPPORTED MTL CROWN,1424.0,925.6,78.57,1466.72,15
HCPCS,D6060,ABUTMENT SUPPORTED MTL CROWN,1347.0,875.55,78.57,1387.41,15
HCPCS,D6061,ABUTMENT SUPPORTED MTL CROWN,1575.0,1023.75,78.57,1622.25,15
HCPCS,D6062,ABUTMENT SUPPORTED MTL CROWN,1575.0,1023.75,78.57,1622.25,15
HCPCS,D6065,IMPLANT SUPPORTED CROWN,1421.0,923.65,78.57,1463.63,15
HCPCS,D6066,IMPLANT SUPPORTED MTL CROWN,1384.0,899.6,78.57,1425.52,15
HCPCS,D6067,IMPLANT SUPPORTED MTL CROWN,1343.0,872.95,78.57,1383.29,15
HCPCS,D6069,ABUTMENT SUPPORTED RETAINER,8925.0,5801.25,78.57,9192.75,15
HCPCS,D6071,ABUTMENT SUPPORTED RETAINER,1680.0,1092.0,78.57,1730.4,15
HCPCS,D6072,ABUTMENT SUPPORTED RETAINER,6825.0,4436.25,78.57,7029.75,15
HCPCS,D6076,IMPLANT SUPPORTED RETAINER,3780.0,2457.0,78.57,3893.4,15
HCPCS,D6077,IMPLANT SUPPORTED RETAINER,12600.0,8190.0,78.57,12978.0,15
HCPCS,D6080,IMPLANT MAINTENANCE,158.0,102.7,71.1,192.29,15
HCPCS,D6090,REPAIR IMPLANT,158.0,102.7,71.1,614.57,15
HCPCS,D6095,ODONTICS REPR ABUTMENT,712.0,462.8,284.8,733.36,14
HCPCS,D6100,SURG REMOVAL OF IMPLANT BODY,588.0,382.2,0.01,1921.45,32
HCPCS,D6101,DEBRIDEMENT OF A PERIIMPLANT,419.0,272.35,0.01,749.84,32
HCPCS,D6102,DEBRIDEMENT & CONTOURING,741.0,481.65,0.01,1413.16,32
HCPCS,D6103,BONE GRAFT REPAIR PERIMPLANT,425.0,276.25,0.01,1663.36,32
HCPCS,D6104,BONE GRAFT TIME OF IMPLANT,862.0,560.3,78.57,887.86,15
HCPCS,D6105,REMOVE IMPLANT BODY,600.0,390.0,78.57,618.0,15
HCPCS,D6190,RADIO/SURGICAL IMPLANT INDEX,368.0,239.2,78.57,379.04,15
HCPCS,D6193,REPLACE IMPLNT SCREW,200.0,130.0,73.6,356.39,15
HCPCS,D6210,PROSTHODONT HIGH NOBLE METAL,920.0,598.0,78.57,1098.12,15
HCPCS,D6212,BRIDGE NOBLE METAL CAST,1062.0,690.3,78.57,1093.86,15
HCPCS,D6240,BRIDGE PORCELAIN HIGH NOBLE,704.345,457.825,44.25,1268.64,34
HCPCS,D6242,BRIDGE PORCELAIN NOBEL METAL,1048.0,681.2,78.57,1098.12,15
HCPCS,D6245,BRIDGE PORCELAIN/CERAMIC,1028.0,668.2,78.57,1058.84,15
HCPCS,D6250,BRIDGE RESIN W/HIGH NOBLE,895.0,581.75,78.57,1098.12,15
HCPCS,D6545,DENTAL RETAINR CAST METL,368.0,239.2,78.57,521.36,15
HCPCS,D6740,CROWN PORCELAIN/CERAMIC,1067.0,693.55,78.57,1114.17,15
HCPCS,D6750,CROWN PORCELAIN HIGH NOBLE,1228.0,798.2,78.57,1317.69,15
HCPCS,D6752,CROWN PORCELAIN NOBLE METAL,1173.0,762.45,78.57,1208.19,15
HCPCS,D6790,CROWN FULL HIGH NOBLE METAL,1186.0,770.9,78.57,1221.58,15
HCPCS,D6920,DENTAL CONNECTOR BAR,1050.0,682.5,78.57,1081.5,15
HCPCS,D6930,RECEMENT/BOND PART DENTURE,147.0,95.55,44.96,127.09,15
HCPCS,D6950,PRECISION ATTACHMENT,637.0,414.05,78.57,656.11,15
HCPCS,D6980,FIXED PARTIAL REPAIR,276.0,179.4,78.57,362.95,15
HCPCS,D7111,EXTRACTION CORONAL REMNANTS,149.0,96.85,52.91,196.33,15
HCPCS,D7140,EXTRACTION ERUPTED TOOTH/EXR,224.0,145.6,65.34,196.33,15
HCPCS,D7210,REM IMP TOOTH W MUCOPER FLP,425.0,276.25,78.57,451.52,15
HCPCS,D7220,IMPACT TOOTH REMOV SOFT TISS,413.0,268.45,78.57,451.52,15
HCPCS,D7230,IMPACT TOOTH REMOV PART BONY,565.0,367.25,78.57,689.21,15
HCPCS,D7240,IMPACT TOOTH REMOV COMP BONY,684.0,444.6,78.57,689.21,15
HCPCS,D7241,IMPACT TOOTH REM BONY W/COMP,717.0,466.05,78.57,726.85,15
HCPCS,D7250,TOOTH ROOT REMOVAL,298.0,193.7,78.57,290.48,15
HCPCS,D7251,CORONECTOMY,520.0,338.0,78.57,690.74,15
HCPCS,D7260,ORAL ANTRAL FISTULA CLOSURE,1661.0,1079.65,78.57,1710.83,15
HCPCS,D7261,PRIMARY CLOSURE SINUS PERF,660.0,429.0,78.57,763.61,15
HCPCS,D7270,TOOTH REIMPLANTATION,525.0,341.25,78.57,523.96,15
HCPCS,D7272,TOOTH TRANSPLANTATION,660.0,429.0,78.57,726.85,15
HCPCS,D7280,EXPOSURE OF UNERUPTED TOOTH,474.0,308.1,78.57,437.26,15
HCPCS,D7282,MOBILIZE ERUPTED/MALPOS TOOT,386.0,250.9,78.57,531.02,15
HCPCS,D7283,PLACE DEVICE IMPACTED TOOTH,210.0,136.5,78.57,553.03,15
HCPCS,D7285,BIOPSY OF ORAL TISSUE HARD,522.5,339.625,0.01,1775.48,32
HCPCS,D7286,BIOPSY OF ORAL TISSUE SOFT,298.0,193.7,0.01,1775.48,32
HCPCS,D7290,REPOSITIONING OF TEETH,1250.0,812.5,78.57,1287.5,15
HCPCS,D7291,TRANSSEPTAL FIBEROTOMY,315.0,204.75,78.57,324.45,15
HCPCS,D7292,SCREW RETAINED PLATE,635.0,412.75,78.57,7634.4,15
HCPCS,D7296,"CORTICOTOMY, 1-3 TEETH",670.0,435.5,78.57,1745.06,15
HCPCS,D7297,"CORTICOTOMY, 4 OR MORE TEETH",695.0,451.75,78.57,1817.93,15
HCPCS,D7300,REM ANCHORAGE DEV W/O FLAP,588.0,382.2,73.6,605.64,15
HCPCS,D7310,ALVEOPLASTY W/ EXTRACTION,473.0,307.45,78.57,305.46,15
HCPCS,D7311,ALVEOLOPLASTY W/EXTRACT 1-3,368.0,239.2,78.57,384.47,15
HCPCS,D7320,ALVEOPLASTY W/O EXTRACTION,525.0,341.25,78.57,394.47,15
HCPCS,D7321,ALVEOLOPLASTY NOT W/EXTRACTS,368.0,239.2,78.57,560.07,15
HCPCS,D7340,VESTIBULOPLASTY RIDGE EXTENS,1750.0,1137.5,78.57,1802.5,15
HCPCS,D7350,VESTIBULOPLASTY EXTEN GRAFT,5090.0,3308.5,78.57,5242.7,15
HCPCS,D7410,RAD EXC LESION UP TO 1.25 CM,437.5,284.375,0.01,2697.15,32
HCPCS,D7411,EXCISION BENIGN LESION>1.25C,660.0,429.0,0.01,1775.48,32
HCPCS,D7450,REM ODONTOGEN CYST TO 1.25CM,710.0,461.5,0.01,1775.48,32
HCPCS,D7451,REM ODONTOGEN CYST > 1.25 CM,2416.0,1570.4,78.57,2488.48,15
HCPCS,D7460,REM NONODONTO CYST TO 1.25CM,6300.0,4095.0,78.57,6489.0,15
HCPCS,D7461,REM NONODONTO CYST > 1.25 CM,1581.0,1027.65,78.57,1628.43,15
HCPCS,D7465,LESION DESTRUCTION,263.0,170.95,78.57,394.47,15
HCPCS,D7471,REM EXOSTOSIS ANY SITE,960.0,624.0,78.57,900.45,15
HCPCS,D7472,REMOVAL OF TORUS PALATINUS,1125.0,731.25,78.57,1158.75,15
HCPCS,D7473,REMOVE TORUS MANDIBULARIS,1060.0,689.0,78.57,1091.8,15
HCPCS,D7485,SURG REDUCT OSSEOUSTUBEROSIT,1104.0,717.6,78.57,1137.12,15
HCPCS,D7490,MAXILLA OR MANDIBLE RESECTIO,7635.0,4962.75,78.57,9015.96,15
HCPCS,D7510,I&D ABSC INTRAORAL SOFT TISS,313.5,203.775,0.01,1775.48,32
HCPCS,D7511,INCISION/DRAIN ABSCESS INTRA,580.0,377.0,0.01,1775.48,32
HCPCS,D7520,I&D ABSCESS EXTRAORAL,1305.0,848.25,78.57,1344.15,15
HCPCS,D7530,REMOVAL FB SKIN/AREOLAR TISS,290.0,188.5,0.01,1775.48,32
HCPCS,D7550,REMOVAL OF SLOUGHED OFF BONE,1299.5,844.675,0.01,2563.67,32
HCPCS,D7560,MAXILLARY SINUSOTOMY,2580.0,1677.0,78.57,2657.4,15
HCPCS,D7630,OPEN RED SIMPL MANDIBLE FX,5831.0,3790.15,78.57,6005.93,15
HCPCS,D7640,CLSD RED SIMPL MANDIBLE FX,4725.0,3071.25,78.57,4866.75,15
HCPCS,D7650,OPEN RED SIMP MALAR/ZYGOM FX,3675.0,2388.75,78.57,4580.4,15
HCPCS,D7730,OPEN REDUCT COMPD MANDBLE FX,7090.0,4608.5,78.57,7302.7,15
HCPCS,D7840,REMOVAL OF TMJ CONDYLE,6250.0,4062.5,78.57,6437.5,15
HCPCS,D7858,TMJ RECONSTRUCTION,13875.0,9018.75,78.57,14291.25,15
HCPCS,D7865,TMJ RESHAPING COMPONENTS,8860.0,5759.0,78.57,9125.8,15
HCPCS,D7870,TMJ ASPIRATION JOINT FLUID,525.0,341.25,78.57,540.75,15
HCPCS,D7880,OCCLUSAL ORTHOTIC APPLIANCE,1231.69,800.6,78.57,1268.64,15
HCPCS,D7910,DENT SUTUR RECENT WND TO 5CM,420.0,273.0,78.57,432.6,15
HCPCS,D7921,COLLECT & APPL BLOOD PRODUCT,490.0,318.5,78.57,504.7,15
HCPCS,D7941,BONE CUTTING RAMUS CLOSED,9900.0,6435.0,78.57,10197.0,15
HCPCS,D7943,CUTTING RAMUS OPEN W/GRAFT,7200.0,4680.0,78.57,10324.68,15
HCPCS,D7945,BONE CUTTING BODY MANDIBLE,8530.0,5544.5,78.57,8785.9,15
HCPCS,D7946,RECONSTRUCTION MAXILLA TOTAL,10565.0,6867.25,78.57,10881.95,15
HCPCS,D7947,RECONSTRUCT MAXILLA SEGMENT,10619.0,6902.35,78.57,10937.57,15
HCPCS,D7948,RECONSTRUCT MIDFACE NO GRAFT,11530.0,7494.5,78.57,11875.9,15
HCPCS,D7950,MANDIBLE GRAFT,842.5,547.625,0.01,3879.59,32
HCPCS,D7951,SINUS AUG W BONE OR BONE SUB,2984.0,1939.6,0.01,4428.99,32
HCPCS,D7953,BONE REPLACEMENT GRAFT,449.0,291.85,0.01,3879.59,32
HCPCS,D7955,REPAIR MAXILLOFACIAL DEFECTS,260.0,169.0,78.57,3429.52,15
HCPCS,D7960,FRENULECTOMY/FRENECTOMY,228.5,148.525,0.01,1775.48,29
HCPCS,D7963,FRENULOPLASTY,909.0,590.85,78.57,936.27,15
HCPCS,D7970,EXCISION HYPERPLASTIC TISSUE,814.0,529.1,78.57,838.42,15
HCPCS,D7971,EXCISION PERICORONAL GINGIVA,275.0,178.75,0.01,1567.53,32
HCPCS,D7972,SURG REDCT FIBROUS TUBEROSIT,739.0,480.35,78.57,761.17,15
HCPCS,D7983,CLOSURE OF SALIVARY FISTULA,2444.0,1588.6,78.57,2517.32,15
HCPCS,D7991,DENTAL CORONOIDECTOMY,3820.0,2483.0,78.57,4507.53,15
HCPCS,D7994,SURG PLACE ZYGOMATIC IMPL,1691.0,1099.15,78.57,3998.32,15
HCPCS,D7995,SYNTHETIC GRAFT FACIAL BONES,525.0,341.25,73.6,540.75,15
HCPCS,D7999,ORAL SURGERY PROCEDURE,358.31,232.9,73.6,369.06,15
HCPCS,D8030,LIMITED DENTAL TX ADOLESCENT,263.0,170.95,78.57,2373.33,15
HCPCS,D8080,COMPRE DENTAL TX ADOLESCENT,394.0,256.1,78.57,6169.89,15
HCPCS,D8210,ORTHODONTIC REM APPLIANCE TX,508.0,330.2,78.57,806.62,15
HCPCS,D8693,REBOND/RECEMENT RETAINERS,137.0,89.05,61.65,141.11,12
HCPCS,D9110,PALLIATIVE TX DENTAL PAIN,105.0,68.25,27.66,95.64,15
HCPCS,D9120,FIX PARTIAL DENTURE SECTION,237.0,154.05,63.4,244.11,15
HCPCS,D9210,DENT ANESTHESIA W/O SURGERY,63.0,40.95,16.5,78.57,15
HCPCS,D9211,REGIONAL BLOCK ANESTHESIA,79.0,51.35,21.67,81.37,15
HCPCS,D9212,TRIGEMINAL BLOCK ANESTHESIA,210.0,136.5,62.16,216.3,15
HCPCS,D9222,"DEEP ANEST, 1ST 15 MIN",298.0,193.7,46.9,149.0,15
HCPCS,D9223,GENERAL ANESTH EA ADDL 15 MI,274.0,178.1,46.9,137.0,15
HCPCS,D9230,ANALGESIA,105.0,68.25,16.5,78.57,15
HCPCS,D9239,"IV MOD SEDATION, 1ST 15 MIN",150.0,97.5,0.01,232.43,32
HCPCS,D9243,IV SEDATION EA ADDL 15M,137.5,89.375,0.01,232.43,32
HCPCS,D9248,SEDATION (NON-IV),77.5,50.375,0.01,204.65,28
HCPCS,D9310,DENTAL CONSULTATION,143.0,92.95,29.11,198.75,15
HCPCS,D9430,OFFICE VISIT DURING HOURS,59.0,38.35,21.67,78.57,15
HCPCS,D9610,DENT THERAPEUTIC DRUG INJECT,110.0,71.5,18.11,113.3,15
HCPCS,D9612,THERA PAR DRUGS 2 OR > ADMIN,203.0,131.95,45.29,209.09,15
HCPCS,D9630,DRUGS/MEDS DISP FOR HOME USE,53.0,34.45,9.06,78.57,15
HCPCS,D9910,DENT APPL DESENSITIZING MED,59.0,38.35,16.5,78.57,15
HCPCS,D9911,APPL DESENSITIZING RESIN,73.0,47.45,19.73,78.57,15
HCPCS,D9920,BEHAVIOR MANAGEMENT,75.0,48.75,29.11,87.81,15
HCPCS,D9930,TREATMENT OF COMPLICATIONS,89.0,57.85,30.73,91.77,15
HCPCS,D9941,FABRICATION ATHLETIC GUARD,210.0,136.5,52.72,216.3,15
HCPCS,D9944,"OCC GUARD, HARD, FULL ARCH",577.0,375.05,78.57,393.18,15
HCPCS,D9945,"OCC GUARD, SOFT, FULL ARCH",577.0,375.05,78.57,323.8,15
HCPCS,D9946,"OCC GUARD, HARD, PART ARCH",555.0,360.75,78.57,297.61,15
HCPCS,D9951,LIMITED OCCLUSAL ADJUSTMENT,110.0,71.5,41.73,113.3,15
HCPCS,D9952,COMPLETE OCCLUSAL ADJUSTMENT,756.0,491.4,78.57,778.68,15
HCPCS,D9970,ENAMEL MICROABRASION,85.0,55.25,38.25,123.35,15
HCPCS,D9971,ODONTOPLASTY PER TOOTH,153.0,99.45,48.84,157.59,15
HCPCS,D9972,EXTRNL BLEACHING PER ARCH,333.0,216.45,78.57,342.99,15
HCPCS,D9973,EXTRNL BLEACHING PER TOOTH,236.0,153.4,42.07,243.08,15
HCPCS,D9974,INTRNL BLEACHING PER TOOTH,284.0,184.6,74.4,292.52,15
HCPCS,E0114,"CRUTCHES UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, PAIR, WITH PADS, TIPS AND HANDGRIPS",40.5,26.33,20.25,167.98,19
HCPCS,E0486,"ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY, ADJUSTABLE OR NON-ADJUSTABLE, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",1758.9099999999999,1143.29,73.6,2200.0,19
HCPCS,E0710,"RESTRAINTS, ANY TYPE (BODY, CHEST, WRIST OR ANKLE)",32.0,20.8,8.0,82.64,16
HCPCS,E0720,"TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) DEVICE, TWO LEAD, LOCALIZED STIMULATION",45.5,29.575,10.25,178.3,35
HCPCS,E0856,"CERVICAL TRACTION DEVICE, WITH INFLATABLE AIR BLADDER(S)",875.0,568.75,21.93,901.25,19
HCPCS,E0935,CONTINUOUS PASSIVE MOTION EXERCISE DEVICE FOR USE ON KNEE ONLY,107.0,69.55,26.75,74.9,16
HCPCS,E0942,CERVICAL HEAD HARNESS/HALTER,33.6,21.84,5.86,78.57,19
HCPCS,G0008,ADMINISTRATION OF INFLUENZA VIRUS VACCINE,80.0,52.0,20.0,206.6,53
HCPCS,G0009,ADMINISTRATION OF PNEUMOCOCCAL VACCINE,50.0,32.5,11.25,232.43,53
HCPCS,G0010,ADMINISTRATION OF HEPATITIS B VACCINE,65.0,42.25,14.18,185.94,53
HCPCS,G0023,"PRINCIPAL ILLNESS NAVIGATION SERVICES BY CERTIFIED OR TRAINED AUXILIARY PERSONNEL UNDER THE DIRECTION OF A PHYSICIAN OR OTHER PRACTITIONER, INCLUDING A PATIENT NAVIGATOR; 60 MINUTES PER CALENDAR MONTH",260.0,169.0,65.0,671.45,17
HCPCS,G0024,"PRINCIPAL ILLNESS NAVIGATION SERVICES, ADDITIONAL 30 MINUTES PER CALENDAR MONTH (LIST SEPARATELY IN ADDITION TO G0023)",130.0,84.5,32.5,335.73,17
HCPCS,G0027,SEMEN ANALYSIS; PRESENCE AND/OR MOTILITY OF SPERM EXCLUDING HUHNER,23.5,15.28,1.53,78.57,19
HCPCS,G0076,"BRIEF (20 MINUTES) CARE MANAGEMENT HOME VISIT FOR A NEW PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, ASSIST",132.0,85.8,47.5,135.96,19
HCPCS,G0077,"LIMITED (30 MINUTES) CARE MANAGEMENT HOME VISIT FOR A NEW PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, ASSI",190.0,123.5,71.38,198.68,19
HCPCS,G0078,"MODERATE (45 MINUTES) CARE MANAGEMENT HOME VISIT FOR A NEW PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, ASS",311.0,202.15,78.57,324.55,19
HCPCS,G0079,"COMPREHENSIVE (60 MINUTES) CARE MANAGEMENT HOME VISIT FOR A NEW PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME",436.0,283.4,78.57,449.08,19
HCPCS,G0080,"EXTENSIVE (75 MINUTES) CARE MANAGEMENT HOME VISIT FOR A NEW PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, AS",530.0,344.5,78.57,552.89,19
HCPCS,G0081,"BRIEF (20 MINUTES) CARE MANAGEMENT HOME VISIT FOR AN EXISTING PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, ",132.0,85.8,47.47,135.96,19
HCPCS,G0082,"LIMITED (30 MINUTES) CARE MANAGEMENT HOME VISIT FOR AN EXISTING PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME",200.0,130.0,77.34,210.49,19
HCPCS,G0083,"MODERATE (45 MINUTES) CARE MANAGEMENT HOME VISIT FOR AN EXISTING PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOM",308.0,200.2,78.57,326.73,19
HCPCS,G0084,"COMPREHENSIVE (60 MINUTES) CARE MANAGEMENT HOME VISIT FOR AN EXISTING PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, RES",428.0,278.2,78.57,459.62,19
HCPCS,G0085,"EXTENSIVE (75 MINUTES) CARE MANAGEMENT HOME VISIT FOR AN EXISTING PATIENT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HO",530.0,344.5,78.57,552.89,19
HCPCS,G0086,"LIMITED (30 MINUTES) CARE MANAGEMENT HOME CARE PLAN OVERSIGHT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, ASSISTED",184.0,119.6,69.53,195.68,19
HCPCS,G0087,"COMPREHENSIVE (60 MINUTES) CARE MANAGEMENT HOME CARE PLAN OVERSIGHT. FOR USE ONLY IN A MEDICARE-APPROVED CMMI MODEL. (SERVICES MUST BE FURNISHED WITHIN A BENEFICIARY'S HOME, DOMICILIARY, REST HOME, AS",300.0,195.0,78.57,309.0,19
HCPCS,G0101,CERVICAL OR VAGINAL CANCER SCREENING; PELVIC AND CLINICAL BREAST EXAMINATION,75.0,48.75,18.75,193.69,35
HCPCS,G0102,PROSTATE CANCER SCREENING; DIGITAL RECTAL EXAMINATION,53.6,34.84,7.37,78.57,19
HCPCS,G0103,PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA),82.65,53.725,11.59,232.43,38
HCPCS,G0104,COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY,363.3,236.15,49.43,446.91,19
HCPCS,G0105,COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK,1074.2,698.23,78.57,1106.43,19
HCPCS,G0106,"COLORECTAL CANCER SCREENING; ALTERNATIVE TO G0104, SCREENING SIGMOIDOSCOPY, BARIUM ENEMA",572.3,372.0,228.92,589.47,14
HCPCS,G0108,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",174.6,113.49000000000001,53.07,568.15,247
HCPCS,G0109,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",41.5,26.975,7.5,273.0,171
HCPCS,G0120,"COLORECTAL CANCER SCREENING; ALTERNATIVE TO G0105, SCREENING COLONOSCOPY, BARIUM ENEMA.",572.3,372.0,228.92,589.47,14
HCPCS,G0121,COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK,1060.0,689.0,78.57,1091.8,19
HCPCS,G0122,COLORECTAL CANCER SCREENING; BARIUM ENEMA,785.9,510.84,314.36,809.48,14
HCPCS,G0123,"SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION",70.9,46.085,12.16,162.7,95
HCPCS,G0127,"TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER",60.35,39.230000000000004,0.01,167.86,36
HCPCS,G0130,"SINGLE ENERGY X-RAY ABSORPTIOMETRY (SEXA) BONE DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) (E.G., RADIUS, WRIST, HEEL)",100.8,65.52,10.53,103.82,19
HCPCS,G0136,"ADMINISTRATION OF A STANDARDIZED, EVIDENCE-BASED ASSESSMENT OF PHYSICAL ACTIVITY AND NUTRITION, 5-15 MINUTES, NOT MORE OFTEN THAN EVERY 6 MONTHS",58.0,37.7,7.68,247.92,36
HCPCS,G0159,"SERVICES PERFORMED BY A QUALIFIED PHYSICAL THERAPIST, IN THE HOME HEALTH SETTING, IN THE ESTABLISHMENT OR DELIVERY OF A SAFE AND EFFECTIVE PHYSICAL THERAPY MAINTENANCE PROGRAM, EACH 15 MINUTES",477.8,310.57,73.6,492.13,15
HCPCS,G0166,"EXTERNAL COUNTERPULSATION, PER TREATMENT SESSION",347.6,225.94,62.5,1052.0,38
HCPCS,G0179,"PHYSICIAN OR ALLOWED PRACTITIONER RE-CERTIFICATION FOR MEDICARE-COVERED HOME HEALTH SERVICES UNDER A HOME HEALTH PLAN OF CARE (PATIENT NOT PRESENT), INCLUDING CONTACTS WITH HOME HEALTH AGENCY AND REVI",135.5,88.08,41.59,139.57,19
HCPCS,G0180,"PHYSICIAN OR ALLOWED PRACTITIONER CERTIFICATION FOR MEDICARE-COVERED HOME HEALTH SERVICES UNDER A HOME HEALTH PLAN OF CARE (PATIENT NOT PRESENT), INCLUDING CONTACTS WITH HOME HEALTH AGENCY AND REVIEW ",177.5,115.38,53.17,182.83,19
HCPCS,G0181,PHYSICIAN OR ALLOWED PRACTITIONER SUPERVISION OF A PATIENT RECEIVING MEDICARE-COVERED SERVICES PROVIDED BY A PARTICIPATING HOME HEALTH AGENCY (PATIENT NOT PRESENT) REQUIRING COMPLEX AND MULTIDISCIPLIN,305.6,198.64,78.57,314.77,19
HCPCS,G0182,PHYSICIAN SUPERVISION OF A PATIENT UNDER A MEDICARE-APPROVED HOSPICE (PATIENT NOT PRESENT) REQUIRING COMPLEX AND MULTIDISCIPLINARY CARE MODALITIES INVOLVING REGULAR PHYSICIAN DEVELOPMENT AND/OR REVISI,306.6,199.29,78.57,315.8,19
HCPCS,G0237,"THERAPEUTIC PROCEDURES TO INCREASE STRENGTH OR ENDURANCE OF RESPIRATORY MUSCLES, FACE TO FACE, ONE ON ONE, EACH 15 MINUTES (INCLUDES MONITORING)",135.0,87.75,33.75,1177.0,38
HCPCS,G0238,"THERAPEUTIC PROCEDURES TO IMPROVE RESPIRATORY FUNCTION, OTHER THAN DESCRIBED BY G0237, ONE ON ONE, FACE TO FACE, PER 15 MINUTES (INCLUDES MONITORING)",150.0,97.5,37.5,1177.0,38
HCPCS,G0239,"THERAPEUTIC PROCEDURES TO IMPROVE RESPIRATORY FUNCTION OR INCREASE STRENGTH OR ENDURANCE OF RESPIRATORY MUSCLES, TWO OR MORE INDIVIDUALS (INCLUDES MONITORING)",433.0,281.45,45.0,1771.6,38
HCPCS,G0245,"INITIAL PHYSICIAN EVALUATION AND MANAGEMENT OF A DIABETIC PATIENT WITH DIABETIC SENSORY NEUROPATHY RESULTING IN A LOSS OF PROTECTIVE SENSATION (LOPS) WHICH MUST INCLUDE: (1) THE DIAGNOSIS OF LOPS, (2)",162.8,105.82,33.55,167.68,19
HCPCS,G0246,FOLLOW-UP PHYSICIAN EVALUATION AND MANAGEMENT OF A DIABETIC PATIENT WITH DIABETIC SENSORY NEUROPATHY RESULTING IN A LOSS OF PROTECTIVE SENSATION (LOPS) TO INCLUDE AT LEAST THE FOLLOWING: (1) A PATIENT,92.4,60.06,16.8,95.17,19
HCPCS,G0247,"ROUTINE FOOT CARE BY A PHYSICIAN OF A DIABETIC PATIENT WITH DIABETIC SENSORY NEUROPATHY RESULTING IN A LOSS OF PROTECTIVE SENSATION (LOPS) TO INCLUDE, THE LOCAL CARE OF SUPERFICIAL WOUNDS (I.E. SUPERF",123.9,80.54,18.47,202.48,19
HCPCS,G0250,"PHYSICIAN REVIEW, INTERPRETATION, AND PATIENT MANAGEMENT OF HOME INR TESTING FOR PATIENT WITH EITHER MECHANICAL HEART VALVE(S), CHRONIC ATRIAL FIBRILLATION, OR VENOUS THROMBOEMBOLISM WHO MEETS MEDICAR",12.0,7.8,6.0,78.57,19
HCPCS,G0252,"PET IMAGING, FULL AND PARTIAL-RING PET SCANNERS ONLY, FOR INITIAL DIAGNOSIS OF BREAST CANCER AND/OR SURGICAL PLANNING FOR BREAST CANCER (E.G., INITIAL STAGING OF AXILLARY LYMPH NODES)",524.0,340.6,78.57,539.72,15
HCPCS,G0257,UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL OUTPATIENT DEPARTMENT THAT IS NOT CERTIFIED AS AN ESRD FACILITY,1535.0,997.75,73.6,4281.79,163
HCPCS,G0259,INJECTION PROCEDURE FOR SACROILIAC JOINT; ARTHROGRAPHY,1637.0,1064.05,409.25,4227.55,19
HCPCS,G0260,"INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID AND/OR OTHER THERAPEUTIC AGENT, WITH OR WITHOUT ARTHROGRAPHY",2509.3,1631.0500000000002,73.6,10568.88,110
HCPCS,G0268,REMOVAL OF IMPACTED CERUMEN (ONE OR BOTH EARS) BY PHYSICIAN ON SAME DATE OF SERVICE AS AUDIOLOGIC FUNCTION TESTING,139.7,90.81,25.34,143.89,19
HCPCS,G0269,"PLACEMENT OF OCCLUSIVE DEVICE INTO EITHER A VENOUS OR ARTERIAL ACCESS SITE, POST SURGICAL OR INTERVENTIONAL PROCEDURE (E.G., ANGIOSEAL PLUG, VASCULAR PLUG)",249.75,162.34,38.25,8477.27,65
HCPCS,G0276,"BLINDED PROCEDURE FOR LUMBAR STENOSIS, PERCUTANEOUS IMAGE-GUIDED LUMBAR DECOMPRESSION (PILD) OR PLACEBO-CONTROL, PERFORMED IN AN APPROVED COVERAGE WITH EVIDENCE DEVELOPMENT (CED) CLINICAL TRIAL",973.4,632.71,78.57,1002.6,19
HCPCS,G0277,"HYPERBARIC OXYGEN UNDER PRESSURE, FULL BODY CHAMBER, PER 30 MINUTE INTERVAL",1233.15,801.55,55.65,6081.79,38
HCPCS,G0278,"ILIAC AND/OR FEMORAL ARTERY ANGIOGRAPHY, NON-SELECTIVE, BILATERAL OR IPSILATERAL TO CATHETER INSERTION, PERFORMED AT THE SAME TIME AS CARDIAC CATHETERIZATION AND/OR CORONARY ANGIOGRAPHY, INCLUDES POSI",1555.4,1011.01,10.32,7884.37,37
HCPCS,G0279,"DIAGNOSTIC DIGITAL BREAST TOMOSYNTHESIS, UNILATERAL OR BILATERAL (LIST SEPARATELY IN ADDITION TO 77065 OR 77066)",91.15,59.25,11.25,141.42,37
HCPCS,G0283,"ELECTRICAL STIMULATION (UNATTENDED), TO ONE OR MORE AREAS FOR INDICATION(S) OTHER THAN WOUND CARE, AS PART OF A THERAPY PLAN OF CARE",49.25,32.015,11.5,277.0,38
HCPCS,G0289,"ARTHROSCOPY, KNEE, SURGICAL, FOR REMOVAL OF LOOSE BODY, FOREIGN BODY, DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY) AT THE TIME OF OTHER SURGICAL KNEE ARTHROSCOPY IN A DIFFERENT COMPARTME",370.2,240.63,65.63,381.31,19
HCPCS,G0296,COUNSELING VISIT TO DISCUSS NEED FOR LUNG CANCER SCREENING USING LOW DOSE CT SCAN (LDCT) (SERVICE IS FOR ELIGIBILITY DETERMINATION AND SHARED DECISION MAKING),68.0,44.2,21.45,78.57,19
HCPCS,G0316,PROLONGED HOSPITAL INPATIENT OR OBSERVATION CARE EVALUATION AND MANAGEMENT SERVICE(S) BEYOND THE TOTAL TIME FOR THE PRIMARY SERVICE (WHEN THE PRIMARY SERVICE HAS BEEN SELECTED USING TIME ON THE DATE O,70.5,45.83,26.25,81.04,19
HCPCS,G0317,PROLONGED NURSING FACILITY EVALUATION AND MANAGEMENT SERVICE(S) BEYOND THE TOTAL TIME FOR THE PRIMARY SERVICE (WHEN THE PRIMARY SERVICE HAS BEEN SELECTED USING TIME ON THE DATE OF THE PRIMARY SERVICE),70.5,45.83,25.81,80.17,19
HCPCS,G0318,PROLONGED HOME OR RESIDENCE EVALUATION AND MANAGEMENT SERVICE(S) BEYOND THE TOTAL TIME FOR THE PRIMARY SERVICE (WHEN THE PRIMARY SERVICE HAS BEEN SELECTED USING TIME ON THE DATE OF THE PRIMARY SERVICE,69.0,44.85,25.94,79.3,19
HCPCS,G0323,"CARE MANAGEMENT SERVICES FOR BEHAVIORAL HEALTH CONDITIONS, AT LEAST 20 MINUTES OF CLINICAL PSYCHOLOGIST, CLINICAL SOCIAL WORKER, MENTAL HEALTH COUNSELOR, OR MARRIAGE AND FAMILY THERAPIST TIME, PER CAL",67.5,43.88,33.75,114.61,19
HCPCS,G0328,"COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS",82.5,53.625,8.12,123.6,38
HCPCS,G0339,"IMAGE-GUIDED ROBOTIC LINEAR ACCELERATOR-BASED STEREOTACTIC RADIOSURGERY, COMPLETE COURSE OF THERAPY IN ONE SESSION OR FIRST SESSION OF FRACTIONATED TREATMENT",38392.5,24955.125,1197.0,104366.57,38
HCPCS,G0340,"IMAGE-GUIDED ROBOTIC LINEAR ACCELERATOR-BASED STEREOTACTIC RADIOSURGERY, DELIVERY INCLUDING COLLIMATOR CHANGES AND CUSTOM PLUGGING, FRACTIONATED TREATMENT, ALL LESIONS, PER SESSION, SECOND THROUGH FIF",8182.5,5318.625,1197.0,22243.07,38
HCPCS,G0341,"PERCUTANEOUS ISLET CELL TRANSPLANT, INCLUDES PORTAL VEIN CATHETERIZATION AND INFUSION",1226.4,797.16,78.57,3908.65,19
HCPCS,G0365,"VESSEL MAPPING OF VESSELS FOR HEMODIALYSIS ACCESS (SERVICES FOR PREOPERATIVE VESSEL MAPPING PRIOR TO CREATION OF HEMODIALYSIS ACCESS USING AN AUTOGENOUS HEMODIALYSIS CONDUIT, INCLUDING ARTERIAL INFLOW",694.3,451.3,73.6,715.13,12
HCPCS,G0372,PHYSICIAN SERVICE REQUIRED TO ESTABLISH AND DOCUMENT THE NEED FOR A POWER MOBILITY DEVICE,42.0,27.3,7.35,78.57,19
HCPCS,G0378,"HOSPITAL OBSERVATION SERVICE, PER HOUR",191.0,124.15,33.0,9520.0,38
HCPCS,G0379,DIRECT ADMISSION OF PATIENT FOR HOSPITAL OBSERVATION CARE,1228.0,798.2,240.75,9520.0,17
HCPCS,G0390,TRAUMA RESPONSE TEAM ASSOCIATED WITH HOSPITAL CRITICAL CARE SERVICE,4457.0,2897.05,1114.25,11510.2,17
HCPCS,G0396,"ALCOHOL AND/OR SUBSTANCE (OTHER THAN TOBACCO) MISUSE STRUCTURED ASSESSMENT (E.G., AUDIT, DAST), AND BRIEF INTERVENTION 15 TO 30 MINUTES",77.0,50.05,27.4,90.4,19
HCPCS,G0397,"ALCOHOL AND/OR SUBSTANCE (OTHER THAN TOBACCO) MISUSE STRUCTURED ASSESSMENT (E.G., AUDIT, DAST), AND INTERVENTION, GREATER THAN 30 MINUTES",152.0,98.8,52.94,175.01,19
HCPCS,G0398,"HOME SLEEP STUDY TEST (HST) WITH TYPE II PORTABLE MONITOR, UNATTENDED; MINIMUM OF 7 CHANNELS: EEG, EOG, EMG, ECG/HEART RATE, AIRFLOW, RESPIRATORY EFFORT AND OXYGEN SATURATION",205.1,133.32,72.46,220.02,15
HCPCS,G0399,"HOME SLEEP TEST (HST) WITH TYPE III PORTABLE MONITOR, UNATTENDED; MINIMUM OF 4 CHANNELS: 2 RESPIRATORY MOVEMENT/AIRFLOW, 1 ECG/HEART RATE AND 1 OXYGEN SATURATION",159.6,103.74,39.79,209.25,15
HCPCS,G0400,"HOME SLEEP TEST (HST) WITH TYPE IV PORTABLE MONITOR, UNATTENDED; MINIMUM OF 3 CHANNELS",205.1,133.32,52.72,211.25,15
HCPCS,G0402,"INITIAL PREVENTIVE PHYSICAL EXAMINATION; FACE-TO-FACE VISIT, SERVICES LIMITED TO NEW BENEFICIARY DURING THE FIRST 12 MONTHS OF MEDICARE ENROLLMENT",346.0,224.9,78.57,428.42,19
HCPCS,G0403,"ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATION WITH INTERPRETATION AND REPORT",63.0,40.95,14.25,78.57,19
HCPCS,G0404,"ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT, PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATION",52.5,34.125,6.29,339.0,38
HCPCS,G0405,"ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; INTERPRETATION AND REPORT ONLY, PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATION",30.0,19.5,7.96,78.57,19
HCPCS,G0412,"OPEN TREATMENT OF ILIAC SPINE(S), TUBEROSITY AVULSION, OR ILIAC WING FRACTURE(S), UNILATERAL OR BILATERAL FOR PELVIC BONE FRACTURE PATTERNS WHICH DO NOT DISRUPT THE PELVIC RING INCLUDES INTERNAL FIXAT",1910.0,1241.5,78.57,1967.3,19
HCPCS,G0413,"PERCUTANEOUS SKELETAL FIXATION OF POSTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION, FOR FRACTURE PATTERNS WHICH DISRUPT THE PELVIC RING, UNILATERAL OR BILATERAL, (INCLUDES ILIUM, SACROILIAC JOINT AND",4010.0,2606.5,78.57,4130.3,19
HCPCS,G0414,"OPEN TREATMENT OF ANTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION FOR FRACTURE PATTERNS WHICH DISRUPT THE PELVIC RING, UNILATERAL OR BILATERAL, INCLUDES INTERNAL FIXATION WHEN PERFORMED (INCLUDES PUB",3202.5,2081.63,78.57,3298.58,19
HCPCS,G0415,"OPEN TREATMENT OF POSTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION, FOR FRACTURE PATTERNS WHICH DISRUPT THE PELVIC RING, UNILATERAL OR BILATERAL, INCLUDES INTERNAL FIXATION, WHEN PERFORMED (INCLUDES ",4586.4,2981.16,78.57,4723.99,19
HCPCS,G0416,"SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATIONS, FOR PROSTATE NEEDLE BIOPSY, ANY METHOD",1068.05,694.235,78.57,1670.88,38
HCPCS,G0420,"FACE-TO-FACE EDUCATIONAL SERVICES RELATED TO THE CARE OF CHRONIC KIDNEY DISEASE; INDIVIDUAL, PER SESSION, PER ONE HOUR",278.3,180.9,78.57,288.83,19
HCPCS,G0424,"PULMONARY REHABILITATION, INCLUDING EXERCISE (INCLUDES MONITORING), ONE HOUR, PER SESSION, UP TO TWO SESSIONS PER DAY",350.0,227.5,87.5,903.88,34
HCPCS,G0429,"DERMAL FILLER INJECTION(S) FOR THE TREATMENT OF FACIAL LIPODYSTROPHY SYNDROME (LDS) (E.G., AS A RESULT OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY)",1885.7,1225.705,0.01,8633.3,36
HCPCS,G0438,"ANNUAL WELLNESS VISIT; INCLUDES A PERSONALIZED PREVENTION PLAN OF SERVICE (PPS), INITIAL VISIT",395.0,256.75,78.57,439.36,19
HCPCS,G0439,"ANNUAL WELLNESS VISIT, INCLUDES A PERSONALIZED PREVENTION PLAN OF SERVICE (PPS), SUBSEQUENT VISIT",275.0,178.75,78.57,345.1,19
HCPCS,G0442,"ANNUAL ALCOHOL MISUSE SCREENING, 5 TO 15 MINUTES",20.0,13.0,7.68,78.57,19
HCPCS,G0443,"BRIEF FACE-TO-FACE BEHAVIORAL COUNSELING FOR ALCOHOL MISUSE, 15 MINUTES",67.0,43.55,25.17,80.08,19
HCPCS,G0444,"ANNUAL DEPRESSION SCREENING, 5 TO 15 MINUTES",69.0,44.85,0.01,216.93,36
HCPCS,G0446,"ANNUAL, FACE-TO-FACE INTENSIVE BEHAVIORAL THERAPY FOR CARDIOVASCULAR DISEASE, INDIVIDUAL, 15 MINUTES",64.6,41.99,25.17,80.08,19
HCPCS,G0447,"FACE-TO-FACE BEHAVIORAL COUNSELING FOR OBESITY, 15 MINUTES",75.0,48.75,0.01,232.43,55
HCPCS,G0452,MOLECULAR PATHOLOGY PROCEDURE; PHYSICIAN INTERPRETATION AND REPORT,298.5,194.025,3.11,1425.54,36
HCPCS,G0455,"PREPARATION WITH INSTILLATION OF FECAL MICROBIOTA BY ANY METHOD, INCLUDING ASSESSMENT OF DONOR SPECIMEN",246.8,160.42,57.55,316.43,19
HCPCS,G0473,"FACE-TO-FACE BEHAVIORAL COUNSELING FOR OBESITY, GROUP (2-10), 30 MINUTES",68.125,44.28,9.66,349.54,36
HCPCS,G0480,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",194.0,126.1,15.0,1900.72,855
HCPCS,G0481,"DRUG TEST(S), DEFINITIVE, UTILIZING (1) DRUG IDENTIFICATION METHODS ABLE TO IDENTIFY INDIVIDUAL DRUGS AND DISTINGUISH BETWEEN STRUCTURAL ISOMERS (BUT NOT NECESSARILY STEREOISOMERS), INCLUDING, BUT NOT",180.0,117.0,45.0,464.85,19
HCPCS,G0500,"MODERATE SEDATION SERVICES PROVIDED BY THE SAME PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING A GASTROINTESTINAL ENDOSCOPIC SERVICE THAT SEDATION SUPPORTS, REQUIRING THE PRESENCE OF",75.0,48.75,4.64,135.21,19
HCPCS,G0515,"DEVELOPMENT OF COGNITIVE SKILLS TO IMPROVE ATTENTION, MEMORY, PROBLEM SOLVING (INCLUDES COMPENSATORY TRAINING), DIRECT (ONE-ON-ONE) PATIENT CONTACT, EACH 15 MINUTES",117.0,76.05,18.5,413.2,57
HCPCS,G0541,"CAREGIVER TRAINING IN DIRECT CARE STRATEGIES AND TECHNIQUES TO SUPPORT CARE FOR PATIENTS WITH AN ONGOING CONDITION OR ILLNESS AND TO REDUCE COMPLICATIONS (INCLUDING, BUT NOT LIMITED TO, TECHNIQUES TO ",75.0,48.75,18.75,273.0,17
HCPCS,G0542,"CAREGIVER TRAINING IN DIRECT CARE STRATEGIES AND TECHNIQUES TO SUPPORT CARE FOR PATIENTS WITH AN ONGOING CONDITION OR ILLNESS AND TO REDUCE COMPLICATIONS (INCLUDING, BUT NOT LIMITED TO, TECHNIQUES TO ",50.0,32.5,12.5,273.0,17
HCPCS,G0543,"GROUP CAREGIVER TRAINING IN DIRECT CARE STRATEGIES AND TECHNIQUES TO SUPPORT CARE FOR PATIENTS WITH AN ONGOING CONDITION OR ILLNESS AND TO REDUCE COMPLICATIONS (INCLUDING, BUT NOT LIMITED TO, TECHNIQU",75.0,48.75,18.75,273.0,17
HCPCS,G0545,"VISIT COMPLEXITY INHERENT TO HOSPITAL INPATIENT OR OBSERVATION CARE ASSOCIATED WITH A CONFIRMED OR SUSPECTED INFECTIOUS DISEASE BY AN INFECTIOUS DISEASES SPECIALIST, INCLUDING DISEASE TRANSMISSION RIS",100.0,65.0,38.32,150.08,19
HCPCS,G0546,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD ASSESSMENT AND MANAGEMENT SERVICE PROVIDED BY A PRACTITIONER IN A SPECIALTY   WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICES FO,40.0,26.0,14.97,78.57,19
HCPCS,G0547,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD ASSESSMENT AND MANAGEMENT SERVICE PROVIDED BY A PRACTITIONER IN A SPECIALTY WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICES FOR ,80.0,52.0,30.12,119.77,19
HCPCS,G0548,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD ASSESSMENT AND MANAGEMENT SERVICE PROVIDED BY A PRACTITIONER IN A SPECIALTY WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICES FOR ,120.0,78.0,45.15,180.58,19
HCPCS,G0549,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD ASSESSMENT AND MANAGEMENT SERVICE PROVIDED BY A PRACTITIONER IN A SPECIALTY WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICES FOR ,160.0,104.0,59.99,242.15,19
HCPCS,G0550,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD ASSESSMENT AND MANAGEMENT SERVICE PROVIDED BY A PRACTITIONER IN A SPECIALTY WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICES FOR ,76.0,49.4,28.64,113.44,19
HCPCS,G0551,INTERPROFESSIONAL TELEPHONE/INTERNET/ELECTRONIC HEALTH RECORD REFERRAL SERVICE(S) PROVIDED BY A TREATING/REQUESTING PRACTITIONER IN A SPECIALTY WHOSE COVERED SERVICES ARE LIMITED BY STATUTE TO SERVICE,79.0,51.35,29.56,119.02,19
HCPCS,G2010,"REMOTE EVALUATION OF RECORDED VIDEO AND/OR IMAGES SUBMITTED BY AN ESTABLISHED PATIENT (E.G., STORE AND FORWARD), INCLUDING INTERPRETATION WITH FOLLOW-UP WITH THE PATIENT WITHIN 24 BUSINESS HOURS, NOT ",30.0,19.5,7.68,78.57,19
HCPCS,G2011,"ALCOHOL AND/OR SUBSTANCE (OTHER THAN TOBACCO) MISUSE STRUCTURED ASSESSMENT (E.G., AUDIT, DAST), AND BRIEF INTERVENTION, 5-14 MINUTES",40.0,26.0,13.87,78.57,19
HCPCS,G2058,"CHRONIC CARE MANAGEMENT SERVICES, EACH ADDITIONAL 20 MINUTES OF CLINICAL STAFF TIME DIRECTED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, PER CALENDAR MONTH (LIST SEPARATELY IN ADDITION",89.0,57.85,40.05,91.67,12
HCPCS,G2061,"QUALIFIED NONPHYSICIAN HEALTHCARE PROFESSIONAL ONLINE ASSESSMENT AND MANAGEMENT SERVICE, FOR AN ESTABLISHED PATIENT, FOR UP TO SEVEN DAYS, CUMULATIVE TIME DURING THE 7 DAYS; 5-10 MINUTES",30.0,19.5,12.0,30.9,14
HCPCS,G2062,"QUALIFIED NONPHYSICIAN HEALTHCARE PROFESSIONAL ONLINE ASSESSMENT AND MANAGEMENT SERVICE, FOR AN ESTABLISHED PATIENT, FOR UP TO SEVEN DAYS, CUMULATIVE TIME DURING THE 7 DAYS; 11-20 MINUTES",60.0,39.0,24.0,61.8,14
HCPCS,G2063,"QUALIFIED NONPHYSICIAN HEALTHCARE PROFESSIONAL ONLINE ASSESSMENT AND MANAGEMENT SERVICE, FOR AN ESTABLISHED PATIENT, FOR UP TO SEVEN DAYS, CUMULATIVE TIME DURING THE 7 DAYS; 21 OR MORE MINUTES",90.0,58.5,36.0,92.7,14
HCPCS,G2064,"COMPREHENSIVE CARE MANAGEMENT SERVICES FOR A SINGLE HIGH-RISK DISEASE, E.G., PRINCIPAL CARE MANAGEMENT, AT LEAST 30 MINUTES OF PHYSICIAN  OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL  TIME PER CALENDAR",215.0,139.75,86.0,221.45,14
HCPCS,G2065,"COMPREHENSIVE CARE MANAGEMENT FOR A SINGLE HIGH-RISK DISEASE SERVICES, E.G. PRINCIPAL CARE MANAGEMENT, AT LEAST 30 MINUTES OF CLINICAL STAFF TIME DIRECTED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE",92.5,60.13,37.0,95.28,14
HCPCS,G2066,"INTERROGATION DEVICE EVALUATION(S), (REMOTE) UP TO 30 DAYS; IMPLANTABLE CARDIOVASCULAR PHYSIOLOGIC MONITOR SYSTEM, IMPLANTABLE LOOP RECORDER SYSTEM, OR SUBCUTANEOUS CARDIAC RHYTHM MONITOR SYSTEM, REMO",137.5,89.375,18.75,1124.0,34
HCPCS,G2082,OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT THAT REQUIRES THE SUPERVISION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL AND PROVISION OF U,805.6,523.64,29.2,3954.32,38
HCPCS,G2083,OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT THAT REQUIRES THE SUPERVISION OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL AND PROVISION OF  ,1158.675,753.14,29.2,5777.96,38
HCPCS,G2086,"OFFICE-BASED TREATMENT FOR OPIOID USE DISORDER, INCLUDING DEVELOPMENT OF THE TREATMENT PLAN, CARE COORDINATION, INDIVIDUAL THERAPY AND GROUP THERAPY AND COUNSELING; AT LEAST 70 MINUTES IN THE FIRST CA",981.75,638.14,78.57,1085.57,19
HCPCS,G2087,"OFFICE-BASED TREATMENT FOR OPIOID USE DISORDER, INCLUDING CARE COORDINATION, INDIVIDUAL THERAPY AND GROUP THERAPY AND COUNSELING; AT LEAST 60 MINUTES IN A SUBSEQUENT CALENDAR MONTH",880.0,572.0,78.57,1024.93,19
HCPCS,G2088,"OFFICE-BASED TREATMENT FOR OPIOID USE DISORDER, INCLUDING CARE COORDINATION, INDIVIDUAL THERAPY AND GROUP THERAPY AND COUNSELING; EACH ADDITIONAL 30 MINUTES BEYOND THE FIRST 120 MINUTES (LIST SEPARATE",164.25,106.76,32.64,169.18,19
HCPCS,G2211,VISIT COMPLEXITY INHERENT TO EVALUATION AND MANAGEMENT ASSOCIATED WITH MEDICAL CARE SERVICES THAT SERVE AS THE CONTINUING FOCAL POINT FOR ALL NEEDED HEALTH CARE SERVICES AND/OR WITH MEDICAL CARE SERVI,45.0,29.25,13.74,78.57,19
HCPCS,G2212,PROLONGED OFFICE OR OTHER OUTPATIENT EVALUATION AND MANAGEMENT SERVICE(S) BEYOND THE MAXIMUM REQUIRED TIME OF THE PRIMARY PROCEDURE WHICH HAS BEEN SELECTED USING TOTAL TIME ON THE DATE OF THE PRIMARY ,78.5,51.03,25.94,81.89,19
HCPCS,G3002,"CHRONIC PAIN MANAGEMENT AND TREATMENT, MONTHLY BUNDLE INCLUDING, DIAGNOSIS; ASSESSMENT AND MONITORING; ADMINISTRATION OF A VALIDATED PAIN RATING SCALE OR TOOL; THE DEVELOPMENT, IMPLEMENTATION, REVISIO",169.0,109.85,61.04,199.53,19
HCPCS,G3003,"EACH ADDITIONAL 15 MINUTES OF CHRONIC PAIN MANAGEMENT AND TREATMENT BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, PER CALENDAR MONTH. (LIST SEPARATELY IN ADDITION TO CODE FOR G3002. WHEN",58.5,38.03,21.34,78.57,19
HCPCS,G6017,"INTRA-FRACTION LOCALIZATION AND TRACKING OF TARGET OR PATIENT MOTION DURING DELIVERY OF RADIATION THERAPY (EG,3D POSITIONAL TRACKING, GATING, 3D SURFACE TRACKING), EACH FRACTION OF TREATMENT",245.0,159.25,70.43,193.24,15
HCPCS,G9016,"SMOKING CESSATION COUNSELING, INDIVIDUAL, IN THE ABSENCE OF OR IN ADDITION TO ANY OTHER EVALUATION AND MANAGEMENT SERVICE, PER SESSION (6-10 MINUTES) [DEMO PROJECT CODE ONLY]",42.0,27.3,18.9,80.89,15
HCPCS,H0001,ALCOHOL AND/OR DRUG ASSESSMENT,236.3,153.6,76.53,243.39,15
HCPCS,H0002,BEHAVIORAL HEALTH SCREENING TO DETERMINE ELIGIBILITY FOR ADMISSION TO TREATMENT PROGRAM,350.0,227.5,76.53,360.5,15
HCPCS,H0004,"BEHAVIORAL HEALTH COUNSELING AND THERAPY, PER 15 MINUTES",21.0,13.65,1.0,80.89,15
HCPCS,H0005,ALCOHOL AND/OR DRUG SERVICES; GROUP COUNSELING BY A CLINICIAN,63.0,40.95,28.35,80.89,15
HCPCS,H0015,"ALCOHOL AND/OR DRUG SERVICES; INTENSIVE OUTPATIENT (TREATMENT PROGRAM THAT OPERATES AT LEAST 3 HOURS/DAY AND AT LEAST 3 DAYS/WEEK AND IS BASED ON AN INDIVIDUALIZED TREATMENT PLAN), INCLUDING ASSESSMEN",525.0,341.25,267.75,1355.81,16
HCPCS,H0031,"MENTAL HEALTH ASSESSMENT, BY NON-PHYSICIAN",351.8,228.67,76.53,362.35,15
HCPCS,H0032,MENTAL HEALTH SERVICE PLAN DEVELOPMENT BY NON-PHYSICIAN,144.4,93.86,64.98,148.73,15
HCPCS,H0046,"MENTAL HEALTH SERVICES, NOT OTHERWISE SPECIFIED",57.95,37.67,12.5,191.9,32
HCPCS,H1002,"PRENATAL CARE, AT RISK ENHANCED SERVICE; CARE COORDINATION",225.0,146.25,56.25,581.06,19
HCPCS,H2000,COMPREHENSIVE MULTIDISCIPLINARY EVALUATION,840.0,546.0,76.53,865.2,15
HCPCS,H2012,"BEHAVIORAL HEALTH DAY TREATMENT, PER HOUR",144.4,93.86,64.98,148.73,15
HCPCS,H2014,"SKILLS TRAINING AND DEVELOPMENT, PER 15 MINUTES",15.8,10.27,7.11,80.89,15
HCPCS,J0013,"ESKETAMINE, NASAL SPRAY, 1 MG",949.615,617.25,60.93,5984.94,64
HCPCS,J0121,"INJECTION, OMADACYCLINE, 1 MG",2081.41,1352.92,4.39,5375.24,19
HCPCS,J0129,"INJECTION, ABATACEPT, 10 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",9998.53,6499.04,43.38,41815.61,53
HCPCS,J0131,"INJECTION, ACETAMINOPHEN, NOT OTHERWISE SPECIFIED,10 MG",6.285,4.085,0.06,24.9,34
HCPCS,J0132,"INJECTION, ACETYLCYSTEINE, 100 MG",13.68,8.89,0.39,64.56,34
HCPCS,J0133,"INJECTION, ACYCLOVIR, 5 MG",10.309999999999999,6.699999999999999,0.13,50.1,34
HCPCS,J0139,"INJECTION, ADALIMUMAB, 1 MG",1522.0,989.3,73.6,1826.4,15
HCPCS,J0153,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",12.565000000000001,8.17,0.56,74.61,68
HCPCS,J0171,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",19.91,12.945,0.36,330.82,190
HCPCS,J0174,"INJECTION, LECANEMAB-IRMB, 1 MG",968.29,629.39,1.41,2500.61,19
HCPCS,J0178,"INJECTION, AFLIBERCEPT, 1 MG",95997.485,62398.365,78.57,717502.61,72
HCPCS,J0208,"INJECTION, SODIUM THIOSULFATE (PEDMARK), 100 MG",17.495,11.370000000000001,3.66,7236.29,38
HCPCS,J0219,"INJECTION, AVALGLUCOSIDASE ALFA-NGPT, 4 MG",3910.6,2541.89,86.18,35052.23,19
HCPCS,J0225,"INJECTION, VUTRISIRAN, 1 MG",712903.04,463386.98,5310.13,1841072.1,19
HCPCS,J0248,"INJECTION, REMDESIVIR, 1 MG",4514.03,2934.12,6.3,13201.4,53
HCPCS,J0256,"INJECTION, ALPHA 1 PROTEINASE INHIBITOR (HUMAN), NOT OTHERWISE SPECIFIED, 10 MG",2073.19,1347.57,5.69,8262.35,57
HCPCS,J0270,"INJECTION, ALPROSTADIL, 1.25 MCG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",1069.02,694.86,0.51,2760.74,17
HCPCS,J0278,"INJECTION, AMIKACIN SULFATE, 100 MG",44.96,29.22,0.66,212.69,34
HCPCS,J0280,"INJECTION, AMINOPHYLLIN, UP TO 250 MG",10.58,6.88,0.86,78.57,66
HCPCS,J0281,"INJECTION, AMINOCAPROIC ACID, 1 GRAM",13.18,8.565,1.33,54.36,34
HCPCS,J0282,"INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG",3.25,2.11,0.33,78.57,49
HCPCS,J0283,"INJECTION, AMIODARONE HYDROCHLORIDE (NEXTERONE), 30 MG",2.56,1.66,0.64,6.61,17
HCPCS,J0285,"INJECTION, AMPHOTERICIN B, 50 MG",254.59,165.48,45.89,657.48,17
HCPCS,J0289,"INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG",1315.97,855.38,21.96,3845.63,57
HCPCS,J0290,"INJECTION, AMPICILLIN SODIUM, 500 MG",126.8,82.42,0.63,2528.11,204
HCPCS,J0295,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",58.575,38.075,1.41,4473.25,102
HCPCS,J0330,"INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG",35.04,22.78,1.64,114.92,34
HCPCS,J0360,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",117.30499999999999,76.25,4.65,369.81,34
HCPCS,J0401,"INJECTION, ARIPIPRAZOLE (ABILIFY MAINTENA), 1 MG",11111.71,7222.61,7.72,28695.99,19
HCPCS,J0456,"INJECTION, AZITHROMYCIN, 500 MG",139.05,90.38,2.16,1312.58,51
HCPCS,J0457,"INJECTION, AZTREONAM, 100 MG",271.81,176.68,2.36,1144.23,34
HCPCS,J0461,"INJECTION, ATROPINE SULFATE, 0.01 MG",242.45,157.59,0.11,691.08,85
HCPCS,J0475,"INJECTION, BACLOFEN, 10 MG",62.47,40.61,6.63,1606.32,129
HCPCS,J0476,"INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL",193.6,125.84,48.4,499.97,17
HCPCS,J0480,"INJECTION, BASILIXIMAB, 20 MG",21954.56,14270.46,2865.52,66058.31,57
HCPCS,J0485,"INJECTION, BELATACEPT, 1 MG",1027.55,667.91,4.12,3216.35,38
HCPCS,J0490,"INJECTION, BELIMUMAB, 10 MG",6901.45,4485.94,45.43,70749.16,53
HCPCS,J0491,"INJECTION, ANIFROLUMAB-FNIA, 1 MG",25196.72,16377.87,19.44,65070.53,19
HCPCS,J0500,"INJECTION, DICYCLOMINE HCL, UP TO 20 MG",60.055,39.035,10.82,198.41,34
HCPCS,J0515,"INJECTION, BENZTROPINE MESYLATE, PER 1 MG",45.83,29.79,6.95,164.97,34
HCPCS,J0517,"INJECTION, BENRALIZUMAB, 1 MG",23154.19,15050.22,173.81,59795.7,19
HCPCS,J0558,"INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, 100,000 UNITS",12.0,7.8,5.4,78.57,15
HCPCS,J0561,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",553.21,359.59,11.25,3383.08,91
HCPCS,J0565,"INJECTION, BEZLOTOXUMAB, 10 MG",641.7,417.11,42.22,2058.35,19
HCPCS,J0570,"BUPRENORPHINE IMPLANT, 74.2 MG",23.2,15.08,10.44,1361.3,12
HCPCS,J0571,"BUPRENORPHINE, ORAL, 1 MG",28.255,18.369999999999997,1.34,134.55,68
HCPCS,J0572,"BUPRENORPHINE/NALOXONE, ORAL, LESS THAN OR EQUAL TO 3 MG BUPRENORPHINE",33.96,22.07,6.48,87.7,17
HCPCS,J0573,"BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 3 MG, BUT LESS THAN OR EQUAL TO 6 MG BUPRENORPHINE",28.62,18.605,4.35,102.89,34
HCPCS,J0583,"INJECTION, BIVALIRUDIN, 1 MG",8.49,5.52,0.17,2427.4,183
HCPCS,J0585,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",2853.15,1854.55,3.0,14948.57,110
HCPCS,J0586,"INJECTION, ABOBOTULINUMTOXINA, 5 UNITS",2223.88,1445.52,1.0,11564.05,57
HCPCS,J0587,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",1528.8200000000002,993.7349999999999,10.4,4087.58,72
HCPCS,J0588,"INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT",645.14,419.34,4.73,6861.16,53
HCPCS,J0597,"INJECTION, C-1 ESTERASE INHIBITOR (HUMAN), BERINERT, 10 UNITS",12205.849999999999,7933.8,80.41,45610.62,38
HCPCS,J0612,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",7.04,4.574999999999999,0.03,78.57,66
HCPCS,J0613,"INJECTION, CALCIUM GLUCONATE (WG CRITICAL CARE), NOT THERAPEUTICALLY EQUIVALENT TO J0612, 10 MG",3.79,2.46,0.1,12.73,85
HCPCS,J0630,"INJECTION, CALCITONIN SALMON, UP TO 400 UNITS",1611.68,1047.59,184.49,6418.6,38
HCPCS,J0636,"INJECTION, CALCITRIOL, 0.1 MCG",48.31,31.4,1.26,125.43,34
HCPCS,J0640,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",211.33,137.36,2.0,1674.69,151
HCPCS,J0665,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",5.05,3.285,0.01,125.9,204
HCPCS,J0666,"INJECTION, BUPIVACAINE LIPOSOME, 1 MG",122.59,79.685,1.53,403.41,34
HCPCS,J0670,"INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML",3.94,2.56,0.54,79.93,51
HCPCS,J0689,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",2.13,1.38,0.4,9.97,85
HCPCS,J0690,"INJECTION, CEFAZOLIN SODIUM, 500 MG",93.01,60.46,0.88,10492.0,153
HCPCS,J0692,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",138.57,90.07,0.86,653.4,83
HCPCS,J0694,"INJECTION, CEFOXITIN SODIUM, 1 GM",111.0,72.15,3.25,1930.5,221
HCPCS,J0695,"INJECTION, CEFTOLOZANE 50 MG AND TAZOBACTAM 25 MG",786.125,510.98,9.49,3124.36,38
HCPCS,J0696,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",35.37,22.99,0.46,1177.1,321
HCPCS,J0697,"INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG",179.09,116.41,2.17,928.54,51
HCPCS,J0699,"INJECTION, CEFIDEROCOL, 10 MG",1510.32,981.71,2.57,3900.4,19
HCPCS,J0701,"INJECTION, CEFEPIME HYDROCHLORIDE (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO MAXIPIME, 500 MG",10.915,7.095,0.4,61.7,68
HCPCS,J0702,"INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG",29.25,19.01,6.85,183.28,49
HCPCS,J0706,"INJECTION, CAFFEINE CITRATE, 5 MG",102.165,66.41,2.15,482.57,34
HCPCS,J0712,"INJECTION, CEFTAROLINE FOSAMIL, 10 MG",1443.395,938.2049999999999,4.49,3811.59,38
HCPCS,J0713,"INJECTION, CEFTAZIDIME, PER 500 MG",70.65,45.925,1.46,1355.81,134
HCPCS,J0714,"INJECTION, CEFTAZIDIME AND AVIBACTAM, 0.5 G/0.125 G",2800.14,1820.09,110.99,7231.36,19
HCPCS,J0717,"INJECTION, CERTOLIZUMAB PEGOL, 1 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",21088.72,13707.67,3.86,135063.46,53
HCPCS,J0736,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",3.3600000000000003,2.1849999999999996,0.42,10.67,102
HCPCS,J0739,"INJECTION, CABOTEGRAVIR, 1MG, FDA APPROVED PRESCRIPTION, ONLY FOR USE AS HIV PRE-EXPOSURE PROPHYLAXIS (NOT FOR USE AS TREATMENT FOR HIV)",2500.14,1625.09,7.58,6456.61,19
HCPCS,J0740,"INJECTION, CIDOFOVIR, 375 MG",1055.785,686.26,238.71,2987.23,38
HCPCS,J0741,"INJECTION, CABOTEGRAVIR AND RILPIVIRINE, 2MG/3MG",1195.58,777.13,25.61,11761.89,57
HCPCS,J0742,"INJECTION, IMIPENEM 4 MG, CILASTATIN 4 MG AND RELEBACTAM 2 MG",2157.33,1402.26,2.76,5571.3,19
HCPCS,J0743,"INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG",266.38,173.15,7.53,687.93,17
HCPCS,J0770,"INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG",174.64,113.52,12.8,451.01,17
HCPCS,J0775,"INJECTION, COLLAGENASE, CLOSTRIDIUM HISTOLYTICUM, 0.01 MG",14988.77,9742.7,83.33,38708.5,19
HCPCS,J0780,"INJECTION, PROCHLORPERAZINE, UP TO 10 MG",36.52,23.740000000000002,2.52,145.78,66
HCPCS,J0791,"INJECTION, CRIZANLIZUMAB-TMCA, 5 MG",333.24,216.605,46.45,1578.71,38
HCPCS,J0834,"INJECTION, COSYNTROPIN, 0.25 MG",202.55,131.655,21.89,861.45,68
HCPCS,J0850,"INJECTION, CYTOMEGALOVIRUS IMMUNE GLOBULIN INTRAVENOUS (HUMAN), PER VIAL",255.71,166.21,63.93,5812.21,19
HCPCS,J0872,"INJECTION, DAPTOMYCIN (XELLIA), UNREFRIGERATED, NOT THERAPEUTICALLY EQUIVALENT TO J0878 OR J0873, 1 MG",162.57,105.67,0.06,497.44,34
HCPCS,J0875,"INJECTION, DALBAVANCIN, 5 MG",10669.015,6934.86,16.53,29383.17,38
HCPCS,J0878,"INJECTION, DAPTOMYCIN, 1 MG",167.72,109.02,0.03,668.38,34
HCPCS,J0881,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",5341.66,3472.08,2.92,95333.09,129
HCPCS,J0883,"INJECTION, ARGATROBAN, 1 MG (FOR NON-ESRD USE)",191.06,124.19,0.65,949.17,38
HCPCS,J0885,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",765.1,497.315,7.08,3622.34,72
HCPCS,J0894,"INJECTION, DECITABINE, 1 MG",423.66999999999996,275.385,0.64,1963.35,72
HCPCS,J0895,"INJECTION, DEFEROXAMINE MESYLATE, 500 MG",114.63,74.51,8.98,296.03,17
HCPCS,J0896,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",34407.11,22364.62,38.25,282346.92,91
HCPCS,J0897,"INJECTION, DENOSUMAB, 1 MG",4722.56,3069.66,18.0,80799.94,91
HCPCS,J1010,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",79.735,51.83,0.13,331.33,68
HCPCS,J1020,"INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG",6.1,3.97,2.44,10.15,14
HCPCS,J1030,"INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG",9.4,6.11,3.76,15.65,14
HCPCS,J1040,"INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG",23.5,15.28,9.4,39.12,14
HCPCS,J1050,"INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG",246.02,159.91,0.51,1549.76,51
HCPCS,J1071,"INJECTION, TESTOSTERONE CYPIONATE, 1 MG",103.705,67.405,0.03,414.88,34
HCPCS,J1073,"TESTOSTERONE PELLET, IMPLANT, 75 MG",197.315,128.255,47.19,487.45,28
HCPCS,J1100,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",50.45,32.79,0.12,337.17,170
HCPCS,J1110,"INJECTION, DIHYDROERGOTAMINE MESYLATE, PER 1 MG",653.775,424.95500000000004,60.5,1936.36,34
HCPCS,J1120,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",252.035,163.82,19.4,845.46,68
HCPCS,J1160,"INJECTION, DIGOXIN, UP TO 0.5 MG",53.19,34.57,3.38,2679.34,51
HCPCS,J1165,"INJECTION, PHENYTOIN SODIUM, PER 50 MG",57.0,37.05,0.64,147.2,17
HCPCS,J1171,"INJECTION, HYDROMORPHONE, 0.1 MG",50.269999999999996,32.675,0.15,731.52,255
HCPCS,J1190,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",563.18,366.07,58.01,2406.24,53
HCPCS,J1200,"INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG",127.58,82.93,0.66,644.57,49
HCPCS,J1205,"INJECTION, CHLOROTHIAZIDE SODIUM, PER 500 MG",2017.86,1311.61,61.62,5211.12,17
HCPCS,J1212,"INJECTION, DMSO, DIMETHYL SULFOXIDE, 50%, 50 ML",34.72,22.57,8.19,1105.28,53
HCPCS,J1230,"INJECTION, METHADONE HCL, UP TO 10 MG",145.94,94.86500000000001,18.76,462.73,34
HCPCS,J1240,"INJECTION, DIMENHYDRINATE, UP TO 50 MG",146.95,95.52,0.98,381.05,34
HCPCS,J1246,UNITUXIN 17.5 MG/ 5 ML VIAL,43538.74,28300.18,10884.69,112438.8,16
HCPCS,J1250,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",7.61,4.95,0.37,235.01,82
HCPCS,J1265,"INJECTION, DOPAMINE HCL, 40 MG",16.695,10.85,0.85,50.77,34
HCPCS,J1299,"INJECTION, ECULIZUMAB, 2 MG",1866.7450000000001,1213.385,47.73,6941.4,34
HCPCS,J1303,"INJECTION, RAVULIZUMAB-CWVZ, 10 MG",8543.64,5553.37,238.29,35052.23,19
HCPCS,J1304,"INJECTION, TOFERSEN, 1 MG",2175.65,1414.17,169.61,5618.62,17
HCPCS,J1306,"INJECTION, INCLISIRAN, 1 MG",15251.02,9913.16,13.45,39385.76,19
HCPCS,J1325,"INJECTION, EPOPROSTENOL, 0.5 MG",262.235,170.45,16.59,968.08,68
HCPCS,J1327,"INJECTION, EPTIFIBATIDE, 5 MG",5.17,3.3600000000000003,0.39,58.57,76
HCPCS,J1335,"INJECTION, ERTAPENEM SODIUM, 500 MG",201.81,131.18,9.16,720.57,49
HCPCS,J1364,"INJECTION, ERYTHROMYCIN LACTOBIONATE, PER 500 MG",506.7,329.36,21.37,1308.55,17
HCPCS,J1380,"INJECTION, ESTRADIOL VALERATE, UP TO 10 MG",40.31,26.205,3.29,189.3,32
HCPCS,J1411,"INJECTION, ETRANACOGENE DEZAPARVOVEC-DRLB, PER THERAPEUTIC DOSE",5250000.0,3412500.0,34364.93,13558125.0,19
HCPCS,J1412,"INJECTION, VALOCTOCOGENE ROXAPARVOVEC-RVOX, PER ML, CONTAINING NOMINAL 2 X 10^13 VECTOR GENOMES",18375.0,11943.75,4593.75,47453.44,17
HCPCS,J1439,"INJECTION, FERRIC CARBOXYMALTOSE, 1 MG",479.885,311.925,1.11,2471.27,34
HCPCS,J1442,"INJECTION, FILGRASTIM (G-CSF), EXCLUDES BIOSIMILARS, 1 MICROGRAM",2.0,1.3,0.9,78.57,15
HCPCS,J1450,"INJECTION FLUCONAZOLE, 200 MG",1.465,0.95,0.3,20.58,68
HCPCS,J1451,"INJECTION, FOMEPIZOLE, 15 MG",2356.79,1531.91,6.82,6086.41,19
HCPCS,J1453,"INJECTION, FOSAPREPITANT, 1 MG",2822.2,1834.43,0.1,11631.22,49
HCPCS,J1455,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",93.0,60.45,2.95,2862.7,91
HCPCS,J1459,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",121.92,79.25,30.48,2058.35,53
HCPCS,J1561,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",46.385000000000005,30.15,4.66,2058.35,148
HCPCS,J1566,"INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G., POWDER), NOT OTHERWISE SPECIFIED, 500 MG",102.9,66.89,46.31,125.81,15
HCPCS,J1568,"INJECTION, IMMUNE GLOBULIN, (OCTAGAM), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",133.27,86.63,33.32,2058.35,19
HCPCS,J1569,"INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G., LIQUID), 500 MG",84.955,55.225,20.61,2922.83,38
HCPCS,J1570,"INJECTION, GANCICLOVIR SODIUM, 500 MG",137.95,89.67,23.98,464.85,34
HCPCS,J1571,"INJECTION, HEPATITIS B IMMUNE GLOBULIN (HEPAGAM B), INTRAMUSCULAR, 0.5 ML",1059.93,688.95,73.77,2737.27,19
HCPCS,J1573,"INJECTION, HEPATITIS B IMMUNE GLOBULIN (HEPAGAM B), INTRAVENOUS, 0.5 ML",466.1,302.97,73.77,1203.7,19
HCPCS,J1580,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",92.42500000000001,60.075,2.16,1025.46,66
HCPCS,J1596,"INJECTION, GLYCOPYRROLATE, 0.1 MG",38.495,25.02,0.4,103.51,34
HCPCS,J1602,"INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE",2583.245,1679.11,10.77,13163.11,34
HCPCS,J1610,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",657.69,427.5,73.61,2945.16,76
HCPCS,J1611,"INJECTION, GLUCAGON HYDROCHLORIDE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J1610, PER 1 MG",980.755,637.495,151.85,2960.09,38
HCPCS,J1626,"INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG",123.2,80.08,0.16,318.16,17
HCPCS,J1628,"INJECTION, GUSELKUMAB, 1 MG",32019.76,20812.84,77.32,82691.03,19
HCPCS,J1630,"INJECTION, HALOPERIDOL, UP TO 5 MG",99.2,64.48,0.77,337.33,34
HCPCS,J1631,"INJECTION, HALOPERIDOL DECANOATE, PER 50 MG",106.91,69.49,3.93,276.1,49
HCPCS,J1640,"INJECTION, HEMIN, 1 MG",69268.7,45024.66,37.43,178886.42,19
HCPCS,J1642,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",5.79,3.76,0.02,41.01,85
HCPCS,J1644,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",26.67,17.34,0.17,571.51,287
HCPCS,J1650,"INJECTION, ENOXAPARIN SODIUM, 10 MG",52.33,34.01,0.56,938.49,255
HCPCS,J1652,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",189.25,123.01,0.93,1302.75,85
HCPCS,J1670,"INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS",2003.125,1302.03,301.23,6778.16,38
HCPCS,J1720,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",314.0,204.1,14.85,1599.42,83
HCPCS,J1740,"INJECTION, IBANDRONATE SODIUM, 1 MG",155.07,100.8,13.93,400.47,19
HCPCS,J1742,"INJECTION, IBUTILIDE FUMARATE, 1 MG",66.7,43.36,16.68,210.42,19
HCPCS,J1745,"INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG",6094.035,3961.125,30.52,30818.11,34
HCPCS,J1750,"INJECTION, IRON DEXTRAN, 50 MG",34.2,22.23,15.39,78.57,15
HCPCS,J1756,"INJECTION, IRON SUCROSE, 1 MG",59.18,38.47,0.23,400.03,83
HCPCS,J1786,"INJECTION, IMIGLUCERASE, 10 UNITS",3902.77,2536.8,45.82,11535.65,19
HCPCS,J1790,"INJECTION, DROPERIDOL, UP TO 5 MG",34.16,22.205,5.27,121.97,34
HCPCS,J1800,"INJECTION, PROPRANOLOL HCL, UP TO 1 MG",39.55,25.705,8.91,112.21,34
HCPCS,J1805,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",5.89,3.83,0.22,86.54,85
HCPCS,J1815,"INJECTION, INSULIN, PER 5 UNITS",121.525,78.99000000000001,0.22,3754.59,603
HCPCS,J1836,"INJECTION, METRONIDAZOLE, 10 MG",1.59,1.03,0.03,16.06,50
HCPCS,J1885,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",52.73,34.27,0.33,183.54,117
HCPCS,J1920,"INJECTION, LABETALOL HYDROCHLORIDE, 5 MG",85.775,55.754999999999995,0.37,298.8,34
HCPCS,J1930,"INJECTION, LANREOTIDE, 1 MG",42618.72,27702.17,35.38,531785.33,91
HCPCS,J1938,"INJECTION, FUROSEMIDE, 1 MG",11.68,7.59,0.01,898.92,83
HCPCS,J1939,"INJECTION, BUMETANIDE, 0.5 MG",2.96,1.92,0.38,32.41,51
HCPCS,J1944,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",1437.27,934.23,3.54,4447.66,57
HCPCS,J1950,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",22712.29,14762.99,78.57,84137.59,91
HCPCS,J1953,"INJECTION, LEVETIRACETAM, 10 MG",2.6799999999999997,1.74,0.04,27.63,102
HCPCS,J1955,"INJECTION, LEVOCARNITINE, PER 1 GM",33.015,21.46,5.01,118.74,34
HCPCS,J1956,"INJECTION, LEVOFLOXACIN, 250 MG",2.05,1.74,0.25,78.57,100
HCPCS,J2001,"INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG",11.05,7.1850000000000005,0.02,55.58,62
HCPCS,J2060,"INJECTION, LORAZEPAM, 2 MG",83.37,54.19,1.49,276.33,68
HCPCS,J2150,"INJECTION, MANNITOL, 25% IN 50 ML",3.1550000000000002,2.05,0.33,78.57,31
HCPCS,J2175,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",77.505,50.379999999999995,3.15,265.22,133
HCPCS,J2180,"INJECTION, MEPERIDINE AND PROMETHAZINE HCL, UP TO 50 MG",44.0,28.6,11.0,113.63,16
HCPCS,J2182,"INJECTION, MEPOLIZUMAB, 1 MG",24713.515,16063.785,33.8,71580.52,38
HCPCS,J2185,"INJECTION, MEROPENEM, 100 MG",124.05,80.63,0.4,402.17,85
HCPCS,J2210,"INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG",136.985,89.04,22.64,471.95,34
HCPCS,J2212,"INJECTION, METHYLNALTREXONE, 0.1 MG",1264.095,821.6600000000001,2.23,4796.19,34
HCPCS,J2248,"INJECTION, MICAFUNGIN SODIUM, 1 MG",562.4,365.565,0.27,3057.22,68
HCPCS,J2250,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",47.35,30.78,0.15,184.83,187
HCPCS,J2251,"INJECTION, MIDAZOLAM IN 0.9% SODIUM CHLORIDE, INTRAVENOUS, NOT THERAPEUTICALLY EQUIVALENT TO J2250, 1 MG",1.55,1.01,0.19,4.13,34
HCPCS,J2260,"INJECTION, MILRINONE LACTATE, 5 MG",3.145,2.04,0.54,10.67,34
HCPCS,J2270,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",18.5,12.03,0.26,550.59,185
HCPCS,J2272,"INJECTION, MORPHINE SULFATE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J2270, UP TO 10 MG",59.94500000000001,38.965,7.18,171.19,34
HCPCS,J2274,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",17.9,11.635,0.72,166.03,102
HCPCS,J2278,"INJECTION, ZICONOTIDE, 1 MICROGRAM",335.18,217.86499999999998,6.5,2058.35,38
HCPCS,J2300,"INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 MG",94.825,61.64,3.66,443.54,34
HCPCS,J2305,"INJECTION, NITROGLYCERIN, 5 MG",55.3,35.95,1.61,209.75,51
HCPCS,J2310,"INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG",33.275,21.630000000000003,6.02,285.5,64
HCPCS,J2315,"INJECTION, NALTREXONE, DEPOT FORM, 1 MG",17354.06,11280.14,4.49,44816.86,19
HCPCS,J2323,"INJECTION, NATALIZUMAB, 1 MG",1777.955,1155.67,24.37,9023.02,34
HCPCS,J2327,"INJECTION, RISANKIZUMAB-RZAA, INTRAVENOUS, 1 MG",7533.76,4896.94,15.83,19455.94,19
HCPCS,J2329,"INJECTION, UBLITUXIMAB-XIIY, 1MG",10802.58,7021.68,74.39,27897.66,19
HCPCS,J2350,"INJECTION, OCRELIZUMAB, 1 MG",20082.38,13053.55,62.88,51862.75,19
HCPCS,J2353,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",29878.8,19421.22,78.57,150173.38,91
HCPCS,J2354,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",37.335,24.27,0.59,407.44,100
HCPCS,J2356,"INJECTION, TEZEPELUMAB-EKKO, 1 MG",20474.74,13308.58,18.89,52876.02,19
HCPCS,J2357,"INJECTION, OMALIZUMAB, 5 MG",5635.88,3663.32,40.12,41468.73,53
HCPCS,J2359,"INJECTION, OLANZAPINE, 0.5 MG",189.74,123.33,0.86,857.31,68
HCPCS,J2371,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",166.92,108.5,0.01,2595.41,68
HCPCS,J2400,"INJECTION, CHLOROPROCAINE HYDROCHLORIDE, PER 30 ML",3.33,2.16,0.83,8.6,16
HCPCS,J2401,"INJECTION, CHLOROPROCAINE HYDROCHLORIDE, PER 1 MG",21.775,14.155,0.04,61.64,34
HCPCS,J2405,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",10.0,6.5,0.09,97.68,83
HCPCS,J2426,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (INVEGA SUSTENNA), 1 MG",10448.45,6791.495000000001,16.02,42308.4,114
HCPCS,J2430,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",22.245,14.46,0.8,82.87,66
HCPCS,J2440,"INJECTION, PAPAVERINE HCL, UP TO 60 MG",136.79000000000002,88.91,27.41,423.35,34
HCPCS,J2469,"INJECTION, PALONOSETRON HCL, 25 MCG",45.8,29.77,0.35,149.58,83
HCPCS,J2501,"INJECTION, PARICALCITOL, 1 MCG",313.0,203.45,1.03,1601.15,34
HCPCS,J2506,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",49955.71,32471.21,19.98,203601.51,106
HCPCS,J2507,"INJECTION, PEGLOTICASE, 1 MG",5000.0,3250.0,78.57,6000.0,15
HCPCS,J2510,"INJECTION, PENICILLIN G PROCAINE, AQUEOUS, UP TO 600,000 UNITS",26.3,17.1,11.84,85.19,15
HCPCS,J2515,"INJECTION, PENTOBARBITAL SODIUM, PER 50 MG",230.035,149.525,38.44,594.21,38
HCPCS,J2540,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",276.63500000000005,179.815,0.28,3626.66,68
HCPCS,J2543,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",11.475000000000001,7.46,0.43,2392.58,68
HCPCS,J2545,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",596.64,387.82,75.15,2292.25,91
HCPCS,J2550,"INJECTION, PROMETHAZINE HCL, UP TO 50 MG",13.1,8.52,3.31,78.57,32
HCPCS,J2560,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",315.975,205.385,30.82,835.36,34
HCPCS,J2562,"INJECTION, PLERIXAFOR, 1 MG",361.65,235.07,32.5,7236.29,19
HCPCS,J2590,"INJECTION, OXYTOCIN, UP TO 10 UNITS",31.675,20.59,2.85,131.97,34
HCPCS,J2597,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",554.5899999999999,360.48,3.61,1793.34,38
HCPCS,J2598,"INJECTION, VASOPRESSIN, 1 UNIT",237.995,154.695,0.48,5857.11,68
HCPCS,J2680,"INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG",36.2,23.53,6.19,111.05,32
HCPCS,J2690,"INJECTION, PROCAINAMIDE HCL, UP TO 1 GM",346.42499999999995,225.18,13.08,4647.96,66
HCPCS,J2700,"INJECTION, OXACILLIN SODIUM, UP TO 250 MG",71.68,46.59,0.6,360.65,51
HCPCS,J2704,"INJECTION, PROPOFOL, 10 MG",7.41,4.82,0.1,25.1,51
HCPCS,J2710,"INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG",17.5,11.375,1.49,65.65,34
HCPCS,J2720,"INJECTION, PROTAMINE SULFATE, PER 10 MG",26.805,17.425,1.66,118.23,34
HCPCS,J2760,"INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG",1984.765,1290.1,185.44,7448.01,38
HCPCS,J2765,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",37.88,24.62,0.95,126.54,49
HCPCS,J2777,"INJECTION, FARICIMAB-SVOA, 0.1 MG",226866.35,147463.13,34.87,585882.35,19
HCPCS,J2778,"INJECTION, RANIBIZUMAB, 0.1 MG",805.0,523.25,65.44,504620.5,53
HCPCS,J2783,"INJECTION, RASBURICASE, 0.5 MG",2744.83,1784.14,78.57,25909.6,53
HCPCS,J2785,"INJECTION, REGADENOSON, 0.1 MG",287.56,186.91,2.67,2616.36,49
HCPCS,J2786,"INJECTION, RESLIZUMAB, 1 MG",490.93,319.1,11.8,2058.35,19
HCPCS,J2787,"RIBOFLAVIN 5'-PHOSPHATE, OPHTHALMIC SOLUTION (PHOTREXA VISCOUS/PHOTREXA), UP TO 3 ML",978.81,636.23,244.7,2900.16,17
HCPCS,J2790,"INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, FULL DOSE, 300 MICROGRAMS (1500 I.U.)",458.4,297.96,85.36,1183.82,38
HCPCS,J2794,"INJECTION, RISPERIDONE (RISPERDAL CONSTA), 0.5 MG",11.6,7.54,5.22,78.57,15
HCPCS,J2795,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",4.49,2.92,0.05,42.92,51
HCPCS,J2802,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",17904.01,11637.61,10.52,99998.48,117
HCPCS,J2805,"INJECTION, SINCALIDE, 5 MICROGRAMS",276.48,179.71,45.96,1769.94,56
HCPCS,J2820,"INJECTION, SARGRAMOSTIM (GM-CSF), 50 MCG",1490.84,969.0450000000001,65.46,5714.84,38
HCPCS,J2850,"INJECTION, SECRETIN, SYNTHETIC, HUMAN, 1 MICROGRAM",1704.05,1107.63,42.87,4400.71,19
HCPCS,J2860,"INJECTION, SILTUXIMAB, 10 MG",14225.53,9246.595,78.57,72738.85,34
HCPCS,J2916,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",17.81,11.58,1.94,79.54,49
HCPCS,J2919,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",212.89,138.38,0.25,1643.89,253
HCPCS,J2920,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 40 MG",10.0,6.5,4.0,60.0,14
HCPCS,J2930,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UP TO 125 MG",37.0,24.05,14.8,222.0,14
HCPCS,J2997,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",13840.99,8996.645,67.5,132890.31,148
HCPCS,J3010,"INJECTION, FENTANYL CITRATE, 0.1 MG",50.55,32.86,0.92,621.58,303
HCPCS,J3030,"INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",131.9,85.74,18.57,496.44,49
HCPCS,J3032,"INJECTION, EPTINEZUMAB-JJMR, 1 MG",9825.895,6386.83,21.73,30910.23,38
HCPCS,J3055,"INJECTION, TALQUETAMAB-TGVS, 0.25 MG",35663.95,23181.57,79.42,129045.33,51
HCPCS,J3101,"INJECTION, TENECTEPLASE, 1 MG",34575.47,22474.06,198.19,89291.15,19
HCPCS,J3105,"INJECTION, TERBUTALINE SULFATE, UP TO 1 MG",190.11,123.57,2.62,490.96,17
HCPCS,J3111,"INJECTION, ROMOSOZUMAB-AQQG, 1 MG",13525.55,8791.61,7.65,35553.95,53
HCPCS,J3145,"INJECTION, TESTOSTERONE UNDECANOATE, 1 MG",1670.15,1085.6,2.19,4313.16,19
HCPCS,J3230,"INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG",66.7,43.355000000000004,4.36,299.44,34
HCPCS,J3240,"INJECTION, THYROTROPIN ALPHA, 0.9 MG, PROVIDED IN 1.1 MG VIAL",5019.99,3262.995,552.5,20220.92,38
HCPCS,J3241,"INJECTION, TEPROTUMUMAB-TRBW, 10 MG",35521.55,23089.01,391.47,91734.4,19
HCPCS,J3243,"INJECTION, TIGECYCLINE, 1 MG",242.3,157.5,0.59,625.74,17
HCPCS,J3260,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",64.38,41.85,2.19,859.22,85
HCPCS,J3262,"INJECTION, TOCILIZUMAB, 1 MG",1587.165,1031.655,5.6,8161.55,34
HCPCS,J3263,"INJECTION, TORIPALIMAB-TPZI, 1 MG",1133.89,737.03,42.62,2928.27,17
HCPCS,J3285,"INJECTION, TREPROSTINIL, 1 MG",559.32,363.56,57.75,6775.19,57
HCPCS,J3300,"INJECTION, TRIAMCINOLONE ACETONIDE, PRESERVATIVE FREE, 1 MG",1846.56,1200.26,25.96,4768.74,19
HCPCS,J3301,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",31.13,20.23,0.74,401.45,117
HCPCS,J3304,"INJECTION, TRIAMCINOLONE ACETONIDE, PRESERVATIVE-FREE, EXTENDED-RELEASE, MICROSPHERE FORMULATION, 1 MG",45.0,29.25,18.01,78.57,15
HCPCS,J3315,"INJECTION, TRIPTORELIN PAMOATE, 3.75 MG",865.0,562.25,78.57,1038.0,15
HCPCS,J3357,"USTEKINUMAB, FOR SUBCUTANEOUS INJECTION, 1 MG",127.0,82.55,57.15,311.77,15
HCPCS,J3360,"INJECTION, DIAZEPAM, UP TO 5 MG",71.015,46.16,5.79,303.57,65
HCPCS,J3370,"INJECTION, VANCOMYCIN HCL, 500 MG",19.994999999999997,12.995000000000001,0.51,3167.88,286
HCPCS,J3380,"INJECTION, VEDOLIZUMAB, INTRAVENOUS, 1 MG",306.38,199.15,20.32,7236.29,53
HCPCS,J3385,"INJECTION, VELAGLUCERASE ALFA, 100 UNITS",3350.46,2177.8,409.62,11535.65,38
HCPCS,J3392,"INJECTION, EXAGAMGLOGENE AUTOTEMCEL, PER TREATMENT",4620000.0,3003000.0,1155000.0,11931150.0,17
HCPCS,J3396,"INJECTION, VERTEPORFIN, 0.1 MG",23.0,14.95,5.75,10547.16,53
HCPCS,J3410,"INJECTION, HYDROXYZINE HCL, UP TO 25 MG",5.5,3.58,2.48,78.57,15
HCPCS,J3411,"INJECTION, THIAMINE HCL, 100 MG",92.975,60.435,1.92,435.18,34
HCPCS,J3415,"INJECTION, PYRIDOXINE HCL, 100 MG",189.83,123.39,16.49,490.24,17
HCPCS,J3420,"INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG",54.18,35.22,0.63,223.08,49
HCPCS,J3430,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",79.2,51.48,0.7,1011.72,83
HCPCS,J3465,"INJECTION, VORICONAZOLE, 10 MG",23.865,15.51,0.75,545.68,66
HCPCS,J3473,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",337.97,219.68,0.38,962.91,34
HCPCS,J3475,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",2.79,1.81,0.32,78.57,117
HCPCS,J3480,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.48,0.97,0.12,180.1,168
HCPCS,J3486,"INJECTION, ZIPRASIDONE MESYLATE, 10 MG",78.58,51.08,9.7,202.93,17
HCPCS,J3489,"INJECTION, ZOLEDRONIC ACID, 1 MG",38.675,25.14,0.63,283.5,100
HCPCS,J3490,UNCLASSIFIED DRUGS,16.695,12.35,0.25,9785092.5,13200
HCPCS,J3535,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,25.46,16.55,1.27,139.89,160
HCPCS,J3590,UNCLASSIFIED BIOLOGICS,3902.4900000000002,2536.6200000000003,71.69,19698.02,64
HCPCS,J7030,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",4.47,2.91,0.36,78.57,65
HCPCS,J7040,"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML = 1 UNIT)",8.0,5.2,1.24,78.57,15
HCPCS,J7042,5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT),5.0,3.25,1.25,78.57,15
HCPCS,J7050,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",4.0,2.6,0.62,78.57,15
HCPCS,J7060,5% DEXTROSE/WATER (500 ML = 1 UNIT),2.32,1.51,0.26,78.57,66
HCPCS,J7070,"INFUSION, D5W, 1000 CC",19.0,12.35,2.93,78.57,15
HCPCS,J7120,"RINGERS LACTATE INFUSION, UP TO 1000 CC",6.0,3.9,2.3,78.57,15
HCPCS,J7168,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",154.005,100.1,2.22,2922.83,76
HCPCS,J7175,"INJECTION, FACTOR X, (HUMAN), 1 I.U.",126.925,82.5,7.9,35052.23,38
HCPCS,J7186,"INJECTION, ANTIHEMOPHILIC FACTOR VIII/VON WILLEBRAND FACTOR COMPLEX (HUMAN), PER FACTOR VIII I.U.",3792.35,2465.03,1.31,9793.74,19
HCPCS,J7187,"INJECTION, VON WILLEBRAND FACTOR COMPLEX (HUMATE-P), PER IU VWF:RCO",5894.360000000001,3831.335,1.58,15668.26,38
HCPCS,J7189,"FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT), (NOVOSEVEN RT), 1 MICROGRAM",8878.09,5770.76,2.78,22974.67,38
HCPCS,J7192,"FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U., NOT OTHERWISE SPECIFIED",4798.19,3118.82,1.69,15220.74,57
HCPCS,J7195,"INJECTION, FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER IU, NOT OTHERWISE SPECIFIED",7070.72,4595.97,1.94,18260.13,38
HCPCS,J7197,"ANTITHROMBIN III (HUMAN), PER I.U.",13067.29,8493.74,4.29,33746.28,19
HCPCS,J7198,"ANTI-INHIBITOR, PER I.U.",20306.87,13199.47,2.59,52442.49,19
HCPCS,J7296,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM, (KYLEENA), 19.5 MG",2145.85,1394.8,78.57,2575.02,15
HCPCS,J7297,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (LILETTA), 52 MG",1690.0,1098.5,78.57,2028.0,15
HCPCS,J7298,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (MIRENA), 52 MG",4734.97,3077.73,78.57,22534.2,53
HCPCS,J7300,INTRAUTERINE COPPER CONTRACEPTIVE,4020.37,2613.24,78.57,16079.94,53
HCPCS,J7301,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (SKYLA), 13.5 MG",1454.4,945.36,78.57,1745.28,15
HCPCS,J7306,"LEVONORGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANTS AND SUPPLIES",1636.0,1063.4,78.57,1963.2,15
HCPCS,J7307,"ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES",2911.12,1892.23,78.57,18533.67,53
HCPCS,J7308,"AMINOLEVULINIC ACID HCL FOR TOPICAL ADMINISTRATION, 20%, SINGLE UNIT DOSAGE FORM (354 MG)",949.16,616.95,237.29,2451.21,19
HCPCS,J7312,"INJECTION, DEXAMETHASONE, INTRAVITREAL IMPLANT, 0.1 MG",392.0,254.8,78.57,25830.04,53
HCPCS,J7313,"INJECTION, FLUOCINOLONE ACETONIDE, INTRAVITREAL IMPLANT (ILUVIEN), 0.01 MG",1196.95,778.02,78.57,11535.65,34
HCPCS,J7315,"MITOMYCIN, OPHTHALMIC, 0.2 MG",2170.0,1410.5,155.18,5604.03,18
HCPCS,J7316,"INJECTION, OCRIPLASMIN, 0.125 MG",3950.0,2567.5,78.57,4740.0,15
HCPCS,J7323,"HYALURONAN OR DERIVATIVE, EUFLEXXA, FOR INTRA-ARTICULAR INJECTION, PER DOSE",429.98,279.49,107.5,1110.42,19
HCPCS,J7324,"HYALURONAN OR DERIVATIVE, ORTHOVISC, FOR INTRA-ARTICULAR INJECTION, PER DOSE",798.0,518.7,78.57,957.6,15
HCPCS,J7325,"HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULAR INJECTION, 1 MG",220.88,143.57,8.01,1349.41,72
HCPCS,J7326,"HYALURONAN OR DERIVATIVE, GEL-ONE, FOR INTRA-ARTICULAR INJECTION, PER DOSE",1919.825,1247.885,78.57,6275.48,33
HCPCS,J7330,"AUTOLOGOUS CULTURED CHONDROCYTES, IMPLANT",218727.0,142172.55,54681.75,564862.48,16
HCPCS,J7352,"AFAMELANOTIDE IMPLANT, 1 MG",125775.9,81754.34,3120.03,324816.26,19
HCPCS,J7354,"CANTHARIDIN FOR TOPICAL ADMINISTRATION, 0.7%, SINGLE UNIT DOSE APPLICATOR (3.2 MG)",3385.21,2200.39,695.89,8742.3,17
HCPCS,J7500,"AZATHIOPRINE, ORAL, 50 MG",7.38,4.8,0.06,31.74,51
HCPCS,J7502,"CYCLOSPORINE, ORAL, 100 MG",19.67,12.79,1.92,191.26,51
HCPCS,J7503,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",19.515,12.685,1.36,118.8,102
HCPCS,J7504,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, EQUINE, PARENTERAL, 250 MG",6106.98,3969.54,1526.75,15771.28,19
HCPCS,J7507,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",11.23,7.3,0.21,130.03,119
HCPCS,J7509,"METHYLPREDNISOLONE ORAL, PER 4 MG",26.545,17.255000000000003,0.15,150.07,102
HCPCS,J7510,"PREDNISOLONE ORAL, PER 5 MG",10.18,6.62,0.43,40.47,68
HCPCS,J7511,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25 MG",5948.25,3866.36,985.34,16673.6,57
HCPCS,J7512,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",13.58,8.83,0.01,376.48,272
HCPCS,J7515,"CYCLOSPORINE, ORAL, 25 MG",16.81,10.925,0.56,55.08,34
HCPCS,J7516,"INJECTION, CYCLOSPORINE, 250 MG",138.29,89.89,34.57,357.13,17
HCPCS,J7517,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",11.55,7.51,0.16,64.95,102
HCPCS,J7518,"MYCOPHENOLIC ACID, ORAL, 180 MG",47.230000000000004,30.699999999999996,0.34,260.16,68
HCPCS,J7519,"INJECTION, MYCOPHENOLATE MOFETIL, 10 MG",1076.76,699.89,0.39,2780.73,19
HCPCS,J7520,"SIROLIMUS, ORAL, 1 MG",36.61,23.8,1.03,241.21,85
HCPCS,J7525,"TACROLIMUS, PARENTERAL, 5 MG",1099.15,714.45,185.44,2838.55,19
HCPCS,J7527,"EVEROLIMUS, ORAL, 0.25 MG",151.16,98.25,1.25,502.3,51
HCPCS,J7608,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",18.56,12.06,2.75,49.51,51
HCPCS,J7611,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG",3.74,2.43,0.28,28.15,84
HCPCS,J7613,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",4.33,2.81,0.07,78.57,117
HCPCS,J7614,"LEVALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 0.5 MG",13.7,8.91,0.08,78.57,15
HCPCS,J7620,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",16.34,10.62,0.19,78.57,81
HCPCS,J7626,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",21.0,13.65,1.04,130.8,83
HCPCS,J7639,"DORNASE ALFA, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",369.23,240.0,58.47,953.54,19
HCPCS,J7644,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",4.56,2.96,0.36,78.57,83
HCPCS,J7674,"METHACHOLINE CHLORIDE ADMINISTERED AS INHALATION SOLUTION THROUGH A NEBULIZER, PER 1 MG",20.81,13.53,2.01,53.74,17
HCPCS,J7676,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",728.165,473.305,73.6,1942.04,31
HCPCS,J7682,"TOBRAMYCIN, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, UNIT DOSE FORM, ADMINISTERED THROUGH DME, PER 300 MILLIGRAMS",30.38,19.75,7.6,78.46,17
HCPCS,J7699,"NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME",43.22,28.095,2.9,246.22,64
HCPCS,J8499,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.48,11.62,0.26,9412.95,25760
HCPCS,J8501,"APREPITANT, ORAL, 5 MG",891.94,579.765,2.94,5954.65,102
HCPCS,J8530,"CYCLOPHOSPHAMIDE; ORAL, 25 MG",123.8,80.47,1.93,319.71,17
HCPCS,J8540,"DEXAMETHASONE, ORAL, 0.25 MG",7.56,4.91,0.01,110.22,119
HCPCS,J8597,"ANTIEMETIC DRUG, ORAL, NOT OTHERWISE SPECIFIED",161.73,105.12,40.43,417.67,16
HCPCS,J8610,"METHOTREXATE; ORAL, 2.5 MG",161.155,104.75,0.16,1138.55,68
HCPCS,J8999,"PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS",80.73,52.47,20.18,208.49,16
HCPCS,J9000,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",14.0,9.1,0.28,84.0,84
HCPCS,J9015,"INJECTION, ALDESLEUKIN, PER SINGLE USE VIAL",34890.45,22678.79,1477.95,90104.59,19
HCPCS,J9017,"INJECTION, ARSENIC TRIOXIDE, 1 MG",45.02,29.26,3.8,202.84,54
HCPCS,J9022,"INJECTION, ATEZOLIZUMAB, 10 MG",3127.98,2033.19,78.57,12694.49,54
HCPCS,J9023,"INJECTION, AVELUMAB, 10 MG",589.9,383.435,78.57,7236.29,35
HCPCS,J9025,"INJECTION, AZACITIDINE, 1 MG",3414.365,2219.335,0.32,10837.25,73
HCPCS,J9029,"INTRAVESICAL INSTILLATION, NADOFARAGENE FIRADENOVEC-VNCG, PER THERAPEUTIC DOSE",94729.75,61574.34,23682.44,244639.58,19
HCPCS,J9030,"BCG LIVE INTRAVESICAL INSTILLATION, 1 MG",413.01,268.46,3.48,1066.6,19
HCPCS,J9031,BCG (INTRAVESICAL) PER INSTILLATION,260.4,169.26,104.16,804.64,15
HCPCS,J9032,"INJECTION, BELINOSTAT, 10 MG",130.0,84.5,50.92,156.0,16
HCPCS,J9033,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, 1 MG",1610.12,1046.58,1.24,23982.23,54
HCPCS,J9034,"INJECTION, BENDAMUSTINE HCL (BENDEKA), 1 MG",58.0,37.7,12.83,78.57,16
HCPCS,J9035,"INJECTION, BEVACIZUMAB, 10 MG",693.0,450.45,72.73,9284.09,129
HCPCS,J9036,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, (BELRAPZO/BENDAMUSTINE), 1 MG",45.0,29.25,13.64,78.57,16
HCPCS,J9039,"INJECTION, BLINATUMOMAB, 1 MICROGRAM",70197.2,45628.18,173.5,181284.27,19
HCPCS,J9040,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",370.185,240.62,16.4,1800.0,67
HCPCS,J9041,"INJECTION, BORTEZOMIB, 0.1 MG",135.0,87.75,2.5,175.5,16
HCPCS,J9042,"INJECTION, BRENTUXIMAB VEDOTIN, 1 MG",66430.68,43179.94,78.57,399697.14,54
HCPCS,J9043,"INJECTION, CABAZITAXEL, 1 MG",45966.61,29878.295,78.57,272896.41,35
HCPCS,J9045,"INJECTION, CARBOPLATIN, 50 MG",8.0,5.2,1.78,78.57,50
HCPCS,J9047,"INJECTION, CARFILZOMIB, 1 MG",7497.495,4873.375,51.85,99746.71,73
HCPCS,J9050,"INJECTION, CARMUSTINE, 100 MG",1459.695,948.8000000000001,108.25,6421.1,38
HCPCS,J9055,"INJECTION, CETUXIMAB, 10 MG",146.63,95.31,27.07,2922.83,35
HCPCS,J9057,"INJECTION, COPANLISIB, 1 MG",154.0,100.1,69.3,278.69,16
HCPCS,J9060,"INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG",4.51,2.93,0.52,120.0,50
HCPCS,J9061,"INJECTION, AMIVANTAMAB-VMJW, 2 MG",2425.8,1576.77,23.91,7236.29,19
HCPCS,J9063,"INJECTION, MIRVETUXIMAB SORAVTANSINE-GYNX, 1 MG",2122.28,1379.48,75.44,25740.26,19
HCPCS,J9065,"INJECTION, CLADRIBINE, PER 1 MG",46.0,29.9,7.41,276.0,16
HCPCS,J9070,"CYCLOPHOSPHAMIDE, 100 MG",75.0,48.75,30.0,231.75,15
HCPCS,J9075,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",1406.7,914.355,0.63,11121.95,102
HCPCS,J9100,"INJECTION, CYTARABINE, 100 MG",26.125,16.985,0.81,1709.94,67
HCPCS,J9119,"INJECTION, CEMIPLIMAB-RWLC, 1 MG",5119.235,3327.505,28.69,26229.08,35
HCPCS,J9120,"INJECTION, DACTINOMYCIN, 0.5 MG",2925.0,1901.25,78.57,3510.0,16
HCPCS,J9130,"DACARBAZINE, 100 MG",45.0,29.25,4.12,434.49,50
HCPCS,J9144,"INJECTION, DARATUMUMAB, 10 MG AND HYALURONIDASE-FIHJ",1562.74,1015.78,49.5,15900.92,54
HCPCS,J9145,"INJECTION, DARATUMUMAB, 10 MG",2307.27,1499.73,75.04,5958.52,19
HCPCS,J9150,"INJECTION, DAUNORUBICIN, 10 MG",76.63,49.81,15.67,271.8,38
HCPCS,J9153,"INJECTION, LIPOSOMAL, 1 MG DAUNORUBICIN AND 2.27 MG CYTARABINE",79876.935,51920.009999999995,276.12,349401.56,38
HCPCS,J9155,"INJECTION, DEGARELIX, 1 MG",4803.5,3122.28,4.72,15603.99,57
HCPCS,J9171,"INJECTION, DOCETAXEL, 1 MG",119.38000000000001,77.595,0.61,945.54,73
HCPCS,J9173,"INJECTION, DURVALUMAB, 10 MG",956.97,622.03,78.57,9558.63,54
HCPCS,J9176,"INJECTION, ELOTUZUMAB, 1 MG",5359.58,3483.73,7.73,17810.99,54
HCPCS,J9177,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",17051.415,11083.42,38.92,93252.73,76
HCPCS,J9179,"INJECTION, ERIBULIN MESYLATE, 0.1 MG",2710.675,1761.94,72.6,13091.6,35
HCPCS,J9181,"INJECTION, ETOPOSIDE, 10 MG",25.76,16.74,1.04,98.43,50
HCPCS,J9185,"INJECTION, FLUDARABINE PHOSPHATE, 50 MG",367.48,238.85999999999999,53.54,1562.46,34
HCPCS,J9190,"INJECTION, FLUOROURACIL, 500 MG",14.36,9.334999999999999,0.88,251.31,135
HCPCS,J9201,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",9.74,6.33,1.31,270.0,50
HCPCS,J9202,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",9397.23,6108.2,78.57,48821.07,54
HCPCS,J9203,"INJECTION, GEMTUZUMAB OZOGAMICIN, 0.1 MG",955.3,620.95,238.83,7236.29,19
HCPCS,J9204,"INJECTION, MOGAMULIZUMAB-KPKC, 1 MG",5352.17,3478.91,268.68,13821.98,19
HCPCS,J9205,"INJECTION, IRINOTECAN LIPOSOME, 1 MG",1252.9,814.385,65.25,6096.77,35
HCPCS,J9206,"INJECTION, IRINOTECAN, 20 MG",52.22,33.94,1.64,209.85,67
HCPCS,J9208,"INJECTION, IFOSFAMIDE, 1 GRAM",35.745,23.235,2.82,620.55,67
HCPCS,J9209,"INJECTION, MESNA, 200 MG",25.0,16.25,1.36,150.0,50
HCPCS,J9210,"INJECTION, EMAPALUMAB-LZSG, 1 MG",13936.814999999999,9058.93,1688.78,54538.55,36
HCPCS,J9211,"INJECTION, IDARUBICIN HYDROCHLORIDE, 5 MG",86.84,56.45,21.71,260.52,19
HCPCS,J9217,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",2842.08,1847.35,61.25,111712.8,168
HCPCS,J9223,"INJECTION, LURBINECTEDIN, 0.1 MG",35339.645,22970.77,78.57,181392.97,35
HCPCS,J9228,"INJECTION, IPILIMUMAB, 1 MG",3758.715,2443.165,78.57,18194.82,35
HCPCS,J9229,"INJECTION, INOTUZUMAB OZOGAMICIN, 0.1 MG",180174.18,117113.215,2985.78,643477.16,38
HCPCS,J9245,"INJECTION, MELPHALAN HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 50 MG",765.43,497.53000000000003,44.95,3489.14,38
HCPCS,J9250,"METHOTREXATE SODIUM, 5 MG",5.0,3.25,2.0,30.0,15
HCPCS,J9260,"INJECTION, METHOTREXATE SODIUM, 50 MG",14.0,9.1,1.56,1150.95,118
HCPCS,J9261,"INJECTION, NELARABINE, 50 MG",37.77,24.549999999999997,4.95,7236.29,38
HCPCS,J9263,"INJECTION, OXALIPLATIN, 0.5 MG",4.77,3.1,0.04,98.13,50
HCPCS,J9264,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG",7559.23,4913.5,8.18,40775.63,54
HCPCS,J9266,"INJECTION, PEGASPARGASE, PER SINGLE DOSE VIAL",44796.89,29117.98,5578.63,173748.69,38
HCPCS,J9267,"INJECTION, PACLITAXEL, 1 MG",6.25,4.06,0.09,84.72,50
HCPCS,J9271,"INJECTION, PEMBROLIZUMAB, 1 MG",6913.75,4493.94,59.35,37523.73,54
HCPCS,J9272,"INJECTION, DOSTARLIMAB-GXLY, 10 MG",7910.48,5141.81,262.29,20428.81,19
HCPCS,J9274,"INJECTION, TEBENTAFUSP-TEBN, 1 MICROGRAM",185037.65,120274.47,235.54,477859.73,19
HCPCS,J9280,"INJECTION, MITOMYCIN, 5 MG",1150.93,748.1,25.6,8033.9,149
HCPCS,J9286,"INJECTION, GLOFITAMAB-GXBM, 2.5 MG",8730.39,5674.754999999999,916.3,35627.14,34
HCPCS,J9293,"INJECTION, MITOXANTRONE HYDROCHLORIDE, PER 5 MG",62.19,40.42,15.55,202.84,19
HCPCS,J9298,"INJECTION, NIVOLUMAB AND RELATLIMAB-RMBW, 3 MG/1 MG",3267.375,2123.795,78.57,35052.23,35
HCPCS,J9299,"INJECTION, NIVOLUMAB, 1 MG",1803.185,1172.07,32.35,9091.36,35
HCPCS,J9301,"INJECTION, OBINUTUZUMAB, 10 MG",2711.61,1762.55,48.6,8473.36,54
HCPCS,J9303,"INJECTION, PANITUMUMAB, 10 MG",1641.42,1066.925,78.57,7524.99,35
HCPCS,J9305,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",289.74,188.32999999999998,3.59,45706.2,73
HCPCS,J9306,"INJECTION, PERTUZUMAB, 1 MG",1958.0,1272.7,15.75,10022.68,35
HCPCS,J9308,"INJECTION, RAMUCIRUMAB, 5 MG",1288.84,837.75,80.11,7236.29,19
HCPCS,J9309,"INJECTION, POLATUZUMAB VEDOTIN-PIIQ, 1 MG",138934.29,90307.29000000001,144.98,416911.65,38
HCPCS,J9311,"INJECTION, RITUXIMAB 10 MG AND HYALURONIDASE",1867.55,1213.91,36.87,9284.35,35
HCPCS,J9312,"INJECTION, RITUXIMAB, 10 MG",838.255,544.865,74.76,5812.21,73
HCPCS,J9315,"INJECTION, ROMIDEPSIN, 1 MG",932.0,605.8,336.66,2879.88,15
HCPCS,J9317,"INJECTION, SACITUZUMAB GOVITECAN-HZIY, 2.5 MG",4785.43,3110.53,35.8,24479.16,35
HCPCS,J9321,"INJECTION, EPCORITAMAB-BYSP, 0.16 MG",45721.75,29719.14,60.22,118076.42,17
HCPCS,J9325,"INJECTION, TALIMOGENE LAHERPAREPVEC, PER 1 MILLION PLAQUE FORMING UNITS",178.65,116.12,44.66,39780.39,54
HCPCS,J9328,"INJECTION, TEMOZOLOMIDE, 1 MG",12806.24,8324.06,11.02,33072.11,19
HCPCS,J9332,"INJECTION, EFGARTIGIMOD ALFA-FCAB, 2MG",1381.88,898.22,34.15,11535.65,19
HCPCS,J9340,"INJECTION, THIOTEPA, 15 MG",2476.6549999999997,1609.825,129.01,11459.28,32
HCPCS,J9347,"INJECTION, TREMELIMUMAB-ACTL, 1 MG",19742.29,12832.49,151.6,50984.46,19
HCPCS,J9349,"INJECTION, TAFASITAMAB-CXIX, 2 MG",9382.98,6098.94,13.93,44758.08,54
HCPCS,J9351,"INJECTION, TOPOTECAN, 0.1 MG",50.51,32.83,1.24,1031.16,50
HCPCS,J9352,"INJECTION, TRABECTEDIN, 0.1 MG",16908.29,10990.39,414.53,59040.52,38
HCPCS,J9354,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",36151.29,23498.34,38.25,146452.21,54
HCPCS,J9355,"INJECTION, TRASTUZUMAB, EXCLUDES BIOSIMILAR, 10 MG",175.0,113.75,73.48,238.08,16
HCPCS,J9358,"INJECTION, FAM-TRASTUZUMAB DERUXTECAN-NXKI, 1 MG",13209.725,8586.32,27.0,68073.28,35
HCPCS,J9359,"INJECTION, LONCASTUXIMAB TESIRINE-LPYL, 0.075 MG",121713.4,79113.71,234.49,314324.86,19
HCPCS,J9360,"INJECTION, VINBLASTINE SULFATE, 1 MG",43.29,28.14,5.14,240.0,50
HCPCS,J9370,"VINCRISTINE SULFATE, 1 MG",65.32,42.46,8.15,360.0,50
HCPCS,J9380,"INJECTION, TECLISTAMAB-CQYV, 0.5 MG",19166.53,12458.24,36.65,68912.82,57
HCPCS,J9390,"INJECTION, VINORELBINE TARTRATE, 10 MG",32.56,21.16,5.77,97.68,17
HCPCS,J9395,"INJECTION, FULVESTRANT, 25 MG",100.53,65.34,5.72,390.0,54
HCPCS,J9600,"INJECTION, PORFIMER SODIUM, 75 MG",6465.34,4202.47,1616.34,35052.23,19
HCPCS,L0140,"CERVICAL, SEMI-RIGID, ADJUSTABLE (PLASTIC COLLAR)",139.5,90.68,19.13,174.71,48
HCPCS,L0621,"SACROILIAC ORTHOSIS, FLEXIBLE, PROVIDES PELVIC-SACRAL SUPPORT, REDUCES MOTION ABOUT THE SACROILIAC JOINT, INCLUDES STRAPS, CLOSURES, MAY INCLUDE PENDULOUS ABDOMEN DESIGN, PREFABRICATED, OFF-THE-SHELF",79.0,51.35,19.75,284.9,67
HCPCS,L0625,"LUMBAR ORTHOSIS, FLEXIBLE, PROVIDES LUMBAR SUPPORT, POSTERIOR EXTENDS FROM L-1 TO BELOW L-5 VERTEBRA, PRODUCES INTRACAVITARY PRESSURE TO REDUCE LOAD ON THE INTERVERTEBRAL DISCS, INCLUDES STRAPS, CLOSU",39.9,25.94,18.18,138.82,19
HCPCS,L1830,"KNEE ORTHOSIS, IMMOBILIZER, CANVAS LONGITUDINAL, PREFABRICATED, OFF-THE-SHELF",25.0,16.25,6.25,215.8,35
HCPCS,L1832,"KNEE ORTHOSIS, ADJUSTABLE KNEE JOINTS (UNICENTRIC OR POLYCENTRIC), POSITIONAL ORTHOSIS, RIGID SUPPORT, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT",212.5,138.13,78.57,1439.79,19
HCPCS,L1902,"ANKLE ORTHOSIS, ANKLE GAUNTLET OR SIMILAR, WITH OR WITHOUT JOINTS, PREFABRICATED, OFF-THE-SHELF",61.75,40.14,36.14,199.52,19
HCPCS,L1906,"ANKLE FOOT ORTHOSIS, MULTILIGAMENTOUS ANKLE SUPPORT, PREFABRICATED, OFF-THE-SHELF",92.5,60.13,51.58,284.81,19
HCPCS,L2999,"LOWER EXTREMITY ORTHOSES, NOT OTHERWISE SPECIFIED",200.0,130.0,73.6,240.0,15
HCPCS,L3040,"FOOT, ARCH SUPPORT, REMOVABLE, PREMOLDED, LONGITUDINAL, EACH",55.0,35.75,21.49,118.63,19
HCPCS,L3332,"LIFT, ELEVATION, INSIDE SHOE, TAPERED, UP TO ONE-HALF INCH",30.0,19.5,8.75,185.82,35
HCPCS,L3450,"HEEL, SACH CUSHION TYPE",98.5,64.03,48.18,266.02,19
HCPCS,L3485,"HEEL, PAD, REMOVABLE FOR SPUR",37.0,24.05,4.58,78.57,15
HCPCS,L3540,"ORTHOPEDIC SHOE ADDITION, SOLE, FULL",106.0,68.9,23.22,128.2,19
HCPCS,L3650,"SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, OFF-THE-SHELF",37.5,24.38,29.55,163.14,19
HCPCS,L3660,"SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND WEBBING, PREFABRICATED, OFF-THE-SHELF",188.0,122.2,47.0,225.6,16
HCPCS,L3674,"SHOULDER ORTHOSIS, ABDUCTION POSITIONING (AIRPLANE DESIGN), THORACIC COMPONENT AND SUPPORT BAR, WITH OR WITHOUT NONTORSION JOINT/TURNBUCKLE, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCL",146.0,94.9,36.0,2711.26,35
HCPCS,L3702,"ELBOW ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",106.05,68.935,26.5,662.38,51
HCPCS,L3760,"ELBOW ORTHOSIS (EO), WITH ADJUSTABLE POSITION LOCKING JOINT(S), PREFABRICATED, ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC  PATIENT BY AN INDIVIDUAL ",174.0,113.1,43.5,595.56,16
HCPCS,L3762,"ELBOW ORTHOSIS, RIGID, WITHOUT JOINTS, INCLUDES SOFT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",55.0,35.75,8.75,180.0,64
HCPCS,L3763,"ELBOW WRIST HAND ORTHOSIS, RIGID, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",106.0,68.9,26.5,845.44,16
HCPCS,L3806,"WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMEN",143.0,92.95,26.25,1041.91,67
HCPCS,L3807,"WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE",43.875,28.52,10.5,573.45,35
HCPCS,L3808,"WRIST HAND FINGER ORTHOSIS, RIGID WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE MATERIAL; STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",50.8,33.02,12.25,788.17,51
HCPCS,L3906,"WRIST HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",48.3,31.4,11.5,926.27,67
HCPCS,L3908,"WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK-UP, NON MOLDED, PREFABRICATED, OFF-THE-SHELF",96.4,62.660000000000004,10.75,179.76,35
HCPCS,L3913,"HAND FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",44.0,28.6,11.0,322.54,16
HCPCS,L3917,"HAND ORTHOSIS, METACARPAL FRACTURE ORTHOSIS, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE",132.5,86.13,43.87,242.2,19
HCPCS,L3919,"HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",44.0,28.6,10.0,621.24,51
HCPCS,L3923,"HAND FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN IND",37.0,24.05,4.75,106.86,48
HCPCS,L3925,"FINGER ORTHOSIS, PROXIMAL INTERPHALANGEAL (PIP)/DISTAL INTERPHALANGEAL (DIP), NON TORSION JOINT/SPRING, EXTENSION/FLEXION, MAY INCLUDE SOFT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",36.0,23.4,7.5,147.27,51
HCPCS,L3927,"FINGER ORTHOSIS, PROXIMAL INTERPHALANGEAL (PIP)/DISTAL INTERPHALANGEAL (DIP), WITHOUT JOINT/SPRING, EXTENSION/FLEXION (E.G., STATIC OR RING TYPE), MAY INCLUDE SOFT INTERFACE MATERIAL, PREFABRICATED, O",131.0,85.15,32.75,157.2,16
HCPCS,L3930,"HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, OFF-THE-SHELF",89.3,58.05,42.29,233.51,19
HCPCS,L3931,"WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT",69.0,44.85,17.25,269.63,16
HCPCS,L3933,"FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT",43.0,27.95,6.5,489.36,51
HCPCS,L3956,"ADDITION OF JOINT TO UPPER EXTREMITY ORTHOSIS, ANY MATERIAL; PER JOINT",89.3,58.05,73.6,107.16,13
HCPCS,L4386,"WALKING BOOT, NON-PNEUMATIC, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PA",100.5,65.33,72.38,399.63,19
HCPCS,L4387,"WALKING BOOT, NON-PNEUMATIC, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF",80.0,52.0,20.0,399.63,35
HCPCS,L8000,"BREAST PROSTHESIS, MASTECTOMY BRA, WITHOUT INTEGRATED BREAST PROSTHESIS FORM, ANY SIZE, ANY TYPE",104.0,67.6,26.0,124.8,16
HCPCS,L8047,"NASAL SEPTAL PROSTHESIS, PROVIDED BY A NON-PHYSICIAN",1305.0,848.25,326.25,1671.06,16
HCPCS,L8501,TRACHEOSTOMY SPEAKING VALVE,314.0,204.1,78.5,376.8,16
HCPCS,L8509,"TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, INSERTED BY A LICENSED HEALTH CARE PROVIDER, ANY TYPE",357.0,232.05,89.25,428.4,16
HCPCS,L8603,"INJECTABLE BULKING AGENT, COLLAGEN IMPLANT, URINARY TRACT, 2.5 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",325.5,211.58,78.57,1104.81,19
HCPCS,L8606,"INJECTABLE BULKING AGENT, SYNTHETIC IMPLANT, URINARY TRACT, 1 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",1389.5,903.18,78.57,5670.0,67
HCPCS,L8610,OCULAR IMPLANT,2625.0,1706.25,78.57,7170.0,52
HCPCS,L8680,"IMPLANTABLE NEUROSTIMULATOR ELECTRODE, EACH",2189.3,1423.05,78.57,2627.16,15
HCPCS,L8681,"PATIENT PROGRAMMER (EXTERNAL) FOR USE WITH IMPLANTABLE PROGRAMMABLE NEUROSTIMULATOR PULSE GENERATOR, REPLACEMENT ONLY",1365.0,887.25,78.57,3629.1,19
HCPCS,L8699,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",34177.5,22215.38,73.6,395122.5,503
HCPCS,M0220,"INJECTION, TIXAGEVIMAB AND CILGAVIMAB, FOR THE PRE-EXPOSURE PROPHYLAXIS ONLY, FOR CERTAIN ADULTS AND PEDIATRIC INDIVIDUALS (12 YEARS OF AGE AND OLDER WEIGHING AT LEAST 40KG) WITH NO KNOWN SARS-COV-2 E",375.0,243.75,76.0,968.44,48
HCPCS,M0222,"INTRAVENOUS INJECTION, BEBTELOVIMAB, INCLUDES INJECTION AND POST ADMINISTRATION MONITORING",642.5,417.625,76.0,1730.28,48
HCPCS,M0224,"INTRAVENOUS INFUSION, PEMIVIBART, FOR THE PRE-EXPOSURE PROPHYLAXIS ONLY, FOR CERTAIN ADULTS AND ADOLESCENTS (12 YEARS OF AGE AND OLDER WEIGHING AT LEAST 40 KG) WITH NO KNOWN SARS-COV-2 EXPOSURE, WHO E",775.0,503.75,76.0,2001.44,32
HCPCS,M0233,"INTRAVENOUS INFUSION, TOCILIZUMAB-AAZG, FOR HOSPITALIZED ADULT PATIENTS WITH COVID-19 WHO ARE RECEIVING SYSTEMIC CORTICOSTEROIDS AND REQUIRE SUPPLEMENTAL OXYGEN, NON-INVASIVE OR INVASIVE MECHANICAL VE",775.0,503.75,76.0,2001.44,17
HCPCS,M0234,"INTRAVENOUS INFUSION, TOCILIZUMAB-AAZG, FOR HOSPITALIZED ADULT PATIENTS WITH COVID-19 WHO ARE RECEIVING SYSTEMIC CORTICOSTEROIDS AND REQUIRE SUPPLEMENTAL OXYGEN, NON-INVASIVE OR INVASIVE MECHANICAL VE",775.0,503.75,76.0,2001.44,17
HCPCS,M0239,"INTRAVENOUS INFUSION, BAMLANIVIMAB-XXXX, INCLUDES INFUSION AND POST ADMINISTRATION MONITORING",775.0,503.75,193.75,2001.44,17
HCPCS,M0240,"INTRAVENOUS INFUSION OR SUBCUTANEOUS INJECTION, CASIRIVIMAB AND IMDEVIMAB INCLUDES INFUSION OR INJECTION, AND POST ADMINISTRATION MONITORING, SUBSEQUENT REPEAT DOSES",775.0,503.75,76.0,2001.44,17
HCPCS,M0243,"INTRAVENOUS INFUSION OR SUBCUTANEOUS INJECTION, CASIRIVIMAB AND IMDEVIMAB INCLUDES INFUSION OR INJECTION, AND POST ADMINISTRATION MONITORING",775.0,503.75,76.0,2001.44,17
HCPCS,M0245,"INTRAVENOUS INFUSION, BAMLANIVIMAB AND ETESEVIMAB, INCLUDES INFUSION AND POST ADMINISTRATION MONITORING",775.0,503.75,193.75,2001.44,17
HCPCS,M0247,"INTRAVENOUS INFUSION, SOTROVIMAB, INCLUDES INFUSION AND POST ADMINISTRATION MONITORING",775.0,503.75,193.75,2001.44,17
HCPCS,NONE,HC SPECIMEN COLLECTION COVID 19,50.0,32.5,12.5,129.13,16
HCPCS,P3000,"SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, BY TECHNICIAN UNDER PHYSICIAN SUPERVISION",103.0,66.95,15.92,266.0,19
HCPCS,P9010,"BLOOD (WHOLE), FOR TRANSFUSION, PER UNIT",1959.75,1273.84,182.26,5061.05,38
HCPCS,P9011,"BLOOD, SPLIT UNIT",730.17,474.61,52.73,2690.32,418
HCPCS,P9012,"CRYOPRECIPITATE, EACH UNIT",210.6,136.89,1.44,3263.25,129
HCPCS,P9016,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",954.72,620.57,106.33,5184.63,418
HCPCS,P9017,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",263.9,171.54,32.99,1764.57,228
HCPCS,P9019,"PLATELETS, EACH UNIT",1454.7749999999999,945.6049999999999,0.95,7508.49,53
HCPCS,P9021,"RED BLOOD CELLS, EACH UNIT",1109.2350000000001,721.005,182.26,3417.34,114
HCPCS,P9022,"RED BLOOD CELLS, WASHED, EACH UNIT",1244.88,809.17,311.22,3214.9,76
HCPCS,P9031,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",2236.2,1453.53,215.1,7857.13,323
HCPCS,P9033,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1957.28,1272.23,63.6,8198.56,190
HCPCS,P9035,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",2434.77,1582.6,12.6,8213.38,608
HCPCS,P9036,"PLATELETS, PHERESIS, IRRADIATED, EACH UNIT",550.2,357.63,55.2,2271.57,76
HCPCS,P9037,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",2634.48,1712.415,337.4,7849.92,228
HCPCS,P9038,"RED BLOOD CELLS, IRRADIATED, EACH UNIT",851.265,553.3199999999999,61.76,3758.78,114
HCPCS,P9039,"RED BLOOD CELLS, DEGLYCEROLIZED, EACH UNIT",1347.045,875.5799999999999,182.26,3988.65,57
HCPCS,P9040,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1050.3,682.695,122.85,3758.78,304
HCPCS,P9041,"INFUSION, ALBUMIN (HUMAN), 5%, 50 ML",1.61,1.05,0.37,185.91,57
HCPCS,P9044,"PLASMA, CRYOPRECIPITATE REDUCED, EACH UNIT",263.25,171.11,65.81,679.84,38
HCPCS,P9046,"INFUSION, ALBUMIN (HUMAN), 25%, 20 ML",11.3,7.35,2.83,185.91,19
HCPCS,P9047,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",6.1899999999999995,4.0200000000000005,1.48,185.91,38
HCPCS,P9050,"GRANULOCYTES, PHERESIS, EACH UNIT",2710.8,1762.02,401.85,42905.66,380
HCPCS,P9051,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT",1117.8,726.57,182.26,5271.4,190
HCPCS,P9052,"PLATELETS, HLA-MATCHED LEUKOCYTES REDUCED, APHERESIS/PHERESIS, EACH UNIT",2208.0,1435.2,401.85,5702.16,38
HCPCS,P9053,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, CMV-NEGATIVE, IRRADIATED, EACH UNIT",2434.77,1582.6,401.85,6287.79,38
HCPCS,P9054,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, FROZEN, DEGLYCEROL, WASHED, EACH UNIT",1256.1599999999999,816.505,182.26,3432.45,57
HCPCS,P9055,"PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT",1979.1399999999999,1286.44,36.3,8198.56,836
HCPCS,P9057,"RED BLOOD CELLS, FROZEN/DEGLYCEROLIZED/WASHED, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1244.4,808.86,182.26,3213.66,38
HCPCS,P9058,"RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, IRRADIATED, EACH UNIT",982.8,638.82,182.26,2538.08,38
HCPCS,Q0035,CARDIOKYMOGRAPHY,33.2,21.58,7.65,78.57,19
HCPCS,Q0091,"SCREENING PAPANICOLAOU SMEAR; OBTAINING, PREPARING AND CONVEYANCE OF CERVICAL OR VAGINAL SMEAR TO LABORATORY",76.5,49.725,13.25,136.87,38
HCPCS,Q0111,"WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL OR SKIN SPECIMENS",29.9,19.435000000000002,2.93,113.63,38
HCPCS,Q0112,ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS,17.45,11.344999999999999,0.01,78.57,36
HCPCS,Q0114,FERN TEST,22.9,14.885,1.54,78.57,38
HCPCS,Q0138,"INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG (NON-ESRD USE)",118.21,76.83500000000001,0.38,412.81,38
HCPCS,Q0144,"AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM",4.93,3.2,0.53,114.72,49
HCPCS,Q0161,"CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED",11.615,7.550000000000001,1.63,63.61,64
HCPCS,Q0162,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",17.25,11.215,0.01,179.9,135
HCPCS,Q0163,"DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A ",12.51,8.13,1.51,75.25,51
HCPCS,Q0164,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",21.865000000000002,14.215,0.83,187.95,68
HCPCS,Q0167,"DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",114.13,74.18,1.43,294.74,17
HCPCS,Q0169,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",9.21,5.99,0.31,82.82,68
HCPCS,Q0175,"PERPHENAZINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",10.9,7.09,0.71,60.04,51
HCPCS,Q0224,"INJECTION, PEMIVIBART, FOR THE PRE-EXPOSURE PROPHYLAXIS ONLY, FOR CERTAIN ADULTS AND ADOLESCENTS (12 YEARS OF AGE AND OLDER WEIGHING AT LEAST 40 KG) WITH NO KNOWN SARS-COV-2 EXPOSURE, AND WHO EITHER H",1521.09,988.71,380.27,7673.34,17
HCPCS,Q0249,"INJECTION, TOCILIZUMAB, FOR HOSPITALIZED ADULTS AND PEDIATRIC PATIENTS (2 YEARS OF AGE AND OLDER) WITH COVID-19 WHO ARE RECEIVING SYSTEMIC CORTICOSTEROIDS AND REQUIRE SUPPLEMENTAL OXYGEN, NON-INVASIVE",1529.32,994.06,8.02,4559.64,57
HCPCS,Q0477,"POWER MODULE PATIENT CABLE FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",5625.0,3656.25,950.64,6750.0,17
HCPCS,Q0479,"POWER MODULE FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",38880.0,25272.0,9720.0,46656.0,17
HCPCS,Q0481,"MICROPROCESSOR CONTROL UNIT FOR USE WITH ELECTRIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",26703.41,17357.22,6675.85,32044.09,17
HCPCS,Q0495,"BATTERY/POWER PACK CHARGER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",34992.0,22744.8,5118.21,41990.4,17
HCPCS,Q0496,"BATTERY, OTHER THAN LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",405.0,263.25,101.25,1965.57,16
HCPCS,Q0498,"HOLSTER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",1374.6,893.4949999999999,78.57,2303.64,35
HCPCS,Q0499,"BELT/VEST/BAG FOR USE TO CARRY EXTERNAL PERIPHERAL COMPONENTS OF ANY TYPE VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",1579.5,1026.68,204.47,1895.4,16
HCPCS,Q0501,"SHOWER COVER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",1093.5,710.78,273.38,1312.2,32
HCPCS,Q0506,"BATTERY, LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",5811.18,3777.27,562.5,14580.0,50
HCPCS,Q0508,MISCELLANEOUS SUPPLY OR ACCESSORY FOR USE WITH AN IMPLANTED VENTRICULAR ASSIST DEVICE,1919.7,1247.81,29.3,25375.33,48
HCPCS,Q2009,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",15.6,10.14,1.42,213.24,68
HCPCS,Q2026,"INJECTION, RADIESSE, 0.1 ML",558.6,363.09,73.6,1446.2,63
HCPCS,Q2028,"INJECTION, SCULPTRA, 0.5 MG",302.675,196.73999999999998,0.59,1557.25,33
HCPCS,Q2035,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (AFLURIA)",30.0,19.5,13.5,78.57,15
HCPCS,Q2036,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (FLULAVAL)",5.0,3.25,2.25,80.89,15
HCPCS,Q2037,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (FLUVIRIN)",5.3,3.45,2.39,78.57,15
HCPCS,Q2038,"INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FOR INTRAMUSCULAR USE (FLUZONE)",5.0,3.25,2.25,78.57,15
HCPCS,Q2039,"INFLUENZA VIRUS VACCINE, NOT OTHERWISE SPECIFIED",5.0,3.25,2.25,80.89,15
HCPCS,Q2041,"AXICABTAGENE CILOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3404000.0,2212600.0,65239.56,8790830.0,38
HCPCS,Q2042,"TISAGENLECLEUCEL, UP TO 600 MILLION CAR-POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3499000.0,2274350.0,65239.56,9694705.0,76
HCPCS,Q2049,"INJECTION, DOXORUBICIN HYDROCHLORIDE, LIPOSOMAL, IMPORTED LIPODOX, 10 MG",900.0,585.0,78.57,1170.0,15
HCPCS,Q2050,"INJECTION, DOXORUBICIN HYDROCHLORIDE, LIPOSOMAL, NOT OTHERWISE SPECIFIED, 10 MG",569.69,370.3,59.85,1170.0,34
HCPCS,Q2053,"BREXUCABTAGENE AUTOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3123000.0,2029950.0,65239.56,8065147.5,38
HCPCS,Q2054,"LISOCABTAGENE MARALEUCEL, UP TO 110 MILLION AUTOLOGOUS ANTI-CD19 CAR-POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3459000.0,2248350.0,65239.56,8932867.5,38
HCPCS,Q2055,"IDECABTAGENE VICLEUCEL, UP TO 510 MILLION AUTOLOGOUS B-CELL MATURATION ANTIGEN (BCMA) DIRECTED CAR-POSITIVE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3374000.0,2193100.0,65239.56,8713355.0,38
HCPCS,Q2056,"CILTACABTAGENE AUTOLEUCEL, UP TO 100 MILLION AUTOLOGOUS B-CELL MATURATION ANTIGEN (BCMA) DIRECTED CAR-POSITIVE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",3547000.0,2305550.0,65239.56,9160127.5,19
HCPCS,Q3014,TELEHEALTH ORIGINATING SITE FACILITY FEE,60.0,39.0,15.0,154.95,33
HCPCS,Q3031,COLLAGEN SKIN TEST,52.5,34.13,23.63,80.89,15
HCPCS,Q4002,"CAST SUPPLIES, BODY CAST ADULT, WITH OR WITHOUT HEAD, FIBERGLASS",403.2,262.08,78.57,485.63,19
HCPCS,Q4004,"CAST SUPPLIES, SHOULDER CAST, ADULT (11 YEARS +), FIBERGLASS",265.7,172.71,57.87,319.49,19
HCPCS,Q4006,"CAST SUPPLIES, LONG ARM CAST, ADULT (11 YEARS +), FIBERGLASS",63.0,40.95,13.89,78.57,19
HCPCS,Q4008,"CAST SUPPLIES, LONG ARM CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS",190.75,123.99,6.94,420.0,35
HCPCS,Q4009,"CAST SUPPLIES, SHORT ARM CAST, ADULT (11 YEARS +), PLASTER",350.0,227.5,11.03,420.0,16
HCPCS,Q4010,"CAST SUPPLIES, SHORT ARM CAST, ADULT (11 YEARS +), FIBERGLASS",196.0,127.4,9.26,420.0,35
HCPCS,Q4012,"CAST SUPPLIES, SHORT ARM CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS",21.0,13.65,4.64,78.57,19
HCPCS,Q4022,"CAST SUPPLIES, SHORT ARM SPLINT, ADULT (11 YEARS +), FIBERGLASS",188.15,122.3,5.78,420.0,35
HCPCS,Q4024,"CAST SUPPLIES, SHORT ARM SPLINT, PEDIATRIC (0-10 YEARS), FIBERGLASS",15.8,10.27,2.9,78.57,19
HCPCS,Q4025,"CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), ADULT (11 YEARS +), PLASTER",84.0,54.6,17.96,100.8,19
HCPCS,Q4026,"CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), ADULT (11 YEARS +), FIBERGLASS",257.3,167.25,56.11,309.78,19
HCPCS,Q4028,"CAST SUPPLIES, HIP SPICA (ONE OR BOTH LEGS), PEDIATRIC (0-10 YEARS), FIBERGLASS",129.2,83.98,28.07,155.04,19
HCPCS,Q4030,"CAST SUPPLIES, LONG LEG CAST, ADULT (11 YEARS +), FIBERGLASS",165.9,107.84,36.18,199.74,19
HCPCS,Q4031,"CAST SUPPLIES, LONG LEG CAST, PEDIATRIC (0-10 YEARS), PLASTER",31.5,20.48,6.86,78.57,19
HCPCS,Q4032,"CAST SUPPLIES, LONG LEG CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS",84.0,54.6,18.09,100.8,19
HCPCS,Q4034,"CAST SUPPLIES, LONG LEG CYLINDER CAST, ADULT (11 YEARS +), FIBERGLASS",147.0,95.55,31.88,176.4,19
HCPCS,Q4038,"CAST SUPPLIES, SHORT LEG CAST, ADULT (11 YEARS +), FIBERGLASS",89.3,58.05,19.59,108.12,19
HCPCS,Q4040,"CAST SUPPLIES, SHORT LEG CAST, PEDIATRIC (0-10 YEARS), FIBERGLASS",47.3,30.75,9.79,78.57,19
HCPCS,Q4046,"CAST SUPPLIES, SHORT LEG SPLINT, ADULT (11 YEARS +), FIBERGLASS",42.0,27.3,8.88,78.57,19
HCPCS,Q4051,"SPLINT SUPPLIES, MISCELLANEOUS (INCLUDES THERMOPLASTICS, STRAPPING, FASTENERS, PADDING AND OTHER SUPPLIES)",26.3,17.1,11.84,80.89,15
HCPCS,Q4100,"SKIN SUBSTITUTE, NOT OTHERWISE SPECIFIED",310.69,201.95,2.43,1013.37,96
HCPCS,Q4101,"APLIGRAF, PER SQUARE CENTIMETER",1022.47,664.61,33.11,4939.03,34
HCPCS,Q4102,"OASIS WOUND MATRIX, PER SQUARE CENTIMETER",60.71,39.46,15.18,156.78,17
HCPCS,Q4103,"OASIS BURN MATRIX, PER SQUARE CENTIMETER",48.83,31.74,1.97,334.18,85
HCPCS,Q4106,"DERMAGRAFT, PER SQUARE CENTIMETER",2849.8,1852.37,33.57,14526.56,31
HCPCS,Q4107,"GRAFTJACKET, PER SQUARE CENTIMETER",278.0,180.7,69.5,717.94,17
HCPCS,Q4110,"PRIMATRIX, PER SQUARE CENTIMETER",176.49,114.72,31.5,576.85,219
HCPCS,Q4115,"ALLOSKIN, PER SQUARE CENTIMETER",33.19,21.57,8.3,134.77,17
HCPCS,Q4116,"ALLODERM, PER SQUARE CENTIMETER",136.46499999999997,92.49,30.1,848.35,368
HCPCS,Q4118,"MATRISTEM MICROMATRIX, 1 MG",10548.0,6856.2,2637.0,27240.21,17
HCPCS,Q4121,"THERASKIN, PER SQUARE CENTIMETER",253.84499999999997,165.0,32.88,1785.8,85
HCPCS,Q4124,"OASIS ULTRA TRI-LAYER WOUND MATRIX, PER SQUARE CENTIMETER",40.8,26.52,2.62,149.48,102
HCPCS,Q4125,"ARTHROFLEX, PER SQUARE CENTIMETER",693.62,450.85,120.83,23470.28,85
HCPCS,Q4126,"MEMODERM, DERMASPAN, TRANZGRAFT OR INTEGUPLY, PER SQUARE CENTIMETER",583.2,379.08,134.77,1506.11,17
HCPCS,Q4130,"STRATTICE TM, PER SQUARE CENTIMETER",104.33,67.81,20.1,277.49,220
HCPCS,Q4132,"GRAFIX CORE AND GRAFIXPL CORE, PER SQUARE CENTIMETER",439.2,285.48,109.8,1134.23,17
HCPCS,Q4133,"GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER",742.5,482.63,87.9,3068.01,220
HCPCS,Q4136,"EZ-DERM, PER SQUARE CENTIMETER",774.63,503.51,193.66,2000.48,16
HCPCS,Q4137,"AMNIOEXCEL, AMNIOEXCEL PLUS OR BIODEXCEL, PER SQUARE CENTIMETER",207.0,134.55,44.82,906.46,51
HCPCS,Q4166,"CYTAL, PER SQUARE CENTIMETER",115.66499999999999,75.18,15.86,9285.38,136
HCPCS,Q4186,"EPIFIX, PER SQUARE CENTIMETER",840.0,546.0,134.77,2169.3,17
HCPCS,Q4196,"PURAPLY AM, PER SQUARE CENTIMETER",530.4000000000001,344.76,112.5,2854.18,153
HCPCS,Q4197,"PURAPLY XT, PER SQUARE CENTIMETER",450.0,292.5,112.5,1162.13,17
HCPCS,Q5101,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",2750.85,1788.0549999999998,0.37,8895.86,76
HCPCS,Q5103,"INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG",2332.705,1516.26,17.84,11803.08,34
HCPCS,Q5104,"INJECTION, INFLIXIMAB-ABDA, BIOSIMILAR, (RENFLEXIS), 10 MG",3641.36,2366.88,27.75,9634.09,53
HCPCS,Q5106,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",375.505,244.07999999999998,7.07,22914.83,224
HCPCS,Q5107,"INJECTION, BEVACIZUMAB-AWWB, BIOSIMILAR, (MVASI), 10 MG",1522.0,989.3,23.84,5500.88,53
HCPCS,Q5108,"INJECTION, PEGFILGRASTIM-JMDB (FULPHILA), BIOSIMILAR, 0.5 MG",1075.0,698.75,78.57,1397.5,15
HCPCS,Q5110,"INJECTION, FILGRASTIM-AAFI, BIOSIMILAR, (NIVESTYM), 1 MICROGRAM",348.75,226.69,0.3,900.65,19
HCPCS,Q5111,"INJECTION, PEGFILGRASTIM-CBQV (UDENYCA), BIOSIMILAR, 0.5 MG",25992.62,16895.2,78.57,83449.72,53
HCPCS,Q5113,"INJECTION, TRASTUZUMAB-PKRB, BIOSIMILAR, (HERZUMA), 10 MG",27045.04,17579.28,58.76,69843.82,19
HCPCS,Q5115,"INJECTION, RITUXIMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10 MG",160.0,104.0,30.14,2922.83,53
HCPCS,Q5116,"INJECTION, TRASTUZUMAB-QYYP, BIOSIMILAR, (TRAZIMERA), 10 MG",115.0,74.75,8.2,149.5,15
HCPCS,Q5117,"INJECTION, TRASTUZUMAB-ANNS, BIOSIMILAR, (KANJINTI), 10 MG",13814.31,8979.3,27.91,70648.47,34
HCPCS,Q5119,"INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG",467.28,303.73,13.27,2922.83,91
HCPCS,Q5120,"INJECTION, PEGFILGRASTIM-BMEZ (ZIEXTENZO), BIOSIMILAR, 0.5 MG",605.0,393.25,24.71,786.5,15
HCPCS,Q5121,"INJECTION, INFLIXIMAB-AXXQ, BIOSIMILAR, (AVSOLA), 10 MG",911.11,592.22,23.81,4279.77,34
HCPCS,Q5125,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",543.72,353.41499999999996,0.36,3966.85,114
HCPCS,Q9950,"INJECTION, SULFUR HEXAFLUORIDE LIPID MICROSPHERES, PER ML",350.775,228.005,13.75,1669.72,33
HCPCS,Q9956,"INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML",320.67,208.44,42.62,1002.01,68
HCPCS,Q9957,"INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML",1480.35,962.23,40.2,24210.94,98
HCPCS,Q9958,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",2.165,1.4100000000000001,0.07,52.13,102
HCPCS,Q9961,"HIGH OSMOLAR CONTRAST MATERIAL, 250-299 MG/ML IODINE CONCENTRATION, PER ML",3.195,2.075,0.28,10.08,34
HCPCS,Q9963,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",7.32,4.76,0.23,33.13,51
HCPCS,Q9966,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",7.64,4.97,0.42,169.13,136
HCPCS,Q9967,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",12.6,8.19,0.16,500.96,202
HCPCS,Q9968,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",77.92,50.65,5.69,3433.36,119
HCPCS,Q9992,"INJECTION, BUPRENORPHINE EXTENDED-RELEASE (SUBLOCADE), GREATER THAN 100 MG",4143.13,2693.035,688.46,14287.53,38
HCPCS,S0020,"INJECTION, BUPIVICAINE HYDROCHLORIDE, 30 ML",10.5,6.83,3.29,7.88,14
HCPCS,S0092,"INJECTION, HYDROMORPHONE HYDROCHLORIDE, 250 MG (LOADING DOSE FOR INFUSION PUMP)",247.0,160.55,61.75,637.88,16
HCPCS,S0138,"FINASTERIDE, 5 MG",23.625,15.355,4.84,72.08,32
HCPCS,S0169,"CALCITROL, 0.25 MICROGRAM",9.275,6.03,1.12,36.36,32
HCPCS,S0190,"MIFEPRISTONE, ORAL, 200 MG",456.235,296.555,83.74,1491.39,36
HCPCS,S0596,PHAKIC INTRAOCULAR LENS FOR CORRECTION OF REFRACTIVE ERROR,1237.5,804.38,73.6,1274.63,15
HCPCS,S0620,ROUTINE OPHTHALMOLOGICAL EXAMINATION INCLUDING REFRACTION; NEW PATIENT,78.8,51.22,35.46,81.16,15
HCPCS,S0621,ROUTINE OPHTHALMOLOGICAL EXAMINATION INCLUDING REFRACTION; ESTABLISHED PATIENT,78.8,51.22,35.46,81.16,15
HCPCS,S0630,REMOVAL OF SUTURES; BY A PHYSICIAN OTHER THAN THE PHYSICIAN WHO ORIGINALLY CLOSED THE WOUND,50.0,32.5,22.5,80.89,15
HCPCS,S0800,LASER IN SITU KERATOMILEUSIS (LASIK),1846.0,1199.9,73.6,8477.27,84
HCPCS,S0810,PHOTOREFRACTIVE KERATECTOMY (PRK),1846.0,1199.9,73.6,8477.27,66
HCPCS,S0812,PHOTOTHERAPEUTIC KERATECTOMY (PTK),1846.0,1199.9,73.6,8477.27,33
HCPCS,S2067,"BREAST RECONSTRUCTION OF A SINGLE BREAST WITH ""STACKED"" DEEP INFERIOR EPIGASTRIC PERFORATOR (DIEP) FLAP(S) AND/OR GLUTEAL ARTERY PERFORATOR (GAP) FLAP(S), INCLUDING HARVESTING OF THE FLAP(S), MICROVAS",45000.0,29250.0,73.6,46350.0,15
HCPCS,S2068,"BREAST RECONSTRUCTION WITH DEEP INFERIOR EPIGASTRIC PERFORATOR (DIEP) FLAP OR SUPERFICIAL INFERIOR EPIGASTRIC ARTERY (SIEA) FLAP, INCLUDING HARVESTING OF THE FLAP, MICROVASCULAR TRANSFER, CLOSURE OF D",67500.0,43875.0,73.6,69525.0,15
HCPCS,S2083,ADJUSTMENT OF GASTRIC BAND DIAMETER VIA SUBCUTANEOUS PORT BY INJECTION OR ASPIRATION OF SALINE,260.0,169.0,73.6,267.8,15
HCPCS,S2102,ISLET CELL TISSUE TRANSPLANT FROM PANCREAS; ALLOGENEIC,3654.0,2375.1,73.6,3763.62,15
HCPCS,S2115,"OSTEOTOMY, PERIACETABULAR, WITH INTERNAL FIXATION",7350.0,4777.5,73.6,7570.5,15
HCPCS,S2325,HIP CORE DECOMPRESSION,5869.5,3815.18,73.6,6045.59,15
HCPCS,S4989,"CONTRACEPTIVE INTRAUTERINE DEVICE (E.G., PROGESTACERT IUD), INCLUDING IMPLANTS AND SUPPLIES",2145.83,1394.79,78.57,2210.2,15
HCPCS,S4990,"NICOTINE PATCHES, LEGEND",19.665,12.785,4.05,87.91,96
HCPCS,S4995,SMOKING CESSATION GUM,20.125,13.08,1.5,88.45,32
HCPCS,S5108,"HOME CARE TRAINING TO HOME CARE CLIENT, PER 15 MINUTES",32.8,21.32,14.76,80.89,15
HCPCS,S8037,MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY (MRCP),308.7,200.66,73.6,317.96,15
HCPCS,S8096,PORTABLE PEAK FLOW METER,73.5,47.78,33.08,80.89,15
HCPCS,S8110,PEAK EXPIRATORY FLOW RATE (PHYSICIAN SERVICES),47.3,30.75,21.29,80.89,15
HCPCS,S8450,"SPLINT, PREFABRICATED, DIGIT (SPECIFY DIGIT BY USE OF MODIFIER)",26.3,17.1,11.84,80.89,15
HCPCS,S9443,"LACTATION CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION",135.0,87.75,33.75,348.64,19
HCPCS,S9460,"DIABETIC MANAGEMENT PROGRAM, NURSE VISIT",65.0,42.25,29.25,80.89,15
HCPCS,S9470,"NUTRITIONAL COUNSELING, DIETITIAN VISIT",87.2,56.68,39.24,89.82,15
HCPCS,S9480,"INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES, PER DIEM",892.5,580.125,73.6,1355.81,31
HCPCS,S9976,"LODGING, PER DIEM, NOT OTHERWISE CLASSIFIED",660.0,429.0,174.24,462.0,9
HCPCS,S9986,NOT MEDICALLY NECESSARY SERVICE (PATIENT IS AWARE THAT SERVICE NOT MEDICALLY NECESSARY),525.0,341.25,73.6,540.75,15
HCPCS,T1013,"SIGN LANGUAGE OR ORAL INTERPRETIVE SERVICES, PER 15 MINUTES",30.0,19.5,13.5,80.89,30
HCPCS,T1014,"TELEHEALTH TRANSMISSION, PER MINUTE, PROFESSIONAL SERVICES BILL SEPARATELY",6.6,4.29,0.09,80.89,15
HCPCS,U0002,"2019-NCOV CORONAVIRUS, SARS-COV-2/2019-NCOV (COVID-19), ANY TECHNIQUE, MULTIPLE TYPES OR SUBTYPES (INCLUDES ALL TARGETS), NON-CDC",130.0,84.5,12.47,335.73,19
HCPCS,U0005,"INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS-COV-2) (CORONAVIRUS DISEASE [COVID-19]), AMPLIFIED PROBE TECHNIQUE, CDC OR NON-CDC, MAKIN",25.0,16.25,6.25,64.56,36
HCPCS,V2510,"CONTACT LENS, GAS PERMEABLE, SPHERICAL, PER LENS",459.9,298.94,56.03,473.7,19
HCPCS,V2514,"PR BASIC CRS HA BINAURAL ITC/ITC, V5214",2200.0,1430.0,880.0,2266.0,14
HCPCS,V2520,"CONTACT LENS, HYDROPHILIC, SPHERICAL, PER LENS",236.3,153.6,55.98,374.55,19
HCPCS,V2599,"CONTACT LENS, OTHER TYPE",351.5,228.475,18.25,648.9,31
HCPCS,V2628,FABRICATION AND FITTING OF OCULAR CONFORMER,350.0,227.5,78.57,1240.33,19
HCPCS,V2785,"PROCESSING, PRESERVING AND TRANSPORTING CORNEAL TISSUE",13019.93,8462.955,2193.75,44586.5,35
HCPCS,V2787,ASTIGMATISM CORRECTING FUNCTION OF INTRAOCULAR LENS,367.5,238.88,73.6,378.53,15
HCPCS,V2788,PRESBYOPIA CORRECTING FUNCTION OF INTRAOCULAR LENS,525.0,341.25,73.6,540.75,15
HCPCS,V2790,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",3836.25,2493.565,73.6,14236.03,158
HCPCS,V5050,"HEARING AID, MONAURAL, IN THE EAR",1500.0,975.0,78.57,6198.0,124
HCPCS,V5060,"HEARING AID, MONAURAL, BEHIND THE EAR",1800.0,1170.0,78.57,6714.5,201
HCPCS,V5130,"BINAURAL, IN THE EAR",3000.0,1950.0,78.57,12396.0,124
HCPCS,V5140,"BINAURAL, BEHIND THE EAR",3600.0,2340.0,78.57,13429.0,217
HCPCS,V5160,"DISPENSING FEE, BINAURAL",900.0,585.0,44.39,7360.13,154
HCPCS,V5171,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR (ITE)",2505.0,1628.25,73.6,10355.83,47
HCPCS,V5172,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE CANAL (ITC)",2505.0,1628.25,73.6,10355.83,47
HCPCS,V5181,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, BEHIND THE EAR (BTE)",4510.0,2931.5,78.57,20711.65,47
HCPCS,V5200,"DISPENSING FEE, CONTRALATERAL, MONAURAL",400.0,260.0,44.39,3615.5,136
HCPCS,V5211,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE",3100.0,2015.0,73.6,20711.65,109
HCPCS,V5212,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC",3100.0,2015.0,78.57,20711.65,109
HCPCS,V5213,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE",3100.0,2015.0,73.6,20711.65,109
HCPCS,V5214,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC",3100.0,2015.0,73.6,20711.65,94
HCPCS,V5215,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE",3100.0,2015.0,73.6,20711.65,109
HCPCS,V5221,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE",3100.0,2015.0,78.57,20711.65,109
HCPCS,V5240,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",500.0,325.0,44.39,7360.13,136
HCPCS,V5241,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",400.0,260.0,44.39,3615.5,136
HCPCS,V5256,"HEARING AID, DIGITAL, MONAURAL, ITE",3050.0,1982.5,762.5,7876.63,16
HCPCS,V5257,"HEARING AID, DIGITAL, MONAURAL, BTE",3050.0,1982.5,762.5,7876.63,16
HCPCS,V5260,"HEARING AID, DIGITAL, BINAURAL, ITE",7700.0,5005.0,1925.0,19885.25,16
HCPCS,V5261,"HEARING AID, DIGITAL, BINAURAL, BTE",7700.0,5005.0,1925.0,19885.25,16
HCPCS,V5264,"EAR MOLD/INSERT, NOT DISPOSABLE, ANY TYPE",75.0,48.75,12.5,619.8,78
HCPCS,V5266,BATTERY FOR USE IN HEARING DEVICE,5.5600000000000005,3.615,0.28,25.83,32
HCPCS,V5267,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",300.0,195.0,31.25,1291.25,682
HCPCS,V5299,"HEARING SERVICE, MISCELLANEOUS",750.0,487.5,187.5,1936.88,17
HCPCS,V5362,SPEECH SCREENING,236.3,153.6,73.6,243.39,15
MS-DRG,001,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,1208189.98,785323.49,250134.89,845732.99,16
MS-DRG,002,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,822025.2,534316.38,101145.04,575417.64,16
MS-DRG,003,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",890985.63,579140.66,189451.25,623689.94,19
MS-DRG,004,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",448347.82,291426.08,118363.82,373392.19,19
MS-DRG,005,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,831489.74,540468.33,92029.15,582042.82,16
MS-DRG,006,LIVER TRANSPLANT WITHOUT MCC,486998.56,316549.07,41388.8,340898.99,16
MS-DRG,007,LUNG TRANSPLANT,1134168.37,737209.44,115590.51,793917.86,16
MS-DRG,008,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,717983.64,466689.37,50025.37,502588.55,16
MS-DRG,011,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",228770.21,148700.64,48682.04,160139.15,19
MS-DRG,012,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",233822.76,151984.8,37631.05,163675.93,19
MS-DRG,013,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",107027.7,69568.0,25722.28,77684.68,19
MS-DRG,014,ALLOGENEIC BONE MARROW TRANSPLANT,547273.41,355727.72,107269.01,383091.39,17
MS-DRG,016,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,183530.8,119295.02,48452.13,150566.94,18
MS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,2517874.0,1636618.1,385439.74,1762511.8,18
MS-DRG,020,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,299595.96,194737.37,70235.1,212119.24,19
MS-DRG,021,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,158162.04,102805.32,41754.78,142704.97,19
MS-DRG,022,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,107962.88,70175.87,27447.64,82895.47,19
MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,229463.42,149151.22,51147.34,160624.39,19
MS-DRG,024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,126300.99,82095.64,33343.46,105453.09,19
MS-DRG,025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,172708.9,112260.78,40582.8,122565.39,19
MS-DRG,026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,122930.73,79904.97,27752.0,86051.51,19
MS-DRG,027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,107284.21,69734.74,22518.83,75098.95,19
MS-DRG,028,SPINAL PROCEDURES WITH MCC,194800.97,126620.63,51427.46,161965.74,19
MS-DRG,029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,108254.54,70365.45,28579.2,91966.5,19
MS-DRG,030,SPINAL PROCEDURES WITHOUT CC/MCC,78366.02,50937.91,19593.85,59176.01,19
MS-DRG,031,VENTRICULAR SHUNT PROCEDURES WITH MCC,132580.97,86177.63,35001.37,120780.84,19
MS-DRG,032,VENTRICULAR SHUNT PROCEDURES WITH CC,70306.09,45698.96,18560.81,57445.37,19
MS-DRG,033,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,72641.29,47216.84,14842.66,50848.9,19
MS-DRG,034,CAROTID ARTERY STENT PROCEDURES WITH MCC,140591.19,91384.27,34548.98,104342.46,19
MS-DRG,035,CAROTID ARTERY STENT PROCEDURES WITH CC,81707.2,53109.68,21337.05,64440.71,19
MS-DRG,036,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,75012.13,48757.88,17340.99,52508.49,19
MS-DRG,037,EXTRACRANIAL PROCEDURES WITH MCC,71131.01,46235.16,18778.59,71131.01,19
MS-DRG,038,EXTRACRANIAL PROCEDURES WITH CC,75266.19,48923.02,14482.95,52686.33,19
MS-DRG,039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,38655.94,25126.36,10205.17,31687.95,19
MS-DRG,040,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",129401.86,84111.21,34162.09,104086.37,19
MS-DRG,041,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",101335.87,65868.31,19625.09,70935.11,19
MS-DRG,042,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",53798.85,34969.26,14202.9,46573.61,19
MS-DRG,052,SPINAL DISORDERS AND INJURIES WITH CC/MCC,43119.31,28027.55,11383.5,43119.31,19
MS-DRG,053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,20239.83,13155.89,5343.31,20239.83,19
MS-DRG,054,NERVOUS SYSTEM NEOPLASMS WITH MCC,43627.23,28357.7,11517.59,41160.64,19
MS-DRG,055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,53183.68,34569.39,9100.72,37228.57,19
MS-DRG,056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,107191.39,69674.4,20735.46,75033.97,19
MS-DRG,057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,44403.98,28862.59,11564.23,34925.49,19
MS-DRG,058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,79638.98,51765.34,15258.6,55747.29,19
MS-DRG,059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,62977.32,40935.26,11075.99,44084.12,19
MS-DRG,060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,53261.18,34619.77,8209.92,37282.83,19
MS-DRG,061,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",37432.66,24331.23,9882.22,37432.66,19
MS-DRG,062,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",53212.03,34587.82,14047.98,47368.84,19
MS-DRG,063,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",40952.53,26619.14,10811.47,37842.24,19
MS-DRG,064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,65456.82,42546.93,17280.6,54210.53,19
MS-DRG,065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,32015.56,20810.12,8452.11,27234.66,19
MS-DRG,066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,20072.82,13047.33,5299.22,18449.37,19
MS-DRG,068,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,22018.59,14312.08,5812.91,22018.59,19
MS-DRG,069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,20029.16,13018.95,5287.7,20029.16,19
MS-DRG,070,OTHER CEREBROVASCULAR DISORDERS WITH MCC,43974.15,28583.2,11609.18,43974.15,19
MS-DRG,071,OTHER CEREBROVASCULAR DISORDERS WITH CC,50608.91,32895.79,9157.84,35426.24,19
MS-DRG,072,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,30327.62,19712.95,6749.67,21229.34,19
MS-DRG,073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,60791.7,39514.61,14319.61,43247.12,19
MS-DRG,074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,31641.82,20567.18,8353.44,27787.28,19
MS-DRG,075,VIRAL MENINGITIS WITH CC/MCC,22364.61,14537.0,5904.26,22364.61,19
MS-DRG,076,VIRAL MENINGITIS WITHOUT CC/MCC,16731.88,10875.72,4417.22,16731.88,19
MS-DRG,077,HYPERTENSIVE ENCEPHALOPATHY WITH MCC,17915.48,11645.06,4729.69,17915.48,19
MS-DRG,078,HYPERTENSIVE ENCEPHALOPATHY WITH CC,25721.77,16719.15,6790.55,25721.77,19
MS-DRG,080,NONTRAUMATIC STUPOR AND COMA WITH MCC,30261.9,19670.24,7989.14,30261.9,19
MS-DRG,081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,14485.6,9415.64,3824.2,14485.6,19
MS-DRG,082,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,78462.51,51000.63,20400.74,61612.92,19
MS-DRG,083,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,39189.24,25473.01,10345.96,37626.58,19
MS-DRG,084,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,27899.39,18134.6,7365.44,25765.5,19
MS-DRG,085,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,71978.14,46785.79,19002.23,61243.61,19
MS-DRG,086,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,30583.7,19879.41,8074.1,30583.7,19
MS-DRG,087,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,20800.91,13520.59,5491.44,20800.91,19
MS-DRG,089,CONCUSSION WITH CC,40635.02,26412.76,9805.85,29614.96,19
MS-DRG,090,CONCUSSION WITHOUT CC/MCC,15610.06,10146.54,4121.05,15610.06,19
MS-DRG,091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,59193.31,38475.65,15627.03,47341.88,19
MS-DRG,092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,40583.22,26379.09,9131.06,28408.25,19
MS-DRG,093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,20141.92,13092.25,5317.47,20141.92,19
MS-DRG,094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,140358.11,91232.77,31413.35,98250.67,19
MS-DRG,095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,97021.64,63064.07,23021.35,69527.49,19
MS-DRG,096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,85498.49,55574.02,22571.6,69527.49,19
MS-DRG,097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,106554.99,69260.74,28130.52,97363.29,19
MS-DRG,098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,111552.95,72509.42,20483.75,78087.07,19
MS-DRG,099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,83235.43,54103.03,12160.47,58264.8,19
MS-DRG,100,SEIZURES WITH MCC,61961.71,40275.11,16357.89,52210.32,19
MS-DRG,101,SEIZURES WITHOUT MCC,20639.75,13415.84,5448.89,20639.75,19
MS-DRG,102,HEADACHES WITH MCC,35952.66,23369.23,9491.5,30216.1,19
MS-DRG,103,HEADACHES WITHOUT MCC,23670.0,15385.5,6248.88,22544.14,18
MS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC,109208.95,70985.82,20985.38,76446.27,19
MS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC,37643.97,24468.58,9938.01,36472.82,19
MS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,35437.92,23034.65,9355.61,35437.92,19
MS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC,60802.39,39521.56,16051.83,48740.95,19
MS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,24567.03,15968.57,6485.69,24567.03,19
MS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,27841.89,18097.23,7013.87,21182.81,19
MS-DRG,123,NEUROLOGICAL EYE DISORDERS,37232.23,24200.95,7128.12,26062.56,19
MS-DRG,124,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,40643.37,26418.19,10729.85,35666.81,19
MS-DRG,125,OTHER DISORDERS OF THE EYE WITHOUT MCC,42060.26,27339.17,6853.21,29442.18,19
MS-DRG,135,SINUS AND MASTOID PROCEDURES WITH CC/MCC,128084.39,83254.85,18879.79,89659.07,19
MS-DRG,137,MOUTH PROCEDURES WITH CC/MCC,37886.77,24626.4,10002.11,37886.77,19
MS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC,24946.0,16214.9,6585.74,23889.29,19
MS-DRG,139,SALIVARY GLAND PROCEDURES,33668.8,21884.72,8888.56,32580.23,19
MS-DRG,140,MAJOR HEAD AND NECK PROCEDURES WITH MCC,147051.43,95583.43,38071.09,114979.69,19
MS-DRG,141,MAJOR HEAD AND NECK PROCEDURES WITH CC,79477.14,51660.14,19468.0,58795.91,19
MS-DRG,142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,48252.24,31363.95,12738.59,43034.15,19
MS-DRG,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",88083.24,57254.1,23253.97,88083.24,19
MS-DRG,144,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",49342.43,32072.58,13026.4,46713.79,19
MS-DRG,145,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",53977.29,35085.24,10731.45,37784.1,19
MS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",38186.98,24821.53,10081.36,38186.98,19
MS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",49576.75,32224.89,11349.12,34703.73,19
MS-DRG,149,DYSEQUILIBRIUM,17855.59,11606.13,4713.88,17855.59,19
MS-DRG,151,EPISTAXIS WITHOUT MCC,21796.02,14167.41,5754.15,19786.44,19
MS-DRG,152,OTITIS MEDIA AND URI WITH MCC,39616.94,25751.01,10458.87,31868.57,19
MS-DRG,153,OTITIS MEDIA AND URI WITHOUT MCC,26472.87,17207.36,6589.0,19899.66,19
MS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",58093.3,37760.65,13955.44,42147.27,19
MS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",28087.78,18257.06,7415.17,24706.09,19
MS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",16821.02,10933.66,4440.75,16821.02,19
MS-DRG,157,DENTAL AND ORAL DISEASES WITH MCC,25712.59,16713.18,6788.12,25712.59,19
MS-DRG,158,DENTAL AND ORAL DISEASES WITH CC,22684.71,14745.06,5988.76,22684.71,19
MS-DRG,159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC,21808.23,14175.35,5757.37,19099.03,19
MS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC,185842.19,120797.42,40003.52,130089.53,19
MS-DRG,164,MAJOR CHEST PROCEDURES WITH CC,103483.2,67264.08,22528.64,72438.24,19
MS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC,79736.07,51828.45,17085.71,55815.25,19
MS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,90362.41,58735.56,23855.68,90362.41,19
MS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,108543.19,70553.07,16096.73,75980.23,19
MS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,69686.22,45296.04,12196.17,48780.35,19
MS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,47598.19,30938.82,12260.44,37028.14,19
MS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC,21315.27,13854.93,5627.23,21315.27,19
MS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,73931.12,48055.23,13948.3,51751.79,19
MS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,80645.69,52419.7,8711.55,56451.98,19
MS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,45892.51,29830.13,6738.96,32124.76,19
MS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC,83346.15,54175.0,15762.91,58342.31,19
MS-DRG,181,RESPIRATORY NEOPLASMS WITH CC,16751.54,10888.5,4422.41,16751.54,19
MS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC,18002.55,11701.66,4752.67,18002.55,19
MS-DRG,183,MAJOR CHEST TRAUMA WITH MCC,47051.89,30583.73,12421.7,41241.51,19
MS-DRG,184,MAJOR CHEST TRAUMA WITH CC,32298.0,20993.7,8526.67,28684.94,19
MS-DRG,185,MAJOR CHEST TRAUMA WITHOUT CC/MCC,21116.26,13725.57,5574.69,21116.26,19
MS-DRG,186,PLEURAL EFFUSION WITH MCC,54848.15,35651.3,13910.81,42012.48,19
MS-DRG,187,PLEURAL EFFUSION WITH CC,30848.98,20051.83,8144.13,26663.17,19
MS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC,22388.35,14552.43,5910.53,19333.56,19
MS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE,57163.24,37156.11,11026.9,40014.27,19
MS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,38017.81,24711.57,9887.08,29860.27,19
MS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,30660.78,19929.51,7524.42,22724.75,19
MS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,14531.15,9445.25,3836.22,14531.15,19
MS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC,47080.62,30602.41,11732.03,35432.28,19
MS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY WITH CC,27617.52,17951.39,7193.28,21724.65,19
MS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,11457.05,7447.08,3024.66,11457.05,19
MS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC,78127.26,50782.72,16844.71,54689.08,19
MS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC,28616.97,18601.03,7554.88,25584.89,19
MS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,20746.7,13485.36,5477.13,19306.6,19
MS-DRG,199,PNEUMOTHORAX WITH MCC,50031.7,32520.6,13208.37,47554.84,19
MS-DRG,200,PNEUMOTHORAX WITH CC,25472.15,16556.9,6724.65,25472.15,19
MS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC,10376.28,6744.58,2739.34,10376.28,19
MS-DRG,202,BRONCHITIS AND ASTHMA WITH CC/MCC,29765.64,19347.67,7858.13,26180.64,19
MS-DRG,203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC,18502.0,12026.3,4884.53,18061.19,19
MS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS,22830.44,14839.78,6027.24,21765.08,19
MS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,79695.92,51802.35,16343.08,55787.14,19
MS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,37737.23,24529.2,8400.04,26416.06,19
MS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,236592.37,153785.04,57434.65,173460.21,19
MS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,93247.24,60610.71,24534.26,74096.71,19
MS-DRG,212,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,403031.56,261970.51,97059.72,293133.11,19
MS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT,275482.7,179063.75,72727.43,268410.85,19
MS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,373144.17,242543.71,87319.02,263714.94,19
MS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,275424.84,179026.14,58689.62,192797.38,19
MS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,256289.31,166588.05,67660.38,206983.93,19
MS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,190327.77,123713.05,47599.35,143756.29,19
MS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,212227.92,137948.15,44987.67,148559.54,19
MS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC,228538.38,148549.95,44159.35,159976.86,19
MS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,121921.3,79248.85,28111.71,85344.91,19
MS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC,315983.68,205389.39,75243.35,227244.81,19
MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,268681.74,174643.13,68239.3,206091.66,19
MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,157017.82,102061.58,41452.71,147258.0,19
MS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,177422.32,115324.51,46839.49,158199.85,19
MS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,134863.21,87661.08,35603.89,112917.48,19
MS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,263974.08,171583.15,43929.96,184781.86,19
MS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,98194.08,63826.15,25442.91,76840.93,19
MS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,21669.54,14085.2,5720.76,21669.54,19
MS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,142763.09,92796.01,28498.2,99934.17,19
MS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,99955.16,64970.85,19019.92,69968.61,19
MS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,86902.51,56486.63,16133.33,60831.75,19
MS-DRG,245,AICD GENERATOR PROCEDURES,382925.64,248901.67,40722.93,268047.95,19
MS-DRG,246,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS,111161.92,72255.25,26736.25,80747.0,19
MS-DRG,247,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC,78714.09,51164.16,17043.76,55099.86,19
MS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,85032.4,55271.06,19480.49,59522.68,19
MS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,74972.23,48731.95,13339.56,52480.56,19
MS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC,162186.96,105421.53,31135.76,113530.87,19
MS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC,84769.52,55100.19,22379.15,69969.59,19
MS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,63490.22,41268.64,15903.04,48029.29,19
MS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,54843.39,35648.2,14478.65,54843.39,19
MS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,98148.47,63796.51,15155.06,68703.93,19
MS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,64464.25,41901.76,17018.56,64464.25,19
MS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,168706.17,109659.01,29033.74,118094.32,19
MS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,88805.93,57723.86,16874.17,62164.15,19
MS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,53434.11,34732.17,14106.61,43937.21,19
MS-DRG,263,VEIN LIGATION AND STRIPPING,118107.77,76770.05,27289.65,82675.44,19
MS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,113205.86,73583.81,29817.43,90052.55,19
MS-DRG,265,AICD LEAD PROCEDURES,82831.09,53840.21,21867.41,82831.09,19
MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,233650.93,151873.1,54700.69,165203.28,19
MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,229419.56,149122.71,42493.81,160593.69,19
MS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,301922.69,196249.75,61390.55,211345.88,19
MS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,171287.04,111336.58,37695.31,119900.93,19
MS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,168005.1,109203.31,44353.34,142233.22,19
MS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,148879.28,96771.53,31742.72,104215.49,19
MS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,111356.17,72381.51,22787.49,77949.32,19
MS-DRG,273,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,148724.76,96671.09,36823.26,111211.1,19
MS-DRG,274,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,132916.43,86395.68,29380.96,93041.5,19
MS-DRG,275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,291946.79,189765.41,63644.31,204362.75,19
MS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,217370.43,141290.78,53613.53,161919.92,19
MS-DRG,277,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,227613.61,147948.84,41223.67,159329.53,19
MS-DRG,278,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,33367.7,21689.01,8809.07,49682.62,19
MS-DRG,279,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,122943.36,79913.18,32189.9,97217.72,19
MS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",56557.69,36762.5,14317.83,43241.72,19
MS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",33281.84,21633.2,8203.68,24776.18,19
MS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",27986.52,18191.24,6454.22,19590.56,19
MS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",62666.94,40733.51,16544.07,53396.43,19
MS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",49900.62,32435.4,6178.42,34930.43,19
MS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",82012.66,53308.23,19750.94,59650.45,19
MS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",51302.96,33346.92,9551.47,35912.07,19
MS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,96355.5,62631.07,24154.92,72951.03,19
MS-DRG,290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,6641.15,4316.75,1753.26,8298.29,19
MS-DRG,291,HEART FAILURE AND SHOCK WITH MCC,34754.54,22590.45,9175.2,34607.4,19
MS-DRG,292,HEART FAILURE AND SHOCK WITH CC,22618.45,14701.99,5971.27,22618.45,19
MS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC,11292.4,7340.06,2981.19,11292.4,19
MS-DRG,294,DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC,52525.74,34141.73,10959.95,36768.01,19
MS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC",72785.0,47310.25,13941.16,50949.5,19
MS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC,61563.4,40016.21,14573.1,44012.69,19
MS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC,25397.6,16508.44,6704.97,25397.6,19
MS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,25235.78,16403.25,6423.88,19400.95,19
MS-DRG,302,ATHEROSCLEROSIS WITH MCC,39752.8,25839.32,10494.74,32256.75,18
MS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC,17199.14,11179.44,4540.57,17199.14,19
MS-DRG,304,HYPERTENSION WITH MCC,29809.5,19376.17,7869.71,29809.5,19
MS-DRG,305,HYPERTENSION WITHOUT MCC,22044.66,14329.03,5819.79,20355.23,19
MS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,47633.99,30962.09,12575.37,42478.84,19
MS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,16867.3,10963.75,4452.97,16867.3,19
MS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,34969.59,22730.23,9231.97,32456.23,19
MS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,19710.81,12812.03,5203.65,19710.81,19
MS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,19269.52,12525.19,5052.88,15260.36,19
MS-DRG,311,ANGINA PECTORIS,20366.37,13238.14,5376.72,18921.12,19
MS-DRG,312,SYNCOPE AND COLLAPSE,22318.52,14507.04,5892.09,22318.52,19
MS-DRG,313,CHEST PAIN,14060.66,9139.43,3712.01,14060.66,19
MS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,58932.55,38306.16,15558.19,56210.74,19
MS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,45727.73,29723.02,8598.19,32009.41,19
MS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,22383.91,14549.54,5909.35,18387.37,19
MS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,270895.87,176082.32,39834.82,189627.11,19
MS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,120767.02,78498.56,21469.15,84536.91,19
MS-DRG,321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,126259.45,82068.64,24285.24,88381.61,19
MS-DRG,322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,82134.69,53387.55,15736.13,57494.29,19
MS-DRG,323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,153171.3,99561.35,38625.38,116653.72,19
MS-DRG,324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,117634.38,76462.35,28125.1,84941.51,19
MS-DRG,325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,146856.01,95456.41,28655.29,102799.21,19
MS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",233600.97,151840.63,44516.39,163520.68,19
MS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",127922.02,83149.31,21816.37,89545.41,19
MS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",65788.77,42762.7,14301.76,46052.14,19
MS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,154641.93,100517.25,40825.47,129828.85,19
MS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,95899.07,62334.39,21396.86,67129.35,19
MS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,55184.05,35869.64,14568.59,45365.94,19
MS-DRG,332,RECTAL RESECTION WITH MCC,408413.62,265468.85,32317.54,285889.53,19
MS-DRG,333,RECTAL RESECTION WITH CC,102931.45,66905.44,20905.94,72052.01,19
MS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC,11704.55,7607.96,3090.0,14619.52,19
MS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC,147026.16,95567.0,31873.03,102918.31,19
MS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC,77186.29,50171.09,18821.77,56844.23,19
MS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,49645.06,32269.29,13106.3,41379.0,19
MS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,131222.03,85294.32,23053.48,91855.42,19
MS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,57744.11,37533.67,13430.61,40562.2,19
MS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,27066.37,17593.14,7145.52,27066.37,19
MS-DRG,347,ANAL AND STOMAL PROCEDURES WITH MCC,95531.25,62095.31,20490.0,66871.88,19
MS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC,57491.65,37369.57,11682.05,40244.15,19
MS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,26455.44,17196.04,6984.24,23468.76,19
MS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,121836.59,79193.78,22242.13,85285.61,19
MS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,55801.7,36271.11,13607.34,41095.95,19
MS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,43176.58,28064.78,10423.51,31480.38,19
MS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,89312.82,58053.33,23578.59,78229.21,19
MS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,69548.53,45206.54,15016.72,48683.97,19
MS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,50445.07,32789.3,12005.16,36257.17,19
MS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,99636.43,64763.68,26304.02,99636.43,19
MS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,81993.91,53296.04,20756.88,62688.5,19
MS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,41951.37,27268.39,11075.16,37683.19,19
MS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC,34844.98,22649.23,9199.07,34844.98,19
MS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC,26213.58,17038.83,6920.38,26213.58,19
MS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,22466.12,14602.98,5931.06,18891.47,19
MS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,53381.01,34697.66,14092.59,47797.46,19
MS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,33124.66,21531.03,8744.91,27523.1,19
MS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,20753.21,13489.59,5478.85,19608.52,19
MS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC,82246.55,53460.25,19089.54,57652.94,19
MS-DRG,375,DIGESTIVE MALIGNANCY WITH CC,30121.73,19579.12,7952.14,30121.73,19
MS-DRG,377,GASTROINTESTINAL HEMORRHAGE WITH MCC,59892.74,38930.28,15811.68,49277.4,19
MS-DRG,378,GASTROINTESTINAL HEMORRHAGE WITH CC,38451.01,24993.16,8753.5,26915.71,19
MS-DRG,379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,24358.01,15832.71,5626.81,17050.61,19
MS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC,52873.64,34367.87,13958.64,52873.64,19
MS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC,41677.21,27090.18,9671.07,29207.91,19
MS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,25453.63,16544.86,6719.76,21581.77,19
MS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,26446.99,17190.54,6982.0,23042.84,19
MS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC,62410.2,40566.63,14123.25,43687.14,19
MS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC,47210.48,30686.81,8714.23,33047.33,19
MS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,26168.03,17009.22,6081.13,18365.8,19
MS-DRG,388,GASTROINTESTINAL OBSTRUCTION WITH MCC,65333.91,42467.04,13181.58,45733.73,19
MS-DRG,389,GASTROINTESTINAL OBSTRUCTION WITH CC,19274.15,12528.2,5088.38,19274.15,19
MS-DRG,390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,13419.66,8722.78,3542.79,13419.66,19
MS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",46863.08,30461.0,11320.55,43433.56,19
MS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",26460.98,17199.64,6958.53,21015.68,19
MS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,48369.61,31440.25,12769.58,43112.33,19
MS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,31429.43,20429.13,8297.37,25223.66,19
MS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,19366.85,12588.45,5112.85,17495.09,19
MS-DRG,397,APPENDIX PROCEDURES WITH MCC,90343.38,58723.2,21376.33,64559.32,19
MS-DRG,398,APPENDIX PROCEDURES WITH CC,49374.76,32093.59,13034.94,40802.12,19
MS-DRG,399,APPENDIX PROCEDURES WITHOUT CC/MCC,37503.64,24377.37,9900.96,30857.68,19
MS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",240270.52,156175.84,48828.42,168189.36,19
MS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",110998.42,72148.97,25886.52,78180.69,19
MS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",95100.56,61815.36,19811.64,66570.39,19
MS-DRG,408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,115244.04,74908.63,30424.43,96117.88,19
MS-DRG,409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,62876.18,40869.52,16599.31,58693.48,19
MS-DRG,410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,62240.79,40456.51,14171.45,43568.55,19
MS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC,39386.17,25601.01,10397.95,39386.17,19
MS-DRG,413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,68215.9,44340.34,14821.24,47751.13,19
MS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,58095.21,37761.88,15337.13,58095.21,19
MS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,70922.79,46099.82,18446.89,55712.03,19
MS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,72144.3,46893.8,19046.1,64330.18,19
MS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,49404.16,32112.71,13042.7,45600.46,19
MS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,45617.78,29651.56,12043.09,36817.87,19
MS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,137427.42,89327.82,30410.99,96199.19,19
MS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,53276.74,34629.88,14065.06,46837.79,19
MS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,49610.72,32246.97,12491.62,37726.32,19
MS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,141428.61,91928.6,37068.72,111952.42,19
MS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,99085.59,64405.63,19528.69,69359.91,19
MS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,67336.36,43768.63,17567.7,53056.77,19
MS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,30121.14,19578.74,7951.98,28471.98,19
MS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,13536.23,8798.55,3573.56,13536.23,19
MS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,58514.5,38034.43,15447.83,49511.92,19
MS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,30350.84,19728.05,8012.62,30350.84,19
MS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,8364.21,5436.74,2208.15,8364.21,19
MS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,52940.32,34411.21,13976.25,43945.3,19
MS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,24636.95,16014.02,6504.15,22676.23,19
MS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,16229.76,10549.34,4284.66,16229.76,19
MS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",72860.88,47359.57,16019.08,51002.62,19
MS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",30323.64,19710.37,8005.44,26021.59,19
MS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",19909.31,12941.05,5256.06,18861.81,19
MS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC,74196.22,48227.55,14914.07,51937.36,19
MS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC,30248.88,19661.77,7985.7,29501.74,19
MS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,20959.96,13623.98,5533.43,20959.96,19
MS-DRG,453,COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC,280663.21,182431.08,74095.09,238876.76,19
MS-DRG,454,COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC,169453.58,110144.82,44735.74,164877.1,19
MS-DRG,455,COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC,123117.54,80026.4,32503.03,123117.54,19
MS-DRG,456,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",257393.39,167305.7,67951.86,226530.45,19
MS-DRG,457,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",162810.63,105826.91,42982.01,160747.29,19
MS-DRG,458,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",103483.83,67264.49,27319.73,103483.83,19
MS-DRG,459,SPINAL FUSION EXCEPT CERVICAL WITH MCC,201176.08,130764.45,53110.48,178786.91,19
MS-DRG,460,SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,98495.8,64022.27,26002.89,98495.8,19
MS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,161442.01,104937.31,42620.69,144505.69,19
MS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,188962.21,122825.44,23742.55,132273.55,19
MS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,265941.44,172861.94,50872.43,186159.01,19
MS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,119281.4,77532.91,27801.1,83962.97,19
MS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,60956.77,39621.9,16092.59,49161.48,19
MS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,183800.91,119470.59,46462.2,140321.97,19
MS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC,113284.63,73635.01,29907.14,95066.56,19
MS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,109181.81,70968.18,24528.02,76427.27,19
MS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,178929.68,116304.29,27073.65,125250.77,19
MS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,91333.12,59366.53,17216.92,63933.19,19
MS-DRG,471,CERVICAL SPINAL FUSION WITH MCC,141810.34,92176.72,37437.93,130167.27,19
MS-DRG,472,CERVICAL SPINAL FUSION WITH CC,91414.2,59419.23,24133.35,79418.02,19
MS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,62890.79,40879.01,16603.17,62890.79,19
MS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,165276.13,107429.49,38317.44,115723.71,19
MS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,94099.74,61164.83,20312.37,65869.82,19
MS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,29296.56,19042.76,7734.29,29296.56,19
MS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,101930.55,66254.86,26909.67,93125.65,19
MS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,63971.1,41581.22,16888.37,63971.1,19
MS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,6068.5,3944.53,1602.08,16592.11,19
MS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,149627.48,97257.86,25994.52,104739.24,19
MS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,84692.97,55050.43,18695.03,59285.08,19
MS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,58332.39,37916.05,14557.93,43966.87,19
MS-DRG,483,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,162011.09,105307.21,24741.34,113407.77,19
MS-DRG,485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,95644.93,62169.2,25250.26,86992.93,19
MS-DRG,486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,64822.27,42134.47,17113.08,56369.78,19
MS-DRG,487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,52128.89,33883.78,13762.03,42220.05,19
MS-DRG,488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,85064.71,55292.06,13599.3,59545.3,19
MS-DRG,489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,67342.47,43772.61,9968.3,47139.73,19
MS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",131719.89,85617.93,32771.86,98975.32,19
MS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",79416.63,51620.81,20965.99,68365.65,19
MS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",52990.33,34443.71,13989.45,52990.33,19
MS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,661078.74,429701.18,32362.16,462755.12,19
MS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,114090.3,74158.7,16101.2,79863.21,19
MS-DRG,497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,37944.41,24663.87,10017.32,31046.38,19
MS-DRG,498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,85739.81,55730.88,22635.31,81323.88,19
MS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC,126152.43,81999.08,28248.28,88306.7,19
MS-DRG,501,SOFT TISSUE PROCEDURES WITH CC,50841.18,33046.77,13422.07,47123.53,19
MS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC,46376.85,30144.95,12013.19,36281.43,19
MS-DRG,503,FOOT PROCEDURES WITH MCC,127751.24,83038.3,24912.72,89425.86,19
MS-DRG,504,FOOT PROCEDURES WITH CC,97208.23,63185.35,16684.05,68045.76,19
MS-DRG,506,MAJOR THUMB OR JOINT PROCEDURES,28509.96,18531.47,7526.63,28509.96,19
MS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,105082.63,68303.71,16123.51,73557.84,19
MS-DRG,509,ARTHROSCOPY,76183.05,49518.98,15678.12,53328.14,19
MS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",101942.64,66262.72,26912.86,81423.62,19
MS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",73875.69,48019.2,18560.25,56054.39,19
MS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",37364.78,24287.11,9864.3,37364.78,19
MS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",35565.5,23117.58,9389.29,35565.5,19
MS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",18882.58,12273.68,4985.0,18882.58,19
MS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,195582.59,127128.69,28445.54,136907.82,19
MS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,87321.71,56759.11,18548.64,61125.2,19
MS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,53313.68,34653.89,13716.23,41424.82,19
MS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,139940.9,90961.59,33358.28,100746.4,19
MS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,66038.1,42924.76,17434.06,53919.39,19
MS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,33680.32,21892.21,8891.6,33680.32,19
MS-DRG,521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,114390.68,74353.94,25618.75,80073.48,19
MS-DRG,522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,72021.79,46814.16,18902.1,57086.84,19
MS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC,24056.61,15636.79,6350.94,21730.04,19
MS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC,68166.27,44308.07,11442.84,47716.39,19
MS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC,29592.95,19235.42,7208.45,21770.47,19
MS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",27984.5,18189.93,7387.91,25725.07,19
MS-DRG,539,OSTEOMYELITIS WITH MCC,28115.86,18275.31,7422.59,28115.86,19
MS-DRG,540,OSTEOMYELITIS WITH CC,45000.77,29250.5,11570.48,34944.36,19
MS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,77834.36,50592.33,15767.37,54484.05,19
MS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,45733.8,29726.97,9175.69,32013.66,19
MS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,9689.83,6298.39,2558.11,9689.83,19
MS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC,51681.56,33593.02,13643.93,51681.56,19
MS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC,82435.33,53582.96,10294.98,57704.73,19
MS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,46151.87,29998.72,7463.73,32306.31,19
MS-DRG,548,SEPTIC ARTHRITIS WITH MCC,54159.58,35203.73,14298.13,52051.27,19
MS-DRG,549,SEPTIC ARTHRITIS WITH CC,8185.66,5320.68,2161.01,10775.19,19
MS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC,21052.4,13684.06,5557.83,21052.4,19
MS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC,52996.97,34448.03,13991.2,45182.63,19
MS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC,28086.24,18256.06,7414.77,25913.76,19
MS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC,71694.84,46601.64,11570.48,50186.39,19
MS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,35182.2,22868.43,7409.28,24627.54,19
MS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,14454.75,9395.59,3816.05,14454.75,19
MS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,25173.37,16362.69,6645.77,22390.48,19
MS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",52512.69,34133.25,13271.73,40082.36,19
MS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",21133.6,13736.84,5579.27,21133.6,19
MS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",42740.29,27781.19,11283.44,42740.29,19
MS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",42836.15,27843.49,10051.31,30356.28,19
MS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",63986.22,41591.05,12717.44,44790.36,19
MS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",31369.24,20390.01,7993.03,24139.99,19
MS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,72870.67,47365.94,13777.82,51009.47,19
MS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,31557.39,20512.31,8331.15,26266.9,19
MS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,13219.29,8592.54,3489.89,13219.29,19
MS-DRG,570,SKIN DEBRIDEMENT WITH MCC,55976.63,36384.81,14777.83,55976.63,19
MS-DRG,571,SKIN DEBRIDEMENT WITH CC,48722.3,31669.5,12862.69,45543.85,19
MS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC,39650.88,25773.07,10231.61,30900.81,19
MS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,280819.76,182532.84,58476.29,196573.83,19
MS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,164282.06,106783.34,30984.92,114997.44,19
MS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,177033.53,115071.8,43746.98,132121.65,19
MS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,102194.74,66426.58,23659.54,71536.32,19
MS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,52626.22,34207.04,13893.32,43303.72,19
MS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",95095.15,61811.85,25105.12,87300.24,19
MS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",78585.97,51080.88,15423.73,55010.18,19
MS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",53321.28,34658.83,12880.78,38901.65,19
MS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC,179539.22,116700.49,17196.39,125677.45,19
MS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,194251.97,126263.78,15391.6,135976.38,19
MS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",199442.09,129637.36,19107.4,139609.46,19
MS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",195780.03,127257.02,17218.7,137046.02,19
MS-DRG,592,SKIN ULCERS WITH MCC,45769.28,29750.03,12083.09,45769.28,19
MS-DRG,593,SKIN ULCERS WITH CC,29049.06,18881.89,7668.95,29049.06,19
MS-DRG,595,MAJOR SKIN DISORDERS WITH MCC,136506.96,88729.52,18928.88,95554.87,19
MS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC,63261.83,41120.19,9662.15,44283.28,19
MS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC,47936.66,31158.83,12655.28,44940.01,19
MS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC,47435.06,30832.79,10097.72,33204.54,19
MS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,17953.98,11670.09,4739.85,17953.98,19
MS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,16881.06,10972.69,4456.6,16308.99,19
MS-DRG,602,CELLULITIS WITH MCC,46970.85,30531.05,12400.3,38313.98,19
MS-DRG,603,CELLULITIS WITHOUT MCC,22078.93,14351.31,5828.84,22078.93,19
MS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",31794.67,20666.53,8393.79,31794.67,19
MS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",18463.59,12001.33,4874.39,18463.59,19
MS-DRG,606,MINOR SKIN DISORDERS WITH MCC,55613.59,36148.83,13506.48,40791.33,19
MS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC,28366.44,18438.19,7488.74,24433.82,19
MS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,85215.94,55390.36,19563.5,59651.16,19
MS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,56563.59,36766.34,12489.83,39594.52,19
MS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",184318.32,119806.91,31127.73,129022.82,19
MS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",77014.14,50059.19,16693.87,53909.9,19
MS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC,181217.63,117791.46,25772.27,126852.34,19
MS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC,59387.19,38601.67,14283.91,41571.03,19
MS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,56286.79,36586.41,13463.63,39400.75,19
MS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",225020.39,146263.25,31768.6,157514.27,19
MS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",80423.92,52275.55,16011.94,56296.74,19
MS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",68070.87,44246.07,17970.71,68070.87,19
MS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",67864.97,44112.23,13383.3,47505.48,19
MS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",35477.35,23060.28,9366.02,35477.35,19
MS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",70624.24,45905.76,18644.8,70624.24,19
MS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",113907.44,74039.83,19447.47,79735.2,19
MS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",30574.0,19873.1,8071.54,30574.0,19
MS-DRG,637,DIABETES WITH MCC,37518.47,24387.01,9904.88,37518.47,19
MS-DRG,638,DIABETES WITH CC,21050.45,13682.79,5557.32,21050.45,19
MS-DRG,639,DIABETES WITHOUT CC/MCC,12896.56,8382.76,3404.69,12896.56,19
MS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",53265.79,34622.76,11921.26,37286.05,19
MS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",23208.36,15085.43,6127.01,20977.94,19
MS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM,49440.37,32136.24,12693.34,38335.55,19
MS-DRG,643,ENDOCRINE DISORDERS WITH MCC,53141.03,34541.67,14029.23,44373.92,19
MS-DRG,644,ENDOCRINE DISORDERS WITH CC,24721.11,16068.72,6526.37,24721.11,19
MS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC,15131.76,9835.64,3994.78,15131.76,19
MS-DRG,650,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,483215.04,314089.78,41963.62,338250.53,18
MS-DRG,651,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,290888.08,189077.25,33077.12,203621.66,18
MS-DRG,652,KIDNEY TRANSPLANT,320728.18,208473.32,28825.77,224509.73,16
MS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC,116597.08,75788.1,30781.63,116597.08,19
MS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC,97098.25,63113.86,24985.91,75460.73,19
MS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,76777.04,49905.08,18892.28,57057.19,19
MS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,91693.25,59600.61,24207.02,85825.7,19
MS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,61472.51,39957.13,16228.74,49331.31,19
MS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,56204.85,36533.16,13851.01,41831.87,19
MS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,85816.32,55780.61,22655.51,68495.04,19
MS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,41915.97,27245.38,11065.81,35629.07,19
MS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,36501.11,23725.72,9241.74,27911.28,19
MS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC,48726.15,31672.0,12863.7,48726.15,19
MS-DRG,663,MINOR BLADDER PROCEDURES WITH CC,67228.24,43698.36,13568.96,47059.77,19
MS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC,145353.97,94480.08,9344.39,101747.78,19
MS-DRG,665,PROSTATECTOMY WITH MCC,210097.09,136563.11,27859.11,147067.96,19
MS-DRG,666,PROSTATECTOMY WITH CC,47563.99,30916.59,12556.89,47155.88,19
MS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC,76567.07,49768.6,20213.71,76567.07,19
MS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC,82611.14,53697.24,13852.8,57827.8,19
MS-DRG,671,URETHRAL PROCEDURES WITH CC/MCC,57918.23,37646.85,15290.41,48387.82,19
MS-DRG,672,URETHRAL PROCEDURES WITHOUT CC/MCC,50164.11,32606.67,9635.37,35114.88,19
MS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,153063.89,99491.53,37502.52,113262.53,19
MS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,73993.09,48095.51,19534.18,63041.64,19
MS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,45224.37,29395.84,11939.23,44247.22,19
MS-DRG,682,RENAL FAILURE WITH MCC,58037.71,37724.51,13219.07,40626.4,19
MS-DRG,683,RENAL FAILURE WITH CC,24561.81,15965.17,6484.32,23608.94,19
MS-DRG,684,RENAL FAILURE WITHOUT CC/MCC,18844.78,12249.11,4975.02,16182.29,19
MS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,73994.51,48096.43,16099.41,51796.15,19
MS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,48705.81,31658.78,9352.42,34094.07,19
MS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,34814.51,22629.43,9191.03,31278.21,19
MS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,21088.05,13707.23,5567.24,21088.05,19
MS-DRG,693,URINARY STONES WITH MCC,55966.22,36378.04,12000.7,39176.35,19
MS-DRG,694,URINARY STONES WITHOUT MCC,20431.55,13280.51,5393.93,20431.55,19
MS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,7903.33,5137.17,2086.48,7903.33,19
MS-DRG,697,URETHRAL STRICTURE,18640.14,12116.09,4921.0,18640.14,19
MS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,46466.38,30203.15,12267.12,44597.66,19
MS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,35755.79,23241.26,9059.66,27361.36,19
MS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,21138.6,13740.09,5580.59,18597.63,19
MS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,52333.39,34016.7,13816.02,52333.39,19
MS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,46970.16,30530.61,12400.12,41357.43,19
MS-DRG,709,PENIS PROCEDURES WITH CC/MCC,85234.74,55402.58,20771.16,62731.63,19
MS-DRG,711,TESTES PROCEDURES WITH CC/MCC,356661.62,231830.05,18599.52,249663.13,19
MS-DRG,712,TESTES PROCEDURES WITHOUT CC/MCC,30940.68,20111.44,8168.34,29644.61,19
MS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,144286.54,93786.25,13419.0,101000.57,19
MS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,64209.92,41736.44,9438.11,44946.94,19
MS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,145845.9,94799.84,19969.63,102092.13,19
MS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,50797.56,33018.41,13129.81,39653.75,19
MS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,49393.7,32105.9,13039.94,49393.7,19
MS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,25773.19,16752.57,6804.12,25773.19,19
MS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",180018.1,117011.77,16152.97,126012.67,19
MS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,15593.67,10135.89,4116.73,15593.67,19
MS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,31524.8,20491.12,8322.55,31524.8,19
MS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,20559.33,13363.57,5427.66,20559.33,19
MS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,14301.64,9296.07,3775.63,14301.64,19
MS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",79383.46,51599.25,19011.89,57418.41,19
MS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",52841.73,34347.12,12009.62,36989.21,19
MS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,155705.36,101208.48,31905.16,108993.75,19
MS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,75242.21,48907.44,18392.44,55547.59,19
MS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,44652.01,29023.81,11788.13,39586.35,19
MS-DRG,739,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,102840.23,66846.15,27149.82,95058.47,19
MS-DRG,740,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,68782.31,44708.5,16152.07,48781.39,19
MS-DRG,741,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,37191.37,24174.39,9818.52,37191.37,19
MS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,48598.02,31588.71,12829.88,48598.02,19
MS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,38754.25,25190.26,10231.12,33445.55,19
MS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",53158.13,34552.79,14033.75,53158.13,19
MS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",22011.0,14307.15,5810.9,22011.0,19
MS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",77062.89,50090.88,15504.96,53944.02,19
MS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",19948.01,12966.21,5266.27,19948.01,19
MS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,97636.24,63463.55,22917.81,69214.79,19
MS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,67243.75,43708.43,13172.65,47070.62,19
MS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",28388.22,18452.34,7494.49,28388.22,19
MS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",36599.71,23789.81,9662.32,29323.82,19
MS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",61359.73,39883.82,8573.2,42951.81,19
MS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",53772.5,34952.12,12780.81,38599.73,19
MS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",22364.21,14536.74,5904.15,22364.21,19
MS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",14804.61,9623.0,3908.42,14804.61,19
MS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,24588.46,15982.5,6491.35,24588.46,19
MS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,4268.59,2774.58,1126.91,5084.12,19
MS-DRG,768,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,24137.09,15689.11,6372.19,23128.77,19
MS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,44061.0,28639.65,11632.1,44061.0,19
MS-DRG,770,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",26746.29,17385.09,7061.02,26746.29,19
MS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,18256.0,11866.4,4819.58,17648.75,19
MS-DRG,779,ABORTION WITHOUT D&C,28765.3,18697.45,6364.97,20135.71,19
MS-DRG,783,CESAREAN SECTION WITH STERILIZATION WITH MCC,33971.68,22081.59,8968.52,33971.68,19
MS-DRG,784,CESAREAN SECTION WITH STERILIZATION WITH CC,42964.08,27926.65,9462.21,30074.86,19
MS-DRG,785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,23445.03,15239.27,6189.49,20672.58,19
MS-DRG,786,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,53285.24,34635.41,10907.0,37299.67,19
MS-DRG,787,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,32508.63,21130.61,8582.28,24104.34,19
MS-DRG,788,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,27199.65,17679.77,7180.71,20694.16,19
MS-DRG,789,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",105832.55,68791.16,16086.02,163247.55,19
MS-DRG,790,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",214099.08,139164.4,53050.31,372050.08,19
MS-DRG,791,PREMATURITY WITH MAJOR PROBLEMS,89952.78,58469.31,23747.53,158786.78,19
MS-DRG,792,PREMATURITY WITHOUT MAJOR PROBLEMS,26807.97,17425.18,7077.3,49421.97,19
MS-DRG,793,FULL TERM NEONATE WITH MAJOR PROBLEMS,40697.55,26453.41,10744.15,62586.55,19
MS-DRG,794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS,8650.74,5622.98,2283.8,24618.74,19
MS-DRG,795,NORMAL NEWBORN,5663.7,3681.4,1495.21,21631.7,18
MS-DRG,796,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,40216.59,26140.78,6826.0,28151.61,19
MS-DRG,797,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,21169.42,13760.12,5588.73,21169.42,19
MS-DRG,798,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,21539.54,14000.7,5686.44,20657.47,19
MS-DRG,799,SPLENIC PROCEDURES WITH MCC,122163.94,79406.56,32251.28,122085.56,19
MS-DRG,800,SPLENIC PROCEDURES WITH CC,123900.19,80535.12,25076.06,86730.13,19
MS-DRG,801,SPLENIC PROCEDURES WITHOUT CC/MCC,58910.96,38292.12,15552.49,51458.22,19
MS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,194111.81,126172.68,35561.16,135878.27,19
MS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,49786.89,32361.48,13143.74,49786.89,19
MS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,63912.94,41543.41,12103.34,44739.06,19
MS-DRG,805,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,23631.23,15360.3,6238.65,23292.81,19
MS-DRG,806,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,16133.57,10486.82,4259.26,16133.57,19
MS-DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,13936.25,9058.56,3679.17,13936.25,19
MS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,111092.86,72210.36,19707.21,77765.0,19
MS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,62867.33,40863.77,11299.13,44007.13,19
MS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,338841.21,220246.78,9341.71,237188.85,19
MS-DRG,811,RED BLOOD CELL DISORDERS WITH MCC,56297.19,36593.18,12534.46,39408.03,19
MS-DRG,812,RED BLOOD CELL DISORDERS WITHOUT MCC,28806.08,18723.95,7604.8,24751.92,19
MS-DRG,813,COAGULATION DISORDERS,89992.42,58495.07,13614.48,62994.69,19
MS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,116470.66,75705.93,18982.44,81529.46,19
MS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,48878.93,31771.3,9050.73,34215.25,19
MS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,14021.61,9114.04,3701.7,14021.61,19
MS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,70367.06,45738.59,15066.7,49256.94,19
MS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,37483.58,24364.33,9409.55,28418.07,19
MS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,21681.7,14093.11,5723.97,21681.7,19
MS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,282648.65,183721.62,52347.86,197854.06,19
MS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,69188.25,44972.36,18265.7,60345.94,19
MS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,37697.53,24503.39,9952.15,32456.23,19
MS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,296657.07,192827.09,40922.87,207659.95,19
MS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,84094.56,54661.46,20222.22,61073.78,19
MS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,74081.0,48152.65,12044.43,51856.7,19
MS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,217974.59,141683.48,41752.97,152582.21,19
MS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,115037.21,74774.19,20629.24,80526.05,19
MS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,77457.31,50347.25,15207.73,54220.12,19
MS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,133323.95,86660.56,28205.43,93326.76,19
MS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,51652.04,33573.83,13433.28,40570.29,19
MS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,26621.52,17303.99,7028.08,26621.52,19
MS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,14733.57,9576.82,3889.66,14733.57,19
MS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,11107.27,7219.72,2932.32,11107.27,19
MS-DRG,834,ACUTE LEUKEMIA WITH MCC,256119.94,166477.96,49001.58,179283.96,19
MS-DRG,835,ACUTE LEUKEMIA WITH CC,142221.15,92443.75,18617.37,99554.81,19
MS-DRG,836,ACUTE LEUKEMIA WITHOUT CC/MCC,99152.92,64449.39,10884.98,69407.04,19
MS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,143097.13,93013.13,37777.64,129509.52,19
MS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,79193.55,51475.81,18631.65,56270.04,19
MS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,68443.5,44488.28,12887.92,47910.45,19
MS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,91726.04,59621.93,24215.68,87203.2,19
MS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,46543.54,30253.3,12287.49,43977.65,19
MS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,31993.23,20795.6,8446.21,27237.35,19
MS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,22434.78,14582.6,5922.78,22434.78,19
MS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,42787.29,27811.74,10866.23,32817.45,19
MS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,135362.64,87985.71,23140.06,94753.84,19
MS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,68322.39,44409.55,11676.69,47825.67,19
MS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,20585.05,13380.28,5434.45,20585.05,19
MS-DRG,849,RADIOTHERAPY,46175.99,30014.4,12190.46,46175.99,19
MS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,210327.67,136712.99,44080.81,147229.37,19
MS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,81849.39,53202.1,17834.58,57294.57,19
MS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,168394.78,109456.61,40600.65,122619.31,19
MS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,62416.58,40570.78,16477.98,57728.42,19
MS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,30141.14,19591.74,7957.26,30141.14,19
MS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,56424.22,36675.74,14895.99,49161.48,19
MS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,27878.48,18121.01,7359.92,26900.39,19
MS-DRG,864,FEVER AND INFLAMMATORY CONDITIONS,30513.06,19833.49,7923.41,23929.73,19
MS-DRG,865,VIRAL ILLNESS WITH MCC,57693.97,37501.08,13373.48,40389.67,19
MS-DRG,866,VIRAL ILLNESS WITHOUT MCC,29151.68,18948.59,7696.04,23441.81,19
MS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,47363.73,30786.43,12504.03,47363.73,19
MS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,50795.71,33017.21,9203.36,35557.0,19
MS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,22847.71,14851.01,6031.79,19670.52,19
MS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,336493.8,218720.97,61693.14,235545.66,19
MS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,76768.14,49899.29,17338.31,53737.7,19
MS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,33494.84,21771.65,8842.64,27585.1,19
MS-DRG,876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,110621.8,71904.17,29204.15,104186.11,19
MS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,21103.56,13717.31,5571.34,21103.56,19
MS-DRG,881,DEPRESSIVE NEUROSES,20259.68,13168.79,5348.56,20259.68,19
MS-DRG,882,NEUROSES EXCEPT DEPRESSIVE,13902.68,9036.74,3670.31,13902.68,19
MS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,50552.28,32858.98,13345.8,44538.45,19
MS-DRG,885,PSYCHOSES,41082.87,26703.87,10845.88,37653.54,19
MS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS,4013.65,2608.87,1059.6,18523.65,19
MS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES,44724.24,29070.76,5938.46,31306.97,19
MS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",14185.81,9220.78,3745.05,14185.81,19
MS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",32727.38,21272.8,8640.03,32727.38,19
MS-DRG,897,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",18910.03,12291.52,4992.25,39387.41,19
MS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,145365.52,94487.58,37457.89,113127.75,19
MS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC,70363.27,45736.12,17088.39,51609.18,19
MS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,54535.03,35447.77,10439.58,38174.52,19
MS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC,85656.76,55676.89,22613.38,85656.76,19
MS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,49716.99,32316.04,12779.92,38597.03,19
MS-DRG,906,HAND PROCEDURES FOR INJURIES,57413.29,37318.64,15157.11,47509.02,19
MS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,173214.72,112589.57,34268.71,121250.31,19
MS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC,77697.96,50503.68,17808.7,54388.57,19
MS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,67926.62,44152.3,11716.86,47548.63,19
MS-DRG,913,TRAUMATIC INJURY WITH MCC,67674.16,43988.21,14590.06,47371.91,19
MS-DRG,914,TRAUMATIC INJURY WITHOUT MCC,26108.67,16970.63,6892.69,23870.42,19
MS-DRG,915,ALLERGIC REACTIONS WITH MCC,28475.39,18509.01,7517.5,28475.39,19
MS-DRG,916,ALLERGIC REACTIONS WITHOUT MCC,18387.15,11951.65,4854.21,17961.45,19
MS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,46023.97,29915.58,12150.33,42279.36,19
MS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,23529.89,15294.43,6211.89,23104.84,19
MS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC,114657.11,74527.12,16341.3,80259.98,19
MS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC,46654.99,30325.75,8946.3,32658.49,19
MS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,18332.73,11916.28,4839.84,18332.73,19
MS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",108234.3,70352.29,15614.74,75764.01,19
MS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",37558.8,24413.22,9083.76,27434.14,19
MS-DRG,935,NON-EXTENSIVE BURNS,15088.64,9807.62,3983.4,18387.09,19
MS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,62388.72,40552.67,16470.62,62388.72,19
MS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,74885.37,48675.49,19769.74,62995.81,19
MS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,35593.85,23136.0,9396.78,35593.85,19
MS-DRG,947,SIGNS AND SYMPTOMS WITH MCC,37672.8,24487.32,9945.62,34219.22,19
MS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC,20717.02,13466.06,5469.29,20717.02,19
MS-DRG,949,AFTERCARE WITH CC/MCC,12341.65,8022.07,3258.2,12341.65,19
MS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS,19492.88,12670.37,4962.73,14988.09,19
MS-DRG,955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,279972.39,181982.05,60080.25,195980.67,19
MS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",207741.66,135032.08,33587.67,145419.16,19
MS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,244641.52,159016.99,64585.36,205409.64,19
MS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,149528.71,97193.66,37612.3,113594.1,19
MS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,89947.86,58466.11,23746.23,73695.05,19
MS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,35882.03,23323.32,9472.86,35882.03,19
MS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,27431.5,17830.48,7241.92,25353.06,19
MS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,270087.15,175556.65,54637.32,189061.01,19
MS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC,166345.83,108124.79,25759.77,116442.08,19
MS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC,33338.7,21670.16,8801.42,33338.7,19
MS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,88760.28,57694.18,7984.1,62132.2,19
MS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION,73578.81,47826.22,11314.31,51505.17,19
MS-DRG,981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,169353.39,110079.71,41877.93,126476.85,19
MS-DRG,982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,94734.2,61577.23,21944.01,66313.94,19
MS-DRG,983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,57294.47,37241.41,15125.74,46204.3,19
MS-DRG,987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,182995.74,118947.23,30601.11,128097.02,19
MS-DRG,988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,44496.79,28922.91,11747.15,44306.53,19
MS-DRG,989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,40901.52,26585.98,10703.78,32326.83,19
MS-DRG,998,PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS,18538.35,12049.93,4894.12,12976.85,9
NDC,00002-1200-01,AMYVID PATIENT READY DOSE VIAL,15396.16,10007.5,3849.04,10777.31,11
NDC,00002-1460-01,MOUNJARO 12.5 MG/0.5 ML PEN,1322.5,859.63,330.63,925.75,11
NDC,00002-1495-01,MOUNJARO 5 MG/0.5 ML PEN,1322.5,859.63,330.63,925.75,11
NDC,00002-2506-01,ZEPBOUND 2.5 MG/0.5 ML PEN,3759.3,2443.55,939.83,2631.51,11
NDC,00002-3239-30,STRATTERA 60 MG CAPSULE,92.95,60.42,23.24,65.07,11
NDC,00002-4182-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",634.61,412.5,158.65,1638.88,16
NDC,00002-4491-01,REYVOW 100 MG TABLET,210.35,136.73,52.59,147.25,11
NDC,00002-7510-17,"INJECTION, INSULIN, PER 5 UNITS",467.27,303.73,0.56,1595.49,50
NDC,00002-7533-01,"INJECTION, INSULIN, PER 5 UNITS",990.0,643.5,0.56,2556.68,17
NDC,00002-7597-01,"INJECTION, OLANZAPINE, 0.5 MG",78.42,50.97,0.86,202.52,17
NDC,00002-7669-01,"INJECTION, RAMUCIRUMAB, 5 MG",1288.84,837.75,80.11,7236.29,19
NDC,00002-8147-01,UNCLASSIFIED DRUGS,6302.27,4096.48,1575.57,16275.61,16
NDC,00002-8215-01,"INJECTION, INSULIN, PER 5 UNITS",214.46,139.395,0.56,1042.63,34
NDC,00002-8215-17,"INJECTION, INSULIN, PER 5 UNITS",1453.86,945.01,0.56,3754.59,17
NDC,00002-8315-01,"INJECTION, INSULIN, PER 5 UNITS",154.0,100.1,0.56,397.71,17
NDC,00002-8715-01,"INJECTION, INSULIN, PER 5 UNITS",80.935,52.605000000000004,0.56,253.96,34
NDC,00002-9401-01,KISUNLA 350 MG/20 ML VIAL,318.53,207.04,79.63,222.97,11
NDC,00003-0100-60,COBENFY 100 MG-20 MG CAPSULE,78.75,51.19,19.69,55.13,11
NDC,00003-0293-28,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",103.45,67.24,0.78,267.16,17
NDC,00003-0315-05,KENALOG-80 80 MG/ML VIAL,53.25,34.61,13.31,37.28,11
NDC,00003-0371-13,"INJECTION, BELATACEPT, 1 MG",1027.55,667.91,4.12,3216.35,38
NDC,00003-0494-20,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",66.46000000000001,43.195,0.78,262.87,34
NDC,00003-0524-11,SPRYCEL 70 MG TABLET,2283.05,1483.98,570.76,1598.14,11
NDC,00003-0527-11,SPRYCEL 20 MG TABLET,1147.73,746.02,286.93,803.41,11
NDC,00003-0528-11,SPRYCEL 50 MG TABLET,1551.305,1008.345,204.78,1598.44,22
NDC,00003-0852-22,SPRYCEL 100 MG TABLET,4154.55,2700.46,1038.64,2908.19,11
NDC,00003-0893-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.05,8.48,3.26,33.7,16
NDC,00003-0893-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.9,17.49,6.73,69.47,16
NDC,00003-0894-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.37,17.14,6.59,68.1,16
NDC,00003-0894-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.94,14.26,5.49,56.66,16
NDC,00003-2187-13,"INJECTION, ABATACEPT, 10 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",13095.220000000001,8511.89,47.46,41815.61,38
NDC,00003-2291-11,"INJECTION, ELOTUZUMAB, 1 MG",5359.58,3483.73,8.52,13841.12,19
NDC,00003-2327-11,"INJECTION, IPILIMUMAB, 1 MG",7045.43,4579.53,198.12,18194.82,19
NDC,00003-3772-11,"INJECTION, NIVOLUMAB, 1 MG",3520.37,2288.24,35.58,9091.36,19
NDC,00003-4522-11,"INJECTION, ELOTUZUMAB, 1 MG",6896.8,4482.92,8.52,17810.99,19
NDC,00003-7125-11,"INJECTION, NIVOLUMAB AND RELATLIMAB-RMBW, 3 MG/1 MG",6089.75,3958.34,213.75,35052.23,19
NDC,00004-0801-85,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",93.65,60.87,23.41,241.85,16
NDC,00004-0802-85,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",93.65,60.87,23.41,241.85,16
NDC,00005-2000-01,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use",859.5350000000001,558.6949999999999,143.17,2960.55,38
NDC,00006-0005-10,BELSOMRA 5 MG TABLET,101.07,65.7,25.27,70.75,11
NDC,00006-0033-10,BELSOMRA 10 MG TABLET,113.9,74.04,28.48,79.73,11
NDC,00006-0227-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",152.575,99.175,16.78,614.76,32
NDC,00006-0335-10,BELSOMRA 20 MG TABLET,110.4,71.76,27.6,77.28,11
NDC,00006-3025-01,"INJECTION, BEZLOTOXUMAB, 10 MG",641.7,417.11,42.22,2058.35,19
NDC,00006-3026-01,"INJECTION, PEMBROLIZUMAB, 1 MG",10721.875,6969.219999999999,63.31,37523.73,38
NDC,00006-3061-00,"INJECTION, FOSAPREPITANT, 1 MG",4503.86,2927.51,0.12,11631.22,17
NDC,00006-3069-01,PIFELTRO 100 MG TABLET,288.35,187.43,52.34,257.15,22
NDC,00006-3075-01,PREVYMIS 240 MG TABLET,1924.25,1250.76,481.06,1346.98,11
NDC,00006-3076-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1924.25,1250.76,481.06,4969.38,16
NDC,00006-3076-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1392.0,904.8,348.0,3594.84,16
NDC,00006-3856-01,"INJECTION, IMIPENEM 4 MG, CILASTATIN 4 MG AND RELEBACTAM 2 MG",2157.33,1402.26,2.76,5571.3,19
NDC,00006-4047-01,ROTATEQ VACCINE,910.0,591.5,227.5,637.0,11
NDC,00006-4047-41,ROTATEQ VACCINE,121.78,79.16,30.45,85.25,11
NDC,00006-4093-01,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",402.4,261.56,30.97,1039.2,19
NDC,00006-4093-01,RECOMBIVAX HB 5 MCG/0.5 ML SYR,402.4,261.56,100.6,281.68,11
NDC,00006-4095-01,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",225.0,146.25,56.25,581.06,19
NDC,00006-4119-01,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",387.0,251.55,96.75,999.43,19
NDC,00006-4121-01,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",1441.72,937.12,163.76,5587.29,57
NDC,00006-4171-01,PROQUAD VIAL,670.9,436.09,167.73,469.63,11
NDC,00006-4827-00,Varicella vaccine,462.95,300.92,115.74,1195.57,19
NDC,00006-4827-01,Varicella vaccine,721.9,469.235,35.82,3358.64,38
NDC,00006-4837-01,Hepatitis A vaccine adult dosage,140.76,91.49,30.97,363.51,19
NDC,00006-4897-00,"Haemophilus influenzae type b vaccine, PRP-OMP conjugate",464.0,301.6,30.97,1198.28,19
NDC,00006-4897-01,"Haemophilus influenzae type b vaccine, PRP-OMP conjugate",557.59,362.435,12.5,2750.83,38
NDC,00006-4981-01,"INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML",9375.0,6093.75,42.62,24210.94,17
NDC,00006-4992-00,RECOMBIVAX HB 40 MCG/ML VIAL,798.1,518.77,199.53,558.67,11
NDC,00006-5004-02,UNCLASSIFIED DRUGS,115.25,74.91,28.81,297.63,16
NDC,00006-5423-02,UNCLASSIFIED DRUGS,606.95,394.52,151.74,1567.45,16
NDC,00006-5423-12,UNCLASSIFIED DRUGS,570.87,371.07,142.72,1474.27,16
NDC,00008-0100-01,"INJECTION, INOTUZUMAB OZOGAMICIN, 0.1 MG",180174.18,117113.215,2985.78,643477.16,38
NDC,00008-1210-30,PRISTIQ ER 25 MG TABLET,94.7,61.56,23.68,66.29,11
NDC,00008-1211-01,PRISTIQ ER 50 MG TABLET,94.7,61.56,23.68,66.29,11
NDC,00008-1222-01,PRISTIQ ER 100 MG TABLET,70.275,45.68,10.65,68.57,22
NDC,00008-4510-01,"INJECTION, GEMTUZUMAB OZOGAMICIN, 0.1 MG",955.3,620.95,238.83,7236.29,19
NDC,00009-0003-02,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",259.015,168.36,0.28,774.49,34
NDC,00009-0011-03,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",533.14,346.54,23.38,1599.42,17
NDC,00009-0011-04,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",403.15,262.05,23.38,1209.45,17
NDC,00009-0013-05,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",314.0,204.1,23.38,942.0,17
NDC,00009-0018-20,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",558.3399999999999,362.91999999999996,0.28,1643.89,34
NDC,00009-0039-28,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",98.87,64.27,0.28,255.33,17
NDC,00009-0039-33,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",82.46,53.6,0.28,212.95,17
NDC,00009-0047-22,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",154.99,100.74,0.28,400.26,17
NDC,00009-0047-25,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",212.89,138.38,0.28,549.79,17
NDC,00009-0056-02,"METHYLPREDNISOLONE ORAL, PER 4 MG",16.2,10.53,0.15,41.84,17
NDC,00009-0433-04,UNCLASSIFIED DRUGS,420.83500000000004,273.545,102.25,1117.37,32
NDC,00009-0436-01,UNCLASSIFIED DRUGS,1.7,1.105,0.37,4.96,32
NDC,00009-0450-03,COLESTID 1 GM TABLET,16.29,10.59,4.07,11.4,11
NDC,00009-0698-01,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",321.26,208.82,0.28,829.65,17
NDC,00009-0775-20,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",3.48,2.26,0.87,8.99,17
NDC,00009-0775-26,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",2.77,1.8,0.69,7.15,17
NDC,00009-0825-01,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",63.13,41.03,15.78,189.39,17
NDC,00009-3073-01,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",69.6,45.24,0.13,179.74,17
NDC,00009-3073-22,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",64.25,41.76,0.13,165.93,17
NDC,00009-3169-01,"INJECTION, ALPROSTADIL, 1.25 MCG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",1069.02,694.86,0.51,2760.74,17
NDC,00009-3475-01,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",128.3,83.4,0.13,331.33,17
NDC,00009-3794-01,"INJECTION, IBUTILIDE FUMARATE, 1 MG",66.7,43.36,16.68,210.42,19
NDC,00009-5401-01,NICOTROL NS 10 MG/ML SPRAY,91.25,59.31,22.81,63.88,11
NDC,00009-7224-01,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, EQUINE, PARENTERAL, 250 MG",6106.98,3969.54,1526.75,15771.28,19
NDC,00009-7663-04,AROMASIN 25 MG TABLET,243.15,158.05,60.79,170.21,11
NDC,00013-2576-05,"INJECTION, IDARUBICIN HYDROCHLORIDE, 5 MG",86.84,56.45,21.71,260.52,19
NDC,00019-0862-07,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",17.28,11.23,0.07,52.13,34
NDC,00019-9096-20,"TECHNETIUM TC-99M MERTIATIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",3735.0,2427.75,840.87,11313.38,34
NDC,00023-0312-04,UNCLASSIFIED DRUGS,18.57,12.07,4.64,47.96,16
NDC,00023-0506-50,UNCLASSIFIED DRUGS,12.870000000000001,8.365,1.59,50.07,32
NDC,00023-1145-01,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",5244.855,3409.16,7.16,14948.57,38
NDC,00023-3205-03,LUMIGAN 0.01% EYE DROPS,4605.0,2993.25,1151.25,3223.5,11
NDC,00023-3348-07,"INJECTION, DEXAMETHASONE, INTRAVITREAL IMPLANT, 0.1 MG",10001.95,6501.27,216.81,25830.04,19
NDC,00023-3919-50,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",1005.0,653.25,7.16,2595.41,19
NDC,00023-5301-05,RESTASIS MULTIDOSE 0.05% EYE,1651.25,1073.31,412.81,1155.88,11
NDC,00023-5858-01,LILETTA 52 MG SYSTEM,812.9,528.39,203.23,569.03,11
NDC,00023-6153-01,UNCLASSIFIED DRUGS,584.8,380.12,146.2,1510.25,16
NDC,00023-6153-08,UNCLASSIFIED DRUGS,206.35,134.13,51.59,532.9,16
NDC,00023-6498-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",535.92,348.35,95.67,1779.73,32
NDC,00023-6501-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",551.39,358.4,106.96,1743.08,32
NDC,00023-9205-15,UNCLASSIFIED DRUGS,3.505,2.2750000000000004,0.7,10.9,32
NDC,00023-9652-01,DURYSTA 10 MCG IMPLANT,5072.5,3297.13,1268.13,3550.75,11
NDC,00024-1596-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.53,9.44,3.63,37.52,16
NDC,00024-4142-60,MULTAQ 400 MG TABLET,109.795,71.37,22.1,91.85,22
NDC,00024-5150-10,"INJECTION, RASBURICASE, 0.5 MG",2744.83,1784.14,406.37,7088.52,19
NDC,00024-5154-11,"INJECTION, RASBURICASE, 0.5 MG",10032.76,6521.29,406.37,25909.6,19
NDC,00024-5823-15,"INJECTION, CABAZITAXEL, 1 MG",91453.22,59444.59,244.65,272896.41,19
NDC,00024-5914-01,UNCLASSIFIED DRUGS,11623.22,7555.09,2905.81,30016.97,16
NDC,00024-5926-05,"INJECTION, INSULIN, PER 5 UNITS",661.0699999999999,429.695,0.56,3447.38,100
NDC,00032-0046-70,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.62,10.8,4.16,42.92,16
NDC,00032-0047-70,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.91,16.84,5.63,75.69,32
NDC,00032-1206-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.14,7.89,3.04,31.35,16
NDC,00032-1224-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",54.9,35.69,13.73,141.78,16
NDC,00032-2636-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.17,20.26,7.79,80.5,16
NDC,00032-3016-13,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",83.96,54.57,20.99,216.83,16
NDC,00037-0678-08,GASTROCROM 100 MG/5 ML CONC,11.655,7.574999999999999,1.91,10.98,22
NDC,00037-2001-01,SOMA 350 MG TABLET,73.75,47.94,18.44,51.63,11
NDC,00037-6823-15,UNCLASSIFIED DRUGS,31.11,20.22,4.97,109.39,32
NDC,00046-0872-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",97.09,63.11,24.27,250.73,16
NDC,00046-1100-81,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",49.25,32.01,12.31,127.19,16
NDC,00046-1102-81,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",46.41,30.17,11.6,119.85,16
NDC,00046-1103-81,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.7,31.01,11.93,123.19,16
NDC,00046-1107-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",45.25,29.415,7.44,156.89,32
NDC,00049-0014-81,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",18.85,12.25,1.41,48.68,17
NDC,00049-0520-84,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",545.69,354.7,0.83,1409.24,17
NDC,00049-0530-22,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",1404.32,912.81,0.83,3626.66,17
NDC,00049-3190-28,"INJECTION, VORICONAZOLE, 10 MG",211.3,137.35,0.8,545.68,17
NDC,00051-8462-33,ANDROGEL 1.62% GEL PUMP,1805.0,1173.25,451.25,1263.5,11
NDC,00052-0602-01,"BCG LIVE INTRAVESICAL INSTILLATION, 1 MG",413.01,268.46,3.48,1066.6,19
NDC,00054-0010-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.01,9.105,1.7,54.8,32
NDC,00054-0011-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.3,6.05,2.33,24.02,16
NDC,00054-0018-20,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",6.47,4.21,0.01,16.71,17
NDC,00054-0019-25,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",8.18,5.32,0.01,21.12,17
NDC,00054-0020-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.48,3.56,1.37,14.15,16
NDC,00054-0021-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.55,7.51,2.89,29.83,16
NDC,00054-0045-44,UNCLASSIFIED DRUGS,7.07,4.6,1.77,18.26,16
NDC,00054-0046-41,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.78,3.11,1.2,12.34,16
NDC,00054-0057-46,UNCLASSIFIED DRUGS,18.88,12.27,4.72,48.76,16
NDC,00054-0235-24,UNCLASSIFIED DRUGS,18.86,12.26,4.72,48.71,16
NDC,00054-0235-25,UNCLASSIFIED DRUGS,45.32,29.46,11.33,117.04,16
NDC,00054-0236-24,UNCLASSIFIED DRUGS,10.89,7.08,2.72,28.12,16
NDC,00054-0237-63,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.67,23.84,9.17,94.7,16
NDC,00054-0238-63,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.17,5.31,2.03,21.25,32
NDC,00054-0249-13,IMATINIB MESYLATE 400 MG TAB,403.05,261.98,100.76,282.14,11
NDC,00054-0271-21,CAPECITABINE 150 MG TABLET,32.55,21.16,8.14,22.79,11
NDC,00054-0272-23,CAPECITABINE 500 MG TABLET,58.3,37.9,14.58,40.81,11
NDC,00054-0278-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.65,8.22,3.16,32.67,16
NDC,00054-0279-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.05,11.08,4.26,44.03,16
NDC,00054-0334-25,CEVIMELINE HCL 30 MG CAPSULE,9.85,6.4,2.46,6.9,11
NDC,00054-0356-13,DISULFIRAM 250 MG TABLET,31.8,20.67,7.95,22.26,11
NDC,00054-0356-13,DISULFIRAM 250 MG TABLET [2540],17.18,11.17,4.3,12.03,11
NDC,00054-0386-63,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.975,6.485,1.34,37.7,32
NDC,00054-0413-13,FEBUXOSTAT 40 MG TABLET,26.29,17.09,6.57,18.4,11
NDC,00054-0414-13,FEBUXOSTAT 80 MG TABLET,5.9,3.84,1.48,4.13,11
NDC,00054-0425-23,RUFINAMIDE 200 MG TABLET,23.66,15.38,5.92,16.56,11
NDC,00054-0472-21,"EVEROLIMUS, ORAL, 0.25 MG",194.5,126.43,1.25,502.3,17
NDC,00054-0508-23,ICOSAPENT ETHYL 1 GRAM CAPSULE,18.45,11.99,4.61,12.92,11
NDC,00054-0534-22,DROXIDOPA 300 MG CAPSULE,24.03,15.62,6.01,16.82,11
NDC,00054-0710-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.94,4.51,1.74,17.92,16
NDC,00054-0749-13,PRUCALOPRIDE 1 MG TABLET,79.1,51.42,19.78,55.37,11
NDC,00054-0750-13,PRUCALOPRIDE 2 MG TABLET,69.31,45.05,14.96,55.14,22
NDC,00054-2526-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.26,1.47,0.57,5.84,16
NDC,00054-3120-41,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.76,36.24,13.94,144.0,16
NDC,00054-3176-44,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.49,3.57,1.37,14.18,16
NDC,00054-3177-57,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.9249999999999998,1.25,0.47,5.06,32
NDC,00054-3270-99,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,8.74,5.68,2.19,22.57,16
NDC,00054-3294-50,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.71,2.41,0.93,9.58,16
NDC,00054-3500-49,UNCLASSIFIED DRUGS,15.39,10.0,3.85,39.74,16
NDC,00054-3505-47,UNCLASSIFIED DRUGS,5.71,3.71,1.43,14.75,16
NDC,00054-3532-55,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",60.52,39.34,15.13,156.29,16
NDC,00054-3721-44,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",20.345,13.225000000000001,0.01,71.35,34
NDC,00054-3722-50,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",1.8,1.17,0.01,4.65,17
NDC,00054-3722-63,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",4.93,3.2,0.01,12.73,17
NDC,00054-3727-63,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.7000000000000002,1.105,0.39,4.73,32
NDC,00054-4146-22,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.69,13.45,5.17,53.43,16
NDC,00054-4181-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.95,3.22,1.24,12.78,16
NDC,00054-4183-25,"DEXAMETHASONE, ORAL, 0.25 MG",7.56,4.91,0.01,19.52,17
NDC,00054-4184-25,"DEXAMETHASONE, ORAL, 0.25 MG",21.41,13.92,0.01,55.29,17
NDC,00054-4581-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.399999999999999,8.71,2.86,39.64,32
NDC,00054-8526-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.58,5.58,2.15,22.16,16
NDC,00054-8528-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.34,3.47,1.34,13.79,16
NDC,00054-8724-25,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",5.19,3.37,0.01,13.4,17
NDC,00056-0173-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.9,8.385,1.2,54.23,32
NDC,00065-0085-15,UNCLASSIFIED DRUGS,4.865,3.165,0.92,15.65,32
NDC,00065-0359-05,UNCLASSIFIED DRUGS,59.004999999999995,38.355,7.42,228.09,32
NDC,00065-0411-30,BETADINE 5% EYE SOLUTION,1.05,0.68,0.26,0.74,11
NDC,00065-0426-36,GENTEAL TEARS 0.1%-0.2%-0.3%,3.05,1.985,0.52,2.82,22
NDC,00065-0474-01,UNCLASSIFIED DRUGS,4.17,2.71,1.04,10.77,16
NDC,00065-0530-01,UNCLASSIFIED DRUGS,2.44,1.59,0.61,6.3,16
NDC,00065-0741-14,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.799999999999997,19.369999999999997,7.35,77.99,32
NDC,00065-0795-15,UNCLASSIFIED DRUGS,3.2,2.08,0.8,8.26,16
NDC,00065-0795-50,UNCLASSIFIED DRUGS,4.65,3.02,1.16,12.01,16
NDC,00065-0800-50,UNCLASSIFIED DRUGS,1.15,0.75,0.29,2.97,16
NDC,00065-8064-01,UNCLASSIFIED DRUGS,10.02,6.51,2.51,25.88,16
NDC,00067-8152-01,VOLTAREN ARTHRITIS PAIN 1% GEL,18.78,12.21,4.7,13.15,11
NDC,00068-0597-01,UNCLASSIFIED DRUGS,1149.04,746.88,287.26,2967.4,16
NDC,00069-0209-10,"INJECTION, PROPOFOL, 10 MG",4.73,3.075,0.1,19.14,34
NDC,00069-0238-01,"INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG",554.365,360.335,14.07,2922.83,38
NDC,00069-0249-01,"INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG",517.65,336.47,14.07,2922.83,38
NDC,00069-0293-10,"INJECTION, FILGRASTIM-AAFI, BIOSIMILAR, (NIVESTYM), 1 MICROGRAM",348.75,226.69,0.3,900.65,19
NDC,00069-0324-01,NYVEPRIA 6 MG/0.6 ML SYRINGE,3308.98,2150.84,827.25,2316.29,11
NDC,00069-0344-05,ABRYSVO VIAL WITH DILUENT SYRG,2574.54,1673.45,643.64,1802.18,11
NDC,00069-0344-05,"BRACHYTHERAPY SOURCE, NON-STRANDED, YTTRIUM-90, PER SOURCE",97800.0,63570.0,16299.55,252568.5,18
NDC,00069-0469-56,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",57.75,37.54,14.44,149.14,16
NDC,00069-0809-01,"INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG",4570.41,2970.77,25.67,11803.08,19
NDC,00069-1001-01,XELJANZ 5 MG TABLET,687.25,446.71,171.81,481.08,11
NDC,00069-1002-01,XELJANZ 10 MG TABLET,691.88,449.72,172.97,484.32,11
NDC,00069-1305-01,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",206.43,134.18,8.02,533.11,19
NDC,00069-1305-10,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",89.98,58.49,8.02,307.25,19
NDC,00069-1306-01,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",423.89,275.53,8.02,1094.7,19
NDC,00069-1306-10,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",172.48,112.11,8.02,445.43,19
NDC,00069-1307-01,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",327.12,212.63,8.02,844.79,19
NDC,00069-1307-10,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",116.4,75.66,8.02,307.25,19
NDC,00069-1308-01,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",1503.6,977.34,8.02,3883.05,19
NDC,00069-1308-10,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",1357.3,882.25,8.02,3505.23,19
NDC,00069-1309-01,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",3514.14,2284.19,8.02,9075.27,19
NDC,00069-1309-04,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",8873.12,5767.53,8.02,22914.83,19
NDC,00069-1311-01,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 UNITS",1197.5,778.38,8.02,3092.54,19
NDC,00069-2432-01,COMIRNATY 2024-25(12Y UP) SYRG,1784.185,1159.72,224.39,1869.58,22
NDC,00069-2465-19,"Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use",1895.11,1231.82,30.97,4894.12,19
NDC,00069-2528-01,COMIRNATY 2025-26(12Y UP) SYRG,10788.425,7012.475,899.04,12586.48,22
NDC,00069-5045-06,PAXLOVID 300-100 MG DOSE PACK,314.9,204.69,78.73,220.43,11
NDC,00069-5321-30,UNCLASSIFIED DRUGS,609.475,396.16,81.0,2311.21,32
NDC,00069-5434-02,PAXLOVID 150-100 MG (MODERATE),490.5,318.83,122.63,343.35,11
NDC,00069-6111-02,"INJECTION, IMMUNE GLOBULIN, (OCTAGAM), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",133.27,86.63,33.32,2058.35,19
NDC,00074-0039-14,ORILISSA 200 MG TABLET,146.05,94.93,36.51,102.24,22
NDC,00074-0554-02,HUMIRA(CF) PEN 40 MG/0.4 ML,22591.15,14684.25,5647.79,15813.81,11
NDC,00074-0561-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",92.38,60.05,23.1,238.57,16
NDC,00074-0566-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",456.55,296.76,114.14,1179.04,16
NDC,00074-0576-11,VENCLEXTA 100 MG TABLET,906.06,588.94,226.52,634.24,11
NDC,00074-1055-01,EMRELIS 100 MG VIAL,86501.26,56225.82,21625.32,60550.88,11
NDC,00074-1658-01,"INJECTION, PARICALCITOL, 1 MCG",313.0,203.45,1.03,1601.15,34
NDC,00074-2625-01,MAVYRET 100-40 MG TABLET,1073.67,697.89,268.42,751.57,11
NDC,00074-3346-03,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",31039.3,20175.545,181.03,111712.8,38
NDC,00074-3473-03,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",26234.74,17052.58,181.03,78704.22,19
NDC,00074-3641-03,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",20042.440000000002,13027.585,1547.76,58654.49,38
NDC,00074-3642-03,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",8178.04,5315.73,181.03,24534.12,19
NDC,00074-3663-03,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",27845.480000000003,18099.565,1547.76,84137.59,38
NDC,00074-3683-03,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",1718.75,1117.19,181.03,5156.25,19
NDC,00074-3799-02,HUMIRA 40 MG/0.8 ML SYRINGE,22657.47,14727.36,5664.37,15860.23,11
NDC,00074-4378-05,UNCLASSIFIED DRUGS,29.2,18.98,7.3,75.41,16
NDC,00074-5015-01,"INJECTION, RISANKIZUMAB-RZAA, INTRAVENOUS, 1 MG",7533.76,4896.94,15.83,19455.94,19
NDC,00074-7094-04,QULIPTA 60 MG TABLET,242.3,157.5,60.58,169.61,11
NDC,00074-7094-30,QULIPTA 60 MG TABLET,98.4,63.96,24.6,68.88,11
NDC,00075-0621-01,"INJECTION, ENOXAPARIN SODIUM, 10 MG",58.49,38.02,0.56,175.47,17
NDC,00075-8013-01,"INJECTION, ENOXAPARIN SODIUM, 10 MG",312.83,203.34,0.56,938.49,17
NDC,00078-0109-01,"INJECTION, CYCLOSPORINE, 250 MG",138.29,89.89,34.57,357.13,17
NDC,00078-0248-15,"CYCLOSPORINE, ORAL, 100 MG",14.48,9.41,1.92,37.39,17
NDC,00078-0331-84,"INJECTION, BASILIXIMAB, 20 MG",23746.445,15435.19,2865.52,66058.31,38
NDC,00078-0385-66,"MYCOPHENOLIC ACID, ORAL, 180 MG",51.79,33.66,0.34,133.75,17
NDC,00078-0393-61,"INJECTION, BASILIXIMAB, 20 MG",21954.56,14270.46,2865.52,56697.65,19
NDC,00078-0431-05,FOCALIN XR 10 MG CAPSULE,35.8,23.27,8.95,25.06,11
NDC,00078-0456-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.31,14.5,5.58,57.62,16
NDC,00078-0501-15,EXELON 4.6 MG/24HR PATCH,151.675,98.59,31.43,124.36,22
NDC,00078-0568-45,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.1,24.12,9.28,95.81,16
NDC,00078-0656-15,JADENU 360 MG TABLET,1493.9,971.04,373.48,1045.73,11
NDC,00078-0659-67,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",166.02,107.91,41.51,428.75,16
NDC,00078-0685-15,PROMACTA 25 MG TABLET,1815.47,1180.06,453.87,1270.83,11
NDC,00078-0686-15,PROMACTA 50 MG TABLET,3284.49,2134.92,821.12,2299.14,11
NDC,00078-0696-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",77.19,50.17,19.3,199.34,16
NDC,00078-0698-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1478.78,961.21,369.7,3818.95,16
NDC,00078-0729-10,UNCLASSIFIED DRUGS,265.92,172.85,66.48,686.74,16
NDC,00078-0734-61,ILARIS 150 MG/ML VIAL,81781.03,53157.67,20445.26,57246.72,11
NDC,00078-0777-67,UNCLASSIFIED DRUGS,36.9,23.99,9.23,95.29,16
NDC,00078-0797-61,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",34536.755,22448.89,211.12,101220.34,38
NDC,00078-0811-81,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",7263.53,4721.29,211.12,18758.07,19
NDC,00078-0813-01,UNCLASSIFIED DRUGS,317.91,206.64,79.48,821.0,16
NDC,00078-0825-81,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",58150.39,37797.75,211.12,150173.38,19
NDC,00078-0841-01,UNCLASSIFIED DRUGS,421.64,274.07,105.41,1088.89,16
NDC,00078-0876-01,UNCLASSIFIED DRUGS,173.29,112.64,43.09,449.95,32
NDC,00078-0883-61,"INJECTION, CRIZANLIZUMAB-TMCA, 5 MG",333.24,216.605,46.45,1578.71,38
NDC,00078-0897-78,"INJECTION, TRIAMCINOLONE ACETONIDE, PRESERVATIVE FREE, 1 MG",1846.56,1200.26,25.96,4768.74,19
NDC,00078-0986-15,MAYZENT 2 MG TABLET,2333.9,1517.04,583.48,1633.73,11
NDC,00078-1000-60,"INJECTION, INCLISIRAN, 1 MG",15251.02,9913.16,13.45,39385.76,19
NDC,00078-1014-15,MAYZENT 1 MG TABLET,2333.9,1517.04,583.48,1633.73,11
NDC,00078-1098-20,SCEMBLIX 40 MG TABLET,2584.44,1679.89,646.11,1809.11,11
NDC,00078-1168-61,COSENTYX 125 MG/5 ML VIAL,4905.74,3188.73,1226.44,3434.02,11
NDC,00085-1381-01,"INJECTION, TEMOZOLOMIDE, 1 MG",12806.24,8324.06,11.02,33072.11,19
NDC,00087-0402-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.07,1.35,0.52,5.35,16
NDC,00087-0405-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.08,1.35,0.52,5.37,16
NDC,00087-5126-12,ENFAMIL DHA-ARA SUPPLEMENT LIQ,2.86,1.86,0.72,2.0,11
NDC,00088-1174-47,GAVISCON ES TABLET CHEW,2.4,1.56,0.6,1.68,11
NDC,00088-2160-30,ARAVA 10 MG TABLET,314.6,204.49,78.65,220.22,11
NDC,00088-2161-30,ARAVA 20 MG TABLET,345.61,224.65,86.4,241.93,11
NDC,00088-2220-33,"INJECTION, INSULIN, PER 5 UNITS",145.21,94.38499999999999,0.56,580.24,66
NDC,00088-2500-33,UNCLASSIFIED DRUGS,1019.0,662.35,254.75,2631.57,16
NDC,00093-0262-30,UNCLASSIFIED DRUGS,1.51,0.98,0.38,3.9,16
NDC,00093-0318-01,UNCLASSIFIED DRUGS,1.95,1.27,0.29,7.1,32
NDC,00093-0771-98,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.05,9.135,2.73,44.42,32
NDC,00093-0810-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.98,14.29,5.5,56.76,16
NDC,00093-0811-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.2,6.63,2.55,26.34,16
NDC,00093-1125-89,ABIRATERONE ACETATE 250 MG TAB,594.95,386.72,148.74,416.47,11
NDC,00093-1177-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.535,4.9,1.74,20.97,32
NDC,00093-1712-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.42,2.22,0.86,8.83,16
NDC,00093-1716-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.3,2.8,1.08,11.1,16
NDC,00093-1721-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.09,20.21,7.77,80.29,16
NDC,00093-1723-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.5,13.33,5.13,52.94,16
NDC,00093-2064-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.0,4.55,1.75,18.08,16
NDC,00093-2204-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.24,5.36,2.06,21.28,16
NDC,00093-2274-34,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.75,5.69,2.19,22.6,16
NDC,00093-2275-34,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.99,11.69,4.5,46.46,16
NDC,00093-3017-56,TADALAFIL 5 MG TABLET,7.65,4.97,1.91,5.36,11
NDC,00093-3061-56,RASAGILINE MESYLATE 1 MG TAB,55.31,35.95,13.83,38.72,11
NDC,00093-3109-53,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.33,14.51,5.58,57.67,16
NDC,00093-3123-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.5649999999999995,3.615,1.03,18.08,32
NDC,00093-3125-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.5,5.53,2.13,21.95,16
NDC,00093-3145-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.9,7.09,2.73,28.15,16
NDC,00093-3219-15,KETOCONAZOLE 2% CREAM,14.65,9.52,3.66,10.26,11
NDC,00093-3239-21,UNCLASSIFIED DRUGS,466.25,303.06,116.56,1204.09,16
NDC,00093-3425-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",33.08,21.5,8.27,85.43,16
NDC,00093-3426-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",51.14,33.24,12.79,132.07,16
NDC,00093-3541-43,UNCLASSIFIED DRUGS,3.05,1.98,0.76,7.88,16
NDC,00093-3657-21,UNCLASSIFIED DRUGS,565.88,367.82,141.47,1461.39,16
NDC,00093-3658-21,UNCLASSIFIED DRUGS,193.65,125.87,48.41,500.1,16
NDC,00093-3659-21,UNCLASSIFIED DRUGS,568.4,369.46000000000004,74.45,2166.72,32
NDC,00093-4067-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.81,9.63,3.7,38.25,16
NDC,00093-4127-73,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.16,0.75,0.29,3.0,16
NDC,00093-4146-45,LEVALBUTEROL 0.63 MG/3 ML SOL,15.0,9.75,3.75,10.5,11
NDC,00093-4161-73,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.41,0.92,0.35,3.64,16
NDC,00093-4177-73,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.11,2.67,1.03,10.61,16
NDC,00093-5060-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.82,8.33,3.21,33.11,16
NDC,00093-5061-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.62,9.5,3.66,37.76,16
NDC,00093-5420-88,CABERGOLINE 0.5 MG TABLET,104.88,68.17,26.22,73.42,11
NDC,00093-5539-01,ESZOPICLONE 3 MG TABLET,20.45,13.29,5.11,14.32,11
NDC,00093-5940-40,"LANTHANUM CARB 1,000 MG TB CHW",46.25,30.06,11.56,32.38,11
NDC,00093-6450-56,ESOMEPRAZOLE MAG DR 20 MG CAP,9.5,6.18,2.38,6.65,11
NDC,00093-6816-19,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",50.65,32.92,1.11,130.8,17
NDC,00093-7201-10,UNCLASSIFIED DRUGS,7.84,5.1,1.96,20.25,16
NDC,00093-7202-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.25,4.71,1.81,18.72,16
NDC,00093-7353-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.85,9.65,3.71,38.35,16
NDC,00093-7387-56,MOXIFLOXACIN HCL 400 MG TABLET,194.1,126.17,48.53,135.87,11
NDC,00093-7472-19,RIZATRIPTAN 10 MG TABLET,12.85,8.35,3.21,9.0,11
NDC,00093-8739-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.45,15.89,6.11,63.14,16
NDC,00093-8740-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.15,15.05,5.79,59.78,16
NDC,00093-9018-19,"CYCLOSPORINE, ORAL, 25 MG",21.33,13.86,0.56,55.08,17
NDC,00093-9020-19,"CYCLOSPORINE, ORAL, 100 MG",74.06,48.14,1.92,191.26,17
NDC,00093-9290-19,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.5,6.18,2.38,24.53,16
NDC,00093-9291-19,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.48,8.76,3.37,34.81,16
NDC,00093-9604-12,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
NDC,00093-9703-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.59,8.83,1.41,55.6,32
NDC,00113-9458-13,GS ALL DAY ALLERGY 10 MG TAB,4.3149999999999995,2.8049999999999997,0.83,3.73,22
NDC,00115-1320-19,COLESEVELAM 625 MG TABLET,7.15,4.65,1.79,5.01,11
NDC,00115-1486-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.95,8.42,3.24,33.44,16
NDC,00115-1488-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.32,6.71,2.58,26.65,16
NDC,00115-1660-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.31,15.8,6.08,62.78,16
NDC,00115-1687-76,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",48.03,31.22,1.11,124.04,17
NDC,00115-1697-01,UNCLASSIFIED DRUGS,12.76,8.29,3.19,32.95,16
NDC,00115-1700-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.64,7.57,2.91,30.06,16
NDC,00115-1745-01,METAXALONE 400 MG TABLET,34.03,22.12,8.51,23.82,11
NDC,00115-1748-01,METAXALONE 800 MG TABLET,87.75,57.04,21.94,61.43,11
NDC,00115-2622-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.015,11.71,3.93,52.5,32
NDC,00115-2790-06,CHLOROQUINE PH 250 MG TABLET,27.2,17.68,6.8,19.04,11
NDC,00115-3511-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.09,9.81,3.77,38.97,16
NDC,00115-4411-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.22,8.59,3.31,34.14,16
NDC,00115-4422-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.92,7.75,1.88,42.2,32
NDC,00115-4433-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.765,6.995,1.98,35.12,32
NDC,00115-5922-01,PILOCARPINE HCL 5 MG TABLET,9.2,5.98,2.3,6.44,11
NDC,00121-0489-00,"DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A ",11.07,7.2,1.51,28.59,17
NDC,00121-0489-05,"DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A ",12.51,8.13,1.51,32.31,17
NDC,00121-0530-05,UNCLASSIFIED DRUGS,5.82,3.78,1.46,15.03,16
NDC,00121-0595-15,UNCLASSIFIED DRUGS,2.08,1.35,0.52,5.37,16
NDC,00121-0670-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.17,0.76,0.29,3.02,16
NDC,00121-0675-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.99,1.94,0.75,7.72,16
NDC,00121-0676-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.21,0.79,0.3,3.12,16
NDC,00121-0677-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.4,0.91,0.35,3.62,16
NDC,00121-0722-08,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.955,1.27,0.42,5.76,32
NDC,00121-0759-05,"PREDNISOLONE ORAL, PER 5 MG",12.24,7.96,0.98,31.61,17
NDC,00121-0759-08,"PREDNISOLONE ORAL, PER 5 MG",1.7,1.11,0.43,4.39,17
NDC,00121-0770-55,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.22,35.89,13.81,142.61,16
NDC,00121-0868-00,UNCLASSIFIED DRUGS,4.24,2.76,1.06,10.95,16
NDC,00121-0893-15,UNCLASSIFIED DRUGS,1.18,0.77,0.3,3.05,16
NDC,00121-0940-10,UNCLASSIFIED DRUGS,2.5,1.625,0.62,6.53,32
NDC,00121-0942-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.39,9.35,3.6,37.16,16
NDC,00121-1154-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.63,1.06,0.41,4.21,16
NDC,00121-1154-40,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.03,0.67,0.26,2.66,16
NDC,00121-1576-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.04,1.98,0.76,7.85,16
NDC,00121-1775-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.48,2.915,0.6,16.92,32
NDC,00121-1870-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.83,1.19,0.46,4.73,16
NDC,00121-2044-10,UNCLASSIFIED DRUGS,1.56,1.01,0.39,4.03,16
NDC,00121-4048-74,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.59,4.28,1.65,17.02,16
NDC,00121-4675-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.7799999999999998,1.155,0.32,5.89,32
NDC,00121-4759-05,PREDNISOLONE 15MG/5ML SOLN CUP,2.8499999999999996,1.8499999999999999,0.53,2.5,22
NDC,00121-4759-05,"PREDNISOLONE ORAL, PER 5 MG",8.12,5.28,0.98,20.97,17
NDC,00121-4766-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.88,2.52,0.97,10.02,16
NDC,00131-2478-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",139.18,90.47,34.8,359.43,16
NDC,00131-2479-35,VIMPAT 150 MG TABLET,138.35,89.93,34.59,96.85,11
NDC,00135-0200-01,ABREVA 10% CREAM,90.3,58.7,22.58,63.21,11
NDC,00143-1240-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.03,11.72,4.51,46.56,16
NDC,00143-1772-01,UNCLASSIFIED DRUGS,9.11,5.92,1.27,33.93,32
NDC,00143-9087-01,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",19.19,12.47,2.95,57.57,17
NDC,00143-9094-01,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",55.64,36.17,10.4,143.69,17
NDC,00143-9098-01,BORTEZOMIB 3.5 MG VIAL,311.9,202.74,77.98,218.33,11
NDC,00143-9152-01,VANCOMYCIN HCL 1.25 GRAM VIAL,45.33,29.46,11.33,31.73,11
NDC,00143-9162-01,"INJECTION, VANCOMYCIN HCL, 500 MG",23.1,15.02,5.78,59.66,16
NDC,00143-9164-01,"INJECTION, VANCOMYCIN HCL, 500 MG",1226.67,797.34,306.67,3167.88,16
NDC,00143-9192-01,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",1108.5,720.53,7.11,2862.7,19
NDC,00143-9209-10,"INJECTION, CHLOROPROCAINE HYDROCHLORIDE, PER 1 MG",19.68,12.79,0.04,50.82,17
NDC,00143-9210-10,"INJECTION, CHLOROPROCAINE HYDROCHLORIDE, PER 30 ML",3.33,2.16,0.83,8.6,16
NDC,00143-9241-01,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",513.3,333.65,24.4,1539.9,17
NDC,00143-9247-01,DEXRAZOXANE 250 MG VIAL,627.915,408.145,81.98,649.54,22
NDC,00143-9273-01,"INJECTION, DIHYDROERGOTAMINE MESYLATE, PER 1 MG",749.8,487.37,60.5,1936.36,17
NDC,00143-9279-01,"INJECTION, MITOMYCIN, 5 MG",1150.93,748.1,27.67,2972.28,19
NDC,00143-9280-01,"INJECTION, MITOMYCIN, 5 MG",2445.705,1589.71,27.67,8033.9,38
NDC,00143-9284-01,UNCLASSIFIED DRUGS,158.93,103.3,39.73,410.44,16
NDC,00143-9284-10,UNCLASSIFIED DRUGS,132.52,86.14,33.13,342.23,16
NDC,00143-9289-01,"INJECTION, ESTRADIOL VALERATE, UP TO 10 MG",73.3,47.65,7.9,189.3,17
NDC,00143-9290-01,ESTRADIOL VALERATE 100 MG/5 ML,107.6,69.94,26.9,75.32,11
NDC,00143-9298-01,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",17.81,11.58,2.34,45.99,17
NDC,00143-9333-01,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",6.48,4.21,0.01,16.73,17
NDC,00143-9382-01,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",138.57,90.07,0.92,357.86,17
NDC,00143-9383-10,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",253.01,164.46,0.92,653.4,17
NDC,00143-9391-10,UNCLASSIFIED DRUGS,199.37,129.59,49.84,514.87,16
NDC,00143-9392-01,UNCLASSIFIED DRUGS,600.38,390.25,150.1,1550.48,16
NDC,00143-9503-01,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",202.49,131.62,19.4,845.46,34
NDC,00143-9506-10,UNCLASSIFIED DRUGS,9.41,6.12,2.35,24.3,16
NDC,00143-9508-01,UNCLASSIFIED DRUGS,4.13,2.68,1.03,10.67,16
NDC,00143-9508-10,UNCLASSIFIED DRUGS,5.06,3.29,0.99,56.17,48
NDC,00143-9511-01,"INJECTION, ETOPOSIDE, 10 MG",32.81,21.33,1.1,98.43,17
NDC,00143-9519-01,"INJECTION, METHOTREXATE SODIUM, 50 MG",383.65,249.37,2.73,1150.95,17
NDC,00143-9525-01,UNCLASSIFIED DRUGS,3.06,1.99,0.77,7.9,16
NDC,00143-9531-01,"INJECTION, IFOSFAMIDE, 1 GRAM",11.385,7.4,2.82,34.47,34
NDC,00143-9553-01,LEUCOVORIN CALCIUM 200 MG VIAL,56.8,36.92,14.2,39.76,11
NDC,00143-9559-01,"INJECTION, ARGATROBAN, 1 MG (FOR NON-ESRD USE)",14.58,9.48,0.65,158.28,19
NDC,00143-9564-01,"INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG",1085.5,705.58,185.44,2803.3,19
NDC,00143-9570-01,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",30.8,20.02,2.34,79.54,17
NDC,00143-9594-25,"INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG",21.52,13.99,5.38,55.58,16
NDC,00143-9606-01,"INJECTION, AZACITIDINE, 1 MG",2958.17,1922.81,0.49,7639.47,19
NDC,00143-9621-01,"INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG",54.18,35.22,0.68,139.92,17
NDC,00143-9681-01,"INJECTION, GLYCOPYRROLATE, 0.1 MG",40.08,26.05,0.4,103.51,17
NDC,00143-9689-01,UNCLASSIFIED DRUGS,26.61,17.3,6.65,68.72,16
NDC,00143-9709-01,"INJECTION, MILRINONE LACTATE, 5 MG",4.13,2.68,1.03,10.67,17
NDC,00143-9721-01,"INJECTION, LEVOFLOXACIN, 250 MG",1.42,0.92,0.36,3.67,17
NDC,00143-9726-01,"INJECTION, TESTOSTERONE CYPIONATE, 1 MG",46.76,30.39,0.03,120.76,17
NDC,00143-9729-01,"INJECTION, BENZTROPINE MESYLATE, PER 1 MG",45.83,29.79,6.95,164.97,34
NDC,00143-9754-01,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",10.2,6.63,0.28,26.34,17
NDC,00143-9783-01,UNCLASSIFIED DRUGS,42.0,27.3,10.5,108.47,16
NDC,00143-9784-10,UNCLASSIFIED DRUGS,6.25,4.06,1.56,16.14,16
NDC,00143-9786-01,UNCLASSIFIED DRUGS,75.3,48.95,18.83,194.46,16
NDC,00143-9850-01,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",50.2,32.63,0.28,129.64,17
NDC,00143-9852-01,"INJECTION, LEVOCARNITINE, PER 1 GM",45.98,29.89,11.5,118.74,17
NDC,00143-9852-10,"INJECTION, LEVOCARNITINE, PER 1 GM",20.05,13.03,5.01,51.78,17
NDC,00143-9856-01,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",48.09,31.26,0.49,124.19,17
NDC,00143-9887-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.67,14.09,5.42,55.96,16
NDC,00143-9924-90,"INJECTION, CEFAZOLIN SODIUM, 500 MG",46.2,30.03,0.88,284.59,85
NDC,00143-9927-01,CIPROFLOXACIN HCL 250 MG TAB,10.4,6.76,2.6,7.28,11
NDC,00143-9929-50,CIPROFLOXACIN HCL 750 MG TAB,5.55,3.61,1.39,3.89,11
NDC,00143-9977-22,"INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG",359.55,233.71,2.17,928.54,17
NDC,00143-9979-22,"INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG",121.85,79.2,2.17,314.68,17
NDC,00143-9979-90,"INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG",179.09,116.41,2.17,462.5,17
NDC,00143-9983-03,"INJECTION, CEFAZOLIN SODIUM, 500 MG",4062.73,2640.77,0.88,10492.0,17
NDC,00143-9983-91,"INJECTION, CEFAZOLIN SODIUM, 500 MG",344.29,223.79,0.88,889.13,17
NDC,00168-0015-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.28,1.48,0.57,5.89,16
NDC,00168-0020-31,UNCLASSIFIED DRUGS,2.18,1.42,0.55,5.63,16
NDC,00168-0080-31,UNCLASSIFIED DRUGS,1.78,1.16,0.45,4.6,16
NDC,00168-0146-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.84,1.2,0.46,4.75,16
NDC,00168-0258-46,UNCLASSIFIED DRUGS,7.46,4.85,1.87,19.27,16
NDC,00168-0265-15,BETAMETHASONE DP AUG 0.05% CRM,39.17,25.46,9.79,27.42,11
NDC,00168-0277-40,UNCLASSIFIED DRUGS,12.32,8.01,3.08,31.82,16
NDC,00169-1833-11,"INJECTION, INSULIN, PER 5 UNITS",21.85,14.2,0.56,56.43,17
NDC,00169-1834-11,"INJECTION, INSULIN, PER 5 UNITS",853.92,555.05,0.56,2205.25,17
NDC,00169-4130-01,OZEMPIC 1 MG/DOSE (4 MG/3 ML),781.67,508.09,195.42,547.17,11
NDC,00169-4181-03,OZEMPIC 0.25-0.5 MG/DOSE PEN,798.83,519.24,199.71,559.18,11
NDC,00169-4525-01,WEGOVY 0.25 MG/0.5 ML PEN,4646.4,3020.16,1161.6,3252.48,11
NDC,00169-4772-11,OZEMPIC 2 MG/DOSE (8 MG/3 ML),781.67,508.09,195.42,547.17,11
NDC,00169-7201-01,"FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT), (NOVOSEVEN RT), 1 MICROGRAM",8896.29,5782.59,2.78,22974.67,19
NDC,00169-7202-01,"FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT), (NOVOSEVEN RT), 1 MICROGRAM",8859.89,5758.93,2.78,22880.67,19
NDC,00169-7501-11,"INJECTION, INSULIN, PER 5 UNITS",13.93,9.05,0.56,35.97,17
NDC,00172-4096-80,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.5,4.23,1.63,16.79,16
NDC,00172-4097-80,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.44,4.84,1.86,19.21,16
NDC,00172-5241-60,ANAGRELIDE HCL 0.5 MG CAPSULE,12.5,8.13,3.13,8.75,11
NDC,00172-5728-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.84,14.85,5.71,58.98,16
NDC,00172-7313-20,"CYCLOSPORINE, ORAL, 100 MG",19.67,12.79,1.92,50.8,17
NDC,00173-0478-00,IMITREX 6 MG/0.5 ML CARTRIDGES,1075.9,699.34,268.98,753.13,11
NDC,00173-0518-01,UNCLASSIFIED DRUGS,2.26,1.47,0.57,5.84,16
NDC,00173-0682-24,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,20.81,13.53,5.2,53.74,16
NDC,00173-0857-01,UNCLASSIFIED DRUGS,3.5,2.28,0.88,9.04,16
NDC,00173-0869-06,UNCLASSIFIED DRUGS,50.96,33.12,12.74,131.6,16
NDC,00173-0873-06,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,22.134999999999998,14.39,4.17,71.3,32
NDC,00173-0874-14,UNCLASSIFIED DRUGS,13.465,8.754999999999999,3.36,34.86,32
NDC,00173-0876-14,UNCLASSIFIED DRUGS,21.68,14.095,4.2,68.57,32
NDC,00173-0881-01,"INJECTION, MEPOLIZUMAB, 1 MG",24713.515,16063.785,33.8,71580.52,38
NDC,00173-0887-10,TRELEGY ELLIPTA 100-62.5-25,73.62,47.85,18.41,51.53,11
NDC,00173-0893-10,TRELEGY ELLIPTA 200-62.5-25,71.08,46.2,17.77,49.76,11
NDC,00173-0893-14,TRELEGY ELLIPTA 200-62.5-25,4.31,2.8,1.08,3.02,11
NDC,00173-0898-03,"INJECTION, DOSTARLIMAB-GXLY, 10 MG",7910.48,5141.81,262.29,20428.81,19
NDC,00185-0055-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.48,4.86,1.87,19.32,16
NDC,00185-0129-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.62,3.65,1.41,14.51,16
NDC,00185-0939-98,UNCLASSIFIED DRUGS,1.15,0.75,0.29,2.97,16
NDC,00185-5050-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.32,4.76,1.83,18.9,16
NDC,00186-0370-28,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,41.345,26.87,8.23,128.51,32
NDC,00186-0372-28,"NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME",95.34,61.97,23.84,246.22,16
NDC,00186-0776-60,BRILINTA 60 MG TABLET,51.65,33.57,12.91,36.16,11
NDC,00186-0777-39,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",52.93,34.4,13.23,136.69,16
NDC,00187-1704-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",199.1,129.42,49.78,514.18,16
NDC,00187-5600-15,"INJECTION, VERTEPORFIN, 0.1 MG",4084.09,2654.66,12.25,10547.16,19
NDC,00225-0525-47,UNCLASSIFIED DRUGS,3.83,2.49,0.96,9.89,16
NDC,00225-0800-47,UNCLASSIFIED DRUGS,2.665,1.73,0.35,10.15,32
NDC,00225-0805-47,UNCLASSIFIED DRUGS,4.09,2.66,1.02,10.56,16
NDC,00228-2076-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.58,8.83,3.4,35.07,16
NDC,00228-2127-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.43,2.88,1.11,11.44,16
NDC,00228-2128-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.65,1.72,0.66,6.84,16
NDC,00228-2571-11,INDAPAMIDE 2.5 MG TABLET,7.65,4.97,1.91,5.36,11
NDC,00228-2853-11,GUANFACINE HCL ER 3 MG TABLET,10.75,6.99,2.69,7.53,11
NDC,00245-0108-10,UNCLASSIFIED DRUGS,6.04,3.93,1.51,15.6,16
NDC,00245-0147-89,UNCLASSIFIED DRUGS,5.47,3.56,1.37,14.13,16
NDC,00245-0213-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.13,3.98,1.53,15.83,16
NDC,00245-5315-89,KLOR-CON 8 MEQ TABLET,2.27,1.48,0.57,1.59,11
NDC,00245-5326-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.07,5.25,2.02,20.84,16
NDC,00245-5326-89,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.65,9.52,3.66,37.83,16
NDC,00254-1010-19,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",62.61,40.7,15.65,161.69,16
NDC,00254-1016-36,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",64.7,42.06,16.18,167.09,16
NDC,00254-2008-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",41.004999999999995,26.655,9.4,114.66,32
NDC,00254-3028-02,LUBIPROSTONE 8 MCG CAPSULE,17.2,11.18,4.3,12.04,11
NDC,00254-3029-02,LUBIPROSTONE 24 MCG CAPSULE,17.2,11.184999999999999,3.88,13.23,22
NDC,00259-1605-01,"INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT",645.14,419.34,5.78,1666.07,19
NDC,00259-1610-01,"INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT",2656.79,1726.91,5.78,6861.16,19
NDC,00264-3103-11,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",1.9849999999999999,1.29,0.46,5.5,34
NDC,00264-3123-11,"INJECTION, CEFOXITIN SODIUM, 1 GM",93.965,61.08,5.02,400.67,34
NDC,00264-3125-11,"INJECTION, CEFOXITIN SODIUM, 1 GM",74.96000000000001,48.725,5.02,217.37,34
NDC,00264-4204-52,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",1.56,1.01,0.39,4.03,17
NDC,00264-7387-50,UNCLASSIFIED DRUGS,1.29,0.84,0.32,3.33,16
NDC,00264-7510-20,5% DEXTROSE/WATER (500 ML = 1 UNIT),1.97,1.28,0.49,5.09,17
NDC,00264-7800-00,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",4.47,2.91,1.12,11.54,17
NDC,00264-7805-10,UNCLASSIFIED DRUGS,1.18,0.77,0.3,3.05,16
NDC,00268-0249-01,DILUENT FOR ALLERGENIC EXTRACTS NO.1 INJECTION SOLUTION [188702],7.17,4.66,1.79,5.02,11
NDC,00270-0149-60,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",1.12,0.73,0.07,3.38,17
NDC,00270-0445-35,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",7.32,4.76,0.23,22.08,17
NDC,00270-0445-40,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",10.98,7.14,0.23,33.13,17
NDC,00270-0556-15,"INJECTION, SINCALIDE, 5 MICROGRAMS",276.48,179.71,69.12,714.01,19
NDC,00270-1315-25,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",12.6,8.19,0.16,38.01,17
NDC,00270-1316-95,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",6.03,3.92,0.16,18.19,17
NDC,00270-1317-02,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",2.21,1.44,0.42,6.67,17
NDC,00270-1317-05,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",1.98,1.29,0.42,5.97,17
NDC,00270-1410-30,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",2.46,1.6,0.07,7.42,34
NDC,00270-1411-11,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",18.66,12.13,0.42,56.3,17
NDC,00270-1411-25,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",56.06,36.44,0.42,169.13,17
NDC,00270-1412-15,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",66.14,42.99,0.16,199.54,17
NDC,00270-5164-12,"INJECTION, GADOBENATE DIMEGLUMINE (MULTIHANCE), PER ML",7.69,5.0,1.91,23.2,17
NDC,00270-5264-16,"INJECTION, GADOBENATE DIMEGLUMINE (MULTIHANCE), PER ML",14.8,9.62,1.91,44.65,17
NDC,00270-7025-40,"INJECTION, GADOPICLENOL, 1 ML",98.0,63.7,3.5,295.66,17
NDC,00270-7030-42,"INJECTION, GADOPICLENOL, 1 ML",80.86,52.56,3.5,243.95,17
NDC,00270-7099-16,"INJECTION, SULFUR HEXAFLUORIDE LIPID MICROSPHERES, PER ML",646.55,420.26,19.26,1669.72,17
NDC,00281-0205-43,UNCLASSIFIED DRUGS,1.98,1.29,0.5,5.11,16
NDC,00281-0205-45,UNCLASSIFIED DRUGS,7.3,4.75,1.83,18.85,16
NDC,00281-0326-08,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",78.46,51.0,19.62,202.62,16
NDC,00281-0326-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.33,11.91,4.58,47.34,16
NDC,00283-0610-26,HURRICAINE ONE 20% U-D SPRAY,42.6,27.69,10.65,29.82,11
NDC,00283-0679-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.03,4.57,1.76,18.16,16
NDC,00310-0088-28,DALIRESP 250 MCG TABLET,89.15,57.95,22.29,62.41,11
NDC,00310-1105-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",59.480000000000004,38.66,13.63,166.39,32
NDC,00310-1110-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",111.05,72.18,27.76,286.79,16
NDC,00310-1110-39,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",79.55,51.71,19.89,205.44,16
NDC,00310-1248-30,TAGRISSO 40 MG TABLET,4196.65,2727.82,1049.16,2937.66,11
NDC,00310-1730-30,"INJECTION, BENRALIZUMAB, 1 MG",23154.19,15050.22,173.81,59795.7,19
NDC,00310-3040-00,"INJECTION, ANIFROLUMAB-FNIA, 1 MG",25196.72,16377.87,19.44,65070.53,19
NDC,00310-4535-30,"INJECTION, TREMELIMUMAB-ACTL, 1 MG",19742.29,12832.49,151.6,50984.46,19
NDC,00310-4611-50,"INJECTION, DURVALUMAB, 10 MG",2329.14,1513.94,91.45,9558.63,38
NDC,00310-6210-39,FARXIGA 10 MG TABLET,130.53,84.84,32.63,91.37,11
NDC,00316-0225-15,UNCLASSIFIED DRUGS,1.35,0.88,0.34,3.49,16
NDC,00338-0004-03,"STERILE WATER/SALINE, 500 ML",1.78,1.16,0.45,4.15,16
NDC,00338-0013-04,"STERILE WATER/SALINE, 500 ML",11.14,7.24,2.79,7.8,16
NDC,00338-0017-11,5% DEXTROSE/WATER (500 ML = 1 UNIT),2.67,1.74,0.67,6.9,17
NDC,00338-0023-02,UNCLASSIFIED DRUGS,1.01,0.66,0.25,2.61,16
NDC,00338-0049-02,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",3.72,2.42,0.62,2.6,16
NDC,00338-0049-04,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",1.51,0.98,0.38,1.06,16
NDC,00338-0049-38,UNCLASSIFIED DRUGS,1.28,0.83,0.32,3.31,16
NDC,00338-0049-41,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",1.62,1.05,0.41,1.13,16
NDC,00338-0049-48,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",1.8,1.17,0.45,1.26,16
NDC,00338-0054-03,UNCLASSIFIED DRUGS,1.17,0.76,0.29,3.02,16
NDC,00338-0072-25,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",52.73,34.27,0.35,136.18,17
NDC,00338-0112-20,UNCLASSIFIED DRUGS,26.33,17.115000000000002,3.84,96.38,32
NDC,00338-0126-12,"INJECTION, INSULIN, PER 5 UNITS",3.44,2.24,0.53,10.82,185
NDC,00338-0289-47,UNCLASSIFIED DRUGS,1.52,0.99,0.38,3.93,16
NDC,00338-0519-09,UNCLASSIFIED DRUGS,1.71,1.11,0.43,4.42,16
NDC,00338-0519-58,UNCLASSIFIED DRUGS,5.82,3.78,1.46,15.03,16
NDC,00338-0703-48,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.47,0.96,0.13,3.85,51
NDC,00338-0705-48,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.3050000000000002,0.85,0.13,3.38,51
NDC,00338-0714-24,DAPTOMYCIN 500 MG/50 ML-NS BAG,3.4850000000000003,2.2649999999999997,0.28,2.48,44
NDC,00338-0716-12,DAPTOMYCIN 700 MG/100ML-NS BAG,3.13,2.03,0.78,2.19,11
NDC,00338-0718-12,"DAPTOMYCIN 1,000 MG/100 ML-NS",3.67,2.385,0.6,3.46,22
NDC,00338-1007-02,"INJECTION, DOPAMINE HCL, 40 MG",19.66,12.78,0.85,50.77,17
NDC,00338-1009-02,"INJECTION, DOPAMINE HCL, 40 MG",13.73,8.92,0.85,35.46,17
NDC,00338-1015-41,"INJECTION, OXACILLIN SODIUM, UP TO 250 MG",37.410000000000004,24.315,0.6,185.11,34
NDC,00338-1025-41,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",1.1,0.72,0.28,2.84,17
NDC,00338-1047-02,"INJECTION, NITROGLYCERIN, 5 MG",55.3,35.95,1.61,142.81,17
NDC,00338-1055-48,"INJECTION, METRONIDAZOLE, 10 MG",3.6999999999999997,2.4050000000000002,0.03,16.06,34
NDC,00338-1075-02,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",2.99,1.94,0.75,8.5,17
NDC,00338-1301-48,"INJECTION, CEFEPIME HYDROCHLORIDE (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO MAXIPIME, 500 MG",10.915,7.095,0.4,61.7,68
NDC,00338-1305-01,"INJECTION, MESNA, 200 MG",43.22,28.09,1.8,129.66,17
NDC,00338-3508-41,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",3.68,2.39,0.4,9.97,51
NDC,00338-3552-48,"INJECTION, VANCOMYCIN HCL, 500 MG",4.92,3.2,0.51,20.14,32
NDC,00338-3612-50,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",3.24,2.11,0.81,8.37,17
NDC,00338-3814-24,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",4.115,2.675,1.03,10.67,34
NDC,00338-5002-41,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",4.925,3.2,0.49,20.04,34
NDC,00338-5197-41,UNCLASSIFIED DRUGS,3.54,2.3,0.71,11.0,32
NDC,00338-9557-12,UNCLASSIFIED DRUGS,18.18,11.82,4.55,46.95,16
NDC,00338-9564-01,UNCLASSIFIED DRUGS,219.48999999999998,142.67000000000002,31.91,804.04,32
NDC,00338-9568-01,UNCLASSIFIED DRUGS,289.03,187.87,45.01,1027.86,32
NDC,00338-9638-01,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",2.92,1.9,0.73,7.54,17
NDC,00338-9638-01,ZOSYN 4.5 GM/100 ML GALAXY BAG,3.2,2.08,0.8,2.24,11
NDC,00338-9638-12,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",1.72,1.12,0.43,4.44,17
NDC,00338-9662-35,UNCLASSIFIED DRUGS,1.1,0.72,0.28,2.84,16
NDC,00362-0557-05,UNCLASSIFIED DRUGS,10.07,6.55,2.52,26.01,16
NDC,00363-0955-26,UNCLASSIFIED DRUGS,1.94,1.26,0.49,5.01,16
NDC,00378-0144-91,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.15,2.7,1.04,10.72,16
NDC,00378-0345-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.71,10.21,3.93,40.57,16
NDC,00378-0399-18,DIMETHYL FUMARATE 240 MG CAPSULEDELAYED RELEASE,470.2,305.63,117.55,329.14,11
NDC,00378-0403-01,UNCLASSIFIED DRUGS,10.33,6.71,2.58,26.68,16
NDC,00378-0871-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",183.74,119.43,45.94,474.51,16
NDC,00378-0872-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",319.35,207.58,79.84,824.72,16
NDC,00378-0873-99,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",390.0,253.5,97.5,1007.18,16
NDC,00378-1667-19,TIZANIDINE HCL 6 MG CAPSULE,36.55,23.76,9.14,25.59,11
NDC,00378-1905-77,ROFLUMILAST 500 MCG TABLET,25.65,16.67,6.41,17.96,11
NDC,00378-2047-01,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",7.37,4.79,0.21,19.03,17
NDC,00378-2302-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.28,2.78,1.07,11.05,16
NDC,00378-2895-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",52.43,34.08,13.11,135.4,16
NDC,00378-3005-01,THIOTHIXENE 5 MG CAPSULE,20.2,13.13,5.05,14.14,11
NDC,00378-3340-53,XULANE 150-35 MCG/DAY PATCH,289.25,188.01,72.31,202.48,11
NDC,00378-3350-99,ESTRADIOL 0.05 MG PATCH (1/WK),137.05,89.08,34.26,95.94,11
NDC,00378-3360-16,ESTRADIOL 0.0375MG PATCH(1/WK),112.0,72.8,28.0,78.4,11
NDC,00378-3951-77,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.72,2.42,0.93,9.61,16
NDC,00378-3979-93,PALIPERIDONE ER 3 MG TABLETEXTENDED RELEASE 24 HR,90.205,58.629999999999995,1.44,122.26,22
NDC,00378-3980-93,PALIPERIDONE ER 6 MG TABLETEXTENDED RELEASE 24 HR,17.65,11.47,4.41,12.36,11
NDC,00378-4145-91,RILUZOLE 50 MG TABLET,68.9,44.79,17.23,48.23,11
NDC,00378-4271-93,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",126.95,82.52,31.74,327.85,16
NDC,00378-4640-16,UNCLASSIFIED DRUGS,30.3,19.7,7.58,78.25,16
NDC,00378-5431-35,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",66.32,43.11,16.58,171.27,16
NDC,00378-5573-05,MODAFINIL 100 MG TABLET,50.52,32.84,12.63,35.36,11
NDC,00378-6090-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.63,19.91,7.66,79.1,16
NDC,00378-6233-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",44.87,29.17,11.22,115.88,16
NDC,00378-6320-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.77,8.3,3.19,32.98,16
NDC,00378-6470-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",308.81,200.73,77.2,797.5,16
NDC,00378-6921-91,ABIRATERONE ACETATE 500 MG TAB,684.78,445.11,171.2,479.35,11
NDC,00378-6961-12,GLATIRAMER 40 MG/ML SYRINGE,1059.65,688.77,264.91,741.76,11
NDC,00378-6981-88,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",78.83,51.24,19.71,203.58,16
NDC,00378-7017-05,BICALUTAMIDE 50 MG TABLET,7.45,4.84,1.86,5.22,11
NDC,00378-7274-53,NORETHIN-EE 1.5-0.03 MG(21) TB,8.73,5.67,2.18,6.11,11
NDC,00378-7283-53,NORETH-EE-FE 1-0.02(21)-75 TAB,36.2,23.53,9.05,25.34,11
NDC,00378-7291-89,NORETHINDRONE 5 MG TABLET,46.0,29.9,11.5,32.2,11
NDC,00378-7293-53,NORGESTIMATE-ETHINYL ESTRADIOL 0.18 MG-0.215MG-0.25MG-35 MCG(28)TABLET,4.85,3.15,1.21,3.4,11
NDC,00378-7502-32,"NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME",47.0,30.55,11.75,121.38,16
NDC,00378-8065-32,GLUCAGON 1 MG VIAL,1748.25,1136.36,437.06,1223.78,11
NDC,00378-8106-93,GALANTAMINE ER 16 MG CAPSULE,93.1,60.52,23.28,65.17,22
NDC,00378-8766-16,"BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 3 MG, BUT LESS THAN OR EQUAL TO 6 MG BUPRENORPHINE",39.84,25.9,9.96,102.89,17
NDC,00378-9071-16,RIVASTIGMINE 9.5 MG/24HR PATCH,20.35,13.23,5.09,14.25,11
NDC,00378-9102-93,"INFUSION, ALBUMIN (HUMAN), 25%, 20 ML",11.3,7.35,2.83,185.91,19
NDC,00378-9104-16,UNCLASSIFIED DRUGS,6.8549999999999995,4.455,1.17,23.32,32
NDC,00378-9112-93,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.2,5.33,2.05,21.18,16
NDC,00378-9119-16,"INJECTION, FENTANYL CITRATE, 0.1 MG",80.405,52.265,1.26,382.24,34
NDC,00378-9122-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",222.4,144.56,55.6,574.35,16
NDC,00378-9124-16,"INJECTION, FENTANYL CITRATE, 0.1 MG",183.05,118.98,1.26,472.73,17
NDC,00394-0859-32,UNCLASSIFIED DRUGS,1.16,0.75,0.29,3.0,16
NDC,00395-1003-92,UNCLASSIFIED DRUGS,1.27,0.83,0.32,3.28,16
NDC,00406-0123-23,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.26,17.07,6.57,67.82,16
NDC,00406-0123-62,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",49.8,32.37,12.45,128.61,16
NDC,00406-0125-62,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",45.66,29.68,11.42,117.92,16
NDC,00406-0512-23,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.11,13.72,5.28,54.52,16
NDC,00406-0552-23,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.54,15.3,5.89,60.79,16
NDC,00406-1170-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",66.5,43.23,16.63,171.74,16
NDC,00406-1236-01,UNCLASSIFIED DRUGS,20.31,13.2,5.08,52.45,16
NDC,00406-3243-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.03,16.92,6.51,67.22,16
NDC,00406-3249-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.96,12.97,4.99,51.55,16
NDC,00406-5755-23,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.42,10.02,3.86,39.82,16
NDC,00406-5755-62,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.75,10.24,3.94,40.67,16
NDC,00406-5771-23,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.84,9.65,3.71,38.32,16
NDC,00406-8315-23,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.33,10.61,4.08,42.17,16
NDC,00406-8330-23,UNCLASSIFIED DRUGS,33.15,21.55,8.29,85.61,16
NDC,00406-8390-23,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",40.9,26.59,10.23,105.62,16
NDC,00406-9175-76,"INJECTION, FENTANYL CITRATE, 0.1 MG",90.65,58.92,1.26,234.1,17
NDC,00407-1412-33,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",11.455,7.449999999999999,0.42,46.07,34
NDC,00407-1413-10,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",166.05,107.93,0.16,500.96,17
NDC,00407-1413-59,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",166.05,107.93,0.16,500.96,17
NDC,00407-2223-17,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",10.11,6.57,0.16,30.5,17
NDC,00407-2707-03,"INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML",320.67,208.44,42.62,828.13,34
NDC,00409-0001-25,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",58.46,38.0,0.15,150.97,17
NDC,00409-0152-01,"INJECTION, METRONIDAZOLE, 10 MG",1.59,1.03,0.4,4.11,16
NDC,00409-0302-01,"INJECTION, TOPOTECAN, 0.1 MG",343.72,223.42,1.33,1031.16,17
NDC,00409-1144-02,UNCLASSIFIED DRUGS,75.2,48.88,18.8,194.2,16
NDC,00409-1160-01,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",2.76,1.79,0.01,7.13,17
NDC,00409-1163-18,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",3.08,2.0,0.01,7.95,17
NDC,00409-1178-30,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",85.7,55.71,8.64,221.32,17
NDC,00409-1207-03,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",397.08,258.1,2.3,1025.46,17
NDC,00409-1283-03,"INJECTION, HYDROMORPHONE, 0.1 MG",79.72,51.82,0.15,205.88,17
NDC,00409-1283-31,"INJECTION, HYDROMORPHONE, 0.1 MG",55.08,35.8,0.15,142.24,17
NDC,00409-1323-05,UNCLASSIFIED DRUGS,5.49,3.57,1.37,14.18,16
NDC,00409-1362-11,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",26.2,17.03,6.55,67.66,17
NDC,00409-1463-71,"INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 MG",171.75,111.64,3.66,443.54,17
NDC,00409-1464-61,"INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 MG",17.9,11.64,3.66,46.23,17
NDC,00409-1560-29,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",4.86,3.16,0.01,12.55,17
NDC,00409-1593-14,UNCLASSIFIED DRUGS,4.38,2.85,1.1,11.31,16
NDC,00409-1630-15,"INJECTION, ATROPINE SULFATE, 0.01 MG",8.14,5.29,0.11,21.02,17
NDC,00409-1775-40,UNCLASSIFIED DRUGS,14.37,9.34,1.67,56.97,32
NDC,00409-1886-02,"INJECTION, LEVETIRACETAM, 10 MG",10.7,6.96,0.04,27.63,17
NDC,00409-1902-01,"INJECTION, PROCAINAMIDE HCL, UP TO 1 GM",52.3,34.0,13.08,365.2,17
NDC,00409-1966-02,UNCLASSIFIED DRUGS,2.58,1.68,0.65,6.66,16
NDC,00409-1966-07,UNCLASSIFIED DRUGS,24.91,16.19,6.23,64.33,16
NDC,00409-1985-03,LORAZEPAM 2 MG/ML CARPUJECT,38.17,24.81,9.54,26.72,11
NDC,00409-2051-15,UNCLASSIFIED DRUGS,14.88,9.67,3.72,38.43,16
NDC,00409-2305-04,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",39.4,25.61,0.15,101.75,17
NDC,00409-2305-17,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",52.35,34.03,0.15,135.19,17
NDC,00409-2308-02,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",67.43,43.83,0.15,174.14,17
NDC,00409-2344-02,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",7.61,4.95,1.9,19.65,17
NDC,00409-2596-15,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",38.69,25.150000000000002,0.15,184.83,34
NDC,00409-2634-10,"INJECTION, HYDROMORPHONE, 0.1 MG",29.3,19.05,0.15,75.67,34
NDC,00409-2721-01,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",112.73,73.27,0.19,291.13,17
NDC,00409-3177-01,UNCLASSIFIED DRUGS,9.88,6.42,2.47,25.52,16
NDC,00409-3178-01,UNCLASSIFIED DRUGS,9.66,6.28,2.42,24.95,16
NDC,00409-3181-01,UNCLASSIFIED DRUGS,19.53,12.69,4.88,50.44,16
NDC,00409-3182-01,UNCLASSIFIED DRUGS,46.5,30.23,11.63,120.09,16
NDC,00409-3183-01,UNCLASSIFIED DRUGS,12.16,7.9,3.04,31.4,16
NDC,00409-3308-03,UNCLASSIFIED DRUGS,4.18,2.72,1.05,10.79,16
NDC,00409-3578-01,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",64.38,41.85,2.19,166.26,17
NDC,00409-3613-01,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",23.905,15.535,0.01,96.48,34
NDC,00409-3724-32,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",1.48,0.96,0.37,8.5,17
NDC,00409-3814-11,MORPHINE 5 MG/10 ML VIAL,906.0,588.9,226.5,634.2,11
NDC,00409-3815-12,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",7.31,4.75,0.72,30.37,34
NDC,00409-4031-16,"INJECTION, MANNITOL, 25% IN 50 ML",1.31,0.85,0.33,3.38,16
NDC,00409-4092-01,UNCLASSIFIED DRUGS,32.52,21.14,8.13,83.98,16
NDC,00409-4264-01,"INJECTION, HYDROMORPHONE, 0.1 MG",170.8,111.02,0.15,441.09,17
NDC,00409-4264-11,"INJECTION, HYDROMORPHONE, 0.1 MG",64.68,42.04,0.15,167.04,17
NDC,00409-4278-01,UNCLASSIFIED DRUGS,1.77,1.15,0.44,4.57,16
NDC,00409-4283-11,UNCLASSIFIED DRUGS,16.47,10.705,1.35,71.15,32
NDC,00409-4332-01,"INJECTION, VANCOMYCIN HCL, 500 MG",116.08,75.45,29.02,299.78,16
NDC,00409-4332-11,"INJECTION, VANCOMYCIN HCL, 500 MG",15.25,9.91,3.81,39.38,16
NDC,00409-4444-01,"INJECTION, LEVOFLOXACIN, 250 MG",1.01,0.66,0.25,2.61,17
NDC,00409-4699-24,UNCLASSIFIED DRUGS,3.44,2.24,0.86,8.88,16
NDC,00409-4759-01,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",1.75,1.14,0.1,5.25,17
NDC,00409-4887-17,"STERILE WATER/SALINE, 500 ML",2.15,1.4,0.54,4.15,16
NDC,00409-4888-10,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",12.14,7.89,0.62,8.5,16
NDC,00409-4900-34,UNCLASSIFIED DRUGS,10.62,6.9,2.66,27.43,16
NDC,00409-4902-34,UNCLASSIFIED DRUGS,3.35,2.18,0.84,8.65,16
NDC,00409-4928-11,UNCLASSIFIED DRUGS,3.61,2.35,0.9,9.32,16
NDC,00409-4933-01,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",8.55,5.56,2.14,22.08,16
NDC,00409-5534-14,UNCLASSIFIED DRUGS,7.914999999999999,5.145,1.2,28.51,32
NDC,00409-5921-01,"INJECTION, AMINOPHYLLIN, UP TO 250 MG",3.42,2.22,0.86,11.03,17
NDC,00409-5922-16,"INJECTION, AMINOPHYLLIN, UP TO 250 MG",10.58,6.88,1.48,39.41,34
NDC,00409-6102-19,"INJECTION, FUROSEMIDE, 1 MG",11.68,7.59,0.02,30.16,17
NDC,00409-6476-44,"INJECTION, ERYTHROMYCIN LACTOBIONATE, PER 500 MG",506.7,329.36,21.37,1308.55,17
NDC,00409-6509-01,VANCOMYCIN HCL 5 GM VIAL,204.125,132.68,4.48,273.24,22
NDC,00409-6531-02,VANCOMYCIN HCL 750 MG VIAL,121.535,79.0,23.21,105.17,22
NDC,00409-6533-01,"INJECTION, VANCOMYCIN HCL, 500 MG",50.74,32.98,12.69,131.04,16
NDC,00409-6533-21,"INJECTION, VANCOMYCIN HCL, 500 MG",8.99,5.84,2.25,23.22,16
NDC,00409-6635-01,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",4.48,2.91,0.13,11.57,17
NDC,00409-6648-16,UNCLASSIFIED DRUGS,4.38,2.85,1.1,11.31,16
NDC,00409-6727-11,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",1.29,0.84,0.32,3.33,17
NDC,00409-7332-11,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",106.81,69.43,0.49,605.57,51
NDC,00409-7335-13,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",263.23,171.1,0.49,1177.1,51
NDC,00409-7338-01,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",23.12,15.03,0.49,59.71,17
NDC,00409-7338-11,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",30.86,20.06,0.49,79.7,17
NDC,00409-7517-66,UNCLASSIFIED DRUGS,2.81,1.83,0.7,7.26,16
NDC,00409-7600-01,UNCLASSIFIED DRUGS,2.07,1.35,0.52,5.35,16
NDC,00409-7650-05,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",26.67,17.34,0.19,68.88,17
NDC,00409-7853-01,UNCLASSIFIED DRUGS,1.51,0.98,0.38,3.9,16
NDC,00409-9042-01,UNCLASSIFIED DRUGS,3.21,2.09,0.8,8.29,16
NDC,00409-9043-01,UNCLASSIFIED DRUGS,3.4,2.21,0.85,8.78,16
NDC,00409-9045-01,UNCLASSIFIED DRUGS,3.64,2.37,0.91,9.4,16
NDC,00409-9045-16,UNCLASSIFIED DRUGS,10.75,6.99,2.69,27.76,16
NDC,00409-9094-12,"INJECTION, FENTANYL CITRATE, 0.1 MG",50.55,32.86,1.26,130.55,17
NDC,00409-9158-01,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",79.2,51.48,2.98,204.53,17
NDC,00409-9558-05,UNCLASSIFIED DRUGS,1108.5,720.53,277.13,2862.7,16
NDC,00440-5185-01,ENZONATATE 100 MG CAPSULE,5.25,3.41,1.31,3.68,11
NDC,00450-0930-32,"LACTAID FAST ACT 9,000 UNIT",7.08,4.6,1.77,4.96,11
NDC,00456-0400-01,"INJECTION, CEFTAROLINE FOSAMIL, 10 MG",1475.93,959.35,4.49,3811.59,19
NDC,00456-0458-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.7,12.81,4.93,50.88,16
NDC,00456-0459-01,UNCLASSIFIED DRUGS,15.89,10.33,3.97,41.04,16
NDC,00456-0600-01,"INJECTION, CEFTAROLINE FOSAMIL, 10 MG",1410.86,917.06,4.49,3643.55,19
NDC,00456-1110-30,VIIBRYD 10 MG TABLET,81.05,52.68,20.26,56.74,11
NDC,00456-1120-30,VIIBRYD 20 MG TABLET,74.355,48.335,16.73,57.27,22
NDC,00456-1140-30,VIIBRYD 40 MG TABLET,83.32,54.16,20.83,58.32,11
NDC,00456-1201-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",87.86500000000001,57.114999999999995,14.2,307.19,32
NDC,00456-1202-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",121.5,78.98,30.38,313.77,16
NDC,00456-1203-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",91.07000000000001,59.195,14.62,319.4,32
NDC,00456-1410-30,NEBIVOLOL 10 MG TABLET,41.0,26.65,10.25,28.7,11
NDC,00456-1550-60,SAVELLA 50 MG TABLET,56.8,36.92,14.2,39.76,11
NDC,00456-2700-01,"INJECTION, CEFTAZIDIME AND AVIBACTAM, 0.5 G/0.125 G",2800.14,1820.09,110.99,7231.36,19
NDC,00469-0125-99,XTANDI 40 MG CAPSULE,864.19,561.72,216.05,604.93,11
NDC,00469-0420-01,CRESEMBA 372 MG VIAL,2479.425,1611.625,607.71,1769.61,22
NDC,00469-0520-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",450.30999999999995,292.7,47.77,1832.44,32
NDC,00469-0617-73,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",5.53,3.59,0.21,14.28,17
NDC,00469-0625-99,XTANDI 40 MG TABLET,865.7,562.71,216.43,605.99,11
NDC,00469-0725-60,XTANDI 80 MG TABLET,1725.15,1121.35,431.29,1207.61,11
NDC,00469-1425-90,XOSPATA 40 MG TABLET,2243.67,1458.39,560.92,1570.57,11
NDC,00469-3016-01,"TACROLIMUS, PARENTERAL, 5 MG",1099.15,714.45,185.44,2838.55,19
NDC,00469-3051-30,"INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG",1315.97,855.38,21.96,3398.49,19
NDC,00469-3211-10,"INJECTION, MICAFUNGIN SODIUM, 1 MG",480.3,312.2,0.27,1240.37,17
NDC,00469-3250-10,"INJECTION, MICAFUNGIN SODIUM, 1 MG",644.5,418.93,0.27,1664.42,17
NDC,00469-3425-10,VYLOY 100 MG VIAL,10049.18,6531.97,2512.3,7034.43,11
NDC,00469-4425-30,VYLOY 300 MG VIAL,29707.78,19310.06,7426.95,20795.45,11
NDC,00469-6501-89,"INJECTION, REGADENOSON, 0.1 MG",1013.11,658.52,2.84,2616.36,17
NDC,00472-0242-60,UNCLASSIFIED DRUGS,13.64,8.87,3.41,35.23,16
NDC,00472-0379-45,UNCLASSIFIED DRUGS,5.73,3.72,1.43,14.8,16
NDC,00472-1738-03,UNCLASSIFIED DRUGS,91.32,59.36,22.83,235.83,16
NDC,00480-2043-56,VILAZODONE HCL 40 MG TABLET,60.5,39.33,15.13,42.35,11
NDC,00480-2045-56,VILAZODONE HCL 10 MG TABLET,32.2,20.93,8.05,22.54,11
NDC,00480-2357-01,TOPIRAMATE ER 50 MG CAPSULE,115.6,75.14,28.9,80.92,11
NDC,00480-2359-01,TOPIRAMATE ER 200 MG CAPSULE,361.77,235.15,76.66,291.84,22
NDC,00480-2596-34,FIDAXOMICIN 200 MG TABLET,1406.8,914.42,351.7,984.76,11
NDC,00480-3156-56,TERIFLUNOMIDE 14 MG TABLET,85.275,55.43,20.33,62.48,22
NDC,00480-3610-87,PIRFENIDONE 267 MG TABLET,64.45,41.89,16.11,45.12,11
NDC,00480-9242-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.57,3.62,1.39,14.38,16
NDC,00487-0201-01,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",13.66,8.88,0.21,42.2,49
NDC,00487-2784-01,"NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME",11.58,7.53,2.9,29.91,16
NDC,00487-5901-99,"NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME",39.44,25.64,9.86,101.85,16
NDC,00487-9007-30,UNCLASSIFIED DRUGS,6.57,4.27,1.64,16.97,16
NDC,00487-9007-60,UNCLASSIFIED DRUGS,8.51,5.53,2.13,21.98,16
NDC,00487-9301-33,UNCLASSIFIED DRUGS,13.79,8.96,3.45,35.61,16
NDC,00487-9501-01,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",12.49,8.12,0.07,32.26,17
NDC,00487-9601-01,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",9.18,5.97,1.11,23.71,17
NDC,00487-9801-01,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",16.01,10.41,0.42,41.35,17
NDC,00487-9901-30,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG",3.74,2.43,0.28,28.15,84
NDC,00487-9904-25,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",15.31,9.95,0.07,39.54,17
NDC,00517-0301-10,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",101.38,65.9,10.4,261.81,17
NDC,00517-0374-01,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",22.75,14.79,5.69,58.75,17
NDC,00517-0374-05,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",58.47,38.01,10.4,151.0,17
NDC,00517-0375-10,UNCLASSIFIED DRUGS,16.07,10.445,3.5,46.82,32
NDC,00517-0650-01,"INJECTION, FERRIC CARBOXYMALTOSE, 1 MG",956.93,622.0,1.19,2471.27,19
NDC,00517-0720-01,"INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG",50.11,32.57,7.31,183.28,34
NDC,00517-0735-01,UNCLASSIFIED DRUGS,19.75,12.84,4.94,51.0,16
NDC,00517-0740-01,"INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG",182.75,118.79,22.64,471.95,17
NDC,00517-0740-20,"INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG",91.22,59.29,22.64,235.58,17
NDC,00517-0901-25,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",143.2,93.08,4.65,369.81,17
NDC,00517-1001-01,"INJECTION, ATROPINE SULFATE, 0.01 MG",254.625,165.505,0.11,689.01,34
NDC,00517-2310-05,"INJECTION, IRON SUCROSE, 1 MG",59.18,38.47,0.25,152.83,17
NDC,00517-2340-01,"INJECTION, IRON SUCROSE, 1 MG",154.9,100.69,0.25,400.03,17
NDC,00517-2340-10,"INJECTION, IRON SUCROSE, 1 MG",144.16,93.7,0.25,372.29,17
NDC,00517-2502-01,UNCLASSIFIED DRUGS,87.015,56.56,17.14,272.4,32
NDC,00517-2930-25,UNCLASSIFIED DRUGS,5.2,3.38,1.3,13.43,16
NDC,00517-4002-01,"INJECTION, PAPAVERINE HCL, UP TO 60 MG",163.93,106.55,40.98,423.35,17
NDC,00517-4300-01,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG",11674.22,7588.245,8.67,40775.63,38
NDC,00517-4810-25,"INJECTION, NITROGLYCERIN, 5 MG",45.435,29.53,1.61,209.75,34
NDC,00517-7305-01,UNCLASSIFIED DRUGS,31.25,20.31,7.81,80.7,16
NDC,00517-7504-25,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",10.99,7.14,2.75,28.38,17
NDC,00517-7604-25,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",18.56,12.06,4.64,47.93,17
NDC,00517-9120-01,"INJECTION, AMINOCAPROIC ACID, 1 GRAM",13.18,8.565,1.33,54.36,34
NDC,00517-9305-01,UNCLASSIFIED DRUGS,189.16,122.95,47.29,488.51,16
NDC,00517-9702-01,"INJECTION, DROPERIDOL, UP TO 5 MG",47.23,30.7,7.61,121.97,17
NDC,00517-9702-25,"INJECTION, DROPERIDOL, UP TO 5 MG",21.09,13.71,5.27,54.46,17
NDC,00527-1341-01,UNCLASSIFIED DRUGS,13.07,8.495,0.92,57.98,32
NDC,00527-1367-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.555,15.31,4.13,79.02,32
NDC,00527-1368-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.92,11.0,4.23,43.7,16
NDC,00527-1632-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.585,6.880000000000001,1.21,42.22,32
NDC,00527-1695-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.4,9.36,3.6,37.19,16
NDC,00527-1790-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.05,13.68,5.26,54.36,16
NDC,00527-1818-43,UNCLASSIFIED DRUGS,184.53,119.94,46.13,476.55,16
NDC,00527-1859-43,UNCLASSIFIED DRUGS,188.81,122.73,47.2,487.6,16
NDC,00527-1917-69,LEVOCETIRIZINE 2.5 MG/5 ML ORAL SOLUTION [91552],3.29,2.14,0.82,2.3,11
NDC,00527-1948-68,UNCLASSIFIED DRUGS,12.2,7.93,3.05,31.51,16
NDC,00527-1948-70,UNCLASSIFIED DRUGS,7.54,4.9,1.89,19.47,16
NDC,00527-2133-35,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.19,24.17,9.3,96.04,16
NDC,00527-2395-32,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.27,4.08,1.57,16.19,16
NDC,00527-2962-37,"CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED",24.63,16.01,6.16,63.61,16
NDC,00527-3283-46,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.5,18.53,7.13,73.6,16
NDC,00527-4116-37,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.24,15.76,6.06,62.6,16
NDC,00527-4117-37,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.18,5.965,1.21,34.94,32
NDC,00527-4960-32,LEVOTHYROXINE 150 MCG CAPSULE,19.55,12.71,4.89,13.69,11
NDC,00527-5160-82,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",25.15,16.35,0.16,64.95,17
NDC,00536-1054-29,UNCLASSIFIED DRUGS,47.89,31.13,11.97,123.68,16
NDC,00536-1211-95,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.01,1.31,0.5,5.19,16
NDC,00536-1214-29,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",108.82,70.73,27.21,281.03,16
NDC,00536-1219-94,UNCLASSIFIED DRUGS,3.16,2.05,0.79,8.16,16
NDC,00536-1232-01,UNCLASSIFIED DRUGS,10.565,6.865,0.78,46.54,32
NDC,00536-1234-41,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.2,2.73,1.05,10.85,16
NDC,00536-1254-94,UNCLASSIFIED DRUGS,5.985,3.8899999999999997,0.65,24.22,32
NDC,00536-1297-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.61,12.75,4.9,50.64,16
NDC,00536-1316-28,UNCLASSIFIED DRUGS,2.36,1.53,0.59,6.09,16
NDC,00536-1342-01,UNCLASSIFIED DRUGS,22.15,14.4,5.54,57.2,16
NDC,00536-1344-80,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.73,4.37,1.68,17.38,16
NDC,00536-1352-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.7,21.26,8.18,84.45,16
NDC,00536-1362-23,SMOKING CESSATION GUM,6.0,3.9,1.5,15.5,16
NDC,00536-1407-95,UNCLASSIFIED DRUGS,2.3449999999999998,1.525,0.39,8.13,32
NDC,00536-3112-01,SMOKING CESSATION GUM,34.25,22.26,8.56,88.45,16
NDC,00536-3292-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.63,3.01,1.16,11.96,16
NDC,00536-3443-08,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.93,2.55,0.98,10.15,16
NDC,00536-3445-08,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.86,2.51,0.97,9.97,16
NDC,00536-5894-88,"NICOTINE PATCHES, LEGEND",17.82,11.58,4.46,46.02,16
NDC,00536-5895-88,"NICOTINE PATCHES, LEGEND",25.12,16.33,6.28,64.87,16
NDC,00536-5896-88,"NICOTINE PATCHES, LEGEND",19.87,12.92,4.97,51.31,16
NDC,00548-5400-00,"INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG",135.35,87.98,0.51,349.54,17
NDC,00548-5701-00,"INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG",600.1,390.07,0.51,1549.76,17
NDC,00548-5900-00,"INJECTION, COSYNTROPIN, 0.25 MG",202.55,131.655,21.89,759.93,34
NDC,00555-0606-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
NDC,00555-0607-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.03,3.92,1.51,15.57,16
NDC,00555-0779-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.52,8.79,3.38,34.92,16
NDC,00555-0872-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.165,10.51,0.65,76.75,32
NDC,00555-0886-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.56,2.96,1.14,11.78,16
NDC,00555-0899-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.315,7.355,0.98,48.37,32
NDC,00555-0971-02,UNCLASSIFIED DRUGS,16.29,10.59,4.07,42.07,16
NDC,00555-0972-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.7,10.86,4.18,43.13,16
NDC,00555-9049-58,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.155,2.7,0.77,13.51,32
NDC,00573-2660-24,UNCLASSIFIED DRUGS,9.15,5.95,2.29,23.63,16
NDC,00574-0069-15,UNCLASSIFIED DRUGS,4.78,3.11,1.2,12.34,16
NDC,00574-0153-30,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",22.73,14.77,3.22,58.7,17
NDC,00574-0292-01,AMILORIDE HCL 5 MG TABLET,3.98,2.59,1.0,2.79,11
NDC,00574-0827-01,"INJECTION, TESTOSTERONE CYPIONATE, 1 MG",160.65,104.42,0.03,414.88,17
NDC,00574-1133-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.395,9.36,2.98,43.57,32
NDC,00574-2008-15,UNCLASSIFIED DRUGS,13.37,8.69,3.34,34.53,16
NDC,00574-4021-35,UNCLASSIFIED DRUGS,83.74,54.43,20.94,216.26,16
NDC,00574-4024-35,UNCLASSIFIED DRUGS,55.37,35.99,13.84,142.99,16
NDC,00574-4031-05,UNCLASSIFIED DRUGS,35.79,23.26,5.71,125.85,32
NDC,00574-4250-35,UNCLASSIFIED DRUGS,21.09,13.71,5.27,54.46,16
NDC,00574-7034-12,UNCLASSIFIED DRUGS,18.82,12.235,3.09,65.31,32
NDC,00574-7050-50,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.03,13.67,5.26,54.31,16
NDC,00574-9855-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.72,10.22,3.93,40.6,16
NDC,00591-2312-15,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",809.4,526.11,202.35,2090.28,16
NDC,00591-2312-45,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1546.18,1005.02,386.55,3993.01,16
NDC,00591-2472-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.82,5.73,2.21,22.78,16
NDC,00591-2533-60,DALFAMPRIDINE ER 10 MG TABLET,13.175,8.565000000000001,2.91,10.29,22
NDC,00591-2712-02,ALBENDAZOLE 200 MG TABLET,116.08,75.45,29.02,81.26,11
NDC,00591-2880-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.5,13.33,5.13,52.94,16
NDC,00591-2927-54,LEVALBUTEROL TAR HFA 45MCG INH,31.56,20.51,7.89,22.09,11
NDC,00591-4012-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.47,2.26,0.87,8.96,16
NDC,00591-5335-01,TRIHEXYPHENIDYL 2 MG TABLET,4.8,3.12,1.2,3.36,11
NDC,00591-5694-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.88,3.17,1.22,12.6,16
NDC,00597-0053-01,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",1140.43,741.28,174.75,2945.16,19
NDC,00597-0108-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.15,15.05,5.79,59.78,16
NDC,00597-0140-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",111.18,72.27,27.8,287.12,16
NDC,00597-0140-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",100.9,65.59,25.23,260.57,16
NDC,00597-0143-60,OFEV 100 MG CAPSULE,1580.45,1027.29,395.11,1106.32,11
NDC,00597-0152-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",134.9,87.69,33.73,348.38,16
NDC,00597-0152-37,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",657.46,427.35,164.37,1697.89,16
NDC,00597-0155-61,STIOLTO RESPIMAT INHALER (60),537.29,349.24,134.32,376.1,11
NDC,00597-0197-05,UNCLASSIFIED DRUGS,456.59,296.785,60.32,1735.16,32
NDC,00597-0355-56,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.65,11.47,4.41,45.58,16
NDC,00597-0360-82,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.7,22.56,8.68,89.61,16
NDC,00603-1585-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.37,2.19,0.84,8.7,16
NDC,00603-1880-10,UNCLASSIFIED DRUGS,102.03,66.32,25.51,263.49,16
NDC,00603-2434-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",33.1,21.52,8.28,85.48,16
NDC,00603-4593-21,"METHYLPREDNISOLONE ORAL, PER 4 MG",44.26,28.77,0.15,114.3,17
NDC,00603-5060-21,"PERPHENAZINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",23.25,15.11,0.71,60.04,17
NDC,00603-5168-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.31,6.05,2.33,24.04,16
NDC,00603-5336-21,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",21.48,13.96,0.01,55.47,17
NDC,00641-0367-21,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",15.575,10.120000000000001,0.12,66.99,34
NDC,00641-0476-21,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",308.48,200.51,30.82,796.65,17
NDC,00641-0477-25,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",323.47,210.26,30.82,835.36,17
NDC,00641-0928-21,"INJECTION, PROMETHAZINE HCL, UP TO 50 MG",16.7,10.86,4.18,43.13,17
NDC,00641-1398-31,"INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG",17.45,11.34,4.36,45.06,17
NDC,00641-1398-35,"INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG",115.95,75.37,25.2,299.44,17
NDC,00641-1410-31,"INJECTION, DIGOXIN, UP TO 0.5 MG",13.5,8.78,3.38,34.86,17
NDC,00641-1410-35,"INJECTION, DIGOXIN, UP TO 0.5 MG",53.19,34.57,10.14,137.36,17
NDC,00641-1496-35,PROMETHAZINE 50 MG/ML AMPUL,27.8,18.07,6.95,19.46,11
NDC,00641-6001-01,"INJECTION, LORAZEPAM, 2 MG",90.37,58.74,1.49,233.38,17
NDC,00641-6003-01,"INJECTION, LORAZEPAM, 2 MG",107.0,69.55,1.49,276.33,17
NDC,00641-6008-01,"INJECTION, BUMETANIDE, 0.5 MG",2.635,1.71,0.38,7.64,34
NDC,00641-6013-01,UNCLASSIFIED DRUGS,36.08,23.45,9.02,93.18,16
NDC,00641-6022-25,UNCLASSIFIED DRUGS,64.73,42.07,16.18,167.17,16
NDC,00641-6027-25,"INJECTION, FENTANYL CITRATE, 0.1 MG",46.53,30.24,1.26,120.16,17
NDC,00641-6039-01,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",24.04,15.63,6.01,62.08,17
NDC,00641-6040-01,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",39.54,25.7,9.89,102.11,17
NDC,00641-6045-25,"INJECTION, LORAZEPAM, 2 MG",15.89,10.33,1.49,41.04,17
NDC,00641-6052-01,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",97.3,63.25,8.64,265.22,51
NDC,00641-6052-25,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",68.93,44.8,8.64,178.01,17
NDC,00641-6079-01,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",1.56,1.01,0.1,4.68,17
NDC,00641-6080-25,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",19.3,12.55,0.1,57.9,17
NDC,00641-6117-01,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",134.8,87.62,1.41,348.12,17
NDC,00641-6125-01,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",9.775,6.3549999999999995,0.26,47.78,34
NDC,00641-6125-25,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",12.28,7.98,3.07,31.71,17
NDC,00641-6127-01,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",116.99,76.04,3.22,302.13,17
NDC,00641-6127-25,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",213.2,138.58,3.22,550.59,17
NDC,00641-6149-10,"INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG",9.58,6.23,1.49,24.74,17
NDC,00641-6204-01,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",174.0,113.1,0.19,449.36,17
NDC,00641-6205-01,"INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG",29.23,19.0,7.31,75.49,16
NDC,00641-6244-01,"INJECTION, DIAZEPAM, UP TO 5 MG",98.03,63.72,7.09,253.16,17
NDC,00641-6281-25,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",51.84,33.7,0.15,133.88,17
NDC,00641-6282-01,"INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG",249.59,162.23,0.75,644.57,17
NDC,00703-0113-01,"INJECTION, HYDROMORPHONE, 0.1 MG",5.03,3.27,0.15,12.99,17
NDC,00703-0666-01,"INJECTION, TREPROSTINIL, 1 MG",559.32,363.56,57.75,1444.44,19
NDC,00703-0676-01,"INJECTION, TREPROSTINIL, 1 MG",361.87,235.22,57.75,934.53,19
NDC,00703-0686-01,"INJECTION, TREPROSTINIL, 1 MG",2623.5,1705.28,57.75,6775.19,19
NDC,00703-3671-01,"INJECTION, METHOTREXATE SODIUM, 50 MG",160.66,104.43,2.73,481.98,17
NDC,00703-4502-91,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",37.88,24.62,1.14,97.83,17
NDC,00713-0132-06,UNCLASSIFIED DRUGS,342.0,222.3,85.5,883.22,16
NDC,00713-0135-06,UNCLASSIFIED DRUGS,28.25,18.36,7.06,72.96,16
NDC,00713-0280-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.09,5.26,2.02,20.89,16
NDC,00713-0526-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.98,20.134999999999998,6.71,90.72,32
NDC,00713-0635-15,UNCLASSIFIED DRUGS,7.4,4.81,1.85,19.11,16
NDC,00713-0656-31,UNCLASSIFIED DRUGS,9.96,6.47,2.49,25.72,16
NDC,00713-0663-31,UNCLASSIFIED DRUGS,21.91,14.24,5.48,56.58,16
NDC,00713-0678-31,UNCLASSIFIED DRUGS,10.63,6.91,2.66,27.45,16
NDC,00713-0682-15,UNCLASSIFIED DRUGS,8.98,5.84,2.25,23.19,16
NDC,00713-0686-31,UNCLASSIFIED DRUGS,1.36,0.88,0.34,3.51,16
NDC,00766-7388-08,TUMS E-X TABLET CHEWABLE,2.05,1.33,0.51,1.44,11
NDC,00781-1061-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.7,8.91,3.43,35.38,16
NDC,00781-2020-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.755,1.79,0.37,10.41,32
NDC,00781-2081-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.33,13.21,5.08,52.5,16
NDC,00781-2322-06,"APREPITANT, ORAL, 5 MG",539.87,350.92,2.94,1394.21,17
NDC,00781-2613-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.69,2.4,0.92,9.53,16
NDC,00781-3114-95,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",20.03,13.02,1.16,51.73,17
NDC,00781-3152-95,UNCLASSIFIED DRUGS,4.81,3.13,1.2,12.42,16
NDC,00781-3154-01,"INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG (NON-ESRD USE)",118.21,76.83500000000001,0.38,412.81,38
NDC,00781-3208-85,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",27.08,17.6,0.49,69.93,17
NDC,00781-3220-95,UNCLASSIFIED DRUGS,6.98,4.54,1.75,18.03,16
NDC,00781-3238-01,"INJECTION, ENOXAPARIN SODIUM, 10 MG",52.33,34.01,0.56,156.99,17
NDC,00781-3244-94,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",1054.39,685.35,0.63,2722.96,17
NDC,00781-3246-02,"INJECTION, ENOXAPARIN SODIUM, 10 MG",85.89,55.83,0.56,257.67,17
NDC,00781-3256-03,"INJECTION, ENOXAPARIN SODIUM, 10 MG",47.23,30.7,0.56,141.69,17
NDC,00781-3290-91,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",1.68,1.09,0.42,4.34,17
NDC,00781-3402-95,"INJECTION, AMPICILLIN SODIUM, 500 MG",178.05,115.73,0.63,459.81,17
NDC,00781-3404-85,"INJECTION, AMPICILLIN SODIUM, 500 MG",57.66,37.480000000000004,0.63,249.7,34
NDC,00781-3407-78,"INJECTION, AMPICILLIN SODIUM, 500 MG",348.75,226.69,0.63,900.65,17
NDC,00781-3408-80,"INJECTION, AMPICILLIN SODIUM, 500 MG",14.0,9.1,0.63,36.16,17
NDC,00781-3408-95,"INJECTION, AMPICILLIN SODIUM, 500 MG",77.625,50.455,0.63,327.46,34
NDC,00781-3409-46,"INJECTION, AMPICILLIN SODIUM, 500 MG",170.69,110.95,0.63,440.81,17
NDC,00781-3411-70,"INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG",25.58,16.63,1.64,66.06,17
NDC,00781-3416-94,"INJECTION, VORICONAZOLE, 10 MG",37.73,24.52,0.8,97.44,17
NDC,00781-3440-95,"INJECTION, COSYNTROPIN, 0.25 MG",206.64499999999998,134.32,21.89,861.45,34
NDC,00781-3466-70,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",1005.0,653.25,0.01,2595.41,17
NDC,00781-3491-94,"INJECTION, AZACITIDINE, 1 MG",3870.56,2515.86,0.49,9995.72,19
NDC,00781-3540-10,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",104.44,67.89,0.19,269.72,17
NDC,00781-3555-10,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",221.3,143.85,0.19,571.51,17
NDC,00781-5061-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.96,14.27,5.49,56.71,16
NDC,00781-6021-94,UNCLASSIFIED DRUGS,263.47,171.26,65.87,680.41,16
NDC,00781-6023-52,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.96,7.12,2.74,28.3,16
NDC,00781-6041-58,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.795,1.17,0.42,4.91,32
NDC,00781-6136-94,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",7.58,4.93,0.83,19.58,17
NDC,00781-6186-67,UNCLASSIFIED DRUGS,46.2,30.03,11.55,119.31,16
NDC,00781-7296-85,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,45.36,29.485,9.14,139.89,32
NDC,00781-8972-01,DESIPRAMINE 25 MG TABLET [2286],16.3,10.6,4.08,11.41,11
NDC,00810-0798-87,UNCLASSIFIED DRUGS,8.94,5.81,2.24,23.09,16
NDC,00832-0511-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",52.67,34.24,13.17,136.02,16
NDC,00832-0512-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.489999999999998,7.465,1.71,41.66,32
NDC,00832-0581-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",69.59,45.235,5.35,304.22,32
NDC,00832-1015-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.7,16.06,6.18,63.79,16
NDC,00832-1211-89,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.23,7.95,0.83,47.75,48
NDC,00832-1212-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.08,3.3,1.27,13.12,16
NDC,00832-1213-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.59,2.985,0.95,13.95,32
NDC,00832-1213-89,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.98,6.49,2.5,25.77,16
NDC,00832-1214-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.81,2.48,0.95,9.84,16
NDC,00832-1215-89,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.45,11.99,4.61,47.65,16
NDC,00832-1216-89,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.89,3.18,1.22,12.63,16
NDC,00832-1218-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.3,3.45,1.33,13.69,16
NDC,00832-1219-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.545,5.555000000000001,0.89,34.97,32
NDC,00832-1358-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.57,4.92,1.89,19.55,16
NDC,00832-1359-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.4350000000000005,2.885,0.63,16.45,32
NDC,00832-1410-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",610.0,396.5,152.5,1575.33,16
NDC,00832-1410-03,UNCLASSIFIED DRUGS,89.39,58.1,22.35,230.85,16
NDC,00832-6020-00,"CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED",10.05,6.53,2.51,25.95,16
NDC,00832-6024-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.85,8.35,3.21,33.19,16
NDC,00832-6032-12,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.83,1.84,0.71,7.31,16
NDC,00832-6053-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.15,20.9,8.04,83.03,16
NDC,00832-7124-89,UNCLASSIFIED DRUGS,11.98,7.79,3.0,30.94,16
NDC,00884-6297-30,UNCLASSIFIED DRUGS,76.4,49.66,19.1,197.3,16
NDC,00904-0277-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.25,2.76,1.06,10.98,16
NDC,00904-0428-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.47,17.86,6.87,70.94,16
NDC,00904-0430-04,DOXYCYCLINE HYCLATE 100 MG TAB,35.5,23.08,8.88,24.85,11
NDC,00904-0523-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.96,22.72,8.74,90.28,16
NDC,00904-2085-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.69,6.3,2.42,25.02,16
NDC,00904-2272-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.105,5.92,0.76,39.18,32
NDC,00904-3854-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.24,11.86,4.56,47.1,16
NDC,00904-4215-51,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.65,1.07,0.41,4.26,16
NDC,00904-5053-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.7,11.51,4.43,45.71,16
NDC,00904-5354-31,UNCLASSIFIED DRUGS,1.6,1.04,0.4,4.13,16
NDC,00904-5448-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.27,10.58,4.07,42.02,16
NDC,00904-5463-35,INFANT IBUPROFEN 50 MG/1.25 ML,3.07,2.0,0.77,2.15,11
NDC,00904-5486-52,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.78,7.01,2.7,27.84,16
NDC,00904-5522-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.15,11.8,4.54,46.87,16
NDC,00904-5523-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.2,13.78,5.3,54.75,16
NDC,00904-5677-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.44,2.24,0.86,8.88,16
NDC,00904-5725-14,UNCLASSIFIED DRUGS,3.52,2.29,0.88,9.09,16
NDC,00904-5789-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.23,9.9,3.81,39.33,16
NDC,00904-5791-46,UNCLASSIFIED DRUGS,2.56,1.665,0.35,9.58,32
NDC,00904-5823-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.45,6.79,2.61,26.99,16
NDC,00904-5892-61,UNCLASSIFIED DRUGS,30.33,19.71,7.58,78.33,16
NDC,00904-5894-30,UNCLASSIFIED DRUGS,1.21,0.79,0.3,3.12,16
NDC,00904-5921-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.43,4.18,1.61,16.61,16
NDC,00904-5959-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.4,4.81,1.85,19.11,16
NDC,00904-6008-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.7,12.81,4.93,50.88,16
NDC,00904-6009-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.23,6.65,2.56,26.42,16
NDC,00904-6084-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.52,11.39,4.38,45.25,16
NDC,00904-6290-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",33.53,21.79,8.38,86.59,16
NDC,00904-6292-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.68,20.59,7.92,81.81,16
NDC,00904-6294-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.23,7.95,3.06,31.58,16
NDC,00904-6300-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.92,12.95,4.98,51.44,16
NDC,00904-6303-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.4050000000000002,1.565,0.47,7.62,32
NDC,00904-6352-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.33,3.46,1.33,13.76,16
NDC,00904-6353-61,UNCLASSIFIED DRUGS,9.73,6.32,2.43,25.13,16
NDC,00904-6359-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.67,8.24,3.17,32.72,16
NDC,00904-6363-61,UNCLASSIFIED DRUGS,12.1,7.87,3.03,31.25,16
NDC,00904-6369-61,UNCLASSIFIED DRUGS,32.75,21.29,8.19,84.58,16
NDC,00904-6371-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.29,15.79,6.07,62.73,16
NDC,00904-6376-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.0,13.65,5.25,54.23,16
NDC,00904-6377-61,UNCLASSIFIED DRUGS,4.3,2.8,1.08,11.1,16
NDC,00904-6407-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.364999999999998,6.084999999999999,0.63,41.89,32
NDC,00904-6412-92,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.03,20.17,7.76,80.14,16
NDC,00904-6426-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.0,3.25,1.25,12.91,16
NDC,00904-6427-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.52,9.44,3.63,37.5,16
NDC,00904-6436-04,TEMAZEPAM 7.5 MG CAPSULE,22.045,14.33,5.32,15.98,22
NDC,00904-6441-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.86,18.76,7.22,74.53,16
NDC,00904-6442-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.5,9.43,3.63,37.45,16
NDC,00904-6450-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.2,11.83,4.55,47.0,16
NDC,00904-6461-61,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",7.52,4.89,0.31,19.42,17
NDC,00904-6474-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.95,14.92,5.74,59.27,16
NDC,00904-6475-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.7,14.11,5.43,56.04,16
NDC,00904-6477-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.41,15.22,5.85,60.46,16
NDC,00904-6478-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.76,16.09,6.19,63.94,16
NDC,00904-6488-38,UNCLASSIFIED DRUGS,18.43,11.98,4.61,47.6,16
NDC,00904-6500-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.73,6.97,2.68,27.71,16
NDC,00904-6505-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.28,18.38,7.07,73.03,16
NDC,00904-6506-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",40.46,26.3,10.12,104.49,16
NDC,00904-6519-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",42.93,27.9,10.73,110.87,16
NDC,00904-6522-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.63,17.31,6.66,68.77,16
NDC,00904-6553-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.4,21.06,8.1,83.67,16
NDC,00904-6558-61,UNCLASSIFIED DRUGS,20.2,13.13,5.05,52.17,16
NDC,00904-6570-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.4,15.21,5.85,60.43,16
NDC,00904-6572-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.7,13.46,5.18,53.46,16
NDC,00904-6583-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.4,23.01,8.85,91.42,16
NDC,00904-6599-61,"PERPHENAZINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",8.85,5.75,0.71,22.86,17
NDC,00904-6600-61,"PERPHENAZINE, 4 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",10.9,7.09,0.71,28.15,17
NDC,00904-6617-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.47,23.71,9.12,94.18,16
NDC,00904-6619-61,UNCLASSIFIED DRUGS,6.95,4.52,1.74,17.95,16
NDC,00904-6622-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.03,18.22,7.01,72.39,16
NDC,00904-6623-61,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",13.42,8.72,0.21,34.66,17
NDC,00904-6624-61,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",50.35,32.73,0.21,130.03,17
NDC,00904-6638-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.69,3.05,1.17,12.11,16
NDC,00904-6640-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.58,2.33,0.9,9.25,16
NDC,00904-6641-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.18,2.07,0.8,8.21,16
NDC,00904-6703-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",57.65,37.47,14.41,148.88,16
NDC,00904-6718-39,UNCLASSIFIED DRUGS,27.61,17.95,6.9,71.3,16
NDC,00904-6728-52,UNCLASSIFIED DRUGS,6.925,4.505,0.94,26.08,32
NDC,00904-6730-80,UNCLASSIFIED DRUGS,77.34,50.27,19.34,199.73,16
NDC,00904-6761-30,UNCLASSIFIED DRUGS,3.56,2.31,0.89,9.19,16
NDC,00904-6773-61,UNCLASSIFIED DRUGS,12.98,8.44,3.25,33.52,16
NDC,00904-6778-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.23,6.0,2.31,23.84,16
NDC,00904-6782-61,UNCLASSIFIED DRUGS,13.38,8.7,3.35,34.55,16
NDC,00904-6785-04,"MYCOPHENOLIC ACID, ORAL, 180 MG",11.07,7.2,0.34,28.59,17
NDC,00904-6786-04,"MYCOPHENOLIC ACID, ORAL, 180 MG",42.67,27.74,0.34,110.2,17
NDC,00904-6794-80,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.46,23.7,9.12,94.16,16
NDC,00904-6797-61,UNCLASSIFIED DRUGS,3.95,2.57,0.99,10.2,16
NDC,00904-6798-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.21,11.84,4.55,47.03,16
NDC,00904-6799-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.37,2.84,1.09,11.29,16
NDC,00904-6808-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",83.16,54.05,20.79,214.76,16
NDC,00904-6818-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.83,14.84,5.71,58.96,16
NDC,00904-6830-61,"FINASTERIDE, 5 MG",27.91,18.14,6.98,72.08,16
NDC,00904-6832-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.69,12.15,4.67,48.27,16
NDC,00904-6852-89,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.39,3.5,1.35,13.92,16
NDC,00904-6868-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.67,17.34,6.67,68.88,16
NDC,00904-6869-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.38,7.4,2.85,29.39,16
NDC,00904-6917-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.2,10.53,4.05,41.84,16
NDC,00904-6924-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.4,17.81,6.85,70.76,16
NDC,00904-6925-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.36,10.63,4.09,42.25,16
NDC,00904-6926-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.27,10.58,4.07,42.02,16
NDC,00904-6927-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",63.87,41.52,15.97,164.94,16
NDC,00904-6928-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.73,2.42,0.93,9.63,16
NDC,00904-6929-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.02,15.61,6.01,62.03,16
NDC,00904-6931-86,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",142.38,92.55,35.6,367.7,16
NDC,00904-6939-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.08,3.3,1.27,13.12,16
NDC,00904-6949-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.9,21.39,8.23,84.96,16
NDC,00904-6950-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.54,16.6,6.39,65.96,16
NDC,00904-6953-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.99,12.99,5.0,51.62,16
NDC,00904-6954-61,UNCLASSIFIED DRUGS,22.2,14.43,5.55,57.33,16
NDC,00904-6955-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.88,18.12,6.97,72.0,16
NDC,00904-6956-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.05,14.98,5.76,59.53,16
NDC,00904-6988-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.55,23.11,8.89,91.81,16
NDC,00904-6990-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.75,2.44,0.94,9.68,16
NDC,00904-6991-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",74.18,48.22,18.55,191.57,16
NDC,00904-6992-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",85.2,55.38,21.3,220.03,16
NDC,00904-7000-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",82.11,53.37,20.53,212.05,16
NDC,00904-7001-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",78.8,51.22,19.7,203.5,16
NDC,00904-7002-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",75.05,48.78,18.76,193.82,16
NDC,00904-7007-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.66,16.03,6.17,63.68,16
NDC,00904-7008-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.65,9.52,3.66,37.83,16
NDC,00904-7010-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.475,10.71,0.5,79.93,32
NDC,00904-7021-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.67,6.94,2.67,27.56,16
NDC,00904-7022-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.14,13.09,5.04,52.01,16
NDC,00904-7027-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.14,3.99,1.54,15.86,16
NDC,00904-7036-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",62.54,40.65,15.64,161.51,16
NDC,00904-7044-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.95,19.47,7.49,77.35,16
NDC,00904-7045-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.2,17.68,6.8,70.24,16
NDC,00904-7046-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.78,19.36,7.45,76.91,16
NDC,00904-7049-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.54,19.85,7.64,78.87,16
NDC,00904-7052-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.5,14.63,5.63,58.11,16
NDC,00904-7053-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.27,10.58,4.07,42.02,16
NDC,00904-7057-61,METHOCARBAMOL 500 MG TABLET,4.31,2.8,0.76,3.92,22
NDC,00904-7058-61,METHOCARBAMOL 750 MG TABLET,4.755,3.09,0.95,4.01,22
NDC,00904-7073-41,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",17.83,11.59,0.01,46.05,17
NDC,00904-7078-61,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",12.8,8.32,0.16,33.06,17
NDC,00904-7093-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.62,8.2,3.16,32.59,16
NDC,00904-7097-61,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",20.47,13.31,0.21,52.86,17
NDC,00904-7107-61,RIVASTIGMINE 1.5 MG CAPSULE,20.305,13.2,4.34,16.28,22
NDC,00904-7117-41,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.8,11.57,4.45,45.97,16
NDC,00904-7122-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.6,9.49,3.65,37.7,16
NDC,00904-7123-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.37,2.84,1.09,11.29,16
NDC,00904-7124-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.38,2.85,1.1,11.31,16
NDC,00904-7125-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.14,3.34,1.29,13.27,16
NDC,00904-7127-61,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",30.94,20.11,0.01,79.9,17
NDC,00904-7130-61,"CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED",13.18,8.57,3.3,34.04,16
NDC,00904-7135-72,UNCLASSIFIED DRUGS,11.71,7.61,2.93,30.24,16
NDC,00904-7140-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.45,10.69,4.11,42.48,16
NDC,00904-7141-10,"METHOTREXATE; ORAL, 2.5 MG",23.88,15.52,0.16,61.67,17
NDC,00904-7145-04,"DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",114.13,74.18,1.43,294.74,17
NDC,00904-7154-04,"BUPRENORPHINE, ORAL, 1 MG",18.21,11.84,1.34,47.03,17
NDC,00904-7156-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.45,3.54,1.36,14.07,16
NDC,00904-7162-61,UNCLASSIFIED DRUGS,15.2,9.88,3.8,39.25,16
NDC,00904-7172-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",158.67,103.14,39.67,409.77,16
NDC,00904-7177-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
NDC,00904-7178-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.41,2.87,1.1,11.39,16
NDC,00904-7179-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.75,31.04,11.94,123.31,16
NDC,00904-7180-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.69,14.75,5.67,58.6,16
NDC,00904-7183-61,UNCLASSIFIED DRUGS,28.99,18.84,7.25,74.87,16
NDC,00904-7187-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.7,17.36,6.68,68.95,16
NDC,00904-7193-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",95.17,61.86,23.79,245.78,16
NDC,00904-7206-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.28,20.98,8.07,83.36,16
NDC,00904-7211-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.85,9.0,3.46,35.77,16
NDC,00904-7213-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.38,6.1,2.35,24.22,16
NDC,00904-7214-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.8,3.77,1.45,14.98,16
NDC,00904-7217-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.53,13.99,5.38,55.6,16
NDC,00904-7218-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.5,19.83,7.63,78.77,16
NDC,00904-7224-61,UNCLASSIFIED DRUGS,15.38,10.0,3.85,39.72,16
NDC,00904-7229-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.72,5.02,1.93,19.94,16
NDC,00904-7236-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.52,14.64,5.63,58.16,16
NDC,00904-7237-24,"DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A ",29.14,18.94,1.51,75.25,17
NDC,00904-7244-68,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",40.2,26.13,10.05,103.82,16
NDC,00904-7245-68,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.53,5.54,2.13,22.03,16
NDC,00904-7261-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.41,8.72,3.35,34.63,16
NDC,00904-7262-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",41.26,26.82,10.32,106.55,16
NDC,00904-7276-41,UNCLASSIFIED DRUGS,5.13,3.33,1.28,13.25,16
NDC,00904-7278-41,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.93,2.55,0.98,10.15,16
NDC,00904-7283-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
NDC,00904-7284-54,UNCLASSIFIED DRUGS,92.92,60.4,23.23,239.97,16
NDC,00904-7288-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.75,3.09,1.19,12.27,16
NDC,00904-7317-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.69,16.05,6.17,63.76,16
NDC,00904-7321-03,UNCLASSIFIED DRUGS,2.51,1.63,0.63,6.48,16
NDC,00904-7327-62,UNCLASSIFIED DRUGS,1.33,0.86,0.33,3.43,16
NDC,00904-7345-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.72,2.42,0.93,9.61,16
NDC,00904-7346-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.45,4.84,1.86,19.24,16
NDC,00904-7350-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.85,10.95,4.21,43.52,16
NDC,00904-7360-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.8,6.37,2.45,25.31,16
NDC,00904-7364-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.2,4.03,1.55,16.01,16
NDC,00904-7376-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.19,6.62,2.55,26.32,16
NDC,00904-7381-06,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",21.98,14.29,0.83,56.76,17
NDC,00904-7389-61,UNCLASSIFIED DRUGS,8.95,5.82,2.24,23.11,16
NDC,00904-7390-61,UNCLASSIFIED DRUGS,17.76,11.54,4.44,45.87,16
NDC,00904-7400-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.57,18.57,7.14,73.78,16
NDC,00904-7401-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",236.06,153.44,59.02,609.63,16
NDC,00904-7410-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.35,17.13,6.59,68.05,16
NDC,00904-7411-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.7,13.46,5.18,53.46,16
NDC,00904-7440-61,UNCLASSIFIED DRUGS,23.03,14.97,5.76,59.48,16
NDC,00904-7442-61,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",48.3,31.4,12.08,124.73,16
NDC,00904-7452-61,UNCLASSIFIED DRUGS,19.36,12.58,4.84,50.0,16
NDC,00904-7461-88,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.78,1.81,0.7,7.18,16
NDC,00904-7463-41,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.7,22.56,8.68,89.61,16
NDC,00904-7470-66,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.62,4.3,1.66,17.1,16
NDC,00904-7478-35,UNCLASSIFIED DRUGS,5.3,3.45,1.33,13.69,16
NDC,00904-7533-15,UNCLASSIFIED DRUGS,5.58,3.63,1.4,14.41,16
NDC,00904-7751-27,UNCLASSIFIED DRUGS,1.32,0.86,0.33,3.41,16
NDC,00904-7914-61,UNCLASSIFIED DRUGS,17.5,11.375,1.22,77.78,32
NDC,00904-8805-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.81,1.83,0.7,7.26,16
NDC,00904-8805-67,UNCLASSIFIED DRUGS,4.3,2.8,1.08,11.1,16
NDC,00942-0641-04,UNCLASSIFIED DRUGS,12.27,7.98,3.07,31.69,16
NDC,00944-2700-02,"INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G., LIQUID), 500 MG",87.47,56.86,21.87,2922.83,19
NDC,00944-2700-10,"INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G., LIQUID), 500 MG",82.44,53.59,20.61,2922.83,19
NDC,00944-2803-03,"INJECTION, ALPHA 1 PROTEINASE INHIBITOR (HUMAN), NOT OTHERWISE SPECIFIED, 10 MG",824.62,536.0,5.69,2129.58,19
NDC,00944-2804-04,"INJECTION, ALPHA 1 PROTEINASE INHIBITOR (HUMAN), NOT OTHERWISE SPECIFIED, 10 MG",3199.36,2079.58,5.69,8262.35,19
NDC,00944-3030-02,"INJECTION, FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER IU, NOT OTHERWISE SPECIFIED",7070.72,4595.97,1.94,18260.13,38
NDC,00944-3046-10,"ADVATE 2,401-3,600 UNIT VIAL",27543.72,17903.42,6885.93,19280.6,11
NDC,00944-3052-02,"FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U., NOT OTHERWISE SPECIFIED",2784.35,1809.83,1.69,7236.29,19
NDC,00944-3053-02,"FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U., NOT OTHERWISE SPECIFIED",5345.995,3474.895,1.69,15220.74,38
NDC,00990-7935-19,UNCLASSIFIED DRUGS,8.65,5.62,2.16,22.34,16
NDC,00990-7983-02,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",7.375,4.795,0.62,6.9,32
NDC,00990-7983-03,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",1.44,0.94,0.36,3.72,17
NDC,03700-0032-30,UNCLASSIFIED DRUGS,1.13,0.73,0.28,2.92,16
NDC,04351-0797-10,UNCLASSIFIED DRUGS,67.725,44.019999999999996,8.45,262.51,32
NDC,05446-1268-01,UNCLASSIFIED DRUGS,8.85,5.75,2.21,22.86,16
NDC,07610-0032-20,VITAMIN B-2 100 MG TABLET,4.0,2.6,1.0,2.8,11
NDC,07610-0178-40,"VITAMIN D3 5,000 UNIT TABLET",2.03,1.32,0.51,1.42,11
NDC,08065-1830-85,UNCLASSIFIED DRUGS,1752.6100000000001,1139.1999999999998,399.06,4929.94,32
NDC,08065-1831-35,UNCLASSIFIED DRUGS,636.6,413.79,159.15,1644.02,16
NDC,08065-1831-50,UNCLASSIFIED DRUGS,603.55,392.31,150.89,1558.67,16
NDC,08065-1839-75,UNCLASSIFIED DRUGS,2088.305,1357.4,487.7,5748.15,32
NDC,08290-3064-14,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",5.79,3.76,0.02,14.95,17
NDC,08290-3064-24,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",15.88,10.32,0.02,41.01,17
NDC,09999-1112-34,OMEPRAZOLE 2 MG/ML ORAL SUSPENSION COMPOUNDED [4087065],3.35,2.175,0.59,3.03,22
NDC,09999-1114-63,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.26,4.72,1.82,18.75,16
NDC,09999-1115-03,PHENYLALANINE FREE AA 9.4 % SOLUTION [4087547],7.44,4.84,1.86,5.21,11
NDC,10006-0700-13,UNCLASSIFIED DRUGS,14.65,9.52,3.66,37.83,16
NDC,10006-0730-16,UNCLASSIFIED DRUGS,3.33,2.16,0.83,8.6,16
NDC,10006-0730-38,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",59.49,38.67,14.87,153.63,16
NDC,10013-0910-97,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.025,1.9649999999999999,0.56,9.87,32
NDC,10019-0075-87,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",9.73,6.32,0.22,25.13,17
NDC,10019-0120-01,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",33.51,21.78,0.22,86.54,17
NDC,10019-0553-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",94.23,61.25,23.56,243.35,16
NDC,10019-0925-82,"INJECTION, IFOSFAMIDE, 1 GRAM",206.85,134.45,26.33,620.55,17
NDC,10019-0956-01,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",1759.01,1143.36,0.63,4542.64,17
NDC,10019-0957-01,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",4306.66,2799.33,0.63,11121.95,17
NDC,10122-0510-01,UNCLASSIFIED DRUGS,2589.79,1683.36,647.45,6688.13,16
NDC,10122-0510-03,UNCLASSIFIED DRUGS,2535.39,1648.0,633.85,6547.64,16
NDC,10122-0620-01,"INJECTION, CANGRELOR, 1 MG",5576.6849999999995,3624.845,21.14,16501.97,38
NDC,10454-0710-10,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",1582.8,1028.82,14.62,4087.58,19
NDC,10454-0711-10,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",1518.72,987.17,14.62,3922.09,19
NDC,10454-0712-10,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",1538.92,1000.3,14.62,3974.26,19
NDC,10702-0018-50,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",48.7,31.66,12.18,125.77,16
NDC,10702-0237-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.54,6.2,2.39,24.64,16
NDC,10702-0253-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.17,15.71,6.04,62.42,16
NDC,10702-0808-03,CYCLOSPORINE 0.05% EYE EMULS,193.33,125.66,48.33,135.33,11
NDC,10858-0901-00,KONSYL DAILY FIBER POWDER PKT,12.405000000000001,8.065000000000001,1.54,13.06,22
NDC,11534-0166-44,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.29,0.84,0.32,3.33,16
NDC,11701-0067-23,CRITIC-AID CLEAR AF 2% OINT,1.43,0.93,0.36,1.0,11
NDC,11845-0118-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.125,3.98,0.53,26.16,32
NDC,11917-0050-14,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.16,10.5,4.04,41.73,16
NDC,11980-0174-05,UNCLASSIFIED DRUGS,177.56,115.41499999999999,36.77,537.26,32
NDC,11980-0180-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",50.79,33.01,12.7,131.17,16
NDC,11994-0011-01,"INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML",2555.765,1661.25,42.62,6600.43,34
NDC,12165-0100-01,UNCLASSIFIED DRUGS,22.55,14.66,5.64,58.24,16
NDC,12496-0100-01,"INJECTION, BUPRENORPHINE EXTENDED-RELEASE (SUBLOCADE), GREATER THAN 100 MG",5532.44,3596.09,1383.11,14287.53,19
NDC,12496-0300-01,"INJECTION, BUPRENORPHINE EXTENDED-RELEASE (SUBLOCADE), GREATER THAN 100 MG",2753.82,1789.98,688.46,7111.74,19
NDC,12870-0001-01,UNCLASSIFIED DRUGS,29.79,19.36,7.45,76.93,16
NDC,13107-0003-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.84,13.55,5.21,53.82,16
NDC,13107-0154-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.96,13.62,5.24,54.13,16
NDC,13107-0283-01,CLORAZEPATE 7.5 MG TABLET,38.96,25.32,9.74,27.27,11
NDC,13533-0606-12,"ANTITHROMBIN III (HUMAN), PER I.U.",13067.29,8493.74,4.29,33746.28,19
NDC,13533-0634-02,"INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS",2003.125,1302.03,301.23,6778.16,38
NDC,13533-0705-01,"INJECTION, ALPHA 1 PROTEINASE INHIBITOR (HUMAN), NOT OTHERWISE SPECIFIED, 10 MG",2073.19,1347.57,5.69,5354.01,19
NDC,13533-0800-12,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",18.64,12.12,4.66,2058.35,19
NDC,13533-0800-20,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",58.37,37.94,14.59,2058.35,19
NDC,13533-0800-21,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",44.39,28.85,11.1,2058.35,19
NDC,13533-0800-41,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",53.3,34.65,13.33,2058.35,19
NDC,13533-0800-72,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",35.545,23.105,5.68,2058.35,38
NDC,13668-0007-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.95,8.42,3.24,33.44,16
NDC,13668-0008-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.5,13.33,5.13,52.94,16
NDC,13668-0010-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.85,15.5,5.96,61.59,16
NDC,13668-0091-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.045,4.58,0.6,30.16,32
NDC,13668-0093-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.36,8.035,0.63,57.33,32
NDC,13668-0094-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.9399999999999995,5.16,0.65,34.3,32
NDC,13668-0107-05,RABEPRAZOLE 20 MG TABLETDELAYED RELEASE,12.0,7.8,3.0,8.4,11
NDC,13668-0190-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",163.6,106.34,40.9,422.5,16
NDC,13668-0268-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.22,16.39,6.31,65.13,16
NDC,13668-0586-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",68.1,44.27,17.03,175.87,16
NDC,13668-0591-80,"APREPITANT, ORAL, 5 MG",478.55,311.06,2.94,1235.86,17
NDC,13668-0593-80,"APREPITANT, ORAL, 5 MG",1949.835,1267.395,2.94,5954.65,34
NDC,13925-0522-01,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",887.61,576.95,155.18,2292.25,19
NDC,14789-0011-01,UNCLASSIFIED DRUGS,397.65,258.47,99.41,1026.93,16
NDC,14789-0133-07,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",36.73,23.87,0.62,25.71,16
NDC,14789-0220-08,"INJECTION, LEVETIRACETAM, 10 MG",1.64,1.07,0.04,4.24,17
NDC,14789-0252-10,EMERPHED 50 MG/10 ML SYRINGE,12.6,8.19,3.15,8.82,11
NDC,14789-0500-10,UNCLASSIFIED DRUGS,34.41,22.37,8.6,88.86,16
NDC,14789-0900-07,"INJECTION, PROCAINAMIDE HCL, UP TO 1 GM",1220.17,793.1099999999999,160.14,4647.96,34
NDC,15054-0043-01,"INJECTION, IRINOTECAN LIPOSOME, 1 MG",2360.8,1534.52,69.92,6096.77,19
NDC,15054-0500-01,"INJECTION, ABOBOTULINUMTOXINA, 5 UNITS",4477.85,2910.6,9.68,11564.05,19
NDC,15054-0530-06,"INJECTION, ABOBOTULINUMTOXINA, 5 UNITS",2223.88,1445.52,9.68,5743.17,19
NDC,15054-1060-04,"INJECTION, LANREOTIDE, 1 MG",136179.95,88516.97,37.51,351684.72,19
NDC,15054-1120-04,"INJECTION, LANREOTIDE, 1 MG",124268.765,80774.70000000001,37.51,531785.33,38
NDC,16500-0023-22,UNCLASSIFIED DRUGS,10.8,7.02,2.7,27.89,16
NDC,16500-0088-06,PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,2.75,1.79,0.69,1.93,11
NDC,16500-0566-75,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.35,3.48,1.34,13.82,16
NDC,16571-0127-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.865,9.66,1.88,57.33,32
NDC,16571-0245-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.47,5.51,2.12,21.87,16
NDC,16571-0330-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.87,1.22,0.47,4.83,16
NDC,16571-0664-50,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.09,12.41,4.77,49.3,16
NDC,16571-0667-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.49,13.97,5.37,55.5,16
NDC,16571-0673-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.76,9.59,3.69,38.12,16
NDC,16571-0676-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.95,24.02,9.24,95.42,16
NDC,16571-0723-48,UNCLASSIFIED DRUGS,8.4,5.46,2.1,21.69,16
NDC,16571-0735-28,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",38.2,24.83,9.55,98.65,16
NDC,16571-0769-24,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.57,1.67,0.64,6.64,16
NDC,16571-0872-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.7,16.71,6.43,66.37,16
NDC,16714-0066-01,"INJECTION, ENOXAPARIN SODIUM, 10 MG",16.07,10.45,0.56,48.21,17
NDC,16714-0067-01,CARBIDOPA 25 MG TABLET,27.8,18.07,6.95,19.46,11
NDC,16714-0137-01,"INJECTION, PACLITAXEL, 1 MG",28.24,18.36,0.11,84.72,17
NDC,16714-0172-01,TIZANIDINE HCL 4 MG TABLET,5.05,3.28,1.26,3.54,11
NDC,16714-0388-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.83,13.54,5.21,53.79,16
NDC,16714-0529-01,BISOPROLOL FUMARATE 5 MG TAB,8.325,5.41,1.86,6.44,33
NDC,16714-0795-01,TERBINAFINE HCL 250 MG TABLET,42.0,27.3,10.5,29.4,11
NDC,16729-0094-16,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",15.37,9.99,0.16,39.69,17
NDC,16729-0108-11,"INJECTION, MITOMYCIN, 5 MG",1150.93,748.1,27.67,2972.28,19
NDC,16729-0115-05,"INJECTION, MITOMYCIN, 5 MG",1056.655,686.825,27.67,3922.82,38
NDC,16729-0151-31,TOPOTECAN HCL 4 MG VIAL,744.55,483.96,186.14,521.19,11
NDC,16729-0171-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.05,11.08,4.26,44.03,16
NDC,16729-0174-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.02,7.81,3.01,31.04,16
NDC,16729-0182-17,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.06,13.69,5.27,54.39,16
NDC,16729-0183-17,UNCLASSIFIED DRUGS,17.98,11.69,4.5,46.43,16
NDC,16729-0202-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.3,6.7,2.58,26.6,16
NDC,16729-0224-05,"INJECTION, DECITABINE, 1 MG",760.25,494.16,0.69,1963.35,19
NDC,16729-0242-31,"INJECTION, ZOLEDRONIC ACID, 1 MG",47.35,30.78,5.38,142.05,17
NDC,16729-0243-31,"INJECTION, TOPOTECAN, 0.1 MG",50.51,32.83,1.33,151.53,17
NDC,16729-0277-30,"INJECTION, METHOTREXATE SODIUM, 50 MG",24.265,15.77,1.6,126.39,34
NDC,16729-0443-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.06,20.84,8.02,82.8,16
NDC,16729-0449-17,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.56,16.61,6.39,66.01,16
NDC,16729-0450-15,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.09,15.01,5.77,59.63,16
NDC,16729-0456-15,UNCLASSIFIED DRUGS,26.55,17.26,6.64,68.57,16
NDC,16784-0114-02,UNCLASSIFIED DRUGS,7.54,4.9,1.89,19.47,16
NDC,16784-0116-13,UNCLASSIFIED DRUGS,9.01,5.86,2.25,23.27,16
NDC,17156-0021-01,"INDIUM IN-111 OXYQUINOLINE, DIAGNOSTIC, PER 0.5 MILLICURIE",27222.940000000002,17694.91,881.35,94278.13,34
NDC,17156-0026-30,"TECHNETIUM TC-99M TETROFOSMIN, DIAGNOSTIC, PER STUDY DOSE",570.37,370.745,123.91,1769.32,34
NDC,17156-0210-01,"IODINE 1-123 IOFLUPANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 5 MILLICURIES",4688.55,3047.56,1172.14,14144.89,17
NDC,17156-0235-01,"IODINE I-123 IOBENGUANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",31395.35,20406.98,2456.55,81078.49,17
NDC,17156-0251-08,INDIUM IN-111 DTPA SOLUTION,18543.96,12053.57,4635.99,12980.77,11
NDC,17238-0900-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.96,18.82,7.24,74.79,16
NDC,17238-0900-99,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.3,13.85,5.33,55.01,16
NDC,17478-0215-02,UNCLASSIFIED DRUGS,136.17,88.51,34.04,351.66,16
NDC,17478-0253-10,UNCLASSIFIED DRUGS,74.4,48.36,18.6,192.14,16
NDC,17478-0380-20,"INJECTION, METHADONE HCL, UP TO 10 MG",179.18,116.47,18.76,462.73,17
NDC,17478-0711-31,UNCLASSIFIED DRUGS,33.57,21.82,8.39,86.69,16
NDC,17478-0763-06,DRONABINOL 10 MG CAPSULE [9903],35.9,23.34,8.98,25.13,11
NDC,17478-0830-05,LOTEPREDNOL ETABONATE 0.5 % EYE GEL DROPS [163075],1077.5,700.38,269.38,754.25,11
NDC,17772-0131-07,QELBREE ER 100 MG CAPSULE,81.93,53.25,20.48,57.35,11
NDC,17772-0133-07,QELBREE ER 200 MG CAPSULE,77.62,50.45,19.41,54.33,11
NDC,17856-3555-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.46,10.05,3.87,39.93,16
NDC,18657-0117-02,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",372.86,242.36,0.38,962.91,17
NDC,18657-0117-04,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",303.08,197.0,0.38,782.7,17
NDC,19515-0904-41,FLULAVAL 2025-2026 SYRINGE,363.22,236.09,90.81,254.25,11
NDC,20555-0001-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.35,6.074999999999999,0.91,38.87,32
NDC,20555-0032-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.13,7.88,3.03,31.33,16
NDC,20555-0033-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.65,2.37,0.91,9.43,16
NDC,20555-0040-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.6,2.99,1.15,11.88,16
NDC,21922-0016-05,UNCLASSIFIED DRUGS,1.66,1.08,0.42,4.29,16
NDC,21922-0025-05,KETOCONAZOLE 2% CREAM,2.19,1.42,0.55,1.53,11
NDC,21922-0063-30,UNCLASSIFIED DRUGS,1.59,1.03,0.4,4.11,16
NDC,23155-0003-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.95,2.57,0.99,10.2,16
NDC,23155-0009-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.885,7.7250000000000005,0.92,51.86,32
NDC,23155-0026-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.835,5.745,1.39,31.25,32
NDC,23155-0070-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.865,3.8099999999999996,1.08,19.11,32
NDC,23155-0071-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.645,4.970000000000001,0.94,29.75,32
NDC,23155-0102-05,UNCLASSIFIED DRUGS,2.79,1.81,0.7,7.21,16
NDC,23155-0147-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.015,4.5600000000000005,1.13,24.61,32
NDC,23155-0166-31,UNCLASSIFIED DRUGS,10.66,6.93,2.67,27.53,16
NDC,23155-0194-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.3,6.05,2.33,24.02,16
NDC,23155-0216-31,"INJECTION, CIDOFOVIR, 375 MG",954.85,620.65,238.71,2465.9,19
NDC,23155-0229-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.57,2.32,0.89,9.22,16
NDC,23155-0240-31,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",49.0,31.85,1.14,126.54,17
NDC,23155-0290-31,"INJECTION, AMIKACIN SULFATE, 100 MG",7.56,4.91,0.66,19.52,17
NDC,23155-0313-31,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",299.25,194.51,27.13,772.81,17
NDC,23155-0486-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.385,4.15,1.51,17.35,32
NDC,23155-0489-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.43,3.53,1.36,14.02,16
NDC,23155-0490-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.85,8.35,3.21,33.19,16
NDC,23155-0502-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.725,6.32,1.01,39.77,32
NDC,23155-0512-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.78,8.96,3.45,35.59,16
NDC,23155-0530-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.74,5.68,2.19,22.57,16
NDC,23155-0547-31,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",32.56,21.16,0.1,97.68,17
NDC,23155-0647-31,"INJECTION, CARMUSTINE, 100 MG",433.0,281.45,108.25,2922.83,19
NDC,23155-0662-01,"CALCITROL, 0.25 MICROGRAM",4.47,2.91,1.12,11.54,16
NDC,23155-0693-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.51,10.08,3.88,40.05,16
NDC,23155-0704-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.625,4.96,1.24,26.6,32
NDC,23155-0705-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.05,2.63,1.01,10.46,16
NDC,23155-0735-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.95,5.17,1.99,20.53,16
NDC,23155-0736-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.51,6.185,0.87,40.16,32
NDC,23155-0737-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.45,6.79,2.61,26.99,16
NDC,23155-0738-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.279999999999999,4.734999999999999,1.01,27.17,32
NDC,23155-0764-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
NDC,23155-0767-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.72,12.82,4.93,50.93,16
NDC,23155-0771-31,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",101.5,65.98,7.11,262.12,19
NDC,23155-0772-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.215,4.6899999999999995,1.06,26.34,32
NDC,23155-0773-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.47,2.91,1.12,11.54,16
NDC,23155-0833-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.3,4.75,1.83,18.85,16
NDC,23155-0871-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.58,1.68,0.65,6.66,16
NDC,23155-0875-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.03,16.92,6.51,67.22,16
NDC,23155-0939-63,TETRABENAZINE 25 MG TABLET,20.53,13.34,5.13,14.37,11
NDC,24201-0100-01,"INJECTION, ACETAMINOPHEN, NOT OTHERWISE SPECIFIED,10 MG",6.285,4.085,0.06,24.9,34
NDC,24208-0040-40,XIPERE 40 MG/ML VIAL,4610.6,2996.89,1152.65,3227.42,11
NDC,24208-0276-15,UNCLASSIFIED DRUGS,6.355,4.13,0.87,23.84,32
NDC,24208-0290-05,UNCLASSIFIED DRUGS,38.99,25.34,9.75,100.69,16
NDC,24208-0315-10,UNCLASSIFIED DRUGS,4.27,2.78,1.07,11.03,16
NDC,24208-0385-55,UNCLASSIFIED DRUGS,25.835,16.79,3.88,93.33,32
NDC,24208-0398-30,UNCLASSIFIED DRUGS,10.29,6.69,2.57,26.57,16
NDC,24208-0457-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.795,8.965,2.65,43.9,32
NDC,24208-0463-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",44.65,29.02,11.16,115.31,16
NDC,24208-0486-10,UNCLASSIFIED DRUGS,9.19,5.97,2.3,23.73,16
NDC,24208-0539-20,UNCLASSIFIED DRUGS,427.07,277.6,43.43,1427.45,48
NDC,24208-0555-55,UNCLASSIFIED DRUGS,62.23,40.45,15.56,160.71,16
NDC,24208-0590-64,UNCLASSIFIED DRUGS,3.85,2.5,0.96,9.94,16
NDC,24208-0602-03,PROLENSA 0.07% EYE DROPS,537.54,349.405,70.58,554.95,22
NDC,24208-0635-62,UNCLASSIFIED DRUGS,21.9,14.24,5.48,56.56,16
NDC,24208-0697-62,PRESERVISION AREDS 2 SOFTGEL,5.2,3.38,1.3,3.64,11
NDC,24208-0720-02,UNCLASSIFIED DRUGS,61.165000000000006,39.760000000000005,12.77,184.03,32
NDC,24208-0730-06,UNCLASSIFIED DRUGS,7.51,4.88,1.88,19.39,16
NDC,24208-0735-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",33.775,21.955000000000002,3.06,142.81,32
NDC,24208-0780-55,UNCLASSIFIED DRUGS,31.22,20.29,7.81,80.63,16
NDC,24208-0795-35,UNCLASSIFIED DRUGS,42.63,27.71,10.66,110.09,16
NDC,24208-0830-60,UNCLASSIFIED DRUGS,20.415,13.27,3.95,64.67,32
NDC,24208-0910-19,UNCLASSIFIED DRUGS,91.89,59.73,22.97,237.31,16
NDC,24338-0110-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",89.45,58.14,22.36,231.0,16
NDC,24338-0230-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",74.25,48.26,18.56,191.75,16
NDC,24338-0260-08,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",73.51,47.78,18.38,189.84,16
NDC,24510-0050-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",62.025000000000006,40.315,9.42,223.05,32
NDC,24979-0027-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.16,3.35,1.29,13.33,16
NDC,24979-0028-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.07,3.3,1.27,13.09,16
NDC,24979-0029-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.035,9.125,1.32,58.88,32
NDC,24979-0186-46,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.57,15.97,6.14,63.45,16
NDC,25021-0053-01,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",112.39,73.05,0.12,337.17,17
NDC,25021-0100-10,"INJECTION, CEFAZOLIN SODIUM, 500 MG",133.36,86.685,0.88,640.59,34
NDC,25021-0109-10,"INJECTION, CEFOXITIN SODIUM, 1 GM",49.085,31.904999999999998,3.25,220.0,34
NDC,25021-0110-20,"INJECTION, CEFOXITIN SODIUM, 1 GM",128.37,83.44,5.02,517.15,51
NDC,25021-0132-81,"INJECTION, LEVOFLOXACIN, 250 MG",2.68,1.74,0.67,6.92,17
NDC,25021-0132-82,"INJECTION, LEVOFLOXACIN, 250 MG",1.41,0.92,0.35,3.64,17
NDC,25021-0132-82,LEVOFLOXACIN 500 MG/100 ML-D5W,1.91,1.24,0.48,1.34,11
NDC,25021-0132-83,"INJECTION, LEVOFLOXACIN, 250 MG",7.28,4.73,1.82,18.8,17
NDC,25021-0173-02,"INJECTION, AMIKACIN SULFATE, 100 MG",82.36,53.53,0.66,212.69,17
NDC,25021-0179-15,"INJECTION, DAPTOMYCIN, 1 MG",258.81,168.23,0.03,668.38,17
NDC,25021-0179-16,"INJECTION, DAPTOMYCIN, 1 MG",76.63,49.81,0.03,197.9,17
NDC,25021-0180-10,"INJECTION, AZITHROMYCIN, 500 MG",139.05,90.38,2.16,359.1,17
NDC,25021-0184-82,"INJECTION FLUCONAZOLE, 200 MG",1.34,0.87,0.3,4.75,51
NDC,25021-0184-87,"INJECTION FLUCONAZOLE, 200 MG",7.97,5.18,1.99,20.58,17
NDC,25021-0185-10,"INJECTION, GANCICLOVIR SODIUM, 500 MG",95.9,62.34,23.98,247.66,17
NDC,25021-0204-01,"INJECTION, VINORELBINE TARTRATE, 10 MG",32.56,21.16,5.77,97.68,17
NDC,25021-0207-51,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",10.34,6.72,2.59,31.02,17
NDC,25021-0239-52,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",9.74,6.33,2.44,29.22,17
NDC,25021-0247-50,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",863.03,560.97,0.63,2228.78,17
NDC,25021-0255-50,"INJECTION, PACLITAXEL, 1 MG",6.25,4.06,0.11,18.75,17
NDC,25021-0313-82,"INJECTION, MILRINONE LACTATE, 5 MG",2.16,1.4,0.54,5.58,17
NDC,25021-0317-20,"INJECTION, LABETALOL HYDROCHLORIDE, 5 MG",115.7,75.21,0.37,298.8,17
NDC,25021-0318-02,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",28.89,18.78,0.56,74.61,17
NDC,25021-0319-05,UNCLASSIFIED DRUGS,52.97,34.43,13.24,136.8,16
NDC,25021-0415-10,UNCLASSIFIED DRUGS,43.65,28.37,10.91,112.73,16
NDC,25021-0418-82,UNCLASSIFIED DRUGS,1.53,0.99,0.38,3.95,16
NDC,25021-0468-10,UNCLASSIFIED DRUGS,583.05,378.98,145.76,1505.73,16
NDC,25021-0481-01,"INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG",127.58,82.93,0.75,329.48,17
NDC,25021-0500-02,"INJECTION, THIAMINE HCL, 100 MG",17.44,11.34,1.92,45.04,17
NDC,25021-0601-03,"INJECTION, CAFFEINE CITRATE, 5 MG",17.47,11.36,2.15,45.12,17
NDC,25021-0661-10,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",12.1,7.87,0.15,31.25,17
NDC,25021-0676-20,"INJECTION, PENTOBARBITAL SODIUM, PER 50 MG",230.09,149.56,38.44,594.21,19
NDC,25021-0676-50,"INJECTION, PENTOBARBITAL SODIUM, PER 50 MG",229.98,149.49,38.44,593.92,19
NDC,25021-0679-20,"INJECTION, BACLOFEN, 10 MG",32.89,21.38,8.22,741.6,19
NDC,25021-0681-71,"INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL",193.6,125.84,48.4,499.97,17
NDC,25021-0682-20,UNCLASSIFIED DRUGS,49.01,31.86,12.25,126.57,16
NDC,25021-0790-02,"INJECTION, PROCHLORPERAZINE, UP TO 10 MG",43.575,28.325,2.67,145.78,34
NDC,25021-0797-05,UNCLASSIFIED DRUGS,42.0,27.3,10.5,108.47,16
NDC,25021-0798-10,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",45.08,29.3,1.42,213.24,34
NDC,25021-0812-30,"INJECTION, ACETYLCYSTEINE, 100 MG",25.0,16.25,0.39,64.56,17
NDC,25021-0816-30,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",173.315,112.655,4.07,761.19,34
NDC,25021-0826-82,"INJECTION, ZOLEDRONIC ACID, 1 MG",2.9299999999999997,1.905,0.63,10.05,34
NDC,25357-0025-03,"RIBOFLAVIN 5'-PHOSPHATE, OPHTHALMIC SOLUTION (PHOTREXA VISCOUS/PHOTREXA), UP TO 3 ML",978.81,636.23,244.7,2900.16,17
NDC,25682-0001-01,"INJECTION, ECULIZUMAB, 2 MG",1866.7450000000001,1213.385,47.73,6941.4,34
NDC,25682-0025-01,"INJECTION, RAVULIZUMAB-CWVZ, 10 MG",8543.64,5553.37,238.29,35052.23,19
NDC,27241-0049-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.7,6.31,2.43,25.05,16
NDC,27241-0063-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",61.43,39.93,15.36,158.64,16
NDC,27241-0155-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.08,6.55,2.52,26.03,16
NDC,27241-0156-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.045,5.2299999999999995,0.81,33.16,32
NDC,27241-0160-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.95,3.87,1.49,15.37,16
NDC,27241-0161-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.5,7.48,2.88,29.7,16
NDC,27241-0168-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.3,4.75,1.83,18.85,16
NDC,27241-0249-49,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.26,11.22,4.32,44.57,16
NDC,27241-0286-01,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",9.46,6.15,0.83,24.43,17
NDC,27241-0287-01,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",21.75,14.14,0.83,56.17,17
NDC,27808-0065-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.07,2.65,1.02,10.51,16
NDC,27808-0199-01,DROXIDOPA 100 MG CAPSULE,11.3,7.35,2.83,7.91,11
NDC,28595-0120-49,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",126.21,82.035,28.89,353.42,32
NDC,29300-0128-01,UNCLASSIFIED DRUGS,4.76,3.09,1.19,12.29,16
NDC,29300-0131-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.405000000000001,9.36,2.66,46.9,32
NDC,29300-0169-10,TIZANIDINE HCL 4 MG TABLET,5.25,3.41,1.31,3.68,11
NDC,29300-0171-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.68,3.69,1.42,14.67,16
NDC,29300-0213-13,IRBESARTAN 150 MG TABLET,5.6,3.64,1.4,3.92,11
NDC,29300-0220-19,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.43,10.68,4.11,42.43,16
NDC,29300-0245-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.44,2.24,0.86,8.88,16
NDC,29300-0413-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.4,4.81,1.85,19.11,16
NDC,29300-0420-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.3,3.45,1.33,13.69,16
NDC,30698-0477-01,HIPREX 1 GM TABLET,18.4,11.96,4.6,12.88,11
NDC,31722-0005-30,UNCLASSIFIED DRUGS,27.77,18.05,6.94,71.72,16
NDC,31722-0006-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.855,3.8099999999999996,0.81,21.87,32
NDC,31722-0016-47,UNCLASSIFIED DRUGS,3.44,2.24,0.86,8.88,16
NDC,31722-0035-23,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.75,31.04,11.94,123.31,16
NDC,31722-0054-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",71.23,46.3,17.81,183.95,16
NDC,31722-0067-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.7,14.11,5.43,56.04,16
NDC,31722-0092-90,GABAPENTIN ER 600 MG TABLET,20.85,13.55,5.21,14.6,11
NDC,31722-0117-02,UNCLASSIFIED DRUGS,49.12,31.93,12.28,126.85,16
NDC,31722-0151-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.81,17.43,6.7,69.24,16
NDC,31722-0276-30,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",4.18,2.72,0.01,10.79,17
NDC,31722-0308-01,"INJECTION, OLANZAPINE, 0.5 MG",207.78500000000003,135.06,0.86,857.31,34
NDC,31722-0529-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.56,4.91,1.89,19.52,16
NDC,31722-0532-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",43.2,28.08,10.8,111.56,16
NDC,31722-0574-47,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.08,1.35,0.52,5.37,16
NDC,31722-0629-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.24,4.705,1.73,19.5,32
NDC,31722-0681-47,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.86,1.21,0.47,4.8,16
NDC,31722-0682-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.59,4.28,1.65,17.02,16
NDC,31722-0702-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.9,7.09,2.73,28.15,16
NDC,31722-0705-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.8,14.82,5.7,58.88,16
NDC,31722-0727-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.2,2.73,1.05,10.85,16
NDC,31722-0749-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",41.15,26.75,10.29,106.27,16
NDC,31722-0777-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.97,3.23,1.24,12.84,16
NDC,31722-0778-01,UNCLASSIFIED DRUGS,4.77,3.1,1.19,12.32,16
NDC,31722-0822-11,TETRABENAZINE 25 MG TABLET,20.69,13.45,5.17,14.48,11
NDC,31722-0832-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.15,13.1,5.04,52.04,16
NDC,31722-0833-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.130000000000003,11.785,2.56,67.22,32
NDC,31722-0873-90,PIRFENIDONE 801 MG TABLET,45.15,29.35,11.29,31.61,11
NDC,31722-0899-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.8,17.42,6.7,69.21,16
NDC,31722-0981-10,"INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG",44.5,28.93,1.64,114.92,17
NDC,33342-0001-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.2,11.83,4.55,47.0,16
NDC,33342-0002-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.16,13.105,2.66,76.62,32
NDC,33342-0025-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.6,3.64,1.4,14.46,16
NDC,33342-0083-07,UNCLASSIFIED DRUGS,25.89,16.83,6.47,66.86,16
NDC,33342-0084-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.8,10.27,3.95,40.8,16
NDC,33342-0091-09,RIVASTIGMINE 4.5 MG CAPSULE,5.6,3.64,1.4,3.92,11
NDC,33342-0093-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.41,11.97,4.6,47.54,16
NDC,33342-0094-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.19,15.07,5.8,59.89,16
NDC,33342-0096-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.6,8.19,2.8,36.16,32
NDC,33342-0111-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.81,1.825,0.42,10.15,32
NDC,33342-0554-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.15,13.75,5.29,54.62,16
NDC,35046-0003-22,MAGNESIUM GLUC 500 MG TABLET,3.95,2.57,0.99,2.77,11
NDC,35356-0532-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",40.01,26.01,10.0,103.33,16
NDC,35573-0428-51,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.53,10.09,3.88,40.11,16
NDC,35573-0433-02,KETOCONAZOLE 200 MG TABLET,31.55,20.51,7.89,22.09,11
NDC,36000-0033-10,UNCLASSIFIED DRUGS,15.94,10.36,3.99,41.17,16
NDC,36000-0284-25,"INJECTION, FUROSEMIDE, 1 MG",4.61,3.0,0.02,11.91,17
NDC,37000-0023-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.0,14.95,5.75,59.4,16
NDC,37000-0023-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.18,4.67,1.8,18.54,16
NDC,38779-0068-08,CITRIC ACID POWDER,1.67,1.09,0.42,1.17,11
NDC,38779-0629-09,UNCLASSIFIED DRUGS,1.62,1.05,0.41,4.18,16
NDC,38779-1284-05,UNCLASSIFIED DRUGS,6.96,4.52,1.74,17.97,16
NDC,39328-0058-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.4449999999999998,0.94,0.29,4.49,32
NDC,39328-0106-10,UNCLASSIFIED DRUGS,4.41,2.87,1.1,11.39,16
NDC,39328-0530-99,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.73,1.12,0.43,4.47,16
NDC,39822-0151-01,UNCLASSIFIED DRUGS,1693.5,1100.775,201.79,6662.46,32
NDC,39822-0250-01,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",325.96,211.87,0.63,841.79,17
NDC,39822-0412-01,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",150.86,98.06,2.19,389.6,17
NDC,39822-1055-05,"INJECTION, AMPHOTERICIN B, 50 MG",254.59,165.48,45.89,657.48,17
NDC,39822-1100-01,UNCLASSIFIED DRUGS,20.07,13.05,5.02,51.83,16
NDC,40093-0101-44,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.24,2.11,0.81,8.37,16
NDC,40985-0211-54,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.95,2.57,0.99,10.2,16
NDC,40985-0274-95,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.05,2.63,1.01,10.46,16
NDC,41100-0811-25,UNCLASSIFIED DRUGS,100.5,65.33,25.13,259.54,16
NDC,41167-0006-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.31,3.45,1.33,13.71,16
NDC,41167-4120-00,ALLEGRA ALLERGY 180 MG TABLET,12.3,8.0,3.08,8.61,11
NDC,41616-0931-40,UNCLASSIFIED DRUGS,14.42,9.37,3.61,37.24,16
NDC,42023-0104-01,UNCLASSIFIED DRUGS,1172.0,761.8,293.0,3026.69,16
NDC,42023-0105-01,UNCLASSIFIED DRUGS,1257.425,817.325,223.51,4185.79,32
NDC,42023-0115-10,UNCLASSIFIED DRUGS,46.45,30.19,11.61,119.96,16
NDC,42023-0157-01,UNCLASSIFIED DRUGS,23888.03,15527.22,5972.01,61690.84,16
NDC,42023-0159-01,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",128.1,83.27,32.03,330.82,16
NDC,42023-0159-25,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",65.94,42.86,16.49,170.29,16
NDC,42023-0164-01,"INJECTION, VASOPRESSIN, 1 UNIT",470.8,306.02,0.56,1215.84,17
NDC,42023-0168-01,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",24.244999999999997,15.760000000000002,5.63,67.12,32
NDC,42023-0237-01,"INJECTION, VASOPRESSIN, 1 UNIT",5.19,3.37,0.56,13.4,17
NDC,42023-0237-10,"INJECTION, VASOPRESSIN, 1 UNIT",1.93,1.25,0.48,4.98,17
NDC,42023-0622-01,"INJECTION, BIVALIRUDIN, 1 MG",8.49,5.52,2.12,158.28,90
NDC,42023-0622-10,"INJECTION, BIVALIRUDIN, 1 MG",8.02,5.21,0.17,158.28,55
NDC,42192-0338-01,UNCLASSIFIED DRUGS,6.91,4.49,1.73,17.85,16
NDC,42192-0608-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.365,2.19,0.47,12.55,32
NDC,42192-0614-05,"INJECTION, PHENYTOIN SODIUM, PER 50 MG",57.0,37.05,0.64,147.2,17
NDC,42192-0626-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.99,6.49,2.5,25.8,16
NDC,42385-0953-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",418.35,271.93,104.59,1080.39,16
NDC,42388-0024-26,CABOMETYX 20 MG TABLET,5971.55,3881.51,1492.89,4180.09,11
NDC,42515-0002-01,IXIARO 6 UNIT(6 MCG)/0.5ML SYR,385.0,250.25,96.25,269.5,11
NDC,42571-0137-25,UNCLASSIFIED DRUGS,354.07,230.15,88.52,914.39,16
NDC,42571-0176-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.15,9.85,3.79,39.12,16
NDC,42571-0243-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.46,23.05,8.87,91.58,16
NDC,42571-0315-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.33,5.41,2.08,21.51,16
NDC,42571-0332-01,METHENAMINE HIPP 1 GM TABLET,50.8,33.02,12.7,35.56,11
NDC,42571-0344-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.53,2.94,1.13,11.7,16
NDC,42658-0010-01,CLADRIBINE 10 MG/10 ML VIAL,54.415,35.370000000000005,10.51,46.76,22
NDC,42658-0021-01,"INJECTION, DAUNORUBICIN, 10 MG",76.63,49.81,15.67,271.8,38
NDC,42702-0102-15,UNCLASSIFIED DRUGS,14.7,9.56,3.68,37.96,16
NDC,42747-0761-01,"INJECTION, MOGAMULIZUMAB-KPKC, 1 MG",5352.17,3478.91,268.68,13821.98,19
NDC,42794-0005-02,AMILORIDE HCL 5 MG TABLET,11.2,7.28,2.8,7.84,11
NDC,42794-0018-12,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.71,6.31,2.43,25.08,16
NDC,42794-0019-12,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.76,10.89,4.19,43.28,16
NDC,42806-0150-33,"AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM",3.5149999999999997,2.285,0.53,13.81,34
NDC,42806-0270-98,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.97,24.68,9.49,98.06,16
NDC,42806-0339-01,UNCLASSIFIED DRUGS,16.39,10.65,4.1,42.33,16
NDC,42806-0358-01,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",8.0,5.2,2.0,24.0,17
NDC,42806-0513-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",80.04,52.03,20.01,206.7,16
NDC,42806-0547-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.66,3.03,1.17,12.03,16
NDC,42806-0799-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.65,16.02,6.16,63.66,16
NDC,42852-0001-28,"INJECTION, BEVACIZUMAB, 0.25 MG",1662.215,1080.44,1.95,6541.47,34
NDC,42858-0118-30,UNCLASSIFIED DRUGS,156.09,101.46,39.02,403.1,16
NDC,42858-0301-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",70.64,45.92,17.66,182.43,16
NDC,42858-0302-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.93,12.95,4.98,51.47,16
NDC,42858-0353-40,UNCLASSIFIED DRUGS,337.1,219.12,84.28,870.56,16
NDC,43063-0547-79,CIPROFLOXACIN HCL 500 MG TAB,5.75,3.74,1.44,4.03,11
NDC,43063-0906-20,TERBINAFINE HCL 250 MG TABLET,11.15,7.25,2.79,7.81,11
NDC,43066-0021-10,UNCLASSIFIED DRUGS,3.05,1.98,0.76,7.88,16
NDC,43066-0127-05,UNCLASSIFIED DRUGS,4.58,2.98,1.15,11.83,16
NDC,43066-0150-10,"INJECTION, AMIODARONE HYDROCHLORIDE (NEXTERONE), 30 MG",2.56,1.66,0.64,6.61,17
NDC,43066-0360-20,NEXTERONE 360 MG/200 ML BAG,2.04,1.33,0.51,1.43,22
NDC,43386-0405-03,NITAZOXANIDE 500 MG TABLET,346.6,225.29,86.65,242.62,11
NDC,43386-0770-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",126.13,81.98,31.53,325.73,16
NDC,43528-0003-01,"Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use",1806.96,1174.52,25.0,4727.78,57
NDC,43547-0269-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.8,3.12,1.2,12.4,16
NDC,43547-0270-50,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.4,3.51,1.35,13.95,16
NDC,43547-0272-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.37,2.84,1.09,11.29,16
NDC,43547-0275-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.61,3.0,1.15,11.91,16
NDC,43547-0276-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.35,2.83,1.09,11.23,16
NDC,43547-0280-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.130000000000001,4.635,1.03,26.21,32
NDC,43547-0288-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.23,9.25,3.56,36.75,16
NDC,43547-0345-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.635,4.965,0.89,30.27,32
NDC,43547-0346-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",46.6,30.29,1.51,225.14,32
NDC,43547-0368-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.34,9.32,3.59,37.03,16
NDC,43547-0386-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.7,14.11,5.43,56.04,16
NDC,43547-0387-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.35,3.48,1.34,13.82,16
NDC,43547-0403-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.24,7.96,1.05,52.42,32
NDC,43547-0548-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.11,10.47,4.03,41.6,16
NDC,43547-0603-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",89.27,58.03,22.32,230.54,16
NDC,43598-0051-11,"INJECTION, CALCITONIN SALMON, UP TO 400 UNITS",2485.42,1615.52,621.36,6418.6,19
NDC,43598-0106-11,"INJECTION, DIAZEPAM, UP TO 5 MG",117.55,76.41,7.09,303.57,17
NDC,43598-0126-11,UNCLASSIFIED DRUGS,3.93,2.55,0.98,10.15,16
NDC,43598-0128-11,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",217.98,141.69,0.28,562.93,17
NDC,43598-0129-01,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",21.45,13.94,0.28,55.39,17
NDC,43598-0142-06,"INJECTION, NELARABINE, 50 MG",37.77,24.549999999999997,4.95,7236.29,38
NDC,43598-0164-05,UNCLASSIFIED DRUGS,103.55,67.31,25.89,267.42,16
NDC,43598-0262-23,"INJECTION, FULVESTRANT, 25 MG",72.43,47.08,6.06,202.84,19
NDC,43598-0326-75,UNCLASSIFIED DRUGS,36.87,23.97,9.12,159.81,48
NDC,43598-0339-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.52,10.74,4.13,42.66,16
NDC,43598-0352-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",300.6,195.39,75.15,776.3,16
NDC,43598-0391-50,"INJECTION, MELPHALAN HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 50 MG",179.79,116.86,44.95,1578.71,19
NDC,43598-0393-35,UNCLASSIFIED DRUGS,1.72,1.12,0.43,4.44,16
NDC,43598-0405-11,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",144.91,94.19,2.98,374.23,17
NDC,43598-0580-01,"BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 3 MG, BUT LESS THAN OR EQUAL TO 6 MG BUPRENORPHINE",17.4,11.31,4.35,44.94,17
NDC,43598-0582-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.37,22.99,8.84,91.34,16
NDC,43598-0588-11,UNCLASSIFIED DRUGS,123.47999999999999,80.25999999999999,24.69,382.73,32
NDC,43598-0601-60,DASATINIB 70 MG TABLET,3107.2,2019.68,776.8,2175.04,11
NDC,43598-0635-10,"INJECTION, LEVETIRACETAM, 10 MG",1.53,0.99,0.04,3.95,17
NDC,43598-0635-52,"INJECTION, LEVETIRACETAM, 10 MG",2.71,1.76,0.04,7.0,17
NDC,43598-0637-52,"INJECTION, LEVETIRACETAM, 10 MG",4.71,3.06,0.04,12.16,17
NDC,43598-0685-30,ESLICARBAZEPINE 400 MG TABLET,61.25,39.81,15.31,42.88,11
NDC,43598-0698-11,UNCLASSIFIED DRUGS,434.78,282.61,108.7,1122.82,16
NDC,43598-0698-58,UNCLASSIFIED DRUGS,101.9,66.24,25.48,263.16,16
NDC,43598-0725-25,UNCLASSIFIED DRUGS,106.71,69.36,26.68,275.58,16
NDC,43825-0200-01,TERLIVAZ 0.85 MG VIAL,4646.075000000001,3019.95,611.33,4792.8,22
NDC,43975-0305-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.67,13.44,5.17,53.38,16
NDC,43975-0322-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",126.96,82.52,31.74,327.87,16
NDC,43975-0444-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.64,3.02,1.16,11.98,16
NDC,44087-3535-01,"INJECTION, AVELUMAB, 10 MG",923.8,600.47,111.29,7236.29,19
NDC,44206-0251-91,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",5.93,3.85,1.48,185.91,19
NDC,44206-0310-50,"INFUSION, ALBUMIN (HUMAN), 5%, 50 ML",1.46,0.95,0.37,185.91,19
NDC,44206-0436-05,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",121.92,79.25,30.48,2058.35,19
NDC,44206-0439-40,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",176.18,114.52,44.05,2058.35,19
NDC,44567-0101-10,"INJECTION, AMPICILLIN SODIUM, 500 MG",144.86,94.16,0.63,374.1,17
NDC,44567-0103-10,"INJECTION, AMPICILLIN SODIUM, 500 MG",126.8,82.42,0.63,327.46,17
NDC,44567-0104-01,"INJECTION, AMPICILLIN SODIUM, 500 MG",978.94,636.31,0.63,2528.11,17
NDC,44567-0235-25,"INJECTION, CEFTAZIDIME, PER 500 MG",318.475,207.01,1.56,1310.62,34
NDC,44567-0236-10,"INJECTION, CEFTAZIDIME, PER 500 MG",37.9,24.64,1.56,267.03,51
NDC,44567-0245-25,"INJECTION, CEFOXITIN SODIUM, 1 GM",494.35,321.33,5.02,1276.66,17
NDC,44567-0247-10,"INJECTION, CEFOXITIN SODIUM, 1 GM",429.265,279.02,5.02,1930.5,34
NDC,44567-0421-24,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",1.65,1.07,0.41,4.26,17
NDC,44567-0451-10,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",5.3,3.45,0.22,13.69,17
NDC,44567-0600-04,UNCLASSIFIED DRUGS,46.535,30.245,3.5,1351.22,64
NDC,44567-0611-01,"INJECTION, MIDAZOLAM IN 0.9% SODIUM CHLORIDE, INTRAVENOUS, NOT THERAPEUTICALLY EQUIVALENT TO J2250, 1 MG",1.6,1.04,0.19,4.13,17
NDC,44567-0611-10,"INJECTION, MIDAZOLAM IN 0.9% SODIUM CHLORIDE, INTRAVENOUS, NOT THERAPEUTICALLY EQUIVALENT TO J2250, 1 MG",1.5,0.98,0.19,3.87,17
NDC,44567-0620-01,"INJECTION, CALCIUM GLUCONATE (WG CRITICAL CARE), NOT THERAPEUTICALLY EQUIVALENT TO J0612, 10 MG",4.49,2.92,0.1,12.73,51
NDC,44567-0621-24,"INJECTION, CALCIUM GLUCONATE (WG CRITICAL CARE), NOT THERAPEUTICALLY EQUIVALENT TO J0612, 10 MG",1.25,0.81,0.1,3.23,17
NDC,44567-0705-01,"INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG",266.38,173.15,7.53,687.93,17
NDC,45567-0030-01,"TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, PER STUDY DOSE, UP TO 20 MILLICURIES",7661.41,4979.92,796.48,25276.73,34
NDC,45567-0455-01,"TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",218.16500000000002,141.81,53.3,673.22,34
NDC,45802-0046-35,UNCLASSIFIED DRUGS,7.72,5.02,1.93,19.94,16
NDC,45802-0049-35,UNCLASSIFIED DRUGS,3.12,2.03,0.5,10.95,32
NDC,45802-0054-36,UNCLASSIFIED DRUGS,3.97,2.58,0.99,10.25,16
NDC,45802-0055-05,UNCLASSIFIED DRUGS,4.42,2.87,1.11,11.41,16
NDC,45802-0056-35,UNCLASSIFIED DRUGS,18.78,12.21,4.7,48.5,16
NDC,45802-0059-11,UNCLASSIFIED DRUGS,4.78,3.11,1.2,12.34,16
NDC,45802-0060-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.7,1.11,0.43,4.39,16
NDC,45802-0063-36,UNCLASSIFIED DRUGS,1.41,0.92,0.35,3.64,16
NDC,45802-0065-35,UNCLASSIFIED DRUGS,5.2,3.38,1.3,13.43,16
NDC,45802-0098-46,UNCLASSIFIED DRUGS,1.81,1.18,0.45,4.67,16
NDC,45802-0122-46,UNCLASSIFIED DRUGS,9.55,6.21,2.39,24.66,16
NDC,45802-0410-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",96.73,62.87,24.18,249.81,16
NDC,45802-0465-64,KETOCONAZOLE 2% SHAMPOO,1.79,1.16,0.45,1.25,11
NDC,45802-0562-02,UNCLASSIFIED DRUGS,1.56,1.01,0.35,4.47,32
NDC,45802-0578-84,UNCLASSIFIED DRUGS,113.95,74.07,28.49,294.28,16
NDC,45802-0700-00,TACROLIMUS 0.1% OINTMENT,11.42,7.42,2.86,7.99,11
NDC,45802-0730-00,UNCLASSIFIED DRUGS,5.75,3.74,1.44,14.85,16
NDC,45802-0730-30,UNCLASSIFIED DRUGS,17.1,11.12,4.28,44.16,16
NDC,45802-0732-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.8,7.67,2.95,30.47,16
NDC,45802-0758-30,UNCLASSIFIED DRUGS,96.07499999999999,62.45,22.58,263.03,32
NDC,45802-0880-94,UNCLASSIFIED DRUGS,1.32,0.86,0.33,3.41,16
NDC,45802-0953-01,DICLOFENAC SODIUM 1% GEL,9.44,6.14,2.36,6.61,11
NDC,45963-0418-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.55,11.41,4.39,45.32,16
NDC,45963-0438-64,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.77,1.8,0.69,7.15,16
NDC,45963-0676-96,UNCLASSIFIED DRUGS,13.8,8.97,3.45,35.64,16
NDC,45963-0678-11,UNCLASSIFIED DRUGS,20.7,13.46,5.18,53.46,16
NDC,46122-0221-71,UNCLASSIFIED DRUGS,5.0,3.25,1.25,12.91,16
NDC,46122-0457-73,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.1,23.47,9.03,93.23,16
NDC,46122-0616-04,OMEPRAZOLE DR 20 MG ODT,16.61,10.8,4.15,11.63,11
NDC,46122-0787-34,UNCLASSIFIED DRUGS,2.78,1.81,0.7,7.18,16
NDC,46122-0788-15,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.51,11.38,4.38,45.22,16
NDC,46287-0006-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.64,1.72,0.66,6.82,16
NDC,46287-0024-10,POTASSIUM PHOSPH 45 MMOL/15 ML,14.92,9.7,3.73,10.44,11
NDC,46287-0500-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.06,2.6399999999999997,0.95,11.13,32
NDC,46287-0508-16,PETROLATUM BASE OINTMENT,10.25,6.66,2.56,7.18,11
NDC,47335-0049-40,"INJECTION, DOXORUBICIN HYDROCHLORIDE, LIPOSOMAL, NOT OTHERWISE SPECIFIED, 10 MG",239.38,155.6,59.85,903.53,19
NDC,47335-0171-48,"TOBRAMYCIN, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, UNIT DOSE FORM, ADMINISTERED THROUGH DME, PER 300 MILLIGRAMS",30.38,19.75,7.6,78.46,17
NDC,47335-0177-95,ILUMYA 100 MG/ML SYRINGE,110850.32,72052.71,27712.58,77595.22,11
NDC,47335-0236-83,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2852.25,1853.96,713.06,7365.94,16
NDC,47335-0237-83,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",126.95,82.52,31.74,327.85,16
NDC,47335-0322-86,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.35,4.13,1.59,16.4,16
NDC,47335-0614-81,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.47,7.46,2.87,29.62,16
NDC,47335-0756-48,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",22.47,14.61,0.21,58.03,17
NDC,47335-0788-91,UNCLASSIFIED DRUGS,25.65,16.67,6.41,66.24,16
NDC,47335-0929-60,TEMOZOLOMIDE 140 MG CAPSULE,230.55,149.86,57.64,161.39,11
NDC,47426-0301-02,ZYNRELEF 400-12 MG/14 ML VIAL,75.885,49.324999999999996,12.22,72.02,22
NDC,47426-0303-01,ZYNRELEF 200-6 MG/7 ML VIAL,32.92,21.395,3.73,35.65,22
NDC,47682-0223-99,UNCLASSIFIED DRUGS,10.27,6.68,2.57,26.52,16
NDC,47781-0176-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.4,7.41,2.85,29.44,16
NDC,47781-0355-03,"BUPRENORPHINE/NALOXONE, ORAL, LESS THAN OR EQUAL TO 3 MG BUPRENORPHINE",33.96,22.07,6.48,87.7,17
NDC,47781-0357-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.4,15.21,5.85,60.43,16
NDC,47781-0358-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.769999999999996,22.6,0.34,176.1,32
NDC,47781-0424-11,"INJECTION, FENTANYL CITRATE, 0.1 MG",83.29,54.14,1.26,215.1,17
NDC,47781-0426-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",131.84,85.7,32.96,340.48,16
NDC,47781-0427-11,"INJECTION, FENTANYL CITRATE, 0.1 MG",170.92,111.1,1.26,441.4,17
NDC,47781-0428-11,"INJECTION, FENTANYL CITRATE, 0.1 MG",240.69,156.45,1.26,621.58,17
NDC,48433-0215-01,SODIUM CHLORIDE 23.4% ORAL SOL,6.32,4.11,1.58,4.42,11
NDC,48815-1001-01,"IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER 100 MICROCURIES, UP TO 999 MICROCURIES",230.8,150.02,57.7,696.3,17
NDC,49100-0381-64,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.3,11.9,4.58,47.26,16
NDC,49100-0400-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.44,6.14,2.36,24.38,16
NDC,49281-0124-88,FLUZONE HIGH-DOSE TRIV 2024-25,100.0,65.0,25.0,70.0,22
NDC,49281-0125-65,FLUZONE HIGH-DOSE 2025-26 SYR,200.0,130.0,50.0,140.0,11
NDC,49281-0125-88,FLUZONE HIGH-DOSE 2025-26 SYR,387.5,251.875,18.75,490.0,22
NDC,49281-0215-58,Diphtheria and tetanus vaccine (7 years or older),40.0,26.0,10.0,103.3,19
NDC,49281-0425-50,FLUZONE 2025-2026 SYRINGE,103.8,67.47,25.95,72.66,11
NDC,49281-0547-58,ACTHIB VACCINE VIAL,21.27,13.83,5.32,14.89,11
NDC,49281-0574-15,BEYFORTUS 100 MG/ML SYRINGE,1000.0,650.0,250.0,700.0,11
NDC,49281-0574-88,BEYFORTUS 100 MG/ML SYRINGE,3078.3,2000.9,769.58,2154.81,11
NDC,49281-0575-00,BEYFORTUS 50 MG/0.5 ML SYRINGE,6201.6,4031.04,1550.4,4341.12,11
NDC,49281-0725-10,FLUBLOK 2025-2026 SYRINGE,2230.54,1449.85,557.64,1561.38,11
NDC,49281-0725-88,FLUBLOK 2025-2026 SYRINGE,5.0,3.25,1.25,3.5,11
NDC,49281-0752-78,UNCLASSIFIED DRUGS,1172.0,761.8,293.0,3026.69,16
NDC,49281-0790-51,TYPHIM VI 25 MCG/0.5 ML SYRNG,115.0,74.75,28.75,80.5,11
NDC,49281-0915-58,YF-VAX 1 DOSE VIAL,246.0,159.9,61.5,172.2,11
NDC,49401-0101-01,"INJECTION, BELIMUMAB, 10 MG",6901.45,4485.94,60.59,17822.99,19
NDC,49401-0102-01,"INJECTION, BELIMUMAB, 10 MG",27395.61,17807.15,60.59,70749.16,19
NDC,49411-0050-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",141.45,91.94,35.36,365.29,16
NDC,49483-0080-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.01,1.96,0.75,7.77,16
NDC,49483-0340-10,UNCLASSIFIED DRUGS,63.74,41.43,15.94,164.61,16
NDC,49483-0481-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.27,17.08,6.57,67.84,16
NDC,49502-0102-01,UNCLASSIFIED DRUGS,1780.38,1157.25,445.1,4597.83,16
NDC,49502-0102-02,UNCLASSIFIED DRUGS,912.64,593.22,228.16,2356.89,16
NDC,49502-0501-01,UNCLASSIFIED DRUGS,681.85,443.2,170.46,1760.88,16
NDC,49502-0900-01,EMSAM 6 MG/24 HOURS PATCH,503.8,327.47,125.95,352.66,11
NDC,49502-0901-01,EMSAM 9 MG/24 HOURS PATCH,503.8,327.47,125.95,352.66,11
NDC,49591-0052-11,"INJECTION, HEPATITIS B IMMUNE GLOBULIN (HEPAGAM B), INTRAMUSCULAR, 0.5 ML",1059.93,688.95,73.77,2737.27,19
NDC,49591-0126-11,VARIZIG 125 UNIT/1.2 ML VIAL,12946.83,8415.44,3236.71,9062.78,11
NDC,49591-0532-50,"INJECTION, CYTOMEGALOVIRUS IMMUNE GLOBULIN INTRAVENOUS (HUMAN), PER VIAL",255.71,166.21,63.93,5812.21,19
NDC,49702-0228-13,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",525.23,341.4,131.31,1356.41,16
NDC,49702-0231-13,UNCLASSIFIED DRUGS,1050.3000000000002,682.7,220.93,3142.64,32
NDC,49702-0240-15,"INJECTION, CABOTEGRAVIR AND RILPIVIRINE, 2MG/3MG",2700.395,1755.255,25.61,11761.89,38
NDC,49702-0242-13,JULUCA 50-25 MG TABLET,826.0,536.9,206.5,578.2,11
NDC,49702-0253-15,"INJECTION, CABOTEGRAVIR AND RILPIVIRINE, 2MG/3MG",1195.58,777.13,25.61,5812.21,19
NDC,49702-0264-23,"INJECTION, CABOTEGRAVIR, 1MG, FDA APPROVED PRESCRIPTION, ONLY FOR USE AS HIV PRE-EXPOSURE PROPHYLAXIS (NOT FOR USE AS TREATMENT FOR HIV)",2500.14,1625.09,7.58,6456.61,19
NDC,49771-0002-01,"MITOMYCIN, OPHTHALMIC, 0.2 MG",2170.0,1410.5,155.18,5604.03,18
NDC,49884-0009-01,UNCLASSIFIED DRUGS,19.42,12.620000000000001,2.51,74.43,32
NDC,49884-0257-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.565000000000001,6.865,1.31,41.01,32
NDC,49884-0306-52,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.56,2.96,1.14,11.78,16
NDC,49884-0412-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.87,9.02,3.47,35.82,16
NDC,49884-0465-64,CHOLESTYRAMINE PACKET,37.995000000000005,24.695,3.36,43.79,22
NDC,50016-0957-11,GEL-ONE 30 MG/3 ML SYRINGE,965.31,627.45,241.33,675.72,11
NDC,50024-0432-03,UNCLASSIFIED DRUGS,7.5,4.88,1.88,19.37,16
NDC,50090-0544-02,DICLOFENAC SOD EC 75 MG TAB,15.95,10.37,3.99,11.17,11
NDC,50090-2594-00,DROSPIRENONE-EE 3-0.02 MG TAB,35.95,23.37,8.99,25.17,11
NDC,50090-3161-01,CHLORTHALIDONE 50 MG TABLET,13.95,9.07,3.49,9.77,11
NDC,50090-4236-00,ATOMOXETINE HCL 40 MG CAPSULE,43.15,28.05,10.79,30.21,11
NDC,50090-6247-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",954.03,620.12,238.51,2463.78,16
NDC,50111-0450-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.06,10.44,4.02,41.47,16
NDC,50190-0740-60,UNCLASSIFIED DRUGS,9.555,6.21,2.29,25.7,32
NDC,50227-1030-05,UNCLASSIFIED DRUGS,3.0700000000000003,1.995,0.66,9.09,32
NDC,50228-0117-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.27,18.38,7.07,73.01,16
NDC,50228-0119-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.71,8.26,3.18,32.82,16
NDC,50228-0174-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.1,3.32,1.28,13.17,16
NDC,50228-0457-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.435,6.13,0.73,41.17,32
NDC,50228-0458-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.6,4.29,1.65,17.04,16
NDC,50228-0461-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.95,5.17,1.99,20.53,16
NDC,50228-0481-01,UNCLASSIFIED DRUGS,12.12,7.88,3.03,31.3,16
NDC,50228-0482-01,UNCLASSIFIED DRUGS,5.8,3.77,1.45,14.98,16
NDC,50228-0482-05,UNCLASSIFIED DRUGS,20.3,13.2,5.08,52.42,16
NDC,50228-0483-01,UNCLASSIFIED DRUGS,3.96,2.57,0.99,10.23,16
NDC,50242-0037-06,"INJECTION, TENECTEPLASE, 1 MG",34575.47,22474.06,198.19,89291.15,19
NDC,50242-0040-62,"INJECTION, OMALIZUMAB, 5 MG",16057.59,10437.43,48.23,41468.73,19
NDC,50242-0041-64,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",2478.46,1610.995,99.46,6725.84,38
NDC,50242-0044-06,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",30273.5,19677.78,99.46,78181.31,19
NDC,50242-0044-13,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",9361.98,6085.29,99.46,24177.31,19
NDC,50242-0051-21,"INJECTION, RITUXIMAB, 10 MG",1256.37,816.64,79.26,5812.21,19
NDC,50242-0053-06,"INJECTION, RITUXIMAB, 10 MG",838.255,544.865,79.26,5812.21,38
NDC,50242-0060-01,"INJECTION, BEVACIZUMAB, 10 MG",867.905,564.14,78.05,9284.09,75
NDC,50242-0070-01,"INJECTION, OBINUTUZUMAB, 10 MG",2996.34,1947.625,86.53,8473.36,38
NDC,50242-0077-01,"HERCEPTIN HYLECTA 600MG-10,000",2087.5,1356.88,521.88,1461.25,11
NDC,50242-0080-03,"INJECTION, RANIBIZUMAB, 0.1 MG",195400.0,127010.0,69.37,504620.5,19
NDC,50242-0080-86,LUCENTIS 0.5 MG/0.05 ML VIAL,5075.0,3298.75,1268.75,3552.5,11
NDC,50242-0085-25,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",19127.8,12433.07,99.46,132890.31,57
NDC,50242-0087-01,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",56709.47,36861.16,44.72,146452.21,19
NDC,50242-0088-01,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",36151.29,23498.34,44.72,93360.71,19
NDC,50242-0096-01,"INJECTION, FARICIMAB-SVOA, 0.1 MG",226866.35,147463.13,34.87,585882.35,19
NDC,50242-0100-39,"DORNASE ALFA, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",369.23,240.0,58.47,953.54,19
NDC,50242-0103-01,POLIVY 30 MG VIAL,26875.515,17469.085,6707.72,18844.12,22
NDC,50242-0105-01,"INJECTION, POLATUZUMAB VEDOTIN-PIIQ, 1 MG",138934.29,90307.29000000001,144.98,416911.65,38
NDC,50242-0108-01,"INJECTION, RITUXIMAB 10 MG AND HYALURONIDASE",3595.1,2336.82,39.08,9284.35,19
NDC,50242-0125-01,"INJECTION, GLOFITAMAB-GXBM, 2.5 MG",13795.6,8967.14,3014.21,35627.14,17
NDC,50242-0127-01,"INJECTION, GLOFITAMAB-GXBM, 2.5 MG",3665.18,2382.37,916.3,9465.33,17
NDC,50242-0130-01,ALECENSA 150 MG CAPSULE,203.68,132.39,50.92,142.58,11
NDC,50242-0135-01,"INJECTION, TOCILIZUMAB, FOR HOSPITALIZED ADULTS AND PEDIATRIC PATIENTS (2 YEARS OF AGE AND OLDER) WITH COVID-19 WHO ARE RECEIVING SYSTEMIC CORTICOSTEROIDS AND REQUIRE SUPPLEMENTAL OXYGEN, NON-INVASIVE",1529.32,994.06,8.02,3949.47,19
NDC,50242-0137-01,"INJECTION, TOCILIZUMAB, FOR HOSPITALIZED ADULTS AND PEDIATRIC PATIENTS (2 YEARS OF AGE AND OLDER) WITH COVID-19 WHO ARE RECEIVING SYSTEMIC CORTICOSTEROIDS AND REQUIRE SUPPLEMENTAL OXYGEN, NON-INVASIVE",1098.58,714.075,8.02,4559.64,38
NDC,50242-0138-01,"INJECTION, TOCILIZUMAB, 1 MG",3160.33,2054.21,5.95,8161.55,19
NDC,50242-0142-01,LUNSUMIO 30 MG/30 ML VIAL,4235.73,2753.22,1058.93,2965.01,11
NDC,50242-0145-01,"INJECTION, PERTUZUMAB, 1 MG",3881.0,2522.65,18.03,10022.68,19
NDC,50242-0150-01,"INJECTION, OCRELIZUMAB, 1 MG",20082.38,13053.55,62.88,51862.75,19
NDC,50242-0159-01,LUNSUMIO 1 MG/ML VIAL,6448.26,4191.37,1612.07,4513.78,11
NDC,50242-0215-01,"INJECTION, OMALIZUMAB, 5 MG",5635.88,3663.32,48.23,14554.66,19
NDC,50242-0215-55,XOLAIR 150 MG/ML AUTOINJECTOR,866.83,563.44,216.71,606.78,11
NDC,50242-0245-01,"PHESGO 1,200-600MG-30,000 UNIT",2063.1,1341.02,515.78,1444.17,11
NDC,50242-0260-01,"PHESGO 600-600 MG-20,000 UNIT",4145.54,2694.6,1036.39,2901.88,11
NDC,50242-0554-01,"OCREVUS ZUNOVO 920 MG-23,000",12943.05,8412.98,3235.76,9060.14,11
NDC,50242-0917-01,"INJECTION, ATEZOLIZUMAB, 10 MG",4915.58,3195.13,99.54,12694.49,19
NDC,50242-0918-01,"INJECTION, ATEZOLIZUMAB, 10 MG",3127.98,2033.19,99.54,11535.65,19
NDC,50268-0061-15,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.97,11.68,4.49,46.41,16
NDC,50268-0087-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.32,14.51,5.58,57.64,16
NDC,50268-0090-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.3,14.5,5.58,57.59,16
NDC,50268-0105-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.16,7.25,2.79,28.82,16
NDC,50268-0128-11,"BUPRENORPHINE, ORAL, 1 MG",38.3,24.9,1.34,98.91,17
NDC,50268-0144-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.61,18.6,7.15,73.89,16
NDC,50268-0152-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.07,12.4,4.77,49.25,16
NDC,50268-0169-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",106.05,68.93,26.51,273.87,16
NDC,50268-0260-11,UNCLASSIFIED DRUGS,8.04,5.23,2.01,20.76,16
NDC,50268-0277-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.32,8.01,3.08,31.82,16
NDC,50268-0277-15,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.88,7.72,2.97,30.68,16
NDC,50268-0400-15,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.84,18.1,6.96,71.9,16
NDC,50268-0482-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.58,12.73,4.9,50.57,16
NDC,50268-0550-11,UNCLASSIFIED DRUGS,20.73,13.47,5.18,53.54,16
NDC,50268-0561-11,UNCLASSIFIED DRUGS,22.6,14.69,5.65,58.36,16
NDC,50268-0585-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.29,3.44,1.32,13.66,16
NDC,50268-0595-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.7,3.06,1.18,12.14,16
NDC,50268-0674-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.71,4.36,1.68,17.33,16
NDC,50268-0686-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.43,3.53,1.36,14.02,16
NDC,50268-0710-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.86,20.06,7.72,79.7,16
NDC,50268-0740-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.88,3.17,1.22,12.6,16
NDC,50268-0741-11,ROPINIROLE HCL 0.25 MG TABLET,16.14,10.49,4.04,11.3,11
NDC,50268-0741-15,ROPINIROLE HCL 0.25 MG TABLET,5.85,3.8,1.46,4.1,11
NDC,50268-0745-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.87,4.47,1.72,17.74,16
NDC,50268-0757-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.91,3.19,1.23,12.68,16
NDC,50268-0759-11,TIZANIDINE HCL 2 MG TABLET,9.53,6.19,2.38,6.67,11
NDC,50268-0766-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.0,13.65,5.25,54.23,16
NDC,50268-0779-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.45,11.99,4.61,47.65,16
NDC,50268-0788-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.93,36.35,13.98,144.44,16
NDC,50268-0851-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.78,19.36,7.45,76.91,16
NDC,50268-0852-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.3,9.3,3.58,36.93,16
NDC,50268-0868-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.86,3.16,1.22,12.55,16
NDC,50419-0208-01,"RADIUM RA-223 DICHLORIDE, THERAPEUTIC, PER MICROCURIE",22169.78,14410.36,182.24,57253.46,19
NDC,50419-0250-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",807.55,524.91,201.89,2085.5,16
NDC,50419-0251-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",847.75,551.04,211.94,2189.31,16
NDC,50419-0252-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",847.45,550.84,211.86,2188.54,16
NDC,50419-0253-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",847.7,551.01,211.93,2189.19,16
NDC,50419-0254-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",846.36,550.13,211.59,2185.72,16
NDC,50419-0254-91,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",325.23,211.4,81.31,839.91,16
NDC,50419-0320-01,"INJECTION, GADOXETATE DISODIUM, 1 ML",202.015,131.31,15.64,620.49,34
NDC,50419-0325-03,"INJECTION, GADOBUTROL, 0.1 ML",249.0,161.85,0.3,751.21,17
NDC,50419-0325-13,"INJECTION, GADOBUTROL, 0.1 ML",622.5,404.63,0.3,1878.02,17
NDC,50419-0344-05,ULTRAVIST 300 MG/ML VIAL,1.49,0.97,0.37,1.04,11
NDC,50419-0344-10,ULTRAVIST 300 MG/ML VIAL,12.53,8.14,3.13,8.77,11
NDC,50419-0346-10,ULTRAVIST 370 MG/ML VIAL,7.05,4.58,1.76,4.94,11
NDC,50419-0346-28,ULTRAVIST 370 MG/ML BOTTLE,2.61,1.7,0.65,1.83,11
NDC,50419-0346-60,ULTRAVIST 370 MG/ML BOTTLE,2.61,1.7,0.65,1.83,11
NDC,50419-0346-62,ULTRAVIST 370 MG/ML VIAL,7.05,4.58,1.76,4.94,11
NDC,50419-0395-01,NUBEQA 300 MG TABLET,695.75,452.24,173.94,487.03,11
NDC,50419-0422-01,SKYLA 13.5 MG SYSTEM,2297.27,1493.23,574.32,1608.09,11
NDC,50419-0423-01,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (MIRENA), 52 MG",6730.35,4374.725,727.06,22534.2,38
NDC,50419-0424-01,KYLEENA 19.5 MG SYSTEM,2834.35,1842.33,708.59,1984.05,11
NDC,50419-0773-01,CIPRO 10% SUSPENSION,18.33,11.91,4.58,12.83,11
NDC,50458-0028-02,"ESKETAMINE, NASAL SPRAY, 1 MG",243.7,158.41,60.93,629.36,16
NDC,50458-0028-03,"ESKETAMINE, NASAL SPRAY, 1 MG",949.615,617.25,233.89,2488.7,32
NDC,50458-0562-01,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (INVEGA SUSTENNA), 1 MG",9902.465,6436.6,16.02,42308.4,38
NDC,50458-0563-01,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (INVEGA SUSTENNA), 1 MG",9029.22,5868.99,16.02,40795.88,38
NDC,50458-0564-01,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (INVEGA SUSTENNA), 1 MG",10448.45,6791.495000000001,16.02,39659.01,38
NDC,50458-0577-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.6,2.34,0.9,9.3,16
NDC,50458-0577-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.1,13.07,5.03,51.91,16
NDC,50458-0578-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.05,13.03,5.01,51.78,16
NDC,50458-0578-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.6,8.84,3.4,35.12,16
NDC,50458-0579-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.8,2.47,0.95,9.81,16
NDC,50458-0579-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.65,12.77,4.91,50.75,16
NDC,50458-0580-01,UNCLASSIFIED DRUGS,27.56,17.91,6.89,71.17,16
NDC,50458-0580-90,UNCLASSIFIED DRUGS,4.21,2.74,1.05,10.87,16
NDC,50474-0570-66,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",170.65,110.92,42.66,440.7,16
NDC,50474-0700-62,"INJECTION, CERTOLIZUMAB PEGOL, 1 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",21088.72,13707.67,4.1,54461.62,19
NDC,50474-0710-79,"INJECTION, CERTOLIZUMAB PEGOL, 1 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",52299.5,33994.68,4.1,135063.46,19
NDC,50474-0770-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",99.685,64.795,9.46,417.15,32
NDC,50474-0802-03,NEUPRO 2 MG/24 HR PATCH,221.35,143.88,55.34,154.95,11
NDC,50474-0804-03,NEUPRO 4 MG/24 HR PATCH,214.85,139.65,53.71,150.4,11
NDC,50474-0807-46,UNCLASSIFIED DRUGS,470.61,305.9,117.65,1215.35,16
NDC,50474-0970-63,UNCLASSIFIED DRUGS,46.91,30.49,11.73,121.15,16
NDC,50474-0982-84,RYSTIGGO 560 MG/4 ML VIAL,13798.58,8969.08,3449.65,9659.01,11
NDC,50484-0010-30,UNCLASSIFIED DRUGS,33.64,21.865000000000002,1.21,161.3,32
NDC,50580-0533-24,BENADRYL ALLERGY 50 MG TABLET,10.7,6.96,2.68,7.49,11
NDC,50580-0536-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.97,1.28,0.49,5.09,16
NDC,50580-0590-02,UNCLASSIFIED DRUGS,19.76,12.84,4.94,51.03,16
NDC,50632-0010-01,Rabies vaccine for injection into muscle,2977.215,1935.19,163.76,7688.7,38
NDC,50632-0013-01,RABAVERT RABIES VACCINE VIAL,348.29,226.39,87.07,243.8,11
NDC,50633-0220-04,VISTOGARD 10 GRAM PACKET,29870.56,19415.86,7467.64,20909.39,11
NDC,50633-0310-11,UNCLASSIFIED DRUGS,8681.175,5642.76,1043.61,34057.83,32
NDC,50742-0239-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.6,7.54,2.9,29.96,16
NDC,50742-0240-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.94,10.36,3.99,41.17,16
NDC,50742-0250-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.75,14.14,5.44,56.17,16
NDC,50742-0257-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.55,4.26,1.64,16.92,16
NDC,50742-0258-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.6,15.99,6.15,63.53,16
NDC,50742-0259-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.26,7.32,2.82,29.08,16
NDC,50742-0260-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.81,7.03,2.7,27.92,16
NDC,50742-0261-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.35,8.68,3.34,34.48,16
NDC,50742-0350-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.99,15.59,6.0,61.95,16
NDC,50742-0351-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.73,5.67,2.18,22.55,16
NDC,50742-0550-01,"INJECTION, FENTANYL CITRATE, 0.1 MG",3.68,2.39,0.92,9.5,17
NDC,50742-0622-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.95,3.87,1.49,15.37,16
NDC,50881-0005-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2129.83,1384.39,532.46,5500.29,16
NDC,50881-0006-03,ZYNYZ 500 MG/20 ML VIAL,4107.25,2669.71,1026.81,2875.08,11
NDC,50881-0010-60,JAKAFI 10 MG TABLET,1260.12,819.0799999999999,184.0,1248.97,22
NDC,50881-0013-03,"INJECTION, TAFASITAMAB-CXIX, 2 MG",9382.98,6098.94,15.09,24231.55,19
NDC,50881-0023-11,NIKTIMVO 22 MG/0.44 ML VIAL,102881.19,66872.77,25720.3,72016.83,11
NDC,51079-0072-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.85,19.4,7.46,77.09,16
NDC,51079-0087-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.88,3.17,1.22,12.6,16
NDC,51079-0255-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.83,3.14,1.21,12.47,16
NDC,51079-0284-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.8,10.92,4.2,43.39,16
NDC,51079-0284-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.53,5.54,2.13,22.03,16
NDC,51079-0285-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.85,9.0,3.46,35.77,16
NDC,51079-0286-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.91,18.14,6.98,72.08,16
NDC,51079-0300-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.545,14.004999999999999,5.07,58.96,32
NDC,51079-0417-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.52,14.64,5.63,58.16,16
NDC,51079-0436-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.95,4.52,1.74,17.95,16
NDC,51079-0438-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.95,6.47,2.49,25.7,16
NDC,51079-0632-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.7,20.61,7.93,81.87,16
NDC,51079-0684-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.12,19.58,7.53,77.78,16
NDC,51079-0733-01,UNCLASSIFIED DRUGS,5.49,3.57,1.37,14.18,16
NDC,51079-0734-01,UNCLASSIFIED DRUGS,7.41,4.82,1.85,19.14,16
NDC,51079-0735-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.62,3.65,1.41,14.51,16
NDC,51079-0753-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.91,3.84,1.48,15.26,16
NDC,51079-0801-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.75,11.54,4.44,45.84,16
NDC,51079-0821-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.59,6.23,2.4,24.77,16
NDC,51079-0870-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.85,4.45,1.71,17.69,16
NDC,51079-0922-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.12,5.28,2.03,20.97,16
NDC,51079-0923-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.6,7.54,2.9,29.96,16
NDC,51079-0924-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.16,22.205000000000002,6.06,113.89,32
NDC,51079-0985-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.38,2.85,1.1,11.31,16
NDC,51144-0020-01,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",15832.59,10291.185,38.92,63821.06,38
NDC,51144-0030-01,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",22749.705,14787.305,38.92,93252.73,38
NDC,51144-0050-01,"ESKETAMINE, NASAL SPRAY, 1 MG",2317.5,1506.38,579.38,5984.94,16
NDC,51144-0050-01,"INJECTION, BRENTUXIMAB VEDOTIN, 1 MG",110601.04,71890.675,284.56,399697.14,38
NDC,51167-0121-01,ALYFTREK 10-50-125 MG TABLET,2369.33,1540.06,592.33,1658.53,11
NDC,51167-0200-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1076.8,699.92,269.2,2780.84,16
NDC,51167-0331-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2511.04,1632.175,500.29,7801.55,32
NDC,51167-0548-30,JOURNAVX 50 MG TABLET,74.715,48.565,11.46,72.51,22
NDC,51228-0000-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.91,31.14,11.98,123.73,16
NDC,51248-0150-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",86.65,56.32,21.66,223.77,16
NDC,51285-0368-01,"METHOTREXATE; ORAL, 2.5 MG",369.65,240.27499999999998,0.16,1138.55,34
NDC,51660-0724-11,UNCLASSIFIED DRUGS,9.675,6.29,1.96,29.7,32
NDC,51672-1258-02,UNCLASSIFIED DRUGS,4.34,2.82,1.09,11.21,16
NDC,51672-1259-02,UNCLASSIFIED DRUGS,7.63,4.96,1.91,19.7,16
NDC,51672-1263-02,UNCLASSIFIED DRUGS,2.41,1.57,0.6,6.22,16
NDC,51672-1272-02,UNCLASSIFIED DRUGS,8.14,5.29,2.04,21.02,16
NDC,51672-1275-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.92,2.55,0.98,10.12,16
NDC,51672-1290-06,UNCLASSIFIED DRUGS,2.04,1.33,0.51,5.27,16
NDC,51672-1407-00,UNCLASSIFIED DRUGS,7.68,4.99,1.92,19.83,16
NDC,51672-2001-02,UNCLASSIFIED DRUGS,1.98,1.29,0.5,5.11,16
NDC,51672-2002-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.49,0.97,0.37,3.85,16
NDC,51672-2003-06,UNCLASSIFIED DRUGS,1.45,0.94,0.36,3.74,16
NDC,51672-2035-06,UNCLASSIFIED DRUGS,1.73,1.12,0.43,4.47,16
NDC,51672-2114-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.705,5.655,1.71,27.27,32
NDC,51672-2115-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.98,5.19,2.0,20.61,16
NDC,51672-2116-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.445,10.690000000000001,1.61,68.28,32
NDC,51672-2131-08,UNCLASSIFIED DRUGS,2.57,1.67,0.64,6.64,16
NDC,51672-3020-09,UNCLASSIFIED DRUGS,32.84,21.35,8.21,84.81,16
NDC,51672-4001-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.2,2.73,1.05,10.85,16
NDC,51672-4011-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.79,7.01,2.7,27.87,16
NDC,51672-4011-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.63,2.36,0.91,9.37,16
NDC,51672-4013-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.75,4.39,1.69,17.43,16
NDC,51672-4047-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.5,0.98,0.38,3.87,16
NDC,51672-4069-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.96,1.27,0.49,5.06,16
NDC,51672-4111-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.23,6.0,2.31,23.84,16
NDC,51672-4118-06,FLUOROURACIL 5% CREAM,16.95,11.02,4.24,11.87,11
NDC,51672-4133-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.0,2.6,1.0,10.33,16
NDC,51672-4146-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.69,5.0,1.92,19.86,16
NDC,51672-5316-09,UNCLASSIFIED DRUGS,7.86,5.11,1.97,20.3,16
NDC,51754-0500-01,"INJECTION, CAFFEINE CITRATE, 5 MG",186.86,121.46,2.15,482.57,17
NDC,51754-1000-01,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",15.28,9.93,0.43,39.46,17
NDC,51754-1029-01,UNCLASSIFIED DRUGS,1.23,0.8,0.31,3.18,16
NDC,51754-2001-04,UNCLASSIFIED DRUGS,1.46,0.95,0.37,3.77,16
NDC,51754-5011-04,UNCLASSIFIED DRUGS,22.53,14.64,5.63,58.18,16
NDC,51862-0240-30,UNCLASSIFIED DRUGS,21.83,14.19,5.46,56.38,16
NDC,51862-0486-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.61,8.2,3.15,32.57,16
NDC,51991-0002-98,"INJECTION, METHADONE HCL, UP TO 10 MG",112.7,73.26,18.76,291.05,17
NDC,51991-0203-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.38,2.85,1.1,11.31,16
NDC,51991-0379-06,"EVEROLIMUS, ORAL, 0.25 MG",58.19,37.82,1.25,150.28,17
NDC,51991-0735-99,GRANISETRON HCL 1 MG TABLET,19.6,12.74,4.9,13.72,11
NDC,51991-0759-33,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",94.1,61.17,23.53,243.01,16
NDC,51991-0817-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.82,10.28,3.96,40.86,16
NDC,51991-0822-33,EVEROLIMUS 5 MG TABLET,238.125,154.78,59.31,167.3,22
NDC,51991-0824-99,EVEROLIMUS 10 MG TABLET,94.15,61.2,23.54,65.91,11
NDC,51991-0907-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.19,18.32,7.05,72.8,16
NDC,51991-0983-99,UNCLASSIFIED DRUGS,40.54,26.35,10.14,104.69,16
NDC,52015-0080-01,DIFICID 200 MG TABLET,1655.31,1075.95,413.83,1158.72,11
NDC,52244-0200-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",38.54,25.05,9.64,99.53,16
NDC,52268-0012-01,UNCLASSIFIED DRUGS,2.3,1.5,0.58,5.94,16
NDC,52380-0126-02,UNCLASSIFIED DRUGS,35.85,23.3,8.96,92.58,16
NDC,52536-0096-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.96,9.07,3.49,36.05,16
NDC,52536-0180-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",65.72,42.72,16.43,169.72,16
NDC,52536-0186-03,ERYTHROMYCIN DR 500 MG TABLET,296.25,192.56,74.06,207.38,11
NDC,52536-0600-11,BACLOFEN 25 MG/5 ML SUSPENSION,33.68,21.89,8.42,23.58,11
NDC,52652-5001-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.81,18.73,7.2,74.4,16
NDC,52652-8001-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.74,6.335,0.41,46.07,32
NDC,52652-9001-03,EPRONTIA 25 MG/ML SOLUTION,13.525,8.79,2.02,13.27,22
NDC,52817-0210-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.17,2.71,1.04,10.77,16
NDC,52817-0268-30,BISOPROLOL FUMARATE 2.5 MG TAB,19.8,12.87,4.95,13.86,11
NDC,52817-0364-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.27,24.23,9.32,96.25,16
NDC,52817-0365-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.55,36.11,13.89,143.46,16
NDC,53276-1010-02,UNCLASSIFIED DRUGS,1369.83,890.39,178.47,5231.63,32
NDC,53436-0084-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",163.03,105.97,40.76,421.03,16
NDC,53436-0084-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",217.7,141.51,54.43,562.21,16
NDC,53436-0168-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",153.34,99.67,38.34,396.0,16
NDC,53489-0143-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.165,9.86,1.25,65.39,32
NDC,53489-0144-01,UNCLASSIFIED DRUGS,11.85,7.7,2.96,30.6,16
NDC,53489-0386-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.715,6.3149999999999995,1.1,38.87,32
NDC,53746-0442-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.9,12.94,4.98,51.39,16
NDC,53746-0544-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.87,23.97,9.22,95.22,16
NDC,53746-0545-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.03,15.62,6.01,62.06,16
NDC,53746-0734-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",99.9,64.94,24.98,257.99,16
NDC,53746-0735-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",112.8,73.32,28.2,291.31,16
NDC,54092-0189-81,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.415,16.52,5.2,77.6,32
NDC,54092-0477-01,MYDAYIS ER 50 MG CAPSULE,84.05,54.63,21.01,58.84,11
NDC,54092-0701-04,"INJECTION, VELAGLUCERASE ALFA, 100 UNITS",3350.46,2177.8,409.62,11535.65,38
NDC,54288-0103-01,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",23.87,15.52,4.33,171.09,48
NDC,54288-0105-15,UNCLASSIFIED DRUGS,872.78,567.31,218.2,2253.95,16
NDC,54288-0142-01,"INJECTION, PAPAVERINE HCL, UP TO 60 MG",109.65,71.27,27.41,283.17,17
NDC,54288-0147-01,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",77.92,50.65,10.4,201.23,17
NDC,54643-5649-01,UNCLASSIFIED DRUGS,15.4,10.01,3.85,39.77,16
NDC,54643-5650-02,UNCLASSIFIED DRUGS,2.38,1.55,0.6,6.15,16
NDC,54643-5659-01,INFUVITE ADULT VIAL 2,15.855,10.305,2.64,14.8,22
NDC,54838-0006-50,UNCLASSIFIED DRUGS,1.57,1.02,0.39,4.05,16
NDC,54838-0510-80,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.1,0.72,0.28,2.84,16
NDC,54838-0511-80,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.38,1.5499999999999998,0.37,8.52,32
NDC,54838-0512-40,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.89,5.125,0.84,32.07,32
NDC,55111-0256-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.195,4.68,1.02,26.65,32
NDC,55111-0259-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.33,9.315000000000001,1.67,56.82,32
NDC,55111-0262-79,UNCLASSIFIED DRUGS,20.85,13.55,5.21,53.85,16
NDC,55111-0263-79,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.45,15.24,5.86,60.56,16
NDC,55111-0279-50,UNCLASSIFIED DRUGS,7.84,5.095000000000001,1.23,27.76,32
NDC,55111-0280-50,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",53.13,34.53,13.28,137.21,16
NDC,55111-0281-30,UNCLASSIFIED DRUGS,20.52,13.34,5.13,52.99,16
NDC,55111-0284-48,FLUOXETINE DR 90 MG CAPSULE,204.86,133.16,51.22,143.4,11
NDC,55111-0321-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.3,13.2,5.08,52.42,16
NDC,55111-0322-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.9,2.54,0.98,10.07,16
NDC,55111-0556-10,"INJECTION, DECITABINE, 1 MG",267.28,173.73,0.69,690.25,19
NDC,55111-0678-02,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",189.25,123.01,0.93,567.75,17
NDC,55111-0679-02,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",434.25,282.26,0.93,1302.75,17
NDC,55111-0680-11,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",161.08,104.7,0.93,483.24,17
NDC,55111-0681-10,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",432.19,280.92,0.93,1296.57,17
NDC,55111-0685-07,"INJECTION, ZOLEDRONIC ACID, 1 MG",94.5,61.43,5.38,283.5,17
NDC,55111-0694-07,"INJECTION, PALONOSETRON HCL, 25 MCG",31.89,20.73,0.37,82.36,17
NDC,55111-0719-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.8,8.32,3.2,33.06,16
NDC,55111-0720-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.36,4.78,1.84,19.01,16
NDC,55111-0730-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",95.9,62.34,23.98,247.66,16
NDC,55135-0132-01,"INJECTION, SACITUZUMAB GOVITECAN-HZIY, 2.5 MG",9478.86,6161.26,39.2,24479.16,19
NDC,55150-0118-99,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",1732.14,1125.89,1.41,4473.25,17
NDC,55150-0121-50,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",926.46,602.2,1.16,2392.58,17
NDC,55150-0155-20,"INJECTION, ACYCLOVIR, 5 MG",1.22,0.79,0.13,3.15,17
NDC,55150-0162-05,UNCLASSIFIED DRUGS,13.395000000000001,8.705,0.96,59.24,32
NDC,55150-0165-05,"INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG",8.15,5.3,2.04,21.05,16
NDC,55150-0166-13,UNCLASSIFIED DRUGS,149.33,97.06,37.33,385.64,16
NDC,55150-0171-10,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",7.96,5.17,0.01,20.56,17
NDC,55150-0173-01,"INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",103.08000000000001,67.005,18.57,340.63,34
NDC,55150-0194-10,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",5.89,3.83,0.22,15.21,17
NDC,55150-0198-30,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",4.49,2.92,0.05,11.6,17
NDC,55150-0221-10,UNCLASSIFIED DRUGS,35.75,23.24,8.94,92.32,16
NDC,55150-0232-00,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",48.58,31.58,0.93,145.74,17
NDC,55150-0235-01,UNCLASSIFIED DRUGS,35.9,23.34,8.98,92.71,16
NDC,55150-0235-10,UNCLASSIFIED DRUGS,2270.0,1475.5,567.5,5862.28,16
NDC,55150-0236-01,UNCLASSIFIED DRUGS,49.98,32.49,12.5,129.07,16
NDC,55150-0250-50,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",2.91,1.89,0.01,7.52,17
NDC,55150-0251-10,UNCLASSIFIED DRUGS,16.3,10.6,4.08,42.09,16
NDC,55150-0254-10,UNCLASSIFIED DRUGS,5.96,3.87,1.49,15.39,16
NDC,55150-0267-05,"INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG",43.0,27.95,6.57,111.05,17
NDC,55150-0308-01,"INJECTION, OLANZAPINE, 0.5 MG",295.88,192.32,0.86,764.11,17
NDC,55150-0328-01,"INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG",110.55,71.86,27.64,285.5,16
NDC,55150-0330-01,"INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG",246.02,159.91,0.51,635.35,17
NDC,55150-0337-01,BORTEZOMIB 3.5 MG VIAL,4052.38,2634.05,1013.1,2836.67,11
NDC,55150-0345-01,"INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG",37.32,24.26,9.33,96.38,16
NDC,55150-0354-01,"INJECTION, IRINOTECAN, 20 MG",54.215,35.24,1.9,209.85,34
NDC,55150-0365-01,AMPHOTERICIN B LIPOSOME 50 MG,615.18,399.87,153.8,430.63,11
NDC,55150-0365-01,"INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG",929.0849999999999,603.905,21.96,3845.63,38
NDC,55150-0370-25,"INJECTION, VASOPRESSIN, 1 UNIT",2268.0,1474.2,0.56,5857.11,17
NDC,55150-0420-01,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",4.03,2.62,0.22,10.41,17
NDC,55150-0439-01,UNCLASSIFIED DRUGS,9.18,5.97,2.3,23.71,16
NDC,55292-0702-55,"INJECTION, HEMIN, 1 MG",69268.7,45024.66,37.43,178886.42,19
NDC,55513-0003-01,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",763.64,496.37,3.2,1972.1,19
NDC,55513-0005-01,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",5341.66,3472.08,3.2,13794.84,19
NDC,55513-0021-01,ARANESP 40 MCG/0.4 ML SYRINGE,1898.09,1233.76,474.52,1328.66,11
NDC,55513-0023-01,ARANESP 60 MCG/0.3 ML SYRINGE,3783.41,2459.22,945.85,2648.39,11
NDC,55513-0025-01,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",3758.62,2443.1,3.2,9706.64,19
NDC,55513-0028-01,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",36915.04,23994.78,3.2,95333.09,19
NDC,55513-0032-01,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",25271.28,16426.33,3.2,65263.08,19
NDC,55513-0059-01,IMDELLTRA 1 MG VIAL,3500.79,2275.51,822.26,2598.77,22
NDC,55513-0077-01,IMDELLTRA 10 MG VIAL,32570.595,21170.89,7932.17,23388.75,22
NDC,55513-0078-01,"INJECTION, TALIMOGENE LAHERPAREPVEC, PER 1 MILLION PLAQUE FORMING UNITS",178.65,116.12,44.66,7236.29,19
NDC,55513-0079-01,"INJECTION, TALIMOGENE LAHERPAREPVEC, PER 1 MILLION PLAQUE FORMING UNITS",15403.83,10012.49,78.38,39780.39,19
NDC,55513-0111-01,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",28147.63,18295.96,3.2,72691.25,19
NDC,55513-0112-01,"INJECTION, TEZEPELUMAB-EKKO, 1 MG",20474.74,13308.58,18.89,52876.02,19
NDC,55513-0123-01,TEZSPIRE 210 MG/1.91 ML PEN,5471.33,3556.36,1367.83,3829.93,11
NDC,55513-0132-01,"INJECTION, TRASTUZUMAB-ANNS, BIOSIMILAR, (KANJINTI), 10 MG",27356.62,17781.8,54.53,70648.47,19
NDC,55513-0141-01,KANJINTI 150 MG VIAL,10400.29,6760.19,2600.07,7280.2,11
NDC,55513-0144-01,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",820.2,533.13,8.2,2118.17,19
NDC,55513-0160-01,"INJECTION, BLINATUMOMAB, 1 MICROGRAM",70197.2,45628.18,173.5,181284.27,19
NDC,55513-0190-01,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",72405.505,47063.58,130.21,203601.51,38
NDC,55513-0192-01,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",54647.115,35520.625,130.21,194604.03,38
NDC,55513-0206-01,"INJECTION, BEVACIZUMAB-AWWB, BIOSIMILAR, (MVASI), 10 MG",2130.06,1384.54,25.27,5500.88,19
NDC,55513-0207-01,"INJECTION, BEVACIZUMAB-AWWB, BIOSIMILAR, (MVASI), 10 MG",1522.0,989.3,25.27,3930.57,19
NDC,55513-0221-01,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",18577.699999999997,12075.505000000001,11.71,49716.71,34
NDC,55513-0222-01,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",36674.130000000005,23838.184999999998,11.71,99998.48,34
NDC,55513-0223-01,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",9252.91,6014.39,11.71,25034.39,34
NDC,55513-0283-01,"EPOGEN 20,000 UNIT/2 ML VIAL",14.42,9.37,3.61,10.09,11
NDC,55513-0326-01,RIABNI 500 MG/50 ML VIAL,17.9,11.64,4.48,12.53,11
NDC,55513-0670-01,"INJECTION, INFLIXIMAB-AXXQ, BIOSIMILAR, (AVSOLA), 10 MG",1657.22,1077.19,25.24,4279.77,19
NDC,55513-0710-21,"INJECTION, DENOSUMAB, 1 MG",17910.985,11642.14,31.23,80799.94,38
NDC,55513-0730-01,"INJECTION, DENOSUMAB, 1 MG",10212.210000000001,6637.9349999999995,31.23,40550.05,38
NDC,55513-0800-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",68.19,44.32,17.05,176.1,16
NDC,55513-0810-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",51.68,33.59,12.92,133.46,16
NDC,55513-0956-01,"INJECTION, PANITUMUMAB, 10 MG",2913.84,1894.0,184.09,7524.99,19
NDC,55513-0998-01,"INJECTION, ROMOSOZUMAB-AQQG, 1 MG",13525.55,8791.61,12.84,34929.73,19
NDC,55513-0998-02,"INJECTION, ROMOSOZUMAB-AQQG, 1 MG",13767.26,8948.72,12.84,35553.95,19
NDC,55566-1050-00,"INTRAVESICAL INSTILLATION, NADOFARAGENE FIRADENOVEC-VNCG, PER THERAPEUTIC DOSE",94729.75,61574.34,23682.44,244639.58,19
NDC,55566-2300-00,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",694.42,451.37,3.61,1793.34,19
NDC,55566-4100-00,"HYALURONAN OR DERIVATIVE, EUFLEXXA, FOR INTRA-ARTICULAR INJECTION, PER DOSE",429.98,279.49,107.5,1110.42,19
NDC,55566-8303-01,"INJECTION, DEGARELIX, 1 MG",3312.5,2153.13,4.72,9937.5,19
NDC,55566-8402-00,"INJECTION, DEGARELIX, 1 MG",5002.415,3251.57,4.72,15603.99,38
NDC,55571-0023-01,MAG GLYCINATE 100 MG TABLET,5.4,3.51,1.35,3.78,11
NDC,56184-0120-41,UNCLASSIFIED DRUGS,58.92,38.3,14.73,152.16,16
NDC,57237-0017-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.56,6.86,2.64,27.27,16
NDC,57237-0018-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.89,6.43,2.47,25.54,16
NDC,57237-0019-99,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.26,6.02,2.32,23.91,16
NDC,57237-0042-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.14,11.14,4.29,44.26,16
NDC,57237-0043-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.33,11.91,4.58,47.34,16
NDC,57237-0045-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.5,4.88,1.88,19.37,16
NDC,57237-0047-05,UNCLASSIFIED DRUGS,4.5,2.93,1.13,11.62,16
NDC,57237-0048-05,UNCLASSIFIED DRUGS,4.88,3.17,1.22,12.6,16
NDC,57237-0077-10,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",55.42,36.02,0.01,143.12,17
NDC,57237-0106-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.99,4.54,1.75,18.05,16
NDC,57237-0172-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.77,2.45,0.94,9.74,16
NDC,57237-0173-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.8,4.42,1.7,17.56,16
NDC,57237-0175-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.59,16.63,6.4,66.09,16
NDC,57237-0176-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.35,7.38,2.84,29.31,16
NDC,57237-0219-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.385,4.805,1.12,26.6,32
NDC,57237-0220-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.654999999999999,4.98,1.2,27.12,32
NDC,57237-0221-30,PIOGLITAZONE HCL 45 MG TABLET,7.75,5.04,1.24,7.39,22
NDC,57237-0232-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.04,3.28,1.26,13.02,16
NDC,57237-0233-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.47,2.91,1.12,11.54,16
NDC,57237-0305-16,UNCLASSIFIED DRUGS,1.75,1.14,0.44,4.52,16
NDC,57237-0310-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.1,2.67,1.03,10.59,16
NDC,57237-0325-52,UNCLASSIFIED DRUGS,16.37,10.64,4.09,42.28,16
NDC,57237-0337-51,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.51,3.58,1.38,14.23,16
NDC,57664-0395-88,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.59,2.98,1.15,11.85,16
NDC,57894-0030-01,"INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG",11933.44,7756.74,34.37,30818.11,19
NDC,57894-0350-01,"INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE",5097.04,3313.08,12.33,13163.11,19
NDC,57894-0449-01,"INJECTION, TECLISTAMAB-CQYV, 0.5 MG",8381.69,5448.1,36.65,21645.71,19
NDC,57894-0450-01,"INJECTION, TECLISTAMAB-CQYV, 0.5 MG",22925.535,14901.595000000001,36.65,68912.82,38
NDC,57894-0469-01,"INJECTION, TALQUETAMAB-TGVS, 0.25 MG",5628.97,3658.83,79.42,14536.82,17
NDC,57894-0470-01,"INJECTION, TALQUETAMAB-TGVS, 0.25 MG",42816.55,27830.760000000002,79.42,129045.33,34
NDC,57894-0501-00,"INJECTION, AMIVANTAMAB-VMJW, 2 MG",2425.8,1576.77,23.91,7236.29,19
NDC,57894-0503-01,"INJECTION, DARATUMUMAB, 10 MG AND HYALURONIDASE-FIHJ",3859.96,2508.975,58.36,15900.92,38
NDC,57894-0505-05,"INJECTION, DARATUMUMAB, 10 MG",2307.27,1499.73,75.04,5958.52,19
NDC,57894-0510-01,"RYBREVANT FASPRO 1,600 MG VIAL",2759.03,1793.37,689.76,1931.32,11
NDC,57894-0640-11,"INJECTION, GUSELKUMAB, 1 MG",32019.76,20812.84,77.32,82691.03,19
NDC,57894-0650-01,TREMFYA 200 MG/20 ML VIAL,1630.38,1059.75,407.6,1141.27,11
NDC,57896-0145-14,UNCLASSIFIED DRUGS,3.85,2.5,0.96,9.94,16
NDC,57896-0181-05,UNCLASSIFIED DRUGS,1.42,0.92,0.36,3.67,16
NDC,57896-0401-01,UNCLASSIFIED DRUGS,4.44,2.89,1.11,11.47,16
NDC,57896-0555-01,UNCLASSIFIED DRUGS,8.73,5.67,2.18,22.55,16
NDC,57896-0901-01,UNCLASSIFIED DRUGS,14.15,9.2,3.54,36.54,16
NDC,57970-0100-01,"INJECTION, DALBAVANCIN, 5 MG",10669.015,6934.86,16.53,29383.17,38
NDC,58151-0118-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.37,7.39,2.84,29.36,16
NDC,58160-0810-43,"Diphtheria, tetanus, and acellular pertussis vaccine (younger than 7 years)",379.32,246.56,7.55,1058.83,57
NDC,58160-0811-43,"Diphtheria, tetanus, acellular pertussis, hepatitis B, and polio vaccine",325.1,211.32,30.97,839.57,19
NDC,58160-0812-43,KINRIX TIP-LOK SYRINGE,42.09,27.36,10.52,29.46,11
NDC,58160-0815-43,Hepatitis A and hepatitis B vaccine,827.38,537.795,163.76,2444.44,38
NDC,58160-0819-12,Shingles vaccine for injection into muscle,1184.38,769.85,163.76,3058.66,18
NDC,58160-0820-43,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",356.19,231.52,30.97,919.86,19
NDC,58160-0820-43,"RADIUM RA-223 DICHLORIDE, THERAPEUTIC, PER MICROCURIE",738.45,479.99,182.24,18303.64,19
NDC,58160-0820-52,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",122.2,79.43,30.55,315.58,19
NDC,58160-0821-01,"Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule)",245.53,159.59,61.38,634.08,19
NDC,58160-0821-43,"Hepatitis B vaccine, adult dosage (3 dose schedule)",348.3,226.4,30.97,899.48,19
NDC,58160-0821-43,"Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule)",100.0,65.0,25.0,258.25,19
NDC,58160-0821-52,"Hepatitis B vaccine, adult dosage (3 dose schedule)",580.4,377.26,30.97,1498.88,19
NDC,58160-0823-11,Shingles vaccine for injection into muscle,920.1,598.065,113.14,3583.61,36
NDC,58160-0826-43,Hepatitis A vaccine adult dosage,344.44,223.89,30.97,889.52,19
NDC,58160-0826-48,Hepatitis A vaccine adult dosage,45.0,29.25,11.25,116.21,19
NDC,58160-0842-01,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",776.4,504.66,30.97,2005.05,19
NDC,58160-0842-11,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",388.39,252.45,30.97,1003.02,19
NDC,58160-0842-43,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",647.0,420.55,30.97,1859.4,38
NDC,58160-0848-11,AREXVY VIAL KIT,1263.5,821.28,148.13,1198.16,33
NDC,58160-0912-41,FLUARIX 2025-2026 SYRINGE,12.25,7.96,3.06,8.58,11
NDC,58160-0955-09,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",281.83,183.19,70.46,727.83,19
NDC,58160-0958-01,MENVEO MENA COMPONENT,405.88,263.825,68.49,376.47,22
NDC,58160-0958-01,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",200.0,130.0,50.0,516.5,19
NDC,58160-0976-02,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",579.845,376.9,95.5,2008.38,38
NDC,58160-0976-20,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",3109.94,2021.46,163.76,8031.42,19
NDC,58468-0030-01,"INJECTION, THYROTROPIN ALPHA, 0.9 MG, PROVIDED IN 1.1 MG VIAL",7829.98,5089.49,1547.76,20220.92,19
NDC,58468-0070-01,ALDURAZYME 2.9 MG/5 ML VIAL,145.25,94.41,36.31,101.68,11
NDC,58468-0080-01,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25 MG",5948.25,3866.36,985.34,16673.6,57
NDC,58468-0090-01,"HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULAR INJECTION, 1 MG",177.76,115.54,8.01,459.07,19
NDC,58468-0090-03,"HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULAR INJECTION, 1 MG",522.52,339.64,8.01,1349.41,19
NDC,58468-0426-01,"INJECTION, AVALGLUCOSIDASE ALFA-NGPT, 4 MG",3910.6,2541.89,86.18,35052.23,19
NDC,58468-4663-01,"INJECTION, IMIGLUCERASE, 10 UNITS",3902.77,2536.8,45.82,11535.65,19
NDC,58526-0005-57,UNCLASSIFIED DRUGS,9.03,5.87,2.26,23.32,16
NDC,58980-0012-05,UNCLASSIFIED DRUGS,4.66,3.03,1.17,12.03,16
NDC,58980-0409-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.06,9.14,2.56,46.15,32
NDC,58980-0780-21,UNCLASSIFIED DRUGS,3.05,1.98,0.76,7.88,16
NDC,59011-0410-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.655,17.325,3.55,101.05,32
NDC,59011-0420-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",41.045,26.68,4.33,167.27,32
NDC,59011-0440-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",113.69,73.9,28.42,293.6,16
NDC,59011-0750-04,UNCLASSIFIED DRUGS,301.3,195.85,75.33,778.11,16
NDC,59011-0751-04,UNCLASSIFIED DRUGS,619.95,402.97,154.99,1601.02,16
NDC,59011-0758-04,UNCLASSIFIED DRUGS,768.15,499.3,192.04,1983.75,16
NDC,59148-0019-71,ABILIFY MAINTENA ER 400 MG VL,17454.91,11345.69,4363.73,12218.44,11
NDC,59148-0020-50,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3644.9,2369.19,911.23,9412.95,16
NDC,59148-0036-13,REXULTI 0.5 MG TABLET,319.21,207.49,79.8,223.45,11
NDC,59148-0037-13,REXULTI 1 MG TABLET,220.85,143.555,30.68,223.3,22
NDC,59148-0038-13,REXULTI 2 MG TABLET,172.37,112.045,6.12,224.19,22
NDC,59148-0039-13,REXULTI 3 MG TABLET,322.51,209.63,80.63,225.76,11
NDC,59148-0053-16,NUEDEXTA 20-10 MG CAPSULE,172.2,111.93,43.05,120.54,11
NDC,59148-0072-80,"INJECTION, ARIPIPRAZOLE (ABILIFY MAINTENA), 1 MG",11111.71,7222.61,7.72,28695.99,19
NDC,59148-0114-80,ABILIFY ASIMTUFII 960 MG/3.2ML,1194.56,776.46,298.64,836.19,11
NDC,59212-0681-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",114.35,74.33,28.59,295.31,16
NDC,59310-0579-22,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,23.31,15.15,5.83,60.2,16
NDC,59310-0610-31,"INJECTION, RESLIZUMAB, 1 MG",490.93,319.1,11.8,2058.35,19
NDC,59365-5128-01,INTRAUTERINE COPPER CONTRACEPTIVE,5123.4349999999995,3330.2349999999997,155.18,16079.94,38
NDC,59385-0021-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",62.2,40.43,15.55,160.63,16
NDC,59385-0022-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",51.805,33.67,11.88,144.83,32
NDC,59385-0023-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",74.235,48.254999999999995,15.69,221.37,32
NDC,59385-0025-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",109.45,71.14,27.36,282.65,16
NDC,59417-0102-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",74.13,48.18,18.53,191.44,16
NDC,59417-0105-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",68.01,44.205,11.93,228.01,32
NDC,59572-0711-01,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",31455.620000000003,20446.15,45.34,88856.36,38
NDC,59572-0775-01,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",92862.875,60360.87,45.34,282346.92,38
NDC,59584-0138-01,UNCLASSIFIED DRUGS,1555.77,1011.25,388.94,4017.78,16
NDC,59630-0266-01,"INJECTION, CEFIDEROCOL, 10 MG",1510.32,981.71,2.57,3900.4,19
NDC,59651-0018-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.3,7.35,2.83,29.18,16
NDC,59651-0026-55,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.96,2.575,0.56,14.67,32
NDC,59651-0086-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.25,15.114999999999998,4.0,78.77,32
NDC,59651-0152-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.65,12.12,4.66,48.16,16
NDC,59651-0153-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.76,5.04,1.33,26.32,32
NDC,59651-0214-30,AZELASTINE 0.1% (137 MCG) SPRY,4.91,3.19,1.23,3.44,11
NDC,59651-0256-01,UNCLASSIFIED DRUGS,11.5,7.48,2.88,29.7,16
NDC,59651-0257-01,UNCLASSIFIED DRUGS,19.555,12.71,1.87,81.74,32
NDC,59651-0360-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.48,10.71,4.12,42.56,16
NDC,59651-0362-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.61,17.95,6.9,71.3,16
NDC,59651-0421-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.66,14.08,5.42,55.94,16
NDC,59651-0484-01,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",2.95,1.92,0.01,7.62,17
NDC,59651-0485-01,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",14.1,9.17,0.01,36.41,17
NDC,59651-0487-01,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",16.79,10.91,0.01,43.36,17
NDC,59651-0539-05,UNCLASSIFIED DRUGS,5.67,3.69,1.42,14.64,16
NDC,59651-0540-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.29,3.44,1.32,13.66,16
NDC,59651-0722-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.5,10.73,4.13,42.61,16
NDC,59651-0723-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.26,11.22,4.32,44.57,16
NDC,59651-0780-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.3,2.8,1.08,11.1,16
NDC,59651-0781-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.89,7.73,0.8,53.2,32
NDC,59651-0782-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.770000000000001,7.65,1.34,46.92,32
NDC,59676-0320-00,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",710.0,461.5,8.2,1833.58,19
NDC,59676-0340-00,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",1402.65,911.72,8.2,3622.34,19
NDC,59676-0575-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",382.235,248.45499999999998,52.1,1436.05,32
NDC,59676-0610-01,"INJECTION, TRABECTEDIN, 0.1 MG",16908.29,10990.39,414.53,59040.52,38
NDC,59676-0800-30,SYMTUZA 800-150-200-10 MG TAB,393.25,255.61,98.31,275.28,11
NDC,59741-0301-12,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",52.15,33.9,13.04,134.68,16
NDC,59746-0010-32,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.895,9.03,2.81,42.71,32
NDC,59746-0020-22,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.055,7.84,2.26,38.92,32
NDC,59746-0030-22,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",41.5,26.98,10.38,107.17,16
NDC,59746-0171-06,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",12.72,8.27,0.01,32.85,17
NDC,59746-0383-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.0,4.55,1.75,18.08,16
NDC,59762-0050-01,"METHYLPREDNISOLONE ORAL, PER 4 MG",21.86,14.21,0.15,65.21,34
NDC,59762-0051-01,"METHYLPREDNISOLONE ORAL, PER 4 MG",42.975,27.935000000000002,0.15,150.07,34
NDC,59762-0073-01,UNCLASSIFIED DRUGS,20.43,13.28,5.11,52.76,16
NDC,59762-0075-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",58.06,37.74,14.52,149.94,16
NDC,59762-1002-01,"SIROLIMUS, ORAL, 1 MG",93.4,60.71,1.03,241.21,17
NDC,59762-1207-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.3,7.35,2.83,29.18,16
NDC,59762-1350-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",75.25,48.91,18.81,194.33,16
NDC,59762-1576-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.12,2.6799999999999997,0.88,12.19,32
NDC,59762-2012-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",45.95,29.87,11.49,118.67,16
NDC,59762-2888-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.2,16.38,6.3,65.08,16
NDC,59762-3720-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",45.06,29.29,11.27,116.37,16
NDC,59762-5000-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.68,8.89,3.42,35.33,16
NDC,59762-5000-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.31,2.15,0.83,8.55,16
NDC,59781-0666-88,ARGININE 7 GRAM-GLUTAM 7 GRAM-CAHMB 1.5 GRAM-COLLA-MV-MIN ORAL PWD PKT,17.87,11.615,4.26,13.08,22
NDC,59922-0631-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",733.21,476.59,183.3,1893.51,16
NDC,60219-1266-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",101.8,66.17,25.45,262.9,16
NDC,60219-1748-02,UNCLASSIFIED DRUGS,149.18,96.97,37.3,385.26,16
NDC,60219-3955-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",240.68,156.44,60.17,621.56,16
NDC,60258-0171-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.84,2.5,0.96,9.92,16
NDC,60258-0850-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.8,2.47,0.95,9.81,16
NDC,60267-0705-50,"INJECTION, SODIUM THIOSULFATE (PEDMARK), 100 MG",17.495,11.370000000000001,3.66,7236.29,38
NDC,60432-0150-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.565,1.02,0.36,4.36,32
NDC,60432-0608-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.945,1.915,0.33,11.85,32
NDC,60505-0080-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.955,8.42,1.1,55.6,32
NDC,60505-0083-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.19,17.02,6.55,67.64,16
NDC,60505-0094-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.96,24.67,9.49,98.03,16
NDC,60505-0095-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.2,20.93,8.05,83.16,16
NDC,60505-0141-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.91,5.145,0.93,31.3,32
NDC,60505-0142-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.1,6.57,2.53,26.08,16
NDC,60505-0157-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.97,5.83,2.24,23.17,16
NDC,60505-0158-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.02,3.91,1.51,15.55,16
NDC,60505-0159-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.285,8.635,1.1,57.23,32
NDC,60505-0363-01,UNCLASSIFIED DRUGS,38.56,25.06,9.64,99.58,16
NDC,60505-0815-00,UNCLASSIFIED DRUGS,82.68,53.74,20.67,213.52,16
NDC,60505-0823-06,UNCLASSIFIED DRUGS,183.58,119.33,45.9,474.1,16
NDC,60505-0829-01,DRUG ADMINISTERED THROUGH A METERED DOSE INHALER,5.06,3.29,1.27,13.07,16
NDC,60505-1003-01,UNCLASSIFIED DRUGS,476.44,309.69,119.11,1230.41,16
NDC,60505-2522-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.75,22.59,8.69,89.74,16
NDC,60505-2575-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.75,3.74,1.32,16.09,32
NDC,60505-2578-08,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.87,2.52,0.97,9.99,16
NDC,60505-3110-00,UNCLASSIFIED DRUGS,21.14,13.74,5.29,54.59,16
NDC,60505-3112-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.4,6.76,2.6,26.86,16
NDC,60505-3113-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",51.09,33.21,12.77,131.94,16
NDC,60505-3438-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.515,12.685,3.18,67.92,32
NDC,60505-4630-03,"CYCLOSPORINE, ORAL, 25 MG",12.29,7.99,0.56,31.74,17
NDC,60505-4643-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.15,7.25,2.79,28.79,16
NDC,60505-4741-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",64.0,41.6,16.0,165.28,16
NDC,60505-6097-00,"INJECTION, IBANDRONATE SODIUM, 1 MG",155.07,100.8,13.93,400.47,19
NDC,60505-6116-00,"INJECTION, REGADENOSON, 0.1 MG",287.56,186.91,2.84,742.62,17
NDC,60505-6128-01,"INJECTION, IRINOTECAN, 20 MG",65.96,42.87,1.9,197.88,17
NDC,60505-6132-07,"INJECTION, OXALIPLATIN, 0.5 MG",4.77,3.1,0.05,14.31,17
NDC,60505-6145-00,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",162.24,105.46,0.92,418.98,17
NDC,60505-6146-00,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",123.25,80.11,0.92,318.29,17
NDC,60505-6148-00,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",31.674999999999997,20.59,0.49,91.34,34
NDC,60505-6149-00,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",189.435,123.13499999999999,0.49,613.34,34
NDC,60505-6151-04,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",8.73,5.67,0.49,22.55,17
NDC,60505-6152-04,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",114.4,74.36,0.49,295.44,17
NDC,60505-6196-00,"INJECTION, ERTAPENEM SODIUM, 500 MG",201.81,131.18,9.71,521.17,17
NDC,60505-6197-02,"SIROLIMUS, ORAL, 1 MG",34.12,22.18,1.03,88.11,17
NDC,60505-6229-04,"INJECTION, DAPTOMYCIN (XELLIA), UNREFRIGERATED, NOT THERAPEUTICALLY EQUIVALENT TO J0878 OR J0873, 1 MG",132.52,86.14,0.06,342.23,17
NDC,60505-6231-05,CEFAZOLIN 2 GM VIAL,42.72,27.77,4.99,45.85,22
NDC,60505-6249-01,"DEXAMETHASONE, ORAL, 0.25 MG",4.975,3.235,0.01,13.43,34
NDC,60505-6251-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.88,10.97,4.22,43.59,16
NDC,60505-7061-00,"NICOTINE PATCHES, LEGEND",16.2,10.53,4.05,41.84,16
NDC,60505-7062-00,"NICOTINE PATCHES, LEGEND",34.04,22.13,8.51,87.91,16
NDC,60505-7063-00,"NICOTINE PATCHES, LEGEND",19.46,12.65,4.87,50.26,16
NDC,60687-0105-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.93,7.1,2.73,28.23,16
NDC,60687-0112-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.41,14.57,5.6,57.87,16
NDC,60687-0121-95,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.75,10.24,3.94,40.67,16
NDC,60687-0168-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",61.86,40.21,15.47,159.75,16
NDC,60687-0195-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.5,5.53,2.13,21.95,16
NDC,60687-0229-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.24,22.91,8.81,91.01,16
NDC,60687-0234-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.95,14.27,5.49,56.69,16
NDC,60687-0245-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.22,9.24,3.56,36.72,16
NDC,60687-0249-40,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.475,2.255,0.61,11.7,32
NDC,60687-0256-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.54,6.2,2.39,24.64,16
NDC,60687-0272-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.35,17.775,6.81,70.97,32
NDC,60687-0319-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",44.24,28.76,11.06,114.25,16
NDC,60687-0327-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.13,13.73,5.28,54.57,16
NDC,60687-0330-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",45.57,29.62,11.39,117.68,16
NDC,60687-0333-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",56.37,36.64,14.09,145.58,16
NDC,60687-0349-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.55,6.86,2.64,27.25,16
NDC,60687-0369-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.37,4.79,1.84,19.03,16
NDC,60687-0377-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.76,16.09,6.19,63.94,16
NDC,60687-0380-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.42,4.82,1.86,19.16,16
NDC,60687-0387-11,UNCLASSIFIED DRUGS,6.17,4.01,1.54,15.93,16
NDC,60687-0394-79,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",4.56,2.96,0.42,11.78,17
NDC,60687-0395-79,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",3.61,2.35,0.07,9.32,17
NDC,60687-0406-77,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.68,11.49,4.42,45.66,16
NDC,60687-0407-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.57,12.72,4.89,50.54,16
NDC,60687-0417-44,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.7800000000000002,1.81,0.67,7.46,32
NDC,60687-0418-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.5,11.38,4.38,45.19,16
NDC,60687-0422-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.48,7.46,2.87,29.65,16
NDC,60687-0423-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",197.73,128.52,49.43,510.64,16
NDC,60687-0428-11,"FINASTERIDE, 5 MG",19.34,12.57,4.84,49.95,16
NDC,60687-0432-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.6,7.54,2.9,29.96,16
NDC,60687-0438-11,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",10.3,6.7,0.16,26.6,17
NDC,60687-0443-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.54,2.95,1.14,11.72,16
NDC,60687-0451-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.52,13.99,5.38,55.58,16
NDC,60687-0451-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",46.6,30.29,11.65,120.34,16
NDC,60687-0454-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.87,2.52,0.97,9.99,16
NDC,60687-0457-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.93,14.25,5.48,56.63,16
NDC,60687-0473-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.62,17.3,6.66,68.75,16
NDC,60687-0484-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",96.0,62.4,24.0,247.92,16
NDC,60687-0487-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.5,4.88,1.88,19.37,16
NDC,60687-0492-11,"BUPRENORPHINE, ORAL, 1 MG",32.65,21.224999999999998,1.34,134.55,34
NDC,60687-0494-11,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",4.79,3.11,0.16,12.37,17
NDC,60687-0495-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",103.56,67.31,25.89,267.44,16
NDC,60687-0506-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.75,23.24,8.94,92.32,16
NDC,60687-0508-11,UNCLASSIFIED DRUGS,6.43,4.18,1.61,16.61,16
NDC,60687-0513-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.57,10.12,3.89,40.21,16
NDC,60687-0517-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",107.05,69.58,26.76,276.46,16
NDC,60687-0524-79,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",9.03,5.87,1.11,23.32,17
NDC,60687-0541-11,UNCLASSIFIED DRUGS,13.64,8.87,3.41,35.23,16
NDC,60687-0552-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.55,17.91,6.89,71.15,16
NDC,60687-0558-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.84,4.45,1.71,17.66,16
NDC,60687-0576-86,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.95,4.52,1.74,17.95,16
NDC,60687-0578-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.6,17.94,6.9,71.28,16
NDC,60687-0580-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.73,3.72,1.43,14.8,16
NDC,60687-0582-11,UNCLASSIFIED DRUGS,19.65,12.77,4.91,50.75,16
NDC,60687-0583-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.9,14.24,5.48,56.56,16
NDC,60687-0587-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.39,15.85,6.1,62.99,16
NDC,60687-0590-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",105.0,68.25,26.25,271.16,16
NDC,60687-0591-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.9,14.89,5.73,59.14,16
NDC,60687-0605-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.1,3.97,1.53,15.75,16
NDC,60687-0608-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.99,3.24,1.25,12.89,16
NDC,60687-0608-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.96,12.32,4.74,48.96,16
NDC,60687-0609-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.5,4.23,1.63,16.79,16
NDC,60687-0612-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.2,9.23,3.55,36.67,16
NDC,60687-0620-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.32,12.56,4.83,49.89,16
NDC,60687-0623-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.19,5.97,2.3,23.73,16
NDC,60687-0631-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.64,19.92,7.66,79.13,16
NDC,60687-0653-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.1,8.52,3.28,33.83,16
NDC,60687-0656-11,UNCLASSIFIED DRUGS,10.63,6.91,2.66,27.45,16
NDC,60687-0660-11,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",8.45,5.495,0.31,28.15,34
NDC,60687-0661-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.67,12.79,4.92,50.8,16
NDC,60687-0664-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.6,15.99,6.15,63.53,16
NDC,60687-0677-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.44,12.64,4.86,50.2,16
NDC,60687-0678-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.35,9.98,3.84,39.64,16
NDC,60687-0689-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.18,4.02,1.55,15.96,16
NDC,60687-0693-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.545,5.555,1.57,27.89,32
NDC,60687-0695-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.06,15.64,6.02,62.13,16
NDC,60687-0699-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.34,19.07,7.34,75.77,16
NDC,60687-0709-11,UNCLASSIFIED DRUGS,7.7,5.01,1.93,19.89,16
NDC,60687-0714-64,UNCLASSIFIED DRUGS,2.0,1.3,0.5,5.17,16
NDC,60687-0717-11,UNCLASSIFIED DRUGS,5.0,3.25,1.25,12.91,16
NDC,60687-0718-11,"DEXAMETHASONE, ORAL, 0.25 MG",42.68,27.74,0.01,110.22,17
NDC,60687-0722-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.73,8.27,3.18,32.88,16
NDC,60687-0723-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.2,9.88,3.8,39.25,16
NDC,60687-0735-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.57,1.02,0.39,4.05,16
NDC,60687-0744-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.53,15.94,6.13,63.35,16
NDC,60687-0746-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.88,10.97,4.22,43.59,16
NDC,60687-0747-11,LURASIDONE HCL 20 MG TABLET,21.25,13.81,5.31,14.88,11
NDC,60687-0750-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.36,7.38,2.84,29.34,16
NDC,60687-0752-33,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.18,20.27,7.8,80.52,16
NDC,60687-0773-11,"DEXAMETHASONE, ORAL, 0.25 MG",8.52,5.54,0.01,22.0,17
NDC,60687-0783-11,UNCLASSIFIED DRUGS,21.19,13.77,5.3,54.72,16
NDC,60687-0789-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.77,24.55,9.44,97.54,16
NDC,60687-0797-42,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.88,1.87,0.72,7.44,16
NDC,60687-0804-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.49,22.42,8.62,89.07,16
NDC,60687-0810-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.71,5.01,1.93,19.91,16
NDC,60687-0811-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.99,23.39,9.0,92.94,16
NDC,60687-0820-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.09,9.16,3.52,36.39,16
NDC,60687-0825-11,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",72.78,47.31,0.83,187.95,17
NDC,60687-0841-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.52,5.54,2.13,22.0,16
NDC,60687-0844-11,UNCLASSIFIED DRUGS,9.71,6.31,2.43,25.08,16
NDC,60687-0850-11,NITROFURANTOIN MCR 100 MG CAP,17.2,11.18,4.3,12.04,11
NDC,60687-0851-40,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.86,2.51,0.97,9.97,16
NDC,60687-0854-11,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",27.2,17.68,0.01,70.24,17
NDC,60687-0855-99,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",46.78,30.41,11.7,120.81,16
NDC,60687-0857-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.1,15.02,5.78,59.66,16
NDC,60687-0861-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",49.33,32.06,12.33,127.39,16
NDC,60687-0863-42,UNCLASSIFIED DRUGS,2.05,1.33,0.51,5.29,16
NDC,60687-0872-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.2,14.43,5.55,57.33,16
NDC,60687-0883-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.99,7.14,2.75,28.38,16
NDC,60687-0887-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.01,16.91,6.5,67.17,16
NDC,60687-0908-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.27,18.38,7.07,73.01,16
NDC,60758-0119-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",173.32,112.66,43.33,447.6,16
NDC,60758-0801-05,UNCLASSIFIED DRUGS,3.0,1.95,0.75,7.75,16
NDC,60758-0908-10,UNCLASSIFIED DRUGS,12.65,8.22,3.16,32.67,16
NDC,60793-0215-05,UNCLASSIFIED BIOLOGICS,441.3,286.85,110.33,1139.66,16
NDC,60793-0217-20,UNCLASSIFIED DRUGS,910.785,592.015,127.43,3387.9,32
NDC,60793-0217-21,UNCLASSIFIED DRUGS,1602.5,1041.63,400.63,4138.46,16
NDC,60793-0217-22,UNCLASSIFIED DRUGS,1091.155,709.25,107.5,4525.37,32
NDC,60793-0315-01,UNCLASSIFIED BIOLOGICS,286.74,186.38,71.69,740.51,16
NDC,60793-0700-10,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",452.5,294.13,33.89,1168.58,19
NDC,60793-0701-02,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",553.21,359.59,33.89,1428.66,19
NDC,60793-0701-10,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",1310.0,851.5,33.89,3383.08,19
NDC,60793-0702-10,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",1139.35,740.58,33.89,2942.37,19
NDC,60793-0705-05,UNCLASSIFIED DRUGS,338.55,220.06,39.15,1344.19,32
NDC,61314-0016-01,UNCLASSIFIED DRUGS,19.0,12.35,4.75,49.07,16
NDC,61314-0019-10,UNCLASSIFIED DRUGS,6.58,4.28,1.65,16.99,16
NDC,61314-0143-10,UNCLASSIFIED DRUGS,18.73,12.17,4.68,48.37,16
NDC,61314-0203-15,UNCLASSIFIED DRUGS,24.34,15.82,6.09,62.86,16
NDC,61314-0204-15,UNCLASSIFIED DRUGS,24.885,16.175,5.21,74.69,32
NDC,61314-0226-05,UNCLASSIFIED DRUGS,13.9,9.04,3.48,35.9,16
NDC,61314-0227-05,UNCLASSIFIED DRUGS,16.0,10.4,4.0,41.32,16
NDC,61314-0318-05,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",3444.67,2239.04,0.37,8895.86,19
NDC,61314-0326-01,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",2750.85,1788.0549999999998,0.37,7486.67,38
NDC,61314-0326-05,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",2161.87,1405.22,0.37,5583.03,19
NDC,61314-0355-01,UNCLASSIFIED DRUGS,9.22,5.99,2.31,23.81,16
NDC,61314-0396-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.5,12.03,4.63,47.78,16
NDC,61314-0631-36,UNCLASSIFIED DRUGS,13.7,8.91,3.43,35.38,16
NDC,61314-0633-05,UNCLASSIFIED DRUGS,3.94,2.56,0.99,10.18,16
NDC,61314-0643-05,UNCLASSIFIED DRUGS,8.56,5.56,2.14,22.11,16
NDC,61314-0656-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.17,13.11,5.04,52.09,16
NDC,61314-0665-05,UNCLASSIFIED DRUGS,26.17,17.009999999999998,5.94,73.81,32
NDC,61703-0305-58,"INJECTION, CYTARABINE, 100 MG",12.64,8.22,0.89,37.92,17
NDC,61703-0309-06,"VINCRISTINE SULFATE, 1 MG",83.53,54.29,8.64,250.59,17
NDC,61703-0309-16,"VINCRISTINE SULFATE, 1 MG",65.32,42.46,8.64,195.96,17
NDC,61703-0319-22,"INJECTION, CYTARABINE, 100 MG",39.61,25.75,0.89,118.83,17
NDC,61703-0324-18,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",3.21,2.09,0.8,11.97,17
NDC,61703-0339-56,"INJECTION, CARBOPLATIN, 50 MG",7.12,4.63,1.78,21.36,17
NDC,61703-0408-41,"INJECTION, METHOTREXATE SODIUM, 50 MG",6.24,4.06,1.56,18.72,17
NDC,61703-0600-05,"INJECTION, CARBOPLATIN, 50 MG",11.69,7.6,2.92,35.07,17
NDC,61755-0005-02,"INJECTION, AFLIBERCEPT, 1 MG",277832.57,180591.17,809.73,717502.61,19
NDC,61755-0005-54,"INJECTION, AFLIBERCEPT, 1 MG",189579.97,123226.98,809.73,489590.27,19
NDC,61755-0008-01,"INJECTION, CEMIPLIMAB-RWLC, 1 MG",10156.47,6601.71,30.41,26229.08,19
NDC,61755-0050-00,EYLEA HD 8 MG/0.07 ML VIAL,174956.68,113721.84,43739.17,122469.68,11
NDC,61755-0054-01,LYNOZYFIC 5 MG/2.5 ML VIAL,1360.0,884.0,340.0,952.0,11
NDC,61755-0056-01,LYNOZYFIC 200 MG/10 ML VIAL,12504.5,8127.925,2940.25,9273.6,22
NDC,61874-0115-11,VRAYLAR 1.5 MG CAPSULE,224.465,145.905,31.74,225.39,22
NDC,61874-0130-11,VRAYLAR 3 MG CAPSULE,329.68,214.29,82.42,230.78,11
NDC,61874-0130-30,VRAYLAR 3 MG CAPSULE,147.16,95.65,36.79,103.01,11
NDC,61874-0145-30,VRAYLAR 4.5 MG CAPSULE,226.875,147.47,30.71,231.63,22
NDC,61874-0160-30,VRAYLAR 6 MG CAPSULE,175.38,114.0,6.68,226.84,22
NDC,61958-0901-01,UNCLASSIFIED DRUGS,23.884999999999998,15.524999999999999,2.95,92.89,32
NDC,61958-1901-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",952.85,619.35,238.21,2460.74,16
NDC,61958-2002-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",188.95,122.82,47.24,487.96,16
NDC,61958-2002-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",504.55,327.96,126.14,1303.0,16
NDC,61958-2301-01,VEMLIDY 25 MG TABLET,333.77,216.95,83.44,233.64,11
NDC,61958-2501-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",230.2,149.63,57.55,594.49,16
NDC,61958-2901-02,"INJECTION, REMDESIVIR, 1 MG",4812.95,3128.42,7.31,13201.4,38
NDC,61958-3004-01,SUNLENCA 463.5 MG/1.5 ML VIAL,16104.2,10467.73,4026.05,11272.94,11
NDC,61958-3402-01,YEZTUGO 463.5 MG/1.5 ML VIAL,10482.6,6813.69,2620.65,7337.82,11
NDC,62135-0330-41,"PREDNISOLONE ORAL, PER 5 MG",15.67,10.19,0.98,40.47,17
NDC,62205-0000-25,ENTERAL PUMP ACCESSORY FOR FAT HYDROLYSIS CARTRIDGE,395.88,257.32,98.97,277.12,11
NDC,62332-0025-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.350000000000001,9.98,3.23,45.97,32
NDC,62332-0031-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.13,16.98,6.53,67.48,16
NDC,62332-0032-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.08,11.75,4.52,46.69,16
NDC,62332-0034-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.61,11.45,4.4,45.48,16
NDC,62332-0040-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.47,6.81,2.62,27.04,16
NDC,62332-0084-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.43,14.58,5.61,57.93,16
NDC,62332-0085-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.49,4.22,1.62,16.76,16
NDC,62332-0098-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",65.15,42.35,16.29,168.25,16
NDC,62332-0099-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.97,5.18,1.99,20.58,16
NDC,62332-0100-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.6,7.54,2.9,29.96,16
NDC,62332-0112-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.14,20.24,7.79,80.42,16
NDC,62332-0114-31,UNCLASSIFIED DRUGS,50.68,32.94,12.67,130.88,16
NDC,62332-0127-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.6,7.54,2.9,29.96,16
NDC,62332-0141-31,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.3,14.5,5.58,57.59,16
NDC,62332-0142-71,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",136.56,88.76,34.14,352.67,16
NDC,62332-0199-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",45.95,29.87,11.49,118.67,16
NDC,62332-0365-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.92,7.1,2.73,28.2,16
NDC,62332-0556-45,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",77.74,50.53,19.44,200.76,16
NDC,62332-0557-45,UNCLASSIFIED DRUGS,84.19,54.72,21.05,217.42,16
NDC,62332-0582-04,UNCLASSIFIED DRUGS,20.91,13.59,5.23,54.0,16
NDC,62332-0585-30,UNCLASSIFIED DRUGS,1.54,1.0,0.39,3.98,16
NDC,62332-0619-31,"CYCLOPHOSPHAMIDE; ORAL, 25 MG",123.8,80.47,1.93,319.71,17
NDC,62332-0679-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",70.36,45.73,17.59,181.7,16
NDC,62530-0000-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.65,13.424999999999999,2.13,84.65,32
NDC,62559-0153-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",59.835,38.894999999999996,14.2,162.34,32
NDC,62559-0158-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.435,2.8850000000000002,0.69,15.75,32
NDC,62559-0160-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.935,5.81,1.03,35.51,32
NDC,62559-0190-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.01,1.96,0.75,7.77,16
NDC,62559-0232-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.9,4.49,1.73,17.82,16
NDC,62559-0381-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.69,6.95,2.67,27.61,16
NDC,62559-0422-01,UNCLASSIFIED DRUGS,19.36,12.58,4.84,50.0,16
NDC,62559-0431-30,UNCLASSIFIED DRUGS,6.53,4.24,1.63,16.86,16
NDC,62559-0631-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",54.75,35.59,13.69,141.39,16
NDC,62559-0741-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.56,12.71,4.89,50.51,16
NDC,62559-0742-01,UNCLASSIFIED DRUGS,10.8,7.02,2.7,27.89,16
NDC,62584-0266-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.84,2.5,0.96,9.92,16
NDC,62584-0267-11,UNCLASSIFIED DRUGS,3.89,2.53,0.97,10.05,16
NDC,62584-0984-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.17,13.76,5.29,54.67,16
NDC,62756-0059-40,"INJECTION, EPOPROSTENOL, 0.5 MG",132.7,86.26,16.59,342.7,17
NDC,62756-0060-40,"INJECTION, EPOPROSTENOL, 0.5 MG",356.74,231.88,16.59,968.08,34
NDC,62756-0130-01,ONDANSETRON HCL 4 MG TABLET,11.274999999999999,7.33,2.74,8.12,22
NDC,62756-0260-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.1,3.97,1.53,15.75,16
NDC,62756-0430-88,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.74,10.88,4.19,43.23,16
NDC,62756-0589-88,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.23,11.85,4.56,47.08,16
NDC,62856-0212-01,"INJECTION, LECANEMAB-IRMB, 1 MG",968.29,629.39,1.41,2500.61,19
NDC,62856-0274-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.83,18.09,6.96,71.87,16
NDC,62856-0278-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",170.87,111.07,42.72,441.27,16
NDC,62856-0389-01,"INJECTION, ERIBULIN MESYLATE, 0.1 MG",5069.35,3295.08,76.97,13091.6,19
NDC,62856-0410-30,DAYVIGO 10 MG TABLET,79.55,51.71,19.89,55.69,11
NDC,62856-0704-05,LENVIMA 4 MG CAPSULE,5772.83,3752.34,1443.21,4040.98,11
NDC,62856-0710-05,LENVIMA 10 MG DAILY DOSE,5784.6,3759.99,1446.15,4049.22,11
NDC,62935-0227-10,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",2842.08,1847.35,181.03,8526.24,19
NDC,62935-0461-50,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",2840.0,1846.0,181.03,8520.0,19
NDC,62935-0756-80,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",245.0,159.25,61.25,735.0,19
NDC,63044-0150-05,UNCLASSIFIED DRUGS,13.27,8.63,3.32,34.27,16
NDC,63044-0622-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.78,8.96,3.45,35.59,16
NDC,63090-0340-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",784.0550000000001,509.64,176.98,2221.49,32
NDC,63304-0450-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.55,10.76,4.14,42.74,16
NDC,63323-0010-03,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",25.92,16.85,2.3,66.94,17
NDC,63323-0012-03,"INJECTION, OXYTOCIN, UP TO 10 UNITS",51.1,33.22,2.85,131.97,17
NDC,63323-0012-11,"INJECTION, OXYTOCIN, UP TO 10 UNITS",12.25,7.96,2.85,31.64,17
NDC,63323-0044-01,"INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG",86.38,56.15,0.68,223.08,17
NDC,63323-0093-30,UNCLASSIFIED DRUGS,4.015000000000001,2.6100000000000003,0.72,13.3,32
NDC,63323-0103-51,"INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG",4.51,2.93,1.13,13.53,17
NDC,63323-0106-02,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",2.79,1.81,0.43,7.21,17
NDC,63323-0113-10,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",518.645,337.12,110.16,1540.82,38
NDC,63323-0117-10,"INJECTION, FLUOROURACIL, 500 MG",83.77,54.45,2.06,251.31,17
NDC,63323-0117-61,"INJECTION, FLUOROURACIL, 500 MG",14.079999999999998,9.155,0.88,200.91,68
NDC,63323-0120-20,"INJECTION, CYTARABINE, 100 MG",569.98,370.49,0.89,1709.94,17
NDC,63323-0127-00,"DACARBAZINE, 100 MG",27.88,18.12,4.37,83.64,17
NDC,63323-0130-11,UNCLASSIFIED DRUGS,1555.91,1011.34,388.98,4018.14,16
NDC,63323-0132-12,"INJECTION, MITOXANTRONE HYDROCHLORIDE, PER 5 MG",62.19,40.42,15.55,202.84,19
NDC,63323-0137-20,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",440.37,286.24,24.4,1321.11,17
NDC,63323-0162-01,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",70.07,45.55,0.35,180.96,17
NDC,63323-0162-25,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",47.25,30.71,0.35,122.02,17
NDC,63323-0165-05,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",48.31,31.4,0.12,144.93,17
NDC,63323-0170-05,UNCLASSIFIED DRUGS,29.93,19.45,7.48,77.29,16
NDC,63323-0173-01,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",158.93,103.3,2.3,410.44,17
NDC,63323-0180-01,"INJECTION, PYRIDOXINE HCL, 100 MG",189.83,123.39,16.49,490.24,17
NDC,63323-0184-10,UNCLASSIFIED DRUGS,32.04,20.83,8.01,82.74,16
NDC,63323-0185-10,"STERILE WATER/SALINE, 500 ML",3.98,2.59,1.0,4.15,16
NDC,63323-0186-10,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",1.78,1.16,0.45,1.25,16
NDC,63323-0192-02,"INJECTION, FLUDARABINE PHOSPHATE, 50 MG",367.48,238.85999999999999,53.54,1562.46,34
NDC,63323-0201-03,UNCLASSIFIED DRUGS,31.29,20.34,7.82,80.81,16
NDC,63323-0208-01,UNCLASSIFIED DRUGS,3.05,1.98,0.76,7.88,16
NDC,63323-0208-05,UNCLASSIFIED DRUGS,10.94,7.11,2.74,28.25,16
NDC,63323-0229-05,"INJECTION, PROTAMINE SULFATE, PER 10 MG",7.83,5.09,1.66,20.22,17
NDC,63323-0229-30,"INJECTION, PROTAMINE SULFATE, PER 10 MG",45.78,29.76,1.66,118.23,17
NDC,63323-0254-10,UNCLASSIFIED DRUGS,16.61,10.795,3.65,48.11,32
NDC,63323-0260-37,"INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML",2.14,1.39,0.54,5.53,17
NDC,63323-0262-06,"HEPARIN SOD 5,000 UNIT/ML VIAL",12.15,7.9,3.04,8.51,11
NDC,63323-0265-30,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",548.54,356.55,0.28,1416.6,17
NDC,63323-0269-22,"INJECTION, PROPOFOL, 10 MG",9.72,6.32,0.1,25.1,17
NDC,63323-0276-02,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",7.8,5.07,0.19,20.14,17
NDC,63323-0278-10,"INJECTION, VINBLASTINE SULFATE, 1 MG",45.019999999999996,29.265,5.49,140.25,34
NDC,63323-0280-10,"INJECTION, FUROSEMIDE, 1 MG",348.08,226.25,0.02,898.92,17
NDC,63323-0284-20,"INJECTION, VANCOMYCIN HCL, 500 MG",19.994999999999997,12.995000000000001,0.7,211.17,96
NDC,63323-0285-23,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",1.26,0.82,0.05,3.25,17
NDC,63323-0286-30,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",16.62,10.8,0.05,42.92,17
NDC,63323-0294-27,"INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML",17.445,11.34,0.99,79.93,34
NDC,63323-0303-51,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",332.71,216.26,2.19,859.22,17
NDC,63323-0306-01,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",47.68,30.99,2.19,123.13,17
NDC,63323-0306-05,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",21.0,13.65,2.19,54.23,17
NDC,63323-0342-01,"INJECTION, CEFOXITIN SODIUM, 1 GM",197.5,128.38,5.02,510.04,17
NDC,63323-0360-01,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",4.99,3.24,0.03,12.89,17
NDC,63323-0360-19,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",9.05,5.88,0.03,23.37,17
NDC,63323-0366-00,"INJECTION, DIMENHYDRINATE, UP TO 50 MG",146.35,95.13,0.98,377.95,17
NDC,63323-0366-01,"INJECTION, DIMENHYDRINATE, UP TO 50 MG",147.55,95.91,0.98,381.05,17
NDC,63323-0376-01,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",14.16,9.2,0.7,36.57,17
NDC,63323-0377-01,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",74.25,48.26,0.7,191.75,17
NDC,63323-0401-20,UNCLASSIFIED DRUGS,252.8,164.32,63.2,652.86,16
NDC,63323-0402-01,"INJECTION, AZTREONAM, 100 MG",443.07,288.0,2.36,1144.23,17
NDC,63323-0402-20,"INJECTION, AZTREONAM, 100 MG",100.55,65.36,2.36,259.67,17
NDC,63323-0412-03,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",27.39,17.805,0.15,115.64,34
NDC,63323-0415-10,"INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG",25.42,16.52,1.49,65.65,17
NDC,63323-0417-01,UNCLASSIFIED DRUGS,3.46,2.25,0.87,8.94,16
NDC,63323-0461-57,UNCLASSIFIED DRUGS,1.11,0.72,0.28,2.87,16
NDC,63323-0463-57,UNCLASSIFIED DRUGS,3.3449999999999998,2.175,0.29,14.26,32
NDC,63323-0464-17,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",5.0,3.25,0.01,12.91,17
NDC,63323-0465-57,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",5.1,3.32,0.01,13.17,17
NDC,63323-0468-37,UNCLASSIFIED DRUGS,2.83,1.84,0.71,7.31,16
NDC,63323-0469-01,"INJECTION, HALOPERIDOL DECANOATE, PER 50 MG",106.91,69.49,4.18,276.1,17
NDC,63323-0472-17,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",48.75,31.69,0.01,125.9,17
NDC,63323-0474-00,"INJECTION, HALOPERIDOL, UP TO 5 MG",130.62,84.9,0.77,337.33,17
NDC,63323-0476-37,NESACAINE 2% VIAL,3.33,2.16,0.83,2.33,11
NDC,63323-0477-01,"INJECTION, CHLOROPROCAINE HYDROCHLORIDE, PER 1 MG",23.87,15.52,0.04,61.64,17
NDC,63323-0481-01,UNCLASSIFIED DRUGS,10.35,6.73,2.59,26.73,16
NDC,63323-0482-17,UNCLASSIFIED DRUGS,18.05,11.73,4.51,46.61,16
NDC,63323-0483-27,UNCLASSIFIED DRUGS,45.63,29.66,11.41,117.84,16
NDC,63323-0486-02,UNCLASSIFIED DRUGS,4.51,2.93,1.13,11.65,16
NDC,63323-0487-07,UNCLASSIFIED DRUGS,11.56,7.51,2.89,29.85,16
NDC,63323-0487-37,UNCLASSIFIED DRUGS,20.95,13.62,5.24,54.1,16
NDC,63323-0488-17,UNCLASSIFIED DRUGS,16.27,10.58,4.07,42.02,16
NDC,63323-0489-17,UNCLASSIFIED DRUGS,11.1,7.22,2.78,28.67,16
NDC,63323-0491-01,UNCLASSIFIED DRUGS,46.75,30.39,11.69,120.73,16
NDC,63323-0492-04,UNCLASSIFIED DRUGS,19.52,12.69,4.88,50.41,16
NDC,63323-0492-57,UNCLASSIFIED DRUGS,34.25,22.26,8.56,88.45,16
NDC,63323-0495-07,"INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG",13.95,9.07,3.49,36.03,16
NDC,63323-0507-20,"INJECTION, MEROPENEM, 100 MG",142.65,92.72,0.4,368.39,17
NDC,63323-0508-01,"INJECTION, MEROPENEM, 100 MG",64.6,41.99,0.4,166.83,17
NDC,63323-0516-10,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",63.45,41.24,0.12,190.35,17
NDC,63323-0530-21,UNCLASSIFIED DRUGS,1.17,0.76,0.29,3.02,16
NDC,63323-0531-90,"INJECTION, ENOXAPARIN SODIUM, 10 MG",67.89,44.13,0.56,203.67,17
NDC,63323-0540-05,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",11.97,7.78,0.19,30.91,17
NDC,63323-0540-15,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",15.93,10.35,0.19,41.14,17
NDC,63323-0542-13,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",59.22,38.49,0.19,152.94,17
NDC,63323-0562-10,"INJECTION, BIVALIRUDIN, 1 MG",939.94,610.96,0.17,2427.4,19
NDC,63323-0563-10,UNCLASSIFIED DRUGS,61.0,39.65,15.25,157.53,16
NDC,63323-0589-21,"INJECTION, ENOXAPARIN SODIUM, 10 MG",97.0,63.05,0.56,291.0,17
NDC,63323-0593-03,"INJECTION, GLUCAGON HYDROCHLORIDE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J1610, PER 1 MG",815.3,529.95,151.85,2105.51,19
NDC,63323-0593-03,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",657.69,427.5,129.32,2061.09,38
NDC,63323-0596-11,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",294.43,191.38,73.61,760.37,19
NDC,63323-0596-13,"INJECTION, GLUCAGON HYDROCHLORIDE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J1610, PER 1 MG",1146.21,745.04,151.85,2960.09,19
NDC,63323-0597-10,"INJECTION, DEFEROXAMINE MESYLATE, 500 MG",114.63,74.51,8.98,296.03,17
NDC,63323-0604-01,"INJECTION, PROPRANOLOL HCL, UP TO 1 MG",39.55,25.705,8.91,112.21,34
NDC,63323-0605-84,"INJECTION, ENOXAPARIN SODIUM, 10 MG",53.52,34.79,0.56,160.56,17
NDC,63323-0614-01,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",91.41,59.42,4.65,236.07,17
NDC,63323-0616-02,"INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG",3.25,2.11,0.43,8.39,17
NDC,63323-0637-03,"INJECTION, ARSENIC TRIOXIDE, 1 MG",45.02,29.26,7.83,202.84,19
NDC,63323-0642-01,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",18.09,11.76,0.43,46.72,17
NDC,63323-0649-07,UNCLASSIFIED DRUGS,585.19,380.37,145.19,1577.75,48
NDC,63323-0655-21,"INJECTION, ENOXAPARIN SODIUM, 10 MG",29.66,19.28,0.56,88.98,17
NDC,63323-0658-20,"INJECTION, CHLOROTHIAZIDE SODIUM, PER 500 MG",2017.86,1311.61,61.62,5211.12,17
NDC,63323-0660-05,UNCLASSIFIED DRUGS,14.08,9.15,3.52,36.36,16
NDC,63323-0665-00,"INJECTION, TERBUTALINE SULFATE, UP TO 1 MG",190.11,123.57,2.62,490.96,17
NDC,63323-0673-21,"INJECTION, PALONOSETRON HCL, 25 MCG",55.18,35.870000000000005,0.37,149.58,34
NDC,63323-0673-89,"INJECTION, PALONOSETRON HCL, 25 MCG",45.8,29.77,0.37,118.28,17
NDC,63323-0711-00,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",410.885,267.08000000000004,4.07,1674.69,68
NDC,63323-0728-01,"INJECTION, MICAFUNGIN SODIUM, 1 MG",45.85,29.8,0.27,118.41,17
NDC,63323-0729-10,"INJECTION, MICAFUNGIN SODIUM, 1 MG",1183.82,769.48,0.27,3057.22,17
NDC,63323-0733-10,"INJECTION, MESNA, 200 MG",12.74,8.28,1.8,38.22,17
NDC,63323-0738-06,UNCLASSIFIED DRUGS,86.86,56.46,21.72,224.32,16
NDC,63323-0738-20,FAMOTIDINE 200 MG/20 ML VIAL,39.3,25.55,9.83,27.51,11
NDC,63323-0812-20,"INJECTION, OXACILLIN SODIUM, UP TO 250 MG",139.65,90.77,0.6,360.65,17
NDC,63323-0820-00,UNCLASSIFIED DRUGS,2.86,1.86,0.66,17.97,48
NDC,63323-0820-74,UNCLASSIFIED DRUGS,3.74,2.43,0.94,9.66,16
NDC,63323-0823-01,"INJECTION, ERTAPENEM SODIUM, 500 MG",279.02,181.36,9.71,720.57,17
NDC,63323-0842-21,"INJECTION, DICYCLOMINE HCL, UP TO 20 MG",76.83,49.94,12.01,198.41,17
NDC,63323-0851-03,"INJECTION, HYDROMORPHONE, 0.1 MG",30.37,19.74,0.15,78.43,17
NDC,63323-0875-50,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",11.8,7.67,2.95,189.15,19
NDC,63323-0877-15,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",599.76,389.84,149.94,1548.88,19
NDC,63323-0881-01,UNCLASSIFIED DRUGS,9.66,6.28,2.42,24.95,16
NDC,63323-0883-30,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",7.705,5.005,0.28,42.84,34
NDC,63323-0925-17,ROMIDEPSIN 10 MG VIAL,16996.295,11047.59,3567.35,13806.23,22
NDC,63323-0963-30,"INJECTION, ACETYLCYSTEINE, 100 MG",2.36,1.53,0.39,6.09,17
NDC,63323-0965-20,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.47,0.96,0.13,3.8,17
NDC,63323-0966-00,"INJECTION, ZOLEDRONIC ACID, 1 MG",60.69,39.45,5.38,182.07,17
NDC,63323-0967-30,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",69.74,45.33,0.13,180.1,17
NDC,63459-0103-10,"INJECTION, RITUXIMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10 MG",227.51999999999998,147.89000000000001,31.96,2922.83,38
NDC,63459-0303-43,HERZUMA 150 MG VIAL,4895.0,3181.75,1223.75,3426.5,11
NDC,63459-0307-41,"INJECTION, TRASTUZUMAB-PKRB, BIOSIMILAR, (HERZUMA), 10 MG",27045.04,17579.28,58.76,69843.82,19
NDC,63459-0910-12,GRANIX 300 MCG/0.5 ML SAFE SYR,757.5,492.38,189.38,530.25,11
NDC,63459-0912-12,GRANIX 480 MCG/0.8 ML SAFE SYR,746.56,485.26,186.64,522.59,11
NDC,63629-1485-02,KETOCONAZOLE 200 MG TABLET,31.55,20.51,7.89,22.09,11
NDC,63736-0143-08,UNCLASSIFIED DRUGS,19.105,12.42,4.18,55.52,32
NDC,63739-0403-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.8,14.82,5.7,58.88,16
NDC,63739-0902-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.98,15.59,6.0,61.93,16
NDC,63739-0976-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.35,1.53,0.59,6.07,16
NDC,63833-0386-02,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",142.015,92.31,2.22,2922.83,38
NDC,63833-0387-02,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",154.005,100.1,2.22,2922.83,38
NDC,63833-0616-02,"INJECTION, VON WILLEBRAND FACTOR COMPLEX (HUMATE-P), PER IU VWF:RCO",5894.360000000001,3831.335,1.58,15668.26,38
NDC,63833-0617-02,"HUMATE-P 2,400 UNIT VWF:RCO",17883.5,11624.28,4470.88,12518.45,11
NDC,63833-0761-40,"STERILE WATER/SALINE, 500 ML",12.69,8.25,3.17,8.88,16
NDC,63833-0835-01,"INJECTION, C-1 ESTERASE INHIBITOR (HUMAN), BERINERT, 10 UNITS",12205.849999999999,7933.8,80.41,45610.62,38
NDC,64067-0216-01,UNCLASSIFIED DRUGS,305.84000000000003,198.795,39.14,1175.37,32
NDC,64193-0325-01,"ANTI-INHIBITOR, PER I.U.",20306.87,13199.47,2.59,52442.49,19
NDC,64208-7753-01,"INJECTION, FACTOR X, (HUMAN), 1 I.U.",126.925,82.5,7.9,35052.23,38
NDC,64253-0222-35,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",5.25,3.41,0.02,13.56,17
NDC,64253-0333-35,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",3.23,2.1,0.02,8.34,17
NDC,64253-0444-22,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",13.65,8.87,0.02,35.25,17
NDC,64380-0158-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.85,7.05,2.71,28.02,16
NDC,64380-0160-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.985,2.59,0.85,11.85,32
NDC,64380-0723-06,"CALCITROL, 0.25 MICROGRAM",14.08,9.15,3.52,36.36,16
NDC,64380-0737-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.71,14.76,5.68,58.65,16
NDC,64380-0783-08,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",26.57,17.27,0.01,68.62,17
NDC,64380-0784-07,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",145.78,94.76,0.01,376.48,17
NDC,64380-0797-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",135.45,88.04,33.86,349.8,16
NDC,64380-0799-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",65.46,42.55,16.37,169.05,16
NDC,64380-0842-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.87,12.27,4.72,48.73,16
NDC,64380-0878-06,ETHOSUXIMIDE 250 MG CAPSULE,3.53,2.29,0.88,2.47,11
NDC,64380-0883-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.38,11.3,4.35,44.88,16
NDC,64380-0918-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.12,11.78,4.53,46.79,16
NDC,64406-0008-01,"INJECTION, NATALIZUMAB, 1 MG",3493.91,2271.04,25.98,9023.02,19
NDC,64406-0024-01,TOFIDENCE 80 MG/4 ML VIAL,224.14,145.69,56.04,156.9,11
NDC,64406-0109-01,"INJECTION, TOFERSEN, 1 MG",2175.65,1414.17,169.61,5618.62,17
NDC,64764-0300-20,"INJECTION, VEDOLIZUMAB, INTRAVENOUS, 1 MG",323.87,210.515,22.65,7236.29,38
NDC,64764-0720-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",67.22,43.69500000000001,6.29,282.24,32
NDC,64764-0730-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",98.35499999999999,63.93,21.35,287.51,32
NDC,64764-0750-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",85.28,55.42999999999999,14.86,287.02,32
NDC,64764-0800-28,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1604.71,1043.06,401.18,4144.16,16
NDC,64875-0001-01,"MIFEPRISTONE, ORAL, 200 MG",456.235,296.555,83.74,1491.39,36
NDC,64896-0403-01,ONGENTYS 50 MG CAPSULE,64.8,42.12,16.2,45.36,11
NDC,64896-0661-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.305,18.4,6.85,75.41,32
NDC,64896-0662-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",32.67,21.235,6.99,96.56,32
NDC,64896-0663-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.450000000000003,15.895,5.41,70.4,32
NDC,64896-0664-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.0,18.2,5.41,88.71,32
NDC,64950-0216-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.105,5.915,1.1,35.69,32
NDC,64950-0354-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",53.23,34.6,13.31,137.47,16
NDC,64980-0104-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.17,5.3100000000000005,1.03,31.56,32
NDC,64980-0279-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.6,10.14,3.9,40.29,16
NDC,64980-0320-05,UNCLASSIFIED DRUGS,87.52,56.89,21.88,226.02,16
NDC,64980-0340-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.61,3.0,1.15,11.91,16
NDC,64980-0342-14,UNCLASSIFIED DRUGS,11.05,7.18,2.76,28.54,16
NDC,64980-0409-06,UNCLASSIFIED DRUGS,7.775,5.055,1.68,22.83,32
NDC,64980-0504-48,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.64,1.065,0.29,5.5,32
NDC,64980-0509-24,"DEXAMETHASONE, ORAL, 0.25 MG",1.27,0.83,0.01,3.28,17
NDC,64980-0513-05,UNCLASSIFIED DRUGS,5.22,3.39,1.31,13.48,16
NDC,64980-0515-05,UNCLASSIFIED DRUGS,19.96,12.97,4.99,51.55,16
NDC,64980-0566-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.4,16.51,6.35,65.6,16
NDC,65145-0146-01,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",71.07,46.2,0.35,183.54,17
NDC,65162-0024-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",82.62,53.7,20.66,213.37,16
NDC,65162-0272-50,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",37.36,24.28,9.34,96.48,16
NDC,65162-0321-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.45,3.54,1.36,14.07,16
NDC,65162-0351-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",421.35,273.88,105.34,1088.14,16
NDC,65162-0441-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.05,2.63,1.01,10.46,16
NDC,65162-0478-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",59.11,38.42,14.78,152.65,16
NDC,65162-0596-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",26.7,17.36,6.68,68.95,16
NDC,65162-0649-78,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.91,3.19,1.23,12.68,16
NDC,65162-0673-84,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.275,22.93,0.76,174.32,32
NDC,65162-0681-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.315,8.655,1.23,56.04,32
NDC,65162-0691-79,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",5.14,3.34,0.01,13.27,17
NDC,65162-0755-10,UNCLASSIFIED DRUGS,8.01,5.21,2.0,20.69,16
NDC,65162-0757-50,UNCLASSIFIED DRUGS,15.34,9.97,3.84,39.62,16
NDC,65162-0764-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.34,11.27,4.34,44.78,16
NDC,65162-0896-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.64,6.27,2.41,24.9,16
NDC,65162-0898-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.16,5.3,2.04,21.07,16
NDC,65162-0901-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.93,3.2,1.23,12.73,16
NDC,65162-0902-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.379999999999999,5.445,1.48,27.97,32
NDC,65162-0949-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.05,4.58,1.76,18.21,16
NDC,65162-0993-08,UNCLASSIFIED DRUGS,64.95,42.22,16.24,167.73,16
NDC,65162-0995-04,UNCLASSIFIED DRUGS,57.92,37.65,14.48,149.58,16
NDC,65162-0997-04,UNCLASSIFIED DRUGS,128.15,83.3,32.04,330.95,16
NDC,65174-0270-30,"TECHNETIUM TC-99M MACROAGGREGATED ALBUMIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES",1336.365,868.635,32.21,4080.81,34
NDC,65174-0660-30,"TECHNETIUM TC-99M MEDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",213.62,138.85500000000002,53.36,645.01,34
NDC,65219-0014-01,"INJECTION, AMPICILLIN SODIUM, 500 MG",121.75,79.14,0.63,314.42,17
NDC,65219-0056-09,UNCLASSIFIED DRUGS,33.51,21.78,8.38,86.54,16
NDC,65219-0184-01,UNCLASSIFIED DRUGS,45.44,29.54,11.36,117.35,16
NDC,65219-0240-50,5% DEXTROSE/WATER (500 ML = 1 UNIT),1.02,0.66,0.26,2.63,17
NDC,65219-0295-10,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",414.76,269.59,3.61,1071.12,19
NDC,65219-0368-01,"INJECTION, LORAZEPAM, 2 MG",76.37,49.64,1.49,197.23,17
NDC,65219-0383-10,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",10.11,6.57,0.16,30.5,17
NDC,65219-0533-01,UNCLASSIFIED DRUGS,4.17,2.71,1.04,10.77,16
NDC,65219-0534-10,UNCLASSIFIED DRUGS,2.74,1.78,0.69,7.08,16
NDC,65219-0590-04,TYENNE 80 MG/4 ML VIAL,978.875,636.27,165.32,907.54,22
NDC,65219-0592-10,TYENNE 200 MG/10 ML VIAL,855.765,556.25,105.95,901.43,22
NDC,65219-0594-20,TYENNE 400 MG/20 ML VIAL,985.8799999999999,640.8199999999999,171.11,901.13,22
NDC,65219-0622-02,"INJECTION, ACYCLOVIR, 5 MG",19.4,12.61,0.13,50.1,17
NDC,65250-0133-04,"INJECTION, BUPIVACAINE LIPOSOME, 1 MG",156.21,101.54,1.53,403.41,17
NDC,65250-0266-09,"INJECTION, BUPIVACAINE LIPOSOME, 1 MG",88.97,57.83,1.53,229.77,17
NDC,65597-0202-30,SAVAYSA 30 MG TABLET,99.1,64.42,24.78,69.37,11
NDC,65597-0203-30,SAVAYSA 60 MG TABLET,71.625,46.56,11.04,69.37,22
NDC,65597-0406-01,"INJECTION, FAM-TRASTUZUMAB DERUXTECAN-NXKI, 1 MG",26359.45,17133.64,33.18,68073.28,19
NDC,65597-0801-01,DATROWAY 100 MG VIAL,60595.91,39387.34,15148.98,42417.14,11
NDC,65628-0080-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.96,12.32,4.74,48.96,16
NDC,65628-0206-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.83,7.04,2.71,27.97,16
NDC,65649-0301-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",56.730000000000004,36.875,9.28,197.2,32
NDC,65649-0303-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",389.39,253.1,97.35,1005.6,16
NDC,65649-0303-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",155.12,100.83,38.78,400.6,16
NDC,65649-0311-12,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.56,4.91,1.89,19.52,16
NDC,65649-0400-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",322.5,209.63,80.63,832.86,16
NDC,65649-0551-02,"INJECTION, METHYLNALTREXONE, 0.1 MG",1857.19,1207.17,2.23,4796.19,17
NDC,65649-0551-07,"INJECTION, METHYLNALTREXONE, 0.1 MG",671.0,436.15,2.23,1732.86,17
NDC,65757-0302-02,"INJECTION, NALTREXONE, DEPOT FORM, 1 MG",17354.06,11280.14,4.49,44816.86,19
NDC,65757-0402-03,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",1722.23,1119.45,3.54,4447.66,19
NDC,65757-0403-03,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",1437.27,934.23,3.54,3711.75,19
NDC,65757-0404-03,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",1324.87,861.17,3.54,3421.48,19
NDC,65857-0450-05,"TECHNETIUM TC-99M TILMANOCEPT, DIAGNOSTIC, UP TO 0.5 MILLICURIES",20943.365,13613.19,3756.26,81039.06,32
NDC,65862-0015-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.37,4.79,1.84,19.03,16
NDC,65862-0048-24,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.75,3.74,1.44,14.85,16
NDC,65862-0055-24,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.93,1.25,0.48,4.98,16
NDC,65862-0146-36,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.27,6.675000000000001,1.43,38.27,32
NDC,65862-0147-36,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.75,6.335,1.38,36.13,32
NDC,65862-0160-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.04,9.78,3.76,38.84,16
NDC,65862-0169-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.5,2.93,1.13,11.62,16
NDC,65862-0170-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.334999999999999,4.12,0.95,22.91,32
NDC,65862-0175-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.475,2.91,0.94,13.43,32
NDC,65862-0176-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.399999999999999,6.765000000000001,1.28,40.55,32
NDC,65862-0186-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.05,5.88,2.26,23.37,16
NDC,65862-0192-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.51,11.38,4.38,45.22,16
NDC,65862-0201-99,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.63,14.71,5.66,58.44,16
NDC,65862-0202-99,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.21,15.74,6.05,62.52,16
NDC,65862-0211-50,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.75,10.89,4.19,43.26,16
NDC,65862-0250-47,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.17,2.71,1.04,10.77,16
NDC,65862-0290-84,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.2,6.63,2.55,26.34,16
NDC,65862-0390-10,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",9.55,6.21,2.39,24.66,16
NDC,65862-0391-10,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",16.67,10.84,0.01,43.05,17
NDC,65862-0419-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",46.45,30.19,11.61,119.96,16
NDC,65862-0497-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.35,9.98,3.84,39.64,16
NDC,65862-0502-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.38,12.6,4.85,50.05,16
NDC,65862-0503-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.97,15.58,5.99,61.9,16
NDC,65862-0527-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.62,4.3,1.66,17.1,16
NDC,65862-0528-99,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.0,4.55,1.75,18.08,16
NDC,65862-0533-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.12,2.03,0.78,8.06,16
NDC,65862-0534-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.18,0.77,0.3,3.05,16
NDC,65862-0534-50,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.95,1.27,0.49,5.04,16
NDC,65862-0535-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.69,2.4000000000000004,0.42,14.77,32
NDC,65862-0559-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.3,16.45,6.33,65.34,16
NDC,65862-0596-02,UNCLASSIFIED DRUGS,1.4500000000000002,0.9450000000000001,0.34,4.0,32
NDC,65862-0598-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.0,16.25,6.25,64.56,16
NDC,65862-0654-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.55,14.66,5.64,58.24,16
NDC,65862-0677-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.8,20.67,7.95,82.12,16
NDC,65862-0678-01,UNCLASSIFIED DRUGS,12.34,8.02,2.91,33.7,32
NDC,65862-0687-30,UNCLASSIFIED DRUGS,14.32,9.309999999999999,3.53,37.55,32
NDC,65862-0697-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.15,4.0,1.54,15.88,16
NDC,65862-0700-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",24.55,15.955,1.56,110.66,32
NDC,65862-0732-60,UNCLASSIFIED DRUGS,23.72,15.42,5.93,61.26,16
NDC,65862-0844-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.035,5.2250000000000005,0.92,31.97,32
NDC,65862-0846-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.73,6.97,2.68,27.71,16
NDC,65862-0880-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.97,6.48,1.97,31.15,32
NDC,65862-0892-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.36,6.73,2.59,26.75,16
NDC,65862-0921-27,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.2,23.53,9.05,93.49,16
NDC,66215-0501-15,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1403.96,912.575,252.28,4645.45,32
NDC,66215-0602-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1706.555,1109.26,361.67,5078.31,32
NDC,66215-0606-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1605.225,1043.4,212.83,6092.5,32
NDC,66215-0608-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2357.5,1532.38,589.38,6088.24,16
NDC,66302-0014-01,UNITUXIN 17.5 MG/ 5 ML VIAL,43538.74,28300.18,10884.69,112438.8,16
NDC,66302-0300-01,ORENITRAM ER 0.125 MG TABLET,300.275,195.18,42.59,301.15,22
NDC,66302-0310-01,ORENITRAM ER 1 MG TABLET,239.66500000000002,155.785,37.77,229.77,22
NDC,66302-0616-01,TYVASO DPI 16 MCG CARTRIDGE,438.07,284.75,109.52,306.65,11
NDC,66302-0648-01,TYVASO DPI 48 MCG CARTRIDGE,1718.3,1116.9,429.58,1202.81,11
NDC,66302-0664-01,TYVASO DPI 64 MCG CARTRIDGE,1715.67,1115.19,428.92,1200.97,11
NDC,66658-0234-01,UNCLASSIFIED DRUGS,785.74,510.73,196.44,2029.17,16
NDC,66658-0234-07,UNCLASSIFIED DRUGS,2207.78,1435.06,551.95,5701.59,16
NDC,66658-0501-01,"INJECTION, EMAPALUMAB-LZSG, 1 MG",21118.51,13727.03,5279.63,54538.55,18
NDC,66658-0510-01,"INJECTION, EMAPALUMAB-LZSG, 1 MG",6755.12,4390.83,1688.78,35052.23,18
NDC,66689-0307-08,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",9.14,5.94,0.16,23.6,17
NDC,66733-0948-23,"INJECTION, CETUXIMAB, 10 MG",108.26,70.37,27.07,2922.83,19
NDC,66794-0155-02,"INJECTION, BACLOFEN, 10 MG",64.41,41.87,16.1,741.6,19
NDC,66794-0156-01,"GABLOFEN 20,000 MCG/20 ML SYRG",38.24,24.86,9.56,26.77,11
NDC,66794-0156-02,"INJECTION, BACLOFEN, 10 MG",42.33,27.51,10.58,741.6,19
NDC,66794-0157-01,"INJECTION, BACLOFEN, 10 MG",26.5,17.23,6.63,741.6,19
NDC,66794-0157-02,"INJECTION, BACLOFEN, 10 MG",62.47,40.61,15.62,741.6,19
NDC,66794-0160-02,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",64.29,41.79,14.31,166.03,17
NDC,66887-0003-01,"INJECTION, COLLAGENASE, CLOSTRIDIUM HISTOLYTICUM, 0.01 MG",14988.77,9742.7,83.33,38708.5,19
NDC,66887-0004-01,"TESTOSTERONE PELLET, IMPLANT, 75 MG",188.75,122.69,47.19,487.45,16
NDC,66993-0002-10,UNCLASSIFIED DRUGS,12.96,8.42,3.24,33.47,16
NDC,66993-0078-96,UNCLASSIFIED DRUGS,17.23,11.200000000000001,1.46,73.96,32
NDC,66993-0082-69,UNCLASSIFIED DRUGS,189.5,123.18,47.38,489.38,16
NDC,66993-0135-97,FLUTICASONE-VILANTEROL 100-25,1198.33,778.91,299.58,838.83,11
NDC,66993-0431-85,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.56,5.56,2.14,22.11,16
NDC,66993-0457-30,DAPAGLIFLOZIN 10 MG TABLET,45.56,29.61,11.39,31.89,11
NDC,66993-0831-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",106.5,69.23,26.63,275.04,16
NDC,67066-0005-01,"INJECTION, SECRETIN, SYNTHETIC, HUMAN, 1 MICROGRAM",1704.05,1107.63,42.87,4400.71,19
NDC,67157-0101-50,UNCLASSIFIED DRUGS,102.285,66.485,24.05,279.87,32
NDC,67308-0101-01,"AMINOLEVULINIC ACID HCL FOR TOPICAL ADMINISTRATION, 20%, SINGLE UNIT DOSAGE FORM (354 MG)",949.16,616.95,237.29,2451.21,19
NDC,67386-0130-51,"INJECTION, EPTINEZUMAB-JJMR, 1 MG",9825.895,6386.83,21.73,30910.23,38
NDC,67457-0162-02,UNCLASSIFIED DRUGS,216.91,140.995,47.35,631.19,32
NDC,67457-0163-02,UNCLASSIFIED DRUGS,244.18,158.72,46.42,781.7,32
NDC,67457-0177-50,"INJECTION, DMSO, DIMETHYL SULFOXIDE, 50%, 50 ML",33.735,21.93,8.19,794.18,38
NDC,67457-0193-50,"INJECTION, MELPHALAN HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 50 MG",1351.07,878.2,92.16,3489.14,19
NDC,67457-0196-02,"INJECTION, THIAMINE HCL, 100 MG",168.51,109.53,1.92,435.18,17
NDC,67457-0198-05,UNCLASSIFIED DRUGS,491.14,319.24,122.79,1268.37,16
NDC,67457-0210-05,"INJECTION, CIDOFOVIR, 375 MG",1156.72,751.87,289.18,2987.23,19
NDC,67457-0212-02,"INJECTION, ARGATROBAN, 1 MG (FOR NON-ESRD USE)",367.54,238.9,0.65,949.17,19
NDC,67457-0220-05,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",1190.76,773.995,10.4,3433.36,34
NDC,67457-0245-00,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",21.7,14.11,0.7,56.04,17
NDC,67457-0266-10,"INJECTION, LEVETIRACETAM, 10 MG",2.65,1.72,0.04,6.84,17
NDC,67457-0292-02,"INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG",24.06,15.64,6.02,62.13,16
NDC,67457-0340-00,"INJECTION, VANCOMYCIN HCL, 500 MG",227.46,147.85,56.87,587.42,16
NDC,67457-0423-12,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",50.45,32.79,0.12,151.35,17
NDC,67457-0426-00,"INJECTION, HALOPERIDOL, UP TO 5 MG",67.78,44.06,0.77,175.04,17
NDC,67457-0430-10,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",14.49,9.42,3.62,37.42,17
NDC,67457-0446-10,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",32.09,20.86,8.02,82.87,17
NDC,67457-0530-35,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",59.74,38.83,4.07,179.22,17
NDC,67457-0587-10,"INJECTION, EPOPROSTENOL, 0.5 MG",185.85,120.8,16.59,479.96,17
NDC,67457-0618-10,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",5.22,3.39,1.31,15.66,17
NDC,67457-0629-10,"INJECTION, EPTIFIBATIDE, 5 MG",12.0,7.8,1.34,58.57,38
NDC,67457-0631-10,"INJECTION, EPTIFIBATIDE, 5 MG",3.2750000000000004,2.125,0.39,58.57,38
NDC,67457-0638-00,"INJECTION, IRON SUCROSE, 1 MG",57.85,37.6,0.25,149.4,17
NDC,67457-0675-02,"INJECTION, CALCITONIN SALMON, UP TO 400 UNITS",737.94,479.66,184.49,2058.35,19
NDC,67457-0781-08,"INJECTION, DOCETAXEL, 1 MG",119.38000000000001,77.595,0.69,546.06,38
NDC,67457-0823-99,VANCOMYCIN HCL 1.25 GRAM VIAL,225.44,146.54,56.36,157.81,11
NDC,67457-0852-00,UNCLASSIFIED DRUGS,12.69,8.25,3.17,32.77,16
NDC,67457-0853-50,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",204.82,133.13,27.13,528.95,17
NDC,67457-0855-02,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",8.03,5.22,0.56,20.74,17
NDC,67457-0856-20,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",9.685,6.3,0.56,44.16,34
NDC,67457-0863-01,"INJECTION, GRANISETRON HYDROCHLORIDE, 100 MCG",123.2,80.08,0.16,318.16,17
NDC,67618-0111-28,UNCLASSIFIED DRUGS,10.94,7.109999999999999,1.3,43.08,32
NDC,67618-0150-04,UNCLASSIFIED DRUGS,2.96,1.92,0.74,7.64,16
NDC,67684-1901-02,UNCLASSIFIED DRUGS,892.595,580.185,66.2,3926.43,32
NDC,67850-0140-05,ASCLERA 10 MG/2 ML (0.5%) AMP,27.76,18.04,6.94,19.43,11
NDC,67850-0141-00,ASCLERA 20 MG/2 ML (1%) AMPULE,31.13,20.23,7.78,21.79,11
NDC,67877-0124-05,UNCLASSIFIED DRUGS,1.81,1.18,0.45,4.67,16
NDC,67877-0124-40,UNCLASSIFIED DRUGS,8.25,5.36,2.06,21.31,16
NDC,67877-0159-01,UNCLASSIFIED DRUGS,5.71,3.71,1.43,14.75,16
NDC,67877-0198-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.56,14.01,5.39,55.68,16
NDC,67877-0219-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.73,3.07,1.18,12.22,16
NDC,67877-0220-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.55,3.61,1.39,14.33,16
NDC,67877-0223-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.94,1.91,0.74,7.59,16
NDC,67877-0224-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.55,1.66,0.64,6.59,16
NDC,67877-0246-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.77,5.7,2.19,22.65,16
NDC,67877-0318-15,UNCLASSIFIED DRUGS,3.06,1.99,0.77,7.9,16
NDC,67877-0319-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.99,2.59,1.0,10.3,16
NDC,67877-0320-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.61,3.0,1.15,11.91,16
NDC,67877-0321-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.1,3.32,1.28,13.17,16
NDC,67877-0454-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.2,15.08,5.8,59.91,16
NDC,67877-0490-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.65,36.17,13.91,143.72,16
NDC,67877-0491-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",65.09,42.31,16.27,168.09,16
NDC,67877-0493-01,"AZATHIOPRINE, ORAL, 50 MG",12.29,7.99,0.06,31.74,17
NDC,67877-0512-90,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.47,14.61,5.62,58.03,16
NDC,67877-0544-88,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.11,0.72,0.28,2.87,16
NDC,67877-0545-68,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.65,3.67,1.41,14.59,16
NDC,67877-0547-98,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.415,0.9199999999999999,0.32,4.0,32
NDC,67877-0590-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.28,17.73,6.82,70.45,16
NDC,67877-0591-05,UNCLASSIFIED DRUGS,27.95,18.17,6.99,72.18,16
NDC,67877-0592-05,UNCLASSIFIED DRUGS,60.99,39.64,15.25,157.51,16
NDC,67877-0636-33,UNCLASSIFIED DRUGS,3871.75,2516.64,967.94,9998.79,16
NDC,67877-0638-30,LURASIDONE HCL 20 MG TABLET,18.38,11.95,4.6,12.87,11
NDC,67877-0639-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",117.97,76.68,29.49,304.66,16
NDC,67877-0640-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.66,6.93,1.39,40.75,32
NDC,67877-0641-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.26,4.715,1.78,19.08,32
NDC,67877-0719-33,"EVEROLIMUS, ORAL, 0.25 MG",151.16,98.25,1.25,390.37,17
NDC,67877-0746-01,"SIROLIMUS, ORAL, 1 MG",19.85,12.9,1.03,51.26,17
NDC,67877-0747-01,"SIROLIMUS, ORAL, 1 MG",59.12,38.43,1.03,152.68,17
NDC,67919-0030-01,"INJECTION, CEFTOLOZANE 50 MG AND TAZOBACTAM 25 MG",786.125,510.98,9.49,3124.36,38
NDC,67979-0511-43,"INJECTION, TESTOSTERONE UNDECANOATE, 1 MG",1670.15,1085.6,2.19,4313.16,19
NDC,68001-0151-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.73,10.22,3.93,40.62,16
NDC,68001-0152-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.54,12.05,4.64,47.88,16
NDC,68001-0154-03,UNCLASSIFIED DRUGS,21.07,13.7,5.27,54.41,16
NDC,68001-0155-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.56,6.21,2.39,24.69,16
NDC,68001-0157-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.27,4.73,1.82,18.77,16
NDC,68001-0158-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.7,13.46,5.18,53.46,16
NDC,68001-0254-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",82.0,53.3,20.5,211.77,16
NDC,68001-0265-26,"INJECTION, ETOPOSIDE, 10 MG",25.76,16.74,1.1,77.28,17
NDC,68001-0308-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.63,10.16,3.91,40.36,16
NDC,68001-0356-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.49,4.87,1.87,19.34,16
NDC,68001-0362-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.82,5.08,1.96,20.2,16
NDC,68001-0381-00,UNCLASSIFIED DRUGS,5.96,3.87,1.49,15.39,16
NDC,68001-0382-00,UNCLASSIFIED DRUGS,7.7,5.01,1.93,19.89,16
NDC,68001-0427-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",43.93,28.55,10.98,113.45,16
NDC,68001-0438-96,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",111.5,72.48,27.88,287.95,16
NDC,68001-0473-03,UNCLASSIFIED DRUGS,10.51,6.83,2.63,27.14,16
NDC,68001-0477-48,UNCLASSIFIED DRUGS,5.3,3.45,1.33,13.69,16
NDC,68001-0483-45,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.81,1.18,0.45,4.67,16
NDC,68001-0486-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.68,14.09,5.42,55.99,16
NDC,68001-0518-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.64,13.42,5.16,53.3,16
NDC,68001-0531-46,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.07,1.35,0.52,5.35,16
NDC,68001-0533-50,UNCLASSIFIED DRUGS,1.75,1.14,0.44,4.52,16
NDC,68001-0597-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.95,13.62,5.24,54.1,16
NDC,68001-0613-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.4,13.26,5.1,52.68,16
NDC,68084-0040-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.02,3.91,0.66,24.33,32
NDC,68084-0059-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.51,23.08,8.88,91.7,16
NDC,68084-0059-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.75,19.99,7.69,79.41,16
NDC,68084-0075-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",184.46,119.9,46.12,476.37,16
NDC,68084-0082-11,UNCLASSIFIED DRUGS,7.52,4.89,1.88,19.42,16
NDC,68084-0099-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.07,5.25,2.02,20.84,16
NDC,68084-0119-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.14,3.34,1.29,13.27,16
NDC,68084-0128-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.65,3.02,1.16,12.01,16
NDC,68084-0155-11,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",32.07,20.85,0.31,82.82,17
NDC,68084-0189-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.32,9.96,3.83,39.56,16
NDC,68084-0203-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.66,3.68,1.42,14.62,16
NDC,68084-0229-01,"AZATHIOPRINE, ORAL, 50 MG",7.38,4.8,0.06,19.06,17
NDC,68084-0229-11,"AZATHIOPRINE, ORAL, 50 MG",5.53,3.59,0.06,14.28,17
NDC,68084-0244-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",35.12,22.83,8.78,90.7,16
NDC,68084-0271-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.89,8.38,3.22,33.29,16
NDC,68084-0280-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.73,4.37,1.68,17.38,16
NDC,68084-0280-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.77,6.35,2.44,25.23,16
NDC,68084-0284-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.46,4.2,1.62,16.68,16
NDC,68084-0313-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.18,4.67,1.8,18.54,16
NDC,68084-0319-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.65,3.02,1.16,12.01,16
NDC,68084-0326-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.34,2.82,1.09,11.21,16
NDC,68084-0346-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.02,3.91,1.51,15.55,16
NDC,68084-0347-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.09,10.46,4.02,41.55,16
NDC,68084-0381-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.7,13.46,5.18,53.46,16
NDC,68084-0430-99,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.03,17.57,6.76,69.81,16
NDC,68084-0447-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.9,3.19,1.23,12.65,16
NDC,68084-0525-11,UNCLASSIFIED DRUGS,3.97,2.58,0.99,10.25,16
NDC,68084-0536-01,CLOPIDOGREL 75 MG TABLET,1.335,0.87,0.29,1.06,22
NDC,68084-0536-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.74,9.58,3.69,38.07,16
NDC,68084-0539-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.53,14.64,5.63,58.18,16
NDC,68084-0572-01,UNCLASSIFIED DRUGS,8.41,5.47,2.1,21.72,16
NDC,68084-0597-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.55,14.66,5.64,58.24,16
NDC,68084-0617-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.48,15.26,5.87,60.64,16
NDC,68084-0618-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",30.75,19.99,7.69,79.41,16
NDC,68084-0640-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.58,2.98,1.15,11.83,16
NDC,68084-0655-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.7,12.16,4.68,48.29,16
NDC,68084-0659-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.274999999999999,9.28,1.4,59.27,32
NDC,68084-0676-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.5,10.73,4.13,42.61,16
NDC,68084-0698-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.2,14.43,5.55,57.33,16
NDC,68084-0709-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.02,14.96,5.76,59.45,16
NDC,68084-0713-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",22.28,14.48,5.57,57.54,16
NDC,68084-0805-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.14,5.29,2.04,21.02,16
NDC,68084-0805-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",50.1,32.57,12.53,129.38,16
NDC,68084-0808-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.88,5.77,2.22,22.93,16
NDC,68084-0823-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.59,10.135,3.65,42.87,32
NDC,68084-0918-95,"MYCOPHENOLIC ACID, ORAL, 180 MG",100.74,65.48,0.34,260.16,17
NDC,68084-0975-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",27.37,17.79,6.84,70.68,16
NDC,68094-0018-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.03,13.02,5.01,51.73,16
NDC,68094-0029-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.33,2.16,0.83,8.6,16
NDC,68094-0031-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.54,9.45,3.64,37.55,16
NDC,68094-0065-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.46,12.65,4.87,50.26,16
NDC,68094-0101-20,"INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG",2884.03,1874.62,185.44,7448.01,19
NDC,68094-0110-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.29,2.79,1.07,11.08,16
NDC,68094-0114-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.91,3.19,1.23,12.68,16
NDC,68094-0129-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.9,1.89,0.73,7.49,16
NDC,68094-0231-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.17,1.4100000000000001,0.43,6.74,32
NDC,68094-0356-01,MORPHINE 20 MG/ML ORAL SYRINGE,30.23,19.65,7.56,21.16,11
NDC,68094-0494-59,UNCLASSIFIED DRUGS,1.73,1.12,0.43,4.47,16
NDC,68094-0750-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.2,7.28,2.8,28.92,16
NDC,68094-0756-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.65,3.67,1.41,14.59,16
NDC,68094-0756-62,"INJECTION, FUROSEMIDE, 1 MG",13.69,8.9,0.02,35.35,17
NDC,68094-0763-62,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",13.89,9.03,0.01,35.87,17
NDC,68094-0764-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.73,6.97,2.68,27.71,16
NDC,68176-0000-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.35,2.83,1.09,11.23,16
NDC,68176-0000-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.585,6.879999999999999,1.75,36.57,32
NDC,68180-0151-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",420.44,273.29,105.11,1085.79,16
NDC,68180-0152-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",88.8,57.72,22.2,229.33,16
NDC,68180-0159-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.235,6.654999999999999,1.75,34.76,32
NDC,68180-0180-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.1,4.62,1.78,18.34,16
NDC,68180-0214-60,CYCLOSPORINE 0.05% EYE EMULS,363.94,236.56,90.99,254.76,11
NDC,68180-0280-01,ETHAMBUTOL HCL 100 MG TABLET,3.94,2.56,0.99,2.76,11
NDC,68180-0320-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.95,3.22,1.24,12.78,16
NDC,68180-0351-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.61,3.65,1.4,14.49,16
NDC,68180-0353-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.67,3.04,1.17,12.06,16
NDC,68180-0422-01,UNCLASSIFIED DRUGS,69.09,44.91,17.27,178.42,16
NDC,68180-0512-01,UNCLASSIFIED DRUGS,6.13,3.98,1.53,15.83,16
NDC,68180-0513-01,UNCLASSIFIED DRUGS,10.7,6.96,2.68,27.63,16
NDC,68180-0657-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.475,0.96,0.27,4.83,32
NDC,68180-0658-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.25,12.51,4.81,49.71,16
NDC,68180-0659-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",44.45,28.89,11.11,114.79,16
NDC,68180-0678-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.64,2.365,0.52,13.4,32
NDC,68180-0799-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.42,2.87,1.11,11.41,16
NDC,68180-0861-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.34,9.97,3.84,39.62,16
NDC,68180-0965-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.6,3.64,1.4,14.46,16
NDC,68180-0966-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.94,9.06,3.49,36.0,16
NDC,68180-0967-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.59,4.28,1.65,17.02,16
NDC,68180-0969-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.57,4.27,1.64,16.97,16
NDC,68180-0971-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.16,4.65,1.79,18.49,16
NDC,68180-0973-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.85,9.0,3.46,35.77,16
NDC,68180-0975-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.18,9.22,3.55,36.62,16
NDC,68180-0980-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.4,2.86,1.1,11.36,16
NDC,68180-0986-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.42,3.52,1.36,14.0,16
NDC,68382-0006-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.33,2.16,0.83,8.6,16
NDC,68382-0022-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.005,4.555,0.98,26.08,32
NDC,68382-0079-01,UNCLASSIFIED DRUGS,6.95,4.52,1.74,17.95,16
NDC,68382-0092-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.06,2.64,1.02,10.48,16
NDC,68382-0093-05,UNCLASSIFIED DRUGS,4.28,2.78,1.07,11.05,16
NDC,68382-0094-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.18,2.72,1.05,10.79,16
NDC,68382-0095-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.89,2.53,0.97,10.05,16
NDC,68382-0097-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.65,3.67,1.41,14.59,16
NDC,68382-0106-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.31,2.8,1.08,11.13,16
NDC,68382-0110-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",50.05,32.53,12.51,129.25,16
NDC,68382-0112-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.95,3.22,1.24,12.78,16
NDC,68382-0113-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.93,3.2,1.23,12.73,16
NDC,68382-0114-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.04,2.63,1.01,10.43,16
NDC,68382-0115-14,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.29,4.74,0.89,28.43,32
NDC,68382-0116-14,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.61,8.85,3.4,35.15,16
NDC,68382-0138-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.74,8.93,3.44,35.48,16
NDC,68382-0139-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.14,10.49,4.04,41.68,16
NDC,68382-0140-14,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.42,3.52,1.36,14.0,16
NDC,68382-0141-14,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.84,4.445,0.84,26.63,32
NDC,68382-0297-06,UNCLASSIFIED DRUGS,18.66,12.13,4.67,48.19,16
NDC,68382-0298-06,UNCLASSIFIED DRUGS,12.15,7.9,3.04,31.38,16
NDC,68382-0318-18,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.37,3.49,1.34,13.87,16
NDC,68382-0396-01,SOD PHENYLACET-SOD BENZOATE VL,386.5,251.23,96.63,270.55,11
NDC,68382-0529-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.92,7.75,1.99,39.51,48
NDC,68382-0662-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.55,14.01,5.39,55.65,16
NDC,68382-0711-19,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",67.29,43.74,16.82,173.78,16
NDC,68382-0720-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.41,10.67,4.1,42.38,16
NDC,68382-0772-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",42.95,27.92,10.74,110.92,16
NDC,68382-0775-01,"METHOTREXATE; ORAL, 2.5 MG",4.15,2.7,0.16,10.72,17
NDC,68382-0910-01,UNCLASSIFIED DRUGS,183.6,119.34,45.9,474.15,16
NDC,68382-0981-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",101.7,66.11,25.43,262.64,16
NDC,68382-0982-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",106.45,69.19,26.61,274.91,16
NDC,68462-0101-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.51,6.83,1.57,38.07,32
NDC,68462-0102-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.67,6.29,2.42,24.97,16
NDC,68462-0104-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.49,9.42,3.62,37.42,16
NDC,68462-0138-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.66,5.63,2.17,22.36,16
NDC,68462-0143-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.75,3.09,1.19,12.27,16
NDC,68462-0153-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.07,2.65,1.02,10.51,16
NDC,68462-0158-40,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",69.66,45.28,0.01,179.9,17
NDC,68462-0190-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.75,3.09,1.19,12.27,16
NDC,68462-0226-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",34.55,22.46,8.64,89.23,16
NDC,68462-0260-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.13,9.835,2.83,48.96,32
NDC,68462-0264-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.46,2.9,1.12,11.52,16
NDC,68462-0293-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.5,13.98,5.38,55.52,16
NDC,68462-0302-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.1,4.615,0.96,26.73,32
NDC,68462-0305-84,NORETHINDRONE 0.35 MG TABLET,7.25,4.71,1.81,5.08,11
NDC,68462-0406-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.325,6.06,0.91,38.79,32
NDC,68462-0418-20,UNCLASSIFIED DRUGS,40.92,26.6,10.23,105.68,16
NDC,68462-0469-40,"INJECTION, BUMETANIDE, 0.5 MG",12.55,8.16,0.38,32.41,17
NDC,68462-0583-40,"APREPITANT, ORAL, 5 MG",787.84,512.1,2.94,2034.6,17
NDC,68462-0584-40,"APREPITANT, ORAL, 5 MG",996.04,647.43,2.94,2572.27,17
NDC,68462-0622-10,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",15.184999999999999,9.87,1.42,60.97,34
NDC,68462-0639-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.36,9.33,3.59,37.08,16
NDC,68462-0682-01,"SIROLIMUS, ORAL, 1 MG",36.61,23.8,1.03,94.55,17
NDC,68462-0896-01,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",52.97,34.43,0.7,136.8,17
NDC,68462-0897-01,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",157.77,102.55,0.7,407.44,17
NDC,68462-0904-01,UNCLASSIFIED DRUGS,204.93,133.2,51.23,529.23,16
NDC,68516-4603-02,"INJECTION, ANTIHEMOPHILIC FACTOR VIII/VON WILLEBRAND FACTOR COMPLEX (HUMAN), PER FACTOR VIII I.U.",3792.35,2465.03,1.31,9793.74,19
NDC,68516-5219-00,"INFUSION, ALBUMIN (HUMAN), 5%, 50 ML",1.61,1.05,0.4,185.91,19
NDC,68516-5219-02,"INFUSION, ALBUMIN (HUMAN), 5%, 50 ML",3.08,2.0,0.77,185.91,19
NDC,68546-0170-60,AUSTEDO 6 MG TABLET,542.95,352.92,135.74,380.07,11
NDC,68547-0501-02,UNCLASSIFIED DRUGS,12256.09,7966.46,3064.02,31651.35,16
NDC,68585-0005-75,UNCLASSIFIED DRUGS,2.53,1.64,0.63,6.53,16
NDC,68682-0109-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.65,8.87,3.41,35.25,16
NDC,68682-0920-64,UNCLASSIFIED DRUGS,13.37,8.69,3.34,34.53,16
NDC,68727-0712-01,"INJECTION, LURBINECTEDIN, 0.1 MG",70239.29,45655.54,223.43,181392.97,19
NDC,68727-0745-01,"INJECTION, LIPOSOMAL, 1 MG DAUNORUBICIN AND 2.27 MG CYTARABINE",135295.86,87942.31,276.12,349401.56,19
NDC,68727-0745-02,"INJECTION, LIPOSOMAL, 1 MG DAUNORUBICIN AND 2.27 MG CYTARABINE",24458.01,15897.71,276.12,63162.81,19
NDC,68727-0800-01,UNCLASSIFIED DRUGS,2781.96,1808.27,695.49,7184.41,16
NDC,68727-0950-01,ZIIHERA 300 MG VIAL,44216.64,28740.82,11054.16,30951.65,11
NDC,68803-0612-10,UNCLASSIFIED DRUGS,255.0,165.75,63.75,658.54,16
NDC,68803-0722-05,UNCLASSIFIED DRUGS,715.0,464.75,178.75,1846.49,16
NDC,68968-0514-01,COMBIPATCH 0.05-0.14 MG PTCH,238.25,154.86,59.56,166.78,11
NDC,68992-3010-01,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",12.504999999999999,8.13,1.36,50.57,34
NDC,68992-3040-01,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",45.09,29.31,1.98,118.8,34
NDC,68992-3075-01,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",12.52,8.135,1.4,50.23,34
NDC,69097-0126-05,UNCLASSIFIED DRUGS,4.19,2.72,1.05,10.82,16
NDC,69097-0127-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.47,9.41,3.62,37.37,16
NDC,69097-0128-15,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.72,3.72,1.43,14.77,16
NDC,69097-0223-16,UNCLASSIFIED DRUGS,6.14,3.99,1.54,15.86,16
NDC,69097-0224-16,UNCLASSIFIED DRUGS,8.18,5.32,2.05,21.12,16
NDC,69097-0301-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.4,11.31,4.35,44.94,16
NDC,69097-0422-12,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.11,5.92,2.28,23.53,16
NDC,69097-0822-12,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.0,2.6,1.0,10.33,16
NDC,69097-0823-12,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.23,2.75,1.06,10.92,16
NDC,69097-0824-12,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.15,2.7,1.04,10.72,16
NDC,69097-0856-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.35,2.83,1.09,11.23,16
NDC,69097-0857-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.93,11.65,4.48,46.3,16
NDC,69097-0858-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.82,5.085,1.21,27.89,32
NDC,69097-0870-67,"INJECTION, LANREOTIDE, 1 MG",39054.75,25385.59,37.51,100858.89,19
NDC,69194-0978-10,UNCLASSIFIED DRUGS,4.34,2.82,1.09,11.21,16
NDC,69238-1054-01,"CHLORPROMAZINE HYDROCHLORIDE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED",6.5,4.23,1.63,16.79,16
NDC,69238-1123-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.85,10.3,3.96,40.93,16
NDC,69238-1471-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",67.75,44.04,16.94,174.96,16
NDC,69238-1489-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.52,3.59,1.38,14.26,16
NDC,69238-1490-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.0,4.55,1.75,18.08,16
NDC,69238-1535-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.2,10.530000000000001,0.76,75.87,32
NDC,69238-1617-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.55,10.11,3.89,40.16,16
NDC,69238-1678-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.65,8.22,3.16,32.67,16
NDC,69238-1729-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.13,7.88,3.03,31.33,16
NDC,69238-2017-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.67,8.24,3.17,32.72,16
NDC,69238-2077-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.15,3.35,1.29,13.3,16
NDC,69238-2078-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.83,6.39,2.46,25.39,16
NDC,69238-2079-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.84,7.05,2.71,27.99,16
NDC,69238-2512-09,NITROFURANTOIN 25 MG/5 ML SUSP,39.93,25.95,9.98,27.95,11
NDC,69315-0117-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.28,11.88,4.57,47.21,16
NDC,69315-0127-10,UNCLASSIFIED DRUGS,14.62,9.5,3.66,37.76,16
NDC,69315-0137-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.98,3.24,1.25,12.86,16
NDC,69315-0306-15,UNCLASSIFIED DRUGS,14.48,9.41,3.62,37.39,16
NDC,69315-0308-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.33,8.01,3.08,31.84,16
NDC,69315-0312-28,UNCLASSIFIED DRUGS,18.52,12.04,4.63,47.83,16
NDC,69315-0701-50,UNCLASSIFIED DRUGS,700.15,455.1,175.04,1808.14,16
NDC,69315-0906-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.38,11.3,4.35,44.88,16
NDC,69315-0910-01,UNCLASSIFIED DRUGS,21.52,13.99,5.38,55.58,16
NDC,69339-0150-01,UNCLASSIFIED DRUGS,2.79,1.81,0.7,7.21,16
NDC,69367-0166-20,UNCLASSIFIED DRUGS,21.4,13.91,5.35,55.27,16
NDC,69367-0220-01,UNCLASSIFIED DRUGS,4.39,2.85,1.1,11.34,16
NDC,69367-0236-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.95,10.37,3.99,41.19,16
NDC,69367-0258-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.34,3.47,1.34,13.79,16
NDC,69367-0314-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.4,2.86,1.1,11.36,16
NDC,69367-0411-02,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.5,6.18,2.38,24.53,16
NDC,69374-0525-25,UNCLASSIFIED DRUGS,1.65,1.07,0.41,4.26,16
NDC,69374-0542-06,"METHACHOLINE CHLORIDE ADMINISTERED AS INHALATION SOLUTION THROUGH A NEBULIZER, PER 1 MG",20.81,13.53,2.01,53.74,17
NDC,69374-0925-10,UNCLASSIFIED DRUGS,13.4,8.71,3.35,34.61,16
NDC,69374-0955-10,UNCLASSIFIED DRUGS,9.78,6.36,2.45,25.26,16
NDC,69374-0957-10,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",12.87,8.37,0.01,33.24,17
NDC,69374-0982-55,UNCLASSIFIED DRUGS,35.33,22.96,8.83,91.24,16
NDC,69448-0027-63,UDENYCA 6 MG/0.6 ML ONBODY,45421.46,29523.95,11355.37,31795.02,11
NDC,69452-0131-17,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.6,3.64,1.4,14.46,16
NDC,69452-0150-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.6,12.09,4.65,48.03,16
NDC,69452-0156-74,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.46,6.8,2.62,27.01,16
NDC,69452-0157-74,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.63,6.26,2.41,24.87,16
NDC,69452-0208-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.37,6.09,2.34,24.2,16
NDC,69452-0209-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.55,8.16,3.14,32.41,16
NDC,69452-0233-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.4,3.51,1.35,13.95,16
NDC,69452-0291-20,UNCLASSIFIED DRUGS,10.5,6.83,2.63,27.12,16
NDC,69452-0312-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.44,5.49,2.11,21.8,16
NDC,69488-0001-40,"GALLIUM GA-68, DOTATATE, DIAGNOSTIC, 0.1 MILLICURIE",18782.325,12208.51,52.61,62688.83,34
NDC,69488-0003-01,"LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MILLICURIE",100453.3,65294.65,340.02,259420.65,19
NDC,69488-0010-61,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC, 1 MILLICURIE",82723.99,53770.59,274.88,213634.7,19
NDC,69543-0455-20,UNCLASSIFIED DRUGS,15.43,10.03,3.72,59.86,48
NDC,69584-0852-50,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.65,3.02,1.16,12.01,16
NDC,69616-0272-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",89.46,58.150000000000006,11.74,340.84,32
NDC,69616-0274-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",258.66,168.13,64.67,667.99,16
NDC,69616-0278-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",260.0,169.0,65.0,671.45,16
NDC,69724-0112-10,SOTALOL HCL 150 MG/10 ML VIAL,1668.2849999999999,1084.385,207.72,1753.98,22
NDC,69784-0230-10,UNCLASSIFIED DRUGS,1.7,1.11,0.43,4.39,16
NDC,69918-0101-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.64,7.57,2.91,30.06,16
NDC,69918-0201-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.6,8.84,3.4,35.12,16
NDC,69918-0301-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",33.33,21.66,8.33,86.07,16
NDC,69945-0091-20,TECHNESCAN HDP PREP KIT,21375.0,13893.75,5062.5,15750.0,22
NDC,70000-0239-01,IBUPROFEN JR STR 100 MG TB CHW,2.33,1.51,0.58,1.63,11
NDC,70000-0381-02,OMEPRAZOLE DR 20 MG ODT,5.03,3.27,1.26,3.52,11
NDC,70000-0409-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.48,3.56,1.37,14.15,16
NDC,70000-0455-01,UNCLASSIFIED DRUGS,6.84,4.45,1.71,17.66,16
NDC,70000-0490-01,UNCLASSIFIED DRUGS,4.62,3.0,1.16,11.93,16
NDC,70004-0200-17,"INJECTION, FENTANYL CITRATE, 0.1 MG",14.955,9.719999999999999,1.26,42.22,66
NDC,70004-0244-40,UNCLASSIFIED DRUGS,1.645,1.07,0.41,4.26,32
NDC,70004-0303-21,UNCLASSIFIED DRUGS,3.87,2.5149999999999997,0.8,11.75,80
NDC,70004-0380-05,METHADONE HCL 10 MG/ML SYRINGE,503.905,327.53499999999997,125.97,352.75,22
NDC,70004-0613-40,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",1.42,0.92,0.36,3.67,16
NDC,70004-0725-09,UNCLASSIFIED DRUGS,7.68,4.99,1.44,24.84,32
NDC,70004-0811-12,UNCLASSIFIED DRUGS,3.22,2.09,0.81,8.32,16
NDC,70004-0900-25,UNCLASSIFIED DRUGS,42.945,27.915,10.11,117.4,32
NDC,70010-0002-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",50.5,32.83,12.63,130.42,16
NDC,70010-0027-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",31.24,20.31,7.81,80.68,16
NDC,70010-0029-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.3,9.95,3.83,39.51,16
NDC,70010-0031-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.42,9.37,3.61,37.24,16
NDC,70010-0064-01,UNCLASSIFIED DRUGS,7.05,4.58,0.91,26.99,32
NDC,70010-0137-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.58,2.33,0.9,9.25,16
NDC,70010-0137-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.35,13.88,5.34,55.14,16
NDC,70010-0782-05,UNCLASSIFIED DRUGS,7.6,4.94,1.9,19.63,16
NDC,70010-0783-01,UNCLASSIFIED DRUGS,8.02,5.21,2.01,20.71,16
NDC,70010-0786-28,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",103.2,67.08,25.8,266.51,16
NDC,70069-0019-01,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",19.17,12.46,4.79,49.51,17
NDC,70069-0021-01,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",57.6,37.44,0.12,172.8,17
NDC,70069-0021-25,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",96.21,62.54,0.12,288.63,17
NDC,70069-0051-01,UNCLASSIFIED DRUGS,2.44,1.59,0.61,6.3,16
NDC,70069-0121-01,UNCLASSIFIED DRUGS,26.08,16.95,6.52,67.35,16
NDC,70069-0231-01,UNCLASSIFIED DRUGS,11.72,7.62,2.93,30.27,16
NDC,70069-0362-01,UNCLASSIFIED DRUGS,29.83,19.39,7.46,77.04,16
NDC,70069-0363-01,UNCLASSIFIED DRUGS,2.36,1.53,0.59,6.09,16
NDC,70069-0501-01,UNCLASSIFIED DRUGS,9.3,6.05,2.33,24.02,16
NDC,70069-0641-01,"INJECTION, ATROPINE SULFATE, 0.01 MG",267.6,173.94,0.11,691.08,17
NDC,70069-0651-01,BRIMONIDINE-TIMOLOL 0.2%-0.5%,31.98,20.79,8.0,22.39,11
NDC,70069-0746-01,UNCLASSIFIED DRUGS,34.93,22.7,8.73,90.21,16
NDC,70092-1046-46,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",54.2,35.23,0.01,139.97,17
NDC,70092-1086-44,UNCLASSIFIED DRUGS,26.2,17.03,6.5,68.18,32
NDC,70092-1475-50,UNCLASSIFIED DRUGS,3.93,2.55,0.98,10.15,16
NDC,70092-1512-46,UNCLASSIFIED DRUGS,8.25,5.36,1.0,32.31,32
NDC,70092-1519-48,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",4.405,2.865,0.83,14.18,50
NDC,70092-1519-48,UNCLASSIFIED DRUGS,3.32,2.16,0.83,8.57,96
NDC,70092-1663-43,UNCLASSIFIED DRUGS,9.61,6.25,2.4,24.82,16
NDC,70092-1687-48,UNCLASSIFIED DRUGS,4.51,2.93,1.12,11.75,48
NDC,70092-1692-44,UNCLASSIFIED DRUGS,44.3,28.8,11.08,114.4,16
NDC,70092-9119-44,UNCLASSIFIED DRUGS,45.72,29.72,11.43,118.07,16
NDC,70100-0424-01,UNCLASSIFIED DRUGS,2275.91,1479.34,568.98,5877.54,16
NDC,70100-0825-02,UNCLASSIFIED DRUGS,2112.18,1372.92,528.05,5454.7,16
NDC,70114-0101-01,"INJECTION, PEGFILGRASTIM-CBQV (UDENYCA), BIOSIMILAR, 0.5 MG",29153.08,18949.5,171.71,83449.72,38
NDC,70114-0340-01,"INJECTION, TORIPALIMAB-TPZI, 1 MG",1133.89,737.03,42.62,2928.27,17
NDC,70121-1222-01,"INJECTION, DOCETAXEL, 1 MG",315.18,204.87,0.69,945.54,19
NDC,70121-1240-01,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",2092.95,1360.42,0.63,5405.04,17
NDC,70121-1453-01,"INJECTION, MEROPENEM, 100 MG",155.73,101.22,0.4,402.17,17
NDC,70121-1454-01,"INJECTION, MEROPENEM, 100 MG",69.725,45.32,0.4,320.36,34
NDC,70121-1463-02,"INJECTION, FULVESTRANT, 25 MG",100.53,65.34,6.06,259.62,19
NDC,70121-1483-01,"INJECTION, ARSENIC TRIOXIDE, 1 MG",15.21,9.89,3.8,202.84,19
NDC,70121-1568-01,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",511.745,332.635,0.36,1324.82,38
NDC,70121-1568-07,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",1536.05,998.43,0.36,3966.85,19
NDC,70121-1570-01,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",1001.6,651.04,0.36,3818.59,38
NDC,70121-1570-07,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",562.88,365.87,0.36,1453.64,19
NDC,70121-1574-01,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",89.87,58.42,0.13,232.09,17
NDC,70121-1577-05,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",279.64,181.77,0.01,722.17,17
NDC,70121-1627-01,FYLNETRA 6 MG/0.6 ML SYRINGE,31385.53,20400.595,5118.2,29608.78,22
NDC,70121-1694-02,"INJECTION, PLERIXAFOR, 1 MG",361.65,235.07,32.5,7236.29,19
NDC,70121-1705-07,"INJECTION, ATROPINE SULFATE, 0.01 MG",19.66,12.78,0.11,50.77,17
NDC,70121-2309-01,UNCLASSIFIED DRUGS,5.7,3.71,1.43,14.72,16
NDC,70121-2504-02,LIORESAL IT 10 MG/20 ML KIT,54.12,35.18,13.53,37.88,11
NDC,70121-2505-02,LIORESAL IT 40 MG/20 ML KIT,105.04,68.28,26.26,73.53,11
NDC,70127-0100-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",111.54,72.5,27.89,288.05,16
NDC,70127-0100-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.11,2.02,0.78,8.03,16
NDC,70199-0026-11,UNCLASSIFIED DRUGS,1988.12,1292.28,497.03,5134.32,16
NDC,70257-0051-51,"INJECTION, HEPATITIS B IMMUNE GLOBULIN (HEPAGAM B), INTRAVENOUS, 0.5 ML",466.1,302.97,73.77,1203.7,19
NDC,70370-2040-01,INGREZZA 40 MG CAPSULE,1231.62,800.5500000000001,162.76,1268.53,22
NDC,70377-0014-11,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",11.23,7.3,0.21,29.0,17
NDC,70377-0060-13,UNCLASSIFIED DRUGS,25.13,16.33,6.28,64.9,16
NDC,70377-0102-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.05,6.53,2.51,25.95,16
NDC,70377-0104-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.04,4.58,1.76,18.18,16
NDC,70436-0007-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.79,4.41,1.7,17.54,16
NDC,70436-0019-82,"INJECTION, AZITHROMYCIN, 500 MG",70.4,45.76,2.16,181.81,17
NDC,70436-0126-82,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",82.67,53.74,0.16,249.41,17
NDC,70436-0127-40,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",6.6,4.29,0.16,19.91,17
NDC,70436-0147-80,"INJECTION, DICYCLOMINE HCL, UP TO 20 MG",43.28,28.13,10.82,111.77,17
NDC,70436-0206-80,UNCLASSIFIED DRUGS,6.34,4.12,1.59,16.37,16
NDC,70436-0219-40,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",20.16,13.1,0.16,60.82,17
NDC,70436-0227-48,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.33,4.76,1.83,18.93,16
NDC,70436-0230-39,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",71.22,46.29,17.81,183.93,16
NDC,70436-0232-72,"INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG",25.99,16.89,0.43,67.12,17
NDC,70515-0263-10,"INJECTION, DIGOXIN, UP TO 0.5 MG",1037.5,674.38,10.14,2679.34,17
NDC,70594-0023-01,"INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG",174.64,113.52,12.8,451.01,17
NDC,70594-0048-01,"INJECTION, VANCOMYCIN HCL, 500 MG",6.71,4.36,1.68,17.33,16
NDC,70700-0189-22,"INJECTION, FLUOROURACIL, 500 MG",22.74,14.78,2.06,68.22,17
NDC,70700-0268-94,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",451.84,293.7,112.96,1166.88,16
NDC,70710-1014-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",211.035,137.175,1.87,1070.73,32
NDC,70710-1110-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.55,3.61,1.39,14.33,16
NDC,70710-1159-09,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",102.8,66.82,25.7,265.48,16
NDC,70710-1160-03,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",100.34,65.22,25.09,259.13,16
NDC,70710-1286-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.59,6.23,2.4,24.77,16
NDC,70710-1359-01,UNCLASSIFIED DRUGS,2.32,1.51,0.58,5.99,16
NDC,70710-1461-09,"INJECTION, HALOPERIDOL DECANOATE, PER 50 MG",33.32,21.66,4.18,86.05,17
NDC,70710-1478-01,"INJECTION, FOMEPIZOLE, 15 MG",2356.79,1531.91,6.82,6086.41,19
NDC,70710-1614-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.73,12.17,4.68,48.37,16
NDC,70710-1643-07,UNCLASSIFIED DRUGS,24.42,15.87,6.11,63.06,16
NDC,70710-1886-01,UNCLASSIFIED DRUGS,5.17,3.36,1.29,13.35,16
NDC,70720-0723-10,"INJECTION, ZICONOTIDE, 1 MICROGRAM",644.36,418.83,11.2,2058.35,19
NDC,70720-0950-36,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",9397.23,6108.2,824.15,28191.69,19
NDC,70720-0951-30,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",16273.69,10577.9,824.15,48821.07,19
NDC,70727-0497-25,RHOPRESSA 0.02% OPHTH SOLUTION,1535.0,997.75,383.75,1074.5,11
NDC,70748-0258-07,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",442.5,287.63,110.63,1142.76,16
NDC,70752-0130-05,UNCLASSIFIED DRUGS,3.51,2.28,0.88,9.06,16
NDC,70756-0014-05,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.68,8.24,3.17,32.75,16
NDC,70756-0201-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.84,3.15,1.21,12.5,16
NDC,70756-0203-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.69,4.35,1.67,17.28,16
NDC,70756-0204-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.83,7.04,2.71,27.97,16
NDC,70756-0205-11,UNCLASSIFIED DRUGS,7.82,5.085,1.24,27.63,32
NDC,70756-0404-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",16.6,10.79,4.15,42.87,16
NDC,70756-0607-30,UNCLASSIFIED DRUGS,31.16,20.25,7.79,80.47,16
NDC,70756-0609-15,UNCLASSIFIED DRUGS,13.72,8.92,3.43,35.43,16
NDC,70756-0614-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.87,11.62,4.47,46.15,16
NDC,70756-0649-35,UNCLASSIFIED DRUGS,27.11,17.62,6.78,70.01,16
NDC,70756-0703-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.76,12.19,4.69,48.45,16
NDC,70756-0721-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.15,7.9,3.04,31.38,16
NDC,70842-0120-01,UNCLASSIFIED DRUGS,1403.56,912.31,350.89,3624.69,16
NDC,70842-0240-01,REZZAYO 200 MG VIAL,13690.1,8898.57,1510.27,9752.72,33
NDC,70860-0100-10,"INJECTION, AZITHROMYCIN, 500 MG",508.26,330.37,2.16,1312.58,17
NDC,70860-0600-02,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",47.35,30.78,0.15,122.28,17
NDC,70860-0781-42,"INJECTION, GLYCOPYRROLATE, 0.1 MG",36.91,23.99,0.4,95.32,17
NDC,70860-0784-41,UNCLASSIFIED DRUGS,18.62,12.1,4.66,48.09,16
NDC,70954-0005-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",28.76,18.69,7.19,74.27,16
NDC,70954-0135-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.33,2.81,1.08,11.18,16
NDC,70954-0136-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.52,6.84,2.63,27.17,16
NDC,70954-0139-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.75,1.79,0.69,7.1,16
NDC,70954-0202-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.33,4.765,1.35,23.91,32
NDC,70954-0252-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.13,5.28,2.03,21.0,16
NDC,70954-0258-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.6,1.04,0.4,4.13,16
NDC,70954-0273-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.14,4.64,1.79,18.44,16
NDC,70954-0275-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.1,15.02,5.78,59.66,16
NDC,70954-0316-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.45,5.49,2.11,21.82,16
NDC,70954-0319-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.74,6.98,2.69,27.74,16
NDC,70954-0443-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.06,7.84,3.02,31.15,16
NDC,70954-0444-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.3,8.65,3.33,34.35,16
NDC,70954-0518-10,UNCLASSIFIED DRUGS,6.59,4.28,1.65,17.02,16
NDC,70954-0564-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.41,3.52,1.35,13.97,16
NDC,70954-0565-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.8,7.02,2.7,27.89,16
NDC,70954-0600-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.36,0.88,0.34,3.51,16
NDC,70954-0668-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.44,4.19,1.61,16.63,16
NDC,70954-0978-20,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",19.55,12.71,4.89,50.49,16
NDC,71258-0022-01,"PIFLUFOLASTAT F-18, DIAGNOSTIC, 1 MILLICURIE",67330.22,43764.64,367.28,203128.54,17
NDC,71266-6290-01,L.E.T.(LIDO-EPINEPH-TETRA) GEL,6.42,4.17,1.61,4.49,11
NDC,71288-0016-15,"INJECTION, DAPTOMYCIN (XELLIA), UNREFRIGERATED, NOT THERAPEUTICALLY EQUIVALENT TO J0878 OR J0873, 1 MG",192.62,125.2,0.06,497.44,17
NDC,71288-0019-10,"INJECTION, TIGECYCLINE, 1 MG",242.3,157.5,0.59,625.74,17
NDC,71288-0030-21,DOXYCYCLINE HYCLATE 100 MG VL,254.68,165.54,63.67,178.28,11
NDC,71288-0031-20,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",52.160000000000004,33.905,1.41,237.98,34
NDC,71288-0033-75,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",25.0,16.25,1.41,64.56,17
NDC,71288-0102-10,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, 1 MG",1610.12,1046.58,2.17,4158.13,19
NDC,71288-0103-20,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, 1 MG",9286.44,6036.19,2.17,23982.23,19
NDC,71288-0106-10,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",65.61,42.65,16.4,196.83,17
NDC,71288-0115-30,"INJECTION, AZACITIDINE, 1 MG",4196.42,2727.67,0.49,10837.25,19
NDC,71288-0116-11,BUSULFAN 60 MG/10 ML VIAL,23.17,15.06,5.79,16.22,11
NDC,71288-0129-02,DACTINOMYCIN 500 MCG VIAL,1099.79,714.86,274.95,769.85,11
NDC,71288-0138-50,"INJECTION, MITOMYCIN, 5 MG",564.43,366.88,27.67,1457.64,19
NDC,71288-0166-10,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",102.73,66.77,3.81,2058.35,19
NDC,71288-0167-50,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",9029.955,5869.469999999999,3.81,45706.2,38
NDC,71288-0174-20,"DACARBAZINE, 100 MG",144.83,94.14,4.37,434.49,17
NDC,71288-0402-10,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",31.475,20.46,0.19,130.11,34
NDC,71288-0405-80,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",74.18,48.214999999999996,0.19,330.41,34
NDC,71288-0406-81,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",64.25,41.76,0.19,165.93,17
NDC,71288-0426-03,"INJECTION, ENOXAPARIN SODIUM, 10 MG",60.75,39.49,0.56,182.25,17
NDC,71288-0427-11,"INJECTION, BIVALIRUDIN, 1 MG",246.24,160.06,0.17,635.91,19
NDC,71288-0437-91,"INJECTION, ENOXAPARIN SODIUM, 10 MG",36.0,23.4,0.56,108.0,17
NDC,71288-0503-02,HALOPERIDOL DEC 100 MG/ML VIAL,36.24,23.56,9.06,25.37,11
NDC,71288-0600-10,UNCLASSIFIED DRUGS,115.185,74.87,18.13,407.62,32
NDC,71288-0803-20,"INJECTION, MYCOPHENOLATE MOFETIL, 10 MG",1076.76,699.89,0.39,2780.73,19
NDC,71300-6610-03,LOTREXONE 4.5 MG CAPSULE,39.2,25.48,9.8,27.44,11
NDC,71321-0802-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.7,3.71,1.43,14.72,16
NDC,71336-1003-01,"INJECTION, VUTRISIRAN, 1 MG",712903.04,463386.98,5310.13,1841072.1,19
NDC,71349-0070-01,"CANTHARIDIN FOR TOPICAL ADMINISTRATION, 0.7%, SINGLE UNIT DOSE APPLICATOR (3.2 MG)",3385.21,2200.39,695.89,8742.3,17
NDC,71351-0025-30,JELCAINE STERILE 2% JELLY,40.13,26.08,10.03,28.09,11
NDC,71369-0020-10,DOPTELET (10 TAB PK) 20 MG TAB,2976.725,1934.87,734.91,2109.68,22
NDC,71384-0721-07,TOBRAMYCIN 1.5%-VANCOMYCIN 5%,515.39,335.0,128.85,360.77,11
NDC,71390-0011-00,BYFAVO 20 MG VIAL,268.2,174.33,67.05,187.74,11
NDC,71390-0011-11,BYFAVO 20 MG VIAL,696.06,452.44,174.02,487.24,11
NDC,71399-7401-05,UNCLASSIFIED DRUGS,1.33,0.86,0.33,3.43,16
NDC,71399-9940-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.25,4.06,1.56,16.14,16
NDC,71449-0091-43,"INJECTION, BEVACIZUMAB, 0.25 MG",871.3,566.35,1.95,2250.13,17
NDC,71449-0091-43,"INJECTION, BEVACIZUMAB, 10 MG",2650.0,1722.5,78.05,6843.63,19
NDC,71699-0025-30,XCOPRI 25 MG TABLET,263.27,171.13,65.82,184.29,11
NDC,71699-0050-30,UNCLASSIFIED DRUGS,172.07999999999998,111.85000000000001,21.38,667.91,32
NDC,71699-0100-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",202.625,131.705,38.76,646.22,32
NDC,71699-0150-30,UNCLASSIFIED DRUGS,425.42499999999995,276.525,64.23,1533.82,32
NDC,71715-0001-01,"INJECTION, OMADACYCLINE, 1 MG",2081.41,1352.92,4.39,5375.24,19
NDC,71715-0002-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1713.18,1113.57,428.3,4424.29,16
NDC,71837-5843-01,"INJECTION, SARGRAMOSTIM (GM-CSF), 50 MCG",1490.84,969.0450000000001,65.46,5714.84,38
NDC,71839-0110-10,"INJECTION, ENOXAPARIN SODIUM, 10 MG",31.5,20.48,0.56,94.5,17
NDC,71839-0112-10,"INJECTION, ENOXAPARIN SODIUM, 10 MG",25.45,16.54,0.56,76.35,17
NDC,71839-0113-10,"INJECTION, ENOXAPARIN SODIUM, 10 MG",24.52,15.94,0.56,73.56,17
NDC,72060-0110-40,CAPLYTA 10.5 MG CAPSULE,359.4,233.61,89.85,251.58,11
NDC,72060-0121-40,CAPLYTA 21 MG CAPSULE,359.4,233.61,89.85,251.58,11
NDC,72060-0142-01,CAPLYTA 42 MG CAPSULE,372.25,241.96,93.06,260.58,11
NDC,72060-0142-07,CAPLYTA 42 MG CAPSULE,361.15,234.75,90.29,252.81,11
NDC,72078-0034-01,UNCLASSIFIED DRUGS,116.23,75.55,29.06,300.16,16
NDC,72205-0019-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",55.33,35.96,13.83,142.89,16
NDC,72205-0031-01,"INJECTION, DECITABINE, 1 MG",580.06,377.04,0.69,1498.0,19
NDC,72205-0039-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.23,3.4,1.31,13.51,16
NDC,72205-0040-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.55,7.51,2.75,31.25,32
NDC,72205-0041-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",15.015,9.76,1.94,57.49,32
NDC,72205-0045-01,"INJECTION, THIOTEPA, 15 MG",516.03,335.42,129.01,1332.65,16
NDC,72205-0046-01,"INJECTION, THIOTEPA, 15 MG",4437.28,2884.23,1109.32,11459.28,16
NDC,72205-0094-92,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",29.58,19.23,7.4,76.39,16
NDC,72205-0102-01,UNCLASSIFIED DRUGS,4.98,3.24,1.25,12.86,16
NDC,72205-0170-72,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.98,1.94,0.75,7.7,16
NDC,72205-0198-01,"INJECTION, CARMUSTINE, 100 MG",2486.39,1616.15,246.58,6421.1,19
NDC,72205-0205-01,"INJECTION, ZIPRASIDONE MESYLATE, 10 MG",78.58,51.08,9.7,202.93,17
NDC,72205-0282-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",79.99,51.99,20.0,206.57,16
NDC,72266-0101-01,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",931.75,605.64,61.49,2406.24,19
NDC,72266-0102-01,"INJECTION, LABETALOL HYDROCHLORIDE, 5 MG",55.85,36.3,0.37,144.23,17
NDC,72266-0119-25,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",66.23,43.05,0.35,171.04,17
NDC,72266-0162-01,"INJECTION, OXALIPLATIN, 0.5 MG",32.71,21.26,0.05,98.13,17
NDC,72266-0234-01,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",22.8,14.82,0.35,58.88,17
NDC,72266-0248-01,"INJECTION, SINCALIDE, 5 MICROGRAMS",685.36,445.48,116.74,1769.94,19
NDC,72266-0251-01,"INJECTION, CALCITRIOL, 0.1 MCG",48.31,31.4,1.26,125.43,34
NDC,72266-0253-01,"INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG",2.06,1.34,0.52,6.18,17
NDC,72426-0118-03,NEXLETOL 180 MG TABLET,90.95,59.12,22.74,63.67,11
NDC,72485-0611-30,UNCLASSIFIED DRUGS,20.94,13.61,5.24,54.08,16
NDC,72493-0101-40,JELMYTO 40 MG VIAL,55097.405,35813.315,13773.7,38570.0,22
NDC,72512-0929-01,QUTENZA 8% KIT (2 PATCH),2200.22,1430.14,550.06,1540.15,11
NDC,72570-0122-35,UNCLASSIFIED DRUGS,14.37,9.34,3.59,37.11,16
NDC,72578-0007-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.38,5.45,2.1,21.64,16
NDC,72578-0008-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.89,4.48,1.72,17.79,16
NDC,72578-0040-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.2,3.38,1.3,13.43,16
NDC,72578-0041-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.55,2.96,1.14,11.75,16
NDC,72578-0042-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.7,5.01,1.93,19.89,16
NDC,72578-0062-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",52.33,34.01,13.08,135.14,16
NDC,72578-0082-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.41,13.27,5.1,52.71,16
NDC,72578-0089-04,UNCLASSIFIED DRUGS,4.69,3.05,1.17,12.11,16
NDC,72578-0150-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.21,2.74,1.05,10.87,16
NDC,72579-0011-02,BRUKINSA 80 MG CAPSULE,910.98,592.14,227.75,637.69,11
NDC,72579-0121-01,TEVIMBRA 100 MG/10 ML VIAL,6841.0,4446.65,1710.25,4788.7,11
NDC,72606-0037-01,STOBOCLO 60 MG/ML SYRINGE,10955.49,7121.07,2738.87,7668.84,11
NDC,72611-0716-01,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",563.18,366.07,61.49,1454.41,19
NDC,72618-3000-02,NURTEC ODT 75 MG TABLET,814.94,529.71,203.74,570.46,11
NDC,72694-0515-01,"ASPARLAS 3,750 UNIT/5 ML VIAL",24705.29,16058.435000000001,3267.35,25438.83,22
NDC,72694-0954-01,"INJECTION, PEGASPARGASE, PER SINGLE DOSE VIAL",44796.89,29117.98,5578.63,173748.69,38
NDC,72819-0234-06,UNCLASSIFIED DRUGS,4.66,3.03,1.17,12.03,16
NDC,72888-0052-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.6,12.09,4.65,48.03,16
NDC,72888-0061-30,UNCLASSIFIED DRUGS,35.85,23.3,8.96,92.58,16
NDC,72888-0085-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.265,16.425,4.93,79.62,32
NDC,72888-0095-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.205,11.18,1.62,72.13,32
NDC,72888-0125-15,UNCLASSIFIED DRUGS,5.26,3.42,1.32,13.58,16
NDC,72888-0157-39,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.93,1.9,0.73,7.57,16
NDC,72888-0206-08,IVERMECTIN 3 MG TABLET,29.78,19.36,7.45,20.85,11
NDC,72888-0207-08,IVERMECTIN 6 MG TABLET,65.82,42.78,16.46,46.07,11
NDC,72903-0853-01,"INJECTION, MIRVETUXIMAB SORAVTANSINE-GYNX, 1 MG",2122.28,1379.48,75.44,25740.26,19
NDC,72934-5404-02,ENZNONUTY 20%-10%-10% OINTMENT,10.86,7.06,2.72,7.6,11
NDC,72960-0112-01,DAXXIFY 100 UNIT VIAL,915.72,595.22,228.93,641.0,11
NDC,72974-0120-01,ORGOVYX 120 MG TABLET,648.1,421.27,162.03,453.67,11
NDC,73070-0100-11,"INJECTION, INSULIN, PER 5 UNITS",95.89,62.33,0.56,247.64,17
NDC,73090-0420-01,SYLVANT 100 MG VIAL,7818.46,5082.0,1954.62,5472.92,11
NDC,73090-0421-01,"INJECTION, SILTUXIMAB, 10 MG",28166.06,18307.94,178.8,72738.85,19
NDC,73150-0150-06,"INJECTION, UBLITUXIMAB-XIIY, 1MG",10802.58,7021.68,74.39,27897.66,19
NDC,73302-0456-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",130.805,85.02,24.11,426.53,32
NDC,73336-0075-07,GEMTESA 75 MG TABLET,102.9,66.89,25.73,72.03,11
NDC,73336-0075-30,GEMTESA 75 MG TABLET,48.6,31.59,12.15,34.02,11
NDC,73372-0116-01,"AFAMELANOTIDE IMPLANT, 1 MG",125775.9,81754.34,3120.03,324816.26,19
NDC,73475-3041-05,"INJECTION, EFGARTIGIMOD ALFA-FCAB, 2MG",1381.88,898.22,34.15,11535.65,19
NDC,73475-3102-03,"VYVGART HYTRULO 1,008MG-11,200",19222.9,12494.89,4805.73,13456.03,11
NDC,73535-0208-01,"INJECTION, TAFASITAMAB-CXIX, 2 MG",17331.3,11265.35,15.09,44758.08,19
NDC,73555-0502-00,REVUFORJ 160 MG TABLET,4565.75,2967.74,1141.44,3196.03,11
NDC,73562-0104-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.370000000000001,9.34,0.27,71.43,32
NDC,73562-0114-01,"ZENPEP DR 40,000 UNIT CAPSULE",102.59,66.68,25.65,71.81,11
NDC,73562-0208-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",54.2,35.23,13.55,139.97,16
NDC,73702-0140-71,UNCLASSIFIED DRUGS,2080.855,1352.5549999999998,435.97,6244.1,32
NDC,74725-0100-25,"GALLIUM GA-68 GOZETOTIDE, DIAGNOSTIC, (ILLUCCIX), 1 MILLICURIE",19912.06,12942.84,507.23,60072.69,17
NDC,75826-0115-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.725,3.075,0.76,16.55,32
NDC,75826-0141-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.25,7.96,3.06,31.64,16
NDC,75826-0142-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.1,5.92,2.28,23.5,16
NDC,75834-0010-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.75,8.29,3.19,32.93,16
NDC,75834-0158-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.76,3.74,1.44,14.88,16
NDC,75907-0023-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",69.1,44.92,17.28,178.45,16
NDC,75907-0024-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",96.8,62.92,24.2,249.99,16
NDC,75907-0025-11,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",84.6,54.99,21.15,218.48,16
NDC,75907-0045-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.05,11.08,4.26,44.03,16
NDC,75907-0046-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",36.8,23.92,7.21,115.57,32
NDC,75907-0070-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.48,2.26,0.87,8.99,16
NDC,75987-0130-15,"INJECTION, TEPROTUMUMAB-TRBW, 10 MG",35521.55,23089.01,391.47,91734.4,19
NDC,75987-0150-01,UPLIZNA 100 MG/10 ML VIAL,20097.65,13063.47,5024.41,14068.36,11
NDC,76014-0005-25,UNCLASSIFIED DRUGS,97.03,63.07,24.26,250.58,16
NDC,76045-0004-01,"INJECTION, MORPHINE SULFATE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J2270, UP TO 10 MG",66.29,43.09,7.18,171.19,17
NDC,76045-0004-11,"INJECTION, MORPHINE SULFATE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J2270, UP TO 10 MG",53.6,34.84,7.18,138.42,17
NDC,76045-0005-10,MORPHINE 4 MG/ML SYRINGE,47.46,30.85,11.87,33.22,11
NDC,76045-0005-11,MORPHINE 4 MG/ML SYRINGE,15.65,10.17,3.91,10.96,11
NDC,76045-0009-01,"INJECTION, HYDROMORPHONE, 0.1 MG",41.17,26.76,0.15,106.32,17
NDC,76045-0009-96,"INJECTION, HYDROMORPHONE, 0.1 MG",215.8,140.27,0.15,731.52,51
NDC,76045-0108-10,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",15.294999999999998,9.945,0.19,43.64,34
NDC,76045-0121-01,"INJECTION, HYDROMORPHONE, 0.1 MG",95.9,62.34,0.15,247.66,17
NDC,76045-0121-11,"INJECTION, HYDROMORPHONE, 0.1 MG",13.38,8.7,0.15,34.55,17
NDC,76075-0101-01,"INJECTION, CARFILZOMIB, 1 MG",38624.09,25105.66,58.95,99746.71,19
NDC,76075-0102-01,"INJECTION, CARFILZOMIB, 1 MG",12486.92,8116.5,58.95,32247.47,19
NDC,76075-0103-01,"INJECTION, CARFILZOMIB, 1 MG",2508.07,1630.25,58.95,6477.09,19
NDC,76125-0150-02,Rabies immune globulin for injection,1272.84,827.35,244.46,4048.95,38
NDC,76125-0792-25,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",6.45,4.19,1.61,185.91,19
NDC,76125-0900-10,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",24.79,16.11,6.2,2058.35,19
NDC,76128-0155-75,"INJECTION, PORFIMER SODIUM, 75 MG",6465.34,4202.47,1616.34,35052.23,19
NDC,76154-0474-15,UNCLASSIFIED DRUGS,5.63,3.66,1.41,14.54,16
NDC,76204-0011-11,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",4.33,2.81,0.07,11.18,17
NDC,76204-0100-01,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",5.955,3.87,0.42,21.05,34
NDC,76204-0200-01,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",3.87,2.515,0.07,16.32,34
NDC,76204-0900-01,LEVALBUTEROL 1.25 MG/3 ML SOL,15.32,9.96,3.83,10.72,11
NDC,76310-0022-01,"INJECTION, ALDESLEUKIN, PER SINGLE USE VIAL",34890.45,22678.79,1477.95,90104.59,19
NDC,76329-1240-01,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",197.28,128.23,0.7,1011.72,34
NDC,76329-3013-05,UNCLASSIFIED DRUGS,10.515,6.835,1.67,37.08,32
NDC,76329-3304-01,UNCLASSIFIED DRUGS,12.860000000000001,8.36,2.14,44.34,32
NDC,76329-3318-01,"INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG",7.23,4.7,1.81,18.67,16
NDC,76329-3352-01,UNCLASSIFIED DRUGS,4.08,2.65,0.74,13.4,32
NDC,76329-3390-01,UNCLASSIFIED DRUGS,29.87,19.42,7.47,77.14,16
NDC,76385-0134-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.58,7.53,1.02,49.3,32
NDC,77333-0049-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",13.96,9.07,3.49,36.05,16
NDC,77333-0113-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.91,13.59,5.23,54.0,16
NDC,77333-0812-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.04,14.98,5.76,59.5,16
NDC,77333-0937-25,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",17.94,11.66,4.49,46.33,16
NDC,77333-0940-25,UNCLASSIFIED DRUGS,21.52,13.99,5.38,55.58,16
NDC,77790-0022-15,UNCLASSIFIED DRUGS,9.76,6.34,1.08,39.23,32
NDC,78206-0126-01,DULERA 200 MCG-5 MCG INHALER,173.17,112.56,43.29,121.22,11
NDC,78206-0145-01,"ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES",5043.88,3278.5249999999996,727.06,18533.67,38
NDC,78206-0162-01,"INJECTION, INFLIXIMAB-ABDA, BIOSIMILAR, (RENFLEXIS), 10 MG",3730.53,2424.84,29.42,9634.09,19
NDC,78206-0162-99,"INJECTION, INFLIXIMAB-ABDA, BIOSIMILAR, (RENFLEXIS), 10 MG",3641.36,2366.88,29.42,9403.81,19
NDC,79952-0110-01,"INJECTION, LONCASTUXIMAB TESIRINE-LPYL, 0.075 MG",121713.4,79113.71,234.49,314324.86,19
NDC,80203-0347-01,"ENJAYMO 1,100 MG/22 ML VIAL",7250.035,4712.525,475.02,8820.0,22
NDC,80446-0401-01,"INJECTION, TEBENTAFUSP-TEBN, 1 MICROGRAM",185037.65,120274.47,235.54,477859.73,19
NDC,80681-0011-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.89,2.53,0.97,10.05,16
NDC,80681-0049-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",7.36,4.78,1.84,19.01,16
NDC,80681-0057-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",4.85,3.15,1.21,12.53,16
NDC,80681-0063-00,UNCLASSIFIED DRUGS,4.05,2.63,1.01,10.46,16
NDC,80681-0063-01,UNCLASSIFIED DRUGS,26.32,17.11,6.58,67.97,16
NDC,80681-0071-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.75,3.74,1.44,14.85,16
NDC,80681-0099-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.01,1.96,0.75,7.77,16
NDC,80681-0116-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.65,2.37,0.91,9.43,16
NDC,80681-0131-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",21.18,13.77,5.3,54.7,16
NDC,80681-0134-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.63,1.71,0.66,6.79,16
NDC,80681-0135-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",20.46,13.3,5.12,52.84,16
NDC,80681-0140-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.94,2.56,0.99,10.18,16
NDC,80681-0168-00,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",63.87,41.52,15.97,164.94,16
NDC,80777-0113-09,SPIKEVAX 2025-26 (6M-11Y) SYR,225.0,146.25,56.25,157.5,11
NDC,80803-0153-50,FYARRO 100 MG VIAL,31287.62,20336.95,7821.91,21901.33,11
NDC,80830-1672-01,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",7.08,4.6,0.03,18.28,17
NDC,80830-2329-01,UNCLASSIFIED DRUGS,2.3,1.5,0.58,5.94,16
NDC,80830-2329-02,UNCLASSIFIED DRUGS,1.53,0.99,0.38,3.95,16
NDC,80830-2363-01,"INJECTION, CALCIUM GLUCONATE (WG CRITICAL CARE), NOT THERAPEUTICALLY EQUIVALENT TO J0612, 10 MG",3.79,2.46,0.1,9.79,17
NDC,81033-0020-50,UNCLASSIFIED DRUGS,93.15,60.55,23.29,240.56,16
NDC,81033-0025-05,UNCLASSIFIED DRUGS,34.16,22.2,8.54,88.22,16
NDC,81033-0102-10,UNCLASSIFIED DRUGS,1.53,0.99,0.38,3.95,16
NDC,81284-0411-00,"INJECTION, DIHYDROERGOTAMINE MESYLATE, PER 1 MG",557.75,362.54,60.5,1440.39,17
NDC,81284-0611-00,UNCLASSIFIED DRUGS,9.55,6.21,2.39,24.66,16
NDC,81284-0612-00,UNCLASSIFIED DRUGS,2.87,1.87,0.72,7.41,16
NDC,81298-5781-01,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",155.45,101.04,0.78,401.45,17
NDC,81520-0200-30,VOQUEZNA 20 MG TABLET,150.7,97.96,37.68,105.49,11
NDC,81643-9270-01,FLOXURIDINE 500 MG VIAL,1293.4250000000002,840.73,301.67,966.13,22
NDC,81665-0301-02,"COCAINE HYDROCHLORIDE NASAL SOLUTION (NUMBRINO), 1 MG",573.26,372.62,143.32,1480.44,16
NDC,81960-0031-03,"INJECTION, PEMIVIBART, FOR THE PRE-EXPOSURE PROPHYLAXIS ONLY, FOR CERTAIN ADULTS AND ADOLESCENTS (12 YEARS OF AGE AND OLDER WEIGHING AT LEAST 40 KG) WITH NO KNOWN SARS-COV-2 EXPOSURE, AND WHO EITHER H",1521.09,988.71,380.27,7673.34,17
NDC,82293-0004-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.11,3.97,1.53,15.78,16
NDC,82293-0005-10,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",11.5,7.48,2.88,29.7,16
NDC,82584-0792-01,UNCLASSIFIED DRUGS,55.58,36.13,13.9,143.54,16
NDC,82625-8801-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",95.24,61.91,23.81,245.96,16
NDC,82625-8802-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",95.93,62.35,23.98,247.74,16
NDC,82705-0010-01,"INJECTION, EPCORITAMAB-BYSP, 0.16 MG",45721.75,29719.14,60.22,118076.42,17
NDC,82829-0002-01,IZERVAY 2 MG/0.1 ML VIAL,52600.0,34190.0,13150.0,36820.0,11
NDC,82959-0111-01,RYTELO 188 MG VIAL,20624.84,13406.15,5156.21,14437.39,11
NDC,82959-0112-01,RYTELO 47 MG VIAL,5156.22,3351.54,1289.06,3609.35,11
NDC,83090-0007-01,UNCLASSIFIED DRUGS,66.58,43.275,7.64,264.96,32
NDC,83257-0005-41,FULPHILA 6 MG/0.6 ML SYRINGE,6584.4,4279.86,1646.1,4609.08,11
NDC,83257-0023-41,YESINTEK 45 MG/0.5 ML SYRINGE,19544.75,12704.09,4886.19,13681.33,11
NDC,83257-0025-41,YESINTEK 90 MG/ML SYRINGE,19788.65,12862.62,4947.16,13852.06,11
NDC,83634-0303-41,UNCLASSIFIED DRUGS,584.57,379.97,146.14,1509.65,16
NDC,83634-0306-05,UNCLASSIFIED DRUGS,1106.85,719.45,276.71,2858.44,16
NDC,83634-0776-10,"INJECTION, FOSAPREPITANT, 1 MG",2822.2,1834.43,0.12,7288.33,17
NDC,83634-0778-41,"INJECTION, PROCHLORPERAZINE, UP TO 10 MG",42.34,27.52,2.67,109.34,17
NDC,83980-0001-01,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",23.01,14.96,5.75,59.42,16
NDC,85446-0369-81,UNCLASSIFIED DRUGS,811.77,527.65,202.94,2096.4,16
NDC,87651-0760-30,AZO BORIC ACID 600 MG VAG SUPP,10.1,6.57,2.53,7.07,11
NDC,89122-0724-20,HYALGAN 20 MG/2 ML SYRINGE,67.45,43.84,16.86,47.22,11
NDC,96295-0135-33,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",41.66,27.08,1.14,203.37,32
NDC,99990-0002-68,METHOHEXITAL 10 MG/ML IN SW COMPOUND [4083531],5.05,3.28,1.26,3.54,11
NDC,99990-0002-97,UNCLASSIFIED DRUGS,1.39,0.9,0.35,3.59,16
NDC,99990-0003-06,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.14,0.74,0.29,2.94,16
NDC,99990-0003-17,"ANTIEMETIC DRUG, ORAL, NOT OTHERWISE SPECIFIED",161.73,105.12,40.43,417.67,16
NDC,99990-0003-25,UNCLASSIFIED DRUGS,1.05,0.68,0.26,2.71,16
NDC,99990-0003-46,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.055,1.335,0.4,6.51,32
NDC,99990-0003-49,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",47.83,31.09,11.96,123.52,16
NDC,99990-0003-57,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",14.27,9.28,3.57,36.85,16
NDC,99990-0003-59,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.2,2.08,0.8,8.26,16
NDC,99990-0003-69,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",6.54,4.25,1.64,16.89,16
NDC,99990-0003-71,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",12.83,8.34,3.21,33.13,16
NDC,99990-0003-80,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.46,1.595,0.49,7.64,32
NDC,99990-0003-86,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.8599999999999999,1.21,0.35,5.99,32
NDC,99990-0003-91,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.29,0.84,0.32,3.33,16
NDC,99990-0003-95,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.17,0.76,0.29,3.02,16
NDC,99990-0004-04,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",10.78,7.01,2.7,27.84,16
NDC,99990-0004-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.0,1.95,0.75,7.75,16
NDC,99990-0004-17,UNCLASSIFIED DRUGS,15.62,10.15,3.91,40.34,16
NDC,99990-0004-24,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.78,1.16,0.45,4.6,16
NDC,99990-0004-26,UNCLASSIFIED DRUGS,1.43,0.93,0.36,3.69,16
NDC,99990-0004-30,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",8.78,5.71,2.2,22.67,16
NDC,99990-0004-33,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.95,2.57,0.99,10.2,16
NDC,99990-0004-36,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.07,3.3,1.23,13.53,32
NDC,99990-0004-45,UNCLASSIFIED DRUGS,11.09,7.21,1.23,44.6,32
NDC,99990-0004-49,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.24,1.46,0.56,5.78,16
NDC,99990-0004-52,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",5.69,3.7,1.42,14.69,16
NDC,99990-0004-54,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.33,2.165,0.72,9.76,32
NDC,99990-0004-57,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.475,2.2600000000000002,0.32,14.62,32
NDC,99990-0004-60,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",9.26,6.02,2.32,23.91,16
NDC,99990-0004-70,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.5,1.63,0.63,6.46,16
NDC,99990-0004-72,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.44,2.235,0.83,9.22,32
NDC,99990-0004-75,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",3.025,1.9649999999999999,0.29,12.68,32
NDC,99990-0005-17,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",18.3,11.895,2.45,69.26,32
NDC,99990-0005-21,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",1.15,0.75,0.29,2.97,16
NDC,99990-0005-24,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",2.57,1.67,0.64,6.64,16
NDC,99990-0005-32,"BRACHYTHERAPY SOURCE, NON-STRANDED, YTTRIUM-90, PER SOURCE",304653.53,198024.79,16299.55,786767.74,19