code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
APC,0763,"Inj, bupivacaine liposome",,,,,0
APC,0764,Ketorolac tromethamine inj,,,,,0
APC,0792,"Inj, glycopyrrolate, 0.1 mg",,,,,0
APC,0794,"Inj, bumetanide, 0.5 mg",,,,,0
APC,1511,New Technology - Level 11 ($901 - $1000),,,,,0
APC,1521,New Technology - Level 21 ($1901-$2000),,,,,0
APC,1522,New Technology - Level 22 ($2001-$2500),,,,,0
APC,1580,"New Technology - Level 43 ($40,001-$50,000)",,,,,0
APC,2040,"Endo, single, urinary tract",,,,,0
APC,2044,"Ret dev, laser, ivc filter",,,,,0
APC,2045,"Grft, trnsmurl/trnsvens byps",,,,,0
APC,2050,Cath coronary drug-delivery,,,,,0
APC,2051,Cath renal denerv radiofreq,,,,,0
APC,2616,"Brachytx, non-str,Yttrium-90",,,,,0
APC,5012,Clinic Visits and Related Services,,,,,0
APC,5021,Level 1 Type A ED Visits,,,,,0
APC,5022,Level 2 Type A ED Visits,,,,,0
APC,5023,Level 3 Type A ED Visits,,,,,0
APC,5024,Level 4 Type A ED Visits,,,,,0
APC,5025,Level 5 Type A ED Visits,,,,,0
APC,5041,Critical Care,,,,,0
APC,5045,Trauma Response with Critical Care,,,,,0
APC,5051,Level 1 Skin Procedures,,,,,0
APC,5052,Level 2 Skin Procedures,,,,,0
APC,5053,Level 3 Skin Procedures,,,,,0
APC,5054,Level 4 Skin Procedures,,,,,0
APC,5055,Level 5 Skin Procedures,,,,,0
APC,5061,Hyperbaric Oxygen,,,,,0
APC,5071,Level 1 Excision/ Biopsy/ Incision and Drainage,,,,,0
APC,5072,Level 2 Excision/ Biopsy/ Incision and Drainage,,,,,0
APC,5073,Level 3 Excision/ Biopsy/ Incision and Drainage,,,,,0
APC,5091,Level 1 Breast/Lymphatic Surgery and Related Procedures,,,,,0
APC,5092,Level 2 Breast/Lymphatic Surgery and Related Procedures,,,,,0
APC,5093,Level 3 Breast/Lymphatic Surgery and Related Procedures,,,,,0
APC,5094,Level 4 Breast/Lymphatic Surgery and Related Procedures,,,,,0
APC,5101,Level 1 Strapping and Cast Application,,,,,0
APC,5102,Level 2 Strapping and Cast Application,,,,,0
APC,5111,Level 1 Musculoskeletal Procedures,,,,,0
APC,5112,Level 2 Musculoskeletal Procedures,,,,,0
APC,5113,Level 3 Musculoskeletal Procedures,,,,,0
APC,5114,Level 4 Musculoskeletal Procedures,,,,,0
APC,5115,Level 5 Musculoskeletal Procedures,,,,,0
APC,5116,Level 6 Musculoskeletal Procedures,,,,,0
APC,5151,Level 1 Airway Endoscopy,,,,,0
APC,5153,Level 3 Airway Endoscopy,,,,,0
APC,5154,Level 4 Airway Endoscopy,,,,,0
APC,5155,Level 5 Airway Endoscopy,,,,,0
APC,5161,Level 1 ENT Procedures,,,,,0
APC,5162,Level 2 ENT Procedures,,,,,0
APC,5163,Level 3 ENT Procedures,,,,,0
APC,5164,Level 4 ENT Procedures,,,,,0
APC,5165,Level 5 ENT Procedures,,,,,0
APC,5166,Cochlear Implant Procedure,,,,,0
APC,5181,Level 1 Vascular Procedures,,,,,0
APC,5182,Level 2 Vascular Procedures,,,,,0
APC,5183,Level 3 Vascular Procedures,,,,,0
APC,5184,Level 4 Vascular Procedures,,,,,0
APC,5191,Level 1 Endovascular Procedures,,,,,0
APC,5192,Level 2 Endovascular Procedures,,,,,0
APC,5193,Level 3 Endovascular Procedures,,,,,0
APC,5194,Level 4 Endovascular Procedures,,,,,0
APC,5200,Implantation Wireless PA Pressure Monitor,,,,,0
APC,5211,Level 1 Electrophysiologic Procedures,,,,,0
APC,5212,Level 2 Electrophysiologic Procedures,,,,,0
APC,5213,Level 3 Electrophysiologic Procedures,,,,,0
APC,5221,Level 1 Pacemaker and Similar Procedures,,,,,0
APC,5222,Level 2 Pacemaker and Similar Procedures,,,,,0
APC,5223,Level 3 Pacemaker and Similar Procedures,,,,,0
APC,5224,Level 4 Pacemaker and Similar Procedures,,,,,0
APC,5231,Level 1 ICD and Similar Procedures,,,,,0
APC,5232,Level 2 ICD and Similar Procedures,,,,,0
APC,5241,Level 1 Blood Product Exchange and Related Services,,,,,0
APC,5242,Level 2 Blood Product Exchange and Related Services,,,,,0
APC,5301,Level 1 Upper GI Procedures,,,,,0
APC,5302,Level 2 Upper GI Procedures,,,,,0
APC,5303,Level 3 Upper GI Procedures,,,,,0
APC,5311,Level 1 Lower GI Procedures,,,,,0
APC,5312,Level 2 Lower GI Procedures,,,,,0
APC,5313,Level 3 Lower GI Procedures,,,,,0
APC,5331,Complex GI Procedures,,,,,0
APC,5341,Level 1 Abdominal/Peritoneal/Biliary and Related Procedures,,,,,0
APC,5342,Level 2 Abdominal/Peritoneal/Biliary and Related Procedures,,,,,0
APC,5361,Level 1 Laparoscopy and Related Services,,,,,0
APC,5362,Level 2 Laparoscopy and Related Services,,,,,0
APC,5371,Level 1 Urology and Related Services,,,,,0
APC,5372,Level 2 Urology and Related Services,,,,,0
APC,5373,Level 3 Urology and Related Services,,,,,0
APC,5374,Level 4 Urology and Related Services,,,,,0
APC,5375,Level 5 Urology and Related Services,,,,,0
APC,5376,Level 6 Urology and Related Services,,,,,0
APC,5377,Level 7 Urology and Related Services,,,,,0
APC,5378,Level 8 Urology and Related Services,,,,,0
APC,5401,Dialysis,,,,,0
APC,5411,Level 1 Gynecologic Procedures,,,,,0
APC,5412,Level 2 Gynecologic Procedures,,,,,0
APC,5413,Level 3 Gynecologic Procedures,,,,,0
APC,5414,Level 4 Gynecologic Procedures,,,,,0
APC,5415,Level 5 Gynecologic Procedures,,,,,0
APC,5416,Level 6 Gynecologic Procedures,,,,,0
APC,5431,Level 1 Nerve Procedures,,,,,0
APC,5432,Level 2 Nerve Procedures,,,,,0
APC,5441,Level 1 Nerve Injections,,,,,0
APC,5442,Level 2 Nerve Injections,,,,,0
APC,5443,Level 3 Nerve Injections,,,,,0
APC,5461,Level 1 Neurostimulator and Related Procedures,,,,,0
APC,5462,Level 2 Neurostimulator and Related Procedures,,,,,0
APC,5463,Level 3 Neurostimulator and Related Procedures,,,,,0
APC,5464,Level 4 Neurostimulator and Related Procedures,,,,,0
APC,5465,Level 5 Neurostimulator and Related Procedures,,,,,0
APC,5471,Implantation of Drug Infusion Device,,,,,0
APC,5493,Level 3 Intraocular Procedures,,,,,0
APC,5503,"Level 3 Extraocular, Repair, and Plastic Eye Procedures",,,,,0
APC,5504,"Level 4 Extraocular, Repair, and Plastic Eye Procedures",,,,,0
APC,5521,Level 1 Imaging without Contrast,,,,,0
APC,5522,Level 2 Imaging without Contrast,,,,,0
APC,5523,Level 3 Imaging without Contrast,,,,,0
APC,5524,Level 4 Imaging without Contrast,,,,,0
APC,5571,Level 1 Imaging with Contrast,,,,,0
APC,5572,Level 2 Imaging with Contrast,,,,,0
APC,5573,Level 3 Imaging with Contrast,,,,,0
APC,5591,Level 1 Nuclear Medicine and Related Services,,,,,0
APC,5592,Level 2 Nuclear Medicine and Related Services,,,,,0
APC,5593,Level 3 Nuclear Medicine and Related Services,,,,,0
APC,5594,Level 4 Nuclear Medicine and Related Services,,,,,0
APC,5611,Level 1 Therapeutic Radiation Treatment Preparation,,,,,0
APC,5612,Level 2 Therapeutic Radiation Treatment Preparation,,,,,0
APC,5613,Level 3 Therapeutic Radiation Treatment Preparation,,,,,0
APC,5622,Level 2 Radiation Therapy,,,,,0
APC,5623,Level 3 Radiation Therapy,,,,,0
APC,5624,Level 4 Radiation Therapy,,,,,0
APC,5626,Level 6 Radiation Therapy,,,,,0
APC,5627,Level 7 Radiation Therapy,,,,,0
APC,5661,Therapeutic Nuclear Medicine,,,,,0
APC,5671,Level 1 Pathology,,,,,0
APC,5672,Level 2 Pathology,,,,,0
APC,5673,Level 3 Pathology,,,,,0
APC,5674,Level 4 Pathology,,,,,0
APC,5691,Level 1 Drug Administration,,,,,0
APC,5692,Level 2 Drug Administration,,,,,0
APC,5693,Level 3 Drug Administration,,,,,0
APC,5694,Level 4 Drug Administration,,,,,0
APC,5721,Level 1 Diagnostic Tests and Related Services,,,,,0
APC,5722,Level 2 Diagnostic Tests and Related Services,,,,,0
APC,5723,Level 3 Diagnostic Tests and Related Services,,,,,0
APC,5724,Level 4 Diagnostic Tests and Related Services,,,,,0
APC,5731,Level 1 Minor Procedures,,,,,0
APC,5732,Level 2 Minor Procedures,,,,,0
APC,5733,Level 3 Minor Procedures,,,,,0
APC,5734,Level 4 Minor Procedures,,,,,0
APC,5735,Level 5 Minor Procedures,,,,,0
APC,5742,Level 2 Electronic Analysis of Devices,,,,,0
APC,5771,Cardiac Rehabilitation,,,,,0
APC,5781,Resuscitation and Cardioversion,,,,,0
APC,5791,Pulmonary Treatment,,,,,0
APC,5801,Ventilation Initiation and Management,,,,,0
APC,5822,Level 2 Health and Behavior Services,,,,,0
APC,5823,Level 3 Health and Behavior Services,,,,,0
APC,5871,Dental Procedures,,,,,0
APC,9132,Prothrombin complex kcentra,,,,,0
APC,9518,Washed red blood cells unit,,,,,0
APC,9522,RBC leukoreduced irradiated,,,,,0
APC,9530,Plate pheres leukoredu irrad,,,,,0
APC,9536,Platelets pheresis path redu,,,,,0
APC,N800,Clinical Diagnostic Lab Services,,,,,0
APC,N801,Therapy Services,,,,,0
APC,N804,Mammography Services,,,,,0
APC,N805,Durable Medical Equipment,,,,,0
APC,N806,Pharmacy Services,,,,,0
APC,N809,Other Medicine,,,,,0
APC,N900,Non-covered Services,,,,,0
APC,N902,Packaged Services,,,,,0
APC,N905,Not Recognized by OPPS,,,,,0
APC,N908,Partial Hospitalization,,,,,0
CDM,11100001,Hc Room And Bed Private Med Surg Or Gyn,2832.0,1840.8,,,0
CDM,11100002,Hc Room And Bed Ip Only Periop Discharge,1.0,0.65,,,0
CDM,11200001,Hc Room And Bed Private Ob,2832.0,1840.8,,,0
CDM,11400001,Hc Room And Bed Private Psych,2928.0,1903.2,,,0
CDM,11700001,Hc Room And Bed Private Oncology,2832.0,1840.8,,,0
CDM,12100001,Hc Room And Bed Semi Private Med Surg Or Gyn,2832.0,1840.8,,,0
CDM,12200001,Hc Room And Bed Semi Private Ob,2832.0,1840.8,,,0
CDM,12400001,Hc Room And Bed Semi Private Psych,2928.0,1903.2,,,0
CDM,12800001,Hc Room And Bed Semi Private Rehab,2832.0,1840.8,,,0
CDM,15100001,Hc Asoc Routine Care,1509.0,980.85,,,0
CDM,17000001,Hc Room And Bed Nursery General,2725.0,1771.25,,,0
CDM,17200002,Hc Special Care Nursery Level 2,4699.0,3054.35,,,0
CDM,18000001,Hc Room And Bed Leave Of Absence,1.0,0.65,,,0
CDM,20000001,Hc Room And Bed Icu,8267.0,5373.55,,,0
CDM,20600001,Hc Room And Bed Intermediate,5054.0,3285.1,,,0
CDM,21000001,Hc Room And Bed Ccu,8267.0,5373.55,,,0
CDM,22000001,"Hc Breast Milk Per Oz Process,Storage,Dist",4.38,2.85,,,0
CDM,25000003,Hc Celestone Per 3 Mg,35.36,22.98,,,0
CDM,25000007,Hc Dexamehtasone 1 Mg,1.04,0.68,,,0
CDM,25000012,Hc Lexiscan 0.1Mg,139.36,90.58,,,0
CDM,25000016,Hc Kenalog 40 Per 10 Mg,39.52,25.69,,,0
CDM,25000021,Hc Synvisc Per Mg,58.24,37.86,,,0
CDM,25000031,Hc Dilapan,20.48,13.31,,,0
CDM,25000034,Hc Inhaled Nitric Oxide Per Hour,1559.05,1013.38,,,0
CDM,25000049_250,Noncdm Charge Record Pharmacy,107.01,69.56,,,0
CDM,25000049_J0874_636,Noncdm Charge Record Pharmacy,0.23,0.15,,,0
CDM,25000049_J2404_636,Noncdm Charge Record Pharmacy,0.96,0.62,,,0
CDM,25000049_J7030_250,Noncdm Charge Record Pharmacy,68.2,44.33,,,0
CDM,25000049_J7030_636,Noncdm Charge Record Pharmacy,68.22,44.34,,,0
CDM,25000049_J7040_250,Noncdm Charge Record Pharmacy,66.85,43.45,,,0
CDM,25000049_J7040_636,Noncdm Charge Record Pharmacy,66.13,42.98,,,0
CDM,25000049_J7042_250,Noncdm Charge Record Pharmacy,38.18,24.82,,,0
CDM,25000049_J7042_636,Noncdm Charge Record Pharmacy,35.73,23.22,,,0
CDM,25000049_J7050_250,Noncdm Charge Record Pharmacy,67.92,44.15,,,0
CDM,25000049_J7050_636,Noncdm Charge Record Pharmacy,65.69,42.7,,,0
CDM,25000049_J7060_636,Noncdm Charge Record Pharmacy,66.16,43.0,,,0
CDM,25000049_J7070_636,Noncdm Charge Record Pharmacy,69.07,44.9,,,0
CDM,25000049_J7120_250,Noncdm Charge Record Pharmacy,65.12,42.33,,,0
CDM,25000049_J7120_636,Noncdm Charge Record Pharmacy,65.8,42.77,,,0
CDM,25000049_J7121_250,Noncdm Charge Record Pharmacy,70.58,45.88,,,0
CDM,25000049_J7121_636,Noncdm Charge Record Pharmacy,70.11,45.57,,,0
CDM,25000049_J7999_250,Noncdm Charge Record Pharmacy,55.73,36.22,,,0
CDM,25000049_J7999_636,Noncdm Charge Record Pharmacy,58.19,37.82,,,0
CDM,25000050,Hc Desflurane Per 15 Minutes,29.52,19.19,,,0
CDM,25000051,Hc Sevoflurane,29.45,19.14,,,0
CDM,25000052,Hc Isoflurane Per 15 Minutes,29.41,19.12,,,0
CDM,25000053,Hc Hemostatic Agent,1135.08,737.8,,,0
CDM,25500008,Hc Locm 100 199 Mg Per Ml Iodine Per Ml,9.36,6.08,,,0
CDM,25500013,"Hc Gadobenate Dimeglumine (Multihance), Per Ml",31.2,20.28,,,0
CDM,25600001_256,Noncdm Charge Record Pharmacy,0.68,0.44,,,0
CDM,25600001_J3490_256,Noncdm Charge Record Pharmacy,0.68,0.44,,,0
CDM,25600001_J7050_256,Noncdm Charge Record Pharmacy,0.68,0.44,,,0
CDM,25600001_J9047_256,Noncdm Charge Record Pharmacy,0.02,0.01,,,0
CDM,25800001_258,Noncdm Charge Record Pharmacy,135.67,88.19,,,0
CDM,25800001_J7999_636,Noncdm Charge Record Pharmacy,136.45,88.69,,,0
CDM,26000001,Hc Hydration Therapy Initial 31 Min To 1 Hr,643.0,417.95,,,0
CDM,26000002,Hc Hydration Therapy Ea Addl Hr,193.0,125.45,,,0
CDM,26000003,Hc Infusion Therapy Initial Up To 1 Hr,666.0,432.9,,,0
CDM,26000004,Hc Infusion Therapy Each Addl Hr,218.0,141.7,,,0
CDM,26000005,Hc Infusion Therapy Sequential Drug Up To 1 Hr,324.0,210.6,,,0
CDM,26000006,Hc Infusion Therapy Concurrent,353.0,229.45,,,0
CDM,26000007,Hc Subcutaneous Infusion Initial Up To 1 Hr,477.0,310.05,,,0
CDM,26000009,Hc Infusion More Than 8 Hrs W Pump Nonchemo,1915.0,1244.75,,,0
CDM,26000010,Hc Injection; Intra-Arterial,349.0,226.85,,,0
CDM,26000011,Hc Covid-19 Antibody (Bamlanivimab) Infusion Service,930.0,604.5,,,0
CDM,26000012,Hc Covid-19 Antibody Casirivimab/Imdevimab (Regn-Cov2) Infusn Or Sq Inj,930.0,604.5,,,0
CDM,26000013,Hc Admin Rsv Monoclonal Antibody Im,32.0,20.8,,,0
CDM,27000001,Hc Co2 Detector Easy Cap,21.81,14.18,,,0
CDM,27000002,Hc Medical Supply,17642.52,11467.64,,,0
CDM,27100001,Hc Oxygen Per Hr,4.1,2.66,,,0
CDM,27100002,Hc Shoe Post Op,38.25,24.86,,,0
CDM,27100003,Hc Supplies Splinting,54.92,35.7,,,0
CDM,27100004,Hc Set Cervical Collar Adult,92.4,60.06,,,0
CDM,27100005,Hc Collar Miami J W/Adj No Ots,364.01,236.61,,,0
CDM,27100006,Hc Oxygen 1St 30 Min,30.03,19.52,,,0
CDM,27100007,Hc Oxygen Addl 15 Min,13.31,8.65,,,0
CDM,27100008,Hc Neonate O2 Cannula Init 12Hrs,286.18,186.02,,,0
CDM,27100010,Hc Neonate O2 For Oxyhood Daily,97.27,63.23,,,0
CDM,27100012,Hc Artic Gel Cooling (Not Universal),7728.71,5023.66,,,0
CDM,27100016,Hc Kit Metabolic Screen,240.15,156.1,,,0
CDM,27100017,Hc Neonate O2 For Oxyhood Init 12Hrs,97.27,63.23,,,0
CDM,27100019,Hc Phototherapy Per Day,340.13,221.08,,,0
CDM,27100020,Hc Pillow Abduction,119.6,77.74,,,0
CDM,27100021,Hc Special Order Garment Or Orthotic,1729.26,1124.02,,,0
CDM,27100022,Hc Elbow Immobilizer,29.69,19.3,,,0
CDM,27100023,Hc Traction Bucks Disp,32.76,21.29,,,0
CDM,27100024,Hc Heliox Therapy Per 12 Hrs,448.47,291.51,,,0
CDM,27100025,Hc Oxygen Per Day,85.91,55.84,,,0
CDM,27100026,Hc Sling Arm Horizontal,16.38,10.65,,,0
CDM,27100027,Hc Valve Pep Initial,112.52,73.14,,,0
CDM,27100033,Hc Non Sterile Supply,567.34,368.77,,,0
CDM,27100036,Hc Sleeve Scd Level 1 X Small And Small,39.25,25.51,,,0
CDM,27100038,Hc Sleeve Scd Level 2 Medium,39.49,25.67,,,0
CDM,27100041,Hc Turn Assist System Regular,491.47,319.46,,,0
CDM,27100042,Hc Automatic Resuscitator,288.74,187.68,,,0
CDM,27100045,Hc Electrode Mri Ct Compatible,455.74,296.23,,,0
CDM,27100053,Hc Eeg Electrodes Disposable,93.0,60.45,,,0
CDM,27100054,Hc Kit Tenex,4150.26,2697.67,,,0
CDM,27200001,Hc Canister Wound Vac Therapy,436.18,283.52,,,0
CDM,27200002,Hc Dressing Wound Vac Therapy,491.47,319.46,,,0
CDM,27200005,Hc Tube Tracheostomy,197.61,128.45,,,0
CDM,27200006,Hc Catheter Picc Sgl Dbl Lumen,625.83,406.79,,,0
CDM,27200008,Hc Balloon Nasal Rapid Rhino,138.34,89.92,,,0
CDM,27200009,Hc Catheter Balloon Direct Vision,902.06,586.34,,,0
CDM,27200010,Hc Catheter Barthilon,80.55,52.36,,,0
CDM,27200011,Hc Drain Pleurevac,135.54,88.1,,,0
CDM,27200022,Hc Needle Intraosseous,440.48,286.31,,,0
CDM,27200023,Hc Set Rapid Infuser And Tubing,426.2,277.03,,,0
CDM,27200028,Hc Tube Gastrostomy,176.11,114.47,,,0
CDM,27200032,Hc Cervical Ripening Balloon,13.31,8.65,,,0
CDM,27200033,Hc Agent Hemostatic,783.9,509.54,,,0
CDM,27200039,Hc Prisma Cassette,711.46,462.45,,,0
CDM,27200046,Hc Catheter Lycox Camino W Tl Bolt,2632.45,1711.09,,,0
CDM,27200078,Hc Needle Nerve Stim,43.42,28.22,,,0
CDM,27200092,Hc Set Uterine Tamponade Balloon,443.76,288.44,,,0
CDM,27200116,Hc Catheter Suprapubic,193.7,125.9,,,0
CDM,27200176,Hc Closure Femoral Stop,263.14,171.04,,,0
CDM,27200179,Hc Hemostatic Surgicel,542.3,352.5,,,0
CDM,27200184,Hc Needle Seed Implant,34.81,22.63,,,0
CDM,27200193,Hc Tray Catheter Picc Midline Single Lumen,431.19,280.27,,,0
CDM,27200199,Hc Vacuum Extractor,137.57,89.42,,,0
CDM,27200203,Hc Sleeve Scd Level 03 Large And Extra Large,145.44,94.54,,,0
CDM,27200232,Hc Sterile Supply,220.27,143.18,,,0
CDM,27200234,Hc Clip Filshie,360.41,234.27,,,0
CDM,27200279,Hc Laser Probe Argon Coagulator,718.78,467.21,,,0
CDM,27200293,Hc Retractor Soft Tissue,963.15,626.05,,,0
CDM,27200294,Hc Sleeve Foot,52.94,34.41,,,0
CDM,27200297,Hc Cath Transluminal Atherectomy Directional,11810.69,7676.95,,,0
CDM,27200298,Hc Catheter Transluminal Atherectomy Rotational,8017.63,5211.46,,,0
CDM,27200299,Hc Catheter Transluminal Angioplasty,616.64,400.82,,,0
CDM,27200300,Hc Catheter Balloon Non Vascular,719.08,467.4,,,0
CDM,27200301,Hc Catheter Balloon Tissue Dissector,927.9,603.14,,,0
CDM,27200302,Hc Catheter Drainage,226.63,147.31,,,0
CDM,27200305,Hc Cath Ep Dx Not 3D Up To 19 Electrodes,1003.86,652.51,,,0
CDM,27200306,Hc Cath Ep Dx Not 3D 20 Or More Electrodes,6173.5,4012.78,,,0
CDM,27200307,Hc Catheter Ep Dx Ablation 3D Or Vector Mapping,5668.43,3684.48,,,0
CDM,27200308,Hc Catheter Ep Dx Ablation Not 3D Or Vector Mapping,17039.67,11075.79,,,0
CDM,27200309,Hc Catheter Dialysis Long Term,679.89,441.93,,,0
CDM,27200312,Hc Catheter Infusion,608.74,395.68,,,0
CDM,27200317,Hc Catheter Dialysis Short Term,546.63,355.31,,,0
CDM,27200321,Hc Catheter Intravascular Ultrasound,2334.24,1517.26,,,0
CDM,27200322,Hc Catheter Intradiscal,2301.58,1496.03,,,0
CDM,27200324,Hc Catheter Thrombectomy Embolectomy,10480.95,6812.62,,,0
CDM,27200326,Hc Catheter Ureteral,5165.7,3357.7,,,0
CDM,27200327,Hc Catheter Intracardiac Echo,6696.44,4352.69,,,0
CDM,27200328,Hc Introducer Sheath Ep Sterrable Not Peel,3523.79,2290.46,,,0
CDM,27200329,Hc Guidewire,292.15,189.9,,,0
CDM,27200335,Hc Retrieval Device For Fractured Medical Devices,1804.88,1173.17,,,0
CDM,27200336,Hc Morcellator3,1970.56,1280.86,,,0
CDM,27200337,Hc Retinal Tamponade Device Silicone Oil,1225.61,796.65,,,0
CDM,27200338,Hc Catheter Transluminal Angioplasty Laser,9283.57,6034.32,,,0
CDM,27200339,Hc Catheter Guiding,737.63,479.46,,,0
CDM,27200340,Hc Intro/Sheath Cardiac Electrophysiological Peel Away,189.78,123.36,,,0
CDM,27200341,Hc Intro/Sheath Cardiac Electrophysiological Not Peel Away,1607.21,1044.69,,,0
CDM,27200342,Hc Introducer Sheath,205.83,133.79,,,0
CDM,27200344,Hc Probe Cryoablation,5342.37,3472.54,,,0
CDM,27200346,Hc Catheter Occlusion,2501.04,1625.68,,,0
CDM,27200347,Hc Introducer Sheath Not Guid Ep Laser,10108.77,6570.7,,,0
CDM,27200348,Hc Catheter Ep Abl Not 3D Cooltip,6131.82,3985.68,,,0
CDM,27200351,Hc Cannula Femoral Venous,1240.76,806.49,,,0
CDM,27200355,Hc Affinity Biohead,639.13,415.43,,,0
CDM,27200360,Hc Wire Pacing Temporary,61.97,40.28,,,0
CDM,27200365,Hc Cable Pacing Temporary,49.41,32.12,,,0
CDM,27200366,Hc Cannula Femoral Arterial,1073.87,698.02,,,0
CDM,27200367,Hc Introducer Single Lumen,258.29,167.89,,,0
CDM,27200369,Hc Set Cardioplegia Blood,161.11,104.72,,,0
CDM,27200374,Hc Catheter Iabp,2617.67,1701.49,,,0
CDM,27200375,Hc Cannula Retrograde,191.82,124.68,,,0
CDM,27200376,Hc Reservoir Cellsaver,106.33,69.11,,,0
CDM,27200377,Hc Autotransfusion Collection,216.62,140.8,,,0
CDM,27200378,Hc Cannula Axillary Aortic,146.26,95.07,,,0
CDM,27200379,Hc Suture Device,344.03,223.62,,,0
CDM,27200381,Hc Cannula Ecmo Carmeda,1023.75,665.44,,,0
CDM,27200384,Hc Maze Product Level 01,2840.3,1846.2,,,0
CDM,27200385,Hc Maze Product Level 02,4315.15,2804.85,,,0
CDM,27200386,Hc Maze Product Level 03,2053.63,1334.86,,,0
CDM,27200387,Hc Maze Product Level 04,7734.6,5027.49,,,0
CDM,27200388,Hc Maze Product Level 05,9035.92,5873.35,,,0
CDM,27200389,Hc Maze Product Level 06,3743.38,2433.2,,,0
CDM,27200390,Hc Maze Product Level 07,12133.22,7886.59,,,0
CDM,27200391,Hc Maze Product Level 08,4838.95,3145.32,,,0
CDM,27200392,Hc Atrial Excluder,3558.26,2312.87,,,0
CDM,27200393,Hc Aspiration Embolectomy System,47550.94,30908.11,,,0
CDM,27200397,Hc Introducer Ecmo,131.06,85.19,,,0
CDM,27200398,Hc Kit Hypertherm Chemo Delivery Sys,11443.62,7438.35,,,0
CDM,27200401,Hc Blood Pump Disposable,41319.48,26857.66,,,0
CDM,27200425,Hc Kit Midline Catheter Basic,218.24,141.86,,,0
CDM,27200426,Hc Kit Midline Catheter Full,349.94,227.46,,,0
CDM,27200427,Hc Picc Sgl/Dbl Solo W/ Sherlock,920.52,598.34,,,0
CDM,27200428,Hc Picc Triple Lumen Solo,978.01,635.71,,,0
CDM,27200429,Hc Kit Stem Cell,3199.25,2079.51,,,0
CDM,27200431,Hc Kit Pleural Drainange Aspira,5537.25,3599.21,,,0
CDM,27200435,Hc Catheter Latex Free Swan,185.33,120.46,,,0
CDM,27200436,Hc Catheter Swan Ganz,208.61,135.6,,,0
CDM,27200437,Hc Kit Sheath Introducer,131.74,85.63,,,0
CDM,27200438,Hc Introducer Dual Lumen,413.84,269.0,,,0
CDM,27200454,Hc Introducer Sheath Dryseal,1875.78,1219.26,,,0
CDM,27200455,Hc Hmii Modular Belt,1350.52,877.84,,,0
CDM,27200456,Hc Atriclip Exclusion System,11630.99,7560.14,,,0
CDM,27200458,Hc Pico Negative Pressure Wound Vac Device,742.74,482.78,,,0
CDM,27200462,Hc Starter Sns W Bottle,65.12,42.33,,,0
CDM,27200463,Hc Large Sns,135.15,87.85,,,0
CDM,27200471,Hc Rx 272 Sterile Supply,150.36,97.73,,,0
CDM,27200472,Hc Vad Cardiohelp (Hls Set Advanced 7.0),45191.87,29374.72,,,0
CDM,27200477,Hc Catheter Reboa,7190.44,4673.79,,,0
CDM,27200495,Hc Laser Guidewire - Critical Limb,1108.88,720.77,,,0
CDM,27200497,Hc Cage 13 X 36Mm 8Deg Lumbar Ant Peek Midline Ii M361308,20300.87,13195.57,,,0
CDM,27200498,Hc Cath Dual Lumen Edi Nava Ventilation,737.21,479.19,,,0
CDM,27200500,Hc Ecmo Circuit,7952.63,5169.21,,,0
CDM,27200503,Hc Allograft 10Mm Disc Floweraminopatch,1902.41,1236.57,,,0
CDM,27200504,Hc Allograft 12Mm Disc Floweraminopatch,2046.78,1330.41,,,0
CDM,27200505,Hc Allograft 16Mm Disc Floweraminopatch,2029.37,1319.09,,,0
CDM,27200506,Hc Allograft 2 X 2Cm Floweramniopatch Per Sq Cm,614.34,399.32,,,0
CDM,27200508,Hc Allograft 4 X 4Cm Floweramniopatch Per Sq Cm,245.74,159.73,,,0
CDM,27200511,Hc Allograft 2 X 3Cm Floweramniopatch Per Sq Cm,408.54,265.55,,,0
CDM,27200513,Hc Atriclip Exclusion Pro-V Series,19709.05,12810.88,,,0
CDM,27200515,Hc Ligasure Hand Piece,1696.82,1102.93,,,0
CDM,27200516,Hc Graft Fish-Skin Omega3 Wound Per Sq Cm,120.35,78.23,,,0
CDM,27200518,Hc Graft 16Mm Disc Fish-Skin Omega3 Wound Per Sq Cm,812.42,528.07,,,0
CDM,27200519,Hc Graft 1.75X1.75 Cm Fish-Skin Omega3 Wound Per Sq Cm,565.63,367.66,,,0
CDM,27200520,Hc Graft 3X3.5 Cm Fish-Skin Omega3 Wound Per Sq Cm,204.78,133.11,,,0
CDM,27200521,Hc Graft 3X7 Cm Fish-Skin Omega3 Wound Per Sq Cm,182.25,118.46,,,0
CDM,27200524,Hc Catheter Extravascular Tissue Ablation Any Modality,6074.23,3948.25,,,0
CDM,27200525,Hc Fibrin Sealant Patch,3093.2,2010.58,,,0
CDM,27200526,Hc Kit Multi-2 Cooled Radiofrequency Ablation,4280.3,2782.2,,,0
CDM,27200528,Hc Hud Cath Trans Angio C1725,4269.66,2775.28,,,0
CDM,27200529,Hc Grafixpl Prime 3 X 3 Per Sq Cm,433.11,281.52,,,0
CDM,27200531,Hc Glidepath Tape,535.35,347.98,,,0
CDM,27200532,Hc Kit Neuroplasty Carpal Tunnel,3475.12,2258.83,,,0
CDM,27200533,Hc Robotic Transcranial Doppler Head Cradle Pad,811.95,527.77,,,0
CDM,27200534,Hc Grafixpl Prime 16Mm Per Sq Cm,991.39,644.4,,,0
CDM,27200535,Hc Grafixpl Prime 1.5 X 2 Per Sq Cm,913.32,593.66,,,0
CDM,27200536,Hc Grafixpl Prime 2 X 3 Per Sq Cm,566.56,368.26,,,0
CDM,27200537,Hc Grafixpl Prime 3 X 4 Per Sq Cm,351.2,228.28,,,0
CDM,27200538,Hc Grafixpl Prime 5 X 5 Per Sq Cm,358.36,232.93,,,0
CDM,27200539,Hc Powered Bone Marrow Biopsy Needle,480.43,312.28,,,0
CDM,27200540,Hc Endoscope Single Use,9000.08,5850.05,,,0
CDM,27200542,Hc Graft 5X7 Cm Fish-Skin Omega3 Wound Per Sq Cm,134.13,87.18,,,0
CDM,27200543,Hc Graft 7X7 Cm Fish-Skin Omega3 Wound Per Sq Cm,115.7,75.2,,,0
CDM,27200545,Hc Protek Duo Cannula,42000.38,27300.25,,,0
CDM,27200546,Hc Jada System (Vac Induced Hemorrhage Control),3842.85,2497.85,,,0
CDM,27200547,Hc Fetal Pillow,1991.08,1294.2,,,0
CDM,27200548,Hc Atriclip Exclusion Flexv Series,5925.31,3851.45,,,0
CDM,27200549,Hc Implant No Hcpcs,725.59,471.63,,,0
CDM,27200550,Hc Ecmo Nautilus And Circuit,15249.63,9912.26,,,0
CDM,27200551,Hc Non-Implant Device Not Otherwise Classified,7991.45,5194.44,,,0
CDM,27200552,Hc Laminaria Cervical Dilator,36.86,23.96,,,0
CDM,27200553,Hc Maze Product Level 09,15230.51,9899.83,,,0
CDM,27200554,Hc Maze Product Level 10,16331.72,10615.62,,,0
CDM,27200555,Hc Arista Hemostat,267.24,173.71,,,0
CDM,27200556,Hc Bone Marrow Aspirate Kit With Deminerallized Bone Powder (Dbm),5736.91,3728.99,,,0
CDM,27200558,Hc Rfa Sclero Guidewire - Critical Limb,2082.88,1353.87,,,0
CDM,27200559,Hc Cath Thrombectomy Penumbra Lightning Aspiration Tubing,16128.13,10483.28,,,0
CDM,27200560,Hc Gammagraft Skin Substitute Per Sq Cm,29.88,19.42,,,0
CDM,27200561,Hc Puraply Antimicrobial 4X4/Sq Cm,348.13,226.28,,,0
CDM,27200562,Hc Argon Straight Fire Flex Probe Plab Bronch,846.77,550.4,,,0
CDM,27200563,Hc Ebus 21 Gauge Needle Plab Bronch,494.54,321.45,,,0
CDM,27200564,Hc Balloon Dilator Cath Plab Bronch,1351.55,878.51,,,0
CDM,27200565,Hc Cryo Disposable Probe Plab Bronch,1081.24,702.81,,,0
CDM,27200566,Hc Rigid Needle Knife Rx Triple Lumen Plab Bronch,790.45,513.79,,,0
CDM,27200567,Hc Ebus Balloon Plab Bronch,76.04,49.43,,,0
CDM,27200568,Hc Balloon Dilator Syringe Gauge Plab Bronch,157.68,102.49,,,0
CDM,27200569,Hc Pleurex Cath Plab Bronch,3329.72,2164.32,,,0
CDM,27200570,Hc Thoracentesis Wayne Set Plab Bronch,215.02,139.76,,,0
CDM,27200571,Hc Thoracentesis Kit Plab Bronch,708.54,460.55,,,0
CDM,27200572,Hc Forceps Endojaw Plab Bronch,70.85,46.05,,,0
CDM,27200573,"Hc Endoscope, Single-Use, Urinary Tract Device",5512.93,3583.4,,,0
CDM,27200574,Hc Cytology Wang Needle Plab Bronch,156.66,101.83,,,0
CDM,27200575,Hc Bronchoscope Disposable Flex 5.0 Plab Bronch,905.13,588.33,,,0
CDM,27200578,Hc Sealer 20Cm Tissue Enseal X1 Large Jaw,1671.72,1086.62,,,0
CDM,27200581,Hc Core Dx Forceps Plab,1658.72,1078.17,,,0
CDM,27200582,Hc Embolectomy Sgl Lumen Plab,218.09,141.76,,,0
CDM,27200583,Hc Supra Sdrm Wound Matrix Per Sq Cm,141.95,92.27,,,0
CDM,27200584,Hc Graft 8 Sq Cm Fish-Skin Omega3 Wound Per Sq Cm,240.62,156.4,,,0
CDM,27200585,Hc Graft 19 Sq Cm Fish-Skin Omega3 Wound Per Sq Cm,169.97,110.48,,,0
CDM,27200587,Hc Puraply Antimicrobial 3X4/Sq Cm,337.89,219.63,,,0
CDM,27200590,Hc Kit Single Cooled Radiofrequency Ablation,2303.78,1497.46,,,0
CDM,27200591,Hc Irraflow Cassette,10750.95,6988.12,,,0
CDM,27200592,Hc Headband Ceribell Eeg,1843.02,1197.96,,,0
CDM,27200600,Hc Theraskin 6 Sq Cm Per Sq Cm,537.55,349.41,,,0
CDM,27200601,Hc Theraskin 116 Sq Cm Per Sq Cm,95.22,61.89,,,0
CDM,27200602,Hc Theraskin 26 Sq Cm Per Sq Cm,158.7,103.16,,,0
CDM,27400001,Hc Orthotic Device Custom,1260.07,819.05,,,0
CDM,27400003,Hc Splint Dynamic Whfo Custom,1371.0,891.15,,,0
CDM,27400004,Hc Splint Finger Pip Dip Custom,638.91,415.29,,,0
CDM,27400005,Hc Splint Elbow Custom,866.22,563.04,,,0
CDM,27400006,Hc Splint Dyn Hand Finger Custom,1009.57,656.22,,,0
CDM,27400007,Hc Splint Hand Finger Custom,809.9,526.44,,,0
CDM,27400008,Hc Splint Hand Wrist Prefab Ots,22.85,14.85,,,0
CDM,27400009,Hc Walking Boot Pneum Prefab Ots,131.55,85.51,,,0
CDM,27400011,Hc Prefab Afo W/Adj No Ots,829.36,539.08,,,0
CDM,27400013,Hc Custom Foot Orthotic,251.88,163.72,,,0
CDM,27400019,Hc Walking Boot Pneum Fit To Pt W/Adj,852.91,554.39,,,0
CDM,27400020,Hc Walking Boot Non-Pneum Fit To Pt W/Adj,524.24,340.76,,,0
CDM,27400022,Hc Knee Immobilizer Custom,2387.73,1552.02,,,0
CDM,27400023,Hc Splint Finger Pip Dip Spring Pf Ots,46.08,29.95,,,0
CDM,27400024,Hc Splint Finger Pip Dip Stat Rng Pf Ots,20.48,13.31,,,0
CDM,27400027,Hc Brace Ankle Stirrup Gel Or Air Ots,41.24,26.81,,,0
CDM,27400028,Hc Splint Ewho Rigid Wo Jnts Custom,2243.36,1458.18,,,0
CDM,27400030,Hc Brace Fracture Tibial Custom,2390.81,1554.03,,,0
CDM,27400031,Hc Brace Knee Double Upright Fit To Pt W/Adj,2758.39,1792.95,,,0
CDM,27400033,Hc Collar Soft Ots,12.29,7.99,,,0
CDM,27400034,Hc Collar Philadelphia W/Adj No Ots,346.29,225.09,,,0
CDM,27400035,Hc Immobilizer Knee Ots,45.37,29.49,,,0
CDM,27400036,Hc Orthosis Ankle Foot W/Adj No Ots,804.79,523.11,,,0
CDM,27400040,Hc Sling And Swath Ots,163.82,106.48,,,0
CDM,27400042,Hc Splint Wrist Hand Custom Custom,1518.44,986.99,,,0
CDM,27400043,Hc Splint Afo Dynamic Custom,1603.43,1042.23,,,0
CDM,27400044,Hc Splint Dynamic Hand Wrist Custom,2971.36,1931.38,,,0
CDM,27400045,Hc Multi Podus Boot W/Adj,550.86,358.06,,,0
CDM,27400046,Hc Splint Whfo Rigid Wo Jnts Custom,1065.88,692.82,,,0
CDM,27400047,Hc Splint Whfo Prefab With Modification W/Adj,748.47,486.51,,,0
CDM,27400049,Hc Support Lumbar Sacral Ots,71.67,46.59,,,0
CDM,27400050,Hc Support Shoulder Abduction Ots,124.92,81.2,,,0
CDM,27400051,Hc Tube Trach Speaking Passy Muir,225.28,146.43,,,0
CDM,27400053,Hc Brace Fracture Humeral Pf W/Adj No Ots,1219.46,792.65,,,0
CDM,27400054,Hc Brace Ankle Stirrup Universal Ots,41.98,27.29,,,0
CDM,27400055,Hc Aspen Vista Collar Ots,112.77,73.3,,,0
CDM,27400056,Hc Posterior Afo Static Custom,1603.43,1042.23,,,0
CDM,27400057,Hc Splint Ewhfo Rigid W/O Jnts Cust0M,3839.62,2495.75,,,0
CDM,27400059,Hc Splint Ewhfo W/Joints Custom,4276.83,2779.94,,,0
CDM,27400060,Hc Splint Ho W/O Joints Custom,809.9,526.44,,,0
CDM,27400061,Hc Splint Fo Nontor Joint Custom,662.46,430.6,,,0
CDM,27400064,Hc Repair Ortho Device Labor,196.59,127.78,,,0
CDM,27400069,Hc Collar Cervical Ots,208.88,135.77,,,0
CDM,27400070,Hc Collar Cervical Semi Rigid W/Adj No Ots,119.8,77.87,,,0
CDM,27400071,Hc Collar Cervical Semi Rigid 2 Pc Ots,400.34,260.22,,,0
CDM,27400073,Hc Knee Brace W/Adj,1023.9,665.54,,,0
CDM,27400086,Hc Splint Whfo Prefab Wo Modification Ots,45.24,29.41,,,0
CDM,27400087,Hc Walk Boot Prefab Off The Shelf Ots,134.13,87.18,,,0
CDM,27400088,Hc L2036 Kafo Custom Plastic Double Upright Custom,6102.44,3966.59,,,0
CDM,27400089,Hc Hmii Pocket Controller,17502.55,11376.66,,,0
CDM,27400090,Hc Hmii Volt Li-Lon Backup Battery,1620.75,1053.49,,,0
CDM,27400091,Hc 14 Volt Li-Lon Battery Each,1989.44,1293.14,,,0
CDM,27400092,Hc 14 Volt Li-Lon Battery Clip Each,1749.85,1137.4,,,0
CDM,27400093,Hc Pocket Controller Shower Bag Each,872.36,567.03,,,0
CDM,27400094,Hc Stabilization Belts,411.61,267.55,,,0
CDM,27400095,Hc Battery Holster,815.02,529.76,,,0
CDM,27400096,Hc Pocket Controler Consolidated Bag,1271.17,826.26,,,0
CDM,27400097,Hc Holster Vest Small,1257.35,817.28,,,0
CDM,27400098,Hc Power Module,25458.25,16547.86,,,0
CDM,27400099,Hc Battery Charger,22912.83,14893.34,,,0
CDM,27400100,Hc Pocket Controller Wear Access Kit,540.62,351.4,,,0
CDM,27400101,Hc Power Module Cable,5139.98,3340.99,,,0
CDM,27400102,Hc Power Module Ac Cord,139.25,90.51,,,0
CDM,27400103,Hc Power Module Dc Input Cable,925.61,601.65,,,0
CDM,27400104,Hc 12 Volt Sla Battery Each,238.57,155.07,,,0
CDM,27400106,Hc Display Module To Power Module,1311.62,852.55,,,0
CDM,27400228,Hc L3980 Humeral Fx Brace W/Adj No Ots,1219.46,792.65,,,0
CDM,27400231,Hc L3995 Upper Extremity Fx Sock,124.92,81.2,,,0
CDM,27400256,Hc Cervical Traction Over Door,88.06,57.24,,,0
CDM,27400278,Hc Afo Footplate Dynamic,656.32,426.61,,,0
CDM,27400279,Hc Afo Prefab Ots,65.53,42.59,,,0
CDM,27400280,Hc Hw Waist Pack,1615.71,1050.21,,,0
CDM,27400286,Hc Hm3 Lvad Controller W Ebb,17635.91,11463.34,,,0
CDM,27400287,Hc Hm3 Lvad Modular Cable,15752.7,10239.26,,,0
CDM,27400291,Hc Heartmate Ii System Controller Epc,16609.71,10796.31,,,0
CDM,27400330,Hc Hand Finger W/O Joints W/Adj,200.68,130.44,,,0
CDM,27400331,Hc Who Nontorsion Jnts W/Adj,1094.55,711.46,,,0
CDM,27500002,Hc Pacemaker Dual Chamber Rate Responsive,9407.28,6114.73,,,0
CDM,27500003,Hc Pacemaker Single Chamber Rate Responsive,31974.38,20783.35,,,0
CDM,27500004,Hc Lead Pacemaker Not Transvenous Vdd Sgl Pass,930.08,604.55,,,0
CDM,27500006,Hc Lead Coronary Venous System,4431.39,2880.4,,,0
CDM,27500009,Hc Pacemaker Other Than Sgl Or Dual Chamber,13682.47,8893.61,,,0
CDM,27800002,Hc Skin Substitute Not Otherwise Specified,26.48,17.21,,,0
CDM,27800003,Hc Apligraf Per Sq Cm,95.03,61.77,,,0
CDM,27800005,Hc Bilayer Matrix Wound Drsg Per Sq Cm,97.59,63.43,,,0
CDM,27800006,Hc Dermal Regeneration Template Per Sq Cm,231.69,150.6,,,0
CDM,27800008,Hc Graft Jacket Per Sq Cm,426.39,277.15,,,0
CDM,27800009,Hc Integra Matrix Per Sq Cm,260.81,169.53,,,0
CDM,27800014,Hc Alloderm Per Sq Cm,128.05,83.23,,,0
CDM,27800015,Hc Matristem Micromatrix Per Mg,7.77,5.05,,,0
CDM,27800018,Hc Strattice Per Sq Cm,105.27,68.43,,,0
CDM,27800032,Hc Clip Marker,313.31,203.65,,,0
CDM,27800045,Hc Yttrium-90 Nonstranded Per Source,58208.72,37835.67,,,0
CDM,27800062,Hc Brachytherapy Source I 125 Nonstranded Per Source,53.24,34.61,,,0
CDM,27800063,Hc Rt Isotope Ir-192,560.45,364.29,,,0
CDM,27800065,Hc Seprafilm Adhesion Barrier,980.9,637.58,,,0
CDM,27800068,Hc Implant,4871.42,3166.42,,,0
CDM,27800072,Hc Anchor Screw Bone Or Soft Tissue To Bone,1320.74,858.48,,,0
CDM,27800073,Hc Icd Dual Chamber,32141.14,20891.74,,,0
CDM,27800074,Hc Icd Single Chamber,46921.77,30499.15,,,0
CDM,27800075,Hc Closure Device Vascular,638.85,415.25,,,0
CDM,27800076,Hc Connective Tissue Human,5902.41,3836.57,,,0
CDM,27800077,Hc Vasc Closure Device Angioseal,525.26,341.42,,,0
CDM,27800078,Hc Connective Tissue Non Human,2993.36,1945.68,,,0
CDM,27800079,Hc Event Recorder Cardiac,13052.11,8483.87,,,0
CDM,27800080,Hc Adhesion Barrier,1176.39,764.65,,,0
CDM,27800081,Hc Generator Neurostim Nonrechargeable,47339.6,30770.74,,,0
CDM,27800082,Hc Graft Vascular,2504.78,1628.11,,,0
CDM,27800083,Hc Sling Incontinence Device,4354.59,2830.48,,,0
CDM,27800084,Hc Infusion Pump Programmable,34674.89,22538.68,,,0
CDM,27800085,Hc Joint Implant,3932.23,2555.95,,,0
CDM,27800086,Hc Lead Icd Single Coil,7343.05,4772.98,,,0
CDM,27800088,Hc Lead Neurostimulator Implantable,8543.76,5553.44,,,0
CDM,27800089,Hc Mesh Implantable,1767.66,1148.98,,,0
CDM,27800090,Hc Patient Programmer Neurostimulator,3938.67,2560.14,,,0
CDM,27800091,Hc Port Indwelling,1379.75,896.84,,,0
CDM,27800092,Hc Prosthesis Breast,4233.05,2751.48,,,0
CDM,27800093,Hc Prosthesis Penile Inflatable,15746.8,10235.42,,,0
CDM,27800094,Hc Prosthesis Urinary Sphincter,16951.48,11018.46,,,0
CDM,27800095,Hc Implant Septal Occlusion,23639.5,15365.68,,,0
CDM,27800096,Hc Generator Neurostim W Charging System,39993.18,25995.57,,,0
CDM,27800097,Hc Stent  Coated W Delivery System,3211.74,2087.63,,,0
CDM,27800099,Hc Stent Non Coated W Delivery System,11980.32,7787.21,,,0
CDM,27800100,Hc Stent Non Coated Wo Delivery System,2580.23,1677.15,,,0
CDM,27800101,Hc Material Vocal Cord Medlztn Synth,2088.76,1357.69,,,0
CDM,27800103,Hc Filter Vena Cava,2864.14,1861.69,,,0
CDM,27800104,Hc Dialysis Access System Implant,339.93,220.95,,,0
CDM,27800105,Hc Icd Other Than Single Or Dual Chamber,40045.24,26029.41,,,0
CDM,27800106,Hc Extension Pacing Or Neurostim Lead,1362.34,885.52,,,0
CDM,27800107,Hc Embolization Protection System,4415.29,2869.94,,,0
CDM,27800108,Hc Lead Icd Dual Coil,13226.38,8597.15,,,0
CDM,27800109,Noncdm Charge Record Medical Supplies,14116.66,9175.83,,,0
CDM,27800110,Hc Lead Neurostim Test Kit,2172.48,1412.11,,,0
CDM,27800112,Hc Stent Non Coronary Temp Wo Deliv,389.19,252.97,,,0
CDM,27800113,Hc Prosthesis Penile Non Inflatable,30647.19,19920.67,,,0
CDM,27800114,Hc Stent Non Coronary Temp W Deliv,700.73,455.47,,,0
CDM,27800116,Hc Brachytherapy Source I 125 Stranded Per Source,77.82,50.58,,,0
CDM,27800118,Hc Sealant Fibrin Human Plasma (Artiss) Per 2Ml,710.76,461.99,,,0
CDM,27800119,Hc Nerve Guide Per Cm Length,2410.06,1566.54,,,0
CDM,27800120,Hc Neurowrap Per Cm Length,1733.04,1126.48,,,0
CDM,27800121,Hc Tenoglide Tendon Protector Per Sq Cm,89.67,58.29,,,0
CDM,27800126,Hc Agent Bulking Synth Urin Tract,3228.52,2098.54,,,0
CDM,27800127,Hc Cochlear W All Int And Ext Components,43218.38,28091.95,,,0
CDM,27800128,Hc Aud Osseointegrated Device W All Int And Ext Comps,21598.56,14039.06,,,0
CDM,27800129,Hc Amniotic Membrane For Surg Recon Per Procedure,1585.95,1030.87,,,0
CDM,27800136,Hc Heart Valve,1663.84,1081.5,,,0
CDM,27800145,Hc Lead Myocardial,1302.06,846.34,,,0
CDM,27800148,Hc Heart Valve 2,1980.22,1287.14,,,0
CDM,27800149,Hc Heart Valve 3,2639.61,1715.75,,,0
CDM,27800150,Hc Heart Valve 4,3301.05,2145.68,,,0
CDM,27800151,Hc Heart Valve 5,3960.45,2574.29,,,0
CDM,27800152,Hc Heart Valve 6,4621.88,3004.22,,,0
CDM,27800153,Hc Heart Valve 7,5160.24,3354.16,,,0
CDM,27800154,Hc Heart Valve 8,5785.34,3760.47,,,0
CDM,27800155,Hc Heart Valve 9,6465.21,4202.39,,,0
CDM,27800156,Hc Heart Valve 10,7731.1,5025.22,,,0
CDM,27800157,Hc Heart Valve 11,9241.72,6007.12,,,0
CDM,27800158,Hc Heart Valve 12,10343.95,6723.57,,,0
CDM,27800159,Hc Heart Valve 13,11706.76,7609.39,,,0
CDM,27800160,Hc Heart Valve 14,12869.98,8365.49,,,0
CDM,27800161,Hc Heart Valve 15,14187.16,9221.65,,,0
CDM,27800162,Hc Heart Valve 16,15375.91,9994.34,,,0
CDM,27800163,Hc Heart Valve 17,17164.66,11157.03,,,0
CDM,27800164,Hc Heart Valve 18,18485.49,12015.57,,,0
CDM,27800165,Hc Heart Valve 19,19219.63,12492.76,,,0
CDM,27800166,Hc Heart Valve 20,21127.15,13732.65,,,0
CDM,27800167,Hc Heart Valve 21,21948.58,14266.58,,,0
CDM,27800168,Hc Heart Valve 22,23766.77,15448.4,,,0
CDM,27800169,Hc Heart Valve 23,24570.91,15971.09,,,0
CDM,27800170,Hc Heart Valve 24,25626.17,16657.01,,,0
CDM,27800171,Hc Implant Impella Device 3.5,65169.19,42359.97,,,0
CDM,27800172,Hc Pipeline Embolization L8699,40780.13,26507.08,,,0
CDM,27800181,Hc Flex Hd Per Sq Cm,94.34,61.32,,,0
CDM,27800186,Hc Bone Filler Putty Per .5Cc,5679.57,3691.72,,,0
CDM,27800198,Hc Lead Neurostim Multi Lead Trialing Cable,555.98,361.39,,,0
CDM,27800203,Hc Aortic Homograft Valve,50805.92,33023.85,,,0
CDM,27800206,Hc Gen Neurostim Hi Freq Recharg Batt And Charg Sys,24443.31,15888.15,,,0
CDM,27800208,Hc Catheter Ta Drug-Coated Non-Laser,5887.81,3827.08,,,0
CDM,27800211,Hc Prosthetic Implant,42512.9,27633.38,,,0
CDM,27800212,Hc Implant Not Otherwise Classifed,7804.89,5073.18,,,0
CDM,27800213,Hc Impella Right Side,49190.2,31973.63,,,0
CDM,27800214,Hc Impella Purge Cassette,636.87,413.97,,,0
CDM,27800217,Hc Wireless Pressure Sensor Incl All Components,66041.55,42927.01,,,0
CDM,27800218,Hc Hm3 Lvad Implant Kit W Controller,317989.55,206693.21,,,0
CDM,27800219,Hc Heart Valve 25,26906.04,17488.93,,,0
CDM,27800220,Hc Heart Valve 26,29047.02,18880.56,,,0
CDM,27800221,Hc Heart Valve 27,30365.8,19737.77,,,0
CDM,27800222,Hc Heart Valve 28,31684.59,20594.98,,,0
CDM,27800223,Hc Heart Valve 29,33004.39,21452.85,,,0
CDM,27800224,Hc Heart Valve 30,34324.2,22310.73,,,0
CDM,27800225,Hc Heart Valve 31,35644.01,23168.61,,,0
CDM,27800226,Hc Heart Valve 32,36962.79,24025.81,,,0
CDM,27800227,Hc Heart Valve 33,38283.62,24884.35,,,0
CDM,27800228,Hc Heart Valve 34,39602.4,25741.56,,,0
CDM,27800229,Hc Tissue Marker Implantable Each,355.34,230.97,,,0
CDM,27800232,Hc Generator Neurostim Non-Rchge With Sensing&Stim Leads,52218.9,33942.28,,,0
CDM,27800234,Hc Heart Valve 35,40922.21,26599.44,,,0
CDM,27800235,Hc Heart Valve 36,42242.02,27457.31,,,0
CDM,27800236,Hc Heart Valve 37,43561.83,28315.19,,,0
CDM,27800238,Hc Perfusion Tavr Valve,106578.77,69276.2,,,0
CDM,27800239,Hc Surgical Tissue Localization Device,90.88,59.07,,,0
CDM,27800242,Hc Hud Joint Implant C1776,3792.53,2465.14,,,0
CDM,27800246,Hc Hud Stent Coated W Del Sys C1874,3416.41,2220.67,,,0
CDM,27800247,Hc Hud Stent Non Coated W Del Sys C1876,8977.9,5835.64,,,0
CDM,27800250,Hc K-Wire,100.08,65.05,,,0
CDM,27800252,Hc Augment Bone Matrix,7038.45,4574.99,,,0
CDM,27800253,Hc Heart Valve 38,44880.61,29172.4,,,0
CDM,27800254,Hc Heart Valve 39,46201.44,30030.94,,,0
CDM,27800255,Hc Heart Valve 40,46523.71,30240.41,,,0
CDM,27800256,Hc Heart Valve 41,48839.01,31745.36,,,0
CDM,27800257,Hc Heart Valve 42,50159.84,32603.9,,,0
CDM,27800258,Hc Interspinous Implant,15777.37,10255.29,,,0
CDM,27800261,Hc Catheter Pressure Gen W One Way Valve Occlusive,23805.68,15473.69,,,0
CDM,27800263,Hc Lung Biopsy Plug With Delivery System,1075.1,698.82,,,0
CDM,27800264,Hc Ossicula Implant,1051.95,683.77,,,0
CDM,27800265,Hc Hemospray Topical Gi Hemostatic Agent,2579.44,1676.64,,,0
CDM,27800267,Hc Intravertebral Fx Aug Implant - Stryker Spinejack,12793.63,8315.86,,,0
CDM,27800268,Hc Implant Impella Device 5.5,131215.86,85290.31,,,0
CDM,27800269,Hc Cath Trans Intra Litho Coro,14436.99,9384.04,,,0
CDM,27800270,Noncdm Charge Record Medical Supplies,54522.68,35439.74,,,0
CDM,27800272,Hc Kit Sprint Conversion System,16068.06,10444.24,,,0
CDM,27800273,Hc Kit Sprint Pns Endura Single Lead,15830.52,10289.84,,,0
CDM,27800274,Hc Kit Sprint Pns Extensa Dual Lead,25578.05,16625.73,,,0
CDM,27800275,"Hc Generator Barostim Implantable Device, Non-Rechargeable",61280.42,39832.27,,,0
CDM,27800276,Hc Cardiac Contractility Modulation Device,79864.2,51911.73,,,0
CDM,27800278,Hc Synthetic Bone Void Filler,16423.16,10675.05,,,0
CDM,27800279,Noncdm Charge Record Medical Supplies,19249.32,12512.06,,,0
CDM,27800280,Hc Ifuse Bedrock Granite Implant System Ntap,10259.48,6668.66,,,0
CDM,30000001,Hc Venipuncture,20.0,13.0,,,0
CDM,30000002,Hc Collection Capillary Blood Specimen,20.0,13.0,,,0
CDM,30000003,Hc Blood Processing Fee Autologous,214.0,139.1,,,0
CDM,30000004,Hc Blood Salvage Autologous Intra Op,9343.0,6072.95,,,0
CDM,30000005,Hc Blood Typing Abo,133.0,86.45,,,0
CDM,30000006,Hc Blood Typing Rh D,40.0,26.0,,,0
CDM,30000007,Hc Rbc Antigen Scr Reagent Unit,498.0,323.7,,,0
CDM,30000008,Hc Screen Preselected Unit Per Unit,688.0,447.2,,,0
CDM,30000009,Hc Rbc Antigen Typing Non Abo Rh,421.0,273.65,,,0
CDM,30000010,Hc Rh Phenotype,762.0,495.3,,,0
CDM,30000011,Hc Crossmatch Immediate Spin,223.0,144.95,,,0
CDM,30000012,Hc Incubation Of Crossmatch,176.0,114.4,,,0
CDM,30000013,Hc Agt Phase Of Crossmatch,174.0,113.1,,,0
CDM,30000014,Hc Crossmatch Electronic,176.0,114.4,,,0
CDM,30000017,Hc Blood Product Pooling,297.0,193.05,,,0
CDM,30000018,Hc Pretreatment Rbcs W Chemical Drug,400.0,260.0,,,0
CDM,30000019,Hc Pretreatment With Enzymes Each,343.0,222.95,,,0
CDM,30000020,Hc Reticulocyte Separation,652.0,423.8,,,0
CDM,30000021,Hc Incubation Of Serum W/Drugs Each,1190.0,773.5,,,0
CDM,30000022,Hc Dilution Of Serum,612.0,397.8,,,0
CDM,30000023,Hc Inhibition Of Serum,525.0,341.25,,,0
CDM,30000024,Hc Differential Adsorption Serum Ea,1095.0,711.75,,,0
CDM,30000025,Hc Split Blood Product Each,458.0,297.7,,,0
CDM,30000026,Hc Bilirubin Total Transcutaneous,461.0,299.65,,,0
CDM,30000027,Hc Cell Count Body Fluid,169.0,109.85,,,0
CDM,30000030,Hc Cell Count W Diff Body Fluid,716.0,465.4,,,0
CDM,30000036,Hc Crystal Id Tissue Or Fluid,245.0,159.25,,,0
CDM,30000037,Hc Fat Stain Urine,58.0,37.7,,,0
CDM,30000039,Hc Smear Nasal Eosinophils,250.0,162.5,,,0
CDM,30000040,Hc Semen Analysis W Who Morphology So,431.0,280.15,,,0
CDM,30000041,Hc Semen Count Post Vasectomy,209.0,135.85,,,0
CDM,30000042,Hc Semen Analysis Complete,209.0,135.85,,,0
CDM,30000043,Hc Sperm Antibody,445.0,289.25,,,0
CDM,30000044,Hc Insert Catheter Spec Collect Only,420.0,273.0,,,0
CDM,30000048,Hc Venipuncture Amb,20.0,13.0,,,0
CDM,30000057,Hc Crystal Id Tissue Only,245.0,159.25,,,0
CDM,30000058,Hc Semen Analysis Strict Morphologic Criteria So,410.0,266.5,,,0
CDM,30000060,Hc Rbc Dna Hea 35 Ag 11 Bld Grp So,2030.0,1319.5,,,0
CDM,30000066,Hc Fibrin Degradation Products,412.0,267.8,,,0
CDM,30000090,Hc Carbon Dioxide (Bicarbonate) So,9.0,5.85,,,0
CDM,30000105,Hc Psa Total So,45.0,29.25,,,0
CDM,30000106,Hc Psa Free So,126.0,81.9,,,0
CDM,30000107,Hc Protein Total So,23.0,14.95,,,0
CDM,30000127,Hc Fibrin Dgradj Splt Produxs Paracoagj So,471.0,306.15,,,0
CDM,30000128,Hc D Dimer So,534.0,347.1,,,0
CDM,30000129,Hc Fibrinogen So,510.0,331.5,,,0
CDM,30000131,Hc Pt/Inr So,226.0,146.9,,,0
CDM,30000133,Hc Thrombin Time Plasma So,303.0,196.95,,,0
CDM,30000134,Hc Aptt So,315.0,204.75,,,0
CDM,30000174,Hc Consult Path Requiring Prep So,540.0,351.0,,,0
CDM,30000176,Hc Morph Anyls Tumor Ihc Comp Assist So,504.0,327.6,,,0
CDM,30000181,Hc Coronavirus (Covid-19) Ldt Panel So,247.0,160.55,,,0
CDM,30000182,Hc Covid-19 Lab Test Non-Cdc,247.0,160.55,,,0
CDM,30000183,Hc Cdc 2019 Novel Coronavirus (2019-Ncov) Rt-Pcr Diagnostic Panel So,250.0,162.5,,,0
CDM,30000186,Hc Covid-19 Lab Test Non-Cdc Rapid,247.0,160.55,,,0
CDM,30000187,Hc Fsed Covid-19 Lab Test Non-Cdc Rapid,247.0,160.55,,,0
CDM,30000188,Hc Atxn1 Gene Detc Abnor Allele So,1018.0,661.7,,,0
CDM,30000189,Hc Atxn2 Gene Detc Abnor Allele So,1018.0,661.7,,,0
CDM,30000190,Hc Atxn3 Gene Detc Abnor Allele So,1018.0,661.7,,,0
CDM,30000191,Hc Fxn Gene Detc Abnor Alleles So,2156.0,1401.4,,,0
CDM,30000192,Hc Fetal Chrmoml Aneuploidy Genomic Seq Analys So,5765.0,3747.25,,,0
CDM,30000193,Hc Nfct Ds 22 Trgt Sars-Cov-2,1363.0,885.95,,,0
CDM,30000195,Hc Jak2 Gene Target Sequence Analysis So,766.0,497.9,,,0
CDM,30000197,"Hc Mpl Gene Analysis; Sequence Analysis, Exon 10 So",788.0,512.2,,,0
CDM,30000198,Hc Sf3B1 Gene Common Variants So,759.0,493.35,,,0
CDM,30000200,Hc Tp53 Gene Analysis; Full Gene Sequence So,2068.0,1344.2,,,0
CDM,30000201,Hc Tp53 Gene Analysis; Targeted Sequence Analysis So,1746.0,1134.9,,,0
CDM,30000202,Hc Tp53 Gene Analysis; Known Familial Variant So,1274.0,828.1,,,0
CDM,30000212,Hc Hereditary Brst Ca-Related Gen Seq Analys 10 Gen So,10632.0,6910.8,,,0
CDM,30000213,Hc Unlisted Reprod Med Lab Proc So,239.0,155.35,,,0
CDM,30000214,Hc F5 Coagulation Factor V Anal Leiden So,135.0,87.75,,,0
CDM,30000215,Hc F2 Gene Analysis 20210G>A Variant So,216.0,140.4,,,0
CDM,30000216,Hc Nfct Ds Vir Resp Rna 3 Trgt,550.0,357.5,,,0
CDM,30000217,Hc Pat Venipuncture,20.0,13.0,,,0
CDM,30000221,Hc Hla I Typing 1 Locus Lr Ea So,540.0,351.0,,,0
CDM,30000222,Hc Pathogen Test For Platelets,277.0,180.05,,,0
CDM,30000235,Hc Autoimmune Rheumatoid Arthrts Analys 12 Biomrkrs Karius So,4548.0,2956.2,,,0
CDM,30000236,Hc Hepcidin-25 Elisa Serum Or Plasma So,841.0,546.65,,,0
CDM,30000237,Hc Trb@ Gene Rearrange Amplify Special So,4380.0,2847.0,,,0
CDM,30000238,Hc Whole Mitochondrial Genome So,2587.0,1681.55,,,0
CDM,30000239,Hc Nuclear Mitochondrial 100 Gene Genomic Seq So,9187.0,5971.55,,,0
CDM,30000240,Hc Heredtry Nurondcrn Tum Dsrdrs Gen Seq Anal 6 Gen So,9585.0,6230.25,,,0
CDM,30000241,Hc Autoimmune Rheumatoid Arthrts Analys 12 Biomrkrs Vectra So,4657.0,3027.05,,,0
CDM,30000242,Hc Donor Blood Typing Abo,21.0,13.65,,,0
CDM,30000243,Hc Donor Blood Typing Rh D,10.0,6.5,,,0
CDM,30000244,Hc Recipient Comparative Analysis Str Markers Patient&Comp Spec So,840.0,546.0,,,0
CDM,30000245,Hc Recipient Comparative Analysis Str Markers Ea Addl Specimen So,1140.0,741.0,,,0
CDM,30000246,Hc Recipient Chimerism W/Comp To Baseline W/O Cell Selection So,1050.0,682.5,,,0
CDM,30000247,Hc Recipient Chimerism W/Comp To Baseline W/Cell Selection Ea So,2001.0,1300.65,,,0
CDM,30000248,Hc Recipient Hla I Typing Complete Lr So,870.0,565.5,,,0
CDM,30000249,Hc Recipient Hla I Typing 1 Locus Lr So,426.0,276.9,,,0
CDM,30000250,Hc Recipient Hla Ii Typing 1 Locus Lr So,747.0,485.55,,,0
CDM,30000251,Hc Recipient Hla I&Ii High Resolution Hla-A -B -C And -Drb1 So,990.0,643.5,,,0
CDM,30000252,Hc Recipient Hla I Typing Complete Hr So,1050.0,682.5,,,0
CDM,30000253,Hc Recipient Hla I Typing 1 Locus Hr So,960.0,624.0,,,0
CDM,30000254,Hc Recipient Hla Class Ii Typing High Resolution One Locus Ea So,990.0,643.5,,,0
CDM,30000255,Hc Recipient Blood Typing Abo,123.0,79.95,,,0
CDM,30000256,Hc Recipient Blood Typing Rh D,40.0,26.0,,,0
CDM,30000257,Hc Gjb6 Gene Analysis Common Variants So,1326.0,861.9,,,0
CDM,30000258,Hc Rbc Dna Gnotyp 12 Bld Grp Predict 44 Rbc Ag Phnt So,1728.0,1123.2,,,0
CDM,30000259,Hc Cacna1A Gen Known Family Variant So,1273.0,827.45,,,0
CDM,30000260,Hc Cstb Gene Known Family Variant So,1273.0,827.45,,,0
CDM,30000261,Hc Gjb2 Gene Known Family Variant So,1273.0,827.45,,,0
CDM,30000262,Hc Hba1/Hba2 Gene Family Variant So,1273.0,827.45,,,0
CDM,30000263,Hc Hbb Gene Known Family Variant So,1273.0,827.45,,,0
CDM,30000264,Hc Pmp22 Gene Known Family Variant So,1273.0,827.45,,,0
CDM,30000265,Hc Pten Gene Known Family Variant So,1273.0,827.45,,,0
CDM,30000266,Hc Neurflmnt Lt Chn Dig Ia Quant So,3240.0,2106.0,,,0
CDM,30000267,Hc Neuro Alys B-Amyl 1-42&1-40 So,3024.0,1965.6,,,0
CDM,30000268,Hc Ashkenazi Jewish Associated Disorders So,2449.0,1591.85,,,0
CDM,30000269,Hc Msh6 Gene Analysis Full Sequence Analysis So,2259.0,1468.35,,,0
CDM,30000270,Hc Pms2 Gene Dup/Delet Variants So,673.0,437.45,,,0
CDM,30000271,Hc Pms2 Gene Dup/Delet Variants Special So,1715.0,1114.75,,,0
CDM,30000272,"Hc Hla I Low Resolution One Antigen Equivalent, Each So",645.0,419.25,,,0
CDM,30000273,Hc Cytogen M Array Copy No And Snp Special So,8918.0,5796.7,,,0
CDM,30000274,Hc Mopath Level 2 Special So,2556.0,1661.4,,,0
CDM,30000275,Hc Mopath Level 4 Special So,2628.0,1708.2,,,0
CDM,30000276,Hc Genetic Testing For Severe Inherited Conditions Special So,14826.0,9636.9,,,0
CDM,30000277,Hc Mopath Unlisted Special So,4767.0,3098.55,,,0
CDM,30000278,Hc Ar Gene Known Familial Variant So,1748.0,1136.2,,,0
CDM,30000279,Hc Fxn Gene Known Familial Variant So,1748.0,1136.2,,,0
CDM,30000280,Hc Palb2 Gene Known Familial Variant So,1748.0,1136.2,,,0
CDM,30000283,Hc Clonoseq Assay Adaptive Biotechnologies So,7020.0,4563.0,,,0
CDM,30000284,Hc Pten Full Gene Analysis So,5368.0,3489.2,,,0
CDM,30000285,"Hc Apolipoprotein L1 (Apol1) Renal Risk Variant Genotyping, Quest Diagnostics So",450.0,292.5,,,0
CDM,30000286,Hc Liver Ds Alys 3 Bmrk Srm Alg,401.0,260.65,,,0
CDM,30000287,Hc Des-Gamma-Carboxy Prothrombin S So,600.0,390.0,,,0
CDM,30000288,Hc Amyloid Beta 42 Peptipe So,2580.0,1677.0,,,0
CDM,30000289,"Hc Precivityad2, P So",5220.0,3393.0,,,0
CDM,30000293,"Hc Metagenomic Sequencing, Csf So",9000.0,5850.0,,,0
CDM,30000294,"Hc Reticulocyte Profile, B So",318.0,206.7,,,0
CDM,30100001,Hc Basic Metabolic Panel Calcium Ionized,63.0,40.95,,,0
CDM,30100002,Hc Basic Metabolic Panel Calcium Total,56.0,36.4,,,0
CDM,30100003,Hc General Health Panel,219.0,142.35,,,0
CDM,30100004,Hc Electrolyte Panel,46.0,29.9,,,0
CDM,30100005,Hc Comprehensive Metabolic Panel,74.0,48.1,,,0
CDM,30100006,Hc Obstetric Panel,302.0,196.3,,,0
CDM,30100007,Hc Lipid Panel,61.0,39.65,,,0
CDM,30100008,Hc Renal Function Panel,66.0,42.9,,,0
CDM,30100009,Hc Hepatitis Panel Acute,438.0,284.7,,,0
CDM,30100010,Hc Hepatic Function Panel,28.0,18.2,,,0
CDM,30100014,Hc Amikacin,110.0,71.5,,,0
CDM,30100017,Hc Carbamazepine Total,85.0,55.25,,,0
CDM,30100018,Hc Carbamazepine Free So,649.0,421.85,,,0
CDM,30100019,Hc Cyclosporine Level So,53.0,34.45,,,0
CDM,30100021,Hc Digoxin,90.0,58.5,,,0
CDM,30100022,Hc Valproic Acid,66.0,42.9,,,0
CDM,30100024,Hc Ethosuximide So,127.0,82.55,,,0
CDM,30100025,Hc Gentamicin,59.0,38.35,,,0
CDM,30100027,Hc Haloperidol So,192.0,124.8,,,0
CDM,30100029,Hc Lidocaine So,234.0,152.1,,,0
CDM,30100030,Hc Lithium,82.0,53.3,,,0
CDM,30100033,Hc Phenytoin Total,85.0,55.25,,,0
CDM,30100034,Hc Phenytoin Free,154.0,100.1,,,0
CDM,30100035,Hc Primidone So,171.0,111.15,,,0
CDM,30100036,Hc Procainamide So,148.0,96.2,,,0
CDM,30100037,Hc Quinidine So,128.0,83.2,,,0
CDM,30100038,Hc Sirolimus So,41.0,26.65,,,0
CDM,30100039,Hc Salicylate,90.0,58.5,,,0
CDM,30100040,Hc Tacrolimus So,92.0,59.8,,,0
CDM,30100041,Hc Theophylline,108.0,70.2,,,0
CDM,30100042,Hc Tobramycin,124.0,80.6,,,0
CDM,30100043,Hc Topiramate So,103.0,66.95,,,0
CDM,30100044,Hc Vancomycin,88.0,57.2,,,0
CDM,30100046,Hc Acth Stimulation Panel Adrenal Insufficiency,528.0,343.2,,,0
CDM,30100047,Hc Urine Volume Measurement,54.0,35.1,,,0
CDM,30100048,Hc Aspa Gene Analysis Common Variants So,518.0,336.7,,,0
CDM,30100051,Hc Bcr Abl1 Other Breakpnt Qualitative Quantitative,789.0,512.85,,,0
CDM,30100052,Hc Bloom Syndrome Mutation Analysis So,1128.0,733.2,,,0
CDM,30100053,Hc Braf Gene Mut Anlys V600E Tumor,2968.0,1929.2,,,0
CDM,30100054,Hc Cystic Fibrosis Mutation Panel So,521.0,338.65,,,0
CDM,30100055,Hc Cftr Gene  Known Mutation So,1273.0,827.45,,,0
CDM,30100056,Hc Cftr Gene Duplication Deletion Variants So,1522.0,989.3,,,0
CDM,30100057,Hc Cyp2C19 Gene Analysis Common Variants So,1350.0,877.5,,,0
CDM,30100058,Hc Cyp2D6 Gene Analysis Common Variants So,652.0,423.8,,,0
CDM,30100060,Hc Cytogen Microarray Number So,5693.0,3700.45,,,0
CDM,30100061,Hc Prothrombin G20210A Mutation,211.0,137.15,,,0
CDM,30100062,Hc Factor V Leiden (R506Q) Mutation,211.0,137.15,,,0
CDM,30100063,Hc Fanconi Anemia  Mutation Analysis,1128.0,733.2,,,0
CDM,30100064,Hc Fmr1 Gene Detection So,675.0,438.75,,,0
CDM,30100065,Hc Fmr1 Gene Characterization So,821.0,533.65,,,0
CDM,30100066,Hc Flt3 Mutation Analysis So,1286.0,835.9,,,0
CDM,30100067,Hc Gaucher Disease Mutation Analysis So,943.0,612.95,,,0
CDM,30100068,Hc Tay-Sachs Mutation Analysis So,837.0,544.05,,,0
CDM,30100069,Hc Hemochromatosis Hfe Gene Analysis So,404.0,262.6,,,0
CDM,30100070,Hc Hba1/Hba2 Alpha-Globin Gene Anlys Common Deletions/Variant So,970.0,630.5,,,0
CDM,30100071,Hc Familial Dysautonomia Mutation So,1128.0,733.2,,,0
CDM,30100072,Hc Igvh Mutation Analysis,1591.0,1034.15,,,0
CDM,30100073,Hc Str Markers Specimen Anlys So,1466.0,952.9,,,0
CDM,30100074,Hc Jak2 V617F Mutation Detection So,675.0,438.75,,,0
CDM,30100075,Hc Kras Gene  7 Mutation Panel Tumor,2994.0,1946.1,,,0
CDM,30100076,Hc Mucolipidosis Iv Mutation Analys,1175.0,763.75,,,0
CDM,30100077,Hc Mthfr Mutation So,222.0,144.3,,,0
CDM,30100078,Hc Mlh1 Gene Full Seq So,2183.0,1418.95,,,0
CDM,30100079,Hc Mlh1 Known Variants,540.0,351.0,,,0
CDM,30100081,Hc Msh2 Gene Full Sequence Analysis So,2183.0,1418.95,,,0
CDM,30100082,Hc Msh2 Known Mutation So,1273.0,827.45,,,0
CDM,30100084,Hc Msh6 Mutation Screen,2121.0,1378.65,,,0
CDM,30100085,Hc Msh6 Known Mutation So,1273.0,827.45,,,0
CDM,30100087,Hc Microsatellite Instability Msi Tum So,3041.0,1976.65,,,0
CDM,30100089,Hc Mecp2 Gene Known Mutation So,1273.0,827.45,,,0
CDM,30100091,Hc Npm1 Gene,1262.0,820.3,,,0
CDM,30100092,Hc Pml/Raralpha Common Breakpoints So,1400.0,910.0,,,0
CDM,30100093,Hc Niemann Pick Disease Type A And B,1128.0,733.2,,,0
CDM,30100094,Hc Prader Willi Angelman Mol Analysis So,1044.0,678.6,,,0
CDM,30100095,Hc Serpina 1 Gene,252.0,163.8,,,0
CDM,30100096,Hc Trb@ Gene Rearrange Amplify So,343.0,222.95,,,0
CDM,30100098,Hc Trb@ Gene Rearrangement Analysis So,343.0,222.95,,,0
CDM,30100099,Hc Ugt1A1 Sequence Gene Analysis So,2638.0,1714.7,,,0
CDM,30100100,Hc Hla Class I Typing Low Resolution Complete So,538.0,349.7,,,0
CDM,30100101,Hc Hla Class Ii Mol Typing Dis Assoc So,343.0,222.95,,,0
CDM,30100102,Hc Hla Ii Typing 1 Locus Lr Each So,297.0,193.05,,,0
CDM,30100104,Hc Hla Typing 1 Allele Hr So,472.0,306.8,,,0
CDM,30100105,Hc Narcolepsy Associated Ag,210.0,136.5,,,0
CDM,30100108,Hc Molecular Pathology Procedure Level 5 So,2861.0,1859.65,,,0
CDM,30100110,Hc Fbn1  Full Gene Sequence,8067.0,5243.55,,,0
CDM,30100111,Hc Unlisted Molecular Pathology Procedure,1845.0,1199.25,,,0
CDM,30100114,Hc Fet Con Abn Afp4 Algorithm,265.0,172.25,,,0
CDM,30100115,Hc Analgesics Non-Opiod; 1 Or 2,90.0,58.5,,,0
CDM,30100116,Hc Ketone Bodies Serum Qualitative,81.0,52.65,,,0
CDM,30100117,Hc Ketone Bodies Serum Quantitative,114.0,74.1,,,0
CDM,30100118,Hc Acetylcholinesterase So,361.0,234.65,,,0
CDM,30100119,Hc Acylcarnitines Quantitative So,195.0,126.75,,,0
CDM,30100120,Hc Acth,117.0,76.05,,,0
CDM,30100121,Hc Cyclic Amp,180.0,117.0,,,0
CDM,30100122,Hc Albumin,10.0,6.5,,,0
CDM,30100123,"Hc Albumin Other Source, Quant, Ea Spec",178.0,115.7,,,0
CDM,30100124,Hc Microalbumin Urine Quantitative,86.0,55.9,,,0
CDM,30100127,Hc Aldolase So,27.0,17.55,,,0
CDM,30100128,Hc Aldosterone So,57.0,37.05,,,0
CDM,30100129,Hc Alpha 1 Antitrypsin Total,117.0,76.05,,,0
CDM,30100130,Hc Alpha-1 Antitrypsin Phenotype So,120.0,78.0,,,0
CDM,30100131,Hc Alpha Fetoprotein Serum,71.0,46.15,,,0
CDM,30100132,Hc Alpha Fetoprotein Amniotic Fluid So,148.0,96.2,,,0
CDM,30100133,Hc Afp L3 Fract Isoform And Total Afp W Ratio,291.0,189.15,,,0
CDM,30100134,Hc Aluminum,115.0,74.75,,,0
CDM,30100137,Hc Amino Acids Single Quantitative Ea Specimen So,475.0,308.75,,,0
CDM,30100138,Hc Aminolevulinic Acid Ala So,206.0,133.9,,,0
CDM,30100139,Hc Amino Acids Quantitative 2-5 So,231.0,150.15,,,0
CDM,30100140,Hc Amino Acids Quant More Than 5 Plasma Or Urine,507.0,329.55,,,0
CDM,30100141,Hc Ammonia,59.0,38.35,,,0
CDM,30100143,Hc Amphetamine Or Methamphetamine So,114.0,74.1,,,0
CDM,30100144,Hc Amylase,83.0,53.95,,,0
CDM,30100146,Hc Androstenedione So,74.0,48.1,,,0
CDM,30100148,Hc Angiotensin I Converting Enzyme So,30.0,19.5,,,0
CDM,30100149,Hc Apolipoprotein A 1 So,94.0,61.1,,,0
CDM,30100150,Hc Arsenic,256.0,166.4,,,0
CDM,30100151,Hc Vitamin C (Ascorbic Acid) So,102.0,66.3,,,0
CDM,30100152,Hc Atomic Absorption Spectroscopy Ea Analyte So,404.0,262.6,,,0
CDM,30100154,Hc Beta 2 Microglobulin,240.0,156.0,,,0
CDM,30100155,Hc Bile Acids Total So,145.0,94.25,,,0
CDM,30100157,Hc Bilirubin Total,10.0,6.5,,,0
CDM,30100158,Hc Bilirubin Direct,70.0,45.5,,,0
CDM,30100159,Hc Occult Blood Stool,72.0,46.8,,,0
CDM,30100160,Hc Gastrocult Gastric,70.0,45.5,,,0
CDM,30100161,Hc Occult Blood Stool 1-3 Simult Det,50.0,32.5,,,0
CDM,30100162,Hc Cadmium,201.0,130.65,,,0
CDM,30100163,Hc Vitamin D Total 25-Oh,134.0,87.1,,,0
CDM,30100164,Hc Calcitonin So,68.0,44.2,,,0
CDM,30100165,Hc Calcium Total,9.0,5.85,,,0
CDM,30100166,Hc Calcium Ionized,69.0,44.85,,,0
CDM,30100167,Hc Calcium Urine Timed,87.0,56.55,,,0
CDM,30100169,Hc Carbohydrate Deficient Transferrin So,148.0,96.2,,,0
CDM,30100170,Hc Bicarbonate,9.0,5.85,,,0
CDM,30100171,Hc Carboxyhemoglobin,115.0,74.75,,,0
CDM,30100172,Hc Cea,149.0,96.85,,,0
CDM,30100174,Hc Carotene So,508.0,330.2,,,0
CDM,30100178,Hc Ceruloplasmin,115.0,74.75,,,0
CDM,30100181,Hc Chloride Blood,9.0,5.85,,,0
CDM,30100182,Hc Chloride Urine,67.0,43.55,,,0
CDM,30100183,Hc Chloride Body Fluid,51.0,33.15,,,0
CDM,30100184,Hc Chlorinated Hydrocarbons Screen So,387.0,251.55,,,0
CDM,30100186,Hc Cholinesterase Serum So,31.0,20.15,,,0
CDM,30100187,Hc Cholinesterase Rbc So,65.0,42.25,,,0
CDM,30100191,Hc Chromatography Qn Column Multi,873.0,567.45,,,0
CDM,30100192,Hc Chromium So,161.0,104.65,,,0
CDM,30100193,Hc Citrate So,49.0,31.85,,,0
CDM,30100194,Hc Cocaine Quantitative So,112.0,72.8,,,0
CDM,30100195,Hc Collagen Cross Links Any Method So,338.0,219.7,,,0
CDM,30100196,Hc Copper So,86.0,55.9,,,0
CDM,30100198,Hc Cortisol Free,301.0,195.65,,,0
CDM,30100199,Hc Cortisol Total,72.0,46.8,,,0
CDM,30100200,Hc Creatine So,60.0,39.0,,,0
CDM,30100205,Hc Cpk,65.0,42.25,,,0
CDM,30100206,Hc Cpk Isoenzymes So,71.0,46.15,,,0
CDM,30100207,Hc Cpk Mb Only,64.0,41.6,,,0
CDM,30100208,Hc Creatinine,9.0,5.85,,,0
CDM,30100210,Hc Creatinine Clearance,48.0,31.2,,,0
CDM,30100211,Hc Cryofibrinogen,117.0,76.05,,,0
CDM,30100212,Hc Cryoglobulin,108.0,70.2,,,0
CDM,30100213,Hc Cyanide So,191.0,124.15,,,0
CDM,30100214,Hc Vitamin B 12,62.0,40.3,,,0
CDM,30100215,Hc Vitamin B 12 Binding So,457.0,297.05,,,0
CDM,30100216,Hc Cystatin C So,128.0,83.2,,,0
CDM,30100217,Hc Dhea So,62.0,40.3,,,0
CDM,30100218,Hc Dhea Sulfate Dhea S,88.0,57.2,,,0
CDM,30100219,Hc Desoxycorticosteroid,775.0,503.75,,,0
CDM,30100220,Hc Deoxycortisol  11 So,119.0,77.35,,,0
CDM,30100221,Hc Dibucaine Number,126.0,81.9,,,0
CDM,30100223,Hc Dihydrotestosterone Dht,140.0,91.0,,,0
CDM,30100224,Hc Vitamin D (1 25 Dihydroxy),133.0,86.45,,,0
CDM,30100225,Hc Pancreatic Elastase 1 (Pe1) So,240.0,156.0,,,0
CDM,30100228,Hc Electrophoresis Nes So,189.0,122.85,,,0
CDM,30100229,Hc Erythropoietin,89.0,57.85,,,0
CDM,30100230,Hc Estradiol; Total,53.0,34.45,,,0
CDM,30100232,Hc Estriol,340.0,221.0,,,0
CDM,30100233,Hc Estrone,488.0,317.2,,,0
CDM,30100235,Hc Ethylene Glycol So,271.0,176.15,,,0
CDM,30100238,Hc Fatty Acids Nonesterified So,98.0,63.7,,,0
CDM,30100240,Hc Ferritin,62.0,40.3,,,0
CDM,30100241,Hc Fetal Fibronectin (Ffn),269.0,174.85,,,0
CDM,30100242,Hc Fluoride So,193.0,125.45,,,0
CDM,30100244,Hc Folic Acid Serum,62.0,40.3,,,0
CDM,30100245,Hc Folate For Rbc,67.0,43.55,,,0
CDM,30100246,Hc Fructose Semen So,310.0,201.5,,,0
CDM,30100247,Hc Galactose So,1113.0,723.45,,,0
CDM,30100250,Hc Ige Immunoglobulins So,41.0,26.65,,,0
CDM,30100251,Hc Immunoglobulin Subclasses Each So,83.0,53.95,,,0
CDM,30100252,Hc Ph Blood Gas,95.0,61.75,,,0
CDM,30100253,Hc Arterial Blood Gases,111.0,72.15,,,0
CDM,30100254,Hc Abg With Direct O2 Saturation Pulm,111.0,72.15,,,0
CDM,30100255,Hc O2 Saturation Direct,75.0,48.75,,,0
CDM,30100258,Hc Gastrin So,54.0,35.1,,,0
CDM,30100259,Hc Glucagon So,143.0,92.95,,,0
CDM,30100260,Hc Glucose Body Fluid,71.0,46.15,,,0
CDM,30100261,Hc Glucose Quantitative Blood,9.0,5.85,,,0
CDM,30100262,Hc Glucose Post Glucose Dose,21.0,13.65,,,0
CDM,30100263,Hc Glucose Tolerance 1St 3 Specimen,46.0,29.9,,,0
CDM,30100264,Hc Glucose Tolerance Addl Specimen,45.0,29.25,,,0
CDM,30100265,Hc G6Pd Enzyme Quant So,93.0,60.45,,,0
CDM,30100268,Hc Glutramyltransferase Gamma Ggt,51.0,33.15,,,0
CDM,30100271,Hc Fsh,39.0,25.35,,,0
CDM,30100272,Hc Luteinizing Hormone Lh,53.0,34.45,,,0
CDM,30100273,Hc Human Growth Hormone (Hgh),276.0,179.4,,,0
CDM,30100274,Hc Haptoglobin,77.0,50.05,,,0
CDM,30100275,Hc H Pylori Breath So,102.0,66.3,,,0
CDM,30100278,Hc Hemoglobin Other,1745.0,1134.25,,,0
CDM,30100282,Hc Methemoglobin Quantitative,67.0,43.55,,,0
CDM,30100283,Hc Hemoglobin Plasma,201.0,130.65,,,0
CDM,30100284,Hc Hemoglobin Stability Screen So,153.0,99.45,,,0
CDM,30100285,Hc Hemosiderin Qualitative,580.0,377.0,,,0
CDM,30100287,Hc Histamine So,336.0,218.4,,,0
CDM,30100288,Hc Homocysteine,337.0,219.05,,,0
CDM,30100289,Hc Homovanillic Acid Hva So,100.0,65.0,,,0
CDM,30100290,Hc 17-Hydroxycorticosteroid,543.0,352.95,,,0
CDM,30100291,Hc Hydroxyindolacetic Acid (5-Hiaa) So,102.0,66.3,,,0
CDM,30100292,Hc 17-Hydroxyprogesterone So,51.0,33.15,,,0
CDM,30100295,Hc Immunoassay Noninfectious Agent,318.0,206.7,,,0
CDM,30100296,Hc Immunassay Noninfect Agnt Qnt Ria,571.0,371.15,,,0
CDM,30100297,Hc Immunassay Noninfect Agnt Qnt Nos,460.0,299.0,,,0
CDM,30100298,Hc Insulin,71.0,46.15,,,0
CDM,30100299,Hc Insulin Free So,157.0,102.05,,,0
CDM,30100300,Hc Iron,51.0,33.15,,,0
CDM,30100301,Hc Iron Binding Capacity,50.0,32.5,,,0
CDM,30100303,Hc 17 Ketosteroids Total 24Hr,254.0,165.1,,,0
CDM,30100305,Hc Lactic Acid Lactate,79.0,51.35,,,0
CDM,30100306,Hc Ldh,25.0,16.25,,,0
CDM,30100307,Hc Ldh Isoenzymes So,191.0,124.15,,,0
CDM,30100308,Hc Lactoferrin Detection So,322.0,209.3,,,0
CDM,30100309,Hc Lactogen Placental So,405.0,263.25,,,0
CDM,30100311,Hc L S Ratio,580.0,377.0,,,0
CDM,30100313,Hc Lamellar Body Count,98.0,63.7,,,0
CDM,30100315,Hc Lipase,74.0,48.1,,,0
CDM,30100316,Hc Lipoprotein A,55.0,35.75,,,0
CDM,30100318,Hc Lipoprotein Electrophoresis,145.0,94.25,,,0
CDM,30100319,Hc Lipoprotein High Res Fract And Quant So,178.0,115.7,,,0
CDM,30100320,Hc Nmr Lipoprofile & Particles So,109.0,70.85,,,0
CDM,30100321,Hc Cholesterol Hdl,50.0,32.5,,,0
CDM,30100322,Hc Cholesterol Vldl Chylomicrons,77.0,50.05,,,0
CDM,30100323,Hc Cholesterol Ldl Direct,77.0,50.05,,,0
CDM,30100324,Hc Gonadotropin Releasing Hormone So,755.0,490.75,,,0
CDM,30100325,Hc Magnesium,55.0,35.75,,,0
CDM,30100327,Hc Mass Spectrometry Qual/Quan So,409.0,265.85,,,0
CDM,30100330,Hc Mercury So,75.0,48.75,,,0
CDM,30100331,Hc Metanephrines Fractionated So,51.0,33.15,,,0
CDM,30100332,Hc Methadone Dolophine So,194.0,126.1,,,0
CDM,30100333,Hc Methsuximide,238.0,154.7,,,0
CDM,30100336,Hc Myoglobin,123.0,79.95,,,0
CDM,30100337,Hc Myeloperoxidase Antibody,135.0,87.75,,,0
CDM,30100338,Hc Brain Natriuretic Peptide Bnp,269.0,174.85,,,0
CDM,30100339,Hc Nephelometry Each Analyte,250.0,162.5,,,0
CDM,30100340,Hc Nickel So,173.0,112.45,,,0
CDM,30100341,Hc Nicotine So,175.0,113.75,,,0
CDM,30100342,Hc Nucleotidase 5 So,1000.0,650.0,,,0
CDM,30100343,Hc Oligoclonal Bands So,156.0,101.4,,,0
CDM,30100347,Hc 6 Mam Urine So,212.0,137.8,,,0
CDM,30100348,Hc Osmolality Blood,104.0,67.6,,,0
CDM,30100349,Hc Osmolality Urine,103.0,66.95,,,0
CDM,30100350,Hc Osteocalcin So,137.0,89.05,,,0
CDM,30100353,Hc Pth Intact,110.0,71.5,,,0
CDM,30100354,Hc Ph Body Fluid Nes,93.0,60.45,,,0
CDM,30100355,Hc Phencyclidine Pcp So,153.0,99.45,,,0
CDM,30100356,Hc Calprotectin Fecal So,330.0,214.5,,,0
CDM,30100358,Hc Phenylalanine So,121.0,78.65,,,0
CDM,30100359,Hc Acid Phosphatase Prostatic,59.0,38.35,,,0
CDM,30100360,Hc Alkaline Phosphatase Alk Phos,10.0,6.5,,,0
CDM,30100361,Hc Alkaline Phosphatase Isoenzyme So,79.0,51.35,,,0
CDM,30100362,Hc Phosphatidylglycerol,251.0,163.15,,,0
CDM,30100363,Hc Glucose Phosphate Isomerase Rbc So,734.0,477.1,,,0
CDM,30100364,Hc Phosphorus,55.0,35.75,,,0
CDM,30100365,Hc Phosphorus Urine,109.0,70.85,,,0
CDM,30100366,Hc Porphobilinogen Urine Qualitative,121.0,78.65,,,0
CDM,30100367,Hc Porphobilinogen Urine Quantitative So,90.0,58.5,,,0
CDM,30100368,Hc Rapid Rom Test,588.0,382.2,,,0
CDM,30100370,Hc Porphyrin Urine Quantitative,314.0,204.1,,,0
CDM,30100371,Hc Porphyrins Feces Quantitative So,379.0,246.35,,,0
CDM,30100373,Hc Potassium Serum Plasma Or Whole Blood,9.0,5.85,,,0
CDM,30100374,Hc Potassium Urine,59.0,38.35,,,0
CDM,30100375,Hc Prealbumin,89.0,57.85,,,0
CDM,30100376,Hc Pregnenolone So,112.0,72.8,,,0
CDM,30100377,Hc 17 Hydroxypregnenolone So,224.0,145.6,,,0
CDM,30100378,Hc Progesterone,39.0,25.35,,,0
CDM,30100379,Hc Procalcitonin Pct,644.0,418.6,,,0
CDM,30100380,Hc Prolactin,41.0,26.65,,,0
CDM,30100381,Hc Prostaglandin Each So,184.0,119.6,,,0
CDM,30100382,Hc Psa Total,84.0,54.6,,,0
CDM,30100383,Hc Psa Free,84.0,54.6,,,0
CDM,30100384,Hc Protein Total,10.0,6.5,,,0
CDM,30100385,Hc Protein Urine,51.0,33.15,,,0
CDM,30100388,Hc Protein Electrophoresis Serum,316.0,205.4,,,0
CDM,30100389,Hc Protein Electrophoresis Body Fluid,378.0,245.7,,,0
CDM,30100391,Hc Western Blot Immuno Probe Band Id,632.0,410.8,,,0
CDM,30100392,Hc Protoporphyrin Rbc Quantitative So,387.0,251.55,,,0
CDM,30100393,Hc Protoporphyrin Rbc Screen,422.0,274.3,,,0
CDM,30100394,Hc Proinsulin So,100.0,65.0,,,0
CDM,30100395,Hc Vitamin B 6 Pyridoxal Phos So,78.0,50.7,,,0
CDM,30100396,Hc Pyruvic Acid So,72.0,46.8,,,0
CDM,30100397,Hc Pyruvate Kinase So,153.0,99.45,,,0
CDM,30100403,Hc Vitamin B 2 Riboflavin So,118.0,76.7,,,0
CDM,30100404,Hc Selenium So,54.0,35.1,,,0
CDM,30100405,Hc Serotonin So,102.0,66.3,,,0
CDM,30100406,Hc Sex Hormone Binding Globulin,154.0,100.1,,,0
CDM,30100408,Hc Silica So,573.0,372.45,,,0
CDM,30100409,Hc Sodium,9.0,5.85,,,0
CDM,30100410,Hc Sodium Urine,69.0,44.85,,,0
CDM,30100411,Hc Sodium  Other,290.0,188.5,,,0
CDM,30100412,Hc Somatomedin,249.0,161.85,,,0
CDM,30100413,Hc Somatostatin So,522.0,339.3,,,0
CDM,30100414,Hc Spectrophotometry Analyte Nes So,185.0,120.25,,,0
CDM,30100418,Hc Sulfate Urine So,112.0,72.8,,,0
CDM,30100419,Hc Testosterone Free,200.0,130.0,,,0
CDM,30100420,Hc Testosterone Total,109.0,70.85,,,0
CDM,30100422,Hc Thiocyanate So,158.0,102.7,,,0
CDM,30100423,Hc Thyroglobulin,280.0,182.0,,,0
CDM,30100424,Hc T4 Total,59.0,38.35,,,0
CDM,30100425,Hc T4 Free,37.0,24.05,,,0
CDM,30100426,Hc Thyroxin Binding Globulin So,99.0,64.35,,,0
CDM,30100427,Hc Tsh,71.0,46.15,,,0
CDM,30100428,Hc Thyroid Stimulating Immunoglob So,148.0,96.2,,,0
CDM,30100429,Hc Vitamin E So,43.0,27.95,,,0
CDM,30100430,Hc Transcortin Cortisol Bind Globulin,580.0,377.0,,,0
CDM,30100431,Hc Ast Sgot,10.0,6.5,,,0
CDM,30100432,Hc Alt Sgpt,10.0,6.5,,,0
CDM,30100433,Hc Transferrin,124.0,80.6,,,0
CDM,30100434,Hc Triglycerides,53.0,34.45,,,0
CDM,30100435,Hc Thyroid Hormone Uptake Ratio T3U So,215.0,139.75,,,0
CDM,30100436,Hc T3 Total,53.0,34.45,,,0
CDM,30100437,Hc T3 Free,59.0,38.35,,,0
CDM,30100438,Hc Reverse T3 So,75.0,48.75,,,0
CDM,30100439,Hc Troponin Quantitative,92.0,59.8,,,0
CDM,30100441,Hc Tyrosine So,226.0,146.9,,,0
CDM,30100442,Hc Bun,9.0,5.85,,,0
CDM,30100443,Hc Urea Nitrogen Urine,53.0,34.45,,,0
CDM,30100444,Hc Urea Clearance,49.0,31.85,,,0
CDM,30100445,Hc Uric Acid Blood,17.0,11.05,,,0
CDM,30100446,Hc Uric Acid Other Source,51.0,33.15,,,0
CDM,30100450,Hc Vma Urine So,64.0,41.6,,,0
CDM,30100451,Hc Vasoactive Intestinal Peptide Vip So,168.0,109.2,,,0
CDM,30100452,Hc Vasopressin So,338.0,219.7,,,0
CDM,30100453,Hc Vitamin A So,43.0,27.95,,,0
CDM,30100455,Hc Vitamin K So,185.0,120.25,,,0
CDM,30100456,Hc Volatile Panel  So,309.0,200.85,,,0
CDM,30100457,Hc Zinc So,29.0,18.85,,,0
CDM,30100458,Hc C Peptide,49.0,31.85,,,0
CDM,30100459,Hc Hcg Quantitative,47.0,30.55,,,0
CDM,30100460,Hc Hcg Qualitative,32.0,20.8,,,0
CDM,30100490,Hc Carbamazepine Total So,138.0,89.7,,,0
CDM,30100491,Hc Phenobarbital,42.0,27.3,,,0
CDM,30100493,Hc Drug Quantitative,338.0,219.7,,,0
CDM,30100499,Hc Caffeine So,146.0,94.9,,,0
CDM,30100505,Hc Clozapine Level So,79.0,51.35,,,0
CDM,30100508,Hc Drug Quantitative Nes So,317.0,206.05,,,0
CDM,30100516,Hc Lamotrigine Lamictal,146.0,94.9,,,0
CDM,30100518,Hc Levetiracetam Keppra,293.0,190.45,,,0
CDM,30100525,Hc Mycophenolic Acid So,84.0,54.6,,,0
CDM,30100530,Hc Neurontin Gabapentin So,63.0,40.95,,,0
CDM,30100533,Hc Oxcarbazepine Trileptal So,52.0,33.8,,,0
CDM,30100535,Hc Propoxyphene So,163.0,105.95,,,0
CDM,30100543,Hc Tiagabine Gabitril So,133.0,86.45,,,0
CDM,30100551,Hc Zonisamide Zonegran So,108.0,70.2,,,0
CDM,30100552,Hc Bcr Abl1 Gene Major Bp,1521.0,988.65,,,0
CDM,30100553,Hc Bcr/Abl 1 Gene Minor Bp,1710.0,1111.5,,,0
CDM,30100556,Hc Cyp2C9 Sequence Genotype So,1825.0,1186.25,,,0
CDM,30100577,"Hc Albumin Othr Source, Qnt, Ea Spec",178.0,115.7,,,0
CDM,30100579,Hc Alcohols,75.0,48.75,,,0
CDM,30100581,Hc Alcohols So,118.0,76.7,,,0
CDM,30100583,Hc Alpha 1 Antitrypsin Total So,68.0,44.2,,,0
CDM,30100587,Hc Amino Acids Quant More Than 5 So,470.0,305.5,,,0
CDM,30100600,Hc Apolipoprotein B,112.0,72.8,,,0
CDM,30100604,Hc Beta 2 Microglobulin Fluid So,88.0,57.2,,,0
CDM,30100608,Hc Calcium Ionized Wb  Pulm,69.0,44.85,,,0
CDM,30100611,Hc Carboxyhemoglobin Pulm,115.0,74.75,,,0
CDM,30100613,Hc Cea So,414.0,269.1,,,0
CDM,30100615,Hc Catecholamines Fraction So,78.0,50.7,,,0
CDM,30100616,Hc Chemiluminescent Assay So,98.0,63.7,,,0
CDM,30100620,Hc Chloride Stool So,29.0,18.85,,,0
CDM,30100621,Hc Cholesterol Total,51.0,33.15,,,0
CDM,30100623,Hc Chromatography Qn Column Single So,377.0,245.05,,,0
CDM,30100665,Hc Pregabalin Lyrica So,115.0,74.75,,,0
CDM,30100673,Hc Creatinine Other Source,51.0,33.15,,,0
CDM,30100689,Hc Igg Iga Igm Immunoglobulins So,125.0,81.25,,,0
CDM,30100691,Hc Igg Iga Igm Immunoglobulins,109.0,70.85,,,0
CDM,30100693,Hc Direct O2 Saturation,155.0,100.75,,,0
CDM,30100701,Hc Hemoglobin Fraction And Quant By Electrophoresis So,231.0,150.15,,,0
CDM,30100702,Hc Hemoglobin Chromatography,1424.0,925.6,,,0
CDM,30100703,Hc Hemoglobin A1C,102.0,66.3,,,0
CDM,30100706,Hc Hexosaminidase Total Serum,749.0,486.85,,,0
CDM,30100788,Hc Iron Liver Tissue Or Urine So,137.0,89.05,,,0
CDM,30100790,Hc D Lactate So,182.0,118.3,,,0
CDM,30100797,Hc Lead So,13.0,8.45,,,0
CDM,30100802,Hc Magnesium So,75.0,48.75,,,0
CDM,30100819,Hc Methadone Assay,126.0,81.9,,,0
CDM,30100821,Hc Myoglobin So,55.0,35.75,,,0
CDM,30100823,Hc Nephelometry Each Analyte So,54.0,35.1,,,0
CDM,30100829,Hc Buprenorphine So,99.0,64.35,,,0
CDM,30100830,Hc Fentanyl So,69.0,44.85,,,0
CDM,30100832,Hc Opiates,92.0,59.8,,,0
CDM,30100834,Hc Opiates 1 Or More So,148.0,96.2,,,0
CDM,30100838,Hc Oxalate So,147.0,95.55,,,0
CDM,30100850,Hc Macroprolactin So,194.0,126.1,,,0
CDM,30100853,Hc Protein Body Fluid Or Csf,69.0,44.85,,,0
CDM,30100870,Hc Renin Activity Plasma So,47.0,30.55,,,0
CDM,30100872,Hc Sodium Wb Pulm,9.0,5.85,,,0
CDM,30100884,Hc Reducing Substance Not Glucose,82.0,53.3,,,0
CDM,30100885,Hc Sugars Single Qual So,68.0,44.2,,,0
CDM,30100888,Hc Testosterone Free So,132.0,85.8,,,0
CDM,30100892,Hc T4 Free By Dialysis So,88.0,57.2,,,0
CDM,30100910,Hc Unlisted Chemistry Procedure So,156.0,101.4,,,0
CDM,30100931,Hc Drug Test Prsmv Chem Anlyzr,123.0,79.95,,,0
CDM,30100933,Hc Drug Test Prsmv Dir Opt Obs,119.0,77.35,,,0
CDM,30100941,Hc Occult Blood Fecal Ia,89.0,57.85,,,0
CDM,30100952,Hc Igh Gene Rearrange Analysis,943.0,612.95,,,0
CDM,30100953,Hc Igk Rearrange Abn Clonal Pop,943.0,612.95,,,0
CDM,30100954,Hc Valproic Acid Free So,115.0,74.75,,,0
CDM,30100955,Hc 25-Hydroxyvitamin D2 And D3 So,25.0,16.25,,,0
CDM,30100956,Hc Calcium Ionized Amb,69.0,44.85,,,0
CDM,30100957,Hc Chloride Blood Amb,9.0,5.85,,,0
CDM,30100958,Hc Creatinine Amb,9.0,5.85,,,0
CDM,30100959,Hc Arterial Blood Gases Lab,111.0,72.15,,,0
CDM,30100960,Hc Abg With Direct O2 Saturation,111.0,72.15,,,0
CDM,30100962,Hc Glucose Quantitative Pulmonary,9.0,5.85,,,0
CDM,30100963,Hc Glucose Quantitative Amb,9.0,5.85,,,0
CDM,30100964,Hc Methemoglobin Quantitative Lab,67.0,43.55,,,0
CDM,30100965,Hc Lactic Acid Lactate Pulmonary,79.0,51.35,,,0
CDM,30100968,Hc Potassium Whole Blood Pulmonary,9.0,5.85,,,0
CDM,30100969,Hc Potassium Amb,9.0,5.85,,,0
CDM,30100977,Hc Troponin Quantitative So,39.0,25.35,,,0
CDM,30100978,Hc Bun Amb,9.0,5.85,,,0
CDM,30100994,Hc Glucose Quant Blood,9.0,5.85,,,0
CDM,30100998,Hc Sodium Amb,9.0,5.85,,,0
CDM,30101001,Hc Everolimus So,92.0,59.8,,,0
CDM,30101002,Hc Mopath Level 4 So,1146.0,744.9,,,0
CDM,30101011,Hc Cftr Gene  Full Gene Analysis So,3285.0,2135.25,,,0
CDM,30101013,Hc Hla-Dqa1,575.0,373.75,,,0
CDM,30101014,Hc Bcr Abl1 Gene Major Bp So,891.0,579.15,,,0
CDM,30101015,Hc Bcr/Abl 1 Gene Minor Bp So,366.0,237.9,,,0
CDM,30101016,Hc Molecular Path Proc Level 1 So,1091.0,709.15,,,0
CDM,30101017,Hc Mopath Level 2 So,550.0,357.5,,,0
CDM,30101018,Hc Amylase So,118.0,76.7,,,0
CDM,30101019,Hc Arsenic So,320.0,208.0,,,0
CDM,30101020,Hc Barbiturate Quantitative So,141.0,91.65,,,0
CDM,30101021,Hc Cadmium So,104.0,67.6,,,0
CDM,30101022,Hc Calculus Anlys Infrared Spectroscopy So,51.0,33.15,,,0
CDM,30101023,Hc Carnitine So,93.0,60.45,,,0
CDM,30101025,Hc Col Chromotography Qual/Quan So,306.0,198.9,,,0
CDM,30101026,Hc Cortisol Free So,56.0,36.4,,,0
CDM,30101029,Hc Enzyme Act Blood Cell Tiss Non Rad Nes Ea Spec So,292.0,189.8,,,0
CDM,30101030,Hc Estrone So,31.0,20.15,,,0
CDM,30101031,Hc Fat Lipids Stool Quant So,102.0,66.3,,,0
CDM,30101032,Hc Fatty Acids Very Long Chain So,184.0,119.6,,,0
CDM,30101033,Hc Galactose Transferase G 1 Put Qn So,131.0,85.15,,,0
CDM,30101034,Hc Glycated Protein So,57.0,37.05,,,0
CDM,30101036,Hc Hexosaminidase Total Serum So,156.0,101.4,,,0
CDM,30101037,Hc Immunoassay Noninfectious Agent So,153.0,99.45,,,0
CDM,30101038,Hc Immunassay Noninfect Agnt Qnt Ria So,273.0,177.45,,,0
CDM,30101040,Hc Glucosidase Beta So,1547.0,1005.55,,,0
CDM,30101041,Hc Immunassay Noninfect Agnt Qnt Nos So,226.0,146.9,,,0
CDM,30101042,Hc Ldh So,25.0,16.25,,,0
CDM,30101043,Hc Lipoprotein Assoc Phospholipase A2 So,480.0,312.0,,,0
CDM,30101044,Hc Manganese So,133.0,86.45,,,0
CDM,30101045,Hc Heavy Metal Quant Nes Special So,802.0,521.3,,,0
CDM,30101046,Hc Organic Acids Qualitative Each So,153.0,99.45,,,0
CDM,30101047,Hc Organic Acid Single Quant So,47.0,30.55,,,0
CDM,30101048,Hc Porphyrin Urine Quantitative So,162.0,105.3,,,0
CDM,30101049,Hc Protein Electrophoresis Body Fluid So,185.0,120.25,,,0
CDM,30101050,Hc Western Blot So,397.0,258.05,,,0
CDM,30101051,Hc Western Blot Immuno Probe Band Id Sp So,422.0,274.3,,,0
CDM,30101052,Hc Protoporphyrin Rbc Quantitative So,387.0,251.55,,,0
CDM,30101053,Hc Receptor Assay Non Endocrine So,98.0,63.7,,,0
CDM,30101055,Hc Somatomedin So,47.0,30.55,,,0
CDM,30101056,Hc Sugars Single Quantitative Each So,273.0,177.45,,,0
CDM,30101057,Hc Vitamin B 1 Thiamine So,89.0,57.85,,,0
CDM,30101058,Hc Vitamin Nos So,541.0,351.65,,,0
CDM,30101061,Hc Hcg Quantitative So,63.0,40.95,,,0
CDM,30101063,Hc Braf Gene Mut Anlys V600E Tumor So,1485.0,965.25,,,0
CDM,30101070,Hc Alkoloids Nos So,495.0,321.75,,,0
CDM,30101073,Hc Antidepressants Class; 1- 2 So,340.0,221.0,,,0
CDM,30101075,Hc Antidepressants Tricyclic And Other Cyclicals; 1-2 So,184.0,119.6,,,0
CDM,30101077,Hc Antidepressant Not Specified So,282.0,183.3,,,0
CDM,30101079,Hc Antiepileptics Nos 1 To 3 So,270.0,175.5,,,0
CDM,30101080,Hc Antipsychotics Nos 1 To 3 So,347.0,225.55,,,0
CDM,30101081,Hc Cannabinoids Natural So,146.0,94.9,,,0
CDM,30101084,Hc Methylphenidate So,452.0,293.8,,,0
CDM,30101085,Hc Drug Screening Opioids And Opiate Analogs 1 Or 2 So,815.0,529.75,,,0
CDM,30101086,Hc Sedative Hypnotics So,190.0,123.5,,,0
CDM,30101088,Hc Stimulants Synthetic So,604.0,392.6,,,0
CDM,30101090,Hc Drug Or Substance Definitive Qual Quant Nos 1-3 So,750.0,487.5,,,0
CDM,30101091,Hc Skeletal Muscle Relaxant 1 To 2 So,319.0,207.35,,,0
CDM,30101093,Hc Oxycodone So,149.0,96.85,,,0
CDM,30101097,Hc Digoxin Free So,787.0,511.55,,,0
CDM,30101098,Hc Tapentadol & Metabolite So,208.0,135.2,,,0
CDM,30101099,Hc Tramadol & Metabolite So,114.0,74.1,,,0
CDM,30101100,Hc Drug Screen Benzodiazepines 1-12 So,152.0,98.8,,,0
CDM,30101102,Hc Biotinidase So,70.0,45.5,,,0
CDM,30101103,Hc Pms2 Gene Analysis Known Familial Variants So,1364.0,886.6,,,0
CDM,30101104,Hc Chloride Wb Pulm,9.0,5.85,,,0
CDM,30101108,Hc Psa Screen,84.0,54.6,,,0
CDM,30101109,Hc Nash Fibrosure,1526.0,991.9,,,0
CDM,30101110,Hc Ketamine And Norketamine So,871.0,566.15,,,0
CDM,30101111,Hc Mgmt Gene Promoter Methylation Analysis So,1242.0,807.3,,,0
CDM,30101112,Hc Mlh1 Promoter Mrthlyation Analysis So,1190.0,773.5,,,0
CDM,30101113,Hc Apc Gene Known Fam Variants So,1273.0,827.45,,,0
CDM,30101114,Hc Pth Fnab Needle Wash So,195.0,126.75,,,0
CDM,30101115,Hc Galectin 3 So,349.0,226.85,,,0
CDM,30101116,Hc Ethyl Glucuronide Etg So,231.0,150.15,,,0
CDM,30101117,Hc Amphetamines 5 Or More So,452.0,293.8,,,0
CDM,30101118,Hc Benzodiazepines 13 Or More So,229.0,148.85,,,0
CDM,30101120,Hc Cytogen M Array Copy No And Snp So,4784.0,3109.6,,,0
CDM,30101121,Hc Mopath Procedure Level 3 So,2120.0,1378.0,,,0
CDM,30101122,Hc Mopath Procedure Level 6 So,4083.0,2653.95,,,0
CDM,30101123,Hc Mopath Level 7 So,4577.0,2975.05,,,0
CDM,30101124,"Hc Fibrinolysis Or Coagulopathy Screen, Interp And Rpt So",116.0,75.4,,,0
CDM,30101126,Hc Mopath Procedure Level 6 Special So,7988.0,5192.2,,,0
CDM,30101128,Hc Aerobe Ident By Sequencing So,339.0,220.35,,,0
CDM,30101130,Hc Calr Gene Analysis Common Variants Exon9 So,810.0,526.5,,,0
CDM,30101132,Hc Creatinine W Microalbumin,51.0,33.15,,,0
CDM,30101133,Hc T4 Total So,225.0,146.25,,,0
CDM,30101134,Hc Pdgfra Mutation Analysis So,1778.0,1155.7,,,0
CDM,30101135,Hc Kit Gene Analys D816 Variant So,1339.0,870.35,,,0
CDM,30101136,Hc Hrditary Colon Ca Dsrdrs Gen Seq Analys 10 Gen So,8627.0,5607.55,,,0
CDM,30101137,Hc Egfr Gene Com Variants So,1890.0,1228.5,,,0
CDM,30101138,Hc Kit Gene Targeted Seq Analys So,2803.0,1821.95,,,0
CDM,30101139,Hc Cannabinoids Synthetic 7 Or More So,431.0,280.15,,,0
CDM,30101141,Hc Nras Gene Variants Exon 2 And 3 So,1110.0,721.5,,,0
CDM,30101142,Hc Mopath Procedure Level 8 So,2753.0,1789.45,,,0
CDM,30101143,Hc Ml Alcohols So,21.0,13.65,,,0
CDM,30101144,Hc Ml Alcohol Biomarkers; 1-2 So,21.0,13.65,,,0
CDM,30101145,Hc Ml Alkaloids Nos So,21.0,13.65,,,0
CDM,30101146,Hc Ml Amphetamines; 1 Or 2 So,21.0,13.65,,,0
CDM,30101147,Hc Ml Anabolic Steroids; 1-2 So,21.0,13.65,,,0
CDM,30101148,Hc Ml Analgesics Non-Opiod; 1-2 So,21.0,13.65,,,0
CDM,30101149,"Hc Ml Antidepressants, Serotonergic Class; 1 Or 2 So",21.0,13.65,,,0
CDM,30101150,"Hc Ml Antidepressants, Tricyclic And Other Cyclicals; 1 Or 2 So",21.0,13.65,,,0
CDM,30101151,Hc Ml Antidepressants Nos So,21.0,13.65,,,0
CDM,30101152,Hc Ml Antiepileptics Nos; 1-3 So,21.0,13.65,,,0
CDM,30101153,Hc Ml Antipsychotics Nos; 1-3 So,21.0,13.65,,,0
CDM,30101154,Hc Ml Barbiturates So,21.0,13.65,,,0
CDM,30101155,Hc Ml Benzodiazepines; 1-12 So,21.0,13.65,,,0
CDM,30101156,Hc Ml Buprenorphine So,21.0,13.65,,,0
CDM,30101157,Hc Ml Cannabinoids Natural So,21.0,13.65,,,0
CDM,30101158,Hc Ml Cannabinoids Synthetic; 7 Or More So,21.0,13.65,,,0
CDM,30101159,Hc Ml Cocaine So,21.0,13.65,,,0
CDM,30101160,Hc Ml Fentanyl So,21.0,13.65,,,0
CDM,30101161,Hc Ml Gabapentin Non-Blood So,21.0,13.65,,,0
CDM,30101162,Hc Ml Heroin Metabolite So,21.0,13.65,,,0
CDM,30101163,Hc Ml Ketamine And Norketamine So,21.0,13.65,,,0
CDM,30101164,Hc Ml Methadone So,21.0,13.65,,,0
CDM,30101165,"Hc Ml Methylenedioxyamphetamines (Mda, Mdea, Mdma) So",21.0,13.65,,,0
CDM,30101166,Hc Ml Methylphenidate So,21.0,13.65,,,0
CDM,30101167,"Hc Ml Opiates, 1+ So",21.0,13.65,,,0
CDM,30101168,Hc Ml Opiods And Opiate Analogs; 1 - 2 So,21.0,13.65,,,0
CDM,30101169,Hc Ml Oxycodone So,21.0,13.65,,,0
CDM,30101170,Hc Ml Phencyclidine (Pcp) So,21.0,13.65,,,0
CDM,30101171,Hc Ml Pregabalin So,21.0,13.65,,,0
CDM,30101172,Hc Ml Propoxyphene So,21.0,13.65,,,0
CDM,30101173,Hc Ml Sedative Hypnotics Non-Benzodiazepines So,21.0,13.65,,,0
CDM,30101174,Hc Ml Skeletal Muscle Relaxants; 1 - 2 So,21.0,13.65,,,0
CDM,30101175,Hc Ml Stimulants Synthetic So,21.0,13.65,,,0
CDM,30101176,Hc Ml Tapentadol & Metabolite So,21.0,13.65,,,0
CDM,30101177,Hc Ml Tramadol So,21.0,13.65,,,0
CDM,30101178,"Hc Ml Stereoisomer (Enantiomer) Anlys, Sgl Drug Class So",21.0,13.65,,,0
CDM,30101179,"Hc Ml Drugs Or Substances, Defin, Ql Or Qt; 1-3 So",21.0,13.65,,,0
CDM,30101180,Hc Abl1 Gene Analysis Kinase Domain Variants So,945.0,614.25,,,0
CDM,30101181,Hc Cebpa Gene Full Sequence So,1345.0,874.25,,,0
CDM,30101182,Hc Flt3 Tkd Gene Analysis So,669.0,434.85,,,0
CDM,30101183,Hc Gen Seq Analys Solid Organ Neoplasm 5-50 Gene So,6083.0,3953.95,,,0
CDM,30101185,Hc Drug Test Prsmv Chem Anlyzer So,128.0,83.2,,,0
CDM,30101194,Hc Testosterone Bioavailable So,110.0,71.5,,,0
CDM,30101195,Hc Tgsap Hematolymphoid Neo/Do 5-50 Genes Rna Analysis So,7155.0,4650.75,,,0
CDM,30101196,Hc Hemosiderin Qual So,68.0,44.2,,,0
CDM,30101197,Hc Triglycerides So,86.0,55.9,,,0
CDM,30101198,Hc Fsed Basic Metabolic Panel Calcium Total,56.0,36.4,,,0
CDM,30101199,Hc Fsed Comprehensive Metabolic Panel,74.0,48.1,,,0
CDM,30101200,Hc Fsed Renal Function Panel,66.0,42.9,,,0
CDM,30101201,Hc Fsed Drug Test Prsmv Dir Opt Obs,119.0,77.35,,,0
CDM,30101202,Hc Fsed Albumin,10.0,6.5,,,0
CDM,30101203,Hc Fsed Amylase,83.0,53.95,,,0
CDM,30101204,Hc Fsed Bilirubin Total,10.0,6.5,,,0
CDM,30101205,Hc Fsed Occult Blood Stool,72.0,46.8,,,0
CDM,30101206,Hc Fsed Gastrocult Gastric,70.0,45.5,,,0
CDM,30101207,Hc Fsed Calcium Ionized,69.0,44.85,,,0
CDM,30101208,Hc Fsed Chloride Blood,9.0,5.85,,,0
CDM,30101209,Hc Fsed Creatinine,9.0,5.85,,,0
CDM,30101210,Hc Fsed Arterial Blood Gases,111.0,72.15,,,0
CDM,30101211,Hc Fsed Glucose Quantitative Blood,9.0,5.85,,,0
CDM,30101212,Hc Fsed Glutramyltransferase Gamma Ggt,51.0,33.15,,,0
CDM,30101213,Hc Fsed Lactic Acid Lactate,79.0,51.35,,,0
CDM,30101214,Hc Fsed Magnesium,55.0,35.75,,,0
CDM,30101215,Hc Fsed Brain Natriuretic Peptide Bnp,269.0,174.85,,,0
CDM,30101216,Hc Fsed Alkaline Phosphatase Alk Phos,10.0,6.5,,,0
CDM,30101217,Hc Fsed Potassium Serum Plasma Or Whole Blood,9.0,5.85,,,0
CDM,30101218,Hc Fsed Protein Total,10.0,6.5,,,0
CDM,30101219,Hc Fsed Sodium,9.0,5.85,,,0
CDM,30101220,Hc Fsed Ast Sgot,10.0,6.5,,,0
CDM,30101221,Hc Fsed Alt Sgpt,10.0,6.5,,,0
CDM,30101222,Hc Fsed Troponin Quantitative,92.0,59.8,,,0
CDM,30101223,Hc Fsed Hcg Qualitative,32.0,20.8,,,0
CDM,30101224,Hc Whole Mitochondrial Genome So,6212.0,4037.8,,,0
CDM,30101225,Hc Kras Gene Addl Variants So,683.0,443.95,,,0
CDM,30101226,Hc Fsed Bun,9.0,5.85,,,0
CDM,30101227,Hc Fsed Bicarbonate,9.0,5.85,,,0
CDM,30101228,Hc Fsed Calcium Total,9.0,5.85,,,0
CDM,30101229,Hc Fsed Phosphorus,55.0,35.75,,,0
CDM,30101230,Hc Brca1 And 2 Seq And Full Dup/Del So,5670.0,3685.5,,,0
CDM,30101231,Hc Drug/Substance Nos 7/More So,291.0,189.15,,,0
CDM,30101232,Hc Hla I Typing 1 Locus Hr So,1564.0,1016.6,,,0
CDM,30101233,Hc Pms2 Gene Full Seq Analysis So,2718.0,1766.7,,,0
CDM,30101234,Hc Methemoglobin Blood Quant So,83.0,53.95,,,0
CDM,30101235,Hc Sulfhemoglobin Blood Quant So,82.0,53.3,,,0
CDM,30101236,Hc Glutathione So,1054.0,685.1,,,0
CDM,30101237,Hc Fet Con Abn Afp4 Algorithm So,122.0,79.3,,,0
CDM,30101238,Hc Creatinine Other Source So,47.0,30.55,,,0
CDM,30101239,Hc Procainamide Total So,116.0,75.4,,,0
CDM,30101240,"Hc  Methylenedioxyamphetamines (Mda, Mdea, Mdma) So",85.0,55.25,,,0
CDM,30101241,Hc Antidepressants Class; 3-5 So,326.0,211.9,,,0
CDM,30101242,Hc Antidepressants Tricyclic And Other Cyclicals; 6 Or More So,184.0,119.6,,,0
CDM,30101243,Hc Rbc Enzymes So,4018.0,2611.7,,,0
CDM,30101245,Hc Phenobarbital So,118.0,76.7,,,0
CDM,30101246,Hc Insulin Total So,72.0,46.8,,,0
CDM,30101247,Hc Alkaline Phosphatase So,10.0,6.5,,,0
CDM,30101249,Hc Calcium Urine So,69.0,44.85,,,0
CDM,30101250,Hc Potassium Urine So,30.0,19.5,,,0
CDM,30101251,Hc Osmolality Urine So,60.0,39.0,,,0
CDM,30101252,Hc Uric Acid Other Source So,146.0,94.9,,,0
CDM,30101253,Hc Sodium Urine So,104.0,67.6,,,0
CDM,30101254,Hc Chloride Urine So,34.0,22.1,,,0
CDM,30101255,Hc Phosphorus Urine So,64.0,41.6,,,0
CDM,30101256,Hc Ph Body Fluid Nos So,34.0,22.1,,,0
CDM,30101257,Hc Ammonia So,350.0,227.5,,,0
CDM,30101258,Hc Urea Nitrogen Urine So,71.0,46.15,,,0
CDM,30101259,Hc Str Markers Spec Anal Addl So,720.0,468.0,,,0
CDM,30101261,Hc Ketone Bodies Quantitative So,145.0,94.25,,,0
CDM,30101262,Hc Cortisol Total So,135.0,87.75,,,0
CDM,30101263,Hc Ferritin So,246.0,159.9,,,0
CDM,30101264,Hc Hemoglobin Fraction And Quant By Chromatography So,84.0,54.6,,,0
CDM,30101265,Hc Phosphorus So,300.0,195.0,,,0
CDM,30101266,Hc Noonan Spectrum Disorders Gen Seq Analys 12 Gen So,5344.0,3473.6,,,0
CDM,30101267,Hc Tca; 1- 2 So,41.0,26.65,,,0
CDM,30101268,Hc Antidepressants Tca And Other Cyclicals; 1-2 So,16.0,10.4,,,0
CDM,30101269,Hc Human Platelet Antigen 1 Genotyping So,173.0,112.45,,,0
CDM,30101270,Hc Human Platelet Antigen 2 Genotyping So,173.0,112.45,,,0
CDM,30101271,Hc Human Platelet Antigen 3 Genotyping So,173.0,112.45,,,0
CDM,30101272,Hc Human Platelet Antigen 4 Genotyping So,173.0,112.45,,,0
CDM,30101273,Hc Human Platelet Antigen 5 Genotyping So,173.0,112.45,,,0
CDM,30101274,Hc Human Platelet Antigen 6 Genotyping So,173.0,112.45,,,0
CDM,30101275,Hc Human Platelet Antigen 9 Genotyping So,173.0,112.45,,,0
CDM,30101276,Hc Human Platelet Antigen 15 Genotyping So,173.0,112.45,,,0
CDM,30101277,"Hc Idh1, Common Variants So",1029.0,668.85,,,0
CDM,30101278,"Hc Idh2 , Common Variants So",1029.0,668.85,,,0
CDM,30101281,"Hc Cyp3A4, Gene Analysis, Common Variant(S) So",1562.0,1015.3,,,0
CDM,30101282,"Hc Cyp3A5 , Gene Analysis, Common Variants So",1825.0,1186.25,,,0
CDM,30101283,"Hc Dpyd, Gene Analysis, Common Variant(S) So",1688.0,1097.2,,,0
CDM,30101284,"Hc F9, Full Gene Sequence So",5729.0,3723.85,,,0
CDM,30101286,"Hc G6Pd, Gene Analysis; Known Familial Variant(S) So",7297.0,4743.05,,,0
CDM,30101287,"Hc G6Pd, Gene Analysis; Full Gene Sequence So",3135.0,2037.75,,,0
CDM,30101289,"Hc Hba1/Hba2, Gene Analysis; Full Gene Sequence So",1371.0,891.15,,,0
CDM,30101290,"Hc Hba1/Hba2, Gene Analysis; Duplication/Deletion Variants So",877.0,570.05,,,0
CDM,30101292,"Hc Slco1B1, Gene Analysis, Common Variant(S) So",1562.0,1015.3,,,0
CDM,30101294,"Hc Tpmt, Gene Analysis, Common Variants So",1430.0,929.5,,,0
CDM,30101298,"Hc Hbb, Duplication/Deletion Variant(S) So",945.0,614.25,,,0
CDM,30101299,"Hc Hbb, Full Gene Sequence So",964.0,626.6,,,0
CDM,30101300,Hc Herdtry Periph Neuropth Rel Genom Seq Anlys Pnl 5+ So,7066.0,4592.9,,,0
CDM,30101305,Hc Exome Sequence Analysis So,13270.0,8625.5,,,0
CDM,30101306,Hc Thyroglobulin So,574.0,373.1,,,0
CDM,30101307,Hc Ia Noninfect Agnt Qnt Ria Special So,2454.0,1595.1,,,0
CDM,30101308,"Hc Ifnl3 Gene Analysis, Rs12979860 Variant So",1038.0,674.7,,,0
CDM,30101309,Hc Testosterone Total So,52.0,33.8,,,0
CDM,30101310,Hc Luteinizing Hormone Lh So,330.0,214.5,,,0
CDM,30101311,Hc Estradiol; Total So,68.0,44.2,,,0
CDM,30101312,Hc Tgsap Sol Org/ Hematolymphoid Neo/Do 51+ Genes Dna Or Combo So,10530.0,6844.5,,,0
CDM,30101313,Hc Glucagon Tolerance Panel Insulinoma,288.0,187.2,,,0
CDM,30101314,Hc Growth Hormone Stimulation Panel,1306.0,848.9,,,0
CDM,30101315,Hc Drug Qnt Nes Special So,1430.0,929.5,,,0
CDM,30101316,Hc Ia Noninfectious Agent Special So,1450.0,942.5,,,0
CDM,30101317,Hc Lipid Panel So,61.0,39.65,,,0
CDM,30101318,Hc Ia Noninfect Agnt Qnt Nos Special So,743.0,482.95,,,0
CDM,30101364,Hc Albumin So,10.0,6.5,,,0
CDM,30101365,Hc Corticosterone So,71.0,46.15,,,0
CDM,30101366,Hc Col Chrom Incl Ms Ql/Qt Nes Each Spec So,2229.0,1448.85,,,0
CDM,30101367,Hc Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 So,1009.0,655.85,,,0
CDM,30101368,Hc Rx Metab Advrs Rx Rxn & Rspse Trgt Seq Alys So,2706.0,1758.9,,,0
CDM,30101369,Hc Rx Metab Warfarin Rx Response Trgt Seq Alys So,3799.0,2469.35,,,0
CDM,30101370,Hc Cyp1A2 Gene Analysis Common Variants So,2435.0,1582.75,,,0
CDM,30101371,Hc Comt Gene Analysis C.472G>A Variant So,2978.0,1935.7,,,0
CDM,30101372,Hc Htr2A Htr2C Gene Analysis Common Variants So,2706.0,1758.9,,,0
CDM,30101373,Hc Tpmt Nudt15 Gene Analysis Common Variants So,1397.0,908.05,,,0
CDM,30101374,Hc Mopath Level 7 Ap So,6921.0,4498.65,,,0
CDM,30101375,Hc Mopath Procedure Level 6 Ap So,2868.0,1864.2,,,0
CDM,30101376,Hc Mopath Unlisted So,1582.0,1028.3,,,0
CDM,30101377,"Hc Apc Gene, Full Gene Analysis So",3794.0,2466.1,,,0
CDM,30101378,Hc Dmd/Bmd Deletion/Duplication So,3071.0,1996.15,,,0
CDM,30101379,Hc Unlisted Chemistry Procedure Special So,419.0,272.35,,,0
CDM,30101380,Hc Aortic Dysfunctin/Dilation Genomic Seq Analysis So,7368.0,4789.2,,,0
CDM,30101381,Hc Sugars Multiple Qualitative Each Spec So,233.0,151.45,,,0
CDM,30101382,Hc Glucose Body Fluid Not Blood So,69.0,44.85,,,0
CDM,30101383,Hc Protein Body Fluid So,35.0,22.75,,,0
CDM,30101384,Hc Hereditary Cardiomyopathy Gen Seq Analys 5 Gen So,8535.0,5547.75,,,0
CDM,30101385,Hc Brca1 Gene Known Fam Variant So,1364.0,886.6,,,0
CDM,30101386,Hc G6Pc Gene So,134.0,87.1,,,0
CDM,30101396,Hc Atn1 Gene Analysis Evaluation To Detect Abnormal Alleles So,1785.0,1160.25,,,0
CDM,30101410,Hc Ar Gene Analysis Characterization Of Alleles So,817.0,531.05,,,0
CDM,30101416,Hc Htt Gene Analysis Evaluation To Detect Abnormal Alleles So,675.0,438.75,,,0
CDM,30101422,Hc Myd88 Gene Analysis P.Leu265Pro (L265P) Variant So,1215.0,789.75,,,0
CDM,30101426,Hc Smn1 Gene Analysis Dosage/Deletion Analysis Includes Smn2 Analysis So,1080.0,702.0,,,0
CDM,30101428,Hc Smn1 Gene Analysis Full Gene Sequence So,1928.0,1253.2,,,0
CDM,30101429,Hc Smn1 Gene Analysis Known Familial Sequence Variant(S) So,1364.0,886.6,,,0
CDM,30101432,Hc Tert Gene Analysis Targeted Sequence Analysis So,2246.0,1459.9,,,0
CDM,30101435,Hc Chronic Hepatitis C Virus (Hcv) Infection Six Biochemical Assays Serum So,826.0,536.9,,,0
CDM,30101436,Hc Dihydrotestosterone (Dht) So,120.0,78.0,,,0
CDM,30101438,Hc Brca2 Gene Known Fam Variant So,1364.0,886.6,,,0
CDM,30101439,Hc Cyp2D6 Gen Com&Slct Rar Vrnt So,1111.0,722.15,,,0
CDM,30101440,Hc Neuro Csf Prion Prtn Qual So,2838.0,1844.7,,,0
CDM,30101441,Hc Cnbp Gene Detc Abnor Allele So,3631.0,2360.15,,,0
CDM,30101442,Hc Dmpk Gene Detc Abnor Allele So,2242.0,1457.3,,,0
CDM,30101443,Hc Genetic Testing For Severe Inherited Conditions So,6075.0,3948.75,,,0
CDM,30101444,Hc Gjb2 Gene Full Sequence So,1193.0,775.45,,,0
CDM,30101445,Hc Mstu Sodium,9.0,5.85,,,0
CDM,30101446,Hc Mstu Potassium Serum Plasma Or Wb,9.0,5.85,,,0
CDM,30101447,Hc Mstu Chloride Blood,9.0,5.85,,,0
CDM,30101448,Hc Mstu Glucose Quant Blood,9.0,5.85,,,0
CDM,30101449,Hc Mstu Creatinine,9.0,5.85,,,0
CDM,30101450,Hc Mstu Calcium Ionized,69.0,44.85,,,0
CDM,30101451,Hc Mstu Lactic Acid (Lactate),79.0,51.35,,,0
CDM,30101452,Hc Mstu Bun,9.0,5.85,,,0
CDM,30101453,Hc Mstu Bicarbonate Total (Tco2),9.0,5.85,,,0
CDM,30101454,Hc Mstu Basic Metabolic Panel Calcium Ionized,63.0,40.95,,,0
CDM,30101456,Hc Sodium Wb Cath Lab,9.0,5.85,,,0
CDM,30101457,Hc Abg With Direct O2 Saturation Cath Lab,111.0,72.15,,,0
CDM,30101458,Hc Potassium Whole Blood Cath Lab,9.0,5.85,,,0
CDM,30101459,Hc Glucose Quantitative Cath Lab,9.0,5.85,,,0
CDM,30101460,Hc Chloride Wb Cath Lab,9.0,5.85,,,0
CDM,30101461,Hc Calcium Ionized Wb  Cath Lab,69.0,44.85,,,0
CDM,30101462,Hc Lactic Acid Lactate Cath Lab,79.0,51.35,,,0
CDM,30101463,Hc Carboxyhemoglobin Cath Lab,115.0,74.75,,,0
CDM,30101464,Hc Methemoglobin Quantitative Cath Lab,67.0,43.55,,,0
CDM,30101465,Hc Sodium Wb Perfusion,9.0,5.85,,,0
CDM,30101466,Hc Abg With Direct O2 Saturation Perfusion,111.0,72.15,,,0
CDM,30101467,Hc Potassium Whole Blood Perfusion,9.0,5.85,,,0
CDM,30101468,Hc Glucose Quantitative Perfusion,9.0,5.85,,,0
CDM,30101469,Hc Chloride Wb Perfusion,9.0,5.85,,,0
CDM,30101470,Hc Calcium Ionized Wb Perfusion,69.0,44.85,,,0
CDM,30101471,Hc Lactic Acid Lactate Perfusion,79.0,51.35,,,0
CDM,30101472,Hc Carboxyhemoglobin Perfusion,115.0,74.75,,,0
CDM,30101473,Hc Methemoglobin Quantitative Perfusion,67.0,43.55,,,0
CDM,30101474,Hc Albumin Specials,10.0,6.5,,,0
CDM,30101476,Hc Adalimumab So,693.0,450.45,,,0
CDM,30101477,Hc Posaconazole So,196.0,127.4,,,0
CDM,30101478,Hc Infliximab So,495.0,321.75,,,0
CDM,30101479,Hc Lacosamide So,313.0,203.45,,,0
CDM,30101480,Hc Vedolizumab So,1154.0,750.1,,,0
CDM,30101481,Hc Voriconazole So,256.0,166.4,,,0
CDM,30101482,Hc Cytogenomic Neoplasia Microarray Analysis So,4577.0,2975.05,,,0
CDM,30101489,Hc Mycoplasma Genitalium Detection By Nucleic Acid Amplified Probe So,270.0,175.5,,,0
CDM,30101490,Hc O2 Saturation Direct Cath Lab,155.0,100.75,,,0
CDM,30101491,"Hc Fsed Basic Metabolic Panel Calcium, Ionized",63.0,40.95,,,0
CDM,30101492,Hc Enzyme Act Blood Cell Tiss Radact Substrate Ea So,574.0,373.1,,,0
CDM,30101493,Hc Ml Alcohol Biomarkers; 3+ So,21.0,13.65,,,0
CDM,30101494,Hc Ml Amphetamines; 3-4 So,21.0,13.65,,,0
CDM,30101495,Hc Ml Amphetamines; 5+ So,21.0,13.65,,,0
CDM,30101496,Hc Cytogenomic Neoplasia Microarray Analysis Ap So,6921.0,4498.65,,,0
CDM,30101497,Hc Opioid &Opiate Analog 5+ So,135.0,87.75,,,0
CDM,30101498,"Hc Ml Antidepressants, Serotonergic Class; 3-5 So",21.0,13.65,,,0
CDM,30101499,"Hc Ml Antidepressants, Tricyclic And Other Cyclicals; 3-5 So",21.0,13.65,,,0
CDM,30101500,Hc Ml Antipsychotics Nos; 4-6 So,21.0,13.65,,,0
CDM,30101501,Hc Ml Opiods And Opiate Analogs; 3-4 So,21.0,13.65,,,0
CDM,30101502,Hc Ml Opiods And Opiate Analogs; 5+ So,21.0,13.65,,,0
CDM,30101503,Hc Aldosterone,91.0,59.15,,,0
CDM,30101504,Hc Protein Electrophoresis So,75.0,48.75,,,0
CDM,30101505,Hc Drug Test Prsmv Chem Anlyzer Special So,870.0,565.5,,,0
CDM,30101506,Hc Wbc Antibody Identification So,208.0,135.2,,,0
CDM,30101507,Hc Drug Assay Acetaminophen,192.0,124.8,,,0
CDM,30101508,Hc Drug Assay Amiodarone So,65.0,42.25,,,0
CDM,30101509,"Hc Asy Carbamazepine; -10, 11-Epoxide So",69.0,44.85,,,0
CDM,30101510,Hc Drug Assay Felbamate So,116.0,75.4,,,0
CDM,30101511,Hc Drug Assay Salicylate,201.0,130.65,,,0
CDM,30101512,Hc Drug Assay Flecainide So,101.0,65.65,,,0
CDM,30101513,Hc Drug Assay Itraconazole So,132.0,85.8,,,0
CDM,30101514,Hc Drug Assay Leflunomide So,103.0,66.95,,,0
CDM,30101515,Hc Drug Assay Methotrexate,1600.0,1040.0,,,0
CDM,30101516,Hc Drug Assay Rufinamide So,132.0,85.8,,,0
CDM,30101517,"Hc Alcohol (Ethanol) Level, Except Urine And Breath",225.0,146.25,,,0
CDM,30101518,"Hc Estradiol Free, Direct Measure So",437.0,284.05,,,0
CDM,30101519,"Hc Estradiol Free, Direct Measure",779.0,506.35,,,0
CDM,30101520,Hc Fsed Electrolyte Panel,46.0,29.9,,,0
CDM,30101521,Hc Homocysteine So,84.0,54.6,,,0
CDM,30101522,Hc Organic Acids Total Quant Ea  Spec So,1134.0,737.1,,,0
CDM,30101523,Hc Prostaglandin Each Special So,1382.0,898.3,,,0
CDM,30101524,Hc Valproic Acid Total So,118.0,76.7,,,0
CDM,30101525,Hc Fsed Hepatic Function Panel,28.0,18.2,,,0
CDM,30101530,Hc Drug Assay Hydroxychloroquine So,727.0,472.55,,,0
CDM,30101531,Hc Elastase Pancreatic Fecal Quantitative So,317.0,206.05,,,0
CDM,30101532,Hc Immunoglobulin Light Chains Free Each So,210.0,136.5,,,0
CDM,30101533,Hc Immunoglobulin Light Chains Free Each,541.0,351.65,,,0
CDM,30101534,Hc Assay Of Interleukin-6 (Il-6) So,226.0,146.9,,,0
CDM,30101535,Hc Lactoferrin Fecal Quant So,654.0,425.1,,,0
CDM,30101536,Hc Manganese Special So,516.0,335.4,,,0
CDM,30101537,Hc Lipoprotein A So,55.0,35.75,,,0
CDM,30101538,Hc Tacrolimus,92.0,59.8,,,0
CDM,30101539,"Hc Hydroxyindolacetic Acid, 5-(Hiaa) Plasma So",1499.0,974.35,,,0
CDM,30101540,Hc Chromium Whole Blood Or Fluid So,970.0,630.5,,,0
CDM,30101541,Hc Enzyme Act Blood Cell Tiss Non Rad Nes Ea Special So,1080.0,702.0,,,0
CDM,30101542,Hc Cannabinoids Natural Serum So,771.0,501.15,,,0
CDM,30101543,Hc Mass Spect&Tandem Mass Spect Nondrg Anal Nes Ea So,913.0,593.45,,,0
CDM,30101544,Hc Prostaglndin Each Special So,954.0,620.1,,,0
CDM,30101545,Hc Mucopolysaccharides Acid Quant So,1426.0,926.9,,,0
CDM,30101546,Hc Thiopurine S-Methytransferase (Tpmt) So,415.0,269.75,,,0
CDM,30101547,Hc Calcium Total So,77.0,50.05,,,0
CDM,30101548,"Hc Angiotensin I-Converting Enzyme, Csf So",206.0,133.9,,,0
CDM,30101549,Hc Arsenic Special So,92.0,59.8,,,0
CDM,30101550,Hc Chemiluminescent Assay Special So,528.0,343.2,,,0
CDM,30101551,Hc Heavy Metal Quant Nes So,151.0,98.15,,,0
CDM,30101552,Hc Hexosaminidase Total Serum Special So,704.0,457.6,,,0
CDM,30101553,Hc Nephelometry Each Analyte Special So,150.0,97.5,,,0
CDM,30101554,Hc Pyruvic Acid Special So,191.0,124.15,,,0
CDM,30101555,Hc Hcg Quantitative Special So,591.0,384.15,,,0
CDM,30101556,Hc Desoxycorticosteroid So,71.0,46.15,,,0
CDM,30101557,Hc Ia Noninfectious Agent Special Facn1 So,495.0,321.75,,,0
CDM,30101558,Hc G6Pd Enzyme Quant Special Eeev1 So,602.0,391.3,,,0
CDM,30101559,Hc Pyruvate Kinase Special Eeev1 So,587.0,381.55,,,0
CDM,30101560,Hc Fatty Acids Nonesterified Special Fapep So,280.0,182.0,,,0
CDM,30101561,Hc Assay Anti-Mullerian Hormone So,169.0,109.85,,,0
CDM,30101562,Hc Amphetamines 3-4 So,62.0,40.3,,,0
CDM,30101563,Hc Oxycodone Special So,719.0,467.35,,,0
CDM,30101564,Hc Angiotensin Ii So,75.0,48.75,,,0
CDM,30101565,Hc Lidocaine,191.0,124.15,,,0
CDM,30101567,Hc Beta-Amyloid 1-42 (Abeta 42),878.0,570.7,,,0
CDM,30101569,Hc Tau Phosphorylated Ea,1500.0,975.0,,,0
CDM,30101570,Hc Total Tau,1500.0,975.0,,,0
CDM,30200001,Hc Febrile Agglutinin Each,74.0,48.1,,,0
CDM,30200006,Hc Antibody Identification Platelet Associated Igm So,170.0,110.5,,,0
CDM,30200007,Hc Antinuclear Abs (Ana),189.0,122.85,,,0
CDM,30200008,Hc Ana  Titer,194.0,126.1,,,0
CDM,30200009,Hc Antistreptolysin O Titer,32.0,20.8,,,0
CDM,30200011,Hc C Reactive Protein Crp,38.0,24.7,,,0
CDM,30200012,Hc C Reactive Protein Cardiac Risk,38.0,24.7,,,0
CDM,30200013,Hc Beta 2 Glycoprotein 1 Antibody Each So,71.0,46.15,,,0
CDM,30200014,Hc Cardiolipin Antibody Ea Ig Class,135.0,87.75,,,0
CDM,30200015,Hc Anti Phosphatidylserine Ab,587.0,381.55,,,0
CDM,30200016,Hc Cold Agglutinin Titer,80.0,52.0,,,0
CDM,30200017,Hc Complement Antigen Each Component,55.0,35.75,,,0
CDM,30200019,Hc Complement Ch50 Total So,60.0,39.0,,,0
CDM,30200020,Hc Complement Fixation Tests Ea Antigen So,221.0,143.65,,,0
CDM,30200021,Hc Ccp Antibody,162.0,105.3,,,0
CDM,30200022,Hc Dnase Antibody So,48.0,31.2,,,0
CDM,30200023,Hc Dna Double Strand Antibody Dna Ds,238.0,154.7,,,0
CDM,30200024,Hc Dna Antibody Single Stranded So,469.0,304.85,,,0
CDM,30200025,Hc Ena Antibody Each So,344.0,223.6,,,0
CDM,30200026,Hc Fluorescent Antibody Screen,236.0,153.4,,,0
CDM,30200027,Hc Fluorescent Antibody Titer So,210.0,136.5,,,0
CDM,30200029,Hc Ia For Tumor Antigen Quant Ca27.29,145.0,94.25,,,0
CDM,30200031,Hc Ca 125 So,39.0,25.35,,,0
CDM,30200032,Hc Human Epididymis Protein 4 He4 So,113.0,73.45,,,0
CDM,30200033,Hc Heterophile Antibodies Screen,181.0,117.65,,,0
CDM,30200034,Hc Heterophile Antibodies Titer,50.0,32.5,,,0
CDM,30200036,Hc Immunoassay Infect Agent Ab Quant Nos,223.0,144.95,,,0
CDM,30200041,Hc Immunodiffusion  Gel Dif Qual Ea Ag Antb,144.0,93.6,,,0
CDM,30200042,Hc Immune Complex Assay So,240.0,156.0,,,0
CDM,30200043,Hc Immunofixation Electrophoresis Serum Ife,320.0,208.0,,,0
CDM,30200044,Hc Immunofixation Electrophoresis Other Fluid Ife So,215.0,139.75,,,0
CDM,30200045,Hc Inhibin A So,78.0,50.7,,,0
CDM,30200046,Hc Insulin Antibody So,104.0,67.6,,,0
CDM,30200047,Hc Intrinsic Factor Antibody So,55.0,35.75,,,0
CDM,30200048,Hc Islet Cell Antibody So,84.0,54.6,,,0
CDM,30200050,Hc Cell Fxn Assay Stim And Detect Biomrkr So,1527.0,992.55,,,0
CDM,30200051,Hc Lymphocyte Mitogen Proliferation So,667.0,433.55,,,0
CDM,30200052,Hc B Cells Total Count,580.0,377.0,,,0
CDM,30200053,Hc Mononuclear Cell Ag Quant Nos Ea,276.0,179.4,,,0
CDM,30200054,Hc Natural Killer Cells Total Ct,579.0,376.35,,,0
CDM,30200055,Hc T Cells Total Count,645.0,419.25,,,0
CDM,30200056,Hc Cd4 And Cd8 Count W Ratio,467.0,303.55,,,0
CDM,30200057,Hc Cd4 Count,442.0,287.3,,,0
CDM,30200058,Hc Stem Cells Total Count Cd34 Auto Donor,365.0,237.25,,,0
CDM,30200059,Hc Microsomal Liver Or Kidney Antibody Each So,59.0,38.35,,,0
CDM,30200064,Hc Rheumatoid Factor Rf Quantitative,58.0,37.7,,,0
CDM,30200065,Hc M Tuberculosis By Quantiferon So,106.0,68.9,,,0
CDM,30200066,Hc T Spot Tb Screen So,194.0,126.1,,,0
CDM,30200067,Hc Skin Test Tb Intradermal  So,101.0,65.65,,,0
CDM,30200068,Hc Rpr Qualitative,12.0,7.8,,,0
CDM,30200069,Hc Rpr Quantitative,103.0,66.95,,,0
CDM,30200070,Hc Aspergillus Antibody,191.0,124.15,,,0
CDM,30200071,Hc Bacterium Antibody So,216.0,140.4,,,0
CDM,30200072,Hc Bartonella Antibody So,109.0,70.85,,,0
CDM,30200073,Hc Blastomyces Antibody,189.0,122.85,,,0
CDM,30200074,Hc Bordetella Antibody,468.0,304.2,,,0
CDM,30200075,Hc Lyme Disease Confirmation So,73.0,47.45,,,0
CDM,30200076,Hc Lyme Disease Antibody,190.0,123.5,,,0
CDM,30200079,Hc Campylobacter Jejuni Antibody,78.0,50.7,,,0
CDM,30200080,Hc Candida Antibody,244.0,158.6,,,0
CDM,30200082,Hc Chlamydia Igm So,113.0,73.45,,,0
CDM,30200083,Hc Coccidioides Antibody,200.0,130.0,,,0
CDM,30200084,Hc Q Fever Antibody So,164.0,106.6,,,0
CDM,30200085,Hc Cmv Antibody,189.0,122.85,,,0
CDM,30200086,Hc Cmv Antibody Igm,187.0,121.55,,,0
CDM,30200087,Hc Diphtheria Antibody,145.0,94.25,,,0
CDM,30200088,Hc Encephalitis California Antibody So,67.0,43.55,,,0
CDM,30200089,Hc Encephalitis Eastern Equine Antib So,146.0,94.9,,,0
CDM,30200090,Hc St Louis Encephalitis Antibody So,67.0,43.55,,,0
CDM,30200091,Hc Encephalitis Western Equine Antib So,170.0,110.5,,,0
CDM,30200092,Hc Enterovirus Antibody So,184.0,119.6,,,0
CDM,30200093,Hc Ebv Early Antigen,84.0,54.6,,,0
CDM,30200094,Hc Ebv Nuclear Antigen Ebna,164.0,106.6,,,0
CDM,30200095,Hc Ebv Viral Capsid Vca,100.0,65.0,,,0
CDM,30200096,Hc Ehrlichia Antibody So,116.0,75.4,,,0
CDM,30200097,Hc Fungus Antibody Nes So,67.0,43.55,,,0
CDM,30200098,Hc Giardia Antibody So,167.0,108.55,,,0
CDM,30200099,Hc Helicobacter Iga Igm So,88.0,57.2,,,0
CDM,30200101,Hc Haemophilus Influenza Antibody So,68.0,44.2,,,0
CDM,30200102,Hc Htlv 1 Antibody,88.0,57.2,,,0
CDM,30200104,Hc Hiv Or Htlv Antibody Confirm,230.0,149.5,,,0
CDM,30200105,Hc Hepatitis Delta Antibody So,200.0,130.0,,,0
CDM,30200108,Hc Herpes Simplex Type 2 Igg,102.0,66.3,,,0
CDM,30200109,Hc Histoplasma Antibody,142.0,92.3,,,0
CDM,30200110,Hc Hiv 2 Antibody So,104.0,67.6,,,0
CDM,30200111,Hc Hiv 1 And 2 Single Result,38.0,24.7,,,0
CDM,30200112,Hc Hepatitis B Core Total Antibody,88.0,57.2,,,0
CDM,30200113,Hc Hepatitis B Core Igm,94.0,61.1,,,0
CDM,30200114,Hc Hepatitis B Surface Antibody,72.0,46.8,,,0
CDM,30200115,Hc Hepatitis Be Antibody So,37.0,24.05,,,0
CDM,30200116,Hc Hepatitis A Total Antibody,71.0,46.15,,,0
CDM,30200117,Hc Hepatitis A Igm,76.0,49.4,,,0
CDM,30200118,Hc Influenza Antibodies So,83.0,53.95,,,0
CDM,30200119,Hc Legionella Antibody So,54.0,35.1,,,0
CDM,30200120,Hc Leishmania Antibody So,105.0,68.25,,,0
CDM,30200121,Hc Leptospira Antibody So,134.0,87.1,,,0
CDM,30200122,Hc Listeria Antibody,235.0,152.75,,,0
CDM,30200123,Hc Lymphocytic Choriomeningitis Antibody,305.0,198.25,,,0
CDM,30200124,Hc Mumps Antibodies So,56.0,36.4,,,0
CDM,30200126,Hc Parvovirus Antibody So,54.0,35.1,,,0
CDM,30200127,Hc Malaria Antibody Screen,36.0,23.4,,,0
CDM,30200130,Hc Rickettsia Antibody So,108.0,70.2,,,0
CDM,30200132,Hc Rubeola Antibody Igg,196.0,127.4,,,0
CDM,30200133,Hc Salmonella Antibody So,75.0,48.75,,,0
CDM,30200134,Hc Tetanus Antibody,145.0,94.25,,,0
CDM,30200135,Hc Toxoplasma Antibody,39.0,25.35,,,0
CDM,30200136,Hc Toxoplasma Igm Antibody,39.0,25.35,,,0
CDM,30200137,Hc Treponema Pallidum Antibody,35.0,22.75,,,0
CDM,30200138,Hc Trichinella Antibody So,165.0,107.25,,,0
CDM,30200139,Hc Varicella Zoster Igg Antibody,194.0,126.1,,,0
CDM,30200140,Hc West Nile Virus Antibody Igm So,142.0,92.3,,,0
CDM,30200141,Hc West Nile Virus Antibodies So,142.0,92.3,,,0
CDM,30200142,Hc Yersinia Antibody So,323.0,209.95,,,0
CDM,30200143,Hc Thyroglobulin Antibody Tbg Ab,126.0,81.9,,,0
CDM,30200146,Hc Crossmatch Platelet,1837.0,1194.05,,,0
CDM,30200148,Hc Hla Matched Product,191.0,124.15,,,0
CDM,30200153,Hc Antibody Elution Rbc Each Elution,1324.0,860.6,,,0
CDM,30200154,Hc Antibody Identification,764.0,496.6,,,0
CDM,30200156,Hc Ahg Indirect Qual Ea Rgt Red Cell,176.0,114.4,,,0
CDM,30200157,Hc Indirect Coombs Ea Antibody Titer,673.0,437.45,,,0
CDM,30200349,Hc Platelet Antibody So,84.0,54.6,,,0
CDM,30200350,Hc Platelet Antibody,722.0,469.3,,,0
CDM,30200355,Hc Complement Antigen Each Component So,108.0,70.2,,,0
CDM,30200367,Hc Complement Functional Activity Each So,272.0,176.8,,,0
CDM,30200371,Hc Ena Screen,183.0,118.95,,,0
CDM,30200377,Hc Fluorescent Ab Scrn Ea Ab So,490.0,318.5,,,0
CDM,30200400,Hc Fluorescent Antibody Titer,223.0,144.95,,,0
CDM,30200409,Hc Ca 19 9,39.0,25.35,,,0
CDM,30200410,Hc Ca 19 9 Pancreatic Cyst Fluid So,43.0,27.95,,,0
CDM,30200418,Hc Immunodiffusion  Gel Dif Qual Ea Ag Antb So,253.0,164.45,,,0
CDM,30200428,Hc Thyroid Peroxidase Antibody Tpo,76.0,49.4,,,0
CDM,30200434,Hc Particle Agglutination Titer Ea Antibody So,206.0,133.9,,,0
CDM,30200435,Hc Rheumatoid Factor Rf Body Fluid So,40.0,26.0,,,0
CDM,30200436,Hc Rpr Vdrl So,12.0,7.8,,,0
CDM,30200438,Hc Vdrl Quantitative So,49.0,31.85,,,0
CDM,30200439,Hc Adenovirus Antibody,216.0,140.4,,,0
CDM,30200440,Hc Aspergillus Fumigatus Antbdy Igg So,81.0,52.65,,,0
CDM,30200443,Hc Lyme Disease Antibody So,68.0,44.2,,,0
CDM,30200452,Hc Chlamydia Antibody So,113.0,73.45,,,0
CDM,30200469,Hc Helicobacter Pylori Igg,165.0,107.25,,,0
CDM,30200485,Hc Herpes 1 Igg,102.0,66.3,,,0
CDM,30200486,Hc Histoplasma Mycelial Antibody So,81.0,52.65,,,0
CDM,30200492,Hc Mumps Antibody,199.0,129.35,,,0
CDM,30200494,Hc Mycoplasma Antibody So,86.0,55.9,,,0
CDM,30200495,Hc Mycoplasma Antibody Igm,185.0,120.25,,,0
CDM,30200501,Hc Rickettsia Antibody,114.0,74.1,,,0
CDM,30200505,Hc Rubella Antibody,36.0,23.4,,,0
CDM,30200508,Hc Rubeola Antibody So,54.0,35.1,,,0
CDM,30200510,Hc Treponema Pallidum Antibody So,103.0,66.95,,,0
CDM,30200515,Hc Varicella Zoster Igm Antibody So,54.0,35.1,,,0
CDM,30200518,Hc Virus Antibody Nes So,92.0,59.8,,,0
CDM,30200527,Hc Hepatitis C Antibody Screen,36.0,23.4,,,0
CDM,30200528,Hc Hla Typing B So,81.0,52.65,,,0
CDM,30200531,Hc Antibody Screen Rbc,59.0,38.35,,,0
CDM,30200536,Hc Direct Coombs Dat,200.0,130.0,,,0
CDM,30200539,Hc Indirect Coombs Ea Antibody Titer So,321.0,208.65,,,0
CDM,30200540,Hc C Difficile Toxin Assay A And B,192.0,124.8,,,0
CDM,30200542,Hc Cryptosporidium Antigen By Eia,204.0,132.6,,,0
CDM,30200544,Hc Giardia Antigen By Eia,207.0,134.55,,,0
CDM,30200545,Hc Entamoeba Histolytica Antgn Feces So,291.0,189.15,,,0
CDM,30200546,Hc H Pylori Antigen Stool So,170.0,110.5,,,0
CDM,30200547,Hc Hepatitis B Surface Antigen,31.0,20.15,,,0
CDM,30200548,Hc Iaad Ia Hepatitis B Surface Ag Neutralization So,135.0,87.75,,,0
CDM,30200549,Hc Hepatitis Be Antigen,49.0,31.85,,,0
CDM,30200550,Hc Hepatitis D Delta Antigen So,465.0,302.25,,,0
CDM,30200555,Hc Influenza A And B Antigen Screen,264.0,171.6,,,0
CDM,30200556,Hc Rotavirus Antigen Feces So,105.0,68.25,,,0
CDM,30200557,Hc Infectious Agent Antigen By Eia So,404.0,262.6,,,0
CDM,30200558,Hc Infectious Agent Antigen By Eia,308.0,200.2,,,0
CDM,30200565,Hc Hiv Antibody Hiv1 Hiv2,79.0,51.35,,,0
CDM,30200566,Hc Allergen Specific Igg Ea Allergen So,178.0,115.7,,,0
CDM,30200567,"Hc Allergen Specific Ige, Qt/Semi-Qt, Crude Allergen Extract, Each So",55.0,35.75,,,0
CDM,30200569,Hc Antinuclear Abs (Ana) So,101.0,65.65,,,0
CDM,30200577,Hc Immunofixation Electrophoresis Other Fluid Ife,380.0,247.0,,,0
CDM,30200579,Hc Particle Agglutination Screen So,118.0,76.7,,,0
CDM,30200594,Hc Immunoassay Tumor Antigen Quantitative So,54.0,35.1,,,0
CDM,30200595,Hc Immunoassay Infect Agent Ab Quant Nos So,94.0,61.1,,,0
CDM,30200596,Hc Neutralization Test Viral So,382.0,248.3,,,0
CDM,30200597,Hc Bordetella Antibody So,216.0,140.4,,,0
CDM,30200598,Hc Brucella Antibody Confirm So,121.0,78.65,,,0
CDM,30200599,Hc Coccidioides Antibody So,109.0,70.85,,,0
CDM,30200600,Hc Enterovirus Antibody So,184.0,119.6,,,0
CDM,30200602,Hc Helminth Antibody Nes So,121.0,78.65,,,0
CDM,30200603,Hc Hiv Or Htlv Antibody Confirm So,350.0,227.5,,,0
CDM,30200604,Hc Protozoa Antibody Nes So,132.0,85.8,,,0
CDM,30200606,Hc Histoplasma Antgn Quant Eia Mvist So,225.0,146.25,,,0
CDM,30200609,Hc Hiv-1/-2 Ags And Abs Single Result,90.0,58.5,,,0
CDM,30200611,Hc Hiv-1/-2 Ab Differentiation So,521.0,338.65,,,0
CDM,30200614,Hc Cell Enumeration And Id So,1584.0,1029.6,,,0
CDM,30200616,Hc Rheumatoid Factor Qualitative,50.0,32.5,,,0
CDM,30200617,Hc Influenza Antigen Immunoassay W Dir Optical Obs,101.0,65.65,,,0
CDM,30200620,Hc C Reactive Protein Crp So,30.0,19.5,,,0
CDM,30200621,Hc Fsed Heterophile Antibodies Screen,181.0,117.65,,,0
CDM,30200622,Hc Hiv 1 And 2 Single Result Rapid,38.0,24.7,,,0
CDM,30200623,Hc Herpes Simplex Antibody So,49.0,31.85,,,0
CDM,30200625,"Hc Antibody; Zika Virus, Igm So",299.0,194.35,,,0
CDM,30200627,"Hc Infectious Agent Detect By Nucleic Acid; Zika Virus, Amp Probe Technique So",811.0,527.15,,,0
CDM,30200628,"Hc Allergen Spec Ige, Qt/Semiqt, Recombinant/Purified Comp Ea So",15.0,9.75,,,0
CDM,30200629,Hc Zinc Transporter 8 (Znt8) Antibody So,1304.0,847.6,,,0
CDM,30200630,Hc Fluorescent Antibody Special So,1240.0,806.0,,,0
CDM,30200631,Hc Fluorescent Antibody Titer Special So,420.0,273.0,,,0
CDM,30200632,Hc Immune Complex Assay Special So,1268.0,824.2,,,0
CDM,30200642,Hc Natural Killer Cells Total Ct So,51.0,33.15,,,0
CDM,30200643,Hc T Cells Total Count So,51.0,33.15,,,0
CDM,30200644,Hc Cd4 And Cd8 Count W Ratio So,62.0,40.3,,,0
CDM,30200665,Hc Ena Antibodies Each So,55.0,35.75,,,0
CDM,30200666,Hc Fsed Influenza Antigen Immunoassay W Dir Optical Obs,201.0,130.65,,,0
CDM,30200667,Hc Blastomyces Antibody So,122.0,79.3,,,0
CDM,30200668,Hc Cancer Antigen 15-3 (Ca 15-3) So,53.0,34.45,,,0
CDM,30200669,Hc Dna Double Strand Antibody So,36.0,23.4,,,0
CDM,30200670,Hc Cardiolipin (Phospholipid) Antibody Ea Ig Class So,54.0,35.1,,,0
CDM,30200671,Hc Francisella Tularensis Antibody So,401.0,260.65,,,0
CDM,30200672,Hc Hiv-1/-2 Ags And Abs Single Result So,69.0,44.85,,,0
CDM,30200673,Hc Cmv Antibody So,407.0,264.55,,,0
CDM,30200674,Hc Sars-Cov-2 Covid-19 Antibody So,116.0,75.4,,,0
CDM,30200675,Hc Sars-Cov-2 Covid-19 Antibody,73.0,47.45,,,0
CDM,30200676,Hc Ana Titer So,27.0,17.55,,,0
CDM,30200680,Hc B Cells Total Count So,51.0,33.15,,,0
CDM,30200681,Hc Leukocyte Histamine Release Test Lhr So,446.0,289.9,,,0
CDM,30200682,Hc Rubella Antibody So,28.0,18.2,,,0
CDM,30200683,Hc Neutralizing Antibody Sars-Cov2 Titer So,810.0,526.5,,,0
CDM,30200684,Hc Actin Smooth Muscle Antibody Each So,45.0,29.25,,,0
CDM,30200685,Hc Actin Smooth Muscle Antibody Each,207.0,134.55,,,0
CDM,30200686,Hc Antineutrophil Cytoplasmic Antb Screen Ea Antb So,53.0,34.45,,,0
CDM,30200687,Hc Antineutrophil Cytoplasmic Antb Screen Ea Antb,220.0,143.0,,,0
CDM,30200688,Hc Antineutrophil Cytoplasmic Antb Titer Ea Antb So,55.0,35.75,,,0
CDM,30200689,Hc Antineutrophil Cytoplasmic Antb Titer Ea Antb,207.0,134.55,,,0
CDM,30200692,Hc Aquaporin-4 Antibody Flow Cytometry Each So,532.0,345.8,,,0
CDM,30200693,Hc Endomysial Antibody Each Immunoglobulin Class So,67.0,43.55,,,0
CDM,30200694,Hc Gliadin Antibody Each Immunoglobulin Class So,54.0,35.1,,,0
CDM,30200696,Hc Mog-Igg1 Antibody Cell-Based Imfluor Assay Each So,2052.0,1333.8,,,0
CDM,30200697,Hc Mog-Igg1 Antibody Flow Cytometry Each So,1283.0,833.95,,,0
CDM,30200698,Hc Tissue Transglutaminase Ea Immunoglobulin Class So,52.0,33.8,,,0
CDM,30200699,Hc Tissue Transglutaminase Ea Immunoglobulin Class,198.0,128.7,,,0
CDM,30200700,Hc Mitochondrial Antibody Each,220.0,143.0,,,0
CDM,30200701,Hc Voltage-Gated Calcium Channel Antibody Each So,690.0,448.5,,,0
CDM,30200702,Hc Culture Typing Id Bld Pthgn&Resist Typing 6+Trgt So,2342.0,1522.3,,,0
CDM,30200703,Hc Complement Functional Activity Each Special So,457.0,297.05,,,0
CDM,30200704,Hc Complement Antigen Each Component Special So,409.0,265.85,,,0
CDM,30200705,Hc Complement Ch50 Total Special So,861.0,559.65,,,0
CDM,30200706,Hc Culture Typing Id Bld Pthgn&Resist Typing 6+Trgt,882.0,573.3,,,0
CDM,30200707,Hc Leukocyte Histamine Release So,401.0,260.65,,,0
CDM,30200708,Hc Antibody Hla Class I High Definition Panel Qual So,1125.0,731.25,,,0
CDM,30200709,Hc Antibody Hla Class Ii High Definition Panel Qual So,1125.0,731.25,,,0
CDM,30200710,Hc Complement Ch50 Total Special So,775.0,503.75,,,0
CDM,30200711,Hc Complement Antigen Each Component Special So,409.0,265.85,,,0
CDM,30200712,Hc Toxoplasma Antibody Igg Special So,433.0,281.45,,,0
CDM,30200713,Hc Toxoplasma Antibody Igm Special So,424.0,275.6,,,0
CDM,30200714,Hc T Cells Total Count Bmt So,60.0,39.0,,,0
CDM,30200715,Hc Recipient Syphilis-Pk-Tp So,32.0,20.8,,,0
CDM,30200716,Hc Recipient Cytomegalovirus Antibody-Pk-Cmv So,35.0,22.75,,,0
CDM,30200717,Hc Recipient Htlv-I Antibody (Htlv-I)-Abbott So,32.0,20.8,,,0
CDM,30200718,Hc Recipient Htlv-Ii Antibody (Htlv-Ii)-Abbott So,32.0,20.8,,,0
CDM,30200719,Hc Recipient Hiv Antibody (Hiv-1/2/O) So,38.0,24.7,,,0
CDM,30200720,Hc Recipient Hepatitis B Core Antibody (Hbc)-Abbott So,45.0,29.25,,,0
CDM,30200721,Hc Recipient Chagas Tcruzi Ab So,56.0,36.4,,,0
CDM,30200722,Hc Recipient Hepatitis C Virus Antibody (Hcv)-Abbott So,36.0,23.4,,,0
CDM,30200723,Hc Recipient Hla Typing Lymphocyte Culture Mixed So,405.0,263.25,,,0
CDM,30200724,Hc Recipient Antibody Hla Class I & Class Ii Antigens Qual So,405.0,263.25,,,0
CDM,30200725,Hc Recipient Antibody Hla Class Ii Phenotype Panel Qual So,1125.0,731.25,,,0
CDM,30200726,Hc Antibody Hla Class I High Definition Panel Qual So,1125.0,731.25,,,0
CDM,30200727,Hc Recipient Antibody Hla Class Ii High Definition Panel Qual So,1125.0,731.25,,,0
CDM,30200728,Hc Recipient Hepatitis B Surface Antigen (Hbsag)-Abbott So,31.0,20.15,,,0
CDM,30200729,Hc Recipient Hiv Antibody (Hiv-1/2/O)-Abbott So,35.0,22.75,,,0
CDM,30200730,Hc Recipient Wnv Nat Idt-Roche So,44.0,28.6,,,0
CDM,30200731,Hc Recipient Hiv/Hcv/Hbv (Mpx) Nat Idt-Roche So,300.0,195.0,,,0
CDM,30200740,"Hc Allergen Specific Ige, Qt/Semi-Qt, Crude Extract Special, Each So",213.0,138.45,,,0
CDM,30200741,Hc Hep C Ab Test Confirm So,779.0,506.35,,,0
CDM,30200742,"Hc Allergen Spec Ige, Qt/Semiqt, Recombinant/Purified Comp Ea Special So",375.0,243.75,,,0
CDM,30200743,Hc Endomysial Antibody Each Immunoglobulin Class Special So,360.0,234.0,,,0
CDM,30200744,Hc Ena Antibodies Each Special So,1188.0,772.2,,,0
CDM,30200745,Hc Virus Antibody Nes Special So,516.0,335.4,,,0
CDM,30200746,Hc Inhibin A,47.0,30.55,,,0
CDM,30200747,Hc Hepatitis Be Antibody,41.0,26.65,,,0
CDM,30200748,Hc Immunoassay Tumor Antigen Quant Special So,564.0,366.6,,,0
CDM,30200749,Hc T Cells Total Count Bmt,328.0,213.2,,,0
CDM,30200750,Hc T Cells Total Count Special So,714.0,464.1,,,0
CDM,30200751,Hc Cd4 Count Special So,507.0,329.55,,,0
CDM,30200752,Hc Mononuclear Cell Ag Quant Nos Ea So,282.0,183.3,,,0
CDM,30200753,Hc Mononuclear Cell Ag Quant Nos Ea Special So,405.0,263.25,,,0
CDM,30200754,Hc Acetylcholine Receptor Binding Antibody So,100.0,65.0,,,0
CDM,30200755,Hc Acetylcholine Receptor Modulating Antibody So,225.0,146.25,,,0
CDM,30200756,Hc Muscle-Specific Kinase Antibody So,1650.0,1072.5,,,0
CDM,30200757,Hc M Tuberculosis By Quantiferon,212.0,137.8,,,0
CDM,30401440,Hc Cyp2D6 Full Gene Sequence So,3672.0,2386.8,,,0
CDM,30401441,Hc Cyp2D6 Gen Cyp2D6-2D7 Hybrid So,4982.0,3238.3,,,0
CDM,30401442,Hc Cyp2D6 Gen Cyp2D7-2D6 Hybrid So,5506.0,3578.9,,,0
CDM,30401443,Hc Cyp2D6 Nonduplicated Gene So,6294.0,4091.1,,,0
CDM,30401444,Hc Cyp2D6 5' Gene Dup/Mlt So,6818.0,4431.7,,,0
CDM,30401445,Hc Cyp2D6 3' Gene Dup/Mlt So,7342.0,4772.3,,,0
CDM,30401446,Hc Hpa 1 Genotyping Arc,160.0,104.0,,,0
CDM,30401447,Hc Hpa 15 Genotyping Arc,160.0,104.0,,,0
CDM,30401448,Hc Hpa 2 Genotyping Arc,160.0,104.0,,,0
CDM,30401449,Hc Hpa 3 Genotyping Arc,160.0,104.0,,,0
CDM,30401450,Hc Hpa 4 Genotyping Arc,160.0,104.0,,,0
CDM,30401451,Hc Hpa 5 Genotyping Arc,160.0,104.0,,,0
CDM,30401452,Hc Hpa 6 Genotyping Arc,160.0,104.0,,,0
CDM,30401453,Hc Hpa 9 Genotyping Arc,160.0,104.0,,,0
CDM,30401454,Hc Mopath Level 4 Arc,642.0,417.3,,,0
CDM,30500002,Hc Differential Manual,177.0,115.05,,,0
CDM,30500003,Hc Manual Smear Exam W/O Diff,159.0,103.35,,,0
CDM,30500005,Hc Hematocrit,9.0,5.85,,,0
CDM,30500006,Hc Hemoglobin,10.0,6.5,,,0
CDM,30500007,Hc Cbc With Diff,31.0,20.15,,,0
CDM,30500008,Hc Cbc Without Diff,28.0,18.2,,,0
CDM,30500009,Hc Cell Count Manual Each,109.0,70.85,,,0
CDM,30500012,Hc Reticulocyte Count,58.0,37.7,,,0
CDM,30500014,Hc Wbc Count Auto,48.0,31.2,,,0
CDM,30500015,Hc Platelet Count Auto,50.0,32.5,,,0
CDM,30500016,Hc Chromogenic Substrate Assay,120.0,78.0,,,0
CDM,30500018,Hc Factor 2 Clotting  Assay,1671.0,1086.15,,,0
CDM,30500019,Hc Factor 5 Clotting  Assay,1450.0,942.5,,,0
CDM,30500020,Hc Factor 7 Clotting  Assay,929.0,603.85,,,0
CDM,30500021,Hc Factor 8 Clotting  Assay,1345.0,874.25,,,0
CDM,30500023,Hc Ristocetin Cofactor So,112.0,72.8,,,0
CDM,30500024,Hc Factor 8 Vonwillebrand Antigen So,86.0,55.9,,,0
CDM,30500025,Hc Factor 8 Vonwillebrand Multimetric So,175.0,113.75,,,0
CDM,30500027,Hc Factor 10 Clotting Assay,1389.0,902.85,,,0
CDM,30500028,Hc Factor 11 Clotting Assay,1606.0,1043.9,,,0
CDM,30500029,Hc Factor 12 Clotting Assay,1671.0,1086.15,,,0
CDM,30500030,Hc Factor 13 Fibrin Stabilizing So,579.0,376.35,,,0
CDM,30500031,Hc Factor 13 Screen,1418.0,921.7,,,0
CDM,30500034,Hc Antithrombin At3,559.0,363.35,,,0
CDM,30500035,Hc Antithrombin Iii Antigen So,106.0,68.9,,,0
CDM,30500036,Hc Protein C Antigen,233.0,151.45,,,0
CDM,30500037,Hc Protein C Activity,1003.0,651.95,,,0
CDM,30500038,Hc Protein S Antigen Total,226.0,146.9,,,0
CDM,30500039,Hc Protein S Antigen Free Total,800.0,520.0,,,0
CDM,30500040,Hc Activated Protein C Resistance So,170.0,110.5,,,0
CDM,30500041,Hc Factor Inhibitor,1386.0,900.9,,,0
CDM,30500043,Hc Coag Time Activated Act,605.0,393.25,,,0
CDM,30500044,Hc Euglobulin Lysis,70.0,45.5,,,0
CDM,30500046,Hc D Dimer,185.0,120.25,,,0
CDM,30500047,Hc Fibrinogen,62.0,40.3,,,0
CDM,30500048,Hc Fibrinogen Antigen So,215.0,139.75,,,0
CDM,30500049,Hc Clotting Functional Activity Nos Each So,76.0,49.4,,,0
CDM,30500050,Hc Alpha 2 Antiplasmin So,165.0,107.25,,,0
CDM,30500051,Hc Plasminogen Activator So,474.0,308.1,,,0
CDM,30500052,Hc Plasminogen,832.0,540.8,,,0
CDM,30500053,Hc Heinz Bodies Direct So,67.0,43.55,,,0
CDM,30500054,Hc Kleihauer-Betke Fetal Hemoglobin,2074.0,1348.1,,,0
CDM,30500055,Hc Fetal Screen,687.0,446.55,,,0
CDM,30500057,Hc Heparin Assay,1661.0,1079.65,,,0
CDM,30500061,Hc Rbc Osmotic Frag Incubated,216.0,140.4,,,0
CDM,30500062,Hc Platelet Aggregation,592.0,384.8,,,0
CDM,30500063,Hc Phospholipid Neutralization Platelet So,494.0,321.1,,,0
CDM,30500064,Hc Phospholipid Neutralization Hexagonal,738.0,479.7,,,0
CDM,30500065,Hc Pt/Inr,36.0,23.4,,,0
CDM,30500066,Hc Pt Mixing Studies,1364.0,886.6,,,0
CDM,30500067,Hc Dilute Russell Viper Venom Drvvt,821.0,533.65,,,0
CDM,30500068,Hc Reptilase Time So,132.0,85.8,,,0
CDM,30500069,Hc Sed Rate Esr Non Automated,81.0,52.65,,,0
CDM,30500070,Hc Sed Rate Esr Automated,74.0,48.1,,,0
CDM,30500071,Hc Sickle Cell Screen,232.0,150.8,,,0
CDM,30500072,Hc Thrombin Time Plasma,132.0,85.8,,,0
CDM,30500074,Hc Aptt,59.0,38.35,,,0
CDM,30500075,Hc Ptt Mixing Studies,1166.0,757.9,,,0
CDM,30500077,Hc Immunochemical Fecal Occult Blood,83.0,53.95,,,0
CDM,30500081,Hc Hemoglobin Wb  Pulm,10.0,6.5,,,0
CDM,30500085,Hc Ristocetin Cofactor Assay,2929.0,1903.85,,,0
CDM,30500086,Hc Factor 9 Assay,1487.0,966.55,,,0
CDM,30500090,Hc Clotting Funct Activity Nos Ea,1408.0,915.2,,,0
CDM,30500107,Hc Hematocrit Amb,9.0,5.85,,,0
CDM,30500108,Hc Cbc With Diff Amb,31.0,20.15,,,0
CDM,30500114,Hc Factor Inhibitor So,937.0,609.05,,,0
CDM,30500119,Hc Hexagonal Phospholipid Neutraliza So,216.0,140.4,,,0
CDM,30500120,Hc Pt Inr Amb,36.0,23.4,,,0
CDM,30500122,Hc Immunochemical Fecal Occult Blood So,183.0,118.95,,,0
CDM,30500123,Hc Hematocrit Pulmonary,9.0,5.85,,,0
CDM,30500127,Hc Muramidase So,66.0,42.9,,,0
CDM,30500128,Hc Viscosity Serum So,82.0,53.3,,,0
CDM,30500129,Hc Fsed Hematocrit,9.0,5.85,,,0
CDM,30500130,Hc Fsed Cbc With Diff,31.0,20.15,,,0
CDM,30500131,Hc Fsed D Dimer,185.0,120.25,,,0
CDM,30500132,Hc Fsed Pt/Inr,36.0,23.4,,,0
CDM,30500133,Hc Fsed Cbc Without Diff,28.0,18.2,,,0
CDM,30500134,Hc Sickle Cell Screen So,99.0,64.35,,,0
CDM,30500137,Hc Chromogenic Substrate Assay So,858.0,557.7,,,0
CDM,30500138,Hc Mstu Inr,36.0,23.4,,,0
CDM,30500139,Hc Mstu Hematocrit,9.0,5.85,,,0
CDM,30500140,Hc Hemoglobin Wb  Cath Lab,10.0,6.5,,,0
CDM,30500141,Hc Hemoglobin Wb  Perfusion,10.0,6.5,,,0
CDM,30500142,Hc Antithrombin At3 So,107.0,69.55,,,0
CDM,30500143,Hc Protein C Activity So,125.0,81.25,,,0
CDM,30500144,Hc Dilute Russell Viper Venom Drvvt So,86.0,55.9,,,0
CDM,30500145,Hc Clotting Functional Activity Nos Each Special So,399.0,259.35,,,0
CDM,30500146,Hc Clotting Factor Viii Vw Factor Antigen Special So,3034.0,1972.1,,,0
CDM,30500147,Hc Preallikrein Assay So,625.0,406.25,,,0
CDM,30500148,Hc High Molecular Weight Kininogen Assay So,625.0,406.25,,,0
CDM,30600001,Hc Concentration Any Type For Inf Ag So,206.0,133.9,,,0
CDM,30600002,Hc Culture Blood Aerob Anaerob Pltlt,144.0,93.6,,,0
CDM,30600003,Hc Culture Stool Aerobic Ssyc,362.0,235.3,,,0
CDM,30600004,Hc Culture Stool Additional Pathogen,153.0,99.45,,,0
CDM,30600005,Hc Culture Aerobic,297.0,193.05,,,0
CDM,30600006,Hc Culture Bac Quantitative Aerobic,403.0,261.95,,,0
CDM,30600007,Hc Concentration Afb,129.0,83.85,,,0
CDM,30600008,Hc Malaria Thick Smear,129.0,83.85,,,0
CDM,30600010,Hc Culture Blood,243.0,157.95,,,0
CDM,30600045,Hc Culture Anaerobic,346.0,224.9,,,0
CDM,30600054,Hc Culture Anaerobic Id,374.0,243.1,,,0
CDM,30600055,Hc Organism Ref For Id Anaerobe So,114.0,74.1,,,0
CDM,30600058,Hc Bacterial Identification,186.0,120.9,,,0
CDM,30600059,Hc Organism Ref For Id Aerobe So,117.0,76.05,,,0
CDM,30600061,Hc Culture Presumptive Path Org Scrn,118.0,76.7,,,0
CDM,30600066,Hc Culture Presumptive Path Org Scrn So,156.0,101.4,,,0
CDM,30600071,Hc Culture Urine Aerobic Colony Count,209.0,135.85,,,0
CDM,30600072,Hc Cult Urine Isol Presump Id Each,81.0,52.65,,,0
CDM,30600073,Hc Culture Fungus Skin Hair Nails,581.0,377.65,,,0
CDM,30600074,Hc Culture Fungus Not Blood,473.0,307.45,,,0
CDM,30600089,Hc Culture Blood Fungus,491.0,319.15,,,0
CDM,30600090,Hc Culture Fungus Id Yeast,216.0,140.4,,,0
CDM,30600091,Hc Fungi Identification Mold So,147.0,95.55,,,0
CDM,30600092,Hc Culture Mycoplasma So,234.0,152.1,,,0
CDM,30600095,Hc Culture Chlamydia,385.0,250.25,,,0
CDM,30600096,Hc Culture Afb Tb,480.0,312.0,,,0
CDM,30600121,Hc Culture Mycobacteria Id,361.0,234.65,,,0
CDM,30600122,Hc Culture Type By Ifa Each,207.0,134.55,,,0
CDM,30600124,Hc Culture Typing Serologic,151.0,98.15,,,0
CDM,30600126,Hc Culture Typing Nuc Acid Probe,265.0,172.25,,,0
CDM,30600130,Hc Arthropod Exam,183.0,118.95,,,0
CDM,30600131,Hc Worm Exam,162.0,105.3,,,0
CDM,30600132,Hc Pinworm Prep Rectum,171.0,111.15,,,0
CDM,30600133,Hc Homogenization Tissue For Culture,209.0,135.85,,,0
CDM,30600134,Hc Ova & Parasite O And P Stool,462.0,300.3,,,0
CDM,30600135,Hc Susceptibility Anaerobic Mic So,102.0,66.3,,,0
CDM,30600137,Hc Susceptibility Study E Test,145.0,94.25,,,0
CDM,30600140,Hc Susceptibility Study Enzyme Det,67.0,43.55,,,0
CDM,30600142,Hc Sensitivity Mic,159.0,103.35,,,0
CDM,30600143,Hc Susceptibility Aerobic Mic So,348.0,226.2,,,0
CDM,30600148,Hc Susceptibility Mtb Complex So,625.0,406.25,,,0
CDM,30600152,Hc Gram Stain Smear Only,162.0,105.3,,,0
CDM,30600153,Hc Smear Fluorescent Acid Stain,215.0,139.75,,,0
CDM,30600159,Hc Smear Spec Stain Bodies Parasites,186.0,120.9,,,0
CDM,30600161,Hc Stain For Inclusion Bodies Parasites So,643.0,417.95,,,0
CDM,30600162,Hc Smr Prim Src Cplx Spec Stain So,207.0,134.55,,,0
CDM,30600163,Hc Trichrome Stain,294.0,191.1,,,0
CDM,30600165,Hc Smear Wet Preparation,198.0,128.7,,,0
CDM,30600169,Hc T Culture Addl Studies By Ifa,209.0,135.85,,,0
CDM,30600170,Hc Culture Viral Comprehensive So,57.0,37.05,,,0
CDM,30600172,Hc Virus Isol Shell Vial Ea,60.0,39.0,,,0
CDM,30600173,Hc Culture Viral Hsv,356.0,231.4,,,0
CDM,30600174,Hc Adenovirus Antigen,139.0,90.35,,,0
CDM,30600177,Hc Legionella Dfa,178.0,115.7,,,0
CDM,30600179,Hc Rsv Antigen Dfa,349.0,226.85,,,0
CDM,30600180,Hc Pneumocystis Dfa Bronchial,386.0,250.9,,,0
CDM,30600184,Hc Rsv Antigen,106.0,68.9,,,0
CDM,30600187,Hc Bartonella By Pcr,276.0,179.4,,,0
CDM,30600189,Hc Lyme Disease By Pcr So,247.0,160.55,,,0
CDM,30600190,Hc Candida Species Direct Probe,163.0,105.95,,,0
CDM,30600191,Hc Chlamydia Pneumoniae Amp Probe,952.0,618.8,,,0
CDM,30600192,Hc Dna Probe Chlamydia,57.0,37.05,,,0
CDM,30600196,Hc Rna Probe Amplified Chlamydia,91.0,59.15,,,0
CDM,30600197,Hc C Difficile Toxin Gene Pcr,229.0,148.85,,,0
CDM,30600198,Hc C Difficile Toxin Pcr,229.0,148.85,,,0
CDM,30600199,Hc Cmv Amplified Probe So,180.0,117.0,,,0
CDM,30600200,Hc Cmv By Pcr Quant So,186.0,120.9,,,0
CDM,30600205,Hc Influenza Rna Amp Probe,409.0,265.85,,,0
CDM,30600206,Hc Influenza Dna Amp Probe Addl,99.0,64.35,,,0
CDM,30600207,Hc Gardnerella Vaginalis Direct Prob,163.0,105.95,,,0
CDM,30600209,Hc Hepatitis B Viral Dna So,255.0,165.75,,,0
CDM,30600214,Hc Hcv Virus Quantitation,1261.0,819.65,,,0
CDM,30600220,Hc Herpes Simplex Virus By Pcr,409.0,265.85,,,0
CDM,30600221,Hc Human Herpes Virus-6 Hhv 6 Pcr So,225.0,146.25,,,0
CDM,30600222,Hc Hiv Amplified Probe,189.0,122.85,,,0
CDM,30600223,Hc Hiv-1 Quant And Reverse Transcription So,255.0,165.75,,,0
CDM,30600224,Hc Hiv 1 Virus Quantitation,1116.0,725.4,,,0
CDM,30600225,Hc Hiv 2 Amplified Probe,601.0,390.65,,,0
CDM,30600226,Hc Tuberculosis By Pcr So,435.0,282.75,,,0
CDM,30600227,Hc Mycoplasma Pneumoniae By Pcr,477.0,310.05,,,0
CDM,30600228,Hc Dna Probe Gonorrhoeae Gc,287.0,186.55,,,0
CDM,30600230,Hc Rna Probe Amplified Gonorrhoeae,91.0,59.15,,,0
CDM,30600232,Hc Hpv Types 16 And 18 Only,101.0,65.65,,,0
CDM,30600235,Hc Mrsa Screen  Probe,627.0,407.55,,,0
CDM,30600236,Hc Streptococcus Grp A Direct Probe,332.0,215.8,,,0
CDM,30600238,Hc Trichomonas Vaginalis Direct Prob,163.0,105.95,,,0
CDM,30600243,Hc Infectious Agent Det Amplified Probe So,790.0,513.5,,,0
CDM,30600248,Hc Infectious Agent Det Amplified Probe,463.0,300.95,,,0
CDM,30600257,Hc Infectious Agent Quant Dir Probe So,320.0,208.0,,,0
CDM,30600259,Hc Dna/Rna; Multi Org-Amp Pr,298.0,193.7,,,0
CDM,30600262,Hc Rapid Strep Antigen Grp A Throat,88.0,57.2,,,0
CDM,30600268,Hc Inf Agnt Drg Sscep Phen Pred Bioi So,759.0,493.35,,,0
CDM,30600269,Hc Genotype Hiv Reverse T So,1497.0,973.05,,,0
CDM,30600271,Hc Infct Phentyp Resist Tiss Cul Hiv 1St 1 To 10 Drugs So,2839.0,1845.35,,,0
CDM,30600272,Hc Infct Phentyp Resist Tiss Cul Hiv Ea Addl Drug So,151.0,98.15,,,0
CDM,30600276,Hc M Tuberculosis Amplified Probe,543.0,352.95,,,0
CDM,30600277,Hc Resp Virus 3 To 5 Targets,536.0,348.4,,,0
CDM,30600278,Hc Genotype Dna Or Rna Hiv So,1328.0,863.2,,,0
CDM,30600279,Hc Enterovirus By Pcr Amplified Prob So,121.0,78.65,,,0
CDM,30600280,Hc Influenza Dna Or  Rna Amp Probe,409.0,265.85,,,0
CDM,30600283,Hc Strep Group B By Pcr Amp Probe,356.0,231.4,,,0
CDM,30600286,Hc Inf Agnt Det Optical Obs Nos,233.0,151.45,,,0
CDM,30600289,Hc Aspergillus Antigen So,150.0,97.5,,,0
CDM,30600290,Hc Hsv By Pcr So,131.0,85.15,,,0
CDM,30600291,Hc Hpv Probe High Risk Types So,173.0,112.45,,,0
CDM,30600293,Hc Inf Agt Det By Nuc Acid Amp Pr So,374.0,243.1,,,0
CDM,30600294,Hc Trichomonas Vaginalis Amplif So,150.0,97.5,,,0
CDM,30600295,Hc Susceptibility Study Enzyme Det So,78.0,50.7,,,0
CDM,30600296,Hc Susceptibility Mic Each Per Plate So,503.0,326.95,,,0
CDM,30600297,Hc Chlamydia Trachomatis Amplified Rna So,91.0,59.15,,,0
CDM,30600298,Hc Neisseria Gonnorrhoeae Amplified Rna So,91.0,59.15,,,0
CDM,30600299,Hc Resp Virus 6 To 11 Targets So,468.0,304.2,,,0
CDM,30600300,Hc Hcv Viral Rna Drug Resistance So,387.0,251.55,,,0
CDM,30600301,Hc Culture Typing Nuc Acid Probe Amp Panel,98.0,63.7,,,0
CDM,30600302,Hc Infectious Agent Det Amp Probe Panel,107.0,69.55,,,0
CDM,30600303,Hc Strep Group B Amp Probe Panel,356.0,231.4,,,0
CDM,30600304,Hc Cmv Amp Probe Panel,135.0,87.75,,,0
CDM,30600305,Hc Enterovirus Amp Probe Panel,107.0,69.55,,,0
CDM,30600306,Hc Human Herpes Virus-6 Amp Probe Panel,107.0,69.55,,,0
CDM,30600307,Hc Hsv Amp Probe Panel,107.0,69.55,,,0
CDM,30600308,Hc Iadna-Dna/Rna Gi Pthgn Multiplex Probe Tq 12-25,1324.0,860.6,,,0
CDM,30600309,Hc Iadna Respiratry Probe & Rev Trnscr 12-25 Target,940.0,611.0,,,0
CDM,30600310,Hc Chylmd Pneum Dna Amp Probe So,59.0,38.35,,,0
CDM,30600311,Hc Myco Pneumon Dna Amp Probe So,59.0,38.35,,,0
CDM,30600312,Hc Trichomonas Vaginalis Amplified Probe,96.0,62.4,,,0
CDM,30600313,Hc Iadna-Dna/Rna Gi Pthgn Multiplex Probe Tq 12-25 So,900.0,585.0,,,0
CDM,30600314,Hc Cns Dna Amp Probe Type 12-25,1520.0,988.0,,,0
CDM,30600315,Hc Nfct Agent Dna/Rna Gastrointestinal Pathogen So,228.0,148.2,,,0
CDM,30600316,Hc Fsed Influenza Dna Amp Probe,409.0,265.85,,,0
CDM,30600317,Hc Fsed Rsv Antigen Nasal Swab,545.0,354.25,,,0
CDM,30600318,Hc Fsed Trichomonas,32.0,20.8,,,0
CDM,30600319,Hc Fsed Rapid Strep Antigen Grp A Throat,88.0,57.2,,,0
CDM,30600320,Hc Genotype Dna Hepatitis B So,1425.0,926.25,,,0
CDM,30600321,Hc Ova And Parasites Smears So,53.0,34.45,,,0
CDM,30600322,Hc Iadna Candida Species Amp Probe,168.0,109.2,,,0
CDM,30600323,Hc Inf Agnt Det Optical Obs Nos Rapid,34.0,22.1,,,0
CDM,30600324,Hc Smear Spec Stain Bodies Parasites Blood,220.0,143.0,,,0
CDM,30600328,Hc Iadna Herpes Virus 6 Quant So,2038.0,1324.7,,,0
CDM,30600329,Hc Smear Wet Preparation So,296.0,192.4,,,0
CDM,30600330,Hc Cultyp Nuc Acid Amp Prb Cult/Isolate Ea Orgnism So,236.0,153.4,,,0
CDM,30600331,Hc Streptococcus Group A Amplified Probe,192.0,124.8,,,0
CDM,30600332,Hc Culture Fungus Not Blood So,158.0,102.7,,,0
CDM,30600333,Hc Culture Stool Additional Pathogen So,120.0,78.0,,,0
CDM,30600334,Hc Culture Stool Aerobic Ssyc So,53.0,34.45,,,0
CDM,30600335,Hc Strep A Amplif Na Probe,192.0,124.8,,,0
CDM,30600336,Hc Rsv Dna/Rna Amp Probe,215.0,139.75,,,0
CDM,30600337,Hc Hepatitis C Quant And Reverse Transcription So,270.0,175.5,,,0
CDM,30600338,Hc Sarscov2 And Flu A/B Amp Probe,355.0,230.75,,,0
CDM,30600339,Hc Sarscov2 And Flu A/B And Rsv Amp Probe,355.0,230.75,,,0
CDM,30600340,Hc Inf Agt Det By Nuc Acid Amp Pr Special So,1100.0,715.0,,,0
CDM,30600341,Hc Sars-Cov2 And Flu A/B Amp Probe,355.0,230.75,,,0
CDM,30600342,Hc Sars-Cov2 And Flu A/B Amp Probe So,429.0,278.85,,,0
CDM,30600343,Hc Fsed Strep Group A Amplified Probe,192.0,124.8,,,0
CDM,30600344,Hc Staph Aureus Dna Amp Probe So,474.0,308.1,,,0
CDM,30600345,Hc Amplif Na Probe Nos Agent So,127.0,82.55,,,0
CDM,30600346,Hc Mycobacteria Dna Amp Probe So,977.0,635.05,,,0
CDM,30600349,Hc Iadna-Dna/Rna Gi Pthgn Multiplex Probe Tq 6-11,1324.0,860.6,,,0
CDM,30600350,Hc C Diff Amplified Probe So,177.0,115.05,,,0
CDM,30600351,Hc Hearing Loss Dup/Del Analysis So,2466.0,1602.9,,,0
CDM,30600352,"Hc Bacterial Culture, Cell Product",144.0,93.6,,,0
CDM,30600353,"Hc Donor Culture Bacterial Aerobic (Excp Urn Bld Stool), Cell Product",87.0,56.55,,,0
CDM,30600354,"Hc Aerobic Definitive Identification Each, Cell Product",58.0,37.7,,,0
CDM,30600355,"Hc Donor Immunologic Serotyping Each, Cell Product",45.0,29.25,,,0
CDM,30600356,"Hc Cultyp Nuc Acid Amp Prb Cult/Isolate Ea Organism, Cell Product",98.0,63.7,,,0
CDM,30600357,"Hc Microbe Susceptibility E-Test Each, Cell Product",45.0,29.25,,,0
CDM,30600358,"Hc Microbe Enzyme Detection Each, Cell Product",54.0,35.1,,,0
CDM,30600359,"Hc Microbe Suseptibility Mic Each, Cell Product",75.0,48.75,,,0
CDM,30600360,Hc Infectious Agent Quant Dir Probe Special So,946.0,614.9,,,0
CDM,30600361,"Hc Inf Agt Det; Orthopoxvirus (Monkeypox, Cowpox, Vaccinia) By Amp Probe So",288.0,187.2,,,0
CDM,30600362,Hc Toxin Or Antitoxin Assay Tissue Culture So,129.0,83.85,,,0
CDM,30600363,"Hc Hepatitis B Surface Antigen, Quant So",751.0,488.15,,,0
CDM,30600364,"Hc Infect Agent Detect Nuc Acid (Dnr/Rna); Anaplasma Phagocytophilim, Amp Probe So",51.0,33.15,,,0
CDM,30600365,"Hc Infect Agent Detect Nuc Acid (Dnr/Rna); Babesia Microti, Amp Probe So",165.0,107.25,,,0
CDM,30600366,"Hc Infect Agent Detect Nuc Acid (Dnr/Rna); Borrelia Miyamotoi, Amp Probe So",1298.0,843.7,,,0
CDM,30600367,"Hc Infect Agent Detect Nuc Acid (Dnr/Rna); Ehrlichia Chaffeensis, Amp Probe So",51.0,33.15,,,0
CDM,30600368,Hc Nfct Agt Genotype Alys Nucleic Acid Cmv So,2040.0,1326.0,,,0
CDM,30600369,Hc Protein S Antigen Free Total So,138.0,89.7,,,0
CDM,30600370,Hc Culture Mycobacteria Id So,181.0,117.65,,,0
CDM,30600371,Hc Organism Ref For Id Anaerobe Special So,300.0,195.0,,,0
CDM,30600372,"Hc C Difficille Toxin Pcr, Fecal So",1724.0,1120.6,,,0
CDM,30600373,Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method St,259.0,168.35,,,0
CDM,30600374,Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method So,259.0,168.35,,,0
CDM,30600375,Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method Mb,259.0,168.35,,,0
CDM,30600377,Hc Biofire Joint Panel,750.0,487.5,,,0
CDM,30600378,Hc Inf Agt Det By Nuc Acid Amp Pr Metagenomic Ngs So,9000.0,5850.0,,,0
CDM,30600379,Hc H Pylri Clrthmcn Rst Amp Prb,228.0,148.2,,,0
CDM,30600380,Hc Mtb Rifampin Rst Amp Prb Tq,463.0,300.95,,,0
CDM,30600382,Hc Hpv Sep Hi-Rsk Typ&Pool Rslt,101.0,65.65,,,0
CDM,30700002,Hc Urinalysis Automated,12.0,7.8,,,0
CDM,30700003,Hc Urinalysis Nonauto Wo Micro,115.0,74.75,,,0
CDM,30700006,Hc Urinalysis Microscopic Only,92.0,59.8,,,0
CDM,30700007,Hc Urine Pregnancy Visual,128.0,83.2,,,0
CDM,30700016,Hc Urine Analysis Dipstick Automated,62.0,40.3,,,0
CDM,30700018,Hc Urine Analysis Dipstick Auto Amb,50.0,32.5,,,0
CDM,30700019,Hc Urine Pregnancy Visual Amb,70.0,45.5,,,0
CDM,30700020,Hc Fsed Urine Analysis Dipstick Automated,62.0,40.3,,,0
CDM,31000001,Hc Cytopath Fluid Smear,292.0,189.8,,,0
CDM,31000003,Hc Cytopath Concentration,467.0,303.55,,,0
CDM,31000004,Hc Cytopath Selective Concentration,452.0,293.8,,,0
CDM,31000005,Hc Cyp Fish Urinary Morh Ea Manual So,794.0,516.1,,,0
CDM,31000006,Hc Cytopath Smear S P Imprint,918.0,596.7,,,0
CDM,31000008,Hc Tiss Cul Non Neo Disorders Lymphocyte So,3268.0,2124.2,,,0
CDM,31000009,Hc Chromosome Analysis Tissue So,3422.0,2224.3,,,0
CDM,31000011,Hc Tiss Cul Non Neo Disorders Amnio/Chornc Cells So,3436.0,2233.4,,,0
CDM,31000016,Hc Tiss Cul Neo Disorders Blood Or Bone Marrow So,1353.0,879.45,,,0
CDM,31000017,Hc Tiss Cul Neo Disorders Solid Tumor So,2611.0,1697.15,,,0
CDM,31000018,Hc Cell Cryoprsrv Frzing/Storage Ea Cell Line So,251.0,163.15,,,0
CDM,31000020,Hc Chrmsm Anlys 5 Cls 1 Krytyp W/Bnd So,1885.0,1225.25,,,0
CDM,31000022,Hc Cytogenetics Blood Peripheral So,642.0,417.3,,,0
CDM,31000024,Hc Chromosome Analysis 20 To 25 Cells So,642.0,417.3,,,0
CDM,31000025,Hc Chromosome Count Amnio Cv 15 Cells 1 Karyotype So,2124.0,1380.6,,,0
CDM,31000027,Hc Chrmsm Situ Amnio Cll 6 To 12 Colonies 1 Karytyp So,642.0,417.3,,,0
CDM,31000028,Hc Mol Cyto Dna Fish Probe Ea  So,313.0,203.45,,,0
CDM,31000029,Hc Mol Cyto In Situ 10 To 30 Cells So,108.0,70.2,,,0
CDM,31000030,Hc Mol Cyto In Situ 25 To 99 Cells So,110.0,71.5,,,0
CDM,31000031,Hc Mol Cyto In Situ 100 To 300 Cells So,163.0,105.95,,,0
CDM,31000032,Hc Chrom Addl Karyotyp Each Study So,37.0,24.05,,,0
CDM,31000033,Hc Chrom Anlys Addl Cell Ct  Ea Stdy So,275.0,178.75,,,0
CDM,31000034,Hc Chrom Analysis Add Hi Res Study So,558.0,362.7,,,0
CDM,31000037,Hc Gross Only Level I  1 Spec,253.0,164.45,,,0
CDM,31000039,Hc Gross And Micro Level Ii,520.0,338.0,,,0
CDM,31000042,Hc Gross And Micro Level Iii,603.0,391.95,,,0
CDM,31000046,Hc Gross And Micro Level Iv,707.0,459.55,,,0
CDM,31000056,Hc Gross And Micro Level V,885.0,575.25,,,0
CDM,31000061,Hc Mineralized Bone Histo Uk So,885.0,575.25,,,0
CDM,31000062,Hc Gross And Micro Level Vi,1130.0,734.5,,,0
CDM,31000065,Hc Decalcification,234.0,152.1,,,0
CDM,31000066,Hc Special Stain I,534.0,347.1,,,0
CDM,31000069,Hc Special Stain Group Ii So,292.0,189.8,,,0
CDM,31000070,Hc Special Stain Ii,541.0,351.65,,,0
CDM,31000074,Hc Histochem Stain W Frozen Section So,235.0,152.75,,,0
CDM,31000080,Hc Enzyme Histochemistry,785.0,510.25,,,0
CDM,31000081,Hc Histochemistry Enzyme Stain,785.0,510.25,,,0
CDM,31000084,Hc Consult Path Requiring Prep,416.0,270.4,,,0
CDM,31000087,Hc Consult Path Review And Report,273.0,177.45,,,0
CDM,31000088,Hc Consult Path Surgery,245.0,159.25,,,0
CDM,31000089,Hc Consult Path Surgery W Frozen,801.0,520.65,,,0
CDM,31000090,Hc Consult Path Surgery Each Addl,453.0,294.45,,,0
CDM,31000091,Hc Consult Path Surg Imprint Initial,695.0,451.75,,,0
CDM,31000092,Hc Consult Path Surg Imprint Addl,325.0,211.25,,,0
CDM,31000095,Hc Immunocytochemistry Antibody Stain So,202.0,131.3,,,0
CDM,31000096,Hc Immunofluorescent Study Ea Ab Dir,309.0,200.85,,,0
CDM,31000097,Hc Immunofluorescent Study Ea Ab Dir So,309.0,200.85,,,0
CDM,31000101,Hc Electron Microscopy Diagnostic So,1734.0,1127.1,,,0
CDM,31000102,Hc Morph Anyls Tumor Ihc Manual,1055.0,685.75,,,0
CDM,31000104,Hc In Situ Hybridization 1St Probe Stain,302.0,196.3,,,0
CDM,31000106,Hc In Situ Hybridization 1St Probe Stain So,302.0,196.3,,,0
CDM,31000107,Hc Morph Anlys Ish Comp Assist 1St Probe Stain So,1103.0,716.95,,,0
CDM,31000109,Hc Morph Anlys Ish Manual 1St Probe Stain,1100.0,715.0,,,0
CDM,31000113,Hc Microdissection Laser Capture,2719.0,1767.35,,,0
CDM,31000114,Hc Microdissection Manual,2319.0,1507.35,,,0
CDM,31000119,"Hc Prostate Biopsy, Any Method",707.0,459.55,,,0
CDM,31000124,Hc Immunocytochemistry Antibody Stain,330.0,214.5,,,0
CDM,31000130,Hc Ihc Or Icc Ea Addl Antibody Slide,330.0,214.5,,,0
CDM,31000131,Hc Ihc Or Icc Ea Multi Antibody Slide,330.0,214.5,,,0
CDM,31000132,Hc In Situ Hybrid Ea Add Probe Stain So,302.0,196.3,,,0
CDM,31000134,Hc Mrph Alys Ish Quant Semiq Comp Addl So,1103.0,716.95,,,0
CDM,31000135,Hc Mrph Alys Ish Quant Semiq Comp Mpx So,2205.0,1433.25,,,0
CDM,31000136,Hc Mrph Alys Ish Quant Semiq Man Addl So,1100.0,715.0,,,0
CDM,31000137,Hc Mrph Alys Ish Quant Semiq Man Multi So,2198.0,1428.7,,,0
CDM,31000139,Hc Immunofluorescence Ea Addl Sgl Ab Stain,178.0,115.7,,,0
CDM,31000140,Hc Immunofluorescence Ea Addl Sgl Ab Stain So,178.0,115.7,,,0
CDM,31000141,Hc Chrsme Anlys Addl Specialized Banding So,118.0,76.7,,,0
CDM,31000142,Hc Morph Anyls Tumor Ihc Manual So,578.0,375.7,,,0
CDM,31000143,Hc Microdissection Manual So,202.0,131.3,,,0
CDM,31000144,Hc Mol Cyto Dna Fish Probe Ea  So,557.0,362.05,,,0
CDM,31000146,Hc Ish 1St Probe Stain So,1042.0,677.3,,,0
CDM,31000147,Hc Ish Ea Add Probe Stain So,803.0,521.95,,,0
CDM,31000148,Hc Tiss Cul Neo Disorders Bone Marrow Blood Cells Mayo So,917.0,596.05,,,0
CDM,31000149,Hc Mrph Alys Ish Quant Semiq Man Ea Multiprb So,1382.0,898.3,,,0
CDM,31000150,Hc Gross And Micro Level Iv So,817.0,531.05,,,0
CDM,31000151,Hc Ihc Or Icc Ea Addl Antibody Slide So,351.0,228.15,,,0
CDM,31000152,Hc M-Protein Isotype Maldi-Tof Ms So,1573.0,1022.45,,,0
CDM,31000153,Hc Merkel Smt Oncoprotein Antibody Titer So,1645.0,1069.25,,,0
CDM,31000154,Hc Merkel Virus Vp1 Capsid Antibody So,1488.0,967.2,,,0
CDM,31000159,Hc Ntrk Translocation Analysis So,4504.0,2927.6,,,0
CDM,31000163,Hc Cacna1A Gen Detc Abnor Allel So,1506.0,978.9,,,0
CDM,31000164,Hc Cryopreserve & Store Auto Stem Cells For Transplant,2658.0,1727.7,,,0
CDM,31000165,Hc Thaw W/O Wash Auto Cells For Transplant,2658.0,1727.7,,,0
CDM,31000166,Hc Chrmsm Breakage Synds Score 100 Cll So,1225.0,796.25,,,0
CDM,31000167,Hc Hearing Loss Sequence Analysis So,5897.0,3833.05,,,0
CDM,31000168,Hc Drug Metabolism Genomic Sequence Analysis Panel 6 Genes So,5432.0,3530.8,,,0
CDM,31000172,Hc Tgsap Sol Org/ Hematolymphoid Neo/Do 51+ Genes Rna Analysis So,9415.0,6119.75,,,0
CDM,31000173,Hc Morph Anyls Tumor Ihc Manual Special So,1017.0,661.05,,,0
CDM,31000175,Hc Brca1/2 Gene Full Seq Analysis Tumor So,4200.0,2730.0,,,0
CDM,31000176,Hc Pmp22 Gene Duplication/Deletion Analysis So,1893.0,1230.45,,,0
CDM,31000177,Hc Atxn7 Gene Analysis Eval To Detect Abnormal Alleles So,479.0,311.35,,,0
CDM,31000178,Hc Gsap Sol Org Neo Dna Anal Microsatellite Instab So,6000.0,3900.0,,,0
CDM,31000179,Hc Gsap Sol Org Neo Dna Anal Microsatellite Instab Noncp Mcsrc Special So,11400.0,7410.0,,,0
CDM,31000180,"Hc Gsap Sol Org Neo Dna Or Combo Anal Cpy Nmbr, Mcrstl, Tum Mut & Rearrg So",14400.0,9360.0,,,0
CDM,31000181,Hc Glycine Alpha 1 Igg Srm/Csf So,1890.0,1228.5,,,0
CDM,31000182,Hc Klhl11 Antb Sr/Csf Assay Qual So,1800.0,1170.0,,,0
CDM,31000183,Hc Malabsorption Eval Panel So,2520.0,1638.0,,,0
CDM,31000184,Hc Gsap Sol Org Neo Cell Free Nuc Acid Dna Anal Cpy Numbr & Mcrstl Instab So,10800.0,7020.0,,,0
CDM,31100001,Hc Cytopath Pap Smear Thin,69.0,44.85,,,0
CDM,31100002,Hc Cyto Pap Smear Automated Mcare,131.0,85.15,,,0
CDM,31100006,Hc Fine Needle Aspiration Eval,428.0,278.2,,,0
CDM,31100007,Hc Fine Needle Aspiration Interp,1128.0,733.2,,,0
CDM,31100008,Hc Cyto Pap Smear Automated,78.0,50.7,,,0
CDM,31100009,Hc Fna Immed Each Eval Same Site,369.0,239.85,,,0
CDM,31100010,Hc Flow Cytometry Cell Cycle Dna,167.0,108.55,,,0
CDM,31100013,Hc Flow Cytometry Initial Marker,309.0,200.85,,,0
CDM,31100014,Hc Flow Cytometry Initial Marker So,343.0,222.95,,,0
CDM,31100016,Hc Flow Cytometry Marker Tc Ea Addl,145.0,94.25,,,0
CDM,31100022,Hc Flow Cytometry Marker Tc Ea Addl So,161.0,104.65,,,0
CDM,31100023,Hc Flow Cytometry Cell Cycle Dna Analysis So,1163.0,755.95,,,0
CDM,31100024,Hc Mol Cyto Dna Fish Probe Ea Special So,707.0,459.55,,,0
CDM,31100025,Hc Mol Cyto In Situ 100 To 300 Cells Special So,956.0,621.4,,,0
CDM,31100026,Hc Flow Cytometry Initial Marker Special So,328.0,213.2,,,0
CDM,31100027,Hc Flow Cytometry Marker Tc Ea Addl Special So,328.0,213.2,,,0
CDM,32000003,Hc Xr Eye For Foreign Body,275.0,178.75,,,0
CDM,32000003_50,Hc Xr Eye For Foreign Body,550.0,357.5,,,0
CDM,32000004,Hc Mandible  Partial Less Than 4 Vw,213.0,138.45,,,0
CDM,32000005,Hc Xr Mandible Complete 4 + Vw,363.0,235.95,,,0
CDM,32000006,Hc Xr Mastoids Complete 3 + Vw Per Side,496.0,322.4,,,0
CDM,32000006_50,Hc Xr Mastoids Complete 3 + Vw Per Side,992.0,644.8,,,0
CDM,32000007,Hc Xr Internal Auditory Meati Complete,1883.0,1223.95,,,0
CDM,32000008,Hc Xr Facial Bones Less Than 3 Vw,206.0,133.9,,,0
CDM,32000009,Hc Xr Facial Bones Complete 3 + Vw,388.0,252.2,,,0
CDM,32000010,Hc Xr Nasal Bones Complete 3 + Vw,238.0,154.7,,,0
CDM,32000011,Hc Xr Optic Foramina,379.0,246.35,,,0
CDM,32000011_50,Hc Xr Optic Foramina,758.0,492.7,,,0
CDM,32000012,Hc Xr Orbits Complete 4 + Vw,428.0,278.2,,,0
CDM,32000013,Hc Xr Sinuses Paranasal Less Than  3 Vw,222.0,144.3,,,0
CDM,32000014,Hc Xr Sinuses Paranasal Complete 3 + Vw,398.0,258.7,,,0
CDM,32000015,Hc Xr Sella Turcica,273.0,177.45,,,0
CDM,32000016,Hc Xr Skull Less Than 4 Vw,359.0,233.35,,,0
CDM,32000017,Hc Xr Skull Complete 4 + Vw,519.0,337.35,,,0
CDM,32000018,Hc Xr Tmj Open And Closed Mouth Unilat,227.0,147.55,,,0
CDM,32000019,Hc Xr Tmj Open And Closed Mouth Bilat,373.0,242.45,,,0
CDM,32000022,Hc Orthopantogram,262.0,170.3,,,0
CDM,32000023,Hc Xr Neck Soft Tissue,312.0,202.8,,,0
CDM,32000027,Hc Xr Sialogram,736.0,478.4,,,0
CDM,32000028,Hc Xr Ribs Unilateral 2 Vw,322.0,209.3,,,0
CDM,32000029,Hc Xr Ribs Unilateral W Cxr 3 + Vw,505.0,328.25,,,0
CDM,32000030,Hc Xr Ribs Bilateral 3 Vw,545.0,354.25,,,0
CDM,32000031,Hc Xr Ribs Bilateral W Cxr 4 + Vw,645.0,419.25,,,0
CDM,32000032,Hc Xr Sternum 2 + Vw,300.0,195.0,,,0
CDM,32000033,Hc Xr Sternoclavicular Joints 3 + Vw,355.0,230.75,,,0
CDM,32000034,Hc Xr Spine 1 Vw Specify Level,315.0,204.75,,,0
CDM,32000035,Hc Xr Cervical Spine 2 To 3 Views,363.0,235.95,,,0
CDM,32000036,Hc Xr Cervical Spine 4 To 5  Vw,461.0,299.65,,,0
CDM,32000037,Hc Xr Cervical Spine 6 + Vw,555.0,360.75,,,0
CDM,32000039,Hc Xr Thoracic Spine 2 Vw,333.0,216.45,,,0
CDM,32000040,Hc Xr Thoracic Spine 3 Vw,398.0,258.7,,,0
CDM,32000041,Hc Xr Thoracic Spine 4 + Vw,494.0,321.1,,,0
CDM,32000042,Hc Xr Thoracolumbar Spine 2 Vw,315.0,204.75,,,0
CDM,32000044,Hc Xr Lumbosacral Spine 2 Or 3 Vw,318.0,206.7,,,0
CDM,32000045,Hc Xr Lumbosacral Spine 4 + Vw,441.0,286.65,,,0
CDM,32000046,Hc Xr Lumbosacral Spine Complete W Bend 6 + Vw,564.0,366.6,,,0
CDM,32000047,Hc Xr Lumbosacral Spine Bending Only 2 Or 3 Vw,318.0,206.7,,,0
CDM,32000048,Hc Xr Pelvis 1 Or 2 Vw,361.0,234.65,,,0
CDM,32000049,Hc Xr Pelvis Complete 3 + Vw,463.0,300.95,,,0
CDM,32000050,Hc Xr Sacroiliac Joints Less Than 3 Vw,267.0,173.55,,,0
CDM,32000051,Hc Xr Sacroiliac Joints 3 + Vw,362.0,235.3,,,0
CDM,32000052,Hc Xr Sacrum/Coccyx 2 + Vw,344.0,223.6,,,0
CDM,32000053,Hc Myelogram Cervical,1417.0,921.05,,,0
CDM,32000054,Hc Myelogram Thoracic,1462.0,950.3,,,0
CDM,32000055,Hc Myelogram Lumbosacral,1493.0,970.45,,,0
CDM,32000056,Hc Myelogram 2 Or More Regions,1817.0,1181.05,,,0
CDM,32000058,Hc Discogram Cervical Or Thoracic,4071.0,2646.15,,,0
CDM,32000060,Hc Discogram Lumbar,2934.0,1907.1,,,0
CDM,32000061,Hc Xr Clavicle Complete,297.0,193.05,,,0
CDM,32000061_50,Hc Xr Clavicle Complete,594.0,386.1,,,0
CDM,32000062,Hc Xr Scapula Complete,344.0,223.6,,,0
CDM,32000062_50,Hc Xr Scapula Complete,688.0,447.2,,,0
CDM,32000063,Hc Xr Shoulder 1 Vw,296.0,192.4,,,0
CDM,32000063_50,Hc Xr Shoulder 1 Vw,592.0,384.8,,,0
CDM,32000064,Hc Xr Shoulder Complete 2 + Vw,443.0,287.95,,,0
CDM,32000064_50,Hc Xr Shoulder Complete 2 + Vw,886.0,575.9,,,0
CDM,32000065,Hc Xr Arthrogram Shoulder,815.0,529.75,,,0
CDM,32000065_50,Hc Xr Arthrogram Shoulder,1630.0,1059.5,,,0
CDM,32000066,Hc Xr Ac Joints Bilateral,331.0,215.15,,,0
CDM,32000067,Hc Xr Humerus 2 + Vw,335.0,217.75,,,0
CDM,32000068,Hc Xr Elbow 2 Vw,315.0,204.75,,,0
CDM,32000068_50,Hc Xr Elbow 2 Vw,630.0,409.5,,,0
CDM,32000069,Hc Xr Elbow Complete 3 + Vw,370.0,240.5,,,0
CDM,32000069_50,Hc Xr Elbow Complete 3 + Vw,740.0,481.0,,,0
CDM,32000070,Hc Xr Arthrogram Elbow,1013.0,658.45,,,0
CDM,32000070_50,Hc Xr Arthrogram Elbow,2026.0,1316.9,,,0
CDM,32000071,Hc Xr Forearm 2 Vw,332.0,215.8,,,0
CDM,32000071_50,Hc Xr Forearm 2 Vw,664.0,431.6,,,0
CDM,32000072,Hc Xr Upper Extremity Infant 2 + Vw,379.0,246.35,,,0
CDM,32000072_50,Hc Xr Upper Extremity Infant 2 + Vw,758.0,492.7,,,0
CDM,32000073,Hc Xr Wrist 2 Vw,227.0,147.55,,,0
CDM,32000073_50,Hc Xr Wrist 2 Vw,454.0,295.1,,,0
CDM,32000074,Hc Xr Wrist Complete 3 + Vw,280.0,182.0,,,0
CDM,32000074_50,Hc Xr Wrist Complete 3 + Vw,560.0,364.0,,,0
CDM,32000075,Hc Xr Arthrogram Wrist,821.0,533.65,,,0
CDM,32000075_50,Hc Xr Arthrogram Wrist,1642.0,1067.3,,,0
CDM,32000076,Hc Xr Hand 2 Vw,246.0,159.9,,,0
CDM,32000076_50,Hc Xr Hand 2 Vw,492.0,319.8,,,0
CDM,32000077,Hc Xr Hand Complete 3 + Vw,320.0,208.0,,,0
CDM,32000077_50,Hc Xr Hand Complete 3 + Vw,640.0,416.0,,,0
CDM,32000078,Hc Xr Fingers 2 + Vw,254.0,165.1,,,0
CDM,32000078_50,Hc Xr Fingers 2 + Vw,508.0,330.2,,,0
CDM,32000082,Hc Xr Arthrogram Hip,864.0,561.6,,,0
CDM,32000082_50,Hc Xr Arthrogram Hip,1728.0,1123.2,,,0
CDM,32000086,Hc Xr Knee 1 Or 2 Vw,314.0,204.1,,,0
CDM,32000086_50,Hc Xr Knee 1 Or 2 Vw,628.0,408.2,,,0
CDM,32000087,Hc Xr Knee 3 Vw,377.0,245.05,,,0
CDM,32000087_50,Hc Xr Knee 3 Vw,754.0,490.1,,,0
CDM,32000088,Hc Xr Knee Complete 4 + Vw,406.0,263.9,,,0
CDM,32000088_50,Hc Xr Knee Complete 4 + Vw,812.0,527.8,,,0
CDM,32000089,Hc Xr Knee Ap Standing Bilateral,322.0,209.3,,,0
CDM,32000090,Hc Xr Arthrogram Knee,784.0,509.6,,,0
CDM,32000090_50,Hc Xr Arthrogram Knee,1568.0,1019.2,,,0
CDM,32000091,Hc Xr Tibia Fibula 2 Vw,307.0,199.55,,,0
CDM,32000091_50,Hc Xr Tibia Fibula 2 Vw,614.0,399.1,,,0
CDM,32000092,Hc Xr Lower Extremity Infant 2 + Vw,291.0,189.15,,,0
CDM,32000092_50,Hc Xr Lower Extremity Infant 2 + Vw,582.0,378.3,,,0
CDM,32000093,Hc Xr Ankle 2 Vw,336.0,218.4,,,0
CDM,32000093_50,Hc Xr Ankle 2 Vw,672.0,436.8,,,0
CDM,32000094,Hc Xr Ankle Complete 3 + Vw,371.0,241.15,,,0
CDM,32000094_50,Hc Xr Ankle Complete 3 + Vw,742.0,482.3,,,0
CDM,32000095,Hc Xr Arthrogram Ankle,784.0,509.6,,,0
CDM,32000095_50,Hc Xr Arthrogram Ankle,1568.0,1019.2,,,0
CDM,32000096,Hc Xr Foot 2 Vw,284.0,184.6,,,0
CDM,32000096_50,Hc Xr Foot 2 Vw,568.0,369.2,,,0
CDM,32000097,Hc Xr Foot Complete 3 + Vw,377.0,245.05,,,0
CDM,32000097_50,Hc Xr Foot Complete 3 + Vw,754.0,490.1,,,0
CDM,32000098,Hc Xr Calcaneus 2 + Vw,320.0,208.0,,,0
CDM,32000098_50,Hc Xr Calcaneus 2 + Vw,640.0,416.0,,,0
CDM,32000099,Hc Xr Toes 2 + Vw,337.0,219.05,,,0
CDM,32000099_50,Hc Xr Toes 2 + Vw,674.0,438.1,,,0
CDM,32000103,Hc Xr Acute Abdominal Series W 1 Vw Chest,553.0,359.45,,,0
CDM,32000104,Hc Xr Peritoneogram,1145.0,744.25,,,0
CDM,32000105,Hc Xr Esophagus Single Contrast Study,544.0,353.6,,,0
CDM,32000106,Hc Xr Swallowing Function Contrast Study,463.0,300.95,,,0
CDM,32000107,Hc Remove Fb Esophagus W Balloon Cath,1143.0,742.95,,,0
CDM,32000108,Hc Xr Upper Gi Single Contrast Study,823.0,534.95,,,0
CDM,32000111,Hc Xr Upper Gi Double Contrast Study,964.0,626.6,,,0
CDM,32000114,Hc Xr Small Intestine Single Contrast Study,760.0,494.0,,,0
CDM,32000115,Hc Xr Small Intestine Double Contrast Study,954.0,620.1,,,0
CDM,32000116,Hc Xr Colon Single Contrast Study,813.0,528.45,,,0
CDM,32000117,Hc Xr Colon Double Contrast Study,1024.0,665.6,,,0
CDM,32000120,Hc Cholangiogram Intraop,601.0,390.65,,,0
CDM,32000121,Hc Cholangiogram Intraop Addl,308.0,200.2,,,0
CDM,32000125,Hc Xr Ercp Complete,1097.0,713.05,,,0
CDM,32000126,Hc Xr Introduction Long Gi Tube W Fluoro,704.0,457.6,,,0
CDM,32000127,Hc Placement Enteroclysis Tube,1130.0,734.5,,,0
CDM,32000128,Hc Intraluminal Dilation Esoph,696.0,452.4,,,0
CDM,32000129,Hc Dilation Biliary Duct Strictures,1333.0,866.45,,,0
CDM,32000130,Hc Urogram Intravenous (Ivp) W Or Wo Kub Or Tomogram,1129.0,733.85,,,0
CDM,32000133,Hc Urogram Retrograde W Or Wo Kub,1279.0,831.35,,,0
CDM,32000134,Hc Urogram Antegrade,785.0,510.25,,,0
CDM,32000135,Hc Cystogram 3 + Vw,727.0,472.55,,,0
CDM,32000136,Hc Corpora Cavernosogram,2237.0,1454.05,,,0
CDM,32000137,Hc Urethrocystogram Retrograde,945.0,614.25,,,0
CDM,32000138,Hc Urethrocystogram Voiding,1017.0,661.05,,,0
CDM,32000139,Hc Xr Renal Cyst Study Translumbar,3575.0,2323.75,,,0
CDM,32000142,Hc Dilation Ureters Or Urethra,3375.0,2193.75,,,0
CDM,32000143,Hc Hysterosalpingogram,592.0,384.8,,,0
CDM,32000144,Hc Transcervical Cath Fallopian Tube,1990.0,1293.5,,,0
CDM,32000145,Hc Perineogram,1727.0,1122.55,,,0
CDM,32000146,Hc Lymphangiogram Extremity Bilateral,3020.0,1963.0,,,0
CDM,32000147,Hc Lymphangiogram Pelvic Abdominal Unilateral,3509.0,2280.85,,,0
CDM,32000148,Hc Lymphangiogram Pelvic Abdominal Bilateral,5127.0,3332.55,,,0
CDM,32000149,Hc Shuntogram Nonvascular,599.0,389.35,,,0
CDM,32000150,Hc Splenoportogram,6694.0,4351.1,,,0
CDM,32000151,Hc Venogram Extremity Unilat,1167.0,758.55,,,0
CDM,32000152,Hc Venogram Extremity Bilat,2048.0,1331.2,,,0
CDM,32000153,Hc Venocavagram Inferior,5127.0,3332.55,,,0
CDM,32000154,Hc Venocavagram Superior,2229.0,1448.85,,,0
CDM,32000155,Hc Venogram Renal Unilateral,5127.0,3332.55,,,0
CDM,32000156,Hc Venogram Renal Bilateral,5673.0,3687.45,,,0
CDM,32000157,Hc Venogram Adrenal Unilatateral,5127.0,3332.55,,,0
CDM,32000158,Hc Venogram Adrenal Bilateral,8502.0,5526.3,,,0
CDM,32000159,Hc Venogram Sinus Jugular,5127.0,3332.55,,,0
CDM,32000160,Hc Venogram Superior Sagittal,3397.0,2208.05,,,0
CDM,32000161,Hc Venogram Epidural,4750.0,3087.5,,,0
CDM,32000162,Hc Portogram W Hemodynamics,5127.0,3332.55,,,0
CDM,32000163,Hc Portogram Wo Hemodynamics,5127.0,3332.55,,,0
CDM,32000164,Hc Venogram Hepatic W Hemodynamics,5127.0,3332.55,,,0
CDM,32000165,Hc Venogram Hepatic Wo Hemodynamics,5127.0,3332.55,,,0
CDM,32000166,Hc Venous Sampling Through Catheter,8502.0,5526.3,,,0
CDM,32000167,Hc Transcath Therapy Embolization,2920.0,1898.0,,,0
CDM,32000169,Hc Transcath Angio Not Thromblysis,3509.0,2280.85,,,0
CDM,32000170,Hc Removal Of Fibrin Sheath,689.0,447.85,,,0
CDM,32000171,Hc Mech Remvl Intraluminal Obstructive Material,529.0,343.85,,,0
CDM,32000177,Hc Endovasc Rep Descending Thoracic Aorta Subclavian,1689.0,1097.85,,,0
CDM,32000178,Hc Endovasc Rep Descending Thoracic Aorta Celiac,1448.0,941.2,,,0
CDM,32000179,Hc Proximal Exten Prosth Descending Thoracic Aorta,1938.0,1259.7,,,0
CDM,32000180,Hc Distal Exten Prosth Descending Thoracic Aorta,1689.0,1097.85,,,0
CDM,32000186,Hc Transcatheter Biopsy R S&I,2882.0,1873.3,,,0
CDM,32000190,Hc Drainage Catheter Exchange W Contrast,690.0,448.5,,,0
CDM,32000191,Hc Rad Guidance For Drainage W Cath Placement,1493.0,970.45,,,0
CDM,32000192,Hc Fluoro Up To 1 Hour Separate Procedure,550.0,357.5,,,0
CDM,32000194,Hc Xr Nose To Rectum For Foreign Body Child,952.0,618.8,,,0
CDM,32000195,Hc Xr Abscess Fistula Sinus Tract,918.0,596.7,,,0
CDM,32000196,Hc Rad Exam Surgical Specimen,967.0,628.55,,,0
CDM,32000197,Hc Xr Tomogram Single Plane,757.0,492.05,,,0
CDM,32000199,Hc Unlisted Fluoro Procedure,412.0,267.8,,,0
CDM,32000201,Hc Fluoro Central Venous Access Placement,672.0,436.8,,,0
CDM,32000202,Hc Fluoro Guided Needle Placement,447.0,290.55,,,0
CDM,32000203,Hc Fluoro Guided Spinal Injection,378.0,245.7,,,0
CDM,32000206,Hc Mammary Ductogram Or Galactogram Sgl,517.0,336.05,,,0
CDM,32000207,Hc Mammary Ductogram Or Galactogram Mult,517.0,336.05,,,0
CDM,32000209,Hc Bone Age Studies,316.0,205.4,,,0
CDM,32000210,Hc Bone Length Studies,344.0,223.6,,,0
CDM,32000211,Hc Xr Bone Survey Limited,435.0,282.75,,,0
CDM,32000212,Hc Xr Bone Survey Complete,793.0,515.45,,,0
CDM,32000213,Hc Xr Bone Survey Infant,435.0,282.75,,,0
CDM,32000214,Hc Joint Survey Single View,332.0,215.8,,,0
CDM,32000215,Hc Bone Density Dexa Axial,448.0,291.2,,,0
CDM,32000216,Hc Bone Density Dexa Appendicular,313.0,203.45,,,0
CDM,32000220,Hc Xr Ercp Biliary Ductal System Only,685.0,445.25,,,0
CDM,32000221,Hc Xr Ercp Pancreatic Ductal System Only,685.0,445.25,,,0
CDM,32000223,Hc Lymphangiogram Extremity Unilateral,1254.0,815.1,,,0
CDM,32000224,Hc Xr Bone Density Dexa Axial And Verteb,696.0,452.4,,,0
CDM,32000225,Hc Xr Dexa Vertebral Fracture Assess,179.0,116.35,,,0
CDM,32000226,Hc Xr Spine Entire Thoracic And Lumbar 1 View,200.0,130.0,,,0
CDM,32000227,Hc Xr Spine Entire Thoracic And Lumbar 2-3 Views,365.0,237.25,,,0
CDM,32000228,Hc Xr Spine Entire Thoracic And Lumbar 4-5 Views,436.0,283.4,,,0
CDM,32000229,Hc Xr Spine Entire Thoracic And Lumbar 6+ Views,513.0,333.45,,,0
CDM,32000230,Hc Xr Hip Unilateral 1 View,319.0,207.35,,,0
CDM,32000231,Hc Xr Hip Unilateral W Pelvis 2-3 Views,362.0,235.3,,,0
CDM,32000232,Hc Xr Hip Unilateral W Pelvis 4+ Views,406.0,263.9,,,0
CDM,32000233,Hc Xr Hips Bilateral 2 Views,331.0,215.15,,,0
CDM,32000234,Hc Xr Hips Bilateral W Pelvis 3-4 Views,485.0,315.25,,,0
CDM,32000235,Hc Xr Hips Bilateral W Pelvis 5+ Views,546.0,354.9,,,0
CDM,32000236,Hc Xr Femur 1 View,192.0,124.8,,,0
CDM,32000236_50,Hc Xr Femur 1 View,384.0,249.6,,,0
CDM,32000237,Hc Xr Femur 2+ Views,235.0,152.75,,,0
CDM,32000237_50,Hc Xr Femur 2+ Views,470.0,305.5,,,0
CDM,32000239,Hc Xr Abdomen 1 View,251.0,163.15,,,0
CDM,32000240,Hc Xr Abdomen 2 Views,388.0,252.2,,,0
CDM,32000241,Hc Xr Abdomen 3+ Views,406.0,263.9,,,0
CDM,32000242,Hc Xr Manual Appl Of Stress For Joint Xray,241.0,156.65,,,0
CDM,32000243,Hc Xr Esophagus Double Contrast Study,765.0,497.25,,,0
CDM,32000244,Hc Xr Small Intestine Follow Through Study Add On,582.0,378.3,,,0
CDM,32000245,Hc Medical Physics Dose Eval For Radiation Exposure,2991.0,1944.15,,,0
CDM,32300001,Hc Aortogram Thoracic Serialogram,8676.0,5639.4,,,0
CDM,32300002,Hc Aortogram Abdominal Serialogram,5127.0,3332.55,,,0
CDM,32300003,Hc Aortogram Abd W Bilat Ileofemoral Low Ext,5419.0,3522.35,,,0
CDM,32300005,Hc Angiogram Spinal Selective,8502.0,5526.3,,,0
CDM,32300006,Hc Angiogram Extremity Unilateral,5127.0,3332.55,,,0
CDM,32300007,Hc Angiogram Extremity Bilateral,5245.0,3409.25,,,0
CDM,32300008,Hc Angiogram Visceral,8502.0,5526.3,,,0
CDM,32300009,Hc Angiogram Adrenal Unilateral,3383.0,2198.95,,,0
CDM,32300010,Hc Angiogram Adrenal Bilateral,5127.0,3332.55,,,0
CDM,32300011,Hc Angiogram Pelvic,8502.0,5526.3,,,0
CDM,32300012,Hc Angiogram Pulmonary Unilateral,5127.0,3332.55,,,0
CDM,32300013,Hc Angiogram Pulmonary  Bilateral,5197.0,3378.05,,,0
CDM,32300014,Hc Angiogram Pulmonary Non-Select,4793.0,3115.45,,,0
CDM,32300015,Hc Internal Mammary Arteriogram,2747.0,1785.55,,,0
CDM,32300016,Hc Angiogram Each Addl Vessel,2070.0,1345.5,,,0
CDM,32300019,Hc Angio Iliac Artery W Cath,4541.0,2951.65,,,0
CDM,32300020,Hc Renal Transcath Sympath Denerv Uni,16296.0,10592.4,,,0
CDM,32300021,Hc Renal Transcath Sympath Denerv Bil,21728.0,14123.2,,,0
CDM,32400009,Hc Xr Chest 3 Views,386.0,250.9,,,0
CDM,32400010,Hc Xr Chest 4+ Views,421.0,273.65,,,0
CDM,32400011,Hc Xr Chest 1 View,263.0,170.95,,,0
CDM,32400012,Hc Xr Chest 2 Views,307.0,199.55,,,0
CDM,33100001,Hc Chemo Sq Im Non Horm Antineoplast,396.0,257.4,,,0
CDM,33100002,Hc Chemo Sq Im Horm Antineoplast,396.0,257.4,,,0
CDM,33100003,Hc Chemo Intralesional Up To 7 Lesions,302.0,196.3,,,0
CDM,33100004,Hc Chemo Ivp Single Or Initial Drug,932.0,605.8,,,0
CDM,33100005,Hc Chemo Ivp Ea Addl Drug Or Substance,783.0,508.95,,,0
CDM,33100006,Hc Chemo Admin Peritoneal Cavity,1874.0,1218.1,,,0
CDM,33100007,Hc Chemo Admin Cns W Lp,2278.0,1480.7,,,0
CDM,33100008,Hc Chemo Intrathecal Via Reservoir,738.0,479.7,,,0
CDM,33100009,Hc Chemo Intralesional Over 7 Lesions,607.0,394.55,,,0
CDM,33300001,Hc Therapeutic Radiation Simulation Simple,1614.0,1049.1,,,0
CDM,33300002,Hc Therapeutic Radiation Simulation Intermediate,2942.0,1912.3,,,0
CDM,33300003,Hc Therapeutic Radiation Simulation Complex,5977.0,3885.05,,,0
CDM,33300004,Hc Therapeutic Radiation Simulation 3D,7800.0,5070.0,,,0
CDM,33300006,Hc Radiation Dosimetry Basic,2762.0,1795.3,,,0
CDM,33300007,Hc Imrt Planning,19984.0,12989.6,,,0
CDM,33300011,Hc Special Teletherapy Port Plan,7728.0,5023.2,,,0
CDM,33300015,Hc Dosimetry Special,1081.0,702.65,,,0
CDM,33300016,Hc Treatment Devices Desgn And Cnstrct Simple,1759.0,1143.35,,,0
CDM,33300017,Hc Treatment Devices Desgn And Cnstrct Intermediate,1759.0,1143.35,,,0
CDM,33300018,Hc Treatment Devices Desgn And Cnstrct Complex,1759.0,1143.35,,,0
CDM,33300019,Hc Medical Physics Consult Continuing,2423.0,1574.95,,,0
CDM,33300020,Hc Mlc Imrt Device Desgn And Cnstrct,1704.0,1107.6,,,0
CDM,33300021,Hc Medical Physics Special Consultation,3221.0,2093.65,,,0
CDM,33300031,Hc Therapeutic Radiology Port Film(S),838.0,544.7,,,0
CDM,33300034,Hc Special Treatment Procedure,4220.0,2743.0,,,0
CDM,33300035,Hc Hyperthermia Ext Generated Deep,4750.0,3087.5,,,0
CDM,33300041,Hc Interstitial Radiation Source Application Complex,4935.0,3207.75,,,0
CDM,33300046,Hc Unlisted Procedure Clinical Brachytherapy,1623.0,1054.95,,,0
CDM,33300049,Hc Stereotactic Radiosurgery,7322.0,4759.3,,,0
CDM,33300050,Hc Stereotactic Radiotx 1-5 Sources,5021.0,3263.65,,,0
CDM,33300053,Hc Resp Motion Mgmt Simulation,3418.0,2221.7,,,0
CDM,33300054,Hc Tele Isodose Plan Simple Incl Dosim,10688.0,6947.2,,,0
CDM,33300055,Hc Tele Isodose Plan Complex Incl Dosim,13159.0,8553.35,,,0
CDM,33300056,Hc Isodose Brachy Simple Incl Dosim,4875.0,3168.75,,,0
CDM,33300057,Hc Isodose Brachy Interm Incl Dosim,8500.0,5525.0,,,0
CDM,33300058,Hc Isodose Brachy Complex Incl Dosim,8500.0,5525.0,,,0
CDM,33300059,Hc Imrt Simple Incl Image Guidance,4042.0,2627.3,,,0
CDM,33300060,Hc Imrt Complex Incl Image Guidance,4042.0,2627.3,,,0
CDM,33300061,Hc Rad Trt Guidance Incl Intrafraction,1653.0,1074.45,,,0
CDM,33300062,Hc Radiation Trtmnt Delivery Simple,1862.0,1210.3,,,0
CDM,33300063,Hc Radiation Trtmnt Delivery Intermed,1862.0,1210.3,,,0
CDM,33300064,Hc Radiation Trtmnt Delivery; Complex,2040.0,1326.0,,,0
CDM,33300065,"Hc Hdr Interstitial Or Intracavitar 1 Channel, Incl Dosimetry",10238.0,6654.7,,,0
CDM,33300066,"Hc Hdr Interstitial Or Intracavitary, 2-12 Channels, Incl Dosimetry",10238.0,6654.7,,,0
CDM,33300067,"Hc Hdr Interstitial Or Intracavitary, >12 Channels, Incl Dosimetry",10238.0,6654.7,,,0
CDM,33300068,Hc Rad Therapy Anal Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300069,Hc Rad Therapy Bladder Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300070,Hc Rad Ther Bone Metastases Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300071,Hc Rad Ther Brain Metastases Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300072,Hc Rad Therapy Breast Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300073,Hc Rad Ther Cervical Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300074,Hc Rad Therapy Cns Tumors Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300075,Hc Rad Ther Colorectal Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300076,Hc Rad Ther Head And Neck Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300077,Hc Rad Therapy Lung Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300078,Hc Rad Therapy Lymphoma Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300079,Hc Rad Ther Pancreatic Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300080,Hc Rad Therapy Prostate Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300081,Hc Rad Therapy Gi Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33300082,Hc Rad Therapy Uterine Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
CDM,33500001,Hc Chemo Infusion Initial Up To 1 Hr,1616.0,1050.4,,,0
CDM,33500002,Hc Chemo Infusion Ea Addl Hr,972.0,631.8,,,0
CDM,33500003,Hc Chemo Iv Initiate Pump For More Than 8 Hrs Inf,4450.0,2892.5,,,0
CDM,33500004,Hc Chemo Infusion Sequential  Drug Up To  1 Hr,1044.0,678.6,,,0
CDM,33500005,Hc Chemo Ia Push Technique,5000.0,3250.0,,,0
CDM,33500007,Hc Refill Maintain Imp Pump Chemo,384.0,249.6,,,0
CDM,33500008,Hc Unlisted Chemotherapy - Concurrent Chemo,819.0,532.35,,,0
CDM,34100001,Hc Thyroid Uptake Single Or Mult,1119.0,727.35,,,0
CDM,34100002,Hc Thyroid Imaging W Vascular Flow,1303.0,846.95,,,0
CDM,34100003,Hc Thyroid Imaging W Uptake(S),2407.0,1564.55,,,0
CDM,34100004,Hc Thyroid Ca Mets Imaging Whole Body,2910.0,1891.5,,,0
CDM,34100005,Hc Thyroid Ca Mets Uptake,730.0,474.5,,,0
CDM,34100006,Hc Parathyroid Planar Imaging,2845.0,1849.25,,,0
CDM,34100007,Hc Parathyroid Planar Imaging W Spect,3574.0,2323.1,,,0
CDM,34100008,Hc Parathyroid Planar Imaging W Spect And Ct,3574.0,2323.1,,,0
CDM,34100009,Hc Adrenal Scan,2797.0,1818.05,,,0
CDM,34100010,Hc Bone Marrow Imaging Limited,1122.0,729.3,,,0
CDM,34100011,Hc Bone Marrow Imaging Mult Images,1420.0,923.0,,,0
CDM,34100012,Hc Bone Marrow Imaging Whole Body,1718.0,1116.7,,,0
CDM,34100013,Hc Lymphoscintigram,2375.0,1543.75,,,0
CDM,34100014,Hc Liver Imaging Static Only,2425.0,1576.25,,,0
CDM,34100015,Hc Liver Imaging W Vascular Flow,2827.0,1837.55,,,0
CDM,34100018,Hc Liver And Spleen Imaging Static Only,1675.0,1088.75,,,0
CDM,34100019,Hc Hepatobiliary System Imaging,3197.0,2078.05,,,0
CDM,34100020,Hc Hepatobiliary System Imaging W Pharm Intervention,4826.0,3136.9,,,0
CDM,34100021,Hc Salivary Gland Imaging,2709.0,1760.85,,,0
CDM,34100023,Hc Gastric Emptying Study,3394.0,2206.1,,,0
CDM,34100024,Hc Gi Bleed Scan,4258.0,2767.7,,,0
CDM,34100025,Hc Intestine Imaging Meckels Gastric Mucosa,3686.0,2395.9,,,0
CDM,34100026,Hc Shunt Patency Test,1115.0,724.75,,,0
CDM,34100027,Hc Bone Imaging Limited,1990.0,1293.5,,,0
CDM,34100028,Hc Bone Imaging Multiple Areas,2189.0,1422.85,,,0
CDM,34100029,Hc Bone Imaging Whole Body,2314.0,1504.1,,,0
CDM,34100030,Hc Bone Imaging Phase 3 Study,2874.0,1868.1,,,0
CDM,34100032,Hc Cardiac Shunt Detection,978.0,635.7,,,0
CDM,34100033,Hc Noncardiac Vascular Flow Imaging,1026.0,666.9,,,0
CDM,34100034,Hc Myocard Perfusion Imaging Spect Single,3095.0,2011.75,,,0
CDM,34100035,Hc Myocard Perfusion Imaging Spect Multiple,5005.0,3253.25,,,0
CDM,34100036,Hc Myocard Perfusion Imaging Planar Single,2722.0,1769.3,,,0
CDM,34100037,Hc Myocard Perfusion Imaging Planar Multiple,3915.0,2544.75,,,0
CDM,34100038,Hc Venous Thrombosis Imaging Bilateral,2407.0,1564.55,,,0
CDM,34100039,Hc Myocardial Imaging Infarct,2252.0,1463.8,,,0
CDM,34100040,Hc Myocardial Imaging Infarct W Ejection Fraction,2252.0,1463.8,,,0
CDM,34100041,Hc Myocardial Imaging Infarct Spect,2252.0,1463.8,,,0
CDM,34100042,Hc Cardiac Blood Pool Gated Planar 1 Study Rest Or Stress,2773.0,1802.45,,,0
CDM,34100043,Hc Cardiac Blood Pool 1St Pass 1 Study Rest Or Stress Wm Ef,1257.0,817.05,,,0
CDM,34100044,Hc Cardiac Blood Pool Gated Spect Rest Wm Ef,2293.0,1490.45,,,0
CDM,34100046,Hc Pulmonary Ventilation Imaging,1328.0,863.2,,,0
CDM,34100047,Hc Pulm Perfusion Imaging Particulate,1422.0,924.3,,,0
CDM,34100048,Hc Pulm Ventilation And Perfusion Imaging,1678.0,1090.7,,,0
CDM,34100049,Hc Quant Pulm Perfusion W Or Wo Imaging,1002.0,651.3,,,0
CDM,34100052,Hc Brain Imaging < 4 Static Views,1499.0,974.35,,,0
CDM,34100053,Hc Brain Imaging 4+ Static Views,1932.0,1255.8,,,0
CDM,34100054,Hc Brain Imaging 4+ Views W Vascular Flow,1932.0,1255.8,,,0
CDM,34100056,Hc Brain Imaging Vascular Flow Only,1233.0,801.45,,,0
CDM,34100057,Hc Cisternography,1545.0,1004.25,,,0
CDM,34100058,Hc Shunt Evaluation Csf,1233.0,801.45,,,0
CDM,34100059,Hc Csf Leak Detection,2986.0,1940.9,,,0
CDM,34100060,Hc Kidney Imaging,1130.0,734.5,,,0
CDM,34100061,Hc Kidney Imaging W Vascular Flow,1190.0,773.5,,,0
CDM,34100062,Hc Kidney Imaging W Flow And Function,1233.0,801.45,,,0
CDM,34100063,Hc Kidney Imaging W Flow And Funct W Rx Intervention Sgl,1356.0,881.4,,,0
CDM,34100064,Hc Kidney Imaging W Flow And Funct W Rx Intervention Mult,1578.0,1025.7,,,0
CDM,34100066,Hc Testicular Imaging W Vasc Flow,905.0,588.25,,,0
CDM,34100067,Hc Tumor Or Inflam Process Localization Planar Single Area 1 Day,2806.0,1823.9,,,0
CDM,34100068,Hc Tumor Or Inflam Process Localization Planar Multi Area Or Single Area 2+ Days,2946.0,1914.9,,,0
CDM,34100069,Hc Tumor Or Inflam Process Localization Planar Whole Body 1 Day,3241.0,2106.65,,,0
CDM,34100070,Hc Tumor Or Inflam Process Localization Spect Single Area 1 Day,3902.0,2536.3,,,0
CDM,34100071,Hc Tumor Localization Whole Body 2 + Days,3825.0,2486.25,,,0
CDM,34100079,Hc Muga Multiple Studies Pre Post,2773.0,1802.45,,,0
CDM,34100081,Hc Brain Scan Ltmd W Flow,1499.0,974.35,,,0
CDM,34100084,Hc Voiding Cystogram,3600.0,2340.0,,,0
CDM,34100085,Hc Gastric Emptying Img Study W Small Bowel Transit,3394.0,2206.1,,,0
CDM,34100086,Hc Gastric Emptying Img Study W Sm Bowel Colon Trans Mult Days,3394.0,2206.1,,,0
CDM,34100087,Hc Pet Myo Metabolic Eval Single Study W Ct,5148.0,3346.2,,,0
CDM,34100088,Hc Pet Myo Perf Single Rst Or St W Ct,3006.0,1953.9,,,0
CDM,34100089,Hc Pet Myo Perf Multi Rst And St W Ct,6864.0,4461.6,,,0
CDM,34100091,Hc Pet Myo Perf And Metabolic Eval Study Dual Radiotracer W Ct,6746.0,4384.9,,,0
CDM,34100092,Hc Pet Absolute Quantitation Myocardial Blood Flow Rst And St Add On,547.0,355.55,,,0
CDM,34100093,Hc Tumor Or Inflam Process Localization Spect W Ct Single Area 1 Day,4292.0,2789.8,,,0
CDM,34100094,Hc Tumor Or Inflam Process Localization Spect Multi Areas Or Single Area 2+ Days,4497.0,2923.05,,,0
CDM,34100095,Hc Tumor Or Inflam Process Localization Spect W Ct Multi Areas Or Single Area 2+ Days,4701.0,3055.65,,,0
CDM,34100096,Hc Radiopharm Quantification Measure Single Area Add On,2262.0,1470.3,,,0
CDM,34100098,Hc Nm Red Cell Sequestration,1422.0,924.3,,,0
CDM,34100099,Hc Muga Rv Ef By First Pass Technique Add On,445.0,289.25,,,0
CDM,34100100,Hc Nm Absolute Quant Myocardial Blood Flow Rst And St Spect Add On,2200.0,1430.0,,,0
CDM,34200001,Hc Inj Non Img Loclztn Probe Study Parathyroid,1036.0,673.4,,,0
CDM,34200002,Hc Radiopharm Therapy Oral Administration,2337.0,1519.05,,,0
CDM,34200003,Hc Radiopharm Therapy Iv Administration,2329.0,1513.85,,,0
CDM,34200004,Hc Radiotherapy Radiolabeled Monoclonal Ab Iv,4008.0,2605.2,,,0
CDM,34200005,Hc Radiopharm Therapy Intra Arterial Administration,1886.0,1225.9,,,0
CDM,34300034_343,Noncdm Charge Record Radiopharmaceuticals,1066.33,693.11,,,0
CDM,34300034_A9500_343,Noncdm Charge Record Radiopharmaceuticals,98.94,64.31,,,0
CDM,34300034_A9502_343,Noncdm Charge Record Radiopharmaceuticals,105.0,68.25,,,0
CDM,34300034_A9503_343,Noncdm Charge Record Radiopharmaceuticals,104.92,68.2,,,0
CDM,34300034_A9509_343,Noncdm Charge Record Radiopharmaceuticals,649.0,421.85,,,0
CDM,34300034_A9512_343,Noncdm Charge Record Radiopharmaceuticals,1.6,1.04,,,0
CDM,34300034_A9516_343,Noncdm Charge Record Radiopharmaceuticals,110.95,72.12,,,0
CDM,34300034_A9520_343,Noncdm Charge Record Radiopharmaceuticals,1253.5,814.78,,,0
CDM,34300034_A9521_343,Noncdm Charge Record Radiopharmaceuticals,2895.66,1882.18,,,0
CDM,34300034_A9528_343,Noncdm Charge Record Radiopharmaceuticals,51.5,33.48,,,0
CDM,34300034_A9529_343,Noncdm Charge Record Radiopharmaceuticals,51.5,33.48,,,0
CDM,34300034_A9537_343,Noncdm Charge Record Radiopharmaceuticals,91.5,59.48,,,0
CDM,34300034_A9538_343,Noncdm Charge Record Radiopharmaceuticals,116.8,75.92,,,0
CDM,34300034_A9539_343,Noncdm Charge Record Radiopharmaceuticals,487.05,316.58,,,0
CDM,34300034_A9540_343,Noncdm Charge Record Radiopharmaceuticals,480.1,312.06,,,0
CDM,34300034_A9541_343,Noncdm Charge Record Radiopharmaceuticals,379.07,246.4,,,0
CDM,34300034_A9547_343,Noncdm Charge Record Radiopharmaceuticals,5550.0,3607.5,,,0
CDM,34300034_A9548_343,Noncdm Charge Record Radiopharmaceuticals,2345.33,1524.46,,,0
CDM,34300034_A9552_343,Noncdm Charge Record Radiopharmaceuticals,375.0,243.75,,,0
CDM,34300034_A9555_343,Noncdm Charge Record Radiopharmaceuticals,1947.0,1265.55,,,0
CDM,34300034_A9556_343,Noncdm Charge Record Radiopharmaceuticals,25.5,16.58,,,0
CDM,34300034_A9557_343,Noncdm Charge Record Radiopharmaceuticals,2461.29,1599.84,,,0
CDM,34300034_A9560_343,Noncdm Charge Record Radiopharmaceuticals,363.93,236.55,,,0
CDM,34300034_A9561_343,Noncdm Charge Record Radiopharmaceuticals,131.35,85.38,,,0
CDM,34300034_A9562_343,Noncdm Charge Record Radiopharmaceuticals,805.55,523.61,,,0
CDM,34300034_A9567_343,Noncdm Charge Record Radiopharmaceuticals,492.65,320.22,,,0
CDM,34300034_A9569_343,Noncdm Charge Record Radiopharmaceuticals,6023.15,3915.05,,,0
CDM,34300034_A9570_343,Noncdm Charge Record Radiopharmaceuticals,5096.95,3313.02,,,0
CDM,34300034_A9571_343,Noncdm Charge Record Radiopharmaceuticals,5096.95,3313.02,,,0
CDM,34300034_A9580_343,Noncdm Charge Record Radiopharmaceuticals,375.0,243.75,,,0
CDM,34300034_A9582_343,Noncdm Charge Record Radiopharmaceuticals,12223.75,7945.44,,,0
CDM,34300034_A9584_343,Noncdm Charge Record Radiopharmaceuticals,6505.04,4228.28,,,0
CDM,34300034_A9592_343,Noncdm Charge Record Radiopharmaceuticals,2928.23,1903.35,,,0
CDM,34300034_A9595_343,Noncdm Charge Record Radiopharmaceuticals,1593.56,1035.81,,,0
CDM,34300034_A9596_343,Noncdm Charge Record Radiopharmaceuticals,2525.65,1641.67,,,0
CDM,34300035,Hc Non-Heu Tc-99M Add-On Per Dose,1.03,0.67,,,0
CDM,34300036,Hc Magnatrace Inj Per Study Dose,1751.28,1138.33,,,0
CDM,34400007,Hc 344 Radiopharm Therapeutic,126.71,82.36,,,0
CDM,35000001,Hc 3D Reconstruct On Scanner,494.0,321.1,,,0
CDM,35000002,Hc 3D Reconstruct On Separate Workstation,744.0,483.6,,,0
CDM,35000003,Hc Ct Limited Follow Up,649.0,421.85,,,0
CDM,35000004,Hc Ct Guided Localization Stereotactic,1872.0,1216.8,,,0
CDM,35000005,Hc Ct Guided Needle Placement,1416.0,920.4,,,0
CDM,35000006,Hc Ct Guided Visceral Tissue Ablation,1778.0,1155.7,,,0
CDM,35000007,Hc Ct Guided Radiother Fields Plcmnt,2922.0,1899.3,,,0
CDM,35000008,Hc Unlisted Ct Procedure,4917.0,3196.05,,,0
CDM,35000010,Hc Cdsm Evicore G1001,0.01,0.01,,,0
CDM,35000011,Hc Cdsm Medcurrent G1002,0.01,0.01,,,0
CDM,35000012,Hc Cdsm Medicalis G1003,0.01,0.01,,,0
CDM,35000013,Hc Cdsm Ndsc G1004,0.01,0.01,,,0
CDM,35000016,Hc Cdsm Aim G1007,0.01,0.01,,,0
CDM,35000017,Hc Cdsm Cranberry Peak G1008,0.01,0.01,,,0
CDM,35000018,Hc Cdsm Sage G1009,0.01,0.01,,,0
CDM,35000019,Hc Cdsm Stanson G1010,0.01,0.01,,,0
CDM,35000020,Hc Cdsm Nos G1011,0.01,0.01,,,0
CDM,35000024,Hc 3D Contour Simulation Liver For Lesion Microwave Ablation,835.0,542.75,,,0
CDM,35100001,Hc Ct Brain Wo Contrast,1285.0,835.25,,,0
CDM,35100002,Hc Ct Brain W Contrast,1463.0,950.95,,,0
CDM,35100003,Hc Ct Brain W Wo Contrast,1658.0,1077.7,,,0
CDM,35100004,Hc Ct Orbit Sella Post Fossa Ear Wo Contrast,1326.0,861.9,,,0
CDM,35100005,Hc Ct Orbit Sella Post Fossa Ear W Contrast,1623.0,1054.95,,,0
CDM,35100006,Hc Ct Orbit Sella Post Fossa Ear W Wo Contrast,1920.0,1248.0,,,0
CDM,35100007,Hc Ct Maxillofacial Wo Contrast,1347.0,875.55,,,0
CDM,35100008,Hc Ct Maxillofacial W Contrast,1770.0,1150.5,,,0
CDM,35100009,Hc Ct Maxillofacial W Wo Contrast,1938.0,1259.7,,,0
CDM,35100010,Hc Ct Soft Tissue Neck Wo Contrast,1531.0,995.15,,,0
CDM,35100011,Hc Ct Soft Tissue Neck W Contrast,1818.0,1181.7,,,0
CDM,35100012,Hc Ct Soft Tissue Neck W And Wo Contrast,1960.0,1274.0,,,0
CDM,35100013,Hc Cta Head W Wo Contrast,2003.0,1301.95,,,0
CDM,35100014,Hc Cta Neck W Wo Contrast,2001.0,1300.65,,,0
CDM,35100015,Hc Ct Cerebral Perf Analysis With Contrast,2075.0,1348.75,,,0
CDM,35200001,Hc Ct Chest Diagnostic Wo Contrast,1533.0,996.45,,,0
CDM,35200002,Hc Ct Chest Diagnostic W Contrast,2106.0,1368.9,,,0
CDM,35200003,Hc Ct Chest Diagnostic W Wo Contrast,2513.0,1633.45,,,0
CDM,35200004,Hc Cta Chest W Wo Contrast,2179.0,1416.35,,,0
CDM,35200005,Hc Ct Cervical Spine Wo Contrast,1651.0,1073.15,,,0
CDM,35200006,Hc Ct Cervical Spine W Contrast,1816.0,1180.4,,,0
CDM,35200007,Hc Ct Cervical Spine W Wo Contrast,1910.0,1241.5,,,0
CDM,35200008,Hc Ct Thoracic Spine Wo Contrast,1285.0,835.25,,,0
CDM,35200009,Hc Ct Thoracic Spine W Contrast,1547.0,1005.55,,,0
CDM,35200010,Hc Ct Thoracic Spine W Wo Contrast,1704.0,1107.6,,,0
CDM,35200011,Hc Ct Lumbar Spine Wo Contrast,1335.0,867.75,,,0
CDM,35200012,Hc Ct Lumbar Spine W Contrast,1463.0,950.95,,,0
CDM,35200013,Hc Ct Lumbar Spine W Wo Contrast,1736.0,1128.4,,,0
CDM,35200014,Hc Cta Pelvis W Wo Contrast,1912.0,1242.8,,,0
CDM,35200015,Hc Ct Pelvis Wo Contrast,1569.0,1019.85,,,0
CDM,35200016,Hc Ct Pelvis W Contrast,1694.0,1101.1,,,0
CDM,35200017,Hc Ct Pelvis W Wo Contrast,1819.0,1182.35,,,0
CDM,35200019,Hc Ct Upper Extremity Wo Contrast,1303.0,846.95,,,0
CDM,35200019_50,Hc Ct Upper Extremity Wo Contrast,2606.0,1693.9,,,0
CDM,35200020,Hc Ct Upper Extremity W Contrast,1569.0,1019.85,,,0
CDM,35200020_50,Hc Ct Upper Extremity W Contrast,3138.0,2039.7,,,0
CDM,35200021,Hc Ct Upper Extremity W Wo Contrast,1703.0,1106.95,,,0
CDM,35200021_50,Hc Ct Upper Extremity W Wo Contrast,3406.0,2213.9,,,0
CDM,35200022,Hc Cta Upper Extremity W Wo Contrast,2094.0,1361.1,,,0
CDM,35200023,Hc Ct Lower Extrem Wo Contrast,1342.0,872.3,,,0
CDM,35200023_50,Hc Ct Lower Extrem Wo Contrast,2684.0,1744.6,,,0
CDM,35200024,Hc Ct Lower Extrem W Contrast,1560.0,1014.0,,,0
CDM,35200024_50,Hc Ct Lower Extrem W Contrast,3120.0,2028.0,,,0
CDM,35200025,Hc Ct Lower Extrem W Wo Contrast,1895.0,1231.75,,,0
CDM,35200025_50,Hc Ct Lower Extrem W Wo Contrast,3790.0,2463.5,,,0
CDM,35200026,Hc Cta Lower Extrem W Wo Contrast,2067.0,1343.55,,,0
CDM,35200026_50,Hc Cta Lower Extrem W Wo Contrast,4134.0,2687.1,,,0
CDM,35200027,Hc Ct Abdomen Wo Contrast,1644.0,1068.6,,,0
CDM,35200028,Hc Ct Abdomen W Contrast,1796.0,1167.4,,,0
CDM,35200029,Hc Ct Abdomen W Wo Contrast,1948.0,1266.2,,,0
CDM,35200030,Hc Cta Abdomen Pelvis W Wo Contrast,3312.0,2152.8,,,0
CDM,35200031,Hc Cta Abdomen W Wo Contrast,2046.0,1329.9,,,0
CDM,35200032,Hc Ct Abdomen Pelvis Wo Contrast,2417.0,1571.05,,,0
CDM,35200033,Hc Ct Abdomen Pelvis W Contrast,2972.0,1931.8,,,0
CDM,35200034,Hc Ct Abdomen Pelvis W Wo Contrast,3156.0,2051.4,,,0
CDM,35200035,Hc Ct Colonogram Diagnostic,1256.0,816.4,,,0
CDM,35200036,Hc Ct Colonogram Screening,1256.0,816.4,,,0
CDM,35200037,Hc Ct Coronary Calcium Scan Screening,95.0,61.75,,,0
CDM,35200038,Hc Ct Heart Contrast Eval Card Function,1532.0,995.8,,,0
CDM,35200039,Hc Ct Heart Contrast Eval Card Function Congenital,1716.0,1115.4,,,0
CDM,35200040,Hc Cta Heart W Dye Cor Ateries And Bypass Grafts,1878.0,1220.7,,,0
CDM,35200041,Hc Cta Abd Aorta Bilateral Lower Ext Runoff,1405.0,913.25,,,0
CDM,35200043,Hc Ct Chest Low Dose Lung Cancer Screening Wo Contrast,532.0,345.8,,,0
CDM,35200044,Hc Ct Coronary Calcium Scan Diagnostic,585.0,380.25,,,0
CDM,36000001,Hc Induced Del After Partial Miscarriage,7622.0,4954.3,,,0
CDM,36000004,Hc Insertion Iabp Perc,3704.0,2407.6,,,0
CDM,36000005,Hc Vad Insert Extracorp Single Ventricle,4321.0,2808.65,,,0
CDM,36000006,Hc Vad Insert Extracorp Biventricular,10242.0,6657.3,,,0
CDM,36000007,Hc Vad Remove Extracorp Single Ventricle,5376.0,3494.4,,,0
CDM,36000008,Hc Vad Remove Extracorp Biventricular,4765.0,3097.25,,,0
CDM,36000009,Hc Stem Cell / Platelet Concentration,2658.0,1727.7,,,0
CDM,36000010,Hc Anesthesia 1St 30 Minutes,1985.0,1290.25,,,0
CDM,36000011,Hc Anesthesia Ea Addl 15 Minutes,659.0,428.35,,,0
CDM,36000012,Hc Assemble Operate Heartlung Machine,23375.0,15193.75,,,0
CDM,36000013,Hc Closed Manipulation In Pacu,820.0,533.0,,,0
CDM,36000014,Hc Closed Reduction In Pacu,1588.0,1032.2,,,0
CDM,36000015,Hc Cont Infusion Nerve Block,540.0,351.0,,,0
CDM,36000016,Hc D And C Diagnostic Or Therapeutic,2791.0,1814.15,,,0
CDM,36000018,Hc Hemoconcentration,916.0,595.4,,,0
CDM,36000019,Hc Injection Nerve Block,1542.0,1002.3,,,0
CDM,36000020,Hc Ligation Fallopian Tubes W Bps,5384.0,3499.6,,,0
CDM,36000021,Hc Minor Surgery Or Procedure Per Hr,4131.0,2685.15,,,0
CDM,36000022,Hc Monitor Iabp Per Day,2536.0,1648.4,,,0
CDM,36000023,Hc Or Cosmetic 1St 30 Minutes,820.0,533.0,,,0
CDM,36000024,Hc Or Cosmetic Addl 15 Minutes,80.0,52.0,,,0
CDM,36000025,Hc Or Level 1 1St 30 Minutes,4227.0,2747.55,,,0
CDM,36000026,Hc Or Level 1 1St Addl 15 Minutes,1131.0,735.15,,,0
CDM,36000027,Hc Or Level 2 1St 30 Minutes,7462.0,4850.3,,,0
CDM,36000028,Hc Or Level 2 Addl 15 Minutes,2362.0,1535.3,,,0
CDM,36000029,Hc Or Level 3 1St 30 Minutes,10614.0,6899.1,,,0
CDM,36000030,Hc Or Level 3 Addl 15 Minutes,3721.0,2418.65,,,0
CDM,36000031,Hc Or Level 4 1St 30 Minutes,12303.0,7996.95,,,0
CDM,36000032,Hc Or Level 4 Addl 15 Minutes,4990.0,3243.5,,,0
CDM,36000033,Hc Or Level 5 1St 30 Minutes,13960.0,9074.0,,,0
CDM,36000034,Hc Or Level 5 Addl 15 Minutes,6061.0,3939.65,,,0
CDM,36000035,Hc Or Level 6 1St 30 Minutes,15925.0,10351.25,,,0
CDM,36000036,Hc Or Level 6 Addl 15 Minutes,7158.0,4652.7,,,0
CDM,36000041,Hc Pacemaker Analysis,1703.0,1106.95,,,0
CDM,36000044,Hc Procedure Other,1130.0,734.5,,,0
CDM,36000047,Hc Thermodilution Cardiac Output,672.0,436.8,,,0
CDM,36000048,Hc Total Hysterectomy Abdominal,6492.0,4219.8,,,0
CDM,36000049,Hc Inj Platelet Rich Plasma,11972.0,7781.8,,,0
CDM,36000051,Hc Bedside Procedure,4223.0,2744.95,,,0
CDM,36000053,Hc Insert Left Vad Arterial Access Percutaneous W/ Img,4215.0,2739.75,,,0
CDM,36000054,Hc Insert Left Vad Arterial & Venous Access Percutaneous W/ Img,4215.0,2739.75,,,0
CDM,36000055,Hc Remove Left Vad Percutaneous,2871.0,1866.15,,,0
CDM,36000056,Hc Reposition Right Or Left Vad Percutaneous W/ Img,2508.0,1630.2,,,0
CDM,36000058,Hc Ecmo Initial Day Veno-Veno,41522.0,26989.3,,,0
CDM,36000059,Hc Ecmo Initial Day Veno-Arterial,41522.0,26989.3,,,0
CDM,36000060,Hc Ecmo Addl Day Veno-Veno,41522.0,26989.3,,,0
CDM,36000061,Hc Ecmo Addl Day Veno-Arterial,41522.0,26989.3,,,0
CDM,36000062,Hc Vad Insert Intracorp Single Ventricle,6442.0,4187.3,,,0
CDM,36000063,Hc Vad Removal Intracorp Single Ventricle,8515.0,5534.75,,,0
CDM,36000064,Hc Vad Pump Replace Extracorp,3958.0,2572.7,,,0
CDM,36000065,Hc Vad Pump Replace Intracorporeal W Bypass,11060.0,7189.0,,,0
CDM,36000070,Hc Insert Vad Venous Access Percutaneous W Img,1405.0,913.25,,,0
CDM,36000071,Hc Transapical Mitral Valve Repair Transthc Echo,42905.0,27888.25,,,0
CDM,36000072,Hc Transcath Mitral Valve Annulus Reconstruct W Device Perct,42905.0,27888.25,,,0
CDM,36000073,Hc Transcath Tricuspid Valve Annulus Reconstruct W Device Perct,42905.0,27888.25,,,0
CDM,36000077,Hc Or Level 1 Local Procedure 1St 30 Minutes,4276.0,2779.4,,,0
CDM,36000078,Hc Or Level 1 Local Procedure Addl 15 Minutes,1143.0,742.95,,,0
CDM,36000079,Hc Insert Right Vad Arterial Access Percutaneous W Img,1405.0,913.25,,,0
CDM,36000080,Hc Remove Right Vad Percutaneous,957.0,622.05,,,0
CDM,36000081,Hc Instlj Ch Tube/Cath Agent Fbrnlysis Sbsq Day,1315.0,854.75,,,0
CDM,36000082,Hc Ins/Repl Cranl Nstim Pg/Rcvr W 1 Elctr Array,61293.0,39840.45,,,0
CDM,36000083,Hc Insj/Rplcmt Cranial Neurostim Gener 2/> Eltrds,144644.0,94018.6,,,0
CDM,36000084,Hc Perc Impltj Neurostimulator Eltrd Peripheral Nerve,24800.0,16120.0,,,0
CDM,36000085,Hc Perc Impltj Neurostimulator Eltrd Cranial Nerve,29760.0,19344.0,,,0
CDM,36000086,Hc Injection Anes/Steroid Lumbar Plexus Cont Infs Cath,6617.0,4301.05,,,0
CDM,36000087,Hc Inc Impltj Crnl Nrv Nstim Eltrds & Pulse Gener,87102.0,56616.3,,,0
CDM,36100001,Hc Fine Needle Asp Biopsy Wo Img 1St Lesion,1291.0,839.15,,,0
CDM,36100003,Hc I And D Abscess Simple,931.0,605.15,,,0
CDM,36100004,Hc I And D Abscess Complicated,2059.0,1338.35,,,0
CDM,36100005,Hc I And D Pilonidal Cyst Simple,1374.0,893.1,,,0
CDM,36100006,Hc I And D Fb Subq Simple,1414.0,919.1,,,0
CDM,36100007,Hc I And D Fb Subq Complicated,2388.0,1552.2,,,0
CDM,36100008,Hc I And D Hematoma Seroma Fluid,6858.0,4457.7,,,0
CDM,36100009,Hc Puncture Aspiration Of Cyst,1896.0,1232.4,,,0
CDM,36100010,Hc I And D Post Op Infection Comp,14554.0,9460.1,,,0
CDM,36100011,Hc Debr Skin Up To 10% Body Surface,777.0,505.05,,,0
CDM,36100012,Hc Debride Skin At Fx Site,1857.0,1207.05,,,0
CDM,36100013,Hc Debr Subq Tissue <=20 Sq Cm,1395.0,906.75,,,0
CDM,36100014,Hc Debr Muscle Fascia <=20 Sq Cm,1930.0,1254.5,,,0
CDM,36100015,Hc Debr Bone <=20 Sq Cm,5183.0,3368.95,,,0
CDM,36100016,Hc Debr Subq Tissue Add 20Sq Cm,498.0,323.7,,,0
CDM,36100017,Hc Debr Muscle Fascia Addl 20Sq Cm,500.0,325.0,,,0
CDM,36100018,Hc Debr Bone Addl 20 Sq Cm,571.0,371.15,,,0
CDM,36100019,Hc Trimming Of Skin Lesion,540.0,351.0,,,0
CDM,36100020,Hc Trim Skin Lesions 2-4,713.0,463.45,,,0
CDM,36100021,Hc Trim Skin Lesions >4,1002.0,651.3,,,0
CDM,36100024,Hc Shave Epidermal Dermal Lesion Trunk Arm Leg 0.5Cm Or Less,1044.0,678.6,,,0
CDM,36100025,Hc Exc Ben Lesion S N H F G 1.1-2Cm,5046.0,3279.9,,,0
CDM,36100026,Hc Exc Malignant Les Face 2.1-3.0 Cm,5046.0,3279.9,,,0
CDM,36100027,Hc Debr Nails Up To 5,560.0,364.0,,,0
CDM,36100028,Hc Debr Nails 6 Or More,840.0,546.0,,,0
CDM,36100029,Hc Avulsion Nail Plate Single,898.0,583.7,,,0
CDM,36100030,Hc Avulsion Nail Plate Each Addl,546.0,354.9,,,0
CDM,36100031,Hc Evacuation Subungual Hematoma,894.0,581.1,,,0
CDM,36100032,Hc Excision Nail And Matrix,1356.0,881.4,,,0
CDM,36100033,Hc Repair Nail Bed,935.0,607.75,,,0
CDM,36100034,Hc Excision Nail Fold Toe,1205.0,783.25,,,0
CDM,36100035,Hc Removal Contraceptive Capsule,1168.0,759.2,,,0
CDM,36100036,Hc Insertion Contraceptive Capsule,1168.0,759.2,,,0
CDM,36100037,Hc Lac Repair Simple,485.0,315.25,,,0
CDM,36100038,Hc Lac Repair Intermediate,1345.0,874.25,,,0
CDM,36100040,Hc Secondary Closure Surg Wound,2906.0,1888.9,,,0
CDM,36100043,Hc High Cost  Applic Ss Tal 1St 25 Up To 100 Sq Cm,3263.0,2120.95,,,0
CDM,36100044,Hc High Cost Applic Ss Tal Addl 25 Up To 100 Sq Cm,3526.0,2291.9,,,0
CDM,36100045,Hc High Cost Applic Ss Tal 1St 100Sq Cm More Than 100Sq Cm,4325.0,2811.25,,,0
CDM,36100046,Hc High Cost Applic Ss Tal Addl 100 Sq Cm,4772.0,3101.8,,,0
CDM,36100047,Hc High Cost Applic Ss Hhfg 1St 25 Up To 100 Sqcm,3305.0,2148.25,,,0
CDM,36100048,Hc High Cost Applic Ss Hhfg Addl 25 Up To 100 Sqcm,3892.0,2529.8,,,0
CDM,36100049,Hc High Cost Applic Ss Hhfg 1St 100=>100Sq Cm,5561.0,3614.65,,,0
CDM,36100050,Hc High Cost Applic Ss Hhfg Addl 100=>100Sq Cm,4772.0,3101.8,,,0
CDM,36100051,Hc Treatment Burn Initial,1314.0,854.1,,,0
CDM,36100052,Hc Dress Or Debr Burn Wo Anes Small,553.0,359.45,,,0
CDM,36100053,Hc Dress Or Debr Burn Wo Anes Medium,1136.0,738.4,,,0
CDM,36100054,Hc Dress Or Debr Burn Wo Anes Large,1470.0,955.5,,,0
CDM,36100055,Hc Destruction Flat Warts <15,1002.0,651.3,,,0
CDM,36100056,Hc Cauterize Tissue Chemical,466.0,302.9,,,0
CDM,36100057,Hc Unlisted Procedure Skin Or Tissue,2402.0,1561.3,,,0
CDM,36100058,Hc Aspiration Cyst Breast Initial,1030.0,669.5,,,0
CDM,36100059,Hc Aspiration Cyst Breast Addl,572.0,371.8,,,0
CDM,36100060,Hc Inj Ductogram Or Galactogram,3162.0,2055.3,,,0
CDM,36100060_50,Hc Inj Ductogram Or Galactogram,6324.0,4110.6,,,0
CDM,36100061,Hc Bx Breast Percutaneous Wo Img,1224.0,795.6,,,0
CDM,36100061_50,Hc Bx Breast Percutaneous Wo Img,2448.0,1591.2,,,0
CDM,36100072,Hc Exploration Penetrating Wnd Extremity,1296.0,842.4,,,0
CDM,36100073,Hc Biopsy Muscle Percutaneous,4861.0,3159.65,,,0
CDM,36100074,Hc Biopsy Bone Superficial,4861.0,3159.65,,,0
CDM,36100075,Hc Biopsy Bone Deep,5850.0,3802.5,,,0
CDM,36100076,Hc Injection Sinus Tract Tx,2854.0,1855.1,,,0
CDM,36100077,Hc Injection Sinus Tract Dx,5795.0,3766.75,,,0
CDM,36100078,Hc Rem Fb Muscle Or Tendon Sheath Simple,4115.0,2674.75,,,0
CDM,36100079,Hc Injection Carpal Tunnel,1390.0,903.5,,,0
CDM,36100079_50,Hc Injection Carpal Tunnel,2780.0,1807.0,,,0
CDM,36100080,Hc Inj Single Tendon Sheath Or Ligament,1400.0,910.0,,,0
CDM,36100080_50,Hc Inj Single Tendon Sheath Or Ligament,2800.0,1820.0,,,0
CDM,36100081,Hc Tendon Origin Insertion,1400.0,910.0,,,0
CDM,36100082,Hc Inj Trigger Point 1 Or 2 Muscles,1686.0,1095.9,,,0
CDM,36100083,Hc Inj Trigger Point 3 Or More Muscles,2248.0,1461.2,,,0
CDM,36100084,Hc Asp Or Inj Joint Small,2593.0,1685.45,,,0
CDM,36100084_50,Hc Asp Or Inj Joint Small,5186.0,3370.9,,,0
CDM,36100085,Hc Asp Or Inj Joint Intermediate,2851.0,1853.15,,,0
CDM,36100085_50,Hc Asp Or Inj Joint Intermediate,5702.0,3706.3,,,0
CDM,36100086,Hc Asp Or Inj Joint Large,3109.0,2020.85,,,0
CDM,36100086_50,Hc Asp Or Inj Joint Large,6218.0,4041.7,,,0
CDM,36100087,Hc Asp Or Inj Ganglion Cyst,2219.0,1442.35,,,0
CDM,36100088,Hc Removal Implant Superficial,14699.0,9554.35,,,0
CDM,36100090,Hc Ct Guided Rf Ablation Bone Tumor,18389.0,11952.85,,,0
CDM,36100090_50,Hc Ct Guided Rf Ablation Bone Tumor,36778.0,23905.7,,,0
CDM,36100093,Hc Biopsy Soft Tissue Neck Or Thorax,4752.0,3088.8,,,0
CDM,36100095,Hc Biopsy Soft Tissue Back Or Flank Sup,6865.0,4462.25,,,0
CDM,36100096,Hc Biopsy Soft Tissue Back Or Flank Deep,6865.0,4462.25,,,0
CDM,36100097,Hc Vertebroplasty Thoracic Percutaneous W Img,18546.0,12054.9,,,0
CDM,36100098,Hc Vertebroplasty Lumbar Percutaneous W Img,19822.0,12884.3,,,0
CDM,36100099,Hc Vertebroplasty Ea Addl Thor Or Lumb W Img,10059.0,6538.35,,,0
CDM,36100100,Hc Kyphoplasty Thoracic W Img,26637.0,17314.05,,,0
CDM,36100101,Hc Kyphoplasty Lumbar W Img,28302.0,18396.3,,,0
CDM,36100102,Hc Kyphoplasty Ea Addl Thor Or Lumb W Img,13558.0,8812.7,,,0
CDM,36100105,Hc Unlisted Procedure Spine,15001.0,9750.65,,,0
CDM,36100106,Hc Biopsy Soft Tissue Shoulder Sup,6865.0,4462.25,,,0
CDM,36100106_50,Hc Biopsy Soft Tissue Shoulder Sup,13730.0,8924.5,,,0
CDM,36100107,Hc Inj Arthrography Shoulder,1424.0,925.6,,,0
CDM,36100107_50,Hc Inj Arthrography Shoulder,2848.0,1851.2,,,0
CDM,36100108,Hc Bx Soft Tissue Upper Arm Or Elbow Sup,4354.0,2830.1,,,0
CDM,36100108_50,Hc Bx Soft Tissue Upper Arm Or Elbow Sup,8708.0,5660.2,,,0
CDM,36100109,Hc Bx Soft Tissue Upper Arm Or Elbow Deep,5225.0,3396.25,,,0
CDM,36100109_50,Hc Bx Soft Tissue Upper Arm Or Elbow Deep,10450.0,6792.5,,,0
CDM,36100110,Hc Inj Arthrography Elbow,1926.0,1251.9,,,0
CDM,36100110_50,Hc Inj Arthrography Elbow,3852.0,2503.8,,,0
CDM,36100111,Hc Tenotomy Percutaneous Elbow,5056.0,3286.4,,,0
CDM,36100111_50,Hc Tenotomy Percutaneous Elbow,10112.0,6572.8,,,0
CDM,36100112,Hc Inj Arthrography Wrist,1212.0,787.8,,,0
CDM,36100112_50,Hc Inj Arthrography Wrist,2424.0,1575.6,,,0
CDM,36100113,Hc Repair Hand Tendon Or Flexor,2801.0,1820.65,,,0
CDM,36100114,Hc Closed Tx Metacarpal W Manip,3500.0,2275.0,,,0
CDM,36100115,Hc Perc Fixation Finger Or Thumb Each,4192.0,2724.8,,,0
CDM,36100116,Hc Amputation Finger Or Thumb,7920.0,5148.0,,,0
CDM,36100117,Hc Inj Arthrography Hip Wo Anes,2322.0,1509.3,,,0
CDM,36100117_50,Hc Inj Arthrography Hip Wo Anes,4644.0,3018.6,,,0
CDM,36100118,Hc Tenotomy Perc Thigh Tendon/Adctr/Hamstrng Sgl,5303.0,3446.95,,,0
CDM,36100118_50,Hc Tenotomy Perc Thigh Tendon/Adctr/Hamstrng Sgl,10606.0,6893.9,,,0
CDM,36100119,Hc Biopsy Soft Tissue Knee,6865.0,4462.25,,,0
CDM,36100119_50,Hc Biopsy Soft Tissue Knee,13730.0,8924.5,,,0
CDM,36100121,Hc Tenotomy Perc Achilles Local Anes,4816.0,3130.4,,,0
CDM,36100121_50,Hc Tenotomy Perc Achilles Local Anes,9632.0,6260.8,,,0
CDM,36100122,Hc Biopsy Soft Tissue Lower Extremity,7582.0,4928.3,,,0
CDM,36100122_50,Hc Biopsy Soft Tissue Lower Extremity,15164.0,9856.6,,,0
CDM,36100123,Hc Inj Arthrography Ankle,1203.0,781.95,,,0
CDM,36100123_50,Hc Inj Arthrography Ankle,2406.0,1563.9,,,0
CDM,36100124,Hc Removal Foreign Body Foot Subq,946.0,614.9,,,0
CDM,36100124_50,Hc Removal Foreign Body Foot Subq,1892.0,1229.8,,,0
CDM,36100125,Hc Tenotomy Open Foot Tendon Sgl Or Mult,3691.0,2399.15,,,0
CDM,36100125_50,Hc Tenotomy Open Foot Tendon Sgl Or Mult,7382.0,4798.3,,,0
CDM,36100126,Hc Laryngoscopy Fiberoptic,804.0,522.6,,,0
CDM,36100127,Hc Tracheostomy Planned,4037.0,2624.05,,,0
CDM,36100128,Hc Bronchoscopy Through Tracheostomy,4459.0,2898.35,,,0
CDM,36100130,Hc Bronchoscopy,4220.0,2743.0,,,0
CDM,36100131,Hc Bronchoscopy With Brushing,6016.0,3910.4,,,0
CDM,36100132,Hc Bronchoscopy W Alveolar Lavage,4663.0,3030.95,,,0
CDM,36100133,Hc Bronchoscopy W Biopsy,5432.0,3530.8,,,0
CDM,36100134,Hc Bronchoscopy W Insert Fiducial Markers,6600.0,4290.0,,,0
CDM,36100135,Hc Bronchoscopy W Computer Assist Nav,6539.0,4250.35,,,0
CDM,36100136,Hc Bronchoscopy W Transbronch Lung Bx,5432.0,3530.8,,,0
CDM,36100137,Hc Bronchoscopy W Transbronch Needle Asp,4442.0,2887.3,,,0
CDM,36100138,Hc Bronchoscopy W Dilation Or Fx Repair,8710.0,5661.5,,,0
CDM,36100139,Hc Bronchoscopy W Insert Trachial Stent,6859.0,4458.35,,,0
CDM,36100140,Hc Bronchoscopy W Lung Biopsy Ea Addl Lobe,2827.0,1837.55,,,0
CDM,36100141,Hc Bronchoscopy W Needle Bx Ea Addl Lobe,4680.0,3042.0,,,0
CDM,36100142,Hc Bronchoscopy W Removal Foreign Body,6362.0,4135.3,,,0
CDM,36100143,Hc Bronchoscopy W Insert Bronchial Stent,6600.0,4290.0,,,0
CDM,36100144,Hc Bronchoscopy  W Stent Ea Addl,1172.0,761.8,,,0
CDM,36100145,Hc Bronchoscopy W Stent Revision,6600.0,4290.0,,,0
CDM,36100146,Hc Bronchoscopy W Excision Of Tumor,7054.0,4585.1,,,0
CDM,36100147,Hc Bronchoscopy W Destruction Of Tumor,4307.0,2799.55,,,0
CDM,36100148,Hc Bronchoscopy W Plcmnt Radiation Cath,4899.0,3184.35,,,0
CDM,36100149,Hc Bronchoscopy W Therap Asp Of Trach Ini,4442.0,2887.3,,,0
CDM,36100150,Hc Bronchoscopy W Therap Asp Of Trach Sub,708.0,460.2,,,0
CDM,36100151,Hc Bronchoscopy W Insert Bronch Valves Ini,6600.0,4290.0,,,0
CDM,36100152,Hc Bronchoscopy W Rem Bronch Valves Ini,5601.0,3640.65,,,0
CDM,36100153,Hc Bronchoscopy W Rem Bronch Valves Addl,4132.0,2685.8,,,0
CDM,36100154,Hc Bronchoscopy W Insert Bronch Valves Addl,5745.0,3734.25,,,0
CDM,36100155,Hc Img Guide Fluid Coll Drng By Cath Visceral Perc,13425.0,8726.25,,,0
CDM,36100156,Hc Biopsy Pleura Percutaneous Needle,4996.0,3247.4,,,0
CDM,36100158,Hc Insert Tunneled Pleural Catheter,11864.0,7711.6,,,0
CDM,36100159,Hc Thoracostomy Tube Open,2736.0,1778.4,,,0
CDM,36100159_50,Hc Thoracostomy Tube Open,5472.0,3556.8,,,0
CDM,36100160,Hc Remove Tunneled Pleural Cath W Cuff,3732.0,2425.8,,,0
CDM,36100161,Hc Thoracentesis Wo Imaging,3710.0,2411.5,,,0
CDM,36100161_50,Hc Thoracentesis Wo Imaging,7420.0,4823.0,,,0
CDM,36100162,Hc Thoracentesis W Imaging,5627.0,3657.55,,,0
CDM,36100162_50,Hc Thoracentesis W Imaging,11254.0,7315.1,,,0
CDM,36100163,Hc Perc Pleural Drnge W Ins Catheter Wo Img,5421.0,3523.65,,,0
CDM,36100163_50,Hc Perc Pleural Drnge W Ins Catheter Wo Img,10842.0,7047.3,,,0
CDM,36100164,Hc Perc Pleural Drnge W Ins Catheter W Img,8132.0,5285.8,,,0
CDM,36100164_50,Hc Perc Pleural Drnge W Ins Catheter W Img,16264.0,10571.6,,,0
CDM,36100165,Hc Chemical Pleurodesis,2728.0,1773.2,,,0
CDM,36100166,Hc Rf Ablation Pulm Tumor Unilat W Img,15456.0,10046.4,,,0
CDM,36100166_50,Hc Rf Ablation Pulm Tumor Unilat W Img,30912.0,20092.8,,,0
CDM,36100167,Hc Unlisted Procedure Lungs Or Pleura,2736.0,1778.4,,,0
CDM,36100171,Hc Insert Pacer Atrial W Lead,21785.0,14160.25,,,0
CDM,36100172,Hc Insert Pacer Ventricular W Lead,22288.0,14487.2,,,0
CDM,36100173,Hc Insert Pacer Atrial And Ventricular W Lead,26652.0,17323.8,,,0
CDM,36100174,Hc Insert Temporary Pacemaker,10844.0,7048.6,,,0
CDM,36100175,Hc Insert Pulse Generator Only Sgl,15770.0,10250.5,,,0
CDM,36100176,Hc Insert Pulse Generator Only Dual,18580.0,12077.0,,,0
CDM,36100177,Hc Upgrade Implanted Pacemaker,18580.0,12077.0,,,0
CDM,36100178,Hc Reposition Previously Implanted Pacer,11992.0,7794.8,,,0
CDM,36100179,Hc Insertion Transvenous Electrode Single,21986.0,14290.9,,,0
CDM,36100180,Hc Insertion Transvenous Electrode Dual,23085.0,15005.25,,,0
CDM,36100181,Hc Repair Transvenous Electrode Single,17335.0,11267.75,,,0
CDM,36100182,Hc Repair Transvenous Electrode Dual,18433.0,11981.45,,,0
CDM,36100183,Hc Insert Pacer Pulse Generator Mult Leads,31030.0,20169.5,,,0
CDM,36100184,Hc Revision Skin Pocket Pacemaker,10452.0,6793.8,,,0
CDM,36100185,Hc Revision Skin Pocket Icd,10452.0,6793.8,,,0
CDM,36100186,Hc Ins Electrode Prev Placed Icd Or Pacer,34671.0,22536.15,,,0
CDM,36100187,Hc Ins Electrode At Ins Icd Or Pacer,20520.0,13338.0,,,0
CDM,36100188,Hc Reposition Previously Impl Cvs Electrode,11992.0,7794.8,,,0
CDM,36100189,Hc Rem And Replace Pacer Pulse Gen Single,20170.0,13110.5,,,0
CDM,36100190,Hc Rem And Replace Pacer Pulse Gen Dual,22315.0,14504.75,,,0
CDM,36100191,Hc Rem And Replace Pacer Pulse Gen Mult,18676.0,12139.4,,,0
CDM,36100192,Hc Insert Icd Generator Only Dual,23817.0,15481.05,,,0
CDM,36100193,Hc Insert Icd Generator Only Mult,32544.0,21153.6,,,0
CDM,36100194,Hc Remover Pacer Pulse Generator Only,23695.0,15401.75,,,0
CDM,36100195,Hc Remove Tvs Electrode Sgl Lead System,13868.0,9014.2,,,0
CDM,36100196,Hc Remove Tvs Electrode Dual Lead System,15654.0,10175.1,,,0
CDM,36100197,Hc Insertion Icd Generator Only Single,26020.0,16913.0,,,0
CDM,36100198,Hc Remove Icd Generator Only,20853.0,13554.45,,,0
CDM,36100199,Hc Icd Lead Extraction,20853.0,13554.45,,,0
CDM,36100200,Hc Ins Or Repl Icd W Pulse Gen Sgl Or Dual,24020.0,15613.0,,,0
CDM,36100201,Hc Remove Replace Icd Gen Sgl Lead Sys,22018.0,14311.7,,,0
CDM,36100202,Hc Remove Replace Icd Gen Dual Lead Sys,21707.0,14109.55,,,0
CDM,36100203,Hc Remove Replace Icd Gen Mult Lead Sys,21260.0,13819.0,,,0
CDM,36100206,Hc Tavr Tavi Perc Fem Art Approach,42905.0,27888.25,,,0
CDM,36100207,Hc Tavr Tavi Open Fem Art Approach,42905.0,27888.25,,,0
CDM,36100208,Hc Tavr Tavi Open Axil Art Approach,42905.0,27888.25,,,0
CDM,36100210,Hc Tavr Tavi Transaortic Approach,53222.0,34594.3,,,0
CDM,36100211,Hc Endovasc Rep Descend Thorac Aorta Subclav,3563.0,2315.95,,,0
CDM,36100212,Hc Endovasc Rep Descend Thorac Aorta No Subcl,3563.0,2315.95,,,0
CDM,36100213,Hc Plcmnt Prox Ext Prosthesis Rpr Desc Aorta,1305.0,848.25,,,0
CDM,36100214,Hc Plcmnt Prox Ext Prosthesis Rpr Desc Aorta Addl,1305.0,848.25,,,0
CDM,36100215,Hc Plcmnt Dist Ext Prosthesis Delayd After Rpr,3563.0,2315.95,,,0
CDM,36100216,Hc Unlisted Procedure Cardiac Surgery,1450.0,942.5,,,0
CDM,36100222,Hc Embolectomy Fem Pop Aortoiliac Art,6677.0,4340.05,,,0
CDM,36100222_50,Hc Embolectomy Fem Pop Aortoiliac Art,13354.0,8680.1,,,0
CDM,36100244,Hc Intro Needle Or Intracatheter Vein,1057.0,687.05,,,0
CDM,36100245,Hc Injection Thrombin Pseudoaneurysm,4608.0,2995.2,,,0
CDM,36100245_50,Hc Injection Thrombin Pseudoaneurysm,9216.0,5990.4,,,0
CDM,36100246,Hc Injection Extremity Venogram,2925.0,1901.25,,,0
CDM,36100246_50,Hc Injection Extremity Venogram,5850.0,3802.5,,,0
CDM,36100247,Hc Introduction Catheter Inf Or Sup Vena Cava,1920.0,1248.0,,,0
CDM,36100247_50,Hc Introduction Catheter Inf Or Sup Vena Cava,3840.0,2496.0,,,0
CDM,36100248,Hc Sel Cath Placement Venous 1St Order,1528.0,993.2,,,0
CDM,36100248_50,Hc Sel Cath Placement Venous 1St Order,3056.0,1986.4,,,0
CDM,36100249,Hc Sel Cath Placement Venous 2Nd Order,1549.0,1006.85,,,0
CDM,36100249_50,Hc Sel Cath Placement Venous 2Nd Order,3098.0,2013.7,,,0
CDM,36100250,Hc Intro Catheter Rt Heart Or Main Pulm Art,535.0,347.75,,,0
CDM,36100251,Hc Sel Cath Placement Rt Or Lt Pulm Artery,1652.0,1073.8,,,0
CDM,36100251_50,Hc Sel Cath Placement Rt Or Lt Pulm Artery,3304.0,2147.6,,,0
CDM,36100252,Hc Sel Cath Placement Seg Or Subseg Pulm Artery,1399.0,909.35,,,0
CDM,36100252_50,Hc Sel Cath Placement Seg Or Subseg Pulm Artery,2798.0,1818.7,,,0
CDM,36100254,Hc Intro Needle Or Cath Extremity Artery,3210.0,2086.5,,,0
CDM,36100257,Hc Intro Needle Or Cath Aorta Translumbar,1907.0,1239.55,,,0
CDM,36100258,Hc Introduction Catheter Aorta,3210.0,2086.5,,,0
CDM,36100258_50,Hc Introduction Catheter Aorta,6420.0,4173.0,,,0
CDM,36100259,Hc Sel Cath Plc Thrc Brch Cphlc Brnch 1St Ord,2390.0,1553.5,,,0
CDM,36100260,Hc Sel Cath Plc Thrc Brch Cphlc Brnch 2Nd Ord 1St,2236.0,1453.4,,,0
CDM,36100261,Hc Sel Cath Plc Thrc Brch Cphlc Brnch 3Rd+ Ord,2150.0,1397.5,,,0
CDM,36100262,Hc Sel Cath Plc Thrc Brch Cphlc Brnch Addl 2Nd Or 3Rd,1961.0,1274.65,,,0
CDM,36100263,Hc Nonsel Cath Thor Aorta Angio Intr Xtrcranial Art,5740.0,3731.0,,,0
CDM,36100264,Hc Sel Cath Plc Cmn Crtd Angio Xtrcrnl Art,15588.0,10132.2,,,0
CDM,36100264_50,Hc Sel Cath Plc Cmn Crtd Angio Xtrcrnl Art,31176.0,20264.4,,,0
CDM,36100265,Hc Sel Cath Plc Cmn Crtd Angio Intrcrnl Art,10759.0,6993.35,,,0
CDM,36100265_50,Hc Sel Cath Plc Cmn Crtd Angio Intrcrnl Art,21518.0,13986.7,,,0
CDM,36100266,Hc Sel Cath Plc Int Crtd Angio Intrcrnl Art,13970.0,9080.5,,,0
CDM,36100266_50,Hc Sel Cath Plc Int Crtd Angio Intrcrnl Art,27940.0,18161.0,,,0
CDM,36100267,Hc Sel Cath Plc Subclv Art Angio Vertebral Art,5168.0,3359.2,,,0
CDM,36100267_50,Hc Sel Cath Plc Subclv Art Angio Vertebral Art,10336.0,6718.4,,,0
CDM,36100268,Hc Sel Cath Plc Vertebral Art Angio Vertebral Art,5168.0,3359.2,,,0
CDM,36100268_50,Hc Sel Cath Plc Vertebral Art Angio Vertebral Art,10336.0,6718.4,,,0
CDM,36100269,Hc Sel Cath Plc Xtrnl Crtd Art Angio Xtrnl Crtd Circ,2347.0,1525.55,,,0
CDM,36100270,Hc Sel Cath Plc Intrcrnl Branch Angio Ntrnl Crtd Vert,2752.0,1788.8,,,0
CDM,36100271,Hc Sel Cath Plc Ea 1St Order Abd Pel Le Art Branch,2085.0,1355.25,,,0
CDM,36100271_50,Hc Sel Cath Plc Ea 1St Order Abd Pel Le Art Branch,4170.0,2710.5,,,0
CDM,36100272,Hc Sel Cath Plc 2Nd Order Abd Pel Le Art Branch,2098.0,1363.7,,,0
CDM,36100272_50,Hc Sel Cath Plc 2Nd Order Abd Pel Le Art Branch,4196.0,2727.4,,,0
CDM,36100273,Hc Sel Cath Plc 3Rd+ Order Abd Pel Le Art Branch,2098.0,1363.7,,,0
CDM,36100273_50,Hc Sel Cath Plc 3Rd+ Order Abd Pel Le Art Branch,4196.0,2727.4,,,0
CDM,36100274,Hc Sel Cath Plc Ea 2Nd+ Order Abd Pel Le Art Branch,2008.0,1305.2,,,0
CDM,36100275,Hc Sel Cath Plc 1St Order Renal Artery Uni W Img,16507.0,10729.55,,,0
CDM,36100276,Hc Sel Cath Plc 1St Order Renal Artery Bil W Img,19504.0,12677.6,,,0
CDM,36100277,Hc Ins Cath 2Nd+ Order Ren Art Uni W Img,10909.0,7090.85,,,0
CDM,36100278,Hc Ins Cath 2Nd+ Order Ren Art Bil W Img,15090.0,9808.5,,,0
CDM,36100279,Hc Unlisted Procedure Vascular Injection,476.0,309.4,,,0
CDM,36100280,Hc Inj Sclerosant For Spider Veins Limb Or Trunk,644.0,418.6,,,0
CDM,36100281,Hc Inj Sclerosing Soln Single Incompetent Vein,712.0,462.8,,,0
CDM,36100281_50,Hc Inj Sclerosing Soln Single Incompetent Vein,1424.0,925.6,,,0
CDM,36100282,Hc Inj Sclerosing Soln Mult Incompetent Veins Same Leg,712.0,462.8,,,0
CDM,36100282_50,Hc Inj Sclerosing Soln Mult Incompetent Veins Same Leg,1424.0,925.6,,,0
CDM,36100283,Hc Endovenous Ablation Ext Rf 1St Vein,9406.0,6113.9,,,0
CDM,36100283_50,Hc Endovenous Ablation Ext Rf 1St Vein,18812.0,12227.8,,,0
CDM,36100284,Hc Endovenous Ablation Ext Rf 2Nd+ Veins,5706.0,3708.9,,,0
CDM,36100285,Hc Endovenous Ablation Ext Laser 1St Vein,9406.0,6113.9,,,0
CDM,36100285_50,Hc Endovenous Ablation Ext Laser 1St Vein,18812.0,12227.8,,,0
CDM,36100286,Hc Endovenous Ablation Ext Laser 2Nd+ Veins,5706.0,3708.9,,,0
CDM,36100287,Hc Perc Portal Vein Catheterization,752.0,488.8,,,0
CDM,36100288,Hc Cath Venous Sel Organ Blood Sample,506.0,328.9,,,0
CDM,36100289,Hc Cath Umbilical Vein,516.0,335.4,,,0
CDM,36100290,Hc Therapeutic Apheresis For Wbc,4532.0,2945.8,,,0
CDM,36100291,Hc Therapeutic Apheresis For Rbc,8102.0,5266.3,,,0
CDM,36100292,Hc Therapeutic Apheresis For Platelets,7553.0,4909.45,,,0
CDM,36100293,Hc Therapeutic Pheresis For Plasma,8352.0,5428.8,,,0
CDM,36100294,Hc Insert Cvc Nontunneled Age 5 Or Older,3389.0,2202.85,,,0
CDM,36100295,Hc Insert Cvc Tunneled Age 5 Or Older,10800.0,7020.0,,,0
CDM,36100295_50,Hc Insert Cvc Tunneled Age 5 Or Older,21600.0,14040.0,,,0
CDM,36100296,Hc Insert Cva Device W Port,11520.0,7488.0,,,0
CDM,36100296_50,Hc Insert Cva Device W Port,23040.0,14976.0,,,0
CDM,36100297,Hc Insert Cva 2 Caths Wo Port,12240.0,7956.0,,,0
CDM,36100297_50,Hc Insert Cva 2 Caths Wo Port,24480.0,15912.0,,,0
CDM,36100298,Hc Insert Cva 2 Caths W Port,12960.0,8424.0,,,0
CDM,36100298_50,Hc Insert Cva 2 Caths W Port,25920.0,16848.0,,,0
CDM,36100299,Hc Insert Picc Wo Sq Port Wo Imaging Guidance Age 5 Or Older,3389.0,2202.85,,,0
CDM,36100300,Hc Repair Cva Catheter,6590.0,4283.5,,,0
CDM,36100301,Hc Repair Cva Device W Port,8120.0,5278.0,,,0
CDM,36100302,Hc Replace Cath Cva Device W Port,13676.0,8889.4,,,0
CDM,36100303,Hc Replace Non-Tunneled Cvc,3389.0,2202.85,,,0
CDM,36100304,Hc Replace Tunneled Cvc,10080.0,6552.0,,,0
CDM,36100305,Hc Repl Tunneled Cva Dev W Sq Port,10800.0,7020.0,,,0
CDM,36100306,Hc Replace Picc Wo Sq Port Incl All Imaging,4919.0,3197.35,,,0
CDM,36100307,Hc Rem Tun Cvc Wo Port,4926.0,3201.9,,,0
CDM,36100308,Hc Rem Implant Access Port Sub,7146.0,4644.9,,,0
CDM,36100309,Hc Collect Bld Spec Impl Vad,794.0,516.1,,,0
CDM,36100310,Hc Collect Spec Picc Or Cvc,192.0,124.8,,,0
CDM,36100311,Hc Declot Cath Or Vad By Thrombolytic,2933.0,1906.45,,,0
CDM,36100312,Hc Rem Pericath Obstructive Material,5284.0,3434.6,,,0
CDM,36100313,Hc Rem Intraluminal Obscructive Material,2386.0,1550.9,,,0
CDM,36100314,Hc Reposition Cvc W Fluoro,6126.0,3981.9,,,0
CDM,36100315,Hc Contrast Inj Vad W Fluoro,3455.0,2245.75,,,0
CDM,36100315_50,Hc Contrast Inj Vad W Fluoro,6910.0,4491.5,,,0
CDM,36100316,Hc Abg Puncture,329.0,213.85,,,0
CDM,36100317,Hc Insert Arterial Cath Percutaneous,999.0,649.35,,,0
CDM,36100326,Hc Insertion Of Tips,37873.0,24617.45,,,0
CDM,36100327,Hc Revision Of Tips,28472.0,18506.8,,,0
CDM,36100328,Hc Art Mech Throm (Non Cor) 1St Ves,19016.0,12360.4,,,0
CDM,36100328_50,Hc Art Mech Throm (Non Cor) 1St Ves,38032.0,24720.8,,,0
CDM,36100329,Hc Art Mech Throm (Non Cor)Addl Ves,20512.0,13332.8,,,0
CDM,36100330,Hc Art Mech Throm (Non Cor) Secondary,23233.0,15101.45,,,0
CDM,36100331,Hc Ven Mechanical Thrombectomy,19495.0,12671.75,,,0
CDM,36100331_50,Hc Ven Mechanical Thrombectomy,38990.0,25343.5,,,0
CDM,36100332,Hc Ven Mechanical Thromb Repeat Tx,12350.0,8027.5,,,0
CDM,36100332_50,Hc Ven Mechanical Thromb Repeat Tx,24700.0,16055.0,,,0
CDM,36100333,Hc Insert Ivc Filter,19286.0,12535.9,,,0
CDM,36100334,Hc Reposition Ivc Filter,7234.0,4702.1,,,0
CDM,36100335,Hc Remove Ivc Filter,13466.0,8752.9,,,0
CDM,36100336,Hc Thrombolysis Cerebral Iv Infusion,575.0,373.75,,,0
CDM,36100337,Hc Transcath Rtrvl Intrvas Fb W Img,10772.0,7001.8,,,0
CDM,36100338,Hc Transcatheter Biopsy,14434.0,9382.1,,,0
CDM,36100346,Hc Trnscth Tx Thrmb Art Init Day,48736.0,31678.4,,,0
CDM,36100346_50,Hc Trnscth Tx Thrmb Art Init Day,97472.0,63356.8,,,0
CDM,36100347,Hc Trnscth Tx Thrmb Ven Init Day,36848.0,23951.2,,,0
CDM,36100347_50,Hc Trnscth Tx Thrmb Ven Init Day,73696.0,47902.4,,,0
CDM,36100348,Hc Trnscth Tx Thrmb Subq Day,39480.0,25662.0,,,0
CDM,36100349,Hc Trnscth Tx Thrmb Cessation,37704.0,24507.6,,,0
CDM,36100350,Hc Transcath Stent Cca W Eps,40766.0,26497.9,,,0
CDM,36100350_50,Hc Transcath Stent Cca W Eps,81532.0,52995.8,,,0
CDM,36100351,Hc Transcath Stent Cca Wo Eps,18523.0,12039.95,,,0
CDM,36100352,Hc Revasc Endo Iliac Init W Pta,20791.0,13514.15,,,0
CDM,36100352_50,Hc Revasc Endo Iliac Init W Pta,41582.0,27028.3,,,0
CDM,36100353,Hc Revasc/Endo Iliac W Stnt W/Wo Pta,21474.0,13958.1,,,0
CDM,36100353_50,Hc Revasc/Endo Iliac W Stnt W/Wo Pta,42948.0,27916.2,,,0
CDM,36100354,Hc Iliac Ea Addl Ipsilat Vsl W Pta,5451.0,3543.15,,,0
CDM,36100355,Hc Iliac Ea Adl Ipsil Vsl W Stent,6275.0,4078.75,,,0
CDM,36100356,Hc Revasc Endo Fempop W Pta,21131.0,13735.15,,,0
CDM,36100356_50,Hc Revasc Endo Fempop W Pta,42262.0,27470.3,,,0
CDM,36100357,Hc Revasc Endo Fempop W Atherectomy,25299.0,16444.35,,,0
CDM,36100357_50,Hc Revasc Endo Fempop W Atherectomy,50598.0,32888.7,,,0
CDM,36100358,Hc Revasc Endo Fempop W Stent,22355.0,14530.75,,,0
CDM,36100358_50,Hc Revasc Endo Fempop W Stent,44710.0,29061.5,,,0
CDM,36100359,Hc Revasc Endo Fempop W Stnt&Atherec,28110.0,18271.5,,,0
CDM,36100359_50,Hc Revasc Endo Fempop W Stnt&Atherec,56220.0,36543.0,,,0
CDM,36100360,Hc Revasc Endo Tibiopero W Pta,22105.0,14368.25,,,0
CDM,36100360_50,Hc Revasc Endo Tibiopero W Pta,44210.0,28736.5,,,0
CDM,36100361,Hc Revasc Endo Tibiopero W Atherectm,22245.0,14459.25,,,0
CDM,36100361_50,Hc Revasc Endo Tibiopero W Atherectm,44490.0,28918.5,,,0
CDM,36100362,Hc Revasc Endo Tibiopero W Stent,23262.0,15120.3,,,0
CDM,36100362_50,Hc Revasc Endo Tibiopero W Stent,46524.0,30240.6,,,0
CDM,36100363,Hc Revasc/Endo Tibioper W Stnt&Ather,34432.0,22380.8,,,0
CDM,36100363_50,Hc Revasc/Endo Tibioper W Stnt&Ather,68864.0,44761.6,,,0
CDM,36100364,Hc Tibiopero Ea Addl W Pta,5068.0,3294.2,,,0
CDM,36100365,Hc Tibiopero W Atherectmy Ea Addl,5068.0,3294.2,,,0
CDM,36100366,Hc Tibiopero W Stent Ea Addl,5068.0,3294.2,,,0
CDM,36100367,Hc Tibiopero W Stnt&Atherec Ea Addl,5068.0,3294.2,,,0
CDM,36100371,Hc Stab Phleb Veins 1 Leg 10-20 Incis,14232.0,9250.8,,,0
CDM,36100371_50,Hc Stab Phleb Veins 1 Leg 10-20 Incis,28464.0,18501.6,,,0
CDM,36100372,Hc Unlisted Procedure Vascular Surg,627.0,407.55,,,0
CDM,36100373,Hc Inj Splenoportogram,1238.0,804.7,,,0
CDM,36100374,Hc Bone Marrow Diagnostic Aspiration(S) Only,4717.0,3066.05,,,0
CDM,36100374_50,Hc Bone Marrow Diagnostic Aspiration(S) Only,9434.0,6132.1,,,0
CDM,36100375,Hc Bone Marrow Diagnostic Biopsy(Ies) Only,4954.0,3220.1,,,0
CDM,36100375_50,Hc Bone Marrow Diagnostic Biopsy(Ies) Only,9908.0,6440.2,,,0
CDM,36100376,Hc Biopsy Lymph Node Superficial,3970.0,2580.5,,,0
CDM,36100376_50,Hc Biopsy Lymph Node Superficial,7940.0,5161.0,,,0
CDM,36100377,Hc Injection For Lymphangiography,2036.0,1323.4,,,0
CDM,36100377_50,Hc Injection For Lymphangiography,4072.0,2646.8,,,0
CDM,36100378,Hc Injection Tracer For Sentinel Node Id,2036.0,1323.4,,,0
CDM,36100378_50,Hc Injection Tracer For Sentinel Node Id,4072.0,2646.8,,,0
CDM,36100380,Hc Unlisted Dentoalvolar Procedure,1108.0,720.2,,,0
CDM,36100381,Hc Biopsy Salivary Gland Needle,2635.0,1712.75,,,0
CDM,36100382,Hc Injection For Sialogram,3863.0,2510.95,,,0
CDM,36100383,Hc Dil Cath Salivary Duct W Wo Injection,509.0,330.85,,,0
CDM,36100384,Hc Ng Tube Placement,3085.0,2005.25,,,0
CDM,36100385,Hc Reposition Oro Or Naso Gastric Tube,3085.0,2005.25,,,0
CDM,36100388,Hc Introduction Long Gi Tube,2111.0,1372.15,,,0
CDM,36100390,Hc Biopsy Liver Needle,6197.0,4028.05,,,0
CDM,36100391,Hc Biopsy Liver W Other Procedure,1853.0,1204.45,,,0
CDM,36100394,Hc Rf Ablation Liver Percutaneous,16832.0,10940.8,,,0
CDM,36100396,Hc Cholecystostomy W Img And Cath Plcmnt Perc,10337.0,6719.05,,,0
CDM,36100404,Hc Biliary Endo Perc With Biopsy,6540.0,4251.0,,,0
CDM,36100409,Hc Unlisted Procedure Biliary Tract,5804.0,3772.6,,,0
CDM,36100410,Hc Biopsy Pancreas Perc Needle,4904.0,3187.6,,,0
CDM,36100413,Hc Img Guide Fluid Coll Drng By Cath Peri Or Retro Perc,13066.0,8492.9,,,0
CDM,36100418,Hc Abdominal Paracentesis Wo Img,4465.0,2902.25,,,0
CDM,36100419,Hc Abdominal Paracentesis W Img,5183.0,3368.95,,,0
CDM,36100420,Hc Biopsy Abd Or Retroperitoneal Needle Perc,7513.0,4883.45,,,0
CDM,36100424,Hc Injection Air Or Contrast Peritoneal Cavity,7728.0,5023.2,,,0
CDM,36100425,Hc Insert Tunneled Intraperitoneal Cath W Img,16118.0,10476.7,,,0
CDM,36100426,Hc Insert Tunneled Intraperitoneal Cath Subq Port,15001.0,9750.65,,,0
CDM,36100427,Hc Insert Tunneled Intraperitoneal Cath Open,16118.0,10476.7,,,0
CDM,36100428,Hc Remove Tunneled Intraperitoneal Cath,7368.0,4789.2,,,0
CDM,36100429,Hc Drainage Catheter Exchange W Img,3068.0,1994.2,,,0
CDM,36100430,Hc Inject Contrast Abscess Or Cyst,960.0,624.0,,,0
CDM,36100431,Hc Inject Contrast Shuntogram,5606.0,3643.9,,,0
CDM,36100432,Hc Place G Tube Percutaneous W Fluoro,10099.0,6564.35,,,0
CDM,36100433,Hc Place J Tube Percutaneous W Fluoro,10099.0,6564.35,,,0
CDM,36100434,Hc Convert G To Gj Tube W Fluoro,9959.0,6473.35,,,0
CDM,36100435,Hc Replace G Tube W Fluoro,6732.0,4375.8,,,0
CDM,36100436,Hc Replace J Tube W Fluoro,8078.0,5250.7,,,0
CDM,36100437,Hc Replace G J Tube W Fluoro,8078.0,5250.7,,,0
CDM,36100438,Hc Inject Contrast Existing G Tube,7087.0,4606.55,,,0
CDM,36100439,Hc Unlisted Procedure Abd Peritoneum Omentum,8094.0,5261.1,,,0
CDM,36100441,Hc Nephrostolithotomy Up To 2Cm,13215.0,8589.75,,,0
CDM,36100441_50,Hc Nephrostolithotomy Up To 2Cm,26430.0,17179.5,,,0
CDM,36100442,Hc Biopsy Renal Percutaneous Needle,6425.0,4176.25,,,0
CDM,36100442_50,Hc Biopsy Renal Percutaneous Needle,12850.0,8352.5,,,0
CDM,36100443,Hc Rem And Repl Ureteral Stent Perc,11706.0,7608.9,,,0
CDM,36100443_50,Hc Rem And Repl Ureteral Stent Perc,23412.0,15217.8,,,0
CDM,36100444,Hc Rem Ureteral Stent Perc,12354.0,8030.1,,,0
CDM,36100444_50,Hc Rem Ureteral Stent Perc,24708.0,16060.2,,,0
CDM,36100445,Hc Rem And Repl Ureteral Stent Transurethral,11953.0,7769.45,,,0
CDM,36100445_50,Hc Rem And Repl Ureteral Stent Transurethral,23906.0,15538.9,,,0
CDM,36100446,Hc Rem Ureteral Stent Transurethral,7373.0,4792.45,,,0
CDM,36100446_50,Hc Rem Ureteral Stent Transurethral,14746.0,9584.9,,,0
CDM,36100447,Hc Rem And Repl Transnephric Ureteral Stent,11953.0,7769.45,,,0
CDM,36100447_50,Hc Rem And Repl Transnephric Ureteral Stent,23906.0,15538.9,,,0
CDM,36100448,Hc Remove Nephrostomy Tube,3022.0,1964.3,,,0
CDM,36100448_50,Hc Remove Nephrostomy Tube,6044.0,3928.6,,,0
CDM,36100449,Hc Asp Or Inj Renal Cyst Or Pelvis,5879.0,3821.35,,,0
CDM,36100449_50,Hc Asp Or Inj Renal Cyst Or Pelvis,11758.0,7642.7,,,0
CDM,36100450,Hc Instill Chemo Kidney Via Nephrostomy,1124.0,730.6,,,0
CDM,36100450_50,Hc Instill Chemo Kidney Via Nephrostomy,2248.0,1461.2,,,0
CDM,36100455,Hc Manometric Study Thru Tube,14507.0,9429.55,,,0
CDM,36100455_50,Hc Manometric Study Thru Tube,29014.0,18859.1,,,0
CDM,36100458,Hc Rf Ablation Renal Tumors Percutaneous,14068.0,9144.2,,,0
CDM,36100458_50,Hc Rf Ablation Renal Tumors Percutaneous,28136.0,18288.4,,,0
CDM,36100459,Hc Cryoablation Renal Tumor Unilat,14514.0,9434.1,,,0
CDM,36100459_50,Hc Cryoablation Renal Tumor Unilat,29028.0,18868.2,,,0
CDM,36100460,Hc Inj For Ureterography Or Ureteropyelography,2088.0,1357.2,,,0
CDM,36100460_50,Hc Inj For Ureterography Or Ureteropyelography,4176.0,2714.4,,,0
CDM,36100461,Hc Change Nephroureteral Tube Or Stent,5708.0,3710.2,,,0
CDM,36100462,Hc Injection Ileal Conduit,3863.0,2510.95,,,0
CDM,36100463,Hc Cystostomy Cystotomy W Drainage,13614.0,8849.1,,,0
CDM,36100464,Hc Inj Cystography Or Voiding Urethrocysto,3818.0,2481.7,,,0
CDM,36100465,Hc Inj For Retrograde Urethrocystography,3420.0,2223.0,,,0
CDM,36100466,Hc Irrig Bladder Simple And Or Instillation,1591.0,1034.15,,,0
CDM,36100467,Hc Insertion Catheter Straight,745.0,484.25,,,0
CDM,36100468,Hc Insertion Catheter Foley,912.0,592.8,,,0
CDM,36100469,Hc Change Cysto Tube Simple,4766.0,3097.9,,,0
CDM,36100470,Hc Change Cysto Tube Complicated,14068.0,9144.2,,,0
CDM,36100471,Hc Cystourethroscopy,4045.0,2629.25,,,0
CDM,36100472,Hc Cystourethroscopy W Irrigation,4645.0,3019.25,,,0
CDM,36100474,Hc Cysto W Removal Fb Simple,6959.0,4523.35,,,0
CDM,36100476,Hc Cystoscopy W Ins Ureteral Stent,7691.0,4999.15,,,0
CDM,36100476_50,Hc Cystoscopy W Ins Ureteral Stent,15382.0,9998.3,,,0
CDM,36100478,Hc Cystoscopy W Ureteroscopy,7234.0,4702.1,,,0
CDM,36100480,Hc Unlisted Procedure Urinary System,3524.0,2290.6,,,0
CDM,36100481,Hc Circumcision,2484.0,1614.6,,,0
CDM,36100482,Hc Inj Corpora Cavernosography,4025.0,2616.25,,,0
CDM,36100483,Hc Punc Asp Hydrocele Tunica Vag,1724.0,1120.6,,,0
CDM,36100483_50,Hc Punc Asp Hydrocele Tunica Vag,3448.0,2241.2,,,0
CDM,36100484,Hc Biopsy Prostate Needle,2146.0,1394.9,,,0
CDM,36100485,Hc Placement Needle Transperineal Prostate,5575.0,3623.75,,,0
CDM,36100487,Hc Insertion Uterine Tandem Ovoid,5000.0,3250.0,,,0
CDM,36100488,Hc Endometrial Sampling Biopsy,1022.0,664.3,,,0
CDM,36100489,Hc Catheterization For Hysterosalpingogram,565.0,367.25,,,0
CDM,36100490,Hc Introduction Catheter Fallopian Tube,12350.0,8027.5,,,0
CDM,36100490_50,Hc Introduction Catheter Fallopian Tube,24700.0,16055.0,,,0
CDM,36100491,Hc Reopen Fallopian Tube,23569.0,15319.85,,,0
CDM,36100491_50,Hc Reopen Fallopian Tube,47138.0,30639.7,,,0
CDM,36100492,Hc Img Guide Fluid Coll Drng By Cath Transvag Or Rec Perc,13760.0,8944.0,,,0
CDM,36100493,Hc Unlisted Fem Genital Procedure,1903.0,1236.95,,,0
CDM,36100494,Hc Amniocentesis Diagnostic,2573.0,1672.45,,,0
CDM,36100495,Hc Amniocentesis Therapeutic W Us Guidance,2701.0,1755.65,,,0
CDM,36100496,Hc Cordocentisis Intrauterine,1734.0,1127.1,,,0
CDM,36100497,Hc Fetal Contraction Stress Test,1022.0,664.3,,,0
CDM,36100498,Hc Cerclage Cervix During Pregnancy,6230.0,4049.5,,,0
CDM,36100499,Hc Hysterorrhaphy Ruptured Uterus,7745.0,5034.25,,,0
CDM,36100500,Hc Biopsy Thyroid Percutaneous Core Needle,1765.0,1147.25,,,0
CDM,36100501,Hc Asp Or Inj Thyroid Cyst,1765.0,1147.25,,,0
CDM,36100502,Hc Unlisted Procedure  Endocrine System,8337.0,5419.05,,,0
CDM,36100503,Hc Cervical Puncture,152.0,98.8,,,0
CDM,36100504,Hc Cervical Puncture W Injection,215.0,139.75,,,0
CDM,36100505,Hc Puncture Shunt Tube For Asp Or Inj,2708.0,1760.2,,,0
CDM,36100506,Hc Endovasc Temp Balloon Arterial Occlus Head Or Neck,24696.0,16052.4,,,0
CDM,36100507,Hc Transcath Permanent Occlus Or Embol Cns,30065.0,19542.25,,,0
CDM,36100508,Hc Transcath Permanent Occlus Or Embol Non Cns,35062.0,22790.3,,,0
CDM,36100509,Hc Balloon Angioplasty Intracranial Percutaneous,12350.0,8027.5,,,0
CDM,36100510,Hc Stent Intracranial Transcath,24700.0,16055.0,,,0
CDM,36100511,Hc Balloon Dilat Intracranial Vasospasm Init Vessel,28956.0,18821.4,,,0
CDM,36100512,Hc Blln Dilat Intracran Vasospasm Addl Ves Diff Vas Territory,18836.0,12243.4,,,0
CDM,36100515,Hc Perc Lysis Of Adhesions Mult Sessns 1 Day,16392.0,10654.8,,,0
CDM,36100516,Hc Percutaneous Aspiration Intervertebral Disc,15049.0,9781.85,,,0
CDM,36100517,Hc Percutaneous Aspiration Spinal Cord Cyst,22820.0,14833.0,,,0
CDM,36100518,Hc Spinal Puncture Lumbar Diagnostic Wo Img,1944.0,1263.6,,,0
CDM,36100519,Hc Spinal Puncture Lumbar Therapeutic Wo Img,4732.0,3075.8,,,0
CDM,36100520,Hc Injection Epidural Of Blood Clot Or Patch,5910.0,3841.5,,,0
CDM,36100523,Hc Injection Myelogram Spinal Not C1 C2,1617.0,1051.05,,,0
CDM,36100524,Hc Perc Decompression 1 Or More Levels Lumbar,6890.0,4478.5,,,0
CDM,36100525,Hc Injection For Discogram Lumbar,5239.0,3405.35,,,0
CDM,36100526,Hc Injection For Discogram Cervical Or Thoracic,5239.0,3405.35,,,0
CDM,36100531,Hc Remove Spinal Catheter,3024.0,1965.6,,,0
CDM,36100532,Hc Implant Or Replace Programmable Pump,79192.0,51474.8,,,0
CDM,36100533,Hc Removal Subq Reservoir Or Pump,18383.0,11948.95,,,0
CDM,36100534,Hc Elec Anlys Progrmble Pump W Reprgrm,2807.0,1824.55,,,0
CDM,36100535,Hc Elec Anlys Progrmble Pump W Reprgrm And Refill,2489.0,1617.85,,,0
CDM,36100536,Hc Elec Anlys Prgrmble Pump W Rprgrm And Fill Phys Asst,2489.0,1617.85,,,0
CDM,36100537,Hc Perc Implant Neurostim Electrode Array,24800.0,16120.0,,,0
CDM,36100538,Hc Remove Neuro Electrode Perc Array,16392.0,10654.8,,,0
CDM,36100539,Hc Revise Neuroelectrode Perc,25142.0,16342.3,,,0
CDM,36100540,Hc Ins Or Repl Spinal Neurostim Pulse Gen,11308.0,7350.2,,,0
CDM,36100541,Hc Revise Or Remove Neurostimulator,3585.0,2330.25,,,0
CDM,36100542,Hc Injection Anes/Steroid Trigeminal Nerve Each Branch,1124.0,730.6,,,0
CDM,36100542_50,Hc Injection Anes/Steroid Trigeminal Nerve Each Branch,2248.0,1461.2,,,0
CDM,36100544,Hc Injection Anes/Steroid Greater Occipital Nerve,1686.0,1095.9,,,0
CDM,36100544_50,Hc Injection Anes/Steroid Greater Occipital Nerve,3372.0,2191.8,,,0
CDM,36100545,Hc Injection Anes Brachial Plexus,5004.0,3252.6,,,0
CDM,36100545_50,Hc Injection Anes Brachial Plexus,10008.0,6505.2,,,0
CDM,36100546,Hc Injection Anes/Steroid Suprascapular Nerve,5918.0,3846.7,,,0
CDM,36100546_50,Hc Injection Anes/Steroid Suprascapular Nerve,11836.0,7693.4,,,0
CDM,36100547,Hc Injection Anes/Steroid Intercostal Nerve Single,3506.0,2278.9,,,0
CDM,36100548,Hc Injection Anes/Steroid Intercostal Nerves Ea Addl,5983.0,3888.95,,,0
CDM,36100549,Hc Injection Anes/Steroid Ilioinguinal Or Ileohypergastric Nerve,3506.0,2278.9,,,0
CDM,36100549_50,Hc Injection Anes/Steroid Ilioinguinal Or Ileohypergastric Nerve,7012.0,4557.8,,,0
CDM,36100550,Hc Injection Anes/Steroid Pudendal Nerve,6858.0,4457.7,,,0
CDM,36100550_50,Hc Injection Anes/Steroid Pudendal Nerve,13716.0,8915.4,,,0
CDM,36100551,Hc Injection Anes/Steroid Sciatic Nerve Single,5918.0,3846.7,,,0
CDM,36100551_50,Hc Injection Anes/Steroid Sciatic Nerve Single,11836.0,7693.4,,,0
CDM,36100553,Hc Injection Anes/Steroid Femoral Nerve Single,2574.0,1673.1,,,0
CDM,36100553_50,Hc Injection Anes/Steroid Femoral Nerve Single,5148.0,3346.2,,,0
CDM,36100555,Hc Injection Anes/Steroid Other Peripheral Nerve Branch,1977.0,1285.05,,,0
CDM,36100555_50,Hc Injection Anes/Steroid Other Peripheral Nerve Branch,3954.0,2570.1,,,0
CDM,36100556,Hc Injection Anes/Steroid Plantar Common Digital Nerve,1686.0,1095.9,,,0
CDM,36100556_50,Hc Injection Anes/Steroid Plantar Common Digital Nerve,3372.0,2191.8,,,0
CDM,36100557,Hc Injection Anes/Steroid Trnsfrmnl Epi Cerv/Thor W Img Sgl,3350.0,2177.5,,,0
CDM,36100557_50,Hc Injection Anes/Steroid Trnsfrmnl Epi Cerv/Thor W Img Sgl,6700.0,4355.0,,,0
CDM,36100558,Hc Injection Anes/Steroid Trnsfrmnl Epi Cerv/Thor W Img Ea Addl,1939.0,1260.35,,,0
CDM,36100559,Hc Injection Anes/Steroid Trnsfrmnl Epi Lumb/Sacr W Img Sgl,3350.0,2177.5,,,0
CDM,36100559_50,Hc Injection Anes/Steroid Trnsfrmnl Epi Lumb/Sacr W Img Sgl,6700.0,4355.0,,,0
CDM,36100560,Hc Injection Anes/Steroid Trnsfrmnl Epi Lumb/Sacr W Img Ea Addl,1939.0,1260.35,,,0
CDM,36100561,Hc Injection Anes Facet Joint Crv Or Thrc W Img Sgl,4508.0,2930.2,,,0
CDM,36100561_50,Hc Injection Anes Facet Joint Crv Or Thrc W Img Sgl,9016.0,5860.4,,,0
CDM,36100562,Hc Injection Anes Facet Joint Crv Or Thrc W Img 2Nd Addl,2661.0,1729.65,,,0
CDM,36100563,Hc Injection Anes Facet Joint Crv Or Thrc W Img 3Rd Addl,2661.0,1729.65,,,0
CDM,36100564,Hc Injection Anes Facet Joint Lum Or Sacr W Img Sgl,5693.0,3700.45,,,0
CDM,36100564_50,Hc Injection Anes Facet Joint Lum Or Sacr W Img Sgl,11386.0,7400.9,,,0
CDM,36100565,Hc Injection Anes Facet Joint Lum Or Sacr W Img 2Nd Addl,2107.0,1369.55,,,0
CDM,36100566,Hc Injection Anes Facet Joint Lum Or Sacr W Img 3Rd Addl,2107.0,1369.55,,,0
CDM,36100567,Hc Injection Anes Stellate Ganglion,7432.0,4830.8,,,0
CDM,36100567_50,Hc Injection Anes Stellate Ganglion,14864.0,9661.6,,,0
CDM,36100568,Hc Injection Anes Superior Hypogastric Plexus,10976.0,7134.4,,,0
CDM,36100569,Hc Injection Anes Lumbar Sympathetic,7463.0,4850.95,,,0
CDM,36100569_50,Hc Injection Anes Lumbar Sympathetic,14926.0,9701.9,,,0
CDM,36100570,Hc Injection Anes Celiac Plexus,8030.0,5219.5,,,0
CDM,36100575,Hc Dest Neurolytic Trigeminal Nerve Supraorb Or Infraorb,11239.0,7305.35,,,0
CDM,36100578,Hc Dest Neurolytic Intercostal Nerve,7890.0,5128.5,,,0
CDM,36100579,Hc Dest Neurolytic Pudendal Nerve,3151.0,2048.15,,,0
CDM,36100580,Hc Dest Neurolytic Plantar Nerve,4936.0,3208.4,,,0
CDM,36100580_50,Hc Dest Neurolytic Plantar Nerve,9872.0,6416.8,,,0
CDM,36100581,Hc Dest Neurolytic Facet Joint Cerv Or Thrc W Img Sgl,8282.0,5383.3,,,0
CDM,36100581_50,Hc Dest Neurolytic Facet Joint Cerv Or Thrc W Img Sgl,16564.0,10766.6,,,0
CDM,36100582,Hc Dest Neurolytic Facet Joint Cerv Or Thrc W Img Addl,4416.0,2870.4,,,0
CDM,36100583,Hc Dest Neurolytic Facet Joint Lumb Or Sacr W Img Sgl,6331.0,4115.15,,,0
CDM,36100583_50,Hc Dest Neurolytic Facet Joint Lumb Or Sacr W Img Sgl,12662.0,8230.3,,,0
CDM,36100584,Hc Dest Neurolytic Facet Joint Lumb Or Sacr W Img Addl,4445.0,2889.25,,,0
CDM,36100585,Hc Dest Neurolytic Other Peripheral Nerve Or Branch,3024.0,1965.6,,,0
CDM,36100585_50,Hc Dest Neurolytic Other Peripheral Nerve Or Branch,6048.0,3931.2,,,0
CDM,36100586,Hc Dest Neurolytic Celiac Plexus,8006.0,5203.9,,,0
CDM,36100587,Hc Dest Neurolytic Superior Hypogastric Plexus,8024.0,5215.6,,,0
CDM,36100590,Hc Unlisted Procedure Nervous System,6331.0,4115.15,,,0
CDM,36100591,Hc Transcath Plcmnt Radiation Del Dev,2234.0,1452.1,,,0
CDM,36100592,Hc Elect Analysis Neurostim Gen Wo Prog,636.0,413.4,,,0
CDM,36100593,Hc Elect Analysis Neurostim Gen Simple Spine W Prog,563.0,365.95,,,0
CDM,36100594,Hc Elect Analysis Neurostim Gen Brn Complex Spine W Prog,1689.0,1097.85,,,0
CDM,36100598,Hc Lac Repair Complex,1410.0,916.5,,,0
CDM,36100599,Hc Lac Repair Ea Addl 5Cm Or Less Complex,365.0,237.25,,,0
CDM,36100600,Hc Or Level 1 Ep 1St 30 Min,4227.0,2747.55,,,0
CDM,36100601,Hc Or Level 1 Ep Addl 15 Min,1131.0,735.15,,,0
CDM,36100604,Hc Transcath Stent Xtracran Cca Perc Initial Vessel,50656.0,32926.4,,,0
CDM,36100605,Hc Transcath Stent Xtracran Cca Perc Addl Vessel,22800.0,14820.0,,,0
CDM,36100608,Hc Sacroplasty Inj Unilat W Balloon Or Device,34984.0,22739.6,,,0
CDM,36100608_50,Hc Sacroplasty Inj Unilat W Balloon Or Device,69968.0,45479.2,,,0
CDM,36100609,Hc Sacroplasty Inj Bilat W Balloon Or Device,38069.0,24744.85,,,0
CDM,36100613,Hc Translum Peripheral Atherectomy Brachiocephalic,23984.0,15589.6,,,0
CDM,36100614,Hc Translum Peripheral Atherectomy Iliac Artery,30604.0,19892.6,,,0
CDM,36100619,Hc Inj Sacroiliac Joint Anes/ Steroid W Or Wo Arthrogram,4649.0,3021.85,,,0
CDM,36100619_50,Hc Inj Sacroiliac Joint Anes/ Steroid W Or Wo Arthrogram,9298.0,6043.7,,,0
CDM,36100620,Hc Placement Occlusive Device,290.0,188.5,,,0
CDM,36100624,Hc Skin Tag Removal 1-15 Lesions,1182.0,768.3,,,0
CDM,36100627,Hc Exc Bng Lsn Mrgs 1.1-2.0 Cm,2140.0,1391.0,,,0
CDM,36100660,Hc Unlist Procd Femur Knee,5393.0,3505.45,,,0
CDM,36100660_50,Hc Unlist Procd Femur Knee,10786.0,7010.9,,,0
CDM,36100713,Hc Insert Nontunnel Cv Cath Younger Than 5 Yrs,3307.0,2149.55,,,0
CDM,36100716,Hc Pain Procedure Lumbar Or Sacral Wo Fluoro 1St 30 Min,6601.0,4290.65,,,0
CDM,36100717,Hc Img Guide Fluid Coll Drng By Cath Soft Tissue Perc,1631.0,1060.15,,,0
CDM,36100718,Hc Bx Breast W Device Stereotactic 1St Les5,5923.0,3849.95,,,0
CDM,36100719,Hc Bx Breast W Device Stereotactic Addl Les,1584.0,1029.6,,,0
CDM,36100720,Hc Bx Breast W Device Us Guidance 1St Les,5923.0,3849.95,,,0
CDM,36100721,Hc Bx Breast W Device Us Guidance Addl Les,1584.0,1029.6,,,0
CDM,36100722,Hc Bx Breast W Device Mr Guidance 1St Les,5408.0,3515.2,,,0
CDM,36100723,Hc Bx Breast W Device Mr Guidance Addl Les,1584.0,1029.6,,,0
CDM,36100724,Hc Plc Breast Lcl Device W Mammo Guid 1St Les,3086.0,2005.9,,,0
CDM,36100725,Hc Plc Breast Lcl Device W Mammo Guid Addl Les,788.0,512.2,,,0
CDM,36100726,Hc Plc Breast Lcl Device Stereotactic 1St Les,1340.0,871.0,,,0
CDM,36100727,Hc Plc Breast Lcl Device Stereotactic Addl Les,802.0,521.3,,,0
CDM,36100728,Hc Plc Breast Lcl Device Us Guidance 1St Les,1340.0,871.0,,,0
CDM,36100729,Hc Plc Breast Lcl Device Us Guidance Addl Les,788.0,512.2,,,0
CDM,36100733,Hc Trcath Replace Aortic Valve,42905.0,27888.25,,,0
CDM,36100735,Hc Endovasc Visc Aorta 2 Graft,17178.0,11165.7,,,0
CDM,36100742,Hc Stent Placemt Retro Carotid,19993.0,12995.45,,,0
CDM,36100742_50,Hc Stent Placemt Retro Carotid,39986.0,25990.9,,,0
CDM,36100743,Hc Open Or Perq Place Stent 1St Artery,17499.0,11374.35,,,0
CDM,36100743_50,Hc Open Or Perq Place Stent 1St Artery,34998.0,22748.7,,,0
CDM,36100744,Hc Open Or Perq Place Stent Ea Add Art,8748.0,5686.2,,,0
CDM,36100745,Hc Open Or Perq Place Stent 1St Vein,17499.0,11374.35,,,0
CDM,36100745_50,Hc Open Or Perq Place Stent 1St Vein,34998.0,22748.7,,,0
CDM,36100746,Hc Open Or Perq Place Stent Ea Add Vein,8748.0,5686.2,,,0
CDM,36100747,Hc Vasc Embolize Occlude Venous,30688.0,19947.2,,,0
CDM,36100748,Hc Vasc Embolize Occlude Artery,30688.0,19947.2,,,0
CDM,36100749,Hc Vasc Embolize Occlude Organ Tumor Infarct,30688.0,19947.2,,,0
CDM,36100750,Hc Vasc Embolize Occlude Bleed,30688.0,19947.2,,,0
CDM,36100753,Hc Insert Subq Defib W Electrode,24020.0,15613.0,,,0
CDM,36100754,Hc Insert Subq Defib Electrode,21986.0,14290.9,,,0
CDM,36100758,Hc Removal Subq Defib Electrode,20853.0,13554.45,,,0
CDM,36100759,Hc Repos Subq Defib Electrode And Gen,21632.0,14060.8,,,0
CDM,36100760,Hc Unlisted Procedure Hemic Or Lymphatic System,802.0,521.3,,,0
CDM,36100761,Hc Excise Benign Lesion Face 1.1-2Cm,5046.0,3279.9,,,0
CDM,36100762,Hc Stab Phlb Veins 1 Extr > 20 Incis,14232.0,9250.8,,,0
CDM,36100762_50,Hc Stab Phlb Veins 1 Extr > 20 Incis,28464.0,18501.6,,,0
CDM,36100763,Hc St Laryngoscopy With Stroboscopy,1972.0,1281.8,,,0
CDM,36100764,Hc Asp Or Inj Joint Small W Us Guidance,3537.0,2299.05,,,0
CDM,36100764_50,Hc Asp Or Inj Joint Small W Us Guidance,7074.0,4598.1,,,0
CDM,36100765,Hc Asp Or Inj Joint Intermediate W Us Guidance,4393.0,2855.45,,,0
CDM,36100765_50,Hc Asp Or Inj Joint Intermediate W Us Guidance,8786.0,5710.9,,,0
CDM,36100766,Hc Asp Or Inj Joint Large W Us Guidance,4821.0,3133.65,,,0
CDM,36100766_50,Hc Asp Or Inj Joint Large W Us Guidance,9642.0,6267.3,,,0
CDM,36100771,Hc Transcath Stent Intrathoracic,19993.0,12995.45,,,0
CDM,36100771_50,Hc Transcath Stent Intrathoracic,39986.0,25990.9,,,0
CDM,36100772,Hc Inj Myelogram Cervical W  Imaging,4512.0,2932.8,,,0
CDM,36100773,Hc Inj Myelogram Thoracic W Imaging,5683.0,3693.95,,,0
CDM,36100774,Hc Inj Myelogram Ls W Imaging,5683.0,3693.95,,,0
CDM,36100775,Hc Inj Myelogram 2 Or More Regions W Imaging,6820.0,4433.0,,,0
CDM,36100776,Hc Cryoablation Bone Tumor W Img,12095.0,7861.75,,,0
CDM,36100776_50,Hc Cryoablation Bone Tumor W Img,24190.0,15723.5,,,0
CDM,36100777,Hc Cryoablation Liver Tumor,10856.0,7056.4,,,0
CDM,36100778,Hc Cryoablation Pulm Tumor Unilat W Img,9200.0,5980.0,,,0
CDM,36100778_50,Hc Cryoablation Pulm Tumor Unilat W Img,18400.0,11960.0,,,0
CDM,36100779,Hc Aspiration Bladder W Ins Suprapubic Cath,5708.0,3710.2,,,0
CDM,36100780,Hc Placement Fiducial Marker,2065.0,1342.25,,,0
CDM,36100781,Hc Insertion Vaginal Radiation Device,1959.0,1273.35,,,0
CDM,36100784,Hc Athrodesis Sacroiliac Joint W Img Guidance,76124.0,49480.6,,,0
CDM,36100784_50,Hc Athrodesis Sacroiliac Joint W Img Guidance,152248.0,98961.2,,,0
CDM,36100785,Hc Ligation/Biopsy Temporal Artery,4354.0,2830.1,,,0
CDM,36100785_50,Hc Ligation/Biopsy Temporal Artery,8708.0,5660.2,,,0
CDM,36100788,Hc Injection For Dx Cholangiogram W Img Existing Access,10086.0,6555.9,,,0
CDM,36100789,Hc Injection For Dx Cholangiogram W Img New Access,14548.0,9456.2,,,0
CDM,36100790,Hc Place Biliary Drain Catheter W Img External,23822.0,15484.3,,,0
CDM,36100791,Hc Place Biliary Drain Catheter W Img Internal-External,25013.0,16258.45,,,0
CDM,36100792,Hc Convert Biliary Drain To Internal-External W Img,17406.0,11313.9,,,0
CDM,36100793,Hc Exchange Biliary Drain Catheter W Img,14504.0,9427.6,,,0
CDM,36100794,Hc Remove Biliary Drain Catheter W Fluoro,2068.0,1344.2,,,0
CDM,36100795,Hc Place Stent Bile Duct W Img Via Existing Access Each,27790.0,18063.5,,,0
CDM,36100796,Hc Place Stent Bile Duct W Img Via New Acc Wo Separate Bdc,31885.0,20725.25,,,0
CDM,36100797,Hc Place Stent Bile Duct W Img Via New Acc W Separate Bdc,33348.0,21676.2,,,0
CDM,36100798,Hc Place Access Thru Biliary Tree/ Small Int W Img Via New Acc,35670.0,23185.5,,,0
CDM,36100799,Hc Balloon Dilation Biliary Duct Or Ampulla W Img Each Duct,13895.0,9031.75,,,0
CDM,36100800,Hc Endoluminal Bx Biliary Tree W Img Single Or Mult Add On,11312.0,7352.8,,,0
CDM,36100801,Hc Remove Calculi Or Debris From Biliary Duct Or Gallbladder,11312.0,7352.8,,,0
CDM,36100802,Hc Inj For Dx Nephrostogram Or Ureterogram W Img Via New Acc,6714.0,4364.1,,,0
CDM,36100802_50,Hc Inj For Dx Nephrostogram Or Ureterogram W Img Via New Acc,13428.0,8728.2,,,0
CDM,36100803,Hc Inj For Dx Nephrostogram Or Ureterogram W Img Via Exist Acc,6714.0,4364.1,,,0
CDM,36100803_50,Hc Inj For Dx Nephrostogram Or Ureterogram W Img Via Exist Acc,13428.0,8728.2,,,0
CDM,36100804,Hc Place Nephrostomy Catheter W Img,11706.0,7608.9,,,0
CDM,36100804_50,Hc Place Nephrostomy Catheter W Img,23412.0,15217.8,,,0
CDM,36100805,Hc Place Nephroureteral Catheter W Img Via New Access,15683.0,10193.95,,,0
CDM,36100805_50,Hc Place Nephroureteral Catheter W Img Via New Access,31366.0,20387.9,,,0
CDM,36100806,Hc Convert Nephrostomy Cath To Nephroureteral Cath W Img Exist Tract,9755.0,6340.75,,,0
CDM,36100806_50,Hc Convert Nephrostomy Cath To Nephroureteral Cath W Img Exist Tract,19510.0,12681.5,,,0
CDM,36100807,Hc Exchange Nephrostomy Cath  W Img Via Existing Tract,9755.0,6340.75,,,0
CDM,36100807_50,Hc Exchange Nephrostomy Cath  W Img Via Existing Tract,19510.0,12681.5,,,0
CDM,36100808,Hc Endoluminal Biopsy Ureter Or Renal Pelvis W Img Add On,3524.0,2290.6,,,0
CDM,36100809,Hc Place Ureteral Stent W Img Via Existing Tract,15683.0,10193.95,,,0
CDM,36100809_50,Hc Place Ureteral Stent W Img Via Existing Tract,31366.0,20387.9,,,0
CDM,36100810,Hc Place Ureteral Stent W Img Via New Access Wo Separate Neph Cath,16153.0,10499.45,,,0
CDM,36100810_50,Hc Place Ureteral Stent W Img Via New Access Wo Separate Neph Cath,32306.0,20998.9,,,0
CDM,36100811,Hc Place Ureteral Stent W Img Via New Access W Separate Neph Cath,16624.0,10805.6,,,0
CDM,36100811_50,Hc Place Ureteral Stent W Img Via New Access W Separate Neph Cath,33248.0,21611.2,,,0
CDM,36100812,Hc Ureteral Embolization Or Occlusion W Img Add On,3356.0,2181.4,,,0
CDM,36100813,Hc Balloon Dilation Or Ureteral Stricture W Img Add On,3524.0,2290.6,,,0
CDM,36100814,Hc Sclerotherapy For Fluid Collection W Img,9650.0,6272.5,,,0
CDM,36100815,Hc Perc Art Trans Mech Thrombectomy Or Infus For Thrombolysis Intracranial,37966.0,24677.9,,,0
CDM,36100815_50,Hc Perc Art Trans Mech Thrombectomy Or Infus For Thrombolysis Intracranial,75932.0,49355.8,,,0
CDM,36100816,Hc Paravertebral Block Thoracic W Img Single Injection,6601.0,4290.65,,,0
CDM,36100816_50,Hc Paravertebral Block Thoracic W Img Single Injection,13202.0,8581.3,,,0
CDM,36100817,Hc Paravertebral Block Thoracic W Img Addl Injection,3300.0,2145.0,,,0
CDM,36100819,Hc Ivus Non-Coronary Initial Vessel W Img Initial Vessel,5343.0,3472.95,,,0
CDM,36100820,Hc Ivus Non-Coronary Initial Vessel W Img Ea Addl Vessel,2055.0,1335.75,,,0
CDM,36100821,Hc Endo Intracranial Prolong Adm Of Pharm Agent Nonthrom W Img Initial,32006.0,20803.9,,,0
CDM,36100822,Hc Endo Intracranial Prolong Adm Of Pharm Agent Nonthrom W Img Ea Addl,9266.0,6022.9,,,0
CDM,36100823,Hc Bronchoscopy Endobronchial Us 1-2 Nodes,9634.0,6262.1,,,0
CDM,36100824,Hc Bronchoscopy Endobronchial Us 3 Or More Nodes,9634.0,6262.1,,,0
CDM,36100825,Hc Bronchoscopy W Ebus W Intvj Periph Lesions,5195.0,3376.75,,,0
CDM,36100827,Hc Chemodenervation Neck Muscle Dystonia,3818.0,2481.7,,,0
CDM,36100827_50,Hc Chemodenervation Neck Muscle Dystonia,7636.0,4963.4,,,0
CDM,36100829,Hc Obstructive Material Removal From Gi Tube,14455.0,9395.75,,,0
CDM,36100830,Hc Plcmnt Fiducial Dev Rt Guid Abd Pelvis Retro,2065.0,1342.25,,,0
CDM,36100836,Hc Dialysis Circuit Intro Needle/Cath W Img,4897.0,3183.05,,,0
CDM,36100837,Hc Dialysis Circuit Intro Needle/Cath W Tba Peripheral W Img,16652.0,10823.8,,,0
CDM,36100838,Hc Dialysis Circuit Intro Needle/Cath  W Plcmt Of Stent Peripheral W Img,35777.0,23255.05,,,0
CDM,36100839,Hc Dialysis Circuit Perc Thrombectomy Or Thrombolysis Infu W Img,15425.0,10026.25,,,0
CDM,36100840,Hc Dialysis Circuit Perc Thrombectomy Or Thrombolysis Infu W Tba Peripheral W Img,24596.0,15987.4,,,0
CDM,36100841,Hc Dialysis Circuit Perc Thrombectomy Or Thrombolysis Infu W Plcmt Of Stent Peripheral W Img,43720.0,28418.0,,,0
CDM,36100842,Hc Dialysis Circuit Tba Central W Img Add On,11756.0,7641.4,,,0
CDM,36100843,Hc Dialysis Circuit Plcmt Of Stent Central Incld Angioplasty W Img Add On,15050.0,9782.5,,,0
CDM,36100844,Hc Dialysis Circuit Vasc Embolization Or Occlusion W Img Add On,15050.0,9782.5,,,0
CDM,36100845,Hc Transluminal Balloon Angioplasty W Img Artery Initial,16162.0,10505.3,,,0
CDM,36100845_50,Hc Transluminal Balloon Angioplasty W Img Artery Initial,32324.0,21010.6,,,0
CDM,36100846,Hc Transluminal Balloon Angioplasty W Img Artery Each Addl,12200.0,7930.0,,,0
CDM,36100847,Hc Transluminal Balloon Angioplasty W Img Vein Initial,16296.0,10592.4,,,0
CDM,36100847_50,Hc Transluminal Balloon Angioplasty W Img Vein Initial,32592.0,21184.8,,,0
CDM,36100848,Hc Transluminal Balloon Angioplasty W Img Vein Each Addl,11756.0,7641.4,,,0
CDM,36100849,Hc Injection Dx Or Ther Epidur Or Subarach Cer Or Thor Wo Img,7799.0,5069.35,,,0
CDM,36100850,Hc Injection Dx Or Ther Epidur Or Subarach Cer Or Thor W Img,8100.0,5265.0,,,0
CDM,36100851,Hc Injection Dx Or Ther Epidur Or Subarach Lum Or Sacr Wo Img,6601.0,4290.65,,,0
CDM,36100852,Hc Injection Dx Or Ther Epidur Or Subarach Lum Or Sacr W Img,7281.0,4732.65,,,0
CDM,36100856,Hc Injection Incl Cath Plcmnt Lumbar Or Sacral W Img,13643.0,8867.95,,,0
CDM,36100873,Hc Aspiration And Injection Bone Cyst,1795.0,1166.75,,,0
CDM,36100874,Hc Blln Dilat Intracran Vasospasm Addl Ves Same Vas Territory,18836.0,12243.4,,,0
CDM,36100875,Hc Amputation Toe Interphalangeal Joint,4636.0,3013.4,,,0
CDM,36100876,Hc Tenotomy Shoulder,13459.0,8748.35,,,0
CDM,36100877,Hc Cfs Shunt Reprogram,890.0,578.5,,,0
CDM,36100880,Hc Plcmnt Interstial Dev Prostate Sngl Or Mult For Rad Therapy,16174.0,10513.1,,,0
CDM,36100882,Hc Venipuncture Or Midline Cath By Phys Or Qhcp,1530.0,994.5,,,0
CDM,36100884,Hc Biopsy Pelvis Or Hip Soft Tissue Superficial,4752.0,3088.8,,,0
CDM,36100885,Hc Tenotomy Percutaneous Single Toe,3130.0,2034.5,,,0
CDM,36100886,Hc Bone Marrow Diagnostic Biopsy(Ies) And Aspiration(S),5201.0,3380.65,,,0
CDM,36100892,Hc Endvsc Rep Infrnl Aorta By Aorto-Aortic Endgrft Not Rupt W Img,43380.0,28197.0,,,0
CDM,36100893,Hc Endvsc Rep Infrnl Aorta By Aorto-Aortic Endgrft Rupt W Img,43380.0,28197.0,,,0
CDM,36100894,Hc Endvsc Rep Infrnl Aort/Ilc Art By Aorto-Uni-Ilc Endgrft Not Rupt W Img,44303.0,28796.95,,,0
CDM,36100895,Hc Endvsc Rep Infrnl Aort/Ilc Art By Aorto-Uni-Ilc Endgrft Rupt W Img,44303.0,28796.95,,,0
CDM,36100896,Hc Endvsc Rep Infrnl Aort/Ilc Art By Aorto-Bi-Ilc Endgrft Not Rupt W Img,45882.0,29823.3,,,0
CDM,36100897,Hc Endvsc Rep Infrnl Aort/Ilc Art By Aorto-Bi-Ilc Endgrft Rupt W Img,45882.0,29823.3,,,0
CDM,36100898,Hc Endvsc Rep Iliac Art By Ilio-Iliac Endgrft Uni Not Rupt W Img,50712.0,32962.8,,,0
CDM,36100899,Hc Endvsc Rep Iliac Art By Ilio-Iliac Endgrft Uni Rupt W Img,50712.0,32962.8,,,0
CDM,36100900,Hc Plcmnt Ext Prosthesis For Endovasc Rep Per Vessel W Img Add On,16367.0,10638.55,,,0
CDM,36100901,Hc Delayed Plcmnt Ext Prosthesis For Endovasc Rep Init Vessel W Img,18687.0,12146.55,,,0
CDM,36100902,Hc Delayed Plcmnt Ext Prosthesis For Endovasc Rep Ea Addl Vessel W Img,16385.0,10650.25,,,0
CDM,36100903,Hc Transcatheter Delivery Fixation Devices To Endograft W Img,15695.0,10201.75,,,0
CDM,36100904,Hc Perc Access & Closure Fem Art For Endgrft Del Uni W Img Add On,17429.0,11328.85,,,0
CDM,36100905,Hc Inj Foam Sclerosant W Ultrasound Compression Extremity Single Vein,2988.0,1942.2,,,0
CDM,36100906,Hc Inj Foam Sclerosant W Ultrasound Compression Extremity Multiple Veins,4482.0,2913.3,,,0
CDM,36100907,Hc Endoven Ablat Incompetent Ext Vein W Img Initial Vein,5774.0,3753.1,,,0
CDM,36100908,Hc Endoven Ablat Incompetent Ext Vein W Img Addl Vein,3761.0,2444.65,,,0
CDM,36100909,Hc Biopsy Pelvis Or Hip Soft Tissue Deep,4832.0,3140.8,,,0
CDM,36100910,Hc Removal Of Iapb Percutaneous,971.0,631.15,,,0
CDM,36100911,Hc Insert Peritoneal-Venous Shunt,7681.0,4992.65,,,0
CDM,36100912,Hc Biliary Endo Perc With Calculus Removal,9920.0,6448.0,,,0
CDM,36100913,Hc Biopsy Bone Open Superficial,4861.0,3159.65,,,0
CDM,36100914,Hc Removal Nonbiodegrad Drug Delivery Implant,7338.0,4769.7,,,0
CDM,36100915,Hc Repair Recurrent Inguinal Hernia,8723.0,5669.95,,,0
CDM,36100916,Hc Place Soft Tissue Localization Device W Img 1St Lesion,1340.0,871.0,,,0
CDM,36100917,Hc Place Soft Tissue Localization Device W Img Ea Addt Lesion,696.0,452.4,,,0
CDM,36100918,Hc Instillation Via Chest Tube/Cath Fibrinolysis Initial,1315.0,854.75,,,0
CDM,36100919,Hc Metatarsectomy,4804.0,3122.6,,,0
CDM,36100920,Hc Fine Needle Asp Biopsy W Fluoro 1St Lesion,5536.0,3598.4,,,0
CDM,36100921,Hc Fine Needle Asp Biopsy W Fluoro Ea Addl Lesion,2704.0,1757.6,,,0
CDM,36100922,Hc Fine Needle Asp Biopsy W Ct 1St Lesion,5536.0,3598.4,,,0
CDM,36100923,Hc Fine Needle Asp Biopsy W Ct Ea Addl Lesion,2704.0,1757.6,,,0
CDM,36100926,Hc Tangential Biopsy Skin Single Les,676.0,439.4,,,0
CDM,36100927,Hc Tangential Biopsy Skin Ea Sep/Addl,361.0,234.65,,,0
CDM,36100928,Hc Punch Biopsy Skin Single Lesion,730.0,474.5,,,0
CDM,36100929,Hc Punch Biopsy Skin Ea Sep/Addl,355.0,230.75,,,0
CDM,36100930,Hc Incisional Biopsy Of Skin Single Lesion,1328.0,863.2,,,0
CDM,36100931,Hc Incisional Biopsy Of Skin Each Additional,722.0,469.3,,,0
CDM,36100932,Hc Injection For Contrast Knee Arthrography,2753.0,1789.45,,,0
CDM,36100933,Hc Trcath Ins Or Repl Perm Leadless Pacer Right,22288.0,14487.2,,,0
CDM,36100934,Hc Trcath Remove Permanent Leadless Pacer Right W Img,22288.0,14487.2,,,0
CDM,36100935,Hc Insert Subq Cardiac Rhythm Monitor Incl Programming,19702.0,12806.3,,,0
CDM,36100936,Hc Removal Of Subq Cardiac Rhythm Monitor,2391.0,1554.15,,,0
CDM,36100937,Hc Trcath Implant Of Wireless Pulm Artery Pressure Sensor,23226.0,15096.9,,,0
CDM,36100940,"Hc Insert Picc, Wo Sq Port, With Imaging, > 5 Yo",5804.0,3772.6,,,0
CDM,36100941,Hc Dilation Of Exst Tract W Guid W Tube Plcmt,19716.0,12815.4,,,0
CDM,36100942,Hc Dilation Of Exst Tract W Guid W Tube Plcmt Incl New Access,21328.0,13863.2,,,0
CDM,36100948,Hc Endovenous Femoral-Popliteal Arterial Revasc,22355.0,14530.75,,,0
CDM,36100956,Hc Removal And Rplce Cardiac Stimulator Left,24280.0,15782.0,,,0
CDM,36100957,Hc Removal And Rplce Cardiac Stimulator Left W New Electro,24280.0,15782.0,,,0
CDM,36100958,Hc Fine Needle Asp Biopsy W Ultrasound 1St Lesion,5126.0,3331.9,,,0
CDM,36100959,Hc Fine Needle Asp Biopsy W Ultrasound Ea Addl Lesion,2704.0,1757.6,,,0
CDM,36100960,Hc Destrct Intraosseous Basivet Nerve First 2 Vert Incl Img Guid,13559.0,8813.35,,,0
CDM,36100961,Hc Destrct Of Intraosseous Basivetnerve Ea Addl Incl Img Guid,986.0,640.9,,,0
CDM,36100962,Hc Fine Needle Asp Biopsy Wo Img Ea Addl Lesion,491.0,319.15,,,0
CDM,36100963,Hc Cementoplasty Of Acetabulum,5393.0,3505.45,,,0
CDM,36100964,Hc Intraprocedural Coronary Ffr Values For Stenosis Interven Add On,476.0,309.4,,,0
CDM,36100966,Hc Replace Pericath W Subq Port Same Venous Access,14264.0,9271.6,,,0
CDM,36100967,Hc Revision/Removal Intracranial Electrodes,3300.0,2145.0,,,0
CDM,36100968,Hc Revision/Removal Cranial Neurostim Pulse Gen Or Receiver,30264.0,19671.6,,,0
CDM,36100970,Hc Colposcopy With Upper Adjacent Vagina,502.0,326.3,,,0
CDM,36100971,Hc Colposcopy With Biopsy(S),882.0,573.3,,,0
CDM,36100973,Hc Place Cecostomy Percutaneous W Fluoro,14543.0,9452.95,,,0
CDM,36100974,Hc Pericardiocentesis W Img,13413.0,8718.45,,,0
CDM,36100975,Hc Perc Pericardial Drainage W Fluoro Or Us,15499.0,10074.35,,,0
CDM,36100976,Hc Perc Pericardial Drainage W Ct,18480.0,12012.0,,,0
CDM,36100977,Hc Spinal Puncture Diagnostic Lumbar W Img,4947.0,3215.55,,,0
CDM,36100978,Hc Spinal Puncture Therapeutic Drain Csf W Img,4323.0,2809.95,,,0
CDM,36100979,Hc Injection Anes/Steroid Si Joint Nerves W Img,4547.0,2955.55,,,0
CDM,36100979_50,Hc Injection Anes/Steroid Si Joint Nerves W Img,9094.0,5911.1,,,0
CDM,36100980,Hc Injection Anes/Steroid Genicular Nerve Branches W Img,3789.0,2462.85,,,0
CDM,36100980_50,Hc Injection Anes/Steroid Genicular Nerve Branches W Img,7578.0,4925.7,,,0
CDM,36100981,Hc Rf Ablation Nerves Inervating Si Joint W Img,6331.0,4115.15,,,0
CDM,36100981_50,Hc Rf Ablation Nerves Inervating Si Joint W Img,12662.0,8230.3,,,0
CDM,36100984,Hc Perm Fallopian Tube Occ W Implnt Transcervical App W Trnsvg Us,17659.0,11478.35,,,0
CDM,36100985,Hc Confirm Occ Of Fallopian Tubes Transcerv App Incl Transv And Pelvic Us,953.0,619.45,,,0
CDM,36100986,Hc Transcath Tricuspid Valve Repair Perct App Initial Prosthesis,42905.0,27888.25,,,0
CDM,36100987,Hc Transcath Tricuspid Valve Repair Perct App Each Addtl Prosthesis,21451.0,13943.15,,,0
CDM,36100988,Hc Insert Or Replce Impnt Cardioverter Defib System W Substernal Elect Incl Img,24020.0,15613.0,,,0
CDM,36100989,Hc Insertion Of Substernal Implantable Defib Electrode,21986.0,14290.9,,,0
CDM,36100990,Hc Removal Of Substernal Implantable Defib Electrode,21986.0,14290.9,,,0
CDM,36100991,Hc Reposition Of Prev Implanted Substernal Implantable Defib Pacing,21986.0,14290.9,,,0
CDM,36100992,Hc Removal Of Substernal Implantable Defib Pulse Generator Only,21986.0,14290.9,,,0
CDM,36100993,Hc Cryoablation Breast Tumor Unilat W Img,6047.0,3930.55,,,0
CDM,36100993_50,Hc Cryoablation Breast Tumor Unilat W Img,12094.0,7861.1,,,0
CDM,36100998,Hc Endovasc Repair Of Iliac Artery At Time Of Aortoiliac Endograft Plcmt Unilat,50712.0,32962.8,,,0
CDM,36100999,Hc Endovasc Repair Of Iliac Artery Not Assoc W Aortoiliac Endograft Plcmt Unilat,50712.0,32962.8,,,0
CDM,36100999_50,Hc Endovasc Repair Of Iliac Artery Not Assoc W Aortoiliac Endograft Plcmt Unilat,101424.0,65925.6,,,0
CDM,36101000,Hc Needle Insertion Without Injection 1 Or 2 Muscles,35.0,22.75,,,0
CDM,36101001,Hc Needle Insertion Without Injection 3 Or More Muscles,50.0,32.5,,,0
CDM,36101004,Hc Perc Implnt/Rplc Integrated Sgl Device Neurostim Syst Posterior Tibial Nerve,1847.0,1200.55,,,0
CDM,36101005,Hc Revise Or Rmv  Integrated Sgl Device Neurostim Syst Posterior Tibial Nerve,1194.0,776.1,,,0
CDM,36101006,Hc Elect Anlys W/Smpl Prgrm Implant Integrated Neurostim Syst Post Tibial Nerve 1-3,1126.0,731.9,,,0
CDM,36101007,Hc Elect Anlys/Cmplx Prgrm Implant Integrated Neurostim Syst Post Tibial Nerve 4+,1126.0,731.9,,,0
CDM,36101008,"Hc Destruct, Genicular Nerve Branches, Incl Image Guidance",6331.0,4115.15,,,0
CDM,36101008_50,"Hc Destruct, Genicular Nerve Branches, Incl Image Guidance",12662.0,8230.3,,,0
CDM,36101011,Hc Chemodenervation One Extremity 5 Or More Muscles,5744.0,3733.6,,,0
CDM,36101012,Hc Chemodenervation Ea Addl Extremity 5 Or More Muscles,3962.0,2575.3,,,0
CDM,36101013,Hc Needle Emg For Chemodenervation Guidance,1838.0,1194.7,,,0
CDM,36101014,Hc Percutaneous Laminotomy Laminectomy Lumbar,19002.0,12351.3,,,0
CDM,36101015,Hc Rpair Cor Arteriovenous/Cardiac Fistula Wo Bypass,16533.0,10746.45,,,0
CDM,36101016,Hc Unlisted Procedure Pancreas,5804.0,3772.6,,,0
CDM,36101017,Hc Vasectomy Without Anesthesia,14308.0,9300.2,,,0
CDM,36101018,Hc Neuroplasty Carpal Tunnel Median Nerve,6438.0,4184.7,,,0
CDM,36101019,Hc Irrevers Electroporation Ablat Per Organ Perc W Imag,17417.0,11321.05,,,0
CDM,36101020,Hc Revas Intravasc Lithotripsy Incl Angioplasty,21131.0,13735.15,,,0
CDM,36101021,Hc Revas Intravsc Lithotrip And Transluminal Stent Plcmt Incl Angio,25299.0,16444.35,,,0
CDM,36101022,Hc Revas Intravasc Lithotrip And Atherectomy Incl Angio,25299.0,16444.35,,,0
CDM,36101023,Hc Revas Intravasc Lithotrip Translum Stent And Atherect Incl Angio,28110.0,18271.5,,,0
CDM,36101024,Hc Insj Stablj Device Wo Dcmp 1Lv,96382.0,62648.3,,,0
CDM,36101025,Hc Insj Stablj Device Wo Dcmp 2Lv,48192.0,31324.8,,,0
CDM,36101026,Hc Exc Ben Lesion S N H F G 3.1-4Cm,6055.0,3935.75,,,0
CDM,36101027,Hc Biopsy Lung Or Mediastinum Perc W Img,7582.0,4928.3,,,0
CDM,36101031,Hc Hifu Ablation Prostate Transrectal W Img,17417.0,11321.05,,,0
CDM,36101032,Hc Percut Trnscath Interatrial Septal Shunt Device W Img Gud,16533.0,10746.45,,,0
CDM,36101033,Hc Remve And Rplce Substernal Defib Pulse Generator,24020.0,15613.0,,,0
CDM,36101034,Hc Endvc Venous Arterialization Tibial Or Peronael Vein W Trnscth,17499.0,11374.35,,,0
CDM,36101035,Hc Percut Trnscath Us Ablation Nervess Pulm Arteries Inc Right Hrt Cath,12271.0,7976.15,,,0
CDM,36101036,Hc Revas Endo Lithotrip Tibial Peroneal Artery Angio,25299.0,16444.35,,,0
CDM,36101037,Hc Revas Endo Lithotr Tib Per Stent Angio,28110.0,18271.5,,,0
CDM,36101038,Hc Revas Endo Lithotr Atherectomy Tib Per Angio,28110.0,18271.5,,,0
CDM,36101039,Hc Revas Endo Lithotr Atherectomy Tib Per Stent Angio,28110.0,18271.5,,,0
CDM,36101040,Hc Insert Replc Temp Transvenous Dual Chamber Pacing Elect,10844.0,7048.6,,,0
CDM,36101041,Hc Insj Stablj Device W Dcmp 1Lv,96382.0,62648.3,,,0
CDM,36101042,Hc Insj Stablj Device W Dcmp 2Lv,48192.0,31324.8,,,0
CDM,36101043,Hc Cryoablation Nerve Plexus Or Truncal Nerve W Img,13516.0,8785.4,,,0
CDM,36101045,Hc Excision Partial Bone Talus Calcaneus,5393.0,3505.45,,,0
CDM,36101046,Hc Removal Open Calcareous Deposits Subdeltoid,10321.0,6708.65,,,0
CDM,36101047,Hc Treatment Superficial Wound Dehiscence Simple,918.0,596.7,,,0
CDM,36101048,Hc Intermediate Wnd Repair N H F G 2.6-7.0 Cm,1248.0,811.2,,,0
CDM,36101050,Hc Removal Hypoglossal Nerve Nstim Ra Pulse Gen Respir Snr,18383.0,11948.95,,,0
CDM,36101051,Hc Thermal Dstrct Intraosseous Bvn 1St 2 Lmbr Sac,96382.0,62648.3,,,0
CDM,36101053,Hc Thermal Dstrct Intraosseous Bvn Ea Addtl Lmbr Sac,48192.0,31324.8,,,0
CDM,36101055,Hc Laser Ablation Benign Thyroid Nodule W Img,10608.0,6895.2,,,0
CDM,36101056,Hc Histotripsy Mal Hepatocellular Tiss W Img Gdn,38719.0,25167.35,,,0
CDM,36101058,Hc Inj Bone Sub Matrl Into Subchondral Bone Defect,8958.0,5822.7,,,0
CDM,36101059,Hc Exc Bng Lsn Mrgs 0.6-1 Cm,1268.0,824.2,,,0
CDM,36101060,Hc Tenotomy Perc Toe Multiple Tendons,3182.0,2068.3,,,0
CDM,36101061,Hc Trach Tube Change,1966.0,1277.9,,,0
CDM,36101062,Hc Harvest Auto Pbsc For Transplant Per Collect,7277.0,4730.05,,,0
CDM,36101063,Hc Chemodenervation Of Trunk Muscle(S) 1-5,5744.0,3733.6,,,0
CDM,36101064,Hc Chemodenervation Of Trunk Muscle(S) 6 Or More,5744.0,3733.6,,,0
CDM,36101065,Hc Cystourethroscopy Inj Chemodenervation Bladder,2770.0,1800.5,,,0
CDM,36101066,Hc Thaw W/Wash Auto Harvest Cells For Transplant,2744.0,1783.6,,,0
CDM,36101067,Hc T-Cell Depletion Of Harvest Cells For Transplant,2575.0,1673.75,,,0
CDM,36101068,Hc Tumor Cell Depletion Of Harvest Cells For Transplant,674.0,438.1,,,0
CDM,36101069,Hc Rbc Removal Harvest Cells For Transplant,2575.0,1673.75,,,0
CDM,36101070,Hc Plasma Depletion Auto Harvest Cells For Transplant,2575.0,1673.75,,,0
CDM,36101071,Hc Cell Concentration  Auto Harvest Cells For Transplant,2744.0,1783.6,,,0
CDM,36101072,Hc Arteriovenous Fistula Creation Up Extrem Single Access Perc W Img,19973.0,12982.45,,,0
CDM,36101073,Hc Arteriovenous Fistula Creation Up Extrem Separate Access Perc W Img,22288.0,14487.2,,,0
CDM,36101075,Hc Exc Bng Lsn Mrgs 2.1-3.0 Cm,2140.0,1391.0,,,0
CDM,36101076,Hc Exc Bng Lsn Mrgs 3.1-4.0 Cm,4135.0,2687.75,,,0
CDM,36101079,Hc Injection Anes Agent Sphenopalatine Ganglion,566.0,367.9,,,0
CDM,36101079_50,Hc Injection Anes Agent Sphenopalatine Ganglion,1132.0,735.8,,,0
CDM,36101080,Hc Insert Phrenic Nerve Stimulator System,32093.0,20860.45,,,0
CDM,36101081,Hc Insert Phrenic Nerve Stim Transvenous Sensing Lead Add On,1500.0,975.0,,,0
CDM,36101082,Hc Remove Phrenic Nerve Stimulator System,10709.0,6960.85,,,0
CDM,36101083,Hc Remove Phrenic Nerve Stim Transvenous Stim Or Sensing Lead(S) Only,9735.0,6327.75,,,0
CDM,36101084,Hc Remove Phrenic Nerve Stim Pulse Generator Only,9735.0,6327.75,,,0
CDM,36101085,Hc Reposition Phrenic Nerve Stim Transvenous Lead(S),9735.0,6327.75,,,0
CDM,36101086,Hc Remove & Replace Phrenic Nerve Stim Pulse Generator,21028.0,13668.2,,,0
CDM,36101087,Hc Remove & Replace Phrenic Nerve Stim Transvenous Stim Or Sensing Lead(S),21028.0,13668.2,,,0
CDM,36101088,Hc Transcath Insert Perm Single Chamb Leadless Pacemaker Right Atrial,37168.0,24159.2,,,0
CDM,36101089,Hc Transcath Remove Perm Single Chamb Leadless Pacemaker Right Atrial,9120.0,5928.0,,,0
CDM,36101090,Hc Transcath Remove & Replace Perm Single Chamb Leadless Pacemaker Right Atrial,37168.0,24159.2,,,0
CDM,36101091,Hc Remove Wireless Cardiac Stim Left Ventric Pacing Pulse Gen Both Components,11235.0,7302.75,,,0
CDM,36101092,Hc Relocate Wireless Cardiac Stim Left Ventric Pacing Pulse Gen Battery Only,5217.0,3391.05,,,0
CDM,36101093,Hc Relocate Wireless Cardiac Stim Left Ventric Pacing Pulse Gen Transmitter Only,5217.0,3391.05,,,0
CDM,36101094,Hc Excise Tumor Soft Tis Foot/Toe 1.5Cm Or Greater,7289.0,4737.85,,,0
CDM,36101095,Hc Injection Anes Inferior Hypogastric Plexus,10976.0,7134.4,,,0
CDM,36101096,Hc Injection Anes Prev Sacroiliac Fusion Site,6506.0,4228.9,,,0
CDM,36101098,Hc Intermed Wnd Repair H N F G 2.5Cm Or Less,1040.0,676.0,,,0
CDM,36101099,Hc Trachelorrhaphy Plastic Repair Of Cervix,5192.0,3374.8,,,0
CDM,36101100,Hc Dest Neurolytc Trigeminal Nrv Supraorb Or Infraorb 2 Or 3 Div Brnch,5276.0,3429.4,,,0
CDM,36101100_50,Hc Dest Neurolytc Trigeminal Nrv Supraorb Or Infraorb 2 Or 3 Div Brnch,10552.0,6858.8,,,0
CDM,36101101,Hc Exc Ben Lesion Xcp Sk Tg F/E/E/N/L/M 2.1-3.0Cm,6055.0,3935.75,,,0
CDM,36101102,Hc Trcath Ins Perm Dual Chamb Leadless Pacer Comp System,26745.0,17384.25,,,0
CDM,36101103,Hc Tap Block W Img Unilat,5501.0,3575.65,,,0
CDM,36101104,Hc Abltj Perc Cryoabltj Img Gdn Lxtr/Perph Nerve,6331.0,4115.15,,,0
CDM,36101104_50,Hc Abltj Perc Cryoabltj Img Gdn Lxtr/Perph Nerve,12662.0,8230.3,,,0
CDM,36101105,Hc Tap Block W Img Bilat,11002.0,7151.3,,,0
CDM,36101106,Hc Thoracic Fascial Plane Block W Img Unilat,5501.0,3575.65,,,0
CDM,36101108,Hc Thoracic Fascial Plane Block W Img Bilat,11002.0,7151.3,,,0
CDM,36101110,Hc Le Fascial Plane Block W Img Unilat,5501.0,3575.65,,,0
CDM,36101110_50,Hc Le Fascial Plane Block W Img Unilat,11002.0,7151.3,,,0
CDM,36101112,Hc Insert Perm Ccm-D Sys Pulse Gen & Eltrds,24020.0,15613.0,,,0
CDM,36101113,Hc Insert Perm Ccm-D Sys Pulse Gen Only,22018.0,14311.7,,,0
CDM,36101114,Hc Insert Perm Ccm-D Sys 1 Lead Only,18387.0,11951.55,,,0
CDM,36101115,Hc Insert Perm Ccm-D Sys Dual Leads Only,18387.0,11951.55,,,0
CDM,36101116,Hc Remove Perm Ccm-D Sys Pulse Gen Only,14756.0,9591.4,,,0
CDM,36101117,Hc Remove Perm Ccm-D Sys 1 Pacing Lead Only,14756.0,9591.4,,,0
CDM,36101118,Hc Remove Perm Ccm-D Sys 1 Defib Lead Only,14756.0,9591.4,,,0
CDM,36101119,Hc Remove Perm Ccm-D Sys Dual Leads Only,14756.0,9591.4,,,0
CDM,36101120,Hc Remove & Replace Perm Ccm-D Pulse Gen Only,22018.0,14311.7,,,0
CDM,36101121,Hc Reposition Prev Ccm-D Electrodes/ Leads,2507.0,1629.55,,,0
CDM,36101122,Hc Relocate Skin Pocket Ccm-D Pulse Gen,7417.0,4821.05,,,0
CDM,36101123,Hc Ephys Eval Ccm-D Ld At Initial Implant,4922.0,3199.3,,,0
CDM,36101124,Hc Transcath Implant Wrls Lt Atr Prs Snsr,11671.0,7586.15,,,0
CDM,36101125,Hc I And D Pilonidal Cyst Complicated,1910.0,1241.5,,,0
CDM,36101129,Hc Ephys Eval Ccm-D Ld Separate From Date Of Insert,4922.0,3199.3,,,0
CDM,36101130,Hc Open Axillary/Subclavian Art Expos W/Conduit Crtj,1373.0,892.45,,,0
CDM,37000004,Hc Mod Sed Same Phys As Proc Addl 15 Min,599.0,389.35,,,0
CDM,37000008,Hc Mod Sed Other Provider Than Proc Addl 15 Min,599.0,389.35,,,0
CDM,37000010,Hc Mod Sed Same Phys As Proc Up To 5 Yrs 1St 15 Min,599.0,389.35,,,0
CDM,37000011,Hc Mod Sed Same Phys As Proc 1St 15 Min,599.0,389.35,,,0
CDM,37000013,Hc Mod Sed Dif Phys As Proc Up To 5 Yrs 1St 15 Min,599.0,389.35,,,0
CDM,37000014,Hc Mod Sed Other Provider Than Proc 1St 15 Min,599.0,389.35,,,0
CDM,39000001,Hc Whole Blood 1 Unit,2503.0,1626.95,,,0
CDM,39000004,Hc Cryoprecipitate 1 Unit,364.0,236.6,,,0
CDM,39000007,Hc Red Cells Leuko Reduced 1 Unit,982.0,638.3,,,0
CDM,39000008,Hc Fresh Frozen Plasma 1 Unit,219.0,142.35,,,0
CDM,39000012,Hc Red Cells Packed 1 Unit,1030.0,669.5,,,0
CDM,39000013,Hc Red Cells Washed 1 Unit,2074.0,1348.1,,,0
CDM,39000014,Hc Platelets Leuko Reduced Directed 1 Unit,507.0,329.55,,,0
CDM,39000015,Hc Platelets Leuko Reduced 1 Unit,4428.0,2878.2,,,0
CDM,39000016,Hc Platelets Leuko Reduced Irradiated 1 Unit,425.0,276.25,,,0
CDM,39000017,Hc Platelets Pheresis Leukocyte Reduced 1 Unit,3063.0,1990.95,,,0
CDM,39000018,Hc Platelets Pheresis L R Irradiated 1 Unit,3291.0,2139.15,,,0
CDM,39000019,Hc Red Cells Leuko Reduced Irradiated 1 Unit,1210.0,786.5,,,0
CDM,39000025,Hc Red Cells Frozen Deglycerol Lr Washed 1 Unit,2711.0,1762.15,,,0
CDM,39000029,"Hc Platelets, Pheresis, Pathogen-Reduced, Each Unit",3382.0,2198.3,,,0
CDM,39000030,Hc Fresh Frozen Plasma 1 Unit <8Hrs Covid19 Research,85.0,55.25,,,0
CDM,39000032,"Hc Plasma, Cryoprecipitate Reduced, Pathogen Reduced, Each Unit",136.0,88.4,,,0
CDM,39000033,"Hc Cryoprecipitated Fibrinogen Complex, Pathogen Reduced, Each Unit",314.0,204.1,,,0
CDM,39000034,"Hc Granulocytes, Pheresis, Each Unit",12918.0,8396.7,,,0
CDM,39000035,Hc Nfct Agent Hiv Trgt Viral Next-Gnrj Seq Alys Alg So,1286.0,835.9,,,0
CDM,39000036,Hc Autologous Blood Product 1 Unit,1818.0,1181.7,,,0
CDM,39000037,"Hc Platelets, Hla-Matched Leukocyte Reduced, Apheresis/Pheresis, Each Unit",2962.0,1925.3,,,0
CDM,39100001,Hc Transfuse Blood Products Level I,2131.0,1385.15,,,0
CDM,39100002,Hc Transfusion Fetal Intrauterine,1045.0,679.25,,,0
CDM,39100003,Hc Transfuse Blood Products Level Ii,2770.0,1800.5,,,0
CDM,39100004,Hc Transfuse Blood Products Level Iii,3409.0,2215.85,,,0
CDM,40100004,Hc Mammogram Diag Bilat Digital W Cad,832.0,540.8,,,0
CDM,40100005,Hc Mammogram Diag Unilat Digital W Cad,742.0,482.3,,,0
CDM,40100007,Hc Tomosynthesis Diag Unilat,77.0,50.05,,,0
CDM,40100008,Hc Tomosynthesis Diag Bilat,77.0,50.05,,,0
CDM,40200001,Hc Encephalogram,347.0,225.55,,,0
CDM,40200002,Hc Us Soft Tissue Head And Neck,736.0,478.4,,,0
CDM,40200003,Hc Us Chest,381.0,247.65,,,0
CDM,40200005,Hc Us Abdomen Complete,620.0,403.0,,,0
CDM,40200006,Hc Us Abdomen Limited,546.0,354.9,,,0
CDM,40200007,Hc Us Retroperitioneal Complete,675.0,438.75,,,0
CDM,40200008,Hc Us Retroperitioneal Limited,494.0,321.1,,,0
CDM,40200009,Hc Us Spinal Canal And Contents,826.0,536.9,,,0
CDM,40200010,Hc Us Pregnant Uterus 1St Trimester Sgl Fetus,463.0,300.95,,,0
CDM,40200011,Hc Us Pregnant Uterus 1St Trimester Ea Addl Fetus,275.0,178.75,,,0
CDM,40200012,Hc Us Pregnant Uterus After 1St Trimester Sgl Fetus,512.0,332.8,,,0
CDM,40200013,Hc Us Pregnant Uterus After 1St Trimester Ea Addl Fetus,331.0,215.15,,,0
CDM,40200014,Hc Us Pregnant Uterus W Detail Fetal Anatomy Sgl Fetus,687.0,446.55,,,0
CDM,40200015,Hc Us Pregnant Uterus W Detail Fetal Anatomy Addl Fetus,259.0,168.35,,,0
CDM,40200016,Hc Us Fetal Nuchal Translucency Sgl,227.0,147.55,,,0
CDM,40200017,Hc Us Fetal Nuchal Translucency Addl,153.0,99.45,,,0
CDM,40200018,Hc Us Pregnant Uterus Limited 1 Or More Fetuses,211.0,137.15,,,0
CDM,40200019,Hc Us Pregnant Uterus Follow Up Per Fetus,327.0,212.55,,,0
CDM,40200020,Hc Us Pregnant Uterus Transvaginal,438.0,284.7,,,0
CDM,40200021,Hc Us Fetal Biophysical Profile W Nst,413.0,268.45,,,0
CDM,40200022,Hc Us Fetal Biophysical Profile Wo Nst,376.0,244.4,,,0
CDM,40200023,Hc Us Velocimetry Umbilical Artery,243.0,157.95,,,0
CDM,40200024,Hc Us Velocimetry Fetal Middle Cerebral Artery,223.0,144.95,,,0
CDM,40200025,Hc Fetal Heart Echo 2D W Wo M Mode Recording,959.0,623.35,,,0
CDM,40200026,Hc Fetal Heart Echo 2D W Wo M Mode Follow Up,345.0,224.25,,,0
CDM,40200027,Hc Fetal Heart Echo Complete,600.0,390.0,,,0
CDM,40200028,Hc Fetal Heart Echo Follow Up,196.0,127.4,,,0
CDM,40200029,Hc Us Transvaginal,658.0,427.7,,,0
CDM,40200030,Hc Sonohystogram,624.0,405.6,,,0
CDM,40200031,Hc Us Pelvis Non Ob Complete,347.0,225.55,,,0
CDM,40200032,Hc Us Pelvis Non Ob Limited Follow Up,282.0,183.3,,,0
CDM,40200033,Hc Us Scrotum,615.0,399.75,,,0
CDM,40200034,Hc Us Transrectal,648.0,421.2,,,0
CDM,40200035,Hc Us Prostate Volume Study For Brachytherapy Planning,685.0,445.25,,,0
CDM,40200036,Hc Us Extremity Complete Joint,667.0,433.55,,,0
CDM,40200037,Hc Us Extremity Limited Joint Or Non Vasc Structure,429.0,278.85,,,0
CDM,40200040,Hc Us Guided Compression Repair,519.0,337.35,,,0
CDM,40200041,Hc Us Guided Vascular Access,431.0,280.15,,,0
CDM,40200042,Hc Us Guided Parenchymal Tissue Ablation,268.0,174.2,,,0
CDM,40200043,Hc Us Guided Needle Placement,679.0,441.35,,,0
CDM,40200044,Hc Us Guided Chorionic Villus Sampling,153.0,99.45,,,0
CDM,40200045,Hc Us Guided Amniocentesis,269.0,174.85,,,0
CDM,40200046,Hc Us Guided Interstitial Radioelement Application,658.0,427.7,,,0
CDM,40200048,Hc Us Intraoperative,594.0,386.1,,,0
CDM,40200049,Hc Unlisted Ultrasound Procedure,546.0,354.9,,,0
CDM,40200051,Hc Us For Aaa Screening,231.0,150.15,,,0
CDM,40200054,Hc Us Breast Complete,939.0,610.35,,,0
CDM,40200054_50,Hc Us Breast Complete,1878.0,1220.7,,,0
CDM,40200055,Hc Us Breast Limited,715.0,464.75,,,0
CDM,40200055_50,Hc Us Breast Limited,1422.0,924.3,,,0
CDM,40200057,Hc Us Screening Breast Unilat,225.0,146.25,,,0
CDM,40200057_50,Hc Us Screening Breast Unilat,450.0,292.5,,,0
CDM,40200058,Hc Us Guidance Cordocentesis Or Fetal Transfusion,399.0,259.35,,,0
CDM,40200060,Hc Us Screening Breast Bilat,450.0,292.5,,,0
CDM,40200061,Hc Us Elastography Parenchyma (Organ),483.0,313.95,,,0
CDM,40200066,Hc Elastography Liver Wo Img,547.0,355.55,,,0
CDM,40300003,Hc Mammogram Screening Digital W Cad,247.0,160.55,,,0
CDM,40300004,Hc Tomosynthesis Screening Add On,66.0,42.9,,,0
CDM,40400003,Hc Brain Imaging Pet Metabolic Eval,7083.0,4603.95,,,0
CDM,40400004,Hc Pet Imaging W Ct Skull Base To Mid Thigh,7657.0,4977.05,,,0
CDM,40400005,Hc Pet Imaging W Ct Whole Body,9232.0,6000.8,,,0
CDM,40400008,Hc Pet Imaging W Ct Limited Area,6287.0,4086.55,,,0
CDM,41000004,Hc Ventilator Init Day,2544.0,1653.6,,,0
CDM,41000008,Hc Ventilator Subq Day,1462.0,950.3,,,0
CDM,41000014,Hc Inhalation Treatment For Aao Or Sputum Induction,377.0,245.05,,,0
CDM,41000024,Hc Pentamidine Aerosol Inhalation,2174.0,1413.1,,,0
CDM,41000025,Hc Cont Inhal Tx W Aerosol 1St Hr,1180.0,767.0,,,0
CDM,41000026,Hc Cont Inhal Tx W Aerosol Ea Addl H,725.0,471.25,,,0
CDM,41000027,Hc Cpap Bipap,813.0,528.45,,,0
CDM,41000031,Hc Pts Own Cpap Bipap Init Day,376.0,244.4,,,0
CDM,41000032,Hc Pts Own Cpap Bipap Subseq Day,376.0,244.4,,,0
CDM,41000033,Hc Mdi Instruction Only,560.0,364.0,,,0
CDM,41000035,Hc Postural Drainage Percussion Init,490.0,318.5,,,0
CDM,41000040,Hc Postural Drainage Percussion Subseq,408.0,265.2,,,0
CDM,41000043,Hc Pulm Vest Therapy Each Session,560.0,364.0,,,0
CDM,41000044,Hc Respiratory Therapy One On One 15 Min,122.0,79.3,,,0
CDM,41000045,Hc Surfactant Administered Through Et Tube,185.0,120.25,,,0
CDM,41300001,Hc Hyperbaric Oxygen Full Body Per 30Min,2017.0,1311.05,,,0
CDM,41900001,Hc Improve Resp Fxn Other Group,533.0,346.45,,,0
CDM,42000001,Hc Application Short Leg Cast,1304.0,847.6,,,0
CDM,42000001_50,Hc Application Short Leg Cast,2608.0,1695.2,,,0
CDM,42000002,Hc Application Short Leg Cast Walking,1267.0,823.55,,,0
CDM,42000002_50,Hc Application Short Leg Cast Walking,2534.0,1647.1,,,0
CDM,42000005,Hc Pt Canalith Respositioning Proc,304.0,197.6,,,0
CDM,42000007,Hc Pt Traction Mechanical,105.0,68.25,,,0
CDM,42000008,Hc Pt Vasopneumatic Treatment,125.0,81.25,,,0
CDM,42000009,Hc Pt Paraffin Bath,107.0,69.55,,,0
CDM,42000012,Hc Pt Fluidotherapy Or Whirlpool,135.0,87.75,,,0
CDM,42000014,Hc Pt Electrical Stim Attended 15 Min,203.0,131.95,,,0
CDM,42000015,Hc Pt  Iontophoresis 15 Min,204.0,132.6,,,0
CDM,42000016,Hc Pt  Contrast Bath 15 Min,174.0,113.1,,,0
CDM,42000017,Hc Pt  Ultrasound 15 Min,106.0,68.9,,,0
CDM,42000018,Hc Pt Exercise Therapeutic 15 Min,193.0,125.45,,,0
CDM,42000019,Hc Pt Neuromuscular Reeducation 15 Min,165.0,107.25,,,0
CDM,42000020,Hc Pt Aquatic Therapy Exercise 15Min,185.0,120.25,,,0
CDM,42000021,Hc Pt Gait Training 15 Min,189.0,122.85,,,0
CDM,42000022,Hc Pt Therapeutic Massage 15 Min,122.0,79.3,,,0
CDM,42000023,Hc Pt Manual Therapy 15 Min,198.0,128.7,,,0
CDM,42000024,Hc Pt Group Exercise,132.0,85.8,,,0
CDM,42000025,Hc Pt Functional Activity 15 Min,190.0,123.5,,,0
CDM,42000026,Hc Pt Sensory Integration 15 Min,161.0,104.65,,,0
CDM,42000027,Hc Pt Self Care Home Mangagement 15 Min,174.0,113.1,,,0
CDM,42000028,Hc Pt Community Work Reintegration 15 Min,129.0,83.85,,,0
CDM,42000029,Hc Pt Wheelchair Training 15 Min,136.0,88.4,,,0
CDM,42000030,Hc Pt Work Harden Conditioning Init 2Hrs,235.0,152.75,,,0
CDM,42000031,Hc Pt Work Harden Conditioning Ea Addl Hour,116.0,75.4,,,0
CDM,42000032,Hc Removal Devitalized Tissue Up To 20 Sq Cm,1265.0,822.25,,,0
CDM,42000033,Hc Removal Devitalized Tissue Ea Addl 20 Sq Cm,377.0,245.05,,,0
CDM,42000034,Hc Pt Performance Test 15 Min,159.0,103.35,,,0
CDM,42000035,Hc Pt Initial Orthotic Fitting Training 15 Min,215.0,139.75,,,0
CDM,42000036,Hc Pt Initial Prosthetic Training 15 Min,161.0,104.65,,,0
CDM,42000038,Hc Pt Electrical Stim Unattended,197.0,128.05,,,0
CDM,42000041,Hc Pt Bwc Transitional Work 15 Min,103.0,66.95,,,0
CDM,42000042,Hc Pt Bwc Ergonomic Study 15 Min,144.0,93.6,,,0
CDM,42000043,Hc Pt Job Analysis 15 Min,144.0,93.6,,,0
CDM,42000049,Hc Pt Bwc Work Conditioning Per 15 Min,145.0,94.25,,,0
CDM,42000123,Hc Pt Developmental Screening,254.0,165.1,,,0
CDM,42000125,Hc Pt Tx Cpt 15 Min,21.0,13.65,,,0
CDM,42000126,Hc Pt Eval Epv,166.0,107.9,,,0
CDM,42000129,Hc Pt Subsequent Orthotic Prosthetic Check 15 Min,166.0,107.9,,,0
CDM,42000130,Hc Pt Rehab Family Conference - 30 Min Or More,185.0,120.25,,,0
CDM,42000131,"Hc Pt Developmental Testing, First Hour",667.0,433.55,,,0
CDM,42000132,"Hc Pt Developmental Testing, Ea Add 30 Min",333.0,216.45,,,0
CDM,42000136,Hc Pt Applic Multi Layer Comp Sys Leg/Ankle/Foot,938.0,609.7,,,0
CDM,42000136_50,Hc Pt Applic Multi Layer Comp Sys Leg/Ankle/Foot,1876.0,1219.4,,,0
CDM,42000137,Hc Pt Applic Multi Layer Comp Sys Arm/Hand/Fingers,1126.0,731.9,,,0
CDM,42000137_50,Hc Pt Applic Multi Layer Comp Sys Arm/Hand/Fingers,2252.0,1463.8,,,0
CDM,42000138,Hc Pt E-Stim Unattend For Chronic Ulcers,197.0,128.05,,,0
CDM,42000139,Hc Pt Caregiver Training Initial 30 Min,352.0,228.8,,,0
CDM,42000140,Hc Pt Caregiver Training Ea Addl 15 Min,176.0,114.4,,,0
CDM,42000141,Hc Pt Caregiver Training Group,89.0,57.85,,,0
CDM,42400005,Hc Pt Eval Low Complexity,428.0,278.2,,,0
CDM,42400006,Hc Pt Eval Moderate Complexity,465.0,302.25,,,0
CDM,42400007,Hc Pt Eval High Complexity,503.0,326.95,,,0
CDM,42400008,Hc Pt Re-Eval,277.0,180.05,,,0
CDM,43000001,Hc Application Cast Long Arm,425.0,276.25,,,0
CDM,43000001_50,Hc Application Cast Long Arm,850.0,552.5,,,0
CDM,43000002,Hc Application Cast Short Arm,425.0,276.25,,,0
CDM,43000002_50,Hc Application Cast Short Arm,850.0,552.5,,,0
CDM,43000003,Hc Application Cast Hand Or Wrist,612.0,397.8,,,0
CDM,43000003_50,Hc Application Cast Hand Or Wrist,1224.0,795.6,,,0
CDM,43000004,Hc Application Cast Finger,308.0,200.2,,,0
CDM,43000004_50,Hc Application Cast Finger,616.0,400.4,,,0
CDM,43000005,Hc Drive Com/Wk Reint 15Min,29.0,18.85,,,0
CDM,43000006,Hc Php Ot Per Session 45 Min Or More,523.0,339.95,,,0
CDM,43000008,Hc Ot Bwc Ergonomic Study Per 15 Min,144.0,93.6,,,0
CDM,43000009,Hc Standard Cognitive Performance,294.0,191.1,,,0
CDM,43000012,Hc Ot Developmental Screening,254.0,165.1,,,0
CDM,43000014,Hc Ot Vasopneumatic Treatment,125.0,81.25,,,0
CDM,43000015,Hc Ot Paraffin Bath,107.0,69.55,,,0
CDM,43000016,Hc Ot Fluidotherapy Or Whirlpool,135.0,87.75,,,0
CDM,43000017,Hc Ot Electrical Stim Attended 15 Min,203.0,131.95,,,0
CDM,43000018,Hc Ot Iontophoresis 15 Min,204.0,132.6,,,0
CDM,43000019,Hc Ot Contrast Bath 15 Min,174.0,113.1,,,0
CDM,43000020,Hc Ot Ultrasound 15 Min,106.0,68.9,,,0
CDM,43000021,Hc Ot Exercise Therapeutic 15 Min,193.0,125.45,,,0
CDM,43000022,Hc Ot Neuromuscular Reeducation 15 Min,165.0,107.25,,,0
CDM,43000023,Hc Ot Aquatic Therapy Exercise 15Min,185.0,120.25,,,0
CDM,43000024,Hc Ot Therapeutic Massage 15 Min,122.0,79.3,,,0
CDM,43000025,Hc Ot Manual Therapy 15 Min,198.0,128.7,,,0
CDM,43000026,Hc Ot Group Exercise,132.0,85.8,,,0
CDM,43000027,Hc Ot Functional Activity 15 Min,190.0,123.5,,,0
CDM,43000028,Hc Ot Sensory Integration 15 Min,161.0,104.65,,,0
CDM,43000029,Hc Ot Self Care Home Mangagement 15 Min,174.0,113.1,,,0
CDM,43000030,Hc Ot Community Work Reintegration 15 Min,129.0,83.85,,,0
CDM,43000032,Hc Ot Wheelchair Training 15 Min,136.0,88.4,,,0
CDM,43000033,Hc Ot Work Harden Conditioning Init 2Hrs,235.0,152.75,,,0
CDM,43000035,Hc Ot Removal Devitalized Tissue Up To 20 Sq Cm,1518.0,986.7,,,0
CDM,43000036,Hc Ot Removal Devitalized Tissue Ea Addl 20 Sq Cm,377.0,245.05,,,0
CDM,43000037,Hc Ot Performance Test 15 Min,159.0,103.35,,,0
CDM,43000038,Hc Ot Initial Orthotic Fitting Training 15 Min,215.0,139.75,,,0
CDM,43000039,Hc Ot Initial Prosthetic Training 15 Min,161.0,104.65,,,0
CDM,43000059,Hc Ot Tx Cot 15 Min,21.0,13.65,,,0
CDM,43000060,Hc Ot Eval Eov,166.0,107.9,,,0
CDM,43000063,Hc Assist Tech Assess,92.0,59.8,,,0
CDM,43000064,Hc Ot Tx Ot Pt Assistant 15 Min,18.0,11.7,,,0
CDM,43000065,Hc Ot Electrical Stim Unattended,197.0,128.05,,,0
CDM,43000066,Hc Ot Bwc Transitional Work Per 15 Min,103.0,66.95,,,0
CDM,43000067,Hc Ot Bwc Work Conditioning  Per 15 Min,145.0,94.25,,,0
CDM,43000069,Hc Ot Subsequent Orthotic Prosthetic Check 15Min,166.0,107.9,,,0
CDM,43000072,Hc Ot Rehab Family Conference - 30 Min Or More,185.0,120.25,,,0
CDM,43000073,"Hc Ot Developmental Testing, First Hour",667.0,433.55,,,0
CDM,43000074,"Hc Ot Developmental Testing, Ea Add 30 Min",333.0,216.45,,,0
CDM,43000075,Hc Ot Cognitive Training Initial 15 Minutes,132.0,85.8,,,0
CDM,43000076,Hc Ot Cognitive Training Each Addl 15 Minutes,132.0,85.8,,,0
CDM,43000078,Hc Ot Job Analysis 15 Min,144.0,93.6,,,0
CDM,43000079,Hc Ot Applic Multi Layer Comp Sys Leg/Ankle/Foot,938.0,609.7,,,0
CDM,43000079_50,Hc Ot Applic Multi Layer Comp Sys Leg/Ankle/Foot,1876.0,1219.4,,,0
CDM,43000080,Hc Ot Applic Multi Layer Comp Sys Arm/Hand/Fingers,1126.0,731.9,,,0
CDM,43000080_50,Hc Ot Applic Multi Layer Comp Sys Arm/Hand/Fingers,2252.0,1463.8,,,0
CDM,43000081,Hc Ot E-Stim Unattend For Chronic Ulcers,197.0,128.05,,,0
CDM,43000082,Hc Ot E-Stim Unattend For Wound Care Other,197.0,128.05,,,0
CDM,43000083,Hc Ot Caregiver Training Initial 30 Min,352.0,228.8,,,0
CDM,43000084,Hc Ot Caregiver Training Ea Add 15 Min,176.0,114.4,,,0
CDM,43000085,Hc Ot Caregiver Training Group,89.0,57.85,,,0
CDM,43400006,Hc Ot Eval Low Complexity,402.0,261.3,,,0
CDM,43400007,Hc Ot Eval Moderate Complexity,422.0,274.3,,,0
CDM,43400008,Hc Ot Eval High Complexity,444.0,288.6,,,0
CDM,43400009,Hc Ot Re-Eval,261.0,169.65,,,0
CDM,43400010,Hc Ot Drive Low Complexity,272.0,176.8,,,0
CDM,43400011,Hc Ot Drive Moderate Complexity,272.0,176.8,,,0
CDM,43400012,Hc Ot Drive High Complexity,272.0,176.8,,,0
CDM,44000002,Hc St Ped Treat Basic,336.0,218.4,,,0
CDM,44000003,Hc St Ped Treat Complex,416.0,270.4,,,0
CDM,44000004,Hc St Treat Basic,336.0,218.4,,,0
CDM,44000005,Hc St Treat Complex,416.0,270.4,,,0
CDM,44000007,Hc St Therapy Group,156.0,101.4,,,0
CDM,44000009,Hc Treat Swall Oral Function Basic,303.0,196.95,,,0
CDM,44000010,Hc Treat Swall Oral Func Complex,389.0,252.85,,,0
CDM,44000036,Hc St Standard Cognitive Performance,294.0,191.1,,,0
CDM,44000037,Hc Speech Gen Device Services,351.0,228.15,,,0
CDM,44000039,Hc St Sensory Integration 15 Min,161.0,104.65,,,0
CDM,44000041,Hc St Rehab Family Conference - 30 Min Or More,185.0,120.25,,,0
CDM,44000042,Hc St Community Work Reintegration 15 Min,129.0,83.85,,,0
CDM,44000043,Hc St Functional Activity,190.0,123.5,,,0
CDM,44000044,"Hc St Developmental Testing, First Hour",667.0,433.55,,,0
CDM,44000045,"Hc St Developmental Testing, Ea Add 30 Min",333.0,216.45,,,0
CDM,44000046,Hc St Cognitive Training Initial 15 Minutes,132.0,85.8,,,0
CDM,44000047,Hc St Cognitive Training Each Addl 15 Minutes,132.0,85.8,,,0
CDM,44000048,Hc Pt Biofeedback Training Perineal Anorectal Or Urethral Sphincter Initial 15 Min,170.0,110.5,,,0
CDM,44000049,Hc Pt Biofeedback Training Perineal Anorectal Or Urethral Sphincter Ea Addl 15 Min,170.0,110.5,,,0
CDM,44000050,Hc St Caregiver Training Initial 30 Min,352.0,228.8,,,0
CDM,44000051,Hc St Caregiver Training Ea Add 15 Min,176.0,114.4,,,0
CDM,44000052,Hc St Caregiver Training Group,89.0,57.85,,,0
CDM,44400003,Hc St Eval Voice Prosthetic Basic,136.0,88.4,,,0
CDM,44400004,Hc St Eval Voice Prosthetic Complex,261.0,169.65,,,0
CDM,44400005,Hc St Eval Speech Device 1St Hr,405.0,263.25,,,0
CDM,44400006,Hc St Eval Speech Device Ea Addl 30M,135.0,87.75,,,0
CDM,44400007,Hc Eval Swallow Oral Func Basic,293.0,190.45,,,0
CDM,44400008,Hc Eval Swallow Oral Func Complex,435.0,282.75,,,0
CDM,44400009,Hc Ped Eval Swall/Oral Func Basic,293.0,190.45,,,0
CDM,44400010,Hc St Eval Swall Video/Fluoro,460.0,299.0,,,0
CDM,44400011,Hc St Eval Swall Endo Cine/Video,532.0,345.8,,,0
CDM,44400012,Hc St Eval Aphasia Per Hour,490.0,318.5,,,0
CDM,44400014,Hc St Speech Fluency Eval,205.0,133.25,,,0
CDM,44400015,Hc St Speech Sound Eval,168.0,109.2,,,0
CDM,44400016,Hc St Speech And Comprehension Eval,349.0,226.85,,,0
CDM,44400017,Hc St Behvrl And Qual Analysis Of Voice,176.0,114.4,,,0
CDM,45000001,Hc Application Finger Splint,690.0,448.5,,,0
CDM,45000001_50,Hc Application Finger Splint,1380.0,897.0,,,0
CDM,45000002,Hc Removal Foreign Body Nasal,685.0,445.25,,,0
CDM,45000003,Hc Control Nosebleed Simple,1285.0,835.25,,,0
CDM,45000003_50,Hc Control Nosebleed Simple,2570.0,1670.5,,,0
CDM,45000004,Hc Control Nosebleed Complex,1862.0,1210.3,,,0
CDM,45000004_50,Hc Control Nosebleed Complex,3724.0,2420.6,,,0
CDM,45000005,Hc Intubation Endotracheal,1966.0,1277.9,,,0
CDM,45000006,Hc Tracheotomy Cricothyroidotomy,4156.0,2701.4,,,0
CDM,45000007,Hc Needle Plcmt Intraosseous Infusion,1150.0,747.5,,,0
CDM,45000008,Hc Repair Lip Vermilion Only,1277.0,830.05,,,0
CDM,45000009,Hc Drn Abs/Cyst/Hemtma/Mouth Smpl,895.0,581.75,,,0
CDM,45000010,Hc Drain Dental Abscess,1362.0,885.3,,,0
CDM,45000011,Hc I And D Peritonsillar Abscess,1426.0,926.9,,,0
CDM,45000012,Hc Gastric Intub And Aspiration,1220.0,793.0,,,0
CDM,45000014,Hc I And D Perianal Abscess,1387.0,901.55,,,0
CDM,45000015,Hc Incision External Hemorrhoid,1350.0,877.5,,,0
CDM,45000016,Hc Anoscopy,472.0,306.8,,,0
CDM,45000017,Hc Peritoneal Lavage,2266.0,1472.9,,,0
CDM,45000018,Hc I And D Vulva Or Perineal Abscess,1864.0,1211.6,,,0
CDM,45000019,Hc I And D Bartholin's Gland Abscess,1362.0,885.3,,,0
CDM,45000021,Hc Remove Fb External Eye,691.0,449.15,,,0
CDM,45000021_50,Hc Remove Fb External Eye,1382.0,898.3,,,0
CDM,45000022,Hc Remove Fb Cornea W Slit Lamp,754.0,490.1,,,0
CDM,45000022_50,Hc Remove Fb Cornea W Slit Lamp,1508.0,980.2,,,0
CDM,45000023,Hc Drain Abscess Or Hematoma Ext Ear Smpl,919.0,597.35,,,0
CDM,45000023_50,Hc Drain Abscess Or Hematoma Ext Ear Smpl,1838.0,1194.7,,,0
CDM,45000024,Hc Remove Foreign Body Ear,685.0,445.25,,,0
CDM,45000024_50,Hc Remove Foreign Body Ear,1370.0,890.5,,,0
CDM,45000025,Hc Removal Impacted Cerumen,970.0,630.5,,,0
CDM,45000025_50,Hc Removal Impacted Cerumen,1940.0,1261.0,,,0
CDM,45000026,Hc Cpr,2458.0,1597.7,,,0
CDM,45000027,Hc Temporary External Pacing,1378.0,895.7,,,0
CDM,45000028,Hc Cardioversion Elective External,7902.0,5136.3,,,0
CDM,45000029,Hc Debrid Nonselect Wet Moist Dressing,1247.0,810.55,,,0
CDM,45000030,Hc Er Level I,673.0,437.45,,,0
CDM,45000032,Hc Er Level Ii,1104.0,717.6,,,0
CDM,45000034,Hc Er Level Iii,1748.0,1136.2,,,0
CDM,45000036,Hc Er Level Iv,2891.0,1879.15,,,0
CDM,45000038,Hc Er Level V,4144.0,2693.6,,,0
CDM,45000040,Hc Critical Care First 30 To 74 Min,5794.0,3766.1,,,0
CDM,45000041,Hc Er Critical Care Addl 30 Min,710.0,461.5,,,0
CDM,45000042,Hc Apply Casts Body And Upper Ext,1543.0,1002.95,,,0
CDM,45000043,Hc Apply Casts Lower Ext,1595.0,1036.75,,,0
CDM,45000044,Hc Apply Splints Body And Upper Ext,1042.0,677.3,,,0
CDM,45000045,Hc Apply Splints Lower Ext,727.0,472.55,,,0
CDM,45000046,Hc Rep Window Wedge Cast,789.0,512.85,,,0
CDM,45000047,Hc Thoracotomy,7222.0,4694.3,,,0
CDM,45000048,Hc Tx Fx Dislocation Open,1416.0,920.4,,,0
CDM,45000049,Hc Tx Fx Dislocation W Anesthesia,1930.0,1254.5,,,0
CDM,45000050,Hc Tx Fx Dislocation Wo Anesthesia,976.0,634.4,,,0
CDM,45000051,Hc Trim Of Nondystrophic Nails,187.0,121.55,,,0
CDM,45000058,Hc Rem Fb Muscle Or Tendon Sheath Complex,5094.0,3311.1,,,0
CDM,45000140,Hc Drain Finger Abcess Simple,1750.0,1137.5,,,0
CDM,45000173,Hc Strapping Hand Or Finger,1186.0,770.9,,,0
CDM,45000173_50,Hc Strapping Hand Or Finger,2372.0,1541.8,,,0
CDM,45000177,Hc Appl Rigid Total Cont Leg Cast,2130.0,1384.5,,,0
CDM,45000177_50,Hc Appl Rigid Total Cont Leg Cast,4260.0,2769.0,,,0
CDM,45000183,Hc Strapping Toe,1186.0,770.9,,,0
CDM,45000183_50,Hc Strapping Toe,2372.0,1541.8,,,0
CDM,45000191,Hc Laryngscpy Indirect Diagnos,825.0,536.25,,,0
CDM,45000213,Hc Control Oropharyngeal Hemor,1277.0,830.05,,,0
CDM,45000215,Hc Unlist Procedure Intestine,1903.0,1236.95,,,0
CDM,45000217,Hc I&D Ischrec Perirec Abcess,3200.0,2080.0,,,0
CDM,45000218,Hc Enuc Excsn Ext Thrm Hemorrd,5506.0,3578.9,,,0
CDM,45000219,Hc Unlisted Procedure Anus,4832.0,3140.8,,,0
CDM,45000225,Hc Irrigation Of Corpona Cavernos,1489.0,967.85,,,0
CDM,45000228,Hc Unlst Proc Male Genital Sys,1489.0,967.85,,,0
CDM,45000233,Hc Rem Fb Ext Eye Corn Wo Lmp,754.0,490.1,,,0
CDM,45000233_50,Hc Rem Fb Ext Eye Corn Wo Lmp,1508.0,980.2,,,0
CDM,45000243,Hc Osteo Manip Tx 3-4 Body Region,600.0,390.0,,,0
CDM,45000248,Hc Insertion Catheter Complicated,1356.0,881.4,,,0
CDM,45000250,Hc Removal Impacted Cerumen By Irrig Unilat,899.0,584.35,,,0
CDM,45000250_50,Hc Removal Impacted Cerumen By Irrig Unilat,1798.0,1168.7,,,0
CDM,45000251,Hc Blepharotomy For Abscess Drainage,1894.0,1231.1,,,0
CDM,45000252,Hc Injection Of Corpora Cavernosa With Pharm Agent,1489.0,967.85,,,0
CDM,45000253,Hc Strapping Upper Extremity,836.0,543.4,,,0
CDM,45000254,Hc Drainage Of Finger Abscess Complicated,3995.0,2596.75,,,0
CDM,45000255,Hc Cntrl Post Nosebleed Subqnt Uni Or Bilat,2174.0,1413.1,,,0
CDM,45000256,Hc Cntrl Post Nosebleed Init,1394.0,906.1,,,0
CDM,45000256_50,Hc Cntrl Post Nosebleed Init,2788.0,1812.2,,,0
CDM,45000257,Hc Creation Of Pericardiotomy Window,6288.0,4087.2,,,0
CDM,45000258,Hc Incision Of Breast Lesion W Exploration Or Drainage,5812.0,3777.8,,,0
CDM,46000001,Hc Spirometry Pft Simple,676.0,439.4,,,0
CDM,46000002,Hc Spirometry Pft Pre Post Bronchodilation,1366.0,887.9,,,0
CDM,46000003,Hc Spirometry Bronchial Provocation Challenge,2628.0,1708.2,,,0
CDM,46000004,Hc High Altitude Sim Test,625.0,406.25,,,0
CDM,46000005,Hc High Altitude Sim Test W O2,625.0,406.25,,,0
CDM,46000008,Hc Cardiopulmonary Exercise Testing,3066.0,1992.9,,,0
CDM,46000010,Hc Lung Vols Plethysmography W Wo Airway Resistance,188.0,122.2,,,0
CDM,46000011,Hc Lung Vols Washout Gas Dilution,426.0,276.9,,,0
CDM,46000012,Hc Carbon Monoxide Diff Dlco,435.0,282.75,,,0
CDM,46000013,Hc Pulse Ox Overnight Study,410.0,266.5,,,0
CDM,46000020,Hc Exer Test For Brnchspasm W Pre Post Spiro Ecg Record And Pulse Ox,618.0,401.7,,,0
CDM,46000021,Hc Pulm Stress Test Heart Rate Oxmtry And Oxygen Titration When Perf,618.0,401.7,,,0
CDM,46000022,Hc Car Seat Testing 1St 60 Minutes,141.0,91.65,,,0
CDM,46000023,Hc Car Seat Testing Each Addl Full 30 Minutes,53.0,34.45,,,0
CDM,46000026,Hc Pulm Stress Test Heart Rate Oxmtry Oxygen Titration Wo Ecg Record,618.0,401.7,,,0
CDM,46000027,Hc O2 Uptake Exp Gas Analysis Rest Indirect,300.0,195.0,,,0
CDM,47100002,Hc Audio Pure Tone Air Screen,110.0,71.5,,,0
CDM,47100006,Hc Auditory Evoked Oae,253.0,164.45,,,0
CDM,47100007,Hc Hearing Screen Evoked Oae,110.0,71.5,,,0
CDM,47100008,"Hc Audiometry Pure Tone, Air Only",110.0,71.5,,,0
CDM,47100009,"Hc Audiometry Pure Tone, Air And Bone",133.0,86.45,,,0
CDM,47100013,Hc Auditory Ep Screen Auditory Potential W Broadband Stimuli Analysis,81.0,52.65,,,0
CDM,48000001,Hc Perc Translumin Cor Thrombectomy,4026.0,2616.9,,,0
CDM,48000004,Hc Ivus Coronary Initial Vessel,5538.0,3599.7,,,0
CDM,48000005,Hc Ivus Coronary Each Addl Vessel,2820.0,1833.0,,,0
CDM,48000007,Hc Program Device Eval Single Pacer,205.0,133.25,,,0
CDM,48000008,Hc Program Device Eval Dual Pacer,205.0,133.25,,,0
CDM,48000009,Hc Program Device Eval Multi Pacer,238.0,154.7,,,0
CDM,48000010,Hc Program Device Eval Single Defib,220.0,143.0,,,0
CDM,48000011,Hc Program Device Eval Dual Defib,279.0,181.35,,,0
CDM,48000012,Hc Program Device Eval Multi Defib,316.0,205.4,,,0
CDM,48000013,Hc Program Sq Crm Incl Retreival Report,145.0,94.25,,,0
CDM,48000014,Hc Interrogation Pacer Wo Reprogram,118.0,76.7,,,0
CDM,48000015,Hc Interrogation Defib Wo Reprogram,200.0,130.0,,,0
CDM,48000016,Hc Interrogation Implant Monitor System,93.0,60.45,,,0
CDM,48000017,Hc Interrogation Sq Crm,112.0,72.8,,,0
CDM,48000018,Hc Transtelephonic Pacer Eval,158.0,102.7,,,0
CDM,48000019,Hc Interrogation Pacer Defib Remote,97.0,63.05,,,0
CDM,48000020,Hc Remote Interrogation Sq Crm,167.0,108.55,,,0
CDM,48000021,Hc Heart Flow Reserve Measure Addl,2872.0,1866.8,,,0
CDM,48000022,Hc Transcath Closure Asd W/Implant,16533.0,10746.45,,,0
CDM,48000023,Hc Transcath Closure Vsd W/Implant,17841.0,11596.65,,,0
CDM,48000024,Hc Bundle Of His Recording,6921.0,4498.65,,,0
CDM,48000025,Hc Intra Atrial Recording,6225.0,4046.25,,,0
CDM,48000026,Hc Right Ventricular Recording,7257.0,4717.05,,,0
CDM,48000027,Hc Intravent Intra Atrial Mapping,13300.0,8645.0,,,0
CDM,48000028,Hc Intra Atrial Pacing,6294.0,4091.1,,,0
CDM,48000029,Hc Intraventricular Pacing,7257.0,4717.05,,,0
CDM,48000030,Hc Intracard Electrophys 3D Mapping,15306.0,9948.9,,,0
CDM,48000031,Hc Arrhythmia Induction Electrical,6395.0,4156.75,,,0
CDM,48000032,Hc Ep Comprehensive Wo Induction Arrhythmia,16066.0,10442.9,,,0
CDM,48000033,Hc Ep Comprehensive W Induction Arrhythmia,31802.0,20671.3,,,0
CDM,48000034,Hc Ep Comprehensive Left Atrium,13482.0,8763.3,,,0
CDM,48000035,Hc Ep Comprehensive Left Ventricle,13576.0,8824.4,,,0
CDM,48000036,Hc Ep Study With Rx,8469.0,5504.85,,,0
CDM,48000037,Hc Ep Followup Study,19699.0,12804.35,,,0
CDM,48000038,Hc Analysis Icd Leads At Implant,5159.0,3353.35,,,0
CDM,48000039,Hc Analysis Icd Lead Generator At Implant,4334.0,2817.1,,,0
CDM,48000040,Hc Ep Eval Icd Implant,11657.0,7577.05,,,0
CDM,48000041,Hc Ablation Av,26309.0,17100.85,,,0
CDM,48000042,Hc Ep Eval W Ablation Svt Including 3D Mapping,63198.0,41078.7,,,0
CDM,48000043,Hc Ep Eval W Ablation Vt Including 3D Mapping,63198.0,41078.7,,,0
CDM,48000044,Hc Ablation Distinct From Primary,6466.0,4202.9,,,0
CDM,48000045,Hc Ep Eval W Ablation A Fib Including 3D Mapping,63198.0,41078.7,,,0
CDM,48000046,Hc Ablation Addl A Fib,6466.0,4202.9,,,0
CDM,48000047,Hc Tilt Table Eval,3008.0,1955.2,,,0
CDM,48000048,Hc Intracardiac Echo Add On,5276.0,3429.4,,,0
CDM,48000050,Hc Interrogation Vad,393.0,255.45,,,0
CDM,48000052,Hc Unlisted Cardiovascular Procedure,4536.0,2948.4,,,0
CDM,48000053,Hc External Counterpulsation,6906.0,4488.9,,,0
CDM,48000056,Hc Perq Transcath Septal Reduction,16533.0,10746.45,,,0
CDM,48000058,Hc Subq Defib Interrogation Device Eval,247.0,160.55,,,0
CDM,48000059,Hc Subq Defib Programming Device Eval,244.0,158.6,,,0
CDM,48000060,Hc Implant Subq Defib Device Sys Eval,244.0,158.6,,,0
CDM,48000062,Hc Ep Eval Subq Implantable Defib,220.0,143.0,,,0
CDM,48000063,Hc Heart Flow Reserve Measure Init,5255.0,3415.75,,,0
CDM,48000064,Hc Perc Transcath Closure Paravalvular Leak Mitral Valve,16533.0,10746.45,,,0
CDM,48000065,Hc Perc Transcath Closure Paravalvular Leak Aortic Valve,16533.0,10746.45,,,0
CDM,48000066,Hc Perc Transcath Closure Paravalvular Leak Each Addl,7987.0,5191.55,,,0
CDM,48000070,Hc Peri-Proc Device Eval And Program Pacemaker,214.0,139.1,,,0
CDM,48000071,Hc Peri-Proc Device Eval And Program Implantable Defibrillator,284.0,184.6,,,0
CDM,48000072,"Hc Peripheral Arterial Diseas (Pad) Rehabilitation, Per Session",177.0,115.05,,,0
CDM,48000075,Hc Prog Device Eval In Person Implnt Cardioverter Deb System W Adjustment,244.0,158.6,,,0
CDM,48000077,Hc Prog Device Eval In Person Implnt Cardioverter Deb System W Arrythmia Induct,1063.0,690.95,,,0
CDM,48000079,Hc Interrog Device Eval Remote Up To 90 Days Cardio Defib W Remote Data Acq,222.0,144.3,,,0
CDM,48000080,Hc Electronic Analysis Antitachycardia Pacemaker,1218.0,791.7,,,0
CDM,48000083,Hc Perct Balloon Angioplasty Pulmnary Ea Addtl Vessel,7975.0,5183.75,,,0
CDM,48000084,Hc Esophageal Rec Atrial Electrogram,7257.0,4717.05,,,0
CDM,48000085,Hc Esophageal Rec Atrial Electrogram W Pacing,7257.0,4717.05,,,0
CDM,48000086,Hc Intraop Epi And Endocardial Pacing Localize Tachycardia,445.0,289.25,,,0
CDM,48000087,Hc Exclusion L Atr Appendage Thoracoscopic Any Method,42905.0,27888.25,,,0
CDM,48000094,Hc Ins Rplcmt Pulse Generator Only Isdss,3640.0,2366.0,,,0
CDM,48000095,Hc Relocation Pulse Generator Only Isdss,3067.0,1993.55,,,0
CDM,48000096,Hc Removal Pulse Generator Only Isdss,23695.0,15401.75,,,0
CDM,48000097,Hc Bdy Surf Activation Mapg Pm Cvdfb Leads Tm Implt,244.0,158.6,,,0
CDM,48000098,Hc Bdy Surf Activation Mapg Pm Cvdfb Leads Tm Flwup,244.0,158.6,,,0
CDM,48000099,Hc Ambulatory Bp Monitor 24Hr Or More - Recording Only,519.0,337.35,,,0
CDM,48000100,Hc Cardiac Ablation Radiation Non-Invasive Arrhythmia Local,11126.0,7231.9,,,0
CDM,48000101,Hc Cardiac Ablation Radiation Conversion Arrhythmia Local Map,11126.0,7231.9,,,0
CDM,48000102,Hc Cardiac Ablation Radiation Arrhythmia Deliv Rad Therapy,11126.0,7231.9,,,0
CDM,48000104,Hc Eval Leadless Pacemaker W Adjust,205.0,133.25,,,0
CDM,48000105,Hc Perc Transluminal Coronary Lithotripsy Add On,6000.0,3900.0,,,0
CDM,48000106,Hc Coronary Ffr Estimate From Ccta,3764.0,2446.6,,,0
CDM,48000108,Hc Remote Interrogation Cv Physiologic Ms - Heartlogic,135.0,87.75,,,0
CDM,48000109,Hc Remote Interrogation Of Sq Cardiac Rhythm Monitor,150.0,97.5,,,0
CDM,48100001,Hc Ptca Sgl Maj Cor Art Or Branch,7237.0,4704.05,,,0
CDM,48100002,Hc Ptca Addl Branch Maj Cor Art,6926.0,4501.9,,,0
CDM,48100003,Hc Atherectomy Sgl Maj Cor Art Or Branch,18072.0,11746.8,,,0
CDM,48100004,Hc Atherectomy Ea Add Branch Maj Cor Art,15784.0,10259.6,,,0
CDM,48100005,Hc Stent Sgl Maj Cor Art Or Branch,16245.0,10559.25,,,0
CDM,48100006,Hc Stent Ea Addl Maj Cor Art Or Branch,14124.0,9180.6,,,0
CDM,48100007,Hc Atherectomy W Stent Maj Cor Art Or Branch,18072.0,11746.8,,,0
CDM,48100008,Hc Revascularization Cabg 1 Vessel,16106.0,10468.9,,,0
CDM,48100009,Hc Revascularization Cabg Ea Addl Vessel,14124.0,9180.6,,,0
CDM,48100010,Hc Revasc Acute Occlusion During Mi Sgl Ves,19293.0,12540.45,,,0
CDM,48100011,Hc Revasc Chronic Occlusion Sgl Vessel,26779.0,17406.35,,,0
CDM,48100012,Hc Revasc Chronic Occlusion Ea Addl Vessel,14124.0,9180.6,,,0
CDM,48100013,Hc Percutaneous Balloon Valvoplasty Aortic,31809.0,20675.85,,,0
CDM,48100014,Hc Percutaneous Balloon Valvoplasty Mitral,15950.0,10367.5,,,0
CDM,48100015,Hc Percutaneous Balloon Valvoplasty Pulm,15950.0,10367.5,,,0
CDM,48100016,Hc Percutaneous Balloon Angioplasty Pulmnary,15950.0,10367.5,,,0
CDM,48100017,Hc Right Heart Cath,12693.0,8250.45,,,0
CDM,48100018,Hc Left Heart Cath,9096.0,5912.4,,,0
CDM,48100019,Hc Right And Left Heart Cath,21391.0,13904.15,,,0
CDM,48100020,Hc Coronary Angiography,11671.0,7586.15,,,0
CDM,48100021,Hc Coronary Angio W Bypass Grafts,14199.0,9229.35,,,0
CDM,48100022,Hc Coronary Angiography W Rhc,15695.0,10201.75,,,0
CDM,48100023,Hc Coronary Angiogrphy W Byp Grfts And Rhc,15984.0,10389.6,,,0
CDM,48100024,Hc Coronary Angiography W Lhc,14387.0,9351.55,,,0
CDM,48100025,Hc Coronary Angiogrphy W Byp Grfts And Lhc,15224.0,9895.6,,,0
CDM,48100026,Hc Coronary Angiography W Lhc And Rhc,15839.0,10295.35,,,0
CDM,48100027,Hc Coronary Angiogrphy W Byp Grfts Lhc And Rhc,17782.0,11558.3,,,0
CDM,48100028,Hc Lhc Via Transseptal Puncture,10643.0,6917.95,,,0
CDM,48100029,Hc Pharm Agent Admin Nitric Oxide,1214.0,789.1,,,0
CDM,48100030,Hc Insert Swan Ganz Catheter,7370.0,4790.5,,,0
CDM,48100031,Hc Biopsy Endomyocardial,12271.0,7976.15,,,0
CDM,48100032,Hc Inj Right Atrial Ventricular Angio,1214.0,789.1,,,0
CDM,48100033,Hc Inj Aortography Supravalvular,3258.0,2117.7,,,0
CDM,48100034,Hc Inj Pulmonary Angiography,3563.0,2315.95,,,0
CDM,48100035,Hc De Stent Sgl Maj Cor Artery Or Branch,16245.0,10559.25,,,0
CDM,48100036,Hc De Stent Ea Addl Maj Cor Artery Or Branch,7231.0,4700.15,,,0
CDM,48100037,Hc De Stent W Ather Maj Cor Artery Or Branch,19973.0,12982.45,,,0
CDM,48100038,Hc De Stent W Atherectomyaddl Branch,15784.0,10259.6,,,0
CDM,48100039,Hc Revasc Cabg De Stent,17209.0,11185.85,,,0
CDM,48100040,Hc Revasc De Stent Add Brnch Cabg,7393.0,4805.45,,,0
CDM,48100041,Hc Revasc Occ During Mi De Stent Sgl,20699.0,13454.35,,,0
CDM,48100042,Hc Revasc Chronic Occ De Stent Sgl Vessel,26495.0,17221.75,,,0
CDM,48100043,Hc Revasc Chronic Occ De Stent Addl Vessel,11261.0,7319.65,,,0
CDM,48100045,Hc Atherectomy W Stent Addl Branch,14124.0,9180.6,,,0
CDM,48100046,Hc Transcath Mitral Valve Rep Perc,42905.0,27888.25,,,0
CDM,48100047,Hc Transcath Mitral Valve Rep Ea Add,1305.0,848.25,,,0
CDM,48100049,Hc Transcatheter Closure L Atrial Appendage,42905.0,27888.25,,,0
CDM,48100050,Hc Ins Or Rep Perm Card Contrac Mod Sys Pulse Gen W Transven Electrode,24020.0,15613.0,,,0
CDM,48100076,Hc Tmvi W Prosthetic Valve Percutaneous,42905.0,27888.25,,,0
CDM,48100077,Hc Tmvi W Prosthetic Valve Transthoracic Exposure,42905.0,27888.25,,,0
CDM,48100078,Hc Phys Exercise Study Incl Hemodynamic Measure,428.0,278.2,,,0
CDM,48100079,Hc Transcath Pulm Valve Plcmnt Perc,42905.0,27888.25,,,0
CDM,48100080,Hc Transcath Intracoronary Nfs Supersat O2,2478.0,1610.7,,,0
CDM,48100081,Hc Transcath Plcmnt Sbsq Removal Cepd Perq,413.0,268.45,,,0
CDM,48100082,Hc Transcath Removal/Debulk Icar Mass Suction Device Perq,16652.0,10823.8,,,0
CDM,48100083,Hc Ttvi/Rplcmnt Prostc Vlv Perq Right Hrt Cath&Angiography,42905.0,27888.25,,,0
CDM,48100084,Hc Ecmo Insertion Peripheral Cannula,41522.0,26989.3,,,0
CDM,48100085,Hc Perq Pulm Artery Revasularization Initial Normal Connect Unilateral,22355.0,14530.75,,,0
CDM,48100086,Hc Perq Pulm Artery Revasularization Initial Normal Connect Bilateral,26826.0,17436.9,,,0
CDM,48100087,Hc Perq Pulm Artery Revasularization Initial Abnormal Connect Unilateral,26495.0,17221.75,,,0
CDM,48100088,Hc Perq Pulm Artery Revasularization Initial Abnormal Connect Bilateral,31794.0,20666.1,,,0
CDM,48100089,Hc Perq Pulm Artery Revasularization Ea Addl Norm/Abnorm Connect,13564.0,8816.6,,,0
CDM,48100090,Hc Injection Cardiac Cath Selective Pulm Arterial Angio Unilateral,1500.0,975.0,,,0
CDM,48100091,Hc Injection Cardiac Cath Selective Pulm Arterial Angio Bilateral,2000.0,1300.0,,,0
CDM,48100092,Hc Injection Cardiac Cath Selective Pulm Venous Angio Each Vein,1500.0,975.0,,,0
CDM,48100093,Hc Injection Cardiac Cath Selective Pulm Venous Angio Mapcas Each Vessel,2000.0,1300.0,,,0
CDM,48100094,Hc Ptca De Balloon W Ivus Or Oct Single Major Ca Or Branch,16162.0,10505.3,,,0
CDM,48100095,Hc Ptca De Balloon Sep Lesion W Ivus Or Oct Single Major Ca Or Branch Add On,8081.0,5252.65,,,0
CDM,48200001,Hc Stress Test Tracing Only,1168.0,759.2,,,0
CDM,48300001,Hc Echo Congen Cardiac Anomaly Comp,2993.0,1945.45,,,0
CDM,48300002,Hc Echo Congen Cardiac Anomaly Ltd,2101.0,1365.65,,,0
CDM,48300003,Hc Echo Complete W Doppler,2408.0,1565.2,,,0
CDM,48300005,Hc Echo Limited Or Follow Up,1725.0,1121.25,,,0
CDM,48300006,Hc Echo Tee Complete,2725.0,1771.25,,,0
CDM,48300007,Hc Echo Tee Probe Plcmt Only,1955.0,1270.75,,,0
CDM,48300008,Hc Echo Tee Congen Cardiac Anomaly Comp,2399.0,1559.35,,,0
CDM,48300009,Hc Echo Doppler Add On,319.0,207.35,,,0
CDM,48300010,Hc Echo Doppler Limited Add On,299.0,194.35,,,0
CDM,48300011,Hc Echo Color Flow Velocity Mapping Add On,222.0,144.3,,,0
CDM,48300012,Hc Echo Rest And Stress,2473.0,1607.45,,,0
CDM,48300015,Hc Echo Congen Cardiac Anomaly Comp W Cont,2993.0,1945.45,,,0
CDM,48300017,Hc Echo Complete Wo Doppler W Contrast,2461.0,1599.65,,,0
CDM,48300018,Hc Echo Limited Or Follow Up W Contrast,1725.0,1121.25,,,0
CDM,48300019,Hc Echo Tee Complete W Contrast,2725.0,1771.25,,,0
CDM,48300021,Hc Echo Rest And Stress W Contrast,2473.0,1607.45,,,0
CDM,48300023,Hc Echo Complete W Doppler W Contrast,2408.0,1565.2,,,0
CDM,48300025,Hc Athletic Screening Echo,95.0,61.75,,,0
CDM,48300026,Hc Echo Tee Guide For Structural Intvn,3606.0,2343.9,,,0
CDM,48300029,Hc Myocardial Strain Imaging Add On,299.0,194.35,,,0
CDM,48300030,Hc Echo Tee 3D Add On,358.0,232.7,,,0
CDM,51000001,Hc Strapping Lower Extremity,1312.0,852.8,,,0
CDM,51000001_50,Hc Strapping Lower Extremity,2624.0,1705.6,,,0
CDM,51000002,Hc Strapping Unna Boot,923.0,599.95,,,0
CDM,51000002_50,Hc Strapping Unna Boot,1846.0,1199.9,,,0
CDM,51000003,Hc Applic Multi Layer Comp Sys Leg/Ankle/Foot,923.0,599.95,,,0
CDM,51000003_50,Hc Applic Multi Layer Comp Sys Leg/Ankle/Foot,1846.0,1199.9,,,0
CDM,51000006,Hc Applic Multi Layer Comp Sys Arm Or Hand,938.0,609.7,,,0
CDM,51000007,Hc Cast Removal,3541.0,2301.65,,,0
CDM,51000007_50,Hc Cast Removal,7082.0,4603.3,,,0
CDM,51000008,Hc Chemo Bladder Instillation,956.0,621.4,,,0
CDM,51000019,Hc Biopsy Cervix,5803.0,3771.95,,,0
CDM,51000021,Hc Insertion Intrauterine Device,3520.0,2288.0,,,0
CDM,51000022,Hc Removal Intrauterine Device,2346.0,1524.9,,,0
CDM,51000023,Hc Chorionic Villus Sampling,6167.0,4008.55,,,0
CDM,51000024,Hc Fetal Non Stress Test,765.0,497.25,,,0
CDM,51000025,Hc Transabdominal Amnioinfusion W Us Guid,6230.0,4049.5,,,0
CDM,51000026,Hc Fetal Fluid Drainage W Us Guidance,6127.0,3982.55,,,0
CDM,51000027,Hc Fetal Shunt Placement W Us Guid,10982.0,7138.3,,,0
CDM,51000028,Hc Insert Cervical Dilator,1799.0,1169.35,,,0
CDM,51000031,Hc Impl Revsn Or Repos Intrathecal Or Epid Catheter,7007.0,4554.55,,,0
CDM,51000036,Hc Injection Anes Axillary Nerve,7120.0,4628.0,,,0
CDM,51000036_50,Hc Injection Anes Axillary Nerve,14240.0,9256.0,,,0
CDM,51000041,Hc Irrigation Of Impl Ven Access Device,363.0,235.95,,,0
CDM,51000042,Hc Negative Pressure Wound Ther Up To 50 Sq Cm,1883.0,1223.95,,,0
CDM,51000043,Hc Negative Pressure Wound Ther More Than 50 Sq Cm,3399.0,2209.35,,,0
CDM,51000044,Hc Phlebotomy Therapeutic,473.0,307.45,,,0
CDM,51000046,Hc Visit Op New Level 2,158.0,102.7,,,0
CDM,51000047,Hc Visit Op New Level 3,185.0,120.25,,,0
CDM,51000048,Hc Visit Op New Level 4,213.0,138.45,,,0
CDM,51000049,Hc Visit Op New Level 5,261.0,169.65,,,0
CDM,51000050,Hc Visit Op Estab Level 1,129.0,83.85,,,0
CDM,51000051,Hc Visit Op Estab Level 2,158.0,102.7,,,0
CDM,51000052,Hc Visit Op Estab Level 3,185.0,120.25,,,0
CDM,51000053,Hc Visit Op Estab Level 4,213.0,138.45,,,0
CDM,51000054,Hc Visit Op Estab Level 5,261.0,169.65,,,0
CDM,51000055,Hc Visit Preventive New 12-17 Yrs,158.0,102.7,,,0
CDM,51000056,Hc Visit Preventive New 18-39 Yrs,158.0,102.7,,,0
CDM,51000057,Hc Visit Preventive New 40-64 Yrs,158.0,102.7,,,0
CDM,51000058,Hc Visit Preventive New >65 Yrs,158.0,102.7,,,0
CDM,51000059,Hc Visit Preventive Estab 12-17 Yrs,158.0,102.7,,,0
CDM,51000060,Hc Visit Preventive Estab 18-39 Yrs,158.0,102.7,,,0
CDM,51000061,Hc Visit Preventive Estab 40-64 Yrs,158.0,102.7,,,0
CDM,51000062,Hc Visit Preventive Estab >65 Yrs,158.0,102.7,,,0
CDM,51000063,Hc Preventive Med Counsel 15Min,162.0,105.3,,,0
CDM,51000064,Hc Preventive Med Counsel 30Min,192.0,124.8,,,0
CDM,51000065,Hc Preventive Med Counsel 45Min,222.0,144.3,,,0
CDM,51000066,Hc Preventive Med Counsel 60Min,271.0,176.15,,,0
CDM,51000067,Hc Excise Benign Lesion Face,1996.0,1297.4,,,0
CDM,51000068,Hc Excise Benign Lesion S N H F G,1996.0,1297.4,,,0
CDM,51000069,Hc Excise Benign Lesion Tal,2322.0,1509.3,,,0
CDM,51000076,Hc Tenotomy Perc Thigh Tendon/Adctr/Hamstrng Mult,5303.0,3446.95,,,0
CDM,51000076_50,Hc Tenotomy Perc Thigh Tendon/Adctr/Hamstrng Mult,10606.0,6893.9,,,0
CDM,51000077,Hc Fasciotomy Foot Toe,5303.0,3446.95,,,0
CDM,51000077_50,Hc Fasciotomy Foot Toe,10606.0,6893.9,,,0
CDM,51000078,Hc Botox Inj Chronic Migraine,1988.0,1292.2,,,0
CDM,51000080,Hc Low Cost Appl Skn Grft Trunk Arm Leg 100 Cm 1St 25 Cm,1327.0,862.55,,,0
CDM,51000081,Hc Low Cost Appl Sg Trnk Arms Legs 100 Cm; Ea Add 25 Cm,1006.0,653.9,,,0
CDM,51000082,Hc Low Cost Appl Sg Trnk Arm Leg 100Cm Or More 1St 100 Cm,1750.0,1137.5,,,0
CDM,51000083,Hc Low Cost Appl Sg Trnk Arm Leg 100Cm Or More Add 100 Cm,1006.0,653.9,,,0
CDM,51000084,Hc Low Cost Appl Sg Hhfg To 100 Cm 1St 25 Cm,1909.0,1240.85,,,0
CDM,51000085,Hc Low Cost Appl Sg Hhfg To 100 Cm Ea Addl 25 Cm,1006.0,653.9,,,0
CDM,51000089,Hc Neg Press Disp Non Dme Wnd Ther <50Cm,1271.0,826.15,,,0
CDM,51000090,Hc Neg Press Wnd Disp Non Dme Ther >50Cm,1271.0,826.15,,,0
CDM,51000091,Hc Refill And Maintain Portable Pump,384.0,249.6,,,0
CDM,51000095,Hc Endoscopy Nasal,819.0,532.35,,,0
CDM,51000111,Hc Nasal Endoscopy With Maxillary Sinusoscopy,1972.0,1281.8,,,0
CDM,51000114,Hc Inject Skin Lesions 7 Or Less,907.0,589.55,,,0
CDM,51000116,Hc  Amputation Of Toe; M J,4804.0,3122.6,,,0
CDM,51000117,"Hc Tenotomy, Abductor Of Hip, Percutaneous",4816.0,3130.4,,,0
CDM,51000117_50,"Hc Tenotomy, Abductor Of Hip, Percutaneous",9632.0,6260.8,,,0
CDM,51000119,Hc Tenotomy Open Flexor Tendon Toe Sgl,3691.0,2399.15,,,0
CDM,51000119_50,Hc Tenotomy Open Flexor Tendon Toe Sgl,7382.0,4798.3,,,0
CDM,51000120,Hc Excision Partial Bone Phalanx Toe,4804.0,3122.6,,,0
CDM,51000122,Hc Incision Tongue Fold,2902.0,1886.3,,,0
CDM,51000124,Hc Mist Therapy,854.0,555.1,,,0
CDM,51000125,Hc I And D Deep Abscess Or Hematoma Leg Or Ankle,7289.0,4737.85,,,0
CDM,51000126,Hc Exc Malignant Les Trunk Arm Or Leg 0.6-1.0 Cm,1499.0,974.35,,,0
CDM,51000127,Hc Exc Malignant Les S N H F G 2.1-3.0Cm,4205.0,2733.25,,,0
CDM,51000128,Hc Removal Sutures Or Staples Wo Anes,72.0,46.8,,,0
CDM,51000129,Hc Removal Sutures And Staples Wo Anes,72.0,46.8,,,0
CDM,51000132,Hc Retail Prp Inj,504.0,327.6,,,0
CDM,51000134,Hc Device Eval Barostim In Person,392.0,254.8,,,0
CDM,51000135,Hc Device Eval Barostim In Person W Programming,392.0,254.8,,,0
CDM,51000137,Hc Part Removal Of Metatarsal,4003.0,2601.95,,,0
CDM,53000001,Hc Omt 1-2 Body Regions,600.0,390.0,,,0
CDM,61000004,Hc Mr Quant Anal Tissue Comp W/ Mri Single Organ Add On,1725.0,1121.25,,,0
CDM,61000005,Hc Mr Safety Implant/Fb Assess By Tech Initial 15 Min,75.0,48.75,,,0
CDM,61000006,Hc Mr Safety Implant/Fb Assess By Tech Ea Addl 30 Min,25.0,16.25,,,0
CDM,61000007,Hc Mr Safety Determination By Radiologist,265.0,172.25,,,0
CDM,61000008,Hc Mr Safety Implant Electronics Prep,275.0,178.75,,,0
CDM,61000009,Hc Mr Safety Implant Positioning Or Immobilization,180.0,117.0,,,0
CDM,61100001,Hc Mri Tmj,2032.0,1320.8,,,0
CDM,61100001_50,Hc Mri Tmj,4064.0,2641.6,,,0
CDM,61100002,Hc Mri Orbit Face Neck Wo Contrast,2034.0,1322.1,,,0
CDM,61100003,Hc Mri Orbit Face Neck W Contrast,2402.0,1561.3,,,0
CDM,61100004,Hc Mri Orbit Face Neck W Wo Contrast,2832.0,1840.8,,,0
CDM,61100005,Hc Mri Brain Stem Wo Contrast,1961.0,1274.65,,,0
CDM,61100006,Hc Mri Brain Stem W Contrast,2521.0,1638.65,,,0
CDM,61100007,Hc Mri Brain Stem W Wo Contrast,3084.0,2004.6,,,0
CDM,61100008,Hc Mri Brain Functional W Tech Only,2502.0,1626.3,,,0
CDM,61100008_50,Hc Mri Brain Functional W Tech Only,5004.0,3252.6,,,0
CDM,61100009,Hc Mri Brain During Open Proc Wo Cont,3044.0,1978.6,,,0
CDM,61100010,Hc Mri Brain During Open Proc W Cont,3346.0,2174.9,,,0
CDM,61100011,Hc Mri Brain During Open Proc W And Wo Cont,3648.0,2371.2,,,0
CDM,61100012,Hc Mri Brain Functional W Radiologist,2877.0,1870.05,,,0
CDM,61200001,Hc Mri Cervical Spine Wo Contrast,1987.0,1291.55,,,0
CDM,61200002,Hc Mri Cervical Spine W Contrast,2433.0,1581.45,,,0
CDM,61200003,Hc Mri Thoracic Spine Wo Contrast,1979.0,1286.35,,,0
CDM,61200004,Hc Mri Thoracic Spine W Contrast,2386.0,1550.9,,,0
CDM,61200005,Hc Mri Lumbar Spine Wo Contrast,2014.0,1309.1,,,0
CDM,61200006,Hc Mri Lumbar Spine W Contrast,2510.0,1631.5,,,0
CDM,61200007,Hc Mri Cervical Spine W Wo Contrast,2868.0,1864.2,,,0
CDM,61200008,Hc Mri Thoracic Spine W Wo Contrast,2978.0,1935.7,,,0
CDM,61200009,Hc Mri Lumbar Spine W Wo Contrast,2835.0,1842.75,,,0
CDM,61400001,Hc Mri Chest Wo Contrast,1972.0,1281.8,,,0
CDM,61400002,Hc Mri Chest W Contrast,2440.0,1586.0,,,0
CDM,61400003,Hc Mri Chest W Wo Contrast,2907.0,1889.55,,,0
CDM,61400004,Hc Mri Pelvis Wo Contrast,2036.0,1323.4,,,0
CDM,61400005,Hc Mri Pelvis W Contrast,2472.0,1606.8,,,0
CDM,61400006,Hc Mri Pelvis W Wo Contrast,2910.0,1891.5,,,0
CDM,61400007,Hc Mri Upper Ext Non Joint Wo Contrast,1828.0,1188.2,,,0
CDM,61400007_50,Hc Mri Upper Ext Non Joint Wo Contrast,3656.0,2376.4,,,0
CDM,61400008,Hc Mri Upper Ext Non Joint W Contrast,2126.0,1381.9,,,0
CDM,61400008_50,Hc Mri Upper Ext Non Joint W Contrast,4252.0,2763.8,,,0
CDM,61400009,Hc Mri Upper Ext Non Joint W Wo  Contrast,2521.0,1638.65,,,0
CDM,61400009_50,Hc Mri Upper Ext Non Joint W Wo  Contrast,5042.0,3277.3,,,0
CDM,61400010,Hc Mri Upper Ext Joint Wo Contrast,1945.0,1264.25,,,0
CDM,61400010_50,Hc Mri Upper Ext Joint Wo Contrast,3890.0,2528.5,,,0
CDM,61400011,Hc Mri Upper Ext Joint W Contrast,2126.0,1381.9,,,0
CDM,61400011_50,Hc Mri Upper Ext Joint W Contrast,4252.0,2763.8,,,0
CDM,61400012,Hc Mri Upper Ext Joint W Wo Contrast,2321.0,1508.65,,,0
CDM,61400012_50,Hc Mri Upper Ext Joint W Wo Contrast,4642.0,3017.3,,,0
CDM,61400013,Hc Mri Low Extrem Non Joint Wo Contrast,1977.0,1285.05,,,0
CDM,61400013_50,Hc Mri Low Extrem Non Joint Wo Contrast,3954.0,2570.1,,,0
CDM,61400014,Hc Mri Low Extrem Non Joint W Contrast,2082.0,1353.3,,,0
CDM,61400014_50,Hc Mri Low Extrem Non Joint W Contrast,4164.0,2706.6,,,0
CDM,61400015,Hc Mri Low Extrem Non Joint W Wo Contrast,2619.0,1702.35,,,0
CDM,61400015_50,Hc Mri Low Extrem Non Joint W Wo Contrast,5238.0,3404.7,,,0
CDM,61400016,Hc Mri Low Extremity Joint Wo Contrast,1883.0,1223.95,,,0
CDM,61400016_50,Hc Mri Low Extremity Joint Wo Contrast,3766.0,2447.9,,,0
CDM,61400017,Hc Mri Low Extremity Joint W Contrast,2226.0,1446.9,,,0
CDM,61400017_50,Hc Mri Low Extremity Joint W Contrast,4452.0,2893.8,,,0
CDM,61400018,Hc Mri Low Extremity Joint W Wo Contrast,2597.0,1688.05,,,0
CDM,61400018_50,Hc Mri Low Extremity Joint W Wo Contrast,5194.0,3376.1,,,0
CDM,61400019,Hc Mri Abdomen Wo Contrast,1977.0,1285.05,,,0
CDM,61400020,Hc Mri Abdomen W Contrast,2507.0,1629.55,,,0
CDM,61400021,Hc Mri Abdomen W Wo Contrast,3122.0,2029.3,,,0
CDM,61400022,Hc Mri Card Morphology And Function Wo Contrast,1796.0,1167.4,,,0
CDM,61400024,Hc Mri Card Ltd W And Wo Contrast And Further Seq,1995.0,1296.75,,,0
CDM,61400025,Hc Mri Card For Velocity Flow Mapping,757.0,492.05,,,0
CDM,61400026,Hc Mri Spectroscopy,1777.0,1155.05,,,0
CDM,61400030,Hc Mri Breast Unilat W Contrast,2499.0,1624.35,,,0
CDM,61400031,Hc Mri Breast Unilat Wo Contrast,2361.0,1534.65,,,0
CDM,61400032,Hc Mri Breast Unilat W And Wo Contrast,2623.0,1704.95,,,0
CDM,61400033,Hc Mri Breast Bilat W Contrast,2521.0,1638.65,,,0
CDM,61400034,Hc Mri Breast Bilat Wo Contrast,3030.0,1969.5,,,0
CDM,61400035,Hc Mri Breast Bilat W And Wo Contrast,3365.0,2187.25,,,0
CDM,61400036,Hc Mri Bone Marrow Blood Supply,2366.0,1537.9,,,0
CDM,61400037,Hc Mri Radiation Treatment Planning,574.0,373.1,,,0
CDM,61400039,Hc Mri Breast Cad Unilat Or Bilat,1.0,0.65,,,0
CDM,61400040,Hc Mrgfus Ablation Intracranial Lesion,57968.0,37679.2,,,0
CDM,61400041,Hc Mri Cardiac W And Wo Contrast W Stress,2086.0,1355.9,,,0
CDM,61400042,Hc Mri Breast Abbreviated Bilat W & Wo Cont,532.0,345.8,,,0
CDM,61400043,Hc Mr Quantitative Analysis Brain Add On,886.0,575.9,,,0
CDM,61400044,Hc Mrghifus Ablation Intracranial Target,57968.0,37679.2,,,0
CDM,61500001,Hc Mra Brain Wo Contrast,1428.0,928.2,,,0
CDM,61500002,Hc Mra Brain W Contrast,1663.0,1080.95,,,0
CDM,61500003,Hc Mra Brain W Wo Contrast,1898.0,1233.7,,,0
CDM,61500004,Hc Mra Neck Wo Contrast,1428.0,928.2,,,0
CDM,61500005,Hc Mra Neck W Contrast,1668.0,1084.2,,,0
CDM,61500006,Hc Mra Neck W Wo Contrast,1908.0,1240.2,,,0
CDM,61600001,Hc Mra Lower Extremity W Contrast,2533.0,1646.45,,,0
CDM,61600001_50,Hc Mra Lower Extremity W Contrast,5066.0,3292.9,,,0
CDM,61600002,Hc Mra Lower Extremity Wo Contrast,2134.0,1387.1,,,0
CDM,61600002_50,Hc Mra Lower Extremity Wo Contrast,4268.0,2774.2,,,0
CDM,61600003,Hc Mra Lower Extremity W And Wo Contrast,2749.0,1786.85,,,0
CDM,61600003_50,Hc Mra Lower Extremity W And Wo Contrast,5498.0,3573.7,,,0
CDM,61800002,Hc Mra Upper Extremity W Wo Contrast,2766.0,1797.9,,,0
CDM,61800002_50,Hc Mra Upper Extremity W Wo Contrast,5532.0,3595.8,,,0
CDM,61800003,Hc Mra Abdomen W Contrast,2746.0,1784.9,,,0
CDM,61800004,Hc Mra Abdomen Wo Contrast,2214.0,1439.1,,,0
CDM,61800005,Hc Mra Abdomen W And Wo Contrast,3280.0,2132.0,,,0
CDM,61800006,Hc Mra Chest W Contrast,2391.0,1554.15,,,0
CDM,61800007,Hc Mra Chest Wo Contrast,2153.0,1399.45,,,0
CDM,61800008,Hc Mra Chest W And Wo Contrast,2656.0,1726.4,,,0
CDM,61800009,Hc Mra Pelvis W Contrast,2605.0,1693.25,,,0
CDM,61800010,Hc Mra Pelvis Wo Contrast,2153.0,1399.45,,,0
CDM,61800011,Hc Mra Pelvis W And Wo Contrast,3057.0,1987.05,,,0
CDM,61800012,Hc Mra Upper Extremity Wo Contrast,1822.0,1184.3,,,0
CDM,61800012_50,Hc Mra Upper Extremity Wo Contrast,3644.0,2368.6,,,0
CDM,61800013,Hc Mra Upper Extremity W Contrast,2205.0,1433.25,,,0
CDM,61800013_50,Hc Mra Upper Extremity W Contrast,4410.0,2866.5,,,0
CDM,62400089,Hc Ide G130007 Pro1140762 Brk,1.0,0.65,,,0
CDM,62400097,Hc Ide G130005 Pro 1143399 Evas 1 Nellix Catheter,8250.0,5362.5,,,0
CDM,62400124,Hc Ide G140059 Pro1148561 Evolut R,33000.0,21450.0,,,0
CDM,62400128,Hc Ide G140056 Pro 1149152,6500.0,4225.0,,,0
CDM,62400129,Hc Ide G140090 Pro11499986 Repriseiii,25000.0,16250.0,,,0
CDM,62400135,Hc Ide G130286 Proj 1157910 Web-It Device,1.0,0.65,,,0
CDM,62400136,Hc Ide G130286 Proj 1157910 Web-It Delivery System,1.0,0.65,,,0
CDM,62400139,Hc Ide G120169 Pro 1136831 Evolutr Corevalve,33000.0,21450.0,,,0
CDM,62400140,Hc Ide G150210 Project 20151943 Reduce Lap-Hf,1.0,0.65,,,0
CDM,62400141,Hc Ide G150121 Pro 1161749 Surveilsurmodics,1.0,0.65,,,0
CDM,62400156,"Hc Ide G160022 Pro 1165258 Evolut R 23,26,29Mm",33000.0,21450.0,,,0
CDM,62400159,Hc Ide G160039 Pro 1165489 Tavr 2.0,33000.0,21450.0,,,0
CDM,62400160,Hc Ide G160055 Pro02768402 Transcath Mitral Valve Repl,1.0,0.65,,,0
CDM,62400162,Hc Ide G130221 Pro Ohi-15-00603 Crest 2 Xact,1650.0,1072.5,,,0
CDM,62400165,Hc Ide G130221 Pro Ohi-15-00603 Crest 2 Nav 6 Filter,1475.0,958.75,,,0
CDM,62400168,Hc Ide G130221 Pro Ohi-15-00603 Crest 2 Moma Ultra Filter,1495.0,971.75,,,0
CDM,62400173,Hc Ide G130084 Converge Epi-Sense Coag System Visitrax,7020.0,4563.0,,,0
CDM,62400175,Hc Ide G150107 Amaze Guidewire,1100.0,715.0,,,0
CDM,62400176,Hc Ide G150107 Amaze Occlusion Balloon,650.0,422.5,,,0
CDM,62400177,Hc Ide G150107 Amaze Suture Cutter,400.0,260.0,,,0
CDM,62400178,Hc Ide G150107 Amaze Soft Guide Cannula,300.0,195.0,,,0
CDM,62400179,Hc Ide G150107 Amaze Tensure Suture Tightener,200.0,130.0,,,0
CDM,62400180,Hc Ide G160074 Madit S-Icd Emblem,17000.0,11050.0,,,0
CDM,62400181,Hc Ide G160074 Madit S-Icd Subq Electrode Lead,4000.0,2600.0,,,0
CDM,62400184,Hc Ide G160163 Abre,400.0,260.0,,,0
CDM,62400187,Hc Ide G160144 Toba Ii Btk Nitinol Tacks,1.0,0.65,,,0
CDM,62400188,Hc Ide G160020 Apollo Percutaneous Valve System,45000.0,29250.0,,,0
CDM,62400189,Hc Ide G170113 Wavecrest Left Atrial Appendage Occlusion System,1.0,0.65,,,0
CDM,62400190,Hc Ide G160227 Optimize Svelte Coronary Stent System,1.0,0.65,,,0
CDM,62400191,Hc Ide G150101 Control Htn Rox Coupler,1.0,0.65,,,0
CDM,62400192,Hc Ide G150121 Transcend Surveil Drug Coated Balloon Catheter,1.0,0.65,,,0
CDM,62400193,Hc Ide G170251 Wing-It Wingman Catheter,1.0,0.65,,,0
CDM,62400194,Hc Ide G150057 Aaa 13-03 Gore Excluder Trunk-Ipsi Leg Endo,9500.0,6175.0,,,0
CDM,62400195,Hc Ide G150057 Aaa 13-03 Gore Excluder Aortic Ext Endo,2500.0,1625.0,,,0
CDM,62400197,Hc Ide G150107 Amaze Lariat-Rs Suture Delivery Device,7950.0,5167.5,,,0
CDM,62400198,Hc Ide G180004 Tiger Revascularzation Device,1.0,0.65,,,0
CDM,62400199,Hc Ide G150200 Pinnacle Flex Watchman Closure Device,1.0,0.65,,,0
CDM,62400200,Hc Ide G160259 Early Tavr Sapien 3 Valve System,30000.0,19500.0,,,0
CDM,62400201,Hc Ide G160171 Asap Too Watchman Device,17000.0,11050.0,,,0
CDM,62400202,Hc Ide G160171 Asap Too Watchman Delivery Cath,1000.0,650.0,,,0
CDM,62400203,Hc Ide G170258 Guide Hf Cardiomems Hf System,21500.0,13975.0,,,0
CDM,62400204,Hc Ide G180045 Exceed Edwards Centera Heart Valve,32500.0,21125.0,,,0
CDM,62400205,Hc Ide G180073 Saval Des Btk Vascular Stent,1.0,0.65,,,0
CDM,62400206,Hc Ide G160022 Low Risk Bicuspid Tavr System,33000.0,21450.0,,,0
CDM,62400207,Hc Ide G140178 Onyx Resolute Coronary Stent A,825.0,536.25,,,0
CDM,62400208,Hc Ide G140178 Onyx Resolute Coronary Stent B,900.0,585.0,,,0
CDM,62400209,Hc Ide G170215 Unpinning Icd Lead,1.0,0.65,,,0
CDM,62400210,Hc Ide G170215 Unpinning Accessory Sheath,1.0,0.65,,,0
CDM,62400211,Hc Ide G170215 Unpinning Mapping Catheter,1.0,0.65,,,0
CDM,62400212,Hc Ide G170215 Unpinning Ice Catheter,1.0,0.65,,,0
CDM,62400213,Hc Ide G170215 Unpinning Ensite Patch,1.0,0.65,,,0
CDM,62400214,Hc Ide G170215 Unpinning Cess System,1.0,0.65,,,0
CDM,62400215,Hc Ide G180106 Foldax Polymer Aortic Valve,1.0,0.65,,,0
CDM,62400216,Hc Ide G190051 Accurate Ide Neo2 Aortic Valve System,28000.0,18200.0,,,0
CDM,62400217,Hc Ide G180270 Option Watchman Procedure Charge,20000.0,13000.0,,,0
CDM,62400218,Hc Ide G170166 Clasp 2D2F Implant System,30000.0,19500.0,,,0
CDM,62400219,Hc Ide G170166 Clasp 2D2F Guide Sheath,1.0,0.65,,,0
CDM,62400220,Hc Ide G170166 Clasp 2D2F Stabilizer,1.0,0.65,,,0
CDM,62400221,Hc Ide G170118 Triluminate Clip Initial,30000.0,19500.0,,,0
CDM,62400222,Hc Ide G170118 Triluminate Guide Catheter,1.0,0.65,,,0
CDM,62400223,Hc Ide G170118 Triluminate Clip Addtl,1.0,0.65,,,0
CDM,62400224,Hc Ide G180270 Option Watchman Device,1.0,0.65,,,0
CDM,62400225,Hc Ide G180270 Option Watchman Delivery Catheter,1.0,0.65,,,0
CDM,62400226,Hc Ide G190186 Ev Icd Device,21710.0,14111.5,,,0
CDM,62400227,Hc Ide G190186 Ev Icd Icd Lead,6295.0,4091.75,,,0
CDM,62400228,Hc Ide G190186 Ev Icd Sternal Tunneling Tool,950.0,617.5,,,0
CDM,62400229,Hc Ide G190186 Ev Icd Transverse Tunneling Tool,950.0,617.5,,,0
CDM,62400230,Hc Ide G190186 Ev Icd Safesheath Ii,95.0,61.75,,,0
CDM,62400231,Hc Ide G170215 Unpinning Cable,1.0,0.65,,,0
CDM,62400232,Hc Ide G170215 Unpinning Guidewire,1.0,0.65,,,0
CDM,62400233,Hc Ide G170215 Unpinning Introducer,1.0,0.65,,,0
CDM,62400234,Hc Ide G170215 Unpinning Diagnostic Catheter,1.0,0.65,,,0
CDM,62400235,Hc Ide G190099 Prost Preset Thrombectomy Device,5800.0,3770.0,,,0
CDM,62400236,Hc Ide G200119 Ttvr Efs Intrepid Trnscth Tricuspid Valve Rplcmt,1.0,0.65,,,0
CDM,62400237,Hc Ide G190069 Endolow Embotrap Ii Revasc,6000.0,3900.0,,,0
CDM,62400239,Hc Ide G190030 Vivid Vesper Vesper Duo Venous Stent System,1.0,0.65,,,0
CDM,62400240,Hc Ide G190111 Life Btk Esprit Btk Everolimus Eluting Bio Scaffold System,1.0,0.65,,,0
CDM,62400241,Hc Ide G180263 Iclas Af Cryoablation System,1.0,0.65,,,0
CDM,62400242,Hc Ide G150035 Align Tavr - Transfemoral Jenavalve Pericardial Tavr,1.0,0.65,,,0
CDM,62400243,Hc Ide G150035 Align Tavr Accessories (Delivery Cath & Loading Tool),0.75,0.49,,,0
CDM,62400244,Hc Ide G180106 Foldax Polymer Mitral Valve,1.0,0.65,,,0
CDM,62400245,Hc Ide G200310 Membrane Trufill Nbca Liquid Emolic System,1.0,0.65,,,0
CDM,62400246,Hc Ide G210339 Aveir Dual Chamber Leadless Pacemaker,1.0,0.65,,,0
CDM,62400248,Hc Ide #G200110 Alleviate Hf - Reveal Linq Insertalbe Cardiac Monitor,1.0,0.65,,,0
CDM,62400249,Hc Ide #G200110 Alleviate Hf - Reveal Linq Accessories,1.0,0.65,,,0
CDM,62400250,Hc Ide #G220034 Admire - Ire Ablation System Varipulse Catheter,1.0,0.65,,,0
CDM,62400251,Hc Ide G210167 Occluflex - Flex Ii Pfo Occluder Device,1.0,0.65,,,0
CDM,62400252,Hc Ide G210167 Occluflex - Occlutech Pistol Pusher Delivery System,1.0,0.65,,,0
CDM,62400253,Hc Ide G200106 Champion-Af Watchman Flex,17000.0,11050.0,,,0
CDM,62400254,Hc Ide G200106 Champion-Af Watchman Flex Delivery,1000.0,650.0,,,0
CDM,62400255,Hc Ide G150035 Align Tavr - Transfemoral Jenavalve Pericardial Tavr System,32500.0,21125.0,,,0
CDM,62400256,Hc Ide G210002 Summit Max  - Route 92 Medical Base Camp Sheath,1.0,0.65,,,0
CDM,62400257,Hc Ide G210002 Summit Max - Accessories,1.0,0.65,,,0
CDM,62400258,Hc Ide G210170 Sphere-9 Mapping And Ablation Catheter,1.0,0.65,,,0
CDM,62400259,Hc Ide G220079 Farawave Pfa Balloon Catheter,6500.0,4225.0,,,0
CDM,62400260,Hc Ide G220079 Farapoint Pfa Point Catheter,3250.0,2112.5,,,0
CDM,62400261,Hc Ide G220079 Faradrive Steerable Sheath,1400.0,910.0,,,0
CDM,62400262,Hc Ide G220079 Farastar Catheter Connection Cable,850.0,552.5,,,0
CDM,62400263,Hc Ide G210083 Innovalve Twist Efs - Valve,1.0,0.65,,,0
CDM,62400264,Hc Ide G210083 Innovalve Twist Efs - Delivery System,1.0,0.65,,,0
CDM,62400265,Hc Ide G200042 Aim Higher - Optimizer Smart Mini System,26000.0,16900.0,,,0
CDM,62400266,Hc Ide G200319 Modular Atp - Empower System - Initial,9750.0,6337.5,,,0
CDM,62400267,Hc Ide G200319 Modular Atp - Empower Pacemaker And Delivery Catheter,1.0,0.65,,,0
CDM,62400268,Hc Ide G200319 Modular Atp - Empower Introducer Sheath,1.0,0.65,,,0
CDM,62400269,Hc Ide G200319 Modular Atp - Empower Accessory,1.0,0.65,,,0
CDM,62400270,Hc Ide G200319 Modular Atp - Empower Retrieval System - Initial,3500.0,2275.0,,,0
CDM,62400271,Hc Ide G200319 Modular Atp - Empower Retrieval Catheter,1.0,0.65,,,0
CDM,62400272,Hc Ide G200319 Modular Atp - Empower Single-Loop Snare,1.0,0.65,,,0
CDM,62400273,Hc Ide G200319 Modular Atp - Empower Tri-Loop Snare,1.0,0.65,,,0
CDM,62400274,Hc Ide #G210339 - Aveir - Delivery System,1.0,0.65,,,0
CDM,62400275,Hc Ide #G210339 - Aveir - Introducer Sheath,1.0,0.65,,,0
CDM,62400276,Hc Ide #G180189-S016 Conform Pivotal Plug And Delivery,1.0,0.65,,,0
CDM,62400277,Hc Ide #G180189-S016 Conform Pivotal Sheath,1.0,0.65,,,0
CDM,62400278,Hc Ide #G180189-S016 Conform Pivotal Loader,1.0,0.65,,,0
CDM,62400279,Hc Ide #G220087 Deeper Reveal - Bare Temporary Spur Stent System,1.0,0.65,,,0
CDM,62400280,Hc Ide #G220087 Deeper Reveal - Bare Temporary Spur Stent Delivery,1.0,0.65,,,0
CDM,62400281,Hc Ide #G220109 Gore Viafort - Gore Viafort Vascular Stent,1.0,0.65,,,0
CDM,62400282,Hc Ide #G220109 Gore Viafort - Gore Viafort Vascular Stent Delivery,1.0,0.65,,,0
CDM,62400283,Hc Ide#  G190051 - Acurate Ide Prime Xl Aortic Valve - Initial,28000.0,18200.0,,,0
CDM,62400284,Hc Ide#  G190051 - Acurate Ide Prime Xl Aortic Valve,1.0,0.65,,,0
CDM,62400285,Hc Ide#  G190051 - Acurate Ide Prime Xl Delivery Catheter,1.0,0.65,,,0
CDM,62400286,Hc Ide#  G190051 - Acurate Ide Prime Xl Loader,1.0,0.65,,,0
CDM,62400287,Hc Ide #G150036 Spyral Affirm - Symplicity Spyral Renal Denervation Catheter System,1.02,0.66,,,0
CDM,62400288,Hc Ide #G220033 Protect H2H - Embolic Protection Device Catheter,1.02,0.66,,,0
CDM,62400289,Hc Ide #G200119 Ttvr Efs - Delivery,1.02,0.66,,,0
CDM,62400290,Hc Ide #G200119 Ttvr Efs - Loader,1.02,0.66,,,0
CDM,62400291,Hc Ide #G220207 - Telltale Electosurgical Guidewire,1.02,0.66,,,0
CDM,62400292,Hc Ide #G220207 - Telltale Electosurgical Accessories,1.02,0.66,,,0
CDM,62400293,Hc Ide G200051 Aspire Ph Balloon Catheter,1.02,0.66,,,0
CDM,62400294,Hc Ide G200051 Aspire Ph Delivery System,1.02,0.66,,,0
CDM,62400295,Hc Ide G200051 Aspire Ph Accessories,1.02,0.66,,,0
CDM,62400296,Hc Ide G210320 Selution Slr De Balloon,1.02,0.66,,,0
CDM,62400297,Hc Ide G220096 Escape-Mevo Solitaire X,1.02,0.66,,,0
CDM,62400298,Hc Ide# G190051 - Acurate Ide Prime Xl Isleeve,1.02,0.66,,,0
CDM,62400299,Hc Ide# G190051 - Acurate Ide Prime Xl Wire,1.02,0.66,,,0
CDM,62400300,Hc Ide G230027/ S001 - Aventus Aspiration Catheter,1.02,0.66,,,0
CDM,62400301,Hc Ide G230027/ S001 - Aventus Clot Management System,1.02,0.66,,,0
CDM,62400302,Hc Ide #G200119 Ttvr Efs - Accessory,1.02,0.66,,,0
CDM,62400303,Hc Ide #G230170 Smartpulse Paf - Thermocool Smarttouch Sf Catheter,1.02,0.66,,,0
CDM,62400304,Hc Ide G230249 Avant Guard - Farawave Pfa Balloon Catheter,6604.16,4292.7,,,0
CDM,62400305,Hc Ide G230249 Avant Guard - Faradrive Steerable Sheath,1331.07,865.2,,,0
CDM,62400306,Hc Ide G230249 Avant Guard - Farastar Catheter Connection Cable,204.78,133.11,,,0
CDM,62400307,Hc Ide G180213/ S028 - Venus Hf Precardia Balloon Occlusion Cath,1.02,0.66,,,0
CDM,62400308,Hc Ide G180213/ S028 - Venus Hf Accessory,1.02,0.66,,,0
CDM,62400309,Hc Ide #G200007 - Performance Iii Neuroguard Iep Direct System,3993.21,2595.59,,,0
CDM,62400310,Hc Ide #G200007 - Performance Iii Neuroguard Direct Access Kit,2559.75,1663.84,,,0
CDM,62400311,Hc Ide #G220093 Atriclip Excluder,1177.48,765.36,,,0
CDM,62400312,Hc Ide #G220093 Atriclip Exclusion Flexv Series,1843.02,1197.96,,,0
CDM,62400318,Hc Ide G230284 Picante - Kardion Cory P4 System,25597.5,16638.38,,,0
CDM,62400319,Hc Ide G240108 - Power Pad Ii Pulse Periph Ivl Balloon Cath,1.02,0.66,,,0
CDM,62400320,Hc Ide Proj Ide G220141 - Laax Laminar Left Atrial Appendage Closure System,1.02,0.66,,,0
CDM,62400321,Hc Ide G230146 Envision - Navitor Valve,26877.38,17470.3,,,0
CDM,62400322,Hc Ide G230146 Envision - Navitor Loader,511.95,332.77,,,0
CDM,62400323,Hc Ide G230146 Envision - Flexnav Delivery,1535.85,998.3,,,0
CDM,62400324,Hc Ide #G150036 Spyral Affirm - Guidewire,1.02,0.66,,,0
CDM,62400325,Hc Ide #G150036 Spyral Affirm - Guidecath,1.02,0.66,,,0
CDM,62400326,Hc Ide #G190234 Ultra-Hfib-Redo - Paradise Catheter,1.02,0.66,,,0
CDM,62400327,Hc Ide #G190234 Ultra-Hfib-Redo - Paradise Cartridge62400327,1.02,0.66,,,0
CDM,62400328,Hc Ide #G190234 Ultra-Hfib-Redo - Paradise Connection Cable,1.02,0.66,,,0
CDM,62400329,Hc Ide# G230119 Picasso,1.02,0.66,,,0
CDM,63600006_250,Noncdm Charge Record Pharmacy,43.7,28.4,,,0
CDM,63600006_636,Noncdm Charge Record Pharmacy,128.93,83.8,,,0
CDM,63600006_90371_636,Noncdm Charge Record Pharmacy,296.4,192.66,,,0
CDM,63600006_90375_636,Noncdm Charge Record Pharmacy,1280.13,832.08,,,0
CDM,63600006_90380_636,Noncdm Charge Record Pharmacy,2229.34,1449.07,,,0
CDM,63600006_90396_636,Noncdm Charge Record Pharmacy,11332.63,7366.21,,,0
CDM,63600006_90746_636,Noncdm Charge Record Pharmacy,162.66,105.73,,,0
CDM,63600006_A9589_636,Noncdm Charge Record Pharmacy,6885.01,4475.26,,,0
CDM,63600006_C9047_636,Noncdm Charge Record Pharmacy,3240.14,2106.09,,,0
CDM,63600006_C9088_636,Noncdm Charge Record Pharmacy,3.76,2.44,,,0
CDM,63600006_C9113_636,Noncdm Charge Record Pharmacy,46.42,30.17,,,0
CDM,63600006_C9143_636,Noncdm Charge Record Pharmacy,5.83,3.79,,,0
CDM,63600006_C9163_636,Noncdm Charge Record Pharmacy,272.58,177.18,,,0
CDM,63600006_C9254_636,Noncdm Charge Record Pharmacy,0.77,0.5,,,0
CDM,63600006_C9290_636,Noncdm Charge Record Pharmacy,8.0,5.2,,,0
CDM,63600006_C9399_636,Noncdm Charge Record Pharmacy,7042.17,4577.41,,,0
CDM,63600006_C9460_636,Noncdm Charge Record Pharmacy,93.33,60.66,,,0
CDM,63600006_J0129_636,Noncdm Charge Record Pharmacy,291.3,189.34,,,0
CDM,63600006_J0131_636,Noncdm Charge Record Pharmacy,0.69,0.45,,,0
CDM,63600006_J0132_636,Noncdm Charge Record Pharmacy,3.59,2.33,,,0
CDM,63600006_J0133_636,Noncdm Charge Record Pharmacy,0.41,0.27,,,0
CDM,63600006_J0134_636,Noncdm Charge Record Pharmacy,0.64,0.42,,,0
CDM,63600006_J0135_636,Noncdm Charge Record Pharmacy,0.51,0.33,,,0
CDM,63600006_J0136_636,Noncdm Charge Record Pharmacy,0.65,0.42,,,0
CDM,63600006_J0137_636,Noncdm Charge Record Pharmacy,0.59,0.38,,,0
CDM,63600006_J0153_636,Noncdm Charge Record Pharmacy,6.02,3.91,,,0
CDM,63600006_J0171_636,Noncdm Charge Record Pharmacy,5.48,3.56,,,0
CDM,63600006_J0173_636,Noncdm Charge Record Pharmacy,4.1,2.66,,,0
CDM,63600006_J0174_636,Noncdm Charge Record Pharmacy,6.66,4.33,,,0
CDM,63600006_J0180_636,Noncdm Charge Record Pharmacy,983.48,639.26,,,0
CDM,63600006_J0209_636,Noncdm Charge Record Pharmacy,4.21,2.74,,,0
CDM,63600006_J0222_636,Noncdm Charge Record Pharmacy,368.86,239.76,,,0
CDM,63600006_J0225_636,Noncdm Charge Record Pharmacy,15712.13,10212.88,,,0
CDM,63600006_J0248_636,Noncdm Charge Record Pharmacy,31.41,20.42,,,0
CDM,63600006_J0257_636,Noncdm Charge Record Pharmacy,41.36,26.88,,,0
CDM,63600006_J0270_636,Noncdm Charge Record Pharmacy,8.84,5.75,,,0
CDM,63600006_J0278_636,Noncdm Charge Record Pharmacy,7.72,5.02,,,0
CDM,63600006_J0280_636,Noncdm Charge Record Pharmacy,60.37,39.24,,,0
CDM,63600006_J0282_636,Noncdm Charge Record Pharmacy,7.72,5.02,,,0
CDM,63600006_J0283_636,Noncdm Charge Record Pharmacy,11.88,7.72,,,0
CDM,63600006_J0285_636,Noncdm Charge Record Pharmacy,217.98,141.69,,,0
CDM,63600006_J0289_636,Noncdm Charge Record Pharmacy,118.64,77.12,,,0
CDM,63600006_J0290_636,Noncdm Charge Record Pharmacy,12.51,8.13,,,0
CDM,63600006_J0295_636,Noncdm Charge Record Pharmacy,29.7,19.3,,,0
CDM,63600006_J0330_636,Noncdm Charge Record Pharmacy,12.84,8.35,,,0
CDM,63600006_J0360_636,Noncdm Charge Record Pharmacy,42.53,27.64,,,0
CDM,63600006_J0391_636,Noncdm Charge Record Pharmacy,228.97,148.83,,,0
CDM,63600006_J0456_636,Noncdm Charge Record Pharmacy,47.42,30.82,,,0
CDM,63600006_J0457_636,Noncdm Charge Record Pharmacy,13.87,9.02,,,0
CDM,63600006_J0461_636,Noncdm Charge Record Pharmacy,1.21,0.79,,,0
CDM,63600006_J0475_636,Noncdm Charge Record Pharmacy,942.38,612.55,,,0
CDM,63600006_J0476_636,Noncdm Charge Record Pharmacy,334.05,217.13,,,0
CDM,63600006_J0485_636,Noncdm Charge Record Pharmacy,19.95,12.97,,,0
CDM,63600006_J0490_636,Noncdm Charge Record Pharmacy,180.02,117.01,,,0
CDM,63600006_J0491_636,Noncdm Charge Record Pharmacy,88.09,57.26,,,0
CDM,63600006_J0500_636,Noncdm Charge Record Pharmacy,87.85,57.1,,,0
CDM,63600006_J0515_636,Noncdm Charge Record Pharmacy,98.03,63.72,,,0
CDM,63600006_J0517_636,Noncdm Charge Record Pharmacy,827.97,538.18,,,0
CDM,63600006_J0561_636,Noncdm Charge Record Pharmacy,118.33,76.91,,,0
CDM,63600006_J0565_636,Noncdm Charge Record Pharmacy,165.64,107.67,,,0
CDM,63600006_J0583_636,Noncdm Charge Record Pharmacy,1.22,0.79,,,0
CDM,63600006_J0585_636,Noncdm Charge Record Pharmacy,33.47,21.76,,,0
CDM,63600006_J0594_636,Noncdm Charge Record Pharmacy,2.64,1.72,,,0
CDM,63600006_J0597_636,Noncdm Charge Record Pharmacy,361.14,234.74,,,0
CDM,63600006_J0612_636,Noncdm Charge Record Pharmacy,0.64,0.42,,,0
CDM,63600006_J0613_636,Noncdm Charge Record Pharmacy,0.76,0.49,,,0
CDM,63600006_J0630_636,Noncdm Charge Record Pharmacy,3401.5,2210.98,,,0
CDM,63600006_J0637_636,Noncdm Charge Record Pharmacy,26.57,17.27,,,0
CDM,63600006_J0640_636,Noncdm Charge Record Pharmacy,14.26,9.27,,,0
CDM,63600006_J0650_636,Noncdm Charge Record Pharmacy,36.35,23.63,,,0
CDM,63600006_J0651_636,Noncdm Charge Record Pharmacy,37.86,24.61,,,0
CDM,63600006_J0665_636,Noncdm Charge Record Pharmacy,0.3,0.2,,,0
CDM,63600006_J0670_636,Noncdm Charge Record Pharmacy,36.57,23.77,,,0
CDM,63600006_J0689_636,Noncdm Charge Record Pharmacy,25.28,16.43,,,0
CDM,63600006_J0690_636,Noncdm Charge Record Pharmacy,38.96,25.32,,,0
CDM,63600006_J0692_636,Noncdm Charge Record Pharmacy,23.96,15.57,,,0
CDM,63600006_J0694_636,Noncdm Charge Record Pharmacy,39.69,25.8,,,0
CDM,63600006_J0695_636,Noncdm Charge Record Pharmacy,39.67,25.79,,,0
CDM,63600006_J0696_636,Noncdm Charge Record Pharmacy,18.8,12.22,,,0
CDM,63600006_J0699_636,Noncdm Charge Record Pharmacy,10.82,7.03,,,0
CDM,63600006_J0701_636,Noncdm Charge Record Pharmacy,28.8,18.72,,,0
CDM,63600006_J0702_636,Noncdm Charge Record Pharmacy,54.72,35.57,,,0
CDM,63600006_J0703_636,Noncdm Charge Record Pharmacy,34.56,22.46,,,0
CDM,63600006_J0706_636,Noncdm Charge Record Pharmacy,11.9,7.74,,,0
CDM,63600006_J0712_636,Noncdm Charge Record Pharmacy,17.36,11.28,,,0
CDM,63600006_J0713_636,Noncdm Charge Record Pharmacy,17.18,11.17,,,0
CDM,63600006_J0714_636,Noncdm Charge Record Pharmacy,476.14,309.49,,,0
CDM,63600006_J0717_636,Noncdm Charge Record Pharmacy,74.04,48.13,,,0
CDM,63600006_J0735_636,Noncdm Charge Record Pharmacy,40.21,26.14,,,0
CDM,63600006_J0736_636,Noncdm Charge Record Pharmacy,30.8,20.02,,,0
CDM,63600006_J0737_636,Noncdm Charge Record Pharmacy,30.69,19.95,,,0
CDM,63600006_J0740_636,Noncdm Charge Record Pharmacy,2448.52,1591.54,,,0
CDM,63600006_J0743_636,Noncdm Charge Record Pharmacy,34.54,22.45,,,0
CDM,63600006_J0744_636,Noncdm Charge Record Pharmacy,36.86,23.96,,,0
CDM,63600006_J0780_636,Noncdm Charge Record Pharmacy,50.0,32.5,,,0
CDM,63600006_J0834_636,Noncdm Charge Record Pharmacy,172.98,112.44,,,0
CDM,63600006_J0874_636,Noncdm Charge Record Pharmacy,0.23,0.15,,,0
CDM,63600006_J0875_636,Noncdm Charge Record Pharmacy,86.61,56.3,,,0
CDM,63600006_J0877_636,Noncdm Charge Record Pharmacy,0.41,0.27,,,0
CDM,63600006_J0878_636,Noncdm Charge Record Pharmacy,0.23,0.15,,,0
CDM,63600006_J0881_636,Noncdm Charge Record Pharmacy,17.37,11.29,,,0
CDM,63600006_J0883_636,Noncdm Charge Record Pharmacy,5.98,3.89,,,0
CDM,63600006_J0884_636,Noncdm Charge Record Pharmacy,8.6,5.59,,,0
CDM,63600006_J0885_636,Noncdm Charge Record Pharmacy,62.66,40.73,,,0
CDM,63600006_J0888_636,Noncdm Charge Record Pharmacy,18.18,11.82,,,0
CDM,63600006_J0894_636,Noncdm Charge Record Pharmacy,6.16,4.0,,,0
CDM,63600006_J0896_636,Noncdm Charge Record Pharmacy,200.15,130.1,,,0
CDM,63600006_J0897_636,Noncdm Charge Record Pharmacy,140.51,91.33,,,0
CDM,63600006_J0898_636,Noncdm Charge Record Pharmacy,7.64,4.97,,,0
CDM,63600006_J0899_636,Noncdm Charge Record Pharmacy,7.58,4.93,,,0
CDM,63600006_J1010_636,Noncdm Charge Record Pharmacy,1.33,0.86,,,0
CDM,63600006_J1030_636,Noncdm Charge Record Pharmacy,53.82,34.98,,,0
CDM,63600006_J1040_636,Noncdm Charge Record Pharmacy,70.41,45.77,,,0
CDM,63600006_J1050_636,Noncdm Charge Record Pharmacy,1.71,1.11,,,0
CDM,63600006_J1071_636,Noncdm Charge Record Pharmacy,0.46,0.3,,,0
CDM,63600006_J1100_636,Noncdm Charge Record Pharmacy,5.97,3.88,,,0
CDM,63600006_J1110_636,Noncdm Charge Record Pharmacy,173.07,112.5,,,0
CDM,63600006_J1120_636,Noncdm Charge Record Pharmacy,154.88,100.67,,,0
CDM,63600006_J1160_636,Noncdm Charge Record Pharmacy,50.55,32.86,,,0
CDM,63600006_J1162_636,Noncdm Charge Record Pharmacy,22990.55,14943.86,,,0
CDM,63600006_J1165_636,Noncdm Charge Record Pharmacy,13.39,8.7,,,0
CDM,63600006_J1170_636,Noncdm Charge Record Pharmacy,46.41,30.17,,,0
CDM,63600006_J1171_636,Noncdm Charge Record Pharmacy,7.3,4.74,,,0
CDM,63600006_J1200_636,Noncdm Charge Record Pharmacy,36.5,23.72,,,0
CDM,63600006_J1205_636,Noncdm Charge Record Pharmacy,204.49,132.92,,,0
CDM,63600006_J1230_636,Noncdm Charge Record Pharmacy,110.67,71.94,,,0
CDM,63600006_J1250_636,Noncdm Charge Record Pharmacy,52.99,34.44,,,0
CDM,63600006_J1265_636,Noncdm Charge Record Pharmacy,10.61,6.9,,,0
CDM,63600006_J1300_636,Noncdm Charge Record Pharmacy,750.98,488.14,,,0
CDM,63600006_J1303_636,Noncdm Charge Record Pharmacy,916.1,595.46,,,0
CDM,63600006_J1305_636,Noncdm Charge Record Pharmacy,562.95,365.92,,,0
CDM,63600006_J1306_636,Noncdm Charge Record Pharmacy,60.72,39.47,,,0
CDM,63600006_J1325_636,Noncdm Charge Record Pharmacy,120.47,78.31,,,0
CDM,63600006_J1335_636,Noncdm Charge Record Pharmacy,86.99,56.54,,,0
CDM,63600006_J1364_636,Noncdm Charge Record Pharmacy,166.6,108.29,,,0
CDM,63600006_J1380_636,Noncdm Charge Record Pharmacy,97.7,63.5,,,0
CDM,63600006_J1410_636,Noncdm Charge Record Pharmacy,1844.35,1198.83,,,0
CDM,63600006_J1430_636,Noncdm Charge Record Pharmacy,2230.55,1449.86,,,0
CDM,63600006_J1438_636,Noncdm Charge Record Pharmacy,0.69,0.45,,,0
CDM,63600006_J1439_636,Noncdm Charge Record Pharmacy,6.74,4.38,,,0
CDM,63600006_J1450_636,Noncdm Charge Record Pharmacy,43.31,28.15,,,0
CDM,63600006_J1451_636,Noncdm Charge Record Pharmacy,30.06,19.54,,,0
CDM,63600006_J1453_636,Noncdm Charge Record Pharmacy,1.18,0.77,,,0
CDM,63600006_J1459_636,Noncdm Charge Record Pharmacy,155.12,100.83,,,0
CDM,63600006_J1561_636,Noncdm Charge Record Pharmacy,237.68,154.49,,,0
CDM,63600006_J1568_636,Noncdm Charge Record Pharmacy,194.0,126.1,,,0
CDM,63600006_J1569_636,Noncdm Charge Record Pharmacy,153.31,99.65,,,0
CDM,63600006_J1570_636,Noncdm Charge Record Pharmacy,211.67,137.59,,,0
CDM,63600006_J1580_636,Noncdm Charge Record Pharmacy,20.7,13.46,,,0
CDM,63600006_J1595_636,Noncdm Charge Record Pharmacy,259.29,168.54,,,0
CDM,63600006_J1596_636,Noncdm Charge Record Pharmacy,14.78,9.61,,,0
CDM,63600006_J1602_636,Noncdm Charge Record Pharmacy,173.27,112.63,,,0
CDM,63600006_J1610_636,Noncdm Charge Record Pharmacy,706.59,459.28,,,0
CDM,63600006_J1611_636,Noncdm Charge Record Pharmacy,611.63,397.56,,,0
CDM,63600006_J1630_636,Noncdm Charge Record Pharmacy,35.24,22.91,,,0
CDM,63600006_J1631_636,Noncdm Charge Record Pharmacy,50.47,32.81,,,0
CDM,63600006_J1640_636,Noncdm Charge Record Pharmacy,156.81,101.93,,,0
CDM,63600006_J1642_636,Noncdm Charge Record Pharmacy,0.73,0.47,,,0
CDM,63600006_J1643_636,Noncdm Charge Record Pharmacy,4.0,2.6,,,0
CDM,63600006_J1644_636,Noncdm Charge Record Pharmacy,5.75,3.74,,,0
CDM,63600006_J1650_636,Noncdm Charge Record Pharmacy,12.26,7.97,,,0
CDM,63600006_J1652_636,Noncdm Charge Record Pharmacy,15.38,10.0,,,0
CDM,63600006_J1670_636,Noncdm Charge Record Pharmacy,2825.37,1836.49,,,0
CDM,63600006_J1720_636,Noncdm Charge Record Pharmacy,91.8,59.67,,,0
CDM,63600006_J1742_636,Noncdm Charge Record Pharmacy,460.02,299.01,,,0
CDM,63600006_J1744_636,Noncdm Charge Record Pharmacy,267.02,173.56,,,0
CDM,63600006_J1745_636,Noncdm Charge Record Pharmacy,230.64,149.92,,,0
CDM,63600006_J1750_636,Noncdm Charge Record Pharmacy,87.05,56.58,,,0
CDM,63600006_J1756_636,Noncdm Charge Record Pharmacy,1.96,1.27,,,0
CDM,63600006_J1790_636,Noncdm Charge Record Pharmacy,47.8,31.07,,,0
CDM,63600006_J1800_636,Noncdm Charge Record Pharmacy,74.94,48.71,,,0
CDM,63600006_J1805_636,Noncdm Charge Record Pharmacy,2.31,1.5,,,0
CDM,63600006_J1823_636,Noncdm Charge Record Pharmacy,1743.93,1133.55,,,0
CDM,63600006_J1833_636,Noncdm Charge Record Pharmacy,5.08,3.3,,,0
CDM,63600006_J1836_636,Noncdm Charge Record Pharmacy,1.37,0.89,,,0
CDM,63600006_J1885_636,Noncdm Charge Record Pharmacy,27.45,17.84,,,0
CDM,63600006_J1920_636,Noncdm Charge Record Pharmacy,19.27,12.53,,,0
CDM,63600006_J1921_636,Noncdm Charge Record Pharmacy,10.89,7.08,,,0
CDM,63600006_J1939_636,Noncdm Charge Record Pharmacy,5.7,3.7,,,0
CDM,63600006_J1940_636,Noncdm Charge Record Pharmacy,16.76,10.89,,,0
CDM,63600006_J1943_636,Noncdm Charge Record Pharmacy,3.76,2.44,,,0
CDM,63600006_J1944_636,Noncdm Charge Record Pharmacy,3.45,2.24,,,0
CDM,63600006_J1950_636,Noncdm Charge Record Pharmacy,6542.35,4252.53,,,0
CDM,63600006_J1953_636,Noncdm Charge Record Pharmacy,0.5,0.32,,,0
CDM,63600006_J1955_636,Noncdm Charge Record Pharmacy,191.98,124.79,,,0
CDM,63600006_J1956_636,Noncdm Charge Record Pharmacy,25.84,16.8,,,0
CDM,63600006_J1980_636,Noncdm Charge Record Pharmacy,158.13,102.78,,,0
CDM,63600006_J2001_636,Noncdm Charge Record Pharmacy,0.4,0.26,,,0
CDM,63600006_J2020_636,Noncdm Charge Record Pharmacy,32.77,21.3,,,0
CDM,63600006_J2060_636,Noncdm Charge Record Pharmacy,36.18,23.52,,,0
CDM,63600006_J2150_636,Noncdm Charge Record Pharmacy,40.44,26.29,,,0
CDM,63600006_J2175_636,Noncdm Charge Record Pharmacy,47.87,31.12,,,0
CDM,63600006_J2182_636,Noncdm Charge Record Pharmacy,187.24,121.71,,,0
CDM,63600006_J2183_636,Noncdm Charge Record Pharmacy,9.28,6.03,,,0
CDM,63600006_J2184_636,Noncdm Charge Record Pharmacy,13.6,8.84,,,0
CDM,63600006_J2185_636,Noncdm Charge Record Pharmacy,5.93,3.85,,,0
CDM,63600006_J2186_636,Noncdm Charge Record Pharmacy,10.79,7.01,,,0
CDM,63600006_J2210_636,Noncdm Charge Record Pharmacy,130.64,84.92,,,0
CDM,63600006_J2247_636,Noncdm Charge Record Pharmacy,1.5,0.98,,,0
CDM,63600006_J2248_636,Noncdm Charge Record Pharmacy,1.92,1.25,,,0
CDM,63600006_J2250_636,Noncdm Charge Record Pharmacy,18.9,12.28,,,0
CDM,63600006_J2251_636,Noncdm Charge Record Pharmacy,1.35,0.88,,,0
CDM,63600006_J2260_636,Noncdm Charge Record Pharmacy,20.86,13.56,,,0
CDM,63600006_J2265_636,Noncdm Charge Record Pharmacy,12.42,8.07,,,0
CDM,63600006_J2270_636,Noncdm Charge Record Pharmacy,44.53,28.94,,,0
CDM,63600006_J2272_636,Noncdm Charge Record Pharmacy,44.66,29.03,,,0
CDM,63600006_J2274_636,Noncdm Charge Record Pharmacy,41.0,26.65,,,0
CDM,63600006_J2300_636,Noncdm Charge Record Pharmacy,47.18,30.67,,,0
CDM,63600006_J2305_636,Noncdm Charge Record Pharmacy,18.0,11.7,,,0
CDM,63600006_J2310_636,Noncdm Charge Record Pharmacy,57.15,37.15,,,0
CDM,63600006_J2315_636,Noncdm Charge Record Pharmacy,8.74,5.68,,,0
CDM,63600006_J2323_636,Noncdm Charge Record Pharmacy,112.55,73.16,,,0
CDM,63600006_J2327_636,Noncdm Charge Record Pharmacy,34.17,22.21,,,0
CDM,63600006_J2329_636,Noncdm Charge Record Pharmacy,248.93,161.8,,,0
CDM,63600006_J2350_636,Noncdm Charge Record Pharmacy,244.72,159.07,,,0
CDM,63600006_J2353_636,Noncdm Charge Record Pharmacy,1133.7,736.9,,,0
CDM,63600006_J2356_636,Noncdm Charge Record Pharmacy,100.62,65.4,,,0
CDM,63600006_J2357_636,Noncdm Charge Record Pharmacy,237.65,154.47,,,0
CDM,63600006_J2359_636,Noncdm Charge Record Pharmacy,8.08,5.25,,,0
CDM,63600006_J2360_636,Noncdm Charge Record Pharmacy,103.88,67.52,,,0
CDM,63600006_J2371_636,Noncdm Charge Record Pharmacy,0.02,0.01,,,0
CDM,63600006_J2401_636,Noncdm Charge Record Pharmacy,0.26,0.17,,,0
CDM,63600006_J2404_636,Noncdm Charge Record Pharmacy,0.86,0.56,,,0
CDM,63600006_J2405_636,Noncdm Charge Record Pharmacy,8.87,5.77,,,0
CDM,63600006_J2407_636,Noncdm Charge Record Pharmacy,141.82,92.18,,,0
CDM,63600006_J2426_636,Noncdm Charge Record Pharmacy,15.33,9.96,,,0
CDM,63600006_J2427_636,Noncdm Charge Record Pharmacy,60.88,39.57,,,0
CDM,63600006_J2430_636,Noncdm Charge Record Pharmacy,68.16,44.3,,,0
CDM,63600006_J2469_636,Noncdm Charge Record Pharmacy,7.37,4.79,,,0
CDM,63600006_J2470_636,Noncdm Charge Record Pharmacy,41.78,27.16,,,0
CDM,63600006_J2471_636,Noncdm Charge Record Pharmacy,47.25,30.71,,,0
CDM,63600006_J2501_636,Noncdm Charge Record Pharmacy,22.99,14.94,,,0
CDM,63600006_J2506_636,Noncdm Charge Record Pharmacy,1307.71,850.01,,,0
CDM,63600006_J2507_636,Noncdm Charge Record Pharmacy,16284.4,10584.86,,,0
CDM,63600006_J2515_636,Noncdm Charge Record Pharmacy,181.34,117.87,,,0
CDM,63600006_J2540_636,Noncdm Charge Record Pharmacy,17.24,11.21,,,0
CDM,63600006_J2543_636,Noncdm Charge Record Pharmacy,45.33,29.46,,,0
CDM,63600006_J2547_636,Noncdm Charge Record Pharmacy,8.1,5.26,,,0
CDM,63600006_J2560_636,Noncdm Charge Record Pharmacy,163.09,106.01,,,0
CDM,63600006_J2562_636,Noncdm Charge Record Pharmacy,1300.92,845.6,,,0
CDM,63600006_J2590_636,Noncdm Charge Record Pharmacy,28.66,18.63,,,0
CDM,63600006_J2597_636,Noncdm Charge Record Pharmacy,24.95,16.22,,,0
CDM,63600006_J2598_636,Noncdm Charge Record Pharmacy,11.52,7.49,,,0
CDM,63600006_J2599_636,Noncdm Charge Record Pharmacy,7.58,4.93,,,0
CDM,63600006_J2679_636,Noncdm Charge Record Pharmacy,43.76,28.44,,,0
CDM,63600006_J2680_636,Noncdm Charge Record Pharmacy,51.5,33.48,,,0
CDM,63600006_J2690_636,Noncdm Charge Record Pharmacy,323.18,210.07,,,0
CDM,63600006_J2704_636,Noncdm Charge Record Pharmacy,1.61,1.05,,,0
CDM,63600006_J2710_636,Noncdm Charge Record Pharmacy,9.33,6.06,,,0
CDM,63600006_J2720_636,Noncdm Charge Record Pharmacy,9.17,5.96,,,0
CDM,63600006_J2760_636,Noncdm Charge Record Pharmacy,2028.76,1318.69,,,0
CDM,63600006_J2765_636,Noncdm Charge Record Pharmacy,38.2,24.83,,,0
CDM,63600006_J2783_636,Noncdm Charge Record Pharmacy,1552.07,1008.85,,,0
CDM,63600006_J2785_636,Noncdm Charge Record Pharmacy,47.58,30.93,,,0
CDM,63600006_J2790_636,Noncdm Charge Record Pharmacy,646.57,420.27,,,0
CDM,63600006_J2791_636,Noncdm Charge Record Pharmacy,26.51,17.23,,,0
CDM,63600006_J2794_636,Noncdm Charge Record Pharmacy,58.96,38.32,,,0
CDM,63600006_J2795_636,Noncdm Charge Record Pharmacy,0.71,0.46,,,0
CDM,63600006_J2796_636,Noncdm Charge Record Pharmacy,491.59,319.53,,,0
CDM,63600006_J2800_636,Noncdm Charge Record Pharmacy,60.93,39.6,,,0
CDM,63600006_J2805_636,Noncdm Charge Record Pharmacy,163.63,106.36,,,0
CDM,63600006_J2806_636,Noncdm Charge Record Pharmacy,152.33,99.01,,,0
CDM,63600006_J2916_636,Noncdm Charge Record Pharmacy,10.89,7.08,,,0
CDM,63600006_J2919_636,Noncdm Charge Record Pharmacy,3.27,2.13,,,0
CDM,63600006_J2920_636,Noncdm Charge Record Pharmacy,55.86,36.31,,,0
CDM,63600006_J2930_636,Noncdm Charge Record Pharmacy,49.56,32.21,,,0
CDM,63600006_J2997_636,Noncdm Charge Record Pharmacy,378.18,245.82,,,0
CDM,63600006_J3010_636,Noncdm Charge Record Pharmacy,19.29,12.54,,,0
CDM,63600006_J3032_636,Noncdm Charge Record Pharmacy,91.14,59.24,,,0
CDM,63600006_J3055_636,Noncdm Charge Record Pharmacy,285.57,185.62,,,0
CDM,63600006_J3101_636,Noncdm Charge Record Pharmacy,554.29,360.29,,,0
CDM,63600006_J3105_636,Noncdm Charge Record Pharmacy,36.3,23.6,,,0
CDM,63600006_J3111_636,Noncdm Charge Record Pharmacy,54.56,35.46,,,0
CDM,63600006_J3230_636,Noncdm Charge Record Pharmacy,210.83,137.04,,,0
CDM,63600006_J3240_636,Noncdm Charge Record Pharmacy,10733.83,6976.99,,,0
CDM,63600006_J3241_636,Noncdm Charge Record Pharmacy,1393.0,905.45,,,0
CDM,63600006_J3243_636,Noncdm Charge Record Pharmacy,15.47,10.06,,,0
CDM,63600006_J3246_636,Noncdm Charge Record Pharmacy,19.47,12.66,,,0
CDM,63600006_J3260_636,Noncdm Charge Record Pharmacy,19.91,12.94,,,0
CDM,63600006_J3262_636,Noncdm Charge Record Pharmacy,20.71,13.46,,,0
CDM,63600006_J3285_636,Noncdm Charge Record Pharmacy,221.29,143.84,,,0
CDM,63600006_J3301_636,Noncdm Charge Record Pharmacy,9.73,6.32,,,0
CDM,63600006_J3357_636,Noncdm Charge Record Pharmacy,0.01,0.01,,,0
CDM,63600006_J3358_636,Noncdm Charge Record Pharmacy,80.9,52.58,,,0
CDM,63600006_J3360_636,Noncdm Charge Record Pharmacy,76.72,49.87,,,0
CDM,63600006_J3370_636,Noncdm Charge Record Pharmacy,30.37,19.74,,,0
CDM,63600006_J3371_636,Noncdm Charge Record Pharmacy,43.35,28.18,,,0
CDM,63600006_J3372_636,Noncdm Charge Record Pharmacy,44.77,29.1,,,0
CDM,63600006_J3380_636,Noncdm Charge Record Pharmacy,140.51,91.33,,,0
CDM,63600006_J3410_636,Noncdm Charge Record Pharmacy,74.54,48.45,,,0
CDM,63600006_J3411_636,Noncdm Charge Record Pharmacy,22.71,14.76,,,0
CDM,63600006_J3415_636,Noncdm Charge Record Pharmacy,60.24,39.16,,,0
CDM,63600006_J3420_636,Noncdm Charge Record Pharmacy,41.88,27.22,,,0
CDM,63600006_J3424_636,Noncdm Charge Record Pharmacy,4807.05,3124.58,,,0
CDM,63600006_J3430_636,Noncdm Charge Record Pharmacy,76.36,49.63,,,0
CDM,63600006_J3465_636,Noncdm Charge Record Pharmacy,8.12,5.28,,,0
CDM,63600006_J3473_636,Noncdm Charge Record Pharmacy,1.58,1.03,,,0
CDM,63600006_J3475_636,Noncdm Charge Record Pharmacy,10.29,6.69,,,0
CDM,63600006_J3480_636,Noncdm Charge Record Pharmacy,6.85,4.45,,,0
CDM,63600006_J3486_636,Noncdm Charge Record Pharmacy,59.43,38.63,,,0
CDM,63600006_J3489_636,Noncdm Charge Record Pharmacy,40.74,26.48,,,0
CDM,63600006_J3490_636,Noncdm Charge Record Pharmacy,15.3,9.94,,,0
CDM,63600006_J3590_636,Noncdm Charge Record Pharmacy,126.26,82.07,,,0
CDM,63600006_J7060_636,Noncdm Charge Record Pharmacy,67.47,43.86,,,0
CDM,63600006_J7070_636,Noncdm Charge Record Pharmacy,69.26,45.02,,,0
CDM,63600006_J7120_636,Noncdm Charge Record Pharmacy,69.09,44.91,,,0
CDM,63600006_J7131_636,Noncdm Charge Record Pharmacy,0.18,0.12,,,0
CDM,63600006_J7168_636,Noncdm Charge Record Pharmacy,8.79,5.71,,,0
CDM,63600006_J7187_636,Noncdm Charge Record Pharmacy,4.45,2.89,,,0
CDM,63600006_J7189_636,Noncdm Charge Record Pharmacy,11.35,7.38,,,0
CDM,63600006_J7192_636,Noncdm Charge Record Pharmacy,6.2,4.03,,,0
CDM,63600006_J7195_636,Noncdm Charge Record Pharmacy,8.1,5.26,,,0
CDM,63600006_J7197_636,Noncdm Charge Record Pharmacy,18.23,11.85,,,0
CDM,63600006_J7296_636,Noncdm Charge Record Pharmacy,3370.64,2190.92,,,0
CDM,63600006_J7297_636,Noncdm Charge Record Pharmacy,2753.9,1790.04,,,0
CDM,63600006_J7298_250,Noncdm Charge Record Pharmacy,3463.67,2251.39,,,0
CDM,63600006_J7298_636,Noncdm Charge Record Pharmacy,3402.02,2211.31,,,0
CDM,63600006_J7300_636,Noncdm Charge Record Pharmacy,3304.08,2147.65,,,0
CDM,63600006_J7301_636,Noncdm Charge Record Pharmacy,2807.48,1824.86,,,0
CDM,63600006_J7307_636,Noncdm Charge Record Pharmacy,3290.22,2138.64,,,0
CDM,63600006_J7504_636,Noncdm Charge Record Pharmacy,19522.93,12689.9,,,0
CDM,63600006_J7511_636,Noncdm Charge Record Pharmacy,5493.29,3570.64,,,0
CDM,63600006_J7516_636,Noncdm Charge Record Pharmacy,142.49,92.62,,,0
CDM,63600006_J7519_636,Noncdm Charge Record Pharmacy,2.17,1.41,,,0
CDM,63600006_J7525_636,Noncdm Charge Record Pharmacy,441.33,286.86,,,0
CDM,63600006_J7674_636,Noncdm Charge Record Pharmacy,2.65,1.72,,,0
CDM,63600006_J7999_636,Noncdm Charge Record Pharmacy,109.82,71.38,,,0
CDM,63600006_J9000_636,Noncdm Charge Record Pharmacy,31.49,20.47,,,0
CDM,63600006_J9017_636,Noncdm Charge Record Pharmacy,29.1,18.92,,,0
CDM,63600006_J9022_636,Noncdm Charge Record Pharmacy,358.29,232.89,,,0
CDM,63600006_J9023_636,Noncdm Charge Record Pharmacy,406.64,264.32,,,0
CDM,63600006_J9025_636,Noncdm Charge Record Pharmacy,2.1,1.36,,,0
CDM,63600006_J9030_636,Noncdm Charge Record Pharmacy,14.75,9.59,,,0
CDM,63600006_J9034_636,Noncdm Charge Record Pharmacy,75.84,49.3,,,0
CDM,63600006_J9035_636,Noncdm Charge Record Pharmacy,334.71,217.56,,,0
CDM,63600006_J9039_636,Noncdm Charge Record Pharmacy,632.97,411.43,,,0
CDM,63600006_J9040_636,Noncdm Charge Record Pharmacy,116.09,75.46,,,0
CDM,63600006_J9041_636,Noncdm Charge Record Pharmacy,8.2,5.33,,,0
CDM,63600006_J9042_636,Noncdm Charge Record Pharmacy,864.1,561.66,,,0
CDM,63600006_J9043_636,Noncdm Charge Record Pharmacy,942.05,612.33,,,0
CDM,63600006_J9045_636,Noncdm Charge Record Pharmacy,21.65,14.07,,,0
CDM,63600006_J9047_636,Noncdm Charge Record Pharmacy,183.27,119.13,,,0
CDM,63600006_J9050_636,Noncdm Charge Record Pharmacy,932.52,606.14,,,0
CDM,63600006_J9055_636,Noncdm Charge Record Pharmacy,305.09,198.31,,,0
CDM,63600006_J9060_636,Noncdm Charge Record Pharmacy,24.31,15.8,,,0
CDM,63600006_J9063_636,Noncdm Charge Record Pharmacy,273.72,177.92,,,0
CDM,63600006_J9065_636,Noncdm Charge Record Pharmacy,52.15,33.9,,,0
CDM,63600006_J9070_636,Noncdm Charge Record Pharmacy,136.16,88.5,,,0
CDM,63600006_J9071_636,Noncdm Charge Record Pharmacy,2.87,1.87,,,0
CDM,63600006_J9073_636,Noncdm Charge Record Pharmacy,6.38,4.15,,,0
CDM,63600006_J9075_636,Noncdm Charge Record Pharmacy,3.64,2.37,,,0
CDM,63600006_J9100_636,Noncdm Charge Record Pharmacy,6.17,4.01,,,0
CDM,63600006_J9119_636,Noncdm Charge Record Pharmacy,124.95,81.22,,,0
CDM,63600006_J9120_636,Noncdm Charge Record Pharmacy,6018.96,3912.32,,,0
CDM,63600006_J9130_636,Noncdm Charge Record Pharmacy,34.01,22.11,,,0
CDM,63600006_J9144_636,Noncdm Charge Record Pharmacy,220.1,143.06,,,0
CDM,63600006_J9145_636,Noncdm Charge Record Pharmacy,296.0,192.4,,,0
CDM,63600006_J9150_636,Noncdm Charge Record Pharmacy,121.23,78.8,,,0
CDM,63600006_J9153_636,Noncdm Charge Record Pharmacy,953.97,620.08,,,0
CDM,63600006_J9155_636,Noncdm Charge Record Pharmacy,26.0,16.9,,,0
CDM,63600006_J9171_636,Noncdm Charge Record Pharmacy,6.2,4.03,,,0
CDM,63600006_J9173_636,Noncdm Charge Record Pharmacy,352.85,229.35,,,0
CDM,63600006_J9177_636,Noncdm Charge Record Pharmacy,150.49,97.82,,,0
CDM,63600006_J9179_636,Noncdm Charge Record Pharmacy,615.2,399.88,,,0
CDM,63600006_J9181_636,Noncdm Charge Record Pharmacy,7.51,4.88,,,0
CDM,63600006_J9185_636,Noncdm Charge Record Pharmacy,3461.87,2250.22,,,0
CDM,63600006_J9190_636,Noncdm Charge Record Pharmacy,26.32,17.11,,,0
CDM,63600006_J9201_636,Noncdm Charge Record Pharmacy,22.83,14.84,,,0
CDM,63600006_J9202_636,Noncdm Charge Record Pharmacy,4115.18,2674.87,,,0
CDM,63600006_J9203_636,Noncdm Charge Record Pharmacy,940.26,611.17,,,0
CDM,63600006_J9204_636,Noncdm Charge Record Pharmacy,890.31,578.7,,,0
CDM,63600006_J9205_636,Noncdm Charge Record Pharmacy,269.66,175.28,,,0
CDM,63600006_J9206_636,Noncdm Charge Record Pharmacy,18.35,11.93,,,0
CDM,63600006_J9208_636,Noncdm Charge Record Pharmacy,127.92,83.15,,,0
CDM,63600006_J9209_636,Noncdm Charge Record Pharmacy,22.41,14.57,,,0
CDM,63600006_J9217_636,Noncdm Charge Record Pharmacy,657.98,427.69,,,0
CDM,63600006_J9223_636,Noncdm Charge Record Pharmacy,859.55,558.71,,,0
CDM,63600006_J9227_636,Noncdm Charge Record Pharmacy,235.52,153.09,,,0
CDM,63600006_J9228_636,Noncdm Charge Record Pharmacy,696.49,452.72,,,0
CDM,63600006_J9245_636,Noncdm Charge Record Pharmacy,386.28,251.08,,,0
CDM,63600006_J9250_636,Noncdm Charge Record Pharmacy,8.82,5.73,,,0
CDM,63600006_J9255_636,Noncdm Charge Record Pharmacy,9.94,6.46,,,0
CDM,63600006_J9259_636,Noncdm Charge Record Pharmacy,59.93,38.95,,,0
CDM,63600006_J9260_636,Noncdm Charge Record Pharmacy,5.85,3.8,,,0
CDM,63600006_J9261_636,Noncdm Charge Record Pharmacy,237.37,154.29,,,0
CDM,63600006_J9263_636,Noncdm Charge Record Pharmacy,0.7,0.46,,,0
CDM,63600006_J9264_636,Noncdm Charge Record Pharmacy,65.72,42.72,,,0
CDM,63600006_J9266_636,Noncdm Charge Record Pharmacy,84852.91,55154.39,,,0
CDM,63600006_J9267_636,Noncdm Charge Record Pharmacy,1.06,0.69,,,0
CDM,63600006_J9271_636,Noncdm Charge Record Pharmacy,231.03,150.17,,,0
CDM,63600006_J9272_636,Noncdm Charge Record Pharmacy,979.94,636.96,,,0
CDM,63600006_J9273_636,Noncdm Charge Record Pharmacy,718.52,467.04,,,0
CDM,63600006_J9280_636,Noncdm Charge Record Pharmacy,140.53,91.34,,,0
CDM,63600006_J9281_636,Noncdm Charge Record Pharmacy,1275.66,829.18,,,0
CDM,63600006_J9294_636,Noncdm Charge Record Pharmacy,6.76,4.39,,,0
CDM,63600006_J9296_636,Noncdm Charge Record Pharmacy,17.45,11.34,,,0
CDM,63600006_J9299_636,Noncdm Charge Record Pharmacy,130.86,85.06,,,0
CDM,63600006_J9301_636,Noncdm Charge Record Pharmacy,351.73,228.62,,,0
CDM,63600006_J9303_636,Noncdm Charge Record Pharmacy,672.67,437.24,,,0
CDM,63600006_J9305_636,Noncdm Charge Record Pharmacy,5.55,3.61,,,0
CDM,63600006_J9306_636,Noncdm Charge Record Pharmacy,59.25,38.51,,,0
CDM,63600006_J9307_636,Noncdm Charge Record Pharmacy,1540.65,1001.42,,,0
CDM,63600006_J9308_636,Noncdm Charge Record Pharmacy,309.42,201.12,,,0
CDM,63600006_J9309_636,Noncdm Charge Record Pharmacy,167.01,108.56,,,0
CDM,63600006_J9311_636,Noncdm Charge Record Pharmacy,166.67,108.34,,,0
CDM,63600006_J9312_636,Noncdm Charge Record Pharmacy,379.76,246.84,,,0
CDM,63600006_J9316_636,Noncdm Charge Record Pharmacy,313.88,204.02,,,0
CDM,63600006_J9317_636,Noncdm Charge Record Pharmacy,143.65,93.37,,,0
CDM,63600006_J9323_636,Noncdm Charge Record Pharmacy,6.31,4.1,,,0
CDM,63600006_J9332_636,Noncdm Charge Record Pharmacy,155.81,101.28,,,0
CDM,63600006_J9333_636,Noncdm Charge Record Pharmacy,112.16,72.9,,,0
CDM,63600006_J9334_636,Noncdm Charge Record Pharmacy,162.47,105.61,,,0
CDM,63600006_J9340_636,Noncdm Charge Record Pharmacy,2251.3,1463.34,,,0
CDM,63600006_J9347_636,Noncdm Charge Record Pharmacy,544.91,354.19,,,0
CDM,63600006_J9349_636,Noncdm Charge Record Pharmacy,57.53,37.39,,,0
CDM,63600006_J9351_636,Noncdm Charge Record Pharmacy,32.15,20.9,,,0
CDM,63600006_J9352_636,Noncdm Charge Record Pharmacy,1474.5,958.42,,,0
CDM,63600006_J9354_636,Noncdm Charge Record Pharmacy,167.96,109.17,,,0
CDM,63600006_J9355_636,Noncdm Charge Record Pharmacy,448.29,291.39,,,0
CDM,63600006_J9356_636,Noncdm Charge Record Pharmacy,334.34,217.32,,,0
CDM,63600006_J9358_636,Noncdm Charge Record Pharmacy,113.98,74.09,,,0
CDM,63600006_J9360_636,Noncdm Charge Record Pharmacy,28.15,18.3,,,0
CDM,63600006_J9370_636,Noncdm Charge Record Pharmacy,79.48,51.66,,,0
CDM,63600006_J9390_636,Noncdm Charge Record Pharmacy,49.83,32.39,,,0
CDM,63600006_J9395_636,Noncdm Charge Record Pharmacy,26.53,17.24,,,0
CDM,63600006_P9045_636,Noncdm Charge Record Pharmacy,187.61,121.95,,,0
CDM,63600006_P9047_636,Noncdm Charge Record Pharmacy,172.04,111.83,,,0
CDM,63600006_Q0138_636,Noncdm Charge Record Pharmacy,2.93,1.9,,,0
CDM,63600006_Q0249_636,Noncdm Charge Record Pharmacy,28.0,18.2,,,0
CDM,63600006_Q2004_636,Noncdm Charge Record Pharmacy,84.92,55.2,,,0
CDM,63600006_Q2009_636,Noncdm Charge Record Pharmacy,11.16,7.25,,,0
CDM,63600006_Q2050_636,Noncdm Charge Record Pharmacy,649.68,422.29,,,0
CDM,63600006_Q4081_634,Noncdm Charge Record Pharmacy,6.85,4.45,,,0
CDM,63600006_Q4081_636,Noncdm Charge Record Pharmacy,7.42,4.82,,,0
CDM,63600006_Q4801_636,Noncdm Charge Record Pharmacy,10.14,6.59,,,0
CDM,63600006_Q5101_636,Noncdm Charge Record Pharmacy,3.54,2.3,,,0
CDM,63600006_Q5103_636,Noncdm Charge Record Pharmacy,280.82,182.53,,,0
CDM,63600006_Q5104_636,Noncdm Charge Record Pharmacy,152.83,99.34,,,0
CDM,63600006_Q5105_635,Noncdm Charge Record Pharmacy,5.45,3.54,,,0
CDM,63600006_Q5105_636,Noncdm Charge Record Pharmacy,4.78,3.11,,,0
CDM,63600006_Q5106_636,Noncdm Charge Record Pharmacy,45.0,29.25,,,0
CDM,63600006_Q5107_636,Noncdm Charge Record Pharmacy,274.94,178.71,,,0
CDM,63600006_Q5108_636,Noncdm Charge Record Pharmacy,604.53,392.94,,,0
CDM,63600006_Q5110_636,Noncdm Charge Record Pharmacy,1.54,1.0,,,0
CDM,63600006_Q5111_636,Noncdm Charge Record Pharmacy,1074.87,698.67,,,0
CDM,63600006_Q5112_636,Noncdm Charge Record Pharmacy,162.89,105.88,,,0
CDM,63600006_Q5113_636,Noncdm Charge Record Pharmacy,396.44,257.69,,,0
CDM,63600006_Q5115_636,Noncdm Charge Record Pharmacy,257.31,167.25,,,0
CDM,63600006_Q5117_636,Noncdm Charge Record Pharmacy,377.34,245.27,,,0
CDM,63600006_Q5118_636,Noncdm Charge Record Pharmacy,230.22,149.64,,,0
CDM,63600006_Q5119_636,Noncdm Charge Record Pharmacy,244.88,159.17,,,0
CDM,63600006_Q5120_636,Noncdm Charge Record Pharmacy,1558.94,1013.31,,,0
CDM,63600006_Q5121_636,Noncdm Charge Record Pharmacy,249.16,161.95,,,0
CDM,63600006_Q5122_636,Noncdm Charge Record Pharmacy,91.66,59.58,,,0
CDM,63600006_Q5123_636,Noncdm Charge Record Pharmacy,242.98,157.94,,,0
CDM,63600006_Q5130_636,Noncdm Charge Record Pharmacy,964.28,626.78,,,0
CDM,63600006_Q9957_636,Noncdm Charge Record Pharmacy,124.23,80.75,,,0
CDM,63600006_Q9968_636,Noncdm Charge Record Pharmacy,54.6,35.49,,,0
CDM,63600006_S0028_636,Noncdm Charge Record Pharmacy,37.53,24.39,,,0
CDM,63600006_S0074_636,Noncdm Charge Record Pharmacy,32.98,21.44,,,0
CDM,63600007_636,Noncdm Charge Record Pharmacy,0.44,0.29,,,0
CDM,63600007_A9575_636,Noncdm Charge Record Pharmacy,0.44,0.29,,,0
CDM,63600007_A9577_636,Noncdm Charge Record Pharmacy,7.6,4.94,,,0
CDM,63600007_A9579_636,Noncdm Charge Record Pharmacy,9.45,6.14,,,0
CDM,63600007_A9581_636,Noncdm Charge Record Pharmacy,69.77,45.35,,,0
CDM,63600007_Q9958_636,Noncdm Charge Record Pharmacy,0.25,0.16,,,0
CDM,63600007_Q9965_636,Noncdm Charge Record Pharmacy,23.61,15.35,,,0
CDM,63600007_Q9966_636,Noncdm Charge Record Pharmacy,1.45,0.94,,,0
CDM,63600007_Q9967_636,Noncdm Charge Record Pharmacy,0.54,0.35,,,0
CDM,63600011,Hc Arthroflex Per Sq Cm,1118.06,726.74,,,0
CDM,63600014,Hc Epifix 2X3 Per Sq Cm,625.6,406.64,,,0
CDM,63600015,Hc Epifix 1.4 Per Sq Cm Disk,733.11,476.52,,,0
CDM,63600017,Hc Epifix 2X2 Per Sq Cm,872.36,567.03,,,0
CDM,63600018,Hc Epifix 2X4 Per Sq Cm,552.91,359.39,,,0
CDM,63600019,Hc Epifix 3X4 Per Sq Cm,650.18,422.62,,,0
CDM,63600020,Hc Epifix 4X4 Per Sq Cm,625.6,406.64,,,0
CDM,63600021,Hc Epifix 4X4.5 Mesh Per Sq Cm,252.9,164.38,,,0
CDM,63600025,Hc Dermaspan Per Sq Cm,340.07,221.05,,,0
CDM,63600028,Hc Grafix Or Stravix Prime Per Sq Cm,990.1,643.56,,,0
CDM,63600030,Hc Theraskin 39 Sq Cm Per Sq Cm,109.56,71.21,,,0
CDM,63600031,Hc Theraskin 13 Sq Cm Per Sq Cm,223.21,145.09,,,0
CDM,63600032,Hc Puraply Antimicrobial Per Sq Cm,281.58,183.03,,,0
CDM,63600033,Hc Puraply Antimicrobial 2X2/Sq Cm,606.55,394.26,,,0
CDM,63600034,Hc Puraply Antimicrobial 2X4/Sq Cm,388.57,252.57,,,0
CDM,63600035,Hc Puraply Antimicrobial 5X5/Sq Cm,360.41,234.27,,,0
CDM,63600036,Hc Puraply Antimicrobial 6X9/Sq Cm,360.41,234.27,,,0
CDM,63600038,"Hc Neox Or Clarix Cord, Per Sq Cm",349.32,227.06,,,0
CDM,63600041,Hc Cytal Per Sq Cm,105.27,68.43,,,0
CDM,63600042,Hc Allowrap Ds Or Dry Per Sq Cm,852.74,554.28,,,0
CDM,63600043_90619_636,Noncdm Charge Record Pharmacy,629.14,408.94,,,0
CDM,63600043_90620_636,Noncdm Charge Record Pharmacy,1069.62,695.25,,,0
CDM,63600043_90632_636,Noncdm Charge Record Pharmacy,375.78,244.26,,,0
CDM,63600043_90633_636,Noncdm Charge Record Pharmacy,155.97,101.38,,,0
CDM,63600043_90648_636,Noncdm Charge Record Pharmacy,93.35,60.68,,,0
CDM,63600043_90656_636,Noncdm Charge Record Pharmacy,110.81,72.03,,,0
CDM,63600043_90662_636,Noncdm Charge Record Pharmacy,323.81,210.48,,,0
CDM,63600043_90675_636,Noncdm Charge Record Pharmacy,1463.69,951.4,,,0
CDM,63600043_90677_636,Noncdm Charge Record Pharmacy,1249.64,812.27,,,0
CDM,63600043_90686_636,Noncdm Charge Record Pharmacy,121.97,79.28,,,0
CDM,63600043_90707_636,Noncdm Charge Record Pharmacy,464.86,302.16,,,0
CDM,63600043_90714_636,Noncdm Charge Record Pharmacy,208.4,135.46,,,0
CDM,63600043_90715_636,Noncdm Charge Record Pharmacy,227.79,148.06,,,0
CDM,63600043_90716_636,Noncdm Charge Record Pharmacy,860.5,559.32,,,0
CDM,63600043_90732_636,Noncdm Charge Record Pharmacy,606.78,394.41,,,0
CDM,63600043_90744_636,Noncdm Charge Record Pharmacy,1.03,0.67,,,0
CDM,63600043_90750_636,Noncdm Charge Record Pharmacy,849.37,552.09,,,0
CDM,63600044,Hc Grafix Prime 16Mm Per Sq Cm,991.39,644.4,,,0
CDM,63600045,Hc Grafix Prime 1.5 X 2 Cm Per Sq Cm,913.32,593.66,,,0
CDM,63600046,Hc Grafix Prime 2 X 3 Per Sq Cm,560.76,364.49,,,0
CDM,63600047,Hc Grafix Prime 3 X 4 Per Sq Cm,340.96,221.62,,,0
CDM,63600048,Hc Grafix Prime 5 X 5 Per Sq Cm,358.36,232.93,,,0
CDM,63600049,Hc Grafix Core 16Mm Per Sq Cm,1013.66,658.88,,,0
CDM,63600050,Hc Grafix Core 1.5 X 2 Cm Per Sq Cm,913.32,593.66,,,0
CDM,63600051,Hc Grafix Core 2 X 3 Per Sq Cm,572.36,372.03,,,0
CDM,63600052,Hc Grafix Core 3 X 4 Per Sq Cm,351.2,228.28,,,0
CDM,63600053,Hc Grafix Core 5 X 5 Per Sq Cm,358.36,232.93,,,0
CDM,63600054,Hc Dermapure Per Sq Cm,7525.66,4891.68,,,0
CDM,63600058,Hc Puraply Antimicrobial 1.6Cm Disc Per Sq Cm,915.62,595.15,,,0
CDM,63600059,Hc Affinity 2.25Cm Per Sq Cm,543.69,353.4,,,0
CDM,63600060,Hc Affinity 6.25 Cm Pr Sq Cm,1075.1,698.82,,,0
CDM,63600061,Hc Nushield 1.6 Sq Cm Disc Per Sq Cm,809.9,526.44,,,0
CDM,63600062,Hc Nushield 2X3 Per Sq Cm,431.83,280.69,,,0
CDM,63600063,Hc Nushield 2X4 Per Sq Cm,386.27,251.08,,,0
CDM,63600064,Hc Nushield 3X4 Per Sq Cm,371.68,241.59,,,0
CDM,63600065,Hc Nushield 4X4 Per Sq Cm,381.91,248.24,,,0
CDM,63600066,Hc Nushield 4X6 Per Sq Cm,355.29,230.94,,,0
CDM,63600067,Hc Nushield 6X6 Per Sq Cm,323.55,210.31,,,0
CDM,63600068,Hc Floweramniopatch Amniotic Membrane,412.68,268.24,,,0
CDM,63600069,Hc Floweramnioflo,9055.37,5885.99,,,0
CDM,63600080,Hc Hpv Vaccine 9 Valent,761.28,494.83,,,0
CDM,63600081,Hc Grant Funded Hpv Vaccine 9 Valent,761.28,494.83,,,0
CDM,63600082,Hc Rx Oh Cablivi Ntap,3052.79,1984.31,,,0
CDM,63600083,Hc Rx Oh Remdesivir Ntap,30.46,19.8,,,0
CDM,63600084,Hc Rx Oh Tecentriq Ntap,351.88,228.72,,,0
CDM,63600085,Hc Rx Oh Imfinzi Ntap,339.78,220.86,,,0
CDM,63600086,Hc Rx Oh Soliris Ntap,873.28,567.63,,,0
CDM,63600087,Hc Rx Oh Zerbaxa Ntap,39.96,25.97,,,0
CDM,63600088,Hc Mometasone Furoate Propel Implant 370 Mcgs Per 10 Mcg,3377.11,2195.12,,,0
CDM,63600089,Hc Isovue-M 200 299 Mg Per Ml Iodine Per Ml,4.16,2.7,,,0
CDM,63600090,Hc Mfn Add On,349.44,227.14,,,0
CDM,63600092,Hc Covid-19 Antibody Bamlanivimab & Entesevimab Infusion,930.0,604.5,,,0
CDM,63600093,Hc Rx Oh Fetroja Ntap,11.02,7.16,,,0
CDM,63600095,Hc Rx Oh Rybrevant Ntap,87.08,56.6,,,0
CDM,63600099,Hc Rx Oh Darzalex Faspro Ntap,207.31,134.75,,,0
CDM,63600103,Hc Rx Oh Columvi Ntap,11225.19,7296.37,,,0
CDM,63600105,Hc Rx Oh Spevigo Ntap,242.87,157.87,,,0
CDM,63600106,Hc Rx Oh Tecvayli Ntap,135.26,87.92,,,0
CDM,63700001_250,Noncdm Charge Record Pharmacy,5.82,3.78,,,0
CDM,63700001_637,Noncdm Charge Record Pharmacy,6.05,3.93,,,0
CDM,63700001_J0571_250,Noncdm Charge Record Pharmacy,14.67,9.54,,,0
CDM,63700001_J0571_637,Noncdm Charge Record Pharmacy,6.7,4.36,,,0
CDM,63700001_J0572_250,Noncdm Charge Record Pharmacy,12.54,8.15,,,0
CDM,63700001_J0572_637,Noncdm Charge Record Pharmacy,12.26,7.97,,,0
CDM,63700001_J0574_250,Noncdm Charge Record Pharmacy,20.42,13.27,,,0
CDM,63700001_J0574_637,Noncdm Charge Record Pharmacy,20.69,13.45,,,0
CDM,63700001_J1815_250,Noncdm Charge Record Pharmacy,9.68,6.29,,,0
CDM,63700001_J1815_637,Noncdm Charge Record Pharmacy,9.03,5.87,,,0
CDM,63700001_J2212_250,Noncdm Charge Record Pharmacy,6.8,4.42,,,0
CDM,63700001_J2212_636,Noncdm Charge Record Pharmacy,6.74,4.38,,,0
CDM,63700001_J2212_637,Noncdm Charge Record Pharmacy,6.83,4.44,,,0
CDM,63700001_J2354_250,Noncdm Charge Record Pharmacy,5.94,3.86,,,0
CDM,63700001_J2354_636,Noncdm Charge Record Pharmacy,11.61,7.55,,,0
CDM,63700001_J2354_637,Noncdm Charge Record Pharmacy,5.27,3.43,,,0
CDM,63700001_J2440_250,Noncdm Charge Record Pharmacy,110.97,72.13,,,0
CDM,63700001_J2440_637,Noncdm Charge Record Pharmacy,107.65,69.97,,,0
CDM,63700001_J3030_250,Noncdm Charge Record Pharmacy,58.43,37.98,,,0
CDM,63700001_J3030_637,Noncdm Charge Record Pharmacy,56.32,36.61,,,0
CDM,63700001_J3490_637,Noncdm Charge Record Pharmacy,3.03,1.97,,,0
CDM,63700001_J3535_250,Noncdm Charge Record Pharmacy,3.38,2.2,,,0
CDM,63700001_J3535_636,Noncdm Charge Record Pharmacy,1.66,1.08,,,0
CDM,63700001_J3535_637,Noncdm Charge Record Pharmacy,3.02,1.96,,,0
CDM,63700001_J7500_250,Noncdm Charge Record Pharmacy,4.91,3.19,,,0
CDM,63700001_J7500_637,Noncdm Charge Record Pharmacy,4.47,2.91,,,0
CDM,63700001_J7502_250,Noncdm Charge Record Pharmacy,16.89,10.98,,,0
CDM,63700001_J7502_637,Noncdm Charge Record Pharmacy,7.67,4.99,,,0
CDM,63700001_J7503_250,Noncdm Charge Record Pharmacy,4.67,3.04,,,0
CDM,63700001_J7503_637,Noncdm Charge Record Pharmacy,4.58,2.98,,,0
CDM,63700001_J7507_250,Noncdm Charge Record Pharmacy,5.78,3.76,,,0
CDM,63700001_J7507_637,Noncdm Charge Record Pharmacy,5.24,3.41,,,0
CDM,63700001_J7509_250,Noncdm Charge Record Pharmacy,5.07,3.3,,,0
CDM,63700001_J7509_637,Noncdm Charge Record Pharmacy,4.96,3.22,,,0
CDM,63700001_J7510_250,Noncdm Charge Record Pharmacy,2.26,1.47,,,0
CDM,63700001_J7510_637,Noncdm Charge Record Pharmacy,2.29,1.49,,,0
CDM,63700001_J7512_250,Noncdm Charge Record Pharmacy,0.16,0.1,,,0
CDM,63700001_J7512_637,Noncdm Charge Record Pharmacy,0.13,0.08,,,0
CDM,63700001_J7515_250,Noncdm Charge Record Pharmacy,3.54,2.3,,,0
CDM,63700001_J7515_637,Noncdm Charge Record Pharmacy,4.63,3.01,,,0
CDM,63700001_J7517_250,Noncdm Charge Record Pharmacy,4.4,2.86,,,0
CDM,63700001_J7517_637,Noncdm Charge Record Pharmacy,4.12,2.68,,,0
CDM,63700001_J7518_250,Noncdm Charge Record Pharmacy,11.74,7.63,,,0
CDM,63700001_J7518_637,Noncdm Charge Record Pharmacy,12.56,8.16,,,0
CDM,63700001_J7520_250,Noncdm Charge Record Pharmacy,26.36,17.13,,,0
CDM,63700001_J7520_637,Noncdm Charge Record Pharmacy,22.32,14.51,,,0
CDM,63700001_J7527_250,Noncdm Charge Record Pharmacy,18.21,11.84,,,0
CDM,63700001_J7527_637,Noncdm Charge Record Pharmacy,21.08,13.7,,,0
CDM,63700001_J8501_250,Noncdm Charge Record Pharmacy,28.64,18.62,,,0
CDM,63700001_J8501_637,Noncdm Charge Record Pharmacy,28.49,18.52,,,0
CDM,63700001_J8515_250,Noncdm Charge Record Pharmacy,5.28,3.43,,,0
CDM,63700001_J8515_637,Noncdm Charge Record Pharmacy,5.69,3.7,,,0
CDM,63700001_J8530_250,Noncdm Charge Record Pharmacy,8.64,5.62,,,0
CDM,63700001_J8530_637,Noncdm Charge Record Pharmacy,9.49,6.17,,,0
CDM,63700001_J8540_250,Noncdm Charge Record Pharmacy,0.34,0.22,,,0
CDM,63700001_J8540_636,Noncdm Charge Record Pharmacy,0.2,0.13,,,0
CDM,63700001_J8540_637,Noncdm Charge Record Pharmacy,0.3,0.2,,,0
CDM,63700001_J8610_250,Noncdm Charge Record Pharmacy,7.41,4.82,,,0
CDM,63700001_J8610_637,Noncdm Charge Record Pharmacy,6.98,4.54,,,0
CDM,63700001_Q0144_637,Noncdm Charge Record Pharmacy,75.52,49.09,,,0
CDM,63700003,Hc Rx Insulin Lispro,1.58,1.03,,,0
CDM,63700004,Hc Rx Oh Baricitinib Ntap,276.68,179.84,,,0
CDM,63700006,Hc Rx Insulin Glargine Pen,2.03,1.32,,,0
CDM,68100001,Hc Trauma Activation Cat 1 Level 1 Grant Only,19535.0,12697.75,,,0
CDM,68100002,Hc Trauma Activation Cat 2 Level 1 Grant Only,15630.0,10159.5,,,0
CDM,68200001,Hc Trauma  Activation Fee Cat 1 Lev 2,19535.0,12697.75,,,0
CDM,68200002,Hc Trauma Activation Fee Cat 2 Lev 2,15630.0,10159.5,,,0
CDM,68300001,Hc Trauma Activation Fee Cat 1 Lev 3,11124.0,7230.6,,,0
CDM,68300002,Hc Trauma Activation Fee Cat2 Lev 3,8652.0,5623.8,,,0
CDM,71000001,Hc Pacu 1St 30 Minutes,1139.0,740.35,,,0
CDM,71000002,Hc Pacu Addl 15 Minutes,445.0,289.25,,,0
CDM,71000004,Hc Pacu L And D 1St Hour,1810.0,1176.5,,,0
CDM,71000005,Hc Pacu L And D Addl 30 Minutes,772.0,501.8,,,0
CDM,71000006,Hc Pacu Stage 2 1St 30 Minutes,1139.0,740.35,,,0
CDM,71000007,Hc Pacu Stage 2 Addl 15 Minutes,445.0,289.25,,,0
CDM,72000001,Hc Delivery Placenta (Separate Proc),2215.0,1439.75,,,0
CDM,72000003,Hc Newborn Resuscitation,2458.0,1597.7,,,0
CDM,72200001,Hc Delivery Cesarean,8136.0,5288.4,,,0
CDM,72200004,Hc Delivery Vaginal,7405.0,4813.25,,,0
CDM,73000001,Hc Ekg,153.0,99.45,,,0
CDM,73000002,Hc Ekg Rhythm Tracing Only,339.0,220.35,,,0
CDM,73000003,Hc N-Invas Augmnt Arrhyt Alys Quan Card Arrhyt Simul,3388.0,2202.2,,,0
CDM,73100001,Hc Holter Scan Recording Up To 48 Hr,577.0,375.05,,,0
CDM,73100002,Hc Event Recording,577.0,375.05,,,0
CDM,73100003,Hc Ekg Signal Averaged,829.0,538.85,,,0
CDM,73100007,Hc Holter Recording 49 Hrs Up To 7 Days,577.0,375.05,,,0
CDM,73100009,Hc Holter Recording 8 Days Up To 15 Days,577.0,375.05,,,0
CDM,74000001,Hc Eeg Monitor 41-60 Minutes,1634.0,1062.1,,,0
CDM,74000002,Hc Eeg Monitor 61 To 119 Minutes,1634.0,1062.1,,,0
CDM,74000003,Hc Eeg Awake And Drowsy,1634.0,1062.1,,,0
CDM,74000004,Hc Eeg Awake And Asleep,1634.0,1062.1,,,0
CDM,74000005,Hc Eeg Coma Or Sleep,1634.0,1062.1,,,0
CDM,74000006,Hc Eeg Cerebral Death,3120.0,2028.0,,,0
CDM,74000007,Hc Electrocorticogram At Surgery,11303.0,7346.95,,,0
CDM,74000012,Hc Eeg Analysis Digital,269.0,174.85,,,0
CDM,74000013,Hc Eeg Hemisphere Function Wada,991.0,644.15,,,0
CDM,74000014,Hc Functional Mapping Stimulation,6762.0,4395.3,,,0
CDM,74000023,Hc Lt Eeg Tech Setup,2717.0,1766.05,,,0
CDM,74000030,Hc Veeg Lt Unmonitored 2-12 Hrs,4320.0,2808.0,,,0
CDM,74000031,Hc Veeg Lt Intermittent 2-12 Hrs,4320.0,2808.0,,,0
CDM,74000032,Hc Veeg Lt Continuous 2-12 Hrs,4320.0,2808.0,,,0
CDM,74000033,Hc Veeg Lt Unmonitored 12-26 Hrs,7553.0,4909.45,,,0
CDM,74000034,Hc Veeg Lt Intermittent 12-26 Hrs,7553.0,4909.45,,,0
CDM,74000035,Hc Veeg Lt Continuous 12-26 Hrs,7553.0,4909.45,,,0
CDM,74000046,Hc Ambulatory Eeg Lt Unmonitored 2-12 Hrs,4320.0,2808.0,,,0
CDM,74000047,Hc Ambulatory Eeg Lt Unmonitored 12-26 Hrs,7553.0,4909.45,,,0
CDM,75000001,Hc Esophagoscopy,3433.0,2231.45,,,0
CDM,75000002,Hc Esophagoscopy W Injections,3970.0,2580.5,,,0
CDM,75000003,Hc Esophagoscopy W Biopsy,5130.0,3334.5,,,0
CDM,75000004,Hc Esophagoscopy W/ Sclerosis Varices,3970.0,2580.5,,,0
CDM,75000005,Hc Esophagoscopy W Band Ligation,3970.0,2580.5,,,0
CDM,75000006,Hc Esophagoscopy W Fb Removal,3677.0,2390.05,,,0
CDM,75000007,Hc Esophagoscopy W Tumor Removal Snare,4421.0,2873.65,,,0
CDM,75000008,Hc Esophagoscopy W/ Balloon Dilation,3835.0,2492.75,,,0
CDM,75000009,Hc Esophagoscopy W/ Otw Dilation,4275.0,2778.75,,,0
CDM,75000010,Hc Esophagoscopy W/ Tumor Ablation,4172.0,2711.8,,,0
CDM,75000011,Hc Egd,3998.0,2598.7,,,0
CDM,75000012,Hc Egd W Injections,2023.0,1314.95,,,0
CDM,75000013,Hc Ugi Endo Us Limited To Esophagus,5573.0,3622.45,,,0
CDM,75000014,Hc Ugi Endo Us With Fna Esophagus,5314.0,3454.1,,,0
CDM,75000015,Hc Egd W Biopsy,4213.0,2738.45,,,0
CDM,75000016,Hc Egd W Drainage Pseudocyst,7028.0,4568.2,,,0
CDM,75000017,Hc Egd W Plcmnt Transendo Tube Or Cath,3838.0,2494.7,,,0
CDM,75000018,Hc Ugi Endo Us Guided Fna,5594.0,3636.1,,,0
CDM,75000019,Hc Egd W Sclerotherapy,4619.0,3002.35,,,0
CDM,75000020,Hc Egd W Band Esoph Gastric Varices,5380.0,3497.0,,,0
CDM,75000021,Hc Ugi Endo Dilation Gastric Outlet Obstruction,4948.0,3216.2,,,0
CDM,75000022,Hc Egd W Peg Placement,4040.0,2626.0,,,0
CDM,75000023,Hc Egd W Removal Fb,5881.0,3822.65,,,0
CDM,75000024,Hc Egd W Esoph Dilation Over Guide,5116.0,3325.4,,,0
CDM,75000025,Hc Egd W Esoph Balloon Dilation,5098.0,3313.7,,,0
CDM,75000026,Hc Egd W/Tumor/Polyp Remove Cautery,4285.0,2785.25,,,0
CDM,75000027,Hc Egd W/Tumor/Polyp Remove Snare,4802.0,3121.3,,,0
CDM,75000028,Hc Egd W/Control Of Bleeding,4889.0,3177.85,,,0
CDM,75000029,Hc Ugi Endo W/Stent Placement,5700.0,3705.0,,,0
CDM,75000030,Hc Egd W/Ablation By Laser,4604.0,2992.6,,,0
CDM,75000031,Hc Egd Endoscopic Ultrasound Exam,5701.0,3705.65,,,0
CDM,75000032,Hc Ercp,9038.0,5874.7,,,0
CDM,75000033,Hc Ercp W Biopsy,10300.0,6695.0,,,0
CDM,75000034,Hc Ercp W/Sphincterotomy/Papillotomy,10577.0,6875.05,,,0
CDM,75000036,Hc Ercp W/Stone Removal,10420.0,6773.0,,,0
CDM,75000037,Hc Ercp W/Lithotripsy,9908.0,6440.2,,,0
CDM,75000038,Hc Ercp Stent Placement Biliary/Pancreatic Duct,6016.0,3910.4,,,0
CDM,75000040,Hc Ercp W Fb Remov Or Stent Biliary/Panc Duct,9933.0,6456.45,,,0
CDM,75000041,Hc Ercp W/Balloon Dilation,9908.0,6440.2,,,0
CDM,75000043,Hc Ercp Direct Vis/Exam Comn Bil Duc,7810.0,5076.5,,,0
CDM,75000044,Hc Dilation Esoph Sound Or Bougie,7057.0,4587.05,,,0
CDM,75000047,Hc Small Intestine Endoscopy,4416.0,2870.4,,,0
CDM,75000048,Hc Small Intestine Endoscopy W Biopsy,4460.0,2899.0,,,0
CDM,75000049,Hc Small Intestine Endoscopy W Removal Fb,5629.0,3658.85,,,0
CDM,75000050,Hc Small Intestine Endoscopy W Removal Lesion Snare,4815.0,3129.75,,,0
CDM,75000051,Hc Small Intestine Endoscopy W Removal Lesion Cautery,4679.0,3041.35,,,0
CDM,75000052,Hc Small Intestine Endoscopy W Control Bleeding,5565.0,3617.25,,,0
CDM,75000053,Hc Small Intestine Endoscopy W Ablation,4750.0,3087.5,,,0
CDM,75000054,Hc Small Intestine Endoscopy W Stent Plcmnt,9391.0,6104.15,,,0
CDM,75000055,Hc Small Intestine Endoscopy W J Tube Plcmnt,5835.0,3792.75,,,0
CDM,75000057,Hc Small Intestine Endo Incl Ileum Spec Coll By Brush,5581.0,3627.65,,,0
CDM,75000058,Hc Small Intestine Endo Incl Ileum W Biopsy,5567.0,3618.55,,,0
CDM,75000059,Hc Small Intestine Endo Incl Ileum W/ Control Bleeding,5845.0,3799.25,,,0
CDM,75000060,Hc Small Intestine Endo Incl Ileum W Stent Plcmnt,6461.0,4199.65,,,0
CDM,75000061,Hc Ileoscopy Thru Stoma,5056.0,3286.4,,,0
CDM,75000062,Hc Ileoscopy Thru Stoma W Biopsy,5044.0,3278.6,,,0
CDM,75000064,Hc Endo Eval Sm Intest Pouch,4630.0,3009.5,,,0
CDM,75000065,Hc Endo Eval Sm Intest Pouch W Biopsy,4729.0,3073.85,,,0
CDM,75000066,Hc Colonoscopy Thru Stoma,4198.0,2728.7,,,0
CDM,75000067,Hc Colonoscopy Thru Stoma W Biopsy,5081.0,3302.65,,,0
CDM,75000068,Hc Colonoscopy Thru Stoma W Fb Removal,4921.0,3198.65,,,0
CDM,75000069,Hc Colonoscopy Thru Stoma W Control Bleeding,4653.0,3024.45,,,0
CDM,75000070,Hc Colonoscopy Thru Stoma W Tumor Removal,4686.0,3045.9,,,0
CDM,75000071,Hc Colonoscopy Thru Stoma W Tumor Removal Snare,4972.0,3231.8,,,0
CDM,75000073,Hc Proctosigmoidoscopy Rigid,928.0,603.2,,,0
CDM,75000075,Hc Proctosigmoidoscopy W Biopsy,3208.0,2085.2,,,0
CDM,75000082,Hc Sigmoidoscopy,3944.0,2563.6,,,0
CDM,75000083,Hc Sigmoidoscopy W Biopsy,4196.0,2727.4,,,0
CDM,75000084,Hc Sigmoidoscopy W Removal Fb,4460.0,2899.0,,,0
CDM,75000085,Hc Sigmoidoscopy W Polypectomy,4815.0,3129.75,,,0
CDM,75000086,Hc Sigmoidoscopy W Control Bleeding,4637.0,3014.05,,,0
CDM,75000087,Hc Sigmoidoscopy W Injections,4320.0,2808.0,,,0
CDM,75000088,Hc Sigmoidoscopy W Decompression Volvulus,4476.0,2909.4,,,0
CDM,75000089,Hc Sigmoidoscopy W Removal Lesion By Snare,4575.0,2973.75,,,0
CDM,75000091,Hc Sigmoidoscopy W Balloon Dilation,4575.0,2973.75,,,0
CDM,75000092,Hc Sigmoidoscopy W Us Eval,4240.0,2756.0,,,0
CDM,75000093,Hc Sigmoidoscopy W Us Guided Fna,5099.0,3314.35,,,0
CDM,75000095,Hc Colonoscopy,4424.0,2875.6,,,0
CDM,75000096,Hc Colonoscopy W Removal Fb,5291.0,3439.15,,,0
CDM,75000097,Hc Colonoscopy W Biopsy,4921.0,3198.65,,,0
CDM,75000098,Hc Colonoscopy W Injections,4558.0,2962.7,,,0
CDM,75000099,Hc Colonoscopy W Control Bleeding,4633.0,3011.45,,,0
CDM,75000101,Hc Colonoscopy W Rem Lesion Forcep,4692.0,3049.8,,,0
CDM,75000102,Hc Colonoscopy W Polypectomy,5109.0,3320.85,,,0
CDM,75000103,Hc Colonoscopy W Balloon Dilation,5063.0,3290.95,,,0
CDM,75000106,Hc Hemorrhoidectomy Simple Ligature,6583.0,4278.95,,,0
CDM,75000112,Hc Anoscopy W Control Bleeding,5720.0,3718.0,,,0
CDM,75000114,Hc Motility Study Esophagus,3628.0,2358.2,,,0
CDM,75000118,Hc Gastroesophageal Reflux Test W Ph Electrode Plcmnt,7886.0,5125.9,,,0
CDM,75000119,Hc Gastroesoph Reflux W Mucosal Ph Electrode Plcmnt,8201.0,5330.65,,,0
CDM,75000120,Hc Esoph Imped Func Test,4167.0,2708.55,,,0
CDM,75000121,Hc Ph Impedance Test 24 Hours,6794.0,4416.1,,,0
CDM,75000123,Hc Anorectal Manometry Test,2472.0,1606.8,,,0
CDM,75000125,Hc Or Level 1 Endoscopy 1St 30 Minutes,4234.0,2752.1,,,0
CDM,75000126,Hc Or Level 1 Endoscopy Addl 15 Minutes,1133.0,736.45,,,0
CDM,75000127,Hc Screening Col Cancer Flex Sig,2982.0,1938.3,,,0
CDM,75000128,Hc Screen Can Colonoscopy High Risk,3758.0,2442.7,,,0
CDM,75000129,Hc Screen Col Cancer Colonoscopy Not Hr,3758.0,2442.7,,,0
CDM,75000141,Hc Esophagoscopy Flex W Mucosal Resection,4857.0,3157.05,,,0
CDM,75000142,Hc Esophagoscopy Transoral Stent Plcmnt,8452.0,5493.8,,,0
CDM,75000143,Hc Esophagoscopy Flex W Balln Dilatn 30 Mm,4275.0,2778.75,,,0
CDM,75000144,Hc Egd Esophagus Balloon Dilation 30 Mm,4350.0,2827.5,,,0
CDM,75000145,Hc Ercp W Stent Exchange W Dilation,6028.0,3918.2,,,0
CDM,75000146,Hc Egd Flex Us Guide Injection,4774.0,3103.1,,,0
CDM,75000147,Hc Egd Endo Mucosal Resection,4857.0,3157.05,,,0
CDM,75000148,Hc Ileoscopy Stoma W Plcmnt Endoscopic Stent,5574.0,3623.1,,,0
CDM,75000149,Hc Colonoscopy Stoma W Plcmnt Endoscopic Stent,5610.0,3646.5,,,0
CDM,75000150,Hc Colonoscpy Stoma W/ Mucosal Resection,5330.0,3464.5,,,0
CDM,75000151,Hc Colonoscpy Stoma W/  Submucosal Inj,4558.0,2962.7,,,0
CDM,75000152,Hc Colonoscopy Stoma W Balloon Dilat,5063.0,3290.95,,,0
CDM,75000153,Hc Colonoscopy Thru Stoma W/ Endo Us,5109.0,3320.85,,,0
CDM,75000155,Hc Colonoscopy Stoma W  Decompression,4921.0,3198.65,,,0
CDM,75000156,Hc Sigmoidoscopy Flx Ablation Tumor Or Lesion,5099.0,3314.35,,,0
CDM,75000157,Hc Sigmoidoscopy Flx W/ Endoscopic Stent Plcmnt,5099.0,3314.35,,,0
CDM,75000158,Hc Sigmoidoscopy Flx  W/ Band Ligation,4160.0,2704.0,,,0
CDM,75000159,Hc Colonoscopy Flx Ablation Tumor Or Lesion,4660.0,3029.0,,,0
CDM,75000160,Hc Colonoscopy Flx W Encoscopic Stent Plcmnt,5291.0,3439.15,,,0
CDM,75000161,Hc Colonoscopy Flx W Decompression,5109.0,3320.85,,,0
CDM,75000162,Hc Colonoscopy Flx  W Band Ligation,4692.0,3049.8,,,0
CDM,75000163,Hc Colonoscopy W Mucosal Resection,5291.0,3439.15,,,0
CDM,75000164,Hc Stomach Procedure Other,7895.0,5131.75,,,0
CDM,75000166,Hc Sigmoidoscopy W Mucosal Resection,5099.0,3314.35,,,0
CDM,75000167,Hc Gastrointestinal Tract Imaging Capsule Endoscopy,4695.0,3051.75,,,0
CDM,75000171,Hc Dest. Internal Hemorrhoid With Thermal Energy,8582.0,5578.3,,,0
CDM,75000172,Hc Replacement Of G-Tube Tube Perc Wo Img No Revision,2561.0,1664.65,,,0
CDM,75000173,Hc Replacement Of G-Tube Tube Perc Wo Img W Revision,4580.0,2977.0,,,0
CDM,75000174,Hc Bronchoscopy By Microwave Energy,21438.0,13934.7,,,0
CDM,75000176,Hc Ercp Tumor/Polyp/Lesion Ablation W/Dilation&Wire,10420.0,6773.0,,,0
CDM,75000177,Hc Endoscopic Submucosal Dissection Endoscopy Or Colonoscopy,4140.0,2691.0,,,0
CDM,75000178,Hc Gi Tract Imaging Intraluminal Colon I&R,4695.0,3051.75,,,0
CDM,75000179,Hc Colonoscopy W Endoscope Us,4558.0,2962.7,,,0
CDM,75000182,Hc Esophageal Mucosal Integrity Test By Electrical Impedance,8134.0,5287.1,,,0
CDM,75000183,Hc Esophagoscopy With Endoscopic Us Exam,3970.0,2580.5,,,0
CDM,75000184,Hc Ileoscopy Thru Stoma W Balloon Dilation,5574.0,3623.1,,,0
CDM,75000185,Hc Surg Tx Anal Fistula Subq,5600.0,3640.0,,,0
CDM,75000186,Hc Colonoscopy Thru Stoma W/ Ablation Lesion,5063.0,3290.95,,,0
CDM,75000187,Hc Egd Esophagogastrc Fndoplsty,13063.0,8490.95,,,0
CDM,75000188,Hc Unlisted Procedure Colon,1903.0,1236.95,,,0
CDM,76000001,Hc Observation Initial Assessment,706.0,458.9,,,0
CDM,76100001,Hc Cephalic Version,4435.0,2882.75,,,0
CDM,76100002,Hc Refill And Maintenance Of Implanted Pump,1523.0,989.95,,,0
CDM,76100003,Hc Refill And Maintnce Of Implanted Pump Phys Asstd,2430.0,1579.5,,,0
CDM,76100004,Hc Injection Im/Subcutaneous,281.0,182.65,,,0
CDM,76100005,Hc Ivp Single Or Initial Drug,349.0,226.85,,,0
CDM,76100006,Hc Ivp Ea Addl Drug Or Substance,319.0,207.35,,,0
CDM,76100007,Hc Ivp Ea Addl Push Same Drug Or Substance,237.0,154.05,,,0
CDM,76100013,Hc Application On Body Injector For Timed Injection,223.0,144.95,,,0
CDM,76100014,Hc Excise Lip Or Cheek Fold Newborn (Frenulectomy),2854.0,1855.1,,,0
CDM,76100015,Hc I And D Foot Single Bursa Space,2849.0,1851.85,,,0
CDM,76100015_50,Hc I And D Foot Single Bursa Space,5698.0,3703.7,,,0
CDM,76100016,Hc Trim Dystrophic Nails,319.0,207.35,,,0
CDM,76100017,Hc Ip Wc Negative Pressure Wound Ther Up To 50 Sq Cm,1883.0,1223.95,,,0
CDM,76100018,Hc Ip Wc Negative Pressure Wound Ther More Than 50 Sq Cm,3776.0,2454.4,,,0
CDM,76100019,Hc Exc Malignant Les S N H F G 1.1-2.0Cm,2102.0,1366.3,,,0
CDM,76100020,Hc Shave Epidermal Dermal Lesion Trunk Arm Leg 0.6 To 1.0 Cm,1202.0,781.3,,,0
CDM,76100021,Hc I And D Foot Multiple Bursal Areas,4746.0,3084.9,,,0
CDM,76100022,Hc Nasal/Sinus Endo With Control Hemorrhage,2800.0,1820.0,,,0
CDM,76100022_50,Hc Nasal/Sinus Endo With Control Hemorrhage,5600.0,3640.0,,,0
CDM,76100023,Hc Biopsy Oropharynx,2854.0,1855.1,,,0
CDM,76200007,Hc Observation Per Hour,118.0,76.7,,,0
CDM,76200014,Hc Observation Per Hour Bh,122.0,79.3,,,0
CDM,76200023,Hc Observation Per Hour Carve Out,118.0,76.7,,,0
CDM,76200024,Hc Bh Observation Per Hour Carve Out,122.0,79.3,,,0
CDM,77100001,Hc Admin Immun One Vaccine,73.0,47.45,,,0
CDM,77100002,Hc Admin Immun Ea Addl Vaccine,50.0,32.5,,,0
CDM,77100003,Hc Admin Influenza Vaccine,50.0,32.5,,,0
CDM,77100004,Hc Admin Pneumococcal Vaccine,50.0,32.5,,,0
CDM,77100005,Hc Admin Hep B Vaccine,50.0,32.5,,,0
CDM,77100011,Hc Admin Tocilizumab 1St Dose,1350.0,877.5,,,0
CDM,77100012,Hc Admin Tocilizumab 2Nd Dose,1350.0,877.5,,,0
CDM,77100020,Hc Covid-19 Antibody Sotrovimab Infusion,930.0,604.5,,,0
CDM,77100021,Hc Covid-19 Mab Evusheld Im Injections (Tixagev And Cilgav),450.0,292.5,,,0
CDM,77100022,Hc Covid-19 Bebtelovimab Iv Injection,1050.0,682.5,,,0
CDM,77100027,Hc Vaccine Admin Pfizer Covid-19 Bivalent Omicron Booster,50.0,32.5,,,0
CDM,77100028,Hc Vaccine Admin Moderna Covid-19 Bivalent Omicron Booster,50.0,32.5,,,0
CDM,78000001,Hc Telehealth Originating Site,151.0,98.15,,,0
CDM,80100001,Hc Hemodialysis Proc Ip 1 Eval,5490.0,3568.5,,,0
CDM,80100002,Hc Dialysis,5490.0,3568.5,,,0
CDM,81500003,Hc Mgt & Acq Allo Unrel Domestic Donor,1830.0,1189.5,,,0
CDM,81500004,Hc Mgt & Acq Allo Unrel Intnl Donor,1578.75,1026.19,,,0
CDM,81500005,Hc Nmdp Non-Network Search Management Fee,1120.0,728.0,,,0
CDM,81500006,Hc Nmdp Formal Search Fee,1480.0,962.0,,,0
CDM,81500007,Hc Nmdp Fast Track Search Fee,7625.0,4956.25,,,0
CDM,81500008,Hc Nmdp Allo Pbsc International  Product For Transplant,55150.0,35847.5,,,0
CDM,81500009,Hc Nmdp Allo Bone Marrow Harvest,42705.0,27758.25,,,0
CDM,81500010,Hc  Nmdp Allo Pbsc  For Transplant Per Collect,43875.0,28518.75,,,0
CDM,81500011,Hc Nmdp Allo T-Cell For Transplant Per Collect,20515.0,13334.75,,,0
CDM,81500012,Hc Harvest Allo Pbsc For Transplant Per Collect,3240.0,2106.0,,,0
CDM,81500013,Hc Harvest Allo T-Cell For Transplant Per Collection,3240.0,2106.0,,,0
CDM,81500014,Hc Cryopreservation & Store Allo Stem Cells For Transplant,1486.0,965.9,,,0
CDM,81500015,Hc Thaw W/O Wash Allo Harvest Cells For Transplant,1486.0,965.9,,,0
CDM,81500016,Hc Thaw W/Wash Allo Harvest Cells For Transplant,1701.0,1105.65,,,0
CDM,81500017,Hc Plasma Depletion Allo Harvest Cells For Transplant,1392.0,904.8,,,0
CDM,81500018,Hc Cell Concentration Buffy Coat Allo Harvest Cells For Transplant,1486.0,965.9,,,0
CDM,81500019,Hc Stem Cells Total Count Cd34 Product,328.0,213.2,,,0
CDM,81500020,Hc Stem Cells Total Count Cd34 Allo Donor,365.0,237.25,,,0
CDM,81500021,Hc Donor Comparative Analysis Str Markers Patient&Comp Spec So,840.0,546.0,,,0
CDM,81500022,Hc Donor Comparative Analysis Str Markers Ea Addl Specimen So,1140.0,741.0,,,0
CDM,81500023,Hc Donor Chimerism W/Comp To Baseline W/O Cell Selection So,1050.0,682.5,,,0
CDM,81500024,Hc Donor Chimerism W/Comp To Baseline W/Cell Selection Ea So,2001.0,1300.65,,,0
CDM,81500025,Hc Donor Hla I&Ii High Resolution Hla-A -B -C And -Drb1 So,990.0,643.5,,,0
CDM,81500026,Hc Donor Hla Class Ii Typing High Resolution One Locus Ea So,990.0,643.5,,,0
CDM,81500027,Hc Donor Syphilis-Pk-Tp So,32.0,20.8,,,0
CDM,81500028,Hc Donor Cytomegalovirus Antibody-Pk-Cmv So,35.0,22.75,,,0
CDM,81500029,Hc Donor Htlv-I Antibody (Htlv-I)-Abbott So,32.0,20.8,,,0
CDM,81500030,Hc Donor Htlv-Ii Antibody (Htlv-Ii)-Abbott So,32.0,20.8,,,0
CDM,81500031,Hc Donor Hiv Antibody (Hiv-1/2/O) So,38.0,24.7,,,0
CDM,81500032,Hc Donor Hepatitis B Core Antibody (Hbc)-Abbott So,45.0,29.25,,,0
CDM,81500033,Hc Donor Chagas Tcruzi Ab So,56.0,36.4,,,0
CDM,81500034,Hc Donor Hepatitis C Virus Antibody (Hcv)-Abbott So,36.0,23.4,,,0
CDM,81500035,Hc Donor Antibody Hla Class I & Class Ii Antigens Qual So,405.0,263.25,,,0
CDM,81500036,Hc Donor Antibody Hla Class I High Definition Panel Qual So,1125.0,731.25,,,0
CDM,81500037,Hc Donor Antibody Hla Class Ii High Definition Panel Qual So,1125.0,731.25,,,0
CDM,81500038,Hc Donor Hepatitis B Surface Antigen (Hbsag)-Abbott So,31.0,20.15,,,0
CDM,81500039,Hc Donor Hiv Antibody (Hiv-1/2/O)-Abbott So,35.0,22.75,,,0
CDM,81500040,Hc Donor Wnv Nat Idt-Roche So,44.0,28.6,,,0
CDM,81500041,Hc Donor Hiv/Hcv/Hbv (Mpx) Nat Idt-Roche So,35.0,22.75,,,0
CDM,81500042,Hc Donor Hla I Typing Complete Lr So,870.0,565.5,,,0
CDM,81500043,Hc Donor Hla I Typing 1 Locus Lr So,426.0,276.9,,,0
CDM,81500044,Hc Donor Hla Ii Typing 1 Locus Lr So,747.0,485.55,,,0
CDM,81500045,Hc Donor Hla I Typing Complete Hr So,1050.0,682.5,,,0
CDM,81500046,Hc Donor Hla I Typing 1 Locus Hr So,960.0,624.0,,,0
CDM,81500047,Hc Donor Hla Typing Lymphocyte Culture Mixed So,405.0,263.25,,,0
CDM,81500048,Hc Donor Antibody Hla Class Ii Phenotype Panel Qual So,1125.0,731.25,,,0
CDM,81500049,Hc Donor Hla-Drb1 Single Antigen Disease Association So,594.0,386.1,,,0
CDM,81500050,Hc Recipient Hla-Drb1 Single Antigen Disease Association So,594.0,386.1,,,0
CDM,87100001,Hc Car-T Cell Harvest,6064.0,3941.6,,,0
CDM,87100002,Hc Car-T Cell Harvest,5458.0,3547.7,,,0
CDM,87200001,"Hc Car-T Cell Prep For Transport,Cryopreserve,Storage",2215.0,1439.75,,,0
CDM,87200002,"Hc Car-T Cell Prep For Transport,Cryopreserve,Storage",1994.0,1296.1,,,0
CDM,87300001,Hc Car-T Cell Prep Product For Administration,2215.0,1439.75,,,0
CDM,87300002,Hc Car-T Cell Prep Product For Administration,1994.0,1296.1,,,0
CDM,87400001,"Hc Car-T Cell Administration, Autologous",6771.0,4401.15,,,0
CDM,87400002,"Hc Car-T Cell Administration, Autologous",6094.0,3961.1,,,0
CDM,88000002,Hc Dialysis Esrd Unsched Emerg Op,6100.0,3965.0,,,0
CDM,88100001,Hc Peritoneal Dialysis,895.0,581.75,,,0
CDM,88100002,Hc Prisma Therapy Crrt,9886.0,6425.9,,,0
CDM,88100003,Hc Ultrafiltration,7299.0,4744.35,,,0
CDM,90000001,Hc Psychotherapy Complex Interactive,57.0,37.05,,,0
CDM,90000002,Hc Psych Diagnostic Eval,502.0,326.3,,,0
CDM,90000003,Hc Psych Diag Eval W Med Srvcs,687.0,446.55,,,0
CDM,90000004,Hc Therap Tms Treatment Intial,889.0,577.85,,,0
CDM,90000005,Hc Therap Tms Treat Subseq Del And Mgmt,630.0,409.5,,,0
CDM,90000006,Hc Tms Subseq Mot Thresh W Del And Mgmt,889.0,577.85,,,0
CDM,90100001,Hc Ect Single Seizure,4714.0,3064.1,,,0
CDM,90400001,Hc Activity Therapy Per Session 45 Min Or More,678.0,440.7,,,0
CDM,91400001,Hc Psychotherapy W Pt 30 Min,279.0,181.35,,,0
CDM,91400003,Hc Psychotherapy W Pt 45 Min,502.0,326.3,,,0
CDM,91400005,Hc Psychotherapy W Pt 60 Min,560.0,364.0,,,0
CDM,91400007,Hc Psychoanalysis,957.0,622.05,,,0
CDM,91400008,Hc Narcosynthsis For Psych Dx And Tx,957.0,622.05,,,0
CDM,91400009,Hc Hypnotherapy,957.0,622.05,,,0
CDM,91500001,Hc Iop Group Psych Therapy,838.0,544.7,,,0
CDM,91500002,Hc Php Group Psychotherapy 45 To 50 Min,474.0,308.1,,,0
CDM,91500003,Hc Php Interactive Group Psycotherapy 45 To 50 Min,474.0,308.1,,,0
CDM,91500004,Hc Mcd Bh Tx Per Hour-Min 31 Min,319.0,207.35,,,0
CDM,91500005,Hc Mcd Bh Tx Per Day - Min 2.5 Hr,1276.0,829.4,,,0
CDM,91500006,Hc Mcd Group Psychotherapy <30 Min,245.0,159.25,,,0
CDM,91500007,Hc Pnes Group Psychotherapy,280.0,182.0,,,0
CDM,91500008,Hc Group Psychotherapy Less Than 30 Minutes,245.0,159.25,,,0
CDM,91500009,Hc Aftercare Group Therapy,838.0,544.7,,,0
CDM,91500010,Hc Iop Group Psychotherapy 45 To 50 Min,474.0,308.1,,,0
CDM,91600001,Hc Family Psychotherapy Wo Pt 50 Min,560.0,364.0,,,0
CDM,91600002,Hc Family Psychotherapy W Pt 50 Min,560.0,364.0,,,0
CDM,91800004,Hc Neurobhvrl Exam Md Or Qhcp,832.0,540.8,,,0
CDM,92000002,Hc Allergy Test Perq And Ic Drug Or Biological,222.0,144.3,,,0
CDM,92000007,Hc Spontaneous Nystagmus W/Gaze,338.0,219.7,,,0
CDM,92000008,Hc Positional Nystagmus,338.0,219.7,,,0
CDM,92000009,"Hc Spontaneous Nystagmus W/Gaze, W/Fixation And Recording",326.0,211.9,,,0
CDM,92000010,Hc Positional Nystagmus 4 Position W/Recording,326.0,211.9,,,0
CDM,92000011,Hc Elect Analysis Neurostim Gen W Brain Neurostim Gen 1St 15 Mins,140.0,91.0,,,0
CDM,92000012,Hc Elect Analysis Neurostim Gen W Brain Neurostim Gen Each Addl 15 Mins,94.0,61.1,,,0
CDM,92000014,Hc Neurofunctional Testing During Fmri,448.0,291.2,,,0
CDM,92100001,Hc Duplex Scan Extracranial Arteries Bilat,1238.0,804.7,,,0
CDM,92100002,Hc Duplex Scan Extracranial Arteries Unilat,899.0,584.35,,,0
CDM,92100003,Hc Doppler Transcranial Complete,887.0,576.55,,,0
CDM,92100004,Hc Doppler Transcranial Limited,665.0,432.25,,,0
CDM,92100005,Hc Noninvsve Physiolgc Studies Ext Art Ltd Bilat,863.0,560.95,,,0
CDM,92100006,Hc Noninvsve Physiolgc Studies Ext Art Cmplt Bilat,1084.0,704.6,,,0
CDM,92100007,Hc Noninvsve Physiolgc Studies Le Art W Stress,1228.0,798.2,,,0
CDM,92100008,Hc Duplex Scan Lower Extrem Arteries Complt Bilat,1549.0,1006.85,,,0
CDM,92100009,Hc Duplex Scan Lower Extrem Arteries Ltd Unilat,1073.0,697.45,,,0
CDM,92100011,Hc Duplex Scan Upper Extrem Arteries Complt Bilat,1520.0,988.0,,,0
CDM,92100012,Hc Duplex Scan Upper Extrem Arteries Ltd Unilat,999.0,649.35,,,0
CDM,92100014,Hc Duplex Scan Extremity Veins Complete Bilat,1433.0,931.45,,,0
CDM,92100015,Hc Duplex Scan Extremity Veins Limited Unilat,1132.0,735.8,,,0
CDM,92100017,Hc Duplex Scan Abd Pelvic Retroperit Arteries Cmplt,1520.0,988.0,,,0
CDM,92100018,Hc Duplex Scan Abd Pelvic Retroperit Arteries Ltd,999.0,649.35,,,0
CDM,92100019,Hc Duplex Scan Aorta Ivc Graft Complete,1497.0,973.05,,,0
CDM,92100020,Hc Duplex Scan Aorta Ivc Graft Limited,805.0,523.25,,,0
CDM,92100021,Hc Duplex Scan Penile Vessels Complete,1369.0,889.85,,,0
CDM,92100022,Hc Duplex Scan Penile Vessels Limited,760.0,494.0,,,0
CDM,92100024,Hc Duplex Scan Hemodialysis Access,1319.0,857.35,,,0
CDM,92100025,Hc Duplex Scan Preop Vessel Assess Prior To Hemodialysis Access Bilat,1063.0,690.95,,,0
CDM,92100026,Hc Duplex Scan Preop Vessel Assess Prior To Hemodialysis Access Unilat,1063.0,690.95,,,0
CDM,92200010,Hc Needle Emg Cranial Nerve Musc Unilateral,1776.0,1154.4,,,0
CDM,92200011,Hc Needle Emg Cranial Nerve Musc Bilateral,2664.0,1731.6,,,0
CDM,92200012,Hc Needle Emg Musc 1 Extrem Or Nonlimb Musc Limited,1600.0,1040.0,,,0
CDM,92200013,Hc Ss Evok Potent Up Limb,2074.0,1348.1,,,0
CDM,92200014,Hc Ss Evok Potent Low Limb,1994.0,1296.1,,,0
CDM,92200016,Hc Cent Mot Evoke Potent Lower Limbs,506.0,328.9,,,0
CDM,92200017,Hc Visual Evoked Potential Except Glaucoma,890.0,578.5,,,0
CDM,92200018,Hc Ss Evok Potent Up And Low Limb,4070.0,2645.5,,,0
CDM,92200021,Hc Needle Emg Ea Extremity W/ Paraspinal Area Limited,385.0,250.25,,,0
CDM,92200022,Hc Needle Emg Ea Extremity W/ Paraspinal Area Complete,385.0,250.25,,,0
CDM,92200023,Hc Nerve Conduction Studies 1-2,890.0,578.5,,,0
CDM,92200024,Hc Nerve Conduction Studies 3-4,1776.0,1154.4,,,0
CDM,92200025,Hc Nerve Conduction Studies 5-6,1776.0,1154.4,,,0
CDM,92200026,Hc Nerve Conduction Studies 7-8,1776.0,1154.4,,,0
CDM,92200027,Hc Nerve Conduction Studies 9-10,3033.0,1971.45,,,0
CDM,92200028,Hc Nerve Conduction Studies 11-12,3033.0,1971.45,,,0
CDM,92200029,Hc Nerve Conduction Studies 13 Or More,3033.0,1971.45,,,0
CDM,92400001,Hc Inhalation Bronch Challenge Test W/Histamine Methacholine Compound,3033.0,1971.45,,,0
CDM,94000001,Hc Nch Neonate Services 1-15 Min,82.0,53.3,,,0
CDM,94000002,Hc Nch Neonate Services 16-30 Min,194.0,126.1,,,0
CDM,94000003,Hc Nch Neonate Services 31-45 Min,309.0,200.85,,,0
CDM,94000004,Hc Nch Neonate Services 46 Min Or More,435.0,282.75,,,0
CDM,94000005,Hc Other Resp Proc One On One Per 15 Min,122.0,79.3,,,0
CDM,94000006,Hc Mind/Body Therapy Integrative Care,45.0,29.25,,,0
CDM,94000007,Hc Acupuncture Integrative Care,45.0,29.25,,,0
CDM,94000008,Hc Massage Integrative Care,45.0,29.25,,,0
CDM,94000009,Hc Nutrition Consult Integrative Care,45.0,29.25,,,0
CDM,94000010,Hc Demonstrate Use Home Inr Monitor,213.0,138.45,,,0
CDM,94000011,Hc Art Therapy Integrative Care,45.0,29.25,,,0
CDM,94000016,Hc Stem Cell Allogeneic Transplant Per Donor,9175.0,5963.75,,,0
CDM,94000017,Hc Stem Cell Autologous Transplant,8125.0,5281.25,,,0
CDM,94000018,Hc Post-Allo Trnsplnt Donor Lymphocyte Inf After Relapse,5238.0,3404.7,,,0
CDM,94000019,Hc Post-Allo Trnsplnt Donor Lymphocyte Infusion,7258.0,4717.7,,,0
CDM,94200001,Hc Medical Nutrition Assess Indiv Initial Ea 15 Min,65.0,42.25,,,0
CDM,94200002,Hc Medical Nutrition Reassess Indiv Initial Ea 15 Min,45.0,29.25,,,0
CDM,94200003,Hc Medical Nutrition Therapy Group Ea 30 Minutes,65.0,42.25,,,0
CDM,94200004,Hc Adapting Vlc Per Class,30.0,19.5,,,0
CDM,94200005,Hc Med Weight Re-Enroll Screen,176.0,114.4,,,0
CDM,94200006,Hc Med Weight Tx Screening Lc,346.0,224.9,,,0
CDM,94200007,Hc Med Weight Tx Screening Tlc,346.0,224.9,,,0
CDM,94200008,Hc Med Wt Screen Promotion,176.0,114.4,,,0
CDM,94200009,Hc Med Wt Screen W/Outside Ekg,261.0,169.65,,,0
CDM,94200010,Hc Med Wt Screen W/Outside Lab,287.0,186.55,,,0
CDM,94200011,Hc Med Wt Screen W/Outside Lab&Ekg,317.0,206.05,,,0
CDM,94200012,Hc Reduce Vlc Per Class,30.0,19.5,,,0
CDM,94200013,Hc Reduce Or Dm Type Ii Vlc Per Class,30.0,19.5,,,0
CDM,94200014,Hc Reducing Or Dm Lc Per Class,30.0,19.5,,,0
CDM,94200015,Hc Weight Maintnce Lc Per Class,30.0,19.5,,,0
CDM,94200016,Hc Weight Maintnce Vlc Per Class,30.0,19.5,,,0
CDM,94200017,Hc Smoke Tobacco Counseling 3-10 Min,35.0,22.75,,,0
CDM,94200018,Hc Smoke Tobacco Counsel More Than 10 Mins,46.0,29.9,,,0
CDM,94200019,Hc Train Therapy Diab Ind Session 30 M,93.0,60.45,,,0
CDM,94200020,Hc Train Therapy Diab Grp Session 30 M,76.0,49.4,,,0
CDM,94200021,Hc Train Educ Related To Care And Tx 45 Min Or More,409.0,265.85,,,0
CDM,94200022,Hc Mnt Second Referral Per 15 Min,40.0,26.0,,,0
CDM,94200030,Hc Fitness Consultation,93.0,60.45,,,0
CDM,94200031,Hc Nutrition Therapy Group Educ Ob,182.0,118.3,,,0
CDM,94200032,Hc Mcaid Ob Nutrition Intervention Diettcian,67.0,43.55,,,0
CDM,94300001,Hc Card Rehab Wo Mon,318.0,206.7,,,0
CDM,94300002,Hc Card Rehab W Mon,455.0,295.75,,,0
CDM,94800002,Hc Pulm Rehab Wo Oximetry Mon,178.0,115.7,,,0
CDM,94800003,Hc Pulm Rehab W Cont Oximetry Mon,178.0,115.7,,,0
CDM,99800001,Hc Nonchargeable Equipment,2906.49,1889.22,,,0
CDM,99800171,Hc Nonchargeable Supply,866.95,563.52,,,0
CDM,99911111,Hc Miscellaneous Charge,3000.0,1950.0,,,0
CDM,RX-10000,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,263.3,171.14,,,0
CDM,RX-10009,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,34.8,22.62,,,0
CDM,RX-10010,FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,37.55,24.41,,,0
CDM,RX-10011,FAMOTIDINE 20 MG TABLET,5.0,3.25,,,0
CDM,RX-10012,FAMOTIDINE 40 MG TABLET,4.95,3.22,,,0
CDM,RX-10014,FAT EMULSION 20 % INTRAVENOUS,99.1,64.41,,,0
CDM,RX-10024,FELBAMATE 400 MG TABLET,7.45,4.84,,,0
CDM,RX-10025,FELBAMATE 600 MG TABLET,17.15,11.15,,,0
CDM,RX-100272,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) INTRAVENOUS KIT,18255.05,11865.78,,,0
CDM,RX-100344,ROMIDEPSIN 10 MG/2 ML INTRAVENOUS POWDER FOR SOLUTION,12226.05,7946.93,,,0
CDM,RX-10036,FILGRASTIM 300 MCG/ML INJECTION SOLUTION,1566.6,1018.29,,,0
CDM,RX-10037,FINASTERIDE 5 MG TABLET,6.15,4.0,,,0
CDM,RX-10041,FLECAINIDE 100 MG TABLET,6.45,4.19,,,0
CDM,RX-10043,FLECAINIDE 50 MG TABLET,5.95,3.87,,,0
CDM,RX-10044,FLUCONAZOLE 100 MG TABLET,8.05,5.23,,,0
CDM,RX-10045,FLUCONAZOLE 200 MG TABLET,9.7,6.3,,,0
CDM,RX-10046,FLUCONAZOLE 50 MG TABLET,5.75,3.74,,,0
CDM,RX-10049,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,66.55,43.26,,,0
CDM,RX-100491,"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",1429.95,929.47,,,0
CDM,RX-10050,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,75.55,49.11,,,0
CDM,RX-10051,FLUCYTOSINE 250 MG CAPSULE,175.65,114.17,,,0
CDM,RX-10052,FLUCYTOSINE 500 MG CAPSULE,304.15,197.7,,,0
CDM,RX-10054,FLUDROCORTISONE 0.1 MG TABLET,5.7,3.7,,,0
CDM,RX-10059,FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,191.75,124.64,,,0
CDM,RX-100611,DICLOFENAC 1 % TOPICAL GEL,53.45,34.74,,,0
CDM,RX-100614,DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL 12 HOUR PATCH,23.5,15.28,,,0
CDM,RX-10065,FLUOROURACIL 5 % TOPICAL CREAM,113.2,73.58,,,0
CDM,RX-10069,FLUOXETINE 10 MG CAPSULE,4.7,3.06,,,0
CDM,RX-10070,FLUOXETINE 20 MG CAPSULE,4.85,3.15,,,0
CDM,RX-100740,IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,447.55,290.91,,,0
CDM,RX-100796,"DALFAMPRIDINE ER 10 MG TABLET,EXTENDED RELEASE,12 HR",6.75,4.39,,,0
CDM,RX-10085,FLUVOXAMINE 50 MG TABLET,5.3,3.44,,,0
CDM,RX-10093,FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,1609.2,1045.98,,,0
CDM,RX-100995,RITONAVIR 100 MG TABLET,26.3,17.1,,,0
CDM,RX-101,ACETAMINOPHEN 325 MG TABLET,0.05,0.03,,,0
CDM,RX-10101,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,274.85,178.65,,,0
CDM,RX-10106,GENTAMICIN 80 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,67.55,43.91,,,0
CDM,RX-10108,GENTAMICIN 100 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,68.4,44.46,,,0
CDM,RX-10117,GLIPIZIDE 5 MG TABLET,5.2,3.38,,,0
CDM,RX-10137,GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT,4768.15,3099.3,,,0
CDM,RX-10149,GUANFACINE 1 MG TABLET,12.5,8.12,,,0
CDM,RX-10159,HALOBETASOL PROPIONATE 0.05 % TOPICAL CREAM,74.2,48.23,,,0
CDM,RX-10162,HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,41.6,27.04,,,0
CDM,RX-10163,HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,49.35,32.08,,,0
CDM,RX-10176,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",37.0,24.05,,,0
CDM,RX-10181,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",37.3,24.24,,,0
CDM,RX-10210,HYDROCORTISONE 100 MG/60 ML ENEMA,66.6,43.29,,,0
CDM,RX-10225,HYDROMORPHONE 1 MG/ML ORAL LIQUID,9.4,6.11,,,0
CDM,RX-10227,HYDROMORPHONE 3 MG RECTAL SUPPOSITORY,46.05,29.93,,,0
CDM,RX-10235,HYDROXYCHLOROQUINE 200 MG TABLET,7.5,4.88,,,0
CDM,RX-10236,HYDROXYUREA 500 MG CAPSULE,6.6,4.29,,,0
CDM,RX-10239,HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,137.25,89.21,,,0
CDM,RX-10246,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.75,0.49,,,0
CDM,RX-10248,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,305.7,198.7,,,0
CDM,RX-10266,INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,795.15,516.85,,,0
CDM,RX-10286,INSULIN HUMAN U-100 NPH-REGULR 70-30 MIX 100 UNIT/ML SUBCUTANEOUS SUSP,126.7,82.36,,,0
CDM,RX-10289,INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,55.35,35.98,,,0
CDM,RX-10323,IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION,174.45,113.39,,,0
CDM,RX-10328,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,77.0,50.05,,,0
CDM,RX-10358,ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION,519.95,337.97,,,0
CDM,RX-10364,ITRACONAZOLE 100 MG CAPSULE,12.7,8.26,,,0
CDM,RX-10368,KETOCONAZOLE 2 % TOPICAL CREAM,63.6,41.34,,,0
CDM,RX-10369,KETOCONAZOLE 200 MG TABLET,7.65,4.97,,,0
CDM,RX-10373,LABETALOL 100 MG TABLET,5.55,3.61,,,0
CDM,RX-10375,LABETALOL 300 MG TABLET,5.65,3.67,,,0
CDM,RX-10380,AMMONIUM LACTATE 12 % LOTION,50.1,32.56,,,0
CDM,RX-103890,TAMSULOSIN 0.4 MG CAPSULE,5.2,3.38,,,0
CDM,RX-10394,LEVOBUNOLOL 0.5 % EYE DROPS,72.3,47.0,,,0
CDM,RX-104,ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,0.85,0.55,,,0
CDM,RX-10403,LEVOTHYROXINE 88 MCG TABLET,6.05,3.93,,,0
CDM,RX-10404,LEVOTHYROXINE 112 MCG TABLET,5.95,3.87,,,0
CDM,RX-10406,LEVOTHYROXINE 175 MCG TABLET,6.3,4.1,,,0
CDM,RX-104207,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,39.1,25.42,,,0
CDM,RX-104208,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,65.3,42.44,,,0
CDM,RX-10427,"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",34.0,22.1,,,0
CDM,RX-10430,"LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION",34.0,22.1,,,0
CDM,RX-10431,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",37.45,24.34,,,0
CDM,RX-10434,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,86.05,55.93,,,0
CDM,RX-10443,LIOTHYRONINE 5 MCG TABLET,6.1,3.96,,,0
CDM,RX-10449,LISINOPRIL 10 MG TABLET,4.75,3.09,,,0
CDM,RX-1045,BETHANECHOL CHLORIDE 5 MG TABLET,4.9,3.18,,,0
CDM,RX-10451,LISINOPRIL 5 MG TABLET,4.8,3.12,,,0
CDM,RX-10454,"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",5.7,3.7,,,0
CDM,RX-10455,"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",6.15,4.0,,,0
CDM,RX-104555,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,14.85,9.65,,,0
CDM,RX-104576,TRANEXAMIC ACID 650 MG TABLET,13.1,8.52,,,0
CDM,RX-104604,RIFAXIMIN 550 MG TABLET,180.0,117.0,,,0
CDM,RX-10466,LORATADINE 10 MG TABLET,0.2,0.13,,,0
CDM,RX-10467,LORAZEPAM 2 MG/ML INJECTION SOLUTION,34.25,22.265,,,0
CDM,RX-10468,LORAZEPAM 4 MG/ML INJECTION SOLUTION,77.65,50.47,,,0
CDM,RX-10475,"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",24712.65,16063.22,,,0
CDM,RX-105,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,0.35,0.23,,,0
CDM,RX-10512,"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",453.75,294.94,,,0
CDM,RX-10521,MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,5.55,3.61,,,0
CDM,RX-10522,MELPHALAN HCL 50 MG INTRAVENOUS POWDER FOR SOLUTION,853.1,554.52,,,0
CDM,RX-10531,MERCAPTOPURINE 50 MG TABLET,10.35,6.73,,,0
CDM,RX-10535,MESALAMINE 4 GRAM/60 ML ENEMA,28.95,18.82,,,0
CDM,RX-10537,MESNA 100 MG/ML INTRAVENOUS SOLUTION,114.65,74.52,,,0
CDM,RX-10544,METFORMIN 500 MG TABLET,4.8,3.12,,,0
CDM,RX-10546,METHADONE 10 MG/ML INJECTION SOLUTION,904.4,587.86,,,0
CDM,RX-10549,METHENAMINE HIPPURATE 1 GRAM TABLET,9.85,6.4,,,0
CDM,RX-105502,DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE,9177.0,5965.05,,,0
CDM,RX-10553,METHIMAZOLE 5 MG TABLET,5.05,3.28,,,0
CDM,RX-105552,CEFEPIME 2 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,125.25,81.41,,,0
CDM,RX-105633,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",50.65,32.92,,,0
CDM,RX-105640,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,36.55,23.76,,,0
CDM,RX-105644,CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,54267.0,35273.55,,,0
CDM,RX-105698,MOMETASONE-FORMOTEROL HFA 100 MCG-5 MCG/ACTUATION AEROSOL INHALER,243.9,158.54,,,0
CDM,RX-105699,MOMETASONE-FORMOTEROL HFA 200 MCG-5 MCG/ACTUATION AEROSOL INHALER,243.9,158.54,,,0
CDM,RX-10571,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,109.2,70.98,,,0
CDM,RX-10577,"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",236.65,153.82,,,0
CDM,RX-10578,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION,43.8,28.47,,,0
CDM,RX-10580,METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION,61.05,39.68,,,0
CDM,RX-10581,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,145.3,94.44,,,0
CDM,RX-10586,METOLAZONE 10 MG TABLET,11.7,7.6,,,0
CDM,RX-10587,METOLAZONE 2.5 MG TABLET,10.4,6.76,,,0
CDM,RX-10588,METOLAZONE 5 MG TABLET,12.4,8.06,,,0
CDM,RX-105899,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,44.35,28.83,,,0
CDM,RX-105900,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,46.7,30.36,,,0
CDM,RX-105901,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,48.75,31.69,,,0
CDM,RX-105902,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,64.2,41.73,,,0
CDM,RX-105903,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,72.15,46.9,,,0
CDM,RX-105904,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,63.05,40.98,,,0
CDM,RX-105906,DONEPEZIL 23 MG TABLET,5.55,3.61,,,0
CDM,RX-10592,METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL,85.75,55.74,,,0
CDM,RX-10595,MEXILETINE 150 MG CAPSULE,8.5,5.52,,,0
CDM,RX-10596,MEXILETINE 200 MG CAPSULE,9.15,5.95,,,0
CDM,RX-10597,MEXILETINE 250 MG CAPSULE,6.65,4.32,,,0
CDM,RX-10599,MICONAZOLE NITRATE 2 % TOPICAL POWDER,2.65,1.72,,,0
CDM,RX-106061,"SODIUM,POTASSIUM,MAG SULFATES 17.5 GRAM-3.13 GRAM-1.6 GRAM ORAL SOLN",130.8,85.02,,,0
CDM,RX-106079,ULIPRISTAL 30 MG TABLET,116.6,75.79,,,0
CDM,RX-10609,MIDODRINE 2.5 MG TABLET,6.4,4.16,,,0
CDM,RX-10610,MIDODRINE 5 MG TABLET,6.35,4.13,,,0
CDM,RX-10612,MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,1320.75,858.49,,,0
CDM,RX-106120,HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLUTION,6620.2,4303.13,,,0
CDM,RX-106176,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM,14.7,9.56,,,0
CDM,RX-106177,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,21.95,14.27,,,0
CDM,RX-106249,"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",69.4,45.11,,,0
CDM,RX-106274,ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 20 MG/ML (2 %) INTRAVENOUS SOLN,4005.75,2603.74,,,0
CDM,RX-106278,DIAZEPAM 5 MG/ML INJECTION SYRINGE,52.1,33.86,,,0
CDM,RX-10628,MISOPROSTOL 100 MCG TABLET,8.95,5.82,,,0
CDM,RX-10629,MISOPROSTOL 200 MCG TABLET,9.4,6.11,,,0
CDM,RX-10630,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,294.15,191.2,,,0
CDM,RX-106348,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,34.8,22.62,,,0
CDM,RX-106363,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,43.5,28.28,,,0
CDM,RX-106364,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",51.05,33.18,,,0
CDM,RX-106443,DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,187.1,121.62,,,0
CDM,RX-106490,DABIGATRAN ETEXILATE 75 MG CAPSULE,13.7,8.9,,,0
CDM,RX-10655,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,8.6,5.59,,,0
CDM,RX-10674,MUPIROCIN 2 % TOPICAL OINTMENT,22.0,14.3,,,0
CDM,RX-106783,FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION,141.75,92.14,,,0
CDM,RX-106804,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,16852.9,10954.38,,,0
CDM,RX-10685,NALTREXONE 50 MG TABLET,12.15,7.9,,,0
CDM,RX-1069,BIOTIN 10 MG TABLET,4.8,3.12,,,0
CDM,RX-10708,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",69.9,45.44,,,0
CDM,RX-10717,NICOTINE (POLACRILEX) 2 MG GUM,0.2,0.13,,,0
CDM,RX-10722,NIMODIPINE 30 MG CAPSULE,8.1,5.26,,,0
CDM,RX-10723,NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,2688.3,1747.4,,,0
CDM,RX-10734,NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,53.55,34.81,,,0
CDM,RX-10735,NORETHINDRONE 1 MG-ETHINYL ESTRADIOL 20 MCG (21)-IRON 75 MG (7) TABLET,16.6,10.79,,,0
CDM,RX-10747,NORETHINDRONE ACETATE 5 MG TABLET,6.35,4.13,,,0
CDM,RX-10749,NORGESTIMATE 0.25 MG-ETHINYL ESTRADIOL 0.035 MG TABLET,24.3,15.8,,,0
CDM,RX-107660,BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,157.6,102.44,,,0
CDM,RX-107661,BUPRENORPHINE 10 MCG/HOUR WEEKLY TRANSDERMAL PATCH,158.8,103.22,,,0
CDM,RX-107668,LURASIDONE 40 MG TABLET,12.35,8.03,,,0
CDM,RX-107669,LURASIDONE 80 MG TABLET,12.55,8.16,,,0
CDM,RX-107671,CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,976.1,634.46,,,0
CDM,RX-107798,BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,57.7,37.5,,,0
CDM,RX-107799,"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",507.4,329.81,,,0
CDM,RX-107800,"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",1366.2,888.03,,,0
CDM,RX-10781,BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,32.7,21.26,,,0
CDM,RX-10782,SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,3.0,1.95,,,0
CDM,RX-1079,"BISACODYL 5 MG TABLET,DELAYED RELEASE",0.05,0.03,,,0
CDM,RX-1080,BISACODYL 10 MG RECTAL SUPPOSITORY,1.0,0.65,,,0
CDM,RX-108021,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",53.7,34.9,,,0
CDM,RX-108028,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,72.5,47.12,,,0
CDM,RX-108029,FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SOLUTION SYRINGE,181.4,117.91,,,0
CDM,RX-108042,DARBEPOETIN ALFA 40 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,1540.65,1001.42,,,0
CDM,RX-108043,DARBEPOETIN ALFA 60 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE,2294.5,1491.42,,,0
CDM,RX-108047,DARBEPOETIN ALFA 200 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,7571.55,4921.51,,,0
CDM,RX-108049,"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",1744.15,1133.7,,,0
CDM,RX-108050,"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",3539.6,2300.74,,,0
CDM,RX-108061,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,2235.3,1452.94,,,0
CDM,RX-108062,TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,5465.2,3552.38,,,0
CDM,RX-108063,TOCILIZUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,10848.35,7051.43,,,0
CDM,RX-108065,BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,483.05,313.98,,,0
CDM,RX-108072,CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,6864.0,4461.6,,,0
CDM,RX-108074,FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,2475.05,1608.78,,,0
CDM,RX-108096,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,685.55,445.61,,,0
CDM,RX-10810,OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,4.9,3.18,,,0
CDM,RX-108108,PALIPERIDONE PALMITATE 117 MG/0.75 ML INTRAMUSCULAR SYRINGE,8560.75,5564.49,,,0
CDM,RX-108109,PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,17088.8,11107.72,,,0
CDM,RX-108118,LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,64.65,42.02,,,0
CDM,RX-108119,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,66.75,43.39,,,0
CDM,RX-10812,OXYCODONE 20 MG/ML ORAL CONCENTRATE,180.7,117.46,,,0
CDM,RX-108120,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,67.55,43.91,,,0
CDM,RX-108121,PIPERACILLIN-TAZOBACTAM 4.5 GRAM/100 ML DEXTROSE(ISO-OSM) IV PIGGYBACK,165.2,107.38,,,0
CDM,RX-10813,OXYCODONE 5 MG/5 ML ORAL SOLUTION,18.25,11.86,,,0
CDM,RX-108130,CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,67.55,43.91,,,0
CDM,RX-108132,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,69.65,45.27,,,0
CDM,RX-108133,"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",53.95,35.07,,,0
CDM,RX-10814,OXYCODONE 5 MG TABLET,8.7,5.66,,,0
CDM,RX-108150,HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,558.65,363.12,,,0
CDM,RX-108155,BACLOFEN 500 MCG/ML INTRATHECAL SOLUTION,763.7,496.4,,,0
CDM,RX-108156,"BACLOFEN 2,000 MCG/ML INTRATHECAL SOLUTION",2200.1,1430.06,,,0
CDM,RX-10839,PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,92.4,60.06,,,0
CDM,RX-108421,DASATINIB 80 MG TABLET,312.8,203.32,,,0
CDM,RX-108422,DASATINIB 140 MG TABLET,357.75,232.54,,,0
CDM,RX-10855,PAROXETINE 20 MG TABLET,4.75,3.09,,,0
CDM,RX-10856,PAROXETINE 30 MG TABLET,6.15,4.0,,,0
CDM,RX-108590,TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,267.0,173.55,,,0
CDM,RX-1088,BISMUTH SUBGALLATE (BULK) POWDER,61.4,39.91,,,0
CDM,RX-108842,BELIMUMAB 120 MG INTRAVENOUS SOLUTION,2767.8,1799.07,,,0
CDM,RX-108843,BELIMUMAB 400 MG INTRAVENOUS SOLUTION,9033.7,5871.9,,,0
CDM,RX-108850,"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",0.2,0.13,,,0
CDM,RX-10894,PENICILLAMINE 250 MG CAPSULE,761.25,494.81,,,0
CDM,RX-108955,IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,37642.05,24467.33,,,0
CDM,RX-108956,IPILIMUMAB 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION,150321.75,97709.14,,,0
CDM,RX-1090,BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION,2.05,1.33,,,0
CDM,RX-10900,PENICILLIN G POT 3 MILLION UNIT/50 ML-DEXTROSE INTRAVENOUS PIGGYBACK,72.4,47.06,,,0
CDM,RX-109034,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,53.8,34.97,,,0
CDM,RX-10910,PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,9884.1,6424.66,,,0
CDM,RX-109401,ROFLUMILAST 500 MCG TABLET,10.65,6.92,,,0
CDM,RX-109402,VILAZODONE 10 MG TABLET,39.75,25.84,,,0
CDM,RX-109403,VILAZODONE 20 MG TABLET,19.4,12.61,,,0
CDM,RX-10947,PHENTOLAMINE 5 MG INJECTION SOLUTION,1512.25,982.96,,,0
CDM,RX-109817,ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,261.8,170.17,,,0
CDM,RX-109909,RILPIVIRINE HCL 25 MG TABLET,147.5,95.88,,,0
CDM,RX-11018,PHENYTOIN 50 MG CHEWABLE TABLET,7.55,4.91,,,0
CDM,RX-11019,PHENYTOIN SODIUM EXTENDED 30 MG CAPSULE,8.95,5.82,,,0
CDM,RX-11023,PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,52.2,33.93,,,0
CDM,RX-11024,PHYTONADIONE (VITAMIN K1) 5 MG TABLET,157.6,102.44,,,0
CDM,RX-110250,RIVAROXABAN 10 MG TABLET,47.8,31.07,,,0
CDM,RX-110258,"AMIODARONE 360 MG/200 ML (1.8 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",122.45,79.59,,,0
CDM,RX-110306,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,1244.3,808.8,,,0
CDM,RX-110360,FIDAXOMICIN 200 MG TABLET,373.05,242.48,,,0
CDM,RX-110361,"VITAMIN E (DL, ACETATE) 450 MG (1,000 UNIT) CAPSULE",0.15,0.1,,,0
CDM,RX-110427,TICAGRELOR 90 MG TABLET,26.9,17.48,,,0
CDM,RX-11046,CALCIUM POLYCARBOPHIL 625 MG TABLET,0.55,0.36,,,0
CDM,RX-11050,POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,0.1,0.06,,,0
CDM,RX-11067,SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,7.4,4.81,,,0
CDM,RX-11074,POTASSIUM CHLORIDE 10 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,69.65,45.27,,,0
CDM,RX-110751,LEUPROLIDE ACETATE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT,4389.0,2852.85,,,0
CDM,RX-11076,POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,193.7,125.9,,,0
CDM,RX-11079,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,69.25,45.01,,,0
CDM,RX-11081,POTASSIUM CHLORIDE 20 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,71.35,46.38,,,0
CDM,RX-11082,POTASSIUM CHLORIDE 40 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,75.55,49.11,,,0
CDM,RX-11083,"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",10.7,6.96,,,0
CDM,RX-110998,OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,30.6,19.89,,,0
CDM,RX-11111,PRAVASTATIN 20 MG TABLET,5.85,3.8,,,0
CDM,RX-11112,PRAVASTATIN 40 MG TABLET,6.35,4.13,,,0
CDM,RX-111196,FERROUS GLUCONATE 324 MG (37.5 MG IRON) TABLET,0.05,0.03,,,0
CDM,RX-111216,IODINE-POTASSIUM IODIDE 5 %-10 % TOPICAL SOLUTION,56.85,36.95,,,0
CDM,RX-111273,EMTRICITABINE 200 MG-RILPIVIRINE 25 MG-TENOFOVIR DISPROX 300 MG TABLET,393.15,255.55,,,0
CDM,RX-11129,PRIMIDONE 50 MG TABLET,6.5,4.22,,,0
CDM,RX-111348,BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,52662.6,34230.69,,,0
CDM,RX-11138,PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,29.1,18.92,,,0
CDM,RX-111395,ICATIBANT 30 MG/3 ML SUBCUTANEOUS SYRINGE,6061.35,3939.88,,,0
CDM,RX-11143,PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,13.0,8.45,,,0
CDM,RX-111437,HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,4892.85,3180.35,,,0
CDM,RX-11144,PROMETHAZINE 25 MG RECTAL SUPPOSITORY,21.3,13.84,,,0
CDM,RX-11146,PROPAFENONE 150 MG TABLET,5.05,3.28,,,0
CDM,RX-11150,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,33.85,22.0,,,0
CDM,RX-112,ACETAZOLAMIDE 125 MG TABLET,5.3,3.44,,,0
CDM,RX-11218,PSYLLIUM HUSK 3.4 GRAM ORAL POWDER PACKET,0.45,0.29,,,0
CDM,RX-11237,PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,60.85,39.55,,,0
CDM,RX-11238,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,10.15,6.6,,,0
CDM,RX-11239,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,7.2,4.68,,,0
CDM,RX-11240,"PYRIDOSTIGMINE BROMIDE ER 180 MG TABLET,EXTENDED RELEASE",16.95,11.02,,,0
CDM,RX-112481,POLIDOCANOL 1 % (20 MG/2 ML) INTRAVENOUS SOLUTION,137.75,89.54,,,0
CDM,RX-11259,RAMIPRIL 10 MG CAPSULE,4.8,3.12,,,0
CDM,RX-11261,RAMIPRIL 5 MG CAPSULE,4.75,3.09,,,0
CDM,RX-112703,CLOBAZAM 10 MG TABLET,11.2,7.28,,,0
CDM,RX-112781,BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,1600.55,1040.36,,,0
CDM,RX-112787,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,126.05,81.93,,,0
CDM,RX-112788,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,191.4,124.41,,,0
CDM,RX-112834,RIVAROXABAN 15 MG TABLET,47.8,31.07,,,0
CDM,RX-112835,RIVAROXABAN 20 MG TABLET,47.8,31.07,,,0
CDM,RX-11287,RIBAVIRIN 200 MG TABLET,6.4,4.16,,,0
CDM,RX-11290,RIFABUTIN 150 MG CAPSULE,27.85,18.1,,,0
CDM,RX-11291,RIFAMPIN 600 MG INTRAVENOUS SOLUTION,634.3,412.3,,,0
CDM,RX-11292,RIFAMPIN 150 MG CAPSULE,11.9,7.74,,,0
CDM,RX-112936,RUXOLITINIB 5 MG TABLET,916.5,595.72,,,0
CDM,RX-112937,RUXOLITINIB 10 MG TABLET,916.5,595.72,,,0
CDM,RX-112938,RUXOLITINIB 15 MG TABLET,916.5,595.72,,,0
CDM,RX-112939,RUXOLITINIB 20 MG TABLET,916.5,595.72,,,0
CDM,RX-112940,RUXOLITINIB 25 MG TABLET,916.5,595.72,,,0
CDM,RX-113082,RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,10.4,6.76,,,0
CDM,RX-113088,"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",866.9,563.48,,,0
CDM,RX-11349,SENNOSIDES 8.6 MG TABLET,0.05,0.03,,,0
CDM,RX-11350,SERTRALINE 100 MG TABLET,5.45,3.54,,,0
CDM,RX-11351,SERTRALINE 50 MG TABLET,5.4,3.51,,,0
CDM,RX-11359,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,39.95,25.97,,,0
CDM,RX-11364,SIMVASTATIN 10 MG TABLET,5.05,3.28,,,0
CDM,RX-11365,SIMVASTATIN 20 MG TABLET,5.15,3.35,,,0
CDM,RX-11366,SIMVASTATIN 40 MG TABLET,4.95,3.22,,,0
CDM,RX-11368,SINCALIDE 5 MCG SOLUTION FOR INJECTION,417.85,271.6,,,0
CDM,RX-114,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,148.9,96.78,,,0
CDM,RX-11403,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,67.15,43.65,,,0
CDM,RX-114047,"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",10.55,6.86,,,0
CDM,RX-11421,SOTALOL 80 MG TABLET,7.35,4.78,,,0
CDM,RX-11425,SPIRONOLACTONE 100 MG TABLET,6.15,4.0,,,0
CDM,RX-11426,SPIRONOLACTONE 50 MG TABLET,5.2,3.38,,,0
CDM,RX-11441,SUCRALFATE 100 MG/ML ORAL SUSPENSION,16.2,10.53,,,0
CDM,RX-11500,TEMAZEPAM 7.5 MG CAPSULE,17.5,11.38,,,0
CDM,RX-11507,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,34.4,22.36,,,0
CDM,RX-11509,TERBUTALINE 5 MG TABLET,10.15,6.6,,,0
CDM,RX-11561,TIMOLOL MALEATE 0.25 % EYE DROPS,18.45,11.99,,,0
CDM,RX-11562,TIMOLOL MALEATE 0.5 % EYE DROPS,63.4,41.21,,,0
CDM,RX-11565,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,293.35,190.68,,,0
CDM,RX-11566,TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,1014.2,659.23,,,0
CDM,RX-11567,"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",57.7,37.5,,,0
CDM,RX-11573,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",43.6,28.34,,,0
CDM,RX-11574,TRANYLCYPROMINE 10 MG TABLET,7.55,4.91,,,0
CDM,RX-11584,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,35.75,23.24,,,0
CDM,RX-116024,"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",179416.9,116620.98,,,0
CDM,RX-116027,IVERMECTIN 0.5 % LOTION,571.9,371.74,,,0
CDM,RX-11624,URSODIOL 300 MG CAPSULE,12.95,8.42,,,0
CDM,RX-11627,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,1059.1,688.42,,,0
CDM,RX-11628,VANCOMYCIN 125 MG CAPSULE,10.4,6.76,,,0
CDM,RX-11634,VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,72.35,47.03,,,0
CDM,RX-116345,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,36.6,23.79,,,0
CDM,RX-11641,"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",357.55,232.41,,,0
CDM,RX-116596,PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,28374.15,18443.2,,,0
CDM,RX-11664,WARFARIN 1 MG TABLET,5.0,3.25,,,0
CDM,RX-116807,HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,37.25,24.21,,,0
CDM,RX-11691,ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,168.3,109.4,,,0
CDM,RX-11692,ZIDOVUDINE 100 MG CAPSULE,9.0,5.85,,,0
CDM,RX-11693,ZIDOVUDINE 10 MG/ML ORAL SYRUP,13.3,8.64,,,0
CDM,RX-11701,ZOLPIDEM 5 MG TABLET,8.6,5.59,,,0
CDM,RX-117032,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,128.65,83.62,,,0
CDM,RX-117047,CARFILZOMIB 60 MG INTRAVENOUS SOLUTION,14754.7,9590.56,,,0
CDM,RX-117293,ELVITEG 150 MG-COB 150 MG-EMTRICIT 200 MG-TENOFO DISOPRO 300 MG TABLET,452.5,294.12,,,0
CDM,RX-117352,LINACLOTIDE 145 MCG CAPSULE,59.3,38.54,,,0
CDM,RX-117353,LINACLOTIDE 290 MCG CAPSULE,59.3,38.54,,,0
CDM,RX-117592,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,88.4,57.46,,,0
CDM,RX-119001,"BCG VACCINE, LIVE (PF) 50 MG PERCUTANEOUS INJECTION SUSPENSION",785.85,510.8,,,0
CDM,RX-119007,"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",12.6,8.19,,,0
CDM,RX-119040,APIXABAN 2.5 MG TABLET,26.5,17.22,,,0
CDM,RX-119135,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,37.45,24.34,,,0
CDM,RX-119142,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,37.35,24.28,,,0
CDM,RX-119168,DARUNAVIR 800 MG TABLET,223.15,145.05,,,0
CDM,RX-119246,"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",11.3,7.34,,,0
CDM,RX-119248,"MORPHINE ER 100 MG TABLET,EXTENDED RELEASE",25.15,16.35,,,0
CDM,RX-11934,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,159.6,103.74,,,0
CDM,RX-119614,APIXABAN 5 MG TABLET,26.5,17.22,,,0
CDM,RX-120086,ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION,16631.5,10810.48,,,0
CDM,RX-120087,ADO-TRASTUZUMAB EMTANSINE 160 MG INTRAVENOUS SOLUTION,26561.05,17264.68,,,0
CDM,RX-12024,MECLIZINE 12.5 MG TABLET,5.55,3.61,,,0
CDM,RX-12025,MECLIZINE 25 MG TABLET,5.8,3.77,,,0
CDM,RX-12098,"THEOPHYLLINE ER 300 MG TABLET,EXTENDED RELEASE,12 HR",8.35,5.43,,,0
CDM,RX-121175,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,308.85,200.75,,,0
CDM,RX-121237,CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,177.05,115.08,,,0
CDM,RX-121241,IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,10.7,6.96,,,0
CDM,RX-121301,LIDOCAINE 4 % TOPICAL PATCH,1.05,0.68,,,0
CDM,RX-121407,"THEOPHYLLINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR",8.5,5.52,,,0
CDM,RX-121432,BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,47.8,31.07,,,0
CDM,RX-121502,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,9.05,5.88,,,0
CDM,RX-121731,SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,9.75,6.34,,,0
CDM,RX-121761,PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,80.0,52.0,,,0
CDM,RX-121784,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,36.55,23.76,,,0
CDM,RX-121787,DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),97.6,63.44,,,0
CDM,RX-121831,HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLUTION,43.45,28.24,,,0
CDM,RX-121872,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,52.85,34.35,,,0
CDM,RX-121891,"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SPRAY",698.95,454.32,,,0
CDM,RX-121929,BENZOCAINE 20 % TOPICAL AEROSOL,3.75,2.44,,,0
CDM,RX-121940,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,101.475,65.96,,,0
CDM,RX-12197,"QUINIDINE GLUCONATE ER 324 MG TABLET,EXTENDED RELEASE",21.45,13.94,,,0
CDM,RX-121981,"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",611.8,397.67,,,0
CDM,RX-122,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,25.65,16.67,,,0
CDM,RX-122018,HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,120.55,78.36,,,0
CDM,RX-122026,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,0.95,0.62,,,0
CDM,RX-12203,VENLAFAXINE 25 MG TABLET,7.35,4.78,,,0
CDM,RX-12204,VENLAFAXINE 50 MG TABLET,5.05,3.28,,,0
CDM,RX-12205,VENLAFAXINE 100 MG TABLET,5.2,3.38,,,0
CDM,RX-12206,VENLAFAXINE 75 MG TABLET,6.85,4.45,,,0
CDM,RX-12207,VENLAFAXINE 37.5 MG TABLET,6.15,4.0,,,0
CDM,RX-122106,MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,127.5,82.88,,,0
CDM,RX-12211,DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,411.05,267.18,,,0
CDM,RX-122159,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-30 MG RECTAL SUPPOSITORY,87.75,57.04,,,0
CDM,RX-122174,PHENYLEPHRINE 1 % NASAL SPRAY,23.65,15.37,,,0
CDM,RX-1222,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,34.25,22.26,,,0
CDM,RX-122262,"THEOPHYLLINE ER 600 MG TABLET,EXTENDED RELEASE 24 HR",10.2,6.63,,,0
CDM,RX-122267,DEXTROAMPHETAMINE-AMPHETAMINE 20 MG TABLET,9.05,5.88,,,0
CDM,RX-1223,BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,34.2,22.23,,,0
CDM,RX-122308,"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",28.4,18.46,,,0
CDM,RX-122454,DIAZEPAM 5 MG/ML ORAL CONCENTRATE,9.0,5.85,,,0
CDM,RX-122471,LIDOCAINE HCL 2 % MUCOSAL SOLUTION,10.75,6.99,,,0
CDM,RX-122552,MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,67.5,43.88,,,0
CDM,RX-122568,COAL TAR 1 % SHAMPOO,95.85,62.3,,,0
CDM,RX-122892,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,9.35,6.08,,,0
CDM,RX-123,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,20.5,13.32,,,0
CDM,RX-123669,HYDROMORPHONE 2 MG/ML INJECTION SYRINGE,42.55,27.66,,,0
CDM,RX-12370,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,77.65,50.47,,,0
CDM,RX-124096,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS PEN,123.2,80.08,,,0
CDM,RX-124681,PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE,559.6,363.74,,,0
CDM,RX-124729,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,74.0,48.1,,,0
CDM,RX-124737,LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,90.2,58.63,,,0
CDM,RX-124895,LORAZEPAM 2 MG/ML INJECTION SYRINGE,36.35,23.63,,,0
CDM,RX-124908,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,42.0,27.3,,,0
CDM,RX-12491,ESTRADIOL 0.5 MG TABLET,4.9,3.18,,,0
CDM,RX-124928,FENTANYL (PF) 50 MCG/ML INJECTION SYRINGE,37.75,24.54,,,0
CDM,RX-124935,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE,98.1,63.76,,,0
CDM,RX-124942,NALOXONE 0.4 MG/ML INJECTION SYRINGE,104.5,67.92,,,0
CDM,RX-12519,PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,109863.6,71411.34,,,0
CDM,RX-125366,INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN,104.6,67.99,,,0
CDM,RX-12556,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,1.0,0.65,,,0
CDM,RX-12580,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,5.35,3.48,,,0
CDM,RX-1259,CAFFEINE 200 MG TABLET,0.05,0.03,,,0
CDM,RX-125923,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,70.1,45.56,,,0
CDM,RX-125938,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,34.85,22.65,,,0
CDM,RX-1262,CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,112.85,73.35,,,0
CDM,RX-126678,GENTAMICIN 120 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,69.25,45.01,,,0
CDM,RX-126797,"BACITRACIN ZINC 500 UNIT-POLYMYXIN B 10,000 UNIT/GRAM TOPICAL OINTMENT",3.2,2.08,,,0
CDM,RX-12724,TERBINAFINE HCL 250 MG TABLET,5.35,3.48,,,0
CDM,RX-127257,ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,6.05,3.93,,,0
CDM,RX-127625,OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,143.7,93.4,,,0
CDM,RX-127631,CEFAZOLIN 2 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS SOLUTION,114.5,74.42,,,0
CDM,RX-127668,HALOPERIDOL LACTATE 5 MG/ML INTRAMUSCULAR SYRINGE,37.55,24.41,,,0
CDM,RX-127673,SENNA LEAF EXTRACT 176 MG/5 ML ORAL SYRUP,7.35,4.78,,,0
CDM,RX-127698,SODIUM CHLORIDE-ALOE VERA NASAL GEL,18.75,12.19,,,0
CDM,RX-127778,PHENOL 89 % TOPICAL SWAB,17.75,11.54,,,0
CDM,RX-127851,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,96.6,62.79,,,0
CDM,RX-127883,"VITAMIN E (DL, ACETATE) 45 MG (100 UNIT) CAPSULE",0.05,0.03,,,0
CDM,RX-127974,MULTIVITAMIN-MINERALS-FOLIC ACID-LUTEIN 0.4 MG-250 MCG TABLET,4.95,3.22,,,0
CDM,RX-128022,MEPERIDINE (PF) 25 MG/ML INJECTION SYRINGE,62.2,40.43,,,0
CDM,RX-128032,CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,0.1,0.06,,,0
CDM,RX-128039,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,71.67500000000001,46.59,,,0
CDM,RX-128040,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,70.95,46.12,,,0
CDM,RX-128067,BCG LIVE 50 MG INTRAVESICAL SUSPENSION,783.45,509.24,,,0
CDM,RX-128087,PORACTANT ALFA 240 MG/3 ML INTRATRACHEAL SUSPENSION,3365.7,2187.7,,,0
CDM,RX-128157,"ANTI-INHIBITOR COAGULANT COMPLX 1,750 UNIT-3,250 UNIT INTRAVENOUS SOLN",21652.2,14073.93,,,0
CDM,RX-128178,"HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJECTION SOLUTION",57.5,37.38,,,0
CDM,RX-128277,LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,40.15,26.1,,,0
CDM,RX-128535,METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM,2.55,1.66,,,0
CDM,RX-128574,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,38.05,24.73,,,0
CDM,RX-12858,CADEXOMER IODINE 0.9 % TOPICAL GEL,52.7,34.26,,,0
CDM,RX-128662,HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) INTRAMUSCULAR SOLUTION,3360.3,2184.2,,,0
CDM,RX-128663,HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,418.2,271.83,,,0
CDM,RX-128822,HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE,168.75,109.69,,,0
CDM,RX-129043,HYDROMORPHONE (PF) 2 MG/ML INJECTION SYRINGE,39.65,25.77,,,0
CDM,RX-12933,"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",7.35,4.78,,,0
CDM,RX-129339,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,42.55,27.66,,,0
CDM,RX-12934,"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",9.25,6.01,,,0
CDM,RX-12935,TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,1276.5,829.72,,,0
CDM,RX-129393,"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",165.4,107.51,,,0
CDM,RX-129448,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,34.2,22.23,,,0
CDM,RX-129504,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,72.2,46.93,,,0
CDM,RX-129578,MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,73.45,47.74,,,0
CDM,RX-129579,"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",79.7,51.8,,,0
CDM,RX-129648,"DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP",144.05,93.63,,,0
CDM,RX-129705,PHENYTOIN 100 MG/4 ML ORAL SUSPENSION,20.6,13.39,,,0
CDM,RX-129747,HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION,365.5,237.58,,,0
CDM,RX-129749,HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,134.95,87.72,,,0
CDM,RX-129774,TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,2716.7,1765.86,,,0
CDM,RX-129897,"HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV",75.55,49.11,,,0
CDM,RX-1299,"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",8.3,5.4,,,0
CDM,RX-129903,WHITE PETROLATUM-MINERAL OIL 94 %-3 % EYE OINTMENT,27.75,18.04,,,0
CDM,RX-129965,SALIVA STIMULANT COMBINATION NO.3 ORAL MUCOSAL SPRAY,30.35,19.73,,,0
CDM,RX-129971,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,28.05,18.23,,,0
CDM,RX-129974,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,122.6,79.69,,,0
CDM,RX-1300,"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",0.05,0.03,,,0
CDM,RX-130004,DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,116.75,75.89,,,0
CDM,RX-130005,DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION,105.25,68.41,,,0
CDM,RX-130088,DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,42.95,27.92,,,0
CDM,RX-130165,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,62.15,40.4,,,0
CDM,RX-130186,FENTANYL (PF) 100 MCG/2 ML (50 MCG/ML) INTRAVENOUS SYRINGE,37.1,24.12,,,0
CDM,RX-130190,LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLUTION,10.5,6.82,,,0
CDM,RX-130249,METHYL SALICYLATE 10 %-MENTHOL 3 % TOPICAL PATCH,1.2,0.78,,,0
CDM,RX-130445,COMPOUNDING VEHICLE SUGAR-FREE NO.9 ORAL LIQUID,76.0,49.4,,,0
CDM,RX-130472,THYROID (PORK) 30 MG TABLET,6.6,4.29,,,0
CDM,RX-130473,THYROID (PORK) 60 MG TABLET,6.85,4.45,,,0
CDM,RX-1306,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,51.45,33.44,,,0
CDM,RX-130647,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION,0.65,0.42,,,0
CDM,RX-13073,"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",5.3,3.44,,,0
CDM,RX-130755,METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,56.65,36.82,,,0
CDM,RX-130756,METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,70.65,45.92,,,0
CDM,RX-130757,METHYLPREDNISOLONE SOD SUCC (PF) 500 MG/4 ML INTRAVENOUS SOLUTION,251.15,163.25,,,0
CDM,RX-130758,"METHYLPREDNISOLONE SOD SUCC (PF) 1,000 MG/8 ML INTRAVENOUS SOLUTION",316.7,205.86,,,0
CDM,RX-1308,CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,0.05,0.03,,,0
CDM,RX-130805,ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,22.95,14.92,,,0
CDM,RX-130841,FENTANYL (PF) 300 MCG/30 ML (10 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE,35.0,22.75,,,0
CDM,RX-130864,HYDROMORPHONE (PF) 0.2 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLN,55.05,35.78,,,0
CDM,RX-13089,LISINOPRIL 2.5 MG TABLET,4.7,3.06,,,0
CDM,RX-130942,HYDROCORTISONE SOD SUCCINATE (PF) 500 MG/4 ML SOLUTION FOR INJECTION,437.3,284.24,,,0
CDM,RX-130943,HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,238.3,154.9,,,0
CDM,RX-130944,HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,132.05,85.83,,,0
CDM,RX-131038,PRENATAL VITAMINS WITH CALCIUM NO.72-IRON 27 MG-FOLIC ACID 1 MG TABLET,0.1,0.06,,,0
CDM,RX-131039,VANCOMYCIN 1.25 GRAM/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,90.2,58.63,,,0
CDM,RX-131041,VANCOMYCIN 1.75 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,98.6,64.09,,,0
CDM,RX-131042,VANCOMYCIN 2 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,102.75,66.79,,,0
CDM,RX-131067,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,35.45,23.04,,,0
CDM,RX-131069,SUCCINYLCHOLINE CHLORIDE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SYRINGE,40.95,26.62,,,0
CDM,RX-131124,THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,0.2,0.13,,,0
CDM,RX-131187,BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,70.55,45.86,,,0
CDM,RX-13133,VALACYCLOVIR 500 MG TABLET,8.45,5.49,,,0
CDM,RX-131337,IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,1469.15,954.95,,,0
CDM,RX-131338,IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,2879.5,1871.68,,,0
CDM,RX-131339,IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,5700.2,3705.13,,,0
CDM,RX-131353,"DILTIAZEM HCL 125 MG/125 ML (1 MG/ML) IN SOD CHLORIDE,ISO-OSM IV SOLN",142.55,92.66,,,0
CDM,RX-131372,TETRACAINE HCL (PF) 0.5 % EYE DROPS,59.65,38.77,,,0
CDM,RX-131390,POTASSIUM PHOSPHATE 15 MMOL/250 ML IN 0.9 % SODIUM CHLORIDE IV SOLN,3133.8,2036.97,,,0
CDM,RX-131439,"SODIUM BICARBONATE 150 MEQ/1,000 ML IN DEXTROSE 5 % INTRAVENOUS",134.2,87.23,,,0
CDM,RX-131557,OCTREOTIDE ACETATE 100 MCG/ML (1 ML) INJECTION SYRINGE,57.25,37.21,,,0
CDM,RX-131616,LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,799.9,519.94,,,0
CDM,RX-131803,HYDROMORPHONE 15 MG/30 ML (0.5 MG/ML) IN 0.9 % NACL IV PCA SYRINGE,111.8,72.67,,,0
CDM,RX-13184,"VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE",6.35,4.13,,,0
CDM,RX-131883,MULTIVITAMIN-MINERAL-FOLIC ACID 400 MCG-LUTEIN 250 MCG CHEWABLE TABLET,0.2,0.13,,,0
CDM,RX-131987,NOREPINEPHRINE BITARTRATE 16 MG/250 ML (64 MCG/ML) IN 0.9 % NACL IV,69.25,45.01,,,0
CDM,RX-132015,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,54.35,35.33,,,0
CDM,RX-132049,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,8.6,5.59,,,0
CDM,RX-132058,VALPROIC ACID (AS SODIUM SALT) 500 MG/10 ML (10 ML) ORAL SOLUTION,8.0,5.2,,,0
CDM,RX-132075,MORPHINE (PF) 2 MG/2 ML(1 MG/ML) IN 0.9% SODIUM CHLORIDE IV SYRINGE,46.8,30.42,,,0
CDM,RX-132167,METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SYRINGE,558.25,362.86,,,0
CDM,RX-132172,"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",147.0,95.55,,,0
CDM,RX-132288,ISOFLURANE 99.9 % INHALATION LIQUID,68.1,44.26,,,0
CDM,RX-132321,MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,77.65,50.47,,,0
CDM,RX-132326,MORPHINE (PF) 2 MG/2 ML (1 MG/ML) IN 0.9% SODIUM CHLORIDE INJ SYRINGE,44.85,29.15,,,0
CDM,RX-132405,"HEPARIN (PORCINE) 5,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV SOLN",63.1,41.02,,,0
CDM,RX-132437,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) INTRAVENOUS SOLUTION,18255.05,11865.78,,,0
CDM,RX-132533,HEPATITIS B VIRUS VACCINE RECMB(PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE,134.95,87.72,,,0
CDM,RX-132556,"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SPRAY SYRINGE",178.75,116.19,,,0
CDM,RX-132557,"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SPRAY SYRINGE",698.95,454.32,,,0
CDM,RX-132558,"THROMBIN (BOVINE) 5,000 UNIT NASAL SPRAY SYRINGE",191.65,124.57,,,0
CDM,RX-132720,GABAPENTIN 300 MG/6 ML (6 ML) ORAL SOLUTION,15.45,10.04,,,0
CDM,RX-132783,EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,113.95,74.07,,,0
CDM,RX-132830,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLUTION,32.2,20.93,,,0
CDM,RX-132918,MULTIVIT-MINS-FERROUS GLUCONATE 9 MG IRON/15 ML (15 ML) ORAL LIQUID,1.95,1.27,,,0
CDM,RX-133072,LIDOCAINE 4 %-EPINEPHRINE 0.18 %-TETRACAINE 0.5 % TOPICAL SOLUTION KIT,13.0,8.45,,,0
CDM,RX-13369,SUMATRIPTAN 100 MG TABLET,10.0,6.5,,,0
CDM,RX-1350,CAPSAICIN 0.025 % TOPICAL CREAM,21.2,13.78,,,0
CDM,RX-1355,CARBAMAZEPINE 100 MG CHEWABLE TABLET,5.75,3.74,,,0
CDM,RX-1356,CARBAMAZEPINE 200 MG/10 ML ORAL SUSPENSION,282.3,183.5,,,0
CDM,RX-1357,CARBAMAZEPINE 200 MG TABLET,5.75,3.74,,,0
CDM,RX-13691,LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,7383.5,4799.28,,,0
CDM,RX-13818,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,1.15,0.75,,,0
CDM,RX-1395,CARISOPRODOL 350 MG TABLET,4.8,3.12,,,0
CDM,RX-13981,LAMOTRIGINE 25 MG TABLET,5.1,3.32,,,0
CDM,RX-13982,LAMOTRIGINE 100 MG TABLET,5.1,3.32,,,0
CDM,RX-14087,ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET,9.95,6.47,,,0
CDM,RX-14132,KETOCONAZOLE 2 % SHAMPOO,64.45,41.89,,,0
CDM,RX-14203,VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,112.9,73.38,,,0
CDM,RX-14232,FLUCONAZOLE 10 MG/ML ORAL SUSPENSION,14.05,9.13,,,0
CDM,RX-14233,FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,8.9,5.78,,,0
CDM,RX-14266,LAMOTRIGINE 150 MG TABLET,5.6,3.64,,,0
CDM,RX-1445,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,35.75,23.24,,,0
CDM,RX-1446,CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,52.9,34.38,,,0
CDM,RX-14471,DORZOLAMIDE 2 % EYE DROPS,139.7,90.8,,,0
CDM,RX-1448,CEFAZOLIN 500 MG SOLUTION FOR INJECTION,38.85,25.25,,,0
CDM,RX-14626,"VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE",5.55,3.61,,,0
CDM,RX-14632,TRAMADOL 50 MG TABLET,8.65,5.62,,,0
CDM,RX-14643,"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",1440.35,936.23,,,0
CDM,RX-14702,ACETIC ACID (BULK) 5 % LIQUID,57.65,37.474999999999994,,,0
CDM,RX-14719,METFORMIN 850 MG TABLET,5.15,3.35,,,0
CDM,RX-14792,TIZANIDINE 2 MG TABLET,6.4,4.16,,,0
CDM,RX-14793,TIZANIDINE 4 MG TABLET,4.8,3.12,,,0
CDM,RX-14823,LOSARTAN 25 MG TABLET,5.6,3.64,,,0
CDM,RX-14824,LOSARTAN 50 MG TABLET,5.4,3.51,,,0
CDM,RX-14825,FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACKET,204.9,133.18,,,0
CDM,RX-14845,"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",99.65,64.77,,,0
CDM,RX-14847,DOXYLAMINE SUCCINATE 25 MG TABLET,0.05,0.03,,,0
CDM,RX-14868,LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,75.55,49.11,,,0
CDM,RX-14870,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",33.15,21.55,,,0
CDM,RX-14953,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,29.95,19.47,,,0
CDM,RX-14979,"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",42.15,27.4,,,0
CDM,RX-14983,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",37.05,24.08,,,0
CDM,RX-15065,FAMOTIDINE 10 MG TABLET,5.55,3.61,,,0
CDM,RX-15113,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,5.9,3.84,,,0
CDM,RX-15119,SEVOFLURANE 99.97 % INHALATION LIQUID,269.45,175.14,,,0
CDM,RX-15327,SUMATRIPTAN 25 MG TABLET,5.6,3.64,,,0
CDM,RX-15328,SUMATRIPTAN 50 MG TABLET,6.15,4.0,,,0
CDM,RX-15370,LEUCOVORIN CALCIUM 10 MG/ML INJECTION SOLUTION,114.9,74.68,,,0
CDM,RX-15426,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,108.0,70.2,,,0
CDM,RX-1562,CHERRY FLAVOR (BULK) ORAL LIQUID,39.3,25.54,,,0
CDM,RX-15706,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,11.5,7.48,,,0
CDM,RX-15723,SOTALOL 120 MG TABLET,5.25,3.41,,,0
CDM,RX-15738,CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,297.3,193.24,,,0
CDM,RX-15746,BICALUTAMIDE 50 MG TABLET,5.75,3.74,,,0
CDM,RX-15747,CARVEDILOL 6.25 MG TABLET,4.9,3.18,,,0
CDM,RX-15748,CARVEDILOL 25 MG TABLET,4.85,3.15,,,0
CDM,RX-15749,CARVEDILOL 12.5 MG TABLET,4.85,3.15,,,0
CDM,RX-15797,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,12.85,8.35,,,0
CDM,RX-15847,"HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV",77.65,50.47,,,0
CDM,RX-15848,"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",63.15,41.05,,,0
CDM,RX-15849,"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",92.3,60.0,,,0
CDM,RX-15852,MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,42.65,27.72,,,0
CDM,RX-15859,NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,127.9,83.14,,,0
CDM,RX-15880,LAMIVUDINE 150 MG TABLET,18.5,12.02,,,0
CDM,RX-15881,LAMIVUDINE 10 MG/ML ORAL SOLUTION,11.15,7.25,,,0
CDM,RX-15895,ACARBOSE 50 MG TABLET,5.1,3.32,,,0
CDM,RX-15950,SODIUM HYPOCHLORITE 0.25 % SOLUTION,58.15,37.8,,,0
CDM,RX-15956,"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",36.15,23.5,,,0
CDM,RX-15985,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",34.9,22.68,,,0
CDM,RX-15996,METHADONE 10 MG/ML ORAL CONCENTRATE,9.3,6.04,,,0
CDM,RX-16005,TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,66.1,42.96,,,0
CDM,RX-16014,POTASSIUM CHLORIDE 20 MEQ/L-LACTATED RINGERS-5 % DEXTROSE INTRAVENOUS,75.55,49.11,,,0
CDM,RX-16050,GLUCOSE 4 GRAM CHEWABLE TABLET,5.25,3.41,,,0
CDM,RX-16053,DESMOPRESSIN 0.2 MG TABLET,10.3,6.7,,,0
CDM,RX-16124,RILUZOLE 50 MG TABLET,6.3,4.1,,,0
CDM,RX-16162,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,64.65,42.02,,,0
CDM,RX-16169,CISATRACURIUM CONCENTRATE 10 MG/ML (ICU USE ONLY) INTRAVENOUS SOLUTION,1470.55,955.86,,,0
CDM,RX-16205,ANASTROZOLE 1 MG TABLET,6.95,4.52,,,0
CDM,RX-16218,CALCITRIOL 1 MCG/ML ORAL SOLUTION,8.4,5.46,,,0
CDM,RX-16254,GOSERELIN 10.8 MG SUBCUTANEOUS IMPLANT,15618.1,10151.76,,,0
CDM,RX-16299,DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,1.55,1.01,,,0
CDM,RX-1635,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,131.5,85.48,,,0
CDM,RX-16356,GLIMEPIRIDE 2 MG TABLET,5.75,3.74,,,0
CDM,RX-16369,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,49.15,31.95,,,0
CDM,RX-16371,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,98.45,63.99,,,0
CDM,RX-164645,SODIUM GLYCEROPHOSPHATE 1 MMOL/ML INTRAVENOUS SOLUTION,86.15,56.0,,,0
CDM,RX-164705,CANAGLIFLOZIN 100 MG TABLET,62.25,40.46,,,0
CDM,RX-164706,CANAGLIFLOZIN 300 MG TABLET,62.25,40.46,,,0
CDM,RX-164749,"DESVENLAFAXINE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",15.95,10.37,,,0
CDM,RX-164810,DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,98.15,63.8,,,0
CDM,RX-164812,DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,118.25,76.86,,,0
CDM,RX-164827,TRACE ELEMENTS #1 5.33 MCG-0.34 MG-0.54 MG/ML INTRAVENOUS SOLUTION,100.25,65.16,,,0
CDM,RX-164887,CARBOXYMETHYL 0.5 %-GLYCERIN 1 %-POLYSORB 80 0.5 %-PF EYE DROPPERETTE,5.8,3.77,,,0
CDM,RX-1649,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,160.2,104.13,,,0
CDM,RX-165024,FLUTICASONE FUROATE 100 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER,24.25,15.76,,,0
CDM,RX-165106,DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,13.2,8.58,,,0
CDM,RX-165151,CEFIXIME 400 MG CAPSULE,39.3,25.54,,,0
CDM,RX-165188,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INTRAVENOUS SOLUTION,42.2,27.43,,,0
CDM,RX-165189,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,42.2,27.43,,,0
CDM,RX-165225,"LIPASE-PROTEASE-AMYLASE (PORK)36,000-114,000-180K UNIT CAPSULE,DEL REL",41.95,27.27,,,0
CDM,RX-1653,CHLORPROMAZINE 10 MG TABLET,11.6,7.54,,,0
CDM,RX-165368,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,90.85,59.05,,,0
CDM,RX-1654,CHLORPROMAZINE 100 MG TABLET,21.65,14.07,,,0
CDM,RX-165471,PSYLLIUM HUSK 6 GRAM ORAL POWDER PACKET,0.45,0.29,,,0
CDM,RX-165473,FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,5193.6,3375.84,,,0
CDM,RX-1656,CHLORPROMAZINE 25 MG TABLET,13.6,8.84,,,0
CDM,RX-1661,CHLORTHALIDONE 25 MG TABLET,9.75,6.34,,,0
CDM,RX-16632,PAROXETINE 10 MG TABLET,4.7,3.06,,,0
CDM,RX-16633,PAROXETINE 40 MG TABLET,4.85,3.15,,,0
CDM,RX-166481,ETHIODIZED OIL 480 MG IODINE/ML FOR INJECTION,6098.55,3964.06,,,0
CDM,RX-166500,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,37.35,24.28,,,0
CDM,RX-166501,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,34.0,22.1,,,0
CDM,RX-166510,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,151.35,98.38,,,0
CDM,RX-166519,COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,4370.0,2840.5,,,0
CDM,RX-166520,"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",8707.05,5659.58,,,0
CDM,RX-166521,"COAGULATION FACTOR IX (RECOMB) 2,000 UNIT INTRAVENOUS SOLUTION",17381.1,11297.72,,,0
CDM,RX-166522,"COAGULATION FACTOR IX (RECOMB) 3,000 UNIT INTRAVENOUS SOLUTION",26055.25,16935.91,,,0
CDM,RX-166524,COPPER 380 SQUARE MM INTRAUTERINE DEVICE,3377.45,2195.34,,,0
CDM,RX-166571,PHENYLEPHRINE 0.25 %-MINERAL OIL 14 %-PETROLATM 74.9 % RECTAL OINTMENT,16.05,10.43,,,0
CDM,RX-166611,DOLUTEGRAVIR 50 MG TABLET,240.1,156.06,,,0
CDM,RX-166882,VORTIOXETINE 10 MG TABLET,54.15,35.2,,,0
CDM,RX-166883,VORTIOXETINE 20 MG TABLET,54.15,35.2,,,0
CDM,RX-166909,RIOCIGUAT 0.5 MG TABLET,496.9,322.98,,,0
CDM,RX-166910,RIOCIGUAT 1 MG TABLET,496.9,322.98,,,0
CDM,RX-166913,RIOCIGUAT 2.5 MG TABLET,434.2,282.23,,,0
CDM,RX-166988,MACITENTAN 10 MG TABLET,1254.95,815.72,,,0
CDM,RX-167037,"OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION",37416.15,24320.5,,,0
CDM,RX-167070,WHITE PETROLATUM 42 % TOPICAL OINTMENT,7.75,5.04,,,0
CDM,RX-167100,PHENYLEPHRINE 0.25 %-COCOA BUTTER 88.44 % RECTAL SUPPOSITORY,5.2,3.38,,,0
CDM,RX-167157,"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",64.55,41.96,,,0
CDM,RX-167178,POLIDOCANOL 1 % INTRAVENOUS FOAM,1822.1,1184.36,,,0
CDM,RX-167214,PERAMPANEL 2 MG TABLET,73.75,47.94,,,0
CDM,RX-167216,PERAMPANEL 6 MG TABLET,165.9,107.84,,,0
CDM,RX-167236,"TREPROSTINIL DIOLAMINE ER 1 MG TABLET,EXTENDED RELEASE",204.15,132.7,,,0
CDM,RX-167286,UMECLIDINIUM 62.5 MCG-VILANTEROL 25 MCG/ACTUATION POWDR FOR INHALATION,28.15,18.3,,,0
CDM,RX-167304,DAPAGLIFLOZIN PROPANEDIOL 5 MG TABLET,41.05,26.68,,,0
CDM,RX-167305,DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,52.0,33.8,,,0
CDM,RX-167359,GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRINGE,537.25,349.21,,,0
CDM,RX-167443,ESLICARBAZEPINE 200 MG TABLET,9.8,6.37,,,0
CDM,RX-167445,ESLICARBAZEPINE 400 MG TABLET,10.65,6.92,,,0
CDM,RX-167524,MORPHINE 4 MG/ML INTRAVENOUS SYRINGE,40.55,26.36,,,0
CDM,RX-167557,POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,412.8,268.32,,,0
CDM,RX-167769,RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,6307.55,4099.91,,,0
CDM,RX-16830,MELATONIN 3 MG TABLET,0.15,0.1,,,0
CDM,RX-169090,CYCLOPHOSPHAMIDE 50 MG CAPSULE,46.0,29.9,,,0
CDM,RX-169092,"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",0.7,0.46,,,0
CDM,RX-169186,"HUMAN PROTHROMBIN COMPLEX,4-FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION",3711.7,2412.6,,,0
CDM,RX-169212,VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION,46735.2,30377.88,,,0
CDM,RX-169346,"HUM PROTHROMBIN CPLX, 4-FACTOR 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",7341.25,4771.81,,,0
CDM,RX-169803,BELINOSTAT 500 MG INTRAVENOUS SOLUTION,10577.95,6875.67,,,0
CDM,RX-169891,DANTROLENE 250 MG INTRAVENOUS SUSPENSION,10363.1,6736.02,,,0
CDM,RX-170138,DROXIDOPA 100 MG CAPSULE,7.85,5.1,,,0
CDM,RX-170209,EMPAGLIFLOZIN 25 MG TABLET,52.8,34.32,,,0
CDM,RX-170210,EMPAGLIFLOZIN 10 MG TABLET,52.8,34.32,,,0
CDM,RX-17023,HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,4.95,3.22,,,0
CDM,RX-170545,GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRINGE,1189.25,773.01,,,0
CDM,RX-170551,BUPRENORPHINE 7.5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,158.95,103.32,,,0
CDM,RX-170552,OXYCHLOROSENE SODIUM TOPICAL POWDER FOR SOLUTION,21.2,13.78,,,0
CDM,RX-170575,ORITAVANCIN 400 MG INTRAVENOUS SOLUTION,5405.15,3513.35,,,0
CDM,RX-170653,FERRIC CITRATE 210 MG IRON TABLET,24.0,15.6,,,0
CDM,RX-170715,DULAGLUTIDE 0.75 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,717.65,466.47,,,0
CDM,RX-170716,DULAGLUTIDE 1.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1430.7,929.96,,,0
CDM,RX-170958,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION MIST FOR INHALATION,143.6,93.34,,,0
CDM,RX-170978,COBICISTAT 150 MG TABLET,34.95,22.72,,,0
CDM,RX-171003,COLCHICINE 0.6 MG CAPSULE,17.5,11.38,,,0
CDM,RX-171117,IMMUNE GLOB G 40 GRAM/400 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,11341.6,7372.04,,,0
CDM,RX-17121,GEMCITABINE 200 MG INTRAVENOUS SOLUTION,123.45,80.24,,,0
CDM,RX-171371,VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,45.75,29.74,,,0
CDM,RX-171407,ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,116350.05,75627.53,,,0
CDM,RX-171532,PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,1568.4,1019.46,,,0
CDM,RX-171549,FLUTICASONE FUROATE 100 MCG/ACTUATION BLISTER POWDER FOR INHALATION,276.45,179.69,,,0
CDM,RX-171615,BLINATUMOMAB 35 MCG INTRAVENOUS KIT,23132.15,15035.9,,,0
CDM,RX-171680,CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,841.45,546.94,,,0
CDM,RX-171700,NIVOLUMAB 40 MG/4 ML INTRAVENOUS SOLUTION,5573.55,3622.81,,,0
CDM,RX-171701,NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,13810.65,8976.92,,,0
CDM,RX-171927,"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",1078.05,700.73,,,0
CDM,RX-171929,"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",26.6,17.29,,,0
CDM,RX-171930,"OXYCODONE ER 15 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",35.3,22.94,,,0
CDM,RX-171931,"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",42.5,27.62,,,0
CDM,RX-171933,"OXYCODONE ER 40 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",66.85,43.45,,,0
CDM,RX-172035,"CARBIDOPA ER 23.75 MG-LEVODOPA 95 MG CAPSULE,EXTENDED RELEASE",16.65,10.82,,,0
CDM,RX-172036,"CARBIDOPA ER 36.25 MG-LEVODOPA 145 MG CAPSULE,EXTENDED RELEASE",16.65,10.82,,,0
CDM,RX-172037,"CARBIDOPA ER 48.75 MG-LEVODOPA 195 MG CAPSULE,EXTENDED RELEASE",16.65,10.82,,,0
CDM,RX-172038,"CARBIDOPA ER 61.25 MG-LEVODOPA 245 MG CAPSULE,EXTENDED RELEASE",19.7,12.8,,,0
CDM,RX-172050,PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR,15393.0,10005.45,,,0
CDM,RX-172073,NALOXEGOL 12.5 MG TABLET,46.65,30.32,,,0
CDM,RX-172074,NALOXEGOL 25 MG TABLET,46.65,30.32,,,0
CDM,RX-172084,PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,25035.75,16273.24,,,0
CDM,RX-172605,DEXTROSE 15 GRAM/33 GRAM ORAL GEL PACKET,15.4,10.01,,,0
CDM,RX-172616,ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,338.95,220.32,,,0
CDM,RX-17280,SELEGILINE 5 MG CAPSULE,6.05,3.93,,,0
CDM,RX-17285,TOPOTECAN 4 MG INTRAVENOUS SOLUTION,192.5,125.12,,,0
CDM,RX-172896,IVABRADINE 5 MG TABLET,6.8,4.42,,,0
CDM,RX-172899,"OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",22317.85,14506.6,,,0
CDM,RX-172900,"OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",33402.85,21711.85,,,0
CDM,RX-172901,"OCTREOTIDE,MICROSPHERES ER 10 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",17042.1,11077.36,,,0
CDM,RX-172906,FLUTICASONE FUROATE 200 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER,24.25,15.76,,,0
CDM,RX-172920,CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,1862.8,1210.82,,,0
CDM,RX-172923,"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",1540.35,1001.23,,,0
CDM,RX-172924,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",4538.725,2950.17,,,0
CDM,RX-172950,LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,1786.05,1160.93,,,0
CDM,RX-173114,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,605.05,393.28,,,0
CDM,RX-173168,CEFAZOLIN 3 GRAM/100 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,71.15,46.25,,,0
CDM,RX-17378,CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,2351.6,1528.54,,,0
CDM,RX-17379,MEROPENEM 500 MG INTRAVENOUS SOLUTION,44.75,29.09,,,0
CDM,RX-17380,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,53.8,34.97,,,0
CDM,RX-173832,"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",6452.65,4194.22,,,0
CDM,RX-173855,CANGRELOR 50 MG INTRAVENOUS SOLUTION,4666.5,3033.22,,,0
CDM,RX-17387,AZITHROMYCIN 600 MG TABLET,9.85,6.4,,,0
CDM,RX-173925,SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,38.6,25.09,,,0
CDM,RX-173926,SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,38.6,25.09,,,0
CDM,RX-173927,SACUBITRIL 97 MG-VALSARTAN 103 MG TABLET,38.6,25.09,,,0
CDM,RX-173951,BREXPIPRAZOLE 0.5 MG TABLET,150.6,97.89,,,0
CDM,RX-173952,BREXPIPRAZOLE 1 MG TABLET,150.6,97.89,,,0
CDM,RX-173953,BREXPIPRAZOLE 2 MG TABLET,150.6,97.89,,,0
CDM,RX-1740,CLINDAMYCIN HCL 150 MG CAPSULE,5.2,3.38,,,0
CDM,RX-17403,NEVIRAPINE 200 MG TABLET,5.0,3.25,,,0
CDM,RX-17405,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,90.35,58.73,,,0
CDM,RX-1742,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,42.8,27.82,,,0
CDM,RX-17451,ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,738.8,480.22,,,0
CDM,RX-17465,MIRTAZAPINE 30 MG TABLET,5.1,3.32,,,0
CDM,RX-17466,MIRTAZAPINE 15 MG TABLET,5.05,3.28,,,0
CDM,RX-174718,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,1370.8,891.02,,,0
CDM,RX-174719,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,1370.8,891.02,,,0
CDM,RX-174797,TICAGRELOR 60 MG TABLET,26.9,17.48,,,0
CDM,RX-175177,TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,15385.85,10000.8,,,0
CDM,RX-175182,MEROPENEM 500 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,103.25,67.11,,,0
CDM,RX-175183,MEROPENEM 1 GRAM/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,118.9,77.28,,,0
CDM,RX-175186,ROLAPITANT 90 MG TABLET,1034.8,672.62,,,0
CDM,RX-175213,MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,43.9,28.54,,,0
CDM,RX-175244,"ARIPIPRAZOLE LAUROXIL ER 662 MG/2.4 ML SUSPENSION, EXT.REL. IM SYRINGE",11108.3,7220.4,,,0
CDM,RX-175245,"ARIPIPRAZOLE LAUROXIL ER 441 MG/1.6 ML SUSPENSION, EXT.REL. IM SYRINGE",7410.9,4817.08,,,0
CDM,RX-175246,"ARIPIPRAZOLE LAUROXIL ER 882 MG/3.2 ML SUSPENSION, EXT.REL. IM SYRINGE",14788.8,9612.72,,,0
CDM,RX-175296,PHENYLEPHRINE 50 MG/250 ML (200 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,150.95,98.12,,,0
CDM,RX-175313,MIDAZOLAM (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,108.65,70.62,,,0
CDM,RX-175328,IDARUCIZUMAB 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,12698.7,8254.16,,,0
CDM,RX-175346,IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS,12746.2,8285.03,,,0
CDM,RX-175367,TALIMOGENE LAHERPAREPVEC 10EXP6 (1 MILLION) PFU/ML SUSP FOR INJECTION,374.85,243.65,,,0
CDM,RX-175368,TALIMOGENE LAHERPAREPVEC 10EXP8 (100 MILLION)PFU/ML SUSP FOR INJECTION,29352.55,19079.16,,,0
CDM,RX-175379,WHEAT DEXTRIN 3 GRAM/4 GRAM ORAL POWDER PACKET,0.4,0.26,,,0
CDM,RX-1754,CLOMIPRAMINE 50 MG CAPSULE,35.5,23.08,,,0
CDM,RX-175407,ELVITEG 150 MG-COB 150 MG-EMTRICIT 200 MG-TENOFO ALAFENAM 10 MG TABLET,431.55,280.51,,,0
CDM,RX-175414,CEFAZOLIN 2 GRAM/100 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,97.75,63.54,,,0
CDM,RX-175422,COMPOUNDING VEHICLE SUSPENSION SUGAR-FREE NO.20 ORAL,16.1,10.46,,,0
CDM,RX-1755,CLONIDINE HCL 0.1 MG TABLET,5.3,3.44,,,0
CDM,RX-1756,CLONIDINE HCL 0.2 MG TABLET,5.4,3.51,,,0
CDM,RX-175759,BUPRENORPHINE HCL 75 MCG BUCCAL FILM,37.25,24.21,,,0
CDM,RX-175760,BUPRENORPHINE HCL 150 MCG BUCCAL FILM,37.25,24.21,,,0
CDM,RX-175761,BUPRENORPHINE HCL 300 MCG BUCCAL FILM,53.8,34.97,,,0
CDM,RX-175776,PATIROMER CALCIUM SORBITEX 8.4 GRAM ORAL POWDER PACKET,97.1,63.12,,,0
CDM,RX-175871,ELOTUZUMAB 300 MG INTRAVENOUS SOLUTION,9710.55,6311.86,,,0
CDM,RX-175872,ELOTUZUMAB 400 MG INTRAVENOUS SOLUTION,12919.9,8397.94,,,0
CDM,RX-176034,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,5898.5,3834.02,,,0
CDM,RX-176089,SELEXIPAG 200 MCG TABLET,825.8,536.77,,,0
CDM,RX-176250,SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,664.25,431.76,,,0
CDM,RX-176263,SELENIUM SULFIDE 2.5 % LOTION,42.8,27.82,,,0
CDM,RX-176319,PHOSPHATE DIALYSIS SOLN WITHOUT DEXTR K 4 MEQ-CA 2.5 MEQ-PO4 1 MMOL/L,289.2,187.98,,,0
CDM,RX-176887,FENTANYL (PF) 300 MCG/30 ML (10 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE,35.0,22.75,,,0
CDM,RX-176888,FENTANYL (PF) 300 MCG/30 ML (10 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE,35.0,22.75,,,0
CDM,RX-176890,HYDROMORPHONE 0.5 MG/ML PCA HIGH RISK,100.5,65.32,,,0
CDM,RX-176891,HYDROMORPHONE 0.5 MG/ML PCA HIGH RISK,100.5,65.32,,,0
CDM,RX-1769,CLOTRIMAZOLE 1 % VAGINAL CREAM,24.25,15.76,,,0
CDM,RX-176904,CARIPRAZINE 1.5 MG CAPSULE,150.85,98.05,,,0
CDM,RX-176905,CARIPRAZINE 3 MG CAPSULE,150.85,98.05,,,0
CDM,RX-177052,"CARDIOPLEGIC SOLUTION NO.16 26 MEQ/1,052.8 ML(POTASSIUM) FOR PERFUSION",346.9,225.48,,,0
CDM,RX-177101,EMTRICITABINE 200 MG-RILPIVIRINE 25 MG-TENOFOVIR ALAFENAM 25 MG TABLET,393.15,255.55,,,0
CDM,RX-177620,HYDROMORPHONE 0.5 MG/ML PCA HIGH RISK,100.5,65.32,,,0
CDM,RX-177623,FENTANYL (PF) 300 MCG/30 ML (10 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE,35.0,22.75,,,0
CDM,RX-177631,DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,4146.35,2695.13,,,0
CDM,RX-177708,CITRIC AC 1980.6 MG-GLUCONO 59.4 MG-MAG CARB 980.4 MG/30 ML IRRIG.SOLN,82.15,53.4,,,0
CDM,RX-177732,VANCOMYCIN 1.5 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLN,94.4,61.36,,,0
CDM,RX-177760,VENETOCLAX 10 MG TABLET,45.05,29.28,,,0
CDM,RX-177761,VENETOCLAX 50 MG TABLET,206.95,134.52,,,0
CDM,RX-177762,VENETOCLAX 100 MG TABLET,409.25,266.01,,,0
CDM,RX-17801,ACETIC ACID 2 % EAR SOLUTION,89.9,58.44,,,0
CDM,RX-178105,BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,44.65,29.02,,,0
CDM,RX-178108,BRIVARACETAM 25 MG TABLET,75.55,49.11,,,0
CDM,RX-178109,BRIVARACETAM 50 MG TABLET,75.55,49.11,,,0
CDM,RX-178174,OXYCODONE ER 9 MG CAPSULE SPRINKLE EXTENDED RELEASE 12 HR(DON'T CRUSH),23.8,15.47,,,0
CDM,RX-178175,OXYCODONE ER 13.5 MG CAPSULE SPRINKLE EXTEND RELEASE 12HR(DON'T CRUSH),32.8,21.32,,,0
CDM,RX-178178,OXYCODONE ER 36 MG CAPSULE SPRINKLE EXTENDED RELEASE 12HR(DON'T CRUSH),65.85,42.8,,,0
CDM,RX-178217,EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,34.9,22.68,,,0
CDM,RX-178229,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION",48155.95,31301.37,,,0
CDM,RX-178243,VANCOMYCIN 750 MG/150 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,112.85,73.35,,,0
CDM,RX-178276,MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),19.85,12.9,,,0
CDM,RX-17837,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,71.05,46.18,,,0
CDM,RX-178449,FENTANYL PCA (PALLIATIVE CARE) 2500 MCG/50 ML,78.45,50.99,,,0
CDM,RX-178450,HYDROMORPHONE PCA (PALLIATIVE CARE) 500 MG/50 ML,511.8,332.67,,,0
CDM,RX-17881,BRIMONIDINE 0.2 % EYE DROPS,19.5,12.68,,,0
CDM,RX-179011,FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,157.65,102.47,,,0
CDM,RX-179041,SODIUM POLYSTYRENE SULFONATE 15 GRAM-SORBITOL 20 GRAM/60 ML ORAL SUSP,101.65,66.07,,,0
CDM,RX-179327,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,441.0,286.65,,,0
CDM,RX-17936,OLANZAPINE 5 MG TABLET,5.3,3.44,,,0
CDM,RX-179452,USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,10603.9,6892.54,,,0
CDM,RX-179600,INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,2875.8,1869.27,,,0
CDM,RX-17961,ZIDOVUDINE 300 MG TABLET,7.35,4.78,,,0
CDM,RX-179621,LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,3402.85,2211.85,,,0
CDM,RX-179627,ROPIVACAINE (PF) 100 MG/20 ML (5 MG/ML) 0.5 % INJECTION SYRINGE,418.6,272.09,,,0
CDM,RX-17997,AMMONIUM LACTATE 12 % TOPICAL CREAM,33.85,22.0,,,0
CDM,RX-1801,CODEINE SULFATE 15 MG TABLET,11.0,7.15,,,0
CDM,RX-180111,BEZLOTOXUMAB 25 MG/ML INTRAVENOUS SOLUTION,15844.85,10299.15,,,0
CDM,RX-1802,CODEINE SULFATE 30 MG TABLET,11.2,7.28,,,0
CDM,RX-180473,SALIVA STIMULANT COMBINATION NO.7 ORAL MUCOSAL GEL,34.5,22.42,,,0
CDM,RX-180484,PLECANATIDE 3 MG TABLET,59.1,38.42,,,0
CDM,RX-180504,HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,46.4,30.16,,,0
CDM,RX-180885,AVELUMAB 20 MG/ML INTRAVENOUS SOLUTION,8768.3,5699.4,,,0
CDM,RX-180899,OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION,85702.9,55706.88,,,0
CDM,RX-181274,THIOTEPA 100 MG SOLUTION FOR INJECTION,7407.0,4814.55,,,0
CDM,RX-181278,PIRFENIDONE 267 MG TABLET,124.95,81.22,,,0
CDM,RX-181723,TRASTUZUMAB 150 MG INTRAVENOUS SOLUTION,6547.95,4256.17,,,0
CDM,RX-181755,CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,79.3,51.54,,,0
CDM,RX-181756,CLINDAMYCIN 900 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,84.1,54.66,,,0
CDM,RX-181765,MIDOSTAURIN 25 MG CAPSULE,666.65,433.32,,,0
CDM,RX-181771,DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION,4357.65,2832.47,,,0
CDM,RX-18192,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,178.6,116.09,,,0
CDM,RX-18194,ROPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,59.9,38.94,,,0
CDM,RX-18195,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,44.5,28.92,,,0
CDM,RX-182001,"RITUXIMAB 1,400 MG/11.7 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN",27362.4,17785.56,,,0
CDM,RX-182023,UREA 15 GRAM ORAL POWDER PACKET,17.15,11.15,,,0
CDM,RX-182032,"ARIPIPRAZOLE LAUROXIL ER 1,064 MG/3.9 ML SUSPENSION,EXT.REL IM SYRINGE",17833.75,11591.94,,,0
CDM,RX-182080,"RITUXIMAB 1,600 MG/13.4 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN|DISCARDED DRUG NOT ADMINISTERED",27536.85,17898.95,,,0
CDM,RX-1821,COLCHICINE 0.6 MG TABLET,12.15,7.9,,,0
CDM,RX-182532,INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,1592.65,1035.22,,,0
CDM,RX-18260,TRACE ELEMENTS CR-CU-MN-SE-ZN 4-400-100-20 MCG-1000 MCG/ML IV SOLUTION,223.3,145.14,,,0
CDM,RX-18262,TRACE ELEMENTS CR-CU-MN-ZN 10 MCG-1 MG-0.5 MG-5 MG/ML INTRAVENOUS SOLN,55.5,36.08,,,0
CDM,RX-182724,SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,59.25,38.51,,,0
CDM,RX-182810,DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,45628.2,29658.33,,,0
CDM,RX-182823,INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,99287.85,64537.1,,,0
CDM,RX-18288,BISOPROLOL FUMARATE 5 MG TABLET,7.5,4.88,,,0
CDM,RX-18293,TORSEMIDE 20 MG TABLET,5.55,3.61,,,0
CDM,RX-18295,TORSEMIDE 5 MG TABLET,5.3,3.44,,,0
CDM,RX-182971,TISAGENLECLEUCEL 0.2 X10EXP6 TO 2.5X10EXP8 CELL INTRAVENOUS SUSPENSION,2486986.75,1616541.39,,,0
CDM,RX-182980,GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONCENTRATION) IV SOLN,42374.8,27543.62,,,0
CDM,RX-18302,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,59.05,38.38,,,0
CDM,RX-183036,HYDROMORPHONE 0.5 MG/ML PCA HIGH RISK,100.5,65.32,,,0
CDM,RX-18307,GABAPENTIN 400 MG CAPSULE,5.05,3.28,,,0
CDM,RX-18308,GABAPENTIN 300 MG CAPSULE,4.95,3.22,,,0
CDM,RX-18309,GABAPENTIN 100 MG CAPSULE,4.9,3.18,,,0
CDM,RX-18311,RISPERIDONE 2 MG TABLET,5.1,3.32,,,0
CDM,RX-18312,RISPERIDONE 3 MG TABLET,5.15,3.35,,,0
CDM,RX-18313,RISPERIDONE 1 MG TABLET,5.1,3.32,,,0
CDM,RX-18315,"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",104.85,68.15,,,0
CDM,RX-183156,MEROPENEM-VABORBACTAM 2 GRAM INTRAVENOUS SOLUTION,1138.95,740.32,,,0
CDM,RX-183196,FLUTICASONE FUR. 100 MCG-UMECLID 62.5 MCG-VILANT 25 MCG INHALAT.POWDER,37.25,24.21,,,0
CDM,RX-183265,AXICABTAGENE CILOLEUCEL INTRAVENOUS SUSPENSION,1935862.05,1258310.33,,,0
CDM,RX-183277,"VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT",816.7,530.86,,,0
CDM,RX-183279,VARICELLA-ZOSTER GLYCOP E VACCINE (VIAL 2 OF 2) 50 MCG IM SUSPENSION,1031.3,670.34,,,0
CDM,RX-183543,LETERMOVIR 480 MG TABLET,866.2,563.03,,,0
CDM,RX-183545,LETERMOVIR 480 MG/24 ML INTRAVENOUS SOLUTION,1945.3,1264.44,,,0
CDM,RX-18385,"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",6.5,4.22,,,0
CDM,RX-18386,"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",6.25,4.06,,,0
CDM,RX-18398,REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,145.6,94.64,,,0
CDM,RX-184017,BORTEZOMIB 3.5 MG INTRAVENOUS POWDER FOR SOLUTION,5245.25,3409.41,,,0
CDM,RX-184031,NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLUTION,33030.75,21469.99,,,0
CDM,RX-184305,BICTEGRAVIR 50 MG-EMTRICITABINE 200 MG-TENOFOVIR ALAFENAM 25 MG TABLET,431.55,280.51,,,0
CDM,RX-184466,TENECTEPLASE 50 MG INTRAVENOUS SOLUTION,32069.85,20845.4,,,0
CDM,RX-184474,ASCORBIC ACID (VITAMIN C) 500 MG/ML INTRAVENOUS SOLUTION,37.95,24.67,,,0
CDM,RX-184475,NETARSUDIL 0.02 % EYE DROPS,970.1,630.56,,,0
CDM,RX-184479,VANCOMYCIN 25 MG/ML ORAL SOLUTION,13.35,8.68,,,0
CDM,RX-184540,STERILE TALC 4 GRAM INTRAPLEURAL SUSPENSION,738.5,480.02,,,0
CDM,RX-184759,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2323.65,1510.37,,,0
CDM,RX-184939,MORPHINE 4 MG/ML INJECTION SOLUTION,41.65,27.07,,,0
CDM,RX-184945,BARICITINIB 2 MG TABLET,267.15,173.65,,,0
CDM,RX-184949,COCAINE 4 % NASAL SOLUTION,960.85,624.55,,,0
CDM,RX-184963,SARILUMAB 200 MG/1.14 ML SUBCUTANEOUS PEN INJECTOR,11257.25,7317.21,,,0
CDM,RX-185021,TISAGENLECLEUCEL 0.6 X 10EXP8 TO 6 X10EXP8 CELL INTRAVENOUS SUSPENSION,2048685.85,1331645.8,,,0
CDM,RX-185086,"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",124.6,80.99,,,0
CDM,RX-185087,"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",170.4,110.76,,,0
CDM,RX-185088,"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",216.2,140.53,,,0
CDM,RX-185089,"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",491.15,319.25,,,0
CDM,RX-185090,"EPOETIN ALFA-EPBX 40,000 UNIT/ML INJECTION SOLUTION",1865.9,1212.84,,,0
CDM,RX-185201,COMPOUNDING VEHICLE SYRUP NO.23,72.05,46.83,,,0
CDM,RX-185449,PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,6859.6,4458.74,,,0
CDM,RX-185477,"ARIPIPRAZOLE LAUROXIL,SUBMIC. ER 675 MG/2.4 ML SUSP,EXT.REL.IM SYRINGE",11325.75,7361.74,,,0
CDM,RX-185478,NITROPRUSSIDE 20 MG/100 ML (0.2 MG/ML) IN 0.9% SODIUM CHLORIDE IV SOLN,195.2,126.88,,,0
CDM,RX-18551,CARVEDILOL 3.125 MG TABLET,4.9,3.18,,,0
CDM,RX-185737,CARFILZOMIB 10 MG INTRAVENOUS SOLUTION,2527.55,1642.91,,,0
CDM,RX-185746,PARENTERAL AMINO ACID 15 % COMBINATION NO.5 INTRAVENOUS SOLUTION,274.85,178.65,,,0
CDM,RX-185747,SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM ORAL POWDER PACKET,64.35,41.83,,,0
CDM,RX-185748,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL POWDER PACKET,64.35,41.83,,,0
CDM,RX-185805,MOGAMULIZUMAB-KPKC 4 MG/ML INTRAVENOUS SOLUTION,19727.4,12822.81,,,0
CDM,RX-185808,PATISIRAN (LIPID COMPLEX) 2 MG/ML INTRAVENOUS SOLUTION,41081.2,26702.78,,,0
CDM,RX-186011,FILGRASTIM-AAFI 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,457.25,297.21,,,0
CDM,RX-186012,FILGRASTIM-AAFI 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,457.2,297.18,,,0
CDM,RX-186041,"KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLOR,ISO-OSMOTIC INJ SYRINGE",61.9,40.24,,,0
CDM,RX-186072,CALCIUM GLUCONATE 1 GRAM/10 ML (100 MG/ML) IN STERILE WATER IV SYRINGE,51.8,33.67,,,0
CDM,RX-186087,DORAVIRINE 100 MG TABLET,190.95,124.12,,,0
CDM,RX-18621,LATANOPROST 0.005 % EYE DROPS,18.25,11.86,,,0
CDM,RX-186271,EVEROLIMUS (IMMUNOSUPPRESSIVE) 1 MG TABLET,51.3,33.34,,,0
CDM,RX-186275,AMINOLEVULINIC ACID HCL 30 MG/ML ORAL SOLUTION,10040.05,6526.03,,,0
CDM,RX-186280,RIVAROXABAN 2.5 MG TABLET,26.25,17.06,,,0
CDM,RX-186906,PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,8810.1,5726.56,,,0
CDM,RX-187113,ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,2813.0,1828.45,,,0
CDM,RX-187129,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 800 MG/100 ML SOLN,140.5,91.32,,,0
CDM,RX-187160,"FACTOR XA,INACTIVATED-ZHZO (RECOMBINANT) 200 MG INTRAVENOUS SOLUTION",10452.3,6794.0,,,0
CDM,RX-187340,CAPLACIZUMAB-YHDP 11 MG SOLUTION FOR INJECTION,35638.3,23164.9,,,0
CDM,RX-187341,CAPLACIZUMAB-YHDP 11 MG INJECTION KIT,35638.3,23164.9,,,0
CDM,RX-187478,"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",140108.05,91070.23,,,0
CDM,RX-187541,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION,33733.8,21926.97,,,0
CDM,RX-187713,"TRASTUZUMAB 600 MG-HYALURONIDASE-OYSK 10,000 UNIT/5 ML SUBCUT SOLUTION",19475.45,12659.04,,,0
CDM,RX-187753,ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE,10987.15,7141.65,,,0
CDM,RX-187771,PARENTERAL AMINO ACID 15 % COMBINATION NO.6 INTRAVENOUS SOLUTION,284.0,184.6,,,0
CDM,RX-18786,DONEPEZIL 5 MG TABLET,4.9,3.18,,,0
CDM,RX-18787,DONEPEZIL 10 MG TABLET,4.9,3.18,,,0
CDM,RX-187934,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,363.85,236.5,,,0
CDM,RX-188446,BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLUTION,2854.0,1855.1,,,0
CDM,RX-188563,"ROPIVACAINE(PF) 0.2 %-0.9 % NACL 545ML INFIL,HI VAR RATE,PCA,ELAS PUMP",689.4,448.11,,,0
CDM,RX-18877,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,51.05,33.18,,,0
CDM,RX-188791,"TRANEXAMIC ACID 1,000 MG/100 ML(10 MG/ML)IN SOD CHLOR,ISO IV PIGGYBACK",55.6,36.14,,,0
CDM,RX-188805,"ROPIVACAINE (PF) 0.2 %-0.9 % NACL 745 ML INFIL,LOW VAR RATE ELAST PUMP",930.3,604.7,,,0
CDM,RX-189017,ANTI-INHIBITOR COAGULANT COMPLEX 350 UNIT-650 UNIT INTRAVENOUS SOLN,4396.1,2857.46,,,0
CDM,RX-189018,"ANTI-INHIBITOR COAGULANT COMPLEX 700 UNIT-1,300 UNIT INTRAVENOUS SOLN",8710.15,5661.6,,,0
CDM,RX-189021,INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,120.35,78.23,,,0
CDM,RX-18908,SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,88.6,57.59,,,0
CDM,RX-189100,SEMAGLUTIDE 3 MG TABLET,4.6,2.99,,,0
CDM,RX-18918,LEVOFLOXACIN 250 MG TABLET,5.1,3.32,,,0
CDM,RX-18919,LEVOFLOXACIN 500 MG TABLET,5.25,3.41,,,0
CDM,RX-18920,TOPIRAMATE 25 MG TABLET,5.3,3.44,,,0
CDM,RX-18922,TOPIRAMATE 100 MG TABLET,5.7,3.7,,,0
CDM,RX-189403,TRASTUZUMAB-ANNS 150 MG INTRAVENOUS SOLUTION,5485.35,3565.48,,,0
CDM,RX-189594,TRASTUZUMAB-DKST 420 MG INTRAVENOUS SOLUTION,8207.5,5334.88,,,0
CDM,RX-189595,RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,12421.85,8074.2,,,0
CDM,RX-189667,LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLUTION,20555.85,13361.3,,,0
CDM,RX-189668,LUSPATERCEPT-AAMT 75 MG SUBCUTANEOUS SOLUTION,61601.45,40040.94,,,0
CDM,RX-189687,CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,10257.15,6667.15,,,0
CDM,RX-189700,ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLUTION,6901.3,4485.84,,,0
CDM,RX-189874,"MINERAL OIL, LIGHT STERILE",70.4,45.76,,,0
CDM,RX-189953,ENFORTUMAB VEDOTIN-EJFV 20 MG INTRAVENOUS SOLUTION,11734.1,7627.16,,,0
CDM,RX-189954,ENFORTUMAB VEDOTIN-EJFV 30 MG INTRAVENOUS SOLUTION,17560.1,11414.06,,,0
CDM,RX-189958,FAM-TRASTUZUMAB DERUXTECAN-NXKI 100 MG INTRAVENOUS SOLUTION,12885.1,8375.32,,,0
CDM,RX-190109,BEVACIZUMAB-BVZR 25 MG/ML INTRAVENOUS SOLUTION,5316.4,3455.66,,,0
CDM,RX-190111,RITUXIMAB-PVVR 10 MG/ML INTRAVENOUS SOLUTION,7125.674999999999,4631.69,,,0
CDM,RX-190210,TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,74826.5,48637.22,,,0
CDM,RX-190358,CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,1112.7,723.26,,,0
CDM,RX-190565,CENOBAMATE 50 MG TABLET,121.65,79.07,,,0
CDM,RX-190568,CENOBAMATE 200 MG TABLET,121.65,79.07,,,0
CDM,RX-190599,RIMEGEPANT 75 MG DISINTEGRATING TABLET,376.25,244.56,,,0
CDM,RX-190609,ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION,10907.625,7089.955,,,0
CDM,RX-190917,SACITUZUMAB GOVITECAN-HZIY 180 MG INTRAVENOUS SOLUTION,10715.75,6965.24,,,0
CDM,RX-191088,NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),145.15,94.35,,,0
CDM,RX-191098,"DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN",43716.0,28415.4,,,0
CDM,RX-191439,INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION,581846.95,378200.52,,,0
CDM,RX-191443,LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION,34303.9,22297.54,,,0
CDM,RX-191683,"PERTUZUMAB 1,200 MG-TRASTUZUMAB 600 MG-HYALURON-ZZXF/15 ML SUBCUT SOLN",57809.25,37576.01,,,0
CDM,RX-19176,ATORVASTATIN 10 MG TABLET,5.1,3.32,,,0
CDM,RX-19177,ATORVASTATIN 40 MG TABLET,5.25,3.41,,,0
CDM,RX-19178,ATORVASTATIN 20 MG TABLET,5.1,3.32,,,0
CDM,RX-19179,AZELASTINE 137 MCG (0.1 %) NASAL SPRAY,58.3,37.9,,,0
CDM,RX-19180,INSULIN REGULAR HUMAN U-500(CONCENTRATE) 500 UNIT/ML SUBCUTANEOUS SOLN,6859.7,4458.8,,,0
CDM,RX-191994,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,1797.65,1168.47,,,0
CDM,RX-192004,TAFASITAMAB-CXIX 200 MG INTRAVENOUS SOLUTION,5872.3,3817.0,,,0
CDM,RX-192019,METHACHOLINE CHLORIDE 3 MG/3 ML (1 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
CDM,RX-192020,METHACHOLINE CHLORIDE 12 MG/3 ML (4 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
CDM,RX-192021,METHACHOLINE CHLORIDE 48 MG/3 ML (16 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
CDM,RX-192023,METHACHOLINE CHLORIDE 0.1875 MG/3 ML (0.0625 MG/ML) NEBULIZATION SOLN,15.45,10.04,,,0
CDM,RX-192024,METHACHOLINE CHLORIDE 0.75 MG/3 ML (0.25 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
CDM,RX-192080,METHACHOLINE CHLORIDE 0 MG/3 ML (0 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
CDM,RX-19226,CABERGOLINE 0.5 MG TABLET,10.35,6.73,,,0
CDM,RX-192261,"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",615.0,399.75,,,0
CDM,RX-192265,TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,150.15,97.6,,,0
CDM,RX-192312,COPPER CU-64 DOTATATE 148 MBQ/4 ML (4 MCI/4 ML) INTRAVENOUS SOLUTION,12000.0,7800.0,,,0
CDM,RX-192326,"DEXMEDETOMIDINE 1,000 MCG/250 ML(4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV",220.1,143.06,,,0
CDM,RX-192581,FLUTICASONE FUR. 200 MCG-UMECLID 62.5 MCG-VILANT 25 MCG INHALAT.POWDER,37.25,24.21,,,0
CDM,RX-192625,RAVULIZUMAB-CWVZ 100 MG/ML INTRAVENOUS SOLUTION,63305.450000000004,41148.545,,,0
CDM,RX-193027,"EPOETIN ALFA-EPBX 20,000 UNIT/ML INJECTION SOLUTION",949.4,617.11,,,0
CDM,RX-19333,"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",44.95,29.22,,,0
CDM,RX-193653,LISOCABTAGENE MARALEUCEL 1.5 X 10EXP6 TO 70 X 10EXP6 CELL/ML IV SUSP,2043869.5,1328515.18,,,0
CDM,RX-193873,LISOCABTAGENE MARALEUCEL(CD8) 1.5X TO 70X 10EXP6 CELL/ML IV SUSP(1OF2),2042612.5,1327698.12,,,0
CDM,RX-193874,LISOCABTAGENE MARALEUCEL(CD4) 1.5X TO 70X 10EXP6 CELL/ML IV SUSP(2OF2),2042612.5,1327698.12,,,0
CDM,RX-194047,IDECABTAGENE VICLEUCEL 300 X 10EXP6 TO 510 X 10EXP6 CELL IV SUSPENSION,2088411.4,1357467.41,,,0
CDM,RX-194269,THYROTROPIN ALFA 0.9 MG INTRAMUSCULAR SOLUTION,10734.0,6977.1,,,0
CDM,RX-194274,ARTESUNATE 110 MG INTRAVENOUS SOLUTION,24316.4,15805.66,,,0
CDM,RX-19433,WARFARIN 3 MG TABLET,5.0,3.25,,,0
CDM,RX-19434,WARFARIN 6 MG TABLET,5.15,3.35,,,0
CDM,RX-194713,BUPIVACAINE-MELOXICAM ER 400 MG-12 MG/14 ML SURGICAL SITE INSTILL SOLN,761.55,495.01,,,0
CDM,RX-19483,CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,0.05,0.03,,,0
CDM,RX-195234,PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,1135.2,737.88,,,0
CDM,RX-195447,ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION,27179.55,17666.71,,,0
CDM,RX-195685,POLYETHYLENE GLYCOL 400  1 % EYE DROPS,5.0,3.25,,,0
CDM,RX-195747,TISOTUMAB VEDOTIN-TFTV 40 MG INTRAVENOUS SOLUTION,30781.35,20007.88,,,0
CDM,RX-195911,BREXUCABTAGENE AUTOLEUCEL 1X 10EXP6 TO 1X 10EXP8 CELL IV SUSPENSION,1935862.05,1258310.33,,,0
CDM,RX-196401,EFGARTIGIMOD ALFA-FCAB 20 MG/ML INTRAVENOUS SOLUTION,31538.25,20499.86,,,0
CDM,RX-196786,VASOPRESSIN 0.2 UNIT/ML INTRAVENOUS SOLUTION,172.05,111.83,,,0
CDM,RX-196983,CILTACABTAGENE AUTOLEUCEL 0.5 X 10EXP6 TO 1X 10EXP8 CELL IV SUSPENSION,2187494.6,1421871.49,,,0
CDM,RX-197056,"UPADACITINIB ER 45 MG TABLET,EXTENDED RELEASE 24 HR",1372.25,891.96,,,0
CDM,RX-197064,NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION,64054.0,41635.1,,,0
CDM,RX-19711,CLINDAMYCIN 1 % LOTION,378.45,245.99,,,0
CDM,RX-19713,DIAZOXIDE 50 MG/ML ORAL SUSPENSION,851.65,553.57,,,0
CDM,RX-19733,KETOROLAC 0.5 % EYE DROPS,116.6,75.79,,,0
CDM,RX-19736,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,277.0,180.05,,,0
CDM,RX-197381,NIRMATRELVIR 150 MG (10)-RITONAVIR 100 MG (10) TABLETS IN A DOSE PACK,220.75,143.49,,,0
CDM,RX-19749,PRAMOXINE 1 % TOPICAL FOAM,358.0,232.7,,,0
CDM,RX-19770,TRIAMCINOLONE ACETONIDE 0.147 MG/GRAM TOPICAL AEROSOL,759.9,493.94,,,0
CDM,RX-19779,UREA 10 % LOTION,37.575,24.425,,,0
CDM,RX-197839,PEMETREXED DISODIUM 25 MG/ML INTRAVENOUS SOLUTION,253.45000000000002,164.745,,,0
CDM,RX-197867,VUTRISIRAN 25 MG/0.5 ML SUBCUTANEOUS SYRINGE,500162.75,325105.79,,,0
CDM,RX-197875,RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION,43182.45,28068.59,,,0
CDM,RX-19805,METRONIDAZOLE 0.75 % TOPICAL CREAM,269.95,175.47,,,0
CDM,RX-198515,"KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLOR,ISO-OSMOTIC IV SYRINGE",63.2,41.08,,,0
CDM,RX-19882,SERTRALINE 25 MG TABLET,5.35,3.48,,,0
CDM,RX-199160,TECLISTAMAB-CQYV 90 MG/ML SUBCUTANEOUS SOLUTION,43419.6,28222.74,,,0
CDM,RX-199161,TECLISTAMAB-CQYV 10 MG/ML SUBCUTANEOUS SOLUTION,8579.6,5576.74,,,0
CDM,RX-19928,ITRACONAZOLE 10 MG/ML ORAL SOLUTION,782.95,508.92,,,0
CDM,RX-199649,MOSUNETUZUMAB-AXGB 1 MG/ML INTRAVENOUS SOLUTION,40218.925,26142.305,,,0
CDM,RX-199840,UBLITUXIMAB-XIIY 25 MG/ML INTRAVENOUS SOLUTION,46167.45,30008.84,,,0
CDM,RX-2007,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",33.35,21.68,,,0
CDM,RX-2008,CYANOCOBALAMIN (VIT B-12) 100 MCG TABLET,0.15,0.1,,,0
CDM,RX-2009,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",0.1,0.06,,,0
CDM,RX-2010,CYANOCOBALAMIN (VIT B-12) 250 MCG TABLET,0.15,0.1,,,0
CDM,RX-201038,EPINEPHRINE 4 MG/250 ML (16 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV SOLN,182.4,118.56,,,0
CDM,RX-201188,EPCORITAMAB-BYSP 48 MG/0.8 ML SUBCUTANEOUS SOLUTION,68444.0,44488.6,,,0
CDM,RX-201189,EPCORITAMAB-BYSP 4 MG/0.8 ML SUBCUTANEOUS SOLUTION,5778.95,3756.32,,,0
CDM,RX-2012,CYANOCOBALAMIN (VIT B-12) 500 MCG TABLET,0.2,0.13,,,0
CDM,RX-201546,GLOFITAMAB-GXBM 1 MG/ML INTRAVENOUS SOLUTION,28188.85,18322.754999999997,,,0
CDM,RX-20156,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,130.1,84.56,,,0
CDM,RX-2017,CYCLOBENZAPRINE 10 MG TABLET,5.05,3.28,,,0
CDM,RX-201784,"RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION",1299.15,844.45,,,0
CDM,RX-202140,TALQUETAMAB-TGVS 40 MG/ML SUBCUTANEOUS SOLUTION,48005.2,31203.38,,,0
CDM,RX-202141,TALQUETAMAB-TGVS 2 MG/ML SUBCUTANEOUS SOLUTION,3676.35,2389.63,,,0
CDM,RX-202169,ELRANATAMAB-BCMM 40 MG/ML SUBCUTANEOUS SOLUTION,9438.95,6135.32,,,0
CDM,RX-2025,CYCLOPENTOLATE 1 % EYE DROPS,55.3,35.94,,,0
CDM,RX-202948,MEROPENEM 2 GRAM INTRAVENOUS SOLUTION,160.45,104.29,,,0
CDM,RX-203004,TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION,39582.45,25728.59,,,0
CDM,RX-2033,CYPROHEPTADINE 4 MG TABLET,4.8,3.12,,,0
CDM,RX-203439,PHYSOSTIGMINE 0.4 MG/ML INTRAVENOUS SOLUTION,662.9,430.88,,,0
CDM,RX-203448,CAMPHOR 3.1 %-METHYL SALICYLATE 10 %-MENTHOL 6 % TOPICAL PATCH (LARGE),0.6,0.39,,,0
CDM,RX-203546,PEGFILGRASTIM-CBQV 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUT INJECTOR,16607.15,10794.65,,,0
CDM,RX-203560,HYDROMORPHONE 0.25 MG/0.5 ML INJECTION SYRINGE,45.6,29.64,,,0
CDM,RX-203965,"METHADONE 10 MG/ML IN SODIUM CHLORIDE,ISO-OSMOTIC INTRAVENOUS SYRINGE",1135.5,738.08,,,0
CDM,RX-20446,ANAGRELIDE 0.5 MG CAPSULE,7.05,4.58,,,0
CDM,RX-204538,"KETAMINE (PF) 5 MG/ML IN SODIUM CHLORIDE, ISO-OSMOTIC IV SOLUTION",185.0,120.25,,,0
CDM,RX-20472,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,41.6,27.04,,,0
CDM,RX-20566,MELOXICAM 7.5 MG TABLET,4.9,3.18,,,0
CDM,RX-20580,MELOXICAM 15 MG TABLET,5.05,3.28,,,0
CDM,RX-207741,CHOLESTYRAMINE 4 GRAM ORAL POWDER FOR SUSPENSION IN A PACKET,7.2,4.68,,,0
CDM,RX-20887,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,44.05,28.63,,,0
CDM,RX-208900,"OLIVE, SOYBEAN OIL FAT EMULSION 20 % INTRAVENOUS",65.7,42.7,,,0
CDM,RX-209277,FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE,467.5,303.88,,,0
CDM,RX-209281,FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,138.15,89.8,,,0
CDM,RX-20954,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,213.2,138.58,,,0
CDM,RX-21044,LEUPROLIDE ACETATE 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,21986.45,14291.19,,,0
CDM,RX-21045,LEUPROLIDE ACETATE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,2235.55,1453.11,,,0
CDM,RX-21057,OLANZAPINE 2.5 MG TABLET,5.5,3.58,,,0
CDM,RX-21061,OXCARBAZEPINE 300 MG TABLET,6.55,4.26,,,0
CDM,RX-21062,CITALOPRAM 20 MG TABLET,4.8,3.12,,,0
CDM,RX-21063,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,46.45,30.19,,,0
CDM,RX-21108,LEUPROLIDE 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,2953.3,1919.64,,,0
CDM,RX-21135,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),504.15,327.7,,,0
CDM,RX-2120,DANAZOL 200 MG CAPSULE,14.3,9.3,,,0
CDM,RX-21287,PRAMIPEXOLE 0.125 MG TABLET,4.8,3.12,,,0
CDM,RX-21290,PRAMIPEXOLE 0.25 MG TABLET,5.1,3.32,,,0
CDM,RX-21300,"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",5.85,3.8,,,0
CDM,RX-2131,DAPSONE 100 MG TABLET,8.1,5.26,,,0
CDM,RX-2132,DAPSONE 25 MG TABLET,7.15,4.65,,,0
CDM,RX-21372,WARFARIN 4 MG TABLET,4.9,3.18,,,0
CDM,RX-21374,MYCOPHENOLATE MOFETIL 500 MG TABLET,6.5,4.22,,,0
CDM,RX-21509,LETROZOLE 2.5 MG TABLET,5.75,3.74,,,0
CDM,RX-21672,CARMUSTINE IN POLIFEPROSAN 7.7 MG WAFER FOR IMPLANT,22205.25,14433.41,,,0
CDM,RX-21688,ROPINIROLE 0.25 MG TABLET,5.6,3.64,,,0
CDM,RX-21689,ROPINIROLE 1 MG TABLET,5.65,3.67,,,0
CDM,RX-21690,ROPINIROLE 2 MG TABLET,4.8,3.12,,,0
CDM,RX-21800,ROPINIROLE 0.5 MG TABLET,4.95,3.22,,,0
CDM,RX-21810,LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,8.3,5.4,,,0
CDM,RX-21823,QUETIAPINE 25 MG TABLET,5.0,3.25,,,0
CDM,RX-21824,QUETIAPINE 100 MG TABLET,5.15,3.35,,,0
CDM,RX-21825,QUETIAPINE 200 MG TABLET,5.55,3.61,,,0
CDM,RX-21827,TIAGABINE 4 MG TABLET,22.95,14.92,,,0
CDM,RX-21880,BACLOFEN 50 MCG/ML INTRATHECAL SOLUTION,108.5,70.52,,,0
CDM,RX-21900,AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,413.2,268.58,,,0
CDM,RX-22120,"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",1346.4,875.16,,,0
CDM,RX-22142,CLOPIDOGREL 75 MG TABLET,5.25,3.41,,,0
CDM,RX-22149,"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",11773.8,7652.969999999999,,,0
CDM,RX-22150,NICOTINE 10 MG INHALATION CARTRIDGE,13.7,8.9,,,0
CDM,RX-22185,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,2467.55,1603.91,,,0
CDM,RX-22240,TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,20.3,13.2,,,0
CDM,RX-22251,MUPIROCIN CALCIUM 2 % TOPICAL CREAM,123.4,80.21,,,0
CDM,RX-22257,OFLOXACIN 0.3 % EAR DROPS,504.3,327.8,,,0
CDM,RX-22289,CEFDINIR 300 MG CAPSULE,12.25,7.96,,,0
CDM,RX-22290,CEFDINIR 125 MG/5 ML ORAL SUSPENSION,26.75,17.39,,,0
CDM,RX-22472,KETOROLAC 15 MG/ML INJECTION SOLUTION,36.05,23.43,,,0
CDM,RX-22473,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,36.15,23.5,,,0
CDM,RX-22509,MONTELUKAST 10 MG TABLET,5.6,3.64,,,0
CDM,RX-22560,SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,11.25,7.31,,,0
CDM,RX-22586,REPAGLINIDE 1 MG TABLET,12.1,7.86,,,0
CDM,RX-22588,LOSARTAN 100 MG TABLET,5.9,3.84,,,0
CDM,RX-22719,PRAMIPEXOLE 0.5 MG TABLET,6.5,4.22,,,0
CDM,RX-2284,DESIPRAMINE 100 MG TABLET,6.1,3.96,,,0
CDM,RX-2286,DESIPRAMINE 25 MG TABLET,5.05,3.28,,,0
CDM,RX-2291,DESONIDE 0.05 % TOPICAL CREAM,46.65,30.32,,,0
CDM,RX-22959,PAROXETINE 10 MG/5 ML ORAL SUSPENSION,32.2,20.93,,,0
CDM,RX-22981,AMPHOTERICIN B LIPID COMPLEX 5 MG/ML INTRAVENOUS SUSPENSION,519.9,337.94,,,0
CDM,RX-22982,DORZOLAMIDE 22.3 MG-TIMOLOL 6.8 MG/ML EYE DROPS,85.75,55.74,,,0
CDM,RX-22992,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET,15.8,10.27,,,0
CDM,RX-22993,CAPECITABINE 150 MG TABLET,8.15,5.3,,,0
CDM,RX-23049,"TIROFIBAN 250 MCG/ML CONCENTRATE,INTRAVENOUS",158.1,102.76,,,0
CDM,RX-23050,TIROFIBAN 5 MG/100 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS,183.9,119.54,,,0
CDM,RX-23063,CAMPHOR-MENTHOL 0.5 %-0.5 % LOTION,18.85,12.25,,,0
CDM,RX-2320,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,9.25,6.01,,,0
CDM,RX-2322,DEXAMETHASONE 0.5 MG TABLET,4.95,3.22,,,0
CDM,RX-2326,DEXAMETHASONE 2 MG TABLET,6.4,4.16,,,0
CDM,RX-2327,DEXAMETHASONE 4 MG TABLET,7.55,4.91,,,0
CDM,RX-2331,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,34.85,22.65,,,0
CDM,RX-2332,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,34.3,22.3,,,0
CDM,RX-2335,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,216.4,140.66,,,0
CDM,RX-23461,LIDOCAINE 4 % TOPICAL CREAM,2.6,1.69,,,0
CDM,RX-23490,CITALOPRAM 40 MG TABLET,4.75,3.09,,,0
CDM,RX-2350,DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,312.25,202.96,,,0
CDM,RX-2357,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,69.25,45.01,,,0
CDM,RX-2364,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,66.1,42.96,,,0
CDM,RX-2365,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,68.5,44.52,,,0
CDM,RX-2367,DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,109.05,70.88,,,0
CDM,RX-23796,INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,5724.65,3721.02,,,0
CDM,RX-23814,ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,14.75,9.59,,,0
CDM,RX-23872,LEFLUNOMIDE 10 MG TABLET,6.75,4.39,,,0
CDM,RX-23873,LEFLUNOMIDE 20 MG TABLET,8.55,5.56,,,0
CDM,RX-23968,MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,116.95,76.02,,,0
CDM,RX-2403,DIAZEPAM 10 MG TABLET,8.5,5.52,,,0
CDM,RX-2404,DIAZEPAM 2 MG TABLET,8.45,5.49,,,0
CDM,RX-2405,DIAZEPAM 5 MG TABLET,8.45,5.49,,,0
CDM,RX-24119,NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,6.05,3.93,,,0
CDM,RX-2412,DIBUCAINE 1 % TOPICAL OINTMENT,22.35,14.53,,,0
CDM,RX-2414,DICLOXACILLIN 250 MG CAPSULE,6.25,4.06,,,0
CDM,RX-2417,DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION,48.35,31.43,,,0
CDM,RX-24176,MIDAZOLAM 2 MG/ML ORAL SYRUP,25.45,16.54,,,0
CDM,RX-2418,DICYCLOMINE 10 MG CAPSULE,5.6,3.64,,,0
CDM,RX-24216,SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,0.15,0.1,,,0
CDM,RX-24268,"ISOSORBIDE MONONITRATE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",5.35,3.48,,,0
CDM,RX-24329,"HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV",92.3,60.0,,,0
CDM,RX-24385,HYDROCORTISONE-ACETIC ACID 1 %-2 % EAR DROPS,449.1,291.92,,,0
CDM,RX-24419,LAMIVUDINE 100 MG TABLET,38.5,25.02,,,0
CDM,RX-24425,VALRUBICIN 40 MG/ML INTRAVESICAL SOLUTION,7834.6,5092.49,,,0
CDM,RX-24438,ABACAVIR 300 MG TABLET,18.05,11.73,,,0
CDM,RX-24439,ABACAVIR 20 MG/ML ORAL SOLUTION,26.65,17.32,,,0
CDM,RX-2445,DIGOXIN 250 MCG (0.25 MG) TABLET,7.45,4.84,,,0
CDM,RX-24474,CILOSTAZOL 100 MG TABLET,6.65,4.32,,,0
CDM,RX-24500,CELECOXIB 100 MG CAPSULE,6.95,4.52,,,0
CDM,RX-24501,CELECOXIB 200 MG CAPSULE,8.1,5.26,,,0
CDM,RX-24513,"EPOETIN ALFA 40,000 UNIT/ML INJECTION SOLUTION",2847.75,1851.04,,,0
CDM,RX-24521,"ISOSORBIDE MONONITRATE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",5.3,3.44,,,0
CDM,RX-24585,ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,5675.05,3688.78,,,0
CDM,RX-24695,BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,211.15,137.25,,,0
CDM,RX-24702,MODAFINIL 100 MG TABLET,28.35,18.43,,,0
CDM,RX-24731,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,104.9,68.18,,,0
CDM,RX-2475,DILTIAZEM 30 MG TABLET,5.35,3.48,,,0
CDM,RX-2476,DILTIAZEM 60 MG TABLET,6.25,4.06,,,0
CDM,RX-2477,DILTIAZEM 90 MG TABLET,6.8,4.42,,,0
CDM,RX-24914,"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",7.5,4.88,,,0
CDM,RX-24916,LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,9.25,6.01,,,0
CDM,RX-24932,SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,73.2,47.58,,,0
CDM,RX-24984,POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,28.55,18.56,,,0
CDM,RX-250,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,5.5,3.58,,,0
CDM,RX-25005,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,12.0,7.8,,,0
CDM,RX-2505,DIPHENHYDRAMINE 25 MG TABLET,0.2,0.13,,,0
CDM,RX-2508,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,33.4,21.71,,,0
CDM,RX-25118,CIPROFLOXACIN 250 MG TABLET,5.25,3.41,,,0
CDM,RX-25120,CIPROFLOXACIN 750 MG TABLET,5.3,3.44,,,0
CDM,RX-2515,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,30.75,19.99,,,0
CDM,RX-2516,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,11.9,7.74,,,0
CDM,RX-2528,DIPYRIDAMOLE 25 MG TABLET,5.95,3.87,,,0
CDM,RX-2529,DIPYRIDAMOLE 50 MG TABLET,10.15,6.6,,,0
CDM,RX-253,ALBUTEROL SULFATE 2 MG TABLET,19.35,12.58,,,0
CDM,RX-2536,DISOPYRAMIDE PHOSPHATE 150 MG CAPSULE,8.55,5.56,,,0
CDM,RX-25365,CEFAZOLIN 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,91.05,59.18,,,0
CDM,RX-2537,"DISOPYRAMIDE PHOSPHATE ER 100 MG CAPSULE,EXTENDED RELEASE",17.1,11.12,,,0
CDM,RX-25424,POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,1.05,0.68,,,0
CDM,RX-2551,"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",4.8,3.12,,,0
CDM,RX-25519,RISPERIDONE 0.25 MG TABLET,5.1,3.32,,,0
CDM,RX-2552,"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",4.85,3.15,,,0
CDM,RX-25520,RISPERIDONE 0.5 MG TABLET,5.1,3.32,,,0
CDM,RX-25528,PIOGLITAZONE 15 MG TABLET,8.65,5.62,,,0
CDM,RX-25529,PIOGLITAZONE 30 MG TABLET,12.65,8.22,,,0
CDM,RX-2553,"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",5.1,3.32,,,0
CDM,RX-2566,DOCUSATE SODIUM 100 MG CAPSULE,0.15,0.1,,,0
CDM,RX-2568,DOCUSATE SODIUM 50 MG CAPSULE,0.25,0.16,,,0
CDM,RX-25820,IVERMECTIN 3 MG TABLET,16.15,10.5,,,0
CDM,RX-2595,DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,46.4,30.16,,,0
CDM,RX-2608,DOXEPIN 10 MG CAPSULE,6.15,4.0,,,0
CDM,RX-2611,DOXEPIN 25 MG CAPSULE,6.6,4.29,,,0
CDM,RX-2612,DOXEPIN 50 MG CAPSULE,7.35,4.78,,,0
CDM,RX-2614,DOXEPIN 10 MG/ML ORAL CONCENTRATE,12.7,8.26,,,0
CDM,RX-2622,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,84.4,54.86,,,0
CDM,RX-26224,"PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE",5.2,3.38,,,0
CDM,RX-26225,"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",5.1,3.32,,,0
CDM,RX-26226,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,38.2,24.83,,,0
CDM,RX-2623,DOXYCYCLINE HYCLATE 100 MG CAPSULE,8.5,5.52,,,0
CDM,RX-2625,DOXYCYCLINE HYCLATE 100 MG TABLET,8.95,5.82,,,0
CDM,RX-26371,"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",6.5,4.22,,,0
CDM,RX-2654,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,37.1,24.12,,,0
CDM,RX-26546,OSELTAMIVIR 75 MG CAPSULE,7.35,4.78,,,0
CDM,RX-26547,ENTACAPONE 200 MG TABLET,14.25,9.26,,,0
CDM,RX-26550,PROGESTERONE MICRONIZED 200 MG CAPSULE,6.95,4.52,,,0
CDM,RX-26551,EXEMESTANE 25 MG TABLET,9.45,6.14,,,0
CDM,RX-26816,LEVETIRACETAM 250 MG TABLET,5.05,3.28,,,0
CDM,RX-26817,LEVETIRACETAM 500 MG TABLET,5.1,3.32,,,0
CDM,RX-26966,DOFETILIDE 250 MCG CAPSULE,11.6,7.54,,,0
CDM,RX-27023,TERBINAFINE HCL 1 % TOPICAL CREAM,32.5,21.12,,,0
CDM,RX-27032,METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION,267.55,173.91,,,0
CDM,RX-27103,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,41.95,27.27,,,0
CDM,RX-27181,"NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",8.0,5.2,,,0
CDM,RX-27182,"NIACIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR",10.4,6.76,,,0
CDM,RX-27234,MONTELUKAST 4 MG CHEWABLE TABLET,6.6,4.29,,,0
CDM,RX-27327,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,50.9,33.08,,,0
CDM,RX-27390,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,39.15,25.45,,,0
CDM,RX-27392,MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,1724.25,1120.76,,,0
CDM,RX-27430,PENTAMIDINE 300 MG SOLUTION FOR INJECTION,218.4,141.96,,,0
CDM,RX-27431,"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",1816.95,1181.02,,,0
CDM,RX-27458,ESTRADIOL 0.0375 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,30.8,20.02,,,0
CDM,RX-27459,ESTRADIOL 0.05 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,29.1,18.92,,,0
CDM,RX-27461,ESTRADIOL 0.1 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,29.4,19.11,,,0
CDM,RX-27466,DEXTROSE 40 % ORAL GEL,2.95,1.92,,,0
CDM,RX-27467,"DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE",1594.2,1036.23,,,0
CDM,RX-27471,NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,6.35,4.13,,,0
CDM,RX-27472,NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,6.25,4.06,,,0
CDM,RX-27474,NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,6.8,4.42,,,0
CDM,RX-27505,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,25.55,16.61,,,0
CDM,RX-27506,CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,36.65,23.82,,,0
CDM,RX-27507,CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,183.45,119.24,,,0
CDM,RX-27631,"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",5.35,3.48,,,0
CDM,RX-27634,"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",5.9,3.84,,,0
CDM,RX-27635,"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",13.3,8.64,,,0
CDM,RX-27659,"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",10.35,6.73,,,0
CDM,RX-27660,"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",7.5,4.88,,,0
CDM,RX-27663,FLUORESCEIN 1 MG EYE STRIPS,5.3,3.44,,,0
CDM,RX-27666,BENZOCAINE 20 % MUCOSAL SPRAY,0.95,0.62,,,0
CDM,RX-27696,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,33.2,21.58,,,0
CDM,RX-27697,ONDANSETRON 4 MG DISINTEGRATING TABLET,5.7,3.7,,,0
CDM,RX-27698,ONDANSETRON 8 MG DISINTEGRATING TABLET,5.7,3.7,,,0
CDM,RX-27780,ZONISAMIDE 100 MG CAPSULE,5.9,3.84,,,0
CDM,RX-27796,PERITON.DIALYSIS SOLN 6-1.5 % DEXTROS LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L,159.7,103.8,,,0
CDM,RX-27800,PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L,159.7,103.8,,,0
CDM,RX-27804,PERITON. DIALYSIS SOLN 8-4.25 % DEXTROSE CALC 2.5 MEQ/L-MAG 0.5 MEQ/L,161.85,105.2,,,0
CDM,RX-27838,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,67.15,43.65,,,0
CDM,RX-27857,"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",5.85,3.8,,,0
CDM,RX-27858,"VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR",5.9,3.84,,,0
CDM,RX-27859,"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",6.0,3.9,,,0
CDM,RX-27860,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,1.15,0.75,,,0
CDM,RX-27862,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,1.15,0.75,,,0
CDM,RX-27863,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,1.15,0.75,,,0
CDM,RX-27905,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,27.5,17.88,,,0
CDM,RX-27906,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,35.2,22.88,,,0
CDM,RX-27907,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,46.8,30.42,,,0
CDM,RX-27908,FENTANYL 100 MCG/HR TRANSDERMAL PATCH,58.35,37.93,,,0
CDM,RX-27913,FENTANYL 200 MCG LOZENGE ON A HANDLE,32.75,21.29,,,0
CDM,RX-27927,AMINO ACID 4.25 % NO.1 IN DEXTROSE 5 % INTRAVENOUS SOLUTION,117.65,76.47,,,0
CDM,RX-27963,AMINO ACID 5 % NO.6-DEXTROSE 15 %-ELECTROLYTES NO.23 IV SOLUTION,359.45,233.64,,,0
CDM,RX-27980,ARTIFICIAL TEARS (HYPROMELLOSE) 0.5 % EYE DROPS,116.4,75.66,,,0
CDM,RX-27994,POLYVINYL ALCOHOL 1.4 % EYE DROPS,40.1,26.06,,,0
CDM,RX-28011,SERTRALINE 20 MG/ML ORAL CONCENTRATE,7.3,4.74,,,0
CDM,RX-28055,CALAMINE 8 %-ZINC OXIDE 8 % LOTION,1.45,0.94,,,0
CDM,RX-28112,ELECTROLYTE-148 INTRAVENOUS SOLUTION,109.05,70.88,,,0
CDM,RX-28113,ELECTROLYTE-A INTRAVENOUS SOLUTION,75.55,49.11,,,0
CDM,RX-28158,OLANZAPINE 20 MG TABLET,6.0,3.9,,,0
CDM,RX-28159,OLANZAPINE 5 MG DISINTEGRATING TABLET,7.1,4.62,,,0
CDM,RX-28224,LINEZOLID 600 MG TABLET,10.8,7.02,,,0
CDM,RX-28225,LINEZOLID 100 MG/5 ML ORAL SUSPENSION,794.9,516.68,,,0
CDM,RX-28228,CITALOPRAM 10 MG/5 ML ORAL SOLUTION,8.15,5.3,,,0
CDM,RX-28235,PENTAMIDINE 300 MG SOLUTION FOR INHALATION,284.5,184.92,,,0
CDM,RX-28252,FENOFIBRATE 160 MG TABLET,8.4,5.46,,,0
CDM,RX-28278,RIVASTIGMINE 1.5 MG CAPSULE,11.3,7.34,,,0
CDM,RX-28282,INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,311.2,202.28,,,0
CDM,RX-28351,AZELASTINE 0.05 % EYE DROPS,30.8,20.02,,,0
CDM,RX-28372,COLESEVELAM 625 MG TABLET,12.85,8.35,,,0
CDM,RX-28384,HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,10.2,6.63,,,0
CDM,RX-28400,"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",71.35,46.38,,,0
CDM,RX-28409,ESTRADIOL 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,55.05,35.78,,,0
CDM,RX-2848,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,48.9,31.78,,,0
CDM,RX-28530,TENECTEPLASE 50 MG INTRAVENOUS KIT,1897.5,1233.38,,,0
CDM,RX-2863,"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",7.1,4.62,,,0
CDM,RX-28645,ATORVASTATIN 80 MG TABLET,5.85,3.8,,,0
CDM,RX-28774,BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,23.0,14.95,,,0
CDM,RX-28775,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,15.0,9.75,,,0
CDM,RX-28810,"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",308.4,200.46,,,0
CDM,RX-28824,HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR,43.95,28.57,,,0
CDM,RX-28829,METHYL SALICYLATE TOPICAL LIQUID,34.6,22.49,,,0
CDM,RX-28842,CYCLOSPORINE MODIFIED 25 MG CAPSULE,5.9,3.84,,,0
CDM,RX-28843,CYCLOSPORINE MODIFIED 100 MG CAPSULE,9.95,6.47,,,0
CDM,RX-28844,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,1856.3,1206.6,,,0
CDM,RX-2888,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,59.5,38.68,,,0
CDM,RX-28899,OXYCODONE 15 MG TABLET,11.2,7.28,,,0
CDM,RX-28900,OXYCODONE 30 MG TABLET,8.2,5.33,,,0
CDM,RX-28911,CARMUSTINE 100 MG INTRAVENOUS SOLUTION,1539.35,1000.58,,,0
CDM,RX-28912,DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,11317.4,7356.31,,,0
CDM,RX-28947,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,589.45,383.14,,,0
CDM,RX-28958,SIROLIMUS 1 MG TABLET,24.65,16.02,,,0
CDM,RX-28964,LEVOFLOXACIN 750 MG TABLET,5.75,3.74,,,0
CDM,RX-2899,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,27.1,17.62,,,0
CDM,RX-28995,"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",4.7,3.06,,,0
CDM,RX-2900,ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,57.4,37.31,,,0
CDM,RX-2901,ERYTHROMYCIN ETHYLSUCCINATE 400 MG TABLET,39.8,25.87,,,0
CDM,RX-2903,ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,316.65,205.82,,,0
CDM,RX-29071,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,228.05,148.23,,,0
CDM,RX-29132,IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,197.6,128.44,,,0
CDM,RX-29169,GABAPENTIN 250 MG/5 ML ORAL SOLUTION,33.25,21.61,,,0
CDM,RX-29267,QUETIAPINE 300 MG TABLET,5.65,3.67,,,0
CDM,RX-29270,"DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24 HR",5.55,3.61,,,0
CDM,RX-29272,"DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR",5.65,3.67,,,0
CDM,RX-29274,"DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24 HR",5.6,3.64,,,0
CDM,RX-29280,LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,3402.85,2211.85,,,0
CDM,RX-29287,DOCOSANOL 10 % TOPICAL CREAM,9.8,6.37,,,0
CDM,RX-2929,ESTRADIOL CYPIONATE 5 MG/ML INTRAMUSCULAR OIL,78.45,50.99,,,0
CDM,RX-29299,BALSALAZIDE 750 MG CAPSULE,6.7,4.36,,,0
CDM,RX-2931,ESTRADIOL VALERATE 20 MG/ML INTRAMUSCULAR OIL,119.7,77.8,,,0
CDM,RX-29313,CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,14860.7,9659.46,,,0
CDM,RX-29335,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,55.2,35.88,,,0
CDM,RX-2938,CONJUGATED ESTROGENS 1.25 MG TABLET,25.05,16.28,,,0
CDM,RX-29396,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,214.6,139.49,,,0
CDM,RX-29424,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,72.3,47.0,,,0
CDM,RX-29434,"TOLTERODINE ER 2 MG CAPSULE,EXTENDED RELEASE 24 HR",23.2,15.08,,,0
CDM,RX-29437,NATEGLINIDE 60 MG TABLET,9.5,6.18,,,0
CDM,RX-29464,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,47.0,30.55,,,0
CDM,RX-2951,ETHYL CHLORIDE 100 % TOPICAL SPRAY,123.45,80.24,,,0
CDM,RX-29531,MIRTAZAPINE 15 MG DISINTEGRATING TABLET,5.95,3.87,,,0
CDM,RX-29676,SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,12.15,7.9,,,0
CDM,RX-29778,ZIPRASIDONE 20 MG CAPSULE,10.15,6.6,,,0
CDM,RX-29779,ZIPRASIDONE 40 MG CAPSULE,10.2,6.63,,,0
CDM,RX-29805,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",400.25,260.16,,,0
CDM,RX-29806,GALANTAMINE 4 MG TABLET,15.2,9.88,,,0
CDM,RX-29807,GALANTAMINE 8 MG TABLET,6.55,4.26,,,0
CDM,RX-29822,HYOSCYAMINE 0.125 MG DISINTEGRATING TABLET,5.1,3.32,,,0
CDM,RX-29833,VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,4.8,3.12,,,0
CDM,RX-30070,"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",5.65,3.67,,,0
CDM,RX-30071,"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",6.05,3.93,,,0
CDM,RX-30148,VALGANCICLOVIR 450 MG TABLET,33.35,21.68,,,0
CDM,RX-3037,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,36.35,23.63,,,0
CDM,RX-30479,OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,7.25,4.71,,,0
CDM,RX-30538,GUAR GUM ORAL PACKET,39.4,25.61,,,0
CDM,RX-30594,MORPHINE 2 MG/ML INJECTION SOLUTION,41.45,26.94,,,0
CDM,RX-30699,ROPINIROLE 3 MG TABLET,5.05,3.28,,,0
CDM,RX-3071,FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQUID,8.95,5.82,,,0
CDM,RX-3074,FERROUS SULFATE 325 MG (65 MG IRON) TABLET,0.05,0.03,,,0
CDM,RX-30807,FENTANYL (PF) 10 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,243.0,157.95,,,0
CDM,RX-30961,CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,6.8,4.42,,,0
CDM,RX-310,ALLOPURINOL 100 MG TABLET,5.15,3.35,,,0
CDM,RX-31025,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",274.8,178.62,,,0
CDM,RX-311,ALLOPURINOL 300 MG TABLET,5.7,3.7,,,0
CDM,RX-31158,BRIMONIDINE 0.15 % EYE DROPS,599.8,389.87,,,0
CDM,RX-31209,VALSARTAN 80 MG TABLET,5.55,3.61,,,0
CDM,RX-31210,VALSARTAN 160 MG TABLET,5.35,3.48,,,0
CDM,RX-31270,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS SUSPENSION,752.9,489.38,,,0
CDM,RX-31288,TRAMADOL 37.5 MG-ACETAMINOPHEN 325 MG TABLET,8.85,5.75,,,0
CDM,RX-31310,ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,696.25,452.56,,,0
CDM,RX-31432,DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,23098.9,15014.28,,,0
CDM,RX-31576,"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",28.75,18.69,,,0
CDM,RX-31588,"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",12.45,8.09,,,0
CDM,RX-31684,TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,9.4,6.11,,,0
CDM,RX-31784,ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,1084.15,704.7,,,0
CDM,RX-31863,OXYCODONE-ACETAMINOPHEN 7.5 MG-325 MG TABLET,13.0,8.45,,,0
CDM,RX-31864,OXYCODONE-ACETAMINOPHEN 10 MG-325 MG TABLET,12.85,8.35,,,0
CDM,RX-3187,FLUOCINONIDE 0.05 % TOPICAL CREAM,69.45,45.14,,,0
CDM,RX-3189,FLUOCINONIDE 0.05 % TOPICAL OINTMENT,57.6,37.44,,,0
CDM,RX-3190,FLUOCINONIDE 0.05 % TOPICAL SOLUTION,76.1,49.46,,,0
CDM,RX-31921,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,88.6,57.59,,,0
CDM,RX-31922,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,152.3,99.0,,,0
CDM,RX-3215,FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION,51.5,33.48,,,0
CDM,RX-3216,FLUPHENAZINE 2.5 MG/ML INJECTION SOLUTION,58.35,37.93,,,0
CDM,RX-3218,FLUPHENAZINE 1 MG TABLET,8.95,5.82,,,0
CDM,RX-3220,FLUPHENAZINE 2.5 MG TABLET,11.95,7.77,,,0
CDM,RX-3221,FLUPHENAZINE 5 MG TABLET,13.6,8.84,,,0
CDM,RX-32215,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,63.4,41.21,,,0
CDM,RX-32267,PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,15393.0,10005.45,,,0
CDM,RX-32298,EFAVIRENZ 600 MG TABLET,12.35,8.03,,,0
CDM,RX-3232,FOLIC ACID 5 MG/ML INJECTION SOLUTION,35.7,23.2,,,0
CDM,RX-3233,FOLIC ACID 1 MG TABLET,5.0,3.25,,,0
CDM,RX-324,ALPRAZOLAM 0.25 MG TABLET,9.1,5.92,,,0
CDM,RX-32415,"DEXTROAMPHETAMINE SULFATE ER 5 MG CAPSULE,EXTENDED RELEASE",13.75,8.94,,,0
CDM,RX-32416,"DEXTROAMPHETAMINE SULFATE ER 10 MG CAPSULE,EXTENDED RELEASE",15.3,9.94,,,0
CDM,RX-32569,STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,521.9,339.24,,,0
CDM,RX-32589,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,99.65,64.77,,,0
CDM,RX-326,ALPRAZOLAM 1 MG TABLET,8.35,5.43,,,0
CDM,RX-32700,ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,3313.95,2154.07,,,0
CDM,RX-32855,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,163.05,105.98,,,0
CDM,RX-32893,LEUPROLIDE 7.5 MG (1 MONTH) SUBCUTANEOUS SYRINGE,456.85,296.95,,,0
CDM,RX-3291,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,39.75,25.84,,,0
CDM,RX-3293,FUROSEMIDE 40 MG/5 ML (8 MG/ML) ORAL SOLUTION,10.25,6.66,,,0
CDM,RX-32931,TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,6584.9,4280.18,,,0
CDM,RX-3294,FUROSEMIDE 20 MG TABLET,4.75,3.09,,,0
CDM,RX-3295,FUROSEMIDE 40 MG TABLET,4.75,3.09,,,0
CDM,RX-32950,MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,77.2,50.18,,,0
CDM,RX-3296,FUROSEMIDE 80 MG TABLET,5.75,3.74,,,0
CDM,RX-33010,VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,99.65,64.77,,,0
CDM,RX-33083,MIDODRINE 10 MG TABLET,6.85,4.45,,,0
CDM,RX-33175,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,97.85,63.6,,,0
CDM,RX-33227,AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,5.55,3.61,,,0
CDM,RX-33228,AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,6.0,3.9,,,0
CDM,RX-33230,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,35.0,22.75,,,0
CDM,RX-33512,ESCITALOPRAM 10 MG TABLET,5.2,3.38,,,0
CDM,RX-33541,VALSARTAN 40 MG TABLET,6.65,4.32,,,0
CDM,RX-33591,RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,4674.0,3038.1,,,0
CDM,RX-3378,GEMFIBROZIL 600 MG TABLET,5.25,3.41,,,0
CDM,RX-33963,METAXALONE 800 MG TABLET,15.9,10.34,,,0
CDM,RX-34034,PEGINTERFERON ALFA-2A 180 MCG/ML SUBCUTANEOUS SOLUTION,3905.4,2538.51,,,0
CDM,RX-34153,EZETIMIBE 10 MG TABLET,18.25,11.86,,,0
CDM,RX-3423,GENTAMICIN 0.1 % TOPICAL CREAM,160.9,104.58,,,0
CDM,RX-3424,GENTAMICIN 0.1 % TOPICAL OINTMENT,70.15,45.6,,,0
CDM,RX-3426,GENTAMICIN 40 MG/ML INJECTION SOLUTION,148.65,96.62,,,0
CDM,RX-3428,GENTAMICIN 0.3 % EYE DROPS,23.7,15.4,,,0
CDM,RX-3430,GENTIAN VIOLET 1 % TOPICAL SOLUTION,5.5,3.58,,,0
CDM,RX-34369,ARIPIPRAZOLE 10 MG TABLET,5.8,3.77,,,0
CDM,RX-34370,ARIPIPRAZOLE 15 MG TABLET,8.2,5.33,,,0
CDM,RX-34418,"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",5.0,3.25,,,0
CDM,RX-34444,ATOMOXETINE 10 MG CAPSULE,9.35,6.08,,,0
CDM,RX-34445,ATOMOXETINE 18 MG CAPSULE,9.35,6.08,,,0
CDM,RX-34447,ATOMOXETINE 40 MG CAPSULE,9.75,6.34,,,0
CDM,RX-34448,ATOMOXETINE 60 MG CAPSULE,8.15,5.3,,,0
CDM,RX-34505,HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,9.6,6.24,,,0
CDM,RX-34524,PIPERACILLIN-TAZOBACTAM 3.375 GRAM/50 ML DEXTROSE(ISO-OS) IV PIGGYBACK,143.85,93.5,,,0
CDM,RX-34544,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET,9.85,6.4,,,0
CDM,RX-34711,BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET,15.15,9.85,,,0
CDM,RX-34712,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,20.1,13.06,,,0
CDM,RX-34713,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,14.6,9.49,,,0
CDM,RX-34714,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,16.15,10.5,,,0
CDM,RX-34770,NICOTINE (POLACRILEX) 4 MG BUCCAL LOZENGE,0.3,0.2,,,0
CDM,RX-34814,"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG/ML-10,000 UNIT/ML-1 % EAR SOLUTION",230.0,149.5,,,0
CDM,RX-35126,"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",585.7,380.7,,,0
CDM,RX-35134,ROSUVASTATIN 10 MG TABLET,7.3,4.74,,,0
CDM,RX-35135,ROSUVASTATIN 20 MG TABLET,7.8,5.07,,,0
CDM,RX-35184,CYCLOBENZAPRINE 5 MG TABLET,5.8,3.77,,,0
CDM,RX-35236,LEUPROLIDE 30 MG (4 MONTH) SUBCUTANEOUS SYRINGE,1580.95,1027.62,,,0
CDM,RX-3542,GUAIFENESIN 100 MG/5 ML ORAL LIQUID,2.95,1.92,,,0
CDM,RX-35640,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,61.3,39.84,,,0
CDM,RX-35686,RISPERIDONE 0.5 MG DISINTEGRATING TABLET,8.75,5.69,,,0
CDM,RX-35687,RISPERIDONE 1 MG DISINTEGRATING TABLET,16.45,10.69,,,0
CDM,RX-35688,RISPERIDONE 2 MG DISINTEGRATING TABLET,12.95,8.42,,,0
CDM,RX-35699,MOXIFLOXACIN 0.5 % EYE DROPS,266.7,173.36,,,0
CDM,RX-35771,"METFORMIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR",5.45,3.54,,,0
CDM,RX-35775,AGALSIDASE BETA 35 MG INTRAVENOUS SOLUTION,39483.35,25664.18,,,0
CDM,RX-3578,HALOPERIDOL 0.5 MG TABLET,5.45,3.54,,,0
CDM,RX-3579,HALOPERIDOL 1 MG TABLET,5.8,3.77,,,0
CDM,RX-3580,HALOPERIDOL 10 MG TABLET,7.0,4.55,,,0
CDM,RX-3581,HALOPERIDOL 2 MG TABLET,6.25,4.06,,,0
CDM,RX-3583,HALOPERIDOL 5 MG TABLET,6.2,4.03,,,0
CDM,RX-35839,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,124.5,80.92,,,0
CDM,RX-3584,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,33.95,22.07,,,0
CDM,RX-3585,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,5.15,3.35,,,0
CDM,RX-35942,"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",5.65,3.67,,,0
CDM,RX-36046,POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,71.35,46.38,,,0
CDM,RX-36092,IMATINIB 400 MG TABLET,11.0,7.15,,,0
CDM,RX-36135,CARBIDOPA 12.5 MG-LEVODOPA 50 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
CDM,RX-36136,CARBIDOPA 25 MG-LEVODOPA 100 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
CDM,RX-36150,ATAZANAVIR 200 MG CAPSULE,12.55,8.16,,,0
CDM,RX-36151,OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,7381.45,4797.94,,,0
CDM,RX-36198,CONJUGATED ESTROGENS 0.45 MG TABLET,25.05,16.28,,,0
CDM,RX-36252,EMTRICITABINE 200 MG CAPSULE,56.3,36.6,,,0
CDM,RX-364,AMANTADINE HCL 100 MG CAPSULE,7.3,4.74,,,0
CDM,RX-36438,ARIPIPRAZOLE 5 MG TABLET,5.55,3.61,,,0
CDM,RX-365,AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,9.3,6.04,,,0
CDM,RX-36576,"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",314.6,204.49,,,0
CDM,RX-36591,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,102.55,66.66,,,0
CDM,RX-36775,"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",8.35,5.43,,,0
CDM,RX-36959,AMIODARONE 100 MG TABLET,12.7,8.26,,,0
CDM,RX-36962,DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,7.3,4.74,,,0
CDM,RX-36966,MEMANTINE 10 MG TABLET,5.5,3.58,,,0
CDM,RX-3697,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,48.65,31.62,,,0
CDM,RX-3698,HYDRALAZINE 10 MG TABLET,5.15,3.35,,,0
CDM,RX-36983,EPLERENONE 25 MG TABLET,13.0,8.45,,,0
CDM,RX-36987,ZONISAMIDE 25 MG CAPSULE,4.85,3.15,,,0
CDM,RX-36988,ZONISAMIDE 50 MG CAPSULE,5.05,3.28,,,0
CDM,RX-36989,DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,107.15,69.65,,,0
CDM,RX-3700,HYDRALAZINE 25 MG TABLET,4.75,3.09,,,0
CDM,RX-3701,HYDRALAZINE 50 MG TABLET,5.25,3.41,,,0
CDM,RX-37170,MEMANTINE 5 MG TABLET,5.55,3.61,,,0
CDM,RX-3720,HYDROCHLOROTHIAZIDE 25 MG TABLET,5.1,3.32,,,0
CDM,RX-37237,"RISPERIDONE MICROSPHERES ER 25 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE",2965.5,1927.58,,,0
CDM,RX-37238,"RISPERIDONE MICROSPHERES ER 37.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS",4431.95,2880.77,,,0
CDM,RX-37239,"RISPERIDONE MICROSPHERES ER 50 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE",5898.5,3834.02,,,0
CDM,RX-3726,HYDROCORTISONE 1 % TOPICAL CREAM,1.0,0.65,,,0
CDM,RX-3728,HYDROCORTISONE 1 % LOTION,6.75,4.39,,,0
CDM,RX-3733,HYDROCORTISONE 10 MG TABLET,8.6,5.59,,,0
CDM,RX-3734,HYDROCORTISONE 20 MG TABLET,8.5,5.52,,,0
CDM,RX-3738,HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,8.6,5.59,,,0
CDM,RX-37400,TADALAFIL 5 MG TABLET,5.5,3.58,,,0
CDM,RX-3757,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,45.75,29.74,,,0
CDM,RX-3760,HYDROMORPHONE 2 MG TABLET,8.85,5.75,,,0
CDM,RX-3761,HYDROMORPHONE 4 MG TABLET,9.65,6.27,,,0
CDM,RX-37635,ESCITALOPRAM 5 MG TABLET,4.9,3.18,,,0
CDM,RX-37637,METOPROLOL TARTRATE 25 MG TABLET,4.8,3.12,,,0
CDM,RX-37642,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,7.25,4.71,,,0
CDM,RX-37645,"PROPAFENONE ER 425 MG CAPSULE,EXTENDED RELEASE 12 HR",8.5,5.52,,,0
CDM,RX-37665,OLANZAPINE-FLUOXETINE 6 MG-25 MG CAPSULE,23.35,15.18,,,0
CDM,RX-37666,OLANZAPINE-FLUOXETINE 6 MG-50 MG CAPSULE,21.5,13.98,,,0
CDM,RX-37667,OLANZAPINE-FLUOXETINE 12 MG-25 MG CAPSULE,29.2,18.98,,,0
CDM,RX-3769,HYDROXYZINE HCL 25 MG/ML INTRAMUSCULAR SOLUTION,123.25,80.11,,,0
CDM,RX-3770,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,85.85,55.8,,,0
CDM,RX-3771,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,234.85,152.65,,,0
CDM,RX-3772,HYDROXYZINE HCL 10 MG TABLET,5.2,3.38,,,0
CDM,RX-37812,STERILE TALC 5 GRAM INTRAPLEURAL SUSPENSION,473.9,308.04,,,0
CDM,RX-37848,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,44.35,28.83,,,0
CDM,RX-37894,PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,277.15,180.15,,,0
CDM,RX-37989,CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION,3473.05,2257.48,,,0
CDM,RX-38062,"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",27.3,17.74,,,0
CDM,RX-38063,"MYCOPHENOLATE SODIUM 360 MG TABLET,DELAYED RELEASE",23.3,15.14,,,0
CDM,RX-38072,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML INJECTION SYRINGE",357.25,232.21,,,0
CDM,RX-38103,VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,282.3,183.5,,,0
CDM,RX-38224,"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",9.85,6.4,,,0
CDM,RX-38225,"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",10.25,6.66,,,0
CDM,RX-38263,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,97.75,63.54,,,0
CDM,RX-38270,CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,483.0,313.95,,,0
CDM,RX-38271,CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,313.4,203.71,,,0
CDM,RX-38285,ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,9.15,5.95,,,0
CDM,RX-38303,ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,41.75,27.14,,,0
CDM,RX-38315,TIOTROPIUM BROMIDE 18 MCG CAPSULE WITH INHALATION DEVICE,207.25,134.71,,,0
CDM,RX-3841,IBUPROFEN 200 MG TABLET,0.05,0.03,,,0
CDM,RX-38421,MIRTAZAPINE 7.5 MG TABLET,10.4,6.76,,,0
CDM,RX-3843,IBUPROFEN 400 MG TABLET,0.1,0.06,,,0
CDM,RX-3844,IBUPROFEN 600 MG TABLET,0.15,0.1,,,0
CDM,RX-38488,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,6.4,4.16,,,0
CDM,RX-38494,AGALSIDASE BETA 5 MG INTRAVENOUS SOLUTION,5667.75,3684.04,,,0
CDM,RX-3861,IMIPRAMINE 25 MG TABLET,4.85,3.15,,,0
CDM,RX-38701,"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",70.5,45.82,,,0
CDM,RX-38703,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,38.7,25.16,,,0
CDM,RX-38907,TINIDAZOLE 500 MG TABLET,12.55,8.16,,,0
CDM,RX-3897,INDOMETHACIN 25 MG CAPSULE,5.35,3.48,,,0
CDM,RX-38977,TROSPIUM 20 MG TABLET,6.9,4.48,,,0
CDM,RX-3898,INDOMETHACIN 50 MG CAPSULE,5.3,3.44,,,0
CDM,RX-3901,INDOMETHACIN 50 MG RECTAL SUPPOSITORY,483.75,314.44,,,0
CDM,RX-391,AMILORIDE 5 MG TABLET,5.25,3.41,,,0
CDM,RX-39136,"NYSTATIN 100,000 UNIT/GRAM TOPICAL POWDER",35.65,23.17,,,0
CDM,RX-39254,NITAZOXANIDE 500 MG TABLET,394.15,256.2,,,0
CDM,RX-39265,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,214.8,139.62,,,0
CDM,RX-39276,"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",4.9,3.18,,,0
CDM,RX-39277,"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",5.2,3.38,,,0
CDM,RX-39301,ABACAVIR 600 MG-LAMIVUDINE 300 MG TABLET,10.35,6.73,,,0
CDM,RX-39390,"ARGININE HCL (L-ARGININE) 1,000 MG TABLET",4.9,3.18,,,0
CDM,RX-39720,"ACAMPROSATE 333 MG TABLET,DELAYED RELEASE",6.2,4.03,,,0
CDM,RX-39744,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,39.05,25.38,,,0
CDM,RX-39802,NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,99.7,64.8,,,0
CDM,RX-39918,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,42.0,27.3,,,0
CDM,RX-39975,LANTHANUM 500 MG CHEWABLE TABLET,20.15,13.1,,,0
CDM,RX-400291,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,60.85,39.55,,,0
CDM,RX-400291,SODIUM CHLORIDE 0.9 % IV BOLUS,64.0,41.6,,,0
CDM,RX-400292,SODIUM CHLORIDE 0.45 % IV BOLUS,61.900000000000006,40.235,,,0
CDM,RX-400293,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,41.75,27.14,,,0
CDM,RX-400293,DEXTROSE 5 % IV BOLUS,69.25,45.01,,,0
CDM,RX-400294,DEXTROSE 5 % AND 0.9 % NACL IV BOLUS,60.85,39.55,,,0
CDM,RX-400295,DEXTROSE 5 % AND 0.45 % NACL IV BOLUS,60.85,39.55,,,0
CDM,RX-400296,LACTATED RINGERS IV BOLUS,60.85,39.55,,,0
CDM,RX-400297,DEXTROSE 5 % IN LACTATED RINGERS IV BOLUS,65.05,42.28,,,0
CDM,RX-400302,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,64.0,41.6,,,0
CDM,RX-400302,DEXTROSE 10 % IV BOLUS,37.175,24.165,,,0
CDM,RX-40120,NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,37286.0,24235.9,,,0
CDM,RX-40158,SELENIUM SULFIDE 2.25 % SHAMPOO,153.45,99.74,,,0
CDM,RX-4025,ISONIAZID 50 MG/5 ML ORAL SOLUTION,687.85,447.1,,,0
CDM,RX-4027,ISONIAZID 300 MG TABLET,7.5,4.88,,,0
CDM,RX-403,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,70.0,45.5,,,0
CDM,RX-40369,"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",116.5,75.72,,,0
CDM,RX-40475,PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,3069.9,1995.44,,,0
CDM,RX-4064,ISOSORBIDE DINITRATE 10 MG TABLET,5.8,3.77,,,0
CDM,RX-4065,ISOSORBIDE DINITRATE 20 MG TABLET,6.0,3.9,,,0
CDM,RX-4068,ISOSORBIDE DINITRATE 5 MG TABLET,6.3,4.1,,,0
CDM,RX-407,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,90.65,58.92,,,0
CDM,RX-40801,LEUPROLIDE ACETATE 45 MG (6 MONTH) SUBCUTANEOUS SYRINGE,2330.4,1514.76,,,0
CDM,RX-40840026,PROPOFOL INFUSION 10 MG/ML,97.75,63.54,,,0
CDM,RX-40872,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,33.4,21.71,,,0
CDM,RX-41003,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.1,0.06,,,0
CDM,RX-411026,BLEOMYCIN 15 UNIT/ML (IM/SC CONCENTRATION),193.05,125.48,,,0
CDM,RX-41124,PHENOL (BULK) 89 % LIQUID,12.6,8.19,,,0
CDM,RX-41144,MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,114.3,74.3,,,0
CDM,RX-41147,ENTECAVIR 0.5 MG TABLET,8.5,5.52,,,0
CDM,RX-41149,ENTECAVIR 0.05 MG/ML ORAL SOLUTION,136.8,88.92,,,0
CDM,RX-41294,FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,371.25,241.31,,,0
CDM,RX-41382,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,25.2,16.38,,,0
CDM,RX-41412,PEG 400-HYPROMELLOSE-GLYCERIN 1 %-0.2 %-0.2 % EYE DROPS,1.55,1.01,,,0
CDM,RX-41623,LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,6.25,4.06,,,0
CDM,RX-41628,"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",222.4,144.56,,,0
CDM,RX-41652,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,98.7,64.16,,,0
CDM,RX-41673,VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,193.9,126.04,,,0
CDM,RX-41787,SODIUM TETRADECYL SULFATE 1 % (10 MG/ML) INTRAVENOUS SOLUTION,377.0,245.05,,,0
CDM,RX-41793,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,114.1,74.16,,,0
CDM,RX-41829,MEMANTINE 2 MG/ML ORAL SOLUTION,21.15,13.75,,,0
CDM,RX-41831,LIDOCAINE 5 % TOPICAL OINTMENT,39.65,25.77,,,0
CDM,RX-41832,SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,6.25,4.06,,,0
CDM,RX-41899,METRONIDAZOLE 1 % TOPICAL GEL,263.55,171.31,,,0
CDM,RX-42162,PREGABALIN 25 MG CAPSULE,9.8,6.37,,,0
CDM,RX-42163,PREGABALIN 50 MG CAPSULE,9.8,6.37,,,0
CDM,RX-42164,PREGABALIN 75 MG CAPSULE,9.8,6.37,,,0
CDM,RX-42219,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,2.05,1.33,,,0
CDM,RX-4237,KETAMINE 100 MG/ML INJECTION SOLUTION,73.2,47.58,,,0
CDM,RX-4238,KETAMINE 50 MG/ML INJECTION SOLUTION,33.3,21.64,,,0
CDM,RX-42989,EMTRICITABINE 10 MG/ML ORAL SOLUTION,350.55,227.86,,,0
CDM,RX-431592,CRRT BK 0/3.5 5000 ML SOLUTION,146.75,95.39,,,0
CDM,RX-4319,LACTATED RINGERS IRRIGATION SOLUTION,81.175,52.76,,,0
CDM,RX-432,AMITRIPTYLINE 10 MG TABLET,5.45,3.54,,,0
CDM,RX-433,AMITRIPTYLINE 100 MG TABLET,4.9,3.18,,,0
CDM,RX-43391,LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,25.95,16.87,,,0
CDM,RX-435,AMITRIPTYLINE 25 MG TABLET,5.4,3.51,,,0
CDM,RX-436,AMITRIPTYLINE 50 MG TABLET,5.75,3.74,,,0
CDM,RX-437,AMITRIPTYLINE 75 MG TABLET,4.8,3.12,,,0
CDM,RX-4392,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,87.45,56.84,,,0
CDM,RX-4393,LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,140.85,91.55,,,0
CDM,RX-4398,LEUCOVORIN CALCIUM 5 MG TABLET,9.2,5.98,,,0
CDM,RX-441001,AZATHIOPRINE 25 MG SPLIT TABLET,5.4,3.51,,,0
CDM,RX-441008,MERCAPTOPURINE 25 MG SPLIT TABLET,6.45,4.19,,,0
CDM,RX-441010,MISOPROSTOL 25 MCG SPLIT TABLET,5.1,3.32,,,0
CDM,RX-441011,MISOPROSTOL 50 MCG SPLIT TABLET,5.6,3.64,,,0
CDM,RX-441022,ALTEPLASE 10 MG/10 ML IV SOLUTION,1220.475,793.31,,,0
CDM,RX-441023,METHOHEXITAL 100 MG/10 ML INJECTION,61.55,40.01,,,0
CDM,RX-441065,CRRT BGK 2/0 (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
CDM,RX-441066,CRRT B22GK 4/0 (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
CDM,RX-441067,CRRT BGK 4/0/1.2 (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
CDM,RX-441068,CRRT BGK 4/2.5 WITH CALCIUM (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
CDM,RX-441069,CEFAZOLIN IVPB 2 G IN D5W 50 ML (CMP PMX),92.3,60.0,,,0
CDM,RX-441070,NICARDIPINE 25 MG IN NS 250 ML (CMP PMX),112.85,73.35,,,0
CDM,RX-441071,CLINDAMYCIN 600 MG/1000 ML IN NS IRRIGATION (CMP PMX),72.2,46.93,,,0
CDM,RX-441075,NITROGLYCERIN 100 MCG/ML 10ML SYRINGE (CMP PMX),35.95,23.37,,,0
CDM,RX-441077,NICARDIPINE 100 MCG/ML 4ML INJECTION (CMP PMX),34.2,22.23,,,0
CDM,RX-441078,PRIMING SOLUTION 1100 ML (CMP PMX),100.65,65.42,,,0
CDM,RX-441079,CEFAZOLIN 1 GM/500 ML IN NS IRRIGATION (CMP PMX),68.2,44.33,,,0
CDM,RX-441080,GENTAMICIN IRRIGATION 160 MG/1000 ML (CMP PMX),72.4,47.06,,,0
CDM,RX-441081,CARDIOPLEGIC 1000 ML BASE SOLUTION (CMP),226.35,147.13,,,0
CDM,RX-441089,VANCOMYCIN ORAL 250 MG/5 ML,5.95,3.87,,,0
CDM,RX-441090,ADENOSINE 90 MG IN 90 ML NS IVPB (CMP PMX),717.3,466.24,,,0
CDM,RX-441095,CLINDAMYCIN 600 MG/500 ML IN NS IRRIGATION (CMP PMX),1908.65,1240.62,,,0
CDM,RX-441101,CEFAZOLIN IVPB 2 G IN NS 50 ML (CMP PMX),92.3,60.0,,,0
CDM,RX-441102,NICARDIPINE 5 MG/5 ML SYRINGE (CMP PMX),62.85,40.85,,,0
CDM,RX-441103,NITROGLYCERIN 50 MCG/ML 10ML VIAL (CMP PMX),33.1,21.52,,,0
CDM,RX-441117,CEFAZOLIN 1 GM/250 ML IN NS IRRIGATION (CMP PMX),68.2,44.33,,,0
CDM,RX-441118,CLINDAMYCIN 600 MG/250 ML IN NS IRRIGATION (CMP PMX),72.2,46.93,,,0
CDM,RX-441123,ALUM BLADDER IRRIGATION 1% IN STERILE WATER,498.7,324.16,,,0
CDM,RX-441127,GENTAMICIN FORTIFIED OPH DROPS 14 MG/ML,62.75,40.79,,,0
CDM,RX-441130,LEECH KIT (STERILE),53.3,34.64,,,0
CDM,RX-441133,ELECTROLYTE-A INTRAVENOUS SOLUTION,62.95,40.92,,,0
CDM,RX-441134,SODIUM CHLORIDE 0.9 % (COLD) INTRAVENOUS SOLUTION,67.15,43.65,,,0
CDM,RX-441137,BORTEZOMIB 3.5 MG SOLUTION FOR INJECTION INTRAVENOUS,6731.5,4375.48,,,0
CDM,RX-441138,HYDROXYPROGESTERONE CAPROATE (PF) 250 MG/ML INTRAMUSCULAR INJE,264.75,172.09,,,0
CDM,RX-441139,SODIUM CHLORIDE 0.9 % FOR PRESSURIZED LINE SOLUTION,155.125,100.83000000000001,,,0
CDM,RX-441139,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,67.15,43.65,,,0
CDM,RX-441139,SODIUM CHLORIDE 0.9 % IV BOLUS,79.725,51.82,,,0
CDM,RX-441140,MAGNESIUM SULFATE 2 GRAM/50 ML (4%) IN WATER IVPB (CMP),60.45,39.29,,,0
CDM,RX-441144,VANCOMYCIN INTRAVITREAL SOLUTION 1000 MCG/0.1 ML,60.4,39.26,,,0
CDM,RX-441148,TOBRAMYCIN FORTIFIED OPH DROPS 13.6 MG/ML,75.95,49.37,,,0
CDM,RX-441149,ROPIVACAINE (PF) 2 MG/ML (0.2 %) EPIDURAL,208.3,135.4,,,0
CDM,RX-441150,ROPIVACAINE (PF) 2 MG/ML (0.2 %) PCEA,123.15,80.05,,,0
CDM,RX-441151,AMPICILLIN INJECTION (IM) 1 GM VIAL,38.6,25.09,,,0
CDM,RX-441153,"KETAMINE 50 MG, PROPOFOL 50 MG 10 ML SYRINGE",37.75,24.54,,,0
CDM,RX-441154,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,69.25,45.01,,,0
CDM,RX-441157,ALTEPLASE BOLUS AND INFUSION,35757.2,23242.18,,,0
CDM,RX-441160,FLUCONAZOLE 600 MG/300 ML (NS) IVPB,83.9,54.54,,,0
CDM,RX-441161,FLUCONAZOLE 800 MG/400 ML (NS) IVPB,92.3,60.0,,,0
CDM,RX-441166,FORMALIN 4% IRRIGATION IN STERILE WATER,456.8,296.92,,,0
CDM,RX-441170,PHENYLEPHRINE 200 MCG/ML INJECTION (1 ML),37.95,24.67,,,0
CDM,RX-441185,CEFTRIAXONE (IM) 250 MG INJECTION,36.6,23.79,,,0
CDM,RX-441186,CEFTRIAXONE (IM) 500 MG INJECTION,36.1,23.46,,,0
CDM,RX-441191,AMPICILLIN IV 100 MG/ML (WELL BABY CONC),49.25,32.01,,,0
CDM,RX-441193,SODIUM CHLORIDE 0.9 % BLADDER IRRIGATION SOLUTION,71.35,46.38,,,0
CDM,RX-441195,EPINEPHRINE 4 MG IN NS 250 ML INFUSION (CMP PMX),87.2,56.68,,,0
CDM,RX-441201,PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION (CMP),12.25,7.96,,,0
CDM,RX-441202,TACROLIMUS 1 MG/ML ORAL SUSPENSION,9.6,6.24,,,0
CDM,RX-441203,ZONISAMIDE 10 MG/ML ORAL SUSPENSION,5.4,3.51,,,0
CDM,RX-441204,"LACTATED RINGERS 500ML +LIDO 1%, SOD BICARB (VENOUS ABLATION) 500 ML",177.3,115.24,,,0
CDM,RX-441208,FLUCONAZOLE 100 MG/50 ML IN SOD. CHLORIDE (ISO) IVPB (CMP),73.45,47.74,,,0
CDM,RX-441209,METRONIDAZOLE 250 MG/50 ML-SODIUM CHLORIDE(ISO) IVPB (CMP),61.1,39.72,,,0
CDM,RX-441211,TENECTEPLASE 5 MG/10 ML SYRINGE,2426.4,1577.16,,,0
CDM,RX-441212,"LACTATED RINGERS 1000ML+EPI,LIDO 1%, SOD BICARB (VENOUS ABLATION)",177.3,115.24,,,0
CDM,RX-441228,NIMODIPINE 30 MG/ML ORAL SOLUTION,31.85,20.7,,,0
CDM,RX-441229,AMPICILLIN INJECTION (IM) 250 MG VIAL,48.45,31.49,,,0
CDM,RX-441230,AMPICILLIN INJECTION (IM) 500 MG VIAL,38.75,25.19,,,0
CDM,RX-441231,DOXYCYCLINE LYMPHOCELE INJECTON 1000 MG/50 ML SYRINGE,39.65,25.77,,,0
CDM,RX-441242,"METRONIDAZOLE 1%, MORPHINE 0.5% TOPICAL SOLUTION",1579.85,1026.9,,,0
CDM,RX-441245,VANCOMYCIN 750 MG IN NS 250 ML IVPB (CMP PMX),76.6,49.79,,,0
CDM,RX-441247,MANNITOL 20% IVPB 125 ML (CMP),71.7,46.6,,,0
CDM,RX-441258,"METRONIDAZOLE/MORPHINE 1%/0.5% CREAM, 30GM",197.15,128.15,,,0
CDM,RX-441259,MITOMYCIN 40 MG/20 ML INTRAVENOUS SOLUTION,4996.8,3247.92,,,0
CDM,RX-441272,ALTEPLASE 1 MG/ML  (INTRAVENTRICULAR-PF)  1 ML- SYRINGE,323.0,209.95,,,0
CDM,RX-441274,MORPHINE/LIDOCAINE 4%/4% SPRAY,364.8,237.12,,,0
CDM,RX-441280,PENICILLIN G POT 2.5 MU IN NS 100 ML (CMP PMX),30.05,19.53,,,0
CDM,RX-441287,MUPIROCIN 2 % TOPICAL OINTMENT (NASAL TXSUB),43.75,28.44,,,0
CDM,RX-441289,MANNITOL 20% IVPB 62.5 ML (CMP),71.6,46.54,,,0
CDM,RX-441290,DOXORUBICIN INJECTION (BEAD IMPREGNATION),84.55,54.96,,,0
CDM,RX-441295,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION (PAIN BALL),77.9,50.64,,,0
CDM,RX-441295,ROPIVACAINE (PF) 2 MG/ML (0.2 %) PCEA,123.15,80.05,,,0
CDM,RX-441298,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION,40.8,26.52,,,0
CDM,RX-441299,FENTANYL 10 MCG/ML NASAL SYRINGE (NEONATE/PED),37.35,24.28,,,0
CDM,RX-441300,LORAZEPAM 0.5 MG/ML ORAL SYRINGE (NEONATE),5.4,3.51,,,0
CDM,RX-441301,MORPHINE 0.5 MG/ML INJECTABLE SYRINGE (NEONATE),33.25,21.61,,,0
CDM,RX-441303,MAGIC MOUTHWASH ORAL SUSPENSION (CMP),22.95,14.92,,,0
CDM,RX-441305,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,84.4,54.86,,,0
CDM,RX-441307,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION (ORAL),122.9,79.88,,,0
CDM,RX-441315,CLONIDINE 20 MCG/ML ORAL SUSPENSION,10.1,6.56,,,0
CDM,RX-441318,VECURONIUM INJ 0.1 MG/ML FOR PUBS PROCEDURE,35.05,22.78,,,0
CDM,RX-441321,PHENYLEPHRINE 500 MCG/ML INJECTION,33.55,21.81,,,0
CDM,RX-441324,MORPHINE 1% TOPICAL GEL (CMP),25.75,16.74,,,0
CDM,RX-441325,MORPHINE 1% IN METRONIDAZOLE 1% TOPICAL GEL (CMP),342.35,222.53,,,0
CDM,RX-441326,MORPHINE 0.5% IN LIDOCAINE TOPICAL SPRAY (CMP),35.0,22.75,,,0
CDM,RX-441327,LIDOCAINE (BUFFERED) TOPICAL SOLUTION (CMP),22.35,14.53,,,0
CDM,RX-441328,DEXAMETHASONE 4 MG/ML INJ (ORAL USE),34.3,22.3,,,0
CDM,RX-441329,DEXAMETHASONE 10 MG/ML INJ (ORAL USE),6.45,4.19,,,0
CDM,RX-441330,ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT IV KIT (FVIII UNITS),3018.95,1962.32,,,0
CDM,RX-441331,"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT IV KIT (FVIII UNIITS)",5955.8,3871.27,,,0
CDM,RX-441332,"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT IV KIT (FVIII UNITS)",11829.5,7689.18,,,0
CDM,RX-441335,METHACHOLINE 0.025 MG/ML CHALLENGE SOLUTION (CMP),164.0,106.6,,,0
CDM,RX-441353,CARDIOPLEGIC SOLUTION + 0 MEQ KCL (CMP),99.65,64.77,,,0
CDM,RX-441354,CARDIOPLEGIC SOLUTION + 15 MEQ KCL (CMP),106.1,68.96,,,0
CDM,RX-441355,CARDIOPLEGIC SOLUTION + 80 MEQ KCL (CMP),133.8,86.97,,,0
CDM,RX-441356,GENTAMICIN IRRIGATION 360 MG/3000 ML (CMP PMX),128.8,83.72,,,0
CDM,RX-441371,FLUCYTOSINE 50 MG/ML ORAL SUSPENSION (CMP),117.8,76.57,,,0
CDM,RX-441378,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION (RND 0.01),125.65,81.67,,,0
CDM,RX-441379,LACTATED RINGERS IV BOLUS,60.85,39.55,,,0
CDM,RX-441380,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,60.85,39.55,,,0
CDM,RX-441381,BEVACIZUMAB (AVASTIN) INTRAVITREAL SOLUTION 1.25 MG/0.05 ML,123.4,80.21,,,0
CDM,RX-441386,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,67.15,43.65,,,0
CDM,RX-441387,PENICILLIN VK (DOSE 1) ORAL DESENSITIZATION,11.6,7.54,,,0
CDM,RX-441388,PENICILLIN VK (DOSE 2) ORAL DESENSITIZATION,11.6,7.54,,,0
CDM,RX-441389,PENICILLIN VK (DOSE 3) ORAL DESENSITIZATION,11.55,7.51,,,0
CDM,RX-441391,PENICILLIN VK (DOSE 5) ORAL DESENSITIZATION,11.5,7.48,,,0
CDM,RX-441392,PENICILLIN VK (DOSE 6) ORAL DESENSITIZATION,11.45,7.44,,,0
CDM,RX-441393,PENICILLIN VK (DOSE 7) ORAL DESENSITIZATION,11.3,7.34,,,0
CDM,RX-441394,PENICILLIN VK (DOSE 8) ORAL DESENSITIZATION,11.55,7.51,,,0
CDM,RX-441395,PENICILLIN VK (DOSE 9) ORAL DESENSITIZATION,11.5,7.48,,,0
CDM,RX-441396,PENICILLIN VK (DOSE 10) ORAL DESENSITIZATION,11.4,7.41,,,0
CDM,RX-441397,PENICILLIN VK (DOSE 11) ORAL DESENSITIZATION,11.55,7.51,,,0
CDM,RX-441398,PENICILLIN VK (DOSE 12) ORAL DESENSITIZATION,11.5,7.48,,,0
CDM,RX-441399,PENICILLIN VK (DOSE 13) ORAL DESENSITIZATION,11.4,7.41,,,0
CDM,RX-441400,PENICILLIN VK (DOSE 14) ORAL DESENSITIZATION,11.25,7.31,,,0
CDM,RX-441402,PENICILLIN G POT 100 MG/ML (DESENSITIZATION INGREDIENT A),82.3,53.5,,,0
CDM,RX-441403,PENICILLIN G POT 10 MG/ML (DESENSITIZATION INGREDIENT B),82.3,53.5,,,0
CDM,RX-441404,PENICILLIN G POT 1 MG/ML (DESENSITIZATION INGREDIENT C),82.3,53.5,,,0
CDM,RX-441405,PENICILLIN G POT 0.1 MG/ML (DESENSITIZATION INGREDIENT D),82.3,53.5,,,0
CDM,RX-441408,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML ORAL SOLUTION (NEONATE),16.7,10.86,,,0
CDM,RX-441420,ADENOSINE INTRACORONARY SOLUTION (CATH LAB USE ONLY),33.15,21.55,,,0
CDM,RX-441423,"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION (IO)",183.2,119.08,,,0
CDM,RX-441424,"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION (IO)",246.3,160.1,,,0
CDM,RX-441427,VANCOMYCIN ORAL 125 MG/5 ML,7.25,4.71,,,0
CDM,RX-441429,METRONIDAZOLE 5 MG/ML IVPB,65.5,42.58,,,0
CDM,RX-441447,FECAL MICROBIOTA TRANSPLANT (FMT)LOWER DELIVERY (OPENIBIOME) MICROBIOTA PREP,2040.75,1326.49,,,0
CDM,RX-441485,CODEINE 15 MG/5 ML ORAL SYRUP,10.3,6.7,,,0
CDM,RX-441492,EPINEPHRINE 1 MG/ML ANAPHYLAXIS KIT,83.95,54.57,,,0
CDM,RX-441496,CEFTAZIDIME (IM) 1000 MG INJECTION,53.9,35.04,,,0
CDM,RX-441510,FLUCONAZOLE 1400 MG/700 ML IN SODIUM CHLORIDE IVPB,143.85,93.5,,,0
CDM,RX-441511,FLUCONAZOLE 1200 MG/600 ML IN SODIUM CHLORIDE IVPB,131.7,85.6,,,0
CDM,RX-441512,FLUCONAZOLE 1000 MG/500 ML IN SODIUM CHLORIDE IVPB,119.55,77.71,,,0
CDM,RX-441517,NALOXONE 2 MG/2 ML INTRANASAL KIT,175.85,114.3,,,0
CDM,RX-441531,FENTANYL 50 MCG/ML NASAL SYRINGE (NEONATE/PED),37.0,24.05,,,0
CDM,RX-441532,MIDAZOLAM 1 MG/ML NASAL SYRINGE (NEONATE/PED),33.4,21.71,,,0
CDM,RX-441533,MIDAZOLAM 5 MG/ML NASAL SYRINGE (NEONATAL/PED),34.25,22.26,,,0
CDM,RX-441534,MANNITOL 20% IVPB 250 ML (CMP),110.1,71.56,,,0
CDM,RX-441541,MORPHINE NEONATAL 0.2 MG/ML ORAL SYRINGE,8.25,5.36,,,0
CDM,RX-441547,AMPHOTERICIN  INTRAVENTRICULAR 0.1 MG/2 ML SYRINGE,75.95,49.37,,,0
CDM,RX-441550,COLISTIMETHATE SODIUM (COLYMYCIN) INTRAVENTRICULAR 5 MG/2 ML SYRINGE,34.7,22.56,,,0
CDM,RX-441552,GENTAMICIN INTRAVENTRICULAR 5MG/2 ML SYRINGE,34.95,22.72,,,0
CDM,RX-441554,TOLVAPTAN 7.5 MG SPLIT TABLET,821.35,533.88,,,0
CDM,RX-441556,MITOMYCIN 0.2 MG/ML TOPICAL OPHTHALMIC SOLUTION (COMPOUND),114.0,74.1,,,0
CDM,RX-441561,ASCORBIC ACID 1500 MG IN SODIUM CHLORIDE 0.9% 250 ML IVPB (CMP PREMIX),64.4,41.86,,,0
CDM,RX-441562,ASCORBIC ACID 500 MG IN SODIUM CHLORIDE 0.9% 100 ML IVPB (CMP PREMIX),41.5,26.98,,,0
CDM,RX-441626,SELENIUM INJ 4 MCG/ML (CAPS),33.0,21.45,,,0
CDM,RX-441659,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,130.1,84.56,,,0
CDM,RX-441665,HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSPENSION,13.25,8.61,,,0
CDM,RX-441669,KETAMINE ORAL SOLUTION 20 MG/5 ML,10.4,6.76,,,0
CDM,RX-441671,CRRT BGK 2/3.5 ( PRISMASOL) 5000 ML SOLUTION,163.5,106.28,,,0
CDM,RX-441672,REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,3279.8,2131.87,,,0
CDM,RX-441679,MITOMYCIN 0.4 MG/ML BLADDER NECK INJECTION SOLUTION,444.7,289.055,,,0
CDM,RX-441693,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION (PWD VIAL),218.4,141.96,,,0
CDM,RX-441694,"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",165.4,107.51,,,0
CDM,RX-441703,FENTANYL INFUSION 50 MCG/ML (PEDS),38.05,24.73,,,0
CDM,RX-441713,CALCIUM GLUCONATE 3 GM IN 100 ML NS IVPB (PREMIX),50.55,32.86,,,0
CDM,RX-441717,METHOHEXITAL 50 MG/5 ML SYRINGE (IR-NEURO USE),72.4,47.06,,,0
CDM,RX-441720,MITOMYCIN 20 MG/10 ML INTRAVENOUS SOLUTION,209.2,135.98,,,0
CDM,RX-441723,DIPHENHYDRAMINE 10 MG/ML (1%) SUBQ SOLUTION,38.65,25.12,,,0
CDM,RX-441761,"POLYMYXIN B SULFATE 500,000 UNIT/2 ML SOLUTION FOR INJECTION",49.15,31.95,,,0
CDM,RX-441772,"HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJECTION SOLUTION (BMT)",82.1,53.36,,,0
CDM,RX-441780,SODIUM BICARB CONCENTRATED INFUSION 250 MEQ IN 250 ML,209.3,136.04,,,0
CDM,RX-441781,LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,75.55,49.11,,,0
CDM,RX-441783,SODIUM BICARBONATE MOUTHWASH 5 G/250 ML IN STERILE WATER,12.8,8.32,,,0
CDM,RX-441786,FECAL MICROBIOTA TRANSPLANT (FMT) STANDARD DOSE LIQUID PREP (MTP-101LR),7110.65,4621.92,,,0
CDM,RX-441787,FECAL MICROBIOTA TRANSPLANT (FMT) HIGH DOSE LIQUID PREP (MTP-101LF),7110.65,4621.92,,,0
CDM,RX-441795,DICLOFENAC 50 MG RECTAL SUPPOSITORY,8.9,5.78,,,0
CDM,RX-441796,GLYCERIN 99.5% ANHYDROUS INJECTION,763.7,496.4,,,0
CDM,RX-441797,PHENYLEPHRINE 0.2 MG/ML IV SYRINGE 20 ML (RMH ANESTHESIA ONLY),161.75,105.14,,,0
CDM,RX-441798,"SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (CADD PUMP,EPOCH)",71.35,46.379999999999995,,,0
CDM,RX-441802,METHADONE ORAL SOLUTION 10 MG/1 ML,10.85,7.05,,,0
CDM,RX-441805,ANTITHYMOCYTE GLOBULIN-ATG (ATGAM) TEST DOSE,337.9,219.64,,,0
CDM,RX-441807,ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,696.25,452.56,,,0
CDM,RX-441810,HYDROXYUREA 100 MG/ML ORAL SUSPENSION,17.3,11.24,,,0
CDM,RX-441822,(COMPOUNDING ONLY) EPCORITAMAB 1.6 MG/2ML IN NS,4006.05,2603.93,,,0
CDM,RX-441826,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",43.6,28.34,,,0
CDM,RX-441834,CALCIUM GLUCONATE 2.5% (CALGONATE) TOPICAL GEL 25 GM,36.0,23.4,,,0
CDM,RX-441848,SODIUM CHLORIDE 0.9 % INTRAVENOUS FLUSH (BAG SIZE 100 ML OR LESS),66.3,43.1,,,0
CDM,RX-441849,NICARDIPINE 400 MCG/4 ML INJECTION (CMP),61.85,40.2,,,0
CDM,RX-441853,MITOMYCIN 20 MG/10 ML INTRAVENOUS SOLUTION,209.2,135.98,,,0
CDM,RX-441855,KETAMINE 5% TOPICAL GEL (CMP),22.45,14.59,,,0
CDM,RX-441859,SODIUM CHLORIDE 3 % HYPEROSMOLAR INTRAVENOUS INJECTION SOLUTION,64.0,41.6,,,0
CDM,RX-441870,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,605.05,393.28,,,0
CDM,RX-441875,TRETINOIN 2.5 MG/ML ORAL SOLUTION,19.4,12.61,,,0
CDM,RX-4420,LEVOTHYROXINE 25 MCG TABLET,5.55,3.61,,,0
CDM,RX-4421,LEVOTHYROXINE 50 MCG TABLET,5.55,3.61,,,0
CDM,RX-4422,LEVOTHYROXINE 75 MCG TABLET,5.75,3.74,,,0
CDM,RX-4423,LEVOTHYROXINE 100 MCG TABLET,5.8,3.77,,,0
CDM,RX-4424,LEVOTHYROXINE 125 MCG TABLET,6.0,3.9,,,0
CDM,RX-4425,LEVOTHYROXINE 150 MCG TABLET,6.0,3.9,,,0
CDM,RX-4426,LEVOTHYROXINE 200 MCG TABLET,6.65,4.32,,,0
CDM,RX-4450,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,73.15,47.55,,,0
CDM,RX-4451,LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,53.6,34.84,,,0
CDM,RX-4452,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,42.9,27.884999999999998,,,0
CDM,RX-4454,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,44.7,29.06,,,0
CDM,RX-4455,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,47.25,30.71,,,0
CDM,RX-4459,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,63.05,40.98,,,0
CDM,RX-450,AMOXICILLIN 250 MG CAPSULE,4.85,3.15,,,0
CDM,RX-4505,LIOTHYRONINE 50 MCG TABLET,7.2,4.68,,,0
CDM,RX-451,AMOXICILLIN 500 MG CAPSULE,5.0,3.25,,,0
CDM,RX-451038,"SODIUM PHOSPHATE P-32, THERAPEUTIC, PER MILLICURIE",0.05,0.03,,,0
CDM,RX-4526,LISINOPRIL 20 MG TABLET,4.9,3.18,,,0
CDM,RX-4528,LITHIUM CARBONATE 150 MG CAPSULE,5.05,3.28,,,0
CDM,RX-4529,LITHIUM CARBONATE 300 MG CAPSULE,4.9,3.18,,,0
CDM,RX-454,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,5.05,3.28,,,0
CDM,RX-4560,LOPERAMIDE 2 MG CAPSULE,6.7,4.36,,,0
CDM,RX-4571,LORAZEPAM 2 MG/ML ORAL CONCENTRATE,129.9,84.44,,,0
CDM,RX-4572,LORAZEPAM 0.5 MG TABLET,8.4,5.46,,,0
CDM,RX-4574,LORAZEPAM 2 MG TABLET,8.45,5.49,,,0
CDM,RX-4599,LOXAPINE SUCCINATE 10 MG CAPSULE,6.3,4.1,,,0
CDM,RX-4600,LOXAPINE SUCCINATE 25 MG CAPSULE,7.2,4.68,,,0
CDM,RX-4601,LOXAPINE SUCCINATE 5 MG CAPSULE,5.45,3.54,,,0
CDM,RX-461002,"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",0.2,0.13,,,0
CDM,RX-461005,POTASSIUM CHLORIDE ER 10 MEQ TABLET SORD,5.25,3.41,,,0
CDM,RX-461008,DOXYCYCLINE HYCLATE 100 MG ORAL SOLID SORD,8.95,5.82,,,0
CDM,RX-461012,TETANUS AND DIPHTHERIA TOX (PF) 5-2 LF UNIT IM SORD,222.35,144.53,,,0
CDM,RX-461013,MIDAZOLAM 5 MG/ML INJECTION SORD,36.05,23.43,,,0
CDM,RX-461014,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,34.0,22.1,,,0
CDM,RX-461016,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,34.85,22.65,,,0
CDM,RX-461019,POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAP SORD,4.95,3.22,,,0
CDM,RX-461020,MULTIVITAMIN ORAL SOLID SORD,0.05,0.03,,,0
CDM,RX-461021,FOLIC ACID-VIT B6-VIT B12 TABLET SORD,6.85,4.45,,,0
CDM,RX-461023,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,37.5,24.38,,,0
CDM,RX-461024,MORPHINE 10 MG/ML INJECTION SOLUTION SORD,39.15,25.45,,,0
CDM,RX-461025,MEPERIDINE (PF) 50 MG/ML INJECTION SORD,43.35,28.18,,,0
CDM,RX-461027,POTASSIUM CHLORIDE ER 20 MEQ TABLET SORD,5.3,3.44,,,0
CDM,RX-461028,LIDOCAINE 10 MG/ML (1 %) INJECTION SOLUTION SORD,37.25,24.21,,,0
CDM,RX-461029,WHITE PETROLATUM-MINERAL OIL EYE OINTMENT SORD,7.9,5.14,,,0
CDM,RX-461030,LIDOCAINE 20 MG/ML (2 %) INJECTION SOLUTION SORD,52.35,34.03,,,0
CDM,RX-461032,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INJECTION SOLUTION SORD,33.95,22.07,,,0
CDM,RX-461034,CYCLOPHOSPHAMIDE 25 MG ORAL SOLID SORD,26.25,17.06,,,0
CDM,RX-461035,CYCLOPHOSPHAMIDE 50 MG ORAL SOLID SORD,44.35,28.83,,,0
CDM,RX-461036,"NIFEDIPINE ER 30 MG TABLET, EXT RELEASE ORAL SOLID SORD",6.8,4.42,,,0
CDM,RX-461037,"NIFEDIPINE ER 60 MG TABLET, EXT RELEASE ORAL SOLID SORD",10.35,6.73,,,0
CDM,RX-461038,"NIFEDIPINE ER 90 MG TABLET, EXT RELEASE ORAL SOLID SORD",11.85,7.7,,,0
CDM,RX-461041,MORPHINE CONCENTRATE (20 MG/ML) ORAL SOLUTION SORD,8.5,5.52,,,0
CDM,RX-461042,DIGOXIN 50 MCG/ML ORAL SOLUTION SORD,216.4,140.66,,,0
CDM,RX-461043,BUPROPION HCL SR 150 MG TABLET SORD,5.9,3.84,,,0
CDM,RX-461045,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",37.45,24.34,,,0
CDM,RX-461050,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,35.45,23.04,,,0
CDM,RX-461056,CEFOTETAN INJ (SORD FOR COMPOUNDING),224.2,145.73,,,0
CDM,RX-461073,EPINEPHRINE 1 MG/10 ML (100 MCG/ML) INJECTION (NSORD),40.5,26.32,,,0
CDM,RX-461074,SUCCINYLCHOLINE CHLORIDE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SYRINGE,113.3,73.64,,,0
CDM,RX-461075,METHOTREXATE SODIUM 25 MG/ML INJECTION FOR ECTOPIC PREGNANCY (SORD),101.5,65.98,,,0
CDM,RX-461080,DEXAMETHASONE 10 MG/ML INJ (ORAL USE),35.8,23.27,,,0
CDM,RX-464,AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,208.9,135.78,,,0
CDM,RX-469,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,38.6,25.09,,,0
CDM,RX-471,AMPICILLIN 125 MG SOLUTION FOR INJECTION,52.3,34.0,,,0
CDM,RX-4712,MAGNESIUM CITRATE ORAL SOLUTION,13.6,8.84,,,0
CDM,RX-472,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,42.5,27.62,,,0
CDM,RX-4720,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,35.05,22.78,,,0
CDM,RX-473,AMPICILLIN INJECTION (IM) 250 MG VIAL,48.45,31.49,,,0
CDM,RX-474,AMPICILLIN 500 MG SOLUTION FOR INJECTION,37.5,24.38,,,0
CDM,RX-4749,MANNITOL 20 % INTRAVENOUS SOLUTION,71.7,46.6,,,0
CDM,RX-4750,MANNITOL 25 % INTRAVENOUS SOLUTION,38.35,24.93,,,0
CDM,RX-481003,FLUCONAZOLE 2 MG/ML INTRAVENOUS SOLUTION,83.275,54.13,,,0
CDM,RX-481004,LEVETIRACETAM 10 MG/ML INTRAVENOUS SOLUTION,129.15,83.95,,,0
CDM,RX-481005,LEVETIRACETAM 15 MG/ML INTRAVENOUS SOLUTION,150.95,98.12,,,0
CDM,RX-481006,LEVETIRACETAM 5 MG/ML INTRAVENOUS SOLUTION,107.4,69.81,,,0
CDM,RX-4854,MEDROXYPROGESTERONE 10 MG TABLET,8.05,5.23,,,0
CDM,RX-4855,MEDROXYPROGESTERONE 2.5 MG TABLET,5.05,3.28,,,0
CDM,RX-4870,MEGESTROL 20 MG TABLET,5.05,3.28,,,0
CDM,RX-4871,MEGESTROL 40 MG TABLET,5.3,3.44,,,0
CDM,RX-4903,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,43.0,27.95,,,0
CDM,RX-4904,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,43.35,28.18,,,0
CDM,RX-491002,INV ERLOTINIB/PLACEBO 150 MG TABLET,0.65,0.42,,,0
CDM,RX-491003,INV ERLOTINIB/PLACEBO 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491004,INV ERLOTINIB/PLACEBO 25 MG TABLET,0.65,0.42,,,0
CDM,RX-491005,INV CLOPIDROGEL/PLACEBO TABLET,0.65,0.42,,,0
CDM,RX-491006,INV PRASUGREL/PLACEBO 5 MG TABLET,0.65,0.42,,,0
CDM,RX-491007,INV PRASUGREL/PLACEBO 10 MG TABLET,0.65,0.42,,,0
CDM,RX-491008,INV DULOXETINE/PLACEBO 30 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491009,INV ERLOTINIB 150 MG TABLET,0.65,0.42,,,0
CDM,RX-491010,INV ERLOTINIB 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491011,INV ERLOTINIB 25 MG TABLET,0.65,0.42,,,0
CDM,RX-491012,INV LENALIDOMIDE 5 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491013,"INV CB-183,315/PLACEBO/VANCOMYCIN CAPSULE",0.65,0.42,,,0
CDM,RX-491014,"INV CB-183,315/PLACEBO/VANCOMYCIN CAPSULE (KIT)",0.65,0.42,,,0
CDM,RX-491015,INV CELECOXIB/PLACEBO 400 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491016,INV LISINOPRIL/CARVEDILOL CR/PLACEBO 10 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491017,INV SODIUM CHLORIDE 0.9% INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491018,INV EVEROLIMUS/PLACEBO 5 MG TABLET,0.65,0.42,,,0
CDM,RX-491019,INV LENALIDOMIDE 25 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491020,INV DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491021,INV PAZOPANIB/PLACEBO 200 MG TABLET,0.65,0.42,,,0
CDM,RX-491022,INV TICAGRELOR/PLACEBO 60 MG TABLET,0.65,0.42,,,0
CDM,RX-491023,INV TICAGRELOR/PLACEBO 90 MG TABLET,0.65,0.42,,,0
CDM,RX-491024,INV CLOPIDOGREL/PLACEBO 75 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491025,INV RANOLAZINE/PLACEBO 500 MG TB12 TABLET,0.65,0.42,,,0
CDM,RX-491026,INV EFLORNITHINE/PLACEBO 250 MG TABLET,0.65,0.42,,,0
CDM,RX-491027,INV LENALIDOMIDE 2.5 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491028,INV SULINDAC/PLACEBO 150 MG TABLET,0.65,0.42,,,0
CDM,RX-491029,INV SMT 199969/PLACEBO/VANCOMYCIN CAPSULE,0.65,0.42,,,0
CDM,RX-491030,INV CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491031,INV ASPIRIN/PLACEBO 325 MG TABLET,0.65,0.42,,,0
CDM,RX-491032,INV ASPIRIN/PLACEBO 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491033,INV AZTREONAM 2 GRAM SOLUTION FOR INJECTION,0.65,0.42,,,0
CDM,RX-491034,INV TRASTUZUMAB 440 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491035,INV LACTATED RINGERS INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491036,INV FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,0.65,0.42,,,0
CDM,RX-491037,INV SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491038,INV SORAFENIB TOSYLATE  (BAY 43-9006) 200 MG TABLET,0.65,0.42,,,0
CDM,RX-491040,INV AZTREONAM 1 GRAM SOLUTION FOR INJECTION,0.65,0.42,,,0
CDM,RX-491041,INV PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS,0.65,0.42,,,0
CDM,RX-491044,INV ART-123/PLACEBO 6 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491045,INV BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491046,INV ARMODAFINIL 150 MG/ARMODAFINIL 250 MG/PLACEBO TABLET,0.65,0.42,,,0
CDM,RX-491047,INV METFORMIN/PLACEBO 850 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491048,INV ELESCLOMOL 250 MG/5.54 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491049,INV SERELAXIN/PLACEBO 3.5 MG/3.5 ML INJECTION,0.65,0.42,,,0
CDM,RX-491050,INV INDOCYANINE GREEN 25 MG/5 ML SOLUTION FOR INJECTION,0.65,0.42,,,0
CDM,RX-491051,INV TELAVANCIN 750 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491052,INV ALTEPLASE/PLACEBO 50 MG/50 ML,0.65,0.42,,,0
CDM,RX-491053,"INV VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION",0.65,0.42,,,0
CDM,RX-491054,"INV HEPARIN/PLACEBO 1,000 UNIT/ML INJECTION SOLUTION",0.65,0.42,,,0
CDM,RX-491056,INV TREBANANIB/PLACEBO 30 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491058,INV CLOSTRIDIUM DIFFICILE TOXOID VACCINE/PLACEBO,0.65,0.42,,,0
CDM,RX-491059,INV AMIKACIN/PLACEBO 125 MG/ML SOLUTION,0.65,0.42,,,0
CDM,RX-491060,INV POLYMYXIN-B/SHAM CARTRIDGE,0.65,0.42,,,0
CDM,RX-491061,INV DEXAMETHASONE 4 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491062,INV ALTEPLASE/PLACEBO BOLUS FROM THE BAG,0.65,0.42,,,0
CDM,RX-491063,INV METRONIDAZOLE IN NACL 500 MG/100 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491064,INV TRC105 7 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491073,INV NEBULIZER RESERVOIR AND CAP KIT,0.65,0.42,,,0
CDM,RX-491076,INV DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491077,INV CEFAZOLIN 1 GRAM INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491080,INV PDDS CLINICAL CONTROL MODULE,0.65,0.42,,,0
CDM,RX-491081,INV PDDS CLINICAL ON-VENT ADAPTOR KIT,0.65,0.42,,,0
CDM,RX-491083,INV PDDS CLINICAL HANDHELD ADAPTOR,0.65,0.42,,,0
CDM,RX-491084,INV USL261/PLACEBO 5 MG/0.1 ML NASAL SPRAY,0.65,0.42,,,0
CDM,RX-491094,INV FARLETUZUMAB/PLACEBO 5 MG/ML INFUSION,0.65,0.42,,,0
CDM,RX-491104,INV METHYLYPREDNISOLONE SOD SUC (PF) 125 MG/2 ML INJECTION,0.65,0.42,,,0
CDM,RX-491107,INV KEYHOLE LIMPET HEMOCYANIN 1 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491108,INV OCRELIZUMAB 30 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491112,INV VELIPARIB/PLACEBO 50 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491113,INV VELIPARIB/PLACEBO 100 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491117,INV POLYETHYLENE GLYCOL SOLUTION,0.65,0.42,,,0
CDM,RX-491118,INV MAGNESIUM CITRATE SOLUTION,0.65,0.42,,,0
CDM,RX-491119,INV SER-109 CAPSULE,0.65,0.42,,,0
CDM,RX-491120,INV SER-109/PLACEBO CAPSULE,0.65,0.42,,,0
CDM,RX-491121,INV SYN-004/PLACEBO 75 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491122,INV CHOLESTYRAMINE-ASPARTAME 4 GM PACKET,0.65,0.42,,,0
CDM,RX-491123,INV ACTIVATED CHARCOAL-SORBITOL SUSPENSION,0.65,0.42,,,0
CDM,RX-491124,INV PONESIMOD/PLACEBO TABLET,0.65,0.42,,,0
CDM,RX-491125,INV PONESIMOD 20 MG OR TERIFLUNOMIDE 14 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491126,INV TERIFLUNOMIDE/PLACEBO 14 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491128,INV TRC105 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491129,INV PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491131,INV CERITINIB 150 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491132,INV LJPC-501/PLACEBO 2.5 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491139,INV ECULIZUMAB 10 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491140,INV ECULIZUMAB/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491143,INV ASPIRIN EC 81 MG TABLET,0.65,0.42,,,0
CDM,RX-491144,INV ASPIRIN EC/PLACEBO 81 MG TABLET,0.65,0.42,,,0
CDM,RX-491145,INV TICAGRELOR 90 MG TABLET,0.65,0.42,,,0
CDM,RX-491146,INV DCVAX-L 1.25 MILLION CELLS INJECTION,0.65,0.42,,,0
CDM,RX-491147,INV DCVAX-L/PLACEBO 1.25 MILLION CELLS INJECTION,0.65,0.42,,,0
CDM,RX-491148,INV JVS-100/PLACEBO 1 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491149,INV CAP-1002/PLACEBO 25 MILLION CELLS/10 ML INJECTION,0.65,0.42,,,0
CDM,RX-491150,INV NITROGLYCERIN 400 MCG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491151,INV HEPARIN 1000 UNIT/ML INJECTION,0.65,0.42,,,0
CDM,RX-491155,INV STAPHYLOCOCCUS AUREUS 4-ANTIGEN VACCINE/PLACEBO INJ,0.65,0.42,,,0
CDM,RX-491156,INV GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
CDM,RX-491157,INV GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
CDM,RX-491158,INV NIVOLUMAB 10 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491160,INV ASPIRIN EC 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491161,INV RIVAROXOBAN/PLACEBO 2.5 MG TABLET,0.65,0.42,,,0
CDM,RX-491162,INV CEDIRANIB 15 MG TABLET,0.65,0.42,,,0
CDM,RX-491163,INV CEDIRANIB 20 MG TABLET,0.65,0.42,,,0
CDM,RX-491164,INV OLAPARIB 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491165,INV OLAPARIB 150 MG TABLET,0.65,0.42,,,0
CDM,RX-491170,INV NAFCILLIN 200 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491173,INV SELEPRESSIN/PLACEBO INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491174,"INV HEPARIN 25,000 UNITS IN DEXTROSE 5% 250 ML INFUSION",121.6,79.04,,,0
CDM,RX-491177,INV BMS-986141/PLACEBO TABLET,0.65,0.42,,,0
CDM,RX-491178,INV RIVAROXOBAN 10 MG TABLET,0.65,0.42,,,0
CDM,RX-491179,INV RIVAROXOBAN 15 MG TABLET,0.65,0.42,,,0
CDM,RX-491180,INV RIVAROXOBAN 20 MG TABLET,0.65,0.42,,,0
CDM,RX-491189,INV POLYMYXIN-B CARTRIDGE,0.65,0.42,,,0
CDM,RX-491192,INV ENTINOSTAT/PLACEBO 5 MG TABLET,0.65,0.42,,,0
CDM,RX-491193,INV ENTINOSTAT/PLACEBO 1 MG TABLET,0.65,0.42,,,0
CDM,RX-491195,INV EXEMESTANE 25 MG TABLET,0.65,0.42,,,0
CDM,RX-491196,INV OFATUMUMAB/PLACEBO 20 MG/0.4 ML SYRINGE,0.65,0.42,,,0
CDM,RX-491197,INV ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
CDM,RX-491198,INV ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
CDM,RX-491199,INV ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
CDM,RX-491200,INV ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
CDM,RX-491201,INV ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
CDM,RX-491202,INV ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
CDM,RX-491203,INV ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
CDM,RX-491205,INV DROXIDOPA 100 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491206,INV DROXIDOPA 200 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491207,INV DROXIDOPA 300 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491208,INV DROXIDOPA/PLACEBO 100 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491209,INV DROXIDOPA/PLACEBO 200 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491210,INV DROXIDOPA/PLACEBO 300 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491219,INV SER-262/PLACEBO CAPSULE,0.65,0.42,,,0
CDM,RX-491220,POLIDOCANOL 1 % INTRAVENOUS FOAM,0.65,0.42,,,0
CDM,RX-491221,INV VARITHENA ADMINISTRATION PACK,0.65,0.42,,,0
CDM,RX-491222,INV TRAMETINIB 0.5 MG TABLET,0.65,0.42,,,0
CDM,RX-491223,INV TRAMETINIB 2 MG TABLET,0.65,0.42,,,0
CDM,RX-491225,INV ADO-TRASTUZUMAB EMTANSINE 160 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491228,INV CRIZOTINIB 250 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491230,INV MIRVETUXIMAB SORAVTANSINE 5 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491234,INV PREDNISOLONE ACETATE 1% OPHTHALMIC SUSPENSION,0.65,0.42,,,0
CDM,RX-491235,INV REFRESH OPTIVE ADVANCED (PRESERVATIVE-FREE) OPHTHALMIC SOLUTION,0.65,0.42,,,0
CDM,RX-491236,INV COPANLISIB (BAY 80-6946) 15 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491239,INV ATORVASTATIN/PLACEBO 40 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491240,"INV AERUCIN/PLACEBO (AERUBUMAB, AR-105) 27.5 MG/ML INJECTION",0.65,0.42,,,0
CDM,RX-491242,INV EFLORNITHINE 150 MG/ML ORAL SOLUTION,0.65,0.42,,,0
CDM,RX-491243,INV DONEPEZIL/PLACEBO 5 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491244,INV ASPIRIN/PLACEBO 300 MG TABLET,0.65,0.42,,,0
CDM,RX-491245,INV TRIAPINE 5 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491248,INV TAK-700 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491249,INV PONESIMOD/PLACEBO 20 MG TABLET,0.65,0.42,,,0
CDM,RX-491250,INV ATEZOLIZUMAB/PLACEBO 1200 MG/20 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491252,INV YKP3089 (CENOBAMATE) 12.5 MG TABLET,0.65,0.42,,,0
CDM,RX-491253,INV YKP3089 (CENOBAMATE) 25 MG TABLET,0.65,0.42,,,0
CDM,RX-491254,INV YKP3089 (CENOBAMATE) 50 MG TABLET,0.65,0.42,,,0
CDM,RX-491255,INV YKP3089 (CENOBAMATE) 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491256,INV O.N.E. MULTIVITAMIN CAPSULE,0.65,0.42,,,0
CDM,RX-491257,INV CALCIUM-VIT D3 150 MG-133 UNIT CAPSULE,0.65,0.42,,,0
CDM,RX-491258,INV AFATINIB 20 MG TABLET,0.65,0.42,,,0
CDM,RX-491259,INV AFATINIB 30 MG TABLET,0.65,0.42,,,0
CDM,RX-491260,INV AFATINIB 40 MG TABLET,0.65,0.42,,,0
CDM,RX-491262,INV CARFILZOMIB 60 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491264,INV LLG783/PLACEBO 150 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491266,INV OMECAMTIV MECARBIL/PLACEBO TABLET,0.65,0.42,,,0
CDM,RX-491267,INV BUPROPION XL/PLACEBO 24 HR CAPSULE 150 MG,0.65,0.42,,,0
CDM,RX-491268,INV APIXABAN 2.5 MG TABLET,0.65,0.42,,,0
CDM,RX-491269,INV APIXABAN 5 MG TABLET,0.65,0.42,,,0
CDM,RX-491271,INV DALTEPARIN 2500 UNITS/0.2ML SYRINGE,0.65,0.42,,,0
CDM,RX-491272,INV DALTEPARIN 5000 UNITS/0.2 ML SYRINGE,0.65,0.42,,,0
CDM,RX-491273,INV DALTEPARIN 7500 UNITS/0.3 ML SYRINGE,0.65,0.42,,,0
CDM,RX-491274,"INV DALTEPARIN 10,000 UNITS/1 ML SYRINGE",0.65,0.42,,,0
CDM,RX-491275,"INV DALTEPARIN 12,500 UNITS/0.5 ML SYRINGE",0.65,0.42,,,0
CDM,RX-491276,"INV DALTEPARIN 15,000 UNITS/0.6 ML SYRINGE",0.65,0.42,,,0
CDM,RX-491277,"INV DALTEPARIN 18,000 UNITS/0.72 ML SYRINGE",0.65,0.42,,,0
CDM,RX-491282,INV OPICINUMAB (BIIB003)/PLACEBO 200 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491284,INV DEXAMETHASONE 10 MG/ML INJECTION SOLUTION,0.65,0.42,,,0
CDM,RX-491285,INV DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,0.65,0.42,,,0
CDM,RX-491286,INV TERIFLUNOMIDE/PLACEBO 14 MG TABLET,0.65,0.42,,,0
CDM,RX-491290,INV IMMUNE GLOBULIN (IGG)(OCTAGAM) 10% INFUSION,0.65,0.42,,,0
CDM,RX-491291,INV IMMUNE GLOBULIN (IGG)/PLACEBO (OCTAGAM/PLACEBO) 10% INFUSION,0.65,0.42,,,0
CDM,RX-491292,INV DIMETHYL FUMARATE 120 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491294,INV PEGINTERFERON BETA-1A 63 MCG/0.5 ML SYRINGE,0.65,0.42,,,0
CDM,RX-491295,INV PEGINTERFERON BETA-1A 94 MCG/0.5 ML SYRINGE,0.65,0.42,,,0
CDM,RX-491296,INV PEGINTERFERON BETA-1A 125 MCG/0.5 ML SYRINGE,0.65,0.42,,,0
CDM,RX-491297,INV DEXAMETHASONE 2 MG TABLET,0.65,0.42,,,0
CDM,RX-491298,INV DEXAMETHASONE 4 MG TABLET,0.65,0.42,,,0
CDM,RX-491299,INV PANTOPRAZOLE EC 40 MG TABLET,0.65,0.42,,,0
CDM,RX-491300,INV DIPHENHYDRAMINE 25 MG TABLET,0.65,0.42,,,0
CDM,RX-491301,INV PONESIMOD 20 MG TABLET,0.65,0.42,,,0
CDM,RX-491302,INV PONESIMOD TABLET,0.65,0.42,,,0
CDM,RX-491303,INV DURVALUMAB 50 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491305,INV TREMELIMUMAB 20 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491307,INV VIS410/PLACEBO 25 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491308,INV VIS410 2000 MG/VIS410 4000MG/PLACEBO INFUSION,0.65,0.42,,,0
CDM,RX-491309,INV DIPHENHYDRAMINE 50 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491310,INV ACETYLSALICYLIC ACID 325 MG TABLET,0.65,0.42,,,0
CDM,RX-491312,INV OSELTAMIVIR 30 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491313,INV SODIUM CHLORIDE (NS) 0.9% FLUSH SYRINGE 26 ML,0.65,0.42,,,0
CDM,RX-491315,INV UBLITUXIMAB/PLACEBO 25 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491318,INV IBUPROFEN 400 MG TABLET,0.65,0.42,,,0
CDM,RX-491320,INV PROCHLORPERAZINE 5 MG TABLET,0.65,0.42,,,0
CDM,RX-491321,INV ASPIRIN/PLACEBO 81 MG TABLET,0.65,0.42,,,0
CDM,RX-491322,INV APIXABAN/PLACEBO 2.5 MG TABLET,0.65,0.42,,,0
CDM,RX-491323,INV APIXABAN/PLACEBO 5 MG TABLET,0.65,0.42,,,0
CDM,RX-491324,INV PREDNISONE 5 MG TABLET,0.65,0.42,,,0
CDM,RX-491325,INV METHYLPREDNISOLONE 1000 MG/8 ML INJECTION,0.65,0.42,,,0
CDM,RX-491327,INV MEDI-551/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491329,INV MEDI-551 10 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491331,INV IMMUNE GLOBULIN (IGG) (PRIVIGEN) 10%,0.65,0.42,,,0
CDM,RX-491332,INV CALCIUM GLUCONATE 100 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491334,INV ALBUMIN HUMAN 5% INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491335,INV REXLEMESTROCEL-L (CEP-41750)/PLACEBO 37.5 MIL CELLS/ML INJECTION,0.65,0.42,,,0
CDM,RX-491337,INV NA-1/PLACEBO 20 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491339,INV NIRAPARIB 100 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491340,INV CF-301/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491342,INV EVEROLIMUS 2.5 MG TABLET,0.65,0.42,,,0
CDM,RX-491343,INV EVEROLIMUS 5 MG TABLET,0.65,0.42,,,0
CDM,RX-491344,INV EVEROLIMUS 10 MG TABLET,0.65,0.42,,,0
CDM,RX-491345,INV YKP3089 (CENOBAMATE) 150 MG TABLET,0.65,0.42,,,0
CDM,RX-491346,INV YKP3089 (CENOBAMATE) 200 MG TABLET,0.65,0.42,,,0
CDM,RX-491347,INV ATEZOLIZUMAB 60 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491349,INV RUXOLITINIB 5 MG TABLET,0.65,0.42,,,0
CDM,RX-491350,INV AMANTADINE (ADS-5102) 68.5 MG/137 MG/PLACEBO ER CAPSULE,0.65,0.42,,,0
CDM,RX-491351,INV AMANTADINE (ADS-5102) 137 MG ER CAPSULE,0.65,0.42,,,0
CDM,RX-491352,INV OFATUMUMAB 20 MG/0.4 ML PRE-FILLED SYRINGE,0.65,0.42,,,0
CDM,RX-491353,INV OFATUMUMAB 20 MG/0.4 ML AUTO-INJECTOR,0.65,0.42,,,0
CDM,RX-491354,INV NETUPITANT-PALONOSETRON (AKYNZEO) 300-0.5 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491355,INV OLANZAPINE/PLACEBO 10 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491356,INV PROCHLORPERAZINE/PLACEBO 10 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491357,INV URCC 16070 TAKE HOME KIT,0.65,0.42,,,0
CDM,RX-491358,INV CLOSTRIDIUM DIFFICILE VACCINE/PLACEBO 200 MCG/0.5 ML,0.65,0.42,,,0
CDM,RX-491361,INV DAPTOMYCIN/PLACEBO 500 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491363,INV AZTREONAM/PLACEBO 1 GRAM SOLUTION FOR INJECTION,0.65,0.42,,,0
CDM,RX-491365,INV CEFTOBIPROLE/PLACEBO 500MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491369,INV OBINUTUZUMAB 25MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491371,INV METHYLENE BLUE 5MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491372,INV ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,0.65,0.42,,,0
CDM,RX-491375,INV CIPROFLOXACIN 500 MG/AMOXICILLIN-CLAVULANATE 875 MG-125 MG/PLACEBO CAPSULE,0.65,0.42,,,0
CDM,RX-491376,INV SULOPENEM ETZADROXIL 500 MG & PROBENECID 500MG/PLACEBO TABLET,0.65,0.42,,,0
CDM,RX-491377,INV ERTAPENEM/PLACEBO 1000 MG/10ML INJECTION,0.65,0.42,,,0
CDM,RX-491379,INV SULOPENEM/PLACEBO 1000MG/10ML INJECTION,0.65,0.42,,,0
CDM,RX-491381,INV CIPROFLOXACIN 500 MG/AMOXICILLIN-CLAVULANATE 875 MG-125 MG/PLACEBO AND METRONIDAZOLE 500 MG/PLACEBO CAPSULE,0.65,0.42,,,0
CDM,RX-491382,INV NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491384,INV RUCAPARIB/PLACEBO 200 MG TABLET,0.65,0.42,,,0
CDM,RX-491385,INV RUCAPARIB/PLACEBO 250 MG TABLET,0.65,0.42,,,0
CDM,RX-491386,INV RUCAPARIB/PLACEBO 300 MG TABLET,0.65,0.42,,,0
CDM,RX-491388,INV NIVOLUMAB/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491390,INV CENOBAMATE/PLACEBO 12.5 MG TABLET,0.65,0.42,,,0
CDM,RX-491392,INV CENOBAMATE 50 MG/100 MG/PLACEBO TABLET,0.65,0.42,,,0
CDM,RX-491393,INV CENOBAMATE/PLACEBO 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491394,INV CENOBAMATE/PLACEBO 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491395,INV CENOBAMATE 50 MG/100 MG/PLACEBO TABLET,0.65,0.42,,,0
CDM,RX-491397,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS (NOT ROUNDED)",356.1,231.46,,,0
CDM,RX-491400,INV CAFFEINE CITRATE 60 MG/3 ML INJECTION,0.65,0.42,,,0
CDM,RX-491402,INV AMINOPHYLLINE 250 MG/10 ML INJECTION,0.65,0.42,,,0
CDM,RX-491403,"INV FLURPIRIDAZ F-18, DIAGNOSTIC, PER STUDY DOSE, UP TO 14",0.65,0.42,,,0
CDM,RX-491405,INV SIPONIMOD 0.25 MG TABLET,0.65,0.42,,,0
CDM,RX-491406,INV SIPONIMOD 2 MG TABLET,0.65,0.42,,,0
CDM,RX-491407,INV CIPROFLOXACIN 500 MG TABLET,0.65,0.42,,,0
CDM,RX-491408,INV PENICILLIN V POTASSIUM 250 MG TABLET,0.65,0.42,,,0
CDM,RX-491409,INV RAVULIZUMAB 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491410,INV RAVULIZUMAB/PLACEBO 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491414,INV OPICINUMAB (BIIB003) 200 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491416,INV PADSEVONIL 25 MG/100 MG/200 MG/PLACEBO TABLET 4-DAY KIT,0.65,0.42,,,0
CDM,RX-491417,INV PADSEVONIL 25 MG/100 MG/200 MG/PLACEBO TABLET 7-DAY KIT,0.65,0.42,,,0
CDM,RX-491418,INV TENECTEPLASE/PLACEBO 5 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491419,INV AGEN2034 50 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491421,INV AGEN1884/PLACEBO 50 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491425,INV VENETOCLAX 10 MG TABLET,0.65,0.42,,,0
CDM,RX-491426,INV VENETOCLAX 50 MG TABLET,0.65,0.42,,,0
CDM,RX-491427,INV VENETOCLAX 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491430,INV NAB-PACLITAXIL (ABRAXANE) INJECTION,0.65,0.42,,,0
CDM,RX-491431,INV PEMBROLIZUMAB/PLACEBO 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491433,INV SODIUM CHLORIDE (NS) 0.9% SLUSH IRRIGATION SOLUTION,322.75,209.79,,,0
CDM,RX-491434,INV UBLITUXIMAB 25 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491437,INV SODIUM CHLORIDE 0.9% SOLUTION FLUSH,0.65,0.42,,,0
CDM,RX-491438,INV DEXTROSE 5% SOLUTION FLUSH,0.65,0.42,,,0
CDM,RX-491439,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS (NOT ROUNDED)",356.1,231.46,,,0
CDM,RX-491441,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION (RESEARCH TRIAL ROUNDING TO 1 MG),221.2,143.78,,,0
CDM,RX-491443,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION (RESEARCH TRIAL ROUNDING TO 1 MG),138.975,90.33,,,0
CDM,RX-491445,BLEOMYCIN 15 UNIT/ML (IM/SC CONCENTRATION),193.05,125.48,,,0
CDM,RX-491446,INV OLAPARIB/PLACEBO 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491447,INV OLAPARIB/PLACEBO 150 MG TABLET,0.65,0.42,,,0
CDM,RX-491448,INV SATRALIZUMAB 120 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491449,INV REMDESIVIR 100 MG/20 ML INJECTION,0.65,0.42,,,0
CDM,RX-491456,INV MAS825/PLACEBO 100 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491458,INV DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491459,INV REMDESIVIR 5 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491461,INV TOCILIZUMAB/PLACEBO 20MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491463,INV TL-895/PLACEBO 50 MG TABLET,0.65,0.42,,,0
CDM,RX-491464,INV TL-895 50 MG TABLET,0.65,0.42,,,0
CDM,RX-491465,INV REGN10933 + INV REGN10987 2.4 GM/8 GM/PLACEBO IN 0.9% SODIUM CHLORIDE 250 ML,0.65,0.42,,,0
CDM,RX-491466,INV DURVALUMAB/PLACEBO 50 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491469,INV EVOBRUTINIB/PLACEBO 45 MG TABLET,0.65,0.42,,,0
CDM,RX-491470,INV SARS-COV-2 HYPERIMMUNE GLOBULIN (HIVIG)/PLACEBO 100 MG/ML IV,0.65,0.42,,,0
CDM,RX-491471,"INV DARATUMUMAB-RHUPH20 120 MG-2,000 UNITS/ML INJECTION",0.65,0.42,,,0
CDM,RX-491472,INV BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491474,INV OCRELIZUMAB/PLACEBO 30 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491478,INV TELAGLENASTAT/PLACEBO 200 MG TABLET,0.65,0.42,,,0
CDM,RX-491479,INV TD-0903/PLACEBO NEBULIZER SOLUTION,0.65,0.42,,,0
CDM,RX-491480,INV IPILIMUMAB 5 MG/ML INTRAVENOUS SOLUTION (ROUNDED TO 1 MG),0.65,0.42,,,0
CDM,RX-491484,INV IMMUNE GLOBULIN (IGG) (GAMMAGARD) 10%,0.65,0.42,,,0
CDM,RX-491489,INV REMDESIVIR/PLACEBO 5 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491490,INV INFLIXIMAB 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491493,INV BATIRAXCEPT (AVB-S6-500)/PLACEBO 20 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491496,INV PATIROMER/PLACEBO 8.4 GRAM PACKET,0.65,0.42,,,0
CDM,RX-491497,INV FENEBRUTINIB/PLACEBO 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491498,INV CABOZANTINIB 20 MG TABLET,0.65,0.42,,,0
CDM,RX-491499,INV CABOZANTINIB 60 MG TABLET,0.65,0.42,,,0
CDM,RX-491500,INV OSIMERTINIB 40 MG TABLET,0.65,0.42,,,0
CDM,RX-491501,INV OSIMERTINIB 80 MG TABLET,0.65,0.42,,,0
CDM,RX-491505,INV PATISIRAN (ALN-TTR02) 2 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491507,INV DARATUMUMAB 20 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491510,INV IXAZOMIB 2.3 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491511,INV IXAZOMIB 3 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491512,INV IXAZOMIB 4 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491514,INV LONCASTUXIMAB TESIRINE-LPYL (ADCT-402) 5 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491516,INV DEXAMETHASONE 4 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491517,INV DEXAMETHASONE/PLACEBO 4 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491518,INV LAU-7B/PLACEBO 100 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491519,INV NEMVALEUKIN ALFA (ALKS 4230) 55.6 MCG/ML,0.65,0.42,,,0
CDM,RX-491520,INV NEMVALEUKIN ALFA (ALKS 4230) 37.7 MCG/ML,0.65,0.42,,,0
CDM,RX-491524,INV SATRALIZUMAB 60 MG/0.5 ML SYRINGE,0.65,0.42,,,0
CDM,RX-491525,INV SATRALIZUMAB 120 MG/ML SYRINGE,0.65,0.42,,,0
CDM,RX-491527,INV SATRALIZUMAB/PLACEBO 120 MG/ML SYRINGE,0.65,0.42,,,0
CDM,RX-491530,INV ZN-C3 25 MG TABLETS,0.65,0.42,,,0
CDM,RX-491531,INV ZN-C3 100 MG TABLETS,0.65,0.42,,,0
CDM,RX-491532,INV ELRANATAMAB (PF-06863135) 40 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491533,INV TECOVIRIMAT 200 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491534,INV CLOFAZIMINE 50 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491535,INV LENALIDOMIDE 10 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491536,INV IXAZOMIB/PLACEBO 2.3 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491537,INV IXAZOMIB/PLACEBO 3 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491538,INV IXAZOMIB/PLACEBO 4 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491539,INV TERIFLUNOMIDE/PLACEBO 14 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491540,INV FENEBRUTINIB 100 MG TABLET,0.65,0.42,,,0
CDM,RX-491541,INV IBERDOMIDE (CC-220) 0.75 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491542,INV IBERDOMIDE (CC-220) 1 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491543,INV IBERDOMIDE (CC-220) 1.3 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491544,INV IBERDOMIDE (CC-220) 1.6 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491549,INV FAM-TRASTUZUMAB DERUXTECAN-NXKI 20 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491553,INV FLECAINIDE ACETATE (FLECIH-103)/PLACEBO,0.65,0.42,,,0
CDM,RX-491554,INV ASUNDEXIAN/PLACEBO 50MG TABLET,0.65,0.42,,,0
CDM,RX-491556,INV TRASTUZUMAB-PKRB 21 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491557,INV PERTUZUMAB 30MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491559,INV OLPASIRAN (AMG890)/PLACEBO 142 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491560,INV EVOGLIPTIN (DA-1229) 5 MG/10 MG/PLACEBO,0.65,0.42,,,0
CDM,RX-491561,INV VEBRELTINIB (APL-101) 100MG,0.65,0.42,,,0
CDM,RX-491562,INV TALQUETAMAB (JNJ-64407564) 2 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491563,INV TALQUETAMAB (JNJ-64407564) 40 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491565,INV SIROLIMUS PROTEIN BOUND 5 MG/ML INTRAVENOUS SUSPENSION,0.65,0.42,,,0
CDM,RX-491566,INV ALDESLEUKIN INJECTION,0.65,0.42,,,0
CDM,RX-491567,INV FLUDARABINE 50MG/2ML INJECTABLE,0.65,0.42,,,0
CDM,RX-491568,INV RITUXIMAB-ABBS 10MG/ML SOLUTION FOR INJECTION,0.65,0.42,,,0
CDM,RX-491571,INV MEZIGDOMIDE (CC-92480) 0.2 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491572,INV MEZIGDOMIDE (CC-92480) 0.3 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491573,INV MEZIGDOMIDE (CC-92480) 0.4 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491574,INV MEZIGDOMIDE (CC-92480) 0.6 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491575,INV MEZIGDOMIDE (CC-92480) 0.8 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491576,INV MEZIGDOMIDE (CC-92480) 1 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491577,INV BENDAMUSTINE 2.5 MG/ML POWDER FOR SOLUTION,0.65,0.42,,,0
CDM,RX-491585,INV SELINEXOR/PLACEBO 20 MG TABLET,0.65,0.42,,,0
CDM,RX-491586,INV 3K3A-APC/PLACEBO INJECTION,0.65,0.42,,,0
CDM,RX-491588,INV IS-001 LYOPHILIZED POWDER,0.65,0.42,,,0
CDM,RX-491589,INV RUSFERTIDE (PTG-300) 10 MG/0.5 ML INJECTION,0.65,0.42,,,0
CDM,RX-491590,INV RUSFERTIDE (PTG-300) 20 MG/0.5 ML INJECTION,0.65,0.42,,,0
CDM,RX-491591,INV RUSFERTIDE (PTG-300) 30 MG/0.5 ML INJECTION,0.65,0.42,,,0
CDM,RX-491592,INV RUSFERTIDE (PTG-300) 45 MG/0.5 ML INJECTION,0.65,0.42,,,0
CDM,RX-491593,INV RUSFERTIDE (PTG-300) 60 MG/0.5 ML INJECTION,0.65,0.42,,,0
CDM,RX-491596,INV RUSFERTIDE (PTG-300)/PLACEBO 10 MG/0.5 ML INJECTION,0.65,0.42,,,0
CDM,RX-491597,INV RUSFERTIDE (PTG-300)/PLACEBO 20 MG/0.5 ML INJECTION,0.65,0.42,,,0
CDM,RX-491598,INV RUSFERTIDE (PTG-300)/PLACEBO 30 MG/0.5 ML INJECTION,0.65,0.42,,,0
CDM,RX-491599,INV RUSFERTIDE (PTG-300)/PLACEBO 45 MG/0.5 ML INJECTION,0.65,0.42,,,0
CDM,RX-491600,INV RUSFERTIDE (PTG-300)/PLACEBO 60 MG/0.5 ML INJECTION,0.65,0.42,,,0
CDM,RX-491603,INV FREXALIMAB/PLACEBO 150 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491605,INV MILVEXIAN/PLACEBO 25 MG TABLET,0.65,0.42,,,0
CDM,RX-491613,INV ONDANSETRON 8 MG TABLET,0.65,0.42,,,0
CDM,RX-491614,INV ONDANSETRON/PLACEBO 8 MG TABLET,0.65,0.42,,,0
CDM,RX-491615,INV NAVTEMADLIN 30 MG TABLET,0.65,0.42,,,0
CDM,RX-491616,INV NAVTEMADLIN 60 MG TABLET,0.65,0.42,,,0
CDM,RX-491617,INV NAVTEMADLIN/PLACEBO 30 MG TABLET,0.65,0.42,,,0
CDM,RX-491618,INV NAVTEMADLIN/PLACEBO 60 MG TABLET,0.65,0.42,,,0
CDM,RX-491619,INV LOPERAMIDE 2 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491620,INV LOPERAMIDE/PLACEBO 2 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491623,INV EPCORITAMAB-BYSP 4 MG/0.8 ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491624,INV EPCORITAMAB-BYSP 48 MG/0.8 ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491625,INV SOTORASIB 120 MG TABLET,0.65,0.42,,,0
CDM,RX-491628,INV PANITUMUMAB INJECTION 100 MG/5 ML,0.65,0.42,,,0
CDM,RX-491633,INV EPCORITAMAB-BYSP 3 MG CHEMO INJECTION (STEP UP DOSE 3),0.65,0.42,,,0
CDM,RX-491634,INV SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491635,INV STABILIZER MIXTURE (PENTAGALLOYL GLUCOSE-IODOMIDOL) INJECTION,0.65,0.42,,,0
CDM,RX-491637,INV LOMUSTINE 10 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491638,INV LOMUSTINE 40 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491639,INV LOMUSTINE 100 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491640,INV BINIMETINIB 15 MG TABLET,0.65,0.42,,,0
CDM,RX-491641,INV PALBOCICLIB 125 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491642,INV PALBOCICLIB 100 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491643,INV PALBOCICLIB 75 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491645,INV BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,0.65,0.42,,,0
CDM,RX-491646,INV VINCRISTINE 1 MG/ML INJECTION,0.65,0.42,,,0
CDM,RX-491647,INV DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491651,INV PREDNISONE 20 MG TABLET,0.65,0.42,,,0
CDM,RX-491654,INV PLOZASIRAN (ARO-APOC3)/PLACEBO INJECTION 25MG,0.65,0.42,,,0
CDM,RX-491655,INV DAROLUTAMIDE 300MG TABLET,0.65,0.42,,,0
CDM,RX-491657,INV PLASMALYTE-A 1000ML BAG,0.65,0.42,,,0
CDM,RX-491658,INV PLASMALYTE-A 500ML BAG,0.65,0.42,,,0
CDM,RX-491659,INV PLASMALYTE-A 10ML SYRINGE,0.65,0.42,,,0
CDM,RX-491660,INV OLVIMULOGENE NANIVACIREPVEC (OLVI-VEC) 1.9 X10EXP8 PFU/ML SUSPENSION FOR INJECTION,0.65,0.42,,,0
CDM,RX-491662,INV RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491666,INV VUTRISIRAN (ALN-TTRSC02) 25 MG/0.5 ML SOLUTION FOR INJECTION,0.65,0.42,,,0
CDM,RX-491667,INV RELATLIMAB (BMS-986016) INJECTION,0.65,0.42,,,0
CDM,RX-491669,INV NTLA-2001/PLACEBO INJECTION,0.65,0.42,,,0
CDM,RX-491671,INV ABEMACICLIB 50 MG TABLET,0.65,0.42,,,0
CDM,RX-491672,INV ENTRECTINIB 200 MG CAPSULE,0.65,0.42,,,0
CDM,RX-491674,INV ADAGRASIB 200MG TABLET,0.65,0.42,,,0
CDM,RX-491675,INV TECLISTAMAB (JNJ-64407957) 10 MG/ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491676,INV TECLISTAMAB (JNJ-64407957) 90 MG/ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491678,INV QUIZARTINIB DIHYDROCHLORIDE/PLACEBO 30 MG TABLET,0.65,0.42,,,0
CDM,RX-491679,INV QUIZARTINIB DIHYDROCHLORIDE/PLACEBO 20 MG TABLET,0.65,0.42,,,0
CDM,RX-491680,INV GLOFITAMAB (RO7082859) 1 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491682,INV ENGLUMAFUSP ALFA (RO7227166) 5 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491690,INV DEXAMETHASONE 8 MG TABLET,0.65,0.42,,,0
CDM,RX-491693,INV BELINOSTAT 500 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491694,INV PRALATREXATE 20 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
CDM,RX-491695,INV OCRELIZUMAB 920 MG-HYALURONIDASE-OCSQ 23000 UNIT/23 ML SUBCUT SOLN,0.65,0.42,,,0
CDM,RX-4952,METHADONE 5 MG/5 ML ORAL SOLUTION,16.0,10.4,,,0
CDM,RX-4954,METHADONE 5 MG TABLET,9.6,6.24,,,0
CDM,RX-4961,METHAZOLAMIDE 25 MG TABLET,7.1,4.62,,,0
CDM,RX-4962,METHAZOLAMIDE 50 MG TABLET,11.75,7.64,,,0
CDM,RX-4970,METHOCARBAMOL 100 MG/ML INJECTION SOLUTION,40.8,26.52,,,0
CDM,RX-4971,METHOCARBAMOL 500 MG TABLET,5.1,3.32,,,0
CDM,RX-4972,METHOCARBAMOL 750 MG TABLET,5.25,3.41,,,0
CDM,RX-4973,METHOTREXATE SODIUM 2.5 MG TABLET,10.7,6.96,,,0
CDM,RX-4974,METHOTREXATE SODIUM 25 MG/ML INJECTION FOR ECTOPIC PREGNANCY (SORD),87.15,56.65,,,0
CDM,RX-4986,METHYLPHENIDATE 10 MG TABLET,13.1,8.52,,,0
CDM,RX-4988,METHYLPHENIDATE 5 MG TABLET,15.35,9.98,,,0
CDM,RX-4992,METHYLPREDNISOLONE 16 MG TABLET,11.8,7.67,,,0
CDM,RX-4993,METHYLPREDNISOLONE 4 MG TABLET,7.8,5.07,,,0
CDM,RX-4995,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,44.35,28.83,,,0
CDM,RX-4996,METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION,62.25,40.46,,,0
CDM,RX-5002,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,34.8,22.62,,,0
CDM,RX-5006,METOCLOPRAMIDE 5 MG TABLET,6.0,3.9,,,0
CDM,RX-5007,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,35.75,23.24,,,0
CDM,RX-5008,METOPROLOL TARTRATE 100 MG TABLET,5.1,3.32,,,0
CDM,RX-5009,METOPROLOL TARTRATE 50 MG TABLET,4.85,3.15,,,0
CDM,RX-5016,METRONIDAZOLE 500 MG TABLET,6.0,3.9,,,0
CDM,RX-5018,METRONIDAZOLE 5 MG/ML IVPB,62.15,40.4,,,0
CDM,RX-5039,MICONAZOLE NITRATE 2 % TOPICAL CREAM,4.0,2.6,,,0
CDM,RX-5040,MICONAZOLE NITRATE 2 % VAGINAL CREAM,25.05,16.28,,,0
CDM,RX-5086,MINERAL OIL ORAL,0.95,0.62,,,0
CDM,RX-5087,MINERAL OIL ENEMA,10.45,6.79,,,0
CDM,RX-5111,MINOCYCLINE 50 MG CAPSULE,5.3,3.44,,,0
CDM,RX-5114,MINOXIDIL 10 MG TABLET,5.15,3.35,,,0
CDM,RX-5115,MINOXIDIL 2.5 MG TABLET,5.95,3.87,,,0
CDM,RX-5170,MORPHINE 2 MG/ML INJECTION SYRINGE,44.45,28.89,,,0
CDM,RX-5172,MORPHINE 4 MG/ML INJECTION SYRINGE,36.8,23.92,,,0
CDM,RX-5176,MORPHINE 10 MG/5 ML ORAL SOLUTION,13.45,8.74,,,0
CDM,RX-5178,MORPHINE 15 MG IMMEDIATE RELEASE TABLET,11.15,7.25,,,0
CDM,RX-5179,MORPHINE 30 MG IMMEDIATE RELEASE TABLET,13.2,8.58,,,0
CDM,RX-5335,NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,46.4,30.16,,,0
CDM,RX-5339,NALBUPHINE 10 MG/ML INJECTION SOLUTION,48.75,31.69,,,0
CDM,RX-5340,NALBUPHINE 20 MG/ML INJECTION SOLUTION,54.0,35.1,,,0
CDM,RX-5373,NALOXONE 0.4 MG/ML INJECTION SOLUTION,217.95,141.67,,,0
CDM,RX-5374,NALOXONE 1 MG/ML INJECTION SYRINGE,130.3,84.7,,,0
CDM,RX-5391,NAPROXEN 250 MG TABLET,5.15,3.35,,,0
CDM,RX-5392,NAPROXEN 375 MG TABLET,5.15,3.35,,,0
CDM,RX-5393,NAPROXEN 500 MG TABLET,5.25,3.41,,,0
CDM,RX-5474,"NEOMYCIN 1.75 MG-POLYMYXIN 10,000 UNIT-GRAMICIDIN 0.025MG/ML EYE DROPS",205.45,133.54,,,0
CDM,RX-5539,NIACIN 100 MG TABLET,5.4,3.51,,,0
CDM,RX-5542,NIACIN 500 MG TABLET,4.7,3.06,,,0
CDM,RX-5545,"NIACIN ER 500 MG TABLET,EXTENDED RELEASE",0.3,0.2,,,0
CDM,RX-5558,NIFEDIPINE 10 MG CAPSULE,5.8,3.77,,,0
CDM,RX-5559,NIFEDIPINE 20 MG CAPSULE,7.5,4.88,,,0
CDM,RX-5599,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,94.25,61.26,,,0
CDM,RX-5600,"NITROGLYCERIN ER 2.5 MG CAPSULE,EXTENDED RELEASE",5.7,3.7,,,0
CDM,RX-5601,"NITROGLYCERIN ER 6.5 MG CAPSULE,EXTENDED RELEASE",5.95,3.87,,,0
CDM,RX-5604,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,65.8,42.77,,,0
CDM,RX-5606,NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,11.0,7.15,,,0
CDM,RX-5749,"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",26.9,17.48,,,0
CDM,RX-5750,"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",27.55,17.91,,,0
CDM,RX-5752,"NYSTATIN 500,000 UNIT TABLET",7.5,4.88,,,0
CDM,RX-5754,"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",26.4,17.16,,,0
CDM,RX-5886,ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION,83.9,54.54,,,0
CDM,RX-5940,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,8.9,5.78,,,0
CDM,RX-5943,OXYMETAZOLINE 0.05 % NASAL SPRAY,16.8,10.92,,,0
CDM,RX-5944,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,34.3,22.3,,,0
CDM,RX-6030,PAPAVERINE 30 MG/ML INJECTION SOLUTION,110.0,71.5,,,0
CDM,RX-6085,PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,155.9,101.34,,,0
CDM,RX-6086,PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,55.45,36.04,,,0
CDM,RX-6091,PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,30.35,19.73,,,0
CDM,RX-6092,PENICILLIN V POTASSIUM 250 MG TABLET,4.8,3.12,,,0
CDM,RX-6097,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,554.0,360.1,,,0
CDM,RX-6158,PERPHENAZINE 4 MG TABLET,7.15,4.65,,,0
CDM,RX-6212,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,15.25,9.91,,,0
CDM,RX-6217,PHENOBARBITAL 32.4 MG TABLET,8.8,5.72,,,0
CDM,RX-6220,PHENOBARBITAL 97.2 MG TABLET,8.95,5.82,,,0
CDM,RX-6221,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,178.85,116.25,,,0
CDM,RX-6224,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,86.15,56.0,,,0
CDM,RX-6242,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,32.95,21.42,,,0
CDM,RX-6244,PHENYLEPHRINE 0.5 % NASAL SPRAY,22.0,14.3,,,0
CDM,RX-6256,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,35.95,23.37,,,0
CDM,RX-6279,PILOCARPINE 1 % EYE DROPS,312.55,203.16,,,0
CDM,RX-6280,PILOCARPINE 2 % EYE DROPS,135.9,88.34,,,0
CDM,RX-6282,PILOCARPINE 4 % EYE DROPS,139.75,90.84,,,0
CDM,RX-6393,"POLYMYXIN B SULFATE 500,000 UNIT/2 ML SOLUTION FOR INJECTION",49.15,31.95,,,0
CDM,RX-6420,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,47.65,30.97,,,0
CDM,RX-6423,POTASSIUM BICARBONATE-CITRIC ACID 25 MEQ EFFERVESCENT TABLET,5.6,3.64,,,0
CDM,RX-6429,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,45.5,29.58,,,0
CDM,RX-6432,POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,11.25,7.31,,,0
CDM,RX-6445,POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,19.1,12.42,,,0
CDM,RX-6451,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,81.6,53.04,,,0
CDM,RX-6462,PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,2444.95,1589.22,,,0
CDM,RX-6468,PRAZOSIN 1 MG CAPSULE,7.35,4.78,,,0
CDM,RX-6469,PRAZOSIN 2 MG CAPSULE,8.85,5.75,,,0
CDM,RX-6470,PRAZOSIN 5 MG CAPSULE,14.75,9.59,,,0
CDM,RX-6487,"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",114.35,74.33,,,0
CDM,RX-6492,PREDNISONE 5 MG/5 ML ORAL SOLUTION,10.95,7.12,,,0
CDM,RX-6493,PREDNISONE 1 MG TABLET,13.3,8.64,,,0
CDM,RX-6494,PREDNISONE 10 MG TABLET,4.95,3.22,,,0
CDM,RX-6495,PREDNISONE 2.5 MG TABLET,5.05,3.28,,,0
CDM,RX-6496,PREDNISONE 20 MG TABLET,5.05,3.28,,,0
CDM,RX-6497,PREDNISONE 5 MG TABLET,5.05,3.28,,,0
CDM,RX-6498,PREDNISONE 50 MG TABLET,5.55,3.61,,,0
CDM,RX-654,ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,34.65,22.52,,,0
CDM,RX-6541,PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,8.5,5.52,,,0
CDM,RX-6544,PRIMIDONE 250 MG TABLET,6.4,4.16,,,0
CDM,RX-6561,PROBENECID 500 MG TABLET,10.45,6.79,,,0
CDM,RX-6562,PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,221.65,144.07,,,0
CDM,RX-6580,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,34.9,22.68,,,0
CDM,RX-6582,PROCHLORPERAZINE MALEATE 10 MG TABLET,6.15,4.0,,,0
CDM,RX-6583,PROCHLORPERAZINE MALEATE 5 MG TABLET,7.35,4.78,,,0
CDM,RX-6597,PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,33.6,21.84,,,0
CDM,RX-6620,PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,5.6,3.64,,,0
CDM,RX-6622,PROMETHAZINE 25 MG TABLET,5.05,3.28,,,0
CDM,RX-6624,PROMETHAZINE 50 MG RECTAL SUPPOSITORY,82.1,53.36,,,0
CDM,RX-663,ASCORBIC ACID (VITAMIN C) 250 MG TABLET,0.15,0.1,,,0
CDM,RX-664,ASCORBIC ACID (VITAMIN C) 500 MG TABLET,0.05,0.03,,,0
CDM,RX-6644,PROPARACAINE 0.5 % EYE DROPS,132.25,85.96,,,0
CDM,RX-6656,PROPRANOLOL 10 MG TABLET,5.25,3.41,,,0
CDM,RX-6657,PROPRANOLOL 20 MG TABLET,5.05,3.28,,,0
CDM,RX-6662,PROPYLTHIOURACIL 50 MG TABLET,11.5,7.48,,,0
CDM,RX-6677,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,39.0,25.35,,,0
CDM,RX-6714,PSEUDOEPHEDRINE 30 MG TABLET,0.05,0.03,,,0
CDM,RX-6716,"PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE",0.3,0.2,,,0
CDM,RX-6738,PYRAZINAMIDE 500 MG TABLET,17.7,11.5,,,0
CDM,RX-6744,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,38.55,25.06,,,0
CDM,RX-6748,PYRIDOXINE (VITAMIN B6) 50 MG TABLET,0.15,0.1,,,0
CDM,RX-6777,QUINIDINE SULFATE 200 MG TABLET,39.5,25.68,,,0
CDM,RX-679,ASPIRIN 81 MG CHEWABLE TABLET,0.1,0.06,,,0
CDM,RX-681,ASPIRIN 325 MG TABLET,0.1,0.06,,,0
CDM,RX-685,"ASPIRIN 325 MG TABLET,DELAYED RELEASE",0.05,0.03,,,0
CDM,RX-688,"ASPIRIN 81 MG TABLET,DELAYED RELEASE",0.05,0.03,,,0
CDM,RX-693,ASPIRIN 300 MG RECTAL SUPPOSITORY,1.1,0.72,,,0
CDM,RX-70255,POLYVINYL ALCOHOL-POVIDONE 0.5 %-0.6 % EYE DROPS,3.6,2.34,,,0
CDM,RX-70267,NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,629.5,409.18,,,0
CDM,RX-7028,"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",33.4,21.71,,,0
CDM,RX-70284,"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",6.2,4.03,,,0
CDM,RX-70287,ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,7591.05,4934.18,,,0
CDM,RX-70306,ARIPIPRAZOLE 2 MG TABLET,6.7,4.36,,,0
CDM,RX-7034,SALSALATE 500 MG TABLET,5.5,3.58,,,0
CDM,RX-70397,QUETIAPINE 50 MG TABLET,5.3,3.44,,,0
CDM,RX-70404,ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT IV KIT (FVIII UNITS),3018.95,1962.32,,,0
CDM,RX-70405,"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT IV KIT (FVIII UNIITS)",5955.8,3871.27,,,0
CDM,RX-70406,"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT IV KIT (FVIII UNITS)",11829.5,7689.18,,,0
CDM,RX-70434,"RANOLAZINE ER 500 MG TABLET,EXTENDED RELEASE,12 HR",7.95,5.17,,,0
CDM,RX-70472,LUBIPROSTONE 24 MCG CAPSULE,7.25,4.71,,,0
CDM,RX-70536,"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",41.95,27.27,,,0
CDM,RX-70545,METHOHEXITAL 500 MG SOLUTION FOR INJECTION,551.5,358.48,,,0
CDM,RX-70838,CETIRIZINE 1 MG/ML ORAL SOLUTION,4.9,3.18,,,0
CDM,RX-716,ATENOLOL 100 MG TABLET,5.25,3.41,,,0
CDM,RX-717,ATENOLOL 25 MG TABLET,5.1,3.32,,,0
CDM,RX-718,ATENOLOL 50 MG TABLET,4.9,3.18,,,0
CDM,RX-7224,SILVER SULFADIAZINE 1 % TOPICAL CREAM,48.2,31.33,,,0
CDM,RX-7226,SIMETHICONE 125 MG CHEWABLE TABLET,4.85,3.15,,,0
CDM,RX-7227,SIMETHICONE 80 MG CHEWABLE TABLET,0.05,0.03,,,0
CDM,RX-7228,"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",2.125,1.38,,,0
CDM,RX-7242,SIMPLE SYRUP,62.15,40.4,,,0
CDM,RX-730,ATROPINE 0.1 MG/ML INJECTION SYRINGE,37.0,24.05,,,0
CDM,RX-7301,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,46.95,30.52,,,0
CDM,RX-7310,SODIUM BICARBONATE (BULK) POWDER,197.15,128.15,,,0
CDM,RX-7311,SODIUM BICARBONATE 325 MG TABLET,0.05,0.03,,,0
CDM,RX-7318,SODIUM CHLORIDE 0.45 % IV BOLUS,67.15,43.65,,,0
CDM,RX-7321,SODIUM CHLORIDE 3 % HYPEROSMOLAR INTRAVENOUS INJECTION SOLUTION,69.25,45.01,,,0
CDM,RX-7322,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,62.4,40.56,,,0
CDM,RX-734,ATROPINE 1 MG/ML INJECTION SOLUTION,50.25,32.66,,,0
CDM,RX-7351,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,80.25,52.16,,,0
CDM,RX-7356,SODIUM POLYSTYRENE SULFONATE 15 GRAM ORAL POWDER,202.8,131.82,,,0
CDM,RX-7359,SULFACETAMIDE SODIUM 10 % EYE DROPS,157.95,102.67,,,0
CDM,RX-736,ATROPINE 1 % EYE DROPS,280.5,182.32,,,0
CDM,RX-7364,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,531.9,345.74,,,0
CDM,RX-7413,SORBITOL 70 % SOLUTION,7.85,5.1,,,0
CDM,RX-7415,SORBITOL 3 % IRRIGATION SOLUTION,109.05,70.88,,,0
CDM,RX-7437,SPIRONOLACTONE 25 MG TABLET,5.0,3.25,,,0
CDM,RX-7485,"WATER FOR IRRIGATION, STERILE SOLUTION",67.15,43.65,,,0
CDM,RX-7536,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,34.4,22.36,,,0
CDM,RX-7554,SULFADIAZINE 500 MG TABLET,47.85,31.1,,,0
CDM,RX-7555,SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,5.05,3.28,,,0
CDM,RX-7556,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,91.1,59.22,,,0
CDM,RX-7562,SULFASALAZINE 500 MG TABLET,5.2,3.38,,,0
CDM,RX-7563,"SULFASALAZINE 500 MG TABLET,DELAYED RELEASE",5.4,3.51,,,0
CDM,RX-76334,DARBEPOETIN ALFA 500 MCG/ML IN POLYSORBATE INJECTION SYRINGE,5686.9,3696.48,,,0
CDM,RX-76335,ACETYLCYSTEINE 600 MG CAPSULE,0.1,0.06,,,0
CDM,RX-76338,"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",271.0,176.15,,,0
CDM,RX-76364,DECITABINE 50 MG INTRAVENOUS SOLUTION,371.25,241.31,,,0
CDM,RX-76444,VARENICLINE TARTRATE 0.5 MG TABLET,26.8,17.42,,,0
CDM,RX-76445,VARENICLINE TARTRATE 1 MG TABLET,26.8,17.42,,,0
CDM,RX-76480,RASAGILINE 0.5 MG TABLET,10.65,6.92,,,0
CDM,RX-76527,"NALTREXONE ER 380 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE",8275.4,5379.01,,,0
CDM,RX-76677,"OXYMORPHONE ER 5 MG TABLET,EXTENDED RELEASE,12 HR",28.55,18.56,,,0
CDM,RX-76679,"OXYMORPHONE ER 20 MG TABLET,EXTENDED RELEASE,12 HR",77.45,50.34,,,0
CDM,RX-76717,DASATINIB 20 MG TABLET,75.25,48.91,,,0
CDM,RX-76718,DASATINIB 50 MG TABLET,159.8,103.87,,,0
CDM,RX-76719,DASATINIB 70 MG TABLET,203.65,132.37,,,0
CDM,RX-76720,SODIUM HYPOCHLORITE 0.125 % SOLUTION,62.15,40.4,,,0
CDM,RX-76822,ARIPIPRAZOLE 10 MG DISINTEGRATING TABLET,19.05,12.38,,,0
CDM,RX-76823,ARIPIPRAZOLE 15 MG DISINTEGRATING TABLET,19.05,12.38,,,0
CDM,RX-76824,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSPENSION,9.15,5.95,,,0
CDM,RX-76843,APREPITANT 40 MG CAPSULE,127.25,82.71,,,0
CDM,RX-76868,RASBURICASE 7.5 MG INTRAVENOUS SOLUTION,27650.2,17972.63,,,0
CDM,RX-76950,"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",0.05,0.03,,,0
CDM,RX-76966,DARBEPOETIN ALFA 200 MCG/ML IN POLYSORBATE INJECTION,2294.5,1491.42,,,0
CDM,RX-76988,HYDROCHLOROTHIAZIDE 12.5 MG TABLET,4.75,3.09,,,0
CDM,RX-77009,MORPHINE (PF) 10 MG/ML INJECTION SOLUTION,987.8,642.07,,,0
CDM,RX-77012,ETONOGESTREL 68 MG SUBDERMAL IMPLANT,3271.25,2126.31,,,0
CDM,RX-7711,TAMOXIFEN 10 MG TABLET,5.15,3.35,,,0
CDM,RX-77195,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,39.05,25.38,,,0
CDM,RX-77308,SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,101.65,66.07,,,0
CDM,RX-77371,POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,113.4,73.71,,,0
CDM,RX-7753,TEMAZEPAM 15 MG CAPSULE,10.4,6.76,,,0
CDM,RX-77615,SITAGLIPTIN PHOSPHATE 25 MG TABLET,36.4,23.66,,,0
CDM,RX-77616,SITAGLIPTIN PHOSPHATE 50 MG TABLET,36.4,23.66,,,0
CDM,RX-77617,SITAGLIPTIN PHOSPHATE 100 MG TABLET,36.4,23.66,,,0
CDM,RX-77648,ATAZANAVIR 300 MG CAPSULE,35.05,22.78,,,0
CDM,RX-77685,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,140.15,91.1,,,0
CDM,RX-77725,METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,13.85,9.0,,,0
CDM,RX-7783,TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,54.15,35.2,,,0
CDM,RX-7784,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,42.05,27.33,,,0
CDM,RX-7800,TETRAHYDROZOLINE 0.05 % EYE DROPS,3.9,2.54,,,0
CDM,RX-78003,CODEINE 10 MG-GUAIFENESIN 100 MG/5 ML ORAL LIQUID,14.15,9.2,,,0
CDM,RX-78064,"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",30.95,20.12,,,0
CDM,RX-78065,"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",30.95,20.12,,,0
CDM,RX-7821,THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,10.3,6.7,,,0
CDM,RX-78310,"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",29.15,18.95,,,0
CDM,RX-78653,ALISKIREN 150 MG TABLET,37.9,24.64,,,0
CDM,RX-7876,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,36.9,23.98,,,0
CDM,RX-7877,THIAMINE HCL (VITAMIN B1) 100 MG TABLET,0.15,0.1,,,0
CDM,RX-7894,THIORIDAZINE 10 MG TABLET,5.6,3.64,,,0
CDM,RX-7899,THIORIDAZINE 25 MG TABLET,6.0,3.9,,,0
CDM,RX-7901,THIOTEPA 15 MG SOLUTION FOR INJECTION,1624.65,1056.02,,,0
CDM,RX-7906,THIOTHIXENE 5 MG CAPSULE,8.4,5.46,,,0
CDM,RX-7995,TOBRAMYCIN 0.3 % EYE DROPS,27.75,18.04,,,0
CDM,RX-8083,TRAZODONE 100 MG TABLET,5.05,3.28,,,0
CDM,RX-8084,TRAZODONE 150 MG TABLET,5.5,3.58,,,0
CDM,RX-8085,TRAZODONE 50 MG TABLET,4.9,3.18,,,0
CDM,RX-8113,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,13.7,8.9,,,0
CDM,RX-8118,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,26.05,16.93,,,0
CDM,RX-8120,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,41.8,27.17,,,0
CDM,RX-8121,TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,257.2,167.18,,,0
CDM,RX-8132,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,6.75,4.39,,,0
CDM,RX-8134,TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,4.9,3.18,,,0
CDM,RX-81426,"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",11.55,7.51,,,0
CDM,RX-81428,ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML ORAL SUSPENSION,135.35,87.98,,,0
CDM,RX-81434,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,204.15,132.7,,,0
CDM,RX-81453,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,243.85,158.5,,,0
CDM,RX-81454,BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,497.7,323.5,,,0
CDM,RX-8161,TRIFLUOPERAZINE 1 MG TABLET,6.4,4.16,,,0
CDM,RX-8164,TRIFLUOPERAZINE 5 MG TABLET,6.65,4.32,,,0
CDM,RX-8166,TRIHEXYPHENIDYL 2 MG TABLET,4.8,3.12,,,0
CDM,RX-81696,ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,27140.15,17641.1,,,0
CDM,RX-8178,TRIMETHOBENZAMIDE 100 MG/ML INTRAMUSCULAR SOLUTION,291.55,189.51,,,0
CDM,RX-8182,TRIMETHOPRIM 100 MG TABLET,9.8,6.37,,,0
CDM,RX-81838,"RISPERIDONE MICROSPHERES ER 12.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS",1499.4,974.61,,,0
CDM,RX-82090,"QUETIAPINE ER 300 MG TABLET,EXTENDED RELEASE 24 HR",6.15,4.0,,,0
CDM,RX-82091,"QUETIAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR",6.3,4.1,,,0
CDM,RX-82100,ROTIGOTINE 2 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,87.85,57.1,,,0
CDM,RX-82134,SODIUM CHLORIDE 7 % FOR NEBULIZATION,6.55,4.26,,,0
CDM,RX-82180,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,116.2,75.53,,,0
CDM,RX-82200,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,89.55,58.21,,,0
CDM,RX-82228,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,6465.55,4202.61,,,0
CDM,RX-82301,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,40.8,26.52,,,0
CDM,RX-82307,AMBRISENTAN 5 MG TABLET,32.8,21.32,,,0
CDM,RX-82308,AMBRISENTAN 10 MG TABLET,32.8,21.32,,,0
CDM,RX-82464,MELATONIN 1 MG TABLET,0.05,0.03,,,0
CDM,RX-8250,TROPICAMIDE 1 % EYE DROPS,35.2,22.88,,,0
CDM,RX-82504,RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH,12.25,7.96,,,0
CDM,RX-82505,RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH,9.45,6.14,,,0
CDM,RX-8259,TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,80.625,52.41,,,0
CDM,RX-8429,VALPROIC ACID 250 MG CAPSULE,5.6,3.64,,,0
CDM,RX-8442,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",44.75,29.09,,,0
CDM,RX-8443,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,51.1,33.22,,,0
CDM,RX-8444,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,440.7,286.46,,,0
CDM,RX-850,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,1.4,0.91,,,0
CDM,RX-8527,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,48.875,31.77,,,0
CDM,RX-8528,VERAPAMIL 120 MG TABLET,5.95,3.87,,,0
CDM,RX-8529,VERAPAMIL 40 MG TABLET,5.05,3.28,,,0
CDM,RX-8530,VERAPAMIL 80 MG TABLET,5.5,3.58,,,0
CDM,RX-854,"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",1.8,1.17,,,0
CDM,RX-856,"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",35.6,23.14,,,0
CDM,RX-8594,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,287.25,186.71,,,0
CDM,RX-860,BACLOFEN 10 MG TABLET,5.5,3.58,,,0
CDM,RX-8639,"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",0.05,0.03,,,0
CDM,RX-8748,WARFARIN 10 MG TABLET,5.15,3.35,,,0
CDM,RX-8749,WARFARIN 2 MG TABLET,5.0,3.25,,,0
CDM,RX-8750,WARFARIN 2.5 MG TABLET,5.0,3.25,,,0
CDM,RX-8751,WARFARIN 5 MG TABLET,4.85,3.15,,,0
CDM,RX-8752,WARFARIN 7.5 MG TABLET,5.15,3.35,,,0
CDM,RX-87869,DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,553.05,359.48,,,0
CDM,RX-87925,IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,209.6,136.24,,,0
CDM,RX-87998,MARAVIROC 150 MG TABLET,87.95,57.17,,,0
CDM,RX-88010,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,111.4,72.41,,,0
CDM,RX-88011,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,40.0,26.0,,,0
CDM,RX-88225,FORMOTEROL FUMARATE 20 MCG/2 ML SOLUTION FOR NEBULIZATION,19.6,12.74,,,0
CDM,RX-88241,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,820.25,533.16,,,0
CDM,RX-88376,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,151.65,98.57,,,0
CDM,RX-88583,CARBIDOPA 50 MG-LEVODOPA 200 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
CDM,RX-88608,RALTEGRAVIR 400 MG TABLET,110.1,71.56,,,0
CDM,RX-8865,ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,101.1,65.72,,,0
CDM,RX-88704,OSELTAMIVIR 30 MG CAPSULE,7.6,4.94,,,0
CDM,RX-8874,ZINC OXIDE 20 % TOPICAL OINTMENT,35.0,22.75,,,0
CDM,RX-8879,ZINC SULFATE 5 MG/ML INTRAVENOUS SOLUTION,167.75,109.04,,,0
CDM,RX-8880,ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,0.15,0.1,,,0
CDM,RX-88945,"CHOLECALCIFEROL (VITAMIN D3) 1,250 MCG (50,000 UNIT) CAPSULE",0.15,0.1,,,0
CDM,RX-89201,SEVELAMER CARBONATE 800 MG TABLET,9.85,6.4,,,0
CDM,RX-89284,NEBIVOLOL 5 MG TABLET,10.9,7.08,,,0
CDM,RX-89286,NEBIVOLOL 10 MG TABLET,11.7,7.6,,,0
CDM,RX-89346,CLOPIDOGREL 300 MG TABLET,29.3,19.04,,,0
CDM,RX-89350,PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,127.35,82.78,,,0
CDM,RX-89432,ETRAVIRINE 100 MG TABLET,42.55,27.66,,,0
CDM,RX-8962,"ACETAZOLAMIDE ER 500 MG CAPSULE,EXTENDED RELEASE",15.95,10.37,,,0
CDM,RX-8963,ACETIC ACID 0.25 % IRRIGATION SOLUTION,37.95,24.67,,,0
CDM,RX-8969,ACYCLOVIR 200 MG CAPSULE,4.85,3.15,,,0
CDM,RX-8970,ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,227.4,147.81,,,0
CDM,RX-8972,ACYCLOVIR 800 MG TABLET,6.05,3.93,,,0
CDM,RX-8975,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,77.0,50.05,,,0
CDM,RX-8979,ALBENDAZOLE 200 MG TABLET,19.75,12.84,,,0
CDM,RX-89791,PANTOPRAZOLE DR 40 MG GRANULES DELAYED-RELEASE FOR SUSP IN PACKET,37.2,24.18,,,0
CDM,RX-8981,"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",239.15,155.45,,,0
CDM,RX-8982,"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION (IO)",246.3,160.1,,,0
CDM,RX-9002,ALTEPLASE 100 MG INTRAVENOUS SOLUTION,35757.2,23242.18,,,0
CDM,RX-9003,ALTEPLASE 50 MG INTRAVENOUS SOLUTION,17919.65,11647.77,,,0
CDM,RX-9014,ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,8.95,5.82,,,0
CDM,RX-9020,"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",6.55,4.26,,,0
CDM,RX-9049,PARENTERAL AMINO ACID 10 % COMBINATION NO.2 INTRAVENOUS SOLUTION,187.65,121.97,,,0
CDM,RX-9062,AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,23.1,15.02,,,0
CDM,RX-9063,AMINOCAPROIC ACID 500 MG TABLET,57.8,37.57,,,0
CDM,RX-9066,AMIODARONE 200 MG TABLET,5.3,3.44,,,0
CDM,RX-9069,AMLODIPINE 10 MG TABLET,4.95,3.22,,,0
CDM,RX-9070,AMLODIPINE 2.5 MG TABLET,4.85,3.15,,,0
CDM,RX-9071,AMLODIPINE 5 MG TABLET,4.9,3.18,,,0
CDM,RX-9083,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,43.35,28.18,,,0
CDM,RX-9084,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,47.4,30.81,,,0
CDM,RX-91046,HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE,365.5,237.58,,,0
CDM,RX-91185,SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,3364.35,2186.83,,,0
CDM,RX-9119,APRACLONIDINE 0.5 % EYE DROPS,196.65,127.82,,,0
CDM,RX-91278,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,38.25,24.86,,,0
CDM,RX-91279,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,41.65,27.07,,,0
CDM,RX-91281,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,60.15,39.1,,,0
CDM,RX-91300,BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,12129.25,7884.01,,,0
CDM,RX-91408,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,148.9,96.78,,,0
CDM,RX-91534,LUBIPROSTONE 8 MCG CAPSULE,42.55,27.66,,,0
CDM,RX-91651,METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,558.25,362.86,,,0
CDM,RX-9183,AZATHIOPRINE 50 MG TABLET,6.15,4.0,,,0
CDM,RX-9185,AZTREONAM 1 GRAM SOLUTION FOR INJECTION,135.3,87.94,,,0
CDM,RX-9186,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,242.0,157.3,,,0
CDM,RX-91870,ALVIMOPAN 12 MG CAPSULE,331.45,215.44,,,0
CDM,RX-91965,"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",1048.0,681.2,,,0
CDM,RX-9266,BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,68.35,44.43,,,0
CDM,RX-9268,BETAXOLOL 0.5 % EYE DROPS,166.15,108.0,,,0
CDM,RX-9285,BISMUTH SUBSALICYLATE 262 MG CHEWABLE TABLET,0.2,0.13,,,0
CDM,RX-92851,DARUNAVIR 600 MG TABLET,113.9,74.04,,,0
CDM,RX-92853,"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",11529.95,7494.47,,,0
CDM,RX-92854,"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",23027.0,14967.55,,,0
CDM,RX-92855,"COAGULATION FACTOR VIIA RECOMB 5 MG (5,000 MCG) INTRAVENOUS SOLUTION",57518.1,37386.76,,,0
CDM,RX-9289,BLEOMYCIN 15 UNIT/ML (IM/SC CONCENTRATION),193.05,125.48,,,0
CDM,RX-92895,VANCOMYCIN 1 GRAM/200 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,171.9,111.74,,,0
CDM,RX-92897,DASATINIB 100 MG TABLET,298.9,194.28,,,0
CDM,RX-93084,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,43.7,28.4,,,0
CDM,RX-9309,BUMETANIDE 0.5 MG TABLET,7.2,4.68,,,0
CDM,RX-9310,BUMETANIDE 1 MG TABLET,6.9,4.48,,,0
CDM,RX-9311,BUMETANIDE 2 MG TABLET,8.1,5.26,,,0
CDM,RX-9321,BUPROPION HCL 100 MG TABLET,7.8,5.07,,,0
CDM,RX-9322,BUPROPION HCL 75 MG TABLET,7.0,4.55,,,0
CDM,RX-9323,BUSPIRONE 10 MG TABLET,5.0,3.25,,,0
CDM,RX-9324,BUSPIRONE 5 MG TABLET,4.9,3.18,,,0
CDM,RX-9347,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,713.9,464.04,,,0
CDM,RX-9350,CALCITRIOL 0.25 MCG CAPSULE,6.65,4.32,,,0
CDM,RX-93566,ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,13769.4,8950.11,,,0
CDM,RX-93567,ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,27505.75,17878.74,,,0
CDM,RX-93834,"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",5.5,3.58,,,0
CDM,RX-93838,CEFEPIME 2 GRAM/100 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,237.25,154.21,,,0
CDM,RX-9385,CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.05,0.03,,,0
CDM,RX-93931,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,5.45,3.54,,,0
CDM,RX-93936,CLEVIDIPINE 25 MG/50 ML INTRAVENOUS EMULSION,433.35,281.68,,,0
CDM,RX-9401,CAPTOPRIL 12.5 MG TABLET,8.25,5.36,,,0
CDM,RX-9403,CAPTOPRIL 50 MG TABLET,10.0,6.5,,,0
CDM,RX-9406,CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,5.0,3.25,,,0
CDM,RX-9407,CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,5.2,3.38,,,0
CDM,RX-9410,CARBOPLATIN 150 MG INTRAVENOUS SOLUTION,1443.95,938.57,,,0
CDM,RX-9413,CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,217.35,141.28,,,0
CDM,RX-94158,"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",0.25,0.16,,,0
CDM,RX-9417,CARTEOLOL 1 % EYE DROPS,50.25,32.66,,,0
CDM,RX-94219,NICARDIPINE 20 MG/200 ML(0.1 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN,212.95,138.42,,,0
CDM,RX-94236,CARBIDOPA 18.75 MG-LEVODOPA 75 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
CDM,RX-9436,CEFADROXIL 500 MG CAPSULE,5.6,3.64,,,0
CDM,RX-9439,CEFADROXIL 500 MG/5 ML ORAL SUSPENSION,8.75,5.69,,,0
CDM,RX-94563,TETRABENAZINE 12.5 MG TABLET,38.4,24.96,,,0
CDM,RX-9458,CEFOTETAN 1 GRAM SOLUTION FOR INJECTION,79.5,51.68,,,0
CDM,RX-9460,CEFOTETAN 2 GRAM SOLUTION FOR INJECTION,126.05,81.93,,,0
CDM,RX-9474,CEFTAZIDIME (IM) 1000 MG INJECTION,53.9,35.04,,,0
CDM,RX-9487,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,37.5,24.38,,,0
CDM,RX-9488,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,41.7,27.1,,,0
CDM,RX-9489,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,35.5,23.08,,,0
CDM,RX-9490,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,36.1,23.46,,,0
CDM,RX-9492,CEFTRIAXONE 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOT) INTRAVENOUS PIGGYBACK,103.6,67.34,,,0
CDM,RX-9493,CEFTRIAXONE 2 GRAM/50 ML IN DEXTROSE (ISO-OSM) INTRAVENOUS PIGGYBACK,118.5,77.02,,,0
CDM,RX-9495,CEFUROXIME AXETIL 250 MG TABLET,13.2,8.58,,,0
CDM,RX-9496,CEFUROXIME AXETIL 500 MG TABLET,14.95,9.72,,,0
CDM,RX-9499,CEPHALEXIN 250 MG CAPSULE,5.4,3.51,,,0
CDM,RX-9500,CEPHALEXIN 500 MG CAPSULE,5.35,3.48,,,0
CDM,RX-9501,CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION,10.05,6.53,,,0
CDM,RX-9502,CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,10.3,6.7,,,0
CDM,RX-9516,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,7.05,4.58,,,0
CDM,RX-9526,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,179.55,116.71,,,0
CDM,RX-95676,"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",5.0,3.25,,,0
CDM,RX-95687,"MESALAMINE ER 0.375 GRAM CAPSULE,EXTENDED RELEASE 24 HR",12.3,8.0,,,0
CDM,RX-95691,RUFINAMIDE 200 MG TABLET,7.75,5.04,,,0
CDM,RX-95692,RUFINAMIDE 400 MG TABLET,9.8,6.37,,,0
CDM,RX-95811,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,34.7,22.56,,,0
CDM,RX-95849,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,728.55,473.56,,,0
CDM,RX-9598,CICLOPIROX 0.77 % TOPICAL CREAM,18.35,11.93,,,0
CDM,RX-9603,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,82.45,53.59,,,0
CDM,RX-9610,CIPROFLOXACIN 0.3 % EYE DROPS,26.25,17.06,,,0
CDM,RX-9615,CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,359.65,233.77,,,0
CDM,RX-9616,CLARITHROMYCIN 250 MG TABLET,10.4,6.76,,,0
CDM,RX-9617,CLARITHROMYCIN 500 MG TABLET,15.4,10.01,,,0
CDM,RX-9626,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,79.3,51.54,,,0
CDM,RX-9627,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,93.35,60.68,,,0
CDM,RX-9630,CLOBETASOL 0.05 % TOPICAL CREAM,22.45,14.59,,,0
CDM,RX-9631,CLOBETASOL 0.05 % TOPICAL OINTMENT,27.0,17.55,,,0
CDM,RX-9635,CLOMIPRAMINE 25 MG CAPSULE,31.0,20.15,,,0
CDM,RX-9637,CLONAZEPAM 0.5 MG TABLET,9.7,6.3,,,0
CDM,RX-9638,CLONAZEPAM 1 MG TABLET,8.6,5.59,,,0
CDM,RX-9644,CLOTRIMAZOLE 10 MG TROCHE,12.55,8.16,,,0
CDM,RX-9647,CLOZAPINE 100 MG TABLET,6.75,4.39,,,0
CDM,RX-9648,CLOZAPINE 25 MG TABLET,5.45,3.54,,,0
CDM,RX-9681,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,80.5,52.32,,,0
CDM,RX-9682,COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,1152.25,748.96,,,0
CDM,RX-9686,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,125.65,81.67,,,0
CDM,RX-96930,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,4.8,3.12,,,0
CDM,RX-96948,ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,20.85,13.55,,,0
CDM,RX-96968,LACOSAMIDE 50 MG TABLET,11.45,7.44,,,0
CDM,RX-96969,LACOSAMIDE 100 MG TABLET,10.85,7.05,,,0
CDM,RX-96970,LACOSAMIDE 150 MG TABLET,5.45,3.54,,,0
CDM,RX-96971,LACOSAMIDE 200 MG TABLET,9.3,6.04,,,0
CDM,RX-96972,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,86.15,56.0,,,0
CDM,RX-96982,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,101.7,66.1,,,0
CDM,RX-96984,SILODOSIN 4 MG CAPSULE,5.55,3.61,,,0
CDM,RX-96985,SILODOSIN 8 MG CAPSULE,5.6,3.64,,,0
CDM,RX-96986,DEGARELIX 80 MG SUBCUTANEOUS SOLUTION,1965.2,1277.38,,,0
CDM,RX-96987,DEGARELIX 120 MG SUBCUTANEOUS SOLUTION,3020.1,1963.06,,,0
CDM,RX-96989,"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",5059.8,3288.87,,,0
CDM,RX-9699,CYCLOPENTOLATE 0.5 % EYE DROPS,381.15,247.75,,,0
CDM,RX-9700,CYCLOPENTOLATE 2 % EYE DROPS,179.25,116.51,,,0
CDM,RX-9701,CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,144.8,94.12,,,0
CDM,RX-9705,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,363.0,235.95,,,0
CDM,RX-9706,CYCLOSPORINE 100 MG CAPSULE,57.4,37.31,,,0
CDM,RX-9707,CYCLOSPORINE 25 MG CAPSULE,16.25,10.56,,,0
CDM,RX-97087,MILNACIPRAN 12.5 MG TABLET,29.25,19.01,,,0
CDM,RX-97089,MILNACIPRAN 50 MG TABLET,29.25,19.01,,,0
CDM,RX-9716,DANTROLENE 20 MG INTRAVENOUS SOLUTION,385.7,250.7,,,0
CDM,RX-9717,DANTROLENE 100 MG CAPSULE,9.3,6.04,,,0
CDM,RX-9718,DANTROLENE 25 MG CAPSULE,8.6,5.59,,,0
CDM,RX-9723,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,101.35,65.88,,,0
CDM,RX-97252,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,34.9,22.68,,,0
CDM,RX-97255,OCTREOTIDE ACETATE 200 MCG/ML INJECTION SOLUTION,35.85,23.3,,,0
CDM,RX-9726,DEMECLOCYCLINE 150 MG TABLET,22.95,14.92,,,0
CDM,RX-97343,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,51.25,33.31,,,0
CDM,RX-97353,CALCIUM 200 MG (AS CITRATE)-VITAMIN D3 6.25 MCG (250 UNIT) TABLET,0.1,0.06,,,0
CDM,RX-97382,"LEVETIRACETAM ER 750 MG TABLET,EXTENDED RELEASE 24 HR",5.8,3.77,,,0
CDM,RX-97463,"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) TABLET",0.2,0.13,,,0
CDM,RX-9748,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,50.6,32.89,,,0
CDM,RX-9751,DESONIDE 0.05 % TOPICAL OINTMENT,47.15,30.65,,,0
CDM,RX-9759,DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,301.8,196.17,,,0
CDM,RX-9774,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,1.75,1.14,,,0
CDM,RX-9788,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,67.15,43.65,,,0
CDM,RX-97893,TOLVAPTAN 15 MG TABLET,177.95,115.67,,,0
CDM,RX-97894,TOLVAPTAN 30 MG TABLET,155.85,101.3,,,0
CDM,RX-9791,POTASSIUM CHLORIDE 20 MEQ/L IN 5 % DEXTROSE INTRAVENOUS SOLUTION,75.55,49.11,,,0
CDM,RX-97915,CIPROFLOXACIN 0.2 % EAR DROPS IN A DROPPERETTE,32.55,21.16,,,0
CDM,RX-9795,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,71.35,46.38,,,0
CDM,RX-97979,RISPERIDONE 0.25 MG DISINTEGRATING TABLET,13.85,9.0,,,0
CDM,RX-9799,POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,75.55,49.11,,,0
CDM,RX-9800,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,75.55,49.11,,,0
CDM,RX-9801,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,71.35,46.38,,,0
CDM,RX-98034,"LIPASE-PROTEASE-AMYLASE (PORK)6,000-19,000-30,000 UNIT CAPSULE,DEL REL",10.85,7.05,,,0
CDM,RX-9804,POTASSIUM CHLORIDE 30 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,75.55,49.11,,,0
CDM,RX-9807,POTASSIUM CHLORIDE 40 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,75.55,49.11,,,0
CDM,RX-9812,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,67.15,43.65,,,0
CDM,RX-9814,DEXTROSE 5 % AND 0.45 % NACL IV BOLUS,67.15,43.65,,,0
CDM,RX-9814,DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,67.15,43.65,,,0
CDM,RX-9815,DEXTROSE 5 % AND 0.9 % NACL IV BOLUS,67.15,43.65,,,0
CDM,RX-98249,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,149.95,97.47,,,0
CDM,RX-98253,TAPENTADOL 50 MG TABLET,39.8,25.87,,,0
CDM,RX-98329,DRONEDARONE 400 MG TABLET,42.85,27.85,,,0
CDM,RX-98372,PRASUGREL HCL 5 MG TABLET,7.0,4.55,,,0
CDM,RX-98373,PRASUGREL HCL 10 MG TABLET,8.15,5.3,,,0
CDM,RX-9859,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,148.85,96.75,,,0
CDM,RX-988,BENZONATATE 100 MG CAPSULE,5.65,3.67,,,0
CDM,RX-989,BENZOYL PEROXIDE 10 % TOPICAL GEL,24.65,16.02,,,0
CDM,RX-9891,DIPYRIDAMOLE 5 MG/ML INTRAVENOUS SOLUTION,120.15,78.1,,,0
CDM,RX-9892,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,64.25,41.76,,,0
CDM,RX-9894,DOXAZOSIN 1 MG TABLET,6.8,4.42,,,0
CDM,RX-9895,DOXAZOSIN 2 MG TABLET,6.0,3.9,,,0
CDM,RX-9896,DOXAZOSIN 4 MG TABLET,6.1,3.96,,,0
CDM,RX-9902,DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,18.7,12.16,,,0
CDM,RX-9904,DRONABINOL 2.5 MG CAPSULE,15.4,10.01,,,0
CDM,RX-9938,"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",736.65,478.82,,,0
CDM,RX-9939,"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",291.0,189.15,,,0
CDM,RX-9940,"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",420.0,273.0,,,0
CDM,RX-9941,"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",549.0,356.85,,,0
CDM,RX-9943,"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",9.1,5.92,,,0
CDM,RX-99443,VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,603.4,392.21,,,0
CDM,RX-99445,LEVONORGESTREL 1.5 MG TABLET,3.35,2.18,,,0
CDM,RX-99454,ILOPERIDONE 2 MG TABLET,93.35,60.68,,,0
CDM,RX-99456,ILOPERIDONE 6 MG TABLET,113.8,73.97,,,0
CDM,RX-9957,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,63.75,41.44,,,0
CDM,RX-99610,OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,263.45,171.24,,,0
CDM,RX-99612,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,431.95,280.77,,,0
CDM,RX-9967,ESTRADIOL 1 MG TABLET,4.95,3.22,,,0
CDM,RX-9968,ESTRADIOL 2 MG TABLET,4.85,3.15,,,0
CDM,RX-9969,ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,286.25,186.06,,,0
CDM,RX-99694,SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,31.95,20.77,,,0
CDM,RX-99702,PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,11403.75,7412.44,,,0
CDM,RX-9972,CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,1780.65,1157.42,,,0
CDM,RX-9973,CONJUGATED ESTROGENS 0.3 MG TABLET,25.05,16.28,,,0
CDM,RX-9974,CONJUGATED ESTROGENS 0.625 MG TABLET,25.05,16.28,,,0
CDM,RX-99754,ASENAPINE 5 MG SUBLINGUAL TABLET,15.25,9.91,,,0
CDM,RX-9977,CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,1785.25,1160.41,,,0
CDM,RX-9979,ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,2615.9,1700.34,,,0
CDM,RX-998,BENZTROPINE 0.5 MG TABLET,5.65,3.67,,,0
CDM,RX-9980,ETHACRYNIC ACID 25 MG TABLET,75.25,48.91,,,0
CDM,RX-9982,ETHAMBUTOL 100 MG TABLET,5.55,3.61,,,0
CDM,RX-9983,ETHAMBUTOL 400 MG TABLET,6.65,4.32,,,0
CDM,RX-99835,"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",6.75,4.39,,,0
CDM,RX-9984,ETHANOLAMINE OLEATE 5 % INTRAVENOUS SOLUTION,1201.3,780.84,,,0
CDM,RX-9989,ETHOSUXIMIDE 250 MG CAPSULE,8.1,5.26,,,0
CDM,RX-999,BENZTROPINE 1 MG TABLET,5.6,3.64,,,0
HCPCS,0001U,Hc Rbc Dna Hea 35 Ag 11 Bld Grp So,2030.0,1319.5,,,0
HCPCS,0001U,Rbc dna hea 35 ag 11 bld grp,,,720.0,2700.0,3
HCPCS,0002M,Liver dis 10 assays w/ash,,,503.4,503.4,1
HCPCS,0002U,Onc clrct 3 ur metab alg plp,,,25.0,93.75,3
HCPCS,0003M,Hc Nash Fibrosure,1526.0,991.9,,,0
HCPCS,0003M,Liver dis 10 assays w/nash,,,503.4,503.4,1
HCPCS,0003U,Onc ovar 5 prtn ser alg scor,,,950.0,3562.5,3
HCPCS,0004M,Scoliosis dna alys,,,79.0,79.0,1
HCPCS,0005U,Onco prst8 3 gene ur alg,,,760.0,2850.0,3
HCPCS,0006M,Onc hep gene risk classifier,,,150.0,150.0,1
HCPCS,0007M,Onc gastro 51 gene nomogram,,,375.0,375.0,1
HCPCS,0007U,Rx test prsmv ur w/def conf,,,114.43,429.11,3
HCPCS,0008U,Hpylori detcj abx rstnc dna,,,597.91,2242.16,3
HCPCS,0009U,Onc brst ca erbb2 amp/nonamp,,,107.0,401.25,3
HCPCS,0010U,Nfct ds strn typ whl gen seq,,,427.26,1602.23,3
HCPCS,0011M,Onc prst8 ca mrna 12 gen alg,,,760.0,2850.0,3
HCPCS,0011U,Rx mntr lc-ms/ms oral fluid,,,114.43,429.11,3
HCPCS,0012M,Onc mrna 5 gen rsk urthl ca,,,760.0,2850.0,3
HCPCS,0013M,Onc mrna 5 gen recr urthl ca,,,760.0,2850.0,3
HCPCS,0015M,Adrnl cortcl tum bchm asy 25,,,1305.37,4895.14,3
HCPCS,0016M,Onc bladder mrna 209 gen alg,,,3489.63,13086.11,3
HCPCS,0016U,Onc hmtlmf neo rna bcr/abl1,,,163.96,614.85,3
HCPCS,0017M,Onc dlbcl mrna 20 genes alg,,,2510.21,9413.29,3
HCPCS,0017U,Onc hmtlmf neo jak2 mut dna,,,91.66,343.73,3
HCPCS,0018M,Trnsplj rnl meas cd154+cll,,,640.73,2402.74,3
HCPCS,0018U,Onc thyr 10 microrna seq alg,,,3002.09,11257.84,3
HCPCS,0019M,Cv ds plasma alys prtn bmrk,,,712.4,712.4,1
HCPCS,0019U,Onc rna tiss predict alg,,,3675.0,13781.25,3
HCPCS,0021U,Onc prst8 detcj 8 autoantb,,,760.0,2850.0,3
HCPCS,0022U,Trgt gen seq dna&rna 23 gene,,,1950.0,7312.5,3
HCPCS,0023U,Onc aml dna detcj/nondetcj,,,248.51,931.91,3
HCPCS,0024U,Glyca nuc mr spectrsc quan,,,34.19,128.21,3
HCPCS,0025U,Tenofovir liq chrom ur quan,,,114.43,321.64,3
HCPCS,0026U,Onc thyr dna&mrna 112 genes,,,3600.0,13500.0,3
HCPCS,0027U,Hc Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 So,1009.0,655.85,,,0
HCPCS,0027U,Jak2 gene trgt seq alys,,,121.91,457.16,3
HCPCS,0029U,Hc Rx Metab Advrs Rx Rxn & Rspse Trgt Seq Alys So,2706.0,1758.9,,,0
HCPCS,0029U,Rx metab advrs trgt seq alys,,,742.27,2783.51,3
HCPCS,0030U,Hc Rx Metab Warfarin Rx Response Trgt Seq Alys So,3799.0,2469.35,,,0
HCPCS,0030U,Rx metab warf trgt seq alys,,,134.13,502.99,3
HCPCS,0031U,Cyp1a2 gene,,,174.81,655.54,3
HCPCS,0031U,Hc Cyp1A2 Gene Analysis Common Variants So,2435.0,1582.75,,,0
HCPCS,0032U,Comt gene,,,174.81,655.54,3
HCPCS,0032U,Hc Comt Gene Analysis C.472G>A Variant So,2978.0,1935.7,,,0
HCPCS,0033U,Hc Htr2A Htr2C Gene Analysis Common Variants So,2706.0,1758.9,,,0
HCPCS,0033U,Htr2a htr2c genes,,,1311.08,1311.08,2
HCPCS,0034U,Hc Tpmt Nudt15 Gene Analysis Common Variants So,1397.0,908.05,,,0
HCPCS,0034U,Tpmt nudt15 genes,,,466.17,1748.14,3
HCPCS,0035U,Hc Neuro Csf Prion Prtn Qual So,2838.0,1844.7,,,0
HCPCS,0035U,Neuro csf prion prtn qual,,,540.99,2028.71,3
HCPCS,0036U,Xome tum & nml spec seq alys,,,4780.0,17925.0,3
HCPCS,0037U,Trgt gen seq dna 324 genes,,,3500.0,13125.0,3
HCPCS,0038U,Vitamin d srm microsamp quan,,,29.6,111.0,3
HCPCS,0039U,Dna antb 2strand hi avidity,,,13.74,51.53,3
HCPCS,0040U,Bcr/abl1 gene major bp quan,,,409.9,1537.13,3
HCPCS,0041U,B brgdrferi antb 5 prtn igm,,,17.21,64.54,3
HCPCS,0042T,Hc Ct Cerebral Perf Analysis With Contrast,2075.0,1348.75,,,0
HCPCS,0042U,B brgdrferi antb 12 prtn igg,,,17.21,64.54,3
HCPCS,0043U,Tbrf b grp antb 4 prtn igm,,,14.86,55.73,3
HCPCS,0044U,Tbrf b grp antb 4 prtn igg,,,14.86,55.73,3
HCPCS,0045U,Onc brst dux carc is 12 gene,,,3873.0,14523.75,3
HCPCS,0046U,Flt3 gene itd variants quan,,,407.43,1527.86,3
HCPCS,0047U,Onc prst8 mrna 17 gene alg,,,3873.0,14523.75,3
HCPCS,0048U,Onc sld org neo dna 468 gene,,,2919.6,10948.5,3
HCPCS,0049U,Npm1 gene analysis quan,,,407.43,1527.86,3
HCPCS,0050U,Trgt gen seq dna 194 genes,,,2916.6,10937.25,3
HCPCS,0051U,Rx mntr lc-ms/ms ur 31 pnl,,,246.92,726.41,3
HCPCS,0052U,Lpoprtn bld w/5 maj classes,,,33.86,126.98,3
HCPCS,0054U,Rx mntr 14+ drugs & sbsts,,,198.74,558.6,3
HCPCS,0055U,Card hrt trnspl 96 dna seq,,,3240.0,12150.0,3
HCPCS,0058U,Hc Merkel Smt Oncoprotein Antibody Titer So,1645.0,1069.25,,,0
HCPCS,0058U,Onc merkel cll carc srm quan,,,322.96,1211.1,3
HCPCS,0059U,Hc Merkel Virus Vp1 Capsid Antibody So,1488.0,967.2,,,0
HCPCS,0059U,Onc merkel cll carc srm +/-,,,322.96,1211.1,3
HCPCS,0060U,Twn zyg gen seq alys chrms2,,,759.05,2846.44,3
HCPCS,0061U,Tc meas 5 bmrk sfdi m-s alys,,,25.1,94.13,3
HCPCS,0062U,Ai sle igg&igm alys 80 bmrk,,,380.72,1427.7,3
HCPCS,0063U,Neuro autism 32 amines alg,,,750.0,2812.5,3
HCPCS,0064U,Antb tp total&rpr ia qual,,,31.33,117.49,3
HCPCS,0065U,Syfls tst nontreponemal antb,,,18.09,67.84,3
HCPCS,0067U,Onc brst imhchem prfl 4 bmrk,,,1897.0,7113.75,3
HCPCS,0068U,Candida species pnl amp prb,,,142.63,534.86,3
HCPCS,0069U,Onc clrct microrna mir-31-3p,,,380.0,1425.0,3
HCPCS,0070U,Cyp2d6 gen com&slct rar vrnt,,,676.37,2536.39,3
HCPCS,0070U,Hc Cyp2D6 Gen Com&Slct Rar Vrnt So,1111.0,722.15,,,0
HCPCS,0071T,Us leiomyomata ablate <200,,,3121.31,3121.31,1
HCPCS,0071U,Cyp2d6 full gene sequence,,,600.0,2250.0,3
HCPCS,0071U,Hc Cyp2D6 Full Gene Sequence So,3672.0,2386.8,,,0
HCPCS,0072T,Us leiomyomata ablate >200,,,3121.31,3121.31,1
HCPCS,0072U,Cyp2d6 gen cyp2d6-2d7 hybrid,,,450.91,1690.91,3
HCPCS,0072U,Hc Cyp2D6 Gen Cyp2D6-2D7 Hybrid So,4982.0,3238.3,,,0
HCPCS,0073U,Cyp2d6 gen cyp2d7-2d6 hybrid,,,450.91,1690.91,3
HCPCS,0073U,Hc Cyp2D6 Gen Cyp2D7-2D6 Hybrid So,5506.0,3578.9,,,0
HCPCS,0074U,Cyp2d6 nonduplicated gene,,,450.91,1690.91,3
HCPCS,0074U,Hc Cyp2D6 Nonduplicated Gene So,6294.0,4091.1,,,0
HCPCS,0075T,Hc Transcath Stent Xtracran Cca Perc Initial Vessel,50656.0,32926.4,,,0
HCPCS,0075T,Perq Stent/Chest Vert Art,,,15689.0,15689.0,1
HCPCS,0075U,Cyp2d6 5' gene dup/mlt,,,450.91,1690.91,3
HCPCS,0075U,Hc Cyp2D6 5' Gene Dup/Mlt So,6818.0,4431.7,,,0
HCPCS,0076T,Hc Transcath Stent Xtracran Cca Perc Addl Vessel,22800.0,14820.0,,,0
HCPCS,0076T,S&I Stent/Chest Vert Art,,,15689.0,15689.0,1
HCPCS,0076U,Cyp2d6 3' gene dup/mlt,,,450.91,1690.91,3
HCPCS,0076U,Hc Cyp2D6 3' Gene Dup/Mlt So,7342.0,4772.3,,,0
HCPCS,0077U,Hc M-Protein Isotype Maldi-Tof Ms So,1573.0,1022.45,,,0
HCPCS,0077U,Ig paraprotein qual bld/ur,,,43.43,162.86,3
HCPCS,0078U,Pain mgt opi use gnotyp pnl,,,1690.91,1690.91,2
HCPCS,0080U,Onc lng 5 clin rsk factr alg,,,3520.0,13200.0,3
HCPCS,0082U,Rx test def 90+ rx/sbsts ur,,,246.92,925.95,3
HCPCS,0083U,Onc rspse chemo cntrst tomog,,,167.35,627.56,3
HCPCS,0084U,Rbc dna gnotyp 10 bld groups,,,720.0,2700.0,3
HCPCS,0086U,Nfct ds bact&fng org id 6+,,,200.0,750.0,3
HCPCS,0087U,Crd hrt trnspl mrna 1283 gen,,,3159.42,11847.83,3
HCPCS,0088U,Trnsplj kdn algrft rej 1494,,,3159.42,11847.83,3
HCPCS,0089U,Onc mlnma prame & linc00518,,,760.0,2850.0,3
HCPCS,0090U,Onc cutan mlnma mrna 23 gene,,,1950.0,6581.25,3
HCPCS,0092U,Onc lng 3 prtn bmrk plsm alg,,,2488.0,9330.0,3
HCPCS,0093U,Rx mntr 65 com drugs urine,,,62.14,233.03,3
HCPCS,0094U,Genome rapid sequence alys,,,7582.2,28433.25,3
HCPCS,0095T,Rmvl artific disc addl crvcl,,,31685.0,31685.0,1
HCPCS,0095U,Inflm ee elisa alys alg,,,771.98,2894.93,3
HCPCS,0096U,Hpv hi risk types male urine,,,35.09,131.59,3
HCPCS,0098T,Rev Artific Disc Addl,,,31685.0,31685.0,1
HCPCS,0100T,Prosth Retina Receive&Gen,,,63079.0,63079.0,1
HCPCS,0101T,Extracorp shockwv tx hi enrg,,,237.84,15689.0,2
HCPCS,0101U,Hered colon ca do 15 genes,,,1743.95,6539.81,3
HCPCS,0102T,Extracorp shockwv tx anesth,,,3154.93,15689.0,2
HCPCS,0102U,Hered brst ca rltd do 17 gen,,,1303.95,4889.81,3
HCPCS,0103U,Hered ova ca pnl 24 genes,,,1743.95,6539.81,3
HCPCS,0105U,Neph ckd mult eclia tum nec,,,950.0,3562.5,3
HCPCS,0106T,Touch Quant Sensory Test,,,36.01,36.01,1
HCPCS,0106U,Gstr emptg 7 timed brth spec,,,874.49,3279.34,3
HCPCS,0107T,Vibrate Quant Sensory Test,,,36.01,36.01,1
HCPCS,0107U,C diff tox ag detcj ia stool,,,16.0,60.0,3
HCPCS,0108T,Cool Quant Sensory Test,,,56.88,56.88,1
HCPCS,0108U,Gi barrett esoph 9 prtn bmrk,,,4950.0,18562.5,3
HCPCS,0109T,Heat Quant Sensory Test,,,36.01,36.01,1
HCPCS,0109U,Id aspergillus dna 4 species,,,142.63,534.86,3
HCPCS,0110T,Nos Quant Sensory Test,,,128.29,128.29,1
HCPCS,0110U,Rx mntr 1+oral onc rx&sbsts,,,27.11,101.66,3
HCPCS,0111U,Onc colon ca kras&nras alys,,,682.29,2558.59,3
HCPCS,0112U,Iadi 16s&18s rrna genes,,,356.13,1335.49,3
HCPCS,0113U,Onc prst8 pca3&tmprss2-erg,,,760.0,2850.0,3
HCPCS,0114U,Gi barretts esoph vim&ccna1,,,1938.01,7267.54,3
HCPCS,0115U,Respir iadna 18 viral&2 bact,,,275.35,1032.56,3
HCPCS,0116U,Rx mntr nzm ia 35+oral flu,,,246.92,925.95,3
HCPCS,0117U,Pain mgmt 11 endogenous anal,,,840.65,3152.44,3
HCPCS,0118U,Trnsplj don-drv cll-fr dna,,,2753.25,10324.69,3
HCPCS,0119U,Crd ceramides liq chrom plsm,,,83.76,314.1,3
HCPCS,0120U,Onc b cll lymphm mrna 58 gen,,,2510.21,9413.29,3
HCPCS,0121U,Sc dis vcam-1 whole blood,,,509.2,1909.5,3
HCPCS,0122U,Sc dis p-selectin whl blood,,,526.23,1973.36,3
HCPCS,0123U,Mchnl fragility rbc prflg,,,357.63,1341.11,3
HCPCS,0124A,Hc Vaccine Admin Pfizer Covid-19 Bivalent Omicron Booster,50.0,32.5,,,0
HCPCS,0129U,Hered brst ca rltd do panel,,,1303.95,4889.81,3
HCPCS,0130U,Hered colon ca do mrna pnl,,,584.9,2193.38,3
HCPCS,0131U,Hered brst ca rltd do pnl 13,,,2662.5,2662.5,2
HCPCS,0132U,Hered ova ca rltd do pnl 17,,,2781.15,2781.15,2
HCPCS,0133U,Hered prst8 ca rltd do 11,,,690.29,2588.59,3
HCPCS,0134A,Hc Vaccine Admin Moderna Covid-19 Bivalent Omicron Booster,50.0,32.5,,,0
HCPCS,0134U,Hered pan ca mrna pnl 18 gen,,,748.39,2806.46,3
HCPCS,0135U,Hered gyn ca mrna pnl 12 gen,,,2627.1,2627.1,2
HCPCS,0136U,Atm mrna seq alys,,,407.43,1527.86,3
HCPCS,0137U,Palb2 mrna seq alys,,,282.88,1060.8,3
HCPCS,0138U,Brca1 brca2 mrna seq alys,,,468.33,1756.24,3
HCPCS,0140U,Nfct ds fungi dna 15 trgt,,,156.75,587.81,3
HCPCS,0141U,Nfct ds bact&fng gram pos,,,156.75,587.81,3
HCPCS,0142U,Nfct ds bact&fng gram neg,,,156.75,587.81,3
HCPCS,0152U,Hc Autoimmune Rheumatoid Arthrts Analys 12 Biomrkrs Karius So,4548.0,2956.2,,,0
HCPCS,0152U,Nfct bct fng prst dna >1000,,,2126.2,7973.25,3
HCPCS,0153U,Onc breast mrna 101 genes,,,3159.42,11847.83,3
HCPCS,0154U,Fgfr3 gene analysis,,,482.14,1808.03,3
HCPCS,0155U,Pik3ca gene analysis,,,274.83,1030.61,3
HCPCS,0156U,Copy number sequence alys,,,1740.0,6525.0,3
HCPCS,0157U,Apc mrna seq alys,,,282.88,1060.8,3
HCPCS,0158U,Mlh1 mrna seq alys,,,282.88,1060.8,3
HCPCS,0159U,Msh2 mrna seq alys,,,282.88,1060.8,3
HCPCS,0160U,Msh6 mrna seq alys,,,282.88,1060.8,3
HCPCS,0161U,Pms2 mrna seq alys,,,282.88,1060.8,3
HCPCS,0162U,Hered colon ca trgt mrna pnl,,,486.54,1824.53,3
HCPCS,0163U,Onc clrct scr 3 prtn alg,,,1465.31,1465.31,2
HCPCS,0164T,Remove Lumb Artif Disc Addl,,,31685.0,31685.0,1
HCPCS,0164U,Gi ibs ia anti-cdtb&vinculin,,,112.02,420.08,3
HCPCS,0165T,Revise Lumb Artif Disc Addl,,,31685.0,31685.0,1
HCPCS,0165U,Peanut allg spec asmt 64 epi,,,463.76,1739.1,3
HCPCS,0166U,Liver ds 10 biochem asy srm,,,503.4,1887.75,3
HCPCS,0167U,Chornc gonadotropin hcg ia,,,28.2,28.2,2
HCPCS,0169U,Nudt15&tpmt gene com vrnt,,,466.17,1748.14,3
HCPCS,0170U,Neuro asd rna next gen seq,,,1950.0,6581.25,3
HCPCS,0171U,Trgt gen seq alys pnl dna 23,,,1519.06,5696.48,3
HCPCS,0172U,Onc sld tum alys brca1 brca2,,,3030.0,11362.5,3
HCPCS,0173U,Psyc gen alys panel 14 genes,,,466.17,1748.14,3
HCPCS,0174U,Onc solid tumor 30 prtn trgt,,,1305.37,4895.14,3
HCPCS,0175U,Psyc gen alys panel 15 genes,,,1336.09,5010.34,3
HCPCS,0176U,Cdtb&vinculin igg antb ia,,,64.19,240.71,3
HCPCS,0177U,Onc brst ca dna pik3ca 11,,,274.83,1030.61,3
HCPCS,0178U,Peanut allg asmt epi clin rx,,,459.86,1724.48,3
HCPCS,0179U,Onc nonsm cll lng ca alys 23,,,1943.21,7287.04,3
HCPCS,0180U,Abo gnotyp abo 7 exons,,,274.83,1030.61,3
HCPCS,0181U,Co gnotyp aqp1 exon 1,,,185.2,694.5,3
HCPCS,0182U,Crom gnotyp cd55 exons 1-10,,,301.35,1130.06,3
HCPCS,0183U,Di gnotyp slc4a1 exon 19,,,185.2,694.5,3
HCPCS,0184T,Exc rectal tumor endoscopic,,,5853.69,20001.0,2
HCPCS,0184U,Do gnotyp art4 exon 2,,,185.2,694.5,3
HCPCS,0185U,Fut1 gnotyp fut1 exon 4,,,185.2,694.5,3
HCPCS,0186U,Fut2 gnotyp fut2 exon 2,,,185.2,694.5,3
HCPCS,0187U,Fy gnotyp ackr1 exons 1-2,,,274.83,1030.61,3
HCPCS,0188U,Ge gnotyp gypc exons 1-4,,,274.83,1030.61,3
HCPCS,0189U,Gypa gnotyp ntrns 1 5 exon 2,,,274.83,1030.61,3
HCPCS,0190U,Gypb gnotyp ntrns 1 5 seux 3,,,274.83,1030.61,3
HCPCS,0191U,In gnotyp cd44 exons 2 3 6,,,274.83,1030.61,3
HCPCS,0192U,Jk gnotyp slc14a1 exon 9,,,274.83,1030.61,3
HCPCS,0193U,Jr gnotyp abcg2 exons 2-26,,,282.88,1060.8,3
HCPCS,0194U,Kel gnotyp kel exon 8,,,185.2,694.5,3
HCPCS,0195U,Klf1 targeted sequencing,,,375.25,1407.19,3
HCPCS,0196U,Lu gnotyp bcam exon 3,,,185.2,694.5,3
HCPCS,0197U,Lw gnotyp icam4 exon 1,,,185.2,694.5,3
HCPCS,0198T,Ocular blood flow measure,,,128.29,128.29,1
HCPCS,0198U,Rhd&rhce gntyp rhd1-10&rhce5,,,282.88,1060.8,3
HCPCS,0199U,Sc gnotyp ermap exons 4 12,,,274.83,1030.61,3
HCPCS,0200T,Hc Sacroplasty Inj Unilat W Balloon Or Device,52476.0,34109.399999999994,,,0
HCPCS,0200T,Perq sacral augmt unilat inj,,,6996.6,31685.0,2
HCPCS,0200U,Xk gnotyp xk exons 1-3,,,274.83,1030.61,3
HCPCS,0201T,Hc Sacroplasty Inj Bilat W Balloon Or Device,38069.0,24744.85,,,0
HCPCS,0201T,Perq sacral augmt bilat inj,,,6996.6,31685.0,2
HCPCS,0201U,Yt gnotyp ache exon 2,,,185.2,694.5,3
HCPCS,0202T,Post vert arthrplst 1 lumbar,,,12379.34,15689.0,2
HCPCS,0202U,Hc Nfct Ds 22 Trgt Sars-Cov-2,1363.0,885.95,,,0
HCPCS,0202U,Nfct ds 22 trgt sars-cov-2,,,416.78,1562.93,3
HCPCS,0203U,Ai ibd mrna xprsn prfl 17,,,760.0,2850.0,3
HCPCS,0204U,Onc thyr mrna xprsn alys 593,,,10948.5,10948.5,2
HCPCS,0205U,Oph amd alys 3 gene variants,,,47.0,176.25,3
HCPCS,0206U,Neuro alzheimer cell aggregj,,,2215.4,8307.75,3
HCPCS,0207T,Clear eyelid gland w/heat,,,128.29,3714.0,2
HCPCS,0207U,Neuro alzheimer quan imaging,,,1917.0,1917.0,2
HCPCS,0208T,Audiometry air only,,,36.01,36.01,1
HCPCS,0209T,Audiometry air & bone,,,36.01,36.01,1
HCPCS,0209U,Cytog const alys interrog,,,787.15,2951.81,3
HCPCS,0210T,Speech audiometry threshold,,,36.01,36.01,1
HCPCS,0210U,Syphilis tst antb ia quan,,,18.63,69.86,3
HCPCS,0211T,Speech audiom thresh & recog,,,36.01,36.01,1
HCPCS,0211U,Onc pan-tum dna&rna gnrj seq,,,8455.0,31706.25,3
HCPCS,0212T,Compre audiometry evaluation,,,124.07,124.07,1
HCPCS,0212U,Rare ds gen dna alys proband,,,5475.2,20532.0,3
HCPCS,0213T,Njx paravert w/us cer/thor,,,852.83,3714.0,2
HCPCS,0213U,Rare ds gen dna alys ea comp,,,2709.95,10162.31,3
HCPCS,0214U,Rare ds xom dna alys proband,,,5224.6,19592.25,3
HCPCS,0215U,Rare ds xom dna alys ea comp,,,2574.65,9654.94,3
HCPCS,0216T,Njx paravert w/us lumb/sac,,,852.83,3714.0,2
HCPCS,0216U,Neuro inh ataxia dna 12 com,,,1537.02,5763.83,3
HCPCS,0217U,Neuro inh ataxia dna 51 gene,,,2198.35,8243.81,3
HCPCS,0218U,Neuro musc dys dmd seq alys,,,2279.0,8546.25,3
HCPCS,0219T,Plmt post facet implt cerv,,,12379.34,31685.0,2
HCPCS,0219U,Hc Nfct Agent Hiv Trgt Viral Next-Gnrj Seq Alys Alg So,1286.0,835.9,,,0
HCPCS,0219U,Nfct agt hiv gnrj seq alys,,,725.0,2718.75,3
HCPCS,0220T,Plmt post facet implt thor,,,12379.34,31685.0,2
HCPCS,0220U,Onc brst ca ai assmt 12 feat,,,706.25,2648.44,3
HCPCS,0221T,Plmt post facet implt lumb,,,6996.6,31685.0,2
HCPCS,0221U,Abo gnotyp next gnrj seq abo,,,274.83,1030.61,3
HCPCS,0222U,Rhd&rhce gntyp next gnrj seq,,,282.88,1060.8,3
HCPCS,0223U,Nfct ds 22 trgt sars-cov-2,,,416.78,1562.93,3
HCPCS,0224U,Antibody sars-cov-2 titer(s),,,51.43,192.86,3
HCPCS,0225U,Nfct ds dna&rna 21 sarscov2,,,416.78,1562.93,3
HCPCS,0226U,Svnt sarscov2 elisa plsm srm,,,42.28,158.55,3
HCPCS,0227U,Rx asy prsmv 30+rx/metablt,,,62.14,233.03,3
HCPCS,0228U,Onc prst8 ma molec prfl alg,,,173.03,648.86,3
HCPCS,0229U,Bcat1 promoter mthyltn alys,,,384.0,1440.0,3
HCPCS,0230U,Ar full sequence analysis,,,301.35,1130.06,3
HCPCS,0231U,Cacna1a full gene analysis,,,846.27,3173.51,3
HCPCS,0232T,Hc Inj Platelet Rich Plasma,11972.0,7781.8,,,0
HCPCS,0232T,Njx platelet plasma,,,430.74,3714.0,2
HCPCS,0232U,Cstb full gene analysis,,,274.83,1030.61,3
HCPCS,0233U,Fxn gene analysis,,,274.83,1030.61,3
HCPCS,0234T,Trluml perip athrc renal art,,,11131.16,38216.0,2
HCPCS,0234U,Mecp2 full gene analysis,,,527.87,1979.51,3
HCPCS,0235T,Trluml perip athrc visceral,,,38216.0,38216.0,1
HCPCS,0235U,Pten full gene analysis,,,600.0,2250.0,3
HCPCS,0236T,Trluml perip athrc abd aorta,,,11131.16,38216.0,2
HCPCS,0236U,Smn1&smn2 full gene analysis,,,602.7,2260.13,3
HCPCS,0237T,Hc Translum Peripheral Atherectomy Brachiocephalic,23984.0,15589.6,,,0
HCPCS,0237T,Trluml perip athrc brchiocph,,,11131.16,38216.0,2
HCPCS,0237U,Car ion chnlpthy gen seq pnl,,,584.9,2193.38,3
HCPCS,0238T,Hc Translum Peripheral Atherectomy Iliac Artery,30604.0,19892.6,,,0
HCPCS,0238T,Trluml perip athrc iliac art,,,17675.76,63079.0,2
HCPCS,0238U,Onc lnch syn gen dna seq aly,,,584.9,2193.38,3
HCPCS,0239U,Trgt gen seq alys pnl 311+,,,3500.0,13125.0,3
HCPCS,0240U,Hc Nfct Ds Vir Resp Rna 3 Trgt,550.0,357.5,,,0
HCPCS,0240U,Nfct ds vir resp rna 3 trgt,,,534.86,534.86,2
HCPCS,0241U,Nfct ds vir resp rna 4 trgt,,,534.86,534.86,2
HCPCS,0242U,Trgt gen seq alys pnl 55-74,,,5000.0,18750.0,3
HCPCS,0243U,Ob pe biochem assay pgf alg,,,64.41,241.54,3
HCPCS,0244U,Onc solid orgn dna 257 genes,,,3500.0,13125.0,3
HCPCS,0245U,Onc thyr mut alys 10 gen&37,,,1266.07,4747.76,3
HCPCS,0246U,Rbc dna gnotyp 16 bld groups,,,720.0,2700.0,3
HCPCS,0247U,Ob prtrm brth ibp4 shbg meas,,,750.0,2812.5,3
HCPCS,0248U,Onc brn sphrd cll 12 rx pnl,,,3033.86,11376.98,3
HCPCS,0249U,Onc brst alys 32 phsprtn alg,,,2219.13,8321.74,3
HCPCS,0250U,Onc sld org neo dna 505 gene,,,2919.6,10948.5,3
HCPCS,0251U,Hc Hepcidin-25 Elisa Serum Or Plasma So,841.0,546.65,,,0
HCPCS,0251U,Hepcidin-25 elisa serum/plsm,,,17.27,64.76,3
HCPCS,0252U,Ftl aneuploidy str alys dna,,,759.05,2846.44,3
HCPCS,0253T,Insert aqueous drain device,,,3985.54,20001.0,2
HCPCS,0253U,Rprdtve med rna gen prfl 238,,,3159.42,11847.83,3
HCPCS,0254U,Reprdtve med alys 24 chrmsm,,,759.05,2846.44,3
HCPCS,0255U,Andrology infertility assmt,,,31.6,118.5,3
HCPCS,0256U,Tma/tmao prfl ms/ms ur alg,,,159.95,599.81,3
HCPCS,0257U,Vlcad leuk nzm actv whl bld,,,712.47,2671.76,3
HCPCS,0258U,Ai psor mrna 50-100 gen alg,,,3675.0,13781.25,3
HCPCS,0259U,Neph ckd nuc mrs meas gfr,,,52.71,197.66,3
HCPCS,0260U,Rare ds id opt genome mapg,,,1263.53,4738.24,3
HCPCS,0261U,Onc clrct ca img alys w/ai,,,2513.25,18562.5,3
HCPCS,0262U,Onc sld tum rt-pcr 7 gen,,,3200.0,12000.0,3
HCPCS,0263T,Im b1 mrw cel ther cmpl,,,4199.67,20001.0,2
HCPCS,0263U,Neuro asd meas 16 c metblt,,,750.0,2812.5,3
HCPCS,0264T,Im b1 mrw cel ther xcl hrvst,,,4199.67,20001.0,2
HCPCS,0264U,Rare ds id opt genome mapg,,,1263.53,4738.24,3
HCPCS,0265T,Im b1 mrw cel ther hrvst onl,,,4199.67,20001.0,2
HCPCS,0265U,Rar do whl gn&mtcdrl dna als,,,5475.8,20534.25,3
HCPCS,0266T,Implt/rpl crtd sns dev total,,,63079.0,63079.0,1
HCPCS,0266U,Unxpl cnst hrtbl do gn xprsn,,,3200.0,12000.0,3
HCPCS,0267T,Implt/rpl crtd sns dev lead,,,15689.0,15689.0,1
HCPCS,0267U,Rare do id opt gen mapg&seq,,,6739.33,25272.49,3
HCPCS,0268T,Implt/rpl crtd sns dev gen,,,63079.0,63079.0,1
HCPCS,0268U,Hem ahus gen seq alys 15 gen,,,608.17,2280.64,3
HCPCS,0269T,Rev/remvl crtd sns dev total,,,20001.0,20001.0,1
HCPCS,0269U,Hem aut dm cgen trmbctpna 14,,,608.17,2280.64,3
HCPCS,0270T,Rev/remvl crtd sns dev lead,,,15689.0,15689.0,1
HCPCS,0270U,Hem cgen coagj do 20 genes,,,608.17,2280.64,3
HCPCS,0271T,Rev/remvl crtd sns dev gen,,,15689.0,15689.0,1
HCPCS,0271U,Hem cgen neutropenia 23 gen,,,608.17,2280.64,3
HCPCS,0272T,Hc Device Eval Barostim In Person,392.0,254.8,,,0
HCPCS,0272T,Interrogate crtd sns dev,,,3714.0,3714.0,1
HCPCS,0272U,Hem genetic bld do 51 genes,,,608.17,2280.64,3
HCPCS,0273T,Hc Device Eval Barostim In Person W Programming,392.0,254.8,,,0
HCPCS,0273T,Interrogate crtd sns w/pgrmg,,,3714.0,3714.0,1
HCPCS,0273U,Hem gen hyprfibrnlysis 8 gen,,,608.17,2280.64,3
HCPCS,0274T,Perq lamot/lam crv/thrc,,,6996.6,31685.0,2
HCPCS,0274U,Hem gen pltlt do 43 genes,,,608.17,2280.64,3
HCPCS,0275T,Hc Percutaneous Laminotomy Laminectomy Lumbar,19002.0,12351.3,,,0
HCPCS,0275T,Perq lamot/lam lumbar,,,31685.0,31685.0,1
HCPCS,0275U,Hem heprn nduc trmbctpna srm,,,18.37,68.89,3
HCPCS,0276U,Hem inh thrombocytopenia 23,,,2448.56,9182.1,3
HCPCS,0277U,Hem gen pltlt funcj do 31,,,608.17,2280.64,3
HCPCS,0278T,Tempr,,,124.07,3714.0,2
HCPCS,0278U,Hem gen thrombosis 12 genes,,,608.17,2280.64,3
HCPCS,0279U,Hem vw factor&clgn iii bndg,,,11.53,43.24,3
HCPCS,0280U,Hem vw factor&clgn iv bndg,,,17.27,64.76,3
HCPCS,0281U,Hem vwd propeptide ag lvl,,,17.27,64.76,3
HCPCS,0282U,Hc Rbc Dna Gnotyp 12 Bld Grp Predict 44 Rbc Ag Phnt So,1728.0,1123.2,,,0
HCPCS,0282U,Rbc dna gntyp 12 bld grp gen,,,720.0,2700.0,3
HCPCS,0283U,Vw factor type 2b eval plsm,,,18.4,69.0,3
HCPCS,0284U,Vw factor type 2n eval plsm,,,17.27,64.76,3
HCPCS,0285U,Onc rsps radj cll fr dna tox,,,443.31,1662.41,3
HCPCS,0286U,Cep72 nudt15&tpmt gene alys,,,134.13,502.99,3
HCPCS,0287U,Onc thyr dna&mrna 112 genes,,,3600.0,13500.0,3
HCPCS,0288U,Onc lung mrna quan pcr 11&3,,,3873.0,14523.75,3
HCPCS,0289U,Neuro alzheimer mrna 24 gen,,,760.0,2850.0,3
HCPCS,0290U,Pain mgmt mrna gen xprsn 36,,,760.0,2850.0,3
HCPCS,0291U,Psyc mood do mrna 144 genes,,,1755.0,6581.25,3
HCPCS,0292U,Psyc strs do mrna 72 genes,,,1755.0,6581.25,3
HCPCS,0293U,Psyc suicidal idea mrna 54,,,760.0,2850.0,3
HCPCS,0294U,Lngvty&mrtlty rsk mrna 18gen,,,2850.0,2850.0,2
HCPCS,0295U,Onc brst dux carc 7 proteins,,,5435.0,7113.75,3
HCPCS,0296U,Onc orl&/orop ca 20 mlc feat,,,1950.0,6581.25,3
HCPCS,0297U,Onc pan tum whl gen seq dna,,,2919.6,10948.5,3
HCPCS,0298U,Onc pan tum whl trns seq rna,,,2919.6,10948.5,3
HCPCS,0299U,Onc pan tum whl gen opt mapg,,,1863.22,6987.08,3
HCPCS,0300U,Onc pan tum whl gen seq&opt,,,4183.13,15686.74,3
HCPCS,0301U,Iadna bartonella ddpcr,,,262.72,985.2,3
HCPCS,0302U,Iadna brtnla ddpcr flwg liq,,,361.37,1355.14,3
HCPCS,0303U,Hem rbc ads whl bld hypoxic,,,2201.62,8256.08,3
HCPCS,0304U,Hem rbc ads whl bld normoxic,,,2075.8,7784.25,3
HCPCS,0305U,Hem rbc fnclty&dfrm shr strs,,,662.58,2484.68,3
HCPCS,0306U,Onc mrd nxt-gnrj alys 1st,,,3878.45,14544.19,3
HCPCS,0307U,Onc mrd nxt-gnrj alys sbsq,,,794.49,2979.34,3
HCPCS,0308T,Insj ocular telescope prosth,,,15871.89,63079.0,2
HCPCS,0308U,Crd cad alys 3 prtn plsm alg,,,390.75,1465.31,3
HCPCS,0309U,Crd cv ds aly 4 prtn plm alg,,,390.75,1465.31,3
HCPCS,0310U,Ped vsclts kd alys 3 bmrks,,,390.75,1465.31,3
HCPCS,0311U,Nfct ds bct quan antmcrb sc,,,8.08,30.3,3
HCPCS,0312U,Ai ds sle alys 8 igg autoant,,,840.65,3152.44,3
HCPCS,0313U,Onc pncrs dna&mrna seq 74,,,3600.0,13500.0,3
HCPCS,0314U,Onc cutan mlnma mrna 35 gene,,,1950.0,7312.5,3
HCPCS,0315U,Onc cutan sq cll ca mrna 40,,,8500.0,31875.0,3
HCPCS,0316U,B brgdrferi lyme ds ospa evl,,,18.66,69.98,3
HCPCS,0317U,Onc lung ca 4-prb fish assay,,,2030.0,7612.5,3
HCPCS,0318U,Ped whl gen mthyltn alys 50+,,,1770.48,6639.3,3
HCPCS,0319U,Neph rna pretrnspl perph bld,,,2650.0,9937.5,3
HCPCS,0320U,Neph rna psttrnspl perph bld,,,2650.0,9937.5,3
HCPCS,0321U,Iadna gu pthgn 20bct&fng org,,,634.84,2380.65,3
HCPCS,0322U,Neuro asd meas 14 acyl carn,,,750.0,2812.5,3
HCPCS,0323U,Iadna cns pthgn next gen seq,,,2126.2,7973.25,3
HCPCS,0326U,Trgt gen seq alys pnl 83+,,,5000.0,18750.0,3
HCPCS,0327U,Ftl aneuploidy trsmy dna seq,,,795.0,2981.25,3
HCPCS,0328U,Drug assay 120+ rx&metablt,,,114.43,429.11,3
HCPCS,0329U,Onc neo xome&trns seq alys,,,3437.98,12892.43,3
HCPCS,0330T,Tear film img uni/bi w/i&r,,,36.01,36.01,1
HCPCS,0330U,Iadna vag pthgn panel 27 org,,,416.78,1562.93,3
HCPCS,0331T,Heart symp image plnr,,,1248.33,1248.33,1
HCPCS,0331U,Onc hl neo opt gen mapping,,,1863.22,6987.08,3
HCPCS,0332T,Heart symp image plnr spect,,,1248.33,1248.33,1
HCPCS,0332U,Onc pan tum gen prflg 8 dna,,,1142.06,4282.73,3
HCPCS,0333U,Onc lvr surveilanc hcc cfdna,,,662.32,2483.7,3
HCPCS,0334U,Onc sld orgn tgsa dna 84/+,,,3500.0,10948.5,3
HCPCS,0335T,Extraosseous joint stblztion,,,6996.6,31685.0,2
HCPCS,0335U,Rare ds whl gen seq fetal,,,5224.6,19592.25,3
HCPCS,0336U,Rare ds whl gen seq bld/slv,,,2574.65,9654.94,3
HCPCS,0337U,Onc plsm cell do&myeloma id,,,2435.0,9131.25,3
HCPCS,0338T,Hc Renal Transcath Sympath Denerv Uni,16296.0,10592.4,,,0
HCPCS,0338T,Trnscth renal symp denrv unl,,,5487.93,30765.0,2
HCPCS,0338U,Onc sld tum crcg tum cl slct,,,2435.0,9131.25,3
HCPCS,0339T,Hc Renal Transcath Sympath Denerv Bil,21728.0,14123.2,,,0
HCPCS,0339T,Trnscth renal symp denrv bil,,,5487.93,30765.0,2
HCPCS,0339U,Onc prst8 mrna hoxc6 & dlx1,,,760.0,2850.0,3
HCPCS,0340U,Onc pan ca alys mrd plasma,,,3590.0,14700.0,3
HCPCS,0341U,Ftl aneup dna seq cmpr alys,,,1900.2,7125.75,3
HCPCS,0342T,Thxp apheresis w/hdl delip,,,4199.67,20001.0,2
HCPCS,0342U,Onc pncrtc ca mult ia eclia,,,3363.75,3363.75,2
HCPCS,0343U,Onc prst8 xom aly 442 sncrna,,,760.0,2850.0,3
HCPCS,0344U,Hep nafld semiq evl 28 lipid,,,792.17,2970.64,3
HCPCS,0345T,Transcath mtral vlve repair,,,38216.0,38216.0,1
HCPCS,0345U,Psyc genom alys pnl 15 gen,,,1336.09,5010.34,3
HCPCS,0346U,Beta amyl a?40&a?42 lc-ms/ms,,,349.73,349.73,2
HCPCS,0346U,Hc Amyloid Beta 42 Peptipe So,2580.0,1677.0,,,0
HCPCS,0347T,Ins bone device for rsa,,,56.88,3714.0,2
HCPCS,0347U,Rx metab/pcx dna 16 gen alys,,,1336.09,5010.34,3
HCPCS,0348T,RSA spine exam,,,100.81,100.81,1
HCPCS,0348U,Rx metab/pcx dna 25 gen alys,,,742.27,2783.51,3
HCPCS,0349T,RSA upper extr exam,,,100.81,100.81,1
HCPCS,0349U,Rx metab/pcx dna 27gen rx ia,,,742.27,2783.51,3
HCPCS,0350T,RSA lower extr exam,,,83.91,83.91,1
HCPCS,0350U,Rx metab/pcx dna 27 gen alys,,,1336.09,5010.34,3
HCPCS,0351U,Nfct ds bct/viral trail ip10,,,260.5,976.88,3
HCPCS,0352U,Nfct ds bv&vaginitis amp prb,,,534.86,534.86,2
HCPCS,0353U,Iadna chlmyd&gonorr amp prb,,,263.18,263.18,2
HCPCS,0354U,Hpv hi rsk qual mrna e6/e7,,,131.59,131.59,2
HCPCS,0355U,Apol1 risk variants,,,137.0,513.75,3
HCPCS,0355U,"Hc Apolipoprotein L1 (Apol1) Renal Risk Variant Genotyping, Quest Diagnostics So",450.0,292.5,,,0
HCPCS,0356U,Onc orop 17 dna ddpcr alg,,,1800.0,1800.0,1
HCPCS,0358T,BIA whole body,,,27.89,27.89,1
HCPCS,0358U,Hc Neuro Alys B-Amyl 1-42&1-40 So,3024.0,1965.6,,,0
HCPCS,0358U,Neuro alys b-amyl 1-42&1-40,,,260.5,976.88,3
HCPCS,0359U,Onc prst8 ca alys all psa,,,760.0,2850.0,3
HCPCS,0360U,Onc lung elisa 7 autoant alg,,,840.65,3152.44,3
HCPCS,0361U,Hc Neurflmnt Lt Chn Dig Ia Quant So,3240.0,2106.0,,,0
HCPCS,0362U,Onc pap thyr ca rna 82&10,,,3600.0,13500.0,3
HCPCS,0363U,Onc urthl mrna 5 gen alg,,,760.0,2850.0,3
HCPCS,0364U,Hc Clonoseq Assay Adaptive Biotechnologies So,7020.0,4563.0,,,0
HCPCS,0364U,Onc hl neo gen seq alys alg,,,2007.25,2007.25,1
HCPCS,0365U,Onc bldr 10 prb bldr ca,,,897.0,3363.75,3
HCPCS,0366U,Onc bldr 10 prb recr bldr ca,,,897.0,3363.75,3
HCPCS,0367U,Onc bldr 10 flwg trurl rescj,,,902.18,3383.18,3
HCPCS,0369U,Iadna gi pthgn 31 org&21 arg,,,1562.93,1562.93,2
HCPCS,0370U,Iadna surg wnd pthgn 34&21,,,1562.93,1562.93,2
HCPCS,0371U,Iadna gu pthgn semiq dna16&1,,,416.78,1562.93,3
HCPCS,0372U,Nfct ds gu pthgn arg detcj,,,416.78,1562.93,3
HCPCS,0373U,Iadna rsp tr nfct 17 8 13&16,,,1562.93,1562.93,2
HCPCS,0374U,Iadna gu pthgn 21 org&21arg,,,1562.93,1562.93,2
HCPCS,0375U,Onc ovrn bchm asy 7 prtn alg,,,897.0,3363.75,3
HCPCS,0376U,Onc prst8 ca img alys 128,,,706.25,2648.44,3
HCPCS,0377U,Cv ds quan advsrm/plsm lprtn,,,47.58,178.43,3
HCPCS,0378U,Rfc1 repeat xpnsj vrnt alys,,,137.0,513.75,3
HCPCS,0379T,Vis field assmnt tech suppt,,,36.01,36.01,1
HCPCS,0379U,Tgsap sl or neo dna523&rna55,,,3288.51,3288.51,1
HCPCS,0380U,Rx metb advrs trgt sq aly 20,,,1562.93,1562.93,2
HCPCS,0381U,Maple syrup ur ds mntr quan,,,44.12,44.12,1
HCPCS,0382U,Hyprphenylalninmia mntr quan,,,51.64,51.64,1
HCPCS,0383U,Tyrosinemia typ i mntr quan,,,52.05,52.05,1
HCPCS,0384U,Neph ckd rsk hi stg kdn ds,,,750.0,2812.5,3
HCPCS,0385U,Neph ckd alg rsk dbtc kdn ds,,,390.75,1465.31,3
HCPCS,0387U,Onc mlnma ambra1&amlo,,,948.5,3556.88,3
HCPCS,0388U,Onc nonsm cll lng ca 37 gen,,,3500.0,3500.0,1
HCPCS,0389U,Ped fbrl kd ifi27&mcemp1 rna,,,70.2,70.2,1
HCPCS,0390U,Ob pe kdr eng&rbp4 ia alg,,,64.41,241.54,3
HCPCS,0391U,Onc sld tum dna&rna 437 gen,,,3600.0,13500.0,3
HCPCS,0392U,Rx metab genrx ia 16 genes,,,1336.09,5010.34,3
HCPCS,0393U,Neu prksn msfl ?-syncln prtn,,,540.99,2028.71,3
HCPCS,0394U,Pfas 16 pfas compnd lc ms/ms,,,198.74,745.28,3
HCPCS,0395T,Hdr elctr ntrst/ntrcv brchtx,,,671.56,671.56,1
HCPCS,0395U,Onc lng multiomics plsm alg,,,797.45,797.45,1
HCPCS,0398T,Hc Mrgfus Ablation Intracranial Lesion,57968.0,37679.2,,,0
HCPCS,0398T,Mrgfus strtctc les abltj,,,38216.0,38216.0,1
HCPCS,0398U,Gi baret esph dna mthyln aly,,,1755.0,1755.0,1
HCPCS,0399U,Neuro cere folate defncy srm,,,300.0,300.0,1
HCPCS,0401U,Crd c hrt ds 9 gen 12 vrnts,,,489.68,489.68,1
HCPCS,0402T,Collagen crosslinking cornea,,,2292.42,9206.0,2
HCPCS,0402U,Nfct agt sti mult amp prb tq,,,142.63,534.86,3
HCPCS,0403U,Onc prst8 mrna 18 gen dre ur,,,760.0,2850.0,3
HCPCS,0404U,Onc brst semiq meas thym kn,,,322.96,1211.1,3
HCPCS,0405U,Onc pncrtc 59 mthltn blk mrk,,,1770.48,6639.3,3
HCPCS,0406U,Onc lung flow cytmtry 5 mrk,,,760.0,2850.0,3
HCPCS,0407U,Neph dbtc ckd mult eclia alg,,,950.0,3562.5,3
HCPCS,0408T,Hc Ins Or Rep Perm Card Contrac Mod Sys Pulse Gen W Transven Electrode,24020.0,15613.0,,,0
HCPCS,0408T,Insj/rplc cardiac modulj sys,,,30265.83,63079.0,2
HCPCS,0408U,Iaad blk ac wv bsnsr sarscv2,,,14.13,14.13,1
HCPCS,0409T,Insj/rplc car modulj pls gn,,,21447.74,63079.0,2
HCPCS,0409U,Onc sld tum dna 80 & rna 36,,,2919.6,10948.5,3
HCPCS,0410T,Insj/rplc car modulj atr elt,,,7979.31,38216.0,2
HCPCS,0410U,Onc pncrtc dna whl gn seq 5-,,,1160.0,4350.0,3
HCPCS,0411T,Insj/rplc car modulj vnt elt,,,7979.31,38216.0,2
HCPCS,0411U,Psyc genom alys pnl 15 gen,,,1336.09,5010.34,3
HCPCS,0412T,Rmvl cardiac modulj pls gen,,,3603.26,15689.0,2
HCPCS,0412U,Beta amyloid a?42/40 imprcip,,,750.0,750.0,1
HCPCS,0413T,Rmvl car modulj tranvns elt,,,3603.26,15689.0,2
HCPCS,0413U,Onc hl neo opt gen mapg dna,,,1263.53,4738.24,3
HCPCS,0414T,Rmvl & rpl car modulj pls gn,,,21447.74,63079.0,2
HCPCS,0414U,Onc lng aug alg aly whl sld8,,,706.25,2648.44,3
HCPCS,0415T,Repos car modulj tranvns elt,,,604.86,3714.0,2
HCPCS,0415U,Cv ds acs bld alg 5 yr score,,,390.75,1465.31,3
HCPCS,0416T,Reloc skin pocket pls gen,,,1989.46,9206.0,2
HCPCS,0416U,Iadna gu pthgn 20bct&fng org,,,1562.93,1562.93,2
HCPCS,0417U,Rare ds alys 335 nuc genes,,,2842.53,2842.53,1
HCPCS,0418U,Onc brst aug alg aly whl sl8,,,706.25,2648.44,3
HCPCS,0419T,Dstrj neurofibroma xtnsv,,,712.63,3714.0,2
HCPCS,0419U,Nrpsyc gen seq vrnt aly 13,,,1336.09,5010.34,3
HCPCS,0420T,Dstrj neurofibroma xtnsv,,,712.63,3714.0,2
HCPCS,0420U,Onc urthl mrna xprsn 6 snp,,,1328.32,1328.32,1
HCPCS,0421T,Waterjet prostate abltj cmpl,,,20001.0,20001.0,1
HCPCS,0422T,Tactile breast img uni/bi,,,83.91,83.91,1
HCPCS,0422U,Onc pan solid tum alys dna,,,1943.21,1943.21,1
HCPCS,0423U,Psyc genomic alys pnl 26 gen,,,416.78,416.78,1
HCPCS,0424U,Onc prst8 xom alys 53 sncrna,,,760.0,760.0,1
HCPCS,0425U,Genom rpd seq alys ea cmprtr,,,4094.39,4094.39,1
HCPCS,0426U,Genome ultra-rapid seq alys,,,7582.2,7582.2,1
HCPCS,0427U,Monocyte dstrbj wdth whl bld,,,4.48,4.48,1
HCPCS,0429U,Hpv orop swab 14 hi-risk typ,,,35.09,35.09,1
HCPCS,0430U,Gi malabs aat calpro pncrtc,,,61.54,61.54,1
HCPCS,0430U,Hc Malabsorption Eval Panel So,2520.0,1638.0,,,0
HCPCS,0431U,Gly rcptr alpha1 igg srm/csf,,,36.57,36.57,1
HCPCS,0431U,Hc Glycine Alpha 1 Igg Srm/Csf So,1890.0,1228.5,,,0
HCPCS,0432U,Hc Klhl11 Antb Sr/Csf Assay Qual So,1800.0,1170.0,,,0
HCPCS,0432U,Klhl11 antb sr/csf asy qual,,,36.57,36.57,1
HCPCS,0433U,Onc prst8 5 dna reg mrk pcr,,,760.0,760.0,1
HCPCS,0434U,Rx metab advrs vrnt alys 25,,,416.78,416.78,1
HCPCS,0435U,Onc chemo rx cytox csc 14 rx,,,3033.86,3033.86,1
HCPCS,0436U,Onc lng plsm alys 388 prtn,,,1504.24,1504.24,1
HCPCS,0437U,Psyc anxiety do mrna 15 bmrk,,,760.0,760.0,1
HCPCS,0438U,Rx metab advrs vrnt alys 33,,,416.78,416.78,1
HCPCS,0439U,Crd chd dna alys 5 snp 3 dna,,,854.0,854.0,1
HCPCS,0440T,Abltj perc uxtr/perph nrv,,,1882.86,20001.0,2
HCPCS,0440U,Crd chd dna alys 10 snp 6dna,,,854.0,854.0,1
HCPCS,0441T,Abltj perc lxtr/perph nrv,,,1882.86,20001.0,2
HCPCS,0441T,Hc Abltj Perc Cryoabltj Img Gdn Lxtr/Perph Nerve,9496.5,6172.724999999999,,,0
HCPCS,0441U,Nfct ds bct fngl/viral semiq,,,444.08,444.08,1
HCPCS,0442T,Abltj perc plex/trncl nrv,,,8461.87,20001.0,2
HCPCS,0442T,Hc Cryoablation Nerve Plexus Or Truncal Nerve W Img,13516.0,8785.4,,,0
HCPCS,0442U,Nfct ds respir nfctj mxa&crp,,,41.38,41.38,1
HCPCS,0443U,Neurflmnt lt chn ultrsens ia,,,116.23,116.23,1
HCPCS,0444U,Onc sld orgn neo tgsap 361,,,2919.6,2919.6,1
HCPCS,0445U,Abeta42 & ptau181 eclia csf,,,260.5,260.5,1
HCPCS,0446T,Insj impltbl glucose sensor,,,3714.0,4011.54,2
HCPCS,0446U,Ai ds sle alys 10 cytokine,,,840.65,840.65,1
HCPCS,0447T,Rmvl impltbl glucose sensor,,,193.46,3714.0,2
HCPCS,0447U,Ai ds sle alys 11 cytokine,,,840.65,840.65,1
HCPCS,0448T,Remvl insj impltbl gluc sens,,,3714.0,4011.54,2
HCPCS,0449T,Insj aqueous drain dev 1st,,,5130.92,20001.0,2
HCPCS,0452U,Onc bldr mthyl penk lte-qmsp,,,192.0,192.0,1
HCPCS,0453U,Onc clrct ca cfdna qpcr asy,,,192.0,192.0,1
HCPCS,0454U,U rare ds id opt genome mapg,,,1263.53,1263.53,1
HCPCS,0455U,Nfct agt sti mult amp prb ur,,,142.63,142.63,1
HCPCS,0457U,Pfas 9 cmpnd lcms/ms pls/sr,,,198.74,198.74,1
HCPCS,0458U,Onc brst ca s100 a8&a9 elisa,,,260.5,260.5,1
HCPCS,0459U,Abeta42 & ttau eclia csf,,,260.5,260.5,1
HCPCS,0460U,Onc whl bld/bucc rtpcr 24gen,,,917.08,917.08,1
HCPCS,0461U,Onc rxgenom alys rtpcr 24gen,,,917.08,917.08,1
HCPCS,0462U,Melatonin lvl tst slp std7/9,,,17.27,17.27,1
HCPCS,0463U,Onc crvx mrna genxprsn 14bmk,,,760.0,760.0,1
HCPCS,0464T,Visual ep test for glaucoma,,,124.07,124.07,1
HCPCS,0464U,Onc clrct scr qrtsa dna mrk,,,591.92,591.92,1
HCPCS,0465U,Onc urthl carc dna qmsp 2gen,,,1938.01,1938.01,1
HCPCS,0466U,Crd cad dna gwas 564856 snp,,,345.43,345.43,1
HCPCS,0467U,Onc bldr dna ngs 60gen&aneup,,,1519.06,1519.06,1
HCPCS,0468U,Hep nash mir34a5p ?2m ykl40,,,251.7,251.7,1
HCPCS,0469U,Rare ds whl gen seq ftl samp,,,1197.94,1197.94,1
HCPCS,0470U,Onc orop detcj mrd 8 dna hpv,,,597.91,597.91,1
HCPCS,0471U,Onc clrc ca 35 vrn kras&nras,,,760.0,760.0,1
HCPCS,0472U,Ca vi psp&sp1 antb sj?gren,,,27.9,27.9,1
HCPCS,0473T,Reprgrmg io rta eltrd ra,,,91.67,91.67,1
HCPCS,0473U,Onc sld tum bld/slv 648 gene,,,4500.0,4500.0,1
HCPCS,0474T,Insj aqueous drg dev io rsvr,,,20001.0,20001.0,1
HCPCS,0474U,Hered pan ca gsap 88gene ngs,,,1303.95,1303.95,1
HCPCS,0475U,Hered prst8 ca gsap 23 genes,,,1303.95,1303.95,1
HCPCS,0476U,Rx metab psyc 14gen&cyp2d6,,,416.78,416.78,1
HCPCS,0477U,Rx metab psy 14&cyp2d6 gn-rx,,,416.78,416.78,1
HCPCS,0478U,Onc nsclc dna&rna dpcr 9 gen,,,552.99,552.99,1
HCPCS,0479T,Fxjl abl lsr 1st 100 sq cm,,,712.63,3714.0,2
HCPCS,0479U,Tau phosphorylated ptau217,,,17.27,17.27,1
HCPCS,0480U,"Hc Metagenomic Sequencing, Csf So",9000.0,5850.0,,,0
HCPCS,0480U,Nfct ds csf metag ngs alys,,,2126.2,2126.2,1
HCPCS,0481T,Njx autol wbc concentrate,,,430.74,3714.0,2
HCPCS,0481U,Idh1 idh2&tert promoter ngs,,,674.24,674.24,1
HCPCS,0482U,Ob pe biochem asy sfit1&pigf,,,128.82,128.82,1
HCPCS,0483T,Hc Tmvi W Prosthetic Valve Percutaneous,42905.0,27888.25,,,0
HCPCS,0483T,Tmvi percutaneous approach,,,38216.0,38216.0,1
HCPCS,0483U,Nfct ds ng gyra s91f pt mut,,,35.09,35.09,1
HCPCS,0484T,Hc Tmvi W Prosthetic Valve Transthoracic Exposure,42905.0,27888.25,,,0
HCPCS,0484T,Tmvi transthoracic exposure,,,26701.0,26701.0,1
HCPCS,0484U,Nfct ds mgen 23s rrna pt mut,,,35.09,35.09,1
HCPCS,0485T,Oct mid ear i&r unilateral,,,36.01,36.01,1
HCPCS,0485U,Onc sol tum cfdna&rna ngs gm,,,3649.48,3649.48,1
HCPCS,0486T,Oct mid ear i&r bilateral,,,36.01,36.01,1
HCPCS,0486U,Onc pan sol tum ngs cfctdna,,,1644.25,1644.25,1
HCPCS,0487U,Onc sol tum cfcdna tgsap 84,,,2919.6,2919.6,1
HCPCS,0489T,Regn cell tx scldr hands,,,15689.0,15689.0,1
HCPCS,0490T,Regn cell tx scldr h mlt inj,,,3714.0,3714.0,1
HCPCS,0490U,Onc cutan/uveal mlnma cd146,,,2435.0,2435.0,1
HCPCS,0491U,Onc sol tum ctc slct er prtn,,,2435.0,2435.0,1
HCPCS,0492U,Onc sol tum ctc slctn pd-l1,,,2435.0,2435.0,1
HCPCS,0493U,Trnspl med quan dd-cfdna ngs,,,2753.25,2753.25,1
HCPCS,0494T,Prep & cannulj cdvr don lung,,,26701.0,26701.0,1
HCPCS,0494U,Rbc ag ftl rhd gene alys ngs,,,759.05,759.05,1
HCPCS,0495T,Mntr cdvr don lng 1st 2 hrs,,,15689.0,15689.0,1
HCPCS,0495U,Onc prst8 alys crcg plsm prt,,,760.0,760.0,1
HCPCS,0496T,Mntr cdvr don lng ea addl hr,,,15689.0,15689.0,1
HCPCS,0496U,Onc clrct cfdna 8/7 genes,,,485.86,485.86,1
HCPCS,0497U,Onc prst8 mrna rt-pcr 6 gene,,,3873.0,3873.0,1
HCPCS,0498U,Onc clrct ngs mut detc 43gen,,,1345.31,1345.31,1
HCPCS,0499U,Onc clrct&lng dna ngs 8gene,,,597.91,597.91,1
HCPCS,0500U,Autoinflam ds vexas synd dna,,,175.4,175.4,1
HCPCS,0502U,Hpv e6/e7 mrk hi-rsk typ crv,,,35.09,35.09,1
HCPCS,0503U,"Hc Precivityad2, P So",5220.0,3393.0,,,0
HCPCS,0503U,Neuro alz ds ?amyl&tau prtn,,,750.0,750.0,1
HCPCS,0504U,Nfct ds uti id 17 path orgs,,,416.78,416.78,1
HCPCS,0505T,Ev fempop artl revsc,,,11131.16,38216.0,2
HCPCS,0505T,Hc Endovenous Femoral-Popliteal Arterial Revasc,22355.0,14530.75,,,0
HCPCS,0505U,Nfct ds vag infctj id 32orgs,,,679.77,679.77,1
HCPCS,0506T,Mac pgmt opt dns meas hfp,,,56.88,56.88,1
HCPCS,0506U,Gi barretts esophgl cell 89,,,1938.01,1938.01,1
HCPCS,0507T,Near ifr 2img mibmn glnd i&r,,,56.88,56.88,1
HCPCS,0507U,Onc ovr dna whole gen w/5hmc,,,1160.0,1160.0,1
HCPCS,0509T,Pattern erg w/i&r,,,208.2,208.2,1
HCPCS,0510T,Rmvl sinus tarsi implant,,,3154.93,15689.0,2
HCPCS,0510U,Onc pncrtc ca alg alys 16gen,,,473.91,473.91,1
HCPCS,0511T,Rmvl&rinsj sinus tarsi implt,,,6996.6,31685.0,2
HCPCS,0511U,Onc sol tum 3dmicroenvir 36+,,,3033.86,3033.86,1
HCPCS,0512T,Esw integ wnd hlg 1st wnd,,,193.46,3714.0,2
HCPCS,0512U,Onc prst8 alys dgtz img msi,,,706.25,706.25,1
HCPCS,0513U,Onc prst8 alg alys msi&hrd,,,706.25,706.25,1
HCPCS,0514U,Gi ibd ia quan deter adl lvl,,,38.57,38.57,1
HCPCS,0515T,Insj wcs lv compl sys,,,21447.74,63079.0,2
HCPCS,0515U,Gi ibd ia quan deter ifx lvl,,,38.57,38.57,1
HCPCS,0516T,Insj wcs lv eltrd only,,,10078.04,38216.0,2
HCPCS,0516U,Rx metab rxgenomic gnotyp 40,,,416.78,416.78,1
HCPCS,0517T,Insj wcs lv pg compnt,,,10078.04,38216.0,2
HCPCS,0517U,Ther rx mntr 80+ psyactiv rx,,,246.92,246.92,1
HCPCS,0518T,Rmvl pg compnt wcs,,,3603.26,15689.0,2
HCPCS,0518U,Ther rx mntr 90+ pn&mtl hlth,,,246.92,246.92,1
HCPCS,0519T,Hc Removal And Rplce Cardiac Stimulator Left,24280.0,15782.0,,,0
HCPCS,0519T,Rmvl & rplcmt pg compnt wcs,,,10078.04,15689.0,2
HCPCS,0519U,Ther rx mntr meds p/d/a 110+,,,246.92,246.92,1
HCPCS,0520T,Hc Removal And Rplce Cardiac Stimulator Left W New Electro,24280.0,15782.0,,,0
HCPCS,0520T,Rmvl&rplcmt pg wcs new eltrd,,,10078.04,63079.0,2
HCPCS,0520U,Ther rx mntr 200+ rx/sbsts,,,246.92,246.92,1
HCPCS,0521T,Interrog dev eval wcs ip,,,27.89,27.89,1
HCPCS,0521U,Rf iga&igm ccp antb sr-a ia,,,51.8,51.8,1
HCPCS,0522U,Ca vi psp&sp1 antb cl semiql,,,260.5,260.5,1
HCPCS,0523T,Hc Intraprocedural Coronary Ffr Values For Stenosis Interven Add On,476.0,309.4,,,0
HCPCS,0523U,Onc soltum dna ngs snv 22gen,,,1352.09,1352.09,1
HCPCS,0524T,Ev cath dir chem abltj w/img,,,3044.51,15689.0,2
HCPCS,0524U,Ob pe sflt-1/plgf ia srm/pls,,,128.82,128.82,1
HCPCS,0525T,Insj/rplcmt compl iims,,,18572.54,38216.0,2
HCPCS,0525U,Onc sphrd cell cul 11-rx pnl,,,3033.86,3033.86,1
HCPCS,0526T,Insj/rplcmt iims eltrd only,,,7979.31,38216.0,2
HCPCS,0527T,Insj/rplcmt iims implt mntr,,,7979.31,38216.0,2
HCPCS,0527U,Hsv 1&2 vzv amp prb tq pthgn,,,142.63,142.63,1
HCPCS,0528U,Lrt iad 18bct/8vir&7arg rna,,,634.84,634.84,1
HCPCS,0530T,Removal complete iims,,,3603.26,15689.0,2
HCPCS,0530U,Onc pan-sol tum ctdna 77 gen,,,2919.6,2919.6,1
HCPCS,0531T,Removal iims electrode only,,,3603.26,15689.0,2
HCPCS,0532T,Removal iims implt mntr only,,,3603.26,15689.0,2
HCPCS,0532U,Rare ds whlgen&mitochdrl dna,,,5031.2,5031.2,1
HCPCS,0533U,Rx metab advrs gnotyp 16gens,,,416.78,416.78,1
HCPCS,0535U,Pfas lc-ms/ms plsm/srm quan,,,62.14,62.14,1
HCPCS,0536U,Rbcag ftl rhd pcr alys exon4,,,192.0,192.0,1
HCPCS,0537T,Bld drv t lymphcyt car-t cll,,,3714.0,3714.0,1
HCPCS,0537T,Hc Car-T Cell Harvest,6064.0,3941.6,,,0
HCPCS,0537U,Onc clrct ca cfdna >2500 dmr,,,1495.0,1495.0,1
HCPCS,0538T,Bld drv t lymphcyt prep trns,,,3714.0,3714.0,1
HCPCS,0538T,"Hc Car-T Cell Prep For Transport,Cryopreserve,Storage",2215.0,1439.75,,,0
HCPCS,0538U,Onc sol tum ngts ffpe 600gen,,,2989.55,2989.55,1
HCPCS,0539T,Hc Car-T Cell Prep Product For Administration,2215.0,1439.75,,,0
HCPCS,0539T,Receipt&prep car-t cll admn,,,3714.0,3714.0,1
HCPCS,0539U,Onc sol tumor cfctdna 152gen,,,3288.51,3288.51,1
HCPCS,0540T,Car-t cll admn autologous,,,3714.0,3714.0,1
HCPCS,0540T,"Hc Car-T Cell Administration, Autologous",6771.0,4401.15,,,0
HCPCS,0540U,Trnsplj med quan dd-cfdna,,,2753.25,2753.25,1
HCPCS,0541T,Myocardial imaging mcg,,,359.81,359.81,1
HCPCS,0543T,Hc Transapical Mitral Valve Repair Transthc Echo,42905.0,27888.25,,,0
HCPCS,0543T,Ta mv rpr w/artif chord tend,,,38216.0,38216.0,1
HCPCS,0543U,Onc sol tum ngs dna 517 gens,,,2989.55,2989.55,1
HCPCS,0544T,Hc Transcath Mitral Valve Annulus Reconstruct W Device Perct,42905.0,27888.25,,,0
HCPCS,0544T,Tcat mv annulus rcnstj,,,38216.0,38216.0,1
HCPCS,0545T,Hc Transcath Tricuspid Valve Annulus Reconstruct W Device Perct,42905.0,27888.25,,,0
HCPCS,0545T,Tcat tv annulus rcnstj,,,38216.0,38216.0,1
HCPCS,0545U,Achr antb id imfluor livecll,,,37.73,37.73,1
HCPCS,0546U,Ldns lrp4 antb imflr livecll,,,37.73,37.73,1
HCPCS,0547T,B1 matrl qual tst mcrind tib,,,15689.0,15689.0,1
HCPCS,0547U,Neurflmnt lt chn cleia plsm,,,116.23,116.23,1
HCPCS,0548U,Gfap cleia plasma,,,116.23,116.23,1
HCPCS,0549U,Onc urthl dna mthyltd rt pcr,,,760.0,760.0,1
HCPCS,0553T,Perq tcat iliac anast implt,,,38216.0,38216.0,1
HCPCS,0553U,Repr med pga embry te strux,,,759.05,759.05,1
HCPCS,0554U,Repr med pga 24chrm te bx qc,,,759.05,759.05,1
HCPCS,0555T,B1 str&fx rsk transmis data,,,27.89,27.89,1
HCPCS,0555U,Repr med pga embryonic te qc,,,759.05,759.05,1
HCPCS,0556T,B1 str & fx rsk assessment,,,230.07,230.07,1
HCPCS,0556U,Nfct ds p-s dna&rna 12 trgts,,,142.63,142.63,1
HCPCS,0557U,Nfct ds bv dna mrk vag fluid,,,262.99,262.99,1
HCPCS,0558T,Ct scan f/biomchn ct alys,,,83.91,83.91,1
HCPCS,0558U,Onc clrct elisa bf7 ag serum,,,20.81,20.81,1
HCPCS,0559T,Antmc mdl 3d print 1st cmpnt,,,128.29,128.29,1
HCPCS,0559U,Onc brs quan elisa bf9ag srm,,,20.81,20.81,1
HCPCS,0560U,Onc mrd gsa cfdna baseline,,,3878.45,3878.45,1
HCPCS,0561T,Antmc guide 3d print 1st gd,,,128.29,128.29,1
HCPCS,0561U,Onc mrd gsa cfdna subsequent,,,794.49,794.49,1
HCPCS,0562U,Onc sol tum tgsa 33gens snvs,,,597.91,597.91,1
HCPCS,0563T,Evac meibomian glnd heat bi,,,56.88,3714.0,2
HCPCS,0563U,Nfct ds pthgn-sna 11vir&4bct,,,416.78,416.78,1
HCPCS,0564T,Onc chemo rx cytotox csc 14,,,188.03,188.03,2
HCPCS,0564U,Nfct ds pthgn-sna 10vir&4bct,,,416.78,416.78,1
HCPCS,0565T,Autol cell implt adps hrvg,,,3714.0,3714.0,1
HCPCS,0565U,Onc hcc ngs detc 6626epigalt,,,1160.0,1160.0,1
HCPCS,0566T,Autol cell implt adps njx,,,3714.0,3714.0,1
HCPCS,0566U,Onc lng qpcr-bsd alys 13dmrs,,,416.78,416.78,1
HCPCS,0567T,Hc Perm Fallopian Tube Occ W Implnt Transcervical App W Trnsvg Us,17659.0,11478.35,,,0
HCPCS,0567T,Perm flp tube occls w/implt,,,20001.0,20001.0,1
HCPCS,0567U,Rare ds whl gen seq srs&lrs,,,5031.2,5031.2,1
HCPCS,0568T,Hc Confirm Occ Of Fallopian Tubes Transcerv App Incl Transv And Pelvic Us,953.0,619.45,,,0
HCPCS,0568T,Intro mix saline&air f/ssg,,,15689.0,15689.0,1
HCPCS,0568U,Neurol dementia ?amyl ptau,,,897.0,897.0,1
HCPCS,0569T,Hc Transcath Tricuspid Valve Repair Perct App Initial Prosthesis,42905.0,27888.25,,,0
HCPCS,0569T,Ttvr perq appr 1st prosth,,,38216.0,38216.0,1
HCPCS,0570T,Hc Transcath Tricuspid Valve Repair Perct App Each Addtl Prosthesis,21451.0,13943.15,,,0
HCPCS,0570T,Ttvr perq ea addl prosth,,,38216.0,38216.0,1
HCPCS,0570U,Neurol tbi alys gfap&uch-l1,,,260.5,260.5,1
HCPCS,0571T,Hc Insert Or Replce Impnt Cardioverter Defib System W Substernal Elect Incl Img,24020.0,15613.0,,,0
HCPCS,0571T,Insj/rplcmt icds ss eltrd,,,30265.83,63079.0,2
HCPCS,0571U,Onc sol tum dna80&rna10g ngs,,,2919.6,2919.6,1
HCPCS,0572T,Hc Insertion Of Substernal Implantable Defib Electrode,21986.0,14290.9,,,0
HCPCS,0572T,Insertion ss dfb electrode,,,7979.31,38216.0,2
HCPCS,0573T,Hc Removal Of Substernal Implantable Defib Electrode,21986.0,14290.9,,,0
HCPCS,0573T,Removal ss dfb electrode,,,3603.26,38216.0,2
HCPCS,0574T,Hc Reposition Of Prev Implanted Substernal Implantable Defib Pacing,21986.0,14290.9,,,0
HCPCS,0574T,Repos prev ss impl dfb eltrd,,,3603.26,38216.0,2
HCPCS,0575T,Hc Prog Device Eval In Person Implnt Cardioverter Deb System W Adjustment,244.0,158.6,,,0
HCPCS,0575U,Trnsplj med lar rtpcr 4genes,,,380.0,380.0,1
HCPCS,0576U,Trnsplj med lar quan ddcfdna,,,3240.0,3240.0,1
HCPCS,0577T,Ephys eval icds ss,,,1173.98,1173.98,1
HCPCS,0577T,Hc Prog Device Eval In Person Implnt Cardioverter Deb System W Arrythmia Induct,1063.0,690.95,,,0
HCPCS,0577U,Onc ovr serum alys 39 gps,,,246.92,246.92,1
HCPCS,0578U,Onc cutan mln rna qpcr 10gen,,,3873.0,3873.0,1
HCPCS,0579T,Hc Interrog Device Eval Remote Up To 90 Days Cardio Defib W Remote Data Acq,222.0,144.3,,,0
HCPCS,0579U,Nfro dbtc ckd elisa apoa4,,,390.75,390.75,1
HCPCS,0580T,Hc Removal Of Substernal Implantable Defib Pulse Generator Only,21986.0,14290.9,,,0
HCPCS,0580T,Rmvl ss impl dfb pg only,,,3603.26,38216.0,2
HCPCS,0580U,Bbrgdrferi antb detc 24rprtn,,,17.21,17.21,1
HCPCS,0581T,Abltj mal brst tum perq crtx,,,3775.35,15689.0,2
HCPCS,0581T,Hc Cryoablation Breast Tumor Unilat W Img,9070.5,5895.825000000001,,,0
HCPCS,0581U,Trnspl med antb nohla 39trgt,,,325.8,325.8,1
HCPCS,0582T,Trurl abltj mal prst8 tiss,,,12721.42,20001.0,2
HCPCS,0582U,Rare ds rpd whlgen dna vrnts,,,7582.2,7582.2,1
HCPCS,0583T,Tmpst auto tube dlvr sys,,,1496.07,9206.0,2
HCPCS,0583U,Rare ds rpd whlgen cmptr dna,,,3791.1,3791.1,1
HCPCS,0584T,Perq islet cell transplant,,,63079.0,63079.0,1
HCPCS,0584U,Neuro csf prion prtn qual,,,540.99,540.99,1
HCPCS,0585T,Laps islet cell transplant,,,63079.0,63079.0,1
HCPCS,0585U,Tgsap so neo cfdna 521 genes,,,2919.6,2919.6,1
HCPCS,0586T,Open islet cell transplant,,,63079.0,63079.0,1
HCPCS,0586U,Onc mrna gen xprsn 216 genes,,,2919.6,2919.6,1
HCPCS,0587T,Hc Perc Implnt/Rplc Integrated Sgl Device Neurostim Syst Posterior Tibial Nerve,1847.0,1200.55,,,0
HCPCS,0587T,Perq impltj/rplcmt isdns ptn,,,3714.0,6144.98,2
HCPCS,0587U,Ther rx mntr 60-150rx&metabl,,,114.43,114.43,1
HCPCS,0588T,Hc Revise Or Rmv  Integrated Sgl Device Neurostim Syst Posterior Tibial Nerve,1194.0,776.1,,,0
HCPCS,0588T,Revision/removal isdns ptn,,,3371.02,3714.0,2
HCPCS,0588U,Nfct ds bct/vir 32genes mrna,,,760.0,760.0,1
HCPCS,0589T,Elec alys smpl prgrmg iins,,,91.67,91.67,1
HCPCS,0589T,Hc Elect Anlys W/Smpl Prgrm Implant Integrated Neurostim Syst Post Tibial Nerve 1-3,1126.0,731.9,,,0
HCPCS,0589U,Pfas24cmpnd hi-perf lc-ms/ms,,,198.74,198.74,1
HCPCS,0590T,Elec alys cplx prgrmg iins,,,91.67,91.67,1
HCPCS,0590T,Hc Elect Anlys/Cmplx Prgrm Implant Integrated Neurostim Syst Post Tibial Nerve 4+,1126.0,731.9,,,0
HCPCS,0591U,Onc prst8 ca 3prtns plsm srm,,,760.0,760.0,1
HCPCS,0592U,Onc hl neo dna tgs 417 genes,,,2919.6,2919.6,1
HCPCS,0593U,Nfct ds gu pthgn dna 46trgt,,,634.84,634.84,1
HCPCS,0594T,Osteot hum xtrnl lngth dev,,,6996.6,31685.0,2
HCPCS,0595U,Nfct ds tfp vctrbrn&zoonotic,,,262.99,262.99,1
HCPCS,0596T,Temp fml iu vlv-pmp 1st insj,,,672.35,3714.0,2
HCPCS,0597T,Temp fml iu valve-pmp rplcmt,,,672.35,3714.0,2
HCPCS,0598T,Ncntc r-t fluor wnd img 1st,,,208.2,208.2,1
HCPCS,0598U,Gi ibs igg antb 18food items,,,300.0,300.0,1
HCPCS,0599U,Onc pncrtc ca mult ia serum,,,897.0,897.0,1
HCPCS,0600T,Hc Irrevers Electroporation Ablat Per Organ Perc W Imag,17417.0,11321.05,,,0
HCPCS,0600T,Ire abltj 1+tum organ perq,,,10249.52,26701.0,2
HCPCS,0601T,Ire abltj 1+tumors open,,,10249.52,26701.0,2
HCPCS,0609T,Mrs disc pain acquisj data,,,230.07,230.07,1
HCPCS,0611T,Mrs disc pain alg alys data,,,230.07,230.07,1
HCPCS,0613T,Hc Percut Trnscath Interatrial Septal Shunt Device W Img Gud,16533.0,10746.45,,,0
HCPCS,0613T,Perq tcat intratrl septl sht,,,38216.0,38216.0,1
HCPCS,0614T,Hc Remve And Rplce Substernal Defib Pulse Generator,24020.0,15613.0,,,0
HCPCS,0614T,Rmvl&rplcmt ss impl dfb pg,,,21447.74,38216.0,2
HCPCS,0615T,Eye mvmt alys w/o calbrj i&r,,,128.29,128.29,1
HCPCS,0616T,Insertion of iris prosthesis,,,9206.0,9206.0,1
HCPCS,0617T,Insj iris prosth w/rmvl&insj,,,20001.0,20001.0,1
HCPCS,0618T,Insj iris prosth sec io lens,,,20001.0,20001.0,1
HCPCS,0619T,Cysto w/prst8 commissurotomy,,,20001.0,20001.0,1
HCPCS,0620T,Evasc ven artlz tibl/prnl vn,,,42470.57,63079.0,2
HCPCS,0620T,Hc Endvc Venous Arterialization Tibial Or Peronael Vein W Trnscth,17499.0,11374.35,,,0
HCPCS,0621T,Trabeculostomy interno laser,,,3985.54,9206.0,2
HCPCS,0622T,Trabeculostomy int lsr w/scp,,,9206.0,9206.0,1
HCPCS,0627T,Perq njx algc fluor lmbr 1st,,,12379.34,38216.0,2
HCPCS,0629T,Perq njx algc ct lmbr 1st,,,12379.34,38216.0,2
HCPCS,0632T,Hc Percut Trnscath Us Ablation Nervess Pulm Arteries Inc Right Hrt Cath,12271.0,7976.15,,,0
HCPCS,0632T,Perq tcat us abltj nrv p-art,,,17675.76,20001.0,2
HCPCS,0633T,Ct breast w/3d uni c-,,,100.81,100.81,1
HCPCS,0634T,Ct breast w/3d uni c+,,,169.13,169.13,1
HCPCS,0635T,Ct breast w/3d uni c-/c+,,,169.13,169.13,1
HCPCS,0636T,Ct breast w/3d bi c-,,,230.07,230.07,1
HCPCS,0637T,Ct breast w/3d bi c+,,,336.39,336.39,1
HCPCS,0638T,Ct breast w/3d bi c-/c+,,,336.39,336.39,1
HCPCS,0640T,Ncntc nr ifr spctrsc wnd,,,36.01,36.01,1
HCPCS,0643T,Tcat l ventr rstrj dev implt,,,30765.0,30765.0,1
HCPCS,0644T,Hc Transcath Removal/Debulk Icar Mass Suction Device Perq,16652.0,10823.8,,,0
HCPCS,0644T,Tcat rmvl/dblk icar mas perq,,,5487.93,30765.0,2
HCPCS,0645T,Tcat impltj c sins rdctj dev,,,17675.76,38216.0,2
HCPCS,0646T,Hc Ttvi/Rplcmnt Prostc Vlv Perq Right Hrt Cath&Angiography,42905.0,27888.25,,,0
HCPCS,0646T,Ttvi/rplcmt w/prstc vlv perq,,,38216.0,38216.0,1
HCPCS,0647T,Insj gtube perq mag gastrpxy,,,1850.25,9206.0,2
HCPCS,0648T,Quan mr alys tiss w/o mri,,,897.06,897.06,1
HCPCS,0649T,Hc Mr Quant Anal Tissue Comp W/ Mri Single Organ Add On,1725.0,1121.25,,,0
HCPCS,0649T,Quan mr alys tiss w/mri,,,897.06,897.06,1
HCPCS,0651T,Mag ctrld capsule endoscopy,,,874.53,874.53,1
HCPCS,0652T,Egd flx transnasal dx br/wa,,,1850.25,3714.0,2
HCPCS,0653T,Egd flx transnasal bx 1/ml,,,1850.25,3714.0,2
HCPCS,0654T,Egd flx transnasal tube/cath,,,3717.53,9206.0,2
HCPCS,0655T,Tprnl focal abltj mal prst8,,,5169.96,15689.0,2
HCPCS,0656T,Vrt bdy tethering ant,,,16906.49,31685.0,2
HCPCS,0657T,Vrt bdy tethering ant 8+ seg,,,16906.49,31685.0,2
HCPCS,0658T,Elec impd spectrsc 1+skn les,,,56.88,56.88,1
HCPCS,0659T,Hc Transcath Intracoronary Nfs Supersat O2,2478.0,1610.7,,,0
HCPCS,0659T,Tcat intra-c nfs supersat o2,,,38216.0,38216.0,1
HCPCS,0660T,Implt ant sgm io nbio rx sys,,,3985.54,20001.0,2
HCPCS,0661T,Rmvl&Rimpltj ant sgm implt,,,3985.54,20001.0,2
HCPCS,0664T,Don hysterectomy open cdvr,,,15689.0,15689.0,1
HCPCS,0665T,Don hysterectomy open liv,,,15689.0,15689.0,1
HCPCS,0666T,Don hysterectomy laps liv,,,15689.0,15689.0,1
HCPCS,0667T,Don hysterectomy rcp uter,,,15689.0,15689.0,1
HCPCS,0668T,Bkbench prep don uter algrft,,,15689.0,15689.0,1
HCPCS,0669T,Bkbench rcnstj don uter ven,,,15689.0,15689.0,1
HCPCS,0670T,Bkbench rcnstj don uter artl,,,15689.0,15689.0,1
HCPCS,0671T,Insj ant sgm aq drg dev 1+,,,5130.92,9206.0,2
HCPCS,0672T,Ndovag cryg rf remdl tiss,,,20001.0,20001.0,1
HCPCS,0673T,Abltj b9 thyr ndul perq lasr,,,1592.51,9206.0,2
HCPCS,0673T,Hc Laser Ablation Benign Thyroid Nodule W Img,10608.0,6895.2,,,0
HCPCS,0674T,Laps insj nw/rpcmt prm isdss,,,15689.0,29753.66,2
HCPCS,0675T,Laps insj nw/rpcmt isdss 1ld,,,10744.03,15689.0,2
HCPCS,0676T,Laps insj nw/rpcmt isdss ea,,,15689.0,15689.0,1
HCPCS,0677T,Laps repos lead isdss 1st ld,,,10249.52,15689.0,2
HCPCS,0678T,Laps repos lead isdss ea add,,,15689.0,15689.0,1
HCPCS,0679T,Laps rmvl lead isdss,,,10249.52,15689.0,2
HCPCS,0680T,Hc Ins Rplcmt Pulse Generator Only Isdss,3640.0,2366.0,,,0
HCPCS,0680T,Insj/rplcmt pg only isdss,,,15689.0,18706.01,2
HCPCS,0681T,Hc Relocation Pulse Generator Only Isdss,3067.0,1993.55,,,0
HCPCS,0681T,Rlcj pulse gen only isdss,,,3371.02,15689.0,2
HCPCS,0682T,Hc Removal Pulse Generator Only Isdss,23695.0,15401.75,,,0
HCPCS,0682T,Removal pulse gen only isdss,,,3371.02,15689.0,2
HCPCS,0686T,Hc Histotripsy Mal Hepatocellular Tiss W Img Gdn,38719.0,25167.35,,,0
HCPCS,0686T,Histotripsy mal hepatcel tis,,,26701.0,33032.77,2
HCPCS,0689T,Quan us tis charac w/o dx us,,,83.91,83.91,1
HCPCS,0692T,Therapeutic ultrafiltration,,,1501.7,1501.7,1
HCPCS,0695T,Hc Bdy Surf Activation Mapg Pm Cvdfb Leads Tm Implt,244.0,158.6,,,0
HCPCS,0696T,Hc Bdy Surf Activation Mapg Pm Cvdfb Leads Tm Flwup,244.0,158.6,,,0
HCPCS,0697T,Quan mr tis wo mri mlt orgn,,,897.06,897.06,1
HCPCS,0698T,Quan mr tiss w/mri mlt orgn,,,897.06,897.06,1
HCPCS,0699T,Njx pst chmbr eye medication,,,2225.25,9206.0,2
HCPCS,0707T,Hc Inj Bone Sub Matrl Into Subchondral Bone Defect,8958.0,5822.7,,,0
HCPCS,0707T,Njx b1 sub mtrl sbchdrl dfct,,,3154.93,15689.0,2
HCPCS,0712T,N-nvs artl plaq alys quan,,,208.2,208.2,1
HCPCS,0714T,Tprnl lsr ablt b9 prst8 hypr,,,5169.96,20001.0,2
HCPCS,0716T,Car acous wavfrm rec cad rsk,,,56.88,56.88,1
HCPCS,0717T,Adrc ther prtl rc tear,,,3416.94,15689.0,2
HCPCS,0718T,Adrc ther prtl rc tear njx,,,3416.94,3714.0,2
HCPCS,0719T,Pst vrt jt rplcmt lmbr 1 sgm,,,15689.0,15689.0,1
HCPCS,0720T,Prq elc nrv stim cn wo implt,,,3714.0,3714.0,1
HCPCS,0723T,Qmrcp w/o dx mri sm anat ses,,,897.06,897.06,1
HCPCS,0724T,Qmrcp w/dx mri same anatomy,,,897.06,897.06,1
HCPCS,0725T,Vestibular dev impltj uni,,,20001.0,20001.0,1
HCPCS,0726T,Rmvl implt vstibular dev uni,,,20001.0,20001.0,1
HCPCS,0727T,Rmvl&rplcmt implt vstblr dev,,,20001.0,20001.0,1
HCPCS,0730T,Trabeculotomy lsr w/oct gdn,,,9206.0,9206.0,1
HCPCS,0731T,Augmnt ai-based fcl phnt a/r,,,56.88,56.88,1
HCPCS,0736T,Colonic lavage 35+l water,,,124.07,3714.0,2
HCPCS,0737T,Xenograft impltj artclr surf,,,12379.34,31685.0,2
HCPCS,0740T,Rem auton alg nsln cal setup,,,56.88,56.88,1
HCPCS,0742T,Hc Nm Absolute Quant Myocardial Blood Flow Rst And St Spect Add On,2200.0,1430.0,,,0
HCPCS,0743T,B1 str & fx rsk vrt fx assmt,,,230.07,230.07,1
HCPCS,0744T,Insj bioprostc vlv fem vn,,,5365.4,20001.0,2
HCPCS,0745T,Hc Cardiac Ablation Radiation Non-Invasive Arrhythmia Local,11126.0,7231.9,,,0
HCPCS,0746T,Hc Cardiac Ablation Radiation Conversion Arrhythmia Local Map,11126.0,7231.9,,,0
HCPCS,0747T,Hc Cardiac Ablation Radiation Arrhythmia Deliv Rad Therapy,11126.0,7231.9,,,0
HCPCS,0764T,Asstv alg ecg rsk asmt cncrt,,,128.29,128.29,1
HCPCS,0765T,Asstv alg ecg rsk asmt prev,,,128.29,128.29,1
HCPCS,0766T,Tc mag stimj pn 1st tx 1nrv,,,208.2,208.2,1
HCPCS,0778T,Smmg cncrnt appl imu snr,,,124.07,124.07,1
HCPCS,0779T,Gi myoelectrical actv study,,,359.81,359.81,1
HCPCS,0780T,Instlj fecal microbiota ssp,,,128.29,3714.0,2
HCPCS,0781T,Brnchsc rf dstrj pulm nrv bi,,,30765.0,30765.0,1
HCPCS,0782T,Brnchsc rf dstrj plm nrv uni,,,30765.0,30765.0,1
HCPCS,0783T,Tc auriculr neurostimulation,,,124.07,124.07,1
HCPCS,0784T,Ins/rplmt eltrd ra spi nstim,,,10744.03,38216.0,2
HCPCS,0785T,Revj/rmvl nea spi w/nstim,,,3371.02,15689.0,2
HCPCS,0786T,Insj/rplcmt prq ra sac nstim,,,10744.03,38216.0,2
HCPCS,0787T,Revj/rmvl nea sac w/nstim,,,3371.02,15689.0,2
HCPCS,0788T,Elec aly smp iins sp/sac nrv,,,91.67,91.67,1
HCPCS,0789T,Elec aly cpx iins sp/sac nrv,,,91.67,91.67,1
HCPCS,0790T,Revj rplcmt/rmvl vrt tethrg,,,16906.49,31685.0,2
HCPCS,0793T,Prq tcat thrm ablt nrv p-art,,,17675.76,63079.0,2
HCPCS,0794T,Pt spec alg rx-onc tx option,,,56.88,56.88,1
HCPCS,0795T,Hc Trcath Ins Perm Dual Chamb Leadless Pacer Comp System,26745.0,17384.25,,,0
HCPCS,0795T,Tcat ins 2chmbr ldls pm cmpl,,,18572.54,63079.0,2
HCPCS,0796T,Tcat ins 2chmbr ldls pm ra,,,18572.54,63079.0,2
HCPCS,0797T,Tcat ins 2chmbr ldls pm rv,,,18572.54,63079.0,2
HCPCS,0798T,Tcat rmv 2chmbr ldls pm cmpl,,,3044.51,15689.0,2
HCPCS,0799T,Tcat rmvl 2chmbr ldls pm ra,,,3044.51,15689.0,2
HCPCS,0800T,Tcat rmvl 2chmbr ldls pm rv,,,3044.51,15689.0,2
HCPCS,0801T,Tcat rmv&rpl 2chmbr ldls pm,,,18572.54,63079.0,2
HCPCS,0802T,Tcat rmv&rpl2chmb ldls pm ra,,,18572.54,63079.0,2
HCPCS,0803T,Tcat rmv&rpl2chmb ldls pm rv,,,18572.54,63079.0,2
HCPCS,0805T,Tcat s&ivc prstc vl impl prq,,,38216.0,38216.0,1
HCPCS,0806T,Tcat s&ivc prstc vl impl opn,,,38216.0,38216.0,1
HCPCS,0807T,Pulm tiss vntj alys prev ct,,,208.2,208.2,1
HCPCS,0808T,Pulm tiss vntj alys w/ct,,,208.2,208.2,1
HCPCS,0810T,Subrta njx rx agt w/vtrc,,,3714.0,4011.54,2
HCPCS,0811T,Rem mlt day uroflow setup,,,128.37,128.37,1
HCPCS,0812T,Rem mlt day uroflow dev sply,,,124.07,124.07,1
HCPCS,0813T,Egd vol adjmt bariatric balo,,,874.53,3714.0,2
HCPCS,0814T,Prq njx biod osteo matrl fem,,,63079.0,63079.0,1
HCPCS,0816T,Opn insj/rplcmt ins ptn subq,,,18706.01,63079.0,2
HCPCS,0817T,Opn insj/rplcmt ins ptn subf,,,18706.01,63079.0,2
HCPCS,0818T,Revj/rmvl ins ptn subq,,,3371.02,15689.0,2
HCPCS,0819T,Revj/rmvl ins ptn subf,,,3371.02,15689.0,2
HCPCS,0823T,Hc Transcath Insert Perm Single Chamb Leadless Pacemaker Right Atrial,37168.0,24159.2,,,0
HCPCS,0823T,Tcat ins 1chmbr ldls pm ra,,,18572.54,63079.0,2
HCPCS,0824T,Hc Transcath Remove Perm Single Chamb Leadless Pacemaker Right Atrial,9120.0,5928.0,,,0
HCPCS,0824T,Tcat rmv 1chmbr ldls pm ra,,,3044.51,15689.0,2
HCPCS,0825T,Hc Transcath Remove & Replace Perm Single Chamb Leadless Pacemaker Right Atrial,37168.0,24159.2,,,0
HCPCS,0825T,Tcat rmv&rpl1chmb ldls pm ra,,,18572.54,63079.0,2
HCPCS,0826T,Hc Eval Leadless Pacemaker W Adjust,205.0,133.25,,,0
HCPCS,0857T,Opto-acoustic img breast uni,,,100.81,100.81,1
HCPCS,0861T,Hc Remove Wireless Cardiac Stim Left Ventric Pacing Pulse Gen Both Components,11235.0,7302.75,,,0
HCPCS,0861T,Rmvl pg wcs lv both compnt,,,3603.26,15689.0,2
HCPCS,0862T,Hc Relocate Wireless Cardiac Stim Left Ventric Pacing Pulse Gen Battery Only,5217.0,3391.05,,,0
HCPCS,0862T,Rlcj pg wcs lv battery only,,,1989.46,9206.0,2
HCPCS,0863T,Hc Relocate Wireless Cardiac Stim Left Ventric Pacing Pulse Gen Transmitter Only,5217.0,3391.05,,,0
HCPCS,0863T,Rlcj pg wcs lv trnsmtr only,,,1989.46,9206.0,2
HCPCS,0864T,Low ntsty eswt corpus cvrnsm,,,240.91,240.91,1
HCPCS,0865T,Quan mri alys brn w/o dx mri,,,230.07,230.07,1
HCPCS,0866T,Hc Mr Quantitative Analysis Brain Add On,886.0,575.9,,,0
HCPCS,0866T,Quan mri alys brn w/dx mri,,,230.07,230.07,1
HCPCS,0867T,Tpla b9 prst8 hyprplsa>=50ml,,,5169.96,20001.0,2
HCPCS,0868T,Hi-res gastric ep mapping,,,359.81,359.81,1
HCPCS,0869T,Njx b1 sub mtrl hw fixj aug,,,3154.93,15689.0,2
HCPCS,0870T,Imp subq prtl ascts pmp sys,,,63079.0,63079.0,1
HCPCS,0871T,Rplcmt subq prtl ascites pmp,,,63079.0,63079.0,1
HCPCS,0872T,Rplcmt ndwllg bldr&prtl cath,,,63079.0,63079.0,1
HCPCS,0873T,Revj subq prtl asct pmp sys,,,63079.0,63079.0,1
HCPCS,0874T,Rmvl pertl ascites pmp sys,,,20001.0,20001.0,1
HCPCS,0881T,Cryotherapy oral cavity,,,430.74,430.74,1
HCPCS,0884T,Esphgsc flx 1st tndsc dilat,,,5853.69,15689.0,2
HCPCS,0885T,Colsc flx 1st tndsc dilat,,,5853.69,9206.0,2
HCPCS,0886T,Sgmdsc flx 1st tndsc dilat,,,5853.69,9206.0,2
HCPCS,0888T,Histotripsy mal renal tissue,,,16516.62,26701.0,2
HCPCS,0889T,Prsnlz trgt dvl arhfcmrigtbs,,,897.06,897.06,1
HCPCS,0893T,N-invas assmt bld oxygnation,,,128.29,128.29,1
HCPCS,0894T,Cannulation liver allograft,,,26701.0,26701.0,1
HCPCS,0895T,Connj lvr algrft prfu dev 1,,,26701.0,26701.0,1
HCPCS,0896T,Connj lvr algrft prfu dev ea,,,15689.0,15689.0,1
HCPCS,0897T,Hc N-Invas Augmnt Arrhyt Alys Quan Card Arrhyt Simul,3388.0,2202.2,,,0
HCPCS,0897T,N-invas augmnt arrhyt alys,,,828.02,828.02,1
HCPCS,0898T,N-invas prst8 cancer est map,,,828.02,828.02,1
HCPCS,0902T,Qtc ntrvl augmnt alg aly ecg,,,128.29,128.29,1
HCPCS,0904T,Ecg alg 12 ld rdcd trcg only,,,56.88,56.88,1
HCPCS,0906T,Coms ther 1st appl<=50 sq cm,,,193.46,193.46,1
HCPCS,0908T,Opn imp int nstm sys vgs nrv,,,29753.66,63079.0,2
HCPCS,0909T,Rplcmt int nstim sys vgs nrv,,,29753.66,38216.0,2
HCPCS,0910T,Rmvl int nstim sys vagus nrv,,,3371.02,20001.0,2
HCPCS,0911T,Elec aly nstm sys vgs nrv wo,,,56.88,56.88,1
HCPCS,0912T,Elec alys nstim sys vgs smpl,,,91.67,91.67,1
HCPCS,0913T,Hc Ptca De Balloon W Ivus Or Oct Single Major Ca Or Branch,16162.0,10505.3,,,0
HCPCS,0913T,Prq tcat ther rx ntrac balo1,,,11131.16,11131.16,1
HCPCS,0914T,Hc Ptca De Balloon Sep Lesion W Ivus Or Oct Single Major Ca Or Branch Add On,8081.0,5252.65,,,0
HCPCS,0915T,Hc Insert Perm Ccm-D Sys Pulse Gen & Eltrds,24020.0,15613.0,,,0
HCPCS,0915T,Insj perm ccm-d sys pg&eltrd,,,30265.83,63079.0,2
HCPCS,0916T,Hc Insert Perm Ccm-D Sys Pulse Gen Only,22018.0,14311.7,,,0
HCPCS,0916T,Insj perm ccm-d sys pg only,,,21447.74,63079.0,2
HCPCS,0917T,Hc Insert Perm Ccm-D Sys 1 Lead Only,18387.0,11951.55,,,0
HCPCS,0917T,Insj perm ccm-d sys 1 lead,,,7979.31,38216.0,2
HCPCS,0918T,Hc Insert Perm Ccm-D Sys Dual Leads Only,18387.0,11951.55,,,0
HCPCS,0918T,Insj perm ccm-d sys dual ld,,,7979.31,38216.0,2
HCPCS,0919T,Hc Remove Perm Ccm-D Sys Pulse Gen Only,14756.0,9591.4,,,0
HCPCS,0919T,Rmvl perm ccm-d sys pg only,,,3603.26,15689.0,2
HCPCS,0920T,Hc Remove Perm Ccm-D Sys 1 Pacing Lead Only,14756.0,9591.4,,,0
HCPCS,0920T,Rmvl perm ccm-d sys 1 pac ld,,,3603.26,15689.0,2
HCPCS,0921T,Hc Remove Perm Ccm-D Sys 1 Defib Lead Only,14756.0,9591.4,,,0
HCPCS,0921T,Rmvl perm ccm-d sys 1 dfb ld,,,3603.26,15689.0,2
HCPCS,0922T,Hc Remove Perm Ccm-D Sys Dual Leads Only,14756.0,9591.4,,,0
HCPCS,0922T,Rmvl perm ccm-d sys dual ld,,,3603.26,15689.0,2
HCPCS,0923T,Hc Remove & Replace Perm Ccm-D Pulse Gen Only,22018.0,14311.7,,,0
HCPCS,0923T,Rmvl&rplcmt perm ccm-d pg,,,21447.74,63079.0,2
HCPCS,0924T,Hc Reposition Prev Ccm-D Electrodes/ Leads,2507.0,1629.55,,,0
HCPCS,0924T,Rpos prv ccm-d trnsvns eltrd,,,604.86,3714.0,2
HCPCS,0925T,Hc Relocate Skin Pocket Ccm-D Pulse Gen,7417.0,4821.05,,,0
HCPCS,0925T,Rlcj skin pocket ccm-d pg,,,1989.46,9206.0,2
HCPCS,0930T,Ephys eval ccm-d ld 1st impl,,,1173.98,1173.98,1
HCPCS,0930T,Hc Ephys Eval Ccm-D Ld At Initial Implant,4922.0,3199.3,,,0
HCPCS,0931T,Ephys eval ccm-d ld separate,,,1173.98,1173.98,1
HCPCS,0931T,Hc Ephys Eval Ccm-D Ld Separate From Date Of Insert,4922.0,3199.3,,,0
HCPCS,0933T,Hc Transcath Implant Wrls Lt Atr Prs Snsr,11671.0,7586.15,,,0
HCPCS,0933T,Tcat impl wrls l atr prs snr,,,3125.94,15689.0,2
HCPCS,0935T,Cysto w/rnl pel symp dnrvtj,,,3714.0,3714.0,1
HCPCS,0941T,Cysto flx ins&xpns urtl scaf,,,15689.0,15689.0,1
HCPCS,0942T,Cysto flx rmv&rplc urtl scaf,,,63079.0,63079.0,1
HCPCS,0943T,Cysto flx rmvl urtl scaffold,,,15689.0,15689.0,1
HCPCS,0944T,3d cntr simula trgt lvr les,,,230.07,230.07,1
HCPCS,0944T,Hc 3D Contour Simulation Liver For Lesion Microwave Ablation,835.0,542.75,,,0
HCPCS,0946T,Ortho impl mvmt alys pair ct,,,100.81,100.81,1
HCPCS,0950T,Abltj b9 prst8 tissue hifu,,,9127.77,9127.77,1
HCPCS,0957T,Rev s-sclp eltr ra rcvr&tlmt,,,1550.46,1550.46,1
HCPCS,0958T,Rmv s-sclp eltr ra rcvr&tlmt,,,3154.93,3154.93,1
HCPCS,0959T,Rmv/rplc magnet coil assem,,,1592.51,1592.51,1
HCPCS,0962T,Asstv alg alys acous&ecg rec,,,128.29,128.29,1
HCPCS,0963T,Anosc sbmcsl njx bulking agt,,,1153.83,1153.83,1
HCPCS,0964T,I&cust prep jaw xpnsj 1arch,,,3196.84,3196.84,1
HCPCS,0965T,I&cst prp jw xpn dl arch non,,,3196.84,3196.84,1
HCPCS,0966T,I&cst prp jw xpn dl arch fxd,,,3196.84,3196.84,1
HCPCS,0967T,Tranal ins tmp clrc anst dev,,,1153.83,1153.83,1
HCPCS,0970T,Ablt b9 brst tum perq lsr ea,,,3775.35,3775.35,1
HCPCS,0971T,Ablt mal brst tum pq lsr uni,,,3775.35,3775.35,1
HCPCS,0973T,Slctv nzmtc dbrdmt t/a/l 1st,,,391.97,391.97,1
HCPCS,0975T,Slctv nzmtc dbrdmt s/n/hf 1,,,391.97,391.97,1
HCPCS,0977T,Upr gi bld detcj snr capsule,,,874.53,874.53,1
HCPCS,0981T,Tcat impl wrls ivc snr,,,17675.76,17675.76,1
HCPCS,0982T,Rem mntr impl ivc snr set-up,,,128.37,128.37,1
HCPCS,0989T,Revj/rmvl ins ptn subq&subf,,,3371.02,3371.02,1
HCPCS,0991T,Cysto lo-nrg lithtrp&mcrsphr,,,9127.77,9127.77,1
HCPCS,0992T,N-invas assmt car rsk w/o ct,,,230.07,230.07,1
HCPCS,0993T,N-invas assmt car rsk w/ct,,,230.07,230.07,1
HCPCS,10004,Hc Fine Needle Asp Biopsy Wo Img Ea Addl Lesion,491.0,319.15,,,0
HCPCS,10005,Fna bx w/us gdn 1st les,,,682.8,3714.0,2
HCPCS,10005,Hc Fine Needle Asp Biopsy W Ultrasound 1St Lesion,5126.0,3331.9,,,0
HCPCS,10006,Hc Fine Needle Asp Biopsy W Ultrasound Ea Addl Lesion,2704.0,1757.6,,,0
HCPCS,10007,Fna bx w/fluor gdn 1st les,,,682.8,3714.0,2
HCPCS,10007,Hc Fine Needle Asp Biopsy W Fluoro 1St Lesion,5536.0,3598.4,,,0
HCPCS,10008,Hc Fine Needle Asp Biopsy W Fluoro Ea Addl Lesion,2704.0,1757.6,,,0
HCPCS,10009,Fna bx w/ct gdn 1st les,,,682.8,3714.0,2
HCPCS,10009,Hc Fine Needle Asp Biopsy W Ct 1St Lesion,5536.0,3598.4,,,0
HCPCS,10010,Hc Fine Needle Asp Biopsy W Ct Ea Addl Lesion,2704.0,1757.6,,,0
HCPCS,10011,Fna bx w/mr gdn 1st les,,,682.8,3714.0,2
HCPCS,10021,Fna w/o image,,,391.97,3714.0,2
HCPCS,10021,Hc Fine Needle Asp Biopsy Wo Img 1St Lesion,1291.0,839.15,,,0
HCPCS,1002T,Air displacmnt plethysmograp,,,27.89,27.89,1
HCPCS,10030,Guide cathet fluid drainage,,,682.8,3714.0,2
HCPCS,10030,Hc Img Guide Fluid Coll Drng By Cath Soft Tissue Perc,1631.0,1060.15,,,0
HCPCS,10035,Hc Place Soft Tissue Localization Device W Img 1St Lesion,1340.0,871.0,,,0
HCPCS,10035,Perq dev soft tiss 1st imag,,,682.8,3714.0,2
HCPCS,10036,Hc Place Soft Tissue Localization Device W Img Ea Addt Lesion,696.0,452.4,,,0
HCPCS,1003T,Arthrp 1st crp/mtcrpl prostc,,,12379.34,12379.34,1
HCPCS,10040,Acne surgery,,,193.46,3714.0,2
HCPCS,1004T,Elec alys s-scl eeg wo prgrm,,,128.29,128.29,1
HCPCS,1005T,Elec alys s-scl eeg prgr 1st,,,91.67,91.67,1
HCPCS,10060,Drainage of skin abscess,,,193.46,3714.0,2
HCPCS,10060,Hc I And D Abscess Simple,931.0,605.15,,,0
HCPCS,10061,Drainage of skin abscess,,,391.97,3714.0,2
HCPCS,10061,Hc I And D Abscess Complicated,2059.0,1338.35,,,0
HCPCS,10080,Drainage of pilonidal cyst,,,682.8,3714.0,2
HCPCS,10080,Hc I And D Pilonidal Cyst Simple,1374.0,893.1,,,0
HCPCS,10081,Drainage of pilonidal cyst,,,682.8,3714.0,2
HCPCS,10081,Hc I And D Pilonidal Cyst Complicated,1910.0,1241.5,,,0
HCPCS,1008T,Rem mntr s-scl eeg sys setup,,,128.37,128.37,1
HCPCS,1010T,Cptr oph alys monoc eye mvmt,,,128.29,128.29,1
HCPCS,10120,Hc I And D Fb Subq Simple,1414.0,919.1,,,0
HCPCS,10120,Remove foreign body,,,391.97,3714.0,2
HCPCS,10121,Hc I And D Fb Subq Complicated,2388.0,1552.2,,,0
HCPCS,10121,Remove foreign body,,,1592.51,9206.0,2
HCPCS,1013T,Lap srg imp/rpl eso nea&pg/r,,,18706.01,18706.01,1
HCPCS,10140,Drainage of hematoma/fluid,,,1592.51,9206.0,2
HCPCS,10140,Hc I And D Hematoma Seroma Fluid,6858.0,4457.7,,,0
HCPCS,1014T,Lap rv/rmv eso sph nstm eltr,,,10744.03,10744.03,1
HCPCS,1015T,Rev/rmv lw esoph sphnc npg/r,,,3371.02,3371.02,1
HCPCS,10160,Hc Puncture Aspiration Of Cyst,1896.0,1232.4,,,0
HCPCS,10160,Puncture drainage of lesion,,,391.97,3714.0,2
HCPCS,1017T,Elec aly npgs esoph sbsq w/o,,,56.88,56.88,1
HCPCS,10180,Complex drainage wound,,,2800.79,15689.0,2
HCPCS,10180,Hc I And D Post Op Infection Comp,14554.0,9460.1,,,0
HCPCS,1019T,Lymphovenous bypass per xtr,,,6402.59,6402.59,1
HCPCS,1020T,Raman spectroscopy 1+skn les,,,56.88,56.88,1
HCPCS,1021T,Active thrc irrigation spx,,,604.86,604.86,1
HCPCS,1025T,Alt elec fld dos&dlv sim mdl,,,129.6,129.6,1
HCPCS,11000,Debride infected skin,,,391.97,3714.0,2
HCPCS,11000,Hc Debr Skin Up To 10% Body Surface,777.0,505.05,,,0
HCPCS,11004,Debride genitalia & perineum,,,3714.0,3714.0,1
HCPCS,11005,Debride abdom wall,,,3714.0,3714.0,1
HCPCS,11006,Debride genit/per/abdom wall,,,3714.0,3714.0,1
HCPCS,11008,Remove mesh from abd wall,,,3714.0,3714.0,1
HCPCS,11010,Debride skin at fx site,,,682.8,3714.0,2
HCPCS,11010,Hc Debride Skin At Fx Site,1857.0,1207.05,,,0
HCPCS,11011,Debride skin musc at fx site,,,682.8,3714.0,2
HCPCS,11012,Deb skin bone at fx site,,,2800.79,15689.0,2
HCPCS,11042,Deb subq tissue 20 sq cm/<,,,391.97,3714.0,2
HCPCS,11042,Hc Debr Subq Tissue <=20 Sq Cm,1395.0,906.75,,,0
HCPCS,11043,Deb musc/fascia 20 sq cm/<,,,712.63,3714.0,2
HCPCS,11043,Hc Debr Muscle Fascia <=20 Sq Cm,1930.0,1254.5,,,0
HCPCS,11044,Deb bone 20 sq cm/<,,,1592.51,9206.0,2
HCPCS,11044,Hc Debr Bone <=20 Sq Cm,5183.0,3368.95,,,0
HCPCS,11045,Hc Debr Subq Tissue Add 20Sq Cm,498.0,323.7,,,0
HCPCS,11046,Hc Debr Muscle Fascia Addl 20Sq Cm,500.0,325.0,,,0
HCPCS,11047,Hc Debr Bone Addl 20 Sq Cm,571.0,371.15,,,0
HCPCS,11055,Hc Trimming Of Skin Lesion,540.0,351.0,,,0
HCPCS,11055,Trim skin lesion,,,193.46,3714.0,2
HCPCS,11056,Hc Trim Skin Lesions 2-4,713.0,463.45,,,0
HCPCS,11056,Trim skin lesions 2 to 4,,,193.46,3714.0,2
HCPCS,11057,Hc Trim Skin Lesions >4,1002.0,651.3,,,0
HCPCS,11057,Trim skin lesions over 4,,,193.46,3714.0,2
HCPCS,11102,Hc Tangential Biopsy Skin Single Les,676.0,439.4,,,0
HCPCS,11102,Tangntl bx skin single les,,,391.97,3714.0,2
HCPCS,11103,Hc Tangential Biopsy Skin Ea Sep/Addl,361.0,234.65,,,0
HCPCS,11104,Hc Punch Biopsy Skin Single Lesion,730.0,474.5,,,0
HCPCS,11104,Punch bx skin single lesion,,,391.97,3714.0,2
HCPCS,11105,Hc Punch Biopsy Skin Ea Sep/Addl,355.0,230.75,,,0
HCPCS,11106,Hc Incisional Biopsy Of Skin Single Lesion,1328.0,863.2,,,0
HCPCS,11106,Incal bx skn single les,,,712.63,3714.0,2
HCPCS,11107,Hc Incisional Biopsy Of Skin Each Additional,722.0,469.3,,,0
HCPCS,11200,Hc Skin Tag Removal 1-15 Lesions,1182.0,768.3,,,0
HCPCS,11200,Removal of skin tags <w/15,,,193.46,3714.0,2
HCPCS,11300,Hc Shave Epidermal Dermal Lesion Trunk Arm Leg 0.5Cm Or Less,1044.0,678.6,,,0
HCPCS,11300,Shave skin lesion 0.5 cm/<,,,391.97,3714.0,2
HCPCS,11301,Hc Shave Epidermal Dermal Lesion Trunk Arm Leg 0.6 To 1.0 Cm,1202.0,781.3,,,0
HCPCS,11301,Shave skin lesion 0.6-1.0 cm,,,193.46,3714.0,2
HCPCS,11302,Shave skin lesion 1.1-2.0 cm,,,193.46,3714.0,2
HCPCS,11303,Shave skin lesion >2.0 cm,,,391.97,3714.0,2
HCPCS,11305,Shave skin lesion 0.5 cm/<,,,193.46,3714.0,2
HCPCS,11306,Shave skin lesion 0.6-1.0 cm,,,193.46,3714.0,2
HCPCS,11307,Shave skin lesion 1.1-2.0 cm,,,193.46,3714.0,2
HCPCS,11308,Shave skin lesion >2.0 cm,,,391.97,3714.0,2
HCPCS,11310,Shave skin lesion 0.5 cm/<,,,193.46,3714.0,2
HCPCS,11311,Shave skin lesion 0.6-1.0 cm,,,193.46,3714.0,2
HCPCS,11312,Shave skin lesion 1.1-2.0 cm,,,391.97,3714.0,2
HCPCS,11313,Shave skin lesion >2.0 cm,,,391.97,3714.0,2
HCPCS,11400,Exc tr-ext b9+marg 0.5 cm<,,,682.8,3714.0,2
HCPCS,11401,Exc tr-ext b9+marg 0.6-1 cm,,,391.97,3714.0,2
HCPCS,11401,Hc Exc Bng Lsn Mrgs 0.6-1 Cm,1268.0,824.2,,,0
HCPCS,11402,Exc tr-ext b9+marg 1.1-2 cm,,,682.8,3714.0,2
HCPCS,11402,Hc Exc Bng Lsn Mrgs 1.1-2.0 Cm,2140.0,1391.0,,,0
HCPCS,11403,Exc tr-ext b9+marg 2.1-3cm/<,,,682.8,3714.0,2
HCPCS,11403,Hc Exc Bng Lsn Mrgs 2.1-3.0 Cm,2140.0,1391.0,,,0
HCPCS,11404,Exc tr-ext b9+marg 3.1-4 cm,,,1592.51,9206.0,2
HCPCS,11404,Hc Exc Bng Lsn Mrgs 3.1-4.0 Cm,4135.0,2687.75,,,0
HCPCS,11406,Exc tr-ext b9+marg >4.0 cm,,,1592.51,9206.0,2
HCPCS,11420,Exc h-f-nk-sp b9+marg 0.5/<,,,1592.51,9206.0,2
HCPCS,11421,Exc h-f-nk-sp b9+marg 0.6-1,,,682.8,3714.0,2
HCPCS,11422,Exc h-f-nk-sp b9+marg 1.1-2,,,1592.51,9206.0,2
HCPCS,11422,Hc Exc Ben Lesion S N H F G 1.1-2Cm,5046.0,3279.9,,,0
HCPCS,11423,Exc h-f-nk-sp b9+marg 2.1-3,,,1592.51,9206.0,2
HCPCS,11424,Exc h-f-nk-sp b9+marg 3.1-4,,,1592.51,9206.0,2
HCPCS,11424,Hc Exc Ben Lesion S N H F G 3.1-4Cm,6055.0,3935.75,,,0
HCPCS,11426,Exc h-f-nk-sp b9+marg >4 cm,,,2800.79,15689.0,2
HCPCS,11440,Exc face-mm b9+marg 0.5 cm/<,,,682.8,3714.0,2
HCPCS,11441,Exc face-mm b9+marg 0.6-1 cm,,,682.8,3714.0,2
HCPCS,11442,Exc face-mm b9+marg 1.1-2 cm,,,682.8,3714.0,2
HCPCS,11442,Hc Excise Benign Lesion Face 1.1-2Cm,5046.0,3279.9,,,0
HCPCS,11443,Exc face-mm b9+marg 2.1-3 cm,,,1592.51,9206.0,2
HCPCS,11443,Hc Exc Ben Lesion Xcp Sk Tg F/E/E/N/L/M 2.1-3.0Cm,6055.0,3935.75,,,0
HCPCS,11444,Exc face-mm b9+marg 3.1-4 cm,,,1592.51,9206.0,2
HCPCS,11446,Exc face-mm b9+marg >4 cm,,,2800.79,15689.0,2
HCPCS,11450,Removal sweat gland lesion,,,2800.79,15689.0,2
HCPCS,11451,Removal sweat gland lesion,,,2800.79,15689.0,2
HCPCS,11462,Removal sweat gland lesion,,,2800.79,15689.0,2
HCPCS,11463,Removal sweat gland lesion,,,2800.79,15689.0,2
HCPCS,11470,Removal sweat gland lesion,,,2800.79,15689.0,2
HCPCS,11471,Removal sweat gland lesion,,,2800.79,15689.0,2
HCPCS,11600,Exc tr-ext mal+marg 0.5 cm/<,,,682.8,3714.0,2
HCPCS,11601,Exc tr-ext mal+marg 0.6-1 cm,,,682.8,3714.0,2
HCPCS,11601,Hc Exc Malignant Les Trunk Arm Or Leg 0.6-1.0 Cm,1499.0,974.35,,,0
HCPCS,11602,Exc tr-ext mal+marg 1.1-2 cm,,,391.97,3714.0,2
HCPCS,11603,Exc tr-ext mal+marg 2.1-3 cm,,,682.8,3714.0,2
HCPCS,11604,Exc tr-ext mal+marg 3.1-4 cm,,,682.8,3714.0,2
HCPCS,11606,Exc tr-ext mal+marg >4 cm,,,1592.51,9206.0,2
HCPCS,11620,Exc h-f-nk-sp mal+marg 0.5/<,,,1592.51,9206.0,2
HCPCS,11621,Exc s/n/h/f/g mal+mrg 0.6-1,,,682.8,3714.0,2
HCPCS,11622,Exc s/n/h/f/g mal+mrg 1.1-2,,,682.8,3714.0,2
HCPCS,11622,Hc Exc Malignant Les S N H F G 1.1-2.0Cm,2102.0,1366.3,,,0
HCPCS,11623,Exc s/n/h/f/g mal+mrg 2.1-3,,,1592.51,9206.0,2
HCPCS,11623,Hc Exc Malignant Les S N H F G 2.1-3.0Cm,4205.0,2733.25,,,0
HCPCS,11624,Exc s/n/h/f/g mal+mrg 3.1-4,,,1592.51,9206.0,2
HCPCS,11626,Exc s/n/h/f/g mal+mrg >4 cm,,,2800.79,15689.0,2
HCPCS,11640,Exc f/e/e/n/l mal+mrg 0.5cm<,,,682.8,3714.0,2
HCPCS,11641,Exc f/e/e/n/l mal+mrg 0.6-1,,,682.8,3714.0,2
HCPCS,11642,Exc f/e/e/n/l mal+mrg 1.1-2,,,682.8,3714.0,2
HCPCS,11643,Exc f/e/e/n/l mal+mrg 2.1-3,,,1592.51,9206.0,2
HCPCS,11643,Hc Exc Malignant Les Face 2.1-3.0 Cm,5046.0,3279.9,,,0
HCPCS,11644,Exc f/e/e/n/l mal+mrg 3.1-4,,,1592.51,9206.0,2
HCPCS,11646,Exc f/e/e/n/l mal+mrg >4 cm,,,2800.79,15689.0,2
HCPCS,11719,Hc Trim Of Nondystrophic Nails,187.0,121.55,,,0
HCPCS,11719,Trim nail(s) any number,,,56.88,3714.0,2
HCPCS,11720,Debride nail 1-5,,,56.88,3714.0,2
HCPCS,11720,Hc Debr Nails Up To 5,560.0,364.0,,,0
HCPCS,11721,Debride nail 6 or more,,,56.88,3714.0,2
HCPCS,11721,Hc Debr Nails 6 Or More,840.0,546.0,,,0
HCPCS,11730,Hc Avulsion Nail Plate Single,898.0,583.7,,,0
HCPCS,11730,Removal of nail plate,,,193.46,3714.0,2
HCPCS,11732,Hc Avulsion Nail Plate Each Addl,546.0,354.9,,,0
HCPCS,11740,Drain blood from under nail,,,128.29,3714.0,2
HCPCS,11740,Hc Evacuation Subungual Hematoma,894.0,581.1,,,0
HCPCS,11750,Hc Excision Nail And Matrix,1356.0,881.4,,,0
HCPCS,11750,Removal of nail bed,,,391.97,3714.0,2
HCPCS,11755,Biopsy nail unit,,,682.8,3714.0,2
HCPCS,11760,Hc Repair Nail Bed,935.0,607.75,,,0
HCPCS,11760,Repair of nail bed,,,712.63,3714.0,2
HCPCS,11762,Reconstruction of nail bed,,,1989.46,9206.0,2
HCPCS,11765,Excision of nail fold toe,,,391.97,3714.0,2
HCPCS,11765,Hc Excision Nail Fold Toe,1205.0,783.25,,,0
HCPCS,11770,Remove pilonidal cyst simple,,,2800.79,15689.0,2
HCPCS,11771,Remove pilonidal cyst exten,,,2800.79,15689.0,2
HCPCS,11772,Remove pilonidal cyst compl,,,2800.79,15689.0,2
HCPCS,11900,Hc Inject Skin Lesions 7 Or Less,907.0,589.55,,,0
HCPCS,11900,Inject skin lesions <=w 7,,,193.46,3714.0,2
HCPCS,11901,Inject skin lesions >7,,,193.46,3714.0,2
HCPCS,11920,Correct skin color 6.0 cm/<,,,712.63,3714.0,2
HCPCS,11921,Correct skn color 6.1-20.0cm,,,712.63,3714.0,2
HCPCS,11950,Tx contour defects 1 cc/<,,,193.46,3714.0,2
HCPCS,11951,Tx contour defects 1.1-5.0cc,,,712.63,3714.0,2
HCPCS,11952,Tx contour defects 5.1-10cc,,,712.63,3714.0,2
HCPCS,11954,Tx contour defects >10.0 cc,,,712.63,3714.0,2
HCPCS,11960,Insert tissue expander(s),,,3416.94,15689.0,2
HCPCS,11970,Replace tissue expander,,,6996.6,31685.0,2
HCPCS,11971,Remove tissue expander(s),,,2800.79,15689.0,2
HCPCS,11976,Hc Removal Contraceptive Capsule,1168.0,759.2,,,0
HCPCS,11976,Remove contraceptive capsule,,,682.8,3714.0,2
HCPCS,11980,Implant hormone pellet(s),,,430.74,3714.0,2
HCPCS,11981,Hc Insertion Contraceptive Capsule,1168.0,759.2,,,0
HCPCS,11981,Insert drug implant device,,,128.29,3714.0,2
HCPCS,11982,Hc Removal Nonbiodegrad Drug Delivery Implant,7338.0,4769.7,,,0
HCPCS,11982,Remove drug implant device,,,430.74,3714.0,2
HCPCS,11983,Remove/insert drug implant,,,430.74,3714.0,2
HCPCS,12001,Rpr s/n/ax/gen/trnk 2.5cm/<,,,193.46,3714.0,2
HCPCS,12002,Rpr s/n/ax/gen/trnk2.6-7.5cm,,,193.46,3714.0,2
HCPCS,12004,Rpr s/n/ax/gen/trk7.6-12.5cm,,,193.46,3714.0,2
HCPCS,12005,Rpr s/n/a/gen/trk12.6-20.0cm,,,391.97,3714.0,2
HCPCS,12006,Rpr s/n/a/gen/trk20.1-30.0cm,,,391.97,3714.0,2
HCPCS,12007,Rpr s/n/ax/gen/trnk >30.0 cm,,,193.46,3714.0,2
HCPCS,12011,Rpr f/e/e/n/l/m 2.5 cm/<,,,193.46,3714.0,2
HCPCS,12013,Rpr f/e/e/n/l/m 2.6-5.0 cm,,,193.46,3714.0,2
HCPCS,12014,Rpr f/e/e/n/l/m 5.1-7.5 cm,,,193.46,3714.0,2
HCPCS,12015,Rpr f/e/e/n/l/m 7.6-12.5 cm,,,193.46,3714.0,2
HCPCS,12016,Rpr fe/e/en/l/m 12.6-20.0 cm,,,391.97,3714.0,2
HCPCS,12017,Rpr fe/e/en/l/m 20.1-30.0 cm,,,391.97,3714.0,2
HCPCS,12018,Rpr f/e/e/n/l/m >30.0 cm,,,193.46,3714.0,2
HCPCS,12020,Closure of split wound,,,712.63,3714.0,2
HCPCS,12020,Hc Treatment Superficial Wound Dehiscence Simple,918.0,596.7,,,0
HCPCS,12021,Closure of split wound,,,391.97,3714.0,2
HCPCS,12031,Hc Lac Repair Intermediate,1345.0,874.25,,,0
HCPCS,12031,Intmd rpr s/a/t/ext 2.5 cm/<,,,391.97,3714.0,2
HCPCS,12032,Intmd rpr s/a/t/ext 2.6-7.5,,,391.97,3714.0,2
HCPCS,12034,Intmd rpr s/tr/ext 7.6-12.5,,,391.97,3714.0,2
HCPCS,12035,Intmd rpr s/a/t/ext 12.6-20,,,391.97,3714.0,2
HCPCS,12036,Intmd rpr s/a/t/ext 20.1-30,,,712.63,3714.0,2
HCPCS,12037,Intmd rpr s/tr/ext >30.0 cm,,,1989.46,9206.0,2
HCPCS,12041,Hc Intermed Wnd Repair H N F G 2.5Cm Or Less,1040.0,676.0,,,0
HCPCS,12041,Intmd rpr n-hf/genit 2.5cm/<,,,391.97,3714.0,2
HCPCS,12042,Hc Intermediate Wnd Repair N H F G 2.6-7.0 Cm,1248.0,811.2,,,0
HCPCS,12042,Intmd rpr n-hf/genit2.6-7.5,,,391.97,3714.0,2
HCPCS,12044,Intmd rpr n-hf/genit7.6-12.5,,,712.63,3714.0,2
HCPCS,12045,Intmd rpr n-hf/genit12.6-20,,,712.63,3714.0,2
HCPCS,12046,Intmd rpr n-hf/genit20.1-30,,,712.63,3714.0,2
HCPCS,12047,Intmd rpr n-hf/genit >30.0cm,,,1989.46,9206.0,2
HCPCS,12051,Intmd rpr face/mm 2.5 cm/<,,,391.97,3714.0,2
HCPCS,12052,Intmd rpr face/mm 2.6-5.0 cm,,,391.97,3714.0,2
HCPCS,12053,Intmd rpr face/mm 5.1-7.5 cm,,,391.97,3714.0,2
HCPCS,12054,Intmd rpr face/mm 7.6-12.5cm,,,391.97,3714.0,2
HCPCS,12055,Intmd rpr face/mm 12.6-20 cm,,,391.97,3714.0,2
HCPCS,12056,Intmd rpr face/mm 20.1-30.0,,,391.97,3714.0,2
HCPCS,12057,Intmd rpr face/mm >30.0 cm,,,391.97,3714.0,2
HCPCS,13100,Cmplx rpr trunk 1.1-2.5 cm,,,712.63,3714.0,2
HCPCS,13101,Cmplx rpr trunk 2.6-7.5 cm,,,712.63,3714.0,2
HCPCS,13120,Cmplx rpr s/a/l 1.1-2.5 cm,,,391.97,3714.0,2
HCPCS,13121,Cmplx rpr s/a/l 2.6-7.5 cm,,,391.97,3714.0,2
HCPCS,13131,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,391.97,3714.0,2
HCPCS,13132,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,391.97,3714.0,2
HCPCS,13151,Cmplx rpr e/n/e/l 1.1-2.5 cm,,,712.63,3714.0,2
HCPCS,13152,Cmplx rpr e/n/e/l 2.6-7.5 cm,,,712.63,3714.0,2
HCPCS,13160,Hc Secondary Closure Surg Wound,2906.0,1888.9,,,0
HCPCS,13160,Late closure of wound,,,3416.94,9206.0,2
HCPCS,14000,Tis trnfr trunk 10 sq cm/<,,,1989.46,9206.0,2
HCPCS,14001,Tis trnfr trunk 10.1-30sqcm,,,1989.46,9206.0,2
HCPCS,14020,Tis trnfr s/a/l 10 sq cm/<,,,1989.46,9206.0,2
HCPCS,14021,Tis trnfr s/a/l 10.1-30 sqcm,,,1989.46,9206.0,2
HCPCS,14040,Tis trnfr f/c/c/m/n/a/g/h/f,,,1989.46,9206.0,2
HCPCS,14041,Tis trnfr f/c/c/m/n/a/g/h/f,,,1989.46,9206.0,2
HCPCS,14060,Tis trnfr e/n/e/l 10 sq cm/<,,,1989.46,9206.0,2
HCPCS,14061,Tis trnfr e/n/e/l10.1-30sqcm,,,1989.46,9206.0,2
HCPCS,14301,Tis trnfr any 30.1-60 sq cm,,,3416.94,15689.0,2
HCPCS,14350,Filleted finger/toe flap,,,1989.46,9206.0,2
HCPCS,15002,Wound prep trk/arm/leg,,,712.63,9206.0,2
HCPCS,15004,Wound prep f/n/hf/g,,,391.97,3714.0,2
HCPCS,15011,Hrv skn cll ssp agrft 1st 25,,,1989.46,9206.0,2
HCPCS,15013,Prepj skn cll ssp agrft 1st,,,3714.0,6842.88,2
HCPCS,15015,App skn cl ssp agrft t/a/l 1,,,1989.46,9206.0,2
HCPCS,15017,App skn cll ssp f/n/g/hf 1st,,,1989.46,9206.0,2
HCPCS,15040,Harvest cultured skin graft,,,1989.46,9206.0,2
HCPCS,15050,Skin pinch graft,,,712.63,3714.0,2
HCPCS,15100,Skin splt grft trnk/arm/leg,,,1989.46,9206.0,2
HCPCS,15110,Epidrm autogrft trnk/arm/leg,,,1989.46,9206.0,2
HCPCS,15115,Epidrm a-grft face/nck/hf/g,,,1989.46,9206.0,2
HCPCS,15120,Skn splt a-grft fac/nck/hf/g,,,3416.94,15689.0,2
HCPCS,15130,Derm autograft trnk/arm/leg,,,1989.46,9206.0,2
HCPCS,15135,Derm autograft face/nck/hf/g,,,3416.94,15689.0,2
HCPCS,15150,Cult skin grft t/arm/leg,,,1989.46,9206.0,2
HCPCS,15155,Cult skin graft f/n/hf/g,,,3416.94,15689.0,2
HCPCS,15200,Skin full graft trunk,,,1989.46,9206.0,2
HCPCS,15220,Skin full graft sclp/arm/leg,,,1989.46,9206.0,2
HCPCS,15240,Skin full grft face/genit/hf,,,1989.46,9206.0,2
HCPCS,15260,Skin full graft een & lips,,,1989.46,9206.0,2
HCPCS,15271,Hc High Cost  Applic Ss Tal 1St 25 Up To 100 Sq Cm,3263.0,2120.95,,,0
HCPCS,15271,Skin sub graft trnk/arm/leg,,,712.63,9206.0,2
HCPCS,15272,Hc High Cost Applic Ss Tal Addl 25 Up To 100 Sq Cm,3526.0,2291.9,,,0
HCPCS,15273,Hc High Cost Applic Ss Tal 1St 100Sq Cm More Than 100Sq Cm,4325.0,2811.25,,,0
HCPCS,15273,Skin sub grft t/arm/lg child,,,1989.46,15689.0,2
HCPCS,15274,Hc High Cost Applic Ss Tal Addl 100 Sq Cm,4772.0,3101.8,,,0
HCPCS,15275,Hc High Cost Applic Ss Hhfg 1St 25 Up To 100 Sqcm,3305.0,2148.25,,,0
HCPCS,15275,Skin sub graft face/nk/hf/g,,,712.63,9206.0,2
HCPCS,15276,Hc High Cost Applic Ss Hhfg Addl 25 Up To 100 Sqcm,3892.0,2529.8,,,0
HCPCS,15277,Hc High Cost Applic Ss Hhfg 1St 100=>100Sq Cm,5561.0,3614.65,,,0
HCPCS,15277,Skn sub grft f/n/hf/g child,,,1989.46,9206.0,2
HCPCS,15278,Hc High Cost Applic Ss Hhfg Addl 100=>100Sq Cm,4772.0,3101.8,,,0
HCPCS,15570,Skin pedicle flap trunk,,,1989.46,9206.0,2
HCPCS,15572,Skin pedicle flap arms/legs,,,3416.94,15689.0,2
HCPCS,15574,Pedcle fh/ch/ch/m/n/ax/g/h/f,,,1989.46,9206.0,2
HCPCS,15576,Pedicle e/n/e/l/ntroral,,,1989.46,9206.0,2
HCPCS,15600,Delay flap trunk,,,3416.94,15689.0,2
HCPCS,15610,Delay flap arms/legs,,,1989.46,9206.0,2
HCPCS,15620,Delay flap f/c/c/n/ax/g/h/f,,,1989.46,9206.0,2
HCPCS,15630,Delay flap eye/nos/ear/lip,,,1989.46,9206.0,2
HCPCS,15650,Transfer skin pedicle flap,,,1989.46,9206.0,2
HCPCS,15730,Mdfc flap w/prsrv vasc pedcl,,,3416.94,15689.0,2
HCPCS,15731,Forehead Flap w/Vasc Pedicle,,,3416.94,15689.0,2
HCPCS,15733,Musc myoq/fscq flp h&n pedcl,,,3416.94,15689.0,2
HCPCS,15734,Muscle-skin graft trunk,,,3416.94,15689.0,2
HCPCS,15736,Muscle-skin graft arm,,,1989.46,9206.0,2
HCPCS,15738,Muscle-skin graft leg,,,3416.94,15689.0,2
HCPCS,15740,Island pedicle flap graft,,,1989.46,9206.0,2
HCPCS,15750,Neurovascular pedicle flap,,,3416.94,15689.0,2
HCPCS,15756,Free myo/skin flap microvasc,,,15689.0,15689.0,1
HCPCS,15757,Free skin flap microvasc,,,15689.0,15689.0,1
HCPCS,15758,Free fascial flap microvasc,,,15689.0,15689.0,1
HCPCS,15760,Composite skin graft,,,1989.46,9206.0,2
HCPCS,15769,Grfg autol soft tiss dir exc,,,3416.94,15689.0,2
HCPCS,15770,Derma-fat-fascia graft,,,3416.94,15689.0,2
HCPCS,15771,Grfg autol fat lipo 50 cc/<,,,3416.94,15689.0,2
HCPCS,15773,Grfg autol fat lipo 25 cc/<,,,1989.46,9206.0,2
HCPCS,15775,Hair trnspl 1-15 punch grfts,,,391.97,3714.0,2
HCPCS,15776,Hair trnspl >15 punch grafts,,,391.97,3714.0,2
HCPCS,15778,Impl absrb msh/prsth dly cls,,,38216.0,38216.0,1
HCPCS,15780,Dermabrasion total face,,,2800.79,15689.0,2
HCPCS,15781,Dermabrasion segmental face,,,682.8,3714.0,2
HCPCS,15782,Dermabrasion other than face,,,2800.79,9206.0,2
HCPCS,15783,Dermabrasion suprfl any site,,,391.97,3714.0,2
HCPCS,15786,Abrasion lesion single,,,193.46,3714.0,2
HCPCS,15788,Chemical peel face epiderm,,,391.97,3714.0,2
HCPCS,15789,Chemical peel face dermal,,,712.63,3714.0,2
HCPCS,15792,Chemical peel nonfacial,,,712.63,3714.0,2
HCPCS,15793,Chemical peel nonfacial,,,391.97,3714.0,2
HCPCS,15819,Plastic surgery neck,,,9206.0,9206.0,1
HCPCS,15820,Revision of lower eyelid,,,1989.46,9206.0,2
HCPCS,15821,Revision of lower eyelid,,,1989.46,9206.0,2
HCPCS,15822,Revision of upper eyelid,,,1989.46,9206.0,2
HCPCS,15823,Revision of upper eyelid,,,1989.46,9206.0,2
HCPCS,15824,Removal of forehead wrinkles,,,1989.46,9206.0,2
HCPCS,15825,Removal of neck wrinkles,,,3416.94,15689.0,2
HCPCS,15826,Removal of brow wrinkles,,,3416.94,15689.0,2
HCPCS,15828,Removal of face wrinkles,,,3416.94,15689.0,2
HCPCS,15829,Removal of skin wrinkles,,,3416.94,15689.0,2
HCPCS,15830,Exc Skin Abd,,,6402.59,30765.0,2
HCPCS,15832,Excise excessive skin thigh,,,2800.79,15689.0,2
HCPCS,15833,Excise excessive skin leg,,,2800.79,15689.0,2
HCPCS,15834,Excise excessive skin hip,,,2800.79,15689.0,2
HCPCS,15835,Excise excessive skin buttck,,,2800.79,15689.0,2
HCPCS,15836,Excise excessive skin arm,,,2800.79,15689.0,2
HCPCS,15837,Excise excess skin arm/hand,,,2800.79,15689.0,2
HCPCS,15838,Excise excess skin fat pad,,,2800.79,15689.0,2
HCPCS,15839,Excise excess skin & tissue,,,2800.79,15689.0,2
HCPCS,15840,Nerve palsy fascial graft,,,3416.94,15689.0,2
HCPCS,15841,Nerve palsy muscle graft,,,3416.94,15689.0,2
HCPCS,15842,Nerve palsy microsurg graft,,,1989.46,9206.0,2
HCPCS,15845,Skin and muscle repair face,,,3416.94,15689.0,2
HCPCS,15850,Remove sutures same surgeon,,,3714.0,3714.0,1
HCPCS,15851,Remove sutures diff surgeon,,,1989.46,9206.0,2
HCPCS,15852,Dressing change not for burn,,,712.63,3714.0,2
HCPCS,15853,Hc Removal Sutures Or Staples Wo Anes,72.0,46.8,,,0
HCPCS,15854,Hc Removal Sutures And Staples Wo Anes,72.0,46.8,,,0
HCPCS,15860,Test for blood flow in graft,,,430.74,3714.0,2
HCPCS,15876,Suction lipectomy head&neck,,,3416.94,15689.0,2
HCPCS,15877,Suction lipectomy trunk,,,3416.94,15689.0,2
HCPCS,15878,Suction lipectomy upr extrem,,,1989.46,9206.0,2
HCPCS,15879,Suction lipectomy lwr extrem,,,3416.94,15689.0,2
HCPCS,15920,Removal of tail bone ulcer,,,2800.79,15689.0,2
HCPCS,15922,Removal of tail bone ulcer,,,3416.94,15689.0,2
HCPCS,15931,Remove sacrum pressure sore,,,2800.79,9206.0,2
HCPCS,15933,Remove sacrum pressure sore,,,2800.79,15689.0,2
HCPCS,15934,Remove sacrum pressure sore,,,3416.94,15689.0,2
HCPCS,15935,Remove sacrum pressure sore,,,3416.94,15689.0,2
HCPCS,15936,Remove sacrum pressure sore,,,1989.46,9206.0,2
HCPCS,15937,Remove sacrum pressure sore,,,1989.46,9206.0,2
HCPCS,15940,Remove hip pressure sore,,,2800.79,15689.0,2
HCPCS,15941,Remove hip pressure sore,,,2800.79,15689.0,2
HCPCS,15944,Remove hip pressure sore,,,3416.94,15689.0,2
HCPCS,15945,Remove hip pressure sore,,,1989.46,9206.0,2
HCPCS,15946,Remove hip pressure sore,,,1989.46,9206.0,2
HCPCS,15950,Remove thigh pressure sore,,,1592.51,9206.0,2
HCPCS,15951,Remove thigh pressure sore,,,2800.79,15689.0,2
HCPCS,15952,Remove thigh pressure sore,,,1989.46,9206.0,2
HCPCS,15953,Remove thigh pressure sore,,,3416.94,15689.0,2
HCPCS,15956,Remove thigh pressure sore,,,1989.46,9206.0,2
HCPCS,15958,Remove thigh pressure sore,,,3416.94,15689.0,2
HCPCS,15999,Removal of pressure sore,,,682.8,16564.0,2
HCPCS,16000,Hc Treatment Burn Initial,1314.0,854.1,,,0
HCPCS,16000,Initial treatment of burn(s),,,193.46,3714.0,2
HCPCS,16020,Dress/debrid p-thick burn s,,,193.46,3714.0,2
HCPCS,16020,Hc Dress Or Debr Burn Wo Anes Small,553.0,359.45,,,0
HCPCS,16025,Dress/debrid p-thick burn m,,,193.46,3714.0,2
HCPCS,16025,Hc Dress Or Debr Burn Wo Anes Medium,1136.0,738.4,,,0
HCPCS,16030,Dress/debrid p-thick burn l,,,391.97,3714.0,2
HCPCS,16030,Hc Dress Or Debr Burn Wo Anes Large,1470.0,955.5,,,0
HCPCS,16035,Incision of burn scab initi,,,391.97,3714.0,2
HCPCS,16036,Escharotomy addl incision,,,3714.0,3714.0,1
HCPCS,17000,Destruct premalg lesion,,,193.46,3714.0,2
HCPCS,17004,Destroy premal lesions 15/>,,,391.97,3714.0,2
HCPCS,17106,Destruction of skin lesions,,,391.97,3714.0,2
HCPCS,17107,Destruction of skin lesions,,,712.63,3714.0,2
HCPCS,17108,Destruction of skin lesions,,,1989.46,9206.0,2
HCPCS,17110,Destruct b9 lesion 1-14,,,193.46,3714.0,2
HCPCS,17110,Hc Destruction Flat Warts <15,1002.0,651.3,,,0
HCPCS,17111,Destruct lesion 15 or more,,,193.46,3714.0,2
HCPCS,17250,Chemical cautery tissue,,,193.46,3714.0,2
HCPCS,17250,Hc Cauterize Tissue Chemical,466.0,302.9,,,0
HCPCS,17260,Destruction of skin lesions,,,193.46,3714.0,2
HCPCS,17261,Destruction of skin lesions,,,193.46,3714.0,2
HCPCS,17262,Destruction of skin lesions,,,193.46,3714.0,2
HCPCS,17263,Destruction of skin lesions,,,193.46,3714.0,2
HCPCS,17264,Destruction of skin lesions,,,391.97,3714.0,2
HCPCS,17266,Destruction of skin lesions,,,391.97,3714.0,2
HCPCS,17270,Destruction of skin lesions,,,193.46,3714.0,2
HCPCS,17271,Destruction of skin lesions,,,193.46,3714.0,2
HCPCS,17272,Destruction of skin lesions,,,193.46,3714.0,2
HCPCS,17273,Destruction of skin lesions,,,391.97,3714.0,2
HCPCS,17274,Destruction of skin lesions,,,391.97,3714.0,2
HCPCS,17276,Destruction of skin lesions,,,391.97,3714.0,2
HCPCS,17280,Destruction of skin lesions,,,193.46,3714.0,2
HCPCS,17281,Destruction of skin lesions,,,193.46,3714.0,2
HCPCS,17282,Destruction of skin lesions,,,193.46,3714.0,2
HCPCS,17283,Destruction of skin lesions,,,391.97,3714.0,2
HCPCS,17284,Destruction of skin lesions,,,712.63,3714.0,2
HCPCS,17286,Destruction of skin lesions,,,712.63,3714.0,2
HCPCS,17311,Mohs 1 stage h/n/hf/g,,,712.63,3714.0,2
HCPCS,17313,Mohs 1 stage t/a/l,,,712.63,3714.0,2
HCPCS,17340,Cryotherapy of skin,,,56.88,3714.0,2
HCPCS,17360,Skin peel therapy,,,193.46,3714.0,2
HCPCS,17380,Hair removal by electrolysis,,,712.63,3714.0,2
HCPCS,17999,Hc Unlisted Procedure Skin Or Tissue,2402.0,1561.3,,,0
HCPCS,17999,Skin tissue procedure,,,193.46,16564.0,2
HCPCS,19000,Drainage of breast lesion,,,682.8,3714.0,2
HCPCS,19000,Hc Aspiration Cyst Breast Initial,1030.0,669.5,,,0
HCPCS,19001,Hc Aspiration Cyst Breast Addl,572.0,371.8,,,0
HCPCS,19020,Hc Incision Of Breast Lesion W Exploration Or Drainage,5812.0,3777.8,,,0
HCPCS,19020,Incision of breast lesion,,,1592.51,9206.0,2
HCPCS,19030,Hc Inj Ductogram Or Galactogram,4743.0,3082.9500000000003,,,0
HCPCS,19081,Bx breast 1st lesion strtctc,,,1592.51,9206.0,2
HCPCS,19081,Hc Bx Breast W Device Stereotactic 1St Les5,5923.0,3849.95,,,0
HCPCS,19082,Hc Bx Breast W Device Stereotactic Addl Les,1584.0,1029.6,,,0
HCPCS,19083,Bx breast 1st lesion us imag,,,1592.51,9206.0,2
HCPCS,19083,Hc Bx Breast W Device Us Guidance 1St Les,5923.0,3849.95,,,0
HCPCS,19084,Hc Bx Breast W Device Us Guidance Addl Les,1584.0,1029.6,,,0
HCPCS,19085,Bx breast 1st lesion mr imag,,,1592.51,9206.0,2
HCPCS,19085,Hc Bx Breast W Device Mr Guidance 1St Les,5408.0,3515.2,,,0
HCPCS,19086,Hc Bx Breast W Device Mr Guidance Addl Les,1584.0,1029.6,,,0
HCPCS,19100,Bx breast percut w/o image,,,1592.51,9206.0,2
HCPCS,19100,Hc Bx Breast Percutaneous Wo Img,1836.0,1193.4,,,0
HCPCS,19101,Biopsy of breast open,,,3775.35,15689.0,2
HCPCS,19105,Cryosurg ablate fa each,,,3775.35,15689.0,2
HCPCS,19110,Nipple exploration,,,3775.35,15689.0,2
HCPCS,19112,Excise breast duct fistula,,,3775.35,15689.0,2
HCPCS,19120,Removal of breast lesion,,,3775.35,15689.0,2
HCPCS,19125,Excision breast lesion,,,3775.35,15689.0,2
HCPCS,19281,Hc Plc Breast Lcl Device W Mammo Guid 1St Les,3086.0,2005.9,,,0
HCPCS,19281,Perq device breast 1st imag,,,1592.51,3714.0,2
HCPCS,19282,Hc Plc Breast Lcl Device W Mammo Guid Addl Les,788.0,512.2,,,0
HCPCS,19283,Hc Plc Breast Lcl Device Stereotactic 1St Les,1340.0,871.0,,,0
HCPCS,19283,Perq dev breast 1st strtctc,,,682.8,3714.0,2
HCPCS,19284,Hc Plc Breast Lcl Device Stereotactic Addl Les,802.0,521.3,,,0
HCPCS,19285,Hc Plc Breast Lcl Device Us Guidance 1St Les,1340.0,871.0,,,0
HCPCS,19285,Perq dev breast 1st us imag,,,682.8,3714.0,2
HCPCS,19286,Hc Plc Breast Lcl Device Us Guidance Addl Les,788.0,512.2,,,0
HCPCS,19287,Perq dev breast 1st mr guide,,,682.8,3714.0,2
HCPCS,19296,Place po breast cath for rad,,,7880.96,38216.0,2
HCPCS,19298,Place breast rad tube/caths,,,13287.89,30765.0,2
HCPCS,19300,Removal of Breast Tissue,,,3775.35,15689.0,2
HCPCS,19301,Partial Mastectomy,,,3775.35,15689.0,2
HCPCS,19302,P-Mastectomy w/LN Removal,,,6402.59,30765.0,2
HCPCS,19303,Mast simple complete,,,6402.59,30765.0,2
HCPCS,19305,Mast radical,,,30765.0,30765.0,1
HCPCS,19306,Mast rad urban type,,,30765.0,30765.0,1
HCPCS,19307,Mast mod rad,,,6402.59,30765.0,2
HCPCS,19316,Suspension of breast,,,6402.59,30765.0,2
HCPCS,19318,Reduction of large breast,,,6402.59,30765.0,2
HCPCS,19325,Enlarge breast with implant,,,7880.96,38216.0,2
HCPCS,19328,Removal of breast implant,,,3775.35,15689.0,2
HCPCS,19330,Removal of implant material,,,3775.35,15689.0,2
HCPCS,19340,Immediate breast prosthesis,,,7880.96,30765.0,2
HCPCS,19342,Delayed breast prosthesis,,,7880.96,38216.0,2
HCPCS,19350,Breast reconstruction,,,3775.35,15689.0,2
HCPCS,19355,Correct inverted nipple(s),,,3775.35,15689.0,2
HCPCS,19357,Breast reconstruction,,,13287.89,38216.0,2
HCPCS,19361,Breast reconstr w/lat flap,,,30765.0,30765.0,1
HCPCS,19364,Breast reconstruction,,,30765.0,30765.0,1
HCPCS,19367,Breast reconstruction,,,30765.0,30765.0,1
HCPCS,19368,Breast reconstruction,,,30765.0,30765.0,1
HCPCS,19369,Breast reconstruction,,,30765.0,30765.0,1
HCPCS,19370,Surgery of breast capsule,,,3775.35,15689.0,2
HCPCS,19371,Removal of breast capsule,,,3775.35,15689.0,2
HCPCS,19380,Revise breast reconstruction,,,6402.59,30765.0,2
HCPCS,19396,Design custom breast implant,,,3775.35,15689.0,2
HCPCS,19499,Breast surgery procedure,,,3775.35,16564.0,2
HCPCS,20100,Explore wound neck,,,520.03,3714.0,2
HCPCS,20101,Explore wound chest,,,1989.46,9206.0,2
HCPCS,20102,Explore wound abdomen,,,1989.46,9206.0,2
HCPCS,20103,Explore wound extremity,,,1592.51,3714.0,2
HCPCS,20103,Hc Exploration Penetrating Wnd Extremity,1296.0,842.4,,,0
HCPCS,20150,Excise epiphyseal bar,,,3154.93,15689.0,2
HCPCS,20200,Muscle biopsy,,,1592.51,9206.0,2
HCPCS,20205,Deep muscle biopsy,,,2800.79,15689.0,2
HCPCS,20206,Hc Biopsy Muscle Percutaneous,4861.0,3159.65,,,0
HCPCS,20206,Needle biopsy muscle,,,1592.51,9206.0,2
HCPCS,20220,Bone biopsy trocar/needle,,,1592.51,9206.0,2
HCPCS,20220,Hc Biopsy Bone Superficial,4861.0,3159.65,,,0
HCPCS,20225,Bone biopsy trocar/needle,,,1592.51,9206.0,2
HCPCS,20225,Hc Biopsy Bone Deep,5850.0,3802.5,,,0
HCPCS,20240,Bone biopsy open superficial,,,2800.79,15689.0,2
HCPCS,20240,Hc Biopsy Bone Open Superficial,4861.0,3159.65,,,0
HCPCS,20245,Bone biopsy open deep,,,2800.79,15689.0,2
HCPCS,20250,Open bone biopsy,,,3154.93,15689.0,2
HCPCS,20251,Open bone biopsy,,,6996.6,31685.0,2
HCPCS,20500,Hc Injection Sinus Tract Tx,2854.0,1855.1,,,0
HCPCS,20500,Injection of sinus tract,,,1496.07,9206.0,2
HCPCS,20501,Hc Injection Sinus Tract Dx,5795.0,3766.75,,,0
HCPCS,20520,Hc Rem Fb Muscle Or Tendon Sheath Simple,4115.0,2674.75,,,0
HCPCS,20520,Removal of foreign body,,,1592.51,9206.0,2
HCPCS,20525,Hc Rem Fb Muscle Or Tendon Sheath Complex,5094.0,3311.1,,,0
HCPCS,20525,Removal of foreign body,,,2800.79,15689.0,2
HCPCS,20526,Hc Injection Carpal Tunnel,2085.0,1355.25,,,0
HCPCS,20526,Ther injection carp tunnel,,,295.97,3714.0,2
HCPCS,20527,Inj dupuytren cord w/enzyme,,,295.97,3714.0,2
HCPCS,20550,Hc Inj Single Tendon Sheath Or Ligament,2100.0,1365.0,,,0
HCPCS,20550,Inj tendon sheath/ligament,,,295.97,3714.0,2
HCPCS,20551,Hc Tendon Origin Insertion,1400.0,910.0,,,0
HCPCS,20551,Inj tendon origin/insertion,,,295.97,3714.0,2
HCPCS,20552,Hc Inj Trigger Point 1 Or 2 Muscles,1686.0,1095.9,,,0
HCPCS,20552,Inj trigger point 1/2 muscl,,,295.97,3714.0,2
HCPCS,20553,Hc Inj Trigger Point 3 Or More Muscles,2248.0,1461.2,,,0
HCPCS,20553,Inject trigger points 3/>,,,295.97,3714.0,2
HCPCS,20555,Place ndl musc/tis for rt,,,3154.93,15689.0,2
HCPCS,20560,Hc Needle Insertion Without Injection 1 Or 2 Muscles,35.0,22.75,,,0
HCPCS,20560,Ndl insj w/o njx 1 or 2 musc,,,27.89,3714.0,2
HCPCS,20561,Hc Needle Insertion Without Injection 3 Or More Muscles,50.0,32.5,,,0
HCPCS,20561,Ndl insj w/o njx 3+ musc,,,27.89,3714.0,2
HCPCS,20600,Drain/inj joint/bursa w/o us,,,295.97,3714.0,2
HCPCS,20600,Hc Asp Or Inj Joint Small,3889.5,2528.175,,,0
HCPCS,20604,Drain/inj joint/bursa w/us,,,295.97,3714.0,2
HCPCS,20604,Hc Asp Or Inj Joint Small W Us Guidance,5305.5,3448.5750000000003,,,0
HCPCS,20605,Drain/inj joint/bursa w/o us,,,295.97,3714.0,2
HCPCS,20605,Hc Asp Or Inj Joint Intermediate,4276.5,2779.7250000000004,,,0
HCPCS,20606,Drain/inj joint/bursa w/us,,,680.63,3714.0,2
HCPCS,20606,Hc Asp Or Inj Joint Intermediate W Us Guidance,6589.5,4283.174999999999,,,0
HCPCS,20610,Drain/inj joint/bursa w/o us,,,295.97,3714.0,2
HCPCS,20610,Hc Asp Or Inj Joint Large,4663.5,3031.2749999999996,,,0
HCPCS,20611,Drain/inj joint/bursa w/us,,,295.97,3714.0,2
HCPCS,20611,Hc Asp Or Inj Joint Large W Us Guidance,7231.5,4700.475,,,0
HCPCS,20612,Aspirate/inj ganglion cyst,,,295.97,3714.0,2
HCPCS,20612,Hc Asp Or Inj Ganglion Cyst,2219.0,1442.35,,,0
HCPCS,20615,Hc Aspiration And Injection Bone Cyst,1795.0,1166.75,,,0
HCPCS,20615,Treatment of bone cyst,,,682.8,3714.0,2
HCPCS,20650,Insert and remove bone pin,,,3154.93,15689.0,2
HCPCS,20660,Apply rem fixation device,,,1550.46,9206.0,2
HCPCS,20661,Application of head brace,,,1550.46,9206.0,2
HCPCS,20662,Application of pelvis brace,,,1550.46,9206.0,2
HCPCS,20663,Application of thigh brace,,,3154.93,15689.0,2
HCPCS,20664,Application of halo,,,1550.46,9206.0,2
HCPCS,20665,Removal of fixation device,,,430.74,3714.0,2
HCPCS,20670,Hc Removal Implant Superficial,14699.0,9554.35,,,0
HCPCS,20670,Removal of support implant,,,1592.51,9206.0,2
HCPCS,20680,Removal of support implant,,,2800.79,15689.0,2
HCPCS,20690,Apply bone fixation device,,,6996.6,31685.0,2
HCPCS,20692,Apply bone fixation device,,,12379.34,38216.0,2
HCPCS,20693,Adjust bone fixation device,,,6996.6,31685.0,2
HCPCS,20694,Remove bone fixation device,,,1550.46,9206.0,2
HCPCS,20696,Comp multiplane ext fixation,,,26163.21,63079.0,2
HCPCS,20697,Comp ext fixate strut change,,,1550.46,9206.0,2
HCPCS,20802,Replantation arm complete,,,16906.49,31685.0,2
HCPCS,20805,Replant forearm complete,,,16906.49,31685.0,2
HCPCS,20808,Replantation hand complete,,,16906.49,31685.0,2
HCPCS,20816,Replantation digit complete,,,1550.46,31685.0,2
HCPCS,20822,Replantation digit complete,,,1550.46,9206.0,2
HCPCS,20824,Replantation thumb complete,,,1550.46,31685.0,2
HCPCS,20827,Replantation thumb complete,,,1550.46,31685.0,2
HCPCS,20838,Replantation foot complete,,,16906.49,31685.0,2
HCPCS,20900,Removal of bone for graft,,,6996.6,31685.0,2
HCPCS,20902,Removal of bone for graft,,,6996.6,31685.0,2
HCPCS,20910,Remove cartilage for graft,,,712.63,3714.0,2
HCPCS,20912,Remove cartilage for graft,,,3416.94,15689.0,2
HCPCS,20920,Removal of fascia for graft,,,1989.46,9206.0,2
HCPCS,20922,Removal of fascia for graft,,,1989.46,9206.0,2
HCPCS,20924,Removal of tendon for graft,,,6996.6,31685.0,2
HCPCS,20950,Fluid pressure muscle,,,682.8,3714.0,2
HCPCS,20955,Fibula bone graft microvasc,,,6996.6,31685.0,2
HCPCS,20956,Iliac bone graft microvasc,,,6996.6,31685.0,2
HCPCS,20957,Mt bone graft microvasc,,,6996.6,31685.0,2
HCPCS,20962,Other bone graft microvasc,,,6996.6,31685.0,2
HCPCS,20969,Bone/skin graft microvasc,,,6996.6,31685.0,2
HCPCS,20970,Bone/skin graft iliac crest,,,6996.6,31685.0,2
HCPCS,20972,Bone/skin graft metatarsal,,,6996.6,31685.0,2
HCPCS,20973,Bone/skin graft great toe,,,6996.6,31685.0,2
HCPCS,20974,Electrical bone stimulation,,,48.6,3714.0,2
HCPCS,20979,Us bone stimulation,,,27.89,3714.0,2
HCPCS,20982,Ablate bone tumor(s) perq,,,16906.49,31685.0,2
HCPCS,20982,Hc Ct Guided Rf Ablation Bone Tumor,27583.5,17929.275,,,0
HCPCS,20983,Ablate bone tumor(s) perq,,,6996.6,31685.0,2
HCPCS,20983,Hc Cryoablation Bone Tumor W Img,18142.5,11792.625,,,0
HCPCS,20999,Musculoskeletal surgery,,,237.84,16564.0,2
HCPCS,21010,Incision of jaw joint,,,3196.84,9206.0,2
HCPCS,21011,Exc face les sc <2 cm,,,1592.51,9206.0,2
HCPCS,21012,Exc face les sbq 2 cm/>,,,1592.51,9206.0,2
HCPCS,21013,Exc face tum deep < 2 cm,,,1592.51,9206.0,2
HCPCS,21014,Exc face tum deep 2 cm/>,,,2800.79,15689.0,2
HCPCS,21015,Resect face/scalp tum < 2 cm,,,2800.79,15689.0,2
HCPCS,21016,Resect face/scalp tum 2 cm/>,,,2800.79,15689.0,2
HCPCS,21025,Excision of bone lower jaw,,,5708.03,20001.0,2
HCPCS,21026,Excision of facial bone(s),,,5708.03,20001.0,2
HCPCS,21029,Contour of face bone lesion,,,3196.84,9206.0,2
HCPCS,21030,Excise max/zygoma b9 tumor,,,5708.03,20001.0,2
HCPCS,21031,Remove exostosis mandible,,,3196.84,9206.0,2
HCPCS,21032,Remove exostosis maxilla,,,3196.84,9206.0,2
HCPCS,21034,Excise max/zygoma mal tumor,,,5708.03,20001.0,2
HCPCS,21040,Excise mandible lesion,,,3196.84,9206.0,2
HCPCS,21044,Removal of jaw bone lesion,,,5708.03,20001.0,2
HCPCS,21045,Extensive jaw surgery,,,5708.03,20001.0,2
HCPCS,21046,Remove mandible cyst complex,,,5708.03,20001.0,2
HCPCS,21047,Excise lwr jaw cyst w/repair,,,5708.03,20001.0,2
HCPCS,21048,Remove maxilla cyst complex,,,5708.03,20001.0,2
HCPCS,21049,Excis uppr jaw cyst w/repair,,,5708.03,20001.0,2
HCPCS,21050,Removal of jaw joint,,,5708.03,20001.0,2
HCPCS,21060,Remove jaw joint cartilage,,,5708.03,20001.0,2
HCPCS,21070,Remove coronoid process,,,5708.03,20001.0,2
HCPCS,21073,Mnpj of tmj w/anesth,,,1496.07,9206.0,2
HCPCS,21076,Prepare face/oral prosthesis,,,1496.07,9206.0,2
HCPCS,21077,Prepare face/oral prosthesis,,,5708.03,20001.0,2
HCPCS,21079,Prepare face/oral prosthesis,,,3196.84,9206.0,2
HCPCS,21080,Prepare face/oral prosthesis,,,3196.84,9206.0,2
HCPCS,21081,Prepare face/oral prosthesis,,,5708.03,20001.0,2
HCPCS,21082,Prepare face/oral prosthesis,,,3196.84,9206.0,2
HCPCS,21083,Prepare face/oral prosthesis,,,3196.84,9206.0,2
HCPCS,21084,Prepare face/oral prosthesis,,,3196.84,9206.0,2
HCPCS,21085,Prepare face/oral prosthesis,,,228.38,3714.0,2
HCPCS,21086,Prepare face/oral prosthesis,,,3196.84,9206.0,2
HCPCS,21087,Prepare face/oral prosthesis,,,5708.03,20001.0,2
HCPCS,21088,Prepare face/oral prosthesis,,,3196.84,9206.0,2
HCPCS,21089,Prepare face/oral prosthesis,,,228.38,3714.0,2
HCPCS,21100,Maxillofacial fixation,,,5708.03,20001.0,2
HCPCS,21110,Interdental fixation,,,1496.07,9206.0,2
HCPCS,21120,Reconstruction of chin,,,5708.03,20001.0,2
HCPCS,21121,Reconstruction of chin,,,3196.84,9206.0,2
HCPCS,21122,Reconstruction of chin,,,5708.03,20001.0,2
HCPCS,21123,Reconstruction of chin,,,3196.84,9206.0,2
HCPCS,21125,Augmentation lower jaw bone,,,5708.03,20001.0,2
HCPCS,21127,Augmentation lower jaw bone,,,5708.03,20001.0,2
HCPCS,21137,Reduction of forehead,,,3196.84,9206.0,2
HCPCS,21138,Reduction of forehead,,,5708.03,20001.0,2
HCPCS,21139,Reduction of forehead,,,5708.03,20001.0,2
HCPCS,21141,Lefort i-1 piece w/o graft,,,5708.03,20001.0,2
HCPCS,21142,Lefort i-2 piece w/o graft,,,5708.03,20001.0,2
HCPCS,21143,Lefort i-3/> piece w/o graft,,,5708.03,20001.0,2
HCPCS,21145,Lefort i-1 piece w/ graft,,,5708.03,20001.0,2
HCPCS,21146,Lefort i-2 piece w/ graft,,,5708.03,20001.0,2
HCPCS,21147,Lefort i-3/> piece w/ graft,,,5708.03,20001.0,2
HCPCS,21150,Lefort ii anterior intrusion,,,5708.03,20001.0,2
HCPCS,21151,Lefort ii w/bone grafts,,,5708.03,20001.0,2
HCPCS,21154,Lefort iii w/o lefort i,,,5708.03,20001.0,2
HCPCS,21155,Lefort iii w/ lefort i,,,5708.03,20001.0,2
HCPCS,21159,Lefort iii w/fhdw/o lefort i,,,5708.03,20001.0,2
HCPCS,21160,Lefort iii w/fhd w/ lefort i,,,5708.03,20001.0,2
HCPCS,21172,Reconstruct orbit/forehead,,,5708.03,20001.0,2
HCPCS,21175,Reconstruct orbit/forehead,,,5708.03,20001.0,2
HCPCS,21179,Reconstruct entire forehead,,,5708.03,20001.0,2
HCPCS,21180,Reconstruct entire forehead,,,5708.03,20001.0,2
HCPCS,21181,Contour cranial bone lesion,,,5708.03,20001.0,2
HCPCS,21182,Reconstruct cranial bone,,,5708.03,20001.0,2
HCPCS,21183,Reconstruct cranial bone,,,5708.03,20001.0,2
HCPCS,21184,Reconstruct cranial bone,,,5708.03,20001.0,2
HCPCS,21188,Reconstruction of midface,,,5708.03,20001.0,2
HCPCS,21193,Reconst lwr jaw w/o graft,,,5708.03,20001.0,2
HCPCS,21194,Reconst lwr jaw w/graft,,,5708.03,20001.0,2
HCPCS,21195,Reconst lwr jaw w/o fixation,,,5708.03,20001.0,2
HCPCS,21196,Reconst lwr jaw w/fixation,,,5708.03,20001.0,2
HCPCS,21198,Reconstr lwr jaw segment,,,5708.03,20001.0,2
HCPCS,21199,Reconstr Lwr Jaw W/Advance,,,5708.03,16564.0,2
HCPCS,21206,Reconstruct upper jaw bone,,,5708.03,20001.0,2
HCPCS,21208,Augmentation of facial bones,,,5708.03,20001.0,2
HCPCS,21209,Reduction of facial bones,,,5708.03,20001.0,2
HCPCS,21210,Face bone graft,,,5708.03,20001.0,2
HCPCS,21215,Lower jaw bone graft,,,5708.03,20001.0,2
HCPCS,21230,Rib cartilage graft,,,5708.03,20001.0,2
HCPCS,21235,Ear cartilage graft,,,5708.03,20001.0,2
HCPCS,21240,Reconstruction of jaw joint,,,5708.03,20001.0,2
HCPCS,21242,Reconstruction of jaw joint,,,5708.03,20001.0,2
HCPCS,21243,Reconstruction of jaw joint,,,26163.21,63079.0,2
HCPCS,21244,Reconstruction of lower jaw,,,5708.03,20001.0,2
HCPCS,21245,Reconstruction of jaw,,,5708.03,20001.0,2
HCPCS,21246,Reconstruction of jaw,,,5708.03,20001.0,2
HCPCS,21247,Reconstruct lower jaw bone,,,5708.03,20001.0,2
HCPCS,21248,Reconstruction of jaw,,,5708.03,20001.0,2
HCPCS,21249,Reconstruction of jaw,,,5708.03,20001.0,2
HCPCS,21255,Reconstruct lower jaw bone,,,5708.03,20001.0,2
HCPCS,21256,Reconstruction of orbit,,,5708.03,20001.0,2
HCPCS,21260,Revise eye sockets,,,5708.03,20001.0,2
HCPCS,21261,Revise eye sockets,,,5708.03,20001.0,2
HCPCS,21263,Revise eye sockets,,,5708.03,20001.0,2
HCPCS,21267,Revise eye sockets,,,5708.03,20001.0,2
HCPCS,21268,Revise eye sockets,,,5708.03,20001.0,2
HCPCS,21270,Augmentation cheek bone,,,5708.03,20001.0,2
HCPCS,21275,Revision orbitofacial bones,,,5708.03,20001.0,2
HCPCS,21280,Revision of eyelid,,,3196.84,9206.0,2
HCPCS,21282,Revision of eyelid,,,3196.84,9206.0,2
HCPCS,21295,Revision of jaw muscle/bone,,,1496.07,9206.0,2
HCPCS,21296,Revision of jaw muscle/bone,,,3196.84,9206.0,2
HCPCS,21299,Cranio/maxillofacial surgery,,,228.38,16564.0,2
HCPCS,21315,Closed tx nose fx w/o stablj,,,1496.07,9206.0,2
HCPCS,21320,Closed tx nose fx w/ stablj,,,3196.84,9206.0,2
HCPCS,21325,Open tx nose fx uncomplicatd,,,3196.84,9206.0,2
HCPCS,21330,Open tx nose fx w/skele fixj,,,5708.03,20001.0,2
HCPCS,21335,Open tx nose & septal fx,,,3196.84,9206.0,2
HCPCS,21336,Open tx septal fx w/wo stabj,,,3154.93,15689.0,2
HCPCS,21337,Closed tx septal&nose fx,,,3196.84,9206.0,2
HCPCS,21338,Open nasoethmoid fx w/o fixj,,,5708.03,20001.0,2
HCPCS,21339,Open nasoethmoid fx w/ fixj,,,5708.03,20001.0,2
HCPCS,21340,Perq tx nasoethmoid fx,,,3196.84,9206.0,2
HCPCS,21343,Open tx dprsd front sinus fx,,,5708.03,20001.0,2
HCPCS,21344,Open tx compl front sinus fx,,,5708.03,20001.0,2
HCPCS,21345,Closed tx nose/jaw fx,,,1496.07,9206.0,2
HCPCS,21346,Opn tx nasomax fx w/fixj,,,5708.03,20001.0,2
HCPCS,21347,Opn tx nasomax fx multple,,,5708.03,20001.0,2
HCPCS,21348,Opn tx nasomax fx w/graft,,,5708.03,20001.0,2
HCPCS,21355,Perq tx malar fracture,,,3196.84,9206.0,2
HCPCS,21356,Opn tx dprsd zygomatic arch,,,5708.03,20001.0,2
HCPCS,21360,Opn tx dprsd malar fracture,,,5708.03,20001.0,2
HCPCS,21365,Opn tx complx malar fx,,,5708.03,20001.0,2
HCPCS,21366,Opn tx complx malar w/grft,,,5708.03,20001.0,2
HCPCS,21385,Opn tx orbit fx transantral,,,5708.03,20001.0,2
HCPCS,21386,Opn tx orbit fx periorbital,,,5708.03,20001.0,2
HCPCS,21387,Opn tx orbit fx combined,,,5708.03,20001.0,2
HCPCS,21390,Opn tx orbit periorbtl implt,,,5708.03,20001.0,2
HCPCS,21395,Opn tx orbit periorbt w/grft,,,5708.03,20001.0,2
HCPCS,21400,Closed tx orbit w/o manipulj,,,520.03,3714.0,2
HCPCS,21401,Closed tx orbit w/manipulj,,,1496.07,9206.0,2
HCPCS,21406,Opn tx orbit fx w/o implant,,,5708.03,20001.0,2
HCPCS,21407,Opn tx orbit fx w/implant,,,5708.03,20001.0,2
HCPCS,21408,Opn tx orbit fx w/bone grft,,,5708.03,20001.0,2
HCPCS,21421,Treat mouth roof fracture,,,3196.84,9206.0,2
HCPCS,21422,Treat mouth roof fracture,,,5708.03,20001.0,2
HCPCS,21423,Treat mouth roof fracture,,,5708.03,20001.0,2
HCPCS,21431,Treat craniofacial fracture,,,5708.03,15689.0,2
HCPCS,21432,Treat craniofacial fracture,,,5708.03,20001.0,2
HCPCS,21433,Treat craniofacial fracture,,,5708.03,20001.0,2
HCPCS,21435,Treat craniofacial fracture,,,5708.03,20001.0,2
HCPCS,21436,Treat craniofacial fracture,,,5708.03,20001.0,2
HCPCS,21440,Treat dental ridge fracture,,,3196.84,9206.0,2
HCPCS,21445,Treat dental ridge fracture,,,5708.03,20001.0,2
HCPCS,21450,Treat lower jaw fracture,,,520.03,3714.0,2
HCPCS,21451,Treat lower jaw fracture,,,1496.07,9206.0,2
HCPCS,21452,Treat lower jaw fracture,,,5708.03,20001.0,2
HCPCS,21453,Treat lower jaw fracture,,,5708.03,20001.0,2
HCPCS,21454,Treat lower jaw fracture,,,5708.03,20001.0,2
HCPCS,21461,Treat lower jaw fracture,,,5708.03,20001.0,2
HCPCS,21462,Treat lower jaw fracture,,,5708.03,20001.0,2
HCPCS,21465,Treat lower jaw fracture,,,5708.03,20001.0,2
HCPCS,21470,Treat lower jaw fracture,,,5708.03,20001.0,2
HCPCS,21480,Reset dislocated jaw,,,237.84,3714.0,2
HCPCS,21485,Reset dislocated jaw,,,1496.07,9206.0,2
HCPCS,21490,Repair dislocated jaw,,,3196.84,9206.0,2
HCPCS,21497,Interdental wiring,,,1496.07,9206.0,2
HCPCS,21499,Head surgery procedure,,,228.38,16564.0,2
HCPCS,21501,Drain neck/chest lesion,,,2800.79,15689.0,2
HCPCS,21502,Drain chest lesion,,,3154.93,15689.0,2
HCPCS,21510,Drainage of bone lesion,,,3154.93,15689.0,2
HCPCS,21550,Biopsy of neck/chest,,,1592.51,9206.0,2
HCPCS,21550,Hc Biopsy Soft Tissue Neck Or Thorax,4752.0,3088.8,,,0
HCPCS,21552,Exc neck les sc 3 cm/>,,,2800.79,15689.0,2
HCPCS,21554,Exc neck tum deep 5 cm/>,,,2800.79,15689.0,2
HCPCS,21555,Exc neck les sc < 3 cm,,,1592.51,9206.0,2
HCPCS,21556,Exc neck tum deep < 5 cm,,,2800.79,15689.0,2
HCPCS,21557,Resect neck thorax tumor<5cm,,,2800.79,15689.0,2
HCPCS,21558,Resect neck tumor 5 cm/>,,,2800.79,15689.0,2
HCPCS,21600,Partial removal of rib,,,6996.6,31685.0,2
HCPCS,21601,Exc chest wall tumor w/ribs,,,2800.79,15689.0,2
HCPCS,21602,Exc ch wal tum w/o lymphadec,,,6996.6,30765.0,2
HCPCS,21603,Exc ch wal tum w/lymphadec,,,6996.6,30765.0,2
HCPCS,21610,Partial removal of rib,,,3154.93,15689.0,2
HCPCS,21615,Removal of rib,,,6996.6,15689.0,2
HCPCS,21616,Removal of rib and nerves,,,6996.6,15689.0,2
HCPCS,21620,Partial removal of sternum,,,3154.93,15689.0,2
HCPCS,21627,Sternal debridement,,,3154.93,15689.0,2
HCPCS,21630,Extensive sternum surgery,,,6996.6,15689.0,2
HCPCS,21632,Extensive sternum surgery,,,15689.0,15689.0,1
HCPCS,21685,Hyoid myotomy & suspension,,,5708.03,20001.0,2
HCPCS,21700,Revision of neck muscle,,,6996.6,15689.0,2
HCPCS,21705,Revision of neck muscle/rib,,,6996.6,9206.0,2
HCPCS,21720,Revision of neck muscle,,,3154.93,15689.0,2
HCPCS,21725,Revision of neck muscle,,,682.8,3714.0,2
HCPCS,21740,Reconstruction of sternum,,,6996.6,15689.0,2
HCPCS,21742,Repair stern/nuss w/o scope,,,3154.93,15689.0,2
HCPCS,21743,Repair sternum/nuss w/scope,,,3154.93,15689.0,2
HCPCS,21750,Repair of sternum separation,,,6996.6,15689.0,2
HCPCS,21811,Optx of rib fx w/fixj scope,,,6996.6,15689.0,2
HCPCS,21812,Treatment of rib fracture,,,6996.6,15689.0,2
HCPCS,21813,Treatment of rib fracture,,,1550.46,9206.0,2
HCPCS,21820,Treat sternum fracture,,,237.84,3714.0,2
HCPCS,21825,Treat sternum fracture,,,6996.6,15689.0,2
HCPCS,21899,Neck/chest surgery procedure,,,228.38,16564.0,2
HCPCS,21920,Biopsy soft tissue of back,,,1592.51,9206.0,2
HCPCS,21920,Hc Biopsy Soft Tissue Back Or Flank Sup,6865.0,4462.25,,,0
HCPCS,21925,Biopsy soft tissue of back,,,1592.51,9206.0,2
HCPCS,21925,Hc Biopsy Soft Tissue Back Or Flank Deep,6865.0,4462.25,,,0
HCPCS,21930,Exc back les sc < 3 cm,,,1592.51,9206.0,2
HCPCS,21931,Exc back les sc 3 cm/>,,,1592.51,9206.0,2
HCPCS,21932,Exc back tum deep < 5 cm,,,2800.79,15689.0,2
HCPCS,21933,Exc back tum deep 5 cm/>,,,2800.79,15689.0,2
HCPCS,21935,Resect back tum < 5 cm,,,2800.79,15689.0,2
HCPCS,21936,Resect back tum 5 cm/>,,,2800.79,15689.0,2
HCPCS,22010,I&d p-spine c/t/cerv-thor,,,6996.6,9206.0,2
HCPCS,22015,I&d abscess p-spine l/s/ls,,,6996.6,9206.0,2
HCPCS,22100,Remove part of neck vertebra,,,6996.6,31685.0,2
HCPCS,22101,Remove part thorax vertebra,,,6996.6,15689.0,2
HCPCS,22102,Remove part lumbar vertebra,,,6996.6,31685.0,2
HCPCS,22110,Remove part of neck vertebra,,,6996.6,15689.0,2
HCPCS,22112,Remove part thorax vertebra,,,6996.6,15689.0,2
HCPCS,22114,Remove part lumbar vertebra,,,6996.6,15689.0,2
HCPCS,22116,Remove extra spine segment,,,15689.0,15689.0,1
HCPCS,22206,Incis spine 3 column thorac,,,6996.6,31685.0,2
HCPCS,22207,Incis spine 3 column lumbar,,,6996.6,31685.0,2
HCPCS,22208,Incis spine 3 column adl seg,,,31685.0,31685.0,1
HCPCS,22210,Incis 1 vertebral seg cerv,,,6996.6,15689.0,2
HCPCS,22212,Incis 1 vertebral seg thorac,,,6996.6,15689.0,2
HCPCS,22214,Incis 1 vertebral seg lumbar,,,6996.6,15689.0,2
HCPCS,22216,Incis addl spine segment,,,15689.0,15689.0,1
HCPCS,22220,Incis w/discectomy cervical,,,6996.6,15689.0,2
HCPCS,22222,Incis w/discectomy thoracic,,,6996.6,15689.0,2
HCPCS,22224,Incis w/discectomy lumbar,,,6996.6,15689.0,2
HCPCS,22226,Revise extra spine segment,,,38216.0,38216.0,1
HCPCS,22310,Closed tx vert fx w/o manj,,,237.84,3714.0,2
HCPCS,22315,Closed tx vert fx w/manj,,,3154.93,15689.0,2
HCPCS,22318,Treat odontoid fx w/o graft,,,12379.34,15689.0,2
HCPCS,22319,Treat odontoid fx w/graft,,,12379.34,15689.0,2
HCPCS,22325,Treat spine fracture,,,12379.34,15689.0,2
HCPCS,22326,Treat neck spine fracture,,,12379.34,15689.0,2
HCPCS,22327,Treat thorax spine fracture,,,12379.34,15689.0,2
HCPCS,22328,Treat each add spine fx,,,15689.0,15689.0,1
HCPCS,22505,Manipulation of spine,,,1550.46,9206.0,2
HCPCS,22510,Hc Vertebroplasty Thoracic Percutaneous W Img,18546.0,12054.9,,,0
HCPCS,22510,Perq cervicothoracic inject,,,3154.93,15689.0,2
HCPCS,22511,Hc Vertebroplasty Lumbar Percutaneous W Img,19822.0,12884.3,,,0
HCPCS,22511,Perq lumbosacral injection,,,3154.93,15689.0,2
HCPCS,22512,Hc Vertebroplasty Ea Addl Thor Or Lumb W Img,10059.0,6538.35,,,0
HCPCS,22513,Hc Kyphoplasty Thoracic W Img,26637.0,17314.05,,,0
HCPCS,22513,Perq vertebral augmentation,,,6996.6,31685.0,2
HCPCS,22514,Hc Kyphoplasty Lumbar W Img,28302.0,18396.3,,,0
HCPCS,22514,Perq vertebral augmentation,,,6996.6,31685.0,2
HCPCS,22515,Hc Kyphoplasty Ea Addl Thor Or Lumb W Img,13558.0,8812.7,,,0
HCPCS,22526,Idet single level,,,15689.0,15689.0,1
HCPCS,22527,Idet 1 or more levels,,,15689.0,15689.0,1
HCPCS,22532,Lat thorax spine fusion,,,12379.34,31685.0,2
HCPCS,22533,Lat lumbar spine fusion,,,16906.49,31685.0,2
HCPCS,22534,Lat thor/lumb addl seg,,,31685.0,31685.0,1
HCPCS,22548,Neck spine fusion,,,12379.34,15689.0,2
HCPCS,22551,Neck spine fuse&remov bel c2,,,12379.34,38216.0,2
HCPCS,22554,Neck spine fusion,,,12379.34,38216.0,2
HCPCS,22556,Thorax spine fusion,,,15689.0,16906.49,2
HCPCS,22558,Lumbar spine fusion,,,15689.0,26163.21,2
HCPCS,22586,Prescrl fuse w/ instr l5-s1,,,16906.49,38216.0,2
HCPCS,22590,Spine & skull spinal fusion,,,12379.34,15689.0,2
HCPCS,22595,Neck spinal fusion,,,12379.34,15689.0,2
HCPCS,22600,Neck spine fusion,,,16906.49,38216.0,2
HCPCS,22610,Thorax spine fusion,,,16906.49,38216.0,2
HCPCS,22612,Lumbar spine fusion,,,16906.49,38216.0,2
HCPCS,22630,Lumbar spine fusion,,,26163.21,38216.0,2
HCPCS,22632,Spine fusion extra segment,,,38216.0,38216.0,1
HCPCS,22633,Lumbar spine fusion combined,,,26163.21,38216.0,2
HCPCS,22800,Post fusion <=6 vert seg,,,15689.0,16906.49,2
HCPCS,22802,Post fusion 7-12 vert seg,,,16906.49,31685.0,2
HCPCS,22804,Post fusion 13/> vert seg,,,16906.49,31685.0,2
HCPCS,22808,Ant fusion 2-3 vert seg,,,15689.0,16906.49,2
HCPCS,22810,Ant fusion 4-7 vert seg,,,15689.0,16906.49,2
HCPCS,22812,Ant fusion 8/> vert seg,,,16906.49,31685.0,2
HCPCS,22818,Kyphectomy 1-2 segments,,,16906.49,31685.0,2
HCPCS,22819,Kyphectomy 3 or more,,,16906.49,31685.0,2
HCPCS,22830,Exploration of spinal fusion,,,6996.6,15689.0,2
HCPCS,22836,Ant thrc vrt body tethrg <7,,,16906.49,31685.0,2
HCPCS,22837,Ant thrc vrt body tethrg 8+,,,16906.49,31685.0,2
HCPCS,22838,Rev rplc/rmv thrc vrt tethrg,,,16906.49,31685.0,2
HCPCS,22841,Insert spine fixation device,,,9206.0,9206.0,1
HCPCS,22843,Insert spine fixation device,,,9206.0,9206.0,1
HCPCS,22844,Insert spine fixation device,,,9206.0,9206.0,1
HCPCS,22846,Insert spine fixation device,,,9206.0,9206.0,1
HCPCS,22847,Insert spine fixation device,,,9206.0,9206.0,1
HCPCS,22848,Insert pelv fixation device,,,9206.0,9206.0,1
HCPCS,22849,Reinsert spinal fixation,,,9206.0,12379.34,2
HCPCS,22850,Remove spine fixation device,,,6996.6,9206.0,2
HCPCS,22852,Remove spine fixation device,,,6996.6,9206.0,2
HCPCS,22855,Remove spine fixation device,,,6996.6,9206.0,2
HCPCS,22856,Cerv artific diskectomy,,,16906.49,63079.0,2
HCPCS,22857,Lumbar Artif Diskectomy,,,16906.49,31685.0,2
HCPCS,22860,Tot disc arthrp 2ntrspc lmbr,,,63079.0,63079.0,1
HCPCS,22861,Revise cerv artific disc,,,16906.49,31685.0,2
HCPCS,22862,Revise Lumbar Artif Disc,,,16906.49,31685.0,2
HCPCS,22864,Remove cerv artif disc,,,6996.6,31685.0,2
HCPCS,22865,Remove Lumb Artif Disc,,,6996.6,31685.0,2
HCPCS,22867,Hc Insj Stablj Device W Dcmp 1Lv,96382.0,62648.3,,,0
HCPCS,22867,Insj stablj dev w/dcmprn,,,16906.49,63079.0,2
HCPCS,22868,Hc Insj Stablj Device W Dcmp 2Lv,48192.0,31324.8,,,0
HCPCS,22869,Hc Insj Stablj Device Wo Dcmp 1Lv,96382.0,62648.3,,,0
HCPCS,22869,Insj stablj dev w/o dcmprn,,,12379.34,63079.0,2
HCPCS,22870,Hc Insj Stablj Device Wo Dcmp 2Lv,48192.0,31324.8,,,0
HCPCS,22899,Hc Unlisted Procedure Spine,15001.0,9750.65,,,0
HCPCS,22899,Spine surgery procedure,,,237.84,16564.0,2
HCPCS,22900,Exc abdl tum deep < 5 cm,,,2800.79,15689.0,2
HCPCS,22901,Exc abdl tum deep 5 cm/>,,,2800.79,15689.0,2
HCPCS,22902,Exc abd les sc < 3 cm,,,1592.51,9206.0,2
HCPCS,22903,Exc abd les sc 3 cm/>,,,2800.79,15689.0,2
HCPCS,22904,Radical resect abd tumor<5cm,,,2800.79,15689.0,2
HCPCS,22905,Rad resect abd tumor 5 cm/>,,,2800.79,15689.0,2
HCPCS,22999,Abdomen surgery procedure,,,237.84,16564.0,2
HCPCS,23000,Hc Removal Open Calcareous Deposits Subdeltoid,10321.0,6708.65,,,0
HCPCS,23000,Removal of calcium deposits,,,2800.79,15689.0,2
HCPCS,23020,Release shoulder joint,,,3154.93,15689.0,2
HCPCS,23030,Drain shoulder lesion,,,2800.79,15689.0,2
HCPCS,23031,Drain shoulder bursa,,,2800.79,9206.0,2
HCPCS,23035,Drain shoulder bone lesion,,,1550.46,9206.0,2
HCPCS,23040,Exploratory shoulder surgery,,,3154.93,15689.0,2
HCPCS,23044,Exploratory shoulder surgery,,,3154.93,15689.0,2
HCPCS,23065,Biopsy shoulder tissues,,,1592.51,9206.0,2
HCPCS,23065,Hc Biopsy Soft Tissue Shoulder Sup,10297.5,6693.375,,,0
HCPCS,23066,Biopsy shoulder tissues,,,2800.79,15689.0,2
HCPCS,23071,Exc shoulder les sc 3 cm/>,,,1592.51,9206.0,2
HCPCS,23073,Exc shoulder tum deep 5 cm/>,,,2800.79,15689.0,2
HCPCS,23075,Exc shoulder les sc < 3 cm,,,1592.51,9206.0,2
HCPCS,23076,Exc shoulder tum deep < 5 cm,,,2800.79,15689.0,2
HCPCS,23077,Resect shoulder tumor < 5 cm,,,2800.79,15689.0,2
HCPCS,23078,Resect shoulder tumor 5 cm/>,,,2800.79,15689.0,2
HCPCS,23100,Biopsy of shoulder joint,,,3154.93,15689.0,2
HCPCS,23101,Shoulder joint surgery,,,3154.93,15689.0,2
HCPCS,23105,Remove shoulder joint lining,,,6996.6,31685.0,2
HCPCS,23106,Incision of collarbone joint,,,3154.93,15689.0,2
HCPCS,23107,Explore treat shoulder joint,,,6996.6,31685.0,2
HCPCS,23120,Partial removal collar bone,,,3154.93,15689.0,2
HCPCS,23125,Removal of collar bone,,,3154.93,15689.0,2
HCPCS,23130,Remove shoulder bone part,,,3154.93,15689.0,2
HCPCS,23140,Removal of bone lesion,,,3154.93,15689.0,2
HCPCS,23145,Removal of bone lesion,,,3154.93,15689.0,2
HCPCS,23146,Removal of bone lesion,,,6996.6,31685.0,2
HCPCS,23150,Removal of humerus lesion,,,3154.93,15689.0,2
HCPCS,23155,Removal of humerus lesion,,,6996.6,31685.0,2
HCPCS,23156,Removal of humerus lesion,,,6996.6,31685.0,2
HCPCS,23170,Remove collar bone lesion,,,3154.93,15689.0,2
HCPCS,23172,Remove shoulder blade lesion,,,3154.93,15689.0,2
HCPCS,23174,Remove humerus lesion,,,6996.6,15689.0,2
HCPCS,23180,Remove collar bone lesion,,,6996.6,15689.0,2
HCPCS,23182,Remove shoulder blade lesion,,,6996.6,15689.0,2
HCPCS,23184,Remove humerus lesion,,,6996.6,31685.0,2
HCPCS,23190,Partial removal of scapula,,,3154.93,15689.0,2
HCPCS,23195,Removal of head of humerus,,,6996.6,31685.0,2
HCPCS,23200,Resect clavicle tumor,,,6996.6,15689.0,2
HCPCS,23210,Resect scapula tumor,,,6996.6,15689.0,2
HCPCS,23220,Resect prox humerus tumor,,,6996.6,15689.0,2
HCPCS,23330,Remove shoulder foreign body,,,1592.51,3714.0,2
HCPCS,23333,Remove shoulder fb deep,,,2800.79,9206.0,2
HCPCS,23334,Shoulder prosthesis removal,,,6996.6,15689.0,2
HCPCS,23335,Shoulder prosthesis removal,,,6996.6,15689.0,2
HCPCS,23350,Hc Inj Arthrography Shoulder,2136.0,1388.4,,,0
HCPCS,23395,Muscle transfer shoulder/arm,,,6996.6,31685.0,2
HCPCS,23397,Muscle transfers,,,6996.6,31685.0,2
HCPCS,23400,Fixation of shoulder blade,,,6996.6,31685.0,2
HCPCS,23405,Hc Tenotomy Shoulder,13459.0,8748.35,,,0
HCPCS,23405,Incision of tendon & muscle,,,6996.6,31685.0,2
HCPCS,23406,Incise tendon(s) & muscle(s),,,6996.6,15689.0,2
HCPCS,23410,Repair rotator cuff acute,,,6996.6,31685.0,2
HCPCS,23412,Repair rotator cuff chronic,,,6996.6,31685.0,2
HCPCS,23415,Release of shoulder ligament,,,6996.6,31685.0,2
HCPCS,23420,Repair of shoulder,,,6996.6,31685.0,2
HCPCS,23430,Repair biceps tendon,,,6996.6,31685.0,2
HCPCS,23440,Remove/transplant tendon,,,6996.6,15689.0,2
HCPCS,23450,Repair shoulder capsule,,,6996.6,31685.0,2
HCPCS,23455,Repair shoulder capsule,,,6996.6,31685.0,2
HCPCS,23460,Repair shoulder capsule,,,6996.6,31685.0,2
HCPCS,23462,Repair shoulder capsule,,,6996.6,31685.0,2
HCPCS,23465,Repair shoulder capsule,,,6996.6,31685.0,2
HCPCS,23466,Repair shoulder capsule,,,6996.6,31685.0,2
HCPCS,23470,Reconstruct shoulder joint,,,12379.34,38216.0,2
HCPCS,23472,Reconstruct shoulder joint,,,16906.49,31685.0,2
HCPCS,23473,Revis reconst shoulder joint,,,12379.34,38216.0,2
HCPCS,23474,Revis reconst shoulder joint,,,12379.34,38216.0,2
HCPCS,23480,Revision of collar bone,,,6996.6,31685.0,2
HCPCS,23485,Revision of collar bone,,,12379.34,38216.0,2
HCPCS,23490,Reinforce clavicle,,,6996.6,31685.0,2
HCPCS,23491,Reinforce shoulder bones,,,12379.34,38216.0,2
HCPCS,23500,Treat clavicle fracture,,,237.84,3714.0,2
HCPCS,23505,Treat clavicle fracture,,,1550.46,9206.0,2
HCPCS,23515,Treat clavicle fracture,,,6996.6,31685.0,2
HCPCS,23520,Treat clavicle dislocation,,,1550.46,9206.0,2
HCPCS,23525,Treat clavicle dislocation,,,237.84,3714.0,2
HCPCS,23530,Treat clavicle dislocation,,,6996.6,31685.0,2
HCPCS,23532,Treat clavicle dislocation,,,6996.6,31685.0,2
HCPCS,23540,Treat clavicle dislocation,,,237.84,3714.0,2
HCPCS,23545,Treat clavicle dislocation,,,237.84,3714.0,2
HCPCS,23550,Treat clavicle dislocation,,,6996.6,31685.0,2
HCPCS,23552,Treat clavicle dislocation,,,6996.6,31685.0,2
HCPCS,23570,Treat shoulder blade fx,,,237.84,3714.0,2
HCPCS,23575,Treat shoulder blade fx,,,1550.46,9206.0,2
HCPCS,23585,Treat scapula fracture,,,6996.6,31685.0,2
HCPCS,23600,Treat humerus fracture,,,237.84,3714.0,2
HCPCS,23605,Treat humerus fracture,,,1550.46,9206.0,2
HCPCS,23615,Treat humerus fracture,,,12379.34,38216.0,2
HCPCS,23616,Treat humerus fracture,,,16906.49,63079.0,2
HCPCS,23620,Treat humerus fracture,,,237.84,3714.0,2
HCPCS,23625,Treat humerus fracture,,,1550.46,9206.0,2
HCPCS,23630,Treat humerus fracture,,,6996.6,31685.0,2
HCPCS,23650,Treat shoulder dislocation,,,237.84,3714.0,2
HCPCS,23655,Treat shoulder dislocation,,,1550.46,9206.0,2
HCPCS,23660,Treat shoulder dislocation,,,6996.6,31685.0,2
HCPCS,23665,Treat dislocation/fracture,,,1550.46,9206.0,2
HCPCS,23670,Treat dislocation/fracture,,,6996.6,31685.0,2
HCPCS,23675,Treat dislocation/fracture,,,1550.46,9206.0,2
HCPCS,23680,Treat dislocation/fracture,,,12379.34,38216.0,2
HCPCS,23700,Fixation of shoulder,,,1550.46,9206.0,2
HCPCS,23800,Fusion of shoulder joint,,,6996.6,31685.0,2
HCPCS,23802,Fusion of shoulder joint,,,12379.34,38216.0,2
HCPCS,23900,Amputation of arm & girdle,,,12379.34,15689.0,2
HCPCS,23920,Amputation at shoulder joint,,,12379.34,15689.0,2
HCPCS,23921,Amputation follow-up surgery,,,1989.46,9206.0,2
HCPCS,23929,Shoulder surgery procedure,,,237.84,3714.0,2
HCPCS,23930,Drainage of arm lesion,,,2800.79,9206.0,2
HCPCS,23931,Drainage of arm bursa,,,1592.51,9206.0,2
HCPCS,23935,Drain arm/elbow bone lesion,,,3154.93,15689.0,2
HCPCS,24000,Exploratory elbow surgery,,,3154.93,15689.0,2
HCPCS,24006,Release elbow joint,,,3154.93,15689.0,2
HCPCS,24065,Biopsy arm/elbow soft tissue,,,1592.51,9206.0,2
HCPCS,24065,Hc Bx Soft Tissue Upper Arm Or Elbow Sup,6531.0,4245.15,,,0
HCPCS,24066,Biopsy arm/elbow soft tissue,,,2800.79,15689.0,2
HCPCS,24066,Hc Bx Soft Tissue Upper Arm Or Elbow Deep,7837.5,5094.375,,,0
HCPCS,24071,Exc arm/elbow les sc 3 cm/>,,,2800.79,15689.0,2
HCPCS,24073,Ex arm/elbow tum deep 5 cm/>,,,2800.79,15689.0,2
HCPCS,24075,Exc arm/elbow les sc < 3 cm,,,1592.51,9206.0,2
HCPCS,24076,Ex arm/elbow tum deep < 5 cm,,,2800.79,15689.0,2
HCPCS,24077,Resect arm/elbow tum < 5 cm,,,2800.79,15689.0,2
HCPCS,24079,Resect arm/elbow tum 5 cm/>,,,2800.79,15689.0,2
HCPCS,24100,Biopsy elbow joint lining,,,3154.93,15689.0,2
HCPCS,24101,Explore/treat elbow joint,,,3154.93,15689.0,2
HCPCS,24102,Remove elbow joint lining,,,3154.93,15689.0,2
HCPCS,24105,Removal of elbow bursa,,,3154.93,15689.0,2
HCPCS,24110,Remove humerus lesion,,,3154.93,15689.0,2
HCPCS,24115,Remove/graft bone lesion,,,6996.6,31685.0,2
HCPCS,24116,Remove/graft bone lesion,,,6996.6,31685.0,2
HCPCS,24120,Remove elbow lesion,,,3154.93,15689.0,2
HCPCS,24125,Remove/graft bone lesion,,,3154.93,15689.0,2
HCPCS,24126,Remove/graft bone lesion,,,6996.6,31685.0,2
HCPCS,24130,Removal of head of radius,,,3154.93,15689.0,2
HCPCS,24134,Removal of arm bone lesion,,,6996.6,31685.0,2
HCPCS,24136,Remove radius bone lesion,,,3154.93,15689.0,2
HCPCS,24138,Remove elbow bone lesion,,,6996.6,31685.0,2
HCPCS,24140,Partial removal of arm bone,,,3154.93,15689.0,2
HCPCS,24145,Partial removal of radius,,,6996.6,31685.0,2
HCPCS,24147,Partial removal of elbow,,,3154.93,15689.0,2
HCPCS,24149,Radical resection of elbow,,,6996.6,31685.0,2
HCPCS,24150,Resect distal humerus tumor,,,6996.6,31685.0,2
HCPCS,24152,Resect radius tumor,,,6996.6,31685.0,2
HCPCS,24155,Removal of elbow joint,,,3154.93,15689.0,2
HCPCS,24160,Remove elbow joint implant,,,3154.93,15689.0,2
HCPCS,24164,Remove radius head implant,,,3154.93,15689.0,2
HCPCS,24200,Removal of arm foreign body,,,1592.51,9206.0,2
HCPCS,24201,Removal of arm foreign body,,,2800.79,15689.0,2
HCPCS,24220,Hc Inj Arthrography Elbow,2889.0,1877.8500000000001,,,0
HCPCS,24300,Manipulate elbow w/anesth,,,1550.46,9206.0,2
HCPCS,24301,Muscle/tendon transfer,,,6996.6,31685.0,2
HCPCS,24305,Arm tendon lengthening,,,3154.93,15689.0,2
HCPCS,24310,Revision of arm tendon,,,3154.93,15689.0,2
HCPCS,24320,Repair of arm tendon,,,6996.6,31685.0,2
HCPCS,24330,Revision of arm muscles,,,6996.6,15689.0,2
HCPCS,24331,Revision of arm muscles,,,6996.6,31685.0,2
HCPCS,24332,Tenolysis triceps,,,3154.93,15689.0,2
HCPCS,24340,Repair of biceps tendon,,,6996.6,31685.0,2
HCPCS,24341,Repair arm tendon/muscle,,,6996.6,31685.0,2
HCPCS,24342,Repair of ruptured tendon,,,6996.6,31685.0,2
HCPCS,24343,Repr elbow lat ligmnt w/tiss,,,3154.93,15689.0,2
HCPCS,24344,Reconstruct elbow lat ligmnt,,,6996.6,31685.0,2
HCPCS,24345,Repr elbw med ligmnt w/tissu,,,6996.6,31685.0,2
HCPCS,24346,Reconstruct elbow med ligmnt,,,12379.34,38216.0,2
HCPCS,24357,Hc Tenotomy Percutaneous Elbow,7584.0,4929.6,,,0
HCPCS,24357,Repair elbow perc,,,3154.93,15689.0,2
HCPCS,24358,Repair elbow w/deb open,,,3154.93,15689.0,2
HCPCS,24359,Repair elbow deb/attch open,,,3154.93,15689.0,2
HCPCS,24360,Reconstruct elbow joint,,,6996.6,31685.0,2
HCPCS,24361,Reconstruct elbow joint,,,16906.49,63079.0,2
HCPCS,24362,Reconstruct elbow joint,,,12379.34,38216.0,2
HCPCS,24363,Replace elbow joint,,,16906.49,63079.0,2
HCPCS,24365,Reconstruct head of radius,,,12379.34,38216.0,2
HCPCS,24366,Reconstruct head of radius,,,12379.34,38216.0,2
HCPCS,24370,Revise reconst elbow joint,,,12379.34,38216.0,2
HCPCS,24371,Revise reconst elbow joint,,,16906.49,63079.0,2
HCPCS,24400,Revision of humerus,,,6996.6,31685.0,2
HCPCS,24410,Revision of humerus,,,12379.34,38216.0,2
HCPCS,24420,Revision of humerus,,,6996.6,31685.0,2
HCPCS,24430,Repair of humerus,,,12379.34,38216.0,2
HCPCS,24435,Repair humerus with graft,,,12379.34,38216.0,2
HCPCS,24470,Revision of elbow joint,,,3154.93,15689.0,2
HCPCS,24495,Decompression of forearm,,,6996.6,31685.0,2
HCPCS,24498,Reinforce humerus,,,12379.34,38216.0,2
HCPCS,24500,Treat humerus fracture,,,237.84,3714.0,2
HCPCS,24505,Treat humerus fracture,,,1550.46,9206.0,2
HCPCS,24515,Treat humerus fracture,,,12379.34,38216.0,2
HCPCS,24516,Treat humerus fracture,,,12379.34,38216.0,2
HCPCS,24530,Treat humerus fracture,,,237.84,3714.0,2
HCPCS,24535,Treat humerus fracture,,,1550.46,9206.0,2
HCPCS,24538,Treat humerus fracture,,,6996.6,31685.0,2
HCPCS,24545,Treat humerus fracture,,,12379.34,38216.0,2
HCPCS,24546,Treat humerus fracture,,,12379.34,63079.0,2
HCPCS,24560,Treat humerus fracture,,,237.84,3714.0,2
HCPCS,24565,Treat humerus fracture,,,1550.46,9206.0,2
HCPCS,24566,Treat humerus fracture,,,1550.46,9206.0,2
HCPCS,24575,Treat humerus fracture,,,12379.34,38216.0,2
HCPCS,24576,Treat humerus fracture,,,237.84,3714.0,2
HCPCS,24577,Treat humerus fracture,,,1550.46,9206.0,2
HCPCS,24579,Treat humerus fracture,,,12379.34,38216.0,2
HCPCS,24582,Treat humerus fracture,,,6996.6,15689.0,2
HCPCS,24586,Treat elbow fracture,,,12379.34,38216.0,2
HCPCS,24587,Treat elbow fracture,,,12379.34,38216.0,2
HCPCS,24600,Treat elbow dislocation,,,237.84,3714.0,2
HCPCS,24605,Treat elbow dislocation,,,1550.46,9206.0,2
HCPCS,24615,Treat elbow dislocation,,,6996.6,31685.0,2
HCPCS,24620,Treat elbow fracture,,,1550.46,9206.0,2
HCPCS,24635,Treat elbow fracture,,,6996.6,31685.0,2
HCPCS,24640,Treat elbow dislocation,,,237.84,3714.0,2
HCPCS,24650,Treat radius fracture,,,237.84,3714.0,2
HCPCS,24655,Treat radius fracture,,,1550.46,9206.0,2
HCPCS,24665,Treat radius fracture,,,6996.6,31685.0,2
HCPCS,24666,Treat radius fracture,,,12379.34,38216.0,2
HCPCS,24670,Treat ulnar fracture,,,237.84,3714.0,2
HCPCS,24675,Treat ulnar fracture,,,1550.46,9206.0,2
HCPCS,24685,Treat ulnar fracture,,,6996.6,31685.0,2
HCPCS,24800,Fusion of elbow joint,,,6996.6,31685.0,2
HCPCS,24802,Fusion/graft of elbow joint,,,12379.34,38216.0,2
HCPCS,24900,Amputation of upper arm,,,12379.34,15689.0,2
HCPCS,24920,Amputation of upper arm,,,12379.34,15689.0,2
HCPCS,24925,Amputation follow-up surgery,,,3154.93,15689.0,2
HCPCS,24930,Amputation follow-up surgery,,,6996.6,15689.0,2
HCPCS,24931,Amputate upper arm & implant,,,12379.34,15689.0,2
HCPCS,24935,Revision of amputation,,,6996.6,31685.0,2
HCPCS,24940,Revision of upper arm,,,12379.34,15689.0,2
HCPCS,24999,Upper arm/elbow surgery,,,237.84,16564.0,2
HCPCS,25000,Incision of tendon sheath,,,1550.46,9206.0,2
HCPCS,25000049,ACETIC ACID (BULK) 5 % LIQUID,57.65,37.474999999999994,,,0
HCPCS,25000049,ACETIC ACID 0.25 % IRRIGATION SOLUTION,37.95,24.67,,,0
HCPCS,25000049,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,25.65,16.67,,,0
HCPCS,25000049,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,20.5,13.32,,,0
HCPCS,25000049,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION (ORAL),122.9,79.88,,,0
HCPCS,25000049,ADENOSINE 90 MG IN 90 ML NS IVPB (CMP PMX),717.3,466.24,,,0
HCPCS,25000049,AMINO ACID 4.25 % NO.1 IN DEXTROSE 5 % INTRAVENOUS SOLUTION,117.65,76.47,,,0
HCPCS,25000049,AMINO ACID 5 % NO.6-DEXTROSE 15 %-ELECTROLYTES NO.23 IV SOLUTION,359.45,233.64,,,0
HCPCS,25000049,AMPHOTERICIN  INTRAVENTRICULAR 0.1 MG/2 ML SYRINGE,75.95,49.37,,,0
HCPCS,25000049,"ARGININE HCL (L-ARGININE) 1,000 MG TABLET",4.9,3.18,,,0
HCPCS,25000049,ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,34.65,22.52,,,0
HCPCS,25000049,ASCORBIC ACID (VITAMIN C) 500 MG/ML INTRAVENOUS SOLUTION,37.95,24.67,,,0
HCPCS,25000049,ASCORBIC ACID 1500 MG IN SODIUM CHLORIDE 0.9% 250 ML IVPB (CMP PREMIX),64.4,41.86,,,0
HCPCS,25000049,ASCORBIC ACID 500 MG IN SODIUM CHLORIDE 0.9% 100 ML IVPB (CMP PREMIX),41.5,26.98,,,0
HCPCS,25000049,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,37.35,24.28,,,0
HCPCS,25000049,BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,32.7,21.26,,,0
HCPCS,25000049,BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,70.55,45.86,,,0
HCPCS,25000049,BIOTIN 10 MG TABLET,4.8,3.12,,,0
HCPCS,25000049,BRIVARACETAM 25 MG TABLET,75.55,49.11,,,0
HCPCS,25000049,BRIVARACETAM 50 MG TABLET,75.55,49.11,,,0
HCPCS,25000049,BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,44.65,29.02,,,0
HCPCS,25000049,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",50.65,32.92,,,0
HCPCS,25000049,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",51.05,33.18,,,0
HCPCS,25000049,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",37.05,24.08,,,0
HCPCS,25000049,CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,112.85,73.35,,,0
HCPCS,25000049,"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",6.55,4.26,,,0
HCPCS,25000049,CANAGLIFLOZIN 100 MG TABLET,62.25,40.46,,,0
HCPCS,25000049,CANAGLIFLOZIN 300 MG TABLET,62.25,40.46,,,0
HCPCS,25000049,"CARBIDOPA ER 23.75 MG-LEVODOPA 95 MG CAPSULE,EXTENDED RELEASE",16.65,10.82,,,0
HCPCS,25000049,"CARBIDOPA ER 36.25 MG-LEVODOPA 145 MG CAPSULE,EXTENDED RELEASE",16.65,10.82,,,0
HCPCS,25000049,"CARBIDOPA ER 48.75 MG-LEVODOPA 195 MG CAPSULE,EXTENDED RELEASE",16.65,10.82,,,0
HCPCS,25000049,"CARBIDOPA ER 61.25 MG-LEVODOPA 245 MG CAPSULE,EXTENDED RELEASE",19.7,12.8,,,0
HCPCS,25000049,CARBOXYMETHYL 0.5 %-GLYCERIN 1 %-POLYSORB 80 0.5 %-PF EYE DROPPERETTE,5.8,3.77,,,0
HCPCS,25000049,CARDIOPLEGIC 1000 ML BASE SOLUTION (CMP),226.35,147.13,,,0
HCPCS,25000049,CARDIOPLEGIC SOLUTION + 0 MEQ KCL (CMP),99.65,64.77,,,0
HCPCS,25000049,CARDIOPLEGIC SOLUTION + 15 MEQ KCL (CMP),106.1,68.96,,,0
HCPCS,25000049,CARDIOPLEGIC SOLUTION + 80 MEQ KCL (CMP),133.8,86.97,,,0
HCPCS,25000049,CARMUSTINE IN POLIFEPROSAN 7.7 MG WAFER FOR IMPLANT,22205.25,14433.41,,,0
HCPCS,25000049,CEFAZOLIN 1 GM/250 ML IN NS IRRIGATION (CMP PMX),68.2,44.33,,,0
HCPCS,25000049,CEFAZOLIN 1 GM/500 ML IN NS IRRIGATION (CMP PMX),68.2,44.33,,,0
HCPCS,25000049,CISATRACURIUM CONCENTRATE 10 MG/ML (ICU USE ONLY) INTRAVENOUS SOLUTION,1470.55,955.86,,,0
HCPCS,25000049,CLINDAMYCIN 600 MG/1000 ML IN NS IRRIGATION (CMP PMX),72.2,46.93,,,0
HCPCS,25000049,CLINDAMYCIN 600 MG/250 ML IN NS IRRIGATION (CMP PMX),72.2,46.93,,,0
HCPCS,25000049,CLINDAMYCIN 600 MG/500 ML IN NS IRRIGATION (CMP PMX),1908.65,1240.62,,,0
HCPCS,25000049,COMPOUNDING VEHICLE SUGAR-FREE NO.9 ORAL LIQUID,76.0,49.4,,,0
HCPCS,25000049,COMPOUNDING VEHICLE SYRUP NO.23,72.05,46.83,,,0
HCPCS,25000049,CRRT B22GK 4/0 (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
HCPCS,25000049,CRRT BGK 2/0 (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
HCPCS,25000049,CRRT BGK 2/3.5 ( PRISMASOL) 5000 ML SOLUTION,163.5,106.28,,,0
HCPCS,25000049,CRRT BGK 4/0/1.2 (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
HCPCS,25000049,CRRT BGK 4/2.5 WITH CALCIUM (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
HCPCS,25000049,CRRT BK 0/3.5 5000 ML SOLUTION,146.75,95.39,,,0
HCPCS,25000049,"DESVENLAFAXINE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",15.95,10.37,,,0
HCPCS,25000049,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,216.4,140.66,,,0
HCPCS,25000049,"DEXMEDETOMIDINE 1,000 MCG/250 ML(4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV",220.1,143.06,,,0
HCPCS,25000049,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,41.95,27.27,,,0
HCPCS,25000049,DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,98.15,63.8,,,0
HCPCS,25000049,DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,118.25,76.86,,,0
HCPCS,25000049,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,64.0,41.6,,,0
HCPCS,25000049,DEXTROSE 10 % IV BOLUS,37.175,24.165,,,0
HCPCS,25000049,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,90.85,59.05,,,0
HCPCS,25000049,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 800 MG/100 ML SOLN,140.5,91.32,,,0
HCPCS,25000049,DEXTROSE 5 % AND 0.45 % NACL IV BOLUS,60.85,39.55,,,0
HCPCS,25000049,DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,109.05,70.88,,,0
HCPCS,25000049,DICLOFENAC 50 MG RECTAL SUPPOSITORY,8.9,5.78,,,0
HCPCS,25000049,DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,13.2,8.58,,,0
HCPCS,25000049,DIPHENHYDRAMINE 25 MG TABLET,0.2,0.13,,,0
HCPCS,25000049,DOLUTEGRAVIR 50 MG TABLET,240.1,156.06,,,0
HCPCS,25000049,DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,411.05,267.18,,,0
HCPCS,25000049,DROXIDOPA 100 MG CAPSULE,7.85,5.1,,,0
HCPCS,25000049,DULAGLUTIDE 0.75 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,717.65,466.47,,,0
HCPCS,25000049,DULAGLUTIDE 1.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1430.7,929.96,,,0
HCPCS,25000049,ELECTROLYTE-148 INTRAVENOUS SOLUTION,109.05,70.88,,,0
HCPCS,25000049,ELECTROLYTE-A INTRAVENOUS SOLUTION,75.55,49.11,,,0
HCPCS,25000049,EMPAGLIFLOZIN 10 MG TABLET,52.8,34.32,,,0
HCPCS,25000049,EMPAGLIFLOZIN 25 MG TABLET,52.8,34.32,,,0
HCPCS,25000049,EMTRICITABINE 200 MG-RILPIVIRINE 25 MG-TENOFOVIR ALAFENAM 25 MG TABLET,393.15,255.55,,,0
HCPCS,25000049,EMTRICITABINE 200 MG-RILPIVIRINE 25 MG-TENOFOVIR DISPROX 300 MG TABLET,393.15,255.55,,,0
HCPCS,25000049,EPINEPHRINE 4 MG IN NS 250 ML INFUSION (CMP PMX),87.2,56.68,,,0
HCPCS,25000049,ETHIODIZED OIL 480 MG IODINE/ML FOR INJECTION,6098.55,3964.06,,,0
HCPCS,25000049,ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,2813.0,1828.45,,,0
HCPCS,25000049,FAT EMULSION 20 % INTRAVENOUS,99.1,64.41,,,0
HCPCS,25000049,FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,157.65,102.47,,,0
HCPCS,25000049,FENTANYL (PF) 300 MCG/30 ML (10 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE,35.0,22.75,,,0
HCPCS,25000049,FLUTICASONE FUR. 100 MCG-UMECLID 62.5 MCG-VILANT 25 MCG INHALAT.POWDER,37.25,24.21,,,0
HCPCS,25000049,FLUTICASONE FUR. 200 MCG-UMECLID 62.5 MCG-VILANT 25 MCG INHALAT.POWDER,37.25,24.21,,,0
HCPCS,25000049,FLUTICASONE FUROATE 100 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER,24.25,15.76,,,0
HCPCS,25000049,FLUTICASONE FUROATE 200 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER,24.25,15.76,,,0
HCPCS,25000049,GENTAMICIN FORTIFIED OPH DROPS 14 MG/ML,62.75,40.79,,,0
HCPCS,25000049,GENTAMICIN IRRIGATION 160 MG/1000 ML (CMP PMX),72.4,47.06,,,0
HCPCS,25000049,GENTAMICIN IRRIGATION 360 MG/3000 ML (CMP PMX),128.8,83.72,,,0
HCPCS,25000049,GLYCERIN 99.5% ANHYDROUS INJECTION,763.7,496.4,,,0
HCPCS,25000049,HYDROMORPHONE 1 MG/ML ORAL LIQUID,9.4,6.11,,,0
HCPCS,25000049,HYDROMORPHONE 15 MG/30 ML (0.5 MG/ML) IN 0.9 % NACL IV PCA SYRINGE,111.8,72.67,,,0
HCPCS,25000049,HYDROXYPROGESTERONE CAPROATE (PF) 250 MG/ML INTRAMUSCULAR INJE,264.75,172.09,,,0
HCPCS,25000049,IDARUCIZUMAB 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,12698.7,8254.16,,,0
HCPCS,25000049,INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,795.15,516.85,,,0
HCPCS,25000049,INV DIMETHYL FUMARATE 120 MG CAPSULE,0.65,0.42,,,0
HCPCS,25000049,INV SODIUM CHLORIDE (NS) 0.9% SLUSH IRRIGATION SOLUTION,322.75,209.79,,,0
HCPCS,25000049,IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,10.7,6.96,,,0
HCPCS,25000049,ISOFLURANE 99.9 % INHALATION LIQUID,68.1,44.26,,,0
HCPCS,25000049,KETAMINE 100 MG/ML INJECTION SOLUTION,73.2,47.58,,,0
HCPCS,25000049,"KETAMINE 50 MG, PROPOFOL 50 MG 10 ML SYRINGE",37.75,24.54,,,0
HCPCS,25000049,"KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLOR,ISO-OSMOTIC IV SYRINGE",63.2,41.08,,,0
HCPCS,25000049,KETAMINE 50 MG/ML INJECTION SOLUTION,33.3,21.64,,,0
HCPCS,25000049,KETAMINE ORAL SOLUTION 20 MG/5 ML,10.4,6.76,,,0
HCPCS,25000049,"LACTATED RINGERS 1000ML+EPI,LIDO 1%, SOD BICARB (VENOUS ABLATION)",177.3,115.24,,,0
HCPCS,25000049,"LACTATED RINGERS 500ML +LIDO 1%, SOD BICARB (VENOUS ABLATION) 500 ML",177.3,115.24,,,0
HCPCS,25000049,LACTATED RINGERS IRRIGATION SOLUTION,81.175,52.76,,,0
HCPCS,25000049,LEECH KIT (STERILE),53.3,34.64,,,0
HCPCS,25000049,LETERMOVIR 480 MG/24 ML INTRAVENOUS SOLUTION,1945.3,1264.44,,,0
HCPCS,25000049,LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,9.25,6.01,,,0
HCPCS,25000049,"LEVETIRACETAM ER 750 MG TABLET,EXTENDED RELEASE 24 HR",5.8,3.77,,,0
HCPCS,25000049,LIDOCAINE (BUFFERED) TOPICAL SOLUTION (CMP),22.35,14.53,,,0
HCPCS,25000049,LIDOCAINE 4 %-EPINEPHRINE 0.18 %-TETRACAINE 0.5 % TOPICAL SOLUTION KIT,13.0,8.45,,,0
HCPCS,25000049,METHYL SALICYLATE 10 %-MENTHOL 3 % TOPICAL PATCH,1.2,0.78,,,0
HCPCS,25000049,MICONAZOLE NITRATE 2 % TOPICAL POWDER,2.65,1.72,,,0
HCPCS,25000049,MITOMYCIN 0.2 MG/ML TOPICAL OPHTHALMIC SOLUTION (COMPOUND),114.0,74.1,,,0
HCPCS,25000049,MITOMYCIN 0.4 MG/ML BLADDER NECK INJECTION SOLUTION,444.7,289.055,,,0
HCPCS,25000049,MORPHINE 0.5% IN LIDOCAINE TOPICAL SPRAY (CMP),35.0,22.75,,,0
HCPCS,25000049,MORPHINE 1% IN METRONIDAZOLE 1% TOPICAL GEL (CMP),342.35,222.53,,,0
HCPCS,25000049,MORPHINE 1% TOPICAL GEL (CMP),25.75,16.74,,,0
HCPCS,25000049,MORPHINE/LIDOCAINE 4%/4% SPRAY,364.8,237.12,,,0
HCPCS,25000049,MULTIVITAMIN-MINERALS-FOLIC ACID-LUTEIN 0.4 MG-250 MCG TABLET,4.95,3.22,,,0
HCPCS,25000049,"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",147.0,95.55,,,0
HCPCS,25000049,NALOXEGOL 12.5 MG TABLET,46.65,30.32,,,0
HCPCS,25000049,NALOXEGOL 25 MG TABLET,46.65,30.32,,,0
HCPCS,25000049,NETARSUDIL 0.02 % EYE DROPS,970.1,630.56,,,0
HCPCS,25000049,NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,6.05,3.93,,,0
HCPCS,25000049,NICARDIPINE 25 MG IN NS 250 ML (CMP PMX),112.85,73.35,,,0
HCPCS,25000049,NICOTINE 10 MG INHALATION CARTRIDGE,13.7,8.9,,,0
HCPCS,25000049,NITAZOXANIDE 500 MG TABLET,394.15,256.2,,,0
HCPCS,25000049,NITROPRUSSIDE 20 MG/100 ML (0.2 MG/ML) IN 0.9% SODIUM CHLORIDE IV SOLN,195.2,126.88,,,0
HCPCS,25000049,"OLIVE, SOYBEAN OIL FAT EMULSION 20 % INTRAVENOUS",65.7,42.7,,,0
HCPCS,25000049,OXYCHLOROSENE SODIUM TOPICAL POWDER FOR SOLUTION,21.2,13.78,,,0
HCPCS,25000049,PATIROMER CALCIUM SORBITEX 8.4 GRAM ORAL POWDER PACKET,97.1,63.12,,,0
HCPCS,25000049,PENICILLIN G POT 2.5 MU IN NS 100 ML (CMP PMX),30.05,19.53,,,0
HCPCS,25000049,PENTAMIDINE 300 MG SOLUTION FOR INHALATION,284.5,184.92,,,0
HCPCS,25000049,PENTAMIDINE 300 MG SOLUTION FOR INJECTION,218.4,141.96,,,0
HCPCS,25000049,PERITON. DIALYSIS SOLN 8-4.25 % DEXTROSE CALC 2.5 MEQ/L-MAG 0.5 MEQ/L,161.85,105.2,,,0
HCPCS,25000049,PERITON.DIALYSIS SOLN 6-1.5 % DEXTROS LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L,159.7,103.8,,,0
HCPCS,25000049,PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L,159.7,103.8,,,0
HCPCS,25000049,PHENYLEPHRINE 0.2 MG/ML IV SYRINGE 20 ML (RMH ANESTHESIA ONLY),161.75,105.14,,,0
HCPCS,25000049,PHENYLEPHRINE 200 MCG/ML INJECTION (1 ML),37.95,24.67,,,0
HCPCS,25000049,PHOSPHATE DIALYSIS SOLN WITHOUT DEXTR K 4 MEQ-CA 2.5 MEQ-PO4 1 MMOL/L,289.2,187.98,,,0
HCPCS,25000049,PHYSOSTIGMINE 0.4 MG/ML INTRAVENOUS SOLUTION,662.9,430.88,,,0
HCPCS,25000049,"POLYMYXIN B SULFATE 500,000 UNIT/2 ML SOLUTION FOR INJECTION",49.15,31.95,,,0
HCPCS,25000049,PORACTANT ALFA 240 MG/3 ML INTRATRACHEAL SUSPENSION,3365.7,2187.7,,,0
HCPCS,25000049,POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,412.8,268.32,,,0
HCPCS,25000049,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,47.65,30.97,,,0
HCPCS,25000049,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,81.6,53.04,,,0
HCPCS,25000049,PRIMING SOLUTION 1100 ML (CMP PMX),100.65,65.42,,,0
HCPCS,25000049,PSYLLIUM HUSK 6 GRAM ORAL POWDER PACKET,0.45,0.29,,,0
HCPCS,25000049,PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,60.85,39.55,,,0
HCPCS,25000049,REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,145.6,94.64,,,0
HCPCS,25000049,RILPIVIRINE HCL 25 MG TABLET,147.5,95.88,,,0
HCPCS,25000049,RILUZOLE 50 MG TABLET,6.3,4.1,,,0
HCPCS,25000049,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,34.7,22.56,,,0
HCPCS,25000049,ROTIGOTINE 2 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,87.85,57.1,,,0
HCPCS,25000049,SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,101.65,66.07,,,0
HCPCS,25000049,SELENIUM INJ 4 MCG/ML (CAPS),33.0,21.45,,,0
HCPCS,25000049,SELENIUM SULFIDE 2.5 % LOTION,42.8,27.82,,,0
HCPCS,25000049,SEMAGLUTIDE 3 MG TABLET,4.6,2.99,,,0
HCPCS,25000049,SENNA LEAF EXTRACT 176 MG/5 ML ORAL SYRUP,7.35,4.78,,,0
HCPCS,25000049,SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,31.95,20.77,,,0
HCPCS,25000049,SEVOFLURANE 99.97 % INHALATION LIQUID,269.45,175.14,,,0
HCPCS,25000049,SODIUM BICARBONATE (BULK) POWDER,197.15,128.15,,,0
HCPCS,25000049,SODIUM CHLORIDE 0.45 % IV BOLUS,62.95,40.92,,,0
HCPCS,25000049,SODIUM CHLORIDE 0.9 % (COLD) INTRAVENOUS SOLUTION,67.15,43.65,,,0
HCPCS,25000049,SODIUM CHLORIDE 0.9 % BLADDER IRRIGATION SOLUTION,71.35,46.38,,,0
HCPCS,25000049,SODIUM CHLORIDE 0.9 % FOR PRESSURIZED LINE SOLUTION,155.125,100.83000000000001,,,0
HCPCS,25000049,SODIUM CHLORIDE 0.9 % INTRAVENOUS FLUSH (BAG SIZE 100 ML OR LESS),66.3,43.1,,,0
HCPCS,25000049,"SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (CADD PUMP,EPOCH)",71.35,46.379999999999995,,,0
HCPCS,25000049,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,67.15,43.65,,,0
HCPCS,25000049,"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",33.4,21.71,,,0
HCPCS,25000049,SODIUM CHLORIDE 7 % FOR NEBULIZATION,6.55,4.26,,,0
HCPCS,25000049,SODIUM CHLORIDE-ALOE VERA NASAL GEL,18.75,12.19,,,0
HCPCS,25000049,SODIUM GLYCEROPHOSPHATE 1 MMOL/ML INTRAVENOUS SOLUTION,86.15,56.0,,,0
HCPCS,25000049,SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,88.6,57.59,,,0
HCPCS,25000049,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,80.25,52.16,,,0
HCPCS,25000049,SODIUM POLYSTYRENE SULFONATE 15 GRAM ORAL POWDER,202.8,131.82,,,0
HCPCS,25000049,"SODIUM,POTASSIUM,MAG SULFATES 17.5 GRAM-3.13 GRAM-1.6 GRAM ORAL SOLN",130.8,85.02,,,0
HCPCS,25000049,SORBITOL 3 % IRRIGATION SOLUTION,109.05,70.88,,,0
HCPCS,25000049,STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,521.9,339.24,,,0
HCPCS,25000049,STERILE TALC 4 GRAM INTRAPLEURAL SUSPENSION,738.5,480.02,,,0
HCPCS,25000049,STERILE TALC 5 GRAM INTRAPLEURAL SUSPENSION,473.9,308.04,,,0
HCPCS,25000049,SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,664.25,431.76,,,0
HCPCS,25000049,TAPENTADOL 50 MG TABLET,39.8,25.87,,,0
HCPCS,25000049,"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",611.8,397.67,,,0
HCPCS,25000049,"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SPRAY",698.95,454.32,,,0
HCPCS,25000049,"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SPRAY SYRINGE",698.95,454.32,,,0
HCPCS,25000049,"THROMBIN (BOVINE) 5,000 UNIT NASAL SPRAY SYRINGE",191.65,124.57,,,0
HCPCS,25000049,"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",165.4,107.51,,,0
HCPCS,25000049,"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SPRAY SYRINGE",178.75,116.19,,,0
HCPCS,25000049,"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",1048.0,681.2,,,0
HCPCS,25000049,TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,20.3,13.2,,,0
HCPCS,25000049,TOBRAMYCIN FORTIFIED OPH DROPS 13.6 MG/ML,75.95,49.37,,,0
HCPCS,25000049,TRACE ELEMENTS #1 5.33 MCG-0.34 MG-0.54 MG/ML INTRAVENOUS SOLUTION,100.25,65.16,,,0
HCPCS,25000049,TRACE ELEMENTS CR-CU-MN-SE-ZN 4-400-100-20 MCG-1000 MCG/ML IV SOLUTION,223.3,145.14,,,0
HCPCS,25000049,TRACE ELEMENTS CR-CU-MN-ZN 10 MCG-1 MG-0.5 MG-5 MG/ML INTRAVENOUS SOLN,55.5,36.08,,,0
HCPCS,25000049,TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,150.15,97.6,,,0
HCPCS,25000049,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",43.6,28.34,,,0
HCPCS,25000049,TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,257.2,167.18,,,0
HCPCS,25000049,UMECLIDINIUM 62.5 MCG-VILANTEROL 25 MCG/ACTUATION POWDR FOR INHALATION,28.15,18.3,,,0
HCPCS,25000049,VANCOMYCIN INTRAVITREAL SOLUTION 1000 MCG/0.1 ML,60.4,39.26,,,0
HCPCS,25000049,VENETOCLAX 10 MG TABLET,45.05,29.28,,,0
HCPCS,25000049,VENETOCLAX 100 MG TABLET,409.25,266.01,,,0
HCPCS,25000049,VENETOCLAX 50 MG TABLET,206.95,134.52,,,0
HCPCS,25000049,"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",357.55,232.41,,,0
HCPCS,25000049,"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",42.15,27.4,,,0
HCPCS,25000049,"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",71.35,46.38,,,0
HCPCS,25000049,"WATER FOR IRRIGATION, STERILE SOLUTION",67.15,43.65,,,0
HCPCS,25000049,WHITE PETROLATUM-MINERAL OIL 94 %-3 % EYE OINTMENT,27.75,18.04,,,0
HCPCS,25000049,ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,101.1,65.72,,,0
HCPCS,25000049,ZINC SULFATE 5 MG/ML INTRAVENOUS SOLUTION,167.75,109.04,,,0
HCPCS,25001,Incise flexor carpi radialis,,,3154.93,15689.0,2
HCPCS,25020,Decompress forearm 1 space,,,1550.46,9206.0,2
HCPCS,25023,Decompress forearm 1 space,,,3154.93,15689.0,2
HCPCS,25024,Decompress forearm 2 spaces,,,3154.93,15689.0,2
HCPCS,25025,Decompress forearm 2 spaces,,,1550.46,9206.0,2
HCPCS,25028,Drainage of forearm lesion,,,3154.93,15689.0,2
HCPCS,25031,Drainage of forearm bursa,,,1550.46,9206.0,2
HCPCS,25035,Treat forearm bone lesion,,,6996.6,31685.0,2
HCPCS,25040,Explore/treat wrist joint,,,3154.93,15689.0,2
HCPCS,25065,Biopsy forearm soft tissues,,,1592.51,9206.0,2
HCPCS,25066,Biopsy forearm soft tissues,,,2800.79,15689.0,2
HCPCS,25071,Exc forearm les sc 3 cm/>,,,1592.51,9206.0,2
HCPCS,25073,Exc forearm tum deep 3 cm/>,,,2800.79,15689.0,2
HCPCS,25075,Exc forearm les sc < 3 cm,,,1592.51,9206.0,2
HCPCS,25076,Exc forearm tum deep < 3 cm,,,1592.51,9206.0,2
HCPCS,25077,Resect forearm/wrist tum<3cm,,,2800.79,9206.0,2
HCPCS,25078,Resect forarm/wrist tum 3cm>,,,2800.79,15689.0,2
HCPCS,25085,Incision of wrist capsule,,,3154.93,15689.0,2
HCPCS,25100,Biopsy of wrist joint,,,3154.93,15689.0,2
HCPCS,25101,Explore/treat wrist joint,,,3154.93,15689.0,2
HCPCS,25105,Remove wrist joint lining,,,3154.93,15689.0,2
HCPCS,25107,Remove wrist joint cartilage,,,3154.93,15689.0,2
HCPCS,25109,Excise tendon forearm/wrist,,,3154.93,15689.0,2
HCPCS,25110,Remove wrist tendon lesion,,,1550.46,9206.0,2
HCPCS,25111,Remove wrist tendon lesion,,,1550.46,9206.0,2
HCPCS,25112,Reremove wrist tendon lesion,,,1550.46,9206.0,2
HCPCS,25115,Remove wrist/forearm lesion,,,1550.46,9206.0,2
HCPCS,25116,Remove wrist/forearm lesion,,,3154.93,15689.0,2
HCPCS,25118,Excise wrist tendon sheath,,,1550.46,9206.0,2
HCPCS,25119,Partial removal of ulna,,,3154.93,15689.0,2
HCPCS,25120,Removal of forearm lesion,,,3154.93,15689.0,2
HCPCS,25125,Remove/graft forearm lesion,,,1550.46,9206.0,2
HCPCS,25126,Remove/graft forearm lesion,,,3154.93,15689.0,2
HCPCS,25130,Removal of wrist lesion,,,3154.93,15689.0,2
HCPCS,25135,Remove & graft wrist lesion,,,6996.6,15689.0,2
HCPCS,25136,Remove & graft wrist lesion,,,6996.6,31685.0,2
HCPCS,25145,Remove forearm bone lesion,,,3154.93,15689.0,2
HCPCS,25150,Partial removal of ulna,,,3154.93,15689.0,2
HCPCS,25151,Partial removal of radius,,,3154.93,15689.0,2
HCPCS,25170,Resect radius/ulnar tumor,,,6996.6,31685.0,2
HCPCS,25210,Removal of wrist bone,,,3154.93,15689.0,2
HCPCS,25215,Removal of wrist bones,,,3154.93,15689.0,2
HCPCS,25230,Partial removal of radius,,,3154.93,15689.0,2
HCPCS,25240,Partial removal of ulna,,,3154.93,15689.0,2
HCPCS,25246,Hc Inj Arthrography Wrist,1818.0,1181.6999999999998,,,0
HCPCS,25248,Remove forearm foreign body,,,1550.46,9206.0,2
HCPCS,25250,Removal of wrist prosthesis,,,1550.46,9206.0,2
HCPCS,25251,Removal of wrist prosthesis,,,3154.93,15689.0,2
HCPCS,25259,Manipulate wrist w/anesthes,,,1550.46,9206.0,2
HCPCS,25260,Repair forearm tendon/muscle,,,3154.93,15689.0,2
HCPCS,25263,Repair forearm tendon/muscle,,,6996.6,15689.0,2
HCPCS,25265,Repair forearm tendon/muscle,,,3154.93,15689.0,2
HCPCS,25270,Repair forearm tendon/muscle,,,3154.93,15689.0,2
HCPCS,25272,Repair forearm tendon/muscle,,,3154.93,15689.0,2
HCPCS,25274,Repair forearm tendon/muscle,,,3154.93,15689.0,2
HCPCS,25275,Repair forearm tendon sheath,,,3154.93,15689.0,2
HCPCS,25280,Revise wrist/forearm tendon,,,3154.93,15689.0,2
HCPCS,25290,Incise wrist/forearm tendon,,,3154.93,15689.0,2
HCPCS,25295,Release wrist/forearm tendon,,,3154.93,15689.0,2
HCPCS,25300,Fusion of tendons at wrist,,,3154.93,15689.0,2
HCPCS,25301,Fusion of tendons at wrist,,,3154.93,15689.0,2
HCPCS,25310,Transplant forearm tendon,,,3154.93,15689.0,2
HCPCS,25312,Transplant forearm tendon,,,3154.93,15689.0,2
HCPCS,25315,Revise palsy hand tendon(s),,,6996.6,31685.0,2
HCPCS,25316,Revise palsy hand tendon(s),,,6996.6,31685.0,2
HCPCS,25320,Repair/revise wrist joint,,,6996.6,31685.0,2
HCPCS,25332,Revise wrist joint,,,3154.93,15689.0,2
HCPCS,25335,Realignment of hand,,,3154.93,15689.0,2
HCPCS,25337,Reconstruct ulna/radioulnar,,,6996.6,31685.0,2
HCPCS,25350,Revision of radius,,,6996.6,31685.0,2
HCPCS,25355,Revision of radius,,,3154.93,15689.0,2
HCPCS,25360,Revision of ulna,,,6996.6,31685.0,2
HCPCS,25365,Revise radius & ulna,,,12379.34,38216.0,2
HCPCS,25370,Revise radius or ulna,,,3154.93,15689.0,2
HCPCS,25375,Revise radius & ulna,,,3154.93,15689.0,2
HCPCS,25390,Shorten radius or ulna,,,6996.6,31685.0,2
HCPCS,25391,Lengthen radius or ulna,,,12379.34,38216.0,2
HCPCS,25392,Shorten radius & ulna,,,6996.6,15689.0,2
HCPCS,25393,Lengthen radius & ulna,,,6996.6,15689.0,2
HCPCS,25394,Repair carpal bone shorten,,,3154.93,15689.0,2
HCPCS,25400,Repair radius or ulna,,,6996.6,31685.0,2
HCPCS,25405,Repair/graft radius or ulna,,,6996.6,31685.0,2
HCPCS,25415,Repair radius & ulna,,,6996.6,31685.0,2
HCPCS,25420,Repair/graft radius & ulna,,,6996.6,31685.0,2
HCPCS,25425,Repair/graft radius or ulna,,,6996.6,31685.0,2
HCPCS,25426,Repair/graft radius & ulna,,,3154.93,15689.0,2
HCPCS,25430,Vasc graft into carpal bone,,,3154.93,15689.0,2
HCPCS,25431,Repair nonunion carpal bone,,,6996.6,31685.0,2
HCPCS,25440,Repair/graft wrist bone,,,6996.6,31685.0,2
HCPCS,25441,Reconstruct wrist joint,,,12379.34,38216.0,2
HCPCS,25442,Reconstruct wrist joint,,,16906.49,63079.0,2
HCPCS,25443,Reconstruct wrist joint,,,6996.6,31685.0,2
HCPCS,25444,Reconstruct wrist joint,,,12379.34,38216.0,2
HCPCS,25445,Reconstruct wrist joint,,,6996.6,31685.0,2
HCPCS,25446,Wrist replacement,,,16906.49,63079.0,2
HCPCS,25447,Repair wrist joints,,,3154.93,15689.0,2
HCPCS,25448,Arthrp ntrcrpl/crp/mtcrp ssp,,,3154.93,15689.0,2
HCPCS,25449,Remove wrist joint implant,,,6996.6,31685.0,2
HCPCS,25450,Revision of wrist joint,,,3154.93,15689.0,2
HCPCS,25455,Revision of wrist joint,,,3154.93,15689.0,2
HCPCS,25490,Reinforce radius,,,6996.6,31685.0,2
HCPCS,25491,Reinforce ulna,,,12379.34,38216.0,2
HCPCS,25492,Reinforce radius and ulna,,,3154.93,15689.0,2
HCPCS,25500,Treat fracture of radius,,,237.84,3714.0,2
HCPCS,25505,Treat fracture of radius,,,1550.46,9206.0,2
HCPCS,25515,Treat fracture of radius,,,6996.6,31685.0,2
HCPCS,25520,Treat fracture of radius,,,1550.46,9206.0,2
HCPCS,25525,Treat fracture of radius,,,6996.6,31685.0,2
HCPCS,25526,Treat fracture of radius,,,6996.6,31685.0,2
HCPCS,25530,Treat fracture of ulna,,,237.84,3714.0,2
HCPCS,25535,Treat fracture of ulna,,,237.84,3714.0,2
HCPCS,25545,Treat fracture of ulna,,,6996.6,31685.0,2
HCPCS,25560,Treat fracture radius & ulna,,,237.84,3714.0,2
HCPCS,25565,Treat fracture radius & ulna,,,1550.46,9206.0,2
HCPCS,25574,Treat fracture radius & ulna,,,6996.6,31685.0,2
HCPCS,25575,Treat fracture radius/ulna,,,6996.6,31685.0,2
HCPCS,25600,Treat fracture radius/ulna,,,237.84,3714.0,2
HCPCS,25600001,INV ACETYLSALICYLIC ACID 325 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ACTIVATED CHARCOAL-SORBITOL SUSPENSION,0.65,0.42,,,0
HCPCS,25600001,"INV AERUCIN/PLACEBO (AERUBUMAB, AR-105) 27.5 MG/ML INJECTION",0.65,0.42,,,0
HCPCS,25600001,INV AFATINIB 20 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV AFATINIB 30 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV AFATINIB 40 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ALTEPLASE/PLACEBO BOLUS FROM THE BAG,0.65,0.42,,,0
HCPCS,25600001,INV AMANTADINE (ADS-5102) 137 MG ER CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV AMANTADINE (ADS-5102) 68.5 MG/137 MG/PLACEBO ER CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV APIXABAN 2.5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV APIXABAN 5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV APIXABAN/PLACEBO 2.5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV APIXABAN/PLACEBO 5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ARMODAFINIL 150 MG/ARMODAFINIL 250 MG/PLACEBO TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ART-123/PLACEBO 6 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV ASPIRIN EC 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ASPIRIN EC 81 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ASPIRIN EC/PLACEBO 81 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ASPIRIN/PLACEBO 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ASPIRIN/PLACEBO 300 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ASPIRIN/PLACEBO 325 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ASPIRIN/PLACEBO 81 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ASUNDEXIAN/PLACEBO 50MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ATORVASTATIN/PLACEBO 40 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV AZTREONAM 1 GRAM SOLUTION FOR INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV AZTREONAM 2 GRAM SOLUTION FOR INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV AZTREONAM/PLACEBO 1 GRAM SOLUTION FOR INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV BATIRAXCEPT (AVB-S6-500)/PLACEBO 20 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV BINIMETINIB 15 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV BMS-986141/PLACEBO TABLET,0.65,0.42,,,0
HCPCS,25600001,INV BUPROPION XL/PLACEBO 24 HR CAPSULE 150 MG,0.65,0.42,,,0
HCPCS,25600001,INV CABOZANTINIB 20 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV CABOZANTINIB 60 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV CALCIUM-VIT D3 150 MG-133 UNIT CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV CAP-1002/PLACEBO 25 MILLION CELLS/10 ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,"INV CB-183,315/PLACEBO/VANCOMYCIN CAPSULE",0.65,0.42,,,0
HCPCS,25600001,"INV CB-183,315/PLACEBO/VANCOMYCIN CAPSULE (KIT)",0.65,0.42,,,0
HCPCS,25600001,INV CEDIRANIB 15 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV CEDIRANIB 20 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV CELECOXIB/PLACEBO 400 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV CENOBAMATE 50 MG/100 MG/PLACEBO TABLET,0.65,0.42,,,0
HCPCS,25600001,INV CENOBAMATE/PLACEBO 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV CENOBAMATE/PLACEBO 12.5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV CERITINIB 150 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV CF-301/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV CHOLESTYRAMINE-ASPARTAME 4 GM PACKET,0.65,0.42,,,0
HCPCS,25600001,INV CIPROFLOXACIN 500 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV CIPROFLOXACIN 500 MG/AMOXICILLIN-CLAVULANATE 875 MG-125 MG/PLACEBO AND METRONIDAZOLE 500 MG/PLACEBO CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV CIPROFLOXACIN 500 MG/AMOXICILLIN-CLAVULANATE 875 MG-125 MG/PLACEBO CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV CLOFAZIMINE 50 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV CLOPIDOGREL/PLACEBO 75 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV CLOPIDROGEL/PLACEBO TABLET,0.65,0.42,,,0
HCPCS,25600001,INV CLOSTRIDIUM DIFFICILE TOXOID VACCINE/PLACEBO,0.65,0.42,,,0
HCPCS,25600001,INV CLOSTRIDIUM DIFFICILE VACCINE/PLACEBO 200 MCG/0.5 ML,0.65,0.42,,,0
HCPCS,25600001,INV CRIZOTINIB 250 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV DAROLUTAMIDE 300MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV DCVAX-L 1.25 MILLION CELLS INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV DCVAX-L/PLACEBO 1.25 MILLION CELLS INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV DEXTROSE 5% SOLUTION FLUSH,0.65,0.42,,,0
HCPCS,25600001,INV DIPHENHYDRAMINE 25 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV DIPHENHYDRAMINE 50 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV DONEPEZIL/PLACEBO 5 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV DROXIDOPA 100 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV DROXIDOPA 200 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV DROXIDOPA 300 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV DROXIDOPA/PLACEBO 100 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV DROXIDOPA/PLACEBO 200 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV DROXIDOPA/PLACEBO 300 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV DULOXETINE/PLACEBO 30 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV EFLORNITHINE 150 MG/ML ORAL SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV EFLORNITHINE/PLACEBO 250 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ELESCLOMOL 250 MG/5.54 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV ENTINOSTAT/PLACEBO 1 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ENTINOSTAT/PLACEBO 5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ERLOTINIB 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ERLOTINIB 150 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ERLOTINIB 25 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ERLOTINIB/PLACEBO 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ERLOTINIB/PLACEBO 150 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ERLOTINIB/PLACEBO 25 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV EVEROLIMUS 10 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV EVEROLIMUS 2.5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV EVEROLIMUS 5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV EVEROLIMUS/PLACEBO 5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV EVOBRUTINIB/PLACEBO 45 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV EVOGLIPTIN (DA-1229) 5 MG/10 MG/PLACEBO,0.65,0.42,,,0
HCPCS,25600001,INV EXEMESTANE 25 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV FARLETUZUMAB/PLACEBO 5 MG/ML INFUSION,0.65,0.42,,,0
HCPCS,25600001,INV FENEBRUTINIB 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV FENEBRUTINIB/PLACEBO 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV FLECAINIDE ACETATE (FLECIH-103)/PLACEBO,0.65,0.42,,,0
HCPCS,25600001,INV IBERDOMIDE (CC-220) 0.75 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV IBERDOMIDE (CC-220) 1 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV IBERDOMIDE (CC-220) 1.3 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV IBERDOMIDE (CC-220) 1.6 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV IBUPROFEN 400 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV INDOCYANINE GREEN 25 MG/5 ML SOLUTION FOR INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV IXAZOMIB 2.3 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV IXAZOMIB 3 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV IXAZOMIB 4 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV IXAZOMIB/PLACEBO 2.3 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV IXAZOMIB/PLACEBO 3 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV IXAZOMIB/PLACEBO 4 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV JVS-100/PLACEBO 1 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV KEYHOLE LIMPET HEMOCYANIN 1 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV LACTATED RINGERS INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV LAU-7B/PLACEBO 100 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV LENALIDOMIDE 10 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV LENALIDOMIDE 2.5 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV LENALIDOMIDE 25 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV LENALIDOMIDE 5 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV LISINOPRIL/CARVEDILOL CR/PLACEBO 10 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV LJPC-501/PLACEBO 2.5 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV LLG783/PLACEBO 150 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV LOMUSTINE 10 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV LOMUSTINE 100 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV LOMUSTINE 40 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV LOPERAMIDE 2 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV LOPERAMIDE/PLACEBO 2 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV MAGNESIUM CITRATE SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV MAS825/PLACEBO 100 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV MEDI-551 10 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV MEDI-551/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV METFORMIN/PLACEBO 850 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV METRONIDAZOLE IN NACL 500 MG/100 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV MEZIGDOMIDE (CC-92480) 0.2 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV MEZIGDOMIDE (CC-92480) 0.3 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV MEZIGDOMIDE (CC-92480) 0.4 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV MEZIGDOMIDE (CC-92480) 0.6 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV MEZIGDOMIDE (CC-92480) 0.8 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV MEZIGDOMIDE (CC-92480) 1 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV MILVEXIAN/PLACEBO 25 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV NA-1/PLACEBO 20 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV NAVTEMADLIN 30 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV NAVTEMADLIN 60 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV NAVTEMADLIN/PLACEBO 30 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV NAVTEMADLIN/PLACEBO 60 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV NEBULIZER RESERVOIR AND CAP KIT,0.65,0.42,,,0
HCPCS,25600001,INV NETUPITANT-PALONOSETRON (AKYNZEO) 300-0.5 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV NIRAPARIB 100 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV NITROGLYCERIN 400 MCG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV O.N.E. MULTIVITAMIN CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV OLANZAPINE/PLACEBO 10 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV OLAPARIB 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV OLAPARIB 150 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV OLAPARIB/PLACEBO 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV OLAPARIB/PLACEBO 150 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV OMECAMTIV MECARBIL/PLACEBO TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ONDANSETRON 8 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ONDANSETRON/PLACEBO 8 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV OPICINUMAB (BIIB003) 200 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV OPICINUMAB (BIIB003)/PLACEBO 200 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV OSELTAMIVIR 30 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV OSIMERTINIB 40 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV OSIMERTINIB 80 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV PADSEVONIL 25 MG/100 MG/200 MG/PLACEBO TABLET 4-DAY KIT,0.65,0.42,,,0
HCPCS,25600001,INV PADSEVONIL 25 MG/100 MG/200 MG/PLACEBO TABLET 7-DAY KIT,0.65,0.42,,,0
HCPCS,25600001,INV PALBOCICLIB 100 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV PALBOCICLIB 125 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV PALBOCICLIB 75 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV PANTOPRAZOLE EC 40 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV PATIROMER/PLACEBO 8.4 GRAM PACKET,0.65,0.42,,,0
HCPCS,25600001,INV PAZOPANIB/PLACEBO 200 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV PDDS CLINICAL CONTROL MODULE,0.65,0.42,,,0
HCPCS,25600001,INV PDDS CLINICAL HANDHELD ADAPTOR,0.65,0.42,,,0
HCPCS,25600001,INV PDDS CLINICAL ON-VENT ADAPTOR KIT,0.65,0.42,,,0
HCPCS,25600001,INV PEGINTERFERON BETA-1A 125 MCG/0.5 ML SYRINGE,0.65,0.42,,,0
HCPCS,25600001,INV PEGINTERFERON BETA-1A 63 MCG/0.5 ML SYRINGE,0.65,0.42,,,0
HCPCS,25600001,INV PEGINTERFERON BETA-1A 94 MCG/0.5 ML SYRINGE,0.65,0.42,,,0
HCPCS,25600001,INV PENICILLIN V POTASSIUM 250 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV PLASMALYTE-A 10ML SYRINGE,0.65,0.42,,,0
HCPCS,25600001,INV POLYETHYLENE GLYCOL SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV POLYMYXIN-B CARTRIDGE,0.65,0.42,,,0
HCPCS,25600001,INV POLYMYXIN-B/SHAM CARTRIDGE,0.65,0.42,,,0
HCPCS,25600001,INV PONESIMOD 20 MG OR TERIFLUNOMIDE 14 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV PONESIMOD 20 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV PONESIMOD TABLET,0.65,0.42,,,0
HCPCS,25600001,INV PONESIMOD/PLACEBO 20 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV PONESIMOD/PLACEBO TABLET,0.65,0.42,,,0
HCPCS,25600001,INV PRASUGREL/PLACEBO 10 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV PRASUGREL/PLACEBO 5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV PREDNISOLONE ACETATE 1% OPHTHALMIC SUSPENSION,0.65,0.42,,,0
HCPCS,25600001,INV PROCHLORPERAZINE 5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV PROCHLORPERAZINE/PLACEBO 10 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV QUIZARTINIB DIHYDROCHLORIDE/PLACEBO 20 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV QUIZARTINIB DIHYDROCHLORIDE/PLACEBO 30 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV RANOLAZINE/PLACEBO 500 MG TB12 TABLET,0.65,0.42,,,0
HCPCS,25600001,INV REFRESH OPTIVE ADVANCED (PRESERVATIVE-FREE) OPHTHALMIC SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV REGN10933 + INV REGN10987 2.4 GM/8 GM/PLACEBO IN 0.9% SODIUM CHLORIDE 250 ML,0.65,0.42,,,0
HCPCS,25600001,INV REMDESIVIR 100 MG/20 ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV REMDESIVIR 5 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV REXLEMESTROCEL-L (CEP-41750)/PLACEBO 37.5 MIL CELLS/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV RIVAROXOBAN 10 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV RIVAROXOBAN 15 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV RIVAROXOBAN 20 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV RIVAROXOBAN/PLACEBO 2.5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV RUCAPARIB/PLACEBO 200 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV RUCAPARIB/PLACEBO 250 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV RUCAPARIB/PLACEBO 300 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV RUXOLITINIB 5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV SARS-COV-2 HYPERIMMUNE GLOBULIN (HIVIG)/PLACEBO 100 MG/ML IV,0.65,0.42,,,0
HCPCS,25600001,INV SATRALIZUMAB 120 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV SELEPRESSIN/PLACEBO INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV SELINEXOR/PLACEBO 20 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV SER-109 CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV SER-109/PLACEBO CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV SER-262/PLACEBO CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV SERELAXIN/PLACEBO 3.5 MG/3.5 ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV SIPONIMOD 0.25 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV SIPONIMOD 2 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV SMT 199969/PLACEBO/VANCOMYCIN CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV SODIUM CHLORIDE (NS) 0.9% FLUSH SYRINGE 26 ML,0.65,0.42,,,0
HCPCS,25600001,INV SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV SODIUM CHLORIDE 0.9% INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV SODIUM CHLORIDE 0.9% SOLUTION FLUSH,0.65,0.42,,,0
HCPCS,25600001,INV SORAFENIB TOSYLATE  (BAY 43-9006) 200 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV SOTORASIB 120 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV STAPHYLOCOCCUS AUREUS 4-ANTIGEN VACCINE/PLACEBO INJ,0.65,0.42,,,0
HCPCS,25600001,INV SULINDAC/PLACEBO 150 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV SULOPENEM ETZADROXIL 500 MG & PROBENECID 500MG/PLACEBO TABLET,0.65,0.42,,,0
HCPCS,25600001,INV SULOPENEM/PLACEBO 1000MG/10ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV SYN-004/PLACEBO 75 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV TAK-700 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV TD-0903/PLACEBO NEBULIZER SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV TECOVIRIMAT 200 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV TELAGLENASTAT/PLACEBO 200 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV TERIFLUNOMIDE/PLACEBO 14 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV TERIFLUNOMIDE/PLACEBO 14 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV TICAGRELOR 90 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV TICAGRELOR/PLACEBO 60 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV TICAGRELOR/PLACEBO 90 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV TL-895 50 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV TL-895/PLACEBO 50 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV TRAMETINIB 0.5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV TRAMETINIB 2 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV TRC105 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV TRC105 7 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV TREBANANIB/PLACEBO 30 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV TRIAPINE 5 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,25600001,INV URCC 16070 TAKE HOME KIT,0.65,0.42,,,0
HCPCS,25600001,INV USL261/PLACEBO 5 MG/0.1 ML NASAL SPRAY,0.65,0.42,,,0
HCPCS,25600001,INV VARITHENA ADMINISTRATION PACK,0.65,0.42,,,0
HCPCS,25600001,INV VEBRELTINIB (APL-101) 100MG,0.65,0.42,,,0
HCPCS,25600001,INV VELIPARIB/PLACEBO 100 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV VELIPARIB/PLACEBO 50 MG CAPSULE,0.65,0.42,,,0
HCPCS,25600001,INV VENETOCLAX 10 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV VENETOCLAX 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV VENETOCLAX 50 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV VIS410 2000 MG/VIS410 4000MG/PLACEBO INFUSION,0.65,0.42,,,0
HCPCS,25600001,INV VIS410/PLACEBO 25 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,25600001,INV YKP3089 (CENOBAMATE) 100 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV YKP3089 (CENOBAMATE) 12.5 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV YKP3089 (CENOBAMATE) 150 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV YKP3089 (CENOBAMATE) 200 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV YKP3089 (CENOBAMATE) 25 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV YKP3089 (CENOBAMATE) 50 MG TABLET,0.65,0.42,,,0
HCPCS,25600001,INV ZN-C3 100 MG TABLETS,0.65,0.42,,,0
HCPCS,25600001,INV ZN-C3 25 MG TABLETS,0.65,0.42,,,0
HCPCS,25600001,POLIDOCANOL 1 % INTRAVENOUS FOAM,0.65,0.42,,,0
HCPCS,25605,Treat fracture radius/ulna,,,1550.46,9206.0,2
HCPCS,25606,Treat Fx Distal Radial,,,3154.93,15689.0,2
HCPCS,25607,Treat Fx Rad Extra-Articul,,,6996.6,31685.0,2
HCPCS,25608,Treat Fx Rad Intra-Articul,,,6996.6,31685.0,2
HCPCS,25609,Treat Fx Radial 3+ Frag,,,6996.6,31685.0,2
HCPCS,25622,Treat wrist bone fracture,,,237.84,3714.0,2
HCPCS,25624,Treat wrist bone fracture,,,1550.46,9206.0,2
HCPCS,25628,Treat wrist bone fracture,,,6996.6,31685.0,2
HCPCS,25630,Treat wrist bone fracture,,,237.84,3714.0,2
HCPCS,25635,Treat wrist bone fracture,,,1550.46,9206.0,2
HCPCS,25645,Treat wrist bone fracture,,,3154.93,15689.0,2
HCPCS,25650,Treat wrist bone fracture,,,237.84,3714.0,2
HCPCS,25651,Pin ulnar styloid fracture,,,3154.93,15689.0,2
HCPCS,25652,Treat fracture ulnar styloid,,,6996.6,31685.0,2
HCPCS,25660,Treat wrist dislocation,,,237.84,3714.0,2
HCPCS,25670,Treat wrist dislocation,,,6996.6,15689.0,2
HCPCS,25671,Pin radioulnar dislocation,,,3154.93,15689.0,2
HCPCS,25675,Treat wrist dislocation,,,237.84,3714.0,2
HCPCS,25676,Treat wrist dislocation,,,6996.6,31685.0,2
HCPCS,25680,Treat wrist fracture,,,237.84,3714.0,2
HCPCS,25685,Treat wrist fracture,,,6996.6,15689.0,2
HCPCS,25690,Treat wrist dislocation,,,1550.46,9206.0,2
HCPCS,25695,Treat wrist dislocation,,,6996.6,31685.0,2
HCPCS,25800,Fusion of wrist joint,,,6996.6,31685.0,2
HCPCS,25805,Fusion/graft of wrist joint,,,6996.6,31685.0,2
HCPCS,25810,Fusion/graft of wrist joint,,,12379.34,38216.0,2
HCPCS,25820,Fusion of hand bones,,,6996.6,31685.0,2
HCPCS,25825,Fuse hand bones with graft,,,6996.6,31685.0,2
HCPCS,25830,Fusion radioulnar jnt/ulna,,,6996.6,31685.0,2
HCPCS,25900,Amputation of forearm,,,6996.6,15689.0,2
HCPCS,25905,Amputation of forearm,,,6996.6,15689.0,2
HCPCS,25907,Amputation follow-up surgery,,,3154.93,15689.0,2
HCPCS,25909,Amputation follow-up surgery,,,6996.6,15689.0,2
HCPCS,25915,Amputation of forearm,,,6996.6,15689.0,2
HCPCS,25920,Amputate hand at wrist,,,3154.93,15689.0,2
HCPCS,25922,Amputate hand at wrist,,,1550.46,9206.0,2
HCPCS,25924,Amputation follow-up surgery,,,3154.93,15689.0,2
HCPCS,25927,Amputation of hand,,,3154.93,15689.0,2
HCPCS,25929,Amputation follow-up surgery,,,1989.46,9206.0,2
HCPCS,25931,Amputation follow-up surgery,,,3154.93,15689.0,2
HCPCS,25999,Forearm or wrist surgery,,,237.84,16564.0,2
HCPCS,26010,Drainage of finger abscess,,,193.46,3714.0,2
HCPCS,26010,Hc Drain Finger Abcess Simple,1750.0,1137.5,,,0
HCPCS,26011,Drainage of finger abscess,,,1592.51,9206.0,2
HCPCS,26011,Hc Drainage Of Finger Abscess Complicated,3995.0,2596.75,,,0
HCPCS,26020,Drain hand tendon sheath,,,3154.93,15689.0,2
HCPCS,26025,Drainage of palm bursa,,,3154.93,15689.0,2
HCPCS,26030,Drainage of palm bursas,,,3154.93,15689.0,2
HCPCS,26034,Treat hand bone lesion,,,1550.46,9206.0,2
HCPCS,26035,Decompress fingers/hand,,,3154.93,15689.0,2
HCPCS,26037,Decompress fingers/hand,,,3154.93,15689.0,2
HCPCS,26040,Release palm contracture,,,1550.46,9206.0,2
HCPCS,26045,Release palm contracture,,,3154.93,15689.0,2
HCPCS,26055,Incise finger tendon sheath,,,1550.46,9206.0,2
HCPCS,26060,Incision of finger tendon,,,1550.46,9206.0,2
HCPCS,26070,Explore/treat hand joint,,,1550.46,9206.0,2
HCPCS,26075,Explore/treat finger joint,,,3154.93,15689.0,2
HCPCS,26080,Explore/treat finger joint,,,1550.46,9206.0,2
HCPCS,26100,Biopsy hand joint lining,,,3154.93,15689.0,2
HCPCS,26105,Biopsy finger joint lining,,,3154.93,15689.0,2
HCPCS,26110,Biopsy finger joint lining,,,1550.46,9206.0,2
HCPCS,26111,Exc hand les sc 1.5 cm/>,,,1592.51,9206.0,2
HCPCS,26113,Exc hand tum deep 1.5 cm/>,,,1592.51,9206.0,2
HCPCS,26115,Exc hand les sc < 1.5 cm,,,1592.51,9206.0,2
HCPCS,26116,Exc hand tum deep < 1.5 cm,,,1592.51,9206.0,2
HCPCS,26117,Rad resect hand tumor < 3 cm,,,2800.79,15689.0,2
HCPCS,26118,Rad resect hand tumor 3 cm/>,,,2800.79,15689.0,2
HCPCS,26121,Release palm contracture,,,3154.93,15689.0,2
HCPCS,26123,Release palm contracture,,,3154.93,15689.0,2
HCPCS,26130,Remove wrist joint lining,,,3154.93,15689.0,2
HCPCS,26135,Revise finger joint each,,,3154.93,15689.0,2
HCPCS,26140,Revise finger joint each,,,1550.46,9206.0,2
HCPCS,26145,Tendon excision palm/finger,,,1550.46,9206.0,2
HCPCS,26160,Remove tendon sheath lesion,,,1550.46,9206.0,2
HCPCS,26170,Removal of palm tendon each,,,1550.46,9206.0,2
HCPCS,26180,Removal of finger tendon,,,1550.46,9206.0,2
HCPCS,26185,Remove finger bone,,,1550.46,9206.0,2
HCPCS,26200,Remove hand bone lesion,,,1550.46,9206.0,2
HCPCS,26205,Remove/graft bone lesion,,,6996.6,31685.0,2
HCPCS,26210,Removal of finger lesion,,,1550.46,9206.0,2
HCPCS,26215,Remove/graft finger lesion,,,3154.93,15689.0,2
HCPCS,26230,Partial removal of hand bone,,,3154.93,15689.0,2
HCPCS,26235,Partial removal finger bone,,,1550.46,9206.0,2
HCPCS,26236,Partial removal finger bone,,,1550.46,9206.0,2
HCPCS,26250,Extensive hand surgery,,,3154.93,15689.0,2
HCPCS,26260,Resect prox finger tumor,,,3154.93,15689.0,2
HCPCS,26262,Resect distal finger tumor,,,1550.46,9206.0,2
HCPCS,26320,Removal of implant from hand,,,1592.51,9206.0,2
HCPCS,26340,Manipulate finger w/anesth,,,1550.46,9206.0,2
HCPCS,26341,Manipulat palm cord post inj,,,237.84,3714.0,2
HCPCS,26350,Repair finger/hand tendon,,,3154.93,15689.0,2
HCPCS,26352,Repair/graft hand tendon,,,6996.6,15689.0,2
HCPCS,26356,Repair finger/hand tendon,,,3154.93,15689.0,2
HCPCS,26357,Repair finger/hand tendon,,,3154.93,15689.0,2
HCPCS,26358,Repair/graft hand tendon,,,6996.6,15689.0,2
HCPCS,26370,Repair finger/hand tendon,,,3154.93,15689.0,2
HCPCS,26372,Repair/graft hand tendon,,,6996.6,31685.0,2
HCPCS,26373,Repair finger/hand tendon,,,3154.93,15689.0,2
HCPCS,26390,Revise hand/finger tendon,,,6996.6,31685.0,2
HCPCS,26392,Repair/graft hand tendon,,,6996.6,31685.0,2
HCPCS,26410,Repair hand tendon,,,1550.46,9206.0,2
HCPCS,26412,Repair/graft hand tendon,,,3154.93,15689.0,2
HCPCS,26415,Excision hand/finger tendon,,,3154.93,15689.0,2
HCPCS,26416,Graft hand or finger tendon,,,3154.93,15689.0,2
HCPCS,26418,Hc Repair Hand Tendon Or Flexor,2801.0,1820.65,,,0
HCPCS,26418,Repair finger tendon,,,1550.46,9206.0,2
HCPCS,26420,Repair/graft finger tendon,,,3154.93,15689.0,2
HCPCS,26426,Repair finger/hand tendon,,,3154.93,15689.0,2
HCPCS,26428,Repair/graft finger tendon,,,3154.93,15689.0,2
HCPCS,26432,Repair finger tendon,,,1550.46,9206.0,2
HCPCS,26433,Repair finger tendon,,,3154.93,15689.0,2
HCPCS,26434,Repair/graft finger tendon,,,3154.93,15689.0,2
HCPCS,26437,Realignment of tendons,,,3154.93,15689.0,2
HCPCS,26440,Release palm/finger tendon,,,1550.46,9206.0,2
HCPCS,26442,Release palm & finger tendon,,,3154.93,15689.0,2
HCPCS,26445,Release hand/finger tendon,,,3154.93,15689.0,2
HCPCS,26449,Release forearm/hand tendon,,,3154.93,15689.0,2
HCPCS,26450,Incision of palm tendon,,,3154.93,15689.0,2
HCPCS,26455,Incision of finger tendon,,,1550.46,9206.0,2
HCPCS,26460,Incise hand/finger tendon,,,1550.46,9206.0,2
HCPCS,26471,Fusion of finger tendons,,,3154.93,15689.0,2
HCPCS,26474,Fusion of finger tendons,,,1550.46,9206.0,2
HCPCS,26476,Tendon lengthening,,,3154.93,15689.0,2
HCPCS,26477,Tendon shortening,,,3154.93,15689.0,2
HCPCS,26478,Lengthening of hand tendon,,,3154.93,15689.0,2
HCPCS,26479,Shortening of hand tendon,,,3154.93,15689.0,2
HCPCS,26480,Transplant hand tendon,,,3154.93,15689.0,2
HCPCS,26483,Transplant/graft hand tendon,,,3154.93,15689.0,2
HCPCS,26485,Transplant palm tendon,,,3154.93,15689.0,2
HCPCS,26489,Transplant/graft palm tendon,,,3154.93,15689.0,2
HCPCS,26490,Revise thumb tendon,,,3154.93,15689.0,2
HCPCS,26492,Tendon transfer with graft,,,3154.93,15689.0,2
HCPCS,26494,Hand tendon/muscle transfer,,,3154.93,15689.0,2
HCPCS,26496,Revise thumb tendon,,,3154.93,15689.0,2
HCPCS,26497,Finger tendon transfer,,,3154.93,15689.0,2
HCPCS,26498,Finger tendon transfer,,,3154.93,15689.0,2
HCPCS,26499,Revision of finger,,,3154.93,15689.0,2
HCPCS,26500,Hand tendon reconstruction,,,6996.6,31685.0,2
HCPCS,26502,Hand tendon reconstruction,,,3154.93,15689.0,2
HCPCS,26508,Release thumb contracture,,,3154.93,15689.0,2
HCPCS,26510,Thumb tendon transfer,,,3154.93,15689.0,2
HCPCS,26516,Fusion of knuckle joint,,,3154.93,15689.0,2
HCPCS,26517,Fusion of knuckle joints,,,3154.93,15689.0,2
HCPCS,26518,Fusion of knuckle joints,,,6996.6,15689.0,2
HCPCS,26520,Release knuckle contracture,,,3154.93,15689.0,2
HCPCS,26525,Release finger contracture,,,1550.46,9206.0,2
HCPCS,26530,Revise knuckle joint,,,6996.6,15689.0,2
HCPCS,26531,Revise knuckle with implant,,,6996.6,31685.0,2
HCPCS,26535,Revise finger joint,,,3154.93,15689.0,2
HCPCS,26536,Revise/implant finger joint,,,6996.6,31685.0,2
HCPCS,26540,Repair hand joint,,,3154.93,15689.0,2
HCPCS,26541,Repair hand joint with graft,,,3154.93,15689.0,2
HCPCS,26542,Repair hand joint with graft,,,3154.93,15689.0,2
HCPCS,26545,Reconstruct finger joint,,,3154.93,15689.0,2
HCPCS,26546,Repair nonunion hand,,,6996.6,31685.0,2
HCPCS,26548,Reconstruct finger joint,,,3154.93,15689.0,2
HCPCS,26550,Construct thumb replacement,,,3154.93,15689.0,2
HCPCS,26551,Great toe-hand transfer,,,6996.6,15689.0,2
HCPCS,26553,Single transfer toe-hand,,,6996.6,15689.0,2
HCPCS,26554,Double transfer toe-hand,,,6996.6,15689.0,2
HCPCS,26555,Positional change of finger,,,6996.6,31685.0,2
HCPCS,26556,Toe joint transfer,,,6996.6,15689.0,2
HCPCS,26560,Repair of web finger,,,1550.46,9206.0,2
HCPCS,26561,Repair of web finger,,,3154.93,15689.0,2
HCPCS,26562,Repair of web finger,,,3154.93,15689.0,2
HCPCS,26565,Correct metacarpal flaw,,,3154.93,15689.0,2
HCPCS,26567,Correct finger deformity,,,3154.93,15689.0,2
HCPCS,26568,Lengthen metacarpal/finger,,,6996.6,31685.0,2
HCPCS,26580,Repair hand deformity,,,3154.93,15689.0,2
HCPCS,26587,Reconstruct extra finger,,,3154.93,15689.0,2
HCPCS,26590,Repair finger deformity,,,1550.46,9206.0,2
HCPCS,26591,Repair muscles of hand,,,3154.93,15689.0,2
HCPCS,26593,Release muscles of hand,,,3154.93,15689.0,2
HCPCS,26596,Excision constricting tissue,,,3154.93,15689.0,2
HCPCS,26600,Treat metacarpal fracture,,,237.84,3714.0,2
HCPCS,26605,Hc Closed Tx Metacarpal W Manip,3500.0,2275.0,,,0
HCPCS,26605,Treat metacarpal fracture,,,237.84,3714.0,2
HCPCS,26607,Treat metacarpal fracture,,,3154.93,15689.0,2
HCPCS,26608,Treat metacarpal fracture,,,3154.93,15689.0,2
HCPCS,26615,Treat metacarpal fracture,,,3154.93,15689.0,2
HCPCS,26641,Treat thumb dislocation,,,237.84,3714.0,2
HCPCS,26645,Treat thumb fracture,,,1550.46,9206.0,2
HCPCS,26650,Treat thumb fracture,,,3154.93,15689.0,2
HCPCS,26665,Treat thumb fracture,,,3154.93,15689.0,2
HCPCS,26670,Treat hand dislocation,,,237.84,3714.0,2
HCPCS,26675,Treat hand dislocation,,,1550.46,9206.0,2
HCPCS,26676,Pin hand dislocation,,,3154.93,15689.0,2
HCPCS,26685,Treat hand dislocation,,,3154.93,15689.0,2
HCPCS,26686,Treat hand dislocation,,,3154.93,15689.0,2
HCPCS,26700,Treat knuckle dislocation,,,237.84,3714.0,2
HCPCS,26705,Treat knuckle dislocation,,,1550.46,9206.0,2
HCPCS,26706,Pin knuckle dislocation,,,3154.93,15689.0,2
HCPCS,26715,Treat knuckle dislocation,,,3154.93,15689.0,2
HCPCS,26720,Treat finger fracture each,,,237.84,3714.0,2
HCPCS,26725,Treat finger fracture each,,,237.84,3714.0,2
HCPCS,26727,Treat finger fracture each,,,3154.93,15689.0,2
HCPCS,26735,Treat finger fracture each,,,3154.93,15689.0,2
HCPCS,26740,Treat finger fracture each,,,237.84,3714.0,2
HCPCS,26742,Treat finger fracture each,,,1550.46,9206.0,2
HCPCS,26746,Treat finger fracture each,,,3154.93,15689.0,2
HCPCS,26750,Treat finger fracture each,,,237.84,3714.0,2
HCPCS,26755,Treat finger fracture each,,,237.84,3714.0,2
HCPCS,26756,Hc Perc Fixation Finger Or Thumb Each,4192.0,2724.8,,,0
HCPCS,26756,Pin finger fracture each,,,3154.93,15689.0,2
HCPCS,26765,Treat finger fracture each,,,3154.93,15689.0,2
HCPCS,26770,Treat finger dislocation,,,237.84,3714.0,2
HCPCS,26775,Treat finger dislocation,,,269.69,3714.0,2
HCPCS,26776,Pin finger dislocation,,,3154.93,15689.0,2
HCPCS,26785,Treat finger dislocation,,,3154.93,15689.0,2
HCPCS,26820,Thumb fusion with graft,,,6996.6,31685.0,2
HCPCS,26841,Fusion of thumb,,,6996.6,31685.0,2
HCPCS,26842,Thumb fusion with graft,,,6996.6,31685.0,2
HCPCS,26843,Fusion of hand joint,,,6996.6,31685.0,2
HCPCS,26844,Fusion/graft of hand joint,,,6996.6,31685.0,2
HCPCS,26850,Fusion of knuckle,,,6996.6,31685.0,2
HCPCS,26852,Fusion of knuckle with graft,,,6996.6,31685.0,2
HCPCS,26860,Fusion of finger joint,,,3154.93,15689.0,2
HCPCS,26862,Fusion/graft of finger joint,,,3154.93,15689.0,2
HCPCS,26910,Amputate metacarpal bone,,,3154.93,15689.0,2
HCPCS,26951,Amputation of finger/thumb,,,3154.93,15689.0,2
HCPCS,26951,Hc Amputation Finger Or Thumb,7920.0,5148.0,,,0
HCPCS,26952,Amputation of finger/thumb,,,3154.93,15689.0,2
HCPCS,26989,Hand/finger surgery,,,237.84,3714.0,2
HCPCS,26990,Drainage of pelvis lesion,,,3154.93,15689.0,2
HCPCS,26991,Drainage of pelvis bursa,,,1550.46,9206.0,2
HCPCS,26992,Drainage of bone lesion,,,3154.93,9206.0,2
HCPCS,27000,"Hc Tenotomy, Abductor Of Hip, Percutaneous",7224.0,4695.6,,,0
HCPCS,27000,Incision of hip tendon,,,1550.46,9206.0,2
HCPCS,27001,Incision of hip tendon,,,3154.93,15689.0,2
HCPCS,27003,Incision of hip tendon,,,6996.6,31685.0,2
HCPCS,27005,Incision of hip tendon,,,3154.93,15689.0,2
HCPCS,27006,Incision of hip tendons,,,3154.93,15689.0,2
HCPCS,27025,Incision of hip/thigh fascia,,,3154.93,15689.0,2
HCPCS,27027,Buttock fasciotomy,,,6996.6,31685.0,2
HCPCS,27030,Drainage of hip joint,,,6996.6,15689.0,2
HCPCS,27033,Exploration of hip joint,,,6996.6,15689.0,2
HCPCS,27035,Denervation of hip joint,,,3154.93,15689.0,2
HCPCS,27036,Excision of hip joint/muscle,,,6996.6,15689.0,2
HCPCS,27040,Biopsy of soft tissues,,,1592.51,9206.0,2
HCPCS,27040,Hc Biopsy Pelvis Or Hip Soft Tissue Superficial,4752.0,3088.8,,,0
HCPCS,27041,Biopsy of soft tissues,,,1592.51,9206.0,2
HCPCS,27041,Hc Biopsy Pelvis Or Hip Soft Tissue Deep,4832.0,3140.8,,,0
HCPCS,27043,Exc hip pelvis les sc 3 cm/>,,,2800.79,15689.0,2
HCPCS,27045,Exc hip/pelv tum deep 5 cm/>,,,2800.79,15689.0,2
HCPCS,27047,Exc hip/pelvis les sc < 3 cm,,,2800.79,15689.0,2
HCPCS,27048,Exc hip/pelv tum deep < 5 cm,,,2800.79,15689.0,2
HCPCS,27049,Resect hip/pelv tum < 5 cm,,,2800.79,15689.0,2
HCPCS,27050,Biopsy of sacroiliac joint,,,1550.46,9206.0,2
HCPCS,27052,Biopsy of hip joint,,,1550.46,9206.0,2
HCPCS,27054,Removal of hip joint lining,,,3154.93,15689.0,2
HCPCS,27057,Buttock fasciotomy w/dbrdmt,,,1550.46,9206.0,2
HCPCS,27059,Resect hip/pelv tum 5 cm/>,,,2800.79,15689.0,2
HCPCS,27060,Removal of ischial bursa,,,6996.6,15689.0,2
HCPCS,27062,Remove femur lesion/bursa,,,3154.93,15689.0,2
HCPCS,27065,Remove hip bone les super,,,6996.6,15689.0,2
HCPCS,27066,Remove hip bone les deep,,,3154.93,15689.0,2
HCPCS,27067,Remove/graft hip bone lesion,,,6996.6,31685.0,2
HCPCS,27070,Part remove hip bone super,,,3154.93,15689.0,2
HCPCS,27071,Part removal hip bone deep,,,3154.93,15689.0,2
HCPCS,27075,Resect hip tumor,,,6996.6,15689.0,2
HCPCS,27076,Resect hip tum incl acetabul,,,6996.6,15689.0,2
HCPCS,27077,Resect hip tum w/innom bone,,,6996.6,15689.0,2
HCPCS,27078,Rsect hip tum incl femur,,,6996.6,15689.0,2
HCPCS,27080,Removal of tail bone,,,3154.93,15689.0,2
HCPCS,27086,Remove hip foreign body,,,2800.79,9206.0,2
HCPCS,27087,Remove hip foreign body,,,3154.93,15689.0,2
HCPCS,27090,Removal of hip prosthesis,,,6996.6,15689.0,2
HCPCS,27091,Removal of hip prosthesis,,,12379.34,15689.0,2
HCPCS,27093,Hc Inj Arthrography Hip Wo Anes,3483.0,2263.95,,,0
HCPCS,27096,Inject sacroiliac joint,,,3714.0,3714.0,1
HCPCS,27097,Revision of hip tendon,,,3154.93,15689.0,2
HCPCS,27098,Transfer tendon to pelvis,,,3154.93,15689.0,2
HCPCS,27100,Transfer of abdominal muscle,,,6996.6,31685.0,2
HCPCS,27105,Transfer of spinal muscle,,,3154.93,15689.0,2
HCPCS,27110,Transfer of iliopsoas muscle,,,6996.6,31685.0,2
HCPCS,27111,Transfer of iliopsoas muscle,,,3154.93,15689.0,2
HCPCS,27120,Reconstruction of hip socket,,,12379.34,15689.0,2
HCPCS,27122,Reconstruction of hip socket,,,6996.6,15689.0,2
HCPCS,27125,Partial hip replacement,,,12379.34,15689.0,2
HCPCS,27130,Total hip arthroplasty,,,12379.34,31685.0,2
HCPCS,27132,Total hip arthroplasty,,,12379.34,31685.0,2
HCPCS,27134,Revise hip joint replacement,,,12379.34,31685.0,2
HCPCS,27137,Revise hip joint replacement,,,12379.34,31685.0,2
HCPCS,27138,Revise hip joint replacement,,,12379.34,31685.0,2
HCPCS,27140,Transplant femur ridge,,,6996.6,15689.0,2
HCPCS,27146,Incision of hip bone,,,6996.6,15689.0,2
HCPCS,27147,Revision of hip bone,,,6996.6,15689.0,2
HCPCS,27151,Incision of hip bones,,,6996.6,15689.0,2
HCPCS,27156,Revision of hip bones,,,6996.6,15689.0,2
HCPCS,27158,Revision of pelvis,,,6996.6,15689.0,2
HCPCS,27161,Incision of neck of femur,,,6996.6,15689.0,2
HCPCS,27165,Incision/fixation of femur,,,6996.6,15689.0,2
HCPCS,27170,Repair/graft femur head/neck,,,6996.6,15689.0,2
HCPCS,27175,Treat slipped epiphysis,,,3154.93,15689.0,2
HCPCS,27176,Treat slipped epiphysis,,,3154.93,15689.0,2
HCPCS,27177,Treat slipped epiphysis,,,3154.93,15689.0,2
HCPCS,27178,Treat slipped epiphysis,,,3154.93,15689.0,2
HCPCS,27179,Revise head/neck of femur,,,6996.6,31685.0,2
HCPCS,27181,Treat slipped epiphysis,,,6996.6,15689.0,2
HCPCS,27185,Revision of femur epiphysis,,,3154.93,15689.0,2
HCPCS,27187,Reinforce hip bones,,,6996.6,15689.0,2
HCPCS,27197,Clsd tx pelvic ring fx,,,237.84,3714.0,2
HCPCS,27198,Clsd tx pelvic ring fx,,,237.84,3714.0,2
HCPCS,27200,Treat tail bone fracture,,,237.84,3714.0,2
HCPCS,27200471,FECAL MICROBIOTA TRANSPLANT (FMT) HIGH DOSE LIQUID PREP (MTP-101LF),7110.65,4621.92,,,0
HCPCS,27200471,FECAL MICROBIOTA TRANSPLANT (FMT) STANDARD DOSE LIQUID PREP (MTP-101LR),7110.65,4621.92,,,0
HCPCS,27200471,FECAL MICROBIOTA TRANSPLANT (FMT)LOWER DELIVERY (OPENIBIOME) MICROBIOTA PREP,2040.75,1326.49,,,0
HCPCS,27200471,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,39.95,25.97,,,0
HCPCS,27202,Treat tail bone fracture,,,3154.93,15689.0,2
HCPCS,27215,Treat pelvic fracture(s),,,15689.0,15689.0,1
HCPCS,27216,Treat pelvic ring fracture,,,15689.0,15689.0,1
HCPCS,27217,Treat pelvic ring fracture,,,15689.0,15689.0,1
HCPCS,27218,Treat pelvic ring fracture,,,15689.0,15689.0,1
HCPCS,27220,Treat hip socket fracture,,,237.84,3714.0,2
HCPCS,27222,Treat hip socket fracture,,,237.84,3714.0,2
HCPCS,27226,Treat hip wall fracture,,,6996.6,15689.0,2
HCPCS,27227,Treat hip fracture(s),,,6996.6,15689.0,2
HCPCS,27228,Treat hip fracture(s),,,6996.6,15689.0,2
HCPCS,27230,Treat thigh fracture,,,237.84,3714.0,2
HCPCS,27232,Treat thigh fracture,,,1550.46,3714.0,2
HCPCS,27235,Treat thigh fracture,,,6996.6,31685.0,2
HCPCS,27236,Treat thigh fracture,,,6996.6,15689.0,2
HCPCS,27238,Treat thigh fracture,,,1550.46,9206.0,2
HCPCS,27240,Treat thigh fracture,,,1550.46,9206.0,2
HCPCS,27244,Treat thigh fracture,,,6996.6,15689.0,2
HCPCS,27245,Treat thigh fracture,,,6996.6,15689.0,2
HCPCS,27246,Treat thigh fracture,,,237.84,3714.0,2
HCPCS,27248,Treat thigh fracture,,,6996.6,15689.0,2
HCPCS,27250,Treat hip dislocation,,,237.84,3714.0,2
HCPCS,27252,Treat hip dislocation,,,1550.46,9206.0,2
HCPCS,27253,Treat hip dislocation,,,3154.93,15689.0,2
HCPCS,27254,Treat hip dislocation,,,6996.6,15689.0,2
HCPCS,27256,Treat hip dislocation,,,237.84,3714.0,2
HCPCS,27257,Treat hip dislocation,,,1550.46,9206.0,2
HCPCS,27258,Treat hip dislocation,,,3154.93,15689.0,2
HCPCS,27259,Treat hip dislocation,,,3154.93,15689.0,2
HCPCS,27265,Treat hip dislocation,,,237.84,3714.0,2
HCPCS,27266,Treat hip dislocation,,,1550.46,9206.0,2
HCPCS,27267,Cltx thigh fx,,,3154.93,15689.0,2
HCPCS,27268,Cltx thigh fx w/mnpj,,,1550.46,3714.0,2
HCPCS,27269,Optx thigh fx,,,6996.6,15689.0,2
HCPCS,27275,Manipulation of hip joint,,,1550.46,9206.0,2
HCPCS,27278,Arthrd si jt prq wo tfxj dev,,,16906.49,63079.0,2
HCPCS,27279,Arthrodesis sacroiliac joint,,,16906.49,63079.0,2
HCPCS,27279,Hc Athrodesis Sacroiliac Joint W Img Guidance,114186.0,74220.9,,,0
HCPCS,27280,Fusion of sacroiliac joint,,,15689.0,16906.49,2
HCPCS,27282,Fusion of pubic bones,,,3154.93,15689.0,2
HCPCS,27284,Fusion of hip joint,,,12379.34,15689.0,2
HCPCS,27286,Fusion of hip joint,,,12379.34,15689.0,2
HCPCS,27290,Amputation of leg at hip,,,15689.0,16906.49,2
HCPCS,27295,Amputation of leg at hip,,,15689.0,16906.49,2
HCPCS,27299,Hc Cementoplasty Of Acetabulum,5393.0,3505.45,,,0
HCPCS,27299,Pelvis/hip joint surgery,,,237.84,16564.0,2
HCPCS,27301,Drain thigh/knee lesion,,,2800.79,15689.0,2
HCPCS,27303,Drainage of bone lesion,,,3154.93,9206.0,2
HCPCS,27305,Incise thigh tendon & fascia,,,3154.93,15689.0,2
HCPCS,27306,Hc Tenotomy Perc Thigh Tendon/Adctr/Hamstrng Sgl,7954.5,5170.424999999999,,,0
HCPCS,27306,Incision of thigh tendon,,,3154.93,15689.0,2
HCPCS,27307,Hc Tenotomy Perc Thigh Tendon/Adctr/Hamstrng Mult,7954.5,5170.424999999999,,,0
HCPCS,27307,Incision of thigh tendons,,,3154.93,15689.0,2
HCPCS,27310,Exploration of knee joint,,,3154.93,15689.0,2
HCPCS,27323,Biopsy thigh soft tissues,,,1592.51,9206.0,2
HCPCS,27323,Hc Biopsy Soft Tissue Knee,10297.5,6693.375,,,0
HCPCS,27324,Biopsy thigh soft tissues,,,2800.79,15689.0,2
HCPCS,27325,Neurectomy hamstring,,,1882.86,9206.0,2
HCPCS,27326,Neurectomy popliteal,,,1882.86,9206.0,2
HCPCS,27327,Exc thigh/knee les sc < 3 cm,,,1592.51,9206.0,2
HCPCS,27328,Exc thigh/knee tum deep <5cm,,,2800.79,15689.0,2
HCPCS,27329,Resect thigh/knee tum < 5 cm,,,2800.79,15689.0,2
HCPCS,27330,Biopsy knee joint lining,,,3154.93,15689.0,2
HCPCS,27331,Explore/treat knee joint,,,3154.93,15689.0,2
HCPCS,27332,Removal of knee cartilage,,,3154.93,15689.0,2
HCPCS,27333,Removal of knee cartilage,,,3154.93,15689.0,2
HCPCS,27334,Remove knee joint lining,,,3154.93,15689.0,2
HCPCS,27335,Remove knee joint lining,,,6996.6,31685.0,2
HCPCS,27337,Exc thigh/knee les sc 3 cm/>,,,2800.79,15689.0,2
HCPCS,27339,Exc thigh/knee tum dep 5cm/>,,,2800.79,15689.0,2
HCPCS,27340,Removal of kneecap bursa,,,3154.93,15689.0,2
HCPCS,27345,Removal of knee cyst,,,3154.93,15689.0,2
HCPCS,27347,Remove knee cyst,,,3154.93,15689.0,2
HCPCS,27350,Removal of kneecap,,,6996.6,15689.0,2
HCPCS,27355,Remove femur lesion,,,3154.93,15689.0,2
HCPCS,27356,Remove femur lesion/graft,,,12379.34,38216.0,2
HCPCS,27357,Remove femur lesion/graft,,,6996.6,31685.0,2
HCPCS,27360,Partial removal leg bone(s),,,3154.93,15689.0,2
HCPCS,27364,Resect thigh/knee tum 5 cm/>,,,2800.79,15689.0,2
HCPCS,27365,Resect femur/knee tumor,,,3154.93,15689.0,2
HCPCS,27369,Hc Injection For Contrast Knee Arthrography,2753.0,1789.45,,,0
HCPCS,27372,Removal of foreign body,,,2800.79,15689.0,2
HCPCS,27380,Repair of kneecap tendon,,,6996.6,31685.0,2
HCPCS,27381,Repair/graft kneecap tendon,,,6996.6,31685.0,2
HCPCS,27385,Repair of thigh muscle,,,6996.6,31685.0,2
HCPCS,27386,Repair/graft of thigh muscle,,,6996.6,31685.0,2
HCPCS,27390,Incision of thigh tendon,,,3154.93,15689.0,2
HCPCS,27391,Incision of thigh tendons,,,3154.93,15689.0,2
HCPCS,27392,Incision of thigh tendons,,,3154.93,15689.0,2
HCPCS,27393,Lengthening of thigh tendon,,,6996.6,15689.0,2
HCPCS,27394,Lengthening of thigh tendons,,,6996.6,31685.0,2
HCPCS,27395,Lengthening of thigh tendons,,,3154.93,15689.0,2
HCPCS,27396,Transplant of thigh tendon,,,6996.6,31685.0,2
HCPCS,27397,Transplants of thigh tendons,,,6996.6,31685.0,2
HCPCS,27400,Revise thigh muscles/tendons,,,6996.6,31685.0,2
HCPCS,27403,Repair of knee cartilage,,,6996.6,15689.0,2
HCPCS,27405,Repair of knee ligament,,,6996.6,31685.0,2
HCPCS,27407,Repair of knee ligament,,,6996.6,31685.0,2
HCPCS,27409,Repair of knee ligaments,,,6996.6,31685.0,2
HCPCS,27412,Autochondrocyte implant knee,,,6996.6,31685.0,2
HCPCS,27415,Osteochondral knee allograft,,,12379.34,38216.0,2
HCPCS,27416,Osteochondral knee autograft,,,6996.6,31685.0,2
HCPCS,27418,Repair degenerated kneecap,,,6996.6,31685.0,2
HCPCS,27420,Revision of unstable kneecap,,,6996.6,31685.0,2
HCPCS,27422,Revision of unstable kneecap,,,6996.6,31685.0,2
HCPCS,27424,Revision/removal of kneecap,,,6996.6,31685.0,2
HCPCS,27425,Lat retinacular release open,,,3154.93,15689.0,2
HCPCS,27427,Reconstruction knee,,,6996.6,31685.0,2
HCPCS,27428,Reconstruction knee,,,12379.34,38216.0,2
HCPCS,27429,Reconstruction knee,,,12379.34,38216.0,2
HCPCS,27430,Revision of thigh muscles,,,6996.6,31685.0,2
HCPCS,27435,Incision of knee joint,,,3154.93,15689.0,2
HCPCS,27437,Revise kneecap,,,6996.6,31685.0,2
HCPCS,27438,Revise kneecap with implant,,,12379.34,38216.0,2
HCPCS,27440,Revision of knee joint,,,12379.34,38216.0,2
HCPCS,27441,Revision of knee joint,,,12379.34,38216.0,2
HCPCS,27442,Revision of knee joint,,,12379.34,38216.0,2
HCPCS,27443,Revision of knee joint,,,12379.34,38216.0,2
HCPCS,27445,Revision of knee joint,,,31685.0,31685.0,1
HCPCS,27446,Revision of knee joint,,,12379.34,38216.0,2
HCPCS,27447,Total knee arthroplasty,,,12379.34,38216.0,2
HCPCS,27448,Incision of thigh,,,6996.6,15689.0,2
HCPCS,27450,Incision of thigh,,,6996.6,15689.0,2
HCPCS,27454,Realignment of thigh bone,,,6996.6,15689.0,2
HCPCS,27455,Realignment of knee,,,6996.6,15689.0,2
HCPCS,27457,Realignment of knee,,,6996.6,15689.0,2
HCPCS,27458,Osteot femur imed lngth dev,,,6996.6,6996.6,1
HCPCS,27465,Shortening of thigh bone,,,6996.6,15689.0,2
HCPCS,27466,Lengthening of thigh bone,,,6996.6,15689.0,2
HCPCS,27468,Shorten/lengthen thighs,,,15689.0,15689.0,1
HCPCS,27470,Repair of thigh,,,6996.6,15689.0,2
HCPCS,27472,Repair/graft of thigh,,,6996.6,15689.0,2
HCPCS,27475,Surgery to stop leg growth,,,6996.6,31685.0,2
HCPCS,27477,Surgery to stop leg growth,,,6996.6,15689.0,2
HCPCS,27479,Surgery to stop leg growth,,,6996.6,31685.0,2
HCPCS,27485,Surgery to stop leg growth,,,6996.6,15689.0,2
HCPCS,27486,Revise/replace knee joint,,,12379.34,31685.0,2
HCPCS,27487,Revise/replace knee joint,,,16906.49,31685.0,2
HCPCS,27488,Removal of knee prosthesis,,,12379.34,31685.0,2
HCPCS,27495,Reinforce thigh,,,6996.6,15689.0,2
HCPCS,27496,Decompression of thigh/knee,,,3154.93,15689.0,2
HCPCS,27497,Decompression of thigh/knee,,,3154.93,15689.0,2
HCPCS,27498,Decompression of thigh/knee,,,1550.46,9206.0,2
HCPCS,27499,Decompression of thigh/knee,,,6996.6,16564.0,2
HCPCS,27500,Treatment of thigh fracture,,,237.84,3714.0,2
HCPCS,27501,Treatment of thigh fracture,,,237.84,3714.0,2
HCPCS,27502,Treatment of thigh fracture,,,1550.46,9206.0,2
HCPCS,27503,Treatment of thigh fracture,,,1550.46,9206.0,2
HCPCS,27506,Treatment of thigh fracture,,,6996.6,15689.0,2
HCPCS,27507,Treatment of thigh fracture,,,6996.6,15689.0,2
HCPCS,27508,Treatment of thigh fracture,,,237.84,3714.0,2
HCPCS,27509,Treatment of thigh fracture,,,6996.6,31685.0,2
HCPCS,27510,Treatment of thigh fracture,,,1550.46,9206.0,2
HCPCS,27511,Treatment of thigh fracture,,,12379.34,15689.0,2
HCPCS,27513,Treatment of thigh fracture,,,12379.34,15689.0,2
HCPCS,27514,Treatment of thigh fracture,,,12379.34,15689.0,2
HCPCS,27516,Treat thigh fx growth plate,,,237.84,3714.0,2
HCPCS,27517,Treat thigh fx growth plate,,,1550.46,9206.0,2
HCPCS,27519,Treat thigh fx growth plate,,,6996.6,15689.0,2
HCPCS,27520,Treat kneecap fracture,,,237.84,3714.0,2
HCPCS,27524,Treat kneecap fracture,,,6996.6,31685.0,2
HCPCS,27530,Treat knee fracture,,,237.84,3714.0,2
HCPCS,27532,Treat knee fracture,,,3154.93,15689.0,2
HCPCS,27535,Treat knee fracture,,,6996.6,15689.0,2
HCPCS,27536,Treat knee fracture,,,6996.6,15689.0,2
HCPCS,27538,Treat knee fracture(s),,,237.84,3714.0,2
HCPCS,27540,Treat knee fracture,,,6996.6,15689.0,2
HCPCS,27550,Treat knee dislocation,,,237.84,3714.0,2
HCPCS,27552,Treat knee dislocation,,,1550.46,9206.0,2
HCPCS,27556,Treat knee dislocation,,,6996.6,15689.0,2
HCPCS,27557,Treat knee dislocation,,,6996.6,15689.0,2
HCPCS,27558,Treat knee dislocation,,,6996.6,15689.0,2
HCPCS,27560,Treat kneecap dislocation,,,237.84,3714.0,2
HCPCS,27562,Treat kneecap dislocation,,,237.84,3714.0,2
HCPCS,27566,Treat kneecap dislocation,,,6996.6,31685.0,2
HCPCS,27570,Fixation of knee joint,,,1550.46,9206.0,2
HCPCS,27580,Fusion of knee,,,12379.34,15689.0,2
HCPCS,27590,Amputate leg at thigh,,,3154.93,15689.0,2
HCPCS,27591,Amputate leg at thigh,,,3154.93,15689.0,2
HCPCS,27592,Amputate leg at thigh,,,3154.93,15689.0,2
HCPCS,27594,Amputation follow-up surgery,,,3154.93,15689.0,2
HCPCS,27596,Amputation follow-up surgery,,,3154.93,15689.0,2
HCPCS,27598,Amputate lower leg at knee,,,3154.93,15689.0,2
HCPCS,27599,Hc Unlist Procd Femur Knee,8089.5,5258.174999999999,,,0
HCPCS,27599,Leg surgery procedure,,,237.84,16564.0,2
HCPCS,27600,Decompression of lower leg,,,3154.93,15689.0,2
HCPCS,27601,Decompression of lower leg,,,3154.93,15689.0,2
HCPCS,27602,Decompression of lower leg,,,3154.93,15689.0,2
HCPCS,27603,Drain lower leg lesion,,,2800.79,15689.0,2
HCPCS,27603,Hc I And D Deep Abscess Or Hematoma Leg Or Ankle,7289.0,4737.85,,,0
HCPCS,27604,Drain lower leg bursa,,,3154.93,15689.0,2
HCPCS,27605,Hc Tenotomy Perc Achilles Local Anes,7224.0,4695.6,,,0
HCPCS,27605,Incision of achilles tendon,,,1550.46,9206.0,2
HCPCS,27606,Incision of achilles tendon,,,3154.93,15689.0,2
HCPCS,27607,Treat lower leg bone lesion,,,3154.93,15689.0,2
HCPCS,27610,Explore/treat ankle joint,,,3154.93,15689.0,2
HCPCS,27612,Exploration of ankle joint,,,3154.93,15689.0,2
HCPCS,27613,Biopsy lower leg soft tissue,,,1592.51,9206.0,2
HCPCS,27613,Hc Biopsy Soft Tissue Lower Extremity,11373.0,7392.450000000001,,,0
HCPCS,27614,Biopsy lower leg soft tissue,,,2800.79,15689.0,2
HCPCS,27615,Resect leg/ankle tum < 5 cm,,,2800.79,15689.0,2
HCPCS,27616,Resect leg/ankle tum 5 cm/>,,,2800.79,15689.0,2
HCPCS,27618,Exc leg/ankle tum < 3 cm,,,1592.51,9206.0,2
HCPCS,27619,Exc leg/ankle tum deep <5 cm,,,2800.79,15689.0,2
HCPCS,27620,Explore/treat ankle joint,,,3154.93,15689.0,2
HCPCS,27625,Remove ankle joint lining,,,3154.93,15689.0,2
HCPCS,27626,Remove ankle joint lining,,,3154.93,15689.0,2
HCPCS,27630,Removal of tendon lesion,,,3154.93,15689.0,2
HCPCS,27632,Exc leg/ankle les sc 3 cm/>,,,2800.79,15689.0,2
HCPCS,27634,Exc leg/ankle tum dep 5 cm/>,,,2800.79,15689.0,2
HCPCS,27635,Remove lower leg bone lesion,,,3154.93,15689.0,2
HCPCS,27637,Remove/graft leg bone lesion,,,6996.6,31685.0,2
HCPCS,27638,Remove/graft leg bone lesion,,,6996.6,31685.0,2
HCPCS,27640,Partial removal of tibia,,,3154.93,15689.0,2
HCPCS,27641,Partial removal of fibula,,,3154.93,15689.0,2
HCPCS,27645,Resect tibia tumor,,,3154.93,15689.0,2
HCPCS,27646,Resect fibula tumor,,,3154.93,15689.0,2
HCPCS,27647,Resect talus/calcaneus tum,,,3154.93,15689.0,2
HCPCS,27648,Hc Inj Arthrography Ankle,1804.5,1172.9250000000002,,,0
HCPCS,27650,Repair achilles tendon,,,6996.6,15689.0,2
HCPCS,27652,Repair/graft achilles tendon,,,6996.6,31685.0,2
HCPCS,27654,Repair of achilles tendon,,,6996.6,31685.0,2
HCPCS,27656,Repair leg fascia defect,,,3154.93,15689.0,2
HCPCS,27658,Repair of leg tendon each,,,3154.93,15689.0,2
HCPCS,27659,Repair of leg tendon each,,,6996.6,31685.0,2
HCPCS,27664,Repair of leg tendon each,,,6996.6,31685.0,2
HCPCS,27665,Repair of leg tendon each,,,6996.6,31685.0,2
HCPCS,27675,Repair lower leg tendons,,,3154.93,15689.0,2
HCPCS,27676,Repair lower leg tendons,,,6996.6,31685.0,2
HCPCS,27680,Release of lower leg tendon,,,3154.93,15689.0,2
HCPCS,27681,Release of lower leg tendons,,,3154.93,15689.0,2
HCPCS,27685,Revision of lower leg tendon,,,3154.93,15689.0,2
HCPCS,27686,Revise lower leg tendons,,,3154.93,15689.0,2
HCPCS,27687,Revision of calf tendon,,,3154.93,15689.0,2
HCPCS,27690,Revise lower leg tendon,,,6996.6,31685.0,2
HCPCS,27691,Revise lower leg tendon,,,6996.6,31685.0,2
HCPCS,27695,Repair of ankle ligament,,,6996.6,31685.0,2
HCPCS,27696,Repair of ankle ligaments,,,6996.6,31685.0,2
HCPCS,27698,Repair of ankle ligament,,,6996.6,31685.0,2
HCPCS,27700,Revision of ankle joint,,,6996.6,31685.0,2
HCPCS,27702,Reconstruct ankle joint,,,15689.0,26163.21,2
HCPCS,27703,Reconstruction ankle joint,,,16906.49,31685.0,2
HCPCS,27704,Removal of ankle implant,,,3154.93,15689.0,2
HCPCS,27705,Incision of tibia,,,6996.6,31685.0,2
HCPCS,27707,Incision of fibula,,,3154.93,15689.0,2
HCPCS,27709,Incision of tibia & fibula,,,12379.34,38216.0,2
HCPCS,27712,Realignment of lower leg,,,12379.34,15689.0,2
HCPCS,27713,Osteot tibia imed lngth dev,,,6996.6,6996.6,1
HCPCS,27715,Revision of lower leg,,,12379.34,15689.0,2
HCPCS,27720,Repair of tibia,,,6996.6,31685.0,2
HCPCS,27722,Repair/graft of tibia,,,6996.6,31685.0,2
HCPCS,27724,Repair/graft of tibia,,,6996.6,15689.0,2
HCPCS,27725,Repair of lower leg,,,6996.6,15689.0,2
HCPCS,27726,Repair fibula nonunion,,,6996.6,31685.0,2
HCPCS,27727,Repair of lower leg,,,3154.93,15689.0,2
HCPCS,27730,Repair of tibia epiphysis,,,3154.93,15689.0,2
HCPCS,27732,Repair of fibula epiphysis,,,3154.93,15689.0,2
HCPCS,27734,Repair lower leg epiphyses,,,3154.93,15689.0,2
HCPCS,27740,Repair of leg epiphyses,,,3154.93,15689.0,2
HCPCS,27742,Repair of leg epiphyses,,,3154.93,15689.0,2
HCPCS,27745,Reinforce tibia,,,6996.6,31685.0,2
HCPCS,27750,Treatment of tibia fracture,,,237.84,3714.0,2
HCPCS,27752,Treatment of tibia fracture,,,1550.46,9206.0,2
HCPCS,27756,Treatment of tibia fracture,,,6996.6,31685.0,2
HCPCS,27758,Treatment of tibia fracture,,,12379.34,38216.0,2
HCPCS,27759,Treatment of tibia fracture,,,12379.34,38216.0,2
HCPCS,27760,Cltx medial ankle fx,,,237.84,3714.0,2
HCPCS,27762,Cltx med ankle fx w/mnpj,,,1550.46,9206.0,2
HCPCS,27766,Optx medial ankle fx,,,6996.6,31685.0,2
HCPCS,27767,Cltx post ankle fx,,,237.84,3714.0,2
HCPCS,27768,Cltx post ankle fx w/mnpj,,,1550.46,9206.0,2
HCPCS,27769,Optx post ankle fx,,,6996.6,31685.0,2
HCPCS,27780,Treatment of fibula fracture,,,237.84,3714.0,2
HCPCS,27781,Treatment of fibula fracture,,,1550.46,9206.0,2
HCPCS,27784,Treatment of fibula fracture,,,6996.6,31685.0,2
HCPCS,27786,Treatment of ankle fracture,,,237.84,3714.0,2
HCPCS,27788,Treatment of ankle fracture,,,237.84,3714.0,2
HCPCS,27792,Treatment of ankle fracture,,,6996.6,31685.0,2
HCPCS,27808,Treatment of ankle fracture,,,237.84,3714.0,2
HCPCS,27810,Treatment of ankle fracture,,,1550.46,9206.0,2
HCPCS,27814,Treatment of ankle fracture,,,6996.6,31685.0,2
HCPCS,27816,Treatment of ankle fracture,,,237.84,3714.0,2
HCPCS,27818,Treatment of ankle fracture,,,1550.46,9206.0,2
HCPCS,27822,Treatment of ankle fracture,,,6996.6,31685.0,2
HCPCS,27823,Treatment of ankle fracture,,,6996.6,31685.0,2
HCPCS,27824,Treat lower leg fracture,,,237.84,3714.0,2
HCPCS,27825,Treat lower leg fracture,,,1550.46,9206.0,2
HCPCS,27826,Treat lower leg fracture,,,6996.6,31685.0,2
HCPCS,27827,Treat lower leg fracture,,,12379.34,38216.0,2
HCPCS,27828,Treat lower leg fracture,,,12379.34,38216.0,2
HCPCS,27829,Treat lower leg joint,,,6996.6,31685.0,2
HCPCS,27830,Treat lower leg dislocation,,,237.84,3714.0,2
HCPCS,27831,Treat lower leg dislocation,,,3154.93,15689.0,2
HCPCS,27832,Treat lower leg dislocation,,,6996.6,31685.0,2
HCPCS,27840,Treat ankle dislocation,,,237.84,3714.0,2
HCPCS,27842,Treat ankle dislocation,,,1550.46,9206.0,2
HCPCS,27846,Treat ankle dislocation,,,6996.6,31685.0,2
HCPCS,27848,Treat ankle dislocation,,,6996.6,31685.0,2
HCPCS,27860,Fixation of ankle joint,,,3154.93,15689.0,2
HCPCS,27870,Fusion of ankle joint open,,,12379.34,38216.0,2
HCPCS,27871,Fusion of tibiofibular joint,,,12379.34,38216.0,2
HCPCS,27880,Amputation of lower leg,,,6996.6,15689.0,2
HCPCS,27881,Amputation of lower leg,,,3154.93,15689.0,2
HCPCS,27882,Amputation of lower leg,,,3154.93,15689.0,2
HCPCS,27884,Amputation follow-up surgery,,,3154.93,15689.0,2
HCPCS,27886,Amputation follow-up surgery,,,3154.93,15689.0,2
HCPCS,27888,Amputation of foot at ankle,,,3154.93,15689.0,2
HCPCS,27889,Amputation of foot at ankle,,,6996.6,31685.0,2
HCPCS,27892,Decompression of leg,,,3154.93,15689.0,2
HCPCS,27893,Decompression of leg,,,6996.6,31685.0,2
HCPCS,27894,Decompression of leg,,,3154.93,15689.0,2
HCPCS,27899,Leg/ankle surgery procedure,,,237.84,16564.0,2
HCPCS,28001,Drainage of bursa of foot,,,1592.51,9206.0,2
HCPCS,28002,Hc I And D Foot Single Bursa Space,4273.5,2777.7749999999996,,,0
HCPCS,28002,Treatment of foot infection,,,1550.46,9206.0,2
HCPCS,28003,Hc I And D Foot Multiple Bursal Areas,4746.0,3084.9,,,0
HCPCS,28003,Treatment of foot infection,,,3154.93,15689.0,2
HCPCS,28005,Treat foot bone lesion,,,3154.93,15689.0,2
HCPCS,28008,Hc Fasciotomy Foot Toe,7954.5,5170.424999999999,,,0
HCPCS,28008,Incision of foot fascia,,,3154.93,15689.0,2
HCPCS,28010,Hc Tenotomy Percutaneous Single Toe,3130.0,2034.5,,,0
HCPCS,28010,Incision of toe tendon,,,1550.46,9206.0,2
HCPCS,28011,Hc Tenotomy Perc Toe Multiple Tendons,3182.0,2068.3,,,0
HCPCS,28011,Incision of toe tendons,,,1550.46,9206.0,2
HCPCS,28020,Exploration of foot joint,,,3154.93,15689.0,2
HCPCS,28022,Exploration of foot joint,,,3154.93,15689.0,2
HCPCS,28024,Exploration of toe joint,,,1550.46,9206.0,2
HCPCS,28035,Decompression of tibia nerve,,,1882.86,9206.0,2
HCPCS,28039,Exc foot/toe tum sc 1.5 cm/>,,,2800.79,15689.0,2
HCPCS,28039,Hc Excise Tumor Soft Tis Foot/Toe 1.5Cm Or Greater,7289.0,4737.85,,,0
HCPCS,28041,Exc foot/toe tum dep 1.5cm/>,,,2800.79,15689.0,2
HCPCS,28043,Exc foot/toe tum sc < 1.5 cm,,,1592.51,9206.0,2
HCPCS,28045,Exc foot/toe tum deep <1.5cm,,,2800.79,15689.0,2
HCPCS,28046,Resect foot/toe tumor < 3 cm,,,2800.79,15689.0,2
HCPCS,28047,Resect foot/toe tumor 3 cm/>,,,2800.79,15689.0,2
HCPCS,28050,Biopsy of foot joint lining,,,3154.93,15689.0,2
HCPCS,28052,Biopsy of foot joint lining,,,3154.93,15689.0,2
HCPCS,28054,Biopsy of toe joint lining,,,3154.93,15689.0,2
HCPCS,28055,Neurectomy foot,,,1882.86,9206.0,2
HCPCS,28060,Partial removal foot fascia,,,3154.93,15689.0,2
HCPCS,28062,Removal of foot fascia,,,3154.93,15689.0,2
HCPCS,28070,Removal of foot joint lining,,,6996.6,15689.0,2
HCPCS,28072,Removal of foot joint lining,,,3154.93,15689.0,2
HCPCS,28080,Removal of foot lesion,,,1550.46,9206.0,2
HCPCS,28086,Excise foot tendon sheath,,,3154.93,15689.0,2
HCPCS,28088,Excise foot tendon sheath,,,3154.93,15689.0,2
HCPCS,28090,Removal of foot lesion,,,1550.46,9206.0,2
HCPCS,28092,Removal of toe lesions,,,1550.46,9206.0,2
HCPCS,28100,Removal of ankle/heel lesion,,,3154.93,15689.0,2
HCPCS,28102,Remove/graft foot lesion,,,6996.6,31685.0,2
HCPCS,28103,Remove/graft foot lesion,,,6996.6,31685.0,2
HCPCS,28104,Removal of foot lesion,,,3154.93,15689.0,2
HCPCS,28106,Remove/graft foot lesion,,,6996.6,31685.0,2
HCPCS,28107,Remove/graft foot lesion,,,6996.6,31685.0,2
HCPCS,28108,Removal of toe lesions,,,1550.46,9206.0,2
HCPCS,28110,Part removal of metatarsal,,,3154.93,15689.0,2
HCPCS,28111,Part removal of metatarsal,,,3154.93,15689.0,2
HCPCS,28112,Part removal of metatarsal,,,3154.93,15689.0,2
HCPCS,28113,Hc Part Removal Of Metatarsal,4003.0,2601.95,,,0
HCPCS,28113,Part removal of metatarsal,,,3154.93,15689.0,2
HCPCS,28114,Removal of metatarsal heads,,,3154.93,15689.0,2
HCPCS,28116,Revision of foot,,,3154.93,15689.0,2
HCPCS,28118,Removal of heel bone,,,3154.93,15689.0,2
HCPCS,28119,Removal of heel spur,,,3154.93,15689.0,2
HCPCS,28120,Hc Excision Partial Bone Talus Calcaneus,5393.0,3505.45,,,0
HCPCS,28120,Part removal of ankle/heel,,,3154.93,15689.0,2
HCPCS,28122,Partial removal of foot bone,,,3154.93,15689.0,2
HCPCS,28124,Hc Excision Partial Bone Phalanx Toe,4804.0,3122.6,,,0
HCPCS,28124,Partial removal of toe,,,3154.93,15689.0,2
HCPCS,28126,Partial removal of toe,,,3154.93,15689.0,2
HCPCS,28130,Removal of ankle bone,,,6996.6,15689.0,2
HCPCS,28140,Hc Metatarsectomy,4804.0,3122.6,,,0
HCPCS,28140,Removal of metatarsal,,,3154.93,15689.0,2
HCPCS,28150,Removal of toe,,,3154.93,15689.0,2
HCPCS,28153,Partial removal of toe,,,3154.93,15689.0,2
HCPCS,28160,Partial removal of toe,,,3154.93,15689.0,2
HCPCS,28171,Resect tarsal tumor,,,3154.93,15689.0,2
HCPCS,28173,Resect metatarsal tumor,,,3154.93,15689.0,2
HCPCS,28175,Resect phalanx of toe tumor,,,1550.46,9206.0,2
HCPCS,28190,Hc Removal Foreign Body Foot Subq,1419.0,922.3499999999999,,,0
HCPCS,28190,Removal of foot foreign body,,,682.8,3714.0,2
HCPCS,28192,Removal of foot foreign body,,,1592.51,9206.0,2
HCPCS,28193,Removal of foot foreign body,,,1592.51,9206.0,2
HCPCS,28200,Repair of foot tendon,,,3154.93,15689.0,2
HCPCS,28202,Repair/graft of foot tendon,,,6996.6,31685.0,2
HCPCS,28208,Repair of foot tendon,,,3154.93,15689.0,2
HCPCS,28210,Repair/graft of foot tendon,,,6996.6,31685.0,2
HCPCS,28220,Release of foot tendon,,,1550.46,9206.0,2
HCPCS,28222,Release of foot tendons,,,3154.93,15689.0,2
HCPCS,28225,Release of foot tendon,,,3154.93,15689.0,2
HCPCS,28226,Release of foot tendons,,,3154.93,15689.0,2
HCPCS,28230,Hc Tenotomy Open Foot Tendon Sgl Or Mult,5536.5,3598.7250000000004,,,0
HCPCS,28230,Incision of foot tendon(s),,,1550.46,9206.0,2
HCPCS,28232,Hc Tenotomy Open Flexor Tendon Toe Sgl,5536.5,3598.7250000000004,,,0
HCPCS,28232,Incision of toe tendon,,,1550.46,9206.0,2
HCPCS,28234,Incision of foot tendon,,,1550.46,9206.0,2
HCPCS,28238,Revision of foot tendon,,,6996.6,31685.0,2
HCPCS,28240,Release of big toe,,,3154.93,15689.0,2
HCPCS,28250,Revision of foot fascia,,,3154.93,15689.0,2
HCPCS,28260,Release of midfoot joint,,,3154.93,15689.0,2
HCPCS,28261,Revision of foot tendon,,,1550.46,9206.0,2
HCPCS,28262,Revision of foot and ankle,,,6996.6,31685.0,2
HCPCS,28264,Release of midfoot joint,,,1550.46,9206.0,2
HCPCS,28270,Release of foot contracture,,,3154.93,15689.0,2
HCPCS,28272,Release of toe joint each,,,1550.46,9206.0,2
HCPCS,28280,Fusion of toes,,,3154.93,15689.0,2
HCPCS,28285,Repair of hammertoe,,,3154.93,15689.0,2
HCPCS,28286,Repair of hammertoe,,,3154.93,15689.0,2
HCPCS,28288,Partial removal of foot bone,,,3154.93,15689.0,2
HCPCS,28289,Corrj halux rigdus w/o implt,,,3154.93,15689.0,2
HCPCS,28291,Corrj halux rigdus w/implt,,,6996.6,31685.0,2
HCPCS,28292,Correction hallux valgus,,,3154.93,15689.0,2
HCPCS,28295,Correction hallux valgus,,,3154.93,15689.0,2
HCPCS,28296,Correction hallux valgus,,,3154.93,15689.0,2
HCPCS,28297,Correction hallux valgus,,,12379.34,31685.0,2
HCPCS,28298,Correction hallux valgus,,,6996.6,31685.0,2
HCPCS,28299,Correction hallux valgus,,,6996.6,16564.0,2
HCPCS,28300,Incision of heel bone,,,6996.6,31685.0,2
HCPCS,28302,Incision of ankle bone,,,6996.6,31685.0,2
HCPCS,28304,Incision of midfoot bones,,,6996.6,31685.0,2
HCPCS,28305,Incise/graft midfoot bones,,,6996.6,31685.0,2
HCPCS,28306,Incision of metatarsal,,,6996.6,31685.0,2
HCPCS,28307,Incision of metatarsal,,,6996.6,15689.0,2
HCPCS,28308,Incision of metatarsal,,,3154.93,15689.0,2
HCPCS,28309,Incision of metatarsals,,,6996.6,31685.0,2
HCPCS,28310,Revision of big toe,,,6996.6,15689.0,2
HCPCS,28312,Revision of toe,,,3154.93,15689.0,2
HCPCS,28313,Repair deformity of toe,,,3154.93,15689.0,2
HCPCS,28315,Removal of sesamoid bone,,,3154.93,15689.0,2
HCPCS,28320,Repair of foot bones,,,12379.34,38216.0,2
HCPCS,28322,Repair of metatarsals,,,6996.6,31685.0,2
HCPCS,28340,Resect enlarged toe tissue,,,3154.93,15689.0,2
HCPCS,28341,Resect enlarged toe,,,3154.93,15689.0,2
HCPCS,28344,Repair extra toe(s),,,3154.93,15689.0,2
HCPCS,28345,Repair webbed toe(s),,,1550.46,9206.0,2
HCPCS,28360,Reconstruct cleft foot,,,6996.6,31685.0,2
HCPCS,28400,Treatment of heel fracture,,,237.84,3714.0,2
HCPCS,28405,Treatment of heel fracture,,,237.84,3714.0,2
HCPCS,28406,Treatment of heel fracture,,,6996.6,31685.0,2
HCPCS,28415,Treat heel fracture,,,6996.6,31685.0,2
HCPCS,28420,Treat/graft heel fracture,,,12379.34,38216.0,2
HCPCS,28430,Treatment of ankle fracture,,,237.84,3714.0,2
HCPCS,28435,Treatment of ankle fracture,,,1550.46,9206.0,2
HCPCS,28436,Treatment of ankle fracture,,,6996.6,31685.0,2
HCPCS,28445,Treat ankle fracture,,,6996.6,31685.0,2
HCPCS,28446,Osteochondral talus autogrft,,,6996.6,31685.0,2
HCPCS,28450,Treat midfoot fracture each,,,237.84,3714.0,2
HCPCS,28455,Treat midfoot fracture each,,,1550.46,9206.0,2
HCPCS,28456,Treat midfoot fracture,,,6996.6,31685.0,2
HCPCS,28465,Treat midfoot fracture each,,,6996.6,31685.0,2
HCPCS,28470,Treat metatarsal fracture,,,237.84,3714.0,2
HCPCS,28475,Treat metatarsal fracture,,,237.84,3714.0,2
HCPCS,28476,Treat metatarsal fracture,,,3154.93,15689.0,2
HCPCS,28485,Treat metatarsal fracture,,,6996.6,31685.0,2
HCPCS,28490,Treat big toe fracture,,,237.84,3714.0,2
HCPCS,28495,Treat big toe fracture,,,237.84,3714.0,2
HCPCS,28496,Treat big toe fracture,,,3154.93,15689.0,2
HCPCS,28505,Treat big toe fracture,,,3154.93,15689.0,2
HCPCS,28510,Treatment of toe fracture,,,237.84,3714.0,2
HCPCS,28515,Treatment of toe fracture,,,237.84,3714.0,2
HCPCS,28525,Treat toe fracture,,,3154.93,15689.0,2
HCPCS,28530,Treat sesamoid bone fracture,,,237.84,3714.0,2
HCPCS,28531,Treat sesamoid bone fracture,,,6996.6,31685.0,2
HCPCS,28540,Treat foot dislocation,,,237.84,3714.0,2
HCPCS,28545,Treat foot dislocation,,,3154.93,15689.0,2
HCPCS,28546,Treat foot dislocation,,,1550.46,9206.0,2
HCPCS,28555,Repair foot dislocation,,,6996.6,31685.0,2
HCPCS,28570,Treat foot dislocation,,,237.84,3714.0,2
HCPCS,28575,Treat foot dislocation,,,3154.93,15689.0,2
HCPCS,28576,Treat foot dislocation,,,6996.6,15689.0,2
HCPCS,28585,Repair foot dislocation,,,6996.6,31685.0,2
HCPCS,28600,Treat foot dislocation,,,237.84,3714.0,2
HCPCS,28605,Treat foot dislocation,,,237.84,3714.0,2
HCPCS,28606,Treat foot dislocation,,,3154.93,15689.0,2
HCPCS,28615,Repair foot dislocation,,,6996.6,31685.0,2
HCPCS,28630,Treat toe dislocation,,,237.84,3714.0,2
HCPCS,28635,Treat toe dislocation,,,1550.46,9206.0,2
HCPCS,28636,Treat toe dislocation,,,3154.93,15689.0,2
HCPCS,28645,Repair toe dislocation,,,3154.93,15689.0,2
HCPCS,28660,Treat toe dislocation,,,237.84,3714.0,2
HCPCS,28665,Treat toe dislocation,,,269.69,3714.0,2
HCPCS,28666,Treat toe dislocation,,,3154.93,15689.0,2
HCPCS,28675,Repair of toe dislocation,,,3154.93,15689.0,2
HCPCS,28705,Fusion of foot bones,,,16906.49,63079.0,2
HCPCS,28715,Fusion of foot bones,,,12379.34,38216.0,2
HCPCS,28725,Fusion of foot bones,,,12379.34,38216.0,2
HCPCS,28730,Fusion of foot bones,,,12379.34,38216.0,2
HCPCS,28735,Fusion of foot bones,,,12379.34,38216.0,2
HCPCS,28737,Revision of foot bones,,,12379.34,38216.0,2
HCPCS,28740,Fusion of foot bones,,,6996.6,31685.0,2
HCPCS,28750,Fusion of big toe joint,,,6996.6,31685.0,2
HCPCS,28755,Fusion of big toe joint,,,6996.6,31685.0,2
HCPCS,28760,Fusion of big toe joint,,,6996.6,31685.0,2
HCPCS,28800,Amputation of midfoot,,,3154.93,31685.0,2
HCPCS,28805,Amputation thru metatarsal,,,3154.93,15689.0,2
HCPCS,28810,Amputation toe & metatarsal,,,3154.93,15689.0,2
HCPCS,28820,Amputation of toe,,,3154.93,15689.0,2
HCPCS,28820,Hc  Amputation Of Toe; M J,4804.0,3122.6,,,0
HCPCS,28825,Hc Amputation Toe Interphalangeal Joint,4636.0,3013.4,,,0
HCPCS,28825,Partial amputation of toe,,,3154.93,15689.0,2
HCPCS,28890,Hi enrgy eswt plantar fascia,,,1550.46,9206.0,2
HCPCS,28899,Foot/toes surgery procedure,,,237.84,16564.0,2
HCPCS,29000,Application of body cast,,,269.69,3714.0,2
HCPCS,29010,Application of body cast,,,269.69,3714.0,2
HCPCS,29015,Application of body cast,,,269.69,3714.0,2
HCPCS,29035,Application of body cast,,,269.69,3714.0,2
HCPCS,29040,Application of body cast,,,269.69,3714.0,2
HCPCS,29044,Application of body cast,,,156.69,3714.0,2
HCPCS,29046,Application of body cast,,,269.69,3714.0,2
HCPCS,29049,Application of figure eight,,,269.69,3714.0,2
HCPCS,29055,Application of shoulder cast,,,269.69,3714.0,2
HCPCS,29058,Application of shoulder cast,,,269.69,3714.0,2
HCPCS,29065,Application of long arm cast,,,269.69,3714.0,2
HCPCS,29065,Hc Application Cast Long Arm,637.5,414.375,,,0
HCPCS,29075,Application of forearm cast,,,269.69,3714.0,2
HCPCS,29075,Hc Application Cast Short Arm,637.5,414.375,,,0
HCPCS,29085,Apply hand/wrist cast,,,156.69,3714.0,2
HCPCS,29085,Hc Application Cast Hand Or Wrist,918.0,596.7,,,0
HCPCS,29086,Apply finger cast,,,156.69,3714.0,2
HCPCS,29086,Hc Application Cast Finger,462.0,300.29999999999995,,,0
HCPCS,29105,Apply long arm splint,,,156.69,3714.0,2
HCPCS,29125,Apply forearm splint,,,128.29,3714.0,2
HCPCS,29126,Apply forearm splint,,,128.29,3714.0,2
HCPCS,29130,Application of finger splint,,,128.29,3714.0,2
HCPCS,29130,Hc Application Finger Splint,1035.0,672.75,,,0
HCPCS,29131,Application of finger splint,,,56.88,3714.0,2
HCPCS,29200,Strapping of chest,,,156.69,3714.0,2
HCPCS,29240,Strapping of shoulder,,,128.29,3714.0,2
HCPCS,29260,Strapping of elbow or wrist,,,56.88,3714.0,2
HCPCS,29280,Hc Strapping Hand Or Finger,1779.0,1156.35,,,0
HCPCS,29280,Strapping of hand or finger,,,56.88,3714.0,2
HCPCS,29305,Application of hip cast,,,269.69,3714.0,2
HCPCS,29325,Application of hip casts,,,269.69,3714.0,2
HCPCS,29345,Application of long leg cast,,,269.69,3714.0,2
HCPCS,29355,Application of long leg cast,,,269.69,3714.0,2
HCPCS,29358,Apply long leg cast brace,,,269.69,3714.0,2
HCPCS,29365,Application of long leg cast,,,269.69,3714.0,2
HCPCS,29405,Apply short leg cast,,,269.69,3714.0,2
HCPCS,29405,Hc Application Short Leg Cast,1956.0,1271.4,,,0
HCPCS,29425,Apply short leg cast,,,269.69,3714.0,2
HCPCS,29425,Hc Application Short Leg Cast Walking,1900.5,1235.3249999999998,,,0
HCPCS,29435,Apply short leg cast,,,269.69,3714.0,2
HCPCS,29440,Addition of walker to cast,,,156.69,3714.0,2
HCPCS,29445,Apply rigid leg cast,,,269.69,3714.0,2
HCPCS,29445,Hc Appl Rigid Total Cont Leg Cast,3195.0,2076.75,,,0
HCPCS,29450,Application of leg cast,,,156.69,3714.0,2
HCPCS,29505,Application long leg splint,,,156.69,3714.0,2
HCPCS,29515,Application lower leg splint,,,156.69,3714.0,2
HCPCS,29520,Strapping of hip,,,128.29,3714.0,2
HCPCS,29530,Strapping of knee,,,128.29,3714.0,2
HCPCS,29540,Hc Strapping Lower Extremity,1968.0,1279.1999999999998,,,0
HCPCS,29540,Strapping of ankle and/or ft,,,156.69,3714.0,2
HCPCS,29550,Hc Strapping Toe,1779.0,1156.35,,,0
HCPCS,29550,Strapping of toes,,,56.88,3714.0,2
HCPCS,29580,Application of paste boot,,,156.69,3714.0,2
HCPCS,29580,Hc Strapping Unna Boot,1384.5,899.9250000000001,,,0
HCPCS,29581,Apply multlay comprs lwr leg,,,156.69,3714.0,2
HCPCS,29581,Hc Applic Multi Layer Comp Sys Leg/Ankle/Foot,1384.5,899.9250000000001,,,0
HCPCS,29581,Hc Ot Applic Multi Layer Comp Sys Leg/Ankle/Foot,1407.0,914.5500000000001,,,0
HCPCS,29581,Hc Pt Applic Multi Layer Comp Sys Leg/Ankle/Foot,1407.0,914.5500000000001,,,0
HCPCS,29584,Appl multlay comprs arm/hand,,,156.69,3714.0,2
HCPCS,29584,Hc Applic Multi Layer Comp Sys Arm Or Hand,938.0,609.7,,,0
HCPCS,29584,Hc Ot Applic Multi Layer Comp Sys Arm/Hand/Fingers,1689.0,1097.85,,,0
HCPCS,29584,Hc Pt Applic Multi Layer Comp Sys Arm/Hand/Fingers,1689.0,1097.85,,,0
HCPCS,29700,Removal/revision of cast,,,269.69,3714.0,2
HCPCS,29705,Hc Cast Removal,5311.5,3452.4750000000004,,,0
HCPCS,29705,Removal/revision of cast,,,269.69,3714.0,2
HCPCS,29710,Removal/revision of cast,,,269.69,3714.0,2
HCPCS,29720,Repair of body cast,,,156.69,3714.0,2
HCPCS,29730,Windowing of cast,,,156.69,3714.0,2
HCPCS,29740,Wedging of cast,,,269.69,3714.0,2
HCPCS,29750,Wedging of clubfoot cast,,,269.69,3714.0,2
HCPCS,29799,Casting/strapping procedure,,,156.69,16564.0,2
HCPCS,29800,Jaw arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29804,Jaw arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29805,Shoulder arthroscopy dx,,,3154.93,15689.0,2
HCPCS,29806,Shoulder arthroscopy/surgery,,,6996.6,31685.0,2
HCPCS,29807,Shoulder arthroscopy/surgery,,,6996.6,31685.0,2
HCPCS,29819,Shoulder arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29820,Shoulder arthroscopy/surgery,,,6996.6,31685.0,2
HCPCS,29821,Shoulder arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29822,Shoulder arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29823,Shoulder arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29824,Shoulder arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29825,Shoulder arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29827,Arthroscop rotator cuff repr,,,6996.6,31685.0,2
HCPCS,29828,Arthroscopy biceps tenodesis,,,6996.6,31685.0,2
HCPCS,29830,Elbow arthroscopy,,,3154.93,15689.0,2
HCPCS,29834,Elbow arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29835,Elbow arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29836,Elbow arthroscopy/surgery,,,6996.6,31685.0,2
HCPCS,29837,Elbow arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29838,Elbow arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29840,Wrist arthroscopy,,,3154.93,15689.0,2
HCPCS,29843,Wrist arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29844,Wrist arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29845,Wrist arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29846,Wrist arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29847,Wrist arthroscopy/surgery,,,6996.6,31685.0,2
HCPCS,29848,Wrist endoscopy/surgery,,,1550.46,9206.0,2
HCPCS,29850,Knee arthroscopy/surgery,,,1550.46,9206.0,2
HCPCS,29851,Knee arthroscopy/surgery,,,1550.46,9206.0,2
HCPCS,29855,Tibial arthroscopy/surgery,,,6996.6,31685.0,2
HCPCS,29856,Tibial arthroscopy/surgery,,,12379.34,38216.0,2
HCPCS,29860,Hip arthroscopy dx,,,6996.6,31685.0,2
HCPCS,29861,Hip arthro w/fb removal,,,6996.6,15689.0,2
HCPCS,29862,Hip arthr0 w/debridement,,,6996.6,31685.0,2
HCPCS,29863,Hip arthr0 w/synovectomy,,,3154.93,15689.0,2
HCPCS,29866,Autgrft implnt knee w/scope,,,6996.6,31685.0,2
HCPCS,29867,Allgrft implnt knee w/scope,,,12379.34,38216.0,2
HCPCS,29868,Meniscal trnspl knee w/scpe,,,6996.6,31685.0,2
HCPCS,29870,Knee arthroscopy dx,,,3154.93,15689.0,2
HCPCS,29871,Knee arthroscopy/drainage,,,3154.93,15689.0,2
HCPCS,29873,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29874,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29875,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29876,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29877,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29879,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29880,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29881,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29882,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29883,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29884,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29885,Knee arthroscopy/surgery,,,6996.6,31685.0,2
HCPCS,29886,Knee arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29887,Knee arthroscopy/surgery,,,6996.6,31685.0,2
HCPCS,29888,Knee arthroscopy/surgery,,,6996.6,31685.0,2
HCPCS,29889,Knee arthroscopy/surgery,,,12379.34,38216.0,2
HCPCS,29891,Ankle arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29892,Ankle arthroscopy/surgery,,,6996.6,31685.0,2
HCPCS,29893,Scope plantar fasciotomy,,,3154.93,15689.0,2
HCPCS,29894,Ankle arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29895,Ankle arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29897,Ankle arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29898,Ankle arthroscopy/surgery,,,3154.93,15689.0,2
HCPCS,29899,Ankle arthroscopy/surgery,,,6996.6,16564.0,2
HCPCS,29900,Mcp joint arthroscopy dx,,,3154.93,15689.0,2
HCPCS,29901,Mcp joint arthroscopy surg,,,3154.93,15689.0,2
HCPCS,29902,Mcp joint arthroscopy surg,,,1550.46,9206.0,2
HCPCS,29904,Subtalar arthro w/fb rmvl,,,3154.93,15689.0,2
HCPCS,29905,Subtalar arthro w/exc,,,6996.6,15689.0,2
HCPCS,29906,Subtalar arthro w/deb,,,3154.93,15689.0,2
HCPCS,29907,Subtalar arthro w/fusion,,,12379.34,38216.0,2
HCPCS,29914,Hip arthro w/femoroplasty,,,6996.6,31685.0,2
HCPCS,29915,Hip arthro acetabuloplasty,,,6996.6,31685.0,2
HCPCS,29916,Hip arthro w/labral repair,,,6996.6,31685.0,2
HCPCS,29999,Arthroscopy of joint,,,237.84,16564.0,2
HCPCS,30000,Drainage of nose lesion,,,228.38,3714.0,2
HCPCS,30020,Drainage of nose lesion,,,520.03,3714.0,2
HCPCS,30100,Intranasal biopsy,,,1496.07,9206.0,2
HCPCS,30110,Removal of nose polyp(s),,,1496.07,9206.0,2
HCPCS,30115,Removal of nose polyp(s),,,3196.84,9206.0,2
HCPCS,30117,Removal of intranasal lesion,,,3196.84,9206.0,2
HCPCS,30118,Removal of intranasal lesion,,,3196.84,9206.0,2
HCPCS,30120,Revision of nose,,,3196.84,9206.0,2
HCPCS,30124,Removal of nose lesion,,,1496.07,9206.0,2
HCPCS,30125,Removal of nose lesion,,,5708.03,20001.0,2
HCPCS,30130,Excise inferior turbinate,,,3196.84,9206.0,2
HCPCS,30140,Resect inferior turbinate,,,3196.84,9206.0,2
HCPCS,30150,Partial removal of nose,,,5708.03,20001.0,2
HCPCS,30160,Removal of nose,,,5708.03,20001.0,2
HCPCS,30200,Injection treatment of nose,,,520.03,3714.0,2
HCPCS,30210,Nasal sinus therapy,,,1496.07,9206.0,2
HCPCS,30220,Insert nasal septal button,,,1496.07,9206.0,2
HCPCS,30300,Hc Removal Foreign Body Nasal,685.0,445.25,,,0
HCPCS,30300,Remove nasal foreign body,,,128.29,3714.0,2
HCPCS,30310,Remove nasal foreign body,,,3196.84,9206.0,2
HCPCS,30320,Remove nasal foreign body,,,1496.07,9206.0,2
HCPCS,30400,Reconstruction of nose,,,5708.03,20001.0,2
HCPCS,30410,Reconstruction of nose,,,5708.03,20001.0,2
HCPCS,30420,Reconstruction of nose,,,5708.03,20001.0,2
HCPCS,30430,Revision of nose,,,5708.03,20001.0,2
HCPCS,30435,Revision of nose,,,5708.03,20001.0,2
HCPCS,30450,Revision of nose,,,5708.03,20001.0,2
HCPCS,30460,Revision of nose,,,5708.03,20001.0,2
HCPCS,30462,Revision of nose,,,5708.03,20001.0,2
HCPCS,30465,Repair Nasal Stenosis,,,5708.03,20001.0,2
HCPCS,30468,Rpr nsl vlv collapse w/implt,,,5708.03,20001.0,2
HCPCS,30469,Rpr nsl vlv collapse w/rmdlg,,,5708.03,20001.0,2
HCPCS,30520,Repair of nasal septum,,,3196.84,9206.0,2
HCPCS,30540,Repair nasal defect,,,5708.03,20001.0,2
HCPCS,30545,Repair nasal defect,,,5708.03,20001.0,2
HCPCS,30560,Release of nasal adhesions,,,520.03,3714.0,2
HCPCS,30580,Repair upper jaw fistula,,,5708.03,20001.0,2
HCPCS,30600,Repair mouth/nose fistula,,,5708.03,20001.0,2
HCPCS,30620,Intranasal reconstruction,,,5708.03,20001.0,2
HCPCS,30630,Repair nasal septum defect,,,3196.84,9206.0,2
HCPCS,30801,Ablate inf turbinate superf,,,1496.07,9206.0,2
HCPCS,30802,Ablate inf turbinate submuc,,,1496.07,9206.0,2
HCPCS,30901,Control of nosebleed,,,128.29,3714.0,2
HCPCS,30901,Hc Control Nosebleed Simple,1927.5,1252.875,,,0
HCPCS,30903,Control of nosebleed,,,128.29,3714.0,2
HCPCS,30903,Hc Control Nosebleed Complex,2793.0,1815.4499999999998,,,0
HCPCS,30905,Control of nosebleed,,,128.29,3714.0,2
HCPCS,30905,Hc Cntrl Post Nosebleed Init,2091.0,1359.15,,,0
HCPCS,30906,Hc Cntrl Post Nosebleed Subqnt Uni Or Bilat,2174.0,1413.1,,,0
HCPCS,30906,Repeat control of nosebleed,,,228.38,3714.0,2
HCPCS,30915,Ligation nasal sinus artery,,,3044.51,15689.0,2
HCPCS,30920,Ligation upper jaw artery,,,3044.51,15689.0,2
HCPCS,30930,Ther fx nasal inf turbinate,,,3196.84,9206.0,2
HCPCS,30999,Nasal surgery procedure,,,228.38,16564.0,2
HCPCS,31000,Irrigation maxillary sinus,,,228.38,3714.0,2
HCPCS,31002,Irrigation sphenoid sinus,,,1496.07,9206.0,2
HCPCS,31020,Exploration maxillary sinus,,,3196.84,9206.0,2
HCPCS,31030,Exploration maxillary sinus,,,5708.03,20001.0,2
HCPCS,31032,Explore sinus remove polyps,,,5708.03,20001.0,2
HCPCS,31040,Exploration behind upper jaw,,,5708.03,20001.0,2
HCPCS,31050,Exploration sphenoid sinus,,,5708.03,20001.0,2
HCPCS,31051,Sphenoid sinus surgery,,,5708.03,20001.0,2
HCPCS,31070,Exploration of frontal sinus,,,5708.03,20001.0,2
HCPCS,31075,Exploration of frontal sinus,,,5708.03,20001.0,2
HCPCS,31080,Removal of frontal sinus,,,5708.03,20001.0,2
HCPCS,31081,Removal of frontal sinus,,,5708.03,20001.0,2
HCPCS,31084,Removal of frontal sinus,,,5708.03,20001.0,2
HCPCS,31085,Removal of frontal sinus,,,5708.03,20001.0,2
HCPCS,31086,Removal of frontal sinus,,,5708.03,20001.0,2
HCPCS,31087,Removal of frontal sinus,,,5708.03,20001.0,2
HCPCS,31090,Exploration of sinuses,,,5708.03,20001.0,2
HCPCS,31200,Removal of ethmoid sinus,,,5708.03,20001.0,2
HCPCS,31201,Removal of ethmoid sinus,,,1496.07,9206.0,2
HCPCS,31205,Removal of ethmoid sinus,,,3196.84,9206.0,2
HCPCS,31225,Removal of upper jaw,,,20001.0,20001.0,1
HCPCS,31230,Removal of upper jaw,,,20001.0,20001.0,1
HCPCS,31231,Hc Endoscopy Nasal,819.0,532.35,,,0
HCPCS,31231,Nasal endoscopy dx,,,192.47,3714.0,2
HCPCS,31233,Hc Nasal Endoscopy With Maxillary Sinusoscopy,1972.0,1281.8,,,0
HCPCS,31233,Nasal/sinus endoscopy dx,,,377.13,3714.0,2
HCPCS,31235,Nasal/sinus endoscopy dx,,,1716.22,9206.0,2
HCPCS,31237,Nasal/sinus endoscopy surg,,,1716.22,9206.0,2
HCPCS,31238,Hc Nasal/Sinus Endo With Control Hemorrhage,4200.0,2730.0,,,0
HCPCS,31238,Nasal/sinus endoscopy surg,,,1716.22,9206.0,2
HCPCS,31239,Nasal/sinus endoscopy surg,,,3594.95,15689.0,2
HCPCS,31240,Nasal/sinus endoscopy surg,,,1716.22,9206.0,2
HCPCS,31241,Nsl/sins ndsc w/artery lig,,,1716.22,9206.0,2
HCPCS,31242,Nsl/sinus ndsc rf abltj pnn,,,5708.03,20001.0,2
HCPCS,31243,Nsl/sinus ndsc cryoabltj pnn,,,5708.03,20001.0,2
HCPCS,31253,Nsl/sins ndsc total,,,6804.96,30765.0,2
HCPCS,31254,Revision of ethmoid sinus,,,6804.96,30765.0,2
HCPCS,31255,Removal of ethmoid sinus,,,6804.96,30765.0,2
HCPCS,31256,Exploration maxillary sinus,,,3594.95,15689.0,2
HCPCS,31257,Nsl/sins ndsc tot w/sphendt,,,6804.96,30765.0,2
HCPCS,31259,Nsl/sins ndsc sphn tiss rmvl,,,6804.96,30765.0,2
HCPCS,31267,Endoscopy maxillary sinus,,,6804.96,30765.0,2
HCPCS,31276,Sinus endoscopy surgical,,,6804.96,30765.0,2
HCPCS,31287,Nasal/sinus endoscopy surg,,,6804.96,30765.0,2
HCPCS,31288,Nasal/sinus endoscopy surg,,,6804.96,30765.0,2
HCPCS,31290,Nasal/sinus endoscopy surg,,,30765.0,30765.0,1
HCPCS,31291,Nasal/sinus endoscopy surg,,,30765.0,30765.0,1
HCPCS,31292,Nasal/sinus endoscopy surg,,,6804.96,30765.0,2
HCPCS,31293,Nasal/sinus endoscopy surg,,,6804.96,30765.0,2
HCPCS,31294,Nasal/sinus endoscopy surg,,,6804.96,30765.0,2
HCPCS,31295,Sinus endo w/balloon dil,,,6804.96,30765.0,2
HCPCS,31296,Sinus endo w/balloon dil,,,6804.96,30765.0,2
HCPCS,31297,Sinus endo w/balloon dil,,,6804.96,30765.0,2
HCPCS,31298,Nsl/sins ndsc w/sins dilat,,,6804.96,30765.0,2
HCPCS,31299,Sinus surgery procedure,,,228.38,16564.0,2
HCPCS,31300,Removal of larynx lesion,,,3196.84,9206.0,2
HCPCS,31360,Removal of larynx,,,20001.0,20001.0,1
HCPCS,31365,Removal of larynx,,,20001.0,20001.0,1
HCPCS,31367,Partial removal of larynx,,,20001.0,20001.0,1
HCPCS,31368,Partial removal of larynx,,,20001.0,20001.0,1
HCPCS,31370,Partial removal of larynx,,,20001.0,20001.0,1
HCPCS,31375,Partial removal of larynx,,,20001.0,20001.0,1
HCPCS,31380,Partial removal of larynx,,,20001.0,20001.0,1
HCPCS,31382,Partial removal of larynx,,,20001.0,20001.0,1
HCPCS,31390,Removal of larynx & pharynx,,,20001.0,20001.0,1
HCPCS,31395,Reconstruct larynx & pharynx,,,20001.0,20001.0,1
HCPCS,31400,Revision of larynx,,,5708.03,20001.0,2
HCPCS,31420,Removal of epiglottis,,,5708.03,20001.0,2
HCPCS,31500,Hc Intubation Endotracheal,1966.0,1277.9,,,0
HCPCS,31500,Insert emergency airway,,,228.38,3714.0,2
HCPCS,31502,Change of windpipe airway,,,228.38,3714.0,2
HCPCS,31502,Hc Trach Tube Change,1966.0,1277.9,,,0
HCPCS,31505,Diagnostic laryngoscopy,,,192.47,3714.0,2
HCPCS,31505,Hc Laryngscpy Indirect Diagnos,825.0,536.25,,,0
HCPCS,31510,Laryngoscopy with biopsy,,,3594.95,15689.0,2
HCPCS,31511,Remove foreign body larynx,,,192.47,3714.0,2
HCPCS,31512,Removal of larynx lesion,,,3594.95,15689.0,2
HCPCS,31513,Injection into vocal cord,,,377.13,3714.0,2
HCPCS,31515,Laryngoscopy for aspiration,,,377.13,3714.0,2
HCPCS,31520,Dx laryngoscopy newborn,,,377.13,3714.0,2
HCPCS,31525,Dx laryngoscopy excl nb,,,1716.22,9206.0,2
HCPCS,31526,Dx laryngoscopy w/oper scope,,,1716.22,9206.0,2
HCPCS,31527,Laryngoscopy for treatment,,,3594.95,15689.0,2
HCPCS,31528,Laryngoscopy and dilation,,,3594.95,15689.0,2
HCPCS,31529,Laryngoscopy and dilation,,,3594.95,15689.0,2
HCPCS,31530,Laryngoscopy w/fb removal,,,1716.22,9206.0,2
HCPCS,31531,Laryngoscopy w/fb & op scope,,,3594.95,15689.0,2
HCPCS,31535,Laryngoscopy w/biopsy,,,3594.95,15689.0,2
HCPCS,31536,Laryngoscopy w/bx & op scope,,,3594.95,15689.0,2
HCPCS,31540,Laryngoscopy w/exc of tumor,,,3594.95,15689.0,2
HCPCS,31541,Larynscop w/tumr exc + scope,,,3594.95,15689.0,2
HCPCS,31545,Remove vc lesion w/scope,,,3594.95,15689.0,2
HCPCS,31546,Remove vc lesion scope/graft,,,6804.96,30765.0,2
HCPCS,31551,Laryngoplasty laryngeal sten,,,5708.03,20001.0,2
HCPCS,31552,Laryngoplasty laryngeal sten,,,5708.03,20001.0,2
HCPCS,31553,Laryngoplasty laryngeal sten,,,5708.03,20001.0,2
HCPCS,31554,Laryngoplasty laryngeal sten,,,5708.03,20001.0,2
HCPCS,31560,Laryngoscop w/arytenoidectom,,,6804.96,30765.0,2
HCPCS,31561,Larynscop remve cart + scop,,,6804.96,30765.0,2
HCPCS,31570,Laryngoscope w/vc inj,,,3594.95,15689.0,2
HCPCS,31571,Laryngoscop w/vc inj + scope,,,3594.95,15689.0,2
HCPCS,31572,Largsc w/laser dstrj les,,,3594.95,15689.0,2
HCPCS,31573,Largsc w/ther injection,,,1716.22,9206.0,2
HCPCS,31574,Largsc w/njx augmentation,,,1716.22,9206.0,2
HCPCS,31575,Diagnostic laryngoscopy,,,192.47,3714.0,2
HCPCS,31575,Hc Laryngoscopy Fiberoptic,804.0,522.6,,,0
HCPCS,31576,Laryngoscopy with biopsy,,,1716.22,9206.0,2
HCPCS,31577,Largsc w/rmvl foreign bdy(s),,,377.13,3714.0,2
HCPCS,31578,Largsc w/removal lesion,,,3594.95,15689.0,2
HCPCS,31579,Hc St Laryngoscopy With Stroboscopy,1972.0,1281.8,,,0
HCPCS,31579,Laryngoscopy telescopic,,,377.13,3714.0,2
HCPCS,31580,Laryngoplasty laryngeal web,,,5708.03,20001.0,2
HCPCS,31584,Laryngoplasty fx rdctj fixj,,,5708.03,20001.0,2
HCPCS,31587,Laryngoplasty cricoid split,,,5708.03,20001.0,2
HCPCS,31590,Reinnervate larynx,,,5708.03,20001.0,2
HCPCS,31591,Laryngoplasty medialization,,,5708.03,20001.0,2
HCPCS,31592,Cricotracheal resection,,,5708.03,20001.0,2
HCPCS,31599,Larynx surgery procedure,,,228.38,16564.0,2
HCPCS,31600,Hc Tracheostomy Planned,4037.0,2624.05,,,0
HCPCS,31600,Incision of windpipe,,,3196.84,9206.0,2
HCPCS,31601,Incision of windpipe,,,5708.03,20001.0,2
HCPCS,31603,Incision of windpipe,,,1496.07,9206.0,2
HCPCS,31605,Hc Tracheotomy Cricothyroidotomy,4156.0,2701.4,,,0
HCPCS,31605,Incision of windpipe,,,228.38,3714.0,2
HCPCS,31610,Incision of windpipe,,,5708.03,20001.0,2
HCPCS,31611,Surgery/speech prosthesis,,,3196.84,9206.0,2
HCPCS,31612,Puncture/clear windpipe,,,3196.84,9206.0,2
HCPCS,31613,Repair windpipe opening,,,3196.84,9206.0,2
HCPCS,31614,Repair windpipe opening,,,5708.03,20001.0,2
HCPCS,31615,Hc Bronchoscopy Through Tracheostomy,4459.0,2898.35,,,0
HCPCS,31615,Visualization of windpipe,,,520.03,3714.0,2
HCPCS,31622,Dx bronchoscope/wash,,,1716.22,9206.0,2
HCPCS,31622,Hc Bronchoscopy,4220.0,2743.0,,,0
HCPCS,31623,Dx bronchoscope/brush,,,1716.22,9206.0,2
HCPCS,31623,Hc Bronchoscopy With Brushing,6016.0,3910.4,,,0
HCPCS,31624,Dx bronchoscope/lavage,,,1716.22,9206.0,2
HCPCS,31624,Hc Bronchoscopy W Alveolar Lavage,4663.0,3030.95,,,0
HCPCS,31625,Bronchoscopy w/biopsy(s),,,1716.22,9206.0,2
HCPCS,31625,Hc Bronchoscopy W Biopsy,5432.0,3530.8,,,0
HCPCS,31626,Bronchoscopy w/markers,,,6804.96,30765.0,2
HCPCS,31626,Hc Bronchoscopy W Insert Fiducial Markers,6600.0,4290.0,,,0
HCPCS,31627,Hc Bronchoscopy W Computer Assist Nav,6539.0,4250.35,,,0
HCPCS,31628,Bronchoscopy/lung bx each,,,3594.95,15689.0,2
HCPCS,31628,Hc Bronchoscopy W Transbronch Lung Bx,5432.0,3530.8,,,0
HCPCS,31629,Bronchoscopy/needle bx each,,,3594.95,15689.0,2
HCPCS,31629,Hc Bronchoscopy W Transbronch Needle Asp,4442.0,2887.3,,,0
HCPCS,31630,Bronchoscopy dilate/fx repr,,,3594.95,15689.0,2
HCPCS,31630,Hc Bronchoscopy W Dilation Or Fx Repair,8710.0,5661.5,,,0
HCPCS,31631,Bronchoscopy dilate w/stent,,,6804.96,30765.0,2
HCPCS,31631,Hc Bronchoscopy W Insert Trachial Stent,6859.0,4458.35,,,0
HCPCS,31632,Hc Bronchoscopy W Lung Biopsy Ea Addl Lobe,2827.0,1837.55,,,0
HCPCS,31633,Hc Bronchoscopy W Needle Bx Ea Addl Lobe,4680.0,3042.0,,,0
HCPCS,31634,Bronch w/balloon occlusion,,,6804.96,30765.0,2
HCPCS,31635,Bronchoscopy w/fb removal,,,1716.22,9206.0,2
HCPCS,31635,Hc Bronchoscopy W Removal Foreign Body,6362.0,4135.3,,,0
HCPCS,31636,Bronchoscopy bronch stents,,,6804.96,30765.0,2
HCPCS,31636,Hc Bronchoscopy W Insert Bronchial Stent,6600.0,4290.0,,,0
HCPCS,31637,Hc Bronchoscopy  W Stent Ea Addl,1172.0,761.8,,,0
HCPCS,31638,Bronchoscopy revise stent,,,6804.96,30765.0,2
HCPCS,31638,Hc Bronchoscopy W Stent Revision,6600.0,4290.0,,,0
HCPCS,31640,Bronchoscopy w/tumor excise,,,3594.95,15689.0,2
HCPCS,31640,Hc Bronchoscopy W Excision Of Tumor,7054.0,4585.1,,,0
HCPCS,31641,Bronchoscopy treat blockage,,,3594.95,15689.0,2
HCPCS,31641,Hc Bronchoscopy W Destruction Of Tumor,4307.0,2799.55,,,0
HCPCS,31643,Diag bronchoscope/catheter,,,1716.22,9206.0,2
HCPCS,31643,Hc Bronchoscopy W Plcmnt Radiation Cath,4899.0,3184.35,,,0
HCPCS,31645,Bronchoscopy clear airways,,,1716.22,9206.0,2
HCPCS,31645,Hc Bronchoscopy W Therap Asp Of Trach Ini,4442.0,2887.3,,,0
HCPCS,31646,Bronchoscopy reclear airway,,,377.13,3714.0,2
HCPCS,31646,Hc Bronchoscopy W Therap Asp Of Trach Sub,708.0,460.2,,,0
HCPCS,31647,Bronchial valve init insert,,,6804.96,30765.0,2
HCPCS,31647,Hc Bronchoscopy W Insert Bronch Valves Ini,6600.0,4290.0,,,0
HCPCS,31648,Bronchial valve remov init,,,3594.95,15689.0,2
HCPCS,31648,Hc Bronchoscopy W Rem Bronch Valves Ini,5601.0,3640.65,,,0
HCPCS,31649,Bronchial valve remov addl,,,1716.22,9206.0,2
HCPCS,31649,Hc Bronchoscopy W Rem Bronch Valves Addl,4132.0,2685.8,,,0
HCPCS,31651,Hc Bronchoscopy W Insert Bronch Valves Addl,5745.0,3734.25,,,0
HCPCS,31652,Bronch ebus samplng 1/2 node,,,3594.95,15689.0,2
HCPCS,31652,Hc Bronchoscopy Endobronchial Us 1-2 Nodes,9634.0,6262.1,,,0
HCPCS,31653,Bronch ebus samplng 3/> node,,,3594.95,15689.0,2
HCPCS,31653,Hc Bronchoscopy Endobronchial Us 3 Or More Nodes,9634.0,6262.1,,,0
HCPCS,31654,Hc Bronchoscopy W Ebus W Intvj Periph Lesions,5195.0,3376.75,,,0
HCPCS,31660,Bronch thermoplsty 1 lobe,,,6804.96,30765.0,2
HCPCS,31661,Bronch thermoplsty 2/> lobes,,,6804.96,30765.0,2
HCPCS,31717,Bronchial brush biopsy,,,377.13,3714.0,2
HCPCS,31720,Clearance of airways,,,211.14,3714.0,2
HCPCS,31725,Clearance of airways,,,9206.0,9206.0,1
HCPCS,31730,Intro windpipe wire/tube,,,1716.22,9206.0,2
HCPCS,31750,Repair of windpipe,,,5708.03,20001.0,2
HCPCS,31755,Repair of windpipe,,,5708.03,20001.0,2
HCPCS,31760,Repair of windpipe,,,20001.0,20001.0,1
HCPCS,31766,Reconstruction of windpipe,,,20001.0,20001.0,1
HCPCS,31770,Repair/graft of bronchus,,,20001.0,20001.0,1
HCPCS,31775,Reconstruct bronchus,,,20001.0,20001.0,1
HCPCS,31780,Reconstruct windpipe,,,20001.0,20001.0,1
HCPCS,31781,Reconstruct windpipe,,,20001.0,20001.0,1
HCPCS,31785,Remove windpipe lesion,,,5708.03,20001.0,2
HCPCS,31786,Remove windpipe lesion,,,20001.0,20001.0,1
HCPCS,31800,Repair of windpipe injury,,,15689.0,15689.0,1
HCPCS,31805,Repair of windpipe injury,,,15689.0,15689.0,1
HCPCS,31820,Closure of windpipe lesion,,,3196.84,9206.0,2
HCPCS,31825,Repair of windpipe defect,,,3196.84,9206.0,2
HCPCS,31830,Revise windpipe scar,,,3196.84,9206.0,2
HCPCS,31899,Airways surgical procedure,,,192.47,16564.0,2
HCPCS,32035,Thoracostomy w/rib resection,,,26701.0,26701.0,1
HCPCS,32036,Thoracostomy w/flap drainage,,,26701.0,26701.0,1
HCPCS,32096,Open wedge/bx lung infiltr,,,26701.0,26701.0,1
HCPCS,32097,Open wedge/bx lung nodule,,,26701.0,26701.0,1
HCPCS,32098,Open biopsy of lung pleura,,,26701.0,26701.0,1
HCPCS,32100,Exploration of chest,,,30765.0,30765.0,1
HCPCS,32110,Explore/repair chest,,,30765.0,30765.0,1
HCPCS,32120,Re-exploration of chest,,,30765.0,30765.0,1
HCPCS,32124,Explore chest free adhesions,,,30765.0,30765.0,1
HCPCS,32140,Removal of lung lesion(s),,,30765.0,30765.0,1
HCPCS,32141,Remove/treat lung lesions,,,30765.0,30765.0,1
HCPCS,32150,Removal of lung lesion(s),,,30765.0,30765.0,1
HCPCS,32151,Remove lung foreign body,,,30765.0,30765.0,1
HCPCS,32160,Open chest heart massage,,,30765.0,30765.0,1
HCPCS,32200,Drain open lung lesion,,,26701.0,26701.0,1
HCPCS,32215,Treat chest lining,,,26701.0,26701.0,1
HCPCS,32220,Release of lung,,,26701.0,26701.0,1
HCPCS,32225,Partial release of lung,,,26701.0,26701.0,1
HCPCS,32310,Removal of chest lining,,,26701.0,26701.0,1
HCPCS,32320,Free/remove chest lining,,,26701.0,26701.0,1
HCPCS,32400,Hc Biopsy Pleura Percutaneous Needle,4996.0,3247.4,,,0
HCPCS,32400,Needle biopsy chest lining,,,1592.51,9206.0,2
HCPCS,32408,Core ndl bx lng/med perq,,,1592.51,9206.0,2
HCPCS,32408,Hc Biopsy Lung Or Mediastinum Perc W Img,7582.0,4928.3,,,0
HCPCS,32440,Remove lung pneumonectomy,,,38216.0,38216.0,1
HCPCS,32442,Sleeve pneumonectomy,,,38216.0,38216.0,1
HCPCS,32445,Removal of lung extrapleural,,,38216.0,38216.0,1
HCPCS,32480,Partial removal of lung,,,38216.0,38216.0,1
HCPCS,32482,Bilobectomy,,,38216.0,38216.0,1
HCPCS,32484,Segmentectomy,,,38216.0,38216.0,1
HCPCS,32486,Sleeve lobectomy,,,38216.0,38216.0,1
HCPCS,32488,Completion pneumonectomy,,,38216.0,38216.0,1
HCPCS,32491,Lung volume reduction,,,38216.0,38216.0,1
HCPCS,32501,Repair bronchus add-on,,,38216.0,38216.0,1
HCPCS,32503,Resect apical lung tumor,,,38216.0,38216.0,1
HCPCS,32504,Resect apical lung tum/chest,,,38216.0,38216.0,1
HCPCS,32505,Wedge resect of lung initial,,,38216.0,38216.0,1
HCPCS,32506,Wedge resect of lung add-on,,,38216.0,38216.0,1
HCPCS,32507,Wedge resect of lung diag,,,38216.0,38216.0,1
HCPCS,32540,Removal of lung lesion,,,38216.0,38216.0,1
HCPCS,32550,Hc Insert Tunneled Pleural Catheter,11864.0,7711.6,,,0
HCPCS,32550,Insert pleural cath,,,3452.3,15689.0,2
HCPCS,32551,Hc Thoracostomy Tube Open,4104.0,2667.6000000000004,,,0
HCPCS,32551,Insertion of chest tube,,,1517.83,9206.0,2
HCPCS,32552,Hc Remove Tunneled Pleural Cath W Cuff,3732.0,2425.8,,,0
HCPCS,32552,Remove lung catheter,,,604.86,3714.0,2
HCPCS,32553,Hc Placement Fiducial Marker,2065.0,1342.25,,,0
HCPCS,32553,Ins mark thor for rt perq,,,1334.61,9206.0,2
HCPCS,32554,Aspirate pleura w/o imaging,,,604.86,3714.0,2
HCPCS,32554,Hc Thoracentesis Wo Imaging,5565.0,3617.25,,,0
HCPCS,32555,Aspirate pleura w/ imaging,,,604.86,3714.0,2
HCPCS,32555,Hc Thoracentesis W Imaging,8440.5,5486.325000000001,,,0
HCPCS,32556,Hc Perc Pleural Drnge W Ins Catheter Wo Img,8131.5,5285.475,,,0
HCPCS,32556,Insert cath pleura w/o image,,,1850.25,9206.0,2
HCPCS,32557,Hc Perc Pleural Drnge W Ins Catheter W Img,12198.0,7928.700000000001,,,0
HCPCS,32557,Insert cath pleura w/ image,,,1517.83,9206.0,2
HCPCS,32560,Hc Chemical Pleurodesis,2728.0,1773.2,,,0
HCPCS,32560,Treat pleurodesis w/agent,,,604.86,3714.0,2
HCPCS,32561,Hc Instillation Via Chest Tube/Cath Fibrinolysis Initial,1315.0,854.75,,,0
HCPCS,32561,Lyse chest fibrin init day,,,604.86,3714.0,2
HCPCS,32562,Hc Instlj Ch Tube/Cath Agent Fbrnlysis Sbsq Day,1315.0,854.75,,,0
HCPCS,32562,Lyse chest fibrin subq day,,,604.86,3714.0,2
HCPCS,32601,Thoracoscopy diagnostic,,,5829.23,26701.0,2
HCPCS,32604,Thoracoscopy wbx sac,,,10249.52,26701.0,2
HCPCS,32606,Thoracoscopy w/bx med space,,,5829.23,26701.0,2
HCPCS,32607,Thoracoscopy w/bx infiltrate,,,10249.52,26701.0,2
HCPCS,32608,Thoracoscopy w/bx nodule,,,10249.52,26701.0,2
HCPCS,32609,Thoracoscopy w/bx pleura,,,5829.23,26701.0,2
HCPCS,32650,Thoracoscopy w/pleurodesis,,,26701.0,26701.0,1
HCPCS,32651,Thoracoscopy remove cortex,,,26701.0,26701.0,1
HCPCS,32652,Thoracoscopy rem totl cortex,,,26701.0,26701.0,1
HCPCS,32653,Thoracoscopy remov fb/fibrin,,,26701.0,26701.0,1
HCPCS,32654,Thoracoscopy contrl bleeding,,,26701.0,26701.0,1
HCPCS,32655,Thoracoscopy resect bullae,,,26701.0,26701.0,1
HCPCS,32656,Thoracoscopy w/pleurectomy,,,26701.0,26701.0,1
HCPCS,32658,Thoracoscopy w/sac fb remove,,,26701.0,26701.0,1
HCPCS,32659,Thoracoscopy w/sac drainage,,,26701.0,26701.0,1
HCPCS,32661,Thoracoscopy w/pericard exc,,,26701.0,26701.0,1
HCPCS,32662,Thoracoscopy w/mediast exc,,,26701.0,26701.0,1
HCPCS,32663,Thoracoscopy w/lobectomy,,,26701.0,26701.0,1
HCPCS,32664,Thoracoscopy w/ th nrv exc,,,26701.0,26701.0,1
HCPCS,32665,Thoracoscop w/esoph musc exc,,,26701.0,26701.0,1
HCPCS,32666,Thoracoscopy w/wedge resect,,,38216.0,38216.0,1
HCPCS,32667,Thoracoscopy w/w resect addl,,,26701.0,26701.0,1
HCPCS,32668,Thoracoscopy w/w resect diag,,,26701.0,26701.0,1
HCPCS,32669,Thoracoscopy remove segment,,,26701.0,26701.0,1
HCPCS,32670,Thoracoscopy bilobectomy,,,26701.0,26701.0,1
HCPCS,32671,Thoracoscopy pneumonectomy,,,26701.0,26701.0,1
HCPCS,32672,Thoracoscopy for lvrs,,,26701.0,26701.0,1
HCPCS,32673,Thoracoscopy w/thymus resect,,,26701.0,26701.0,1
HCPCS,32674,Thoracoscopy lymph node exc,,,26701.0,26701.0,1
HCPCS,32701,Thorax stereo rad targetw/tx,,,3714.0,3714.0,1
HCPCS,32800,Repair lung hernia,,,26701.0,26701.0,1
HCPCS,32810,Close chest after drainage,,,26701.0,26701.0,1
HCPCS,32815,Close bronchial fistula,,,26701.0,26701.0,1
HCPCS,32820,Reconstruct injured chest,,,26701.0,26701.0,1
HCPCS,32850,Donor pneumonectomy,,,26701.0,26701.0,1
HCPCS,32851,Lung transplant single,,,63079.0,63079.0,1
HCPCS,32852,Lung transplant with bypass,,,63079.0,63079.0,1
HCPCS,32853,Lung transplant double,,,63079.0,63079.0,1
HCPCS,32854,Lung transplant with bypass,,,63079.0,63079.0,1
HCPCS,32855,Prepare donor lung single,,,26701.0,26701.0,1
HCPCS,32856,Prepare donor lung double,,,26701.0,26701.0,1
HCPCS,32900,Removal of rib(s),,,15689.0,15689.0,1
HCPCS,32905,Revise & repair chest wall,,,38216.0,38216.0,1
HCPCS,32906,Revise & repair chest wall,,,38216.0,38216.0,1
HCPCS,32940,Revision of lung,,,38216.0,38216.0,1
HCPCS,32960,Therapeutic pneumothorax,,,604.86,3714.0,2
HCPCS,32994,Ablate pulm tumor perq crybl,,,10249.52,26701.0,2
HCPCS,32994,Hc Cryoablation Pulm Tumor Unilat W Img,13800.0,8970.0,,,0
HCPCS,32997,Total lung lavage,,,15689.0,15689.0,1
HCPCS,32998,Hc Rf Ablation Pulm Tumor Unilat W Img,23184.0,15069.599999999999,,,0
HCPCS,32998,Perq rf ablate tx pul tumor,,,5829.23,26701.0,2
HCPCS,32999,Chest surgery procedure,,,604.86,16564.0,2
HCPCS,32999,Hc Unlisted Procedure Lungs Or Pleura,2736.0,1778.4,,,0
HCPCS,33016,Hc Pericardiocentesis W Img,13413.0,8718.45,,,0
HCPCS,33016,Pericardiocentesis w/imaging,,,1517.83,9206.0,2
HCPCS,33017,Hc Perc Pericardial Drainage W Fluoro Or Us,15499.0,10074.35,,,0
HCPCS,33017,Prcrd drg 6yr+ w/o cgen car,,,9206.0,9206.0,1
HCPCS,33018,Prcrd drg 0-5yr or w/anomly,,,9206.0,9206.0,1
HCPCS,33019,Hc Perc Pericardial Drainage W Ct,18480.0,12012.0,,,0
HCPCS,33019,Perq prcrd drg insj cath ct,,,9206.0,9206.0,1
HCPCS,33020,Incision of heart sac,,,30765.0,30765.0,1
HCPCS,33025,Hc Creation Of Pericardiotomy Window,6288.0,4087.2,,,0
HCPCS,33025,Incision of heart sac,,,30765.0,30765.0,1
HCPCS,33030,Partial removal of heart sac,,,30765.0,30765.0,1
HCPCS,33031,Partial removal of heart sac,,,30765.0,30765.0,1
HCPCS,33050,Resect heart sac lesion,,,30765.0,30765.0,1
HCPCS,33120,Removal of heart lesion,,,38216.0,38216.0,1
HCPCS,33130,Removal of heart lesion,,,30765.0,30765.0,1
HCPCS,33140,Heart revascularize (tmr),,,30765.0,30765.0,1
HCPCS,33141,Heart Tmr W/Other Procedure,,,30765.0,30765.0,1
HCPCS,33202,Insert epicard eltrd open,,,38216.0,38216.0,1
HCPCS,33203,Insert epicard eltrd endo,,,38216.0,38216.0,1
HCPCS,33206,Hc Insert Pacer Atrial W Lead,21785.0,14160.25,,,0
HCPCS,33206,Insert heart pm atrial,,,10078.04,38216.0,2
HCPCS,33207,Hc Insert Pacer Ventricular W Lead,22288.0,14487.2,,,0
HCPCS,33207,Insert heart pm ventricular,,,10078.04,38216.0,2
HCPCS,33208,Hc Insert Pacer Atrial And Ventricular W Lead,26652.0,17323.8,,,0
HCPCS,33208,Insrt heart pm atrial & vent,,,10078.04,38216.0,2
HCPCS,33210,Hc Insert Temporary Pacemaker,10844.0,7048.6,,,0
HCPCS,33210,Insert electrd/pm cath sngl,,,7979.31,38216.0,2
HCPCS,33211,Hc Insert Replc Temp Transvenous Dual Chamber Pacing Elect,10844.0,7048.6,,,0
HCPCS,33211,Insert card electrodes dual,,,7979.31,38216.0,2
HCPCS,33212,Hc Insert Pulse Generator Only Sgl,15770.0,10250.5,,,0
HCPCS,33212,Insert pulse gen sngl lead,,,7979.31,38216.0,2
HCPCS,33213,Hc Insert Pulse Generator Only Dual,18580.0,12077.0,,,0
HCPCS,33213,Insert pulse gen dual leads,,,10078.04,38216.0,2
HCPCS,33214,Hc Upgrade Implanted Pacemaker,18580.0,12077.0,,,0
HCPCS,33214,Upgrade of pacemaker system,,,10078.04,38216.0,2
HCPCS,33215,Hc Reposition Previously Implanted Pacer,11992.0,7794.8,,,0
HCPCS,33215,Reposition pacing-defib lead,,,3044.51,15689.0,2
HCPCS,33216,Hc Insertion Transvenous Electrode Single,21986.0,14290.9,,,0
HCPCS,33216,Insert 1 electrode pm-defib,,,7979.31,38216.0,2
HCPCS,33217,Hc Insertion Transvenous Electrode Dual,23085.0,15005.25,,,0
HCPCS,33217,Insert 2 electrode pm-defib,,,7979.31,38216.0,2
HCPCS,33218,Hc Repair Transvenous Electrode Single,17335.0,11267.75,,,0
HCPCS,33218,Repair lead pace-defib one,,,3603.26,15689.0,2
HCPCS,33220,Hc Repair Transvenous Electrode Dual,18433.0,11981.45,,,0
HCPCS,33220,Repair lead pace-defib dual,,,3603.26,15689.0,2
HCPCS,33221,Hc Insert Pacer Pulse Generator Mult Leads,31030.0,20169.5,,,0
HCPCS,33221,Insert pulse gen mult leads,,,18572.54,63079.0,2
HCPCS,33222,Hc Revision Skin Pocket Pacemaker,10452.0,6793.8,,,0
HCPCS,33222,Relocation pocket pacemaker,,,1989.46,9206.0,2
HCPCS,33223,Hc Revision Skin Pocket Icd,10452.0,6793.8,,,0
HCPCS,33223,Relocate pocket for defib,,,1989.46,9206.0,2
HCPCS,33224,Hc Ins Electrode Prev Placed Icd Or Pacer,34671.0,22536.15,,,0
HCPCS,33224,Insert pacing lead & connect,,,10078.04,38216.0,2
HCPCS,33225,Hc Ins Electrode At Ins Icd Or Pacer,20520.0,13338.0,,,0
HCPCS,33226,Hc Reposition Previously Impl Cvs Electrode,11992.0,7794.8,,,0
HCPCS,33226,Reposition l ventric lead,,,3044.51,15689.0,2
HCPCS,33227,Hc Rem And Replace Pacer Pulse Gen Single,20170.0,13110.5,,,0
HCPCS,33227,Remove&replace pm gen singl,,,7979.31,38216.0,2
HCPCS,33228,Hc Rem And Replace Pacer Pulse Gen Dual,22315.0,14504.75,,,0
HCPCS,33228,Remv&replc pm gen dual lead,,,10078.04,38216.0,2
HCPCS,33229,Hc Rem And Replace Pacer Pulse Gen Mult,18676.0,12139.4,,,0
HCPCS,33229,Remv&replc pm gen mult leads,,,18572.54,63079.0,2
HCPCS,33230,Hc Insert Icd Generator Only Dual,23817.0,15481.05,,,0
HCPCS,33230,Insrt pulse gen w/dual leads,,,21447.74,63079.0,2
HCPCS,33231,Hc Insert Icd Generator Only Mult,32544.0,21153.6,,,0
HCPCS,33231,Insrt pulse gen w/mult leads,,,30265.83,63079.0,2
HCPCS,33233,Hc Remover Pacer Pulse Generator Only,23695.0,15401.75,,,0
HCPCS,33233,Removal of pm generator,,,7979.31,38216.0,2
HCPCS,33234,Hc Remove Tvs Electrode Sgl Lead System,13868.0,9014.2,,,0
HCPCS,33234,Removal of pacemaker system,,,3603.26,15689.0,2
HCPCS,33235,Hc Remove Tvs Electrode Dual Lead System,15654.0,10175.1,,,0
HCPCS,33235,Removal pacemaker electrode,,,3603.26,15689.0,2
HCPCS,33236,Remove electrode/thoracotomy,,,15689.0,15689.0,1
HCPCS,33237,Remove electrode/thoracotomy,,,15689.0,15689.0,1
HCPCS,33238,Remove electrode/thoracotomy,,,15689.0,15689.0,1
HCPCS,33240,Hc Insertion Icd Generator Only Single,26020.0,16913.0,,,0
HCPCS,33240,Insrt pulse gen w/singl lead,,,21447.74,63079.0,2
HCPCS,33241,Hc Remove Icd Generator Only,20853.0,13554.45,,,0
HCPCS,33241,Remove pulse generator,,,3603.26,15689.0,2
HCPCS,33243,Remove eltrd/thoracotomy,,,15689.0,15689.0,1
HCPCS,33244,Hc Icd Lead Extraction,20853.0,13554.45,,,0
HCPCS,33244,Remove elctrd transvenously,,,3603.26,15689.0,2
HCPCS,33249,Hc Ins Or Repl Icd W Pulse Gen Sgl Or Dual,24020.0,15613.0,,,0
HCPCS,33249,Insj/rplcmt defib w/lead(s),,,30265.83,63079.0,2
HCPCS,33250,Ablate heart dysrhythm focus,,,30765.0,30765.0,1
HCPCS,33251,Ablate heart dysrhythm focus,,,30765.0,30765.0,1
HCPCS,33254,Ablate atria lmtd,,,30765.0,30765.0,1
HCPCS,33255,Ablate atria w/o bypass ext,,,30765.0,30765.0,1
HCPCS,33256,Ablate atria w/bypass exten,,,30765.0,30765.0,1
HCPCS,33257,Ablate atria lmtd add-on,,,30765.0,30765.0,1
HCPCS,33258,Ablate atria x10sv add-on,,,30765.0,30765.0,1
HCPCS,33259,Ablate atria w/bypass add-on,,,30765.0,30765.0,1
HCPCS,33261,Ablate heart dysrhythm focus,,,30765.0,30765.0,1
HCPCS,33262,Hc Remove Replace Icd Gen Sgl Lead Sys,22018.0,14311.7,,,0
HCPCS,33262,Rmvl& replc pulse gen 1 lead,,,21447.74,63079.0,2
HCPCS,33263,Hc Remove Replace Icd Gen Dual Lead Sys,21707.0,14109.55,,,0
HCPCS,33263,Rmvl & rplcmt dfb gen 2 lead,,,21447.74,63079.0,2
HCPCS,33264,Hc Remove Replace Icd Gen Mult Lead Sys,21260.0,13819.0,,,0
HCPCS,33264,Rmvl & rplcmt dfb gen mlt ld,,,30265.83,63079.0,2
HCPCS,33265,Ablate atria lmtd endo,,,30765.0,30765.0,1
HCPCS,33266,Ablate atria x10sv endo,,,30765.0,30765.0,1
HCPCS,33267,Excl laa open any method,,,63079.0,63079.0,1
HCPCS,33268,Excl laa opn oth px any meth,,,63079.0,63079.0,1
HCPCS,33269,Excl laa thrscp any method,,,63079.0,63079.0,1
HCPCS,33269,Hc Exclusion L Atr Appendage Thoracoscopic Any Method,42905.0,27888.25,,,0
HCPCS,33270,Hc Insert Subq Defib W Electrode,24020.0,15613.0,,,0
HCPCS,33270,Ins/rep subq defibrillator,,,30265.83,63079.0,2
HCPCS,33271,Hc Insert Subq Defib Electrode,21986.0,14290.9,,,0
HCPCS,33271,Insj subq impltbl dfb elctrd,,,7979.31,38216.0,2
HCPCS,33272,Hc Removal Subq Defib Electrode,20853.0,13554.45,,,0
HCPCS,33272,Rmvl of subq defibrillator,,,3603.26,15689.0,2
HCPCS,33273,Hc Repos Subq Defib Electrode And Gen,21632.0,14060.8,,,0
HCPCS,33273,Repos prev impltbl subq dfb,,,3603.26,15689.0,2
HCPCS,33274,Hc Trcath Ins Or Repl Perm Leadless Pacer Right,22288.0,14487.2,,,0
HCPCS,33274,Tcat insj/rpl perm ldls pm,,,18572.54,63079.0,2
HCPCS,33275,Hc Trcath Remove Permanent Leadless Pacer Right W Img,22288.0,14487.2,,,0
HCPCS,33275,Tcat rmvl perm ldls pm,,,3044.51,15689.0,2
HCPCS,33276,Hc Insert Phrenic Nerve Stimulator System,32093.0,20860.45,,,0
HCPCS,33276,Insj phrnc nrv stim sys,,,42470.57,63079.0,2
HCPCS,33277,Hc Insert Phrenic Nerve Stim Transvenous Sensing Lead Add On,1500.0,975.0,,,0
HCPCS,33278,Hc Remove Phrenic Nerve Stimulator System,10709.0,6960.85,,,0
HCPCS,33278,Rmvl phrnc nrv stim sys,,,3371.02,15689.0,2
HCPCS,33279,Hc Remove Phrenic Nerve Stim Transvenous Stim Or Sensing Lead(S) Only,9735.0,6327.75,,,0
HCPCS,33279,Rmvl phrnc nrv stim transvns,,,3371.02,15689.0,2
HCPCS,33280,Hc Remove Phrenic Nerve Stim Pulse Generator Only,9735.0,6327.75,,,0
HCPCS,33280,Rmvl phrnc nrv stim pg only,,,3371.02,15689.0,2
HCPCS,33281,Hc Reposition Phrenic Nerve Stim Transvenous Lead(S),9735.0,6327.75,,,0
HCPCS,33281,Reposg phrnc nrv stim trnsvn,,,3371.02,15689.0,2
HCPCS,33285,Hc Insert Subq Cardiac Rhythm Monitor Incl Programming,19702.0,12806.3,,,0
HCPCS,33285,Insj subq car rhythm mntr,,,7979.31,38216.0,2
HCPCS,33286,Hc Removal Of Subq Cardiac Rhythm Monitor,2391.0,1554.15,,,0
HCPCS,33286,Rmvl subq car rhythm mntr,,,682.8,3714.0,2
HCPCS,33287,Hc Remove & Replace Phrenic Nerve Stim Pulse Generator,21028.0,13668.2,,,0
HCPCS,33287,Rmv&rplcmt phrnc nrv stim pg,,,29753.66,63079.0,2
HCPCS,33288,Hc Remove & Replace Phrenic Nerve Stim Transvenous Stim Or Sensing Lead(S),21028.0,13668.2,,,0
HCPCS,33288,Rmv&rplcmt phrnc nrv stim ld,,,10744.03,38216.0,2
HCPCS,33289,Hc Trcath Implant Of Wireless Pulm Artery Pressure Sensor,23226.0,15096.9,,,0
HCPCS,33289,Tcat impl wrls p-art prs snr,,,27657.11,63079.0,2
HCPCS,33300,Repair of heart wound,,,38216.0,38216.0,1
HCPCS,33305,Repair of heart wound,,,38216.0,38216.0,1
HCPCS,33310,Exploratory heart surgery,,,38216.0,38216.0,1
HCPCS,33315,Exploratory heart surgery,,,38216.0,38216.0,1
HCPCS,33320,Repair major blood vessel(s),,,30765.0,30765.0,1
HCPCS,33321,Repair major vessel,,,30765.0,30765.0,1
HCPCS,33322,Repair major blood vessel(s),,,30765.0,30765.0,1
HCPCS,33330,Insert major vessel graft,,,30765.0,30765.0,1
HCPCS,33335,Insert major vessel graft,,,30765.0,30765.0,1
HCPCS,33340,Hc Transcatheter Closure L Atrial Appendage,42905.0,27888.25,,,0
HCPCS,33340,Perq clsr tcat l atr apndge,,,38216.0,38216.0,1
HCPCS,33361,Hc Tavr Tavi Perc Fem Art Approach,42905.0,27888.25,,,0
HCPCS,33361,Replace aortic valve perq,,,38216.0,38216.0,1
HCPCS,33362,Hc Tavr Tavi Open Fem Art Approach,42905.0,27888.25,,,0
HCPCS,33362,Replace aortic valve open,,,38216.0,38216.0,1
HCPCS,33363,Hc Tavr Tavi Open Axil Art Approach,42905.0,27888.25,,,0
HCPCS,33363,Replace aortic valve open,,,38216.0,38216.0,1
HCPCS,33364,Replace aortic valve open,,,38216.0,38216.0,1
HCPCS,33365,Hc Tavr Tavi Transaortic Approach,53222.0,34594.3,,,0
HCPCS,33365,Replace aortic valve open,,,38216.0,38216.0,1
HCPCS,33366,Hc Trcath Replace Aortic Valve,42905.0,27888.25,,,0
HCPCS,33366,Trcath replace aortic valve,,,38216.0,38216.0,1
HCPCS,33367,Replace aortic valve w/byp,,,38216.0,38216.0,1
HCPCS,33368,Replace aortic valve w/byp,,,38216.0,38216.0,1
HCPCS,33369,Replace aortic valve w/byp,,,38216.0,38216.0,1
HCPCS,33370,Hc Transcath Plcmnt Sbsq Removal Cepd Perq,413.0,268.45,,,0
HCPCS,33390,Valvuloplasty aortic valve,,,38216.0,38216.0,1
HCPCS,33391,Valvuloplasty aortic valve,,,63079.0,63079.0,1
HCPCS,33404,Prepare heart-aorta conduit,,,30765.0,30765.0,1
HCPCS,33405,Replacement aortic valve opn,,,38216.0,38216.0,1
HCPCS,33406,Replacement aortic valve opn,,,38216.0,38216.0,1
HCPCS,33410,Replacement aortic valve opn,,,38216.0,38216.0,1
HCPCS,33411,Replacement of aortic valve,,,38216.0,38216.0,1
HCPCS,33412,Replacement of aortic valve,,,38216.0,38216.0,1
HCPCS,33413,Replacement of aortic valve,,,38216.0,38216.0,1
HCPCS,33414,Repair of aortic valve,,,38216.0,38216.0,1
HCPCS,33415,Revision subvalvular tissue,,,38216.0,38216.0,1
HCPCS,33416,Revise ventricle muscle,,,38216.0,38216.0,1
HCPCS,33417,Repair of aortic valve,,,38216.0,38216.0,1
HCPCS,33418,Hc Transcath Mitral Valve Rep Perc,42905.0,27888.25,,,0
HCPCS,33418,Repair tcat mitral valve,,,15689.0,15689.0,1
HCPCS,33419,Hc Transcath Mitral Valve Rep Ea Add,1305.0,848.25,,,0
HCPCS,33420,Revision of mitral valve,,,38216.0,38216.0,1
HCPCS,33422,Revision of mitral valve,,,63079.0,63079.0,1
HCPCS,33425,Repair of mitral valve,,,38216.0,38216.0,1
HCPCS,33426,Repair of mitral valve,,,38216.0,38216.0,1
HCPCS,33427,Repair of mitral valve,,,38216.0,38216.0,1
HCPCS,33430,Replacement of mitral valve,,,38216.0,38216.0,1
HCPCS,33440,Rplcmt a-valve tlcj autol pv,,,38216.0,38216.0,1
HCPCS,33460,Revision of tricuspid valve,,,38216.0,38216.0,1
HCPCS,33463,Valvuloplasty tricuspid,,,38216.0,38216.0,1
HCPCS,33464,Valvuloplasty tricuspid,,,38216.0,38216.0,1
HCPCS,33465,Replace tricuspid valve,,,38216.0,38216.0,1
HCPCS,33468,Revision of tricuspid valve,,,38216.0,38216.0,1
HCPCS,33471,Valvotomy pulmonary valve,,,38216.0,38216.0,1
HCPCS,33474,Revision of pulmonary valve,,,38216.0,38216.0,1
HCPCS,33475,Replacement pulmonary valve,,,38216.0,38216.0,1
HCPCS,33476,Revision of heart chamber,,,38216.0,38216.0,1
HCPCS,33477,Hc Transcath Pulm Valve Plcmnt Perc,42905.0,27888.25,,,0
HCPCS,33477,Implant tcat pulm vlv perq,,,30765.0,30765.0,1
HCPCS,33478,Revision of heart chamber,,,38216.0,38216.0,1
HCPCS,33496,Repair prosth valve clot,,,30765.0,30765.0,1
HCPCS,33500,Repair heart vessel fistula,,,38216.0,38216.0,1
HCPCS,33501,Hc Rpair Cor Arteriovenous/Cardiac Fistula Wo Bypass,16533.0,10746.45,,,0
HCPCS,33501,Repair heart vessel fistula,,,38216.0,38216.0,1
HCPCS,33502,Coronary artery correction,,,38216.0,38216.0,1
HCPCS,33503,Coronary artery graft,,,38216.0,38216.0,1
HCPCS,33504,Coronary artery graft,,,38216.0,38216.0,1
HCPCS,33505,Repair artery w/tunnel,,,38216.0,38216.0,1
HCPCS,33506,Repair artery translocation,,,38216.0,38216.0,1
HCPCS,33507,Repair art intramural,,,38216.0,38216.0,1
HCPCS,33509,Ndsc hrv uxtr art 1 sgm cab,,,15689.0,15689.0,1
HCPCS,33510,Cabg vein single,,,38216.0,38216.0,1
HCPCS,33511,Cabg vein two,,,38216.0,38216.0,1
HCPCS,33512,Cabg vein three,,,38216.0,38216.0,1
HCPCS,33513,Cabg vein four,,,38216.0,38216.0,1
HCPCS,33514,Cabg vein five,,,38216.0,38216.0,1
HCPCS,33516,Cabg vein six or more,,,38216.0,38216.0,1
HCPCS,33517,Cabg artery-vein single,,,38216.0,38216.0,1
HCPCS,33518,Cabg artery-vein two,,,38216.0,38216.0,1
HCPCS,33519,Cabg artery-vein three,,,38216.0,38216.0,1
HCPCS,33521,Cabg artery-vein four,,,38216.0,38216.0,1
HCPCS,33522,Cabg artery-vein five,,,38216.0,38216.0,1
HCPCS,33523,Cabg art-vein six or more,,,38216.0,38216.0,1
HCPCS,33530,Coronary artery bypass/reop,,,38216.0,38216.0,1
HCPCS,33533,Cabg arterial single,,,38216.0,38216.0,1
HCPCS,33534,Cabg arterial two,,,38216.0,38216.0,1
HCPCS,33535,Cabg arterial three,,,38216.0,38216.0,1
HCPCS,33536,Cabg arterial four or more,,,38216.0,38216.0,1
HCPCS,33542,Removal of heart lesion,,,38216.0,38216.0,1
HCPCS,33545,Repair of heart damage,,,38216.0,38216.0,1
HCPCS,33548,Restore/remodel ventricle,,,38216.0,38216.0,1
HCPCS,33572,Open coronary endarterectomy,,,38216.0,38216.0,1
HCPCS,33600,Closure of valve,,,38216.0,38216.0,1
HCPCS,33602,Closure of valve,,,38216.0,38216.0,1
HCPCS,33606,Anastomosis/artery-aorta,,,38216.0,38216.0,1
HCPCS,33608,Repair anomaly w/conduit,,,38216.0,38216.0,1
HCPCS,33610,Repair by enlargement,,,38216.0,38216.0,1
HCPCS,33611,Repair double ventricle,,,38216.0,38216.0,1
HCPCS,33612,Repair double ventricle,,,38216.0,38216.0,1
HCPCS,33615,Repair modified fontan,,,38216.0,38216.0,1
HCPCS,33617,Repair single ventricle,,,38216.0,38216.0,1
HCPCS,33619,Repair single ventricle,,,38216.0,38216.0,1
HCPCS,33620,Apply r&l pulm art bands,,,30765.0,30765.0,1
HCPCS,33621,Transthor cath for stent,,,15689.0,15689.0,1
HCPCS,33622,Redo compl cardiac anomaly,,,38216.0,38216.0,1
HCPCS,33641,Repair heart septum defect,,,38216.0,38216.0,1
HCPCS,33645,Revision of heart veins,,,30765.0,30765.0,1
HCPCS,33647,Repair heart septum defects,,,38216.0,38216.0,1
HCPCS,33660,Repair of heart defects,,,38216.0,38216.0,1
HCPCS,33665,Repair of heart defects,,,38216.0,38216.0,1
HCPCS,33670,Repair of heart chambers,,,38216.0,38216.0,1
HCPCS,33675,Close Mult Vsd,,,38216.0,38216.0,1
HCPCS,33676,Close mult vsd w/resection,,,38216.0,38216.0,1
HCPCS,33677,Cl mult vsd w/rem pul band,,,38216.0,38216.0,1
HCPCS,33681,Repair heart septum defect,,,38216.0,38216.0,1
HCPCS,33684,Repair heart septum defect,,,38216.0,38216.0,1
HCPCS,33688,Repair heart septum defect,,,38216.0,38216.0,1
HCPCS,33690,Reinforce pulmonary artery,,,30765.0,30765.0,1
HCPCS,33692,Repair of heart defects,,,38216.0,38216.0,1
HCPCS,33694,Repair of heart defects,,,38216.0,38216.0,1
HCPCS,33697,Repair of heart defects,,,38216.0,38216.0,1
HCPCS,33702,Repair of heart defects,,,38216.0,38216.0,1
HCPCS,33710,Repair of heart defects,,,38216.0,38216.0,1
HCPCS,33720,Repair of heart defect,,,38216.0,38216.0,1
HCPCS,33724,Repair Venous Anomaly,,,30765.0,30765.0,1
HCPCS,33726,Repair Pul Venous Stenosis,,,30765.0,30765.0,1
HCPCS,33730,Repair heart-vein defect(s),,,30765.0,30765.0,1
HCPCS,33732,Repair heart-vein defect,,,30765.0,30765.0,1
HCPCS,33735,Revision of heart chamber,,,38216.0,38216.0,1
HCPCS,33736,Revision of heart chamber,,,63079.0,63079.0,1
HCPCS,33737,Revision of heart chamber,,,63079.0,63079.0,1
HCPCS,33741,Tas congenital car anomal,,,38216.0,38216.0,1
HCPCS,33745,Tis cgen car anomal 1st shnt,,,38216.0,38216.0,1
HCPCS,33746,Tis cgen car anomal ea addl,,,38216.0,38216.0,1
HCPCS,33750,Major vessel shunt,,,30765.0,30765.0,1
HCPCS,33755,Major vessel shunt,,,30765.0,30765.0,1
HCPCS,33762,Major vessel shunt,,,30765.0,30765.0,1
HCPCS,33764,Major vessel shunt & graft,,,30765.0,30765.0,1
HCPCS,33766,Major vessel shunt,,,30765.0,30765.0,1
HCPCS,33767,Major vessel shunt,,,30765.0,30765.0,1
HCPCS,33768,Cavopulmonary shunting,,,30765.0,30765.0,1
HCPCS,33770,Repair great vessels defect,,,30765.0,30765.0,1
HCPCS,33771,Repair great vessels defect,,,30765.0,30765.0,1
HCPCS,33774,Repair great vessels defect,,,30765.0,30765.0,1
HCPCS,33775,Repair great vessels defect,,,30765.0,30765.0,1
HCPCS,33776,Repair great vessels defect,,,30765.0,30765.0,1
HCPCS,33777,Repair great vessels defect,,,30765.0,30765.0,1
HCPCS,33778,Repair great vessels defect,,,30765.0,30765.0,1
HCPCS,33779,Repair great vessels defect,,,30765.0,30765.0,1
HCPCS,33780,Repair great vessels defect,,,30765.0,30765.0,1
HCPCS,33781,Repair great vessels defect,,,30765.0,30765.0,1
HCPCS,33782,Nikaidoh proc,,,30765.0,30765.0,1
HCPCS,33783,Nikaidoh proc w/ostia implt,,,30765.0,30765.0,1
HCPCS,33786,Repair arterial trunk,,,30765.0,30765.0,1
HCPCS,33788,Revision of pulmonary artery,,,30765.0,30765.0,1
HCPCS,33800,Aortic suspension,,,30765.0,30765.0,1
HCPCS,33802,Repair vessel defect,,,30765.0,30765.0,1
HCPCS,33803,Repair vessel defect,,,30765.0,30765.0,1
HCPCS,33813,Repair septal defect,,,38216.0,38216.0,1
HCPCS,33814,Repair septal defect,,,38216.0,38216.0,1
HCPCS,33820,Revise major vessel,,,30765.0,30765.0,1
HCPCS,33822,Revise major vessel,,,30765.0,30765.0,1
HCPCS,33824,Revise major vessel,,,30765.0,30765.0,1
HCPCS,33840,Remove aorta constriction,,,38216.0,38216.0,1
HCPCS,33845,Remove aorta constriction,,,38216.0,38216.0,1
HCPCS,33851,Remove aorta constriction,,,38216.0,38216.0,1
HCPCS,33852,Repair septal defect,,,38216.0,38216.0,1
HCPCS,33853,Repair septal defect,,,38216.0,38216.0,1
HCPCS,33858,As-aort grf f/aortic dsj,,,38216.0,38216.0,1
HCPCS,33859,As-aort grf f/ds oth/thn dsj,,,38216.0,38216.0,1
HCPCS,33863,Ascending aortic graft,,,38216.0,38216.0,1
HCPCS,33864,Ascending aortic graft,,,38216.0,38216.0,1
HCPCS,33871,Transvrs a-arch grf hypthrm,,,38216.0,38216.0,1
HCPCS,33875,Thoracic aortic graft,,,38216.0,38216.0,1
HCPCS,33877,Thoracoabdominal graft,,,38216.0,38216.0,1
HCPCS,33880,Endovasc taa repr incl subcl,,,38216.0,38216.0,1
HCPCS,33880,Hc Endovasc Rep Descend Thorac Aorta Subclav,3563.0,2315.95,,,0
HCPCS,33881,Endovasc taa repr w/o subcl,,,38216.0,38216.0,1
HCPCS,33881,Hc Endovasc Rep Descend Thorac Aorta No Subcl,3563.0,2315.95,,,0
HCPCS,33883,Hc Plcmnt Prox Ext Prosthesis Rpr Desc Aorta,1305.0,848.25,,,0
HCPCS,33883,Insert endovasc prosth taa,,,38216.0,38216.0,1
HCPCS,33884,Endovasc prosth taa add-on,,,38216.0,38216.0,1
HCPCS,33884,Hc Plcmnt Prox Ext Prosthesis Rpr Desc Aorta Addl,1305.0,848.25,,,0
HCPCS,33886,Endovasc prosth delayed,,,38216.0,38216.0,1
HCPCS,33886,Hc Plcmnt Dist Ext Prosthesis Delayd After Rpr,3563.0,2315.95,,,0
HCPCS,33889,Artery transpose/endovas taa,,,38216.0,38216.0,1
HCPCS,33891,Car-car bp grft/endovas taa,,,38216.0,38216.0,1
HCPCS,33894,Evasc st rpr thrc/aa acrs br,,,38216.0,38216.0,1
HCPCS,33895,Evasc st rpr thrc/aa x crsg,,,38216.0,38216.0,1
HCPCS,33897,Perq trluml angp nt/recr coa,,,38216.0,38216.0,1
HCPCS,33900,Hc Perq Pulm Artery Revasularization Initial Normal Connect Unilateral,22355.0,14530.75,,,0
HCPCS,33900,Perq p-art revsc 1 nm nt uni,,,11131.16,38216.0,2
HCPCS,33901,Hc Perq Pulm Artery Revasularization Initial Normal Connect Bilateral,26826.0,17436.9,,,0
HCPCS,33901,Perq p-art revsc 1 nm nt bi,,,11131.16,38216.0,2
HCPCS,33902,Hc Perq Pulm Artery Revasularization Initial Abnormal Connect Unilateral,26495.0,17221.75,,,0
HCPCS,33902,Perq p-art revsc 1 abnor uni,,,17675.76,63079.0,2
HCPCS,33903,Hc Perq Pulm Artery Revasularization Initial Abnormal Connect Bilateral,31794.0,20666.1,,,0
HCPCS,33903,Perq p-art revsc 1 abnor bi,,,11131.16,38216.0,2
HCPCS,33904,Hc Perq Pulm Artery Revasularization Ea Addl Norm/Abnorm Connect,13564.0,8816.6,,,0
HCPCS,33910,Remove lung artery emboli,,,38216.0,38216.0,1
HCPCS,33915,Remove lung artery emboli,,,38216.0,38216.0,1
HCPCS,33916,Surgery of great vessel,,,30765.0,30765.0,1
HCPCS,33917,Repair pulmonary artery,,,30765.0,30765.0,1
HCPCS,33920,Repair pulmonary atresia,,,30765.0,30765.0,1
HCPCS,33922,Transect pulmonary artery,,,30765.0,30765.0,1
HCPCS,33924,Remove pulmonary shunt,,,30765.0,30765.0,1
HCPCS,33925,Rpr pul art unifocal w/o cpb,,,30765.0,30765.0,1
HCPCS,33926,Repr pul art unifocal w/cpb,,,30765.0,30765.0,1
HCPCS,33927,Impltj tot rplcmt hrt sys,,,63079.0,63079.0,1
HCPCS,33928,Rmvl & rplcmt tot hrt sys,,,63079.0,63079.0,1
HCPCS,33929,Rmvl rplcmt hrt sys f/trnspl,,,63079.0,63079.0,1
HCPCS,33930,Removal of donor heart/lung,,,26701.0,26701.0,1
HCPCS,33933,Prepare donor heart/lung,,,26701.0,26701.0,1
HCPCS,33935,Transplantation heart/lung,,,63079.0,63079.0,1
HCPCS,33940,Removal of donor heart,,,26701.0,26701.0,1
HCPCS,33944,Prepare donor heart,,,26701.0,26701.0,1
HCPCS,33945,Transplantation of heart,,,63079.0,63079.0,1
HCPCS,33946,Ecmo/ecls initiation venous,,,9206.0,9206.0,1
HCPCS,33946,Hc Ecmo Initial Day Veno-Veno,41522.0,26989.3,,,0
HCPCS,33947,Ecmo/ecls initiation artery,,,9206.0,9206.0,1
HCPCS,33947,Hc Ecmo Initial Day Veno-Arterial,41522.0,26989.3,,,0
HCPCS,33948,Ecmo/ecls daily mgmt-venous,,,9206.0,9206.0,1
HCPCS,33948,Hc Ecmo Addl Day Veno-Veno,41522.0,26989.3,,,0
HCPCS,33949,Ecmo/ecls daily mgmt artery,,,9206.0,9206.0,1
HCPCS,33949,Hc Ecmo Addl Day Veno-Arterial,41522.0,26989.3,,,0
HCPCS,33951,Ecmo/ecls insj prph cannula,,,9206.0,9206.0,1
HCPCS,33952,Ecmo/ecls insj prph cannula,,,9206.0,9206.0,1
HCPCS,33952,Hc Ecmo Insertion Peripheral Cannula,41522.0,26989.3,,,0
HCPCS,33953,Ecmo/ecls insj prph cannula,,,9206.0,9206.0,1
HCPCS,33954,Ecmo/ecls insj prph cannula,,,9206.0,9206.0,1
HCPCS,33955,Ecmo/ecls insj ctr cannula,,,9206.0,9206.0,1
HCPCS,33956,Ecmo/ecls insj ctr cannula,,,9206.0,9206.0,1
HCPCS,33957,Ecmo/ecls repos perph cnula,,,9206.0,9206.0,1
HCPCS,33958,Ecmo/ecls repos perph cnula,,,9206.0,9206.0,1
HCPCS,33959,Ecmo/ecls repos perph cnula,,,9206.0,9206.0,1
HCPCS,33962,Ecmo/ecls repos perph cnula,,,9206.0,9206.0,1
HCPCS,33963,Ecmo/ecls repos perph cnula,,,9206.0,9206.0,1
HCPCS,33964,Ecmo/ecls repos perph cnula,,,9206.0,9206.0,1
HCPCS,33965,Ecmo/ecls rmvl perph cannula,,,9206.0,9206.0,1
HCPCS,33966,Ecmo/ecls rmvl prph cannula,,,9206.0,9206.0,1
HCPCS,33967,Hc Insertion Iabp Perc,3704.0,2407.6,,,0
HCPCS,33967,Insert i-aort percut device,,,15689.0,15689.0,1
HCPCS,33968,Hc Removal Of Iapb Percutaneous,971.0,631.15,,,0
HCPCS,33968,Remove aortic assist device,,,15689.0,15689.0,1
HCPCS,33969,Ecmo/ecls rmvl perph cannula,,,9206.0,9206.0,1
HCPCS,33970,Aortic circulation assist,,,15689.0,15689.0,1
HCPCS,33971,Aortic circulation assist,,,15689.0,15689.0,1
HCPCS,33973,Insert balloon device,,,15689.0,15689.0,1
HCPCS,33974,Remove intra-aortic balloon,,,15689.0,15689.0,1
HCPCS,33975,Hc Vad Insert Extracorp Single Ventricle,4321.0,2808.65,,,0
HCPCS,33975,Implant ventricular device,,,38216.0,38216.0,1
HCPCS,33976,Hc Vad Insert Extracorp Biventricular,10242.0,6657.3,,,0
HCPCS,33976,Implant ventricular device,,,38216.0,38216.0,1
HCPCS,33977,Hc Vad Remove Extracorp Single Ventricle,5376.0,3494.4,,,0
HCPCS,33977,Remove ventricular device,,,38216.0,38216.0,1
HCPCS,33978,Hc Vad Remove Extracorp Biventricular,4765.0,3097.25,,,0
HCPCS,33978,Remove ventricular device,,,38216.0,38216.0,1
HCPCS,33979,Hc Vad Insert Intracorp Single Ventricle,6442.0,4187.3,,,0
HCPCS,33979,Insert intracorporeal device,,,38216.0,38216.0,1
HCPCS,33980,Hc Vad Removal Intracorp Single Ventricle,8515.0,5534.75,,,0
HCPCS,33980,Remove intracorporeal device,,,38216.0,38216.0,1
HCPCS,33981,Hc Vad Pump Replace Extracorp,3958.0,2572.7,,,0
HCPCS,33981,Replace vad pump ext,,,38216.0,38216.0,1
HCPCS,33982,Replace vad intra w/o bp,,,38216.0,38216.0,1
HCPCS,33983,Hc Vad Pump Replace Intracorporeal W Bypass,11060.0,7189.0,,,0
HCPCS,33983,Replace vad intra w/bp,,,38216.0,38216.0,1
HCPCS,33984,Ecmo/ecls rmvl prph cannula,,,9206.0,9206.0,1
HCPCS,33985,Ecmo/ecls rmvl ctr cannula,,,9206.0,9206.0,1
HCPCS,33986,Ecmo/ecls rmvl ctr cannula,,,9206.0,9206.0,1
HCPCS,33987,Artery expos/graft artery,,,20001.0,20001.0,1
HCPCS,33988,Insertion of left heart vent,,,38216.0,38216.0,1
HCPCS,33989,Removal of left heart vent,,,38216.0,38216.0,1
HCPCS,33990,Hc Insert Left Vad Arterial Access Percutaneous W/ Img,4215.0,2739.75,,,0
HCPCS,33990,Insert vad artery access,,,38216.0,38216.0,1
HCPCS,33991,Hc Insert Left Vad Arterial & Venous Access Percutaneous W/ Img,4215.0,2739.75,,,0
HCPCS,33991,Insert vad art&vein access,,,38216.0,38216.0,1
HCPCS,33992,Hc Remove Left Vad Percutaneous,2871.0,1866.15,,,0
HCPCS,33992,Remove vad different session,,,38216.0,38216.0,1
HCPCS,33993,Hc Reposition Right Or Left Vad Percutaneous W/ Img,2508.0,1630.2,,,0
HCPCS,33993,Reposition vad diff session,,,38216.0,38216.0,1
HCPCS,33995,Hc Insert Right Vad Arterial Access Percutaneous W Img,1405.0,913.25,,,0
HCPCS,33995,Insj perq vad r hrt venous,,,38216.0,38216.0,1
HCPCS,33997,Hc Remove Right Vad Percutaneous,957.0,622.05,,,0
HCPCS,33997,Rmvl perq right heart vad,,,15689.0,15689.0,1
HCPCS,33999,Cardiac surgery procedure,,,604.86,16564.0,2
HCPCS,33999,Hc Insert Vad Venous Access Percutaneous W Img,1405.0,913.25,,,0
HCPCS,33999,Hc Unlisted Procedure Cardiac Surgery,1450.0,942.5,,,0
HCPCS,34001,Removal of artery clot,,,20001.0,20001.0,1
HCPCS,34051,Removal of artery clot,,,20001.0,20001.0,1
HCPCS,34101,Removal of artery clot,,,5365.4,20001.0,2
HCPCS,34111,Removal of arm artery clot,,,5365.4,20001.0,2
HCPCS,34151,Removal of artery clot,,,20001.0,20001.0,1
HCPCS,34201,Hc Embolectomy Fem Pop Aortoiliac Art,10015.5,6510.075000000001,,,0
HCPCS,34201,Removal of artery clot,,,5365.4,20001.0,2
HCPCS,34203,Removal of leg artery clot,,,5365.4,20001.0,2
HCPCS,34401,Removal of vein clot,,,20001.0,20001.0,1
HCPCS,34421,Removal of vein clot,,,3044.51,15689.0,2
HCPCS,34451,Removal of vein clot,,,20001.0,20001.0,1
HCPCS,34471,Removal of vein clot,,,604.86,3714.0,2
HCPCS,34490,Removal of vein clot,,,3044.51,15689.0,2
HCPCS,34501,Repair valve femoral vein,,,5365.4,20001.0,2
HCPCS,34502,Reconstruct vena cava,,,38216.0,38216.0,1
HCPCS,34510,Transposition of vein valve,,,5365.4,20001.0,2
HCPCS,34520,Cross-over vein graft,,,5365.4,20001.0,2
HCPCS,34530,Leg vein fusion,,,3044.51,15689.0,2
HCPCS,34701,Evasc rpr a-ao ndgft,,,38216.0,38216.0,1
HCPCS,34701,Hc Endvsc Rep Infrnl Aorta By Aorto-Aortic Endgrft Not Rupt W Img,43380.0,28197.0,,,0
HCPCS,34702,Evasc rpr a-ao ndgft rpt,,,38216.0,38216.0,1
HCPCS,34702,Hc Endvsc Rep Infrnl Aorta By Aorto-Aortic Endgrft Rupt W Img,43380.0,28197.0,,,0
HCPCS,34703,Evasc rpr a-unilac ndgft,,,38216.0,38216.0,1
HCPCS,34703,Hc Endvsc Rep Infrnl Aort/Ilc Art By Aorto-Uni-Ilc Endgrft Not Rupt W Img,44303.0,28796.95,,,0
HCPCS,34704,Evasc rpr a-unilac ndgft rpt,,,38216.0,38216.0,1
HCPCS,34704,Hc Endvsc Rep Infrnl Aort/Ilc Art By Aorto-Uni-Ilc Endgrft Rupt W Img,44303.0,28796.95,,,0
HCPCS,34705,Evac rpr a-biiliac ndgft,,,38216.0,38216.0,1
HCPCS,34705,Hc Endvsc Rep Infrnl Aort/Ilc Art By Aorto-Bi-Ilc Endgrft Not Rupt W Img,45882.0,29823.3,,,0
HCPCS,34706,Evasc rpr a-biiliac rpt,,,38216.0,38216.0,1
HCPCS,34706,Hc Endvsc Rep Infrnl Aort/Ilc Art By Aorto-Bi-Ilc Endgrft Rupt W Img,45882.0,29823.3,,,0
HCPCS,34707,Evasc rpr ilio-iliac ndgft,,,30765.0,30765.0,1
HCPCS,34707,Hc Endvsc Rep Iliac Art By Ilio-Iliac Endgrft Uni Not Rupt W Img,50712.0,32962.8,,,0
HCPCS,34708,Evasc rpr ilio-iliac rpt,,,30765.0,30765.0,1
HCPCS,34708,Hc Endvsc Rep Iliac Art By Ilio-Iliac Endgrft Uni Rupt W Img,50712.0,32962.8,,,0
HCPCS,34709,Hc Plcmnt Ext Prosthesis For Endovasc Rep Per Vessel W Img Add On,16367.0,10638.55,,,0
HCPCS,34709,Plmt xtn prosth evasc rpr,,,30765.0,30765.0,1
HCPCS,34710,Dlyd plmt xtn prosth 1st vsl,,,30765.0,30765.0,1
HCPCS,34710,Hc Delayed Plcmnt Ext Prosthesis For Endovasc Rep Init Vessel W Img,18687.0,12146.55,,,0
HCPCS,34711,Dlyd plmt xtn prosth ea addl,,,30765.0,30765.0,1
HCPCS,34711,Hc Delayed Plcmnt Ext Prosthesis For Endovasc Rep Ea Addl Vessel W Img,16385.0,10650.25,,,0
HCPCS,34712,Hc Transcatheter Delivery Fixation Devices To Endograft W Img,15695.0,10201.75,,,0
HCPCS,34712,Tcat dlvr enhncd fixj dev,,,15689.0,15689.0,1
HCPCS,34713,Hc Perc Access & Closure Fem Art For Endgrft Del Uni W Img Add On,17429.0,11328.85,,,0
HCPCS,34716,Hc Open Axillary/Subclavian Art Expos W/Conduit Crtj,1373.0,892.45,,,0
HCPCS,34717,Evasc rpr a-iliac ndgft,,,38216.0,38216.0,1
HCPCS,34717,Hc Endovasc Repair Of Iliac Artery At Time Of Aortoiliac Endograft Plcmt Unilat,50712.0,32962.8,,,0
HCPCS,34718,Evasc rpr n/a a-iliac ndgft,,,38216.0,38216.0,1
HCPCS,34718,Hc Endovasc Repair Of Iliac Artery Not Assoc W Aortoiliac Endograft Plcmt Unilat,76068.0,49444.200000000004,,,0
HCPCS,34808,Endovas iliac a device addon,,,15689.0,15689.0,1
HCPCS,34812,Xpose for endoprosth femorl,,,9206.0,9206.0,1
HCPCS,34813,Femoral endovas graft add-on,,,15689.0,15689.0,1
HCPCS,34820,Xpose for endoprosth iliac,,,15689.0,15689.0,1
HCPCS,34830,Open Aortic Tube Prosth Repr,,,38216.0,38216.0,1
HCPCS,34831,Open Aortoiliac Prosth Repr,,,38216.0,38216.0,1
HCPCS,34832,Open Aortofemor Prosth Repr,,,38216.0,38216.0,1
HCPCS,34833,Xpose for endoprosth iliac,,,15689.0,15689.0,1
HCPCS,34834,Xpose endoprosth brachial,,,9206.0,9206.0,1
HCPCS,34839,Plnning pt spec fenest graft,,,3714.0,3714.0,1
HCPCS,34841,Endovasc visc aorta 1 graft,,,30765.0,30765.0,1
HCPCS,34842,Endovasc visc aorta 2 graft,,,30765.0,30765.0,1
HCPCS,34842,Hc Endovasc Visc Aorta 2 Graft,17178.0,11165.7,,,0
HCPCS,34843,Endovasc visc aorta 3 graft,,,30765.0,30765.0,1
HCPCS,34844,Endovasc visc aorta 4 graft,,,30765.0,30765.0,1
HCPCS,34845,Visc & infraren abd 1 prosth,,,30765.0,30765.0,1
HCPCS,34846,Visc & infraren abd 2 prosth,,,30765.0,30765.0,1
HCPCS,34847,Visc & infraren abd 3 prosth,,,30765.0,30765.0,1
HCPCS,34848,Visc & infraren abd 4+ prost,,,30765.0,30765.0,1
HCPCS,35001,Repair defect of artery,,,30765.0,30765.0,1
HCPCS,35002,Repair artery rupture neck,,,30765.0,30765.0,1
HCPCS,35005,Repair defect of artery,,,30765.0,30765.0,1
HCPCS,35011,Repair defect of artery,,,5365.4,20001.0,2
HCPCS,35013,Repair artery rupture arm,,,20001.0,20001.0,1
HCPCS,35021,Repair defect of artery,,,20001.0,20001.0,1
HCPCS,35022,Repair artery rupture chest,,,20001.0,20001.0,1
HCPCS,35045,Repair defect of arm artery,,,5365.4,20001.0,2
HCPCS,35081,Repair defect of artery,,,20001.0,20001.0,1
HCPCS,35082,Repair artery rupture aorta,,,20001.0,20001.0,1
HCPCS,35091,Repair defect of artery,,,20001.0,20001.0,1
HCPCS,35092,Repair artery rupture aorta,,,20001.0,20001.0,1
HCPCS,35102,Repair defect of artery,,,20001.0,20001.0,1
HCPCS,35103,Repair artery rupture aorta,,,20001.0,20001.0,1
HCPCS,35111,Repair defect of artery,,,20001.0,20001.0,1
HCPCS,35112,Repair artery rupture spleen,,,20001.0,20001.0,1
HCPCS,35121,Repair defect of artery,,,20001.0,20001.0,1
HCPCS,35122,Repair artery rupture belly,,,20001.0,20001.0,1
HCPCS,35131,Repair defect of artery,,,20001.0,20001.0,1
HCPCS,35132,Repair artery rupture groin,,,20001.0,20001.0,1
HCPCS,35141,Repair defect of artery,,,20001.0,20001.0,1
HCPCS,35142,Repair artery rupture thigh,,,20001.0,20001.0,1
HCPCS,35151,Repair defect of artery,,,20001.0,20001.0,1
HCPCS,35152,Repair ruptd popliteal art,,,20001.0,20001.0,1
HCPCS,35180,Repair blood vessel lesion,,,1517.83,3714.0,2
HCPCS,35182,Repair blood vessel lesion,,,15689.0,15689.0,1
HCPCS,35184,Repair blood vessel lesion,,,3044.51,15689.0,2
HCPCS,35188,Repair blood vessel lesion,,,5365.4,20001.0,2
HCPCS,35189,Repair blood vessel lesion,,,15689.0,15689.0,1
HCPCS,35190,Repair blood vessel lesion,,,5365.4,20001.0,2
HCPCS,35201,Repair blood vessel lesion,,,5365.4,20001.0,2
HCPCS,35206,Repair blood vessel lesion,,,3044.51,15689.0,2
HCPCS,35207,Repair blood vessel lesion,,,3044.51,15689.0,2
HCPCS,35211,Repair blood vessel lesion,,,20001.0,20001.0,1
HCPCS,35216,Repair blood vessel lesion,,,20001.0,20001.0,1
HCPCS,35221,Repair blood vessel lesion,,,20001.0,20001.0,1
HCPCS,35226,Repair blood vessel lesion,,,682.8,3714.0,2
HCPCS,35231,Repair blood vessel lesion,,,3044.51,15689.0,2
HCPCS,35236,Repair blood vessel lesion,,,5365.4,20001.0,2
HCPCS,35241,Repair blood vessel lesion,,,20001.0,20001.0,1
HCPCS,35246,Repair blood vessel lesion,,,20001.0,20001.0,1
HCPCS,35251,Repair blood vessel lesion,,,20001.0,20001.0,1
HCPCS,35256,Repair blood vessel lesion,,,5365.4,20001.0,2
HCPCS,35261,Repair blood vessel lesion,,,3044.51,15689.0,2
HCPCS,35266,Repair blood vessel lesion,,,5365.4,20001.0,2
HCPCS,35271,Repair blood vessel lesion,,,20001.0,20001.0,1
HCPCS,35276,Repair blood vessel lesion,,,20001.0,20001.0,1
HCPCS,35281,Repair blood vessel lesion,,,20001.0,20001.0,1
HCPCS,35286,Repair blood vessel lesion,,,5365.4,20001.0,2
HCPCS,35301,Rechanneling of artery,,,20001.0,20001.0,1
HCPCS,35302,Rechanneling of Artery,,,20001.0,20001.0,1
HCPCS,35303,Rechanneling of Artery,,,20001.0,20001.0,1
HCPCS,35304,Rechanneling of Artery,,,20001.0,20001.0,1
HCPCS,35305,Rechanneling of Artery,,,20001.0,20001.0,1
HCPCS,35306,Rechanneling of Artery,,,20001.0,20001.0,1
HCPCS,35311,Rechanneling of artery,,,20001.0,20001.0,1
HCPCS,35321,Rechanneling of artery,,,5365.4,20001.0,2
HCPCS,35331,Rechanneling of artery,,,20001.0,20001.0,1
HCPCS,35341,Rechanneling of artery,,,20001.0,20001.0,1
HCPCS,35351,Rechanneling of artery,,,20001.0,20001.0,1
HCPCS,35355,Rechanneling of artery,,,20001.0,20001.0,1
HCPCS,35361,Rechanneling of artery,,,20001.0,20001.0,1
HCPCS,35363,Rechanneling of artery,,,20001.0,20001.0,1
HCPCS,35371,Rechanneling of artery,,,15689.0,15689.0,1
HCPCS,35372,Rechanneling of artery,,,5365.4,15689.0,2
HCPCS,35390,Reoperation carotid add-on,,,20001.0,20001.0,1
HCPCS,35400,Angioscopy,,,9206.0,9206.0,1
HCPCS,35501,Art byp grft ipsilat carotid,,,20001.0,20001.0,1
HCPCS,35506,Art byp grft subclav-carotid,,,20001.0,20001.0,1
HCPCS,35508,Art byp grft carotid-vertbrl,,,20001.0,20001.0,1
HCPCS,35509,Art byp grft contral carotid,,,20001.0,20001.0,1
HCPCS,35510,Art byp grft carotid-brchial,,,20001.0,20001.0,1
HCPCS,35511,Art byp grft subclav-subclav,,,20001.0,20001.0,1
HCPCS,35512,Art byp grft subclav-brchial,,,20001.0,20001.0,1
HCPCS,35515,Art byp grft subclav-vertbrl,,,20001.0,20001.0,1
HCPCS,35516,Art byp grft subclav-axilary,,,20001.0,20001.0,1
HCPCS,35518,Art byp grft axillary-axilry,,,20001.0,20001.0,1
HCPCS,35521,Art byp grft axill-femoral,,,20001.0,20001.0,1
HCPCS,35522,Art byp grft axill-brachial,,,20001.0,20001.0,1
HCPCS,35523,Art byp grft brchl-ulnr-rdl,,,20001.0,20001.0,1
HCPCS,35525,Art byp grft brachial-brchl,,,20001.0,20001.0,1
HCPCS,35526,Art byp grft aor/carot/innom,,,20001.0,20001.0,1
HCPCS,35531,Art byp grft aorcel/aormesen,,,20001.0,20001.0,1
HCPCS,35533,Art byp grft axill/fem/fem,,,20001.0,20001.0,1
HCPCS,35535,Art byp grft hepatorenal,,,20001.0,20001.0,1
HCPCS,35536,Art byp grft splenorenal,,,20001.0,20001.0,1
HCPCS,35537,Art byp grft aortoiliac,,,20001.0,20001.0,1
HCPCS,35538,Art byp grft aortobi-iliac,,,20001.0,20001.0,1
HCPCS,35539,Art byp grft aortofemoral,,,20001.0,20001.0,1
HCPCS,35540,Art byp grft aortbifemoral,,,20001.0,20001.0,1
HCPCS,35556,Art byp grft fem-popliteal,,,20001.0,20001.0,1
HCPCS,35558,Art byp grft fem-femoral,,,20001.0,20001.0,1
HCPCS,35560,Art byp grft aortorenal,,,20001.0,20001.0,1
HCPCS,35563,Art byp grft ilioiliac,,,20001.0,20001.0,1
HCPCS,35565,Art byp grft iliofemoral,,,20001.0,20001.0,1
HCPCS,35566,Art byp fem-ant-post tib/prl,,,20001.0,20001.0,1
HCPCS,35570,Art byp tibial-tib/peroneal,,,20001.0,20001.0,1
HCPCS,35571,Art byp pop-tibl-prl-other,,,20001.0,20001.0,1
HCPCS,35583,Vein byp grft fem-popliteal,,,20001.0,20001.0,1
HCPCS,35585,Vein byp fem-tibial peroneal,,,20001.0,20001.0,1
HCPCS,35587,Vein byp pop-tibl peroneal,,,20001.0,20001.0,1
HCPCS,35600,Harvest art for cabg add-on,,,15689.0,15689.0,1
HCPCS,35601,Art byp common ipsi carotid,,,20001.0,20001.0,1
HCPCS,35606,Art byp carotid-subclavian,,,20001.0,20001.0,1
HCPCS,35612,Art byp subclav-subclavian,,,20001.0,20001.0,1
HCPCS,35616,Art byp subclav-axillary,,,20001.0,20001.0,1
HCPCS,35621,Art byp axillary-femoral,,,20001.0,20001.0,1
HCPCS,35623,Art byp axillary-pop-tibial,,,20001.0,20001.0,1
HCPCS,35626,Art byp aorsubcl/carot/innom,,,20001.0,20001.0,1
HCPCS,35631,Art byp aor-celiac-msn-renal,,,20001.0,20001.0,1
HCPCS,35632,Art byp ilio-celiac,,,20001.0,20001.0,1
HCPCS,35633,Art byp ilio-mesenteric,,,20001.0,20001.0,1
HCPCS,35634,Art byp iliorenal,,,20001.0,20001.0,1
HCPCS,35636,Art byp spenorenal,,,20001.0,20001.0,1
HCPCS,35637,Art byp aortoiliac,,,20001.0,20001.0,1
HCPCS,35638,Art byp aortobi-iliac,,,20001.0,20001.0,1
HCPCS,35642,Art byp carotid-vertebral,,,20001.0,20001.0,1
HCPCS,35645,Art byp subclav-vertebrl,,,20001.0,20001.0,1
HCPCS,35646,Art byp aortobifemoral,,,20001.0,20001.0,1
HCPCS,35647,Art byp aortofemoral,,,20001.0,20001.0,1
HCPCS,35650,Art byp axillary-axillary,,,20001.0,20001.0,1
HCPCS,35654,Art byp axill-fem-femoral,,,20001.0,20001.0,1
HCPCS,35656,Art byp femoral-popliteal,,,20001.0,20001.0,1
HCPCS,35661,Art byp femoral-femoral,,,20001.0,20001.0,1
HCPCS,35663,Art byp ilioiliac,,,20001.0,20001.0,1
HCPCS,35665,Art byp iliofemoral,,,20001.0,20001.0,1
HCPCS,35666,Art byp fem-ant-post tib/prl,,,20001.0,20001.0,1
HCPCS,35671,Art byp pop-tibl-prl-other,,,20001.0,20001.0,1
HCPCS,35681,Composite byp grft pros&vein,,,15689.0,15689.0,1
HCPCS,35682,Composite byp grft 2 veins,,,15689.0,15689.0,1
HCPCS,35683,Composite byp grft 3/> segmt,,,15689.0,15689.0,1
HCPCS,35691,Art trnsposj vertbrl carotid,,,20001.0,20001.0,1
HCPCS,35693,Art trnsposj subclavian,,,20001.0,20001.0,1
HCPCS,35694,Art trnsposj subclav carotid,,,20001.0,20001.0,1
HCPCS,35695,Art trnsposj carotid subclav,,,20001.0,20001.0,1
HCPCS,35697,Reimplant artery each,,,20001.0,20001.0,1
HCPCS,35700,Reoperation bypass graft,,,20001.0,20001.0,1
HCPCS,35701,Exploration carotid artery,,,15689.0,15689.0,1
HCPCS,35702,Expl n/flwd surg uxtr art,,,9206.0,9206.0,1
HCPCS,35703,Expl n/flwd surg lxtr art,,,9206.0,9206.0,1
HCPCS,35800,Explore neck vessels,,,5365.4,15689.0,2
HCPCS,35820,Explore chest vessels,,,15689.0,15689.0,1
HCPCS,35840,Explore abdominal vessels,,,15689.0,15689.0,1
HCPCS,35860,Explore limb vessels,,,3044.51,15689.0,2
HCPCS,35870,Repair vessel graft defect,,,20001.0,20001.0,1
HCPCS,35875,Removal of clot in graft,,,5365.4,20001.0,2
HCPCS,35876,Removal of clot in graft,,,5365.4,20001.0,2
HCPCS,35879,Revise graft w/vein,,,5365.4,20001.0,2
HCPCS,35881,Revise graft w/vein,,,5365.4,20001.0,2
HCPCS,35883,Revise Graft w/Nonauto Graft,,,5365.4,20001.0,2
HCPCS,35884,Revise graft w/vein,,,5365.4,20001.0,2
HCPCS,35901,Excision graft neck,,,15689.0,15689.0,1
HCPCS,35903,Excision graft extremity,,,3044.51,15689.0,2
HCPCS,35905,Excision graft thorax,,,20001.0,20001.0,1
HCPCS,35907,Excision graft abdomen,,,20001.0,20001.0,1
HCPCS,36000,Hc Intro Needle Or Intracatheter Vein,1057.0,687.05,,,0
HCPCS,36002,Hc Injection Thrombin Pseudoaneurysm,6912.0,4492.799999999999,,,0
HCPCS,36002,Pseudoaneurysm injection trt,,,604.86,3714.0,2
HCPCS,36005,Hc Injection Extremity Venogram,4387.5,2851.875,,,0
HCPCS,36010,Hc Introduction Catheter Inf Or Sup Vena Cava,2880.0,1872.0,,,0
HCPCS,36011,Hc Sel Cath Placement Venous 1St Order,2292.0,1489.8000000000002,,,0
HCPCS,36012,Hc Sel Cath Placement Venous 2Nd Order,2323.5,1510.275,,,0
HCPCS,36013,Hc Intro Catheter Rt Heart Or Main Pulm Art,535.0,347.75,,,0
HCPCS,36014,Hc Sel Cath Placement Rt Or Lt Pulm Artery,2478.0,1610.6999999999998,,,0
HCPCS,36015,Hc Sel Cath Placement Seg Or Subseg Pulm Artery,2098.5,1364.025,,,0
HCPCS,36140,Hc Intro Needle Or Cath Extremity Artery,3210.0,2086.5,,,0
HCPCS,36160,Hc Intro Needle Or Cath Aorta Translumbar,1907.0,1239.55,,,0
HCPCS,36200,Hc Introduction Catheter Aorta,4815.0,3129.75,,,0
HCPCS,36215,Hc Sel Cath Plc Thrc Brch Cphlc Brnch 1St Ord,2390.0,1553.5,,,0
HCPCS,36216,Hc Sel Cath Plc Thrc Brch Cphlc Brnch 2Nd Ord 1St,2236.0,1453.4,,,0
HCPCS,36217,Hc Sel Cath Plc Thrc Brch Cphlc Brnch 3Rd+ Ord,2150.0,1397.5,,,0
HCPCS,36218,Hc Sel Cath Plc Thrc Brch Cphlc Brnch Addl 2Nd Or 3Rd,1961.0,1274.65,,,0
HCPCS,36221,Hc Nonsel Cath Thor Aorta Angio Intr Xtrcranial Art,5740.0,3731.0,,,0
HCPCS,36221,Place cath thoracic aorta,,,3044.51,15689.0,2
HCPCS,36222,Hc Sel Cath Plc Cmn Crtd Angio Xtrcrnl Art,23382.0,15198.300000000001,,,0
HCPCS,36222,Place cath carotid/inom art,,,3044.51,15689.0,2
HCPCS,36223,Hc Sel Cath Plc Cmn Crtd Angio Intrcrnl Art,16138.5,10490.025000000001,,,0
HCPCS,36223,Place cath carotid/inom art,,,5365.4,20001.0,2
HCPCS,36224,Hc Sel Cath Plc Int Crtd Angio Intrcrnl Art,20955.0,13620.75,,,0
HCPCS,36224,Place cath carotd art,,,5365.4,20001.0,2
HCPCS,36225,Hc Sel Cath Plc Subclv Art Angio Vertebral Art,7752.0,5038.799999999999,,,0
HCPCS,36225,Place cath subclavian art,,,3044.51,15689.0,2
HCPCS,36226,Hc Sel Cath Plc Vertebral Art Angio Vertebral Art,7752.0,5038.799999999999,,,0
HCPCS,36226,Place cath vertebral art,,,5365.4,20001.0,2
HCPCS,36227,Hc Sel Cath Plc Xtrnl Crtd Art Angio Xtrnl Crtd Circ,2347.0,1525.55,,,0
HCPCS,36228,Hc Sel Cath Plc Intrcrnl Branch Angio Ntrnl Crtd Vert,2752.0,1788.8,,,0
HCPCS,36245,Hc Sel Cath Plc Ea 1St Order Abd Pel Le Art Branch,3127.5,2032.875,,,0
HCPCS,36246,Hc Sel Cath Plc 2Nd Order Abd Pel Le Art Branch,3147.0,2045.5500000000002,,,0
HCPCS,36247,Hc Sel Cath Plc 3Rd+ Order Abd Pel Le Art Branch,3147.0,2045.5500000000002,,,0
HCPCS,36248,Hc Sel Cath Plc Ea 2Nd+ Order Abd Pel Le Art Branch,2008.0,1305.2,,,0
HCPCS,36251,Hc Sel Cath Plc 1St Order Renal Artery Uni W Img,16507.0,10729.55,,,0
HCPCS,36251,Ins cath ren art 1st unilat,,,3044.51,15689.0,2
HCPCS,36252,Hc Sel Cath Plc 1St Order Renal Artery Bil W Img,19504.0,12677.6,,,0
HCPCS,36252,Ins cath ren art 1st bilat,,,3044.51,15689.0,2
HCPCS,36253,Hc Ins Cath 2Nd+ Order Ren Art Uni W Img,10909.0,7090.85,,,0
HCPCS,36253,Ins cath ren art 2nd+ unilat,,,5365.4,20001.0,2
HCPCS,36254,Hc Ins Cath 2Nd+ Order Ren Art Bil W Img,15090.0,9808.5,,,0
HCPCS,36254,Ins cath ren art 2nd+ bilat,,,3044.51,15689.0,2
HCPCS,36260,Insertion of infusion pump,,,5365.4,20001.0,2
HCPCS,36261,Revision of infusion pump,,,3603.26,15689.0,2
HCPCS,36262,Removal of infusion pump,,,3603.26,15689.0,2
HCPCS,36299,Hc Unlisted Procedure Vascular Injection,476.0,309.4,,,0
HCPCS,36410,Hc Venipuncture Or Midline Cath By Phys Or Qhcp,1530.0,994.5,,,0
HCPCS,36415,Hc Pat Venipuncture,20.0,13.0,,,0
HCPCS,36415,Hc Venipuncture,20.0,13.0,,,0
HCPCS,36415,Hc Venipuncture Amb,20.0,13.0,,,0
HCPCS,36415,Routine venipuncture,,,9.34,32.14,3
HCPCS,36416,Capillary blood draw,,,31.76,31.76,2
HCPCS,36416,Hc Collection Capillary Blood Specimen,20.0,13.0,,,0
HCPCS,36420,Vein access cutdown < 1 yr,,,128.29,3714.0,2
HCPCS,36425,Vein access cutdown > 1 yr,,,430.74,3714.0,2
HCPCS,36430,Blood transfusion service,,,425.39,3714.0,2
HCPCS,36430,Hc Transfuse Blood Products Level I,2131.0,1385.15,,,0
HCPCS,36430,Hc Transfuse Blood Products Level Ii,2770.0,1800.5,,,0
HCPCS,36430,Hc Transfuse Blood Products Level Iii,3409.0,2215.85,,,0
HCPCS,36440,Bl push transfuse 2 yr/<,,,425.39,3714.0,2
HCPCS,36450,Bl exchange/transfuse nb,,,425.39,3714.0,2
HCPCS,36455,Bl exchange/transfuse non-nb,,,425.39,3714.0,2
HCPCS,36456,Prtl exchange transfuse nb,,,425.39,3714.0,2
HCPCS,36460,Hc Transfusion Fetal Intrauterine,1045.0,679.25,,,0
HCPCS,36460,Transfusion service fetal,,,425.39,3714.0,2
HCPCS,36465,Hc Inj Foam Sclerosant W Ultrasound Compression Extremity Single Vein,2988.0,1942.2,,,0
HCPCS,36465,Njx noncmpnd sclrsnt 1 vein,,,1989.46,9206.0,2
HCPCS,36466,Hc Inj Foam Sclerosant W Ultrasound Compression Extremity Multiple Veins,4482.0,2913.3,,,0
HCPCS,36466,Njx noncmpnd sclrsnt mlt vn,,,1989.46,9206.0,2
HCPCS,36468,Hc Inj Sclerosant For Spider Veins Limb Or Trunk,644.0,418.6,,,0
HCPCS,36468,Injection(s) spider veins,,,391.97,3714.0,2
HCPCS,36470,Hc Inj Sclerosing Soln Single Incompetent Vein,1068.0,694.2,,,0
HCPCS,36470,Injection therapy of vein,,,391.97,3714.0,2
HCPCS,36471,Hc Inj Sclerosing Soln Mult Incompetent Veins Same Leg,1068.0,694.2,,,0
HCPCS,36471,Injection therapy of veins,,,391.97,3714.0,2
HCPCS,36473,Endovenous mchnchem 1st vein,,,3044.51,15689.0,2
HCPCS,36475,Endovenous rf 1st vein,,,3044.51,15689.0,2
HCPCS,36475,Hc Endovenous Ablation Ext Rf 1St Vein,14109.0,9170.849999999999,,,0
HCPCS,36476,Hc Endovenous Ablation Ext Rf 2Nd+ Veins,5706.0,3708.9,,,0
HCPCS,36478,Endovenous laser 1st vein,,,3044.51,15689.0,2
HCPCS,36478,Hc Endovenous Ablation Ext Laser 1St Vein,14109.0,9170.849999999999,,,0
HCPCS,36479,Hc Endovenous Ablation Ext Laser 2Nd+ Veins,5706.0,3708.9,,,0
HCPCS,36481,Hc Perc Portal Vein Catheterization,752.0,488.8,,,0
HCPCS,36482,Endoven ther chem adhes 1st,,,5365.4,20001.0,2
HCPCS,36482,Hc Endoven Ablat Incompetent Ext Vein W Img Initial Vein,5774.0,3753.1,,,0
HCPCS,36483,Hc Endoven Ablat Incompetent Ext Vein W Img Addl Vein,3761.0,2444.65,,,0
HCPCS,36500,Hc Cath Venous Sel Organ Blood Sample,506.0,328.9,,,0
HCPCS,36510,Hc Cath Umbilical Vein,516.0,335.4,,,0
HCPCS,36511,Apheresis wbc,,,1501.7,9206.0,2
HCPCS,36511,Hc Therapeutic Apheresis For Wbc,4532.0,2945.8,,,0
HCPCS,36512,Apheresis rbc,,,1501.7,9206.0,2
HCPCS,36512,Hc Therapeutic Apheresis For Rbc,8102.0,5266.3,,,0
HCPCS,36513,Apheresis platelets,,,425.39,3714.0,2
HCPCS,36513,Hc Therapeutic Apheresis For Platelets,7553.0,4909.45,,,0
HCPCS,36514,Apheresis plasma,,,1501.7,9206.0,2
HCPCS,36514,Hc Therapeutic Pheresis For Plasma,8352.0,5428.8,,,0
HCPCS,36516,Apheresis selective,,,4199.67,20001.0,2
HCPCS,36522,Photopheresis,,,4199.67,20001.0,2
HCPCS,36555,Hc Insert Nontunnel Cv Cath Younger Than 5 Yrs,3307.0,2149.55,,,0
HCPCS,36555,Insert non-tunnel cv cath,,,3044.51,9206.0,2
HCPCS,36556,Hc Insert Cvc Nontunneled Age 5 Or Older,3389.0,2202.85,,,0
HCPCS,36556,Insert non-tunnel cv cath,,,3044.51,9206.0,2
HCPCS,36557,Insert tunneled cv cath,,,5365.4,20001.0,2
HCPCS,36558,Hc Insert Cvc Tunneled Age 5 Or Older,16200.0,10530.0,,,0
HCPCS,36558,Insert tunneled cv cath,,,3044.51,15689.0,2
HCPCS,36560,Insert tunneled cv cath,,,3044.51,15689.0,2
HCPCS,36561,Hc Insert Cva Device W Port,17280.0,11232.0,,,0
HCPCS,36561,Insert tunneled cv cath,,,3044.51,15689.0,2
HCPCS,36563,Insert tunneled cv cath,,,5365.4,20001.0,2
HCPCS,36565,Hc Insert Cva 2 Caths Wo Port,18360.0,11934.0,,,0
HCPCS,36565,Insert tunneled cv cath,,,3044.51,15689.0,2
HCPCS,36566,Hc Insert Cva 2 Caths W Port,19440.0,12636.0,,,0
HCPCS,36566,Insert tunneled cv cath,,,5365.4,20001.0,2
HCPCS,36568,Insert picc cath,,,1517.83,3714.0,2
HCPCS,36569,Hc Insert Picc Wo Sq Port Wo Imaging Guidance Age 5 Or Older,3389.0,2202.85,,,0
HCPCS,36569,Insert picc cath,,,1517.83,9206.0,2
HCPCS,36570,Insert picvad cath,,,3044.51,15689.0,2
HCPCS,36571,Insert picvad cath,,,3044.51,15689.0,2
HCPCS,36572,Insj picc rs&i <5 yr,,,604.86,3714.0,2
HCPCS,36573,"Hc Insert Picc, Wo Sq Port, With Imaging, > 5 Yo",5804.0,3772.6,,,0
HCPCS,36573,Insj picc rs&i 5 yr+,,,1517.83,9206.0,2
HCPCS,36575,Hc Repair Cva Catheter,6590.0,4283.5,,,0
HCPCS,36575,Repair tunneled cv cath,,,604.86,3714.0,2
HCPCS,36576,Hc Repair Cva Device W Port,8120.0,5278.0,,,0
HCPCS,36576,Repair tunneled cv cath,,,1517.83,9206.0,2
HCPCS,36578,Hc Replace Cath Cva Device W Port,13676.0,8889.4,,,0
HCPCS,36578,Replace tunneled cv cath,,,3044.51,15689.0,2
HCPCS,36580,Hc Replace Non-Tunneled Cvc,3389.0,2202.85,,,0
HCPCS,36580,Replace cvad cath,,,1517.83,9206.0,2
HCPCS,36581,Hc Replace Tunneled Cvc,10080.0,6552.0,,,0
HCPCS,36581,Replace tunneled cv cath,,,3044.51,15689.0,2
HCPCS,36582,Hc Repl Tunneled Cva Dev W Sq Port,10800.0,7020.0,,,0
HCPCS,36582,Replace tunneled cv cath,,,3044.51,15689.0,2
HCPCS,36583,Replace tunneled cv cath,,,5365.4,20001.0,2
HCPCS,36584,Hc Replace Picc Wo Sq Port Incl All Imaging,4919.0,3197.35,,,0
HCPCS,36584,Replace picc cath,,,1517.83,9206.0,2
HCPCS,36585,Hc Replace Pericath W Subq Port Same Venous Access,14264.0,9271.6,,,0
HCPCS,36585,Replace picvad cath,,,3044.51,15689.0,2
HCPCS,36589,Hc Rem Tun Cvc Wo Port,4926.0,3201.9,,,0
HCPCS,36589,Removal tunneled cv cath,,,604.86,3714.0,2
HCPCS,36590,Hc Rem Implant Access Port Sub,7146.0,4644.9,,,0
HCPCS,36590,Removal tunneled cv cath,,,1517.83,3714.0,2
HCPCS,36591,Draw blood off venous device,,,128.29,128.29,1
HCPCS,36591,Hc Collect Bld Spec Impl Vad,794.0,516.1,,,0
HCPCS,36592,Collect blood from picc,,,128.29,128.29,1
HCPCS,36592,Hc Collect Spec Picc Or Cvc,192.0,124.8,,,0
HCPCS,36593,Declot vascular device,,,318.49,3714.0,2
HCPCS,36593,Hc Declot Cath Or Vad By Thrombolytic,2933.0,1906.45,,,0
HCPCS,36595,Hc Rem Pericath Obstructive Material,5284.0,3434.6,,,0
HCPCS,36595,Mech remov tunneled cv cath,,,3044.51,15689.0,2
HCPCS,36596,Hc Rem Intraluminal Obscructive Material,2386.0,1550.9,,,0
HCPCS,36596,Mech remov tunneled cv cath,,,1517.83,9206.0,2
HCPCS,36597,Hc Reposition Cvc W Fluoro,6126.0,3981.9,,,0
HCPCS,36597,Reposition venous catheter,,,1517.83,9206.0,2
HCPCS,36598,Hc Contrast Inj Vad W Fluoro,5182.5,3368.625,,,0
HCPCS,36598,Inj w/fluor eval cv device,,,205.09,3714.0,2
HCPCS,36600,Hc Abg Puncture,329.0,213.85,,,0
HCPCS,36600,Withdrawal of arterial blood,,,128.29,3714.0,2
HCPCS,36620,Hc Insert Arterial Cath Percutaneous,999.0,649.35,,,0
HCPCS,36640,Insertion catheter artery,,,3044.51,15689.0,2
HCPCS,36660,Insertion catheter artery,,,9206.0,9206.0,1
HCPCS,36680,Hc Needle Plcmt Intraosseous Infusion,1150.0,747.5,,,0
HCPCS,36680,Insert needle bone cavity,,,430.74,3714.0,2
HCPCS,36800,Insertion of cannula,,,5365.4,20001.0,2
HCPCS,36810,Insertion of cannula,,,3044.51,15689.0,2
HCPCS,36815,Insertion of cannula,,,5365.4,20001.0,2
HCPCS,36818,Av fuse uppr arm cephalic,,,5365.4,20001.0,2
HCPCS,36819,Av fuse uppr arm basilic,,,5365.4,20001.0,2
HCPCS,36820,Av fusion/forearm vein,,,5365.4,20001.0,2
HCPCS,36821,Av fusion direct any site,,,3044.51,15689.0,2
HCPCS,36823,Insertion of cannula(s),,,15689.0,15689.0,1
HCPCS,36825,Artery-vein autograft,,,5365.4,20001.0,2
HCPCS,36830,Artery-vein nonautograft,,,5365.4,20001.0,2
HCPCS,36831,Open thrombect av fistula,,,5365.4,20001.0,2
HCPCS,36832,Av fistula revision open,,,5365.4,20001.0,2
HCPCS,36833,Av fistula revision,,,5365.4,20001.0,2
HCPCS,36835,Artery to vein shunt,,,3044.51,15689.0,2
HCPCS,36836,Hc Arteriovenous Fistula Creation Up Extrem Single Access Perc W Img,19973.0,12982.45,,,0
HCPCS,36836,Prq av fstl crtj uxtr 1 acs,,,17675.76,63079.0,2
HCPCS,36837,Hc Arteriovenous Fistula Creation Up Extrem Separate Access Perc W Img,22288.0,14487.2,,,0
HCPCS,36837,Prq av fstl crt uxtr sep acs,,,17675.76,63079.0,2
HCPCS,36838,Dist revas ligation hemo,,,5365.4,20001.0,2
HCPCS,36860,External cannula declotting,,,1517.83,3714.0,2
HCPCS,36861,Cannula declotting,,,5365.4,20001.0,2
HCPCS,36901,Hc Dialysis Circuit Intro Needle/Cath W Img,4897.0,3183.05,,,0
HCPCS,36901,Intro cath dialysis circuit,,,1517.83,9206.0,2
HCPCS,36902,Hc Dialysis Circuit Intro Needle/Cath W Tba Peripheral W Img,16652.0,10823.8,,,0
HCPCS,36902,Intro cath dialysis circuit,,,5487.93,30765.0,2
HCPCS,36903,Hc Dialysis Circuit Intro Needle/Cath  W Plcmt Of Stent Peripheral W Img,35777.0,23255.05,,,0
HCPCS,36903,Intro cath dialysis circuit,,,11131.16,38216.0,2
HCPCS,36904,Hc Dialysis Circuit Perc Thrombectomy Or Thrombolysis Infu W Img,15425.0,10026.25,,,0
HCPCS,36904,Thrmbc/nfs dialysis circuit,,,5487.93,30765.0,2
HCPCS,36905,Hc Dialysis Circuit Perc Thrombectomy Or Thrombolysis Infu W Tba Peripheral W Img,24596.0,15987.4,,,0
HCPCS,36905,Thrmbc/nfs dialysis circuit,,,11131.16,38216.0,2
HCPCS,36906,Hc Dialysis Circuit Perc Thrombectomy Or Thrombolysis Infu W Plcmt Of Stent Peripheral W Img,43720.0,28418.0,,,0
HCPCS,36906,Thrmbc/nfs dialysis circuit,,,17675.76,63079.0,2
HCPCS,36907,Hc Dialysis Circuit Tba Central W Img Add On,11756.0,7641.4,,,0
HCPCS,36908,Hc Dialysis Circuit Plcmt Of Stent Central Incld Angioplasty W Img Add On,15050.0,9782.5,,,0
HCPCS,36909,Hc Dialysis Circuit Vasc Embolization Or Occlusion W Img Add On,15050.0,9782.5,,,0
HCPCS,37140,Revision of circulation,,,20001.0,20001.0,1
HCPCS,37145,Revision of circulation,,,20001.0,20001.0,1
HCPCS,37160,Revision of circulation,,,20001.0,20001.0,1
HCPCS,37180,Revision of circulation,,,20001.0,20001.0,1
HCPCS,37181,Splice spleen/kidney veins,,,20001.0,20001.0,1
HCPCS,37182,Hc Insertion Of Tips,37873.0,24617.45,,,0
HCPCS,37182,Insert hepatic shunt (tips),,,17675.76,20001.0,2
HCPCS,37183,Hc Revision Of Tips,28472.0,18506.8,,,0
HCPCS,37183,Remove hepatic shunt (tips),,,5487.93,30765.0,2
HCPCS,37184,Hc Art Mech Throm (Non Cor) 1St Ves,28524.0,18540.6,,,0
HCPCS,37184,Prim art m-thrmbc 1st vsl,,,17675.76,30765.0,2
HCPCS,37185,Hc Art Mech Throm (Non Cor)Addl Ves,20512.0,13332.8,,,0
HCPCS,37186,Hc Art Mech Throm (Non Cor) Secondary,23233.0,15101.45,,,0
HCPCS,37187,Hc Ven Mechanical Thrombectomy,29242.5,19007.625,,,0
HCPCS,37187,Venous mech thrombectomy,,,11131.16,30765.0,2
HCPCS,37188,Hc Ven Mechanical Thromb Repeat Tx,18525.0,12041.25,,,0
HCPCS,37188,Venous m-thrombectomy add-on,,,3044.51,15689.0,2
HCPCS,37191,Hc Insert Ivc Filter,19286.0,12535.9,,,0
HCPCS,37191,Ins endovas vena cava filtr,,,5365.4,20001.0,2
HCPCS,37192,Hc Reposition Ivc Filter,7234.0,4702.1,,,0
HCPCS,37192,Redo endovas vena cava filtr,,,3044.51,15689.0,2
HCPCS,37193,Hc Remove Ivc Filter,13466.0,8752.9,,,0
HCPCS,37193,Rem endovas vena cava filter,,,3044.51,15689.0,2
HCPCS,37195,Hc Thrombolysis Cerebral Iv Infusion,575.0,373.75,,,0
HCPCS,37195,Thrombolytic therapy stroke,,,318.49,3714.0,2
HCPCS,37197,Hc Transcath Rtrvl Intrvas Fb W Img,10772.0,7001.8,,,0
HCPCS,37197,Remove intrvas foreign body,,,3044.51,15689.0,2
HCPCS,37200,Hc Transcatheter Biopsy,14434.0,9382.1,,,0
HCPCS,37200,Transcatheter biopsy,,,5365.4,20001.0,2
HCPCS,37211,Hc Trnscth Tx Thrmb Art Init Day,73104.0,47517.600000000006,,,0
HCPCS,37211,Thrombolytic art therapy,,,5365.4,20001.0,2
HCPCS,37212,Hc Trnscth Tx Thrmb Ven Init Day,55272.0,35926.8,,,0
HCPCS,37212,Thrombolytic venous therapy,,,3044.51,15689.0,2
HCPCS,37213,Hc Trnscth Tx Thrmb Subq Day,39480.0,25662.0,,,0
HCPCS,37213,Thromblytic art/ven therapy,,,3044.51,9206.0,2
HCPCS,37214,Cessj therapy cath removal,,,3044.51,9206.0,2
HCPCS,37214,Hc Trnscth Tx Thrmb Cessation,37704.0,24507.6,,,0
HCPCS,37215,Hc Transcath Stent Cca W Eps,61149.0,39746.850000000006,,,0
HCPCS,37215,Transcath stent cca w/eps,,,15689.0,15689.0,1
HCPCS,37216,Hc Transcath Stent Cca Wo Eps,18523.0,12039.95,,,0
HCPCS,37216,Transcath stent cca w/o eps,,,31685.0,31685.0,1
HCPCS,37217,Hc Stent Placemt Retro Carotid,29989.5,19493.175000000003,,,0
HCPCS,37217,Stent placemt retro carotid,,,30765.0,30765.0,1
HCPCS,37218,Hc Transcath Stent Intrathoracic,29989.5,19493.175000000003,,,0
HCPCS,37218,Stent placemt ante carotid,,,15689.0,15689.0,1
HCPCS,37220,Hc Revasc Endo Iliac Init W Pta,31186.5,20271.225,,,0
HCPCS,37220,Iliac revasc,,,30765.0,30765.0,1
HCPCS,37221,Hc Revasc/Endo Iliac W Stnt W/Wo Pta,32211.0,20937.15,,,0
HCPCS,37221,Iliac revasc w/stent,,,38216.0,38216.0,1
HCPCS,37222,Hc Iliac Ea Addl Ipsilat Vsl W Pta,5451.0,3543.15,,,0
HCPCS,37223,Hc Iliac Ea Adl Ipsil Vsl W Stent,6275.0,4078.75,,,0
HCPCS,37224,Fem/popl revas w/tla,,,30765.0,30765.0,1
HCPCS,37224,Hc Revasc Endo Fempop W Pta,31696.5,20602.725,,,0
HCPCS,37225,Fem/popl revas w/ather,,,38216.0,38216.0,1
HCPCS,37225,Hc Revasc Endo Fempop W Atherectomy,37948.5,24666.524999999998,,,0
HCPCS,37226,Fem/popl revasc w/stent,,,38216.0,38216.0,1
HCPCS,37226,Hc Revasc Endo Fempop W Stent,33532.5,21796.125,,,0
HCPCS,37227,Fem/popl revasc stnt & ather,,,63079.0,63079.0,1
HCPCS,37227,Hc Revasc Endo Fempop W Stnt&Atherec,42165.0,27407.25,,,0
HCPCS,37228,Hc Revasc Endo Tibiopero W Pta,33157.5,21552.375,,,0
HCPCS,37228,Tib/per revasc w/tla,,,38216.0,38216.0,1
HCPCS,37229,Hc Revasc Endo Tibiopero W Atherectm,33367.5,21688.875,,,0
HCPCS,37229,Tib/per revasc w/ather,,,63079.0,63079.0,1
HCPCS,37230,Hc Revasc Endo Tibiopero W Stent,34893.0,22680.449999999997,,,0
HCPCS,37230,Tib/per revasc w/stent,,,63079.0,63079.0,1
HCPCS,37231,Hc Revasc/Endo Tibioper W Stnt&Ather,51648.0,33571.2,,,0
HCPCS,37231,Tib/per revasc stent & ather,,,63079.0,63079.0,1
HCPCS,37232,Hc Tibiopero Ea Addl W Pta,5068.0,3294.2,,,0
HCPCS,37233,Hc Tibiopero W Atherectmy Ea Addl,5068.0,3294.2,,,0
HCPCS,37234,Hc Tibiopero W Stent Ea Addl,5068.0,3294.2,,,0
HCPCS,37235,Hc Tibiopero W Stnt&Atherec Ea Addl,5068.0,3294.2,,,0
HCPCS,37236,Hc Open Or Perq Place Stent 1St Artery,26248.5,17061.525,,,0
HCPCS,37236,Open/perq place stent 1st,,,11131.16,38216.0,2
HCPCS,37237,Hc Open Or Perq Place Stent Ea Add Art,8748.0,5686.2,,,0
HCPCS,37238,Hc Open Or Perq Place Stent 1St Vein,26248.5,17061.525,,,0
HCPCS,37238,Open/perq place stent same,,,11131.16,38216.0,2
HCPCS,37239,Hc Open Or Perq Place Stent Ea Add Vein,8748.0,5686.2,,,0
HCPCS,37241,Hc Vasc Embolize Occlude Venous,30688.0,19947.2,,,0
HCPCS,37241,Vasc embolize/occlude venous,,,11131.16,38216.0,2
HCPCS,37242,Hc Vasc Embolize Occlude Artery,30688.0,19947.2,,,0
HCPCS,37242,Vasc embolize/occlude artery,,,17675.76,38216.0,2
HCPCS,37243,Hc Vasc Embolize Occlude Organ Tumor Infarct,30688.0,19947.2,,,0
HCPCS,37243,Vasc embolize/occlude organ,,,11131.16,38216.0,2
HCPCS,37244,Hc Vasc Embolize Occlude Bleed,30688.0,19947.2,,,0
HCPCS,37244,Vasc embolize/occlude bleed,,,11131.16,38216.0,2
HCPCS,37246,Hc Transluminal Balloon Angioplasty W Img Artery Initial,24243.0,15757.949999999999,,,0
HCPCS,37246,Trluml balo angiop 1st art,,,5487.93,30765.0,2
HCPCS,37247,Hc Transluminal Balloon Angioplasty W Img Artery Each Addl,12200.0,7930.0,,,0
HCPCS,37248,Hc Transluminal Balloon Angioplasty W Img Vein Initial,24444.0,15888.599999999999,,,0
HCPCS,37248,Trluml balo angiop 1st vein,,,5487.93,30765.0,2
HCPCS,37249,Hc Transluminal Balloon Angioplasty W Img Vein Each Addl,11756.0,7641.4,,,0
HCPCS,37252,Hc Ivus Non-Coronary Initial Vessel W Img Initial Vessel,5343.0,3472.95,,,0
HCPCS,37253,Hc Ivus Non-Coronary Initial Vessel W Img Ea Addl Vessel,2055.0,1335.75,,,0
HCPCS,37254,Revsc evasc ivt angio sf 1st,,,5487.93,5487.93,1
HCPCS,37256,Revsc evasc ivt angio cplx 1,,,5487.93,5487.93,1
HCPCS,37258,Revsc evasc ivt stent sf 1st,,,11131.16,11131.16,1
HCPCS,37260,Revsc evasc ivt st cplx 1st,,,11131.16,11131.16,1
HCPCS,37263,Revsc evasc fpvt angio sf 1,,,5487.93,5487.93,1
HCPCS,37265,Revsc evsc fpvt angio cplx 1,,,5487.93,5487.93,1
HCPCS,37267,Revsc evsc fpvt stent sf 1st,,,11131.16,11131.16,1
HCPCS,37269,Revsc evasc fpvt st cplx 1st,,,11131.16,11131.16,1
HCPCS,37271,Revsc evsc fpvt athrc sf 1st,,,17675.76,17675.76,1
HCPCS,37273,Revsc evsc fpvt athrc cplx 1,,,17675.76,17675.76,1
HCPCS,37275,Rvsc evsc fpvt st athrc sf 1,,,17675.76,17675.76,1
HCPCS,37277,Rvsc evsc fpvt st athr cpx 1,,,17675.76,17675.76,1
HCPCS,37280,Revsc evsc tpvt angio sf 1st,,,11131.16,11131.16,1
HCPCS,37282,Rvsc evsc tpvt angio cplx 1,,,11131.16,11131.16,1
HCPCS,37284,Revsc evasc tpvt st sf 1st,,,17675.76,17675.76,1
HCPCS,37286,Revsc evasc tpvt st cplx 1st,,,17675.76,17675.76,1
HCPCS,37288,Revsc evsc tpvt athrc sf 1st,,,17675.76,17675.76,1
HCPCS,37290,Revsc evsc tpvt athrc cplx 1,,,17675.76,17675.76,1
HCPCS,37292,Rvsc evsc tpvt st athrc sf 1,,,17675.76,17675.76,1
HCPCS,37294,Rvsc evsc tpvt st athr cpx 1,,,17675.76,17675.76,1
HCPCS,37296,Revsc evasc imvt angio sf 1,,,11131.16,11131.16,1
HCPCS,37298,Revsc evsc imvt angio cplx 1,,,11131.16,11131.16,1
HCPCS,37500,Endoscopy ligate perf veins,,,20001.0,20001.0,1
HCPCS,37501,Vascular endoscopy procedure,,,604.86,3714.0,2
HCPCS,37565,Ligation of neck vein,,,3044.51,9206.0,2
HCPCS,37600,Ligation of neck artery,,,3044.51,15689.0,2
HCPCS,37605,Ligation of neck artery,,,3044.51,15689.0,2
HCPCS,37606,Ligation of neck artery,,,3044.51,15689.0,2
HCPCS,37607,Ligation of a-v fistula,,,3044.51,15689.0,2
HCPCS,37609,Hc Ligation/Biopsy Temporal Artery,6531.0,4245.15,,,0
HCPCS,37609,Temporal artery procedure,,,1592.51,9206.0,2
HCPCS,37615,Ligation of neck artery,,,3044.51,9206.0,2
HCPCS,37616,Ligation of chest artery,,,15689.0,15689.0,1
HCPCS,37617,Ligation of abdomen artery,,,5365.4,15689.0,2
HCPCS,37618,Ligation of extremity artery,,,15689.0,15689.0,1
HCPCS,37619,Ligation of inf vena cava,,,5365.4,20001.0,2
HCPCS,37650,Revision of major vein,,,3044.51,15689.0,2
HCPCS,37660,Revision of major vein,,,15689.0,15689.0,1
HCPCS,37700,Revise leg vein,,,3044.51,15689.0,2
HCPCS,37718,Ligate/strip short leg vein,,,3044.51,15689.0,2
HCPCS,37722,Ligate/strip long leg vein,,,3044.51,15689.0,2
HCPCS,37735,Removal of leg veins/lesion,,,3044.51,15689.0,2
HCPCS,37760,Ligate leg veins radical,,,3044.51,15689.0,2
HCPCS,37761,Ligate leg veins open,,,3044.51,9206.0,2
HCPCS,37765,Hc Stab Phleb Veins 1 Leg 10-20 Incis,21348.0,13876.199999999999,,,0
HCPCS,37765,Stab phleb veins xtr 10-20,,,3044.51,15689.0,2
HCPCS,37766,Hc Stab Phlb Veins 1 Extr > 20 Incis,21348.0,13876.199999999999,,,0
HCPCS,37766,Phleb veins - extrem 20+,,,3044.51,15689.0,2
HCPCS,37780,Revision of leg vein,,,3044.51,9206.0,2
HCPCS,37785,Ligate/divide/excise vein,,,3044.51,15689.0,2
HCPCS,37788,Revascularization penis,,,15689.0,15689.0,1
HCPCS,37790,Penile venous occlusion,,,3398.86,15689.0,2
HCPCS,37799,Hc Unlisted Procedure Vascular Surg,627.0,407.55,,,0
HCPCS,37799,Vascular surgery procedure,,,604.86,16564.0,2
HCPCS,38100,Removal of spleen total,,,15689.0,15689.0,1
HCPCS,38101,Removal of spleen partial,,,15689.0,15689.0,1
HCPCS,38102,Removal of spleen total,,,15689.0,15689.0,1
HCPCS,38115,Repair of ruptured spleen,,,15689.0,15689.0,1
HCPCS,38120,Laparoscopy splenectomy,,,10249.52,38216.0,2
HCPCS,38129,Laparoscope proc spleen,,,5829.23,26701.0,2
HCPCS,38200,Hc Inj Splenoportogram,1238.0,804.7,,,0
HCPCS,38204,Hc Mgt & Acq Allo Unrel Domestic Donor,1830.0,1189.5,,,0
HCPCS,38204,Hc Mgt & Acq Allo Unrel Intnl Donor,1578.75,1026.19,,,0
HCPCS,38204,Hc Nmdp Fast Track Search Fee,7625.0,4956.25,,,0
HCPCS,38204,Hc Nmdp Formal Search Fee,1480.0,962.0,,,0
HCPCS,38204,Hc Nmdp Non-Network Search Management Fee,1120.0,728.0,,,0
HCPCS,38205,Harvest allogeneic stem cell,,,20001.0,20001.0,1
HCPCS,38205,Hc  Nmdp Allo Pbsc  For Transplant Per Collect,43875.0,28518.75,,,0
HCPCS,38205,Hc Harvest Allo Pbsc For Transplant Per Collect,3240.0,2106.0,,,0
HCPCS,38205,Hc Harvest Allo T-Cell For Transplant Per Collection,3240.0,2106.0,,,0
HCPCS,38205,Hc Nmdp Allo Pbsc International  Product For Transplant,55150.0,35847.5,,,0
HCPCS,38205,Hc Nmdp Allo T-Cell For Transplant Per Collect,20515.0,13334.75,,,0
HCPCS,38206,Harvest auto stem cells,,,1501.7,9206.0,2
HCPCS,38206,Hc Harvest Auto Pbsc For Transplant Per Collect,7277.0,4730.05,,,0
HCPCS,38207,Cryopreserve stem cells,,,425.39,3714.0,2
HCPCS,38207,Hc Cryopreservation & Store Allo Stem Cells For Transplant,1486.0,965.9,,,0
HCPCS,38207,Hc Cryopreserve & Store Auto Stem Cells For Transplant,2658.0,1727.7,,,0
HCPCS,38208,Hc Thaw W/O Wash Allo Harvest Cells For Transplant,1486.0,965.9,,,0
HCPCS,38208,Hc Thaw W/O Wash Auto Cells For Transplant,2658.0,1727.7,,,0
HCPCS,38208,Thaw preserved stem cells,,,425.39,3714.0,2
HCPCS,38209,Hc Thaw W/Wash Allo Harvest Cells For Transplant,1701.0,1105.65,,,0
HCPCS,38209,Hc Thaw W/Wash Auto Harvest Cells For Transplant,2744.0,1783.6,,,0
HCPCS,38209,Wash harvest stem cells,,,425.39,3714.0,2
HCPCS,38210,Hc T-Cell Depletion Of Harvest Cells For Transplant,2575.0,1673.75,,,0
HCPCS,38210,T-cell depletion of harvest,,,425.39,3714.0,2
HCPCS,38211,Hc Tumor Cell Depletion Of Harvest Cells For Transplant,674.0,438.1,,,0
HCPCS,38211,Tumor cell deplete of harvst,,,425.39,3714.0,2
HCPCS,38212,Hc Rbc Removal Harvest Cells For Transplant,2575.0,1673.75,,,0
HCPCS,38212,Rbc depletion of harvest,,,425.39,3714.0,2
HCPCS,38213,Platelet deplete of harvest,,,425.39,3714.0,2
HCPCS,38214,Hc Plasma Depletion Allo Harvest Cells For Transplant,1392.0,904.8,,,0
HCPCS,38214,Hc Plasma Depletion Auto Harvest Cells For Transplant,2575.0,1673.75,,,0
HCPCS,38214,Volume deplete of harvest,,,425.39,3714.0,2
HCPCS,38215,Harvest stem cell concentrte,,,425.39,3714.0,2
HCPCS,38215,Hc Cell Concentration  Auto Harvest Cells For Transplant,2744.0,1783.6,,,0
HCPCS,38215,Hc Cell Concentration Buffy Coat Allo Harvest Cells For Transplant,1486.0,965.9,,,0
HCPCS,38215,Hc Stem Cell / Platelet Concentration,2658.0,1727.7,,,0
HCPCS,38220,Bone marrow aspiration,,,1592.51,9206.0,2
HCPCS,38220,Hc Bone Marrow Diagnostic Aspiration(S) Only,7075.5,4599.075000000001,,,0
HCPCS,38221,Bone marrow biopsy,,,1592.51,9206.0,2
HCPCS,38221,Hc Bone Marrow Diagnostic Biopsy(Ies) Only,7431.0,4830.15,,,0
HCPCS,38222,Dx bone marrow bx & aspir,,,2800.79,9206.0,2
HCPCS,38222,Hc Bone Marrow Diagnostic Biopsy(Ies) And Aspiration(S),5201.0,3380.65,,,0
HCPCS,38225,Car-t hrv bld-drv t lymphcyt,,,3714.0,3714.0,1
HCPCS,38225,Hc Car-T Cell Harvest,5458.0,3547.7,,,0
HCPCS,38226,Car-t prep t lymphcyt f/trns,,,3714.0,3714.0,1
HCPCS,38226,"Hc Car-T Cell Prep For Transport,Cryopreserve,Storage",1994.0,1296.1,,,0
HCPCS,38227,Car-t receipt&prepj admn,,,3714.0,3714.0,1
HCPCS,38227,Hc Car-T Cell Prep Product For Administration,1994.0,1296.1,,,0
HCPCS,38228,Car-t admn autologous,,,318.49,3714.0,2
HCPCS,38228,"Hc Car-T Cell Administration, Autologous",6094.0,3961.1,,,0
HCPCS,38230,Bone marrow harvest allogen,,,1501.7,9206.0,2
HCPCS,38230,Hc Nmdp Allo Bone Marrow Harvest,42705.0,27758.25,,,0
HCPCS,38232,Bone marrow harvest autolog,,,4199.67,20001.0,2
HCPCS,38240,Hc Stem Cell Allogeneic Transplant Per Donor,9175.0,5963.75,,,0
HCPCS,38240,Transplt allo hct/donor,,,60650.62,63079.0,2
HCPCS,38241,Hc Stem Cell Autologous Transplant,8125.0,5281.25,,,0
HCPCS,38241,Transplt autol hct/donor,,,1501.7,9206.0,2
HCPCS,38242,Hc Post-Allo Trnsplnt Donor Lymphocyte Inf After Relapse,5238.0,3404.7,,,0
HCPCS,38242,Transplt allo lymphocytes,,,1501.7,9206.0,2
HCPCS,38243,Hc Post-Allo Trnsplnt Donor Lymphocyte Infusion,7258.0,4717.7,,,0
HCPCS,38243,Transplj hematopoietic boost,,,1501.7,9206.0,2
HCPCS,38300,Drainage lymph node lesion,,,2800.79,9206.0,2
HCPCS,38305,Drainage lymph node lesion,,,2800.79,9206.0,2
HCPCS,38308,Incision of lymph channels,,,3775.35,15689.0,2
HCPCS,38380,Thoracic duct procedure,,,15689.0,15689.0,1
HCPCS,38381,Thoracic duct procedure,,,15689.0,15689.0,1
HCPCS,38382,Thoracic duct procedure,,,15689.0,15689.0,1
HCPCS,38500,Biopsy/removal lymph nodes,,,3775.35,15689.0,2
HCPCS,38505,Hc Biopsy Lymph Node Superficial,5955.0,3870.75,,,0
HCPCS,38505,Needle biopsy lymph nodes,,,1592.51,9206.0,2
HCPCS,38510,Biopsy/removal lymph nodes,,,3775.35,15689.0,2
HCPCS,38520,Biopsy/removal lymph nodes,,,3775.35,15689.0,2
HCPCS,38525,Biopsy/removal lymph nodes,,,3775.35,15689.0,2
HCPCS,38530,Biopsy/removal lymph nodes,,,3775.35,15689.0,2
HCPCS,38531,Open bx/exc inguinofem nodes,,,3775.35,15689.0,2
HCPCS,38542,Explore deep node(s) neck,,,5829.23,26701.0,2
HCPCS,38550,Removal neck/armpit lesion,,,3775.35,15689.0,2
HCPCS,38555,Removal neck/armpit lesion,,,6402.59,30765.0,2
HCPCS,38562,Removal pelvic lymph nodes,,,7880.96,26701.0,2
HCPCS,38564,Removal abdomen lymph nodes,,,26701.0,26701.0,1
HCPCS,38570,Laparoscopy lymph node biop,,,5829.23,26701.0,2
HCPCS,38571,Laparoscopy lymphadenectomy,,,10249.52,38216.0,2
HCPCS,38572,Laparoscopy lymphadenectomy,,,10249.52,38216.0,2
HCPCS,38573,Laps pelvic lymphadec,,,10249.52,38216.0,2
HCPCS,38589,Laparoscope proc lymphatic,,,5829.23,26701.0,2
HCPCS,38700,Removal of lymph nodes neck,,,6402.59,30765.0,2
HCPCS,38720,Removal of lymph nodes neck,,,6402.59,38216.0,2
HCPCS,38724,Removal of lymph nodes neck,,,26701.0,26701.0,1
HCPCS,38740,Remove armpit lymph nodes,,,5829.23,26701.0,2
HCPCS,38745,Remove armpit lymph nodes,,,5829.23,26701.0,2
HCPCS,38746,Remove thoracic lymph nodes,,,26701.0,26701.0,1
HCPCS,38747,Remove abdominal lymph nodes,,,26701.0,26701.0,1
HCPCS,38760,Remove groin lymph nodes,,,6402.59,30765.0,2
HCPCS,38765,Remove groin lymph nodes,,,26701.0,26701.0,1
HCPCS,38770,Remove pelvis lymph nodes,,,26701.0,26701.0,1
HCPCS,38780,Remove abdomen lymph nodes,,,26701.0,26701.0,1
HCPCS,38790,Hc Injection For Lymphangiography,3054.0,1985.1000000000001,,,0
HCPCS,38792,Hc Injection Tracer For Sentinel Node Id,3054.0,1985.1000000000001,,,0
HCPCS,38792,Ra tracer id of sentinl node,,,385.47,3714.0,2
HCPCS,38999,Blood/lymph system procedure,,,425.39,16564.0,2
HCPCS,38999,Hc Unlisted Procedure Hemic Or Lymphatic System,802.0,521.3,,,0
HCPCS,39000,Exploration of chest,,,26701.0,26701.0,1
HCPCS,39010,Exploration of chest,,,26701.0,26701.0,1
HCPCS,39200,Resect mediastinal cyst,,,26701.0,26701.0,1
HCPCS,39220,Resect mediastinal tumor,,,26701.0,26701.0,1
HCPCS,39401,Mediastinoscpy w/medstnl bx,,,5829.23,26701.0,2
HCPCS,39402,Mediastinoscpy w/lmph nod bx,,,5829.23,26701.0,2
HCPCS,39499,Chest procedure,,,16564.0,16564.0,1
HCPCS,39501,Repair diaphragm laceration,,,26701.0,26701.0,1
HCPCS,39503,Repair of diaphragm hernia,,,26701.0,26701.0,1
HCPCS,39540,Repair of diaphragm hernia,,,26701.0,26701.0,1
HCPCS,39541,Repair of diaphragm hernia,,,26701.0,26701.0,1
HCPCS,39545,Revision of diaphragm,,,26701.0,26701.0,1
HCPCS,39560,Resect diaphragm simple,,,26701.0,26701.0,1
HCPCS,39561,Resect diaphragm complex,,,26701.0,26701.0,1
HCPCS,39599,Diaphragm surgery procedure,,,16564.0,16564.0,1
HCPCS,40490,Biopsy of lip,,,228.38,3714.0,2
HCPCS,40500,Partial excision of lip,,,3196.84,9206.0,2
HCPCS,40510,Partial excision of lip,,,3196.84,9206.0,2
HCPCS,40520,Partial excision of lip,,,3196.84,9206.0,2
HCPCS,40525,Reconstruct lip with flap,,,3196.84,9206.0,2
HCPCS,40527,Reconstruct lip with flap,,,5708.03,20001.0,2
HCPCS,40530,Partial removal of lip,,,3196.84,9206.0,2
HCPCS,40650,Hc Repair Lip Vermilion Only,1277.0,830.05,,,0
HCPCS,40650,Repair lip,,,520.03,3714.0,2
HCPCS,40652,Repair lip,,,520.03,3714.0,2
HCPCS,40654,Repair lip,,,1496.07,9206.0,2
HCPCS,40700,Repair cleft lip/nasal,,,5708.03,20001.0,2
HCPCS,40701,Repair cleft lip/nasal,,,5708.03,20001.0,2
HCPCS,40702,Repair cleft lip/nasal,,,5708.03,20001.0,2
HCPCS,40720,Repair cleft lip/nasal,,,3196.84,9206.0,2
HCPCS,40761,Repair cleft lip/nasal,,,5708.03,20001.0,2
HCPCS,40799,Lip surgery procedure,,,228.38,16564.0,2
HCPCS,40800,Drainage of mouth lesion,,,682.8,3714.0,2
HCPCS,40800,Hc Drn Abs/Cyst/Hemtma/Mouth Smpl,895.0,581.75,,,0
HCPCS,40801,Drainage of mouth lesion,,,520.03,3714.0,2
HCPCS,40804,Removal foreign body mouth,,,874.53,3714.0,2
HCPCS,40805,Removal foreign body mouth,,,520.03,3714.0,2
HCPCS,40806,Incision of lip fold,,,520.03,3714.0,2
HCPCS,40808,Biopsy of mouth lesion,,,520.03,3714.0,2
HCPCS,40810,Excision of mouth lesion,,,3196.84,9206.0,2
HCPCS,40812,Excise/repair mouth lesion,,,1496.07,9206.0,2
HCPCS,40814,Excise/repair mouth lesion,,,3196.84,9206.0,2
HCPCS,40816,Excision of mouth lesion,,,3196.84,9206.0,2
HCPCS,40818,Excise oral mucosa for graft,,,520.03,3714.0,2
HCPCS,40819,Excise lip or cheek fold,,,1496.07,9206.0,2
HCPCS,40819,Hc Excise Lip Or Cheek Fold Newborn (Frenulectomy),2854.0,1855.1,,,0
HCPCS,40820,Treatment of mouth lesion,,,3196.84,9206.0,2
HCPCS,40830,Repair mouth laceration,,,228.38,3714.0,2
HCPCS,40831,Repair mouth laceration,,,520.03,3714.0,2
HCPCS,40840,Reconstruction of mouth,,,5708.03,20001.0,2
HCPCS,40842,Reconstruction of mouth,,,5708.03,20001.0,2
HCPCS,40843,Reconstruction of mouth,,,5708.03,20001.0,2
HCPCS,40844,Reconstruction of mouth,,,5708.03,20001.0,2
HCPCS,40845,Reconstruction of mouth,,,5708.03,20001.0,2
HCPCS,40899,Mouth surgery procedure,,,228.38,16564.0,2
HCPCS,41000,Drainage of mouth lesion,,,520.03,3714.0,2
HCPCS,41005,Drainage of mouth lesion,,,228.38,3714.0,2
HCPCS,41006,Drainage of mouth lesion,,,1496.07,9206.0,2
HCPCS,41007,Drainage of mouth lesion,,,1496.07,9206.0,2
HCPCS,41008,Drainage of mouth lesion,,,3196.84,9206.0,2
HCPCS,41009,Drainage of mouth lesion,,,520.03,3714.0,2
HCPCS,41010,Hc Incision Tongue Fold,2902.0,1886.3,,,0
HCPCS,41010,Incision of tongue fold,,,1496.07,9206.0,2
HCPCS,41015,Drainage of mouth lesion,,,520.03,3714.0,2
HCPCS,41016,Drainage of mouth lesion,,,5708.03,20001.0,2
HCPCS,41017,Drainage of mouth lesion,,,3196.84,9206.0,2
HCPCS,41018,Drainage of mouth lesion,,,1496.07,9206.0,2
HCPCS,41019,Place needles h&n for rt,,,5708.03,20001.0,2
HCPCS,41100,Biopsy of tongue,,,520.03,3714.0,2
HCPCS,41105,Biopsy of tongue,,,3196.84,9206.0,2
HCPCS,41108,Biopsy of floor of mouth,,,1592.51,9206.0,2
HCPCS,41110,Excision of tongue lesion,,,3196.84,9206.0,2
HCPCS,41112,Excision of tongue lesion,,,3196.84,9206.0,2
HCPCS,41113,Excision of tongue lesion,,,3196.84,9206.0,2
HCPCS,41114,Excision of tongue lesion,,,3196.84,9206.0,2
HCPCS,41115,Excision of tongue fold,,,1496.07,9206.0,2
HCPCS,41116,Excision of mouth lesion,,,3196.84,9206.0,2
HCPCS,41120,Partial removal of tongue,,,5708.03,20001.0,2
HCPCS,41130,Partial removal of tongue,,,20001.0,20001.0,1
HCPCS,41135,Tongue and neck surgery,,,20001.0,20001.0,1
HCPCS,41140,Removal of tongue,,,20001.0,20001.0,1
HCPCS,41145,Tongue removal neck surgery,,,20001.0,20001.0,1
HCPCS,41150,Tongue mouth jaw surgery,,,20001.0,20001.0,1
HCPCS,41153,Tongue mouth neck surgery,,,20001.0,20001.0,1
HCPCS,41155,Tongue jaw & neck surgery,,,20001.0,20001.0,1
HCPCS,41250,Repair tongue laceration,,,430.74,3714.0,2
HCPCS,41251,Repair tongue laceration,,,228.38,3714.0,2
HCPCS,41252,Repair tongue laceration,,,228.38,3714.0,2
HCPCS,41510,Tongue to lip surgery,,,3196.84,9206.0,2
HCPCS,41512,Tongue suspension,,,5708.03,20001.0,2
HCPCS,41520,Reconstruction tongue fold,,,3196.84,9206.0,2
HCPCS,41530,Tongue base vol reduction,,,3196.84,9206.0,2
HCPCS,41599,Tongue and mouth surgery,,,228.38,16564.0,2
HCPCS,41800,Drainage of gum lesion,,,128.29,3714.0,2
HCPCS,41800,Hc Drain Dental Abscess,1362.0,885.3,,,0
HCPCS,41805,Removal foreign body gum,,,1496.07,9206.0,2
HCPCS,41806,Removal foreign body jawbone,,,1496.07,9206.0,2
HCPCS,41820,Excision gum each quadrant,,,3196.84,9206.0,2
HCPCS,41821,Excision of gum flap,,,1496.07,9206.0,2
HCPCS,41822,Excision of gum lesion,,,1496.07,9206.0,2
HCPCS,41823,Excision of gum lesion,,,5708.03,20001.0,2
HCPCS,41825,Excision of gum lesion,,,3196.84,9206.0,2
HCPCS,41826,Excision of gum lesion,,,3196.84,9206.0,2
HCPCS,41827,Excision of gum lesion,,,5708.03,20001.0,2
HCPCS,41828,Excision of gum lesion,,,1496.07,9206.0,2
HCPCS,41830,Removal of gum tissue,,,3196.84,9206.0,2
HCPCS,41850,Treatment of gum lesion,,,1496.07,9206.0,2
HCPCS,41870,Gum graft,,,1496.07,9206.0,2
HCPCS,41872,Repair gum,,,3196.84,9206.0,2
HCPCS,41874,Repair tooth socket,,,3196.84,9206.0,2
HCPCS,41899,Dental surgery procedure,,,228.38,16564.0,2
HCPCS,41899,Hc Unlisted Dentoalvolar Procedure,1108.0,720.2,,,0
HCPCS,42000,Drainage mouth roof lesion,,,228.38,3714.0,2
HCPCS,42100,Biopsy roof of mouth,,,1496.07,9206.0,2
HCPCS,42104,Excision lesion mouth roof,,,3196.84,9206.0,2
HCPCS,42106,Excision lesion mouth roof,,,3196.84,9206.0,2
HCPCS,42107,Excision lesion mouth roof,,,5708.03,20001.0,2
HCPCS,42120,Remove palate/lesion,,,5708.03,20001.0,2
HCPCS,42140,Excision of uvula,,,3196.84,9206.0,2
HCPCS,42145,Repair palate pharynx/uvula,,,5708.03,20001.0,2
HCPCS,42160,Treatment mouth roof lesion,,,3196.84,9206.0,2
HCPCS,42180,Repair palate,,,520.03,3714.0,2
HCPCS,42182,Repair palate,,,5708.03,20001.0,2
HCPCS,42200,Reconstruct cleft palate,,,5708.03,20001.0,2
HCPCS,42205,Reconstruct cleft palate,,,3196.84,9206.0,2
HCPCS,42210,Reconstruct cleft palate,,,5708.03,20001.0,2
HCPCS,42215,Reconstruct cleft palate,,,5708.03,20001.0,2
HCPCS,42220,Reconstruct cleft palate,,,5708.03,20001.0,2
HCPCS,42225,Reconstruct cleft palate,,,5708.03,20001.0,2
HCPCS,42226,Lengthening of palate,,,5708.03,20001.0,2
HCPCS,42227,Lengthening of palate,,,5708.03,20001.0,2
HCPCS,42235,Repair palate,,,5708.03,20001.0,2
HCPCS,42260,Repair nose to lip fistula,,,5708.03,20001.0,2
HCPCS,42280,Preparation palate mold,,,520.03,3714.0,2
HCPCS,42281,Insertion palate prosthesis,,,5708.03,20001.0,2
HCPCS,42299,Palate/uvula surgery,,,228.38,16564.0,2
HCPCS,42300,Drainage of salivary gland,,,1496.07,9206.0,2
HCPCS,42305,Drainage of salivary gland,,,3196.84,9206.0,2
HCPCS,42310,Drainage of salivary gland,,,520.03,3714.0,2
HCPCS,42320,Drainage of salivary gland,,,520.03,3714.0,2
HCPCS,42330,Removal of salivary stone,,,3196.84,9206.0,2
HCPCS,42335,Removal of salivary stone,,,3196.84,9206.0,2
HCPCS,42340,Removal of salivary stone,,,3196.84,9206.0,2
HCPCS,42400,Biopsy of salivary gland,,,682.8,3714.0,2
HCPCS,42400,Hc Biopsy Salivary Gland Needle,2635.0,1712.75,,,0
HCPCS,42405,Biopsy of salivary gland,,,1496.07,9206.0,2
HCPCS,42408,Excision of salivary cyst,,,3196.84,9206.0,2
HCPCS,42409,Drainage of salivary cyst,,,3196.84,9206.0,2
HCPCS,42410,Excise parotid gland/lesion,,,5708.03,20001.0,2
HCPCS,42415,Excise parotid gland/lesion,,,5708.03,20001.0,2
HCPCS,42420,Excise parotid gland/lesion,,,5708.03,20001.0,2
HCPCS,42425,Excise parotid gland/lesion,,,5708.03,20001.0,2
HCPCS,42426,Excise parotid gland/lesion,,,20001.0,20001.0,1
HCPCS,42440,Excise submaxillary gland,,,5708.03,20001.0,2
HCPCS,42450,Excise sublingual gland,,,5708.03,20001.0,2
HCPCS,42500,Repair salivary duct,,,5708.03,20001.0,2
HCPCS,42505,Repair salivary duct,,,5708.03,20001.0,2
HCPCS,42507,Parotid duct diversion,,,5708.03,20001.0,2
HCPCS,42509,Parotid duct diversion,,,5708.03,20001.0,2
HCPCS,42510,Parotid duct diversion,,,3196.84,9206.0,2
HCPCS,42550,Hc Injection For Sialogram,3863.0,2510.95,,,0
HCPCS,42600,Closure of salivary fistula,,,3196.84,9206.0,2
HCPCS,42650,Dilation of salivary duct,,,1496.07,9206.0,2
HCPCS,42660,Dilation of salivary duct,,,520.03,3714.0,2
HCPCS,42660,Hc Dil Cath Salivary Duct W Wo Injection,509.0,330.85,,,0
HCPCS,42665,Ligation of salivary duct,,,3196.84,9206.0,2
HCPCS,42699,Salivary surgery procedure,,,228.38,16564.0,2
HCPCS,42700,Drainage of tonsil abscess,,,228.38,3714.0,2
HCPCS,42700,Hc I And D Peritonsillar Abscess,1426.0,926.9,,,0
HCPCS,42720,Drainage of throat abscess,,,3196.84,9206.0,2
HCPCS,42725,Drainage of throat abscess,,,5708.03,20001.0,2
HCPCS,42800,Biopsy of throat,,,1496.07,9206.0,2
HCPCS,42800,Hc Biopsy Oropharynx,2854.0,1855.1,,,0
HCPCS,42804,Biopsy of upper nose/throat,,,3196.84,9206.0,2
HCPCS,42806,Biopsy of upper nose/throat,,,3196.84,9206.0,2
HCPCS,42808,Excise pharynx lesion,,,3196.84,9206.0,2
HCPCS,42809,Remove pharynx foreign body,,,430.74,3714.0,2
HCPCS,42810,Excision of neck cyst,,,3196.84,9206.0,2
HCPCS,42815,Excision of neck cyst,,,5708.03,20001.0,2
HCPCS,42820,Remove tonsils and adenoids,,,5708.03,20001.0,2
HCPCS,42821,Remove tonsils and adenoids,,,3196.84,9206.0,2
HCPCS,42825,Removal of tonsils,,,5708.03,20001.0,2
HCPCS,42826,Removal of tonsils,,,3196.84,9206.0,2
HCPCS,42830,Removal of adenoids,,,3196.84,9206.0,2
HCPCS,42831,Removal of adenoids,,,3196.84,9206.0,2
HCPCS,42835,Removal of adenoids,,,3196.84,9206.0,2
HCPCS,42836,Removal of adenoids,,,3196.84,9206.0,2
HCPCS,42842,Extensive surgery of throat,,,5708.03,20001.0,2
HCPCS,42844,Extensive surgery of throat,,,5708.03,20001.0,2
HCPCS,42845,Extensive surgery of throat,,,20001.0,20001.0,1
HCPCS,42860,Excision of tonsil tags,,,3196.84,9206.0,2
HCPCS,42870,Excision of lingual tonsil,,,5708.03,20001.0,2
HCPCS,42890,Partial removal of pharynx,,,5708.03,20001.0,2
HCPCS,42892,Revision of pharyngeal walls,,,5708.03,20001.0,2
HCPCS,42894,Revision of pharyngeal walls,,,20001.0,20001.0,1
HCPCS,42900,Repair throat wound,,,1496.07,9206.0,2
HCPCS,42950,Reconstruction of throat,,,5708.03,20001.0,2
HCPCS,42953,Repair throat esophagus,,,15689.0,15689.0,1
HCPCS,42955,Surgical opening of throat,,,1496.07,9206.0,2
HCPCS,42960,Control throat bleeding,,,520.03,3714.0,2
HCPCS,42960,Hc Control Oropharyngeal Hemor,1277.0,830.05,,,0
HCPCS,42961,Control throat bleeding,,,15689.0,15689.0,1
HCPCS,42962,Control throat bleeding,,,3196.84,9206.0,2
HCPCS,42970,Control nose/throat bleeding,,,228.38,3714.0,2
HCPCS,42971,Control nose/throat bleeding,,,15689.0,15689.0,1
HCPCS,42972,Control nose/throat bleeding,,,3196.84,9206.0,2
HCPCS,42975,Dise eval slp do brth flx dx,,,1716.22,9206.0,2
HCPCS,42999,Throat surgery procedure,,,228.38,16564.0,2
HCPCS,43020,Incision of esophagus,,,1496.07,9206.0,2
HCPCS,43030,Throat muscle surgery,,,5708.03,20001.0,2
HCPCS,43045,Incision of esophagus,,,20001.0,20001.0,1
HCPCS,43100,Excision of esophagus lesion,,,15689.0,15689.0,1
HCPCS,43101,Excision of esophagus lesion,,,20001.0,20001.0,1
HCPCS,43107,Removal of esophagus,,,20001.0,20001.0,1
HCPCS,43108,Removal of esophagus,,,20001.0,20001.0,1
HCPCS,43112,Removal of esophagus,,,20001.0,20001.0,1
HCPCS,43113,Removal of esophagus,,,20001.0,20001.0,1
HCPCS,43116,Partial removal of esophagus,,,20001.0,20001.0,1
HCPCS,43117,Partial removal of esophagus,,,20001.0,20001.0,1
HCPCS,43118,Partial removal of esophagus,,,20001.0,20001.0,1
HCPCS,43121,Partial removal of esophagus,,,20001.0,20001.0,1
HCPCS,43122,Partial removal of esophagus,,,20001.0,20001.0,1
HCPCS,43123,Partial removal of esophagus,,,20001.0,20001.0,1
HCPCS,43124,Removal of esophagus,,,20001.0,20001.0,1
HCPCS,43130,Removal of esophagus pouch,,,5708.03,20001.0,2
HCPCS,43135,Removal of esophagus pouch,,,15689.0,15689.0,1
HCPCS,43180,Esophagoscopy rigid trnso,,,5708.03,20001.0,2
HCPCS,43191,Esophagoscopy rigid trnso dx,,,1850.25,9206.0,2
HCPCS,43192,Esophagoscp rig trnso inject,,,1850.25,9206.0,2
HCPCS,43193,Esophagoscp rig trnso biopsy,,,1850.25,9206.0,2
HCPCS,43194,Esophagoscp rig trnso rem fb,,,1850.25,9206.0,2
HCPCS,43195,Esophagoscopy rigid balloon,,,3717.53,15689.0,2
HCPCS,43196,Esophagoscp guide wire dilat,,,1850.25,15689.0,2
HCPCS,43197,Esophagoscopy flex dx brush,,,874.53,3714.0,2
HCPCS,43198,Esophagosc flex trnsn biopsy,,,874.53,3714.0,2
HCPCS,43200,Esophagoscopy flexible brush,,,874.53,3714.0,2
HCPCS,43200,Hc Esophagoscopy,3433.0,2231.45,,,0
HCPCS,43201,Esoph scope w/submucous inj,,,1850.25,9206.0,2
HCPCS,43201,Hc Esophagoscopy W Injections,3970.0,2580.5,,,0
HCPCS,43202,Esophagoscopy flex biopsy,,,1850.25,9206.0,2
HCPCS,43202,Hc Esophagoscopy W Biopsy,5130.0,3334.5,,,0
HCPCS,43204,Esoph scope w/sclerosis inj,,,1850.25,9206.0,2
HCPCS,43204,Hc Esophagoscopy W/ Sclerosis Varices,3970.0,2580.5,,,0
HCPCS,43205,Esophagus endoscopy/ligation,,,1850.25,9206.0,2
HCPCS,43205,Hc Esophagoscopy W Band Ligation,3970.0,2580.5,,,0
HCPCS,43206,Esoph optical endomicroscopy,,,1850.25,9206.0,2
HCPCS,43210,Egd esophagogastrc fndoplsty,,,10249.52,38216.0,2
HCPCS,43210,Hc Egd Esophagogastrc Fndoplsty,13063.0,8490.95,,,0
HCPCS,43211,Esophagoscop mucosal resect,,,1850.25,9206.0,2
HCPCS,43211,Hc Esophagoscopy Flex W Mucosal Resection,4857.0,3157.05,,,0
HCPCS,43212,Esophagoscop stent placement,,,5853.69,20001.0,2
HCPCS,43212,Hc Esophagoscopy Transoral Stent Plcmnt,8452.0,5493.8,,,0
HCPCS,43213,Esophagoscopy retro balloon,,,1850.25,9206.0,2
HCPCS,43214,Esophagosc dilate balloon 30,,,1850.25,9206.0,2
HCPCS,43214,Hc Esophagoscopy Flex W Balln Dilatn 30 Mm,4275.0,2778.75,,,0
HCPCS,43215,Esophagoscopy flex remove fb,,,1850.25,9206.0,2
HCPCS,43215,Hc Esophagoscopy W Fb Removal,3677.0,2390.05,,,0
HCPCS,43216,Esophagoscopy lesion removal,,,1850.25,9206.0,2
HCPCS,43217,Esophagoscopy snare les remv,,,1850.25,9206.0,2
HCPCS,43217,Hc Esophagoscopy W Tumor Removal Snare,4421.0,2873.65,,,0
HCPCS,43220,Esophagoscopy balloon <30mm,,,1850.25,9206.0,2
HCPCS,43220,Hc Esophagoscopy W/ Balloon Dilation,3835.0,2492.75,,,0
HCPCS,43226,Esoph endoscopy dilation,,,1850.25,9206.0,2
HCPCS,43226,Hc Esophagoscopy W/ Otw Dilation,4275.0,2778.75,,,0
HCPCS,43227,Esophagoscopy control bleed,,,1850.25,9206.0,2
HCPCS,43229,Esophagoscopy lesion ablate,,,3717.53,15689.0,2
HCPCS,43229,Hc Esophagoscopy W/ Tumor Ablation,4172.0,2711.8,,,0
HCPCS,43231,Esophagoscop ultrasound exam,,,1850.25,9206.0,2
HCPCS,43231,Hc Esophagoscopy With Endoscopic Us Exam,3970.0,2580.5,,,0
HCPCS,43232,Esophagoscopy w/us needle bx,,,1850.25,9206.0,2
HCPCS,43233,Egd balloon dil esoph30 mm/>,,,1850.25,9206.0,2
HCPCS,43233,Hc Egd Esophagus Balloon Dilation 30 Mm,4350.0,2827.5,,,0
HCPCS,43235,Egd diagnostic brush wash,,,874.53,3714.0,2
HCPCS,43235,Hc Egd,3998.0,2598.7,,,0
HCPCS,43236,Hc Egd W Injections,2023.0,1314.95,,,0
HCPCS,43236,Uppr gi scope w/submuc inj,,,874.53,3714.0,2
HCPCS,43237,Endoscopic us exam esoph,,,1850.25,9206.0,2
HCPCS,43237,Hc Ugi Endo Us Limited To Esophagus,5573.0,3622.45,,,0
HCPCS,43238,Egd us fine needle bx/aspir,,,1850.25,9206.0,2
HCPCS,43238,Hc Ugi Endo Us With Fna Esophagus,5314.0,3454.1,,,0
HCPCS,43239,Egd biopsy single/multiple,,,874.53,3714.0,2
HCPCS,43239,Hc Egd W Biopsy,4213.0,2738.45,,,0
HCPCS,43240,Egd w/transmural drain cyst,,,5853.69,15689.0,2
HCPCS,43240,Hc Egd W Drainage Pseudocyst,7028.0,4568.2,,,0
HCPCS,43241,Egd tube/cath insertion,,,1850.25,9206.0,2
HCPCS,43241,Hc Egd W Plcmnt Transendo Tube Or Cath,3838.0,2494.7,,,0
HCPCS,43242,Egd us fine needle bx/aspir,,,1850.25,9206.0,2
HCPCS,43242,Hc Ugi Endo Us Guided Fna,5594.0,3636.1,,,0
HCPCS,43243,Egd injection varices,,,1850.25,9206.0,2
HCPCS,43243,Hc Egd W Sclerotherapy,4619.0,3002.35,,,0
HCPCS,43244,Egd varices ligation,,,1850.25,9206.0,2
HCPCS,43244,Hc Egd W Band Esoph Gastric Varices,5380.0,3497.0,,,0
HCPCS,43245,Egd dilate stricture,,,1850.25,9206.0,2
HCPCS,43245,Hc Ugi Endo Dilation Gastric Outlet Obstruction,4948.0,3216.2,,,0
HCPCS,43246,Egd place gastrostomy tube,,,1850.25,9206.0,2
HCPCS,43246,Hc Egd W Peg Placement,4040.0,2626.0,,,0
HCPCS,43247,Egd remove foreign body,,,874.53,3714.0,2
HCPCS,43247,Hc Egd W Removal Fb,5881.0,3822.65,,,0
HCPCS,43248,Egd guide wire insertion,,,874.53,3714.0,2
HCPCS,43248,Hc Egd W Esoph Dilation Over Guide,5116.0,3325.4,,,0
HCPCS,43249,Esoph egd dilation <30 mm,,,1850.25,9206.0,2
HCPCS,43249,Hc Egd W Esoph Balloon Dilation,5098.0,3313.7,,,0
HCPCS,43250,Egd cautery tumor polyp,,,1850.25,9206.0,2
HCPCS,43250,Hc Egd W/Tumor/Polyp Remove Cautery,4285.0,2785.25,,,0
HCPCS,43251,Egd remove lesion snare,,,1850.25,9206.0,2
HCPCS,43251,Hc Egd W/Tumor/Polyp Remove Snare,4802.0,3121.3,,,0
HCPCS,43252,Egd optical endomicroscopy,,,1850.25,15689.0,2
HCPCS,43253,Egd us transmural injxn/mark,,,1850.25,9206.0,2
HCPCS,43253,Hc Egd Flex Us Guide Injection,4774.0,3103.1,,,0
HCPCS,43254,Egd endo mucosal resection,,,1850.25,9206.0,2
HCPCS,43254,Hc Egd Endo Mucosal Resection,4857.0,3157.05,,,0
HCPCS,43255,Egd control bleeding any,,,1850.25,9206.0,2
HCPCS,43255,Hc Egd W/Control Of Bleeding,4889.0,3177.85,,,0
HCPCS,43257,Egd w/thrml txmnt gerd,,,3717.53,15689.0,2
HCPCS,43259,Egd us exam duodenum/jejunum,,,1850.25,9206.0,2
HCPCS,43259,Hc Egd Endoscopic Ultrasound Exam,5701.0,3705.65,,,0
HCPCS,43260,Ercp w/specimen collection,,,3717.53,15689.0,2
HCPCS,43260,Hc Ercp,9038.0,5874.7,,,0
HCPCS,43261,Endo cholangiopancreatograph,,,3717.53,15689.0,2
HCPCS,43261,Hc Ercp W Biopsy,10300.0,6695.0,,,0
HCPCS,43262,Endo cholangiopancreatograph,,,3717.53,15689.0,2
HCPCS,43262,Hc Ercp W/Sphincterotomy/Papillotomy,10577.0,6875.05,,,0
HCPCS,43263,Ercp sphincter pressure meas,,,1850.25,15689.0,2
HCPCS,43264,Ercp remove duct calculi,,,3717.53,15689.0,2
HCPCS,43264,Hc Ercp W/Stone Removal,10420.0,6773.0,,,0
HCPCS,43265,Ercp lithotripsy calculi,,,5853.69,20001.0,2
HCPCS,43265,Hc Ercp W/Lithotripsy,9908.0,6440.2,,,0
HCPCS,43266,Egd endoscopic stent place,,,5853.69,20001.0,2
HCPCS,43266,Hc Ugi Endo W/Stent Placement,5700.0,3705.0,,,0
HCPCS,43270,Egd lesion ablation,,,1850.25,9206.0,2
HCPCS,43270,Hc Egd W/Ablation By Laser,4604.0,2992.6,,,0
HCPCS,43273,Hc Ercp Direct Vis/Exam Comn Bil Duc,7810.0,5076.5,,,0
HCPCS,43274,Ercp duct stent placement,,,5853.69,20001.0,2
HCPCS,43274,Hc Ercp Stent Placement Biliary/Pancreatic Duct,6016.0,3910.4,,,0
HCPCS,43275,Ercp remove forgn body duct,,,1850.25,15689.0,2
HCPCS,43275,Hc Ercp W Fb Remov Or Stent Biliary/Panc Duct,9933.0,6456.45,,,0
HCPCS,43276,Ercp stent exchange w/dilate,,,5853.69,20001.0,2
HCPCS,43276,Hc Ercp W Stent Exchange W Dilation,6028.0,3918.2,,,0
HCPCS,43277,Ercp ea duct/ampulla dilate,,,3717.53,15689.0,2
HCPCS,43277,Hc Ercp W/Balloon Dilation,9908.0,6440.2,,,0
HCPCS,43278,Ercp lesion ablate w/dilate,,,3717.53,15689.0,2
HCPCS,43278,Hc Ercp Tumor/Polyp/Lesion Ablation W/Dilation&Wire,10420.0,6773.0,,,0
HCPCS,43279,Lap myotomy heller,,,38216.0,38216.0,1
HCPCS,43280,Laparoscopy fundoplasty,,,10249.52,38216.0,2
HCPCS,43281,Lap paraesophag hern repair,,,10249.52,38216.0,2
HCPCS,43282,Lap paraesoph her rpr w/mesh,,,10249.52,38216.0,2
HCPCS,43283,Lap esoph lengthening,,,38216.0,38216.0,1
HCPCS,43284,Laps esophgl sphnctr agmntj,,,10249.52,38216.0,2
HCPCS,43285,Rmvl esophgl sphnctr dev,,,5829.23,26701.0,2
HCPCS,43286,Esphg tot w/laps moblj,,,26701.0,26701.0,1
HCPCS,43287,Esphg dstl 2/3 w/laps moblj,,,26701.0,26701.0,1
HCPCS,43288,Esphg thrsc moblj,,,26701.0,26701.0,1
HCPCS,43289,Laparoscope proc esoph,,,5829.23,26701.0,2
HCPCS,43290,Egd flx trnsorl dplmnt balo,,,1850.25,9206.0,2
HCPCS,43291,Egd flx trnsorl rmvl balo,,,874.53,3714.0,2
HCPCS,43300,Repair of esophagus,,,20001.0,20001.0,1
HCPCS,43305,Repair esophagus and fistula,,,20001.0,20001.0,1
HCPCS,43310,Repair of esophagus,,,20001.0,20001.0,1
HCPCS,43312,Repair esophagus and fistula,,,20001.0,20001.0,1
HCPCS,43313,Esophagoplasty congenital,,,20001.0,20001.0,1
HCPCS,43314,Tracheo-esophagoplasty cong,,,20001.0,20001.0,1
HCPCS,43320,Fuse esophagus & stomach,,,20001.0,20001.0,1
HCPCS,43325,Revise esophagus & stomach,,,20001.0,20001.0,1
HCPCS,43327,Esoph fundoplasty lap,,,26701.0,26701.0,1
HCPCS,43328,Esoph fundoplasty thor,,,26701.0,26701.0,1
HCPCS,43330,Esophagomyotomy abdominal,,,20001.0,20001.0,1
HCPCS,43331,Esophagomyotomy thoracic,,,20001.0,20001.0,1
HCPCS,43332,Transab esoph hiat hern rpr,,,26701.0,26701.0,1
HCPCS,43333,Transab esoph hiat hern rpr,,,26701.0,26701.0,1
HCPCS,43334,Transthor diaphrag hern rpr,,,26701.0,26701.0,1
HCPCS,43335,Transthor diaphrag hern rpr,,,26701.0,26701.0,1
HCPCS,43336,Thorabd diaphr hern repair,,,26701.0,26701.0,1
HCPCS,43337,Thorabd diaphr hern repair,,,26701.0,26701.0,1
HCPCS,43338,Esoph lengthening,,,26701.0,26701.0,1
HCPCS,43340,Fuse esophagus & intestine,,,20001.0,20001.0,1
HCPCS,43341,Fuse esophagus & intestine,,,20001.0,20001.0,1
HCPCS,43351,Surgical opening esophagus,,,20001.0,20001.0,1
HCPCS,43352,Surgical opening esophagus,,,20001.0,20001.0,1
HCPCS,43360,Gastrointestinal repair,,,20001.0,20001.0,1
HCPCS,43361,Gastrointestinal repair,,,20001.0,20001.0,1
HCPCS,43400,Ligate esophagus veins,,,20001.0,20001.0,1
HCPCS,43405,Ligate/staple esophagus,,,20001.0,20001.0,1
HCPCS,43410,Repair esophagus wound,,,20001.0,20001.0,1
HCPCS,43415,Repair esophagus wound,,,20001.0,20001.0,1
HCPCS,43420,Repair esophagus opening,,,3196.84,9206.0,2
HCPCS,43425,Repair esophagus opening,,,20001.0,20001.0,1
HCPCS,43450,Dilate esophagus 1/mult pass,,,874.53,3714.0,2
HCPCS,43450,Hc Dilation Esoph Sound Or Bougie,7057.0,4587.05,,,0
HCPCS,43453,Dilate esophagus,,,1850.25,9206.0,2
HCPCS,43460,Pressure treatment esophagus,,,9206.0,9206.0,1
HCPCS,43496,Free jejunum flap microvasc,,,15689.0,15689.0,1
HCPCS,43497,Transorl lwr esophgl myotomy,,,5853.69,15689.0,2
HCPCS,43499,Esophagus surgery procedure,,,874.53,16564.0,2
HCPCS,43500,Surgical opening of stomach,,,15689.0,15689.0,1
HCPCS,43501,Surgical repair of stomach,,,15689.0,15689.0,1
HCPCS,43502,Surgical repair of stomach,,,15689.0,15689.0,1
HCPCS,43510,Surgical opening of stomach,,,874.53,3714.0,2
HCPCS,43520,Incision of pyloric muscle,,,15689.0,15689.0,1
HCPCS,43605,Biopsy of stomach,,,15689.0,15689.0,1
HCPCS,43610,Excision of stomach lesion,,,15689.0,15689.0,1
HCPCS,43611,Excision of stomach lesion,,,15689.0,15689.0,1
HCPCS,43620,Removal of stomach,,,15689.0,15689.0,1
HCPCS,43621,Removal of stomach,,,15689.0,15689.0,1
HCPCS,43622,Removal of stomach,,,15689.0,15689.0,1
HCPCS,43631,Removal of stomach partial,,,15689.0,15689.0,1
HCPCS,43632,Removal of stomach partial,,,15689.0,15689.0,1
HCPCS,43633,Removal of stomach partial,,,15689.0,15689.0,1
HCPCS,43634,Removal of stomach partial,,,15689.0,15689.0,1
HCPCS,43635,Removal of stomach partial,,,15689.0,15689.0,1
HCPCS,43640,Vagotomy & pylorus repair,,,15689.0,15689.0,1
HCPCS,43641,Vagotomy & pylorus repair,,,15689.0,15689.0,1
HCPCS,43644,Lap gastric bypass/roux-en-y,,,26701.0,26701.0,1
HCPCS,43645,Lap gastr bypass incl smll i,,,26701.0,26701.0,1
HCPCS,43647,Lap impl electrode antrum,,,10744.03,38216.0,2
HCPCS,43648,Lap revise/remv eltrd antrum,,,10249.52,26701.0,2
HCPCS,43651,Laparoscopy vagus nerve,,,5829.23,26701.0,2
HCPCS,43652,Laparoscopy vagus nerve,,,5829.23,26701.0,2
HCPCS,43653,Laparoscopy gastrostomy,,,5829.23,26701.0,2
HCPCS,43659,Laparoscope proc stom,,,5829.23,26701.0,2
HCPCS,43752,Hc Ng Tube Placement,3085.0,2005.25,,,0
HCPCS,43752,Nasal/orogastric w/tube plmt,,,430.74,3714.0,2
HCPCS,43753,Hc Gastric Intub And Aspiration,1220.0,793.0,,,0
HCPCS,43753,Tx gastro intub w/asp,,,208.2,3714.0,2
HCPCS,43754,Dx gastr intub w/asp spec,,,208.2,3714.0,2
HCPCS,43755,Dx gastr intub w/asp specs,,,124.07,3714.0,2
HCPCS,43756,Dx duod intub w/asp spec,,,874.53,3714.0,2
HCPCS,43757,Dx duod intub w/asp specs,,,874.53,3714.0,2
HCPCS,43761,Hc Reposition Oro Or Naso Gastric Tube,3085.0,2005.25,,,0
HCPCS,43761,Reposition gastrostomy tube,,,240.91,3714.0,2
HCPCS,43762,Hc Replacement Of G-Tube Tube Perc Wo Img No Revision,2561.0,1664.65,,,0
HCPCS,43762,Rplc gtube no revj trc,,,240.91,3714.0,2
HCPCS,43763,Hc Replacement Of G-Tube Tube Perc Wo Img W Revision,4580.0,2977.0,,,0
HCPCS,43763,Rplc gtube  revj gstrst trc,,,240.91,3714.0,2
HCPCS,43770,Lap place gastr adj device,,,10249.52,38216.0,2
HCPCS,43771,Lap revise gastr adj device,,,26701.0,26701.0,1
HCPCS,43772,Lap rmvl gastr adj device,,,3717.53,15689.0,2
HCPCS,43773,Lap replace gastr adj device,,,5829.23,26701.0,2
HCPCS,43774,Lap rmvl gastr adj all parts,,,3717.53,15689.0,2
HCPCS,43775,Lap sleeve gastrectomy,,,26701.0,26701.0,1
HCPCS,43800,Reconstruction of pylorus,,,15689.0,15689.0,1
HCPCS,43810,Fusion of stomach and bowel,,,15689.0,15689.0,1
HCPCS,43820,Fusion of stomach and bowel,,,15689.0,15689.0,1
HCPCS,43825,Fusion of stomach and bowel,,,15689.0,15689.0,1
HCPCS,43830,Place gastrostomy tube,,,1850.25,9206.0,2
HCPCS,43831,Place gastrostomy tube,,,874.53,3714.0,2
HCPCS,43832,Place gastrostomy tube,,,15689.0,15689.0,1
HCPCS,43840,Repair of stomach lesion,,,3717.53,15689.0,2
HCPCS,43842,V-band gastroplasty,,,15689.0,15689.0,1
HCPCS,43843,Gastroplasty w/o v-band,,,15689.0,15689.0,1
HCPCS,43845,Gastroplasty duodenal switch,,,15689.0,15689.0,1
HCPCS,43846,Gastric bypass for obesity,,,15689.0,15689.0,1
HCPCS,43847,Gastric bypass incl small i,,,15689.0,15689.0,1
HCPCS,43848,Revision gastroplasty,,,15689.0,15689.0,1
HCPCS,43860,Revise stomach-bowel fusion,,,15689.0,15689.0,1
HCPCS,43865,Revise stomach-bowel fusion,,,15689.0,15689.0,1
HCPCS,43870,Repair stomach opening,,,3717.53,15689.0,2
HCPCS,43880,Repair stomach-bowel fistula,,,15689.0,15689.0,1
HCPCS,43881,Impl/redo electrd antrum,,,15689.0,15689.0,1
HCPCS,43882,Revise/remove electrd antrum,,,15689.0,15689.0,1
HCPCS,43886,Revise gastric port open,,,3416.94,15689.0,2
HCPCS,43887,Remove gastric port open,,,1989.46,9206.0,2
HCPCS,43888,Change gastric port open,,,3416.94,15689.0,2
HCPCS,43889,Gstr rstcv px trnsorl esg,,,10249.52,10249.52,1
HCPCS,43999,Hc Stomach Procedure Other,7895.0,5131.75,,,0
HCPCS,43999,Stomach surgery procedure,,,874.53,16564.0,2
HCPCS,44005,Freeing of bowel adhesion,,,15689.0,15689.0,1
HCPCS,44010,Incision of small bowel,,,15689.0,15689.0,1
HCPCS,44015,Insert needle cath bowel,,,15689.0,15689.0,1
HCPCS,44020,Explore small intestine,,,15689.0,15689.0,1
HCPCS,44021,Decompress small bowel,,,15689.0,15689.0,1
HCPCS,44025,Incision of large bowel,,,15689.0,15689.0,1
HCPCS,44050,Reduce bowel obstruction,,,15689.0,15689.0,1
HCPCS,44055,Correct malrotation of bowel,,,15689.0,15689.0,1
HCPCS,44100,Biopsy of bowel,,,874.53,3714.0,2
HCPCS,44110,Excise intestine lesion(s),,,15689.0,15689.0,1
HCPCS,44111,Excision of bowel lesion(s),,,15689.0,15689.0,1
HCPCS,44120,Removal of small intestine,,,15689.0,15689.0,1
HCPCS,44121,Removal of small intestine,,,15689.0,15689.0,1
HCPCS,44125,Removal of small intestine,,,15689.0,15689.0,1
HCPCS,44126,Enterectomy w/o taper cong,,,15689.0,15689.0,1
HCPCS,44127,Enterectomy w/taper cong,,,15689.0,15689.0,1
HCPCS,44128,Enterectomy cong add-on,,,15689.0,15689.0,1
HCPCS,44130,Bowel to bowel fusion,,,15689.0,15689.0,1
HCPCS,44132,Enterectomy cadaver donor,,,20001.0,20001.0,1
HCPCS,44133,Enterectomy live donor,,,15689.0,15689.0,1
HCPCS,44135,Intestine transplnt cadaver,,,20001.0,20001.0,1
HCPCS,44136,Intestine transplant live,,,15689.0,15689.0,1
HCPCS,44137,Remove intestinal allograft,,,15689.0,15689.0,1
HCPCS,44139,Mobilization of colon,,,15689.0,15689.0,1
HCPCS,44140,Partial removal of colon,,,15689.0,15689.0,1
HCPCS,44141,Partial removal of colon,,,15689.0,15689.0,1
HCPCS,44143,Partial removal of colon,,,15689.0,15689.0,1
HCPCS,44144,Partial removal of colon,,,15689.0,15689.0,1
HCPCS,44145,Partial removal of colon,,,15689.0,15689.0,1
HCPCS,44146,Partial removal of colon,,,15689.0,15689.0,1
HCPCS,44147,Partial removal of colon,,,15689.0,15689.0,1
HCPCS,44150,Removal of colon,,,15689.0,15689.0,1
HCPCS,44151,Removal of colon/ileostomy,,,15689.0,15689.0,1
HCPCS,44155,Removal of colon/ileostomy,,,15689.0,15689.0,1
HCPCS,44156,Removal of colon/ileostomy,,,15689.0,15689.0,1
HCPCS,44157,Colectomy w/Ileoanal Anast,,,15689.0,15689.0,1
HCPCS,44158,Colectomy w/Neo-Rectum Pouch,,,15689.0,15689.0,1
HCPCS,44160,Removal of colon,,,15689.0,15689.0,1
HCPCS,44180,Lap enterolysis,,,5829.23,26701.0,2
HCPCS,44186,Lap jejunostomy,,,5829.23,26701.0,2
HCPCS,44187,Lap ileo/jejuno-stomy,,,26701.0,26701.0,1
HCPCS,44188,Lap colostomy,,,26701.0,26701.0,1
HCPCS,44202,Lap enterectomy,,,26701.0,26701.0,1
HCPCS,44203,Lap resect s/intestine addl,,,26701.0,26701.0,1
HCPCS,44204,Laparo partial colectomy,,,26701.0,26701.0,1
HCPCS,44205,Lap colectomy part w/ileum,,,26701.0,26701.0,1
HCPCS,44206,Lap part colectomy w/stoma,,,26701.0,26701.0,1
HCPCS,44207,L colectomy/coloproctostomy,,,26701.0,26701.0,1
HCPCS,44208,L colectomy/coloproctostomy,,,26701.0,26701.0,1
HCPCS,44210,Laparo total proctocolectomy,,,26701.0,26701.0,1
HCPCS,44211,Lap colectomy w/proctectomy,,,26701.0,26701.0,1
HCPCS,44212,Laparo total proctocolectomy,,,26701.0,26701.0,1
HCPCS,44213,Lap mobil splenic fl add-on,,,26701.0,26701.0,1
HCPCS,44227,Lap close enterostomy,,,26701.0,26701.0,1
HCPCS,44238,Laparoscope proc intestine,,,5829.23,26701.0,2
HCPCS,44300,Open bowel to skin,,,1850.25,15689.0,2
HCPCS,44310,Ileostomy/jejunostomy,,,15689.0,15689.0,1
HCPCS,44312,Revision of ileostomy,,,3416.94,15689.0,2
HCPCS,44314,Revision of ileostomy,,,3416.94,15689.0,2
HCPCS,44316,Devise bowel pouch,,,15689.0,15689.0,1
HCPCS,44320,Colostomy,,,15689.0,15689.0,1
HCPCS,44322,Colostomy with biopsies,,,15689.0,15689.0,1
HCPCS,44340,Revision of colostomy,,,3416.94,15689.0,2
HCPCS,44345,Revision of colostomy,,,3416.94,15689.0,2
HCPCS,44346,Revision of colostomy,,,3416.94,15689.0,2
HCPCS,44360,Hc Small Intestine Endoscopy,4416.0,2870.4,,,0
HCPCS,44360,Small bowel endoscopy,,,1850.25,9206.0,2
HCPCS,44361,Hc Small Intestine Endoscopy W Biopsy,4460.0,2899.0,,,0
HCPCS,44361,Small bowel endoscopy/biopsy,,,1850.25,9206.0,2
HCPCS,44363,Hc Small Intestine Endoscopy W Removal Fb,5629.0,3658.85,,,0
HCPCS,44363,Small bowel endoscopy,,,1850.25,9206.0,2
HCPCS,44364,Hc Small Intestine Endoscopy W Removal Lesion Snare,4815.0,3129.75,,,0
HCPCS,44364,Small bowel endoscopy,,,1850.25,9206.0,2
HCPCS,44365,Hc Small Intestine Endoscopy W Removal Lesion Cautery,4679.0,3041.35,,,0
HCPCS,44365,Small bowel endoscopy,,,1850.25,9206.0,2
HCPCS,44366,Hc Small Intestine Endoscopy W Control Bleeding,5565.0,3617.25,,,0
HCPCS,44366,Small bowel endoscopy,,,1850.25,9206.0,2
HCPCS,44369,Hc Small Intestine Endoscopy W Ablation,4750.0,3087.5,,,0
HCPCS,44369,Small bowel endoscopy,,,1850.25,9206.0,2
HCPCS,44370,Hc Small Intestine Endoscopy W Stent Plcmnt,9391.0,6104.15,,,0
HCPCS,44370,Small Bowel Endoscopy/Stent,,,5853.69,20001.0,2
HCPCS,44372,Hc Small Intestine Endoscopy W J Tube Plcmnt,5835.0,3792.75,,,0
HCPCS,44372,Small bowel endoscopy,,,1850.25,9206.0,2
HCPCS,44373,Small bowel endoscopy,,,1850.25,9206.0,2
HCPCS,44376,Hc Small Intestine Endo Incl Ileum Spec Coll By Brush,5581.0,3627.65,,,0
HCPCS,44376,Small bowel endoscopy,,,1850.25,9206.0,2
HCPCS,44377,Hc Small Intestine Endo Incl Ileum W Biopsy,5567.0,3618.55,,,0
HCPCS,44377,Small bowel endoscopy/biopsy,,,1850.25,9206.0,2
HCPCS,44378,Hc Small Intestine Endo Incl Ileum W/ Control Bleeding,5845.0,3799.25,,,0
HCPCS,44378,Small bowel endoscopy,,,1850.25,9206.0,2
HCPCS,44379,Hc Small Intestine Endo Incl Ileum W Stent Plcmnt,6461.0,4199.65,,,0
HCPCS,44379,S Bowel Endoscope W/Stent,,,5853.69,20001.0,2
HCPCS,44380,Hc Ileoscopy Thru Stoma,5056.0,3286.4,,,0
HCPCS,44380,Small bowel endoscopy br/wa,,,874.53,3714.0,2
HCPCS,44381,Hc Ileoscopy Thru Stoma W Balloon Dilation,5574.0,3623.1,,,0
HCPCS,44381,Small bowel endoscopy br/wa,,,1850.25,9206.0,2
HCPCS,44382,Hc Ileoscopy Thru Stoma W Biopsy,5044.0,3278.6,,,0
HCPCS,44382,Small bowel endoscopy,,,874.53,3714.0,2
HCPCS,44384,Hc Ileoscopy Stoma W Plcmnt Endoscopic Stent,5574.0,3623.1,,,0
HCPCS,44384,Small bowel endoscopy,,,1850.25,15689.0,2
HCPCS,44385,Endoscopy of bowel pouch,,,896.69,3714.0,2
HCPCS,44385,Hc Endo Eval Sm Intest Pouch,4630.0,3009.5,,,0
HCPCS,44386,Endoscopy bowel pouch/biop,,,896.69,3714.0,2
HCPCS,44386,Hc Endo Eval Sm Intest Pouch W Biopsy,4729.0,3073.85,,,0
HCPCS,44388,Colonoscopy thru stoma spx,,,896.69,3714.0,2
HCPCS,44388,Hc Colonoscopy Thru Stoma,4198.0,2728.7,,,0
HCPCS,44389,Colonoscopy with biopsy,,,1153.83,9206.0,2
HCPCS,44389,Hc Colonoscopy Thru Stoma W Biopsy,5081.0,3302.65,,,0
HCPCS,44390,Colonoscopy for foreign body,,,896.69,9206.0,2
HCPCS,44390,Hc Colonoscopy Thru Stoma W Fb Removal,4921.0,3198.65,,,0
HCPCS,44391,Colonoscopy for bleeding,,,1153.83,9206.0,2
HCPCS,44391,Hc Colonoscopy Thru Stoma W Control Bleeding,4653.0,3024.45,,,0
HCPCS,44392,Colonoscopy & polypectomy,,,1153.83,9206.0,2
HCPCS,44392,Hc Colonoscopy Thru Stoma W Tumor Removal,4686.0,3045.9,,,0
HCPCS,44394,Colonoscopy w/snare,,,1153.83,9206.0,2
HCPCS,44394,Hc Colonoscopy Thru Stoma W Tumor Removal Snare,4972.0,3231.8,,,0
HCPCS,44401,Colonoscopy with ablation,,,1153.83,9206.0,2
HCPCS,44401,Hc Colonoscopy Thru Stoma W/ Ablation Lesion,5063.0,3290.95,,,0
HCPCS,44402,Colonoscopy w/stent plcmt,,,5853.69,20001.0,2
HCPCS,44402,Hc Colonoscopy Stoma W Plcmnt Endoscopic Stent,5610.0,3646.5,,,0
HCPCS,44403,Colonoscopy w/resection,,,1153.83,9206.0,2
HCPCS,44403,Hc Colonoscpy Stoma W/ Mucosal Resection,5330.0,3464.5,,,0
HCPCS,44404,Colonoscopy w/injection,,,1153.83,9206.0,2
HCPCS,44404,Hc Colonoscpy Stoma W/  Submucosal Inj,4558.0,2962.7,,,0
HCPCS,44405,Colonoscopy w/dilation,,,1153.83,9206.0,2
HCPCS,44405,Hc Colonoscopy Stoma W Balloon Dilat,5063.0,3290.95,,,0
HCPCS,44406,Colonoscopy w/ultrasound,,,1153.83,9206.0,2
HCPCS,44406,Hc Colonoscopy Thru Stoma W/ Endo Us,5109.0,3320.85,,,0
HCPCS,44407,Colonoscopy w/ndl aspir/bx,,,1153.83,9206.0,2
HCPCS,44408,Colonoscopy w/decompression,,,896.69,3714.0,2
HCPCS,44408,Hc Colonoscopy Stoma W  Decompression,4921.0,3198.65,,,0
HCPCS,44500,Hc Introduction Long Gi Tube,2111.0,1372.15,,,0
HCPCS,44500,Intro gastrointestinal tube,,,874.53,3714.0,2
HCPCS,44602,Suture small intestine,,,3717.53,15689.0,2
HCPCS,44603,Suture small intestine,,,15689.0,15689.0,1
HCPCS,44604,Suture large intestine,,,15689.0,15689.0,1
HCPCS,44605,Repair of bowel lesion,,,15689.0,15689.0,1
HCPCS,44615,Intestinal stricturoplasty,,,15689.0,15689.0,1
HCPCS,44620,Repair bowel opening,,,15689.0,15689.0,1
HCPCS,44625,Repair bowel opening,,,15689.0,15689.0,1
HCPCS,44626,Repair bowel opening,,,15689.0,15689.0,1
HCPCS,44640,Repair bowel-skin fistula,,,15689.0,15689.0,1
HCPCS,44650,Repair bowel fistula,,,15689.0,15689.0,1
HCPCS,44660,Repair bowel-bladder fistula,,,15689.0,15689.0,1
HCPCS,44661,Repair bowel-bladder fistula,,,15689.0,15689.0,1
HCPCS,44680,Surgical revision intestine,,,15689.0,15689.0,1
HCPCS,44700,Suspend bowel w/prosthesis,,,15689.0,15689.0,1
HCPCS,44705,Prepare fecal microbiota,,,3714.0,3714.0,1
HCPCS,44715,Prepare donor intestine,,,15689.0,15689.0,1
HCPCS,44720,Prep donor intestine/venous,,,15689.0,15689.0,1
HCPCS,44721,Prep donor intestine/artery,,,15689.0,15689.0,1
HCPCS,44799,Hc Unlist Procedure Intestine,1903.0,1236.95,,,0
HCPCS,44799,Unlisted px small intestine,,,874.53,16564.0,2
HCPCS,44800,Excision of bowel pouch,,,15689.0,15689.0,1
HCPCS,44820,Excision of mesentery lesion,,,15689.0,15689.0,1
HCPCS,44850,Repair of mesentery,,,15689.0,15689.0,1
HCPCS,44899,Bowel surgery procedure,,,16564.0,16564.0,1
HCPCS,44900,Drain appendix abscess open,,,9206.0,9206.0,1
HCPCS,44950,Appendectomy,,,6242.2,15689.0,2
HCPCS,44960,Appendectomy,,,15689.0,15689.0,1
HCPCS,44970,Laparoscopy appendectomy,,,5829.23,26701.0,2
HCPCS,44979,Laparoscope proc app,,,5829.23,26701.0,2
HCPCS,45000,Drainage of pelvic abscess,,,1153.83,9206.0,2
HCPCS,45005,Drainage of rectal abscess,,,1153.83,9206.0,2
HCPCS,45020,Drainage of rectal abscess,,,2676.35,9206.0,2
HCPCS,45100,Biopsy of rectum,,,2676.35,9206.0,2
HCPCS,45108,Removal of anorectal lesion,,,2676.35,9206.0,2
HCPCS,45110,Removal of rectum,,,15689.0,15689.0,1
HCPCS,45111,Partial removal of rectum,,,15689.0,15689.0,1
HCPCS,45112,Removal of rectum,,,15689.0,15689.0,1
HCPCS,45113,Partial proctectomy,,,15689.0,15689.0,1
HCPCS,45114,Partial removal of rectum,,,15689.0,15689.0,1
HCPCS,45116,Partial removal of rectum,,,15689.0,15689.0,1
HCPCS,45119,Remove rectum w/reservoir,,,15689.0,15689.0,1
HCPCS,45120,Removal of rectum,,,15689.0,15689.0,1
HCPCS,45121,Removal of rectum and colon,,,15689.0,15689.0,1
HCPCS,45123,Partial proctectomy,,,15689.0,15689.0,1
HCPCS,45126,Pelvic exenteration,,,15689.0,15689.0,1
HCPCS,45130,Excision of rectal prolapse,,,15689.0,15689.0,1
HCPCS,45135,Excision of rectal prolapse,,,15689.0,15689.0,1
HCPCS,45136,Excise ileoanal reservior,,,15689.0,15689.0,1
HCPCS,45150,Excision of rectal stricture,,,1153.83,9206.0,2
HCPCS,45160,Excision of rectal lesion,,,2676.35,9206.0,2
HCPCS,45171,Exc rect tum transanal part,,,2676.35,9206.0,2
HCPCS,45172,Exc rect tum transanal full,,,2676.35,9206.0,2
HCPCS,45190,Destruction rectal tumor,,,2676.35,9206.0,2
HCPCS,45300,Hc Proctosigmoidoscopy Rigid,928.0,603.2,,,0
HCPCS,45300,Proctosigmoidoscopy dx,,,896.69,3714.0,2
HCPCS,45303,Proctosigmoidoscopy dilate,,,1153.83,9206.0,2
HCPCS,45305,Hc Proctosigmoidoscopy W Biopsy,3208.0,2085.2,,,0
HCPCS,45305,Proctosigmoidoscopy w/bx,,,1153.83,9206.0,2
HCPCS,45307,Proctosigmoidoscopy fb,,,2676.35,9206.0,2
HCPCS,45308,Proctosigmoidoscopy removal,,,2676.35,9206.0,2
HCPCS,45309,Proctosigmoidoscopy removal,,,1153.83,9206.0,2
HCPCS,45315,Proctosigmoidoscopy removal,,,1153.83,9206.0,2
HCPCS,45317,Proctosigmoidoscopy bleed,,,1153.83,9206.0,2
HCPCS,45320,Proctosigmoidoscopy ablate,,,2676.35,9206.0,2
HCPCS,45321,Proctosigmoidoscopy volvul,,,2676.35,9206.0,2
HCPCS,45327,Proctosigmoidoscopy W/Stent,,,5853.69,20001.0,2
HCPCS,45330,Diagnostic sigmoidoscopy,,,896.69,3714.0,2
HCPCS,45330,Hc Sigmoidoscopy,3944.0,2563.6,,,0
HCPCS,45331,Hc Sigmoidoscopy W Biopsy,4196.0,2727.4,,,0
HCPCS,45331,Sigmoidoscopy and biopsy,,,896.69,3714.0,2
HCPCS,45332,Hc Sigmoidoscopy W Removal Fb,4460.0,2899.0,,,0
HCPCS,45332,Sigmoidoscopy w/fb removal,,,1153.83,9206.0,2
HCPCS,45333,Hc Sigmoidoscopy W Polypectomy,4815.0,3129.75,,,0
HCPCS,45333,Sigmoidoscopy & polypectomy,,,896.69,3714.0,2
HCPCS,45334,Hc Sigmoidoscopy W Control Bleeding,4637.0,3014.05,,,0
HCPCS,45334,Sigmoidoscopy for bleeding,,,1153.83,9206.0,2
HCPCS,45335,Hc Sigmoidoscopy W Injections,4320.0,2808.0,,,0
HCPCS,45335,Sigmoidoscopy w/submuc inj,,,896.69,3714.0,2
HCPCS,45337,Hc Sigmoidoscopy W Decompression Volvulus,4476.0,2909.4,,,0
HCPCS,45337,Sigmoidoscopy & decompress,,,896.69,9206.0,2
HCPCS,45338,Hc Sigmoidoscopy W Removal Lesion By Snare,4575.0,2973.75,,,0
HCPCS,45338,Sigmoidoscopy w/tumr remove,,,1153.83,9206.0,2
HCPCS,45340,Hc Sigmoidoscopy W Balloon Dilation,4575.0,2973.75,,,0
HCPCS,45340,Sig w/tndsc balloon dilation,,,1153.83,9206.0,2
HCPCS,45341,Hc Sigmoidoscopy W Us Eval,4240.0,2756.0,,,0
HCPCS,45341,Sigmoidoscopy W/Ultrasound,,,896.69,9206.0,2
HCPCS,45342,Hc Sigmoidoscopy W Us Guided Fna,5099.0,3314.35,,,0
HCPCS,45342,Sigmoidoscopy W/Us Guide Bx,,,1153.83,9206.0,2
HCPCS,45346,Hc Sigmoidoscopy Flx Ablation Tumor Or Lesion,5099.0,3314.35,,,0
HCPCS,45346,Sigmoidoscopy w/ablation,,,1153.83,9206.0,2
HCPCS,45347,Hc Sigmoidoscopy Flx W/ Endoscopic Stent Plcmnt,5099.0,3314.35,,,0
HCPCS,45347,Sigmoidoscopy w/plcmt stent,,,5853.69,20001.0,2
HCPCS,45349,Hc Sigmoidoscopy W Mucosal Resection,5099.0,3314.35,,,0
HCPCS,45349,Sigmoidoscopy w/resection,,,2676.35,9206.0,2
HCPCS,45350,Hc Sigmoidoscopy Flx  W/ Band Ligation,4160.0,2704.0,,,0
HCPCS,45350,Sgmdsc w/band ligation,,,1153.83,9206.0,2
HCPCS,45378,Diagnostic colonoscopy,,,896.69,3714.0,2
HCPCS,45378,Hc Colonoscopy,4424.0,2875.6,,,0
HCPCS,45379,Colonoscopy w/fb removal,,,1153.83,9206.0,2
HCPCS,45379,Hc Colonoscopy W Removal Fb,5291.0,3439.15,,,0
HCPCS,45380,Colonoscopy and biopsy,,,1153.83,9206.0,2
HCPCS,45380,Hc Colonoscopy W Biopsy,4921.0,3198.65,,,0
HCPCS,45381,Colonoscopy submucous njx,,,1153.83,9206.0,2
HCPCS,45381,Hc Colonoscopy W Injections,4558.0,2962.7,,,0
HCPCS,45382,Colonoscopy w/control bleed,,,1153.83,9206.0,2
HCPCS,45382,Hc Colonoscopy W Control Bleeding,4633.0,3011.45,,,0
HCPCS,45384,Colonoscopy w/lesion removal,,,1153.83,9206.0,2
HCPCS,45384,Hc Colonoscopy W Rem Lesion Forcep,4692.0,3049.8,,,0
HCPCS,45385,Colonoscopy w/lesion removal,,,1153.83,9206.0,2
HCPCS,45385,Hc Colonoscopy W Polypectomy,5109.0,3320.85,,,0
HCPCS,45386,Colonoscopy w/balloon dilat,,,1153.83,9206.0,2
HCPCS,45386,Hc Colonoscopy W Balloon Dilation,5063.0,3290.95,,,0
HCPCS,45388,Colonoscopy w/ablation,,,1153.83,9206.0,2
HCPCS,45388,Hc Colonoscopy Flx Ablation Tumor Or Lesion,4660.0,3029.0,,,0
HCPCS,45389,Colonoscopy w/stent plcmt,,,5853.69,20001.0,2
HCPCS,45389,Hc Colonoscopy Flx W Encoscopic Stent Plcmnt,5291.0,3439.15,,,0
HCPCS,45390,Colonoscopy w/resection,,,2676.35,9206.0,2
HCPCS,45390,Hc Colonoscopy W Mucosal Resection,5291.0,3439.15,,,0
HCPCS,45391,Colonoscopy w/endoscope us,,,1153.83,9206.0,2
HCPCS,45391,Hc Colonoscopy W Endoscope Us,4558.0,2962.7,,,0
HCPCS,45392,Colonoscopy w/endoscopic fnb,,,1153.83,9206.0,2
HCPCS,45393,Colonoscopy w/decompression,,,1153.83,9206.0,2
HCPCS,45393,Hc Colonoscopy Flx W Decompression,5109.0,3320.85,,,0
HCPCS,45395,Lap removal of rectum,,,15689.0,15689.0,1
HCPCS,45397,Lap remove rectum w/pouch,,,15689.0,15689.0,1
HCPCS,45398,Colonoscopy w/band ligation,,,1153.83,9206.0,2
HCPCS,45398,Hc Colonoscopy Flx  W Band Ligation,4692.0,3049.8,,,0
HCPCS,45399,Hc Unlisted Procedure Colon,1903.0,1236.95,,,0
HCPCS,45399,Unlisted procedure colon,,,896.69,16564.0,2
HCPCS,45400,Laparoscopic proc,,,15689.0,15689.0,1
HCPCS,45402,Lap proctopexy w/sig resect,,,15689.0,15689.0,1
HCPCS,45499,Laparoscope proc rectum,,,5829.23,16564.0,2
HCPCS,45500,Repair of rectum,,,2676.35,9206.0,2
HCPCS,45505,Repair of rectum,,,2676.35,9206.0,2
HCPCS,45520,Treatment of rectal prolapse,,,896.69,3714.0,2
HCPCS,45540,Correct rectal prolapse,,,15689.0,15689.0,1
HCPCS,45541,Correct rectal prolapse,,,2676.35,9206.0,2
HCPCS,45550,Repair rectum/remove sigmoid,,,15689.0,15689.0,1
HCPCS,45560,Repair of rectocele,,,2676.35,9206.0,2
HCPCS,45562,Exploration/repair of rectum,,,15689.0,15689.0,1
HCPCS,45563,Exploration/repair of rectum,,,15689.0,15689.0,1
HCPCS,45800,Repair rect/bladder fistula,,,15689.0,15689.0,1
HCPCS,45805,Repair fistula w/colostomy,,,15689.0,15689.0,1
HCPCS,45820,Repair rectourethral fistula,,,15689.0,15689.0,1
HCPCS,45825,Repair fistula w/colostomy,,,15689.0,15689.0,1
HCPCS,45900,Reduction of rectal prolapse,,,896.69,3714.0,2
HCPCS,45905,Dilation of anal sphincter,,,1153.83,9206.0,2
HCPCS,45910,Dilation of rectal narrowing,,,1153.83,9206.0,2
HCPCS,45915,Remove rectal obstruction,,,1153.83,9206.0,2
HCPCS,45990,Surg dx exam anorectal,,,2676.35,9206.0,2
HCPCS,45999,Rectum surgery procedure,,,896.69,16564.0,2
HCPCS,46020,Placement of seton,,,2676.35,9206.0,2
HCPCS,46030,Removal of rectal marker,,,1153.83,9206.0,2
HCPCS,46040,Hc I&D Ischrec Perirec Abcess,3200.0,2080.0,,,0
HCPCS,46040,Incision of rectal abscess,,,1153.83,9206.0,2
HCPCS,46045,Incision of rectal abscess,,,2676.35,9206.0,2
HCPCS,46050,Hc I And D Perianal Abscess,1387.0,901.55,,,0
HCPCS,46050,Incision of anal abscess,,,896.69,3714.0,2
HCPCS,46060,Incision of rectal abscess,,,2676.35,9206.0,2
HCPCS,46070,Incision of anal septum,,,2676.35,9206.0,2
HCPCS,46080,Incision of anal sphincter,,,2676.35,9206.0,2
HCPCS,46083,Hc Incision External Hemorrhoid,1350.0,877.5,,,0
HCPCS,46083,Incise external hemorrhoid,,,240.91,3714.0,2
HCPCS,46200,Removal of anal fissure,,,2676.35,9206.0,2
HCPCS,46220,Excise anal ext tag/papilla,,,1153.83,9206.0,2
HCPCS,46221,Hc Hemorrhoidectomy Simple Ligature,6583.0,4278.95,,,0
HCPCS,46221,Ligation of hemorrhoid(s),,,896.69,3714.0,2
HCPCS,46230,Removal of anal tags,,,2676.35,9206.0,2
HCPCS,46250,Remove ext hem groups 2+,,,2676.35,9206.0,2
HCPCS,46255,Remove int/ext hem 1 group,,,2676.35,9206.0,2
HCPCS,46257,Remove in/ex hem grp & fiss,,,2676.35,9206.0,2
HCPCS,46258,Remove in/ex hem grp w/fistu,,,2676.35,9206.0,2
HCPCS,46260,Remove in/ex hem groups 2+,,,2676.35,9206.0,2
HCPCS,46261,Remove in/ex hem grps & fiss,,,2676.35,9206.0,2
HCPCS,46262,Remove in/ex hem grps w/fist,,,2676.35,9206.0,2
HCPCS,46270,Hc Surg Tx Anal Fistula Subq,5600.0,3640.0,,,0
HCPCS,46270,Remove anal fist subq,,,2676.35,9206.0,2
HCPCS,46275,Remove anal fist inter,,,2676.35,9206.0,2
HCPCS,46280,Remove anal fist complex,,,2676.35,9206.0,2
HCPCS,46285,Remove anal fist 2 stage,,,2676.35,9206.0,2
HCPCS,46288,Repair anal fistula,,,2676.35,9206.0,2
HCPCS,46320,Hc Enuc Excsn Ext Thrm Hemorrd,5506.0,3578.9,,,0
HCPCS,46320,Removal of hemorrhoid clot,,,1153.83,9206.0,2
HCPCS,46500,Injection into hemorrhoid(s),,,896.69,3714.0,2
HCPCS,46505,Chemodenervation anal musc,,,1153.83,9206.0,2
HCPCS,46600,Diagnostic anoscopy spx,,,128.29,3714.0,2
HCPCS,46600,Hc Anoscopy,472.0,306.8,,,0
HCPCS,46601,Diagnostic anoscopy,,,430.74,3714.0,2
HCPCS,46604,Anoscopy and dilation,,,1153.83,9206.0,2
HCPCS,46606,Anoscopy and biopsy,,,1153.83,9206.0,2
HCPCS,46607,Diagnostic anoscopy & biopsy,,,1153.83,9206.0,2
HCPCS,46608,Anoscopy remove for body,,,896.69,3714.0,2
HCPCS,46610,Anoscopy remove lesion,,,2676.35,9206.0,2
HCPCS,46611,Anoscopy,,,896.69,3714.0,2
HCPCS,46612,Anoscopy remove lesions,,,2676.35,9206.0,2
HCPCS,46614,Anoscopy control bleeding,,,1153.83,9206.0,2
HCPCS,46614,Hc Anoscopy W Control Bleeding,5720.0,3718.0,,,0
HCPCS,46615,Anoscopy,,,2676.35,9206.0,2
HCPCS,46700,Repair of anal stricture,,,2676.35,9206.0,2
HCPCS,46705,Repair of anal stricture,,,15689.0,15689.0,1
HCPCS,46706,Repr of anal fistula w/glue,,,2676.35,9206.0,2
HCPCS,46707,Repair anorectal fist w/plug,,,2676.35,9206.0,2
HCPCS,46710,Repr per/vag pouch sngl proc,,,15689.0,15689.0,1
HCPCS,46712,Repr per/vag pouch dbl proc,,,15689.0,15689.0,1
HCPCS,46715,Rep perf anoper fistu,,,15689.0,15689.0,1
HCPCS,46716,Rep perf anoper/vestib fistu,,,15689.0,15689.0,1
HCPCS,46730,Construction of absent anus,,,15689.0,15689.0,1
HCPCS,46735,Construction of absent anus,,,15689.0,15689.0,1
HCPCS,46740,Construction of absent anus,,,15689.0,15689.0,1
HCPCS,46742,Repair of imperforated anus,,,15689.0,15689.0,1
HCPCS,46744,Repair of cloacal anomaly,,,15689.0,15689.0,1
HCPCS,46746,Repair of cloacal anomaly,,,15689.0,15689.0,1
HCPCS,46748,Repair of cloacal anomaly,,,15689.0,15689.0,1
HCPCS,46750,Repair of anal sphincter,,,2676.35,9206.0,2
HCPCS,46751,Repair of anal sphincter,,,15689.0,15689.0,1
HCPCS,46753,Reconstruction of anus,,,2676.35,9206.0,2
HCPCS,46754,Removal of suture from anus,,,2676.35,9206.0,2
HCPCS,46760,Repair of anal sphincter,,,2676.35,9206.0,2
HCPCS,46761,Repair of anal sphincter,,,2676.35,9206.0,2
HCPCS,46900,Destruction anal lesion(s),,,391.97,3714.0,2
HCPCS,46910,Destruction anal lesion(s),,,1989.46,9206.0,2
HCPCS,46916,Cryosurgery anal lesion(s),,,193.46,3714.0,2
HCPCS,46917,Laser surgery anal lesions,,,2676.35,9206.0,2
HCPCS,46922,Excision of anal lesion(s),,,2676.35,9206.0,2
HCPCS,46924,Destruction anal lesion(s),,,2676.35,9206.0,2
HCPCS,46930,Destroy internal hemorrhoids,,,1153.83,9206.0,2
HCPCS,46930,Hc Dest. Internal Hemorrhoid With Thermal Energy,8582.0,5578.3,,,0
HCPCS,46940,Treatment of anal fissure,,,2676.35,9206.0,2
HCPCS,46942,Treatment of anal fissure,,,896.69,3714.0,2
HCPCS,46945,Remove by ligat int hem grp,,,2676.35,9206.0,2
HCPCS,46946,Remove by ligat int hem grps,,,2676.35,9206.0,2
HCPCS,46947,Hemorrhoidopexy by stapling,,,2676.35,9206.0,2
HCPCS,46948,Int hrhc tranal dartlzj 2+,,,2676.35,9206.0,2
HCPCS,46999,Anus surgery procedure,,,896.69,16564.0,2
HCPCS,46999,Hc Unlisted Procedure Anus,4832.0,3140.8,,,0
HCPCS,47000,Hc Biopsy Liver Needle,6197.0,4028.05,,,0
HCPCS,47000,Needle biopsy of liver,,,1592.51,9206.0,2
HCPCS,47001,Hc Biopsy Liver W Other Procedure,1853.0,1204.45,,,0
HCPCS,47010,Open drainage liver lesion,,,9206.0,9206.0,1
HCPCS,47015,Inject/aspirate liver cyst,,,9206.0,9206.0,1
HCPCS,47100,Wedge biopsy of liver,,,9206.0,9206.0,1
HCPCS,47120,Partial removal of liver,,,15689.0,15689.0,1
HCPCS,47122,Extensive removal of liver,,,15689.0,15689.0,1
HCPCS,47125,Partial removal of liver,,,15689.0,15689.0,1
HCPCS,47130,Partial removal of liver,,,15689.0,15689.0,1
HCPCS,47133,Removal of donor liver,,,15689.0,15689.0,1
HCPCS,47135,Transplantation of liver,,,63079.0,63079.0,1
HCPCS,47140,Partial removal donor liver,,,15689.0,15689.0,1
HCPCS,47141,Partial removal donor liver,,,15689.0,15689.0,1
HCPCS,47142,Partial removal donor liver,,,15689.0,15689.0,1
HCPCS,47143,Prep donor liver whole,,,15689.0,15689.0,1
HCPCS,47144,Prep donor liver 3-segment,,,15689.0,15689.0,1
HCPCS,47145,Prep donor liver lobe split,,,15689.0,15689.0,1
HCPCS,47146,Prep donor liver/venous,,,15689.0,15689.0,1
HCPCS,47147,Prep donor liver/arterial,,,15689.0,15689.0,1
HCPCS,47300,Surgery for liver lesion,,,15689.0,15689.0,1
HCPCS,47350,Repair liver wound,,,15689.0,15689.0,1
HCPCS,47360,Repair liver wound,,,15689.0,15689.0,1
HCPCS,47361,Repair liver wound,,,15689.0,15689.0,1
HCPCS,47362,Repair liver wound,,,15689.0,15689.0,1
HCPCS,47370,Laparo ablate liver tumor rf,,,10249.52,38216.0,2
HCPCS,47371,Laparo ablate liver cryosurg,,,10249.52,38216.0,2
HCPCS,47379,Laparoscope procedure liver,,,5829.23,26701.0,2
HCPCS,47380,Open ablate liver tumor rf,,,15689.0,15689.0,1
HCPCS,47381,Open ablate liver tumor cryo,,,15689.0,15689.0,1
HCPCS,47382,Hc Rf Ablation Liver Percutaneous,16832.0,10940.8,,,0
HCPCS,47382,Percut ablate liver rf,,,5829.23,26701.0,2
HCPCS,47383,Hc Cryoablation Liver Tumor,10856.0,7056.4,,,0
HCPCS,47383,Perq abltj lvr cryoablation,,,10249.52,26701.0,2
HCPCS,47384,Abltj ire liver 1+ tum perq,,,10249.52,10249.52,1
HCPCS,47399,Liver surgery procedure,,,682.8,16564.0,2
HCPCS,47400,Incision of liver duct,,,15689.0,15689.0,1
HCPCS,47420,Incision of bile duct,,,15689.0,15689.0,1
HCPCS,47425,Incision of bile duct,,,15689.0,15689.0,1
HCPCS,47460,Incise bile duct sphincter,,,15689.0,15689.0,1
HCPCS,47480,Incision of gallbladder,,,15689.0,15689.0,1
HCPCS,47490,Hc Cholecystostomy W Img And Cath Plcmnt Perc,10337.0,6719.05,,,0
HCPCS,47490,Incision of gallbladder,,,3452.3,15689.0,2
HCPCS,47531,Hc Injection For Dx Cholangiogram W Img Existing Access,10086.0,6555.9,,,0
HCPCS,47531,Injection for cholangiogram,,,3452.3,15689.0,2
HCPCS,47532,Hc Injection For Dx Cholangiogram W Img New Access,14548.0,9456.2,,,0
HCPCS,47532,Injection for cholangiogram,,,3452.3,15689.0,2
HCPCS,47533,Hc Place Biliary Drain Catheter W Img External,23822.0,15484.3,,,0
HCPCS,47533,Plmt biliary drainage cath,,,3452.3,15689.0,2
HCPCS,47534,Hc Place Biliary Drain Catheter W Img Internal-External,25013.0,16258.45,,,0
HCPCS,47534,Plmt biliary drainage cath,,,3452.3,15689.0,2
HCPCS,47535,Conversion ext bil drg cath,,,3452.3,15689.0,2
HCPCS,47535,Hc Convert Biliary Drain To Internal-External W Img,17406.0,11313.9,,,0
HCPCS,47536,Exchange biliary drg cath,,,3452.3,15689.0,2
HCPCS,47536,Hc Exchange Biliary Drain Catheter W Img,14504.0,9427.6,,,0
HCPCS,47537,Hc Remove Biliary Drain Catheter W Fluoro,2068.0,1344.2,,,0
HCPCS,47537,Removal biliary drg cath,,,874.53,3714.0,2
HCPCS,47538,Hc Place Stent Bile Duct W Img Via Existing Access Each,27790.0,18063.5,,,0
HCPCS,47538,Perq plmt bile duct stent,,,5829.23,26701.0,2
HCPCS,47539,Hc Place Stent Bile Duct W Img Via New Acc Wo Separate Bdc,31885.0,20725.25,,,0
HCPCS,47539,Perq plmt bile duct stent,,,5829.23,26701.0,2
HCPCS,47540,Hc Place Stent Bile Duct W Img Via New Acc W Separate Bdc,33348.0,21676.2,,,0
HCPCS,47540,Perq plmt bile duct stent,,,5829.23,26701.0,2
HCPCS,47541,Hc Place Access Thru Biliary Tree/ Small Int W Img Via New Acc,35670.0,23185.5,,,0
HCPCS,47541,Plmt access bil tree sm bwl,,,6242.2,15689.0,2
HCPCS,47542,Hc Balloon Dilation Biliary Duct Or Ampulla W Img Each Duct,13895.0,9031.75,,,0
HCPCS,47543,Hc Endoluminal Bx Biliary Tree W Img Single Or Mult Add On,11312.0,7352.8,,,0
HCPCS,47544,Hc Remove Calculi Or Debris From Biliary Duct Or Gallbladder,11312.0,7352.8,,,0
HCPCS,47550,Bile duct endoscopy add-on,,,15689.0,15689.0,1
HCPCS,47552,Biliary endo perq dx w/speci,,,6242.2,15689.0,2
HCPCS,47553,Biliary endoscopy thru skin,,,6242.2,15689.0,2
HCPCS,47553,Hc Biliary Endo Perc With Biopsy,6540.0,4251.0,,,0
HCPCS,47554,Biliary endoscopy thru skin,,,10249.52,26701.0,2
HCPCS,47554,Hc Biliary Endo Perc With Calculus Removal,9920.0,6448.0,,,0
HCPCS,47555,Biliary endoscopy thru skin,,,6242.2,15689.0,2
HCPCS,47556,Biliary endoscopy thru skin,,,10249.52,26701.0,2
HCPCS,47562,Laparoscopic cholecystectomy,,,5829.23,26701.0,2
HCPCS,47563,Laparo cholecystectomy/graph,,,5829.23,26701.0,2
HCPCS,47564,Laparo cholecystectomy/explr,,,10249.52,26701.0,2
HCPCS,47570,Laparo cholecystoenterostomy,,,26701.0,26701.0,1
HCPCS,47579,Laparoscope proc biliary,,,5829.23,26701.0,2
HCPCS,47600,Removal of gallbladder,,,15689.0,15689.0,1
HCPCS,47605,Removal of gallbladder,,,15689.0,15689.0,1
HCPCS,47610,Removal of gallbladder,,,15689.0,15689.0,1
HCPCS,47612,Removal of gallbladder,,,15689.0,15689.0,1
HCPCS,47620,Removal of gallbladder,,,15689.0,15689.0,1
HCPCS,47700,Exploration of bile ducts,,,15689.0,15689.0,1
HCPCS,47701,Bile duct revision,,,15689.0,15689.0,1
HCPCS,47711,Excision of bile duct tumor,,,15689.0,15689.0,1
HCPCS,47712,Excision of bile duct tumor,,,15689.0,15689.0,1
HCPCS,47715,Excision of bile duct cyst,,,15689.0,15689.0,1
HCPCS,47720,Fuse gallbladder & bowel,,,15689.0,15689.0,1
HCPCS,47721,Fuse upper gi structures,,,15689.0,15689.0,1
HCPCS,47740,Fuse gallbladder & bowel,,,15689.0,15689.0,1
HCPCS,47741,Fuse gallbladder & bowel,,,15689.0,15689.0,1
HCPCS,47760,Fuse bile ducts and bowel,,,15689.0,15689.0,1
HCPCS,47765,Fuse liver ducts & bowel,,,15689.0,15689.0,1
HCPCS,47780,Fuse bile ducts and bowel,,,15689.0,15689.0,1
HCPCS,47785,Fuse bile ducts and bowel,,,15689.0,15689.0,1
HCPCS,47800,Reconstruction of bile ducts,,,15689.0,15689.0,1
HCPCS,47801,Placement bile duct support,,,15689.0,15689.0,1
HCPCS,47802,Fuse liver duct & intestine,,,15689.0,15689.0,1
HCPCS,47900,Suture bile duct injury,,,15689.0,15689.0,1
HCPCS,47999,Bile tract surgery procedure,,,874.53,16564.0,2
HCPCS,47999,Hc Unlisted Procedure Biliary Tract,5804.0,3772.6,,,0
HCPCS,48000,Drainage of abdomen,,,15689.0,15689.0,1
HCPCS,48001,Placement of drain pancreas,,,15689.0,15689.0,1
HCPCS,48020,Removal of pancreatic stone,,,15689.0,15689.0,1
HCPCS,48100,Biopsy of pancreas open,,,15689.0,15689.0,1
HCPCS,48102,Hc Biopsy Pancreas Perc Needle,4904.0,3187.6,,,0
HCPCS,48102,Needle biopsy pancreas,,,1592.51,9206.0,2
HCPCS,48105,Resect/Debride Pancreas,,,15689.0,15689.0,1
HCPCS,48120,Removal of pancreas lesion,,,15689.0,15689.0,1
HCPCS,48140,Partial removal of pancreas,,,15689.0,15689.0,1
HCPCS,48145,Partial removal of pancreas,,,15689.0,15689.0,1
HCPCS,48146,Pancreatectomy,,,15689.0,15689.0,1
HCPCS,48148,Removal of pancreatic duct,,,15689.0,15689.0,1
HCPCS,48150,Partial removal of pancreas,,,15689.0,15689.0,1
HCPCS,48152,Pancreatectomy,,,15689.0,15689.0,1
HCPCS,48153,Pancreatectomy,,,15689.0,15689.0,1
HCPCS,48154,Pancreatectomy,,,15689.0,15689.0,1
HCPCS,48155,Removal of pancreas,,,15689.0,15689.0,1
HCPCS,48160,Pancreas removal/transplant,,,15689.0,15689.0,1
HCPCS,48400,Injection intraop add-on,,,3714.0,3714.0,1
HCPCS,48500,Surgery of pancreatic cyst,,,15689.0,15689.0,1
HCPCS,48510,Drain pancreatic pseudocyst,,,15689.0,15689.0,1
HCPCS,48520,Fuse pancreas cyst and bowel,,,15689.0,15689.0,1
HCPCS,48540,Fuse pancreas cyst and bowel,,,15689.0,15689.0,1
HCPCS,48545,Pancreatorrhaphy,,,15689.0,15689.0,1
HCPCS,48547,Duodenal exclusion,,,15689.0,15689.0,1
HCPCS,48548,Fuse Pancreas and Bowel,,,15689.0,15689.0,1
HCPCS,48550,Donor pancreatectomy,,,15689.0,15689.0,1
HCPCS,48551,Prep donor pancreas,,,15689.0,15689.0,1
HCPCS,48552,Prep donor pancreas/venous,,,15689.0,15689.0,1
HCPCS,48554,Transpl allograft pancreas,,,63079.0,63079.0,1
HCPCS,48556,Removal allograft pancreas,,,15689.0,15689.0,1
HCPCS,48999,Hc Unlisted Procedure Pancreas,5804.0,3772.6,,,0
HCPCS,48999,Pancreas surgery procedure,,,682.8,16564.0,2
HCPCS,49000,Exploration of abdomen,,,15689.0,15689.0,1
HCPCS,49002,Reopening of abdomen,,,15689.0,15689.0,1
HCPCS,49010,Exploration behind abdomen,,,6242.2,15689.0,2
HCPCS,49013,Prpertl pel pack hemrrg trma,,,15689.0,15689.0,1
HCPCS,49014,Reexploration pelvic wound,,,15689.0,15689.0,1
HCPCS,49020,Drainage abdom abscess open,,,15689.0,15689.0,1
HCPCS,49040,Drain open abdom abscess,,,15689.0,15689.0,1
HCPCS,49060,Drain open retroperi abscess,,,15689.0,15689.0,1
HCPCS,49062,Drain to peritoneal cavity,,,15689.0,15689.0,1
HCPCS,49082,Abd paracentesis,,,874.53,3714.0,2
HCPCS,49082,Hc Abdominal Paracentesis Wo Img,4465.0,2902.25,,,0
HCPCS,49083,Abd paracentesis w/imaging,,,874.53,3714.0,2
HCPCS,49083,Hc Abdominal Paracentesis W Img,5183.0,3368.95,,,0
HCPCS,49084,Hc Peritoneal Lavage,2266.0,1472.9,,,0
HCPCS,49084,Peritoneal lavage,,,874.53,3714.0,2
HCPCS,49180,Biopsy abdominal mass,,,1592.51,9206.0,2
HCPCS,49180,Hc Biopsy Abd Or Retroperitoneal Needle Perc,7513.0,4883.45,,,0
HCPCS,49185,Hc Sclerotherapy For Fluid Collection W Img,9650.0,6272.5,,,0
HCPCS,49185,Sclerotx fluid collection,,,1592.51,3714.0,2
HCPCS,49186,Opn exc/dstr ntra-abd 5 cm/<,,,15689.0,15689.0,1
HCPCS,49187,Opn exc/dstr ntra-abd 5.1-10,,,15689.0,15689.0,1
HCPCS,49188,Opn exc/dst ntra-abd 10.1-20,,,15689.0,15689.0,1
HCPCS,49189,Opn exc/dst ntra-abd 20.1-30,,,15689.0,15689.0,1
HCPCS,49190,Opn exc/dstr ntra-abd >30 cm,,,15689.0,15689.0,1
HCPCS,49203,Exc abd tum 5 cm or less,,,15689.0,15689.0,1
HCPCS,49204,Exc abd tum over 5 cm,,,15689.0,15689.0,1
HCPCS,49205,Exc abd tum over 10 cm,,,15689.0,15689.0,1
HCPCS,49215,Excise sacral spine tumor,,,15689.0,15689.0,1
HCPCS,49250,Excision of umbilicus,,,3452.3,15689.0,2
HCPCS,49255,Removal of omentum,,,6242.2,15689.0,2
HCPCS,49320,Diag laparo separate proc,,,5829.23,26701.0,2
HCPCS,49321,Laparoscopy biopsy,,,5829.23,26701.0,2
HCPCS,49322,Laparoscopy aspiration,,,5829.23,26701.0,2
HCPCS,49323,Laparo drain lymphocele,,,5829.23,26701.0,2
HCPCS,49324,Lap insert tunnel ip cath,,,5829.23,26701.0,2
HCPCS,49325,Lap Revision Perm IP Cath,,,5829.23,26701.0,2
HCPCS,49329,Laparo proc abdm/per/oment,,,5829.23,26701.0,2
HCPCS,49400,Hc Injection Air Or Contrast Peritoneal Cavity,7728.0,5023.2,,,0
HCPCS,49402,Remove foreign body adbomen,,,3452.3,15689.0,2
HCPCS,49405,Hc Img Guide Fluid Coll Drng By Cath Visceral Perc,13425.0,8726.25,,,0
HCPCS,49405,Image cath fluid colxn visc,,,1592.51,9206.0,2
HCPCS,49406,Hc Img Guide Fluid Coll Drng By Cath Peri Or Retro Perc,13066.0,8492.9,,,0
HCPCS,49406,Image cath fluid peri/retro,,,1592.51,9206.0,2
HCPCS,49407,Hc Img Guide Fluid Coll Drng By Cath Transvag Or Rec Perc,13760.0,8944.0,,,0
HCPCS,49407,Image cath fluid trns/vgnl,,,1592.51,9206.0,2
HCPCS,49411,Hc Plcmnt Fiducial Dev Rt Guid Abd Pelvis Retro,2065.0,1342.25,,,0
HCPCS,49411,Ins mark abd/pel for rt perq,,,1334.61,9206.0,2
HCPCS,49412,Ins device for rt guide open,,,15689.0,15689.0,1
HCPCS,49418,Hc Insert Tunneled Intraperitoneal Cath W Img,16118.0,10476.7,,,0
HCPCS,49418,Insert tun ip cath perc,,,3452.3,15689.0,2
HCPCS,49419,Hc Insert Tunneled Intraperitoneal Cath Subq Port,15001.0,9750.65,,,0
HCPCS,49419,Insert tun ip cath w/port,,,5365.4,20001.0,2
HCPCS,49421,Hc Insert Tunneled Intraperitoneal Cath Open,16118.0,10476.7,,,0
HCPCS,49421,Ins tun ip cath for dial opn,,,3452.3,15689.0,2
HCPCS,49422,Hc Remove Tunneled Intraperitoneal Cath,7368.0,4789.2,,,0
HCPCS,49422,Remove tunneled ip cath,,,3044.51,15689.0,2
HCPCS,49423,Exchange drainage catheter,,,1850.25,9206.0,2
HCPCS,49423,Hc Drainage Catheter Exchange W Img,3068.0,1994.2,,,0
HCPCS,49424,Hc Inject Contrast Abscess Or Cyst,960.0,624.0,,,0
HCPCS,49425,Hc Insert Peritoneal-Venous Shunt,7681.0,4992.65,,,0
HCPCS,49425,Insert abdomen-venous drain,,,15689.0,15689.0,1
HCPCS,49426,Revise abdomen-venous shunt,,,3452.3,15689.0,2
HCPCS,49427,Hc Inject Contrast Shuntogram,5606.0,3643.9,,,0
HCPCS,49428,Ligation of shunt,,,15689.0,15689.0,1
HCPCS,49429,Removal of shunt,,,3044.51,15689.0,2
HCPCS,49436,Embedded IP Cath Exit-Site,,,1850.25,9206.0,2
HCPCS,49440,Hc Place G Tube Percutaneous W Fluoro,10099.0,6564.35,,,0
HCPCS,49440,Place gastrostomy tube perc,,,1850.25,9206.0,2
HCPCS,49441,Hc Place J Tube Percutaneous W Fluoro,10099.0,6564.35,,,0
HCPCS,49441,Place duod/jej tube perc,,,1850.25,9206.0,2
HCPCS,49442,Hc Place Cecostomy Percutaneous W Fluoro,14543.0,9452.95,,,0
HCPCS,49442,Place cecostomy tube perc,,,1153.83,9206.0,2
HCPCS,49446,Change g-tube to g-j perc,,,1850.25,9206.0,2
HCPCS,49446,Hc Convert G To Gj Tube W Fluoro,9959.0,6473.35,,,0
HCPCS,49450,Hc Replace G Tube W Fluoro,6732.0,4375.8,,,0
HCPCS,49450,Replace g/c tube perc,,,874.53,3714.0,2
HCPCS,49451,Hc Replace J Tube W Fluoro,8078.0,5250.7,,,0
HCPCS,49451,Replace duod/jej tube perc,,,874.53,3714.0,2
HCPCS,49452,Hc Replace G J Tube W Fluoro,8078.0,5250.7,,,0
HCPCS,49452,Replace g-j tube perc,,,874.53,3714.0,2
HCPCS,49460,Fix g/colon tube w/device,,,874.53,3714.0,2
HCPCS,49460,Hc Obstructive Material Removal From Gi Tube,14455.0,9395.75,,,0
HCPCS,49465,Fluoro exam of g/colon tube,,,230.07,3714.0,2
HCPCS,49465,Hc Inject Contrast Existing G Tube,7087.0,4606.55,,,0
HCPCS,49491,Rpr hern preemie reduc,,,5829.23,26701.0,2
HCPCS,49492,Rpr ing hern premie blocked,,,3452.3,15689.0,2
HCPCS,49495,Rpr ing hernia baby reduc,,,3452.3,15689.0,2
HCPCS,49496,Rpr ing hernia baby blocked,,,3452.3,15689.0,2
HCPCS,49500,Rpr ing hernia init reduce,,,6242.2,15689.0,2
HCPCS,49501,Rpr ing hernia init blocked,,,3452.3,15689.0,2
HCPCS,49505,Prp i/hern init reduc >5 yr,,,3452.3,15689.0,2
HCPCS,49507,Prp i/hern init block >5 yr,,,3452.3,15689.0,2
HCPCS,49520,Hc Repair Recurrent Inguinal Hernia,8723.0,5669.95,,,0
HCPCS,49520,Rerepair ing hernia reduce,,,3452.3,15689.0,2
HCPCS,49521,Rerepair ing hernia blocked,,,6242.2,15689.0,2
HCPCS,49525,Repair ing hernia sliding,,,3452.3,15689.0,2
HCPCS,49540,Repair lumbar hernia,,,5829.23,26701.0,2
HCPCS,49550,Rpr rem hernia init reduce,,,3452.3,15689.0,2
HCPCS,49553,Rpr fem hernia init blocked,,,3452.3,15689.0,2
HCPCS,49555,Rerepair fem hernia reduce,,,3452.3,15689.0,2
HCPCS,49557,Rerepair fem hernia blocked,,,3452.3,15689.0,2
HCPCS,49591,Rpr aa hrn 1st < 3 cm rdc,,,3452.3,15689.0,2
HCPCS,49592,Rpr aa hrn 1st < 3 ncr/strn,,,5829.23,26701.0,2
HCPCS,49593,Rpr aa hrn 1st 3-10 rdc,,,6242.2,15689.0,2
HCPCS,49594,Rpr aa hrn 1st 3-10 ncr/strn,,,5829.23,26701.0,2
HCPCS,49595,Rpr aa hrn 1st > 10 rdc,,,6242.2,15689.0,2
HCPCS,49596,Rpr aa hrn 1st > 10 ncr/strn,,,15689.0,15689.0,1
HCPCS,49600,Repair umbilical lesion,,,3452.3,15689.0,2
HCPCS,49605,Repair umbilical lesion,,,15689.0,15689.0,1
HCPCS,49606,Repair umbilical lesion,,,15689.0,15689.0,1
HCPCS,49610,Repair umbilical lesion,,,15689.0,15689.0,1
HCPCS,49611,Repair umbilical lesion,,,15689.0,15689.0,1
HCPCS,49613,Rpr aa hrn rcr < 3 rdc,,,3452.3,15689.0,2
HCPCS,49614,Rpr aa hrn rcr < 3 ncr/strn,,,5829.23,26701.0,2
HCPCS,49615,Rpr aa hrn rcr 3-10 rdc,,,6242.2,15689.0,2
HCPCS,49616,Rpr aa hrn rcr 3-10 ncr/strn,,,26701.0,26701.0,1
HCPCS,49617,Rpr aa hrn rcr > 10 rdc,,,26701.0,26701.0,1
HCPCS,49618,Rpr aa hrn rcr > 10 ncr/strn,,,26701.0,26701.0,1
HCPCS,49621,Rpr parastomal hernia rdc,,,15689.0,15689.0,1
HCPCS,49622,Rpr parastomal hrna ncr/strn,,,15689.0,15689.0,1
HCPCS,49650,Lap ing hernia repair init,,,5829.23,26701.0,2
HCPCS,49651,Lap ing hernia repair recur,,,5829.23,26701.0,2
HCPCS,49659,Laparo proc hernia repair,,,5829.23,26701.0,2
HCPCS,49900,Repair of abdominal wall,,,15689.0,15689.0,1
HCPCS,49904,Omental flap extra-abdom,,,15689.0,15689.0,1
HCPCS,49905,Omental flap intra-abdom,,,15689.0,15689.0,1
HCPCS,49906,Free omental flap microvasc,,,15689.0,15689.0,1
HCPCS,49999,Abdomen surgery procedure,,,874.53,16564.0,2
HCPCS,49999,Hc Unlisted Procedure Abd Peritoneum Omentum,8094.0,5261.1,,,0
HCPCS,50010,Exploration of kidney,,,20001.0,20001.0,1
HCPCS,50020,Renal abscess open drain,,,2015.59,9206.0,2
HCPCS,50040,Drainage of kidney,,,20001.0,20001.0,1
HCPCS,50045,Exploration of kidney,,,20001.0,20001.0,1
HCPCS,50060,Removal of kidney stone,,,20001.0,20001.0,1
HCPCS,50065,Incision of kidney,,,20001.0,20001.0,1
HCPCS,50070,Incision of kidney,,,20001.0,20001.0,1
HCPCS,50075,Removal of kidney stone,,,20001.0,20001.0,1
HCPCS,50080,Hc Nephrostolithotomy Up To 2Cm,19822.5,12884.625,,,0
HCPCS,50080,Removal of kidney stone,,,9127.77,38216.0,2
HCPCS,50081,Removal of kidney stone,,,9127.77,38216.0,2
HCPCS,50100,Revise kidney blood vessels,,,20001.0,20001.0,1
HCPCS,50120,Exploration of kidney,,,20001.0,20001.0,1
HCPCS,50125,Explore and drain kidney,,,20001.0,20001.0,1
HCPCS,50130,Removal of kidney stone,,,20001.0,20001.0,1
HCPCS,50135,Exploration of kidney,,,20001.0,20001.0,1
HCPCS,50200,Hc Biopsy Renal Percutaneous Needle,9637.5,6264.375,,,0
HCPCS,50200,Renal biopsy perq,,,1592.51,9206.0,2
HCPCS,50205,Renal biopsy open,,,20001.0,20001.0,1
HCPCS,50220,Remove kidney open,,,20001.0,20001.0,1
HCPCS,50225,Removal kidney open complex,,,20001.0,20001.0,1
HCPCS,50230,Removal kidney open radical,,,20001.0,20001.0,1
HCPCS,50234,Removal of kidney & ureter,,,20001.0,20001.0,1
HCPCS,50236,Removal of kidney & ureter,,,20001.0,20001.0,1
HCPCS,50240,Partial removal of kidney,,,20001.0,20001.0,1
HCPCS,50250,Cryoablate renal mass open,,,20001.0,20001.0,1
HCPCS,50280,Removal of kidney lesion,,,20001.0,20001.0,1
HCPCS,50290,Removal of kidney lesion,,,20001.0,20001.0,1
HCPCS,50300,Remove cadaver donor kidney,,,20001.0,20001.0,1
HCPCS,50320,Remove kidney living donor,,,15689.0,15689.0,1
HCPCS,50323,Prep cadaver renal allograft,,,15689.0,15689.0,1
HCPCS,50325,Prep donor renal graft,,,15689.0,15689.0,1
HCPCS,50327,Prep renal graft/venous,,,15689.0,15689.0,1
HCPCS,50328,Prep renal graft/arterial,,,15689.0,15689.0,1
HCPCS,50329,Prep renal graft/ureteral,,,15689.0,15689.0,1
HCPCS,50340,Removal of kidney,,,15689.0,15689.0,1
HCPCS,50360,Transplantation of kidney,,,63079.0,63079.0,1
HCPCS,50365,Transplantation of kidney,,,63079.0,63079.0,1
HCPCS,50370,Remove transplanted kidney,,,15689.0,15689.0,1
HCPCS,50380,Reimplantation of kidney,,,63079.0,63079.0,1
HCPCS,50382,Change ureter stent percut,,,2015.59,9206.0,2
HCPCS,50382,Hc Rem And Repl Ureteral Stent Perc,17559.0,11413.349999999999,,,0
HCPCS,50384,Hc Rem Ureteral Stent Perc,18531.0,12045.150000000001,,,0
HCPCS,50384,Remove ureter stent percut,,,2015.59,9206.0,2
HCPCS,50385,Change stent via transureth,,,2015.59,9206.0,2
HCPCS,50385,Hc Rem And Repl Ureteral Stent Transurethral,17929.5,11654.175,,,0
HCPCS,50386,Hc Rem Ureteral Stent Transurethral,11059.5,7188.674999999999,,,0
HCPCS,50386,Remove stent via transureth,,,2015.59,9206.0,2
HCPCS,50387,Change nephroureteral cath,,,2015.59,9206.0,2
HCPCS,50387,Hc Rem And Repl Transnephric Ureteral Stent,17929.5,11654.175,,,0
HCPCS,50389,Hc Remove Nephrostomy Tube,4533.0,2946.45,,,0
HCPCS,50389,Remove renal tube w/fluoro,,,672.35,3714.0,2
HCPCS,50390,Drainage of kidney lesion,,,682.8,3714.0,2
HCPCS,50390,Hc Asp Or Inj Renal Cyst Or Pelvis,8818.5,5732.025,,,0
HCPCS,50391,Hc Instill Chemo Kidney Via Nephrostomy,1686.0,1095.9,,,0
HCPCS,50391,Instll rx agnt into rnal tub,,,240.91,3714.0,2
HCPCS,50396,Hc Manometric Study Thru Tube,21760.5,14144.324999999999,,,0
HCPCS,50396,Measure kidney pressure,,,672.35,3714.0,2
HCPCS,50400,Revision of kidney/ureter,,,20001.0,20001.0,1
HCPCS,50405,Revision of kidney/ureter,,,20001.0,20001.0,1
HCPCS,50430,Hc Inj For Dx Nephrostogram Or Ureterogram W Img Via New Acc,10071.0,6546.150000000001,,,0
HCPCS,50430,Njx px nfrosgrm &/urtrgrm,,,672.35,3714.0,2
HCPCS,50431,Hc Inj For Dx Nephrostogram Or Ureterogram W Img Via Exist Acc,10071.0,6546.150000000001,,,0
HCPCS,50431,Njx px nfrosgrm &/urtrgrm,,,672.35,3714.0,2
HCPCS,50432,Hc Place Nephrostomy Catheter W Img,17559.0,11413.349999999999,,,0
HCPCS,50432,Plmt nephrostomy catheter,,,2015.59,9206.0,2
HCPCS,50433,Hc Place Nephroureteral Catheter W Img Via New Access,23524.5,15290.925000000001,,,0
HCPCS,50433,Plmt nephroureteral catheter,,,3398.86,9206.0,2
HCPCS,50434,Convert nephrostomy catheter,,,2015.59,9206.0,2
HCPCS,50434,Hc Convert Nephrostomy Cath To Nephroureteral Cath W Img Exist Tract,14632.5,9511.125,,,0
HCPCS,50435,Exchange nephrostomy cath,,,2015.59,9206.0,2
HCPCS,50435,Hc Exchange Nephrostomy Cath  W Img Via Existing Tract,14632.5,9511.125,,,0
HCPCS,50436,Dilat xst trc ndurlgc px,,,3398.86,9206.0,2
HCPCS,50436,Hc Dilation Of Exst Tract W Guid W Tube Plcmt,19716.0,12815.4,,,0
HCPCS,50437,Dilat xst trc new access rcs,,,3398.86,15689.0,2
HCPCS,50437,Hc Dilation Of Exst Tract W Guid W Tube Plcmt Incl New Access,21328.0,13863.2,,,0
HCPCS,50500,Repair of kidney wound,,,20001.0,20001.0,1
HCPCS,50520,Close kidney-skin fistula,,,20001.0,20001.0,1
HCPCS,50525,Close nephrovisceral fistula,,,20001.0,20001.0,1
HCPCS,50526,Close nephrovisceral fistula,,,20001.0,20001.0,1
HCPCS,50540,Revision of horseshoe kidney,,,20001.0,20001.0,1
HCPCS,50541,Laparo ablate renal cyst,,,10249.52,26701.0,2
HCPCS,50542,Laparo ablate renal mass,,,10249.52,38216.0,2
HCPCS,50543,Laparo partial nephrectomy,,,10249.52,38216.0,2
HCPCS,50544,Laparoscopy pyeloplasty,,,10249.52,38216.0,2
HCPCS,50545,Laparo Radical Nephrectomy,,,26701.0,26701.0,1
HCPCS,50546,Laparoscopic nephrectomy,,,26701.0,26701.0,1
HCPCS,50547,Laparo removal donor kidney,,,26701.0,26701.0,1
HCPCS,50548,Laparo remove w/ureter,,,26701.0,26701.0,1
HCPCS,50549,Laparoscope proc renal,,,5829.23,26701.0,2
HCPCS,50551,Kidney endoscopy,,,5169.96,20001.0,2
HCPCS,50553,Kidney endoscopy,,,5169.96,20001.0,2
HCPCS,50555,Kidney endoscopy & biopsy,,,9127.77,20001.0,2
HCPCS,50557,Kidney endoscopy & treatment,,,9127.77,38216.0,2
HCPCS,50561,Kidney endoscopy & treatment,,,5169.96,20001.0,2
HCPCS,50562,Renal scope w/tumor resect,,,9127.77,38216.0,2
HCPCS,50570,Kidney endoscopy,,,3398.86,15689.0,2
HCPCS,50572,Kidney endoscopy,,,672.35,3714.0,2
HCPCS,50574,Kidney endoscopy & biopsy,,,3398.86,9206.0,2
HCPCS,50575,Kidney endoscopy,,,5169.96,20001.0,2
HCPCS,50576,Kidney endoscopy & treatment,,,9127.77,20001.0,2
HCPCS,50580,Kidney endoscopy & treatment,,,5169.96,20001.0,2
HCPCS,50590,Fragmenting of kidney stone,,,3398.86,15689.0,2
HCPCS,50592,Hc Rf Ablation Renal Tumors Percutaneous,21102.0,13716.300000000001,,,0
HCPCS,50592,Perc rf ablate renal tumor,,,5829.23,26701.0,2
HCPCS,50593,Hc Cryoablation Renal Tumor Unilat,21771.0,14151.150000000001,,,0
HCPCS,50593,Perc cryo ablate renal tum,,,10249.52,38216.0,2
HCPCS,50600,Exploration of ureter,,,15689.0,15689.0,1
HCPCS,50605,Insert ureteral support,,,15689.0,15689.0,1
HCPCS,50606,Hc Endoluminal Biopsy Ureter Or Renal Pelvis W Img Add On,3524.0,2290.6,,,0
HCPCS,50610,Removal of ureter stone,,,15689.0,15689.0,1
HCPCS,50620,Removal of ureter stone,,,15689.0,15689.0,1
HCPCS,50630,Removal of ureter stone,,,15689.0,15689.0,1
HCPCS,50650,Removal of ureter,,,15689.0,15689.0,1
HCPCS,50660,Removal of ureter,,,15689.0,15689.0,1
HCPCS,50684,Hc Inj For Ureterography Or Ureteropyelography,3132.0,2035.8000000000002,,,0
HCPCS,50686,Measure ureter pressure,,,124.07,3714.0,2
HCPCS,50688,Change of ureter tube/stent,,,2015.59,9206.0,2
HCPCS,50688,Hc Change Nephroureteral Tube Or Stent,5708.0,3710.2,,,0
HCPCS,50690,Hc Injection Ileal Conduit,3863.0,2510.95,,,0
HCPCS,50693,Hc Place Ureteral Stent W Img Via Existing Tract,23524.5,15290.925000000001,,,0
HCPCS,50693,Plmt ureteral stent prq,,,3398.86,9206.0,2
HCPCS,50694,Hc Place Ureteral Stent W Img Via New Access Wo Separate Neph Cath,24229.5,15749.175000000001,,,0
HCPCS,50694,Plmt ureteral stent prq,,,3398.86,15689.0,2
HCPCS,50695,Hc Place Ureteral Stent W Img Via New Access W Separate Neph Cath,24936.0,16208.400000000001,,,0
HCPCS,50695,Plmt ureteral stent prq,,,3398.86,15689.0,2
HCPCS,50700,Revision of ureter,,,15689.0,15689.0,1
HCPCS,50705,Hc Ureteral Embolization Or Occlusion W Img Add On,3356.0,2181.4,,,0
HCPCS,50706,Hc Balloon Dilation Or Ureteral Stricture W Img Add On,3524.0,2290.6,,,0
HCPCS,50715,Release of ureter,,,15689.0,15689.0,1
HCPCS,50722,Release of ureter,,,15689.0,15689.0,1
HCPCS,50725,Release/revise ureter,,,15689.0,15689.0,1
HCPCS,50727,Revise ureter,,,3398.86,15689.0,2
HCPCS,50728,Revise ureter,,,15689.0,15689.0,1
HCPCS,50740,Fusion of ureter & kidney,,,15689.0,15689.0,1
HCPCS,50750,Fusion of ureter & kidney,,,15689.0,15689.0,1
HCPCS,50760,Fusion of ureters,,,15689.0,15689.0,1
HCPCS,50770,Splicing of ureters,,,15689.0,15689.0,1
HCPCS,50780,Reimplant ureter in bladder,,,15689.0,15689.0,1
HCPCS,50782,Reimplant ureter in bladder,,,15689.0,15689.0,1
HCPCS,50783,Reimplant ureter in bladder,,,15689.0,15689.0,1
HCPCS,50785,Reimplant ureter in bladder,,,15689.0,15689.0,1
HCPCS,50800,Implant ureter in bowel,,,15689.0,15689.0,1
HCPCS,50810,Fusion of ureter & bowel,,,15689.0,15689.0,1
HCPCS,50815,Urine shunt to intestine,,,15689.0,15689.0,1
HCPCS,50820,Construct bowel bladder,,,15689.0,15689.0,1
HCPCS,50825,Construct bowel bladder,,,15689.0,15689.0,1
HCPCS,50830,Revise urine flow,,,15689.0,15689.0,1
HCPCS,50840,Replace ureter by bowel,,,15689.0,15689.0,1
HCPCS,50845,Appendico-vesicostomy,,,15689.0,15689.0,1
HCPCS,50860,Transplant ureter to skin,,,15689.0,15689.0,1
HCPCS,50900,Repair of ureter,,,15689.0,15689.0,1
HCPCS,50920,Closure ureter/skin fistula,,,15689.0,15689.0,1
HCPCS,50930,Closure ureter/bowel fistula,,,15689.0,15689.0,1
HCPCS,50940,Release of ureter,,,15689.0,15689.0,1
HCPCS,50945,Laparoscopy ureterolithotomy,,,5829.23,26701.0,2
HCPCS,50947,Laparo New Ureter/Bladder,,,10249.52,26701.0,2
HCPCS,50948,Laparo New Ureter/Bladder,,,10249.52,38216.0,2
HCPCS,50949,Laparoscope proc ureter,,,5829.23,26701.0,2
HCPCS,50951,Endoscopy of ureter,,,3398.86,9206.0,2
HCPCS,50953,Endoscopy of ureter,,,3398.86,15689.0,2
HCPCS,50955,Ureter endoscopy & biopsy,,,5169.96,20001.0,2
HCPCS,50957,Ureter endoscopy & treatment,,,5169.96,20001.0,2
HCPCS,50961,Ureter endoscopy & treatment,,,5169.96,20001.0,2
HCPCS,50970,Ureter endoscopy,,,3398.86,9206.0,2
HCPCS,50972,Ureter endoscopy & catheter,,,3398.86,15689.0,2
HCPCS,50974,Ureter endoscopy & biopsy,,,5169.96,20001.0,2
HCPCS,50976,Ureter endoscopy & treatment,,,5169.96,20001.0,2
HCPCS,50980,Ureter endoscopy & treatment,,,5169.96,20001.0,2
HCPCS,51020,Incise & treat bladder,,,3398.86,9206.0,2
HCPCS,51030,Incise & treat bladder,,,15689.0,15689.0,1
HCPCS,51040,Hc Cystostomy Cystotomy W Drainage,13614.0,8849.1,,,0
HCPCS,51040,Incise & drain bladder,,,2015.59,9206.0,2
HCPCS,51045,Incise bladder/drain ureter,,,2015.59,9206.0,2
HCPCS,51050,Removal of bladder stone,,,5169.96,20001.0,2
HCPCS,51060,Removal of ureter stone,,,2015.59,9206.0,2
HCPCS,51065,Remove ureter calculus,,,3398.86,15689.0,2
HCPCS,51080,Drainage of bladder abscess,,,2800.79,15689.0,2
HCPCS,51100,Drain bladder by needle,,,240.91,3714.0,2
HCPCS,51101,Drain bladder by trocar/cath,,,828.02,9206.0,2
HCPCS,51102,Drain bl w/cath insertion,,,2015.59,9206.0,2
HCPCS,51102,Hc Aspiration Bladder W Ins Suprapubic Cath,5708.0,3710.2,,,0
HCPCS,51500,Removal of bladder cyst,,,5829.23,26701.0,2
HCPCS,51520,Removal of bladder lesion,,,3398.86,9206.0,2
HCPCS,51525,Removal of bladder lesion,,,15689.0,15689.0,1
HCPCS,51530,Removal of bladder lesion,,,15689.0,15689.0,1
HCPCS,51535,Repair of ureter lesion,,,3398.86,15689.0,2
HCPCS,51550,Partial removal of bladder,,,15689.0,15689.0,1
HCPCS,51555,Partial removal of bladder,,,15689.0,15689.0,1
HCPCS,51565,Revise bladder & ureter(s),,,15689.0,15689.0,1
HCPCS,51570,Removal of bladder,,,20001.0,20001.0,1
HCPCS,51575,Removal of bladder & nodes,,,20001.0,20001.0,1
HCPCS,51580,Remove bladder/revise tract,,,20001.0,20001.0,1
HCPCS,51585,Removal of bladder & nodes,,,20001.0,20001.0,1
HCPCS,51590,Remove bladder/revise tract,,,20001.0,20001.0,1
HCPCS,51595,Remove bladder/revise tract,,,20001.0,20001.0,1
HCPCS,51596,Remove bladder/create pouch,,,20001.0,20001.0,1
HCPCS,51597,Removal of pelvic structures,,,20001.0,20001.0,1
HCPCS,51600,Hc Inj Cystography Or Voiding Urethrocysto,3818.0,2481.7,,,0
HCPCS,51610,Hc Inj For Retrograde Urethrocystography,3420.0,2223.0,,,0
HCPCS,51700,Hc Irrig Bladder Simple And Or Instillation,1591.0,1034.15,,,0
HCPCS,51700,Irrigation of bladder,,,240.91,3714.0,2
HCPCS,51701,Hc Insertion Catheter Straight,745.0,484.25,,,0
HCPCS,51701,Insert bladder catheter,,,128.29,3714.0,2
HCPCS,51702,Hc Insertion Catheter Foley,912.0,592.8,,,0
HCPCS,51702,Insert temp bladder cath,,,128.29,3714.0,2
HCPCS,51703,Hc Insertion Catheter Complicated,1356.0,881.4,,,0
HCPCS,51703,Insert bladder cath complex,,,124.07,3714.0,2
HCPCS,51705,Change of bladder tube,,,240.91,3714.0,2
HCPCS,51705,Hc Change Cysto Tube Simple,4766.0,3097.9,,,0
HCPCS,51710,Change of bladder tube,,,672.35,3714.0,2
HCPCS,51710,Hc Change Cysto Tube Complicated,14068.0,9144.2,,,0
HCPCS,51715,Endoscopic injection/implant,,,3398.86,15689.0,2
HCPCS,51720,Hc Chemo Bladder Instillation,956.0,621.4,,,0
HCPCS,51720,Treatment of bladder lesion,,,672.35,3714.0,2
HCPCS,51721,Ins trurl ablt trnsdc thr us,,,38216.0,38216.0,1
HCPCS,51725,Simple cystometrogram,,,240.91,240.91,1
HCPCS,51726,Complex cystometrogram,,,240.91,240.91,1
HCPCS,51727,Cystometrogram w/up,,,672.35,672.35,1
HCPCS,51728,Cystometrogram w/vp,,,672.35,672.35,1
HCPCS,51729,Cystometrogram w/vp&up,,,672.35,672.35,1
HCPCS,51736,Urine flow measurement,,,128.29,128.29,1
HCPCS,51741,Electro-uroflowmetry first,,,208.2,208.2,1
HCPCS,51784,Anal/urinary muscle study,,,124.07,124.07,1
HCPCS,51785,Anal/urinary muscle study,,,240.91,240.91,1
HCPCS,51792,Urinary reflex study,,,56.88,56.88,1
HCPCS,51798,Us urine capacity measure,,,56.88,56.88,1
HCPCS,51800,Revision of bladder/urethra,,,20001.0,20001.0,1
HCPCS,51820,Revision of urinary tract,,,20001.0,20001.0,1
HCPCS,51840,Attach bladder/urethra,,,4823.47,15689.0,2
HCPCS,51841,Attach bladder/urethra,,,15689.0,15689.0,1
HCPCS,51845,Repair bladder neck,,,4823.47,20001.0,2
HCPCS,51860,Repair of bladder wound,,,9127.77,20001.0,2
HCPCS,51865,Repair of bladder wound,,,15689.0,15689.0,1
HCPCS,51880,Repair of bladder opening,,,3398.86,15689.0,2
HCPCS,51900,Repair bladder/vagina lesion,,,15689.0,15689.0,1
HCPCS,51920,Close bladder-uterus fistula,,,15689.0,15689.0,1
HCPCS,51925,Hysterectomy/bladder repair,,,26701.0,26701.0,1
HCPCS,51940,Correction of bladder defect,,,20001.0,20001.0,1
HCPCS,51960,Revision of bladder & bowel,,,20001.0,20001.0,1
HCPCS,51980,Construct bladder opening,,,15689.0,15689.0,1
HCPCS,51990,Laparo urethral suspension,,,5829.23,26701.0,2
HCPCS,51992,Laparo sling operation,,,5829.23,26701.0,2
HCPCS,51999,Laparoscope proc bla,,,5829.23,16564.0,2
HCPCS,52000,Cystoscopy,,,672.35,3714.0,2
HCPCS,52000,Hc Cystourethroscopy,4045.0,2629.25,,,0
HCPCS,52001,Cystoscopy removal of clots,,,3398.86,15689.0,2
HCPCS,52001,Hc Cystourethroscopy W Irrigation,4645.0,3019.25,,,0
HCPCS,52005,Cystoscopy & ureter catheter,,,2015.59,9206.0,2
HCPCS,52007,Cystoscopy and biopsy,,,3398.86,15689.0,2
HCPCS,52010,Cystoscopy & duct catheter,,,672.35,3714.0,2
HCPCS,52204,Cystoscopy w/biopsy(s),,,2015.59,9206.0,2
HCPCS,52214,Cystoscopy and treatment,,,3398.86,9206.0,2
HCPCS,52224,Cystoscopy and treatment,,,3398.86,9206.0,2
HCPCS,52234,Cystoscopy and treatment,,,3398.86,15689.0,2
HCPCS,52235,Cystoscopy and treatment,,,3398.86,15689.0,2
HCPCS,52240,Cystoscopy and treatment,,,5169.96,20001.0,2
HCPCS,52250,Cystoscopy and radiotracer,,,3398.86,15689.0,2
HCPCS,52260,Cystoscopy and treatment,,,2015.59,9206.0,2
HCPCS,52265,Cystoscopy and treatment,,,2015.59,9206.0,2
HCPCS,52270,Cystoscopy & revise urethra,,,2015.59,9206.0,2
HCPCS,52275,Cystoscopy & revise urethra,,,2015.59,9206.0,2
HCPCS,52276,Cystoscopy and treatment,,,2015.59,9206.0,2
HCPCS,52277,Cystoscopy and treatment,,,3398.86,15689.0,2
HCPCS,52281,Cystoscopy and treatment,,,2015.59,9206.0,2
HCPCS,52282,Cystoscopy implant stent,,,3398.86,15689.0,2
HCPCS,52283,Cystoscopy and treatment,,,2015.59,9206.0,2
HCPCS,52284,Cysto rx balo cath urtl strx,,,5169.96,20001.0,2
HCPCS,52285,Cystoscopy and treatment,,,672.35,3714.0,2
HCPCS,52287,Cystoscopy chemodenervation,,,2015.59,9206.0,2
HCPCS,52287,Hc Cystourethroscopy Inj Chemodenervation Bladder,2770.0,1800.5,,,0
HCPCS,52290,Cystoscopy and treatment,,,2015.59,9206.0,2
HCPCS,52300,Cystoscopy and treatment,,,3398.86,15689.0,2
HCPCS,52301,Cystoscopy and treatment,,,3398.86,15689.0,2
HCPCS,52305,Cystoscopy and treatment,,,5169.96,20001.0,2
HCPCS,52310,Cystoscopy and treatment,,,2015.59,9206.0,2
HCPCS,52310,Hc Cysto W Removal Fb Simple,6959.0,4523.35,,,0
HCPCS,52315,Cystoscopy and treatment,,,2015.59,9206.0,2
HCPCS,52317,Remove bladder stone,,,3398.86,15689.0,2
HCPCS,52318,Remove bladder stone,,,3398.86,15689.0,2
HCPCS,52320,Cystoscopy and treatment,,,3398.86,15689.0,2
HCPCS,52325,Cystoscopy stone removal,,,5169.96,20001.0,2
HCPCS,52327,Cystoscopy inject material,,,5169.96,20001.0,2
HCPCS,52330,Cystoscopy and treatment,,,3398.86,15689.0,2
HCPCS,52332,Cystoscopy and treatment,,,3398.86,15689.0,2
HCPCS,52332,Hc Cystoscopy W Ins Ureteral Stent,11536.5,7498.724999999999,,,0
HCPCS,52334,Create passage to kidney,,,3398.86,15689.0,2
HCPCS,52341,Cysto W/Ureter Stricture Tx,,,3398.86,9206.0,2
HCPCS,52342,Cysto W/Up Stricture Tx,,,3398.86,15689.0,2
HCPCS,52343,Cysto W/Renal Stricture Tx,,,3398.86,9206.0,2
HCPCS,52344,Cysto/uretero stricture tx,,,3398.86,15689.0,2
HCPCS,52345,Cysto/Uretero W/Up Stricture,,,3398.86,15689.0,2
HCPCS,52346,Cystouretero W/Renal Strict,,,5169.96,20001.0,2
HCPCS,52351,Cystouretero & or pyeloscope,,,3398.86,9206.0,2
HCPCS,52351,Hc Cystoscopy W Ureteroscopy,7234.0,4702.1,,,0
HCPCS,52352,Cystouretero w/stone remove,,,3398.86,15689.0,2
HCPCS,52353,Cystouretero W/Lithotripsy,,,5169.96,20001.0,2
HCPCS,52354,Cystouretero W/Biopsy,,,5169.96,20001.0,2
HCPCS,52355,Cystouretero W/Excise Tumor,,,5169.96,20001.0,2
HCPCS,52356,Cysto/uretero w/lithotripsy,,,5169.96,20001.0,2
HCPCS,52400,Cystouretero W/Congen Repr,,,3398.86,15689.0,2
HCPCS,52402,Cystourethro cut ejacul duct,,,3398.86,15689.0,2
HCPCS,52441,Cystourethro w/implant,,,15689.0,15689.0,1
HCPCS,52442,Cystourethro w/addl implant,,,15689.0,15689.0,1
HCPCS,52443,Cysto 1st trurl prst8 comis,,,9127.77,9127.77,1
HCPCS,52450,Incision of prostate,,,3398.86,15689.0,2
HCPCS,52500,Revision of bladder neck,,,3398.86,15689.0,2
HCPCS,52597,Trurl rbtc wtrjt rescj prst8,,,9127.77,9127.77,1
HCPCS,52601,Prostatectomy (TURP),,,5169.96,20001.0,2
HCPCS,52630,Remove prostate regrowth,,,5169.96,20001.0,2
HCPCS,52640,Relieve bladder contracture,,,3398.86,15689.0,2
HCPCS,52647,Laser surgery of prostate,,,20001.0,20001.0,1
HCPCS,52648,Laser surgery of prostate,,,5169.96,20001.0,2
HCPCS,52649,Prostate laser enucleation,,,5169.96,20001.0,2
HCPCS,52700,Drainage of prostate abscess,,,3398.86,15689.0,2
HCPCS,53000,Incision of urethra,,,2015.59,9206.0,2
HCPCS,53010,Incision of urethra,,,5169.96,20001.0,2
HCPCS,53020,Incision of urethra,,,2015.59,9206.0,2
HCPCS,53025,Incision of urethra,,,2015.59,9206.0,2
HCPCS,53040,Drainage of urethra abscess,,,3398.86,9206.0,2
HCPCS,53060,Drainage of urethra abscess,,,2015.59,9206.0,2
HCPCS,53080,Drainage of urinary leakage,,,672.35,3714.0,2
HCPCS,53085,Drainage of urinary leakage,,,2015.59,9206.0,2
HCPCS,53200,Biopsy of urethra,,,2015.59,9206.0,2
HCPCS,53210,Removal of urethra,,,3398.86,15689.0,2
HCPCS,53215,Removal of urethra,,,5169.96,20001.0,2
HCPCS,53220,Treatment of urethra lesion,,,3398.86,15689.0,2
HCPCS,53230,Removal of urethra lesion,,,5169.96,20001.0,2
HCPCS,53235,Removal of urethra lesion,,,5169.96,20001.0,2
HCPCS,53240,Surgery for urethra pouch,,,3398.86,9206.0,2
HCPCS,53250,Removal of urethra gland,,,3398.86,15689.0,2
HCPCS,53260,Treatment of urethra lesion,,,3398.86,9206.0,2
HCPCS,53265,Treatment of urethra lesion,,,2015.59,9206.0,2
HCPCS,53270,Removal of urethra gland,,,3398.86,9206.0,2
HCPCS,53275,Repair of urethra defect,,,3398.86,9206.0,2
HCPCS,53400,Revise urethra stage 1,,,5169.96,20001.0,2
HCPCS,53405,Revise urethra stage 2,,,5169.96,20001.0,2
HCPCS,53410,Reconstruction of urethra,,,5169.96,20001.0,2
HCPCS,53415,Reconstruction of urethra,,,20001.0,20001.0,1
HCPCS,53420,Reconstruct urethra stage 1,,,5169.96,20001.0,2
HCPCS,53425,Reconstruct urethra stage 2,,,5169.96,20001.0,2
HCPCS,53430,Reconstruction of urethra,,,5169.96,20001.0,2
HCPCS,53431,Reconstruct urethra/bladder,,,5169.96,20001.0,2
HCPCS,53440,Male sling procedure,,,12721.42,38216.0,2
HCPCS,53442,Remove/revise male sling,,,5169.96,20001.0,2
HCPCS,53444,Insert tandem cuff,,,19984.58,63079.0,2
HCPCS,53445,Insert uro/ves nck sphincter,,,19984.58,63079.0,2
HCPCS,53446,Remove uro sphincter,,,5169.96,20001.0,2
HCPCS,53447,Remove/replace ur sphincter,,,19984.58,63079.0,2
HCPCS,53448,Remov/replc ur sphinctr comp,,,20001.0,20001.0,1
HCPCS,53449,Repair uro sphincter,,,9127.77,20001.0,2
HCPCS,53450,Revision of urethra,,,3398.86,9206.0,2
HCPCS,53451,Tprnl balo cntnc dev bi,,,12721.42,63079.0,2
HCPCS,53452,Tprnl balo cntnc dev uni,,,9127.77,20001.0,2
HCPCS,53453,Tprnl balo cntnc dev rmvl ea,,,3398.86,15689.0,2
HCPCS,53454,Tprnl balo cntnc dev adjmt,,,240.91,3714.0,2
HCPCS,53460,Revision of urethra,,,3398.86,9206.0,2
HCPCS,53500,Urethrlys transvag w/ scope,,,3398.86,15689.0,2
HCPCS,53502,Repair of urethra injury,,,3398.86,15689.0,2
HCPCS,53505,Repair of urethra injury,,,5169.96,20001.0,2
HCPCS,53510,Repair of urethra injury,,,5169.96,20001.0,2
HCPCS,53515,Repair of urethra injury,,,5169.96,20001.0,2
HCPCS,53520,Repair of urethra defect,,,5169.96,20001.0,2
HCPCS,53600,Dilate urethra stricture,,,240.91,3714.0,2
HCPCS,53601,Dilate urethra stricture,,,128.29,3714.0,2
HCPCS,53605,Dilate urethra stricture,,,3398.86,9206.0,2
HCPCS,53620,Dilate urethra stricture,,,672.35,3714.0,2
HCPCS,53621,Dilate urethra stricture,,,240.91,3714.0,2
HCPCS,53660,Dilation of urethra,,,124.07,3714.0,2
HCPCS,53661,Dilation of urethra,,,128.29,3714.0,2
HCPCS,53665,Dilation of urethra,,,2015.59,9206.0,2
HCPCS,53850,Prostatic microwave thermotx,,,3398.86,15689.0,2
HCPCS,53852,Prostatic rf thermotx,,,3398.86,15689.0,2
HCPCS,53854,Trurl dstrj prst8 tiss rf wv,,,3398.86,9206.0,2
HCPCS,53855,Insert prost urethral stent,,,2015.59,9206.0,2
HCPCS,53860,Transurethral rf treatment,,,2015.59,9206.0,2
HCPCS,53865,Cysto insj dev ischmc rmdlg,,,9127.77,15689.0,2
HCPCS,53866,Cathj rmvl dev ischmc rmdlg,,,240.91,3714.0,2
HCPCS,53899,Hc Unlisted Procedure Urinary System,3524.0,2290.6,,,0
HCPCS,53899,Urology surgery procedure,,,240.91,16564.0,2
HCPCS,54000,Slitting of prepuce,,,3398.86,9206.0,2
HCPCS,54001,Slitting of prepuce,,,2015.59,9206.0,2
HCPCS,54015,Drain penis lesion,,,1592.51,9206.0,2
HCPCS,54050,Destruction penis lesion(s),,,391.97,3714.0,2
HCPCS,54055,Destruction penis lesion(s),,,1989.46,9206.0,2
HCPCS,54056,Cryosurgery penis lesion(s),,,193.46,3714.0,2
HCPCS,54057,Laser surg penis lesion(s),,,1989.46,9206.0,2
HCPCS,54060,Excision of penis lesion(s),,,1989.46,9206.0,2
HCPCS,54065,Destruction penis lesion(s),,,1989.46,9206.0,2
HCPCS,54100,Biopsy of penis,,,1592.51,9206.0,2
HCPCS,54105,Biopsy of penis,,,2800.79,15689.0,2
HCPCS,54110,Treatment of penis lesion,,,3398.86,15689.0,2
HCPCS,54111,Treat penis lesion graft,,,5169.96,20001.0,2
HCPCS,54112,Treat penis lesion graft,,,9127.77,38216.0,2
HCPCS,54115,Treatment of penis lesion,,,2800.79,15689.0,2
HCPCS,54120,Partial removal of penis,,,3398.86,15689.0,2
HCPCS,54125,Removal of penis,,,15689.0,15689.0,1
HCPCS,54130,Remove penis & nodes,,,15689.0,15689.0,1
HCPCS,54135,Remove penis & nodes,,,15689.0,15689.0,1
HCPCS,54150,Circumcision w/regionl block,,,2015.59,9206.0,2
HCPCS,54150,Hc Circumcision,2484.0,1614.6,,,0
HCPCS,54160,Circumcision neonate,,,672.35,3714.0,2
HCPCS,54161,Circum 28 days or older,,,2015.59,9206.0,2
HCPCS,54162,Lysis penil circumic lesion,,,2015.59,9206.0,2
HCPCS,54163,Repair of circumcision,,,2015.59,9206.0,2
HCPCS,54164,Frenulotomy of penis,,,2015.59,9206.0,2
HCPCS,54200,Treatment of penis lesion,,,240.91,3714.0,2
HCPCS,54205,Treatment of penis lesion,,,5169.96,20001.0,2
HCPCS,54220,Hc Irrigation Of Corpona Cavernos,1489.0,967.85,,,0
HCPCS,54220,Treatment of penis lesion,,,240.91,3714.0,2
HCPCS,54230,Hc Inj Corpora Cavernosography,4025.0,2616.25,,,0
HCPCS,54231,Dynamic cavernosometry,,,240.91,3714.0,2
HCPCS,54235,Hc Injection Of Corpora Cavernosa With Pharm Agent,1489.0,967.85,,,0
HCPCS,54235,Penile injection,,,240.91,3714.0,2
HCPCS,54240,Penis study,,,208.2,3714.0,2
HCPCS,54250,Penis study,,,240.91,3714.0,2
HCPCS,54300,Revision of penis,,,3398.86,15689.0,2
HCPCS,54304,Revision of penis,,,3398.86,15689.0,2
HCPCS,54308,Reconstruction of urethra,,,5169.96,20001.0,2
HCPCS,54312,Reconstruction of urethra,,,3398.86,15689.0,2
HCPCS,54316,Reconstruction of urethra,,,9127.77,20001.0,2
HCPCS,54318,Reconstruction of urethra,,,3398.86,15689.0,2
HCPCS,54322,Reconstruction of urethra,,,3398.86,15689.0,2
HCPCS,54324,Reconstruction of urethra,,,3398.86,15689.0,2
HCPCS,54326,Reconstruction of urethra,,,3398.86,9206.0,2
HCPCS,54328,Revise penis/urethra,,,3398.86,15689.0,2
HCPCS,54332,Revise penis/urethra,,,3398.86,15689.0,2
HCPCS,54336,Revise penis/urethra,,,3398.86,15689.0,2
HCPCS,54340,Secondary urethral surgery,,,3398.86,15689.0,2
HCPCS,54344,Secondary urethral surgery,,,9127.77,20001.0,2
HCPCS,54348,Secondary urethral surgery,,,5169.96,20001.0,2
HCPCS,54352,Reconstruct urethra/penis,,,5169.96,20001.0,2
HCPCS,54360,Penis plastic surgery,,,3398.86,15689.0,2
HCPCS,54380,Repair penis,,,2015.59,9206.0,2
HCPCS,54385,Repair penis,,,2015.59,9206.0,2
HCPCS,54390,Repair penis and bladder,,,15689.0,15689.0,1
HCPCS,54400,Insert semi-rigid prosthesis,,,12721.42,63079.0,2
HCPCS,54401,Insert self-contd prosthesis,,,19984.58,63079.0,2
HCPCS,54405,Insert multi-comp penis pros,,,19984.58,63079.0,2
HCPCS,54406,Remove muti-comp penis pros,,,3398.86,15689.0,2
HCPCS,54408,Repair multi-comp penis pros,,,5169.96,20001.0,2
HCPCS,54410,Remove/replace penis prosth,,,19984.58,63079.0,2
HCPCS,54411,Remov/replc penis pros comp,,,19984.58,63079.0,2
HCPCS,54415,Remove self-contd penis pros,,,3398.86,15689.0,2
HCPCS,54416,Remv/repl penis contain pros,,,19984.58,63079.0,2
HCPCS,54417,Remv/replc penis pros compl,,,19984.58,63079.0,2
HCPCS,54420,Revision of penis,,,3398.86,9206.0,2
HCPCS,54430,Revision of penis,,,15689.0,15689.0,1
HCPCS,54435,Revision of penis,,,3398.86,9206.0,2
HCPCS,54437,Repair corporeal tear,,,3398.86,15689.0,2
HCPCS,54438,Replantation of penis,,,63079.0,63079.0,1
HCPCS,54440,Repair of penis,,,3398.86,15689.0,2
HCPCS,54450,Preputial stretching,,,240.91,3714.0,2
HCPCS,54500,Biopsy of testis,,,2800.79,15689.0,2
HCPCS,54505,Biopsy of testis,,,3398.86,15689.0,2
HCPCS,54512,Excise Lesion Testis,,,3398.86,15689.0,2
HCPCS,54520,Removal of testis,,,3398.86,9206.0,2
HCPCS,54522,Orchiectomy partial,,,3398.86,9206.0,2
HCPCS,54530,Removal of testis,,,3452.3,15689.0,2
HCPCS,54535,Extensive testis surgery,,,3398.86,15689.0,2
HCPCS,54550,Exploration for testis,,,3452.3,15689.0,2
HCPCS,54560,Exploration for testis,,,2015.59,9206.0,2
HCPCS,54600,Reduce testis torsion,,,3398.86,9206.0,2
HCPCS,54620,Suspension of testis,,,3398.86,15689.0,2
HCPCS,54640,Suspension of testis,,,3452.3,15689.0,2
HCPCS,54650,Orchiopexy (Fowler-Stephens),,,3452.3,15689.0,2
HCPCS,54660,Revision of testis,,,5169.96,20001.0,2
HCPCS,54670,Repair testis injury,,,3398.86,9206.0,2
HCPCS,54680,Relocation of testis(es),,,3398.86,9206.0,2
HCPCS,54690,Laparoscopy orchiectomy,,,5829.23,26701.0,2
HCPCS,54692,Laparoscopy orchiopexy,,,5829.23,26701.0,2
HCPCS,54699,Laparoscope proc testis,,,5829.23,16564.0,2
HCPCS,54700,Drainage of scrotum,,,2015.59,9206.0,2
HCPCS,54800,Biopsy of epididymis,,,1592.51,9206.0,2
HCPCS,54830,Remove epididymis lesion,,,3398.86,9206.0,2
HCPCS,54840,Remove epididymis lesion,,,2015.59,9206.0,2
HCPCS,54860,Removal of epididymis,,,3398.86,9206.0,2
HCPCS,54861,Removal of epididymis,,,3398.86,15689.0,2
HCPCS,54865,Explore Epididymis,,,3398.86,9206.0,2
HCPCS,54900,Fusion of spermatic ducts,,,2015.59,9206.0,2
HCPCS,54901,Fusion of spermatic ducts,,,3398.86,15689.0,2
HCPCS,55000,Drainage of hydrocele,,,682.8,3714.0,2
HCPCS,55000,Hc Punc Asp Hydrocele Tunica Vag,2586.0,1680.8999999999999,,,0
HCPCS,55040,Removal of hydrocele,,,3452.3,15689.0,2
HCPCS,55041,Removal of hydroceles,,,3452.3,15689.0,2
HCPCS,55060,Repair of hydrocele,,,3398.86,9206.0,2
HCPCS,55100,Drainage of scrotum abscess,,,1592.51,9206.0,2
HCPCS,55110,Explore scrotum,,,3398.86,15689.0,2
HCPCS,55120,Removal of scrotum lesion,,,2015.59,9206.0,2
HCPCS,55150,Removal of scrotum,,,3398.86,9206.0,2
HCPCS,55175,Revision of scrotum,,,3398.86,15689.0,2
HCPCS,55180,Revision of scrotum,,,5169.96,20001.0,2
HCPCS,55200,Incision of sperm duct,,,3398.86,9206.0,2
HCPCS,55250,Hc Vasectomy Without Anesthesia,14308.0,9300.2,,,0
HCPCS,55250,Removal of sperm duct(s),,,2015.59,9206.0,2
HCPCS,55400,Repair of sperm duct,,,3398.86,15689.0,2
HCPCS,55500,Removal of hydrocele,,,3398.86,9206.0,2
HCPCS,55520,Removal of sperm cord lesion,,,3398.86,9206.0,2
HCPCS,55530,Revise spermatic cord veins,,,3398.86,15689.0,2
HCPCS,55535,Revise spermatic cord veins,,,6242.2,15689.0,2
HCPCS,55540,Revise hernia & sperm veins,,,3452.3,15689.0,2
HCPCS,55550,Laparo ligate spermatic vein,,,5829.23,26701.0,2
HCPCS,55559,Laparo proc spermatic cord,,,5829.23,26701.0,2
HCPCS,55600,Incise sperm duct pouch,,,2015.59,9206.0,2
HCPCS,55605,Incise sperm duct pouch,,,9206.0,9206.0,1
HCPCS,55650,Remove sperm duct pouch,,,9206.0,9206.0,1
HCPCS,55680,Remove sperm pouch lesion,,,3398.86,15689.0,2
HCPCS,55700,Biopsy of prostate,,,9206.0,9206.0,1
HCPCS,55700,Hc Biopsy Prostate Needle,2146.0,1394.9,,,0
HCPCS,55705,Biopsy of prostate,,,3398.86,9206.0,2
HCPCS,55706,Prostate saturation sampling,,,3398.86,9206.0,2
HCPCS,55707,Bx prst8 trct us guided,,,3398.86,3398.86,1
HCPCS,55708,Bx prst8 trct us w/mri fus 1,,,3398.86,3398.86,1
HCPCS,55709,Bx prst8 tprnl us guided,,,3398.86,3398.86,1
HCPCS,55710,Bx prst8 tprn us w/mri fus 1,,,3398.86,3398.86,1
HCPCS,55711,Bx prst8 trct mri-us 1st,,,3398.86,3398.86,1
HCPCS,55712,Bx prst8 tprnl mri-us 1st,,,3398.86,3398.86,1
HCPCS,55713,Bx prst8 in-bore ct/mri bx 1,,,5169.96,5169.96,1
HCPCS,55714,Bx prst8 in-bore ct/mri 1,,,5169.96,5169.96,1
HCPCS,55720,Drainage of prostate abscess,,,3398.86,9206.0,2
HCPCS,55725,Drainage of prostate abscess,,,3398.86,15689.0,2
HCPCS,55801,Removal of prostate,,,15689.0,15689.0,1
HCPCS,55810,Extensive prostate surgery,,,20001.0,20001.0,1
HCPCS,55812,Extensive prostate surgery,,,20001.0,20001.0,1
HCPCS,55815,Extensive prostate surgery,,,20001.0,20001.0,1
HCPCS,55821,Removal of prostate,,,15689.0,15689.0,1
HCPCS,55831,Removal of prostate,,,15689.0,15689.0,1
HCPCS,55840,Extensive prostate surgery,,,20001.0,20001.0,1
HCPCS,55842,Extensive prostate surgery,,,20001.0,20001.0,1
HCPCS,55845,Extensive prostate surgery,,,20001.0,20001.0,1
HCPCS,55860,Surgical exposure prostate,,,5169.96,20001.0,2
HCPCS,55862,Extensive prostate surgery,,,15689.0,15689.0,1
HCPCS,55865,Extensive prostate surgery,,,20001.0,20001.0,1
HCPCS,55866,Laparo radical prostatectomy,,,10249.52,38216.0,2
HCPCS,55867,Laps surg prst8ect smpl stot,,,10249.52,38216.0,2
HCPCS,55868,Lap srg prst8ct lymph nod bx,,,10249.52,10249.52,1
HCPCS,55869,Lap srg prst8ct bi pl lmphad,,,10249.52,10249.52,1
HCPCS,55870,Electroejaculation,,,888.1,3714.0,2
HCPCS,55873,Cryoablate Prostate,,,9127.77,38216.0,2
HCPCS,55874,Tprnl plmt biodegrdabl matrl,,,5169.96,20001.0,2
HCPCS,55875,Hc Placement Needle Transperineal Prostate,5575.0,3623.75,,,0
HCPCS,55875,Transperi needle place pros,,,5169.96,20001.0,2
HCPCS,55876,Hc Plcmnt Interstial Dev Prostate Sngl Or Mult For Rad Therapy,16174.0,10513.1,,,0
HCPCS,55876,Place rt device/marker pros,,,1334.61,9206.0,2
HCPCS,55877,Abltj ire prst8 1+ tum perq,,,10249.52,10249.52,1
HCPCS,55880,Abltj mal prst8 tiss hifu,,,9127.77,20001.0,2
HCPCS,55880,Hc Hifu Ablation Prostate Transrectal W Img,17417.0,11321.05,,,0
HCPCS,55881,Ablt trurl prst8 tis thrm us,,,20001.0,20001.0,1
HCPCS,55882,Ablt trurl prst8 tis trnsdcr,,,12721.42,63079.0,2
HCPCS,55899,Genital surgery procedure,,,240.91,16564.0,2
HCPCS,55899,Hc Unlst Proc Male Genital Sys,1489.0,967.85,,,0
HCPCS,55920,Place needles pelvic for rt,,,4823.47,20001.0,2
HCPCS,55970,Sex transformation m to f,,,4823.47,9206.0,2
HCPCS,55980,Sex transformation f to m,,,3398.86,15689.0,2
HCPCS,56405,Hc I And D Vulva Or Perineal Abscess,1864.0,1211.6,,,0
HCPCS,56405,I & D of vulva/perineum,,,293.83,3714.0,2
HCPCS,56420,Drainage of gland abscess,,,194.94,3714.0,2
HCPCS,56420,Hc I And D Bartholin's Gland Abscess,1362.0,885.3,,,0
HCPCS,56440,Surgery for vulva lesion,,,3121.31,9206.0,2
HCPCS,56441,Lysis of labial lesion(s),,,3121.31,9206.0,2
HCPCS,56442,Hymenotomy,,,3121.31,9206.0,2
HCPCS,56501,Destroy vulva lesions sim,,,1989.46,9206.0,2
HCPCS,56515,Destroy vulva lesion/s compl,,,1989.46,9206.0,2
HCPCS,56605,Biopsy of vulva/perineum,,,888.1,3714.0,2
HCPCS,56620,Partial removal of vulva,,,3121.31,9206.0,2
HCPCS,56625,Complete removal of vulva,,,3121.31,9206.0,2
HCPCS,56630,Extensive vulva surgery,,,4823.47,20001.0,2
HCPCS,56631,Extensive vulva surgery,,,20001.0,20001.0,1
HCPCS,56632,Extensive vulva surgery,,,20001.0,20001.0,1
HCPCS,56633,Extensive vulva surgery,,,20001.0,20001.0,1
HCPCS,56634,Extensive vulva surgery,,,20001.0,20001.0,1
HCPCS,56637,Extensive vulva surgery,,,20001.0,20001.0,1
HCPCS,56640,Extensive vulva surgery,,,20001.0,20001.0,1
HCPCS,56700,Partial removal of hymen,,,3121.31,9206.0,2
HCPCS,56740,Remove vagina gland lesion,,,3121.31,9206.0,2
HCPCS,56800,Repair of vagina,,,3121.31,9206.0,2
HCPCS,56805,Repair clitoris,,,3121.31,9206.0,2
HCPCS,56810,Repair of perineum,,,3121.31,9206.0,2
HCPCS,56820,Exam of vulva w/scope,,,194.94,3714.0,2
HCPCS,56821,Exam/biopsy of vulva w/scope,,,293.83,3714.0,2
HCPCS,57000,Exploration of vagina,,,3121.31,9206.0,2
HCPCS,57010,Drainage of pelvic abscess,,,3121.31,9206.0,2
HCPCS,57020,Drainage of pelvic fluid,,,4823.47,9206.0,2
HCPCS,57022,I & d vaginal hematoma pp,,,2800.79,9206.0,2
HCPCS,57023,I & d vag hematoma non-ob,,,2800.79,15689.0,2
HCPCS,57061,Destroy vag lesions simple,,,3121.31,9206.0,2
HCPCS,57065,Destroy vag lesions complex,,,3121.31,9206.0,2
HCPCS,57100,Biopsy of vagina,,,888.1,3714.0,2
HCPCS,57105,Biopsy of vagina,,,3121.31,9206.0,2
HCPCS,57106,Remove vagina wall partial,,,3121.31,9206.0,2
HCPCS,57107,Remove vagina tissue part,,,3121.31,9206.0,2
HCPCS,57109,Vaginectomy partial w/nodes,,,3121.31,9206.0,2
HCPCS,57110,Remove vagina wall complete,,,20001.0,20001.0,1
HCPCS,57111,Remove vagina tissue compl,,,20001.0,20001.0,1
HCPCS,57120,Closure of vagina,,,4823.47,20001.0,2
HCPCS,57130,Remove vagina lesion,,,3121.31,9206.0,2
HCPCS,57135,Remove vagina lesion,,,3121.31,9206.0,2
HCPCS,57150,Treat vagina infection,,,56.88,3714.0,2
HCPCS,57155,Hc Insertion Uterine Tandem Ovoid,5000.0,3250.0,,,0
HCPCS,57155,Insert uteri tandem/ovoids,,,4823.47,9206.0,2
HCPCS,57156,Hc Insertion Vaginal Radiation Device,1959.0,1273.35,,,0
HCPCS,57156,Ins vag brachytx device,,,293.83,3714.0,2
HCPCS,57160,Insert pessary/other device,,,194.94,3714.0,2
HCPCS,57170,Fitting of diaphragm/cap,,,194.94,3714.0,2
HCPCS,57180,Treat vaginal bleeding,,,194.94,3714.0,2
HCPCS,57200,Repair of vagina,,,3121.31,9206.0,2
HCPCS,57210,Repair vagina/perineum,,,3121.31,9206.0,2
HCPCS,57220,Revision of urethra,,,4823.47,20001.0,2
HCPCS,57230,Repair of urethral lesion,,,3121.31,9206.0,2
HCPCS,57240,Repair bladder & vagina,,,4823.47,20001.0,2
HCPCS,57250,Repair rectum & vagina,,,4823.47,20001.0,2
HCPCS,57260,Repair of vagina,,,4823.47,20001.0,2
HCPCS,57265,Extensive repair of vagina,,,4823.47,20001.0,2
HCPCS,57268,Repair of bowel bulge,,,4823.47,9206.0,2
HCPCS,57270,Repair of bowel pouch,,,20001.0,20001.0,1
HCPCS,57280,Suspension of vagina,,,20001.0,20001.0,1
HCPCS,57282,Colpopexy extraperitoneal,,,7150.12,38216.0,2
HCPCS,57283,Colpopexy intraperitoneal,,,7150.12,38216.0,2
HCPCS,57284,Repair paravag defect open,,,4823.47,20001.0,2
HCPCS,57285,Repair paravag defect vag,,,7150.12,38216.0,2
HCPCS,57287,Revise/Remove Sling Repair,,,3121.31,9206.0,2
HCPCS,57288,Repair bladder defect,,,4823.47,20001.0,2
HCPCS,57289,Repair bladder & vagina,,,7150.12,38216.0,2
HCPCS,57291,Construction of vagina,,,4823.47,9206.0,2
HCPCS,57292,Construct vagina with graft,,,4823.47,20001.0,2
HCPCS,57295,Revise vag graft via vagina,,,3121.31,9206.0,2
HCPCS,57296,Revise vag graft open abd,,,20001.0,20001.0,1
HCPCS,57300,Repair rectum-vagina fistula,,,3121.31,9206.0,2
HCPCS,57305,Repair rectum-vagina fistula,,,20001.0,20001.0,1
HCPCS,57307,Fistula repair & colostomy,,,20001.0,20001.0,1
HCPCS,57308,Fistula repair transperine,,,20001.0,20001.0,1
HCPCS,57310,Repair urethrovaginal lesion,,,7150.12,38216.0,2
HCPCS,57311,Repair urethrovaginal lesion,,,20001.0,20001.0,1
HCPCS,57320,Repair bladder-vagina lesion,,,4823.47,20001.0,2
HCPCS,57330,Repair bladder-vagina lesion,,,7150.12,38216.0,2
HCPCS,57335,Repair vagina,,,4823.47,9206.0,2
HCPCS,57400,Dilation of vagina,,,3121.31,9206.0,2
HCPCS,57410,Pelvic examination,,,3121.31,9206.0,2
HCPCS,57415,Remove vaginal foreign body,,,3121.31,9206.0,2
HCPCS,57420,Exam of vagina w/scope,,,293.83,3714.0,2
HCPCS,57421,Exam/biopsy of vag w/scope,,,888.1,3714.0,2
HCPCS,57423,Repair paravag defect lap,,,10249.52,38216.0,2
HCPCS,57425,Laparoscopy surg colpopexy,,,10249.52,38216.0,2
HCPCS,57426,Revise prosth vag graft lap,,,7150.12,38216.0,2
HCPCS,57452,Exam of cervix w/scope,,,194.94,3714.0,2
HCPCS,57452,Hc Colposcopy With Upper Adjacent Vagina,502.0,326.3,,,0
HCPCS,57454,Bx/curett of cervix w/scope,,,293.83,3714.0,2
HCPCS,57455,Biopsy of cervix w/scope,,,293.83,3714.0,2
HCPCS,57455,Hc Colposcopy With Biopsy(S),882.0,573.3,,,0
HCPCS,57456,Endocerv curettage w/scope,,,293.83,3714.0,2
HCPCS,57460,Bx of cervix w/scope leep,,,3121.31,9206.0,2
HCPCS,57461,Conz of cervix w/scope leep,,,3121.31,9206.0,2
HCPCS,57500,Biopsy of cervix,,,888.1,3714.0,2
HCPCS,57500,Hc Biopsy Cervix,5803.0,3771.95,,,0
HCPCS,57505,Endocervical curettage,,,888.1,3714.0,2
HCPCS,57510,Cauterization of cervix,,,3121.31,9206.0,2
HCPCS,57511,Cryocautery of cervix,,,293.83,3714.0,2
HCPCS,57513,Laser surgery of cervix,,,3121.31,9206.0,2
HCPCS,57520,Conization of cervix,,,3121.31,9206.0,2
HCPCS,57522,Conization of cervix,,,3121.31,9206.0,2
HCPCS,57530,Removal of cervix,,,4823.47,9206.0,2
HCPCS,57531,Removal of cervix radical,,,20001.0,20001.0,1
HCPCS,57540,Removal of residual cervix,,,20001.0,20001.0,1
HCPCS,57545,Remove cervix/repair pelvis,,,20001.0,20001.0,1
HCPCS,57550,Removal of residual cervix,,,4823.47,9206.0,2
HCPCS,57555,Remove cervix/repair vagina,,,4823.47,20001.0,2
HCPCS,57556,Remove cervix repair bowel,,,4823.47,20001.0,2
HCPCS,57558,D&C oF Cervical Stump,,,3121.31,9206.0,2
HCPCS,57700,Revision of cervix,,,3121.31,9206.0,2
HCPCS,57720,Hc Trachelorrhaphy Plastic Repair Of Cervix,5192.0,3374.8,,,0
HCPCS,57720,Revision of cervix,,,3121.31,9206.0,2
HCPCS,57800,Dilation of cervical canal,,,3121.31,9206.0,2
HCPCS,58100,Biopsy of uterus lining,,,194.94,3714.0,2
HCPCS,58100,Hc Endometrial Sampling Biopsy,1022.0,664.3,,,0
HCPCS,58120,Dilation and curettage,,,3121.31,9206.0,2
HCPCS,58140,Myomectomy abdom method,,,20001.0,20001.0,1
HCPCS,58145,Myomectomy vag method,,,3121.31,9206.0,2
HCPCS,58146,Myomectomy abdom complex,,,20001.0,20001.0,1
HCPCS,58150,Total hysterectomy,,,26701.0,26701.0,1
HCPCS,58152,Total hysterectomy,,,26701.0,26701.0,1
HCPCS,58180,Partial hysterectomy,,,26701.0,26701.0,1
HCPCS,58200,Extensive hysterectomy,,,26701.0,26701.0,1
HCPCS,58210,Extensive hysterectomy,,,26701.0,26701.0,1
HCPCS,58240,Removal of pelvis contents,,,20001.0,20001.0,1
HCPCS,58260,Vaginal hysterectomy,,,4823.47,20001.0,2
HCPCS,58262,Vag hyst including t/o,,,4823.47,20001.0,2
HCPCS,58263,Vag hyst w/t/o & vag repair,,,4823.47,20001.0,2
HCPCS,58267,Vag hyst w/urinary repair,,,20001.0,20001.0,1
HCPCS,58270,Vag hyst w/enterocele repair,,,4823.47,20001.0,2
HCPCS,58275,Hysterectomy/revise vagina,,,26701.0,26701.0,1
HCPCS,58280,Hysterectomy/revise vagina,,,26701.0,26701.0,1
HCPCS,58285,Extensive hysterectomy,,,26701.0,26701.0,1
HCPCS,58290,Vag hyst complex,,,7150.12,38216.0,2
HCPCS,58291,Vag hyst incl t/o complex,,,4823.47,20001.0,2
HCPCS,58292,Vag hyst t/o & repair compl,,,7150.12,38216.0,2
HCPCS,58294,Vag hyst w/enterocele compl,,,4823.47,20001.0,2
HCPCS,58300,Hc Insertion Intrauterine Device,3520.0,2288.0,,,0
HCPCS,58300,Insert intrauterine device,,,3714.0,3714.0,1
HCPCS,58301,Hc Removal Intrauterine Device,2346.0,1524.9,,,0
HCPCS,58301,Remove intrauterine device,,,293.83,3714.0,2
HCPCS,58321,Artificial insemination,,,293.83,3714.0,2
HCPCS,58322,Artificial insemination,,,194.94,3714.0,2
HCPCS,58323,Sperm washing,,,194.94,3714.0,2
HCPCS,58340,Hc Catheterization For Hysterosalpingogram,565.0,367.25,,,0
HCPCS,58345,Hc Introduction Catheter Fallopian Tube,18525.0,12041.25,,,0
HCPCS,58345,Reopen fallopian tube,,,3121.31,9206.0,2
HCPCS,58346,Insert heyman uteri capsule,,,4823.47,9206.0,2
HCPCS,58350,Hc Reopen Fallopian Tube,35353.5,22979.775,,,0
HCPCS,58350,Reopen fallopian tube,,,4823.47,20001.0,2
HCPCS,58353,Endometr ablate thermal,,,4823.47,20001.0,2
HCPCS,58356,Endometrial cryoablation,,,4823.47,20001.0,2
HCPCS,58400,Suspension of uterus,,,20001.0,20001.0,1
HCPCS,58410,Suspension of uterus,,,20001.0,20001.0,1
HCPCS,58520,Repair of ruptured uterus,,,20001.0,20001.0,1
HCPCS,58540,Revision of uterus,,,20001.0,20001.0,1
HCPCS,58541,Lsh uterus 250 g or less,,,10249.52,26701.0,2
HCPCS,58542,Lsh w/t/o ut 250 g or less,,,10249.52,38216.0,2
HCPCS,58543,LSH Uterus Above 250 g,,,10249.52,38216.0,2
HCPCS,58544,LSH w/t/o Uterus Above 250 g,,,10249.52,38216.0,2
HCPCS,58545,Laparoscopic myomectomy,,,5829.23,26701.0,2
HCPCS,58546,Laparo-myomectomy complex,,,10249.52,38216.0,2
HCPCS,58548,Lap Radical Hyst,,,20001.0,20001.0,1
HCPCS,58550,Laparo-asst vag hysterectomy,,,5829.23,26701.0,2
HCPCS,58552,Laparo-vag hyst incl t/o,,,10249.52,38216.0,2
HCPCS,58553,Laparo-vag hyst complex,,,10249.52,38216.0,2
HCPCS,58554,Laparo-vag hyst w/t/o compl,,,10249.52,38216.0,2
HCPCS,58555,Hysteroscopy dx sep proc,,,3121.31,9206.0,2
HCPCS,58558,Hysteroscopy biopsy,,,3121.31,9206.0,2
HCPCS,58559,Hysteroscopy lysis,,,4823.47,20001.0,2
HCPCS,58560,Hysteroscopy resect septum,,,4823.47,20001.0,2
HCPCS,58561,Hysteroscopy remove myoma,,,4823.47,20001.0,2
HCPCS,58562,Hysteroscopy remove fb,,,3121.31,9206.0,2
HCPCS,58563,Hysteroscopy ablation,,,4823.47,20001.0,2
HCPCS,58565,Hysteroscopy sterilization,,,4823.47,20001.0,2
HCPCS,58570,Tlh uterus 250 g or less,,,10249.52,38216.0,2
HCPCS,58571,Tlh w/t/o 250 g or less,,,10249.52,38216.0,2
HCPCS,58572,Tlh uterus over 250 g,,,10249.52,38216.0,2
HCPCS,58573,Tlh w/t/o uterus over 250 g,,,10249.52,38216.0,2
HCPCS,58575,Laps tot hyst resj mal,,,15689.0,15689.0,1
HCPCS,58578,Laparo proc uterus,,,5829.23,26701.0,2
HCPCS,58579,Hysteroscope procedure,,,194.94,3714.0,2
HCPCS,58580,Transcrv abltj utrn fibrd rf,,,7150.12,38216.0,2
HCPCS,58600,Division of fallopian tube,,,3121.31,9206.0,2
HCPCS,58605,Division of fallopian tube,,,20001.0,20001.0,1
HCPCS,58611,Ligate oviduct(s) add-on,,,20001.0,20001.0,1
HCPCS,58615,Occlude fallopian tube(s),,,3121.31,9206.0,2
HCPCS,58660,Laparoscopy lysis,,,5829.23,26701.0,2
HCPCS,58661,Laparoscopy remove adnexa,,,5829.23,26701.0,2
HCPCS,58662,Laparoscopy excise lesions,,,5829.23,26701.0,2
HCPCS,58670,Laparoscopy tubal cautery,,,5829.23,26701.0,2
HCPCS,58671,Laparoscopy tubal block,,,5829.23,26701.0,2
HCPCS,58672,Laparoscopy fimbrioplasty,,,5829.23,26701.0,2
HCPCS,58673,Laparoscopy salpingostomy,,,10249.52,26701.0,2
HCPCS,58674,Laps abltj uterine fibroids,,,10249.52,38216.0,2
HCPCS,58679,Laparo proc oviduct-ovary,,,5829.23,26701.0,2
HCPCS,58700,Removal of fallopian tube,,,20001.0,20001.0,1
HCPCS,58720,Removal of ovary/tube(s),,,20001.0,20001.0,1
HCPCS,58740,Adhesiolysis tube ovary,,,20001.0,20001.0,1
HCPCS,58750,Repair oviduct,,,20001.0,20001.0,1
HCPCS,58752,Revise ovarian tube(s),,,20001.0,20001.0,1
HCPCS,58760,Fimbrioplasty,,,20001.0,20001.0,1
HCPCS,58770,Create new tubal opening,,,3121.31,9206.0,2
HCPCS,58800,Drainage of ovarian cyst(s),,,3121.31,9206.0,2
HCPCS,58805,Drainage of ovarian cyst(s),,,3121.31,9206.0,2
HCPCS,58820,Drain ovary abscess open,,,3121.31,9206.0,2
HCPCS,58822,Drain ovary abscess percut,,,20001.0,20001.0,1
HCPCS,58825,Transposition ovary(s),,,20001.0,20001.0,1
HCPCS,58900,Biopsy of ovary(s),,,3121.31,9206.0,2
HCPCS,58920,Partial removal of ovary(s),,,7150.12,38216.0,2
HCPCS,58925,Removal of ovarian cyst(s),,,4823.47,20001.0,2
HCPCS,58940,Removal of ovary(s),,,20001.0,20001.0,1
HCPCS,58943,Removal of ovary(s),,,20001.0,20001.0,1
HCPCS,58950,Resect ovarian malignancy,,,20001.0,20001.0,1
HCPCS,58951,Resect ovarian malignancy,,,20001.0,20001.0,1
HCPCS,58952,Resect ovarian malignancy,,,20001.0,20001.0,1
HCPCS,58953,Tah rad dissect for debulk,,,20001.0,20001.0,1
HCPCS,58954,Tah rad debulk/lymph remove,,,20001.0,20001.0,1
HCPCS,58956,Bso omentectomy w/tah,,,20001.0,20001.0,1
HCPCS,58957,Resect Recurrent Gyn Mal,,,20001.0,20001.0,1
HCPCS,58958,Resect Recur Gyn Mal w/Lym,,,20001.0,20001.0,1
HCPCS,58960,Exploration of abdomen,,,20001.0,20001.0,1
HCPCS,58970,Retrieval of oocyte,,,888.1,3714.0,2
HCPCS,58974,Transfer of embryo,,,888.1,3714.0,2
HCPCS,58976,Transfer of embryo,,,293.83,3714.0,2
HCPCS,58999,Genital surgery procedure,,,194.94,16564.0,2
HCPCS,58999,Hc Unlisted Fem Genital Procedure,1903.0,1236.95,,,0
HCPCS,59000,Amniocentesis diagnostic,,,888.1,3714.0,2
HCPCS,59000,Hc Amniocentesis Diagnostic,2573.0,1672.45,,,0
HCPCS,59001,Amniocentesis therapeutic,,,293.83,3714.0,2
HCPCS,59001,Hc Amniocentesis Therapeutic W Us Guidance,2701.0,1755.65,,,0
HCPCS,59012,Fetal cord puncture prenatal,,,293.83,3714.0,2
HCPCS,59012,Hc Cordocentisis Intrauterine,1734.0,1127.1,,,0
HCPCS,59015,Chorion biopsy,,,888.1,3714.0,2
HCPCS,59015,Hc Chorionic Villus Sampling,6167.0,4008.55,,,0
HCPCS,59020,Fetal contract stress test,,,194.94,194.94,1
HCPCS,59020,Hc Fetal Contraction Stress Test,1022.0,664.3,,,0
HCPCS,59025,Fetal non-stress test,,,194.94,194.94,1
HCPCS,59025,Hc Fetal Non Stress Test,765.0,497.25,,,0
HCPCS,59030,Fetal scalp blood sample,,,293.83,293.83,1
HCPCS,59070,Hc Transabdominal Amnioinfusion W Us Guid,6230.0,4049.5,,,0
HCPCS,59070,Transabdom amnioinfus w/us,,,293.83,3714.0,2
HCPCS,59072,Umbilical cord occlud w/us,,,293.83,3714.0,2
HCPCS,59074,Fetal fluid drainage w/us,,,293.83,3714.0,2
HCPCS,59074,Hc Fetal Fluid Drainage W Us Guidance,6127.0,3982.55,,,0
HCPCS,59076,Fetal shunt placement w/us,,,293.83,3714.0,2
HCPCS,59076,Hc Fetal Shunt Placement W Us Guid,10982.0,7138.3,,,0
HCPCS,59100,Remove uterus lesion,,,4823.47,9206.0,2
HCPCS,59120,Treat ectopic pregnancy,,,20001.0,20001.0,1
HCPCS,59121,Treat ectopic pregnancy,,,20001.0,20001.0,1
HCPCS,59130,Treat ectopic pregnancy,,,20001.0,20001.0,1
HCPCS,59136,Treat ectopic pregnancy,,,20001.0,20001.0,1
HCPCS,59140,Treat ectopic pregnancy,,,20001.0,20001.0,1
HCPCS,59150,Treat ectopic pregnancy,,,5829.23,26701.0,2
HCPCS,59151,Treat ectopic pregnancy,,,5829.23,26701.0,2
HCPCS,59160,D & c after delivery,,,3121.31,9206.0,2
HCPCS,59200,Hc Insert Cervical Dilator,1799.0,1169.35,,,0
HCPCS,59200,Insert cervical dilator,,,293.83,3714.0,2
HCPCS,59300,Episiotomy or vaginal repair,,,3121.31,9206.0,2
HCPCS,59320,Hc Cerclage Cervix During Pregnancy,6230.0,4049.5,,,0
HCPCS,59320,Revision of cervix,,,3121.31,9206.0,2
HCPCS,59325,Revision of cervix,,,20001.0,20001.0,1
HCPCS,59350,Hc Hysterorrhaphy Ruptured Uterus,7745.0,5034.25,,,0
HCPCS,59350,Repair of uterus,,,20001.0,20001.0,1
HCPCS,59400,Obstetrical care,,,15689.0,15689.0,1
HCPCS,59409,Obstetrical care,,,3121.31,9206.0,2
HCPCS,59410,Obstetrical care,,,15689.0,15689.0,1
HCPCS,59412,Antepartum manipulation,,,3121.31,9206.0,2
HCPCS,59412,Hc Cephalic Version,4435.0,2882.75,,,0
HCPCS,59414,Deliver placenta,,,3121.31,9206.0,2
HCPCS,59414,Hc Delivery Placenta (Separate Proc),2215.0,1439.75,,,0
HCPCS,59510,Cesarean delivery,,,15689.0,15689.0,1
HCPCS,59514,Cesarean delivery only,,,9206.0,9206.0,1
HCPCS,59515,Cesarean delivery,,,15689.0,15689.0,1
HCPCS,59525,Remove uterus after cesarean,,,9206.0,9206.0,1
HCPCS,59610,Vbac delivery,,,15689.0,15689.0,1
HCPCS,59612,Vbac delivery only,,,3121.31,9206.0,2
HCPCS,59614,Vbac care after delivery,,,15689.0,15689.0,1
HCPCS,59618,Attempted vbac delivery,,,15689.0,15689.0,1
HCPCS,59620,Attempted vbac delivery only,,,9206.0,9206.0,1
HCPCS,59622,Attempted vbac after care,,,15689.0,15689.0,1
HCPCS,59812,Treatment of miscarriage,,,3121.31,9206.0,2
HCPCS,59820,Care of miscarriage,,,3121.31,9206.0,2
HCPCS,59821,Treatment of miscarriage,,,3121.31,9206.0,2
HCPCS,59830,Treat uterus infection,,,9206.0,9206.0,1
HCPCS,59840,Abortion,,,3121.31,9206.0,2
HCPCS,59841,Abortion,,,3121.31,9206.0,2
HCPCS,59850,Abortion,,,9206.0,9206.0,1
HCPCS,59851,Abortion,,,9206.0,9206.0,1
HCPCS,59852,Abortion,,,9206.0,9206.0,1
HCPCS,59855,Abortion,,,9206.0,9206.0,1
HCPCS,59855,Hc Induced Del After Partial Miscarriage,7622.0,4954.3,,,0
HCPCS,59856,Abortion,,,9206.0,9206.0,1
HCPCS,59857,Abortion,,,9206.0,9206.0,1
HCPCS,59866,Abortion (mpr),,,293.83,3714.0,2
HCPCS,59870,Evacuate mole of uterus,,,3121.31,9206.0,2
HCPCS,59871,Remove cerclage suture,,,3121.31,9206.0,2
HCPCS,59897,Fetal invas px w/us,,,194.94,3714.0,2
HCPCS,59898,Laparo proc ob care/deliver,,,5829.23,26701.0,2
HCPCS,59899,Maternity care procedure,,,194.94,16564.0,2
HCPCS,60000,Drain thyroid/tongue cyst,,,1496.07,9206.0,2
HCPCS,60100,Biopsy of thyroid,,,682.8,3714.0,2
HCPCS,60100,Hc Biopsy Thyroid Percutaneous Core Needle,1765.0,1147.25,,,0
HCPCS,60200,Remove thyroid lesion,,,5829.23,26701.0,2
HCPCS,60210,Partial thyroid excision,,,5829.23,26701.0,2
HCPCS,60212,Partial thyroid excision,,,5829.23,26701.0,2
HCPCS,60220,Partial removal of thyroid,,,5829.23,26701.0,2
HCPCS,60225,Partial removal of thyroid,,,5829.23,26701.0,2
HCPCS,60240,Removal of thyroid,,,5829.23,26701.0,2
HCPCS,60252,Removal of thyroid,,,5708.03,20001.0,2
HCPCS,60254,Extensive thyroid surgery,,,20001.0,20001.0,1
HCPCS,60260,Repeat thyroid surgery,,,5708.03,20001.0,2
HCPCS,60270,Removal of thyroid,,,20001.0,20001.0,1
HCPCS,60271,Removal of thyroid,,,5708.03,20001.0,2
HCPCS,60280,Remove thyroid duct lesion,,,5829.23,26701.0,2
HCPCS,60281,Remove thyroid duct lesion,,,5829.23,26701.0,2
HCPCS,60300,Aspir/inj thyroid cyst,,,682.8,3714.0,2
HCPCS,60300,Hc Asp Or Inj Thyroid Cyst,1765.0,1147.25,,,0
HCPCS,60500,Explore parathyroid glands,,,5708.03,20001.0,2
HCPCS,60502,Re-explore parathyroids,,,5708.03,20001.0,2
HCPCS,60505,Explore parathyroid glands,,,20001.0,20001.0,1
HCPCS,60520,Removal of thymus gland,,,5708.03,20001.0,2
HCPCS,60521,Removal of thymus gland,,,20001.0,20001.0,1
HCPCS,60522,Removal of thymus gland,,,20001.0,20001.0,1
HCPCS,60540,Explore adrenal gland,,,20001.0,20001.0,1
HCPCS,60545,Explore adrenal gland,,,20001.0,20001.0,1
HCPCS,60600,Remove carotid body lesion,,,20001.0,20001.0,1
HCPCS,60605,Remove carotid body lesion,,,20001.0,20001.0,1
HCPCS,60650,Laparoscopy adrenalectomy,,,26701.0,26701.0,1
HCPCS,60659,Laparo proc endocrine,,,5829.23,26701.0,2
HCPCS,60660,Abltj 1/+thyr ndul 1lobe prq,,,1592.51,26701.0,2
HCPCS,60699,Endocrine surgery procedure,,,5829.23,16564.0,2
HCPCS,60699,Hc Unlisted Procedure  Endocrine System,8337.0,5419.05,,,0
HCPCS,61000,Remove cranial cavity fluid,,,680.63,3714.0,2
HCPCS,61001,Remove cranial cavity fluid,,,680.63,3714.0,2
HCPCS,61020,Remove brain cavity fluid,,,852.83,3714.0,2
HCPCS,61026,Injection into brain canal,,,680.63,3714.0,2
HCPCS,61050,Hc Cervical Puncture,152.0,98.8,,,0
HCPCS,61050,Remove brain canal fluid,,,295.97,3714.0,2
HCPCS,61055,Hc Cervical Puncture W Injection,215.0,139.75,,,0
HCPCS,61055,Injection into brain canal,,,295.97,3714.0,2
HCPCS,61070,Brain canal shunt procedure,,,680.63,3714.0,2
HCPCS,61070,Hc Puncture Shunt Tube For Asp Or Inj,2708.0,1760.2,,,0
HCPCS,61105,Twist drill hole,,,9206.0,9206.0,1
HCPCS,61107,Drill skull for implantation,,,9206.0,9206.0,1
HCPCS,61108,Drill skull for drainage,,,15689.0,15689.0,1
HCPCS,61120,Burr hole for puncture,,,15689.0,15689.0,1
HCPCS,61140,Pierce skull for biopsy,,,15689.0,15689.0,1
HCPCS,61150,Pierce skull for drainage,,,15689.0,15689.0,1
HCPCS,61151,Pierce skull for drainage,,,9206.0,9206.0,1
HCPCS,61154,Pierce skull & remove clot,,,15689.0,15689.0,1
HCPCS,61156,Pierce skull for drainage,,,15689.0,15689.0,1
HCPCS,61210,Pierce skull implant device,,,9206.0,9206.0,1
HCPCS,61215,Insert brain-fluid device,,,8461.87,20001.0,2
HCPCS,61250,Pierce skull & explore,,,9206.0,9206.0,1
HCPCS,61253,Pierce skull & explore,,,9206.0,9206.0,1
HCPCS,61304,Open skull for exploration,,,31685.0,31685.0,1
HCPCS,61305,Open skull for exploration,,,31685.0,31685.0,1
HCPCS,61312,Open skull for drainage,,,31685.0,31685.0,1
HCPCS,61313,Open skull for drainage,,,31685.0,31685.0,1
HCPCS,61314,Open skull for drainage,,,31685.0,31685.0,1
HCPCS,61315,Open skull for drainage,,,31685.0,31685.0,1
HCPCS,61316,Implt cran bone flap to abdo,,,31685.0,31685.0,1
HCPCS,61320,Open skull for drainage,,,31685.0,31685.0,1
HCPCS,61321,Open skull for drainage,,,31685.0,31685.0,1
HCPCS,61322,Decompressive craniotomy,,,31685.0,31685.0,1
HCPCS,61323,Decompressive lobectomy,,,31685.0,31685.0,1
HCPCS,61330,Decompress eye socket,,,3196.84,9206.0,2
HCPCS,61333,Explore orbit/remove lesion,,,20001.0,20001.0,1
HCPCS,61340,Subtemporal decompression,,,31685.0,31685.0,1
HCPCS,61343,Incise skull (press relief),,,31685.0,31685.0,1
HCPCS,61345,Relieve cranial pressure,,,31685.0,31685.0,1
HCPCS,61450,Incise skull for surgery,,,31685.0,31685.0,1
HCPCS,61458,Incise skull for brain wound,,,31685.0,31685.0,1
HCPCS,61460,Incise skull for surgery,,,31685.0,31685.0,1
HCPCS,61500,Removal of skull lesion,,,31685.0,31685.0,1
HCPCS,61501,Remove infected skull bone,,,31685.0,31685.0,1
HCPCS,61510,Removal of brain lesion,,,31685.0,31685.0,1
HCPCS,61512,Remove brain lining lesion,,,31685.0,31685.0,1
HCPCS,61514,Removal of brain abscess,,,31685.0,31685.0,1
HCPCS,61516,Removal of brain lesion,,,31685.0,31685.0,1
HCPCS,61517,Implt brain chemotx add-on,,,9206.0,9206.0,1
HCPCS,61518,Removal of brain lesion,,,31685.0,31685.0,1
HCPCS,61519,Remove brain lining lesion,,,31685.0,31685.0,1
HCPCS,61520,Removal of brain lesion,,,31685.0,31685.0,1
HCPCS,61521,Removal of brain lesion,,,31685.0,31685.0,1
HCPCS,61522,Removal of brain abscess,,,31685.0,31685.0,1
HCPCS,61524,Removal of brain lesion,,,31685.0,31685.0,1
HCPCS,61526,Removal of brain lesion,,,31685.0,31685.0,1
HCPCS,61530,Removal of brain lesion,,,31685.0,31685.0,1
HCPCS,61531,Implant brain electrodes,,,31685.0,31685.0,1
HCPCS,61533,Implant brain electrodes,,,31685.0,31685.0,1
HCPCS,61534,Removal of brain lesion,,,31685.0,31685.0,1
HCPCS,61535,Remove brain electrodes,,,31685.0,31685.0,1
HCPCS,61536,Removal of brain lesion,,,31685.0,31685.0,1
HCPCS,61537,Removal of brain tissue,,,31685.0,31685.0,1
HCPCS,61538,Removal of brain tissue,,,31685.0,31685.0,1
HCPCS,61539,Removal of brain tissue,,,31685.0,31685.0,1
HCPCS,61540,Removal of brain tissue,,,31685.0,31685.0,1
HCPCS,61541,Incision of brain tissue,,,31685.0,31685.0,1
HCPCS,61543,Removal of brain tissue,,,31685.0,31685.0,1
HCPCS,61544,Remove & treat brain lesion,,,31685.0,31685.0,1
HCPCS,61545,Excision of brain tumor,,,31685.0,31685.0,1
HCPCS,61546,Removal of pituitary gland,,,31685.0,31685.0,1
HCPCS,61548,Removal of pituitary gland,,,31685.0,31685.0,1
HCPCS,61550,Release of skull seams,,,31685.0,31685.0,1
HCPCS,61552,Release of skull seams,,,31685.0,31685.0,1
HCPCS,61556,Incise skull/sutures,,,31685.0,31685.0,1
HCPCS,61557,Incise skull/sutures,,,31685.0,31685.0,1
HCPCS,61558,Excision of skull/sutures,,,31685.0,31685.0,1
HCPCS,61559,Excision of skull/sutures,,,31685.0,31685.0,1
HCPCS,61563,Excision of skull tumor,,,31685.0,31685.0,1
HCPCS,61564,Excision of skull tumor,,,31685.0,31685.0,1
HCPCS,61566,Removal of brain tissue,,,31685.0,31685.0,1
HCPCS,61567,Incision of brain tissue,,,31685.0,31685.0,1
HCPCS,61570,Remove foreign body brain,,,31685.0,31685.0,1
HCPCS,61571,Incise skull for brain wound,,,31685.0,31685.0,1
HCPCS,61575,Skull base/brainstem surgery,,,31685.0,31685.0,1
HCPCS,61576,Skull base/brainstem surgery,,,31685.0,31685.0,1
HCPCS,61580,Craniofacial approach skull,,,31685.0,31685.0,1
HCPCS,61581,Craniofacial approach skull,,,31685.0,31685.0,1
HCPCS,61582,Craniofacial approach skull,,,31685.0,31685.0,1
HCPCS,61583,Craniofacial approach skull,,,31685.0,31685.0,1
HCPCS,61584,Orbitocranial approach/skull,,,31685.0,31685.0,1
HCPCS,61585,Orbitocranial approach/skull,,,31685.0,31685.0,1
HCPCS,61586,Resect nasopharynx skull,,,31685.0,31685.0,1
HCPCS,61590,Infratemporal approach/skull,,,31685.0,31685.0,1
HCPCS,61591,Infratemporal approach/skull,,,31685.0,31685.0,1
HCPCS,61592,Orbitocranial approach/skull,,,31685.0,31685.0,1
HCPCS,61595,Transtemporal approach/skull,,,31685.0,31685.0,1
HCPCS,61596,Transcochlear approach/skull,,,31685.0,31685.0,1
HCPCS,61597,Transcondylar approach/skull,,,31685.0,31685.0,1
HCPCS,61598,Transpetrosal approach/skull,,,31685.0,31685.0,1
HCPCS,61600,Resect/excise cranial lesion,,,31685.0,31685.0,1
HCPCS,61601,Resect/excise cranial lesion,,,31685.0,31685.0,1
HCPCS,61605,Resect/excise cranial lesion,,,31685.0,31685.0,1
HCPCS,61606,Resect/excise cranial lesion,,,31685.0,31685.0,1
HCPCS,61607,Resect/excise cranial lesion,,,31685.0,31685.0,1
HCPCS,61608,Resect/excise cranial lesion,,,31685.0,31685.0,1
HCPCS,61611,Transect artery sinus,,,9206.0,9206.0,1
HCPCS,61613,Remove aneurysm sinus,,,31685.0,31685.0,1
HCPCS,61615,Resect/excise lesion skull,,,31685.0,31685.0,1
HCPCS,61616,Resect/excise lesion skull,,,31685.0,31685.0,1
HCPCS,61618,Repair dura,,,31685.0,31685.0,1
HCPCS,61619,Repair dura,,,31685.0,31685.0,1
HCPCS,61623,Endovasc tempory vessel occl,,,11131.16,38216.0,2
HCPCS,61623,Hc Endovasc Temp Balloon Arterial Occlus Head Or Neck,24696.0,16052.4,,,0
HCPCS,61624,Hc Transcath Permanent Occlus Or Embol Cns,30065.0,19542.25,,,0
HCPCS,61624,Transcath occlusion cns,,,17675.76,31685.0,2
HCPCS,61626,Hc Transcath Permanent Occlus Or Embol Non Cns,35062.0,22790.3,,,0
HCPCS,61626,Transcath occlusion non-cns,,,11131.16,38216.0,2
HCPCS,61630,Hc Balloon Angioplasty Intracranial Percutaneous,12350.0,8027.5,,,0
HCPCS,61630,Intracranial angioplasty,,,31685.0,31685.0,1
HCPCS,61635,Hc Stent Intracranial Transcath,24700.0,16055.0,,,0
HCPCS,61635,Intracran angioplsty w/stent,,,31685.0,31685.0,1
HCPCS,61640,Dilate ic vasospasm init,,,31685.0,31685.0,1
HCPCS,61640,Hc Balloon Dilat Intracranial Vasospasm Init Vessel,28956.0,18821.4,,,0
HCPCS,61641,Dilate ic vasospasm add-on,,,31685.0,31685.0,1
HCPCS,61641,Hc Blln Dilat Intracran Vasospasm Addl Ves Same Vas Territory,18836.0,12243.4,,,0
HCPCS,61642,Dilate ic vasospasm add-on,,,31685.0,31685.0,1
HCPCS,61642,Hc Blln Dilat Intracran Vasospasm Addl Ves Diff Vas Territory,18836.0,12243.4,,,0
HCPCS,61645,Hc Perc Art Trans Mech Thrombectomy Or Infus For Thrombolysis Intracranial,56949.0,37016.850000000006,,,0
HCPCS,61645,Perq art m-thrombect &/nfs,,,30765.0,30765.0,1
HCPCS,61650,Evasc prlng admn rx agnt 1st,,,30765.0,30765.0,1
HCPCS,61650,Hc Endo Intracranial Prolong Adm Of Pharm Agent Nonthrom W Img Initial,32006.0,20803.9,,,0
HCPCS,61651,Evasc prlng admn rx agnt add,,,30765.0,30765.0,1
HCPCS,61651,Hc Endo Intracranial Prolong Adm Of Pharm Agent Nonthrom W Img Ea Addl,9266.0,6022.9,,,0
HCPCS,61680,Intracranial vessel surgery,,,31685.0,31685.0,1
HCPCS,61682,Intracranial vessel surgery,,,31685.0,31685.0,1
HCPCS,61684,Intracranial vessel surgery,,,31685.0,31685.0,1
HCPCS,61686,Intracranial vessel surgery,,,31685.0,31685.0,1
HCPCS,61690,Intracranial vessel surgery,,,31685.0,31685.0,1
HCPCS,61692,Intracranial vessel surgery,,,31685.0,31685.0,1
HCPCS,61697,Brain aneurysm repr complx,,,31685.0,31685.0,1
HCPCS,61698,Brain aneurysm repr complx,,,31685.0,31685.0,1
HCPCS,61700,Brain aneurysm repr simple,,,31685.0,31685.0,1
HCPCS,61702,Inner skull vessel surgery,,,31685.0,31685.0,1
HCPCS,61703,Clamp neck artery,,,31685.0,31685.0,1
HCPCS,61705,Revise circulation to head,,,31685.0,31685.0,1
HCPCS,61708,Revise circulation to head,,,31685.0,31685.0,1
HCPCS,61710,Revise circulation to head,,,31685.0,31685.0,1
HCPCS,61711,Fusion of skull arteries,,,31685.0,31685.0,1
HCPCS,61715,Hc Mrghifus Ablation Intracranial Target,57968.0,37679.2,,,0
HCPCS,61715,Mrgfus strtctc ablt trgt icr,,,10744.03,38216.0,2
HCPCS,61720,Incise skull/brain surgery,,,8461.87,20001.0,2
HCPCS,61735,Incise skull/brain surgery,,,31685.0,31685.0,1
HCPCS,61736,Litt icr 1 traj 1 smpl les,,,20001.0,20001.0,1
HCPCS,61737,Litt icr mlt trj mlt/cplx ls,,,20001.0,20001.0,1
HCPCS,61750,Incise skull/brain biopsy,,,31685.0,31685.0,1
HCPCS,61751,Brain biopsy w/ct/mr guide,,,31685.0,31685.0,1
HCPCS,61760,Implant brain electrodes,,,31685.0,31685.0,1
HCPCS,61770,Incise skull for treatment,,,3293.92,20001.0,2
HCPCS,61790,Treat trigeminal nerve,,,1882.86,9206.0,2
HCPCS,61791,Treat trigeminal tract,,,1882.86,9206.0,2
HCPCS,61796,Srs cranial lesion simple,,,9206.0,9206.0,1
HCPCS,61797,Srs cran les simple addl,,,9206.0,9206.0,1
HCPCS,61798,Srs cranial lesion complex,,,9206.0,9206.0,1
HCPCS,61799,Srs cran les complex addl,,,16564.0,16564.0,1
HCPCS,61800,Apply srs headframe add-on,,,3714.0,3714.0,1
HCPCS,61850,Implant neuroelectrodes,,,15689.0,15689.0,1
HCPCS,61860,Implant neuroelectrodes,,,31685.0,31685.0,1
HCPCS,61863,Implant neuroelectrode,,,31685.0,31685.0,1
HCPCS,61864,Implant neuroelectrde addl,,,9206.0,9206.0,1
HCPCS,61867,Implant neuroelectrode,,,31685.0,31685.0,1
HCPCS,61868,Implant neuroelectrde addl,,,9206.0,9206.0,1
HCPCS,61880,Hc Revision/Removal Intracranial Electrodes,3300.0,2145.0,,,0
HCPCS,61880,Revise/remove neuroelectrode,,,3371.02,15689.0,2
HCPCS,61885,Hc Ins/Repl Cranl Nstim Pg/Rcvr W 1 Elctr Array,61293.0,39840.45,,,0
HCPCS,61885,Insrt/redo neurostim 1 array,,,29753.66,63079.0,2
HCPCS,61886,Hc Insj/Rplcmt Cranial Neurostim Gener 2/> Eltrds,144644.0,94018.6,,,0
HCPCS,61886,Implant neurostim arrays,,,29753.66,63079.0,2
HCPCS,61888,Hc Revision/Removal Cranial Neurostim Pulse Gen Or Receiver,30264.0,19671.6,,,0
HCPCS,61888,Revise/remove neuroreceiver,,,10744.03,38216.0,2
HCPCS,61889,Ins sk-mnt crnl nstm pg/rcvr,,,63079.0,63079.0,1
HCPCS,61891,Rev/rplcmt sk-mnt crnl nstm,,,29753.66,63079.0,2
HCPCS,61892,Rmv sk-mnt crnl nstm pg/rcvr,,,3154.93,15689.0,2
HCPCS,62000,Treat skull fracture,,,3196.84,9206.0,2
HCPCS,62005,Treat skull fracture,,,31685.0,31685.0,1
HCPCS,62010,Treatment of head injury,,,31685.0,31685.0,1
HCPCS,62100,Repair brain fluid leakage,,,31685.0,31685.0,1
HCPCS,62115,Reduction of skull defect,,,31685.0,31685.0,1
HCPCS,62117,Reduction of skull defect,,,31685.0,31685.0,1
HCPCS,62120,Repair skull cavity lesion,,,31685.0,31685.0,1
HCPCS,62121,Incise skull repair,,,31685.0,31685.0,1
HCPCS,62140,Repair of skull defect,,,15689.0,15689.0,1
HCPCS,62141,Repair of skull defect,,,15689.0,15689.0,1
HCPCS,62142,Remove skull plate/flap,,,15689.0,15689.0,1
HCPCS,62143,Replace skull plate/flap,,,15689.0,15689.0,1
HCPCS,62145,Repair of skull & brain,,,31685.0,31685.0,1
HCPCS,62146,Repair of skull with graft,,,31685.0,31685.0,1
HCPCS,62147,Repair of skull with graft,,,31685.0,31685.0,1
HCPCS,62148,Retr bone flap to fix skull,,,9206.0,9206.0,1
HCPCS,62161,Dissect brain w/scope,,,31685.0,31685.0,1
HCPCS,62162,Remove colloid cyst w/scope,,,31685.0,31685.0,1
HCPCS,62164,Remove brain tumor w/scope,,,31685.0,31685.0,1
HCPCS,62165,Remove pituit tumor w/scope,,,31685.0,31685.0,1
HCPCS,62180,Establish brain cavity shunt,,,31685.0,31685.0,1
HCPCS,62190,Establish brain cavity shunt,,,15689.0,15689.0,1
HCPCS,62192,Establish brain cavity shunt,,,15689.0,15689.0,1
HCPCS,62194,Replace/irrigate catheter,,,1882.86,9206.0,2
HCPCS,62200,Establish brain cavity shunt,,,31685.0,31685.0,1
HCPCS,62201,Brain cavity shunt w/scope,,,15689.0,15689.0,1
HCPCS,62220,Establish brain cavity shunt,,,15689.0,15689.0,1
HCPCS,62223,Establish brain cavity shunt,,,15689.0,15689.0,1
HCPCS,62225,Replace/irrigate catheter,,,3293.92,20001.0,2
HCPCS,62230,Replace/revise brain shunt,,,8461.87,20001.0,2
HCPCS,62252,Csf Shunt Reprogram,,,296.15,3714.0,2
HCPCS,62252,Hc Cfs Shunt Reprogram,890.0,578.5,,,0
HCPCS,62256,Remove brain cavity shunt,,,9206.0,9206.0,1
HCPCS,62258,Replace brain cavity shunt,,,20001.0,20001.0,1
HCPCS,62263,Epidural lysis mult sessions,,,852.83,3714.0,2
HCPCS,62264,Epidural lysis on single day,,,852.83,3714.0,2
HCPCS,62264,Hc Perc Lysis Of Adhesions Mult Sessns 1 Day,16392.0,10654.8,,,0
HCPCS,62267,Hc Percutaneous Aspiration Intervertebral Disc,15049.0,9781.85,,,0
HCPCS,62267,Interdiscal perq aspir dx,,,682.8,3714.0,2
HCPCS,62268,Drain spinal cord cyst,,,852.83,3714.0,2
HCPCS,62268,Hc Percutaneous Aspiration Spinal Cord Cyst,22820.0,14833.0,,,0
HCPCS,62269,Needle biopsy spinal cord,,,1592.51,9206.0,2
HCPCS,62270,Hc Spinal Puncture Lumbar Diagnostic Wo Img,1944.0,1263.6,,,0
HCPCS,62270,Spinal fluid tap diagnostic,,,680.63,3714.0,2
HCPCS,62272,Drain cerebro spinal fluid,,,680.63,3714.0,2
HCPCS,62272,Hc Spinal Puncture Lumbar Therapeutic Wo Img,4732.0,3075.8,,,0
HCPCS,62273,Hc Injection Epidural Of Blood Clot Or Patch,5910.0,3841.5,,,0
HCPCS,62273,Inject epidural patch,,,680.63,3714.0,2
HCPCS,62280,Treat spinal cord lesion,,,852.83,3714.0,2
HCPCS,62281,Treat spinal cord lesion,,,852.83,3714.0,2
HCPCS,62282,Treat spinal canal lesion,,,852.83,3714.0,2
HCPCS,62284,Hc Injection Myelogram Spinal Not C1 C2,1617.0,1051.05,,,0
HCPCS,62287,Hc Perc Decompression 1 Or More Levels Lumbar,6890.0,4478.5,,,0
HCPCS,62287,Percutaneous diskectomy,,,1882.86,20001.0,2
HCPCS,62290,Hc Injection For Discogram Lumbar,5239.0,3405.35,,,0
HCPCS,62291,Hc Injection For Discogram Cervical Or Thoracic,5239.0,3405.35,,,0
HCPCS,62292,Injection into disk lesion,,,1882.86,9206.0,2
HCPCS,62294,Injection into spinal artery,,,852.83,3714.0,2
HCPCS,62302,Hc Inj Myelogram Cervical W  Imaging,4512.0,2932.8,,,0
HCPCS,62302,Myelography lumbar injection,,,755.87,3714.0,2
HCPCS,62303,Hc Inj Myelogram Thoracic W Imaging,5683.0,3693.95,,,0
HCPCS,62303,Myelography lumbar injection,,,755.87,3714.0,2
HCPCS,62304,Hc Inj Myelogram Ls W Imaging,5683.0,3693.95,,,0
HCPCS,62304,Myelography lumbar injection,,,755.87,3714.0,2
HCPCS,62305,Hc Inj Myelogram 2 Or More Regions W Imaging,6820.0,4433.0,,,0
HCPCS,62305,Myelography lumbar injection,,,755.87,3714.0,2
HCPCS,62320,Hc Injection Dx Or Ther Epidur Or Subarach Cer Or Thor Wo Img,7799.0,5069.35,,,0
HCPCS,62320,Njx interlaminar crv/thrc,,,680.63,3714.0,2
HCPCS,62321,Hc Injection Dx Or Ther Epidur Or Subarach Cer Or Thor W Img,8100.0,5265.0,,,0
HCPCS,62321,Njx interlaminar crv/thrc,,,680.63,3714.0,2
HCPCS,62322,Hc Injection Dx Or Ther Epidur Or Subarach Lum Or Sacr Wo Img,6601.0,4290.65,,,0
HCPCS,62322,Hc Pain Procedure Lumbar Or Sacral Wo Fluoro 1St 30 Min,6601.0,4290.65,,,0
HCPCS,62322,Njx interlaminar lmbr/sac,,,852.83,3714.0,2
HCPCS,62323,Hc Injection Dx Or Ther Epidur Or Subarach Lum Or Sacr W Img,7281.0,4732.65,,,0
HCPCS,62323,Njx interlaminar lmbr/sac,,,680.63,3714.0,2
HCPCS,62324,Njx interlaminar crv/thrc,,,852.83,3714.0,2
HCPCS,62325,Njx interlaminar crv/thrc,,,852.83,3714.0,2
HCPCS,62326,Njx interlaminar lmbr/sac,,,852.83,3714.0,2
HCPCS,62327,Hc Injection Incl Cath Plcmnt Lumbar Or Sacral W Img,13643.0,8867.95,,,0
HCPCS,62327,Njx interlaminar lmbr/sac,,,852.83,3714.0,2
HCPCS,62328,Dx lmbr spi pnxr w/fluor/ct,,,680.63,3714.0,2
HCPCS,62328,Hc Spinal Puncture Diagnostic Lumbar W Img,4947.0,3215.55,,,0
HCPCS,62329,Hc Spinal Puncture Therapeutic Drain Csf W Img,4323.0,2809.95,,,0
HCPCS,62329,Ther spi pnxr csf fluor/ct,,,680.63,3714.0,2
HCPCS,62330,Dcmprn prq rmv lig flv 1lmbr,,,6996.6,6996.6,1
HCPCS,62350,Hc Impl Revsn Or Repos Intrathecal Or Epid Catheter,7007.0,4554.55,,,0
HCPCS,62350,Implant spinal canal cath,,,8461.87,20001.0,2
HCPCS,62351,Implant spinal canal cath,,,6996.6,31685.0,2
HCPCS,62355,Hc Remove Spinal Catheter,3024.0,1965.6,,,0
HCPCS,62355,Remove spinal canal catheter,,,1882.86,9206.0,2
HCPCS,62360,Insert spine infusion device,,,17378.99,63079.0,2
HCPCS,62361,Implant spine infusion pump,,,17378.99,63079.0,2
HCPCS,62362,Hc Implant Or Replace Programmable Pump,79192.0,51474.8,,,0
HCPCS,62362,Implant spine infusion pump,,,17378.99,63079.0,2
HCPCS,62365,Hc Removal Subq Reservoir Or Pump,18383.0,11948.95,,,0
HCPCS,62365,Remove spine infusion device,,,3293.92,20001.0,2
HCPCS,62367,Analyze spine infus pump,,,296.15,3714.0,2
HCPCS,62368,Analyze sp inf pump w/reprog,,,296.15,3714.0,2
HCPCS,62368,Hc Elec Anlys Progrmble Pump W Reprgrm,2807.0,1824.55,,,0
HCPCS,62369,Anal sp inf pmp w/reprg&fill,,,296.15,3714.0,2
HCPCS,62369,Hc Elec Anlys Progrmble Pump W Reprgrm And Refill,2489.0,1617.85,,,0
HCPCS,62370,Anl sp inf pmp w/mdreprg&fil,,,296.15,3714.0,2
HCPCS,62370,Hc Elec Anlys Prgrmble Pump W Rprgrm And Fill Phys Asst,2489.0,1617.85,,,0
HCPCS,62380,Ndsc dcmprn 1 ntrspc lumbar,,,6996.6,31685.0,2
HCPCS,63001,Remove spine lamina 1/2 crvl,,,6996.6,31685.0,2
HCPCS,63003,Remove spine lamina 1/2 thrc,,,6996.6,31685.0,2
HCPCS,63005,Remove spine lamina 1/2 lmbr,,,6996.6,31685.0,2
HCPCS,63011,Remove spine lamina 1/2 scrl,,,6996.6,31685.0,2
HCPCS,63012,Remove lamina/facets lumbar,,,6996.6,31685.0,2
HCPCS,63015,Remove spine lamina >2 crvcl,,,6996.6,31685.0,2
HCPCS,63016,Remove spine lamina >2 thrc,,,6996.6,31685.0,2
HCPCS,63017,Remove spine lamina >2 lmbr,,,6996.6,31685.0,2
HCPCS,63020,Neck spine disk surgery,,,6996.6,31685.0,2
HCPCS,63030,Low back disk surgery,,,6996.6,31685.0,2
HCPCS,63040,Laminotomy single cervical,,,6996.6,31685.0,2
HCPCS,63042,Laminotomy single lumbar,,,6996.6,31685.0,2
HCPCS,63045,Remove spine lamina 1 crvl,,,6996.6,31685.0,2
HCPCS,63046,Remove spine lamina 1 thrc,,,6996.6,31685.0,2
HCPCS,63047,Remove spine lamina 1 lmbr,,,6996.6,31685.0,2
HCPCS,63050,Cervical laminoplsty 2/> seg,,,31685.0,31685.0,1
HCPCS,63051,C-laminoplasty w/graft/plate,,,31685.0,31685.0,1
HCPCS,63055,Decompress spinal cord thrc,,,6996.6,31685.0,2
HCPCS,63056,Decompress spinal cord lmbr,,,6996.6,31685.0,2
HCPCS,63064,Decompress spinal cord thrc,,,6996.6,31685.0,2
HCPCS,63075,Neck spine disk surgery,,,6996.6,31685.0,2
HCPCS,63077,Spine disk surgery thorax,,,31685.0,31685.0,1
HCPCS,63078,Spine disk surgery thorax,,,9206.0,9206.0,1
HCPCS,63081,Remove vert body dcmprn crvl,,,31685.0,31685.0,1
HCPCS,63082,Remove vertebral body add-on,,,9206.0,9206.0,1
HCPCS,63085,Remove vert body dcmprn thrc,,,31685.0,31685.0,1
HCPCS,63086,Remove vertebral body add-on,,,9206.0,9206.0,1
HCPCS,63087,Remov vertbr dcmprn thrclmbr,,,31685.0,31685.0,1
HCPCS,63088,Remove vertebral body add-on,,,9206.0,9206.0,1
HCPCS,63090,Remove vert body dcmprn lmbr,,,31685.0,31685.0,1
HCPCS,63091,Remove vertebral body add-on,,,9206.0,9206.0,1
HCPCS,63101,Remove vert body dcmprn thrc,,,31685.0,31685.0,1
HCPCS,63102,Remove vert body dcmprn lmbr,,,31685.0,31685.0,1
HCPCS,63103,Remove vertebral body add-on,,,9206.0,9206.0,1
HCPCS,63170,Incise spinal cord tract(s),,,31685.0,31685.0,1
HCPCS,63172,Drainage of spinal cyst,,,31685.0,31685.0,1
HCPCS,63173,Drainage of spinal cyst,,,31685.0,31685.0,1
HCPCS,63185,Incise spine nrv half segmnt,,,31685.0,31685.0,1
HCPCS,63190,Incise spine nrv >2 segmnts,,,31685.0,31685.0,1
HCPCS,63191,Incise spine accessory nerve,,,31685.0,31685.0,1
HCPCS,63197,Incise spine&cord 2 trx thrc,,,31685.0,31685.0,1
HCPCS,63200,Release spinal cord lumbar,,,31685.0,31685.0,1
HCPCS,63250,Revise spinal cord vsls crvl,,,31685.0,31685.0,1
HCPCS,63251,Revise spinal cord vsls thrc,,,31685.0,31685.0,1
HCPCS,63252,Revise spine cord vsl thrlmb,,,31685.0,31685.0,1
HCPCS,63265,Excise intraspinl lesion crv,,,6996.6,31685.0,2
HCPCS,63266,Excise intrspinl lesion thrc,,,6996.6,31685.0,2
HCPCS,63267,Excise intrspinl lesion lmbr,,,6996.6,31685.0,2
HCPCS,63268,Excise intrspinl lesion scrl,,,6996.6,31685.0,2
HCPCS,63270,Excise intrspinl lesion crvl,,,31685.0,31685.0,1
HCPCS,63271,Excise intrspinl lesion thrc,,,31685.0,31685.0,1
HCPCS,63272,Excise intrspinl lesion lmbr,,,31685.0,31685.0,1
HCPCS,63273,Excise intrspinl lesion scrl,,,31685.0,31685.0,1
HCPCS,63275,Bx/exc xdrl spine lesn crvl,,,31685.0,31685.0,1
HCPCS,63276,Bx/exc xdrl spine lesn thrc,,,31685.0,31685.0,1
HCPCS,63277,Bx/exc xdrl spine lesn lmbr,,,31685.0,31685.0,1
HCPCS,63278,Bx/exc xdrl spine lesn scrl,,,31685.0,31685.0,1
HCPCS,63280,Bx/exc idrl spine lesn crvl,,,31685.0,31685.0,1
HCPCS,63281,Bx/exc idrl spine lesn thrc,,,31685.0,31685.0,1
HCPCS,63282,Bx/exc idrl spine lesn lmbr,,,31685.0,31685.0,1
HCPCS,63283,Bx/exc idrl spine lesn scrl,,,31685.0,31685.0,1
HCPCS,63285,Bx/exc idrl imed lesn cervl,,,31685.0,31685.0,1
HCPCS,63286,Bx/exc idrl imed lesn thrc,,,31685.0,31685.0,1
HCPCS,63287,Bx/exc idrl imed lesn thrlmb,,,31685.0,31685.0,1
HCPCS,63290,Bx/exc xdrl/idrl lsn any lvl,,,31685.0,31685.0,1
HCPCS,63295,Repair laminectomy defect,,,31685.0,31685.0,1
HCPCS,63300,Remove vert xdrl body crvcl,,,31685.0,31685.0,1
HCPCS,63301,Remove vert xdrl body thrc,,,31685.0,31685.0,1
HCPCS,63302,Remove vert xdrl body thrlmb,,,31685.0,31685.0,1
HCPCS,63303,Remov vert xdrl bdy lmbr/sac,,,31685.0,31685.0,1
HCPCS,63304,Remove vert idrl body crvcl,,,31685.0,31685.0,1
HCPCS,63305,Remove vert idrl body thrc,,,31685.0,31685.0,1
HCPCS,63306,Remov vert idrl bdy thrclmbr,,,31685.0,31685.0,1
HCPCS,63307,Remov vert idrl bdy lmbr/sac,,,31685.0,31685.0,1
HCPCS,63308,Remove vertebral body add-on,,,9206.0,9206.0,1
HCPCS,63600,Remove spinal cord lesion,,,1882.86,9206.0,2
HCPCS,63600006,CALCIUM GLUCONATE 3 GM IN 100 ML NS IVPB (PREMIX),50.55,32.86,,,0
HCPCS,63600006,FLUCONAZOLE 1000 MG/500 ML IN SODIUM CHLORIDE IVPB,119.55,77.71,,,0
HCPCS,63600006,FLUCONAZOLE 1200 MG/600 ML IN SODIUM CHLORIDE IVPB,131.7,85.6,,,0
HCPCS,63600006,FLUCONAZOLE 1400 MG/700 ML IN SODIUM CHLORIDE IVPB,143.85,93.5,,,0
HCPCS,63600006,FLUCONAZOLE 600 MG/300 ML (NS) IVPB,83.9,54.54,,,0
HCPCS,63600006,FLUCONAZOLE 800 MG/400 ML (NS) IVPB,92.3,60.0,,,0
HCPCS,63600107,AMINOLEVULINIC ACID HCL 30 MG/ML ORAL SOLUTION,10040.05,6526.03,,,0
HCPCS,63610,Stimulation of spinal cord,,,1882.86,9206.0,2
HCPCS,63620,Srs spinal lesion,,,9206.0,9206.0,1
HCPCS,63621,Srs spinal lesion addl,,,9206.0,9206.0,1
HCPCS,63650,Hc Perc Implant Neurostim Electrode Array,24800.0,16120.0,,,0
HCPCS,63650,Implant neuroelectrodes,,,6144.98,38216.0,2
HCPCS,63655,Implant neuroelectrodes,,,18706.01,63079.0,2
HCPCS,63661,Hc Remove Neuro Electrode Perc Array,16392.0,10654.8,,,0
HCPCS,63661,Remove spine eltrd perq aray,,,1882.86,9206.0,2
HCPCS,63662,Remove spine eltrd plate,,,3371.02,15689.0,2
HCPCS,63663,Hc Revise Neuroelectrode Perc,25142.0,16342.3,,,0
HCPCS,63663,Revise spine eltrd perq aray,,,6144.98,38216.0,2
HCPCS,63664,Revise spine eltrd plate,,,10744.03,63079.0,2
HCPCS,63685,Hc Ins Or Repl Spinal Neurostim Pulse Gen,11308.0,7350.2,,,0
HCPCS,63685,Insrt/redo spine n generator,,,29753.66,63079.0,2
HCPCS,63688,Hc Revise Or Remove Neurostimulator,3585.0,2330.25,,,0
HCPCS,63688,Revise/remove neuroreceiver,,,3371.02,15689.0,2
HCPCS,63700,Repair of spinal herniation,,,15689.0,15689.0,1
HCPCS,63700001,ABACAVIR 20 MG/ML ORAL SOLUTION,26.65,17.32,,,0
HCPCS,63700001,ABACAVIR 300 MG TABLET,18.05,11.73,,,0
HCPCS,63700001,ABACAVIR 600 MG-LAMIVUDINE 300 MG TABLET,10.35,6.73,,,0
HCPCS,63700001,"ACAMPROSATE 333 MG TABLET,DELAYED RELEASE",6.2,4.03,,,0
HCPCS,63700001,ACARBOSE 50 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET,9.95,6.47,,,0
HCPCS,63700001,ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,0.85,0.55,,,0
HCPCS,63700001,ACETAMINOPHEN 325 MG TABLET,0.05,0.03,,,0
HCPCS,63700001,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,0.35,0.23,,,0
HCPCS,63700001,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION,0.65,0.42,,,0
HCPCS,63700001,ACETAZOLAMIDE 125 MG TABLET,5.3,3.44,,,0
HCPCS,63700001,"ACETAZOLAMIDE ER 500 MG CAPSULE,EXTENDED RELEASE",15.95,10.37,,,0
HCPCS,63700001,ACETIC ACID 2 % EAR SOLUTION,89.9,58.44,,,0
HCPCS,63700001,ACETYLCYSTEINE 600 MG CAPSULE,0.1,0.06,,,0
HCPCS,63700001,ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML ORAL SUSPENSION,135.35,87.98,,,0
HCPCS,63700001,ACYCLOVIR 200 MG CAPSULE,4.85,3.15,,,0
HCPCS,63700001,ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,227.4,147.81,,,0
HCPCS,63700001,ACYCLOVIR 800 MG TABLET,6.05,3.93,,,0
HCPCS,63700001,ALBENDAZOLE 200 MG TABLET,19.75,12.84,,,0
HCPCS,63700001,ALBUTEROL SULFATE 2 MG TABLET,19.35,12.58,,,0
HCPCS,63700001,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,5.5,3.58,,,0
HCPCS,63700001,ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,6.05,3.93,,,0
HCPCS,63700001,ALISKIREN 150 MG TABLET,37.9,24.64,,,0
HCPCS,63700001,ALLOPURINOL 100 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,ALLOPURINOL 300 MG TABLET,5.7,3.7,,,0
HCPCS,63700001,ALPRAZOLAM 0.25 MG TABLET,9.1,5.92,,,0
HCPCS,63700001,ALPRAZOLAM 1 MG TABLET,8.35,5.43,,,0
HCPCS,63700001,ALUM BLADDER IRRIGATION 1% IN STERILE WATER,498.7,324.16,,,0
HCPCS,63700001,ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,9.15,5.95,,,0
HCPCS,63700001,ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,8.95,5.82,,,0
HCPCS,63700001,ALVIMOPAN 12 MG CAPSULE,331.45,215.44,,,0
HCPCS,63700001,AMANTADINE HCL 100 MG CAPSULE,7.3,4.74,,,0
HCPCS,63700001,AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,9.3,6.04,,,0
HCPCS,63700001,AMBRISENTAN 10 MG TABLET,32.8,21.32,,,0
HCPCS,63700001,AMBRISENTAN 5 MG TABLET,32.8,21.32,,,0
HCPCS,63700001,AMILORIDE 5 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,23.1,15.02,,,0
HCPCS,63700001,AMINOCAPROIC ACID 500 MG TABLET,57.8,37.57,,,0
HCPCS,63700001,AMIODARONE 100 MG TABLET,12.7,8.26,,,0
HCPCS,63700001,AMIODARONE 200 MG TABLET,5.3,3.44,,,0
HCPCS,63700001,AMITRIPTYLINE 10 MG TABLET,5.45,3.54,,,0
HCPCS,63700001,AMITRIPTYLINE 100 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,AMITRIPTYLINE 25 MG TABLET,5.4,3.51,,,0
HCPCS,63700001,AMITRIPTYLINE 50 MG TABLET,5.75,3.74,,,0
HCPCS,63700001,AMITRIPTYLINE 75 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,AMLODIPINE 10 MG TABLET,4.95,3.22,,,0
HCPCS,63700001,AMLODIPINE 2.5 MG TABLET,4.85,3.15,,,0
HCPCS,63700001,AMLODIPINE 5 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,AMMONIUM LACTATE 12 % LOTION,50.1,32.56,,,0
HCPCS,63700001,AMMONIUM LACTATE 12 % TOPICAL CREAM,33.85,22.0,,,0
HCPCS,63700001,AMOXICILLIN 250 MG CAPSULE,4.85,3.15,,,0
HCPCS,63700001,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET,15.8,10.27,,,0
HCPCS,63700001,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,5.05,3.28,,,0
HCPCS,63700001,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,35.0,22.75,,,0
HCPCS,63700001,AMOXICILLIN 500 MG CAPSULE,5.0,3.25,,,0
HCPCS,63700001,AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,5.55,3.61,,,0
HCPCS,63700001,AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,6.0,3.9,,,0
HCPCS,63700001,ANAGRELIDE 0.5 MG CAPSULE,7.05,4.58,,,0
HCPCS,63700001,ANASTROZOLE 1 MG TABLET,6.95,4.52,,,0
HCPCS,63700001,APIXABAN 2.5 MG TABLET,26.5,17.22,,,0
HCPCS,63700001,APIXABAN 5 MG TABLET,26.5,17.22,,,0
HCPCS,63700001,APRACLONIDINE 0.5 % EYE DROPS,196.65,127.82,,,0
HCPCS,63700001,ARIPIPRAZOLE 10 MG DISINTEGRATING TABLET,19.05,12.38,,,0
HCPCS,63700001,ARIPIPRAZOLE 10 MG TABLET,5.8,3.77,,,0
HCPCS,63700001,ARIPIPRAZOLE 15 MG DISINTEGRATING TABLET,19.05,12.38,,,0
HCPCS,63700001,ARIPIPRAZOLE 15 MG TABLET,8.2,5.33,,,0
HCPCS,63700001,ARIPIPRAZOLE 2 MG TABLET,6.7,4.36,,,0
HCPCS,63700001,ARIPIPRAZOLE 5 MG TABLET,5.55,3.61,,,0
HCPCS,63700001,ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,20.85,13.55,,,0
HCPCS,63700001,ARTIFICIAL TEARS (HYPROMELLOSE) 0.5 % EYE DROPS,116.4,75.66,,,0
HCPCS,63700001,ASCORBIC ACID (VITAMIN C) 250 MG TABLET,0.15,0.1,,,0
HCPCS,63700001,ASCORBIC ACID (VITAMIN C) 500 MG TABLET,0.05,0.03,,,0
HCPCS,63700001,ASENAPINE 5 MG SUBLINGUAL TABLET,15.25,9.91,,,0
HCPCS,63700001,ASPIRIN 300 MG RECTAL SUPPOSITORY,1.1,0.72,,,0
HCPCS,63700001,ASPIRIN 325 MG TABLET,0.1,0.06,,,0
HCPCS,63700001,"ASPIRIN 325 MG TABLET,DELAYED RELEASE",0.05,0.03,,,0
HCPCS,63700001,ASPIRIN 81 MG CHEWABLE TABLET,0.1,0.06,,,0
HCPCS,63700001,"ASPIRIN 81 MG TABLET,DELAYED RELEASE",0.05,0.03,,,0
HCPCS,63700001,ATAZANAVIR 200 MG CAPSULE,12.55,8.16,,,0
HCPCS,63700001,ATAZANAVIR 300 MG CAPSULE,35.05,22.78,,,0
HCPCS,63700001,ATENOLOL 100 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,ATENOLOL 25 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,ATENOLOL 50 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,ATOMOXETINE 10 MG CAPSULE,9.35,6.08,,,0
HCPCS,63700001,ATOMOXETINE 18 MG CAPSULE,9.35,6.08,,,0
HCPCS,63700001,ATOMOXETINE 40 MG CAPSULE,9.75,6.34,,,0
HCPCS,63700001,ATOMOXETINE 60 MG CAPSULE,8.15,5.3,,,0
HCPCS,63700001,ATORVASTATIN 10 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,ATORVASTATIN 20 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,ATORVASTATIN 40 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,ATORVASTATIN 80 MG TABLET,5.85,3.8,,,0
HCPCS,63700001,ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,14.75,9.59,,,0
HCPCS,63700001,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,29.95,19.47,,,0
HCPCS,63700001,ATROPINE 1 % EYE DROPS,280.5,182.32,,,0
HCPCS,63700001,AZELASTINE 0.05 % EYE DROPS,30.8,20.02,,,0
HCPCS,63700001,AZELASTINE 137 MCG (0.1 %) NASAL SPRAY,58.3,37.9,,,0
HCPCS,63700001,AZITHROMYCIN 600 MG TABLET,9.85,6.4,,,0
HCPCS,63700001,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,1.4,0.91,,,0
HCPCS,63700001,"BACITRACIN ZINC 500 UNIT-POLYMYXIN B 10,000 UNIT/GRAM TOPICAL OINTMENT",3.2,2.08,,,0
HCPCS,63700001,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,1.15,0.75,,,0
HCPCS,63700001,"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",35.6,23.14,,,0
HCPCS,63700001,BACLOFEN 10 MG TABLET,5.5,3.58,,,0
HCPCS,63700001,BALSALAZIDE 750 MG CAPSULE,6.7,4.36,,,0
HCPCS,63700001,BARICITINIB 2 MG TABLET,267.15,173.65,,,0
HCPCS,63700001,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-30 MG RECTAL SUPPOSITORY,87.75,57.04,,,0
HCPCS,63700001,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,104.9,68.18,,,0
HCPCS,63700001,BENZOCAINE 20 % MUCOSAL SPRAY,0.95,0.62,,,0
HCPCS,63700001,BENZOCAINE 20 % TOPICAL AEROSOL,3.75,2.44,,,0
HCPCS,63700001,BENZONATATE 100 MG CAPSULE,5.65,3.67,,,0
HCPCS,63700001,BENZOYL PEROXIDE 10 % TOPICAL GEL,24.65,16.02,,,0
HCPCS,63700001,BENZTROPINE 0.5 MG TABLET,5.65,3.67,,,0
HCPCS,63700001,BENZTROPINE 1 MG TABLET,5.6,3.64,,,0
HCPCS,63700001,BETAXOLOL 0.5 % EYE DROPS,166.15,108.0,,,0
HCPCS,63700001,BETHANECHOL CHLORIDE 5 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,BICALUTAMIDE 50 MG TABLET,5.75,3.74,,,0
HCPCS,63700001,BICTEGRAVIR 50 MG-EMTRICITABINE 200 MG-TENOFOVIR ALAFENAM 25 MG TABLET,431.55,280.51,,,0
HCPCS,63700001,BISACODYL 10 MG RECTAL SUPPOSITORY,1.0,0.65,,,0
HCPCS,63700001,"BISACODYL 5 MG TABLET,DELAYED RELEASE",0.05,0.03,,,0
HCPCS,63700001,BISMUTH SUBGALLATE (BULK) POWDER,61.4,39.91,,,0
HCPCS,63700001,BISMUTH SUBSALICYLATE 262 MG CHEWABLE TABLET,0.2,0.13,,,0
HCPCS,63700001,BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION,2.05,1.33,,,0
HCPCS,63700001,BISOPROLOL FUMARATE 5 MG TABLET,7.5,4.88,,,0
HCPCS,63700001,BREXPIPRAZOLE 0.5 MG TABLET,150.6,97.89,,,0
HCPCS,63700001,BREXPIPRAZOLE 1 MG TABLET,150.6,97.89,,,0
HCPCS,63700001,BREXPIPRAZOLE 2 MG TABLET,150.6,97.89,,,0
HCPCS,63700001,BRIMONIDINE 0.15 % EYE DROPS,599.8,389.87,,,0
HCPCS,63700001,BRIMONIDINE 0.2 % EYE DROPS,19.5,12.68,,,0
HCPCS,63700001,BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,23.0,14.95,,,0
HCPCS,63700001,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,15.0,9.75,,,0
HCPCS,63700001,"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",28.75,18.69,,,0
HCPCS,63700001,BUMETANIDE 0.5 MG TABLET,7.2,4.68,,,0
HCPCS,63700001,BUMETANIDE 1 MG TABLET,6.9,4.48,,,0
HCPCS,63700001,BUMETANIDE 2 MG TABLET,8.1,5.26,,,0
HCPCS,63700001,BUPRENORPHINE 10 MCG/HOUR WEEKLY TRANSDERMAL PATCH,158.8,103.22,,,0
HCPCS,63700001,BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,157.6,102.44,,,0
HCPCS,63700001,BUPRENORPHINE 7.5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,158.95,103.32,,,0
HCPCS,63700001,BUPROPION HCL 100 MG TABLET,7.8,5.07,,,0
HCPCS,63700001,BUPROPION HCL 75 MG TABLET,7.0,4.55,,,0
HCPCS,63700001,"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",6.5,4.22,,,0
HCPCS,63700001,BUPROPION HCL SR 150 MG TABLET SORD,5.9,3.84,,,0
HCPCS,63700001,"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",6.25,4.06,,,0
HCPCS,63700001,"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",8.35,5.43,,,0
HCPCS,63700001,BUSPIRONE 10 MG TABLET,5.0,3.25,,,0
HCPCS,63700001,BUSPIRONE 5 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,CADEXOMER IODINE 0.9 % TOPICAL GEL,52.7,34.26,,,0
HCPCS,63700001,CAFFEINE 200 MG TABLET,0.05,0.03,,,0
HCPCS,63700001,CALAMINE 8 %-ZINC OXIDE 8 % LOTION,1.45,0.94,,,0
HCPCS,63700001,CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,297.3,193.24,,,0
HCPCS,63700001,CALCITRIOL 0.25 MCG CAPSULE,6.65,4.32,,,0
HCPCS,63700001,CALCITRIOL 1 MCG/ML ORAL SOLUTION,8.4,5.46,,,0
HCPCS,63700001,CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.05,0.03,,,0
HCPCS,63700001,CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,0.05,0.03,,,0
HCPCS,63700001,CALCIUM 200 MG (AS CITRATE)-VITAMIN D3 6.25 MCG (250 UNIT) TABLET,0.1,0.06,,,0
HCPCS,63700001,CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,0.1,0.06,,,0
HCPCS,63700001,"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",0.05,0.03,,,0
HCPCS,63700001,CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,0.05,0.03,,,0
HCPCS,63700001,"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",8.3,5.4,,,0
HCPCS,63700001,CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,6.8,4.42,,,0
HCPCS,63700001,CALCIUM GLUCONATE 2.5% (CALGONATE) TOPICAL GEL 25 GM,36.0,23.4,,,0
HCPCS,63700001,CALCIUM POLYCARBOPHIL 625 MG TABLET,0.55,0.36,,,0
HCPCS,63700001,CAMPHOR 3.1 %-METHYL SALICYLATE 10 %-MENTHOL 6 % TOPICAL PATCH (LARGE),0.6,0.39,,,0
HCPCS,63700001,CAMPHOR-MENTHOL 0.5 %-0.5 % LOTION,18.85,12.25,,,0
HCPCS,63700001,CAPSAICIN 0.025 % TOPICAL CREAM,21.2,13.78,,,0
HCPCS,63700001,CAPTOPRIL 12.5 MG TABLET,8.25,5.36,,,0
HCPCS,63700001,CAPTOPRIL 50 MG TABLET,10.0,6.5,,,0
HCPCS,63700001,CARBAMAZEPINE 100 MG CHEWABLE TABLET,5.75,3.74,,,0
HCPCS,63700001,CARBAMAZEPINE 200 MG TABLET,5.75,3.74,,,0
HCPCS,63700001,CARBAMAZEPINE 200 MG/10 ML ORAL SUSPENSION,282.3,183.5,,,0
HCPCS,63700001,"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",5.9,3.84,,,0
HCPCS,63700001,"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",13.3,8.64,,,0
HCPCS,63700001,CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,5.0,3.25,,,0
HCPCS,63700001,CARBIDOPA 12.5 MG-LEVODOPA 50 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
HCPCS,63700001,CARBIDOPA 18.75 MG-LEVODOPA 75 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
HCPCS,63700001,CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,5.2,3.38,,,0
HCPCS,63700001,CARBIDOPA 25 MG-LEVODOPA 100 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
HCPCS,63700001,CARBIDOPA 50 MG-LEVODOPA 200 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
HCPCS,63700001,"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",6.5,4.22,,,0
HCPCS,63700001,CARIPRAZINE 1.5 MG CAPSULE,150.85,98.05,,,0
HCPCS,63700001,CARIPRAZINE 3 MG CAPSULE,150.85,98.05,,,0
HCPCS,63700001,CARISOPRODOL 350 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,CARTEOLOL 1 % EYE DROPS,50.25,32.66,,,0
HCPCS,63700001,CARVEDILOL 12.5 MG TABLET,4.85,3.15,,,0
HCPCS,63700001,CARVEDILOL 25 MG TABLET,4.85,3.15,,,0
HCPCS,63700001,CARVEDILOL 3.125 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,CARVEDILOL 6.25 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,CEFADROXIL 500 MG CAPSULE,5.6,3.64,,,0
HCPCS,63700001,CEFADROXIL 500 MG/5 ML ORAL SUSPENSION,8.75,5.69,,,0
HCPCS,63700001,CEFDINIR 125 MG/5 ML ORAL SUSPENSION,26.75,17.39,,,0
HCPCS,63700001,CEFDINIR 300 MG CAPSULE,12.25,7.96,,,0
HCPCS,63700001,CEFIXIME 400 MG CAPSULE,39.3,25.54,,,0
HCPCS,63700001,CEFUROXIME AXETIL 250 MG TABLET,13.2,8.58,,,0
HCPCS,63700001,CEFUROXIME AXETIL 500 MG TABLET,14.95,9.72,,,0
HCPCS,63700001,CELECOXIB 100 MG CAPSULE,6.95,4.52,,,0
HCPCS,63700001,CELECOXIB 200 MG CAPSULE,8.1,5.26,,,0
HCPCS,63700001,CENOBAMATE 200 MG TABLET,121.65,79.07,,,0
HCPCS,63700001,CENOBAMATE 50 MG TABLET,121.65,79.07,,,0
HCPCS,63700001,CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION,10.05,6.53,,,0
HCPCS,63700001,CEPHALEXIN 250 MG CAPSULE,5.4,3.51,,,0
HCPCS,63700001,CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,10.3,6.7,,,0
HCPCS,63700001,CEPHALEXIN 500 MG CAPSULE,5.35,3.48,,,0
HCPCS,63700001,CETIRIZINE 1 MG/ML ORAL SOLUTION,4.9,3.18,,,0
HCPCS,63700001,CHERRY FLAVOR (BULK) ORAL LIQUID,39.3,25.54,,,0
HCPCS,63700001,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,7.05,4.58,,,0
HCPCS,63700001,CHLORPROMAZINE 10 MG TABLET,11.6,7.54,,,0
HCPCS,63700001,CHLORPROMAZINE 100 MG TABLET,21.65,14.07,,,0
HCPCS,63700001,CHLORPROMAZINE 25 MG TABLET,13.6,8.84,,,0
HCPCS,63700001,CHLORTHALIDONE 25 MG TABLET,9.75,6.34,,,0
HCPCS,63700001,"CHOLECALCIFEROL (VITAMIN D3) 1,250 MCG (50,000 UNIT) CAPSULE",0.15,0.1,,,0
HCPCS,63700001,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,4.8,3.12,,,0
HCPCS,63700001,"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) TABLET",0.2,0.13,,,0
HCPCS,63700001,"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",0.05,0.03,,,0
HCPCS,63700001,CHOLESTYRAMINE 4 GRAM ORAL POWDER FOR SUSPENSION IN A PACKET,7.2,4.68,,,0
HCPCS,63700001,CICLOPIROX 0.77 % TOPICAL CREAM,18.35,11.93,,,0
HCPCS,63700001,CILOSTAZOL 100 MG TABLET,6.65,4.32,,,0
HCPCS,63700001,CIPROFLOXACIN 0.2 % EAR DROPS IN A DROPPERETTE,32.55,21.16,,,0
HCPCS,63700001,CIPROFLOXACIN 0.3 % EYE DROPS,26.25,17.06,,,0
HCPCS,63700001,"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",314.6,204.49,,,0
HCPCS,63700001,CIPROFLOXACIN 250 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,CIPROFLOXACIN 750 MG TABLET,5.3,3.44,,,0
HCPCS,63700001,CITALOPRAM 10 MG/5 ML ORAL SOLUTION,8.15,5.3,,,0
HCPCS,63700001,CITALOPRAM 20 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,CITALOPRAM 40 MG TABLET,4.75,3.09,,,0
HCPCS,63700001,CLARITHROMYCIN 250 MG TABLET,10.4,6.76,,,0
HCPCS,63700001,CLARITHROMYCIN 500 MG TABLET,15.4,10.01,,,0
HCPCS,63700001,CLINDAMYCIN 1 % LOTION,378.45,245.99,,,0
HCPCS,63700001,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,7.25,4.71,,,0
HCPCS,63700001,CLINDAMYCIN HCL 150 MG CAPSULE,5.2,3.38,,,0
HCPCS,63700001,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,42.8,27.82,,,0
HCPCS,63700001,CLOBAZAM 10 MG TABLET,11.2,7.28,,,0
HCPCS,63700001,CLOBETASOL 0.05 % TOPICAL CREAM,22.45,14.59,,,0
HCPCS,63700001,CLOBETASOL 0.05 % TOPICAL OINTMENT,27.0,17.55,,,0
HCPCS,63700001,CLOMIPRAMINE 25 MG CAPSULE,31.0,20.15,,,0
HCPCS,63700001,CLOMIPRAMINE 50 MG CAPSULE,35.5,23.08,,,0
HCPCS,63700001,CLONAZEPAM 0.5 MG TABLET,9.7,6.3,,,0
HCPCS,63700001,CLONAZEPAM 1 MG TABLET,8.6,5.59,,,0
HCPCS,63700001,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,25.55,16.61,,,0
HCPCS,63700001,CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,36.65,23.82,,,0
HCPCS,63700001,CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,183.45,119.24,,,0
HCPCS,63700001,CLONIDINE 20 MCG/ML ORAL SUSPENSION,10.1,6.56,,,0
HCPCS,63700001,CLONIDINE HCL 0.1 MG TABLET,5.3,3.44,,,0
HCPCS,63700001,CLONIDINE HCL 0.2 MG TABLET,5.4,3.51,,,0
HCPCS,63700001,CLOPIDOGREL 300 MG TABLET,29.3,19.04,,,0
HCPCS,63700001,CLOPIDOGREL 75 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,CLOTRIMAZOLE 1 % VAGINAL CREAM,24.25,15.76,,,0
HCPCS,63700001,CLOTRIMAZOLE 10 MG TROCHE,12.55,8.16,,,0
HCPCS,63700001,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,72.3,47.0,,,0
HCPCS,63700001,CLOZAPINE 100 MG TABLET,6.75,4.39,,,0
HCPCS,63700001,CLOZAPINE 25 MG TABLET,5.45,3.54,,,0
HCPCS,63700001,COAL TAR 1 % SHAMPOO,95.85,62.3,,,0
HCPCS,63700001,COBICISTAT 150 MG TABLET,34.95,22.72,,,0
HCPCS,63700001,CODEINE 10 MG-GUAIFENESIN 100 MG/5 ML ORAL LIQUID,14.15,9.2,,,0
HCPCS,63700001,CODEINE 15 MG/5 ML ORAL SYRUP,10.3,6.7,,,0
HCPCS,63700001,CODEINE SULFATE 15 MG TABLET,11.0,7.15,,,0
HCPCS,63700001,CODEINE SULFATE 30 MG TABLET,11.2,7.28,,,0
HCPCS,63700001,COLCHICINE 0.6 MG CAPSULE,17.5,11.38,,,0
HCPCS,63700001,COLCHICINE 0.6 MG TABLET,12.15,7.9,,,0
HCPCS,63700001,COLESEVELAM 625 MG TABLET,12.85,8.35,,,0
HCPCS,63700001,COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,1152.25,748.96,,,0
HCPCS,63700001,COMPOUNDING VEHICLE SUSPENSION SUGAR-FREE NO.20 ORAL,16.1,10.46,,,0
HCPCS,63700001,CONJUGATED ESTROGENS 0.3 MG TABLET,25.05,16.28,,,0
HCPCS,63700001,CONJUGATED ESTROGENS 0.45 MG TABLET,25.05,16.28,,,0
HCPCS,63700001,CONJUGATED ESTROGENS 0.625 MG TABLET,25.05,16.28,,,0
HCPCS,63700001,CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,1785.25,1160.41,,,0
HCPCS,63700001,CONJUGATED ESTROGENS 1.25 MG TABLET,25.05,16.28,,,0
HCPCS,63700001,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",0.1,0.06,,,0
HCPCS,63700001,CYANOCOBALAMIN (VIT B-12) 100 MCG TABLET,0.15,0.1,,,0
HCPCS,63700001,CYANOCOBALAMIN (VIT B-12) 250 MCG TABLET,0.15,0.1,,,0
HCPCS,63700001,CYANOCOBALAMIN (VIT B-12) 500 MCG TABLET,0.2,0.13,,,0
HCPCS,63700001,CYCLOBENZAPRINE 10 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,CYCLOBENZAPRINE 5 MG TABLET,5.8,3.77,,,0
HCPCS,63700001,CYCLOPENTOLATE 0.5 % EYE DROPS,381.15,247.75,,,0
HCPCS,63700001,CYCLOPENTOLATE 1 % EYE DROPS,55.3,35.94,,,0
HCPCS,63700001,CYCLOPENTOLATE 2 % EYE DROPS,179.25,116.51,,,0
HCPCS,63700001,CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,144.8,94.12,,,0
HCPCS,63700001,CYPROHEPTADINE 4 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,DABIGATRAN ETEXILATE 75 MG CAPSULE,13.7,8.9,,,0
HCPCS,63700001,"DALFAMPRIDINE ER 10 MG TABLET,EXTENDED RELEASE,12 HR",6.75,4.39,,,0
HCPCS,63700001,DANAZOL 200 MG CAPSULE,14.3,9.3,,,0
HCPCS,63700001,DANTROLENE 100 MG CAPSULE,9.3,6.04,,,0
HCPCS,63700001,DANTROLENE 25 MG CAPSULE,8.6,5.59,,,0
HCPCS,63700001,DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,52.0,33.8,,,0
HCPCS,63700001,DAPAGLIFLOZIN PROPANEDIOL 5 MG TABLET,41.05,26.68,,,0
HCPCS,63700001,DAPSONE 100 MG TABLET,8.1,5.26,,,0
HCPCS,63700001,DAPSONE 25 MG TABLET,7.15,4.65,,,0
HCPCS,63700001,DARUNAVIR 600 MG TABLET,113.9,74.04,,,0
HCPCS,63700001,DARUNAVIR 800 MG TABLET,223.15,145.05,,,0
HCPCS,63700001,DASATINIB 100 MG TABLET,298.9,194.28,,,0
HCPCS,63700001,DASATINIB 140 MG TABLET,357.75,232.54,,,0
HCPCS,63700001,DASATINIB 20 MG TABLET,75.25,48.91,,,0
HCPCS,63700001,DASATINIB 50 MG TABLET,159.8,103.87,,,0
HCPCS,63700001,DASATINIB 70 MG TABLET,203.65,132.37,,,0
HCPCS,63700001,DASATINIB 80 MG TABLET,312.8,203.32,,,0
HCPCS,63700001,DEMECLOCYCLINE 150 MG TABLET,22.95,14.92,,,0
HCPCS,63700001,DESIPRAMINE 100 MG TABLET,6.1,3.96,,,0
HCPCS,63700001,DESIPRAMINE 25 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,DESMOPRESSIN 0.2 MG TABLET,10.3,6.7,,,0
HCPCS,63700001,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),504.15,327.7,,,0
HCPCS,63700001,DESONIDE 0.05 % TOPICAL CREAM,46.65,30.32,,,0
HCPCS,63700001,DESONIDE 0.05 % TOPICAL OINTMENT,47.15,30.65,,,0
HCPCS,63700001,DEXAMETHASONE 10 MG/ML INJ (ORAL USE),6.45,4.19,,,0
HCPCS,63700001,DEXAMETHASONE 4 MG/ML INJ (ORAL USE),34.3,22.3,,,0
HCPCS,63700001,"DEXTROAMPHETAMINE SULFATE ER 10 MG CAPSULE,EXTENDED RELEASE",15.3,9.94,,,0
HCPCS,63700001,"DEXTROAMPHETAMINE SULFATE ER 5 MG CAPSULE,EXTENDED RELEASE",13.75,8.94,,,0
HCPCS,63700001,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,9.05,5.88,,,0
HCPCS,63700001,DEXTROAMPHETAMINE-AMPHETAMINE 20 MG TABLET,9.05,5.88,,,0
HCPCS,63700001,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,9.35,6.08,,,0
HCPCS,63700001,"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",12.45,8.09,,,0
HCPCS,63700001,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,1.75,1.14,,,0
HCPCS,63700001,DEXTROSE 15 GRAM/33 GRAM ORAL GEL PACKET,15.4,10.01,,,0
HCPCS,63700001,DEXTROSE 40 % ORAL GEL,2.95,1.92,,,0
HCPCS,63700001,DIAZEPAM 10 MG TABLET,8.5,5.52,,,0
HCPCS,63700001,DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,553.05,359.48,,,0
HCPCS,63700001,DIAZEPAM 2 MG TABLET,8.45,5.49,,,0
HCPCS,63700001,DIAZEPAM 5 MG TABLET,8.45,5.49,,,0
HCPCS,63700001,"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",10.55,6.86,,,0
HCPCS,63700001,DIAZEPAM 5 MG/ML ORAL CONCENTRATE,9.0,5.85,,,0
HCPCS,63700001,DIAZOXIDE 50 MG/ML ORAL SUSPENSION,851.65,553.57,,,0
HCPCS,63700001,DIBUCAINE 1 % TOPICAL OINTMENT,22.35,14.53,,,0
HCPCS,63700001,DICLOFENAC 1 % TOPICAL GEL,53.45,34.74,,,0
HCPCS,63700001,DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL 12 HOUR PATCH,23.5,15.28,,,0
HCPCS,63700001,DICLOXACILLIN 250 MG CAPSULE,6.25,4.06,,,0
HCPCS,63700001,DICYCLOMINE 10 MG CAPSULE,5.6,3.64,,,0
HCPCS,63700001,DIGOXIN 250 MCG (0.25 MG) TABLET,7.45,4.84,,,0
HCPCS,63700001,DIGOXIN 50 MCG/ML ORAL SOLUTION SORD,216.4,140.66,,,0
HCPCS,63700001,DILTIAZEM 30 MG TABLET,5.35,3.48,,,0
HCPCS,63700001,DILTIAZEM 60 MG TABLET,6.25,4.06,,,0
HCPCS,63700001,DILTIAZEM 90 MG TABLET,6.8,4.42,,,0
HCPCS,63700001,"DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24 HR",5.55,3.61,,,0
HCPCS,63700001,"DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR",5.65,3.67,,,0
HCPCS,63700001,"DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24 HR",5.6,3.64,,,0
HCPCS,63700001,"DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE",1594.2,1036.23,,,0
HCPCS,63700001,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,1.0,0.65,,,0
HCPCS,63700001,DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,1.55,1.01,,,0
HCPCS,63700001,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,11.9,7.74,,,0
HCPCS,63700001,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,30.75,19.99,,,0
HCPCS,63700001,DIPYRIDAMOLE 25 MG TABLET,5.95,3.87,,,0
HCPCS,63700001,DIPYRIDAMOLE 50 MG TABLET,10.15,6.6,,,0
HCPCS,63700001,DISOPYRAMIDE PHOSPHATE 150 MG CAPSULE,8.55,5.56,,,0
HCPCS,63700001,"DISOPYRAMIDE PHOSPHATE ER 100 MG CAPSULE,EXTENDED RELEASE",17.1,11.12,,,0
HCPCS,63700001,"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",5.35,3.48,,,0
HCPCS,63700001,"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",4.8,3.12,,,0
HCPCS,63700001,"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",4.85,3.15,,,0
HCPCS,63700001,"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",5.1,3.32,,,0
HCPCS,63700001,"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",5.0,3.25,,,0
HCPCS,63700001,"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",11.55,7.51,,,0
HCPCS,63700001,DOCOSANOL 10 % TOPICAL CREAM,9.8,6.37,,,0
HCPCS,63700001,DOCUSATE SODIUM 100 MG CAPSULE,0.15,0.1,,,0
HCPCS,63700001,DOCUSATE SODIUM 50 MG CAPSULE,0.25,0.16,,,0
HCPCS,63700001,DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,7.3,4.74,,,0
HCPCS,63700001,DOFETILIDE 250 MCG CAPSULE,11.6,7.54,,,0
HCPCS,63700001,DONEPEZIL 10 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,DONEPEZIL 23 MG TABLET,5.55,3.61,,,0
HCPCS,63700001,DONEPEZIL 5 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,DORAVIRINE 100 MG TABLET,190.95,124.12,,,0
HCPCS,63700001,DORZOLAMIDE 2 % EYE DROPS,139.7,90.8,,,0
HCPCS,63700001,DORZOLAMIDE 22.3 MG-TIMOLOL 6.8 MG/ML EYE DROPS,85.75,55.74,,,0
HCPCS,63700001,DOXAZOSIN 1 MG TABLET,6.8,4.42,,,0
HCPCS,63700001,DOXAZOSIN 2 MG TABLET,6.0,3.9,,,0
HCPCS,63700001,DOXAZOSIN 4 MG TABLET,6.1,3.96,,,0
HCPCS,63700001,DOXEPIN 10 MG CAPSULE,6.15,4.0,,,0
HCPCS,63700001,DOXEPIN 10 MG/ML ORAL CONCENTRATE,12.7,8.26,,,0
HCPCS,63700001,DOXEPIN 25 MG CAPSULE,6.6,4.29,,,0
HCPCS,63700001,DOXEPIN 50 MG CAPSULE,7.35,4.78,,,0
HCPCS,63700001,DOXYCYCLINE HYCLATE 100 MG CAPSULE,8.5,5.52,,,0
HCPCS,63700001,DOXYCYCLINE HYCLATE 100 MG ORAL SOLID SORD,8.95,5.82,,,0
HCPCS,63700001,DOXYCYCLINE HYCLATE 100 MG TABLET,8.95,5.82,,,0
HCPCS,63700001,DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,18.7,12.16,,,0
HCPCS,63700001,DOXYLAMINE SUCCINATE 25 MG TABLET,0.05,0.03,,,0
HCPCS,63700001,DRONABINOL 2.5 MG CAPSULE,15.4,10.01,,,0
HCPCS,63700001,DRONEDARONE 400 MG TABLET,42.85,27.85,,,0
HCPCS,63700001,"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",4.9,3.18,,,0
HCPCS,63700001,"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",5.2,3.38,,,0
HCPCS,63700001,EFAVIRENZ 600 MG TABLET,12.35,8.03,,,0
HCPCS,63700001,ELECTROLYTE-A INTRAVENOUS SOLUTION,62.95,40.92,,,0
HCPCS,63700001,ELVITEG 150 MG-COB 150 MG-EMTRICIT 200 MG-TENOFO ALAFENAM 10 MG TABLET,431.55,280.51,,,0
HCPCS,63700001,ELVITEG 150 MG-COB 150 MG-EMTRICIT 200 MG-TENOFO DISOPRO 300 MG TABLET,452.5,294.12,,,0
HCPCS,63700001,EMTRICITABINE 10 MG/ML ORAL SOLUTION,350.55,227.86,,,0
HCPCS,63700001,EMTRICITABINE 200 MG CAPSULE,56.3,36.6,,,0
HCPCS,63700001,ENTACAPONE 200 MG TABLET,14.25,9.26,,,0
HCPCS,63700001,ENTECAVIR 0.05 MG/ML ORAL SOLUTION,136.8,88.92,,,0
HCPCS,63700001,ENTECAVIR 0.5 MG TABLET,8.5,5.52,,,0
HCPCS,63700001,EPLERENONE 25 MG TABLET,13.0,8.45,,,0
HCPCS,63700001,"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",7.1,4.62,,,0
HCPCS,63700001,"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",9.1,5.92,,,0
HCPCS,63700001,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,59.5,38.68,,,0
HCPCS,63700001,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,27.1,17.62,,,0
HCPCS,63700001,ERYTHROMYCIN ETHYLSUCCINATE 400 MG TABLET,39.8,25.87,,,0
HCPCS,63700001,ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,57.4,37.31,,,0
HCPCS,63700001,ESCITALOPRAM 10 MG TABLET,5.2,3.38,,,0
HCPCS,63700001,ESCITALOPRAM 5 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,ESLICARBAZEPINE 200 MG TABLET,9.8,6.37,,,0
HCPCS,63700001,ESLICARBAZEPINE 400 MG TABLET,10.65,6.92,,,0
HCPCS,63700001,ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,286.25,186.06,,,0
HCPCS,63700001,ESTRADIOL 0.0375 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,30.8,20.02,,,0
HCPCS,63700001,ESTRADIOL 0.05 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,29.1,18.92,,,0
HCPCS,63700001,ESTRADIOL 0.1 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,29.4,19.11,,,0
HCPCS,63700001,ESTRADIOL 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,55.05,35.78,,,0
HCPCS,63700001,ESTRADIOL 0.5 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,ESTRADIOL 1 MG TABLET,4.95,3.22,,,0
HCPCS,63700001,ESTRADIOL 2 MG TABLET,4.85,3.15,,,0
HCPCS,63700001,ETHACRYNIC ACID 25 MG TABLET,75.25,48.91,,,0
HCPCS,63700001,ETHAMBUTOL 100 MG TABLET,5.55,3.61,,,0
HCPCS,63700001,ETHAMBUTOL 400 MG TABLET,6.65,4.32,,,0
HCPCS,63700001,ETHOSUXIMIDE 250 MG CAPSULE,8.1,5.26,,,0
HCPCS,63700001,ETHYL CHLORIDE 100 % TOPICAL SPRAY,123.45,80.24,,,0
HCPCS,63700001,ETRAVIRINE 100 MG TABLET,42.55,27.66,,,0
HCPCS,63700001,EXEMESTANE 25 MG TABLET,9.45,6.14,,,0
HCPCS,63700001,EZETIMIBE 10 MG TABLET,18.25,11.86,,,0
HCPCS,63700001,FAMOTIDINE 10 MG TABLET,5.55,3.61,,,0
HCPCS,63700001,FAMOTIDINE 20 MG TABLET,5.0,3.25,,,0
HCPCS,63700001,FAMOTIDINE 40 MG TABLET,4.95,3.22,,,0
HCPCS,63700001,FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,37.55,24.41,,,0
HCPCS,63700001,FELBAMATE 400 MG TABLET,7.45,4.84,,,0
HCPCS,63700001,FELBAMATE 600 MG TABLET,17.15,11.15,,,0
HCPCS,63700001,FENOFIBRATE 160 MG TABLET,8.4,5.46,,,0
HCPCS,63700001,FENTANYL 100 MCG/HR TRANSDERMAL PATCH,58.35,37.93,,,0
HCPCS,63700001,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,25.2,16.38,,,0
HCPCS,63700001,FENTANYL 200 MCG LOZENGE ON A HANDLE,32.75,21.29,,,0
HCPCS,63700001,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,27.5,17.88,,,0
HCPCS,63700001,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,35.2,22.88,,,0
HCPCS,63700001,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,46.8,30.42,,,0
HCPCS,63700001,FERRIC CITRATE 210 MG IRON TABLET,24.0,15.6,,,0
HCPCS,63700001,FERROUS GLUCONATE 324 MG (37.5 MG IRON) TABLET,0.05,0.03,,,0
HCPCS,63700001,FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQUID,8.95,5.82,,,0
HCPCS,63700001,FERROUS SULFATE 325 MG (65 MG IRON) TABLET,0.05,0.03,,,0
HCPCS,63700001,FIDAXOMICIN 200 MG TABLET,373.05,242.48,,,0
HCPCS,63700001,FINASTERIDE 5 MG TABLET,6.15,4.0,,,0
HCPCS,63700001,FLECAINIDE 100 MG TABLET,6.45,4.19,,,0
HCPCS,63700001,FLECAINIDE 50 MG TABLET,5.95,3.87,,,0
HCPCS,63700001,FLUCONAZOLE 10 MG/ML ORAL SUSPENSION,14.05,9.13,,,0
HCPCS,63700001,FLUCONAZOLE 100 MG TABLET,8.05,5.23,,,0
HCPCS,63700001,FLUCONAZOLE 200 MG TABLET,9.7,6.3,,,0
HCPCS,63700001,FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,8.9,5.78,,,0
HCPCS,63700001,FLUCONAZOLE 50 MG TABLET,5.75,3.74,,,0
HCPCS,63700001,FLUCYTOSINE 250 MG CAPSULE,175.65,114.17,,,0
HCPCS,63700001,FLUCYTOSINE 50 MG/ML ORAL SUSPENSION (CMP),117.8,76.57,,,0
HCPCS,63700001,FLUCYTOSINE 500 MG CAPSULE,304.15,197.7,,,0
HCPCS,63700001,FLUDROCORTISONE 0.1 MG TABLET,5.7,3.7,,,0
HCPCS,63700001,FLUOCINONIDE 0.05 % TOPICAL CREAM,69.45,45.14,,,0
HCPCS,63700001,FLUOCINONIDE 0.05 % TOPICAL OINTMENT,57.6,37.44,,,0
HCPCS,63700001,FLUOCINONIDE 0.05 % TOPICAL SOLUTION,76.1,49.46,,,0
HCPCS,63700001,FLUORESCEIN 1 MG EYE STRIPS,5.3,3.44,,,0
HCPCS,63700001,FLUOROURACIL 5 % TOPICAL CREAM,113.2,73.58,,,0
HCPCS,63700001,FLUOXETINE 10 MG CAPSULE,4.7,3.06,,,0
HCPCS,63700001,FLUOXETINE 20 MG CAPSULE,4.85,3.15,,,0
HCPCS,63700001,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,6.4,4.16,,,0
HCPCS,63700001,FLUPHENAZINE 1 MG TABLET,8.95,5.82,,,0
HCPCS,63700001,FLUPHENAZINE 2.5 MG TABLET,11.95,7.77,,,0
HCPCS,63700001,FLUPHENAZINE 5 MG TABLET,13.6,8.84,,,0
HCPCS,63700001,FLUTICASONE FUROATE 100 MCG/ACTUATION BLISTER POWDER FOR INHALATION,276.45,179.69,,,0
HCPCS,63700001,"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",41.95,27.27,,,0
HCPCS,63700001,FLUVOXAMINE 50 MG TABLET,5.3,3.44,,,0
HCPCS,63700001,FOLIC ACID 1 MG TABLET,5.0,3.25,,,0
HCPCS,63700001,FOLIC ACID-VIT B6-VIT B12 TABLET SORD,6.85,4.45,,,0
HCPCS,63700001,FORMALIN 4% IRRIGATION IN STERILE WATER,456.8,296.92,,,0
HCPCS,63700001,FORMOTEROL FUMARATE 20 MCG/2 ML SOLUTION FOR NEBULIZATION,19.6,12.74,,,0
HCPCS,63700001,FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACKET,204.9,133.18,,,0
HCPCS,63700001,FUROSEMIDE 20 MG TABLET,4.75,3.09,,,0
HCPCS,63700001,FUROSEMIDE 40 MG TABLET,4.75,3.09,,,0
HCPCS,63700001,FUROSEMIDE 40 MG/5 ML (8 MG/ML) ORAL SOLUTION,10.25,6.66,,,0
HCPCS,63700001,FUROSEMIDE 80 MG TABLET,5.75,3.74,,,0
HCPCS,63700001,GABAPENTIN 100 MG CAPSULE,4.9,3.18,,,0
HCPCS,63700001,GABAPENTIN 250 MG/5 ML ORAL SOLUTION,33.25,21.61,,,0
HCPCS,63700001,GABAPENTIN 300 MG CAPSULE,4.95,3.22,,,0
HCPCS,63700001,GABAPENTIN 300 MG/6 ML (6 ML) ORAL SOLUTION,15.45,10.04,,,0
HCPCS,63700001,GABAPENTIN 400 MG CAPSULE,5.05,3.28,,,0
HCPCS,63700001,GALANTAMINE 4 MG TABLET,15.2,9.88,,,0
HCPCS,63700001,GALANTAMINE 8 MG TABLET,6.55,4.26,,,0
HCPCS,63700001,GEMFIBROZIL 600 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,GENTAMICIN 0.1 % TOPICAL CREAM,160.9,104.58,,,0
HCPCS,63700001,GENTAMICIN 0.1 % TOPICAL OINTMENT,70.15,45.6,,,0
HCPCS,63700001,GENTAMICIN 0.3 % EYE DROPS,23.7,15.4,,,0
HCPCS,63700001,GENTIAN VIOLET 1 % TOPICAL SOLUTION,5.5,3.58,,,0
HCPCS,63700001,GLIMEPIRIDE 2 MG TABLET,5.75,3.74,,,0
HCPCS,63700001,GLIPIZIDE 5 MG TABLET,5.2,3.38,,,0
HCPCS,63700001,GLUCOSE 4 GRAM CHEWABLE TABLET,5.25,3.41,,,0
HCPCS,63700001,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.1,0.06,,,0
HCPCS,63700001,GUAIFENESIN 100 MG/5 ML ORAL LIQUID,2.95,1.92,,,0
HCPCS,63700001,"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",0.7,0.46,,,0
HCPCS,63700001,GUANFACINE 1 MG TABLET,12.5,8.12,,,0
HCPCS,63700001,"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",6.75,4.39,,,0
HCPCS,63700001,GUAR GUM ORAL PACKET,39.4,25.61,,,0
HCPCS,63700001,HALOBETASOL PROPIONATE 0.05 % TOPICAL CREAM,74.2,48.23,,,0
HCPCS,63700001,HALOPERIDOL 0.5 MG TABLET,5.45,3.54,,,0
HCPCS,63700001,HALOPERIDOL 1 MG TABLET,5.8,3.77,,,0
HCPCS,63700001,HALOPERIDOL 10 MG TABLET,7.0,4.55,,,0
HCPCS,63700001,HALOPERIDOL 2 MG TABLET,6.25,4.06,,,0
HCPCS,63700001,HALOPERIDOL 5 MG TABLET,6.2,4.03,,,0
HCPCS,63700001,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,5.15,3.35,,,0
HCPCS,63700001,HYDRALAZINE 10 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,HYDRALAZINE 25 MG TABLET,4.75,3.09,,,0
HCPCS,63700001,HYDRALAZINE 50 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,HYDROCHLOROTHIAZIDE 12.5 MG TABLET,4.75,3.09,,,0
HCPCS,63700001,HYDROCHLOROTHIAZIDE 25 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,10.2,6.63,,,0
HCPCS,63700001,HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,9.6,6.24,,,0
HCPCS,63700001,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET,9.85,6.4,,,0
HCPCS,63700001,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,44.35,28.83,,,0
HCPCS,63700001,HYDROCORTISONE 1 % LOTION,6.75,4.39,,,0
HCPCS,63700001,HYDROCORTISONE 1 % TOPICAL CREAM,1.0,0.65,,,0
HCPCS,63700001,HYDROCORTISONE 10 MG TABLET,8.6,5.59,,,0
HCPCS,63700001,HYDROCORTISONE 100 MG/60 ML ENEMA,66.6,43.29,,,0
HCPCS,63700001,HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR,43.95,28.57,,,0
HCPCS,63700001,HYDROCORTISONE 20 MG TABLET,8.5,5.52,,,0
HCPCS,63700001,HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,8.6,5.59,,,0
HCPCS,63700001,HYDROCORTISONE-ACETIC ACID 1 %-2 % EAR DROPS,449.1,291.92,,,0
HCPCS,63700001,HYDROMORPHONE 2 MG TABLET,8.85,5.75,,,0
HCPCS,63700001,HYDROMORPHONE 3 MG RECTAL SUPPOSITORY,46.05,29.93,,,0
HCPCS,63700001,HYDROMORPHONE 4 MG TABLET,9.65,6.27,,,0
HCPCS,63700001,HYDROXYCHLOROQUINE 200 MG TABLET,7.5,4.88,,,0
HCPCS,63700001,HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSPENSION,13.25,8.61,,,0
HCPCS,63700001,HYDROXYUREA 100 MG/ML ORAL SUSPENSION,17.3,11.24,,,0
HCPCS,63700001,HYDROXYUREA 500 MG CAPSULE,6.6,4.29,,,0
HCPCS,63700001,HYDROXYZINE HCL 10 MG TABLET,5.2,3.38,,,0
HCPCS,63700001,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,234.85,152.65,,,0
HCPCS,63700001,HYOSCYAMINE 0.125 MG DISINTEGRATING TABLET,5.1,3.32,,,0
HCPCS,63700001,HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,4.95,3.22,,,0
HCPCS,63700001,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.75,0.49,,,0
HCPCS,63700001,IBUPROFEN 200 MG TABLET,0.05,0.03,,,0
HCPCS,63700001,IBUPROFEN 400 MG TABLET,0.1,0.06,,,0
HCPCS,63700001,IBUPROFEN 600 MG TABLET,0.15,0.1,,,0
HCPCS,63700001,ILOPERIDONE 2 MG TABLET,93.35,60.68,,,0
HCPCS,63700001,ILOPERIDONE 6 MG TABLET,113.8,73.97,,,0
HCPCS,63700001,IMATINIB 400 MG TABLET,11.0,7.15,,,0
HCPCS,63700001,IMIPRAMINE 25 MG TABLET,4.85,3.15,,,0
HCPCS,63700001,INDOMETHACIN 25 MG CAPSULE,5.35,3.48,,,0
HCPCS,63700001,INDOMETHACIN 50 MG CAPSULE,5.3,3.44,,,0
HCPCS,63700001,INDOMETHACIN 50 MG RECTAL SUPPOSITORY,483.75,314.44,,,0
HCPCS,63700001,IODINE-POTASSIUM IODIDE 5 %-10 % TOPICAL SOLUTION,56.85,36.95,,,0
HCPCS,63700001,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,5.45,3.54,,,0
HCPCS,63700001,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,5.35,3.48,,,0
HCPCS,63700001,ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,338.95,220.32,,,0
HCPCS,63700001,ISONIAZID 300 MG TABLET,7.5,4.88,,,0
HCPCS,63700001,ISONIAZID 50 MG/5 ML ORAL SOLUTION,687.85,447.1,,,0
HCPCS,63700001,ISOSORBIDE DINITRATE 10 MG TABLET,5.8,3.77,,,0
HCPCS,63700001,ISOSORBIDE DINITRATE 20 MG TABLET,6.0,3.9,,,0
HCPCS,63700001,ISOSORBIDE DINITRATE 5 MG TABLET,6.3,4.1,,,0
HCPCS,63700001,"ISOSORBIDE MONONITRATE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",5.3,3.44,,,0
HCPCS,63700001,"ISOSORBIDE MONONITRATE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",5.35,3.48,,,0
HCPCS,63700001,ITRACONAZOLE 10 MG/ML ORAL SOLUTION,782.95,508.92,,,0
HCPCS,63700001,ITRACONAZOLE 100 MG CAPSULE,12.7,8.26,,,0
HCPCS,63700001,IVABRADINE 5 MG TABLET,6.8,4.42,,,0
HCPCS,63700001,IVERMECTIN 0.5 % LOTION,571.9,371.74,,,0
HCPCS,63700001,IVERMECTIN 3 MG TABLET,16.15,10.5,,,0
HCPCS,63700001,KETAMINE 5% TOPICAL GEL (CMP),22.45,14.59,,,0
HCPCS,63700001,KETOCONAZOLE 2 % SHAMPOO,64.45,41.89,,,0
HCPCS,63700001,KETOCONAZOLE 2 % TOPICAL CREAM,63.6,41.34,,,0
HCPCS,63700001,KETOCONAZOLE 200 MG TABLET,7.65,4.97,,,0
HCPCS,63700001,KETOROLAC 0.5 % EYE DROPS,116.6,75.79,,,0
HCPCS,63700001,LABETALOL 100 MG TABLET,5.55,3.61,,,0
HCPCS,63700001,LABETALOL 300 MG TABLET,5.65,3.67,,,0
HCPCS,63700001,LACOSAMIDE 100 MG TABLET,10.85,7.05,,,0
HCPCS,63700001,LACOSAMIDE 150 MG TABLET,5.45,3.54,,,0
HCPCS,63700001,LACOSAMIDE 200 MG TABLET,9.3,6.04,,,0
HCPCS,63700001,LACOSAMIDE 50 MG TABLET,11.45,7.44,,,0
HCPCS,63700001,LAMIVUDINE 10 MG/ML ORAL SOLUTION,11.15,7.25,,,0
HCPCS,63700001,LAMIVUDINE 100 MG TABLET,38.5,25.02,,,0
HCPCS,63700001,LAMIVUDINE 150 MG TABLET,18.5,12.02,,,0
HCPCS,63700001,LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,8.3,5.4,,,0
HCPCS,63700001,LAMOTRIGINE 100 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,LAMOTRIGINE 150 MG TABLET,5.6,3.64,,,0
HCPCS,63700001,LAMOTRIGINE 25 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,LANTHANUM 500 MG CHEWABLE TABLET,20.15,13.1,,,0
HCPCS,63700001,LATANOPROST 0.005 % EYE DROPS,18.25,11.86,,,0
HCPCS,63700001,LEFLUNOMIDE 10 MG TABLET,6.75,4.39,,,0
HCPCS,63700001,LEFLUNOMIDE 20 MG TABLET,8.55,5.56,,,0
HCPCS,63700001,LETERMOVIR 480 MG TABLET,866.2,563.03,,,0
HCPCS,63700001,LETROZOLE 2.5 MG TABLET,5.75,3.74,,,0
HCPCS,63700001,LEUCOVORIN CALCIUM 5 MG TABLET,9.2,5.98,,,0
HCPCS,63700001,LEVETIRACETAM 250 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,LEVETIRACETAM 500 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLUTION,10.5,6.82,,,0
HCPCS,63700001,"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",5.5,3.58,,,0
HCPCS,63700001,LEVOBUNOLOL 0.5 % EYE DROPS,72.3,47.0,,,0
HCPCS,63700001,LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,6.25,4.06,,,0
HCPCS,63700001,LEVOFLOXACIN 250 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,LEVOFLOXACIN 500 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,LEVOFLOXACIN 750 MG TABLET,5.75,3.74,,,0
HCPCS,63700001,LEVONORGESTREL 1.5 MG TABLET,3.35,2.18,,,0
HCPCS,63700001,LEVOTHYROXINE 100 MCG TABLET,5.8,3.77,,,0
HCPCS,63700001,LEVOTHYROXINE 112 MCG TABLET,5.95,3.87,,,0
HCPCS,63700001,LEVOTHYROXINE 125 MCG TABLET,6.0,3.9,,,0
HCPCS,63700001,LEVOTHYROXINE 150 MCG TABLET,6.0,3.9,,,0
HCPCS,63700001,LEVOTHYROXINE 175 MCG TABLET,6.3,4.1,,,0
HCPCS,63700001,LEVOTHYROXINE 200 MCG TABLET,6.65,4.32,,,0
HCPCS,63700001,LEVOTHYROXINE 25 MCG TABLET,5.55,3.61,,,0
HCPCS,63700001,LEVOTHYROXINE 50 MCG TABLET,5.55,3.61,,,0
HCPCS,63700001,LEVOTHYROXINE 75 MCG TABLET,5.75,3.74,,,0
HCPCS,63700001,LEVOTHYROXINE 88 MCG TABLET,6.05,3.93,,,0
HCPCS,63700001,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,28.05,18.23,,,0
HCPCS,63700001,LIDOCAINE 4 % TOPICAL CREAM,2.6,1.69,,,0
HCPCS,63700001,LIDOCAINE 4 % TOPICAL PATCH,1.05,0.68,,,0
HCPCS,63700001,LIDOCAINE 5 % TOPICAL OINTMENT,39.65,25.77,,,0
HCPCS,63700001,LIDOCAINE HCL 2 % MUCOSAL SOLUTION,10.75,6.99,,,0
HCPCS,63700001,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,73.15,47.55,,,0
HCPCS,63700001,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,86.05,55.93,,,0
HCPCS,63700001,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,159.6,103.74,,,0
HCPCS,63700001,LINACLOTIDE 145 MCG CAPSULE,59.3,38.54,,,0
HCPCS,63700001,LINACLOTIDE 290 MCG CAPSULE,59.3,38.54,,,0
HCPCS,63700001,LINEZOLID 100 MG/5 ML ORAL SUSPENSION,794.9,516.68,,,0
HCPCS,63700001,LINEZOLID 600 MG TABLET,10.8,7.02,,,0
HCPCS,63700001,LIOTHYRONINE 5 MCG TABLET,6.1,3.96,,,0
HCPCS,63700001,LIOTHYRONINE 50 MCG TABLET,7.2,4.68,,,0
HCPCS,63700001,"LIPASE-PROTEASE-AMYLASE (PORK)36,000-114,000-180K UNIT CAPSULE,DEL REL",41.95,27.27,,,0
HCPCS,63700001,"LIPASE-PROTEASE-AMYLASE (PORK)6,000-19,000-30,000 UNIT CAPSULE,DEL REL",10.85,7.05,,,0
HCPCS,63700001,LISINOPRIL 10 MG TABLET,4.75,3.09,,,0
HCPCS,63700001,LISINOPRIL 2.5 MG TABLET,4.7,3.06,,,0
HCPCS,63700001,LISINOPRIL 20 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,LISINOPRIL 5 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,LITHIUM CARBONATE 150 MG CAPSULE,5.05,3.28,,,0
HCPCS,63700001,LITHIUM CARBONATE 300 MG CAPSULE,4.9,3.18,,,0
HCPCS,63700001,"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",5.7,3.7,,,0
HCPCS,63700001,"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",6.15,4.0,,,0
HCPCS,63700001,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,2.05,1.33,,,0
HCPCS,63700001,LOPERAMIDE 2 MG CAPSULE,6.7,4.36,,,0
HCPCS,63700001,LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,25.95,16.87,,,0
HCPCS,63700001,LORATADINE 10 MG TABLET,0.2,0.13,,,0
HCPCS,63700001,LORAZEPAM 0.5 MG TABLET,8.4,5.46,,,0
HCPCS,63700001,LORAZEPAM 0.5 MG/ML ORAL SYRINGE (NEONATE),5.4,3.51,,,0
HCPCS,63700001,LORAZEPAM 2 MG TABLET,8.45,5.49,,,0
HCPCS,63700001,LORAZEPAM 2 MG/ML ORAL CONCENTRATE,129.9,84.44,,,0
HCPCS,63700001,LOSARTAN 100 MG TABLET,5.9,3.84,,,0
HCPCS,63700001,LOSARTAN 25 MG TABLET,5.6,3.64,,,0
HCPCS,63700001,LOSARTAN 50 MG TABLET,5.4,3.51,,,0
HCPCS,63700001,LOXAPINE SUCCINATE 10 MG CAPSULE,6.3,4.1,,,0
HCPCS,63700001,LOXAPINE SUCCINATE 25 MG CAPSULE,7.2,4.68,,,0
HCPCS,63700001,LOXAPINE SUCCINATE 5 MG CAPSULE,5.45,3.54,,,0
HCPCS,63700001,LUBIPROSTONE 24 MCG CAPSULE,7.25,4.71,,,0
HCPCS,63700001,LUBIPROSTONE 8 MCG CAPSULE,42.55,27.66,,,0
HCPCS,63700001,LURASIDONE 40 MG TABLET,12.35,8.03,,,0
HCPCS,63700001,LURASIDONE 80 MG TABLET,12.55,8.16,,,0
HCPCS,63700001,MACITENTAN 10 MG TABLET,1254.95,815.72,,,0
HCPCS,63700001,MAGIC MOUTHWASH ORAL SUSPENSION (CMP),22.95,14.92,,,0
HCPCS,63700001,MAGNESIUM CITRATE ORAL SOLUTION,13.6,8.84,,,0
HCPCS,63700001,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,0.95,0.62,,,0
HCPCS,63700001,MARAVIROC 150 MG TABLET,87.95,57.17,,,0
HCPCS,63700001,MECLIZINE 12.5 MG TABLET,5.55,3.61,,,0
HCPCS,63700001,MECLIZINE 25 MG TABLET,5.8,3.77,,,0
HCPCS,63700001,MEDROXYPROGESTERONE 10 MG TABLET,8.05,5.23,,,0
HCPCS,63700001,MEDROXYPROGESTERONE 2.5 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,MEGESTROL 20 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,MEGESTROL 40 MG TABLET,5.3,3.44,,,0
HCPCS,63700001,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSPENSION,9.15,5.95,,,0
HCPCS,63700001,MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,5.55,3.61,,,0
HCPCS,63700001,MELATONIN 1 MG TABLET,0.05,0.03,,,0
HCPCS,63700001,MELATONIN 3 MG TABLET,0.15,0.1,,,0
HCPCS,63700001,MELOXICAM 15 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,MELOXICAM 7.5 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,MEMANTINE 10 MG TABLET,5.5,3.58,,,0
HCPCS,63700001,MEMANTINE 2 MG/ML ORAL SOLUTION,21.15,13.75,,,0
HCPCS,63700001,MEMANTINE 5 MG TABLET,5.55,3.61,,,0
HCPCS,63700001,MERCAPTOPURINE 25 MG SPLIT TABLET,6.45,4.19,,,0
HCPCS,63700001,MERCAPTOPURINE 50 MG TABLET,10.35,6.73,,,0
HCPCS,63700001,"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",116.5,75.72,,,0
HCPCS,63700001,"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",29.15,18.95,,,0
HCPCS,63700001,MESALAMINE 4 GRAM/60 ML ENEMA,28.95,18.82,,,0
HCPCS,63700001,MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),19.85,12.9,,,0
HCPCS,63700001,"MESALAMINE ER 0.375 GRAM CAPSULE,EXTENDED RELEASE 24 HR",12.3,8.0,,,0
HCPCS,63700001,METAXALONE 800 MG TABLET,15.9,10.34,,,0
HCPCS,63700001,METFORMIN 500 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,METFORMIN 850 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",4.7,3.06,,,0
HCPCS,63700001,"METFORMIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR",5.45,3.54,,,0
HCPCS,63700001,METHADONE 10 MG/ML ORAL CONCENTRATE,9.3,6.04,,,0
HCPCS,63700001,METHADONE 5 MG TABLET,9.6,6.24,,,0
HCPCS,63700001,METHADONE 5 MG/5 ML ORAL SOLUTION,16.0,10.4,,,0
HCPCS,63700001,METHADONE ORAL SOLUTION 10 MG/1 ML,10.85,7.05,,,0
HCPCS,63700001,METHAZOLAMIDE 25 MG TABLET,7.1,4.62,,,0
HCPCS,63700001,METHAZOLAMIDE 50 MG TABLET,11.75,7.64,,,0
HCPCS,63700001,METHENAMINE HIPPURATE 1 GRAM TABLET,9.85,6.4,,,0
HCPCS,63700001,METHIMAZOLE 5 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,METHOCARBAMOL 500 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,METHOCARBAMOL 750 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM,2.55,1.66,,,0
HCPCS,63700001,METHYL SALICYLATE TOPICAL LIQUID,34.6,22.49,,,0
HCPCS,63700001,METHYLPHENIDATE 10 MG TABLET,13.1,8.52,,,0
HCPCS,63700001,METHYLPHENIDATE 5 MG TABLET,15.35,9.98,,,0
HCPCS,63700001,METOCLOPRAMIDE 5 MG TABLET,6.0,3.9,,,0
HCPCS,63700001,METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,13.85,9.0,,,0
HCPCS,63700001,METOLAZONE 10 MG TABLET,11.7,7.6,,,0
HCPCS,63700001,METOLAZONE 2.5 MG TABLET,10.4,6.76,,,0
HCPCS,63700001,METOLAZONE 5 MG TABLET,12.4,8.06,,,0
HCPCS,63700001,"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",6.05,3.93,,,0
HCPCS,63700001,"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",5.65,3.67,,,0
HCPCS,63700001,METOPROLOL TARTRATE 100 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,METOPROLOL TARTRATE 25 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,METOPROLOL TARTRATE 50 MG TABLET,4.85,3.15,,,0
HCPCS,63700001,METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL,85.75,55.74,,,0
HCPCS,63700001,METRONIDAZOLE 0.75 % TOPICAL CREAM,269.95,175.47,,,0
HCPCS,63700001,METRONIDAZOLE 1 % TOPICAL GEL,263.55,171.31,,,0
HCPCS,63700001,"METRONIDAZOLE 1%, MORPHINE 0.5% TOPICAL SOLUTION",1579.85,1026.9,,,0
HCPCS,63700001,METRONIDAZOLE 500 MG TABLET,6.0,3.9,,,0
HCPCS,63700001,"METRONIDAZOLE/MORPHINE 1%/0.5% CREAM, 30GM",197.15,128.15,,,0
HCPCS,63700001,MEXILETINE 150 MG CAPSULE,8.5,5.52,,,0
HCPCS,63700001,MEXILETINE 200 MG CAPSULE,9.15,5.95,,,0
HCPCS,63700001,MEXILETINE 250 MG CAPSULE,6.65,4.32,,,0
HCPCS,63700001,MICONAZOLE NITRATE 2 % TOPICAL CREAM,4.0,2.6,,,0
HCPCS,63700001,MICONAZOLE NITRATE 2 % VAGINAL CREAM,25.05,16.28,,,0
HCPCS,63700001,MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,67.5,43.88,,,0
HCPCS,63700001,MIDAZOLAM 2 MG/ML ORAL SYRUP,25.45,16.54,,,0
HCPCS,63700001,MIDODRINE 10 MG TABLET,6.85,4.45,,,0
HCPCS,63700001,MIDODRINE 2.5 MG TABLET,6.4,4.16,,,0
HCPCS,63700001,MIDODRINE 5 MG TABLET,6.35,4.13,,,0
HCPCS,63700001,MIDOSTAURIN 25 MG CAPSULE,666.65,433.32,,,0
HCPCS,63700001,MILNACIPRAN 12.5 MG TABLET,29.25,19.01,,,0
HCPCS,63700001,MILNACIPRAN 50 MG TABLET,29.25,19.01,,,0
HCPCS,63700001,MINERAL OIL ENEMA,10.45,6.79,,,0
HCPCS,63700001,MINERAL OIL ORAL,0.95,0.62,,,0
HCPCS,63700001,"MINERAL OIL, LIGHT STERILE",70.4,45.76,,,0
HCPCS,63700001,MINOCYCLINE 50 MG CAPSULE,5.3,3.44,,,0
HCPCS,63700001,MINOXIDIL 10 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,MINOXIDIL 2.5 MG TABLET,5.95,3.87,,,0
HCPCS,63700001,MIRTAZAPINE 15 MG DISINTEGRATING TABLET,5.95,3.87,,,0
HCPCS,63700001,MIRTAZAPINE 15 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,MIRTAZAPINE 30 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,MIRTAZAPINE 7.5 MG TABLET,10.4,6.76,,,0
HCPCS,63700001,MISOPROSTOL 100 MCG TABLET,8.95,5.82,,,0
HCPCS,63700001,MISOPROSTOL 200 MCG TABLET,9.4,6.11,,,0
HCPCS,63700001,MISOPROSTOL 25 MCG SPLIT TABLET,5.1,3.32,,,0
HCPCS,63700001,MISOPROSTOL 50 MCG SPLIT TABLET,5.6,3.64,,,0
HCPCS,63700001,MODAFINIL 100 MG TABLET,28.35,18.43,,,0
HCPCS,63700001,MONTELUKAST 10 MG TABLET,5.6,3.64,,,0
HCPCS,63700001,MONTELUKAST 4 MG CHEWABLE TABLET,6.6,4.29,,,0
HCPCS,63700001,MORPHINE 10 MG/5 ML ORAL SOLUTION,13.45,8.74,,,0
HCPCS,63700001,MORPHINE 15 MG IMMEDIATE RELEASE TABLET,11.15,7.25,,,0
HCPCS,63700001,MORPHINE 30 MG IMMEDIATE RELEASE TABLET,13.2,8.58,,,0
HCPCS,63700001,MORPHINE CONCENTRATE (20 MG/ML) ORAL SOLUTION SORD,8.5,5.52,,,0
HCPCS,63700001,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,8.6,5.59,,,0
HCPCS,63700001,"MORPHINE ER 100 MG TABLET,EXTENDED RELEASE",25.15,16.35,,,0
HCPCS,63700001,"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",11.3,7.34,,,0
HCPCS,63700001,"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",12.6,8.19,,,0
HCPCS,63700001,MORPHINE NEONATAL 0.2 MG/ML ORAL SYRINGE,8.25,5.36,,,0
HCPCS,63700001,MOXIFLOXACIN 0.5 % EYE DROPS,266.7,173.36,,,0
HCPCS,63700001,MULTIVIT-MINS-FERROUS GLUCONATE 9 MG IRON/15 ML (15 ML) ORAL LIQUID,1.95,1.27,,,0
HCPCS,63700001,MULTIVITAMIN ORAL SOLID SORD,0.05,0.03,,,0
HCPCS,63700001,MULTIVITAMIN-MINERAL-FOLIC ACID 400 MCG-LUTEIN 250 MCG CHEWABLE TABLET,0.2,0.13,,,0
HCPCS,63700001,MUPIROCIN 2 % TOPICAL OINTMENT,22.0,14.3,,,0
HCPCS,63700001,MUPIROCIN 2 % TOPICAL OINTMENT (NASAL TXSUB),43.75,28.44,,,0
HCPCS,63700001,MUPIROCIN CALCIUM 2 % TOPICAL CREAM,123.4,80.21,,,0
HCPCS,63700001,NALTREXONE 50 MG TABLET,12.15,7.9,,,0
HCPCS,63700001,NAPROXEN 250 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,NAPROXEN 375 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,NAPROXEN 500 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,NATEGLINIDE 60 MG TABLET,9.5,6.18,,,0
HCPCS,63700001,NEBIVOLOL 10 MG TABLET,11.7,7.6,,,0
HCPCS,63700001,NEBIVOLOL 5 MG TABLET,10.9,7.08,,,0
HCPCS,63700001,"NEOMYCIN 1.75 MG-POLYMYXIN 10,000 UNIT-GRAMICIDIN 0.025MG/ML EYE DROPS",205.45,133.54,,,0
HCPCS,63700001,"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",585.7,380.7,,,0
HCPCS,63700001,"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",69.4,45.11,,,0
HCPCS,63700001,"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",70.5,45.82,,,0
HCPCS,63700001,"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",1.8,1.17,,,0
HCPCS,63700001,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",69.9,45.44,,,0
HCPCS,63700001,"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",308.4,200.46,,,0
HCPCS,63700001,"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG/ML-10,000 UNIT/ML-1 % EAR SOLUTION",230.0,149.5,,,0
HCPCS,63700001,NEVIRAPINE 200 MG TABLET,5.0,3.25,,,0
HCPCS,63700001,NIACIN 100 MG TABLET,5.4,3.51,,,0
HCPCS,63700001,NIACIN 500 MG TABLET,4.7,3.06,,,0
HCPCS,63700001,"NIACIN ER 500 MG TABLET,EXTENDED RELEASE",0.3,0.2,,,0
HCPCS,63700001,"NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",8.0,5.2,,,0
HCPCS,63700001,"NIACIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR",10.4,6.76,,,0
HCPCS,63700001,NICOTINE (POLACRILEX) 2 MG GUM,0.2,0.13,,,0
HCPCS,63700001,NICOTINE (POLACRILEX) 4 MG BUCCAL LOZENGE,0.3,0.2,,,0
HCPCS,63700001,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,1.15,0.75,,,0
HCPCS,63700001,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,1.15,0.75,,,0
HCPCS,63700001,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,1.15,0.75,,,0
HCPCS,63700001,NIFEDIPINE 10 MG CAPSULE,5.8,3.77,,,0
HCPCS,63700001,NIFEDIPINE 20 MG CAPSULE,7.5,4.88,,,0
HCPCS,63700001,"NIFEDIPINE ER 30 MG TABLET, EXT RELEASE ORAL SOLID SORD",6.8,4.42,,,0
HCPCS,63700001,"NIFEDIPINE ER 60 MG TABLET, EXT RELEASE ORAL SOLID SORD",10.35,6.73,,,0
HCPCS,63700001,"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",10.35,6.73,,,0
HCPCS,63700001,"NIFEDIPINE ER 90 MG TABLET, EXT RELEASE ORAL SOLID SORD",11.85,7.7,,,0
HCPCS,63700001,"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",7.5,4.88,,,0
HCPCS,63700001,NIMODIPINE 30 MG CAPSULE,8.1,5.26,,,0
HCPCS,63700001,NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),145.15,94.35,,,0
HCPCS,63700001,NIMODIPINE 30 MG/ML ORAL SOLUTION,31.85,20.7,,,0
HCPCS,63700001,NIRMATRELVIR 150 MG (10)-RITONAVIR 100 MG (10) TABLETS IN A DOSE PACK,220.75,143.49,,,0
HCPCS,63700001,NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,2688.3,1747.4,,,0
HCPCS,63700001,NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,6.35,4.13,,,0
HCPCS,63700001,NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,6.25,4.06,,,0
HCPCS,63700001,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,65.8,42.77,,,0
HCPCS,63700001,NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,6.8,4.42,,,0
HCPCS,63700001,NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,11.0,7.15,,,0
HCPCS,63700001,"NITROGLYCERIN ER 2.5 MG CAPSULE,EXTENDED RELEASE",5.7,3.7,,,0
HCPCS,63700001,"NITROGLYCERIN ER 6.5 MG CAPSULE,EXTENDED RELEASE",5.95,3.87,,,0
HCPCS,63700001,NORETHINDRONE 1 MG-ETHINYL ESTRADIOL 20 MCG (21)-IRON 75 MG (7) TABLET,16.6,10.79,,,0
HCPCS,63700001,NORETHINDRONE ACETATE 5 MG TABLET,6.35,4.13,,,0
HCPCS,63700001,NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,99.7,64.8,,,0
HCPCS,63700001,NORGESTIMATE 0.25 MG-ETHINYL ESTRADIOL 0.035 MG TABLET,24.3,15.8,,,0
HCPCS,63700001,"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",26.9,17.48,,,0
HCPCS,63700001,"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",27.55,17.91,,,0
HCPCS,63700001,"NYSTATIN 100,000 UNIT/GRAM TOPICAL POWDER",35.65,23.17,,,0
HCPCS,63700001,"NYSTATIN 500,000 UNIT TABLET",7.5,4.88,,,0
HCPCS,63700001,"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",26.4,17.16,,,0
HCPCS,63700001,OFLOXACIN 0.3 % EAR DROPS,504.3,327.8,,,0
HCPCS,63700001,OLANZAPINE 2.5 MG TABLET,5.5,3.58,,,0
HCPCS,63700001,OLANZAPINE 20 MG TABLET,6.0,3.9,,,0
HCPCS,63700001,OLANZAPINE 5 MG DISINTEGRATING TABLET,7.1,4.62,,,0
HCPCS,63700001,OLANZAPINE 5 MG TABLET,5.3,3.44,,,0
HCPCS,63700001,OLANZAPINE-FLUOXETINE 12 MG-25 MG CAPSULE,29.2,18.98,,,0
HCPCS,63700001,OLANZAPINE-FLUOXETINE 6 MG-25 MG CAPSULE,23.35,15.18,,,0
HCPCS,63700001,OLANZAPINE-FLUOXETINE 6 MG-50 MG CAPSULE,21.5,13.98,,,0
HCPCS,63700001,ONDANSETRON 4 MG DISINTEGRATING TABLET,5.7,3.7,,,0
HCPCS,63700001,ONDANSETRON 8 MG DISINTEGRATING TABLET,5.7,3.7,,,0
HCPCS,63700001,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,51.05,33.18,,,0
HCPCS,63700001,OSELTAMIVIR 30 MG CAPSULE,7.6,4.94,,,0
HCPCS,63700001,OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,30.6,19.89,,,0
HCPCS,63700001,OSELTAMIVIR 75 MG CAPSULE,7.35,4.78,,,0
HCPCS,63700001,OXCARBAZEPINE 300 MG TABLET,6.55,4.26,,,0
HCPCS,63700001,OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,7.25,4.71,,,0
HCPCS,63700001,OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,4.9,3.18,,,0
HCPCS,63700001,OXYCODONE 15 MG TABLET,11.2,7.28,,,0
HCPCS,63700001,OXYCODONE 20 MG/ML ORAL CONCENTRATE,180.7,117.46,,,0
HCPCS,63700001,OXYCODONE 30 MG TABLET,8.2,5.33,,,0
HCPCS,63700001,OXYCODONE 5 MG TABLET,8.7,5.66,,,0
HCPCS,63700001,OXYCODONE 5 MG/5 ML ORAL SOLUTION,18.25,11.86,,,0
HCPCS,63700001,"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",26.6,17.29,,,0
HCPCS,63700001,OXYCODONE ER 13.5 MG CAPSULE SPRINKLE EXTEND RELEASE 12HR(DON'T CRUSH),32.8,21.32,,,0
HCPCS,63700001,"OXYCODONE ER 15 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",35.3,22.94,,,0
HCPCS,63700001,"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",42.5,27.62,,,0
HCPCS,63700001,OXYCODONE ER 36 MG CAPSULE SPRINKLE EXTENDED RELEASE 12HR(DON'T CRUSH),65.85,42.8,,,0
HCPCS,63700001,"OXYCODONE ER 40 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",66.85,43.45,,,0
HCPCS,63700001,OXYCODONE ER 9 MG CAPSULE SPRINKLE EXTENDED RELEASE 12 HR(DON'T CRUSH),23.8,15.47,,,0
HCPCS,63700001,OXYCODONE-ACETAMINOPHEN 10 MG-325 MG TABLET,12.85,8.35,,,0
HCPCS,63700001,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,8.9,5.78,,,0
HCPCS,63700001,OXYCODONE-ACETAMINOPHEN 7.5 MG-325 MG TABLET,13.0,8.45,,,0
HCPCS,63700001,OXYMETAZOLINE 0.05 % NASAL SPRAY,16.8,10.92,,,0
HCPCS,63700001,"OXYMORPHONE ER 20 MG TABLET,EXTENDED RELEASE,12 HR",77.45,50.34,,,0
HCPCS,63700001,"OXYMORPHONE ER 5 MG TABLET,EXTENDED RELEASE,12 HR",28.55,18.56,,,0
HCPCS,63700001,"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",30.95,20.12,,,0
HCPCS,63700001,"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",30.95,20.12,,,0
HCPCS,63700001,"PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE",5.2,3.38,,,0
HCPCS,63700001,"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",5.1,3.32,,,0
HCPCS,63700001,PANTOPRAZOLE DR 40 MG GRANULES DELAYED-RELEASE FOR SUSP IN PACKET,37.2,24.18,,,0
HCPCS,63700001,PAROXETINE 10 MG TABLET,4.7,3.06,,,0
HCPCS,63700001,PAROXETINE 10 MG/5 ML ORAL SUSPENSION,32.2,20.93,,,0
HCPCS,63700001,PAROXETINE 20 MG TABLET,4.75,3.09,,,0
HCPCS,63700001,PAROXETINE 30 MG TABLET,6.15,4.0,,,0
HCPCS,63700001,PAROXETINE 40 MG TABLET,4.85,3.15,,,0
HCPCS,63700001,PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,92.4,60.06,,,0
HCPCS,63700001,PEG 400-HYPROMELLOSE-GLYCERIN 1 %-0.2 %-0.2 % EYE DROPS,1.55,1.01,,,0
HCPCS,63700001,PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,80.0,52.0,,,0
HCPCS,63700001,PENICILLAMINE 250 MG CAPSULE,761.25,494.81,,,0
HCPCS,63700001,PENICILLIN V POTASSIUM 250 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,30.35,19.73,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 1) ORAL DESENSITIZATION,11.6,7.54,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 10) ORAL DESENSITIZATION,11.4,7.41,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 11) ORAL DESENSITIZATION,11.55,7.51,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 12) ORAL DESENSITIZATION,11.5,7.48,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 13) ORAL DESENSITIZATION,11.4,7.41,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 14) ORAL DESENSITIZATION,11.25,7.31,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 2) ORAL DESENSITIZATION,11.6,7.54,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 3) ORAL DESENSITIZATION,11.55,7.51,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 5) ORAL DESENSITIZATION,11.5,7.48,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 6) ORAL DESENSITIZATION,11.45,7.44,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 7) ORAL DESENSITIZATION,11.3,7.34,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 8) ORAL DESENSITIZATION,11.55,7.51,,,0
HCPCS,63700001,PENICILLIN VK (DOSE 9) ORAL DESENSITIZATION,11.5,7.48,,,0
HCPCS,63700001,"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",5.85,3.8,,,0
HCPCS,63700001,PERAMPANEL 2 MG TABLET,73.75,47.94,,,0
HCPCS,63700001,PERAMPANEL 6 MG TABLET,165.9,107.84,,,0
HCPCS,63700001,PERPHENAZINE 4 MG TABLET,7.15,4.65,,,0
HCPCS,63700001,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,15.25,9.91,,,0
HCPCS,63700001,PHENOBARBITAL 32.4 MG TABLET,8.8,5.72,,,0
HCPCS,63700001,PHENOBARBITAL 97.2 MG TABLET,8.95,5.82,,,0
HCPCS,63700001,PHENOL (BULK) 89 % LIQUID,12.6,8.19,,,0
HCPCS,63700001,PHENOL 89 % TOPICAL SWAB,17.75,11.54,,,0
HCPCS,63700001,PHENYLEPHRINE 0.25 %-COCOA BUTTER 88.44 % RECTAL SUPPOSITORY,5.2,3.38,,,0
HCPCS,63700001,PHENYLEPHRINE 0.25 %-MINERAL OIL 14 %-PETROLATM 74.9 % RECTAL OINTMENT,16.05,10.43,,,0
HCPCS,63700001,PHENYLEPHRINE 0.5 % NASAL SPRAY,22.0,14.3,,,0
HCPCS,63700001,PHENYLEPHRINE 1 % NASAL SPRAY,23.65,15.37,,,0
HCPCS,63700001,PHENYTOIN 100 MG/4 ML ORAL SUSPENSION,20.6,13.39,,,0
HCPCS,63700001,PHENYTOIN 50 MG CHEWABLE TABLET,7.55,4.91,,,0
HCPCS,63700001,PHENYTOIN SODIUM EXTENDED 30 MG CAPSULE,8.95,5.82,,,0
HCPCS,63700001,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML ORAL SOLUTION (NEONATE),16.7,10.86,,,0
HCPCS,63700001,PHYTONADIONE (VITAMIN K1) 5 MG TABLET,157.6,102.44,,,0
HCPCS,63700001,PILOCARPINE 1 % EYE DROPS,312.55,203.16,,,0
HCPCS,63700001,PILOCARPINE 2 % EYE DROPS,135.9,88.34,,,0
HCPCS,63700001,PILOCARPINE 4 % EYE DROPS,139.75,90.84,,,0
HCPCS,63700001,PIOGLITAZONE 15 MG TABLET,8.65,5.62,,,0
HCPCS,63700001,PIOGLITAZONE 30 MG TABLET,12.65,8.22,,,0
HCPCS,63700001,PIRFENIDONE 267 MG TABLET,124.95,81.22,,,0
HCPCS,63700001,PLECANATIDE 3 MG TABLET,59.1,38.42,,,0
HCPCS,63700001,POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,1.05,0.68,,,0
HCPCS,63700001,POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,28.55,18.56,,,0
HCPCS,63700001,POLYETHYLENE GLYCOL 400  1 % EYE DROPS,5.0,3.25,,,0
HCPCS,63700001,"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",28.4,18.46,,,0
HCPCS,63700001,POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAP SORD,4.95,3.22,,,0
HCPCS,63700001,POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,0.1,0.06,,,0
HCPCS,63700001,POLYVINYL ALCOHOL 1.4 % EYE DROPS,40.1,26.06,,,0
HCPCS,63700001,POLYVINYL ALCOHOL-POVIDONE 0.5 %-0.6 % EYE DROPS,3.6,2.34,,,0
HCPCS,63700001,"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",64.55,41.96,,,0
HCPCS,63700001,POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,113.4,73.71,,,0
HCPCS,63700001,POTASSIUM BICARBONATE-CITRIC ACID 25 MEQ EFFERVESCENT TABLET,5.6,3.64,,,0
HCPCS,63700001,POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,11.25,7.31,,,0
HCPCS,63700001,POTASSIUM CHLORIDE ER 10 MEQ TABLET SORD,5.25,3.41,,,0
HCPCS,63700001,"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",5.65,3.67,,,0
HCPCS,63700001,POTASSIUM CHLORIDE ER 20 MEQ TABLET SORD,5.3,3.44,,,0
HCPCS,63700001,"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",10.7,6.96,,,0
HCPCS,63700001,POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,19.1,12.42,,,0
HCPCS,63700001,"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",6.2,4.03,,,0
HCPCS,63700001,PRAMIPEXOLE 0.125 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,PRAMIPEXOLE 0.25 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,PRAMIPEXOLE 0.5 MG TABLET,6.5,4.22,,,0
HCPCS,63700001,PRAMOXINE 1 % TOPICAL FOAM,358.0,232.7,,,0
HCPCS,63700001,PRASUGREL HCL 10 MG TABLET,8.15,5.3,,,0
HCPCS,63700001,PRASUGREL HCL 5 MG TABLET,7.0,4.55,,,0
HCPCS,63700001,PRAVASTATIN 20 MG TABLET,5.85,3.8,,,0
HCPCS,63700001,PRAVASTATIN 40 MG TABLET,6.35,4.13,,,0
HCPCS,63700001,PRAZOSIN 1 MG CAPSULE,7.35,4.78,,,0
HCPCS,63700001,PRAZOSIN 2 MG CAPSULE,8.85,5.75,,,0
HCPCS,63700001,PRAZOSIN 5 MG CAPSULE,14.75,9.59,,,0
HCPCS,63700001,"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",114.35,74.33,,,0
HCPCS,63700001,PREGABALIN 25 MG CAPSULE,9.8,6.37,,,0
HCPCS,63700001,PREGABALIN 50 MG CAPSULE,9.8,6.37,,,0
HCPCS,63700001,PREGABALIN 75 MG CAPSULE,9.8,6.37,,,0
HCPCS,63700001,PRENATAL VITAMINS WITH CALCIUM NO.72-IRON 27 MG-FOLIC ACID 1 MG TABLET,0.1,0.06,,,0
HCPCS,63700001,PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,8.5,5.52,,,0
HCPCS,63700001,PRIMIDONE 250 MG TABLET,6.4,4.16,,,0
HCPCS,63700001,PRIMIDONE 50 MG TABLET,6.5,4.22,,,0
HCPCS,63700001,PROBENECID 500 MG TABLET,10.45,6.79,,,0
HCPCS,63700001,PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,29.1,18.92,,,0
HCPCS,63700001,PROCHLORPERAZINE MALEATE 10 MG TABLET,6.15,4.0,,,0
HCPCS,63700001,PROCHLORPERAZINE MALEATE 5 MG TABLET,7.35,4.78,,,0
HCPCS,63700001,PROGESTERONE MICRONIZED 200 MG CAPSULE,6.95,4.52,,,0
HCPCS,63700001,PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,13.0,8.45,,,0
HCPCS,63700001,PROMETHAZINE 25 MG RECTAL SUPPOSITORY,21.3,13.84,,,0
HCPCS,63700001,PROMETHAZINE 25 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,PROMETHAZINE 50 MG RECTAL SUPPOSITORY,82.1,53.36,,,0
HCPCS,63700001,PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,5.6,3.64,,,0
HCPCS,63700001,PROPAFENONE 150 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,"PROPAFENONE ER 425 MG CAPSULE,EXTENDED RELEASE 12 HR",8.5,5.52,,,0
HCPCS,63700001,PROPARACAINE 0.5 % EYE DROPS,132.25,85.96,,,0
HCPCS,63700001,PROPRANOLOL 10 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,PROPRANOLOL 20 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",9.85,6.4,,,0
HCPCS,63700001,"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",10.25,6.66,,,0
HCPCS,63700001,PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION (CMP),12.25,7.96,,,0
HCPCS,63700001,PROPYLTHIOURACIL 50 MG TABLET,11.5,7.48,,,0
HCPCS,63700001,PSEUDOEPHEDRINE 30 MG TABLET,0.05,0.03,,,0
HCPCS,63700001,"PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE",0.3,0.2,,,0
HCPCS,63700001,PSYLLIUM HUSK 3.4 GRAM ORAL POWDER PACKET,0.45,0.29,,,0
HCPCS,63700001,PYRAZINAMIDE 500 MG TABLET,17.7,11.5,,,0
HCPCS,63700001,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,7.2,4.68,,,0
HCPCS,63700001,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,10.15,6.6,,,0
HCPCS,63700001,"PYRIDOSTIGMINE BROMIDE ER 180 MG TABLET,EXTENDED RELEASE",16.95,11.02,,,0
HCPCS,63700001,PYRIDOXINE (VITAMIN B6) 50 MG TABLET,0.15,0.1,,,0
HCPCS,63700001,QUETIAPINE 100 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,QUETIAPINE 200 MG TABLET,5.55,3.61,,,0
HCPCS,63700001,QUETIAPINE 25 MG TABLET,5.0,3.25,,,0
HCPCS,63700001,QUETIAPINE 300 MG TABLET,5.65,3.67,,,0
HCPCS,63700001,QUETIAPINE 50 MG TABLET,5.3,3.44,,,0
HCPCS,63700001,"QUETIAPINE ER 300 MG TABLET,EXTENDED RELEASE 24 HR",6.15,4.0,,,0
HCPCS,63700001,"QUETIAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR",6.3,4.1,,,0
HCPCS,63700001,"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",5.0,3.25,,,0
HCPCS,63700001,"QUINIDINE GLUCONATE ER 324 MG TABLET,EXTENDED RELEASE",21.45,13.94,,,0
HCPCS,63700001,QUINIDINE SULFATE 200 MG TABLET,39.5,25.68,,,0
HCPCS,63700001,RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,10.4,6.76,,,0
HCPCS,63700001,RALTEGRAVIR 400 MG TABLET,110.1,71.56,,,0
HCPCS,63700001,RAMIPRIL 10 MG CAPSULE,4.8,3.12,,,0
HCPCS,63700001,RAMIPRIL 5 MG CAPSULE,4.75,3.09,,,0
HCPCS,63700001,"RANOLAZINE ER 500 MG TABLET,EXTENDED RELEASE,12 HR",7.95,5.17,,,0
HCPCS,63700001,RASAGILINE 0.5 MG TABLET,10.65,6.92,,,0
HCPCS,63700001,REPAGLINIDE 1 MG TABLET,12.1,7.86,,,0
HCPCS,63700001,RIBAVIRIN 200 MG TABLET,6.4,4.16,,,0
HCPCS,63700001,RIFABUTIN 150 MG CAPSULE,27.85,18.1,,,0
HCPCS,63700001,RIFAMPIN 150 MG CAPSULE,11.9,7.74,,,0
HCPCS,63700001,RIFAXIMIN 550 MG TABLET,180.0,117.0,,,0
HCPCS,63700001,RIMEGEPANT 75 MG DISINTEGRATING TABLET,376.25,244.56,,,0
HCPCS,63700001,RIOCIGUAT 0.5 MG TABLET,496.9,322.98,,,0
HCPCS,63700001,RIOCIGUAT 1 MG TABLET,496.9,322.98,,,0
HCPCS,63700001,RIOCIGUAT 2.5 MG TABLET,434.2,282.23,,,0
HCPCS,63700001,RISPERIDONE 0.25 MG DISINTEGRATING TABLET,13.85,9.0,,,0
HCPCS,63700001,RISPERIDONE 0.25 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,RISPERIDONE 0.5 MG DISINTEGRATING TABLET,8.75,5.69,,,0
HCPCS,63700001,RISPERIDONE 0.5 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,RISPERIDONE 1 MG DISINTEGRATING TABLET,16.45,10.69,,,0
HCPCS,63700001,RISPERIDONE 1 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,RISPERIDONE 2 MG DISINTEGRATING TABLET,12.95,8.42,,,0
HCPCS,63700001,RISPERIDONE 2 MG TABLET,5.1,3.32,,,0
HCPCS,63700001,RISPERIDONE 3 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,RITONAVIR 100 MG TABLET,26.3,17.1,,,0
HCPCS,63700001,RIVAROXABAN 10 MG TABLET,47.8,31.07,,,0
HCPCS,63700001,RIVAROXABAN 15 MG TABLET,47.8,31.07,,,0
HCPCS,63700001,RIVAROXABAN 2.5 MG TABLET,26.25,17.06,,,0
HCPCS,63700001,RIVAROXABAN 20 MG TABLET,47.8,31.07,,,0
HCPCS,63700001,RIVASTIGMINE 1.5 MG CAPSULE,11.3,7.34,,,0
HCPCS,63700001,RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH,12.25,7.96,,,0
HCPCS,63700001,RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH,9.45,6.14,,,0
HCPCS,63700001,ROFLUMILAST 500 MCG TABLET,10.65,6.92,,,0
HCPCS,63700001,ROPINIROLE 0.25 MG TABLET,5.6,3.64,,,0
HCPCS,63700001,ROPINIROLE 0.5 MG TABLET,4.95,3.22,,,0
HCPCS,63700001,ROPINIROLE 1 MG TABLET,5.65,3.67,,,0
HCPCS,63700001,ROPINIROLE 2 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,ROPINIROLE 3 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,ROSUVASTATIN 10 MG TABLET,7.3,4.74,,,0
HCPCS,63700001,ROSUVASTATIN 20 MG TABLET,7.8,5.07,,,0
HCPCS,63700001,RUFINAMIDE 200 MG TABLET,7.75,5.04,,,0
HCPCS,63700001,RUFINAMIDE 400 MG TABLET,9.8,6.37,,,0
HCPCS,63700001,RUXOLITINIB 10 MG TABLET,916.5,595.72,,,0
HCPCS,63700001,RUXOLITINIB 15 MG TABLET,916.5,595.72,,,0
HCPCS,63700001,RUXOLITINIB 20 MG TABLET,916.5,595.72,,,0
HCPCS,63700001,RUXOLITINIB 25 MG TABLET,916.5,595.72,,,0
HCPCS,63700001,RUXOLITINIB 5 MG TABLET,916.5,595.72,,,0
HCPCS,63700001,SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,38.6,25.09,,,0
HCPCS,63700001,SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,38.6,25.09,,,0
HCPCS,63700001,SACUBITRIL 97 MG-VALSARTAN 103 MG TABLET,38.6,25.09,,,0
HCPCS,63700001,SALIVA STIMULANT COMBINATION NO.3 ORAL MUCOSAL SPRAY,30.35,19.73,,,0
HCPCS,63700001,SALIVA STIMULANT COMBINATION NO.7 ORAL MUCOSAL GEL,34.5,22.42,,,0
HCPCS,63700001,SALSALATE 500 MG TABLET,5.5,3.58,,,0
HCPCS,63700001,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,33.2,21.58,,,0
HCPCS,63700001,SELEGILINE 5 MG CAPSULE,6.05,3.93,,,0
HCPCS,63700001,SELENIUM SULFIDE 2.25 % SHAMPOO,153.45,99.74,,,0
HCPCS,63700001,SELEXIPAG 200 MCG TABLET,825.8,536.77,,,0
HCPCS,63700001,SENNOSIDES 8.6 MG TABLET,0.05,0.03,,,0
HCPCS,63700001,SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,0.15,0.1,,,0
HCPCS,63700001,SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,9.75,6.34,,,0
HCPCS,63700001,SERTRALINE 100 MG TABLET,5.45,3.54,,,0
HCPCS,63700001,SERTRALINE 20 MG/ML ORAL CONCENTRATE,7.3,4.74,,,0
HCPCS,63700001,SERTRALINE 25 MG TABLET,5.35,3.48,,,0
HCPCS,63700001,SERTRALINE 50 MG TABLET,5.4,3.51,,,0
HCPCS,63700001,SEVELAMER CARBONATE 800 MG TABLET,9.85,6.4,,,0
HCPCS,63700001,SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,6.25,4.06,,,0
HCPCS,63700001,SILODOSIN 4 MG CAPSULE,5.55,3.61,,,0
HCPCS,63700001,SILODOSIN 8 MG CAPSULE,5.6,3.64,,,0
HCPCS,63700001,SILVER SULFADIAZINE 1 % TOPICAL CREAM,48.2,31.33,,,0
HCPCS,63700001,SIMETHICONE 125 MG CHEWABLE TABLET,4.85,3.15,,,0
HCPCS,63700001,"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",2.125,1.38,,,0
HCPCS,63700001,SIMETHICONE 80 MG CHEWABLE TABLET,0.05,0.03,,,0
HCPCS,63700001,SIMPLE SYRUP,62.15,40.4,,,0
HCPCS,63700001,SIMVASTATIN 10 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,SIMVASTATIN 20 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,SIMVASTATIN 40 MG TABLET,4.95,3.22,,,0
HCPCS,63700001,SITAGLIPTIN PHOSPHATE 100 MG TABLET,36.4,23.66,,,0
HCPCS,63700001,SITAGLIPTIN PHOSPHATE 25 MG TABLET,36.4,23.66,,,0
HCPCS,63700001,SITAGLIPTIN PHOSPHATE 50 MG TABLET,36.4,23.66,,,0
HCPCS,63700001,SODIUM BICARBONATE 325 MG TABLET,0.05,0.03,,,0
HCPCS,63700001,SODIUM BICARBONATE MOUTHWASH 5 G/250 ML IN STERILE WATER,12.8,8.32,,,0
HCPCS,63700001,SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,3.0,1.95,,,0
HCPCS,63700001,SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,12.15,7.9,,,0
HCPCS,63700001,"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",0.25,0.16,,,0
HCPCS,63700001,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,11.5,7.48,,,0
HCPCS,63700001,SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,7.4,4.81,,,0
HCPCS,63700001,SODIUM HYPOCHLORITE 0.125 % SOLUTION,62.15,40.4,,,0
HCPCS,63700001,SODIUM HYPOCHLORITE 0.25 % SOLUTION,58.15,37.8,,,0
HCPCS,63700001,SODIUM POLYSTYRENE SULFONATE 15 GRAM-SORBITOL 20 GRAM/60 ML ORAL SUSP,101.65,66.07,,,0
HCPCS,63700001,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL POWDER PACKET,64.35,41.83,,,0
HCPCS,63700001,SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM ORAL POWDER PACKET,64.35,41.83,,,0
HCPCS,63700001,SORBITOL 70 % SOLUTION,7.85,5.1,,,0
HCPCS,63700001,SOTALOL 120 MG TABLET,5.25,3.41,,,0
HCPCS,63700001,SOTALOL 80 MG TABLET,7.35,4.78,,,0
HCPCS,63700001,SPIRONOLACTONE 100 MG TABLET,6.15,4.0,,,0
HCPCS,63700001,SPIRONOLACTONE 25 MG TABLET,5.0,3.25,,,0
HCPCS,63700001,SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,59.25,38.51,,,0
HCPCS,63700001,SPIRONOLACTONE 50 MG TABLET,5.2,3.38,,,0
HCPCS,63700001,SUCRALFATE 100 MG/ML ORAL SUSPENSION,16.2,10.53,,,0
HCPCS,63700001,SULFACETAMIDE SODIUM 10 % EYE DROPS,157.95,102.67,,,0
HCPCS,63700001,SULFADIAZINE 500 MG TABLET,47.85,31.1,,,0
HCPCS,63700001,SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,11.25,7.31,,,0
HCPCS,63700001,SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,SULFASALAZINE 500 MG TABLET,5.2,3.38,,,0
HCPCS,63700001,"SULFASALAZINE 500 MG TABLET,DELAYED RELEASE",5.4,3.51,,,0
HCPCS,63700001,SUMATRIPTAN 100 MG TABLET,10.0,6.5,,,0
HCPCS,63700001,SUMATRIPTAN 25 MG TABLET,5.6,3.64,,,0
HCPCS,63700001,SUMATRIPTAN 50 MG TABLET,6.15,4.0,,,0
HCPCS,63700001,TADALAFIL 5 MG TABLET,5.5,3.58,,,0
HCPCS,63700001,TAMOXIFEN 10 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,TAMSULOSIN 0.4 MG CAPSULE,5.2,3.38,,,0
HCPCS,63700001,TEMAZEPAM 15 MG CAPSULE,10.4,6.76,,,0
HCPCS,63700001,TEMAZEPAM 7.5 MG CAPSULE,17.5,11.38,,,0
HCPCS,63700001,TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,9.4,6.11,,,0
HCPCS,63700001,TERBINAFINE HCL 1 % TOPICAL CREAM,32.5,21.12,,,0
HCPCS,63700001,TERBINAFINE HCL 250 MG TABLET,5.35,3.48,,,0
HCPCS,63700001,TERBUTALINE 5 MG TABLET,10.15,6.6,,,0
HCPCS,63700001,TETRABENAZINE 12.5 MG TABLET,38.4,24.96,,,0
HCPCS,63700001,TETRACAINE HCL (PF) 0.5 % EYE DROPS,59.65,38.77,,,0
HCPCS,63700001,TETRAHYDROZOLINE 0.05 % EYE DROPS,3.9,2.54,,,0
HCPCS,63700001,THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,10.3,6.7,,,0
HCPCS,63700001,"THEOPHYLLINE ER 300 MG TABLET,EXTENDED RELEASE,12 HR",8.35,5.43,,,0
HCPCS,63700001,"THEOPHYLLINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR",8.5,5.52,,,0
HCPCS,63700001,"THEOPHYLLINE ER 600 MG TABLET,EXTENDED RELEASE 24 HR",10.2,6.63,,,0
HCPCS,63700001,THIAMINE HCL (VITAMIN B1) 100 MG TABLET,0.15,0.1,,,0
HCPCS,63700001,THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,0.2,0.13,,,0
HCPCS,63700001,THIORIDAZINE 10 MG TABLET,5.6,3.64,,,0
HCPCS,63700001,THIORIDAZINE 25 MG TABLET,6.0,3.9,,,0
HCPCS,63700001,THIOTHIXENE 5 MG CAPSULE,8.4,5.46,,,0
HCPCS,63700001,THYROID (PORK) 30 MG TABLET,6.6,4.29,,,0
HCPCS,63700001,THYROID (PORK) 60 MG TABLET,6.85,4.45,,,0
HCPCS,63700001,TIAGABINE 4 MG TABLET,22.95,14.92,,,0
HCPCS,63700001,TICAGRELOR 60 MG TABLET,26.9,17.48,,,0
HCPCS,63700001,TICAGRELOR 90 MG TABLET,26.9,17.48,,,0
HCPCS,63700001,TIMOLOL MALEATE 0.25 % EYE DROPS,18.45,11.99,,,0
HCPCS,63700001,TIMOLOL MALEATE 0.5 % EYE DROPS,63.4,41.21,,,0
HCPCS,63700001,TINIDAZOLE 500 MG TABLET,12.55,8.16,,,0
HCPCS,63700001,TIOTROPIUM BROMIDE 18 MCG CAPSULE WITH INHALATION DEVICE,207.25,134.71,,,0
HCPCS,63700001,TIZANIDINE 2 MG TABLET,6.4,4.16,,,0
HCPCS,63700001,TIZANIDINE 4 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,TOBRAMYCIN 0.3 % EYE DROPS,27.75,18.04,,,0
HCPCS,63700001,"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",57.7,37.5,,,0
HCPCS,63700001,TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,1014.2,659.23,,,0
HCPCS,63700001,"TOLTERODINE ER 2 MG CAPSULE,EXTENDED RELEASE 24 HR",23.2,15.08,,,0
HCPCS,63700001,TOLVAPTAN 15 MG TABLET,177.95,115.67,,,0
HCPCS,63700001,TOLVAPTAN 30 MG TABLET,155.85,101.3,,,0
HCPCS,63700001,TOLVAPTAN 7.5 MG SPLIT TABLET,821.35,533.88,,,0
HCPCS,63700001,TOPIRAMATE 100 MG TABLET,5.7,3.7,,,0
HCPCS,63700001,TOPIRAMATE 25 MG TABLET,5.3,3.44,,,0
HCPCS,63700001,TORSEMIDE 20 MG TABLET,5.55,3.61,,,0
HCPCS,63700001,TORSEMIDE 5 MG TABLET,5.3,3.44,,,0
HCPCS,63700001,TRAMADOL 37.5 MG-ACETAMINOPHEN 325 MG TABLET,8.85,5.75,,,0
HCPCS,63700001,TRAMADOL 50 MG TABLET,8.65,5.62,,,0
HCPCS,63700001,TRANEXAMIC ACID 650 MG TABLET,13.1,8.52,,,0
HCPCS,63700001,TRANYLCYPROMINE 10 MG TABLET,7.55,4.91,,,0
HCPCS,63700001,TRAZODONE 100 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,TRAZODONE 150 MG TABLET,5.5,3.58,,,0
HCPCS,63700001,TRAZODONE 50 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,"TREPROSTINIL DIOLAMINE ER 1 MG TABLET,EXTENDED RELEASE",204.15,132.7,,,0
HCPCS,63700001,TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,66.1,42.96,,,0
HCPCS,63700001,TRETINOIN 2.5 MG/ML ORAL SOLUTION,19.4,12.61,,,0
HCPCS,63700001,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,13.7,8.9,,,0
HCPCS,63700001,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,26.05,16.93,,,0
HCPCS,63700001,TRIAMCINOLONE ACETONIDE 0.147 MG/GRAM TOPICAL AEROSOL,759.9,493.94,,,0
HCPCS,63700001,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,6.75,4.39,,,0
HCPCS,63700001,TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,TRIFLUOPERAZINE 1 MG TABLET,6.4,4.16,,,0
HCPCS,63700001,TRIFLUOPERAZINE 5 MG TABLET,6.65,4.32,,,0
HCPCS,63700001,TRIHEXYPHENIDYL 2 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,TRIMETHOPRIM 100 MG TABLET,9.8,6.37,,,0
HCPCS,63700001,TROPICAMIDE 1 % EYE DROPS,35.2,22.88,,,0
HCPCS,63700001,TROSPIUM 20 MG TABLET,6.9,4.48,,,0
HCPCS,63700001,ULIPRISTAL 30 MG TABLET,116.6,75.79,,,0
HCPCS,63700001,"UPADACITINIB ER 45 MG TABLET,EXTENDED RELEASE 24 HR",1372.25,891.96,,,0
HCPCS,63700001,UREA 10 % LOTION,37.575,24.425,,,0
HCPCS,63700001,UREA 15 GRAM ORAL POWDER PACKET,17.15,11.15,,,0
HCPCS,63700001,URSODIOL 300 MG CAPSULE,12.95,8.42,,,0
HCPCS,63700001,VALACYCLOVIR 500 MG TABLET,8.45,5.49,,,0
HCPCS,63700001,VALGANCICLOVIR 450 MG TABLET,33.35,21.68,,,0
HCPCS,63700001,VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,603.4,392.21,,,0
HCPCS,63700001,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,8.6,5.59,,,0
HCPCS,63700001,VALPROIC ACID (AS SODIUM SALT) 500 MG/10 ML (10 ML) ORAL SOLUTION,8.0,5.2,,,0
HCPCS,63700001,VALPROIC ACID 250 MG CAPSULE,5.6,3.64,,,0
HCPCS,63700001,VALSARTAN 160 MG TABLET,5.35,3.48,,,0
HCPCS,63700001,VALSARTAN 40 MG TABLET,6.65,4.32,,,0
HCPCS,63700001,VALSARTAN 80 MG TABLET,5.55,3.61,,,0
HCPCS,63700001,VANCOMYCIN 125 MG CAPSULE,10.4,6.76,,,0
HCPCS,63700001,VANCOMYCIN 25 MG/ML ORAL SOLUTION,13.35,8.68,,,0
HCPCS,63700001,VANCOMYCIN ORAL 125 MG/5 ML,7.25,4.71,,,0
HCPCS,63700001,VANCOMYCIN ORAL 250 MG/5 ML,5.95,3.87,,,0
HCPCS,63700001,VARENICLINE TARTRATE 0.5 MG TABLET,26.8,17.42,,,0
HCPCS,63700001,VARENICLINE TARTRATE 1 MG TABLET,26.8,17.42,,,0
HCPCS,63700001,VENLAFAXINE 100 MG TABLET,5.2,3.38,,,0
HCPCS,63700001,VENLAFAXINE 25 MG TABLET,7.35,4.78,,,0
HCPCS,63700001,VENLAFAXINE 37.5 MG TABLET,6.15,4.0,,,0
HCPCS,63700001,VENLAFAXINE 50 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,VENLAFAXINE 75 MG TABLET,6.85,4.45,,,0
HCPCS,63700001,"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",6.0,3.9,,,0
HCPCS,63700001,"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",5.85,3.8,,,0
HCPCS,63700001,"VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR",5.9,3.84,,,0
HCPCS,63700001,VERAPAMIL 120 MG TABLET,5.95,3.87,,,0
HCPCS,63700001,VERAPAMIL 40 MG TABLET,5.05,3.28,,,0
HCPCS,63700001,VERAPAMIL 80 MG TABLET,5.5,3.58,,,0
HCPCS,63700001,"VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE",6.35,4.13,,,0
HCPCS,63700001,"VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE",5.55,3.61,,,0
HCPCS,63700001,"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",5.3,3.44,,,0
HCPCS,63700001,VILAZODONE 10 MG TABLET,39.75,25.84,,,0
HCPCS,63700001,VILAZODONE 20 MG TABLET,19.4,12.61,,,0
HCPCS,63700001,"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",0.05,0.03,,,0
HCPCS,63700001,VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,4.8,3.12,,,0
HCPCS,63700001,"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",0.2,0.13,,,0
HCPCS,63700001,"VITAMIN E (DL, ACETATE) 45 MG (100 UNIT) CAPSULE",0.05,0.03,,,0
HCPCS,63700001,"VITAMIN E (DL, ACETATE) 450 MG (1,000 UNIT) CAPSULE",0.15,0.1,,,0
HCPCS,63700001,VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,282.3,183.5,,,0
HCPCS,63700001,VORTIOXETINE 10 MG TABLET,54.15,35.2,,,0
HCPCS,63700001,VORTIOXETINE 20 MG TABLET,54.15,35.2,,,0
HCPCS,63700001,WARFARIN 1 MG TABLET,5.0,3.25,,,0
HCPCS,63700001,WARFARIN 10 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,WARFARIN 2 MG TABLET,5.0,3.25,,,0
HCPCS,63700001,WARFARIN 2.5 MG TABLET,5.0,3.25,,,0
HCPCS,63700001,WARFARIN 3 MG TABLET,5.0,3.25,,,0
HCPCS,63700001,WARFARIN 4 MG TABLET,4.9,3.18,,,0
HCPCS,63700001,WARFARIN 5 MG TABLET,4.85,3.15,,,0
HCPCS,63700001,WARFARIN 6 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,WARFARIN 7.5 MG TABLET,5.15,3.35,,,0
HCPCS,63700001,WHEAT DEXTRIN 3 GRAM/4 GRAM ORAL POWDER PACKET,0.4,0.26,,,0
HCPCS,63700001,WHITE PETROLATUM 42 % TOPICAL OINTMENT,7.75,5.04,,,0
HCPCS,63700001,WHITE PETROLATUM-MINERAL OIL EYE OINTMENT SORD,7.9,5.14,,,0
HCPCS,63700001,ZIDOVUDINE 10 MG/ML ORAL SYRUP,13.3,8.64,,,0
HCPCS,63700001,ZIDOVUDINE 100 MG CAPSULE,9.0,5.85,,,0
HCPCS,63700001,ZIDOVUDINE 300 MG TABLET,7.35,4.78,,,0
HCPCS,63700001,ZINC OXIDE 20 % TOPICAL OINTMENT,35.0,22.75,,,0
HCPCS,63700001,ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,22.95,14.92,,,0
HCPCS,63700001,ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,0.15,0.1,,,0
HCPCS,63700001,ZIPRASIDONE 20 MG CAPSULE,10.15,6.6,,,0
HCPCS,63700001,ZIPRASIDONE 40 MG CAPSULE,10.2,6.63,,,0
HCPCS,63700001,ZOLPIDEM 5 MG TABLET,8.6,5.59,,,0
HCPCS,63700001,ZONISAMIDE 10 MG/ML ORAL SUSPENSION,5.4,3.51,,,0
HCPCS,63700001,ZONISAMIDE 100 MG CAPSULE,5.9,3.84,,,0
HCPCS,63700001,ZONISAMIDE 25 MG CAPSULE,4.85,3.15,,,0
HCPCS,63700001,ZONISAMIDE 50 MG CAPSULE,5.05,3.28,,,0
HCPCS,63702,Repair of spinal herniation,,,15689.0,15689.0,1
HCPCS,63704,Repair of spinal herniation,,,31685.0,31685.0,1
HCPCS,63706,Repair of spinal herniation,,,31685.0,31685.0,1
HCPCS,63707,Repair spinal fluid leakage,,,15689.0,15689.0,1
HCPCS,63709,Repair spinal fluid leakage,,,15689.0,15689.0,1
HCPCS,63710,Graft repair of spine defect,,,15689.0,15689.0,1
HCPCS,63740,Install spinal shunt,,,15689.0,15689.0,1
HCPCS,63741,Install spinal shunt,,,8461.87,20001.0,2
HCPCS,63744,Revision of spinal shunt,,,3293.92,20001.0,2
HCPCS,63746,Removal of spinal shunt,,,1882.86,9206.0,2
HCPCS,64400,Hc Injection Anes/Steroid Trigeminal Nerve Each Branch,1686.0,1095.9,,,0
HCPCS,64400,N block inj trigeminal,,,295.97,3714.0,2
HCPCS,64405,Hc Injection Anes/Steroid Greater Occipital Nerve,2529.0,1643.8500000000001,,,0
HCPCS,64405,N block inj occipital,,,295.97,3714.0,2
HCPCS,64408,N block inj vagus,,,295.97,3714.0,2
HCPCS,64415,Hc Injection Anes Brachial Plexus,7506.0,4878.9,,,0
HCPCS,64415,N block inj brachial plexus,,,852.83,3714.0,2
HCPCS,64416,N block cont infuse b plex,,,852.83,3714.0,2
HCPCS,64417,Hc Injection Anes Axillary Nerve,10680.0,6942.0,,,0
HCPCS,64417,N block inj axillary,,,852.83,3714.0,2
HCPCS,64418,Hc Injection Anes/Steroid Suprascapular Nerve,8877.0,5770.049999999999,,,0
HCPCS,64418,N block inj suprascapular,,,680.63,3714.0,2
HCPCS,64420,Hc Injection Anes/Steroid Intercostal Nerve Single,3506.0,2278.9,,,0
HCPCS,64420,N block inj intercost sng,,,680.63,3714.0,2
HCPCS,64421,Hc Injection Anes/Steroid Intercostal Nerves Ea Addl,5983.0,3888.95,,,0
HCPCS,64421,N block inj intercost mlt,,,852.83,3714.0,2
HCPCS,64425,Hc Injection Anes/Steroid Ilioinguinal Or Ileohypergastric Nerve,5259.0,3418.3500000000004,,,0
HCPCS,64425,N block inj ilio-ing/hypogi,,,680.63,3714.0,2
HCPCS,64430,Hc Injection Anes/Steroid Pudendal Nerve,10287.0,6686.549999999999,,,0
HCPCS,64430,N block inj pudendal,,,852.83,3714.0,2
HCPCS,64435,N block inj paracervical,,,680.63,3714.0,2
HCPCS,64445,Hc Injection Anes/Steroid Sciatic Nerve Single,8877.0,5770.049999999999,,,0
HCPCS,64445,N block inj sciatic sng,,,680.63,3714.0,2
HCPCS,64446,N blk inj sciatic cont inf,,,852.83,3714.0,2
HCPCS,64447,Hc Injection Anes/Steroid Femoral Nerve Single,3861.0,2509.6499999999996,,,0
HCPCS,64447,N block inj fem single,,,680.63,3714.0,2
HCPCS,64448,N block inj fem cont inf,,,852.83,3714.0,2
HCPCS,64449,Hc Injection Anes/Steroid Lumbar Plexus Cont Infs Cath,6617.0,4301.05,,,0
HCPCS,64449,N block inj lumbar plexus,,,852.83,3714.0,2
HCPCS,64450,Hc Injection Anes/Steroid Other Peripheral Nerve Branch,2965.5,1927.5749999999998,,,0
HCPCS,64450,N block other peripheral,,,680.63,3714.0,2
HCPCS,64451,Hc Injection Anes/Steroid Si Joint Nerves W Img,6820.5,4433.325000000001,,,0
HCPCS,64451,Njx aa&/strd nrv nrvtg si jt,,,680.63,3714.0,2
HCPCS,64454,Hc Injection Anes/Steroid Genicular Nerve Branches W Img,5683.5,3694.2749999999996,,,0
HCPCS,64454,Njx aa&/strd gnclr nrv brnch,,,680.63,3714.0,2
HCPCS,64455,Hc Injection Anes/Steroid Plantar Common Digital Nerve,2529.0,1643.8500000000001,,,0
HCPCS,64455,N block inj plantar digit,,,295.97,3714.0,2
HCPCS,64461,Hc Paravertebral Block Thoracic W Img Single Injection,9901.5,6435.974999999999,,,0
HCPCS,64461,Pvb thoracic single inj site,,,680.63,3714.0,2
HCPCS,64462,Hc Paravertebral Block Thoracic W Img Addl Injection,3300.0,2145.0,,,0
HCPCS,64463,Pvb thoracic cont infusion,,,680.63,3714.0,2
HCPCS,64466,Hc Thoracic Fascial Plane Block W Img Unilat,5501.0,3575.65,,,0
HCPCS,64468,Hc Thoracic Fascial Plane Block W Img Bilat,11002.0,7151.3,,,0
HCPCS,64473,Hc Le Fascial Plane Block W Img Unilat,8251.5,5363.475,,,0
HCPCS,64479,Hc Injection Anes/Steroid Trnsfrmnl Epi Cerv/Thor W Img Sgl,5025.0,3266.25,,,0
HCPCS,64479,Inj foramen epidural c/t,,,852.83,3714.0,2
HCPCS,64480,Hc Injection Anes/Steroid Trnsfrmnl Epi Cerv/Thor W Img Ea Addl,1939.0,1260.35,,,0
HCPCS,64483,Hc Injection Anes/Steroid Trnsfrmnl Epi Lumb/Sacr W Img Sgl,5025.0,3266.25,,,0
HCPCS,64483,Inj foramen epidural l/s,,,852.83,3714.0,2
HCPCS,64484,Hc Injection Anes/Steroid Trnsfrmnl Epi Lumb/Sacr W Img Ea Addl,1939.0,1260.35,,,0
HCPCS,64486,Hc Tap Block W Img Unilat,5501.0,3575.65,,,0
HCPCS,64488,Hc Tap Block W Img Bilat,11002.0,7151.3,,,0
HCPCS,64490,Hc Injection Anes Facet Joint Crv Or Thrc W Img Sgl,6762.0,4395.299999999999,,,0
HCPCS,64490,Inj paravert f jnt c/t 1 lev,,,852.83,3714.0,2
HCPCS,64491,Hc Injection Anes Facet Joint Crv Or Thrc W Img 2Nd Addl,2661.0,1729.65,,,0
HCPCS,64492,Hc Injection Anes Facet Joint Crv Or Thrc W Img 3Rd Addl,2661.0,1729.65,,,0
HCPCS,64493,Hc Injection Anes Facet Joint Lum Or Sacr W Img Sgl,8539.5,5550.674999999999,,,0
HCPCS,64493,Inj paravert f jnt l/s 1 lev,,,852.83,3714.0,2
HCPCS,64494,Hc Injection Anes Facet Joint Lum Or Sacr W Img 2Nd Addl,2107.0,1369.55,,,0
HCPCS,64495,Hc Injection Anes Facet Joint Lum Or Sacr W Img 3Rd Addl,2107.0,1369.55,,,0
HCPCS,64505,Hc Injection Anes Agent Sphenopalatine Ganglion,849.0,551.8499999999999,,,0
HCPCS,64505,N block spenopalatine gangl,,,295.97,3714.0,2
HCPCS,64510,Hc Injection Anes Stellate Ganglion,11148.0,7246.200000000001,,,0
HCPCS,64510,N block stellate ganglion,,,852.83,3714.0,2
HCPCS,64517,Hc Injection Anes Superior Hypogastric Plexus,10976.0,7134.4,,,0
HCPCS,64517,N block inj hypogas plxs,,,852.83,3714.0,2
HCPCS,64520,Hc Injection Anes Lumbar Sympathetic,11194.5,7276.424999999999,,,0
HCPCS,64520,N block lumbar/thoracic,,,852.83,3714.0,2
HCPCS,64530,Hc Injection Anes Celiac Plexus,8030.0,5219.5,,,0
HCPCS,64530,N block inj celiac pelus,,,852.83,3714.0,2
HCPCS,64553,Hc Perc Impltj Neurostimulator Eltrd Cranial Nerve,29760.0,19344.0,,,0
HCPCS,64553,Implant neuroelectrodes,,,10744.03,38216.0,2
HCPCS,64555,Hc Perc Impltj Neurostimulator Eltrd Peripheral Nerve,24800.0,16120.0,,,0
HCPCS,64555,Implant neuroelectrodes,,,6144.98,38216.0,2
HCPCS,64561,Implant neuroelectrodes,,,6144.98,38216.0,2
HCPCS,64566,Neuroeltrd stim post tibial,,,295.97,3714.0,2
HCPCS,64567,Perq elec nrv field stimj cn,,,874.53,874.53,1
HCPCS,64568,Hc Inc Impltj Crnl Nrv Nstim Eltrds & Pulse Gener,87102.0,56616.3,,,0
HCPCS,64568,Inc for vagus n elect impl,,,42470.57,63079.0,2
HCPCS,64569,Revise/repl vagus n eltrd,,,10744.03,38216.0,2
HCPCS,64570,Remove vagus n eltrd,,,3293.92,20001.0,2
HCPCS,64575,Implant neuroelectrodes,,,10744.03,63079.0,2
HCPCS,64580,Implant neuroelectrodes,,,18706.01,63079.0,2
HCPCS,64581,Implant neuroelectrodes,,,6144.98,38216.0,2
HCPCS,64582,Opn mpltj hpglsl nstm ary pg,,,29753.66,63079.0,2
HCPCS,64583,Rev/rplct hpglsl nstm ary pg,,,10744.03,38216.0,2
HCPCS,64584,Hc Removal Hypoglossal Nerve Nstim Ra Pulse Gen Respir Snr,18383.0,11948.95,,,0
HCPCS,64584,Rmvl hpglsl nstim ary pg,,,3293.92,20001.0,2
HCPCS,64585,Revise/remove neuroelectrode,,,3371.02,15689.0,2
HCPCS,64590,Insrt/redo pn/gastr stimul,,,18706.01,63079.0,2
HCPCS,64595,Revise/rmv pn/gastr stimul,,,3371.02,15689.0,2
HCPCS,64596,Ins/rplcmt prq eltrd ra pn 1,,,10744.03,38216.0,2
HCPCS,64598,Revj/rmvl nea pn w/int nstim,,,3371.02,15689.0,2
HCPCS,64600,Hc Dest Neurolytic Trigeminal Nerve Supraorb Or Infraorb,11239.0,7305.35,,,0
HCPCS,64600,Injection treatment of nerve,,,852.83,3714.0,2
HCPCS,64605,Hc Dest Neurolytc Trigeminal Nrv Supraorb Or Infraorb 2 Or 3 Div Brnch,7914.0,5144.1,,,0
HCPCS,64605,Injection treatment of nerve,,,1882.86,9206.0,2
HCPCS,64610,Injection treatment of nerve,,,1882.86,9206.0,2
HCPCS,64611,Chemodenerv saliv glands,,,295.97,3714.0,2
HCPCS,64612,Destroy nerve face muscle,,,295.97,3714.0,2
HCPCS,64615,Chemodenerv musc migraine,,,295.97,3714.0,2
HCPCS,64615,Hc Botox Inj Chronic Migraine,1988.0,1292.2,,,0
HCPCS,64616,Chemodenerv musc neck dyston,,,295.97,3714.0,2
HCPCS,64616,Hc Chemodenervation Neck Muscle Dystonia,5727.0,3722.5499999999997,,,0
HCPCS,64617,Chemodener muscle larynx emg,,,680.63,3714.0,2
HCPCS,64620,Hc Dest Neurolytic Intercostal Nerve,7890.0,5128.5,,,0
HCPCS,64620,Injection treatment of nerve,,,852.83,3714.0,2
HCPCS,64624,Dstrj nulyt agt gnclr nrv,,,1882.86,9206.0,2
HCPCS,64624,"Hc Destruct, Genicular Nerve Branches, Incl Image Guidance",9496.5,6172.724999999999,,,0
HCPCS,64625,Hc Rf Ablation Nerves Inervating Si Joint W Img,9496.5,6172.724999999999,,,0
HCPCS,64625,Rf abltj nrv nrvtg si jt,,,1882.86,9206.0,2
HCPCS,64628,Hc Thermal Dstrct Intraosseous Bvn 1St 2 Lmbr Sac,96382.0,62648.3,,,0
HCPCS,64628,Trml dstrj ios bvn 1st 2 l/s,,,12379.34,38216.0,2
HCPCS,64629,Hc Thermal Dstrct Intraosseous Bvn Ea Addtl Lmbr Sac,48192.0,31324.8,,,0
HCPCS,64630,Hc Dest Neurolytic Pudendal Nerve,3151.0,2048.15,,,0
HCPCS,64630,Injection treatment of nerve,,,852.83,3714.0,2
HCPCS,64632,Hc Dest Neurolytic Plantar Nerve,7404.0,4812.6,,,0
HCPCS,64632,N block inj common digit,,,295.97,3714.0,2
HCPCS,64633,Destroy cerv/thor facet jnt,,,1882.86,9206.0,2
HCPCS,64633,Hc Dest Neurolytic Facet Joint Cerv Or Thrc W Img Sgl,12423.0,8074.950000000001,,,0
HCPCS,64634,Hc Dest Neurolytic Facet Joint Cerv Or Thrc W Img Addl,4416.0,2870.4,,,0
HCPCS,64635,Destroy lumb/sac facet jnt,,,1882.86,9206.0,2
HCPCS,64635,Hc Dest Neurolytic Facet Joint Lumb Or Sacr W Img Sgl,9496.5,6172.724999999999,,,0
HCPCS,64636,Hc Dest Neurolytic Facet Joint Lumb Or Sacr W Img Addl,4445.0,2889.25,,,0
HCPCS,64640,Hc Dest Neurolytic Other Peripheral Nerve Or Branch,4536.0,2948.3999999999996,,,0
HCPCS,64640,Injection treatment of nerve,,,852.83,3714.0,2
HCPCS,64642,Chemodenerv 1 extremity 1-4,,,680.63,3714.0,2
HCPCS,64644,Chemodenerv 1 extrem 5/> mus,,,680.63,3714.0,2
HCPCS,64644,Hc Chemodenervation One Extremity 5 Or More Muscles,5744.0,3733.6,,,0
HCPCS,64645,Hc Chemodenervation Ea Addl Extremity 5 Or More Muscles,3962.0,2575.3,,,0
HCPCS,64646,Chemodenerv trunk musc 1-5,,,680.63,3714.0,2
HCPCS,64646,Hc Chemodenervation Of Trunk Muscle(S) 1-5,5744.0,3733.6,,,0
HCPCS,64647,Chemodenerv trunk musc 6/>,,,680.63,3714.0,2
HCPCS,64647,Hc Chemodenervation Of Trunk Muscle(S) 6 Or More,5744.0,3733.6,,,0
HCPCS,64650,Chemodenerv eccrine glands,,,295.97,3714.0,2
HCPCS,64653,Chemodenerv eccrine glands,,,295.97,3714.0,2
HCPCS,64654,1st opn implt bat modulj sys,,,42470.57,42470.57,1
HCPCS,64655,Revj/rplcmt bat mod sys lead,,,3371.02,3371.02,1
HCPCS,64656,Revj/rplcmt bat mod sys pg,,,29753.66,29753.66,1
HCPCS,64657,Rmvl bat modulj sys tot sys,,,3293.92,3293.92,1
HCPCS,64658,Rmvl bat modul sys lead only,,,3371.02,3371.02,1
HCPCS,64659,Rmvl bat modulj sys pg only,,,3371.02,3371.02,1
HCPCS,64680,Hc Dest Neurolytic Celiac Plexus,8006.0,5203.9,,,0
HCPCS,64680,Injection treatment of nerve,,,852.83,3714.0,2
HCPCS,64681,Hc Dest Neurolytic Superior Hypogastric Plexus,8024.0,5215.6,,,0
HCPCS,64681,Injection treatment of nerve,,,852.83,3714.0,2
HCPCS,64702,Revise finger/toe nerve,,,1882.86,9206.0,2
HCPCS,64704,Revise hand/foot nerve,,,1882.86,9206.0,2
HCPCS,64708,Revise arm/leg nerve,,,1882.86,9206.0,2
HCPCS,64712,Revision of sciatic nerve,,,1882.86,9206.0,2
HCPCS,64713,Revision of arm nerve(s),,,1882.86,9206.0,2
HCPCS,64714,Revise low back nerve(s),,,1882.86,9206.0,2
HCPCS,64716,Revision of cranial nerve,,,1882.86,9206.0,2
HCPCS,64718,Revise ulnar nerve at elbow,,,1882.86,9206.0,2
HCPCS,64719,Revise ulnar nerve at wrist,,,1882.86,9206.0,2
HCPCS,64721,Carpal tunnel surgery,,,1882.86,9206.0,2
HCPCS,64721,Hc Neuroplasty Carpal Tunnel Median Nerve,6438.0,4184.7,,,0
HCPCS,64722,Relieve pressure on nerve(s),,,1882.86,9206.0,2
HCPCS,64726,Release foot/toe nerve,,,1882.86,9206.0,2
HCPCS,64728,Dcmprn median nrv carpl tunl,,,1882.86,1882.86,1
HCPCS,64732,Incision of brow nerve,,,1882.86,9206.0,2
HCPCS,64734,Incision of cheek nerve,,,1882.86,9206.0,2
HCPCS,64736,Incision of chin nerve,,,1882.86,9206.0,2
HCPCS,64738,Incision of jaw nerve,,,1882.86,9206.0,2
HCPCS,64740,Incision of tongue nerve,,,1882.86,9206.0,2
HCPCS,64742,Incision of facial nerve,,,1882.86,9206.0,2
HCPCS,64744,Incise nerve back of head,,,1882.86,9206.0,2
HCPCS,64746,Incise diaphragm nerve,,,1882.86,9206.0,2
HCPCS,64755,Incision of stomach nerves,,,20001.0,20001.0,1
HCPCS,64760,Incision of vagus nerve,,,9206.0,9206.0,1
HCPCS,64763,Incise hip/thigh nerve,,,1882.86,9206.0,2
HCPCS,64766,Incise hip/thigh nerve,,,1882.86,20001.0,2
HCPCS,64771,Sever cranial nerve,,,1882.86,9206.0,2
HCPCS,64772,Incision of spinal nerve,,,1882.86,9206.0,2
HCPCS,64774,Remove skin nerve lesion,,,1882.86,9206.0,2
HCPCS,64776,Remove digit nerve lesion,,,1882.86,9206.0,2
HCPCS,64782,Remove limb nerve lesion,,,1882.86,9206.0,2
HCPCS,64784,Remove nerve lesion,,,1882.86,9206.0,2
HCPCS,64786,Remove sciatic nerve lesion,,,3293.92,20001.0,2
HCPCS,64788,Remove skin nerve lesion,,,1882.86,9206.0,2
HCPCS,64790,Removal of nerve lesion,,,1882.86,9206.0,2
HCPCS,64792,Removal of nerve lesion,,,3293.92,20001.0,2
HCPCS,64795,Biopsy of nerve,,,1882.86,9206.0,2
HCPCS,64802,Sympathectomy cervical,,,1882.86,9206.0,2
HCPCS,64804,Remove sympathetic nerves,,,1882.86,9206.0,2
HCPCS,64809,Remove sympathetic nerves,,,20001.0,20001.0,1
HCPCS,64818,Remove sympathetic nerves,,,20001.0,20001.0,1
HCPCS,64820,Sympathectomy digital artery,,,1882.86,9206.0,2
HCPCS,64821,Remove sympathetic nerves,,,3154.93,15689.0,2
HCPCS,64822,Remove sympathetic nerves,,,3154.93,15689.0,2
HCPCS,64823,Sympathectomy supfc palmar,,,3154.93,15689.0,2
HCPCS,64831,Repair of digit nerve,,,1882.86,20001.0,2
HCPCS,64834,Repair of hand or foot nerve,,,3293.92,20001.0,2
HCPCS,64835,Repair of hand or foot nerve,,,3293.92,20001.0,2
HCPCS,64836,Repair of hand or foot nerve,,,3293.92,20001.0,2
HCPCS,64840,Repair of leg nerve,,,8461.87,20001.0,2
HCPCS,64856,Repair/transpose nerve,,,8461.87,20001.0,2
HCPCS,64857,Repair arm/leg nerve,,,3293.92,20001.0,2
HCPCS,64858,Repair sciatic nerve,,,1882.86,20001.0,2
HCPCS,64861,Repair of arm nerves,,,1882.86,20001.0,2
HCPCS,64862,Repair of low back nerves,,,3293.92,20001.0,2
HCPCS,64864,Repair of facial nerve,,,8461.87,20001.0,2
HCPCS,64865,Repair of facial nerve,,,3293.92,20001.0,2
HCPCS,64866,Fusion of facial/other nerve,,,20001.0,20001.0,1
HCPCS,64868,Fusion of facial/other nerve,,,20001.0,20001.0,1
HCPCS,64885,Nerve graft head/neck <=4 cm,,,8461.87,20001.0,2
HCPCS,64886,Nerve graft head/neck >4 cm,,,8461.87,20001.0,2
HCPCS,64890,Nerve graft hand/foot <=4 cm,,,8461.87,20001.0,2
HCPCS,64891,Nerve graft hand/foot >4 cm,,,8461.87,20001.0,2
HCPCS,64892,Nerve graft arm/leg <4 cm,,,8461.87,20001.0,2
HCPCS,64893,Nerve graft arm/leg >4 cm,,,3293.92,20001.0,2
HCPCS,64895,Nerve graft hand/foot <=4 cm,,,8461.87,20001.0,2
HCPCS,64896,Nerve graft hand/foot >4 cm,,,8461.87,20001.0,2
HCPCS,64897,Nerve graft arm/leg <=4 cm,,,8461.87,20001.0,2
HCPCS,64898,Nerve graft arm/leg >4 cm,,,8461.87,20001.0,2
HCPCS,64905,Nerve pedicle transfer,,,8461.87,20001.0,2
HCPCS,64907,Nerve pedicle transfer,,,8461.87,20001.0,2
HCPCS,64910,Nerve repair w/allograft,,,8461.87,20001.0,2
HCPCS,64911,Neurorraphy w/vein autograft,,,8461.87,20001.0,2
HCPCS,64912,Nrv rpr w/nrv algrft 1st,,,8461.87,20001.0,2
HCPCS,64999,Hc Injection Anes Inferior Hypogastric Plexus,10976.0,7134.4,,,0
HCPCS,64999,Hc Injection Anes Prev Sacroiliac Fusion Site,6506.0,4228.9,,,0
HCPCS,64999,Hc Unlisted Procedure Nervous System,6331.0,4115.15,,,0
HCPCS,64999,Nervous system surgery,,,295.97,16564.0,2
HCPCS,65091,Revise eye,,,3790.74,15689.0,2
HCPCS,65093,Revise eye with implant,,,3790.74,15689.0,2
HCPCS,65101,Removal of eye,,,3790.74,15689.0,2
HCPCS,65103,Remove eye/insert implant,,,3790.74,15689.0,2
HCPCS,65105,Remove eye/attach implant,,,3790.74,15689.0,2
HCPCS,65110,Removal of eye,,,3790.74,15689.0,2
HCPCS,65112,Remove eye/revise socket,,,3790.74,15689.0,2
HCPCS,65114,Remove eye/revise socket,,,3790.74,15689.0,2
HCPCS,65125,Revise ocular implant,,,2292.42,9206.0,2
HCPCS,65130,Insert ocular implant,,,3790.74,15689.0,2
HCPCS,65135,Insert ocular implant,,,3790.74,15689.0,2
HCPCS,65140,Attach ocular implant,,,3790.74,15689.0,2
HCPCS,65150,Revise ocular implant,,,3790.74,15689.0,2
HCPCS,65155,Reinsert ocular implant,,,3790.74,15689.0,2
HCPCS,65175,Removal of ocular implant,,,3790.74,15689.0,2
HCPCS,65205,Hc Remove Fb External Eye,1036.5,673.7249999999999,,,0
HCPCS,65205,Remove foreign body from eye,,,128.29,3714.0,2
HCPCS,65210,Remove foreign body from eye,,,430.74,3714.0,2
HCPCS,65220,Hc Rem Fb Ext Eye Corn Wo Lmp,1131.0,735.1500000000001,,,0
HCPCS,65220,Remove foreign body from eye,,,430.74,3714.0,2
HCPCS,65222,Hc Remove Fb Cornea W Slit Lamp,1131.0,735.1500000000001,,,0
HCPCS,65222,Remove foreign body from eye,,,128.29,3714.0,2
HCPCS,65235,Remove foreign body from eye,,,2225.25,9206.0,2
HCPCS,65260,Remove foreign body from eye,,,2225.25,9206.0,2
HCPCS,65265,Remove foreign body from eye,,,2225.25,9206.0,2
HCPCS,65270,Repair of eye wound,,,2292.42,9206.0,2
HCPCS,65272,Repair of eye wound,,,2292.42,9206.0,2
HCPCS,65273,Repair of eye wound,,,9206.0,9206.0,1
HCPCS,65275,Repair of eye wound,,,3790.74,15689.0,2
HCPCS,65280,Repair of eye wound,,,5130.92,20001.0,2
HCPCS,65285,Repair of eye wound,,,5130.92,20001.0,2
HCPCS,65286,Repair of eye wound,,,2225.25,9206.0,2
HCPCS,65290,Repair of eye socket wound,,,3790.74,15689.0,2
HCPCS,65400,Removal of eye lesion,,,961.21,9206.0,2
HCPCS,65410,Biopsy of cornea,,,2292.42,9206.0,2
HCPCS,65420,Removal of eye lesion,,,2292.42,9206.0,2
HCPCS,65426,Removal of eye lesion,,,2292.42,9206.0,2
HCPCS,65430,Corneal smear,,,430.74,3714.0,2
HCPCS,65435,Curette/treat cornea,,,961.21,9206.0,2
HCPCS,65436,Curette/treat cornea,,,2292.42,9206.0,2
HCPCS,65450,Treatment of corneal lesion,,,306.05,3714.0,2
HCPCS,65600,Revision of cornea,,,2292.42,9206.0,2
HCPCS,65710,Corneal transplant,,,5130.92,20001.0,2
HCPCS,65730,Corneal transplant,,,3985.54,20001.0,2
HCPCS,65750,Corneal transplant,,,5130.92,20001.0,2
HCPCS,65755,Corneal transplant,,,3985.54,20001.0,2
HCPCS,65756,Corneal trnspl endothelial,,,3985.54,20001.0,2
HCPCS,65760,Revision of cornea,,,15689.0,15689.0,1
HCPCS,65765,Revision of cornea,,,15689.0,15689.0,1
HCPCS,65767,Corneal tissue transplant,,,15689.0,15689.0,1
HCPCS,65770,Revise cornea with implant,,,13987.1,38216.0,2
HCPCS,65771,Radial keratotomy,,,15689.0,15689.0,1
HCPCS,65772,Correction of astigmatism,,,961.21,9206.0,2
HCPCS,65775,Correction of astigmatism,,,2292.42,9206.0,2
HCPCS,65778,Cover eye w/membrane,,,961.21,9206.0,2
HCPCS,65779,Cover eye w/membrane suture,,,3790.74,15689.0,2
HCPCS,65780,Ocular reconst transplant,,,3790.74,15689.0,2
HCPCS,65781,Ocular reconst transplant,,,5130.92,20001.0,2
HCPCS,65782,Ocular reconst transplant,,,3790.74,15689.0,2
HCPCS,65785,Impltj ntrstrml crnl rng seg,,,3985.54,20001.0,2
HCPCS,65800,Drainage of eye,,,2225.25,9206.0,2
HCPCS,65810,Drainage of eye,,,2225.25,9206.0,2
HCPCS,65815,Drainage of eye,,,2225.25,9206.0,2
HCPCS,65820,Relieve inner eye pressure,,,3985.54,20001.0,2
HCPCS,65850,Incision of eye,,,2225.25,9206.0,2
HCPCS,65855,Trabeculoplasty laser surg,,,530.32,3714.0,2
HCPCS,65860,Incise inner eye adhesions,,,530.32,3714.0,2
HCPCS,65865,Incise inner eye adhesions,,,2225.25,9206.0,2
HCPCS,65870,Incise inner eye adhesions,,,2225.25,9206.0,2
HCPCS,65875,Incise inner eye adhesions,,,2225.25,9206.0,2
HCPCS,65880,Incise inner eye adhesions,,,3985.54,20001.0,2
HCPCS,65900,Remove eye lesion,,,2225.25,9206.0,2
HCPCS,65920,Remove implant of eye,,,2225.25,9206.0,2
HCPCS,65930,Remove blood clot from eye,,,2225.25,9206.0,2
HCPCS,66020,Injection treatment of eye,,,2225.25,9206.0,2
HCPCS,66030,Injection treatment of eye,,,2225.25,9206.0,2
HCPCS,66130,Remove eye lesion,,,2292.42,9206.0,2
HCPCS,66150,Glaucoma surgery,,,3985.54,20001.0,2
HCPCS,66155,Glaucoma surgery,,,3985.54,20001.0,2
HCPCS,66160,Glaucoma surgery,,,2225.25,9206.0,2
HCPCS,66170,Glaucoma surgery,,,2225.25,9206.0,2
HCPCS,66172,Incision of eye,,,2225.25,9206.0,2
HCPCS,66174,Translum dil eye canal,,,3985.54,20001.0,2
HCPCS,66175,Trnslum dil eye canal w/stnt,,,5130.92,20001.0,2
HCPCS,66179,Aqueous shunt eye w/o graft,,,5130.92,20001.0,2
HCPCS,66180,Aqueous shunt eye w/graft,,,5130.92,20001.0,2
HCPCS,66183,Insert ant drainage device,,,3985.54,20001.0,2
HCPCS,66184,Revision of aqueous shunt,,,2225.25,9206.0,2
HCPCS,66185,Revise aqueous shunt eye,,,2225.25,9206.0,2
HCPCS,66225,Repair/graft eye lesion,,,5130.92,20001.0,2
HCPCS,66250,Follow-up surgery of eye,,,2292.42,9206.0,2
HCPCS,66500,Incision of iris,,,2225.25,9206.0,2
HCPCS,66505,Incision of iris,,,2225.25,9206.0,2
HCPCS,66600,Remove iris and lesion,,,3985.54,20001.0,2
HCPCS,66605,Removal of iris,,,2225.25,9206.0,2
HCPCS,66625,Removal of iris,,,2225.25,9206.0,2
HCPCS,66630,Removal of iris,,,2225.25,9206.0,2
HCPCS,66635,Removal of iris,,,2225.25,9206.0,2
HCPCS,66680,Repair iris & ciliary body,,,2225.25,9206.0,2
HCPCS,66682,Repair iris & ciliary body,,,2225.25,9206.0,2
HCPCS,66683,Implantation iris prosthesis,,,9206.0,15871.89,2
HCPCS,66700,Destruction ciliary body,,,2225.25,9206.0,2
HCPCS,66710,Ciliary transsleral therapy,,,2292.42,9206.0,2
HCPCS,66711,Ciliary endoscopic ablation,,,2225.25,9206.0,2
HCPCS,66720,Destruction ciliary body,,,2292.42,9206.0,2
HCPCS,66740,Destruction ciliary body,,,2292.42,9206.0,2
HCPCS,66761,Revision of iris,,,530.32,3714.0,2
HCPCS,66762,Revision of iris,,,530.32,3714.0,2
HCPCS,66770,Removal of inner eye lesion,,,530.32,3714.0,2
HCPCS,66820,Incision secondary cataract,,,2225.25,9206.0,2
HCPCS,66821,After cataract laser surgery,,,530.32,3714.0,2
HCPCS,66825,Reposition intraocular lens,,,2225.25,9206.0,2
HCPCS,66830,Removal of lens lesion,,,2225.25,9206.0,2
HCPCS,66840,Removal of lens material,,,2225.25,9206.0,2
HCPCS,66850,Removal of lens material,,,2225.25,9206.0,2
HCPCS,66852,Removal of lens material,,,3985.54,20001.0,2
HCPCS,66920,Extraction of lens,,,2225.25,9206.0,2
HCPCS,66930,Extraction of lens,,,3985.54,20001.0,2
HCPCS,66940,Extraction of lens,,,2225.25,9206.0,2
HCPCS,66982,Cataract surgery complex,,,2225.25,9206.0,2
HCPCS,66983,Cataract surg w/iol 1 stage,,,2225.25,9206.0,2
HCPCS,66984,Cataract surg w/iol 1 stage,,,2225.25,9206.0,2
HCPCS,66985,Insert lens prosthesis,,,2225.25,9206.0,2
HCPCS,66986,Exchange lens prosthesis,,,2225.25,9206.0,2
HCPCS,66987,Xcapsl ctrc rmvl cplx w/ecp,,,3985.54,20001.0,2
HCPCS,66988,Xcapsl ctrc rmvl w/ecp,,,3985.54,20001.0,2
HCPCS,66989,Xcpsl ctrc rmvl cplx insj 1+,,,5130.92,20001.0,2
HCPCS,66991,Xcapsl ctrc rmvl insj 1+,,,5130.92,20001.0,2
HCPCS,66999,Eye surgery procedure,,,2225.25,16564.0,2
HCPCS,67005,Partial removal of eye fluid,,,2225.25,9206.0,2
HCPCS,67010,Partial removal of eye fluid,,,2225.25,9206.0,2
HCPCS,67015,Release of eye fluid,,,2225.25,9206.0,2
HCPCS,67025,Replace eye fluid,,,2225.25,9206.0,2
HCPCS,67027,Implant eye drug system,,,13453.74,63079.0,2
HCPCS,67028,Injection eye drug,,,318.49,3714.0,2
HCPCS,67030,Incise inner eye strands,,,2225.25,9206.0,2
HCPCS,67031,Laser surgery eye strands,,,530.32,3714.0,2
HCPCS,67036,Removal of inner eye fluid,,,3985.54,20001.0,2
HCPCS,67039,Laser treatment of retina,,,3985.54,20001.0,2
HCPCS,67040,Laser treatment of retina,,,3985.54,20001.0,2
HCPCS,67041,Vit for macular pucker,,,3985.54,20001.0,2
HCPCS,67042,Vit for macular hole,,,3985.54,20001.0,2
HCPCS,67043,Vit for membrane dissect,,,3985.54,20001.0,2
HCPCS,67101,Repair detached retina crtx,,,2225.25,9206.0,2
HCPCS,67105,Repair detached retina pc,,,530.32,3714.0,2
HCPCS,67107,Repair detached retina,,,3985.54,20001.0,2
HCPCS,67108,Repair detached retina,,,3985.54,20001.0,2
HCPCS,67110,Repair detached retina,,,2225.25,9206.0,2
HCPCS,67113,Repair retinal detach cplx,,,5130.92,20001.0,2
HCPCS,67115,Release encircling material,,,3985.54,20001.0,2
HCPCS,67120,Remove eye implant material,,,2225.25,9206.0,2
HCPCS,67121,Remove eye implant material,,,2225.25,9206.0,2
HCPCS,67141,Treatment of retina,,,306.05,3714.0,2
HCPCS,67145,Treatment of retina,,,530.32,3714.0,2
HCPCS,67208,Treatment of retinal lesion,,,306.05,3714.0,2
HCPCS,67210,Treatment of retinal lesion,,,530.32,3714.0,2
HCPCS,67218,Treatment of retinal lesion,,,3790.74,15689.0,2
HCPCS,67220,Treatment of choroid lesion,,,530.32,3714.0,2
HCPCS,67221,Ocular Photodynamic Ther,,,530.32,3714.0,2
HCPCS,67227,Dstrj extensive retinopathy,,,3790.74,15689.0,2
HCPCS,67228,Treatment x10sv retinopathy,,,530.32,3714.0,2
HCPCS,67229,Tr retinal les preterm inf,,,530.32,3714.0,2
HCPCS,67250,Reinforce eye wall,,,2292.42,9206.0,2
HCPCS,67255,Reinforce/graft eye wall,,,3985.54,9206.0,2
HCPCS,67299,Eye surgery procedure,,,2225.25,16564.0,2
HCPCS,67311,Revise eye muscle,,,2292.42,9206.0,2
HCPCS,67312,Revise two eye muscles,,,3790.74,15689.0,2
HCPCS,67314,Revise eye muscle,,,2292.42,9206.0,2
HCPCS,67316,Revise two eye muscles,,,2292.42,9206.0,2
HCPCS,67318,Revise eye muscle(s),,,2292.42,9206.0,2
HCPCS,67343,Release eye tissue,,,2292.42,9206.0,2
HCPCS,67345,Destroy nerve of eye muscle,,,306.05,3714.0,2
HCPCS,67346,Biopsy eye muscle,,,3790.74,15689.0,2
HCPCS,67399,Unlisted px extraocular musc,,,306.05,16564.0,2
HCPCS,67400,Explore/biopsy eye socket,,,3790.74,15689.0,2
HCPCS,67405,Explore/drain eye socket,,,2292.42,9206.0,2
HCPCS,67412,Explore/treat eye socket,,,2292.42,9206.0,2
HCPCS,67413,Explore/treat eye socket,,,2292.42,9206.0,2
HCPCS,67414,Explr/decompress eye socket,,,3790.74,15689.0,2
HCPCS,67415,Aspiration orbital contents,,,2292.42,9206.0,2
HCPCS,67420,Explore/treat eye socket,,,3790.74,15689.0,2
HCPCS,67430,Explore/treat eye socket,,,3790.74,15689.0,2
HCPCS,67440,Explore/drain eye socket,,,3790.74,15689.0,2
HCPCS,67445,Explr/decompress eye socket,,,3790.74,15689.0,2
HCPCS,67450,Explore/biopsy eye socket,,,3790.74,15689.0,2
HCPCS,67500,Inject/treat eye socket,,,306.05,3714.0,2
HCPCS,67505,Inject/treat eye socket,,,306.05,3714.0,2
HCPCS,67515,Inject/treat eye socket,,,306.05,3714.0,2
HCPCS,67516,Sprchoroidal spc njx rx agt,,,318.49,3714.0,2
HCPCS,67550,Insert eye socket implant,,,3790.74,15689.0,2
HCPCS,67560,Revise eye socket implant,,,3790.74,15689.0,2
HCPCS,67570,Decompress optic nerve,,,3790.74,15689.0,2
HCPCS,67599,Orbit surgery procedure,,,306.05,16564.0,2
HCPCS,67700,Drainage of eyelid abscess,,,306.05,3714.0,2
HCPCS,67700,Hc Blepharotomy For Abscess Drainage,1894.0,1231.1,,,0
HCPCS,67710,Incision of eyelid,,,961.21,9206.0,2
HCPCS,67715,Incision of eyelid fold,,,2292.42,9206.0,2
HCPCS,67800,Remove eyelid lesion,,,306.05,3714.0,2
HCPCS,67801,Remove eyelid lesions,,,961.21,9206.0,2
HCPCS,67805,Remove eyelid lesions,,,306.05,3714.0,2
HCPCS,67808,Remove eyelid lesion(s),,,2292.42,9206.0,2
HCPCS,67810,Biopsy eyelid & lid margin,,,306.05,3714.0,2
HCPCS,67820,Revise eyelashes,,,128.29,3714.0,2
HCPCS,67825,Revise eyelashes,,,306.05,3714.0,2
HCPCS,67830,Revise eyelashes,,,961.21,9206.0,2
HCPCS,67835,Revise eyelashes,,,2292.42,9206.0,2
HCPCS,67840,Remove eyelid lesion,,,961.21,9206.0,2
HCPCS,67850,Treat eyelid lesion,,,961.21,9206.0,2
HCPCS,67875,Closure of eyelid by suture,,,961.21,9206.0,2
HCPCS,67880,Revision of eyelid,,,2292.42,9206.0,2
HCPCS,67882,Revision of eyelid,,,2292.42,9206.0,2
HCPCS,67900,Repair brow defect,,,2292.42,9206.0,2
HCPCS,67901,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67902,Repair eyelid defect,,,3790.74,15689.0,2
HCPCS,67903,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67904,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67906,Repair eyelid defect,,,3790.74,15689.0,2
HCPCS,67908,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67909,Revise eyelid defect,,,2292.42,9206.0,2
HCPCS,67911,Revise eyelid defect,,,2292.42,9206.0,2
HCPCS,67912,Correction eyelid w/implant,,,2292.42,9206.0,2
HCPCS,67914,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67915,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67916,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67917,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67921,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67922,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67923,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67924,Repair eyelid defect,,,2292.42,9206.0,2
HCPCS,67930,Repair eyelid wound,,,2292.42,9206.0,2
HCPCS,67935,Repair eyelid wound,,,2292.42,9206.0,2
HCPCS,67938,Remove eyelid foreign body,,,306.05,3714.0,2
HCPCS,67950,Revision of eyelid,,,2292.42,9206.0,2
HCPCS,67961,Revision of eyelid,,,2292.42,9206.0,2
HCPCS,67966,Revision of eyelid,,,2292.42,9206.0,2
HCPCS,67971,Reconstruction of eyelid,,,2292.42,9206.0,2
HCPCS,67973,Reconstruction of eyelid,,,2292.42,9206.0,2
HCPCS,67974,Reconstruction of eyelid,,,3790.74,15689.0,2
HCPCS,67975,Reconstruction of eyelid,,,2292.42,9206.0,2
HCPCS,67999,Revision of eyelid,,,306.05,16564.0,2
HCPCS,68020,Incise/drain eyelid lining,,,961.21,9206.0,2
HCPCS,68040,Treatment of eyelid lesions,,,306.05,3714.0,2
HCPCS,68100,Biopsy of eyelid lining,,,2292.42,9206.0,2
HCPCS,68110,Remove eyelid lining lesion,,,2292.42,9206.0,2
HCPCS,68115,Remove eyelid lining lesion,,,2292.42,9206.0,2
HCPCS,68130,Remove eyelid lining lesion,,,2292.42,9206.0,2
HCPCS,68135,Remove eyelid lining lesion,,,2292.42,9206.0,2
HCPCS,68200,Treat eyelid by injection,,,430.74,3714.0,2
HCPCS,68320,Revise/graft eyelid lining,,,2292.42,9206.0,2
HCPCS,68325,Revise/graft eyelid lining,,,3790.74,15689.0,2
HCPCS,68326,Revise/graft eyelid lining,,,3790.74,15689.0,2
HCPCS,68328,Revise/graft eyelid lining,,,2292.42,9206.0,2
HCPCS,68330,Revise eyelid lining,,,2225.25,9206.0,2
HCPCS,68335,Revise/graft eyelid lining,,,3790.74,15689.0,2
HCPCS,68340,Separate eyelid adhesions,,,2292.42,9206.0,2
HCPCS,68360,Revise eyelid lining,,,3790.74,15689.0,2
HCPCS,68362,Revise eyelid lining,,,2292.42,9206.0,2
HCPCS,68371,Harvest eye tissue alograft,,,2292.42,9206.0,2
HCPCS,68399,Eyelid lining surgery,,,306.05,16564.0,2
HCPCS,68400,Incise/drain tear gland,,,961.21,9206.0,2
HCPCS,68420,Incise/drain tear sac,,,2292.42,9206.0,2
HCPCS,68440,Incise tear duct opening,,,306.05,3714.0,2
HCPCS,68500,Removal of tear gland,,,3790.74,15689.0,2
HCPCS,68505,Partial removal tear gland,,,3790.74,15689.0,2
HCPCS,68510,Biopsy of tear gland,,,2292.42,9206.0,2
HCPCS,68520,Removal of tear sac,,,3790.74,15689.0,2
HCPCS,68525,Biopsy of tear sac,,,2292.42,9206.0,2
HCPCS,68530,Clearance of tear duct,,,306.05,3714.0,2
HCPCS,68540,Remove tear gland lesion,,,2292.42,9206.0,2
HCPCS,68550,Remove tear gland lesion,,,3790.74,15689.0,2
HCPCS,68700,Repair tear ducts,,,2292.42,9206.0,2
HCPCS,68705,Revise tear duct opening,,,306.05,3714.0,2
HCPCS,68720,Create tear sac drain,,,3790.74,15689.0,2
HCPCS,68745,Create tear duct drain,,,3790.74,15689.0,2
HCPCS,68750,Create tear duct drain,,,3790.74,15689.0,2
HCPCS,68760,Close tear duct opening,,,306.05,3714.0,2
HCPCS,68761,Close tear duct opening,,,306.05,3714.0,2
HCPCS,68770,Close tear system fistula,,,2292.42,9206.0,2
HCPCS,68801,Dilate tear duct opening,,,430.74,3714.0,2
HCPCS,68810,Probe nasolacrimal duct,,,306.05,3714.0,2
HCPCS,68811,Probe nasolacrimal duct,,,2292.42,9206.0,2
HCPCS,68815,Probe nasolacrimal duct,,,2292.42,9206.0,2
HCPCS,68816,Probe nl duct w/balloon,,,2292.42,9206.0,2
HCPCS,68840,Explore/irrigate tear ducts,,,306.05,3714.0,2
HCPCS,68841,Insj rx elut implt lac canal,,,2292.42,3714.0,2
HCPCS,68899,Tear duct system surgery,,,306.05,16564.0,2
HCPCS,69000,Drain external ear lesion,,,682.8,3714.0,2
HCPCS,69000,Hc Drain Abscess Or Hematoma Ext Ear Smpl,1378.5,896.0250000000001,,,0
HCPCS,69005,Drain external ear lesion,,,1592.51,9206.0,2
HCPCS,69020,Drain outer ear canal lesion,,,682.8,3714.0,2
HCPCS,69100,Biopsy of external ear,,,228.38,3714.0,2
HCPCS,69105,Biopsy of external ear canal,,,1496.07,9206.0,2
HCPCS,69110,Remove external ear partial,,,2800.79,15689.0,2
HCPCS,69120,Removal of external ear,,,5708.03,20001.0,2
HCPCS,69140,Remove ear canal lesion(s),,,5708.03,20001.0,2
HCPCS,69145,Remove ear canal lesion(s),,,2800.79,15689.0,2
HCPCS,69150,Extensive ear canal surgery,,,5708.03,20001.0,2
HCPCS,69155,Extensive ear/neck surgery,,,20001.0,20001.0,1
HCPCS,69200,Clear outer ear canal,,,128.29,3714.0,2
HCPCS,69200,Hc Remove Foreign Body Ear,1027.5,667.875,,,0
HCPCS,69205,Clear outer ear canal,,,1592.51,9206.0,2
HCPCS,69209,Hc Removal Impacted Cerumen By Irrig Unilat,1348.5,876.5250000000001,,,0
HCPCS,69209,Remove impacted ear wax uni,,,56.88,3714.0,2
HCPCS,69210,Hc Removal Impacted Cerumen,1455.0,945.75,,,0
HCPCS,69210,Remove impacted ear wax uni,,,56.88,3714.0,2
HCPCS,69220,Clean out mastoid cavity,,,193.46,3714.0,2
HCPCS,69222,Clean out mastoid cavity,,,520.03,3714.0,2
HCPCS,69300,Revise external ear,,,3196.84,9206.0,2
HCPCS,69310,Rebuild outer ear canal,,,5708.03,20001.0,2
HCPCS,69320,Rebuild outer ear canal,,,5708.03,20001.0,2
HCPCS,69399,Outer ear surgery procedure,,,228.38,16564.0,2
HCPCS,69420,Incision of eardrum,,,228.38,3714.0,2
HCPCS,69421,Incision of eardrum,,,3196.84,9206.0,2
HCPCS,69424,Remove ventilating tube,,,3196.84,9206.0,2
HCPCS,69433,Create eardrum opening,,,520.03,3714.0,2
HCPCS,69436,Create eardrum opening,,,1496.07,9206.0,2
HCPCS,69440,Exploration of middle ear,,,3196.84,9206.0,2
HCPCS,69450,Eardrum revision,,,3196.84,9206.0,2
HCPCS,69501,Mastoidectomy,,,5708.03,20001.0,2
HCPCS,69502,Mastoidectomy,,,5708.03,20001.0,2
HCPCS,69505,Remove mastoid structures,,,5708.03,20001.0,2
HCPCS,69511,Extensive mastoid surgery,,,5708.03,20001.0,2
HCPCS,69530,Extensive mastoid surgery,,,5708.03,20001.0,2
HCPCS,69535,Remove part of temporal bone,,,20001.0,20001.0,1
HCPCS,69540,Remove ear lesion,,,1496.07,9206.0,2
HCPCS,69550,Remove ear lesion,,,5708.03,20001.0,2
HCPCS,69552,Remove ear lesion,,,5708.03,20001.0,2
HCPCS,69554,Remove ear lesion,,,20001.0,20001.0,1
HCPCS,69601,Mastoid surgery revision,,,5708.03,20001.0,2
HCPCS,69602,Mastoid surgery revision,,,5708.03,20001.0,2
HCPCS,69603,Mastoid surgery revision,,,5708.03,20001.0,2
HCPCS,69604,Mastoid surgery revision,,,5708.03,20001.0,2
HCPCS,69610,Repair of eardrum,,,1496.07,9206.0,2
HCPCS,69620,Repair of eardrum,,,3196.84,9206.0,2
HCPCS,69631,Repair eardrum structures,,,5708.03,20001.0,2
HCPCS,69632,Rebuild eardrum structures,,,5708.03,20001.0,2
HCPCS,69633,Rebuild eardrum structures,,,5708.03,20001.0,2
HCPCS,69635,Repair eardrum structures,,,5708.03,20001.0,2
HCPCS,69636,Rebuild eardrum structures,,,5708.03,20001.0,2
HCPCS,69637,Rebuild eardrum structures,,,5708.03,20001.0,2
HCPCS,69641,Revise middle ear & mastoid,,,5708.03,20001.0,2
HCPCS,69642,Revise middle ear & mastoid,,,5708.03,20001.0,2
HCPCS,69643,Revise middle ear & mastoid,,,5708.03,20001.0,2
HCPCS,69644,Revise middle ear & mastoid,,,5708.03,20001.0,2
HCPCS,69645,Revise middle ear & mastoid,,,5708.03,20001.0,2
HCPCS,69646,Revise middle ear & mastoid,,,5708.03,20001.0,2
HCPCS,69650,Release middle ear bone,,,3196.84,9206.0,2
HCPCS,69660,Revise middle ear bone,,,5708.03,20001.0,2
HCPCS,69661,Revise middle ear bone,,,5708.03,20001.0,2
HCPCS,69662,Revise middle ear bone,,,5708.03,20001.0,2
HCPCS,69666,Repair middle ear structures,,,3196.84,9206.0,2
HCPCS,69667,Repair middle ear structures,,,3196.84,9206.0,2
HCPCS,69670,Remove mastoid air cells,,,5708.03,20001.0,2
HCPCS,69676,Remove middle ear nerve,,,3196.84,9206.0,2
HCPCS,69700,Close mastoid fistula,,,1496.07,9206.0,2
HCPCS,69705,Nps surg dilat eust tube uni,,,5708.03,20001.0,2
HCPCS,69706,Nps surg dilat eust tube bi,,,5708.03,20001.0,2
HCPCS,69710,Implant/replace hearing aid,,,20001.0,20001.0,1
HCPCS,69711,Remove/repair hearing aid,,,3196.84,9206.0,2
HCPCS,69714,Implant Temple Bone W/Stimul,,,12379.34,38216.0,2
HCPCS,69716,Impltj oi implt skl tc esp,,,12379.34,38216.0,2
HCPCS,69717,Temple Bone Implant Revision,,,6996.6,31685.0,2
HCPCS,69719,Revj/rplcmt oi implt tc esp,,,12379.34,38216.0,2
HCPCS,69720,Release facial nerve,,,5708.03,20001.0,2
HCPCS,69725,Release facial nerve,,,5708.03,20001.0,2
HCPCS,69726,Rmvl oi implt skl perq esp,,,3154.93,15689.0,2
HCPCS,69727,Rmvl oi implt skl tc esp,,,3154.93,15689.0,2
HCPCS,69728,Rmv ntr oi imp sktc esp>=100,,,3154.93,15689.0,2
HCPCS,69729,Impl oi implt sk tc esp>=100,,,12379.34,38216.0,2
HCPCS,69730,Rplc oi implt sk tc esp>=100,,,12379.34,38216.0,2
HCPCS,69740,Repair facial nerve,,,5708.03,20001.0,2
HCPCS,69745,Repair facial nerve,,,5708.03,20001.0,2
HCPCS,69799,Middle ear surgery procedure,,,228.38,16564.0,2
HCPCS,69801,Incise inner ear,,,1496.07,9206.0,2
HCPCS,69805,Explore inner ear,,,5708.03,20001.0,2
HCPCS,69806,Explore inner ear,,,5708.03,20001.0,2
HCPCS,69905,Remove inner ear,,,5708.03,20001.0,2
HCPCS,69910,Remove inner ear & mastoid,,,5708.03,20001.0,2
HCPCS,69915,Incise inner ear nerve,,,3196.84,9206.0,2
HCPCS,69930,Implant cochlear device,,,31792.44,63079.0,2
HCPCS,69949,Inner ear surgery procedure,,,228.38,3714.0,2
HCPCS,69950,Incise inner ear nerve,,,20001.0,20001.0,1
HCPCS,69955,Release facial nerve,,,5708.03,20001.0,2
HCPCS,69960,Release inner ear canal,,,5708.03,20001.0,2
HCPCS,69970,Remove inner ear lesion,,,5708.03,20001.0,2
HCPCS,69979,Temporal bone surgery,,,228.38,3714.0,2
HCPCS,70010,Contrast x-ray of brain,,,336.39,336.39,1
HCPCS,70015,Contrast x-ray of brain,,,755.87,755.87,1
HCPCS,70030,Hc Xr Eye For Foreign Body,412.5,268.125,,,0
HCPCS,70030,X-ray eye for foreign body,,,83.91,83.91,1
HCPCS,70100,Hc Mandible  Partial Less Than 4 Vw,213.0,138.45,,,0
HCPCS,70100,X-ray exam of jaw <4views,,,83.91,83.91,1
HCPCS,70110,Hc Xr Mandible Complete 4 + Vw,363.0,235.95,,,0
HCPCS,70110,X-ray exam of jaw 4/> views,,,100.81,100.81,1
HCPCS,70120,X-ray exam of mastoids,,,100.81,100.81,1
HCPCS,70130,Hc Xr Mastoids Complete 3 + Vw Per Side,744.0,483.59999999999997,,,0
HCPCS,70130,X-ray exam of mastoids,,,100.81,100.81,1
HCPCS,70134,Hc Xr Internal Auditory Meati Complete,1883.0,1223.95,,,0
HCPCS,70134,X-ray exam of middle ear,,,526.87,526.87,1
HCPCS,70140,Hc Xr Facial Bones Less Than 3 Vw,206.0,133.9,,,0
HCPCS,70140,X-ray exam of facial bones,,,83.91,83.91,1
HCPCS,70150,Hc Xr Facial Bones Complete 3 + Vw,388.0,252.2,,,0
HCPCS,70150,X-ray exam of facial bones,,,100.81,100.81,1
HCPCS,70160,Hc Xr Nasal Bones Complete 3 + Vw,238.0,154.7,,,0
HCPCS,70160,X-ray exam of nasal bones,,,83.91,83.91,1
HCPCS,70170,X-ray exam of tear duct,,,230.07,230.07,1
HCPCS,70190,Hc Xr Optic Foramina,568.5,369.525,,,0
HCPCS,70190,X-ray exam of eye sockets,,,83.91,83.91,1
HCPCS,70200,Hc Xr Orbits Complete 4 + Vw,428.0,278.2,,,0
HCPCS,70200,X-ray exam of eye sockets,,,100.81,100.81,1
HCPCS,70210,Hc Xr Sinuses Paranasal Less Than  3 Vw,222.0,144.3,,,0
HCPCS,70210,X-ray exam of sinuses,,,83.91,83.91,1
HCPCS,70220,Hc Xr Sinuses Paranasal Complete 3 + Vw,398.0,258.7,,,0
HCPCS,70220,X-ray exam of sinuses,,,83.91,83.91,1
HCPCS,70240,Hc Xr Sella Turcica,273.0,177.45,,,0
HCPCS,70240,X-ray exam pituitary saddle,,,83.91,83.91,1
HCPCS,70250,Hc Xr Skull Less Than 4 Vw,359.0,233.35,,,0
HCPCS,70250,X-ray exam of skull,,,100.81,100.81,1
HCPCS,70260,Hc Xr Skull Complete 4 + Vw,519.0,337.35,,,0
HCPCS,70260,X-ray exam of skull,,,100.81,100.81,1
HCPCS,70300,X-ray exam of teeth,,,83.91,83.91,1
HCPCS,70310,X-ray exam of teeth,,,230.07,230.07,1
HCPCS,70320,Full mouth x-ray of teeth,,,230.07,230.07,1
HCPCS,70328,Hc Xr Tmj Open And Closed Mouth Unilat,227.0,147.55,,,0
HCPCS,70328,X-ray exam of jaw joint,,,83.91,83.91,1
HCPCS,70330,Hc Xr Tmj Open And Closed Mouth Bilat,373.0,242.45,,,0
HCPCS,70330,X-ray exam of jaw joints,,,83.91,83.91,1
HCPCS,70332,X-ray exam of jaw joint,,,230.07,230.07,1
HCPCS,70336,Hc Mri Tmj,3048.0,1981.1999999999998,,,0
HCPCS,70336,Magnetic image jaw joint,,,230.07,230.07,1
HCPCS,70350,X-ray head for orthodontia,,,83.91,83.91,1
HCPCS,70355,Hc Orthopantogram,262.0,170.3,,,0
HCPCS,70355,Panoramic x-ray of jaws,,,83.91,83.91,1
HCPCS,70360,Hc Xr Neck Soft Tissue,312.0,202.8,,,0
HCPCS,70360,X-ray exam of neck,,,83.91,83.91,1
HCPCS,70370,Throat x-ray & fluoroscopy,,,83.91,83.91,1
HCPCS,70371,Speech evaluation complex,,,230.07,230.07,1
HCPCS,70380,X-ray exam of salivary gland,,,83.91,83.91,1
HCPCS,70390,Hc Xr Sialogram,736.0,478.4,,,0
HCPCS,70390,X-ray exam of salivary duct,,,230.07,230.07,1
HCPCS,70450,Ct head/brain w/o dye,,,100.81,100.81,1
HCPCS,70450,Hc Ct Brain Wo Contrast,1285.0,835.25,,,0
HCPCS,70460,Ct head/brain w/dye,,,169.13,169.13,1
HCPCS,70460,Hc Ct Brain W Contrast,1463.0,950.95,,,0
HCPCS,70470,Ct head/brain w/o & w/dye,,,169.13,169.13,1
HCPCS,70470,Hc Ct Brain W Wo Contrast,1658.0,1077.7,,,0
HCPCS,70471,Cta h&n c+ w/noncontrast img,,,336.39,336.39,1
HCPCS,70473,Ct cere prfu aly c+wo ct/cta,,,169.13,169.13,1
HCPCS,70480,Ct orbit/ear/fossa w/o dye,,,100.81,100.81,1
HCPCS,70480,Hc Ct Orbit Sella Post Fossa Ear Wo Contrast,1326.0,861.9,,,0
HCPCS,70481,Ct orbit/ear/fossa w/dye,,,169.13,169.13,1
HCPCS,70481,Hc Ct Orbit Sella Post Fossa Ear W Contrast,1623.0,1054.95,,,0
HCPCS,70482,Ct orbit/ear/fossa w/o&w/dye,,,169.13,169.13,1
HCPCS,70482,Hc Ct Orbit Sella Post Fossa Ear W Wo Contrast,1920.0,1248.0,,,0
HCPCS,70486,Ct maxillofacial w/o dye,,,100.81,100.81,1
HCPCS,70486,Hc Ct Maxillofacial Wo Contrast,1347.0,875.55,,,0
HCPCS,70487,Ct maxillofacial w/dye,,,169.13,169.13,1
HCPCS,70487,Hc Ct Maxillofacial W Contrast,1770.0,1150.5,,,0
HCPCS,70488,Ct maxillofacial w/o & w/dye,,,169.13,169.13,1
HCPCS,70488,Hc Ct Maxillofacial W Wo Contrast,1938.0,1259.7,,,0
HCPCS,70490,Ct soft tissue neck w/o dye,,,100.81,100.81,1
HCPCS,70490,Hc Ct Soft Tissue Neck Wo Contrast,1531.0,995.15,,,0
HCPCS,70491,Ct soft tissue neck w/dye,,,169.13,169.13,1
HCPCS,70491,Hc Ct Soft Tissue Neck W Contrast,1818.0,1181.7,,,0
HCPCS,70492,Ct sft tsue nck w/o & w/dye,,,169.13,169.13,1
HCPCS,70492,Hc Ct Soft Tissue Neck W And Wo Contrast,1960.0,1274.0,,,0
HCPCS,70496,Ct angiography head,,,169.13,169.13,1
HCPCS,70496,Hc Cta Head W Wo Contrast,2003.0,1301.95,,,0
HCPCS,70498,Ct angiography neck,,,169.13,169.13,1
HCPCS,70498,Hc Cta Neck W Wo Contrast,2001.0,1300.65,,,0
HCPCS,70540,Hc Mri Orbit Face Neck Wo Contrast,2034.0,1322.1,,,0
HCPCS,70540,Mri orbit/face/neck w/o dye,,,230.07,230.07,1
HCPCS,70542,Hc Mri Orbit Face Neck W Contrast,2402.0,1561.3,,,0
HCPCS,70542,Mri Orbit/Face/Neck W/Dye,,,336.39,336.39,1
HCPCS,70543,Hc Mri Orbit Face Neck W Wo Contrast,2832.0,1840.8,,,0
HCPCS,70543,Mri orbt/fac/nck w/o &w/dye,,,336.39,336.39,1
HCPCS,70544,Hc Mra Brain Wo Contrast,1428.0,928.2,,,0
HCPCS,70544,Mr Angiography Head W/O Dye,,,230.07,230.07,1
HCPCS,70545,Hc Mra Brain W Contrast,1663.0,1080.95,,,0
HCPCS,70545,Mr Angiography Head W/Dye,,,336.39,336.39,1
HCPCS,70546,Hc Mra Brain W Wo Contrast,1898.0,1233.7,,,0
HCPCS,70546,Mr angiograph head w/o&w/dye,,,336.39,336.39,1
HCPCS,70547,Hc Mra Neck Wo Contrast,1428.0,928.2,,,0
HCPCS,70547,Mr Angiography Neck W/O Dye,,,230.07,230.07,1
HCPCS,70548,Hc Mra Neck W Contrast,1668.0,1084.2,,,0
HCPCS,70548,Mr Angiography Neck W/Dye,,,336.39,336.39,1
HCPCS,70549,Hc Mra Neck W Wo Contrast,1908.0,1240.2,,,0
HCPCS,70549,Mr angiograph neck w/o&w/dye,,,336.39,336.39,1
HCPCS,70551,Hc Mri Brain Stem Wo Contrast,1961.0,1274.65,,,0
HCPCS,70551,Mri brain stem w/o dye,,,230.07,230.07,1
HCPCS,70552,Hc Mri Brain Stem W Contrast,2521.0,1638.65,,,0
HCPCS,70552,Mri brain stem w/dye,,,336.39,336.39,1
HCPCS,70553,Hc Mri Brain Stem W Wo Contrast,3084.0,2004.6,,,0
HCPCS,70553,Mri brain stem w/o & w/dye,,,336.39,336.39,1
HCPCS,70554,Fmri brain by tech,,,230.07,230.07,1
HCPCS,70554,Hc Mri Brain Functional W Tech Only,3753.0,2439.45,,,0
HCPCS,70555,Fmri brain by phys/psych,,,230.07,230.07,1
HCPCS,70555,Hc Mri Brain Functional W Radiologist,2877.0,1870.05,,,0
HCPCS,70557,Hc Mri Brain During Open Proc Wo Cont,3044.0,1978.6,,,0
HCPCS,70557,Mri brain w/o dye,,,526.87,526.87,1
HCPCS,70558,Hc Mri Brain During Open Proc W Cont,3346.0,2174.9,,,0
HCPCS,70558,Mri brain w/dye,,,169.13,169.13,1
HCPCS,70559,Hc Mri Brain During Open Proc W And Wo Cont,3648.0,2371.2,,,0
HCPCS,70559,Mri brain w/o & w/dye,,,169.13,169.13,1
HCPCS,71045,Hc Xr Chest 1 View,263.0,170.95,,,0
HCPCS,71045,X-ray exam chest 1 view,,,83.91,83.91,1
HCPCS,71046,Hc Xr Chest 2 Views,307.0,199.55,,,0
HCPCS,71046,X-ray exam chest 2 views,,,83.91,83.91,1
HCPCS,71047,Hc Xr Chest 3 Views,386.0,250.9,,,0
HCPCS,71047,X-ray exam chest 3 views,,,83.91,83.91,1
HCPCS,71048,Hc Xr Chest 4+ Views,421.0,273.65,,,0
HCPCS,71048,X-ray exam chest 4+ views,,,100.81,100.81,1
HCPCS,71100,Hc Xr Ribs Unilateral 2 Vw,322.0,209.3,,,0
HCPCS,71100,X-ray exam ribs uni 2 views,,,83.91,83.91,1
HCPCS,71101,Hc Xr Ribs Unilateral W Cxr 3 + Vw,505.0,328.25,,,0
HCPCS,71101,X-ray exam unilat ribs/chest,,,100.81,100.81,1
HCPCS,71110,Hc Xr Ribs Bilateral 3 Vw,545.0,354.25,,,0
HCPCS,71110,X-ray exam ribs bil 3 views,,,100.81,100.81,1
HCPCS,71111,Hc Xr Ribs Bilateral W Cxr 4 + Vw,645.0,419.25,,,0
HCPCS,71111,X-ray exam ribs/chest4/> vws,,,100.81,100.81,1
HCPCS,71120,Hc Xr Sternum 2 + Vw,300.0,195.0,,,0
HCPCS,71120,X-ray exam breastbone 2/>vws,,,83.91,83.91,1
HCPCS,71130,Hc Xr Sternoclavicular Joints 3 + Vw,355.0,230.75,,,0
HCPCS,71130,X-ray strenoclavic jt 3/>vws,,,83.91,83.91,1
HCPCS,71250,Ct thorax w/o dye,,,100.81,100.81,1
HCPCS,71250,Hc Ct Chest Diagnostic Wo Contrast,1533.0,996.45,,,0
HCPCS,71260,Ct thorax w/dye,,,169.13,169.13,1
HCPCS,71260,Hc Ct Chest Diagnostic W Contrast,2106.0,1368.9,,,0
HCPCS,71270,Ct thorax w/o & w/dye,,,169.13,169.13,1
HCPCS,71270,Hc Ct Chest Diagnostic W Wo Contrast,2513.0,1633.45,,,0
HCPCS,71271,Ct thorax lung cancer scr c-,,,100.81,100.81,1
HCPCS,71271,Hc Ct Chest Low Dose Lung Cancer Screening Wo Contrast,532.0,345.8,,,0
HCPCS,71275,Ct angiography chest,,,169.13,169.13,1
HCPCS,71275,Hc Cta Chest W Wo Contrast,2179.0,1416.35,,,0
HCPCS,71550,Hc Mri Chest Wo Contrast,1972.0,1281.8,,,0
HCPCS,71550,Mri chest w/o dye,,,230.07,230.07,1
HCPCS,71551,Hc Mri Chest W Contrast,2440.0,1586.0,,,0
HCPCS,71551,Mri Chest W/Dye,,,755.87,755.87,1
HCPCS,71552,Hc Mri Chest W Wo Contrast,2907.0,1889.55,,,0
HCPCS,71552,Mri chest w/o & w/dye,,,336.39,336.39,1
HCPCS,71555,Hc Mra Chest W And Wo Contrast,2656.0,1726.4,,,0
HCPCS,71555,Hc Mra Chest W Contrast,2391.0,1554.15,,,0
HCPCS,71555,Hc Mra Chest Wo Contrast,2153.0,1399.45,,,0
HCPCS,72020,Hc Xr Spine 1 Vw Specify Level,315.0,204.75,,,0
HCPCS,72020,X-ray exam of spine 1 view,,,83.91,83.91,1
HCPCS,72040,Hc Xr Cervical Spine 2 To 3 Views,363.0,235.95,,,0
HCPCS,72040,X-ray exam neck spine 2-3 vw,,,83.91,83.91,1
HCPCS,72050,Hc Xr Cervical Spine 4 To 5  Vw,461.0,299.65,,,0
HCPCS,72050,X-ray exam neck spine 4/5vws,,,100.81,100.81,1
HCPCS,72052,Hc Xr Cervical Spine 6 + Vw,555.0,360.75,,,0
HCPCS,72052,X-ray exam neck spine 6/>vws,,,100.81,100.81,1
HCPCS,72070,Hc Xr Thoracic Spine 2 Vw,333.0,216.45,,,0
HCPCS,72070,X-ray exam thorac spine 2vws,,,100.81,100.81,1
HCPCS,72072,Hc Xr Thoracic Spine 3 Vw,398.0,258.7,,,0
HCPCS,72072,X-ray exam thorac spine 3vws,,,100.81,100.81,1
HCPCS,72074,Hc Xr Thoracic Spine 4 + Vw,494.0,321.1,,,0
HCPCS,72074,X-ray exam thorac spine4/>vw,,,100.81,100.81,1
HCPCS,72080,Hc Xr Thoracolumbar Spine 2 Vw,315.0,204.75,,,0
HCPCS,72080,X-ray exam thoracolmb 2/> vw,,,83.91,83.91,1
HCPCS,72081,Hc Xr Spine Entire Thoracic And Lumbar 1 View,200.0,130.0,,,0
HCPCS,72081,X-ray exam entire spi 1 vw,,,83.91,83.91,1
HCPCS,72082,Hc Xr Spine Entire Thoracic And Lumbar 2-3 Views,365.0,237.25,,,0
HCPCS,72082,X-ray exam entire spi 2/3 vw,,,100.81,100.81,1
HCPCS,72083,Hc Xr Spine Entire Thoracic And Lumbar 4-5 Views,436.0,283.4,,,0
HCPCS,72083,X-ray exam entire spi 4/5 vw,,,100.81,100.81,1
HCPCS,72084,Hc Xr Spine Entire Thoracic And Lumbar 6+ Views,513.0,333.45,,,0
HCPCS,72084,X-ray exam entire spi 6/> vw,,,100.81,100.81,1
HCPCS,72100,Hc Xr Lumbosacral Spine 2 Or 3 Vw,318.0,206.7,,,0
HCPCS,72100,X-ray exam l-s spine 2/3 vws,,,100.81,100.81,1
HCPCS,72110,Hc Xr Lumbosacral Spine 4 + Vw,441.0,286.65,,,0
HCPCS,72110,X-ray exam l-2 spine 4/>vws,,,100.81,100.81,1
HCPCS,72114,Hc Xr Lumbosacral Spine Complete W Bend 6 + Vw,564.0,366.6,,,0
HCPCS,72114,X-ray exam l-s spine bending,,,100.81,100.81,1
HCPCS,72120,Hc Xr Lumbosacral Spine Bending Only 2 Or 3 Vw,318.0,206.7,,,0
HCPCS,72120,X-ray bend only l-s spine,,,100.81,100.81,1
HCPCS,72125,Ct neck spine w/o dye,,,100.81,100.81,1
HCPCS,72125,Hc Ct Cervical Spine Wo Contrast,1651.0,1073.15,,,0
HCPCS,72126,Ct neck spine w/dye,,,336.39,336.39,1
HCPCS,72126,Hc Ct Cervical Spine W Contrast,1816.0,1180.4,,,0
HCPCS,72127,Ct neck spine w/o & w/dye,,,169.13,169.13,1
HCPCS,72127,Hc Ct Cervical Spine W Wo Contrast,1910.0,1241.5,,,0
HCPCS,72128,Ct chest spine w/o dye,,,100.81,100.81,1
HCPCS,72128,Hc Ct Thoracic Spine Wo Contrast,1285.0,835.25,,,0
HCPCS,72129,Ct chest spine w/dye,,,169.13,169.13,1
HCPCS,72129,Hc Ct Thoracic Spine W Contrast,1547.0,1005.55,,,0
HCPCS,72130,Ct chest spine w/o & w/dye,,,169.13,169.13,1
HCPCS,72130,Hc Ct Thoracic Spine W Wo Contrast,1704.0,1107.6,,,0
HCPCS,72131,Ct lumbar spine w/o dye,,,100.81,100.81,1
HCPCS,72131,Hc Ct Lumbar Spine Wo Contrast,1335.0,867.75,,,0
HCPCS,72132,Ct lumbar spine w/dye,,,336.39,336.39,1
HCPCS,72132,Hc Ct Lumbar Spine W Contrast,1463.0,950.95,,,0
HCPCS,72133,Ct lumbar spine w/o & w/dye,,,169.13,169.13,1
HCPCS,72133,Hc Ct Lumbar Spine W Wo Contrast,1736.0,1128.4,,,0
HCPCS,72141,Hc Mri Cervical Spine Wo Contrast,1987.0,1291.55,,,0
HCPCS,72141,Mri neck spine w/o dye,,,230.07,230.07,1
HCPCS,72142,Hc Mri Cervical Spine W Contrast,2433.0,1581.45,,,0
HCPCS,72142,Mri neck spine w/dye,,,336.39,336.39,1
HCPCS,72146,Hc Mri Thoracic Spine Wo Contrast,1979.0,1286.35,,,0
HCPCS,72146,Mri chest spine w/o dye,,,230.07,230.07,1
HCPCS,72147,Hc Mri Thoracic Spine W Contrast,2386.0,1550.9,,,0
HCPCS,72147,Mri chest spine w/dye,,,336.39,336.39,1
HCPCS,72148,Hc Mri Lumbar Spine Wo Contrast,2014.0,1309.1,,,0
HCPCS,72148,Mri lumbar spine w/o dye,,,230.07,230.07,1
HCPCS,72149,Hc Mri Lumbar Spine W Contrast,2510.0,1631.5,,,0
HCPCS,72149,Mri lumbar spine w/dye,,,336.39,336.39,1
HCPCS,72156,Hc Mri Cervical Spine W Wo Contrast,2868.0,1864.2,,,0
HCPCS,72156,Mri neck spine w/o & w/dye,,,336.39,336.39,1
HCPCS,72157,Hc Mri Thoracic Spine W Wo Contrast,2978.0,1935.7,,,0
HCPCS,72157,Mri chest spine w/o & w/dye,,,336.39,336.39,1
HCPCS,72158,Hc Mri Lumbar Spine W Wo Contrast,2835.0,1842.75,,,0
HCPCS,72158,Mri lumbar spine w/o & w/dye,,,336.39,336.39,1
HCPCS,72170,Hc Xr Pelvis 1 Or 2 Vw,361.0,234.65,,,0
HCPCS,72170,X-ray exam of pelvis,,,100.81,100.81,1
HCPCS,72190,Hc Xr Pelvis Complete 3 + Vw,463.0,300.95,,,0
HCPCS,72190,X-ray exam of pelvis,,,100.81,100.81,1
HCPCS,72191,Ct angiograph pelv w/o&w/dye,,,169.13,169.13,1
HCPCS,72191,Hc Cta Pelvis W Wo Contrast,1912.0,1242.8,,,0
HCPCS,72192,Ct pelvis w/o dye,,,100.81,100.81,1
HCPCS,72192,Hc Ct Pelvis Wo Contrast,1569.0,1019.85,,,0
HCPCS,72193,Ct pelvis w/dye,,,169.13,169.13,1
HCPCS,72193,Hc Ct Pelvis W Contrast,1694.0,1101.1,,,0
HCPCS,72194,Ct pelvis w/o & w/dye,,,169.13,169.13,1
HCPCS,72194,Hc Ct Pelvis W Wo Contrast,1819.0,1182.35,,,0
HCPCS,72195,Hc Mri Pelvis Wo Contrast,2036.0,1323.4,,,0
HCPCS,72195,Mri Pelvis W/O Dye,,,230.07,230.07,1
HCPCS,72196,Hc Mri Pelvis W Contrast,2472.0,1606.8,,,0
HCPCS,72196,Mri pelvis w/dye,,,336.39,336.39,1
HCPCS,72197,Hc Mri Pelvis W Wo Contrast,2910.0,1891.5,,,0
HCPCS,72197,Mri pelvis w/o & w/dye,,,336.39,336.39,1
HCPCS,72198,Hc Mra Pelvis W And Wo Contrast,3057.0,1987.05,,,0
HCPCS,72198,Hc Mra Pelvis W Contrast,2605.0,1693.25,,,0
HCPCS,72198,Hc Mra Pelvis Wo Contrast,2153.0,1399.45,,,0
HCPCS,72200,Hc Xr Sacroiliac Joints Less Than 3 Vw,267.0,173.55,,,0
HCPCS,72200,X-ray exam si joints,,,100.81,100.81,1
HCPCS,72202,Hc Xr Sacroiliac Joints 3 + Vw,362.0,235.3,,,0
HCPCS,72202,X-ray exam si joints 3/> vws,,,100.81,100.81,1
HCPCS,72220,Hc Xr Sacrum/Coccyx 2 + Vw,344.0,223.6,,,0
HCPCS,72220,X-ray exam sacrum tailbone,,,83.91,83.91,1
HCPCS,72240,Hc Myelogram Cervical,1417.0,921.05,,,0
HCPCS,72240,Myelography neck spine,,,755.87,755.87,1
HCPCS,72255,Hc Myelogram Thoracic,1462.0,950.3,,,0
HCPCS,72255,Myelography thoracic spine,,,755.87,755.87,1
HCPCS,72265,Hc Myelogram Lumbosacral,1493.0,970.45,,,0
HCPCS,72265,Myelography l-s spine,,,755.87,755.87,1
HCPCS,72270,Hc Myelogram 2 Or More Regions,1817.0,1181.05,,,0
HCPCS,72270,Myelogphy 2/> spine regions,,,755.87,755.87,1
HCPCS,72285,Discography cerv/thor spine,,,1882.86,1882.86,1
HCPCS,72285,Hc Discogram Cervical Or Thoracic,4071.0,2646.15,,,0
HCPCS,72295,Hc Discogram Lumbar,2934.0,1907.1,,,0
HCPCS,72295,X-ray of lower spine disk,,,1882.86,1882.86,1
HCPCS,73000,Hc Xr Clavicle Complete,445.5,289.57500000000005,,,0
HCPCS,73000,X-ray exam of collar bone,,,83.91,83.91,1
HCPCS,73010,Hc Xr Scapula Complete,516.0,335.4,,,0
HCPCS,73010,X-ray exam of shoulder blade,,,100.81,100.81,1
HCPCS,73020,Hc Xr Shoulder 1 Vw,444.0,288.6,,,0
HCPCS,73020,X-ray exam of shoulder,,,83.91,83.91,1
HCPCS,73030,Hc Xr Shoulder Complete 2 + Vw,664.5,431.92499999999995,,,0
HCPCS,73030,X-ray exam of shoulder,,,83.91,83.91,1
HCPCS,73040,Contrast x-ray of shoulder,,,336.39,336.39,1
HCPCS,73040,Hc Xr Arthrogram Shoulder,1222.5,794.625,,,0
HCPCS,73050,Hc Xr Ac Joints Bilateral,331.0,215.15,,,0
HCPCS,73050,X-ray exam of shoulders,,,83.91,83.91,1
HCPCS,73060,Hc Xr Humerus 2 + Vw,335.0,217.75,,,0
HCPCS,73060,X-ray exam of humerus,,,83.91,83.91,1
HCPCS,73070,Hc Xr Elbow 2 Vw,472.5,307.125,,,0
HCPCS,73070,X-ray exam of elbow,,,83.91,83.91,1
HCPCS,73080,Hc Xr Elbow Complete 3 + Vw,555.0,360.75,,,0
HCPCS,73080,X-ray exam of elbow,,,83.91,83.91,1
HCPCS,73085,Contrast x-ray of elbow,,,336.39,336.39,1
HCPCS,73085,Hc Xr Arthrogram Elbow,1519.5,987.6750000000001,,,0
HCPCS,73090,Hc Xr Forearm 2 Vw,498.0,323.70000000000005,,,0
HCPCS,73090,X-ray exam of forearm,,,83.91,83.91,1
HCPCS,73092,Hc Xr Upper Extremity Infant 2 + Vw,568.5,369.525,,,0
HCPCS,73092,X-ray exam of arm infant,,,100.81,100.81,1
HCPCS,73100,Hc Xr Wrist 2 Vw,340.5,221.32500000000002,,,0
HCPCS,73100,X-ray exam of wrist,,,83.91,83.91,1
HCPCS,73110,Hc Xr Wrist Complete 3 + Vw,420.0,273.0,,,0
HCPCS,73110,X-ray exam of wrist,,,83.91,83.91,1
HCPCS,73115,Contrast x-ray of wrist,,,336.39,336.39,1
HCPCS,73115,Hc Xr Arthrogram Wrist,1231.5,800.4749999999999,,,0
HCPCS,73120,Hc Xr Hand 2 Vw,369.0,239.85000000000002,,,0
HCPCS,73120,X-ray exam of hand,,,100.81,100.81,1
HCPCS,73130,Hc Xr Hand Complete 3 + Vw,480.0,312.0,,,0
HCPCS,73130,X-ray exam of hand,,,83.91,83.91,1
HCPCS,73140,Hc Xr Fingers 2 + Vw,381.0,247.64999999999998,,,0
HCPCS,73140,X-ray exam of finger(s),,,83.91,83.91,1
HCPCS,73200,Ct upper extremity w/o dye,,,100.81,100.81,1
HCPCS,73200,Hc Ct Upper Extremity Wo Contrast,1954.5,1270.4250000000002,,,0
HCPCS,73201,Ct upper extremity w/dye,,,336.39,336.39,1
HCPCS,73201,Hc Ct Upper Extremity W Contrast,2353.5,1529.775,,,0
HCPCS,73202,Ct uppr extremity w/o&w/dye,,,169.13,169.13,1
HCPCS,73202,Hc Ct Upper Extremity W Wo Contrast,2554.5,1660.4250000000002,,,0
HCPCS,73206,Ct angio upr extrm w/o&w/dye,,,169.13,169.13,1
HCPCS,73206,Hc Cta Upper Extremity W Wo Contrast,2094.0,1361.1,,,0
HCPCS,73218,Hc Mri Upper Ext Non Joint Wo Contrast,2742.0,1782.3000000000002,,,0
HCPCS,73218,Mri Upper Extremity W/O Dye,,,230.07,230.07,1
HCPCS,73219,Hc Mri Upper Ext Non Joint W Contrast,3189.0,2072.8500000000004,,,0
HCPCS,73219,Mri Upper Extremity W/Dye,,,336.39,336.39,1
HCPCS,73220,Hc Mri Upper Ext Non Joint W Wo  Contrast,3781.5,2457.9750000000004,,,0
HCPCS,73220,Mri uppr extremity w/o&w/dye,,,336.39,336.39,1
HCPCS,73221,Hc Mri Upper Ext Joint Wo Contrast,2917.5,1896.375,,,0
HCPCS,73221,Mri joint upr extrem w/o dye,,,230.07,230.07,1
HCPCS,73222,Hc Mri Upper Ext Joint W Contrast,3189.0,2072.8500000000004,,,0
HCPCS,73222,Mri joint upr extrem w/dye,,,755.87,755.87,1
HCPCS,73223,Hc Mri Upper Ext Joint W Wo Contrast,3481.5,2262.9750000000004,,,0
HCPCS,73223,Mri joint upr extr w/o&w/dye,,,336.39,336.39,1
HCPCS,73225,Hc Mra Upper Extremity W Contrast,3307.5,2149.875,,,0
HCPCS,73225,Hc Mra Upper Extremity W Wo Contrast,4149.0,2696.8500000000004,,,0
HCPCS,73225,Hc Mra Upper Extremity Wo Contrast,2733.0,1776.4499999999998,,,0
HCPCS,73501,Hc Xr Hip Unilateral 1 View,319.0,207.35,,,0
HCPCS,73501,X-ray exam hip uni 1 view,,,83.91,83.91,1
HCPCS,73502,Hc Xr Hip Unilateral W Pelvis 2-3 Views,362.0,235.3,,,0
HCPCS,73502,X-ray exam hip uni 2-3 views,,,83.91,83.91,1
HCPCS,73503,Hc Xr Hip Unilateral W Pelvis 4+ Views,406.0,263.9,,,0
HCPCS,73503,X-ray exam hip uni 4/> views,,,100.81,100.81,1
HCPCS,73521,Hc Xr Hips Bilateral 2 Views,331.0,215.15,,,0
HCPCS,73521,X-ray exam hips bi 2 views,,,100.81,100.81,1
HCPCS,73522,Hc Xr Hips Bilateral W Pelvis 3-4 Views,485.0,315.25,,,0
HCPCS,73522,X-ray exam hips bi 3-4 views,,,100.81,100.81,1
HCPCS,73523,Hc Xr Hips Bilateral W Pelvis 5+ Views,546.0,354.9,,,0
HCPCS,73523,X-ray exam hips bi 5/> views,,,100.81,100.81,1
HCPCS,73525,Contrast x-ray of hip,,,336.39,336.39,1
HCPCS,73525,Hc Xr Arthrogram Hip,1296.0,842.4000000000001,,,0
HCPCS,73551,Hc Xr Femur 1 View,288.0,187.2,,,0
HCPCS,73551,X-ray exam of femur 1,,,83.91,83.91,1
HCPCS,73552,Hc Xr Femur 2+ Views,352.5,229.125,,,0
HCPCS,73552,X-ray exam of femur 2/>,,,83.91,83.91,1
HCPCS,73560,Hc Xr Knee 1 Or 2 Vw,471.0,306.15,,,0
HCPCS,73560,X-ray exam of knee 1 or 2,,,83.91,83.91,1
HCPCS,73562,Hc Xr Knee 3 Vw,565.5,367.57500000000005,,,0
HCPCS,73562,X-ray exam of knee 3,,,83.91,83.91,1
HCPCS,73564,Hc Xr Knee Complete 4 + Vw,609.0,395.84999999999997,,,0
HCPCS,73564,X-ray exam knee 4 or more,,,100.81,100.81,1
HCPCS,73565,Hc Xr Knee Ap Standing Bilateral,322.0,209.3,,,0
HCPCS,73565,X-ray exam of knees,,,83.91,83.91,1
HCPCS,73580,Contrast x-ray of knee joint,,,336.39,336.39,1
HCPCS,73580,Hc Xr Arthrogram Knee,1176.0,764.4000000000001,,,0
HCPCS,73590,Hc Xr Tibia Fibula 2 Vw,460.5,299.32500000000005,,,0
HCPCS,73590,X-ray exam of lower leg,,,83.91,83.91,1
HCPCS,73592,Hc Xr Lower Extremity Infant 2 + Vw,436.5,283.725,,,0
HCPCS,73592,X-ray exam of leg infant,,,83.91,83.91,1
HCPCS,73600,Hc Xr Ankle 2 Vw,504.0,327.6,,,0
HCPCS,73600,X-ray exam of ankle,,,83.91,83.91,1
HCPCS,73610,Hc Xr Ankle Complete 3 + Vw,556.5,361.725,,,0
HCPCS,73610,X-ray exam of ankle,,,83.91,83.91,1
HCPCS,73615,Contrast x-ray of ankle,,,336.39,336.39,1
HCPCS,73615,Hc Xr Arthrogram Ankle,1176.0,764.4000000000001,,,0
HCPCS,73620,Hc Xr Foot 2 Vw,426.0,276.9,,,0
HCPCS,73620,X-ray exam of foot,,,83.91,83.91,1
HCPCS,73630,Hc Xr Foot Complete 3 + Vw,565.5,367.57500000000005,,,0
HCPCS,73630,X-ray exam of foot,,,83.91,83.91,1
HCPCS,73650,Hc Xr Calcaneus 2 + Vw,480.0,312.0,,,0
HCPCS,73650,X-ray exam of heel,,,83.91,83.91,1
HCPCS,73660,Hc Xr Toes 2 + Vw,505.5,328.57500000000005,,,0
HCPCS,73660,X-ray exam of toe(s),,,83.91,83.91,1
HCPCS,73700,Ct lower extremity w/o dye,,,100.81,100.81,1
HCPCS,73700,Hc Ct Lower Extrem Wo Contrast,2013.0,1308.4499999999998,,,0
HCPCS,73701,Ct lower extremity w/dye,,,169.13,169.13,1
HCPCS,73701,Hc Ct Lower Extrem W Contrast,2340.0,1521.0,,,0
HCPCS,73702,Ct lwr extremity w/o&w/dye,,,169.13,169.13,1
HCPCS,73702,Hc Ct Lower Extrem W Wo Contrast,2842.5,1847.625,,,0
HCPCS,73706,Ct angio lwr extr w/o&w/dye,,,169.13,169.13,1
HCPCS,73706,Hc Cta Lower Extrem W Wo Contrast,3100.5,2015.3249999999998,,,0
HCPCS,73718,Hc Mri Low Extrem Non Joint Wo Contrast,2965.5,1927.5749999999998,,,0
HCPCS,73718,Mri Lower Extremity W/O Dye,,,230.07,230.07,1
HCPCS,73719,Hc Mri Low Extrem Non Joint W Contrast,3123.0,2029.9499999999998,,,0
HCPCS,73719,Mri Lower Extremity W/Dye,,,336.39,336.39,1
HCPCS,73720,Hc Mri Low Extrem Non Joint W Wo Contrast,3928.5,2553.5249999999996,,,0
HCPCS,73720,Mri lwr extremity w/o&w/dye,,,336.39,336.39,1
HCPCS,73721,Hc Mri Low Extremity Joint Wo Contrast,2824.5,1835.9250000000002,,,0
HCPCS,73721,Mri jnt of lwr extre w/o dye,,,230.07,230.07,1
HCPCS,73722,Hc Mri Low Extremity Joint W Contrast,3339.0,2170.3500000000004,,,0
HCPCS,73722,Mri Joint Of Lwr Extr W/Dye,,,755.87,755.87,1
HCPCS,73723,Hc Mri Low Extremity Joint W Wo Contrast,3895.5,2532.075,,,0
HCPCS,73723,Mri joint lwr extr w/o&w/dye,,,336.39,336.39,1
HCPCS,73725,Hc Mra Lower Extremity W And Wo Contrast,4123.5,2680.2749999999996,,,0
HCPCS,73725,Hc Mra Lower Extremity W Contrast,3799.5,2469.675,,,0
HCPCS,73725,Hc Mra Lower Extremity Wo Contrast,3201.0,2080.6499999999996,,,0
HCPCS,74018,Hc Xr Abdomen 1 View,251.0,163.15,,,0
HCPCS,74018,X-ray exam abdomen 1 view,,,83.91,83.91,1
HCPCS,74019,Hc Xr Abdomen 2 Views,388.0,252.2,,,0
HCPCS,74019,X-ray exam abdomen 2 views,,,100.81,100.81,1
HCPCS,74021,Hc Xr Abdomen 3+ Views,406.0,263.9,,,0
HCPCS,74021,X-ray exam abdomen 3+ views,,,100.81,100.81,1
HCPCS,74022,Hc Xr Acute Abdominal Series W 1 Vw Chest,553.0,359.45,,,0
HCPCS,74022,X-ray exam series abdomen,,,100.81,100.81,1
HCPCS,74150,Ct abdomen w/o dye,,,100.81,100.81,1
HCPCS,74150,Hc Ct Abdomen Wo Contrast,1644.0,1068.6,,,0
HCPCS,74160,Ct abdomen w/dye,,,169.13,169.13,1
HCPCS,74160,Hc Ct Abdomen W Contrast,1796.0,1167.4,,,0
HCPCS,74170,Ct abdomen w/o & w/dye,,,169.13,169.13,1
HCPCS,74170,Hc Ct Abdomen W Wo Contrast,1948.0,1266.2,,,0
HCPCS,74174,Ct angio abd&pelv w/o&w/dye,,,336.39,336.39,1
HCPCS,74174,Hc Cta Abdomen Pelvis W Wo Contrast,3312.0,2152.8,,,0
HCPCS,74175,Ct angio abdom w/o & w/dye,,,169.13,169.13,1
HCPCS,74175,Hc Cta Abdomen W Wo Contrast,2046.0,1329.9,,,0
HCPCS,74176,Ct abd & pelvis w/o contrast,,,230.07,230.07,1
HCPCS,74176,Hc Ct Abdomen Pelvis Wo Contrast,2417.0,1571.05,,,0
HCPCS,74177,Ct abd & pelv w/contrast,,,336.39,336.39,1
HCPCS,74177,Hc Ct Abdomen Pelvis W Contrast,2972.0,1931.8,,,0
HCPCS,74178,Ct abd & pelv 1/> regns,,,336.39,336.39,1
HCPCS,74178,Hc Ct Abdomen Pelvis W Wo Contrast,3156.0,2051.4,,,0
HCPCS,74181,Hc Mri Abdomen Wo Contrast,1977.0,1285.05,,,0
HCPCS,74181,Mri abdomen w/o dye,,,230.07,230.07,1
HCPCS,74182,Hc Mri Abdomen W Contrast,2507.0,1629.55,,,0
HCPCS,74182,Mri Abdomen W/Dye,,,336.39,336.39,1
HCPCS,74183,Hc Mri Abdomen W Wo Contrast,3122.0,2029.3,,,0
HCPCS,74183,Mri abdomen w/o & w/dye,,,336.39,336.39,1
HCPCS,74185,Hc Mra Abdomen W And Wo Contrast,3280.0,2132.0,,,0
HCPCS,74185,Hc Mra Abdomen W Contrast,2746.0,1784.9,,,0
HCPCS,74185,Hc Mra Abdomen Wo Contrast,2214.0,1439.1,,,0
HCPCS,74190,Hc Xr Peritoneogram,1145.0,744.25,,,0
HCPCS,74190,X-ray exam of peritoneum,,,526.87,526.87,1
HCPCS,74210,Contrst x-ray exam of throat,,,169.13,169.13,1
HCPCS,74220,Contrast x-ray esophagus,,,169.13,169.13,1
HCPCS,74220,Hc Xr Esophagus Single Contrast Study,544.0,353.6,,,0
HCPCS,74221,Hc Xr Esophagus Double Contrast Study,765.0,497.25,,,0
HCPCS,74221,X-ray xm esophagus 2cntrst,,,169.13,169.13,1
HCPCS,74230,Cine/vid x-ray throat/esoph,,,169.13,169.13,1
HCPCS,74230,Hc Xr Swallowing Function Contrast Study,463.0,300.95,,,0
HCPCS,74235,Hc Remove Fb Esophagus W Balloon Cath,1143.0,742.95,,,0
HCPCS,74240,Hc Xr Upper Gi Single Contrast Study,823.0,534.95,,,0
HCPCS,74240,X-ray upper gi delay w/o kub,,,169.13,169.13,1
HCPCS,74246,Contrst x-ray uppr gi tract,,,169.13,169.13,1
HCPCS,74246,Hc Xr Upper Gi Double Contrast Study,964.0,626.6,,,0
HCPCS,74248,Hc Xr Small Intestine Follow Through Study Add On,582.0,378.3,,,0
HCPCS,74250,Hc Xr Small Intestine Single Contrast Study,760.0,494.0,,,0
HCPCS,74250,X-ray exam of small bowel,,,169.13,169.13,1
HCPCS,74251,Hc Xr Small Intestine Double Contrast Study,954.0,620.1,,,0
HCPCS,74251,X-ray exam of small bowel,,,169.13,169.13,1
HCPCS,74261,Ct colonography dx,,,100.81,100.81,1
HCPCS,74261,Hc Ct Colonogram Diagnostic,1256.0,816.4,,,0
HCPCS,74262,Ct colonography dx w/dye,,,169.13,169.13,1
HCPCS,74263,Ct colonography screening,,,230.07,230.07,1
HCPCS,74263,Hc Ct Colonogram Screening,1256.0,816.4,,,0
HCPCS,74270,Contrast x-ray exam of colon,,,169.13,169.13,1
HCPCS,74270,Hc Xr Colon Single Contrast Study,813.0,528.45,,,0
HCPCS,74280,Contrast x-ray exam of colon,,,169.13,169.13,1
HCPCS,74280,Hc Xr Colon Double Contrast Study,1024.0,665.6,,,0
HCPCS,74283,Contrast x-ray exam of colon,,,169.13,169.13,1
HCPCS,74290,Contrast x-ray gallbladder,,,169.13,169.13,1
HCPCS,74300,Hc Cholangiogram Intraop,601.0,390.65,,,0
HCPCS,74301,Hc Cholangiogram Intraop Addl,308.0,200.2,,,0
HCPCS,74328,Hc Xr Ercp Biliary Ductal System Only,685.0,445.25,,,0
HCPCS,74329,Hc Xr Ercp Pancreatic Ductal System Only,685.0,445.25,,,0
HCPCS,74330,Hc Xr Ercp Complete,1097.0,713.05,,,0
HCPCS,74340,Hc Xr Introduction Long Gi Tube W Fluoro,704.0,457.6,,,0
HCPCS,74355,Hc Placement Enteroclysis Tube,1130.0,734.5,,,0
HCPCS,74360,Hc Intraluminal Dilation Esoph,696.0,452.4,,,0
HCPCS,74363,Hc Dilation Biliary Duct Strictures,1333.0,866.45,,,0
HCPCS,74400,Contrst x-ray urinary tract,,,169.13,169.13,1
HCPCS,74400,Hc Urogram Intravenous (Ivp) W Or Wo Kub Or Tomogram,1129.0,733.85,,,0
HCPCS,74410,Contrst x-ray urinary tract,,,169.13,169.13,1
HCPCS,74415,Contrst x-ray urinary tract,,,169.13,169.13,1
HCPCS,74420,Contrst x-ray urinary tract,,,336.39,336.39,1
HCPCS,74420,Hc Urogram Retrograde W Or Wo Kub,1279.0,831.35,,,0
HCPCS,74425,Contrst x-ray urinary tract,,,336.39,336.39,1
HCPCS,74425,Hc Urogram Antegrade,785.0,510.25,,,0
HCPCS,74430,Contrast x-ray bladder,,,336.39,336.39,1
HCPCS,74430,Hc Cystogram 3 + Vw,727.0,472.55,,,0
HCPCS,74440,X-ray male genital tract,,,230.07,230.07,1
HCPCS,74445,Hc Corpora Cavernosogram,2237.0,1454.05,,,0
HCPCS,74445,X-ray exam of penis,,,100.81,100.81,1
HCPCS,74450,Hc Urethrocystogram Retrograde,945.0,614.25,,,0
HCPCS,74450,X-ray urethra/bladder,,,230.07,230.07,1
HCPCS,74455,Hc Urethrocystogram Voiding,1017.0,661.05,,,0
HCPCS,74455,X-ray urethra/bladder,,,230.07,230.07,1
HCPCS,74470,Hc Xr Renal Cyst Study Translumbar,3575.0,2323.75,,,0
HCPCS,74470,X-ray exam of kidney lesion,,,526.87,526.87,1
HCPCS,74485,Hc Dilation Ureters Or Urethra,3375.0,2193.75,,,0
HCPCS,74485,X-ray guide gu dilation,,,2015.59,2015.59,1
HCPCS,74712,Mri fetal sngl/1st gestation,,,230.07,230.07,1
HCPCS,74740,Hc Hysterosalpingogram,592.0,384.8,,,0
HCPCS,74740,X-ray female genital tract,,,230.07,230.07,1
HCPCS,74742,Hc Transcervical Cath Fallopian Tube,1990.0,1293.5,,,0
HCPCS,74775,Hc Perineogram,1727.0,1122.55,,,0
HCPCS,74775,X-ray exam of perineum,,,230.07,230.07,1
HCPCS,75557,Cardiac mri for morph,,,230.07,230.07,1
HCPCS,75557,Hc Mri Card Morphology And Function Wo Contrast,1796.0,1167.4,,,0
HCPCS,75559,Cardiac mri w/stress img,,,526.87,526.87,1
HCPCS,75561,Cardiac mri for morph w/dye,,,336.39,336.39,1
HCPCS,75561,Hc Mri Card Ltd W And Wo Contrast And Further Seq,1995.0,1296.75,,,0
HCPCS,75563,Card mri w/stress img & dye,,,755.87,755.87,1
HCPCS,75563,Hc Mri Cardiac W And Wo Contrast W Stress,2086.0,1355.9,,,0
HCPCS,75565,Hc Mri Card For Velocity Flow Mapping,757.0,492.05,,,0
HCPCS,75571,Ct hrt w/o dye w/ca test,,,83.91,83.91,1
HCPCS,75571,Hc Ct Coronary Calcium Scan Diagnostic,585.0,380.25,,,0
HCPCS,75572,Ct hrt w/3d image,,,336.39,336.39,1
HCPCS,75572,Hc Ct Heart Contrast Eval Card Function,1532.0,995.8,,,0
HCPCS,75573,Ct hrt w/3d image congen,,,336.39,336.39,1
HCPCS,75573,Hc Ct Heart Contrast Eval Card Function Congenital,1716.0,1115.4,,,0
HCPCS,75574,Ct angio hrt w/3d image,,,336.39,336.39,1
HCPCS,75574,Hc Cta Heart W Dye Cor Ateries And Bypass Grafts,1878.0,1220.7,,,0
HCPCS,75577,Quan&char c athrosclrtc plaq,,,897.06,897.06,1
HCPCS,75580,Hc Coronary Ffr Estimate From Ccta,3764.0,2446.6,,,0
HCPCS,75580,N-invas est c ffr sw aly cta,,,828.02,828.02,1
HCPCS,75600,Contrast exam thoracic aorta,,,3044.51,3044.51,1
HCPCS,75605,Contrast exam thoracic aorta,,,5365.4,5365.4,1
HCPCS,75605,Hc Aortogram Thoracic Serialogram,8676.0,5639.4,,,0
HCPCS,75625,Contrast exam abdominl aorta,,,3044.51,3044.51,1
HCPCS,75625,Hc Aortogram Abdominal Serialogram,5127.0,3332.55,,,0
HCPCS,75630,Hc Aortogram Abd W Bilat Ileofemoral Low Ext,5419.0,3522.35,,,0
HCPCS,75630,X-ray aorta leg arteries,,,3044.51,3044.51,1
HCPCS,75635,Ct Angio Abdominal Arteries,,,169.13,169.13,1
HCPCS,75635,Hc Cta Abd Aorta Bilateral Lower Ext Runoff,1405.0,913.25,,,0
HCPCS,75705,Artery x-rays spine,,,5365.4,5365.4,1
HCPCS,75705,Hc Angiogram Spinal Selective,8502.0,5526.3,,,0
HCPCS,75710,Artery x-rays arm/leg,,,3044.51,3044.51,1
HCPCS,75710,Hc Angiogram Extremity Unilateral,5127.0,3332.55,,,0
HCPCS,75716,Artery x-rays arms/legs,,,3044.51,3044.51,1
HCPCS,75716,Hc Angiogram Extremity Bilateral,5245.0,3409.25,,,0
HCPCS,75726,Artery x-rays abdomen,,,5365.4,5365.4,1
HCPCS,75726,Hc Angiogram Visceral,8502.0,5526.3,,,0
HCPCS,75731,Artery x-rays adrenal gland,,,3044.51,3044.51,1
HCPCS,75731,Hc Angiogram Adrenal Unilateral,3383.0,2198.95,,,0
HCPCS,75733,Artery x-rays adrenals,,,3044.51,3044.51,1
HCPCS,75733,Hc Angiogram Adrenal Bilateral,5127.0,3332.55,,,0
HCPCS,75736,Artery x-rays pelvis,,,5365.4,5365.4,1
HCPCS,75736,Hc Angiogram Pelvic,8502.0,5526.3,,,0
HCPCS,75741,Artery x-rays lung,,,3044.51,3044.51,1
HCPCS,75741,Hc Angiogram Pulmonary Unilateral,5127.0,3332.55,,,0
HCPCS,75743,Artery x-rays lungs,,,3044.51,3044.51,1
HCPCS,75743,Hc Angiogram Pulmonary  Bilateral,5197.0,3378.05,,,0
HCPCS,75746,Artery x-rays lung,,,3044.51,3044.51,1
HCPCS,75746,Hc Angiogram Pulmonary Non-Select,4793.0,3115.45,,,0
HCPCS,75756,Artery x-rays chest,,,3044.51,3044.51,1
HCPCS,75756,Hc Internal Mammary Arteriogram,2747.0,1785.55,,,0
HCPCS,75774,Hc Angiogram Each Addl Vessel,2070.0,1345.5,,,0
HCPCS,75801,Hc Lymphangiogram Extremity Unilateral,1254.0,815.1,,,0
HCPCS,75801,Lymph vessel x-ray arm/leg,,,604.86,604.86,1
HCPCS,75803,Hc Lymphangiogram Extremity Bilateral,3020.0,1963.0,,,0
HCPCS,75803,Lymph vessel x-ray arms/legs,,,1517.83,1517.83,1
HCPCS,75805,Hc Lymphangiogram Pelvic Abdominal Unilateral,3509.0,2280.85,,,0
HCPCS,75805,Lymph vessel x-ray trunk,,,3044.51,3044.51,1
HCPCS,75807,Hc Lymphangiogram Pelvic Abdominal Bilateral,5127.0,3332.55,,,0
HCPCS,75807,Lymph vessel x-ray trunk,,,3044.51,3044.51,1
HCPCS,75809,Hc Shuntogram Nonvascular,599.0,389.35,,,0
HCPCS,75809,Nonvascular shunt x-ray,,,100.81,100.81,1
HCPCS,75810,Hc Splenoportogram,6694.0,4351.1,,,0
HCPCS,75810,Vein x-ray spleen/liver,,,3044.51,3044.51,1
HCPCS,75820,Hc Venogram Extremity Unilat,1167.0,758.55,,,0
HCPCS,75820,Vein x-ray arm/leg,,,1517.83,1517.83,1
HCPCS,75822,Hc Venogram Extremity Bilat,2048.0,1331.2,,,0
HCPCS,75822,Vein x-ray arms/legs,,,1517.83,1517.83,1
HCPCS,75825,Hc Venocavagram Inferior,5127.0,3332.55,,,0
HCPCS,75825,Vein x-ray trunk,,,3044.51,3044.51,1
HCPCS,75827,Hc Venocavagram Superior,2229.0,1448.85,,,0
HCPCS,75827,Vein x-ray chest,,,1517.83,1517.83,1
HCPCS,75831,Hc Venogram Renal Unilateral,5127.0,3332.55,,,0
HCPCS,75831,Vein x-ray kidney,,,3044.51,3044.51,1
HCPCS,75833,Hc Venogram Renal Bilateral,5673.0,3687.45,,,0
HCPCS,75833,Vein x-ray kidneys,,,3044.51,3044.51,1
HCPCS,75840,Hc Venogram Adrenal Unilatateral,5127.0,3332.55,,,0
HCPCS,75840,Vein x-ray adrenal gland,,,3044.51,3044.51,1
HCPCS,75842,Hc Venogram Adrenal Bilateral,8502.0,5526.3,,,0
HCPCS,75860,Hc Venogram Sinus Jugular,5127.0,3332.55,,,0
HCPCS,75860,Vein x-ray neck,,,3044.51,3044.51,1
HCPCS,75870,Hc Venogram Superior Sagittal,3397.0,2208.05,,,0
HCPCS,75870,Vein x-ray skull,,,3044.51,3044.51,1
HCPCS,75872,Hc Venogram Epidural,4750.0,3087.5,,,0
HCPCS,75872,Vein x-ray skull epidural,,,604.86,604.86,1
HCPCS,75880,Vein x-ray eye socket,,,604.86,604.86,1
HCPCS,75885,Hc Portogram W Hemodynamics,5127.0,3332.55,,,0
HCPCS,75885,Vein x-ray liver w/hemodynam,,,3044.51,3044.51,1
HCPCS,75887,Hc Portogram Wo Hemodynamics,5127.0,3332.55,,,0
HCPCS,75887,Vein x-ray liver w/o hemodyn,,,3044.51,3044.51,1
HCPCS,75889,Hc Venogram Hepatic W Hemodynamics,5127.0,3332.55,,,0
HCPCS,75889,Vein x-ray liver w/hemodynam,,,3044.51,3044.51,1
HCPCS,75891,Hc Venogram Hepatic Wo Hemodynamics,5127.0,3332.55,,,0
HCPCS,75891,Vein x-ray liver,,,3044.51,3044.51,1
HCPCS,75893,Hc Venous Sampling Through Catheter,8502.0,5526.3,,,0
HCPCS,75893,Venous sampling by catheter,,,5365.4,5365.4,1
HCPCS,75894,Hc Transcath Therapy Embolization,2920.0,1898.0,,,0
HCPCS,75898,Follow-up angiography,,,3044.51,3044.51,1
HCPCS,75898,Hc Transcath Angio Not Thromblysis,3509.0,2280.85,,,0
HCPCS,75901,Hc Removal Of Fibrin Sheath,689.0,447.85,,,0
HCPCS,75902,Hc Mech Remvl Intraluminal Obstructive Material,529.0,343.85,,,0
HCPCS,75956,Hc Endovasc Rep Descending Thoracic Aorta Subclavian,1689.0,1097.85,,,0
HCPCS,75957,Hc Endovasc Rep Descending Thoracic Aorta Celiac,1448.0,941.2,,,0
HCPCS,75958,Hc Proximal Exten Prosth Descending Thoracic Aorta,1938.0,1259.7,,,0
HCPCS,75959,Hc Distal Exten Prosth Descending Thoracic Aorta,1689.0,1097.85,,,0
HCPCS,75970,Hc Transcatheter Biopsy R S&I,2882.0,1873.3,,,0
HCPCS,75984,Hc Drainage Catheter Exchange W Contrast,690.0,448.5,,,0
HCPCS,75989,Hc Rad Guidance For Drainage W Cath Placement,1493.0,970.45,,,0
HCPCS,76000,Fluoroscope examination,,,230.07,230.07,1
HCPCS,76000,Hc Fluoro Up To 1 Hour Separate Procedure,550.0,357.5,,,0
HCPCS,76010,Hc Xr Nose To Rectum For Foreign Body Child,952.0,618.8,,,0
HCPCS,76010,X-ray nose to rectum,,,83.91,83.91,1
HCPCS,76014,Hc Mr Safety Implant/Fb Assess By Tech Initial 15 Min,75.0,48.75,,,0
HCPCS,76014,Mr sfty implt&/fb asmt stf 1,,,27.89,27.89,1
HCPCS,76015,Hc Mr Safety Implant/Fb Assess By Tech Ea Addl 30 Min,25.0,16.25,,,0
HCPCS,76016,Hc Mr Safety Determination By Radiologist,265.0,172.25,,,0
HCPCS,76016,Mr safety deter phys/qhp,,,83.91,83.91,1
HCPCS,76017,Mr sfty med physics xm cstmz,,,230.07,230.07,1
HCPCS,76018,Hc Mr Safety Implant Electronics Prep,275.0,178.75,,,0
HCPCS,76018,Mr safety implant elec prepj,,,91.67,91.67,1
HCPCS,76019,Hc Mr Safety Implant Positioning Or Immobilization,180.0,117.0,,,0
HCPCS,76019,Mr safety implt pos&/immoblj,,,56.88,56.88,1
HCPCS,76080,Hc Xr Abscess Fistula Sinus Tract,918.0,596.7,,,0
HCPCS,76080,X-ray exam of fistula,,,526.87,526.87,1
HCPCS,76098,Hc Rad Exam Surgical Specimen,967.0,628.55,,,0
HCPCS,76098,X-ray exam breast specimen,,,526.87,526.87,1
HCPCS,76100,Hc Xr Tomogram Single Plane,757.0,492.05,,,0
HCPCS,76100,X-ray exam of body section,,,100.81,100.81,1
HCPCS,76120,Cine/video x-rays,,,100.81,100.81,1
HCPCS,76145,Hc Medical Physics Dose Eval For Radiation Exposure,2991.0,1944.15,,,0
HCPCS,76145,Med physic dos eval rad exps,,,359.81,359.81,1
HCPCS,76376,Hc 3D Reconstruct On Scanner,494.0,321.1,,,0
HCPCS,76377,Hc 3D Reconstruct On Separate Workstation,744.0,483.6,,,0
HCPCS,76380,CAT scan follow-up study,,,83.91,83.91,1
HCPCS,76380,Hc Ct Limited Follow Up,649.0,421.85,,,0
HCPCS,76390,Hc Mri Spectroscopy,1777.0,1155.05,,,0
HCPCS,76390,Mr spectroscopy,,,83.91,83.91,1
HCPCS,76391,Mr elastography,,,230.07,230.07,1
HCPCS,76496,Fluoroscopic procedure,,,83.91,83.91,1
HCPCS,76496,Hc Unlisted Fluoro Procedure,412.0,267.8,,,0
HCPCS,76497,Ct procedure,,,83.91,83.91,1
HCPCS,76497,Hc Unlisted Ct Procedure,4917.0,3196.05,,,0
HCPCS,76498,Hc Mri Radiation Treatment Planning,574.0,373.1,,,0
HCPCS,76498,Mri procedure,,,83.91,83.91,1
HCPCS,76499,Radiographic procedure,,,83.91,83.91,1
HCPCS,76506,Echo exam of head,,,100.81,100.81,1
HCPCS,76506,Hc Encephalogram,347.0,225.55,,,0
HCPCS,76510,Ophth us b & quant a,,,128.29,128.29,1
HCPCS,76511,Ophth us quant a only,,,100.81,100.81,1
HCPCS,76512,Ophth us b w/non-quant a,,,100.81,100.81,1
HCPCS,76513,Echo exam of eye water bath,,,100.81,100.81,1
HCPCS,76514,Echo exam of eye thickness,,,27.89,27.89,1
HCPCS,76516,Echo exam of eye,,,100.81,100.81,1
HCPCS,76519,Echo exam of eye,,,100.81,100.81,1
HCPCS,76529,Echo exam of eye,,,83.91,83.91,1
HCPCS,76536,Hc Us Soft Tissue Head And Neck,736.0,478.4,,,0
HCPCS,76536,Us exam of head and neck,,,100.81,100.81,1
HCPCS,76604,Hc Us Chest,381.0,247.65,,,0
HCPCS,76604,Us exam chest,,,100.81,100.81,1
HCPCS,76641,Hc Us Breast Complete,1408.5,915.5250000000001,,,0
HCPCS,76641,Hc Us Screening Breast Bilat,450.0,292.5,,,0
HCPCS,76641,Hc Us Screening Breast Unilat,337.5,219.375,,,0
HCPCS,76641,Ultrasound breast complete,,,100.81,100.81,1
HCPCS,76642,Hc Us Breast Limited,1068.5,694.525,,,0
HCPCS,76642,Ultrasound breast limited,,,83.91,83.91,1
HCPCS,76700,Hc Us Abdomen Complete,620.0,403.0,,,0
HCPCS,76700,Us exam abdom complete,,,100.81,100.81,1
HCPCS,76705,Echo exam of abdomen,,,100.81,100.81,1
HCPCS,76705,Hc Us Abdomen Limited,546.0,354.9,,,0
HCPCS,76706,Hc Us For Aaa Screening,231.0,150.15,,,0
HCPCS,76706,Us abdl aorta screen aaa,,,100.81,100.81,1
HCPCS,76770,Hc Us Retroperitioneal Complete,675.0,438.75,,,0
HCPCS,76770,Us exam abdo back wall comp,,,100.81,100.81,1
HCPCS,76775,Hc Us Retroperitioneal Limited,494.0,321.1,,,0
HCPCS,76775,Us exam abdo back wall lim,,,100.81,100.81,1
HCPCS,76776,Us exam k transpl w/doppler,,,100.81,100.81,1
HCPCS,76800,Hc Us Spinal Canal And Contents,826.0,536.9,,,0
HCPCS,76800,Us exam spinal canal,,,100.81,100.81,1
HCPCS,76801,Hc Us Pregnant Uterus 1St Trimester Sgl Fetus,463.0,300.95,,,0
HCPCS,76801,Ob us < 14 wks single fetus,,,100.81,100.81,1
HCPCS,76802,Hc Us Pregnant Uterus 1St Trimester Ea Addl Fetus,275.0,178.75,,,0
HCPCS,76805,Hc Us Pregnant Uterus After 1St Trimester Sgl Fetus,512.0,332.8,,,0
HCPCS,76805,Ob us >/= 14 wks sngl fetus,,,100.81,100.81,1
HCPCS,76810,Hc Us Pregnant Uterus After 1St Trimester Ea Addl Fetus,331.0,215.15,,,0
HCPCS,76811,Hc Us Pregnant Uterus W Detail Fetal Anatomy Sgl Fetus,687.0,446.55,,,0
HCPCS,76811,Ob us detailed sngl fetus,,,230.07,230.07,1
HCPCS,76812,Hc Us Pregnant Uterus W Detail Fetal Anatomy Addl Fetus,259.0,168.35,,,0
HCPCS,76813,Hc Us Fetal Nuchal Translucency Sgl,227.0,147.55,,,0
HCPCS,76813,Ob us nuchal meas 1 gest,,,100.81,100.81,1
HCPCS,76814,Hc Us Fetal Nuchal Translucency Addl,153.0,99.45,,,0
HCPCS,76815,Hc Us Pregnant Uterus Limited 1 Or More Fetuses,211.0,137.15,,,0
HCPCS,76815,Ob us limited fetus(s),,,100.81,100.81,1
HCPCS,76816,Hc Us Pregnant Uterus Follow Up Per Fetus,327.0,212.55,,,0
HCPCS,76816,Ob us follow-up per fetus,,,100.81,100.81,1
HCPCS,76817,Hc Us Pregnant Uterus Transvaginal,438.0,284.7,,,0
HCPCS,76817,Transvaginal us obstetric,,,100.81,100.81,1
HCPCS,76818,Fetal biophys profile w/nst,,,100.81,100.81,1
HCPCS,76818,Hc Us Fetal Biophysical Profile W Nst,413.0,268.45,,,0
HCPCS,76819,Fetal biophys profil w/o nst,,,100.81,100.81,1
HCPCS,76819,Hc Us Fetal Biophysical Profile Wo Nst,376.0,244.4,,,0
HCPCS,76820,Hc Us Velocimetry Umbilical Artery,243.0,157.95,,,0
HCPCS,76820,Umbilical artery echo,,,100.81,100.81,1
HCPCS,76821,Hc Us Velocimetry Fetal Middle Cerebral Artery,223.0,144.95,,,0
HCPCS,76821,Middle cerebral artery echo,,,100.81,100.81,1
HCPCS,76825,Echo exam of fetal heart,,,526.87,526.87,1
HCPCS,76825,Hc Fetal Heart Echo 2D W Wo M Mode Recording,959.0,623.35,,,0
HCPCS,76826,Echo exam of fetal heart,,,230.07,230.07,1
HCPCS,76826,Hc Fetal Heart Echo 2D W Wo M Mode Follow Up,345.0,224.25,,,0
HCPCS,76827,Echo exam of fetal heart,,,100.81,100.81,1
HCPCS,76827,Hc Fetal Heart Echo Complete,600.0,390.0,,,0
HCPCS,76828,Echo exam of fetal heart,,,100.81,100.81,1
HCPCS,76828,Hc Fetal Heart Echo Follow Up,196.0,127.4,,,0
HCPCS,76830,Hc Us Transvaginal,658.0,427.7,,,0
HCPCS,76830,Transvaginal us non-ob,,,100.81,100.81,1
HCPCS,76831,Echo exam uterus,,,230.07,230.07,1
HCPCS,76831,Hc Sonohystogram,624.0,405.6,,,0
HCPCS,76856,Hc Us Pelvis Non Ob Complete,347.0,225.55,,,0
HCPCS,76856,Us exam pelvic complete,,,100.81,100.81,1
HCPCS,76857,Hc Us Pelvis Non Ob Limited Follow Up,282.0,183.3,,,0
HCPCS,76857,Us exam pelvic limited,,,100.81,100.81,1
HCPCS,76870,Hc Us Scrotum,615.0,399.75,,,0
HCPCS,76870,Us exam scrotum,,,100.81,100.81,1
HCPCS,76872,Hc Us Transrectal,648.0,421.2,,,0
HCPCS,76872,Us transrectal,,,100.81,100.81,1
HCPCS,76873,Echograp trans r pros study,,,100.81,100.81,1
HCPCS,76873,Hc Us Prostate Volume Study For Brachytherapy Planning,685.0,445.25,,,0
HCPCS,76881,Hc Us Extremity Complete Joint,667.0,433.55,,,0
HCPCS,76881,Us xtr non-vasc complete,,,100.81,100.81,1
HCPCS,76882,Hc Us Extremity Limited Joint Or Non Vasc Structure,429.0,278.85,,,0
HCPCS,76882,Us xtr non-vasc lmtd,,,100.81,100.81,1
HCPCS,76883,Us nrv&acc strux 1xtr compre,,,100.81,100.81,1
HCPCS,76885,Us exam infant hips dynamic,,,83.91,83.91,1
HCPCS,76886,Us exam infant hips static,,,83.91,83.91,1
HCPCS,76936,Echo guide for artery repair,,,208.2,208.2,1
HCPCS,76936,Hc Us Guided Compression Repair,519.0,337.35,,,0
HCPCS,76937,Hc Us Guided Vascular Access,431.0,280.15,,,0
HCPCS,76940,Hc Us Guided Parenchymal Tissue Ablation,268.0,174.2,,,0
HCPCS,76941,Hc Us Guidance Cordocentesis Or Fetal Transfusion,399.0,259.35,,,0
HCPCS,76942,Hc Us Guided Needle Placement,679.0,441.35,,,0
HCPCS,76945,Hc Us Guided Chorionic Villus Sampling,153.0,99.45,,,0
HCPCS,76946,Hc Us Guided Amniocentesis,269.0,174.85,,,0
HCPCS,76965,Hc Us Guided Interstitial Radioelement Application,658.0,427.7,,,0
HCPCS,76975,GI endoscopic ultrasound,,,230.07,230.07,1
HCPCS,76977,Us bone density measure,,,100.81,100.81,1
HCPCS,76978,Us trgt dyn mbubb 1st les,,,336.39,336.39,1
HCPCS,76981,Hc Us Elastography Parenchyma (Organ),483.0,313.95,,,0
HCPCS,76981,Use parenchyma,,,100.81,100.81,1
HCPCS,76982,Use 1st target lesion,,,100.81,100.81,1
HCPCS,76998,Hc Us Intraoperative,594.0,386.1,,,0
HCPCS,76999,Echo examination procedure,,,83.91,83.91,1
HCPCS,76999,Hc Unlisted Ultrasound Procedure,546.0,354.9,,,0
HCPCS,77001,Hc Fluoro Central Venous Access Placement,672.0,436.8,,,0
HCPCS,77002,Hc Fluoro Guided Needle Placement,447.0,290.55,,,0
HCPCS,77003,Hc Fluoro Guided Spinal Injection,378.0,245.7,,,0
HCPCS,77011,Hc Ct Guided Localization Stereotactic,1872.0,1216.8,,,0
HCPCS,77012,Hc Ct Guided Needle Placement,1416.0,920.4,,,0
HCPCS,77013,Hc Ct Guided Visceral Tissue Ablation,1778.0,1155.7,,,0
HCPCS,77014,Hc Ct Guided Radiother Fields Plcmnt,2922.0,1899.3,,,0
HCPCS,77046,Hc Mri Breast Unilat Wo Contrast,2361.0,1534.65,,,0
HCPCS,77046,Mri breast c- unilateral,,,230.07,230.07,1
HCPCS,77047,Hc Mri Breast Bilat Wo Contrast,3030.0,1969.5,,,0
HCPCS,77047,Mri breast c- bilateral,,,230.07,230.07,1
HCPCS,77048,Hc Mri Breast Unilat W And Wo Contrast,2623.0,1704.95,,,0
HCPCS,77048,Hc Mri Breast Unilat W Contrast,2499.0,1624.35,,,0
HCPCS,77049,Hc Mri Breast Abbreviated Bilat W & Wo Cont,532.0,345.8,,,0
HCPCS,77049,Hc Mri Breast Bilat W And Wo Contrast,3365.0,2187.25,,,0
HCPCS,77049,Hc Mri Breast Bilat W Contrast,2521.0,1638.65,,,0
HCPCS,77053,Hc Mammary Ductogram Or Galactogram Sgl,517.0,336.05,,,0
HCPCS,77053,X-Ray of Mammary Duct,,,230.07,230.07,1
HCPCS,77054,Hc Mammary Ductogram Or Galactogram Mult,517.0,336.05,,,0
HCPCS,77054,X-ray of mammary ducts,,,230.07,230.07,1
HCPCS,77061,Hc Tomosynthesis Diag Unilat,77.0,50.05,,,0
HCPCS,77062,Hc Tomosynthesis Diag Bilat,77.0,50.05,,,0
HCPCS,77063,Breast tomosynthesis bi,,,21.35,21.35,1
HCPCS,77063,Hc Tomosynthesis Screening Add On,66.0,42.9,,,0
HCPCS,77065,Dx mammo incl cad uni,,,78.71,78.71,1
HCPCS,77065,Hc Mammogram Diag Unilat Digital W Cad,742.0,482.3,,,0
HCPCS,77066,Dx mammo incl cad bi,,,101.0,101.0,1
HCPCS,77066,Hc Mammogram Diag Bilat Digital W Cad,832.0,540.8,,,0
HCPCS,77067,Hc Mammogram Screening Digital W Cad,247.0,160.55,,,0
HCPCS,77067,Scr mammo bi incl cad,,,83.28,83.28,1
HCPCS,77071,Hc Xr Manual Appl Of Stress For Joint Xray,241.0,156.65,,,0
HCPCS,77071,X-Ray Stress View,,,83.91,83.91,1
HCPCS,77072,Hc Bone Age Studies,316.0,205.4,,,0
HCPCS,77072,X-Rays for Bone Age,,,100.81,100.81,1
HCPCS,77073,Hc Bone Length Studies,344.0,223.6,,,0
HCPCS,77073,X-rays bone length studies,,,100.81,100.81,1
HCPCS,77074,Hc Xr Bone Survey Limited,435.0,282.75,,,0
HCPCS,77074,X-rays bone survey limited,,,100.81,100.81,1
HCPCS,77075,Hc Xr Bone Survey Complete,793.0,515.45,,,0
HCPCS,77075,X-rays bone survey complete,,,100.81,100.81,1
HCPCS,77076,Hc Xr Bone Survey Infant,435.0,282.75,,,0
HCPCS,77076,X-rays bone survey infant,,,100.81,100.81,1
HCPCS,77077,Hc Joint Survey Single View,332.0,215.8,,,0
HCPCS,77077,Joint survey single view,,,100.81,100.81,1
HCPCS,77078,Ct bone density axial,,,83.91,83.91,1
HCPCS,77080,Dxa bone density axial,,,100.81,100.81,1
HCPCS,77080,Hc Bone Density Dexa Axial,448.0,291.2,,,0
HCPCS,77081,Dxa bone density/peripheral,,,83.91,83.91,1
HCPCS,77081,Hc Bone Density Dexa Appendicular,313.0,203.45,,,0
HCPCS,77084,Hc Mri Bone Marrow Blood Supply,2366.0,1537.9,,,0
HCPCS,77084,Magnetic image bone marrow,,,230.07,230.07,1
HCPCS,77085,Dxa bone density study,,,100.81,100.81,1
HCPCS,77085,Hc Xr Bone Density Dexa Axial And Verteb,696.0,452.4,,,0
HCPCS,77086,Fracture assessment via dxa,,,83.91,83.91,1
HCPCS,77086,Hc Xr Dexa Vertebral Fracture Assess,179.0,116.35,,,0
HCPCS,77090,Tbs techl prep&transmis data,,,83.91,83.91,1
HCPCS,77091,Tbs techl calculation only,,,83.91,83.91,1
HCPCS,77280,Hc Therapeutic Radiation Simulation Simple,1614.0,1049.1,,,0
HCPCS,77280,Set radiation therapy field,,,129.6,129.6,1
HCPCS,77285,Hc Therapeutic Radiation Simulation Intermediate,2942.0,1912.3,,,0
HCPCS,77285,Set radiation therapy field,,,361.03,361.03,1
HCPCS,77290,Hc Therapeutic Radiation Simulation Complex,5977.0,3885.05,,,0
HCPCS,77290,Set radiation therapy field,,,361.03,361.03,1
HCPCS,77293,Hc Resp Motion Mgmt Simulation,3418.0,2221.7,,,0
HCPCS,77295,3-d radiotherapy plan,,,1334.61,1334.61,1
HCPCS,77295,Hc Therapeutic Radiation Simulation 3D,7800.0,5070.0,,,0
HCPCS,77299,Radiation therapy planning,,,129.6,129.6,1
HCPCS,77300,Hc Radiation Dosimetry Basic,2762.0,1795.3,,,0
HCPCS,77300,Radiation therapy dose plan,,,129.6,129.6,1
HCPCS,77301,Hc Imrt Planning,19984.0,12989.6,,,0
HCPCS,77301,Radiotherapy dose plan imrt,,,1334.61,1334.61,1
HCPCS,77306,Hc Tele Isodose Plan Simple Incl Dosim,10688.0,6947.2,,,0
HCPCS,77306,Telethx isodose plan simple,,,361.03,361.03,1
HCPCS,77307,Hc Tele Isodose Plan Complex Incl Dosim,13159.0,8553.35,,,0
HCPCS,77307,Telethx isodose plan cplx,,,361.03,361.03,1
HCPCS,77316,Brachytx isodose plan simple,,,361.03,361.03,1
HCPCS,77316,Hc Isodose Brachy Simple Incl Dosim,4875.0,3168.75,,,0
HCPCS,77317,Brachytx isodose intermed,,,361.03,361.03,1
HCPCS,77317,Hc Isodose Brachy Interm Incl Dosim,8500.0,5525.0,,,0
HCPCS,77318,Brachytx isodose complex,,,361.03,361.03,1
HCPCS,77318,Hc Isodose Brachy Complex Incl Dosim,8500.0,5525.0,,,0
HCPCS,77321,Hc Special Teletherapy Port Plan,7728.0,5023.2,,,0
HCPCS,77321,Special teletx port plan,,,361.03,361.03,1
HCPCS,77331,Hc Dosimetry Special,1081.0,702.65,,,0
HCPCS,77331,Special radiation dosimetry,,,129.6,129.6,1
HCPCS,77332,Hc Treatment Devices Desgn And Cnstrct Simple,1759.0,1143.35,,,0
HCPCS,77332,Radiation treatment aid(s),,,129.6,129.6,1
HCPCS,77333,Hc Treatment Devices Desgn And Cnstrct Intermediate,1759.0,1143.35,,,0
HCPCS,77333,Radiation treatment aid(s),,,129.6,129.6,1
HCPCS,77334,Hc Treatment Devices Desgn And Cnstrct Complex,1759.0,1143.35,,,0
HCPCS,77334,Radiation treatment aid(s),,,361.03,361.03,1
HCPCS,77336,Hc Medical Physics Consult Continuing,2423.0,1574.95,,,0
HCPCS,77336,Radiation physics consult,,,129.6,129.6,1
HCPCS,77338,Design mlc device for imrt,,,361.03,361.03,1
HCPCS,77338,Hc Mlc Imrt Device Desgn And Cnstrct,1704.0,1107.6,,,0
HCPCS,77370,Hc Medical Physics Special Consultation,3221.0,2093.65,,,0
HCPCS,77370,Radiation physics consult,,,129.6,129.6,1
HCPCS,77371,Srs multisource,,,7101.77,7101.77,1
HCPCS,77372,Hc Stereotactic Radiosurgery,7322.0,4759.3,,,0
HCPCS,77372,Srs linear based,,,7101.77,7101.77,1
HCPCS,77373,Hc Stereotactic Radiotx 1-5 Sources,5021.0,3263.65,,,0
HCPCS,77373,SBRT Delivery,,,1724.08,1724.08,1
HCPCS,77385,Hc Imrt Simple Incl Image Guidance,4042.0,2627.3,,,0
HCPCS,77386,Hc Imrt Complex Incl Image Guidance,4042.0,2627.3,,,0
HCPCS,77387,Hc Rad Trt Guidance Incl Intrafraction,1653.0,1074.45,,,0
HCPCS,77399,External radiation dosimetry,,,129.6,129.6,1
HCPCS,77402,Hc Radiation Trtmnt Delivery Simple,1862.0,1210.3,,,0
HCPCS,77407,Hc Radiation Trtmnt Delivery Intermed,1862.0,1210.3,,,0
HCPCS,77407,Radiation treatment delivery,,,371.9,371.9,1
HCPCS,77412,Hc Radiation Trtmnt Delivery; Complex,2040.0,1326.0,,,0
HCPCS,77412,Radiation treatment delivery,,,532.77,532.77,1
HCPCS,77417,Hc Therapeutic Radiology Port Film(S),838.0,544.7,,,0
HCPCS,77423,Neutron beam tx complex,,,532.77,532.77,1
HCPCS,77424,Io rad tx delivery by x-ray,,,7101.77,7101.77,1
HCPCS,77425,Io rad tx deliver by elctrns,,,7101.77,7101.77,1
HCPCS,77436,Surf radj ther tx planning,,,36.01,36.01,1
HCPCS,77470,Hc Special Treatment Procedure,4220.0,2743.0,,,0
HCPCS,77470,Special radiation treatment,,,532.77,532.77,1
HCPCS,77520,Proton trmt simple w/o comp,,,532.77,532.77,1
HCPCS,77600,Hyperthermia treatment,,,371.9,371.9,1
HCPCS,77605,Hc Hyperthermia Ext Generated Deep,4750.0,3087.5,,,0
HCPCS,77605,Hyperthermia treatment,,,671.56,671.56,1
HCPCS,77610,Hyperthermia treatment,,,532.77,532.77,1
HCPCS,77615,Hyperthermia treatment,,,532.77,532.77,1
HCPCS,77620,Hyperthermia treatment,,,532.77,532.77,1
HCPCS,77750,Infuse radioactive materials,,,371.9,371.9,1
HCPCS,77761,Apply intrcav radiat simple,,,532.77,532.77,1
HCPCS,77762,Apply intrcav radiat interm,,,532.77,532.77,1
HCPCS,77763,Apply intrcav radiat compl,,,671.56,671.56,1
HCPCS,77767,Hdr rdncl skn surf brachytx,,,371.9,371.9,1
HCPCS,77768,Hdr rdncl skn surf brachytx,,,371.9,371.9,1
HCPCS,77770,"Hc Hdr Interstitial Or Intracavitar 1 Channel, Incl Dosimetry",10238.0,6654.7,,,0
HCPCS,77770,Hdr rdncl ntrstl/icav brchtx,,,671.56,671.56,1
HCPCS,77771,"Hc Hdr Interstitial Or Intracavitary, 2-12 Channels, Incl Dosimetry",10238.0,6654.7,,,0
HCPCS,77771,Hdr rdncl ntrstl/icav brchtx,,,671.56,671.56,1
HCPCS,77772,"Hc Hdr Interstitial Or Intracavitary, >12 Channels, Incl Dosimetry",10238.0,6654.7,,,0
HCPCS,77772,Hdr rdncl ntrstl/icav brchtx,,,671.56,671.56,1
HCPCS,77778,Apply interstit radiat compl,,,671.56,671.56,1
HCPCS,77778,Hc Interstitial Radiation Source Application Complex,4935.0,3207.75,,,0
HCPCS,77799,Hc Unlisted Procedure Clinical Brachytherapy,1623.0,1054.95,,,0
HCPCS,78012,Hc Thyroid Uptake Single Or Mult,1119.0,727.35,,,0
HCPCS,78012,Thyroid uptake measurement,,,385.47,385.47,1
HCPCS,78013,Hc Thyroid Imaging W Vascular Flow,1303.0,846.95,,,0
HCPCS,78013,Thyroid imaging w/blood flow,,,385.47,385.47,1
HCPCS,78014,Hc Thyroid Imaging W Uptake(S),2407.0,1564.55,,,0
HCPCS,78014,Thyroid imaging w/blood flow,,,385.47,385.47,1
HCPCS,78015,Thyroid met imaging,,,385.47,385.47,1
HCPCS,78016,Thyroid met imaging/studies,,,385.47,385.47,1
HCPCS,78018,Hc Thyroid Ca Mets Imaging Whole Body,2910.0,1891.5,,,0
HCPCS,78018,Thyroid met imaging body,,,523.54,523.54,1
HCPCS,78020,Hc Thyroid Ca Mets Uptake,730.0,474.5,,,0
HCPCS,78070,Hc Parathyroid Planar Imaging,2845.0,1849.25,,,0
HCPCS,78070,Parathyroid planar imaging,,,385.47,385.47,1
HCPCS,78071,Hc Parathyroid Planar Imaging W Spect,3574.0,2323.1,,,0
HCPCS,78071,Parathyrd planar w/wo subtrj,,,385.47,385.47,1
HCPCS,78072,Hc Parathyroid Planar Imaging W Spect And Ct,3574.0,2323.1,,,0
HCPCS,78072,Parathyrd planar w/spect&ct,,,523.54,523.54,1
HCPCS,78075,Adrenal cortex & medulla img,,,1248.33,1248.33,1
HCPCS,78075,Hc Adrenal Scan,2797.0,1818.05,,,0
HCPCS,78099,Endocrine nuclear procedure,,,385.47,385.47,1
HCPCS,78102,Bone marrow imaging ltd,,,385.47,385.47,1
HCPCS,78102,Hc Bone Marrow Imaging Limited,1122.0,729.3,,,0
HCPCS,78103,Bone marrow imaging mult,,,385.47,385.47,1
HCPCS,78103,Hc Bone Marrow Imaging Mult Images,1420.0,923.0,,,0
HCPCS,78104,Bone marrow imaging body,,,385.47,385.47,1
HCPCS,78104,Hc Bone Marrow Imaging Whole Body,1718.0,1116.7,,,0
HCPCS,78110,Plasma volume single,,,1248.33,1248.33,1
HCPCS,78111,Plasma volume multiple,,,1248.33,1248.33,1
HCPCS,78120,Red cell mass single,,,385.47,385.47,1
HCPCS,78121,Red cell mass multiple,,,523.54,523.54,1
HCPCS,78122,Blood volume,,,523.54,523.54,1
HCPCS,78130,Red cell survival study,,,385.47,385.47,1
HCPCS,78140,Hc Nm Red Cell Sequestration,1422.0,924.3,,,0
HCPCS,78140,Red cell sequestration,,,385.47,385.47,1
HCPCS,78185,Spleen imaging,,,385.47,385.47,1
HCPCS,78191,Platelet survival,,,385.47,385.47,1
HCPCS,78195,Hc Lymphoscintigram,2375.0,1543.75,,,0
HCPCS,78195,Lymph system imaging,,,523.54,523.54,1
HCPCS,78199,Blood/lymph nuclear exam,,,385.47,385.47,1
HCPCS,78201,Hc Liver Imaging Static Only,2425.0,1576.25,,,0
HCPCS,78201,Liver imaging,,,523.54,523.54,1
HCPCS,78202,Hc Liver Imaging W Vascular Flow,2827.0,1837.55,,,0
HCPCS,78202,Liver imaging with flow,,,523.54,523.54,1
HCPCS,78215,Hc Liver And Spleen Imaging Static Only,1675.0,1088.75,,,0
HCPCS,78215,Liver and spleen imaging,,,385.47,385.47,1
HCPCS,78216,Liver & spleen image/flow,,,385.47,385.47,1
HCPCS,78226,Hc Hepatobiliary System Imaging,3197.0,2078.05,,,0
HCPCS,78226,Hepatobiliary system imaging,,,385.47,385.47,1
HCPCS,78227,Hc Hepatobiliary System Imaging W Pharm Intervention,4826.0,3136.9,,,0
HCPCS,78227,Hepatobil syst image w/drug,,,523.54,523.54,1
HCPCS,78230,Hc Salivary Gland Imaging,2709.0,1760.85,,,0
HCPCS,78230,Salivary gland imaging,,,385.47,385.47,1
HCPCS,78231,Serial salivary imaging,,,385.47,385.47,1
HCPCS,78232,Salivary gland function exam,,,385.47,385.47,1
HCPCS,78258,Esophageal motility study,,,385.47,385.47,1
HCPCS,78261,Gastric mucosa imaging,,,385.47,385.47,1
HCPCS,78262,Gastroesophageal reflux exam,,,385.47,385.47,1
HCPCS,78264,Gastric emptying imag study,,,385.47,385.47,1
HCPCS,78264,Hc Gastric Emptying Study,3394.0,2206.1,,,0
HCPCS,78265,Gastric emptying imag study,,,385.47,385.47,1
HCPCS,78265,Hc Gastric Emptying Img Study W Small Bowel Transit,3394.0,2206.1,,,0
HCPCS,78266,Gastric emptying imag study,,,523.54,523.54,1
HCPCS,78266,Hc Gastric Emptying Img Study W Sm Bowel Colon Trans Mult Days,3394.0,2206.1,,,0
HCPCS,78267,Breath tst attain/anal c-14,,,11.06,11.06,1
HCPCS,78268,Breath test analysis c-14,,,94.41,94.41,1
HCPCS,78278,Acute GI blood loss imaging,,,385.47,385.47,1
HCPCS,78278,Hc Gi Bleed Scan,4258.0,2767.7,,,0
HCPCS,78282,GI protein loss exam,,,385.47,385.47,1
HCPCS,78290,Hc Intestine Imaging Meckels Gastric Mucosa,3686.0,2395.9,,,0
HCPCS,78290,Meckels divert exam,,,385.47,385.47,1
HCPCS,78291,Hc Shunt Patency Test,1115.0,724.75,,,0
HCPCS,78291,Leveen/shunt patency exam,,,385.47,385.47,1
HCPCS,78299,GI nuclear procedure,,,385.47,385.47,1
HCPCS,78300,Bone imaging limited area,,,385.47,385.47,1
HCPCS,78300,Hc Bone Imaging Limited,1990.0,1293.5,,,0
HCPCS,78305,Bone imaging multiple areas,,,385.47,385.47,1
HCPCS,78305,Hc Bone Imaging Multiple Areas,2189.0,1422.85,,,0
HCPCS,78306,Bone imaging whole body,,,385.47,385.47,1
HCPCS,78306,Hc Bone Imaging Whole Body,2314.0,1504.1,,,0
HCPCS,78315,Bone imaging 3 phase,,,385.47,385.47,1
HCPCS,78315,Hc Bone Imaging Phase 3 Study,2874.0,1868.1,,,0
HCPCS,78399,Musculoskeletal nuclear exam,,,385.47,385.47,1
HCPCS,78414,Non-imaging heart function,,,523.54,523.54,1
HCPCS,78428,Cardiac shunt imaging,,,385.47,385.47,1
HCPCS,78428,Hc Cardiac Shunt Detection,978.0,635.7,,,0
HCPCS,78429,Hc Pet Myo Metabolic Eval Single Study W Ct,5148.0,3346.2,,,0
HCPCS,78429,Myocrd img pet 1 std w/ct,,,1378.79,1378.79,1
HCPCS,78430,Hc Pet Myo Perf Single Rst Or St W Ct,3006.0,1953.9,,,0
HCPCS,78430,Myocrd img pet rst/strs w/ct,,,1378.79,1378.79,1
HCPCS,78431,Hc Pet Myo Perf Multi Rst And St W Ct,6864.0,4461.6,,,0
HCPCS,78431,Myocrd img pet rst&strs ct,,,2123.98,2123.98,1
HCPCS,78433,Hc Pet Myo Perf And Metabolic Eval Study Dual Radiotracer W Ct,6746.0,4384.9,,,0
HCPCS,78433,Myocrd img pet 2rtracer ct,,,2123.98,2123.98,1
HCPCS,78434,Hc Pet Absolute Quantitation Myocardial Blood Flow Rst And St Add On,547.0,355.55,,,0
HCPCS,78445,Hc Noncardiac Vascular Flow Imaging,1026.0,666.9,,,0
HCPCS,78445,Vascular flow imaging,,,385.47,385.47,1
HCPCS,78451,Hc Myocard Perfusion Imaging Spect Single,3095.0,2011.75,,,0
HCPCS,78451,Ht muscle image spect sing,,,1248.33,1248.33,1
HCPCS,78452,Hc Myocard Perfusion Imaging Spect Multiple,5005.0,3253.25,,,0
HCPCS,78452,Ht muscle image spect mult,,,1248.33,1248.33,1
HCPCS,78453,Hc Myocard Perfusion Imaging Planar Single,2722.0,1769.3,,,0
HCPCS,78453,Ht muscle image planar sing,,,1248.33,1248.33,1
HCPCS,78454,Hc Myocard Perfusion Imaging Planar Multiple,3915.0,2544.75,,,0
HCPCS,78454,Ht musc image planar mult,,,1248.33,1248.33,1
HCPCS,78456,Acute venous thrombus image,,,1248.33,1248.33,1
HCPCS,78457,Venous thrombosis imaging,,,523.54,523.54,1
HCPCS,78458,Hc Venous Thrombosis Imaging Bilateral,2407.0,1564.55,,,0
HCPCS,78458,Ven thrombosis images bilat,,,385.47,385.47,1
HCPCS,78459,Heart muscle imaging (PET),,,1248.33,1248.33,1
HCPCS,78466,Hc Myocardial Imaging Infarct,2252.0,1463.8,,,0
HCPCS,78466,Heart infarct image,,,385.47,385.47,1
HCPCS,78468,Hc Myocardial Imaging Infarct W Ejection Fraction,2252.0,1463.8,,,0
HCPCS,78468,Heart infarct image (ef),,,523.54,523.54,1
HCPCS,78469,Hc Myocardial Imaging Infarct Spect,2252.0,1463.8,,,0
HCPCS,78469,Heart infarct image (3D),,,523.54,523.54,1
HCPCS,78472,Gated heart planar single,,,385.47,385.47,1
HCPCS,78472,Hc Cardiac Blood Pool Gated Planar 1 Study Rest Or Stress,2773.0,1802.45,,,0
HCPCS,78473,Gated heart multiple,,,385.47,385.47,1
HCPCS,78473,Hc Muga Multiple Studies Pre Post,2773.0,1802.45,,,0
HCPCS,78481,Hc Cardiac Blood Pool 1St Pass 1 Study Rest Or Stress Wm Ef,1257.0,817.05,,,0
HCPCS,78481,Heart first pass single,,,523.54,523.54,1
HCPCS,78483,Heart first pass multiple,,,523.54,523.54,1
HCPCS,78491,Heart image (pet) single,,,1378.79,1378.79,1
HCPCS,78492,Heart image (pet) multiple,,,1378.79,1378.79,1
HCPCS,78494,Hc Cardiac Blood Pool Gated Spect Rest Wm Ef,2293.0,1490.45,,,0
HCPCS,78494,Heart image spect,,,385.47,385.47,1
HCPCS,78496,Hc Muga Rv Ef By First Pass Technique Add On,445.0,289.25,,,0
HCPCS,78499,Cardiovascular nuclear exam,,,385.47,385.47,1
HCPCS,78579,Hc Pulmonary Ventilation Imaging,1328.0,863.2,,,0
HCPCS,78579,Lung ventilation imaging,,,385.47,385.47,1
HCPCS,78580,Hc Pulm Perfusion Imaging Particulate,1422.0,924.3,,,0
HCPCS,78580,Lung perfusion imaging,,,385.47,385.47,1
HCPCS,78582,Hc Pulm Ventilation And Perfusion Imaging,1678.0,1090.7,,,0
HCPCS,78582,Lung ventilat&perfus imaging,,,523.54,523.54,1
HCPCS,78597,Hc Quant Pulm Perfusion W Or Wo Imaging,1002.0,651.3,,,0
HCPCS,78597,Lung perfusion differential,,,385.47,385.47,1
HCPCS,78598,Lung perf&ventilat diferentl,,,523.54,523.54,1
HCPCS,78599,Respiratory nuclear exam,,,385.47,385.47,1
HCPCS,78600,Brain image < 4 views,,,385.47,385.47,1
HCPCS,78600,Hc Brain Imaging < 4 Static Views,1499.0,974.35,,,0
HCPCS,78601,Brain image w/flow < 4 views,,,385.47,385.47,1
HCPCS,78601,Hc Brain Scan Ltmd W Flow,1499.0,974.35,,,0
HCPCS,78605,Brain image 4+ views,,,523.54,523.54,1
HCPCS,78605,Hc Brain Imaging 4+ Static Views,1932.0,1255.8,,,0
HCPCS,78606,Brain image w/flow 4 + views,,,523.54,523.54,1
HCPCS,78606,Hc Brain Imaging 4+ Views W Vascular Flow,1932.0,1255.8,,,0
HCPCS,78608,Brain imaging (PET),,,1378.79,1378.79,1
HCPCS,78608,Hc Brain Imaging Pet Metabolic Eval,7083.0,4603.95,,,0
HCPCS,78610,Brain flow imaging only,,,523.54,523.54,1
HCPCS,78610,Hc Brain Imaging Vascular Flow Only,1233.0,801.45,,,0
HCPCS,78630,Cerebrospinal fluid scan,,,523.54,523.54,1
HCPCS,78630,Hc Cisternography,1545.0,1004.25,,,0
HCPCS,78635,CSF ventriculography,,,523.54,523.54,1
HCPCS,78645,CSF shunt evaluation,,,523.54,523.54,1
HCPCS,78645,Hc Shunt Evaluation Csf,1233.0,801.45,,,0
HCPCS,78650,CSF leakage imaging,,,1248.33,1248.33,1
HCPCS,78650,Hc Csf Leak Detection,2986.0,1940.9,,,0
HCPCS,78660,Nuclear exam of tear flow,,,385.47,385.47,1
HCPCS,78699,Nervous system nuclear exam,,,385.47,385.47,1
HCPCS,78700,Hc Kidney Imaging,1130.0,734.5,,,0
HCPCS,78700,Kidney imaging morphol,,,385.47,385.47,1
HCPCS,78701,Hc Kidney Imaging W Vascular Flow,1190.0,773.5,,,0
HCPCS,78701,Kidney imaging with flow,,,385.47,385.47,1
HCPCS,78707,Hc Kidney Imaging W Flow And Function,1233.0,801.45,,,0
HCPCS,78707,K flow/funct image w/o drug,,,523.54,523.54,1
HCPCS,78708,Hc Kidney Imaging W Flow And Funct W Rx Intervention Sgl,1356.0,881.4,,,0
HCPCS,78708,K flow/funct image w/drug,,,523.54,523.54,1
HCPCS,78709,Hc Kidney Imaging W Flow And Funct W Rx Intervention Mult,1578.0,1025.7,,,0
HCPCS,78709,K flow/funct image multiple,,,523.54,523.54,1
HCPCS,78725,Kidney function study,,,385.47,385.47,1
HCPCS,78740,Hc Voiding Cystogram,3600.0,2340.0,,,0
HCPCS,78740,Ureteral reflux study,,,385.47,385.47,1
HCPCS,78761,Hc Testicular Imaging W Vasc Flow,905.0,588.25,,,0
HCPCS,78761,Testicular imaging w/flow,,,385.47,385.47,1
HCPCS,78799,Genitourinary nuclear exam,,,385.47,385.47,1
HCPCS,78800,Hc Tumor Or Inflam Process Localization Planar Single Area 1 Day,2806.0,1823.9,,,0
HCPCS,78800,Tumor imaging limited area,,,385.47,385.47,1
HCPCS,78801,Hc Tumor Or Inflam Process Localization Planar Multi Area Or Single Area 2+ Days,2946.0,1914.9,,,0
HCPCS,78801,Tumor imaging mult areas,,,385.47,385.47,1
HCPCS,78802,Hc Tumor Or Inflam Process Localization Planar Whole Body 1 Day,3241.0,2106.65,,,0
HCPCS,78802,Tumor imaging whole body,,,523.54,523.54,1
HCPCS,78803,Hc Tumor Or Inflam Process Localization Spect Single Area 1 Day,3902.0,2536.3,,,0
HCPCS,78803,Tumor imaging (3D),,,523.54,523.54,1
HCPCS,78804,Hc Tumor Localization Whole Body 2 + Days,3825.0,2486.25,,,0
HCPCS,78804,Tumor imaging whole body,,,523.54,523.54,1
HCPCS,78808,Hc Inj Non Img Loclztn Probe Study Parathyroid,1036.0,673.4,,,0
HCPCS,78808,Iv inj ra drug dx study,,,385.47,385.47,1
HCPCS,78811,Pet image ltd area,,,1248.33,1248.33,1
HCPCS,78812,Pet image skull-thigh,,,1378.79,1378.79,1
HCPCS,78813,Pet image full body,,,1378.79,1378.79,1
HCPCS,78814,Hc Pet Imaging W Ct Limited Area,6287.0,4086.55,,,0
HCPCS,78814,Pet image w/ct lmtd,,,1378.79,1378.79,1
HCPCS,78815,Hc Pet Imaging W Ct Skull Base To Mid Thigh,7657.0,4977.05,,,0
HCPCS,78815,Pet image w/ct skull-thigh,,,1378.79,1378.79,1
HCPCS,78816,Hc Pet Imaging W Ct Whole Body,9232.0,6000.8,,,0
HCPCS,78816,Pet image w/ct full body,,,1378.79,1378.79,1
HCPCS,78830,Hc Tumor Or Inflam Process Localization Spect W Ct Single Area 1 Day,4292.0,2789.8,,,0
HCPCS,78830,Rp loclzj tum spect w/ct 1,,,1248.33,1248.33,1
HCPCS,78831,Hc Tumor Or Inflam Process Localization Spect Multi Areas Or Single Area 2+ Days,4497.0,2923.05,,,0
HCPCS,78831,Rp loclzj tum spect 2 areas,,,1248.33,1248.33,1
HCPCS,78832,Hc Tumor Or Inflam Process Localization Spect W Ct Multi Areas Or Single Area 2+ Days,4701.0,3055.65,,,0
HCPCS,78832,Rp loclzj tum spect w/ct 2,,,1378.79,1378.79,1
HCPCS,78835,Hc Radiopharm Quantification Measure Single Area Add On,2262.0,1470.3,,,0
HCPCS,78999,Nuclear diagnostic exam,,,385.47,385.47,1
HCPCS,79005,Hc Radiopharm Therapy Oral Administration,2337.0,1519.05,,,0
HCPCS,79005,Nuclear rx oral admin,,,224.99,224.99,1
HCPCS,79101,Hc Radiopharm Therapy Iv Administration,2329.0,1513.85,,,0
HCPCS,79101,Nuclear rx iv admin,,,224.99,224.99,1
HCPCS,79200,Nuclear rx intracav admin,,,224.99,224.99,1
HCPCS,79300,Nuclr rx interstit colloid,,,224.99,224.99,1
HCPCS,79403,Hc Radiotherapy Radiolabeled Monoclonal Ab Iv,4008.0,2605.2,,,0
HCPCS,79403,Hematopoietic nuclear tx,,,224.99,224.99,1
HCPCS,79440,Nuclear rx intra-articular,,,224.99,224.99,1
HCPCS,79445,Hc Radiopharm Therapy Intra Arterial Administration,1886.0,1225.9,,,0
HCPCS,79445,Nuclear rx intra-arterial,,,224.99,224.99,1
HCPCS,79999,Nuclear medicine therapy,,,224.99,224.99,1
HCPCS,80047,Hc Basic Metabolic Panel Calcium Ionized,63.0,40.95,,,0
HCPCS,80047,"Hc Fsed Basic Metabolic Panel Calcium, Ionized",63.0,40.95,,,0
HCPCS,80047,Hc Mstu Basic Metabolic Panel Calcium Ionized,63.0,40.95,,,0
HCPCS,80047,Metabolic panel ionized ca,,,13.73,51.49,3
HCPCS,80048,Hc Basic Metabolic Panel Calcium Total,56.0,36.4,,,0
HCPCS,80048,Hc Fsed Basic Metabolic Panel Calcium Total,56.0,36.4,,,0
HCPCS,80048,Metabolic panel total ca,,,8.46,31.73,3
HCPCS,80050,General health panel,,,152.48,152.48,2
HCPCS,80050,Hc General Health Panel,219.0,142.35,,,0
HCPCS,80051,Electrolyte panel,,,7.01,26.29,3
HCPCS,80051,Hc Electrolyte Panel,46.0,29.9,,,0
HCPCS,80051,Hc Fsed Electrolyte Panel,46.0,29.9,,,0
HCPCS,80053,Comprehen metabolic panel,,,10.56,39.6,3
HCPCS,80053,Hc Comprehensive Metabolic Panel,74.0,48.1,,,0
HCPCS,80053,Hc Fsed Comprehensive Metabolic Panel,74.0,48.1,,,0
HCPCS,80055,Hc Obstetric Panel,302.0,196.3,,,0
HCPCS,80055,Obstetric panel,,,47.81,179.29,3
HCPCS,80061,Hc Lipid Panel,61.0,39.65,,,0
HCPCS,80061,Hc Lipid Panel So,61.0,39.65,,,0
HCPCS,80061,Lipid panel,,,13.39,50.21,3
HCPCS,80069,Hc Fsed Renal Function Panel,66.0,42.9,,,0
HCPCS,80069,Hc Renal Function Panel,66.0,42.9,,,0
HCPCS,80069,Renal function panel,,,8.68,32.55,3
HCPCS,80074,Acute hepatitis panel,,,47.63,178.61,3
HCPCS,80074,Hc Hepatitis Panel Acute,438.0,284.7,,,0
HCPCS,80076,Hc Fsed Hepatic Function Panel,28.0,18.2,,,0
HCPCS,80076,Hc Hepatic Function Panel,28.0,18.2,,,0
HCPCS,80076,Hepatic function panel,,,8.17,30.64,3
HCPCS,80081,Obstetric panel,,,74.86,280.73,3
HCPCS,80143,Drug assay acetaminophen,,,18.64,69.9,3
HCPCS,80143,Hc Drug Assay Acetaminophen,192.0,124.8,,,0
HCPCS,80145,Drug assay adalimumab,,,38.57,144.64,3
HCPCS,80145,Hc Adalimumab So,693.0,450.45,,,0
HCPCS,80150,Assay of amikacin,,,15.08,56.55,3
HCPCS,80150,Hc Amikacin,110.0,71.5,,,0
HCPCS,80151,Drug assay amiodarone,,,18.64,69.9,3
HCPCS,80151,Hc Drug Assay Amiodarone So,65.0,42.25,,,0
HCPCS,80155,Drug assay caffeine,,,38.57,144.64,3
HCPCS,80155,Hc Caffeine So,146.0,94.9,,,0
HCPCS,80156,Assay carbamazepine total,,,14.57,54.64,3
HCPCS,80156,Hc Carbamazepine Total,85.0,55.25,,,0
HCPCS,80156,Hc Carbamazepine Total So,138.0,89.7,,,0
HCPCS,80157,Assay carbamazepine free,,,13.25,49.69,3
HCPCS,80157,Hc Carbamazepine Free So,649.0,421.85,,,0
HCPCS,80158,Drug assay cyclosporine,,,18.05,67.69,3
HCPCS,80158,Hc Cyclosporine Level So,53.0,34.45,,,0
HCPCS,80159,Drug assay clozapine,,,20.15,75.56,3
HCPCS,80159,Hc Clozapine Level So,79.0,51.35,,,0
HCPCS,80161,"Asy carbamazepin 10,11-epxid",,,18.64,69.9,3
HCPCS,80161,"Hc Asy Carbamazepine; -10, 11-Epoxide So",69.0,44.85,,,0
HCPCS,80162,Assay of digoxin total,,,13.28,49.8,3
HCPCS,80162,Hc Digoxin,90.0,58.5,,,0
HCPCS,80163,Assay of digoxin free,,,13.28,49.8,3
HCPCS,80163,Hc Digoxin Free So,787.0,511.55,,,0
HCPCS,80164,Assay dipropylacetic acd tot,,,13.54,50.78,3
HCPCS,80164,Hc Valproic Acid,66.0,42.9,,,0
HCPCS,80164,Hc Valproic Acid Total So,118.0,76.7,,,0
HCPCS,80165,Dipropylacetic acid free,,,13.54,50.78,3
HCPCS,80165,Hc Valproic Acid Free So,115.0,74.75,,,0
HCPCS,80167,Drug assay felbamate,,,18.64,69.9,3
HCPCS,80167,Hc Drug Assay Felbamate So,116.0,75.4,,,0
HCPCS,80168,Assay of ethosuximide,,,16.34,61.28,3
HCPCS,80168,Hc Ethosuximide So,127.0,82.55,,,0
HCPCS,80169,Drug assay everolimus,,,13.73,51.49,3
HCPCS,80169,Hc Everolimus So,92.0,59.8,,,0
HCPCS,80170,Assay of gentamicin,,,16.38,61.43,3
HCPCS,80170,Hc Gentamicin,59.0,38.35,,,0
HCPCS,80171,Drug screen quant gabapentin,,,21.67,81.26,3
HCPCS,80171,Hc Neurontin Gabapentin So,63.0,40.95,,,0
HCPCS,80173,Assay Of Haloperidol,,,15.78,59.18,3
HCPCS,80173,Hc Haloperidol So,192.0,124.8,,,0
HCPCS,80175,Drug screen quan lamotrigine,,,13.25,49.69,3
HCPCS,80175,Hc Lamotrigine Lamictal,146.0,94.9,,,0
HCPCS,80176,Assay of lidocaine,,,14.69,55.09,3
HCPCS,80176,Hc Lidocaine,191.0,124.15,,,0
HCPCS,80176,Hc Lidocaine So,234.0,152.1,,,0
HCPCS,80177,Drug scrn quan levetiracetam,,,13.25,49.69,3
HCPCS,80177,Hc Levetiracetam Keppra,293.0,190.45,,,0
HCPCS,80178,Assay of lithium,,,6.61,24.79,3
HCPCS,80178,Hc Lithium,82.0,53.3,,,0
HCPCS,80179,Drug assay salicylate,,,18.64,69.9,3
HCPCS,80179,Hc Drug Assay Salicylate,201.0,130.65,,,0
HCPCS,80180,Drug scrn quan mycophenolate,,,18.05,67.69,3
HCPCS,80180,Hc Mycophenolic Acid So,84.0,54.6,,,0
HCPCS,80181,Drug assay flecainide,,,18.64,69.9,3
HCPCS,80181,Hc Drug Assay Flecainide So,101.0,65.65,,,0
HCPCS,80183,Drug scrn quant oxcarbazepin,,,13.25,49.69,3
HCPCS,80183,Hc Oxcarbazepine Trileptal So,52.0,33.8,,,0
HCPCS,80184,Assay of phenobarbital,,,15.3,57.38,3
HCPCS,80184,Hc Phenobarbital,42.0,27.3,,,0
HCPCS,80184,Hc Phenobarbital So,118.0,76.7,,,0
HCPCS,80185,Assay of phenytoin total,,,13.25,49.69,3
HCPCS,80185,Hc Phenytoin Total,85.0,55.25,,,0
HCPCS,80186,Assay of phenytoin free,,,13.76,51.6,3
HCPCS,80186,Hc Phenytoin Free,154.0,100.1,,,0
HCPCS,80187,Drug assay posaconazole,,,27.11,101.66,3
HCPCS,80187,Hc Posaconazole So,196.0,127.4,,,0
HCPCS,80188,Assay of primidone,,,16.59,62.21,3
HCPCS,80188,Hc Primidone So,171.0,111.15,,,0
HCPCS,80189,Drug assay itraconzaole,,,27.11,101.66,3
HCPCS,80189,Hc Drug Assay Itraconazole So,132.0,85.8,,,0
HCPCS,80190,Assay of procainamide,,,60.0,225.0,3
HCPCS,80190,Hc Procainamide Total So,116.0,75.4,,,0
HCPCS,80192,Assay of procainamide,,,16.75,62.81,3
HCPCS,80192,Hc Procainamide So,148.0,96.2,,,0
HCPCS,80193,Drug assay leflunomide,,,38.57,144.64,3
HCPCS,80193,Hc Drug Assay Leflunomide So,103.0,66.95,,,0
HCPCS,80194,Assay of quinidine,,,14.6,54.75,3
HCPCS,80194,Hc Quinidine So,128.0,83.2,,,0
HCPCS,80195,Assay of sirolimus,,,13.73,51.49,3
HCPCS,80195,Hc Sirolimus So,41.0,26.65,,,0
HCPCS,80197,Assay of tacrolimus,,,13.73,51.49,3
HCPCS,80197,Hc Tacrolimus,92.0,59.8,,,0
HCPCS,80197,Hc Tacrolimus So,92.0,59.8,,,0
HCPCS,80198,Assay of theophylline,,,14.14,53.03,3
HCPCS,80198,Hc Theophylline,108.0,70.2,,,0
HCPCS,80199,Drug screen quant tiagabine,,,27.11,101.66,3
HCPCS,80199,Hc Tiagabine Gabitril So,133.0,86.45,,,0
HCPCS,80200,Assay of tobramycin,,,16.13,60.49,3
HCPCS,80200,Hc Tobramycin,124.0,80.6,,,0
HCPCS,80201,Assay of topiramate,,,11.92,44.7,3
HCPCS,80201,Hc Topiramate So,103.0,66.95,,,0
HCPCS,80202,Assay of vancomycin,,,13.54,50.78,3
HCPCS,80202,Hc Vancomycin,88.0,57.2,,,0
HCPCS,80203,Drug screen quant zonisamide,,,13.25,49.69,3
HCPCS,80203,Hc Zonisamide Zonegran So,108.0,70.2,,,0
HCPCS,80204,Drug assay methotrexate,,,38.57,144.64,3
HCPCS,80204,Hc Drug Assay Methotrexate,1600.0,1040.0,,,0
HCPCS,80210,Drug assay rufinamide,,,27.11,101.66,3
HCPCS,80210,Hc Drug Assay Rufinamide So,132.0,85.8,,,0
HCPCS,80220,Drug asy hydroxychloroquine,,,18.64,69.9,3
HCPCS,80220,Hc Drug Assay Hydroxychloroquine So,727.0,472.55,,,0
HCPCS,80230,Drug assay infliximab,,,38.57,144.64,3
HCPCS,80230,Hc Infliximab So,495.0,321.75,,,0
HCPCS,80235,Drug assay lacosamide,,,27.11,101.66,3
HCPCS,80235,Hc Lacosamide So,313.0,203.45,,,0
HCPCS,80280,Drug assay vedolizumab,,,38.57,144.64,3
HCPCS,80280,Hc Vedolizumab So,1154.0,750.1,,,0
HCPCS,80285,Drug assay voriconazole,,,27.11,101.66,3
HCPCS,80285,Hc Voriconazole So,256.0,166.4,,,0
HCPCS,80299,Hc Drug Qnt Nes Special So,1430.0,929.5,,,0
HCPCS,80299,Hc Drug Quantitative,338.0,219.7,,,0
HCPCS,80299,Hc Drug Quantitative Nes So,317.0,206.05,,,0
HCPCS,80299,Quantitative assay drug,,,18.64,69.9,3
HCPCS,80305,Drug test prsmv dir opt obs,,,12.6,47.25,3
HCPCS,80305,Hc Drug Test Prsmv Dir Opt Obs,119.0,77.35,,,0
HCPCS,80305,Hc Fsed Drug Test Prsmv Dir Opt Obs,119.0,77.35,,,0
HCPCS,80306,Drug test prsmv instrmnt,,,17.14,64.28,3
HCPCS,80307,Drug test prsmv chem anlyzr,,,62.14,233.03,3
HCPCS,80307,Hc Drug Test Prsmv Chem Anlyzer So,128.0,83.2,,,0
HCPCS,80307,Hc Drug Test Prsmv Chem Anlyzer Special So,870.0,565.5,,,0
HCPCS,80307,Hc Drug Test Prsmv Chem Anlyzr,123.0,79.95,,,0
HCPCS,80320,Hc Alcohols,75.0,48.75,,,0
HCPCS,80320,Hc Alcohols So,118.0,76.7,,,0
HCPCS,80320,Hc Ml Alcohols So,21.0,13.65,,,0
HCPCS,80321,Hc Ethyl Glucuronide Etg So,231.0,150.15,,,0
HCPCS,80321,Hc Ml Alcohol Biomarkers; 1-2 So,21.0,13.65,,,0
HCPCS,80322,Hc Ml Alcohol Biomarkers; 3+ So,21.0,13.65,,,0
HCPCS,80323,Hc Alkoloids Nos So,495.0,321.75,,,0
HCPCS,80323,Hc Ml Alkaloids Nos So,21.0,13.65,,,0
HCPCS,80323,Hc Nicotine So,175.0,113.75,,,0
HCPCS,80324,Hc Amphetamine Or Methamphetamine So,114.0,74.1,,,0
HCPCS,80324,Hc Ml Amphetamines; 1 Or 2 So,21.0,13.65,,,0
HCPCS,80325,Hc Amphetamines 3-4 So,62.0,40.3,,,0
HCPCS,80325,Hc Ml Amphetamines; 3-4 So,21.0,13.65,,,0
HCPCS,80326,Hc Amphetamines 5 Or More So,452.0,293.8,,,0
HCPCS,80326,Hc Ml Amphetamines; 5+ So,21.0,13.65,,,0
HCPCS,80327,Hc Dihydrotestosterone Dht,140.0,91.0,,,0
HCPCS,80327,Hc Ml Anabolic Steroids; 1-2 So,21.0,13.65,,,0
HCPCS,80329,Hc Analgesics Non-Opiod; 1 Or 2,90.0,58.5,,,0
HCPCS,80329,Hc Ml Analgesics Non-Opiod; 1-2 So,21.0,13.65,,,0
HCPCS,80329,Hc Salicylate,90.0,58.5,,,0
HCPCS,80332,Hc Antidepressants Class; 1- 2 So,340.0,221.0,,,0
HCPCS,80332,"Hc Ml Antidepressants, Serotonergic Class; 1 Or 2 So",21.0,13.65,,,0
HCPCS,80332,Hc Tca; 1- 2 So,41.0,26.65,,,0
HCPCS,80333,Hc Antidepressants Class; 3-5 So,326.0,211.9,,,0
HCPCS,80333,"Hc Ml Antidepressants, Serotonergic Class; 3-5 So",21.0,13.65,,,0
HCPCS,80335,Hc Antidepressants Tca And Other Cyclicals; 1-2 So,16.0,10.4,,,0
HCPCS,80335,Hc Antidepressants Tricyclic And Other Cyclicals; 1-2 So,184.0,119.6,,,0
HCPCS,80335,"Hc Ml Antidepressants, Tricyclic And Other Cyclicals; 1 Or 2 So",21.0,13.65,,,0
HCPCS,80336,"Hc Ml Antidepressants, Tricyclic And Other Cyclicals; 3-5 So",21.0,13.65,,,0
HCPCS,80337,Hc Antidepressants Tricyclic And Other Cyclicals; 6 Or More So,184.0,119.6,,,0
HCPCS,80338,Hc Antidepressant Not Specified So,282.0,183.3,,,0
HCPCS,80338,Hc Ml Antidepressants Nos So,21.0,13.65,,,0
HCPCS,80339,Hc Antiepileptics Nos 1 To 3 So,270.0,175.5,,,0
HCPCS,80339,Hc Methsuximide,238.0,154.7,,,0
HCPCS,80339,Hc Ml Antiepileptics Nos; 1-3 So,21.0,13.65,,,0
HCPCS,80342,Hc Antipsychotics Nos 1 To 3 So,347.0,225.55,,,0
HCPCS,80342,Hc Ml Antipsychotics Nos; 1-3 So,21.0,13.65,,,0
HCPCS,80343,Hc Ml Antipsychotics Nos; 4-6 So,21.0,13.65,,,0
HCPCS,80345,Hc Barbiturate Quantitative So,141.0,91.65,,,0
HCPCS,80345,Hc Ml Barbiturates So,21.0,13.65,,,0
HCPCS,80346,Hc Drug Screen Benzodiazepines 1-12 So,152.0,98.8,,,0
HCPCS,80346,Hc Ml Benzodiazepines; 1-12 So,21.0,13.65,,,0
HCPCS,80347,Hc Benzodiazepines 13 Or More So,229.0,148.85,,,0
HCPCS,80348,Hc Buprenorphine So,99.0,64.35,,,0
HCPCS,80348,Hc Ml Buprenorphine So,21.0,13.65,,,0
HCPCS,80349,Hc Cannabinoids Natural Serum So,771.0,501.15,,,0
HCPCS,80349,Hc Cannabinoids Natural So,146.0,94.9,,,0
HCPCS,80349,Hc Ml Cannabinoids Natural So,21.0,13.65,,,0
HCPCS,80352,Hc Cannabinoids Synthetic 7 Or More So,431.0,280.15,,,0
HCPCS,80352,Hc Ml Cannabinoids Synthetic; 7 Or More So,21.0,13.65,,,0
HCPCS,80353,Hc Cocaine Quantitative So,112.0,72.8,,,0
HCPCS,80353,Hc Ml Cocaine So,21.0,13.65,,,0
HCPCS,80354,Hc Fentanyl So,69.0,44.85,,,0
HCPCS,80354,Hc Ml Fentanyl So,21.0,13.65,,,0
HCPCS,80355,Hc Ml Gabapentin Non-Blood So,21.0,13.65,,,0
HCPCS,80356,Hc 6 Mam Urine So,212.0,137.8,,,0
HCPCS,80356,Hc Ml Heroin Metabolite So,21.0,13.65,,,0
HCPCS,80357,Hc Ketamine And Norketamine So,871.0,566.15,,,0
HCPCS,80357,Hc Ml Ketamine And Norketamine So,21.0,13.65,,,0
HCPCS,80358,Hc Methadone Assay,126.0,81.9,,,0
HCPCS,80358,Hc Methadone Dolophine So,194.0,126.1,,,0
HCPCS,80358,Hc Ml Methadone So,21.0,13.65,,,0
HCPCS,80359,"Hc  Methylenedioxyamphetamines (Mda, Mdea, Mdma) So",85.0,55.25,,,0
HCPCS,80359,"Hc Ml Methylenedioxyamphetamines (Mda, Mdea, Mdma) So",21.0,13.65,,,0
HCPCS,80360,Hc Methylphenidate So,452.0,293.8,,,0
HCPCS,80360,Hc Ml Methylphenidate So,21.0,13.65,,,0
HCPCS,80361,"Hc Ml Opiates, 1+ So",21.0,13.65,,,0
HCPCS,80361,Hc Opiates,92.0,59.8,,,0
HCPCS,80361,Hc Opiates 1 Or More So,148.0,96.2,,,0
HCPCS,80362,Hc Drug Screening Opioids And Opiate Analogs 1 Or 2 So,815.0,529.75,,,0
HCPCS,80362,Hc Ml Opiods And Opiate Analogs; 1 - 2 So,21.0,13.65,,,0
HCPCS,80363,Hc Ml Opiods And Opiate Analogs; 3-4 So,21.0,13.65,,,0
HCPCS,80364,Hc Ml Opiods And Opiate Analogs; 5+ So,21.0,13.65,,,0
HCPCS,80364,Hc Opioid &Opiate Analog 5+ So,135.0,87.75,,,0
HCPCS,80365,Hc Ml Oxycodone So,21.0,13.65,,,0
HCPCS,80365,Hc Oxycodone So,149.0,96.85,,,0
HCPCS,80365,Hc Oxycodone Special So,719.0,467.35,,,0
HCPCS,80366,Hc Ml Pregabalin So,21.0,13.65,,,0
HCPCS,80366,Hc Pregabalin Lyrica So,115.0,74.75,,,0
HCPCS,80367,Hc Ml Propoxyphene So,21.0,13.65,,,0
HCPCS,80367,Hc Propoxyphene So,163.0,105.95,,,0
HCPCS,80368,Hc Ml Sedative Hypnotics Non-Benzodiazepines So,21.0,13.65,,,0
HCPCS,80368,Hc Sedative Hypnotics So,190.0,123.5,,,0
HCPCS,80369,Hc Ml Skeletal Muscle Relaxants; 1 - 2 So,21.0,13.65,,,0
HCPCS,80369,Hc Skeletal Muscle Relaxant 1 To 2 So,319.0,207.35,,,0
HCPCS,80371,Hc Ml Stimulants Synthetic So,21.0,13.65,,,0
HCPCS,80371,Hc Stimulants Synthetic So,604.0,392.6,,,0
HCPCS,80372,Hc Ml Tapentadol & Metabolite So,21.0,13.65,,,0
HCPCS,80372,Hc Tapentadol & Metabolite So,208.0,135.2,,,0
HCPCS,80373,Hc Ml Tramadol So,21.0,13.65,,,0
HCPCS,80373,Hc Tramadol & Metabolite So,114.0,74.1,,,0
HCPCS,80374,"Hc Ml Stereoisomer (Enantiomer) Anlys, Sgl Drug Class So",21.0,13.65,,,0
HCPCS,80375,Hc Drug Or Substance Definitive Qual Quant Nos 1-3 So,750.0,487.5,,,0
HCPCS,80375,"Hc Ml Drugs Or Substances, Defin, Ql Or Qt; 1-3 So",21.0,13.65,,,0
HCPCS,80377,Hc Drug/Substance Nos 7/More So,291.0,189.15,,,0
HCPCS,80400,Acth stimulation panel,,,32.62,122.33,3
HCPCS,80400,Hc Acth Stimulation Panel Adrenal Insufficiency,528.0,343.2,,,0
HCPCS,80402,Acth stimulation panel,,,86.96,326.1,3
HCPCS,80406,Acth stimulation panel,,,78.26,293.48,3
HCPCS,80408,Aldosterone suppression eval,,,125.5,470.63,3
HCPCS,80410,Calcitonin stimul panel,,,80.37,301.39,3
HCPCS,80412,CRH stimulation panel,,,801.62,3006.08,3
HCPCS,80414,Testosterone response,,,51.64,193.65,3
HCPCS,80415,Estradiol response panel,,,55.89,209.59,3
HCPCS,80416,Renin stimulation panel,,,209.32,784.95,3
HCPCS,80417,Renin stimulation panel,,,43.99,164.96,3
HCPCS,80418,Pituitary evaluation panel,,,579.48,2173.05,3
HCPCS,80420,Dexamethasone panel,,,161.88,607.05,3
HCPCS,80422,Glucagon tolerance panel,,,46.07,172.76,3
HCPCS,80422,Hc Glucagon Tolerance Panel Insulinoma,288.0,187.2,,,0
HCPCS,80424,Glucagon tolerance panel,,,50.5,189.38,3
HCPCS,80426,Gonadotropin hormone panel,,,148.41,556.54,3
HCPCS,80428,Growth hormone panel,,,66.7,250.13,3
HCPCS,80428,Hc Growth Hormone Stimulation Panel,1306.0,848.9,,,0
HCPCS,80430,Growth hormone panel,,,129.33,484.99,3
HCPCS,80432,Insulin suppression panel,,,165.61,621.04,3
HCPCS,80434,Insulin tolerance panel,,,285.03,1068.86,3
HCPCS,80435,Insulin tolerance panel,,,103.0,386.25,3
HCPCS,80436,Metyrapone panel,,,91.16,341.85,3
HCPCS,80438,TRH stimulation panel,,,50.41,189.04,3
HCPCS,80439,TRH stimulation panel,,,67.21,252.04,3
HCPCS,80503,Path clin consltj sf 5-20,,,50.25,188.03,3
HCPCS,80504,Path clin consltj mod 21-40,,,164.27,589.69,3
HCPCS,80505,Path clin consltj high 41-60,,,164.27,589.69,3
HCPCS,80506,Path clin consltj prolng svc,,,161.4,161.4,2
HCPCS,81000,Urinalysis nonauto w/scope,,,4.02,15.08,3
HCPCS,81001,Hc Urinalysis Automated,12.0,7.8,,,0
HCPCS,81001,Urinalysis auto w/scope,,,3.17,11.89,3
HCPCS,81002,Hc Urinalysis Nonauto Wo Micro,115.0,74.75,,,0
HCPCS,81002,Urinalysis nonauto w/o scope,,,3.48,13.05,3
HCPCS,81003,Hc Fsed Urine Analysis Dipstick Automated,62.0,40.3,,,0
HCPCS,81003,Hc Urine Analysis Dipstick Auto Amb,50.0,32.5,,,0
HCPCS,81003,Hc Urine Analysis Dipstick Automated,62.0,40.3,,,0
HCPCS,81003,Urinalysis auto w/o scope,,,2.25,8.44,3
HCPCS,81005,Urinalysis,,,2.17,8.14,3
HCPCS,81007,Urine screen for bacteria,,,29.98,112.43,3
HCPCS,81015,Hc Urinalysis Microscopic Only,92.0,59.8,,,0
HCPCS,81015,Microscopic exam of urine,,,3.05,11.44,3
HCPCS,81020,Urinalysis glass test,,,4.7,17.63,3
HCPCS,81025,Hc Urine Pregnancy Visual,128.0,83.2,,,0
HCPCS,81025,Hc Urine Pregnancy Visual Amb,70.0,45.5,,,0
HCPCS,81025,Urine pregnancy test,,,8.61,32.29,3
HCPCS,81050,Hc Urine Volume Measurement,54.0,35.1,,,0
HCPCS,81050,Urinalysis volume measure,,,3.64,13.65,3
HCPCS,81105,Hc Hpa 1 Genotyping Arc,160.0,104.0,,,0
HCPCS,81105,Hc Human Platelet Antigen 1 Genotyping So,173.0,112.45,,,0
HCPCS,81105,Hpa-1 genotyping,,,122.22,458.33,3
HCPCS,81106,Hc Hpa 2 Genotyping Arc,160.0,104.0,,,0
HCPCS,81106,Hc Human Platelet Antigen 2 Genotyping So,173.0,112.45,,,0
HCPCS,81106,Hpa-2 genotyping,,,122.22,458.33,3
HCPCS,81107,Hc Hpa 3 Genotyping Arc,160.0,104.0,,,0
HCPCS,81107,Hc Human Platelet Antigen 3 Genotyping So,173.0,112.45,,,0
HCPCS,81107,Hpa-3 genotyping,,,122.22,458.33,3
HCPCS,81108,Hc Hpa 4 Genotyping Arc,160.0,104.0,,,0
HCPCS,81108,Hc Human Platelet Antigen 4 Genotyping So,173.0,112.45,,,0
HCPCS,81108,Hpa-4 genotyping,,,122.22,458.33,3
HCPCS,81109,Hc Hpa 5 Genotyping Arc,160.0,104.0,,,0
HCPCS,81109,Hc Human Platelet Antigen 5 Genotyping So,173.0,112.45,,,0
HCPCS,81109,Hpa-5 genotyping,,,122.22,458.33,3
HCPCS,81110,Hc Hpa 6 Genotyping Arc,160.0,104.0,,,0
HCPCS,81110,Hc Human Platelet Antigen 6 Genotyping So,173.0,112.45,,,0
HCPCS,81110,Hpa-6 genotyping,,,122.22,458.33,3
HCPCS,81111,Hc Hpa 9 Genotyping Arc,160.0,104.0,,,0
HCPCS,81111,Hc Human Platelet Antigen 9 Genotyping So,173.0,112.45,,,0
HCPCS,81111,Hpa-9 genotyping,,,122.22,458.33,3
HCPCS,81112,Hc Hpa 15 Genotyping Arc,160.0,104.0,,,0
HCPCS,81112,Hc Human Platelet Antigen 15 Genotyping So,173.0,112.45,,,0
HCPCS,81112,Hpa-15 genotyping,,,122.22,458.33,3
HCPCS,81120,"Hc Idh1, Common Variants So",1029.0,668.85,,,0
HCPCS,81120,Idh1 common variants,,,193.25,724.69,3
HCPCS,81121,"Hc Idh2 , Common Variants So",1029.0,668.85,,,0
HCPCS,81121,Idh2 common variants,,,295.79,1109.21,3
HCPCS,81161,DMD dup/delet analysis,,,279.0,1046.25,3
HCPCS,81161,Hc Dmd/Bmd Deletion/Duplication So,3071.0,1996.15,,,0
HCPCS,81162,Brca1&2 seq & full dup/del,,,1824.88,6843.3,3
HCPCS,81162,Hc Brca1 And 2 Seq And Full Dup/Del So,5670.0,3685.5,,,0
HCPCS,81163,Brca1&2 gene full seq alys,,,468.0,1755.0,3
HCPCS,81163,Hc Brca1/2 Gene Full Seq Analysis Tumor So,4200.0,2730.0,,,0
HCPCS,81164,Brca1&2 gen ful dup/del alys,,,584.23,2190.86,3
HCPCS,81165,Brca1 gene full seq alys,,,282.88,1060.8,3
HCPCS,81166,Brca1 gene full dup/del alys,,,301.35,1130.06,3
HCPCS,81167,Brca2 gene full dup/del alys,,,282.88,1060.8,3
HCPCS,81168,Ccnd1/igh translocation alys,,,207.31,777.41,3
HCPCS,81170,Abl1 gene,,,300.0,1125.0,3
HCPCS,81170,Hc Abl1 Gene Analysis Kinase Domain Variants So,945.0,614.25,,,0
HCPCS,81171,Aff2 gene detc abnor alleles,,,137.0,513.75,3
HCPCS,81172,Aff2 gene charac alleles,,,274.83,1030.61,3
HCPCS,81173,Ar gene full gene sequence,,,301.35,1130.06,3
HCPCS,81174,Ar gene known famil variant,,,185.2,694.5,3
HCPCS,81174,Hc Ar Gene Known Familial Variant So,1748.0,1136.2,,,0
HCPCS,81175,Asxl1 full gene sequence,,,676.5,2536.88,3
HCPCS,81176,Asxl1 gene target seq alys,,,241.9,907.13,3
HCPCS,81177,Atn1 gene detc abnor alleles,,,137.0,513.75,3
HCPCS,81177,Hc Atn1 Gene Analysis Evaluation To Detect Abnormal Alleles So,1785.0,1160.25,,,0
HCPCS,81178,Atxn1 gene detc abnor allele,,,137.0,513.75,3
HCPCS,81178,Hc Atxn1 Gene Detc Abnor Allele So,1018.0,661.7,,,0
HCPCS,81179,Atxn2 gene detc abnor allele,,,137.0,513.75,3
HCPCS,81179,Hc Atxn2 Gene Detc Abnor Allele So,1018.0,661.7,,,0
HCPCS,81180,Atxn3 gene detc abnor allele,,,137.0,513.75,3
HCPCS,81180,Hc Atxn3 Gene Detc Abnor Allele So,1018.0,661.7,,,0
HCPCS,81181,Atxn7 gene detc abnor allele,,,137.0,513.75,3
HCPCS,81181,Hc Atxn7 Gene Analysis Eval To Detect Abnormal Alleles So,479.0,311.35,,,0
HCPCS,81182,Atxn8os gen detc abnor allel,,,137.0,513.75,3
HCPCS,81183,Atxn10 gene detc abnor allel,,,137.0,513.75,3
HCPCS,81184,Cacna1a gen detc abnor allel,,,137.0,513.75,3
HCPCS,81184,Hc Cacna1A Gen Detc Abnor Allel So,1506.0,978.9,,,0
HCPCS,81185,Cacna1a gene full gene seq,,,846.27,3173.51,3
HCPCS,81186,Cacna1a gen known famil vrnt,,,185.2,694.5,3
HCPCS,81186,Hc Cacna1A Gen Known Family Variant So,1273.0,827.45,,,0
HCPCS,81187,Cnbp gene detc abnor allele,,,137.0,513.75,3
HCPCS,81187,Hc Cnbp Gene Detc Abnor Allele So,3631.0,2360.15,,,0
HCPCS,81188,Cstb gene detc abnor allele,,,137.0,513.75,3
HCPCS,81189,Cstb gene full gene sequence,,,274.83,1030.61,3
HCPCS,81190,Cstb gene known famil vrnt,,,185.2,694.5,3
HCPCS,81190,Hc Cstb Gene Known Family Variant So,1273.0,827.45,,,0
HCPCS,81191,Ntrk1 translocation analysis,,,207.31,777.41,3
HCPCS,81192,Ntrk2 translocation analysis,,,207.31,777.41,3
HCPCS,81193,Ntrk3 translocation analysis,,,207.31,777.41,3
HCPCS,81194,Hc Ntrk Translocation Analysis So,4504.0,2927.6,,,0
HCPCS,81194,Ntrk translocation analysis,,,518.28,1943.55,3
HCPCS,81195,Cytog genom-wid alys hem mal,,,1863.22,1863.22,1
HCPCS,81200,Aspa gene,,,47.25,177.19,3
HCPCS,81200,Hc Aspa Gene Analysis Common Variants So,518.0,336.7,,,0
HCPCS,81201,Apc gene full sequence,,,780.0,2925.0,3
HCPCS,81201,"Hc Apc Gene, Full Gene Analysis So",3794.0,2466.1,,,0
HCPCS,81202,Apc gene known fam variants,,,280.0,1050.0,3
HCPCS,81202,Hc Apc Gene Known Fam Variants So,1273.0,827.45,,,0
HCPCS,81203,Apc gene dup/delet variants,,,200.0,750.0,3
HCPCS,81204,Ar gene charac alleles,,,137.0,513.75,3
HCPCS,81204,Hc Ar Gene Analysis Characterization Of Alleles So,817.0,531.05,,,0
HCPCS,81205,Bckdhb gene,,,94.99,356.21,3
HCPCS,81206,Bcr/abl1 gene major bp,,,163.96,614.85,3
HCPCS,81206,Hc Bcr Abl1 Gene Major Bp,1521.0,988.65,,,0
HCPCS,81206,Hc Bcr Abl1 Gene Major Bp So,891.0,579.15,,,0
HCPCS,81207,Bcr/abl1 gene minor bp,,,144.84,543.15,3
HCPCS,81207,Hc Bcr/Abl 1 Gene Minor Bp,1710.0,1111.5,,,0
HCPCS,81207,Hc Bcr/Abl 1 Gene Minor Bp So,366.0,237.9,,,0
HCPCS,81208,Bcr/abl1 gene other bp,,,214.62,804.83,3
HCPCS,81208,Hc Bcr Abl1 Other Breakpnt Qualitative Quantitative,789.0,512.85,,,0
HCPCS,81209,Blm gene,,,39.31,147.41,3
HCPCS,81209,Hc Bloom Syndrome Mutation Analysis So,1128.0,733.2,,,0
HCPCS,81210,Braf gene,,,175.4,657.75,3
HCPCS,81210,Hc Braf Gene Mut Anlys V600E Tumor,2968.0,1929.2,,,0
HCPCS,81210,Hc Braf Gene Mut Anlys V600E Tumor So,1485.0,965.25,,,0
HCPCS,81212,Brca1&2 185&5385&6174 var,,,440.0,1650.0,3
HCPCS,81215,Brca1 gene known fam variant,,,375.25,1407.19,3
HCPCS,81215,Hc Brca1 Gene Known Fam Variant So,1364.0,886.6,,,0
HCPCS,81216,Brca2 gene full sequence,,,185.12,694.2,3
HCPCS,81217,Brca2 gene known fam variant,,,375.25,1407.19,3
HCPCS,81217,Hc Brca2 Gene Known Fam Variant So,1364.0,886.6,,,0
HCPCS,81218,Cebpa gene full sequence,,,241.9,907.13,3
HCPCS,81218,Hc Cebpa Gene Full Sequence So,1345.0,874.25,,,0
HCPCS,81219,Calr gene com variants,,,121.63,456.11,3
HCPCS,81219,Hc Calr Gene Analysis Common Variants Exon9 So,810.0,526.5,,,0
HCPCS,81220,Cftr gene com variants,,,556.6,2087.25,3
HCPCS,81220,Hc Cystic Fibrosis Mutation Panel So,521.0,338.65,,,0
HCPCS,81221,Cftr gene known fam variants,,,97.22,364.58,3
HCPCS,81221,Hc Cftr Gene  Known Mutation So,1273.0,827.45,,,0
HCPCS,81222,Cftr gene dup/delet variants,,,435.07,1631.51,3
HCPCS,81222,Hc Cftr Gene Duplication Deletion Variants So,1522.0,989.3,,,0
HCPCS,81223,Cftr gene full sequence,,,499.0,1871.25,3
HCPCS,81223,Hc Cftr Gene  Full Gene Analysis So,3285.0,2135.25,,,0
HCPCS,81224,Cftr gene intron poly t,,,168.75,632.81,3
HCPCS,81225,Cyp2c19 gene com variants,,,291.36,1092.6,3
HCPCS,81225,Hc Cyp2C19 Gene Analysis Common Variants So,1350.0,877.5,,,0
HCPCS,81226,Cyp2d6 gene com variants,,,450.91,1690.91,3
HCPCS,81226,Hc Cyp2D6 Gene Analysis Common Variants So,652.0,423.8,,,0
HCPCS,81227,Cyp2c9 gene com variants,,,174.81,655.54,3
HCPCS,81227,Hc Cyp2C9 Sequence Genotype So,1825.0,1186.25,,,0
HCPCS,81228,Cytogen micrarray copy nmbr,,,900.0,3375.0,3
HCPCS,81228,Hc Cytogen Microarray Number So,5693.0,3700.45,,,0
HCPCS,81229,Cytogen m array copy no&snp,,,1160.0,4350.0,3
HCPCS,81229,Hc Cytogen M Array Copy No And Snp So,4784.0,3109.6,,,0
HCPCS,81229,Hc Cytogen M Array Copy No And Snp Special So,8918.0,5796.7,,,0
HCPCS,81230,Cyp3a4 gene common variants,,,174.81,655.54,3
HCPCS,81230,"Hc Cyp3A4, Gene Analysis, Common Variant(S) So",1562.0,1015.3,,,0
HCPCS,81231,Cyp3a5 gene common variants,,,174.81,655.54,3
HCPCS,81231,"Hc Cyp3A5 , Gene Analysis, Common Variants So",1825.0,1186.25,,,0
HCPCS,81232,Dpyd gene common variants,,,174.81,655.54,3
HCPCS,81232,"Hc Dpyd, Gene Analysis, Common Variant(S) So",1688.0,1097.2,,,0
HCPCS,81233,Btk gene common variants,,,175.4,657.75,3
HCPCS,81234,Dmpk gene detc abnor allele,,,137.0,513.75,3
HCPCS,81234,Hc Dmpk Gene Detc Abnor Allele So,2242.0,1457.3,,,0
HCPCS,81235,Egfr gene com variants,,,324.58,1217.18,3
HCPCS,81235,Hc Egfr Gene Com Variants So,1890.0,1228.5,,,0
HCPCS,81236,Ezh2 gene full gene sequence,,,282.88,1060.8,3
HCPCS,81237,Ezh2 gene common variants,,,175.4,657.75,3
HCPCS,81238,F9 full gene sequence,,,600.0,2250.0,3
HCPCS,81238,"Hc F9, Full Gene Sequence So",5729.0,3723.85,,,0
HCPCS,81239,Dmpk gene charac alleles,,,274.83,1030.61,3
HCPCS,81240,F2 gene,,,65.69,246.34,3
HCPCS,81240,Hc F2 Gene Analysis 20210G>A Variant So,216.0,140.4,,,0
HCPCS,81240,Hc Prothrombin G20210A Mutation,211.0,137.15,,,0
HCPCS,81241,F5 gene,,,73.37,275.14,3
HCPCS,81241,Hc F5 Coagulation Factor V Anal Leiden So,135.0,87.75,,,0
HCPCS,81241,Hc Factor V Leiden (R506Q) Mutation,211.0,137.15,,,0
HCPCS,81242,Fancc gene,,,36.62,137.33,3
HCPCS,81242,Hc Fanconi Anemia  Mutation Analysis,1128.0,733.2,,,0
HCPCS,81243,Fmr1 gene detection,,,57.04,213.9,3
HCPCS,81243,Hc Fmr1 Gene Detection So,675.0,438.75,,,0
HCPCS,81244,Fmr1 gene characterization,,,44.89,168.34,3
HCPCS,81244,Hc Fmr1 Gene Characterization So,821.0,533.65,,,0
HCPCS,81245,Flt3 gene,,,165.51,620.66,3
HCPCS,81245,Hc Flt3 Mutation Analysis So,1286.0,835.9,,,0
HCPCS,81246,Flt3 gene analysis,,,83.0,311.25,3
HCPCS,81246,Hc Flt3 Tkd Gene Analysis So,669.0,434.85,,,0
HCPCS,81247,G6pd gene alys cmn variant,,,174.81,655.54,3
HCPCS,81248,G6pd known familial variant,,,375.25,1407.19,3
HCPCS,81248,"Hc G6Pd, Gene Analysis; Known Familial Variant(S) So",7297.0,4743.05,,,0
HCPCS,81249,G6pd full gene sequence,,,600.0,2250.0,3
HCPCS,81249,"Hc G6Pd, Gene Analysis; Full Gene Sequence So",3135.0,2037.75,,,0
HCPCS,81250,G6pc gene,,,58.49,219.34,3
HCPCS,81250,Hc G6Pc Gene So,134.0,87.1,,,0
HCPCS,81251,Gba gene,,,47.25,177.19,3
HCPCS,81251,Hc Gaucher Disease Mutation Analysis So,943.0,612.95,,,0
HCPCS,81252,Gjb2 gene full sequence,,,101.12,379.2,3
HCPCS,81252,Hc Gjb2 Gene Full Sequence So,1193.0,775.45,,,0
HCPCS,81253,Gjb2 gene known fam variants,,,61.52,230.7,3
HCPCS,81253,Hc Gjb2 Gene Known Family Variant So,1273.0,827.45,,,0
HCPCS,81254,Gjb6 gene com variants,,,35.0,131.25,3
HCPCS,81254,Hc Gjb6 Gene Analysis Common Variants So,1326.0,861.9,,,0
HCPCS,81255,Hc Tay-Sachs Mutation Analysis So,837.0,544.05,,,0
HCPCS,81255,Hexa gene,,,51.45,192.94,3
HCPCS,81256,Hc Hemochromatosis Hfe Gene Analysis So,404.0,262.6,,,0
HCPCS,81256,Hfe gene,,,65.36,245.1,3
HCPCS,81257,Hba1/hba2 gene,,,102.26,383.48,3
HCPCS,81257,Hc Hba1/Hba2 Alpha-Globin Gene Anlys Common Deletions/Variant So,970.0,630.5,,,0
HCPCS,81258,Hba1/hba2 gene fam vrnt,,,375.25,1407.19,3
HCPCS,81258,Hc Hba1/Hba2 Gene Family Variant So,1273.0,827.45,,,0
HCPCS,81259,Hba1/hba2 full gene sequence,,,600.0,2250.0,3
HCPCS,81259,"Hc Hba1/Hba2, Gene Analysis; Full Gene Sequence So",1371.0,891.15,,,0
HCPCS,81260,Hc Familial Dysautonomia Mutation So,1128.0,733.2,,,0
HCPCS,81260,Ikbkap gene,,,39.31,147.41,3
HCPCS,81261,Hc Igh Gene Rearrange Analysis,943.0,612.95,,,0
HCPCS,81261,Igh gene rearrange amp meth,,,197.99,742.46,3
HCPCS,81262,Igh gene rearrang dir probe,,,68.55,257.06,3
HCPCS,81263,Hc Igvh Mutation Analysis,1591.0,1034.15,,,0
HCPCS,81263,Igh vari regional mutation,,,294.52,1104.45,3
HCPCS,81264,Hc Igk Rearrange Abn Clonal Pop,943.0,612.95,,,0
HCPCS,81264,Igk rearrangeabn clonal pop,,,172.73,647.74,3
HCPCS,81265,Hc Donor Comparative Analysis Str Markers Patient&Comp Spec So,840.0,546.0,,,0
HCPCS,81265,Hc Recipient Comparative Analysis Str Markers Patient&Comp Spec So,840.0,546.0,,,0
HCPCS,81265,Hc Str Markers Specimen Anlys So,1466.0,952.9,,,0
HCPCS,81265,Str markers specimen anal,,,233.07,874.01,3
HCPCS,81266,Hc Donor Comparative Analysis Str Markers Ea Addl Specimen So,1140.0,741.0,,,0
HCPCS,81266,Hc Recipient Comparative Analysis Str Markers Ea Addl Specimen So,1140.0,741.0,,,0
HCPCS,81266,Hc Str Markers Spec Anal Addl So,720.0,468.0,,,0
HCPCS,81266,Str markers spec anal addl,,,304.81,1143.04,3
HCPCS,81267,Chimerism anal no cell selec,,,207.46,777.98,3
HCPCS,81267,Hc Donor Chimerism W/Comp To Baseline W/O Cell Selection So,1050.0,682.5,,,0
HCPCS,81267,Hc Recipient Chimerism W/Comp To Baseline W/O Cell Selection So,1050.0,682.5,,,0
HCPCS,81268,Chimerism anal w/cell select,,,260.79,977.96,3
HCPCS,81268,Hc Donor Chimerism W/Comp To Baseline W/Cell Selection Ea So,2001.0,1300.65,,,0
HCPCS,81268,Hc Recipient Chimerism W/Comp To Baseline W/Cell Selection Ea So,2001.0,1300.65,,,0
HCPCS,81269,Hba1/hba2 gene dup/del vrnts,,,202.4,759.0,3
HCPCS,81269,"Hc Hba1/Hba2, Gene Analysis; Duplication/Deletion Variants So",877.0,570.05,,,0
HCPCS,81270,Hc Jak2 V617F Mutation Detection So,675.0,438.75,,,0
HCPCS,81270,Jak2 gene,,,91.66,343.73,3
HCPCS,81271,Hc Htt Gene Analysis Evaluation To Detect Abnormal Alleles So,675.0,438.75,,,0
HCPCS,81271,Htt gene detc abnor alleles,,,137.0,513.75,3
HCPCS,81272,Hc Kit Gene Targeted Seq Analys So,2803.0,1821.95,,,0
HCPCS,81272,Kit gene targeted seq analys,,,329.51,1235.66,3
HCPCS,81273,Hc Kit Gene Analys D816 Variant So,1339.0,870.35,,,0
HCPCS,81273,Kit gene analys d816 variant,,,124.87,468.26,3
HCPCS,81274,Htt gene charac alleles,,,274.83,1030.61,3
HCPCS,81275,Hc Kras Gene  7 Mutation Panel Tumor,2994.0,1946.1,,,0
HCPCS,81275,Kras gene variants exon 2,,,193.25,724.69,3
HCPCS,81276,Hc Kras Gene Addl Variants So,683.0,443.95,,,0
HCPCS,81276,Kras gene addl variants,,,193.25,724.69,3
HCPCS,81277,Cytogenomic neo microra alys,,,1160.0,4350.0,3
HCPCS,81277,Hc Cytogenomic Neoplasia Microarray Analysis Ap So,6921.0,4498.65,,,0
HCPCS,81277,Hc Cytogenomic Neoplasia Microarray Analysis So,4577.0,2975.05,,,0
HCPCS,81278,Igh@/bcl2 translocation alys,,,207.31,777.41,3
HCPCS,81279,Hc Jak2 Gene Target Sequence Analysis So,766.0,497.9,,,0
HCPCS,81279,Jak2 gene trgt sequence alys,,,185.2,694.5,3
HCPCS,81283,"Hc Ifnl3 Gene Analysis, Rs12979860 Variant So",1038.0,674.7,,,0
HCPCS,81283,Ifnl3 gene,,,73.37,275.14,3
HCPCS,81284,Fxn gene detc abnor alleles,,,137.0,513.75,3
HCPCS,81284,Hc Fxn Gene Detc Abnor Alleles So,2156.0,1401.4,,,0
HCPCS,81285,Fxn gene charac alleles,,,274.83,1030.61,3
HCPCS,81286,Fxn gene full gene sequence,,,274.83,1030.61,3
HCPCS,81287,Hc Mgmt Gene Promoter Methylation Analysis So,1242.0,807.3,,,0
HCPCS,81287,Mgmt gene methylation anal,,,124.64,467.4,3
HCPCS,81288,Hc Mlh1 Promoter Mrthlyation Analysis So,1190.0,773.5,,,0
HCPCS,81288,Mlh1 gene,,,192.32,721.2,3
HCPCS,81289,Fxn gene known famil variant,,,185.2,694.5,3
HCPCS,81289,Hc Fxn Gene Known Familial Variant So,1748.0,1136.2,,,0
HCPCS,81290,Hc Mucolipidosis Iv Mutation Analys,1175.0,763.75,,,0
HCPCS,81290,Mcoln1 gene,,,39.31,147.41,3
HCPCS,81291,Hc Mthfr Mutation So,222.0,144.3,,,0
HCPCS,81291,Mthfr gene,,,65.34,245.03,3
HCPCS,81292,Hc Mlh1 Gene Full Seq So,2183.0,1418.95,,,0
HCPCS,81292,Mlh1 gene full seq,,,675.4,2532.75,3
HCPCS,81293,Hc Mlh1 Known Variants,540.0,351.0,,,0
HCPCS,81293,Mlh1 gene known variants,,,331.0,1241.25,3
HCPCS,81294,Mlh1 gene dup/delete variant,,,202.4,759.0,3
HCPCS,81295,Hc Msh2 Gene Full Sequence Analysis So,2183.0,1418.95,,,0
HCPCS,81295,Msh2 gene full seq,,,381.7,1431.38,3
HCPCS,81296,Hc Msh2 Known Mutation So,1273.0,827.45,,,0
HCPCS,81296,Msh2 gene known variants,,,337.73,1266.49,3
HCPCS,81297,Msh2 gene dup/delete variant,,,213.3,799.88,3
HCPCS,81298,Hc Msh6 Gene Analysis Full Sequence Analysis So,2259.0,1468.35,,,0
HCPCS,81298,Hc Msh6 Mutation Screen,2121.0,1378.65,,,0
HCPCS,81298,Msh6 gene full seq,,,641.85,2406.94,3
HCPCS,81299,Hc Msh6 Known Mutation So,1273.0,827.45,,,0
HCPCS,81299,Msh6 gene known variants,,,308.0,1155.0,3
HCPCS,81300,Msh6 gene dup/delete variant,,,238.0,892.5,3
HCPCS,81301,Hc Microsatellite Instability Msi Tum So,3041.0,1976.65,,,0
HCPCS,81301,Microsatellite instability,,,348.56,1307.1,3
HCPCS,81302,Mecp2 gene full seq,,,527.87,1979.51,3
HCPCS,81303,Hc Mecp2 Gene Known Mutation So,1273.0,827.45,,,0
HCPCS,81303,Mecp2 gene known variant,,,120.0,450.0,3
HCPCS,81304,Mecp2 gene dup/delet variant,,,150.0,562.5,3
HCPCS,81305,Hc Myd88 Gene Analysis P.Leu265Pro (L265P) Variant So,1215.0,789.75,,,0
HCPCS,81305,Myd88 gene p.leu265pro vrnt,,,175.4,657.75,3
HCPCS,81306,Nudt15 gene common variants,,,291.36,1092.6,3
HCPCS,81307,Palb2 gene full gene seq,,,676.5,2536.88,3
HCPCS,81308,Hc Palb2 Gene Known Familial Variant So,1748.0,1136.2,,,0
HCPCS,81308,Palb2 gene known famil vrnt,,,301.35,1130.06,3
HCPCS,81309,Pik3ca gene trgt seq alys,,,274.83,1030.61,3
HCPCS,81310,Hc Npm1 Gene,1262.0,820.3,,,0
HCPCS,81310,Npm1 gene,,,246.52,924.45,3
HCPCS,81311,Hc Nras Gene Variants Exon 2 And 3 So,1110.0,721.5,,,0
HCPCS,81311,Nras gene variants exon 2&3,,,295.79,1109.21,3
HCPCS,81312,Pabpn1 gene detc abnor allel,,,137.0,513.75,3
HCPCS,81313,Pca3/klk3 antigen,,,255.05,956.44,3
HCPCS,81314,Hc Pdgfra Mutation Analysis So,1778.0,1155.7,,,0
HCPCS,81314,Pdgfra gene,,,329.51,1235.66,3
HCPCS,81315,Hc Pml/Raralpha Common Breakpoints So,1400.0,910.0,,,0
HCPCS,81315,Pml/raralpha com breakpoints,,,207.31,777.41,3
HCPCS,81316,Pml/raralpha 1 breakpoint,,,207.31,777.41,3
HCPCS,81317,Hc Pms2 Gene Full Seq Analysis So,2718.0,1766.7,,,0
HCPCS,81317,Pms2 gene full seq analysis,,,676.5,2536.88,3
HCPCS,81318,Hc Pms2 Gene Analysis Known Familial Variants So,1364.0,886.6,,,0
HCPCS,81318,Pms2 known familial variants,,,331.0,1241.25,3
HCPCS,81319,Hc Pms2 Gene Dup/Delet Variants So,673.0,437.45,,,0
HCPCS,81319,Hc Pms2 Gene Dup/Delet Variants Special So,1715.0,1114.75,,,0
HCPCS,81319,Pms2 gene dup/delet variants,,,203.5,763.13,3
HCPCS,81320,Plcg2 gene common variants,,,291.36,1092.6,3
HCPCS,81321,Hc Pten Full Gene Analysis So,5368.0,3489.2,,,0
HCPCS,81321,Pten gene full sequence,,,600.0,2250.0,3
HCPCS,81322,Hc Pten Gene Known Family Variant So,1273.0,827.45,,,0
HCPCS,81322,Pten gene known fam variant,,,46.6,174.75,3
HCPCS,81323,Pten gene dup/delet variant,,,300.0,1125.0,3
HCPCS,81324,Hc Pmp22 Gene Duplication/Deletion Analysis So,1893.0,1230.45,,,0
HCPCS,81324,Pmp22 gene dup/delet,,,758.36,2843.85,3
HCPCS,81325,Pmp22 gene full sequence,,,769.58,2885.93,3
HCPCS,81326,Hc Pmp22 Gene Known Family Variant So,1273.0,827.45,,,0
HCPCS,81326,Pmp22 gene known fam variant,,,46.6,174.75,3
HCPCS,81327,Sept9 methylation analysis,,,192.0,720.0,3
HCPCS,81328,"Hc Slco1B1, Gene Analysis, Common Variant(S) So",1562.0,1015.3,,,0
HCPCS,81328,Slco1b1 gene com variants,,,174.81,655.54,3
HCPCS,81329,Hc Smn1 Gene Analysis Dosage/Deletion Analysis Includes Smn2 Analysis So,1080.0,702.0,,,0
HCPCS,81329,Smn1 gene dos/deletion alys,,,137.0,513.75,3
HCPCS,81330,Hc Niemann Pick Disease Type A And B,1128.0,733.2,,,0
HCPCS,81330,Smpd1 gene common variants,,,47.0,176.25,3
HCPCS,81331,Hc Prader Willi Angelman Mol Analysis So,1044.0,678.6,,,0
HCPCS,81331,Snrpn/ube3a gene,,,51.07,191.51,3
HCPCS,81332,Hc Serpina 1 Gene,252.0,163.8,,,0
HCPCS,81332,Serpina1 gene,,,43.65,163.69,3
HCPCS,81333,Tgfbi gene common variants,,,137.0,513.75,3
HCPCS,81334,Runx1 gene targeted seq alys,,,329.51,1235.66,3
HCPCS,81335,"Hc Tpmt, Gene Analysis, Common Variants So",1430.0,929.5,,,0
HCPCS,81335,Tpmt gene com variants,,,174.81,655.54,3
HCPCS,81336,Hc Smn1 Gene Analysis Full Gene Sequence So,1928.0,1253.2,,,0
HCPCS,81336,Smn1 gene full gene sequence,,,301.35,1130.06,3
HCPCS,81337,Hc Smn1 Gene Analysis Known Familial Sequence Variant(S) So,1364.0,886.6,,,0
HCPCS,81337,Smn1 gen nown famil seq vrnt,,,185.2,694.5,3
HCPCS,81338,Mpl gene common variants,,,150.33,563.74,3
HCPCS,81339,"Hc Mpl Gene Analysis; Sequence Analysis, Exon 10 So",788.0,512.2,,,0
HCPCS,81339,Mpl gene seq alys exon 10,,,185.2,694.5,3
HCPCS,81340,Hc Trb@ Gene Rearrange Amplify So,343.0,222.95,,,0
HCPCS,81340,Hc Trb@ Gene Rearrange Amplify Special So,4380.0,2847.0,,,0
HCPCS,81340,Trb@ gene rearrange amplify,,,208.92,783.45,3
HCPCS,81341,Trb@ gene rearrange dirprobe,,,49.59,185.96,3
HCPCS,81342,Hc Trb@ Gene Rearrangement Analysis So,343.0,222.95,,,0
HCPCS,81342,Trg gene rearrangement anal,,,201.5,755.63,3
HCPCS,81343,Ppp2r2b gen detc abnor allel,,,137.0,513.75,3
HCPCS,81344,Tbp gene detc abnor alleles,,,137.0,513.75,3
HCPCS,81345,Hc Tert Gene Analysis Targeted Sequence Analysis So,2246.0,1459.9,,,0
HCPCS,81345,Tert gene targeted seq alys,,,185.2,694.5,3
HCPCS,81346,Tyms gene com variants,,,174.81,655.54,3
HCPCS,81347,Hc Sf3B1 Gene Common Variants So,759.0,493.35,,,0
HCPCS,81347,Sf3b1 gene common variants,,,193.25,724.69,3
HCPCS,81348,Srsf2 gene common variants,,,175.4,657.75,3
HCPCS,81349,Cytog alys chrml abnr lw-ps,,,1197.94,4350.0,3
HCPCS,81350,Hc Ugt1A1 Sequence Gene Analysis So,2638.0,1714.7,,,0
HCPCS,81350,Ugt1a1 gene,,,234.0,877.5,3
HCPCS,81351,Hc Tp53 Gene Analysis; Full Gene Sequence So,2068.0,1344.2,,,0
HCPCS,81351,Tp53 gene full gene sequence,,,641.85,2406.94,3
HCPCS,81352,Hc Tp53 Gene Analysis; Targeted Sequence Analysis So,1746.0,1134.9,,,0
HCPCS,81352,Tp53 gene trgt sequence alys,,,329.51,1235.66,3
HCPCS,81353,Hc Tp53 Gene Analysis; Known Familial Variant So,1274.0,828.1,,,0
HCPCS,81353,Tp53 gene known famil vrnt,,,308.0,1155.0,3
HCPCS,81354,Cytog alys chrml abnor ogm,,,1263.53,1263.53,1
HCPCS,81355,Vkorc1 gene,,,88.2,330.75,3
HCPCS,81357,U2af1 gene common variants,,,193.25,724.69,3
HCPCS,81360,Zrsr2 gene common variants,,,193.25,724.69,3
HCPCS,81361,Hbb gene com variants,,,174.81,655.54,3
HCPCS,81362,Hbb gene known fam variant,,,375.25,1407.19,3
HCPCS,81362,Hc Hbb Gene Known Family Variant So,1273.0,827.45,,,0
HCPCS,81363,Hbb gene dup/del variants,,,202.4,759.0,3
HCPCS,81363,"Hc Hbb, Duplication/Deletion Variant(S) So",945.0,614.25,,,0
HCPCS,81364,Hbb full gene sequence,,,324.58,1217.18,3
HCPCS,81364,"Hc Hbb, Full Gene Sequence So",964.0,626.6,,,0
HCPCS,81370,Hla i & ii typing lr,,,402.12,1507.95,3
HCPCS,81371,Hla i & ii type verify lr,,,404.52,1516.95,3
HCPCS,81372,Hc Donor Hla I Typing Complete Lr So,870.0,565.5,,,0
HCPCS,81372,Hc Hla Class I Typing Low Resolution Complete So,538.0,349.7,,,0
HCPCS,81372,Hc Recipient Hla I Typing Complete Lr So,870.0,565.5,,,0
HCPCS,81372,Hla i typing complete lr,,,403.59,1513.46,3
HCPCS,81373,Hc Donor Hla I Typing 1 Locus Lr So,426.0,276.9,,,0
HCPCS,81373,Hc Hla I Typing 1 Locus Lr Ea So,540.0,351.0,,,0
HCPCS,81373,Hc Recipient Hla I Typing 1 Locus Lr So,426.0,276.9,,,0
HCPCS,81373,Hla i typing 1 locus lr,,,127.43,477.86,3
HCPCS,81374,"Hc Hla I Low Resolution One Antigen Equivalent, Each So",645.0,419.25,,,0
HCPCS,81374,Hla i typing 1 antigen lr,,,74.33,278.74,3
HCPCS,81375,Hc Hla Class Ii Mol Typing Dis Assoc So,343.0,222.95,,,0
HCPCS,81375,Hla ii typing ag equiv lr,,,220.74,827.78,3
HCPCS,81376,Hc Donor Hla Ii Typing 1 Locus Lr So,747.0,485.55,,,0
HCPCS,81376,Hc Hla Ii Typing 1 Locus Lr Each So,297.0,193.05,,,0
HCPCS,81376,Hc Recipient Hla Ii Typing 1 Locus Lr So,747.0,485.55,,,0
HCPCS,81376,Hla ii typing 1 locus lr,,,122.22,458.33,3
HCPCS,81377,Hc Donor Hla-Drb1 Single Antigen Disease Association So,594.0,386.1,,,0
HCPCS,81377,Hc Recipient Hla-Drb1 Single Antigen Disease Association So,594.0,386.1,,,0
HCPCS,81377,Hla ii type 1 ag equiv lr,,,94.74,355.28,3
HCPCS,81378,Hc Donor Hla I&Ii High Resolution Hla-A -B -C And -Drb1 So,990.0,643.5,,,0
HCPCS,81378,Hc Recipient Hla I&Ii High Resolution Hla-A -B -C And -Drb1 So,990.0,643.5,,,0
HCPCS,81378,Hla i & ii typing hr,,,345.57,1295.89,3
HCPCS,81379,Hc Donor Hla I Typing Complete Hr So,1050.0,682.5,,,0
HCPCS,81379,Hc Recipient Hla I Typing Complete Hr So,1050.0,682.5,,,0
HCPCS,81379,Hla i typing complete hr,,,335.38,1257.68,3
HCPCS,81380,Hc Donor Hla I Typing 1 Locus Hr So,960.0,624.0,,,0
HCPCS,81380,Hc Hla I Typing 1 Locus Hr So,1564.0,1016.6,,,0
HCPCS,81380,Hc Recipient Hla I Typing 1 Locus Hr So,960.0,624.0,,,0
HCPCS,81380,Hla i typing 1 locus hr,,,177.25,664.69,3
HCPCS,81381,Hc Hla Typing 1 Allele Hr So,472.0,306.8,,,0
HCPCS,81381,Hla i typing 1 allele hr,,,169.9,637.13,3
HCPCS,81382,Hc Donor Hla Class Ii Typing High Resolution One Locus Ea So,990.0,643.5,,,0
HCPCS,81382,Hc Hla-Dqa1,575.0,373.75,,,0
HCPCS,81382,Hc Recipient Hla Class Ii Typing High Resolution One Locus Ea So,990.0,643.5,,,0
HCPCS,81382,Hla ii typing 1 loc hr,,,123.68,463.8,3
HCPCS,81383,Hc Narcolepsy Associated Ag,210.0,136.5,,,0
HCPCS,81383,Hla ii typing 1 allele hr,,,109.13,409.24,3
HCPCS,81400,Hc Molecular Path Proc Level 1 So,1091.0,709.15,,,0
HCPCS,81400,Mopath procedure level 1,,,63.96,239.85,3
HCPCS,81401,Hc Mopath Level 2 So,550.0,357.5,,,0
HCPCS,81401,Hc Mopath Level 2 Special So,2556.0,1661.4,,,0
HCPCS,81401,Mopath procedure level 2,,,137.0,513.75,3
HCPCS,81402,Hc Mopath Procedure Level 3 So,2120.0,1378.0,,,0
HCPCS,81402,Mopath procedure level 3,,,150.33,563.74,3
HCPCS,81403,Hc Mopath Level 4 Arc,642.0,417.3,,,0
HCPCS,81403,Hc Mopath Level 4 So,1146.0,744.9,,,0
HCPCS,81403,Hc Mopath Level 4 Special So,2628.0,1708.2,,,0
HCPCS,81403,Mopath procedure level 4,,,185.2,694.5,3
HCPCS,81404,Hc Molecular Pathology Procedure Level 5 So,2861.0,1859.65,,,0
HCPCS,81404,Mopath procedure level 5,,,274.83,1030.61,3
HCPCS,81405,Hc Mopath Procedure Level 6 Ap So,2868.0,1864.2,,,0
HCPCS,81405,Hc Mopath Procedure Level 6 So,4083.0,2653.95,,,0
HCPCS,81405,Hc Mopath Procedure Level 6 Special So,7988.0,5192.2,,,0
HCPCS,81405,Mopath procedure level 6,,,301.35,1130.06,3
HCPCS,81406,Hc Mopath Level 7 Ap So,6921.0,4498.65,,,0
HCPCS,81406,Hc Mopath Level 7 So,4577.0,2975.05,,,0
HCPCS,81406,Mopath procedure level 7,,,282.88,1060.8,3
HCPCS,81407,Hc Mopath Procedure Level 8 So,2753.0,1789.45,,,0
HCPCS,81407,Mopath procedure level 8,,,846.27,3173.51,3
HCPCS,81408,Hc Fbn1  Full Gene Sequence,8067.0,5243.55,,,0
HCPCS,81408,Mopath procedure level 9,,,2000.0,7500.0,3
HCPCS,81410,Aortic dysfunction/dilation,,,504.0,1890.0,3
HCPCS,81410,Hc Aortic Dysfunctin/Dilation Genomic Seq Analysis So,7368.0,4789.2,,,0
HCPCS,81411,Aortic dysfunction/dilation,,,1350.19,5063.21,3
HCPCS,81412,Ashkenazi jewish assoc dis,,,2448.56,9182.1,3
HCPCS,81412,Hc Ashkenazi Jewish Associated Disorders So,2449.0,1591.85,,,0
HCPCS,81413,Car ion chnnlpath inc 10 gns,,,584.9,2193.38,3
HCPCS,81414,Car ion chnnlpath inc 2 gns,,,584.9,2193.38,3
HCPCS,81415,Exome sequence analysis,,,4780.0,17925.0,3
HCPCS,81415,Hc Exome Sequence Analysis So,13270.0,8625.5,,,0
HCPCS,81416,Exome sequence analysis,,,12000.0,45000.0,3
HCPCS,81417,Exome re-evaluation,,,320.0,1200.0,3
HCPCS,81418,Hc Drug Metabolism Genomic Sequence Analysis Panel 6 Genes So,5432.0,3530.8,,,0
HCPCS,81418,Rx metab gen seq alys pnl 6,,,917.08,3439.05,3
HCPCS,81419,Epilepsy gen seq alys panel,,,2448.56,9182.1,3
HCPCS,81420,Fetal chrmoml aneuploidy,,,759.05,2846.44,3
HCPCS,81420,Hc Fetal Chrmoml Aneuploidy Genomic Seq Analys So,5765.0,3747.25,,,0
HCPCS,81422,Fetal chrmoml microdeltj,,,759.05,2846.44,3
HCPCS,81425,Genome sequence analysis,,,5031.2,18867.0,3
HCPCS,81426,Genome sequence analysis,,,2709.95,10162.31,3
HCPCS,81427,Genome re-evaluation,,,2337.65,8766.19,3
HCPCS,81430,Hc Hearing Loss Sequence Analysis So,5897.0,3833.05,,,0
HCPCS,81430,Hearing loss sequence analys,,,1625.0,6093.75,3
HCPCS,81431,Hc Hearing Loss Dup/Del Analysis So,2466.0,1602.9,,,0
HCPCS,81431,Hearing loss dup/del analys,,,679.57,2548.39,3
HCPCS,81432,Hc Hereditary Brst Ca-Related Gen Seq Analys 10 Gen So,10632.0,6910.8,,,0
HCPCS,81432,Hrdtry brst ca-rlatd dsordrs,,,1303.95,2546.44,3
HCPCS,81433,Hrdtry brst ca-rlatd dsordrs,,,1645.99,1645.99,2
HCPCS,81434,Hereditary retinal disorders,,,597.91,2242.16,3
HCPCS,81435,Hc Hrditary Colon Ca Dsrdrs Gen Seq Analys 10 Gen So,8627.0,5607.55,,,0
HCPCS,81435,Hereditary colon ca dsordrs,,,1303.95,2193.38,3
HCPCS,81436,Hereditary colon ca dsordrs,,,2193.38,2193.38,2
HCPCS,81437,Hc Heredtry Nurondcrn Tum Dsrdrs Gen Seq Anal 6 Gen So,9585.0,6230.25,,,0
HCPCS,81437,Heredtry nurondcrn tum dsrdr,,,1303.95,1645.99,3
HCPCS,81438,Heredtry nurondcrn tum dsrdr,,,1645.99,1645.99,2
HCPCS,81439,Hc Hereditary Cardiomyopathy Gen Seq Analys 5 Gen So,8535.0,5547.75,,,0
HCPCS,81439,Inherited cardmypthy 5 gns,,,584.9,2193.38,3
HCPCS,81440,Hc Nuclear Mitochondrial 100 Gene Genomic Seq So,9187.0,5971.55,,,0
HCPCS,81440,Mitochondrial gene,,,3324.0,12465.0,3
HCPCS,81441,Ibmfs seq alys pnl 30 genes,,,2448.56,9182.1,3
HCPCS,81442,Hc Noonan Spectrum Disorders Gen Seq Analys 12 Gen So,5344.0,3473.6,,,0
HCPCS,81442,Noonan spectrum disorders,,,2143.6,8038.5,3
HCPCS,81443,Genetic tstg severe inh cond,,,2448.56,9182.1,3
HCPCS,81443,Hc Genetic Testing For Severe Inherited Conditions So,6075.0,3948.75,,,0
HCPCS,81443,Hc Genetic Testing For Severe Inherited Conditions Special So,14826.0,9636.9,,,0
HCPCS,81445,Hc Gen Seq Analys Solid Organ Neoplasm 5-50 Gene So,6083.0,3953.95,,,0
HCPCS,81445,Targeted genomic seq analys,,,597.91,2242.16,3
HCPCS,81448,Hc Herdtry Periph Neuropth Rel Genom Seq Anlys Pnl 5+ So,7066.0,4592.9,,,0
HCPCS,81448,Hrdtry perph neurphy panel,,,584.9,2193.38,3
HCPCS,81449,Tgsap so neo 5-50 rna alys,,,597.91,2242.16,3
HCPCS,81450,Hc Tgsap Hematolymphoid Neo/Do 5-50 Genes Rna Analysis So,7155.0,4650.75,,,0
HCPCS,81450,Targeted genomic seq analys,,,759.53,2848.24,3
HCPCS,81451,Tgsap hl neo 5-50 rna alys,,,759.53,2848.24,3
HCPCS,81455,Hc Tgsap Sol Org/ Hematolymphoid Neo/Do 51+ Genes Dna Or Combo So,10530.0,6844.5,,,0
HCPCS,81455,Targeted genomic seq analys,,,2919.6,10948.5,3
HCPCS,81456,Hc Tgsap Sol Org/ Hematolymphoid Neo/Do 51+ Genes Rna Analysis So,9415.0,6119.75,,,0
HCPCS,81456,Tgsap so/hl 51/< rna alys,,,2919.6,10948.5,3
HCPCS,81457,Hc Gsap Sol Org Neo Dna Anal Microsatellite Instab Noncp Mcsrc Special So,11400.0,7410.0,,,0
HCPCS,81457,Hc Gsap Sol Org Neo Dna Anal Microsatellite Instab So,6000.0,3900.0,,,0
HCPCS,81457,So neo gsap dna mcrstl ins,,,896.87,896.87,1
HCPCS,81458,So gsap dna cpy nmbr&mcrstl,,,1046.35,1046.35,1
HCPCS,81459,"Hc Gsap Sol Org Neo Dna Or Combo Anal Cpy Nmbr, Mcrstl, Tum Mut & Rearrg So",14400.0,9360.0,,,0
HCPCS,81459,So neo gsap dna/dna&rna,,,2989.55,2989.55,1
HCPCS,81460,Hc Whole Mitochondrial Genome So,6212.0,4037.8,,,0
HCPCS,81460,Whole mitochondrial genome,,,1287.0,4826.25,3
HCPCS,81462,So gsap cll fr dna/dna&rna,,,1195.83,1195.83,1
HCPCS,81463,Hc Gsap Sol Org Neo Cell Free Nuc Acid Dna Anal Cpy Numbr & Mcrstl Instab So,10800.0,7020.0,,,0
HCPCS,81463,So gsap cl fr cpy nmbr&mcrst,,,1345.31,1345.31,1
HCPCS,81464,So gsap cll fr mcrstl ins,,,3288.51,3288.51,1
HCPCS,81465,Hc Whole Mitochondrial Genome So,2587.0,1681.55,,,0
HCPCS,81465,Whole mitochondrial genome,,,936.0,3510.0,3
HCPCS,81470,X-linked intellectual dblt,,,914.0,3427.5,3
HCPCS,81471,X-linked intellectual dblt,,,914.0,3427.5,3
HCPCS,81479,Hc Mopath Unlisted So,1582.0,1028.3,,,0
HCPCS,81479,Hc Mopath Unlisted Special So,4767.0,3098.55,,,0
HCPCS,81479,Hc Unlisted Molecular Pathology Procedure,1845.0,1199.25,,,0
HCPCS,81490,Autoimmune rheumatoid arthr,,,840.65,3152.44,3
HCPCS,81490,Hc Autoimmune Rheumatoid Arthrts Analys 12 Biomrkrs Vectra So,4657.0,3027.05,,,0
HCPCS,81493,Cor artery disease mrna,,,1050.0,3937.5,3
HCPCS,81500,Onco (ovar) two proteins,,,260.5,976.88,3
HCPCS,81503,Onco (ovar) five proteins,,,897.0,3363.75,3
HCPCS,81504,Oncology tissue of origin,,,520.0,1950.0,3
HCPCS,81506,Endo assay seven anal,,,68.92,258.45,3
HCPCS,81507,Fetal aneuploidy trisom risk,,,795.0,2981.25,3
HCPCS,81508,Ftl cgen abnor two proteins,,,54.3,203.63,3
HCPCS,81509,Ftl cgen abnor 3 proteins,,,1487.37,5577.64,3
HCPCS,81510,Ftl cgen abnor three anal,,,55.54,208.28,3
HCPCS,81511,Ftl cgen abnor four anal,,,153.5,575.63,3
HCPCS,81511,Hc Fet Con Abn Afp4 Algorithm,265.0,172.25,,,0
HCPCS,81511,Hc Fet Con Abn Afp4 Algorithm So,122.0,79.3,,,0
HCPCS,81512,Ftl cgen abnor five anal,,,69.52,260.7,3
HCPCS,81513,Nfct ds bv rna vag flu alg,,,142.63,534.86,3
HCPCS,81514,Nfct ds bv&vaginitis dna alg,,,262.99,986.21,3
HCPCS,81515,Nfct ds bv&vaginitis dna alg,,,262.99,262.99,1
HCPCS,81517,Hc Liver Ds Alys 3 Bmrk Srm Alg,401.0,260.65,,,0
HCPCS,81517,Liver ds alys 3 bmrk srm alg,,,176.19,660.71,3
HCPCS,81518,Onc brst mrna 11 genes,,,3873.0,14523.75,3
HCPCS,81519,Oncology breast mrna,,,3873.0,14523.75,3
HCPCS,81520,Onc breast mrna 58 genes,,,2510.21,9413.29,3
HCPCS,81521,Onc breast mrna 70 genes,,,3873.0,14523.75,3
HCPCS,81522,Onc breast mrna 12 genes,,,3873.0,14523.75,3
HCPCS,81523,Onc brst mrna 70 cnt 31 gene,,,3873.0,14523.75,3
HCPCS,81525,Oncology colon mrna,,,3116.0,11685.0,3
HCPCS,81528,Oncology colorectal scr,,,508.87,1908.26,3
HCPCS,81529,Onc cutan mlnma mrna 31 gene,,,7193.0,26973.75,3
HCPCS,81535,Oncology gynecologic,,,579.46,2172.98,3
HCPCS,81536,Oncology gynecologic,,,177.56,665.85,3
HCPCS,81538,Oncology lung,,,2871.0,10766.25,3
HCPCS,81539,Oncology prostate prob score,,,760.0,2850.0,3
HCPCS,81540,Oncology tum unknown origin,,,3750.0,14062.5,3
HCPCS,81541,Onc prostate mrna 46 genes,,,3873.0,14523.75,3
HCPCS,81542,Onc prostate mrna 22 cnt gen,,,3873.0,14523.75,3
HCPCS,81546,"Onc thyr mrna 10,196 gen alg",,,3600.0,13500.0,3
HCPCS,81551,Onc prostate 3 genes,,,2030.0,7612.5,3
HCPCS,81552,Onc uveal mlnma mrna 15 gene,,,7776.0,29160.0,3
HCPCS,81554,Pulm ds ipf mrna 190 gen alg,,,5409.6,20700.0,3
HCPCS,81558,Trnspl rej kdn mrna qpcr 139,,,3240.0,3240.0,1
HCPCS,81560,Trnsplj pd lvr&bwl cd154+cll,,,640.73,2402.74,3
HCPCS,81595,Cardiology hrt trnspl mrna,,,3240.0,12150.0,3
HCPCS,81596,Hc Chronic Hepatitis C Virus (Hcv) Infection Six Biochemical Assays Serum So,826.0,536.9,,,0
HCPCS,81596,Nfct ds chrnc hcv 6 assays,,,72.19,270.71,3
HCPCS,82009,Hc Ketone Bodies Serum Qualitative,81.0,52.65,,,0
HCPCS,82009,Test for acetone/ketones,,,4.52,16.95,3
HCPCS,82010,Acetone assay,,,8.17,30.64,3
HCPCS,82010,Hc Ketone Bodies Quantitative So,145.0,94.25,,,0
HCPCS,82010,Hc Ketone Bodies Serum Quantitative,114.0,74.1,,,0
HCPCS,82013,Acetylcholinesterase assay,,,12.29,46.09,3
HCPCS,82013,Hc Acetylcholinesterase So,361.0,234.65,,,0
HCPCS,82016,Acylcarnitines qual,,,16.49,61.84,3
HCPCS,82017,Acylcarnitines quant,,,16.87,63.26,3
HCPCS,82017,Hc Acylcarnitines Quantitative So,195.0,126.75,,,0
HCPCS,82024,Assay of acth,,,38.62,144.83,3
HCPCS,82024,Hc Acth,117.0,76.05,,,0
HCPCS,82030,Assay of adp & amp,,,25.8,96.75,3
HCPCS,82030,Hc Cyclic Amp,180.0,117.0,,,0
HCPCS,82040,Assay of serum albumin,,,4.95,18.56,3
HCPCS,82040,Hc Albumin,10.0,6.5,,,0
HCPCS,82040,Hc Albumin So,10.0,6.5,,,0
HCPCS,82040,Hc Albumin Specials,10.0,6.5,,,0
HCPCS,82040,Hc Fsed Albumin,10.0,6.5,,,0
HCPCS,82042,Assay of urine albumin,,,7.78,29.18,3
HCPCS,82042,"Hc Albumin Other Source, Quant, Ea Spec",178.0,115.7,,,0
HCPCS,82042,"Hc Albumin Othr Source, Qnt, Ea Spec",178.0,115.7,,,0
HCPCS,82043,Hc Microalbumin Urine Quantitative,86.0,55.9,,,0
HCPCS,82043,Microalbumin quantitative,,,5.78,21.68,3
HCPCS,82044,Microalbumin semiquant,,,6.23,23.36,3
HCPCS,82045,Albumin ischemia modified,,,33.94,127.28,3
HCPCS,82075,Assay of breath ethanol,,,30.0,112.5,3
HCPCS,82077,Assay spec xcp ur&breath ia,,,17.27,64.76,3
HCPCS,82077,"Hc Alcohol (Ethanol) Level, Except Urine And Breath",225.0,146.25,,,0
HCPCS,82085,Assay of aldolase,,,9.71,36.41,3
HCPCS,82085,Hc Aldolase So,27.0,17.55,,,0
HCPCS,82088,Assay of aldosterone,,,40.75,152.81,3
HCPCS,82088,Hc Aldosterone,91.0,59.15,,,0
HCPCS,82088,Hc Aldosterone So,57.0,37.05,,,0
HCPCS,82103,Alpha-1-antitrypsin total,,,13.44,50.4,3
HCPCS,82103,Hc Alpha 1 Antitrypsin Total,117.0,76.05,,,0
HCPCS,82103,Hc Alpha 1 Antitrypsin Total So,68.0,44.2,,,0
HCPCS,82104,Alpha-1-antitrypsin pheno,,,14.46,54.23,3
HCPCS,82104,Hc Alpha-1 Antitrypsin Phenotype So,120.0,78.0,,,0
HCPCS,82105,Alpha-fetoprotein serum,,,16.77,62.89,3
HCPCS,82105,Hc Alpha Fetoprotein Serum,71.0,46.15,,,0
HCPCS,82106,Alpha-fetoprotein amniotic,,,17.0,63.75,3
HCPCS,82106,Hc Alpha Fetoprotein Amniotic Fluid So,148.0,96.2,,,0
HCPCS,82107,Alpha-Fetoprotein L3,,,64.41,241.54,3
HCPCS,82107,Hc Afp L3 Fract Isoform And Total Afp W Ratio,291.0,189.15,,,0
HCPCS,82108,Assay of aluminum,,,25.48,95.55,3
HCPCS,82108,Hc Aluminum,115.0,74.75,,,0
HCPCS,82120,Amines vaginal fluid qual,,,5.99,22.46,3
HCPCS,82127,Amino acid single qual,,,14.18,53.18,3
HCPCS,82128,Amino acids mult qual,,,13.87,52.01,3
HCPCS,82131,Amino acids single quant,,,22.98,86.18,3
HCPCS,82131,Hc Amino Acids Single Quantitative Ea Specimen So,475.0,308.75,,,0
HCPCS,82135,Assay aminolevulinic acid,,,16.45,61.69,3
HCPCS,82135,Hc Aminolevulinic Acid Ala So,206.0,133.9,,,0
HCPCS,82136,Amino acids quant 2-5,,,19.61,73.54,3
HCPCS,82136,Hc Amino Acids Quantitative 2-5 So,231.0,150.15,,,0
HCPCS,82139,Amino acids quan 6 or more,,,16.87,63.26,3
HCPCS,82139,Hc Amino Acids Quant More Than 5 Plasma Or Urine,507.0,329.55,,,0
HCPCS,82139,Hc Amino Acids Quant More Than 5 So,470.0,305.5,,,0
HCPCS,82140,Assay of ammonia,,,14.57,54.64,3
HCPCS,82140,Hc Ammonia,59.0,38.35,,,0
HCPCS,82140,Hc Ammonia So,350.0,227.5,,,0
HCPCS,82143,Amniotic fluid scan,,,9.35,35.06,3
HCPCS,82150,Assay of amylase,,,6.48,24.3,3
HCPCS,82150,Hc Amylase,83.0,53.95,,,0
HCPCS,82150,Hc Amylase So,118.0,76.7,,,0
HCPCS,82150,Hc Fsed Amylase,83.0,53.95,,,0
HCPCS,82154,Androstanediol glucuronide,,,28.83,108.11,3
HCPCS,82157,Assay of androstenedione,,,29.28,109.8,3
HCPCS,82157,Hc Androstenedione So,74.0,48.1,,,0
HCPCS,82160,Assay of androsterone,,,25.55,95.81,3
HCPCS,82163,Assay of angiotensin II,,,20.52,76.95,3
HCPCS,82163,Hc Angiotensin Ii So,75.0,48.75,,,0
HCPCS,82164,Angiotensin I enzyme test,,,14.6,54.75,3
HCPCS,82164,Hc Angiotensin I Converting Enzyme So,30.0,19.5,,,0
HCPCS,82164,"Hc Angiotensin I-Converting Enzyme, Csf So",206.0,133.9,,,0
HCPCS,82166,Assay anti-mullerian horm,,,38.62,144.83,3
HCPCS,82166,Hc Assay Anti-Mullerian Hormone So,169.0,109.85,,,0
HCPCS,82172,Assay of apolipoprotein,,,21.09,79.09,3
HCPCS,82172,Hc Apolipoprotein A 1 So,94.0,61.1,,,0
HCPCS,82172,Hc Apolipoprotein B,112.0,72.8,,,0
HCPCS,82175,Assay of arsenic,,,18.97,71.14,3
HCPCS,82175,Hc Arsenic,256.0,166.4,,,0
HCPCS,82175,Hc Arsenic So,320.0,208.0,,,0
HCPCS,82175,Hc Arsenic Special So,92.0,59.8,,,0
HCPCS,82180,Assay of ascorbic acid,,,9.89,37.09,3
HCPCS,82180,Hc Vitamin C (Ascorbic Acid) So,102.0,66.3,,,0
HCPCS,82190,Atomic absorption,,,15.9,59.63,3
HCPCS,82232,Assay of beta-2 protein,,,16.18,60.68,3
HCPCS,82232,Hc Beta 2 Microglobulin,240.0,156.0,,,0
HCPCS,82232,Hc Beta 2 Microglobulin Fluid So,88.0,57.2,,,0
HCPCS,82233,Beta-amyloid 1-40 (abeta 40),,,128.92,128.92,1
HCPCS,82234,Beta-amyloid 1-42 (abeta 42),,,128.92,128.92,1
HCPCS,82234,Hc Beta-Amyloid 1-42 (Abeta 42),878.0,570.7,,,0
HCPCS,82239,Bile acids total,,,17.12,64.2,3
HCPCS,82239,Hc Bile Acids Total So,145.0,94.25,,,0
HCPCS,82240,Bile acids cholylglycine,,,26.58,99.68,3
HCPCS,82247,Bilirubin total,,,5.02,18.83,3
HCPCS,82247,Hc Bilirubin Total,10.0,6.5,,,0
HCPCS,82247,Hc Fsed Bilirubin Total,10.0,6.5,,,0
HCPCS,82248,Bilirubin direct,,,5.02,18.83,3
HCPCS,82248,Hc Bilirubin Direct,70.0,45.5,,,0
HCPCS,82252,Fecal bilirubin test,,,4.56,17.1,3
HCPCS,82261,Assay of biotinidase,,,16.87,63.26,3
HCPCS,82261,Hc Biotinidase So,70.0,45.5,,,0
HCPCS,82270,Hc Fsed Occult Blood Stool,72.0,46.8,,,0
HCPCS,82270,Hc Occult Blood Stool,72.0,46.8,,,0
HCPCS,82270,Occult blood feces,,,4.38,16.43,3
HCPCS,82271,Hc Fsed Gastrocult Gastric,70.0,45.5,,,0
HCPCS,82271,Hc Gastrocult Gastric,70.0,45.5,,,0
HCPCS,82271,Occult blood other sources,,,5.32,19.95,3
HCPCS,82272,Hc Occult Blood Stool 1-3 Simult Det,50.0,32.5,,,0
HCPCS,82272,Occult bld feces 1-3 tests,,,4.23,15.86,3
HCPCS,82274,Assay test for blood fecal,,,15.92,59.7,3
HCPCS,82274,Hc Occult Blood Fecal Ia,89.0,57.85,,,0
HCPCS,82286,Assay of bradykinin,,,5.16,19.35,3
HCPCS,82300,Assay of cadmium,,,23.64,88.65,3
HCPCS,82300,Hc Cadmium,201.0,130.65,,,0
HCPCS,82300,Hc Cadmium So,104.0,67.6,,,0
HCPCS,82306,Hc 25-Hydroxyvitamin D2 And D3 So,25.0,16.25,,,0
HCPCS,82306,Hc Vitamin D Total 25-Oh,134.0,87.1,,,0
HCPCS,82306,Vitamin d 25 hydroxy,,,29.6,111.0,3
HCPCS,82308,Assay of calcitonin,,,26.79,100.46,3
HCPCS,82308,Hc Calcitonin So,68.0,44.2,,,0
HCPCS,82310,Assay of calcium,,,5.16,19.35,3
HCPCS,82310,Hc Calcium Total,9.0,5.85,,,0
HCPCS,82310,Hc Calcium Total So,77.0,50.05,,,0
HCPCS,82310,Hc Fsed Calcium Total,9.0,5.85,,,0
HCPCS,82330,Assay of calcium,,,13.68,51.3,3
HCPCS,82330,Hc Calcium Ionized,69.0,44.85,,,0
HCPCS,82330,Hc Calcium Ionized Amb,69.0,44.85,,,0
HCPCS,82330,Hc Calcium Ionized Wb  Cath Lab,69.0,44.85,,,0
HCPCS,82330,Hc Calcium Ionized Wb  Pulm,69.0,44.85,,,0
HCPCS,82330,Hc Calcium Ionized Wb Perfusion,69.0,44.85,,,0
HCPCS,82330,Hc Fsed Calcium Ionized,69.0,44.85,,,0
HCPCS,82330,Hc Mstu Calcium Ionized,69.0,44.85,,,0
HCPCS,82331,Calcium infusion test,,,13.34,50.03,3
HCPCS,82340,Assay of calcium in urine,,,6.03,22.61,3
HCPCS,82340,Hc Calcium Urine So,69.0,44.85,,,0
HCPCS,82340,Hc Calcium Urine Timed,87.0,56.55,,,0
HCPCS,82355,Calculus analysis qual,,,11.58,43.43,3
HCPCS,82360,Calculus assay quant,,,12.87,48.26,3
HCPCS,82365,Calculus spectroscopy,,,12.9,48.38,3
HCPCS,82365,Hc Calculus Anlys Infrared Spectroscopy So,51.0,33.15,,,0
HCPCS,82370,X-ray assay calculus,,,12.52,46.95,3
HCPCS,82373,Assay c-d transfer measure,,,18.06,67.73,3
HCPCS,82373,Hc Carbohydrate Deficient Transferrin So,148.0,96.2,,,0
HCPCS,82374,Assay blood carbon dioxide,,,4.88,18.3,3
HCPCS,82374,Hc Bicarbonate,9.0,5.85,,,0
HCPCS,82374,Hc Carbon Dioxide (Bicarbonate) So,9.0,5.85,,,0
HCPCS,82374,Hc Fsed Bicarbonate,9.0,5.85,,,0
HCPCS,82374,Hc Mstu Bicarbonate Total (Tco2),9.0,5.85,,,0
HCPCS,82375,Assay carboxyhb quant,,,12.32,46.2,3
HCPCS,82375,Hc Carboxyhemoglobin,115.0,74.75,,,0
HCPCS,82375,Hc Carboxyhemoglobin Cath Lab,115.0,74.75,,,0
HCPCS,82375,Hc Carboxyhemoglobin Perfusion,115.0,74.75,,,0
HCPCS,82375,Hc Carboxyhemoglobin Pulm,115.0,74.75,,,0
HCPCS,82376,Assay carboxyhb qual,,,14.07,52.76,3
HCPCS,82378,Carcinoembryonic antigen,,,18.96,71.1,3
HCPCS,82378,Hc Cea,149.0,96.85,,,0
HCPCS,82378,Hc Cea So,414.0,269.1,,,0
HCPCS,82379,Assay of carnitine,,,16.87,63.26,3
HCPCS,82379,Hc Carnitine So,93.0,60.45,,,0
HCPCS,82380,Assay of carotene,,,9.22,34.58,3
HCPCS,82380,Hc Carotene So,508.0,330.2,,,0
HCPCS,82382,Assay urine catecholamines,,,27.3,102.38,3
HCPCS,82383,Assay blood catecholamines,,,29.08,109.05,3
HCPCS,82384,Assay three catecholamines,,,25.25,94.69,3
HCPCS,82384,Hc Catecholamines Fraction So,78.0,50.7,,,0
HCPCS,82387,Assay of cathepsin-d,,,18.06,67.73,3
HCPCS,82390,Assay of ceruloplasmin,,,10.74,40.28,3
HCPCS,82390,Hc Ceruloplasmin,115.0,74.75,,,0
HCPCS,82397,Chemiluminescent assay,,,14.12,52.95,3
HCPCS,82397,Hc Chemiluminescent Assay So,98.0,63.7,,,0
HCPCS,82397,Hc Chemiluminescent Assay Special So,528.0,343.2,,,0
HCPCS,82415,Assay of chloramphenicol,,,12.67,47.51,3
HCPCS,82435,Assay of blood chloride,,,4.6,17.25,3
HCPCS,82435,Hc Chloride Blood,9.0,5.85,,,0
HCPCS,82435,Hc Chloride Blood Amb,9.0,5.85,,,0
HCPCS,82435,Hc Chloride Wb Cath Lab,9.0,5.85,,,0
HCPCS,82435,Hc Chloride Wb Perfusion,9.0,5.85,,,0
HCPCS,82435,Hc Chloride Wb Pulm,9.0,5.85,,,0
HCPCS,82435,Hc Fsed Chloride Blood,9.0,5.85,,,0
HCPCS,82435,Hc Mstu Chloride Blood,9.0,5.85,,,0
HCPCS,82436,Assay of urine chloride,,,5.75,21.56,3
HCPCS,82436,Hc Chloride Urine,67.0,43.55,,,0
HCPCS,82436,Hc Chloride Urine So,34.0,22.1,,,0
HCPCS,82438,Assay other fluid chlorides,,,5.0,18.75,3
HCPCS,82438,Hc Chloride Body Fluid,51.0,33.15,,,0
HCPCS,82438,Hc Chloride Stool So,29.0,18.85,,,0
HCPCS,82441,Hc Chlorinated Hydrocarbons Screen So,387.0,251.55,,,0
HCPCS,82441,Test for chlorohydrocarbons,,,6.01,22.54,3
HCPCS,82465,Assay bld/serum cholesterol,,,4.35,16.31,3
HCPCS,82465,Hc Cholesterol Total,51.0,33.15,,,0
HCPCS,82480,Assay serum cholinesterase,,,7.87,29.51,3
HCPCS,82480,Hc Cholinesterase Serum So,31.0,20.15,,,0
HCPCS,82482,Assay rbc cholinesterase,,,9.81,36.79,3
HCPCS,82482,Hc Cholinesterase Rbc So,65.0,42.25,,,0
HCPCS,82485,Assay chondroitin sulfate,,,20.65,77.44,3
HCPCS,82495,Assay of chromium,,,20.28,76.05,3
HCPCS,82495,Hc Chromium So,161.0,104.65,,,0
HCPCS,82495,Hc Chromium Whole Blood Or Fluid So,970.0,630.5,,,0
HCPCS,82507,Assay of citrate,,,27.8,104.25,3
HCPCS,82507,Hc Citrate So,49.0,31.85,,,0
HCPCS,82523,Collagen crosslinks,,,18.68,70.05,3
HCPCS,82523,Hc Collagen Cross Links Any Method So,338.0,219.7,,,0
HCPCS,82525,Assay of copper,,,12.41,46.54,3
HCPCS,82525,Hc Atomic Absorption Spectroscopy Ea Analyte So,404.0,262.6,,,0
HCPCS,82525,Hc Copper So,86.0,55.9,,,0
HCPCS,82528,Assay of corticosterone,,,22.52,84.45,3
HCPCS,82528,Hc Corticosterone So,71.0,46.15,,,0
HCPCS,82530,Cortisol free,,,16.71,62.66,3
HCPCS,82530,Hc Cortisol Free,301.0,195.65,,,0
HCPCS,82530,Hc Cortisol Free So,56.0,36.4,,,0
HCPCS,82533,Hc Cortisol Total,72.0,46.8,,,0
HCPCS,82533,Hc Cortisol Total So,135.0,87.75,,,0
HCPCS,82533,Total cortisol,,,16.3,61.13,3
HCPCS,82540,Assay of creatine,,,4.64,17.4,3
HCPCS,82540,Hc Creatine So,60.0,39.0,,,0
HCPCS,82542,Col chromotography qual/quan,,,24.09,90.34,3
HCPCS,82542,Hc Chromatography Qn Column Multi,873.0,567.45,,,0
HCPCS,82542,Hc Chromatography Qn Column Single So,377.0,245.05,,,0
HCPCS,82542,Hc Col Chrom Incl Ms Ql/Qt Nes Each Spec So,2229.0,1448.85,,,0
HCPCS,82542,Hc Col Chromotography Qual/Quan So,306.0,198.9,,,0
HCPCS,82550,Assay of ck (cpk),,,6.51,24.41,3
HCPCS,82550,Hc Cpk,65.0,42.25,,,0
HCPCS,82552,Assay of cpk in blood,,,13.39,50.21,3
HCPCS,82552,Hc Cpk Isoenzymes So,71.0,46.15,,,0
HCPCS,82553,Creatine mb fraction,,,11.55,43.31,3
HCPCS,82553,Hc Cpk Mb Only,64.0,41.6,,,0
HCPCS,82554,Creatine isoforms,,,11.87,44.51,3
HCPCS,82565,Assay of creatinine,,,5.12,19.2,3
HCPCS,82565,Hc Creatinine,9.0,5.85,,,0
HCPCS,82565,Hc Creatinine Amb,9.0,5.85,,,0
HCPCS,82565,Hc Fsed Creatinine,9.0,5.85,,,0
HCPCS,82565,Hc Mstu Creatinine,9.0,5.85,,,0
HCPCS,82570,Assay of urine creatinine,,,5.18,19.43,3
HCPCS,82570,Hc Creatinine Other Source,51.0,33.15,,,0
HCPCS,82570,Hc Creatinine Other Source So,47.0,30.55,,,0
HCPCS,82570,Hc Creatinine W Microalbumin,51.0,33.15,,,0
HCPCS,82575,Creatinine clearance test,,,9.46,35.48,3
HCPCS,82575,Hc Creatinine Clearance,48.0,31.2,,,0
HCPCS,82585,Assay of cryofibrinogen,,,14.14,53.03,3
HCPCS,82585,Hc Cryofibrinogen,117.0,76.05,,,0
HCPCS,82595,Assay of cryoglobulin,,,6.47,24.26,3
HCPCS,82595,Hc Cryoglobulin,108.0,70.2,,,0
HCPCS,82600,Assay of cyanide,,,19.4,72.75,3
HCPCS,82600,Hc Cyanide So,191.0,124.15,,,0
HCPCS,82607,Hc Vitamin B 12,62.0,40.3,,,0
HCPCS,82607,Vitamin B-12,,,15.08,56.55,3
HCPCS,82608,B-12 binding capacity,,,14.32,53.7,3
HCPCS,82608,Hc Vitamin B 12 Binding So,457.0,297.05,,,0
HCPCS,82610,Cystatin c,,,18.52,69.45,3
HCPCS,82610,Hc Cystatin C So,128.0,83.2,,,0
HCPCS,82615,Test for urine cystines,,,9.55,35.81,3
HCPCS,82626,Dehydroepiandrosterone,,,25.27,94.76,3
HCPCS,82626,Hc Dhea So,62.0,40.3,,,0
HCPCS,82627,Dehydroepiandrosterone,,,22.23,83.36,3
HCPCS,82627,Hc Dhea Sulfate Dhea S,88.0,57.2,,,0
HCPCS,82633,Desoxycorticosterone,,,30.98,116.18,3
HCPCS,82633,Hc Desoxycorticosteroid,775.0,503.75,,,0
HCPCS,82633,Hc Desoxycorticosteroid So,71.0,46.15,,,0
HCPCS,82634,Deoxycortisol,,,29.28,109.8,3
HCPCS,82634,Hc Deoxycortisol  11 So,119.0,77.35,,,0
HCPCS,82638,Assay of dibucaine number,,,12.25,45.94,3
HCPCS,82638,Hc Dibucaine Number,126.0,81.9,,,0
HCPCS,82642,Dihydrotestosterone,,,29.28,109.8,3
HCPCS,82642,Hc Dihydrotestosterone (Dht) So,120.0,78.0,,,0
HCPCS,82652,Hc Vitamin D (1 25 Dihydroxy),133.0,86.45,,,0
HCPCS,82652,Vit d 1 25-dihydroxy,,,38.5,144.38,3
HCPCS,82653,El-1 fecal quantitative,,,22.97,86.14,3
HCPCS,82653,Hc Elastase Pancreatic Fecal Quantitative So,317.0,206.05,,,0
HCPCS,82656,Hc Pancreatic Elastase 1 (Pe1) So,240.0,156.0,,,0
HCPCS,82656,Pancreatic elastase fecal,,,11.53,43.24,3
HCPCS,82657,Enzyme cell activity,,,22.17,83.14,3
HCPCS,82657,Hc Enzyme Act Blood Cell Tiss Non Rad Nes Ea Spec So,292.0,189.8,,,0
HCPCS,82657,Hc Enzyme Act Blood Cell Tiss Non Rad Nes Ea Special So,1080.0,702.0,,,0
HCPCS,82658,Enzyme cell activity ra,,,44.03,165.11,3
HCPCS,82658,Hc Enzyme Act Blood Cell Tiss Radact Substrate Ea So,574.0,373.1,,,0
HCPCS,82664,Electrophoretic test,,,61.5,230.63,3
HCPCS,82664,Hc Electrophoresis Nes So,189.0,122.85,,,0
HCPCS,82668,Assay of erythropoietin,,,18.79,70.46,3
HCPCS,82668,Hc Erythropoietin,89.0,57.85,,,0
HCPCS,82670,Assay of estradiol,,,27.94,104.78,3
HCPCS,82670,Hc Estradiol; Total,53.0,34.45,,,0
HCPCS,82670,Hc Estradiol; Total So,68.0,44.2,,,0
HCPCS,82671,Assay of estrogens,,,32.3,121.13,3
HCPCS,82672,Assay of estrogen,,,21.7,81.38,3
HCPCS,82677,Assay of estriol,,,24.18,90.68,3
HCPCS,82677,Hc Estriol,340.0,221.0,,,0
HCPCS,82679,Assay of estrone,,,24.95,93.56,3
HCPCS,82679,Hc Estrone,488.0,317.2,,,0
HCPCS,82679,Hc Estrone So,31.0,20.15,,,0
HCPCS,82681,Assay dir meas fr estradiol,,,27.94,104.78,3
HCPCS,82681,"Hc Estradiol Free, Direct Measure",779.0,506.35,,,0
HCPCS,82681,"Hc Estradiol Free, Direct Measure So",437.0,284.05,,,0
HCPCS,82693,Assay of ethylene glycol,,,14.9,55.88,3
HCPCS,82693,Hc Ethylene Glycol So,271.0,176.15,,,0
HCPCS,82696,Assay of etiocholanolone,,,26.24,98.4,3
HCPCS,82705,Fats/lipids feces qual,,,5.1,19.13,3
HCPCS,82710,Fats/lipids feces quant,,,16.8,63.0,3
HCPCS,82710,Hc Fat Lipids Stool Quant So,102.0,66.3,,,0
HCPCS,82715,Assay of fecal fat,,,22.97,86.14,3
HCPCS,82725,Assay of blood fatty acids,,,18.77,70.39,3
HCPCS,82725,Hc Fatty Acids Nonesterified So,98.0,63.7,,,0
HCPCS,82725,Hc Fatty Acids Nonesterified Special Fapep So,280.0,182.0,,,0
HCPCS,82726,Hc Fatty Acids Very Long Chain So,184.0,119.6,,,0
HCPCS,82726,Long chain fatty acids,,,19.75,74.06,3
HCPCS,82728,Assay of ferritin,,,13.63,51.11,3
HCPCS,82728,Hc Ferritin,62.0,40.3,,,0
HCPCS,82728,Hc Ferritin So,246.0,159.9,,,0
HCPCS,82731,Assay of fetal fibronectin,,,64.41,241.54,3
HCPCS,82731,Hc Fetal Fibronectin (Ffn),269.0,174.85,,,0
HCPCS,82735,Assay of fluoride,,,18.54,69.53,3
HCPCS,82735,Hc Fluoride So,193.0,125.45,,,0
HCPCS,82746,Assay of folic acid serum,,,14.7,55.13,3
HCPCS,82746,Hc Folic Acid Serum,62.0,40.3,,,0
HCPCS,82747,Assay of folic acid rbc,,,17.65,66.19,3
HCPCS,82747,Hc Folate For Rbc,67.0,43.55,,,0
HCPCS,82757,Assay of semen fructose,,,17.34,65.03,3
HCPCS,82757,Hc Fructose Semen So,310.0,201.5,,,0
HCPCS,82759,Assay of rbc galactokinase,,,21.48,80.55,3
HCPCS,82760,Assay of galactose,,,11.2,42.0,3
HCPCS,82760,Hc Galactose So,1113.0,723.45,,,0
HCPCS,82775,Assay galactose transferase,,,21.07,79.01,3
HCPCS,82775,Hc Galactose Transferase G 1 Put Qn So,131.0,85.15,,,0
HCPCS,82776,Galactose transferase test,,,11.74,44.03,3
HCPCS,82777,Galectin-3,,,44.25,165.94,3
HCPCS,82777,Hc Galectin 3 So,349.0,226.85,,,0
HCPCS,82784,Assay iga/igd/igg/igm each,,,9.3,34.88,3
HCPCS,82784,Hc Igg Iga Igm Immunoglobulins,109.0,70.85,,,0
HCPCS,82784,Hc Igg Iga Igm Immunoglobulins So,125.0,81.25,,,0
HCPCS,82785,Assay of ige,,,16.46,61.73,3
HCPCS,82785,Hc Ige Immunoglobulins So,41.0,26.65,,,0
HCPCS,82787,Hc Immunoglobulin Subclasses Each So,83.0,53.95,,,0
HCPCS,82787,Igg 1 2 3 or 4 each,,,8.02,30.08,3
HCPCS,82800,Blood pH,,,11.0,41.25,3
HCPCS,82800,Hc Ph Blood Gas,95.0,61.75,,,0
HCPCS,82803,Blood gases any combination,,,26.07,97.76,3
HCPCS,82803,Hc Arterial Blood Gases,111.0,72.15,,,0
HCPCS,82803,Hc Arterial Blood Gases Lab,111.0,72.15,,,0
HCPCS,82803,Hc Fsed Arterial Blood Gases,111.0,72.15,,,0
HCPCS,82805,Blood gases w/o2 saturation,,,78.77,295.39,3
HCPCS,82805,Hc Abg With Direct O2 Saturation,111.0,72.15,,,0
HCPCS,82805,Hc Abg With Direct O2 Saturation Cath Lab,111.0,72.15,,,0
HCPCS,82805,Hc Abg With Direct O2 Saturation Perfusion,111.0,72.15,,,0
HCPCS,82805,Hc Abg With Direct O2 Saturation Pulm,111.0,72.15,,,0
HCPCS,82810,Blood gases o2 sat only,,,9.77,36.64,3
HCPCS,82810,Hc Direct O2 Saturation,155.0,100.75,,,0
HCPCS,82810,Hc O2 Saturation Direct,75.0,48.75,,,0
HCPCS,82810,Hc O2 Saturation Direct Cath Lab,155.0,100.75,,,0
HCPCS,82820,Hemoglobin-oxygen affinity,,,13.34,50.03,3
HCPCS,82930,Gastric analy w/ph ea spec,,,6.71,25.16,3
HCPCS,82938,Gastrin test,,,17.69,66.34,3
HCPCS,82941,Assay of gastrin,,,17.63,66.11,3
HCPCS,82941,Hc Gastrin So,54.0,35.1,,,0
HCPCS,82943,Assay of glucagon,,,14.29,53.59,3
HCPCS,82943,Hc Glucagon So,143.0,92.95,,,0
HCPCS,82945,Glucose Other Fluid,,,3.93,14.74,3
HCPCS,82945,Hc Glucose Body Fluid,71.0,46.15,,,0
HCPCS,82945,Hc Glucose Body Fluid Not Blood So,69.0,44.85,,,0
HCPCS,82946,Glucagon tolerance test,,,17.77,66.64,3
HCPCS,82947,Assay glucose blood quant,,,3.93,14.74,3
HCPCS,82947,Hc Fsed Glucose Quantitative Blood,9.0,5.85,,,0
HCPCS,82947,Hc Glucose Quant Blood,9.0,5.85,,,0
HCPCS,82947,Hc Glucose Quantitative Amb,9.0,5.85,,,0
HCPCS,82947,Hc Glucose Quantitative Blood,9.0,5.85,,,0
HCPCS,82947,Hc Glucose Quantitative Cath Lab,9.0,5.85,,,0
HCPCS,82947,Hc Glucose Quantitative Perfusion,9.0,5.85,,,0
HCPCS,82947,Hc Glucose Quantitative Pulmonary,9.0,5.85,,,0
HCPCS,82947,Hc Mstu Glucose Quant Blood,9.0,5.85,,,0
HCPCS,82948,Reagent strip/blood glucose,,,5.04,18.9,3
HCPCS,82950,Glucose test,,,4.75,17.81,3
HCPCS,82950,Hc Glucose Post Glucose Dose,21.0,13.65,,,0
HCPCS,82951,Glucose tolerance test (GTT),,,12.87,48.26,3
HCPCS,82951,Hc Glucose Tolerance 1St 3 Specimen,46.0,29.9,,,0
HCPCS,82952,GTT-added samples,,,3.92,14.7,3
HCPCS,82952,Hc Glucose Tolerance Addl Specimen,45.0,29.25,,,0
HCPCS,82955,Assay of g6pd enzyme,,,9.7,36.38,3
HCPCS,82955,Hc G6Pd Enzyme Quant So,93.0,60.45,,,0
HCPCS,82955,Hc G6Pd Enzyme Quant Special Eeev1 So,602.0,391.3,,,0
HCPCS,82960,Test for G6PD enzyme,,,6.05,22.69,3
HCPCS,82962,Glucose blood test,,,3.28,12.3,3
HCPCS,82963,Assay of glucosidase,,,21.48,80.55,3
HCPCS,82963,Hc Glucosidase Beta So,1547.0,1005.55,,,0
HCPCS,82965,Assay of gdh enzyme,,,13.15,49.31,3
HCPCS,82977,Assay of GGT,,,7.2,27.0,3
HCPCS,82977,Hc Fsed Glutramyltransferase Gamma Ggt,51.0,33.15,,,0
HCPCS,82977,Hc Glutramyltransferase Gamma Ggt,51.0,33.15,,,0
HCPCS,82978,Assay of glutathione,,,15.45,57.94,3
HCPCS,82978,Hc Glutathione So,1054.0,685.1,,,0
HCPCS,82979,Assay rbc glutathione,,,9.44,35.4,3
HCPCS,82985,Assay of glycated protein,,,16.76,62.85,3
HCPCS,82985,Hc Glycated Protein So,57.0,37.05,,,0
HCPCS,83001,Assay of gonadotropin (fsh),,,18.58,69.68,3
HCPCS,83001,Hc Fsh,39.0,25.35,,,0
HCPCS,83002,Assay of gonadotropin (lh),,,18.52,69.45,3
HCPCS,83002,Hc Luteinizing Hormone Lh,53.0,34.45,,,0
HCPCS,83002,Hc Luteinizing Hormone Lh So,330.0,214.5,,,0
HCPCS,83003,Assay growth hormone (hgh),,,16.67,62.51,3
HCPCS,83003,Hc Human Growth Hormone (Hgh),276.0,179.4,,,0
HCPCS,83006,Growth stimulation gene 2,,,75.6,283.5,3
HCPCS,83009,H pylori (c-13) blood,,,67.36,252.6,3
HCPCS,83010,Assay of haptoglobin quant,,,12.58,47.18,3
HCPCS,83010,Hc Haptoglobin,77.0,50.05,,,0
HCPCS,83012,Assay of haptoglobins,,,26.89,100.84,3
HCPCS,83013,H pylori (c-13) breath,,,67.36,252.6,3
HCPCS,83013,Hc H Pylori Breath So,102.0,66.3,,,0
HCPCS,83014,H pylori drug admin,,,7.86,29.48,3
HCPCS,83015,Heavy metal qual any anal,,,20.94,78.53,3
HCPCS,83018,Hc Heavy Metal Quant Nes So,151.0,98.15,,,0
HCPCS,83018,Hc Heavy Metal Quant Nes Special So,802.0,521.3,,,0
HCPCS,83018,Heavy metal quant each nes,,,21.96,82.35,3
HCPCS,83020,Hc Hemoglobin Fraction And Quant By Electrophoresis So,231.0,150.15,,,0
HCPCS,83020,Hc Hemoglobin Other,1745.0,1134.25,,,0
HCPCS,83020,Hemoglobin electrophoresis,,,12.87,48.26,3
HCPCS,83021,Hc Hemoglobin Chromatography,1424.0,925.6,,,0
HCPCS,83021,Hc Hemoglobin Fraction And Quant By Chromatography So,84.0,54.6,,,0
HCPCS,83021,Hemoglobin chromotography,,,18.06,67.73,3
HCPCS,83026,Hemoglobin copper sulfate,,,4.01,15.04,3
HCPCS,83030,Fetal hemoglobin chemical,,,10.74,40.28,3
HCPCS,83033,Fetal hemoglobin assay qual,,,8.0,30.0,3
HCPCS,83036,Glycosylated hemoglobin test,,,9.71,36.41,3
HCPCS,83036,Hc Hemoglobin A1C,102.0,66.3,,,0
HCPCS,83037,Glycosylated hb home device,,,9.71,36.41,3
HCPCS,83045,Blood methemoglobin test,,,6.49,24.34,3
HCPCS,83050,Blood methemoglobin assay,,,8.2,30.75,3
HCPCS,83050,Hc Methemoglobin Blood Quant So,83.0,53.95,,,0
HCPCS,83050,Hc Methemoglobin Quantitative,67.0,43.55,,,0
HCPCS,83050,Hc Methemoglobin Quantitative Cath Lab,67.0,43.55,,,0
HCPCS,83050,Hc Methemoglobin Quantitative Lab,67.0,43.55,,,0
HCPCS,83050,Hc Methemoglobin Quantitative Perfusion,67.0,43.55,,,0
HCPCS,83051,Assay of plasma hemoglobin,,,7.31,27.41,3
HCPCS,83051,Hc Hemoglobin Plasma,201.0,130.65,,,0
HCPCS,83060,Blood sulfhemoglobin assay,,,8.8,33.0,3
HCPCS,83060,Hc Sulfhemoglobin Blood Quant So,82.0,53.3,,,0
HCPCS,83065,Assay of hemoglobin heat,,,9.0,33.75,3
HCPCS,83068,Hc Hemoglobin Stability Screen So,153.0,99.45,,,0
HCPCS,83068,Hemoglobin stability screen,,,9.47,35.51,3
HCPCS,83069,Assay of urine hemoglobin,,,3.95,14.81,3
HCPCS,83070,Assay of hemosiderin qual,,,4.75,17.81,3
HCPCS,83070,Hc Hemosiderin Qual So,68.0,44.2,,,0
HCPCS,83070,Hc Hemosiderin Qualitative,580.0,377.0,,,0
HCPCS,83080,Assay of b hexosaminidase,,,16.87,63.26,3
HCPCS,83080,Hc Hexosaminidase Total Serum,749.0,486.85,,,0
HCPCS,83080,Hc Hexosaminidase Total Serum So,156.0,101.4,,,0
HCPCS,83080,Hc Hexosaminidase Total Serum Special So,704.0,457.6,,,0
HCPCS,83088,Assay of histamine,,,29.53,110.74,3
HCPCS,83088,Hc Histamine So,336.0,218.4,,,0
HCPCS,83090,Assay Of Homocystine,,,17.92,67.2,3
HCPCS,83090,Hc Homocysteine,337.0,219.05,,,0
HCPCS,83090,Hc Homocysteine So,84.0,54.6,,,0
HCPCS,83150,Assay of homovanillic acid,,,22.41,84.04,3
HCPCS,83150,Hc Homovanillic Acid Hva So,100.0,65.0,,,0
HCPCS,83491,Assay of corticosteroids 17,,,17.9,67.13,3
HCPCS,83491,Hc 17-Hydroxycorticosteroid,543.0,352.95,,,0
HCPCS,83497,Assay of 5-hiaa,,,12.9,48.38,3
HCPCS,83497,Hc Hydroxyindolacetic Acid (5-Hiaa) So,102.0,66.3,,,0
HCPCS,83497,"Hc Hydroxyindolacetic Acid, 5-(Hiaa) Plasma So",1499.0,974.35,,,0
HCPCS,83498,Assay of progesterone 17-d,,,27.17,101.89,3
HCPCS,83498,Hc 17-Hydroxyprogesterone So,51.0,33.15,,,0
HCPCS,83500,Assay free hydroxyproline,,,22.65,84.94,3
HCPCS,83505,Assay total hydroxyproline,,,24.3,91.13,3
HCPCS,83516,Hc Ia Noninfectious Agent Special Facn1 So,495.0,321.75,,,0
HCPCS,83516,Hc Ia Noninfectious Agent Special So,1450.0,942.5,,,0
HCPCS,83516,Hc Immunoassay Noninfectious Agent,318.0,206.7,,,0
HCPCS,83516,Hc Immunoassay Noninfectious Agent So,153.0,99.45,,,0
HCPCS,83516,Immunoassay nonantibody,,,11.53,43.24,3
HCPCS,83518,Immunoassay dipstick,,,9.64,36.15,3
HCPCS,83519,Hc Ia Noninfect Agnt Qnt Ria Special So,2454.0,1595.1,,,0
HCPCS,83519,Hc Immunassay Noninfect Agnt Qnt Ria,571.0,371.15,,,0
HCPCS,83519,Hc Immunassay Noninfect Agnt Qnt Ria So,273.0,177.45,,,0
HCPCS,83519,Ria nonantibody,,,18.4,69.0,3
HCPCS,83520,Hc Ia Noninfect Agnt Qnt Nos Special So,743.0,482.95,,,0
HCPCS,83520,Hc Immunassay Noninfect Agnt Qnt Nos,460.0,299.0,,,0
HCPCS,83520,Hc Immunassay Noninfect Agnt Qnt Nos So,226.0,146.9,,,0
HCPCS,83520,Immunoassay quant nos nonab,,,17.27,64.76,3
HCPCS,83521,Hc Immunoglobulin Light Chains Free Each,541.0,351.65,,,0
HCPCS,83521,Hc Immunoglobulin Light Chains Free Each So,210.0,136.5,,,0
HCPCS,83521,Ig light chains free each,,,17.27,64.76,3
HCPCS,83525,Assay of insulin,,,11.43,42.86,3
HCPCS,83525,Hc Insulin,71.0,46.15,,,0
HCPCS,83525,Hc Insulin Total So,72.0,46.8,,,0
HCPCS,83527,Assay of insulin,,,12.95,48.56,3
HCPCS,83527,Hc Insulin Free So,157.0,102.05,,,0
HCPCS,83528,Assay of intrinsic factor,,,19.82,74.33,3
HCPCS,83529,Asay of interleukin-6 (il-6),,,17.27,64.76,3
HCPCS,83529,Hc Assay Of Interleukin-6 (Il-6) So,226.0,146.9,,,0
HCPCS,83540,Assay of iron,,,6.47,24.26,3
HCPCS,83540,Hc Iron,51.0,33.15,,,0
HCPCS,83540,Hc Iron Liver Tissue Or Urine So,137.0,89.05,,,0
HCPCS,83550,Hc Iron Binding Capacity,50.0,32.5,,,0
HCPCS,83550,Iron binding test,,,8.74,32.78,3
HCPCS,83570,Assay of idh enzyme,,,8.85,33.19,3
HCPCS,83582,Assay of ketogenic steroids,,,15.47,58.01,3
HCPCS,83586,Assay 17- ketosteroids,,,12.8,48.0,3
HCPCS,83586,Hc 17 Ketosteroids Total 24Hr,254.0,165.1,,,0
HCPCS,83593,Fractionation ketosteroids,,,28.5,106.88,3
HCPCS,83605,Assay of lactic acid,,,11.57,43.39,3
HCPCS,83605,Hc D Lactate So,182.0,118.3,,,0
HCPCS,83605,Hc Fsed Lactic Acid Lactate,79.0,51.35,,,0
HCPCS,83605,Hc Lactic Acid Lactate,79.0,51.35,,,0
HCPCS,83605,Hc Lactic Acid Lactate Cath Lab,79.0,51.35,,,0
HCPCS,83605,Hc Lactic Acid Lactate Perfusion,79.0,51.35,,,0
HCPCS,83605,Hc Lactic Acid Lactate Pulmonary,79.0,51.35,,,0
HCPCS,83605,Hc Mstu Lactic Acid (Lactate),79.0,51.35,,,0
HCPCS,83615,Hc Ldh,25.0,16.25,,,0
HCPCS,83615,Hc Ldh So,25.0,16.25,,,0
HCPCS,83615,Lactate (LD) (LDH) enzyme,,,6.04,22.65,3
HCPCS,83625,Assay of ldh enzymes,,,12.79,47.96,3
HCPCS,83625,Hc Ldh Isoenzymes So,191.0,124.15,,,0
HCPCS,83630,Hc Lactoferrin Detection So,322.0,209.3,,,0
HCPCS,83630,Lactoferrin fecal (qual),,,19.7,73.88,3
HCPCS,83631,Hc Lactoferrin Fecal Quant So,654.0,425.1,,,0
HCPCS,83631,Lactoferrin fecal (quant),,,19.63,73.61,3
HCPCS,83632,Hc Lactogen Placental So,405.0,263.25,,,0
HCPCS,83632,Placental lactogen,,,20.22,75.83,3
HCPCS,83633,Test urine for lactose,,,11.25,42.19,3
HCPCS,83655,Assay of lead,,,12.11,45.41,3
HCPCS,83655,Hc Lead So,13.0,8.45,,,0
HCPCS,83661,Hc L S Ratio,580.0,377.0,,,0
HCPCS,83661,L/s ratio fetal lung,,,21.99,82.46,3
HCPCS,83662,Foam stability fetal lung,,,18.91,70.91,3
HCPCS,83663,Fluoro polarize fetal lung,,,18.91,70.91,3
HCPCS,83664,Hc Lamellar Body Count,98.0,63.7,,,0
HCPCS,83664,Lamellar bdy fetal lung,,,19.32,72.45,3
HCPCS,83670,Assay of lap enzyme,,,9.81,36.79,3
HCPCS,83690,Assay of lipase,,,6.89,25.84,3
HCPCS,83690,Hc Lipase,74.0,48.1,,,0
HCPCS,83695,Assay of lipoprotein(a),,,14.32,53.7,3
HCPCS,83695,Hc Lipoprotein A,55.0,35.75,,,0
HCPCS,83695,Hc Lipoprotein A So,55.0,35.75,,,0
HCPCS,83698,Assay Lipoprotein Pla2,,,46.31,173.66,3
HCPCS,83698,Hc Lipoprotein Assoc Phospholipase A2 So,480.0,312.0,,,0
HCPCS,83700,Hc Lipoprotein Electrophoresis,145.0,94.25,,,0
HCPCS,83700,Lipopro bld electrophoretic,,,11.26,42.23,3
HCPCS,83701,Hc Lipoprotein High Res Fract And Quant So,178.0,115.7,,,0
HCPCS,83701,Lipoprotein bld hr fraction,,,33.86,126.98,3
HCPCS,83704,Hc Nmr Lipoprofile & Particles So,109.0,70.85,,,0
HCPCS,83704,Lipoprotein bld quan part,,,34.19,128.21,3
HCPCS,83718,Assay of lipoprotein,,,8.19,30.71,3
HCPCS,83718,Hc Cholesterol Hdl,50.0,32.5,,,0
HCPCS,83719,Assay of blood lipoprotein,,,12.75,47.81,3
HCPCS,83719,Hc Cholesterol Vldl Chylomicrons,77.0,50.05,,,0
HCPCS,83721,Assay of blood lipoprotein,,,10.5,39.38,3
HCPCS,83721,Hc Cholesterol Ldl Direct,77.0,50.05,,,0
HCPCS,83722,Lipoprtn dir meas sd ldl chl,,,34.19,128.21,3
HCPCS,83727,Assay of lrh hormone,,,17.19,64.46,3
HCPCS,83727,Hc Gonadotropin Releasing Hormone So,755.0,490.75,,,0
HCPCS,83735,Assay of magnesium,,,6.7,25.13,3
HCPCS,83735,Hc Fsed Magnesium,55.0,35.75,,,0
HCPCS,83735,Hc Magnesium,55.0,35.75,,,0
HCPCS,83735,Hc Magnesium So,75.0,48.75,,,0
HCPCS,83775,Assay malate dehydrogenase,,,7.37,27.64,3
HCPCS,83785,Assay of manganese,,,26.65,99.94,3
HCPCS,83785,Hc Manganese So,133.0,86.45,,,0
HCPCS,83785,Hc Manganese Special So,516.0,335.4,,,0
HCPCS,83789,Hc Mass Spect&Tandem Mass Spect Nondrg Anal Nes Ea So,913.0,593.45,,,0
HCPCS,83789,Hc Mass Spectrometry Qual/Quan So,409.0,265.85,,,0
HCPCS,83789,Mass spectrometry qual/quan,,,24.11,90.41,3
HCPCS,83825,Assay of mercury,,,16.26,60.98,3
HCPCS,83825,Hc Mercury So,75.0,48.75,,,0
HCPCS,83835,Assay of metanephrines,,,16.94,63.53,3
HCPCS,83835,Hc Metanephrines Fractionated So,51.0,33.15,,,0
HCPCS,83857,Assay of methemalbumin,,,10.74,40.28,3
HCPCS,83861,Microfluid analy tears,,,22.48,84.3,3
HCPCS,83864,Hc Mucopolysaccharides Acid Quant So,1426.0,926.9,,,0
HCPCS,83864,Mucopolysaccharides,,,28.5,106.88,3
HCPCS,83872,Assay synovial fluid mucin,,,5.86,21.98,3
HCPCS,83873,Assay of csf protein,,,17.2,64.5,3
HCPCS,83874,Assay of myoglobin,,,12.92,48.45,3
HCPCS,83874,Hc Myoglobin,123.0,79.95,,,0
HCPCS,83874,Hc Myoglobin So,55.0,35.75,,,0
HCPCS,83876,Assay myeloperoxidase,,,50.86,190.73,3
HCPCS,83876,Hc Myeloperoxidase Antibody,135.0,87.75,,,0
HCPCS,83880,Assay of natriuretic peptide,,,39.26,147.23,3
HCPCS,83880,Hc Brain Natriuretic Peptide Bnp,269.0,174.85,,,0
HCPCS,83880,Hc Fsed Brain Natriuretic Peptide Bnp,269.0,174.85,,,0
HCPCS,83883,Assay nephelometry not spec,,,13.6,51.0,3
HCPCS,83883,Hc Nephelometry Each Analyte,250.0,162.5,,,0
HCPCS,83883,Hc Nephelometry Each Analyte So,54.0,35.1,,,0
HCPCS,83883,Hc Nephelometry Each Analyte Special So,150.0,97.5,,,0
HCPCS,83884,Assay neurflmnt light chain,,,116.23,116.23,1
HCPCS,83885,Assay of nickel,,,24.51,91.91,3
HCPCS,83885,Hc Nickel So,173.0,112.45,,,0
HCPCS,83915,Assay of nucleotidase,,,11.15,41.81,3
HCPCS,83915,Hc Nucleotidase 5 So,1000.0,650.0,,,0
HCPCS,83915,Hc Rbc Enzymes So,4018.0,2611.7,,,0
HCPCS,83916,Hc Oligoclonal Bands So,156.0,101.4,,,0
HCPCS,83916,Oligoclonal bands,,,27.39,102.71,3
HCPCS,83918,Hc Organic Acids Total Quant Ea  Spec So,1134.0,737.1,,,0
HCPCS,83918,Organic acids total quant,,,23.6,88.5,3
HCPCS,83919,Hc Organic Acids Qualitative Each So,153.0,99.45,,,0
HCPCS,83919,Organic acids qual each,,,16.45,61.69,3
HCPCS,83921,Hc Organic Acid Single Quant So,47.0,30.55,,,0
HCPCS,83921,Organic acid single quant,,,21.21,79.54,3
HCPCS,83930,Assay of blood osmolality,,,6.61,24.79,3
HCPCS,83930,Hc Osmolality Blood,104.0,67.6,,,0
HCPCS,83935,Assay of urine osmolality,,,6.82,25.58,3
HCPCS,83935,Hc Osmolality Urine,103.0,66.95,,,0
HCPCS,83935,Hc Osmolality Urine So,60.0,39.0,,,0
HCPCS,83937,Assay of osteocalcin,,,29.85,111.94,3
HCPCS,83937,Hc Osteocalcin So,137.0,89.05,,,0
HCPCS,83945,Assay of oxalate,,,14.45,54.19,3
HCPCS,83945,Hc Oxalate So,147.0,95.55,,,0
HCPCS,83950,Oncoprotein her-2/neu,,,64.41,241.54,3
HCPCS,83951,Hc Des-Gamma-Carboxy Prothrombin S So,600.0,390.0,,,0
HCPCS,83951,Oncoprotein dcp,,,64.41,241.54,3
HCPCS,83970,Assay of parathormone,,,41.28,154.8,3
HCPCS,83970,Hc Pth Fnab Needle Wash So,195.0,126.75,,,0
HCPCS,83970,Hc Pth Intact,110.0,71.5,,,0
HCPCS,83986,Assay ph body fluid nos,,,3.58,13.43,3
HCPCS,83986,Hc Ph Body Fluid Nes,93.0,60.45,,,0
HCPCS,83986,Hc Ph Body Fluid Nos So,34.0,22.1,,,0
HCPCS,83987,Exhaled breath condensate,,,3.58,13.43,3
HCPCS,83992,Assay for phencyclidine,,,138.53,138.53,2
HCPCS,83992,Hc Ml Phencyclidine (Pcp) So,21.0,13.65,,,0
HCPCS,83992,Hc Phencyclidine Pcp So,153.0,99.45,,,0
HCPCS,83993,Assay for calprotectin fecal,,,19.63,73.61,3
HCPCS,83993,Hc Calprotectin Fecal So,330.0,214.5,,,0
HCPCS,84030,Assay of blood pku,,,5.5,20.63,3
HCPCS,84030,Hc Phenylalanine So,121.0,78.65,,,0
HCPCS,84035,Assay of phenylketones,,,3.98,14.93,3
HCPCS,84060,Assay acid phosphatase,,,7.64,28.65,3
HCPCS,84066,Assay prostate phosphatase,,,9.66,36.23,3
HCPCS,84066,Hc Acid Phosphatase Prostatic,59.0,38.35,,,0
HCPCS,84075,Assay alkaline phosphatase,,,5.18,19.43,3
HCPCS,84075,Hc Alkaline Phosphatase Alk Phos,10.0,6.5,,,0
HCPCS,84075,Hc Alkaline Phosphatase So,10.0,6.5,,,0
HCPCS,84075,Hc Fsed Alkaline Phosphatase Alk Phos,10.0,6.5,,,0
HCPCS,84078,Assay alkaline phosphatase,,,8.26,30.98,3
HCPCS,84080,Assay alkaline phosphatases,,,14.78,55.43,3
HCPCS,84080,Hc Alkaline Phosphatase Isoenzyme So,79.0,51.35,,,0
HCPCS,84081,Assay phosphatidylglycerol,,,16.52,61.95,3
HCPCS,84081,Hc Phosphatidylglycerol,251.0,163.15,,,0
HCPCS,84085,Assay of rbc pg6d enzyme,,,9.44,35.4,3
HCPCS,84087,Assay phosphohexose enzymes,,,10.73,40.24,3
HCPCS,84087,Hc Glucose Phosphate Isomerase Rbc So,734.0,477.1,,,0
HCPCS,84100,Assay of phosphorus,,,4.74,17.78,3
HCPCS,84100,Hc Fsed Phosphorus,55.0,35.75,,,0
HCPCS,84100,Hc Phosphorus,55.0,35.75,,,0
HCPCS,84100,Hc Phosphorus So,300.0,195.0,,,0
HCPCS,84105,Assay of urine phosphorus,,,5.78,21.68,3
HCPCS,84105,Hc Phosphorus Urine,109.0,70.85,,,0
HCPCS,84105,Hc Phosphorus Urine So,64.0,41.6,,,0
HCPCS,84106,Hc Porphobilinogen Urine Qualitative,121.0,78.65,,,0
HCPCS,84106,Test for porphobilinogen,,,5.82,21.83,3
HCPCS,84110,Assay of porphobilinogen,,,8.44,31.65,3
HCPCS,84110,Hc Porphobilinogen Urine Quantitative So,90.0,58.5,,,0
HCPCS,84112,Eval amniotic fluid protein,,,98.11,367.91,3
HCPCS,84112,Hc Rapid Rom Test,588.0,382.2,,,0
HCPCS,84119,Test urine for porphyrins,,,13.36,50.1,3
HCPCS,84120,Assay of urine porphyrins,,,14.71,55.16,3
HCPCS,84120,Hc Porphyrin Urine Quantitative,314.0,204.1,,,0
HCPCS,84120,Hc Porphyrin Urine Quantitative So,162.0,105.3,,,0
HCPCS,84126,Assay of feces porphyrins,,,39.11,146.66,3
HCPCS,84126,Hc Porphyrins Feces Quantitative So,379.0,246.35,,,0
HCPCS,84132,Assay of serum potassium,,,4.76,17.85,3
HCPCS,84132,Hc Fsed Potassium Serum Plasma Or Whole Blood,9.0,5.85,,,0
HCPCS,84132,Hc Mstu Potassium Serum Plasma Or Wb,9.0,5.85,,,0
HCPCS,84132,Hc Potassium Amb,9.0,5.85,,,0
HCPCS,84132,Hc Potassium Serum Plasma Or Whole Blood,9.0,5.85,,,0
HCPCS,84132,Hc Potassium Whole Blood Cath Lab,9.0,5.85,,,0
HCPCS,84132,Hc Potassium Whole Blood Perfusion,9.0,5.85,,,0
HCPCS,84132,Hc Potassium Whole Blood Pulmonary,9.0,5.85,,,0
HCPCS,84133,Assay of urine potassium,,,4.73,17.74,3
HCPCS,84133,Hc Potassium Urine,59.0,38.35,,,0
HCPCS,84133,Hc Potassium Urine So,30.0,19.5,,,0
HCPCS,84134,Assay of prealbumin,,,14.59,54.71,3
HCPCS,84134,Hc Prealbumin,89.0,57.85,,,0
HCPCS,84135,Assay of pregnanediol,,,21.27,79.76,3
HCPCS,84138,Assay of pregnanetriol,,,21.05,78.94,3
HCPCS,84140,Assay of pregnenolone,,,20.67,77.51,3
HCPCS,84140,Hc Pregnenolone So,112.0,72.8,,,0
HCPCS,84143,Assay of 17-hydroxypregneno,,,22.81,85.54,3
HCPCS,84143,Hc 17 Hydroxypregnenolone So,224.0,145.6,,,0
HCPCS,84144,Assay of progesterone,,,20.86,78.23,3
HCPCS,84144,Hc Progesterone,39.0,25.35,,,0
HCPCS,84145,Hc Procalcitonin Pct,644.0,418.6,,,0
HCPCS,84145,Procalcitonin (PCT),,,27.22,102.08,3
HCPCS,84146,Assay of prolactin,,,19.38,72.68,3
HCPCS,84146,Hc Macroprolactin So,194.0,126.1,,,0
HCPCS,84146,Hc Prolactin,41.0,26.65,,,0
HCPCS,84150,Assay of prostaglandin,,,41.77,156.64,3
HCPCS,84150,Hc Prostaglandin Each So,184.0,119.6,,,0
HCPCS,84150,Hc Prostaglandin Each Special So,1382.0,898.3,,,0
HCPCS,84150,Hc Prostaglndin Each Special So,954.0,620.1,,,0
HCPCS,84152,Assay of psa complexed,,,18.39,68.96,3
HCPCS,84153,Assay of psa total,,,18.39,68.96,3
HCPCS,84153,Hc Psa Total,84.0,54.6,,,0
HCPCS,84153,Hc Psa Total So,45.0,29.25,,,0
HCPCS,84154,Assay of psa free,,,18.39,68.96,3
HCPCS,84154,Hc Psa Free,84.0,54.6,,,0
HCPCS,84154,Hc Psa Free So,126.0,81.9,,,0
HCPCS,84155,Assay of protein serum,,,3.67,13.76,3
HCPCS,84155,Hc Fsed Protein Total,10.0,6.5,,,0
HCPCS,84155,Hc Protein Total,10.0,6.5,,,0
HCPCS,84155,Hc Protein Total So,23.0,14.95,,,0
HCPCS,84156,Assay of protein urine,,,3.67,13.76,3
HCPCS,84156,Hc Protein Urine,51.0,33.15,,,0
HCPCS,84157,Assay of protein other,,,4.0,15.0,3
HCPCS,84157,Hc Protein Body Fluid Or Csf,69.0,44.85,,,0
HCPCS,84157,Hc Protein Body Fluid So,35.0,22.75,,,0
HCPCS,84160,Assay of protein any source,,,5.61,21.04,3
HCPCS,84163,Pappa serum,,,15.05,56.44,3
HCPCS,84165,Hc Protein Electrophoresis Serum,316.0,205.4,,,0
HCPCS,84165,Hc Protein Electrophoresis So,75.0,48.75,,,0
HCPCS,84165,Protein e-phoresis serum,,,10.74,40.28,3
HCPCS,84166,Hc Protein Electrophoresis Body Fluid,378.0,245.7,,,0
HCPCS,84166,Hc Protein Electrophoresis Body Fluid So,185.0,120.25,,,0
HCPCS,84166,Protein e-phoresis/urine/csf,,,17.83,66.86,3
HCPCS,84181,Hc Western Blot So,397.0,258.05,,,0
HCPCS,84181,Western blot test,,,17.03,63.86,3
HCPCS,84182,Hc Western Blot Immuno Probe Band Id,632.0,410.8,,,0
HCPCS,84182,Hc Western Blot Immuno Probe Band Id Sp So,422.0,274.3,,,0
HCPCS,84182,Protein western blot test,,,29.21,109.54,3
HCPCS,84202,Assay RBC protoporphyrin,,,14.35,53.81,3
HCPCS,84202,Hc Protoporphyrin Rbc Quantitative So,387.0,251.55,,,0
HCPCS,84203,Hc Protoporphyrin Rbc Screen,422.0,274.3,,,0
HCPCS,84203,Test RBC protoporphyrin,,,9.74,36.53,3
HCPCS,84206,Assay of proinsulin,,,26.69,100.09,3
HCPCS,84206,Hc Proinsulin So,100.0,65.0,,,0
HCPCS,84207,Assay of vitamin b-6,,,28.1,105.38,3
HCPCS,84207,Hc Vitamin B 6 Pyridoxal Phos So,78.0,50.7,,,0
HCPCS,84210,Assay of pyruvate,,,14.48,54.3,3
HCPCS,84210,Hc Pyruvic Acid So,72.0,46.8,,,0
HCPCS,84210,Hc Pyruvic Acid Special So,191.0,124.15,,,0
HCPCS,84220,Assay of pyruvate kinase,,,9.44,35.4,3
HCPCS,84220,Hc Pyruvate Kinase So,153.0,99.45,,,0
HCPCS,84220,Hc Pyruvate Kinase Special Eeev1 So,587.0,381.55,,,0
HCPCS,84228,Assay of quinine,,,11.63,43.61,3
HCPCS,84233,Assay of estrogen,,,87.88,329.55,3
HCPCS,84234,Assay of progesterone,,,64.88,243.3,3
HCPCS,84235,Assay of endocrine hormone,,,71.23,267.11,3
HCPCS,84238,Assay nonendocrine receptor,,,36.57,137.14,3
HCPCS,84238,Hc Receptor Assay Non Endocrine So,98.0,63.7,,,0
HCPCS,84244,Assay of renin,,,21.99,82.46,3
HCPCS,84244,Hc Renin Activity Plasma So,47.0,30.55,,,0
HCPCS,84252,Assay of vitamin b-2,,,20.24,75.9,3
HCPCS,84252,Hc Vitamin B 2 Riboflavin So,118.0,76.7,,,0
HCPCS,84255,Assay of selenium,,,25.53,95.74,3
HCPCS,84255,Hc Selenium So,54.0,35.1,,,0
HCPCS,84260,Assay of serotonin,,,30.98,116.18,3
HCPCS,84260,Hc Serotonin So,102.0,66.3,,,0
HCPCS,84270,Assay of sex hormone globul,,,21.73,81.49,3
HCPCS,84270,Hc Sex Hormone Binding Globulin,154.0,100.1,,,0
HCPCS,84275,Assay of sialic acid,,,13.44,50.4,3
HCPCS,84285,Assay of silica,,,25.21,94.54,3
HCPCS,84285,Hc Silica So,573.0,372.45,,,0
HCPCS,84295,Assay of serum sodium,,,4.81,18.04,3
HCPCS,84295,Hc Fsed Sodium,9.0,5.85,,,0
HCPCS,84295,Hc Mstu Sodium,9.0,5.85,,,0
HCPCS,84295,Hc Sodium,9.0,5.85,,,0
HCPCS,84295,Hc Sodium Amb,9.0,5.85,,,0
HCPCS,84295,Hc Sodium Wb Cath Lab,9.0,5.85,,,0
HCPCS,84295,Hc Sodium Wb Perfusion,9.0,5.85,,,0
HCPCS,84295,Hc Sodium Wb Pulm,9.0,5.85,,,0
HCPCS,84300,Assay of urine sodium,,,5.06,18.98,3
HCPCS,84300,Hc Sodium Urine,69.0,44.85,,,0
HCPCS,84300,Hc Sodium Urine So,104.0,67.6,,,0
HCPCS,84302,Assay of sweat sodium,,,4.86,18.23,3
HCPCS,84302,Hc Sodium  Other,290.0,188.5,,,0
HCPCS,84305,Assay of somatomedin,,,21.26,79.73,3
HCPCS,84305,Hc Somatomedin,249.0,161.85,,,0
HCPCS,84305,Hc Somatomedin So,47.0,30.55,,,0
HCPCS,84307,Assay of somatostatin,,,18.28,68.55,3
HCPCS,84307,Hc Somatostatin So,522.0,339.3,,,0
HCPCS,84311,Hc Spectrophotometry Analyte Nes So,185.0,120.25,,,0
HCPCS,84311,Spectrophotometry,,,8.1,30.38,3
HCPCS,84315,Body fluid specific gravity,,,3.28,12.3,3
HCPCS,84375,Chromatogram assay sugars,,,39.0,146.25,3
HCPCS,84376,Hc Reducing Substance Not Glucose,82.0,53.3,,,0
HCPCS,84376,Hc Sugars Single Qual So,68.0,44.2,,,0
HCPCS,84376,Sugars single qual,,,5.5,20.63,3
HCPCS,84377,Hc Sugars Multiple Qualitative Each Spec So,233.0,151.45,,,0
HCPCS,84377,Sugars multiple qual,,,5.5,20.63,3
HCPCS,84378,Hc Sugars Single Quantitative Each So,273.0,177.45,,,0
HCPCS,84378,Sugars single quant,,,11.53,43.24,3
HCPCS,84379,Sugars multiple quant,,,11.53,43.24,3
HCPCS,84392,Assay of urine sulfate,,,5.49,20.59,3
HCPCS,84392,Hc Sulfate Urine So,112.0,72.8,,,0
HCPCS,84393,Hc Tau Phosphorylated Ea,1500.0,975.0,,,0
HCPCS,84393,Tau phosphorylated ea,,,128.92,128.92,1
HCPCS,84394,Hc Total Tau,1500.0,975.0,,,0
HCPCS,84394,Total tau,,,128.92,128.92,1
HCPCS,84402,Assay of free testosterone,,,25.47,95.51,3
HCPCS,84402,Hc Testosterone Free,200.0,130.0,,,0
HCPCS,84402,Hc Testosterone Free So,132.0,85.8,,,0
HCPCS,84403,Assay of total testosterone,,,25.81,96.79,3
HCPCS,84403,Hc Testosterone Total,109.0,70.85,,,0
HCPCS,84403,Hc Testosterone Total So,52.0,33.8,,,0
HCPCS,84410,Hc Testosterone Bioavailable So,110.0,71.5,,,0
HCPCS,84410,Testosterone bioavailable,,,51.28,192.3,3
HCPCS,84425,Assay of vitamin b-1,,,21.23,79.61,3
HCPCS,84425,Hc Vitamin B 1 Thiamine So,89.0,57.85,,,0
HCPCS,84430,Assay of thiocyanate,,,11.63,43.61,3
HCPCS,84430,Hc Thiocyanate So,158.0,102.7,,,0
HCPCS,84431,Thromboxane urine,,,35.11,131.66,3
HCPCS,84432,Assay of thyroglobulin,,,16.06,60.23,3
HCPCS,84432,Hc Thyroglobulin,280.0,182.0,,,0
HCPCS,84432,Hc Thyroglobulin So,574.0,373.1,,,0
HCPCS,84433,Asy thiopurin s-mthyltrnsfrs,,,22.17,83.14,3
HCPCS,84433,Hc Thiopurine S-Methytransferase (Tpmt) So,415.0,269.75,,,0
HCPCS,84436,Assay of total thyroxine,,,6.87,25.76,3
HCPCS,84436,Hc T4 Total,59.0,38.35,,,0
HCPCS,84436,Hc T4 Total So,225.0,146.25,,,0
HCPCS,84437,Assay of neonatal thyroxine,,,6.47,24.26,3
HCPCS,84439,Assay of free thyroxine,,,9.02,33.83,3
HCPCS,84439,Hc T4 Free,37.0,24.05,,,0
HCPCS,84439,Hc T4 Free By Dialysis So,88.0,57.2,,,0
HCPCS,84442,Assay of thyroid activity,,,14.78,55.43,3
HCPCS,84442,Hc Thyroxin Binding Globulin So,99.0,64.35,,,0
HCPCS,84443,Assay thyroid stim hormone,,,16.8,63.0,3
HCPCS,84443,Hc Tsh,71.0,46.15,,,0
HCPCS,84445,Assay of tsi globulin,,,50.86,190.73,3
HCPCS,84445,Hc Thyroid Stimulating Immunoglob So,148.0,96.2,,,0
HCPCS,84446,Assay of vitamin e,,,14.18,53.18,3
HCPCS,84446,Hc Vitamin E So,43.0,27.95,,,0
HCPCS,84449,Assay of transcortin,,,18.0,67.5,3
HCPCS,84449,Hc Transcortin Cortisol Bind Globulin,580.0,377.0,,,0
HCPCS,84450,Hc Ast Sgot,10.0,6.5,,,0
HCPCS,84450,Hc Fsed Ast Sgot,10.0,6.5,,,0
HCPCS,84450,Transferase (AST) (SGOT),,,5.18,19.43,3
HCPCS,84460,Alanine amino (ALT) (SGPT),,,5.3,19.88,3
HCPCS,84460,Hc Alt Sgpt,10.0,6.5,,,0
HCPCS,84460,Hc Fsed Alt Sgpt,10.0,6.5,,,0
HCPCS,84466,Assay of transferrin,,,12.76,47.85,3
HCPCS,84466,Hc Transferrin,124.0,80.6,,,0
HCPCS,84478,Assay of triglycerides,,,5.74,21.53,3
HCPCS,84478,Hc Triglycerides,53.0,34.45,,,0
HCPCS,84478,Hc Triglycerides So,86.0,55.9,,,0
HCPCS,84479,Assay of thyroid (t3 or t4),,,6.47,24.26,3
HCPCS,84479,Hc Thyroid Hormone Uptake Ratio T3U So,215.0,139.75,,,0
HCPCS,84480,Assay triiodothyronine (t3),,,14.18,53.18,3
HCPCS,84480,Hc T3 Total,53.0,34.45,,,0
HCPCS,84481,Free assay (FT-3),,,16.94,63.53,3
HCPCS,84481,Hc T3 Free,59.0,38.35,,,0
HCPCS,84482,Hc Reverse T3 So,75.0,48.75,,,0
HCPCS,84482,T3 reverse,,,15.76,59.1,3
HCPCS,84484,Assay of troponin quant,,,12.47,46.76,3
HCPCS,84484,Hc Fsed Troponin Quantitative,92.0,59.8,,,0
HCPCS,84484,Hc Troponin Quantitative,92.0,59.8,,,0
HCPCS,84484,Hc Troponin Quantitative So,39.0,25.35,,,0
HCPCS,84485,Assay duodenal fluid trypsin,,,7.2,27.0,3
HCPCS,84488,Test feces for trypsin,,,7.3,27.38,3
HCPCS,84490,Assay of feces for trypsin,,,9.93,37.24,3
HCPCS,84510,Assay of tyrosine,,,10.63,39.86,3
HCPCS,84510,Hc Tyrosine So,226.0,146.9,,,0
HCPCS,84512,Assay of troponin qual,,,10.09,37.84,3
HCPCS,84520,Assay of urea nitrogen,,,3.95,14.81,3
HCPCS,84520,Hc Bun,9.0,5.85,,,0
HCPCS,84520,Hc Bun Amb,9.0,5.85,,,0
HCPCS,84520,Hc Fsed Bun,9.0,5.85,,,0
HCPCS,84520,Hc Mstu Bun,9.0,5.85,,,0
HCPCS,84525,Urea nitrogen semi-quant,,,5.13,19.24,3
HCPCS,84540,Assay of urine/urea-n,,,5.56,20.85,3
HCPCS,84540,Hc Urea Nitrogen Urine,53.0,34.45,,,0
HCPCS,84540,Hc Urea Nitrogen Urine So,71.0,46.15,,,0
HCPCS,84545,Hc Urea Clearance,49.0,31.85,,,0
HCPCS,84545,Urea-N clearance test,,,7.2,27.0,3
HCPCS,84550,Assay of blood/uric acid,,,4.52,16.95,3
HCPCS,84550,Hc Uric Acid Blood,17.0,11.05,,,0
HCPCS,84560,Assay of urine/uric acid,,,5.08,19.05,3
HCPCS,84560,Hc Uric Acid Other Source,51.0,33.15,,,0
HCPCS,84560,Hc Uric Acid Other Source So,146.0,94.9,,,0
HCPCS,84577,Assay of feces/urobilinogen,,,16.8,63.0,3
HCPCS,84578,Test urine urobilinogen,,,4.47,16.76,3
HCPCS,84580,Assay of urine urobilinogen,,,9.55,35.81,3
HCPCS,84583,Assay of urine urobilinogen,,,6.05,22.69,3
HCPCS,84585,Assay of urine vma,,,15.5,58.13,3
HCPCS,84585,Hc Vma Urine So,64.0,41.6,,,0
HCPCS,84586,Assay of vip,,,35.33,132.49,3
HCPCS,84586,Hc Vasoactive Intestinal Peptide Vip So,168.0,109.2,,,0
HCPCS,84588,Assay of vasopressin,,,33.94,127.28,3
HCPCS,84588,Hc Vasopressin So,338.0,219.7,,,0
HCPCS,84590,Assay of vitamin a,,,11.61,43.54,3
HCPCS,84590,Hc Vitamin A So,43.0,27.95,,,0
HCPCS,84591,Assay Of Nos Vitamin,,,17.06,63.98,3
HCPCS,84591,Hc Vitamin Nos So,541.0,351.65,,,0
HCPCS,84597,Assay of vitamin k,,,13.72,51.45,3
HCPCS,84597,Hc Vitamin K So,185.0,120.25,,,0
HCPCS,84600,Assay of volatiles,,,17.11,64.16,3
HCPCS,84600,Hc Volatile Panel  So,309.0,200.85,,,0
HCPCS,84620,Xylose tolerance test,,,12.91,48.41,3
HCPCS,84630,Assay of zinc,,,11.39,42.71,3
HCPCS,84630,Hc Zinc So,29.0,18.85,,,0
HCPCS,84681,Assay of c-peptide,,,20.81,78.04,3
HCPCS,84681,Hc C Peptide,49.0,31.85,,,0
HCPCS,84702,Chorionic gonadotropin test,,,15.05,56.44,3
HCPCS,84702,Hc Hcg Quantitative,47.0,30.55,,,0
HCPCS,84702,Hc Hcg Quantitative So,63.0,40.95,,,0
HCPCS,84702,Hc Hcg Quantitative Special So,591.0,384.15,,,0
HCPCS,84703,Chorionic gonadotropin assay,,,7.52,28.2,3
HCPCS,84703,Hc Fsed Hcg Qualitative,32.0,20.8,,,0
HCPCS,84703,Hc Hcg Qualitative,32.0,20.8,,,0
HCPCS,84704,Hcg free betachain test,,,15.29,57.34,3
HCPCS,84830,Ovulation tests,,,12.7,47.63,3
HCPCS,84999,Hc Unlisted Chemistry Procedure So,156.0,101.4,,,0
HCPCS,84999,Hc Unlisted Chemistry Procedure Special So,419.0,272.35,,,0
HCPCS,85002,Bleeding time test,,,4.82,18.08,3
HCPCS,85004,Automated diff wbc count,,,6.47,24.26,3
HCPCS,85007,Bl smear w/diff wbc count,,,3.8,14.25,3
HCPCS,85007,Hc Differential Manual,177.0,115.05,,,0
HCPCS,85008,Bl smear w/o diff wbc count,,,3.43,12.86,3
HCPCS,85008,Hc Manual Smear Exam W/O Diff,159.0,103.35,,,0
HCPCS,85009,Manual diff wbc count b-coat,,,5.07,19.01,3
HCPCS,85013,Spun microhematocrit,,,7.0,26.25,3
HCPCS,85014,Hc Fsed Hematocrit,9.0,5.85,,,0
HCPCS,85014,Hc Hematocrit,9.0,5.85,,,0
HCPCS,85014,Hc Hematocrit Amb,9.0,5.85,,,0
HCPCS,85014,Hc Hematocrit Pulmonary,9.0,5.85,,,0
HCPCS,85014,Hc Mstu Hematocrit,9.0,5.85,,,0
HCPCS,85014,Hematocrit,,,2.37,8.89,3
HCPCS,85018,Hc Hemoglobin,10.0,6.5,,,0
HCPCS,85018,Hc Hemoglobin Wb  Cath Lab,10.0,6.5,,,0
HCPCS,85018,Hc Hemoglobin Wb  Perfusion,10.0,6.5,,,0
HCPCS,85018,Hc Hemoglobin Wb  Pulm,10.0,6.5,,,0
HCPCS,85018,Hemoglobin,,,2.37,8.89,3
HCPCS,85025,Complete cbc w/auto diff wbc,,,7.77,29.14,3
HCPCS,85025,Hc Cbc With Diff,31.0,20.15,,,0
HCPCS,85025,Hc Cbc With Diff Amb,31.0,20.15,,,0
HCPCS,85025,Hc Fsed Cbc With Diff,31.0,20.15,,,0
HCPCS,85027,Complete cbc automated,,,6.47,24.26,3
HCPCS,85027,Hc Cbc Without Diff,28.0,18.2,,,0
HCPCS,85027,Hc Fsed Cbc Without Diff,28.0,18.2,,,0
HCPCS,85032,Hc Cell Count Manual Each,109.0,70.85,,,0
HCPCS,85032,Manual cell count each,,,4.31,16.16,3
HCPCS,85041,Automated rbc count,,,3.02,11.33,3
HCPCS,85044,Manual reticulocyte count,,,4.31,16.16,3
HCPCS,85045,Automated reticulocyte count,,,3.99,14.96,3
HCPCS,85045,Hc Reticulocyte Count,58.0,37.7,,,0
HCPCS,85046,"Hc Reticulocyte Profile, B So",318.0,206.7,,,0
HCPCS,85046,Reticyte/hgb concentrate,,,5.57,20.89,3
HCPCS,85048,Automated leukocyte count,,,2.54,9.53,3
HCPCS,85048,Hc Wbc Count Auto,48.0,31.2,,,0
HCPCS,85049,Automated platelet count,,,4.48,16.8,3
HCPCS,85049,Hc Platelet Count Auto,50.0,32.5,,,0
HCPCS,85055,Reticulated platelet assay,,,35.74,134.03,3
HCPCS,85060,Blood smear interpretation,,,90.23,90.23,2
HCPCS,85097,Bone marrow interpretation,,,776.85,2911.91,3
HCPCS,85130,Chromogenic substrate assay,,,11.89,44.59,3
HCPCS,85130,Hc Chromogenic Substrate Assay,120.0,78.0,,,0
HCPCS,85130,Hc Chromogenic Substrate Assay So,858.0,557.7,,,0
HCPCS,85170,Blood clot retraction,,,16.3,61.13,3
HCPCS,85175,Blood clot lysis time,,,20.37,76.39,3
HCPCS,85210,Clot factor ii prothrom spec,,,12.98,48.68,3
HCPCS,85210,Hc Factor 2 Clotting  Assay,1671.0,1086.15,,,0
HCPCS,85220,Blooc clot factor v test,,,17.65,66.19,3
HCPCS,85220,Hc Factor 5 Clotting  Assay,1450.0,942.5,,,0
HCPCS,85230,Clot factor vii proconvertin,,,17.9,67.13,3
HCPCS,85230,Hc Factor 7 Clotting  Assay,929.0,603.85,,,0
HCPCS,85240,Clot factor viii ahg 1 stage,,,17.9,67.13,3
HCPCS,85240,Hc Factor 8 Clotting  Assay,1345.0,874.25,,,0
HCPCS,85244,Clot factor viii reltd antgn,,,20.42,76.58,3
HCPCS,85245,Clot factor viii vw ristoctn,,,22.94,86.03,3
HCPCS,85245,Hc Ristocetin Cofactor Assay,2929.0,1903.85,,,0
HCPCS,85245,Hc Ristocetin Cofactor So,112.0,72.8,,,0
HCPCS,85246,Clot factor viii vw antigen,,,22.94,86.03,3
HCPCS,85246,Hc Clotting Factor Viii Vw Factor Antigen Special So,3034.0,1972.1,,,0
HCPCS,85246,Hc Factor 8 Vonwillebrand Antigen So,86.0,55.9,,,0
HCPCS,85247,Clot factor viii multimetric,,,22.94,86.03,3
HCPCS,85247,Hc Factor 8 Vonwillebrand Multimetric So,175.0,113.75,,,0
HCPCS,85250,Clot factor ix ptc/chrstmas,,,19.04,71.4,3
HCPCS,85250,Hc Factor 9 Assay,1487.0,966.55,,,0
HCPCS,85260,Clot factor x stuart-power,,,17.9,67.13,3
HCPCS,85260,Hc Factor 10 Clotting Assay,1389.0,902.85,,,0
HCPCS,85270,Clot factor xi pta,,,17.9,67.13,3
HCPCS,85270,Hc Factor 11 Clotting Assay,1606.0,1043.9,,,0
HCPCS,85280,Clot factor xii hageman,,,19.35,72.56,3
HCPCS,85280,Hc Factor 12 Clotting Assay,1671.0,1086.15,,,0
HCPCS,85290,Clot factor xiii fibrin stab,,,16.34,61.28,3
HCPCS,85290,Hc Factor 13 Fibrin Stabilizing So,579.0,376.35,,,0
HCPCS,85291,Clot factor xiii fibrin scrn,,,9.11,34.16,3
HCPCS,85291,Hc Factor 13 Screen,1418.0,921.7,,,0
HCPCS,85292,Clot factor fletcher fact,,,18.93,70.99,3
HCPCS,85292,Hc Preallikrein Assay So,625.0,406.25,,,0
HCPCS,85293,Clot factor wght kininogen,,,18.93,70.99,3
HCPCS,85293,Hc High Molecular Weight Kininogen Assay So,625.0,406.25,,,0
HCPCS,85300,Antithrombin iii activity,,,11.85,44.44,3
HCPCS,85300,Hc Antithrombin At3,559.0,363.35,,,0
HCPCS,85300,Hc Antithrombin At3 So,107.0,69.55,,,0
HCPCS,85301,Antithrombin iii antigen,,,10.81,40.54,3
HCPCS,85301,Hc Antithrombin Iii Antigen So,106.0,68.9,,,0
HCPCS,85302,Clot inhibit prot c antigen,,,12.01,45.04,3
HCPCS,85302,Hc Protein C Antigen,233.0,151.45,,,0
HCPCS,85303,Clot inhibit prot c activity,,,13.84,51.9,3
HCPCS,85303,Hc Protein C Activity,1003.0,651.95,,,0
HCPCS,85303,Hc Protein C Activity So,125.0,81.25,,,0
HCPCS,85305,Clot inhibit prot s total,,,11.61,43.54,3
HCPCS,85305,Hc Protein S Antigen Total,226.0,146.9,,,0
HCPCS,85306,Clot inhibit prot s free,,,15.32,57.45,3
HCPCS,85306,Hc Protein S Antigen Free Total,800.0,520.0,,,0
HCPCS,85306,Hc Protein S Antigen Free Total So,138.0,89.7,,,0
HCPCS,85307,Assay Activated Protein C,,,15.32,57.45,3
HCPCS,85307,Hc Activated Protein C Resistance So,170.0,110.5,,,0
HCPCS,85335,Factor inhibitor test,,,12.87,48.26,3
HCPCS,85335,Hc Factor Inhibitor,1386.0,900.9,,,0
HCPCS,85335,Hc Factor Inhibitor So,937.0,609.05,,,0
HCPCS,85337,Thrombomodulin,,,17.27,64.76,3
HCPCS,85345,Coagulation time lee & white,,,4.69,17.59,3
HCPCS,85347,Coagulation time activated,,,4.28,16.05,3
HCPCS,85347,Hc Coag Time Activated Act,605.0,393.25,,,0
HCPCS,85348,Coagulation time otr method,,,4.49,16.84,3
HCPCS,85360,Euglobulin lysis,,,8.41,31.54,3
HCPCS,85360,Hc Euglobulin Lysis,70.0,45.5,,,0
HCPCS,85362,Fibrin degradation products,,,6.89,25.84,3
HCPCS,85362,Hc Fibrin Degradation Products,412.0,267.8,,,0
HCPCS,85366,Fibrinogen test,,,80.46,301.73,3
HCPCS,85366,Hc Fibrin Dgradj Splt Produxs Paracoagj So,471.0,306.15,,,0
HCPCS,85370,Fibrinogen test,,,12.43,46.61,3
HCPCS,85378,Fibrin degrade semiquant,,,9.72,36.45,3
HCPCS,85379,Fibrin degradation quant,,,10.18,38.18,3
HCPCS,85379,Hc D Dimer,185.0,120.25,,,0
HCPCS,85379,Hc D Dimer So,534.0,347.1,,,0
HCPCS,85379,Hc Fsed D Dimer,185.0,120.25,,,0
HCPCS,85380,Fibrin degradj d-dimer,,,10.18,38.18,3
HCPCS,85384,Fibrinogen activity,,,9.72,36.45,3
HCPCS,85384,Hc Fibrinogen,62.0,40.3,,,0
HCPCS,85384,Hc Fibrinogen So,510.0,331.5,,,0
HCPCS,85385,Fibrinogen antigen,,,14.46,54.23,3
HCPCS,85385,Hc Fibrinogen Antigen So,215.0,139.75,,,0
HCPCS,85390,Fibrinolysins screen i&r,,,15.48,58.05,3
HCPCS,85390,"Hc Fibrinolysis Or Coagulopathy Screen, Interp And Rpt So",116.0,75.4,,,0
HCPCS,85396,Clotting assay whole blood,,,72.45,72.45,2
HCPCS,85397,Clotting funct activity,,,30.86,115.73,3
HCPCS,85397,Hc Clotting Funct Activity Nos Ea,1408.0,915.2,,,0
HCPCS,85397,Hc Clotting Functional Activity Nos Each So,76.0,49.4,,,0
HCPCS,85397,Hc Clotting Functional Activity Nos Each Special So,399.0,259.35,,,0
HCPCS,85400,Fibrinolytic plasmin,,,7.71,28.91,3
HCPCS,85410,Fibrinolytic antiplasmin,,,7.71,28.91,3
HCPCS,85410,Hc Alpha 2 Antiplasmin So,165.0,107.25,,,0
HCPCS,85415,Fibrinolytic plasminogen,,,17.19,64.46,3
HCPCS,85415,Hc Plasminogen Activator So,474.0,308.1,,,0
HCPCS,85420,Fibrinolytic plasminogen,,,6.53,24.49,3
HCPCS,85420,Hc Plasminogen,832.0,540.8,,,0
HCPCS,85421,Fibrinolytic plasminogen,,,10.18,38.18,3
HCPCS,85441,Hc Heinz Bodies Direct So,67.0,43.55,,,0
HCPCS,85441,Heinz bodies direct,,,4.2,15.75,3
HCPCS,85445,Heinz bodies induced,,,6.82,25.58,3
HCPCS,85460,Hc Kleihauer-Betke Fetal Hemoglobin,2074.0,1348.1,,,0
HCPCS,85460,Hemoglobin fetal,,,7.73,28.99,3
HCPCS,85461,Hc Fetal Screen,687.0,446.55,,,0
HCPCS,85461,Hemoglobin fetal,,,9.36,35.1,3
HCPCS,85475,Hemolysin acid,,,8.87,33.26,3
HCPCS,85520,Hc Heparin Assay,1661.0,1079.65,,,0
HCPCS,85520,Heparin assay,,,13.09,49.09,3
HCPCS,85525,Heparin neutralization,,,11.84,44.4,3
HCPCS,85530,Heparin-protamine tolerance,,,13.09,49.09,3
HCPCS,85536,Iron Stain Peripheral Blood,,,6.88,25.8,3
HCPCS,85540,Wbc alkaline phosphatase,,,8.6,32.25,3
HCPCS,85547,RBC mechanical fragility,,,8.6,32.25,3
HCPCS,85549,Hc Muramidase So,66.0,42.9,,,0
HCPCS,85549,Muramidase,,,18.75,70.31,3
HCPCS,85555,RBC osmotic fragility,,,7.47,28.01,3
HCPCS,85557,Hc Rbc Osmotic Frag Incubated,216.0,140.4,,,0
HCPCS,85557,RBC osmotic fragility,,,13.36,50.1,3
HCPCS,85576,Blood platelet aggregation,,,24.91,93.41,3
HCPCS,85576,Hc Platelet Aggregation,592.0,384.8,,,0
HCPCS,85597,Hc Phospholipid Neutralization Platelet So,494.0,321.1,,,0
HCPCS,85597,Phospholipid pltlt neutraliz,,,17.98,67.43,3
HCPCS,85598,Hc Hexagonal Phospholipid Neutraliza So,216.0,140.4,,,0
HCPCS,85598,Hc Phospholipid Neutralization Hexagonal,738.0,479.7,,,0
HCPCS,85598,Hexagnal phosph pltlt neutrl,,,17.98,67.43,3
HCPCS,85610,Hc Fsed Pt/Inr,36.0,23.4,,,0
HCPCS,85610,Hc Mstu Inr,36.0,23.4,,,0
HCPCS,85610,Hc Pt Inr Amb,36.0,23.4,,,0
HCPCS,85610,Hc Pt/Inr,36.0,23.4,,,0
HCPCS,85610,Hc Pt/Inr So,226.0,146.9,,,0
HCPCS,85610,Prothrombin time,,,4.29,16.09,3
HCPCS,85611,Hc Pt Mixing Studies,1364.0,886.6,,,0
HCPCS,85611,Prothrombin test,,,3.94,14.78,3
HCPCS,85612,Viper venom prothrombin time,,,17.49,65.59,3
HCPCS,85613,Hc Dilute Russell Viper Venom Drvvt,821.0,533.65,,,0
HCPCS,85613,Hc Dilute Russell Viper Venom Drvvt So,86.0,55.9,,,0
HCPCS,85613,Russell viper venom diluted,,,9.58,35.93,3
HCPCS,85635,Hc Reptilase Time So,132.0,85.8,,,0
HCPCS,85635,Reptilase test,,,9.85,36.94,3
HCPCS,85651,Hc Sed Rate Esr Non Automated,81.0,52.65,,,0
HCPCS,85651,Rbc sed rate nonautomated,,,4.27,16.01,3
HCPCS,85652,Hc Sed Rate Esr Automated,74.0,48.1,,,0
HCPCS,85652,Rbc sed rate automated,,,2.7,10.13,3
HCPCS,85660,Hc Sickle Cell Screen,232.0,150.8,,,0
HCPCS,85660,Hc Sickle Cell Screen So,99.0,64.35,,,0
HCPCS,85660,RBC sickle cell test,,,5.51,20.66,3
HCPCS,85670,Hc Thrombin Time Plasma,132.0,85.8,,,0
HCPCS,85670,Hc Thrombin Time Plasma So,303.0,196.95,,,0
HCPCS,85670,Thrombin time plasma,,,5.77,21.64,3
HCPCS,85675,Thrombin time titer,,,6.85,25.69,3
HCPCS,85705,Thromboplastin inhibition,,,9.63,36.11,3
HCPCS,85730,Hc Aptt,59.0,38.35,,,0
HCPCS,85730,Hc Aptt So,315.0,204.75,,,0
HCPCS,85730,Thromboplastin time partial,,,6.01,22.54,3
HCPCS,85732,Hc Ptt Mixing Studies,1166.0,757.9,,,0
HCPCS,85732,Thromboplastin time partial,,,6.47,24.26,3
HCPCS,85810,Blood viscosity examination,,,11.67,43.76,3
HCPCS,85810,Hc Viscosity Serum So,82.0,53.3,,,0
HCPCS,86000,Agglutinins febrile antigen,,,6.98,26.18,3
HCPCS,86000,Hc Febrile Agglutinin Each,74.0,48.1,,,0
HCPCS,86001,Allergen Specific Igg,,,7.82,29.33,3
HCPCS,86001,Hc Allergen Specific Igg Ea Allergen So,178.0,115.7,,,0
HCPCS,86003,Allergen specific IgE,,,5.22,19.58,3
HCPCS,86003,"Hc Allergen Specific Ige, Qt/Semi-Qt, Crude Allergen Extract, Each So",55.0,35.75,,,0
HCPCS,86003,"Hc Allergen Specific Ige, Qt/Semi-Qt, Crude Extract Special, Each So",213.0,138.45,,,0
HCPCS,86005,Allergen specific IgE,,,7.97,29.89,3
HCPCS,86008,Allg spec ige recomb ea,,,17.93,67.24,3
HCPCS,86008,"Hc Allergen Spec Ige, Qt/Semiqt, Recombinant/Purified Comp Ea So",15.0,9.75,,,0
HCPCS,86008,"Hc Allergen Spec Ige, Qt/Semiqt, Recombinant/Purified Comp Ea Special So",375.0,243.75,,,0
HCPCS,86015,Actin antibody each,,,12.05,45.19,3
HCPCS,86015,Hc Actin Smooth Muscle Antibody Each,207.0,134.55,,,0
HCPCS,86015,Hc Actin Smooth Muscle Antibody Each So,45.0,29.25,,,0
HCPCS,86021,Hc Wbc Antibody Identification So,208.0,135.2,,,0
HCPCS,86021,WBC antibody identification,,,15.05,56.44,3
HCPCS,86022,Hc Platelet Antibody,722.0,469.3,,,0
HCPCS,86022,Hc Platelet Antibody So,84.0,54.6,,,0
HCPCS,86022,Platelet antibodies,,,18.37,68.89,3
HCPCS,86023,Hc Antibody Identification Platelet Associated Igm So,170.0,110.5,,,0
HCPCS,86023,Immunoglobulin assay,,,12.46,46.73,3
HCPCS,86036,Anca screen each antibody,,,12.05,45.19,3
HCPCS,86036,Hc Antineutrophil Cytoplasmic Antb Screen Ea Antb,220.0,143.0,,,0
HCPCS,86036,Hc Antineutrophil Cytoplasmic Antb Screen Ea Antb So,53.0,34.45,,,0
HCPCS,86037,Anca titer each antibody,,,12.05,45.19,3
HCPCS,86037,Hc Antineutrophil Cytoplasmic Antb Titer Ea Antb,207.0,134.55,,,0
HCPCS,86037,Hc Antineutrophil Cytoplasmic Antb Titer Ea Antb So,55.0,35.75,,,0
HCPCS,86038,Antinuclear antibodies,,,12.09,45.34,3
HCPCS,86038,Hc Antinuclear Abs (Ana),189.0,122.85,,,0
HCPCS,86038,Hc Antinuclear Abs (Ana) So,101.0,65.65,,,0
HCPCS,86039,Antinuclear antibodies (ANA),,,11.16,41.85,3
HCPCS,86039,Hc Ana  Titer,194.0,126.1,,,0
HCPCS,86039,Hc Ana Titer So,27.0,17.55,,,0
HCPCS,86041,Acetylcholn rcptr bndng antb,,,18.4,69.0,3
HCPCS,86041,Hc Acetylcholine Receptor Binding Antibody So,100.0,65.0,,,0
HCPCS,86042,Acetylcholn rcptr blckg antb,,,18.4,69.0,3
HCPCS,86043,Acetylcholn rcptr modlg antb,,,12.05,45.19,3
HCPCS,86043,Hc Acetylcholine Receptor Modulating Antibody So,225.0,146.25,,,0
HCPCS,86051,Aquaporin-4 antb elisa,,,11.53,43.24,3
HCPCS,86052,Aquaporin-4 antb cba each,,,12.05,45.19,3
HCPCS,86053,Aqaprn-4 antb flo cytmtry ea,,,37.73,141.49,3
HCPCS,86053,Hc Aquaporin-4 Antibody Flow Cytometry Each So,532.0,345.8,,,0
HCPCS,86060,Antistreptolysin o titer,,,7.3,27.38,3
HCPCS,86060,Hc Antistreptolysin O Titer,32.0,20.8,,,0
HCPCS,86063,Antistreptolysin o screen,,,5.77,21.64,3
HCPCS,86077,Phys blood bank serv xmatch,,,27.89,93.6,3
HCPCS,86078,Phys blood bank serv reactj,,,164.27,589.69,3
HCPCS,86079,Phys blood bank serv authrj,,,50.25,188.03,3
HCPCS,86140,C-reactive protein,,,5.18,19.43,3
HCPCS,86140,Hc C Reactive Protein Crp,38.0,24.7,,,0
HCPCS,86140,Hc C Reactive Protein Crp So,30.0,19.5,,,0
HCPCS,86141,C-reactive protein hs,,,12.95,48.56,3
HCPCS,86141,Hc C Reactive Protein Cardiac Risk,38.0,24.7,,,0
HCPCS,86146,Beta-2 glycoprotein antibody,,,25.45,95.44,3
HCPCS,86146,Hc Beta 2 Glycoprotein 1 Antibody Each So,71.0,46.15,,,0
HCPCS,86147,Cardiolipin antibody ea ig,,,25.45,95.44,3
HCPCS,86147,Hc Cardiolipin (Phospholipid) Antibody Ea Ig Class So,54.0,35.1,,,0
HCPCS,86147,Hc Cardiolipin Antibody Ea Ig Class,135.0,87.75,,,0
HCPCS,86148,Anti-phospholipid antibody,,,16.07,60.26,3
HCPCS,86148,Hc Anti Phosphatidylserine Ab,587.0,381.55,,,0
HCPCS,86152,Cell enumeration & id,,,250.78,940.43,3
HCPCS,86152,Hc Cell Enumeration And Id So,1584.0,1029.6,,,0
HCPCS,86155,Chemotaxis assay,,,15.99,59.96,3
HCPCS,86156,Cold agglutinin screen,,,8.07,30.26,3
HCPCS,86157,Cold agglutinin titer,,,8.06,30.23,3
HCPCS,86157,Hc Cold Agglutinin Titer,80.0,52.0,,,0
HCPCS,86160,Complement antigen,,,12.0,45.0,3
HCPCS,86160,Hc Complement Antigen Each Component,55.0,35.75,,,0
HCPCS,86160,Hc Complement Antigen Each Component So,108.0,70.2,,,0
HCPCS,86160,Hc Complement Antigen Each Component Special So,409.0,265.85,,,0
HCPCS,86161,Complement/function activity,,,12.0,45.0,3
HCPCS,86161,Hc Complement Functional Activity Each So,272.0,176.8,,,0
HCPCS,86161,Hc Complement Functional Activity Each Special So,457.0,297.05,,,0
HCPCS,86162,Complement total (ch50),,,20.32,76.2,3
HCPCS,86162,Hc Complement Ch50 Total So,60.0,39.0,,,0
HCPCS,86162,Hc Complement Ch50 Total Special So,818.0,531.7,,,0
HCPCS,86171,Complement fixation each,,,10.01,37.54,3
HCPCS,86171,Hc Complement Fixation Tests Ea Antigen So,221.0,143.65,,,0
HCPCS,86200,Ccp antibody,,,12.95,48.56,3
HCPCS,86200,Hc Ccp Antibody,162.0,105.3,,,0
HCPCS,86215,Deoxyribonuclease antibody,,,13.25,49.69,3
HCPCS,86215,Hc Dnase Antibody So,48.0,31.2,,,0
HCPCS,86225,Dna antibody native,,,13.74,51.53,3
HCPCS,86225,Hc Dna Double Strand Antibody Dna Ds,238.0,154.7,,,0
HCPCS,86225,Hc Dna Double Strand Antibody So,36.0,23.4,,,0
HCPCS,86226,Dna antibody single strand,,,12.11,45.41,3
HCPCS,86226,Hc Dna Antibody Single Stranded So,469.0,304.85,,,0
HCPCS,86231,Ema each ig class,,,12.09,45.34,3
HCPCS,86231,Hc Endomysial Antibody Each Immunoglobulin Class So,67.0,43.55,,,0
HCPCS,86231,Hc Endomysial Antibody Each Immunoglobulin Class Special So,360.0,234.0,,,0
HCPCS,86235,Hc Ena Antibodies Each So,55.0,35.75,,,0
HCPCS,86235,Hc Ena Antibodies Each Special So,1188.0,772.2,,,0
HCPCS,86235,Hc Ena Antibody Each So,344.0,223.6,,,0
HCPCS,86235,Hc Ena Screen,183.0,118.95,,,0
HCPCS,86235,Nuclear antigen antibody,,,17.93,67.24,3
HCPCS,86255,Fluorescent antibody screen,,,12.05,45.19,3
HCPCS,86255,Hc Fluorescent Ab Scrn Ea Ab So,490.0,318.5,,,0
HCPCS,86255,Hc Fluorescent Antibody Screen,236.0,153.4,,,0
HCPCS,86255,Hc Fluorescent Antibody Special So,1240.0,806.0,,,0
HCPCS,86256,Fluorescent antibody titer,,,12.05,45.19,3
HCPCS,86256,Hc Fluorescent Antibody Titer,223.0,144.95,,,0
HCPCS,86256,Hc Fluorescent Antibody Titer So,210.0,136.5,,,0
HCPCS,86256,Hc Fluorescent Antibody Titer Special So,420.0,273.0,,,0
HCPCS,86258,Dgp antibody each ig class,,,12.05,45.19,3
HCPCS,86258,Hc Gliadin Antibody Each Immunoglobulin Class So,54.0,35.1,,,0
HCPCS,86277,Growth hormone antibody,,,15.74,59.03,3
HCPCS,86280,Hemagglutination inhibition,,,8.19,30.71,3
HCPCS,86294,Immunoassay tumor qual,,,25.57,95.89,3
HCPCS,86300,Hc Cancer Antigen 15-3 (Ca 15-3) So,53.0,34.45,,,0
HCPCS,86300,Hc Ia For Tumor Antigen Quant Ca27.29,145.0,94.25,,,0
HCPCS,86300,Immunoassay tumor ca 15-3,,,20.81,78.04,3
HCPCS,86301,Hc Ca 19 9,39.0,25.35,,,0
HCPCS,86301,Hc Ca 19 9 Pancreatic Cyst Fluid So,43.0,27.95,,,0
HCPCS,86301,Immunoassay tumor ca 19-9,,,20.81,78.04,3
HCPCS,86304,Hc Ca 125 So,39.0,25.35,,,0
HCPCS,86304,Immunoassay tumor ca 125,,,20.81,78.04,3
HCPCS,86305,Hc Human Epididymis Protein 4 He4 So,113.0,73.45,,,0
HCPCS,86305,Human epididymis protein 4,,,20.81,78.04,3
HCPCS,86308,Hc Fsed Heterophile Antibodies Screen,181.0,117.65,,,0
HCPCS,86308,Hc Heterophile Antibodies Screen,181.0,117.65,,,0
HCPCS,86308,Heterophile antibody screen,,,5.18,19.43,3
HCPCS,86309,Heterophile antibody titer,,,6.47,24.26,3
HCPCS,86310,Hc Heterophile Antibodies Titer,50.0,32.5,,,0
HCPCS,86310,Heterophile antibody absrbj,,,7.37,27.64,3
HCPCS,86316,Hc Immunoassay Tumor Antigen Quant Special So,564.0,366.6,,,0
HCPCS,86316,Hc Immunoassay Tumor Antigen Quantitative So,54.0,35.1,,,0
HCPCS,86316,Immunoassay tumor other,,,20.81,78.04,3
HCPCS,86317,Hc Immunoassay Infect Agent Ab Quant Nos,223.0,144.95,,,0
HCPCS,86317,Hc Immunoassay Infect Agent Ab Quant Nos So,94.0,61.1,,,0
HCPCS,86317,Immunoassay infectious agent,,,14.99,56.21,3
HCPCS,86318,Immunoassay infectious agent,,,18.09,67.84,3
HCPCS,86320,Serum immunoelectrophoresis,,,29.92,112.2,3
HCPCS,86325,Other immunoelectrophoresis,,,23.13,86.74,3
HCPCS,86327,Immunoelectrophoresis assay,,,112.2,112.2,2
HCPCS,86328,Ia nfct ab sarscov2 covid19,,,45.28,169.8,3
HCPCS,86329,Immunodiffusion nes,,,14.05,52.69,3
HCPCS,86331,Hc Immunodiffusion  Gel Dif Qual Ea Ag Antb,144.0,93.6,,,0
HCPCS,86331,Hc Immunodiffusion  Gel Dif Qual Ea Ag Antb So,253.0,164.45,,,0
HCPCS,86331,Immunodiffusion ouchterlony,,,11.98,44.93,3
HCPCS,86332,Hc Immune Complex Assay So,240.0,156.0,,,0
HCPCS,86332,Hc Immune Complex Assay Special So,1268.0,824.2,,,0
HCPCS,86332,Immune complex assay,,,24.37,91.39,3
HCPCS,86334,Hc Immunofixation Electrophoresis Serum Ife,320.0,208.0,,,0
HCPCS,86334,Immunofix e-phoresis serum,,,22.34,83.78,3
HCPCS,86335,Hc Immunofixation Electrophoresis Other Fluid Ife,380.0,247.0,,,0
HCPCS,86335,Hc Immunofixation Electrophoresis Other Fluid Ife So,215.0,139.75,,,0
HCPCS,86335,Immunfix e-phorsis/urine/csf,,,29.35,110.06,3
HCPCS,86336,Hc Inhibin A,47.0,30.55,,,0
HCPCS,86336,Hc Inhibin A So,78.0,50.7,,,0
HCPCS,86336,Inhibin A,,,15.59,58.46,3
HCPCS,86337,Hc Insulin Antibody So,104.0,67.6,,,0
HCPCS,86337,Insulin antibodies,,,21.41,80.29,3
HCPCS,86340,Hc Intrinsic Factor Antibody So,55.0,35.75,,,0
HCPCS,86340,Intrinsic factor antibody,,,15.08,56.55,3
HCPCS,86341,Hc Islet Cell Antibody So,84.0,54.6,,,0
HCPCS,86341,Hc Zinc Transporter 8 (Znt8) Antibody So,1304.0,847.6,,,0
HCPCS,86341,Islet cell antibody,,,23.57,88.39,3
HCPCS,86343,Hc Leukocyte Histamine Release So,401.0,260.65,,,0
HCPCS,86343,Hc Leukocyte Histamine Release Test Lhr So,446.0,289.9,,,0
HCPCS,86343,Leukocyte histamine release,,,12.46,46.73,3
HCPCS,86344,Leukocyte phagocytosis,,,10.39,38.96,3
HCPCS,86352,Cell function assay w/stim,,,135.86,509.48,3
HCPCS,86352,Hc Cell Fxn Assay Stim And Detect Biomrkr So,1527.0,992.55,,,0
HCPCS,86353,Hc Lymphocyte Mitogen Proliferation So,667.0,433.55,,,0
HCPCS,86353,Lymphocyte transformation,,,49.03,183.86,3
HCPCS,86355,B cells total count,,,37.73,141.49,3
HCPCS,86355,Hc B Cells Total Count,580.0,377.0,,,0
HCPCS,86355,Hc B Cells Total Count So,51.0,33.15,,,0
HCPCS,86356,Hc Mononuclear Cell Ag Quant Nos Ea,276.0,179.4,,,0
HCPCS,86356,Hc Mononuclear Cell Ag Quant Nos Ea So,282.0,183.3,,,0
HCPCS,86356,Hc Mononuclear Cell Ag Quant Nos Ea Special So,405.0,263.25,,,0
HCPCS,86356,Mononuclear cell antigen,,,26.78,100.43,3
HCPCS,86357,Hc Natural Killer Cells Total Ct,579.0,376.35,,,0
HCPCS,86357,Hc Natural Killer Cells Total Ct So,51.0,33.15,,,0
HCPCS,86357,Nk cells total count,,,37.73,141.49,3
HCPCS,86359,Hc T Cells Total Count,645.0,419.25,,,0
HCPCS,86359,Hc T Cells Total Count Bmt,328.0,213.2,,,0
HCPCS,86359,Hc T Cells Total Count Bmt So,60.0,39.0,,,0
HCPCS,86359,Hc T Cells Total Count So,51.0,33.15,,,0
HCPCS,86359,Hc T Cells Total Count Special So,714.0,464.1,,,0
HCPCS,86359,T cells total count,,,37.73,141.49,3
HCPCS,86360,Hc Cd4 And Cd8 Count W Ratio,467.0,303.55,,,0
HCPCS,86360,Hc Cd4 And Cd8 Count W Ratio So,62.0,40.3,,,0
HCPCS,86360,T cell absolute count/ratio,,,46.98,176.18,3
HCPCS,86361,Hc Cd4 Count,442.0,287.3,,,0
HCPCS,86361,Hc Cd4 Count Special So,507.0,329.55,,,0
HCPCS,86361,T cell absolute count,,,26.78,100.43,3
HCPCS,86362,Hc Mog-Igg1 Antibody Cell-Based Imfluor Assay Each So,2052.0,1333.8,,,0
HCPCS,86362,Mog-igg1 antb cba each,,,12.05,45.19,3
HCPCS,86363,Hc Mog-Igg1 Antibody Flow Cytometry Each So,1283.0,833.95,,,0
HCPCS,86363,Mog-igg1 antb flo cytmtry ea,,,37.73,141.49,3
HCPCS,86364,Hc Tissue Transglutaminase Ea Immunoglobulin Class,198.0,128.7,,,0
HCPCS,86364,Hc Tissue Transglutaminase Ea Immunoglobulin Class So,52.0,33.8,,,0
HCPCS,86364,Tiss trnsgltmnase ea ig clas,,,11.53,43.24,3
HCPCS,86366,Hc Muscle-Specific Kinase Antibody So,1650.0,1072.5,,,0
HCPCS,86366,Muscle-specific kinase antb,,,18.4,69.0,3
HCPCS,86367,Hc Stem Cells Total Count Cd34 Allo Donor,365.0,237.25,,,0
HCPCS,86367,Hc Stem Cells Total Count Cd34 Auto Donor,365.0,237.25,,,0
HCPCS,86367,Hc Stem Cells Total Count Cd34 Product,328.0,213.2,,,0
HCPCS,86367,Stem cells total count,,,77.78,291.68,3
HCPCS,86376,Hc Microsomal Liver Or Kidney Antibody Each So,59.0,38.35,,,0
HCPCS,86376,Hc Thyroid Peroxidase Antibody Tpo,76.0,49.4,,,0
HCPCS,86376,Microsomal antibody each,,,14.55,54.56,3
HCPCS,86381,Hc Mitochondrial Antibody Each,220.0,143.0,,,0
HCPCS,86381,Mitochondrial antibody each,,,25.45,95.44,3
HCPCS,86382,Hc Neutralization Test Viral So,382.0,248.3,,,0
HCPCS,86382,Neutralization test viral,,,16.91,63.41,3
HCPCS,86384,Nitroblue tetrazolium dye,,,13.61,51.04,3
HCPCS,86386,Nuclear matrix protein 22,,,21.78,81.68,3
HCPCS,86403,Hc Particle Agglutination Screen So,118.0,76.7,,,0
HCPCS,86403,Particle agglut antbdy scrn,,,11.54,43.28,3
HCPCS,86406,Hc Particle Agglutination Titer Ea Antibody So,206.0,133.9,,,0
HCPCS,86406,Particle agglut antbdy titr,,,10.64,39.9,3
HCPCS,86408,Neutrlzg antb sarscov2 scr,,,42.13,157.99,3
HCPCS,86409,Hc Neutralizing Antibody Sars-Cov2 Titer So,810.0,526.5,,,0
HCPCS,86409,Neutrlzg antb sarscov2 titer,,,79.61,395.21,3
HCPCS,86413,Sars-cov-2 antb quantitative,,,51.43,157.58,3
HCPCS,86430,Hc Rheumatoid Factor Qualitative,50.0,32.5,,,0
HCPCS,86430,Rheumatoid factor test qual,,,6.14,23.03,3
HCPCS,86431,Hc Rheumatoid Factor Rf Body Fluid So,40.0,26.0,,,0
HCPCS,86431,Hc Rheumatoid Factor Rf Quantitative,58.0,37.7,,,0
HCPCS,86431,Rheumatoid factor quant,,,5.67,21.26,3
HCPCS,86480,Hc M Tuberculosis By Quantiferon,212.0,137.8,,,0
HCPCS,86480,Hc M Tuberculosis By Quantiferon So,106.0,68.9,,,0
HCPCS,86480,Tb test cell immun measure,,,61.98,232.43,3
HCPCS,86481,Hc T Spot Tb Screen So,194.0,126.1,,,0
HCPCS,86481,Tb ag response t-cell susp,,,100.0,375.0,3
HCPCS,86485,Skin test candida,,,27.89,93.6,3
HCPCS,86486,Skin test nos antigen,,,27.89,93.6,3
HCPCS,86490,Coccidioidomycosis skin test,,,215.55,215.55,2
HCPCS,86510,Histoplasmosis skin test,,,36.01,215.55,3
HCPCS,86580,Hc Skin Test Tb Intradermal  So,101.0,65.65,,,0
HCPCS,86580,TB intradermal test,,,27.89,93.6,3
HCPCS,86581,Strptcs pneum antb serot ia,,,92.03,92.03,1
HCPCS,86590,Streptokinase antibody,,,12.66,47.48,3
HCPCS,86592,Hc Donor Syphilis-Pk-Tp So,32.0,20.8,,,0
HCPCS,86592,Hc Recipient Syphilis-Pk-Tp So,32.0,20.8,,,0
HCPCS,86592,Hc Rpr Qualitative,12.0,7.8,,,0
HCPCS,86592,Hc Rpr Vdrl So,12.0,7.8,,,0
HCPCS,86592,Syphilis test non-trep qual,,,4.27,16.01,3
HCPCS,86593,Hc Rpr Quantitative,103.0,66.95,,,0
HCPCS,86593,Hc Vdrl Quantitative So,49.0,31.85,,,0
HCPCS,86593,Syphilis test non-trep quant,,,4.4,16.5,3
HCPCS,86596,Hc Voltage-Gated Calcium Channel Antibody Each So,690.0,448.5,,,0
HCPCS,86596,Voltage-gtd ca chnl antb ea,,,12.05,45.19,3
HCPCS,86602,Antinomyces antibody,,,10.18,38.18,3
HCPCS,86603,Adenovirus antibody,,,12.87,48.26,3
HCPCS,86603,Hc Adenovirus Antibody,216.0,140.4,,,0
HCPCS,86606,Aspergillus antibody,,,15.05,56.44,3
HCPCS,86606,Hc Aspergillus Antibody,191.0,124.15,,,0
HCPCS,86606,Hc Aspergillus Fumigatus Antbdy Igg So,81.0,52.65,,,0
HCPCS,86609,Bacterium antibody,,,12.88,48.3,3
HCPCS,86609,Hc Bacterium Antibody So,216.0,140.4,,,0
HCPCS,86611,Bartonella Antibody,,,10.18,38.18,3
HCPCS,86611,Hc Bartonella Antibody So,109.0,70.85,,,0
HCPCS,86612,Blastomyces antibody,,,12.9,48.38,3
HCPCS,86612,Hc Blastomyces Antibody,189.0,122.85,,,0
HCPCS,86612,Hc Blastomyces Antibody So,122.0,79.3,,,0
HCPCS,86615,Bordetella antibody,,,13.19,49.46,3
HCPCS,86615,Hc Bordetella Antibody,468.0,304.2,,,0
HCPCS,86615,Hc Bordetella Antibody So,216.0,140.4,,,0
HCPCS,86617,Hc Lyme Disease Confirmation So,73.0,47.45,,,0
HCPCS,86617,Lyme disease antibody,,,15.49,58.09,3
HCPCS,86618,Hc Lyme Disease Antibody,190.0,123.5,,,0
HCPCS,86618,Hc Lyme Disease Antibody So,68.0,44.2,,,0
HCPCS,86618,Lyme disease antibody,,,17.03,63.86,3
HCPCS,86619,Borrelia antibody,,,13.38,50.18,3
HCPCS,86622,Brucella antibody,,,8.93,33.49,3
HCPCS,86622,Hc Brucella Antibody Confirm So,121.0,78.65,,,0
HCPCS,86625,Campylobacter antibody,,,13.12,49.2,3
HCPCS,86625,Hc Campylobacter Jejuni Antibody,78.0,50.7,,,0
HCPCS,86628,Candida antibody,,,12.01,45.04,3
HCPCS,86628,Hc Candida Antibody,244.0,158.6,,,0
HCPCS,86631,Chlamydia antibody,,,11.82,44.33,3
HCPCS,86631,Hc Chlamydia Antibody So,113.0,73.45,,,0
HCPCS,86632,Chlamydia igm antibody,,,12.68,47.55,3
HCPCS,86632,Hc Chlamydia Igm So,113.0,73.45,,,0
HCPCS,86635,Coccidioides antibody,,,11.47,43.01,3
HCPCS,86635,Hc Coccidioides Antibody,200.0,130.0,,,0
HCPCS,86635,Hc Coccidioides Antibody So,109.0,70.85,,,0
HCPCS,86638,Hc Q Fever Antibody So,164.0,106.6,,,0
HCPCS,86638,Q fever antibody,,,12.12,45.45,3
HCPCS,86641,Cryptococcus antibody,,,14.41,54.04,3
HCPCS,86644,CMV antibody,,,14.39,53.96,3
HCPCS,86644,Hc Cmv Antibody,189.0,122.85,,,0
HCPCS,86644,Hc Cmv Antibody So,407.0,264.55,,,0
HCPCS,86644,Hc Donor Cytomegalovirus Antibody-Pk-Cmv So,35.0,22.75,,,0
HCPCS,86644,Hc Recipient Cytomegalovirus Antibody-Pk-Cmv So,35.0,22.75,,,0
HCPCS,86645,Cmv antibody igm,,,16.85,63.19,3
HCPCS,86645,Hc Cmv Antibody Igm,187.0,121.55,,,0
HCPCS,86648,Diphtheria antibody,,,15.21,57.04,3
HCPCS,86648,Hc Diphtheria Antibody,145.0,94.25,,,0
HCPCS,86651,Encephalitis californ antbdy,,,13.19,49.46,3
HCPCS,86651,Hc Encephalitis California Antibody So,67.0,43.55,,,0
HCPCS,86652,Encephaltis east eqne anbdy,,,13.19,49.46,3
HCPCS,86652,Hc Encephalitis Eastern Equine Antib So,146.0,94.9,,,0
HCPCS,86653,Encephaltis st louis antbody,,,13.19,49.46,3
HCPCS,86653,Hc St Louis Encephalitis Antibody So,67.0,43.55,,,0
HCPCS,86654,Encephaltis west eqne antbdy,,,13.19,49.46,3
HCPCS,86654,Hc Encephalitis Western Equine Antib So,170.0,110.5,,,0
HCPCS,86658,Enterovirus antibody,,,13.03,48.86,3
HCPCS,86658,Hc Enterovirus Antibody So,184.0,119.6,,,0
HCPCS,86663,Epstein-barr antibody,,,13.12,49.2,3
HCPCS,86663,Hc Ebv Early Antigen,84.0,54.6,,,0
HCPCS,86664,Epstein-barr nuclear antigen,,,15.29,57.34,3
HCPCS,86664,Hc Ebv Nuclear Antigen Ebna,164.0,106.6,,,0
HCPCS,86665,Epstein-barr capsid vca,,,18.14,68.03,3
HCPCS,86665,Hc Ebv Viral Capsid Vca,100.0,65.0,,,0
HCPCS,86666,Ehrlichia Antibody,,,10.18,38.18,3
HCPCS,86666,Hc Ehrlichia Antibody So,116.0,75.4,,,0
HCPCS,86668,Francisella tularensis,,,14.16,53.1,3
HCPCS,86668,Hc Francisella Tularensis Antibody So,401.0,260.65,,,0
HCPCS,86671,Fungus nes antibody,,,12.25,45.94,3
HCPCS,86671,Hc Fungus Antibody Nes So,67.0,43.55,,,0
HCPCS,86674,Giardia lamblia antibody,,,14.72,55.2,3
HCPCS,86674,Hc Giardia Antibody So,167.0,108.55,,,0
HCPCS,86677,Hc Helicobacter Iga Igm So,88.0,57.2,,,0
HCPCS,86677,Hc Helicobacter Pylori Igg,165.0,107.25,,,0
HCPCS,86677,Helicobacter pylori antibody,,,16.85,63.19,3
HCPCS,86682,Hc Helminth Antibody Nes So,121.0,78.65,,,0
HCPCS,86682,Helminth antibody,,,13.01,48.79,3
HCPCS,86684,Hc Haemophilus Influenza Antibody So,68.0,44.2,,,0
HCPCS,86684,Hemophilus influenza antibdy,,,15.84,59.4,3
HCPCS,86687,Hc Donor Htlv-I Antibody (Htlv-I)-Abbott So,32.0,20.8,,,0
HCPCS,86687,Hc Htlv 1 Antibody,88.0,57.2,,,0
HCPCS,86687,Hc Recipient Htlv-I Antibody (Htlv-I)-Abbott So,32.0,20.8,,,0
HCPCS,86687,Htlv-i antibody,,,9.09,34.09,3
HCPCS,86688,Hc Donor Htlv-Ii Antibody (Htlv-Ii)-Abbott So,32.0,20.8,,,0
HCPCS,86688,Hc Recipient Htlv-Ii Antibody (Htlv-Ii)-Abbott So,32.0,20.8,,,0
HCPCS,86688,Htlv-ii antibody,,,14.0,52.5,3
HCPCS,86689,Hc Hiv Or Htlv Antibody Confirm,230.0,149.5,,,0
HCPCS,86689,Hc Hiv Or Htlv Antibody Confirm So,350.0,227.5,,,0
HCPCS,86689,Htlv/hiv confirmj antibody,,,19.35,72.56,3
HCPCS,86692,Hc Hepatitis Delta Antibody So,200.0,130.0,,,0
HCPCS,86692,Hepatitis delta agent antbdy,,,17.16,64.35,3
HCPCS,86694,Hc Herpes Simplex Antibody So,49.0,31.85,,,0
HCPCS,86694,Herpes simplex nes antbdy,,,14.39,53.96,3
HCPCS,86695,Hc Herpes 1 Igg,102.0,66.3,,,0
HCPCS,86695,Herpes simplex type 1 test,,,13.19,49.46,3
HCPCS,86696,Hc Herpes Simplex Type 2 Igg,102.0,66.3,,,0
HCPCS,86696,Herpes simplex type 2 test,,,19.35,72.56,3
HCPCS,86698,Hc Histoplasma Antibody,142.0,92.3,,,0
HCPCS,86698,Hc Histoplasma Mycelial Antibody So,81.0,52.65,,,0
HCPCS,86698,Histoplasma antibody,,,13.79,51.71,3
HCPCS,86701,Hc Hiv-1/-2 Ab Differentiation So,521.0,338.65,,,0
HCPCS,86701,Hiv-1antibody,,,8.89,33.34,3
HCPCS,86702,Hc Hiv 2 Antibody So,104.0,67.6,,,0
HCPCS,86702,Hiv-2 antibody,,,13.52,50.7,3
HCPCS,86703,Hc Donor Hiv Antibody (Hiv-1/2/O) So,38.0,24.7,,,0
HCPCS,86703,Hc Hiv 1 And 2 Single Result,38.0,24.7,,,0
HCPCS,86703,Hc Hiv 1 And 2 Single Result Rapid,38.0,24.7,,,0
HCPCS,86703,Hc Recipient Hiv Antibody (Hiv-1/2/O) So,38.0,24.7,,,0
HCPCS,86703,Hiv-1/hiv-2 1 result antbdy,,,13.71,51.41,3
HCPCS,86704,Hc Donor Hepatitis B Core Antibody (Hbc)-Abbott So,45.0,29.25,,,0
HCPCS,86704,Hc Hepatitis B Core Total Antibody,88.0,57.2,,,0
HCPCS,86704,Hc Recipient Hepatitis B Core Antibody (Hbc)-Abbott So,45.0,29.25,,,0
HCPCS,86704,Hep b core antibody total,,,12.05,45.19,3
HCPCS,86705,Hc Hepatitis B Core Igm,94.0,61.1,,,0
HCPCS,86705,Hep b core antibody igm,,,11.77,44.14,3
HCPCS,86706,Hc Hepatitis B Surface Antibody,72.0,46.8,,,0
HCPCS,86706,Hep b surface antibody,,,10.74,40.28,3
HCPCS,86707,Hc Hepatitis Be Antibody,41.0,26.65,,,0
HCPCS,86707,Hc Hepatitis Be Antibody So,37.0,24.05,,,0
HCPCS,86707,Hepatitis be antibody,,,11.57,43.39,3
HCPCS,86708,Hc Hepatitis A Total Antibody,71.0,46.15,,,0
HCPCS,86708,Hepatitis a antibody,,,12.39,46.46,3
HCPCS,86709,Hc Hepatitis A Igm,76.0,49.4,,,0
HCPCS,86709,Hepatitis a igm antibody,,,11.26,42.23,3
HCPCS,86710,Hc Influenza Antibodies So,83.0,53.95,,,0
HCPCS,86710,Influenza virus antibody,,,13.55,50.81,3
HCPCS,86711,John cunningham antibody,,,16.89,63.34,3
HCPCS,86713,Hc Legionella Antibody So,54.0,35.1,,,0
HCPCS,86713,Legionella antibody,,,15.3,57.38,3
HCPCS,86717,Hc Leishmania Antibody So,105.0,68.25,,,0
HCPCS,86717,Leishmania antibody,,,12.25,45.94,3
HCPCS,86720,Hc Leptospira Antibody So,134.0,87.1,,,0
HCPCS,86720,Leptospira antibody,,,16.2,60.75,3
HCPCS,86723,Hc Listeria Antibody,235.0,152.75,,,0
HCPCS,86723,Listeria monocytogenes,,,13.19,49.46,3
HCPCS,86727,Hc Lymphocytic Choriomeningitis Antibody,305.0,198.25,,,0
HCPCS,86727,Lymph choriomeningitis ab,,,12.87,48.26,3
HCPCS,86732,Mucormycosis antibody,,,15.0,56.25,3
HCPCS,86735,Hc Mumps Antibodies So,56.0,36.4,,,0
HCPCS,86735,Hc Mumps Antibody,199.0,129.35,,,0
HCPCS,86735,Mumps antibody,,,13.05,48.94,3
HCPCS,86738,Hc Mycoplasma Antibody Igm,185.0,120.25,,,0
HCPCS,86738,Hc Mycoplasma Antibody So,86.0,55.9,,,0
HCPCS,86738,Mycoplasma antibody,,,13.24,49.65,3
HCPCS,86741,Neisseria meningitidis,,,13.19,49.46,3
HCPCS,86744,Nocardia antibody,,,15.99,59.96,3
HCPCS,86747,Hc Parvovirus Antibody So,54.0,35.1,,,0
HCPCS,86747,Parvovirus antibody,,,15.03,56.36,3
HCPCS,86750,Hc Malaria Antibody Screen,36.0,23.4,,,0
HCPCS,86750,Malaria antibody,,,13.19,49.46,3
HCPCS,86753,Hc Donor Chagas Tcruzi Ab So,56.0,36.4,,,0
HCPCS,86753,Hc Protozoa Antibody Nes So,132.0,85.8,,,0
HCPCS,86753,Hc Recipient Chagas Tcruzi Ab So,56.0,36.4,,,0
HCPCS,86753,Protozoa antibody nos,,,12.39,46.46,3
HCPCS,86756,Respiratory virus antibody,,,15.89,59.59,3
HCPCS,86757,Hc Rickettsia Antibody,114.0,74.1,,,0
HCPCS,86757,Hc Rickettsia Antibody So,108.0,70.2,,,0
HCPCS,86757,Rickettsia Antibody,,,19.35,72.56,3
HCPCS,86759,Rotavirus antibody,,,18.23,68.36,3
HCPCS,86762,Hc Rubella Antibody,36.0,23.4,,,0
HCPCS,86762,Hc Rubella Antibody So,28.0,18.2,,,0
HCPCS,86762,Rubella antibody,,,14.39,53.96,3
HCPCS,86765,Hc Rubeola Antibody Igg,196.0,127.4,,,0
HCPCS,86765,Hc Rubeola Antibody So,54.0,35.1,,,0
HCPCS,86765,Rubeola antibody,,,12.88,48.3,3
HCPCS,86768,Hc Salmonella Antibody So,75.0,48.75,,,0
HCPCS,86768,Salmonella antibody,,,13.19,49.46,3
HCPCS,86769,Hc Sars-Cov-2 Covid-19 Antibody,73.0,47.45,,,0
HCPCS,86769,Hc Sars-Cov-2 Covid-19 Antibody So,116.0,75.4,,,0
HCPCS,86769,Sars-cov-2 covid-19 antibody,,,42.13,157.99,3
HCPCS,86771,Shigella antibody,,,24.48,91.8,3
HCPCS,86774,Hc Tetanus Antibody,145.0,94.25,,,0
HCPCS,86774,Tetanus antibody,,,14.8,55.5,3
HCPCS,86777,Hc Toxoplasma Antibody,39.0,25.35,,,0
HCPCS,86777,Hc Toxoplasma Antibody Igg Special So,433.0,281.45,,,0
HCPCS,86777,Toxoplasma antibody,,,14.39,53.96,3
HCPCS,86778,Hc Toxoplasma Antibody Igm Special So,424.0,275.6,,,0
HCPCS,86778,Hc Toxoplasma Igm Antibody,39.0,25.35,,,0
HCPCS,86778,Toxoplasma antibody igm,,,14.41,54.04,3
HCPCS,86780,Hc Treponema Pallidum Antibody,35.0,22.75,,,0
HCPCS,86780,Hc Treponema Pallidum Antibody So,103.0,66.95,,,0
HCPCS,86780,Treponema pallidum,,,13.24,49.65,3
HCPCS,86784,Hc Trichinella Antibody So,165.0,107.25,,,0
HCPCS,86784,Trichinella antibody,,,12.56,47.1,3
HCPCS,86787,Hc Varicella Zoster Igg Antibody,194.0,126.1,,,0
HCPCS,86787,Hc Varicella Zoster Igm Antibody So,54.0,35.1,,,0
HCPCS,86787,Varicella-zoster antibody,,,12.88,48.3,3
HCPCS,86788,Hc West Nile Virus Antibody Igm So,142.0,92.3,,,0
HCPCS,86788,West nile virus ab igm,,,16.85,63.19,3
HCPCS,86789,Hc West Nile Virus Antibodies So,142.0,92.3,,,0
HCPCS,86789,West Nile Virus Antibody,,,14.39,53.96,3
HCPCS,86790,Hc Virus Antibody Nes So,92.0,59.8,,,0
HCPCS,86790,Hc Virus Antibody Nes Special So,516.0,335.4,,,0
HCPCS,86790,Virus antibody nos,,,12.88,48.3,3
HCPCS,86793,Hc Yersinia Antibody So,323.0,209.95,,,0
HCPCS,86793,Yersinia antibody,,,13.19,49.46,3
HCPCS,86794,"Hc Antibody; Zika Virus, Igm So",299.0,194.35,,,0
HCPCS,86794,Zika virus igm antibody,,,16.85,63.19,3
HCPCS,86800,Hc Thyroglobulin Antibody Tbg Ab,126.0,81.9,,,0
HCPCS,86800,Thyroglobulin antibody,,,15.91,59.66,3
HCPCS,86803,Hc Donor Hepatitis C Virus Antibody (Hcv)-Abbott So,36.0,23.4,,,0
HCPCS,86803,Hc Hepatitis C Antibody Screen,36.0,23.4,,,0
HCPCS,86803,Hc Recipient Hepatitis C Virus Antibody (Hcv)-Abbott So,36.0,23.4,,,0
HCPCS,86803,Hepatitis c ab test,,,14.27,53.51,3
HCPCS,86804,Hc Hep C Ab Test Confirm So,779.0,506.35,,,0
HCPCS,86804,Hep c ab test confirm,,,15.49,58.09,3
HCPCS,86805,Lymphocytotoxicity assay,,,189.51,710.66,3
HCPCS,86806,Hc Crossmatch Platelet,1837.0,1194.05,,,0
HCPCS,86806,Lymphocytotoxicity assay,,,47.59,178.46,3
HCPCS,86807,Cytotoxic antibody screening,,,78.65,294.94,3
HCPCS,86808,Cytotoxic antibody screening,,,29.68,111.3,3
HCPCS,86812,Hc Hla Matched Product,191.0,124.15,,,0
HCPCS,86812,Hc Hla Typing B So,81.0,52.65,,,0
HCPCS,86812,Hla typing a b or c,,,25.81,96.79,3
HCPCS,86813,Hla typing a b or c,,,58.0,217.5,3
HCPCS,86816,Hla typing dr/dq,,,30.17,113.14,3
HCPCS,86817,Hla typing dr/dq,,,106.14,398.03,3
HCPCS,86821,Hc Donor Hla Typing Lymphocyte Culture Mixed So,405.0,263.25,,,0
HCPCS,86821,Hc Recipient Hla Typing Lymphocyte Culture Mixed So,405.0,263.25,,,0
HCPCS,86821,Lymphocyte culture mixed,,,36.56,137.1,3
HCPCS,86825,Hla x-math non-cytotoxic,,,109.49,410.59,3
HCPCS,86826,Hla x-match noncytotoxc addl,,,36.53,136.99,3
HCPCS,86828,Hc Donor Antibody Hla Class I & Class Ii Antigens Qual So,405.0,263.25,,,0
HCPCS,86828,Hc Recipient Antibody Hla Class I & Class Ii Antigens Qual So,405.0,263.25,,,0
HCPCS,86828,Hla class i&ii antibody qual,,,64.19,240.71,3
HCPCS,86829,Hla class i/ii antibody qual,,,64.19,240.71,3
HCPCS,86830,Hla class i phenotype qual,,,95.52,358.2,3
HCPCS,86831,Hc Donor Antibody Hla Class Ii Phenotype Panel Qual So,1125.0,731.25,,,0
HCPCS,86831,Hc Recipient Antibody Hla Class Ii Phenotype Panel Qual So,1125.0,731.25,,,0
HCPCS,86831,Hla class ii phenotype qual,,,81.88,307.05,3
HCPCS,86832,Hc Antibody Hla Class I High Definition Panel Qual So,1125.0,731.25,,,0
HCPCS,86832,Hc Donor Antibody Hla Class I High Definition Panel Qual So,1125.0,731.25,,,0
HCPCS,86832,Hla class i high defin qual,,,323.75,1214.06,3
HCPCS,86833,Hc Antibody Hla Class Ii High Definition Panel Qual So,1125.0,731.25,,,0
HCPCS,86833,Hc Donor Antibody Hla Class Ii High Definition Panel Qual So,1125.0,731.25,,,0
HCPCS,86833,Hc Recipient Antibody Hla Class Ii High Definition Panel Qual So,1125.0,731.25,,,0
HCPCS,86833,Hla class ii high defin qual,,,325.8,1221.75,3
HCPCS,86834,Hla class i semiquant panel,,,357.56,1340.85,3
HCPCS,86835,Hla class ii semiquant panel,,,322.96,1211.1,3
HCPCS,86850,Hc Antibody Screen Rbc,59.0,38.35,,,0
HCPCS,86850,RBC antibody screen,,,36.64,50.25,3
HCPCS,86860,Hc Antibody Elution Rbc Each Elution,1324.0,860.6,,,0
HCPCS,86860,RBC antibody elution,,,164.27,589.69,3
HCPCS,86870,Hc Antibody Identification,764.0,496.6,,,0
HCPCS,86870,RBC antibody identification,,,345.62,1215.41,3
HCPCS,86880,Coombs test direct,,,20.21,56.88,3
HCPCS,86880,Hc Direct Coombs Dat,200.0,130.0,,,0
HCPCS,86885,Coombs test indirect qual,,,21.45,164.27,3
HCPCS,86885,Hc Ahg Indirect Qual Ea Rgt Red Cell,176.0,114.4,,,0
HCPCS,86886,Coombs test indirect titer,,,19.43,164.27,3
HCPCS,86886,Hc Indirect Coombs Ea Antibody Titer,673.0,437.45,,,0
HCPCS,86886,Hc Indirect Coombs Ea Antibody Titer So,321.0,208.65,,,0
HCPCS,86890,Autologous blood process,,,164.27,589.69,3
HCPCS,86890,Hc Blood Processing Fee Autologous,214.0,139.1,,,0
HCPCS,86891,Autologous blood op salvage,,,776.85,2911.91,3
HCPCS,86891,Hc Blood Salvage Autologous Intra Op,9343.0,6072.95,,,0
HCPCS,86900,Blood typing serologic abo,,,11.21,128.29,3
HCPCS,86900,Hc Blood Typing Abo,133.0,86.45,,,0
HCPCS,86900,Hc Donor Blood Typing Abo,21.0,13.65,,,0
HCPCS,86900,Hc Recipient Blood Typing Abo,123.0,79.95,,,0
HCPCS,86901,Blood typing serologic rh(d),,,11.21,36.01,3
HCPCS,86901,Hc Blood Typing Rh D,40.0,26.0,,,0
HCPCS,86901,Hc Donor Blood Typing Rh D,10.0,6.5,,,0
HCPCS,86901,Hc Recipient Blood Typing Rh D,40.0,26.0,,,0
HCPCS,86902,Blood type antigen donor ea,,,23.81,345.62,3
HCPCS,86902,Hc Rbc Antigen Scr Reagent Unit,498.0,323.7,,,0
HCPCS,86904,Blood typing patient serum,,,56.88,61.28,3
HCPCS,86904,Hc Screen Preselected Unit Per Unit,688.0,447.2,,,0
HCPCS,86905,Blood typing rbc antigens,,,14.36,345.62,3
HCPCS,86905,Hc Rbc Antigen Typing Non Abo Rh,421.0,273.65,,,0
HCPCS,86906,Bld typing serologic rh phnt,,,29.06,36.01,3
HCPCS,86906,Hc Rh Phenotype,762.0,495.3,,,0
HCPCS,86910,Blood typing paternity test,,,94.05,94.05,2
HCPCS,86911,Blood typing antigen system,,,81.34,81.34,2
HCPCS,86920,Compatibility test spin,,,164.27,589.69,3
HCPCS,86920,Hc Crossmatch Immediate Spin,223.0,144.95,,,0
HCPCS,86921,Compatibility test incubate,,,164.27,589.69,3
HCPCS,86921,Hc Incubation Of Crossmatch,176.0,114.4,,,0
HCPCS,86922,Compatibility test antiglob,,,164.27,589.69,3
HCPCS,86922,Hc Agt Phase Of Crossmatch,174.0,113.1,,,0
HCPCS,86923,Compatibility test electric,,,164.27,589.69,3
HCPCS,86923,Hc Crossmatch Electronic,176.0,114.4,,,0
HCPCS,86927,Plasma fresh frozen,,,164.27,589.69,3
HCPCS,86930,Frozen blood prep,,,164.27,1215.41,3
HCPCS,86931,Frozen blood thaw,,,164.27,1215.41,3
HCPCS,86932,Frozen blood freeze/thaw,,,36.01,127.35,3
HCPCS,86940,Hemolysins/agglutinins auto,,,8.77,32.89,3
HCPCS,86941,Hemolysins/agglutinins,,,12.11,45.41,3
HCPCS,86945,Blood product/irradiation,,,36.01,127.35,3
HCPCS,86950,Leukacyte transfusion,,,164.27,589.69,3
HCPCS,86960,Vol reduction of blood/prod,,,164.27,589.69,3
HCPCS,86965,Hc Blood Product Pooling,297.0,193.05,,,0
HCPCS,86965,Pooling blood platelets,,,164.27,589.69,3
HCPCS,86970,Hc Pretreatment Rbcs W Chemical Drug,400.0,260.0,,,0
HCPCS,86970,Rbc pretx incubatj w/chemicl,,,56.88,127.35,3
HCPCS,86971,Hc Pretreatment With Enzymes Each,343.0,222.95,,,0
HCPCS,86971,Rbc pretx incubatj w/enzymes,,,164.27,1215.41,3
HCPCS,86972,Hc Reticulocyte Separation,652.0,423.8,,,0
HCPCS,86972,Rbc pretx incubatj w/density,,,164.27,589.69,3
HCPCS,86975,Hc Incubation Of Serum W/Drugs Each,1190.0,773.5,,,0
HCPCS,86975,Rbc serum pretx incubj drugs,,,430.74,1415.89,3
HCPCS,86976,Hc Dilution Of Serum,612.0,397.8,,,0
HCPCS,86976,Rbc serum pretx id dilution,,,27.89,93.6,3
HCPCS,86977,Hc Inhibition Of Serum,525.0,341.25,,,0
HCPCS,86977,Rbc serum pretx incubj/inhib,,,164.27,589.69,3
HCPCS,86978,Hc Differential Adsorption Serum Ea,1095.0,711.75,,,0
HCPCS,86978,Rbc pretreatment serum,,,56.88,127.35,3
HCPCS,86985,Hc Split Blood Product Each,458.0,297.7,,,0
HCPCS,86985,Split blood or products,,,164.27,589.69,3
HCPCS,86999,Transfusion procedure,,,27.89,93.6,3
HCPCS,87003,Small animal inoculation,,,16.84,63.15,3
HCPCS,87015,Hc Concentration Afb,129.0,83.85,,,0
HCPCS,87015,Hc Concentration Any Type For Inf Ag So,206.0,133.9,,,0
HCPCS,87015,Hc Malaria Thick Smear,129.0,83.85,,,0
HCPCS,87015,Specimen infect agnt concntj,,,6.68,25.05,3
HCPCS,87040,Blood culture for bacteria,,,10.32,38.7,3
HCPCS,87040,"Hc Bacterial Culture, Cell Product",144.0,93.6,,,0
HCPCS,87040,Hc Culture Blood,243.0,157.95,,,0
HCPCS,87040,Hc Culture Blood Aerob Anaerob Pltlt,144.0,93.6,,,0
HCPCS,87045,Feces culture aerobic bact,,,9.44,35.4,3
HCPCS,87045,Hc Culture Stool Aerobic Ssyc,362.0,235.3,,,0
HCPCS,87045,Hc Culture Stool Aerobic Ssyc So,53.0,34.45,,,0
HCPCS,87046,Hc Culture Stool Additional Pathogen,153.0,99.45,,,0
HCPCS,87046,Hc Culture Stool Additional Pathogen So,120.0,78.0,,,0
HCPCS,87046,Stool cultr aerobic bact ea,,,9.44,35.4,3
HCPCS,87070,Culture othr specimn aerobic,,,8.62,32.33,3
HCPCS,87070,Hc Culture Aerobic,297.0,193.05,,,0
HCPCS,87070,"Hc Donor Culture Bacterial Aerobic (Excp Urn Bld Stool), Cell Product",87.0,56.55,,,0
HCPCS,87071,Culture aerobic quant other,,,9.89,37.09,3
HCPCS,87071,Hc Culture Bac Quantitative Aerobic,403.0,261.95,,,0
HCPCS,87073,Culture Bacteria Anaerobic,,,9.66,36.23,3
HCPCS,87075,Cultr bacteria except blood,,,9.47,35.51,3
HCPCS,87075,Hc Culture Anaerobic,346.0,224.9,,,0
HCPCS,87076,Culture anaerobe ident each,,,8.08,30.3,3
HCPCS,87076,Hc Culture Anaerobic Id,374.0,243.1,,,0
HCPCS,87076,Hc Organism Ref For Id Anaerobe So,114.0,74.1,,,0
HCPCS,87076,Hc Organism Ref For Id Anaerobe Special So,300.0,195.0,,,0
HCPCS,87077,Culture Aerobic Identify,,,8.08,30.3,3
HCPCS,87077,"Hc Aerobic Definitive Identification Each, Cell Product",58.0,37.7,,,0
HCPCS,87077,Hc Bacterial Identification,186.0,120.9,,,0
HCPCS,87077,Hc Organism Ref For Id Aerobe So,117.0,76.05,,,0
HCPCS,87081,Culture screen only,,,6.63,24.86,3
HCPCS,87081,Hc Culture Presumptive Path Org Scrn,118.0,76.7,,,0
HCPCS,87081,Hc Culture Presumptive Path Org Scrn So,156.0,101.4,,,0
HCPCS,87084,Culture of specimen by kit,,,27.07,101.51,3
HCPCS,87086,Hc Culture Urine Aerobic Colony Count,209.0,135.85,,,0
HCPCS,87086,Urine culture/colony count,,,8.07,30.26,3
HCPCS,87088,Hc Cult Urine Isol Presump Id Each,81.0,52.65,,,0
HCPCS,87088,Urine bacteria culture,,,8.09,30.34,3
HCPCS,87101,Hc Culture Fungus Skin Hair Nails,581.0,377.65,,,0
HCPCS,87101,Skin fungi culture,,,7.71,28.91,3
HCPCS,87102,Fungus isolation culture,,,8.41,31.54,3
HCPCS,87102,Hc Culture Fungus Not Blood,473.0,307.45,,,0
HCPCS,87102,Hc Culture Fungus Not Blood So,158.0,102.7,,,0
HCPCS,87103,Blood fungus culture,,,20.46,76.73,3
HCPCS,87103,Hc Culture Blood Fungus,491.0,319.15,,,0
HCPCS,87106,Fungi identification yeast,,,10.32,38.7,3
HCPCS,87106,Hc Culture Fungus Id Yeast,216.0,140.4,,,0
HCPCS,87107,Fungi identification mold,,,10.32,38.7,3
HCPCS,87107,Hc Fungi Identification Mold So,147.0,95.55,,,0
HCPCS,87109,Hc Culture Mycoplasma So,234.0,152.1,,,0
HCPCS,87109,Mycoplasma,,,15.39,57.71,3
HCPCS,87110,Chlamydia culture,,,19.6,73.5,3
HCPCS,87110,Hc Culture Chlamydia,385.0,250.25,,,0
HCPCS,87116,Hc Culture Afb Tb,480.0,312.0,,,0
HCPCS,87116,Mycobacteria culture,,,10.8,40.5,3
HCPCS,87118,Hc Culture Mycobacteria Id,361.0,234.65,,,0
HCPCS,87118,Hc Culture Mycobacteria Id So,181.0,117.65,,,0
HCPCS,87118,Mycobacteric identification,,,14.61,54.79,3
HCPCS,87140,Culture type immunofluoresc,,,5.57,20.89,3
HCPCS,87140,Hc Culture Type By Ifa Each,207.0,134.55,,,0
HCPCS,87143,Culture typing glc/hplc,,,12.52,46.95,3
HCPCS,87147,Culture type immunologic,,,5.18,19.43,3
HCPCS,87147,Hc Culture Typing Serologic,151.0,98.15,,,0
HCPCS,87147,"Hc Donor Immunologic Serotyping Each, Cell Product",45.0,29.25,,,0
HCPCS,87149,Dna/rna direct probe,,,20.05,75.19,3
HCPCS,87149,Hc Culture Typing Nuc Acid Probe,265.0,172.25,,,0
HCPCS,87150,Dna/rna amplified probe,,,35.09,131.59,3
HCPCS,87150,Hc Culture Typing Nuc Acid Probe Amp Panel,98.0,63.7,,,0
HCPCS,87150,"Hc Cultyp Nuc Acid Amp Prb Cult/Isolate Ea Organism, Cell Product",98.0,63.7,,,0
HCPCS,87150,Hc Cultyp Nuc Acid Amp Prb Cult/Isolate Ea Orgnism So,236.0,153.4,,,0
HCPCS,87152,Culture Type Pulse Field Gel,,,7.74,29.03,3
HCPCS,87153,Dna/rna sequencing,,,115.36,432.6,3
HCPCS,87153,Hc Aerobe Ident By Sequencing So,339.0,220.35,,,0
HCPCS,87154,Cul typ id bld pthgn 6+ trgt,,,218.06,817.73,3
HCPCS,87154,Hc Culture Typing Id Bld Pthgn&Resist Typing 6+Trgt,882.0,573.3,,,0
HCPCS,87154,Hc Culture Typing Id Bld Pthgn&Resist Typing 6+Trgt So,2342.0,1522.3,,,0
HCPCS,87158,Culture typing added method,,,7.74,29.03,3
HCPCS,87164,Dark field examination,,,10.74,40.28,3
HCPCS,87166,Dark field examination,,,11.3,42.38,3
HCPCS,87168,Hc Arthropod Exam,183.0,118.95,,,0
HCPCS,87168,Macroscopic Exam Arthropod,,,4.27,16.01,3
HCPCS,87169,Hc Worm Exam,162.0,105.3,,,0
HCPCS,87169,Macroscopic exam parasite,,,4.31,16.16,3
HCPCS,87172,Hc Pinworm Prep Rectum,171.0,111.15,,,0
HCPCS,87172,Pinworm Exam,,,4.27,16.01,3
HCPCS,87176,Hc Homogenization Tissue For Culture,209.0,135.85,,,0
HCPCS,87176,Tissue homogenization cultr,,,5.88,22.05,3
HCPCS,87177,Hc Ova & Parasite O And P Stool,462.0,300.3,,,0
HCPCS,87177,Hc Ova And Parasites Smears So,53.0,34.45,,,0
HCPCS,87177,Ova and parasites smears,,,8.9,33.38,3
HCPCS,87181,"Hc Microbe Susceptibility E-Test Each, Cell Product",45.0,29.25,,,0
HCPCS,87181,Hc Susceptibility Anaerobic Mic So,102.0,66.3,,,0
HCPCS,87181,Hc Susceptibility Study E Test,145.0,94.25,,,0
HCPCS,87181,Microbe susceptible diffuse,,,4.75,17.81,3
HCPCS,87183,Sc std carbapenem resist gen,,,35.09,35.09,1
HCPCS,87184,Microbe susceptible disk,,,7.48,28.05,3
HCPCS,87185,"Hc Microbe Enzyme Detection Each, Cell Product",54.0,35.1,,,0
HCPCS,87185,Hc Susceptibility Study Enzyme Det,67.0,43.55,,,0
HCPCS,87185,Hc Susceptibility Study Enzyme Det So,78.0,50.7,,,0
HCPCS,87185,Microbe susceptible enzyme,,,4.75,17.81,3
HCPCS,87186,"Hc Microbe Suseptibility Mic Each, Cell Product",75.0,48.75,,,0
HCPCS,87186,Hc Sensitivity Mic,159.0,103.35,,,0
HCPCS,87186,Hc Susceptibility Aerobic Mic So,348.0,226.2,,,0
HCPCS,87186,Hc Susceptibility Mic Each Per Plate So,503.0,326.95,,,0
HCPCS,87186,Microbe susceptible mic,,,8.65,32.44,3
HCPCS,87187,Microbe susceptible mlc,,,40.17,150.64,3
HCPCS,87188,Hc Susceptibility Mtb Complex So,625.0,406.25,,,0
HCPCS,87188,Microbe suscept macrobroth,,,6.64,24.9,3
HCPCS,87190,Microbe suscept mycobacteri,,,7.31,27.41,3
HCPCS,87197,Bactericidal level serum,,,15.02,56.33,3
HCPCS,87205,Hc Gram Stain Smear Only,162.0,105.3,,,0
HCPCS,87205,Smear gram stain,,,4.27,16.01,3
HCPCS,87206,Hc Smear Fluorescent Acid Stain,215.0,139.75,,,0
HCPCS,87206,Smear fluorescent/acid stai,,,5.39,20.21,3
HCPCS,87207,Hc Smear Spec Stain Bodies Parasites,186.0,120.9,,,0
HCPCS,87207,Hc Smear Spec Stain Bodies Parasites Blood,220.0,143.0,,,0
HCPCS,87207,Hc Stain For Inclusion Bodies Parasites So,643.0,417.95,,,0
HCPCS,87207,Smear special stain,,,5.99,22.46,3
HCPCS,87209,Hc Smr Prim Src Cplx Spec Stain So,207.0,134.55,,,0
HCPCS,87209,Hc Trichrome Stain,294.0,191.1,,,0
HCPCS,87209,Smear complex stain,,,17.98,67.43,3
HCPCS,87210,Hc Smear Wet Preparation,198.0,128.7,,,0
HCPCS,87210,Hc Smear Wet Preparation So,296.0,192.4,,,0
HCPCS,87210,Smear wet mount saline/ink,,,5.82,21.83,3
HCPCS,87220,Tissue exam for fungi,,,4.27,16.01,3
HCPCS,87230,Assay toxin or antitoxin,,,19.74,74.03,3
HCPCS,87230,Hc Toxin Or Antitoxin Assay Tissue Culture So,129.0,83.85,,,0
HCPCS,87250,Virus inoculate eggs/animal,,,19.56,73.35,3
HCPCS,87252,Hc Culture Viral Comprehensive So,57.0,37.05,,,0
HCPCS,87252,Virus inoculation tissue,,,26.07,97.76,3
HCPCS,87253,Hc T Culture Addl Studies By Ifa,209.0,135.85,,,0
HCPCS,87253,Virus inoculate tissue addl,,,20.2,75.75,3
HCPCS,87254,Hc Virus Isol Shell Vial Ea,60.0,39.0,,,0
HCPCS,87254,Virus inoculation shell via,,,19.56,73.35,3
HCPCS,87255,Genet virus isolate hsv,,,33.86,126.98,3
HCPCS,87255,Hc Culture Viral Hsv,356.0,231.4,,,0
HCPCS,87260,Adenovirus ag if,,,14.43,54.11,3
HCPCS,87260,Hc Adenovirus Antigen,139.0,90.35,,,0
HCPCS,87265,Pertussis ag if,,,11.98,44.93,3
HCPCS,87267,Enterovirus antibody dfa,,,13.42,50.33,3
HCPCS,87269,Giardia ag if,,,13.61,51.04,3
HCPCS,87270,Chlamydia trachomatis ag if,,,11.98,44.93,3
HCPCS,87271,Cytomegalovirus dfa,,,13.42,50.33,3
HCPCS,87272,Cryptosporidium ag if,,,11.98,44.93,3
HCPCS,87273,Herpes simplex 2 ag if,,,11.98,44.93,3
HCPCS,87274,Herpes simplex 1 ag if,,,11.98,44.93,3
HCPCS,87275,Influenza b ag if,,,12.25,45.94,3
HCPCS,87276,Influenza a ag if,,,16.07,60.26,3
HCPCS,87278,Hc Legionella Dfa,178.0,115.7,,,0
HCPCS,87278,Legion pneumophilia ag if,,,15.6,58.5,3
HCPCS,87279,Parainfluenza ag if,,,16.43,61.61,3
HCPCS,87280,Hc Rsv Antigen Dfa,349.0,226.85,,,0
HCPCS,87280,Respiratory syncytial ag if,,,13.42,50.33,3
HCPCS,87281,Hc Pneumocystis Dfa Bronchial,386.0,250.9,,,0
HCPCS,87281,Pneumocystis carinii ag if,,,11.98,44.93,3
HCPCS,87283,Rubeola ag if,,,60.8,228.0,3
HCPCS,87285,Treponema pallidum ag if,,,12.18,45.68,3
HCPCS,87290,Varicella zoster ag if,,,13.42,50.33,3
HCPCS,87299,Antibody detection nos if,,,16.1,60.38,3
HCPCS,87300,Ag detection polyval if,,,11.98,44.93,3
HCPCS,87301,Adenovirus ag ia,,,11.98,44.93,3
HCPCS,87305,Aspergillus ag ia,,,11.98,44.93,3
HCPCS,87305,Hc Aspergillus Antigen So,150.0,97.5,,,0
HCPCS,87320,Chylmd trach ag ia,,,15.0,56.25,3
HCPCS,87324,Clostridium ag ia,,,11.98,44.93,3
HCPCS,87324,Hc C Difficile Toxin Assay A And B,192.0,124.8,,,0
HCPCS,87327,Cryptococcus neoform ag ia,,,13.42,50.33,3
HCPCS,87328,Cryptosporidium ag ia,,,13.82,51.83,3
HCPCS,87328,Hc Cryptosporidium Antigen By Eia,204.0,132.6,,,0
HCPCS,87329,Giardia ag ia,,,11.98,44.93,3
HCPCS,87329,Hc Giardia Antigen By Eia,207.0,134.55,,,0
HCPCS,87332,Cytomegalovirus ag ia,,,11.98,44.93,3
HCPCS,87335,E coli 0157 ag ia,,,12.66,47.48,3
HCPCS,87336,Entamoeb hist dispr ag ia,,,16.0,60.0,3
HCPCS,87337,Entamoeb hist group ag ia,,,11.98,44.93,3
HCPCS,87337,Hc Entamoeba Histolytica Antgn Feces So,291.0,189.15,,,0
HCPCS,87338,Hc H Pylori Antigen Stool So,170.0,110.5,,,0
HCPCS,87338,Hpylori stool ia,,,14.38,53.93,3
HCPCS,87339,H pylori ag ia,,,16.0,60.0,3
HCPCS,87340,Hc Donor Hepatitis B Surface Antigen (Hbsag)-Abbott So,31.0,20.15,,,0
HCPCS,87340,Hc Hepatitis B Surface Antigen,31.0,20.15,,,0
HCPCS,87340,Hc Recipient Hepatitis B Surface Antigen (Hbsag)-Abbott So,31.0,20.15,,,0
HCPCS,87340,Hepatitis b surface ag ia,,,10.33,38.74,3
HCPCS,87341,Hc Iaad Ia Hepatitis B Surface Ag Neutralization So,135.0,87.75,,,0
HCPCS,87341,Hepatitis b surface ag ia,,,10.33,38.74,3
HCPCS,87350,Hc Hepatitis Be Antigen,49.0,31.85,,,0
HCPCS,87350,Hepatitis be ag ia,,,11.53,43.24,3
HCPCS,87380,Hc Hepatitis D Delta Antigen So,465.0,302.25,,,0
HCPCS,87380,Hepatitis delta ag ia,,,18.36,68.85,3
HCPCS,87385,Hc Histoplasma Antgn Quant Eia Mvist So,225.0,146.25,,,0
HCPCS,87385,Histoplasma capsul ag ia,,,13.25,49.69,3
HCPCS,87389,Hc Donor Hiv Antibody (Hiv-1/2/O)-Abbott So,35.0,22.75,,,0
HCPCS,87389,Hc Hiv-1/-2 Ags And Abs Single Result,90.0,58.5,,,0
HCPCS,87389,Hc Hiv-1/-2 Ags And Abs Single Result So,69.0,44.85,,,0
HCPCS,87389,Hc Recipient Hiv Antibody (Hiv-1/2/O)-Abbott So,35.0,22.75,,,0
HCPCS,87389,Hiv-1 ag w/hiv-1 & hiv-2 ab,,,24.08,90.3,3
HCPCS,87390,Hiv-1 ag ia,,,24.06,90.23,3
HCPCS,87391,Hiv-2 ag ia,,,21.9,82.13,3
HCPCS,87400,Hc Influenza A And B Antigen Screen,264.0,171.6,,,0
HCPCS,87400,Influenza a/b ag ia,,,14.13,52.99,3
HCPCS,87420,Hc Rsv Antigen,106.0,68.9,,,0
HCPCS,87420,Resp syncytial ag ia,,,13.91,52.16,3
HCPCS,87425,Hc Rotavirus Antigen Feces So,105.0,68.25,,,0
HCPCS,87425,Rotavirus ag ia,,,11.98,44.93,3
HCPCS,87426,Coronavirus ag ia,,,35.33,132.49,3
HCPCS,87427,Shiga-like toxin ag ia,,,11.98,44.93,3
HCPCS,87428,Sarscov & inf vir a&b ag ia,,,70.29,263.59,3
HCPCS,87430,Strep a ag ia,,,16.81,63.04,3
HCPCS,87449,Ag detect nos ia mult,,,11.98,44.93,3
HCPCS,87449,Hc Infectious Agent Antigen By Eia,308.0,200.2,,,0
HCPCS,87449,Hc Infectious Agent Antigen By Eia So,404.0,262.6,,,0
HCPCS,87451,Ag detect polyval ia mult,,,10.51,39.41,3
HCPCS,87467,"Hc Hepatitis B Surface Antigen, Quant So",751.0,488.15,,,0
HCPCS,87467,Hepatitis b surface ag quan,,,25.32,56.44,3
HCPCS,87468,Anaplsma phgcytophlm amp prb,,,35.09,131.59,3
HCPCS,87468,"Hc Infect Agent Detect Nuc Acid (Dnr/Rna); Anaplasma Phagocytophilim, Amp Probe So",51.0,33.15,,,0
HCPCS,87469,Babesia microti amp prb,,,35.09,131.59,3
HCPCS,87469,"Hc Infect Agent Detect Nuc Acid (Dnr/Rna); Babesia Microti, Amp Probe So",165.0,107.25,,,0
HCPCS,87471,Bartonella dna amp probe,,,35.09,131.59,3
HCPCS,87471,Hc Bartonella By Pcr,276.0,179.4,,,0
HCPCS,87472,Bartonella dna quant,,,42.84,160.65,3
HCPCS,87475,Lyme dis dna dir probe,,,20.05,75.19,3
HCPCS,87476,Hc Lyme Disease By Pcr So,247.0,160.55,,,0
HCPCS,87476,Lyme dis dna amp probe,,,35.09,131.59,3
HCPCS,87478,Borrelia miyamotoi amp prb,,,35.09,131.59,3
HCPCS,87478,"Hc Infect Agent Detect Nuc Acid (Dnr/Rna); Borrelia Miyamotoi, Amp Probe So",1298.0,843.7,,,0
HCPCS,87480,Candida dna dir probe,,,20.05,75.19,3
HCPCS,87480,Hc Candida Species Direct Probe,163.0,105.95,,,0
HCPCS,87481,Candida dna amp probe,,,35.09,131.59,3
HCPCS,87481,Hc Iadna Candida Species Amp Probe,168.0,109.2,,,0
HCPCS,87482,Candida dna quant,,,55.74,209.03,3
HCPCS,87483,Cns dna amp probe type 12-25,,,416.78,1562.93,3
HCPCS,87483,Hc Cns Dna Amp Probe Type 12-25,1520.0,988.0,,,0
HCPCS,87484,Ehrlicha chaffeensis amp prb,,,35.09,131.59,3
HCPCS,87484,"Hc Infect Agent Detect Nuc Acid (Dnr/Rna); Ehrlichia Chaffeensis, Amp Probe So",51.0,33.15,,,0
HCPCS,87485,Chylmd pneum dna dir probe,,,20.05,75.19,3
HCPCS,87486,Chylmd pneum dna amp probe,,,35.09,131.59,3
HCPCS,87486,Hc Chlamydia Pneumoniae Amp Probe,952.0,618.8,,,0
HCPCS,87486,Hc Chylmd Pneum Dna Amp Probe So,59.0,38.35,,,0
HCPCS,87487,Chylmd pneum dna quant,,,42.84,160.65,3
HCPCS,87490,Chylmd trach dna dir probe,,,22.75,85.31,3
HCPCS,87490,Hc Dna Probe Chlamydia,57.0,37.05,,,0
HCPCS,87491,Chylmd trach dna amp probe,,,35.09,131.59,3
HCPCS,87491,Hc Chlamydia Trachomatis Amplified Rna So,91.0,59.15,,,0
HCPCS,87491,Hc Rna Probe Amplified Chlamydia,91.0,59.15,,,0
HCPCS,87492,Chylmd trach dna quant,,,53.47,200.51,3
HCPCS,87493,C diff amplified probe,,,37.27,139.76,3
HCPCS,87493,Hc C Diff Amplified Probe So,177.0,115.05,,,0
HCPCS,87493,Hc C Difficile Toxin Gene Pcr,229.0,148.85,,,0
HCPCS,87493,Hc C Difficile Toxin Pcr,229.0,148.85,,,0
HCPCS,87493,"Hc C Difficille Toxin Pcr, Fecal So",1724.0,1120.6,,,0
HCPCS,87494,Chlmy trch&neisra gonor mult,,,70.18,70.18,1
HCPCS,87495,Cytomeg dna dir probe,,,30.03,112.61,3
HCPCS,87496,Cytomeg dna amp probe,,,35.09,131.59,3
HCPCS,87496,Hc Cmv Amp Probe Panel,135.0,87.75,,,0
HCPCS,87496,Hc Cmv Amplified Probe So,180.0,117.0,,,0
HCPCS,87497,Cytomeg dna quant,,,42.84,160.65,3
HCPCS,87497,Hc Cmv By Pcr Quant So,186.0,120.9,,,0
HCPCS,87498,Enterovirus probe&revrs trns,,,35.09,131.59,3
HCPCS,87498,Hc Enterovirus Amp Probe Panel,107.0,69.55,,,0
HCPCS,87498,Hc Enterovirus By Pcr Amplified Prob So,121.0,78.65,,,0
HCPCS,87500,Vanomycin dna amp probe,,,35.09,131.59,3
HCPCS,87501,Influenza dna amp prob 1+,,,51.31,192.41,3
HCPCS,87502,Hc Fsed Influenza Dna Amp Probe,409.0,265.85,,,0
HCPCS,87502,Hc Influenza Dna Or  Rna Amp Probe,409.0,265.85,,,0
HCPCS,87502,Hc Influenza Rna Amp Probe,409.0,265.85,,,0
HCPCS,87502,Influenza dna amp probe,,,95.8,359.25,3
HCPCS,87503,Hc Influenza Dna Amp Probe Addl,99.0,64.35,,,0
HCPCS,87503,Influenza dna amp prob addl,,,29.22,109.58,3
HCPCS,87505,Hc Nfct Agent Dna/Rna Gastrointestinal Pathogen So,228.0,148.2,,,0
HCPCS,87505,Nfct agent detection gi,,,128.29,481.09,3
HCPCS,87506,Hc Iadna-Dna/Rna Gi Pthgn Multiplex Probe Tq 6-11,1324.0,860.6,,,0
HCPCS,87506,Iadna-dna/rna probe tq 6-11,,,262.99,986.21,3
HCPCS,87507,Hc Iadna-Dna/Rna Gi Pthgn Multiplex Probe Tq 12-25,1324.0,860.6,,,0
HCPCS,87507,Hc Iadna-Dna/Rna Gi Pthgn Multiplex Probe Tq 12-25 So,900.0,585.0,,,0
HCPCS,87507,Iadna-dna/rna probe tq 12-25,,,416.78,1562.93,3
HCPCS,87510,Gardner vag dna dir probe,,,20.05,75.19,3
HCPCS,87510,Hc Gardnerella Vaginalis Direct Prob,163.0,105.95,,,0
HCPCS,87511,Gardner vag dna amp probe,,,35.09,131.59,3
HCPCS,87512,Gardner vag dna quant,,,41.76,156.6,3
HCPCS,87513,H pylri clrthmcn rst amp prb,,,35.09,35.09,1
HCPCS,87513,Hc H Pylri Clrthmcn Rst Amp Prb,228.0,148.2,,,0
HCPCS,87516,Hepatitis b dna amp probe,,,35.09,131.59,3
HCPCS,87517,Hc Hepatitis B Viral Dna So,255.0,165.75,,,0
HCPCS,87517,Hepatitis b dna quant,,,42.84,160.65,3
HCPCS,87520,Hepatitis c rna dir probe,,,31.22,117.08,3
HCPCS,87521,Hepatitis c probe&rvrs trnsc,,,35.09,131.59,3
HCPCS,87522,Hc Hcv Virus Quantitation,1261.0,819.65,,,0
HCPCS,87522,Hc Hepatitis C Quant And Reverse Transcription So,270.0,175.5,,,0
HCPCS,87522,Hepatitis c revrs trnscrpj,,,42.84,160.65,3
HCPCS,87523,Hepatitis d quantification,,,42.84,160.65,3
HCPCS,87525,Hepatitis g dna dir probe,,,29.8,111.75,3
HCPCS,87526,Hepatitis g dna amp probe,,,39.26,147.23,3
HCPCS,87527,Hepatitis g dna quant,,,41.76,156.6,3
HCPCS,87528,Hsv dna dir probe,,,20.05,75.19,3
HCPCS,87529,Hc Hsv Amp Probe Panel,107.0,69.55,,,0
HCPCS,87529,Hc Hsv By Pcr So,131.0,85.15,,,0
HCPCS,87529,Hsv dna amp probe,,,35.09,131.59,3
HCPCS,87530,Hc Herpes Simplex Virus By Pcr,409.0,265.85,,,0
HCPCS,87530,Hsv dna quant,,,42.84,160.65,3
HCPCS,87531,Hhv-6 dna dir probe,,,58.0,217.5,3
HCPCS,87532,Hc Human Herpes Virus-6 Amp Probe Panel,107.0,69.55,,,0
HCPCS,87532,Hc Human Herpes Virus-6 Hhv 6 Pcr So,225.0,146.25,,,0
HCPCS,87532,Hhv-6 dna amp probe,,,35.09,131.59,3
HCPCS,87533,Hc Iadna Herpes Virus 6 Quant So,2038.0,1324.7,,,0
HCPCS,87533,Hhv-6 dna quant,,,41.76,156.6,3
HCPCS,87534,Hiv-1 dna dir probe,,,21.92,82.2,3
HCPCS,87535,Hc Hiv Amplified Probe,189.0,122.85,,,0
HCPCS,87535,Hiv-1 probe&reverse trnscrpj,,,35.09,131.59,3
HCPCS,87536,Hc Hiv 1 Virus Quantitation,1116.0,725.4,,,0
HCPCS,87536,Hc Hiv-1 Quant And Reverse Transcription So,255.0,165.75,,,0
HCPCS,87536,Hiv-1 quant&revrse trnscrpj,,,85.1,319.13,3
HCPCS,87537,Hiv-2 dna dir probe,,,21.92,82.2,3
HCPCS,87538,Hc Hiv 2 Amplified Probe,601.0,390.65,,,0
HCPCS,87538,Hiv-2 probe&revrse trnscripj,,,35.09,131.59,3
HCPCS,87539,Hiv-2 quant&revrse trnscripj,,,58.62,219.83,3
HCPCS,87540,Legion pneumo dna dir prob,,,20.05,75.19,3
HCPCS,87541,Legion pneumo dna amp prob,,,35.09,131.59,3
HCPCS,87542,Legion pneumo dna quant,,,41.76,156.6,3
HCPCS,87550,Mycobacteria dna dir probe,,,20.05,75.19,3
HCPCS,87551,Hc Mycobacteria Dna Amp Probe So,977.0,635.05,,,0
HCPCS,87551,Mycobacteria dna amp probe,,,48.24,180.9,3
HCPCS,87552,Mycobacteria dna quant,,,42.84,160.65,3
HCPCS,87555,M.tuberculo dna dir probe,,,26.88,100.8,3
HCPCS,87556,Hc M Tuberculosis Amplified Probe,543.0,352.95,,,0
HCPCS,87556,Hc Tuberculosis By Pcr So,435.0,282.75,,,0
HCPCS,87556,M.tuberculo dna amp probe,,,41.68,156.3,3
HCPCS,87557,M.tuberculo dna quant,,,42.84,160.65,3
HCPCS,87560,M.avium-intra dna dir prob,,,27.29,102.34,3
HCPCS,87561,M.avium-intra dna amp prob,,,35.09,131.59,3
HCPCS,87562,M.avium-intra dna quant,,,42.84,160.65,3
HCPCS,87563,Hc Mycoplasma Genitalium Detection By Nucleic Acid Amplified Probe So,270.0,175.5,,,0
HCPCS,87563,M. genitalium amp probe,,,35.09,131.59,3
HCPCS,87564,Hc Mtb Rifampin Rst Amp Prb Tq,463.0,300.95,,,0
HCPCS,87564,Mtb rifampin rst amp prb tq,,,76.77,76.77,1
HCPCS,87580,M.pneumon dna dir probe,,,20.05,75.19,3
HCPCS,87581,Hc Myco Pneumon Dna Amp Probe So,59.0,38.35,,,0
HCPCS,87581,Hc Mycoplasma Pneumoniae By Pcr,477.0,310.05,,,0
HCPCS,87581,M.pneumon dna amp probe,,,35.09,131.59,3
HCPCS,87582,M.pneumon dna quant,,,302.62,1134.83,3
HCPCS,87590,Hc Dna Probe Gonorrhoeae Gc,287.0,186.55,,,0
HCPCS,87590,N.gonorrhoeae dna dir prob,,,26.88,100.8,3
HCPCS,87591,Hc Neisseria Gonnorrhoeae Amplified Rna So,91.0,59.15,,,0
HCPCS,87591,Hc Rna Probe Amplified Gonorrhoeae,91.0,59.15,,,0
HCPCS,87591,N.gonorrhoeae dna amp prob,,,35.09,131.59,3
HCPCS,87592,N.gonorrhoeae dna quant,,,42.84,160.65,3
HCPCS,87593,"Hc Inf Agt Det; Orthopoxvirus (Monkeypox, Cowpox, Vaccinia) By Amp Probe So",288.0,187.2,,,0
HCPCS,87593,Orthopoxvirus amp prb each,,,51.31,191.89,3
HCPCS,87594,Pneumcysts jirovecii amp prb,,,35.09,35.09,1
HCPCS,87623,Hpv low-risk types,,,35.09,131.59,3
HCPCS,87624,Hc Hpv Probe High Risk Types So,173.0,112.45,,,0
HCPCS,87624,Hpv high-risk types,,,35.09,131.59,3
HCPCS,87625,Hc Hpv Types 16 And 18 Only,101.0,65.65,,,0
HCPCS,87625,Hpv types 16 & 18 only,,,40.55,152.06,3
HCPCS,87626,Hc Hpv Sep Hi-Rsk Typ&Pool Rslt,101.0,65.65,,,0
HCPCS,87626,Hpv sep hi-rsk typ&pool rslt,,,70.2,70.2,1
HCPCS,87627,Jt spc pthgn&rx rsist gen26+,,,679.77,679.77,1
HCPCS,87631,Hc Resp Virus 3 To 5 Targets,536.0,348.4,,,0
HCPCS,87631,Resp virus 3-5 targets,,,142.63,534.86,3
HCPCS,87632,Hc Resp Virus 6 To 11 Targets So,468.0,304.2,,,0
HCPCS,87632,Resp virus 6-11 targets,,,218.06,817.73,3
HCPCS,87633,Hc Iadna Respiratry Probe & Rev Trnscr 12-25 Target,940.0,611.0,,,0
HCPCS,87633,Resp virus 12-25 targets,,,416.78,1562.93,3
HCPCS,87634,Hc Rsv Dna/Rna Amp Probe,215.0,139.75,,,0
HCPCS,87634,Rsv dna/rna amp probe,,,70.2,263.25,3
HCPCS,87635,Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method Mb,259.0,168.35,,,0
HCPCS,87635,Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method So,259.0,168.35,,,0
HCPCS,87635,Hc Sars-Cov-2 Covid-19 Amp Prb High Troughput Method St,259.0,168.35,,,0
HCPCS,87635,Sars-cov-2 covid-19 amp prb,,,51.31,192.41,3
HCPCS,87636,Hc Sars-Cov2 And Flu A/B Amp Probe,355.0,230.75,,,0
HCPCS,87636,Hc Sars-Cov2 And Flu A/B Amp Probe So,429.0,278.85,,,0
HCPCS,87636,Hc Sarscov2 And Flu A/B Amp Probe,355.0,230.75,,,0
HCPCS,87636,Sarscov2 & inf a&b amp prb,,,142.63,534.86,3
HCPCS,87637,Hc Sarscov2 And Flu A/B And Rsv Amp Probe,355.0,230.75,,,0
HCPCS,87637,Sarscov2&inf a&b&rsv amp prb,,,142.63,534.86,3
HCPCS,87640,Hc Staph Aureus Dna Amp Probe So,474.0,308.1,,,0
HCPCS,87640,Staph a dna amp probe,,,35.09,131.59,3
HCPCS,87641,Hc Mrsa Screen  Probe,627.0,407.55,,,0
HCPCS,87641,Mr-staph dna amp probe,,,35.09,131.59,3
HCPCS,87650,Hc Streptococcus Grp A Direct Probe,332.0,215.8,,,0
HCPCS,87650,Strep a dna dir probe,,,20.05,75.19,3
HCPCS,87651,Hc Fsed Strep Group A Amplified Probe,192.0,124.8,,,0
HCPCS,87651,Hc Strep A Amplif Na Probe,192.0,124.8,,,0
HCPCS,87651,Hc Streptococcus Group A Amplified Probe,192.0,124.8,,,0
HCPCS,87651,Strep a dna amp probe,,,35.09,131.59,3
HCPCS,87652,Strep a dna quant,,,41.76,156.6,3
HCPCS,87653,Hc Strep Group B Amp Probe Panel,356.0,231.4,,,0
HCPCS,87653,Hc Strep Group B By Pcr Amp Probe,356.0,231.4,,,0
HCPCS,87653,Strep b dna amp probe,,,35.09,131.59,3
HCPCS,87660,Hc Trichomonas Vaginalis Direct Prob,163.0,105.95,,,0
HCPCS,87660,Trichomonas vagin dir probe,,,20.05,75.19,3
HCPCS,87661,Hc Trichomonas Vaginalis Amplif So,150.0,97.5,,,0
HCPCS,87661,Hc Trichomonas Vaginalis Amplified Probe,96.0,62.4,,,0
HCPCS,87661,Trichomonas vaginalis amplif,,,35.09,131.59,3
HCPCS,87662,"Hc Infectious Agent Detect By Nucleic Acid; Zika Virus, Amp Probe Technique So",811.0,527.15,,,0
HCPCS,87662,Zika virus dna/rna amp probe,,,51.31,192.41,3
HCPCS,87797,Detect agent nos dna dir,,,30.03,112.61,3
HCPCS,87798,Detect agent nos dna amp,,,35.09,131.59,3
HCPCS,87798,Hc Amplif Na Probe Nos Agent So,127.0,82.55,,,0
HCPCS,87798,Hc Donor Wnv Nat Idt-Roche So,44.0,28.6,,,0
HCPCS,87798,Hc Infectious Agent Det Amp Probe Panel,107.0,69.55,,,0
HCPCS,87798,Hc Infectious Agent Det Amplified Probe,463.0,300.95,,,0
HCPCS,87798,Hc Infectious Agent Det Amplified Probe So,790.0,513.5,,,0
HCPCS,87798,Hc Recipient Wnv Nat Idt-Roche So,44.0,28.6,,,0
HCPCS,87799,Detect agent nos dna quant,,,42.84,160.65,3
HCPCS,87799,Hc Infectious Agent Quant Dir Probe So,320.0,208.0,,,0
HCPCS,87799,Hc Infectious Agent Quant Dir Probe Special So,946.0,614.9,,,0
HCPCS,87800,Detect agnt mult dna direc,,,43.67,163.76,3
HCPCS,87801,Detect agnt mult dna ampli,,,70.2,263.25,3
HCPCS,87801,Hc Dna/Rna; Multi Org-Amp Pr,298.0,193.7,,,0
HCPCS,87801,Hc Donor Hiv/Hcv/Hbv (Mpx) Nat Idt-Roche So,35.0,22.75,,,0
HCPCS,87801,Hc Inf Agt Det By Nuc Acid Amp Pr Metagenomic Ngs So,9000.0,5850.0,,,0
HCPCS,87801,Hc Inf Agt Det By Nuc Acid Amp Pr So,374.0,243.1,,,0
HCPCS,87801,Hc Inf Agt Det By Nuc Acid Amp Pr Special So,1100.0,715.0,,,0
HCPCS,87801,Hc Recipient Hiv/Hcv/Hbv (Mpx) Nat Idt-Roche So,300.0,195.0,,,0
HCPCS,87802,Strep b assay w/optic,,,12.73,47.74,3
HCPCS,87803,Clostridium toxin a w/optic,,,16.0,60.0,3
HCPCS,87804,Hc Fsed Influenza Antigen Immunoassay W Dir Optical Obs,201.0,130.65,,,0
HCPCS,87804,Hc Influenza Antigen Immunoassay W Dir Optical Obs,101.0,65.65,,,0
HCPCS,87804,Influenza assay w/optic,,,16.55,62.06,3
HCPCS,87806,Hiv antigen w/hiv antibodies,,,32.77,122.89,3
HCPCS,87807,Hc Fsed Rsv Antigen Nasal Swab,545.0,354.25,,,0
HCPCS,87807,Rsv assay w/optic,,,13.1,49.13,3
HCPCS,87808,Hc Fsed Trichomonas,32.0,20.8,,,0
HCPCS,87808,Trichomonas assay w/optic,,,15.29,57.34,3
HCPCS,87809,Adenovirus assay w/optic,,,21.76,81.6,3
HCPCS,87810,Chylmd trach assay w/optic,,,35.29,132.34,3
HCPCS,87811,Sars-cov-2 covid19 w/optic,,,41.38,155.18,3
HCPCS,87812,Sarscov2&inf typ a&b w/optic,,,74.48,74.48,1
HCPCS,87850,N. gonorrhoeae assay w/optic,,,24.56,92.1,3
HCPCS,87880,Hc Fsed Rapid Strep Antigen Grp A Throat,88.0,57.2,,,0
HCPCS,87880,Hc Rapid Strep Antigen Grp A Throat,88.0,57.2,,,0
HCPCS,87880,Strep a assay w/optic,,,16.53,61.99,3
HCPCS,87899,Agent nos assay w/optic,,,16.07,60.26,3
HCPCS,87899,Hc Inf Agnt Det Optical Obs Nos,233.0,151.45,,,0
HCPCS,87899,Hc Inf Agnt Det Optical Obs Nos Rapid,34.0,22.1,,,0
HCPCS,87900,Hc Inf Agnt Drg Sscep Phen Pred Bioi So,759.0,493.35,,,0
HCPCS,87900,Phenotype infect agent drug,,,130.35,488.81,3
HCPCS,87901,Genotype dna hiv reverse t,,,257.45,965.44,3
HCPCS,87901,Hc Genotype Hiv Reverse T So,1497.0,973.05,,,0
HCPCS,87902,Genotype dna/rna hep c,,,257.45,965.44,3
HCPCS,87902,Hc Hcv Viral Rna Drug Resistance So,387.0,251.55,,,0
HCPCS,87903,Hc Infct Phentyp Resist Tiss Cul Hiv 1St 1 To 10 Drugs So,2839.0,1845.35,,,0
HCPCS,87903,Phenotype dna hiv w/culture,,,488.66,1832.48,3
HCPCS,87904,Hc Infct Phentyp Resist Tiss Cul Hiv Ea Addl Drug So,151.0,98.15,,,0
HCPCS,87904,Phenotype dna hiv w/clt add,,,26.07,97.76,3
HCPCS,87905,Sialidase enzyme assay,,,12.22,45.83,3
HCPCS,87906,Genotype dna/rna hiv,,,128.73,482.74,3
HCPCS,87906,Hc Genotype Dna Or Rna Hiv So,1328.0,863.2,,,0
HCPCS,87910,Genotype cytomegalovirus,,,257.45,965.44,3
HCPCS,87910,Hc Nfct Agt Genotype Alys Nucleic Acid Cmv So,2040.0,1326.0,,,0
HCPCS,87912,Genotype dna hepatitis b,,,257.45,965.44,3
HCPCS,87912,Hc Genotype Dna Hepatitis B So,1425.0,926.25,,,0
HCPCS,87913,Nfct agt gntyp alys sarscov2,,,257.45,965.44,3
HCPCS,87999,Hc Biofire Joint Panel,750.0,487.5,,,0
HCPCS,88000,Autopsy (necropsy) gross,,,791.7,791.7,2
HCPCS,88005,Autopsy (necropsy) gross,,,923.85,923.85,2
HCPCS,88007,Autopsy (necropsy) gross,,,967.05,967.05,2
HCPCS,88012,Autopsy (necropsy) gross,,,791.7,791.7,2
HCPCS,88014,Autopsy (necropsy) gross,,,725.63,725.63,2
HCPCS,88016,Autopsy (necropsy) gross,,,1011.53,1011.53,2
HCPCS,88020,Autopsy (necropsy) complete,,,1363.54,1363.54,2
HCPCS,88025,Autopsy (necropsy) complete,,,1319.06,1319.06,2
HCPCS,88027,Autopsy (necropsy) complete,,,1406.74,1406.74,2
HCPCS,88028,Autopsy (necropsy) complete,,,791.7,791.7,2
HCPCS,88029,Autopsy (necropsy) complete,,,791.7,791.7,2
HCPCS,88036,Limited autopsy,,,395.21,395.21,2
HCPCS,88037,Limited autopsy,,,352.01,352.01,2
HCPCS,88040,Forensic autopsy (necropsy),,,2198.44,2198.44,2
HCPCS,88045,Coroners autopsy (necropsy),,,219.83,219.83,2
HCPCS,88104,Cytopath fl nongyn smears,,,36.01,127.35,3
HCPCS,88104,Hc Cytopath Fluid Smear,292.0,189.8,,,0
HCPCS,88106,Cytopath fl nongyn filter,,,27.89,93.6,3
HCPCS,88108,Cytopath concentrate tech,,,36.01,127.35,3
HCPCS,88108,Hc Cytopath Concentration,467.0,303.55,,,0
HCPCS,88112,Cytopath cell enhance tech,,,50.25,188.03,3
HCPCS,88112,Hc Cytopath Selective Concentration,452.0,293.8,,,0
HCPCS,88120,Cytp urne 3-5 probes ea spec,,,164.27,589.69,3
HCPCS,88120,Hc Cyp Fish Urinary Morh Ea Manual So,794.0,516.1,,,0
HCPCS,88121,Cytp urine 3-5 probes cmptr,,,164.27,589.69,3
HCPCS,88125,Forensic cytopathology,,,50.25,188.03,3
HCPCS,88130,Sex chromatin identification,,,17.98,67.43,3
HCPCS,88140,Sex chromatin identification,,,7.99,29.96,3
HCPCS,88141,Cytopath c/v interpret,,,86.4,86.4,2
HCPCS,88142,Cytopath c/v thin layer,,,20.26,75.98,3
HCPCS,88142,Hc Cytopath Pap Smear Thin,69.0,44.85,,,0
HCPCS,88143,Cytopath c/v thin layer redo,,,23.04,86.4,3
HCPCS,88147,Cytopath c/v automated,,,50.56,189.6,3
HCPCS,88148,Cytopath c/v auto rescreen,,,18.54,64.91,3
HCPCS,88150,Cytopath c/v manual,,,18.54,64.91,3
HCPCS,88152,Cytopath c/v auto redo,,,27.64,103.65,3
HCPCS,88153,Cytopath c/v redo,,,24.03,90.11,3
HCPCS,88155,Cytopath c/v index add-on,,,14.65,54.94,3
HCPCS,88160,Cytopath smear other source,,,27.89,93.6,3
HCPCS,88161,Cytopath smear other source,,,27.89,93.6,3
HCPCS,88161,Hc Cytopath Smear S P Imprint,918.0,596.7,,,0
HCPCS,88162,Cytopath smear other source,,,50.25,188.03,3
HCPCS,88164,Cytopath tbs c/v manual,,,18.54,64.91,3
HCPCS,88165,Cytopath tbs c/v redo,,,42.22,158.33,3
HCPCS,88166,Cytopath tbs c/v auto redo,,,18.54,64.91,3
HCPCS,88167,Cytopath tbs c/v select,,,18.54,64.91,3
HCPCS,88172,Cytp dx eval fna 1st ea site,,,164.27,589.69,3
HCPCS,88172,Hc Fine Needle Aspiration Eval,428.0,278.2,,,0
HCPCS,88173,Cytopath eval fna report,,,50.25,188.03,3
HCPCS,88173,Hc Fine Needle Aspiration Interp,1128.0,733.2,,,0
HCPCS,88174,Cytopath c/v auto in fluid,,,25.37,95.14,3
HCPCS,88175,Cytopath c/v auto fluid redo,,,26.61,99.79,3
HCPCS,88175,Hc Cyto Pap Smear Automated,78.0,50.7,,,0
HCPCS,88177,Cytp fna eval ea addl,,,30.49,30.49,2
HCPCS,88177,Hc Fna Immed Each Eval Same Site,369.0,239.85,,,0
HCPCS,88182,Cell marker study,,,50.25,188.03,3
HCPCS,88182,Hc Flow Cytometry Cell Cycle Dna,167.0,108.55,,,0
HCPCS,88182,Hc Flow Cytometry Cell Cycle Dna Analysis So,1163.0,755.95,,,0
HCPCS,88184,Flowcytometry/ tc 1 marker,,,345.62,1215.41,3
HCPCS,88184,Hc Flow Cytometry Initial Marker,309.0,200.85,,,0
HCPCS,88184,Hc Flow Cytometry Initial Marker So,343.0,222.95,,,0
HCPCS,88184,Hc Flow Cytometry Initial Marker Special So,328.0,213.2,,,0
HCPCS,88185,Flowcytometry/tc add-on,,,90.23,90.23,2
HCPCS,88185,Hc Flow Cytometry Marker Tc Ea Addl,145.0,94.25,,,0
HCPCS,88185,Hc Flow Cytometry Marker Tc Ea Addl So,161.0,104.65,,,0
HCPCS,88185,Hc Flow Cytometry Marker Tc Ea Addl Special So,328.0,213.2,,,0
HCPCS,88187,Flowcytometry/read 2-8,,,132.15,132.15,2
HCPCS,88188,Flowcytometry/read 9-15,,,231.26,231.26,2
HCPCS,88189,Flowcytometry/read 16 & >,,,312.6,312.6,2
HCPCS,88199,Cytopathology procedure,,,50.25,188.03,3
HCPCS,88230,Hc Tiss Cul Non Neo Disorders Lymphocyte So,3268.0,2124.2,,,0
HCPCS,88230,Tissue culture lymphocyte,,,116.49,436.84,3
HCPCS,88233,Hc Chromosome Analysis Tissue So,3422.0,2224.3,,,0
HCPCS,88233,Tissue culture skin/biopsy,,,140.73,527.74,3
HCPCS,88235,Hc Tiss Cul Non Neo Disorders Amnio/Chornc Cells So,3436.0,2233.4,,,0
HCPCS,88235,Tissue culture placenta,,,150.3,563.63,3
HCPCS,88237,Hc Tiss Cul Neo Disorders Blood Or Bone Marrow So,1353.0,879.45,,,0
HCPCS,88237,Hc Tiss Cul Neo Disorders Bone Marrow Blood Cells Mayo So,917.0,596.05,,,0
HCPCS,88237,Tissue culture bone marrow,,,143.75,539.06,3
HCPCS,88239,Hc Tiss Cul Neo Disorders Solid Tumor So,2611.0,1697.15,,,0
HCPCS,88239,Tissue culture tumor,,,147.52,553.2,3
HCPCS,88240,Cell cryopreserve/storage,,,13.07,49.01,3
HCPCS,88240,Hc Cell Cryoprsrv Frzing/Storage Ea Cell Line So,251.0,163.15,,,0
HCPCS,88241,Frozen cell preparation,,,12.09,45.34,3
HCPCS,88245,Chromosome analysis 20-25,,,173.17,649.39,3
HCPCS,88248,Chromosome analysis 50-100,,,173.17,649.39,3
HCPCS,88249,Chromosome analysis 100,,,173.17,649.39,3
HCPCS,88249,Hc Chrmsm Breakage Synds Score 100 Cll So,1225.0,796.25,,,0
HCPCS,88261,Chromosome analysis 5,,,264.34,991.28,3
HCPCS,88261,Hc Chrmsm Anlys 5 Cls 1 Krytyp W/Bnd So,1885.0,1225.25,,,0
HCPCS,88262,Chromosome analysis 15-20,,,125.49,470.59,3
HCPCS,88262,Hc Cytogenetics Blood Peripheral So,642.0,417.3,,,0
HCPCS,88263,Chromosome analysis 45,,,150.29,563.59,3
HCPCS,88264,Chromosome analysis 20-25,,,144.61,542.29,3
HCPCS,88264,Hc Chromosome Analysis 20 To 25 Cells So,642.0,417.3,,,0
HCPCS,88267,Chromosome analys placenta,,,188.57,707.14,3
HCPCS,88267,Hc Chromosome Count Amnio Cv 15 Cells 1 Karyotype So,2124.0,1380.6,,,0
HCPCS,88269,Chromosome analys amniotic,,,173.66,651.23,3
HCPCS,88269,Hc Chrmsm Situ Amnio Cll 6 To 12 Colonies 1 Karytyp So,642.0,417.3,,,0
HCPCS,88271,Cytogenetics dna probe,,,21.42,80.33,3
HCPCS,88271,Hc Mol Cyto Dna Fish Probe Ea  So,435.0,282.75,,,0
HCPCS,88271,Hc Mol Cyto Dna Fish Probe Ea Special So,707.0,459.55,,,0
HCPCS,88272,Cytogenetics 3-5,,,40.7,152.63,3
HCPCS,88273,Cytogenetics 10-30,,,34.81,130.54,3
HCPCS,88273,Hc Mol Cyto In Situ 10 To 30 Cells So,108.0,70.2,,,0
HCPCS,88274,Cytogenetics 25-99,,,42.38,158.93,3
HCPCS,88274,Hc Mol Cyto In Situ 25 To 99 Cells So,110.0,71.5,,,0
HCPCS,88275,Cytogenetics 100-300,,,51.19,191.96,3
HCPCS,88275,Hc Mol Cyto In Situ 100 To 300 Cells So,163.0,105.95,,,0
HCPCS,88275,Hc Mol Cyto In Situ 100 To 300 Cells Special So,956.0,621.4,,,0
HCPCS,88280,Chromosome karyotype study,,,33.47,125.51,3
HCPCS,88280,Hc Chrom Addl Karyotyp Each Study So,37.0,24.05,,,0
HCPCS,88283,Chromosome banding study,,,68.6,257.25,3
HCPCS,88283,Hc Chrsme Anlys Addl Specialized Banding So,118.0,76.7,,,0
HCPCS,88285,Chromosome count additional,,,26.91,100.91,3
HCPCS,88285,Hc Chrom Anlys Addl Cell Ct  Ea Stdy So,275.0,178.75,,,0
HCPCS,88289,Chromosome study additional,,,34.43,129.11,3
HCPCS,88289,Hc Chrom Analysis Add Hi Res Study So,558.0,362.7,,,0
HCPCS,88291,Cyto/molecular report,,,121.99,121.99,2
HCPCS,88299,Cytogenetic study,,,50.25,188.03,3
HCPCS,88300,Hc Gross Only Level I  1 Spec,253.0,164.45,,,0
HCPCS,88300,Surgical path gross,,,27.89,93.6,3
HCPCS,88302,Hc Gross And Micro Level Ii,520.0,338.0,,,0
HCPCS,88302,Tissue exam by pathologist,,,36.01,93.6,3
HCPCS,88304,Hc Gross And Micro Level Iii,603.0,391.95,,,0
HCPCS,88304,Tissue exam by pathologist,,,50.25,188.03,3
HCPCS,88305,Hc Gross And Micro Level Iv,707.0,459.55,,,0
HCPCS,88305,Hc Gross And Micro Level Iv So,817.0,531.05,,,0
HCPCS,88305,"Hc Prostate Biopsy, Any Method",707.0,459.55,,,0
HCPCS,88305,Tissue exam by pathologist,,,50.25,188.03,3
HCPCS,88307,Hc Gross And Micro Level V,885.0,575.25,,,0
HCPCS,88307,Hc Mineralized Bone Histo Uk So,885.0,575.25,,,0
HCPCS,88307,Tissue exam by pathologist,,,345.62,1215.41,3
HCPCS,88309,Hc Gross And Micro Level Vi,1130.0,734.5,,,0
HCPCS,88309,Tissue exam by pathologist,,,776.85,2911.91,3
HCPCS,88311,Decalcify tissue,,,31.76,31.76,2
HCPCS,88311,Hc Decalcification,234.0,152.1,,,0
HCPCS,88312,Hc Special Stain I,534.0,347.1,,,0
HCPCS,88312,Special stains group 1,,,50.25,188.03,3
HCPCS,88313,Hc Special Stain Group Ii So,292.0,189.8,,,0
HCPCS,88313,Hc Special Stain Ii,541.0,351.65,,,0
HCPCS,88313,Special stains group 2,,,127.35,128.29,3
HCPCS,88314,Hc Histochem Stain W Frozen Section So,235.0,152.75,,,0
HCPCS,88314,Histochemical stains add-on,,,266.85,266.85,2
HCPCS,88319,Enzyme histochemistry,,,776.85,2911.91,3
HCPCS,88319,Hc Enzyme Histochemistry,785.0,510.25,,,0
HCPCS,88319,Hc Histochemistry Enzyme Stain,785.0,510.25,,,0
HCPCS,88321,Microslide consultation,,,36.01,127.35,3
HCPCS,88323,Hc Consult Path Requiring Prep,416.0,270.4,,,0
HCPCS,88323,Hc Consult Path Requiring Prep So,540.0,351.0,,,0
HCPCS,88323,Microslide consultation,,,50.25,188.03,3
HCPCS,88325,Comprehensive review of data,,,164.27,589.69,3
HCPCS,88325,Hc Consult Path Review And Report,273.0,177.45,,,0
HCPCS,88329,Hc Consult Path Surgery,245.0,159.25,,,0
HCPCS,88329,Path consult introp,,,56.88,127.35,3
HCPCS,88331,Hc Consult Path Surgery W Frozen,801.0,520.65,,,0
HCPCS,88331,Path consult intraop 1 bloc,,,164.27,589.69,3
HCPCS,88332,Hc Consult Path Surgery Each Addl,453.0,294.45,,,0
HCPCS,88332,Path consult intraop addl,,,94.05,94.05,2
HCPCS,88333,Hc Consult Path Surg Imprint Initial,695.0,451.75,,,0
HCPCS,88333,Intraop cyto path consult 1,,,776.85,2911.91,3
HCPCS,88334,Hc Consult Path Surg Imprint Addl,325.0,211.25,,,0
HCPCS,88334,Intraop cyto path consult 2,,,73.69,73.69,2
HCPCS,88341,Hc Ihc Or Icc Ea Addl Antibody Slide,330.0,214.5,,,0
HCPCS,88341,Hc Ihc Or Icc Ea Addl Antibody Slide So,351.0,228.15,,,0
HCPCS,88341,Immunohisto antb addl slide,,,222.38,222.38,2
HCPCS,88342,Hc Immunocytochemistry Antibody Stain,330.0,214.5,,,0
HCPCS,88342,Hc Immunocytochemistry Antibody Stain So,202.0,131.3,,,0
HCPCS,88342,Immunohisto antb 1st stain,,,164.27,589.69,3
HCPCS,88344,Hc Ihc Or Icc Ea Multi Antibody Slide,330.0,214.5,,,0
HCPCS,88344,Immunohisto antibody slide,,,345.62,1215.41,3
HCPCS,88346,Hc Immunofluorescent Study Ea Ab Dir,309.0,200.85,,,0
HCPCS,88346,Hc Immunofluorescent Study Ea Ab Dir So,309.0,200.85,,,0
HCPCS,88346,Immunofluor antb 1st stain,,,164.27,1215.41,3
HCPCS,88348,Electron microscopy,,,776.85,2911.91,3
HCPCS,88348,Hc Electron Microscopy Diagnostic So,1734.0,1127.1,,,0
HCPCS,88350,Hc Immunofluorescence Ea Addl Sgl Ab Stain,178.0,115.7,,,0
HCPCS,88350,Hc Immunofluorescence Ea Addl Sgl Ab Stain So,178.0,115.7,,,0
HCPCS,88350,Immunofluor antb addl stain,,,334.2,334.2,2
HCPCS,88355,Analysis skeletal muscle,,,164.27,589.69,3
HCPCS,88356,Analysis nerve,,,50.25,188.03,3
HCPCS,88358,Analysis tumor,,,164.27,589.69,3
HCPCS,88360,Hc Morph Anyls Tumor Ihc Manual,1055.0,685.75,,,0
HCPCS,88360,Hc Morph Anyls Tumor Ihc Manual So,578.0,375.7,,,0
HCPCS,88360,Hc Morph Anyls Tumor Ihc Manual Special So,1017.0,661.05,,,0
HCPCS,88360,Tumor immunohistochem/manual,,,164.27,589.69,3
HCPCS,88361,Hc Morph Anyls Tumor Ihc Comp Assist So,504.0,327.6,,,0
HCPCS,88361,Tumor immunohistochem/comput,,,345.62,1215.41,3
HCPCS,88362,Nerve teasing preparations,,,776.85,2911.91,3
HCPCS,88363,Xm archive tissue molec anal,,,27.89,93.6,3
HCPCS,88364,Hc In Situ Hybrid Ea Add Probe Stain So,302.0,196.3,,,0
HCPCS,88364,Hc Ish Ea Add Probe Stain So,803.0,521.95,,,0
HCPCS,88364,Insitu hybridization (fish),,,391.39,391.39,2
HCPCS,88365,Hc In Situ Hybridization 1St Probe Stain,302.0,196.3,,,0
HCPCS,88365,Hc In Situ Hybridization 1St Probe Stain So,302.0,196.3,,,0
HCPCS,88365,Hc Ish 1St Probe Stain So,1042.0,677.3,,,0
HCPCS,88365,Insitu hybridization (fish),,,164.27,589.69,3
HCPCS,88366,Insitu hybridization (fish),,,164.27,1215.41,3
HCPCS,88367,Hc Morph Anlys Ish Comp Assist 1St Probe Stain So,1103.0,716.95,,,0
HCPCS,88367,Insitu hybridization auto,,,345.62,1215.41,3
HCPCS,88368,Hc Morph Anlys Ish Manual 1St Probe Stain,1100.0,715.0,,,0
HCPCS,88368,Insitu hybridization manual,,,345.62,1215.41,3
HCPCS,88369,Hc Mrph Alys Ish Quant Semiq Man Addl So,1100.0,715.0,,,0
HCPCS,88369,M/phmtrc alysishquant/semiq,,,340.58,340.58,2
HCPCS,88371,Protein western blot tissue,,,83.36,83.36,2
HCPCS,88372,Protein analysis w/probe,,,98.33,98.33,2
HCPCS,88373,Hc Mrph Alys Ish Quant Semiq Comp Addl So,1103.0,716.95,,,0
HCPCS,88373,M/phmtrc alys ishquant/semiq,,,166.46,166.46,2
HCPCS,88374,Hc Mrph Alys Ish Quant Semiq Comp Mpx So,2205.0,1433.25,,,0
HCPCS,88374,M/phmtrc alys ishquant/semiq,,,164.27,589.69,3
HCPCS,88375,Optical endomicroscpy interp,,,177.9,177.9,2
HCPCS,88377,Hc Mrph Alys Ish Quant Semiq Man Ea Multiprb So,1382.0,898.3,,,0
HCPCS,88377,Hc Mrph Alys Ish Quant Semiq Man Multi So,2198.0,1428.7,,,0
HCPCS,88377,M/phmtrc alys ishquant/semiq,,,164.27,589.69,3
HCPCS,88380,Hc Microdissection Laser Capture,2719.0,1767.35,,,0
HCPCS,88380,Microdissection laser,,,269.4,269.4,2
HCPCS,88381,Hc Microdissection Manual,2319.0,1507.35,,,0
HCPCS,88381,Hc Microdissection Manual So,202.0,131.3,,,0
HCPCS,88381,Microdissection manual,,,677.33,677.33,2
HCPCS,88387,Tiss exam molecular study,,,29.21,29.21,2
HCPCS,88388,Tiss ex molecul study add-on,,,52.09,52.09,2
HCPCS,88399,Surgical pathology procedure,,,50.25,188.03,3
HCPCS,88720,Bilirubin total transcut,,,5.02,18.83,3
HCPCS,88720,Hc Bilirubin Total Transcutaneous,461.0,299.65,,,0
HCPCS,88738,Hgb quant transcutaneous,,,5.02,18.83,3
HCPCS,88740,Transcutaneous carboxyhb,,,9.37,35.14,3
HCPCS,88741,Transcutaneous methb,,,9.37,35.14,3
HCPCS,89049,Chct for mal hyperthermia,,,164.27,589.69,3
HCPCS,89050,Body fluid cell count,,,4.72,17.7,3
HCPCS,89050,Hc Cell Count Body Fluid,169.0,109.85,,,0
HCPCS,89051,Body fluid cell count,,,5.6,21.0,3
HCPCS,89051,Hc Cell Count W Diff Body Fluid,716.0,465.4,,,0
HCPCS,89055,Leukocyte assessment fecal,,,4.27,16.01,3
HCPCS,89060,Exam synovial fluid crystals,,,7.33,27.49,3
HCPCS,89060,Hc Crystal Id Tissue Only,245.0,159.25,,,0
HCPCS,89060,Hc Crystal Id Tissue Or Fluid,245.0,159.25,,,0
HCPCS,89125,Hc Fat Stain Urine,58.0,37.7,,,0
HCPCS,89125,Specimen fat stain,,,5.88,22.05,3
HCPCS,89160,Exam feces for meat fibers,,,4.85,18.19,3
HCPCS,89190,Hc Smear Nasal Eosinophils,250.0,162.5,,,0
HCPCS,89190,Nasal smear for eosinophils,,,5.79,21.71,3
HCPCS,89220,Sputum specimen collection,,,164.27,589.69,3
HCPCS,89230,Collect sweat for test,,,50.25,188.03,3
HCPCS,89240,Pathology lab procedure,,,50.25,188.03,3
HCPCS,89250,Cultr oocyte/embryo <4 days,,,164.27,589.69,3
HCPCS,89251,Cultr oocyte/embryo <4 days,,,164.27,589.69,3
HCPCS,89253,Embryo hatching,,,164.27,589.69,3
HCPCS,89254,Oocyte identification,,,164.27,589.69,3
HCPCS,89255,Prepare embryo for transfer,,,50.25,188.03,3
HCPCS,89257,Sperm identification,,,50.25,188.03,3
HCPCS,89258,Cryopreservation embryo(s),,,776.85,2911.91,3
HCPCS,89259,Cryopreservation sperm,,,164.27,589.69,3
HCPCS,89260,Sperm isolation simple,,,50.25,188.03,3
HCPCS,89261,Sperm isolation complex,,,50.25,188.03,3
HCPCS,89264,Identify sperm tissue,,,50.25,188.03,3
HCPCS,89268,Insemination of oocytes,,,164.27,589.69,3
HCPCS,89272,Extended culture of oocytes,,,776.85,2911.91,3
HCPCS,89280,Assist oocyte fertilization,,,776.85,2911.91,3
HCPCS,89281,Assist oocyte fertilization,,,164.27,589.69,3
HCPCS,89290,Biopsy oocyte polar body,,,164.27,589.69,3
HCPCS,89291,Biopsy oocyte polar body,,,164.27,589.69,3
HCPCS,89300,Semen analysis w/huhner,,,9.84,36.9,3
HCPCS,89310,Hc Semen Analysis W Who Morphology So,431.0,280.15,,,0
HCPCS,89310,Hc Semen Count Post Vasectomy,209.0,135.85,,,0
HCPCS,89310,Semen analysis w/count,,,8.61,32.29,3
HCPCS,89320,Hc Semen Analysis Complete,209.0,135.85,,,0
HCPCS,89320,Semen anal vol/count/mot,,,12.31,46.16,3
HCPCS,89321,Semen anal sperm detection,,,12.05,45.19,3
HCPCS,89322,Hc Semen Analysis Strict Morphologic Criteria So,410.0,266.5,,,0
HCPCS,89322,Semen anal strict criteria,,,15.5,58.13,3
HCPCS,89325,Hc Sperm Antibody,445.0,289.25,,,0
HCPCS,89325,Sperm antibody test,,,10.67,40.01,3
HCPCS,89329,Sperm evaluation test,,,19.59,73.46,3
HCPCS,89330,Evaluation cervical mucus,,,10.38,38.93,3
HCPCS,89331,Retrograde ejaculation anal,,,19.59,73.46,3
HCPCS,89335,Cryopreserve testicular tiss,,,50.25,188.03,3
HCPCS,89337,Cryopreservation oocyte(s),,,164.27,589.69,3
HCPCS,89342,Storage/year embryo(s),,,164.27,589.69,3
HCPCS,89343,Storage/year sperm/semen,,,164.27,589.69,3
HCPCS,89344,Storage/year reprod tissue,,,164.27,589.69,3
HCPCS,89346,Storage/year oocyte(s),,,164.27,1215.41,3
HCPCS,89352,Thawing cryopresrved embryo,,,164.27,589.69,3
HCPCS,89353,Thawing cryopresrved sperm,,,50.25,188.03,3
HCPCS,89354,Thaw cryoprsvrd reprod tiss,,,164.27,589.69,3
HCPCS,89356,Thawing cryopresrved oocyte,,,164.27,589.69,3
HCPCS,89398,Hc Unlisted Reprod Med Lab Proc So,239.0,155.35,,,0
HCPCS,89398,Unlisted reprod med lab proc,,,50.25,188.03,3
HCPCS,90281,Human ig im,,,161.9,222.49,4
HCPCS,90283,Human ig iv,,,123.88,247.91,4
HCPCS,90284,Human ig sc,,,34.16,62.33,4
HCPCS,90291,Cmv ig iv,,,4111.03,5713.28,4
HCPCS,90371,HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,418.2,271.83,,,0
HCPCS,90371,HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) INTRAMUSCULAR SOLUTION,3360.3,2184.2,,,0
HCPCS,90371,Hep b ig im,,,134.19,396.5,6
HCPCS,90371,Noncdm Charge Record Pharmacy,296.4,192.66,,,0
HCPCS,90375,Noncdm Charge Record Pharmacy,1280.13,832.08,,,0
HCPCS,90375,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2323.65,1510.37,,,0
HCPCS,90375,Rabies ig im/sc,,,279.85,759.8,6
HCPCS,90376,Rabies ig heat treated,,,352.44,1059.01,5
HCPCS,90377,Rabies ig ht&sol human im/sc,,,222.25,678.91,6
HCPCS,90378,Rsv mab im 50mg,,,436.75,4260.34,5
HCPCS,90380,Noncdm Charge Record Pharmacy,2229.34,1449.07,,,0
HCPCS,90380,Rsv monoc antb seasn .5ml im,,,1216.22,3380.45,4
HCPCS,90381,Rsv monoc antb seasnl 1ml im,,,1216.22,1690.23,4
HCPCS,90384,Rh ig full-dose im,,,193.82,324.66,4
HCPCS,90385,Rh ig minidose im,,,69.83,163.3,5
HCPCS,90386,Rh ig iv,,,23.42,1796.0,4
HCPCS,90389,Tetanus ig im,,,1519.06,2111.09,4
HCPCS,90396,Noncdm Charge Record Pharmacy,11332.63,7366.21,,,0
HCPCS,90396,Varicella-zoster ig im,,,2361.82,6103.68,5
HCPCS,90399,Immune globulin,,,1159.58,1159.58,2
HCPCS,90471,Hc Admin Immun One Vaccine,73.0,47.45,,,0
HCPCS,90471,Immunization admin,,,69.42,69.42,1
HCPCS,90472,Hc Admin Immun Ea Addl Vaccine,50.0,32.5,,,0
HCPCS,90473,Immune admin oral/nasal,,,69.42,69.42,1
HCPCS,90581,Anthrax vaccine sc or im,,,231.66,314.52,4
HCPCS,90585,"BCG VACCINE, LIVE (PF) 50 MG PERCUTANEOUS INJECTION SUSPENSION",785.85,510.8,,,0
HCPCS,90585,Bcg vaccine percut,,,397.52,552.46,4
HCPCS,90586,Bcg vaccine intravesical,,,254.92,406.36,5
HCPCS,90587,Dengue vacc quad 3 dose subq,,,154.44,214.63,4
HCPCS,90589,Chikungunya vaccine live im,,,643.5,643.5,2
HCPCS,90611,Smallpox&monkeypox vac 0.5ml,,,0.01,631.8,5
HCPCS,90619,"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",615.0,399.75,,,0
HCPCS,90619,Menacwy-tt vaccine im,,,402.41,558.83,4
HCPCS,90619,Noncdm Charge Record Pharmacy,629.14,408.94,,,0
HCPCS,90620,"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",1078.05,700.73,,,0
HCPCS,90620,Menb rp w/omv vaccine im,,,523.58,675.2,4
HCPCS,90620,Noncdm Charge Record Pharmacy,1069.62,695.25,,,0
HCPCS,90621,Menb rlp vaccine im,,,445.21,618.31,4
HCPCS,90622,Vaccinia vrs vac 0.3 ml perq,,,0.01,0.03,5
HCPCS,90623,Menacwy-tt menb-fhbp vacc im,,,539.96,747.96,4
HCPCS,90625,Cholera vaccine live oral,,,643.5,643.5,2
HCPCS,90626,Tic-brn enceph vac 0.25ml im,,,677.27,677.27,2
HCPCS,90627,Tic-brn enceph vac 0.5ml im,,,677.27,677.27,2
HCPCS,90632,HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION,365.5,237.58,,,0
HCPCS,90632,HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE,365.5,237.58,,,0
HCPCS,90632,Hepa vaccine adult im,,,121.73,194.06,5
HCPCS,90632,Noncdm Charge Record Pharmacy,375.78,244.26,,,0
HCPCS,90633,Hepa vacc ped/adol 2 dose im,,,88.94,113.77,4
HCPCS,90633,Noncdm Charge Record Pharmacy,155.97,101.38,,,0
HCPCS,90634,Hepa vacc ped/adol 3 dose,,,78.89,78.89,2
HCPCS,90636,Hep a/hep b vacc adult im,,,295.31,350.48,4
HCPCS,90644,Hib-mency vacc 6wk-18m0 im,,,0.02,59.62,4
HCPCS,90647,Hib prp-omp vacc 3 dose im,,,71.56,99.02,4
HCPCS,90648,Hib prp-t vaccine 4 dose im,,,28.2,42.22,4
HCPCS,90648,Noncdm Charge Record Pharmacy,93.35,60.68,,,0
HCPCS,90649,4vhpv vaccine 3 dose im,,,0.02,284.9,4
HCPCS,90650,2vhpv vaccine 3 dose im,,,0.02,0.02,2
HCPCS,90651,9vhpv vaccine 3 dose im,,,719.81,999.94,4
HCPCS,90651,Hc Grant Funded Hpv Vaccine 9 Valent,761.28,494.83,,,0
HCPCS,90651,Hc Hpv Vaccine 9 Valent,761.28,494.83,,,0
HCPCS,90653,Iiv adjuvant vaccine im,,,141.93,226.26,5
HCPCS,90655,Iiv3 vacc no prsv 0.25 ml im,,,0.02,34.9,4
HCPCS,90656,FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,138.15,89.8,,,0
HCPCS,90656,Iiv3 vacc no prsv 0.5 ml im,,,38.0,60.57,5
HCPCS,90656,Noncdm Charge Record Pharmacy,110.81,72.03,,,0
HCPCS,90657,Iiv3 vaccine splt 0.25 ml im,,,18.58,29.62,5
HCPCS,90658,Iiv3 vaccine splt 0.5 ml im,,,37.16,59.24,5
HCPCS,90660,Laiv3 vaccine intranasal,,,49.08,78.24,5
HCPCS,90661,Cciiv3 vac no prsv 0.5 ml im,,,62.64,99.86,5
HCPCS,90662,FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE,467.5,303.88,,,0
HCPCS,90662,Iiv no prsv increased ag im,,,141.94,226.26,5
HCPCS,90662,Noncdm Charge Record Pharmacy,323.81,210.48,,,0
HCPCS,90670,Pcv13 vaccine im,,,438.58,699.15,5
HCPCS,90671,Pcv15 vaccine im,,,431.05,687.15,5
HCPCS,90672,Laiv4 vaccine intranasal,,,57.33,82.36,4
HCPCS,90673,Riv3 vaccine no preserv im,,,141.94,226.26,5
HCPCS,90674,Cciiv4 vac no prsv 0.5 ml im,,,70.43,70.43,2
HCPCS,90675,Noncdm Charge Record Pharmacy,1463.69,951.4,,,0
HCPCS,90675,"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",1346.4,875.16,,,0
HCPCS,90675,Rabies vaccine im,,,313.68,888.28,6
HCPCS,90676,Rabies vaccine id,,,236.86,716.71,3
HCPCS,90677,Noncdm Charge Record Pharmacy,1249.64,812.27,,,0
HCPCS,90677,PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,1135.2,737.88,,,0
HCPCS,90677,Pcv20 vaccine im,,,506.66,807.69,5
HCPCS,90678,"RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION",1299.15,844.45,,,0
HCPCS,90678,Rsv vacc pref bivalent im,,,690.3,959.34,4
HCPCS,90679,Rsv vacc pref recomb adjt im,,,687.96,956.09,4
HCPCS,90680,Rv5 vacc 3 dose live oral,,,231.24,320.95,4
HCPCS,90681,Rv1 vacc 2 dose live oral,,,300.51,324.65,4
HCPCS,90682,Riv4 vacc recombinant dna im,,,150.95,150.95,2
HCPCS,90683,Rsv vacc mrna lipid nano im,,,678.6,943.08,4
HCPCS,90684,Pcv21 vaccine im,,,557.42,888.58,5
HCPCS,90685,Iiv4 vacc no prsv 0.25 ml im,,,44.72,44.72,2
HCPCS,90686,Iiv4 vacc no prsv 0.5 ml im,,,46.17,46.17,2
HCPCS,90686,Noncdm Charge Record Pharmacy,121.97,79.28,,,0
HCPCS,90687,Iiv4 vaccine splt 0.25 ml im,,,21.57,21.57,2
HCPCS,90688,Iiv4 vaccine splt 0.5 ml im,,,43.15,43.15,2
HCPCS,90690,Typhoid vaccine oral,,,244.58,249.61,4
HCPCS,90691,Typhoid vaccine im,,,320.19,342.97,4
HCPCS,90694,Vacc aiiv4 no prsrv 0.5ml im,,,159.07,159.07,2
HCPCS,90696,Dtap-ipv vaccine 4-6 yrs im,,,142.93,413.46,4
HCPCS,90697,Dtap-ipv-hib-hepb vaccine im,,,366.49,1014.05,4
HCPCS,90698,Dtap-ipv/hib vaccine im,,,280.94,365.82,4
HCPCS,90700,"DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP",144.05,93.63,,,0
HCPCS,90700,Dtap vaccine < 7 yrs im,,,67.39,95.88,4
HCPCS,90702,Dt vaccine under 7 yrs im,,,45.58,154.65,4
HCPCS,90707,"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",453.75,294.94,,,0
HCPCS,90707,Mmr vaccine sc,,,216.43,303.98,4
HCPCS,90707,Noncdm Charge Record Pharmacy,464.86,302.16,,,0
HCPCS,90710,Mmrv vaccine sc,,,650.89,902.94,4
HCPCS,90713,Poliovirus ipv sc/im,,,104.67,145.07,4
HCPCS,90714,Noncdm Charge Record Pharmacy,208.4,135.46,,,0
HCPCS,90714,TETANUS AND DIPHTHERIA TOX (PF) 5-2 LF UNIT IM SORD,222.35,144.53,,,0
HCPCS,90714,Td vacc no presv 7 yrs+ im,,,56.92,90.73,5
HCPCS,90715,"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",222.4,144.56,,,0
HCPCS,90715,Noncdm Charge Record Pharmacy,227.79,148.06,,,0
HCPCS,90715,Tdap vaccine 7 yrs/> im,,,65.67,104.69,5
HCPCS,90716,Noncdm Charge Record Pharmacy,860.5,559.32,,,0
HCPCS,90716,"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",866.9,563.48,,,0
HCPCS,90716,Var vaccine live subq,,,428.22,594.71,4
HCPCS,90717,Yellow fever vaccine subq,,,478.53,524.09,4
HCPCS,90723,Dtap-hep b-ipv vaccine im,,,229.25,308.43,4
HCPCS,90732,Noncdm Charge Record Pharmacy,606.78,394.41,,,0
HCPCS,90732,PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE,559.6,363.74,,,0
HCPCS,90732,Ppsv23 vacc 2 yrs+ subq/im,,,226.9,361.7,5
HCPCS,90733,Mpsv4 vaccine subq,,,0.02,225.28,4
HCPCS,90734,Mcv4 menacwy vaccine im,,,368.2,492.65,4
HCPCS,90736,Hzv vaccine live subq,,,0.02,360.27,4
HCPCS,90738,Inactivated je vacc im,,,672.98,828.47,4
HCPCS,90739,Hepb vacc 2 dose adult im,,,286.11,456.09,5
HCPCS,90740,HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,558.65,363.12,,,0
HCPCS,90740,Hepb vacc 3 dose immunsup im,,,268.86,428.59,5
HCPCS,90743,Hepb vacc 2 dose adolesc im,,,127.75,203.66,5
HCPCS,90744,HEPATITIS B VIRUS VACCINE RECMB(PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE,134.95,87.72,,,0
HCPCS,90744,HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE,168.75,109.69,,,0
HCPCS,90744,HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,134.95,87.72,,,0
HCPCS,90744,Hepb vacc 3 dose ped/adol im,,,52.31,83.39,5
HCPCS,90744,Noncdm Charge Record Pharmacy,1.03,0.67,,,0
HCPCS,90746,Hepb vaccine 3 dose adult im,,,119.64,190.73,5
HCPCS,90746,Noncdm Charge Record Pharmacy,162.66,105.73,,,0
HCPCS,90747,Hepb vacc 4 dose immunsup im,,,239.28,381.43,5
HCPCS,90748,Hib-hepb vaccine im,,,0.02,125.36,4
HCPCS,90750,Hzv vacc recombinant im njx,,,463.09,463.09,2
HCPCS,90750,Noncdm Charge Record Pharmacy,849.37,552.09,,,0
HCPCS,90750,"VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT",816.7,530.86,,,0
HCPCS,90750,VARICELLA-ZOSTER GLYCOP E VACCINE (VIAL 2 OF 2) 50 MCG IM SUSPENSION,1031.3,670.34,,,0
HCPCS,90756,Cciiv4 vacc abx free im,,,66.74,66.74,2
HCPCS,90759,Hep b vac 3ag 10mcg 3 dos im,,,125.49,200.05,5
HCPCS,90785,Hc Psychotherapy Complex Interactive,57.0,37.05,,,0
HCPCS,90791,Hc Psych Diagnostic Eval,502.0,326.3,,,0
HCPCS,90791,Psych diagnostic evaluation,,,171.15,171.15,1
HCPCS,90792,Hc Psych Diag Eval W Med Srvcs,687.0,446.55,,,0
HCPCS,90792,Psych diag eval w/med srvcs,,,171.15,171.15,1
HCPCS,90832,Hc Psychotherapy W Pt 30 Min,279.0,181.35,,,0
HCPCS,90832,Psytx w pt 30 minutes,,,171.15,171.15,1
HCPCS,90834,Hc Psychotherapy W Pt 45 Min,502.0,326.3,,,0
HCPCS,90834,Psytx w pt 45 minutes,,,171.15,171.15,1
HCPCS,90837,Hc Psychotherapy W Pt 60 Min,560.0,364.0,,,0
HCPCS,90837,Psytx w pt 60 minutes,,,171.15,171.15,1
HCPCS,90839,Psytx crisis initial 60 min,,,171.15,171.15,1
HCPCS,90845,Hc Psychoanalysis,957.0,622.05,,,0
HCPCS,90845,Psychoanalysis,,,171.15,171.15,1
HCPCS,90846,Family psytx w/o pt 50 min,,,171.15,171.15,1
HCPCS,90846,Hc Family Psychotherapy Wo Pt 50 Min,560.0,364.0,,,0
HCPCS,90847,Family psytx w/pt 50 min,,,171.15,171.15,1
HCPCS,90847,Hc Family Psychotherapy W Pt 50 Min,560.0,364.0,,,0
HCPCS,90849,Multiple family group psytx,,,171.15,171.15,1
HCPCS,90853,Group psychotherapy,,,97.95,97.95,1
HCPCS,90853,Hc Aftercare Group Therapy,838.0,544.7,,,0
HCPCS,90853,Hc Group Psychotherapy Less Than 30 Minutes,245.0,159.25,,,0
HCPCS,90853,Hc Iop Group Psych Therapy,838.0,544.7,,,0
HCPCS,90853,Hc Mcd Group Psychotherapy <30 Min,245.0,159.25,,,0
HCPCS,90853,Hc Pnes Group Psychotherapy,280.0,182.0,,,0
HCPCS,90865,Hc Narcosynthsis For Psych Dx And Tx,957.0,622.05,,,0
HCPCS,90865,Narcosynthesis,,,171.15,171.15,1
HCPCS,90867,Hc Therap Tms Treatment Intial,889.0,577.85,,,0
HCPCS,90867,Tcranial magn stim tx plan,,,208.2,208.2,1
HCPCS,90868,Hc Therap Tms Treat Subseq Del And Mgmt,630.0,409.5,,,0
HCPCS,90868,Tcranial magn stim tx deli,,,208.2,208.2,1
HCPCS,90869,Hc Tms Subseq Mot Thresh W Del And Mgmt,889.0,577.85,,,0
HCPCS,90869,Tcran magn stim redetemine,,,208.2,208.2,1
HCPCS,90870,Electroconvulsive therapy,,,828.02,828.02,1
HCPCS,90870,Hc Ect Single Seizure,4714.0,3064.1,,,0
HCPCS,90880,Hc Hypnotherapy,957.0,622.05,,,0
HCPCS,90880,Hypnotherapy,,,97.95,97.95,1
HCPCS,90901,Biofeedback train any meth,,,16.17,16.17,1
HCPCS,90912,Bfb training 1st 15 min,,,36.93,36.93,1
HCPCS,90912,Hc Pt Biofeedback Training Perineal Anorectal Or Urethral Sphincter Initial 15 Min,170.0,110.5,,,0
HCPCS,90913,Bfb training ea addl 15 min,,,20.76,20.76,1
HCPCS,90913,Hc Pt Biofeedback Training Perineal Anorectal Or Urethral Sphincter Ea Addl 15 Min,170.0,110.5,,,0
HCPCS,90935,Hc Dialysis,5490.0,3568.5,,,0
HCPCS,90935,Hc Hemodialysis Proc Ip 1 Eval,5490.0,3568.5,,,0
HCPCS,90935,Hemodialysis one evaluation,,,661.76,661.76,1
HCPCS,90945,Dialysis one evaluation,,,402.33,402.33,1
HCPCS,90945,Hc Peritoneal Dialysis,895.0,581.75,,,0
HCPCS,90947,Hc Prisma Therapy Crrt,9886.0,6425.9,,,0
HCPCS,90999,Hc Ultrafiltration,7299.0,4744.35,,,0
HCPCS,91010,Esophagus motility study,,,359.81,359.81,1
HCPCS,91010,Hc Motility Study Esophagus,3628.0,2358.2,,,0
HCPCS,91020,Gastric motility studies,,,359.81,359.81,1
HCPCS,91022,Duodenal motility study,,,359.81,359.81,1
HCPCS,91030,Acid perfusion of esophagus,,,359.81,359.81,1
HCPCS,91034,Gastroesophageal reflux test,,,359.81,359.81,1
HCPCS,91034,Hc Gastroesophageal Reflux Test W Ph Electrode Plcmnt,7886.0,5125.9,,,0
HCPCS,91035,G-esoph reflx tst w/electrod,,,828.02,828.02,1
HCPCS,91035,Hc Gastroesoph Reflux W Mucosal Ph Electrode Plcmnt,8201.0,5330.65,,,0
HCPCS,91037,Esoph imped function test,,,208.2,208.2,1
HCPCS,91037,Hc Esoph Imped Func Test,4167.0,2708.55,,,0
HCPCS,91038,Esoph imped funct test > 1hr,,,359.81,359.81,1
HCPCS,91038,Hc Ph Impedance Test 24 Hours,6794.0,4416.1,,,0
HCPCS,91040,Esoph balloon distension tst,,,359.81,359.81,1
HCPCS,91065,Breath hydrogen/methane test,,,208.2,208.2,1
HCPCS,91110,Gi tract capsule endoscopy,,,874.53,874.53,1
HCPCS,91110,Hc Gastrointestinal Tract Imaging Capsule Endoscopy,4695.0,3051.75,,,0
HCPCS,91111,Esophageal Capsule Endoscopy,,,874.53,874.53,1
HCPCS,91112,Gi wireless capsule measure,,,874.53,874.53,1
HCPCS,91113,Gi trc img intral colon i&r,,,896.69,896.69,1
HCPCS,91113,Hc Gi Tract Imaging Intraluminal Colon I&R,4695.0,3051.75,,,0
HCPCS,91117,Colon motility 6 hr study,,,208.2,208.2,1
HCPCS,91122,Hc Anorectal Manometry Test,2472.0,1606.8,,,0
HCPCS,91124,Rct snsatn tone&cmplianc std,,,208.2,208.2,1
HCPCS,91125,Anrct mano rct snsatn&balo,,,359.81,359.81,1
HCPCS,91132,Electrogastrography,,,208.2,208.2,1
HCPCS,91133,Electrogastrography W/Test,,,128.29,128.29,1
HCPCS,91200,Hc Elastography Liver Wo Img,547.0,355.55,,,0
HCPCS,91200,Liver elastography,,,124.07,124.07,1
HCPCS,91299,Gastroenterology procedure,,,124.07,124.07,1
HCPCS,91304,Coronavirus vaccine 5,,,274.61,437.77,5
HCPCS,91318,Sarscov2 vac 3mcg trs-suc im,,,111.44,177.64,5
HCPCS,91319,Sarscv2 vac 10mcg trs-suc im,,,149.23,237.88,5
HCPCS,91320,Sarscv2 vac 30mcg trs-suc im,,,265.02,422.49,5
HCPCS,91321,Sarscov2 vac 25 mcg/.25ml im,,,250.0,398.53,5
HCPCS,91322,Sarscov2 vac 50 mcg/0.5ml im,,,274.81,438.07,5
HCPCS,92002,Eye exam new patient,,,128.37,128.37,1
HCPCS,92004,Eye exam new patient,,,128.37,128.37,1
HCPCS,92012,Eye exam establish patient,,,128.37,128.37,1
HCPCS,92014,Eye exam&tx estab pt 1/>vst,,,128.37,128.37,1
HCPCS,92018,New eye exam & treatment,,,2292.42,2292.42,1
HCPCS,92019,Eye exam & treatment,,,2292.42,2292.42,1
HCPCS,92020,Special eye evaluation,,,128.29,128.29,1
HCPCS,92025,Corneal Topography,,,56.88,56.88,1
HCPCS,92060,Special eye evaluation,,,56.88,56.88,1
HCPCS,92066,Orthop traing supvj phys/qhp,,,56.88,56.88,1
HCPCS,92081,Visual field examination(s),,,56.88,56.88,1
HCPCS,92082,Visual field examination(s),,,56.88,56.88,1
HCPCS,92083,Visual field examination(s),,,128.29,128.29,1
HCPCS,92132,Cmptr ophth dx img ant segmt,,,56.88,56.88,1
HCPCS,92133,Cmptr ophth img optic nerve,,,56.88,56.88,1
HCPCS,92134,Cptr ophth dx img post segmt,,,56.88,56.88,1
HCPCS,92136,Ophthalmic biometry,,,128.29,128.29,1
HCPCS,92137,Cptrz oph img pst sg rta oct,,,208.2,208.2,1
HCPCS,92145,Corneal hysteresis deter,,,56.88,56.88,1
HCPCS,92201,Opscpy extnd rta draw uni/bi,,,56.88,56.88,1
HCPCS,92202,Opscpy extnd on/mac draw,,,56.88,56.88,1
HCPCS,92227,Remote dx retinal imaging,,,56.88,56.88,1
HCPCS,92228,Remote retinal imaging mgmt,,,36.01,36.01,1
HCPCS,92229,Img rta detc/mntr ds poc aly,,,56.88,56.88,1
HCPCS,92230,Eye exam with photos,,,359.81,359.81,1
HCPCS,92235,Fluorescein angrph uni/bi,,,208.2,208.2,1
HCPCS,92240,Icg angiography uni/bi,,,208.2,208.2,1
HCPCS,92242,Fluorescein icg angiography,,,208.2,208.2,1
HCPCS,92250,Eye exam with photos,,,128.29,128.29,1
HCPCS,92260,Ophthalmoscopy/dynamometry,,,36.01,36.01,1
HCPCS,92265,Eye muscle evaluation,,,56.88,56.88,1
HCPCS,92270,Electro-oculography,,,128.29,128.29,1
HCPCS,92273,Full field erg w/i&r,,,208.2,208.2,1
HCPCS,92274,Multifocal erg w/i&r,,,124.07,124.07,1
HCPCS,92283,Color vision examination,,,56.88,56.88,1
HCPCS,92284,Dark adaptation eye exam,,,430.74,430.74,1
HCPCS,92285,Eye photography,,,36.01,36.01,1
HCPCS,92286,Internal eye photography,,,128.29,128.29,1
HCPCS,92287,Internal eye photography,,,128.29,128.29,1
HCPCS,92311,Contact lens fitting,,,430.74,430.74,1
HCPCS,92312,Contact lens fitting,,,128.29,128.29,1
HCPCS,92313,Contact lens fitting,,,128.29,128.29,1
HCPCS,92315,Rx cntact lens aphakia 1 eye,,,128.29,128.29,1
HCPCS,92316,Rx cntact lens aphakia 2 eye,,,128.29,128.29,1
HCPCS,92317,Rx corneoscleral cntact lens,,,36.01,36.01,1
HCPCS,92325,Modification of contact lens,,,128.29,128.29,1
HCPCS,92326,Replacement of contact lens,,,56.88,56.88,1
HCPCS,92352,Fit aphakia spectcl monofocl,,,56.88,56.88,1
HCPCS,92353,Fit aphakia spectcl multifoc,,,56.88,56.88,1
HCPCS,92354,Fit spectacles single system,,,36.01,36.01,1
HCPCS,92355,Fit spectacles compound lens,,,36.01,36.01,1
HCPCS,92358,Aphakia prosth service temp,,,56.88,56.88,1
HCPCS,92371,Repair & adjust spectacles,,,56.88,56.88,1
HCPCS,92499,Eye service or procedure,,,27.89,27.89,1
HCPCS,92502,Ear and throat examination,,,520.03,520.03,1
HCPCS,92507,Hc St Ped Treat Basic,336.0,218.4,,,0
HCPCS,92507,Hc St Ped Treat Complex,416.0,270.4,,,0
HCPCS,92507,Hc St Treat Basic,336.0,218.4,,,0
HCPCS,92507,Hc St Treat Complex,416.0,270.4,,,0
HCPCS,92507,Speech/hearing therapy,,,73.34,73.34,1
HCPCS,92508,Hc St Therapy Group,156.0,101.4,,,0
HCPCS,92508,Speech/hearing therapy,,,22.95,22.95,1
HCPCS,92511,Nasopharyngoscopy,,,192.47,192.47,1
HCPCS,92512,Nasal function studies,,,208.2,208.2,1
HCPCS,92516,Facial nerve function test,,,208.2,208.2,1
HCPCS,92517,Vemp test i&r cervical,,,124.07,124.07,1
HCPCS,92518,Vemp test i&r ocular,,,124.07,124.07,1
HCPCS,92519,Vemp tst i&r cervical&ocular,,,208.2,208.2,1
HCPCS,92520,Laryngeal function studies,,,128.29,128.29,1
HCPCS,92521,Evaluation of speech fluency,,,128.22,128.22,1
HCPCS,92521,Hc St Speech Fluency Eval,205.0,133.25,,,0
HCPCS,92522,Evaluate speech production,,,107.86,107.86,1
HCPCS,92522,Hc St Speech Sound Eval,168.0,109.2,,,0
HCPCS,92523,Hc St Speech And Comprehension Eval,349.0,226.85,,,0
HCPCS,92523,Speech sound lang comprehen,,,217.95,217.95,1
HCPCS,92524,Behavral qualit analys voice,,,105.7,105.7,1
HCPCS,92524,Hc St Behvrl And Qual Analysis Of Voice,176.0,114.4,,,0
HCPCS,92526,Hc Treat Swall Oral Func Complex,389.0,252.85,,,0
HCPCS,92526,Hc Treat Swall Oral Function Basic,303.0,196.95,,,0
HCPCS,92526,Oral function therapy,,,80.77,80.77,1
HCPCS,92531,Hc Spontaneous Nystagmus W/Gaze,338.0,219.7,,,0
HCPCS,92532,Hc Positional Nystagmus,338.0,219.7,,,0
HCPCS,92537,Caloric vstblr test w/rec,,,124.07,124.07,1
HCPCS,92538,Caloric vstblr test w/rec,,,208.2,208.2,1
HCPCS,92540,Basic vestibular evaluation,,,208.2,208.2,1
HCPCS,92541,"Hc Spontaneous Nystagmus W/Gaze, W/Fixation And Recording",326.0,211.9,,,0
HCPCS,92541,Spontaneous nystagmus test,,,128.29,128.29,1
HCPCS,92542,Hc Positional Nystagmus 4 Position W/Recording,326.0,211.9,,,0
HCPCS,92542,Positional nystagmus test,,,128.29,128.29,1
HCPCS,92544,Optokinetic nystagmus test,,,124.07,124.07,1
HCPCS,92545,Oscillating tracking test,,,208.2,208.2,1
HCPCS,92546,Sinusoidal rotational test,,,124.07,124.07,1
HCPCS,92548,Posturography,,,128.29,128.29,1
HCPCS,92549,Cdp-sot 6 cond w/i&r mct&adt,,,128.29,128.29,1
HCPCS,92550,Tympanometry & reflex thresh,,,208.2,208.2,1
HCPCS,92551,Hc Audio Pure Tone Air Screen,110.0,71.5,,,0
HCPCS,92552,"Hc Audiometry Pure Tone, Air Only",110.0,71.5,,,0
HCPCS,92552,Pure tone audiometry air,,,128.29,128.29,1
HCPCS,92553,Audiometry air & bone,,,124.07,124.07,1
HCPCS,92553,"Hc Audiometry Pure Tone, Air And Bone",133.0,86.45,,,0
HCPCS,92555,Speech threshold audiometry,,,56.88,56.88,1
HCPCS,92556,Speech audiometry complete,,,56.88,56.88,1
HCPCS,92557,Comprehensive hearing test,,,124.07,124.07,1
HCPCS,92558,Hc Hearing Screen Evoked Oae,110.0,71.5,,,0
HCPCS,92562,Loudness balance test,,,208.2,208.2,1
HCPCS,92563,Tone decay hearing test,,,36.01,36.01,1
HCPCS,92565,Stenger test pure tone,,,56.88,56.88,1
HCPCS,92567,Tympanometry,,,36.01,36.01,1
HCPCS,92568,Acoustic refl threshold tst,,,36.01,36.01,1
HCPCS,92570,Acoustic immitance testing,,,124.07,124.07,1
HCPCS,92571,Filtered speech hearing test,,,36.01,36.01,1
HCPCS,92572,Staggered spondaic word test,,,124.07,124.07,1
HCPCS,92575,Sensorineural acuity test,,,36.01,36.01,1
HCPCS,92576,Synthetic sentence test,,,36.01,36.01,1
HCPCS,92577,Stenger test speech,,,359.81,359.81,1
HCPCS,92579,Visual audiometry (vra),,,208.2,208.2,1
HCPCS,92582,Conditioning play audiometry,,,124.07,124.07,1
HCPCS,92583,Select picture audiometry,,,56.88,56.88,1
HCPCS,92584,Electrocochleography,,,124.07,124.07,1
HCPCS,92587,Evoked auditory test limited,,,208.2,208.2,1
HCPCS,92587,Hc Auditory Evoked Oae,253.0,164.45,,,0
HCPCS,92588,Evoked auditory tst complete,,,359.81,359.81,1
HCPCS,92596,Ear protector evaluation,,,36.01,36.01,1
HCPCS,92597,Hc St Eval Voice Prosthetic Basic,136.0,88.4,,,0
HCPCS,92597,Hc St Eval Voice Prosthetic Complex,261.0,169.65,,,0
HCPCS,92597,Oral speech device eval,,,68.59,68.59,1
HCPCS,92601,Cochlear implt f/up exam <7,,,124.07,124.07,1
HCPCS,92602,Reprogram cochlear implt 7/>,,,124.07,124.07,1
HCPCS,92603,Cochlear implt f/up exam 7/>,,,124.07,124.07,1
HCPCS,92604,Reprogram cochlear implt 7/>,,,124.07,124.07,1
HCPCS,92607,Ex for speech device rx 1hr,,,117.02,117.02,1
HCPCS,92607,Hc St Eval Speech Device 1St Hr,405.0,263.25,,,0
HCPCS,92608,Ex for speech device rx addl,,,45.64,45.64,1
HCPCS,92608,Hc St Eval Speech Device Ea Addl 30M,135.0,87.75,,,0
HCPCS,92609,Hc Speech Gen Device Services,351.0,228.15,,,0
HCPCS,92609,Use of speech device service,,,98.01,98.01,1
HCPCS,92610,Evaluate swallowing function,,,56.57,56.57,1
HCPCS,92610,Hc Eval Swallow Oral Func Basic,293.0,190.45,,,0
HCPCS,92610,Hc Eval Swallow Oral Func Complex,435.0,282.75,,,0
HCPCS,92610,Hc Ped Eval Swall/Oral Func Basic,293.0,190.45,,,0
HCPCS,92611,Hc St Eval Swall Video/Fluoro,460.0,299.0,,,0
HCPCS,92611,Motion fluoroscopy/swallow,,,87.52,87.52,1
HCPCS,92612,Endoscopy swallow (fees) vid,,,53.16,53.16,1
HCPCS,92612,Hc St Eval Swall Endo Cine/Video,532.0,345.8,,,0
HCPCS,92614,Laryngoscopic sensory vid,,,53.2,53.2,1
HCPCS,92616,Fees w/laryngeal sense test,,,78.42,78.42,1
HCPCS,92620,Auditory function 60 min,,,124.07,124.07,1
HCPCS,92622,Dx aly aud oi snd prcsr 1st,,,124.07,124.07,1
HCPCS,92625,Tinnitus assessment,,,124.07,124.07,1
HCPCS,92626,Eval aud rehab status,,,124.07,124.07,1
HCPCS,92640,Aud brainstem implt programg,,,124.07,124.07,1
HCPCS,92650,Hc Auditory Ep Screen Auditory Potential W Broadband Stimuli Analysis,81.0,52.65,,,0
HCPCS,92651,Aep hearing status deter i&r,,,208.2,208.2,1
HCPCS,92652,Aep thrshld est mlt freq i&r,,,208.2,208.2,1
HCPCS,92653,Aep neurodiagnostic i&r,,,208.2,208.2,1
HCPCS,92700,Ent procedure/service,,,27.89,27.89,1
HCPCS,92920,Hc Ptca Sgl Maj Cor Art Or Branch,7237.0,4704.05,,,0
HCPCS,92920,Prq cardiac angioplast 1 art,,,5487.93,30765.0,2
HCPCS,92921,Hc Ptca Addl Branch Maj Cor Art,6926.0,4501.9,,,0
HCPCS,92924,Hc Atherectomy Sgl Maj Cor Art Or Branch,18072.0,11746.8,,,0
HCPCS,92924,Prq card angio/athrect 1 art,,,11131.16,38216.0,2
HCPCS,92925,Hc Atherectomy Ea Add Branch Maj Cor Art,15784.0,10259.6,,,0
HCPCS,92928,Hc Stent Sgl Maj Cor Art Or Branch,16245.0,10559.25,,,0
HCPCS,92928,Prq card stent w/angio 1 vsl,,,11131.16,38216.0,2
HCPCS,92929,Hc Stent Ea Addl Maj Cor Art Or Branch,14124.0,9180.6,,,0
HCPCS,92930,Prq tcat plmt ntrac st 2+les,,,17675.76,17675.76,1
HCPCS,92933,Hc Atherectomy W Stent Maj Cor Art Or Branch,18072.0,11746.8,,,0
HCPCS,92933,Prq card stent/ath/angio,,,17675.76,63079.0,2
HCPCS,92934,Hc Atherectomy W Stent Addl Branch,14124.0,9180.6,,,0
HCPCS,92937,Hc Revascularization Cabg 1 Vessel,16106.0,10468.9,,,0
HCPCS,92937,Prq revasc byp graft 1 vsl,,,11131.16,38216.0,2
HCPCS,92938,Hc Revascularization Cabg Ea Addl Vessel,14124.0,9180.6,,,0
HCPCS,92941,Hc Revasc Acute Occlusion During Mi Sgl Ves,19293.0,12540.45,,,0
HCPCS,92941,Prq card revasc mi 1 vsl,,,38216.0,38216.0,1
HCPCS,92943,Hc Revasc Chronic Occlusion Sgl Vessel,26779.0,17406.35,,,0
HCPCS,92943,Prq card revasc chronic 1vsl,,,11131.16,38216.0,2
HCPCS,92944,Hc Revasc Chronic Occlusion Ea Addl Vessel,14124.0,9180.6,,,0
HCPCS,92945,Prq trl rvs ch occ ant&rtrgr,,,11131.16,11131.16,1
HCPCS,92950,Hc Cpr,2458.0,1597.7,,,0
HCPCS,92950,Heart/lung resuscitation cpr,,,208.2,208.2,1
HCPCS,92953,Hc Temporary External Pacing,1378.0,895.7,,,0
HCPCS,92953,Temporary external pacing,,,637.3,637.3,1
HCPCS,92960,Cardioversion electric ext,,,637.3,637.3,1
HCPCS,92960,Hc Cardioversion Elective External,7902.0,5136.3,,,0
HCPCS,92961,Cardioversion electric int,,,637.3,637.3,1
HCPCS,92972,Hc Perc Transluminal Coronary Lithotripsy Add On,6000.0,3900.0,,,0
HCPCS,92973,Hc Perc Translumin Cor Thrombectomy,4026.0,2616.9,,,0
HCPCS,92974,Hc Transcath Plcmnt Radiation Del Dev,2234.0,1452.1,,,0
HCPCS,92975,Dissolve clot heart vessel,,,3714.0,3714.0,1
HCPCS,92977,Dissolve clot heart vessel,,,3714.0,3714.0,1
HCPCS,92978,Hc Ivus Coronary Initial Vessel,5538.0,3599.7,,,0
HCPCS,92979,Hc Ivus Coronary Each Addl Vessel,2820.0,1833.0,,,0
HCPCS,92986,Hc Percutaneous Balloon Valvoplasty Aortic,31809.0,20675.85,,,0
HCPCS,92986,Revision of aortic valve,,,5487.93,30765.0,2
HCPCS,92987,Hc Percutaneous Balloon Valvoplasty Mitral,15950.0,10367.5,,,0
HCPCS,92987,Revision of mitral valve,,,11131.16,38216.0,2
HCPCS,92990,Hc Percutaneous Balloon Valvoplasty Pulm,15950.0,10367.5,,,0
HCPCS,92990,Revision of pulmonary valve,,,11131.16,38216.0,2
HCPCS,92997,Hc Percutaneous Balloon Angioplasty Pulmnary,15950.0,10367.5,,,0
HCPCS,92997,Pul art balloon repr percut,,,11131.16,11131.16,1
HCPCS,92998,Hc Perct Balloon Angioplasty Pulmnary Ea Addtl Vessel,7975.0,5183.75,,,0
HCPCS,93005,Electrocardiogram tracing,,,56.88,56.88,1
HCPCS,93005,Hc Ekg,153.0,99.45,,,0
HCPCS,93017,Cardiovascular stress test,,,208.2,208.2,1
HCPCS,93017,Hc Stress Test Tracing Only,1168.0,759.2,,,0
HCPCS,93024,Cardiac drug stress test,,,430.74,430.74,1
HCPCS,93025,Microvolt t-wave assess,,,124.07,124.07,1
HCPCS,93041,Hc Ekg Rhythm Tracing Only,339.0,220.35,,,0
HCPCS,93041,Rhythm ecg tracing,,,56.88,56.88,1
HCPCS,93050,Art pressure waveform analys,,,27.89,27.89,1
HCPCS,93145,Interrog crtd sins bat ip wo,,,124.07,124.07,1
HCPCS,93146,Interrog crtd sins bat ip w/,,,124.07,124.07,1
HCPCS,93150,Therapy activation ipnss,,,91.67,91.67,1
HCPCS,93151,Interrog&prgrmg ipnss,,,91.67,91.67,1
HCPCS,93153,Interrog w/o prgrmg ipnss,,,91.67,91.67,1
HCPCS,93225,Ecg monit/reprt up to 48 hrs,,,128.29,128.29,1
HCPCS,93225,Hc Holter Scan Recording Up To 48 Hr,577.0,375.05,,,0
HCPCS,93226,Ecg monit/reprt up to 48 hrs,,,56.88,56.88,1
HCPCS,93229,Remote 30 day ecg tech supp,,,359.81,359.81,1
HCPCS,93242,Ext ecg>48hr<7d recording,,,36.01,36.01,1
HCPCS,93242,Hc Holter Recording 49 Hrs Up To 7 Days,577.0,375.05,,,0
HCPCS,93243,Ext ecg>48hr<7d scan a/r,,,128.29,128.29,1
HCPCS,93246,Ext ecg>7d<15d recording,,,36.01,36.01,1
HCPCS,93246,Hc Holter Recording 8 Days Up To 15 Days,577.0,375.05,,,0
HCPCS,93247,Ext ecg>7d<15d scan a/r,,,128.29,128.29,1
HCPCS,93260,Hc Implant Subq Defib Device Sys Eval,244.0,158.6,,,0
HCPCS,93260,Hc Subq Defib Programming Device Eval,244.0,158.6,,,0
HCPCS,93261,Hc Subq Defib Interrogation Device Eval,247.0,160.55,,,0
HCPCS,93270,Hc Event Recording,577.0,375.05,,,0
HCPCS,93271,Ecg/monitoring and analysis,,,91.67,91.67,1
HCPCS,93278,ECG/signal-averaged,,,56.88,56.88,1
HCPCS,93278,Hc Ekg Signal Averaged,829.0,538.85,,,0
HCPCS,93279,Hc Program Device Eval Single Pacer,205.0,133.25,,,0
HCPCS,93280,Hc Program Device Eval Dual Pacer,205.0,133.25,,,0
HCPCS,93281,Hc Program Device Eval Multi Pacer,238.0,154.7,,,0
HCPCS,93282,Hc Program Device Eval Single Defib,220.0,143.0,,,0
HCPCS,93283,Hc Program Device Eval Dual Defib,279.0,181.35,,,0
HCPCS,93284,Hc Program Device Eval Multi Defib,316.0,205.4,,,0
HCPCS,93285,Hc Program Sq Crm Incl Retreival Report,145.0,94.25,,,0
HCPCS,93286,Hc Peri-Proc Device Eval And Program Pacemaker,214.0,139.1,,,0
HCPCS,93287,Hc Peri-Proc Device Eval And Program Implantable Defibrillator,284.0,184.6,,,0
HCPCS,93288,Hc Interrogation Pacer Wo Reprogram,118.0,76.7,,,0
HCPCS,93289,Hc Interrogation Defib Wo Reprogram,200.0,130.0,,,0
HCPCS,93290,Hc Interrogation Implant Monitor System,93.0,60.45,,,0
HCPCS,93291,Hc Interrogation Sq Crm,112.0,72.8,,,0
HCPCS,93291,Ilr device interrogate,,,27.89,27.89,1
HCPCS,93293,Hc Transtelephonic Pacer Eval,158.0,102.7,,,0
HCPCS,93296,Hc Interrogation Pacer Defib Remote,97.0,63.05,,,0
HCPCS,93297,Hc Remote Interrogation Cv Physiologic Ms - Heartlogic,135.0,87.75,,,0
HCPCS,93298,Hc Remote Interrogation Of Sq Cardiac Rhythm Monitor,150.0,97.5,,,0
HCPCS,93303,Echo transthoracic,,,526.87,526.87,1
HCPCS,93303,Hc Echo Congen Cardiac Anomaly Comp,2993.0,1945.45,,,0
HCPCS,93304,Echo transthoracic,,,526.87,526.87,1
HCPCS,93304,Hc Echo Congen Cardiac Anomaly Ltd,2101.0,1365.65,,,0
HCPCS,93306,Hc Echo Complete W Doppler,2408.0,1565.2,,,0
HCPCS,93306,Tte w/doppler complete,,,526.87,526.87,1
HCPCS,93307,Tte w/o doppler complete,,,230.07,230.07,1
HCPCS,93308,Hc Echo Limited Or Follow Up,1725.0,1121.25,,,0
HCPCS,93308,Tte f-up or lmtd,,,230.07,230.07,1
HCPCS,93312,Echo transesophageal,,,526.87,526.87,1
HCPCS,93312,Hc Echo Tee Complete,2725.0,1771.25,,,0
HCPCS,93313,Echo transesophageal,,,526.87,526.87,1
HCPCS,93313,Hc Echo Tee Probe Plcmt Only,1955.0,1270.75,,,0
HCPCS,93315,Echo transesophageal,,,526.87,526.87,1
HCPCS,93315,Hc Echo Tee Congen Cardiac Anomaly Comp,2399.0,1559.35,,,0
HCPCS,93316,Echo transesophageal,,,526.87,526.87,1
HCPCS,93318,Echo Transesophageal Intraop,,,526.87,526.87,1
HCPCS,93319,Hc Echo Tee 3D Add On,358.0,232.7,,,0
HCPCS,93320,Hc Echo Doppler Add On,319.0,207.35,,,0
HCPCS,93321,Hc Echo Doppler Limited Add On,299.0,194.35,,,0
HCPCS,93325,Hc Echo Color Flow Velocity Mapping Add On,222.0,144.3,,,0
HCPCS,93350,Hc Echo Rest And Stress,2473.0,1607.45,,,0
HCPCS,93350,Stress tte only,,,526.87,526.87,1
HCPCS,93351,Stress tte complete,,,526.87,526.87,1
HCPCS,93355,Hc Echo Tee Guide For Structural Intvn,3606.0,2343.9,,,0
HCPCS,93356,Hc Myocardial Strain Imaging Add On,299.0,194.35,,,0
HCPCS,93451,Hc Right Heart Cath,12693.0,8250.45,,,0
HCPCS,93451,Right heart cath,,,3125.94,15689.0,2
HCPCS,93452,Hc Left Heart Cath,9096.0,5912.4,,,0
HCPCS,93452,Left hrt cath w/ventrclgrphy,,,3125.94,15689.0,2
HCPCS,93453,Hc Right And Left Heart Cath,21391.0,13904.15,,,0
HCPCS,93453,R&l hrt cath w/ventriclgrphy,,,3125.94,15689.0,2
HCPCS,93454,Coronary artery angio s&i,,,3125.94,15689.0,2
HCPCS,93454,Hc Coronary Angiography,11671.0,7586.15,,,0
HCPCS,93455,Coronary art/grft angio s&i,,,3125.94,15689.0,2
HCPCS,93455,Hc Coronary Angio W Bypass Grafts,14199.0,9229.35,,,0
HCPCS,93456,Hc Coronary Angiography W Rhc,15695.0,10201.75,,,0
HCPCS,93456,R hrt coronary artery angio,,,3125.94,15689.0,2
HCPCS,93457,Hc Coronary Angiogrphy W Byp Grfts And Rhc,15984.0,10389.6,,,0
HCPCS,93457,R hrt art/grft angio,,,3125.94,15689.0,2
HCPCS,93458,Hc Coronary Angiography W Lhc,14387.0,9351.55,,,0
HCPCS,93458,L hrt artery/ventricle angio,,,3125.94,15689.0,2
HCPCS,93459,Hc Coronary Angiogrphy W Byp Grfts And Lhc,15224.0,9895.6,,,0
HCPCS,93459,L hrt art/grft angio,,,3125.94,15689.0,2
HCPCS,93460,Hc Coronary Angiography W Lhc And Rhc,15839.0,10295.35,,,0
HCPCS,93460,R&l hrt art/ventricle angio,,,3125.94,15689.0,2
HCPCS,93461,Hc Coronary Angiogrphy W Byp Grfts Lhc And Rhc,17782.0,11558.3,,,0
HCPCS,93461,R&l hrt art/ventricle angio,,,3125.94,15689.0,2
HCPCS,93462,Hc Lhc Via Transseptal Puncture,10643.0,6917.95,,,0
HCPCS,93463,Hc Pharm Agent Admin Nitric Oxide,1214.0,789.1,,,0
HCPCS,93464,Hc Phys Exercise Study Incl Hemodynamic Measure,428.0,278.2,,,0
HCPCS,93503,Hc Insert Swan Ganz Catheter,7370.0,4790.5,,,0
HCPCS,93503,Insert/place heart catheter,,,1517.83,9206.0,2
HCPCS,93505,Biopsy of heart lining,,,3044.51,15689.0,2
HCPCS,93505,Hc Biopsy Endomyocardial,12271.0,7976.15,,,0
HCPCS,93566,Hc Inj Right Atrial Ventricular Angio,1214.0,789.1,,,0
HCPCS,93567,Hc Inj Aortography Supravalvular,3258.0,2117.7,,,0
HCPCS,93568,Hc Inj Pulmonary Angiography,3563.0,2315.95,,,0
HCPCS,93569,Hc Injection Cardiac Cath Selective Pulm Arterial Angio Unilateral,1500.0,975.0,,,0
HCPCS,93571,Hc Heart Flow Reserve Measure Init,5255.0,3415.75,,,0
HCPCS,93572,Hc Heart Flow Reserve Measure Addl,2872.0,1866.8,,,0
HCPCS,93573,Hc Injection Cardiac Cath Selective Pulm Arterial Angio Bilateral,2000.0,1300.0,,,0
HCPCS,93574,Hc Injection Cardiac Cath Selective Pulm Venous Angio Each Vein,1500.0,975.0,,,0
HCPCS,93575,Hc Injection Cardiac Cath Selective Pulm Venous Angio Mapcas Each Vessel,2000.0,1300.0,,,0
HCPCS,93580,Hc Transcath Closure Asd W/Implant,16533.0,10746.45,,,0
HCPCS,93580,Transcath closure of asd,,,17675.76,63079.0,2
HCPCS,93581,Hc Transcath Closure Vsd W/Implant,17841.0,11596.65,,,0
HCPCS,93581,Transcath closure of vsd,,,17675.76,63079.0,2
HCPCS,93582,Perq transcath closure pda,,,17675.76,63079.0,2
HCPCS,93583,Hc Perq Transcath Septal Reduction,16533.0,10746.45,,,0
HCPCS,93583,Perq transcath septal reduxn,,,63079.0,63079.0,1
HCPCS,93590,Hc Perc Transcath Closure Paravalvular Leak Mitral Valve,16533.0,10746.45,,,0
HCPCS,93590,Perq transcath cls mitral,,,17675.76,63079.0,2
HCPCS,93591,Hc Perc Transcath Closure Paravalvular Leak Aortic Valve,16533.0,10746.45,,,0
HCPCS,93591,Perq transcath cls aortic,,,17675.76,63079.0,2
HCPCS,93592,Hc Perc Transcath Closure Paravalvular Leak Each Addl,7987.0,5191.55,,,0
HCPCS,93593,R hrt cath chd nml nt cnj,,,3125.94,15689.0,2
HCPCS,93594,R hrt cath chd abnl nt cnj,,,3125.94,15689.0,2
HCPCS,93595,L hrt cath chd nm/abn nt cnj,,,3125.94,15689.0,2
HCPCS,93596,R&l hrt cath chd nml nt cnj,,,3125.94,15689.0,2
HCPCS,93597,R&l hrt cath chd abnl nt cnj,,,3125.94,15689.0,2
HCPCS,93600,Bundle of His recording,,,7520.61,7520.61,1
HCPCS,93600,Hc Bundle Of His Recording,6921.0,4498.65,,,0
HCPCS,93602,Hc Intra Atrial Recording,6225.0,4046.25,,,0
HCPCS,93602,Intra-atrial recording,,,7520.61,7520.61,1
HCPCS,93603,Hc Right Ventricular Recording,7257.0,4717.05,,,0
HCPCS,93603,Right ventricular recording,,,1173.98,1173.98,1
HCPCS,93609,Hc Intravent Intra Atrial Mapping,13300.0,8645.0,,,0
HCPCS,93610,Hc Intra Atrial Pacing,6294.0,4091.1,,,0
HCPCS,93610,Intra-atrial pacing,,,7520.61,7520.61,1
HCPCS,93612,Hc Intraventricular Pacing,7257.0,4717.05,,,0
HCPCS,93612,Intraventricular pacing,,,7520.61,7520.61,1
HCPCS,93613,Hc Intracard Electrophys 3D Mapping,15306.0,9948.9,,,0
HCPCS,93615,Esophageal recording,,,1173.98,1173.98,1
HCPCS,93615,Hc Esophageal Rec Atrial Electrogram,7257.0,4717.05,,,0
HCPCS,93616,Esophageal recording,,,1173.98,1173.98,1
HCPCS,93616,Hc Esophageal Rec Atrial Electrogram W Pacing,7257.0,4717.05,,,0
HCPCS,93618,Hc Arrhythmia Induction Electrical,6395.0,4156.75,,,0
HCPCS,93618,Heart rhythm pacing,,,1173.98,1173.98,1
HCPCS,93619,Electrophysiology evaluation,,,7520.61,7520.61,1
HCPCS,93619,Hc Ep Comprehensive Wo Induction Arrhythmia,16066.0,10442.9,,,0
HCPCS,93620,Electrophysiology evaluation,,,7520.61,7520.61,1
HCPCS,93620,Hc Ep Comprehensive W Induction Arrhythmia,31802.0,20671.3,,,0
HCPCS,93621,Hc Ep Comprehensive Left Atrium,13482.0,8763.3,,,0
HCPCS,93622,Hc Ep Comprehensive Left Ventricle,13576.0,8824.4,,,0
HCPCS,93623,Hc Ep Study With Rx,8469.0,5504.85,,,0
HCPCS,93624,Electrophysiologic study,,,7520.61,7520.61,1
HCPCS,93624,Hc Ep Followup Study,19699.0,12804.35,,,0
HCPCS,93631,Hc Intraop Epi And Endocardial Pacing Localize Tachycardia,445.0,289.25,,,0
HCPCS,93640,Hc Analysis Icd Leads At Implant,5159.0,3353.35,,,0
HCPCS,93641,Hc Analysis Icd Lead Generator At Implant,4334.0,2817.1,,,0
HCPCS,93642,Electrophysiology evaluation,,,1173.98,1173.98,1
HCPCS,93642,Hc Ep Eval Icd Implant,11657.0,7577.05,,,0
HCPCS,93644,Hc Ep Eval Subq Implantable Defib,220.0,143.0,,,0
HCPCS,93650,Ablate heart dysrhythm focus,,,7520.61,30765.0,2
HCPCS,93650,Hc Ablation Av,26309.0,17100.85,,,0
HCPCS,93653,Ep & ablate supravent arrhyt,,,25202.69,63079.0,2
HCPCS,93653,Hc Ep Eval W Ablation Svt Including 3D Mapping,63198.0,41078.7,,,0
HCPCS,93654,Ep & ablate ventric tachy,,,25202.69,63079.0,2
HCPCS,93654,Hc Ep Eval W Ablation Vt Including 3D Mapping,63198.0,41078.7,,,0
HCPCS,93655,Hc Ablation Distinct From Primary,6466.0,4202.9,,,0
HCPCS,93656,Hc Ep Eval W Ablation A Fib Including 3D Mapping,63198.0,41078.7,,,0
HCPCS,93656,Tx atrial fib pulm vein isol,,,25202.69,63079.0,2
HCPCS,93657,Hc Ablation Addl A Fib,6466.0,4202.9,,,0
HCPCS,93660,Hc Tilt Table Eval,3008.0,1955.2,,,0
HCPCS,93660,Tilt table evaluation,,,359.81,359.81,1
HCPCS,93662,Hc Intracardiac Echo Add On,5276.0,3429.4,,,0
HCPCS,93668,"Hc Peripheral Arterial Diseas (Pad) Rehabilitation, Per Session",177.0,115.05,,,0
HCPCS,93668,Peripheral Vascular Rehab,,,56.88,56.88,1
HCPCS,93701,Bioimpedance cv analysis,,,128.29,128.29,1
HCPCS,93702,Bis xtracell fluid analysis,,,124.07,124.07,1
HCPCS,93724,Hc Electronic Analysis Antitachycardia Pacemaker,1218.0,791.7,,,0
HCPCS,93740,Temperature gradient studies,,,124.07,124.07,1
HCPCS,93750,Hc Interrogation Vad,393.0,255.45,,,0
HCPCS,93750,Interrogation vad in person,,,91.67,91.67,1
HCPCS,93786,Ambulatory BP recording,,,128.29,128.29,1
HCPCS,93786,Hc Ambulatory Bp Monitor 24Hr Or More - Recording Only,519.0,337.35,,,0
HCPCS,93788,Ambulatory BP analysis,,,128.29,128.29,1
HCPCS,93797,Cardiac rehab,,,124.3,124.3,1
HCPCS,93797,Hc Card Rehab Wo Mon,318.0,206.7,,,0
HCPCS,93798,Cardiac rehab/monitor,,,124.3,124.3,1
HCPCS,93798,Hc Card Rehab W Mon,455.0,295.75,,,0
HCPCS,93799,Cardiovascular procedure,,,124.07,124.07,1
HCPCS,93799,Hc Unlisted Cardiovascular Procedure,4536.0,2948.4,,,0
HCPCS,93880,Extracranial bilat study,,,230.07,230.07,1
HCPCS,93880,Hc Duplex Scan Extracranial Arteries Bilat,1238.0,804.7,,,0
HCPCS,93882,Extracranial uni/ltd study,,,100.81,100.81,1
HCPCS,93882,Hc Duplex Scan Extracranial Arteries Unilat,899.0,584.35,,,0
HCPCS,93886,Hc Doppler Transcranial Complete,887.0,576.55,,,0
HCPCS,93886,Intracranial complete study,,,230.07,230.07,1
HCPCS,93888,Hc Doppler Transcranial Limited,665.0,432.25,,,0
HCPCS,93888,Intracranial limited study,,,100.81,100.81,1
HCPCS,93892,Tcd emboli detect w/o inj,,,100.81,100.81,1
HCPCS,93893,Tcd emboli detect w/inj,,,100.81,100.81,1
HCPCS,93922,Hc Noninvsve Physiolgc Studies Ext Art Ltd Bilat,863.0,560.95,,,0
HCPCS,93922,Upr/l xtremity art 2 levels,,,128.29,128.29,1
HCPCS,93923,Hc Noninvsve Physiolgc Studies Ext Art Cmplt Bilat,1084.0,704.6,,,0
HCPCS,93923,Upr/lxtr art stdy 3+ lvls,,,208.2,208.2,1
HCPCS,93924,Hc Noninvsve Physiolgc Studies Le Art W Stress,1228.0,798.2,,,0
HCPCS,93924,Lwr xtr vasc stdy bilat,,,208.2,208.2,1
HCPCS,93925,Hc Duplex Scan Lower Extrem Arteries Complt Bilat,1549.0,1006.85,,,0
HCPCS,93925,Lower extremity study,,,230.07,230.07,1
HCPCS,93926,Hc Duplex Scan Lower Extrem Arteries Ltd Unilat,1073.0,697.45,,,0
HCPCS,93926,Lower extremity study,,,100.81,100.81,1
HCPCS,93930,Hc Duplex Scan Upper Extrem Arteries Complt Bilat,1520.0,988.0,,,0
HCPCS,93930,Upper extremity study,,,230.07,230.07,1
HCPCS,93931,Hc Duplex Scan Upper Extrem Arteries Ltd Unilat,999.0,649.35,,,0
HCPCS,93931,Upper extremity study,,,100.81,100.81,1
HCPCS,93970,Extremity study,,,230.07,230.07,1
HCPCS,93970,Hc Duplex Scan Extremity Veins Complete Bilat,1433.0,931.45,,,0
HCPCS,93971,Extremity study,,,100.81,100.81,1
HCPCS,93971,Hc Duplex Scan Extremity Veins Limited Unilat,1132.0,735.8,,,0
HCPCS,93975,Hc Duplex Scan Abd Pelvic Retroperit Arteries Cmplt,1520.0,988.0,,,0
HCPCS,93975,Vascular study,,,230.07,230.07,1
HCPCS,93976,Hc Duplex Scan Abd Pelvic Retroperit Arteries Ltd,999.0,649.35,,,0
HCPCS,93976,Vascular study,,,100.81,100.81,1
HCPCS,93978,Hc Duplex Scan Aorta Ivc Graft Complete,1497.0,973.05,,,0
HCPCS,93978,Vascular study,,,230.07,230.07,1
HCPCS,93979,Hc Duplex Scan Aorta Ivc Graft Limited,805.0,523.25,,,0
HCPCS,93979,Vascular study,,,100.81,100.81,1
HCPCS,93980,Hc Duplex Scan Penile Vessels Complete,1369.0,889.85,,,0
HCPCS,93980,Penile vascular study,,,100.81,100.81,1
HCPCS,93981,Hc Duplex Scan Penile Vessels Limited,760.0,494.0,,,0
HCPCS,93981,Penile vascular study,,,100.81,100.81,1
HCPCS,93985,Dup-scan hemo compl bi std,,,230.07,230.07,1
HCPCS,93985,Hc Duplex Scan Preop Vessel Assess Prior To Hemodialysis Access Bilat,1063.0,690.95,,,0
HCPCS,93986,Dup-scan hemo compl uni std,,,100.81,100.81,1
HCPCS,93986,Hc Duplex Scan Preop Vessel Assess Prior To Hemodialysis Access Unilat,1063.0,690.95,,,0
HCPCS,93990,Doppler flow testing,,,100.81,100.81,1
HCPCS,93990,Hc Duplex Scan Hemodialysis Access,1319.0,857.35,,,0
HCPCS,93998,Noninvas vasc dx study proc,,,27.89,27.89,1
HCPCS,94002,Hc Ventilator Init Day,2544.0,1653.6,,,0
HCPCS,94002,Vent mgmt inpat init day,,,595.69,595.69,1
HCPCS,94003,Hc Ventilator Subq Day,1462.0,950.3,,,0
HCPCS,94003,Vent mgmt inpat subq day,,,595.69,595.69,1
HCPCS,94010,Breathing capacity test,,,208.2,208.2,1
HCPCS,94010,Hc Spirometry Pft Simple,676.0,439.4,,,0
HCPCS,94011,Spirometry up to 2 yrs old,,,124.07,124.07,1
HCPCS,94012,Spirmtry w/brnchdil inf-2 yr,,,208.2,208.2,1
HCPCS,94013,Meas lung vol thru 2 yrs,,,359.81,359.81,1
HCPCS,94014,Patient recorded spirometry,,,430.74,430.74,1
HCPCS,94015,Patient recorded spirometry,,,208.2,208.2,1
HCPCS,94016,Review patient spirometry,,,24.11,24.11,1
HCPCS,94060,Evaluation of wheezing,,,359.81,359.81,1
HCPCS,94060,Hc Spirometry Pft Pre Post Bronchodilation,1366.0,887.9,,,0
HCPCS,94070,Evaluation of wheezing,,,359.81,359.81,1
HCPCS,94070,Hc Spirometry Bronchial Provocation Challenge,2628.0,1708.2,,,0
HCPCS,94150,Vital capacity test,,,124.07,124.07,1
HCPCS,94200,Lung function test (MBC/MVV),,,56.88,56.88,1
HCPCS,94375,Respiratory flow volume loop,,,208.2,208.2,1
HCPCS,94450,Hypoxia response curve,,,124.07,124.07,1
HCPCS,94452,Hast w/report,,,128.29,128.29,1
HCPCS,94452,Hc High Altitude Sim Test,625.0,406.25,,,0
HCPCS,94453,Hast w/oxygen titrate,,,128.29,128.29,1
HCPCS,94453,Hc High Altitude Sim Test W O2,625.0,406.25,,,0
HCPCS,94610,Hc Surfactant Administered Through Et Tube,185.0,120.25,,,0
HCPCS,94610,Surfactant Admin Thru Tube,,,211.14,211.14,1
HCPCS,94617,Exercise tst brncspsm,,,128.29,128.29,1
HCPCS,94617,Hc Exer Test For Brnchspasm W Pre Post Spiro Ecg Record And Pulse Ox,618.0,401.7,,,0
HCPCS,94618,Hc Pulm Stress Test Heart Rate Oxmtry And Oxygen Titration When Perf,618.0,401.7,,,0
HCPCS,94618,Pulmonary stress testing,,,128.29,128.29,1
HCPCS,94619,Exercise tst brncspsm wo ecg,,,56.88,56.88,1
HCPCS,94619,Hc Pulm Stress Test Heart Rate Oxmtry Oxygen Titration Wo Ecg Record,618.0,401.7,,,0
HCPCS,94621,Hc Cardiopulmonary Exercise Testing,3066.0,1992.9,,,0
HCPCS,94621,Pulm stress test/complex,,,359.81,359.81,1
HCPCS,94625,Hc Pulm Rehab Wo Oximetry Mon,178.0,115.7,,,0
HCPCS,94625,Phy/qhp op pulm rhb w/o mntr,,,56.88,56.88,1
HCPCS,94626,Hc Pulm Rehab W Cont Oximetry Mon,178.0,115.7,,,0
HCPCS,94626,Phy/qhp op pulm rhb w/mntr,,,56.88,56.88,1
HCPCS,94640,Airway inhalation treatment,,,211.14,211.14,1
HCPCS,94640,Hc Inhalation Treatment For Aao Or Sputum Induction,377.0,245.05,,,0
HCPCS,94642,Aerosol inhalation treatment,,,211.14,211.14,1
HCPCS,94642,Hc Pentamidine Aerosol Inhalation,2174.0,1413.1,,,0
HCPCS,94644,Cbt 1st hour,,,128.29,128.29,1
HCPCS,94644,Hc Cont Inhal Tx W Aerosol 1St Hr,1180.0,767.0,,,0
HCPCS,94645,Hc Cont Inhal Tx W Aerosol Ea Addl H,725.0,471.25,,,0
HCPCS,94660,Hc Cpap Bipap,813.0,528.45,,,0
HCPCS,94660,Hc Pts Own Cpap Bipap Init Day,376.0,244.4,,,0
HCPCS,94660,Hc Pts Own Cpap Bipap Subseq Day,376.0,244.4,,,0
HCPCS,94660,Pos airway pressure cpap,,,211.14,211.14,1
HCPCS,94664,Evaluate pt use of inhaler,,,211.14,211.14,1
HCPCS,94664,Hc Mdi Instruction Only,560.0,364.0,,,0
HCPCS,94667,Chest wall manipulation,,,128.29,128.29,1
HCPCS,94667,Hc Postural Drainage Percussion Init,490.0,318.5,,,0
HCPCS,94668,Chest wall manipulation,,,128.29,128.29,1
HCPCS,94668,Hc Postural Drainage Percussion Subseq,408.0,265.2,,,0
HCPCS,94669,Hc Pulm Vest Therapy Each Session,560.0,364.0,,,0
HCPCS,94669,Mechanical chest wall oscill,,,211.14,211.14,1
HCPCS,94680,Exhaled air analysis o2,,,124.07,124.07,1
HCPCS,94681,Exhaled air analysis o2/co2,,,359.81,359.81,1
HCPCS,94690,Exhaled air analysis,,,56.88,56.88,1
HCPCS,94690,Hc O2 Uptake Exp Gas Analysis Rest Indirect,300.0,195.0,,,0
HCPCS,94726,Hc Lung Vols Plethysmography W Wo Airway Resistance,188.0,122.2,,,0
HCPCS,94726,Pulm funct tst plethysmograp,,,359.81,359.81,1
HCPCS,94727,Hc Lung Vols Washout Gas Dilution,426.0,276.9,,,0
HCPCS,94727,Pulm function test by gas,,,208.2,208.2,1
HCPCS,94728,Pulm funct test oscillometry,,,124.07,124.07,1
HCPCS,94729,Hc Carbon Monoxide Diff Dlco,435.0,282.75,,,0
HCPCS,94762,Hc Pulse Ox Overnight Study,410.0,266.5,,,0
HCPCS,94762,Measure blood oxygen level,,,124.07,124.07,1
HCPCS,94772,Breath recording infant,,,359.81,359.81,1
HCPCS,94775,Ped home apnea rec hk-up,,,124.07,124.07,1
HCPCS,94776,Ped home apnea rec downld,,,124.07,124.07,1
HCPCS,94780,Car seat/bed test 60 min,,,36.01,36.01,1
HCPCS,94780,Hc Car Seat Testing 1St 60 Minutes,141.0,91.65,,,0
HCPCS,94781,Hc Car Seat Testing Each Addl Full 30 Minutes,53.0,34.45,,,0
HCPCS,94799,Pulmonary service/procedure,,,124.07,124.07,1
HCPCS,95004,Percut allergy skin tests,,,828.02,828.02,1
HCPCS,95012,Exhaled Nitric Oxide Meas,,,36.01,36.01,1
HCPCS,95017,Perq & icut allg test venoms,,,27.89,27.89,1
HCPCS,95018,Hc Allergy Test Perq And Ic Drug Or Biological,222.0,144.3,,,0
HCPCS,95018,Perq&ic allg test drugs/biol,,,36.01,36.01,1
HCPCS,95024,Icut allergy test drug/bug,,,56.88,56.88,1
HCPCS,95027,Icut allergy titrate-airborn,,,27.89,27.89,1
HCPCS,95028,Icut allergy test-delayed,,,36.01,36.01,1
HCPCS,95044,Allergy patch tests,,,828.02,828.02,1
HCPCS,95052,Photo patch test,,,56.88,56.88,1
HCPCS,95056,Photosensitivity tests,,,128.29,128.29,1
HCPCS,95060,Eye allergy tests,,,128.29,128.29,1
HCPCS,95065,Nose allergy test,,,36.01,36.01,1
HCPCS,95070,Bronchial allergy tests,,,359.81,359.81,1
HCPCS,95070,Hc Inhalation Bronch Challenge Test W/Histamine Methacholine Compound,3033.0,1971.45,,,0
HCPCS,95076,Ingest challenge ini 120 min,,,359.81,359.81,1
HCPCS,95115,Immunotherapy one injection,,,45.15,45.15,1
HCPCS,95117,Immunotherapy injections,,,45.15,45.15,1
HCPCS,95144,Antigen therapy services,,,45.15,45.15,1
HCPCS,95145,Antigen therapy services,,,45.15,45.15,1
HCPCS,95146,Antigen therapy services,,,45.15,45.15,1
HCPCS,95147,Antigen therapy services,,,69.42,69.42,1
HCPCS,95148,Antigen therapy services,,,69.42,69.42,1
HCPCS,95149,Antigen therapy services,,,69.42,69.42,1
HCPCS,95165,Antigen therapy services,,,45.15,45.15,1
HCPCS,95170,Antigen therapy services,,,45.15,45.15,1
HCPCS,95180,Rapid desensitization,,,430.74,430.74,1
HCPCS,95199,Allergy immunology services,,,27.89,27.89,1
HCPCS,95249,Cont gluc mntr pt prov eqp,,,56.88,56.88,1
HCPCS,95250,Glucose monitoring cont,,,128.37,128.37,1
HCPCS,95700,Eeg cont rec w/vid eeg tech,,,208.2,208.2,1
HCPCS,95700,Hc Lt Eeg Tech Setup,2717.0,1766.05,,,0
HCPCS,95705,Eeg w/o vid 2-12 hr unmntr,,,208.2,208.2,1
HCPCS,95705,Hc Ambulatory Eeg Lt Unmonitored 2-12 Hrs,4320.0,2808.0,,,0
HCPCS,95706,Eeg wo vid 2-12hr intmt mntr,,,208.2,208.2,1
HCPCS,95707,Eeg w/o vid 2-12hr cont mntr,,,208.2,208.2,1
HCPCS,95708,Eeg wo vid ea 12-26hr unmntr,,,359.81,359.81,1
HCPCS,95708,Hc Ambulatory Eeg Lt Unmonitored 12-26 Hrs,7553.0,4909.45,,,0
HCPCS,95709,Eeg w/o vid ea 12-26hr intmt,,,359.81,359.81,1
HCPCS,95710,Eeg w/o vid ea 12-26hr cont,,,359.81,359.81,1
HCPCS,95711,Hc Veeg Lt Unmonitored 2-12 Hrs,4320.0,2808.0,,,0
HCPCS,95711,Veeg 2-12 hr unmonitored,,,208.2,208.2,1
HCPCS,95712,Hc Veeg Lt Intermittent 2-12 Hrs,4320.0,2808.0,,,0
HCPCS,95712,Veeg 2-12 hr intmt mntr,,,359.81,359.81,1
HCPCS,95713,Hc Veeg Lt Continuous 2-12 Hrs,4320.0,2808.0,,,0
HCPCS,95713,Veeg 2-12 hr cont mntr,,,359.81,359.81,1
HCPCS,95714,Hc Veeg Lt Unmonitored 12-26 Hrs,7553.0,4909.45,,,0
HCPCS,95714,Veeg ea 12-26 hr unmntr,,,359.81,359.81,1
HCPCS,95715,Hc Veeg Lt Intermittent 12-26 Hrs,7553.0,4909.45,,,0
HCPCS,95715,Veeg ea 12-26hr intmt mntr,,,359.81,359.81,1
HCPCS,95716,Hc Veeg Lt Continuous 12-26 Hrs,7553.0,4909.45,,,0
HCPCS,95716,Veeg ea 12-26hr cont mntr,,,828.02,828.02,1
HCPCS,95782,Polysom <6 yrs 4/> paramtrs,,,828.02,828.02,1
HCPCS,95783,Polysom <6 yrs cpap/bilvl,,,828.02,828.02,1
HCPCS,95800,Slp stdy unattended,,,208.2,208.2,1
HCPCS,95801,Slp stdy unatnd w/anal,,,56.88,56.88,1
HCPCS,95803,Actigraphy testing,,,56.88,56.88,1
HCPCS,95805,Multiple sleep latency test,,,828.02,828.02,1
HCPCS,95806,Sleep study unatt&resp efft,,,208.2,208.2,1
HCPCS,95807,Sleep study attended,,,359.81,359.81,1
HCPCS,95808,Polysom any age 1-3> param,,,828.02,828.02,1
HCPCS,95810,Polysom 6/> yrs 4/> param,,,828.02,828.02,1
HCPCS,95811,Polysom 6/>yrs cpap 4/> parm,,,828.02,828.02,1
HCPCS,95812,Eeg 41-60 minutes,,,208.2,208.2,1
HCPCS,95812,Hc Eeg Monitor 41-60 Minutes,1634.0,1062.1,,,0
HCPCS,95813,Eeg over 1 hour,,,208.2,208.2,1
HCPCS,95813,Hc Eeg Monitor 61 To 119 Minutes,1634.0,1062.1,,,0
HCPCS,95816,Eeg awake and drowsy,,,208.2,208.2,1
HCPCS,95816,Hc Eeg Awake And Drowsy,1634.0,1062.1,,,0
HCPCS,95819,Eeg awake and asleep,,,208.2,208.2,1
HCPCS,95819,Hc Eeg Awake And Asleep,1634.0,1062.1,,,0
HCPCS,95822,Eeg coma or sleep only,,,208.2,208.2,1
HCPCS,95822,Hc Eeg Coma Or Sleep,1634.0,1062.1,,,0
HCPCS,95824,Eeg cerebral death only,,,359.81,359.81,1
HCPCS,95824,Hc Eeg Cerebral Death,3120.0,2028.0,,,0
HCPCS,95829,Hc Electrocorticogram At Surgery,11303.0,7346.95,,,0
HCPCS,95851,Range of motion measurements,,,6.6,6.6,1
HCPCS,95852,Range of motion measurements,,,4.93,4.93,1
HCPCS,95857,Cholinesterase challenge,,,208.2,208.2,1
HCPCS,95860,Muscle test one limb,,,128.29,128.29,1
HCPCS,95861,Muscle test 2 limbs,,,128.29,128.29,1
HCPCS,95863,Muscle test 3 limbs,,,124.07,124.07,1
HCPCS,95864,Muscle test 4 limbs,,,124.07,124.07,1
HCPCS,95865,Muscle test larynx,,,128.29,128.29,1
HCPCS,95866,Muscle test hemidiaphragm,,,124.07,124.07,1
HCPCS,95867,Hc Needle Emg Cranial Nerve Musc Unilateral,1776.0,1154.4,,,0
HCPCS,95867,Muscle test cran nerv unilat,,,208.2,208.2,1
HCPCS,95868,Hc Needle Emg Cranial Nerve Musc Bilateral,2664.0,1731.6,,,0
HCPCS,95868,Muscle test cran nerve bilat,,,208.2,208.2,1
HCPCS,95869,Muscle test thor paraspinal,,,208.2,208.2,1
HCPCS,95870,Hc Needle Emg Musc 1 Extrem Or Nonlimb Musc Limited,1600.0,1040.0,,,0
HCPCS,95870,Muscle test nonparaspinal,,,128.29,128.29,1
HCPCS,95872,Muscle test one fiber,,,208.2,208.2,1
HCPCS,95874,Hc Needle Emg For Chemodenervation Guidance,1838.0,1194.7,,,0
HCPCS,95875,Limb exercise test,,,124.07,124.07,1
HCPCS,95885,Hc Needle Emg Ea Extremity W/ Paraspinal Area Limited,385.0,250.25,,,0
HCPCS,95886,Hc Needle Emg Ea Extremity W/ Paraspinal Area Complete,385.0,250.25,,,0
HCPCS,95905,Motor &/ sens nrve cndj test,,,430.74,430.74,1
HCPCS,95907,Hc Nerve Conduction Studies 1-2,890.0,578.5,,,0
HCPCS,95907,Nvr cndj tst 1-2 studies,,,208.2,208.2,1
HCPCS,95908,Hc Nerve Conduction Studies 3-4,1776.0,1154.4,,,0
HCPCS,95908,Nrv cndj tst 3-4 studies,,,208.2,208.2,1
HCPCS,95909,Hc Nerve Conduction Studies 5-6,1776.0,1154.4,,,0
HCPCS,95909,Nrv cndj tst 5-6 studies,,,208.2,208.2,1
HCPCS,95910,Hc Nerve Conduction Studies 7-8,1776.0,1154.4,,,0
HCPCS,95910,Nrv cndj test 7-8 studies,,,359.81,359.81,1
HCPCS,95911,Hc Nerve Conduction Studies 9-10,3033.0,1971.45,,,0
HCPCS,95911,Nrv cndj test 9-10 studies,,,359.81,359.81,1
HCPCS,95912,Hc Nerve Conduction Studies 11-12,3033.0,1971.45,,,0
HCPCS,95912,Nrv cndj test 11-12 studies,,,359.81,359.81,1
HCPCS,95913,Hc Nerve Conduction Studies 13 Or More,3033.0,1971.45,,,0
HCPCS,95913,Nrv cndj test 13/> studies,,,359.81,359.81,1
HCPCS,95919,Quan puplmtry phy/qhp uni/bi,,,128.29,128.29,1
HCPCS,95921,Autonomic nrv parasym inervj,,,124.07,124.07,1
HCPCS,95922,Autonomic nrv adrenrg inervj,,,128.29,128.29,1
HCPCS,95923,Autonomic nrv syst funj test,,,128.29,128.29,1
HCPCS,95924,Ans parasymp & symp w/tilt,,,208.2,208.2,1
HCPCS,95925,Hc Ss Evok Potent Up Limb,2074.0,1348.1,,,0
HCPCS,95925,Somatosensory testing,,,208.2,208.2,1
HCPCS,95926,Hc Ss Evok Potent Low Limb,1994.0,1296.1,,,0
HCPCS,95926,Somatosensory testing,,,208.2,208.2,1
HCPCS,95927,Somatosensory testing,,,208.2,208.2,1
HCPCS,95928,C motor evoked uppr limbs,,,828.02,828.02,1
HCPCS,95929,C motor evoked lwr limbs,,,359.81,359.81,1
HCPCS,95929,Hc Cent Mot Evoke Potent Lower Limbs,506.0,328.9,,,0
HCPCS,95930,Hc Visual Evoked Potential Except Glaucoma,890.0,578.5,,,0
HCPCS,95930,Visual evoked potential test,,,208.2,208.2,1
HCPCS,95933,Blink reflex test,,,56.88,56.88,1
HCPCS,95937,Neuromuscular junction test,,,124.07,124.07,1
HCPCS,95938,Hc Ss Evok Potent Up And Low Limb,4070.0,2645.5,,,0
HCPCS,95938,Somatosensory testing,,,828.02,828.02,1
HCPCS,95939,C motor evoked upr&lwr limbs,,,828.02,828.02,1
HCPCS,95954,EEG monitoring/giving drugs,,,359.81,359.81,1
HCPCS,95957,Hc Eeg Analysis Digital,269.0,174.85,,,0
HCPCS,95958,EEG monitoring/function test,,,828.02,828.02,1
HCPCS,95958,Hc Eeg Hemisphere Function Wada,991.0,644.15,,,0
HCPCS,95961,Electrode stimulation brain,,,828.02,828.02,1
HCPCS,95961,Hc Functional Mapping Stimulation,6762.0,4395.3,,,0
HCPCS,95965,Meg spontaneous,,,828.02,828.02,1
HCPCS,95966,Meg evoked single,,,828.02,828.02,1
HCPCS,95970,Analyze neurostim no prog,,,128.29,128.29,1
HCPCS,95970,Hc Elect Analysis Neurostim Gen Wo Prog,636.0,413.4,,,0
HCPCS,95971,Analyze neurostim simple,,,91.67,91.67,1
HCPCS,95971,Hc Elect Analysis Neurostim Gen Simple Spine W Prog,563.0,365.95,,,0
HCPCS,95972,Analyze neurostim complex,,,91.67,91.67,1
HCPCS,95972,Hc Elect Analysis Neurostim Gen Brn Complex Spine W Prog,1689.0,1097.85,,,0
HCPCS,95977,Alys cplx cn npgt prgrmg,,,91.67,91.67,1
HCPCS,95981,Io anal gast n-stim subsq,,,56.88,56.88,1
HCPCS,95983,Alys brn npgt prgrmg 15 min,,,91.67,91.67,1
HCPCS,95983,Hc Elect Analysis Neurostim Gen W Brain Neurostim Gen 1St 15 Mins,140.0,91.0,,,0
HCPCS,95984,Hc Elect Analysis Neurostim Gen W Brain Neurostim Gen Each Addl 15 Mins,94.0,61.1,,,0
HCPCS,95990,Hc Refill And Maintenance Of Implanted Pump,1523.0,989.95,,,0
HCPCS,95990,Spin/brain pump refil & main,,,318.49,318.49,1
HCPCS,95991,Hc Refill And Maintnce Of Implanted Pump Phys Asstd,2430.0,1579.5,,,0
HCPCS,95991,Spin/brain pump refil & main,,,295.97,295.97,1
HCPCS,95992,Canalith repositioning proc,,,29.33,29.33,1
HCPCS,95992,Hc Pt Canalith Respositioning Proc,304.0,197.6,,,0
HCPCS,95999,Neurological procedure,,,124.07,124.07,1
HCPCS,96000,Motion analysis video/3d,,,359.81,359.81,1
HCPCS,96001,Motion test w/ft press meas,,,828.02,828.02,1
HCPCS,96002,Dynamic surface emg,,,208.2,208.2,1
HCPCS,96020,Hc Neurofunctional Testing During Fmri,448.0,291.2,,,0
HCPCS,96105,Assessment of aphasia,,,93.98,93.98,1
HCPCS,96105,Hc St Eval Aphasia Per Hour,490.0,318.5,,,0
HCPCS,96110,Hc Ot Developmental Screening,254.0,165.1,,,0
HCPCS,96110,Hc Pt Developmental Screening,254.0,165.1,,,0
HCPCS,96112,Devel tst phys/qhp 1st hr,,,124.07,124.07,1
HCPCS,96112,"Hc Ot Developmental Testing, First Hour",667.0,433.55,,,0
HCPCS,96112,"Hc Pt Developmental Testing, First Hour",667.0,433.55,,,0
HCPCS,96112,"Hc St Developmental Testing, First Hour",667.0,433.55,,,0
HCPCS,96113,"Hc Ot Developmental Testing, Ea Add 30 Min",333.0,216.45,,,0
HCPCS,96113,"Hc Pt Developmental Testing, Ea Add 30 Min",333.0,216.45,,,0
HCPCS,96113,"Hc St Developmental Testing, Ea Add 30 Min",333.0,216.45,,,0
HCPCS,96116,Hc Neurobhvrl Exam Md Or Qhcp,832.0,540.8,,,0
HCPCS,96116,Neurobehavioral status exam,,,208.2,208.2,1
HCPCS,96125,Cognitive test by hc pro,,,98.99,98.99,1
HCPCS,96125,Hc St Standard Cognitive Performance,294.0,191.1,,,0
HCPCS,96125,Hc Standard Cognitive Performance,294.0,191.1,,,0
HCPCS,96127,Brief emotional/behav assmt,,,36.01,36.01,1
HCPCS,96130,Psycl tst eval phys/qhp 1st,,,208.2,208.2,1
HCPCS,96132,Nrpsyc tst eval phys/qhp 1st,,,359.81,359.81,1
HCPCS,96136,Psycl/nrpsyc tst phy/qhp 1st,,,128.29,128.29,1
HCPCS,96138,Psycl/nrpsyc tech 1st,,,430.74,430.74,1
HCPCS,96146,Psycl/nrpsyc tst auto result,,,27.89,27.89,1
HCPCS,96156,Hlth bhv assmt/reassessment,,,97.95,97.95,1
HCPCS,96158,Hlth bhv ivntj indiv 1st 30,,,171.15,171.15,1
HCPCS,96202,Mlt fam grp bhv train 1st 60,,,17.14,17.14,1
HCPCS,96203,Mlt fam grp bhv train ea add,,,4.95,4.95,1
HCPCS,96360,Hc Hydration Therapy Initial 31 Min To 1 Hr,643.0,417.95,,,0
HCPCS,96360,Hydration iv infusion init,,,205.09,570.97,3
HCPCS,96361,Hc Hydration Therapy Ea Addl Hr,193.0,125.45,,,0
HCPCS,96361,Hydrate iv infusion add-on,,,45.15,125.04,3
HCPCS,96365,Hc Infusion Therapy Initial Up To 1 Hr,666.0,432.9,,,0
HCPCS,96365,Ther/proph/diag iv inf init,,,205.09,205.09,1
HCPCS,96366,Hc Infusion Therapy Each Addl Hr,218.0,141.7,,,0
HCPCS,96366,Ther/proph/diag iv inf addon,,,45.15,45.15,1
HCPCS,96367,Hc Infusion Therapy Sequential Drug Up To 1 Hr,324.0,210.6,,,0
HCPCS,96367,Tx/proph/dg addl seq iv inf,,,69.42,69.42,1
HCPCS,96368,Hc Infusion Therapy Concurrent,353.0,229.45,,,0
HCPCS,96369,Hc Subcutaneous Infusion Initial Up To 1 Hr,477.0,310.05,,,0
HCPCS,96369,Sc ther infusion up to 1 hr,,,205.09,205.09,1
HCPCS,96370,Sc ther infusion addl hr,,,45.15,45.15,1
HCPCS,96371,Sc ther infusion reset pump,,,69.42,69.42,1
HCPCS,96372,Hc Injection Im/Subcutaneous,281.0,182.65,,,0
HCPCS,96372,Ther/proph/diag inj sc/im,,,69.42,69.42,1
HCPCS,96373,Hc Injection; Intra-Arterial,349.0,226.85,,,0
HCPCS,96373,Ther/proph/diag inj ia,,,205.09,205.09,1
HCPCS,96374,Hc Ivp Single Or Initial Drug,349.0,226.85,,,0
HCPCS,96374,Ther/proph/diag inj iv push,,,205.09,205.09,1
HCPCS,96375,Hc Ivp Ea Addl Drug Or Substance,319.0,207.35,,,0
HCPCS,96375,Tx/pro/dx inj new drug addon,,,45.15,45.15,1
HCPCS,96376,Hc Ivp Ea Addl Push Same Drug Or Substance,237.0,154.05,,,0
HCPCS,96377,Applicaton on-body injector,,,45.15,45.15,1
HCPCS,96377,Hc Application On Body Injector For Timed Injection,223.0,144.95,,,0
HCPCS,96379,Ther/prop/diag inj/inf proc,,,45.15,45.15,1
HCPCS,96381,Hc Admin Rsv Monoclonal Antibody Im,32.0,20.8,,,0
HCPCS,96401,Chemo anti-neopl sq/im,,,69.42,69.42,1
HCPCS,96401,Hc Chemo Sq Im Non Horm Antineoplast,396.0,257.4,,,0
HCPCS,96402,Chemo hormon antineopl sq/im,,,69.42,69.42,1
HCPCS,96402,Hc Chemo Sq Im Horm Antineoplast,396.0,257.4,,,0
HCPCS,96405,Chemo intralesional up to 7,,,69.42,69.42,1
HCPCS,96405,Hc Chemo Intralesional Up To 7 Lesions,302.0,196.3,,,0
HCPCS,96406,Chemo intralesional over 7,,,205.09,205.09,1
HCPCS,96406,Hc Chemo Intralesional Over 7 Lesions,607.0,394.55,,,0
HCPCS,96409,Chemo iv push sngl drug,,,318.49,318.49,1
HCPCS,96409,Hc Chemo Ivp Single Or Initial Drug,932.0,605.8,,,0
HCPCS,96411,Chemo iv push addl drug,,,69.42,69.42,1
HCPCS,96411,Hc Chemo Ivp Ea Addl Drug Or Substance,783.0,508.95,,,0
HCPCS,96413,Chemo iv infusion 1 hr,,,318.49,318.49,1
HCPCS,96413,Hc Chemo Infusion Initial Up To 1 Hr,1616.0,1050.4,,,0
HCPCS,96415,Chemo iv infusion addl hr,,,69.42,69.42,1
HCPCS,96415,Hc Chemo Infusion Ea Addl Hr,972.0,631.8,,,0
HCPCS,96416,Chemo prolong infuse w/pump,,,318.49,318.49,1
HCPCS,96416,Hc Chemo Iv Initiate Pump For More Than 8 Hrs Inf,4450.0,2892.5,,,0
HCPCS,96417,Chemo iv infus each addl seq,,,69.42,69.42,1
HCPCS,96417,Hc Chemo Infusion Sequential  Drug Up To  1 Hr,1044.0,678.6,,,0
HCPCS,96420,Chemo ia push tecnique,,,318.49,318.49,1
HCPCS,96420,Hc Chemo Ia Push Technique,5000.0,3250.0,,,0
HCPCS,96422,Chemo ia infusion up to 1 hr,,,318.49,318.49,1
HCPCS,96423,Chemo ia infuse each addl hr,,,45.15,45.15,1
HCPCS,96425,Chemotherapy infusion method,,,318.49,318.49,1
HCPCS,96440,Chemotherapy intracavitary,,,318.49,318.49,1
HCPCS,96446,Chemotx admn prtl cavity,,,318.49,318.49,1
HCPCS,96446,Hc Chemo Admin Peritoneal Cavity,1874.0,1218.1,,,0
HCPCS,96450,Chemotherapy into cns,,,318.49,318.49,1
HCPCS,96450,Hc Chemo Admin Cns W Lp,2278.0,1480.7,,,0
HCPCS,96521,Hc Refill And Maintain Portable Pump,384.0,249.6,,,0
HCPCS,96521,Refill/maint portable pump,,,205.09,205.09,1
HCPCS,96522,Hc Refill Maintain Imp Pump Chemo,384.0,249.6,,,0
HCPCS,96522,Refill/maint pump/resvr syst,,,205.09,205.09,1
HCPCS,96523,Hc Irrigation Of Impl Ven Access Device,363.0,235.95,,,0
HCPCS,96523,Irrig drug delivery device,,,56.88,56.88,1
HCPCS,96542,Chemotherapy injection,,,318.49,318.49,1
HCPCS,96542,Hc Chemo Intrathecal Via Reservoir,738.0,479.7,,,0
HCPCS,96549,Chemotherapy unspecified,,,45.15,45.15,1
HCPCS,96549,Hc Unlisted Chemotherapy - Concurrent Chemo,819.0,532.35,,,0
HCPCS,96567,Photodynamic tx skin,,,193.46,193.46,1
HCPCS,96573,Pdt dstr prmlg les phys/qhp,,,193.46,193.46,1
HCPCS,96574,Dbrdmt prmlg les w/pdt,,,193.46,3714.0,2
HCPCS,96900,Ultraviolet light therapy,,,36.01,36.01,1
HCPCS,96910,Photochemotherapy with UV-B,,,56.88,56.88,1
HCPCS,96912,Photochemotherapy with UV-A,,,56.88,56.88,1
HCPCS,96913,Photochemotherapy uv-a or b,,,391.97,391.97,1
HCPCS,96920,Laser tx skin < 250 sq cm,,,193.46,3714.0,2
HCPCS,96921,Laser tx skin 250-500 sq cm,,,193.46,3714.0,2
HCPCS,96922,Laser tx skin >500 sq cm,,,391.97,3714.0,2
HCPCS,96999,Dermatological procedure,,,193.46,193.46,1
HCPCS,97012,Hc Pt Traction Mechanical,105.0,68.25,,,0
HCPCS,97012,Mechanical traction therapy,,,13.84,13.84,1
HCPCS,97016,Hc Ot Vasopneumatic Treatment,125.0,81.25,,,0
HCPCS,97016,Hc Pt Vasopneumatic Treatment,125.0,81.25,,,0
HCPCS,97016,Vasopneumatic device therapy,,,11.53,11.53,1
HCPCS,97018,Hc Ot Paraffin Bath,107.0,69.55,,,0
HCPCS,97018,Hc Pt Paraffin Bath,107.0,69.55,,,0
HCPCS,97018,Paraffin bath therapy,,,5.7,5.7,1
HCPCS,97022,Hc Ot Fluidotherapy Or Whirlpool,135.0,87.75,,,0
HCPCS,97022,Hc Pt Fluidotherapy Or Whirlpool,135.0,87.75,,,0
HCPCS,97022,Whirlpool therapy,,,14.86,14.86,1
HCPCS,97024,Diathermy eg microwave,,,6.91,6.91,1
HCPCS,97026,Infrared therapy,,,6.31,6.31,1
HCPCS,97028,Ultraviolet therapy,,,7.89,7.89,1
HCPCS,97032,Electrical stimulation,,,14.18,14.18,1
HCPCS,97032,Hc Ot Electrical Stim Attended 15 Min,203.0,131.95,,,0
HCPCS,97032,Hc Pt Electrical Stim Attended 15 Min,203.0,131.95,,,0
HCPCS,97033,Electric current therapy,,,18.17,18.17,1
HCPCS,97033,Hc Ot Iontophoresis 15 Min,204.0,132.6,,,0
HCPCS,97033,Hc Pt  Iontophoresis 15 Min,204.0,132.6,,,0
HCPCS,97034,Contrast bath therapy,,,13.45,13.45,1
HCPCS,97034,Hc Ot Contrast Bath 15 Min,174.0,113.1,,,0
HCPCS,97034,Hc Pt  Contrast Bath 15 Min,174.0,113.1,,,0
HCPCS,97035,Hc Ot Ultrasound 15 Min,106.0,68.9,,,0
HCPCS,97035,Hc Pt  Ultrasound 15 Min,106.0,68.9,,,0
HCPCS,97035,Ultrasound therapy,,,13.75,13.75,1
HCPCS,97036,Hydrotherapy,,,32.56,32.56,1
HCPCS,97037,Appl modality 1+lllt po pain,,,36.01,36.01,1
HCPCS,97110,Hc Ot Exercise Therapeutic 15 Min,193.0,125.45,,,0
HCPCS,97110,Hc Pt Exercise Therapeutic 15 Min,193.0,125.45,,,0
HCPCS,97110,Therapeutic exercises,,,27.87,27.87,1
HCPCS,97112,Hc Ot Neuromuscular Reeducation 15 Min,165.0,107.25,,,0
HCPCS,97112,Hc Pt Neuromuscular Reeducation 15 Min,165.0,107.25,,,0
HCPCS,97112,Neuromuscular reeducation,,,31.37,31.37,1
HCPCS,97113,Aquatic therapy/exercises,,,35.28,35.28,1
HCPCS,97113,Hc Ot Aquatic Therapy Exercise 15Min,185.0,120.25,,,0
HCPCS,97113,Hc Pt Aquatic Therapy Exercise 15Min,185.0,120.25,,,0
HCPCS,97116,Gait training therapy,,,27.87,27.87,1
HCPCS,97116,Hc Pt Gait Training 15 Min,189.0,122.85,,,0
HCPCS,97124,Hc Ot Therapeutic Massage 15 Min,122.0,79.3,,,0
HCPCS,97124,Hc Pt Therapeutic Massage 15 Min,122.0,79.3,,,0
HCPCS,97124,Massage therapy,,,28.19,28.19,1
HCPCS,97129,Hc Ot Cognitive Training Initial 15 Minutes,132.0,85.8,,,0
HCPCS,97129,Hc St Cognitive Training Initial 15 Minutes,132.0,85.8,,,0
HCPCS,97129,Ther ivntj 1st 15 min,,,19.48,19.48,1
HCPCS,97130,Hc Ot Cognitive Training Each Addl 15 Minutes,132.0,85.8,,,0
HCPCS,97130,Hc St Cognitive Training Each Addl 15 Minutes,132.0,85.8,,,0
HCPCS,97130,Ther ivntj ea addl 15 min,,,18.17,18.17,1
HCPCS,97140,Hc Ot Manual Therapy 15 Min,198.0,128.7,,,0
HCPCS,97140,Hc Pt Manual Therapy 15 Min,198.0,128.7,,,0
HCPCS,97140,Manual therapy 1/> regions,,,26.59,26.59,1
HCPCS,97150,Group therapeutic procedures,,,17.34,17.34,1
HCPCS,97150,Hc Ot Group Exercise,132.0,85.8,,,0
HCPCS,97150,Hc Pt Group Exercise,132.0,85.8,,,0
HCPCS,97151,Bhv id assmt by phys/qhp,,,97.95,97.95,1
HCPCS,97152,Bhv id suprt assmt by 1 tech,,,97.95,97.95,1
HCPCS,97153,Adaptive behavior tx by tech,,,97.95,97.95,1
HCPCS,97155,Adapt behavior tx phys/qhp,,,171.15,171.15,1
HCPCS,97161,Hc Pt Eval Low Complexity,428.0,278.2,,,0
HCPCS,97161,Pt eval low complex 20 min,,,93.86,93.86,1
HCPCS,97162,Hc Pt Eval Moderate Complexity,465.0,302.25,,,0
HCPCS,97162,Pt eval mod complex 30 min,,,93.86,93.86,1
HCPCS,97163,Hc Pt Eval High Complexity,503.0,326.95,,,0
HCPCS,97163,Pt eval high complex 45 min,,,93.86,93.86,1
HCPCS,97164,Hc Pt Re-Eval,277.0,180.05,,,0
HCPCS,97164,Pt re-eval est plan care,,,64.42,64.42,1
HCPCS,97165,Hc Ot Eval Low Complexity,402.0,261.3,,,0
HCPCS,97165,Ot eval low complex 30 min,,,96.3,96.3,1
HCPCS,97166,Hc Ot Eval Moderate Complexity,422.0,274.3,,,0
HCPCS,97166,Ot eval mod complex 45 min,,,96.3,96.3,1
HCPCS,97167,Hc Ot Eval High Complexity,444.0,288.6,,,0
HCPCS,97167,Ot eval high complex 60 min,,,96.3,96.3,1
HCPCS,97168,Hc Ot Re-Eval,261.0,169.65,,,0
HCPCS,97168,Ot re-eval est plan care,,,65.34,65.34,1
HCPCS,97530,Hc Ot Functional Activity 15 Min,190.0,123.5,,,0
HCPCS,97530,Hc Pt Functional Activity 15 Min,190.0,123.5,,,0
HCPCS,97530,Hc St Functional Activity,190.0,123.5,,,0
HCPCS,97530,Therapeutic activities,,,33.33,33.33,1
HCPCS,97533,Hc Ot Sensory Integration 15 Min,161.0,104.65,,,0
HCPCS,97533,Hc Pt Sensory Integration 15 Min,161.0,104.65,,,0
HCPCS,97533,Hc St Sensory Integration 15 Min,161.0,104.65,,,0
HCPCS,97533,Sensory Integration,,,56.93,56.93,1
HCPCS,97535,Hc Ot Self Care Home Mangagement 15 Min,174.0,113.1,,,0
HCPCS,97535,Hc Pt Self Care Home Mangagement 15 Min,174.0,113.1,,,0
HCPCS,97535,Self care mngment training,,,30.92,30.92,1
HCPCS,97537,Community/work reintegration,,,30.7,30.7,1
HCPCS,97537,Hc Ot Community Work Reintegration 15 Min,129.0,83.85,,,0
HCPCS,97537,Hc Pt Community Work Reintegration 15 Min,129.0,83.85,,,0
HCPCS,97537,Hc St Community Work Reintegration 15 Min,129.0,83.85,,,0
HCPCS,97542,Hc Ot Wheelchair Training 15 Min,136.0,88.4,,,0
HCPCS,97542,Hc Pt Wheelchair Training 15 Min,136.0,88.4,,,0
HCPCS,97542,Wheelchair mngment training,,,29.79,29.79,1
HCPCS,97545,Hc Ot Work Harden Conditioning Init 2Hrs,235.0,152.75,,,0
HCPCS,97545,Hc Pt Work Harden Conditioning Init 2Hrs,235.0,152.75,,,0
HCPCS,97546,Hc Pt Work Harden Conditioning Ea Addl Hour,116.0,75.4,,,0
HCPCS,97550,Caregiver traing 1st 30 min,,,39.23,39.23,1
HCPCS,97550,Hc Ot Caregiver Training Initial 30 Min,352.0,228.8,,,0
HCPCS,97550,Hc Pt Caregiver Training Initial 30 Min,352.0,228.8,,,0
HCPCS,97550,Hc St Caregiver Training Initial 30 Min,352.0,228.8,,,0
HCPCS,97551,Caregiver traing ea addl 15,,,20.78,20.78,1
HCPCS,97551,Hc Ot Caregiver Training Ea Add 15 Min,176.0,114.4,,,0
HCPCS,97551,Hc Pt Caregiver Training Ea Addl 15 Min,176.0,114.4,,,0
HCPCS,97551,Hc St Caregiver Training Ea Add 15 Min,176.0,114.4,,,0
HCPCS,97552,Group caregiver training,,,9.24,9.24,1
HCPCS,97552,Hc Ot Caregiver Training Group,89.0,57.85,,,0
HCPCS,97552,Hc Pt Caregiver Training Group,89.0,57.85,,,0
HCPCS,97552,Hc St Caregiver Training Group,89.0,57.85,,,0
HCPCS,97597,Hc Ot Removal Devitalized Tissue Up To 20 Sq Cm,1518.0,986.7,,,0
HCPCS,97597,Hc Removal Devitalized Tissue Up To 20 Sq Cm,1265.0,822.25,,,0
HCPCS,97597,Rmvl devital tis 20 cm/<,,,193.46,3714.0,2
HCPCS,97598,Hc Ot Removal Devitalized Tissue Ea Addl 20 Sq Cm,377.0,245.05,,,0
HCPCS,97598,Hc Removal Devitalized Tissue Ea Addl 20 Sq Cm,377.0,245.05,,,0
HCPCS,97602,Hc Debrid Nonselect Wet Moist Dressing,1247.0,810.55,,,0
HCPCS,97602,Wound(s) care non-selective,,,193.46,3714.0,2
HCPCS,97605,Hc Ip Wc Negative Pressure Wound Ther Up To 50 Sq Cm,1883.0,1223.95,,,0
HCPCS,97605,Hc Negative Pressure Wound Ther Up To 50 Sq Cm,1883.0,1223.95,,,0
HCPCS,97605,Neg press wound tx <=50 cm,,,193.46,193.46,1
HCPCS,97606,Hc Ip Wc Negative Pressure Wound Ther More Than 50 Sq Cm,3776.0,2454.4,,,0
HCPCS,97606,Hc Negative Pressure Wound Ther More Than 50 Sq Cm,3399.0,2209.35,,,0
HCPCS,97606,Neg press wound tx >50 cm,,,391.97,391.97,1
HCPCS,97607,Hc Neg Press Disp Non Dme Wnd Ther <50Cm,1271.0,826.15,,,0
HCPCS,97607,Neg press wnd tx <=50 sq cm,,,391.97,391.97,1
HCPCS,97608,Hc Neg Press Wnd Disp Non Dme Ther >50Cm,1271.0,826.15,,,0
HCPCS,97608,Neg press wound tx >50 cm,,,391.97,391.97,1
HCPCS,97610,Hc Mist Therapy,854.0,555.1,,,0
HCPCS,97610,Low frequency non-thermal us,,,193.46,193.46,1
HCPCS,97750,Hc Ot Performance Test 15 Min,159.0,103.35,,,0
HCPCS,97750,Hc Pt Performance Test 15 Min,159.0,103.35,,,0
HCPCS,97750,Physical performance test,,,32.14,32.14,1
HCPCS,97755,Assistive technology assess,,,36.29,36.29,1
HCPCS,97755,Hc Assist Tech Assess,92.0,59.8,,,0
HCPCS,97760,Hc Ot Initial Orthotic Fitting Training 15 Min,215.0,139.75,,,0
HCPCS,97760,Hc Pt Initial Orthotic Fitting Training 15 Min,215.0,139.75,,,0
HCPCS,97760,Orthotic mgmt and training,,,43.57,43.57,1
HCPCS,97761,Hc Ot Initial Prosthetic Training 15 Min,161.0,104.65,,,0
HCPCS,97761,Hc Pt Initial Prosthetic Training 15 Min,161.0,104.65,,,0
HCPCS,97761,Prosthetic training,,,38.38,38.38,1
HCPCS,97763,Hc Ot Subsequent Orthotic Prosthetic Check 15Min,166.0,107.9,,,0
HCPCS,97763,Hc Pt Subsequent Orthotic Prosthetic Check 15 Min,166.0,107.9,,,0
HCPCS,97763,Orthc/prostc mgmt sbsq enc,,,47.17,47.17,1
HCPCS,97802,Hc Medical Nutrition Assess Indiv Initial Ea 15 Min,65.0,42.25,,,0
HCPCS,97802,Medical nutrition indiv in,,,25.66,25.66,1
HCPCS,97803,Hc Medical Nutrition Reassess Indiv Initial Ea 15 Min,45.0,29.25,,,0
HCPCS,97803,Med nutrition indiv subseq,,,21.47,21.47,1
HCPCS,97804,Hc Medical Nutrition Therapy Group Ea 30 Minutes,65.0,42.25,,,0
HCPCS,97804,Medical nutrition group,,,12.04,12.04,1
HCPCS,97810,Acupunct w/o stimul 15 min,,,27.89,27.89,1
HCPCS,97813,Acupunct w/stimul 15 min,,,27.89,27.89,1
HCPCS,98925,Hc Omt 1-2 Body Regions,600.0,390.0,,,0
HCPCS,98926,Hc Osteo Manip Tx 3-4 Body Region,600.0,390.0,,,0
HCPCS,98966,Hc pro phone call 5-10 min,,,10.21,10.21,1
HCPCS,98967,Hc pro phone call 11-20 min,,,19.81,19.81,1
HCPCS,98968,Hc pro phone call 21-30 min,,,28.77,28.77,1
HCPCS,98970,Qnhp ol dig e/m svc 5-10min,,,10.21,10.21,1
HCPCS,98971,Qnhp ol dig em svc 11-20min,,,18.72,18.72,1
HCPCS,98972,Qnhp ol dig e/m svc 21+ min,,,28.63,28.63,1
HCPCS,98975,Rem ther mntr 1st setup&edu,,,128.37,128.37,1
HCPCS,98979,Rtm tx mgmt 1st 10 min,,,11.3,11.3,1
HCPCS,98980,Rem ther mntr 1st 20 min,,,25.38,25.38,1
HCPCS,98981,Rem ther mntr ea addl 20 min,,,25.04,25.04,1
HCPCS,99000,Specimen handling office-lab,,,20.33,20.33,2
HCPCS,99001,Specimen handling pt-lab,,,24.15,24.15,2
HCPCS,99151,Hc Mod Sed Same Phys As Proc Up To 5 Yrs 1St 15 Min,599.0,389.35,,,0
HCPCS,99152,Hc Mod Sed Same Phys As Proc 1St 15 Min,599.0,389.35,,,0
HCPCS,99153,Hc Mod Sed Same Phys As Proc Addl 15 Min,599.0,389.35,,,0
HCPCS,99155,Hc Mod Sed Dif Phys As Proc Up To 5 Yrs 1St 15 Min,599.0,389.35,,,0
HCPCS,99156,Hc Mod Sed Other Provider Than Proc 1St 15 Min,599.0,389.35,,,0
HCPCS,99157,Hc Mod Sed Other Provider Than Proc Addl 15 Min,599.0,389.35,,,0
HCPCS,99170,Anogenital exam child w imag,,,194.94,194.94,1
HCPCS,99195,Hc Phlebotomy Therapeutic,473.0,307.45,,,0
HCPCS,99195,Phlebotomy,,,128.29,128.29,1
HCPCS,99281,Emergency dept visit,,,81.31,81.31,1
HCPCS,99281,Hc Er Level I,673.0,437.45,,,0
HCPCS,99282,Emergency dept visit,,,148.05,148.05,1
HCPCS,99282,Hc Er Level Ii,1104.0,717.6,,,0
HCPCS,99283,Emergency dept visit,,,263.21,263.21,1
HCPCS,99283,Hc Er Level Iii,1748.0,1136.2,,,0
HCPCS,99284,Emergency dept visit,,,402.33,402.33,1
HCPCS,99284,Hc Er Level Iv,2891.0,1879.15,,,0
HCPCS,99285,Emergency dept visit,,,574.22,574.22,1
HCPCS,99285,Hc Er Level V,4144.0,2693.6,,,0
HCPCS,99291,Critical care first hour,,,796.47,796.47,1
HCPCS,99291,Hc Critical Care First 30 To 74 Min,5794.0,3766.1,,,0
HCPCS,99292,Hc Er Critical Care Addl 30 Min,710.0,461.5,,,0
HCPCS,99366,Hc Ot Rehab Family Conference - 30 Min Or More,185.0,120.25,,,0
HCPCS,99366,Hc Pt Rehab Family Conference - 30 Min Or More,185.0,120.25,,,0
HCPCS,99366,Hc St Rehab Family Conference - 30 Min Or More,185.0,120.25,,,0
HCPCS,99384,Hc Visit Preventive New 12-17 Yrs,158.0,102.7,,,0
HCPCS,99385,Hc Visit Preventive New 18-39 Yrs,158.0,102.7,,,0
HCPCS,99386,Hc Visit Preventive New 40-64 Yrs,158.0,102.7,,,0
HCPCS,99387,Hc Visit Preventive New >65 Yrs,158.0,102.7,,,0
HCPCS,99394,Hc Visit Preventive Estab 12-17 Yrs,158.0,102.7,,,0
HCPCS,99395,Hc Visit Preventive Estab 18-39 Yrs,158.0,102.7,,,0
HCPCS,99396,Hc Visit Preventive Estab 40-64 Yrs,158.0,102.7,,,0
HCPCS,99397,Hc Visit Preventive Estab >65 Yrs,158.0,102.7,,,0
HCPCS,99401,Hc Preventive Med Counsel 15Min,162.0,105.3,,,0
HCPCS,99402,Hc Preventive Med Counsel 30Min,192.0,124.8,,,0
HCPCS,99403,Hc Preventive Med Counsel 45Min,222.0,144.3,,,0
HCPCS,99404,Hc Preventive Med Counsel 60Min,271.0,176.15,,,0
HCPCS,99406,Hc Smoke Tobacco Counseling 3-10 Min,35.0,22.75,,,0
HCPCS,99407,Hc Smoke Tobacco Counsel More Than 10 Mins,46.0,29.9,,,0
HCPCS,99426,Prin care mgmt staff 1st 30,,,97.95,97.95,1
HCPCS,99453,Rem mntr physiol param setup,,,128.37,128.37,1
HCPCS,99460,Init nb em per day hosp,,,128.37,128.37,1
HCPCS,99463,Same day nb discharge,,,128.37,128.37,1
HCPCS,99465,Hc Newborn Resuscitation,2458.0,1597.7,,,0
HCPCS,99465,Nb resuscitation,,,637.3,637.3,1
HCPCS,99473,Self-meas bp pt educaj/train,,,27.89,27.89,1
HCPCS,99483,Assmt & care pln pt cog imp,,,97.95,97.95,1
HCPCS,99487,Cmplx chron care w/o pt vsit,,,171.15,171.15,1
HCPCS,99490,Chron care mgmt srvc 20 min,,,97.95,97.95,1
HCPCS,99492,1st psyc collab care mgmt,,,97.95,97.95,1
HCPCS,99493,Sbsq psyc collab care mgmt,,,97.95,97.95,1
HCPCS,99495,Trans care mgmt 14 day disch,,,128.37,128.37,1
HCPCS,99496,Trans care mgmt 7 day disch,,,128.37,128.37,1
HCPCS,99497,Advncd care plan 30 min,,,97.95,97.95,1
HCPCS,A2001,Miscellaneous M >=66.50,,,119.99,2984.79,3
HCPCS,A2002,Miscellaneous M >=55.50 and M <66.50,,,119.99,471.59,3
HCPCS,A2004,Miscellaneous M <46.50 and A >=77.50,,,42.28,42.28,2
HCPCS,A2005,Miscellaneous M <46.50 and A <77.50,,,119.99,689.88,3
HCPCS,A2007,"Restrata, per sq cm",,,119.99,218.26,3
HCPCS,A2008,"Theragenesis, per sq cm",,,119.99,243.68,3
HCPCS,A2009,"Symphony, per sq cm",,,119.99,339.21,3
HCPCS,A2011,Hc Supra Sdrm Wound Matrix Per Sq Cm,141.95,92.27,,,0
HCPCS,A2013,"Innovamatrix fs, per sq cm",,,119.99,3329.29,3
HCPCS,A2014,Omeza collag per 100 mg,,,193.09,193.09,2
HCPCS,A2015,"Phoenix wnd mtrx, per sq cm",,,119.99,3898.77,3
HCPCS,A2019,Kerecis marigen shld sq cm,,,119.99,1851.69,3
HCPCS,A2021,Neomatrix per sq cm,,,119.99,3634.35,3
HCPCS,A2022,Innovabrn/innovamatx xl sqcm,,,119.99,3506.36,3
HCPCS,A2023,"Innovamatrix pd, 1 mg",,,40.32,40.32,2
HCPCS,A2024,Resolve matrix per sq cm,,,119.99,5259.54,3
HCPCS,A2025,Miro3d per cubic cm,,,674.09,674.09,2
HCPCS,A4248,Chlorhexidine antisept,,,0.07,0.07,2
HCPCS,A4563,Vag inser rectal control sys,,,1680.58,1680.58,1
HCPCS,A4593,Neuromod sti sys adj rehab,,,52.28,52.28,1
HCPCS,A4596,Ces system monthly supp,,,103.44,103.44,2
HCPCS,A4642,In111 satumomab,,,4399.6,4399.6,2
HCPCS,A4648,Hc Clip Marker,313.31,203.65,,,0
HCPCS,A4648,Hc Tissue Marker Implantable Each,355.34,230.97,,,0
HCPCS,A4802,Protamine sulfate per 50 mg,,,31.17,31.17,2
HCPCS,A6520,G com garmnt glove nghttime,,,126.45,126.45,1
HCPCS,A6521,G com garmnt glove nght cust,,,501.75,501.75,1
HCPCS,A6522,G com garment arm nighttime,,,307.26,307.26,1
HCPCS,A6523,G com garment arm nght custm,,,729.02,729.02,1
HCPCS,A6524,G com garmnt lwr leg/ft nght,,,383.34,383.34,1
HCPCS,A6525,G com garm lwrleg/ft ngt cus,,,773.9,773.9,1
HCPCS,A6526,G com garmt full leg/ft nght,,,693.06,693.06,1
HCPCS,A6527,G garmt full leg/ft nght cus,,,1274.45,1274.45,1
HCPCS,A6528,G com garment bra nighttime,,,666.42,666.42,1
HCPCS,A6529,G com garmt bra night custm,,,1053.04,1053.04,1
HCPCS,A6530,Compression stocking bk18-30,,,39.07,39.07,1
HCPCS,A6531,Compression stocking bk30-40,,,61.66,61.66,1
HCPCS,A6532,Compression stocking bk40-50,,,86.88,86.88,1
HCPCS,A6533,Gc stocking thighlngth 18-30,,,54.86,54.86,1
HCPCS,A6534,Gc stocking thighlngth 30-40,,,62.65,62.65,1
HCPCS,A6535,Gc stocking thighlngth 40-50,,,72.13,72.13,1
HCPCS,A6536,Gc stocking full lngth 18-30,,,73.95,73.95,1
HCPCS,A6537,Gc stocking full lngth 30-40,,,87.67,87.67,1
HCPCS,A6538,Gc stocking full lngth 40-50,,,102.65,102.65,1
HCPCS,A6539,Gc stocking waistlngth 18-30,,,97.86,97.86,1
HCPCS,A6540,Gc stocking waistlngth 30-40,,,116.68,116.68,1
HCPCS,A6541,Gc stocking waistlngth 40-50,,,138.21,138.21,1
HCPCS,A6545,Grad comp non-elastic BK,,,121.41,121.41,1
HCPCS,A6552,Grad com stocking bk 30-40,,,57.97,57.97,1
HCPCS,A6553,G com stcking bk 30-40 custm,,,226.38,226.38,1
HCPCS,A6554,Grad com stocking bk 40+,,,79.72,79.72,1
HCPCS,A6555,G com stcking bk 40+ custm,,,226.38,226.38,1
HCPCS,A6556,G com stcking thgh18-30 cust,,,310.25,310.25,1
HCPCS,A6557,G com stcking thgh30-40 cust,,,310.25,310.25,1
HCPCS,A6558,G com stcking thgh 40+ cust,,,320.17,320.17,1
HCPCS,A6562,G com stckng waist18-30 cust,,,1015.37,1015.37,1
HCPCS,A6563,G com stckng waist30-40 cust,,,1015.37,1015.37,1
HCPCS,A6564,G com stckng waist 40+ cust,,,1093.78,1093.78,1
HCPCS,A6565,Grad comp gauntlet custom,,,175.45,175.45,1
HCPCS,A6566,Grad com garment neck/head,,,254.75,254.75,1
HCPCS,A6567,G com garment neck/head cust,,,800.42,800.42,1
HCPCS,A6568,G com garment torso/shldr,,,166.26,166.26,1
HCPCS,A6569,G com garmnt torso/shdr cust,,,946.74,946.74,1
HCPCS,A6570,Grad com garment genital,,,113.28,113.28,1
HCPCS,A6571,G com garment genital custm,,,680.84,680.84,1
HCPCS,A6572,Grad com garment toe caps,,,105.11,105.11,1
HCPCS,A6573,Grad com garmnt toe cap cust,,,249.43,249.43,1
HCPCS,A6574,Custom gradient sleev/glov,,,317.99,317.99,1
HCPCS,A6575,Gradient comp sleev/glov,,,103.05,103.05,1
HCPCS,A6576,Custom grad com sleeve med,,,195.16,195.16,1
HCPCS,A6577,Custom grad cm sleeve heavy,,,161.53,161.53,1
HCPCS,A6578,Gradient comp sleeve,,,79.55,79.55,1
HCPCS,A6579,Custom grad com glove med,,,313.26,313.26,1
HCPCS,A6580,Custom grad com glove heavy,,,310.96,310.96,1
HCPCS,A6581,Gradient comp glove,,,72.99,72.99,1
HCPCS,A6582,Gradient comp gauntlet,,,48.68,48.68,1
HCPCS,A6583,Grad com wrap w straps bk,,,160.13,160.13,1
HCPCS,A6585,Grad com wrap w straps ak,,,189.6,189.6,1
HCPCS,A6586,Grad com wrap w straps leg,,,558.59,558.59,1
HCPCS,A6587,Grad com wrap w straps foot,,,73.17,73.17,1
HCPCS,A6588,Grad com wrap w straps arm,,,243.87,243.87,1
HCPCS,A6589,Grad com wrap w straps bra,,,96.27,96.27,1
HCPCS,A6594,G comp bandge liner lwr extr,,,35.05,35.05,1
HCPCS,A6595,G comp bandge liner upr extr,,,34.48,34.48,1
HCPCS,A6596,G comp bandge conform gauze,,,0.18,0.18,1
HCPCS,A6597,G comp bandage long stretch,,,1.55,1.55,1
HCPCS,A6598,G comp bandage med stretch,,,0.75,0.75,1
HCPCS,A6599,G comp bandage short stretch,,,1.7,1.7,1
HCPCS,A6600,G com bandge hgh dn foam sht,,,3.07,3.07,1
HCPCS,A6601,G com bandge hgh dn foam pad,,,3.45,3.45,1
HCPCS,A6602,G com bandge hgh dn foamroll,,,5.03,5.03,1
HCPCS,A6603,G com bandge low dn foamchnl,,,2.36,2.36,1
HCPCS,A6604,G com bandge low dn foam flt,,,1.38,1.38,1
HCPCS,A6605,G com bandage padded foam,,,1.57,1.57,1
HCPCS,A6606,G com bandage padded textile,,,4.67,4.67,1
HCPCS,A6607,G com bandage tub protct lyr,,,1.25,1.25,1
HCPCS,A6608,G com bandage tub protct pad,,,5.21,5.21,1
HCPCS,A6610,G com stcking bk 18-30 custm,,,226.38,226.38,1
HCPCS,A9155,Artificial saliva,,,18.04,18.04,2
HCPCS,A9156,Oral mucoadhesive per 1 ml,,,5.66,5.66,2
HCPCS,A9180,"Lice treatment, topical",,,2.08,2.08,2
HCPCS,A9500,Noncdm Charge Record Radiopharmaceuticals,98.94,64.31,,,0
HCPCS,A9500,Tc99m sestamibi,,,1221.07,1221.07,2
HCPCS,A9502,Noncdm Charge Record Radiopharmaceuticals,105.0,68.25,,,0
HCPCS,A9502,Tc99m tetrofosmin,,,199.53,427.77,4
HCPCS,A9503,Noncdm Charge Record Radiopharmaceuticals,104.92,68.2,,,0
HCPCS,A9503,Tc99m medronate,,,30.42,160.4,4
HCPCS,A9504,Tc99m apcitide,,,1379.74,1379.74,2
HCPCS,A9505,Tl201 thallium,,,76.42,116.58,4
HCPCS,A9506,Tc-99m graphite crucible,,,328.6,890.51,5
HCPCS,A9507,In111 capromab,,,0.02,3559.83,5
HCPCS,A9508,"I131 iodobenguate, dx",,,0.02,2792.82,5
HCPCS,A9509,Iodine I-123 sod iodide mil,,,0.02,417.26,4
HCPCS,A9509,Noncdm Charge Record Radiopharmaceuticals,649.0,421.85,,,0
HCPCS,A9510,Tc99m disofenin,,,0.02,162.17,4
HCPCS,A9512,Noncdm Charge Record Radiopharmaceuticals,1.6,1.04,,,0
HCPCS,A9512,Tc99m pertechnetate,,,3.95,33.31,4
HCPCS,A9513,Lutetium lu 177 dotatat ther,,,316.99,802.84,5
HCPCS,A9515,Choline c-11,,,2516.43,11700.0,5
HCPCS,A9516,Iodine I-123 sod iodide mic,,,224.27,302.44,4
HCPCS,A9516,Noncdm Charge Record Radiopharmaceuticals,110.95,72.12,,,0
HCPCS,A9517,"I131 iodide cap, rx",,,24.07,62.68,3
HCPCS,A9520,Noncdm Charge Record Radiopharmaceuticals,1253.5,814.78,,,0
HCPCS,A9520,Tc99 tilmanocept diag 0.5mci,,,1548.07,1548.07,2
HCPCS,A9521,Noncdm Charge Record Radiopharmaceuticals,2895.66,1882.18,,,0
HCPCS,A9521,Tc99m exametazime,,,927.71,4010.69,5
HCPCS,A9524,"I131 serum albumin, dx",,,976.52,976.52,2
HCPCS,A9526,Nitrogen n-13 ammonia,,,1542.06,1993.37,4
HCPCS,A9527,Iodine I-125 sodium iodide,,,396.32,565.25,3
HCPCS,A9528,"Iodine i-131 iodide cap, dx",,,255.96,255.96,2
HCPCS,A9528,Noncdm Charge Record Radiopharmaceuticals,51.5,33.48,,,0
HCPCS,A9529,Noncdm Charge Record Radiopharmaceuticals,51.5,33.48,,,0
HCPCS,A9530,"I131 iodide sol, rx",,,20.77,56.58,3
HCPCS,A9531,I131 max 100uci,,,11.41,11.41,2
HCPCS,A9532,"I125 serum albumin, dx",,,469.06,555.77,3
HCPCS,A9536,Tc99m depreotide,,,2101.2,2101.2,2
HCPCS,A9537,Noncdm Charge Record Radiopharmaceuticals,91.5,59.48,,,0
HCPCS,A9537,Tc99m mebrofenin,,,132.21,307.48,4
HCPCS,A9538,Noncdm Charge Record Radiopharmaceuticals,116.8,75.92,,,0
HCPCS,A9538,Tc99m pyrophosphate,,,104.31,149.88,4
HCPCS,A9539,Noncdm Charge Record Radiopharmaceuticals,487.05,316.58,,,0
HCPCS,A9539,Tc99m pentetate,,,0.02,68.37,4
HCPCS,A9540,Noncdm Charge Record Radiopharmaceuticals,480.1,312.06,,,0
HCPCS,A9540,Tc99m maa,,,70.2,79.78,4
HCPCS,A9541,Noncdm Charge Record Radiopharmaceuticals,379.07,246.4,,,0
HCPCS,A9541,Tc99m sulfur colloid,,,625.65,2036.29,4
HCPCS,A9542,"In111 ibritumomab, dx",,,0.02,2162.63,4
HCPCS,A9543,"Y90 ibritumomab, rx",,,56824.55,153994.53,5
HCPCS,A9546,Co57/58,,,3.5,3.5,2
HCPCS,A9547,In111 oxyquinoline,,,831.46,4925.65,5
HCPCS,A9547,Noncdm Charge Record Radiopharmaceuticals,5550.0,3607.5,,,0
HCPCS,A9548,In111 pentetate,,,745.62,2072.07,5
HCPCS,A9548,Noncdm Charge Record Radiopharmaceuticals,2345.33,1524.46,,,0
HCPCS,A9551,Tc99m succimer,,,659.93,1594.51,3
HCPCS,A9552,F18 fdg,,,1131.67,1131.67,2
HCPCS,A9552,Noncdm Charge Record Radiopharmaceuticals,375.0,243.75,,,0
HCPCS,A9553,Cr51 chromate,,,0.02,1917.96,5
HCPCS,A9554,"I125 iothalamate, dx",,,87.75,649.64,5
HCPCS,A9555,Noncdm Charge Record Radiopharmaceuticals,1947.0,1265.55,,,0
HCPCS,A9555,Rb82 rubidium,,,1225.46,1225.46,2
HCPCS,A9556,Ga67 gallium,,,0.02,59.62,4
HCPCS,A9556,Noncdm Charge Record Radiopharmaceuticals,25.5,16.58,,,0
HCPCS,A9557,Noncdm Charge Record Radiopharmaceuticals,2461.29,1599.84,,,0
HCPCS,A9557,Tc99m bicisate,,,775.52,8579.21,5
HCPCS,A9558,Xe133 xenon 10mci,,,596.93,703.03,4
HCPCS,A9559,Co57 cyano,,,0.02,682.87,4
HCPCS,A9560,Noncdm Charge Record Radiopharmaceuticals,363.93,236.55,,,0
HCPCS,A9560,Tc99m labeled rbc,,,234.0,285.77,4
HCPCS,A9561,Noncdm Charge Record Radiopharmaceuticals,131.35,85.38,,,0
HCPCS,A9561,Tc99m oxidronate,,,136.75,136.75,2
HCPCS,A9562,Noncdm Charge Record Radiopharmaceuticals,805.55,523.61,,,0
HCPCS,A9562,Tc99m mertiatide,,,2081.9,2081.9,2
HCPCS,A9563,P32 na phosphate,,,278.24,713.42,5
HCPCS,A9563,"SODIUM PHOSPHATE P-32, THERAPEUTIC, PER MILLICURIE",0.05,0.03,,,0
HCPCS,A9564,P32 chromic phosphate,,,410.24,410.24,2
HCPCS,A9567,Noncdm Charge Record Radiopharmaceuticals,492.65,320.22,,,0
HCPCS,A9567,Technetium tc-99m aerosol,,,55.23,55.23,2
HCPCS,A9568,Technetium tc99m arcitumomab,,,0.02,2193.77,4
HCPCS,A9569,Noncdm Charge Record Radiopharmaceuticals,6023.15,3915.05,,,0
HCPCS,A9569,Technetium TC-99m auto WBC,,,934.13,4010.69,5
HCPCS,A9570,Indium In-111 auto WBC,,,1103.19,9851.31,5
HCPCS,A9570,Noncdm Charge Record Radiopharmaceuticals,5096.95,3313.02,,,0
HCPCS,A9571,Indium IN-111 auto platelet,,,9851.31,11578.88,4
HCPCS,A9571,Noncdm Charge Record Radiopharmaceuticals,5096.95,3313.02,,,0
HCPCS,A9572,Indium In-111 pentetreotide,,,2000.94,5188.59,3
HCPCS,A9573,"Inj, gadopiclenol, 1 ml",,,6.09,9.7,5
HCPCS,A9575,Inj gadoterate meglumi 0.1ml,,,0.2,0.33,5
HCPCS,A9575,Noncdm Charge Record Pharmacy,0.44,0.29,,,0
HCPCS,A9576,Inj prohance multipack,,,2.48,3.96,5
HCPCS,A9577,"Hc Gadobenate Dimeglumine (Multihance), Per Ml",31.2,20.28,,,0
HCPCS,A9577,Inj multihance,,,3.1,4.93,5
HCPCS,A9577,Noncdm Charge Record Pharmacy,7.6,4.94,,,0
HCPCS,A9578,Inj multihance multipack,,,3.05,4.85,5
HCPCS,A9579,"Gad-base MR contrast NOS,1ml",,,2.52,4.01,5
HCPCS,A9579,Noncdm Charge Record Pharmacy,9.45,6.14,,,0
HCPCS,A9580,Noncdm Charge Record Radiopharmaceuticals,375.0,243.75,,,0
HCPCS,A9580,Sodium fluoride F-18,,,710.05,710.05,2
HCPCS,A9581,Gadoxetate disodium inj,,,24.99,39.84,5
HCPCS,A9581,Noncdm Charge Record Pharmacy,69.77,45.35,,,0
HCPCS,A9582,Iodine I-123 iobenguane,,,2317.5,11953.68,5
HCPCS,A9582,Noncdm Charge Record Radiopharmaceuticals,12223.75,7945.44,,,0
HCPCS,A9583,Gadofosveset trisodium inj,,,0.02,0.02,2
HCPCS,A9584,Iodine i-123 ioflupane,,,1387.74,5775.12,5
HCPCS,A9584,Noncdm Charge Record Radiopharmaceuticals,6505.04,4228.28,,,0
HCPCS,A9585,Gadobutrol injection,,,0.47,0.76,5
HCPCS,A9586,Florbetapir F18,,,1825.64,6686.32,5
HCPCS,A9587,Gallium ga-68,,,49.63,138.45,5
HCPCS,A9588,Fluciclovine f-18,,,322.27,1208.96,5
HCPCS,A9589,HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLUTION,6620.2,4303.13,,,0
HCPCS,A9589,Insti hexaminolevulinate hcl,,,2343.81,3736.3,5
HCPCS,A9589,Noncdm Charge Record Pharmacy,6885.01,4475.26,,,0
HCPCS,A9590,Iodine i-131 iobenguane 1mci,,,749.71,749.71,2
HCPCS,A9591,Fluoroestradiol f 18,,,460.42,1799.86,5
HCPCS,A9592,COPPER CU-64 DOTATATE 148 MBQ/4 ML (4 MCI/4 ML) INTRAVENOUS SOLUTION,12000.0,7800.0,,,0
HCPCS,A9592,Copper cu 64 dotatate diag,,,594.28,2252.25,5
HCPCS,A9592,Noncdm Charge Record Radiopharmaceuticals,2928.23,1903.35,,,0
HCPCS,A9593,Gallium ga-68 psma-11 ucsf,,,550.13,1820.19,5
HCPCS,A9594,"Gallium ga-68 psma-11, ucla",,,363.5,1782.17,5
HCPCS,A9595,Noncdm Charge Record Radiopharmaceuticals,1593.56,1035.81,,,0
HCPCS,A9595,"Piflu f-18, dia 1 millicurie",,,346.49,1357.9,5
HCPCS,A9596,Gallium illuccix 1 millicure,,,478.52,2811.38,5
HCPCS,A9596,Noncdm Charge Record Radiopharmaceuticals,2525.65,1641.67,,,0
HCPCS,A9600,Sr89 strontium,,,4146.34,11236.58,5
HCPCS,A9601,Flortaucipir inj 1 millicuri,,,819.0,10054.1,5
HCPCS,A9602,Fluorodopa f-18 diag per mci,,,855.55,1351.26,5
HCPCS,A9603,"Inj, pafolacianine, 0.1 mg",,,310.78,310.78,2
HCPCS,A9604,Sm 153 lexidronam,,,3159.8,38101.94,5
HCPCS,A9606,Radium ra223 dichloride ther,,,172.22,457.2,5
HCPCS,A9607,Lutetium lu 177 vipivotide,,,255.84,653.68,5
HCPCS,A9608,Flotufolastat f18 diag 1 mci,,,671.22,1766.03,5
HCPCS,A9610,"Xe129 xenon, diagnostic",,,2433.6,2433.6,2
HCPCS,A9611,"INV FLURPIRIDAZ F-18, DIAGNOSTIC, PER STUDY DOSE, UP TO 14",0.65,0.42,,,0
HCPCS,A9612,FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,191.75,124.64,,,0
HCPCS,A9615,"Inj, pegulicianine, 1 mg",,,37.51,101.65,5
HCPCS,A9697,Hc Magnatrace Inj Per Study Dose,1751.28,1138.33,,,0
HCPCS,A9697,"Inj, magtrace per study dose",,,1254.0,3083.87,3
HCPCS,A9699,Radiopharm rx agent noc,,,122549.05,122549.05,2
HCPCS,A9800,Gallium locametz 1 millicuri,,,362.5,2367.02,5
HCPCS,C1052,Hc Hemospray Topical Gi Hemostatic Agent,2579.44,1676.64,,,0
HCPCS,C1062,Hc Intravertebral Fx Aug Implant - Stryker Spinejack,12793.63,8315.86,,,0
HCPCS,C1062,Intravertebral fx aug impl,,,31685.0,31685.0,1
HCPCS,C1605,Noncdm Charge Record Medical Supplies,19249.32,12512.06,,,0
HCPCS,C1713,Hc Anchor Screw Bone Or Soft Tissue To Bone,1320.74,858.48,,,0
HCPCS,C1713,Hc Ifuse Bedrock Granite Implant System Ntap,10259.48,6668.66,,,0
HCPCS,C1713,Hc K-Wire,100.08,65.05,,,0
HCPCS,C1713,Hc Synthetic Bone Void Filler,16423.16,10675.05,,,0
HCPCS,C1714,Hc Cath Transluminal Atherectomy Directional,11810.69,7676.95,,,0
HCPCS,C1715,Hc Needle Seed Implant,34.81,22.63,,,0
HCPCS,C1717,Hc Rt Isotope Ir-192,560.45,364.29,,,0
HCPCS,C1721,Hc Icd Dual Chamber,32141.14,20891.74,,,0
HCPCS,C1722,Hc Icd Single Chamber,46921.77,30499.15,,,0
HCPCS,C1722,Hc Ide G190186 Ev Icd Device,21710.0,14111.5,,,0
HCPCS,C1724,Hc Catheter Transluminal Atherectomy Rotational,8017.63,5211.46,,,0
HCPCS,C1725,Hc Catheter Transluminal Angioplasty,616.64,400.82,,,0
HCPCS,C1725,Hc Hud Cath Trans Angio C1725,4269.66,2775.28,,,0
HCPCS,C1725,Hc Ide G130007 Pro1140762 Brk,1.0,0.65,,,0
HCPCS,C1725,Hc Ide G200051 Aspire Ph Balloon Catheter,1.02,0.66,,,0
HCPCS,C1725,Hc Ide G240108 - Power Pad Ii Pulse Periph Ivl Balloon Cath,1.02,0.66,,,0
HCPCS,C1726,Hc Balloon Dilator Cath Plab Bronch,1351.55,878.51,,,0
HCPCS,C1726,Hc Catheter Balloon Non Vascular,719.08,467.4,,,0
HCPCS,C1726,Hc Ide G220079 Farapoint Pfa Point Catheter,3250.0,2112.5,,,0
HCPCS,C1726,Hc Ide G220079 Farawave Pfa Balloon Catheter,6500.0,4225.0,,,0
HCPCS,C1727,Hc Catheter Balloon Tissue Dissector,927.9,603.14,,,0
HCPCS,C1729,Hc Catheter Drainage,226.63,147.31,,,0
HCPCS,C1729,Hc Pleurex Cath Plab Bronch,3329.72,2164.32,,,0
HCPCS,C1729,Hc Thoracentesis Kit Plab Bronch,708.54,460.55,,,0
HCPCS,C1729,Hc Thoracentesis Wayne Set Plab Bronch,215.02,139.76,,,0
HCPCS,C1730,Hc Cath Ep Dx Not 3D Up To 19 Electrodes,1003.86,652.51,,,0
HCPCS,C1731,Hc Cath Ep Dx Not 3D 20 Or More Electrodes,6173.5,4012.78,,,0
HCPCS,C1732,Hc Catheter Ep Dx Ablation 3D Or Vector Mapping,5668.43,3684.48,,,0
HCPCS,C1732,Hc Ide #G230170 Smartpulse Paf - Thermocool Smarttouch Sf Catheter,1.02,0.66,,,0
HCPCS,C1732,Hc Ide G170215 Unpinning Mapping Catheter,1.0,0.65,,,0
HCPCS,C1733,Hc Catheter Ep Dx Ablation Not 3D Or Vector Mapping,17039.67,11075.79,,,0
HCPCS,C1733,Hc Ide G130084 Converge Epi-Sense Coag System Visitrax,7020.0,4563.0,,,0
HCPCS,C1733,Hc Ide G230249 Avant Guard - Farawave Pfa Balloon Catheter,6604.16,4292.7,,,0
HCPCS,C1734,Hc Augment Bone Matrix,7038.45,4574.99,,,0
HCPCS,C1747,"Hc Endoscope, Single-Use, Urinary Tract Device",5512.93,3583.4,,,0
HCPCS,C1748,Hc Endoscope Single Use,9000.08,5850.05,,,0
HCPCS,C1750,Hc Catheter Dialysis Long Term,679.89,441.93,,,0
HCPCS,C1751,Hc Catheter Infusion,608.74,395.68,,,0
HCPCS,C1751,Hc Catheter Latex Free Swan,185.33,120.46,,,0
HCPCS,C1751,Hc Catheter Picc Sgl Dbl Lumen,625.83,406.79,,,0
HCPCS,C1751,Hc Kit Midline Catheter Basic,218.24,141.86,,,0
HCPCS,C1751,Hc Kit Midline Catheter Full,349.94,227.46,,,0
HCPCS,C1751,Hc Picc Sgl/Dbl Solo W/ Sherlock,920.52,598.34,,,0
HCPCS,C1751,Hc Picc Triple Lumen Solo,978.01,635.71,,,0
HCPCS,C1751,Hc Tray Catheter Picc Midline Single Lumen,431.19,280.27,,,0
HCPCS,C1752,Hc Catheter Dialysis Short Term,546.63,355.31,,,0
HCPCS,C1753,Hc Catheter Intravascular Ultrasound,2334.24,1517.26,,,0
HCPCS,C1754,Hc Catheter Intradiscal,2301.58,1496.03,,,0
HCPCS,C1757,Hc Cath Thrombectomy Penumbra Lightning Aspiration Tubing,16128.13,10483.28,,,0
HCPCS,C1757,Hc Catheter Thrombectomy Embolectomy,10480.95,6812.62,,,0
HCPCS,C1757,Hc Embolectomy Sgl Lumen Plab,218.09,141.76,,,0
HCPCS,C1757,Hc Ide #G220033 Protect H2H - Embolic Protection Device Catheter,1.02,0.66,,,0
HCPCS,C1757,Hc Ide G180004 Tiger Revascularzation Device,1.0,0.65,,,0
HCPCS,C1757,Hc Ide G190069 Endolow Embotrap Ii Revasc,6000.0,3900.0,,,0
HCPCS,C1757,Hc Ide G190099 Prost Preset Thrombectomy Device,5800.0,3770.0,,,0
HCPCS,C1757,Hc Ide G230027/ S001 - Aventus Aspiration Catheter,1.02,0.66,,,0
HCPCS,C1758,Hc Catheter Ureteral,5165.7,3357.7,,,0
HCPCS,C1759,Hc Catheter Intracardiac Echo,6696.44,4352.69,,,0
HCPCS,C1759,Hc Ide G170215 Unpinning Ice Catheter,1.0,0.65,,,0
HCPCS,C1760,Hc Closure Device Vascular,638.85,415.25,,,0
HCPCS,C1760,Hc Vasc Closure Device Angioseal,525.26,341.42,,,0
HCPCS,C1761,Hc Cath Trans Intra Litho Coro,14436.99,9384.04,,,0
HCPCS,C1762,Hc Connective Tissue Human,5902.41,3836.57,,,0
HCPCS,C1763,Hc Connective Tissue Non Human,2993.36,1945.68,,,0
HCPCS,C1764,Hc Event Recorder Cardiac,13052.11,8483.87,,,0
HCPCS,C1764,Hc Ide #G200110 Alleviate Hf - Reveal Linq Insertalbe Cardiac Monitor,1.0,0.65,,,0
HCPCS,C1765,Hc Adhesion Barrier,1176.39,764.65,,,0
HCPCS,C1765,Hc Seprafilm Adhesion Barrier,980.9,637.58,,,0
HCPCS,C1766,Hc Ide G220079 Faradrive Steerable Sheath,1400.0,910.0,,,0
HCPCS,C1766,Hc Ide G230249 Avant Guard - Faradrive Steerable Sheath,1331.07,865.2,,,0
HCPCS,C1766,Hc Introducer Sheath Ep Sterrable Not Peel,3523.79,2290.46,,,0
HCPCS,C1767,Hc Generator Neurostim Nonrechargeable,47339.6,30770.74,,,0
HCPCS,C1768,Hc Graft Vascular,2504.78,1628.11,,,0
HCPCS,C1769,Hc Guidewire,292.15,189.9,,,0
HCPCS,C1769,Hc Ide #G150036 Spyral Affirm - Guidewire,1.02,0.66,,,0
HCPCS,C1769,Hc Ide #G220207 - Telltale Electosurgical Guidewire,1.02,0.66,,,0
HCPCS,C1769,Hc Ide G150107 Amaze Guidewire,1100.0,715.0,,,0
HCPCS,C1769,Hc Ide G170215 Unpinning Guidewire,1.0,0.65,,,0
HCPCS,C1769,Hc Ide# G190051 - Acurate Ide Prime Xl Wire,1.02,0.66,,,0
HCPCS,C1769,Hc Rfa Sclero Guidewire - Critical Limb,2082.88,1353.87,,,0
HCPCS,C1771,Hc Sling Incontinence Device,4354.59,2830.48,,,0
HCPCS,C1772,Hc Infusion Pump Programmable,34674.89,22538.68,,,0
HCPCS,C1773,Hc Ide G200319 Modular Atp - Empower Single-Loop Snare,1.0,0.65,,,0
HCPCS,C1773,Hc Ide G200319 Modular Atp - Empower Tri-Loop Snare,1.0,0.65,,,0
HCPCS,C1773,Hc Retrieval Device For Fractured Medical Devices,1804.88,1173.17,,,0
HCPCS,C1776,Hc Hud Joint Implant C1776,3792.53,2465.14,,,0
HCPCS,C1776,Hc Joint Implant,3932.23,2555.95,,,0
HCPCS,C1777,Hc Lead Icd Single Coil,7343.05,4772.98,,,0
HCPCS,C1778,Hc Kit Sprint Conversion System,16068.06,10444.24,,,0
HCPCS,C1778,Hc Kit Sprint Pns Endura Single Lead,15830.52,10289.84,,,0
HCPCS,C1778,Hc Kit Sprint Pns Extensa Dual Lead,25578.05,16625.73,,,0
HCPCS,C1778,Hc Lead Neurostimulator Implantable,8543.76,5553.44,,,0
HCPCS,C1781,Hc Mesh Implantable,1767.66,1148.98,,,0
HCPCS,C1782,Hc Morcellator3,1970.56,1280.86,,,0
HCPCS,C1785,Hc Pacemaker Dual Chamber Rate Responsive,9407.28,6114.73,,,0
HCPCS,C1786,Hc Ide G200319 Modular Atp - Empower Pacemaker And Delivery Catheter,1.0,0.65,,,0
HCPCS,C1786,Hc Ide G200319 Modular Atp - Empower System - Initial,9750.0,6337.5,,,0
HCPCS,C1786,Hc Ide G210339 Aveir Dual Chamber Leadless Pacemaker,1.0,0.65,,,0
HCPCS,C1786,Hc Pacemaker Single Chamber Rate Responsive,31974.38,20783.35,,,0
HCPCS,C1787,Hc Patient Programmer Neurostimulator,3938.67,2560.14,,,0
HCPCS,C1788,Hc Port Indwelling,1379.75,896.84,,,0
HCPCS,C1789,Hc Prosthesis Breast,4233.05,2751.48,,,0
HCPCS,C1813,Hc Prosthesis Penile Inflatable,15746.8,10235.42,,,0
HCPCS,C1814,Hc Retinal Tamponade Device Silicone Oil,1225.61,796.65,,,0
HCPCS,C1815,Hc Prosthesis Urinary Sphincter,16951.48,11018.46,,,0
HCPCS,C1817,Hc Ide G210167 Occluflex - Flex Ii Pfo Occluder Device,1.0,0.65,,,0
HCPCS,C1817,Hc Implant Septal Occlusion,23639.5,15365.68,,,0
HCPCS,C1819,Hc Surgical Tissue Localization Device,90.88,59.07,,,0
HCPCS,C1820,Hc Generator Neurostim W Charging System,39993.18,25995.57,,,0
HCPCS,C1821,Hc Interspinous Implant,15777.37,10255.29,,,0
HCPCS,C1822,Hc Gen Neurostim Hi Freq Recharg Batt And Charg Sys,24443.31,15888.15,,,0
HCPCS,C1823,Hc Generator Neurostim Non-Rchge With Sensing&Stim Leads,52218.9,33942.28,,,0
HCPCS,C1824,Hc Cardiac Contractility Modulation Device,79864.2,51911.73,,,0
HCPCS,C1824,Hc Ide G200042 Aim Higher - Optimizer Smart Mini System,26000.0,16900.0,,,0
HCPCS,C1825,"Hc Generator Barostim Implantable Device, Non-Rechargeable",61280.42,39832.27,,,0
HCPCS,C1830,Hc Powered Bone Marrow Biopsy Needle,480.43,312.28,,,0
HCPCS,C1874,Hc Hud Stent Coated W Del Sys C1874,3416.41,2220.67,,,0
HCPCS,C1874,Hc Ide #G220087 Deeper Reveal - Bare Temporary Spur Stent System,1.0,0.65,,,0
HCPCS,C1874,Hc Ide #G220109 Gore Viafort - Gore Viafort Vascular Stent,1.0,0.65,,,0
HCPCS,C1874,Hc Ide G130005 Pro 1143399 Evas 1 Nellix Catheter,8250.0,5362.5,,,0
HCPCS,C1874,Hc Ide G140178 Onyx Resolute Coronary Stent A,825.0,536.25,,,0
HCPCS,C1874,Hc Ide G140178 Onyx Resolute Coronary Stent B,900.0,585.0,,,0
HCPCS,C1874,Hc Ide G150057 Aaa 13-03 Gore Excluder Aortic Ext Endo,2500.0,1625.0,,,0
HCPCS,C1874,Hc Ide G150057 Aaa 13-03 Gore Excluder Trunk-Ipsi Leg Endo,9500.0,6175.0,,,0
HCPCS,C1874,Hc Ide G160227 Optimize Svelte Coronary Stent System,1.0,0.65,,,0
HCPCS,C1874,Hc Ide G180073 Saval Des Btk Vascular Stent,1.0,0.65,,,0
HCPCS,C1874,Hc Stent  Coated W Delivery System,3211.74,2087.63,,,0
HCPCS,C1876,Hc Hud Stent Non Coated W Del Sys C1876,8977.9,5835.64,,,0
HCPCS,C1876,Hc Ide #G200007 - Performance Iii Neuroguard Iep Direct System,3993.21,2595.59,,,0
HCPCS,C1876,Hc Ide G130221 Pro Ohi-15-00603 Crest 2 Xact,1650.0,1072.5,,,0
HCPCS,C1876,Hc Ide G190030 Vivid Vesper Vesper Duo Venous Stent System,1.0,0.65,,,0
HCPCS,C1876,Hc Stent Non Coated W Delivery System,11980.32,7787.21,,,0
HCPCS,C1877,Hc Stent Non Coated Wo Delivery System,2580.23,1677.15,,,0
HCPCS,C1878,Hc Material Vocal Cord Medlztn Synth,2088.76,1357.69,,,0
HCPCS,C1880,Hc Filter Vena Cava,2864.14,1861.69,,,0
HCPCS,C1881,Hc Dialysis Access System Implant,339.93,220.95,,,0
HCPCS,C1882,Hc Icd Other Than Single Or Dual Chamber,40045.24,26029.41,,,0
HCPCS,C1883,Hc Extension Pacing Or Neurostim Lead,1362.34,885.52,,,0
HCPCS,C1884,Hc Embolization Protection System,4415.29,2869.94,,,0
HCPCS,C1884,Hc Ide G130221 Pro Ohi-15-00603 Crest 2 Moma Ultra Filter,1495.0,971.75,,,0
HCPCS,C1884,Hc Ide G130221 Pro Ohi-15-00603 Crest 2 Nav 6 Filter,1475.0,958.75,,,0
HCPCS,C1885,Hc Catheter Transluminal Angioplasty Laser,9283.57,6034.32,,,0
HCPCS,C1886,Hc Catheter Extravascular Tissue Ablation Any Modality,6074.23,3948.25,,,0
HCPCS,C1887,Hc Catheter Guiding,737.63,479.46,,,0
HCPCS,C1887,Hc Catheter Swan Ganz,208.61,135.6,,,0
HCPCS,C1887,Hc Ide #G150036 Spyral Affirm - Guidecath,1.02,0.66,,,0
HCPCS,C1887,Hc Ide #G200119 Ttvr Efs - Delivery,1.02,0.66,,,0
HCPCS,C1887,Hc Ide G160171 Asap Too Watchman Delivery Cath,1000.0,650.0,,,0
HCPCS,C1887,Hc Ide G170118 Triluminate Guide Catheter,1.0,0.65,,,0
HCPCS,C1887,Hc Ide G170215 Unpinning Diagnostic Catheter,1.0,0.65,,,0
HCPCS,C1887,Hc Ide G170251 Wing-It Wingman Catheter,1.0,0.65,,,0
HCPCS,C1887,Hc Ide G180270 Option Watchman Delivery Catheter,1.0,0.65,,,0
HCPCS,C1887,Hc Ide G200051 Aspire Ph Delivery System,1.02,0.66,,,0
HCPCS,C1887,Hc Ide G200106 Champion-Af Watchman Flex Delivery,1000.0,650.0,,,0
HCPCS,C1887,Hc Ide G210002 Summit Max  - Route 92 Medical Base Camp Sheath,1.0,0.65,,,0
HCPCS,C1887,Hc Ide G210083 Innovalve Twist Efs - Delivery System,1.0,0.65,,,0
HCPCS,C1887,Hc Ide G210167 Occluflex - Occlutech Pistol Pusher Delivery System,1.0,0.65,,,0
HCPCS,C1887,Hc Ide#  G190051 - Acurate Ide Prime Xl Delivery Catheter,1.0,0.65,,,0
HCPCS,C1888,Hc Ide #G220034 Admire - Ire Ablation System Varipulse Catheter,1.0,0.65,,,0
HCPCS,C1888,Hc Laser Guidewire - Critical Limb,1108.88,720.77,,,0
HCPCS,C1889,Hc Atrial Excluder,3558.26,2312.87,,,0
HCPCS,C1889,Hc Atriclip Exclusion Flexv Series,5925.31,3851.45,,,0
HCPCS,C1889,Hc Atriclip Exclusion System,11630.99,7560.14,,,0
HCPCS,C1889,Hc Ide #G180189-S016 Conform Pivotal Plug And Delivery,1.0,0.65,,,0
HCPCS,C1889,Hc Ide #G220093 Atriclip Excluder,1177.48,765.36,,,0
HCPCS,C1889,Hc Ide #G220093 Atriclip Exclusion Flexv Series,1843.02,1197.96,,,0
HCPCS,C1889,Hc Ide G130286 Proj 1157910 Web-It Delivery System,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G140056 Pro 1149152,6500.0,4225.0,,,0
HCPCS,C1889,Hc Ide G150035 Align Tavr - Transfemoral Jenavalve Pericardial Tavr,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G150035 Align Tavr Accessories (Delivery Cath & Loading Tool),0.75,0.49,,,0
HCPCS,C1889,Hc Ide G150101 Control Htn Rox Coupler,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G150107 Amaze Lariat-Rs Suture Delivery Device,7950.0,5167.5,,,0
HCPCS,C1889,Hc Ide G150107 Amaze Soft Guide Cannula,300.0,195.0,,,0
HCPCS,C1889,Hc Ide G150107 Amaze Suture Cutter,400.0,260.0,,,0
HCPCS,C1889,Hc Ide G150107 Amaze Tensure Suture Tightener,200.0,130.0,,,0
HCPCS,C1889,Hc Ide G150121 Pro 1161749 Surveilsurmodics,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G150200 Pinnacle Flex Watchman Closure Device,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G150210 Project 20151943 Reduce Lap-Hf,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G160074 Madit S-Icd Emblem,17000.0,11050.0,,,0
HCPCS,C1889,Hc Ide G160074 Madit S-Icd Subq Electrode Lead,4000.0,2600.0,,,0
HCPCS,C1889,Hc Ide G160144 Toba Ii Btk Nitinol Tacks,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G160163 Abre,400.0,260.0,,,0
HCPCS,C1889,Hc Ide G160171 Asap Too Watchman Device,17000.0,11050.0,,,0
HCPCS,C1889,Hc Ide G170113 Wavecrest Left Atrial Appendage Occlusion System,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G170118 Triluminate Clip Addtl,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G170118 Triluminate Clip Initial,30000.0,19500.0,,,0
HCPCS,C1889,Hc Ide G170166 Clasp 2D2F Implant System,30000.0,19500.0,,,0
HCPCS,C1889,Hc Ide G170215 Unpinning Cess System,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G170215 Unpinning Introducer,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G180106 Foldax Polymer Mitral Valve,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G180270 Option Watchman Device,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G180270 Option Watchman Procedure Charge,20000.0,13000.0,,,0
HCPCS,C1889,Hc Ide G190111 Life Btk Esprit Btk Everolimus Eluting Bio Scaffold System,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G200310 Membrane Trufill Nbca Liquid Emolic System,1.0,0.65,,,0
HCPCS,C1889,Hc Ide G230146 Envision - Flexnav Delivery,1535.85,998.3,,,0
HCPCS,C1889,Hc Ide Proj Ide G220141 - Laax Laminar Left Atrial Appendage Closure System,1.02,0.66,,,0
HCPCS,C1889,Hc Implant Not Otherwise Classifed,7804.89,5073.18,,,0
HCPCS,C1889,Hc Non-Implant Device Not Otherwise Classified,7991.45,5194.44,,,0
HCPCS,C1892,Hc Intro/Sheath Cardiac Electrophysiological Peel Away,189.78,123.36,,,0
HCPCS,C1893,Hc Intro/Sheath Cardiac Electrophysiological Not Peel Away,1607.21,1044.69,,,0
HCPCS,C1894,Hc Ide #G210339 - Aveir - Introducer Sheath,1.0,0.65,,,0
HCPCS,C1894,Hc Ide G170166 Clasp 2D2F Guide Sheath,1.0,0.65,,,0
HCPCS,C1894,Hc Ide G190186 Ev Icd Safesheath Ii,95.0,61.75,,,0
HCPCS,C1894,Hc Ide G200319 Modular Atp - Empower Introducer Sheath,1.0,0.65,,,0
HCPCS,C1894,Hc Ide G200319 Modular Atp - Empower Retrieval Catheter,1.0,0.65,,,0
HCPCS,C1894,Hc Introducer Dual Lumen,413.84,269.0,,,0
HCPCS,C1894,Hc Introducer Sheath,205.83,133.79,,,0
HCPCS,C1894,Hc Introducer Sheath Dryseal,1875.78,1219.26,,,0
HCPCS,C1894,Hc Kit Sheath Introducer,131.74,85.63,,,0
HCPCS,C1895,Hc Lead Icd Dual Coil,13226.38,8597.15,,,0
HCPCS,C1896,Hc Ide G170215 Unpinning Icd Lead,1.0,0.65,,,0
HCPCS,C1896,Hc Ide G190186 Ev Icd Icd Lead,6295.0,4091.75,,,0
HCPCS,C1896,Noncdm Charge Record Medical Supplies,14116.66,9175.83,,,0
HCPCS,C1897,Hc Lead Neurostim Multi Lead Trialing Cable,555.98,361.39,,,0
HCPCS,C1897,Hc Lead Neurostim Test Kit,2172.48,1412.11,,,0
HCPCS,C1898,Hc Lead Pacemaker Not Transvenous Vdd Sgl Pass,930.08,604.55,,,0
HCPCS,C1900,Hc Lead Coronary Venous System,4431.39,2880.4,,,0
HCPCS,C1982,Hc Catheter Pressure Gen W One Way Valve Occlusive,23805.68,15473.69,,,0
HCPCS,C2596,"Probe, robotic, water-jet",,,20001.0,20001.0,1
HCPCS,C2613,Hc Lung Biopsy Plug With Delivery System,1075.1,698.82,,,0
HCPCS,C2616,"Brachytx, non-str,Yttrium-90",,,17771.01,17771.01,1
HCPCS,C2616,Hc Yttrium-90 Nonstranded Per Source,58208.72,37835.67,,,0
HCPCS,C2616,Noncdm Charge Record Medical Supplies,54522.68,35439.74,,,0
HCPCS,C2617,Hc Stent Non Coronary Temp Wo Deliv,389.19,252.97,,,0
HCPCS,C2618,Hc Probe Cryoablation,5342.37,3472.54,,,0
HCPCS,C2621,Hc Pacemaker Other Than Sgl Or Dual Chamber,13682.47,8893.61,,,0
HCPCS,C2622,Hc Prosthesis Penile Non Inflatable,30647.19,19920.67,,,0
HCPCS,C2623,Hc Catheter Ta Drug-Coated Non-Laser,5887.81,3827.08,,,0
HCPCS,C2623,Hc Ide G150121 Transcend Surveil Drug Coated Balloon Catheter,1.0,0.65,,,0
HCPCS,C2623,Hc Ide G180263 Iclas Af Cryoablation System,1.0,0.65,,,0
HCPCS,C2623,Hc Ide G210320 Selution Slr De Balloon,1.02,0.66,,,0
HCPCS,C2624,Hc Ide G170258 Guide Hf Cardiomems Hf System,21500.0,13975.0,,,0
HCPCS,C2624,Hc Wireless Pressure Sensor Incl All Components,66041.55,42927.01,,,0
HCPCS,C2625,Hc Mometasone Furoate Propel Implant 370 Mcgs Per 10 Mcg,3377.11,2195.12,,,0
HCPCS,C2625,Hc Stent Non Coronary Temp W Deliv,700.73,455.47,,,0
HCPCS,C2627,Hc Catheter Suprapubic,193.7,125.9,,,0
HCPCS,C2628,Hc Catheter Occlusion,2501.04,1625.68,,,0
HCPCS,C2628,Hc Catheter Reboa,7190.44,4673.79,,,0
HCPCS,C2628,Hc Ide G150107 Amaze Occlusion Balloon,650.0,422.5,,,0
HCPCS,C2628,Hc Ide G180213/ S028 - Venus Hf Precardia Balloon Occlusion Cath,1.02,0.66,,,0
HCPCS,C2629,Hc Introducer Sheath Not Guid Ep Laser,10108.77,6570.7,,,0
HCPCS,C2630,Hc Catheter Ep Abl Not 3D Cooltip,6131.82,3985.68,,,0
HCPCS,C2630,Hc Ide G210170 Sphere-9 Mapping And Ablation Catheter,1.0,0.65,,,0
HCPCS,C2638,Hc Brachytherapy Source I 125 Stranded Per Source,77.82,50.58,,,0
HCPCS,C2639,Hc Brachytherapy Source I 125 Nonstranded Per Source,53.24,34.61,,,0
HCPCS,C5271,Hc Low Cost Appl Skn Grft Trunk Arm Leg 100 Cm 1St 25 Cm,1327.0,862.55,,,0
HCPCS,C5271,Low cost skin substitute app,,,3714.0,3714.0,1
HCPCS,C5272,Hc Low Cost Appl Sg Trnk Arms Legs 100 Cm; Ea Add 25 Cm,1006.0,653.9,,,0
HCPCS,C5273,Hc Low Cost Appl Sg Trnk Arm Leg 100Cm Or More 1St 100 Cm,1750.0,1137.5,,,0
HCPCS,C5273,Low cost skin substitute app,,,9206.0,9206.0,1
HCPCS,C5274,Hc Low Cost Appl Sg Trnk Arm Leg 100Cm Or More Add 100 Cm,1006.0,653.9,,,0
HCPCS,C5275,Hc Low Cost Appl Sg Hhfg To 100 Cm 1St 25 Cm,1909.0,1240.85,,,0
HCPCS,C5275,Low cost skin substitute app,,,3714.0,3714.0,1
HCPCS,C5276,Hc Low Cost Appl Sg Hhfg To 100 Cm Ea Addl 25 Cm,1006.0,653.9,,,0
HCPCS,C5277,Low cost skin substitute app,,,3714.0,3714.0,1
HCPCS,C7500,Deb bone 20 cm2 w/drug dev,,,9206.0,9206.0,1
HCPCS,C7501,Perc bx breast lesions stero,,,9206.0,9206.0,1
HCPCS,C7502,Perc bx breast lesions mr,,,9206.0,9206.0,1
HCPCS,C7503,Open exc cerv node(s) w/ id,,,9206.0,9206.0,1
HCPCS,C7504,Perq cvt&ls inj vert bodies,,,15689.0,15689.0,1
HCPCS,C7505,Perq ls&cvt inj vert bodies,,,15689.0,15689.0,1
HCPCS,C7506,Fusion of finger joints,,,31685.0,31685.0,1
HCPCS,C7507,Perq thor&lumb vert aug,,,31685.0,31685.0,1
HCPCS,C7508,Perq lumb&thor vert aug,,,31685.0,31685.0,1
HCPCS,C7509,Dx bronch w/ navigation,,,9206.0,9206.0,1
HCPCS,C7510,Bronch/lavag w/ navigation,,,9206.0,9206.0,1
HCPCS,C7511,Bronch/bpsy(s) w/ navigation,,,9206.0,9206.0,1
HCPCS,C7512,Bronch/bpsy(s) w/ ebus,,,15689.0,15689.0,1
HCPCS,C7513,Cath/angio dialcir w/aplasty,,,30765.0,30765.0,1
HCPCS,C7514,Cath/angio dial cir w/stents,,,30765.0,30765.0,1
HCPCS,C7515,Cath/angio dial cir w/embol,,,38216.0,38216.0,1
HCPCS,C7516,Cor angio w/ ivus or oct,,,15689.0,15689.0,1
HCPCS,C7517,Cor angio w/ilic/fem angio,,,15689.0,15689.0,1
HCPCS,C7518,Cor/gft angio w/ ivus or oct,,,15689.0,15689.0,1
HCPCS,C7519,Cor/gft angio w/ flow resrv,,,15689.0,15689.0,1
HCPCS,C7520,Cor/gft angio w/ilic/fem ang,,,15689.0,15689.0,1
HCPCS,C7521,R hrt angio w/ ivus or oct,,,15689.0,15689.0,1
HCPCS,C7522,R hrt angio w/flow resrv,,,15689.0,15689.0,1
HCPCS,C7523,L hrt angio w/ ivus or oct,,,15689.0,15689.0,1
HCPCS,C7524,L hrt angio w/flow resrv,,,15689.0,15689.0,1
HCPCS,C7525,L hrt gft ang w/ ivus or oct,,,15689.0,15689.0,1
HCPCS,C7526,L hrt gft ang w/flow resrv,,,15689.0,15689.0,1
HCPCS,C7527,R&l hrt angio w/ ivus or oct,,,15689.0,15689.0,1
HCPCS,C7528,R&l hrt angio w/flow resrv,,,15689.0,15689.0,1
HCPCS,C7529,R&l hrt gft ang w/flow resrv,,,15689.0,15689.0,1
HCPCS,C7530,Cath/aplasty dial cir w/stnt,,,38216.0,38216.0,1
HCPCS,C7531,Angio fem/pop w/ us,,,38216.0,38216.0,1
HCPCS,C7532,Angio w/ us non-coronary,,,30765.0,30765.0,1
HCPCS,C7533,Ptca w/ plcmt brachytx dev,,,30765.0,30765.0,1
HCPCS,C7534,Fem/pop revasc w/arthr & us,,,63079.0,63079.0,1
HCPCS,C7535,Fem/pop revasc w/stent & us,,,63079.0,63079.0,1
HCPCS,C7537,Insrt atril pm w/l vent lead,,,38216.0,38216.0,1
HCPCS,C7538,Insrt vent pm w/l vent lead,,,15689.0,15689.0,1
HCPCS,C7539,Insrt a & v pm w/l vent lead,,,63079.0,63079.0,1
HCPCS,C7540,Rmv&rplc pm dul w/l vnt lead,,,38216.0,38216.0,1
HCPCS,C7541,Ercp w/ pancreatoscopy,,,15689.0,15689.0,1
HCPCS,C7542,Ercp w/bx & pancreatoscopy,,,15689.0,15689.0,1
HCPCS,C7543,"Ercp w/otomy, pancreatoscopy",,,15689.0,15689.0,1
HCPCS,C7544,Ercp rmv calc pancreatoscopy,,,20001.0,20001.0,1
HCPCS,C7545,Exch bil cath w/ rmv calculi,,,15689.0,15689.0,1
HCPCS,C7546,Rep nph/urt cath w/dil stric,,,9206.0,9206.0,1
HCPCS,C7547,Cnvrt neph cath w/ dil stric,,,9206.0,9206.0,1
HCPCS,C7548,Exch neph cath w/ dil stric,,,9206.0,9206.0,1
HCPCS,C7549,Chge urtr stent w/ dil stric,,,9206.0,9206.0,1
HCPCS,C7550,Cysto w/ bx(s) w/ blue light,,,9206.0,9206.0,1
HCPCS,C7551,Exc neuroma w/ implnt nv end,,,9206.0,9206.0,1
HCPCS,C7552,R hrt art/grft ang hrt flow,,,15689.0,15689.0,1
HCPCS,C7553,R&l hrt art/vent ang drg ad,,,15689.0,15689.0,1
HCPCS,C7554,Cystureth blu li cyst fl img,,,3714.0,3714.0,1
HCPCS,C7555,Rmvl thyrd w/autotran parath,,,26701.0,26701.0,1
HCPCS,C7556,Bronch lavage w/ebus,,,15689.0,15689.0,1
HCPCS,C7557,Cor angio/vent w/ffr,,,15689.0,15689.0,1
HCPCS,C7558,Cor angio/vent w/drug admin,,,15689.0,15689.0,1
HCPCS,C7562,R&l hrt angio w/ffr & 3d map,,,15689.0,15689.0,1
HCPCS,C7563,Trluml ballo angiop all art,,,30765.0,30765.0,1
HCPCS,C7564,Vein mech throm w/intrvas us,,,30765.0,30765.0,1
HCPCS,C7565,Rpr aa hrn < 3 rdc w/ rmvl,,,15689.0,15689.0,1
HCPCS,C7901,"Hopd mntl hlt, 30-60 min",,,97.95,97.95,1
HCPCS,C8001,3d anat seg imaging preop,,,124.07,124.07,1
HCPCS,C8002,"Prep skin cell susp, automtd",,,6842.88,31685.0,2
HCPCS,C8003,Imp extar knee shck absrb,,,16906.49,38216.0,2
HCPCS,C8004,Sim ang w/prs cath rad emb,,,11131.16,11131.16,1
HCPCS,C8006,Inst pleu-perit shnt w pump,,,6242.2,6242.2,1
HCPCS,C8900,"Mra w/cont, abd",,,336.39,336.39,1
HCPCS,C8901,"Mra w/o cont, abd",,,230.07,230.07,1
HCPCS,C8902,"Mra w/o fol w/cont, abd",,,336.39,336.39,1
HCPCS,C8903,"Mri w/cont, breast,  uni",,,169.13,169.13,1
HCPCS,C8905,"Mri w/o fol w/cont, brst, un",,,336.39,336.39,1
HCPCS,C8906,"Mri w/cont, breast,  bi",,,336.39,336.39,1
HCPCS,C8908,"Mri w/o fol w/cont, breast,",,,336.39,336.39,1
HCPCS,C8909,"MRA w/cont, chest",,,336.39,336.39,1
HCPCS,C8910,"MRA w/o cont, chest",,,230.07,230.07,1
HCPCS,C8911,"MRA w/o fol w/cont, chest",,,336.39,336.39,1
HCPCS,C8912,"Mra w/cont, lwr ext",,,336.39,336.39,1
HCPCS,C8913,"Mra w/o cont, lwr ext",,,230.07,230.07,1
HCPCS,C8914,"Mra w/o fol w/cont, lwr ext",,,336.39,336.39,1
HCPCS,C8918,"MRA w/cont, pelvis",,,336.39,336.39,1
HCPCS,C8919,"MRA w/o cont, pelvis",,,230.07,230.07,1
HCPCS,C8920,"Mra w/o fol w/cont, pelvis",,,336.39,336.39,1
HCPCS,C8921,Hc Echo Congen Cardiac Anomaly Comp W Cont,2993.0,1945.45,,,0
HCPCS,C8921,"Tte w or w/o fol w/cont, com",,,755.87,755.87,1
HCPCS,C8922,"Tte w or w/o fol w/cont, f/u",,,755.87,755.87,1
HCPCS,C8923,"2d tte w or w/o fol w/con,co",,,755.87,755.87,1
HCPCS,C8923,Hc Echo Complete Wo Doppler W Contrast,2461.0,1599.65,,,0
HCPCS,C8924,"2d tte w or w/o fol w/con,fu",,,336.39,336.39,1
HCPCS,C8924,Hc Echo Limited Or Follow Up W Contrast,1725.0,1121.25,,,0
HCPCS,C8925,"2d tee w or w/o fol w/con,in",,,755.87,755.87,1
HCPCS,C8925,Hc Echo Tee Complete W Contrast,2725.0,1771.25,,,0
HCPCS,C8926,"Tee w or w/o fol w/cont,cong",,,755.87,755.87,1
HCPCS,C8927,"TEE w or w/o fol w/cont, mon",,,755.87,755.87,1
HCPCS,C8928,Hc Echo Rest And Stress W Contrast,2473.0,1607.45,,,0
HCPCS,C8928,"Tte w or w/o fol w/con,stres",,,755.87,755.87,1
HCPCS,C8929,Hc Echo Complete W Doppler W Contrast,2408.0,1565.2,,,0
HCPCS,C8929,"TTE w or wo fol wcon,Doppler",,,755.87,755.87,1
HCPCS,C8930,"TTE w or w/o contr, cont ECG",,,755.87,755.87,1
HCPCS,C8931,"MRA, w/dye, spinal canal",,,336.39,336.39,1
HCPCS,C8932,"MRA, w/o dye, spinal canal",,,230.07,230.07,1
HCPCS,C8933,"MRA, w/o&w/dye, spinal canal",,,336.39,336.39,1
HCPCS,C8934,"MRA, w/dye, upper extremity",,,336.39,336.39,1
HCPCS,C8935,"MRA, w/o dye, upper extr",,,230.07,230.07,1
HCPCS,C8936,"MRA, w/o&w/dye, upper extr",,,336.39,336.39,1
HCPCS,C8937,Hc Mri Breast Cad Unilat Or Bilat,1.0,0.65,,,0
HCPCS,C8957,Hc Infusion More Than 8 Hrs W Pump Nonchemo,1915.0,1244.75,,,0
HCPCS,C8957,"Prolonged iv inf, req pump",,,205.09,205.09,1
HCPCS,C9046,COCAINE 4 % NASAL SOLUTION,960.85,624.55,,,0
HCPCS,C9046,Cocaine hcl nasal solution,,,3.58,3.58,2
HCPCS,C9047,CAPLACIZUMAB-YHDP 11 MG INJECTION KIT,35638.3,23164.9,,,0
HCPCS,C9047,CAPLACIZUMAB-YHDP 11 MG SOLUTION FOR INJECTION,35638.3,23164.9,,,0
HCPCS,C9047,"Injection, caplacizumab-yhdp",,,802.49,1753.29,3
HCPCS,C9047,Noncdm Charge Record Pharmacy,3240.14,2106.09,,,0
HCPCS,C9067,Gallium ga-68 dotatoc,,,3.61,17.74,5
HCPCS,C9088,"Instill, bupivac and meloxic",,,1.78,2.09,4
HCPCS,C9088,Noncdm Charge Record Pharmacy,3.76,2.44,,,0
HCPCS,C9089,"Bupivacaine implant, 1 mg",,,1.94,1.94,2
HCPCS,C9101,"Inj, oliceridine 0.1 mg",,,3.02,3.58,4
HCPCS,C9113,Noncdm Charge Record Pharmacy,46.42,30.17,,,0
HCPCS,C9143,Cocaine hcl nasal (numbrino),,,5.24,5.24,2
HCPCS,C9143,Noncdm Charge Record Pharmacy,5.83,3.79,,,0
HCPCS,C9144,"Inj, bupivacaine (posimir)",,,1.12,1.36,4
HCPCS,C9145,"Inj, aponvie, 1 mg",,,1.91,5.04,5
HCPCS,C9163,Noncdm Charge Record Pharmacy,272.58,177.18,,,0
HCPCS,C9173,"Inj, nypozi, 1 mcg",,,1.22,1.46,4
HCPCS,C9248,"Inj, clevidipine butyrate",,,7.59,8.0,4
HCPCS,C9250,Artiss fibrin sealant,,,141.89,364.5,3
HCPCS,C9250,Hc Sealant Fibrin Human Plasma (Artiss) Per 2Ml,710.76,461.99,,,0
HCPCS,C9254,"Injection, lacosamide",,,0.47,0.47,2
HCPCS,C9254,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,86.15,56.0,,,0
HCPCS,C9254,Noncdm Charge Record Pharmacy,0.77,0.5,,,0
HCPCS,C9257,BEVACIZUMAB (AVASTIN) INTRAVITREAL SOLUTION 1.25 MG/0.05 ML,123.4,80.21,,,0
HCPCS,C9257,Bevacizumab injection,,,1.83,4.96,5
HCPCS,C9285,"Patch, lidocaine/tetracaine",,,39.66,39.66,2
HCPCS,C9290,Noncdm Charge Record Pharmacy,8.0,5.2,,,0
HCPCS,C9293,"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",179416.9,116620.98,,,0
HCPCS,C9293,"Injection, glucarpidase",,,427.72,999.39,3
HCPCS,C9352,Hc Nerve Guide Per Cm Length,2410.06,1566.54,,,0
HCPCS,C9353,Hc Neurowrap Per Cm Length,1733.04,1126.48,,,0
HCPCS,C9356,Hc Tenoglide Tendon Protector Per Sq Cm,89.67,58.29,,,0
HCPCS,C9359,Hc Bone Filler Putty Per .5Cc,5679.57,3691.72,,,0
HCPCS,C9399,(COMPOUNDING ONLY) EPCORITAMAB 1.6 MG/2ML IN NS,4006.05,2603.93,,,0
HCPCS,C9399,INV NTLA-2001/PLACEBO INJECTION,0.65,0.42,,,0
HCPCS,C9399,INV REMDESIVIR/PLACEBO 5 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,C9399,INV SATRALIZUMAB 120 MG/ML SYRINGE,0.65,0.42,,,0
HCPCS,C9399,INV SATRALIZUMAB 60 MG/0.5 ML SYRINGE,0.65,0.42,,,0
HCPCS,C9399,INV SATRALIZUMAB/PLACEBO 120 MG/ML SYRINGE,0.65,0.42,,,0
HCPCS,C9399,Noncdm Charge Record Pharmacy,7042.17,4577.41,,,0
HCPCS,C9460,CANGRELOR 50 MG INTRAVENOUS SOLUTION,4666.5,3033.22,,,0
HCPCS,C9460,"Injection, cangrelor",,,19.98,51.0,5
HCPCS,C9460,Noncdm Charge Record Pharmacy,93.33,60.66,,,0
HCPCS,C9462,"Injection, delafloxacin",,,1.1,1.1,2
HCPCS,C9482,Sotalol hydrochloride IV,,,25.05,61.73,5
HCPCS,C9488,Conivaptan HCL,,,104.29,104.29,2
HCPCS,C9600,Hc De Stent Sgl Maj Cor Artery Or Branch,16245.0,10559.25,,,0
HCPCS,C9600,Perc drug-el cor stent sing,,,11131.16,38216.0,2
HCPCS,C9601,Hc De Stent Ea Addl Maj Cor Artery Or Branch,7231.0,4700.15,,,0
HCPCS,C9602,Hc De Stent W Ather Maj Cor Artery Or Branch,19973.0,12982.45,,,0
HCPCS,C9602,Perc d-e cor stent ather s,,,17675.76,63079.0,2
HCPCS,C9603,Hc De Stent W Atherectomyaddl Branch,15784.0,10259.6,,,0
HCPCS,C9604,Hc Revasc Cabg De Stent,17209.0,11185.85,,,0
HCPCS,C9604,Perc d-e cor revasc t cabg s,,,11131.16,38216.0,2
HCPCS,C9605,Hc Revasc De Stent Add Brnch Cabg,7393.0,4805.45,,,0
HCPCS,C9606,Hc Revasc Occ During Mi De Stent Sgl,20699.0,13454.35,,,0
HCPCS,C9606,Perc d-e cor revasc w AMI s,,,63079.0,63079.0,1
HCPCS,C9607,Hc Revasc Chronic Occ De Stent Sgl Vessel,26495.0,17221.75,,,0
HCPCS,C9607,Perc d-e cor revasc chro sin,,,17675.76,63079.0,2
HCPCS,C9608,Hc Revasc Chronic Occ De Stent Addl Vessel,11261.0,7319.65,,,0
HCPCS,C9725,Place endorectal app,,,896.69,896.69,1
HCPCS,C9727,Insert palate implants,,,1496.07,1496.07,1
HCPCS,C9728,"Place device/marker, non pro",,,1334.61,9206.0,2
HCPCS,C9733,Non-ophthalmic FVA,,,336.39,336.39,1
HCPCS,C9734,"U/s trtmt, not leiomyomata",,,12379.34,38216.0,2
HCPCS,C9739,Cystoscopy prostatic imp 1-3,,,5169.96,20001.0,2
HCPCS,C9740,Cysto impl 4 or more,,,9127.77,38216.0,2
HCPCS,C9751,Hc Bronchoscopy By Microwave Energy,21438.0,13934.7,,,0
HCPCS,C9751,"Microwave bronch, 3d, ebus",,,38216.0,38216.0,1
HCPCS,C9752,Hc Destrct Intraosseous Basivet Nerve First 2 Vert Incl Img Guid,13559.0,8813.35,,,0
HCPCS,C9753,Hc Destrct Of Intraosseous Basivetnerve Ea Addl Incl Img Guid,986.0,640.9,,,0
HCPCS,C9757,Spine/lumbar disk surgery,,,12379.34,38216.0,2
HCPCS,C9758,Interatrial shunt IDE,,,16516.62,38216.0,2
HCPCS,C9760,Non-blind interatrial shunt,,,25954.42,38216.0,2
HCPCS,C9761,"Cysto, litho, vacuum kidney",,,9127.77,20001.0,2
HCPCS,C9762,Cardiac MRI seg dys strain,,,526.87,526.87,1
HCPCS,C9763,Cardiac MRI seg dys stress,,,526.87,526.87,1
HCPCS,C9764,Hc Revas Intravasc Lithotripsy Incl Angioplasty,21131.0,13735.15,,,0
HCPCS,C9764,Revasc intravasc lithotripsy,,,11131.16,30765.0,2
HCPCS,C9765,Hc Revas Intravsc Lithotrip And Transluminal Stent Plcmt Incl Angio,25299.0,16444.35,,,0
HCPCS,C9765,Revasc intra lithotrip-stent,,,17675.76,38216.0,2
HCPCS,C9766,Hc Revas Intravasc Lithotrip And Atherectomy Incl Angio,25299.0,16444.35,,,0
HCPCS,C9766,Revasc intra lithotrip-ather,,,17675.76,38216.0,2
HCPCS,C9767,Hc Revas Intravasc Lithotrip Translum Stent And Atherect Incl Angio,28110.0,18271.5,,,0
HCPCS,C9767,Revasc lithotrip-stent-ather,,,17675.76,63079.0,2
HCPCS,C9769,Cysto w/temp pros implant,,,20001.0,20001.0,1
HCPCS,C9772,Hc Revas Endo Lithotrip Tibial Peroneal Artery Angio,25299.0,16444.35,,,0
HCPCS,C9772,Revasc lithotrip tibi/perone,,,11131.16,38216.0,2
HCPCS,C9773,Hc Revas Endo Lithotr Tib Per Stent Angio,28110.0,18271.5,,,0
HCPCS,C9773,Revasc lithotr-stent tib/per,,,17675.76,63079.0,2
HCPCS,C9774,Hc Revas Endo Lithotr Atherectomy Tib Per Angio,28110.0,18271.5,,,0
HCPCS,C9774,Revasc lithotr-ather tib/per,,,17675.76,63079.0,2
HCPCS,C9775,Hc Revas Endo Lithotr Atherectomy Tib Per Stent Angio,28110.0,18271.5,,,0
HCPCS,C9775,Revasc lith-sten-ath tib/per,,,17675.76,63079.0,2
HCPCS,C9777,Esophag mucosal integ add-on,,,3717.53,3717.53,1
HCPCS,C9777,Hc Esophageal Mucosal Integrity Test By Electrical Impedance,8134.0,5287.1,,,0
HCPCS,C9778,"Colpopexy, min/inv, ex-perit",,,4823.47,20001.0,2
HCPCS,C9779,ESD endoscopy or colonoscopy,,,3717.53,9206.0,2
HCPCS,C9779,Hc Endoscopic Submucosal Dissection Endoscopy Or Colonoscopy,4140.0,2691.0,,,0
HCPCS,C9780,Insert cv cath inf & sup app,,,7786.66,38216.0,2
HCPCS,C9781,Arthro/shoul surg; w/spacer,,,12379.34,31685.0,2
HCPCS,C9782,Blind myocar trpl bon marrow,,,16516.62,38216.0,2
HCPCS,C9783,Blind cor sinus reducer impl,,,11131.16,38216.0,2
HCPCS,C9784,Endo sleeve gastro w/tube,,,38216.0,38216.0,1
HCPCS,C9785,Endo outlet restrict w/tube,,,10249.52,38216.0,2
HCPCS,C9789,Instill pharm renal pelvis,,,1180.2,9206.0,2
HCPCS,C9792,Blind/nonblind trans atrial,,,9202.33,38216.0,2
HCPCS,C9793,Pre-plan 3d model w/ccta,,,828.02,828.02,1
HCPCS,C9796,Rpr intst excl anrect fist,,,2676.35,9206.0,2
HCPCS,C9797,Vasc emb/occ w/prs cath,,,17675.76,63079.0,2
HCPCS,C9898,Inpnt stay radiolabeled item,,,0.02,0.02,2
HCPCS,C9901,Endo defect closure GI tract,,,10249.52,38216.0,2
HCPCS,D0120,Periodic oral evaluation,,,128.37,128.37,1
HCPCS,D0140,Limit oral eval problm focus,,,128.37,128.37,1
HCPCS,D0150,Comprehensve oral evaluation,,,128.37,128.37,1
HCPCS,D0160,Extensv oral eval prob focus,,,128.37,128.37,1
HCPCS,D0170,"Re-eval,est pt,problem focus",,,128.37,128.37,1
HCPCS,D0171,Re-eval post-op visit,,,128.37,128.37,1
HCPCS,D0180,Comp periodontal evaluation,,,128.37,128.37,1
HCPCS,D0191,Assessment of a patient,,,128.37,128.37,1
HCPCS,D0210,Intraor complete film series,,,230.07,230.07,1
HCPCS,D0220,Intraoral periapical first,,,83.91,83.91,1
HCPCS,D0240,Intraoral occlusal film,,,83.91,83.91,1
HCPCS,D0250,Extraoral 2d project image,,,83.91,83.91,1
HCPCS,D0251,Extraoral posterior image,,,83.91,83.91,1
HCPCS,D0270,Dental bitewing single image,,,83.91,83.91,1
HCPCS,D0272,Dental bitewings two images,,,83.91,83.91,1
HCPCS,D0273,Bitewings - three images,,,230.07,230.07,1
HCPCS,D0274,Bitewings four images,,,230.07,230.07,1
HCPCS,D0277,Vert bitewings 7 to 8 images,,,230.07,230.07,1
HCPCS,D0310,Dental saliography,,,230.07,230.07,1
HCPCS,D0320,Dental tmj arthrogram incl i,,,230.07,230.07,1
HCPCS,D0321,Other tmj images by report,,,83.91,83.91,1
HCPCS,D0322,Dental tomographic survey,,,100.81,100.81,1
HCPCS,D0330,Panoramic image,,,230.07,230.07,1
HCPCS,D0340,2d cephalometric image,,,83.91,83.91,1
HCPCS,D0350,Oral/facial photo images,,,83.91,83.91,1
HCPCS,D0364,Cone beam ct capt & interp,,,100.81,100.81,1
HCPCS,D0365,Cone beam ct interprete man,,,100.81,100.81,1
HCPCS,D0366,Cone beam ct interprete max,,,100.81,100.81,1
HCPCS,D0367,Cone beam ct interp both jaw,,,100.81,100.81,1
HCPCS,D0368,Cone beam ct interprete TMJ,,,100.81,100.81,1
HCPCS,D0369,Max MRI capture & interprete,,,100.81,100.81,1
HCPCS,D0370,Max ultrasound capt & interp,,,100.81,100.81,1
HCPCS,D0371,Sialoendoscopy capt & interp,,,83.91,83.91,1
HCPCS,D0380,Cone beam ct capture limited,,,100.81,100.81,1
HCPCS,D0381,Cone beam ct capt mandible,,,100.81,100.81,1
HCPCS,D0382,Cone beam ct capt maxilla,,,100.81,100.81,1
HCPCS,D0383,Cone beam ct both jaws,,,100.81,100.81,1
HCPCS,D0384,Cone beam ct capture TMJ,,,100.81,100.81,1
HCPCS,D0385,Max MRI image capture,,,100.81,100.81,1
HCPCS,D0386,Max ultrasound image capture,,,100.81,100.81,1
HCPCS,D0393,Trtmnt simulation 3d image,,,83.91,83.91,1
HCPCS,D0394,Digital sub 2 or more images,,,83.91,83.91,1
HCPCS,D0395,Fusion 2 or more 3d images,,,83.91,83.91,1
HCPCS,D0460,Pulp vitality test,,,623.36,623.36,1
HCPCS,D0600,Non-ionizing diag proc,,,623.36,623.36,1
HCPCS,D0701,Fracture of lower extremity M >=61.50,,,83.91,83.91,1
HCPCS,D0702,Fracture of lower extremity M >=52.50 and M <61.50,,,83.91,83.91,1
HCPCS,D0703,Fracture of lower extremity M >=41.50 and M <52.50,,,83.91,83.91,1
HCPCS,D0705,Extra oral post radio image,,,83.91,83.91,1
HCPCS,D0706,Intraoral occlus radio image,,,83.91,83.91,1
HCPCS,D0707,Intraoral periap radio image,,,83.91,83.91,1
HCPCS,D0708,Intraoral bite radio image,,,83.91,83.91,1
HCPCS,D0709,Intraoral cmplt radio images,,,83.91,83.91,1
HCPCS,D1110,Dental prophylaxis adult,,,128.37,128.37,1
HCPCS,D1510,Space maintainer fxd unilat,,,623.36,623.36,1
HCPCS,D1516,"Fixed bilat space maint, max",,,623.36,623.36,1
HCPCS,D1517,"Fixed bilat space maint, man",,,623.36,623.36,1
HCPCS,D1520,Remove unilat space maintain,,,623.36,623.36,1
HCPCS,D1526,"Remove bilat space main, max",,,623.36,623.36,1
HCPCS,D1527,"Remove bilat space main, man",,,623.36,623.36,1
HCPCS,D1551,Recement space maint - max,,,623.36,623.36,1
HCPCS,D1552,Recement space maint - man,,,623.36,623.36,1
HCPCS,D1553,Recement unilat space maint,,,623.36,623.36,1
HCPCS,D1575,"Dist space maint, fixed unil",,,623.36,623.36,1
HCPCS,D2140,Amalgam one surface permanen,,,623.36,623.36,1
HCPCS,D2150,Amalgam two surfaces permane,,,623.36,623.36,1
HCPCS,D2160,Amalgam three surfaces perma,,,623.36,623.36,1
HCPCS,D2161,Amalgam 4 or > surfaces perm,,,623.36,623.36,1
HCPCS,D2330,Resin one surface-anterior,,,623.36,623.36,1
HCPCS,D2331,Resin two surfaces-anterior,,,623.36,623.36,1
HCPCS,D2332,Resin three surfaces-anterio,,,623.36,623.36,1
HCPCS,D2335,Resin 4/> surf or w incis an,,,623.36,623.36,1
HCPCS,D2390,Ant resin-based cmpst crown,,,623.36,623.36,1
HCPCS,D2391,Post 1 srfc resinbased cmpst,,,623.36,623.36,1
HCPCS,D2392,Post 2 srfc resinbased cmpst,,,623.36,623.36,1
HCPCS,D2393,Post 3 srfc resinbased cmpst,,,623.36,623.36,1
HCPCS,D2394,Post >=4srfc resinbase cmpst,,,623.36,623.36,1
HCPCS,D2410,Dental gold foil one surface,,,623.36,623.36,1
HCPCS,D2420,Dental gold foil two surface,,,623.36,623.36,1
HCPCS,D2430,Dental gold foil three surfa,,,623.36,623.36,1
HCPCS,D2510,Dental inlay metalic 1 surf,,,623.36,623.36,1
HCPCS,D2520,Dental inlay metallic 2 surf,,,623.36,623.36,1
HCPCS,D2530,Dental inlay metl 3/more sur,,,623.36,623.36,1
HCPCS,D2542,Dental onlay metallic 2 surf,,,623.36,623.36,1
HCPCS,D2543,Dental onlay metallic 3 surf,,,623.36,623.36,1
HCPCS,D2544,Dental onlay metl 4/more sur,,,623.36,623.36,1
HCPCS,D2610,Inlay porcelain/ceramic 1 su,,,623.36,623.36,1
HCPCS,D2620,Inlay porcelain/ceramic 2 su,,,623.36,623.36,1
HCPCS,D2630,Dental onlay porc 3/more sur,,,623.36,623.36,1
HCPCS,D2642,Dental onlay porcelin 2 surf,,,623.36,623.36,1
HCPCS,D2643,Dental onlay porcelin 3 surf,,,623.36,623.36,1
HCPCS,D2644,Dental onlay porc 4/more sur,,,623.36,623.36,1
HCPCS,D2650,Inlay composite/resin one su,,,623.36,623.36,1
HCPCS,D2651,Inlay composite/resin two su,,,623.36,623.36,1
HCPCS,D2652,Dental inlay resin 3/mre sur,,,623.36,623.36,1
HCPCS,D2662,Dental onlay resin 2 surface,,,623.36,623.36,1
HCPCS,D2663,Dental onlay resin 3 surface,,,623.36,623.36,1
HCPCS,D2664,Dental onlay resin 4/mre sur,,,623.36,623.36,1
HCPCS,D2710,Crown resin-based indirect,,,623.36,623.36,1
HCPCS,D2712,Crown 3/4 resin-based compos,,,623.36,623.36,1
HCPCS,D2720,Crown resin w/ high noble me,,,623.36,623.36,1
HCPCS,D2721,Crown resin w/ base metal,,,623.36,623.36,1
HCPCS,D2722,Crown resin w/ noble metal,,,623.36,623.36,1
HCPCS,D2740,Crown porcelain/ceramic subs,,,623.36,623.36,1
HCPCS,D2750,Crown porcelain w/ h noble m,,,623.36,623.36,1
HCPCS,D2751,Crown porcelain fused base m,,,623.36,623.36,1
HCPCS,D2752,Crown porcelain w/ noble met,,,623.36,623.36,1
HCPCS,D2753,Crown porc fused to titanium,,,623.36,623.36,1
HCPCS,D2780,Crown 3/4 cast hi noble met,,,623.36,623.36,1
HCPCS,D2781,Crown 3/4 cast base metal,,,623.36,623.36,1
HCPCS,D2782,Crown 3/4 cast noble metal,,,623.36,623.36,1
HCPCS,D2783,Crown 3/4 porcelain/ceramic,,,623.36,623.36,1
HCPCS,D2790,Crown full cast high noble m,,,623.36,623.36,1
HCPCS,D2791,Crown full cast base metal,,,623.36,623.36,1
HCPCS,D2792,Crown full cast noble metal,,,623.36,623.36,1
HCPCS,D2794,Crown-titanium,,,623.36,623.36,1
HCPCS,D2799,Provisional crown,,,623.36,623.36,1
HCPCS,D2910,Recement inlay onlay or part,,,623.36,623.36,1
HCPCS,D2915,Recement cast or prefab post,,,623.36,623.36,1
HCPCS,D2920,Re-cement or re-bond crown,,,623.36,623.36,1
HCPCS,D2921,Reattach tooth fragment,,,623.36,623.36,1
HCPCS,D2928,Prefab porc/cer crown perm,,,623.36,623.36,1
HCPCS,D2929,Prefab porc/ceram crown pri,,,623.36,623.36,1
HCPCS,D2930,Prefab stnlss steel crwn pri,,,623.36,623.36,1
HCPCS,D2931,Prefab stnlss steel crown pe,,,623.36,623.36,1
HCPCS,D2932,Prefabricated resin crown,,,623.36,623.36,1
HCPCS,D2933,Prefab stainless steel crown,,,623.36,623.36,1
HCPCS,D2934,Prefab steel crown primary,,,623.36,623.36,1
HCPCS,D2940,Protective restoration,,,623.36,623.36,1
HCPCS,D2949,Restorative foundation,,,623.36,623.36,1
HCPCS,D2950,Core build-up incl any pins,,,623.36,623.36,1
HCPCS,D2951,Tooth pin retention,,,623.36,623.36,1
HCPCS,D2952,Post and core cast + crown,,,623.36,623.36,1
HCPCS,D2954,Prefab post/core + crown,,,623.36,623.36,1
HCPCS,D2957,Each addtnl prefab post,,,623.36,623.36,1
HCPCS,D2960,Laminate labial veneer,,,623.36,623.36,1
HCPCS,D2961,Lab labial veneer resin,,,623.36,623.36,1
HCPCS,D2962,Lab labial veneer porcelain,,,623.36,623.36,1
HCPCS,D2971,Add proc construct new crown,,,623.36,623.36,1
HCPCS,D2975,Coping,,,623.36,623.36,1
HCPCS,D2980,Crown repair,,,623.36,623.36,1
HCPCS,D2981,Inlay repair,,,623.36,623.36,1
HCPCS,D2982,Onlay repair,,,623.36,623.36,1
HCPCS,D2983,Veneer repair,,,623.36,623.36,1
HCPCS,D2990,Resin infiltration of lesion,,,623.36,623.36,1
HCPCS,D2999,Dental unspec restorative pr,,,623.36,623.36,1
HCPCS,D3110,Pulp cap direct,,,623.36,623.36,1
HCPCS,D3120,Pulp cap indirect,,,623.36,623.36,1
HCPCS,D3220,Therapeutic pulpotomy,,,623.36,623.36,1
HCPCS,D3221,Gross pulpal debridement,,,623.36,623.36,1
HCPCS,D3222,Part pulp for apexogenesis,,,623.36,623.36,1
HCPCS,D3230,Pulpal therapy anterior prim,,,623.36,623.36,1
HCPCS,D3240,Pulpal therapy posterior pri,,,623.36,623.36,1
HCPCS,D3310,"End thxpy, anterior tooth",,,623.36,623.36,1
HCPCS,D3320,"End thxpy, bicuspid tooth",,,623.36,623.36,1
HCPCS,D3330,"End thxpy, molar",,,623.36,623.36,1
HCPCS,D3331,Non-surg tx root canal obs,,,623.36,623.36,1
HCPCS,D3332,Incomplete endodontic tx,,,623.36,623.36,1
HCPCS,D3333,Internal root repair,,,623.36,623.36,1
HCPCS,D3346,Retreat root canal anterior,,,623.36,623.36,1
HCPCS,D3347,Retreat root canal bicuspid,,,623.36,623.36,1
HCPCS,D3348,Retreat root canal molar,,,623.36,623.36,1
HCPCS,D3351,Apexification/recalc initial,,,623.36,623.36,1
HCPCS,D3352,Apexification/recalc interim,,,623.36,623.36,1
HCPCS,D3353,Apexification/recalc final,,,623.36,623.36,1
HCPCS,D3355,Pulpal regeneration initial,,,623.36,623.36,1
HCPCS,D3356,Pulpal regeneration interim,,,623.36,623.36,1
HCPCS,D3357,Pulpal regeneration complete,,,623.36,623.36,1
HCPCS,D3410,Apicoectomy - anterior,,,623.36,623.36,1
HCPCS,D3421,Root surgery bicuspid,,,623.36,623.36,1
HCPCS,D3425,Root surgery molar,,,623.36,623.36,1
HCPCS,D3428,Bone graft peri per tooth,,,623.36,623.36,1
HCPCS,D3430,Retrograde filling,,,623.36,623.36,1
HCPCS,D3431,Biological materials,,,623.36,623.36,1
HCPCS,D3432,Guided tissue regeneration,,,623.36,623.36,1
HCPCS,D3450,Root amputation,,,623.36,623.36,1
HCPCS,D3460,Endodontic endosseous implan,,,623.36,623.36,1
HCPCS,D3470,Intentional replantation,,,623.36,623.36,1
HCPCS,D3471,Surg rep root res anterior,,,623.36,623.36,1
HCPCS,D3472,Surg rep root res premolar,,,623.36,623.36,1
HCPCS,D3473,Surg rep root res molar,,,623.36,623.36,1
HCPCS,D3501,Surg exp root surf anterior,,,623.36,623.36,1
HCPCS,D3502,Surg exp root surf premolar,,,623.36,623.36,1
HCPCS,D3503,Surg exp root surf molar,,,623.36,623.36,1
HCPCS,D3910,Isolation- tooth w rubb dam,,,623.36,623.36,1
HCPCS,D3911,Intraorifice barrier,,,623.36,623.36,1
HCPCS,D3920,Tooth splitting,,,623.36,623.36,1
HCPCS,D3921,D?cor or submerg erupt tooth,,,623.36,623.36,1
HCPCS,D3950,Canal prep/fitting of dowel,,,623.36,623.36,1
HCPCS,D3999,Endodontic procedure,,,623.36,623.36,1
HCPCS,D4210,Gingivectomy/plasty 4 or mor,,,3196.84,3196.84,1
HCPCS,D4211,Gingivectomy/plasty 1 to 3,,,3196.84,3196.84,1
HCPCS,D4212,Gingivectomy/plasty rest,,,3196.84,3196.84,1
HCPCS,D4230,Ana crown exp 4 or> per quad,,,3196.84,3196.84,1
HCPCS,D4231,Ana crown exp 1-3 per quad,,,1496.07,1496.07,1
HCPCS,D4240,Gingival flap proc w/ planin,,,3196.84,3196.84,1
HCPCS,D4241,Gngvl flap w rootplan 1-3 th,,,1496.07,1496.07,1
HCPCS,D4245,Apically positioned flap,,,1496.07,1496.07,1
HCPCS,D4249,Crown lengthen hard tissue,,,623.36,623.36,1
HCPCS,D4260,Osseous surgery 4 or more,,,5708.03,5708.03,1
HCPCS,D4261,Osseous surg 1 to 3 teeth,,,3196.84,3196.84,1
HCPCS,D4263,Bone replce graft first site,,,623.36,623.36,1
HCPCS,D4265,Bio mtrls to aid soft/os reg,,,623.36,623.36,1
HCPCS,D4266,Guided tiss regen resorble,,,1496.07,1496.07,1
HCPCS,D4267,Guided tiss regen nonresorb,,,1496.07,1496.07,1
HCPCS,D4268,Surgical revision procedure,,,623.36,623.36,1
HCPCS,D4270,Pedicle soft tissue graft pr,,,1496.07,1496.07,1
HCPCS,D4273,Auto tissue graft 1st tooth,,,1496.07,1496.07,1
HCPCS,D4274,Mesial/distal wedge proc,,,623.36,623.36,1
HCPCS,D4275,Non-auto graft 1st tooth,,,1496.07,1496.07,1
HCPCS,D4276,Con tissue w dble ped graft,,,1496.07,1496.07,1
HCPCS,D4277,Soft tissue graft firsttooth,,,1496.07,1496.07,1
HCPCS,D4322,Splint intra-coronal,,,623.36,623.36,1
HCPCS,D4323,Splint extra-coronal,,,623.36,623.36,1
HCPCS,D4341,Periodontal scaling & root,,,623.36,623.36,1
HCPCS,D4342,Periodontal scaling 1-3teeth,,,623.36,623.36,1
HCPCS,D4346,Scaling gingiv inflammation,,,623.36,623.36,1
HCPCS,D4355,Full mouth debridement,,,623.36,623.36,1
HCPCS,D4381,Localized delivery antimicro,,,623.36,623.36,1
HCPCS,D4910,Periodontal maint procedures,,,623.36,623.36,1
HCPCS,D4920,Unscheduled dressing change,,,623.36,623.36,1
HCPCS,D4921,Gingival irrigation per quad,,,128.37,128.37,1
HCPCS,D4999,Unspecified periodontal proc,,,228.38,228.38,1
HCPCS,D5911,Facial moulage sectional,,,623.36,623.36,1
HCPCS,D5912,Facial moulage complete,,,623.36,623.36,1
HCPCS,D5983,Radiation applicator,,,623.36,623.36,1
HCPCS,D5984,Radiation shield,,,623.36,623.36,1
HCPCS,D5985,Radiation cone locator,,,623.36,623.36,1
HCPCS,D5987,Commissure splint,,,623.36,623.36,1
HCPCS,D5988,Surgical splint,,,623.36,623.36,1
HCPCS,D6920,Dental connector bar,,,623.36,623.36,1
HCPCS,D7111,Extraction coronal remnants,,,623.36,623.36,1
HCPCS,D7140,Extraction erupted tooth/exr,,,623.36,623.36,1
HCPCS,D7210,Rem imp tooth w mucoper flp,,,1496.07,1496.07,1
HCPCS,D7220,Impact tooth remov soft tiss,,,623.36,623.36,1
HCPCS,D7230,Impact tooth remov part bony,,,623.36,623.36,1
HCPCS,D7240,Impact tooth remov comp bony,,,623.36,623.36,1
HCPCS,D7241,Impact tooth rem bony w/comp,,,623.36,623.36,1
HCPCS,D7250,Tooth root removal,,,623.36,623.36,1
HCPCS,D7251,Coronectomy,,,1496.07,1496.07,1
HCPCS,D7260,Oral antral fistula closure,,,623.36,623.36,1
HCPCS,D7261,Primary closure sinus perf,,,623.36,623.36,1
HCPCS,D7270,Tooth reimplantation,,,623.36,623.36,1
HCPCS,D7272,Tooth transplantation,,,623.36,623.36,1
HCPCS,D7280,Exposure of unerupted tooth,,,623.36,623.36,1
HCPCS,D7291,Transseptal fiberotomy,,,623.36,623.36,1
HCPCS,D7310,Alveoplasty w/ extraction,,,1496.07,1496.07,1
HCPCS,D7311,Alveoloplasty w/extract 1-3,,,1496.07,1496.07,1
HCPCS,D7320,Alveoplasty w/o extraction,,,1496.07,1496.07,1
HCPCS,D7321,Alveoloplasty not w/extracts,,,1496.07,1496.07,1
HCPCS,D7340,Vestibuloplasty ridge extens,,,5708.03,5708.03,1
HCPCS,D7350,Vestibuloplasty exten graft,,,5708.03,5708.03,1
HCPCS,D7410,Rad exc lesion up to 1.25 cm,,,1496.07,1496.07,1
HCPCS,D7411,Excision benign lesion>1.25c,,,1496.07,1496.07,1
HCPCS,D7412,Excision benign lesion compl,,,1496.07,1496.07,1
HCPCS,D7413,Excision malig lesion<=1.25c,,,1496.07,1496.07,1
HCPCS,D7414,Excision malig lesion>1.25cm,,,1496.07,1496.07,1
HCPCS,D7415,Excision malig les complicat,,,1496.07,1496.07,1
HCPCS,D7440,Malig tumor exc to 1.25 cm,,,3196.84,3196.84,1
HCPCS,D7441,Malig tumor > 1.25 cm,,,3196.84,3196.84,1
HCPCS,D7450,Rem odontogen cyst to 1.25cm,,,3196.84,3196.84,1
HCPCS,D7451,Rem odontogen cyst > 1.25 cm,,,3196.84,3196.84,1
HCPCS,D7460,Rem nonodonto cyst to 1.25cm,,,623.36,623.36,1
HCPCS,D7461,Rem nonodonto cyst > 1.25 cm,,,623.36,623.36,1
HCPCS,D7471,Rem exostosis any site,,,3196.84,3196.84,1
HCPCS,D7472,Removal of torus palatinus,,,623.36,623.36,1
HCPCS,D7473,Remove torus mandibularis,,,623.36,623.36,1
HCPCS,D7485,Surg reduct osseoustuberosit,,,5708.03,5708.03,1
HCPCS,D7510,I&d absc intraoral soft tiss,,,682.8,682.8,1
HCPCS,D7511,Incision/drain abscess intra,,,682.8,682.8,1
HCPCS,D7520,I&d abscess extraoral,,,682.8,682.8,1
HCPCS,D7521,Incision/drain abscess extra,,,682.8,682.8,1
HCPCS,D7530,Removal fb skin/areolar tiss,,,623.36,623.36,1
HCPCS,D7540,Removal of fb reaction,,,623.36,623.36,1
HCPCS,D7550,Removal of sloughed off bone,,,623.36,623.36,1
HCPCS,D7670,Closd rductn splint alveolus,,,3196.84,3196.84,1
HCPCS,D7671,Alveolus open reduction,,,5708.03,5708.03,1
HCPCS,D7770,Open reduc compd alveolus fx,,,5708.03,5708.03,1
HCPCS,D7771,Alveolus clsd reduc stblz te,,,3196.84,3196.84,1
HCPCS,D7874,Tmj arthroscopy disc reposit,,,3154.93,3154.93,1
HCPCS,D7922,Place intra-socket bio dress,,,623.36,623.36,1
HCPCS,D7940,Reshaping bone orthognathic,,,623.36,623.36,1
HCPCS,D7950,Mandible graft,,,5708.03,5708.03,1
HCPCS,D9930,Treatment of complications,,,623.36,623.36,1
HCPCS,D9944,"Occ guard, hard, full arch",,,623.36,623.36,1
HCPCS,D9945,"Occ guard, soft, full arch",,,623.36,623.36,1
HCPCS,D9946,"Occ guard, hard, part arch",,,623.36,623.36,1
HCPCS,D9950,Occlusion analysis,,,623.36,623.36,1
HCPCS,D9951,Limited occlusal adjustment,,,623.36,623.36,1
HCPCS,D9952,Complete occlusal adjustment,,,623.36,623.36,1
HCPCS,E0201,Penile contractur devic manu,,,146.52,146.52,1
HCPCS,E0736,Transcut tibial nerv stimula,,,52.35,52.35,1
HCPCS,E0738,Upper extremity rehab,,,2039.64,2039.64,1
HCPCS,E0739,Rehab sys active assist rt,,,1597.66,1597.66,1
HCPCS,E0860,Hc Cervical Traction Over Door,88.06,57.24,,,0
HCPCS,E1905,Vr cbt therapy,,,674.77,674.77,1
HCPCS,E2104,Glucose monitor w cartridge,,,54.52,54.52,1
HCPCS,G0008,Admin influenza virus vac,,,45.15,45.15,1
HCPCS,G0008,Hc Admin Influenza Vaccine,50.0,32.5,,,0
HCPCS,G0009,Admin pneumococcal vaccine,,,45.15,45.15,1
HCPCS,G0009,Hc Admin Pneumococcal Vaccine,50.0,32.5,,,0
HCPCS,G0010,Admin hepatitis b vaccine,,,45.15,45.15,1
HCPCS,G0010,Hc Admin Hep B Vaccine,50.0,32.5,,,0
HCPCS,G0012,Injection of hiv prep drug,,,69.42,69.42,1
HCPCS,G0019,Comm hlth intg svs sdoh 60mn,,,97.95,97.95,1
HCPCS,G0023,Pin service 60m per month,,,97.95,97.95,1
HCPCS,G0027,Semen analysis,,,6.5,24.38,3
HCPCS,G0101,CA screen;pelvic/breast exam,,,97.95,97.95,1
HCPCS,G0103,Hc Psa Screen,84.0,54.6,,,0
HCPCS,G0103,PSA Screening,,,19.31,72.41,3
HCPCS,G0104,CA screen;flexi sigmoidscope,,,896.69,3714.0,2
HCPCS,G0104,Hc Screening Col Cancer Flex Sig,2982.0,1938.3,,,0
HCPCS,G0105,Colorectal scrn; hi risk ind,,,896.69,3714.0,2
HCPCS,G0105,Hc Screen Can Colonoscopy High Risk,3758.0,2442.7,,,0
HCPCS,G0108,Diab manage trn  per indiv,,,53.67,53.67,1
HCPCS,G0108,Hc Train Therapy Diab Ind Session 30 M,93.0,60.45,,,0
HCPCS,G0109,Diab manage trn ind/group,,,15.4,15.4,1
HCPCS,G0109,Hc Train Therapy Diab Grp Session 30 M,76.0,49.4,,,0
HCPCS,G0117,Glaucoma scrn hgh risk direc,,,27.89,27.89,1
HCPCS,G0118,Glaucoma scrn hgh risk direc,,,36.01,36.01,1
HCPCS,G0121,Colon ca scrn not hi rsk ind,,,896.69,3714.0,2
HCPCS,G0121,Hc Screen Col Cancer Colonoscopy Not Hr,3758.0,2442.7,,,0
HCPCS,G0123,Screen cerv/vag thin layer,,,20.26,75.98,3
HCPCS,G0124,Screen c/v thin layer by MD,,,86.4,86.4,2
HCPCS,G0127,Hc Trim Dystrophic Nails,319.0,207.35,,,0
HCPCS,G0127,Trim nail(s),,,56.88,56.88,1
HCPCS,G0129,Hc Php Ot Per Session 45 Min Or More,523.0,339.95,,,0
HCPCS,G0130,Single energy x-ray study,,,100.81,100.81,1
HCPCS,G0140,Nav srv peer sup 60 min pr m,,,97.95,97.95,1
HCPCS,G0141,"Scr c/v cyto,autosys and md",,,86.4,86.4,2
HCPCS,G0143,"Scr c/v cyto,thinlayer,rescr",,,27.05,101.44,3
HCPCS,G0144,"Scr c/v cyto,thinlayer,rescr",,,43.97,164.89,3
HCPCS,G0145,Hc Cyto Pap Smear Automated Mcare,131.0,85.15,,,0
HCPCS,G0145,"Scr c/v cyto,thinlayer,rescr",,,26.49,99.34,3
HCPCS,G0147,"Scr c/v cyto, automated sys",,,18.54,64.91,3
HCPCS,G0148,"Scr c/v cyto, autosys, rescr",,,31.94,119.78,3
HCPCS,G0166,"Extrnl counterpulse, per tx",,,128.29,128.29,1
HCPCS,G0166,Hc External Counterpulsation,6906.0,4488.9,,,0
HCPCS,G0175,"Opps service,sched team conf",,,402.33,402.33,1
HCPCS,G0176,Hc Activity Therapy Per Session 45 Min Or More,678.0,440.7,,,0
HCPCS,G0177,Hc Train Educ Related To Care And Tx 45 Min Or More,409.0,265.85,,,0
HCPCS,G0183,Software meas of cardiac vol,,,83.91,83.91,1
HCPCS,G0235,PET not otherwise specified,,,385.47,385.47,1
HCPCS,G0237,Hc Respiratory Therapy One On One 15 Min,122.0,79.3,,,0
HCPCS,G0237,Therapeutic procd strg endur,,,27.89,27.89,1
HCPCS,G0238,Hc Other Resp Proc One On One Per 15 Min,122.0,79.3,,,0
HCPCS,G0238,"Oth resp proc, indiv",,,27.89,27.89,1
HCPCS,G0239,Hc Improve Resp Fxn Other Group,533.0,346.45,,,0
HCPCS,G0239,"Oth resp proc, group",,,36.01,36.01,1
HCPCS,G0245,Initial foot exam pt lops,,,128.37,128.37,1
HCPCS,G0246,Followup eval of foot pt lop,,,128.37,128.37,1
HCPCS,G0247,Routine footcare pt w lops,,,193.46,193.46,1
HCPCS,G0248,Demonstrate use home inr mon,,,128.37,128.37,1
HCPCS,G0248,Hc Demonstrate Use Home Inr Monitor,213.0,138.45,,,0
HCPCS,G0249,Provide INR test mater/equip,,,128.37,128.37,1
HCPCS,G0257,Hc Dialysis Esrd Unsched Emerg Op,6100.0,3965.0,,,0
HCPCS,G0257,Unsched dialysis ESRD pt hos,,,661.76,661.76,1
HCPCS,G0260,Hc Inj Sacroiliac Joint Anes/ Steroid W Or Wo Arthrogram,6973.5,4532.775,,,0
HCPCS,G0260,Inj for sacroiliac jt anesth,,,680.63,3714.0,2
HCPCS,G0269,Hc Placement Occlusive Device,290.0,188.5,,,0
HCPCS,G0270,Hc Mnt Second Referral Per 15 Min,40.0,26.0,,,0
HCPCS,G0270,MNT subs tx for change dx,,,21.47,21.47,1
HCPCS,G0271,Group MNT 2 or more 30 mins,,,12.04,12.04,1
HCPCS,G0276,Pild/placebo control clin tr,,,6996.6,6996.6,1
HCPCS,G0277,"Hbot, full body chamber, 30m",,,132.69,132.69,1
HCPCS,G0277,Hc Hyperbaric Oxygen Full Body Per 30Min,2017.0,1311.05,,,0
HCPCS,G0278,Hc Angio Iliac Artery W Cath,4541.0,2951.65,,,0
HCPCS,G0279,"Tomosynthesis, mammo",,,11.59,11.59,1
HCPCS,G0281,Elec stim unattend for press,,,11.23,11.23,1
HCPCS,G0281,Hc Ot E-Stim Unattend For Chronic Ulcers,197.0,128.05,,,0
HCPCS,G0281,Hc Pt E-Stim Unattend For Chronic Ulcers,197.0,128.05,,,0
HCPCS,G0282,Hc Ot E-Stim Unattend For Wound Care Other,197.0,128.05,,,0
HCPCS,G0283,Elec stim other than wound,,,12.14,12.14,1
HCPCS,G0283,Hc Ot Electrical Stim Unattended,197.0,128.05,,,0
HCPCS,G0283,Hc Pt Electrical Stim Unattended,197.0,128.05,,,0
HCPCS,G0293,"Non-cov surg proc,clin trial",,,36.01,36.01,1
HCPCS,G0294,"Non-cov proc, clinical trial",,,36.01,36.01,1
HCPCS,G0296,Visit to determ ldct elig,,,97.95,97.95,1
HCPCS,G0302,Pre-op service LVRS complete,,,359.81,359.81,1
HCPCS,G0303,Pre-op service LVRS 10-15dos,,,208.2,208.2,1
HCPCS,G0304,Pre-op service LVRS 1-9 dos,,,359.81,359.81,1
HCPCS,G0305,Post op service LVRS min 6,,,359.81,359.81,1
HCPCS,G0306,CBC/diffwbc w/o platelet,,,7.77,29.14,3
HCPCS,G0307,CBC without platelet,,,6.47,24.26,3
HCPCS,G0328,Fecal blood scrn immunoassay,,,18.05,67.69,3
HCPCS,G0328,Hc Immunochemical Fecal Occult Blood,83.0,53.95,,,0
HCPCS,G0328,Hc Immunochemical Fecal Occult Blood So,183.0,118.95,,,0
HCPCS,G0329,Electromagntic tx for ulcers,,,9.96,9.96,1
HCPCS,G0330,Facility svs dental rehab,,,3196.84,3196.84,1
HCPCS,G0341,Percutaneous islet celltrans,,,26701.0,26701.0,1
HCPCS,G0342,Laparoscopy islet cell trans,,,63079.0,63079.0,1
HCPCS,G0343,Laparotomy islet cell transp,,,63079.0,63079.0,1
HCPCS,G0378,Hc Bh Observation Per Hour Carve Out,122.0,79.3,,,0
HCPCS,G0378,Hc Observation Per Hour,118.0,76.7,,,0
HCPCS,G0378,Hc Observation Per Hour Bh,122.0,79.3,,,0
HCPCS,G0378,Hc Observation Per Hour Carve Out,118.0,76.7,,,0
HCPCS,G0379,Direct refer hospital observ,,,574.22,574.22,1
HCPCS,G0379,Hc Observation Initial Assessment,706.0,458.9,,,0
HCPCS,G0390,Hc Trauma  Activation Fee Cat 1 Lev 2,19535.0,12697.75,,,0
HCPCS,G0390,Hc Trauma Activation Cat 1 Level 1 Grant Only,19535.0,12697.75,,,0
HCPCS,G0390,Hc Trauma Activation Cat 2 Level 1 Grant Only,15630.0,10159.5,,,0
HCPCS,G0390,Hc Trauma Activation Fee Cat 1 Lev 3,11124.0,7230.6,,,0
HCPCS,G0390,Hc Trauma Activation Fee Cat 2 Lev 2,15630.0,10159.5,,,0
HCPCS,G0390,Hc Trauma Activation Fee Cat2 Lev 3,8652.0,5623.8,,,0
HCPCS,G0390,Trauma Respons w/hosp criti,,,1285.22,1285.22,1
HCPCS,G0397,Alcohol/subs interv >30 min,,,171.15,171.15,1
HCPCS,G0398,Home sleep test/type 2 porta,,,208.2,208.2,1
HCPCS,G0399,Home sleep test/type 3 porta,,,208.2,208.2,1
HCPCS,G0400,Home sleep test/type 4 porta,,,208.2,208.2,1
HCPCS,G0402,Initial preventive exam,,,128.37,128.37,1
HCPCS,G0404,EKG tracing for initial prev,,,27.89,27.89,1
HCPCS,G0410,Hc Iop Group Psychotherapy 45 To 50 Min,474.0,308.1,,,0
HCPCS,G0410,Hc Php Group Psychotherapy 45 To 50 Min,474.0,308.1,,,0
HCPCS,G0411,Hc Php Interactive Group Psycotherapy 45 To 50 Min,474.0,308.1,,,0
HCPCS,G0412,Open tx iliac spine uni/bil,,,6996.6,15689.0,2
HCPCS,G0413,Pelvic ring fracture uni/bil,,,6996.6,15689.0,2
HCPCS,G0414,Pelvic ring fx treat int fix,,,6996.6,15689.0,2
HCPCS,G0415,Open tx post pelvic fxcture,,,3154.93,15689.0,2
HCPCS,G0416,"Prostate biopsy, any mthd",,,345.62,1215.41,3
HCPCS,G0420,Ed svc CKD ind per session,,,110.26,110.26,1
HCPCS,G0421,Ed svc CKD grp per session,,,26.55,26.55,1
HCPCS,G0422,Intens cardiac rehab w/exerc,,,124.3,124.3,1
HCPCS,G0423,Intens cardiac rehab no exer,,,124.3,124.3,1
HCPCS,G0429,Dermal filler injection(s),,,1989.46,1989.46,1
HCPCS,G0432,EIA HIV-1/HIV-2 screen,,,19.57,73.39,3
HCPCS,G0432,Hc Hiv Antibody Hiv1 Hiv2,79.0,51.35,,,0
HCPCS,G0433,ELISA HIV-1/HIV-2 screen,,,18.29,68.59,3
HCPCS,G0435,Oral hiv-1/hiv-2 screen,,,11.98,44.93,3
HCPCS,G0438,"PPPS, initial visit",,,167.28,167.28,1
HCPCS,G0439,"PPPS, subseq visit",,,131.63,131.63,1
HCPCS,G0443,Brief alcohol misuse counsel,,,97.95,97.95,1
HCPCS,G0445,High inten beh couns STD 30m,,,97.95,97.95,1
HCPCS,G0447,Behavior counsel obesity 15m,,,97.95,97.95,1
HCPCS,G0448,Place perm pacing cardiovert,,,38216.0,38216.0,1
HCPCS,G0451,Devlopment test interpt&rep,,,97.95,97.95,1
HCPCS,G0452,Molecular pathology interpr,,,11.44,11.44,2
HCPCS,G0455,Fecal microbiota prep instil,,,896.69,896.69,1
HCPCS,G0460,Autologous PRP for ulcers,,,1989.46,1989.46,1
HCPCS,G0463,Hc Visit Op Estab Level 1,129.0,83.85,,,0
HCPCS,G0463,Hc Visit Op Estab Level 2,158.0,102.7,,,0
HCPCS,G0463,Hc Visit Op Estab Level 3,185.0,120.25,,,0
HCPCS,G0463,Hc Visit Op Estab Level 4,213.0,138.45,,,0
HCPCS,G0463,Hc Visit Op Estab Level 5,261.0,169.65,,,0
HCPCS,G0463,Hc Visit Op New Level 2,158.0,102.7,,,0
HCPCS,G0463,Hc Visit Op New Level 3,185.0,120.25,,,0
HCPCS,G0463,Hc Visit Op New Level 4,213.0,138.45,,,0
HCPCS,G0463,Hc Visit Op New Level 5,261.0,169.65,,,0
HCPCS,G0463,Hospital outpt clinic visit,,,128.37,128.37,1
HCPCS,G0471,Ven blood coll snf/hha,,,11.34,11.34,1
HCPCS,G0472,Hep c screen high risk/other,,,46.35,173.81,3
HCPCS,G0475,Hiv combination assay,,,24.08,90.3,3
HCPCS,G0476,Hpv combo assay ca screen,,,35.09,131.59,3
HCPCS,G0480,Drug test def 1-7 classes,,,114.43,429.11,3
HCPCS,G0481,Drug test def 8-14 classes,,,156.59,587.21,3
HCPCS,G0482,Drug test def 15-21 classes,,,198.74,745.28,3
HCPCS,G0483,Drug test def 22+ classes,,,246.92,925.95,3
HCPCS,G0498,Chemo extend iv infus w/pump,,,318.49,318.49,1
HCPCS,G0499,Hepb screen high risk indiv,,,28.27,106.01,3
HCPCS,G0516,"Insert drug del implant, >4",,,430.74,3714.0,2
HCPCS,G0517,Remove drug implant,,,430.74,3714.0,2
HCPCS,G0518,Remove w insert drug implant,,,430.74,3714.0,2
HCPCS,G0538,Ascvd rsk mng clin stf pr mo,,,97.95,97.95,1
HCPCS,G0539,Initial care training 30 m,,,39.23,39.23,1
HCPCS,G0540,Train for caregiver add 15,,,20.78,20.78,1
HCPCS,G0541,No pt prsnt train initial 30,,,27.89,27.89,1
HCPCS,G0543,Group train w/o patient,,,27.89,27.89,1
HCPCS,G0544,Post d/c phone follow up,,,97.95,97.95,1
HCPCS,G0552,Supply of digital device,,,128.37,128.37,1
HCPCS,G0553,Monthly tx for dmht 20mins,,,128.37,128.37,1
HCPCS,G0555,Replacment pt electronic sys,,,828.02,828.02,1
HCPCS,G0558,Adv prim care mgmt lvl 3,,,97.95,97.95,1
HCPCS,G0560,Safety plan interven,,,39.18,39.18,1
HCPCS,G0562,Complex simulation w/pet-ct,,,1840.84,1840.84,1
HCPCS,G0564,365 d implant glucose sensor,,,20001.0,20001.0,1
HCPCS,G0565,Rem/ins glu snsr 365 dif sit,,,20001.0,20001.0,1
HCPCS,G0566,3d bn img algor drvd fr mri,,,124.07,124.07,1
HCPCS,G0567,Screening Hep C detect,,,35.09,35.09,1
HCPCS,G0568,"Int psych care mng, 1 cal mo",,,97.95,97.95,1
HCPCS,G0569,"Subs psych care mng, subs mo",,,97.95,97.95,1
HCPCS,G0659,Drug test def simple all cl,,,62.14,233.03,3
HCPCS,G1001,Hc Cdsm Evicore G1001,0.01,0.01,,,0
HCPCS,G1002,Hc Cdsm Medcurrent G1002,0.01,0.01,,,0
HCPCS,G1003,Hc Cdsm Medicalis G1003,0.01,0.01,,,0
HCPCS,G1004,Hc Cdsm Ndsc G1004,0.01,0.01,,,0
HCPCS,G1007,Hc Cdsm Aim G1007,0.01,0.01,,,0
HCPCS,G1008,Hc Cdsm Cranberry Peak G1008,0.01,0.01,,,0
HCPCS,G1009,Hc Cdsm Sage G1009,0.01,0.01,,,0
HCPCS,G1010,Hc Cdsm Stanson G1010,0.01,0.01,,,0
HCPCS,G1011,Hc Cdsm Nos G1011,0.01,0.01,,,0
HCPCS,G2000,Blinded conv. Tx MDD clin tr,,,359.81,359.81,1
HCPCS,G2011,Alcohol/sub abuse assess,,,27.89,27.89,1
HCPCS,G2066,Hc Remote Interrogation Sq Crm,167.0,108.55,,,0
HCPCS,G2086,Off base opioid tx 70min,,,171.15,171.15,1
HCPCS,G2087,"Off base opioid tx, 60 m",,,171.15,171.15,1
HCPCS,G2214,Init/sub psych care m 1st 30,,,97.95,97.95,1
HCPCS,G2250,"Remot img sub by pt, non e/m",,,7.87,7.87,1
HCPCS,G2251,"Brief chkin, 5-10, non-e/m",,,10.52,10.52,1
HCPCS,G2252,"Brief chkin by md/qhp, 11-20",,,22.01,22.01,1
HCPCS,G9143,Warfarin respon genetic test,,,452.7,452.7,2
HCPCS,H2012,Hc Mcd Bh Tx Per Hour-Min 31 Min,319.0,207.35,,,0
HCPCS,H2020,Hc Mcd Bh Tx Per Day - Min 2.5 Hr,1276.0,829.4,,,0
HCPCS,J0121,"Inj., omadacycline, 1 mg",,,4.02,10.62,6
HCPCS,J0122,"Inj., eravacycline, 1 mg",,,1.3,3.28,6
HCPCS,J0129,ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,7591.05,4934.18,,,0
HCPCS,J0129,Abatacept injection,,,44.11,118.7,6
HCPCS,J0129,Noncdm Charge Record Pharmacy,291.3,189.34,,,0
HCPCS,J0130,Abciximab injection,,,0.02,1513.86,4
HCPCS,J0131,Acetaminophen injection,,,0.08,0.14,5
HCPCS,J0131,Noncdm Charge Record Pharmacy,0.69,0.45,,,0
HCPCS,J0132,ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,41.75,27.14,,,0
HCPCS,J0132,Acetylcysteine injection,,,0.93,1.49,5
HCPCS,J0132,Noncdm Charge Record Pharmacy,3.59,2.33,,,0
HCPCS,J0133,Acyclovir injection,,,0.09,0.14,5
HCPCS,J0133,Noncdm Charge Record Pharmacy,0.41,0.27,,,0
HCPCS,J0134,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",53.7,34.9,,,0
HCPCS,J0134,Inj acetaminophen -fresenius,,,0.07,0.11,5
HCPCS,J0134,Noncdm Charge Record Pharmacy,0.64,0.42,,,0
HCPCS,J0135,Noncdm Charge Record Pharmacy,0.51,0.33,,,0
HCPCS,J0136,"Inj, acetaminophen (b braun)",,,0.08,0.14,5
HCPCS,J0136,Noncdm Charge Record Pharmacy,0.65,0.42,,,0
HCPCS,J0137,"Inj, acetaminophen (hikma)",,,0.08,0.14,5
HCPCS,J0137,Noncdm Charge Record Pharmacy,0.59,0.38,,,0
HCPCS,J0138,"Injection, acetaminoph 10 mg",,,0.04,0.76,5
HCPCS,J0139,"Inj, adalimumab, 1 mg",,,248.59,248.59,2
HCPCS,J0153,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,38.7,25.16,,,0
HCPCS,J0153,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,77.0,50.05,,,0
HCPCS,J0153,ADENOSINE INTRACORONARY SOLUTION (CATH LAB USE ONLY),33.15,21.55,,,0
HCPCS,J0153,Adenosine inj 1mg,,,0.54,0.87,5
HCPCS,J0153,Noncdm Charge Record Pharmacy,6.02,3.91,,,0
HCPCS,J0163,EPINEPHRINE 4 MG/250 ML (16 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV SOLN,182.4,118.56,,,0
HCPCS,J0165,"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",1429.95,929.47,,,0
HCPCS,J0166,EPINEPHRINE 1 MG/ML ANAPHYLAXIS KIT,83.95,54.57,,,0
HCPCS,J0166,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,34.85,22.65,,,0
HCPCS,J0166,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,38.05,24.73,,,0
HCPCS,J0168,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,48.9,31.78,,,0
HCPCS,J0171,Adrenalin epinephrine inject,,,1.3,2.06,5
HCPCS,J0171,Noncdm Charge Record Pharmacy,5.48,3.56,,,0
HCPCS,J0172,"Inj, aducanumab-avwa, 2 mg",,,10.16,16.21,5
HCPCS,J0173,"Inj, epinephrine (belcher)",,,4.05,6.45,5
HCPCS,J0173,Noncdm Charge Record Pharmacy,4.1,2.66,,,0
HCPCS,J0174,"Inj, lecanemab-irmb",,,1.32,3.6,6
HCPCS,J0174,Noncdm Charge Record Pharmacy,6.66,4.33,,,0
HCPCS,J0175,"Inj, donanemab-azbt, 2 mg",,,4.13,11.08,6
HCPCS,J0177,"Inj, aflibercept hd, 1 mg",,,311.38,891.75,6
HCPCS,J0178,Aflibercept injection,,,771.56,2170.9,6
HCPCS,J0179,"Inj, brolucizumab-dbll, 1 mg",,,346.11,918.39,6
HCPCS,J0180,AGALSIDASE BETA 35 MG INTRAVENOUS SOLUTION,39483.35,25664.18,,,0
HCPCS,J0180,AGALSIDASE BETA 5 MG INTRAVENOUS SOLUTION,5667.75,3684.04,,,0
HCPCS,J0180,Agalsidase beta injection,,,230.15,605.74,6
HCPCS,J0180,Noncdm Charge Record Pharmacy,983.48,639.26,,,0
HCPCS,J0184,"Inj, amisulpride, 1 mg",,,9.61,24.61,5
HCPCS,J0185,"Inj., aprepitant, 1 mg",,,1.64,4.61,6
HCPCS,J0202,ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,116350.05,75627.53,,,0
HCPCS,J0202,"Injection, alemtuzumab",,,2429.89,6540.21,6
HCPCS,J0205,Alglucerase injection,,,0.02,81.52,4
HCPCS,J0206,Inj allopurinol sodium 1 mg,,,4.72,11.92,6
HCPCS,J0207,Amifostine,,,2206.24,2507.1,4
HCPCS,J0208,Inj sodium thiosulfate 100mg,,,95.11,260.16,5
HCPCS,J0209,"Inj, sod thiosulfate (hope)",,,0.88,2.52,3
HCPCS,J0209,Noncdm Charge Record Pharmacy,4.21,2.74,,,0
HCPCS,J0209,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,531.9,345.74,,,0
HCPCS,J0210,Methyldopate hcl injection,,,0.02,135.5,4
HCPCS,J0211,"Inj, nithiodote, 3mg / 125mg",,,2.23,5.88,3
HCPCS,J0215,Alefacept,,,0.02,68.37,4
HCPCS,J0216,"Inj, alfentanil hcl, 500mcg",,,12.25,12.25,2
HCPCS,J0217,Inj velmanase alfa-tycv 1 mg,,,465.23,1194.6,6
HCPCS,J0218,Inj olipudase alfa-rpcp 1mg,,,393.66,1034.08,6
HCPCS,J0219,Inj aval alfa-nqpt 4mg,,,80.91,211.0,6
HCPCS,J0220,Alglucosidase alfa injection,,,0.02,0.02,2
HCPCS,J0221,Lumizyme injection,,,206.59,546.44,6
HCPCS,J0222,INV PATISIRAN (ALN-TTR02) 2 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J0222,"Inj., patisiran, 0.1 mg",,,99.97,267.83,6
HCPCS,J0222,Noncdm Charge Record Pharmacy,368.86,239.76,,,0
HCPCS,J0222,PATISIRAN (LIPID COMPLEX) 2 MG/ML INTRAVENOUS SOLUTION,41081.2,26702.78,,,0
HCPCS,J0223,Inj givosiran 0.5 mg,,,117.36,312.92,6
HCPCS,J0224,"Inj. lumasiran, 0.5 mg",,,329.05,861.81,6
HCPCS,J0225,INV VUTRISIRAN (ALN-TTRSC02) 25 MG/0.5 ML SOLUTION FOR INJECTION,0.65,0.42,,,0
HCPCS,J0225,"Inj, vutrisiran, 1 mg",,,5003.64,13327.1,6
HCPCS,J0225,Noncdm Charge Record Pharmacy,15712.13,10212.88,,,0
HCPCS,J0225,VUTRISIRAN 25 MG/0.5 ML SUBCUTANEOUS SYRINGE,500162.75,325105.79,,,0
HCPCS,J0248,"Inj, remdesivir, 1 mg?",,,6.73,17.21,6
HCPCS,J0248,Noncdm Charge Record Pharmacy,31.41,20.42,,,0
HCPCS,J0248,REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,3279.8,2131.87,,,0
HCPCS,J0256,Alpha 1 proteinase inhibitor,,,5.46,13.79,6
HCPCS,J0257,ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 20 MG/ML (2 %) INTRAVENOUS SOLN,4005.75,2603.74,,,0
HCPCS,J0257,Glassia injection,,,5.64,14.93,6
HCPCS,J0257,Noncdm Charge Record Pharmacy,41.36,26.88,,,0
HCPCS,J0270,Alprostadil for injection,,,1.27,24.03,4
HCPCS,J0270,Noncdm Charge Record Pharmacy,8.84,5.75,,,0
HCPCS,J0278,"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",53.95,35.07,,,0
HCPCS,J0278,Amikacin sulfate injection,,,0.92,1.46,5
HCPCS,J0278,INV AMIKACIN/PLACEBO 125 MG/ML SOLUTION,0.65,0.42,,,0
HCPCS,J0278,Noncdm Charge Record Pharmacy,7.72,5.02,,,0
HCPCS,J0280,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,90.65,58.92,,,0
HCPCS,J0280,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,70.1,45.56,,,0
HCPCS,J0280,Aminophyllin 250 MG inj,,,8.79,14.01,5
HCPCS,J0280,INV AMINOPHYLLINE 250 MG/10 ML INJECTION,0.65,0.42,,,0
HCPCS,J0280,Noncdm Charge Record Pharmacy,60.37,39.24,,,0
HCPCS,J0281,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,70.0,45.5,,,0
HCPCS,J0282,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,43.7,28.4,,,0
HCPCS,J0282,Amiodarone HCl,,,0.67,1.06,5
HCPCS,J0282,Noncdm Charge Record Pharmacy,7.72,5.02,,,0
HCPCS,J0283,"AMIODARONE 360 MG/200 ML (1.8 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",122.45,79.59,,,0
HCPCS,J0283,"Inj, amiodarone (nexterone)",,,4.29,6.83,5
HCPCS,J0283,Noncdm Charge Record Pharmacy,11.88,7.72,,,0
HCPCS,J0285,AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,208.9,135.78,,,0
HCPCS,J0285,Amphotericin B,,,85.11,135.69,5
HCPCS,J0285,Noncdm Charge Record Pharmacy,217.98,141.69,,,0
HCPCS,J0287,AMPHOTERICIN B LIPID COMPLEX 5 MG/ML INTRAVENOUS SUSPENSION,519.9,337.94,,,0
HCPCS,J0287,Amphotericin b lipid complex,,,10.3,27.91,5
HCPCS,J0288,Ampho b cholesteryl sulfate,,,0.02,191.98,4
HCPCS,J0289,AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,413.2,268.58,,,0
HCPCS,J0289,Amphotericin b liposome inj,,,21.48,64.99,6
HCPCS,J0289,Noncdm Charge Record Pharmacy,118.64,77.12,,,0
HCPCS,J0290,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,38.6,25.09,,,0
HCPCS,J0290,AMPICILLIN 125 MG SOLUTION FOR INJECTION,52.3,34.0,,,0
HCPCS,J0290,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,42.5,27.62,,,0
HCPCS,J0290,AMPICILLIN 500 MG SOLUTION FOR INJECTION,37.5,24.38,,,0
HCPCS,J0290,AMPICILLIN INJECTION (IM) 1 GM VIAL,38.6,25.09,,,0
HCPCS,J0290,AMPICILLIN INJECTION (IM) 250 MG VIAL,48.45,31.49,,,0
HCPCS,J0290,AMPICILLIN INJECTION (IM) 500 MG VIAL,38.75,25.19,,,0
HCPCS,J0290,AMPICILLIN IV 100 MG/ML (WELL BABY CONC),49.25,32.01,,,0
HCPCS,J0290,Ampicillin 500 MG inj,,,1.21,1.92,5
HCPCS,J0290,Noncdm Charge Record Pharmacy,12.51,8.13,,,0
HCPCS,J0291,"Inj., plazomicin, 5 mg",,,3.5,9.67,6
HCPCS,J0295,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,43.35,28.18,,,0
HCPCS,J0295,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,47.4,30.81,,,0
HCPCS,J0295,Ampicillin sodium per 1.5 gm,,,2.79,4.44,5
HCPCS,J0295,Noncdm Charge Record Pharmacy,29.7,19.3,,,0
HCPCS,J0300,Amobarbital 125 MG inj,,,30.68,428.83,4
HCPCS,J0330,Noncdm Charge Record Pharmacy,12.84,8.35,,,0
HCPCS,J0330,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,34.4,22.36,,,0
HCPCS,J0330,SUCCINYLCHOLINE CHLORIDE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SYRINGE,77.125,50.13,,,0
HCPCS,J0330,Succinycholine chloride inj,,,1.87,4.28,4
HCPCS,J0348,Anidulafungin injection,,,0.86,1.38,5
HCPCS,J0349,"Inj, rezafungin, 1 mg",,,10.62,28.24,6
HCPCS,J0360,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,48.65,31.62,,,0
HCPCS,J0360,Hydralazine hcl injection,,,6.93,11.06,5
HCPCS,J0360,Noncdm Charge Record Pharmacy,42.53,27.64,,,0
HCPCS,J0364,Apomorphine hydrochloride,,,81.24,143.71,4
HCPCS,J0365,"Aprotonin, 10,000 kiu",,,0.02,7.02,4
HCPCS,J0380,Inj metaraminol bitartrate,,,2.63,2.63,2
HCPCS,J0391,ARTESUNATE 110 MG INTRAVENOUS SOLUTION,24316.4,15805.66,,,0
HCPCS,J0391,"Inj, artesunate, 1mg",,,51.83,140.46,5
HCPCS,J0391,Noncdm Charge Record Pharmacy,228.97,148.83,,,0
HCPCS,J0400,Aripiprazole injection,,,0.02,0.87,4
HCPCS,J0401,Inj aripiprazole ext rel 1mg,,,7.28,19.16,6
HCPCS,J0402,"Inj, abilify asimtufii, 1 mg",,,6.03,16.04,6
HCPCS,J0456,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,46.45,30.19,,,0
HCPCS,J0456,Azithromycin,,,3.62,5.77,5
HCPCS,J0456,Noncdm Charge Record Pharmacy,47.42,30.82,,,0
HCPCS,J0457,AZTREONAM 1 GRAM SOLUTION FOR INJECTION,135.3,87.94,,,0
HCPCS,J0457,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,242.0,157.3,,,0
HCPCS,J0457,"Injection, aztreonam, 100 mg",,,3.52,5.61,5
HCPCS,J0457,Noncdm Charge Record Pharmacy,13.87,9.02,,,0
HCPCS,J0461,ATROPINE 0.1 MG/ML INJECTION SYRINGE,37.0,24.05,,,0
HCPCS,J0461,Atropine sulfate injection,,,0.18,0.3,5
HCPCS,J0461,Noncdm Charge Record Pharmacy,1.21,0.79,,,0
HCPCS,J0462,ATROPINE 1 MG/ML INJECTION SOLUTION,50.25,32.66,,,0
HCPCS,J0470,Dimecaprol injection,,,132.02,173.93,4
HCPCS,J0475,"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",507.4,329.81,,,0
HCPCS,J0475,"BACLOFEN 2,000 MCG/ML INTRATHECAL SOLUTION",2200.1,1430.06,,,0
HCPCS,J0475,"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",1366.2,888.03,,,0
HCPCS,J0475,BACLOFEN 500 MCG/ML INTRATHECAL SOLUTION,763.7,496.4,,,0
HCPCS,J0475,Baclofen 10 mg injection,,,181.22,471.11,6
HCPCS,J0475,Noncdm Charge Record Pharmacy,942.38,612.55,,,0
HCPCS,J0476,BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,57.7,37.5,,,0
HCPCS,J0476,BACLOFEN 50 MCG/ML INTRATHECAL SOLUTION,108.5,70.52,,,0
HCPCS,J0476,Baclofen intrathecal trial,,,69.24,110.38,5
HCPCS,J0476,Noncdm Charge Record Pharmacy,334.05,217.13,,,0
HCPCS,J0480,Basiliximab,,,4686.85,12622.04,6
HCPCS,J0485,Belatacept injection,,,3.89,10.65,6
HCPCS,J0485,Noncdm Charge Record Pharmacy,19.95,12.97,,,0
HCPCS,J0490,BELIMUMAB 120 MG INTRAVENOUS SOLUTION,2767.8,1799.07,,,0
HCPCS,J0490,BELIMUMAB 400 MG INTRAVENOUS SOLUTION,9033.7,5871.9,,,0
HCPCS,J0490,Belimumab injection,,,56.07,148.81,6
HCPCS,J0490,Noncdm Charge Record Pharmacy,180.02,117.01,,,0
HCPCS,J0491,ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION,27179.55,17666.71,,,0
HCPCS,J0491,Inj anifrolumab-fnia 1mg,,,18.08,48.13,6
HCPCS,J0491,Noncdm Charge Record Pharmacy,88.09,57.26,,,0
HCPCS,J0500,DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION,48.35,31.43,,,0
HCPCS,J0500,Dicyclomine injection,,,25.34,40.38,5
HCPCS,J0500,Noncdm Charge Record Pharmacy,87.85,57.1,,,0
HCPCS,J0515,Inj benztropine mesylate,,,28.71,45.77,5
HCPCS,J0515,Noncdm Charge Record Pharmacy,98.03,63.72,,,0
HCPCS,J0517,"Inj., benralizumab, 1 mg",,,164.59,449.56,6
HCPCS,J0517,Noncdm Charge Record Pharmacy,827.97,538.18,,,0
HCPCS,J0525,CEFOTETAN 1 GRAM SOLUTION FOR INJECTION,79.5,51.68,,,0
HCPCS,J0525,CEFOTETAN 2 GRAM SOLUTION FOR INJECTION,126.05,81.93,,,0
HCPCS,J0525,CEFOTETAN INJ (SORD FOR COMPOUNDING),224.2,145.73,,,0
HCPCS,J0558,PenG benzathine/procaine inj,,,19.52,47.07,6
HCPCS,J0561,Noncdm Charge Record Pharmacy,118.33,76.91,,,0
HCPCS,J0561,"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",1744.15,1133.7,,,0
HCPCS,J0561,"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",3539.6,2300.74,,,0
HCPCS,J0561,Penicillin g benzathine inj,,,30.01,72.68,6
HCPCS,J0565,BEZLOTOXUMAB 25 MG/ML INTRAVENOUS SOLUTION,15844.85,10299.15,,,0
HCPCS,J0565,"Inj, bezlotoxumab, 10 mg",,,39.83,108.05,6
HCPCS,J0565,Noncdm Charge Record Pharmacy,165.64,107.67,,,0
HCPCS,J0567,"Inj., cerliponase alfa 1 mg",,,120.36,356.91,5
HCPCS,J0571,BUPRENORPHINE HCL 150 MCG BUCCAL FILM,37.25,24.21,,,0
HCPCS,J0571,BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET,15.15,9.85,,,0
HCPCS,J0571,BUPRENORPHINE HCL 300 MCG BUCCAL FILM,53.8,34.97,,,0
HCPCS,J0571,BUPRENORPHINE HCL 75 MCG BUCCAL FILM,37.25,24.21,,,0
HCPCS,J0571,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,20.1,13.06,,,0
HCPCS,J0571,Buprenorphine oral 1mg,,,1.59,3.79,4
HCPCS,J0571,Noncdm Charge Record Pharmacy,10.685,6.949999999999999,,,0
HCPCS,J0572,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM,14.7,9.56,,,0
HCPCS,J0572,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,14.6,9.49,,,0
HCPCS,J0572,Bupren/nal up to 3mg bupreno,,,19.35,19.35,2
HCPCS,J0572,Noncdm Charge Record Pharmacy,12.399999999999999,8.06,,,0
HCPCS,J0573,Bupren/nal 3.1 to 6mg bupren,,,30.6,30.6,2
HCPCS,J0574,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,21.95,14.27,,,0
HCPCS,J0574,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,16.15,10.5,,,0
HCPCS,J0574,Bupren/nal 6.1 to 10mg bupre,,,31.33,31.33,2
HCPCS,J0574,Noncdm Charge Record Pharmacy,20.555,13.36,,,0
HCPCS,J0575,Bupren/nal over 10mg bupreno,,,50.14,50.14,2
HCPCS,J0577,"Inj, brixadi, 7 days or less",,,420.64,1161.67,6
HCPCS,J0578,"Inj brixadi, more than 7 day",,,1682.54,4646.65,6
HCPCS,J0583,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,214.6,139.49,,,0
HCPCS,J0583,Bivalirudin,,,0.28,0.43,5
HCPCS,J0583,Noncdm Charge Record Pharmacy,1.22,0.79,,,0
HCPCS,J0584,"Injection, burosumab-twza 1m",,,484.14,1272.97,6
HCPCS,J0585,"Injection,onabotulinumtoxina",,,6.5,17.53,6
HCPCS,J0585,Noncdm Charge Record Pharmacy,33.47,21.76,,,0
HCPCS,J0585,ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,3313.95,2154.07,,,0
HCPCS,J0586,Abobotulinumtoxina,,,8.75,23.12,6
HCPCS,J0587,"Inj, rimabotulinumtoxinb",,,13.29,35.2,6
HCPCS,J0588,Incobotulinumtoxin a,,,5.57,14.39,6
HCPCS,J0589,Inj daxibotulinumtoxina-lanm,,,3.15,9.83,5
HCPCS,J0591,"Inj deoxycholic acid, 1 mg",,,35.1,35.1,2
HCPCS,J0592,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,96.6,62.79,,,0
HCPCS,J0592,Buprenorphine hydrochloride,,,7.32,11.65,5
HCPCS,J0593,"Inj., lanadelumab-flyo, 1 mg",,,87.28,278.72,5
HCPCS,J0594,BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,211.15,137.25,,,0
HCPCS,J0594,Busulfan injection,,,0.88,3.85,6
HCPCS,J0594,Noncdm Charge Record Pharmacy,2.64,1.72,,,0
HCPCS,J0595,Butorphanol tartrate 1 mg,,,9.66,15.39,5
HCPCS,J0596,"Injection, ruconest",,,36.77,93.96,6
HCPCS,J0597,"C-1 esterase, berinert",,,75.86,196.37,6
HCPCS,J0597,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) INTRAVENOUS KIT,18255.05,11865.78,,,0
HCPCS,J0597,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) INTRAVENOUS SOLUTION,18255.05,11865.78,,,0
HCPCS,J0597,Noncdm Charge Record Pharmacy,361.14,234.74,,,0
HCPCS,J0598,"C-1 esterase, cinryze",,,65.63,173.63,6
HCPCS,J0599,"Inj., haegarda 10 units",,,27.24,39.16,4
HCPCS,J0600,Edetate calcium disodium inj,,,6408.38,16487.91,6
HCPCS,J0601,Sevelamer carbonate 20 mg,,,0.02,0.3,4
HCPCS,J0602,Sevelamer carbonate pdr 20mg,,,0.12,0.81,4
HCPCS,J0603,Sevelamer hydrochloride 20mg,,,0.28,0.54,4
HCPCS,J0604,"Cinacalcet, esrd on dialysis",,,0.05,2.68,4
HCPCS,J0605,Sucroferric oxyhydroxide 5mg,,,0.42,0.57,4
HCPCS,J0606,"Inj, etelcalcetide, 0.1 mg",,,2.29,12.79,5
HCPCS,J0607,Lanthanum carbonate oral 5mg,,,0.12,0.24,4
HCPCS,J0608,Lanthanum carbonate pwdr 5mg,,,0.14,0.22,4
HCPCS,J0609,Ferric citrate orl 3 mg iron,,,0.08,0.26,4
HCPCS,J0610,INV CALCIUM GLUCONATE 100 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J0612,Calcium glucon (fresenius),,,0.06,0.11,5
HCPCS,J0612,Noncdm Charge Record Pharmacy,0.64,0.42,,,0
HCPCS,J0613,Calcium glucon (wg critical),,,0.18,0.3,5
HCPCS,J0613,Noncdm Charge Record Pharmacy,0.76,0.49,,,0
HCPCS,J0615,"Calcium acetate, oral, 23 mg",,,0.05,0.08,4
HCPCS,J0616,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,35.75,23.24,,,0
HCPCS,J0618,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,51.45,33.44,,,0
HCPCS,J0620,Calcium glycer & lact/10 ML,,,0.02,29.81,4
HCPCS,J0630,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,713.9,464.04,,,0
HCPCS,J0630,Calcitonin salmon injection,,,1942.1,3095.93,5
HCPCS,J0630,Noncdm Charge Record Pharmacy,3401.5,2210.98,,,0
HCPCS,J0636,Inj calcitriol per 0.1 mcg,,,2.32,2.9,4
HCPCS,J0637,Caspofungin acetate,,,8.59,13.71,5
HCPCS,J0637,Noncdm Charge Record Pharmacy,26.57,17.27,,,0
HCPCS,J0638,Canakinumab injection,,,141.6,368.23,6
HCPCS,J0640,LEUCOVORIN CALCIUM 10 MG/ML INJECTION SOLUTION,114.9,74.68,,,0
HCPCS,J0640,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,87.45,56.84,,,0
HCPCS,J0640,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,108.0,70.2,,,0
HCPCS,J0640,LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,140.85,91.55,,,0
HCPCS,J0640,Leucovorin calcium injection,,,7.08,11.27,5
HCPCS,J0640,Noncdm Charge Record Pharmacy,14.26,9.27,,,0
HCPCS,J0641,Levoleucovorin injection,,,0.07,0.11,5
HCPCS,J0642,"Injection, khapzory, 0.5 mg",,,2.3,3.66,5
HCPCS,J0650,"Inj, levothyroxine nos 10mcg",,,9.16,14.61,5
HCPCS,J0650,Noncdm Charge Record Pharmacy,36.35,23.63,,,0
HCPCS,J0651,"Inj, levothyroxine, freskabi",,,6.49,10.35,6
HCPCS,J0651,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,363.85,236.5,,,0
HCPCS,J0651,Noncdm Charge Record Pharmacy,37.86,24.61,,,0
HCPCS,J0652,"Inj, levothyroxine, hikma",,,8.73,13.93,5
HCPCS,J0665,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,34.25,22.26,,,0
HCPCS,J0665,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,36.55,23.76,,,0
HCPCS,J0665,BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,47.8,31.07,,,0
HCPCS,J0665,BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,34.2,22.23,,,0
HCPCS,J0665,"Inj, bupivacaine, nos, 0.5mg",,,0.02,0.03,5
HCPCS,J0665,Noncdm Charge Record Pharmacy,0.3,0.2,,,0
HCPCS,J0666,BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,1600.55,1040.36,,,0
HCPCS,J0666,"Inj, bupivacaine liposome",,,1.47,3.93,6
HCPCS,J0668,BUPIVACAINE-MELOXICAM ER 400 MG-12 MG/14 ML SURGICAL SITE INSTILL SOLN,761.55,495.01,,,0
HCPCS,J0670,Inj mepivacaine HCL/10 ml,,,6.04,9.62,5
HCPCS,J0670,Noncdm Charge Record Pharmacy,36.57,23.77,,,0
HCPCS,J0675,CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,217.35,141.28,,,0
HCPCS,J0681,INV CEFTOBIPROLE/PLACEBO 500MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J0687,Inj cefazolin (wg crit care),,,1.89,3.01,5
HCPCS,J0688,"Inj cefazolin sodium, hikma",,,1.71,2.71,5
HCPCS,J0689,CEFAZOLIN 2 GRAM/100 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,97.75,63.54,,,0
HCPCS,J0689,"Inj cefazolin sodium, baxter",,,2.1,3.33,5
HCPCS,J0689,Noncdm Charge Record Pharmacy,25.28,16.43,,,0
HCPCS,J0690,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,35.75,23.24,,,0
HCPCS,J0690,CEFAZOLIN 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,91.05,59.18,,,0
HCPCS,J0690,CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,52.9,34.38,,,0
HCPCS,J0690,CEFAZOLIN 500 MG SOLUTION FOR INJECTION,38.85,25.25,,,0
HCPCS,J0690,CEFAZOLIN IVPB 2 G IN D5W 50 ML (CMP PMX),92.3,60.0,,,0
HCPCS,J0690,CEFAZOLIN IVPB 2 G IN NS 50 ML (CMP PMX),92.3,60.0,,,0
HCPCS,J0690,Cefazolin sodium injection,,,1.38,2.2,5
HCPCS,J0690,INV CEFAZOLIN 1 GRAM INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J0690,Noncdm Charge Record Pharmacy,38.96,25.32,,,0
HCPCS,J0691,Inj lefamulin 1 mg,,,1.59,2.22,4
HCPCS,J0692,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,49.15,31.95,,,0
HCPCS,J0692,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,98.45,63.99,,,0
HCPCS,J0692,Cefepime hcl for injection,,,2.1,3.36,5
HCPCS,J0692,Noncdm Charge Record Pharmacy,23.96,15.57,,,0
HCPCS,J0694,Cefoxitin sodium injection,,,7.57,12.06,5
HCPCS,J0694,Noncdm Charge Record Pharmacy,39.69,25.8,,,0
HCPCS,J0695,CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,841.45,546.94,,,0
HCPCS,J0695,Inj ceftolozane tazobactam,,,9.07,22.09,6
HCPCS,J0695,Noncdm Charge Record Pharmacy,39.67,25.79,,,0
HCPCS,J0696,CEFTRIAXONE (IM) 250 MG INJECTION,36.6,23.79,,,0
HCPCS,J0696,CEFTRIAXONE (IM) 500 MG INJECTION,36.1,23.46,,,0
HCPCS,J0696,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,37.5,24.38,,,0
HCPCS,J0696,CEFTRIAXONE 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOT) INTRAVENOUS PIGGYBACK,103.6,67.34,,,0
HCPCS,J0696,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,41.7,27.1,,,0
HCPCS,J0696,CEFTRIAXONE 2 GRAM/50 ML IN DEXTROSE (ISO-OSM) INTRAVENOUS PIGGYBACK,118.5,77.02,,,0
HCPCS,J0696,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,35.5,23.08,,,0
HCPCS,J0696,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,36.1,23.46,,,0
HCPCS,J0696,Ceftriaxone sodium injection,,,0.76,1.22,5
HCPCS,J0696,Noncdm Charge Record Pharmacy,18.8,12.22,,,0
HCPCS,J0697,Sterile cefuroxime injection,,,3.21,5.12,5
HCPCS,J0698,Cefotaxime sodium injection,,,16.37,22.93,4
HCPCS,J0699,CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,1112.7,723.26,,,0
HCPCS,J0699,"Inj, cefiderocol, 10 mg",,,2.42,6.18,6
HCPCS,J0699,Noncdm Charge Record Pharmacy,10.82,7.03,,,0
HCPCS,J0701,CEFEPIME 2 GRAM/100 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,237.25,154.21,,,0
HCPCS,J0701,Inj. cefepime hcl (baxter),,,9.75,15.56,5
HCPCS,J0701,Noncdm Charge Record Pharmacy,28.8,18.72,,,0
HCPCS,J0702,BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,68.35,44.43,,,0
HCPCS,J0702,Betamethasone acet&sod phosp,,,12.77,20.35,5
HCPCS,J0702,Hc Celestone Per 3 Mg,35.36,22.98,,,0
HCPCS,J0702,Noncdm Charge Record Pharmacy,54.72,35.57,,,0
HCPCS,J0703,CEFEPIME 2 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,125.25,81.41,,,0
HCPCS,J0703,"Inj, cefepime hcl (b braun)",,,8.37,13.33,5
HCPCS,J0703,Noncdm Charge Record Pharmacy,34.56,22.46,,,0
HCPCS,J0706,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,53.8,34.97,,,0
HCPCS,J0706,Caffeine citrate injection,,,3.42,5.45,4
HCPCS,J0706,INV CAFFEINE CITRATE 60 MG/3 ML INJECTION,0.65,0.42,,,0
HCPCS,J0706,Noncdm Charge Record Pharmacy,11.9,7.74,,,0
HCPCS,J0712,CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,976.1,634.46,,,0
HCPCS,J0712,Ceftaroline fosamil inj,,,4.23,10.7,6
HCPCS,J0712,Noncdm Charge Record Pharmacy,17.36,11.28,,,0
HCPCS,J0713,CEFTAZIDIME (IM) 1000 MG INJECTION,53.9,35.04,,,0
HCPCS,J0713,Inj ceftazidime per 500 mg,,,2.8,4.47,5
HCPCS,J0713,Noncdm Charge Record Pharmacy,17.18,11.17,,,0
HCPCS,J0714,CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,1862.8,1210.82,,,0
HCPCS,J0714,Ceftazidime and avibactam,,,104.73,272.98,6
HCPCS,J0714,Noncdm Charge Record Pharmacy,476.14,309.49,,,0
HCPCS,J0715,Ceftizoxime sodium / 500 MG,,,0.02,0.02,2
HCPCS,J0716,Centruroides immune f(ab),,,4871.94,13005.56,5
HCPCS,J0717,Certolizumab pegol inj 1mg,,,3.91,10.57,6
HCPCS,J0717,Noncdm Charge Record Pharmacy,74.04,48.13,,,0
HCPCS,J0720,Chloramphenicol sodium injec,,,50.26,158.21,5
HCPCS,J0725,Chorionic gonadotropin/1000u,,,33.44,53.31,5
HCPCS,J0735,"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",44.95,29.22,,,0
HCPCS,J0735,Clonidine hydrochloride,,,28.45,45.37,5
HCPCS,J0735,Noncdm Charge Record Pharmacy,40.21,26.14,,,0
HCPCS,J0736,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,40.8,26.52,,,0
HCPCS,J0736,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,79.3,51.54,,,0
HCPCS,J0736,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,93.35,60.68,,,0
HCPCS,J0736,"Inj, clindamycin phosp 300mg",,,3.63,5.77,5
HCPCS,J0736,Noncdm Charge Record Pharmacy,30.8,20.02,,,0
HCPCS,J0737,CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,79.3,51.54,,,0
HCPCS,J0737,CLINDAMYCIN 900 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,84.1,54.66,,,0
HCPCS,J0737,"Inj, clindamycin (baxter)",,,4.43,7.07,5
HCPCS,J0737,Noncdm Charge Record Pharmacy,30.69,19.95,,,0
HCPCS,J0739,"Injection, cabotegravir 1 mg",,,7.02,18.67,6
HCPCS,J0740,CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,2351.6,1528.54,,,0
HCPCS,J0740,Cidofovir injection,,,511.88,815.98,6
HCPCS,J0740,Noncdm Charge Record Pharmacy,2448.52,1591.54,,,0
HCPCS,J0741,"Inj, cabote rilpivir 2mg 3mg",,,23.65,62.79,6
HCPCS,J0742,Inj imip 4 cilas 4 releb 2mg,,,4.25,6.78,5
HCPCS,J0743,Cilastatin sodium injection,,,12.24,19.51,5
HCPCS,J0743,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,82.45,53.59,,,0
HCPCS,J0743,Noncdm Charge Record Pharmacy,34.54,22.45,,,0
HCPCS,J0744,CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,67.55,43.91,,,0
HCPCS,J0744,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,69.65,45.27,,,0
HCPCS,J0744,Ciprofloxacin iv,,,1.41,2.25,5
HCPCS,J0744,Noncdm Charge Record Pharmacy,36.86,23.96,,,0
HCPCS,J0745,Inj codeine phosphate /30 MG,,,0.02,2.63,4
HCPCS,J0750,"Hiv prep, ftc/tdf 200/300mg",,,1.73,4.93,6
HCPCS,J0751,"Hiv prep, ftc/taf 200/25mg",,,71.32,193.2,6
HCPCS,J0759,CLEVIDIPINE 25 MG/50 ML INTRAVENOUS EMULSION,433.35,281.68,,,0
HCPCS,J0770,COLISTIMETHATE SODIUM (COLYMYCIN) INTRAVENTRICULAR 5 MG/2 ML SYRINGE,34.7,22.56,,,0
HCPCS,J0770,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,80.5,52.32,,,0
HCPCS,J0770,Colistimethate sodium inj,,,20.67,32.95,5
HCPCS,J0775,"Collagenase, clost hist inj",,,75.9,192.11,6
HCPCS,J0780,Noncdm Charge Record Pharmacy,50.0,32.5,,,0
HCPCS,J0780,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,34.9,22.68,,,0
HCPCS,J0780,Prochlorperazine injection,,,5.02,7.99,5
HCPCS,J0791,CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,10257.15,6667.15,,,0
HCPCS,J0791,Inj crizanlizumab-tmca 5mg,,,129.48,348.72,6
HCPCS,J0795,Corticorelin ovine triflutal,,,0.02,11.41,4
HCPCS,J0801,Inj. acthar gel to 40 units,,,4134.62,10373.42,6
HCPCS,J0802,"Inj. (ani), up to 40 units",,,3534.6,9400.58,6
HCPCS,J0834,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,125.65,81.67,,,0
HCPCS,J0834,Cosyntropin cortrosyn inj,,,56.84,90.6,5
HCPCS,J0834,Noncdm Charge Record Pharmacy,172.98,112.44,,,0
HCPCS,J0840,CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,14860.7,9659.46,,,0
HCPCS,J0840,Crotalidae poly immune fab,,,1828.72,4822.82,6
HCPCS,J0841,Inj crotalidae im f(ab')2 eq,,,1045.15,2783.63,6
HCPCS,J0850,Cytomegalovirus imm IV /vial,,,1808.64,4916.24,6
HCPCS,J0870,"Injection, imetelstat, 1 mg",,,57.03,150.32,5
HCPCS,J0872,Daptomycin (xellia) unrefrig,,,0.07,0.11,5
HCPCS,J0873,"Inj, daptomycin (xellia)",,,0.06,0.11,5
HCPCS,J0874,"Inj, daptomycin (baxter)",,,0.11,0.19,5
HCPCS,J0874,Noncdm Charge Record Pharmacy,0.23,0.15,,,0
HCPCS,J0875,"Injection, dalbavancin",,,15.61,42.28,6
HCPCS,J0875,Noncdm Charge Record Pharmacy,86.61,56.3,,,0
HCPCS,J0877,"Inj, daptomycin (hospira)",,,0.07,0.11,5
HCPCS,J0877,Noncdm Charge Record Pharmacy,0.41,0.27,,,0
HCPCS,J0878,DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,107.15,69.65,,,0
HCPCS,J0878,Daptomycin injection,,,0.06,0.11,5
HCPCS,J0878,INV DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J0878,INV DAPTOMYCIN/PLACEBO 500 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J0878,Noncdm Charge Record Pharmacy,0.23,0.15,,,0
HCPCS,J0879,"Difelikefalin, esrd on dialy",,,0.35,0.54,4
HCPCS,J0881,DARBEPOETIN ALFA 200 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,7571.55,4921.51,,,0
HCPCS,J0881,DARBEPOETIN ALFA 200 MCG/ML IN POLYSORBATE INJECTION,2294.5,1491.42,,,0
HCPCS,J0881,DARBEPOETIN ALFA 40 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,1540.65,1001.42,,,0
HCPCS,J0881,DARBEPOETIN ALFA 500 MCG/ML IN POLYSORBATE INJECTION SYRINGE,5686.9,3696.48,,,0
HCPCS,J0881,DARBEPOETIN ALFA 60 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE,2294.5,1491.42,,,0
HCPCS,J0881,"Darbepoetin alfa, non-esrd",,,2.93,8.05,6
HCPCS,J0881,Noncdm Charge Record Pharmacy,17.37,11.29,,,0
HCPCS,J0882,"Darbepoetin alfa, esrd use",,,2.93,8.05,6
HCPCS,J0883,ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,261.8,170.17,,,0
HCPCS,J0883,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,589.45,383.14,,,0
HCPCS,J0883,Argatroban nonesrd use 1mg,,,0.8,7.37,5
HCPCS,J0883,Noncdm Charge Record Pharmacy,5.98,3.89,,,0
HCPCS,J0884,Argatroban esrd dialysis 1mg,,,1.37,2.17,5
HCPCS,J0884,Noncdm Charge Record Pharmacy,8.6,5.59,,,0
HCPCS,J0885,"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",736.65,478.82,,,0
HCPCS,J0885,"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",291.0,189.15,,,0
HCPCS,J0885,"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",1440.35,936.23,,,0
HCPCS,J0885,"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",420.0,273.0,,,0
HCPCS,J0885,"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",549.0,356.85,,,0
HCPCS,J0885,"EPOETIN ALFA 40,000 UNIT/ML INJECTION SOLUTION",2847.75,1851.04,,,0
HCPCS,J0885,"Epoetin alfa, non-esrd",,,8.54,17.51,6
HCPCS,J0885,Noncdm Charge Record Pharmacy,62.66,40.73,,,0
HCPCS,J0887,Epoetin beta esrd use,,,2.08,3.31,5
HCPCS,J0888,Epoetin beta non esrd,,,2.05,3.28,5
HCPCS,J0888,Noncdm Charge Record Pharmacy,18.18,11.82,,,0
HCPCS,J0889,Daprodustat oral 1mg esrd,,,9.15,9.15,2
HCPCS,J0890,Peginesatide injection,,,0.02,0.02,2
HCPCS,J0891,Argatroban nonesrd (accord),,,1.82,9.27,5
HCPCS,J0892,Argatroban dialysis (accord),,,9.27,12.87,4
HCPCS,J0893,"Inj, decitabine (sun pharma)",,,4.68,100.05,4
HCPCS,J0894,DECITABINE 50 MG INTRAVENOUS SOLUTION,371.25,241.31,,,0
HCPCS,J0894,Decitabine injection,,,3.97,6.31,5
HCPCS,J0894,Noncdm Charge Record Pharmacy,6.16,4.0,,,0
HCPCS,J0895,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,101.35,65.88,,,0
HCPCS,J0895,Deferoxamine mesylate inj,,,15.19,24.23,5
HCPCS,J0896,Inj luspatercept-aamt 0.25mg,,,41.98,111.87,6
HCPCS,J0896,LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLUTION,20555.85,13361.3,,,0
HCPCS,J0896,LUSPATERCEPT-AAMT 75 MG SUBCUTANEOUS SOLUTION,61601.45,40040.94,,,0
HCPCS,J0896,Noncdm Charge Record Pharmacy,200.15,130.1,,,0
HCPCS,J0897,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,16852.9,10954.38,,,0
HCPCS,J0897,DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE,9177.0,5965.05,,,0
HCPCS,J0897,Denosumab injection,,,29.38,74.96,6
HCPCS,J0897,Noncdm Charge Record Pharmacy,140.51,91.33,,,0
HCPCS,J0898,Argatroban nonesrd (auromed),,,3.85,9.13,4
HCPCS,J0898,Noncdm Charge Record Pharmacy,7.64,4.97,,,0
HCPCS,J0899,"Argatroban dialysis, auromed",,,9.13,14.28,4
HCPCS,J0899,Noncdm Charge Record Pharmacy,7.58,4.93,,,0
HCPCS,J0901,Vadadustat oral 1mg for esrd,,,0.33,0.46,4
HCPCS,J0911,Inst tauro 1.35mg/hep 100u,,,6.41,23.47,5
HCPCS,J0945,Brompheniramine maleate inj,,,0.87,0.87,2
HCPCS,J1000,Depo-estradiol cypionate inj,,,65.71,104.74,5
HCPCS,J1000,ESTRADIOL CYPIONATE 5 MG/ML INTRAMUSCULAR OIL,78.45,50.99,,,0
HCPCS,J1010,"Inj, methylpred acetate 1 mg",,,0.2,0.33,5
HCPCS,J1010,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,44.35,28.83,,,0
HCPCS,J1010,METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION,62.25,40.46,,,0
HCPCS,J1010,Noncdm Charge Record Pharmacy,1.33,0.86,,,0
HCPCS,J1030,Noncdm Charge Record Pharmacy,53.82,34.98,,,0
HCPCS,J1040,Noncdm Charge Record Pharmacy,70.41,45.77,,,0
HCPCS,J1050,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,277.0,180.05,,,0
HCPCS,J1050,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE,98.1,63.76,,,0
HCPCS,J1050,Medroxyprogesterone acetate,,,0.02,1.36,4
HCPCS,J1050,Noncdm Charge Record Pharmacy,1.71,1.11,,,0
HCPCS,J1071,Inj testosterone cypionate,,,0.05,0.08,5
HCPCS,J1071,Noncdm Charge Record Pharmacy,0.46,0.3,,,0
HCPCS,J1071,TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,54.15,35.2,,,0
HCPCS,J1071,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,42.05,27.33,,,0
HCPCS,J1094,Inj dexamethasone acetate,,,0.02,0.87,4
HCPCS,J1095,"Injection, dexamethasone 9%",,,2.69,7.34,4
HCPCS,J1096,Dexametha opth insert 0.1 mg,,,102.94,306.09,6
HCPCS,J1097,Phenylep ketorolac opth soln,,,96.91,276.12,5
HCPCS,J1100,DEXAMETHASONE 10 MG/ML INJ (ORAL USE),35.8,23.27,,,0
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,36.6,23.79,,,0
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,34.85,22.65,,,0
HCPCS,J1100,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,34.3,22.3,,,0
HCPCS,J1100,Dexamethasone sodium phos,,,0.18,0.3,5
HCPCS,J1100,Hc Dexamehtasone 1 Mg,1.04,0.68,,,0
HCPCS,J1100,INV DEXAMETHASONE 10 MG/ML INJECTION SOLUTION,0.65,0.42,,,0
HCPCS,J1100,INV DEXAMETHASONE 4 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J1100,INV DEXAMETHASONE 8 MG TABLET,0.65,0.42,,,0
HCPCS,J1100,INV DEXAMETHASONE/PLACEBO 4 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J1100,Noncdm Charge Record Pharmacy,5.97,3.88,,,0
HCPCS,J1105,"Dexmedetomidine film, 1 mcg",,,1.76,1.76,2
HCPCS,J1110,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,148.85,96.75,,,0
HCPCS,J1110,Inj dihydroergotamine mesylt,,,69.76,111.22,5
HCPCS,J1110,Noncdm Charge Record Pharmacy,173.07,112.5,,,0
HCPCS,J1120,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,148.9,96.78,,,0
HCPCS,J1120,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION (PWD VIAL),218.4,141.96,,,0
HCPCS,J1120,Acetazolamid sodium injectio,,,36.75,58.59,5
HCPCS,J1120,Noncdm Charge Record Pharmacy,154.88,100.67,,,0
HCPCS,J1130,Inj diclofenac sodium 0.5mg,,,0.02,0.02,2
HCPCS,J1160,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,36.55,23.76,,,0
HCPCS,J1160,Digoxin injection,,,14.99,23.9,5
HCPCS,J1160,Noncdm Charge Record Pharmacy,50.55,32.86,,,0
HCPCS,J1162,DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,23098.9,15014.28,,,0
HCPCS,J1162,Digoxin immune fab (ovine),,,5168.23,13739.65,6
HCPCS,J1162,Noncdm Charge Record Pharmacy,22990.55,14943.86,,,0
HCPCS,J1163,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,34.9,22.68,,,0
HCPCS,J1163,"DILTIAZEM HCL 125 MG/125 ML (1 MG/ML) IN SOD CHLORIDE,ISO-OSM IV SOLN",142.55,92.66,,,0
HCPCS,J1165,Noncdm Charge Record Pharmacy,13.39,8.7,,,0
HCPCS,J1165,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,35.95,23.37,,,0
HCPCS,J1165,Phenytoin sodium injection,,,0.8,1.27,5
HCPCS,J1170,Noncdm Charge Record Pharmacy,46.41,30.17,,,0
HCPCS,J1171,HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,46.4,30.16,,,0
HCPCS,J1171,HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLUTION,43.45,28.24,,,0
HCPCS,J1171,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,45.75,29.74,,,0
HCPCS,J1171,HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,37.25,24.21,,,0
HCPCS,J1171,HYDROMORPHONE (PF) 2 MG/ML INJECTION SYRINGE,39.65,25.77,,,0
HCPCS,J1171,HYDROMORPHONE 0.25 MG/0.5 ML INJECTION SYRINGE,45.6,29.64,,,0
HCPCS,J1171,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,39.75,25.84,,,0
HCPCS,J1171,HYDROMORPHONE 2 MG/ML INJECTION SYRINGE,42.55,27.66,,,0
HCPCS,J1171,HYDROMORPHONE PCA (PALLIATIVE CARE) 500 MG/50 ML,511.8,332.67,,,0
HCPCS,J1171,"Inj, hydromorphone, 0.1 mg",,,0.15,0.24,5
HCPCS,J1171,Noncdm Charge Record Pharmacy,7.3,4.74,,,0
HCPCS,J1190,Dexrazoxane hcl injection,,,63.06,219.18,6
HCPCS,J1200,DIPHENHYDRAMINE 10 MG/ML (1%) SUBQ SOLUTION,38.65,25.12,,,0
HCPCS,J1200,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,33.4,21.71,,,0
HCPCS,J1200,Diphenhydramine hcl injectio,,,1.25,1.98,5
HCPCS,J1200,INV DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,0.65,0.42,,,0
HCPCS,J1200,Noncdm Charge Record Pharmacy,36.5,23.72,,,0
HCPCS,J1201,Inj. cetirizine hcl 0.5mg,,,16.52,42.63,6
HCPCS,J1202,Miglustat oral 65 mg,,,77.22,107.32,4
HCPCS,J1203,"Inj, cipaglucosidase, 5 mg",,,91.21,242.22,6
HCPCS,J1205,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,179.55,116.71,,,0
HCPCS,J1205,Chlorothiazide sodium inj,,,102.79,163.85,5
HCPCS,J1205,Noncdm Charge Record Pharmacy,204.49,132.92,,,0
HCPCS,J1212,Dimethyl sulfoxide 50% 50 ML,,,748.84,1938.71,6
HCPCS,J1230,"METHADONE 10 MG/ML IN SODIUM CHLORIDE,ISO-OSMOTIC INTRAVENOUS SYRINGE",1135.5,738.08,,,0
HCPCS,J1230,METHADONE 10 MG/ML INJECTION SOLUTION,904.4,587.86,,,0
HCPCS,J1230,Methadone injection,,,35.12,55.99,5
HCPCS,J1230,Noncdm Charge Record Pharmacy,110.67,71.94,,,0
HCPCS,J1240,Dimenhydrinate injection,,,14.74,23.5,5
HCPCS,J1245,DIPYRIDAMOLE 5 MG/ML INTRAVENOUS SOLUTION,120.15,78.1,,,0
HCPCS,J1245,Dipyridamole injection,,,6.57,10.49,5
HCPCS,J1250,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,64.25,41.76,,,0
HCPCS,J1250,"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",104.85,68.15,,,0
HCPCS,J1250,Inj dobutamine HCL/250 mg,,,12.56,20.03,5
HCPCS,J1250,Noncdm Charge Record Pharmacy,52.99,34.44,,,0
HCPCS,J1260,Dolasetron mesylate,,,0.02,9.65,4
HCPCS,J1265,DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,46.4,30.16,,,0
HCPCS,J1265,DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,42.95,27.92,,,0
HCPCS,J1265,"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",99.65,64.77,,,0
HCPCS,J1265,Dopamine injection,,,1.31,2.09,5
HCPCS,J1265,Noncdm Charge Record Pharmacy,10.61,6.9,,,0
HCPCS,J1267,Doripenem injection,,,0.02,1.76,4
HCPCS,J1270,"Injection, doxercalciferol",,,0.64,1.03,5
HCPCS,J1271,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,84.4,54.86,,,0
HCPCS,J1271,DOXYCYCLINE LYMPHOCELE INJECTON 1000 MG/50 ML SYRINGE,39.65,25.77,,,0
HCPCS,J1290,Ecallantide injection,,,579.96,1526.0,6
HCPCS,J1299,ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,27140.15,17641.1,,,0
HCPCS,J1300,Eculizumab injection,,,381.07,607.47,5
HCPCS,J1300,INV ECULIZUMAB 10 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J1300,INV ECULIZUMAB/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J1300,Noncdm Charge Record Pharmacy,750.98,488.14,,,0
HCPCS,J1301,"Injection, edaravone, 1 mg",,,20.99,58.75,6
HCPCS,J1302,"Inj, sutimlimab-jome, 10 mg",,,18.86,49.13,6
HCPCS,J1303,INV RAVULIZUMAB 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J1303,INV RAVULIZUMAB/PLACEBO 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J1303,"Inj., ravulizumab-cwvz 10 mg",,,225.11,597.8,6
HCPCS,J1303,Noncdm Charge Record Pharmacy,916.1,595.46,,,0
HCPCS,J1303,RAVULIZUMAB-CWVZ 100 MG/ML INTRAVENOUS SOLUTION,63305.450000000004,41148.545,,,0
HCPCS,J1304,Inj tofersen intrathec 1 mg,,,159.4,420.97,6
HCPCS,J1305,"Inj, evinacumab-dgnb, 5mg",,,193.76,504.9,6
HCPCS,J1305,Noncdm Charge Record Pharmacy,562.95,365.92,,,0
HCPCS,J1306,"Injection, inclisiran, 1 mg",,,12.32,33.28,6
HCPCS,J1306,Noncdm Charge Record Pharmacy,60.72,39.47,,,0
HCPCS,J1307,"Inj, crovalimab-akkz, 10 mg",,,551.51,1452.29,5
HCPCS,J1308,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,34.2,22.23,,,0
HCPCS,J1308,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,34.8,22.62,,,0
HCPCS,J1322,"Elosulfase alfa, injection",,,308.68,796.52,6
HCPCS,J1323,ELRANATAMAB-BCMM 40 MG/ML SUBCUTANEOUS SOLUTION,9438.95,6135.32,,,0
HCPCS,J1323,INV ELRANATAMAB (PF-06863135) 40 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J1323,"Inj, elranatamab-bcmm, 1 mg",,,184.07,481.43,6
HCPCS,J1324,Enfuvirtide injection,,,1.54,2.17,4
HCPCS,J1325,EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,113.95,74.07,,,0
HCPCS,J1325,Epoprostenol injection,,,27.94,44.55,5
HCPCS,J1325,Noncdm Charge Record Pharmacy,120.47,78.31,,,0
HCPCS,J1327,Eptifibatide injection,,,2.99,68.67,5
HCPCS,J1330,Ergonovine maleate injection,,,0.02,0.02,2
HCPCS,J1335,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,152.3,99.0,,,0
HCPCS,J1335,Ertapenem injection,,,18.72,29.84,5
HCPCS,J1335,INV ERTAPENEM/PLACEBO 1000 MG/10ML INJECTION,0.65,0.42,,,0
HCPCS,J1335,Noncdm Charge Record Pharmacy,86.99,56.54,,,0
HCPCS,J1364,ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,316.65,205.82,,,0
HCPCS,J1364,Erythro lactobionate /500 MG,,,105.64,168.4,5
HCPCS,J1364,Noncdm Charge Record Pharmacy,166.6,108.29,,,0
HCPCS,J1380,ESTRADIOL VALERATE 20 MG/ML INTRAMUSCULAR OIL,119.7,77.8,,,0
HCPCS,J1380,Estradiol valerate 10 MG inj,,,13.5,21.52,5
HCPCS,J1380,Noncdm Charge Record Pharmacy,97.7,63.5,,,0
HCPCS,J1410,CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,1780.65,1157.42,,,0
HCPCS,J1410,Inj estrogen conjugate 25 MG,,,392.06,1037.69,6
HCPCS,J1410,Noncdm Charge Record Pharmacy,1844.35,1198.83,,,0
HCPCS,J1411,"Inj, hemgenix, per tx dose",,,0.02,10054100.0,5
HCPCS,J1412,Inj roctavian ml 2x10^13vc g,,,0.02,31620.2,5
HCPCS,J1413,Inj delandistrogene mox rokl,,,0.02,9002027.89,5
HCPCS,J1414,"Inj, beqvez, per tx dose",,,0.02,10054100.0,4
HCPCS,J1426,"Injection, casimersen, 10 mg",,,166.06,520.32,5
HCPCS,J1427,Inj. viltolarsen,,,131.98,183.41,4
HCPCS,J1428,"Inj, eteplirsen, 10 mg",,,167.35,520.32,5
HCPCS,J1429,Inj golodirsen 10 mg,,,374.4,520.32,4
HCPCS,J1430,ETHANOLAMINE OLEATE 5 % INTRAVENOUS SOLUTION,1201.3,780.84,,,0
HCPCS,J1430,Ethanolamine oleate 100 mg,,,508.96,1332.37,6
HCPCS,J1430,Noncdm Charge Record Pharmacy,2230.55,1449.86,,,0
HCPCS,J1434,"Inj, focinvez, 1mg",,,2.84,8.46,5
HCPCS,J1435,Injection estrone per 1 MG,,,0.87,0.87,2
HCPCS,J1437,Inj. fe derisomaltose 10 mg,,,22.02,56.29,6
HCPCS,J1438,Etanercept injection,,,2143.01,2230.0,4
HCPCS,J1438,Noncdm Charge Record Pharmacy,0.69,0.45,,,0
HCPCS,J1439,FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,5193.6,3375.84,,,0
HCPCS,J1439,Inj ferric carboxymaltos 1mg,,,1.11,3.01,6
HCPCS,J1439,Noncdm Charge Record Pharmacy,6.74,4.38,,,0
HCPCS,J1440,Fecal?microbiota jslm 1 ml,,,63.84,172.36,6
HCPCS,J1442,FILGRASTIM 300 MCG/ML INJECTION SOLUTION,1566.6,1018.29,,,0
HCPCS,J1442,FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,2475.05,1608.78,,,0
HCPCS,J1442,Inj filgrastim excl biosimil,,,1.0,2.66,6
HCPCS,J1443,Inj ferric pyrophosphate cit,,,0.07,0.07,2
HCPCS,J1444,Fe pyro cit pow 0.1 mg iron,,,0.07,0.07,2
HCPCS,J1445,Inj triferic avnu 0.1mg iron,,,0.42,0.42,2
HCPCS,J1447,Inj tbo filgrastim 1 microg,,,0.28,1.08,6
HCPCS,J1448,"Injection, trilaciclib, 1mg",,,5.46,14.55,6
HCPCS,J1449,Inj eflapegrastim-xnst 0.1mg,,,20.87,60.0,6
HCPCS,J1450,FLUCONAZOLE 100 MG/50 ML IN SOD. CHLORIDE (ISO) IVPB (CMP),73.45,47.74,,,0
HCPCS,J1450,FLUCONAZOLE 2 MG/ML INTRAVENOUS SOLUTION,83.275,54.13,,,0
HCPCS,J1450,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,66.55,43.26,,,0
HCPCS,J1450,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,75.55,49.11,,,0
HCPCS,J1450,Fluconazole,,,4.05,6.48,5
HCPCS,J1450,Noncdm Charge Record Pharmacy,43.31,28.15,,,0
HCPCS,J1451,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,2467.55,1603.91,,,0
HCPCS,J1451,"Fomepizole, 15 mg",,,6.28,29.09,5
HCPCS,J1451,Noncdm Charge Record Pharmacy,30.06,19.54,,,0
HCPCS,J1453,FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION,141.75,92.14,,,0
HCPCS,J1453,Fosaprepitant injection,,,0.2,0.33,5
HCPCS,J1453,Noncdm Charge Record Pharmacy,1.18,0.77,,,0
HCPCS,J1454,"Inj fosnetupitant, palonoset",,,575.5,1783.45,6
HCPCS,J1455,FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,1609.2,1045.98,,,0
HCPCS,J1455,Foscarnet sodium injection,,,65.07,103.74,5
HCPCS,J1456,"Inj, fosaprepitant (teva)",,,0.75,1.19,6
HCPCS,J1457,Gallium nitrate injection,,,0.02,3.5,4
HCPCS,J1458,Galsulfase injection,,,508.76,1314.13,6
HCPCS,J1459,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",4538.725,2950.17,,,0
HCPCS,J1459,INV IMMUNE GLOBULIN (IGG) (PRIVIGEN) 10%,0.65,0.42,,,0
HCPCS,J1459,Inj IVIG privigen 500 mg,,,50.74,133.55,6
HCPCS,J1459,Noncdm Charge Record Pharmacy,155.12,100.83,,,0
HCPCS,J1460,Gamma globulin 1 CC inj,,,49.03,133.93,6
HCPCS,J1551,Inj cutaquig 100 mg,,,14.23,39.32,6
HCPCS,J1552,"Inj, alyglo, 500 mg",,,130.24,398.07,6
HCPCS,J1554,Inj. asceniv,,,496.74,1341.37,6
HCPCS,J1555,"Inj cuvitru, 100 mg",,,16.84,45.01,6
HCPCS,J1556,"Inj, imm glob bivigam, 500mg",,,77.39,207.67,6
HCPCS,J1557,Gammaplex injection,,,63.68,153.85,6
HCPCS,J1558,"Inj. xembify, 100 mg",,,14.84,38.64,6
HCPCS,J1559,Hizentra injection,,,14.34,36.96,6
HCPCS,J1560,Gamma globulin > 10 CC inj,,,170.48,1339.17,6
HCPCS,J1561,Gamunex-c/gammaked,,,48.96,132.82,6
HCPCS,J1561,IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,2879.5,1871.68,,,0
HCPCS,J1561,IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,5700.2,3705.13,,,0
HCPCS,J1561,IMMUNE GLOB G 40 GRAM/400 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,11341.6,7372.04,,,0
HCPCS,J1561,IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,1469.15,954.95,,,0
HCPCS,J1561,Noncdm Charge Record Pharmacy,237.68,154.49,,,0
HCPCS,J1562,"Vivaglobin, inj",,,0.02,24.55,4
HCPCS,J1566,"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",6452.65,4194.22,,,0
HCPCS,J1566,"Immune globulin, powder",,,78.8,220.68,6
HCPCS,J1568,INV IMMUNE GLOBULIN (IGG)(OCTAGAM) 10% INFUSION,0.65,0.42,,,0
HCPCS,J1568,INV IMMUNE GLOBULIN (IGG)/PLACEBO (OCTAGAM/PLACEBO) 10% INFUSION,0.65,0.42,,,0
HCPCS,J1568,Noncdm Charge Record Pharmacy,194.0,126.1,,,0
HCPCS,J1568,Octagam injection,,,47.52,133.6,6
HCPCS,J1569,Gammagard liquid injection,,,45.31,125.91,6
HCPCS,J1569,"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",1540.35,1001.23,,,0
HCPCS,J1569,INV IMMUNE GLOBULIN (IGG) (GAMMAGARD) 10%,0.65,0.42,,,0
HCPCS,J1569,Noncdm Charge Record Pharmacy,153.31,99.65,,,0
HCPCS,J1570,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,274.85,178.65,,,0
HCPCS,J1570,Ganciclovir sodium injection,,,48.86,77.89,5
HCPCS,J1570,Noncdm Charge Record Pharmacy,211.67,137.59,,,0
HCPCS,J1571,HepaGam B IM injection,,,66.64,178.7,6
HCPCS,J1572,Flebogamma injection,,,120.7,123.88,4
HCPCS,J1573,"Hepagam B intravenous, inj",,,66.64,178.7,6
HCPCS,J1574,"Inj, ganciclovir (exela)",,,117.0,162.6,4
HCPCS,J1575,Hyqvia 100mg immuneglobulin,,,18.15,47.94,6
HCPCS,J1576,"Inj, panzyga, 500 mg",,,73.0,187.26,6
HCPCS,J1580,GENTAMICIN 100 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,68.4,44.46,,,0
HCPCS,J1580,GENTAMICIN 120 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,69.25,45.01,,,0
HCPCS,J1580,GENTAMICIN 40 MG/ML INJECTION SOLUTION,148.65,96.62,,,0
HCPCS,J1580,GENTAMICIN 80 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,67.55,43.91,,,0
HCPCS,J1580,GENTAMICIN INTRAVENTRICULAR 5MG/2 ML SYRINGE,34.95,22.72,,,0
HCPCS,J1580,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,42.55,27.66,,,0
HCPCS,J1580,Garamycin gentamicin inj,,,4.2,6.69,5
HCPCS,J1580,Noncdm Charge Record Pharmacy,20.7,13.46,,,0
HCPCS,J1595,GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRINGE,1189.25,773.01,,,0
HCPCS,J1595,GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRINGE,537.25,349.21,,,0
HCPCS,J1595,INV GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
HCPCS,J1595,INV GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
HCPCS,J1595,Injection glatiramer acetate,,,134.55,464.95,4
HCPCS,J1595,Noncdm Charge Record Pharmacy,259.29,168.54,,,0
HCPCS,J1596,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,37.45,24.34,,,0
HCPCS,J1596,"Inj, glycopyrrolate, 0.1 mg",,,0.98,1.57,5
HCPCS,J1596,Noncdm Charge Record Pharmacy,14.78,9.61,,,0
HCPCS,J1597,"Inj glycopyrrolate, glyrx-pf",,,3.74,5.31,4
HCPCS,J1598,Inj glycopyrrolate fres kabi,,,3.43,5.47,5
HCPCS,J1599,"Ivig non-lyophilized, NOS",,,348.66,348.66,2
HCPCS,J1600,Gold sodium thiomaleate inj,,,0.02,35.93,4
HCPCS,J1602,Golimumab for iv use 1mg,,,11.04,28.56,6
HCPCS,J1602,Noncdm Charge Record Pharmacy,173.27,112.63,,,0
HCPCS,J1610,Glucagon hydrochloride/1 mg,,,182.45,499.13,6
HCPCS,J1610,Noncdm Charge Record Pharmacy,706.59,459.28,,,0
HCPCS,J1611,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,605.05,393.28,,,0
HCPCS,J1611,"Inj glucagon hcl, fresenius",,,148.99,303.28,6
HCPCS,J1611,Noncdm Charge Record Pharmacy,611.63,397.56,,,0
HCPCS,J1626,Granisetron hcl injection,,,0.39,0.62,5
HCPCS,J1627,"Inj, granisetron, xr, 0.1 mg",,,4.29,14.93,6
HCPCS,J1628,"Inj., guselkumab, 1 mg",,,75.97,199.24,6
HCPCS,J1630,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,33.95,22.07,,,0
HCPCS,J1630,HALOPERIDOL LACTATE 5 MG/ML INTRAMUSCULAR SYRINGE,37.55,24.41,,,0
HCPCS,J1630,Haloperidol injection,,,2.05,3.28,5
HCPCS,J1630,Noncdm Charge Record Pharmacy,35.24,22.91,,,0
HCPCS,J1631,HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,41.6,27.04,,,0
HCPCS,J1631,HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,49.35,32.08,,,0
HCPCS,J1631,Haloperidol decanoate inj,,,9.43,15.04,5
HCPCS,J1631,Noncdm Charge Record Pharmacy,50.47,32.81,,,0
HCPCS,J1632,"Inj., brexanolone, 1 mg",,,174.33,242.27,4
HCPCS,J1640,"Hemin, 1 mg",,,34.18,89.76,6
HCPCS,J1640,Noncdm Charge Record Pharmacy,156.81,101.93,,,0
HCPCS,J1642,Inj heparin sodium per 10 u,,,0.03,0.05,5
HCPCS,J1642,Noncdm Charge Record Pharmacy,0.73,0.47,,,0
HCPCS,J1643,"Inj heparin, pfizer, 1000u",,,5.98,9.54,5
HCPCS,J1643,Noncdm Charge Record Pharmacy,4.0,2.6,,,0
HCPCS,J1644,"HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV",77.65,50.47,,,0
HCPCS,J1644,"HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV",75.55,49.11,,,0
HCPCS,J1644,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",37.0,24.05,,,0
HCPCS,J1644,"HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV",92.3,60.0,,,0
HCPCS,J1644,"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",92.3,60.0,,,0
HCPCS,J1644,"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",63.15,41.05,,,0
HCPCS,J1644,"HEPARIN (PORCINE) 5,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV SOLN",63.1,41.02,,,0
HCPCS,J1644,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",37.3,24.24,,,0
HCPCS,J1644,"HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJECTION SOLUTION",57.5,37.38,,,0
HCPCS,J1644,"HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJECTION SOLUTION (BMT)",82.1,53.36,,,0
HCPCS,J1644,INV HEPARIN 1000 UNIT/ML INJECTION,0.65,0.42,,,0
HCPCS,J1644,"INV HEPARIN 25,000 UNITS IN DEXTROSE 5% 250 ML INFUSION",121.6,79.04,,,0
HCPCS,J1644,"INV HEPARIN/PLACEBO 1,000 UNIT/ML INJECTION SOLUTION",0.65,0.42,,,0
HCPCS,J1644,Inj heparin sodium per 1000u,,,0.34,0.54,5
HCPCS,J1644,Noncdm Charge Record Pharmacy,5.75,3.74,,,0
HCPCS,J1645,Dalteparin sodium,,,23.57,37.56,5
HCPCS,J1645,"INV DALTEPARIN 10,000 UNITS/1 ML SYRINGE",0.65,0.42,,,0
HCPCS,J1645,"INV DALTEPARIN 12,500 UNITS/0.5 ML SYRINGE",0.65,0.42,,,0
HCPCS,J1645,"INV DALTEPARIN 15,000 UNITS/0.6 ML SYRINGE",0.65,0.42,,,0
HCPCS,J1645,"INV DALTEPARIN 18,000 UNITS/0.72 ML SYRINGE",0.65,0.42,,,0
HCPCS,J1645,INV DALTEPARIN 2500 UNITS/0.2ML SYRINGE,0.65,0.42,,,0
HCPCS,J1645,INV DALTEPARIN 5000 UNITS/0.2 ML SYRINGE,0.65,0.42,,,0
HCPCS,J1645,INV DALTEPARIN 7500 UNITS/0.3 ML SYRINGE,0.65,0.42,,,0
HCPCS,J1650,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,72.15,46.9,,,0
HCPCS,J1650,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,63.05,40.98,,,0
HCPCS,J1650,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,88.6,57.59,,,0
HCPCS,J1650,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,44.35,28.83,,,0
HCPCS,J1650,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,46.7,30.36,,,0
HCPCS,J1650,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,48.75,31.69,,,0
HCPCS,J1650,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,64.2,41.73,,,0
HCPCS,J1650,INV ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
HCPCS,J1650,INV ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
HCPCS,J1650,INV ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
HCPCS,J1650,INV ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
HCPCS,J1650,INV ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
HCPCS,J1650,INV ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
HCPCS,J1650,INV ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
HCPCS,J1650,Inj enoxaparin sodium,,,0.96,1.52,5
HCPCS,J1650,Noncdm Charge Record Pharmacy,12.26,7.97,,,0
HCPCS,J1652,FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SOLUTION SYRINGE,181.4,117.91,,,0
HCPCS,J1652,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,63.4,41.21,,,0
HCPCS,J1652,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,72.5,47.12,,,0
HCPCS,J1652,Fondaparinux sodium,,,1.14,1.82,5
HCPCS,J1652,Noncdm Charge Record Pharmacy,15.38,10.0,,,0
HCPCS,J1655,Tinzaparin sodium injection,,,0.02,9.65,4
HCPCS,J1670,Noncdm Charge Record Pharmacy,2825.37,1836.49,,,0
HCPCS,J1670,TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,2716.7,1765.86,,,0
HCPCS,J1670,Tetanus immune globulin inj,,,593.0,1550.31,6
HCPCS,J1675,Histrelin acetate,,,2.63,2.63,2
HCPCS,J1720,HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,132.05,85.83,,,0
HCPCS,J1720,HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,238.3,154.9,,,0
HCPCS,J1720,HYDROCORTISONE SOD SUCCINATE (PF) 500 MG/4 ML SOLUTION FOR INJECTION,437.3,284.24,,,0
HCPCS,J1720,HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,120.55,78.36,,,0
HCPCS,J1720,Hydrocortisone sodium succ i,,,35.6,56.75,5
HCPCS,J1720,Noncdm Charge Record Pharmacy,91.8,59.67,,,0
HCPCS,J1726,"Makena, 10 mg",,,37.45,45.98,4
HCPCS,J1729,Inj hydroxyprogst capoat nos,,,31.92,92.49,4
HCPCS,J1730,Diazoxide injection,,,266.47,266.47,2
HCPCS,J1738,Inj. meloxicam 1 mg,,,7.32,10.19,4
HCPCS,J1740,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,1244.3,808.8,,,0
HCPCS,J1740,Ibandronate sodium injection,,,43.11,68.73,5
HCPCS,J1741,Ibuprofen injection,,,5.04,8.05,5
HCPCS,J1742,IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,447.55,290.91,,,0
HCPCS,J1742,Ibutilide fumarate injection,,,172.31,698.02,5
HCPCS,J1742,Noncdm Charge Record Pharmacy,460.02,299.01,,,0
HCPCS,J1743,Idursulfase injection,,,558.46,1469.42,6
HCPCS,J1744,ICATIBANT 30 MG/3 ML SUBCUTANEOUS SYRINGE,6061.35,3939.88,,,0
HCPCS,J1744,Icatibant injection,,,218.06,366.01,4
HCPCS,J1744,Noncdm Charge Record Pharmacy,267.02,173.56,,,0
HCPCS,J1745,INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,5724.65,3721.02,,,0
HCPCS,J1745,INV INFLIXIMAB 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J1745,Infliximab not biosimil 10mg,,,31.09,82.74,6
HCPCS,J1745,Noncdm Charge Record Pharmacy,230.64,149.92,,,0
HCPCS,J1746,"Inj., ibalizumab-uiyk, 10 mg",,,79.26,209.02,6
HCPCS,J1747,"Inj, spesolimab-sbzo, 1 mg",,,65.73,166.48,6
HCPCS,J1748,"Inj, zymfentra, 10 mg",,,99.76,707.93,6
HCPCS,J1749,"Inj, iloprost, 0.1 mcg",,,12.87,17.89,4
HCPCS,J1750,Inj iron dextran,,,18.11,47.15,6
HCPCS,J1750,Noncdm Charge Record Pharmacy,87.05,56.58,,,0
HCPCS,J1756,IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,197.6,128.44,,,0
HCPCS,J1756,Iron sucrose injection,,,0.38,0.62,5
HCPCS,J1756,Noncdm Charge Record Pharmacy,1.96,1.27,,,0
HCPCS,J1786,Imuglucerase injection,,,43.19,117.56,6
HCPCS,J1790,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,37.1,24.12,,,0
HCPCS,J1790,Droperidol injection,,,22.65,33.03,4
HCPCS,J1790,Noncdm Charge Record Pharmacy,47.8,31.07,,,0
HCPCS,J1800,Noncdm Charge Record Pharmacy,74.94,48.71,,,0
HCPCS,J1800,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,55.2,35.88,,,0
HCPCS,J1800,Propranolol injection,,,22.79,27.37,4
HCPCS,J1805,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,63.75,41.44,,,0
HCPCS,J1805,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",400.25,260.16,,,0
HCPCS,J1805,"Inj, esmolol hcl, 10mg",,,0.36,0.57,5
HCPCS,J1805,Noncdm Charge Record Pharmacy,2.31,1.5,,,0
HCPCS,J1806,Inj esmolol hcl wg crit care,,,0.61,0.98,5
HCPCS,J1807,ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,2615.9,1700.34,,,0
HCPCS,J1808,FOLIC ACID 5 MG/ML INJECTION SOLUTION,35.7,23.2,,,0
HCPCS,J1811,Fiasp for insulin pump use,,,13.43,21.41,5
HCPCS,J1812,Inj. Insulin (fiasp),,,3.39,5.2,4
HCPCS,J1813,Lyumjev for insulin pump use,,,26.31,41.95,5
HCPCS,J1814,Inj. insulin (lyumjev),,,3.21,5.42,4
HCPCS,J1815,INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN,104.6,67.99,,,0
HCPCS,J1815,INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,311.2,202.28,,,0
HCPCS,J1815,INSULIN HUMAN U-100 NPH-REGULR 70-30 MIX 100 UNIT/ML SUBCUTANEOUS SUSP,126.7,82.36,,,0
HCPCS,J1815,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS PEN,123.2,80.08,,,0
HCPCS,J1815,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,90.35,58.73,,,0
HCPCS,J1815,INSULIN REGULAR HUMAN U-500(CONCENTRATE) 500 UNIT/ML SUBCUTANEOUS SOLN,6859.7,4458.8,,,0
HCPCS,J1815,INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,55.35,35.98,,,0
HCPCS,J1815,Insulin injection,,,0.51,1.52,4
HCPCS,J1815,Noncdm Charge Record Pharmacy,9.355,6.08,,,0
HCPCS,J1817,Insulin for insulin pump use,,,4.05,6.45,5
HCPCS,J1823,INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION,581846.95,378200.52,,,0
HCPCS,J1823,"Inj. inebilizumab-cdon, 1 mg",,,495.54,1312.72,6
HCPCS,J1823,Noncdm Charge Record Pharmacy,1743.93,1133.55,,,0
HCPCS,J1826,Interferon Beta-1A inj,,,4835.52,5970.51,4
HCPCS,J1830,Interferon beta-1b / .25 MG,,,1327.33,1662.71,4
HCPCS,J1833,"Injection, isavuconazonium",,,1.0,2.68,5
HCPCS,J1833,Noncdm Charge Record Pharmacy,5.08,3.3,,,0
HCPCS,J1835,Itraconazole injection,,,0.02,2464.96,4
HCPCS,J1836,"Inj, metronidazole, 10 mg",,,0.04,0.08,5
HCPCS,J1836,METRONIDAZOLE 5 MG/ML IVPB,63.825,41.489999999999995,,,0
HCPCS,J1836,Noncdm Charge Record Pharmacy,1.37,0.89,,,0
HCPCS,J1885,KETOROLAC 15 MG/ML INJECTION SOLUTION,36.05,23.43,,,0
HCPCS,J1885,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,36.15,23.5,,,0
HCPCS,J1885,Ketorolac tromethamine inj,,,0.3,2.03,6
HCPCS,J1885,Noncdm Charge Record Pharmacy,27.45,17.84,,,0
HCPCS,J1920,"Inj, labetalol hcl, 5mg",,,0.5,0.79,5
HCPCS,J1920,Noncdm Charge Record Pharmacy,19.27,12.53,,,0
HCPCS,J1921,"Inj labetalol hcl hikma, 5mg",,,2.35,3.74,5
HCPCS,J1921,Noncdm Charge Record Pharmacy,10.89,7.08,,,0
HCPCS,J1930,Lanreotide injection,,,34.05,121.9,6
HCPCS,J1931,Laronidase injection,,,39.87,104.66,6
HCPCS,J1932,"Inj, lanreotide, (cipla) 1mg",,,29.84,83.14,6
HCPCS,J1938,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,39.75,25.84,,,0
HCPCS,J1939,"Inj, bumetanide, 0.5 mg",,,0.98,1.57,5
HCPCS,J1939,Noncdm Charge Record Pharmacy,5.7,3.7,,,0
HCPCS,J1940,Furosemide injection,,,0.66,1.06,5
HCPCS,J1940,Noncdm Charge Record Pharmacy,16.76,10.89,,,0
HCPCS,J1941,"Inj, furoscix, 20 mg",,,554.25,770.26,4
HCPCS,J1943,"ARIPIPRAZOLE LAUROXIL,SUBMIC. ER 675 MG/2.4 ML SUSP,EXT.REL.IM SYRINGE",11325.75,7361.74,,,0
HCPCS,J1943,"Inj., aristada initio, 1 mg",,,3.24,8.48,6
HCPCS,J1943,Noncdm Charge Record Pharmacy,3.76,2.44,,,0
HCPCS,J1944,"ARIPIPRAZOLE LAUROXIL ER 1,064 MG/3.9 ML SUSPENSION,EXT.REL IM SYRINGE",17833.75,11591.94,,,0
HCPCS,J1944,"ARIPIPRAZOLE LAUROXIL ER 441 MG/1.6 ML SUSPENSION, EXT.REL. IM SYRINGE",7410.9,4817.08,,,0
HCPCS,J1944,"ARIPIPRAZOLE LAUROXIL ER 662 MG/2.4 ML SUSPENSION, EXT.REL. IM SYRINGE",11108.3,7220.4,,,0
HCPCS,J1944,"ARIPIPRAZOLE LAUROXIL ER 882 MG/3.2 ML SUSPENSION, EXT.REL. IM SYRINGE",14788.8,9612.72,,,0
HCPCS,J1944,Aripirazole lauroxil 1 mg,,,3.34,8.75,6
HCPCS,J1944,Noncdm Charge Record Pharmacy,3.45,2.24,,,0
HCPCS,J1945,INV DARATUMUMAB 20 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J1945,Lepirudin,,,0.02,393.6,4
HCPCS,J1950,LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,7383.5,4799.28,,,0
HCPCS,J1950,LEUPROLIDE ACETATE 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,21986.45,14291.19,,,0
HCPCS,J1950,Leuprolide acetate /3.75 mg,,,1730.32,4516.97,6
HCPCS,J1950,Noncdm Charge Record Pharmacy,6542.35,4252.53,,,0
HCPCS,J1951,Inj fensolvi 0.25 mg,,,140.99,369.86,6
HCPCS,J1952,"Leuprolide inj, camcevi, 1mg",,,78.92,151.52,6
HCPCS,J1953,LEVETIRACETAM 10 MG/ML INTRAVENOUS SOLUTION,129.15,83.95,,,0
HCPCS,J1953,LEVETIRACETAM 15 MG/ML INTRAVENOUS SOLUTION,150.95,98.12,,,0
HCPCS,J1953,LEVETIRACETAM 5 MG/ML INTRAVENOUS SOLUTION,107.4,69.81,,,0
HCPCS,J1953,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,39.05,25.38,,,0
HCPCS,J1953,Levetiracetam injection,,,0.09,0.14,5
HCPCS,J1953,Noncdm Charge Record Pharmacy,0.5,0.32,,,0
HCPCS,J1954,Leuprolide depot cipla 7.5mg,,,399.98,706.67,6
HCPCS,J1955,Inj levocarnitine per 1 gm,,,43.46,69.27,5
HCPCS,J1955,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,213.2,138.58,,,0
HCPCS,J1955,Noncdm Charge Record Pharmacy,191.98,124.79,,,0
HCPCS,J1956,LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,64.65,42.02,,,0
HCPCS,J1956,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,66.75,43.39,,,0
HCPCS,J1956,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,67.55,43.91,,,0
HCPCS,J1956,Levofloxacin injection,,,3.21,5.12,5
HCPCS,J1956,Noncdm Charge Record Pharmacy,25.84,16.8,,,0
HCPCS,J1960,Levorphanol tartrate inj,,,0.02,7.89,4
HCPCS,J1961,"Inj, lenacapavir, 1 mg",,,22.15,59.57,6
HCPCS,J1980,HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,137.25,89.21,,,0
HCPCS,J1980,Hyoscyamine sulfate inj,,,24.55,126.36,4
HCPCS,J1980,Noncdm Charge Record Pharmacy,158.13,102.78,,,0
HCPCS,J1990,Chlordiazepoxide injection,,,0.02,54.34,4
HCPCS,J2001,Noncdm Charge Record Pharmacy,0.4,0.26,,,0
HCPCS,J2002,"Inj, lidocaine in d5w, 1 mg",,,0.01,0.03,3
HCPCS,J2002,LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,75.55,49.11,,,0
HCPCS,J2003,"Inj, lidocaine hcl, 1 mg",,,0.16,0.16,2
HCPCS,J2003,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,39.1,25.42,,,0
HCPCS,J2003,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,63.05,40.98,,,0
HCPCS,J2003,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,65.3,42.44,,,0
HCPCS,J2003,LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,40.15,26.1,,,0
HCPCS,J2003,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,47.25,30.71,,,0
HCPCS,J2003,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,43.5,28.28,,,0
HCPCS,J2003,LIDOCAINE 10 MG/ML (1 %) INJECTION SOLUTION SORD,37.25,24.21,,,0
HCPCS,J2003,LIDOCAINE 20 MG/ML (2 %) INJECTION SOLUTION SORD,52.35,34.03,,,0
HCPCS,J2003,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,42.9,27.884999999999998,,,0
HCPCS,J2003,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,44.7,29.06,,,0
HCPCS,J2003,LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,53.6,34.84,,,0
HCPCS,J2004,"Inj, lidocaine w epinephrine",,,0.02,0.08,4
HCPCS,J2004,"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",34.0,22.1,,,0
HCPCS,J2004,"LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION",34.0,22.1,,,0
HCPCS,J2004,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",34.9,22.68,,,0
HCPCS,J2004,"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",36.15,23.5,,,0
HCPCS,J2004,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",37.45,24.34,,,0
HCPCS,J2004,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",33.15,21.55,,,0
HCPCS,J2010,Lincomycin injection,,,11.44,18.24,5
HCPCS,J2020,LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,90.2,58.63,,,0
HCPCS,J2020,Linezolid injection,,,5.06,8.08,5
HCPCS,J2020,Noncdm Charge Record Pharmacy,32.77,21.3,,,0
HCPCS,J2021,"Inj, linezolid (hospira)",,,14.06,22.41,5
HCPCS,J2060,LORAZEPAM 2 MG/ML INJECTION SOLUTION,34.25,22.265,,,0
HCPCS,J2060,LORAZEPAM 2 MG/ML INJECTION SYRINGE,36.35,23.63,,,0
HCPCS,J2060,LORAZEPAM 4 MG/ML INJECTION SOLUTION,77.65,50.47,,,0
HCPCS,J2060,Lorazepam injection,,,2.3,3.66,5
HCPCS,J2060,Noncdm Charge Record Pharmacy,36.18,23.52,,,0
HCPCS,J2062,Loxapine for inhalation 1 mg,,,15.9,48.78,5
HCPCS,J2150,Mannitol injection,,,4.31,6.88,5
HCPCS,J2150,Noncdm Charge Record Pharmacy,40.44,26.29,,,0
HCPCS,J2151,MANNITOL 20 % INTRAVENOUS SOLUTION,71.7,46.6,,,0
HCPCS,J2151,MANNITOL 20% IVPB 125 ML (CMP),71.7,46.6,,,0
HCPCS,J2151,MANNITOL 20% IVPB 250 ML (CMP),110.1,71.56,,,0
HCPCS,J2151,MANNITOL 20% IVPB 62.5 ML (CMP),71.6,46.54,,,0
HCPCS,J2151,MANNITOL 25 % INTRAVENOUS SOLUTION,38.35,24.93,,,0
HCPCS,J2170,Mecasermin injection,,,344.1,457.64,4
HCPCS,J2175,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,43.0,27.95,,,0
HCPCS,J2175,MEPERIDINE (PF) 25 MG/ML INJECTION SYRINGE,62.2,40.43,,,0
HCPCS,J2175,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,43.35,28.18,,,0
HCPCS,J2175,MEPERIDINE (PF) 50 MG/ML INJECTION SORD,43.35,28.18,,,0
HCPCS,J2175,Meperidine hydrochl /100 MG,,,11.84,18.86,5
HCPCS,J2175,Noncdm Charge Record Pharmacy,47.87,31.12,,,0
HCPCS,J2180,Meperidine/promethazine inj,,,20.16,20.16,2
HCPCS,J2182,"Injection, mepolizumab, 1mg",,,31.27,83.17,6
HCPCS,J2182,Noncdm Charge Record Pharmacy,187.24,121.71,,,0
HCPCS,J2183,Inj meropenem (wg crit care),,,2.81,4.47,5
HCPCS,J2183,MEROPENEM 2 GRAM INTRAVENOUS SOLUTION,160.45,104.29,,,0
HCPCS,J2183,Noncdm Charge Record Pharmacy,9.28,6.03,,,0
HCPCS,J2184,"Inj, meropenem (b. braun)",,,3.53,5.61,5
HCPCS,J2184,MEROPENEM 1 GRAM/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,118.9,77.28,,,0
HCPCS,J2184,MEROPENEM 500 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,103.25,67.11,,,0
HCPCS,J2184,Noncdm Charge Record Pharmacy,13.6,8.84,,,0
HCPCS,J2185,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,53.8,34.97,,,0
HCPCS,J2185,MEROPENEM 500 MG INTRAVENOUS SOLUTION,44.75,29.09,,,0
HCPCS,J2185,Meropenem,,,0.66,1.06,5
HCPCS,J2185,Noncdm Charge Record Pharmacy,5.93,3.85,,,0
HCPCS,J2186,"Inj., meropenem, vaborbactam",,,2.18,5.69,5
HCPCS,J2186,MEROPENEM-VABORBACTAM 2 GRAM INTRAVENOUS SOLUTION,1138.95,740.32,,,0
HCPCS,J2186,Noncdm Charge Record Pharmacy,10.79,7.01,,,0
HCPCS,J2210,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,109.2,70.98,,,0
HCPCS,J2210,Methylergonovin maleate inj,,,37.1,59.13,5
HCPCS,J2210,Noncdm Charge Record Pharmacy,130.64,84.92,,,0
HCPCS,J2212,METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,558.25,362.86,,,0
HCPCS,J2212,METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SYRINGE,558.25,362.86,,,0
HCPCS,J2212,Methylnaltrexone injection,,,3.14,4.88,4
HCPCS,J2212,Noncdm Charge Record Pharmacy,6.8,4.42,,,0
HCPCS,J2246,"Inj, micafungin (baxter)",,,1.85,2.52,4
HCPCS,J2247,"Inj, micafungin (par pharm)",,,0.53,0.84,5
HCPCS,J2247,Noncdm Charge Record Pharmacy,1.5,0.98,,,0
HCPCS,J2248,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,140.15,91.1,,,0
HCPCS,J2248,MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,114.3,74.3,,,0
HCPCS,J2248,Micafungin sodium injection,,,0.48,0.76,5
HCPCS,J2248,Noncdm Charge Record Pharmacy,1.92,1.25,,,0
HCPCS,J2249,"Inj, remimazolam, 1 mg",,,5.12,6.83,4
HCPCS,J2250,Inj midazolam hydrochloride,,,0.22,0.35,5
HCPCS,J2250,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,34.0,22.1,,,0
HCPCS,J2250,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,37.35,24.28,,,0
HCPCS,J2250,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,33.4,21.71,,,0
HCPCS,J2250,MIDAZOLAM 1 MG/ML NASAL SYRINGE (NEONATE/PED),33.4,21.71,,,0
HCPCS,J2250,MIDAZOLAM 5 MG/ML INJECTION SORD,36.05,23.43,,,0
HCPCS,J2250,MIDAZOLAM 5 MG/ML NASAL SYRINGE (NEONATAL/PED),34.25,22.26,,,0
HCPCS,J2250,Noncdm Charge Record Pharmacy,18.9,12.28,,,0
HCPCS,J2251,Inj midazolam (wg crit care),,,0.28,0.46,5
HCPCS,J2251,MIDAZOLAM (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,108.65,70.62,,,0
HCPCS,J2251,Noncdm Charge Record Pharmacy,1.35,0.88,,,0
HCPCS,J2252,Inj midazolam in 0.8% nacl,,,0.16,0.22,4
HCPCS,J2260,Inj milrinone lactate / 5 mg,,,2.23,3.55,5
HCPCS,J2260,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,50.9,33.08,,,0
HCPCS,J2260,MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,77.2,50.18,,,0
HCPCS,J2260,Noncdm Charge Record Pharmacy,20.86,13.56,,,0
HCPCS,J2265,MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,1320.75,858.49,,,0
HCPCS,J2265,Minocycline hydrochloride,,,2.67,7.02,5
HCPCS,J2265,Noncdm Charge Record Pharmacy,12.42,8.07,,,0
HCPCS,J2267,"Inj, mirikizumab-mrkz, 1 mg",,,43.05,123.01,6
HCPCS,J2270,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,47.0,30.55,,,0
HCPCS,J2270,MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,42.65,27.72,,,0
HCPCS,J2270,MORPHINE (PF) 2 MG/2 ML(1 MG/ML) IN 0.9% SODIUM CHLORIDE IV SYRINGE,46.8,30.42,,,0
HCPCS,J2270,MORPHINE 10 MG/ML INJECTION SOLUTION SORD,39.15,25.45,,,0
HCPCS,J2270,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,39.15,25.45,,,0
HCPCS,J2270,MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,43.9,28.54,,,0
HCPCS,J2270,MORPHINE 4 MG/ML INTRAVENOUS SYRINGE,40.55,26.36,,,0
HCPCS,J2270,MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,127.5,82.88,,,0
HCPCS,J2270,Morphine sulfate injection,,,7.78,12.41,5
HCPCS,J2270,Noncdm Charge Record Pharmacy,44.53,28.94,,,0
HCPCS,J2272,"Inj, morphine (fresenius)",,,6.9,11.0,5
HCPCS,J2272,MORPHINE 2 MG/ML INJECTION SOLUTION,41.45,26.94,,,0
HCPCS,J2272,MORPHINE 2 MG/ML INJECTION SYRINGE,44.45,28.89,,,0
HCPCS,J2272,MORPHINE 4 MG/ML INJECTION SOLUTION,41.65,27.07,,,0
HCPCS,J2272,MORPHINE 4 MG/ML INJECTION SYRINGE,36.8,23.92,,,0
HCPCS,J2272,Noncdm Charge Record Pharmacy,44.66,29.03,,,0
HCPCS,J2274,In morphine preservativ free,,,19.64,31.3,5
HCPCS,J2274,MORPHINE (PF) 10 MG/ML INJECTION SOLUTION,987.8,642.07,,,0
HCPCS,J2274,MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,1724.25,1120.76,,,0
HCPCS,J2274,MORPHINE 0.5 MG/ML INJECTABLE SYRINGE (NEONATE),33.25,21.61,,,0
HCPCS,J2274,Noncdm Charge Record Pharmacy,41.0,26.65,,,0
HCPCS,J2277,"Inj, motixafortide, 0.25 mg",,,25.22,68.35,6
HCPCS,J2278,Ziconotide injection,,,10.14,26.5,6
HCPCS,J2280,"Inj, moxifloxacin 100 mg",,,14.7,23.44,5
HCPCS,J2281,Inj moxifloxacin (fres kabi),,,10.48,16.72,5
HCPCS,J2290,INV NAFCILLIN 200 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J2290,"Inj, nafcillin sodium, 20 mg",,,0.51,0.76,4
HCPCS,J2290,NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,46.4,30.16,,,0
HCPCS,J2300,Inj nalbuphine hydrochloride,,,5.83,9.3,5
HCPCS,J2300,NALBUPHINE 10 MG/ML INJECTION SOLUTION,48.75,31.69,,,0
HCPCS,J2300,NALBUPHINE 20 MG/ML INJECTION SOLUTION,54.0,35.1,,,0
HCPCS,J2300,Noncdm Charge Record Pharmacy,47.18,30.67,,,0
HCPCS,J2305,"Inj, nitroglycerin, 5 mg",,,2.4,3.82,5
HCPCS,J2305,NITROGLYCERIN 100 MCG/ML 10ML SYRINGE (CMP PMX),35.95,23.37,,,0
HCPCS,J2305,NITROGLYCERIN 50 MCG/ML 10ML VIAL (CMP PMX),33.1,21.52,,,0
HCPCS,J2305,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,94.25,61.26,,,0
HCPCS,J2305,NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,127.9,83.14,,,0
HCPCS,J2305,Noncdm Charge Record Pharmacy,18.0,11.7,,,0
HCPCS,J2310,Inj naloxone hydrochloride,,,14.79,23.58,5
HCPCS,J2310,Noncdm Charge Record Pharmacy,57.15,37.15,,,0
HCPCS,J2311,"Inj, naloxone hcl (zimhi)",,,2.54,4.07,5
HCPCS,J2312,NALOXONE 0.4 MG/ML INJECTION SOLUTION,217.95,141.67,,,0
HCPCS,J2312,NALOXONE 0.4 MG/ML INJECTION SYRINGE,104.5,67.92,,,0
HCPCS,J2312,NALOXONE 1 MG/ML INJECTION SYRINGE,130.3,84.7,,,0
HCPCS,J2312,NALOXONE 2 MG/2 ML INTRANASAL KIT,175.85,114.3,,,0
HCPCS,J2315,"NALTREXONE ER 380 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE",8275.4,5379.01,,,0
HCPCS,J2315,"Naltrexone, depot form",,,4.24,11.17,6
HCPCS,J2315,Noncdm Charge Record Pharmacy,8.74,5.68,,,0
HCPCS,J2320,Nandrolone decanoate 50 MG,,,0.02,10.51,4
HCPCS,J2323,INV NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J2323,NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,37286.0,24235.9,,,0
HCPCS,J2323,Natalizumab injection,,,24.0,64.71,6
HCPCS,J2323,Noncdm Charge Record Pharmacy,112.55,73.16,,,0
HCPCS,J2325,Nesiritide injection,,,0.02,78.89,4
HCPCS,J2326,"Inj, nusinersen, 0.1mg",,,1280.25,3379.34,5
HCPCS,J2327,Inj risankizumab-rzaa 1 mg,,,14.94,40.87,6
HCPCS,J2327,Noncdm Charge Record Pharmacy,34.17,22.21,,,0
HCPCS,J2327,RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION,43182.45,28068.59,,,0
HCPCS,J2329,INV UBLITUXIMAB 25 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J2329,INV UBLITUXIMAB/PLACEBO 25 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J2329,"Inj ublituximab-xiiy, 1 mg",,,70.75,187.07,6
HCPCS,J2329,Noncdm Charge Record Pharmacy,248.93,161.8,,,0
HCPCS,J2329,UBLITUXIMAB-XIIY 25 MG/ML INTRAVENOUS SOLUTION,46167.45,30008.84,,,0
HCPCS,J2350,INV OCRELIZUMAB 30 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J2350,INV OCRELIZUMAB/PLACEBO 30 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J2350,"Injection, ocrelizumab, 1 mg",,,59.41,159.27,6
HCPCS,J2350,Noncdm Charge Record Pharmacy,244.72,159.07,,,0
HCPCS,J2350,OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION,85702.9,55706.88,,,0
HCPCS,J2351,INV OCRELIZUMAB 920 MG-HYALURONIDASE-OCSQ 23000 UNIT/23 ML SUBCUT SOLN,0.65,0.42,,,0
HCPCS,J2353,Noncdm Charge Record Pharmacy,1133.7,736.9,,,0
HCPCS,J2353,"OCTREOTIDE,MICROSPHERES ER 10 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",17042.1,11077.36,,,0
HCPCS,J2353,"OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",22317.85,14506.6,,,0
HCPCS,J2353,"OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",33402.85,21711.85,,,0
HCPCS,J2353,"Octreotide injection, depot",,,203.58,591.78,6
HCPCS,J2354,Noncdm Charge Record Pharmacy,5.94,3.86,,,0
HCPCS,J2354,OCTREOTIDE ACETATE 100 MCG/ML (1 ML) INJECTION SYRINGE,57.25,37.21,,,0
HCPCS,J2354,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,41.65,27.07,,,0
HCPCS,J2354,OCTREOTIDE ACETATE 200 MCG/ML INJECTION SOLUTION,35.85,23.3,,,0
HCPCS,J2354,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,38.25,24.86,,,0
HCPCS,J2354,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,60.15,39.1,,,0
HCPCS,J2354,"Octreotide inj, non-depot",,,1.37,2.2,5
HCPCS,J2355,Oprelvekin injection,,,0.02,648.67,4
HCPCS,J2356,"Inj tezepelumab-ekko, 1mg",,,18.01,49.21,6
HCPCS,J2356,Noncdm Charge Record Pharmacy,100.62,65.4,,,0
HCPCS,J2357,Noncdm Charge Record Pharmacy,237.65,154.47,,,0
HCPCS,J2357,OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,7381.45,4797.94,,,0
HCPCS,J2357,Omalizumab injection,,,44.6,102.33,6
HCPCS,J2358,Olanzapine long-acting inj,,,4.96,7.91,5
HCPCS,J2359,"Inj. olanzapine, 0.5mg",,,1.27,2.03,5
HCPCS,J2359,Noncdm Charge Record Pharmacy,8.08,5.25,,,0
HCPCS,J2359,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,97.75,63.54,,,0
HCPCS,J2360,Noncdm Charge Record Pharmacy,103.88,67.52,,,0
HCPCS,J2360,ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION,83.9,54.54,,,0
HCPCS,J2360,Orphenadrine injection,,,23.79,37.91,5
HCPCS,J2371,Inj phenylephrine hcl 20 mcg,,,0.02,0.03,4
HCPCS,J2371,Noncdm Charge Record Pharmacy,0.02,0.01,,,0
HCPCS,J2371,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,32.95,21.42,,,0
HCPCS,J2371,PHENYLEPHRINE 500 MCG/ML INJECTION,33.55,21.81,,,0
HCPCS,J2372,"Inj, biorphen, 20 micrograms",,,0.28,0.46,5
HCPCS,J2373,"Inj, immphentiv, 20 mcg",,,0.24,0.38,5
HCPCS,J2401,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,131.5,85.48,,,0
HCPCS,J2401,Chloroprocaine hcl injection,,,0.05,0.08,5
HCPCS,J2401,Noncdm Charge Record Pharmacy,0.26,0.17,,,0
HCPCS,J2402,Chloroprocaine (clorotekal),,,0.73,1.0,4
HCPCS,J2403,"Chloroprocaine opht gel, 1mg",,,0.58,1.65,6
HCPCS,J2404,"Inj, nicardipine 0.1 mg",,,0.13,0.22,5
HCPCS,J2404,NICARDIPINE 100 MCG/ML 4ML INJECTION (CMP PMX),34.2,22.23,,,0
HCPCS,J2404,NICARDIPINE 20 MG/200 ML(0.1 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN,212.95,138.42,,,0
HCPCS,J2404,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,77.65,50.47,,,0
HCPCS,J2404,NICARDIPINE 400 MCG/4 ML INJECTION (CMP),61.85,40.2,,,0
HCPCS,J2404,NICARDIPINE 5 MG/5 ML SYRINGE (CMP PMX),62.85,40.85,,,0
HCPCS,J2404,Noncdm Charge Record Pharmacy,0.9099999999999999,0.5900000000000001,,,0
HCPCS,J2405,Noncdm Charge Record Pharmacy,8.87,5.77,,,0
HCPCS,J2405,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,34.8,22.62,,,0
HCPCS,J2405,Ondansetron hcl injection,,,0.15,0.24,5
HCPCS,J2406,"Injection, oritavancin 10 mg",,,42.48,117.4,6
HCPCS,J2407,"Injection, oritavancin",,,28.68,77.32,6
HCPCS,J2407,Noncdm Charge Record Pharmacy,141.82,92.18,,,0
HCPCS,J2407,ORITAVANCIN 400 MG INTRAVENOUS SOLUTION,5405.15,3513.35,,,0
HCPCS,J2410,Oxymorphone hcl injection,,,0.02,6.12,4
HCPCS,J2425,Palifermin injection,,,35.55,92.11,6
HCPCS,J2426,Noncdm Charge Record Pharmacy,15.33,9.96,,,0
HCPCS,J2426,PALIPERIDONE PALMITATE 117 MG/0.75 ML INTRAMUSCULAR SYRINGE,8560.75,5564.49,,,0
HCPCS,J2426,PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,11403.75,7412.44,,,0
HCPCS,J2426,PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,17088.8,11107.72,,,0
HCPCS,J2426,Paliperidone palmitate inj,,,15.11,39.92,6
HCPCS,J2427,"Inj, invega hafyera/trinza",,,13.0,34.2,6
HCPCS,J2427,Noncdm Charge Record Pharmacy,60.88,39.57,,,0
HCPCS,J2430,Noncdm Charge Record Pharmacy,68.16,44.3,,,0
HCPCS,J2430,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,99.65,64.77,,,0
HCPCS,J2430,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,163.05,105.98,,,0
HCPCS,J2430,Pamidronate disodium /30 mg,,,21.39,34.09,5
HCPCS,J2440,Noncdm Charge Record Pharmacy,109.31,71.05,,,0
HCPCS,J2440,PAPAVERINE 30 MG/ML INJECTION SOLUTION,110.0,71.5,,,0
HCPCS,J2440,Papaverin hcl injection,,,87.75,124.5,4
HCPCS,J2468,"Inj, palonosetron (avyxa)",,,58.24,161.9,5
HCPCS,J2469,Noncdm Charge Record Pharmacy,7.37,4.79,,,0
HCPCS,J2469,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,102.55,66.66,,,0
HCPCS,J2469,Palonosetron hcl,,,1.0,1.6,5
HCPCS,J2470,Inj pantoprazole sodium 40mg,,,10.65,26.5,4
HCPCS,J2470,Noncdm Charge Record Pharmacy,41.78,27.16,,,0
HCPCS,J2470,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,38.2,24.83,,,0
HCPCS,J2471,Inj pantoprazole(hikma) 40mg,,,15.21,21.14,4
HCPCS,J2471,Noncdm Charge Record Pharmacy,47.25,30.71,,,0
HCPCS,J2472,"Inj, pantoprazole sodium chl",,,20.64,25.96,4
HCPCS,J2501,Noncdm Charge Record Pharmacy,22.99,14.94,,,0
HCPCS,J2501,Paricalcitol,,,1.53,2.44,5
HCPCS,J2502,"Inj, pasireotide long acting",,,572.96,1487.28,5
HCPCS,J2503,Pegaptanib sodium injection,,,0.02,2459.7,4
HCPCS,J2504,"Pegademase bovine, 25 iu",,,0.02,419.02,4
HCPCS,J2506,Inj pegfilgrast ex bio 0.5mg,,,33.97,89.34,6
HCPCS,J2506,Noncdm Charge Record Pharmacy,1307.71,850.01,,,0
HCPCS,J2506,PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR,15393.0,10005.45,,,0
HCPCS,J2506,PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,15393.0,10005.45,,,0
HCPCS,J2507,Noncdm Charge Record Pharmacy,16284.4,10584.86,,,0
HCPCS,J2507,Pegloticase injection,,,3660.83,9620.64,6
HCPCS,J2508,Pegunigalsidase alfa-iwxj,,,228.16,614.6,6
HCPCS,J2510,Penicillin g procaine inj,,,107.52,127.88,4
HCPCS,J2513,Pentastarch 10% solution,,,0.02,0.02,2
HCPCS,J2515,Noncdm Charge Record Pharmacy,181.34,117.87,,,0
HCPCS,J2515,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,554.0,360.1,,,0
HCPCS,J2515,Pentobarbital sodium inj,,,27.99,182.98,5
HCPCS,J2540,Noncdm Charge Record Pharmacy,17.24,11.21,,,0
HCPCS,J2540,PENICILLIN G POT 0.1 MG/ML (DESENSITIZATION INGREDIENT D),82.3,53.5,,,0
HCPCS,J2540,PENICILLIN G POT 1 MG/ML (DESENSITIZATION INGREDIENT C),82.3,53.5,,,0
HCPCS,J2540,PENICILLIN G POT 10 MG/ML (DESENSITIZATION INGREDIENT B),82.3,53.5,,,0
HCPCS,J2540,PENICILLIN G POT 100 MG/ML (DESENSITIZATION INGREDIENT A),82.3,53.5,,,0
HCPCS,J2540,PENICILLIN G POT 3 MILLION UNIT/50 ML-DEXTROSE INTRAVENOUS PIGGYBACK,72.4,47.06,,,0
HCPCS,J2540,PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,155.9,101.34,,,0
HCPCS,J2540,PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,55.45,36.04,,,0
HCPCS,J2540,Penicillin g potassium inj,,,1.27,2.03,5
HCPCS,J2543,Noncdm Charge Record Pharmacy,45.33,29.46,,,0
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 3.375 GRAM/50 ML DEXTROSE(ISO-OS) IV PIGGYBACK,143.85,93.5,,,0
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,59.05,38.38,,,0
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM 4.5 GRAM/100 ML DEXTROSE(ISO-OSM) IV PIGGYBACK,165.2,107.38,,,0
HCPCS,J2543,Piperacillin/tazobactam,,,1.93,3.09,5
HCPCS,J2545,Pentamidine non-comp unit,,,134.95,215.15,5
HCPCS,J2547,"Injection, peramivir",,,1.68,4.55,5
HCPCS,J2547,Noncdm Charge Record Pharmacy,8.1,5.26,,,0
HCPCS,J2547,PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,1568.4,1019.46,,,0
HCPCS,J2550,Promethazine hcl injection,,,6.07,9.67,5
HCPCS,J2560,Noncdm Charge Record Pharmacy,163.09,106.01,,,0
HCPCS,J2560,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,178.85,116.25,,,0
HCPCS,J2560,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,86.15,56.0,,,0
HCPCS,J2560,Phenobarbital sodium inj,,,52.29,83.36,5
HCPCS,J2561,"Inj, sezaby, 1 mg",,,1.19,3.11,5
HCPCS,J2562,Noncdm Charge Record Pharmacy,1300.92,845.6,,,0
HCPCS,J2562,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,728.55,473.56,,,0
HCPCS,J2562,Plerixafor injection,,,25.33,100.49,6
HCPCS,J2590,Noncdm Charge Record Pharmacy,28.66,18.63,,,0
HCPCS,J2590,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,34.3,22.3,,,0
HCPCS,J2590,OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,143.7,93.4,,,0
HCPCS,J2590,Oxytocin injection,,,3.28,5.45,4
HCPCS,J2597,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,50.6,32.89,,,0
HCPCS,J2597,Inj desmopressin acetate,,,8.42,13.41,5
HCPCS,J2597,Noncdm Charge Record Pharmacy,24.95,16.22,,,0
HCPCS,J2598,"Inj, vasopressin, 1 unit",,,2.77,4.42,5
HCPCS,J2598,Noncdm Charge Record Pharmacy,11.52,7.49,,,0
HCPCS,J2598,VASOPRESSIN 0.2 UNIT/ML INTRAVENOUS SOLUTION,172.05,111.83,,,0
HCPCS,J2598,VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,45.75,29.74,,,0
HCPCS,J2599,Inj vasopressin (am reg) 1 u,,,2.04,3.25,5
HCPCS,J2599,Noncdm Charge Record Pharmacy,7.58,4.93,,,0
HCPCS,J2601,"Inj, vasopressin (baxter)",,,2.01,9.84,6
HCPCS,J2675,Inj progesterone per 50 MG,,,1.52,2.41,5
HCPCS,J2675,PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,33.6,21.84,,,0
HCPCS,J2679,FLUPHENAZINE 2.5 MG/ML INJECTION SOLUTION,58.35,37.93,,,0
HCPCS,J2679,Inj fluphenazine hcl 1.25 mg,,,13.08,20.84,5
HCPCS,J2679,Noncdm Charge Record Pharmacy,43.76,28.44,,,0
HCPCS,J2680,FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION,51.5,33.48,,,0
HCPCS,J2680,Fluphenazine decanoate 25 MG,,,16.0,25.5,5
HCPCS,J2680,Noncdm Charge Record Pharmacy,51.5,33.48,,,0
HCPCS,J2690,Noncdm Charge Record Pharmacy,323.18,210.07,,,0
HCPCS,J2690,PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,221.65,144.07,,,0
HCPCS,J2690,Procainamide hcl injection,,,294.69,496.01,6
HCPCS,J2700,Oxacillin sodium injeciton,,,1.81,2.9,5
HCPCS,J2704,"Inj, propofol, 10 mg",,,0.14,0.22,5
HCPCS,J2704,Noncdm Charge Record Pharmacy,1.61,1.05,,,0
HCPCS,J2704,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,33.85,22.0,,,0
HCPCS,J2704,PROPOFOL INFUSION 10 MG/ML,97.75,63.54,,,0
HCPCS,J2710,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INJECTION SOLUTION SORD,33.95,22.07,,,0
HCPCS,J2710,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INTRAVENOUS SOLUTION,42.2,27.43,,,0
HCPCS,J2710,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,42.2,27.43,,,0
HCPCS,J2710,Neostigmine methylslfte inj,,,1.87,4.5,4
HCPCS,J2710,Noncdm Charge Record Pharmacy,9.33,6.06,,,0
HCPCS,J2720,Inj protamine sulfate/10 MG,,,1.94,3.09,5
HCPCS,J2720,Noncdm Charge Record Pharmacy,9.17,5.96,,,0
HCPCS,J2720,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,39.0,25.35,,,0
HCPCS,J2724,Protein C concentrate,,,15.04,40.73,6
HCPCS,J2730,PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,2444.95,1589.22,,,0
HCPCS,J2730,Pralidoxime chloride inj,,,202.88,281.95,4
HCPCS,J2760,Noncdm Charge Record Pharmacy,2028.76,1318.69,,,0
HCPCS,J2760,PHENTOLAMINE 5 MG INJECTION SOLUTION,1512.25,982.96,,,0
HCPCS,J2760,Phentolaine mesylate inj,,,432.02,1069.45,6
HCPCS,J2765,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,34.8,22.62,,,0
HCPCS,J2765,Metoclopramide hcl injection,,,1.75,2.79,5
HCPCS,J2765,Noncdm Charge Record Pharmacy,38.2,24.83,,,0
HCPCS,J2770,Quinupristin/dalfopristin,,,11.54,1090.46,4
HCPCS,J2777,"Inj, faricimab-svoa, 0.1mg",,,33.88,95.53,6
HCPCS,J2778,Ranibizumab injection,,,86.38,335.99,6
HCPCS,J2779,"Inj, susvimo 0.1 mg",,,78.93,218.05,6
HCPCS,J2781,"Inj, pegcetacoplan, 1mg",,,139.18,396.66,6
HCPCS,J2782,Inj avacincaptad pegol 0.1mg,,,105.12,294.58,6
HCPCS,J2783,Noncdm Charge Record Pharmacy,1552.07,1008.85,,,0
HCPCS,J2783,RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,4674.0,3038.1,,,0
HCPCS,J2783,RASBURICASE 7.5 MG INTRAVENOUS SOLUTION,27650.2,17972.63,,,0
HCPCS,J2783,Rasburicase,,,377.52,1002.62,6
HCPCS,J2785,Hc Lexiscan 0.1Mg,139.36,90.58,,,0
HCPCS,J2785,Noncdm Charge Record Pharmacy,47.58,30.93,,,0
HCPCS,J2785,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,148.9,96.78,,,0
HCPCS,J2785,Regadenoson injection,,,6.48,10.33,5
HCPCS,J2786,"Injection, reslizumab, 1mg",,,10.95,27.97,6
HCPCS,J2787,Riboflavin 5?phos opth<=3ml,,,5335.2,7414.56,4
HCPCS,J2788,Rho d immune globulin 50 mcg,,,41.75,66.56,5
HCPCS,J2790,Noncdm Charge Record Pharmacy,646.57,420.27,,,0
HCPCS,J2790,Rho d immune globulin inj,,,141.72,225.91,5
HCPCS,J2791,Noncdm Charge Record Pharmacy,26.51,17.23,,,0
HCPCS,J2791,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML INJECTION SYRINGE",357.25,232.21,,,0
HCPCS,J2791,Rhophylac injection,,,8.32,13.25,5
HCPCS,J2792,"Rho(D) immune globulin h, sd",,,25.46,89.05,6
HCPCS,J2793,Rilonacept injection,,,63.41,73.17,4
HCPCS,J2794,Noncdm Charge Record Pharmacy,58.96,38.32,,,0
HCPCS,J2794,"RISPERIDONE MICROSPHERES ER 12.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS",1499.4,974.61,,,0
HCPCS,J2794,"RISPERIDONE MICROSPHERES ER 25 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE",2965.5,1927.58,,,0
HCPCS,J2794,"RISPERIDONE MICROSPHERES ER 37.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS",4431.95,2880.77,,,0
HCPCS,J2794,"RISPERIDONE MICROSPHERES ER 50 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE",5898.5,3834.02,,,0
HCPCS,J2794,"Risperidone, long acting",,,10.98,29.78,6
HCPCS,J2795,Noncdm Charge Record Pharmacy,0.71,0.46,,,0
HCPCS,J2795,"ROPIVACAINE (PF) 0.2 %-0.9 % NACL 745 ML INFIL,LOW VAR RATE ELAST PUMP",930.3,604.7,,,0
HCPCS,J2795,ROPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,59.9,38.94,,,0
HCPCS,J2795,ROPIVACAINE (PF) 100 MG/20 ML (5 MG/ML) 0.5 % INJECTION SYRINGE,418.6,272.09,,,0
HCPCS,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) EPIDURAL,208.3,135.4,,,0
HCPCS,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION,40.8,26.52,,,0
HCPCS,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION (PAIN BALL),77.9,50.64,,,0
HCPCS,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,178.6,116.09,,,0
HCPCS,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) PCEA,123.15,80.05,,,0
HCPCS,J2795,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,44.5,28.92,,,0
HCPCS,J2795,"ROPIVACAINE(PF) 0.2 %-0.9 % NACL 545ML INFIL,HI VAR RATE,PCA,ELAS PUMP",689.4,448.11,,,0
HCPCS,J2795,Ropivacaine HCl injection,,,0.12,0.19,5
HCPCS,J2796,Noncdm Charge Record Pharmacy,491.59,319.53,,,0
HCPCS,J2797,"Inj., rolapitant, 0.5 mg",,,0.02,0.02,2
HCPCS,J2798,"Inj., perseris, 0.5 mg",,,12.14,33.03,6
HCPCS,J2799,"Inj, uzedy, 1 mg",,,25.04,66.99,6
HCPCS,J2800,METHOCARBAMOL 100 MG/ML INJECTION SOLUTION,40.8,26.52,,,0
HCPCS,J2800,Methocarbamol injection,,,11.16,17.8,5
HCPCS,J2800,Noncdm Charge Record Pharmacy,60.93,39.6,,,0
HCPCS,J2801,"Inj, rykindo, 0.5 mg",,,13.03,35.31,5
HCPCS,J2802,"Inj, romiplostim 1 microgram",,,11.01,28.56,6
HCPCS,J2802,ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLUTION,6901.3,4485.84,,,0
HCPCS,J2802,ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,13769.4,8950.11,,,0
HCPCS,J2802,ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,27505.75,17878.74,,,0
HCPCS,J2804,RIFAMPIN 600 MG INTRAVENOUS SOLUTION,634.3,412.3,,,0
HCPCS,J2805,Noncdm Charge Record Pharmacy,163.63,106.36,,,0
HCPCS,J2805,SINCALIDE 5 MCG SOLUTION FOR INJECTION,417.85,271.6,,,0
HCPCS,J2805,Sincalide injection,,,194.46,310.0,5
HCPCS,J2806,Noncdm Charge Record Pharmacy,152.33,99.01,,,0
HCPCS,J2810,Inj theophylline per 40 MG,,,0.02,2.85,4
HCPCS,J2820,Sargramostim injection,,,50.36,162.65,6
HCPCS,J2840,Inj sebelipase alfa 1 mg,,,539.91,1462.1,5
HCPCS,J2850,Inj secretin synthetic human,,,40.52,115.36,5
HCPCS,J2850,SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,3364.35,2186.83,,,0
HCPCS,J2860,"Injection, siltuximab",,,165.83,422.68,6
HCPCS,J2865,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,91.1,59.22,,,0
HCPCS,J2910,Aurothioglucose injeciton,,,0.02,0.02,2
HCPCS,J2916,Na ferric gluconate complex,,,3.38,5.39,5
HCPCS,J2916,Noncdm Charge Record Pharmacy,10.89,7.08,,,0
HCPCS,J2916,SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,73.2,47.58,,,0
HCPCS,J2919,INV METHYLYPREDNISOLONE SOD SUC (PF) 125 MG/2 ML INJECTION,0.65,0.42,,,0
HCPCS,J2919,"Inj, methylpred sod succ 5mg",,,0.46,0.73,5
HCPCS,J2919,"METHYLPREDNISOLONE SOD SUCC (PF) 1,000 MG/8 ML INTRAVENOUS SOLUTION",316.7,205.86,,,0
HCPCS,J2919,METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,70.65,45.92,,,0
HCPCS,J2919,METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,56.65,36.82,,,0
HCPCS,J2919,METHYLPREDNISOLONE SOD SUCC (PF) 500 MG/4 ML INTRAVENOUS SOLUTION,251.15,163.25,,,0
HCPCS,J2919,"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",236.65,153.82,,,0
HCPCS,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION,43.8,28.47,,,0
HCPCS,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION,61.05,39.68,,,0
HCPCS,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,145.3,94.44,,,0
HCPCS,J2919,Noncdm Charge Record Pharmacy,3.27,2.13,,,0
HCPCS,J2920,Noncdm Charge Record Pharmacy,55.86,36.31,,,0
HCPCS,J2930,INV METHYLPREDNISOLONE 1000 MG/8 ML INJECTION,0.65,0.42,,,0
HCPCS,J2930,Noncdm Charge Record Pharmacy,49.56,32.21,,,0
HCPCS,J2941,Somatropin injection,,,132.57,355.24,4
HCPCS,J2993,Reteplase injection,,,2904.58,7526.05,5
HCPCS,J2995,Inj streptokinase /250000 IU,,,192.84,192.84,2
HCPCS,J2997,ALTEPLASE 1 MG/ML  (INTRAVENTRICULAR-PF)  1 ML- SYRINGE,323.0,209.95,,,0
HCPCS,J2997,ALTEPLASE 10 MG/10 ML IV SOLUTION,1220.475,793.31,,,0
HCPCS,J2997,ALTEPLASE 100 MG INTRAVENOUS SOLUTION,35757.2,23242.18,,,0
HCPCS,J2997,ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,696.25,452.56,,,0
HCPCS,J2997,ALTEPLASE 50 MG INTRAVENOUS SOLUTION,17919.65,11647.77,,,0
HCPCS,J2997,ALTEPLASE BOLUS AND INFUSION,35757.2,23242.18,,,0
HCPCS,J2997,Alteplase recombinant,,,94.45,247.91,6
HCPCS,J2997,INV ALTEPLASE/PLACEBO 50 MG/50 ML,0.65,0.42,,,0
HCPCS,J2997,Noncdm Charge Record Pharmacy,378.18,245.82,,,0
HCPCS,J2998,Inj plasminogen tvmh 1mg,,,32.77,88.13,5
HCPCS,J3000,Streptomycin injection,,,48.05,76.58,5
HCPCS,J3010,FENTANYL (PF) 10 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,243.0,157.95,,,0
HCPCS,J3010,FENTANYL (PF) 100 MCG/2 ML (50 MCG/ML) INTRAVENOUS SYRINGE,37.1,24.12,,,0
HCPCS,J3010,FENTANYL (PF) 300 MCG/30 ML (10 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE,35.0,22.75,,,0
HCPCS,J3010,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,36.35,23.63,,,0
HCPCS,J3010,FENTANYL (PF) 50 MCG/ML INJECTION SYRINGE,37.75,24.54,,,0
HCPCS,J3010,FENTANYL 10 MCG/ML NASAL SYRINGE (NEONATE/PED),37.35,24.28,,,0
HCPCS,J3010,FENTANYL 50 MCG/ML NASAL SYRINGE (NEONATE/PED),37.0,24.05,,,0
HCPCS,J3010,FENTANYL INFUSION 50 MCG/ML (PEDS),38.05,24.73,,,0
HCPCS,J3010,FENTANYL PCA (PALLIATIVE CARE) 2500 MCG/50 ML,78.45,50.99,,,0
HCPCS,J3010,Fentanyl citrate injeciton,,,1.45,2.3,5
HCPCS,J3010,Noncdm Charge Record Pharmacy,19.29,12.54,,,0
HCPCS,J3030,Noncdm Charge Record Pharmacy,57.375,37.295,,,0
HCPCS,J3030,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,51.25,33.31,,,0
HCPCS,J3030,Sumatriptan succinate / 6 MG,,,114.66,438.83,4
HCPCS,J3031,"Inj., fremanezumab-vfrm 1 mg",,,7.63,10.98,4
HCPCS,J3032,Inj. eptinezumab-jjmr 1 mg,,,19.97,52.36,6
HCPCS,J3032,Noncdm Charge Record Pharmacy,91.14,59.24,,,0
HCPCS,J3055,Inj talquetamab-tgvs 0.25 mg,,,72.62,189.62,6
HCPCS,J3055,Noncdm Charge Record Pharmacy,285.57,185.62,,,0
HCPCS,J3055,TALQUETAMAB-TGVS 2 MG/ML SUBCUTANEOUS SOLUTION,3676.35,2389.63,,,0
HCPCS,J3055,TALQUETAMAB-TGVS 40 MG/ML SUBCUTANEOUS SOLUTION,48005.2,31203.38,,,0
HCPCS,J3060,"Inj, taliglucerace alfa 10 u",,,41.11,112.79,6
HCPCS,J3070,Pentazocine injection,,,0.02,71.87,4
HCPCS,J3090,Inj tedizolid phosphate,,,1.96,4.91,6
HCPCS,J3095,INV TELAVANCIN 750 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J3095,Telavancin injection,,,7.11,20.05,6
HCPCS,J3101,INV TENECTEPLASE/PLACEBO 5 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J3101,Noncdm Charge Record Pharmacy,554.29,360.29,,,0
HCPCS,J3101,TENECTEPLASE 5 MG/10 ML SYRINGE,2426.4,1577.16,,,0
HCPCS,J3101,TENECTEPLASE 50 MG INTRAVENOUS KIT,1897.5,1233.38,,,0
HCPCS,J3101,TENECTEPLASE 50 MG INTRAVENOUS SOLUTION,32069.85,20845.4,,,0
HCPCS,J3101,Tenecteplase injection,,,172.22,440.19,6
HCPCS,J3105,Noncdm Charge Record Pharmacy,36.3,23.6,,,0
HCPCS,J3105,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,34.4,22.36,,,0
HCPCS,J3105,Terbutaline sulfate inj,,,3.64,5.8,5
HCPCS,J3110,Teriparatide injection,,,117.77,189.65,4
HCPCS,J3111,Inj. romosozumab-aqqg 1 mg,,,12.07,31.14,6
HCPCS,J3111,Noncdm Charge Record Pharmacy,54.56,35.46,,,0
HCPCS,J3111,ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE,10987.15,7141.65,,,0
HCPCS,J3121,Inj testostero enanthate 1mg,,,0.09,0.14,5
HCPCS,J3145,Testosterone undecanoate 1mg,,,2.07,5.2,6
HCPCS,J3230,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,160.2,104.13,,,0
HCPCS,J3230,Chlorpromazine hcl injection,,,51.81,82.6,5
HCPCS,J3230,Noncdm Charge Record Pharmacy,210.83,137.04,,,0
HCPCS,J3240,Noncdm Charge Record Pharmacy,10733.83,6976.99,,,0
HCPCS,J3240,THYROTROPIN ALFA 0.9 MG INTRAMUSCULAR SOLUTION,10734.0,6977.1,,,0
HCPCS,J3240,Thyrotropin injection,,,2116.32,5604.04,6
HCPCS,J3241,Inj. teprotumumab-trbw 10 mg,,,359.19,940.64,6
HCPCS,J3241,Noncdm Charge Record Pharmacy,1393.0,905.45,,,0
HCPCS,J3241,TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,74826.5,48637.22,,,0
HCPCS,J3243,Noncdm Charge Record Pharmacy,15.47,10.06,,,0
HCPCS,J3243,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,98.7,64.16,,,0
HCPCS,J3243,Tigecycline injection,,,1.07,1.71,5
HCPCS,J3244,Inj. tigecycline (accord),,,5.85,9.16,4
HCPCS,J3245,"Inj., tildrakizumab, 1 mg",,,127.45,360.92,6
HCPCS,J3246,Noncdm Charge Record Pharmacy,19.47,12.66,,,0
HCPCS,J3246,"TIROFIBAN 250 MCG/ML CONCENTRATE,INTRAVENOUS",158.1,102.76,,,0
HCPCS,J3246,TIROFIBAN 5 MG/100 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS,183.9,119.54,,,0
HCPCS,J3246,Tirofiban hcl,,,6.16,9.81,5
HCPCS,J3247,Inj secukinumab intrav 1mg,,,17.84,48.02,6
HCPCS,J3250,TRIMETHOBENZAMIDE 100 MG/ML INTRAMUSCULAR SOLUTION,291.55,189.51,,,0
HCPCS,J3250,Trimethobenzamide hcl inj,,,86.62,138.07,5
HCPCS,J3260,Noncdm Charge Record Pharmacy,19.91,12.94,,,0
HCPCS,J3260,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,293.35,190.68,,,0
HCPCS,J3260,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,42.0,27.3,,,0
HCPCS,J3260,Tobramycin sulfate injection,,,3.34,5.34,5
HCPCS,J3262,INV TOCILIZUMAB/PLACEBO 20MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J3262,Noncdm Charge Record Pharmacy,20.71,13.46,,,0
HCPCS,J3262,TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,5465.2,3552.38,,,0
HCPCS,J3262,TOCILIZUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,10848.35,7051.43,,,0
HCPCS,J3262,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,2235.3,1452.94,,,0
HCPCS,J3262,Tocilizumab injection,,,5.71,16.18,6
HCPCS,J3263,"Inj, toripalimab-tpzi, 1 mg",,,39.41,106.56,6
HCPCS,J3263,TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION,39582.45,25728.59,,,0
HCPCS,J3265,Injection torsemide 10 mg/ml,,,0.02,0.02,2
HCPCS,J3280,Thiethylperazine maleate inj,,,12.28,12.28,2
HCPCS,J3285,Noncdm Charge Record Pharmacy,221.29,143.84,,,0
HCPCS,J3285,TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,6584.9,4280.18,,,0
HCPCS,J3285,Treprostinil injection,,,54.71,151.62,6
HCPCS,J3290,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",43.6,28.34,,,0
HCPCS,J3290,"TRANEXAMIC ACID 1,000 MG/100 ML(10 MG/ML)IN SOD CHLOR,ISO IV PIGGYBACK",55.6,36.14,,,0
HCPCS,J3299,Inj xipere 1 mg,,,47.97,131.22,6
HCPCS,J3300,Triamcinolone A inj PRS-free,,,24.5,76.75,5
HCPCS,J3301,Hc Kenalog 40 Per 10 Mg,39.52,25.69,,,0
HCPCS,J3301,Noncdm Charge Record Pharmacy,9.73,6.32,,,0
HCPCS,J3301,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,35.75,23.24,,,0
HCPCS,J3301,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,41.8,27.17,,,0
HCPCS,J3301,Triamcinolone acet inj nos,,,1.53,2.44,5
HCPCS,J3302,Triamcinolone diacetate inj,,,0.87,0.87,2
HCPCS,J3303,Triamcinolone hexacetonl inj,,,19.02,26.42,4
HCPCS,J3304,Inj triamcinolone ace xr 1mg,,,18.3,48.78,6
HCPCS,J3305,Inj trimetrexate glucoronate,,,0.02,0.02,2
HCPCS,J3315,Triptorelin pamoate,,,474.84,1304.3,6
HCPCS,J3316,"Inj., triptorelin xr 3.75 mg",,,3817.28,9517.76,5
HCPCS,J3355,"Urofollitropin, 75 iu",,,0.02,160.4,4
HCPCS,J3357,Noncdm Charge Record Pharmacy,0.01,0.01,,,0
HCPCS,J3357,"Ustekinumab sub cu inj, 1 mg",,,265.0,422.43,5
HCPCS,J3358,Noncdm Charge Record Pharmacy,80.9,52.58,,,0
HCPCS,J3358,USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,10603.9,6892.54,,,0
HCPCS,J3358,"Ustekinumab, iv inject, 1 mg",,,12.99,34.58,6
HCPCS,J3360,DIAZEPAM 5 MG/ML INJECTION SYRINGE,52.1,33.86,,,0
HCPCS,J3360,Diazepam injection,,,14.53,23.17,5
HCPCS,J3360,Noncdm Charge Record Pharmacy,76.72,49.87,,,0
HCPCS,J3364,Urokinase 5000 IU injection,,,0.02,0.02,2
HCPCS,J3365,"Urokinase 250,000 IU inj",,,0.02,0.02,2
HCPCS,J3370,Noncdm Charge Record Pharmacy,30.37,19.74,,,0
HCPCS,J3370,Vancomycin hcl injection,,,3.17,5.04,5
HCPCS,J3371,"Inj, vancomycin hcl (mylan)",,,10.94,17.43,5
HCPCS,J3371,Noncdm Charge Record Pharmacy,43.35,28.18,,,0
HCPCS,J3372,"Inj, vancomycin hcl (xellia)",,,10.84,17.29,5
HCPCS,J3372,Noncdm Charge Record Pharmacy,44.77,29.1,,,0
HCPCS,J3373,"INV VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION",0.65,0.42,,,0
HCPCS,J3373,VANCOMYCIN 1 GRAM/200 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,171.9,111.74,,,0
HCPCS,J3373,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",44.75,29.09,,,0
HCPCS,J3373,VANCOMYCIN 1.25 GRAM/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,90.2,58.63,,,0
HCPCS,J3373,VANCOMYCIN 1.5 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLN,94.4,61.36,,,0
HCPCS,J3373,VANCOMYCIN 1.75 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,98.6,64.09,,,0
HCPCS,J3373,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,1059.1,688.42,,,0
HCPCS,J3373,VANCOMYCIN 2 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,102.75,66.79,,,0
HCPCS,J3373,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,440.7,286.46,,,0
HCPCS,J3373,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,51.1,33.22,,,0
HCPCS,J3373,VANCOMYCIN 750 MG IN NS 250 ML IVPB (CMP PMX),76.6,49.79,,,0
HCPCS,J3373,VANCOMYCIN 750 MG/150 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,112.85,73.35,,,0
HCPCS,J3380,"Injection, vedolizumab",,,21.31,58.73,6
HCPCS,J3380,Noncdm Charge Record Pharmacy,140.51,91.33,,,0
HCPCS,J3380,VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION,46735.2,30377.88,,,0
HCPCS,J3385,Velaglucerase alfa,,,381.36,1013.59,6
HCPCS,J3392,"Inj, exagamglogene autotem",,,0.02,6319720.0,5
HCPCS,J3393,"Inj, betibeglogene autotemce",,,0.02,8043280.0,5
HCPCS,J3394,"Inj, lovotibeglogene autotem",,,0.02,8653030.0,5
HCPCS,J3396,Verteporfin injection,,,11.54,31.17,6
HCPCS,J3397,"Inj., vestronidase alfa-vjbk",,,279.93,857.55,5
HCPCS,J3398,Inj luxturna 1 billion vec g,,,0.02,8599.45,5
HCPCS,J3399,Inj onase abepar-xioi treat,,,0.02,6513373.21,5
HCPCS,J3401,"Vyjuvek 5x10^9pfu/ml, 0.1 ml",,,1025.44,2755.47,6
HCPCS,J3410,HYDROXYZINE HCL 25 MG/ML INTRAMUSCULAR SOLUTION,123.25,80.11,,,0
HCPCS,J3410,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,85.85,55.8,,,0
HCPCS,J3410,Hydroxyzine hcl injection,,,20.93,33.36,5
HCPCS,J3410,Noncdm Charge Record Pharmacy,74.54,48.45,,,0
HCPCS,J3411,Noncdm Charge Record Pharmacy,22.71,14.76,,,0
HCPCS,J3411,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,36.9,23.98,,,0
HCPCS,J3411,Thiamine hcl 100 mg,,,3.0,4.77,5
HCPCS,J3415,Noncdm Charge Record Pharmacy,60.24,39.16,,,0
HCPCS,J3415,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,38.55,25.06,,,0
HCPCS,J3415,Pyridoxine hcl 100 mg,,,26.82,42.76,5
HCPCS,J3420,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",33.35,21.68,,,0
HCPCS,J3420,Noncdm Charge Record Pharmacy,41.88,27.22,,,0
HCPCS,J3420,Vitamin b12 injection,,,2.16,3.44,5
HCPCS,J3424,HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,4892.85,3180.35,,,0
HCPCS,J3424,Inj hydroxocobalamin iv 25mg,,,5.18,14.04,5
HCPCS,J3424,Noncdm Charge Record Pharmacy,4807.05,3124.58,,,0
HCPCS,J3425,"Inj, hydroxocobalamin",,,0.01,0.03,5
HCPCS,J3430,Noncdm Charge Record Pharmacy,76.36,49.63,,,0
HCPCS,J3430,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,88.4,57.46,,,0
HCPCS,J3430,PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,52.2,33.93,,,0
HCPCS,J3430,Vitamin k phytonadione inj,,,3.75,5.99,5
HCPCS,J3465,"Injection, voriconazole",,,1.66,2.63,5
HCPCS,J3465,Noncdm Charge Record Pharmacy,8.12,5.28,,,0
HCPCS,J3465,VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,99.65,64.77,,,0
HCPCS,J3470,Hyaluronidase injection,,,51.11,81.49,5
HCPCS,J3471,"Ovine, up to 999 usp units",,,1.0,1.17,4
HCPCS,J3472,"Ovine, 1000 USP units",,,0.02,288.4,4
HCPCS,J3473,"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",271.0,176.15,,,0
HCPCS,J3473,Hyaluronidase recombinant,,,0.62,1.0,5
HCPCS,J3473,Noncdm Charge Record Pharmacy,1.58,1.03,,,0
HCPCS,J3475,Inj magnesium sulfate,,,0.83,1.33,5
HCPCS,J3475,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,64.65,42.02,,,0
HCPCS,J3475,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,72.2,46.93,,,0
HCPCS,J3475,MAGNESIUM SULFATE 2 GRAM/50 ML (4%) IN WATER IVPB (CMP),60.45,39.29,,,0
HCPCS,J3475,MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,73.45,47.74,,,0
HCPCS,J3475,"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",79.7,51.8,,,0
HCPCS,J3475,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,35.05,22.78,,,0
HCPCS,J3475,Noncdm Charge Record Pharmacy,10.29,6.69,,,0
HCPCS,J3480,Inj potassium chloride,,,0.18,0.27,5
HCPCS,J3480,Noncdm Charge Record Pharmacy,6.85,4.45,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 10 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,69.65,45.27,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,75.55,49.11,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,45.5,29.58,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,193.7,125.9,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,71.35,46.38,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,71.35,46.38,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN 5 % DEXTROSE INTRAVENOUS SOLUTION,75.55,49.11,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,71.35,46.38,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,75.55,49.11,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,71.35,46.38,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/L-LACTATED RINGERS-5 % DEXTROSE INTRAVENOUS,75.55,49.11,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 30 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,75.55,49.11,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,69.25,45.01,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 40 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,75.55,49.11,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 40 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,75.55,49.11,,,0
HCPCS,J3485,ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,168.3,109.4,,,0
HCPCS,J3485,Zidovudine,,,1.51,4.09,6
HCPCS,J3486,Noncdm Charge Record Pharmacy,59.43,38.63,,,0
HCPCS,J3486,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,97.85,63.6,,,0
HCPCS,J3486,Ziprasidone mesylate,,,12.22,19.48,5
HCPCS,J3489,Noncdm Charge Record Pharmacy,40.74,26.48,,,0
HCPCS,J3489,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,151.35,98.38,,,0
HCPCS,J3489,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,61.3,39.84,,,0
HCPCS,J3489,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,204.15,132.7,,,0
HCPCS,J3489,Zoledronic acid 1mg,,,9.53,15.18,5
HCPCS,J3490,CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,177.05,115.08,,,0
HCPCS,J3490,DANTROLENE 20 MG INTRAVENOUS SOLUTION,385.7,250.7,,,0
HCPCS,J3490,DANTROLENE 250 MG INTRAVENOUS SUSPENSION,10363.1,6736.02,,,0
HCPCS,J3490,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,69.25,45.01,,,0
HCPCS,J3490,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,67.15,43.65,,,0
HCPCS,J3490,DEXTROSE 5 % AND 0.45 % NACL IV BOLUS,67.15,43.65,,,0
HCPCS,J3490,DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,67.15,43.65,,,0
HCPCS,J3490,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,68.5,44.52,,,0
HCPCS,J3490,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,74.0,48.1,,,0
HCPCS,J3490,EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,34.9,22.68,,,0
HCPCS,J3490,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,41.6,27.04,,,0
HCPCS,J3490,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,39.05,25.38,,,0
HCPCS,J3490,INV IS-001 LYOPHILIZED POWDER,0.65,0.42,,,0
HCPCS,J3490,INV NEMVALEUKIN ALFA (ALKS 4230) 37.7 MCG/ML,0.65,0.42,,,0
HCPCS,J3490,INV NEMVALEUKIN ALFA (ALKS 4230) 55.6 MCG/ML,0.65,0.42,,,0
HCPCS,J3490,INV OLPASIRAN (AMG890)/PLACEBO 142 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV PLASMALYTE-A 1000ML BAG,0.65,0.42,,,0
HCPCS,J3490,INV PLASMALYTE-A 500ML BAG,0.65,0.42,,,0
HCPCS,J3490,INV RUSFERTIDE (PTG-300) 10 MG/0.5 ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV RUSFERTIDE (PTG-300) 20 MG/0.5 ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV RUSFERTIDE (PTG-300) 30 MG/0.5 ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV RUSFERTIDE (PTG-300) 45 MG/0.5 ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV RUSFERTIDE (PTG-300) 60 MG/0.5 ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV RUSFERTIDE (PTG-300)/PLACEBO 10 MG/0.5 ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV RUSFERTIDE (PTG-300)/PLACEBO 20 MG/0.5 ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV RUSFERTIDE (PTG-300)/PLACEBO 30 MG/0.5 ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV RUSFERTIDE (PTG-300)/PLACEBO 45 MG/0.5 ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV RUSFERTIDE (PTG-300)/PLACEBO 60 MG/0.5 ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J3490,INV TALQUETAMAB (JNJ-64407564) 2 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,INV TALQUETAMAB (JNJ-64407564) 40 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J3490,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,308.85,200.75,,,0
HCPCS,J3490,METHOHEXITAL 100 MG/10 ML INJECTION,61.55,40.01,,,0
HCPCS,J3490,METHOHEXITAL 50 MG/5 ML SYRINGE (IR-NEURO USE),72.4,47.06,,,0
HCPCS,J3490,METHOHEXITAL 500 MG SOLUTION FOR INJECTION,551.5,358.48,,,0
HCPCS,J3490,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,441.0,286.65,,,0
HCPCS,J3490,METRONIDAZOLE 250 MG/50 ML-SODIUM CHLORIDE(ISO) IVPB (CMP),61.1,39.72,,,0
HCPCS,J3490,NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,53.55,34.81,,,0
HCPCS,J3490,Noncdm Charge Record Pharmacy,3.03,1.97,,,0
HCPCS,J3490,PARENTERAL AMINO ACID 10 % COMBINATION NO.2 INTRAVENOUS SOLUTION,187.65,121.97,,,0
HCPCS,J3490,PARENTERAL AMINO ACID 15 % COMBINATION NO.5 INTRAVENOUS SOLUTION,274.85,178.65,,,0
HCPCS,J3490,PARENTERAL AMINO ACID 15 % COMBINATION NO.6 INTRAVENOUS SOLUTION,284.0,184.6,,,0
HCPCS,J3490,POLIDOCANOL 1 % (20 MG/2 ML) INTRAVENOUS SOLUTION,137.75,89.54,,,0
HCPCS,J3490,POLIDOCANOL 1 % INTRAVENOUS FOAM,1822.1,1184.36,,,0
HCPCS,J3490,POTASSIUM PHOSPHATE 15 MMOL/250 ML IN 0.9 % SODIUM CHLORIDE IV SOLN,3133.8,2036.97,,,0
HCPCS,J3490,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,46.95,30.52,,,0
HCPCS,J3490,SODIUM BICARB CONCENTRATED INFUSION 250 MEQ IN 250 ML,209.3,136.04,,,0
HCPCS,J3490,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,52.85,34.35,,,0
HCPCS,J3490,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,101.475,65.96,,,0
HCPCS,J3490,SODIUM TETRADECYL SULFATE 1 % (10 MG/ML) INTRAVENOUS SOLUTION,377.0,245.05,,,0
HCPCS,J3490,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,114.1,74.16,,,0
HCPCS,J3490,TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,80.625,52.41,,,0
HCPCS,J3490,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,44.05,28.63,,,0
HCPCS,J3490,VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,72.35,47.03,,,0
HCPCS,J3490,VECURONIUM INJ 0.1 MG/ML FOR PUBS PROCEDURE,35.05,22.78,,,0
HCPCS,J3490,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,48.875,31.77,,,0
HCPCS,J3520,Edetate disodium per 150 mg,,,0.02,0.87,4
HCPCS,J3535,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,71.05,46.18,,,0
HCPCS,J3535,BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,497.7,323.5,,,0
HCPCS,J3535,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,243.85,158.5,,,0
HCPCS,J3535,MOMETASONE-FORMOTEROL HFA 100 MCG-5 MCG/ACTUATION AEROSOL INHALER,243.9,158.54,,,0
HCPCS,J3535,MOMETASONE-FORMOTEROL HFA 200 MCG-5 MCG/ACTUATION AEROSOL INHALER,243.9,158.54,,,0
HCPCS,J3535,Noncdm Charge Record Pharmacy,3.02,1.96,,,0
HCPCS,J3535,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION MIST FOR INHALATION,143.6,93.34,,,0
HCPCS,J3590,ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,1084.15,704.7,,,0
HCPCS,J3590,INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,120.35,78.23,,,0
HCPCS,J3590,INV 3K3A-APC/PLACEBO INJECTION,0.65,0.42,,,0
HCPCS,J3590,INV ENGLUMAFUSP ALFA (RO7227166) 5 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J3590,INV FREXALIMAB/PLACEBO 150 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J3590,INV OLVIMULOGENE NANIVACIREPVEC (OLVI-VEC) 1.9 X10EXP8 PFU/ML SUSPENSION FOR INJECTION,0.65,0.42,,,0
HCPCS,J3590,INV PLOZASIRAN (ARO-APOC3)/PLACEBO INJECTION 25MG,0.65,0.42,,,0
HCPCS,J3590,Noncdm Charge Record Pharmacy,126.26,82.07,,,0
HCPCS,J3590,PEGINTERFERON ALFA-2A 180 MCG/ML SUBCUTANEOUS SOLUTION,3905.4,2538.51,,,0
HCPCS,J3590,SARILUMAB 200 MG/1.14 ML SUBCUTANEOUS PEN INJECTOR,11257.25,7317.21,,,0
HCPCS,J7030,Noncdm Charge Record Pharmacy,68.21000000000001,44.335,,,0
HCPCS,J7030,Normal saline solution infus,,,4.26,6.78,5
HCPCS,J7030,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,64.0,41.599999999999994,,,0
HCPCS,J7040,Noncdm Charge Record Pharmacy,66.49,43.215,,,0
HCPCS,J7040,Normal saline solution infus,,,2.13,3.39,5
HCPCS,J7040,SODIUM CHLORIDE 0.9 % IV BOLUS,66.625,43.31,,,0
HCPCS,J7042,5% dextrose/normal saline,,,2.0,3.2,5
HCPCS,J7042,DEXTROSE 5 % AND 0.9 % NACL IV BOLUS,64.0,41.599999999999994,,,0
HCPCS,J7042,Noncdm Charge Record Pharmacy,36.955,24.02,,,0
HCPCS,J7050,Noncdm Charge Record Pharmacy,65.69,42.7,,,0
HCPCS,J7050,Normal saline solution infus,,,1.06,1.71,5
HCPCS,J7050,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,71.67500000000001,46.59,,,0
HCPCS,J7050,SODIUM CHLORIDE 0.9 % IV BOLUS,77.1,50.11,,,0
HCPCS,J7060,5% dextrose/water,,,3.06,4.88,5
HCPCS,J7060,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,70.95,46.12,,,0
HCPCS,J7060,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,53.925,35.05,,,0
HCPCS,J7060,DEXTROSE 5 % IV BOLUS,77.65,50.47,,,0
HCPCS,J7060,Noncdm Charge Record Pharmacy,66.815,43.43,,,0
HCPCS,J7070,D5w infusion,,,6.12,9.76,5
HCPCS,J7070,DEXTROSE 5 % IV BOLUS,60.85,39.55,,,0
HCPCS,J7070,Noncdm Charge Record Pharmacy,69.16499999999999,44.96,,,0
HCPCS,J7100,DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,312.25,202.96,,,0
HCPCS,J7100,DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,301.8,196.17,,,0
HCPCS,J7100,Dextran 40 infusion,,,91.35,139.65,4
HCPCS,J7110,Dextran 75 infusion,,,0.02,0.02,2
HCPCS,J7120,LACTATED RINGERS IV BOLUS,60.85,39.55,,,0
HCPCS,J7120,Noncdm Charge Record Pharmacy,65.8,42.77,,,0
HCPCS,J7120,Ringers lactate infusion,,,4.1,6.53,5
HCPCS,J7121,5% dextrose in lac ringers,,,16.4,18.67,4
HCPCS,J7121,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,67.15,43.65,,,0
HCPCS,J7121,DEXTROSE 5 % IN LACTATED RINGERS IV BOLUS,65.05,42.28,,,0
HCPCS,J7121,Noncdm Charge Record Pharmacy,70.345,45.725,,,0
HCPCS,J7131,Hypertonic saline sol,,,0.24,0.35,4
HCPCS,J7131,Noncdm Charge Record Pharmacy,0.18,0.12,,,0
HCPCS,J7131,SODIUM CHLORIDE 3 % HYPEROSMOLAR INTRAVENOUS INJECTION SOLUTION,66.625,43.305,,,0
HCPCS,J7131,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,62.4,40.56,,,0
HCPCS,J7165,"Inj, human-lans, per i.u",,,1.55,7.37,5
HCPCS,J7168,"HUM PROTHROMBIN CPLX, 4-FACTOR 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",7341.25,4771.81,,,0
HCPCS,J7168,"HUMAN PROTHROMBIN COMPLEX,4-FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION",3711.7,2412.6,,,0
HCPCS,J7168,Noncdm Charge Record Pharmacy,8.79,5.71,,,0
HCPCS,J7168,Prothrombin complex kcentra,,,2.14,6.97,5
HCPCS,J7169,"FACTOR XA,INACTIVATED-ZHZO (RECOMBINANT) 200 MG INTRAVENOUS SOLUTION",10452.3,6794.0,,,0
HCPCS,J7169,"Inj andexxa, 10 mg",,,131.38,357.18,5
HCPCS,J7170,"Inj., emicizumab-kxwh 0.5 mg",,,56.1,140.97,6
HCPCS,J7171,"Inj, adzynma, 10 iu",,,35.59,93.68,6
HCPCS,J7175,"Inj, factor x, (human), 1iu",,,9.78,25.83,6
HCPCS,J7177,"Inj., fibryga, 1 mg",,,1.23,3.01,6
HCPCS,J7178,"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",5059.8,3288.87,,,0
HCPCS,J7178,Human fibrinogen conc inj,,,1.52,4.01,6
HCPCS,J7179,Vonvendi inj 1 iu vwf:rco,,,1.85,5.01,6
HCPCS,J7180,Factor XIII anti-hem factor,,,10.76,28.37,6
HCPCS,J7181,Factor xiii recomb a-subunit,,,18.16,46.53,6
HCPCS,J7182,Factor viii recomb novoeight,,,1.54,3.88,6
HCPCS,J7183,Wilate injection,,,1.29,3.47,6
HCPCS,J7185,Xyntha inj,,,1.67,4.07,6
HCPCS,J7186,Antihemophilic viii/vwf comp,,,1.25,3.25,6
HCPCS,J7187,"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT IV KIT (FVIII UNITS)",11829.5,7689.18,,,0
HCPCS,J7187,ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT IV KIT (FVIII UNITS),3018.95,1962.32,,,0
HCPCS,J7187,"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT IV KIT (FVIII UNIITS)",5955.8,3871.27,,,0
HCPCS,J7187,"Humate-P, inj",,,1.49,3.93,6
HCPCS,J7187,Noncdm Charge Record Pharmacy,4.45,2.89,,,0
HCPCS,J7188,Factor viii recomb obizur,,,3.23,8.75,6
HCPCS,J7189,"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",11529.95,7494.47,,,0
HCPCS,J7189,"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",23027.0,14967.55,,,0
HCPCS,J7189,"COAGULATION FACTOR VIIA RECOMB 5 MG (5,000 MCG) INTRAVENOUS SOLUTION",57518.1,37386.76,,,0
HCPCS,J7189,Factor viia,,,2.66,6.91,6
HCPCS,J7189,Noncdm Charge Record Pharmacy,11.35,7.38,,,0
HCPCS,J7190,Factor viii,,,1.08,3.04,6
HCPCS,J7192,Factor viii recombinant nos,,,1.61,4.17,6
HCPCS,J7192,Noncdm Charge Record Pharmacy,6.2,4.03,,,0
HCPCS,J7193,Factor ix non-recombinant,,,1.4,3.63,6
HCPCS,J7194,Factor ix complex,,,1.7,4.5,6
HCPCS,J7195,"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",8707.05,5659.58,,,0
HCPCS,J7195,"COAGULATION FACTOR IX (RECOMB) 2,000 UNIT INTRAVENOUS SOLUTION",17381.1,11297.72,,,0
HCPCS,J7195,"COAGULATION FACTOR IX (RECOMB) 3,000 UNIT INTRAVENOUS SOLUTION",26055.25,16935.91,,,0
HCPCS,J7195,COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,4370.0,2840.5,,,0
HCPCS,J7195,Factor ix recombinant nos,,,1.85,4.99,6
HCPCS,J7195,Noncdm Charge Record Pharmacy,8.1,5.26,,,0
HCPCS,J7196,Antithrombin recombinant,,,328.77,328.77,2
HCPCS,J7197,Antithrombin iii injection,,,4.1,10.73,6
HCPCS,J7197,Noncdm Charge Record Pharmacy,18.23,11.85,,,0
HCPCS,J7198,ANTI-INHIBITOR COAGULANT COMPLEX 350 UNIT-650 UNIT INTRAVENOUS SOLN,4396.1,2857.46,,,0
HCPCS,J7198,"ANTI-INHIBITOR COAGULANT COMPLEX 700 UNIT-1,300 UNIT INTRAVENOUS SOLN",8710.15,5661.6,,,0
HCPCS,J7198,"ANTI-INHIBITOR COAGULANT COMPLX 1,750 UNIT-3,250 UNIT INTRAVENOUS SOLN",21652.2,14073.93,,,0
HCPCS,J7198,Anti-inhibitor,,,2.41,6.4,6
HCPCS,J7200,Factor ix recombinan rixubis,,,1.69,4.47,6
HCPCS,J7201,Factor ix alprolix recomb,,,3.59,9.7,6
HCPCS,J7202,Factor ix idelvion inj,,,5.32,14.12,6
HCPCS,J7203,Factor ix recomb gly rebinyn,,,4.46,11.9,6
HCPCS,J7204,Inj recombin esperoct per iu,,,2.22,5.93,6
HCPCS,J7205,Factor viii fc fusion recomb,,,2.43,6.34,6
HCPCS,J7207,Factor viii pegylated recomb,,,2.1,5.69,6
HCPCS,J7208,Inj. jivi 1 iu,,,2.65,6.64,6
HCPCS,J7209,Factor viii nuwiq recomb 1iu,,,1.12,3.36,6
HCPCS,J7210,"Inj, afstyla, 1 i.u.",,,1.57,4.12,6
HCPCS,J7211,"Inj, kovaltry, 1 i.u.",,,1.57,4.01,6
HCPCS,J7212,Factor viia recomb sevenfact,,,2.37,6.37,6
HCPCS,J7213,"Inj, ixinity, 1 i.u.",,,1.91,5.96,6
HCPCS,J7214,Altuviiio per factor viii iu,,,4.66,12.57,6
HCPCS,J7294,Seg acet and eth estr yearly,,,5664.06,7871.63,4
HCPCS,J7295,Eth estr and eton monthly,,,287.16,506.63,4
HCPCS,J7296,"Kyleena, 19.5 mg",,,2842.23,3761.89,4
HCPCS,J7296,LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,3402.85,2211.85,,,0
HCPCS,J7296,Noncdm Charge Record Pharmacy,3370.64,2190.92,,,0
HCPCS,J7297,LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,1786.05,1160.93,,,0
HCPCS,J7297,"Liletta, 52 mg",,,2076.42,2885.69,4
HCPCS,J7297,Noncdm Charge Record Pharmacy,2753.9,1790.04,,,0
HCPCS,J7298,LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,3402.85,2211.85,,,0
HCPCS,J7298,"Mirena, 52 mg",,,2842.23,3761.89,4
HCPCS,J7298,Noncdm Charge Record Pharmacy,3432.8450000000003,2231.35,,,0
HCPCS,J7300,COPPER 380 SQUARE MM INTRAUTERINE DEVICE,3377.45,2195.34,,,0
HCPCS,J7300,Intraut copper contraceptive,,,2665.26,3701.86,4
HCPCS,J7300,Noncdm Charge Record Pharmacy,3304.08,2147.65,,,0
HCPCS,J7301,Noncdm Charge Record Pharmacy,2807.48,1824.86,,,0
HCPCS,J7301,"Skyla, 13.5 mg",,,2366.63,3132.38,4
HCPCS,J7306,Levonorgestrel implant sys,,,1018.61,1018.61,2
HCPCS,J7307,ETONOGESTREL 68 MG SUBDERMAL IMPLANT,3271.25,2126.31,,,0
HCPCS,J7307,Etonogestrel implant system,,,2842.23,3949.99,4
HCPCS,J7307,Noncdm Charge Record Pharmacy,3290.22,2138.64,,,0
HCPCS,J7308,Aminolevulinic acid hcl top,,,392.09,1071.15,6
HCPCS,J7309,"Methyl aminolevulinate, top",,,0.02,0.02,2
HCPCS,J7310,Ganciclovir long act implant,,,0.02,11123.93,4
HCPCS,J7311,Fluocinolone acetonide implt,,,340.31,903.05,6
HCPCS,J7312,Dexamethasone intra implant,,,204.61,557.07,6
HCPCS,J7313,Fluocinol acet intravit imp,,,498.14,1337.87,6
HCPCS,J7314,"Inj., yutiq, 0.01 mg",,,529.89,1425.16,6
HCPCS,J7315,Ophthalmic mitomycin,,,1006.2,1006.2,2
HCPCS,J7316,"Inj, ocriplasmin, 0.125 mg",,,0.02,0.02,2
HCPCS,J7318,"Inj, durolane 1 mg",,,6.77,18.16,6
HCPCS,J7320,"Genvisc 850, inj, 1mg",,,5.77,16.72,6
HCPCS,J7321,Hyalgan/supartz inj per dose,,,124.14,197.91,5
HCPCS,J7322,Hymovis injection 1 mg,,,17.62,47.21,6
HCPCS,J7323,Euflexxa inj per dose,,,112.45,327.04,6
HCPCS,J7324,Orthovisc inj per dose,,,114.54,249.7,6
HCPCS,J7325,Hc Synvisc Per Mg,58.24,37.86,,,0
HCPCS,J7325,Synvisc or Synvisc-One,,,7.95,24.82,6
HCPCS,J7326,Gel-one,,,529.26,1426.49,6
HCPCS,J7327,Monovisc inj per dose,,,636.59,1530.2,6
HCPCS,J7328,Gel-syn injection 0.1 mg,,,0.7,1.52,6
HCPCS,J7329,"Inj, trivisc 1 mg",,,4.69,16.53,6
HCPCS,J7330,Cultured chondrocytes implnt,,,141956.1,197282.58,4
HCPCS,J7331,"Synojoynt, inj., 1 mg",,,15.14,24.12,5
HCPCS,J7332,"Inj., triluron, 1 mg",,,10.27,27.34,6
HCPCS,J7336,Capsaicin 8% patch,,,3.42,9.02,6
HCPCS,J7340,Carbidopa levodopa ent 100ml,,,243.61,639.42,6
HCPCS,J7342,Ciprofloxacin otic susp 6 mg,,,66.27,92.09,4
HCPCS,J7345,"Aminolevulinic acid, 10% gel",,,1.79,4.66,6
HCPCS,J7351,Inj bimatoprost itc imp 1mcg,,,213.84,568.8,6
HCPCS,J7352,"Afamelanotide implant, 1 mg",,,2943.42,7786.72,3
HCPCS,J7353,Anacaulase-bcdb 8.8% gel 1 g,,,58.31,154.44,5
HCPCS,J7354,"Cantharidin top, applicator",,,654.76,1928.84,6
HCPCS,J7355,Inj travoprost intra impl,,,195.72,534.3,5
HCPCS,J7402,Mometasone sinus sinuva,,,11.34,30.76,6
HCPCS,J7500,AZATHIOPRINE 25 MG SPLIT TABLET,5.4,3.51,,,0
HCPCS,J7500,AZATHIOPRINE 50 MG TABLET,6.15,4.0,,,0
HCPCS,J7500,Azathioprine oral 50mg,,,2.03,3.22,5
HCPCS,J7500,Noncdm Charge Record Pharmacy,4.6899999999999995,3.05,,,0
HCPCS,J7501,Azathioprine parenteral,,,254.07,620.51,5
HCPCS,J7502,CYCLOSPORINE 100 MG CAPSULE,57.4,37.31,,,0
HCPCS,J7502,CYCLOSPORINE MODIFIED 100 MG CAPSULE,9.95,6.47,,,0
HCPCS,J7502,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,1856.3,1206.6,,,0
HCPCS,J7502,Cyclosporine oral 100 mg,,,3.74,5.96,5
HCPCS,J7502,Noncdm Charge Record Pharmacy,12.280000000000001,7.985,,,0
HCPCS,J7503,Noncdm Charge Record Pharmacy,4.625,3.01,,,0
HCPCS,J7503,Tacrol envarsus ex rel oral,,,3.07,4.88,5
HCPCS,J7504,ANTITHYMOCYTE GLOBULIN-ATG (ATGAM) TEST DOSE,337.9,219.64,,,0
HCPCS,J7504,"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",24712.65,16063.22,,,0
HCPCS,J7504,Lymphocyte immune globulin,,,5135.09,11804.03,6
HCPCS,J7504,Noncdm Charge Record Pharmacy,19522.93,12689.9,,,0
HCPCS,J7505,Monoclonal antibodies,,,0.02,2353.64,4
HCPCS,J7507,Noncdm Charge Record Pharmacy,5.51,3.585,,,0
HCPCS,J7507,"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",7.5,4.88,,,0
HCPCS,J7507,"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",7.35,4.78,,,0
HCPCS,J7507,TACROLIMUS 1 MG/ML ORAL SUSPENSION,9.6,6.24,,,0
HCPCS,J7507,"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",9.25,6.01,,,0
HCPCS,J7507,Tacrolimus imme rel oral 1mg,,,0.3,0.49,5
HCPCS,J7508,Tacrol astagraf ex rel oral,,,0.97,1.54,5
HCPCS,J7509,METHYLPREDNISOLONE 16 MG TABLET,11.8,7.67,,,0
HCPCS,J7509,METHYLPREDNISOLONE 4 MG TABLET,7.8,5.07,,,0
HCPCS,J7509,Methylprednisolone oral,,,0.42,0.68,5
HCPCS,J7509,Noncdm Charge Record Pharmacy,5.015000000000001,3.26,,,0
HCPCS,J7510,Noncdm Charge Record Pharmacy,2.275,1.48,,,0
HCPCS,J7510,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLUTION,32.2,20.93,,,0
HCPCS,J7510,Prednisolone oral per 5 mg,,,0.97,1.54,5
HCPCS,J7511,ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,5675.05,3688.78,,,0
HCPCS,J7511,Antithymocyte globuln rabbit,,,999.37,2575.2,6
HCPCS,J7511,Noncdm Charge Record Pharmacy,5493.29,3570.64,,,0
HCPCS,J7512,INV PREDNISONE 20 MG TABLET,0.65,0.42,,,0
HCPCS,J7512,INV PREDNISONE 5 MG TABLET,0.65,0.42,,,0
HCPCS,J7512,Noncdm Charge Record Pharmacy,0.14500000000000002,0.09,,,0
HCPCS,J7512,PREDNISONE 1 MG TABLET,13.3,8.64,,,0
HCPCS,J7512,PREDNISONE 10 MG TABLET,4.95,3.22,,,0
HCPCS,J7512,PREDNISONE 2.5 MG TABLET,5.05,3.28,,,0
HCPCS,J7512,PREDNISONE 20 MG TABLET,5.05,3.28,,,0
HCPCS,J7512,PREDNISONE 5 MG TABLET,5.05,3.28,,,0
HCPCS,J7512,PREDNISONE 5 MG/5 ML ORAL SOLUTION,10.95,7.12,,,0
HCPCS,J7512,PREDNISONE 50 MG TABLET,5.55,3.61,,,0
HCPCS,J7512,Prednisone ir or dr oral 1mg,,,0.01,0.03,5
HCPCS,J7513,"Daclizumab, parenteral",,,0.02,1015.98,4
HCPCS,J7514,Mycophenol (myhibbin) 100 mg,,,5.1,7.1,4
HCPCS,J7515,CYCLOSPORINE 25 MG CAPSULE,16.25,10.56,,,0
HCPCS,J7515,CYCLOSPORINE MODIFIED 25 MG CAPSULE,5.9,3.84,,,0
HCPCS,J7515,Cyclosporine oral 25 mg,,,1.4,2.25,5
HCPCS,J7515,Noncdm Charge Record Pharmacy,4.085,2.655,,,0
HCPCS,J7516,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,363.0,235.95,,,0
HCPCS,J7516,Cyclosporin parenteral 250mg,,,121.31,193.39,5
HCPCS,J7516,Noncdm Charge Record Pharmacy,142.49,92.62,,,0
HCPCS,J7517,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,12.0,7.8,,,0
HCPCS,J7517,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,5.9,3.84,,,0
HCPCS,J7517,MYCOPHENOLATE MOFETIL 500 MG TABLET,6.5,4.22,,,0
HCPCS,J7517,Mycophenolate mofetil oral,,,0.26,0.41,5
HCPCS,J7517,Noncdm Charge Record Pharmacy,4.26,2.77,,,0
HCPCS,J7518,"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",27.3,17.74,,,0
HCPCS,J7518,"MYCOPHENOLATE SODIUM 360 MG TABLET,DELAYED RELEASE",23.3,15.14,,,0
HCPCS,J7518,Mycophenolic acid,,,0.81,1.3,5
HCPCS,J7518,Noncdm Charge Record Pharmacy,12.15,7.895,,,0
HCPCS,J7519,Inj. mycophenolate mofetil,,,0.7,1.11,5
HCPCS,J7519,MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,116.95,76.02,,,0
HCPCS,J7519,Noncdm Charge Record Pharmacy,2.17,1.41,,,0
HCPCS,J7520,Noncdm Charge Record Pharmacy,24.34,15.82,,,0
HCPCS,J7520,SIROLIMUS 1 MG TABLET,24.65,16.02,,,0
HCPCS,J7520,"Sirolimus, oral",,,1.81,2.87,5
HCPCS,J7525,Noncdm Charge Record Pharmacy,441.33,286.86,,,0
HCPCS,J7525,TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,1276.5,829.72,,,0
HCPCS,J7525,Tacrolimus injection,,,263.15,690.16,6
HCPCS,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,14.85,9.65,,,0
HCPCS,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 1 MG TABLET,51.3,33.34,,,0
HCPCS,J7527,Noncdm Charge Record Pharmacy,19.645,12.77,,,0
HCPCS,J7527,Oral everolimus,,,3.95,6.29,5
HCPCS,J7601,Ensifentrine inh 3 mg,,,115.06,159.89,4
HCPCS,J7605,Arformoterol non-comp unit,,,1.38,2.2,5
HCPCS,J7606,"Formoterol fumarate, inh",,,3.21,5.12,5
HCPCS,J7608,Acetylcysteine non-comp unit,,,13.85,22.09,5
HCPCS,J7609,Albuterol comp unit,,,1.76,1.76,2
HCPCS,J7611,Albuterol non-comp con,,,0.27,0.43,5
HCPCS,J7612,Levalbuterol non-comp con,,,0.5,0.79,5
HCPCS,J7613,Albuterol non-comp unit,,,0.13,0.19,5
HCPCS,J7614,Levalbuterol non-comp unit,,,0.14,0.24,5
HCPCS,J7615,Levalbuterol comp unit,,,5.26,5.26,2
HCPCS,J7620,Albuterol ipratrop non-comp,,,0.32,0.51,5
HCPCS,J7626,Budesonide non-comp unit,,,2.4,3.82,5
HCPCS,J7627,Budesonide comp unit,,,0.7,12.28,4
HCPCS,J7631,Cromolyn sodium noncomp unit,,,0.36,0.57,5
HCPCS,J7632,Cromolyn sodium comp unit,,,0.87,0.87,2
HCPCS,J7633,Budesonide non-comp con,,,0.02,0.02,2
HCPCS,J7639,Dornase alfa non-comp unit,,,91.11,145.23,5
HCPCS,J7641,Flunisolide comp unit,,,27.18,27.18,2
HCPCS,J7644,Ipratropium bromide non-comp,,,0.62,1.0,5
HCPCS,J7665,Mannitol for inhaler,,,3.2,15.4,4
HCPCS,J7669,Metaproterenol non-comp unit,,,0.02,0.02,2
HCPCS,J7674,METHACHOLINE 0.025 MG/ML CHALLENGE SOLUTION (CMP),164.0,106.6,,,0
HCPCS,J7674,METHACHOLINE CHLORIDE 0.1875 MG/3 ML (0.0625 MG/ML) NEBULIZATION SOLN,15.45,10.04,,,0
HCPCS,J7674,METHACHOLINE CHLORIDE 0.75 MG/3 ML (0.25 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
HCPCS,J7674,METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION,267.55,173.91,,,0
HCPCS,J7674,METHACHOLINE CHLORIDE 12 MG/3 ML (4 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
HCPCS,J7674,METHACHOLINE CHLORIDE 3 MG/3 ML (1 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
HCPCS,J7674,METHACHOLINE CHLORIDE 48 MG/3 ML (16 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
HCPCS,J7674,"Methacholine chloride, neb",,,2.74,4.36,5
HCPCS,J7674,Noncdm Charge Record Pharmacy,2.65,1.72,,,0
HCPCS,J7677,Revefenacin inh non-com 1mcg,,,0.33,0.54,5
HCPCS,J7680,Terbutaline sulf comp con,,,34.2,34.2,2
HCPCS,J7681,Terbutaline sulf comp unit,,,34.2,34.2,2
HCPCS,J7682,Tobramycin non-comp unit,,,27.21,43.36,5
HCPCS,J7683,Triamcinolone comp con,,,12.28,12.28,2
HCPCS,J7685,Tobramycin comp unit,,,156.91,156.91,2
HCPCS,J7686,"Treprostinil, non-comp unit",,,1292.26,2060.01,5
HCPCS,J7999,CALCIUM GLUCONATE 1 GRAM/10 ML (100 MG/ML) IN STERILE WATER IV SYRINGE,51.8,33.67,,,0
HCPCS,J7999,"CARDIOPLEGIC SOLUTION NO.16 26 MEQ/1,052.8 ML(POTASSIUM) FOR PERFUSION",346.9,225.48,,,0
HCPCS,J7999,CEFAZOLIN 2 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS SOLUTION,114.5,74.42,,,0
HCPCS,J7999,CEFAZOLIN 3 GRAM/100 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,71.15,46.25,,,0
HCPCS,J7999,EPINEPHRINE 1 MG/10 ML (100 MCG/ML) INJECTION (NSORD),40.5,26.32,,,0
HCPCS,J7999,HYDROMORPHONE (PF) 0.2 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLN,55.05,35.78,,,0
HCPCS,J7999,HYDROMORPHONE 0.5 MG/ML PCA HIGH RISK,100.5,65.32,,,0
HCPCS,J7999,"KETAMINE (PF) 5 MG/ML IN SODIUM CHLORIDE, ISO-OSMOTIC IV SOLUTION",185.0,120.25,,,0
HCPCS,J7999,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,62.15,40.4,,,0
HCPCS,J7999,"KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLOR,ISO-OSMOTIC INJ SYRINGE",61.9,40.24,,,0
HCPCS,J7999,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,54.35,35.33,,,0
HCPCS,J7999,METHACHOLINE CHLORIDE 0 MG/3 ML (0 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
HCPCS,J7999,MORPHINE (PF) 2 MG/2 ML (1 MG/ML) IN 0.9% SODIUM CHLORIDE INJ SYRINGE,44.85,29.15,,,0
HCPCS,J7999,MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,77.65,50.47,,,0
HCPCS,J7999,NOREPINEPHRINE BITARTRATE 16 MG/250 ML (64 MCG/ML) IN 0.9 % NACL IV,69.25,45.01,,,0
HCPCS,J7999,Noncdm Charge Record Pharmacy,84.005,54.599999999999994,,,0
HCPCS,J7999,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,35.45,23.04,,,0
HCPCS,J7999,PHENYLEPHRINE 50 MG/250 ML (200 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,150.95,98.12,,,0
HCPCS,J7999,"SODIUM BICARBONATE 150 MEQ/1,000 ML IN DEXTROSE 5 % INTRAVENOUS",134.2,87.23,,,0
HCPCS,J8501,APREPITANT 40 MG CAPSULE,127.25,82.71,,,0
HCPCS,J8501,Noncdm Charge Record Pharmacy,28.564999999999998,18.57,,,0
HCPCS,J8501,Oral aprepitant,,,4.86,7.75,5
HCPCS,J8510,Oral busulfan,,,10.12,321.45,5
HCPCS,J8515,CABERGOLINE 0.5 MG TABLET,10.35,6.73,,,0
HCPCS,J8515,"Cabergoline, oral 0.25mg",,,5.24,49.67,4
HCPCS,J8515,Noncdm Charge Record Pharmacy,5.485,3.5650000000000004,,,0
HCPCS,J8522,CAPECITABINE 150 MG TABLET,8.15,5.3,,,0
HCPCS,J8522,"Capecitabine, oral, 50 mg",,,0.04,0.11,6
HCPCS,J8530,CYCLOPHOSPHAMIDE 25 MG ORAL SOLID SORD,26.25,17.06,,,0
HCPCS,J8530,CYCLOPHOSPHAMIDE 50 MG CAPSULE,46.0,29.9,,,0
HCPCS,J8530,CYCLOPHOSPHAMIDE 50 MG ORAL SOLID SORD,44.35,28.83,,,0
HCPCS,J8530,Cyclophosphamide oral 25 MG,,,1.42,2.28,5
HCPCS,J8530,Noncdm Charge Record Pharmacy,9.065000000000001,5.895,,,0
HCPCS,J8540,DEXAMETHASONE 0.5 MG TABLET,4.95,3.22,,,0
HCPCS,J8540,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,9.25,6.01,,,0
HCPCS,J8540,DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),97.6,63.44,,,0
HCPCS,J8540,DEXAMETHASONE 2 MG TABLET,6.4,4.16,,,0
HCPCS,J8540,DEXAMETHASONE 4 MG TABLET,7.55,4.91,,,0
HCPCS,J8540,INV DEXAMETHASONE 2 MG TABLET,0.65,0.42,,,0
HCPCS,J8540,INV DEXAMETHASONE 4 MG TABLET,0.65,0.42,,,0
HCPCS,J8540,Noncdm Charge Record Pharmacy,0.3,0.2,,,0
HCPCS,J8540,Oral dexamethasone,,,0.11,0.16,5
HCPCS,J8541,"Oral, hemady, 0.25 mg",,,0.8,1.11,4
HCPCS,J8560,Etoposide oral 50 mg,,,77.46,207.37,6
HCPCS,J8562,Oral fludarabine phosphate,,,0.02,0.02,2
HCPCS,J8565,Gefitinib oral,,,328.09,788.61,4
HCPCS,J8600,Melphalan oral 2 MG,,,21.43,34.96,4
HCPCS,J8610,METHOTREXATE SODIUM 2.5 MG TABLET,10.7,6.96,,,0
HCPCS,J8610,Methotrexate oral 2.5 MG,,,0.3,0.49,5
HCPCS,J8610,Noncdm Charge Record Pharmacy,7.195,4.68,,,0
HCPCS,J8611,Oral methotrexate (jylamvo),,,18.47,51.41,5
HCPCS,J8612,Oral methotrexate (xatmep),,,22.68,56.12,5
HCPCS,J8650,Nabilone oral,,,0.02,41.19,4
HCPCS,J8655,Netupitant palonosetron oral,,,422.89,1083.65,6
HCPCS,J8670,ROLAPITANT 90 MG TABLET,1034.8,672.62,,,0
HCPCS,J8670,"Rolapitant, oral, 1mg",,,1.86,4.39,6
HCPCS,J8700,Temozolomide,,,0.45,0.73,5
HCPCS,J8705,Topotecan oral,,,124.83,338.56,6
HCPCS,J9000,DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION,105.25,68.41,,,0
HCPCS,J9000,DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,116.75,75.89,,,0
HCPCS,J9000,DOXORUBICIN INJECTION (BEAD IMPREGNATION),84.55,54.96,,,0
HCPCS,J9000,Doxorubicin hcl injection,,,5.64,9.0,5
HCPCS,J9000,INV DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9000,Noncdm Charge Record Pharmacy,31.49,20.47,,,0
HCPCS,J9015,Aldesleukin injection,,,3338.87,14366.41,5
HCPCS,J9015,INV ALDESLEUKIN INJECTION,0.65,0.42,,,0
HCPCS,J9017,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,228.05,148.23,,,0
HCPCS,J9017,Arsenic trioxide injection,,,7.96,12.68,5
HCPCS,J9017,Noncdm Charge Record Pharmacy,29.1,18.92,,,0
HCPCS,J9019,Erwinaze injection,,,943.21,1310.83,4
HCPCS,J9020,"Asparaginase, nos",,,0.02,138.51,4
HCPCS,J9021,"Inj, aspara, rylaze, 0.1 mg",,,55.47,146.72,6
HCPCS,J9022,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION",48155.95,31301.37,,,0
HCPCS,J9022,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION,33733.8,21926.97,,,0
HCPCS,J9022,INV ATEZOLIZUMAB 60 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9022,INV ATEZOLIZUMAB/PLACEBO 1200 MG/20 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9022,"Inj, atezolizumab,10 mg",,,91.34,239.08,6
HCPCS,J9022,Noncdm Charge Record Pharmacy,358.29,232.89,,,0
HCPCS,J9023,AVELUMAB 20 MG/ML INTRAVENOUS SOLUTION,8768.3,5699.4,,,0
HCPCS,J9023,"Injection, avelumab, 10 mg",,,100.09,262.73,6
HCPCS,J9023,Noncdm Charge Record Pharmacy,406.64,264.32,,,0
HCPCS,J9025,Azacitidine injection,,,0.48,0.79,5
HCPCS,J9025,Noncdm Charge Record Pharmacy,2.1,1.36,,,0
HCPCS,J9026,"Inj, tarlatamab-dlle, 1 mg",,,1564.64,4269.39,5
HCPCS,J9027,Clofarabine injection,,,4.19,22.93,6
HCPCS,J9028,"Inj, nogapendekin pmln, 1mcg",,,94.66,257.1,6
HCPCS,J9029,"Inj, adstiladrin, per tx dos",,,63342.28,171819.53,6
HCPCS,J9030,BCG LIVE 50 MG INTRAVESICAL SUSPENSION,783.45,509.24,,,0
HCPCS,J9030,Bcg live intravesical 1mg,,,3.26,8.13,6
HCPCS,J9030,Noncdm Charge Record Pharmacy,14.75,9.59,,,0
HCPCS,J9032,BELINOSTAT 500 MG INTRAVENOUS SOLUTION,10577.95,6875.67,,,0
HCPCS,J9032,INV BELINOSTAT 500 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9032,"Injection, belinostat, 10mg",,,52.47,136.26,6
HCPCS,J9033,BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,12129.25,7884.01,,,0
HCPCS,J9033,"Inj., treanda 1 mg",,,1.88,4.88,6
HCPCS,J9034,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,5898.5,3834.02,,,0
HCPCS,J9034,"Inj., bendeka 1 mg",,,13.49,36.45,6
HCPCS,J9034,Noncdm Charge Record Pharmacy,75.84,49.3,,,0
HCPCS,J9035,BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,483.05,313.98,,,0
HCPCS,J9035,Bevacizumab injection,,,73.2,198.34,6
HCPCS,J9035,INV BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9035,Noncdm Charge Record Pharmacy,334.71,217.56,,,0
HCPCS,J9036,Inj. belrapzo/bendamustine,,,12.28,46.42,6
HCPCS,J9037,Inj belantamab mafodont blmf,,,103.26,113.09,4
HCPCS,J9039,BLINATUMOMAB 35 MCG INTRAVENOUS KIT,23132.15,15035.9,,,0
HCPCS,J9039,"Injection, blinatumomab",,,164.25,413.3,6
HCPCS,J9039,Noncdm Charge Record Pharmacy,632.97,411.43,,,0
HCPCS,J9040,BLEOMYCIN 15 UNIT/ML (IM/SC CONCENTRATION),193.05,125.48,,,0
HCPCS,J9040,Bleomycin sulfate injection,,,35.55,56.67,5
HCPCS,J9040,Noncdm Charge Record Pharmacy,116.09,75.46,,,0
HCPCS,J9041,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,124.5,80.92,,,0
HCPCS,J9041,BORTEZOMIB 3.5 MG SOLUTION FOR INJECTION INTRAVENOUS,6731.5,4375.48,,,0
HCPCS,J9041,Bortezomib injection,,,3.77,6.02,5
HCPCS,J9041,INV BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,0.65,0.42,,,0
HCPCS,J9041,Noncdm Charge Record Pharmacy,8.2,5.33,,,0
HCPCS,J9042,BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,52662.6,34230.69,,,0
HCPCS,J9042,Brentuximab vedotin inj,,,258.64,674.6,6
HCPCS,J9042,Noncdm Charge Record Pharmacy,864.1,561.66,,,0
HCPCS,J9043,CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,54267.0,35273.55,,,0
HCPCS,J9043,Cabazitaxel injection,,,227.28,607.28,6
HCPCS,J9043,Noncdm Charge Record Pharmacy,942.05,612.33,,,0
HCPCS,J9045,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,214.8,139.62,,,0
HCPCS,J9045,CARBOPLATIN 150 MG INTRAVENOUS SOLUTION,1443.95,938.57,,,0
HCPCS,J9045,Carboplatin injection,,,6.17,9.84,5
HCPCS,J9045,Noncdm Charge Record Pharmacy,21.65,14.07,,,0
HCPCS,J9046,"Inj, bortezomib, dr. reddy's",,,3.46,107.17,5
HCPCS,J9047,CARFILZOMIB 10 MG INTRAVENOUS SOLUTION,2527.55,1642.91,,,0
HCPCS,J9047,CARFILZOMIB 60 MG INTRAVENOUS SOLUTION,14754.7,9590.56,,,0
HCPCS,J9047,INV CARFILZOMIB 60 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9047,"Injection, carfilzomib, 1 mg",,,55.65,140.84,6
HCPCS,J9047,Noncdm Charge Record Pharmacy,91.64500000000001,59.57,,,0
HCPCS,J9048,BORTEZOMIB 3.5 MG INTRAVENOUS POWDER FOR SOLUTION,5245.25,3409.41,,,0
HCPCS,J9048,"Inj, bortezomib freseniuskab",,,6.97,107.17,5
HCPCS,J9049,"Inj, bortezomib, hospira",,,2.45,3.9,5
HCPCS,J9050,CARMUSTINE 100 MG INTRAVENOUS SOLUTION,1539.35,1000.58,,,0
HCPCS,J9050,Carmustine injection,,,238.46,691.92,6
HCPCS,J9050,Noncdm Charge Record Pharmacy,932.52,606.14,,,0
HCPCS,J9051,"Inj, bortezomib (maia)",,,8.03,8.03,2
HCPCS,J9052,"Inj, carmustine (accord)",,,0.14,573.3,5
HCPCS,J9055,CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION,3473.05,2257.48,,,0
HCPCS,J9055,CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,6864.0,4461.6,,,0
HCPCS,J9055,Cetuximab injection,,,78.37,208.94,6
HCPCS,J9055,INV CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9055,Noncdm Charge Record Pharmacy,305.09,198.31,,,0
HCPCS,J9056,"Inj, bendamustine, 1 mg",,,29.85,77.64,6
HCPCS,J9057,INV COPANLISIB (BAY 80-6946) 15 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9057,"Inj., copanlisib, 1 mg",,,204.89,241.62,4
HCPCS,J9060,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,151.65,98.57,,,0
HCPCS,J9060,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION (RESEARCH TRIAL ROUNDING TO 1 MG),221.2,143.78,,,0
HCPCS,J9060,Cisplatin 10 mg injection,,,4.57,7.29,5
HCPCS,J9060,Noncdm Charge Record Pharmacy,24.31,15.8,,,0
HCPCS,J9061,"Inj, amivantamab-vmjw",,,22.54,58.43,6
HCPCS,J9063,INV MIRVETUXIMAB SORAVTANSINE 5 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9063,"Inj, elahere, 1 mg",,,69.49,184.58,6
HCPCS,J9063,Noncdm Charge Record Pharmacy,273.72,177.92,,,0
HCPCS,J9065,CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,359.65,233.77,,,0
HCPCS,J9065,Inj cladribine per 1 mg,,,10.68,30.54,6
HCPCS,J9065,Noncdm Charge Record Pharmacy,52.15,33.9,,,0
HCPCS,J9070,Noncdm Charge Record Pharmacy,136.16,88.5,,,0
HCPCS,J9071,Inj cyclophosphamd auromedic,,,0.63,1.9,6
HCPCS,J9071,Noncdm Charge Record Pharmacy,2.87,1.87,,,0
HCPCS,J9072,Inj cyclophos dr.reddy's 5mg,,,9.1,28.46,5
HCPCS,J9073,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,1797.65,1168.47,,,0
HCPCS,J9073,Inj cyclophosphamd (ingenus),,,0.78,5.93,6
HCPCS,J9073,Noncdm Charge Record Pharmacy,6.38,4.15,,,0
HCPCS,J9074,"Inj, cyclophosphamd, sandoz",,,3.94,11.79,6
HCPCS,J9075,CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,483.0,313.95,,,0
HCPCS,J9075,CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,313.4,203.71,,,0
HCPCS,J9075,"Inj, cyclophosphamide, nos",,,0.48,2.38,6
HCPCS,J9075,Noncdm Charge Record Pharmacy,3.64,2.37,,,0
HCPCS,J9076,"Inj, cyclophos (baxter) 5mg",,,5.01,15.75,5
HCPCS,J9098,Cytarabine liposome inj,,,0.02,1108.01,4
HCPCS,J9100,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,101.7,66.1,,,0
HCPCS,J9100,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,130.1,84.56,,,0
HCPCS,J9100,Cytarabine hcl 100 mg inj,,,1.34,2.14,5
HCPCS,J9100,Noncdm Charge Record Pharmacy,6.17,4.01,,,0
HCPCS,J9118,Inj. calaspargase pegol-mknl,,,82.08,207.4,6
HCPCS,J9119,"Inj., cemiplimab-rwlc, 1 mg",,,29.29,76.45,6
HCPCS,J9119,Noncdm Charge Record Pharmacy,124.95,81.22,,,0
HCPCS,J9120,DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,11317.4,7356.31,,,0
HCPCS,J9120,Dactinomycin injection,,,328.34,880.21,6
HCPCS,J9120,Noncdm Charge Record Pharmacy,6018.96,3912.32,,,0
HCPCS,J9130,Dacarbazine 100 mg inj,,,7.1,11.3,5
HCPCS,J9130,Noncdm Charge Record Pharmacy,34.01,22.11,,,0
HCPCS,J9144,"DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN",43716.0,28415.4,,,0
HCPCS,J9144,"Daratumumab, hyaluronidase",,,55.57,139.27,6
HCPCS,J9144,"INV DARATUMUMAB-RHUPH20 120 MG-2,000 UNITS/ML INJECTION",0.65,0.42,,,0
HCPCS,J9144,Noncdm Charge Record Pharmacy,220.1,143.06,,,0
HCPCS,J9145,"Injection, daratumumab 10 mg",,,71.37,177.02,6
HCPCS,J9145,Noncdm Charge Record Pharmacy,296.0,192.4,,,0
HCPCS,J9150,Daunorubicin injection,,,39.98,63.74,5
HCPCS,J9150,Noncdm Charge Record Pharmacy,121.23,78.8,,,0
HCPCS,J9151,Daunorubicin citrate inj,,,0.02,140.24,4
HCPCS,J9153,DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,45628.2,29658.33,,,0
HCPCS,J9153,"Inj daunorubicin, cytarabine",,,256.09,673.19,6
HCPCS,J9153,Noncdm Charge Record Pharmacy,953.97,620.08,,,0
HCPCS,J9155,DEGARELIX 120 MG SUBCUTANEOUS SOLUTION,3020.1,1963.06,,,0
HCPCS,J9155,DEGARELIX 80 MG SUBCUTANEOUS SOLUTION,1965.2,1277.38,,,0
HCPCS,J9155,Degarelix injection,,,4.45,11.6,6
HCPCS,J9155,Noncdm Charge Record Pharmacy,26.0,16.9,,,0
HCPCS,J9171,DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,187.1,121.62,,,0
HCPCS,J9171,Docetaxel injection,,,1.25,1.98,5
HCPCS,J9171,Noncdm Charge Record Pharmacy,6.2,4.03,,,0
HCPCS,J9172,"Docetaxel (ingenus), 1 mg",,,50.78,141.49,6
HCPCS,J9173,DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION,4357.65,2832.47,,,0
HCPCS,J9173,INV DURVALUMAB 50 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9173,INV DURVALUMAB/PLACEBO 50 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9173,"Inj., durvalumab, 10 mg",,,85.12,227.31,6
HCPCS,J9173,Noncdm Charge Record Pharmacy,352.85,229.35,,,0
HCPCS,J9175,Elliotts b solution per ml,,,23.87,31.27,4
HCPCS,J9176,ELOTUZUMAB 300 MG INTRAVENOUS SOLUTION,9710.55,6311.86,,,0
HCPCS,J9176,ELOTUZUMAB 400 MG INTRAVENOUS SOLUTION,12919.9,8397.94,,,0
HCPCS,J9176,"Injection, elotuzumab, 1mg",,,7.88,20.92,6
HCPCS,J9177,ENFORTUMAB VEDOTIN-EJFV 20 MG INTRAVENOUS SOLUTION,11734.1,7627.16,,,0
HCPCS,J9177,ENFORTUMAB VEDOTIN-EJFV 30 MG INTRAVENOUS SOLUTION,17560.1,11414.06,,,0
HCPCS,J9177,Inj enfort vedo-ejfv 0.25mg,,,36.74,99.32,6
HCPCS,J9177,Noncdm Charge Record Pharmacy,150.49,97.82,,,0
HCPCS,J9178,"Inj, epirubicin hcl, 2 mg",,,2.76,4.42,5
HCPCS,J9179,Eribulin mesylate injection,,,89.34,361.3,6
HCPCS,J9179,Noncdm Charge Record Pharmacy,615.2,399.88,,,0
HCPCS,J9181,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,263.3,171.14,,,0
HCPCS,J9181,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION (RESEARCH TRIAL ROUNDING TO 1 MG),138.975,90.33,,,0
HCPCS,J9181,ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,738.8,480.22,,,0
HCPCS,J9181,Etoposide injection,,,1.66,2.66,5
HCPCS,J9181,Noncdm Charge Record Pharmacy,7.51,4.88,,,0
HCPCS,J9185,FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,371.25,241.31,,,0
HCPCS,J9185,Fludarabine phosphate inj,,,286.11,456.09,5
HCPCS,J9185,INV FLUDARABINE 50MG/2ML INJECTABLE,0.65,0.42,,,0
HCPCS,J9185,Noncdm Charge Record Pharmacy,3461.87,2250.22,,,0
HCPCS,J9190,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,116.2,75.53,,,0
HCPCS,J9190,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,149.95,97.47,,,0
HCPCS,J9190,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,89.55,58.21,,,0
HCPCS,J9190,Fluorouracil injection,,,3.79,6.04,5
HCPCS,J9190,Noncdm Charge Record Pharmacy,26.32,17.11,,,0
HCPCS,J9196,Inj gemcitabine hcl (accord),,,15.87,25.31,5
HCPCS,J9198,"Inj. infugem, 100 mg",,,88.92,88.92,2
HCPCS,J9200,Floxuridine injection,,,4128.02,10811.92,6
HCPCS,J9201,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,126.05,81.93,,,0
HCPCS,J9201,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,191.4,124.41,,,0
HCPCS,J9201,GEMCITABINE 200 MG INTRAVENOUS SOLUTION,123.45,80.24,,,0
HCPCS,J9201,Gemcitabine hcl injection,,,4.87,7.78,5
HCPCS,J9201,Noncdm Charge Record Pharmacy,22.83,14.84,,,0
HCPCS,J9202,GOSERELIN 10.8 MG SUBCUTANEOUS IMPLANT,15618.1,10151.76,,,0
HCPCS,J9202,GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT,4768.15,3099.3,,,0
HCPCS,J9202,Goserelin acetate implant,,,733.66,1905.29,6
HCPCS,J9202,Noncdm Charge Record Pharmacy,4115.18,2674.87,,,0
HCPCS,J9203,GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONCENTRATION) IV SOLN,42374.8,27543.62,,,0
HCPCS,J9203,Gemtuzumab ozogamicin 0.1 mg,,,236.62,631.76,6
HCPCS,J9203,Noncdm Charge Record Pharmacy,940.26,611.17,,,0
HCPCS,J9204,"Inj mogamulizumab-kpkc, 1 mg",,,248.5,659.4,6
HCPCS,J9204,MOGAMULIZUMAB-KPKC 4 MG/ML INTRAVENOUS SOLUTION,19727.4,12822.81,,,0
HCPCS,J9204,Noncdm Charge Record Pharmacy,890.31,578.7,,,0
HCPCS,J9205,IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS,12746.2,8285.03,,,0
HCPCS,J9205,Inj irinotecan liposome 1 mg,,,66.0,174.04,6
HCPCS,J9205,Noncdm Charge Record Pharmacy,269.66,175.28,,,0
HCPCS,J9206,Irinotecan injection,,,3.36,5.34,5
HCPCS,J9206,Noncdm Charge Record Pharmacy,18.35,11.93,,,0
HCPCS,J9207,Ixabepilone injection,,,139.21,369.73,6
HCPCS,J9208,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,305.7,198.7,,,0
HCPCS,J9208,IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,209.6,136.24,,,0
HCPCS,J9208,Ifosfamide injection,,,42.61,67.94,5
HCPCS,J9208,Noncdm Charge Record Pharmacy,127.92,83.15,,,0
HCPCS,J9209,MESNA 100 MG/ML INTRAVENOUS SOLUTION,114.65,74.52,,,0
HCPCS,J9209,Mesna injection,,,2.69,4.28,5
HCPCS,J9209,Noncdm Charge Record Pharmacy,22.41,14.57,,,0
HCPCS,J9210,"Inj., emapalumab-lzsg, 1 mg",,,384.85,1020.5,6
HCPCS,J9211,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,820.25,533.16,,,0
HCPCS,J9211,Idarubicin hcl injection,,,79.56,126.83,5
HCPCS,J9212,Interferon alfacon-1 inj,,,0.02,16.67,4
HCPCS,J9213,Interferon alfa-2a inj,,,0.02,92.03,4
HCPCS,J9214,Interferon alfa-2b inj,,,34.2,71.91,4
HCPCS,J9215,Interferon alfa-n3 inj,,,70.2,97.94,4
HCPCS,J9216,Interferon gamma 1-b inj,,,19052.54,26478.11,4
HCPCS,J9217,LEUPROLIDE 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,2953.3,1919.64,,,0
HCPCS,J9217,LEUPROLIDE 30 MG (4 MONTH) SUBCUTANEOUS SYRINGE,1580.95,1027.62,,,0
HCPCS,J9217,LEUPROLIDE 7.5 MG (1 MONTH) SUBCUTANEOUS SYRINGE,456.85,296.95,,,0
HCPCS,J9217,LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,799.9,519.94,,,0
HCPCS,J9217,LEUPROLIDE ACETATE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT,4389.0,2852.85,,,0
HCPCS,J9217,LEUPROLIDE ACETATE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,2235.55,1453.11,,,0
HCPCS,J9217,LEUPROLIDE ACETATE 45 MG (6 MONTH) SUBCUTANEOUS SYRINGE,2330.4,1514.76,,,0
HCPCS,J9217,Leuprolide acetate suspnsion,,,176.45,489.94,6
HCPCS,J9217,Noncdm Charge Record Pharmacy,657.98,427.69,,,0
HCPCS,J9218,Leuprolide acetate injeciton,,,15.15,24.15,5
HCPCS,J9219,Leuprolide acetate implant,,,0.02,0.02,2
HCPCS,J9223,"Inj. lurbinectedin, 0.1 mg",,,207.13,555.28,6
HCPCS,J9223,LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION,34303.9,22297.54,,,0
HCPCS,J9223,Noncdm Charge Record Pharmacy,859.55,558.71,,,0
HCPCS,J9225,Vantas implant,,,0.02,12359.93,4
HCPCS,J9226,Supprelin LA implant,,,45020.65,122659.48,6
HCPCS,J9227,ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION,10907.625,7089.955,,,0
HCPCS,J9227,Inj. isatuximab-irfc 10 mg,,,81.9,215.04,6
HCPCS,J9227,Noncdm Charge Record Pharmacy,235.52,153.09,,,0
HCPCS,J9228,INV IPILIMUMAB 5 MG/ML INTRAVENOUS SOLUTION (ROUNDED TO 1 MG),0.65,0.42,,,0
HCPCS,J9228,IPILIMUMAB 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION,150321.75,97709.14,,,0
HCPCS,J9228,IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,37642.05,24467.33,,,0
HCPCS,J9228,Ipilimumab injection,,,183.48,487.94,6
HCPCS,J9228,Noncdm Charge Record Pharmacy,696.49,452.72,,,0
HCPCS,J9229,INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,99287.85,64537.1,,,0
HCPCS,J9229,Inj inotuzumab ozogam 0.1 mg,,,2698.05,7203.53,6
HCPCS,J9230,Mechlorethamine hcl inj,,,0.02,343.63,4
HCPCS,J9245,Inj melphalan hydrochl 50 MG,,,95.9,362.3,6
HCPCS,J9245,MELPHALAN HCL 50 MG INTRAVENOUS POWDER FOR SOLUTION,853.1,554.52,,,0
HCPCS,J9245,Noncdm Charge Record Pharmacy,386.28,251.08,,,0
HCPCS,J9246,"Inj., evomela, 1 mg",,,18.5,48.78,6
HCPCS,J9247,"Inj, melphalan flufenami 1mg",,,0.02,0.02,2
HCPCS,J9248,Inj melphalan (hepzato) 1 mg,,,795.0,2097.0,6
HCPCS,J9250,Noncdm Charge Record Pharmacy,8.82,5.73,,,0
HCPCS,J9255,Noncdm Charge Record Pharmacy,9.94,6.46,,,0
HCPCS,J9259,Noncdm Charge Record Pharmacy,59.93,38.95,,,0
HCPCS,J9260,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,128.65,83.62,,,0
HCPCS,J9260,METHOTREXATE SODIUM 25 MG/ML INJECTION FOR ECTOPIC PREGNANCY (SORD),94.325,61.315,,,0
HCPCS,J9260,Methotrexate sodium inj,,,5.73,9.13,5
HCPCS,J9260,Noncdm Charge Record Pharmacy,5.85,3.8,,,0
HCPCS,J9261,NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,629.5,409.18,,,0
HCPCS,J9261,Nelarabine injection,,,79.86,202.6,6
HCPCS,J9261,Noncdm Charge Record Pharmacy,237.37,154.29,,,0
HCPCS,J9262,"Inj, omacetaxine mep, 0.01mg",,,8.89,10.7,4
HCPCS,J9263,Noncdm Charge Record Pharmacy,0.7,0.46,,,0
HCPCS,J9263,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,431.95,280.77,,,0
HCPCS,J9263,OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,263.45,171.24,,,0
HCPCS,J9263,Oxaliplatin,,,0.13,0.22,5
HCPCS,J9264,INV NAB-PACLITAXIL (ABRAXANE) INJECTION,0.65,0.42,,,0
HCPCS,J9264,Noncdm Charge Record Pharmacy,65.72,42.72,,,0
HCPCS,J9264,PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,3069.9,1995.44,,,0
HCPCS,J9264,Paclitaxel protein bound,,,10.54,36.69,6
HCPCS,J9266,Noncdm Charge Record Pharmacy,84852.91,55154.39,,,0
HCPCS,J9266,PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,109863.6,71411.34,,,0
HCPCS,J9266,Pegaspargase injection,,,28424.06,73361.14,6
HCPCS,J9267,Noncdm Charge Record Pharmacy,1.06,0.69,,,0
HCPCS,J9267,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",274.8,178.62,,,0
HCPCS,J9267,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS (NOT ROUNDED)",356.1,231.46,,,0
HCPCS,J9267,Paclitaxel injection,,,0.19,0.3,5
HCPCS,J9268,PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,9884.1,6424.66,,,0
HCPCS,J9268,Pentostatin injection,,,2608.16,7405.16,6
HCPCS,J9269,Inj. tagraxofusp-erzs 10 mcg,,,356.93,918.39,6
HCPCS,J9269,"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",140108.05,91070.23,,,0
HCPCS,J9271,INV PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9271,INV PEMBROLIZUMAB/PLACEBO 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9271,Inj pembrolizumab,,,60.29,156.1,6
HCPCS,J9271,Noncdm Charge Record Pharmacy,231.03,150.17,,,0
HCPCS,J9271,PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,25035.75,16273.24,,,0
HCPCS,J9272,"Inj, dostarlimab-gxly, 10 mg",,,243.71,650.56,6
HCPCS,J9272,Noncdm Charge Record Pharmacy,979.94,636.96,,,0
HCPCS,J9273,"Inj tisotu vedotin-tftv, 1mg",,,188.76,492.87,6
HCPCS,J9273,Noncdm Charge Record Pharmacy,718.52,467.04,,,0
HCPCS,J9273,TISOTUMAB VEDOTIN-TFTV 40 MG INTRAVENOUS SOLUTION,30781.35,20007.88,,,0
HCPCS,J9274,"Inj, tebentafusp-tebn, 1 mcg",,,217.09,582.0,6
HCPCS,J9280,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,294.15,191.2,,,0
HCPCS,J9280,MITOMYCIN 20 MG/10 ML INTRAVENOUS SOLUTION,209.2,135.98,,,0
HCPCS,J9280,MITOMYCIN 40 MG/20 ML INTRAVENOUS SOLUTION,4996.8,3247.92,,,0
HCPCS,J9280,Mitomycin injection,,,20.35,125.61,6
HCPCS,J9280,Noncdm Charge Record Pharmacy,140.53,91.34,,,0
HCPCS,J9281,Mitomycin instillation,,,318.53,843.79,6
HCPCS,J9281,Noncdm Charge Record Pharmacy,1275.66,829.18,,,0
HCPCS,J9285,"Inj, olaratumab, 10 mg",,,0.02,159.73,4
HCPCS,J9286,GLOFITAMAB-GXBM 1 MG/ML INTRAVENOUS SOLUTION,28188.85,18322.754999999997,,,0
HCPCS,J9286,INV GLOFITAMAB (RO7082859) 1 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9286,"Inj glofitamab gxbm, 2.5 mg",,,2767.88,7509.17,6
HCPCS,J9292,"Inj, pemetrexed (avyxa) 10mg",,,82.34,256.91,5
HCPCS,J9293,Mitoxantrone hydrochl / 5 MG,,,23.88,164.82,6
HCPCS,J9294,"Inj pemetrexed, hospira 10mg",,,3.55,6.96,6
HCPCS,J9294,Noncdm Charge Record Pharmacy,6.76,4.39,,,0
HCPCS,J9294,PEMETREXED DISODIUM 25 MG/ML INTRAVENOUS SOLUTION,253.45000000000002,164.745,,,0
HCPCS,J9295,"Injection, necitumumab, 1 mg",,,5.73,15.53,6
HCPCS,J9296,Inj pemetrexed (accord) 10mg,,,9.74,26.4,5
HCPCS,J9296,Noncdm Charge Record Pharmacy,17.45,11.34,,,0
HCPCS,J9297,Inj pemetrexed (sandoz) 10mg,,,2.6,4.15,5
HCPCS,J9298,Inj nivol relatlimab 3mg/1mg,,,197.83,525.36,6
HCPCS,J9298,NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION,64054.0,41635.1,,,0
HCPCS,J9299,INV NIVOLUMAB 10 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9299,INV NIVOLUMAB/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9299,INV RELATLIMAB (BMS-986016) INJECTION,0.65,0.42,,,0
HCPCS,J9299,"Injection, nivolumab",,,32.96,87.53,6
HCPCS,J9299,NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,13810.65,8976.92,,,0
HCPCS,J9299,NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLUTION,33030.75,21469.99,,,0
HCPCS,J9299,NIVOLUMAB 40 MG/4 ML INTRAVENOUS SOLUTION,5573.55,3622.81,,,0
HCPCS,J9299,Noncdm Charge Record Pharmacy,130.86,85.06,,,0
HCPCS,J9301,INV OBINUTUZUMAB 25MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9301,Noncdm Charge Record Pharmacy,351.73,228.62,,,0
HCPCS,J9301,"OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION",37416.15,24320.5,,,0
HCPCS,J9301,Obinutuzumab inj,,,79.0,202.79,6
HCPCS,J9302,INV OFATUMUMAB 20 MG/0.4 ML AUTO-INJECTOR,0.65,0.42,,,0
HCPCS,J9302,INV OFATUMUMAB 20 MG/0.4 ML PRE-FILLED SYRINGE,0.65,0.42,,,0
HCPCS,J9302,INV OFATUMUMAB/PLACEBO 20 MG/0.4 ML SYRINGE,0.65,0.42,,,0
HCPCS,J9302,Ofatumumab injection,,,62.23,168.64,5
HCPCS,J9303,INV PANITUMUMAB INJECTION 100 MG/5 ML,0.65,0.42,,,0
HCPCS,J9303,Noncdm Charge Record Pharmacy,672.67,437.24,,,0
HCPCS,J9303,Panitumumab injection,,,173.03,449.07,6
HCPCS,J9304,"Inj. pemetrexed, 10 mg",,,46.32,142.82,6
HCPCS,J9305,Noncdm Charge Record Pharmacy,5.55,3.61,,,0
HCPCS,J9305,PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,127.35,82.78,,,0
HCPCS,J9305,PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,277.15,180.15,,,0
HCPCS,J9305,Pemetrexed injection,,,4.36,14.28,6
HCPCS,J9306,INV PERTUZUMAB 30MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9306,"Injection, pertuzumab, 1 mg",,,17.02,43.87,6
HCPCS,J9306,Noncdm Charge Record Pharmacy,59.25,38.51,,,0
HCPCS,J9306,PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,28374.15,18443.2,,,0
HCPCS,J9307,INV PRALATREXATE 20 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9307,Noncdm Charge Record Pharmacy,1540.65,1001.42,,,0
HCPCS,J9307,Pralatrexate injection,,,392.63,1012.92,6
HCPCS,J9308,INV RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9308,"Injection, ramucirumab",,,74.36,197.59,6
HCPCS,J9308,Noncdm Charge Record Pharmacy,309.42,201.12,,,0
HCPCS,J9308,RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,6307.55,4099.91,,,0
HCPCS,J9309,"Inj, polatuzumab vedotin 1mg",,,136.67,360.21,6
HCPCS,J9309,Noncdm Charge Record Pharmacy,167.01,108.56,,,0
HCPCS,J9311,"Inj rituximab, hyaluronidase",,,36.69,99.13,6
HCPCS,J9311,Noncdm Charge Record Pharmacy,166.67,108.34,,,0
HCPCS,J9311,"RITUXIMAB 1,400 MG/11.7 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN",27362.4,17785.56,,,0
HCPCS,J9311,"RITUXIMAB 1,600 MG/13.4 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN|DISCARDED DRUG NOT ADMINISTERED",27536.85,17898.95,,,0
HCPCS,J9312,"Inj., rituximab, 10 mg",,,75.22,207.94,6
HCPCS,J9312,Noncdm Charge Record Pharmacy,379.76,246.84,,,0
HCPCS,J9312,"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",11773.8,7652.969999999999,,,0
HCPCS,J9313,"Inj., lumoxiti, 0.01 mg",,,23.39,63.39,5
HCPCS,J9314,Inj pemetrexed (teva) 10mg,,,12.13,19.35,6
HCPCS,J9316,Noncdm Charge Record Pharmacy,313.88,204.02,,,0
HCPCS,J9316,"PERTUZUMAB 1,200 MG-TRASTUZUMAB 600 MG-HYALURON-ZZXF/15 ML SUBCUT SOLN",57809.25,37576.01,,,0
HCPCS,J9316,"Pertuzu, trastuzu, 10 mg",,,62.1,173.11,6
HCPCS,J9317,Noncdm Charge Record Pharmacy,143.65,93.37,,,0
HCPCS,J9317,SACITUZUMAB GOVITECAN-HZIY 180 MG INTRAVENOUS SOLUTION,10715.75,6965.24,,,0
HCPCS,J9317,Sacituzumab govitecan-hziy,,,36.28,96.04,6
HCPCS,J9318,Inj romidepsin non-lyo 0.1mg,,,28.52,77.29,5
HCPCS,J9319,Inj romidepsin lyophil 0.1mg,,,30.78,82.36,6
HCPCS,J9319,ROMIDEPSIN 10 MG/2 ML INTRAVENOUS POWDER FOR SOLUTION,12226.05,7946.93,,,0
HCPCS,J9320,Streptozocin injection,,,817.2,1135.71,4
HCPCS,J9321,EPCORITAMAB-BYSP 4 MG/0.8 ML SUBCUTANEOUS SOLUTION,5778.95,3756.32,,,0
HCPCS,J9321,EPCORITAMAB-BYSP 48 MG/0.8 ML SUBCUTANEOUS SOLUTION,68444.0,44488.6,,,0
HCPCS,J9321,INV EPCORITAMAB-BYSP 3 MG CHEMO INJECTION (STEP UP DOSE 3),0.65,0.42,,,0
HCPCS,J9321,INV EPCORITAMAB-BYSP 4 MG/0.8 ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9321,INV EPCORITAMAB-BYSP 48 MG/0.8 ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9321,Inj epcoritamab-bysp 0.16 mg,,,55.84,149.56,6
HCPCS,J9322,Inj pemetrexed (bluepoint),,,10.6,22.49,3
HCPCS,J9323,Inj pemetrexed ditromethamin,,,0.12,28.59,5
HCPCS,J9323,Noncdm Charge Record Pharmacy,6.31,4.1,,,0
HCPCS,J9324,"Inj, pemrydi rtu, 10 mg",,,75.81,222.6,6
HCPCS,J9325,Inj talimogene laherparepvec,,,73.94,190.7,6
HCPCS,J9325,TALIMOGENE LAHERPAREPVEC 10EXP6 (1 MILLION) PFU/ML SUSP FOR INJECTION,374.85,243.65,,,0
HCPCS,J9325,TALIMOGENE LAHERPAREPVEC 10EXP8 (100 MILLION)PFU/ML SUSP FOR INJECTION,29352.55,19079.16,,,0
HCPCS,J9328,Temozolomide injection,,,10.39,28.21,6
HCPCS,J9329,"Inj, tislelizumab-jsgr",,,57.44,1494.89,5
HCPCS,J9330,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,6465.55,4202.61,,,0
HCPCS,J9330,Temsirolimus injection,,,26.71,80.0,6
HCPCS,J9331,INV SIROLIMUS PROTEIN BOUND 5 MG/ML INTRAVENOUS SUSPENSION,0.65,0.42,,,0
HCPCS,J9331,Inj sirolimus prot part 1 mg,,,84.57,318.29,6
HCPCS,J9332,EFGARTIGIMOD ALFA-FCAB 20 MG/ML INTRAVENOUS SOLUTION,31538.25,20499.86,,,0
HCPCS,J9332,Inj efgartigimod 2mg,,,32.15,87.94,6
HCPCS,J9332,Noncdm Charge Record Pharmacy,155.81,101.28,,,0
HCPCS,J9333,Inj ronzanolixizum-noli 1 mg,,,23.16,61.84,6
HCPCS,J9333,Noncdm Charge Record Pharmacy,112.16,72.9,,,0
HCPCS,J9334,Inj efgart-alfa 2mg hya-qvfc,,,33.89,89.7,6
HCPCS,J9334,Noncdm Charge Record Pharmacy,162.47,105.61,,,0
HCPCS,J9340,Noncdm Charge Record Pharmacy,2251.3,1463.34,,,0
HCPCS,J9340,THIOTEPA 100 MG SOLUTION FOR INJECTION,7407.0,4814.55,,,0
HCPCS,J9340,THIOTEPA 15 MG SOLUTION FOR INJECTION,1624.65,1056.02,,,0
HCPCS,J9340,Thiotepa injection,,,376.98,600.94,5
HCPCS,J9345,"Inj, retifanlimab-dlwr, 1 mg",,,30.56,79.29,6
HCPCS,J9347,INV TREMELIMUMAB 20 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9347,"Inj, tremelimumab-actl, 1 mg",,,140.9,375.15,6
HCPCS,J9347,Noncdm Charge Record Pharmacy,544.91,354.19,,,0
HCPCS,J9348,"Inj. naxitamab-gqgk, 1 mg",,,686.0,1740.61,6
HCPCS,J9349,"Inj., tafasitamab-cxix",,,14.31,37.86,6
HCPCS,J9349,Noncdm Charge Record Pharmacy,57.53,37.39,,,0
HCPCS,J9349,TAFASITAMAB-CXIX 200 MG INTRAVENOUS SOLUTION,5872.3,3817.0,,,0
HCPCS,J9350,"Inj mosunetuzumab-axgb, 1 mg",,,654.63,1737.3,6
HCPCS,J9350,MOSUNETUZUMAB-AXGB 1 MG/ML INTRAVENOUS SOLUTION,40218.925,26142.305,,,0
HCPCS,J9351,Noncdm Charge Record Pharmacy,32.15,20.9,,,0
HCPCS,J9351,TOPOTECAN 4 MG INTRAVENOUS SOLUTION,192.5,125.12,,,0
HCPCS,J9351,TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,267.0,173.55,,,0
HCPCS,J9351,Topotecan injection,,,3.03,4.82,5
HCPCS,J9352,Injection trabectedin 0.1mg,,,391.07,983.05,6
HCPCS,J9352,Noncdm Charge Record Pharmacy,1474.5,958.42,,,0
HCPCS,J9352,TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,15385.85,10000.8,,,0
HCPCS,J9353,"Inj. margetuximab-cmkb, 5 mg",,,52.49,133.87,6
HCPCS,J9354,ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION,16631.5,10810.48,,,0
HCPCS,J9354,ADO-TRASTUZUMAB EMTANSINE 160 MG INTRAVENOUS SOLUTION,26561.05,17264.68,,,0
HCPCS,J9354,INV ADO-TRASTUZUMAB EMTANSINE 160 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9354,"Inj, ado-trastuzumab emt 1mg",,,42.16,111.03,6
HCPCS,J9354,Noncdm Charge Record Pharmacy,167.96,109.17,,,0
HCPCS,J9355,INV TRASTUZUMAB 440 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9355,Noncdm Charge Record Pharmacy,448.29,291.39,,,0
HCPCS,J9355,TRASTUZUMAB 150 MG INTRAVENOUS SOLUTION,6547.95,4256.17,,,0
HCPCS,J9355,Trastuzumab injection,,,75.03,208.81,6
HCPCS,J9356,"Inj. herceptin hylecta, 10mg",,,61.44,170.89,6
HCPCS,J9356,Noncdm Charge Record Pharmacy,334.34,217.32,,,0
HCPCS,J9356,"TRASTUZUMAB 600 MG-HYALURONIDASE-OYSK 10,000 UNIT/5 ML SUBCUT SOLUTION",19475.45,12659.04,,,0
HCPCS,J9357,VALRUBICIN 40 MG/ML INTRAVESICAL SOLUTION,7834.6,5092.49,,,0
HCPCS,J9357,Valrubicin injection,,,1323.34,3773.73,6
HCPCS,J9358,FAM-TRASTUZUMAB DERUXTECAN-NXKI 100 MG INTRAVENOUS SOLUTION,12885.1,8375.32,,,0
HCPCS,J9358,INV FAM-TRASTUZUMAB DERUXTECAN-NXKI 20 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9358,Inj fam-trastu deru-nxki 1mg,,,29.98,78.08,6
HCPCS,J9358,Noncdm Charge Record Pharmacy,113.98,74.09,,,0
HCPCS,J9359,INV LONCASTUXIMAB TESIRINE-LPYL (ADCT-402) 5 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9359,Inj lon tesirin-lpyl 0.075mg,,,216.9,574.85,6
HCPCS,J9360,Noncdm Charge Record Pharmacy,28.15,18.3,,,0
HCPCS,J9360,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,287.25,186.71,,,0
HCPCS,J9360,Vinblastine sulfate inj,,,8.22,13.09,5
HCPCS,J9370,INV VINCRISTINE 1 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9370,Noncdm Charge Record Pharmacy,79.48,51.66,,,0
HCPCS,J9370,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION (RND 0.01),125.65,81.67,,,0
HCPCS,J9370,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,122.6,79.69,,,0
HCPCS,J9370,Vincristine sulfate 1 MG inj,,,14.16,22.57,5
HCPCS,J9376,"Inj pozelimab-bbfg, 1 mg",,,91.73,281.43,5
HCPCS,J9380,INV TECLISTAMAB (JNJ-64407957) 10 MG/ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9380,INV TECLISTAMAB (JNJ-64407957) 90 MG/ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
HCPCS,J9380,Inj teclistamab cqyv 0.5 mg,,,33.58,88.21,6
HCPCS,J9380,TECLISTAMAB-CQYV 10 MG/ML SUBCUTANEOUS SOLUTION,8579.6,5576.74,,,0
HCPCS,J9380,TECLISTAMAB-CQYV 90 MG/ML SUBCUTANEOUS SOLUTION,43419.6,28222.74,,,0
HCPCS,J9381,Inj teplizumab mzwv 5 mcg,,,37.66,100.92,6
HCPCS,J9390,Noncdm Charge Record Pharmacy,49.83,32.39,,,0
HCPCS,J9390,VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,112.9,73.38,,,0
HCPCS,J9390,VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,193.9,126.04,,,0
HCPCS,J9390,Vinorelbine tartrate inj,,,11.06,17.62,5
HCPCS,J9393,"Inj, fulvestrant (teva)",,,41.67,57.45,5
HCPCS,J9394,"Inj, fulvestrant (fresenius)",,,20.84,33.22,6
HCPCS,J9395,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,685.55,445.61,,,0
HCPCS,J9395,INV FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,0.65,0.42,,,0
HCPCS,J9395,"Injection, Fulvestrant",,,11.32,18.05,5
HCPCS,J9395,Noncdm Charge Record Pharmacy,26.53,17.24,,,0
HCPCS,J9400,"Inj, ziv-aflibercept, 1mg",,,7.88,21.63,6
HCPCS,J9600,Porfimer sodium injection,,,24228.42,65659.02,5
HCPCS,J9999,INV ABEMACICLIB 50 MG TABLET,0.65,0.42,,,0
HCPCS,J9999,INV AGEN1884/PLACEBO 50 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9999,INV AGEN2034 50 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,J9999,INV ENTRECTINIB 200 MG CAPSULE,0.65,0.42,,,0
HCPCS,J99999,INV ADAGRASIB 200MG TABLET,0.65,0.42,,,0
HCPCS,K0672,Removable soft interface le,,,104.22,104.22,1
HCPCS,L0112,Cranial cervical orthosis,,,1720.06,1720.06,1
HCPCS,L0113,Cranial cervical torticollis,,,350.47,350.47,1
HCPCS,L0120,Cerv flex n/adj foam pre ots,,,32.51,32.51,1
HCPCS,L0120,Hc Collar Cervical Ots,208.88,135.77,,,0
HCPCS,L0120,Hc Collar Soft Ots,12.29,7.99,,,0
HCPCS,L0130,Flex thermoplastic collar mo,,,187.59,187.59,1
HCPCS,L0140,Cervical semi-rigid adjustab,,,73.56,73.56,1
HCPCS,L0150,Cerv semi-rig adj molded chn,,,131.54,131.54,1
HCPCS,L0150,Hc Collar Cervical Semi Rigid W/Adj No Ots,119.8,77.87,,,0
HCPCS,L0150,Hc Collar Miami J W/Adj No Ots,364.01,236.61,,,0
HCPCS,L0150,Hc Collar Philadelphia W/Adj No Ots,346.29,225.09,,,0
HCPCS,L0160,Cerv sr wire occ/man pre ots,,,192.08,192.08,1
HCPCS,L0160,Hc Aspen Vista Collar Ots,112.77,73.3,,,0
HCPCS,L0170,Cervical collar molded to pt,,,988.11,988.11,1
HCPCS,L0172,Cerv col sr foam 2pc pre ots,,,174.05,174.05,1
HCPCS,L0172,Hc Collar Cervical Semi Rigid 2 Pc Ots,400.34,260.22,,,0
HCPCS,L0174,Cerv sr 2pc thor ext pre ots,,,342.24,342.24,1
HCPCS,L0180,Cer post col occ/man sup adj,,,554.45,554.45,1
HCPCS,L0190,Cerv collar supp adj cerv ba,,,653.92,653.92,1
HCPCS,L0200,Cerv col supp adj bar & thor,,,758.49,758.49,1
HCPCS,L0220,Thor rib belt custom fabrica,,,158.76,158.76,1
HCPCS,L0450,Tlso flex trunk/thor pre ots,,,123.17,123.17,1
HCPCS,L0454,Tlso trnk sj-t9 pre cst,,,426.22,426.22,1
HCPCS,L0455,Tlso flex trnk sj-t9 pre ots,,,228.66,228.66,1
HCPCS,L0456,Tlso flex trnk sj-ss pre cst,,,1222.31,1222.31,1
HCPCS,L0457,Tlso flex trnk sj-ss pre ots,,,655.74,655.74,1
HCPCS,L0458,TLSO 2Mod symphis-xipho pre,,,1096.06,1096.06,1
HCPCS,L0460,Tlso 2 shl symphys-stern cst,,,1233.68,1233.68,1
HCPCS,L0462,TLSO 3Mod sacro-scap pre,,,1534.47,1534.47,1
HCPCS,L0464,TLSO 4Mod sacro-scap pre,,,1826.79,1826.79,1
HCPCS,L0466,Tlso r fram soft ant pre cst,,,466.26,466.26,1
HCPCS,L0467,Tlso r fram soft pre ots,,,256.45,256.45,1
HCPCS,L0468,Tlso rig fram pelvic pre cst,,,584.34,584.34,1
HCPCS,L0469,Tlso rig fram pelvic pre ots,,,326.76,326.76,1
HCPCS,L0470,TLSO rigid frame pre subclav,,,808.59,808.59,1
HCPCS,L0472,TLSO rigid frame hyperex pre,,,497.56,497.56,1
HCPCS,L0480,TLSO rigid plastic custom fa,,,1856.29,1856.29,1
HCPCS,L0482,TLSO rigid lined custom fab,,,2073.49,2073.49,1
HCPCS,L0484,TLSO rigid plastic cust fab,,,2239.27,2239.27,1
HCPCS,L0486,TLSO rigidlined cust fab two,,,2514.79,2514.79,1
HCPCS,L0488,TLSO rigid lined pre one pie,,,1233.68,1233.68,1
HCPCS,L0490,TLSO rigid plastic pre one,,,347.64,347.64,1
HCPCS,L0491,TLSO 2 piece rigid shell,,,943.84,943.84,1
HCPCS,L0492,TLSO 3 piece rigid shell,,,614.59,614.59,1
HCPCS,L0621,Sio flex pelvic/sacr pre ots,,,64.94,64.94,1
HCPCS,L0622,Sio flex pelvisacral custom,,,328.48,328.48,1
HCPCS,L0623,Sio rig pnl pelv/sac pre ots,,,116.41,116.41,1
HCPCS,L0625,Lo flex l1-below l5 pre ots,,,36.33,36.33,1
HCPCS,L0626,Lo sag rig pnl stays pre cst,,,95.79,95.79,1
HCPCS,L0627,Lo sag ri an/pos pnl pre cst,,,505.13,505.13,1
HCPCS,L0628,Hc Support Lumbar Sacral Ots,71.67,46.59,,,0
HCPCS,L0628,Lso flex no ri stays pre ots,,,55.32,55.32,1
HCPCS,L0630,Lso r post pnl sj-t9 pre cst,,,199.05,199.05,1
HCPCS,L0631,Lso sag r an/pos pnl pre cst,,,1261.6,1261.6,1
HCPCS,L0633,Lso sc r pos/lat pnl pre cst,,,352.41,352.41,1
HCPCS,L0635,Lso sagit rigid panel prefab,,,1228.02,1228.02,1
HCPCS,L0636,Lso sagittal rigid panel cus,,,1666.22,1666.22,1
HCPCS,L0637,Lso sc r ant/pos pnl pre cst,,,1592.13,1592.13,1
HCPCS,L0638,Lso sag-coronal panel custom,,,1620.91,1620.91,1
HCPCS,L0639,Lso s/c shell/panel prefab,,,1592.13,1592.13,1
HCPCS,L0640,Lso s/c shell/panel custom,,,1285.97,1285.97,1
HCPCS,L0641,Lo rig pos pnl l1-l5 pre ots,,,51.4,51.4,1
HCPCS,L0642,Lo sag ri an/pos pnl pre ots,,,271.08,271.08,1
HCPCS,L0643,Lso sag ctr rigi pos pre ots,,,106.8,106.8,1
HCPCS,L0648,Lso sag r an/pos pnl pre ots,,,676.99,676.99,1
HCPCS,L0649,Lso sc r pos/lat pnl pre ots,,,189.11,189.11,1
HCPCS,L0650,Lso sc r ant/pos pnl pre ots,,,783.31,783.31,1
HCPCS,L0651,LSO sag-co shell pnl pre ots,,,783.31,783.31,1
HCPCS,L0700,Ctlso a-p-l control molded,,,2446.57,2446.57,1
HCPCS,L0710,Ctlso a-p-l control w/ inter,,,2689.42,2689.42,1
HCPCS,L0720,Ctlso a-p-l control custom,,,2381.24,2381.24,1
HCPCS,L0810,Halo cervical into jckt vest,,,3284.91,3284.91,1
HCPCS,L0820,Halo cervical into body jack,,,2584.02,2584.02,1
HCPCS,L0830,Halo cerv into milwaukee typ,,,3953.92,3953.92,1
HCPCS,L0859,MRI compatible system,,,1399.89,1399.89,1
HCPCS,L0861,Halo repl liner/interface,,,264.89,264.89,1
HCPCS,L0970,Tlso corset front,,,131.34,131.34,1
HCPCS,L0972,Lso corset front,,,119.54,119.54,1
HCPCS,L0974,Tlso full corset,,,214.76,214.76,1
HCPCS,L0976,Lso full corset,,,183.75,183.75,1
HCPCS,L0978,Axillary crutch extension,,,231.25,231.25,1
HCPCS,L0980,Peroneal straps pair pre ots,,,20.99,20.99,1
HCPCS,L0982,Stocking sup grips 4 pre ots,,,19.23,19.23,1
HCPCS,L0984,Protect body sock ea pre ots,,,83.16,83.16,1
HCPCS,L1000,Ctlso milwauke initial model,,,2492.04,2492.04,1
HCPCS,L1005,Tension based scoliosis orth,,,3933.46,3933.46,1
HCPCS,L1010,Ctlso axilla sling,,,102.83,102.83,1
HCPCS,L1020,Kyphosis pad,,,132.43,132.43,1
HCPCS,L1025,Kyphosis pad floating,,,191.06,191.06,1
HCPCS,L1030,Lumbar bolster pad,,,96.23,96.23,1
HCPCS,L1040,Lumbar or lumbar rib pad,,,108.96,108.96,1
HCPCS,L1050,Sternal pad,,,123.31,123.31,1
HCPCS,L1060,Thoracic pad,,,133.1,133.1,1
HCPCS,L1070,Trapezius sling,,,137.88,137.88,1
HCPCS,L1080,Outrigger,,,64.3,64.3,1
HCPCS,L1085,Outrigger bil w/ vert extens,,,215.27,215.27,1
HCPCS,L1090,Lumbar sling,,,123.66,123.66,1
HCPCS,L1100,Ring flange plastic/leather,,,233.39,233.39,1
HCPCS,L1110,Ring flange plas/leather mol,,,391.31,391.31,1
HCPCS,L1120,Covers for upright each,,,46.74,46.74,1
HCPCS,L1200,Furnsh initial orthosis only,,,2199.24,2199.24,1
HCPCS,L1210,Lateral thoracic extension,,,300.68,300.68,1
HCPCS,L1220,Anterior thoracic extension,,,292.66,292.66,1
HCPCS,L1230,Milwaukee type superstructur,,,819.86,819.86,1
HCPCS,L1240,Lumbar derotation pad,,,111.77,111.77,1
HCPCS,L1250,Anterior asis pad,,,97.2,97.2,1
HCPCS,L1260,Anterior thoracic derotation,,,115.91,115.91,1
HCPCS,L1270,Abdominal pad,,,101.86,101.86,1
HCPCS,L1280,Rib gusset (elastic) each,,,107.39,107.39,1
HCPCS,L1290,Lateral trochanteric pad,,,95.49,95.49,1
HCPCS,L1300,Body jacket mold to patient,,,2118.07,2118.07,1
HCPCS,L1310,Post-operative body jacket,,,2206.15,2206.15,1
HCPCS,L1600,Ho flex frejka w/cov pre cst,,,158.37,158.37,1
HCPCS,L1610,Ho frejka cov only pre cst,,,67.26,67.26,1
HCPCS,L1620,Ho flex pavlik harns pre cst,,,193.1,193.1,1
HCPCS,L1630,Abduct control hip semi-flex,,,259.63,259.63,1
HCPCS,L1640,Pelv band/spread bar thigh c,,,581.79,581.79,1
HCPCS,L1650,HO abduction hip adjustable,,,303.07,303.07,1
HCPCS,L1652,HO bi thighcuffs w sprdr bar,,,438.09,438.09,1
HCPCS,L1660,HO abduction static plastic,,,222.08,222.08,1
HCPCS,L1680,Pelvic & hip control thigh c,,,1400.11,1400.11,1
HCPCS,L1681,Ho bilateral hip abduction,,,2303.12,2303.12,1
HCPCS,L1685,Post-op hip abduct custom fa,,,1366.86,1366.86,1
HCPCS,L1686,HO post-op hip abduction,,,1151.56,1151.56,1
HCPCS,L1690,Combination bilateral HO,,,2376.51,2376.51,1
HCPCS,L1700,Leg perthes orth toronto typ,,,1912.04,1912.04,1
HCPCS,L1710,Legg perthes orth newington,,,2434.79,2434.79,1
HCPCS,L1720,Legg perthes orthosis trilat,,,1812.94,1812.94,1
HCPCS,L1730,Legg perthes orth scottish r,,,1530.52,1530.52,1
HCPCS,L1755,Legg perthes patten bottom t,,,2200.45,2200.45,1
HCPCS,L1810,Ko elastic with joints,,,126.52,126.52,1
HCPCS,L1812,Ko elastic w/joints pre ots,,,78.51,78.51,1
HCPCS,L1820,Ko elas w/ condyle pads & jo,,,174.65,174.65,1
HCPCS,L1830,Hc Immobilizer Knee Ots,45.37,29.49,,,0
HCPCS,L1830,Ko immob canvas long pre ots,,,70.75,70.75,1
HCPCS,L1831,Knee orth pos locking joint,,,361.7,361.7,1
HCPCS,L1832,Ko adj jnt pos r sup pre cst,,,846.51,846.51,1
HCPCS,L1833,Ko adj jnt pos r sup pre ots,,,509.63,509.63,1
HCPCS,L1834,Hc Brace Fracture Tibial Custom,2390.81,1554.03,,,0
HCPCS,L1834,Hc Knee Immobilizer Custom,2387.73,1552.02,,,0
HCPCS,L1834,Ko w/0 joint rigid molded to,,,892.02,892.02,1
HCPCS,L1836,Ko rigid w/o joints pre ots,,,100.03,100.03,1
HCPCS,L1840,Ko derot ant cruciate custom,,,1155.72,1155.72,1
HCPCS,L1843,Ko single upright pre cst,,,1102.71,1102.71,1
HCPCS,L1844,Ko w/adj jt rot cntrl molded,,,1871.51,1871.51,1
HCPCS,L1845,Hc Brace Knee Double Upright Fit To Pt W/Adj,2758.39,1792.95,,,0
HCPCS,L1845,Hc Knee Brace W/Adj,1023.9,665.54,,,0
HCPCS,L1845,Ko double upright pre cst,,,1029.48,1029.48,1
HCPCS,L1846,Ko w adj flex/ext rotat mold,,,1437.92,1437.92,1
HCPCS,L1847,Ko dbl upright w/air pre cst,,,706.86,706.86,1
HCPCS,L1848,Ko dbl upright w/air pre ots,,,706.86,706.86,1
HCPCS,L1850,Ko swedish type pre ots,,,230.4,230.4,1
HCPCS,L1851,Ko single upright prefab ots,,,672.67,672.67,1
HCPCS,L1852,Ko double upright prefab ots,,,641.72,641.72,1
HCPCS,L1860,Ko supracondylar socket mold,,,1532.49,1532.49,1
HCPCS,L1900,Afo sprng wir drsflx calf bd,,,350.64,350.64,1
HCPCS,L1902,Afo ankle gauntlet pre ots,,,91.73,91.73,1
HCPCS,L1904,Afo molded ankle gauntlet,,,554.72,554.72,1
HCPCS,L1906,Afo multilig ank sup pre ots,,,138.2,138.2,1
HCPCS,L1907,AFO supramalleolar custom,,,691.55,691.55,1
HCPCS,L1910,Afo sing bar clasp attach sh,,,344.65,344.65,1
HCPCS,L1920,Afo sing upright w/ adjust s,,,504.86,504.86,1
HCPCS,L1930,Afo plastic,,,309.6,309.6,1
HCPCS,L1930,Hc Orthosis Ankle Foot W/Adj No Ots,804.79,523.11,,,0
HCPCS,L1930,Hc Prefab Afo W/Adj No Ots,829.36,539.08,,,0
HCPCS,L1932,Afo rig ant tib prefab TCF/=,,,1096.64,1096.64,1
HCPCS,L1933,Afo rig ant tib tcf/= ots,,,1096.64,1096.64,1
HCPCS,L1940,Afo molded to patient plasti,,,598.47,598.47,1
HCPCS,L1940,Hc Posterior Afo Static Custom,1603.43,1042.23,,,0
HCPCS,L1940,Hc Splint Afo Dynamic Custom,1603.43,1042.23,,,0
HCPCS,L1945,Afo molded plas rig ant tib,,,1379.49,1379.49,1
HCPCS,L1950,Afo spiral molded to pt plas,,,945.14,945.14,1
HCPCS,L1951,AFO spiral prefabricated,,,1032.09,1032.09,1
HCPCS,L1952,Afo spiral prefab ots,,,1032.09,1032.09,1
HCPCS,L1960,Afo pos solid ank plastic mo,,,761.8,761.8,1
HCPCS,L1970,Afo plastic molded w/ankle j,,,850.61,850.61,1
HCPCS,L1971,"AFO w/ankle joint, prefab",,,576.1,576.1,1
HCPCS,L1980,Afo sing solid stirrup calf,,,496.21,496.21,1
HCPCS,L1990,Afo doub solid stirrup calf,,,574.3,574.3,1
HCPCS,L2000,Kafo sing fre stirr thi/calf,,,1374.81,1374.81,1
HCPCS,L2005,KAFO sng/dbl mechanical act,,,5035.93,5035.93,1
HCPCS,L2010,Kafo sng solid stirrup w/o j,,,1072.34,1072.34,1
HCPCS,L2020,Kafo dbl solid stirrup band/,,,1354.33,1354.33,1
HCPCS,L2030,Kafo dbl solid stirrup w/o j,,,1331.19,1331.19,1
HCPCS,L2034,Kafo pla sin up w/wo k/a cus,,,2496.59,2496.59,1
HCPCS,L2035,KAFO plastic pediatric size,,,212.91,212.91,1
HCPCS,L2036,Hc L2036 Kafo Custom Plastic Double Upright Custom,6102.44,3966.59,,,0
HCPCS,L2036,Kafo plas doub free knee mol,,,2278.43,2278.43,1
HCPCS,L2037,Kafo plas sing free knee mol,,,2038.02,2038.02,1
HCPCS,L2038,Kafo w/o joint multi-axis an,,,1642.94,1642.94,1
HCPCS,L2040,Hkafo torsion bil rot straps,,,248.63,248.63,1
HCPCS,L2050,Hkafo torsion cable hip pelv,,,598.88,598.88,1
HCPCS,L2060,Hkafo torsion ball bearing j,,,749.08,749.08,1
HCPCS,L2070,Hkafo torsion unilat rot str,,,190.75,190.75,1
HCPCS,L2080,Hkafo unilat torsion cable,,,458.63,458.63,1
HCPCS,L2090,Hkafo unilat torsion ball br,,,611.07,611.07,1
HCPCS,L2106,Afo tib fx cast plaster mold,,,968.68,968.68,1
HCPCS,L2108,Afo tib fx cast molded to pt,,,1412.85,1412.85,1
HCPCS,L2112,Afo tibial fracture soft,,,620.02,620.02,1
HCPCS,L2114,Afo tib fx semi-rigid,,,776.59,776.59,1
HCPCS,L2116,Afo tibial fracture rigid,,,947.2,947.2,1
HCPCS,L2126,Kafo fem fx cast thermoplas,,,1569.24,1569.24,1
HCPCS,L2128,Kafo fem fx cast molded to p,,,1970.44,1970.44,1
HCPCS,L2132,Kafo femoral fx cast soft,,,1196.02,1196.02,1
HCPCS,L2134,Kafo fem fx cast semi-rigid,,,1416.24,1416.24,1
HCPCS,L2136,Kafo femoral fx cast rigid,,,1549.86,1549.86,1
HCPCS,L2180,Plas shoe insert w ank joint,,,162.92,162.92,1
HCPCS,L2182,Drop lock knee,,,140.43,140.43,1
HCPCS,L2184,Limited motion knee joint,,,142.35,142.35,1
HCPCS,L2186,Adj motion knee jnt lerman t,,,189.31,189.31,1
HCPCS,L2188,Quadrilateral brim,,,344.15,344.15,1
HCPCS,L2190,Waist belt,,,104.83,104.83,1
HCPCS,L2192,Pelvic band & belt thigh fla,,,409.73,409.73,1
HCPCS,L2200,Limited ankle motion ea jnt,,,61.75,61.75,1
HCPCS,L2210,Dorsiflexion assist each joi,,,77.24,77.24,1
HCPCS,L2220,Dorsi & plantar flex ass/res,,,99.43,99.43,1
HCPCS,L2230,Split flat caliper stirr & p,,,117.56,117.56,1
HCPCS,L2232,"Rocker bottom, contact AFO",,,119.38,119.38,1
HCPCS,L2240,Round caliper and plate atta,,,117.01,117.01,1
HCPCS,L2250,Foot plate molded stirrup at,,,410.5,410.5,1
HCPCS,L2260,Reinforced solid stirrup,,,230.35,230.35,1
HCPCS,L2265,Long tongue stirrup,,,165.21,165.21,1
HCPCS,L2270,Varus/valgus strap padded/li,,,75.76,75.76,1
HCPCS,L2275,Plastic mod low ext pad/line,,,160.19,160.19,1
HCPCS,L2280,Molded inner boot,,,693.78,693.78,1
HCPCS,L2300,Abduction bar jointed adjust,,,309.39,309.39,1
HCPCS,L2310,Abduction bar-straight,,,141.37,141.37,1
HCPCS,L2320,Non-molded lacer,,,237.08,237.08,1
HCPCS,L2330,Lacer molded to patient mode,,,451.21,451.21,1
HCPCS,L2335,Anterior swing band,,,345.46,345.46,1
HCPCS,L2340,Pre-tibial shell molded to p,,,513.58,513.58,1
HCPCS,L2350,Prosthetic type socket molde,,,1023.92,1023.92,1
HCPCS,L2360,Extended steel shank,,,63.37,63.37,1
HCPCS,L2370,Patten bottom,,,393.31,393.31,1
HCPCS,L2375,Torsion ank & half solid sti,,,151.22,151.22,1
HCPCS,L2380,Torsion straight knee joint,,,158.6,158.6,1
HCPCS,L2385,Straight knee joint heavy du,,,180.58,180.58,1
HCPCS,L2387,Add le poly knee custom kafo,,,234.6,234.6,1
HCPCS,L2390,Offset knee joint each,,,125.79,125.79,1
HCPCS,L2395,Offset knee joint heavy duty,,,179.8,179.8,1
HCPCS,L2397,Suspension sleeve lower ext,,,150.0,150.0,1
HCPCS,L2405,Knee joint drop lock ea jnt,,,107.14,107.14,1
HCPCS,L2415,Knee joint cam lock each joi,,,149.3,149.3,1
HCPCS,L2425,Knee disc/dial lock/adj flex,,,176.17,176.17,1
HCPCS,L2430,Knee jnt ratchet lock ea jnt,,,176.17,176.17,1
HCPCS,L2492,Knee lift loop drop lock rin,,,144.15,144.15,1
HCPCS,L2500,Thi/glut/ischia wgt bearing,,,384.58,384.58,1
HCPCS,L2510,Th/wght bear quad-lat brim m,,,991.19,991.19,1
HCPCS,L2520,Th/wght bear quad-lat brim c,,,660.58,660.58,1
HCPCS,L2525,Th/wght bear nar m-l brim mo,,,1400.77,1400.77,1
HCPCS,L2526,Th/wght bear nar m-l brim cu,,,787.09,787.09,1
HCPCS,L2530,Thigh/wght bear lacer non-mo,,,294.73,294.73,1
HCPCS,L2540,Thigh/wght bear lacer molded,,,557.7,557.7,1
HCPCS,L2550,Thigh/wght bear high roll cu,,,418.16,418.16,1
HCPCS,L2570,Hip clevis type 2 posit jnt,,,547.34,547.34,1
HCPCS,L2580,Pelvic control pelvic sling,,,533.32,533.32,1
HCPCS,L2600,Hip clevis/thrust bearing fr,,,262.12,262.12,1
HCPCS,L2610,Hip clevis/thrust bearing lo,,,289.65,289.65,1
HCPCS,L2620,Pelvic control hip heavy dut,,,307.25,307.25,1
HCPCS,L2622,Hip joint adjustable flexion,,,391.07,391.07,1
HCPCS,L2624,Hip adj flex ext abduct cont,,,479.52,479.52,1
HCPCS,L2627,Plastic mold recipro hip & c,,,2626.58,2626.58,1
HCPCS,L2628,Metal frame recipro hip & ca,,,1925.23,1925.23,1
HCPCS,L2630,Pelvic control band & belt u,,,284.55,284.55,1
HCPCS,L2640,Pelvic control band & belt b,,,386.17,386.17,1
HCPCS,L2650,Pelv & thor control gluteal,,,170.06,170.06,1
HCPCS,L2660,Thoracic control thoracic ba,,,220.2,220.2,1
HCPCS,L2670,Thorac cont paraspinal uprig,,,196.02,196.02,1
HCPCS,L2680,Thorac cont lat support upri,,,179.82,179.82,1
HCPCS,L2750,Plating chrome/nickel pr bar,,,96.05,96.05,1
HCPCS,L2755,Carbon graphite lamination,,,160.58,160.58,1
HCPCS,L2760,Extension per extension per,,,69.82,69.82,1
HCPCS,L2768,Ortho sidebar disconnect,,,160.11,160.11,1
HCPCS,L2780,Non-corrosive finish,,,77.77,77.77,1
HCPCS,L2785,Drop lock retainer each,,,36.42,36.42,1
HCPCS,L2795,Knee control full kneecap,,,100.8,100.8,1
HCPCS,L2800,Knee cap medial or lateral p,,,123.76,123.76,1
HCPCS,L2810,Knee control condylar pad,,,100.38,100.38,1
HCPCS,L2820,Soft interface below knee se,,,99.79,99.79,1
HCPCS,L2830,Soft interface above knee se,,,107.96,107.96,1
HCPCS,L2840,Tibial length sock fx or equ,,,53.02,53.02,1
HCPCS,L2850,Femoral lgth sock fx or equa,,,74.34,74.34,1
HCPCS,L2999,Hc Afo Footplate Dynamic,656.32,426.61,,,0
HCPCS,L3000,Ft insert ucb berkeley shell,,,386.06,386.06,1
HCPCS,L3001,Foot insert remov molded spe,,,162.56,162.56,1
HCPCS,L3002,Foot insert plastazote or eq,,,198.48,198.48,1
HCPCS,L3003,Foot insert silicone gel eac,,,214.11,214.11,1
HCPCS,L3010,Foot longitudinal arch suppo,,,214.11,214.11,1
HCPCS,L3020,Foot longitud/metatarsal sup,,,243.83,243.83,1
HCPCS,L3030,Foot arch support remov prem,,,93.77,93.77,1
HCPCS,L3030,Hc Custom Foot Orthotic,251.88,163.72,,,0
HCPCS,L3031,Foot lamin/prepreg composite,,,150.51,150.51,1
HCPCS,L3040,Ft arch suprt premold longit,,,57.84,57.84,1
HCPCS,L3050,Foot arch supp premold metat,,,57.84,57.84,1
HCPCS,L3060,Foot arch supp longitud/meta,,,90.65,90.65,1
HCPCS,L3070,Arch suprt att to sho longit,,,39.08,39.08,1
HCPCS,L3080,Arch supp att to shoe metata,,,39.08,39.08,1
HCPCS,L3090,Arch supp att to shoe long/m,,,50.02,50.02,1
HCPCS,L3100,Hallus-valgus nt dyn pre ots,,,53.16,53.16,1
HCPCS,L3140,Abduction rotation bar shoe,,,109.41,109.41,1
HCPCS,L3150,Abduct rotation bar w/o shoe,,,100.05,100.05,1
HCPCS,L3170,Foot plas heel stabi pre ots,,,62.52,62.52,1
HCPCS,L3224,Woman's shoe oxford brace,,,83.04,83.04,1
HCPCS,L3225,Man's shoe oxford brace,,,90.7,90.7,1
HCPCS,L3300,Sho lift taper to metatarsal,,,64.1,64.1,1
HCPCS,L3310,Shoe lift elev heel/sole neo,,,100.05,100.05,1
HCPCS,L3330,Lifts elevation metal extens,,,695.51,695.51,1
HCPCS,L3332,Shoe lifts tapered to one-ha,,,90.65,90.65,1
HCPCS,L3334,Shoe lifts elevation heel /i,,,46.87,46.87,1
HCPCS,L3340,Shoe wedge sach,,,104.74,104.74,1
HCPCS,L3350,Shoe heel wedge,,,28.11,28.11,1
HCPCS,L3360,Shoe sole wedge outside sole,,,43.76,43.76,1
HCPCS,L3370,Shoe sole wedge between sole,,,60.96,60.96,1
HCPCS,L3380,Shoe clubfoot wedge,,,60.96,60.96,1
HCPCS,L3390,Shoe outflare wedge,,,60.96,60.96,1
HCPCS,L3400,Shoe metatarsal bar wedge ro,,,50.02,50.02,1
HCPCS,L3410,Shoe metatarsal bar between,,,114.09,114.09,1
HCPCS,L3420,Full sole/heel wedge btween,,,67.21,67.21,1
HCPCS,L3430,Sho heel count plast reinfor,,,196.94,196.94,1
HCPCS,L3440,Heel leather reinforced,,,93.77,93.77,1
HCPCS,L3450,Shoe heel sach cushion type,,,129.69,129.69,1
HCPCS,L3455,Shoe heel new leather standa,,,50.02,50.02,1
HCPCS,L3460,Shoe heel new rubber standar,,,42.22,42.22,1
HCPCS,L3465,Shoe heel thomas with wedge,,,71.94,71.94,1
HCPCS,L3470,Shoe heel thomas extend to b,,,76.57,76.57,1
HCPCS,L3480,Shoe heel pad & depress for,,,76.57,76.57,1
HCPCS,L3500,Ortho shoe add leather insol,,,35.93,35.93,1
HCPCS,L3510,Orthopedic shoe add rub insl,,,35.93,35.93,1
HCPCS,L3520,O shoe add felt w leath insl,,,39.08,39.08,1
HCPCS,L3530,Ortho shoe add half sole,,,39.08,39.08,1
HCPCS,L3540,Ortho shoe add full sole,,,62.52,62.52,1
HCPCS,L3550,O shoe add standard toe tap,,,10.99,10.99,1
HCPCS,L3560,O shoe add horseshoe toe tap,,,28.11,28.11,1
HCPCS,L3570,O shoe add instep extension,,,104.74,104.74,1
HCPCS,L3580,O shoe add instep velcro clo,,,79.7,79.7,1
HCPCS,L3590,O shoe convert to sof counte,,,65.66,65.66,1
HCPCS,L3595,Ortho shoe add march bar,,,51.54,51.54,1
HCPCS,L3600,Trans shoe calip plate exist,,,93.77,93.77,1
HCPCS,L3610,Trans shoe caliper plate new,,,123.48,123.48,1
HCPCS,L3620,Trans shoe solid stirrup exi,,,93.77,93.77,1
HCPCS,L3630,Trans shoe solid stirrup new,,,123.48,123.48,1
HCPCS,L3640,Shoe dennis browne splint bo,,,53.16,53.16,1
HCPCS,L3650,Hc Sling And Swath Ots,163.82,106.48,,,0
HCPCS,L3650,Hc Support Shoulder Abduction Ots,124.92,81.2,,,0
HCPCS,L3650,So 8 abd restraint pre ots,,,80.6,80.6,1
HCPCS,L3660,So 8 ab rstr can/web pre ots,,,115.57,115.57,1
HCPCS,L3670,So acro/clav can web pre ots,,,127.15,127.15,1
HCPCS,L3671,SO cap design w/o jnts CF,,,1007.79,1007.79,1
HCPCS,L3674,SO airplane w/wo joint CF,,,1322.06,1322.06,1
HCPCS,L3675,So vest canvas/web pre ots,,,196.31,196.31,1
HCPCS,L3702,EO w/o joints CF,,,322.97,322.97,1
HCPCS,L3702,Hc Splint Elbow Custom,866.22,563.04,,,0
HCPCS,L3710,Eo elas w/metal jnts pre ots,,,159.7,159.7,1
HCPCS,L3720,Forearm/arm cuffs free motio,,,764.22,764.22,1
HCPCS,L3730,Forearm/arm cuffs ext/flex a,,,1013.66,1013.66,1
HCPCS,L3740,Cuffs adj lock w/ active con,,,1201.78,1201.78,1
HCPCS,L3760,"EO withjoint, Prefabricated",,,559.36,559.36,1
HCPCS,L3761,"Eo, adj lock joint prefab ot",,,559.36,559.36,1
HCPCS,L3762,Eo rigid w/o joints pre ots,,,120.25,120.25,1
HCPCS,L3763,EWHO rigid w/o jnts CF,,,836.99,836.99,1
HCPCS,L3763,Hc Splint Ewho Rigid Wo Jnts Custom,2243.36,1458.18,,,0
HCPCS,L3764,EWHO w/joint(s) CF,,,875.94,875.94,1
HCPCS,L3765,EWHFO rigid w/o jnts CF,,,1434.15,1434.15,1
HCPCS,L3765,Hc Splint Ewhfo Rigid W/O Jnts Cust0M,3839.62,2495.75,,,0
HCPCS,L3766,EWHFO w/joint(s) CF,,,1518.68,1518.68,1
HCPCS,L3766,Hc Splint Ewhfo W/Joints Custom,4276.83,2779.94,,,0
HCPCS,L3806,Hc Splint Dynamic Whfo Custom,1371.0,891.15,,,0
HCPCS,L3806,WHFO w/joint(s) custom fab,,,508.03,508.03,1
HCPCS,L3807,Hc Splint Whfo Prefab With Modification W/Adj,748.47,486.51,,,0
HCPCS,L3807,Whfo w/o joints pre cst,,,279.67,279.67,1
HCPCS,L3808,Hc Splint Whfo Rigid Wo Jnts Custom,1065.88,692.82,,,0
HCPCS,L3808,"WHFO, rigid w/o joints",,,398.43,398.43,1
HCPCS,L3809,Hc Splint Whfo Prefab Wo Modification Ots,45.24,29.41,,,0
HCPCS,L3809,Whfo w/o joints pre ots,,,279.67,279.67,1
HCPCS,L3900,Hinge extension/flex wrist/f,,,1811.85,1811.85,1
HCPCS,L3901,Hinge ext/flex wrist finger,,,2374.53,2374.53,1
HCPCS,L3904,Whfo electric custom fitted,,,3775.23,3775.23,1
HCPCS,L3905,Hc Splint Dynamic Hand Wrist Custom,2971.36,1931.38,,,0
HCPCS,L3905,Who w/nontorsion jnt(s) cf,,,1109.16,1109.16,1
HCPCS,L3906,Hc Splint Wrist Hand Custom Custom,1518.44,986.99,,,0
HCPCS,L3906,Who w/o joints cf,,,566.79,566.79,1
HCPCS,L3908,Hc Splint Hand Wrist Prefab Ots,22.85,14.85,,,0
HCPCS,L3908,Who cock-up nonmolde pre ots,,,82.0,82.0,1
HCPCS,L3912,Hfo flexion glove pre ots,,,117.84,117.84,1
HCPCS,L3913,HFO w/o joints CF,,,302.9,302.9,1
HCPCS,L3913,Hc Splint Hand Finger Custom,809.9,526.44,,,0
HCPCS,L3915,Hc Who Nontorsion Jnts W/Adj,1094.55,711.46,,,0
HCPCS,L3915,Who nontorsion jnts pre cst,,,594.54,594.54,1
HCPCS,L3916,Who nontorsion jnts pre ots,,,594.54,594.54,1
HCPCS,L3917,Metacarp fx orthosis pre cst,,,118.11,118.11,1
HCPCS,L3918,Metacarp fx orthosis pre ots,,,118.11,118.11,1
HCPCS,L3919,HO w/o joints CF,,,302.9,302.9,1
HCPCS,L3919,Hc Splint Ho W/O Joints Custom,809.9,526.44,,,0
HCPCS,L3921,HFO w/joint(s) CF,,,359.28,359.28,1
HCPCS,L3921,Hc Splint Dyn Hand Finger Custom,1009.57,656.22,,,0
HCPCS,L3923,Hc Hand Finger W/O Joints W/Adj,200.68,130.44,,,0
HCPCS,L3923,Hfo without joints pre cst,,,108.04,108.04,1
HCPCS,L3924,Hfo without joints pre ots,,,108.04,108.04,1
HCPCS,L3925,Fo pip dip jnt/sprng pre ots,,,73.47,73.47,1
HCPCS,L3925,Hc Splint Finger Pip Dip Spring Pf Ots,46.08,29.95,,,0
HCPCS,L3927,Fo pip dip no jt spr pre ots,,,39.15,39.15,1
HCPCS,L3927,Hc Splint Finger Pip Dip Stat Rng Pf Ots,20.48,13.31,,,0
HCPCS,L3929,Hfo nontorsion jnts pre cst,,,102.16,102.16,1
HCPCS,L3930,Hfo nontorsion jnts pre ots,,,102.16,102.16,1
HCPCS,L3931,WHFO nontorsion joint prefab,,,233.2,233.2,1
HCPCS,L3933,FO w/o joints CF,,,238.64,238.64,1
HCPCS,L3933,Hc Splint Finger Pip Dip Custom,638.91,415.29,,,0
HCPCS,L3935,FO nontorsion joint CF,,,247.07,247.07,1
HCPCS,L3935,Hc Splint Fo Nontor Joint Custom,662.46,430.6,,,0
HCPCS,L3960,Sewho airplan desig abdu pos,,,892.05,892.05,1
HCPCS,L3961,Sewho cap design w/o jnts cf,,,1879.17,1879.17,1
HCPCS,L3962,Sewho erbs palsey design abd,,,806.8,806.8,1
HCPCS,L3967,Sewho airplane w/o jnts cf,,,2218.63,2218.63,1
HCPCS,L3971,Sewho cap design w/jnt(s) cf,,,2106.0,2106.0,1
HCPCS,L3973,Sewho airplane w/jnt(s) cf,,,2218.63,2218.63,1
HCPCS,L3975,Sewhfo cap design w/o jnt cf,,,1879.17,1879.17,1
HCPCS,L3976,Sewhfo airplane w/o jnts cf,,,1879.17,1879.17,1
HCPCS,L3977,Sewhfo cap desgn w/jnt(s) cf,,,2106.0,2106.0,1
HCPCS,L3978,Sewhfo airplane w/jnt(s) cf,,,2218.63,2218.63,1
HCPCS,L3980,Hc Brace Fracture Humeral Pf W/Adj No Ots,1219.46,792.65,,,0
HCPCS,L3980,Hc L3980 Humeral Fx Brace W/Adj No Ots,1219.46,792.65,,,0
HCPCS,L3980,Up ext fx orthos humeral nos,,,432.69,432.69,1
HCPCS,L3981,Ue fx orth shoul cap forearm,,,1125.8,1125.8,1
HCPCS,L3982,Upper ext fx orthosis rad/ul,,,439.35,439.35,1
HCPCS,L3984,Upper ext fx orthosis wrist,,,387.03,387.03,1
HCPCS,L3995,Hc L3995 Upper Extremity Fx Sock,124.92,81.2,,,0
HCPCS,L3995,Sock fracture or equal each,,,45.92,45.92,1
HCPCS,L4000,Repl girdle milwaukee orth,,,1623.97,1623.97,1
HCPCS,L4010,Replace trilateral socket br,,,987.07,987.07,1
HCPCS,L4020,Replace quadlat socket brim,,,1185.74,1185.74,1
HCPCS,L4030,Replace socket brim cust fit,,,753.5,753.5,1
HCPCS,L4040,Replace molded thigh lacer,,,510.29,510.29,1
HCPCS,L4045,Replace non-molded thigh lac,,,376.94,376.94,1
HCPCS,L4050,Replace molded calf lacer,,,505.37,505.37,1
HCPCS,L4055,Replace non-molded calf lace,,,307.2,307.2,1
HCPCS,L4060,Replace high roll cuff,,,399.32,399.32,1
HCPCS,L4070,Replace prox & dist upright,,,323.39,323.39,1
HCPCS,L4080,Repl met band kafo-afo prox,,,122.09,122.09,1
HCPCS,L4090,Repl met band kafo-afo calf/,,,103.88,103.88,1
HCPCS,L4100,Repl leath cuff kafo prox th,,,124.81,124.81,1
HCPCS,L4110,Repl leath cuff kafo-afo cal,,,97.45,97.45,1
HCPCS,L4130,Replace pretibial shell,,,589.05,589.05,1
HCPCS,L4205,Hc Repair Ortho Device Labor,196.59,127.78,,,0
HCPCS,L4205,Ortho dvc repair per 15 min,,,29.92,29.92,1
HCPCS,L4350,Ankle control ortho pre ots,,,118.9,118.9,1
HCPCS,L4350,Hc Brace Ankle Stirrup Gel Or Air Ots,41.24,26.81,,,0
HCPCS,L4350,Hc Brace Ankle Stirrup Universal Ots,41.98,27.29,,,0
HCPCS,L4360,Hc Walking Boot Pneum Fit To Pt W/Adj,852.91,554.39,,,0
HCPCS,L4360,Pneumat walking boot pre cst,,,318.18,318.18,1
HCPCS,L4361,Hc Walk Boot Prefab Off The Shelf Ots,134.13,87.18,,,0
HCPCS,L4361,Hc Walking Boot Pneum Prefab Ots,131.55,85.51,,,0
HCPCS,L4361,Pneuma/vac walk boot pre ots,,,318.18,318.18,1
HCPCS,L4370,Pneum full leg splnt pre ots,,,289.25,289.25,1
HCPCS,L4386,Hc Walking Boot Non-Pneum Fit To Pt W/Adj,524.24,340.76,,,0
HCPCS,L4386,Non-pneum walk boot pre cst,,,194.86,194.86,1
HCPCS,L4387,Non-pneum walk boot pre ots,,,194.86,194.86,1
HCPCS,L4392,Replace AFO soft interface,,,28.91,28.91,1
HCPCS,L4394,Replace foot drop spint,,,21.09,21.09,1
HCPCS,L4396,Hc Multi Podus Boot W/Adj,550.86,358.06,,,0
HCPCS,L4396,Static or dynami afo pre cst,,,206.23,206.23,1
HCPCS,L4397,Hc Afo Prefab Ots,65.53,42.59,,,0
HCPCS,L4397,Static or dynami afo pre ots,,,206.23,206.23,1
HCPCS,L4398,Foot drop splint pre ots,,,94.92,94.92,1
HCPCS,L4631,"Afo, walk boot type, cus fab",,,1811.67,1811.67,1
HCPCS,L5000,Sho insert w arch toe filler,,,705.71,705.71,1
HCPCS,L5010,Mold socket ank hgt w/ toe f,,,1971.82,1971.82,1
HCPCS,L5020,Tibial tubercle hgt w/ toe f,,,3089.2,3089.2,1
HCPCS,L5050,Ank symes mold sckt sach ft,,,3374.0,3374.0,1
HCPCS,L5060,Symes met fr leath socket ar,,,4159.16,4159.16,1
HCPCS,L5100,Molded socket shin sach foot,,,3359.56,3359.56,1
HCPCS,L5105,Plast socket jts/thgh lacer,,,4741.07,4741.07,1
HCPCS,L5150,Mold sckt ext knee shin sach,,,5270.94,5270.94,1
HCPCS,L5160,Mold socket bent knee shin s,,,5787.25,5787.25,1
HCPCS,L5200,Kne sing axis fric shin sach,,,4476.02,4476.02,1
HCPCS,L5210,No knee/ankle joints w/ ft b,,,3553.95,3553.95,1
HCPCS,L5220,No knee joint with artic ali,,,3914.91,3914.91,1
HCPCS,L5230,Fem focal defic constant fri,,,5871.76,5871.76,1
HCPCS,L5250,Hip canad sing axi cons fric,,,6884.81,6884.81,1
HCPCS,L5270,Tilt table locking hip sing,,,7671.01,7671.01,1
HCPCS,L5280,Hemipelvect canad sing axis,,,7456.53,7456.53,1
HCPCS,L5301,Bk mold socket sach ft endo,,,3299.01,3299.01,1
HCPCS,L5312,"Knee disart, SACH ft, endo",,,5197.83,5197.83,1
HCPCS,L5321,Ak open end sach,,,4399.13,4399.13,1
HCPCS,L5331,Hip disart canadian sach ft,,,6443.12,6443.12,1
HCPCS,L5341,Hemipelvectomy canadian sach,,,6848.94,6848.94,1
HCPCS,L5400,Postop dress & 1 cast chg bk,,,1964.57,1964.57,1
HCPCS,L5410,Postop dsg bk ea add cast ch,,,542.75,542.75,1
HCPCS,L5420,Postop dsg & 1 cast chg ak/d,,,2481.17,2481.17,1
HCPCS,L5430,Postop dsg ak ea add cast ch,,,673.51,673.51,1
HCPCS,L5450,Postop app non-wgt bear dsg,,,582.35,582.35,1
HCPCS,L5460,Postop app non-wgt bear dsg,,,763.82,763.82,1
HCPCS,L5500,Init bk ptb plaster direct,,,1815.83,1815.83,1
HCPCS,L5505,Init ak ischal plstr direct,,,2554.38,2554.38,1
HCPCS,L5510,Prep BK ptb plaster molded,,,2168.42,2168.42,1
HCPCS,L5520,Perp BK ptb thermopls direct,,,1943.72,1943.72,1
HCPCS,L5530,Prep BK ptb thermopls molded,,,2555.15,2555.15,1
HCPCS,L5535,Prep BK ptb open end socket,,,2381.94,2381.94,1
HCPCS,L5540,Prep BK ptb laminated socket,,,2522.82,2522.82,1
HCPCS,L5560,Prep AK ischial plast molded,,,2874.62,2874.62,1
HCPCS,L5570,Prep AK ischial direct form,,,2789.92,2789.92,1
HCPCS,L5580,Prep AK ischial thermo mold,,,3462.71,3462.71,1
HCPCS,L5585,Prep AK ischial open end,,,4055.09,4055.09,1
HCPCS,L5590,Prep AK ischial laminated,,,3610.21,3610.21,1
HCPCS,L5595,Hip disartic sach thermopls,,,5641.82,5641.82,1
HCPCS,L5600,Hip disart sach laminat mold,,,6421.23,6421.23,1
HCPCS,L5610,Above knee hydracadence,,,3096.92,3096.92,1
HCPCS,L5611,Ak 4 bar link w/fric swing,,,1972.47,1972.47,1
HCPCS,L5613,Ak 4 bar ling w/hydraul swig,,,3000.26,3000.26,1
HCPCS,L5614,4-bar link above knee w/swng,,,2077.88,2077.88,1
HCPCS,L5615,Ak 4 bar link hydl swg/stanc,,,6927.99,6927.99,1
HCPCS,L5616,Ak univ multiplex sys frict,,,1809.06,1809.06,1
HCPCS,L5617,AK/BK self-aligning unit ea,,,688.96,688.96,1
HCPCS,L5618,Test socket symes,,,411.43,411.43,1
HCPCS,L5620,Test socket below knee,,,365.04,365.04,1
HCPCS,L5622,Test socket knee disarticula,,,491.79,491.79,1
HCPCS,L5624,Test socket above knee,,,491.61,491.61,1
HCPCS,L5626,Test socket hip disarticulat,,,778.27,778.27,1
HCPCS,L5628,Test socket hemipelvectomy,,,788.11,788.11,1
HCPCS,L5629,Below knee acrylic socket,,,389.06,389.06,1
HCPCS,L5630,Syme typ expandabl wall sckt,,,676.01,676.01,1
HCPCS,L5631,Ak/knee disartic acrylic soc,,,537.91,537.91,1
HCPCS,L5632,Symes type ptb brim design s,,,331.54,331.54,1
HCPCS,L5634,Symes type poster opening so,,,414.62,414.62,1
HCPCS,L5636,Symes type medial opening so,,,316.91,316.91,1
HCPCS,L5637,Below knee total contact,,,471.56,471.56,1
HCPCS,L5638,Below knee leather socket,,,794.39,794.39,1
HCPCS,L5639,Below knee wood socket,,,1372.6,1372.6,1
HCPCS,L5640,Knee disarticulat leather so,,,902.21,902.21,1
HCPCS,L5642,Above knee leather socket,,,836.32,836.32,1
HCPCS,L5643,Hip flex inner socket ext fr,,,2466.73,2466.73,1
HCPCS,L5644,Above knee wood socket,,,723.09,723.09,1
HCPCS,L5645,Bk flex inner socket ext fra,,,1199.56,1199.56,1
HCPCS,L5646,Below knee cushion socket,,,760.2,760.2,1
HCPCS,L5647,Below knee suction socket,,,973.84,973.84,1
HCPCS,L5648,Above knee cushion socket,,,898.23,898.23,1
HCPCS,L5649,Isch containmt/narrow m-l so,,,3018.14,3018.14,1
HCPCS,L5650,Tot contact ak/knee disart s,,,597.66,597.66,1
HCPCS,L5651,Ak flex inner socket ext fra,,,1751.06,1751.06,1
HCPCS,L5652,Suction susp ak/knee disart,,,533.75,533.75,1
HCPCS,L5653,Knee disart expand wall sock,,,832.81,832.81,1
HCPCS,L5654,Socket insert symes,,,482.77,482.77,1
HCPCS,L5655,Socket insert below knee,,,348.56,348.56,1
HCPCS,L5656,Socket insert knee articulat,,,529.54,529.54,1
HCPCS,L5658,Socket insert above knee,,,558.94,558.94,1
HCPCS,L5661,Multi-durometer symes,,,801.96,801.96,1
HCPCS,L5665,Multi-durometer below knee,,,712.97,712.97,1
HCPCS,L5666,Below knee cuff suspension,,,94.4,94.4,1
HCPCS,L5668,Bk molded distal cushion,,,140.62,140.62,1
HCPCS,L5670,Bk molded supracondylar susp,,,332.2,332.2,1
HCPCS,L5671,Bk/ak locking mechanism,,,608.96,608.96,1
HCPCS,L5672,Bk removable medial brim sus,,,439.6,439.6,1
HCPCS,L5673,Socket insert w lock mech,,,967.82,967.82,1
HCPCS,L5676,Bk knee joints single axis p,,,443.63,443.63,1
HCPCS,L5677,Bk knee joints polycentric p,,,679.42,679.42,1
HCPCS,L5678,Bk joint covers pair,,,48.61,48.61,1
HCPCS,L5679,Socket insert w/o lock mech,,,806.49,806.49,1
HCPCS,L5680,Bk thigh lacer non-molded,,,372.63,372.63,1
HCPCS,L5681,Intl custm cong/latyp insert,,,1619.74,1619.74,1
HCPCS,L5682,Bk thigh lacer glut/ischia m,,,765.63,765.63,1
HCPCS,L5683,Initial custom socket insert,,,1619.74,1619.74,1
HCPCS,L5684,Bk fork strap,,,58.93,58.93,1
HCPCS,L5685,Below knee sus/seal sleeve,,,157.74,157.74,1
HCPCS,L5686,Bk back check,,,70.87,70.87,1
HCPCS,L5688,Bk waist belt webbing,,,75.28,75.28,1
HCPCS,L5690,Bk waist belt padded and lin,,,153.65,153.65,1
HCPCS,L5692,Ak pelvic control belt light,,,162.67,162.67,1
HCPCS,L5694,Ak pelvic control belt pad/l,,,222.1,222.1,1
HCPCS,L5695,Ak sleeve susp neoprene/equa,,,199.65,199.65,1
HCPCS,L5696,Ak/knee disartic pelvic join,,,241.17,241.17,1
HCPCS,L5697,Ak/knee disartic pelvic band,,,114.53,114.53,1
HCPCS,L5698,Ak/knee disartic silesian ba,,,146.92,146.92,1
HCPCS,L5699,Shoulder harness,,,251.1,251.1,1
HCPCS,L5700,Replace socket below knee,,,3776.99,3776.99,1
HCPCS,L5701,Replace socket above knee,,,4685.7,4685.7,1
HCPCS,L5702,Replace socket hip,,,5905.61,5905.61,1
HCPCS,L5703,Symes ankle w/o (sach) foot,,,3106.52,3106.52,1
HCPCS,L5704,Custom shape cover bk,,,770.11,770.11,1
HCPCS,L5705,Custom shape cover ak,,,1411.9,1411.9,1
HCPCS,L5706,Custom shape cvr knee disart,,,1377.12,1377.12,1
HCPCS,L5707,Custom shape cvr hip disart,,,1850.21,1850.21,1
HCPCS,L5710,Kne-shin exo sng axi mnl loc,,,440.31,440.31,1
HCPCS,L5711,Knee-shin exo mnl lock ultra,,,738.97,738.97,1
HCPCS,L5712,Knee-shin exo frict swg & st,,,527.52,527.52,1
HCPCS,L5714,Knee-shin exo variable frict,,,536.75,536.75,1
HCPCS,L5716,Knee-shin exo mech stance ph,,,1061.36,1061.36,1
HCPCS,L5718,Knee-shin exo frct swg & sta,,,1134.92,1134.92,1
HCPCS,L5722,Knee-shin pneum swg frct exo,,,1380.15,1380.15,1
HCPCS,L5724,Knee-shin exo fluid swing ph,,,2127.27,2127.27,1
HCPCS,L5726,Knee-shin ext jnts fld swg e,,,2532.6,2532.6,1
HCPCS,L5728,Knee-shin fluid swg & stance,,,2967.93,2967.93,1
HCPCS,L5780,Knee-shin pneum/hydra pneum,,,1634.07,1634.07,1
HCPCS,L5781,Lower limb pros vacuum pump,,,4926.9,4926.9,1
HCPCS,L5782,HD low limb pros vacuum pump,,,5194.06,5194.06,1
HCPCS,L5783,Add low ext mec limb vol sys,,,3150.07,3150.07,1
HCPCS,L5785,Exoskeletal bk ultralt mater,,,636.06,636.06,1
HCPCS,L5790,Exoskeletal ak ultra-light m,,,917.99,917.99,1
HCPCS,L5795,Exoskel hip ultra-light mate,,,1314.46,1314.46,1
HCPCS,L5810,Endoskel knee-shin mnl lock,,,700.33,700.33,1
HCPCS,L5811,Endo knee-shin mnl lck ultra,,,966.47,966.47,1
HCPCS,L5812,Endo knee-shin frct swg & st,,,727.31,727.31,1
HCPCS,L5814,Endo knee-shin hydral swg ph,,,4573.12,4573.12,1
HCPCS,L5816,Endo knee-shin polyc mch sta,,,1041.16,1041.16,1
HCPCS,L5818,Endo knee-shin frct swg & st,,,1175.67,1175.67,1
HCPCS,L5822,Endo knee-shin pneum swg frc,,,2156.75,2156.75,1
HCPCS,L5824,Endo knee-shin fluid swing p,,,2038.76,2038.76,1
HCPCS,L5826,Miniature knee joint,,,3845.42,3845.42,1
HCPCS,L5827,Endo knee shin single axis,,,7159.66,7159.66,1
HCPCS,L5828,Endo knee-shin fluid swg/sta,,,3628.49,3628.49,1
HCPCS,L5830,Endo knee-shin pneum/swg pha,,,2446.57,2446.57,1
HCPCS,L5840,Multi-axial knee/shin system,,,4801.96,4801.96,1
HCPCS,L5841,Addition endoskletl knee-shi,,,2814.38,2814.38,1
HCPCS,L5845,Knee-shin sys stance flexion,,,2207.05,2207.05,1
HCPCS,L5848,Knee-shin sys hydraul stance,,,1324.12,1324.12,1
HCPCS,L5850,Endo ak/hip knee extens assi,,,156.61,156.61,1
HCPCS,L5855,Mech hip extension assist,,,378.09,378.09,1
HCPCS,L5856,Elec knee-shin swing/stance,,,29559.78,29559.78,1
HCPCS,L5857,Elec knee-shin swing only,,,10488.92,10488.92,1
HCPCS,L5858,Stance phase only,,,22885.05,22885.05,1
HCPCS,L5859,Knee-shin pro flex/ext cont,,,17866.14,17866.14,1
HCPCS,L5910,Endo below knee alignable sy,,,443.39,443.39,1
HCPCS,L5920,Endo ak/hip alignable system,,,649.58,649.58,1
HCPCS,L5925,Above knee manual lock,,,411.36,411.36,1
HCPCS,L5926,Endoskel posit rotat unit,,,791.74,791.74,1
HCPCS,L5930,High activity knee frame,,,4144.66,4144.66,1
HCPCS,L5940,Endo bk ultra-light material,,,614.1,614.1,1
HCPCS,L5950,Endo ak ultra-light material,,,952.47,952.47,1
HCPCS,L5960,Endo hip ultra-light materia,,,1424.19,1424.19,1
HCPCS,L5961,"Endo poly hip, pneu/hyd/rot",,,5877.61,5877.61,1
HCPCS,L5962,Below knee flex cover system,,,719.6,719.6,1
HCPCS,L5964,Above knee flex cover system,,,1380.34,1380.34,1
HCPCS,L5966,Hip flexible cover system,,,1778.12,1778.12,1
HCPCS,L5968,Multiaxial ankle w dorsiflex,,,4474.62,4474.62,1
HCPCS,L5970,Foot external keel sach foot,,,267.47,267.47,1
HCPCS,L5971,"SACH foot, replacement",,,267.47,267.47,1
HCPCS,L5972,Flexible keel foot,,,487.23,487.23,1
HCPCS,L5973,Ank-foot sys dors-plant flex,,,21739.52,21739.52,1
HCPCS,L5974,Foot single axis ankle/foot,,,285.29,285.29,1
HCPCS,L5975,Combo ankle/foot prosthesis,,,570.86,570.86,1
HCPCS,L5976,Energy storing foot,,,723.64,723.64,1
HCPCS,L5978,Ft prosth multiaxial ankl/ft,,,383.44,383.44,1
HCPCS,L5979,Multi-axial ankle/ft prosth,,,3070.11,3070.11,1
HCPCS,L5980,Flex foot system,,,4677.59,4677.59,1
HCPCS,L5981,Flex-walk sys low ext prosth,,,4201.6,4201.6,1
HCPCS,L5982,Exoskeletal axial rotation u,,,789.31,789.31,1
HCPCS,L5984,Endoskeletal axial rotation,,,791.74,791.74,1
HCPCS,L5985,Lwr ext dynamic prosth pylon,,,347.73,347.73,1
HCPCS,L5986,Multi-axial rotation unit,,,955.08,955.08,1
HCPCS,L5987,Shank ft w vert load pylon,,,8858.1,8858.1,1
HCPCS,L5988,Vertical shock reducing pylo,,,2459.87,2459.87,1
HCPCS,L5990,User adjustable heel height,,,2233.87,2233.87,1
HCPCS,L5991,Low pros ext osseo connector,,,11755.04,11755.04,1
HCPCS,L6000,Part hand thumb rem,,,2168.87,2168.87,1
HCPCS,L6010,Part hand little/ring,,,2413.59,2413.59,1
HCPCS,L6020,Part hand no fingers,,,2250.28,2250.28,1
HCPCS,L6026,Part hand myo exclu term dev,,,5356.25,5356.25,1
HCPCS,L6050,Wrst MLd sck flx hng tri pad,,,3060.84,3060.84,1
HCPCS,L6055,Wrst mold sock w/exp interfa,,,3904.27,3904.27,1
HCPCS,L6100,Elb mold sock flex hinge pad,,,3097.46,3097.46,1
HCPCS,L6110,Elbow mold sock suspension t,,,3276.91,3276.91,1
HCPCS,L6120,Elbow mold doub splt soc ste,,,3706.2,3706.2,1
HCPCS,L6130,Elbow stump activated lock h,,,3910.12,3910.12,1
HCPCS,L6200,Elbow mold outsid lock hinge,,,4027.88,4027.88,1
HCPCS,L6205,Elbow molded w/ expand inter,,,5556.38,5556.38,1
HCPCS,L6250,Elbow inter loc elbow forarm,,,3962.73,3962.73,1
HCPCS,L6300,Shlder disart int lock elbow,,,5465.7,5465.7,1
HCPCS,L6310,Shoulder passive restor comp,,,4953.47,4953.47,1
HCPCS,L6320,Shoulder passive restor cap,,,2581.59,2581.59,1
HCPCS,L6350,Thoracic intern lock elbow,,,5988.72,5988.72,1
HCPCS,L6360,Thoracic passive restor comp,,,5199.26,5199.26,1
HCPCS,L6370,Thoracic passive restor cap,,,3015.22,3015.22,1
HCPCS,L6380,Postop dsg cast chg wrst/elb,,,1743.91,1743.91,1
HCPCS,L6382,Postop dsg cast chg elb dis/,,,2076.05,2076.05,1
HCPCS,L6384,Postop dsg cast chg shlder/t,,,2626.33,2626.33,1
HCPCS,L6386,Postop ea cast chg & realign,,,575.71,575.71,1
HCPCS,L6388,Postop applicat rigid dsg on,,,633.99,633.99,1
HCPCS,L6400,Below elbow prosth tiss shap,,,3350.67,3350.67,1
HCPCS,L6450,Elb disart prosth tiss shap,,,4379.16,4379.16,1
HCPCS,L6500,Above elbow prosth tiss shap,,,4300.25,4300.25,1
HCPCS,L6550,Shldr disar prosth tiss shap,,,5569.71,5569.71,1
HCPCS,L6570,Scap thorac prosth tiss shap,,,6217.85,6217.85,1
HCPCS,L6580,Wrist/elbow bowden cable mol,,,2486.04,2486.04,1
HCPCS,L6582,Wrist/elbow bowden cbl dir f,,,2087.94,2087.94,1
HCPCS,L6584,Elbow fair lead cable molded,,,3091.67,3091.67,1
HCPCS,L6586,Elbow fair lead cable dir fo,,,2754.87,2754.87,1
HCPCS,L6588,Shdr fair lead cable molded,,,4387.49,4387.49,1
HCPCS,L6590,Shdr fair lead cable direct,,,3823.85,3823.85,1
HCPCS,L6600,Polycentric hinge pair,,,279.3,279.3,1
HCPCS,L6605,Single pivot hinge pair,,,287.48,287.48,1
HCPCS,L6610,Flexible metal hinge pair,,,271.77,271.77,1
HCPCS,L6611,"Additional switch, ext power",,,506.97,506.97,1
HCPCS,L6615,Disconnect locking wrist uni,,,263.8,263.8,1
HCPCS,L6616,Disconnect insert locking wr,,,79.41,79.41,1
HCPCS,L6620,Flexion/extension wrist unit,,,461.17,461.17,1
HCPCS,L6621,Flex/ext wrist w/wo friction,,,2816.5,2816.5,1
HCPCS,L6623,Spring-ass rot wrst w/ latch,,,878.53,878.53,1
HCPCS,L6624,Flex/ext/rotation wrist unit,,,4637.39,4637.39,1
HCPCS,L6625,Rotation wrst w/ cable lock,,,651.11,651.11,1
HCPCS,L6628,Quick disconn hook adapter o,,,700.86,700.86,1
HCPCS,L6629,Lamination collar w/ couplin,,,238.81,238.81,1
HCPCS,L6630,Stainless steel any wrist,,,351.8,351.8,1
HCPCS,L6632,Latex suspension sleeve each,,,79.54,79.54,1
HCPCS,L6635,Lift assist for elbow,,,254.26,254.26,1
HCPCS,L6637,Nudge control elbow lock,,,497.8,497.8,1
HCPCS,L6638,Elec lock on manual pw elbow,,,3079.31,3079.31,1
HCPCS,L6640,Shoulder abduction joint pai,,,414.58,414.58,1
HCPCS,L6641,Excursion amplifier pulley t,,,241.41,241.41,1
HCPCS,L6642,Excursion amplifier lever ty,,,354.94,354.94,1
HCPCS,L6645,Shoulder flexion-abduction j,,,448.35,448.35,1
HCPCS,L6646,Multipo locking shoulder jnt,,,3883.7,3883.7,1
HCPCS,L6647,Shoulder lock actuator,,,639.39,639.39,1
HCPCS,L6648,Ext pwrd shlder lock/unlock,,,4005.49,4005.49,1
HCPCS,L6650,Shoulder universal joint,,,486.29,486.29,1
HCPCS,L6655,Standard control cable extra,,,94.34,94.34,1
HCPCS,L6660,Heavy duty control cable,,,126.24,126.24,1
HCPCS,L6665,Teflon or equal cable lining,,,56.38,56.38,1
HCPCS,L6670,Hook to hand cable adapter,,,58.71,58.71,1
HCPCS,L6672,Harness chest/shlder saddle,,,269.43,269.43,1
HCPCS,L6675,Harness figure of 8 sing con,,,147.02,147.02,1
HCPCS,L6676,Harness figure of 8 dual con,,,153.82,153.82,1
HCPCS,L6677,UE triple control harness,,,365.26,365.26,1
HCPCS,L6680,Test sock wrist disart/bel e,,,378.71,378.71,1
HCPCS,L6682,Test sock elbw disart/above,,,418.71,418.71,1
HCPCS,L6684,Test socket shldr disart/tho,,,568.98,568.98,1
HCPCS,L6686,Suction socket,,,844.29,844.29,1
HCPCS,L6687,Frame typ socket bel elbow/w,,,706.16,706.16,1
HCPCS,L6688,Frame typ sock above elb/dis,,,781.53,781.53,1
HCPCS,L6689,Frame typ socket shoulder di,,,931.44,931.44,1
HCPCS,L6690,Frame typ sock interscap-tho,,,1096.63,1096.63,1
HCPCS,L6691,Removable insert each,,,432.88,432.88,1
HCPCS,L6692,Silicone gel insert or equal,,,787.53,787.53,1
HCPCS,L6693,Lockingelbow forearm cntrbal,,,3495.85,3495.85,1
HCPCS,L6694,Elbow socket ins use w/lock,,,967.82,967.82,1
HCPCS,L6695,Elbow socket ins use w/o lck,,,806.49,806.49,1
HCPCS,L6696,Cus elbo skt in for con/atyp,,,1619.74,1619.74,1
HCPCS,L6697,Cus elbo skt in not con/atyp,,,1619.74,1619.74,1
HCPCS,L6698,Below/above elbow lock mech,,,608.96,608.96,1
HCPCS,L6700,Ue add ext power myoel,,,29510.19,29510.19,1
HCPCS,L6703,"Term dev, passive hand mitt",,,430.7,430.7,1
HCPCS,L6704,"Term dev, sport/rec/work att",,,831.35,831.35,1
HCPCS,L6706,Term dev mech hook vol open,,,515.91,515.91,1
HCPCS,L6707,Term dev mech hook vol close,,,1825.05,1825.05,1
HCPCS,L6708,Term dev mech hand vol open,,,1206.42,1206.42,1
HCPCS,L6709,Term dev mech hand vol close,,,1712.21,1712.21,1
HCPCS,L6711,"Ped term dev, hook, vol open",,,827.85,827.85,1
HCPCS,L6712,"Ped term dev, hook, vol clos",,,1524.28,1524.28,1
HCPCS,L6713,"Ped term dev, hand, vol open",,,1923.74,1923.74,1
HCPCS,L6714,"Ped term dev, hand, vol clos",,,1629.4,1629.4,1
HCPCS,L6715,"Term device, multi art digit",,,3887.6,3887.6,1
HCPCS,L6721,"Hook/hand, hvy dty, vol open",,,2896.15,2896.15,1
HCPCS,L6722,"Hook/hand, hvy dty, vol clos",,,2496.64,2496.64,1
HCPCS,L6805,Term dev modifier wrist unit,,,472.26,472.26,1
HCPCS,L6810,Term dev precision pinch dev,,,251.06,251.06,1
HCPCS,L6880,Elec hand ind art digits,,,29420.21,29420.21,1
HCPCS,L6881,Term dev auto grasp feature,,,5034.12,5034.12,1
HCPCS,L6882,Microprocessor control uplmb,,,3818.61,3818.61,1
HCPCS,L6883,Replc sockt below e/w disa,,,2446.07,2446.07,1
HCPCS,L6884,Replc sockt above elbow disa,,,3346.77,3346.77,1
HCPCS,L6885,Replc sockt shldr dis/interc,,,5199.26,5199.26,1
HCPCS,L6890,Prefab glove for term device,,,245.93,245.93,1
HCPCS,L6895,Custom glove for term device,,,822.33,822.33,1
HCPCS,L6900,Hand restorat thumb/1 finger,,,2387.98,2387.98,1
HCPCS,L6905,Hand restoration multiple fi,,,2363.43,2363.43,1
HCPCS,L6910,Hand restoration no fingers,,,2323.42,2323.42,1
HCPCS,L6915,Hand restoration replacmnt g,,,998.28,998.28,1
HCPCS,L6920,Wrist disarticul switch ctrl,,,10315.01,10315.01,1
HCPCS,L6925,Wrist disart myoelectronic c,,,11019.87,11019.87,1
HCPCS,L6930,Below elbow switch control,,,9934.8,9934.8,1
HCPCS,L6935,Below elbow myoelectronic ct,,,10968.08,10968.08,1
HCPCS,L6940,Elbow disarticulation switch,,,12829.08,12829.08,1
HCPCS,L6945,Elbow disart myoelectronic c,,,14312.5,14312.5,1
HCPCS,L6950,Above elbow switch control,,,12805.28,12805.28,1
HCPCS,L6955,Above elbow myoelectronic ct,,,14850.1,14850.1,1
HCPCS,L6960,Shldr disartic switch contro,,,15621.74,15621.74,1
HCPCS,L6965,Shldr disartic myoelectronic,,,18506.37,18506.37,1
HCPCS,L6970,Interscapular-thor switch ct,,,19809.02,19809.02,1
HCPCS,L6975,Interscap-thor myoelectronic,,,21834.21,21834.21,1
HCPCS,L7007,Adult electric hand,,,4497.55,4497.55,1
HCPCS,L7008,Pediatric electric hand,,,6974.35,6974.35,1
HCPCS,L7009,Adult electric hook,,,4601.53,4601.53,1
HCPCS,L7040,Prehensile actuator,,,3745.35,3745.35,1
HCPCS,L7045,Pediatric electric hook,,,1978.79,1978.79,1
HCPCS,L7170,Electronic elbow hosmer swit,,,7406.87,7406.87,1
HCPCS,L7180,Electronic elbow sequential,,,47919.99,47919.99,1
HCPCS,L7181,Electronic elbo simultaneous,,,49338.18,49338.18,1
HCPCS,L7185,Electron elbow adolescent sw,,,7787.04,7787.04,1
HCPCS,L7186,Electron elbow child switch,,,13091.11,13091.11,1
HCPCS,L7190,Elbow adolescent myoelectron,,,10332.65,10332.65,1
HCPCS,L7191,Elbow child myoelectronic ct,,,13769.77,13769.77,1
HCPCS,L7259,Electronic wrist rotator any,,,5046.41,5046.41,1
HCPCS,L7360,Six volt bat otto bock/eq ea,,,325.76,325.76,1
HCPCS,L7362,Battery chrgr six volt otto,,,355.87,355.87,1
HCPCS,L7364,Twelve volt battery utah/equ,,,629.69,629.69,1
HCPCS,L7366,Battery chrgr 12 volt utah/e,,,865.98,865.98,1
HCPCS,L7367,Replacemnt lithium ionbatter,,,479.42,479.42,1
HCPCS,L7368,Lithium ion battery charger,,,621.46,621.46,1
HCPCS,L7400,"Add ue prost be/wd, ultlite",,,377.39,377.39,1
HCPCS,L7401,Add ue prost a/e ultlite mat,,,422.45,422.45,1
HCPCS,L7402,Add ue prost s/d ultlite mat,,,456.27,456.27,1
HCPCS,L7403,Add UE prost b/e acrylic,,,453.48,453.48,1
HCPCS,L7404,Add UE prost a/e acrylic,,,684.45,684.45,1
HCPCS,L7405,Add UE prost s/d acrylic,,,895.08,895.08,1
HCPCS,L7406,Add to upp extr user adj mec,,,3150.07,3150.07,1
HCPCS,L7520,Repair prosthesis per 15 min,,,40.67,40.67,1
HCPCS,L7700,Pros soc insert gasket/seal,,,184.22,184.22,1
HCPCS,L8000,Mastectomy bra,,,52.13,52.13,1
HCPCS,L8001,Breast prosthesis bra & form,,,154.49,154.49,1
HCPCS,L8002,Brst prsth bra & bilat form,,,203.15,203.15,1
HCPCS,L8015,Ext breastprosthesis garment,,,73.81,73.81,1
HCPCS,L8020,Mastectomy form,,,278.4,278.4,1
HCPCS,L8030,Breast prosthes w/o adhesive,,,430.39,430.39,1
HCPCS,L8031,Breast prosthesis w adhesive,,,430.39,430.39,1
HCPCS,L8032,Reusable nipple prosthesis,,,48.23,48.23,1
HCPCS,L8035,Custom breast prosthesis,,,4511.21,4511.21,1
HCPCS,L8040,Nasal prosthesis,,,3052.75,3052.75,1
HCPCS,L8041,Midfacial prosthesis,,,3679.2,3679.2,1
HCPCS,L8042,Orbital prosthesis,,,4133.93,4133.93,1
HCPCS,L8043,Upper facial prosthesis,,,4630.01,4630.01,1
HCPCS,L8044,Hemi-facial prosthesis,,,5126.08,5126.08,1
HCPCS,L8045,Auricular prosthesis,,,4014.06,4014.06,1
HCPCS,L8046,Partial facial prosthesis,,,3307.18,3307.18,1
HCPCS,L8047,Nasal septal prosthesis,,,1694.92,1694.92,1
HCPCS,L8300,Truss single w/ standard pad,,,103.28,103.28,1
HCPCS,L8310,Truss double w/ standard pad,,,182.95,182.95,1
HCPCS,L8320,Truss addition to std pad wa,,,75.9,75.9,1
HCPCS,L8330,Truss add to std pad scrotal,,,60.44,60.44,1
HCPCS,L8400,Sheath below knee,,,19.27,19.27,1
HCPCS,L8410,Sheath above knee,,,25.36,25.36,1
HCPCS,L8415,Sheath upper limb,,,26.24,26.24,1
HCPCS,L8417,Pros sheath/sock w gel cushn,,,92.62,92.62,1
HCPCS,L8420,Prosthetic sock multi ply BK,,,25.68,25.68,1
HCPCS,L8430,Prosthetic sock multi ply AK,,,29.09,29.09,1
HCPCS,L8435,Pros sock multi ply upper lm,,,27.64,27.64,1
HCPCS,L8440,Shrinker below knee,,,57.4,57.4,1
HCPCS,L8460,Shrinker above knee,,,81.59,81.59,1
HCPCS,L8465,Shrinker upper limb,,,75.41,75.41,1
HCPCS,L8470,Pros sock single ply BK,,,8.17,8.17,1
HCPCS,L8480,Pros sock single ply AK,,,11.27,11.27,1
HCPCS,L8485,Pros sock single ply upper l,,,15.17,15.17,1
HCPCS,L8500,Artificial larynx,,,810.32,810.32,1
HCPCS,L8501,Hc Tube Trach Speaking Passy Muir,225.28,146.43,,,0
HCPCS,L8501,Tracheostomy speaking valve,,,147.88,147.88,1
HCPCS,L8507,Trach-esoph voice pros pt in,,,51.55,51.55,1
HCPCS,L8509,Trach-esoph voice pros md in,,,134.48,134.48,1
HCPCS,L8510,Voice amplifier,,,311.17,311.17,1
HCPCS,L8511,Indwelling trach insert,,,89.55,89.55,1
HCPCS,L8512,Gel cap for trach voice pros,,,2.68,2.68,1
HCPCS,L8513,Trach pros cleaning device,,,6.41,6.41,1
HCPCS,L8514,Repl trach puncture dilator,,,116.13,116.13,1
HCPCS,L8515,Gel cap app device for trach,,,77.74,77.74,1
HCPCS,L8605,Inj bulking agent anal canal,,,2019.65,3433.81,4
HCPCS,L8606,Hc Agent Bulking Synth Urin Tract,3228.52,2098.54,,,0
HCPCS,L8607,Inj vocal cord bulking agent,,,120.97,120.97,2
HCPCS,L8613,Hc Ossicula Implant,1051.95,683.77,,,0
HCPCS,L8614,Hc Cochlear W All Int And Ext Components,43218.38,28091.95,,,0
HCPCS,L8615,Coch implant headset replace,,,555.35,555.35,1
HCPCS,L8616,Coch implant microphone repl,,,129.34,129.34,1
HCPCS,L8617,Coch implant trans coil repl,,,112.98,112.98,1
HCPCS,L8618,Coch implant tran cable repl,,,32.29,32.29,1
HCPCS,L8619,Coch imp ext proc/contr rplc,,,10350.06,10350.06,1
HCPCS,L8621,Repl zinc air battery,,,0.77,0.77,1
HCPCS,L8622,Repl alkaline battery,,,0.4,0.4,1
HCPCS,L8623,"Lith ion batt cid,non-earlvl",,,79.65,79.65,1
HCPCS,L8624,"Lith ion batt cid, ear level",,,198.57,198.57,1
HCPCS,L8625,Charger coch impl/aoi battry,,,232.57,232.57,1
HCPCS,L8627,CID ext speech process repl,,,8784.91,8784.91,1
HCPCS,L8628,CID ext controller repl,,,1565.13,1565.13,1
HCPCS,L8629,CID transmit coil and cable,,,220.48,220.48,1
HCPCS,L8681,Pt prgrm for implt neurostim,,,1404.38,1404.38,1
HCPCS,L8683,Radiofq trsmtr for implt neu,,,6635.61,6635.61,1
HCPCS,L8684,Radiof trsmtr implt scrl neu,,,1041.21,1041.21,1
HCPCS,L8689,External recharg sys intern,,,2124.03,2124.03,1
HCPCS,L8690,Hc Aud Osseointegrated Device W All Int And Ext Comps,21598.56,14039.06,,,0
HCPCS,L8691,Osseointegrated snd proc rpl,,,2120.58,2120.58,1
HCPCS,L8693,"Aud osseo dev, abutment",,,1867.13,1867.13,1
HCPCS,L8694,Aoi transducer/actuator repl,,,1162.87,1162.87,1
HCPCS,L8695,External recharg sys extern,,,20.53,20.53,1
HCPCS,L8696,Ext antenna phren nerve stim,,,266.86,266.86,1
HCPCS,L8699,Hc Ide G120169 Pro 1136831 Evolutr Corevalve,33000.0,21450.0,,,0
HCPCS,L8699,Hc Ide G140059 Pro1148561 Evolut R,33000.0,21450.0,,,0
HCPCS,L8699,Hc Ide G140090 Pro11499986 Repriseiii,25000.0,16250.0,,,0
HCPCS,L8699,Hc Ide G160020 Apollo Percutaneous Valve System,45000.0,29250.0,,,0
HCPCS,L8699,Hc Ide G160022 Low Risk Bicuspid Tavr System,33000.0,21450.0,,,0
HCPCS,L8699,"Hc Ide G160022 Pro 1165258 Evolut R 23,26,29Mm",33000.0,21450.0,,,0
HCPCS,L8699,Hc Ide G160039 Pro 1165489 Tavr 2.0,33000.0,21450.0,,,0
HCPCS,L8699,Hc Ide G160055 Pro02768402 Transcath Mitral Valve Repl,1.0,0.65,,,0
HCPCS,L8699,Hc Ide G160259 Early Tavr Sapien 3 Valve System,30000.0,19500.0,,,0
HCPCS,L8699,Hc Ide G180045 Exceed Edwards Centera Heart Valve,32500.0,21125.0,,,0
HCPCS,L8699,Hc Ide G180106 Foldax Polymer Aortic Valve,1.0,0.65,,,0
HCPCS,L8699,Hc Ide G190051 Accurate Ide Neo2 Aortic Valve System,28000.0,18200.0,,,0
HCPCS,L8699,Hc Ide G200119 Ttvr Efs Intrepid Trnscth Tricuspid Valve Rplcmt,1.0,0.65,,,0
HCPCS,L8699,Hc Ide G210083 Innovalve Twist Efs - Valve,1.0,0.65,,,0
HCPCS,L8699,Hc Ide G230146 Envision - Navitor Valve,26877.38,17470.3,,,0
HCPCS,L8699,Hc Ide#  G190051 - Acurate Ide Prime Xl Aortic Valve,1.0,0.65,,,0
HCPCS,L8699,Hc Ide#  G190051 - Acurate Ide Prime Xl Aortic Valve - Initial,28000.0,18200.0,,,0
HCPCS,L8699,Hc Pipeline Embolization L8699,40780.13,26507.08,,,0
HCPCS,L8699,Hc Prosthetic Implant,42512.9,27633.38,,,0
HCPCS,L8701,Pow ue rom dev ewh uprt cust,,,34970.13,34970.13,1
HCPCS,L8702,Pow ue rom dev ewhf uprt cus,,,68801.71,68801.71,1
HCPCS,M0220,Hc Covid-19 Mab Evusheld Im Injections (Tixagev And Cilgav),450.0,292.5,,,0
HCPCS,M0222,Hc Covid-19 Bebtelovimab Iv Injection,1050.0,682.5,,,0
HCPCS,M0239,Hc Covid-19 Antibody (Bamlanivimab) Infusion Service,930.0,604.5,,,0
HCPCS,M0243,Hc Covid-19 Antibody Casirivimab/Imdevimab (Regn-Cov2) Infusn Or Sq Inj,930.0,604.5,,,0
HCPCS,M0245,Hc Covid-19 Antibody Bamlanivimab & Entesevimab Infusion,930.0,604.5,,,0
HCPCS,M0247,Hc Covid-19 Antibody Sotrovimab Infusion,930.0,604.5,,,0
HCPCS,M0249,Hc Admin Tocilizumab 1St Dose,1350.0,877.5,,,0
HCPCS,M0250,Hc Admin Tocilizumab 2Nd Dose,1350.0,877.5,,,0
HCPCS,M1073,Hc Rad Therapy Anal Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1075,Hc Rad Therapy Bladder Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1077,Hc Rad Ther Bone Metastases Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1079,Hc Rad Ther Brain Metastases Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1081,Hc Rad Therapy Breast Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1083,Hc Rad Ther Cervical Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1085,Hc Rad Therapy Cns Tumors Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1087,Hc Rad Ther Colorectal Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1089,Hc Rad Ther Head And Neck Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1095,Hc Rad Therapy Lung Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1097,Hc Rad Therapy Lymphoma Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1099,Hc Rad Ther Pancreatic Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1101,Hc Rad Therapy Prostate Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1103,Hc Rad Therapy Gi Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1105,Hc Rad Therapy Uterine Cancer Ro Model 90 Day Episode,1.0,0.65,,,0
HCPCS,M1145,Hc Mfn Add On,349.44,227.14,,,0
HCPCS,P2028,Cephalin floculation test,,,4.95,18.56,3
HCPCS,P2029,Congo red blood test,,,4.95,18.56,3
HCPCS,P2031,Hair analysis,,,18.56,18.56,2
HCPCS,P2033,Blood thymol turbidity,,,4.95,18.56,3
HCPCS,P2038,Blood mucoprotein,,,4.95,18.56,3
HCPCS,P3000,Screen pap by tech w md supv,,,18.54,64.91,3
HCPCS,P3001,Screening pap smear by phys,,,86.4,86.4,2
HCPCS,P7001,Culture bacterial urine,,,68.63,68.63,2
HCPCS,P9010,Hc Whole Blood 1 Unit,2503.0,1626.95,,,0
HCPCS,P9012,Hc Cryoprecipitate 1 Unit,364.0,236.6,,,0
HCPCS,P9016,Hc Red Cells Leuko Reduced 1 Unit,982.0,638.3,,,0
HCPCS,P9017,Hc Fresh Frozen Plasma 1 Unit,219.0,142.35,,,0
HCPCS,P9017,Hc Fresh Frozen Plasma 1 Unit <8Hrs Covid19 Research,85.0,55.25,,,0
HCPCS,P9021,Hc Autologous Blood Product 1 Unit,1818.0,1181.7,,,0
HCPCS,P9021,Hc Red Cells Packed 1 Unit,1030.0,669.5,,,0
HCPCS,P9022,Hc Red Cells Washed 1 Unit,2074.0,1348.1,,,0
HCPCS,P9022,Washed red blood cells unit,,,368.58,368.58,1
HCPCS,P9023,"Frozen plasma, pooled, sd",,,1.99,55.96,3
HCPCS,P9025,"Hc Plasma, Cryoprecipitate Reduced, Pathogen Reduced, Each Unit",136.0,88.4,,,0
HCPCS,P9026,"Hc Cryoprecipitated Fibrinogen Complex, Pathogen Reduced, Each Unit",314.0,204.1,,,0
HCPCS,P9031,Hc Platelets Leuko Reduced 1 Unit,4428.0,2878.2,,,0
HCPCS,P9031,Hc Platelets Leuko Reduced Directed 1 Unit,507.0,329.55,,,0
HCPCS,P9033,Hc Platelets Leuko Reduced Irradiated 1 Unit,425.0,276.25,,,0
HCPCS,P9035,Hc Platelets Pheresis Leukocyte Reduced 1 Unit,3063.0,1990.95,,,0
HCPCS,P9037,Hc Platelets Pheresis L R Irradiated 1 Unit,3291.0,2139.15,,,0
HCPCS,P9037,Plate pheres leukoredu irrad,,,680.61,680.61,1
HCPCS,P9040,Hc Red Cells Leuko Reduced Irradiated 1 Unit,1210.0,786.5,,,0
HCPCS,P9040,RBC leukoreduced irradiated,,,265.41,265.41,1
HCPCS,P9041,"Albumin (human),5%, 50ml",,,10.62,28.78,6
HCPCS,P9043,"Plasma protein fract,5%,50ml",,,8.11,52.7,3
HCPCS,P9045,"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION (IO)",246.3,160.1,,,0
HCPCS,P9045,"Albumin (human), 5%, 250 ml",,,53.08,143.85,6
HCPCS,P9045,INV ALBUMIN HUMAN 5% INTRAVENOUS SOLUTION,0.65,0.42,,,0
HCPCS,P9045,Noncdm Charge Record Pharmacy,187.61,121.95,,,0
HCPCS,P9046,"Albumin (human), 25%, 20 ml",,,21.23,57.53,6
HCPCS,P9047,"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",239.15,155.45,,,0
HCPCS,P9047,"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION (IO)",183.2,119.08,,,0
HCPCS,P9047,"Albumin (human), 25%, 50ml",,,53.08,143.85,6
HCPCS,P9047,Noncdm Charge Record Pharmacy,172.04,111.83,,,0
HCPCS,P9048,"Plasmaprotein fract,5%,250ml",,,35.32,123.76,3
HCPCS,P9050,"Hc Granulocytes, Pheresis, Each Unit",12918.0,8396.7,,,0
HCPCS,P9052,"Hc Platelets, Hla-Matched Leukocyte Reduced, Apheresis/Pheresis, Each Unit",2962.0,1925.3,,,0
HCPCS,P9054,Hc Red Cells Frozen Deglycerol Lr Washed 1 Unit,2711.0,1762.15,,,0
HCPCS,P9073,"Hc Platelets, Pheresis, Pathogen-Reduced, Each Unit",3382.0,2198.3,,,0
HCPCS,P9073,"Platelets, pathogen reduced",,,607.43,607.43,1
HCPCS,P9100,Hc Pathogen Test For Platelets,277.0,180.05,,,0
HCPCS,P9100,Pathogen test for platelets,,,56.88,215.55,3
HCPCS,P9612,Catheterize for urine spec,,,9.34,32.14,3
HCPCS,P9612,Hc Insert Catheter Spec Collect Only,420.0,273.0,,,0
HCPCS,P9615,Urine specimen collect mult,,,32.14,32.14,2
HCPCS,Q0035,Cardiokymography,,,36.01,36.01,1
HCPCS,Q0091,Obtaining screen pap smear,,,27.89,93.6,3
HCPCS,Q0111,Wet mounts/ w preparations,,,18.54,64.91,3
HCPCS,Q0112,Potassium hydroxide preps,,,5.83,21.86,3
HCPCS,Q0113,Pinworm examinations,,,4.27,16.01,3
HCPCS,Q0114,Fern test,,,9.74,36.53,3
HCPCS,Q0115,Post-coital mucous exam,,,25.0,93.75,3
HCPCS,Q0138,"Ferumoxytol, non-esrd",,,0.32,1.03,6
HCPCS,Q0138,Noncdm Charge Record Pharmacy,2.93,1.9,,,0
HCPCS,Q0139,"Ferumoxytol, esrd use",,,0.32,1.03,6
HCPCS,Q0144,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,12.85,8.35,,,0
HCPCS,Q0144,"Azithromycin dihydrate, oral",,,34.2,57.8,4
HCPCS,Q0144,Noncdm Charge Record Pharmacy,75.52,49.09,,,0
HCPCS,Q0155,Dronabinol (syndros) 0.1 mg,,,7.58,10.54,4
HCPCS,Q0161,Chlorpromazine hcl 5mg oral,,,0.82,0.82,2
HCPCS,Q0162,Ondansetron oral,,,0.02,0.03,5
HCPCS,Q0163,Diphenhydramine HCl 50mg,,,0.05,3.52,4
HCPCS,Q0164,Prochlorperazine maleate 5mg,,,0.82,2.14,4
HCPCS,Q0166,Granisetron HCl 1 mg oral,,,7.02,139.84,4
HCPCS,Q0167,Dronabinol 2.5mg oral,,,3.14,5.01,5
HCPCS,Q0169,Promethazine HCl 12.5mg oral,,,0.19,0.76,4
HCPCS,Q0173,Trimethobenzamide HCl 250mg,,,1.76,1.76,2
HCPCS,Q0174,Thiethylperazine maleate10mg,,,1.76,1.76,2
HCPCS,Q0175,Perphenazine 4mg oral,,,1.1,1.76,4
HCPCS,Q0177,Hydroxyzine pamoate 25mg,,,0.23,5.26,4
HCPCS,Q0180,Dolasetron mesylate oral,,,141.15,389.62,4
HCPCS,Q0220,"Tixagev and cilgav, 300mg",,,0.02,0.03,4
HCPCS,Q0221,"Tixagev and cilgav, 600mg",,,0.02,0.03,4
HCPCS,Q0222,Bebtelovimab 175 mg,,,5601.96,6829.2,4
HCPCS,Q0224,"Inj, pemivibart, 4500 mg",,,11191.95,17841.29,5
HCPCS,Q0240,Casirivi and imdevi 600 mg,,,0.02,0.03,4
HCPCS,Q0243,Casirivimab and imdevimab,,,0.02,0.03,4
HCPCS,Q0244,Casirivi and imdevi 1200 mg,,,0.02,0.03,4
HCPCS,Q0245,Bamlanivimab and etesevima,,,0.02,0.03,4
HCPCS,Q0247,Sotrovimab,,,5601.96,6829.2,4
HCPCS,Q0249,Noncdm Charge Record Pharmacy,28.0,18.2,,,0
HCPCS,Q0249,Tocilizumab for covid-19,,,12.87,20.51,5
HCPCS,Q0477,Pwr module pt cable lvad rpl,,,955.35,955.35,1
HCPCS,Q0478,Hc Power Module Dc Input Cable,925.61,601.65,,,0
HCPCS,Q0478,"Power adapter, combo vad",,,226.28,226.28,1
HCPCS,Q0479,Hc Power Module,25458.25,16547.86,,,0
HCPCS,Q0479,"Power module combo vad, rep",,,14780.89,14780.89,1
HCPCS,Q0480,"driver pneumatic vad, rep",,,110901.76,110901.76,1
HCPCS,Q0481,Hc Heartmate Ii System Controller Epc,16609.71,10796.31,,,0
HCPCS,Q0481,Hc Hm3 Lvad Controller W Ebb,17635.91,11463.34,,,0
HCPCS,Q0481,Hc Hmii Pocket Controller,17502.55,11376.66,,,0
HCPCS,Q0481,"microprcsr cu elec vad, rep",,,17892.75,17892.75,1
HCPCS,Q0482,"microprcsr cu combo vad, rep",,,5604.34,5604.34,1
HCPCS,Q0483,"monitor elec vad, rep",,,23087.32,23087.32,1
HCPCS,Q0484,monitor elec or comb vad rep,,,4483.48,4483.48,1
HCPCS,Q0485,"monitor cable elec vad, rep",,,432.9,432.9,1
HCPCS,Q0486,Hc Display Module To Power Module,1311.62,852.55,,,0
HCPCS,Q0486,mon cable elec/pneum vad rep,,,360.28,360.28,1
HCPCS,Q0487,"leads any type vad, rep only",,,420.31,420.31,1
HCPCS,Q0489,"pwr pck base combo vad, rep",,,20015.46,20015.46,1
HCPCS,Q0490,"emr pwr source elec vad, rep",,,865.78,865.78,1
HCPCS,Q0491,emr pwr source combo vad rep,,,1361.1,1361.1,1
HCPCS,Q0492,"emr pwr cbl elec vad, rep",,,109.67,109.67,1
HCPCS,Q0493,"emr pwr cbl combo vad, rep",,,312.22,312.22,1
HCPCS,Q0494,"emr hd pmp elec/combo, rep",,,264.19,264.19,1
HCPCS,Q0495,Hc Battery Charger,22912.83,14893.34,,,0
HCPCS,Q0495,"charger elec/combo vad, rep",,,5143.47,5143.47,1
HCPCS,Q0496,Hc 12 Volt Sla Battery Each,238.57,155.07,,,0
HCPCS,Q0496,"battery elec/combo vad, rep",,,1846.09,1846.09,1
HCPCS,Q0497,Hc 14 Volt Li-Lon Battery Clip Each,1749.85,1137.4,,,0
HCPCS,Q0497,"bat clps elec/comb vad, rep",,,576.44,576.44,1
HCPCS,Q0498,Hc Battery Holster,815.02,529.76,,,0
HCPCS,Q0498,Hc Holster Vest Small,1257.35,817.28,,,0
HCPCS,Q0498,Hc Hw Waist Pack,1615.71,1050.21,,,0
HCPCS,Q0498,"holster elec/combo vad, rep",,,632.48,632.48,1
HCPCS,Q0499,Hc Pocket Controler Consolidated Bag,1271.17,826.26,,,0
HCPCS,Q0499,belt/vest elec/combo vad rep,,,205.51,205.51,1
HCPCS,Q0500,"filters elec/combo vad, rep",,,37.58,37.58,1
HCPCS,Q0501,Hc Pocket Controller Shower Bag Each,872.36,567.03,,,0
HCPCS,Q0501,"shwr cov elec/combo vad, rep",,,628.84,628.84,1
HCPCS,Q0502,"mobility cart pneum vad, rep",,,800.65,800.65,1
HCPCS,Q0503,battery pneum vad replacemnt,,,1601.2,1601.2,1
HCPCS,Q0504,"pwr adpt pneum vad, rep veh",,,844.96,844.96,1
HCPCS,Q0506,Hc 14 Volt Li-Lon Battery Each,1989.44,1293.14,,,0
HCPCS,Q0506,Hc Hmii Volt Li-Lon Backup Battery,1620.75,1053.49,,,0
HCPCS,Q0506,Lith-ion batt elec/pneum VAD,,,1051.71,1051.71,1
HCPCS,Q0508,Hc Hm3 Lvad Modular Cable,15752.7,10239.26,,,0
HCPCS,Q0508,Hc Pocket Controller Wear Access Kit,540.62,351.4,,,0
HCPCS,Q0508,Hc Power Module Ac Cord,139.25,90.51,,,0
HCPCS,Q0508,Hc Power Module Cable,5139.98,3340.99,,,0
HCPCS,Q0508,Hc Stabilization Belts,411.61,267.55,,,0
HCPCS,Q0515,Sermorelin acetate injection,,,0.02,3.5,4
HCPCS,Q2004,Bladder calculi irrig sol,,,37.7,231.0,4
HCPCS,Q2004,CITRIC AC 1980.6 MG-GLUCONO 59.4 MG-MAG CARB 980.4 MG/30 ML IRRIG.SOLN,82.15,53.4,,,0
HCPCS,Q2004,Noncdm Charge Record Pharmacy,84.92,55.2,,,0
HCPCS,Q2009,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,40.0,26.0,,,0
HCPCS,Q2009,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,111.4,72.41,,,0
HCPCS,Q2009,Fosphenytoin inj pe,,,1.47,22.63,5
HCPCS,Q2009,Noncdm Charge Record Pharmacy,11.16,7.25,,,0
HCPCS,Q2017,"Teniposide, 50 mg",,,5840.52,8116.83,4
HCPCS,Q2026,Radiesse injection,,,349.19,903.57,3
HCPCS,Q2028,"Inj, sculptra, 0.5mg",,,0.02,2.71,5
HCPCS,Q2035,"Afluria vacc, 3 yrs & >, im",,,0.02,67.15,4
HCPCS,Q2036,"Flulaval vacc, 3 yrs & >, im",,,0.02,0.02,2
HCPCS,Q2037,"Fluvirin vacc, 3 yrs & >, im",,,0.02,32.44,4
HCPCS,Q2038,"Fluzone vacc, 3 yrs & >, im",,,0.02,134.47,4
HCPCS,Q2041,AXICABTAGENE CILOLEUCEL INTRAVENOUS SUSPENSION,1935862.05,1258310.33,,,0
HCPCS,Q2041,Axicabtagene ciloleucel car+,,,0.02,1326591.48,6
HCPCS,Q2042,TISAGENLECLEUCEL 0.2 X10EXP6 TO 2.5X10EXP8 CELL INTRAVENOUS SUSPENSION,2486986.75,1616541.39,,,0
HCPCS,Q2042,TISAGENLECLEUCEL 0.6 X 10EXP8 TO 6 X10EXP8 CELL INTRAVENOUS SUSPENSION,2048685.85,1331645.8,,,0
HCPCS,Q2042,Tisagenlecleucel car-pos t,,,0.02,1532840.61,6
HCPCS,Q2043,Sipuleucel-t auto cd54+,,,55272.32,150503.92,6
HCPCS,Q2049,Imported Lipodox inj,,,0.02,1433.21,5
HCPCS,Q2050,"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",1816.95,1181.02,,,0
HCPCS,Q2050,Doxorubicin inj 10mg,,,108.47,368.7,6
HCPCS,Q2050,Noncdm Charge Record Pharmacy,649.68,422.29,,,0
HCPCS,Q2053,BREXUCABTAGENE AUTOLEUCEL 1X 10EXP6 TO 1X 10EXP8 CELL IV SUSPENSION,1935862.05,1258310.33,,,0
HCPCS,Q2053,Brexucabtagene car pos t,,,0.02,1322619.59,6
HCPCS,Q2054,LISOCABTAGENE MARALEUCEL 1.5 X 10EXP6 TO 70 X 10EXP6 CELL/ML IV SUSP,2043869.5,1328515.18,,,0
HCPCS,Q2054,LISOCABTAGENE MARALEUCEL(CD4) 1.5X TO 70X 10EXP6 CELL/ML IV SUSP(2OF2),2042612.5,1327698.12,,,0
HCPCS,Q2054,LISOCABTAGENE MARALEUCEL(CD8) 1.5X TO 70X 10EXP6 CELL/ML IV SUSP(1OF2),2042612.5,1327698.12,,,0
HCPCS,Q2054,Lisocabtagene mara car pos t,,,0.02,1399676.98,6
HCPCS,Q2055,IDECABTAGENE VICLEUCEL 300 X 10EXP6 TO 510 X 10EXP6 CELL IV SUSPENSION,2088411.4,1357467.41,,,0
HCPCS,Q2055,Idecabtagene vicleucel car,,,0.02,1431726.69,6
HCPCS,Q2056,CILTACABTAGENE AUTOLEUCEL 0.5 X 10EXP6 TO 1X 10EXP8 CELL IV SUSPENSION,2187494.6,1421871.49,,,0
HCPCS,Q2056,Ciltacabtagene car-pos t,,,0.02,1494072.7,6
HCPCS,Q3001,Brachytherapy radioelements,,,162.17,162.17,2
HCPCS,Q3014,Hc Telehealth Originating Site,151.0,98.15,,,0
HCPCS,Q3027,Inj beta interferon im 1 mcg,,,94.55,150.73,5
HCPCS,Q3028,Inj beta interferon sq 1 mcg,,,93.65,126.99,4
HCPCS,Q4074,Iloprost non-comp unit dose,,,252.0,401.73,5
HCPCS,Q4081,"Epoetin alfa, 100 units ESRD",,,1.1,1.76,5
HCPCS,Q4081,Noncdm Charge Record Pharmacy,7.135,4.635,,,0
HCPCS,Q4100,Hc Amniotic Membrane For Surg Recon Per Procedure,1585.95,1030.87,,,0
HCPCS,Q4100,Hc Skin Substitute Not Otherwise Specified,26.48,17.21,,,0
HCPCS,Q4101,Apligraf,,,51.81,119.99,4
HCPCS,Q4101,Hc Apligraf Per Sq Cm,95.03,61.77,,,0
HCPCS,Q4102,Oasis wound matrix,,,20.52,119.99,4
HCPCS,Q4103,Oasis burn matrix,,,21.22,119.99,4
HCPCS,Q4104,Hc Bilayer Matrix Wound Drsg Per Sq Cm,97.59,63.43,,,0
HCPCS,Q4104,Integra bmwd,,,89.07,142.0,4
HCPCS,Q4105,Hc Dermal Regeneration Template Per Sq Cm,231.69,150.6,,,0
HCPCS,Q4105,Integra drt or omnigraft,,,51.47,119.99,4
HCPCS,Q4106,Dermagraft,,,138.05,138.05,2
HCPCS,Q4107,Graftjacket,,,119.99,369.83,3
HCPCS,Q4107,Hc Graft Jacket Per Sq Cm,426.39,277.15,,,0
HCPCS,Q4108,Hc Integra Matrix Per Sq Cm,260.81,169.53,,,0
HCPCS,Q4108,Integra matrix,,,76.23,121.52,4
HCPCS,Q4110,Primatrix,,,111.19,177.26,4
HCPCS,Q4111,Gammagraft,,,12.45,119.99,4
HCPCS,Q4111,Hc Gammagraft Skin Substitute Per Sq Cm,29.88,19.42,,,0
HCPCS,Q4113,Graftjacket xpress,,,5413.23,5413.23,2
HCPCS,Q4114,Integra flowable wound matri,,,2721.03,4337.65,3
HCPCS,Q4115,Alloskin,,,25.76,119.99,4
HCPCS,Q4116,Hc Alloderm Per Sq Cm,128.05,83.23,,,0
HCPCS,Q4117,Hyalomatrix,,,81.11,119.99,3
HCPCS,Q4118,Hc Matristem Micromatrix Per Mg,7.77,5.05,,,0
HCPCS,Q4118,Matristem micromatrix,,,4.32,6.88,3
HCPCS,Q4121,Hc Theraskin 116 Sq Cm Per Sq Cm,95.22,61.89,,,0
HCPCS,Q4121,Hc Theraskin 13 Sq Cm Per Sq Cm,223.21,145.09,,,0
HCPCS,Q4121,Hc Theraskin 26 Sq Cm Per Sq Cm,158.7,103.16,,,0
HCPCS,Q4121,Hc Theraskin 39 Sq Cm Per Sq Cm,109.56,71.21,,,0
HCPCS,Q4121,Hc Theraskin 6 Sq Cm Per Sq Cm,537.55,349.41,,,0
HCPCS,Q4121,Theraskin,,,82.37,131.3,4
HCPCS,Q4122,Dermacell,,,119.99,327.99,3
HCPCS,Q4123,Alloskin,,,119.99,216.2,3
HCPCS,Q4124,Oasis tri-layer wound matrix,,,17.37,119.99,4
HCPCS,Q4125,Hc Arthroflex Per Sq Cm,1118.06,726.74,,,0
HCPCS,Q4126,Hc Dermaspan Per Sq Cm,340.07,221.05,,,0
HCPCS,Q4126,Memoderm/derma/tranz/integup,,,101.22,161.35,4
HCPCS,Q4127,Talymed,,,116.43,185.61,4
HCPCS,Q4128,Flexhd/allopatchhd/matrixhd,,,52.01,119.99,4
HCPCS,Q4128,Hc Flex Hd Per Sq Cm,94.34,61.32,,,0
HCPCS,Q4130,Hc Strattice Per Sq Cm,105.27,68.43,,,0
HCPCS,Q4132,Grafix core,,,119.99,370.86,4
HCPCS,Q4132,Hc Grafix Core 1.5 X 2 Cm Per Sq Cm,913.32,593.66,,,0
HCPCS,Q4132,Hc Grafix Core 16Mm Per Sq Cm,1013.66,658.88,,,0
HCPCS,Q4132,Hc Grafix Core 2 X 3 Per Sq Cm,572.36,372.03,,,0
HCPCS,Q4132,Hc Grafix Core 3 X 4 Per Sq Cm,351.2,228.28,,,0
HCPCS,Q4132,Hc Grafix Core 5 X 5 Per Sq Cm,358.36,232.93,,,0
HCPCS,Q4133,Grafix prime,,,119.99,376.01,4
HCPCS,Q4133,Hc Grafix Or Stravix Prime Per Sq Cm,990.1,643.56,,,0
HCPCS,Q4133,Hc Grafix Prime 1.5 X 2 Cm Per Sq Cm,913.32,593.66,,,0
HCPCS,Q4133,Hc Grafix Prime 16Mm Per Sq Cm,991.39,644.4,,,0
HCPCS,Q4133,Hc Grafix Prime 2 X 3 Per Sq Cm,560.76,364.49,,,0
HCPCS,Q4133,Hc Grafix Prime 3 X 4 Per Sq Cm,340.96,221.62,,,0
HCPCS,Q4133,Hc Grafix Prime 5 X 5 Per Sq Cm,358.36,232.93,,,0
HCPCS,Q4133,Hc Grafixpl Prime 1.5 X 2 Per Sq Cm,913.32,593.66,,,0
HCPCS,Q4133,Hc Grafixpl Prime 16Mm Per Sq Cm,991.39,644.4,,,0
HCPCS,Q4133,Hc Grafixpl Prime 2 X 3 Per Sq Cm,566.56,368.26,,,0
HCPCS,Q4133,Hc Grafixpl Prime 3 X 3 Per Sq Cm,433.11,281.52,,,0
HCPCS,Q4133,Hc Grafixpl Prime 3 X 4 Per Sq Cm,351.2,228.28,,,0
HCPCS,Q4133,Hc Grafixpl Prime 5 X 5 Per Sq Cm,358.36,232.93,,,0
HCPCS,Q4137,"Amnioexcel or biodexcel, 1cm",,,119.99,316.2,4
HCPCS,Q4138,"Biodfence dryflex, 1cm",,,119.99,253.57,4
HCPCS,Q4140,Biodfence 1cm,,,119.99,465.61,4
HCPCS,Q4141,"Alloskin ac, 1 cm",,,64.57,119.99,4
HCPCS,Q4147,Architect ecm px fx 1 sq cm,,,119.99,4271.72,3
HCPCS,Q4148,"Hc Neox Or Clarix Cord, Per Sq Cm",349.32,227.06,,,0
HCPCS,Q4148,"Neox 1k, 1cm",,,119.99,345.55,4
HCPCS,Q4149,"Excellagen, 0.1 cc",,,471.54,471.54,2
HCPCS,Q4150,Allowrap ds or dry 1 sq cm,,,119.99,234.96,4
HCPCS,Q4150,Hc Allowrap Ds Or Dry Per Sq Cm,852.74,554.28,,,0
HCPCS,Q4151,"Amnioband, guardian 1 sq cm",,,119.99,388.67,4
HCPCS,Q4152,Dermapure 1 square cm,,,88.49,141.06,4
HCPCS,Q4152,Hc Dermapure Per Sq Cm,7525.66,4891.68,,,0
HCPCS,Q4153,"Dermavest, plurivest sq cm",,,119.99,630.64,4
HCPCS,Q4154,Biovance 1 square cm,,,119.99,391.22,4
HCPCS,Q4155,Neoxflo or clarixflo 1 mg,,,48.83,77.83,3
HCPCS,Q4156,Neox 100 1 square cm,,,108.88,173.58,4
HCPCS,Q4157,Revitalon 1 square cm,,,119.99,549.86,3
HCPCS,Q4158,Hc Graft 1.75X1.75 Cm Fish-Skin Omega3 Wound Per Sq Cm,565.63,367.66,,,0
HCPCS,Q4158,Hc Graft 16Mm Disc Fish-Skin Omega3 Wound Per Sq Cm,812.42,528.07,,,0
HCPCS,Q4158,Hc Graft 19 Sq Cm Fish-Skin Omega3 Wound Per Sq Cm,169.97,110.48,,,0
HCPCS,Q4158,Hc Graft 3X3.5 Cm Fish-Skin Omega3 Wound Per Sq Cm,204.78,133.11,,,0
HCPCS,Q4158,Hc Graft 3X7 Cm Fish-Skin Omega3 Wound Per Sq Cm,182.25,118.46,,,0
HCPCS,Q4158,Hc Graft 5X7 Cm Fish-Skin Omega3 Wound Per Sq Cm,134.13,87.18,,,0
HCPCS,Q4158,Hc Graft 7X7 Cm Fish-Skin Omega3 Wound Per Sq Cm,115.7,75.2,,,0
HCPCS,Q4158,Hc Graft 8 Sq Cm Fish-Skin Omega3 Wound Per Sq Cm,240.62,156.4,,,0
HCPCS,Q4158,Hc Graft Fish-Skin Omega3 Wound Per Sq Cm,120.35,78.23,,,0
HCPCS,Q4158,Marigen 1 square cm,,,119.99,204.5,4
HCPCS,Q4159,Affinity1 square cm,,,119.99,713.68,4
HCPCS,Q4159,Hc Affinity 2.25Cm Per Sq Cm,543.69,353.4,,,0
HCPCS,Q4159,Hc Affinity 6.25 Cm Pr Sq Cm,1075.1,698.82,,,0
HCPCS,Q4160,Hc Nushield 1.6 Sq Cm Disc Per Sq Cm,809.9,526.44,,,0
HCPCS,Q4160,Hc Nushield 2X3 Per Sq Cm,431.83,280.69,,,0
HCPCS,Q4160,Hc Nushield 2X4 Per Sq Cm,386.27,251.08,,,0
HCPCS,Q4160,Hc Nushield 3X4 Per Sq Cm,371.68,241.59,,,0
HCPCS,Q4160,Hc Nushield 4X4 Per Sq Cm,381.91,248.24,,,0
HCPCS,Q4160,Hc Nushield 4X6 Per Sq Cm,355.29,230.94,,,0
HCPCS,Q4160,Hc Nushield 6X6 Per Sq Cm,323.55,210.31,,,0
HCPCS,Q4160,Nushield 1 square cm,,,119.99,254.55,4
HCPCS,Q4161,Bio-connekt per square cm,,,119.99,7891.71,3
HCPCS,Q4162,Amnio bio and woundex flow,,,6955.68,6955.68,2
HCPCS,Q4163,Amnio bio and woundex sq cm,,,119.99,493.71,4
HCPCS,Q4164,"Helicoll, per square cm",,,119.99,4092.32,3
HCPCS,Q4165,"Keramatrix, per square cm",,,119.99,120.89,3
HCPCS,Q4166,"Cytal, per square centimeter",,,34.95,119.99,4
HCPCS,Q4166,Hc Cytal Per Sq Cm,105.27,68.43,,,0
HCPCS,Q4167,"Truskin, per sq centimeter",,,119.99,327.96,3
HCPCS,Q4169,"Artacent wound, per sq cm",,,119.99,9308.47,3
HCPCS,Q4170,"Cygnus, per sq cm",,,119.99,2084.34,3
HCPCS,Q4171,"Interfyl, 1 mg",,,20.25,32.28,3
HCPCS,Q4173,Palingen or palingen xplus,,,119.99,3088.15,3
HCPCS,Q4174,Palingen or promatrx,,,3906.47,3906.47,2
HCPCS,Q4175,Miroderm,,,117.37,187.1,4
HCPCS,Q4176,"Neopatch, per sq centimeter",,,119.99,481.3,3
HCPCS,Q4177,"Floweramnioflo, 0.1 cc",,,487.8,487.8,2
HCPCS,Q4177,Hc Floweramnioflo,9055.37,5885.99,,,0
HCPCS,Q4178,"Floweramniopatch, per sq cm",,,119.99,236.26,4
HCPCS,Q4178,Hc Allograft 10Mm Disc Floweraminopatch,1902.41,1236.57,,,0
HCPCS,Q4178,Hc Allograft 12Mm Disc Floweraminopatch,2046.78,1330.41,,,0
HCPCS,Q4178,Hc Allograft 16Mm Disc Floweraminopatch,2029.37,1319.09,,,0
HCPCS,Q4178,Hc Allograft 2 X 2Cm Floweramniopatch Per Sq Cm,614.34,399.32,,,0
HCPCS,Q4178,Hc Allograft 2 X 3Cm Floweramniopatch Per Sq Cm,408.54,265.55,,,0
HCPCS,Q4178,Hc Allograft 4 X 4Cm Floweramniopatch Per Sq Cm,245.74,159.73,,,0
HCPCS,Q4178,Hc Floweramniopatch Amniotic Membrane,412.68,268.24,,,0
HCPCS,Q4180,"Revita, per sq cm",,,119.99,4520.82,3
HCPCS,Q4181,"Amnio wound, per square cm",,,119.99,441.84,3
HCPCS,Q4183,"Surgigraft, 1 sq cm",,,119.99,436.09,3
HCPCS,Q4184,"Cellesta, 1 sq cm",,,119.99,1691.96,4
HCPCS,Q4186,Epifix 1 sq cm,,,119.99,429.07,4
HCPCS,Q4186,Hc Epifix 1.4 Per Sq Cm Disk,733.11,476.52,,,0
HCPCS,Q4186,Hc Epifix 2X2 Per Sq Cm,872.36,567.03,,,0
HCPCS,Q4186,Hc Epifix 2X3 Per Sq Cm,625.6,406.64,,,0
HCPCS,Q4186,Hc Epifix 2X4 Per Sq Cm,552.91,359.39,,,0
HCPCS,Q4186,Hc Epifix 3X4 Per Sq Cm,650.18,422.62,,,0
HCPCS,Q4186,Hc Epifix 4X4 Per Sq Cm,625.6,406.64,,,0
HCPCS,Q4186,Hc Epifix 4X4.5 Mesh Per Sq Cm,252.9,164.38,,,0
HCPCS,Q4187,Epicord 1 sq cm,,,119.99,657.8,4
HCPCS,Q4188,Amnioarmor 1 sq cm,,,119.99,939.39,4
HCPCS,Q4190,Artacent ac 1 sq cm,,,119.99,638.72,4
HCPCS,Q4191,Restorigin 1 sq cm,,,119.99,2754.2,4
HCPCS,Q4193,Coll-e-derm 1 sq cm,,,119.99,6344.14,3
HCPCS,Q4194,Novachor 1 sq cm,,,119.99,2327.67,4
HCPCS,Q4195,Puraply 1 sq cm,,,119.99,278.56,4
HCPCS,Q4196,Hc Puraply Antimicrobial 1.6Cm Disc Per Sq Cm,915.62,595.15,,,0
HCPCS,Q4196,Hc Puraply Antimicrobial 2X2/Sq Cm,606.55,394.26,,,0
HCPCS,Q4196,Hc Puraply Antimicrobial 2X4/Sq Cm,388.57,252.57,,,0
HCPCS,Q4196,Hc Puraply Antimicrobial 3X4/Sq Cm,337.89,219.63,,,0
HCPCS,Q4196,Hc Puraply Antimicrobial 4X4/Sq Cm,348.13,226.28,,,0
HCPCS,Q4196,Hc Puraply Antimicrobial 5X5/Sq Cm,360.41,234.27,,,0
HCPCS,Q4196,Hc Puraply Antimicrobial 6X9/Sq Cm,360.41,234.27,,,0
HCPCS,Q4196,Hc Puraply Antimicrobial Per Sq Cm,281.58,183.03,,,0
HCPCS,Q4196,Puraply am 1 sq cm,,,119.99,286.42,4
HCPCS,Q4197,Puraply xt 1 sq cm,,,119.99,196.85,4
HCPCS,Q4199,"Cygnus matrix, per sq cm",,,119.99,985.87,4
HCPCS,Q4201,Matrion 1 sq cm,,,119.99,230.43,4
HCPCS,Q4203,"Derma-gide, 1 sq cm",,,119.99,813.49,4
HCPCS,Q4204,Xwrap 1 sq cm,,,119.99,9271.91,3
HCPCS,Q4205,Membrane graft or wrap sq cm,,,119.99,3142.54,4
HCPCS,Q4213,"Ascent, 0.5 mg",,,186.94,186.94,2
HCPCS,Q4217,Woundfix biowound plus xplus,,,119.99,1005.03,4
HCPCS,Q4219,Surgigraft dual per sq cm,,,119.99,2138.16,3
HCPCS,Q4221,Amniowrap2 per sq cm,,,119.99,5205.21,3
HCPCS,Q4222,"Progenamatrix, per sq cm",,,119.99,316.96,4
HCPCS,Q4225,"Amniobind, per sq cm",,,119.99,3955.38,4
HCPCS,Q4227,Amniocore per sq cm,,,119.99,3407.61,3
HCPCS,Q4229,Cogenex amnio memb per sq cm,,,119.99,1411.99,4
HCPCS,Q4231,"Corplex p, per cc",,,1722.29,2745.53,3
HCPCS,Q4232,"Corplex, per sq cm",,,119.99,718.53,4
HCPCS,Q4234,"Xcellerate, per sq cm",,,119.99,691.43,4
HCPCS,Q4235,Amniorepair or altiply sq cm,,,119.99,257.86,4
HCPCS,Q4236,Carepatch per sq cm,,,119.99,1662.86,4
HCPCS,Q4237,"cryo-cord, per sq cm",,,119.99,1353.43,3
HCPCS,Q4238,"Derm-maxx, per sq cm",,,119.99,4222.15,4
HCPCS,Q4239,Amnio-maxx or lite per sq cm,,,119.99,6844.67,3
HCPCS,Q4246,"Coretext or protext, per cc",,,8726.2,8726.2,2
HCPCS,Q4247,"Amniotext patch, per sq cm",,,119.99,6170.97,3
HCPCS,Q4248,Dermacyte Amn mem allo sq cm,,,119.99,7309.85,3
HCPCS,Q4249,"Amniply, per sq cm",,,119.99,7322.85,3
HCPCS,Q4250,AmnioAMP-MP per sq cm,,,119.99,7738.08,3
HCPCS,Q4251,"Vim, per square centimeter",,,119.99,487.8,3
HCPCS,Q4252,"Vendaje, per square centimet",,,119.99,208.59,4
HCPCS,Q4253,Zenith amniotic membrane psc,,,119.99,323.66,4
HCPCS,Q4256,"Mlg complet, per sq cm",,,119.99,2636.37,4
HCPCS,Q4257,"Relese, per sq cm",,,119.99,1321.72,4
HCPCS,Q4258,"Enverse, per sq cm",,,119.99,198.97,4
HCPCS,Q4259,Celera per sq cm,,,119.99,3470.81,4
HCPCS,Q4261,"Tag, per square centimeter",,,119.99,1962.64,3
HCPCS,Q4262,"Dual layer impax, per sq cm",,,119.99,819.83,4
HCPCS,Q4263,"Surgraft tl, per sq cm",,,119.99,2481.47,3
HCPCS,Q4264,"Cocoon membrane, per sq cm",,,119.99,8780.02,3
HCPCS,Q4265,Neostim tl per sq cm,,,119.99,5730.84,4
HCPCS,Q4266,Neostim per sq cm,,,119.99,2408.97,4
HCPCS,Q4267,Neostim dl per sq cm,,,119.99,1006.25,4
HCPCS,Q4268,Surgraft ft per sq cm,,,119.99,3561.54,3
HCPCS,Q4269,Surgraft xt per sq cm,,,119.99,2441.87,3
HCPCS,Q4271,Complete ft per sq cm,,,119.99,4177.76,4
HCPCS,Q4272,"Esano a, per sq cm",,,119.99,948.77,3
HCPCS,Q4274,"Esano ac, per sq cm",,,119.99,5776.28,3
HCPCS,Q4275,"Esano aca, per sq cm",,,119.99,6971.8,3
HCPCS,Q4276,"Orion, per sq cm",,,119.99,1311.07,4
HCPCS,Q4278,"Epieffect, per sq cm",,,119.99,829.45,4
HCPCS,Q4279,"Vendaje ac, per sq cm",,,119.99,6463.35,4
HCPCS,Q4280,Xcell amnio matrix per sq cm,,,119.99,5583.68,4
HCPCS,Q4281,Barrera slor dl per sq cm,,,119.99,2406.78,4
HCPCS,Q4282,Cygnus dual per sq cm,,,119.99,1319.17,4
HCPCS,Q4283,"Biovance tri or 3l, sq cm",,,119.99,1789.63,4
HCPCS,Q4285,Nudyn dl or dl mesh pr sq cm,,,119.99,521.0,3
HCPCS,Q4286,"Nudyn sl or slw, per sq cm",,,119.99,686.71,3
HCPCS,Q4289,"Revoshield+ amnio, per sq cm",,,119.99,5039.25,4
HCPCS,Q4290,Membrane wrap hydr per sq cm,,,119.99,6014.63,3
HCPCS,Q4291,"Lamellas xt, per sq cm",,,119.99,9449.66,3
HCPCS,Q4292,"Lamellas, per sq cm",,,119.99,3985.76,3
HCPCS,Q4293,"Acesso dl, per sq cm",,,119.99,4048.2,3
HCPCS,Q4294,"Amnio quad-core, per sq cm",,,119.99,8131.79,3
HCPCS,Q4295,"Amnio tri-core, per sq cm",,,119.99,7155.97,3
HCPCS,Q4296,"Rebound matrix, per sq cm",,,119.99,7323.29,3
HCPCS,Q4297,"Emerge matrix, per sq cm",,,119.99,4845.91,4
HCPCS,Q4298,"Amnicore pro, per sq cm",,,119.99,5887.23,4
HCPCS,Q4300,"Acesso tl, per sq cm",,,119.99,5730.84,4
HCPCS,Q4301,"Activate matrix, per sq cm",,,119.99,5243.66,4
HCPCS,Q4302,"Complete aca, per sq cm",,,119.99,5443.58,4
HCPCS,Q4303,"Complete aa, per sq cm",,,119.99,9248.66,4
HCPCS,Q4304,"Grafix plus, per sq cm",,,119.99,2493.17,4
HCPCS,Q4309,"Via matrix, per sq cm",,,119.99,5693.85,3
HCPCS,Q4310,"Procenta, per 100 mg",,,3663.46,5840.0,3
HCPCS,Q4313,"Dermabind fm, per sq cm",,,119.99,9393.92,3
HCPCS,Q4319,"Sanograft, per sq cm",,,119.99,2035.59,3
HCPCS,Q4320,"Pellograft, per sq cm",,,119.99,2440.06,3
HCPCS,Q4322,"Caregraft, per sq cm",,,119.99,6397.5,3
HCPCS,Q4323,"Alloply, per sq cm",,,119.99,5312.79,3
HCPCS,Q4324,"Amniotx, per sq cm",,,119.99,5256.37,3
HCPCS,Q4325,"Acapatch, per sq cm",,,119.99,7671.09,3
HCPCS,Q4326,"Woundplus, per sq cm",,,119.99,5090.55,3
HCPCS,Q4328,"Most, per sq cm",,,119.99,9469.07,3
HCPCS,Q4331,"Axolotl graft, per sq cm",,,119.99,5504.69,3
HCPCS,Q4332,"Axolotl dualgraft, per sq cm",,,119.99,5506.58,3
HCPCS,Q4333,"Ardeograft, per sq cm",,,119.99,2320.9,3
HCPCS,Q4339,"Artacent vericlen, per sq cm",,,119.99,7706.97,3
HCPCS,Q4341,"Simplimax, per sq cm",,,119.99,9567.9,3
HCPCS,Q4342,"Theramend, per sq cm",,,119.99,11486.69,3
HCPCS,Q4343,Dermacyte ac matrx per sq cm,,,119.99,7550.9,3
HCPCS,Q4344,"Tri membrane wrap, per sq cm",,,119.99,8290.43,3
HCPCS,Q4346,Shelter dm matrix per sq cm,,,119.99,11391.78,3
HCPCS,Q4348,Sentry sl matrix per sq cm,,,119.99,6346.85,3
HCPCS,Q4349,Mantle dl matrix per sq cm,,,119.99,11391.78,3
HCPCS,Q4350,Palisade dm matrix per sq cm,,,119.99,11391.78,3
HCPCS,Q4351,"Enclose tl matrix, per sq cm",,,119.99,12205.49,3
HCPCS,Q4352,"Overlay sl matrix, per sq cm",,,119.99,6346.85,3
HCPCS,Q4353,Xceed tl matrix per sq cm,,,119.99,9616.27,3
HCPCS,Q4801,Noncdm Charge Record Pharmacy,10.14,6.59,,,0
HCPCS,Q5101,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,1370.8,891.02,,,0
HCPCS,Q5101,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,1370.8,891.02,,,0
HCPCS,Q5101,Inj filgrastim gcsf biosimil,,,0.46,0.98,6
HCPCS,Q5101,Noncdm Charge Record Pharmacy,3.54,2.3,,,0
HCPCS,Q5103,INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,2875.8,1869.27,,,0
HCPCS,Q5103,"Injection, inflectra",,,19.64,31.3,6
HCPCS,Q5103,Noncdm Charge Record Pharmacy,280.82,182.53,,,0
HCPCS,Q5104,INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,1592.65,1035.22,,,0
HCPCS,Q5104,"Injection, renflexis",,,27.0,71.16,6
HCPCS,Q5104,Noncdm Charge Record Pharmacy,152.83,99.34,,,0
HCPCS,Q5105,Inj Retacrit esrd on dialysi,,,1.27,2.03,5
HCPCS,Q5105,Noncdm Charge Record Pharmacy,5.115,3.325,,,0
HCPCS,Q5106,"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",491.15,319.25,,,0
HCPCS,Q5106,"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",124.6,80.99,,,0
HCPCS,Q5106,"EPOETIN ALFA-EPBX 20,000 UNIT/ML INJECTION SOLUTION",949.4,617.11,,,0
HCPCS,Q5106,"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",170.4,110.76,,,0
HCPCS,Q5106,"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",216.2,140.53,,,0
HCPCS,Q5106,"EPOETIN ALFA-EPBX 40,000 UNIT/ML INJECTION SOLUTION",1865.9,1212.84,,,0
HCPCS,Q5106,Inj Retacrit non-esrd use,,,7.85,20.24,6
HCPCS,Q5106,Noncdm Charge Record Pharmacy,45.0,29.25,,,0
HCPCS,Q5107,BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLUTION,2854.0,1855.1,,,0
HCPCS,Q5107,Inj mvasi 10 mg,,,27.86,77.86,6
HCPCS,Q5107,Noncdm Charge Record Pharmacy,274.94,178.71,,,0
HCPCS,Q5108,"Injection, fulphila",,,99.13,339.56,6
HCPCS,Q5108,Noncdm Charge Record Pharmacy,604.53,392.94,,,0
HCPCS,Q5108,PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,6859.6,4458.74,,,0
HCPCS,Q5110,FILGRASTIM-AAFI 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,457.25,297.21,,,0
HCPCS,Q5110,FILGRASTIM-AAFI 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,457.2,297.18,,,0
HCPCS,Q5110,Nivestym,,,0.3,0.79,6
HCPCS,Q5110,Noncdm Charge Record Pharmacy,1.54,1.0,,,0
HCPCS,Q5111,"Injection, udenyca 0.5 mg",,,106.33,367.34,6
HCPCS,Q5111,Noncdm Charge Record Pharmacy,1074.87,698.67,,,0
HCPCS,Q5111,PEGFILGRASTIM-CBQV 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUT INJECTOR,16607.15,10794.65,,,0
HCPCS,Q5111,PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,8810.1,5726.56,,,0
HCPCS,Q5112,Inj ontruzant 10 mg,,,19.0,71.46,6
HCPCS,Q5112,Noncdm Charge Record Pharmacy,162.89,105.88,,,0
HCPCS,Q5113,INV TRASTUZUMAB-PKRB 21 MG/ML INJECTION,0.65,0.42,,,0
HCPCS,Q5113,Inj herzuma 10 mg,,,69.37,195.07,6
HCPCS,Q5113,Noncdm Charge Record Pharmacy,396.44,257.69,,,0
HCPCS,Q5114,Inj  ogivri 10 mg,,,40.29,140.49,6
HCPCS,Q5114,TRASTUZUMAB-DKST 420 MG INTRAVENOUS SOLUTION,8207.5,5334.88,,,0
HCPCS,Q5115,INV RITUXIMAB-ABBS 10MG/ML SOLUTION FOR INJECTION,0.65,0.42,,,0
HCPCS,Q5115,Inj truxima 10 mg,,,29.38,86.26,6
HCPCS,Q5115,Noncdm Charge Record Pharmacy,257.31,167.25,,,0
HCPCS,Q5115,RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,12421.85,8074.2,,,0
HCPCS,Q5116,"Inj., trazimera, 10 mg",,,27.99,51.41,6
HCPCS,Q5117,"Inj., kanjinti, 10 mg",,,47.55,94.01,6
HCPCS,Q5117,Noncdm Charge Record Pharmacy,377.34,245.27,,,0
HCPCS,Q5117,TRASTUZUMAB-ANNS 150 MG INTRAVENOUS SOLUTION,5485.35,3565.48,,,0
HCPCS,Q5118,BEVACIZUMAB-BVZR 25 MG/ML INTRAVENOUS SOLUTION,5316.4,3455.66,,,0
HCPCS,Q5118,"Inj., zirabev, 10 mg",,,25.77,62.33,6
HCPCS,Q5118,Noncdm Charge Record Pharmacy,230.22,149.64,,,0
HCPCS,Q5119,"Inj ruxience, 10 mg",,,27.84,63.93,6
HCPCS,Q5119,Noncdm Charge Record Pharmacy,244.88,159.17,,,0
HCPCS,Q5119,RITUXIMAB-PVVR 10 MG/ML INTRAVENOUS SOLUTION,7125.674999999999,4631.69,,,0
HCPCS,Q5120,Inj pegfilgrastim-bmez 0.5mg,,,30.32,66.96,6
HCPCS,Q5120,Noncdm Charge Record Pharmacy,1558.94,1013.31,,,0
HCPCS,Q5121,"Inj. avsola, 10 mg",,,20.4,53.74,6
HCPCS,Q5121,Noncdm Charge Record Pharmacy,249.16,161.95,,,0
HCPCS,Q5122,"Inj, nyvepria",,,131.16,317.1,6
HCPCS,Q5122,Noncdm Charge Record Pharmacy,91.66,59.58,,,0
HCPCS,Q5123,"Inj. riabni, 10 mg",,,26.51,99.67,6
HCPCS,Q5123,Noncdm Charge Record Pharmacy,242.98,157.94,,,0
HCPCS,Q5124,"Inj. byooviz, 0.1 mg",,,61.8,458.53,6
HCPCS,Q5125,"Inj, releuko 1 mcg",,,0.38,1.22,6
HCPCS,Q5126,Inj alymsys 10 mg,,,37.82,157.8,6
HCPCS,Q5127,"Inj, stimufend, 0.5 mg",,,184.91,808.42,6
HCPCS,Q5128,"Inj, cimerli, 0.1 mg",,,86.16,457.29,6
HCPCS,Q5129,"Inj, vegzelma, 10 mg",,,39.96,140.92,6
HCPCS,Q5130,"Inj, fylnetra, 0.5 mg",,,137.96,497.34,6
HCPCS,Q5130,Noncdm Charge Record Pharmacy,964.28,626.78,,,0
HCPCS,Q5133,"Inj, tofidence, 1 mg",,,5.54,16.26,6
HCPCS,Q5135,"Inj, tyenne, 1 mg",,,4.42,11.14,6
HCPCS,Q5137,"Inj, wezlana, sub cu, 1 mg",,,598.02,598.02,2
HCPCS,Q5138,"Inj, wezlana, iv, 1 mg",,,11.64,921.73,3
HCPCS,Q5140,"Inj adalimumab-fkjp, 1 mg",,,236.15,236.15,2
HCPCS,Q5141,"Inj adalimumab-aaty, 1 mg",,,118.07,118.07,2
HCPCS,Q5142,"Inj adalimumab-ryvk, 1 mg",,,28.56,30.37,4
HCPCS,Q5143,"Inj adalimumab-adbm, 1 mg",,,28.27,28.27,2
HCPCS,Q5144,"Inj, idacio, 1 mg",,,40.7,52.6,4
HCPCS,Q5145,"Inj, abrilada, 1 mg",,,347.07,347.07,2
HCPCS,Q5146,"Inj, hercessi, 10 mg",,,40.02,286.85,5
HCPCS,Q9950,Inj sulf hexa lipid microsph,,,31.75,50.62,5
HCPCS,Q9953,"Inj fe-based mr contrast,1ml",,,0.02,0.02,2
HCPCS,Q9954,"Oral MR contrast, 100 ml",,,0.02,0.02,2
HCPCS,Q9956,"Inj octafluoropropane mic,ml",,,70.73,112.76,5
HCPCS,Q9957,INV PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS,0.65,0.42,,,0
HCPCS,Q9957,"Inj perflutren lip micros,ml",,,70.73,112.76,5
HCPCS,Q9957,Noncdm Charge Record Pharmacy,124.23,80.75,,,0
HCPCS,Q9957,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS SUSPENSION,752.9,489.38,,,0
HCPCS,Q9958,"HOCM <=149 mg/ml iodine, 1ml",,,0.12,0.19,5
HCPCS,Q9958,Noncdm Charge Record Pharmacy,0.25,0.16,,,0
HCPCS,Q9960,"HOCM 200-249mg/ml iodine,1ml",,,0.02,0.02,2
HCPCS,Q9961,"HOCM 250-299mg/ml iodine,1ml",,,0.49,0.79,5
HCPCS,Q9962,"HOCM 300-349mg/ml iodine,1ml",,,0.02,0.02,2
HCPCS,Q9963,"HOCM 350-399mg/ml iodine,1ml",,,0.37,0.6,5
HCPCS,Q9964,"Hocm>= 400mg/ml iodine, 1ml",,,0.02,0.02,2
HCPCS,Q9965,Hc Locm 100 199 Mg Per Ml Iodine Per Ml,9.36,6.08,,,0
HCPCS,Q9965,"LOCM 100-199mg/ml iodine,1ml",,,2.05,3.25,5
HCPCS,Q9965,Noncdm Charge Record Pharmacy,23.61,15.35,,,0
HCPCS,Q9966,Hc Isovue-M 200 299 Mg Per Ml Iodine Per Ml,4.16,2.7,,,0
HCPCS,Q9966,INV STABILIZER MIXTURE (PENTAGALLOYL GLUCOSE-IODOMIDOL) INJECTION,0.65,0.42,,,0
HCPCS,Q9966,"LOCM 200-299mg/ml iodine,1ml",,,0.69,1.11,5
HCPCS,Q9966,Noncdm Charge Record Pharmacy,1.45,0.94,,,0
HCPCS,Q9967,IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION,174.45,113.39,,,0
HCPCS,Q9967,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,77.0,50.05,,,0
HCPCS,Q9967,"LOCM 300-399mg/ml iodine,1ml",,,0.24,0.38,5
HCPCS,Q9967,Noncdm Charge Record Pharmacy,0.54,0.35,,,0
HCPCS,Q9968,INV METHYLENE BLUE 5MG/ML INJECTION,0.65,0.42,,,0
HCPCS,Q9968,ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION,519.95,337.97,,,0
HCPCS,Q9968,Noncdm Charge Record Pharmacy,54.6,35.49,,,0
HCPCS,Q9968,Visualization adjunct,,,8.72,24.12,3
HCPCS,Q9969,Hc Non-Heu Tc-99M Add-On Per Dose,1.03,0.67,,,0
HCPCS,Q9969,Non-HEU TC-99M add-on/dose,,,27.1,27.1,2
HCPCS,Q9982,flutemetamol f18 diagnostic,,,1944.01,7488.0,5
HCPCS,Q9983,florbetaben f18 diagnostic,,,1584.67,7956.0,5
HCPCS,Q9991,Buprenorph xr 100 mg or less,,,2016.42,5235.21,6
HCPCS,Q9992,Buprenorphine xr over 100 mg,,,2016.42,5235.21,6
HCPCS,S0012,"Butorphanal tartrate, nasal spray, 25 mg",,,131.98,149.89,4
HCPCS,S0014,"Tacrine HCl, 10mg",,,0.02,5.26,4
HCPCS,S0017,"Injection, aminocaproic acid, 5mg",,,15.44,29.95,4
HCPCS,S0023,"Injection, cimetidine HCl, 300 mg",,,0.02,5.26,4
HCPCS,S0028,"Injection, famotidine, 20mg",,,1.36,4.82,4
HCPCS,S0028,Noncdm Charge Record Pharmacy,37.53,24.39,,,0
HCPCS,S0032,"Injection, nafcillin sodium, 2 g",,,30.77,73.63,4
HCPCS,S0039,"Injection, sulfamethoxazole and trimethoprim, 10 ml",,,29.34,29.34,2
HCPCS,S0040,"Injection, ticarcillin disodium and clavulanate potassium, 3.1 g",,,0.02,28.05,4
HCPCS,S0074,"Injection, cefotetan disodium, 500 mg",,,28.03,28.03,2
HCPCS,S0074,Noncdm Charge Record Pharmacy,32.98,21.44,,,0
HCPCS,S0078,"Injection, fosphenytoin sodium, 750 mg",,,86.37,344.5,4
HCPCS,S0080,"Injection, pentamidine isethonate, 300 mg",,,228.62,403.44,4
HCPCS,S0081,"Injection, piperacillin sodium, 500 mg",,,0.02,3.5,4
HCPCS,S0088,"Imatinib, 100 mg",,,6.95,6.95,2
HCPCS,S0090,"Sildenafil citrate, 25 mg",,,0.63,152.93,4
HCPCS,S0091,"Granisetron HCl, 1mg (for circumstances falling under the Medicare Statute, use Q0166)",,,7.02,159.54,4
HCPCS,S0092,"Injection, hydromorphone HCl, 250 mg (loading dose for infusion pump)",,,195.16,202.49,4
HCPCS,S0093,"Injection, morphine sulfate, 500mg (loding dose for infusion pump)",,,18.74,465.47,4
HCPCS,S0104,"Zidovudine, oral, 100 mg",,,3.53,5.77,4
HCPCS,S0106,"Buproprion HCl sustained release tablit, 150 mg, per bottle of 60 tablets",,,25.61,35.57,4
HCPCS,S0108,"Mercaptopuine, oral, 50 mg",,,6.67,36.07,4
HCPCS,S0109,"Methadone, oral, 5 mg",,,0.73,1.27,4
HCPCS,S0117,"Tretinoin, topical, 5 g",,,8.78,8.78,2
HCPCS,S0122,"Injection, menotropins, 75 IU",,,568.04,789.42,4
HCPCS,S0126,"Injection, follitropin alfa, 75 IU",,,565.13,660.05,4
HCPCS,S0128,"Injection, follitropin beta, 75 IU",,,508.95,707.31,4
HCPCS,S0132,"Injection, ganirelix acetate, 250 mcg",,,430.56,595.74,4
HCPCS,S0136,"Clozapine, 25 mg",,,1.52,5.75,4
HCPCS,S0137,"Didanosine (ddI), 25 mg",,,0.02,2.09,4
HCPCS,S0138,"Finasteride, 5 mg",,,0.35,16.02,4
HCPCS,S0139,"Minoxidil, 10 mg",,,1.08,3.88,4
HCPCS,S0140,"Saquinavir, 200 mg",,,0.02,3.5,4
HCPCS,S0145,"pegylated interferon alfa-2a, 180 mcg/ ml",,,2605.4,3521.18,4
HCPCS,S0148,Peg interferon alfa-2B/10,,,0.02,0.02,2
HCPCS,S0155,"Sterile dilutant for epoprostenol, 50 ml",,,33.93,33.93,2
HCPCS,S0156,"Exemestane, 25 mg",,,3.91,52.03,4
HCPCS,S0157,"Becaplermin gel 0.01%, 0.5 gm",,,106.05,140.38,4
HCPCS,S0160,"Dextoamphetamine sulfate, 5 mg",,,1.61,14.17,4
HCPCS,S0169,Calcitrol,,,0.63,2.63,4
HCPCS,S0170,"Anastrozole, oral, 1 mg",,,1.12,40.0,4
HCPCS,S0172,"Chlorambucil, oral, 2 mg",,,618.11,1878.25,4
HCPCS,S0174,"Dolasetron mesylate, oral 50 mg (for circumstances falling under the medicare statute, use q0180)",,,69.17,234.31,4
HCPCS,S0175,"Flutamide, oral, 125 mg",,,97.4,97.4,2
HCPCS,S0176,"Hydroxyurea, oral, 500 mg",,,1.31,12.41,4
HCPCS,S0177,"Levamisole HCl, oral, 50 mg",,,9.65,9.65,2
HCPCS,S0178,"Lomustine, oral, 10 mg",,,263.23,352.19,4
HCPCS,S0179,"Megestrol acetate, oral, 20 mg",,,0.66,1.25,4
HCPCS,S0182,"Procarbazine HCl, oral, 50 mg",,,302.49,482.98,4
HCPCS,S0183,"Prochlorperazine maleate, oral, 5 mg (for circumstances falling under the medicare statute, use q0164)",,,0.82,1.63,4
HCPCS,S0187,"Tamoxifen citrate, oral, 10 mg",,,0.44,9.24,4
HCPCS,S0189,"testosterone pellet, 75 mg",,,246.0,351.81,4
HCPCS,S0190,"Mitepristone, oral, 200 mg",,,100.62,139.57,4
HCPCS,S0191,"Misoprostol, oral, 200 mcg",,,2.27,7.67,4
HCPCS,S0194,"Dialysis/stress vitamin supplement, oral, 100 capsules",,,23.05,23.05,2
HCPCS,S4991,Nicotine patch nonlegend,,,4.17,4.17,2
HCPCS,S4993,Contraceptive pills for bc,,,1.85,1.85,2
HCPCS,S5010,5% dextrose and 0.45% saline,,,18.49,18.49,2
HCPCS,S5012,5% dextrose with potassium,,,11.12,11.12,2
HCPCS,S5550,Insulin rapid 5 u,,,0.54,1.3,4
HCPCS,S5551,Insulin most rapid 5 u,,,1.01,1.03,4
HCPCS,S5552,Insulin intermed 5 u,,,0.54,0.76,4
HCPCS,S5553,Insulin long acting 5 u,,,1.06,1.33,4
HCPCS,S5566,Insulin cartridge 300 u,,,62.88,62.88,2
HCPCS,S5570,Insulin dispos pen 1.5 ml,,,234.0,234.0,2
HCPCS,S5571,Insulin dispos pen 3 ml,,,74.46,74.46,2
HCPCS,S9449,Hc Adapting Vlc Per Class,30.0,19.5,,,0
HCPCS,S9449,Hc Med Weight Re-Enroll Screen,176.0,114.4,,,0
HCPCS,S9449,Hc Med Weight Tx Screening Lc,346.0,224.9,,,0
HCPCS,S9449,Hc Med Weight Tx Screening Tlc,346.0,224.9,,,0
HCPCS,S9449,Hc Med Wt Screen Promotion,176.0,114.4,,,0
HCPCS,S9449,Hc Med Wt Screen W/Outside Ekg,261.0,169.65,,,0
HCPCS,S9449,Hc Med Wt Screen W/Outside Lab,287.0,186.55,,,0
HCPCS,S9449,Hc Med Wt Screen W/Outside Lab&Ekg,317.0,206.05,,,0
HCPCS,S9449,Hc Reduce Or Dm Type Ii Vlc Per Class,30.0,19.5,,,0
HCPCS,S9449,Hc Reduce Vlc Per Class,30.0,19.5,,,0
HCPCS,S9449,Hc Reducing Or Dm Lc Per Class,30.0,19.5,,,0
HCPCS,S9449,Hc Weight Maintnce Lc Per Class,30.0,19.5,,,0
HCPCS,S9449,Hc Weight Maintnce Vlc Per Class,30.0,19.5,,,0
HCPCS,S9451,Hc Fitness Consultation,93.0,60.45,,,0
HCPCS,S9452,Hc Nutrition Therapy Group Educ Ob,182.0,118.3,,,0
HCPCS,S9470,Hc Mcaid Ob Nutrition Intervention Diettcian,67.0,43.55,,,0
HCPCS,T2101,"Hc Breast Milk Per Oz Process,Storage,Dist",4.38,2.85,,,0
HCPCS,U0001,2019 nCoV diagnostic P,,,35.92,134.7,3
HCPCS,U0001,Hc Cdc 2019 Novel Coronavirus (2019-Ncov) Rt-Pcr Diagnostic Panel So,250.0,162.5,,,0
HCPCS,U0002,COVID-19 lab test non-CDC,,,51.31,192.41,3
HCPCS,U0002,Hc Coronavirus (Covid-19) Ldt Panel So,247.0,160.55,,,0
HCPCS,U0002,Hc Covid-19 Lab Test Non-Cdc,247.0,160.55,,,0
HCPCS,U0002,Hc Covid-19 Lab Test Non-Cdc Rapid,247.0,160.55,,,0
HCPCS,U0002,Hc Fsed Covid-19 Lab Test Non-Cdc Rapid,247.0,160.55,,,0
HCPCS,V2524,Cntct lens hydrophil photoch,,,171.49,171.49,1
HCPCS,W0637,Hc Ot Bwc Transitional Work Per 15 Min,103.0,66.95,,,0
HCPCS,W0637,Hc Pt Bwc Transitional Work 15 Min,103.0,66.95,,,0
HCPCS,W0644,Hc Ot Bwc Ergonomic Study Per 15 Min,144.0,93.6,,,0
HCPCS,W0644,Hc Pt Bwc Ergonomic Study 15 Min,144.0,93.6,,,0
HCPCS,W0645,Hc Ot Job Analysis 15 Min,144.0,93.6,,,0
HCPCS,W0645,Hc Pt Job Analysis 15 Min,144.0,93.6,,,0
HCPCS,W0710,Hc Ot Bwc Work Conditioning  Per 15 Min,145.0,94.25,,,0
HCPCS,W0710,Hc Pt Bwc Work Conditioning Per 15 Min,145.0,94.25,,,0
HCPCS,j3490,DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,4146.35,2695.13,,,0
HCPCS,j9036,INV BENDAMUSTINE 2.5 MG/ML POWDER FOR SOLUTION,0.65,0.42,,,0
MS-DRG,001,Heart Transplant Or Implant Of Heart Assist System With Mcc,,,218838.96,623350.6,18
MS-DRG,002,Heart Transplant Or Implant Of Heart Assist System Without Mcc,,,89211.24,243876.98,18
MS-DRG,003,"Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck With Major",,,166041.53,474271.76,18
MS-DRG,004,"Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck Without Major O.R.",,,108777.98,312691.11,18
MS-DRG,005,Liver Transplant With Mcc Or Intestinal Transplant,,,81280.01,235664.17,18
MS-DRG,006,Liver Transplant Without Mcc,,,37220.67,107311.01,18
MS-DRG,007,Lung Transplant,,,101779.43,289205.69,18
MS-DRG,008,Simultaneous Pancreas And Kidney Transplant,,,44734.87,120410.34,18
MS-DRG,009,Bone marrow transplant,,,,,0
MS-DRG,010,Pancreas Transplant,,,56935.74,176441.61,18
MS-DRG,011,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc",,,43566.12,119410.02,18
MS-DRG,012,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc",,,33951.27,90812.35,18
MS-DRG,013,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc",,,23590.12,58642.72,18
MS-DRG,014,Allogeneic Bone Marrow Transplant,,,94539.36,289936.02,18
MS-DRG,016,Autologous Bone Marrow Transplant With Cc/Mcc,,,47259.54,133571.65,18
MS-DRG,017,Autologous Bone Marrow Transplant Without Cc/Mcc,,,43396.82,133571.65,18
MS-DRG,018,Chimeric Antigen Receptor (Car) T-Cell And Other Immunotherapies,,,336560.13,834564.44,18
MS-DRG,019,Simultaneous Pancreas And Kidney Transplant With Hemodialysis,,,56616.57,175425.8,18
MS-DRG,020,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc,,,62318.23,178386.93,18
MS-DRG,021,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc,,,42321.26,122324.68,18
MS-DRG,022,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/Mcc,,,25885.69,78131.28,18
MS-DRG,023,Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis With Mcc Or Antineopla,,,45711.04,126250.72,18
MS-DRG,024,Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Without Mcc,,,31589.68,84128.78,18
MS-DRG,025,Craniotomy And Endovascular Intracranial Procedures With Mcc,,,36519.42,98969.83,18
MS-DRG,026,Craniotomy And Endovascular Intracranial Procedures With Cc,,,25356.06,67685.45,18
MS-DRG,027,Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc,,,20802.97,54610.46,18
MS-DRG,028,Spinal Procedures With Mcc,,,47869.93,134536.56,18
MS-DRG,029,Spinal Procedures With Cc Or Spinal Neurostimulators,,,27704.45,74282.7,18
MS-DRG,030,Spinal Procedures Without Cc/Mcc,,,18258.11,49245.9,18
MS-DRG,031,Ventricular Shunt Procedures With Mcc,,,36005.32,92735.53,18
MS-DRG,032,Ventricular Shunt Procedures With Cc,,,17759.55,47260.75,18
MS-DRG,033,Ventricular Shunt Procedures Without Cc/Mcc,,,14124.37,35307.8,18
MS-DRG,034,Carotid Artery Stent Procedures With Mcc,,,31269.73,86056.39,18
MS-DRG,035,Carotid Artery Stent Procedures With Cc,,,19774.78,50339.17,18
MS-DRG,036,Carotid Artery Stent Procedures Without Cc/Mcc,,,16298.02,40566.12,18
MS-DRG,037,Extracranial Procedures With Mcc,,,26776.43,73490.41,18
MS-DRG,038,Extracranial Procedures With Cc,,,13811.41,35655.25,18
MS-DRG,039,Extracranial Procedures Without Cc/Mcc,,,10339.31,25189.5,18
MS-DRG,040,"Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc",,,31195.96,83473.71,18
MS-DRG,041,"Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Peripheral Neurostimulator",,,18285.29,49985.08,18
MS-DRG,042,"Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc",,,14627.59,38895.23,18
MS-DRG,043,Hyphema,,,,,0
MS-DRG,044,Acute Major Eye Infections,,,,,0
MS-DRG,045,Neurological eye disorders,,,,,0
MS-DRG,046,Other Disorders of the Eye Age >17 w CC,,,,,0
MS-DRG,047,Other Disorders of the Eye Age >17 w/o CC,,,,,0
MS-DRG,048,Other Disorders of the Eye Age 0-17,,,,,0
MS-DRG,049,Major Head & Neck Procedures,,,,,0
MS-DRG,050,Sialoadenectomy,,,,,0
MS-DRG,051,Salivary Gland Procedures Except Sialoadenectomy,,,,,0
MS-DRG,052,Spinal Disorders And Injuries With Cc/Mcc,,,15276.82,44536.42,18
MS-DRG,053,Spinal Disorders And Injuries Without Cc/Mcc,,,8814.88,20389.29,18
MS-DRG,054,Nervous System Neoplasms With Mcc,,,13068.22,33176.58,18
MS-DRG,055,Nervous System Neoplasms Without Mcc,,,9128.62,24142.71,18
MS-DRG,056,Degenerative Nervous System Disorders With Mcc,,,19251.36,55416.02,18
MS-DRG,057,Degenerative Nervous System Disorders Without Mcc,,,11271.99,29538.25,18
MS-DRG,058,Multiple Sclerosis And Cerebellar Ataxia With Mcc,,,14486.26,40847.19,18
MS-DRG,059,Multiple Sclerosis And Cerebellar Ataxia With Cc,,,10847.2,27077.28,18
MS-DRG,060,Multiple Sclerosis And Cerebellar Ataxia Without Cc/Mcc,,,8353.59,19749.7,18
MS-DRG,061,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Mcc",,,22621.72,59824.52,18
MS-DRG,062,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Cc",,,14856.69,39410.88,18
MS-DRG,063,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent Without Cc/Mcc",,,12112.25,31087.42,18
MS-DRG,064,Intracranial Hemorrhage Or Cerebral Infarction With Mcc,,,16827.65,44020.77,18
MS-DRG,065,Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours,,,9056.4,22507.23,18
MS-DRG,066,Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc,,,6525.52,15232.77,18
MS-DRG,067,Precerebral Occlusion Without Infarction With Mcc,,,12616.25,32218.31,18
MS-DRG,068,Precerebral Occlusion Without Infarction Without Mcc,,,7923.37,19510.69,18
MS-DRG,069,Transient Ischemia Without Thrombolytic,,,7413.93,17709.23,18
MS-DRG,070,Other Cerebrovascular Disorders With Mcc,,,14139.12,38479.17,18
MS-DRG,071,Other Cerebrovascular Disorders With Cc,,,9178.32,23321.65,18
MS-DRG,072,Other Cerebrovascular Disorders Without Cc/Mcc,,,7083.11,16600.46,18
MS-DRG,073,Cranial And Peripheral Nerve Disorders With Mcc,,,13669.29,34203.46,18
MS-DRG,074,Cranial And Peripheral Nerve Disorders Without Mcc,,,9215.6,23069.35,18
MS-DRG,075,Viral Meningitis With Cc/Mcc,,,16101.55,38118.43,18
MS-DRG,076,Viral Meningitis Without Cc/Mcc,,,7618.95,20291.91,18
MS-DRG,077,Hypertensive Encephalopathy With Mcc,,,26987.37,34218.95,6
MS-DRG,078,Hypertensive Encephalopathy With Cc,,,17415.6,22082.31,6
MS-DRG,079,Hypertensive Encephalopathy Without Cc/Mcc,,,11636.58,14754.74,6
MS-DRG,080,Nontraumatic Stupor And Coma With Mcc,,,15266.72,43992.0,18
MS-DRG,081,Nontraumatic Stupor And Coma Without Mcc,,,8165.66,20024.13,18
MS-DRG,082,Traumatic Stupor And Coma >1 Hour With Mcc,,,18960.14,51346.13,18
MS-DRG,083,Traumatic Stupor And Coma >1 Hour With Cc,,,12050.12,30768.73,18
MS-DRG,084,Traumatic Stupor And Coma >1 Hour Without Cc/Mcc,,,8633.16,21157.24,18
MS-DRG,085,Traumatic Stupor And Coma <1 Hour With Mcc,,,18853.75,50146.63,18
MS-DRG,086,Traumatic Stupor And Coma <1 Hour With Cc,,,11327.12,29027.02,18
MS-DRG,087,Traumatic Stupor And Coma <1 Hour Without Cc/Mcc,,,8313.99,19563.8,18
MS-DRG,088,Concussion With Mcc,,,11708.43,31217.99,18
MS-DRG,089,Concussion With Cc,,,9742.12,23726.65,18
MS-DRG,090,Concussion Without Cc/Mcc,,,7603.42,18970.69,18
MS-DRG,091,Other Disorders Of Nervous System With Mcc,,,14848.92,40340.39,18
MS-DRG,092,Other Disorders Of Nervous System With Cc,,,9155.03,23432.3,18
MS-DRG,093,Other Disorders Of Nervous System Without Cc/Mcc,,,7394.52,17468.0,18
MS-DRG,094,Bacterial And Tuberculous Infections Of Nervous System With Mcc,,,28541.6,80742.74,18
MS-DRG,095,Bacterial And Tuberculous Infections Of Nervous System With Cc,,,21240.18,53048.01,18
MS-DRG,096,Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc,,,21240.18,53048.01,18
MS-DRG,097,Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Mcc,,,29259.16,79335.21,18
MS-DRG,098,Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Cc,,,19032.36,48004.35,18
MS-DRG,099,Non-Bacterial Infection Of Nervous System Except Viral Meningitis Without Cc/Mcc,,,11790.74,30832.91,18
MS-DRG,100,Seizures With Mcc,,,16251.43,43934.46,18
MS-DRG,101,Seizures Without Mcc,,,8220.02,20395.93,18
MS-DRG,102,Headaches With Mcc,,,9915.3,25658.68,18
MS-DRG,103,Headaches Without Mcc,,,7705.15,18815.78,18
MS-DRG,104,Cardiac Valve & Oth Major Cardiothoracic Proc w Cardiac Cath,,,,,0
MS-DRG,105,Cardiac Valve & Oth Major Cardiothoracic Proc w/o Cardiac Cath,,,,,0
MS-DRG,106,Coronary Bypass w PTCA,,,,,0
MS-DRG,107,No Longer Valid,,,,,0
MS-DRG,108,Other Cardiothoracic Procedures,,,,,0
MS-DRG,109,No Longer Valid,,,,,0
MS-DRG,110,Major Cardiovascular Procedures w CC,,,,,0
MS-DRG,111,Major Cardiovascular Procedures w/o CC,,,,,0
MS-DRG,112,No Longer Valid,,,,,0
MS-DRG,113,Orbital Procedures With Cc/Mcc,,,19468.8,49940.81,18
MS-DRG,114,Orbital Procedures Without Cc/Mcc,,,11717.74,26161.06,18
MS-DRG,115,Extraocular Procedures Except Orbit,,,13130.35,33880.35,18
MS-DRG,116,Intraocular Procedures With Cc/Mcc,,,15251.97,36925.57,18
MS-DRG,117,Intraocular Procedures Without Cc/Mcc,,,9635.73,23870.5,18
MS-DRG,118,Cardiac Pacemaker Device Replacement,,,,,0
MS-DRG,119,Vein ligation & stripping,,,,,0
MS-DRG,120,Other circulatory system O.R. procedures,,,,,0
MS-DRG,121,Acute Major Eye Infections With Cc/Mcc,,,10244.57,25740.57,18
MS-DRG,122,Acute Major Eye Infections Without Cc/Mcc,,,7312.98,15011.46,18
MS-DRG,123,Neurological Eye Disorders,,,7412.38,17775.62,18
MS-DRG,124,Other Disorders Of The Eye With Mcc Or Thrombolytic Agent,,,11485.55,28854.4,18
MS-DRG,125,Other Disorders Of The Eye Without Mcc,,,7173.19,18273.57,18
MS-DRG,126,Acute & Subacute Endocarditis,,,,,0
MS-DRG,127,Heart Failure & Shock,,,,,0
MS-DRG,128,Deep Vein Thrombophlebitis,,,,,0
MS-DRG,129,Major Head & Neck Procedures W Cc/Mcc Or Major Device,,,,,0
MS-DRG,130,Major Head & Neck Procedures W/O Cc/Mcc,,,,,0
MS-DRG,131,Cranial/Facial Procedures W Cc/Mcc,,,,,0
MS-DRG,132,Cranial/Facial Procedures W/O Cc/Mcc,,,,,0
MS-DRG,133,"Other Ear, Nose, Mouth & Throat O.R. Procedures W Cc/Mcc",,,,,0
MS-DRG,134,"Other Ear, Nose, Mouth & Throat O.R. Procedures W/O Cc/Mcc",,,,,0
MS-DRG,135,Sinus And Mastoid Procedures With Cc/Mcc,,,18062.41,53355.63,18
MS-DRG,136,Sinus And Mastoid Procedures Without Cc/Mcc,,,9095.23,21648.54,18
MS-DRG,137,Mouth Procedures With Cc/Mcc,,,12806.51,30950.2,18
MS-DRG,138,Mouth Procedures Without Cc/Mcc,,,8092.66,18003.57,18
MS-DRG,139,Salivary Gland Procedures,,,10806.81,30383.65,18
MS-DRG,140,Major Head And Neck Procedures With Mcc,,,34334.12,93592.0,18
MS-DRG,141,Major Head And Neck Procedures With Cc,,,18148.61,47544.03,18
MS-DRG,142,Major Head And Neck Procedures Without Cc/Mcc,,,13607.94,34796.57,18
MS-DRG,143,"Other Ear, Nose, Mouth And Throat O.R. Procedures With Mcc",,,30305.99,73069.92,18
MS-DRG,144,"Other Ear, Nose, Mouth And Throat O.R. Procedures With Cc",,,14667.98,38875.31,18
MS-DRG,145,"Other Ear, Nose, Mouth And Throat O.R. Procedures Without Cc/Mcc",,,10547.44,26218.6,18
MS-DRG,146,"Ear, Nose, Mouth And Throat Malignancy With Mcc",,,17653.93,50766.3,18
MS-DRG,147,"Ear, Nose, Mouth And Throat Malignancy With Cc",,,11084.83,27546.46,18
MS-DRG,148,"Ear, Nose, Mouth And Throat Malignancy Without Cc/Mcc",,,7400.73,17720.29,18
MS-DRG,149,Dysequilibrium,,,7047.38,16542.92,18
MS-DRG,150,Epistaxis With Mcc,,,11550.78,30587.26,18
MS-DRG,151,Epistaxis Without Mcc,,,6910.71,16775.3,18
MS-DRG,152,Otitis Media And Uri With Mcc,,,10391.34,25112.05,18
MS-DRG,153,Otitis Media And Uri Without Mcc,,,6943.32,15750.63,18
MS-DRG,154,"Other Ear, Nose, Mouth And Throat Diagnoses With Mcc",,,13352.45,35989.43,18
MS-DRG,155,"Other Ear, Nose, Mouth And Throat Diagnoses With Cc",,,8327.97,20661.5,18
MS-DRG,156,"Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/Mcc",,,6577.55,14880.88,18
MS-DRG,157,Dental And Oral Diseases With Mcc,,,14542.95,36237.3,18
MS-DRG,158,Dental And Oral Diseases With Cc,,,8275.94,20814.21,18
MS-DRG,159,Dental And Oral Diseases Without Cc/Mcc,,,6712.68,14597.61,18
MS-DRG,160,Hernia Procedures Except Inguinal & Femoral Age >17 w/o CC,,,,,0
MS-DRG,161,Inguinal & Femoral Hernia Procedures Age >17 w CC,,,,,0
MS-DRG,162,Inguinal & Femoral Hernia Procedures Age >17 w/o CC,,,,,0
MS-DRG,163,Major Chest Procedures With Mcc,,,36015.42,101999.57,18
MS-DRG,164,Major Chest Procedures With Cc,,,20811.51,55699.3,18
MS-DRG,165,Major Chest Procedures Without Cc/Mcc,,,16075.92,41249.97,18
MS-DRG,166,Other Respiratory System O.R. Procedures With Mcc,,,30236.88,85226.48,18
MS-DRG,167,Other Respiratory System O.R. Procedures With Cc,,,15215.47,40435.55,18
MS-DRG,168,Other Respiratory System O.R. Procedures Without Cc/Mcc,,,11821.81,29960.95,18
MS-DRG,169,Mouth Procedures w/o CC,,,,,0
MS-DRG,171,Other Digestive System O.R. Procedures w/o CC,,,,,0
MS-DRG,173,Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary Embolism,,,24324.76,67906.76,18
MS-DRG,174,G.I. hemorrhage w CC,,,,,0
MS-DRG,175,Pulmonary Embolism With Mcc Or Acute Cor Pulmonale,,,11877.72,31184.79,18
MS-DRG,176,Pulmonary Embolism Without Mcc,,,7462.08,18025.7,18
MS-DRG,177,Respiratory Infections And Inflammations With Mcc,,,13346.24,35774.76,18
MS-DRG,178,Respiratory Infections And Inflammations With Cc,,,8790.03,21956.17,18
MS-DRG,179,Respiratory Infections And Inflammations Without Cc/Mcc,,,7073.79,17034.23,18
MS-DRG,180,Respiratory Neoplasms With Mcc,,,14925.03,38678.35,18
MS-DRG,181,Respiratory Neoplasms With Cc,,,9527.79,24569.84,18
MS-DRG,182,Respiratory Neoplasms Without Cc/Mcc,,,7064.47,18534.71,18
MS-DRG,183,Major Chest Trauma With Mcc,,,13091.52,35126.32,18
MS-DRG,184,Major Chest Trauma With Cc,,,9474.2,23635.91,18
MS-DRG,185,Major Chest Trauma Without Cc/Mcc,,,7318.41,17209.07,18
MS-DRG,186,Pleural Effusion With Mcc,,,13313.62,34966.98,18
MS-DRG,187,Pleural Effusion With Cc,,,8891.77,22217.31,18
MS-DRG,188,Pleural Effusion Without Cc/Mcc,,,6780.24,16246.37,18
MS-DRG,189,Pulmonary Edema And Respiratory Failure,,,10804.48,27387.11,18
MS-DRG,190,Chronic Obstructive Pulmonary Disease With Mcc,,,9812.79,24859.75,18
MS-DRG,191,Chronic Obstructive Pulmonary Disease With Cc,,,7757.18,19012.74,18
MS-DRG,192,Chronic Obstructive Pulmonary Disease Without Cc/Mcc,,,6196.25,14323.18,18
MS-DRG,193,Simple Pneumonia And Pleurisy With Mcc,,,11417.98,29164.23,18
MS-DRG,194,Simple Pneumonia And Pleurisy With Cc,,,7469.07,18147.42,18
MS-DRG,195,Simple Pneumonia And Pleurisy Without Cc/Mcc,,,6091.41,13783.19,18
MS-DRG,196,Interstitial Lung Disease With Mcc,,,15866.24,41699.23,18
MS-DRG,197,Interstitial Lung Disease With Cc,,,8581.13,21907.48,18
MS-DRG,198,Interstitial Lung Disease Without Cc/Mcc,,,6772.47,15500.55,18
MS-DRG,199,Pneumothorax With Mcc,,,14910.27,39065.64,18
MS-DRG,200,Pneumothorax With Cc,,,9747.56,24507.87,18
MS-DRG,201,Pneumothorax Without Cc/Mcc,,,6763.93,14980.47,18
MS-DRG,202,Bronchitis And Asthma With Cc/Mcc,,,8752.76,21394.04,18
MS-DRG,203,Bronchitis And Asthma Without Cc/Mcc,,,6413.69,15409.82,18
MS-DRG,204,Respiratory Signs And Symptoms,,,7480.72,17946.03,18
MS-DRG,205,Other Respiratory System Diagnoses With Mcc,,,15429.8,41776.69,18
MS-DRG,206,Other Respiratory System Diagnoses Without Mcc,,,8519.01,20046.26,18
MS-DRG,207,Respiratory System Diagnosis With Ventilator Support >96 Hours,,,51181.27,143136.67,18
MS-DRG,208,Respiratory System Diagnosis With Ventilator Support <=96 Hours,,,22556.49,59401.82,18
MS-DRG,209,Complex Aortic Arch Procedures,,,89110.28,89110.28,12
MS-DRG,210,Hip & Femur Procedures Except Major Joint Age >17 w CC,,,,,0
MS-DRG,211,Hip & Femur Procedures Except Major Joint Age >17 w/o CC,,,,,0
MS-DRG,212,Concomitant Aortic And Mitral Valve Procedures,,,85656.82,241075.2,18
MS-DRG,213,Endovascular Abdominal Aorta With Iliac Branch Procedures,,,45529.32,45529.32,12
MS-DRG,214,No Longer Valid,,,,,0
MS-DRG,215,Other Heart Assist System Implant,,,78534.8,234460.24,18
MS-DRG,216,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc,,,77181.99,213573.0,18
MS-DRG,217,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Cc,,,52273.15,142908.72,18
MS-DRG,218,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization Without Cc/Mcc,,,52273.15,131659.53,18
MS-DRG,219,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Mcc,,,60838.84,171227.55,18
MS-DRG,220,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Cc,,,42624.13,117212.42,18
MS-DRG,221,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization Without Cc/M,,,40351.85,101632.19,18
MS-DRG,222,"Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock With Mcc",,,,,0
MS-DRG,223,"Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock Without Mcc",,,,,0
MS-DRG,224,"Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Shock With Mcc",,,,,0
MS-DRG,225,"Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Shock Without Mcc",,,,,0
MS-DRG,226,Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc,,,,,0
MS-DRG,227,Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc,,,,,0
MS-DRG,228,Other Cardiothoracic Procedures With Mcc,,,39631.18,110276.56,18
MS-DRG,229,Other Cardiothoracic Procedures Without Mcc,,,25669.03,68741.1,18
MS-DRG,230,Other cardiothoracic procedures w/o CC/MCC,,,,,0
MS-DRG,231,Coronary Bypass With Ptca With Mcc,,,66675.62,187524.82,18
MS-DRG,232,Coronary Bypass With Ptca Without Mcc,,,48291.62,135182.79,18
MS-DRG,233,Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc,,,60581.79,172971.47,18
MS-DRG,234,Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc,,,43632.9,117734.71,18
MS-DRG,235,Coronary Bypass Without Cardiac Catheterization With Mcc,,,46785.05,130214.38,18
MS-DRG,236,Coronary Bypass Without Cardiac Catheterization Without Mcc,,,33740.04,90998.25,18
MS-DRG,237,Major cardiovasc procedures w MCC,,,,,0
MS-DRG,238,Major cardiovasc procedures w/o MCC,,,,,0
MS-DRG,239,Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc,,,39431.6,111462.78,18
MS-DRG,240,Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc,,,23347.05,64445.47,18
MS-DRG,241,Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc/Mcc,,,11961.59,33413.38,18
MS-DRG,242,Permanent Cardiac Pacemaker Implant With Mcc,,,26005.29,75068.35,18
MS-DRG,243,Permanent Cardiac Pacemaker Implant With Cc,,,17758.77,49854.5,18
MS-DRG,244,Permanent Cardiac Pacemaker Implant Without Cc/Mcc,,,15247.31,39939.82,18
MS-DRG,245,Aicd Generator Procedures,,,36641.34,108143.13,18
MS-DRG,246,Percutaneous Cardiovascular Procedures With Drug-Eluting Stent With Mcc Or 4+ Arteries Or Stents,,,,,0
MS-DRG,247,Percutaneous Cardiovascular Procedures With Drug-Eluting Stent Without Mcc,,,,,0
MS-DRG,248,Percutaneous Cardiovascular Procedures With Non-Drug-Eluting Stent With Mcc Or 4+ Arteries Or Stents,,,,,0
MS-DRG,249,Percutaneous Cardiovascular Procedures With Non-Drug-Eluting Stent Without Mcc,,,,,0
MS-DRG,250,Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc,,,18159.49,51182.36,18
MS-DRG,251,Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc,,,12816.61,34579.69,18
MS-DRG,252,Other Vascular Procedures With Mcc,,,28300.08,75913.76,18
MS-DRG,253,Other Vascular Procedures With Cc,,,21367.54,56498.23,18
MS-DRG,254,Other Vascular Procedures Without Cc/Mcc,,,15046.95,38713.76,18
MS-DRG,255,Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc,,,22158.1,57901.34,18
MS-DRG,256,Upper Limb And Toe Amputation For Circulatory System Disorders With Cc,,,14396.17,37481.06,18
MS-DRG,257,Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/Mcc,,,9692.42,19738.64,18
MS-DRG,258,Cardiac Pacemaker Device Replacement With Mcc,,,25611.56,62086.31,18
MS-DRG,259,Cardiac Pacemaker Device Replacement Without Mcc,,,16913.85,38897.45,18
MS-DRG,260,Cardiac Pacemaker Revision Except Device Replacement With Mcc,,,26471.24,75395.89,18
MS-DRG,261,Cardiac Pacemaker Revision Except Device Replacement With Cc,,,15891.87,41991.36,18
MS-DRG,262,Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc,,,13868.1,33588.22,18
MS-DRG,263,Vein Ligation And Stripping,,,24953.8,59353.13,18
MS-DRG,264,Other Circulatory System O.R. Procedures,,,27153.07,77345.63,18
MS-DRG,265,Aicd Lead Procedures,,,29308.86,78939.06,18
MS-DRG,266,Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc,,,48802.61,132573.54,18
MS-DRG,267,Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc,,,38182.08,104113.08,18
MS-DRG,268,Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc,,,54623.08,147551.8,18
MS-DRG,269,Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc,,,34007.18,92073.81,18
MS-DRG,270,Other Major Cardiovascular Procedures With Mcc,,,42185.36,113594.0,18
MS-DRG,271,Other Major Cardiovascular Procedures With Cc,,,28828.16,76228.02,18
MS-DRG,272,Other Major Cardiovascular Procedures Without Cc/Mcc,,,21036.72,55371.76,18
MS-DRG,273,Percutaneous And Other Intracardiac Procedures With Mcc,,,33248.46,86532.21,18
MS-DRG,274,Percutaneous And Other Intracardiac Procedures Without Mcc,,,26773.33,69066.42,18
MS-DRG,275,Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc,,,56583.95,156388.71,18
MS-DRG,276,Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator,,,47856.73,137079.41,18
MS-DRG,277,Cardiac Defibrillator Implant Without Mcc,,,37077.01,102957.84,18
MS-DRG,278,Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures With Mcc,,,44436.67,110719.18,18
MS-DRG,279,Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures Without Mcc,,,29217.23,70912.15,18
MS-DRG,280,"Acute Myocardial Infarction, Discharged Alive With Mcc",,,13667.74,36328.04,18
MS-DRG,281,"Acute Myocardial Infarction, Discharged Alive With Cc",,,8348.16,20400.36,18
MS-DRG,282,"Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc",,,6826.06,16047.19,18
MS-DRG,283,"Acute Myocardial Infarction, Expired With Mcc",,,16593.12,43274.96,18
MS-DRG,284,"Acute Myocardial Infarction, Expired With Cc",,,6586.1,16396.86,18
MS-DRG,285,"Acute Myocardial Infarction, Expired Without Cc/Mcc",,,5861.55,12422.13,18
MS-DRG,286,"Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc",,,18394.79,48982.54,18
MS-DRG,287,"Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc",,,9520.8,24113.94,18
MS-DRG,288,Acute And Subacute Endocarditis With Mcc,,,22226.44,60446.4,18
MS-DRG,289,Acute And Subacute Endocarditis With Cc,,,14466.07,34891.73,18
MS-DRG,290,Acute And Subacute Endocarditis Without Cc/Mcc,,,8430.48,21666.25,18
MS-DRG,291,Heart Failure And Shock With Mcc,,,11180.35,28878.74,18
MS-DRG,292,Heart Failure And Shock With Cc,,,7803.77,19061.43,18
MS-DRG,293,Heart Failure And Shock Without Cc/Mcc,,,5606.05,12149.92,18
MS-DRG,294,Deep Vein Thrombophlebitis With Cc/Mcc,,,21431.77,27174.65,6
MS-DRG,295,Deep Vein Thrombophlebitis Without Cc/Mcc,,,13785.17,17479.06,6
MS-DRG,296,"Cardiac Arrest, Unexplained With Mcc",,,13340.02,36257.22,18
MS-DRG,297,"Cardiac Arrest, Unexplained With Cc",,,6134.13,15589.08,18
MS-DRG,298,"Cardiac Arrest, Unexplained Without Cc/Mcc",,,4744.82,9773.05,18
MS-DRG,299,Peripheral Vascular Disorders With Mcc,,,13889.84,35801.32,18
MS-DRG,300,Peripheral Vascular Disorders With Cc,,,9500.6,23691.24,18
MS-DRG,301,Peripheral Vascular Disorders Without Cc/Mcc,,,6799.66,15786.04,18
MS-DRG,302,Atherosclerosis With Mcc,,,10503.17,25742.78,18
MS-DRG,303,Atherosclerosis Without Mcc,,,6438.55,14880.88,18
MS-DRG,304,Hypertension With Mcc,,,10451.92,25999.5,18
MS-DRG,305,Hypertension Without Mcc,,,7074.57,16613.74,18
MS-DRG,306,Cardiac Congenital And Valvular Disorders With Mcc,,,13447.97,33138.96,18
MS-DRG,307,Cardiac Congenital And Valvular Disorders Without Mcc,,,8302.34,20499.95,18
MS-DRG,308,Cardiac Arrhythmia And Conduction Disorders With Mcc,,,10560.64,26689.99,18
MS-DRG,309,Cardiac Arrhythmia And Conduction Disorders With Cc,,,6923.91,16361.45,18
MS-DRG,310,Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc,,,5606.83,12382.29,18
MS-DRG,311,Angina Pectoris,,,6661.42,15458.5,18
MS-DRG,312,Syncope And Collapse,,,7979.28,19282.74,18
MS-DRG,313,Chest Pain,,,6801.99,15786.04,18
MS-DRG,314,Other Circulatory System Diagnoses With Mcc,,,17403.87,47656.9,18
MS-DRG,315,Other Circulatory System Diagnoses With Cc,,,8691.41,21296.66,18
MS-DRG,316,Other Circulatory System Diagnoses Without Cc/Mcc,,,6507.66,15106.62,18
MS-DRG,317,Concomitant Left Atrial Appendage Closure And Cardiac Ablation,,,53136.71,136902.37,18
MS-DRG,318,Percutaneous Coronary Atherectomy Without Intraluminal Device,,,20020.95,20020.95,12
MS-DRG,319,Other Endovascular Cardiac Valve Procedures With Mcc,,,35868.65,97210.42,18
MS-DRG,320,Other Endovascular Cardiac Valve Procedures Without Mcc,,,19889.71,51224.41,18
MS-DRG,321,Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ Arteries/Intraluminal,,,22339.82,63000.32,18
MS-DRG,322,Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc,,,14901.73,40037.19,18
MS-DRG,323,Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc,,,34816.38,94260.36,18
MS-DRG,324,Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc,,,25680.68,70708.55,18
MS-DRG,325,Coronary Intravascular Lithotripsy Without Intraluminal Device,,,26141.96,63338.92,18
MS-DRG,326,"Stomach, Esophageal And Duodenal Procedures With Mcc",,,39941.81,112396.71,18
MS-DRG,327,"Stomach, Esophageal And Duodenal Procedures With Cc",,,20191.8,53736.28,18
MS-DRG,328,"Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc",,,13653.76,35263.54,18
MS-DRG,329,Major Small And Large Bowel Procedures With Mcc,,,36906.16,101618.91,18
MS-DRG,330,Major Small And Large Bowel Procedures With Cc,,,19826.81,52311.04,18
MS-DRG,331,Major Small And Large Bowel Procedures Without Cc/Mcc,,,14279.69,36538.28,18
MS-DRG,332,Rectal Resection With Mcc,,,29328.28,76761.37,18
MS-DRG,333,Rectal Resection With Cc,,,19399.69,47030.59,18
MS-DRG,334,Rectal Resection Without Cc/Mcc,,,13930.22,36702.05,18
MS-DRG,335,Peritoneal Adhesiolysis With Mcc,,,28941.54,80200.53,18
MS-DRG,336,Peritoneal Adhesiolysis With Cc,,,17586.37,46749.52,18
MS-DRG,337,Peritoneal Adhesiolysis Without Cc/Mcc,,,13131.12,33971.09,18
MS-DRG,338,Appendectomy With Complicated Principal Diagnosis With Mcc,,,,,0
MS-DRG,339,Appendectomy With Complicated Principal Diagnosis With Cc,,,,,0
MS-DRG,340,Appendectomy With Complicated Principal Diagnosis Without Cc/Mcc,,,,,0
MS-DRG,341,Appendectomy Without Complicated Principal Diagnosis With Mcc,,,,,0
MS-DRG,342,Appendectomy Without Complicated Principal Diagnosis With Cc,,,,,0
MS-DRG,343,Appendectomy Without Complicated Principal Diagnosis Without Cc/Mcc,,,,,0
MS-DRG,344,Minor Small And Large Bowel Procedures With Mcc,,,21268.14,59629.77,18
MS-DRG,345,Minor Small And Large Bowel Procedures With Cc,,,12895.82,32957.49,18
MS-DRG,346,Minor Small And Large Bowel Procedures Without Cc/Mcc,,,10422.41,27557.52,18
MS-DRG,347,Anal And Stomal Procedures With Mcc,,,19037.8,52375.22,18
MS-DRG,348,Anal And Stomal Procedures With Cc,,,11374.5,27858.5,18
MS-DRG,349,Anal And Stomal Procedures Without Cc/Mcc,,,7971.52,19495.2,18
MS-DRG,350,Inguinal And Femoral Hernia Procedures With Mcc,,,20562.23,53552.59,18
MS-DRG,351,Inguinal And Femoral Hernia Procedures With Cc,,,13049.58,33300.52,18
MS-DRG,352,Inguinal And Femoral Hernia Procedures Without Cc/Mcc,,,10279.52,24399.43,18
MS-DRG,353,Hernia Procedures Except Inguinal And Femoral With Mcc,,,23746.99,64905.8,18
MS-DRG,354,Hernia Procedures Except Inguinal And Femoral With Cc,,,14275.8,37647.04,18
MS-DRG,355,Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc,,,11655.62,29502.84,18
MS-DRG,356,Other Digestive System O.R. Procedures With Mcc,,,35324.26,94397.57,18
MS-DRG,357,Other Digestive System O.R. Procedures With Cc,,,19270.0,49836.8,18
MS-DRG,358,Other Digestive System O.R. Procedures Without Cc/Mcc,,,12066.43,29987.51,18
MS-DRG,359,Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc,,,27914.12,27914.12,12
MS-DRG,360,Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc,,,19959.6,19959.6,12
MS-DRG,361,Laparoscopy & Incisional Tubal Interruption,,,,,0
MS-DRG,362,Endoscopic Tubal Interruption,,,,,0
MS-DRG,363,"D&C, Conization & Radio-Implant, for Malignancy",,,,,0
MS-DRG,364,"D&C, Conization Except for Malignancy",,,,,0
MS-DRG,365,Other Female Reproductive System O.R. Procedures,,,,,0
MS-DRG,366,"Malignancy, female reproductive system w CC",,,,,0
MS-DRG,367,"Malignancy, Female Reproductive System w/o CC",,,,,0
MS-DRG,368,Major Esophageal Disorders With Mcc,,,13573.0,36956.56,18
MS-DRG,369,Major Esophageal Disorders With Cc,,,8977.97,22520.51,18
MS-DRG,370,Major Esophageal Disorders Without Cc/Mcc,,,6652.88,15445.22,18
MS-DRG,371,Major Gastrointestinal Disorders And Peritoneal Infections With Mcc,,,14980.16,38691.63,18
MS-DRG,372,Major Gastrointestinal Disorders And Peritoneal Infections With Cc,,,9139.49,22779.44,18
MS-DRG,373,Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc,,,6859.45,16051.61,18
MS-DRG,374,Digestive Malignancy With Mcc,,,17819.34,46729.61,18
MS-DRG,375,Digestive Malignancy With Cc,,,10604.13,27192.36,18
MS-DRG,376,Digestive Malignancy Without Cc/Mcc,,,8388.54,19539.46,18
MS-DRG,377,Gastrointestinal Hemorrhage With Mcc,,,15406.51,40236.37,18
MS-DRG,378,Gastrointestinal Hemorrhage With Cc,,,8826.53,21818.95,18
MS-DRG,379,Gastrointestinal Hemorrhage Without Cc/Mcc,,,6106.17,14088.59,18
MS-DRG,380,Complicated Peptic Ulcer With Mcc,,,16448.68,42586.68,18
MS-DRG,381,Complicated Peptic Ulcer With Cc,,,9624.86,24102.87,18
MS-DRG,382,Complicated Peptic Ulcer Without Cc/Mcc,,,7427.91,16582.76,18
MS-DRG,383,Uncomplicated Peptic Ulcer With Mcc,,,11932.86,27978.01,18
MS-DRG,384,Uncomplicated Peptic Ulcer Without Mcc,,,7848.82,19245.12,18
MS-DRG,385,Inflammatory Bowel Disease With Mcc,,,13498.45,35956.24,18
MS-DRG,386,Inflammatory Bowel Disease With Cc,,,8792.36,21962.8,18
MS-DRG,387,Inflammatory Bowel Disease Without Cc/Mcc,,,6501.45,14834.41,18
MS-DRG,388,Gastrointestinal Obstruction With Mcc,,,12679.15,32532.57,18
MS-DRG,389,Gastrointestinal Obstruction With Cc,,,7344.04,17742.42,18
MS-DRG,390,Gastrointestinal Obstruction Without Cc/Mcc,,,5435.2,12107.87,18
MS-DRG,391,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc",,,11059.98,28436.12,18
MS-DRG,392,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc",,,7264.83,17268.82,18
MS-DRG,393,Other Digestive System Diagnoses With Mcc,,,13630.46,36646.72,18
MS-DRG,394,Other Digestive System Diagnoses With Cc,,,8477.07,20831.91,18
MS-DRG,395,Other Digestive System Diagnoses Without Cc/Mcc,,,6250.61,14084.17,18
MS-DRG,396,Red Blood Cell Disorders Age 0-17,,,,,0
MS-DRG,397,Appendix Procedures With Mcc,,,19808.94,54831.77,18
MS-DRG,398,Appendix Procedures With Cc,,,12964.93,33490.84,18
MS-DRG,399,Appendix Procedures Without Cc/Mcc,,,10100.13,24877.46,18
MS-DRG,400,No Longer Valid,,,,,0
MS-DRG,401,Lymphoma & non-acute leukemia w other O.R. proc w CC,,,,,0
MS-DRG,402,Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical,,,32433.05,86957.13,18
MS-DRG,403,Lymphoma & non-acute leukemia w CC,,,,,0
MS-DRG,404,Lymphoma & Non-Acute Leukemia w/o CC,,,,,0
MS-DRG,405,"Pancreas, Liver And Shunt Procedures With Mcc",,,43693.48,120135.92,18
MS-DRG,406,"Pancreas, Liver And Shunt Procedures With Cc",,,23733.01,62148.27,18
MS-DRG,407,"Pancreas, Liver And Shunt Procedures Without Cc/Mcc",,,18447.6,47262.96,18
MS-DRG,408,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Mcc,,,28900.38,77482.84,18
MS-DRG,409,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Cc,,,18119.1,46393.22,18
MS-DRG,410,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. Without Cc/Mcc,,,13540.38,34325.18,18
MS-DRG,411,Cholecystectomy With C.D.E. With Mcc,,,26863.41,60559.27,18
MS-DRG,412,Cholecystectomy With C.D.E. With Cc,,,17538.22,47172.23,18
MS-DRG,413,Cholecystectomy With C.D.E. Without Cc/Mcc,,,14105.73,36790.57,18
MS-DRG,414,Cholecystectomy Except By Laparoscope Without C.D.E. With Mcc,,,28877.08,77538.17,18
MS-DRG,415,Cholecystectomy Except By Laparoscope Without C.D.E. With Cc,,,17260.2,43775.12,18
MS-DRG,416,Cholecystectomy Except By Laparoscope Without C.D.E. Without Cc/Mcc,,,11797.73,30323.9,18
MS-DRG,417,Laparoscopic Cholecystectomy Without C.D.E. With Mcc,,,19742.94,52594.32,18
MS-DRG,418,Laparoscopic Cholecystectomy Without C.D.E. With Cc,,,14347.25,36704.26,18
MS-DRG,419,Laparoscopic Cholecystectomy Without C.D.E. Without Cc/Mcc,,,11817.15,29159.81,18
MS-DRG,420,Hepatobiliary Diagnostic Procedures With Mcc,,,27669.5,78104.73,18
MS-DRG,421,Hepatobiliary Diagnostic Procedures With Cc,,,14703.7,36239.51,18
MS-DRG,422,Hepatobiliary Diagnostic Procedures Without Cc/Mcc,,,12078.85,32517.08,18
MS-DRG,423,Other Hepatobiliary Or Pancreas O.R. Procedures With Mcc,,,33462.02,90008.99,18
MS-DRG,424,Other Hepatobiliary Or Pancreas O.R. Procedures With Cc,,,18201.42,50527.29,18
MS-DRG,425,Other Hepatobiliary Or Pancreas O.R. Procedures Without Cc/Mcc,,,12861.65,34207.89,18
MS-DRG,426,Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical With Mcc Or Custom-Made,,,86799.17,231968.29,18
MS-DRG,427,Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical With Cc,,,57268.89,157101.33,18
MS-DRG,428,Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Without Cc/Mcc,,,44870.0,121835.58,18
MS-DRG,429,Combined Anterior And Posterior Cervical Spinal Fusion With Mcc,,,71177.47,184572.54,18
MS-DRG,430,Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc,,,45996.82,121058.78,18
MS-DRG,431,Childhood Mental Disorders,,,,,0
MS-DRG,432,Cirrhosis And Alcoholic Hepatitis With Mcc,,,16495.27,43356.84,18
MS-DRG,433,Cirrhosis And Alcoholic Hepatitis With Cc,,,9412.85,23673.53,18
MS-DRG,434,Cirrhosis And Alcoholic Hepatitis Without Cc/Mcc,,,6743.74,15412.03,18
MS-DRG,435,Malignancy Of Hepatobiliary System Or Pancreas With Mcc,,,15474.07,40378.01,18
MS-DRG,436,Malignancy Of Hepatobiliary System Or Pancreas With Cc,,,9994.51,24954.92,18
MS-DRG,437,Malignancy Of Hepatobiliary System Or Pancreas Without Cc/Mcc,,,7837.17,17375.05,18
MS-DRG,438,Disorders Of Pancreas Except Malignancy With Mcc,,,13870.43,36821.56,18
MS-DRG,439,Disorders Of Pancreas Except Malignancy With Cc,,,7743.2,19037.09,18
MS-DRG,440,Disorders Of Pancreas Except Malignancy Without Cc/Mcc,,,6036.28,13612.78,18
MS-DRG,441,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc",,,15147.9,41834.23,18
MS-DRG,442,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc",,,8706.94,21382.97,18
MS-DRG,443,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without Cc/Mcc",,,6644.34,15549.24,18
MS-DRG,444,Disorders Of The Biliary Tract With Mcc,,,14186.5,37279.67,18
MS-DRG,445,Disorders Of The Biliary Tract With Cc,,,9709.51,23998.86,18
MS-DRG,446,Disorders Of The Biliary Tract Without Cc/Mcc,,,7635.26,17642.83,18
MS-DRG,447,Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-Made Anatomically Designed Interbody,,,53098.65,148370.65,18
MS-DRG,448,Multiple Level Spinal Fusion Except Cervical Without Mcc,,,34143.86,90365.3,18
MS-DRG,449,Poisoning & toxic Effects of Drugs Age >17 w CC,,,,,0
MS-DRG,450,Single Level Spinal Fusion Except Cervical With Mcc Or Custom-Made Anatomically Designed Interbody F,,,42599.27,113968.01,18
MS-DRG,451,Single Level Spinal Fusion Except Cervical Without Mcc,,,26297.28,68291.84,18
MS-DRG,452,Complications of treatment w CC,,,,,0
MS-DRG,453,Combined Anterior And Posterior Spinal Fusion With Mcc,,,,,0
MS-DRG,454,Combined Anterior And Posterior Spinal Fusion With Cc,,,106753.9,143145.89,6
MS-DRG,455,Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc,,,85143.73,91107.98,3
MS-DRG,456,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Extensive Fusions With",,,66469.83,187418.59,18
MS-DRG,457,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Extensive Fusions With",,,47518.92,127009.81,18
MS-DRG,458,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Extensive Fusions With",,,33614.23,95555.02,18
MS-DRG,459,Spinal Fusion Except Cervical With Mcc,,,,,0
MS-DRG,460,Spinal Fusion Except Cervical Without Mcc,,,63844.99,85609.49,6
MS-DRG,461,Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc,,,44101.18,135811.31,18
MS-DRG,462,Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc,,,21867.66,63374.33,18
MS-DRG,463,Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders Wit,,,45471.85,119522.89,18
MS-DRG,464,Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders Wit,,,25398.78,65255.47,18
MS-DRG,465,Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders Wit,,,15373.11,38417.2,18
MS-DRG,466,Revision Of Hip Or Knee Replacement With Mcc,,,41634.76,112741.95,18
MS-DRG,467,Revision Of Hip Or Knee Replacement With Cc,,,28597.51,75796.46,18
MS-DRG,468,Revision Of Hip Or Knee Replacement Without Cc/Mcc,,,22551.05,58054.04,18
MS-DRG,469,Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc Or Total Ankle Repl,,,24765.86,72335.17,18
MS-DRG,470,Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc,,,16190.08,41728.0,18
MS-DRG,471,Cervical Spinal Fusion With Mcc,,,38709.38,107490.27,18
MS-DRG,472,Cervical Spinal Fusion With Cc,,,24089.46,64113.51,18
MS-DRG,473,Cervical Spinal Fusion Without Cc/Mcc,,,20169.28,52388.5,18
MS-DRG,474,Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc,,,34548.46,99244.26,18
MS-DRG,475,Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc,,,18883.26,47738.78,18
MS-DRG,476,Amputation For Musculoskeletal System And Connective Tissue Disorders Without Cc/Mcc,,,10375.81,25738.35,18
MS-DRG,477,Biopsies Of Musculoskeletal System And Connective Tissue With Mcc,,,28038.38,76104.08,18
MS-DRG,478,Biopsies Of Musculoskeletal System And Connective Tissue With Cc,,,20308.29,51751.13,18
MS-DRG,479,Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/Mcc,,,15646.47,39298.02,18
MS-DRG,480,Hip And Femur Procedures Except Major Joint With Mcc,,,23826.98,65087.27,18
MS-DRG,481,Hip And Femur Procedures Except Major Joint With Cc,,,17476.09,45919.61,18
MS-DRG,482,Hip And Femur Procedures Except Major Joint Without Cc/Mcc,,,13876.64,35108.62,18
MS-DRG,483,Major Joint Or Limb Reattachment Procedures Of Upper Extremities,,,22736.66,56392.0,18
MS-DRG,484,Major joint & limb reattachment proc of upper extremity w/o CC/MCC,,,,,0
MS-DRG,485,Knee Procedures With Principal Diagnosis Of Infection With Mcc,,,26271.65,71341.49,18
MS-DRG,486,Knee Procedures With Principal Diagnosis Of Infection With Cc,,,17449.69,46933.21,18
MS-DRG,487,Knee Procedures With Principal Diagnosis Of Infection Without Cc/Mcc,,,13373.42,34969.19,18
MS-DRG,488,Knee Procedures Without Principal Diagnosis Of Infection With Cc/Mcc,,,14947.55,43494.05,18
MS-DRG,489,Knee Procedures Without Principal Diagnosis Of Infection Without Cc/Mcc,,,9883.46,27411.46,18
MS-DRG,490,Back & neck proc exc spinal fusion w CC/MCC or disc device/neurostim,,,,,0
MS-DRG,491,Back & neck proc exc spinal fusion w/o CC/MCC,,,,,0
MS-DRG,492,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc",,,29723.56,78587.18,18
MS-DRG,493,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc",,,20905.48,53136.53,18
MS-DRG,494,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc",,,16792.7,41728.0,18
MS-DRG,495,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Mcc,,,29367.11,77907.76,18
MS-DRG,496,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Cc,,,15219.35,43662.25,18
MS-DRG,497,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Without Cc/Mcc,,,10594.03,29721.93,18
MS-DRG,498,Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc/Mcc,,,24638.5,55874.14,18
MS-DRG,499,Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without Cc/Mcc,,,16857.16,25689.66,18
MS-DRG,500,Soft Tissue Procedures With Mcc,,,25787.84,70122.07,18
MS-DRG,501,Soft Tissue Procedures With Cc,,,14786.02,39501.62,18
MS-DRG,502,Soft Tissue Procedures Without Cc/Mcc,,,11662.61,30919.22,18
MS-DRG,503,Foot Procedures With Mcc,,,22885.76,58569.69,18
MS-DRG,504,Foot Procedures With Cc,,,15726.46,38853.18,18
MS-DRG,505,Foot Procedures Without Cc/Mcc,,,15133.15,38853.18,18
MS-DRG,506,Major Thumb Or Joint Procedures,,,11688.23,33174.37,18
MS-DRG,507,Major Shoulder Or Elbow Joint Procedures With Cc/Mcc,,,15238.76,42892.09,18
MS-DRG,508,Major Shoulder Or Elbow Joint Procedures Without Cc/Mcc,,,12971.15,28562.27,18
MS-DRG,509,Arthroscopy,,,30657.95,38873.1,6
MS-DRG,510,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc",,,24667.24,63250.4,18
MS-DRG,511,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc",,,17358.83,43407.74,18
MS-DRG,512,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/Mcc",,,14066.13,35580.01,18
MS-DRG,513,"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/Mcc",,,13436.32,33318.22,18
MS-DRG,514,"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/Mcc",,,9149.59,22564.77,18
MS-DRG,515,Other Musculoskeletal System And Connective Tissue O.R. Procedures With Mcc,,,25959.47,68433.48,18
MS-DRG,516,Other Musculoskeletal System And Connective Tissue O.R. Procedures With Cc,,,17348.74,44518.72,18
MS-DRG,517,Other Musculoskeletal System And Connective Tissue O.R. Procedures Without Cc/Mcc,,,13144.32,33032.73,18
MS-DRG,518,Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurostimulator,,,30233.77,79313.08,18
MS-DRG,519,Back And Neck Procedures Except Spinal Fusion With Cc,,,16743.78,43635.69,18
MS-DRG,520,Back And Neck Procedures Except Spinal Fusion Without Cc/Mcc,,,12811.95,31715.94,18
MS-DRG,521,Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc,,,23500.04,64503.01,18
MS-DRG,522,Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc,,,17656.26,46656.57,18
MS-DRG,523,Alc/Drug Abuse or Depend w/o Rehabilitation therapy w/o CC,,,,,0
MS-DRG,524,Transient ischemia,,,,,0
MS-DRG,525,Other heart assist system implant,,,,,0
MS-DRG,526,No Longer Valid,,,,,0
MS-DRG,527,No Longer Valid,,,,,0
MS-DRG,528,Intracranial Vascular Proc w Pdx Hemorrhage,,,,,0
MS-DRG,529,Ventricular shunt procedures w CC,,,,,0
MS-DRG,530,Ventricular Shunt Procedures w/o CC,,,,,0
MS-DRG,531,Spinal Procedures w CC,,,,,0
MS-DRG,532,Spinal Procedures w/o CC,,,,,0
MS-DRG,533,Fractures Of Femur With Mcc,,,13385.06,33745.35,18
MS-DRG,534,Fractures Of Femur Without Mcc,,,7470.62,18012.42,18
MS-DRG,535,Fractures Of Hip And Pelvis With Mcc,,,11166.37,29432.02,18
MS-DRG,536,Fractures Of Hip And Pelvis Without Mcc,,,7482.27,17946.03,18
MS-DRG,537,"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh With Cc/Mcc",,,8621.51,20336.18,18
MS-DRG,538,"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh Without Cc/Mcc",,,6804.31,14860.97,18
MS-DRG,539,Osteomyelitis With Mcc,,,16506.92,44764.37,18
MS-DRG,540,Osteomyelitis With Cc,,,11277.42,28646.37,18
MS-DRG,541,Osteomyelitis Without Cc/Mcc,,,7325.4,19360.2,18
MS-DRG,542,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Mcc,,,14928.91,41272.1,18
MS-DRG,543,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Cc,,,9193.86,23476.56,18
MS-DRG,544,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy Without Cc/Mcc,,,7070.68,16724.4,18
MS-DRG,545,Connective Tissue Disorders With Mcc,,,20483.02,55918.4,18
MS-DRG,546,Connective Tissue Disorders With Cc,,,10167.69,25621.06,18
MS-DRG,547,Connective Tissue Disorders Without Cc/Mcc,,,7704.37,16514.15,18
MS-DRG,548,Septic Arthritis With Mcc,,,16205.61,44582.9,18
MS-DRG,549,Septic Arthritis With Cc,,,10585.49,26667.86,18
MS-DRG,550,Septic Arthritis Without Cc/Mcc,,,7998.7,19079.14,18
MS-DRG,551,Medical Back Problems With Mcc,,,14226.88,37762.13,18
MS-DRG,552,Medical Back Problems Without Mcc,,,8675.88,21329.86,18
MS-DRG,553,Bone Diseases And Arthropathies With Mcc,,,11277.42,28909.73,18
MS-DRG,554,Bone Diseases And Arthropathies Without Mcc,,,7657.0,18470.53,18
MS-DRG,555,Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc,,,11475.45,29799.39,18
MS-DRG,556,Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc,,,7660.88,18069.96,18
MS-DRG,557,"Tendonitis, Myositis And Bursitis With Mcc",,,12757.59,34296.41,18
MS-DRG,558,"Tendonitis, Myositis And Bursitis Without Mcc",,,8147.02,19116.76,18
MS-DRG,559,"Aftercare, Musculoskeletal System And Connective Tissue With Mcc",,,15693.06,41077.35,18
MS-DRG,560,"Aftercare, Musculoskeletal System And Connective Tissue With Cc",,,9955.68,25202.78,18
MS-DRG,561,"Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc",,,7453.54,18094.31,18
MS-DRG,562,"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh With Mcc",,,12275.33,32393.14,18
MS-DRG,563,"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Without Mcc",,,8164.89,19778.47,18
MS-DRG,564,Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc,,,13197.91,34727.97,18
MS-DRG,565,Other Musculoskeletal System And Connective Tissue Diagnoses With Cc,,,8777.61,22564.77,18
MS-DRG,566,Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc,,,7029.52,16553.99,18
MS-DRG,567,"Stomach, Esophageal & Duodenal Proc Age > 17 w CC w Major Gi Dx",,,,,0
MS-DRG,568,"Stomach, Esophageal & Duodenal Procedures Proc Age > 17 w CC w/o Major Gi Dx",,,,,0
MS-DRG,569,Major Small & Large Bowel Procedures w CC w Major Gi Dx,,,,,0
MS-DRG,570,Skin Debridement With Mcc,,,24050.63,66623.16,18
MS-DRG,571,Skin Debridement With Cc,,,14330.94,37065.0,18
MS-DRG,572,Skin Debridement Without Cc/Mcc,,,10112.55,25282.45,18
MS-DRG,573,Skin Graft For Skin Ulcer Or Cellulitis With Mcc,,,52087.54,136278.27,18
MS-DRG,574,Skin Graft For Skin Ulcer Or Cellulitis With Cc,,,28168.84,76677.28,18
MS-DRG,575,Skin Graft For Skin Ulcer Or Cellulitis Without Cc/Mcc,,,15165.77,44184.54,18
MS-DRG,576,Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc,,,39272.4,119394.53,18
MS-DRG,577,Skin Graft Except For Skin Ulcer Or Cellulitis With Cc,,,21795.44,58926.0,18
MS-DRG,578,Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/Mcc,,,13685.6,37408.03,18
MS-DRG,579,"Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc",,,26360.18,72127.14,18
MS-DRG,580,"Other Skin, Subcutaneous Tissue And Breast Procedures With Cc",,,14629.92,39236.05,18
MS-DRG,581,"Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc",,,12417.44,31848.72,18
MS-DRG,582,Mastectomy For Malignancy With Cc/Mcc,,,16172.21,38753.59,18
MS-DRG,583,Mastectomy For Malignancy Without Cc/Mcc,,,14601.97,36350.17,18
MS-DRG,584,"Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc",,,17834.88,45308.8,18
MS-DRG,585,"Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc",,,16191.63,43930.04,18
MS-DRG,592,Skin Ulcers With Mcc,,,16239.78,45505.76,18
MS-DRG,593,Skin Ulcers With Cc,,,10423.18,27057.36,18
MS-DRG,594,Skin Ulcers Without Cc/Mcc,,,7942.01,18780.37,18
MS-DRG,595,Major Skin Disorders With Mcc,,,17679.56,46807.07,18
MS-DRG,596,Major Skin Disorders Without Mcc,,,9617.09,23923.61,18
MS-DRG,597,Malignant Breast Disorders With Mcc,,,14156.99,38873.1,18
MS-DRG,598,Malignant Breast Disorders With Cc,,,9996.06,23877.14,18
MS-DRG,599,Malignant Breast Disorders Without Cc/Mcc,,,7185.62,18919.79,18
MS-DRG,600,Non-Malignant Breast Disorders With Cc/Mcc,,,9299.47,21183.79,18
MS-DRG,601,Non-Malignant Breast Disorders Without Cc/Mcc,,,5908.92,13267.53,18
MS-DRG,602,Cellulitis With Mcc,,,12248.15,32519.29,18
MS-DRG,603,Cellulitis Without Mcc,,,7973.85,19495.2,18
MS-DRG,604,"Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc",,,12642.65,32880.03,18
MS-DRG,605,"Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc",,,8324.08,20442.4,18
MS-DRG,606,Minor Skin Disorders With Mcc,,,12961.83,35633.12,18
MS-DRG,607,Minor Skin Disorders Without Mcc,,,8249.53,19127.82,18
MS-DRG,614,Adrenal And Pituitary Procedures With Cc/Mcc,,,18231.71,50432.12,18
MS-DRG,615,Adrenal And Pituitary Procedures Without Cc/Mcc,,,12077.3,31711.51,18
MS-DRG,616,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Mcc",,,28293.09,85534.1,18
MS-DRG,617,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Cc",,,15735.0,42761.52,18
MS-DRG,618,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc",,,12224.85,27553.1,18
MS-DRG,619,O.R. Procedures For Obesity With Mcc,,,23633.61,60337.96,18
MS-DRG,620,O.R. Procedures For Obesity With Cc,,,13638.23,35340.99,18
MS-DRG,621,O.R. Procedures For Obesity Without Cc/Mcc,,,12924.55,32348.88,18
MS-DRG,622,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Mcc",,,28850.68,82858.46,18
MS-DRG,623,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Cc",,,15141.69,42358.73,18
MS-DRG,624,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc",,,10932.62,22199.61,18
MS-DRG,625,"Thyroid, Parathyroid And Thyroglossal Procedures With Mcc",,,24664.13,63447.36,18
MS-DRG,626,"Thyroid, Parathyroid And Thyroglossal Procedures With Cc",,,12854.66,33400.11,18
MS-DRG,627,"Thyroid, Parathyroid And Thyroglossal Procedures Without Cc/Mcc",,,11525.93,28035.55,18
MS-DRG,628,"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Mcc",,,30152.23,87335.57,18
MS-DRG,629,"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Cc",,,18130.75,49796.96,18
MS-DRG,630,"Other Endocrine, Nutritional And Metabolic O.R. Procedures Without Cc/Mcc",,,12544.8,31009.96,18
MS-DRG,637,Diabetes With Mcc,,,12367.74,32229.38,18
MS-DRG,638,Diabetes With Cc,,,8170.32,20298.55,18
MS-DRG,639,Diabetes Without Cc/Mcc,,,6034.72,13867.28,18
MS-DRG,640,"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With Mcc",,,11582.62,29392.18,18
MS-DRG,641,"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Without Mcc",,,7253.96,17295.38,18
MS-DRG,642,Inborn And Other Disorders Of Metabolism,,,12254.36,27466.78,18
MS-DRG,643,Endocrine Disorders With Mcc,,,13993.9,36677.71,18
MS-DRG,644,Endocrine Disorders With Cc,,,9170.56,22872.39,18
MS-DRG,645,Endocrine Disorders Without Cc/Mcc,,,7177.07,17240.05,18
MS-DRG,650,Kidney Transplant With Hemodialysis With Mcc,,,37720.79,101957.52,18
MS-DRG,651,Kidney Transplant With Hemodialysis Without Mcc,,,29989.15,76843.26,18
MS-DRG,652,Kidney Transplant,,,26290.29,67968.73,18
MS-DRG,653,Major Bladder Procedures With Mcc,,,41564.87,123362.62,18
MS-DRG,654,Major Bladder Procedures With Cc,,,22949.44,62451.47,18
MS-DRG,655,Major Bladder Procedures Without Cc/Mcc,,,17647.72,45970.51,18
MS-DRG,656,Kidney And Ureter Procedures For Neoplasm With Mcc,,,25935.39,72096.16,18
MS-DRG,657,Kidney And Ureter Procedures For Neoplasm With Cc,,,15422.04,40455.47,18
MS-DRG,658,Kidney And Ureter Procedures For Neoplasm Without Cc/Mcc,,,13261.59,33282.81,18
MS-DRG,659,Kidney And Ureter Procedures For Non-Neoplasm With Mcc,,,20942.75,57190.93,18
MS-DRG,660,Kidney And Ureter Procedures For Non-Neoplasm With Cc,,,11474.67,29653.33,18
MS-DRG,661,Kidney And Ureter Procedures For Non-Neoplasm Without Cc/Mcc,,,9251.32,22719.68,18
MS-DRG,662,Minor Bladder Procedures With Mcc,,,24985.64,69035.44,18
MS-DRG,663,Minor Bladder Procedures With Cc,,,13016.19,33800.68,18
MS-DRG,664,Minor Bladder Procedures Without Cc/Mcc,,,9340.63,23897.05,18
MS-DRG,665,Prostatectomy With Mcc,,,25449.25,75984.58,18
MS-DRG,666,Prostatectomy With Cc,,,14795.34,36454.18,18
MS-DRG,667,Prostatectomy Without Cc/Mcc,,,9801.14,22744.03,18
MS-DRG,668,Transurethral Procedures With Mcc,,,23886.77,64536.21,18
MS-DRG,669,Transurethral Procedures With Cc,,,13263.14,34247.72,18
MS-DRG,670,Transurethral Procedures Without Cc/Mcc,,,8800.13,21148.38,18
MS-DRG,671,Urethral Procedures With Cc/Mcc,,,15150.23,38144.99,18
MS-DRG,672,Urethral Procedures Without Cc/Mcc,,,9593.79,24217.95,18
MS-DRG,673,Other Kidney And Urinary Tract Procedures With Mcc,,,33839.44,92728.89,18
MS-DRG,674,Other Kidney And Urinary Tract Procedures With Cc,,,19371.73,51084.99,18
MS-DRG,675,Other Kidney And Urinary Tract Procedures Without Cc/Mcc,,,13957.4,34639.44,18
MS-DRG,682,Renal Failure With Mcc,,,12711.77,33240.76,18
MS-DRG,683,Renal Failure With Cc,,,8011.9,19672.25,18
MS-DRG,684,Renal Failure Without Cc/Mcc,,,5872.42,13444.58,18
MS-DRG,685,Admit For Renal Dialysis,,,,,0
MS-DRG,686,Kidney And Urinary Tract Neoplasms With Mcc,,,15217.8,41730.21,18
MS-DRG,687,Kidney And Urinary Tract Neoplasms With Cc,,,9347.62,23295.09,18
MS-DRG,688,Kidney And Urinary Tract Neoplasms Without Cc/Mcc,,,7347.92,16027.27,18
MS-DRG,689,Kidney And Urinary Tract Infections With Mcc,,,10221.27,25902.12,18
MS-DRG,690,Kidney And Urinary Tract Infections Without Mcc,,,7497.03,17762.34,18
MS-DRG,691,Urinary Stones W Esw Lithotripsy W Cc/Mcc,,,,,0
MS-DRG,692,Urinary Stones W Esw Lithotripsy W/O Cc/Mcc,,,,,0
MS-DRG,693,Urinary Stones With Mcc,,,11651.74,32539.21,18
MS-DRG,694,Urinary Stones Without Mcc,,,7281.14,17293.16,18
MS-DRG,695,Kidney And Urinary Tract Signs And Symptoms With Mcc,,,10093.14,24957.13,18
MS-DRG,696,Kidney And Urinary Tract Signs And Symptoms Without Mcc,,,6561.24,15308.01,18
MS-DRG,697,Urethral Stricture,,,9580.59,22170.84,18
MS-DRG,698,Other Kidney And Urinary Tract Diagnoses With Mcc,,,14058.36,37200.0,18
MS-DRG,699,Other Kidney And Urinary Tract Diagnoses With Cc,,,9092.9,22569.19,18
MS-DRG,700,Other Kidney And Urinary Tract Diagnoses Without Cc/Mcc,,,6568.23,15361.13,18
MS-DRG,707,Major Male Pelvic Procedures With Cc/Mcc,,,16744.55,42945.21,18
MS-DRG,708,Major Male Pelvic Procedures Without Cc/Mcc,,,13124.91,32806.99,18
MS-DRG,709,Penis Procedures With Cc/Mcc,,,19282.42,49728.36,18
MS-DRG,710,Penis Procedures Without Cc/Mcc,,,12092.06,33225.27,18
MS-DRG,711,Testes Procedures With Cc/Mcc,,,17393.0,42283.49,18
MS-DRG,712,Testes Procedures Without Cc/Mcc,,,9750.66,23671.32,18
MS-DRG,713,Transurethral Prostatectomy With Cc/Mcc,,,12885.72,31999.21,18
MS-DRG,714,Transurethral Prostatectomy Without Cc/Mcc,,,9422.17,20794.29,18
MS-DRG,715,Other Male Reproductive System O.R. Procedures For Malignancy With Cc/Mcc,,,18585.05,49976.22,18
MS-DRG,716,Other Male Reproductive System O.R. Procedures For Malignancy Without Cc/Mcc,,,12634.11,31408.32,18
MS-DRG,717,Other Male Reproductive System O.R. Procedures Except Malignancy With Cc/Mcc,,,15891.87,41061.86,18
MS-DRG,718,Other Male Reproductive System O.R. Procedures Except Malignancy Without Cc/Mcc,,,11640.86,27260.97,18
MS-DRG,722,"Malignancy, Male Reproductive System With Mcc",,,15264.39,38260.07,18
MS-DRG,723,"Malignancy, Male Reproductive System With Cc",,,10084.59,24850.9,18
MS-DRG,724,"Malignancy, Male Reproductive System Without Cc/Mcc",,,6302.64,16124.65,18
MS-DRG,725,Benign Prostatic Hypertrophy With Mcc,,,10298.15,27953.67,18
MS-DRG,726,Benign Prostatic Hypertrophy Without Mcc,,,6817.52,16472.1,18
MS-DRG,727,Inflammation Of The Male Reproductive System With Mcc,,,12726.52,32517.08,18
MS-DRG,728,Inflammation Of The Male Reproductive System Without Mcc,,,7510.23,18083.24,18
MS-DRG,729,Other Male Reproductive System Diagnoses With Cc/Mcc,,,9432.27,24361.8,18
MS-DRG,730,Other Male Reproductive System Diagnoses Without Cc/Mcc,,,6429.23,13431.3,18
MS-DRG,734,"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc",,,17751.78,46534.85,18
MS-DRG,735,"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/Mcc",,,11659.5,26862.61,18
MS-DRG,736,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc,,,28969.5,87136.39,18
MS-DRG,737,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc,,,17212.83,44224.38,18
MS-DRG,738,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/Mcc,,,12614.7,33568.3,18
MS-DRG,739,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Mcc,,,29033.95,88096.87,18
MS-DRG,740,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Cc,,,15263.61,40238.58,18
MS-DRG,741,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy Without Cc/Mcc,,,12285.43,30396.93,18
MS-DRG,742,Uterine And Adnexa Procedures For Non-Malignancy With Cc/Mcc,,,15459.31,40424.48,18
MS-DRG,743,Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc,,,10845.64,26526.22,18
MS-DRG,744,"D&C, Conization, Laparoscopy And Tubal Interruption With Cc/Mcc",,,17123.53,43241.76,18
MS-DRG,745,"D&C, Conization, Laparoscopy And Tubal Interruption Without Cc/Mcc",,,10044.21,22679.85,18
MS-DRG,746,"Vagina, Cervix And Vulva Procedures With Cc/Mcc",,,14700.59,37058.36,18
MS-DRG,747,"Vagina, Cervix And Vulva Procedures Without Cc/Mcc",,,7886.87,21137.32,18
MS-DRG,748,Female Reproductive System Reconstructive Procedures,,,11984.11,30146.85,18
MS-DRG,749,Other Female Reproductive System O.R. Procedures With Cc/Mcc,,,21150.1,57283.88,18
MS-DRG,750,Other Female Reproductive System O.R. Procedures Without Cc/Mcc,,,12671.39,28537.92,18
MS-DRG,754,"Malignancy, Female Reproductive System With Mcc",,,15512.9,40039.41,18
MS-DRG,755,"Malignancy, Female Reproductive System With Cc",,,9658.25,24567.62,18
MS-DRG,756,"Malignancy, Female Reproductive System Without Cc/Mcc",,,8669.66,21132.89,18
MS-DRG,757,"Infections, Female Reproductive System With Mcc",,,12330.47,31319.79,18
MS-DRG,758,"Infections, Female Reproductive System With Cc",,,8813.33,22558.13,18
MS-DRG,759,"Infections, Female Reproductive System Without Cc/Mcc",,,6363.99,14161.63,18
MS-DRG,760,Menstrual And Other Female Reproductive System Disorders With Cc/Mcc,,,9034.66,21810.1,18
MS-DRG,761,Menstrual And Other Female Reproductive System Disorders Without Cc/Mcc,,,5641.0,14028.84,18
MS-DRG,765,Cesarean Section W Cc/Mcc,,,,,0
MS-DRG,766,Cesarean Section W/O Cc/Mcc,,,,,0
MS-DRG,767,Vaginal Delivery W Sterilization &/Or D&C,,,,,0
MS-DRG,768,Vaginal Delivery With O.R. Procedures Except Sterilization And/Or D&C,,,9532.44,24262.22,18
MS-DRG,769,Postpartum And Post Abortion Diagnoses With O.R. Procedures,,,14333.27,30751.02,18
MS-DRG,770,"Abortion With D&C, Aspiration Curettage Or Hysterotomy",,,8997.38,23810.74,18
MS-DRG,774,Vaginal Delivery W Complicating Diagnoses,,,,,0
MS-DRG,775,Vaginal Delivery W/O Complicating Diagnoses,,,,,0
MS-DRG,776,Postpartum And Post Abortion Diagnoses Without O.R. Procedures,,,6294.88,15788.26,18
MS-DRG,777,Ectopic Pregnancy,,,,,0
MS-DRG,778,Threatened Abortion,,,,,0
MS-DRG,779,Abortion Without D&C,,,7743.98,20685.85,18
MS-DRG,780,False Labor,,,,,0
MS-DRG,781,Other Antepartum Diagnoses W Medical Complications,,,,,0
MS-DRG,782,Other Antepartum Diagnoses W/O Medical Complications,,,,,0
MS-DRG,783,Cesarean Section With Sterilization With Mcc,,,20276.45,40765.3,18
MS-DRG,784,Cesarean Section With Sterilization With Cc,,,9443.14,23967.87,18
MS-DRG,785,Cesarean Section With Sterilization Without Cc/Mcc,,,8648.7,19362.41,18
MS-DRG,786,Cesarean Section Without Sterilization With Mcc,,,14020.31,35759.27,18
MS-DRG,787,Cesarean Section Without Sterilization With Cc,,,9883.46,23498.7,18
MS-DRG,788,Cesarean Section Without Sterilization Without Cc/Mcc,,,8656.46,20028.56,18
MS-DRG,789,"Neonates, Died Or Transferred To Another Acute Care Facility",,,15206.15,39895.55,18
MS-DRG,790,"Extreme Immaturity Or Respiratory Distress Syndrome, Neonate",,,47366.71,131568.8,18
MS-DRG,791,Prematurity With Major Problems,,,32732.03,89854.07,18
MS-DRG,792,Prematurity Without Major Problems,,,20230.63,54216.52,18
MS-DRG,793,Full Term Neonate With Major Problems,,,33590.93,92299.55,18
MS-DRG,794,Neonate With Other Significant Problems,,,12672.16,32669.78,18
MS-DRG,795,Normal Newborn,,,2762.21,4421.77,18
MS-DRG,796,Vaginal Delivery With Sterilization And/Or D&C With Mcc,,,10273.3,28252.43,18
MS-DRG,797,Vaginal Delivery With Sterilization And/Or D&C With Cc,,,8979.52,21427.23,18
MS-DRG,798,Vaginal Delivery With Sterilization And/Or D&C Without Cc/Mcc,,,8643.26,21427.23,18
MS-DRG,799,Splenic Procedures With Mcc,,,36381.19,105221.84,18
MS-DRG,800,Splenic Procedures With Cc,,,23027.87,64480.88,18
MS-DRG,801,Splenic Procedures Without Cc/Mcc,,,16034.76,36332.46,18
MS-DRG,802,Other O.R. Procedures Of The Blood And Blood Forming Organs With Mcc,,,32150.37,79330.78,18
MS-DRG,803,Other O.R. Procedures Of The Blood And Blood Forming Organs With Cc,,,15646.47,39390.97,18
MS-DRG,804,Other O.R. Procedures Of The Blood And Blood Forming Organs Without Cc/Mcc,,,11741.04,24465.82,18
MS-DRG,805,Vaginal Delivery Without Sterilization Or D&C With Mcc,,,9591.46,22084.52,18
MS-DRG,806,Vaginal Delivery Without Sterilization Or D&C With Cc,,,7066.02,16011.78,18
MS-DRG,807,Vaginal Delivery Without Sterilization Or D&C Without Cc/Mcc,,,6446.31,14101.87,18
MS-DRG,808,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders ,,,18356.74,50688.84,18
MS-DRG,809,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders ,,,11041.34,27409.24,18
MS-DRG,810,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders ,,,9338.3,21062.07,18
MS-DRG,811,Red Blood Cell Disorders With Mcc,,,12116.13,31133.89,18
MS-DRG,812,Red Blood Cell Disorders Without Mcc,,,8341.17,20424.7,18
MS-DRG,813,Coagulation Disorders,,,13055.79,34256.57,18
MS-DRG,814,Reticuloendothelial And Immunity Disorders With Mcc,,,17726.15,46260.43,18
MS-DRG,815,Reticuloendothelial And Immunity Disorders With Cc,,,9085.13,22487.31,18
MS-DRG,816,Reticuloendothelial And Immunity Disorders Without Cc/Mcc,,,6118.59,14593.18,18
MS-DRG,817,Other Antepartum Diagnoses With O.R. Procedures With Mcc,,,18929.08,56104.3,18
MS-DRG,818,Other Antepartum Diagnoses With O.R. Procedures With Cc,,,10212.73,28504.73,18
MS-DRG,819,Other Antepartum Diagnoses With O.R. Procedures Without Cc/Mcc,,,7888.42,18069.96,18
MS-DRG,820,Lymphoma And Leukemia With Major O.R. Procedures With Mcc,,,46755.54,128844.47,18
MS-DRG,821,Lymphoma And Leukemia With Major O.R. Procedures With Cc,,,18595.15,49400.82,18
MS-DRG,822,Lymphoma And Leukemia With Major O.R. Procedures Without Cc/Mcc,,,10560.64,25309.01,18
MS-DRG,823,Lymphoma And Non-Acute Leukemia With Other Procedures With Mcc,,,36815.3,103555.38,18
MS-DRG,824,Lymphoma And Non-Acute Leukemia With Other Procedures With Cc,,,18804.83,48672.71,18
MS-DRG,825,Lymphoma And Non-Acute Leukemia With Other Procedures Without Cc/Mcc,,,11689.79,27236.62,18
MS-DRG,826,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures With Mcc,,,37537.52,105679.95,18
MS-DRG,827,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures With Cc,,,19158.95,52222.52,18
MS-DRG,828,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures Without C,,,14441.99,35471.57,18
MS-DRG,829,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures With Cc/Mcc,,,25750.57,68243.15,18
MS-DRG,830,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures Without Cc/Mcc,,,12898.15,32364.37,18
MS-DRG,831,Other Antepartum Diagnoses Without O.R. Procedures With Mcc,,,10548.99,25470.57,18
MS-DRG,832,Other Antepartum Diagnoses Without O.R. Procedures With Cc,,,6814.41,16538.5,18
MS-DRG,833,Other Antepartum Diagnoses Without O.R. Procedures Without Cc/Mcc,,,5271.34,11503.69,18
MS-DRG,834,Acute Leukemia With Mcc,,,43844.13,122315.82,18
MS-DRG,835,Acute Leukemia With Cc,,,17408.53,47267.39,18
MS-DRG,836,Acute Leukemia Without Cc/Mcc,,,10681.01,28121.86,18
MS-DRG,837,Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemotherapy Agent With Mc,,,38519.89,110805.49,18
MS-DRG,838,Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Chemotherapy Agent,,,17420.96,44883.88,18
MS-DRG,839,Chemotherapy With Acute Leukemia As Secondary Diagnosis Without Cc/Mcc,,,12423.66,30326.11,18
MS-DRG,840,Lymphoma And Non-Acute Leukemia With Mcc,,,26332.23,70584.61,18
MS-DRG,841,Lymphoma And Non-Acute Leukemia With Cc,,,13879.75,34699.19,18
MS-DRG,842,Lymphoma And Non-Acute Leukemia Without Cc/Mcc,,,9057.18,23277.39,18
MS-DRG,843,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Mcc,,,16701.84,41896.2,18
MS-DRG,844,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Cc,,,10664.7,26448.76,18
MS-DRG,845,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses Without Cc/Mcc,,,7823.97,18517.01,18
MS-DRG,846,Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc,,,21343.47,56513.72,18
MS-DRG,847,Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc,,,11369.84,28119.65,18
MS-DRG,848,Chemotherapy Without Acute Leukemia As Secondary Diagnosis Without Cc/Mcc,,,7806.88,18123.08,18
MS-DRG,849,Radiotherapy,,,22252.07,59109.69,18
MS-DRG,850,Acute Leukemia With Other Procedures,,,68458.65,203855.28,18
MS-DRG,853,Infectious And Parasitic Diseases With O.R. Procedures With Mcc,,,39562.84,110688.2,18
MS-DRG,854,Infectious And Parasitic Diseases With O.R. Procedures With Cc,,,16727.47,44222.16,18
MS-DRG,855,Infectious And Parasitic Diseases With O.R. Procedures Without Cc/Mcc,,,12837.57,35973.94,18
MS-DRG,856,Postoperative Or Post-Traumatic Infections With O.R. Procedures With Mcc,,,36534.95,99839.58,18
MS-DRG,857,Postoperative Or Post-Traumatic Infections With O.R. Procedures With Cc,,,17841.09,48221.24,18
MS-DRG,858,Postoperative Or Post-Traumatic Infections With O.R. Procedures Without Cc/Mcc,,,12027.6,28513.58,18
MS-DRG,862,Postoperative And Post-Traumatic Infections With Mcc,,,15373.11,40690.06,18
MS-DRG,863,Postoperative And Post-Traumatic Infections Without Mcc,,,8960.1,22128.79,18
MS-DRG,864,Fever And Inflammatory Conditions,,,8104.31,19871.42,18
MS-DRG,865,Viral Illness With Mcc,,,12846.12,32663.14,18
MS-DRG,866,Viral Illness Without Mcc,,,7963.75,19579.3,18
MS-DRG,867,Other Infectious And Parasitic Diseases Diagnoses With Mcc,,,17466.0,47453.29,18
MS-DRG,868,Other Infectious And Parasitic Diseases Diagnoses With Cc,,,9217.93,23237.55,18
MS-DRG,869,Other Infectious And Parasitic Diseases Diagnoses Without Cc/Mcc,,,6877.31,15923.25,18
MS-DRG,870,Septicemia Or Severe Sepsis With Mv >96 Hours,,,54886.34,153954.3,18
MS-DRG,871,Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc,,,16295.69,43427.66,18
MS-DRG,872,Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc,,,9157.36,22817.06,18
MS-DRG,876,O.R. Procedures With Principal Diagnosis Of Mental Illness,,,31224.69,86961.55,18
MS-DRG,880,Acute Adjustment Reaction And Psychosocial Dysfunction,,,8667.33,21214.78,18
MS-DRG,881,Depressive Neuroses,,,8517.45,20229.95,18
MS-DRG,882,Neuroses Except Depressive,,,9549.53,21287.81,18
MS-DRG,883,Disorders Of Personality And Impulse Control,,,16480.52,41083.99,18
MS-DRG,884,Organic Disturbances And Intellectual Disability,,,13705.02,36960.98,18
MS-DRG,885,Psychoses,,,12057.89,31193.64,18
MS-DRG,886,Behavioral And Developmental Disorders,,,17326.99,39756.13,18
MS-DRG,887,Other Mental Disorder Diagnoses,,,9527.01,26320.4,18
MS-DRG,894,"Alcohol, Drug Abuse Or Dependence, Left Ama",,,6001.33,13811.96,18
MS-DRG,895,"Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy",,,12203.88,32043.47,18
MS-DRG,896,"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc",,,14762.72,39410.88,18
MS-DRG,897,"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc",,,8066.26,19523.97,18
MS-DRG,901,Wound Debridements For Injuries With Mcc,,,33800.61,98044.76,18
MS-DRG,902,Wound Debridements For Injuries With Cc,,,16078.25,41991.36,18
MS-DRG,903,Wound Debridements For Injuries Without Cc/Mcc,,,10293.49,26977.69,18
MS-DRG,904,Skin Grafts For Injuries With Cc/Mcc,,,29735.21,85445.58,18
MS-DRG,905,Skin Grafts For Injuries Without Cc/Mcc,,,12730.41,36474.1,18
MS-DRG,906,Hand Procedures For Injuries,,,16464.99,48298.69,18
MS-DRG,907,Other O.R. Procedures For Injuries With Mcc,,,31025.88,88158.84,18
MS-DRG,908,Other O.R. Procedures For Injuries With Cc,,,16704.95,44638.23,18
MS-DRG,909,Other O.R. Procedures For Injuries Without Cc/Mcc,,,11404.78,28066.53,18
MS-DRG,913,Traumatic Injury With Mcc,,,13904.6,35812.38,18
MS-DRG,914,Traumatic Injury Without Mcc,,,8087.23,20278.64,18
MS-DRG,915,Allergic Reactions With Mcc,,,14269.59,38459.25,18
MS-DRG,916,Allergic Reactions Without Mcc,,,6384.96,14694.98,18
MS-DRG,917,Poisoning And Toxic Effects Of Drugs With Mcc,,,13390.5,36285.99,18
MS-DRG,918,Poisoning And Toxic Effects Of Drugs Without Mcc,,,7866.68,19572.66,18
MS-DRG,919,Complications Of Treatment With Mcc,,,15428.25,40353.67,18
MS-DRG,920,Complications Of Treatment With Cc,,,8994.27,22480.67,18
MS-DRG,921,Complications Of Treatment Without Cc/Mcc,,,6556.59,15217.28,18
MS-DRG,922,"Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc",,,14796.11,37383.69,18
MS-DRG,923,"Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc",,,9113.87,22569.19,18
MS-DRG,927,Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft,,,167014.58,525009.29,18
MS-DRG,928,Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc,,,56912.44,147801.88,18
MS-DRG,929,Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc,,,26222.73,70381.01,18
MS-DRG,933,Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft,,,31452.23,95754.2,18
MS-DRG,934,Full Thickness Burn Without Skin Graft Or Inhalation Injury,,,18377.71,47486.49,18
MS-DRG,935,Non-Extensive Burns,,,17208.17,48606.32,18
MS-DRG,939,O.R. Procedures With Diagnoses Of Other Contact With Health Services With Mcc,,,29388.85,70239.37,18
MS-DRG,940,O.R. Procedures With Diagnoses Of Other Contact With Health Services With Cc,,,19358.53,46725.18,18
MS-DRG,941,O.R. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/Mcc,,,16957.34,43248.4,18
MS-DRG,945,Rehabilitation With Cc/Mcc,,,13236.74,33780.76,18
MS-DRG,946,Rehabilitation Without Cc/Mcc,,,10116.43,24707.05,18
MS-DRG,947,Signs And Symptoms With Mcc,,,11068.52,28462.68,18
MS-DRG,948,Signs And Symptoms Without Mcc,,,7427.13,17583.08,18
MS-DRG,949,Aftercare With Cc/Mcc,,,10449.59,23877.14,18
MS-DRG,950,Aftercare Without Cc/Mcc,,,6085.2,12970.98,18
MS-DRG,951,Other Factors Influencing Health Status,,,5528.39,12546.06,18
MS-DRG,955,Craniotomy For Multiple Significant Trauma,,,53483.06,151108.25,18
MS-DRG,956,"Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma",,,30433.35,84589.11,18
MS-DRG,957,Other O.R. Procedures For Multiple Significant Trauma With Mcc,,,60385.32,165179.14,18
MS-DRG,958,Other O.R. Procedures For Multiple Significant Trauma With Cc,,,33934.96,90947.34,18
MS-DRG,959,Other O.R. Procedures For Multiple Significant Trauma Without Cc/Mcc,,,24073.93,58507.72,18
MS-DRG,963,Other Multiple Significant Trauma With Mcc,,,22440.78,60121.07,18
MS-DRG,964,Other Multiple Significant Trauma With Cc,,,13112.48,33200.93,18
MS-DRG,965,Other Multiple Significant Trauma Without Cc/Mcc,,,8514.35,20194.54,18
MS-DRG,969,Hiv With Extensive O.R. Procedures With Mcc,,,48747.47,139954.23,18
MS-DRG,970,Hiv With Extensive O.R. Procedures Without Mcc,,,21692.15,58717.97,18
MS-DRG,974,Hiv With Major Related Condition With Mcc,,,23622.74,66083.17,18
MS-DRG,975,Hiv With Major Related Condition With Cc,,,11267.33,31454.79,18
MS-DRG,976,Hiv With Major Related Condition Without Cc/Mcc,,,8220.8,22195.18,18
MS-DRG,977,Hiv With Or Without Other Related Condition,,,11288.3,31908.48,18
MS-DRG,981,Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc,,,37646.24,105217.41,18
MS-DRG,982,Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc,,,20302.85,54187.75,18
MS-DRG,983,Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc,,,14521.2,36916.72,18
MS-DRG,984,Prostatic O.R. Procedure Unrelated To Principal Diagnosis W Mcc,,,,,0
MS-DRG,985,Prostatic O.R. Procedure Unrelated To Principal Diagnosis W Cc,,,,,0
MS-DRG,986,Prostatic O.R. Procedure Unrelated To Principal Diagnosis W/O Cc/Mcc,,,,,0
MS-DRG,987,Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc,,,27834.91,77524.89,18
MS-DRG,988,Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc,,,13974.49,37976.8,18
MS-DRG,989,Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc,,,10523.36,25570.16,18
MS-DRG,998,Principal Diagnosis Invalid As Discharge Diagnosis,,,,,0
MS-DRG,999,Ungroupable,,,,,0
NDC,00000-0000-39,LEECH KIT (STERILE),53.3,34.64,,,0
NDC,00000-0000-74,INV AZTREONAM 2 GRAM SOLUTION FOR INJECTION,0.65,0.42,,,0
NDC,00000-0001-05,GENTAMICIN FORTIFIED OPH DROPS 14 MG/ML,62.75,40.79,,,0
NDC,00000-0001-44,TOBRAMYCIN FORTIFIED OPH DROPS 13.6 MG/ML,75.95,49.37,,,0
NDC,00000-0003-12,METHOHEXITAL 100 MG/10 ML INJECTION,61.55,40.01,,,0
NDC,00000-0003-24,INV SODIUM CHLORIDE 0.9% INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-25,INV SODIUM CHLORIDE 0.9% INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-26,INV SODIUM CHLORIDE 0.9% INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-27,INV SODIUM CHLORIDE 0.9% INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-29,INV SODIUM CHLORIDE 0.9% INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-30,INV SODIUM CHLORIDE 0.9% INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-31,INV DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-32,INV DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-33,INV DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-34,INV DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-35,INV DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-36,INV DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-39,INV LACTATED RINGERS INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-40,INV LACTATED RINGERS INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-52,INV SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0003-73,ALTEPLASE 10 MG/10 ML IV SOLUTION,1608.2,1045.33,,,0
NDC,00000-0003-75,FENTANYL (PF) 300 MCG/30 ML (10 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE,35.0,22.75,,,0
NDC,00000-0004-71,INV DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0005-51,CLINDAMYCIN 600 MG/500 ML IN NS IRRIGATION (CMP PMX),1908.65,1240.62,,,0
NDC,00000-0005-60,INV CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0005-64,ACETIC ACID (BULK) 5 % LIQUID,24.95,16.22,,,0
NDC,00000-0005-70,INV TRASTUZUMAB 440 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0005-86,INV FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,0.65,0.42,,,0
NDC,00000-0006-10,INV SORAFENIB TOSYLATE  (BAY 43-9006) 200 MG TABLET,0.65,0.42,,,0
NDC,00000-0006-11,CEFAZOLIN IVPB 2 G IN D5W 50 ML (CMP PMX),92.3,60.0,,,0
NDC,00000-0006-73,INV AZTREONAM 1 GRAM SOLUTION FOR INJECTION,0.65,0.42,,,0
NDC,00000-0006-77,INV CEFAZOLIN 1 GRAM INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0007-11,HYDROXYPROGESTERONE CAPROATE (PF) 250 MG/ML INTRAMUSCULAR INJE,264.75,172.09,,,0
NDC,00000-0007-12,INV PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS,0.65,0.42,,,0
NDC,00000-0007-65,"SODIUM BICARBONATE 150 MEQ/1,000 ML IN DEXTROSE 5 % INTRAVENOUS",134.2,87.23,,,0
NDC,00000-0008-26,INV METRONIDAZOLE IN NACL 500 MG/100 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0008-47,METRONIDAZOLE 250 MG/50 ML-SODIUM CHLORIDE(ISO) IVPB (CMP),61.1,39.72,,,0
NDC,00000-0008-70,MANNITOL 20% IVPB 62.5 ML (CMP),71.6,46.54,,,0
NDC,00000-0008-71,MANNITOL 20% IVPB 125 ML (CMP),71.7,46.6,,,0
NDC,00000-0008-81,FORMALIN 4% IRRIGATION IN STERILE WATER,456.8,296.92,,,0
NDC,00000-0008-87,NITROGLYCERIN 50 MCG/ML 10ML VIAL (CMP PMX),33.1,21.52,,,0
NDC,00000-0008-88,PRIMING SOLUTION 1100 ML (CMP PMX),100.65,65.42,,,0
NDC,00000-0008-89,CARDIOPLEGIC 1000 ML BASE SOLUTION (CMP),226.35,147.13,,,0
NDC,00000-0009-07,ALUM BLADDER IRRIGATION 1% IN STERILE WATER,498.7,324.16,,,0
NDC,00000-0009-15,MISOPROSTOL 50 MCG SPLIT TABLET,5.6,3.64,,,0
NDC,00000-0009-16,MISOPROSTOL 25 MCG SPLIT TABLET,5.1,3.32,,,0
NDC,00000-0009-17,AZATHIOPRINE 25 MG SPLIT TABLET,5.4,3.51,,,0
NDC,00000-0009-18,MERCAPTOPURINE 25 MG SPLIT TABLET,6.45,4.19,,,0
NDC,00000-0009-95,INV LACTATED RINGERS INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0010-02,FLUCONAZOLE 100 MG/50 ML IN SOD. CHLORIDE (ISO) IVPB (CMP),73.45,47.74,,,0
NDC,00000-0010-10,SODIUM CHLORIDE 0.9 % (COLD) INTRAVENOUS SOLUTION,67.15,43.65,,,0
NDC,00000-0010-26,INV ART-123/PLACEBO 6 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0010-49,INV BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0010-50,INV ERLOTINIB/PLACEBO 150 MG TABLET,0.65,0.42,,,0
NDC,00000-0010-52,INV ERLOTINIB/PLACEBO 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0010-53,INV ERLOTINIB/PLACEBO 25 MG TABLET,0.65,0.42,,,0
NDC,00000-0010-54,INV ERLOTINIB 150 MG TABLET,0.65,0.42,,,0
NDC,00000-0010-55,INV ERLOTINIB 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0010-56,INV ERLOTINIB 25 MG TABLET,0.65,0.42,,,0
NDC,00000-0010-90,INV VENETOCLAX 50 MG TABLET,0.65,0.42,,,0
NDC,00000-0011-04,INV CLOPIDROGEL/PLACEBO TABLET,0.65,0.42,,,0
NDC,00000-0011-12,NICARDIPINE 100 MCG/ML 4ML INJECTION (CMP PMX),34.2,22.23,,,0
NDC,00000-0012-79,CEFAZOLIN 1 GM/500 ML IN NS IRRIGATION (CMP PMX),68.2,44.33,,,0
NDC,00000-0012-80,GENTAMICIN IRRIGATION 160 MG/1000 ML (CMP PMX),72.4,47.06,,,0
NDC,00000-0013-64,HYDROMORPHONE 15 MG/30 ML (0.5 MG/ML) IN 0.9 % NACL IV PCA SYRINGE,111.8,72.67,,,0
NDC,00000-0013-68,CEFAZOLIN IVPB 2 G IN NS 50 ML (CMP PMX),92.3,60.0,,,0
NDC,00000-0013-77,VANCOMYCIN ORAL 250 MG/5 ML,5.95,3.87,,,0
NDC,00000-0013-90,INV PRASUGREL/PLACEBO 5 MG TABLET,0.65,0.42,,,0
NDC,00000-0013-91,INV PRASUGREL/PLACEBO 10 MG TABLET,0.65,0.42,,,0
NDC,00000-0014-21,INV DULOXETINE/PLACEBO 30 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0014-27,"INV CB-183,315/PLACEBO/VANCOMYCIN CAPSULE",0.65,0.42,,,0
NDC,00000-0014-28,"INV CB-183,315/PLACEBO/VANCOMYCIN CAPSULE (KIT)",0.65,0.42,,,0
NDC,00000-0014-54,FLUCONAZOLE 800 MG/400 ML (NS) IVPB,92.3,60.0,,,0
NDC,00000-0014-58,NITROGLYCERIN 100 MCG/ML 10ML SYRINGE (CMP PMX),35.95,23.37,,,0
NDC,00000-0014-59,INV CELECOXIB/PLACEBO 400 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0014-95,INV LISINOPRIL/CARVEDILOL CR/PLACEBO 10 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0015-32,ROPIVACAINE (PF) 100 MG/20 ML (5 MG/ML) 0.5 % INJECTION SYRINGE,418.6,272.09,,,0
NDC,00000-0015-67,INV ELESCLOMOL 250 MG/5.54 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0015-70,TENECTEPLASE 50 MG INTRAVENOUS KIT,1897.5,1233.38,,,0
NDC,00000-0015-90,INV INDOCYANINE GREEN 25 MG/5 ML SOLUTION FOR INJECTION,0.65,0.42,,,0
NDC,00000-0015-92,INV ALTEPLASE/PLACEBO 50 MG/50 ML,0.65,0.42,,,0
NDC,00000-0016-03,HYDROMORPHONE (PF) 0.2 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLN,55.05,35.78,,,0
NDC,00000-0016-04,"INV VANCOMYCIN 1,000 MG INTRAVENOUS SOLUTION",0.65,0.42,,,0
NDC,00000-0016-32,ADENOSINE 90 MG IN 90 ML NS IVPB (CMP PMX),717.3,466.24,,,0
NDC,00000-0016-42,INV PAZOPANIB/PLACEBO 200 MG TABLET,0.65,0.42,,,0
NDC,00000-0016-65,INV TICAGRELOR/PLACEBO 60 MG TABLET,0.65,0.42,,,0
NDC,00000-0016-66,INV TICAGRELOR/PLACEBO 90 MG TABLET,0.65,0.42,,,0
NDC,00000-0016-88,VANCOMYCIN 2 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,102.75,66.79,,,0
NDC,00000-0017-14,INV RANOLAZINE/PLACEBO 500 MG TB12 TABLET,0.65,0.42,,,0
NDC,00000-0017-33,"INV HEPARIN/PLACEBO 1,000 UNIT/ML INJECTION SOLUTION",0.65,0.42,,,0
NDC,00000-0017-34,INV POLYMYXIN-B/SHAM CARTRIDGE,0.65,0.42,,,0
NDC,00000-0017-78,NICARDIPINE 25 MG IN NS 250 ML (CMP PMX),112.85,73.35,,,0
NDC,00000-0017-92,INV EFLORNITHINE/PLACEBO 250 MG TABLET,0.65,0.42,,,0
NDC,00000-0017-93,INV SULINDAC/PLACEBO 150 MG TABLET,0.65,0.42,,,0
NDC,00000-0017-97,NICARDIPINE 5 MG/5 ML SYRINGE (CMP PMX),62.85,40.85,,,0
NDC,00000-0018-11,INV TREBANANIB/PLACEBO 30 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0018-34,INV CLOSTRIDIUM DIFFICILE TOXOID VACCINE/PLACEBO,0.65,0.42,,,0
NDC,00000-0018-47,INV AMIKACIN/PLACEBO 125 MG/ML SOLUTION,0.65,0.42,,,0
NDC,00000-0018-54,INV NEBULIZER RESERVOIR AND CAP KIT,0.65,0.42,,,0
NDC,00000-0018-55,INV PDDS CLINICAL CONTROL MODULE,0.65,0.42,,,0
NDC,00000-0018-56,INV PDDS CLINICAL ON-VENT ADAPTOR KIT,0.65,0.42,,,0
NDC,00000-0018-58,INV PDDS CLINICAL HANDHELD ADAPTOR,0.65,0.42,,,0
NDC,00000-0018-66,INV DEXAMETHASONE 4 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0018-73,INV SMT 199969/PLACEBO/VANCOMYCIN CAPSULE,0.65,0.42,,,0
NDC,00000-0018-83,INV ASPIRIN/PLACEBO 325 MG TABLET,0.65,0.42,,,0
NDC,00000-0018-84,INV ALTEPLASE/PLACEBO BOLUS FROM THE BAG,0.65,0.42,,,0
NDC,00000-0018-96,INV ASPIRIN/PLACEBO 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0019-03,INV TRC105 7 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0019-04,INV ARMODAFINIL 150 MG/ARMODAFINIL 250 MG/PLACEBO TABLET,0.65,0.42,,,0
NDC,00000-0019-13,INV METFORMIN/PLACEBO 850 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0019-20,INV SERELAXIN/PLACEBO 3.5 MG/3.5 ML INJECTION,0.65,0.42,,,0
NDC,00000-0019-24,INV TELAVANCIN 750 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0019-27,INV USL261/PLACEBO 5 MG/0.1 ML NASAL SPRAY,0.65,0.42,,,0
NDC,00000-0019-35,MORPHINE/LIDOCAINE 4%/4% SPRAY,364.8,237.12,,,0
NDC,00000-0100-39,"SODIUM PHOSPHATE P-32, THERAPEUTIC, PER MILLICURIE",0.05,0.03,,,0
NDC,00000-0100-53,NICOTINE 10 MG INHALATION CARTRIDGE,13.7,8.9,,,0
NDC,00000-0100-72,CEFAZOLIN 1 GM/250 ML IN NS IRRIGATION (CMP PMX),68.2,44.33,,,0
NDC,00000-0100-73,CLINDAMYCIN 600 MG/250 ML IN NS IRRIGATION (CMP PMX),72.2,46.93,,,0
NDC,00000-0100-74,CLINDAMYCIN 600 MG/1000 ML IN NS IRRIGATION (CMP PMX),72.2,46.93,,,0
NDC,00000-0100-86,MAGNESIUM SULFATE 2 GRAM/50 ML (4%) IN WATER IVPB (CMP),60.45,39.29,,,0
NDC,00000-0100-95,"KETAMINE 50 MG, PROPOFOL 50 MG 10 ML SYRINGE",37.75,24.54,,,0
NDC,00000-0101-02,FLUCONAZOLE 600 MG/300 ML (NS) IVPB,83.9,54.54,,,0
NDC,00000-0101-03,PHENYLEPHRINE 200 MCG/ML INJECTION (1 ML),37.95,24.67,,,0
NDC,00000-0102-27,EPINEPHRINE 4 MG IN NS 250 ML INFUSION (CMP PMX),87.2,56.68,,,0
NDC,00000-0102-34,PROPYLTHIOURACIL 5 MG/ML ORAL SUSPENSION (CMP),12.25,7.96,,,0
NDC,00000-0102-35,TACROLIMUS 1 MG/ML ORAL SUSPENSION,9.6,6.24,,,0
NDC,00000-0102-36,ZONISAMIDE 10 MG/ML ORAL SUSPENSION,5.4,3.51,,,0
NDC,00000-0102-37,"LACTATED RINGERS 500ML +LIDO 1%, SOD BICARB (VENOUS ABLATION) 500 ML",177.3,115.24,,,0
NDC,00000-0102-38,VANCOMYCIN 1.5 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLN,94.4,61.36,,,0
NDC,00000-0102-41,TENECTEPLASE 5 MG/10 ML SYRINGE,2426.4,1577.16,,,0
NDC,00000-0102-42,"LACTATED RINGERS 1000ML+EPI,LIDO 1%, SOD BICARB (VENOUS ABLATION)",177.3,115.24,,,0
NDC,00000-0102-57,VANCOMYCIN INTRAVITREAL SOLUTION 1000 MCG/0.1 ML,60.4,39.26,,,0
NDC,00000-0102-60,DOXYCYCLINE LYMPHOCELE INJECTON 1000 MG/50 ML SYRINGE,39.65,25.77,,,0
NDC,00000-0102-78,"METRONIDAZOLE 1%, MORPHINE 0.5% TOPICAL SOLUTION",1579.85,1026.9,,,0
NDC,00000-0102-80,VANCOMYCIN 1.25 GRAM/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,90.2,58.63,,,0
NDC,00000-0102-81,VANCOMYCIN 1.75 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,98.6,64.09,,,0
NDC,00000-0102-82,VANCOMYCIN 750 MG IN NS 250 ML IVPB (CMP PMX),76.6,49.79,,,0
NDC,00000-0102-95,"METRONIDAZOLE/MORPHINE 1%/0.5% CREAM, 30GM",197.15,128.15,,,0
NDC,00000-0103-03,INV FARLETUZUMAB/PLACEBO 5 MG/ML INFUSION,0.65,0.42,,,0
NDC,00000-0103-04,INV FARLETUZUMAB/PLACEBO 5 MG/ML INFUSION,0.65,0.42,,,0
NDC,00000-0103-08,ALTEPLASE 1 MG/ML  (INTRAVENTRICULAR-PF)  1 ML- SYRINGE,323.0,209.95,,,0
NDC,00000-0103-22,PENICILLIN G POT 2.5 MU IN NS 100 ML (CMP PMX),30.05,19.53,,,0
NDC,00000-0103-24,INV KEYHOLE LIMPET HEMOCYANIN 1 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0103-25,INV OCRELIZUMAB 30 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0103-28,INV VELIPARIB/PLACEBO 50 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0103-29,INV VELIPARIB/PLACEBO 100 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0103-32,INV POLYETHYLENE GLYCOL SOLUTION,0.65,0.42,,,0
NDC,00000-0103-33,INV MAGNESIUM CITRATE SOLUTION,0.65,0.42,,,0
NDC,00000-0103-34,INV SER-109 CAPSULE,0.65,0.42,,,0
NDC,00000-0103-35,INV SER-109/PLACEBO CAPSULE,0.65,0.42,,,0
NDC,00000-0103-36,INV SYN-004/PLACEBO 75 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0103-37,INV CHOLESTYRAMINE-ASPARTAME 4 GM PACKET,0.65,0.42,,,0
NDC,00000-0103-38,INV ACTIVATED CHARCOAL-SORBITOL SUSPENSION,0.65,0.42,,,0
NDC,00000-0103-39,INV PONESIMOD/PLACEBO TABLET,0.65,0.42,,,0
NDC,00000-0103-40,INV PONESIMOD 20 MG OR TERIFLUNOMIDE 14 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0103-43,DOXORUBICIN INJECTION (BEAD IMPREGNATION),84.55,54.96,,,0
NDC,00000-0103-47,INV TRC105 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0103-48,INV TRC105 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0103-49,INV PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0103-52,INV CERITINIB 150 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0103-53,FENTANYL 10 MCG/ML NASAL SYRINGE (NEONATE/PED),37.35,24.28,,,0
NDC,00000-0103-54,LORAZEPAM 0.5 MG/ML ORAL SYRINGE (NEONATE),5.4,3.51,,,0
NDC,00000-0103-55,INV LJPC-501/PLACEBO 2.5 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0103-56,MORPHINE 0.5 MG/ML INJECTABLE SYRINGE (NEONATE),33.25,21.61,,,0
NDC,00000-0103-58,MAGIC MOUTHWASH ORAL SUSPENSION (CMP),22.95,14.92,,,0
NDC,00000-0103-61,INV ECULIZUMAB 10 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0103-62,INV ECULIZUMAB/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0103-64,INV ASPIRIN EC/PLACEBO 81 MG TABLET,0.65,0.42,,,0
NDC,00000-0103-65,INV TICAGRELOR 90 MG TABLET,0.65,0.42,,,0
NDC,00000-0103-66,INV DCVAX-L 1.25 MILLION CELLS INJECTION,0.65,0.42,,,0
NDC,00000-0103-67,INV DCVAX-L/PLACEBO 1.25 MILLION CELLS INJECTION,0.65,0.42,,,0
NDC,00000-0103-70,INV JVS-100/PLACEBO 1 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0103-71,INV CAP-1002/PLACEBO 25 MILLION CELLS/10 ML INJECTION,0.65,0.42,,,0
NDC,00000-0103-72,INV NITROGLYCERIN 400 MCG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0103-73,INV HEPARIN 1000 UNIT/ML INJECTION,0.65,0.42,,,0
NDC,00000-0103-77,FAT EMULSION 20 % INTRAVENOUS,110.1,71.56,,,0
NDC,00000-0103-78,FAT EMULSION 20 % INTRAVENOUS,88.1,57.26,,,0
NDC,00000-0103-97,INV STAPHYLOCOCCUS AUREUS 4-ANTIGEN VACCINE/PLACEBO INJ,0.65,0.42,,,0
NDC,00000-0104-01,PARENTERAL AMINO ACID 10 % COMBINATION NO.2 INTRAVENOUS SOLUTION,187.65,121.97,,,0
NDC,00000-0104-16,VECURONIUM INJ 0.1 MG/ML FOR PUBS PROCEDURE,35.05,22.78,,,0
NDC,00000-0104-17,INV GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
NDC,00000-0104-18,INV GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
NDC,00000-0104-21,PHENYLEPHRINE 500 MCG/ML INJECTION,33.55,21.81,,,0
NDC,00000-0104-23,MORPHINE 1% TOPICAL GEL (CMP),77.15,50.15,,,0
NDC,00000-0104-24,MORPHINE 1% IN METRONIDAZOLE 1% TOPICAL GEL (CMP),342.35,222.53,,,0
NDC,00000-0104-25,MORPHINE 0.5% IN LIDOCAINE TOPICAL SPRAY (CMP),35.0,22.75,,,0
NDC,00000-0104-26,LIDOCAINE (BUFFERED) TOPICAL SOLUTION (CMP),22.35,14.53,,,0
NDC,00000-0104-27,INV NIVOLUMAB 10 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0104-28,TRACE ELEMENTS CR-CU-MN-SE-ZN 4-400-100-20 MCG-1000 MCG/ML IV SOLUTION,223.3,145.14,,,0
NDC,00000-0104-29,INV ASPIRIN EC 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-31,INV RIVAROXOBAN/PLACEBO 2.5 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-33,INV CEDIRANIB 15 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-34,INV CEDIRANIB 20 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-35,INV OLAPARIB 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-36,INV OLAPARIB 150 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-38,FENTANYL PCA (PALLIATIVE CARE) 2500 MCG/50 ML,78.45,50.99,,,0
NDC,00000-0104-39,HYDROMORPHONE PCA (PALLIATIVE CARE) 500 MG/50 ML,511.8,332.67,,,0
NDC,00000-0104-46,INV NAFCILLIN 200 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0104-47,METHACHOLINE 0.025 MG/ML CHALLENGE SOLUTION (CMP),164.0,106.6,,,0
NDC,00000-0104-53,INV BMS-986141/PLACEBO TABLET,0.65,0.42,,,0
NDC,00000-0104-54,INV RIVAROXOBAN 10 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-55,INV RIVAROXOBAN 15 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-56,INV RIVAROXOBAN 20 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-64,INV POLYMYXIN-B CARTRIDGE,0.65,0.42,,,0
NDC,00000-0104-65,INV ENTINOSTAT/PLACEBO 5 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-66,INV ENTINOSTAT/PLACEBO 1 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-67,INV EXEMESTANE 25 MG TABLET,0.65,0.42,,,0
NDC,00000-0104-69,INV OFATUMUMAB/PLACEBO 20 MG/0.4 ML SYRINGE,0.65,0.42,,,0
NDC,00000-0104-70,INV TERIFLUNOMIDE/PLACEBO 14 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0104-72,INV ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
NDC,00000-0104-73,INV ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
NDC,00000-0104-74,INV ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
NDC,00000-0104-75,INV ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
NDC,00000-0104-76,INV ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
NDC,00000-0104-77,INV ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
NDC,00000-0104-78,INV ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,0.65,0.42,,,0
NDC,00000-0104-79,INV DROXIDOPA 100 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0104-80,INV DROXIDOPA 200 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0104-81,INV DROXIDOPA 300 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0104-82,INV DROXIDOPA/PLACEBO 100 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0104-83,INV DROXIDOPA/PLACEBO 200 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0104-84,INV DROXIDOPA/PLACEBO 300 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0104-87,CARDIOPLEGIC SOLUTION + 0 MEQ KCL (CMP),99.65,64.77,,,0
NDC,00000-0104-88,CARDIOPLEGIC SOLUTION + 15 MEQ KCL (CMP),106.1,68.96,,,0
NDC,00000-0104-89,CARDIOPLEGIC SOLUTION + 80 MEQ KCL (CMP),133.8,86.97,,,0
NDC,00000-0104-90,GENTAMICIN IRRIGATION 360 MG/3000 ML (CMP PMX),128.8,83.72,,,0
NDC,00000-0104-95,INV SER-262/PLACEBO CAPSULE,0.65,0.42,,,0
NDC,00000-0105-00,INV TRAMETINIB 0.5 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-01,INV TRAMETINIB 2 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-02,INV ADO-TRASTUZUMAB EMTANSINE 160 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0105-04,INV CRIZOTINIB 250 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0105-05,FLUCYTOSINE 50 MG/ML ORAL SUSPENSION (CMP),117.8,76.57,,,0
NDC,00000-0105-06,INV MIRVETUXIMAB SORAVTANSINE 5 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0105-20,INV PREDNISOLONE ACETATE 1% OPHTHALMIC SUSPENSION,0.65,0.42,,,0
NDC,00000-0105-21,INV REFRESH OPTIVE ADVANCED (PRESERVATIVE-FREE) OPHTHALMIC SOLUTION,0.65,0.42,,,0
NDC,00000-0105-22,CEFAZOLIN 3 GRAM/100 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,71.15,46.25,,,0
NDC,00000-0105-23,INV SELEPRESSIN/PLACEBO INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0105-26,BEVACIZUMAB (AVASTIN) INTRAVITREAL SOLUTION 1.25 MG/0.05 ML,123.4,80.21,,,0
NDC,00000-0105-33,MORPHINE 1% TOPICAL GEL (CMP),12.05,7.83,,,0
NDC,00000-0105-37,INV COPANLISIB (BAY 80-6946) 15 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0105-40,PENICILLIN VK (DOSE 1) ORAL DESENSITIZATION,11.6,7.54,,,0
NDC,00000-0105-41,PENICILLIN VK (DOSE 2) ORAL DESENSITIZATION,11.6,7.54,,,0
NDC,00000-0105-42,PENICILLIN VK (DOSE 3) ORAL DESENSITIZATION,11.55,7.51,,,0
NDC,00000-0105-44,PENICILLIN VK (DOSE 5) ORAL DESENSITIZATION,11.5,7.48,,,0
NDC,00000-0105-45,PENICILLIN VK (DOSE 6) ORAL DESENSITIZATION,11.45,7.44,,,0
NDC,00000-0105-46,PENICILLIN VK (DOSE 7) ORAL DESENSITIZATION,11.3,7.34,,,0
NDC,00000-0105-47,PENICILLIN VK (DOSE 8) ORAL DESENSITIZATION,11.55,7.51,,,0
NDC,00000-0105-48,PENICILLIN VK (DOSE 9) ORAL DESENSITIZATION,11.5,7.48,,,0
NDC,00000-0105-49,PENICILLIN VK (DOSE 10) ORAL DESENSITIZATION,11.4,7.41,,,0
NDC,00000-0105-50,PENICILLIN VK (DOSE 11) ORAL DESENSITIZATION,11.55,7.51,,,0
NDC,00000-0105-51,PENICILLIN VK (DOSE 12) ORAL DESENSITIZATION,11.5,7.48,,,0
NDC,00000-0105-52,PENICILLIN VK (DOSE 13) ORAL DESENSITIZATION,11.4,7.41,,,0
NDC,00000-0105-53,PENICILLIN VK (DOSE 14) ORAL DESENSITIZATION,11.25,7.31,,,0
NDC,00000-0105-54,PENICILLIN G POT 100 MG/ML (DESENSITIZATION INGREDIENT A),82.3,53.5,,,0
NDC,00000-0105-55,PENICILLIN G POT 10 MG/ML (DESENSITIZATION INGREDIENT B),82.3,53.5,,,0
NDC,00000-0105-56,PENICILLIN G POT 1 MG/ML (DESENSITIZATION INGREDIENT C),82.3,53.5,,,0
NDC,00000-0105-57,PENICILLIN G POT 0.1 MG/ML (DESENSITIZATION INGREDIENT D),82.3,53.5,,,0
NDC,00000-0105-60,INV ATORVASTATIN/PLACEBO 40 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0105-64,"INV AERUCIN/PLACEBO (AERUBUMAB, AR-105) 27.5 MG/ML INJECTION",0.65,0.42,,,0
NDC,00000-0105-66,INV EFLORNITHINE 150 MG/ML ORAL SOLUTION,0.65,0.42,,,0
NDC,00000-0105-67,INV DONEPEZIL/PLACEBO 5 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0105-71,INV ASPIRIN/PLACEBO 300 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-72,INV TRIAPINE 5 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0105-74,INV TAK-700 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-77,INV EVEROLIMUS/PLACEBO 5 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-79,INV PONESIMOD/PLACEBO 20 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-80,INV ATEZOLIZUMAB/PLACEBO 1200 MG/20 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0105-81,INV YKP3089 (CENOBAMATE) 12.5 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-82,INV YKP3089 (CENOBAMATE) 25 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-83,INV YKP3089 (CENOBAMATE) 50 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-84,INV YKP3089 (CENOBAMATE) 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-92,INV O.N.E. MULTIVITAMIN CAPSULE,0.65,0.42,,,0
NDC,00000-0105-93,INV CALCIUM-VIT D3 150 MG-133 UNIT CAPSULE,0.65,0.42,,,0
NDC,00000-0105-94,INV AFATINIB 20 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-95,INV AFATINIB 30 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-96,INV AFATINIB 40 MG TABLET,0.65,0.42,,,0
NDC,00000-0105-98,INV CLOPIDOGREL/PLACEBO 75 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0105-99,VANCOMYCIN ORAL 125 MG/5 ML,7.25,4.71,,,0
NDC,00000-0106-00,INV CARFILZOMIB 60 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0106-01,INV LLG783/PLACEBO 150 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0106-03,INV OMECAMTIV MECARBIL/PLACEBO TABLET,0.65,0.42,,,0
NDC,00000-0106-04,INV BUPROPION XL/PLACEBO 24 HR CAPSULE 150 MG,0.65,0.42,,,0
NDC,00000-0106-07,INV APIXABAN 2.5 MG TABLET,0.65,0.42,,,0
NDC,00000-0106-08,INV APIXABAN 5 MG TABLET,0.65,0.42,,,0
NDC,00000-0106-09,INV DALTEPARIN 2500 UNITS/0.2ML SYRINGE,0.65,0.42,,,0
NDC,00000-0106-10,INV DALTEPARIN 5000 UNITS/0.2 ML SYRINGE,0.65,0.42,,,0
NDC,00000-0106-11,INV DALTEPARIN 7500 UNITS/0.3 ML SYRINGE,0.65,0.42,,,0
NDC,00000-0106-12,"INV DALTEPARIN 10,000 UNITS/1 ML SYRINGE",0.65,0.42,,,0
NDC,00000-0106-13,"INV DALTEPARIN 12,500 UNITS/0.5 ML SYRINGE",0.65,0.42,,,0
NDC,00000-0106-14,"INV DALTEPARIN 15,000 UNITS/0.6 ML SYRINGE",0.65,0.42,,,0
NDC,00000-0106-15,"INV DALTEPARIN 18,000 UNITS/0.72 ML SYRINGE",0.65,0.42,,,0
NDC,00000-0106-31,FECAL MICROBIOTA TRANSPLANT (FMT)LOWER DELIVERY (OPENIBIOME) MICROBIOTA PREP,2040.75,1326.49,,,0
NDC,00000-0106-34,INV OPICINUMAB (BIIB003)/PLACEBO 200 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0106-36,INV DEXAMETHASONE 10 MG/ML INJECTION SOLUTION,0.65,0.42,,,0
NDC,00000-0106-37,INV DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,0.65,0.42,,,0
NDC,00000-0106-43,INV IMMUNE GLOBULIN (IGG)(OCTAGAM) 10% INFUSION,0.65,0.42,,,0
NDC,00000-0106-48,INV IMMUNE GLOBULIN (IGG)/PLACEBO (OCTAGAM/PLACEBO) 10% INFUSION,0.65,0.42,,,0
NDC,00000-0106-52,INV DIMETHYL FUMARATE 120 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0106-54,INV PEGINTERFERON BETA-1A 63 MCG/0.5 ML SYRINGE,0.65,0.42,,,0
NDC,00000-0106-55,INV PEGINTERFERON BETA-1A 94 MCG/0.5 ML SYRINGE,0.65,0.42,,,0
NDC,00000-0106-56,INV PEGINTERFERON BETA-1A 125 MCG/0.5 ML SYRINGE,0.65,0.42,,,0
NDC,00000-0106-78,INV DEXAMETHASONE 2 MG TABLET,0.65,0.42,,,0
NDC,00000-0106-79,INV DEXAMETHASONE 4 MG TABLET,0.65,0.42,,,0
NDC,00000-0106-80,INV PANTOPRAZOLE EC 40 MG TABLET,0.65,0.42,,,0
NDC,00000-0106-81,INV DIPHENHYDRAMINE 25 MG TABLET,0.65,0.42,,,0
NDC,00000-0106-83,INV PONESIMOD 20 MG TABLET,0.65,0.42,,,0
NDC,00000-0106-84,INV PONESIMOD TABLET,0.65,0.42,,,0
NDC,00000-0106-86,INV DURVALUMAB 50 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0106-87,INV TREMELIMUMAB 20 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0106-92,INV DIPHENHYDRAMINE 50 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0106-93,INV ACETYLSALICYLIC ACID 325 MG TABLET,0.65,0.42,,,0
NDC,00000-0106-95,INV OSELTAMIVIR 30 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0106-96,INV SODIUM CHLORIDE (NS) 0.9% FLUSH SYRINGE 26 ML,0.65,0.42,,,0
NDC,00000-0106-98,INV UBLITUXIMAB/PLACEBO 25 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0106-99,INV IBUPROFEN 400 MG TABLET,0.65,0.42,,,0
NDC,00000-0107-00,INV VIS410/PLACEBO 25 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0107-01,INV VIS410 2000 MG/VIS410 4000MG/PLACEBO INFUSION,0.65,0.42,,,0
NDC,00000-0107-03,CODEINE 15 MG/5 ML ORAL SYRUP,10.3,6.7,,,0
NDC,00000-0107-04,ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,696.25,452.56,,,0
NDC,00000-0107-12,EPINEPHRINE 1 MG/ML ANAPHYLAXIS KIT,83.95,54.57,,,0
NDC,00000-0107-14,INV PROCHLORPERAZINE 5 MG TABLET,0.65,0.42,,,0
NDC,00000-0107-16,INV ASPIRIN/PLACEBO 81 MG TABLET,0.65,0.42,,,0
NDC,00000-0107-17,INV APIXABAN/PLACEBO 2.5 MG TABLET,0.65,0.42,,,0
NDC,00000-0107-18,INV APIXABAN/PLACEBO 5 MG TABLET,0.65,0.42,,,0
NDC,00000-0107-24,INV PREDNISONE 5 MG TABLET,0.65,0.42,,,0
NDC,00000-0107-25,INV METHYLPREDNISOLONE 1000 MG/8 ML INJECTION,0.65,0.42,,,0
NDC,00000-0107-26,INV IMMUNE GLOBULIN (IGG) (PRIVIGEN) 10%,0.65,0.42,,,0
NDC,00000-0107-27,INV IMMUNE GLOBULIN (IGG) (PRIVIGEN) 10%,0.65,0.42,,,0
NDC,00000-0107-28,INV ALBUMIN HUMAN 5% INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0107-29,INV ALBUMIN HUMAN 5% INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0107-30,INV CALCIUM GLUCONATE 100 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0107-31,INV MEDI-551/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0107-32,INV MEDI-551 10 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0107-34,INV REXLEMESTROCEL-L (CEP-41750)/PLACEBO 37.5 MIL CELLS/ML INJECTION,0.65,0.42,,,0
NDC,00000-0107-43,INV NA-1/PLACEBO 20 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0107-45,FLUCONAZOLE 1400 MG/700 ML IN SODIUM CHLORIDE IVPB,143.85,93.5,,,0
NDC,00000-0107-46,FLUCONAZOLE 1200 MG/600 ML IN SODIUM CHLORIDE IVPB,131.7,85.6,,,0
NDC,00000-0107-47,FLUCONAZOLE 1000 MG/500 ML IN SODIUM CHLORIDE IVPB,119.55,77.71,,,0
NDC,00000-0107-48,INV NIRAPARIB 100 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0107-50,INV CF-301/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0107-54,NALOXONE 2 MG/2 ML INTRANASAL KIT,175.85,114.3,,,0
NDC,00000-0107-60,INV YKP3089 (CENOBAMATE) 150 MG TABLET,0.65,0.42,,,0
NDC,00000-0107-61,INV YKP3089 (CENOBAMATE) 200 MG TABLET,0.65,0.42,,,0
NDC,00000-0107-62,INV ATEZOLIZUMAB 60 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0107-64,INV RUXOLITINIB 5 MG TABLET,0.65,0.42,,,0
NDC,00000-0107-69,INV AMANTADINE (ADS-5102) 68.5 MG/137 MG/PLACEBO ER CAPSULE,0.65,0.42,,,0
NDC,00000-0107-70,INV AMANTADINE (ADS-5102) 137 MG ER CAPSULE,0.65,0.42,,,0
NDC,00000-0107-72,INV OFATUMUMAB 20 MG/0.4 ML PRE-FILLED SYRINGE,0.65,0.42,,,0
NDC,00000-0107-73,INV OFATUMUMAB 20 MG/0.4 ML AUTO-INJECTOR,0.65,0.42,,,0
NDC,00000-0107-74,INV NETUPITANT-PALONOSETRON (AKYNZEO) 300-0.5 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0107-75,INV OLANZAPINE/PLACEBO 10 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0107-76,INV PROCHLORPERAZINE/PLACEBO 10 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0107-77,INV URCC 16070 TAKE HOME KIT,0.65,0.42,,,0
NDC,00000-0107-78,INV CLOSTRIDIUM DIFFICILE VACCINE/PLACEBO 200 MCG/0.5 ML,0.65,0.42,,,0
NDC,00000-0107-82,MIDAZOLAM 1 MG/ML NASAL SYRINGE (NEONATE/PED),33.4,21.71,,,0
NDC,00000-0107-83,MIDAZOLAM 5 MG/ML NASAL SYRINGE (NEONATAL/PED),34.25,22.26,,,0
NDC,00000-0107-84,MANNITOL 20% IVPB 250 ML (CMP),110.1,71.56,,,0
NDC,00000-0107-87,INV DAPTOMYCIN/PLACEBO 500 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0107-88,INV AZTREONAM/PLACEBO 1 GRAM SOLUTION FOR INJECTION,0.65,0.42,,,0
NDC,00000-0107-89,INV CEFTOBIPROLE/PLACEBO 500MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0107-90,INV OBINUTUZUMAB 25MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0108-10,MORPHINE 1% TOPICAL GEL (CMP),25.75,16.74,,,0
NDC,00000-0108-13,MORPHINE NEONATAL 0.2 MG/ML ORAL SYRINGE,8.25,5.36,,,0
NDC,00000-0108-15,INV METHYLENE BLUE 5MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0108-16,INV ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,0.65,0.42,,,0
NDC,00000-0108-21,INV CIPROFLOXACIN 500 MG/AMOXICILLIN-CLAVULANATE 875 MG-125 MG/PLACEBO CAPSULE,0.65,0.42,,,0
NDC,00000-0108-22,INV SULOPENEM ETZADROXIL 500 MG & PROBENECID 500MG/PLACEBO TABLET,0.65,0.42,,,0
NDC,00000-0108-23,INV ERTAPENEM/PLACEBO 1000 MG/10ML INJECTION,0.65,0.42,,,0
NDC,00000-0108-24,INV SULOPENEM/PLACEBO 1000MG/10ML INJECTION,0.65,0.42,,,0
NDC,00000-0108-28,INV CIPROFLOXACIN 500 MG/AMOXICILLIN-CLAVULANATE 875 MG-125 MG/PLACEBO AND METRONIDAZOLE 500 MG/PLACEBO CAPSULE,0.65,0.42,,,0
NDC,00000-0108-33,AMPHOTERICIN  INTRAVENTRICULAR 0.1 MG/2 ML SYRINGE,75.95,49.37,,,0
NDC,00000-0108-36,COLISTIMETHATE SODIUM (COLYMYCIN) INTRAVENTRICULAR 5 MG/2 ML SYRINGE,34.7,22.56,,,0
NDC,00000-0108-38,GLUCOSE 4 GRAM CHEWABLE TABLET,5.25,3.41,,,0
NDC,00000-0108-39,GENTAMICIN INTRAVENTRICULAR 5MG/2 ML SYRINGE,34.95,22.72,,,0
NDC,00000-0108-41,INV NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0108-42,TOLVAPTAN 7.5 MG SPLIT TABLET,821.35,533.88,,,0
NDC,00000-0108-43,MITOMYCIN 0.2 MG/ML TOPICAL OPHTHALMIC SOLUTION (COMPOUND),114.0,74.1,,,0
NDC,00000-0108-47,INV RUCAPARIB/PLACEBO 200 MG TABLET,0.65,0.42,,,0
NDC,00000-0108-48,INV RUCAPARIB/PLACEBO 250 MG TABLET,0.65,0.42,,,0
NDC,00000-0108-49,INV RUCAPARIB/PLACEBO 300 MG TABLET,0.65,0.42,,,0
NDC,00000-0108-50,INV NIVOLUMAB/PLACEBO 10 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0108-55,ASCORBIC ACID 1500 MG IN SODIUM CHLORIDE 0.9% 250 ML IVPB (CMP PREMIX),64.4,41.86,,,0
NDC,00000-0108-56,ASCORBIC ACID 500 MG IN SODIUM CHLORIDE 0.9% 100 ML IVPB (CMP PREMIX),41.5,26.98,,,0
NDC,00000-0108-57,INV CENOBAMATE/PLACEBO 12.5 MG TABLET,0.65,0.42,,,0
NDC,00000-0108-59,INV CENOBAMATE 50 MG/100 MG/PLACEBO TABLET,0.65,0.42,,,0
NDC,00000-0108-60,INV CENOBAMATE/PLACEBO 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0108-61,INV CENOBAMATE/PLACEBO 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0108-62,INV CENOBAMATE 50 MG/100 MG/PLACEBO TABLET,0.65,0.42,,,0
NDC,00000-0108-63,INV CAFFEINE CITRATE 60 MG/3 ML INJECTION,0.65,0.42,,,0
NDC,00000-0108-65,INV AMINOPHYLLINE 250 MG/10 ML INJECTION,0.65,0.42,,,0
NDC,00000-0108-66,"INV FLURPIRIDAZ F-18, DIAGNOSTIC, PER STUDY DOSE, UP TO 14",0.65,0.42,,,0
NDC,00000-0108-78,INV SIPONIMOD 0.25 MG TABLET,0.65,0.42,,,0
NDC,00000-0108-79,INV SIPONIMOD 2 MG TABLET,0.65,0.42,,,0
NDC,00000-0108-80,INV CIPROFLOXACIN 500 MG TABLET,0.65,0.42,,,0
NDC,00000-0108-81,INV PENICILLIN V POTASSIUM 250 MG TABLET,0.65,0.42,,,0
NDC,00000-0108-82,INV RAVULIZUMAB 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0108-83,INV RAVULIZUMAB/PLACEBO 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0108-87,INV OPICINUMAB (BIIB003) 200 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0108-88,INV PADSEVONIL 25 MG/100 MG/200 MG/PLACEBO TABLET 4-DAY KIT,0.65,0.42,,,0
NDC,00000-0108-89,INV PADSEVONIL 25 MG/100 MG/200 MG/PLACEBO TABLET 7-DAY KIT,0.65,0.42,,,0
NDC,00000-0108-92,INV TENECTEPLASE/PLACEBO 5 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0108-94,INV AGEN2034 50 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0108-95,INV AGEN1884/PLACEBO 50 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0108-98,SELENIUM INJ 4 MCG/ML (CAPS),33.0,21.45,,,0
NDC,00000-0108-99,INV VENETOCLAX 10 MG TABLET,0.65,0.42,,,0
NDC,00000-0109-01,INV VENETOCLAX 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0109-02,INV NAB-PACLITAXIL (ABRAXANE) INJECTION,0.65,0.42,,,0
NDC,00000-0109-03,INV NAB-PACLITAXIL (ABRAXANE) INJECTION,0.65,0.42,,,0
NDC,00000-0109-07,INV PEMBROLIZUMAB/PLACEBO 25 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0109-09,INV UBLITUXIMAB 25 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0109-12,INV SODIUM CHLORIDE 0.9% SOLUTION FLUSH,0.65,0.42,,,0
NDC,00000-0109-13,INV DEXTROSE 5% SOLUTION FLUSH,0.65,0.42,,,0
NDC,00000-0109-17,INV OLAPARIB/PLACEBO 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0109-18,INV OLAPARIB/PLACEBO 150 MG TABLET,0.65,0.42,,,0
NDC,00000-0109-20,INV EVEROLIMUS 2.5 MG TABLET,0.65,0.42,,,0
NDC,00000-0109-21,INV EVEROLIMUS 5 MG TABLET,0.65,0.42,,,0
NDC,00000-0109-22,INV EVEROLIMUS 10 MG TABLET,0.65,0.42,,,0
NDC,00000-0109-24,INV SATRALIZUMAB 120 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0109-26,HYDROXYCHLOROQUINE 25 MG/ML ORAL SUSPENSION,13.25,8.61,,,0
NDC,00000-0109-27,INV REMDESIVIR 100 MG/20 ML INJECTION,0.65,0.42,,,0
NDC,00000-0109-31,KETAMINE ORAL SOLUTION 20 MG/5 ML,10.4,6.76,,,0
NDC,00000-0109-37,INV MAS825/PLACEBO 100 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0109-38,INV REMDESIVIR 5 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0109-39,INV TOCILIZUMAB/PLACEBO 20MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0109-41,INV TL-895/PLACEBO 50 MG TABLET,0.65,0.42,,,0
NDC,00000-0109-42,INV TL-895 50 MG TABLET,0.65,0.42,,,0
NDC,00000-0109-44,MITOMYCIN 0.4 MG/ML BLADDER NECK INJECTION SOLUTION,298.0,193.7,,,0
NDC,00000-0109-45,MITOMYCIN 0.4 MG/ML BLADDER NECK INJECTION SOLUTION,591.4,384.41,,,0
NDC,00000-0109-46,INV REGN10933 + INV REGN10987 2.4 GM/8 GM/PLACEBO IN 0.9% SODIUM CHLORIDE 250 ML,0.65,0.42,,,0
NDC,00000-0109-49,INV DURVALUMAB/PLACEBO 50 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0109-53,INV EVOBRUTINIB/PLACEBO 45 MG TABLET,0.65,0.42,,,0
NDC,00000-0109-56,"INV DARATUMUMAB-RHUPH20 120 MG-2,000 UNITS/ML INJECTION",0.65,0.42,,,0
NDC,00000-0109-63,INV OCRELIZUMAB/PLACEBO 30 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0109-64,CLONIDINE 20 MCG/ML ORAL SUSPENSION,10.1,6.56,,,0
NDC,00000-0109-65,INV SARS-COV-2 HYPERIMMUNE GLOBULIN (HIVIG)/PLACEBO 100 MG/ML IV,0.65,0.42,,,0
NDC,00000-0109-66,INV TELAGLENASTAT/PLACEBO 200 MG TABLET,0.65,0.42,,,0
NDC,00000-0109-70,INV TD-0903/PLACEBO NEBULIZER SOLUTION,0.65,0.42,,,0
NDC,00000-0109-78,INV IPILIMUMAB 5 MG/ML INTRAVENOUS SOLUTION (ROUNDED TO 1 MG),0.65,0.42,,,0
NDC,00000-0109-83,INV IMMUNE GLOBULIN (IGG) (GAMMAGARD) 10%,0.65,0.42,,,0
NDC,00000-0109-90,INV REMDESIVIR/PLACEBO 5 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0109-94,INV INFLIXIMAB 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0110-05,INV BATIRAXCEPT (AVB-S6-500)/PLACEBO 20 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0110-09,INV PATIROMER/PLACEBO 8.4 GRAM PACKET,0.65,0.42,,,0
NDC,00000-0110-18,CALCIUM GLUCONATE 3 GM IN 100 ML NS IVPB (PREMIX),50.55,32.86,,,0
NDC,00000-0110-19,INV FENEBRUTINIB/PLACEBO 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0110-27,METHOHEXITAL 50 MG/5 ML SYRINGE (IR-NEURO USE),72.4,47.06,,,0
NDC,00000-0110-30,INV OSIMERTINIB 40 MG TABLET,0.65,0.42,,,0
NDC,00000-0110-31,INV OSIMERTINIB 80 MG TABLET,0.65,0.42,,,0
NDC,00000-0110-32,INV CABOZANTINIB 20 MG TABLET,0.65,0.42,,,0
NDC,00000-0110-33,INV CABOZANTINIB 60 MG TABLET,0.65,0.42,,,0
NDC,00000-0110-34,DIPHENHYDRAMINE 10 MG/ML (1%) SUBQ SOLUTION,38.65,25.12,,,0
NDC,00000-0110-41,INV ASPIRIN EC 81 MG TABLET,0.65,0.42,,,0
NDC,00000-0110-45,INV PATISIRAN (ALN-TTR02) 2 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0110-46,INV DARATUMUMAB 20 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0110-47,INV IXAZOMIB 2.3 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-48,INV IXAZOMIB 3 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-49,INV IXAZOMIB 4 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-52,INV LONCASTUXIMAB TESIRINE-LPYL (ADCT-402) 5 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0110-53,INV DEXAMETHASONE 4 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0110-54,INV DEXAMETHASONE/PLACEBO 4 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0110-58,INV LAU-7B/PLACEBO 100 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-60,INV NEMVALEUKIN ALFA (ALKS 4230) 55.6 MCG/ML,0.65,0.42,,,0
NDC,00000-0110-61,INV NEMVALEUKIN ALFA (ALKS 4230) 37.7 MCG/ML,0.65,0.42,,,0
NDC,00000-0110-62,INV SATRALIZUMAB 60 MG/0.5 ML SYRINGE,0.65,0.42,,,0
NDC,00000-0110-63,INV SATRALIZUMAB 120 MG/ML SYRINGE,0.65,0.42,,,0
NDC,00000-0110-64,INV SATRALIZUMAB/PLACEBO 120 MG/ML SYRINGE,0.65,0.42,,,0
NDC,00000-0110-71,INV ZN-C3 25 MG TABLETS,0.65,0.42,,,0
NDC,00000-0110-72,INV ZN-C3 100 MG TABLETS,0.65,0.42,,,0
NDC,00000-0110-73,INV ELRANATAMAB (PF-06863135) 40 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0110-74,INV TECOVIRIMAT 200 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-75,INV CLOFAZIMINE 50 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-77,INV IXAZOMIB/PLACEBO 2.3 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-78,INV IXAZOMIB/PLACEBO 3 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-79,INV IXAZOMIB/PLACEBO 4 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-81,INV TERIFLUNOMIDE/PLACEBO 14 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-82,SODIUM BICARB CONCENTRATED INFUSION 250 MEQ IN 250 ML,209.3,136.04,,,0
NDC,00000-0110-83,SODIUM BICARBONATE MOUTHWASH 5 G/250 ML IN STERILE WATER,12.8,8.32,,,0
NDC,00000-0110-84,INV FENEBRUTINIB 100 MG TABLET,0.65,0.42,,,0
NDC,00000-0110-90,DICLOFENAC 50 MG RECTAL SUPPOSITORY,8.9,5.78,,,0
NDC,00000-0110-92,INV IBERDOMIDE (CC-220) 0.75 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-93,INV IBERDOMIDE (CC-220) 1 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-94,INV IBERDOMIDE (CC-220) 1.3 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-95,INV IBERDOMIDE (CC-220) 1.6 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0110-96,GLYCERIN 99.5% ANHYDROUS INJECTION,763.7,496.4,,,0
NDC,00000-0111-01,PHENYLEPHRINE 0.2 MG/ML IV SYRINGE 20 ML (RMH ANESTHESIA ONLY),161.75,105.14,,,0
NDC,00000-0111-02,"SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (CADD PUMP,EPOCH)",67.15,43.65,,,0
NDC,00000-0111-03,"SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (CADD PUMP,EPOCH)",75.55,49.11,,,0
NDC,00000-0111-07,NIMODIPINE 30 MG/ML ORAL SOLUTION,31.85,20.7,,,0
NDC,00000-0111-09,INV LENALIDOMIDE 2.5 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0111-11,INV LENALIDOMIDE 5 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0111-13,INV LENALIDOMIDE 10 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0111-15,INV LENALIDOMIDE 25 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0111-19,FECAL MICROBIOTA TRANSPLANT (FMT) STANDARD DOSE LIQUID PREP (MTP-101LR),7110.65,4621.92,,,0
NDC,00000-0111-20,FECAL MICROBIOTA TRANSPLANT (FMT) HIGH DOSE LIQUID PREP (MTP-101LF),7110.65,4621.92,,,0
NDC,00000-0111-24,INV FAM-TRASTUZUMAB DERUXTECAN-NXKI 20 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-27,INV FLECAINIDE ACETATE (FLECIH-103)/PLACEBO,0.65,0.42,,,0
NDC,00000-0111-29,INV ASUNDEXIAN/PLACEBO 50MG TABLET,0.65,0.42,,,0
NDC,00000-0111-30,INV TRASTUZUMAB-PKRB 21 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-31,INV PERTUZUMAB 30MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-32,INV OLPASIRAN (AMG890)/PLACEBO 142 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-33,INV EVOGLIPTIN (DA-1229) 5 MG/10 MG/PLACEBO,0.65,0.42,,,0
NDC,00000-0111-39,INV VEBRELTINIB (APL-101) 100MG,0.65,0.42,,,0
NDC,00000-0111-41,METHADONE ORAL SOLUTION 10 MG/1 ML,10.85,7.05,,,0
NDC,00000-0111-44,ANTITHYMOCYTE GLOBULIN-ATG (ATGAM) TEST DOSE,337.9,219.64,,,0
NDC,00000-0111-45,INV TALQUETAMAB (JNJ-64407564) 2 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-46,INV TALQUETAMAB (JNJ-64407564) 40 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-56,HYDROXYUREA 100 MG/ML ORAL SUSPENSION,17.3,11.24,,,0
NDC,00000-0111-58,INV SIROLIMUS PROTEIN BOUND 5 MG/ML INTRAVENOUS SUSPENSION,0.65,0.42,,,0
NDC,00000-0111-65,INV ALDESLEUKIN INJECTION,0.65,0.42,,,0
NDC,00000-0111-67,INV FLUDARABINE 50MG/2ML INJECTABLE,0.65,0.42,,,0
NDC,00000-0111-68,INV RITUXIMAB-ABBS 10MG/ML SOLUTION FOR INJECTION,0.65,0.42,,,0
NDC,00000-0111-69,INV RITUXIMAB-ABBS 10MG/ML SOLUTION FOR INJECTION,0.65,0.42,,,0
NDC,00000-0111-72,(COMPOUNDING ONLY) EPCORITAMAB 1.6 MG/2ML IN NS,4006.05,2603.93,,,0
NDC,00000-0111-73,INV MEZIGDOMIDE (CC-92480) 0.2 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0111-74,INV MEZIGDOMIDE (CC-92480) 0.3 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0111-75,INV MEZIGDOMIDE (CC-92480) 0.4 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0111-76,INV MEZIGDOMIDE (CC-92480) 0.6 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0111-77,INV MEZIGDOMIDE (CC-92480) 0.8 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0111-78,INV MEZIGDOMIDE (CC-92480) 1 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0111-79,INV BENDAMUSTINE 2.5 MG/ML POWDER FOR SOLUTION,0.65,0.42,,,0
NDC,00000-0111-84,INV SELINEXOR/PLACEBO 20 MG TABLET,0.65,0.42,,,0
NDC,00000-0111-87,INV 3K3A-APC/PLACEBO INJECTION,0.65,0.42,,,0
NDC,00000-0111-88,INV IS-001 LYOPHILIZED POWDER,0.65,0.42,,,0
NDC,00000-0111-89,INV RUSFERTIDE (PTG-300) 10 MG/0.5 ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-91,INV RUSFERTIDE (PTG-300) 20 MG/0.5 ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-92,INV RUSFERTIDE (PTG-300) 30 MG/0.5 ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-93,INV RUSFERTIDE (PTG-300) 45 MG/0.5 ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-94,INV RUSFERTIDE (PTG-300) 60 MG/0.5 ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-95,INV RUSFERTIDE (PTG-300)/PLACEBO 10 MG/0.5 ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-96,INV RUSFERTIDE (PTG-300)/PLACEBO 20 MG/0.5 ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-97,INV RUSFERTIDE (PTG-300)/PLACEBO 30 MG/0.5 ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-98,INV RUSFERTIDE (PTG-300)/PLACEBO 45 MG/0.5 ML INJECTION,0.65,0.42,,,0
NDC,00000-0111-99,INV RUSFERTIDE (PTG-300)/PLACEBO 60 MG/0.5 ML INJECTION,0.65,0.42,,,0
NDC,00000-0112-05,INV TERIFLUNOMIDE/PLACEBO 14 MG TABLET,0.65,0.42,,,0
NDC,00000-0112-07,INV FREXALIMAB/PLACEBO 150 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0112-08,INV MILVEXIAN/PLACEBO 25 MG TABLET,0.65,0.42,,,0
NDC,00000-0112-17,INV ONDANSETRON 8 MG TABLET,0.65,0.42,,,0
NDC,00000-0112-18,INV ONDANSETRON/PLACEBO 8 MG TABLET,0.65,0.42,,,0
NDC,00000-0112-20,INV NAVTEMADLIN 30 MG TABLET,0.65,0.42,,,0
NDC,00000-0112-21,INV NAVTEMADLIN 60 MG TABLET,0.65,0.42,,,0
NDC,00000-0112-22,INV NAVTEMADLIN/PLACEBO 30 MG TABLET,0.65,0.42,,,0
NDC,00000-0112-23,INV NAVTEMADLIN/PLACEBO 60 MG TABLET,0.65,0.42,,,0
NDC,00000-0112-24,INV LOPERAMIDE 2 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0112-25,INV LOPERAMIDE/PLACEBO 2 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0112-28,INV EPCORITAMAB-BYSP 4 MG/0.8 ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0112-29,INV EPCORITAMAB-BYSP 48 MG/0.8 ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0112-30,INV SOTORASIB 120 MG TABLET,0.65,0.42,,,0
NDC,00000-0112-31,INV PANITUMUMAB INJECTION 100 MG/5 ML,0.65,0.42,,,0
NDC,00000-0112-33,INV EPCORITAMAB-BYSP 3 MG CHEMO INJECTION (STEP UP DOSE 3),0.65,0.42,,,0
NDC,00000-0112-34,INV SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0112-35,INV STABILIZER MIXTURE (PENTAGALLOYL GLUCOSE-IODOMIDOL) INJECTION,0.65,0.42,,,0
NDC,00000-0112-39,INV LOMUSTINE 10 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0112-40,INV LOMUSTINE 40 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0112-41,INV LOMUSTINE 100 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0112-42,INV BINIMETINIB 15 MG TABLET,0.65,0.42,,,0
NDC,00000-0112-43,INV PALBOCICLIB 125 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0112-44,INV PALBOCICLIB 100 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0112-45,INV PALBOCICLIB 75 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0112-50,INV BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,0.65,0.42,,,0
NDC,00000-0112-54,INV VINCRISTINE 1 MG/ML INJECTION,0.65,0.42,,,0
NDC,00000-0112-56,INV DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0112-57,INV PREDNISONE 20 MG TABLET,0.65,0.42,,,0
NDC,00000-0112-66,INV DAROLUTAMIDE 300MG TABLET,0.65,0.42,,,0
NDC,00000-0112-67,INV PLOZASIRAN (ARO-APOC3)/PLACEBO INJECTION 25MG,0.65,0.42,,,0
NDC,00000-0112-92,NICARDIPINE 400 MCG/4 ML INJECTION (CMP),61.85,40.2,,,0
NDC,00000-0112-93,"HEPARIN (PORCINE) 5,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV SOLN",63.1,41.02,,,0
NDC,00000-0112-95,INV PLASMALYTE-A 1000ML BAG,0.65,0.42,,,0
NDC,00000-0112-96,INV PLASMALYTE-A 500ML BAG,0.65,0.42,,,0
NDC,00000-0112-97,INV PLASMALYTE-A 10ML SYRINGE,0.65,0.42,,,0
NDC,00000-0112-98,INV OLVIMULOGENE NANIVACIREPVEC (OLVI-VEC) 1.9 X10EXP8 PFU/ML SUSPENSION FOR INJECTION,0.65,0.42,,,0
NDC,00000-0113-02,INV RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0113-11,KETAMINE 5% TOPICAL GEL (CMP),22.45,14.59,,,0
NDC,00000-0113-13,INV VUTRISIRAN (ALN-TTRSC02) 25 MG/0.5 ML SOLUTION FOR INJECTION,0.65,0.42,,,0
NDC,00000-0113-16,INV RELATLIMAB (BMS-986016) INJECTION,0.65,0.42,,,0
NDC,00000-0113-19,INV NTLA-2001/PLACEBO INJECTION,0.65,0.42,,,0
NDC,00000-0113-21,INV METHYLYPREDNISOLONE SOD SUC (PF) 125 MG/2 ML INJECTION,0.65,0.42,,,0
NDC,00000-0113-26,INV ADAGRASIB 200MG TABLET,0.65,0.42,,,0
NDC,00000-0113-27,INV ENTRECTINIB 200 MG CAPSULE,0.65,0.42,,,0
NDC,00000-0113-28,INV ABEMACICLIB 50 MG TABLET,0.65,0.42,,,0
NDC,00000-0113-31,INV TECLISTAMAB (JNJ-64407957) 10 MG/ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0113-32,INV TECLISTAMAB (JNJ-64407957) 90 MG/ML SUBCUTANEOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0113-33,INV QUIZARTINIB DIHYDROCHLORIDE/PLACEBO 30 MG TABLET,0.65,0.42,,,0
NDC,00000-0113-34,INV QUIZARTINIB DIHYDROCHLORIDE/PLACEBO 20 MG TABLET,0.65,0.42,,,0
NDC,00000-0113-36,INV GLOFITAMAB (RO7082859) 1 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0113-37,INV ENGLUMAFUSP ALFA (RO7227166) 5 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0113-42,TRETINOIN 2.5 MG/ML ORAL SOLUTION,19.4,12.61,,,0
NDC,00000-0113-43,INV DEXAMETHASONE 8 MG TABLET,0.65,0.42,,,0
NDC,00000-0113-45,INV PRALATREXATE 20 MG/ML INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0113-46,INV BELINOSTAT 500 MG INTRAVENOUS SOLUTION,0.65,0.42,,,0
NDC,00000-0113-47,INV OCRELIZUMAB 920 MG-HYALURONIDASE-OCSQ 23000 UNIT/23 ML SUBCUT SOLN,0.65,0.42,,,0
NDC,00000-1053-51,CRRT BGK 2/0 (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
NDC,00000-1069-57,CRRT BGK 4/2.5 WITH CALCIUM (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
NDC,00000-1075-01,CRRT B22GK 4/0 (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
NDC,00000-1104-11,CRRT BGK 4/0/1.2 (PRISMASATE) 5000 ML SOLUTION,146.75,95.39,,,0
NDC,00002-0213-01,INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,55.35,35.98,,,0
NDC,00002-1433-80,DULAGLUTIDE 0.75 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,717.65,466.47,,,0
NDC,00002-1434-80,DULAGLUTIDE 1.5 MG/0.5 ML SUBCUTANEOUS PEN INJECTOR,1430.7,929.96,,,0
NDC,00002-4182-30,BARICITINIB 2 MG TABLET,267.15,173.65,,,0
NDC,00002-7669-01,RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,6307.55,4099.91,,,0
NDC,00002-8501-01,INSULIN REGULAR HUMAN U-500(CONCENTRATE) 500 UNIT/ML SUBCUTANEOUS SOLN,6859.7,4458.8,,,0
NDC,00002-8715-01,INSULIN HUMAN U-100 NPH-REGULR 70-30 MIX 100 UNIT/ML SUBCUTANEOUS SUSP,126.7,82.36,,,0
NDC,00002-8799-59,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS PEN,123.2,80.08,,,0
NDC,00003-0494-20,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,35.75,23.24,,,0
NDC,00003-0893-31,APIXABAN 2.5 MG TABLET,26.5,17.22,,,0
NDC,00003-0894-31,APIXABAN 5 MG TABLET,26.5,17.22,,,0
NDC,00003-1614-12,ENTECAVIR 0.05 MG/ML ORAL SOLUTION,136.8,88.92,,,0
NDC,00003-2187-13,ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,7591.05,4934.18,,,0
NDC,00003-2291-11,ELOTUZUMAB 300 MG INTRAVENOUS SOLUTION,9710.55,6311.86,,,0
NDC,00003-2327-11,IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,37642.05,24467.33,,,0
NDC,00003-2328-22,IPILIMUMAB 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION,150321.75,97709.14,,,0
NDC,00003-3734-13,NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLUTION,33030.75,21469.99,,,0
NDC,00003-3772-11,NIVOLUMAB 40 MG/4 ML INTRAVENOUS SOLUTION,5573.55,3622.81,,,0
NDC,00003-3774-12,NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,13810.65,8976.92,,,0
NDC,00003-4522-11,ELOTUZUMAB 400 MG INTRAVENOUS SOLUTION,12919.9,8397.94,,,0
NDC,00003-7125-11,NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION,64054.0,41635.1,,,0
NDC,00004-0822-05,OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,30.6,19.89,,,0
NDC,00005-2000-10,PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,1135.2,737.88,,,0
NDC,00005-4461-19,MULTIVITAMIN-MINERAL-FOLIC ACID 400 MCG-LUTEIN 250 MCG CHEWABLE TABLET,0.2,0.13,,,0
NDC,00006-0112-28,SITAGLIPTIN PHOSPHATE 50 MG TABLET,36.4,23.66,,,0
NDC,00006-0221-01,SITAGLIPTIN PHOSPHATE 25 MG TABLET,36.4,23.66,,,0
NDC,00006-0227-61,RALTEGRAVIR 400 MG TABLET,110.1,71.56,,,0
NDC,00006-0277-01,SITAGLIPTIN PHOSPHATE 100 MG TABLET,36.4,23.66,,,0
NDC,00006-3025-00,BEZLOTOXUMAB 25 MG/ML INTRAVENOUS SOLUTION,15844.85,10299.15,,,0
NDC,00006-3026-02,PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,25035.75,16273.24,,,0
NDC,00006-3069-01,DORAVIRINE 100 MG TABLET,190.95,124.12,,,0
NDC,00006-3076-01,LETERMOVIR 480 MG TABLET,866.2,563.03,,,0
NDC,00006-4093-02,HEPATITIS B VIRUS VACCINE RECMB(PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE,134.95,87.72,,,0
NDC,00006-4096-01,HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE,365.5,237.58,,,0
NDC,00006-4681-00,"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",453.75,294.94,,,0
NDC,00006-4827-01,"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",866.9,563.48,,,0
NDC,00006-4837-03,PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE,559.6,363.74,,,0
NDC,00006-4841-41,HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION,365.5,237.58,,,0
NDC,00006-4981-01,HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP,134.95,87.72,,,0
NDC,00006-4992-00,HEPATITIS B VIRUS VACCINE RECOMB (PF) 40 MCG/ML INTRAMUSCULAR SUSP,558.65,363.12,,,0
NDC,00006-5004-01,LETERMOVIR 480 MG/24 ML INTRAVENOUS SOLUTION,1945.3,1264.44,,,0
NDC,00006-5423-12,SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,664.25,431.76,,,0
NDC,00008-0100-01,INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN,99287.85,64537.1,,,0
NDC,00008-4510-01,GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONCENTRATION) IV SOLN,42374.8,27543.62,,,0
NDC,00009-0003-02,METHYLPREDNISOLONE SOD SUCC (PF) 500 MG/4 ML INTRAVENOUS SOLUTION,251.15,163.25,,,0
NDC,00009-0011-04,HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,132.05,85.83,,,0
NDC,00009-0013-05,HYDROCORTISONE SOD SUCCINATE (PF) 250 MG/2 ML SOLUTION FOR INJECTION,238.3,154.9,,,0
NDC,00009-0016-12,HYDROCORTISONE SOD SUCCINATE (PF) 500 MG/4 ML SOLUTION FOR INJECTION,437.3,284.24,,,0
NDC,00009-0018-20,"METHYLPREDNISOLONE SOD SUCC (PF) 1,000 MG/8 ML INTRAVENOUS SOLUTION",316.7,205.86,,,0
NDC,00009-0039-33,METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,56.65,36.82,,,0
NDC,00009-0047-22,METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,70.65,45.92,,,0
NDC,00009-0086-01,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,42.05,27.33,,,0
NDC,00009-0271-01,ESTRADIOL CYPIONATE 5 MG/ML INTRAMUSCULAR OIL,78.45,50.99,,,0
NDC,00009-0280-02,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,44.35,28.83,,,0
NDC,00009-0347-02,TESTOSTERONE CYPIONATE 100 MG/ML INTRAMUSCULAR OIL,54.15,35.2,,,0
NDC,00009-0698-01,"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",236.65,153.82,,,0
NDC,00009-0746-30,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,277.0,180.05,,,0
NDC,00009-0758-01,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,145.3,94.44,,,0
NDC,00009-0825-01,HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,120.55,78.36,,,0
NDC,00009-3794-22,IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,447.55,290.91,,,0
NDC,00009-7224-02,"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION",24712.65,16063.22,,,0
NDC,00013-2596-91,IDARUBICIN 1 MG/ML INTRAVENOUS SOLUTION,820.25,533.16,,,0
NDC,00023-0312-04,WHITE PETROLATUM-MINERAL OIL EYE OINTMENT SORD,7.9,5.14,,,0
NDC,00023-1145-01,ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,3313.95,2154.07,,,0
NDC,00023-4491-30,CARBOXYMETHYL 0.5 %-GLYCERIN 1 %-POLYSORB 80 0.5 %-PF EYE DROPPERETTE,5.8,3.77,,,0
NDC,00023-5858-01,LEVONORGESTREL 20.4 MCG/24 HR (UP TO 8 YRS) 52 MG INTRAUTERINE DEVICE,1786.05,1160.93,,,0
NDC,00024-0654-01,ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION,3690.6,2398.89,,,0
NDC,00024-0656-01,ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION,18124.65,11781.02,,,0
NDC,00024-4142-60,DRONEDARONE 400 MG TABLET,42.85,27.85,,,0
NDC,00024-5150-10,RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,4674.0,3038.1,,,0
NDC,00024-5151-75,RASBURICASE 7.5 MG INTRAVENOUS SOLUTION,27650.2,17972.63,,,0
NDC,00024-5824-11,CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,54267.0,35273.55,,,0
NDC,00024-5922-01,SARILUMAB 200 MG/1.14 ML SUBCUTANEOUS PEN INJECTOR,11257.25,7317.21,,,0
NDC,00024-5926-05,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,90.35,58.73,,,0
NDC,00025-2732-31,"DISOPYRAMIDE PHOSPHATE ER 100 MG CAPSULE,EXTENDED RELEASE",17.1,11.12,,,0
NDC,00032-0046-70,"LIPASE-PROTEASE-AMYLASE (PORK)6,000-19,000-30,000 UNIT CAPSULE,DEL REL",10.85,7.05,,,0
NDC,00032-3016-13,"LIPASE-PROTEASE-AMYLASE (PORK)36,000-114,000-180K UNIT CAPSULE,DEL REL",41.95,27.27,,,0
NDC,00037-6823-15,PRAMOXINE 1 % TOPICAL FOAM,358.0,232.7,,,0
NDC,00046-0749-05,CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,1780.65,1157.42,,,0
NDC,00046-0872-21,CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREAM,1785.25,1160.41,,,0
NDC,00046-1100-81,CONJUGATED ESTROGENS 0.3 MG TABLET,25.05,16.28,,,0
NDC,00046-1101-81,CONJUGATED ESTROGENS 0.45 MG TABLET,25.05,16.28,,,0
NDC,00046-1102-81,CONJUGATED ESTROGENS 0.625 MG TABLET,25.05,16.28,,,0
NDC,00046-1104-81,CONJUGATED ESTROGENS 1.25 MG TABLET,25.05,16.28,,,0
NDC,00049-0520-22,PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,55.45,36.04,,,0
NDC,00049-0530-22,PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,155.9,101.34,,,0
NDC,00049-3190-01,VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,99.65,64.77,,,0
NDC,00052-0602-02,BCG LIVE 50 MG INTRAVESICAL SUSPENSION,783.45,509.24,,,0
NDC,00052-0603-02,"BCG VACCINE, LIVE (PF) 50 MG PERCUTANEOUS INJECTION SUSPENSION",785.85,510.8,,,0
NDC,00054-0010-20,FLECAINIDE 50 MG TABLET,5.95,3.87,,,0
NDC,00054-0235-24,MORPHINE 15 MG IMMEDIATE RELEASE TABLET,11.15,7.25,,,0
NDC,00054-0236-24,MORPHINE 30 MG IMMEDIATE RELEASE TABLET,13.2,8.58,,,0
NDC,00054-0243-24,CODEINE SULFATE 15 MG TABLET,11.0,7.15,,,0
NDC,00054-0244-25,CODEINE SULFATE 30 MG TABLET,11.2,7.28,,,0
NDC,00054-0382-25,CYCLOPHOSPHAMIDE 25 MG ORAL SOLID SORD,26.25,17.06,,,0
NDC,00054-0383-25,CYCLOPHOSPHAMIDE 50 MG ORAL SOLID SORD,44.35,28.83,,,0
NDC,00054-0404-01,MORPHINE CONCENTRATE (20 MG/ML) ORAL SOLUTION SORD,8.5,5.52,,,0
NDC,00054-0622-63,DICYCLOMINE 10 MG/5 ML ORAL SOLUTION,13.2,8.58,,,0
NDC,00054-0668-82,ALVIMOPAN 12 MG CAPSULE,331.45,215.44,,,0
NDC,00054-3120-41,CALCITRIOL 1 MCG/ML ORAL SOLUTION,8.4,5.46,,,0
NDC,00054-3176-44,DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),97.6,63.44,,,0
NDC,00054-3177-63,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,9.25,6.01,,,0
NDC,00054-3185-44,DIAZEPAM 5 MG/ML ORAL CONCENTRATE,9.0,5.85,,,0
NDC,00054-3194-46,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG/5 ML ORAL LIQUID,30.75,19.99,,,0
NDC,00054-3532-44,LORAZEPAM 2 MG/ML ORAL CONCENTRATE,129.9,84.44,,,0
NDC,00054-3722-50,PREDNISONE 5 MG/5 ML ORAL SOLUTION,10.95,7.12,,,0
NDC,00054-4179-25,DEXAMETHASONE 0.5 MG TABLET,4.95,3.22,,,0
NDC,00054-8146-22,CLOTRIMAZOLE 10 MG TROCHE,12.55,8.16,,,0
NDC,00054-8175-25,DEXAMETHASONE 4 MG TABLET,7.55,4.91,,,0
NDC,00054-8176-25,DEXAMETHASONE 2 MG TABLET,6.4,4.16,,,0
NDC,00054-8301-25,FUROSEMIDE 80 MG TABLET,5.75,3.74,,,0
NDC,00054-8526-25,LITHIUM CARBONATE 150 MG CAPSULE,5.05,3.28,,,0
NDC,00054-8740-25,PREDNISONE 2.5 MG TABLET,5.05,3.28,,,0
NDC,00065-0359-02,CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,144.8,94.12,,,0
NDC,00065-0395-15,CYCLOPENTOLATE 0.5 % EYE DROPS,381.15,247.75,,,0
NDC,00065-0397-02,CYCLOPENTOLATE 2 % EYE DROPS,179.25,116.51,,,0
NDC,00065-0408-72,ARTIFICIAL TEARS (HYPROMELLOSE) 0.5 % EYE DROPS,116.4,75.66,,,0
NDC,00065-0509-35,WHITE PETROLATUM-MINERAL OIL 94 %-3 % EYE OINTMENT,27.75,18.04,,,0
NDC,00065-0741-14,TETRACAINE HCL (PF) 0.5 % EYE DROPS,59.65,38.77,,,0
NDC,00065-0795-15,BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,32.7,21.26,,,0
NDC,00069-0238-01,RITUXIMAB-PVVR 10 MG/ML INTRAVENOUS SOLUTION,2429.95,1579.47,,,0
NDC,00069-0249-01,RITUXIMAB-PVVR 10 MG/ML INTRAVENOUS SOLUTION,11821.4,7683.91,,,0
NDC,00069-0291-01,FILGRASTIM-AAFI 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,457.25,297.21,,,0
NDC,00069-0292-10,FILGRASTIM-AAFI 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,457.2,297.18,,,0
NDC,00069-0315-01,BEVACIZUMAB-BVZR 25 MG/ML INTRAVENOUS SOLUTION,2175.8,1414.27,,,0
NDC,00069-0342-01,BEVACIZUMAB-BVZR 25 MG/ML INTRAVENOUS SOLUTION,8457.0,5497.05,,,0
NDC,00069-0344-01,"RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION",1299.15,844.45,,,0
NDC,00069-0809-01,INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,2875.8,1869.27,,,0
NDC,00069-1305-10,"EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION",124.6,80.99,,,0
NDC,00069-1306-10,"EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION",170.4,110.76,,,0
NDC,00069-1307-10,"EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION",216.2,140.53,,,0
NDC,00069-1308-10,"EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION",491.15,319.25,,,0
NDC,00069-1309-04,"EPOETIN ALFA-EPBX 40,000 UNIT/ML INJECTION SOLUTION",1865.9,1212.84,,,0
NDC,00069-1311-10,"EPOETIN ALFA-EPBX 20,000 UNIT/ML INJECTION SOLUTION",949.4,617.11,,,0
NDC,00069-2522-02,ELRANATAMAB-BCMM 40 MG/ML SUBCUTANEOUS SOLUTION,9438.95,6135.32,,,0
NDC,00069-4494-02,ELRANATAMAB-BCMM 40 MG/ML SUBCUTANEOUS SOLUTION,9438.95,6135.32,,,0
NDC,00069-5434-02,NIRMATRELVIR 150 MG (10)-RITONAVIR 100 MG (10) TABLETS IN A DOSE PACK,220.75,143.49,,,0
NDC,00069-5471-01,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,40.0,26.0,,,0
NDC,00069-5474-01,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,111.4,72.41,,,0
NDC,00071-2012-06,GABAPENTIN 250 MG/5 ML ORAL SOLUTION,33.25,21.61,,,0
NDC,00071-3740-66,PHENYTOIN SODIUM EXTENDED 30 MG CAPSULE,8.95,5.82,,,0
NDC,00074-0561-11,VENETOCLAX 10 MG TABLET,45.05,29.28,,,0
NDC,00074-0566-11,VENETOCLAX 50 MG TABLET,206.95,134.52,,,0
NDC,00074-0576-30,VENETOCLAX 100 MG TABLET,409.25,266.01,,,0
NDC,00074-1043-28,"UPADACITINIB ER 45 MG TABLET,EXTENDED RELEASE 24 HR",1372.25,891.96,,,0
NDC,00074-3346-03,LEUPROLIDE ACETATE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,2235.55,1453.11,,,0
NDC,00074-3473-03,LEUPROLIDE ACETATE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT,4389.0,2852.85,,,0
NDC,00074-3641-03,LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,7383.5,4799.28,,,0
NDC,00074-3642-03,LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,799.9,519.94,,,0
NDC,00074-3663-03,LEUPROLIDE ACETATE 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,21986.45,14291.19,,,0
NDC,00074-3683-03,LEUPROLIDE 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,2953.3,1919.64,,,0
NDC,00074-4382-20,CISATRACURIUM CONCENTRATE 10 MG/ML (ICU USE ONLY) INTRAVENOUS SOLUTION,1470.55,955.86,,,0
NDC,00074-5015-01,RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION,43182.45,28068.59,,,0
NDC,00078-0109-01,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION,363.0,235.95,,,0
NDC,00078-0241-61,CYCLOSPORINE 100 MG CAPSULE,57.4,37.31,,,0
NDC,00078-0274-22,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,1856.3,1206.6,,,0
NDC,00078-0385-66,"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",27.3,17.74,,,0
NDC,00078-0568-45,ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,20.85,13.55,,,0
NDC,00078-0659-20,SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,38.6,25.09,,,0
NDC,00078-0696-67,SACUBITRIL 97 MG-VALSARTAN 103 MG TABLET,38.6,25.09,,,0
NDC,00078-0698-02,MIDOSTAURIN 25 MG CAPSULE,666.65,433.32,,,0
NDC,00078-0777-67,SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,38.6,25.09,,,0
NDC,00078-0811-81,"OCTREOTIDE,MICROSPHERES ER 10 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",17042.1,11077.36,,,0
NDC,00078-0818-81,"OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",22317.85,14506.6,,,0
NDC,00078-0825-81,"OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",33402.85,21711.85,,,0
NDC,00078-0846-19,TISAGENLECLEUCEL 0.2 X10EXP6 TO 2.5X10EXP8 CELL INTRAVENOUS SUSPENSION,2486986.75,1616541.39,,,0
NDC,00078-0876-01,TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,1014.2,659.23,,,0
NDC,00078-0883-61,CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLUTION,10257.15,6667.15,,,0
NDC,00078-0958-19,TISAGENLECLEUCEL 0.6 X 10EXP8 TO 6 X10EXP8 CELL INTRAVENOUS SUSPENSION,2048685.85,1331645.8,,,0
NDC,00088-2220-33,INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,311.2,202.28,,,0
NDC,00093-0262-30,FLUOCINONIDE 0.05 % TOPICAL CREAM,69.45,45.14,,,0
NDC,00093-0983-01,"NYSTATIN 500,000 UNIT TABLET",7.5,4.88,,,0
NDC,00093-1010-42,MUPIROCIN 2 % TOPICAL OINTMENT (NASAL TXSUB),43.75,28.44,,,0
NDC,00093-2026-31,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,12.85,8.35,,,0
NDC,00093-3060-56,RASAGILINE 0.5 MG TABLET,10.65,6.92,,,0
NDC,00093-3123-01,DICLOXACILLIN 250 MG CAPSULE,6.25,4.06,,,0
NDC,00093-3129-01,DISOPYRAMIDE PHOSPHATE 150 MG CAPSULE,8.55,5.56,,,0
NDC,00093-3196-53,CEFADROXIL 500 MG CAPSULE,5.6,3.64,,,0
NDC,00093-3425-01,LORAZEPAM 0.5 MG TABLET,8.4,5.46,,,0
NDC,00093-3427-01,LORAZEPAM 2 MG TABLET,8.45,5.49,,,0
NDC,00093-3656-21,BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,157.6,102.44,,,0
NDC,00093-4127-73,PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SOLUTION,30.35,19.73,,,0
NDC,00093-4136-64,CEFDINIR 125 MG/5 ML ORAL SUSPENSION,26.75,17.39,,,0
NDC,00093-4175-73,CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION,10.05,6.53,,,0
NDC,00093-4177-74,CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,10.3,6.7,,,0
NDC,00093-5031-56,TIAGABINE 4 MG TABLET,22.95,14.92,,,0
NDC,00093-5504-56,OLANZAPINE-FLUOXETINE 6 MG-25 MG CAPSULE,23.35,15.18,,,0
NDC,00093-5505-56,OLANZAPINE-FLUOXETINE 6 MG-50 MG CAPSULE,21.5,13.98,,,0
NDC,00093-5506-56,OLANZAPINE-FLUOXETINE 12 MG-25 MG CAPSULE,29.2,18.98,,,0
NDC,00093-5528-56,ATAZANAVIR 300 MG CAPSULE,35.05,22.78,,,0
NDC,00093-7163-56,"TOLTERODINE ER 2 MG CAPSULE,EXTENDED RELEASE 24 HR",23.2,15.08,,,0
NDC,00093-7393-98,"NIACIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR",10.4,6.76,,,0
NDC,00093-7473-06,CAPECITABINE 150 MG TABLET,8.15,5.3,,,0
NDC,00093-8740-01,MEXILETINE 200 MG CAPSULE,9.15,5.95,,,0
NDC,00093-9018-19,CYCLOSPORINE MODIFIED 25 MG CAPSULE,5.9,3.84,,,0
NDC,00093-9020-65,CYCLOSPORINE MODIFIED 100 MG CAPSULE,9.95,6.47,,,0
NDC,00093-9701-01,CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,5.0,3.25,,,0
NDC,00115-1070-01,DIPYRIDAMOLE 25 MG TABLET,5.95,3.87,,,0
NDC,00115-4433-01,DANTROLENE 100 MG CAPSULE,9.3,6.04,,,0
NDC,00116-4023-16,PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,5.6,3.64,,,0
NDC,00121-0431-30,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,0.95,0.62,,,0
NDC,00121-0581-05,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,5.15,3.35,,,0
NDC,00121-0638-00,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,1.75,1.14,,,0
NDC,00121-0722-08,SENNA LEAF EXTRACT 176 MG/5 ML ORAL SYRUP,10.95,7.12,,,0
NDC,00121-0893-00,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH,7.05,4.58,,,0
NDC,00121-1190-00,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION,11.5,7.48,,,0
NDC,00121-1350-00,VALPROIC ACID (AS SODIUM SALT) 500 MG/10 ML (10 ML) ORAL SOLUTION,8.0,5.2,,,0
NDC,00121-1544-40,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,44.35,28.83,,,0
NDC,00121-1576-10,METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,13.85,9.0,,,0
NDC,00121-1744-00,GUAIFENESIN 100 MG/5 ML ORAL LIQUID,2.95,1.92,,,0
NDC,00121-1775-05,CODEINE 10 MG-GUAIFENESIN 100 MG/5 ML ORAL LIQUID,14.15,9.2,,,0
NDC,00121-1828-00,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,0.75,0.49,,,0
NDC,00121-1870-00,DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,7.3,4.74,,,0
NDC,00121-4675-00,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,8.6,5.59,,,0
NDC,00121-4722-15,SENNA LEAF EXTRACT 176 MG/5 ML ORAL SYRUP,3.75,2.44,,,0
NDC,00121-4759-05,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLUTION,32.2,20.93,,,0
NDC,00121-4766-05,"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",8.3,5.4,,,0
NDC,00132-0301-40,MINERAL OIL ENEMA,10.45,6.79,,,0
NDC,00143-9088-01,DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION,105.25,68.41,,,0
NDC,00143-9135-01,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,294.15,191.2,,,0
NDC,00143-9261-01,CEFAZOLIN 10 GRAM SOLUTION FOR INJECTION,52.9,34.38,,,0
NDC,00143-9262-25,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,35.75,23.24,,,0
NDC,00143-9309-01,THIOTEPA 15 MG SOLUTION FOR INJECTION,1624.65,1056.02,,,0
NDC,00143-9315-24,LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,64.65,42.02,,,0
NDC,00143-9316-24,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,66.75,43.39,,,0
NDC,00143-9317-24,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,67.55,43.91,,,0
NDC,00143-9380-01,MIDAZOLAM (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,108.65,70.62,,,0
NDC,00143-9428-01,FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION,141.75,92.14,,,0
NDC,00143-9503-01,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,148.9,96.78,,,0
NDC,00143-9506-10,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,41.6,27.04,,,0
NDC,00143-9508-10,KETAMINE 50 MG/ML INJECTION SOLUTION,33.3,21.64,,,0
NDC,00143-9511-01,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION (RESEARCH TRIAL ROUNDING TO 1 MG),174.65,113.52,,,0
NDC,00143-9512-01,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,263.3,171.14,,,0
NDC,00143-9514-01,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,37.1,24.12,,,0
NDC,00143-9531-01,IFOSFAMIDE 1 GRAM/20 ML INTRAVENOUS SOLUTION,209.6,136.24,,,0
NDC,00143-9570-01,SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE 62.5 MG/5 ML INTRAVENOUS,73.2,47.58,,,0
NDC,00143-9637-01,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,44.05,28.63,,,0
NDC,00143-9710-10,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,50.9,33.08,,,0
NDC,00143-9719-01,MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,77.2,50.18,,,0
NDC,00143-9746-10,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,34.4,22.36,,,0
NDC,00143-9837-01,PENICILLIN V POTASSIUM 250 MG TABLET,4.8,3.12,,,0
NDC,00143-9859-01,CEFTRIAXONE (IM) 250 MG INJECTION,36.6,23.79,,,0
NDC,00143-9871-01,CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLUTION,359.65,233.77,,,0
NDC,00143-9872-01,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,55.2,35.88,,,0
NDC,00143-9889-15,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,5.05,3.28,,,0
NDC,00143-9923-90,CEFAZOLIN 500 MG SOLUTION FOR INJECTION,38.85,25.25,,,0
NDC,00168-0099-15,KETOCONAZOLE 2 % TOPICAL CREAM,63.6,41.34,,,0
NDC,00168-0258-15,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,72.3,47.0,,,0
NDC,00168-0323-46,METRONIDAZOLE 0.75 % TOPICAL CREAM,269.95,175.47,,,0
NDC,00168-0357-56,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL KIT,159.6,103.74,,,0
NDC,00169-4303-99,SEMAGLUTIDE 3 MG TABLET,4.6,2.99,,,0
NDC,00169-6339-10,INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) SUBCUTANEOUS PEN,104.6,67.99,,,0
NDC,00169-7201-01,"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",11529.95,7494.47,,,0
NDC,00169-7202-01,"COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLUTION",23027.0,14967.55,,,0
NDC,00169-7205-01,"COAGULATION FACTOR VIIA RECOMB 5 MG (5,000 MCG) INTRAVENOUS SOLUTION",57518.1,37386.76,,,0
NDC,00173-0859-10,FLUTICASONE FUROATE 100 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER,24.25,15.76,,,0
NDC,00173-0869-10,UMECLIDINIUM 62.5 MCG-VILANTEROL 25 MCG/ACTUATION POWDR FOR INHALATION,28.15,18.3,,,0
NDC,00173-0874-14,FLUTICASONE FUROATE 100 MCG/ACTUATION BLISTER POWDER FOR INHALATION,276.45,179.69,,,0
NDC,00173-0882-10,FLUTICASONE FUROATE 200 MCG-VILANTEROL 25 MCG/DOSE INHALATION POWDER,24.25,15.76,,,0
NDC,00173-0887-10,FLUTICASONE FUR. 100 MCG-UMECLID 62.5 MCG-VILANT 25 MCG INHALAT.POWDER,37.25,24.21,,,0
NDC,00173-0893-10,FLUTICASONE FUR. 200 MCG-UMECLID 62.5 MCG-VILANT 25 MCG INHALAT.POWDER,37.25,24.21,,,0
NDC,00178-0800-01,CALCIUM 200 MG (AS CITRATE)-VITAMIN D3 6.25 MCG (250 UNIT) TABLET,0.1,0.06,,,0
NDC,00185-0842-01,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,9.05,5.88,,,0
NDC,00186-0370-28,BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,497.7,323.5,,,0
NDC,00186-0372-28,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,243.85,158.5,,,0
NDC,00186-0776-60,TICAGRELOR 60 MG TABLET,26.9,17.48,,,0
NDC,00186-0777-39,TICAGRELOR 90 MG TABLET,26.9,17.48,,,0
NDC,00187-1416-16,COAL TAR 1 % SHAMPOO,95.85,62.3,,,0
NDC,00224-1901-00,PSYLLIUM HUSK 6 GRAM ORAL POWDER PACKET,0.45,0.29,,,0
NDC,00225-0525-47,SODIUM CHLORIDE-ALOE VERA NASAL GEL,18.75,12.19,,,0
NDC,00225-0805-47,PHENYLEPHRINE 0.5 % NASAL SPRAY,22.0,14.3,,,0
NDC,00225-0810-47,PHENYLEPHRINE 1 % NASAL SPRAY,23.65,15.37,,,0
NDC,00228-2850-11,"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",6.75,4.39,,,0
NDC,00245-5317-89,POTASSIUM CHLORIDE ER 10 MEQ TABLET SORD,5.25,3.41,,,0
NDC,00245-5319-89,POTASSIUM CHLORIDE ER 20 MEQ TABLET SORD,5.3,3.44,,,0
NDC,00254-1016-36,POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,113.4,73.71,,,0
NDC,00254-3029-02,LUBIPROSTONE 24 MCG CAPSULE,7.25,4.71,,,0
NDC,00264-2304-10,ACETIC ACID 0.25 % IRRIGATION SOLUTION,37.95,24.67,,,0
NDC,00264-3103-11,CEFAZOLIN 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,91.05,59.18,,,0
NDC,00264-3153-11,CEFTRIAXONE 1 GRAM/50 ML IN DEXTROSE (ISO-OSMOT) INTRAVENOUS PIGGYBACK,103.6,67.34,,,0
NDC,00264-3155-11,CEFTRIAXONE 2 GRAM/50 ML IN DEXTROSE (ISO-OSM) INTRAVENOUS PIGGYBACK,118.5,77.02,,,0
NDC,00264-3183-11,MEROPENEM 500 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,103.25,67.11,,,0
NDC,00264-3185-11,MEROPENEM 1 GRAM/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,118.9,77.28,,,0
NDC,00264-3195-11,CEFEPIME 2 GRAM/50 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,125.25,81.41,,,0
NDC,00264-4500-00,PARENTERAL AMINO ACID 15 % COMBINATION NO.6 INTRAVENOUS SOLUTION,284.0,184.6,,,0
NDC,00264-7751-00,DEXTROSE 5 % IN LACTATED RINGERS IV BOLUS,65.05,42.28,,,0
NDC,00264-9587-20,"INV HEPARIN 25,000 UNITS IN DEXTROSE 5% 250 ML INFUSION",121.6,79.04,,,0
NDC,00270-1316-52,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,77.0,50.05,,,0
NDC,00281-0326-08,NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,11.0,7.15,,,0
NDC,00283-0610-26,BENZOCAINE 20 % MUCOSAL SPRAY,0.95,0.62,,,0
NDC,00295-7520-40,CALCIUM GLUCONATE 2.5% (CALGONATE) TOPICAL GEL 25 GM,36.0,23.4,,,0
NDC,00310-1105-30,SODIUM ZIRCONIUM CYCLOSILICATE 5 GRAM ORAL POWDER PACKET,64.35,41.83,,,0
NDC,00310-1110-30,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL POWDER PACKET,64.35,41.83,,,0
NDC,00310-3040-00,ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION,27179.55,17666.71,,,0
NDC,00310-4500-12,DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION,4357.65,2832.47,,,0
NDC,00310-6210-39,DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,52.0,33.8,,,0
NDC,00327-0001-10,OXYCHLOROSENE SODIUM TOPICAL POWDER FOR SOLUTION,21.2,13.78,,,0
NDC,00327-0012-30,CITRIC AC 1980.6 MG-GLUCONO 59.4 MG-MAG CARB 980.4 MG/30 ML IRRIG.SOLN,82.15,53.4,,,0
NDC,00338-0003-47,"WATER FOR IRRIGATION, STERILE SOLUTION",65.05,42.28,,,0
NDC,00338-0004-02,"WATER FOR IRRIGATION, STERILE SOLUTION",77.65,50.47,,,0
NDC,00338-0004-03,"WATER FOR IRRIGATION, STERILE SOLUTION",67.15,43.65,,,0
NDC,00338-0013-04,"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",71.35,46.38,,,0
NDC,00338-0017-02,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,53.925,35.05,,,0
NDC,00338-0017-03,DEXTROSE 5 % IV BOLUS,37.95,24.67,,,0
NDC,00338-0017-04,DEXTROSE 5 % IV BOLUS,60.85,39.55,,,0
NDC,00338-0017-41,DEXTROSE 5 % IV BOLUS,78.3,50.9,,,0
NDC,00338-0017-48,DEXTROSE 5 % IV BOLUS,77.65,50.47,,,0
NDC,00338-0023-02,DEXTROSE 10 % IV BOLUS,12.45,8.09,,,0
NDC,00338-0023-03,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,66.625,43.305,,,0
NDC,00338-0023-04,DEXTROSE 10 % IV BOLUS,61.9,40.24,,,0
NDC,00338-0043-03,SODIUM CHLORIDE 0.45 % IV BOLUS,62.95,40.92,,,0
NDC,00338-0043-04,SODIUM CHLORIDE 0.45 % IV BOLUS,64.0,41.599999999999994,,,0
NDC,00338-0047-47,SODIUM CHLORIDE 0.9 % BLADDER IRRIGATION SOLUTION,71.35,46.38,,,0
NDC,00338-0048-04,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,67.15,43.65,,,0
NDC,00338-0049-02,SODIUM CHLORIDE 0.9 % IV BOLUS,77.1,50.11,,,0
NDC,00338-0049-03,SODIUM CHLORIDE 0.9 % IV BOLUS,66.625,43.31,,,0
NDC,00338-0049-04,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,64.0,41.599999999999994,,,0
NDC,00338-0049-31,SODIUM CHLORIDE 0.9 % FOR PRESSURIZED LINE SOLUTION,188.65,122.62,,,0
NDC,00338-0049-38,SODIUM CHLORIDE 0.9 % FOR PRESSURIZED LINE SOLUTION,121.6,79.04,,,0
NDC,00338-0049-48,SODIUM CHLORIDE 0.9 % INTRAVENOUS FLUSH (BAG SIZE 100 ML OR LESS),66.3,43.1,,,0
NDC,00338-0051-44,INV SODIUM CHLORIDE (NS) 0.9% SLUSH IRRIGATION SOLUTION,322.75,209.79,,,0
NDC,00338-0054-03,SODIUM CHLORIDE 3 % HYPEROSMOLAR INTRAVENOUS INJECTION SOLUTION,66.625,43.305,,,0
NDC,00338-0077-04,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,67.15,43.65,,,0
NDC,00338-0085-04,DEXTROSE 5 % AND 0.45 % NACL IV BOLUS,64.0,41.599999999999994,,,0
NDC,00338-0089-04,DEXTROSE 5 % AND 0.9 % NACL IV BOLUS,64.0,41.599999999999994,,,0
NDC,00338-0114-04,LACTATED RINGERS IRRIGATION SOLUTION,65.85,42.8,,,0
NDC,00338-0117-04,LACTATED RINGERS IV BOLUS,60.85,39.55,,,0
NDC,00338-0125-04,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,67.15,43.65,,,0
NDC,00338-0126-12,INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,120.35,78.23,,,0
NDC,00338-0137-27,LACTATED RINGERS IRRIGATION SOLUTION,96.5,62.72,,,0
NDC,00338-0221-04,ELECTROLYTE-A INTRAVENOUS SOLUTION,69.25,45.015,,,0
NDC,00338-0295-47,SORBITOL 3 % IRRIGATION SOLUTION,109.05,70.88,,,0
NDC,00338-0330-01,"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",1048.0,681.2,,,0
NDC,00338-0357-03,MANNITOL 20 % INTRAVENOUS SOLUTION,71.7,46.6,,,0
NDC,00338-0409-03,LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,75.55,49.11,,,0
NDC,00338-0431-03,"HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV",77.65,50.47,,,0
NDC,00338-0433-04,"HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV",75.55,49.11,,,0
NDC,00338-0502-06,PARENTERAL AMINO ACID 15 % COMBINATION NO.5 INTRAVENOUS SOLUTION,274.85,178.65,,,0
NDC,00338-0503-48,GENTAMICIN 80 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,67.55,43.91,,,0
NDC,00338-0505-48,GENTAMICIN 100 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,68.4,44.46,,,0
NDC,00338-0507-48,GENTAMICIN 120 MG/100 ML IN SODIUM CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,69.25,45.01,,,0
NDC,00338-0551-18,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,70.95,46.12,,,0
NDC,00338-0553-11,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,70.95,46.12,,,0
NDC,00338-0553-18,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,70.95,46.12,,,0
NDC,00338-0663-04,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.2 % SODIUM CHLORIDE IV,75.55,49.11,,,0
NDC,00338-0669-04,POTASSIUM CHLORIDE 10 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,75.55,49.11,,,0
NDC,00338-0671-04,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,71.35,46.38,,,0
NDC,00338-0673-04,POTASSIUM CHLORIDE 30 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,75.55,49.11,,,0
NDC,00338-0675-04,POTASSIUM CHLORIDE 40 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,75.55,49.11,,,0
NDC,00338-0683-04,POTASSIUM CHLORIDE 20 MEQ/L IN 5 % DEXTROSE INTRAVENOUS SOLUTION,75.55,49.11,,,0
NDC,00338-0691-04,POTASSIUM CHLORIDE 20 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,71.35,46.38,,,0
NDC,00338-0695-04,POTASSIUM CHLORIDE 40 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,75.55,49.11,,,0
NDC,00338-0703-48,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,69.25,45.01,,,0
NDC,00338-0704-34,POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,71.35,46.38,,,0
NDC,00338-0709-48,POTASSIUM CHLORIDE 10 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,69.65,45.27,,,0
NDC,00338-0719-06,DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,109.05,70.88,,,0
NDC,00338-0803-04,POTASSIUM CHLORIDE 20 MEQ/L IN D5-0.9 % SODIUM CHLORIDE INTRAVENOUS,71.35,46.38,,,0
NDC,00338-0811-04,POTASSIUM CHLORIDE 20 MEQ/L-LACTATED RINGERS-5 % DEXTROSE INTRAVENOUS,75.55,49.11,,,0
NDC,00338-1007-02,"DOPAMINE 400 MG/250 ML (1,600 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",99.65,64.77,,,0
NDC,00338-1025-41,PENICILLIN G POT 3 MILLION UNIT/50 ML-DEXTROSE INTRAVENOUS PIGGYBACK,72.4,47.06,,,0
NDC,00338-1049-02,NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,127.9,83.14,,,0
NDC,00338-1055-48,METRONIDAZOLE 5 MG/ML IVPB,63.825,41.489999999999995,,,0
NDC,00338-1075-02,"DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV",104.85,68.15,,,0
NDC,00338-1089-04,AMINO ACID 4.25 % NO.1 IN DEXTROSE 5 % INTRAVENOUS SOLUTION,149.05,96.88,,,0
NDC,00338-1123-04,AMINO ACID 5 % NO.6-DEXTROSE 15 %-ELECTROLYTES NO.23 IV SOLUTION,359.45,233.64,,,0
NDC,00338-1133-03,AMINO ACID 4.25 % NO.1 IN DEXTROSE 5 % INTRAVENOUS SOLUTION,86.25,56.06,,,0
NDC,00338-1301-48,CEFEPIME 2 GRAM/100 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,237.25,154.21,,,0
NDC,00338-1709-40,MAGNESIUM SULFATE 1 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,64.65,42.02,,,0
NDC,00338-3508-41,CEFAZOLIN 2 GRAM/100 ML IN DEXTROSE(ISO-OSMOTIC) INTRAVENOUS PIGGYBACK,97.75,63.54,,,0
NDC,00338-3552-48,VANCOMYCIN 1 GRAM/200 ML IN DEXTROSE 5 % INTRAVENOUS PIGGYBACK,171.9,111.74,,,0
NDC,00338-3582-01,VANCOMYCIN 750 MG/150 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,112.85,73.35,,,0
NDC,00338-6045-37,FLUCONAZOLE 2 MG/ML INTRAVENOUS SOLUTION,84.75,55.09,,,0
NDC,00338-6046-48,FLUCONAZOLE 2 MG/ML INTRAVENOUS SOLUTION,81.8,53.17,,,0
NDC,00338-9540-07,"OLIVE, SOYBEAN OIL FAT EMULSION 20 % INTRAVENOUS",65.7,42.7,,,0
NDC,00338-9549-24,CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,79.3,51.54,,,0
NDC,00338-9553-24,CLINDAMYCIN 900 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK,84.1,54.66,,,0
NDC,00338-9636-01,PIPERACILLIN-TAZOBACTAM 3.375 GRAM/50 ML DEXTROSE(ISO-OS) IV PIGGYBACK,143.85,93.5,,,0
NDC,00338-9638-12,PIPERACILLIN-TAZOBACTAM 4.5 GRAM/100 ML DEXTROSE(ISO-OSM) IV PIGGYBACK,165.2,107.38,,,0
NDC,00363-0075-64,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,1.4,0.91,,,0
NDC,00378-2401-01,TRIFLUOPERAZINE 1 MG TABLET,6.4,4.16,,,0
NDC,00378-2895-20,FERRIC CITRATE 210 MG IRON TABLET,24.0,15.6,,,0
NDC,00378-3352-16,ESTRADIOL 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,55.05,35.78,,,0
NDC,00378-4050-91,NEVIRAPINE 200 MG TABLET,5.0,3.25,,,0
NDC,00378-4271-93,AMBRISENTAN 10 MG TABLET,32.8,21.32,,,0
NDC,00378-4640-16,ESTRADIOL 0.1 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,29.4,19.11,,,0
NDC,00378-4642-26,ESTRADIOL 0.05 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,29.1,18.92,,,0
NDC,00378-4643-16,ESTRADIOL 0.0375 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,30.8,20.02,,,0
NDC,00378-6174-01,METOLAZONE 10 MG TABLET,11.7,7.6,,,0
NDC,00378-6333-80,"ACAMPROSATE 333 MG TABLET,DELAYED RELEASE",6.2,4.03,,,0
NDC,00378-9102-16,NITROGLYCERIN 0.1 MG/HR TRANSDERMAL 24 HOUR PATCH,6.35,4.13,,,0
NDC,00378-9104-93,NITROGLYCERIN 0.2 MG/HR TRANSDERMAL 24 HOUR PATCH,6.25,4.06,,,0
NDC,00378-9112-93,NITROGLYCERIN 0.4 MG/HR TRANSDERMAL 24 HOUR PATCH,6.8,4.42,,,0
NDC,00386-0001-13,ETHYL CHLORIDE 100 % TOPICAL SPRAY,123.45,80.24,,,0
NDC,00386-0004-04,NORFLURANE-PENTAFLUOROPROPANE TOPICAL SPRAY,99.7,64.8,,,0
NDC,00394-0859-32,HYDROCORTISONE 1 % LOTION,6.75,4.39,,,0
NDC,00395-1003-92,GENTIAN VIOLET 1 % TOPICAL SOLUTION,5.5,3.58,,,0
NDC,00395-1667-92,METHYL SALICYLATE TOPICAL LIQUID,34.6,22.49,,,0
NDC,00395-2662-16,CHERRY FLAVOR (BULK) ORAL LIQUID,39.3,25.54,,,0
NDC,00406-0484-62,ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET,9.95,6.47,,,0
NDC,00406-0512-01,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,8.9,5.78,,,0
NDC,00406-5755-62,METHADONE 5 MG TABLET,9.6,6.24,,,0
NDC,00406-8003-30,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,8.6,5.59,,,0
NDC,00406-8315-62,"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",11.3,7.34,,,0
NDC,00406-8390-23,"MORPHINE ER 100 MG TABLET,EXTENDED RELEASE",25.15,16.35,,,0
NDC,00406-8557-30,OXYCODONE 20 MG/ML ORAL CONCENTRATE,180.7,117.46,,,0
NDC,00406-8891-01,DEXTROAMPHETAMINE-AMPHETAMINE 5 MG TABLET,9.35,6.08,,,0
NDC,00406-8960-01,"DEXTROAMPHETAMINE SULFATE ER 5 MG CAPSULE,EXTENDED RELEASE",13.75,8.94,,,0
NDC,00406-8961-01,"DEXTROAMPHETAMINE SULFATE ER 10 MG CAPSULE,EXTENDED RELEASE",15.3,9.94,,,0
NDC,00406-9202-30,FENTANYL 200 MCG LOZENGE ON A HANDLE,32.75,21.29,,,0
NDC,00407-1414-72,IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION,175.65,114.17,,,0
NDC,00407-1414-91,IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION,173.25,112.61,,,0
NDC,00409-0001-25,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,34.0,22.1,,,0
NDC,00409-0040-10,KETAMINE 100 MG/ML INJECTION SOLUTION,73.2,47.58,,,0
NDC,00409-0181-25,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,126.05,81.93,,,0
NDC,00409-0182-25,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,191.4,124.41,,,0
NDC,00409-0185-01,GEMCITABINE 200 MG INTRAVENOUS SOLUTION,123.45,80.24,,,0
NDC,00409-0801-01,PENTOSTATIN 10 MG INTRAVENOUS SOLUTION,9884.1,6424.66,,,0
NDC,00409-1045-01,PEMETREXED DISODIUM 25 MG/ML INTRAVENOUS SOLUTION,178.3,115.9,,,0
NDC,00409-1144-02,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,39.45,25.64,,,0
NDC,00409-1159-10,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,34.25,22.26,,,0
NDC,00409-1160-01,BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION,47.8,31.07,,,0
NDC,00409-1163-18,BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION,34.2,22.23,,,0
NDC,00409-1174-10,DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,118.25,76.86,,,0
NDC,00409-1176-30,MEPERIDINE (PF) 25 MG/ML INJECTION SYRINGE,62.2,40.43,,,0
NDC,00409-1209-01,"LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION",36.15,23.5,,,0
NDC,00409-1283-31,HYDROMORPHONE 1 MG/ML INJECTION SYRINGE,39.75,25.84,,,0
NDC,00409-1312-03,HYDROMORPHONE 2 MG/ML INJECTION SYRINGE,42.55,27.66,,,0
NDC,00409-1323-05,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,63.05,40.98,,,0
NDC,00409-1434-01,"DEXMEDETOMIDINE 1,000 MCG/250 ML(4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV",220.1,143.06,,,0
NDC,00409-1463-49,NALBUPHINE 10 MG/ML INJECTION SOLUTION,48.75,31.69,,,0
NDC,00409-1467-01,NALBUPHINE 20 MG/ML INJECTION SOLUTION,54.0,35.1,,,0
NDC,00409-1660-50,DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,98.15,63.8,,,0
NDC,00409-1752-50,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",37.05,24.08,,,0
NDC,00409-1782-69,NALOXONE 0.4 MG/ML INJECTION SYRINGE,104.5,67.92,,,0
NDC,00409-1805-10,HYDROMORPHONE 0.25 MG/0.5 ML INJECTION SYRINGE,45.6,29.64,,,0
NDC,00409-1891-01,MORPHINE 4 MG/ML INTRAVENOUS SYRINGE,40.55,26.36,,,0
NDC,00409-1896-20,MORPHINE 50 MG/ML INTRAVENOUS SOLUTION,127.5,82.88,,,0
NDC,00409-1902-11,PROCAINAMIDE 100 MG/ML INJECTION SOLUTION,221.65,144.07,,,0
NDC,00409-1966-07,"SODIUM CHLORIDE 0.9 %, BACTERIOSTATIC INJECTION SOLUTION",33.4,21.71,,,0
NDC,00409-1985-30,LORAZEPAM 2 MG/ML INJECTION SYRINGE,36.35,23.63,,,0
NDC,00409-2011-25,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,39.05,25.38,,,0
NDC,00409-2016-10,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,35.75,23.24,,,0
NDC,00409-2188-01,PEMETREXED DISODIUM 25 MG/ML INTRAVENOUS SOLUTION,328.6,213.59,,,0
NDC,00409-2308-49,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,37.35,24.28,,,0
NDC,00409-2344-02,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,64.25,41.76,,,0
NDC,00409-3177-01,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",33.15,21.55,,,0
NDC,00409-3815-12,MORPHINE (PF) 1 MG/ML INJECTION SOLUTION,42.65,27.72,,,0
NDC,00409-3977-03,"WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION",42.15,27.4,,,0
NDC,00409-4090-01,ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLUTION,101.1,65.72,,,0
NDC,00409-4092-11,CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,177.05,115.08,,,0
NDC,00409-4275-16,LIDOCAINE HCL 5 MG/ML (0.5 %) INJECTION SOLUTION,53.6,34.84,,,0
NDC,00409-4276-01,LIDOCAINE 10 MG/ML (1 %) INJECTION SOLUTION SORD,37.25,24.21,,,0
NDC,00409-4276-17,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,47.8,31.07,,,0
NDC,00409-4277-02,LIDOCAINE 20 MG/ML (2 %) INJECTION SOLUTION SORD,52.35,34.03,,,0
NDC,00409-4277-16,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,44.7,29.06,,,0
NDC,00409-4278-16,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,43.5,28.28,,,0
NDC,00409-4283-11,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,47.25,30.71,,,0
NDC,00409-5160-10,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,34.7,22.56,,,0
NDC,00409-5820-01,DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,46.4,30.16,,,0
NDC,00409-5921-01,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,90.65,58.92,,,0
NDC,00409-5922-01,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,70.1,45.56,,,0
NDC,00409-6102-26,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,39.75,25.84,,,0
NDC,00409-6102-27,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,37.55,24.41,,,0
NDC,00409-6482-01,ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,316.65,205.82,,,0
NDC,00409-6534-01,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,51.1,33.22,,,0
NDC,00409-6625-30,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,52.85,34.35,,,0
NDC,00409-6648-02,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,68.5,44.52,,,0
NDC,00409-7101-02,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,72.4,47.06,,,0
NDC,00409-7299-45,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,46.95,30.52,,,0
NDC,00409-7332-20,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,37.5,24.38,,,0
NDC,00409-7335-21,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,41.7,27.1,,,0
NDC,00409-7337-20,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,35.5,23.08,,,0
NDC,00409-7338-20,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,36.1,23.46,,,0
NDC,00409-7338-21,CEFTRIAXONE (IM) 500 MG INJECTION,36.1,23.46,,,0
NDC,00409-7418-13,DEXTRAN 40 10 % IN 5 % DEXTROSE INTRAVENOUS,301.8,196.17,,,0
NDC,00409-7419-14,DEXTRAN 40 10 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,312.25,202.96,,,0
NDC,00409-8183-25,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,47.65,30.97,,,0
NDC,00409-9093-09,FENTANYL 50 MCG/ML NASAL SYRINGE (NEONATE/PED),37.0,24.05,,,0
NDC,00409-9094-22,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,36.35,23.63,,,0
NDC,00409-9104-20,DOPAMINE 400 MG/10 ML (40 MG/ML) INTRAVENOUS SOLUTION,42.95,27.92,,,0
NDC,00409-9157-01,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML ORAL SOLUTION (NEONATE),16.7,10.86,,,0
NDC,00409-9158-11,PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,52.2,33.93,,,0
NDC,00409-9566-10,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,49.15,31.95,,,0
NDC,00436-0672-16,SODIUM HYPOCHLORITE 0.125 % SOLUTION,62.15,40.4,,,0
NDC,00456-0600-10,CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,976.1,634.46,,,0
NDC,00456-1110-30,VILAZODONE 10 MG TABLET,39.75,25.84,,,0
NDC,00456-1201-30,LINACLOTIDE 145 MCG CAPSULE,59.3,38.54,,,0
NDC,00456-1202-30,LINACLOTIDE 290 MCG CAPSULE,59.3,38.54,,,0
NDC,00456-1512-60,MILNACIPRAN 12.5 MG TABLET,29.25,19.01,,,0
NDC,00456-1550-60,MILNACIPRAN 50 MG TABLET,29.25,19.01,,,0
NDC,00456-2700-10,CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,1862.8,1210.82,,,0
NDC,00469-0520-02,ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,338.95,220.32,,,0
NDC,00469-3016-01,TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,1276.5,829.72,,,0
NDC,00472-1738-03,MICONAZOLE NITRATE 200 MG VAGINAL SUPPOSITORY,67.5,43.88,,,0
NDC,00480-7062-56,PERAMPANEL 2 MG TABLET,73.75,47.94,,,0
NDC,00487-5901-99,RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,10.4,6.76,,,0
NDC,00487-9007-30,SODIUM CHLORIDE 7 % FOR NEBULIZATION,6.55,4.26,,,0
NDC,00487-9501-01,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,5.5,3.58,,,0
NDC,00487-9601-01,BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,23.0,14.95,,,0
NDC,00487-9901-30,ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,6.05,3.93,,,0
NDC,00501-3400-02,ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE,22.95,14.92,,,0
NDC,00517-0374-05,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,441.0,286.65,,,0
NDC,00517-0650-01,FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,5193.6,3375.84,,,0
NDC,00517-0720-01,BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,68.35,44.43,,,0
NDC,00517-0750-01,PROGESTERONE 50 MG/ML INTRAMUSCULAR OIL,33.6,21.84,,,0
NDC,00517-1001-01,ATROPINE 1 MG/ML INJECTION SOLUTION,50.25,32.66,,,0
NDC,00517-1980-05,DICYCLOMINE 10 MG/ML INTRAMUSCULAR SOLUTION,48.35,31.43,,,0
NDC,00517-2102-25,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,81.6,53.04,,,0
NDC,00517-2340-10,IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,197.6,128.44,,,0
NDC,00517-2502-01,CAFFEINE-SODIUM BENZOATE 250 MG/ML(125 MG/ML CAFFEINE) INJECTION SOLN,112.85,73.35,,,0
NDC,00517-4002-25,PAPAVERINE 30 MG/ML INJECTION SOLUTION,110.0,71.5,,,0
NDC,00517-4201-25,HYDROXYZINE HCL 25 MG/ML INTRAMUSCULAR SOLUTION,123.25,80.11,,,0
NDC,00517-4810-25,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,94.25,61.26,,,0
NDC,00517-5601-25,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,85.85,55.8,,,0
NDC,00517-6510-25,SELENIUM 40 MCG/ML INTRAVENOUS SOLUTION,101.65,66.07,,,0
NDC,00517-7201-25,TRACE ELEMENTS CR-CU-MN-ZN 10 MCG-1 MG-0.5 MG-5 MG/ML INTRAVENOUS SOLN,55.5,36.08,,,0
NDC,00517-7604-25,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,20.5,13.32,,,0
NDC,00517-8005-25,ZINC SULFATE 5 MG/ML INTRAVENOUS SOLUTION,167.75,109.04,,,0
NDC,00517-9120-25,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,70.0,45.5,,,0
NDC,00517-9305-01,TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,150.15,97.6,,,0
NDC,00527-1311-01,TERBUTALINE 5 MG TABLET,10.15,6.6,,,0
NDC,00527-1367-01,PROBENECID 500 MG TABLET,10.45,6.79,,,0
NDC,00527-1369-01,DANAZOL 200 MG CAPSULE,14.3,9.3,,,0
NDC,00527-1394-01,LOXAPINE SUCCINATE 5 MG CAPSULE,5.45,3.54,,,0
NDC,00527-1788-01,FLUPHENAZINE 1 MG TABLET,8.95,5.82,,,0
NDC,00527-1927-36,METHADONE 10 MG/ML ORAL CONCENTRATE,9.3,6.04,,,0
NDC,00527-1943-05,MEMANTINE 2 MG/ML ORAL SOLUTION,21.15,13.75,,,0
NDC,00536-1046-10,SODIUM BICARBONATE 325 MG TABLET,0.05,0.03,,,0
NDC,00536-1143-98,WHITE PETROLATUM 42 % TOPICAL OINTMENT,7.75,5.04,,,0
NDC,00536-1186-12,PHENYLEPHRINE 0.25 %-COCOA BUTTER 88.44 % RECTAL SUPPOSITORY,5.2,3.38,,,0
NDC,00536-1202-07,LIDOCAINE 4 % TOPICAL PATCH,1.05,0.68,,,0
NDC,00536-1211-95,DIBUCAINE 1 % TOPICAL OINTMENT,22.35,14.53,,,0
NDC,00536-1223-08,SIMETHICONE 125 MG CHEWABLE TABLET,4.85,3.15,,,0
NDC,00536-1293-83,ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP,9.15,5.95,,,0
NDC,00536-1362-23,NICOTINE (POLACRILEX) 2 MG GUM,0.2,0.13,,,0
NDC,00536-2525-25,CAPSAICIN 0.025 % TOPICAL CREAM,21.2,13.78,,,0
NDC,00536-5894-88,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,1.15,0.75,,,0
NDC,00536-5895-88,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,1.15,0.75,,,0
NDC,00536-5896-88,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,1.15,0.75,,,0
NDC,00548-5900-00,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,125.65,81.67,,,0
NDC,00555-0606-02,MEGESTROL 20 MG TABLET,5.05,3.28,,,0
NDC,00555-0973-02,DEXTROAMPHETAMINE-AMPHETAMINE 20 MG TABLET,9.05,5.88,,,0
NDC,00555-9026-58,NORETHINDRONE 1 MG-ETHINYL ESTRADIOL 20 MCG (21)-IRON 75 MG (7) TABLET,16.6,10.79,,,0
NDC,00574-0069-30,DEXTROSE 40 % ORAL GEL,2.95,1.92,,,0
NDC,00574-0292-01,AMILORIDE 5 MG TABLET,5.25,3.41,,,0
NDC,00574-0302-16,COMPOUNDING VEHICLE SUGAR-FREE NO.9 ORAL LIQUID,76.0,49.4,,,0
NDC,00574-0303-16,COMPOUNDING VEHICLE SUSPENSION SUGAR-FREE NO.20 ORAL,16.1,10.46,,,0
NDC,00574-0304-16,COMPOUNDING VEHICLE SYRUP NO.23,72.05,46.83,,,0
NDC,00574-4024-35,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,59.5,38.68,,,0
NDC,00574-4031-25,"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",57.7,37.5,,,0
NDC,00574-7034-12,ASPIRIN 300 MG RECTAL SUPPOSITORY,1.1,0.72,,,0
NDC,00574-7040-12,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY,104.9,68.18,,,0
NDC,00574-7045-12,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-30 MG RECTAL SUPPOSITORY,87.75,57.04,,,0
NDC,00574-7224-06,HYDROMORPHONE 3 MG RECTAL SUPPOSITORY,46.05,29.93,,,0
NDC,00574-7226-12,PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY,29.1,18.92,,,0
NDC,00591-0404-01,VERAPAMIL 40 MG TABLET,5.05,3.28,,,0
NDC,00591-2533-60,"DALFAMPRIDINE ER 10 MG TABLET,EXTENDED RELEASE,12 HR",6.75,4.39,,,0
NDC,00591-3510-04,CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,183.45,119.24,,,0
NDC,00591-3543-60,BUPROPION HCL SR 150 MG TABLET SORD,5.9,3.84,,,0
NDC,00591-5335-01,TRIHEXYPHENIDYL 2 MG TABLET,4.8,3.12,,,0
NDC,00597-0052-38,BISACODYL 10 MG RECTAL SUPPOSITORY,1.0,0.65,,,0
NDC,00597-0075-75,TIOTROPIUM BROMIDE 18 MCG CAPSULE WITH INHALATION DEVICE,207.25,134.71,,,0
NDC,00597-0100-51,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION MIST FOR INHALATION,143.6,93.34,,,0
NDC,00597-0152-30,EMPAGLIFLOZIN 10 MG TABLET,52.8,34.32,,,0
NDC,00597-0153-30,EMPAGLIFLOZIN 25 MG TABLET,52.8,34.32,,,0
NDC,00597-0197-05,IDARUCIZUMAB 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,12698.7,8254.16,,,0
NDC,00597-0355-56,DABIGATRAN ETEXILATE 75 MG CAPSULE,13.7,8.9,,,0
NDC,00603-1508-05,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,15.25,9.91,,,0
NDC,00641-0367-21,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION,34.85,22.65,,,0
NDC,00641-0376-25,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,33.4,21.71,,,0
NDC,00641-0477-21,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,178.85,116.25,,,0
NDC,00641-1397-31,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,160.2,104.13,,,0
NDC,00641-2569-41,DIPYRIDAMOLE 5 MG/ML INTRAVENOUS SOLUTION,120.15,78.1,,,0
NDC,00641-6020-01,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,47.0,30.55,,,0
NDC,00641-6022-01,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,34.2,22.23,,,0
NDC,00641-6039-01,MORPHINE (PF) 10 MG/ML INJECTION SOLUTION,987.8,642.07,,,0
NDC,00641-6040-01,MORPHINE (PF) 25 MG/ML INJECTION SOLUTION,1724.25,1120.76,,,0
NDC,00641-6044-25,LORAZEPAM 2 MG/ML INJECTION SOLUTION,34.3,22.3,,,0
NDC,00641-6050-01,LORAZEPAM 2 MG/ML INJECTION SOLUTION,34.2,22.23,,,0
NDC,00641-6051-01,LORAZEPAM 4 MG/ML INJECTION SOLUTION,77.65,50.47,,,0
NDC,00641-6052-01,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,43.0,27.95,,,0
NDC,00641-6053-01,MEPERIDINE (PF) 50 MG/ML INJECTION SORD,43.35,28.18,,,0
NDC,00641-6053-25,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,43.35,28.18,,,0
NDC,00641-6057-01,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,33.4,21.71,,,0
NDC,00641-6061-01,MIDAZOLAM 5 MG/ML INJECTION SORD,36.05,23.43,,,0
NDC,00641-6078-25,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,34.8,22.62,,,0
NDC,00641-6117-10,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,47.4,30.81,,,0
NDC,00641-6125-25,MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,43.9,28.54,,,0
NDC,00641-6127-01,MORPHINE 10 MG/ML INJECTION SOLUTION SORD,39.15,25.45,,,0
NDC,00641-6127-25,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,39.15,25.45,,,0
NDC,00641-6139-10,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,35.95,23.37,,,0
NDC,00641-6145-01,DEXAMETHASONE 4 MG/ML INJ (ORAL USE),34.3,22.3,,,0
NDC,00641-6145-25,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,34.3,22.3,,,0
NDC,00641-6149-01,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,42.2,27.43,,,0
NDC,00641-6150-10,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INTRAVENOUS SOLUTION,42.2,27.43,,,0
NDC,00641-6174-10,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,38.25,24.86,,,0
NDC,00641-6184-25,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,36.55,23.76,,,0
NDC,00641-6247-01,FENTANYL INFUSION 50 MCG/ML (PEDS),38.05,24.73,,,0
NDC,00641-9217-01,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,34.9,22.68,,,0
NDC,00703-4502-91,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,34.8,22.62,,,0
NDC,00703-9514-03,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,91.1,59.22,,,0
NDC,00713-0132-06,PROMETHAZINE 50 MG RECTAL SUPPOSITORY,82.1,53.36,,,0
NDC,00713-0526-12,PROMETHAZINE 25 MG RECTAL SUPPOSITORY,21.3,13.84,,,0
NDC,00713-0536-12,PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,13.0,8.45,,,0
NDC,00713-0640-86,HALOBETASOL PROPIONATE 0.05 % TOPICAL CREAM,74.2,48.23,,,0
NDC,00713-0655-40,TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,257.2,167.18,,,0
NDC,00713-0678-15,"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",26.9,17.48,,,0
NDC,00713-0682-15,GENTAMICIN 0.1 % TOPICAL OINTMENT,70.15,45.6,,,0
NDC,00731-0401-06,ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,0.15,0.1,,,0
NDC,00781-2020-01,AMOXICILLIN 250 MG CAPSULE,4.85,3.15,,,0
NDC,00781-2321-51,APREPITANT 40 MG CAPSULE,127.25,82.71,,,0
NDC,00781-2613-01,AMOXICILLIN 500 MG CAPSULE,5.0,3.25,,,0
NDC,00781-3040-72,PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION,60.85,39.55,,,0
NDC,00781-3250-89,GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRINGE,537.25,349.21,,,0
NDC,00781-3290-09,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,93.35,60.68,,,0
NDC,00781-3299-69,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,88.6,57.59,,,0
NDC,00781-3407-95,AMPICILLIN INJECTION (IM) 500 MG VIAL,38.75,25.19,,,0
NDC,00781-3415-75,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,102.55,66.66,,,0
NDC,00781-3481-70,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,98.7,64.16,,,0
NDC,00781-5613-01,CARBIDOPA 12.5 MG-LEVODOPA 50 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
NDC,00781-5625-01,CARBIDOPA 18.75 MG-LEVODOPA 75 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
NDC,00781-5637-01,CARBIDOPA 25 MG-LEVODOPA 100 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
NDC,00781-5669-01,CARBIDOPA 50 MG-LEVODOPA 200 MG-ENTACAPONE 200 MG TABLET,7.05,4.58,,,0
NDC,00781-6186-67,"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",314.6,204.49,,,0
NDC,00781-7296-85,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,71.05,46.18,,,0
NDC,00781-7304-31,RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH,12.25,7.96,,,0
NDC,00781-8034-01,TRIFLUOPERAZINE 5 MG TABLET,6.65,4.32,,,0
NDC,00781-9401-78,AMPICILLIN 125 MG SOLUTION FOR INJECTION,52.3,34.0,,,0
NDC,00781-9402-78,AMPICILLIN INJECTION (IM) 250 MG VIAL,48.45,31.49,,,0
NDC,00781-9404-85,AMPICILLIN INJECTION (IM) 1 GM VIAL,38.6,25.09,,,0
NDC,00781-9404-95,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,38.6,25.09,,,0
NDC,00781-9407-78,AMPICILLIN IV 100 MG/ML (WELL BABY CONC),49.25,32.01,,,0
NDC,00781-9408-95,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,42.5,27.62,,,0
NDC,00832-0310-11,VALPROIC ACID 250 MG CAPSULE,5.6,3.64,,,0
NDC,00832-0510-00,BETHANECHOL CHLORIDE 5 MG TABLET,4.9,3.18,,,0
NDC,00832-0742-60,"PROPAFENONE ER 425 MG CAPSULE,EXTENDED RELEASE 12 HR",8.5,5.52,,,0
NDC,00832-1211-01,WARFARIN 1 MG TABLET,5.0,3.25,,,0
NDC,00832-1212-00,WARFARIN 2 MG TABLET,5.0,3.25,,,0
NDC,00832-1213-00,WARFARIN 2.5 MG TABLET,5.0,3.25,,,0
NDC,00832-1214-00,WARFARIN 3 MG TABLET,5.0,3.25,,,0
NDC,00832-1217-00,WARFARIN 6 MG TABLET,5.15,3.35,,,0
NDC,00832-1218-00,WARFARIN 7.5 MG TABLET,5.15,3.35,,,0
NDC,00832-1219-01,WARFARIN 10 MG TABLET,5.15,3.35,,,0
NDC,00832-6022-11,"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",5.9,3.84,,,0
NDC,00832-6032-12,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,6.4,4.16,,,0
NDC,00884-6297-30,PHENOL 89 % TOPICAL SWAB,17.75,11.54,,,0
NDC,00904-0277-46,"VITAMIN E (DL, ACETATE) 450 MG (1,000 UNIT) CAPSULE",0.15,0.1,,,0
NDC,00904-0523-61,ASCORBIC ACID (VITAMIN C) 500 MG TABLET,0.05,0.03,,,0
NDC,00904-0539-61,MULTIVITAMIN ORAL SOLID SORD,0.05,0.03,,,0
NDC,00904-1883-61,"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",0.05,0.03,,,0
NDC,00904-2085-60,"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",0.05,0.03,,,0
NDC,00904-2272-60,NIACIN 500 MG TABLET,4.7,3.06,,,0
NDC,00904-2533-21,CALAMINE 8 %-ZINC OXIDE 8 % LOTION,1.45,0.94,,,0
NDC,00904-3865-75,SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,12.15,7.9,,,0
NDC,00904-5354-31,DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,1.55,1.01,,,0
NDC,00904-5395-61,POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAPSULE,0.1,0.06,,,0
NDC,00904-5460-72,CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,0.05,0.03,,,0
NDC,00904-5894-62,"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",0.05,0.03,,,0
NDC,00904-5922-61,DIGOXIN 250 MCG (0.25 MG) TABLET,7.45,4.84,,,0
NDC,00904-6085-61,CITALOPRAM 20 MG TABLET,4.8,3.12,,,0
NDC,00904-6351-61,LEVOFLOXACIN 250 MG TABLET,5.1,3.32,,,0
NDC,00904-6352-61,LEVOFLOXACIN 500 MG TABLET,5.25,3.41,,,0
NDC,00904-6353-61,LEVOFLOXACIN 750 MG TABLET,5.75,3.74,,,0
NDC,00904-6369-61,AMLODIPINE 2.5 MG TABLET,4.85,3.15,,,0
NDC,00904-6407-61,"BISACODYL 5 MG TABLET,DELAYED RELEASE",0.05,0.03,,,0
NDC,00904-6765-20,CETIRIZINE 1 MG/ML ORAL SOLUTION,4.9,3.18,,,0
NDC,00904-6773-61,ACETAMINOPHEN 325 MG TABLET,0.05,0.03,,,0
NDC,00904-6782-61,HALOPERIDOL 5 MG TABLET,6.2,4.03,,,0
NDC,00904-6797-61,LISINOPRIL 5 MG TABLET,4.8,3.12,,,0
NDC,00904-6798-61,LISINOPRIL 10 MG TABLET,4.75,3.09,,,0
NDC,00904-6990-61,PSEUDOEPHEDRINE 30 MG TABLET,0.05,0.03,,,0
NDC,00904-7016-61,BUMETANIDE 1 MG TABLET,6.9,4.48,,,0
NDC,00904-7119-06,CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,6.8,4.42,,,0
NDC,00904-7141-10,METHOTREXATE SODIUM 2.5 MG TABLET,10.7,6.96,,,0
NDC,00904-7191-06,THIAMINE HCL (VITAMIN B1) 100 MG TABLET,0.15,0.1,,,0
NDC,00904-7219-61,"DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24 HR",5.6,3.64,,,0
NDC,00904-7236-61,MEGESTROL 40 MG TABLET,5.3,3.44,,,0
NDC,00904-7244-68,LACOSAMIDE 50 MG TABLET,11.45,7.44,,,0
NDC,00904-7247-68,LACOSAMIDE 200 MG TABLET,9.3,6.04,,,0
NDC,00904-7252-60,SENNOSIDES 8.6 MG TABLET,0.05,0.03,,,0
NDC,00904-7305-61,CARVEDILOL 3.125 MG TABLET,4.9,3.18,,,0
NDC,00904-7307-61,CARVEDILOL 12.5 MG TABLET,4.85,3.15,,,0
NDC,00904-7308-61,CARVEDILOL 25 MG TABLET,4.85,3.15,,,0
NDC,00904-7337-61,CEPHALEXIN 500 MG CAPSULE,5.35,3.48,,,0
NDC,00904-7346-61,FLUOXETINE 20 MG CAPSULE,4.85,3.15,,,0
NDC,00904-7523-08,DOFETILIDE 250 MCG CAPSULE,11.6,7.54,,,0
NDC,00904-7591-61,FERROUS SULFATE 325 MG (65 MG IRON) TABLET,0.05,0.03,,,0
NDC,00904-7734-45,MICONAZOLE NITRATE 2 % VAGINAL CREAM,25.05,16.28,,,0
NDC,00904-7914-61,IBUPROFEN 200 MG TABLET,0.05,0.03,,,0
NDC,00941-0409-05,PERITON.DIALYSIS SOLN 6-1.5 % DEXTROS LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L,159.7,103.8,,,0
NDC,00941-0457-02,PERITONEAL DIALYSIS SOLN 7-2.5 % DEXT.LOW CALC 2.5 MEQ/L-MAG 0.5 MEQ/L,159.7,103.8,,,0
NDC,00941-0459-02,PERITON. DIALYSIS SOLN 8-4.25 % DEXTROSE CALC 2.5 MEQ/L-MAG 0.5 MEQ/L,161.85,105.2,,,0
NDC,00942-0641-04,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,90.85,59.05,,,0
NDC,00944-0493-04,"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",239.15,155.45,,,0
NDC,00944-0495-05,"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION (IO)",246.3,160.1,,,0
NDC,00944-2658-04,"IMMUNE GLOB,GAMMA(IGG) 10 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",6452.65,4194.22,,,0
NDC,00944-2700-04,"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",1540.35,1001.23,,,0
NDC,00944-2884-02,ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 20 MG/ML (2 %) INTRAVENOUS SOLN,4005.75,2603.74,,,0
NDC,01490-0039-04,BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION,2.05,1.33,,,0
NDC,10019-0672-10,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",400.25,260.16,,,0
NDC,10019-0938-25,CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS POWDER FOR SOLUTION,313.4,203.71,,,0
NDC,10019-0953-01,MESNA 100 MG/ML INTRAVENOUS SOLUTION,114.65,74.52,,,0
NDC,10119-0002-52,SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,3.0,1.95,,,0
NDC,10122-0510-03,PORACTANT ALFA 240 MG/3 ML INTRATRACHEAL SUSPENSION,3365.7,2187.7,,,0
NDC,10122-0610-01,CLEVIDIPINE 25 MG/50 ML INTRAVENOUS EMULSION,433.35,281.68,,,0
NDC,10122-0620-10,CANGRELOR 50 MG INTRAVENOUS SOLUTION,4666.5,3033.22,,,0
NDC,10481-0111-08,IODINE-POTASSIUM IODIDE 5 %-10 % TOPICAL SOLUTION,56.85,36.95,,,0
NDC,10511-3001-02,HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLUTION,6620.2,4303.13,,,0
NDC,10572-0012-01,"SODIUM,POTASSIUM,MAG SULFATES 17.5 GRAM-3.13 GRAM-1.6 GRAM ORAL SOLN",130.8,85.02,,,0
NDC,10572-0302-01,PEG-ELECTROLYTE SOLUTION 420 GRAM ORAL SOLUTION,80.0,52.0,,,0
NDC,10702-0036-45,SODIUM POLYSTYRENE SULFONATE 15 GRAM ORAL POWDER,202.8,131.82,,,0
NDC,11994-0011-01,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS SUSPENSION,752.9,489.38,,,0
NDC,12870-0001-01,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,39.95,25.97,,,0
NDC,13517-0100-30,DIAZOXIDE 50 MG/ML ORAL SUSPENSION,851.65,553.57,,,0
NDC,13533-0318-01,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2323.65,1510.37,,,0
NDC,13533-0634-02,TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,2716.7,1765.86,,,0
NDC,13533-0636-03,HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,418.2,271.83,,,0
NDC,13533-0636-05,HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) INTRAMUSCULAR SOLUTION,3360.3,2184.2,,,0
NDC,13533-0800-20,IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,1469.15,954.95,,,0
NDC,13533-0800-24,IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,5700.2,3705.13,,,0
NDC,13533-0800-41,IMMUNE GLOB G 40 GRAM/400 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,11341.6,7372.04,,,0
NDC,13533-0800-71,IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,2879.5,1871.68,,,0
NDC,13668-0011-01,CITALOPRAM 40 MG TABLET,4.75,3.09,,,0
NDC,13668-0091-90,PRAMIPEXOLE 0.125 MG TABLET,4.8,3.12,,,0
NDC,13668-0453-01,ANAGRELIDE 0.5 MG CAPSULE,7.05,4.58,,,0
NDC,14537-0967-75,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 800 MG/100 ML SOLN,140.5,91.32,,,0
NDC,14789-0108-10,POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,193.7,125.9,,,0
NDC,14789-0122-05,FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,191.75,124.64,,,0
NDC,15054-0043-01,IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS,12746.2,8285.03,,,0
NDC,16477-0422-06,SELENIUM SULFIDE 2.25 % SHAMPOO,153.45,99.74,,,0
NDC,16571-0673-01,PHENOBARBITAL 32.4 MG TABLET,8.8,5.72,,,0
NDC,16729-0096-12,"QUETIAPINE ER 300 MG TABLET,EXTENDED RELEASE 24 HR",6.15,4.0,,,0
NDC,16729-0097-12,"QUETIAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR",6.3,4.1,,,0
NDC,16729-0116-38,MITOMYCIN 40 MG/20 ML INTRAVENOUS SOLUTION,4996.8,3247.92,,,0
NDC,16729-0132-12,"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",5.0,3.25,,,0
NDC,16729-0174-01,AMITRIPTYLINE 75 MG TABLET,4.8,3.12,,,0
NDC,16729-0175-01,AMITRIPTYLINE 100 MG TABLET,4.9,3.18,,,0
NDC,16729-0182-17,HYDROCHLOROTHIAZIDE 12.5 MG TABLET,4.75,3.09,,,0
NDC,16729-0243-31,TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTION,267.0,173.55,,,0
NDC,16729-0247-11,MITOMYCIN 20 MG/10 ML INTRAVENOUS SOLUTION,209.2,135.98,,,0
NDC,16729-0262-31,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION (RESEARCH TRIAL ROUNDING TO 1 MG),103.3,67.14,,,0
NDC,16729-0267-63,DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION,187.1,121.62,,,0
NDC,16729-0272-10,PRASUGREL HCL 5 MG TABLET,7.0,4.55,,,0
NDC,16729-0351-92,BUSULFAN 60 MG/10 ML INTRAVENOUS SOLUTION,211.15,137.25,,,0
NDC,16837-0872-30,FAMOTIDINE 10 MG TABLET,5.55,3.61,,,0
NDC,18657-0117-04,"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",271.0,176.15,,,0
NDC,19903-0010-21,"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",4.2,2.73,,,0
NDC,20555-0019-00,FERROUS GLUCONATE 324 MG (37.5 MG IRON) TABLET,0.05,0.03,,,0
NDC,20555-0025-00,CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,0.1,0.06,,,0
NDC,20555-0033-00,"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",0.05,0.03,,,0
NDC,20555-0036-01,MELATONIN 3 MG TABLET,0.15,0.1,,,0
NDC,21922-0004-04,DESONIDE 0.05 % TOPICAL OINTMENT,47.15,30.65,,,0
NDC,23155-0026-01,VERAPAMIL 80 MG TABLET,5.5,3.58,,,0
NDC,23155-0043-03,LEFLUNOMIDE 10 MG TABLET,6.75,4.39,,,0
NDC,23155-0070-01,METHIMAZOLE 5 MG TABLET,5.05,3.28,,,0
NDC,23155-0216-31,CIDOFOVIR 75 MG/ML INTRAVENOUS SOLUTION,2351.6,1528.54,,,0
NDC,23155-0290-42,"AMIKACIN 1,000 MG/4 ML INJECTION SOLUTION",53.95,35.07,,,0
NDC,23155-0486-01,VERAPAMIL 120 MG TABLET,5.95,3.87,,,0
NDC,23155-0512-00,NIMODIPINE 30 MG CAPSULE,8.1,5.26,,,0
NDC,23155-0532-01,ETHOSUXIMIDE 250 MG CAPSULE,8.1,5.26,,,0
NDC,23155-0748-31,PENTAMIDINE 300 MG SOLUTION FOR INJECTION,218.4,141.96,,,0
NDC,23155-0823-73,CABERGOLINE 0.5 MG TABLET,10.35,6.73,,,0
NDC,24201-0201-05,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,114.1,74.16,,,0
NDC,24208-0410-05,OFLOXACIN 0.3 % EAR DROPS,504.3,327.8,,,0
NDC,24208-0505-05,LEVOBUNOLOL 0.5 % EYE DROPS,72.3,47.0,,,0
NDC,24208-0555-55,"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",35.6,23.14,,,0
NDC,24208-0631-10,"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG/ML-10,000 UNIT/ML-1 % EAR SOLUTION",230.0,149.5,,,0
NDC,24208-0670-04,SULFACETAMIDE SODIUM 10 % EYE DROPS,157.95,102.67,,,0
NDC,24208-0720-02,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,216.4,140.66,,,0
NDC,24208-0735-01,CYCLOPENTOLATE 1 % EYE DROPS,55.3,35.94,,,0
NDC,24208-0780-55,"NEOMYCIN-BACITRACIN-POLYMYXN 3.5 MG-400 UNIT-10,000 UNIT/GRAM EYE OINT",70.5,45.82,,,0
NDC,24208-0790-62,"NEOMYCIN 1.75 MG-POLYMYXIN 10,000 UNIT-GRAMICIDIN 0.025MG/ML EYE DROPS",205.45,133.54,,,0
NDC,24208-0830-60,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",69.9,45.44,,,0
NDC,24338-0050-08,CARMUSTINE IN POLIFEPROSAN 7.7 MG WAFER FOR IMPLANT,22205.25,14433.41,,,0
NDC,24338-0230-12,NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),145.15,94.35,,,0
NDC,24357-0701-06,LIDOCAINE 4 % TOPICAL CREAM,2.6,1.69,,,0
NDC,24385-0021-03,HYDROCORTISONE 1 % TOPICAL CREAM,1.0,0.65,,,0
NDC,24385-0060-03,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,1.15,0.75,,,0
NDC,24385-0118-78,SIMETHICONE 80 MG CHEWABLE TABLET,0.05,0.03,,,0
NDC,24385-0441-64,DOXYLAMINE SUCCINATE 25 MG TABLET,0.05,0.03,,,0
NDC,24385-0485-47,CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.05,0.03,,,0
NDC,24385-0524-03,TERBINAFINE HCL 1 % TOPICAL CREAM,32.5,21.12,,,0
NDC,24510-0050-10,TAPENTADOL 50 MG TABLET,39.8,25.87,,,0
NDC,24510-0110-10,OXYCODONE ER 9 MG CAPSULE SPRINKLE EXTENDED RELEASE 12 HR(DON'T CRUSH),23.8,15.47,,,0
NDC,24510-0115-10,OXYCODONE ER 13.5 MG CAPSULE SPRINKLE EXTEND RELEASE 12HR(DON'T CRUSH),32.8,21.32,,,0
NDC,24510-0140-10,OXYCODONE ER 36 MG CAPSULE SPRINKLE EXTENDED RELEASE 12HR(DON'T CRUSH),65.85,42.8,,,0
NDC,24571-0101-05,CRRT BK 0/3.5 5000 ML SOLUTION,146.75,95.39,,,0
NDC,24571-0103-06,CRRT BGK 2/3.5 ( PRISMASOL) 5000 ML SOLUTION,163.5,106.28,,,0
NDC,24571-0111-06,BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,70.55,45.86,,,0
NDC,24571-0116-06,PHOSPHATE DIALYSIS SOLN WITHOUT DEXTR K 4 MEQ-CA 2.5 MEQ-PO4 1 MMOL/L,289.2,187.98,,,0
NDC,24979-0004-07,DONEPEZIL 23 MG TABLET,5.55,3.61,,,0
NDC,25010-0215-15,ETHACRYNIC ACID 25 MG TABLET,75.25,48.91,,,0
NDC,25010-0705-15,PENICILLAMINE 250 MG CAPSULE,761.25,494.81,,,0
NDC,25021-0115-06,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,40.8,26.52,,,0
NDC,25021-0127-20,CEFTAZIDIME (IM) 1000 MG INJECTION,53.9,35.04,,,0
NDC,25021-0151-20,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",44.75,29.09,,,0
NDC,25021-0180-66,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,46.45,30.19,,,0
NDC,25021-0184-66,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,66.55,43.26,,,0
NDC,25021-0184-67,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,75.55,49.11,,,0
NDC,25021-0192-82,CIPROFLOXACIN 200 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,67.55,43.91,,,0
NDC,25021-0192-87,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,69.65,45.27,,,0
NDC,25021-0204-01,VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,112.9,73.38,,,0
NDC,25021-0204-05,VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,193.9,126.04,,,0
NDC,25021-0207-25,DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION,116.75,75.89,,,0
NDC,25021-0262-10,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,124.5,80.92,,,0
NDC,25021-0301-67,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,77.0,50.05,,,0
NDC,25021-0305-66,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,179.55,116.71,,,0
NDC,25021-0318-04,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,38.7,25.16,,,0
NDC,25021-0410-77,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,48.75,31.69,,,0
NDC,25021-0414-50,ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,261.8,170.17,,,0
NDC,25021-0462-74,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,685.55,445.61,,,0
NDC,25021-0601-03,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,53.8,34.97,,,0
NDC,25021-0651-02,ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION,83.9,54.54,,,0
NDC,25021-0671-67,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,178.6,116.09,,,0
NDC,25021-0676-20,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,554.0,360.1,,,0
NDC,25021-0677-10,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,34.4,22.36,,,0
NDC,25021-0679-20,"BACLOFEN 40,000 MCG/20 ML (2,000 MCG/ML) INTRATHECAL SOLUTION",1366.2,888.03,,,0
NDC,25021-0681-71,BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRINGE,57.7,37.5,,,0
NDC,25021-0790-02,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,34.9,22.68,,,0
NDC,25021-0822-73,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,1244.3,808.8,,,0
NDC,25021-0826-67,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,151.35,98.38,,,0
NDC,25021-0829-02,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,2467.55,1603.91,,,0
NDC,25021-0830-82,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,204.15,132.7,,,0
NDC,25208-0901-04,"TIROFIBAN 250 MCG/ML CONCENTRATE,INTRAVENOUS",158.1,102.76,,,0
NDC,25208-0902-01,TIROFIBAN 5 MG/100 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS,183.9,119.54,,,0
NDC,25682-0001-01,ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,27140.15,17641.1,,,0
NDC,25682-0025-01,RAVULIZUMAB-CWVZ 100 MG/ML INTRAVENOUS SOLUTION,27177.8,17665.57,,,0
NDC,25682-0028-01,RAVULIZUMAB-CWVZ 100 MG/ML INTRAVENOUS SOLUTION,99433.1,64631.52,,,0
NDC,27241-0115-10,"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",5.35,3.48,,,0
NDC,27241-0249-49,FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,37.55,24.41,,,0
NDC,27808-0033-01,THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,10.3,6.7,,,0
NDC,31604-0017-96,MULTIVITAMIN-MINERALS-FOLIC ACID-LUTEIN 0.4 MG-250 MCG TABLET,4.95,3.22,,,0
NDC,31722-0006-31,ITRACONAZOLE 10 MG/ML ORAL SOLUTION,782.95,508.92,,,0
NDC,31722-0035-23,AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLUTION,23.1,15.02,,,0
NDC,31722-0504-30,EFAVIRENZ 600 MG TABLET,12.35,8.03,,,0
NDC,31722-0506-60,LAMIVUDINE 150 MG-ZIDOVUDINE 300 MG TABLET,8.3,5.4,,,0
NDC,31722-0513-90,SIMVASTATIN 40 MG TABLET,4.95,3.22,,,0
NDC,31722-0520-01,HYDRALAZINE 25 MG TABLET,4.75,3.09,,,0
NDC,31722-0556-12,LOPINAVIR-RITONAVIR 200 MG-50 MG TABLET,25.95,16.87,,,0
NDC,31722-0564-24,CITALOPRAM 10 MG/5 ML ORAL SOLUTION,8.15,5.3,,,0
NDC,31722-0629-21,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,29.95,19.47,,,0
NDC,31722-0635-30,SILODOSIN 4 MG CAPSULE,5.55,3.61,,,0
NDC,31722-0636-90,SILODOSIN 8 MG CAPSULE,5.6,3.64,,,0
NDC,31722-0681-47,ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,227.4,147.81,,,0
NDC,31722-0687-25,OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,7.25,4.71,,,0
NDC,31722-0833-30,ENTECAVIR 0.5 MG TABLET,8.5,5.52,,,0
NDC,31722-0868-31,TOLVAPTAN 15 MG TABLET,177.95,115.67,,,0
NDC,31722-0937-47,SIMPLE SYRUP,62.15,40.4,,,0
NDC,33342-0320-84,FLUOCINONIDE 0.05 % TOPICAL SOLUTION,76.1,49.46,,,0
NDC,35573-0467-02,"DEXTROAMPHETAMINE-AMPHETAMINE ER 20 MG 24HR CAPSULE,EXTEND RELEASE",12.45,8.09,,,0
NDC,36000-0148-10,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,39.05,25.38,,,0
NDC,36000-0244-25,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,42.0,27.3,,,0
NDC,37000-0024-04,PSYLLIUM HUSK 3.4 GRAM ORAL POWDER PACKET,0.45,0.29,,,0
NDC,37000-0477-09,BISMUTH SUBSALICYLATE 262 MG CHEWABLE TABLET,0.2,0.13,,,0
NDC,38396-0913-63,DEXTROSE 15 GRAM/33 GRAM ORAL GEL PACKET,15.4,10.01,,,0
NDC,38485-0980-18,UREA 10 % LOTION,41.8,27.17,,,0
NDC,38779-1046-04,BISMUTH SUBGALLATE (BULK) POWDER,61.4,39.91,,,0
NDC,38779-1938-05,PHENOL (BULK) 89 % LIQUID,12.6,8.19,,,0
NDC,39328-0063-25,SODIUM HYPOCHLORITE 0.25 % SOLUTION,58.15,37.8,,,0
NDC,39822-1055-05,AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,208.9,135.78,,,0
NDC,39822-1100-01,FOLIC ACID 5 MG/ML INJECTION SOLUTION,35.7,23.2,,,0
NDC,39822-2000-01,"CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLUTION",44.95,29.22,,,0
NDC,40565-0122-56,CADEXOMER IODINE 0.9 % TOPICAL GEL,52.7,34.26,,,0
NDC,40985-0270-86,"ARGININE HCL (L-ARGININE) 1,000 MG TABLET",4.9,3.18,,,0
NDC,40985-0277-57,BIOTIN 10 MG TABLET,4.8,3.12,,,0
NDC,42023-0104-01,TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,86.55,56.26,,,0
NDC,42023-0105-01,METHOHEXITAL 500 MG SOLUTION FOR INJECTION,551.5,358.48,,,0
NDC,42023-0111-01,ESTRADIOL VALERATE 20 MG/ML INTRAMUSCULAR OIL,119.7,77.8,,,0
NDC,42023-0119-25,TRIMETHOBENZAMIDE 100 MG/ML INTRAMUSCULAR SOLUTION,291.55,189.51,,,0
NDC,42023-0157-01,ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,2615.9,1700.34,,,0
NDC,42023-0173-25,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,274.85,178.65,,,0
NDC,42023-0179-01,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,96.6,62.79,,,0
NDC,42023-0182-01,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,589.45,383.14,,,0
NDC,42023-0237-01,VASOPRESSIN 0.2 UNIT/ML INTRAVENOUS SOLUTION,172.05,111.83,,,0
NDC,42023-0315-01,EPINEPHRINE 4 MG/250 ML (16 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV SOLN,182.4,118.56,,,0
NDC,42192-0329-01,THYROID (PORK) 30 MG TABLET,6.6,4.29,,,0
NDC,42192-0330-01,THYROID (PORK) 60 MG TABLET,6.85,4.45,,,0
NDC,42192-0338-01,HYOSCYAMINE 0.125 MG DISINTEGRATING TABLET,5.1,3.32,,,0
NDC,42192-0339-01,HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,4.95,3.22,,,0
NDC,42192-0608-40,GABAPENTIN 300 MG/6 ML (6 ML) ORAL SOLUTION,15.45,10.04,,,0
NDC,42192-0626-16,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRUP,10.15,6.6,,,0
NDC,42195-0550-14,CIPROFLOXACIN 0.2 % EAR DROPS IN A DROPPERETTE,32.55,21.16,,,0
NDC,42291-0076-30,CLOBETASOL 0.05 % TOPICAL CREAM,22.45,14.59,,,0
NDC,42291-0077-30,CLOBETASOL 0.05 % TOPICAL OINTMENT,27.0,17.55,,,0
NDC,42292-0038-20,LEVOTHYROXINE 88 MCG TABLET,6.05,3.93,,,0
NDC,42367-0540-32,DANTROLENE 250 MG INTRAVENOUS SUSPENSION,10363.1,6736.02,,,0
NDC,42385-0921-60,ATAZANAVIR 200 MG CAPSULE,12.55,8.16,,,0
NDC,42494-0441-01,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,86.15,56.0,,,0
NDC,42494-0450-20,VANCOMYCIN 125 MG CAPSULE,10.4,6.76,,,0
NDC,42571-0313-75,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,58.3,37.9,,,0
NDC,42571-0408-92,TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,20.3,13.2,,,0
NDC,42747-0761-01,MOGAMULIZUMAB-KPKC 4 MG/ML INTRAVENOUS SOLUTION,19727.4,12822.81,,,0
NDC,42794-0018-12,LIOTHYRONINE 5 MCG TABLET,6.1,3.96,,,0
NDC,42799-0208-01,TINIDAZOLE 500 MG TABLET,12.55,8.16,,,0
NDC,42799-0806-01,IVERMECTIN 3 MG TABLET,16.15,10.5,,,0
NDC,42806-0270-98,CHOLESTYRAMINE 4 GRAM ORAL POWDER FOR SUSPENSION IN A PACKET,7.2,4.68,,,0
NDC,42806-0513-30,QUINIDINE SULFATE 200 MG TABLET,39.5,25.68,,,0
NDC,42806-0757-60,SULFADIAZINE 500 MG TABLET,47.85,31.1,,,0
NDC,42858-0301-25,HYDROMORPHONE 2 MG TABLET,8.85,5.75,,,0
NDC,42858-0304-16,HYDROMORPHONE 1 MG/ML ORAL LIQUID,9.4,6.11,,,0
NDC,42858-0353-40,BUPRENORPHINE 7.5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,158.95,103.32,,,0
NDC,42858-0493-40,BUPRENORPHINE 10 MCG/HOUR WEEKLY TRANSDERMAL PATCH,158.8,103.22,,,0
NDC,43066-0009-10,NICARDIPINE 20 MG/200 ML(0.1 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN,212.95,138.42,,,0
NDC,43066-0360-20,"AMIODARONE 360 MG/200 ML (1.8 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",122.45,79.59,,,0
NDC,43066-0993-24,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,79.3,51.54,,,0
NDC,43068-0102-02,ILOPERIDONE 2 MG TABLET,93.35,60.68,,,0
NDC,43068-0106-02,ILOPERIDONE 6 MG TABLET,113.8,73.97,,,0
NDC,43547-0280-10,ESCITALOPRAM 5 MG TABLET,4.9,3.18,,,0
NDC,43547-0401-10,FUROSEMIDE 20 MG TABLET,4.75,3.09,,,0
NDC,43598-0129-01,METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION,43.8,28.47,,,0
NDC,43598-0330-11,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,61.3,39.84,,,0
NDC,43598-0436-11,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,65.8,42.77,,,0
NDC,43598-0452-02,ALBENDAZOLE 200 MG TABLET,19.75,12.84,,,0
NDC,43598-0478-90,SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,31.95,20.77,,,0
NDC,43598-0575-30,TADALAFIL 5 MG TABLET,5.5,3.58,,,0
NDC,43598-0579-30,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM,14.7,9.56,,,0
NDC,43598-0582-30,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,21.95,14.27,,,0
NDC,43598-0682-35,"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",1816.95,1181.02,,,0
NDC,43598-0725-25,EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,34.9,22.68,,,0
NDC,43598-0734-30,ARIPIPRAZOLE 15 MG DISINTEGRATING TABLET,19.05,12.38,,,0
NDC,43598-0848-58,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,97.85,63.6,,,0
NDC,43598-0917-58,CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,217.35,141.28,,,0
NDC,43900-0976-47,GUAR GUM ORAL PACKET,39.4,25.61,,,0
NDC,43975-0308-10,CYCLOPHOSPHAMIDE 50 MG CAPSULE,46.0,29.9,,,0
NDC,44087-3535-01,AVELUMAB 20 MG/ML INTRAVENOUS SOLUTION,8768.3,5699.4,,,0
NDC,44206-0251-05,"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION (IO)",183.2,119.08,,,0
NDC,44206-0300-01,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML INJECTION SYRINGE",357.25,232.21,,,0
NDC,44206-0436-05,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",1552.1,1008.86,,,0
NDC,44206-0437-10,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",3045.4,1979.51,,,0
NDC,44206-0438-20,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",6032.05,3920.83,,,0
NDC,44206-0439-40,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",12005.3,7803.44,,,0
NDC,44567-0101-10,AMPICILLIN 500 MG SOLUTION FOR INJECTION,37.5,24.38,,,0
NDC,44567-0402-01,MEROPENEM 2 GRAM INTRAVENOUS SOLUTION,160.45,104.29,,,0
NDC,45802-0040-64,SELENIUM SULFIDE 2.5 % LOTION,42.8,27.82,,,0
NDC,45802-0045-01,TRIAMCINOLONE ACETONIDE 0.147 MG/GRAM TOPICAL AEROSOL,759.9,493.94,,,0
NDC,45802-0055-35,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,26.05,16.93,,,0
NDC,45802-0056-35,GENTAMICIN 0.1 % TOPICAL CREAM,160.9,104.58,,,0
NDC,45802-0064-35,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,13.7,8.9,,,0
NDC,45802-0097-35,ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,286.25,186.06,,,0
NDC,45802-0098-51,MESALAMINE 4 GRAM/60 ML ENEMA,28.95,18.82,,,0
NDC,45802-0107-52,"PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE",0.3,0.2,,,0
NDC,45802-0139-70,METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL,85.75,55.74,,,0
NDC,45802-0410-59,OXYMETAZOLINE 0.05 % NASAL SPRAY,16.8,10.92,,,0
NDC,45802-0465-64,KETOCONAZOLE 2 % SHAMPOO,64.45,41.89,,,0
NDC,45802-0525-55,AMMONIUM LACTATE 12 % LOTION,50.1,32.56,,,0
NDC,45802-0562-02,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,42.8,27.82,,,0
NDC,45802-0580-62,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,33.2,21.58,,,0
NDC,45802-0730-30,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,0.35,0.23,,,0
NDC,45802-0880-14,"NYSTATIN-TRIAMCINOLONE 100,000 UNIT/G-0.1 % TOPICAL CREAM",26.4,17.16,,,0
NDC,45802-0953-01,DICLOFENAC 1 % TOPICAL GEL,53.45,34.74,,,0
NDC,46122-0221-71,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.1,0.06,,,0
NDC,46122-0255-16,NICOTINE (POLACRILEX) 4 MG BUCCAL LOZENGE,0.3,0.2,,,0
NDC,46122-0432-40,ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP,8.95,5.82,,,0
NDC,46122-0444-27,MICONAZOLE NITRATE 2 % TOPICAL POWDER,2.65,1.72,,,0
NDC,46122-0457-73,CAFFEINE 200 MG TABLET,0.05,0.03,,,0
NDC,46122-0547-03,"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",0.05,0.03,,,0
NDC,46122-0573-10,CAMPHOR-MENTHOL 0.5 %-0.5 % LOTION,18.85,12.25,,,0
NDC,46122-0645-13,CAMPHOR 3.1 %-METHYL SALICYLATE 10 %-MENTHOL 6 % TOPICAL PATCH (LARGE),0.6,0.39,,,0
NDC,46122-0677-46,PHENYLEPHRINE 0.25 %-MINERAL OIL 14 %-PETROLATM 74.9 % RECTAL OINTMENT,16.05,10.43,,,0
NDC,46122-0681-07,DOCOSANOL 10 % TOPICAL CREAM,9.8,6.37,,,0
NDC,46122-0741-38,MAGNESIUM CITRATE ORAL SOLUTION,13.6,8.84,,,0
NDC,46287-0006-60,SODIUM POLYSTYRENE SULFONATE 15 GRAM-SORBITOL 20 GRAM/60 ML ORAL SUSP,101.65,66.07,,,0
NDC,46287-0009-01,ISONIAZID 50 MG/5 ML ORAL SOLUTION,687.85,447.1,,,0
NDC,46287-0500-30,SORBITOL 70 % SOLUTION,7.85,5.1,,,0
NDC,46581-0675-09,METHYL SALICYLATE 10 %-MENTHOL 3 % TOPICAL PATCH,1.2,0.78,,,0
NDC,47335-0236-83,AMBRISENTAN 5 MG TABLET,32.8,21.32,,,0
NDC,47335-0485-88,BICALUTAMIDE 50 MG TABLET,5.75,3.74,,,0
NDC,47335-0788-91,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),504.15,327.7,,,0
NDC,47335-0931-40,VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,72.35,47.03,,,0
NDC,47426-0501-02,BUPIVACAINE-MELOXICAM ER 400 MG-12 MG/14 ML SURGICAL SITE INSTILL SOLN,761.55,495.01,,,0
NDC,48433-0202-30,MINERAL OIL ORAL,0.95,0.62,,,0
NDC,48433-0219-40,SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,9.75,6.34,,,0
NDC,48433-0230-15,IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,10.7,6.96,,,0
NDC,48582-0001-55,SALIVA STIMULANT COMBINATION NO.3 ORAL MUCOSAL SPRAY,30.35,19.73,,,0
NDC,48582-0512-01,SALIVA STIMULANT COMBINATION NO.7 ORAL MUCOSAL GEL,34.5,22.42,,,0
NDC,49281-0125-65,FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE,467.5,303.88,,,0
NDC,49281-0215-15,TETANUS AND DIPHTHERIA TOX (PF) 5-2 LF UNIT IM SORD,222.35,144.53,,,0
NDC,49281-0286-58,"DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP",144.05,93.63,,,0
NDC,49281-0400-10,"DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP",222.4,144.56,,,0
NDC,49281-0425-88,FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,138.15,89.8,,,0
NDC,49281-0590-58,"MENINGOCOCCAL VAC A,C,Y,W-135,CONJ TET (PF) 10 MCG/0.5 ML IM SOLUTION",615.0,399.75,,,0
NDC,49281-0752-22,TUBERCULIN PPD 5 TUB. UNIT/0.1 ML INTRADERMAL INJECTION SOLUTION,74.7,48.56,,,0
NDC,49401-0101-01,BELIMUMAB 120 MG INTRAVENOUS SOLUTION,2767.8,1799.07,,,0
NDC,49401-0102-01,BELIMUMAB 400 MG INTRAVENOUS SOLUTION,9033.7,5871.9,,,0
NDC,49483-0221-10,"NITROGLYCERIN ER 2.5 MG CAPSULE,EXTENDED RELEASE",5.7,3.7,,,0
NDC,49483-0222-10,"NITROGLYCERIN ER 6.5 MG CAPSULE,EXTENDED RELEASE",5.95,3.87,,,0
NDC,49502-0500-02,"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",1429.95,929.47,,,0
NDC,49502-0605-61,FORMOTEROL FUMARATE 20 MCG/2 ML SOLUTION FOR NEBULIZATION,19.6,12.74,,,0
NDC,49702-0213-01,ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,168.3,109.4,,,0
NDC,49702-0223-18,MARAVIROC 150 MG TABLET,87.95,57.17,,,0
NDC,49702-0228-13,DOLUTEGRAVIR 50 MG TABLET,240.1,156.06,,,0
NDC,49884-0212-55,RISPERIDONE 0.25 MG DISINTEGRATING TABLET,13.85,9.0,,,0
NDC,49884-0257-01,MINOXIDIL 10 MG TABLET,5.15,3.35,,,0
NDC,49884-0315-55,RISPERIDONE 1 MG DISINTEGRATING TABLET,16.45,10.69,,,0
NDC,49884-0907-05,MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,5.55,3.61,,,0
NDC,50111-0789-10,AZITHROMYCIN 600 MG TABLET,9.85,6.4,,,0
NDC,50242-0040-62,OMALIZUMAB 150 MG SUBCUTANEOUS SOLUTION,7381.45,4797.94,,,0
NDC,50242-0041-64,ALTEPLASE 10 MG/10 ML IV SOLUTION,832.75,541.29,,,0
NDC,50242-0044-13,ALTEPLASE 50 MG INTRAVENOUS SOLUTION,17919.65,11647.77,,,0
NDC,50242-0051-21,"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",3979.3,2586.54,,,0
NDC,50242-0053-06,"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",19568.3,12719.4,,,0
NDC,50242-0061-01,BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,483.05,313.98,,,0
NDC,50242-0070-01,"OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION",37416.15,24320.5,,,0
NDC,50242-0077-01,"TRASTUZUMAB 600 MG-HYALURONIDASE-OYSK 10,000 UNIT/5 ML SUBCUT SOLUTION",19475.45,12659.04,,,0
NDC,50242-0085-25,ALTEPLASE BOLUS AND INFUSION,35757.2,23242.18,,,0
NDC,50242-0085-27,ALTEPLASE 100 MG INTRAVENOUS SOLUTION,35757.2,23242.18,,,0
NDC,50242-0087-01,ADO-TRASTUZUMAB EMTANSINE 160 MG INTRAVENOUS SOLUTION,26561.05,17264.68,,,0
NDC,50242-0088-01,ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION,16631.5,10810.48,,,0
NDC,50242-0100-40,DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,411.05,267.18,,,0
NDC,50242-0108-01,"RITUXIMAB 1,400 MG/11.7 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN",27362.4,17785.56,,,0
NDC,50242-0109-01,"RITUXIMAB 1,600 MG/13.4 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN|DISCARDED DRUG NOT ADMINISTERED",27536.85,17898.95,,,0
NDC,50242-0122-06,PIRFENIDONE 267 MG TABLET,124.95,81.22,,,0
NDC,50242-0125-01,GLOFITAMAB-GXBM 1 MG/ML INTRAVENOUS SOLUTION,11324.75,7361.09,,,0
NDC,50242-0127-01,GLOFITAMAB-GXBM 1 MG/ML INTRAVENOUS SOLUTION,45052.95,29284.42,,,0
NDC,50242-0132-01,TRASTUZUMAB 150 MG INTRAVENOUS SOLUTION,6547.95,4256.17,,,0
NDC,50242-0135-01,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,2235.3,1452.94,,,0
NDC,50242-0136-01,TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,5465.2,3552.38,,,0
NDC,50242-0137-01,TOCILIZUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,10848.35,7051.43,,,0
NDC,50242-0142-01,MOSUNETUZUMAB-AXGB 1 MG/ML INTRAVENOUS SOLUTION,77766.3,50548.1,,,0
NDC,50242-0145-01,PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,28374.15,18443.2,,,0
NDC,50242-0150-01,OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION,85702.9,55706.88,,,0
NDC,50242-0159-01,MOSUNETUZUMAB-AXGB 1 MG/ML INTRAVENOUS SOLUTION,2671.55,1736.51,,,0
NDC,50242-0176-01,TENECTEPLASE 50 MG INTRAVENOUS SOLUTION,32069.85,20845.4,,,0
NDC,50242-0245-01,"PERTUZUMAB 1,200 MG-TRASTUZUMAB 600 MG-HYALURON-ZZXF/15 ML SUBCUT SOLN",57809.25,37576.01,,,0
NDC,50242-0917-01,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION",48155.95,31301.37,,,0
NDC,50242-0918-01,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION,33733.8,21926.97,,,0
NDC,50268-0037-15,AMITRIPTYLINE 10 MG TABLET,5.45,3.54,,,0
NDC,50268-0062-15,ACYCLOVIR 800 MG TABLET,6.05,3.93,,,0
NDC,50268-0130-15,BUMETANIDE 0.5 MG TABLET,7.2,4.68,,,0
NDC,50268-0144-11,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,14.6,9.49,,,0
NDC,50268-0145-11,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,16.15,10.5,,,0
NDC,50268-0177-15,CILOSTAZOL 100 MG TABLET,6.65,4.32,,,0
NDC,50268-0178-15,CLARITHROMYCIN 250 MG TABLET,10.4,6.76,,,0
NDC,50268-0187-15,COLCHICINE 0.6 MG TABLET,12.15,7.9,,,0
NDC,50268-0297-15,"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE",7.1,4.62,,,0
NDC,50268-0313-15,FENOFIBRATE 160 MG TABLET,8.4,5.46,,,0
NDC,50268-0321-15,FLECAINIDE 100 MG TABLET,6.45,4.19,,,0
NDC,50268-0330-15,FLUDROCORTISONE 0.1 MG TABLET,5.7,3.7,,,0
NDC,50268-0361-15,GLIPIZIDE 5 MG TABLET,5.2,3.38,,,0
NDC,50268-0367-15,FLUPHENAZINE 2.5 MG TABLET,11.95,7.77,,,0
NDC,50268-0407-15,HYDROCORTISONE 20 MG TABLET,8.5,5.52,,,0
NDC,50268-0411-24,HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,8.6,5.59,,,0
NDC,50268-0430-15,INDOMETHACIN 25 MG CAPSULE,5.35,3.48,,,0
NDC,50268-0431-15,INDOMETHACIN 50 MG CAPSULE,5.3,3.44,,,0
NDC,50268-0447-11,ISOSORBIDE DINITRATE 5 MG TABLET,6.3,4.1,,,0
NDC,50268-0476-15,LETROZOLE 2.5 MG TABLET,5.75,3.74,,,0
NDC,50268-0478-15,LEFLUNOMIDE 20 MG TABLET,8.55,5.56,,,0
NDC,50268-0525-15,MELOXICAM 7.5 MG TABLET,4.9,3.18,,,0
NDC,50268-0551-15,"METFORMIN ER 750 MG TABLET,EXTENDED RELEASE 24 HR",5.45,3.54,,,0
NDC,50268-0573-11,MONTELUKAST 4 MG CHEWABLE TABLET,6.6,4.29,,,0
NDC,50268-0582-11,NIACIN 100 MG TABLET,5.4,3.51,,,0
NDC,50268-0583-11,"NIACIN ER 500 MG TABLET,EXTENDED RELEASE",0.3,0.2,,,0
NDC,50268-0584-11,"NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",8.0,5.2,,,0
NDC,50268-0594-11,NAPROXEN 250 MG TABLET,5.15,3.35,,,0
NDC,50268-0595-11,NAPROXEN 375 MG TABLET,5.15,3.35,,,0
NDC,50268-0599-15,"NIFEDIPINE ER 90 MG TABLET,EXTENDED RELEASE 24 HR",7.5,4.88,,,0
NDC,50268-0678-15,POLYVINYL ALCOHOL 1.4 % EYE DROPS,40.1,26.06,,,0
NDC,50268-0725-15,SOTALOL 120 MG TABLET,5.25,3.41,,,0
NDC,50268-0754-15,TORSEMIDE 5 MG TABLET,5.3,3.44,,,0
NDC,50268-0758-11,TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,9.4,6.11,,,0
NDC,50268-0779-15,TEMAZEPAM 15 MG CAPSULE,10.4,6.76,,,0
NDC,50268-0852-15,CYANOCOBALAMIN (VIT B-12) 100 MCG TABLET,0.15,0.1,,,0
NDC,50268-0853-11,CYANOCOBALAMIN (VIT B-12) 250 MCG TABLET,0.15,0.1,,,0
NDC,50268-0858-15,PYRIDOXINE (VITAMIN B6) 50 MG TABLET,0.15,0.1,,,0
NDC,50268-0860-11,ASCORBIC ACID (VITAMIN C) 250 MG TABLET,0.15,0.1,,,0
NDC,50268-0866-15,"CHOLECALCIFEROL (VITAMIN D3) 125 MCG (5,000 UNIT) TABLET",0.2,0.13,,,0
NDC,50419-0250-01,RIOCIGUAT 0.5 MG TABLET,496.9,322.98,,,0
NDC,50419-0251-01,RIOCIGUAT 1 MG TABLET,496.9,322.98,,,0
NDC,50419-0254-91,RIOCIGUAT 2.5 MG TABLET,434.2,282.23,,,0
NDC,50419-0423-01,LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,3402.85,2211.85,,,0
NDC,50419-0424-01,LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,3402.85,2211.85,,,0
NDC,50458-0140-30,CANAGLIFLOZIN 100 MG TABLET,62.25,40.46,,,0
NDC,50458-0141-30,CANAGLIFLOZIN 300 MG TABLET,62.25,40.46,,,0
NDC,50458-0306-11,"RISPERIDONE MICROSPHERES ER 25 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE",2965.5,1927.58,,,0
NDC,50458-0307-11,"RISPERIDONE MICROSPHERES ER 37.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS",4431.95,2880.77,,,0
NDC,50458-0308-11,"RISPERIDONE MICROSPHERES ER 50 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE",5898.5,3834.02,,,0
NDC,50458-0309-11,"RISPERIDONE MICROSPHERES ER 12.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS",1499.4,974.61,,,0
NDC,50458-0562-01,PALIPERIDONE PALMITATE 117 MG/0.75 ML INTRAMUSCULAR SYRINGE,8560.75,5564.49,,,0
NDC,50458-0563-01,PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,11403.75,7412.44,,,0
NDC,50458-0564-01,PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,17088.8,11107.72,,,0
NDC,50458-0577-10,RIVAROXABAN 2.5 MG TABLET,26.25,17.06,,,0
NDC,50458-0578-30,RIVAROXABAN 15 MG TABLET,47.8,31.07,,,0
NDC,50458-0579-10,RIVAROXABAN 20 MG TABLET,47.8,31.07,,,0
NDC,50458-0580-10,RIVAROXABAN 10 MG TABLET,47.8,31.07,,,0
NDC,50474-0470-66,BRIVARACETAM 25 MG TABLET,75.55,49.11,,,0
NDC,50474-0570-09,BRIVARACETAM 50 MG TABLET,75.55,49.11,,,0
NDC,50474-0802-03,ROTIGOTINE 2 MG/24 HOUR TRANSDERMAL 24 HOUR PATCH,87.85,57.1,,,0
NDC,50474-0970-75,BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,44.65,29.02,,,0
NDC,50484-0010-30,COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,1152.25,748.96,,,0
NDC,50632-0010-01,"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",1346.4,875.16,,,0
NDC,50633-0110-12,CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,14860.7,9659.46,,,0
NDC,50633-0120-11,DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,23098.9,15014.28,,,0
NDC,50633-0210-11,"GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION",179416.9,116620.98,,,0
NDC,50633-0310-11,HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,4892.85,3180.35,,,0
NDC,50742-0113-01,DESIPRAMINE 25 MG TABLET,5.05,3.28,,,0
NDC,50742-0116-01,DESIPRAMINE 100 MG TABLET,6.1,3.96,,,0
NDC,50742-0190-01,CYPROHEPTADINE 4 MG TABLET,4.8,3.12,,,0
NDC,50742-0241-01,MEXILETINE 250 MG CAPSULE,6.65,4.32,,,0
NDC,50742-0362-60,IVABRADINE 5 MG TABLET,6.8,4.42,,,0
NDC,50742-0521-10,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,1797.65,1168.47,,,0
NDC,50742-0549-05,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,25.2,16.38,,,0
NDC,50742-0550-05,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,27.5,17.88,,,0
NDC,50742-0552-05,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,35.2,22.88,,,0
NDC,50742-0554-05,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,46.8,30.42,,,0
NDC,50742-0556-05,FENTANYL 100 MCG/HR TRANSDERMAL PATCH,58.35,37.93,,,0
NDC,50881-0005-60,RUXOLITINIB 5 MG TABLET,916.5,595.72,,,0
NDC,50881-0010-60,RUXOLITINIB 10 MG TABLET,916.5,595.72,,,0
NDC,50881-0013-03,TAFASITAMAB-CXIX 200 MG INTRAVENOUS SOLUTION,5872.3,3817.0,,,0
NDC,50881-0015-60,RUXOLITINIB 15 MG TABLET,916.5,595.72,,,0
NDC,50881-0020-60,RUXOLITINIB 20 MG TABLET,916.5,595.72,,,0
NDC,50881-0025-60,RUXOLITINIB 25 MG TABLET,916.5,595.72,,,0
NDC,51079-0024-01,METOLAZONE 5 MG TABLET,12.4,8.06,,,0
NDC,51079-0058-20,CHLORTHALIDONE 25 MG TABLET,9.75,6.34,,,0
NDC,51079-0083-20,ISONIAZID 300 MG TABLET,7.5,4.88,,,0
NDC,51079-0284-20,DIAZEPAM 2 MG TABLET,8.45,5.49,,,0
NDC,51079-0285-20,DIAZEPAM 5 MG TABLET,8.45,5.49,,,0
NDC,51079-0286-20,DIAZEPAM 10 MG TABLET,8.5,5.52,,,0
NDC,51079-0436-01,DOXEPIN 10 MG CAPSULE,6.15,4.0,,,0
NDC,51079-0437-01,DOXEPIN 25 MG CAPSULE,6.6,4.29,,,0
NDC,51079-0438-01,DOXEPIN 50 MG CAPSULE,7.35,4.78,,,0
NDC,51079-0513-01,PIOGLITAZONE 15 MG TABLET,8.65,5.62,,,0
NDC,51079-0514-01,PIOGLITAZONE 30 MG TABLET,12.65,8.22,,,0
NDC,51079-0565-01,THIORIDAZINE 10 MG TABLET,5.6,3.64,,,0
NDC,51079-0566-01,THIORIDAZINE 25 MG TABLET,6.0,3.9,,,0
NDC,51079-0581-01,LEUCOVORIN CALCIUM 5 MG TABLET,9.2,5.98,,,0
NDC,51079-0632-01,PRAZOSIN 5 MG CAPSULE,14.75,9.59,,,0
NDC,51079-0684-20,ATENOLOL 50 MG TABLET,4.9,3.18,,,0
NDC,51079-0685-01,ATENOLOL 100 MG TABLET,5.25,3.41,,,0
NDC,51079-0690-20,LOPERAMIDE 2 MG CAPSULE,6.7,4.36,,,0
NDC,51079-0721-20,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,5.9,3.84,,,0
NDC,51079-0724-20,ZOLPIDEM 5 MG TABLET,8.6,5.59,,,0
NDC,51079-0733-20,HALOPERIDOL 0.5 MG TABLET,5.45,3.54,,,0
NDC,51079-0734-20,HALOPERIDOL 1 MG TABLET,5.8,3.77,,,0
NDC,51079-0735-20,HALOPERIDOL 2 MG TABLET,6.25,4.06,,,0
NDC,51079-0767-08,"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",11.55,7.51,,,0
NDC,51079-0817-20,"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",7.5,4.88,,,0
NDC,51079-0882-20,CLONAZEPAM 1 MG TABLET,8.6,5.59,,,0
NDC,51079-0901-01,LOXAPINE SUCCINATE 10 MG CAPSULE,6.3,4.1,,,0
NDC,51079-0902-01,LOXAPINE SUCCINATE 25 MG CAPSULE,7.2,4.68,,,0
NDC,51079-0923-01,"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",6.5,4.22,,,0
NDC,51079-0985-20,BUSPIRONE 5 MG TABLET,4.9,3.18,,,0
NDC,51144-0003-01,TISOTUMAB VEDOTIN-TFTV 40 MG INTRAVENOUS SOLUTION,30781.35,20007.88,,,0
NDC,51144-0020-01,ENFORTUMAB VEDOTIN-EJFV 20 MG INTRAVENOUS SOLUTION,11734.1,7627.16,,,0
NDC,51144-0030-01,ENFORTUMAB VEDOTIN-EJFV 30 MG INTRAVENOUS SOLUTION,17560.1,11414.06,,,0
NDC,51144-0050-01,BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,52662.6,34230.69,,,0
NDC,51525-0431-01,FELBAMATE 600 MG TABLET,17.15,11.15,,,0
NDC,51552-0055-06,ACETIC ACID (BULK) 5 % LIQUID,90.35,58.73,,,0
NDC,51552-1345-01,LIDOCAINE 4 %-EPINEPHRINE 0.18 %-TETRACAINE 0.5 % TOPICAL SOLUTION KIT,13.0,8.45,,,0
NDC,51672-1264-01,FLUOCINONIDE 0.05 % TOPICAL OINTMENT,57.6,37.44,,,0
NDC,51672-1370-02,MUPIROCIN CALCIUM 2 % TOPICAL CREAM,123.4,80.21,,,0
NDC,51672-2001-02,MICONAZOLE NITRATE 2 % TOPICAL CREAM,4.0,2.6,,,0
NDC,51672-2003-06,CLOTRIMAZOLE 1 % VAGINAL CREAM,24.25,15.76,,,0
NDC,51672-2116-02,ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,0.85,0.55,,,0
NDC,51672-3007-01,HYDROCORTISONE-ACETIC ACID 1 %-2 % EAR DROPS,449.1,291.92,,,0
NDC,51672-4005-01,CARBAMAZEPINE 200 MG TABLET,5.75,3.74,,,0
NDC,51672-4118-06,FLUOROURACIL 5 % TOPICAL CREAM,113.2,73.58,,,0
NDC,51672-4215-03,METRONIDAZOLE 1 % TOPICAL GEL,263.55,171.31,,,0
NDC,51672-4230-08,IVERMECTIN 0.5 % LOTION,571.9,371.74,,,0
NDC,51754-1029-01,NITROPRUSSIDE 20 MG/100 ML (0.2 MG/ML) IN 0.9% SODIUM CHLORIDE IV SOLN,195.2,126.88,,,0
NDC,51754-5012-01,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,60.95,39.62,,,0
NDC,51801-0001-40,POTASSIUM BICARBONATE-CITRIC ACID 25 MEQ EFFERVESCENT TABLET,5.6,3.64,,,0
NDC,51862-0240-30,AMIODARONE 100 MG TABLET,12.7,8.26,,,0
NDC,51862-0332-01,ESTRADIOL 0.5 MG TABLET,4.9,3.18,,,0
NDC,51862-0333-01,ESTRADIOL 1 MG TABLET,4.95,3.22,,,0
NDC,51862-0334-01,ESTRADIOL 2 MG TABLET,4.85,3.15,,,0
NDC,51991-0002-98,METHADONE 10 MG/ML INJECTION SOLUTION,904.4,587.86,,,0
NDC,51991-0144-17,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,109.2,70.98,,,0
NDC,51991-0198-99,POLYSACCHARIDE IRON COMPLEX 150 MG IRON CAP SORD,4.95,3.22,,,0
NDC,51991-0384-90,FOLIC ACID-VIT B6-VIT B12 TABLET SORD,6.85,4.45,,,0
NDC,51991-0898-30,RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH,9.45,6.14,,,0
NDC,52015-0080-01,FIDAXOMICIN 200 MG TABLET,373.05,242.48,,,0
NDC,52268-0100-01,PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,92.4,60.06,,,0
NDC,52565-0052-10,CEFOTETAN INJ (SORD FOR COMPOUNDING),224.2,145.73,,,0
NDC,52817-0816-15,ACETIC ACID 2 % EAR SOLUTION,89.9,58.44,,,0
NDC,52817-0830-04,LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,6.25,4.06,,,0
NDC,53436-0084-01,PATIROMER CALCIUM SORBITEX 8.4 GRAM ORAL POWDER PACKET,97.1,63.12,,,0
NDC,53489-0141-01,"QUINIDINE GLUCONATE ER 324 MG TABLET,EXTENDED RELEASE",21.45,13.94,,,0
NDC,53746-0617-01,TRAMADOL 37.5 MG-ACETAMINOPHEN 325 MG TABLET,8.85,5.75,,,0
NDC,54288-0103-10,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,38.05,24.73,,,0
NDC,54288-0105-15,ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,2813.0,1828.45,,,0
NDC,54288-0111-01,HYOSCYAMINE 0.5 MG/ML INJECTION SOLUTION,137.25,89.21,,,0
NDC,54288-0120-01,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,34.85,22.65,,,0
NDC,54482-0147-01,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,213.2,138.58,,,0
NDC,54629-0586-05,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",0.1,0.06,,,0
NDC,54629-4097-60,ACETYLCYSTEINE 600 MG CAPSULE,0.1,0.06,,,0
NDC,54643-5649-01,"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",56.45,36.69,,,0
NDC,54643-5650-02,"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",237.55,154.41,,,0
NDC,54838-0502-80,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,234.85,152.65,,,0
NDC,54838-0510-80,OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,4.9,3.18,,,0
NDC,54838-0512-40,DOXEPIN 10 MG/ML ORAL CONCENTRATE,12.7,8.26,,,0
NDC,54879-0036-64,CARMUSTINE 100 MG INTRAVENOUS SOLUTION,1539.35,1000.58,,,0
NDC,55111-0292-36,SUMATRIPTAN 50 MG TABLET,6.15,4.0,,,0
NDC,55111-0522-30,ATOMOXETINE 60 MG CAPSULE,8.15,5.3,,,0
NDC,55111-0527-01,"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",9.25,6.01,,,0
NDC,55111-0556-10,DECITABINE 50 MG INTRAVENOUS SOLUTION,371.25,241.31,,,0
NDC,55111-0733-90,VALSARTAN 160 MG TABLET,5.35,3.48,,,0
NDC,55135-0132-01,SACITUZUMAB GOVITECAN-HZIY 180 MG INTRAVENOUS SOLUTION,10715.75,6965.24,,,0
NDC,55150-0123-16,NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,46.4,30.16,,,0
NDC,55150-0163-30,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,39.1,25.42,,,0
NDC,55150-0169-10,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,36.55,23.76,,,0
NDC,55150-0173-05,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,51.25,33.31,,,0
NDC,55150-0183-10,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,77.65,50.47,,,0
NDC,55150-0209-02,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,41.95,27.27,,,0
NDC,55150-0223-10,METHOCARBAMOL 100 MG/ML INJECTION SOLUTION,40.8,26.52,,,0
NDC,55150-0230-10,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,63.4,41.21,,,0
NDC,55150-0232-10,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,72.5,47.12,,,0
NDC,55150-0234-10,"POLYMYXIN B SULFATE 500,000 UNIT/2 ML SOLUTION FOR INJECTION",49.15,31.95,,,0
NDC,55150-0259-30,ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,41.75,27.14,,,0
NDC,55150-0267-05,FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION,51.5,33.48,,,0
NDC,55150-0282-09,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,152.3,99.0,,,0
NDC,55150-0308-01,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,97.75,63.54,,,0
NDC,55150-0330-01,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE,98.1,63.76,,,0
NDC,55150-0370-24,VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,45.75,29.74,,,0
NDC,55292-0811-55,DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,11317.4,7356.31,,,0
NDC,55513-0006-01,DARBEPOETIN ALFA 200 MCG/ML IN POLYSORBATE INJECTION,2294.5,1491.42,,,0
NDC,55513-0021-04,DARBEPOETIN ALFA 40 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,1540.65,1001.42,,,0
NDC,55513-0023-01,DARBEPOETIN ALFA 60 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE,2294.5,1491.42,,,0
NDC,55513-0028-01,DARBEPOETIN ALFA 200 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,7571.55,4921.51,,,0
NDC,55513-0032-01,DARBEPOETIN ALFA 500 MCG/ML IN POLYSORBATE INJECTION SYRINGE,5686.9,3696.48,,,0
NDC,55513-0078-01,TALIMOGENE LAHERPAREPVEC 10EXP6 (1 MILLION) PFU/ML SUSP FOR INJECTION,374.85,243.65,,,0
NDC,55513-0079-01,TALIMOGENE LAHERPAREPVEC 10EXP8 (100 MILLION)PFU/ML SUSP FOR INJECTION,29352.55,19079.16,,,0
NDC,55513-0141-01,TRASTUZUMAB-ANNS 150 MG INTRAVENOUS SOLUTION,5485.35,3565.48,,,0
NDC,55513-0160-01,BLINATUMOMAB 35 MCG INTRAVENOUS KIT,23132.15,15035.9,,,0
NDC,55513-0190-01,PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,15393.0,10005.45,,,0
NDC,55513-0192-01,PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR,15393.0,10005.45,,,0
NDC,55513-0206-01,BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLUTION,2854.0,1855.1,,,0
NDC,55513-0221-01,ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION,13769.4,8950.11,,,0
NDC,55513-0222-01,ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION,27505.75,17878.74,,,0
NDC,55513-0223-01,ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLUTION,6901.3,4485.84,,,0
NDC,55513-0530-01,FILGRASTIM 300 MCG/ML INJECTION SOLUTION,1566.6,1018.29,,,0
NDC,55513-0546-01,FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,2475.05,1608.78,,,0
NDC,55513-0710-21,DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE,9177.0,5965.05,,,0
NDC,55513-0730-01,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,16852.9,10954.38,,,0
NDC,55513-0880-02,ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE,10987.15,7141.65,,,0
NDC,55566-2800-01,"DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE",1594.2,1036.23,,,0
NDC,55566-8303-01,DEGARELIX 80 MG SUBCUTANEOUS SOLUTION,1965.2,1277.38,,,0
NDC,55566-8403-01,DEGARELIX 120 MG SUBCUTANEOUS SOLUTION,3020.1,1963.06,,,0
NDC,57074-0001-77,"CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET",6.55,4.26,,,0
NDC,57237-0011-06,MIRTAZAPINE 15 MG DISINTEGRATING TABLET,5.95,3.87,,,0
NDC,57237-0098-01,CEFADROXIL 500 MG/5 ML ORAL SUSPENSION,8.75,5.69,,,0
NDC,57237-0149-35,FLUCONAZOLE 10 MG/ML ORAL SUSPENSION,14.05,9.13,,,0
NDC,57237-0150-35,FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,8.9,5.78,,,0
NDC,57237-0274-24,LAMIVUDINE 10 MG/ML ORAL SOLUTION,11.15,7.25,,,0
NDC,57665-0101-41,AMPHOTERICIN B LIPID COMPLEX 5 MG/ML INTRAVENOUS SUSPENSION,519.9,337.94,,,0
NDC,57894-0030-01,INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,5724.65,3721.02,,,0
NDC,57894-0054-27,USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,10603.9,6892.54,,,0
NDC,57894-0111-01,CILTACABTAGENE AUTOLEUCEL 0.5 X 10EXP6 TO 1X 10EXP8 CELL IV SUSPENSION,2187494.6,1421871.49,,,0
NDC,57894-0449-01,TECLISTAMAB-CQYV 10 MG/ML SUBCUTANEOUS SOLUTION,8579.6,5576.74,,,0
NDC,57894-0450-01,TECLISTAMAB-CQYV 90 MG/ML SUBCUTANEOUS SOLUTION,43419.6,28222.74,,,0
NDC,57894-0469-01,TALQUETAMAB-TGVS 2 MG/ML SUBCUTANEOUS SOLUTION,3676.35,2389.63,,,0
NDC,57894-0470-01,TALQUETAMAB-TGVS 40 MG/ML SUBCUTANEOUS SOLUTION,48005.2,31203.38,,,0
NDC,57894-0503-01,"DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN",43716.0,28415.4,,,0
NDC,57896-0116-03,METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM,2.55,1.66,,,0
NDC,57896-0181-05,PEG 400-HYPROMELLOSE-GLYCERIN 1 %-0.2 %-0.2 % EYE DROPS,1.55,1.01,,,0
NDC,57896-0921-10,"ASPIRIN 325 MG TABLET,DELAYED RELEASE",0.05,0.03,,,0
NDC,57896-0981-10,"ASPIRIN 81 MG TABLET,DELAYED RELEASE",0.05,0.03,,,0
NDC,58160-0819-12,"VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT",816.7,530.86,,,0
NDC,58160-0820-52,HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE,168.75,109.69,,,0
NDC,58160-0828-03,VARICELLA-ZOSTER GLYCOP E VACCINE (VIAL 2 OF 2) 50 MCG IM SUSPENSION,1031.3,670.34,,,0
NDC,58160-0976-20,"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",1078.05,700.73,,,0
NDC,58394-0634-03,COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,4370.0,2840.5,,,0
NDC,58394-0635-03,"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",8707.05,5659.58,,,0
NDC,58394-0636-03,"COAGULATION FACTOR IX (RECOMB) 2,000 UNIT INTRAVENOUS SOLUTION",17381.1,11297.72,,,0
NDC,58394-0637-03,"COAGULATION FACTOR IX (RECOMB) 3,000 UNIT INTRAVENOUS SOLUTION",26055.25,16935.91,,,0
NDC,58468-0030-02,THYROTROPIN ALFA 0.9 MG INTRAMUSCULAR SOLUTION,10734.0,6977.1,,,0
NDC,58468-0040-01,AGALSIDASE BETA 35 MG INTRAVENOUS SOLUTION,39483.35,25664.18,,,0
NDC,58468-0041-01,AGALSIDASE BETA 5 MG INTRAVENOUS SOLUTION,5667.75,3684.04,,,0
NDC,58468-0080-01,ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,5675.05,3688.78,,,0
NDC,58468-0200-01,ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,116350.05,75627.53,,,0
NDC,58468-0225-01,CAPLACIZUMAB-YHDP 11 MG INJECTION KIT,35638.3,23164.9,,,0
NDC,58468-0227-01,CAPLACIZUMAB-YHDP 11 MG SOLUTION FOR INJECTION,35638.3,23164.9,,,0
NDC,58526-0005-57,FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQUID,8.95,5.82,,,0
NDC,58914-0501-56,"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",116.5,75.72,,,0
NDC,58980-0012-05,"BACITRACIN ZINC 500 UNIT-POLYMYXIN B 10,000 UNIT/GRAM TOPICAL OINTMENT",3.2,2.08,,,0
NDC,58980-0608-80,UREA 10 % LOTION,33.35,21.68,,,0
NDC,59011-0410-20,"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",26.6,17.29,,,0
NDC,59011-0415-20,"OXYCODONE ER 15 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",35.3,22.94,,,0
NDC,59011-0420-20,"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",42.5,27.62,,,0
NDC,59011-0440-20,"OXYCODONE ER 40 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",66.85,43.45,,,0
NDC,59148-0036-13,BREXPIPRAZOLE 0.5 MG TABLET,150.6,97.89,,,0
NDC,59148-0037-13,BREXPIPRAZOLE 1 MG TABLET,150.6,97.89,,,0
NDC,59148-0038-13,BREXPIPRAZOLE 2 MG TABLET,150.6,97.89,,,0
NDC,59365-5128-01,COPPER 380 SQUARE MM INTRAUTERINE DEVICE,3377.45,2195.34,,,0
NDC,59385-0021-60,BUPRENORPHINE HCL 75 MCG BUCCAL FILM,37.25,24.21,,,0
NDC,59385-0022-60,BUPRENORPHINE HCL 150 MCG BUCCAL FILM,37.25,24.21,,,0
NDC,59385-0023-01,BUPRENORPHINE HCL 300 MCG BUCCAL FILM,53.8,34.97,,,0
NDC,59572-0515-01,IDECABTAGENE VICLEUCEL 300 X 10EXP6 TO 510 X 10EXP6 CELL IV SUSPENSION,2088411.4,1357467.41,,,0
NDC,59572-0711-01,LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLUTION,20555.85,13361.3,,,0
NDC,59572-0775-01,LUSPATERCEPT-AAMT 75 MG SUBCUTANEOUS SOLUTION,61601.45,40040.94,,,0
NDC,59630-0266-01,CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,1112.7,723.26,,,0
NDC,59651-0241-30,IMATINIB 400 MG TABLET,11.0,7.15,,,0
NDC,59651-0299-60,TAMOXIFEN 10 MG TABLET,5.15,3.35,,,0
NDC,59651-0428-01,SPIRONOLACTONE 100 MG TABLET,6.15,4.0,,,0
NDC,59651-0873-50,CIPROFLOXACIN 750 MG TABLET,5.3,3.44,,,0
NDC,59676-0278-01,RILPIVIRINE HCL 25 MG TABLET,147.5,95.88,,,0
NDC,59676-0302-01,"EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION",291.0,189.15,,,0
NDC,59676-0303-00,"EPOETIN ALFA 3,000 UNIT/ML INJECTION SOLUTION",420.0,273.0,,,0
NDC,59676-0304-01,"EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION",549.0,356.85,,,0
NDC,59676-0310-01,"EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION",736.65,478.82,,,0
NDC,59676-0320-04,"EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION",1440.35,936.23,,,0
NDC,59676-0340-01,"EPOETIN ALFA 40,000 UNIT/ML INJECTION SOLUTION",2847.75,1851.04,,,0
NDC,59676-0562-01,DARUNAVIR 600 MG TABLET,113.9,74.04,,,0
NDC,59676-0566-30,DARUNAVIR 800 MG TABLET,223.15,145.05,,,0
NDC,59676-0570-01,ETRAVIRINE 100 MG TABLET,42.55,27.66,,,0
NDC,59676-0610-01,TRABECTEDIN 1 MG INTRAVENOUS SOLUTION,15385.85,10000.8,,,0
NDC,59746-0003-14,METHYLPREDNISOLONE 16 MG TABLET,11.8,7.67,,,0
NDC,59746-0010-32,RISPERIDONE 0.5 MG DISINTEGRATING TABLET,8.75,5.69,,,0
NDC,59746-0030-22,RISPERIDONE 2 MG DISINTEGRATING TABLET,12.95,8.42,,,0
NDC,59746-0115-06,PROCHLORPERAZINE MALEATE 10 MG TABLET,6.15,4.0,,,0
NDC,59746-0217-01,SPIRONOLACTONE 50 MG TABLET,5.2,3.38,,,0
NDC,59762-0055-01,MEDROXYPROGESTERONE 2.5 MG TABLET,5.05,3.28,,,0
NDC,59762-0104-06,"SULFASALAZINE 500 MG TABLET,DELAYED RELEASE",5.4,3.51,,,0
NDC,59762-0333-02,LATANOPROST 0.005 % EYE DROPS,18.25,11.86,,,0
NDC,59762-2012-01,ASENAPINE 5 MG SUBLINGUAL TABLET,15.25,9.91,,,0
NDC,59762-2858-01,EXEMESTANE 25 MG TABLET,9.45,6.14,,,0
NDC,59762-3744-01,CLINDAMYCIN 1 % LOTION,378.45,245.99,,,0
NDC,59762-5000-05,SULFASALAZINE 500 MG TABLET,5.2,3.38,,,0
NDC,60258-0006-01,"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",6.2,4.03,,,0
NDC,60258-0160-01,VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,4.8,3.12,,,0
NDC,60267-0705-50,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,531.9,345.74,,,0
NDC,60505-0033-06,"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",5.85,3.8,,,0
NDC,60505-0055-01,SELEGILINE 5 MG CAPSULE,6.05,3.93,,,0
NDC,60505-0252-02,TIZANIDINE 4 MG TABLET,4.8,3.12,,,0
NDC,60505-0402-05,PAROXETINE 10 MG/5 ML ORAL SUSPENSION,32.2,20.93,,,0
NDC,60505-0582-04,MOXIFLOXACIN 0.5 % EYE DROPS,266.7,173.36,,,0
NDC,60505-0823-06,CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,297.3,193.24,,,0
NDC,60505-0829-01,"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",41.95,27.27,,,0
NDC,60505-0833-05,AZELASTINE 137 MCG (0.1 %) NASAL SPRAY,58.3,37.9,,,0
NDC,60505-2575-07,BALSALAZIDE 750 MG CAPSULE,6.7,4.36,,,0
NDC,60505-3111-00,OLANZAPINE 5 MG TABLET,5.3,3.44,,,0
NDC,60505-3250-06,LAMIVUDINE 100 MG TABLET,38.5,25.02,,,0
NDC,60505-3628-06,DASATINIB 20 MG TABLET,75.25,48.91,,,0
NDC,60505-3629-06,DASATINIB 50 MG TABLET,159.8,103.87,,,0
NDC,60505-3630-06,DASATINIB 70 MG TABLET,203.65,132.37,,,0
NDC,60505-3631-03,DASATINIB 100 MG TABLET,298.9,194.28,,,0
NDC,60505-3816-03,DASATINIB 80 MG TABLET,312.8,203.32,,,0
NDC,60505-3817-03,DASATINIB 140 MG TABLET,357.75,232.54,,,0
NDC,60505-4373-03,VILAZODONE 20 MG TABLET,19.4,12.61,,,0
NDC,60505-4765-05,VARENICLINE TARTRATE 0.5 MG TABLET,26.8,17.42,,,0
NDC,60505-4766-06,VARENICLINE TARTRATE 1 MG TABLET,26.8,17.42,,,0
NDC,60505-6116-00,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,148.9,96.78,,,0
NDC,60505-6147-04,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,98.45,63.99,,,0
NDC,60505-6226-02,ATROPINE 1 % EYE DROPS,280.5,182.32,,,0
NDC,60635-0118-01,POLIDOCANOL 1 % INTRAVENOUS FOAM,911.375,592.39,,,0
NDC,60635-0123-01,INV VARITHENA ADMINISTRATION PACK,0.65,0.42,,,0
NDC,60687-0100-01,URSODIOL 300 MG CAPSULE,12.95,8.42,,,0
NDC,60687-0105-21,MEDROXYPROGESTERONE 10 MG TABLET,8.05,5.23,,,0
NDC,60687-0112-21,ANASTROZOLE 1 MG TABLET,6.95,4.52,,,0
NDC,60687-0113-01,CLONIDINE HCL 0.1 MG TABLET,5.3,3.44,,,0
NDC,60687-0122-01,PREDNISONE 5 MG TABLET,5.05,3.28,,,0
NDC,60687-0124-01,CLONIDINE HCL 0.2 MG TABLET,5.4,3.51,,,0
NDC,60687-0129-01,DOCUSATE SODIUM 100 MG CAPSULE,0.15,0.1,,,0
NDC,60687-0134-01,PREDNISONE 10 MG TABLET,4.95,3.22,,,0
NDC,60687-0143-01,METFORMIN 850 MG TABLET,5.15,3.35,,,0
NDC,60687-0145-01,PREDNISONE 20 MG TABLET,5.05,3.28,,,0
NDC,60687-0152-01,CEPHALEXIN 250 MG CAPSULE,5.4,3.51,,,0
NDC,60687-0155-01,METFORMIN 500 MG TABLET,4.8,3.12,,,0
NDC,60687-0156-25,PHENYTOIN 50 MG CHEWABLE TABLET,7.55,4.91,,,0
NDC,60687-0157-21,ARIPIPRAZOLE 2 MG TABLET,6.7,4.36,,,0
NDC,60687-0168-01,ARIPIPRAZOLE 5 MG TABLET,5.55,3.61,,,0
NDC,60687-0173-57,MEMANTINE 5 MG TABLET,5.55,3.61,,,0
NDC,60687-0179-01,ARIPIPRAZOLE 10 MG TABLET,5.8,3.77,,,0
NDC,60687-0184-57,MEMANTINE 10 MG TABLET,5.5,3.58,,,0
NDC,60687-0188-21,ENTACAPONE 200 MG TABLET,14.25,9.26,,,0
NDC,60687-0191-21,ARIPIPRAZOLE 15 MG TABLET,8.2,5.33,,,0
NDC,60687-0195-01,"DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24 HR",5.55,3.61,,,0
NDC,60687-0199-11,MELOXICAM 15 MG TABLET,5.05,3.28,,,0
NDC,60687-0206-01,"DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR",5.65,3.67,,,0
NDC,60687-0215-11,"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",9.85,6.4,,,0
NDC,60687-0224-01,GEMFIBROZIL 600 MG TABLET,5.25,3.41,,,0
NDC,60687-0226-01,"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",10.25,6.66,,,0
NDC,60687-0230-11,ZONISAMIDE 100 MG CAPSULE,5.9,3.84,,,0
NDC,60687-0231-01,SERTRALINE 25 MG TABLET,5.35,3.48,,,0
NDC,60687-0242-01,SERTRALINE 50 MG TABLET,5.4,3.51,,,0
NDC,60687-0245-11,ROSUVASTATIN 10 MG TABLET,7.3,4.74,,,0
NDC,60687-0249-77,LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLUTION,10.5,6.82,,,0
NDC,60687-0252-86,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,51.05,33.18,,,0
NDC,60687-0253-01,SERTRALINE 100 MG TABLET,5.45,3.54,,,0
NDC,60687-0256-11,ROSUVASTATIN 20 MG TABLET,7.8,5.07,,,0
NDC,60687-0272-94,CEFUROXIME AXETIL 250 MG TABLET,13.2,8.58,,,0
NDC,60687-0275-62,PHENYTOIN 100 MG/4 ML ORAL SUSPENSION,20.6,13.39,,,0
NDC,60687-0283-94,CEFUROXIME AXETIL 500 MG TABLET,14.95,9.72,,,0
NDC,60687-0292-01,DONEPEZIL 5 MG TABLET,4.9,3.18,,,0
NDC,60687-0299-25,ITRACONAZOLE 100 MG CAPSULE,12.7,8.26,,,0
NDC,60687-0303-01,DONEPEZIL 10 MG TABLET,4.9,3.18,,,0
NDC,60687-0304-11,CAPTOPRIL 12.5 MG TABLET,8.25,5.36,,,0
NDC,60687-0309-21,LINEZOLID 600 MG TABLET,10.8,7.02,,,0
NDC,60687-0327-01,QUETIAPINE 25 MG TABLET,5.0,3.25,,,0
NDC,60687-0328-31,SEVELAMER CARBONATE 800 MG TABLET,9.85,6.4,,,0
NDC,60687-0333-01,LISINOPRIL 20 MG TABLET,4.9,3.18,,,0
NDC,60687-0338-11,QUETIAPINE 50 MG TABLET,5.3,3.44,,,0
NDC,60687-0340-01,BUPROPION HCL 75 MG TABLET,7.0,4.55,,,0
NDC,60687-0345-01,CALCITRIOL 0.25 MCG CAPSULE,6.65,4.32,,,0
NDC,60687-0349-01,QUETIAPINE 100 MG TABLET,5.15,3.35,,,0
NDC,60687-0351-01,BUPROPION HCL 100 MG TABLET,7.8,5.07,,,0
NDC,60687-0358-25,COLCHICINE 0.6 MG CAPSULE,17.5,11.38,,,0
NDC,60687-0360-01,QUETIAPINE 200 MG TABLET,5.55,3.61,,,0
NDC,60687-0369-01,DICYCLOMINE 10 MG CAPSULE,5.6,3.64,,,0
NDC,60687-0371-01,QUETIAPINE 300 MG TABLET,5.65,3.67,,,0
NDC,60687-0373-21,EZETIMIBE 10 MG TABLET,18.25,11.86,,,0
NDC,60687-0377-11,ALPRAZOLAM 0.25 MG TABLET,9.1,5.92,,,0
NDC,60687-0381-94,PHYTONADIONE (VITAMIN K1) 5 MG TABLET,157.6,102.44,,,0
NDC,60687-0385-25,COLESEVELAM 625 MG TABLET,12.85,8.35,,,0
NDC,60687-0387-01,MIDODRINE 2.5 MG TABLET,6.4,4.16,,,0
NDC,60687-0394-83,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,5.35,3.48,,,0
NDC,60687-0396-11,HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,9.6,6.24,,,0
NDC,60687-0397-25,"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",29.15,18.95,,,0
NDC,60687-0398-01,MIDODRINE 5 MG TABLET,6.35,4.13,,,0
NDC,60687-0402-01,"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",5.65,3.67,,,0
NDC,60687-0404-01,CLOZAPINE 25 MG TABLET,5.45,3.54,,,0
NDC,60687-0405-79,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,5.45,3.54,,,0
NDC,60687-0406-67,OXYCODONE 5 MG/5 ML ORAL SOLUTION,18.25,11.86,,,0
NDC,60687-0407-01,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET,9.85,6.4,,,0
NDC,60687-0409-25,MIDODRINE 10 MG TABLET,6.85,4.45,,,0
NDC,60687-0413-01,"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",6.05,3.93,,,0
NDC,60687-0415-01,CLOZAPINE 100 MG TABLET,6.75,4.39,,,0
NDC,60687-0418-01,HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,10.2,6.63,,,0
NDC,60687-0419-11,CHLORPROMAZINE 10 MG TABLET,11.6,7.54,,,0
NDC,60687-0420-95,RITONAVIR 100 MG TABLET,26.3,17.1,,,0
NDC,60687-0422-01,AMANTADINE HCL 100 MG CAPSULE,7.3,4.74,,,0
NDC,60687-0423-21,CLOBAZAM 10 MG TABLET,11.2,7.28,,,0
NDC,60687-0428-01,FINASTERIDE 5 MG TABLET,6.15,4.0,,,0
NDC,60687-0430-01,CHLORPROMAZINE 25 MG TABLET,13.6,8.84,,,0
NDC,60687-0432-01,TRAZODONE 150 MG TABLET,5.5,3.58,,,0
NDC,60687-0433-01,AMITRIPTYLINE 25 MG TABLET,5.4,3.51,,,0
NDC,60687-0436-01,CELECOXIB 100 MG CAPSULE,6.95,4.52,,,0
NDC,60687-0437-01,AMIODARONE 200 MG TABLET,5.3,3.44,,,0
NDC,60687-0438-01,MYCOPHENOLATE MOFETIL 500 MG TABLET,6.5,4.22,,,0
NDC,60687-0439-11,LABETALOL 100 MG TABLET,5.55,3.61,,,0
NDC,60687-0443-01,TRAZODONE 50 MG TABLET,4.9,3.18,,,0
NDC,60687-0444-01,AMITRIPTYLINE 50 MG TABLET,5.75,3.74,,,0
NDC,60687-0446-01,IBUPROFEN 400 MG TABLET,0.1,0.06,,,0
NDC,60687-0447-01,CELECOXIB 200 MG CAPSULE,8.1,5.26,,,0
NDC,60687-0451-21,EPLERENONE 25 MG TABLET,13.0,8.45,,,0
NDC,60687-0452-11,CHLORPROMAZINE 100 MG TABLET,21.65,14.07,,,0
NDC,60687-0453-01,LEVOTHYROXINE 25 MCG TABLET,5.55,3.61,,,0
NDC,60687-0454-01,TRAZODONE 100 MG TABLET,5.05,3.28,,,0
NDC,60687-0457-01,IBUPROFEN 600 MG TABLET,0.15,0.1,,,0
NDC,60687-0459-01,"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",30.95,20.12,,,0
NDC,60687-0464-01,LEVOTHYROXINE 50 MCG TABLET,5.55,3.61,,,0
NDC,60687-0465-01,SPIRONOLACTONE 25 MG TABLET,5.0,3.25,,,0
NDC,60687-0470-01,"PALIPERIDONE ER 6 MG TABLET,EXTENDED RELEASE 24 HR",30.95,20.12,,,0
NDC,60687-0473-01,PREGABALIN 25 MG CAPSULE,9.8,6.37,,,0
NDC,60687-0475-01,LEVOTHYROXINE 75 MCG TABLET,5.75,3.74,,,0
NDC,60687-0479-11,CARBAMAZEPINE 100 MG CHEWABLE TABLET,5.75,3.74,,,0
NDC,60687-0481-21,BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET,15.15,9.85,,,0
NDC,60687-0484-01,PREGABALIN 50 MG CAPSULE,9.8,6.37,,,0
NDC,60687-0488-01,AMLODIPINE 5 MG TABLET,4.9,3.18,,,0
NDC,60687-0491-01,NAPROXEN 500 MG TABLET,5.25,3.41,,,0
NDC,60687-0492-21,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,20.1,13.06,,,0
NDC,60687-0495-01,PREGABALIN 75 MG CAPSULE,9.8,6.37,,,0
NDC,60687-0496-01,AMLODIPINE 10 MG TABLET,4.95,3.22,,,0
NDC,60687-0497-01,LEVOTHYROXINE 100 MCG TABLET,5.8,3.77,,,0
NDC,60687-0508-01,LEVOTHYROXINE 112 MCG TABLET,5.95,3.87,,,0
NDC,60687-0513-65,DOXYCYCLINE HYCLATE 100 MG CAPSULE,8.5,5.52,,,0
NDC,60687-0519-01,LEVOTHYROXINE 125 MCG TABLET,6.0,3.9,,,0
NDC,60687-0523-11,"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",64.55,41.96,,,0
NDC,60687-0524-83,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,15.0,9.75,,,0
NDC,60687-0530-01,LEVOTHYROXINE 150 MCG TABLET,6.0,3.9,,,0
NDC,60687-0535-65,BUMETANIDE 2 MG TABLET,8.1,5.26,,,0
NDC,60687-0541-01,LEVOTHYROXINE 175 MCG TABLET,6.3,4.1,,,0
NDC,60687-0549-21,"RANOLAZINE ER 500 MG TABLET,EXTENDED RELEASE,12 HR",7.95,5.17,,,0
NDC,60687-0550-01,METRONIDAZOLE 500 MG TABLET,6.0,3.9,,,0
NDC,60687-0552-01,LEVOTHYROXINE 200 MCG TABLET,6.65,4.32,,,0
NDC,60687-0556-33,MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),19.85,12.9,,,0
NDC,60687-0558-01,CYCLOBENZAPRINE 10 MG TABLET,5.05,3.28,,,0
NDC,60687-0559-01,METHOCARBAMOL 500 MG TABLET,5.1,3.32,,,0
NDC,60687-0568-01,METHOCARBAMOL 750 MG TABLET,5.25,3.41,,,0
NDC,60687-0570-01,PRAMIPEXOLE 0.25 MG TABLET,5.1,3.32,,,0
NDC,60687-0575-21,RIFAMPIN 150 MG CAPSULE,11.9,7.74,,,0
NDC,60687-0576-10,MIDAZOLAM 2 MG/ML ORAL SYRUP,25.45,16.54,,,0
NDC,60687-0577-01,ROPINIROLE 0.25 MG TABLET,5.6,3.64,,,0
NDC,60687-0578-21,"ACETAZOLAMIDE ER 500 MG CAPSULE,EXTENDED RELEASE",15.95,10.37,,,0
NDC,60687-0580-01,GABAPENTIN 100 MG CAPSULE,4.9,3.18,,,0
NDC,60687-0581-21,PRAMIPEXOLE 0.5 MG TABLET,6.5,4.22,,,0
NDC,60687-0582-01,HYDROCORTISONE 10 MG TABLET,8.6,5.59,,,0
NDC,60687-0583-21,"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",13.3,8.64,,,0
NDC,60687-0584-11,MIRTAZAPINE 7.5 MG TABLET,10.4,6.76,,,0
NDC,60687-0587-01,PROPRANOLOL 10 MG TABLET,5.25,3.41,,,0
NDC,60687-0588-01,ROPINIROLE 1 MG TABLET,5.65,3.67,,,0
NDC,60687-0590-01,HYDROMORPHONE 4 MG TABLET,9.65,6.27,,,0
NDC,60687-0591-01,GABAPENTIN 300 MG CAPSULE,4.95,3.22,,,0
NDC,60687-0593-01,HYDROCHLOROTHIAZIDE 25 MG TABLET,5.1,3.32,,,0
NDC,60687-0595-01,FAMOTIDINE 20 MG TABLET,5.0,3.25,,,0
NDC,60687-0596-32,"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",28.75,18.69,,,0
NDC,60687-0599-21,FLUCYTOSINE 250 MG CAPSULE,175.65,114.17,,,0
NDC,60687-0602-01,GABAPENTIN 400 MG CAPSULE,5.05,3.28,,,0
NDC,60687-0605-01,ATENOLOL 25 MG TABLET,5.1,3.32,,,0
NDC,60687-0610-21,FLUCYTOSINE 500 MG CAPSULE,304.15,197.7,,,0
NDC,60687-0612-21,VALSARTAN 40 MG TABLET,6.65,4.32,,,0
NDC,60687-0614-11,SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,5.05,3.28,,,0
NDC,60687-0620-01,METOCLOPRAMIDE 5 MG TABLET,6.0,3.9,,,0
NDC,60687-0622-01,SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,0.15,0.1,,,0
NDC,60687-0624-11,METOLAZONE 2.5 MG TABLET,10.4,6.76,,,0
NDC,60687-0632-11,"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE(PART/CRYST)",5.65,3.67,,,0
NDC,60687-0641-11,NEBIVOLOL 5 MG TABLET,10.9,7.08,,,0
NDC,60687-0650-33,"MESALAMINE ER 0.375 GRAM CAPSULE,EXTENDED RELEASE 24 HR",12.3,8.0,,,0
NDC,60687-0652-21,NEBIVOLOL 10 MG TABLET,11.7,7.6,,,0
NDC,60687-0657-01,LEVETIRACETAM 500 MG TABLET,5.1,3.32,,,0
NDC,60687-0661-11,CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,5.2,3.38,,,0
NDC,60687-0663-11,METAXALONE 800 MG TABLET,15.9,10.34,,,0
NDC,60687-0664-11,HYDROXYZINE HCL 10 MG TABLET,5.2,3.38,,,0
NDC,60687-0673-21,NATEGLINIDE 60 MG TABLET,9.5,6.18,,,0
NDC,60687-0677-01,ALLOPURINOL 100 MG TABLET,5.15,3.35,,,0
NDC,60687-0679-11,BISOPROLOL FUMARATE 5 MG TABLET,7.5,4.88,,,0
NDC,60687-0681-01,FOLIC ACID 1 MG TABLET,5.0,3.25,,,0
NDC,60687-0687-57,LACOSAMIDE 100 MG TABLET,10.85,7.05,,,0
NDC,60687-0688-11,ALLOPURINOL 300 MG TABLET,5.7,3.7,,,0
NDC,60687-0691-11,DEMECLOCYCLINE 150 MG TABLET,22.95,14.92,,,0
NDC,60687-0693-11,LAMOTRIGINE 150 MG TABLET,5.6,3.64,,,0
NDC,60687-0694-21,METHENAMINE HIPPURATE 1 GRAM TABLET,9.85,6.4,,,0
NDC,60687-0699-21,CEFDINIR 300 MG CAPSULE,12.25,7.96,,,0
NDC,60687-0720-21,LAMIVUDINE 150 MG TABLET,18.5,12.02,,,0
NDC,60687-0722-11,OXCARBAZEPINE 300 MG TABLET,6.55,4.26,,,0
NDC,60687-0725-01,"PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE",5.2,3.38,,,0
NDC,60687-0730-11,MECLIZINE 25 MG TABLET,5.8,3.77,,,0
NDC,60687-0732-11,DESMOPRESSIN 0.2 MG TABLET,10.3,6.7,,,0
NDC,60687-0735-11,MISOPROSTOL 100 MCG TABLET,8.95,5.82,,,0
NDC,60687-0736-01,"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",5.1,3.32,,,0
NDC,60687-0738-42,SUCRALFATE 100 MG/ML ORAL SUSPENSION,16.2,10.53,,,0
NDC,60687-0739-95,AMINOCAPROIC ACID 500 MG TABLET,57.8,37.57,,,0
NDC,60687-0740-24,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION,0.65,0.42,,,0
NDC,60687-0746-01,MISOPROSTOL 200 MCG TABLET,9.4,6.11,,,0
NDC,60687-0749-01,FLUPHENAZINE 5 MG TABLET,13.6,8.84,,,0
NDC,60687-0750-21,TRANEXAMIC ACID 650 MG TABLET,13.1,8.52,,,0
NDC,60687-0754-05,LINEZOLID 100 MG/5 ML ORAL SUSPENSION,794.9,516.68,,,0
NDC,60687-0755-86,"DIAZEPAM 5 MG/5 ML (1 MG/ML, 5 ML) ORAL SOLUTION",10.55,6.86,,,0
NDC,60687-0758-11,LURASIDONE 40 MG TABLET,12.35,8.03,,,0
NDC,60687-0765-13,VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,603.4,392.21,,,0
NDC,60687-0775-01,MECLIZINE 12.5 MG TABLET,5.55,3.61,,,0
NDC,60687-0777-01,RIVASTIGMINE 1.5 MG CAPSULE,11.3,7.34,,,0
NDC,60687-0778-21,MEXILETINE 150 MG CAPSULE,8.5,5.52,,,0
NDC,60687-0780-21,LURASIDONE 80 MG TABLET,12.55,8.16,,,0
NDC,60687-0781-11,AMOXICILLIN 250 MG-POTASSIUM CLAVULANATE 125 MG TABLET,15.8,10.27,,,0
NDC,60687-0782-01,"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",8.35,5.43,,,0
NDC,60687-0783-01,"ISOSORBIDE MONONITRATE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",5.3,3.44,,,0
NDC,60687-0786-11,ROFLUMILAST 500 MCG TABLET,10.65,6.92,,,0
NDC,60687-0788-21,SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,6.25,4.06,,,0
NDC,60687-0794-01,"ISOSORBIDE MONONITRATE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",5.35,3.48,,,0
NDC,60687-0795-01,TRAMADOL 50 MG TABLET,8.65,5.62,,,0
NDC,60687-0797-56,AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,9.3,6.04,,,0
NDC,60687-0811-01,HYDRALAZINE 10 MG TABLET,5.15,3.35,,,0
NDC,60687-0812-01,BUSPIRONE 10 MG TABLET,5.0,3.25,,,0
NDC,60687-0814-65,PROCHLORPERAZINE MALEATE 5 MG TABLET,7.35,4.78,,,0
NDC,60687-0815-65,BACLOFEN 10 MG TABLET,5.5,3.58,,,0
NDC,60687-0833-01,HYDRALAZINE 50 MG TABLET,5.25,3.41,,,0
NDC,60687-0854-11,PREDNISONE 50 MG TABLET,5.55,3.61,,,0
NDC,60687-0861-01,CLONAZEPAM 0.5 MG TABLET,9.7,6.3,,,0
NDC,60687-0883-11,PRASUGREL HCL 10 MG TABLET,8.15,5.3,,,0
NDC,60687-0890-11,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,11.9,7.74,,,0
NDC,60687-0897-11,PRAVASTATIN 20 MG TABLET,5.85,3.8,,,0
NDC,60687-0908-11,PRAVASTATIN 40 MG TABLET,6.35,4.13,,,0
NDC,60793-0117-01,LIOTHYRONINE 50 MCG TABLET,7.2,4.68,,,0
NDC,60793-0205-05,"THROMBIN (BOVINE) 5,000 UNIT NASAL SPRAY SYRINGE",191.65,124.57,,,0
NDC,60793-0215-05,"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",165.4,107.51,,,0
NDC,60793-0217-20,"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SOLUTION",611.8,397.67,,,0
NDC,60793-0217-21,"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SPRAY",698.95,454.32,,,0
NDC,60793-0217-22,"THROMBIN (BOVINE) 20,000 UNIT TOPICAL SPRAY SYRINGE",698.95,454.32,,,0
NDC,60793-0701-10,"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",1744.15,1133.7,,,0
NDC,60793-0702-04,"PENICILLIN G BENZATHINE 2,400,000 UNIT/4 ML INTRAMUSCULAR SYRINGE",3539.6,2300.74,,,0
NDC,60793-0705-05,"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SPRAY SYRINGE",178.75,116.19,,,0
NDC,60977-0141-27,PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,2444.95,1589.22,,,0
NDC,61269-0410-20,ETOPOSIDE PHOSPHATE 100 MG INTRAVENOUS SOLUTION,738.8,480.22,,,0
NDC,61314-0016-01,PROPARACAINE 0.5 % EYE DROPS,132.25,85.96,,,0
NDC,61314-0030-02,DORZOLAMIDE 22.3 MG-TIMOLOL 6.8 MG/ML EYE DROPS,85.75,55.74,,,0
NDC,61314-0126-05,KETOROLAC 0.5 % EYE DROPS,116.6,75.79,,,0
NDC,61314-0144-05,BRIMONIDINE 0.15 % EYE DROPS,599.8,389.87,,,0
NDC,61314-0203-15,PILOCARPINE 1 % EYE DROPS,312.55,203.16,,,0
NDC,61314-0226-05,TIMOLOL MALEATE 0.25 % EYE DROPS,18.45,11.99,,,0
NDC,61314-0238-05,CARTEOLOL 1 % EYE DROPS,50.25,32.66,,,0
NDC,61314-0245-01,BETAXOLOL 0.5 % EYE DROPS,166.15,108.0,,,0
NDC,61314-0318-01,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,1370.8,891.02,,,0
NDC,61314-0326-01,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,1370.8,891.02,,,0
NDC,61314-0628-10,"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",28.4,18.46,,,0
NDC,61314-0631-36,"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",69.4,45.11,,,0
NDC,61314-0633-05,GENTAMICIN 0.3 % EYE DROPS,23.7,15.4,,,0
NDC,61314-0637-05,"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",114.35,74.33,,,0
NDC,61314-0641-75,"NEOMYCIN 3.5 MG-POLYMYXIN 10,000 UNIT-HYDROCORT 10 MG/ML EYE DROP,SUSP",585.7,380.7,,,0
NDC,61314-0656-05,CIPROFLOXACIN 0.3 % EYE DROPS,26.25,17.06,,,0
NDC,61314-0665-05,APRACLONIDINE 0.5 % EYE DROPS,196.65,127.82,,,0
NDC,61364-0181-01,PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION,1568.4,1019.46,,,0
NDC,61703-0305-38,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,101.7,66.1,,,0
NDC,61703-0309-25,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,122.6,79.69,,,0
NDC,61703-0309-26,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION (RND 0.01),125.65,81.67,,,0
NDC,61703-0324-18,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,99.65,64.77,,,0
NDC,61703-0339-50,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,214.8,139.62,,,0
NDC,61703-0342-50,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS (NOT ROUNDED)",356.1,231.46,,,0
NDC,61703-0350-38,METHOTREXATE SODIUM 25 MG/ML INJECTION FOR ECTOPIC PREGNANCY (SORD),94.325,61.315,,,0
NDC,61703-0363-18,OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,263.45,171.24,,,0
NDC,61703-0363-22,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,431.95,280.77,,,0
NDC,61703-0408-41,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,128.65,83.62,,,0
NDC,61874-0115-20,CARIPRAZINE 1.5 MG CAPSULE,150.85,98.05,,,0
NDC,61874-0130-20,CARIPRAZINE 3 MG CAPSULE,150.85,98.05,,,0
NDC,61958-0601-01,EMTRICITABINE 200 MG CAPSULE,56.3,36.6,,,0
NDC,61958-0602-01,EMTRICITABINE 10 MG/ML ORAL SOLUTION,350.55,227.86,,,0
NDC,61958-1101-01,EMTRICITABINE 200 MG-RILPIVIRINE 25 MG-TENOFOVIR DISPROX 300 MG TABLET,393.15,255.55,,,0
NDC,61958-1201-01,ELVITEG 150 MG-COB 150 MG-EMTRICIT 200 MG-TENOFO DISOPRO 300 MG TABLET,452.5,294.12,,,0
NDC,61958-1401-01,COBICISTAT 150 MG TABLET,34.95,22.72,,,0
NDC,61958-1901-01,ELVITEG 150 MG-COB 150 MG-EMTRICIT 200 MG-TENOFO ALAFENAM 10 MG TABLET,431.55,280.51,,,0
NDC,61958-2101-01,EMTRICITABINE 200 MG-RILPIVIRINE 25 MG-TENOFOVIR ALAFENAM 25 MG TABLET,393.15,255.55,,,0
NDC,61958-2501-01,BICTEGRAVIR 50 MG-EMTRICITABINE 200 MG-TENOFOVIR ALAFENAM 25 MG TABLET,431.55,280.51,,,0
NDC,61958-2901-02,REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,3279.8,2131.87,,,0
NDC,62135-0470-90,PREDNISONE 1 MG TABLET,13.3,8.64,,,0
NDC,62135-0867-59,CARBAMAZEPINE 200 MG/10 ML ORAL SUSPENSION,282.3,183.5,,,0
NDC,62327-0444-44,STERILE TALC 4 GRAM INTRAPLEURAL SUSPENSION,738.5,480.02,,,0
NDC,62332-0033-31,ROPINIROLE 2 MG TABLET,4.8,3.12,,,0
NDC,62332-0103-30,ARIPIPRAZOLE 10 MG DISINTEGRATING TABLET,19.05,12.38,,,0
NDC,62332-0582-31,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,86.05,55.93,,,0
NDC,62530-0000-11,UREA 15 GRAM ORAL POWDER PACKET,17.15,11.15,,,0
NDC,62559-0138-07,HYDROCORTISONE 100 MG/60 ML ENEMA,66.6,43.29,,,0
NDC,62559-0157-10,POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,1.05,0.68,,,0
NDC,62559-0159-01,FLUVOXAMINE 50 MG TABLET,5.3,3.44,,,0
NDC,62559-0230-01,PROPAFENONE 150 MG TABLET,5.05,3.28,,,0
NDC,62559-0240-01,METHAZOLAMIDE 25 MG TABLET,7.1,4.62,,,0
NDC,62559-0241-01,METHAZOLAMIDE 50 MG TABLET,11.75,7.64,,,0
NDC,62559-0431-30,HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR,43.95,28.57,,,0
NDC,62559-0630-01,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION,27.1,17.62,,,0
NDC,62559-0631-01,ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,57.4,37.31,,,0
NDC,62584-0265-01,METOPROLOL TARTRATE 25 MG TABLET,4.8,3.12,,,0
NDC,62584-0266-01,METOPROLOL TARTRATE 50 MG TABLET,4.85,3.15,,,0
NDC,62584-0267-01,METOPROLOL TARTRATE 100 MG TABLET,5.1,3.32,,,0
NDC,62584-0693-11,DOXYCYCLINE HYCLATE 100 MG ORAL SOLID SORD,8.95,5.82,,,0
NDC,62584-0693-21,DOXYCYCLINE HYCLATE 100 MG TABLET,8.95,5.82,,,0
NDC,62756-0059-40,EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,113.95,74.07,,,0
NDC,62756-0071-64,PANTOPRAZOLE DR 40 MG GRANULES DELAYED-RELEASE FOR SUSP IN PACKET,37.2,24.18,,,0
NDC,62756-0233-01,AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,413.2,268.58,,,0
NDC,62756-0522-69,SUMATRIPTAN 100 MG TABLET,10.0,6.5,,,0
NDC,62756-0796-88,"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",4.8,3.12,,,0
NDC,62935-0303-30,LEUPROLIDE 30 MG (4 MONTH) SUBCUTANEOUS SYRINGE,1580.95,1027.62,,,0
NDC,62935-0453-45,LEUPROLIDE ACETATE 45 MG (6 MONTH) SUBCUTANEOUS SYRINGE,2330.4,1514.76,,,0
NDC,62935-0753-75,LEUPROLIDE 7.5 MG (1 MONTH) SUBCUTANEOUS SYRINGE,456.85,296.95,,,0
NDC,62991-1701-02,SODIUM BICARBONATE (BULK) POWDER,197.15,128.15,,,0
NDC,63020-0049-01,BORTEZOMIB 3.5 MG SOLUTION FOR INJECTION INTRAVENOUS,6731.5,4375.48,,,0
NDC,63037-0101-05,FENTANYL (PF) 10 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,243.0,157.95,,,0
NDC,63037-0117-05,"DILTIAZEM HCL 125 MG/125 ML (1 MG/ML) IN SOD CHLORIDE,ISO-OSM IV SOLN",142.55,92.66,,,0
NDC,63044-0404-20,AMMONIUM LACTATE 12 % TOPICAL CREAM,33.85,22.0,,,0
NDC,63256-0100-30,STERILE TALC 4 GRAM INTRAPLEURAL AEROSOL POWDER,521.9,339.24,,,0
NDC,63256-0200-05,STERILE TALC 5 GRAM INTRAPLEURAL SUSPENSION,473.9,308.04,,,0
NDC,63304-0192-30,"DESVENLAFAXINE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",15.95,10.37,,,0
NDC,63323-0010-20,GENTAMICIN 40 MG/ML INJECTION SOLUTION,148.65,96.62,,,0
NDC,63323-0012-07,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,34.3,22.3,,,0
NDC,63323-0013-09,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,36.9,23.98,,,0
NDC,63323-0024-29,MANNITOL 25 % INTRAVENOUS SOLUTION,38.35,24.93,,,0
NDC,63323-0083-05,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,142.0,92.3,,,0
NDC,63323-0093-01,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,62.4,40.56,,,0
NDC,63323-0103-65,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION (RESEARCH TRIAL ROUNDING TO 1 MG),221.2,143.78,,,0
NDC,63323-0106-02,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,72.2,46.93,,,0
NDC,63323-0106-10,"MAGNESIUM SULFATE 40 GRAM/1,000 ML (4 %) IN WATER INTRAVENOUS SOLUTION",79.7,51.8,,,0
NDC,63323-0106-15,MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,73.45,47.74,,,0
NDC,63323-0117-19,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,89.55,58.21,,,0
NDC,63323-0117-51,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,116.2,75.53,,,0
NDC,63323-0117-69,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,149.95,97.47,,,0
NDC,63323-0120-20,CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLUTION,130.1,84.56,,,0
NDC,63323-0130-13,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,84.4,54.86,,,0
NDC,63323-0136-10,BLEOMYCIN 15 UNIT/ML (IM/SC CONCENTRATION),193.05,125.48,,,0
NDC,63323-0142-10,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,305.7,198.7,,,0
NDC,63323-0143-97,TRACE ELEMENTS #1 5.33 MCG-0.34 MG-0.54 MG/ML INTRAVENOUS SOLUTION,100.25,65.16,,,0
NDC,63323-0161-12,KETOROLAC 15 MG/ML INJECTION SOLUTION,36.05,23.43,,,0
NDC,63323-0162-23,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,36.15,23.5,,,0
NDC,63323-0167-21,CARBOPLATIN 150 MG INTRAVENOUS SOLUTION,1443.95,938.57,,,0
NDC,63323-0173-02,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,42.55,27.66,,,0
NDC,63323-0180-01,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,38.55,25.06,,,0
NDC,63323-0192-02,FLUDARABINE 50 MG/2 ML INTRAVENOUS SOLUTION,371.25,241.31,,,0
NDC,63323-0201-02,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,44.4,28.86,,,0
NDC,63323-0201-10,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,39.55,25.71,,,0
NDC,63323-0208-05,LIDOCAINE (PF) 20 MG/ML (2 %) INTRAVENOUS SOLUTION,40.15,26.1,,,0
NDC,63323-0229-35,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,39.0,25.35,,,0
NDC,63323-0241-20,SODIUM GLYCEROPHOSPHATE 1 MMOL/ML INTRAVENOUS SOLUTION,86.15,56.0,,,0
NDC,63323-0254-10,"MINERAL OIL, LIGHT STERILE",70.4,45.76,,,0
NDC,63323-0255-01,METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION,61.05,39.68,,,0
NDC,63323-0262-26,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",37.3,24.24,,,0
NDC,63323-0269-37,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,33.85,22.0,,,0
NDC,63323-0269-67,PROPOFOL INFUSION 10 MG/ML,97.75,63.54,,,0
NDC,63323-0276-01,"HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJECTION SOLUTION (BMT)",82.1,53.36,,,0
NDC,63323-0276-02,"HEPARIN, PORCINE (PF) 1,000 UNIT/ML INJECTION SOLUTION",57.5,37.38,,,0
NDC,63323-0278-10,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,287.25,186.71,,,0
NDC,63323-0280-02,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,42.6,27.69,,,0
NDC,63323-0281-10,FLUPHENAZINE 2.5 MG/ML INJECTION SOLUTION,58.35,37.93,,,0
NDC,63323-0285-20,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION (PAIN BALL),77.9,50.64,,,0
NDC,63323-0285-61,ROPIVACAINE (PF) 2 MG/ML (0.2 %) EPIDURAL,208.3,135.4,,,0
NDC,63323-0285-67,ROPIVACAINE (PF) 2 MG/ML (0.2 %) PCEA,123.15,80.05,,,0
NDC,63323-0286-35,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,44.5,28.92,,,0
NDC,63323-0288-03,ROPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,59.9,38.94,,,0
NDC,63323-0303-55,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,293.35,190.68,,,0
NDC,63323-0314-68,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,1059.1,688.42,,,0
NDC,63323-0322-93,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,82.45,53.59,,,0
NDC,63323-0376-01,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,41.65,27.07,,,0
NDC,63323-0377-01,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,60.15,39.1,,,0
NDC,63323-0378-05,OCTREOTIDE ACETATE 200 MCG/ML INJECTION SOLUTION,35.85,23.3,,,0
NDC,63323-0385-10,CEFOTETAN 1 GRAM SOLUTION FOR INJECTION,79.5,51.68,,,0
NDC,63323-0386-20,CEFOTETAN 2 GRAM SOLUTION FOR INJECTION,126.05,81.93,,,0
NDC,63323-0401-26,AZTREONAM 1 GRAM SOLUTION FOR INJECTION,135.3,87.94,,,0
NDC,63323-0402-30,AZTREONAM 2 GRAM SOLUTION FOR INJECTION,242.0,157.3,,,0
NDC,63323-0413-10,NEOSTIGMINE METHYLSULFATE 0.5 MG/ML INJECTION SOLUTION SORD,33.95,22.07,,,0
NDC,63323-0434-00,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",53.7,34.9,,,0
NDC,63323-0452-01,MORPHINE 2 MG/ML INJECTION SOLUTION,41.45,26.94,,,0
NDC,63323-0454-00,MORPHINE 4 MG/ML INJECTION SOLUTION,41.65,27.07,,,0
NDC,63323-0462-17,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",51.05,33.18,,,0
NDC,63323-0468-17,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",50.65,32.92,,,0
NDC,63323-0478-27,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,131.5,85.48,,,0
NDC,63323-0482-03,"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",34.0,22.1,,,0
NDC,63323-0483-03,"LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION",34.0,22.1,,,0
NDC,63323-0485-27,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,41.4,26.91,,,0
NDC,63323-0487-37,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",34.9,22.68,,,0
NDC,63323-0489-27,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",37.45,24.34,,,0
NDC,63323-0496-97,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,65.3,42.44,,,0
NDC,63323-0506-01,DEXAMETHASONE 10 MG/ML INJ (ORAL USE),21.125,13.73,,,0
NDC,63323-0507-21,MEROPENEM 500 MG INTRAVENOUS SOLUTION,44.75,29.09,,,0
NDC,63323-0508-31,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,53.8,34.97,,,0
NDC,63323-0517-01,"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",92.3,60.0,,,0
NDC,63323-0518-01,"HEPARIN (PORCINE) 25,000 UNIT/500 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",63.15,41.05,,,0
NDC,63323-0523-74,"HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV",92.3,60.0,,,0
NDC,63323-0540-13,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",37.0,24.05,,,0
NDC,63323-0559-65,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,44.35,28.83,,,0
NDC,63323-0564-97,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,46.7,30.36,,,0
NDC,63323-0574-86,ICATIBANT 30 MG/3 ML SUBCUTANEOUS SYRINGE,6061.35,3939.88,,,0
NDC,63323-0584-21,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,64.2,41.73,,,0
NDC,63323-0586-96,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,72.15,46.9,,,0
NDC,63323-0594-03,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,605.05,393.28,,,0
NDC,63323-0597-10,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,101.35,65.88,,,0
NDC,63323-0614-55,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,48.65,31.62,,,0
NDC,63323-0631-10,LEUCOVORIN CALCIUM 10 MG/ML INJECTION SOLUTION,114.9,74.68,,,0
NDC,63323-0642-20,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,35.05,22.78,,,0
NDC,63323-0651-02,ADENOSINE INTRACORONARY SOLUTION (CATH LAB USE ONLY),33.15,21.55,,,0
NDC,63323-0690-30,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION (ORAL),122.9,79.88,,,0
NDC,63323-0695-04,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,25.65,16.67,,,0
NDC,63323-0710-50,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,108.0,70.2,,,0
NDC,63323-0721-10,BORTEZOMIB 3.5 MG INTRAVENOUS POWDER FOR SOLUTION,5245.25,3409.41,,,0
NDC,63323-0728-10,MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,114.3,74.3,,,0
NDC,63323-0729-10,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,140.15,91.1,,,0
NDC,63323-0738-09,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,34.8,22.62,,,0
NDC,63323-0762-10,TOPOTECAN 4 MG INTRAVENOUS SOLUTION,192.5,125.12,,,0
NDC,63323-0808-01,FENTANYL (PF) 50 MCG/ML INJECTION SYRINGE,37.75,24.54,,,0
NDC,63323-0810-00,FENTANYL (PF) 100 MCG/2 ML (50 MCG/ML) INTRAVENOUS SYRINGE,37.1,24.12,,,0
NDC,63323-0820-04,FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,157.65,102.47,,,0
NDC,63323-0852-03,HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLUTION,43.45,28.24,,,0
NDC,63323-0853-03,HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,37.25,24.21,,,0
NDC,63323-0869-75,DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,67.15,43.65,,,0
NDC,63323-0877-15,PENTAMIDINE 300 MG SOLUTION FOR INHALATION,284.5,184.92,,,0
NDC,63323-0881-16,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,80.25,52.16,,,0
NDC,63323-0885-14,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,363.85,236.5,,,0
NDC,63323-0926-88,ROMIDEPSIN 10 MG/2 ML INTRAVENOUS POWDER FOR SOLUTION,12226.05,7946.93,,,0
NDC,63323-0965-01,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,45.5,29.58,,,0
NDC,63459-0104-50,RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,12421.85,8074.2,,,0
NDC,63459-0348-04,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,5898.5,3834.02,,,0
NDC,63459-0391-20,BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION,12129.25,7884.01,,,0
NDC,63736-0378-82,BENZOCAINE 20 % TOPICAL AEROSOL,3.75,2.44,,,0
NDC,63739-0434-02,ASPIRIN 81 MG CHEWABLE TABLET,0.1,0.06,,,0
NDC,63833-0386-02,"HUMAN PROTHROMBIN COMPLEX,4-FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION",3711.7,2412.6,,,0
NDC,63833-0387-02,"HUM PROTHROMBIN CPLX, 4-FACTOR 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",7341.25,4771.81,,,0
NDC,63833-0615-02,ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT IV KIT (FVIII UNITS),3018.95,1962.32,,,0
NDC,63833-0616-02,"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT IV KIT (FVIII UNIITS)",5955.8,3871.27,,,0
NDC,63833-0617-02,"ANTIHEMOPHILIC FACTOR-VWF 1,000 UNIT-2,400 UNIT IV KIT (FVIII UNITS)",11829.5,7689.18,,,0
NDC,63833-0825-02,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) INTRAVENOUS KIT,18255.05,11865.78,,,0
NDC,63833-0835-01,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) INTRAVENOUS SOLUTION,18255.05,11865.78,,,0
NDC,63833-0891-51,"FIBRINOGEN 1 GRAM (900 MG-1,300 MG) INTRAVENOUS SOLUTION",5059.8,3288.87,,,0
NDC,64193-0424-02,"ANTI-INHIBITOR COAGULANT COMPLEX 700 UNIT-1,300 UNIT INTRAVENOUS SOLN",8710.15,5661.6,,,0
NDC,64193-0425-02,"ANTI-INHIBITOR COAGULANT COMPLX 1,750 UNIT-3,250 UNIT INTRAVENOUS SOLN",21652.2,14073.93,,,0
NDC,64193-0426-02,ANTI-INHIBITOR COAGULANT COMPLEX 350 UNIT-650 UNIT INTRAVENOUS SOLN,4396.1,2857.46,,,0
NDC,64253-0400-91,ATROPINE 0.1 MG/ML INJECTION SYRINGE,37.0,24.05,,,0
NDC,64253-0900-36,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,51.45,33.44,,,0
NDC,64281-0100-00,METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION,267.55,173.91,,,0
NDC,64281-0111-00,METHACHOLINE CHLORIDE 0 MG/3 ML (0 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
NDC,64281-0112-00,METHACHOLINE CHLORIDE 0.1875 MG/3 ML (0.0625 MG/ML) NEBULIZATION SOLN,15.45,10.04,,,0
NDC,64281-0113-00,METHACHOLINE CHLORIDE 0.75 MG/3 ML (0.25 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
NDC,64281-0114-00,METHACHOLINE CHLORIDE 3 MG/3 ML (1 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
NDC,64281-0115-00,METHACHOLINE CHLORIDE 12 MG/3 ML (4 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
NDC,64281-0116-00,METHACHOLINE CHLORIDE 48 MG/3 ML (16 MG/ML) NEBULIZATION SOLUTION,15.45,10.04,,,0
NDC,64380-0172-02,OLANZAPINE 5 MG DISINTEGRATING TABLET,7.1,4.62,,,0
NDC,64380-0176-01,TRANYLCYPROMINE 10 MG TABLET,7.55,4.91,,,0
NDC,64380-0759-06,ACARBOSE 50 MG TABLET,5.1,3.32,,,0
NDC,64380-0827-06,KETOCONAZOLE 200 MG TABLET,7.65,4.97,,,0
NDC,64406-0008-01,NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,37286.0,24235.9,,,0
NDC,64679-0465-51,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,73.15,47.55,,,0
NDC,64764-0300-20,VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION,46735.2,30377.88,,,0
NDC,64764-0730-30,VORTIOXETINE 10 MG TABLET,54.15,35.2,,,0
NDC,64764-0750-30,VORTIOXETINE 20 MG TABLET,54.15,35.2,,,0
NDC,64896-0661-01,"CARBIDOPA ER 23.75 MG-LEVODOPA 95 MG CAPSULE,EXTENDED RELEASE",16.65,10.82,,,0
NDC,64896-0662-01,"CARBIDOPA ER 36.25 MG-LEVODOPA 145 MG CAPSULE,EXTENDED RELEASE",16.65,10.82,,,0
NDC,64896-0663-01,"CARBIDOPA ER 48.75 MG-LEVODOPA 195 MG CAPSULE,EXTENDED RELEASE",16.65,10.82,,,0
NDC,64896-0664-01,"CARBIDOPA ER 61.25 MG-LEVODOPA 245 MG CAPSULE,EXTENDED RELEASE",19.7,12.8,,,0
NDC,64896-0695-13,"OXYMORPHONE ER 5 MG TABLET,EXTENDED RELEASE,12 HR",28.55,18.56,,,0
NDC,64896-0699-13,"OXYMORPHONE ER 20 MG TABLET,EXTENDED RELEASE,12 HR",77.45,50.34,,,0
NDC,64950-0362-04,COCAINE 4 % NASAL SOLUTION,960.85,624.55,,,0
NDC,64980-0134-01,DIPYRIDAMOLE 50 MG TABLET,10.15,6.6,,,0
NDC,64980-0220-03,"PYRIDOSTIGMINE BROMIDE ER 180 MG TABLET,EXTENDED RELEASE",16.95,11.02,,,0
NDC,64980-0373-03,ATOMOXETINE 10 MG CAPSULE,9.35,6.08,,,0
NDC,64980-0374-03,ATOMOXETINE 18 MG CAPSULE,9.35,6.08,,,0
NDC,64980-0376-03,ATOMOXETINE 40 MG CAPSULE,9.75,6.34,,,0
NDC,64980-0405-24,ABACAVIR 20 MG/ML ORAL SOLUTION,26.65,17.32,,,0
NDC,64980-0409-06,SERTRALINE 20 MG/ML ORAL CONCENTRATE,7.3,4.74,,,0
NDC,64980-0448-01,"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",308.4,200.46,,,0
NDC,64980-0514-01,TIMOLOL MALEATE 0.5 % EYE DROPS,63.4,41.21,,,0
NDC,64980-0593-24,NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,2688.3,1747.4,,,0
NDC,65162-0047-10,OXYCODONE 5 MG TABLET,8.7,5.66,,,0
NDC,65162-0512-10,SALSALATE 500 MG TABLET,5.5,3.58,,,0
NDC,65162-0765-10,WARFARIN 4 MG TABLET,4.9,3.18,,,0
NDC,65162-0766-10,WARFARIN 5 MG TABLET,4.85,3.15,,,0
NDC,65219-0029-20,THIOTEPA 100 MG SOLUTION FOR INJECTION,7407.0,4814.55,,,0
NDC,65219-0387-02,ELECTROLYTE-148 INTRAVENOUS SOLUTION,109.05,70.88,,,0
NDC,65250-0266-09,BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,1600.55,1040.36,,,0
NDC,65597-0406-01,FAM-TRASTUZUMAB DERUXTECAN-NXKI 100 MG INTRAVENOUS SOLUTION,12885.1,8375.32,,,0
NDC,65628-0205-10,VANCOMYCIN 25 MG/ML ORAL SOLUTION,13.35,8.68,,,0
NDC,65649-0003-30,PLECANATIDE 3 MG TABLET,59.1,38.42,,,0
NDC,65649-0303-03,RIFAXIMIN 550 MG TABLET,180.0,117.0,,,0
NDC,65649-0551-02,METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,558.25,362.86,,,0
NDC,65649-0551-07,METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SYRINGE,558.25,362.86,,,0
NDC,65757-0300-01,"NALTREXONE ER 380 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE",8275.4,5379.01,,,0
NDC,65757-0401-03,"ARIPIPRAZOLE LAUROXIL ER 441 MG/1.6 ML SUSPENSION, EXT.REL. IM SYRINGE",7410.9,4817.08,,,0
NDC,65757-0402-03,"ARIPIPRAZOLE LAUROXIL ER 662 MG/2.4 ML SUSPENSION, EXT.REL. IM SYRINGE",11108.3,7220.4,,,0
NDC,65757-0403-03,"ARIPIPRAZOLE LAUROXIL ER 882 MG/3.2 ML SUSPENSION, EXT.REL. IM SYRINGE",14788.8,9612.72,,,0
NDC,65757-0404-03,"ARIPIPRAZOLE LAUROXIL ER 1,064 MG/3.9 ML SUSPENSION,EXT.REL IM SYRINGE",17833.75,11591.94,,,0
NDC,65757-0500-03,"ARIPIPRAZOLE LAUROXIL,SUBMIC. ER 675 MG/2.4 ML SUSP,EXT.REL.IM SYRINGE",11325.75,7361.74,,,0
NDC,65862-0024-60,ZIDOVUDINE 300 MG TABLET,7.35,4.78,,,0
NDC,65862-0048-24,ZIDOVUDINE 10 MG/ML ORAL SYRUP,13.3,8.64,,,0
NDC,65862-0057-24,NEVIRAPINE 50 MG/5 ML ORAL SUSPENSION,6.05,3.93,,,0
NDC,65862-0076-01,CIPROFLOXACIN 250 MG TABLET,5.25,3.41,,,0
NDC,65862-0107-01,ZIDOVUDINE 100 MG CAPSULE,9.0,5.85,,,0
NDC,65862-0146-36,SUMATRIPTAN 25 MG TABLET,5.6,3.64,,,0
NDC,65862-0207-68,RIBAVIRIN 200 MG TABLET,6.4,4.16,,,0
NDC,65862-0209-01,MINOCYCLINE 50 MG CAPSULE,5.3,3.44,,,0
NDC,65862-0335-30,ABACAVIR 600 MG-LAMIVUDINE 300 MG TABLET,10.35,6.73,,,0
NDC,65862-0459-60,GALANTAMINE 8 MG TABLET,6.55,4.26,,,0
NDC,65862-0502-20,AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,5.55,3.61,,,0
NDC,65862-0503-01,AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,6.0,3.9,,,0
NDC,65862-0534-01,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,35.0,22.75,,,0
NDC,65862-0594-01,"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",5.0,3.25,,,0
NDC,65862-0596-02,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,7.25,4.71,,,0
NDC,65862-0678-01,ALPRAZOLAM 1 MG TABLET,8.35,5.43,,,0
NDC,66215-0501-15,MACITENTAN 10 MG TABLET,1254.95,815.72,,,0
NDC,66215-0602-06,SELEXIPAG 200 MCG TABLET,825.8,536.77,,,0
NDC,66302-0101-01,TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,6584.9,4280.18,,,0
NDC,66302-0310-02,"TREPROSTINIL DIOLAMINE ER 1 MG TABLET,EXTENDED RELEASE",204.15,132.7,,,0
NDC,66553-0001-01,ASPIRIN 325 MG TABLET,0.1,0.06,,,0
NDC,66658-0234-07,ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,1084.15,704.7,,,0
NDC,66689-0203-08,ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML ORAL SUSPENSION,135.35,87.98,,,0
NDC,66689-0307-08,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,12.0,7.8,,,0
NDC,66689-0327-02,DIGOXIN 50 MCG/ML ORAL SOLUTION SORD,216.4,140.66,,,0
NDC,66733-0948-23,CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION,3473.05,2257.48,,,0
NDC,66733-0958-23,CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,6864.0,4461.6,,,0
NDC,66794-0019-10,ISOFLURANE 99.9 % INHALATION LIQUID,68.1,44.26,,,0
NDC,66794-0022-25,SEVOFLURANE 99.97 % INHALATION LIQUID,269.45,175.14,,,0
NDC,66794-0155-02,"BACLOFEN 10,000 MCG/20 ML (500 MCG/ML) INTRATHECAL SOLUTION",507.4,329.81,,,0
NDC,66794-0236-43,LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,90.2,58.63,,,0
NDC,66993-0456-30,DAPAGLIFLOZIN PROPANEDIOL 5 MG TABLET,41.05,26.68,,,0
NDC,67066-0005-01,SECRETIN (HUMAN) 16 MCG INTRAVENOUS SOLUTION,3364.35,2186.83,,,0
NDC,67157-0101-50,ASCORBIC ACID (VITAMIN C) 500 MG/ML INTRAVENOUS SOLUTION,37.95,24.67,,,0
NDC,67457-0118-50,ASCORBIC ACID (VITAMIN C) 500 MG/ML INJECTION SOLUTION,34.65,22.52,,,0
NDC,67457-0162-02,SODIUM TETRADECYL SULFATE 1 % (10 MG/ML) INTRAVENOUS SOLUTION,377.0,245.05,,,0
NDC,67457-0182-10,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,63.75,41.44,,,0
NDC,67457-0220-05,ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION,519.95,337.97,,,0
NDC,67457-0245-00,OCTREOTIDE ACETATE 100 MCG/ML (1 ML) INJECTION SYRINGE,57.25,37.21,,,0
NDC,67457-0255-00,LEVETIRACETAM 5 MG/ML INTRAVENOUS SOLUTION,107.4,69.81,,,0
NDC,67457-0265-00,LEVETIRACETAM 10 MG/ML INTRAVENOUS SOLUTION,129.15,83.95,,,0
NDC,67457-0266-00,LEVETIRACETAM 15 MG/ML INTRAVENOUS SOLUTION,150.95,98.12,,,0
NDC,67457-0299-00,NALOXONE 0.4 MG/ML INJECTION SOLUTION,217.95,141.67,,,0
NDC,67457-0341-05,VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION,440.7,286.46,,,0
NDC,67457-0426-12,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,33.95,22.07,,,0
NDC,67457-0445-60,RIFAMPIN 600 MG INTRAVENOUS SOLUTION,634.3,412.3,,,0
NDC,67457-0446-10,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,163.05,105.98,,,0
NDC,67457-0585-08,FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SOLUTION SYRINGE,181.4,117.91,,,0
NDC,67457-0853-50,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION (PWD VIAL),218.4,141.96,,,0
NDC,67546-0111-12,NITAZOXANIDE 500 MG TABLET,394.15,256.2,,,0
NDC,67618-0111-28,DOCUSATE SODIUM 50 MG CAPSULE,0.25,0.16,,,0
NDC,67684-1901-02,ETHIODIZED OIL 480 MG IODINE/ML FOR INJECTION,6098.55,3964.06,,,0
NDC,67850-0141-00,POLIDOCANOL 1 % (20 MG/2 ML) INTRAVENOUS SOLUTION,137.75,89.54,,,0
NDC,67871-4790-06,ETHANOLAMINE OLEATE 5 % INTRAVENOUS SOLUTION,1201.3,780.84,,,0
NDC,67877-0124-05,SILVER SULFADIAZINE 1 % TOPICAL CREAM,48.2,31.33,,,0
NDC,67877-0286-60,RILUZOLE 50 MG TABLET,6.3,4.1,,,0
NDC,67877-0416-90,VALSARTAN 80 MG TABLET,5.55,3.61,,,0
NDC,67877-0636-33,TOLVAPTAN 30 MG TABLET,155.85,101.3,,,0
NDC,67877-0718-33,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,14.85,9.65,,,0
NDC,67877-0721-33,EVEROLIMUS (IMMUNOSUPPRESSIVE) 1 MG TABLET,51.3,33.34,,,0
NDC,67877-0735-60,LACOSAMIDE 150 MG TABLET,5.45,3.54,,,0
NDC,67877-0753-60,DRONABINOL 2.5 MG CAPSULE,15.4,10.01,,,0
NDC,67919-0030-01,CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,841.45,546.94,,,0
NDC,67979-0001-01,VALRUBICIN 40 MG/ML INTRAVESICAL SOLUTION,7834.6,5092.49,,,0
NDC,68001-0113-06,"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",5.5,3.58,,,0
NDC,68001-0114-06,"LEVETIRACETAM ER 750 MG TABLET,EXTENDED RELEASE 24 HR",5.8,3.77,,,0
NDC,68001-0156-00,VENLAFAXINE 100 MG TABLET,5.2,3.38,,,0
NDC,68001-0159-00,VENLAFAXINE 50 MG TABLET,5.05,3.28,,,0
NDC,68001-0242-00,ZONISAMIDE 25 MG CAPSULE,4.85,3.15,,,0
NDC,68001-0243-00,ZONISAMIDE 50 MG CAPSULE,5.05,3.28,,,0
NDC,68001-0245-14,ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,14.75,9.59,,,0
NDC,68001-0246-17,ONDANSETRON 4 MG DISINTEGRATING TABLET,5.7,3.7,,,0
NDC,68001-0247-17,ONDANSETRON 8 MG DISINTEGRATING TABLET,5.7,3.7,,,0
NDC,68001-0251-04,FLUCONAZOLE 50 MG TABLET,5.75,3.74,,,0
NDC,68001-0328-00,TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,4.9,3.18,,,0
NDC,68001-0383-03,LABETALOL 300 MG TABLET,5.65,3.67,,,0
NDC,68001-0398-03,FAMOTIDINE 40 MG TABLET,4.95,3.22,,,0
NDC,68001-0399-00,FLUOXETINE 10 MG CAPSULE,4.7,3.06,,,0
NDC,68001-0430-00,RAMIPRIL 5 MG CAPSULE,4.75,3.09,,,0
NDC,68001-0431-03,RAMIPRIL 10 MG CAPSULE,4.8,3.12,,,0
NDC,68001-0473-03,"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",4.85,3.15,,,0
NDC,68001-0474-03,"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",5.1,3.32,,,0
NDC,68001-0483-45,"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",1.8,1.17,,,0
NDC,68001-0505-55,POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,28.55,18.56,,,0
NDC,68001-0595-08,"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",4.9,3.18,,,0
NDC,68001-0596-08,"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",5.2,3.38,,,0
NDC,68001-0609-33,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,151.65,98.57,,,0
NDC,68084-0021-21,ABACAVIR 300 MG TABLET,18.05,11.73,,,0
NDC,68084-0046-01,PAROXETINE 30 MG TABLET,6.15,4.0,,,0
NDC,68084-0075-21,TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,66.1,42.96,,,0
NDC,68084-0082-01,ISOSORBIDE DINITRATE 10 MG TABLET,5.8,3.77,,,0
NDC,68084-0083-01,ISOSORBIDE DINITRATE 20 MG TABLET,6.0,3.9,,,0
NDC,68084-0097-01,ATORVASTATIN 10 MG TABLET,5.1,3.32,,,0
NDC,68084-0098-01,ATORVASTATIN 20 MG TABLET,5.1,3.32,,,0
NDC,68084-0099-01,ATORVASTATIN 40 MG TABLET,5.25,3.41,,,0
NDC,68084-0103-11,ZIPRASIDONE 20 MG CAPSULE,10.15,6.6,,,0
NDC,68084-0104-09,ZIPRASIDONE 40 MG CAPSULE,10.2,6.63,,,0
NDC,68084-0119-01,MIRTAZAPINE 15 MG TABLET,5.05,3.28,,,0
NDC,68084-0120-01,MIRTAZAPINE 30 MG TABLET,5.1,3.32,,,0
NDC,68084-0149-01,METHYLPREDNISOLONE 4 MG TABLET,7.8,5.07,,,0
NDC,68084-0155-01,PROMETHAZINE 25 MG TABLET,5.05,3.28,,,0
NDC,68084-0158-01,"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",12.6,8.19,,,0
NDC,68084-0185-11,OXYCODONE 30 MG TABLET,8.2,5.33,,,0
NDC,68084-0202-01,PRIMIDONE 50 MG TABLET,6.5,4.22,,,0
NDC,68084-0203-11,PRIMIDONE 250 MG TABLET,6.4,4.16,,,0
NDC,68084-0204-01,MINOXIDIL 2.5 MG TABLET,5.95,3.87,,,0
NDC,68084-0214-01,BENZONATATE 100 MG CAPSULE,5.65,3.67,,,0
NDC,68084-0215-01,VALACYCLOVIR 500 MG TABLET,8.45,5.49,,,0
NDC,68084-0229-01,AZATHIOPRINE 50 MG TABLET,6.15,4.0,,,0
NDC,68084-0243-01,CLINDAMYCIN HCL 150 MG CAPSULE,5.2,3.38,,,0
NDC,68084-0248-01,LORATADINE 10 MG TABLET,0.2,0.13,,,0
NDC,68084-0249-11,HALOPERIDOL 10 MG TABLET,7.0,4.55,,,0
NDC,68084-0269-01,HYDROXYCHLOROQUINE 200 MG TABLET,7.5,4.88,,,0
NDC,68084-0270-11,RISPERIDONE 0.25 MG TABLET,5.1,3.32,,,0
NDC,68084-0271-01,RISPERIDONE 0.5 MG TABLET,5.1,3.32,,,0
NDC,68084-0272-01,RISPERIDONE 1 MG TABLET,5.1,3.32,,,0
NDC,68084-0273-01,RISPERIDONE 2 MG TABLET,5.1,3.32,,,0
NDC,68084-0274-11,RISPERIDONE 3 MG TABLET,5.15,3.35,,,0
NDC,68084-0280-01,ETHAMBUTOL 400 MG TABLET,6.65,4.32,,,0
NDC,68084-0284-01,HYDROXYUREA 500 MG CAPSULE,6.6,4.29,,,0
NDC,68084-0291-21,NALTREXONE 50 MG TABLET,12.15,7.9,,,0
NDC,68084-0299-01,TAMSULOSIN 0.4 MG CAPSULE,5.2,3.38,,,0
NDC,68084-0300-21,DANTROLENE 25 MG CAPSULE,8.6,5.59,,,0
NDC,68084-0318-01,LAMOTRIGINE 25 MG TABLET,5.1,3.32,,,0
NDC,68084-0319-01,LAMOTRIGINE 100 MG TABLET,5.1,3.32,,,0
NDC,68084-0326-01,GLIMEPIRIDE 2 MG TABLET,5.75,3.74,,,0
NDC,68084-0342-01,TOPIRAMATE 25 MG TABLET,5.3,3.44,,,0
NDC,68084-0344-01,TOPIRAMATE 100 MG TABLET,5.7,3.7,,,0
NDC,68084-0346-11,LOSARTAN 25 MG TABLET,5.6,3.64,,,0
NDC,68084-0347-01,LOSARTAN 50 MG TABLET,5.4,3.51,,,0
NDC,68084-0348-01,LOSARTAN 100 MG TABLET,5.9,3.84,,,0
NDC,68084-0381-11,BENZTROPINE 0.5 MG TABLET,5.65,3.67,,,0
NDC,68084-0388-11,BENZTROPINE 1 MG TABLET,5.6,3.64,,,0
NDC,68084-0450-11,"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",7.35,4.78,,,0
NDC,68084-0494-01,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,7.2,4.68,,,0
NDC,68084-0511-01,SIMVASTATIN 10 MG TABLET,5.05,3.28,,,0
NDC,68084-0512-01,SIMVASTATIN 20 MG TABLET,5.15,3.35,,,0
NDC,68084-0525-01,OLANZAPINE 2.5 MG TABLET,5.5,3.58,,,0
NDC,68084-0529-01,OLANZAPINE 20 MG TABLET,6.0,3.9,,,0
NDC,68084-0536-01,CLOPIDOGREL 75 MG TABLET,5.25,3.41,,,0
NDC,68084-0539-01,TORSEMIDE 20 MG TABLET,5.55,3.61,,,0
NDC,68084-0549-21,TEMAZEPAM 7.5 MG CAPSULE,17.5,11.38,,,0
NDC,68084-0572-01,"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",0.7,0.46,,,0
NDC,68084-0590-25,ATORVASTATIN 80 MG TABLET,5.85,3.8,,,0
NDC,68084-0597-01,"NIFEDIPINE ER 30 MG TABLET, EXT RELEASE ORAL SOLID SORD",6.8,4.42,,,0
NDC,68084-0598-01,"NIFEDIPINE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",10.35,6.73,,,0
NDC,68084-0598-11,"NIFEDIPINE ER 60 MG TABLET, EXT RELEASE ORAL SOLID SORD",10.35,6.73,,,0
NDC,68084-0602-01,PERPHENAZINE 4 MG TABLET,7.15,4.65,,,0
NDC,68084-0603-11,"NIFEDIPINE ER 90 MG TABLET, EXT RELEASE ORAL SOLID SORD",11.85,7.7,,,0
NDC,68084-0617-01,ESCITALOPRAM 10 MG TABLET,5.2,3.38,,,0
NDC,68084-0621-21,MODAFINIL 100 MG TABLET,28.35,18.43,,,0
NDC,68084-0640-01,"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",5.7,3.7,,,0
NDC,68084-0651-25,CLARITHROMYCIN 500 MG TABLET,15.4,10.01,,,0
NDC,68084-0654-01,SOTALOL 80 MG TABLET,7.35,4.78,,,0
NDC,68084-0655-01,"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",6.15,4.0,,,0
NDC,68084-0697-01,"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",6.5,4.22,,,0
NDC,68084-0698-01,"VENLAFAXINE ER 37.5 MG CAPSULE,EXTENDED RELEASE 24 HR",5.85,3.8,,,0
NDC,68084-0699-01,OXYCODONE-ACETAMINOPHEN 7.5 MG-325 MG TABLET,13.0,8.45,,,0
NDC,68084-0708-25,"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",6.25,4.06,,,0
NDC,68084-0709-01,"VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR",5.9,3.84,,,0
NDC,68084-0710-11,OXYCODONE-ACETAMINOPHEN 10 MG-325 MG TABLET,12.85,8.35,,,0
NDC,68084-0713-01,"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",6.0,3.9,,,0
NDC,68084-0728-11,FLUCONAZOLE 100 MG TABLET,8.05,5.23,,,0
NDC,68084-0729-21,GALANTAMINE 4 MG TABLET,15.2,9.88,,,0
NDC,68084-0735-01,FLUCONAZOLE 200 MG TABLET,9.7,6.3,,,0
NDC,68084-0750-25,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,6.75,4.39,,,0
NDC,68084-0752-25,CLOPIDOGREL 300 MG TABLET,29.3,19.04,,,0
NDC,68084-0753-25,CYCLOBENZAPRINE 5 MG TABLET,5.8,3.77,,,0
NDC,68084-0764-25,SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,7.4,4.81,,,0
NDC,68084-0775-25,TIZANIDINE 2 MG TABLET,6.4,4.16,,,0
NDC,68084-0790-25,CLOMIPRAMINE 25 MG CAPSULE,31.0,20.15,,,0
NDC,68084-0805-11,METHYLPHENIDATE 5 MG TABLET,15.35,9.98,,,0
NDC,68084-0818-95,CLOMIPRAMINE 50 MG CAPSULE,35.5,23.08,,,0
NDC,68084-0823-21,METHYLPHENIDATE 10 MG TABLET,13.1,8.52,,,0
NDC,68084-0836-25,DOXAZOSIN 1 MG TABLET,6.8,4.42,,,0
NDC,68084-0844-01,VENLAFAXINE 37.5 MG TABLET,6.15,4.0,,,0
NDC,68084-0850-32,"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",10.7,6.96,,,0
NDC,68084-0851-01,DOXAZOSIN 2 MG TABLET,6.0,3.9,,,0
NDC,68084-0854-01,CARVEDILOL 6.25 MG TABLET,4.9,3.18,,,0
NDC,68084-0856-01,VENLAFAXINE 75 MG TABLET,6.85,4.45,,,0
NDC,68084-0859-01,LEVETIRACETAM 250 MG TABLET,5.05,3.28,,,0
NDC,68084-0862-01,DOXAZOSIN 4 MG TABLET,6.1,3.96,,,0
NDC,68084-0875-01,MONTELUKAST 10 MG TABLET,5.6,3.64,,,0
NDC,68084-0879-25,CYCLOSPORINE 25 MG CAPSULE,16.25,10.56,,,0
NDC,68084-0896-25,VENLAFAXINE 25 MG TABLET,7.35,4.78,,,0
NDC,68084-0915-25,SIROLIMUS 1 MG TABLET,24.65,16.02,,,0
NDC,68084-0918-25,"MYCOPHENOLATE SODIUM 360 MG TABLET,DELAYED RELEASE",23.3,15.14,,,0
NDC,68084-0949-25,ALBUTEROL SULFATE 2 MG TABLET,19.35,12.58,,,0
NDC,68084-0954-95,REPAGLINIDE 1 MG TABLET,12.1,7.86,,,0
NDC,68084-0964-95,PROPYLTHIOURACIL 50 MG TABLET,11.5,7.48,,,0
NDC,68084-0965-25,VALGANCICLOVIR 450 MG TABLET,33.35,21.68,,,0
NDC,68084-0975-01,OXYCODONE 15 MG TABLET,11.2,7.28,,,0
NDC,68084-0996-01,PRAZOSIN 1 MG CAPSULE,7.35,4.78,,,0
NDC,68084-0997-01,PRAZOSIN 2 MG CAPSULE,8.85,5.75,,,0
NDC,68094-0001-59,MORPHINE 10 MG/5 ML ORAL SOLUTION,13.45,8.74,,,0
NDC,68094-0018-61,DIPHENHYDRAMINE 25 MG TABLET,0.2,0.13,,,0
NDC,68094-0029-62,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,2.05,1.33,,,0
NDC,68094-0031-62,METHADONE 5 MG/5 ML ORAL SOLUTION,16.0,10.4,,,0
NDC,68094-0065-62,GUANFACINE 1 MG TABLET,12.5,8.12,,,0
NDC,68094-0101-20,PHENTOLAMINE 5 MG INJECTION SOLUTION,1512.25,982.96,,,0
NDC,68094-0867-59,FUROSEMIDE 40 MG/5 ML (8 MG/ML) ORAL SOLUTION,10.25,6.66,,,0
NDC,68180-0280-01,ETHAMBUTOL 100 MG TABLET,5.55,3.61,,,0
NDC,68180-0290-06,ESLICARBAZEPINE 200 MG TABLET,9.8,6.37,,,0
NDC,68180-0291-06,ESLICARBAZEPINE 400 MG TABLET,10.65,6.92,,,0
NDC,68180-0423-08,CEFIXIME 400 MG CAPSULE,39.3,25.54,,,0
NDC,68180-0512-02,LISINOPRIL 2.5 MG TABLET,4.7,3.06,,,0
NDC,68180-0657-01,DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION,18.7,12.16,,,0
NDC,68180-0675-11,OSELTAMIVIR 30 MG CAPSULE,7.6,4.94,,,0
NDC,68180-0677-11,OSELTAMIVIR 75 MG CAPSULE,7.35,4.78,,,0
NDC,68180-0819-42,LANTHANUM 500 MG CHEWABLE TABLET,20.15,13.1,,,0
NDC,68180-0852-11,LEVONORGESTREL 1.5 MG TABLET,3.35,2.18,,,0
NDC,68382-0001-16,PAROXETINE 40 MG TABLET,4.85,3.15,,,0
NDC,68382-0097-05,PAROXETINE 10 MG TABLET,4.7,3.06,,,0
NDC,68382-0098-16,PAROXETINE 20 MG TABLET,4.75,3.09,,,0
NDC,68382-0370-01,"NYSTATIN 100,000 UNIT/GRAM TOPICAL POWDER",35.65,23.17,,,0
NDC,68462-0180-22,MUPIROCIN 2 % TOPICAL OINTMENT,22.0,14.3,,,0
NDC,68462-0221-01,LITHIUM CARBONATE 300 MG CAPSULE,4.9,3.18,,,0
NDC,68462-0254-01,ROPINIROLE 0.5 MG TABLET,4.95,3.22,,,0
NDC,68462-0257-01,ROPINIROLE 3 MG TABLET,5.05,3.28,,,0
NDC,68462-0292-01,"VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE",6.35,4.13,,,0
NDC,68462-0293-01,"VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE",5.55,3.61,,,0
NDC,68462-0297-17,CICLOPIROX 0.77 % TOPICAL CREAM,18.35,11.93,,,0
NDC,68462-0304-50,NORETHINDRONE ACETATE 5 MG TABLET,6.35,4.13,,,0
NDC,68462-0356-01,"THEOPHYLLINE ER 600 MG TABLET,EXTENDED RELEASE 24 HR",10.2,6.63,,,0
NDC,68462-0380-01,"THEOPHYLLINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR",8.5,5.52,,,0
NDC,68462-0418-20,LIDOCAINE 5 % TOPICAL OINTMENT,39.65,25.77,,,0
NDC,68462-0461-60,TROSPIUM 20 MG TABLET,6.9,4.48,,,0
NDC,68462-0713-08,RUFINAMIDE 200 MG TABLET,7.75,5.04,,,0
NDC,68462-0714-08,RUFINAMIDE 400 MG TABLET,9.8,6.37,,,0
NDC,68462-0721-01,"THEOPHYLLINE ER 300 MG TABLET,EXTENDED RELEASE,12 HR",8.35,5.43,,,0
NDC,68462-0911-01,POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,412.8,268.32,,,0
NDC,68546-0317-30,GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRINGE,1189.25,773.01,,,0
NDC,68682-0006-50,DILTIAZEM 30 MG TABLET,5.35,3.48,,,0
NDC,68682-0007-10,DILTIAZEM 60 MG TABLET,6.25,4.06,,,0
NDC,68682-0008-10,DILTIAZEM 90 MG TABLET,6.8,4.42,,,0
NDC,68682-0421-12,TETRABENAZINE 12.5 MG TABLET,38.4,24.96,,,0
NDC,68682-0655-20,DIAZEPAM 12.5 MG-15 MG-17.5 MG-20 MG RECTAL KIT,553.05,359.48,,,0
NDC,68727-0712-01,LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION,34303.9,22297.54,,,0
NDC,68727-0745-02,DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,45628.2,29658.33,,,0
NDC,68727-0800-02,DEFIBROTIDE 80 MG/ML INTRAVENOUS SOLUTION,4146.35,2695.13,,,0
NDC,69076-0913-02,MERCAPTOPURINE 50 MG TABLET,10.35,6.73,,,0
NDC,69097-0859-07,TERBINAFINE HCL 250 MG TABLET,5.35,3.48,,,0
NDC,69238-2027-08,SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,59.25,38.51,,,0
NDC,69238-2078-01,PROPRANOLOL 20 MG TABLET,5.05,3.28,,,0
NDC,69292-0526-01,CAPTOPRIL 50 MG TABLET,10.0,6.5,,,0
NDC,69315-0117-10,FUROSEMIDE 40 MG TABLET,4.75,3.09,,,0
NDC,69315-0134-01,IMIPRAMINE 25 MG TABLET,4.85,3.15,,,0
NDC,69315-0211-01,NIFEDIPINE 10 MG CAPSULE,5.8,3.77,,,0
NDC,69315-0212-01,NIFEDIPINE 20 MG CAPSULE,7.5,4.88,,,0
NDC,69315-0304-10,DORZOLAMIDE 2 % EYE DROPS,139.7,90.8,,,0
NDC,69339-0136-97,DIAZEPAM 5 MG/ML INJECTION SYRINGE,52.1,33.86,,,0
NDC,69339-0151-17,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,1.0,0.65,,,0
NDC,69339-0160-19,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSPENSION,9.15,5.95,,,0
NDC,69339-0162-98,LUBIPROSTONE 8 MCG CAPSULE,42.55,27.66,,,0
NDC,69344-0102-33,INDOMETHACIN 50 MG RECTAL SUPPOSITORY,483.75,314.44,,,0
NDC,69367-0267-01,PRENATAL VITAMINS WITH CALCIUM NO.72-IRON 27 MG-FOLIC ACID 1 MG TABLET,0.1,0.06,,,0
NDC,69367-0283-02,"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",9.1,5.92,,,0
NDC,69374-0315-25,NOREPINEPHRINE BITARTRATE 16 MG/250 ML (64 MCG/ML) IN 0.9 % NACL IV,69.25,45.01,,,0
NDC,69374-0321-25,PHENYLEPHRINE 50 MG/250 ML (200 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,150.95,98.12,,,0
NDC,69374-0925-10,EPINEPHRINE 1 MG/10 ML (100 MCG/ML) INJECTION (NSORD),40.5,26.32,,,0
NDC,69374-0950-10,CALCIUM GLUCONATE 1 GRAM/10 ML (100 MG/ML) IN STERILE WATER IV SYRINGE,51.8,33.67,,,0
NDC,69374-0957-10,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,35.45,23.04,,,0
NDC,69374-0979-02,MORPHINE (PF) 2 MG/2 ML (1 MG/ML) IN 0.9% SODIUM CHLORIDE INJ SYRINGE,44.85,29.15,,,0
NDC,69374-0979-30,MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,77.65,50.47,,,0
NDC,69374-0982-55,"KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLOR,ISO-OSMOTIC INJ SYRINGE",61.9,40.24,,,0
NDC,69584-0111-10,CARISOPRODOL 350 MG TABLET,4.8,3.12,,,0
NDC,69616-0276-30,PERAMPANEL 6 MG TABLET,165.9,107.84,,,0
NDC,69853-0102-01,"FACTOR XA,INACTIVATED-ZHZO (RECOMBINANT) 200 MG INTRAVENOUS SOLUTION",10452.3,6794.0,,,0
NDC,69918-0735-02,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,308.85,200.75,,,0
NDC,69918-0901-11,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,50.6,32.89,,,0
NDC,69945-0064-01,COPPER CU-64 DOTATATE 148 MBQ/4 ML (4 MCI/4 ML) INTRAVENOUS SOLUTION,12000.0,7800.0,,,0
NDC,69968-0355-01,TETRAHYDROZOLINE 0.05 % EYE DROPS,3.9,2.54,,,0
NDC,70004-0085-44,OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,143.7,93.4,,,0
NDC,70010-0491-05,"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",4.7,3.06,,,0
NDC,70069-0011-25,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,37.45,24.34,,,0
NDC,70069-0021-01,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,36.6,23.79,,,0
NDC,70069-0061-25,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION,40.8,26.52,,,0
NDC,70069-0091-01,AZELASTINE 0.05 % EYE DROPS,30.8,20.02,,,0
NDC,70069-0121-01,TROPICAMIDE 1 % EYE DROPS,35.2,22.88,,,0
NDC,70069-0131-01,TOBRAMYCIN 0.3 % EYE DROPS,27.75,18.04,,,0
NDC,70069-0191-01,PILOCARPINE 2 % EYE DROPS,135.9,88.34,,,0
NDC,70069-0201-01,PILOCARPINE 4 % EYE DROPS,139.75,90.84,,,0
NDC,70069-0231-01,BRIMONIDINE 0.2 % EYE DROPS,19.5,12.68,,,0
NDC,70092-1019-15,CEFAZOLIN 2 GRAM/100 ML IN DEXTROSE 5 % INTRAVENOUS SOLUTION,114.5,74.42,,,0
NDC,70092-1558-44,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,54.35,35.33,,,0
NDC,70100-0424-01,INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,795.15,516.85,,,0
NDC,70114-0101-01,PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,8810.1,5726.56,,,0
NDC,70114-0130-01,PEGFILGRASTIM-CBQV 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUT INJECTOR,16607.15,10794.65,,,0
NDC,70114-0340-01,TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION,39582.45,25728.59,,,0
NDC,70121-1483-07,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,228.05,148.23,,,0
NDC,70121-1552-01,METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION,62.25,40.46,,,0
NDC,70121-1651-05,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,41.8,27.17,,,0
NDC,70121-1722-09,POTASSIUM PHOSPHATE 15 MMOL/250 ML IN 0.9 % SODIUM CHLORIDE IV SOLN,3133.8,2036.97,,,0
NDC,70199-0026-11,"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",357.55,232.41,,,0
NDC,70257-0560-01,BACLOFEN 500 MCG/ML INTRATHECAL SOLUTION,763.7,496.4,,,0
NDC,70257-0560-02,BACLOFEN 500 MCG/ML INTRATHECAL SOLUTION,763.7,496.4,,,0
NDC,70257-0561-02,"BACLOFEN 2,000 MCG/ML INTRATHECAL SOLUTION",2200.1,1430.06,,,0
NDC,70257-0562-55,BACLOFEN 50 MCG/ML INTRATHECAL SOLUTION,108.5,70.52,,,0
NDC,70436-0230-39,VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,282.3,183.5,,,0
NDC,70594-0023-09,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,80.5,52.32,,,0
NDC,70700-0119-85,NORGESTIMATE 0.25 MG-ETHINYL ESTRADIOL 0.035 MG TABLET,24.3,15.8,,,0
NDC,70700-0163-01,PROGESTERONE MICRONIZED 200 MG CAPSULE,6.95,4.52,,,0
NDC,70700-0268-99,FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACKET,204.9,133.18,,,0
NDC,70710-1726-01,NELARABINE 250 MG/50 ML INTRAVENOUS SOLUTION,629.5,409.18,,,0
NDC,70710-1886-01,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,86.15,56.0,,,0
NDC,70720-0101-02,ROLAPITANT 90 MG TABLET,1034.8,672.62,,,0
NDC,70720-0950-36,GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT,4768.15,3099.3,,,0
NDC,70720-0951-30,GOSERELIN 10.8 MG SUBCUTANEOUS IMPLANT,15618.1,10151.76,,,0
NDC,70727-0497-25,NETARSUDIL 0.02 % EYE DROPS,970.1,630.56,,,0
NDC,70756-0720-11,ACETAZOLAMIDE 125 MG TABLET,5.3,3.44,,,0
NDC,70839-0150-30,ALISKIREN 150 MG TABLET,37.9,24.64,,,0
NDC,70842-0120-06,MEROPENEM-VABORBACTAM 2 GRAM INTRAVENOUS SOLUTION,1138.95,740.32,,,0
NDC,70842-0140-03,ORITAVANCIN 400 MG INTRAVENOUS SOLUTION,5405.15,3513.35,,,0
NDC,70842-0160-01,MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,1320.75,858.49,,,0
NDC,70860-0122-41,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,59.05,38.38,,,0
NDC,70860-0200-50,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",274.8,178.62,,,0
NDC,70954-0016-10,THIOTHIXENE 5 MG CAPSULE,8.4,5.46,,,0
NDC,70954-0041-10,RIFABUTIN 150 MG CAPSULE,27.85,18.1,,,0
NDC,70954-0135-20,DAPSONE 25 MG TABLET,7.15,4.65,,,0
NDC,70954-0136-10,DAPSONE 100 MG TABLET,8.1,5.26,,,0
NDC,70954-0258-10,SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,11.25,7.31,,,0
NDC,70954-0484-20,PYRAZINAMIDE 500 MG TABLET,17.7,11.5,,,0
NDC,70954-0541-10,TRIMETHOPRIM 100 MG TABLET,9.8,6.37,,,0
NDC,71285-0202-01,"CARDIOPLEGIC SOLUTION NO.16 26 MEQ/1,052.8 ML(POTASSIUM) FOR PERFUSION",346.9,225.48,,,0
NDC,71286-2011-01,HYDROMORPHONE 0.5 MG/ML PCA HIGH RISK,100.5,65.32,,,0
NDC,71286-3022-01,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,62.15,40.4,,,0
NDC,71287-0119-01,AXICABTAGENE CILOLEUCEL INTRAVENOUS SUSPENSION,1935862.05,1258310.33,,,0
NDC,71287-0220-01,BREXUCABTAGENE AUTOLEUCEL 1X 10EXP6 TO 1X 10EXP8 CELL IV SUSPENSION,1935862.05,1258310.33,,,0
NDC,71288-0016-15,DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,107.15,69.65,,,0
NDC,71288-0031-91,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,43.35,28.18,,,0
NDC,71288-0132-90,MELPHALAN HCL 50 MG INTRAVENOUS POWDER FOR SOLUTION,853.1,554.52,,,0
NDC,71288-0155-01,PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLUTION,728.55,473.56,,,0
NDC,71288-0161-20,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,87.45,56.84,,,0
NDC,71288-0163-30,LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,140.85,91.55,,,0
NDC,71288-0166-91,PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,127.35,82.78,,,0
NDC,71288-0167-95,PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,277.15,180.15,,,0
NDC,71288-0183-50,PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,3069.9,1995.44,,,0
NDC,71288-0303-02,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",33.35,21.68,,,0
NDC,71288-0427-92,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,214.6,139.49,,,0
NDC,71288-0437-92,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,63.05,40.98,,,0
NDC,71288-0502-01,HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION,49.35,32.08,,,0
NDC,71288-0503-01,HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION,41.6,27.04,,,0
NDC,71288-0600-10,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,38.2,24.83,,,0
NDC,71288-0702-10,ATRACURIUM 10 MG/ML INTRAVENOUS SOLUTION,37.35,24.28,,,0
NDC,71288-0803-92,MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,116.95,76.02,,,0
NDC,71336-1000-01,PATISIRAN (LIPID COMPLEX) 2 MG/ML INTRAVENOUS SOLUTION,41081.2,26702.78,,,0
NDC,71336-1003-01,VUTRISIRAN 25 MG/0.5 ML SUBCUTANEOUS SYRINGE,500162.75,325105.79,,,0
NDC,71399-7401-05,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,4.8,3.12,,,0
NDC,71399-9474-05,BENZOYL PEROXIDE 10 % TOPICAL GEL,24.65,16.02,,,0
NDC,71469-0231-01,AMINOLEVULINIC ACID HCL 30 MG/ML ORAL SOLUTION,10040.05,6526.03,,,0
NDC,71699-0050-30,CENOBAMATE 50 MG TABLET,121.65,79.07,,,0
NDC,71699-0200-30,CENOBAMATE 200 MG TABLET,121.65,79.07,,,0
NDC,72078-0002-04,NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,53.55,34.81,,,0
NDC,72078-0034-01,REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,145.6,94.64,,,0
NDC,72078-0038-02,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,713.9,464.04,,,0
NDC,72078-0046-09,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,43.7,28.4,,,0
NDC,72187-0401-01,"TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION",140108.05,91070.23,,,0
NDC,72205-0072-90,DROXIDOPA 100 MG CAPSULE,7.85,5.1,,,0
NDC,72266-0248-05,SINCALIDE 5 MCG SOLUTION FOR INJECTION,417.85,271.6,,,0
NDC,72485-0105-01,SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,88.6,57.59,,,0
NDC,72485-0505-01,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,32.95,21.42,,,0
NDC,72578-0002-01,ACYCLOVIR 200 MG CAPSULE,4.85,3.15,,,0
NDC,72578-0056-01,FELBAMATE 400 MG TABLET,7.45,4.84,,,0
NDC,72578-0086-01,DESONIDE 0.05 % TOPICAL CREAM,46.65,30.32,,,0
NDC,72578-0089-01,"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",27.55,17.91,,,0
NDC,72611-0785-02,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN,6465.55,4202.61,,,0
NDC,72618-3000-02,RIMEGEPANT 75 MG DISINTEGRATING TABLET,376.25,244.56,,,0
NDC,72694-0954-01,PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION,109863.6,71411.34,,,0
NDC,72888-0125-26,LIDOCAINE HCL 2 % MUCOSAL SOLUTION,10.75,6.99,,,0
NDC,72893-0002-01,BELINOSTAT 500 MG INTRAVENOUS SOLUTION,10577.95,6875.67,,,0
NDC,73150-0150-06,UBLITUXIMAB-XIIY 25 MG/ML INTRAVENOUS SOLUTION,46167.45,30008.84,,,0
NDC,73153-0900-01,LISOCABTAGENE MARALEUCEL 1.5 X 10EXP6 TO 70 X 10EXP6 CELL/ML IV SUSP,2043869.5,1328515.18,,,0
NDC,73153-0901-08,LISOCABTAGENE MARALEUCEL(CD8) 1.5X TO 70X 10EXP6 CELL/ML IV SUSP(1OF2),2042612.5,1327698.12,,,0
NDC,73153-0902-04,LISOCABTAGENE MARALEUCEL(CD4) 1.5X TO 70X 10EXP6 CELL/ML IV SUSP(2OF2),2042612.5,1327698.12,,,0
NDC,73177-0101-02,"KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLOR,ISO-OSMOTIC IV SYRINGE",63.2,41.08,,,0
NDC,73177-0105-01,MORPHINE (PF) 2 MG/2 ML(1 MG/ML) IN 0.9% SODIUM CHLORIDE IV SYRINGE,46.8,30.42,,,0
NDC,73177-0109-13,"ROPIVACAINE(PF) 0.2 %-0.9 % NACL 545ML INFIL,HI VAR RATE,PCA,ELAS PUMP",689.4,448.11,,,0
NDC,73177-0109-20,"ROPIVACAINE (PF) 0.2 %-0.9 % NACL 745 ML INFIL,LOW VAR RATE ELAST PUMP",930.3,604.7,,,0
NDC,73177-0116-03,SUCCINYLCHOLINE CHLORIDE 200 MG/10 ML (20 MG/ML) INTRAVENOUS SYRINGE,77.125,50.13,,,0
NDC,73177-0155-27,"KETAMINE (PF) 5 MG/ML IN SODIUM CHLORIDE, ISO-OSMOTIC IV SOLUTION",185.0,120.25,,,0
NDC,73177-0161-43,"METHADONE 10 MG/ML IN SODIUM CHLORIDE,ISO-OSMOTIC INTRAVENOUS SYRINGE",1135.5,738.08,,,0
NDC,73302-0456-01,ULIPRISTAL 30 MG TABLET,116.6,75.79,,,0
NDC,73475-3041-05,EFGARTIGIMOD ALFA-FCAB 20 MG/ML INTRAVENOUS SOLUTION,31538.25,20499.86,,,0
NDC,73607-0011-11,ARTESUNATE 110 MG INTRAVENOUS SOLUTION,24316.4,15805.66,,,0
NDC,74300-0010-67,POLYETHYLENE GLYCOL 400  1 % EYE DROPS,5.0,3.25,,,0
NDC,75826-0142-10,PHENOBARBITAL 97.2 MG TABLET,8.95,5.82,,,0
NDC,75834-0020-01,"CHOLECALCIFEROL (VITAMIN D3) 1,250 MCG (50,000 UNIT) CAPSULE",0.15,0.1,,,0
NDC,75834-0159-01,"VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE",5.3,3.44,,,0
NDC,75834-0170-02,ZINC OXIDE 20 % TOPICAL OINTMENT,35.0,22.75,,,0
NDC,75834-0280-30,POTASSIUM IODIDE 1 GRAM/ML ORAL SOLUTION,19.1,12.42,,,0
NDC,75907-0023-11,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,25.55,16.61,,,0
NDC,75907-0024-11,CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,36.65,23.82,,,0
NDC,75987-0130-15,TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,74826.5,48637.22,,,0
NDC,75987-0150-03,INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION,581846.95,378200.52,,,0
NDC,76045-0004-01,MORPHINE 2 MG/ML INJECTION SYRINGE,44.45,28.89,,,0
NDC,76045-0005-10,MORPHINE 4 MG/ML INJECTION SYRINGE,36.8,23.92,,,0
NDC,76045-0009-11,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,45.75,29.74,,,0
NDC,76045-0009-96,HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,46.4,30.16,,,0
NDC,76045-0010-01,HYDROMORPHONE (PF) 2 MG/ML INJECTION SYRINGE,39.65,25.77,,,0
NDC,76045-0737-01,HALOPERIDOL LACTATE 5 MG/ML INTRAMUSCULAR SYRINGE,37.55,24.41,,,0
NDC,76075-0101-01,CARFILZOMIB 60 MG INTRAVENOUS SOLUTION,14754.7,9590.56,,,0
NDC,76075-0103-01,CARFILZOMIB 10 MG INTRAVENOUS SOLUTION,2527.55,1642.91,,,0
NDC,76204-0900-11,LEVALBUTEROL 1.25 MG/3 ML SOLUTION FOR NEBULIZATION,9.25,6.01,,,0
NDC,76310-0024-15,FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,1609.2,1045.98,,,0
NDC,76329-1240-01,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,88.4,57.46,,,0
NDC,76329-3011-05,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,28.05,18.23,,,0
NDC,76329-3302-01,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,74.0,48.1,,,0
NDC,76329-3318-01,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,48.9,31.78,,,0
NDC,76329-3369-01,NALOXONE 1 MG/ML INJECTION SYRINGE,130.3,84.7,,,0
NDC,76385-0102-01,PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,8.5,5.52,,,0
NDC,77333-0120-25,CALCIUM POLYCARBOPHIL 625 MG TABLET,0.55,0.36,,,0
NDC,77333-0844-10,"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",0.25,0.16,,,0
NDC,77333-0934-10,THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,0.2,0.13,,,0
NDC,77333-0937-10,CYANOCOBALAMIN (VIT B-12) 500 MCG TABLET,0.2,0.13,,,0
NDC,77333-0951-10,"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",0.2,0.13,,,0
NDC,78112-0736-45,POLYVINYL ALCOHOL-POVIDONE 0.5 %-0.6 % EYE DROPS,3.6,2.34,,,0
NDC,78206-0126-02,MOMETASONE-FORMOTEROL HFA 200 MCG-5 MCG/ACTUATION AEROSOL INHALER,243.9,158.54,,,0
NDC,78206-0127-02,MOMETASONE-FORMOTEROL HFA 100 MCG-5 MCG/ACTUATION AEROSOL INHALER,243.9,158.54,,,0
NDC,78206-0145-01,ETONOGESTREL 68 MG SUBDERMAL IMPLANT,3271.25,2126.31,,,0
NDC,78206-0162-01,INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,1592.65,1035.22,,,0
NDC,78670-0003-67,DANTROLENE 20 MG INTRAVENOUS SOLUTION,385.7,250.7,,,0
NDC,80005-0161-08,ERYTHROMYCIN ETHYLSUCCINATE 400 MG TABLET,39.8,25.87,,,0
NDC,80681-0041-00,MELATONIN 1 MG TABLET,0.05,0.03,,,0
NDC,80681-0134-00,"VITAMIN E (DL, ACETATE) 45 MG (100 UNIT) CAPSULE",0.05,0.03,,,0
NDC,80681-0140-00,CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,0.05,0.03,,,0
NDC,80830-2329-02,"TRANEXAMIC ACID 1,000 MG/100 ML(10 MG/ML)IN SOD CHLOR,ISO IV PIGGYBACK",55.6,36.14,,,0
NDC,81033-0220-15,POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,11.25,7.31,,,0
NDC,81033-0501-15,MULTIVIT-MINS-FERROUS GLUCONATE 9 MG IRON/15 ML (15 ML) ORAL LIQUID,1.95,1.27,,,0
NDC,81284-0411-00,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,148.85,96.75,,,0
NDC,81284-0612-00,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",43.6,28.34,,,0
NDC,81284-0831-05,PHYSOSTIGMINE 0.4 MG/ML INTRAVENOUS SOLUTION,662.9,430.88,,,0
NDC,81298-8112-01,CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION,483.0,313.95,,,0
NDC,82154-0449-01,PEGINTERFERON ALFA-2A 180 MCG/ML SUBCUTANEOUS SOLUTION,3905.4,2538.51,,,0
NDC,82347-0405-05,DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL 12 HOUR PATCH,23.5,15.28,,,0
NDC,82625-8801-01,NALOXEGOL 12.5 MG TABLET,46.65,30.32,,,0
NDC,82625-8802-01,NALOXEGOL 25 MG TABLET,46.65,30.32,,,0
NDC,82705-0002-01,EPCORITAMAB-BYSP 4 MG/0.8 ML SUBCUTANEOUS SOLUTION,5778.95,3756.32,,,0
NDC,82705-0010-01,EPCORITAMAB-BYSP 48 MG/0.8 ML SUBCUTANEOUS SOLUTION,68444.0,44488.6,,,0
NDC,83257-0004-12,TRASTUZUMAB-DKST 420 MG INTRAVENOUS SOLUTION,8207.5,5334.88,,,0
NDC,83257-0005-41,PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,6859.6,4458.74,,,0
NDC,83851-0100-30,FLUORESCEIN 1 MG EYE STRIPS,5.3,3.44,,,0
NDC,86790-0162-80,WHEAT DEXTRIN 3 GRAM/4 GRAM ORAL POWDER PACKET,0.4,0.26,,,0